Prevalence of symptomless proteinuria among school children in Assiut

In a trial to assess the prevalence of symptomless proteinuria among healthy rural and urban school children, 3029 subjects of both sexes, aged from 6-12 years were screened using sulphosalicylic acid method. The prevalence rate of proteinuria was 14.5%. It was significantly higher [P < 0.001] in subjects in rural than those in urban areas [16% versus 9.7%]. Within the groups of males, females, those > 8-10 and > 10-12 years of age there was a significant increase in the prevalence rate among chidren from rural areas. In addition, the prevalence rate was significantly increased with increasing age in rural areas. The highest rate was found among children aged > 10-12 years [21.3%] in rural and among those aged 6-8 years [11.8%] in urban areas. However, no significant differences were observed between males and females of the two communities. The prevalence rates of microscopic haematuria and positive urine for schistosoma ova among proteinuric children were significantly higher among subjects in rural than in those in urban areas and within groups of males and females of rural than of urban but no significant differences between both sexes of the two communities. We recommend routine urine analysis annually for all school children and further investigating those with proteinuria

Immediate diagnostic criteria for bacterial infection of ascitic fluid in liver cirrhosis

We prospectively evaluate the ascitic fluid [AF] pH, total white blood cell [WBC] count, polymorphonuclear [PMN] cell count, lactic dehydrogenase [LDH]; total proteins and complement three [C3] and serum, LDH, total proteins and C3 in addition to AF/serum LDH, total proteins and C3 gradients in 45 patients with cirrhotic ascites for immediate diagnosis of spontaneous bacterial peritonitis[S.B .P.]. They were classified into two groups depending on the presence or absence of clinical evidence of spontaneous bacterial peritonitis and the results of AF culture: Group [I] comprised 39 patients without clinical evidence of S.B.P. and negative AF culture [Sterile ascites]. Group [II] comprised 6 patients with clinical evidence of S.B.P. who were further classified into two subgroups according to the results of AF culture; Group [Il] A: 4 cases with positive culture [S.B.P.] and group [Il] B.:2 cases with negative culture [Culture negative neutrocytic ascites, CNNA]. AF-pH, alpha C [3] serum C [3] and AF/serum C [3] gradient were significantly lower in group [II] as compared with group [I] [P<0.001] with the highest sensitivity, .specificity and diagnostic accuracy with AF C3 < 2mg/dL [100% for each] and with AF pH < 7.3 [83.3%, 100% and 97.8% respectively]. On the other hand AF-WBCs, PMN cells/mm [3] and LDH and AF/serum LDH gradient were significantly higher in group [Il] compared with group [I] [P<0.001] with the highest sensitivity, specificity and diagnostic accuracy [100% for each] with AF PMN cells > 250 cells/mm[3] and AF/serum LDH gradient of value >0.6. There was no significant difference between the two groups as regards the serum LDH, total proteins, AF total proteins and AF/serum total protein gradient. We come to a conclusion that AF pH < 7.3, AF PMN cells > 250/mm[3],AF/ serum LDH gradient > 0.6 and A F C [3] < 2mg/dL are useful parameters for differentiation between infected and sterile ascites and can be relied on as an immediate indicators of infection when AF culture is negative or delayed or when the diagnosis of S.B. P. is suspected in patients with cirrhotic ascites