kinetics of microfilaraemia and antigenaemia status among asymptomatic Bancroftian filariasis before and after treatment

In this study, a total of 54 male patients with asymptomatic cases of lymphatic filariasis were selected from the known endemic governorates; Damietta, Sharkia, Gharbia and Dakahlia. Medical sheets were filled out for each case. Diagnosis was based on detection of circulating microfilariae by specific ELISA. Some were treated with Ivermectin, and Albendazole. The treated cases were parasitologic and serologic evaluated pre-treatment and post-treatment for two years follow-up

Anatomical study of rectus abdominis muscle and its clinical application

To study the neurovascular anatomy of the rectus abdominis muscle with reference to their relation to tendinous intersections of the muscle. Eight human cadavers were injected with latex/lead oxide mixture into the superior epigastric artery and external iliac artery. The vascular architecture of the superior and deep inferior epigastric arteries was studied together with the nerve supply of rectus abdominis muscle. The superior epigastric supplied the upper part of rectus muscle. It pierced the rectus muscle between the first and second tendinous intersections. The inferior epigastric artery had 3 patterns of branching; Type I the artery ascended as a single stem parallel to the muscle fibers [in 37.5% of cases]; Type II the vessel divided into 2 branches of different size after giving a perimuscular branch to the lower portion of rectus [in 50% of cases]; The medial branch was short and small to supply the lower medial portion of rectus while the lateral branch was longer with larger diameter. It ran parallel to the muscle fibers to a level above the umbilicus. Type III the deep inferior epigastric artery divided into 3 branches [in 12.5% of cases], the lower one was the smallest. The other 2 branches were of the same caliber, the medial one was short never reach the umbilicus supplying the lower medial portion of the muscle, and the lateral one was longer, ran parallel to the muscle fibers to a level above the umbilicus. The rectus muscle was innervated by lower thoracic spinal nerves in a segmental manner. The muscular perforators arranged in a vertical row from the posterior rectus sheath to the deep surface of rectus. The point of their perforation to the muscle corresponded approximately to the vascular axis which situated at the junction of lateral 1/3 and medial 2/3 of rectus. The perforators of the anterior rectus sheath to skin arranged also in a vertical row lateral to mid line of rectus above the umbilicus and medial to mid line below the umbilicus. Both the superior and deep inferior epigastric arteries supplied the rectus abdominis. The inferior epigastric artery was more reliable than the superior epigastric artery, as it was easily accessible and easily separated from the muscle with minimal damage. It can be used for free tissue transplantation to perineum, genital area and the abdominal wall. A strip of anterior rectus sheath, should be preserved between the intersections to prevent rupture of the vulnerable rectus abdominis and its vessels due to presence of substantial connective tissue within the muscle between the tendinous intersections. During obtaining muscle flaps, denervation of the remaining muscle occurred if more than medial half of the muscle was taken with the flap, due to vertical arrangement of segmental nerve supply of the rectus at the junction of lateral 1/3 with the medial 2/3

Anatomical study of gracilis muscle: arterial findings enhance graciloplasty

To study the neurovascular anatomy of gracilis and to search for different pedicles of suitable size, proximal to dominant pedicle, which could support blood flow to the whole gracilis. Twelve lower limbs obtained from 6 human cadavers were injected with latex/lead oxide mixture into the femoral arteries. The gracilis muscles were dissected, marking the arterial and venous supply, and the nerve entry points. The overall length of the muscle and the length of its tendon were measured. The overall length of musculotendinous unit of gracilis was 42 to 44 cm. The tendon comprised 6 to 8 cm. The main arterial supply to the muscle entered 9-12 cm from the pubic tubercle [diameter, 0.1-0.3 cm]. It arised from the profundafemoris artery and passed between the adductor longus and brevis to enter the upper third of the muscle. The middle pedicle entered the middle of the muscles 19 to 21.5 cm from the pubic tubercle [diameter 0.1 to 0.2cm]. It originated from the femoral artery, passed on the lower border of adductor longus. The distal pedicle was the smallest one, originated from the femoral artery on the lower border of adductor magnus deep to sartorius. It entered the lower part of gracilis. There were additional 2 pedicles found in 2 lower limbs of the same cadaver. One pedicle was proximal to the dominant pedicle and the other was inferior to the middle pedicle. The former was of 0.2 cm in diameter. It originated from the profundafemoris artery in one limb and from the medial femoral circumflex artery in the other limb. Both entered the muscle 3.3 cm or 3.5 cm inferior to the pubic tubercle. The other pedicle arised from the femoral artery. It supplied the sartorius muscle and entered the gracilis below its middle. The motor nerve arised from obturator nerve and entered the muscle in association with the main pedicle. The neurovascular anatomy of gracilis was found to be remarkably consistent from specimen to specimen varying only in the length of muscle and tendon, and the number of minor pedicles supplying it. The existence of proximal pedicle of suitable diameter suggests that it might be able to support the whole gracilis without supply from the main pedicle. This study confirms the suitability of gracilis for segmental functional muscle transfer

Anatomical study of the nervous and blood supply of the internal oblique abdominal muscle with reference to its clinical application

To study neurovascular supply of the internal oblique. Sixteen internal oblique muscles were dissected in 8 human cadavers. The external iliac artery was washed by saline, then injected with latex/lead oxide mixture, followed by dissection of the deep circumflex iliac artery and its branches. Dissection of arterial supply showed that the main arterial supply was through the deep circumflex iliac artery. It had an inguinal straight course and iliac curved course, medial and lateral to the A.S.I.S. Its iliac part coursed between the transversalis fascia and fascia iliaca. It ran on iliacus muscle separated from it by iliacus fascia. It gave muscular branches to internal oblique and iliacus muscle. The main branch of deep circumflex iliac artery was the ascending branch, originated from the main stem either within 1 cm medial to A.S.I.S. [in about 62.5% of dissections] or 2 to 4 cm medial to A.S.I.S. [in 37.5% of dissections]. It coursed between the transversus abdominis and internal oblique to be intimately related to the lower thoracic spinal nerves. The deep circumflex iliac artery ended by piercing the transversus abdominis. In 2 cadavers the deep circumflex iliac artery pierced also the internal oblique to end in the external oblique. The internal oblique was innervated by lower 3 thoracic spinal nerve, subcostal nerve, iliohypogastric and ilioinguinal nerves, arranged in a segmental manner. It was concluded that the internal oblique had a unique neurovascular supply, firstly because: the motor nerves [lower thoracic spinal nerves, subcostal nerve and L[1]] were not accompanied by the main vascular pedicle [ascending branch of deep circumflex iliac artery] as in most skeletal muscles, secondly, the main arterial supply was single pedicle while, the motor nerve supply was multiple and separate with segmental arrangement. The abnormal course of deep circumflex iliac artery passing between the transversus abdominis and internal oblique may be mistaken with its ascending branch. The deep circumflex iliac artery had a long pedicle length with good diameter making it suitable for free tissue transfer

Study of mastoid canals in dried human skulls

To search for vascular tunnels or canals in the mastoid region which may not been reported before in Egyptian population, and may be of surgical importance. The study was carried on 30 complete dried Egyptian skulls, and 20 hemisected skulls or separated temporal bones. Another 10 hemisected heads preserved in formalin, and injected with gelatin/lead oxide mixture were also used. These heads were used to detect structures traversed the mastoid canal if present. Examination of dried bones revealed the presence of canal or tunnel on the outer surface of the mastoid processes in 37.5% of studied specimens. These canals were anterior to the occipitomastoid suture by a distance ranged from 0.5 to 1.8 cm. The canals were anteroinferior to the asterion by a distance ranged from 1 to 2.3 cm. The length of the canal varied from 0.2 to 2 cm. The lower opening of the canal was anterior or anterosuperior to the mastoid foramen. Dissection of injected heads showed that the canals contained a branch of occipital artery. The mastoid canals are not peculiarly confined to Indian population but they also found in skulls of Egyptian population. The presence of these canals in some skulls may be due to ossification of squamotemporal bone over the vessels during development of the mastoid process. The mastoid canals traversed by the auricular branch of occipital artery, which lied anterior to the mastoid foramina. This branch could be injuried if unnoticed by the surgeon. It is necessary for surgeons operating in this area to be aware of this vascular arrangement to anticipate and avoid troublesome bleeding

Prevalence of toxoplasmosis among hepatosplenic patients with or without lymphadenopathy

To study the prevalence of toxoplasmosis among patients with hepatosplenomegaly attending out patients clinic of Internal Medicine Department of Zagazig University Hospital, 53 patients [4 females, 49 males] were examined 14 of them were under specific chemotherapy at Oncology Unit and the rest were taken from the Internal Medicine Department. Ten healthy subjects were taken from the same different localities of Sharkyia Governorate as a control group. All subjects were thoroughly examined routinely investigated and their sera were tested for the presence of Toxoplasma antibodies by indirect hemagglutination test. Nineteen patients were found to be seropositive for toxoplasmosis [35.8%] among 53 patients, while only one case was seropositive from the ten healthy control group. Toxoplasmosis was more frequent among patients taken from the Oncology Unit presented by lymphadenopathy [78.5%] because they were under the effect of chemotherapy or immunosuppressive drugs. Also the prevalence rate was significantly higher among patients with Neutropenia and/or lymphocytosis or marked liver cell failure manifestations and especially with those patients presented with active schistosomiasis and those with positive history of Cat Contact or row food consumption. So toxoplasmosis must be taken in consideration as a pathogen and searched for in sera of altered hosts [hepatosplenomegaly with or without lymphoproliferative disorders under specific chemotherapy or immunosuppressive drugs] especially when they develop rapid deterioration

Biological and hematological changes in experimental cryptosporidiosis

In experimentally infected laboratory-bred white rats, Cryptosporidium infection rate was higher among immunosuppressed [75%] than immunocompetent ones [37.5%] with statistically insignificant difference. Cryptosporidiosis was found to be a fatal disease especially in immunosuppressed rats [50%]. There was also marked flourishing of the infection as revealed by high intensity of infection in immunosuppressed than the immunocompetent rats [363 and 82.7 oocysts / pellet respectively]. In spite of the severe disease, cyclophosphamide appeared to have no effect on the prepatent period. In both immunosuppressed and immunocompetent infected rats, there was a decrease in the total leucocytic count with marked lymphocytopaenia. This indicates decreased resistance to infection, thus higher oocyst counts in the pellets

Scanning electron microscopy of trichomonas vaginalis

By scanning electron microscopy [SEM], T. vaginalis surface appeared pleated with crater-like depressions. All the flagella appeared to start off in a single bundle from a shallow depression with a prominent rim. The side carrying the undulating membrane is extensively ruffled having a mulberry-like appearance to which flocculent material was frequently adherent. T. vaginalis nutrition appeared to proceed through pseudopodia-like extensions and phagocytosis by a constant deep invagination at the anterior pole which seems to be a cytostome. The mulberry-like surface may serve adhesion of T. vaginalis to the host cells and probably increases the surface area for exchange of nutrients, metabolites and parasite derived factors