Percutaneous transthoracic needle aspiration, lavage and instillation of clindamycin-gentamycin in peripheral pyogenic lung abscess

Lung abscess are defined as localized suppurative necrotizing collection occurring within the pulmonary parenchyma. Some authors emphasized image-guided aspiration of lung abscess before antibiotics use in order to identify the pathogen. Antibiotic lavage is currently widely used in the treatment of patients with peritonitis, but not used previously in lung abscesses. Is to asses the role of percutaneous transthoracic needle aspiration, lavage and instillation of clindamycin-gentamycin on the treatment of peripheral pyogenic lung abscess. Twenty-six patients with peripheral pyogenic lung abscess are included in this study and classified into two groups. Group I received systemic empirical antibiotic, remod-ulated after the result of sputum culture and sensitivity. While group II underwent ultrasound guided percutaneous transthoracic needle aspiration, lavage and local instillation of antibiotics [clindamycin-gentamycin] associated with receiving systemic empirical parentral antibiotics, that were remodulated after the result of aspiration culture and sensitivity. Chest X-ray and chest ultrasound were done pre, post and after intervention by one week and before discharge. There was a statistically significant difference between group I and II as regard duration of systemic antibiotic use, duration of hospital stay, duration of radiological improvement, and size of abscess after intervention. Moreover complications occurred in group I were higher than in group II. Succeeded patients [according to clinical and radiological improvement of lung abscess] were more obvious among group II than group I. Aspirates culture and sensitivity revealed gram negative bacteria and anaerobic microorganisms, which are sensitive to local instillation of antibiotics [clindamycin-gentamycin]. Percutaneous aspiration of peripheral lung abscess has an accurate determination of the causative organisms inside the abscess. The resolution of the abscesses clinically and radiolog-ically was hastened by needle aspiration, lavage and instillation of clindamycin-gentamycin. Early intervention can improve symptoms, decrease morbidity and complications

effect of weight reduction versus reduction mammoplasty on the pulmonary function parameters and leptin level in obese-macromazia subjects

Background: Obese subjects with breast hypertrophy are suffering not only from cosmetic aspects but also negatively affecting the quality of their life so, the aim of this study was to evaluate the effect of weight reduction versus reduction-mammoplasty on pulmonary function parameters and serum-leptin level

Subjects and methods: Forty females with obesity and macromazia were enrolled into the study. They were classified into two groups, group [1] twenty females who were seeking reduction mammoplasty, and group [2] twenty females who refused surgery and were seeking diet-control regimen. Both groups were matched as regards age and body mass index [BMI]. Pulmonary function parameters [FVC%, FEV[1]%, FEV[1]/FVC and PEFR%] and serum leptin level were measured before starting the intervention in both groups and after starting it by three months

Results: Reduction mammoplasty significantly increases FVC% with non-significant improvement regarding BMI and serum leptin level. On the other hand, diet control regimen improves FEV[1]%, FVC%, FEV[1]/FVC and PEFR% with a significant reduction of BMI and serum leptin levels

Conclusion: Reduction mammoplasty can play a role in improving restrictive pulmonary function parameters while diet control regimen has a more significant improvement in both obstructive and restrictive pulmonary function parameters and in the reduction of BMI and serum leptin level in obese subjects with macromazia

Diarrhea among patients attending different hospitals and dispensaries in Aden, Yemen

A diarrhea patients have been investigated at different hospitals, dispensaries and clinical centers [private hospitals and centers are not included], during the period of January 2003-December 2005. A total of 55587 diarrhea cases have been recorded and divided into two categories: bloody diarrhea [BD] and non bloody diarrhea [NBD]. Out of these total cases, 3132 belong to bloody diarrhea [5.6%], while the total number of non bloody diarrhea was 52455 [94.36%]. Increasable rate of diarrhea have been noticed, being at high level in the year 2005. The main causative agents of diarrhea were protozoan parasites [Entamoeba histolytica, Giardia lamblia, and Entamoeba coli], and bacterial agents [Salmonella spp., Shigella spp., and Escherichia coli]. The overall contribution of these pathogens in diarrhea infection was [6.5%], indicating protozoan and bacteria that might be responsible for diarrhea infection. Others factors have not been included. Monthly variations as well as incidence among gender and different age groups were also evaluated. A total fatality ratio among patient of bloody diarrhea was recorded [0.76%] and was [0.169%] of non bloody diarrhea

Biological analysis of drinking water in some primary and secondary schools at Aden governorate

The present study analyzed drinking water in 24 primary and secondary schools in Aden Governorate for the period [January-June 2006]. The study estimated the contamination of drinking water and its safety to the public. Physical properties of water, such as pH, TSS, BOD, were recorded. The study revealed that 7 water samples were polluted by E.coli and coliform bacteria. The presence of E.coli and coliform bacteria indicate inadequate treatment of drinking water, which require immediate attention

Pulmonary tuberculosis among municipal street cleaning workers at Zagazig city; an epidemiological study

The risk for occupational exposure to pulmonary tuberculosis is increasing among municipal workers as they are the poorly paid and poorly educated workers, occupationally exposed to different biohazards, and usually work without adequate protective equipments. The aim of this study is determining the magnitude of pulmonary tuberculosis among municipal street cleaners, identifying some of the associated occupational risk factors, and identifying the DNA fingerprint patterns of mycobacterium tuberculosis isolates among those workers. Three hundred and twenty [320] male municipal street cleaners and 200 male drivers were included in the initial screening procedures of the tuberculosis survey; where they were subjected to a pre-constructed questionnaire, clinical examination, mass miniature radiography [MMR], and tuberculin skin testing. Chest X-ray and CT were done to confirm the diagnosis in subjects with any suspected lesions detected by MMR. Moreover, pulmonary TB suspects underwent sputum examination for acid fast bacilli, sputum culture, and biochemical tests to speciate mycobacterial isolates. Genotyping of Mycobacterium tuberculosis isolates, from the diagnosed cases with active pulmonary TB, was done using polymerase chain reaction amplifying the DNA fragments between insertion sequence IS6110. The study revealed that municipal street cleaners had significantly higher risk for Mycobacterium tuberculosis infection, as detected by tuberculin skin testing and chest radiography, than did the controls [OR=3.88, 95% CI; 2.4-6.19 and OR=3.02, 95 % CI; 1.07-9.22, respectively]. Moreover, higher percent of the street cleaners [3.4%] were classified as pulmonary tuberculosis suspects compared to the controls [1%]; however the difference between both groups of workers was not of statistical significance. Pulmonary tuberculosis disease was confirmed in 7 out of 320 street cleaners [2.2%]. Moreover, long duration of employment and bad street status were found to be associated with pulmonary TB disease in such workers. Finally, genotyping of Mycobacterium tuberculosis isolates from the 7definite cases of pulmonary TB, revealed 2 distinct sets of fingerprint patterns; this may suggest that these workers acquired TB from 2 different sources of infection. The study concluded that: Genotyping of M. tuberculosis isolates is mandatory in the study of TB epidemiology. Municipal street cleaners are at increased risk for occupational acquisition of Mycobacterium tuberculosis infection and contracting pulmonary TB disease