Tissue factors in acute haematogenous osteomyelitis

80 successive cases of acute haematogenous osteomyelitis [AHO]. They were all treated and investigated in the Hadra Orthopaedic and Traumatolology University Hospital, November 1986- May 1988. The immune system was investigated by testing the skin reaction to purified protein derivative [PPD] and dinitrochlorobenzene [DNCB]. The percentage of T-lymphocytes was detected by the E-rosette test and their function was evaluated by the leucocyte migration inhibition test and the phytohaemagglutinin stimulation test. The phagocytic function of the neutrophils was assessed by the nitroblue tetrazolium dye reduction test. All patients were subjected to HLA typing. The percentage and function of T-lymphocytes were found subnormal in patients with AHO. The neutrophil phagocytic function and skin reactivity to PPD were also subnormal. HLAA-A9, B5, B7 and Bw73 were found more in patients with AHO than in normal controls. The HLA-B22, B42 and B15 [63] were more frequent in normal controls

Difficulties and failures of closed continuous saline suction-irrigation for the management of chronic osteomyelitis

In a previous article the authors have published the results of treatment of chronic osteomyelitis by a technique of contiuous irrigation-suction with plain saline after bone operation and primary closure. Of the 110 patients treated 18 [16.4%] were not cured, all of them due to failure of the technique. In the present work the causes of failure and the results of preventing them are reported. The commonest cause of failure was obstruction of the suction tube, mainly prevented by careful wound washing at end of operation, using rigid tubings for feat of kinking and collapse, and the use of two instead of one suction tube. Reversal of the flow succeeded in curing plugging when it took place Slipping of the tubes was prevented by ligating them together in the operation wound and at the skin orifices, and by avoidance of tension on them. Leakage was prevented by air-tight water-tight closure of the wound layers and vaselinising it Statistically significant improvement of the results of treatment was obtained by placing the tubes inside the ostemyelitic cavity, by continuing the irrigation for over 20 days, and not stopping it before the outgoing saline became free of debris

Distribution of paralysis in individual muscles in poliomyelitis [acute stage]

In a material of 936 cases of paralytic poliomyelitis, the most frequently affected muscles in the neck were the flexors [91.8% per side of neck affected], the erector spinae [96.0% per side] in the pack, the deltoid [93.0% per limb] in the upper limb and the quadriceps femoris [90.1% per limb] in the lower extremity. When the overall muscle distribution in the body was computed, the muscles of the lower limb were the most frequently [50% approximately for each], specially the quadriceps [61.7%]. In the neck, trunck and upper limb the range of frequency of affection was 5 to 10%, except the erector spinae [30.5%] and the deltoid [11.4%]. Multiple muscle affection in the body as a whole and in each region was the rule

Regional distribution in the body of paralytic poliomyelitis

In 936 paralytic poliomyelitis children examined in first month of paralysis, the following distribution was noted: Lower limbs 91.3%, trunk 33.4%, upper limbs 20.2%, and neck 8.8%. Respiratory, cranial and encephalomyelitic cases were rare. There was no sensory affection. More than one region of the body was affected in 56.8% of the children

Views on patients rights in Egypt

In this study 119 patients, 45 physicians and 94 nurses were interviewed as regards their perception about patients rights. The study showed that patients, nurses and physicians differ in their perception to patient's rights. It emphasizes the importance of educating physicians and nurses regarding these rights