Effect of synthesized niclosamide organophosphortus derivatives on some metabolic aspects of Biomphalaria alexandrina snails and its compatibility to Schistosoma mansoni

The Molluscicidal potency of four synthesized Mannich bases and ten organophosphorus derivatives of bayluscide [niclosamide] were determined. Using Biomphalaria alexandrina snail, the intermediate host to Schistosoma mansoni in Egypt, of these derivatives,a single Mannich bases derivative [compound No, 13] showed higher molluscicidal effect than niclosamide, LC[50] 0.4 ppm after 24 hours at 25°C compared with 0.5 ppm for niclosamide. Three other derivatives [No. 15, 12 and 8] showed slightly less effect, their LC[50] 1.9, 3.4 and 4.1 ppm, respectively, Meanwhile, the four compounds showed considerable reducting effect on the cercarial production of schistosome-infected snails previously exposed to LC[5] of each compound before miracidial infection. Thus, the mean periodic number of cercariae/snail [two hours weekly] was found to be 55.8 +/- 41.8, 95.9 +/- 78.9, 162.6 +/- 145 and 209.35 +/- 168.4 cercariae/snail, respectively versus 242 +/- 230.4 and 502 +/- 290.4 in the case of niclosamide-treated and non-treated snails. The effect of the four compounds was tested on the glycolytic enzymes of snails, namely, hexolinase [HK], pyruvate kinase [PK] and glucose phosphate isomerase [GPI]. Much more reduction was recognized in [HK] by compounds No. 8 and 13 in comparison, with niclosamide and nontreated snails, being 2.6 +/- 0.82 and 3.7 +/- 1.6 n moles/min/g tissue versus 3.9 +/- 0.58 and 9.8 +/- 2.7 n moles/min/g tissue in niclosamide-treated and non-treated groups, respectively. PK showed also higher reduction with four compounds namely 15, 13, 12 and 8 compared with niclosamide-treated and non-treated snails, being 0.3 +/- 0.1, 0-.39 +/- 0.29, 0.46 +/- 0.08 and 0.98 +/- 0.138 in comparison with 1.51 +/- 0.52 and 1.8 +/- 0.62, respectively. No considerable change was found in the level of GPI in snails treated with 15, 13, 12 and 8 compounds relative to niclosamide-tested snails. The present results show that reduction in the periodic cercarial production is correlated with the lower level of HK enzyme in treated snails

Critical study of latrogenic bile duct injuries

latrogenic bile duct injury remains a serious and challenging complication following surgeries of the biliary tract, specially cholecystectomies. Numerous factors influence the outcome of repair of bile duct injuries. This prospective research was performed on 20 patients we received between May 1998 and March 2001, aiming to study different bile duct injuries following open or laparoscopic cholecystectomy as regards the type of injury. aiming of identification, the clinical presentation, methods of investigations and various modalities of correction and follow up. We received 14 cases after open cholecystectomy and 6 patients after laparoscopic cholecystectomy. 4 of them were recurrent after previous repair. One case was detected intraoperatively and primary repair was done while the time of presentation of the other cases ranged between days and 18 months. The main presentations were or biliary peritonitis. ERCP succeeded in treatment of 4 cases and one case was treated by percutaneous transhepatic dilatation and stenting. The other cases were treated either by primary repair in one case, delayed primary in one case, choledecro-doodenostomy in one case, cholectecro-jejunostomy in one case and 12 cases were treated by either Rouxen-Y or simple loops hepatico-jejunostomy. We had only one recurrence in a redo case which was treated by PTC dilatation and stenting. High or left duct approach offers good results in complicated or recurrent cases. Percutaneous transhepatic dilaration and stenting has to be considered first in recurrent cases

Evaluation of a cooling intra-anal device Anurex for the symptomatic treatment of certain anal conditions

This study included 50 patients with anorectal symptoms. Their ages ranged between 19 and 67 years. The results of treatment have been assessed regarding pain, bleeding, swelling, discharge and pruritus ani. Thirty-nine patients were diagnosed to have hemorrhoids and 12 patients presented with anal fissure. Thirteen out of the 18 female patients presented with temporary anorectal disorders, 53.8% of them related to pregnancy and 46.2% presented in the postpartum period. Anurex was used twice daily for at least seven days. There was a significant reduction of anal pain, specially in the cases of acute anal fissures. Also, significant reduction was recorded in anal bleeding, discharge and pruritus ani. From this study, it was concluded that Anurex cryotherapy is easy, cheap, drug free, morbidity free and can be used for anal pain and minor bleeding as the commonest anal symptoms, especially on temporary basis, temporary etiology as in pregnancy and lactation, or temporary indication during traveling or for patients unfit or refusing surgery

Pheochromocytoma: a clinical and operative study

Pheochromocytomas are tumors that produce, store and secrete catecholamines. This work aimed to study clinical and operative findings of this tumor. The study was performed on 30 cases [18 males and 12 females] of pheochromocytoma with ages ranged between 24-58 years and a mean age of 31.3 years. Eighteen cases were in the right adrenal gland and ten were in the left gland, while two cases were bilateral. Sustained hypertension occurred in twenty-four cases, paroxysmal hypertension in four cases, while normal blood pressure occurred in two cases. Palpitation occurred in 38% of cases, headache in 80% and sweating in 60% of cases. Ventricular hypertrophy was found in 26.6% of cases, while ischemia occurred in 13.3%, 24-hour urinary catecholamine was elevated in all cases. CT scan was accurate in localizing the tumor in 100% of cases. All the studied cases were prepared preoperatively with phenoxybenzamine except in two cases where inderal was added. All the cases were operated upon by the anterior paramedian approach. The mortality rate was 6.6%. Postoperatively, one case had persistent hypertension and died because of metastatic spread and two cases had persistent hypertension

comparative study of clean surgical wound management with and without dressings

The covering of the primarily sutured surgical wound with a sterile dressing is ordinarily considered to be a routine conclusion to aseptic operations. Routine treatment of sutured clean surgical wounds with dressings is based on tradition and not scientifically supported. This prospective study has been completed on 40 patients. Their ages ranged from 25-46 years with an average of 34 years. The total number of exposed wounds showing colonization was 15 out of 20, only one case needed to be drained compared to 5 out of 20 cases of dressed wounds where also one case needed to be drained. The two cases which showed post-operative infection and needed to be drained were incision hernias, in which the operative time was long and the dissection was extensive. The study showed that routine covering of a primarily sutured clean surgical wound and a sterile dressing is not superior to the technique of keeping these wounds after the first post-operative day in the prevention of wound infection and must be reserved for badly sutured clean or clean contaminated wounds. Keeping the wound undressed has many advantages, the wound can be easily examined, patients are more easily able to carryout their personal hygiene, adhesive tap irritation is avoided and the wound without dressing appeared to heal more rapidly and with less local inflammatory reaction

Tumor necrosis factor in malignant tumours and endotoxemia

Tumor necrosis factor [TNF], also called cachectin, has been estimated using Enzyme Amplified Sensitivity Immuno Assay [EASIA] technique in the serum of ten controls [mean 11.3 pg/ml]. It was estimated also in 20 malignant patients: 10 of them with breast cancer and the other 10 with bladder cancer. The preoperative level mean was 28.73 and 38.06 pg/ml and the postoperative one was 29.2 and 40.68 pg/ml respectively. TNF level was found high in the malignant patients in the preoperative and postoperative samples in comparison with the control group and the difference was statistically significant [P <0.05]. The difference between the preoperative level and the postoperative one was not statistically significant. TNF was estimated also in 20 patients with sepsis syndrome, 10 of them have been subjected to indomethacin treatment and TNF level was estimated before and after its injection. TNF was found higher in septicemic patients compared to the control group and this increase was statistically highly significant [P <0.005]. TNF level decreased after indomethacin injection but this decrease was not statistically significant

Risk factors for wound infection after cholecystectomy

Biliary surgery in general, with cholecystectomy in particular, is a common major elective abdominal operation world wide. Wound sepsis after biliary surgery is an extraburden to patients, surgeon and nation. This prospective study completed on 160 patients [105 females and 55 males] undergoing biliary surgery at Kasr El-Aini Hospital. Their ages ranged from 30 to 70 years with an average of 44 years. The overall incidence of postoperative wound infection was 15%. Three major risk factors were detected for wound infection: Age patients above 60, other operative procedures added to cholecystectomy and contaminated bile. Bactibillia was an important endogenous source of postoperative wound infection which was detected in all cases of acute cholecystitis and in 7.5% of cases with calcular obstructive jaundice and in 60% of patients with stones in the common bile duct and have no jaundice. In 21 out of 24 of infected cases, the organisms isolated from wounds were the same as from the corresponding bile samples. Prophylactic antibiotic is recommended in patients with risk factors detected in this study, while routine antibiotic prophylaxis in simple cholecystectomy is probably unjustified

Left ventricular diastolic function impairment after renal transplantation

In a trial to evaluate cardiac function after kidney transplantation, this wok was carried out using Doppler-echocardiography. Fourteen patients were examined before and after renal transplantation [3-9 months with a mean 6.75 months]. End-systolic dimensions and end-diastolic dimensions showed significant decrease after transplantation [P<0.01]. No significant change occurred in fractional shortening of left ventricle. However, both isovolumic relaxation time and A/E ratio of Doppler mitral flow showed significant increase [P <0.1], [P<0.01], respectively. This denotes deterioration in diastolic function after transplantation

Pheochromocytoma: a clinical and operative study

Ten patients with pheochromocytoma were studied as regards clinical presentations, laboratory and radiographic investigations, preoperative preparation, anaesthesia, operative details and operative and postoperative complications.The results showed that the most common site of pheochromocytoma is the suprarenal medulla, the most commonpresentation is hypertension that the 24 hours urinary catecholamines was constantly raised in all patients. CT scan of the abdomen is the most accurate method of localization of the tumour, especially if it is of suprarenal origin.Preoperative preparation with alpha adrenergic receptor blockers is mandatory. Beta adrenergic receptor blockers may or may not be used. Surgical treatment is the ideal method in all patients. The most important operative hazards include hypertensive attacks during tumourmanipulation and hypertension following tumour removal. Persistent hypertention is the most important postoperative complication

Immunoglobulin E in renal failure

In this work serum IgE level was found significantly higher in patients with chronic renal failure [32 patients] in comparison to normal control subjects [10 subjects].The highest level was in patients under conservative treatment followed by patients under haemodialysis then patients under dialysis.We did not find any correlation between age, sex, blood urea or serum creatinine on one hand and serum IgE level on the other hand. IgE level was found positively related to the duration of peritoneal dialysis.The explaination for this may be due to possible alteration in T-cell regulation of immunoglobulin synthesis. Active molecules have been described to regulate the function of T-cells controlling IgE production. If these molecules are proved later to be in the range of middle molecules, it would explain our findings. This needs more investigations and work to reach to the truth

study of the complications of thyroid surgery

This study included 250 consecutive cases undergoing thyroidectomy. The chief indications were nodular goitre [67.6%] and secondary toxic goitre [10%]. There were 132 males and 118 females whose ages ranged from 19 to 68 years. The routine technique involved cutting the strap muscles without exposure of the recurrent laryngeal nerves [RLN]. The majorcomplicationswereinjury to the RLN [2%], hypoparathyroidism [1.2%], reactionary hemorrhage [0.8%] and tracheal instability [0.4%]. The commonest minor complications were wound infection [8%], brawny edema of the upper skin flap [4%], laryngeal edema [2%], injury of the superior laryngeal nerve branches [1.6%] and adherent scar. The overall incidence of complication was 24.4%. Major complications occurred in 4.4% and 6.8% of patients suffered from more than one complication. There was a significantly higher incidence of major and multiple complications among the malignant, toxic and recurrent cases

Some hemostatic variables in diabetes mellitus

The pathogenesis of diabetic vascular disease remains obscure and elusive to all methods of investigations. Recent evidences suggest involvement of the haemostatic system in the initiation and/or the propagation of vascular lesions. Our study included sixty diabetic patients [21 males and 39 females] and 23 normal controls. Diabetics were divided according to their response to insulin and the presence or absence of vascular complications. At III, plasma fibrinogen level and euglobulin lysis time were estimated. Significant high levels of AT III were found in IDD patients and complicated diabetics. Significant high levels of plasma fibrinogen were found in all diabetic subgroups with insignificant difference between complicated and uncomplicated cases. Similarly significantly prolonged lysis time was found in all cases with insignificant difference between complicated and uncomplicated diabetics. Our data showed evidence of hypercoagulable state, as shown by raised fibrinogen levels and decreased fibrinolytic activity, accompanying the diabetic state from the start regardless of the onset of vascular complications. This may support the suggestion that haemostatic abnormalities could have a possible initivative role in the pathogenesis of diabetic vascular disease

Spontaneous healing of appendectomy wounds versus primary skin closure

Thirty patients with severely inflame dappendices under went appendicectomy were divided into two identical groups. In the first [control] group, all layers of the wound were primarily closed, while skin and subcutaneous tissues were left open for spontaneous healings in the second group.The wound was considered septic when pus discharged spontaneously and complete healing was considered when the scab separated leaving healthy epithelium

new method of staging bilharzial liver disease based on clinical, histochemical and 8-glutamyl transferase activity

The histochemical enzymatic activity in liver biopsies and gamma - glutamyl transferase activity were studied in 10 normal and 20 bilharzial cases. The hepatic tissue alkaline phosphatases were found to be slightly affected in the hepatocytes in the first and second stages of bilharzial liver fibrosis, while the sinusoidal reaction was augmented, but in the third and fourth stages, the activity was markedly diminished at both sites. The gamma -glutamyl transferase activity increased steeply with the progress of the disease. Upon clinical, biochemical, histochemical and gamma -glutamyl transferase changes a new more elaborate staging of the disease is suggested

Evaluation of three systems for preoperative hair removal in clean operations

Seventy five male patients were subjected to inguinal herniorraphy. The hair was removed preoperatively by 3 different system each applied to 25 patients. Group A patients were shaved the night before operation, group B were shaved the morning of operation and group C were subjected to depilatory cream the night before operation. Purbulent wound infection occurred in 16%, 4% and 4% in group A, B and C respectively. The mean preoperative bacterial count was 128, 28 and 32/cm[2] in group A, B and C in this orer. All wound infections of group A and B were caused by Staph. aureus that were present preoperatively [auto-infection], while the sngle infection in group C was caused by E. coli not present preoperatively and hence unrelated to the method of skin preparation. 36% of group A and 40% of group B patients complained of discomfort and itching due to hair regrowth; while 28% of group C patients, being males, did not welcome the use of cream as a method of hair removal

mutual interrelation between major surgical trauma and the immunological response as measured by spontaneous rosette formation

The cell mediated immune response was studied by rosette formation in 24 patients before and after major surgery. Nine patients [37.5%] showed preoperative reduction in the number of T lymphocytes, and these patients continued to be suppressed postoperatively. Out of the other 15 patients, nine cases [60%] developed a de novo postoperative fall in their T lymphocyte population; this can be attributed to operative trauma. Among the overall 18 immunosuppressed patients in the postoperative period, 12 developed infection, 5 had other complication, while one died. This last patient had both preoperative and postoperative reduction of T lymphocytes. Infection was encountered in all the 9 patients with preoperative immunodepression, but only in 3 out of the 9 patient who developed postoperative suppression; a finding that may point to greater role of preoperative reduction of T lymphocytes than surgical trauma in the pathogenesis of postoperative morbidity