Helicobacter pylori infection among school children in Alexandria: Possible association with intestinal parasitic infections

This study was conducted on 170 pupils of a primary school in Backos area of Alexandria, Egypt. A complete clinical examination was undertaken together with a thorough past and family history taking. The children completed a pre-designed questionnaire regarding some socioeconomic data and past medical history. A stool examination was carried out to detect different parasitic infections. Helicobacter pylori infection was diagnosed immunologically by the detection of anti-H. Pylori IgG antibodies in salivary samples using the enzyme linked immunosorbent assay [ELISA]. The results revealed that the prevalence of H. Pylori among the examined pupils was 27.1%. Boys were more infected than girls [32.5% vs. 22.2%]; however, the gender effect was not statistically significant. Age was more important as an epidemiologic determinant and H. Pylori infection increased significantly with age. Of the socioeconomic factors investigated, the education of parents, especially mothers, was the most important and H. Pylori infection increased significantly with the decrease of the level of mother's education. A degree of association, which was not statistically significant, was found between H. pylori infection and intestinal parasitic infections, especially helminths as Ascaris, Trichuris, Hymenolepis and Fasciola sp. Suggesting the fecal-oral route of transmission, role of food and the effect of household environment and food hygiene

Eosinophil cationic protein as a serological marker of disease activity in childhood bronchial asthma

To study the value of eosinophil cationic protein [ECP] as a serological marker of disease activity in childhood bronchial asthma, ECP levels were measured in 20 healthy control children and 25 asthmatic children, during and 2 weeks after acute exacerbation. The mean serum ECP level of all asthmatic patients, during and after exacerbation, was significantly higher than the control group and was significantly higher during attacks than 2 weeks after their termination. ECP levels were highest in severe attacks, but did not differ between mild and moderate attacks. ECP levels in asthmatic patients 2 weeks after mild and moderate attacks were comparable to normal; after severe attacks levels remained higher than normal. Measurement of serum ECP will be helpful in determining asthma activity and deciding the use of anti-asthma drugs

Transient tachypnea in neonates of mothers receiving glucose 5% and oxytocin during labour

The aim of this work was to study the frequency of transient tachypnea of the newborn [TTN] and the possible relation to the use of oxytocin and glucose 5% during labour Subjects investigated were enrolled into two groups: the first [study] group consisted of 100 newborn infants born to mothers who have received IV infusion of aqueous glucose solution 5% and oxytocin. The second [control] group consisted of 30 newborns whose mothers did not receive any IV infusion. In the study group, the amount and rate of infusion of oxytocin and glucose 5% were calculated. The blood samples [maternal and cord] were drawn just after delivery in the study and control groups. Newborns were diagnosed as having TTN if they fulfilled the following criteria: persistent tachypnea with onset within 1/2 hour after birth, minimal grunting and retractions, with or without cyanosis in room air, necessity for oxygen therapy, spontaneous improvement starting within 24 hours after birth, Fi02 not more than 0.4 and suggestive radiological findings. Our results showed that maternal and cord serum sodium levels of the study group were significantly lower than those of the control group with a significant negative correlation between the maternal and cord serum sodium and the amount of oxytocin and glucose 5%. No significant difference between maternal and related cord serum sodium in both groups. Hyponatremia developed in 25 out of 100 cases of the study group and in 2 out of 30 cases of the control group with a significant difference. TTN developed in 17% of the study group and in none of the control group. The difference was significant. Serum sodium in the newborns who developed TTN was lower than in those who did not develop TTN. Out of 25 cases with hyponatremia, 8 developed TTN [32%] while out of 75 cases without hyponatremia, only 9 [12%] developed TTN with a significant difference. The amount and rate of infusion of oxytocin were higher in the TTN group than the non-TTN group. TTN was more frequent when the amount of oxytocin exceeded 10 units and the rate of infusion exceeded 25 mu/min. The amount and rate of infusion of glucose 5% did not differ in the TTN group from the non-TTN group. We concluded that the amount of oxytocin and glucose 5% infusion are related to the development of maternal and neonatal hyponatremia and the amount and rate of infusion of oxytocin are related to the occurrence of TTN. To decrease the incidence of TTN, We recommend that the dose of oxytocin should not exceed 10 units at a rate of infusion of less than 25 mu/min

Vaginal births after multiple cesarean sections: a retrospective study

There were 30,824 deliveries at the Department of Obstetrics and Gynecology in Jahra Hospital of Kuwait from 1987 through 1991. Of these 2681 [8.7%] were by cesarean section and 496 [19%] were repeat operations. Most common indications for repeat cesarean section [dystocia, breech and fetal distress] remained the same during the 4-year review period. Only 16 patients with histories of multiple prior sections were delivered vaginally with no augmentation. 10 of them presented with fully dilated cervices. Only one patient was assisted instrumentally. 10 patients were delivered at term and only 2 had Apgar score of less than 7 at 1 minute and 5 minutes, respectively. Given certain precautions, there may still be a room for trial of scar in some patients after multiple abdominal deliveries

10 year review of obstetric hysterectomies in Jahra Hospital of Kuwait

Within 10 years of obstetric practice, 65,016 women were delivered in Jahra Hospital of Kuwait. Of the 1-2% who developed postpartum hemorrhage, 21 patients [0.03%] needed hysterectomy. Two thirds of the operations were subtotal and two thirds of the total number were performed by senior personnel. Uterine atony indicated 38% of cases, uterine rupture 33%, placental pathology 19% and miscellaneous causes 48%. Associated maternal mortality was 4.7%. Perinatal mortality was 14.2%. Subtotal hysterectomies were followed by less postoperative morbidity than total ones. Underestimating blood loss, delay in operating and inexperience of the staff are the major causes of complications. Supervised antenatal care, electronic monitoring and active management of labor seem to help in reducing them

Gastric angiodysplasia in the elderly

This work describes three elderly patients with gastric angiodysplasia, an unusual cause of recurrent blood loss and anaemia. The condition can prove difficult to detect, and consequently a delay in making the diagnosis may occur. The favourable response of gastric angiodysplasia to endoscopic laser treatment suggests age should not bar investigation to establish diagnosis. Review of the mode of presentation, aetiology and possible therapeutic endoscopic procedures for angiodysplasia are also discussed

Auditory brain stem evoked potentials and serum bilirubin levels as screening tests in neonatal jaundice

The operating characteristics [sensitivity and specificity] for ABR and serum bilirubin level as screening tests for brain toxicity in neonatal jaundice were evaluated. Choice of low intensity [30 dBHL] cutoff score in ABR screening helps identify newborns with even mild hearing loss. Serum bilirubin risk cutoff score [>20mg/dl] if used alone as the criterion for referral will minimize confidence in negative results [specificity = 30%]. Thus a bilirubin level lower than 20 mg/dl should be selected and used for screening purposes

Predictability of non-stressed cardiotocography to foetal/neonatal status in insulin-dependent diabetes

Non-stressed cardiotocography was used for foetal surveillance in 115 insulin-dependant diabetic and 194 normal pregnancies from about the 32nd week until delivery. A mean number of 22.4 and 7.2 tests was required respectively. Reactive tests were obtained in 65% of diabetic and in 74.6% of control gravidas, while non-reactive tests were seen in 30.4 and 23.2 of them respectively. The predictive value of reactive tests was highest, approaching 100%, for neonatal Apgar score of >/= 7 in both diabetic and normal pregnancies. Normal metabolic balance and pulmonary function were predicted in 84% versus 89% of fetuses with reactive antepartum tests born to diabetic and non-diabetic mothers. A normal intrapartum foetal heart tracing was forecast in 83.5 versus 84.5. The predictive value of abnormal cardiotocography for pathological intra and neonatal conditions was unexceptionably poor with a maximum of 33% and 43% in both diabetic and control pregnancy. This study shows that non-stressed cardiotocography is as reliable a predictor of normality and as poor a predictor of abnormality in diabetic as in normal pregnancy

Tuberculin skin testing for evaluation of the efficacy of BCG vaccines used in Egypt

The efficacy of the liquid compared to the freeze-dried BCG vaccines used in Egypt was evaluated by studying the tuberculin conversion. Two hundred and eleven apparently healthy infants and children between four months and four years of age were studied. They were divided into two groups, the first included 104 infants and children 4 months to 2.5 years old [vaccinated with the freeze-dried BCG vaccine] and the second included 107 children aged 2.5 to 4 years [vaccinated with the liquid preparation]. Tuberculin test "Mantoux" was done for every child using PPD [2Tu]. The results were read after 48 hours; negative reactors [less than 10 mm] were subjected to a repeat test two weeks later. Tuberculin test was positive in 83.65% of children vaccinated with the freeze-dried preparation and in 56.07% of those vaccinated with the liquid one. The difference between the two groups was highly significant. A significant difference was also observed between the induration diameter of both groups [13.4 mm and 11.4 mm respectively]. Several possibilities were discussed to explain our results