Prune belly syndrome with urethral hypoplasia and vesico-cutaneous fistula: a case report and review of literature

Association between Prune belly syndrome [PBS] and urethral hypoplasia is an unusual condition. It is usually fatal unless there is a communication between the fetal bladder and the amniotic sac. We report a case of PBS with urethral hypoplasia and congenital vesico-cutaneous fistula in a male neonate. Patient underwent cutaneous vesicostomy and was discharged for close follow up of his renal function and for future reconstruction

Dot-Blot Immunoassay of Fasciola gigantica Infection using 27 kDa and Adult Worm Regurge Antigens in Egyptian Patients

The purpose of the present study was to evaluate the potential role of the 27-Kilodalton (KDa) antigen versus Fasciola gigantica adult worm regurge antigens in a DOT-Blot assay and to assess this assay as a practical tool for diagnosis fascioliasis in Egyptian patients. Fasciola gigantica antigen of an approximate molecular mass 27-(KDa) was obtained from adult worms by a simple elution SDS-PAGE. A Dot-Blot was developed comparatively to adult worm regurge antigens for the detection of specific antibodies from patients infected with F. gigantica in Egypt. Control sera were obtained from patients with other parasitic infections and healthy volunteers to assess the test and compare between the antigens. The sensitivity, specificity, positive and negative predictive values of Dot-Blot using the adult worm regurge were 80%, 90%, 94.1%, and 69.2% respectively, while those using 27-KDa were 100% which confirms the diagnostic potential of this antigen. All patients infected with Fasciola were positive, with cross reactivity reported with Schistosoma mansoni serum samples. This 27-KDa Dot-Blot assay showed to be a promising test which can be used for serodiagnosis of fascioliasis in Egyptian patients especially, those presenting with hepatic disease. It is specific, sensitive and easy to perform method for the rapid diagnosis particularly when more complex laboratory tests are unavailable.

Effect of microcurrent skin patch on the epidural fentanyl requirements for post operative pain relief of total hip arthroplasty

Major orthopedic surgery that cause considerable pain like total hip arthroplasty, requires good post operative pain management. Microcurrent therapy [MCT] is a new therapy whereby electric current is provided in literally millionth of an ampere. MCT comes as two self adherent active electrode patches linked by a cable efficacy of MCT in the management of musculoskeletal pain and enhancement of wound healing has been reported. To study the effect of microcurrent therapy [MCT] on the epidural fentanyl requirements and degree of wound healing after total hip arthroplasty. Twenty eight patients undergoing total hip replacement [THR] were randomly allocated into two groups. Group I: had micro current skin patches [two adhesive electrode] attached above the site of operation in addition to the lumbar epidural catheter. Post operative epidural fentanyl infusion with a syringe pump given at a rate ranged between 25 and 75 microgram per hour to keep visual analogue pain score [VAS] less than 3/10. Group II had only continuous epidural infusion with fentanyl at the same range to keep VAS less than 3/1 without MCT. There was statistically significant lower mean epidural fentanyl requirement in Group I [23.24 microgram] when compared to Group II [58.36 microgram]. There was 23% incidence of dermatitis in Group I due to application of micro-current skin patch which resolved by treatment. There was statistically significant higher frequency of grade 1 of wound healing in the microcurrent group [41.3%] when compared to Group II [7.2%]. Grade 2 and 3 were more frequent in Group II] The microcurrent skin therapy lead to reduction in the requirements of the post operative epidural fentanyl with improvement of degrees of wound healing but with considerable incidence of skin dermatitis after total hip arthroplasty

Effect of biofeedback training on fecal incontinence in children with myelomeningocele

This study aimed at evaluating the effects of biofeedback training on children with fecal incontinence. Twenty children [12 males and 8 females], diagnosed as spina-pifida [myelomeningocele], were recruited from pediatrics outpatient clinic, King Abdul-Aziz university hospital, Jeddah, Saudi Arabia. Their age ranged from ten to fifteen years. Anorectal manometric functions were assessed for all children before and after treatment. The children were randomly divided into two groups of equal number [control and study]. Both groups received physical therapy program [daily rectal evacuation program, diet control and pelvic floor muscle exercises]. In addition, the study group received biofeedback training program. Treatment for all patients continued for three months [one hour/session, three times/ week]. The results revealed statistically significant improvement in the outcome measures in the study group. Biofeedback training improved anal squeeze as well as rectal sensation. Biofeedback training in conjunction with conventional therapy program was effective in improving fecal incontinence in children with myelomeningocele

Nosocomial infections and fever of unknown origin in pediatric hematology/oncology unit: a retrospective annual study

Pediatric hematology / oncology patients are faced with an increased risk of nosocomial infections [NIs] that vary in different populations and different institutes with considerable morbidity and mortality. Our aims were to assess the frequency and patterns of NIs in this group of patients relation to the risk of neutropenia and to determine the prevalence of causative organisms and their antimicrobial sensitivities. A retrospective analysis of the data for all children admitted to pediatric hematoloy/oncology unit of Mansoura University, Egypt, was done over one year from January, 2007 to January, 2008. A total of 1564 patients were included [173 children with leukemia, 39 with lymphoma, 49 with other solid tumors, 1293 with thalassemia and 10 withaplastic anemia] corresponding to 2084 admissions and 27092 inpatient days. The Centers for Disease Control and Prevention criteria were used as standard definition for NI. The overall incidence density rates of NIs in all patients and neutropenic patients were 8.6 and 25.3 per 1000 patient-days respectively. The most frequent sites of microbiologically and or clinically documented NIs were blood stream [42.7%], respiratory [25.3%], Urinary [22.2%] and CNS infections [9.8%] whereas nosocomial fever of unknown origin [nFUO] constituted 52.9% of defined cases with incidence density rates of 9.7 and 15.4 per 1000 patient-days in, all patients and neutropenic patients respectively. The frequency of NIs and nFUO were significantly higher during neutropenic days [p<0.001]. Gram-positive organisms represented 64.5% of isolated pathogens [Staphylococci 71.5%, Streptococci 16%, Pneamococci 7% and Enterococci 5.5%], gram-negative organisms represented 30% [E coli 48.6%, Klebsiella 15.7%, and Pseudomonas 35.7%], and Candida 5.5%. Positive cultures were more frequent in summer months [July to September]. The antimicrobial susceptibilities of the isolated organisms were relatively low [cefoperazone/sulbactam 49.9%, amikacin 35.9%, imipenem/cilastatin 34.4%, cefoperazone 33.6% and vancomycin 36.5%]. Blood stream infection and fever of unknown origin are the most common nosocomial infections in pediatric hematology / oncology patients with a higher risk during neutropenic days. Isolated organisms are multi-drug resistant, predominantly gram-positive pathogens

Genetic Variability of Antigen B among Echinococcus granulosus Egyptian Isolates

Genetic polymorphisms of encoding antigen B2 gene (AgB2) in Echinococcus granulosus were studied using PCR-RFLP and DNA sequencing among 20 Egyptian isolates. Five isolates from different host origins (humans, camels, pigs, and sheep) were collected and used. All examined isolates of each host group gave very similar patterns of PCR-RFLP after restriction enzyme digestion with AluI, with the gene size of approximately 140 bp and 240 bp for sheep and human isolates, and approximately 150 bp and 250 bp for pig and camel isolates. No digestion pattern was obtained after incubation of all studied isolates with EcoRI. These results reveal high intra-group homogeneity. DNA sequence analysis highlighted that human infecting strain showed 100% identity with respect to sheep infecting isolate, 96% and 99% with pig and camel infecting isolates, respectively.

Epidemiological study of dementia after retirement

To determine prevalence of dementia and its subtypes among governmental retired employee [above 60 years old] attending Zagazig health insurance out patient clinic, Sharkia governorate, Egypt. A three phase study was carried out to screen 1800 subjects aged 60 years and above. During phase I all subjects were administrated standardized Mini-Mental state Examination [SMMSE]. In phase II, all screened positive subjects were subjected to: complete history taking, clinical examination, Neuropsychiatric scales [Blessed Dementia scale, Clinical Dementia Rating scale and geriatric depression scale]. We diagnosed dementia only in 66 subjects [depending on DSM IV diagnostic criteria] yielding a crude prevalence rate of dementia of 3.66%. From the remaining screened negative subjects we selected 30 age and sex matched controls. To complete and further diagnose dementia subtypes, patients were subjected to some laboratory tests, EEG and brain Imaging [phase III]. Prevalence rates for specific dementia subtypes were 1.4% for Alzheimer's disease [AD], 1.05% for vascular dementia [VaD], 0.5% for mixed dementia [MD], other dementias represented 0.44% and undetermined cases 0.22%. Age specific prevalence ratios for dementia increased steeply with increasing age. There was no gender difference in the prevalence rates of dementia or its subtype. This study proved that professional and administration occupations and higher levels of education had inverse relation with dementia prevalence. Some risk factors such as DM, hypertension and hypercholesterolemia were significantly more frequent in our patients than in controls, while positive family history of dementia was significantly higher among AD patients. Comparison with previous studies suggests that dementia is as frequent in Sharkia, Egypt as elsewhere

Propofol pharmacokinetics in infants

Infant and children differ markedly from adult patients. Since the production of propofol, it has gained popularity as an agent for both induction and maintenance of anaesthesia for adults and children. There has been a lack of pharmacokinetic studies in children less than 3 years. Was to determine the complete pharmacokinetic profile of propofol in infants [2-24 months]. Forty eight patients were randomly assigned into 4 groups, each group has 12 patients. They were scheduled to undergo superficial body surgery of I hour expected duration. Venous blood samples were collected and analyzed used high performance liquid chromatography [HPLC].Non linear mixed effects modelling [NONMEM] software program was used to analyze the pharmacokinetic data. The pharmacokinetic of propofol in infants followed two compartement model with systemic clearance -[Cl] 29.77 +/- 9.46 ml kg[-1] min[-1], central volume of distribution [Vc] 0.62 +/- 0.24 l kg[-1], and the volume at steady state [Vss] 1.67 +/- 0.26 l kg[-1]. The context sensitive half life [HL] was 0.24 +/- 0.02 h. The infants have a larger volume of distribution and a higher clearance of propofol. Therefore, the induction and maintenance doses should be increased in this young age with using population based pharmacokinetic parameters for accurate propofol dosing strategy

Production of cytochalasin B by Helminthosporium solani under different culture conditions and its effect on the mitosis of onion root cells

The optimum temperature for maximum production of cytochalasin B [CB] by Helminthosporium solani was 30°C. The optimum pH value was 5.5 - 6.0, and the maximum CB production was attained after nine days of incubation. Glucose and sodium nitrate were the best carbon and nitrogen sources for CB production. CB at the concentration of 30 microg/ml decreased the mitotic index [MI%] of Allium cepa L. [onion, Giza, 20] roots from 8.42 to 4.83%. The spindle constituents [microtubules] were affected in a way that gave rise to a number of chromosomal abnormalities, namely; stickiness, un-oriented, bridges, free and distributed spindles without multinucleated cells production. CB at this concentration decreased onion seed production by 5.7% compared with the control. CB also induced morphological changes to roots and decreased the root length

Antioxidant and hepatoprotective effects of grape seed extract on carbon tetra chloride-induced hepatotoxicity in rats

In the present study, protective effects of grape seed extract [GSE] have been evaluated on carbon tetrachloride [CCI[4]]-induced hepatotoxicity in rats. Forty Sprague Dawley rats were divided into five groups. Group I was used as control and received liquid paraffin [1 ml/kg, i.p.]. Rats in group H were injected every other day with CCI[4] [1 ml/kg body weight, i.p.] for 1 month, whereas rats in group III were pretreated orally with GSE [500 mg/kg, p.o.] 7 days before CCI[4] injection every other day for 1 month. Groups IV and V were prophylactically treated with GSE [500 mg/kg, p.o.] and silymarin [25 mg/kg, p.o.] for 1 month, respectively. At the end of the experiment, all animals were killed by decapitation and blood samples were obtained. Serum aspartate aminotransferase [AST], alanine aminotransferase [ALT], alkaline phosphatase [ALP], gamma glutamyl transferase [gamma GT], total and conjugated bilirubin levels were determined. Hepatic thiobarbituric acid reactive substances [FBARS, as index of lipid peroxidation] content, reduced glutathione [GSH] and the activities of enzymatic antioxidants; glutathione peroxidase [GSH-Px], superoxide dismutase [SOD] and catalase were determined. For histopathological evaluation, livers of all rats were removed and processed for light microscopy. All biochemical parameters in serum and the hepatic TBARS were significantly higher while enzymatic antioxidants, GSH-Px, SOD, catalase and hepatic GSH were significantly lower in animals treated with CCI[4] than in the controls. Rats treated with CCI[4] and GSE showed a significant reduction in biochemical parameters in serum and hepatic TBARS content Silymarin used as reference standard also exhibited significant hepatoprotective activity against CCI[4]. Livers of rats treated with CCI[4] showed classic histology of cirrhosis, whereas the histopathological changes were reduced after administration of CCI[4] and GSE. Results of this study revealed that GSE could afford a significant protection against CCI[4]-induced hepatotoxicity. GSE had a similar protective effect when compared with silymarin.

In vitro study of antioxidant properties of parsley [petroselinum sativum M.] seed extracts

In this study, the antioxidant activity of aqueous extract of parsley [Petroselinum sativum M.] seeds [PA] was evaluated by various antioxidant assay, including total antioxidant, radical scavenging activity by DPPH reduction, superoxide anion, nitric acid and hydrogen peroxide scavenging activities. Furthermore, inhibition of lipid peroxidation, metal chelating and reducing power activities of PA extract were also evaluated. Those various antioxidant activities were compared to standard antioxidants such as butylated hydroxyanisole [BHA] and a-tocopherol The PA extract of seeds showed strong antioxidant activity. Parsley extract at doses 50, 100 and 200 micro g/ml exhibited 38.2,71.6 and 83.8% inhibition of linoleic acid peroxidation in a concentration-dependant manner, respectively. On the other hand, a-tocopherol or BHA exhibited 413 and 80.2% respectively. The PA extract have effective reducing power, free radical scavenging, superoxide anion radical scavenging, nitric oxide radical scavenging, hydrogen peroxide scavenging, and metal chelating activities. This antioxidant property depends on concentration and increasing with increased amount of sample. In addition, total phenolic compounds in the PA seeds were determined as gallic acid equivalents. The results obtained in the present study indicated that the PA seed is a potential source of natural antioxidant From the above assays, the possible mechanism of antioxidant activity of parsley seeds includes reductive ability, metal chelator, hydrogen donating ability and scavengers of hydrogen peroxide, superoxide and nitric oxide radicals.

Use of the RAPD-PCR technique to fingerprint of Ralstonia solanacearum and its phages

Brown Rot disease of potato is an important plant disease. It leads to significant decreases in potato yield in Egypt and other parts of the world. Therefore, the focus of this work aimed an analysis of the causal agent of this disease [Ralstonia solanacearum] and its phages [from the rhizosphere of potato plants in Egypt] that infect an avirulent strain of this bacterium. The approach taken was to use random amplified polymorphic DNAs [RAPD] by the polymerase chain reaction [PCR] technology. Five decamer oligonucleotide primers OP-Al3; OP-BO2, OP-Bo3, OP-Bo8 and OP-B09 were used in this study to differentiate between the two bacterial isolates virulent [WRCI] and avirulent [DRI] isolataes of R. solanacearum and three lytic phages growing on avirulent strains of this pathogen [RSP1, RSP2 and RSP3]. Statistical analysis of RAPD-PCR polymorphisms results revealed a degree of similarity with ratio of 92.7% between these bacterial isolates. In the case of phages, the statistical analysis of RAPD-PCR polymorphisms revealed a degree of similarities with ratio from 85.7% to 94.7. Therefore, the study paid an attention for the use of RAPD-PCR technology as a new molecular tool for identification and classification of the bacteria as well as the phages

Analgesia for tracheoesophageal fistula repair in neonates: a comparison of single shot thoracic paravertebral block and epidural block with ropivacaine

Perioperative pain treatment in neonates is often insufficient .we aimed to compare a single shot thoracic paravertebral and epidural block with ropivacine for analgesia of tracheoesophageal fistula repair in neonates. This study was carried out on 24 neonates, they were randomly allocated into two groups after general anesthesia, Group I had a single shot unilateral thoracic paravertebral block with 1ml/kg body weight of ropivacaine 0.375% and Group II had thoracic epidural block with 1ml/kg body weight of 0.375% ropivacaine. Mean heart rate and blood pressure, Mean concentration of Sevoflurane, neonatal infant pain Score [NIPS] were measured in both groups. There was no statistically significant difference in the mean sevoflurane concentration in both groups [2.1 +/- 0.34%] in group I versus 1.9 +/- 0.8%] in group II, There was statistically significant more decrease in the heart rate and mean blood pressure in the paravertebral group more than the epidural group. There was also equianalgesia effect regarding NIPS in both groups but longer duration of analgesia in the paravertebral group. Thoracic paravertebral block has equianalgesia effect with longer duration of analgesia and less decrease in the heart rate and mean blood pressure when compared to t horacic epidural block for analgesia of tracheoesophageal fistula repair in neonates

Effect of intravenous administration of dexmedetomjdine on the duration of caudal analgesia with ropivacaine in pediatrics

Dexmedetomidine is a highly selective alpha 2 agonist with potential utility in clinical anaesthesia for its sedative, anesthestic sparing and smypathlytic properties.Rrecent studies has reported a spinal site of action of dexmedetomidine in animals. The aim of the present study was to detect the effect of prior intravenous administration of dexmedetomidine on the duration of caudal analgesia with ropivacaine in pediatrics. This study was carried out on 34 children ASA I or II, age range between 2 and 4 scheduled for elective hypospadius repair, they were randomly allocated into two groups each 17 patients, Group I [Dexmedetomidine group] received 1 microgram /kg of dexmedetomidine in 50 ml of normal saline infused over 10 minutes just before genral anaesthesia and caudal analgesia with ropivacaine 0.375% of volume 0.75 ml l kg. Group II, 50 ml normal saline infused before general analgesia and the same caudal analgesia as in group I. Hear rate and blood pressure, post operative pain score by Toddler preschooler post operative pain score [TPPPS] and time of first administration of analgesics in both groups. There was statistically significant lower TPPPS in group I at 120, 150, 180, 210, 240, 300 minutes [3.2 +/- 0.7, 3.5 +/- 1.3, 3.6 +/- 1.2, 3.9 +/- 1.2, 4.6 +/- 0.3, 3.6 +/- 1.2] respectively when compared to group II at the same time of measurements TPPPS was [4.9 +/- 0.6, 5.1 +/- 1.4, 5.6 +/- 0.7, 5.4 +/- 1.2, 5.7 +/- 1.2, 4.9 +/- 2.3] respectively. Intravenous administration of dexmedetomidine prior to caudal analgesia with ropivacaine has an advantage of prolongation of low post operative pain sore in pediatrics

Biocontrol of peanut southern blight [sclerotium rolfsii] by bacillus subtilis

The effective strains of Bacillus subtilis for antagonism against Sclerotium rolfsii in dual cultures were selected. The effects of substrates and cultural conditions on the antagonism of B. subtilis were also studied. S. rolfsii Sacc. caused southern blight disease of a wide range of hosts including leguminosae. The tested peanut plants showed different pre-emergence and post-emergence infection responses towards the four tested S. rolfsii isolates. S. rolfsii isolate number 1 was the most virulent one. Sixteen out of 30 isolates of Bacillus species showed antagonistic activity against S. rolfsii isolate number 1. Richard's medium gave the maximum antagonistic activity. The optimum environmental conditions needed for B. subtilis to give maximum antagonistic activity were 72 hr incubation period, 35C incubation temperature and pH 6. Sucrose and potassium nitrate proved to be the best carbon and nitrogen sources, respectively. MnSO4 [0.01 g/l] was needed to give the maximum antagonistic activity

Pretreatment with an oral contraceptive reduces the incidence of functional ovarian cyst formation during pituitary suppression by gonadotropins releasing hormone agonists and reduces the time required to achieve pituitary suppression

To assess the effect of pretreatment with combined oral contraceptive pills on ovarian cyst formation during pituitary suppression with buserelin acetate. Prospective study. Seventy six patients [76] who were undergoing IVF ET treatment. Patients in the study group [39] were pretreated with a combined oral contraceptive [OC] for 14 days starting on the second day of menstruation. The administration of buserelin acetate was initiated following the last day of OC administration. Patients in the control group [37] began to receive buserelin acetate on day 2 of menstruation. Ultrasound scans and hormonal assays were performed on the first day of menstruation, 7days after the commencement of buserelin acetate administration and every 4 days thereafter until pituitary suppression was achieved. After 7 days of GnRH-a administration, cysts were found in 3 patients in the study group compared to 12 cases in the control group. These numbers decreased to 1 and 7 cases after 14 days of agonist use. Three cases in the control group required surgical aspiration as the cysts persisted for 21 days after agonist use. Patients in the study group required a significantly shorter period of GnRH-a administration [12.6 days] [range 8-16 days] compared to [16.3 days] [range 11-21 days] in the control group. Days of gonadotropins stimulation and total number of ampoules required to achieve follicular response were significantly less in the study group [10.2 days and 41.2 ampoules] compared to [13.2 days and 53.2 ampoules] in the control group. Patients who were pretreated with the OC achieved marginally higher E2 levels on the day of hCG administration, 1,636 [1,166-3,311] compared to 1,538 [965-2,200] pmol/L in the control group. The patients in the study group produced higher numbers of developed follicles [10.2 versus 9.2], oocytes collected [9.4 versus 8.5], fertilization rate, [80.2% versus 78.2%] and number of good embryos available for transfer [6.3 versus 6.1] but the difference was not significant. Pretreatment with an OC abolishes ovarian cyst formation, shortens the time required to achieve pituitary suppression, and decreases gonadotropins requirements without having a negative effect on pregnancy rates