Zika virus strategic response framework for the gulf states-2016: an urgent need for collaboration

The Zika virus [ZIKV] became the latest threat to global health security when WHO declared on 1[st] February 2016, that recently reported clusters of microcephaly and other neurological disorders in Brazil constitute a Public Health Emergency of International Concern [PHEIC]. These clusters were reported concurrently with an outbreak of ZIKV, which has been ongoing in Brazil and other countries in the America region since 2015. A growing body of clinical and epidemiological data possibly leans towards a causal role for ZEKV as the occurrence of the clusters of microcephaly and other neurological disorders principally the Guillain-Barre' syndrome are associated in time and place with the ongoing ZIKV transmission in the America region. So far, Zika viral transmission has been documented in a total of 69 countries and territories with autochthonous transmission from 2007 to 10 August 2016. The geographical range of ZIKV has been increasing steadily. Considering the presence of competent vectors that transmit ZIKV in some parts of the Gulf countries, and the close relationship with Brazil, a local transmission of the virus is plausible once the virus is introduced through travel. This review suggests the integration of epidemiological and entomological surveillance for monitoring and control of the vectors of ZIKV. The risks associated with ZIKV infection and the possible threat to the Gulf Sates was described. A strategic Zika response framework [SRF] for the Gulf States has been developed to meet their urgent need for a collaborative and coordinated response for prevention and spread of ZIKV infection. A coordinated response of all partners in the Golf States across sectors and services at national, as well as, regional levels is required

Non leaking cystoid macular edema

The current study was conducted to report the discrepancy in findings between Spectral Domain-Optical Coherence Tomography [SD-OCT] and Fundus Fluorescein Angiography [FFA] examinations of the macular area regarding Cystoid Macular Edema [CME] in patients with diabetic retinopathy [DR] or retinal vein occlusion [RVO]. This was a retrospective observational case study, involved 205 eyes of 179 patients. Eyes with diabetic retinopathy or retinal vein occlusion those underwent SD-OCT and FFAwere included in the study. All eyes had SD-OCT detected CME. In the current study, SD-OCT detected CME was associated with diabetic retinopathy in 56.1% of eyes and with retinal vein occlusion in 43.9% of eyes. CME associated with DR or RVO was undetected on FFA examination in 12.2% and 7.3% of eyes, respectively. Both SD-OCT and FFA were complementary to each other in the detection of CME in eyes with DR or RVO. The use of both SD-OCT and FFA aided in the diagnosis, the choice of the treatment option and the final visual outcome

Hallermann-streiff syndrome a case report from Egypt

Hallermann-Streiff syndrome [HSS] is a rare genetic disorder that is primarily characterized by distinctive malformations of the skull and facial [craniofacial] region; sparse hair [hypotrichosis]; eye abnormalities; dental defects; degenerative skin changes [atrophy], particularly in the scalp and nasal regions; and proportionate short stature. Here we describe a case with HSS

Echographic evaluation of optic disc excavation

To evaluate the role of high resolution B-scan echography in differentiating the causes of optic disc excavation. A prospective study was conducted on 30 subjects presenting to Al-Zahraa University Hospital [2009 - 2011] with optic nerve excavation. Of these patients 10 with coloboma, 10 with cup-shaped posterior staphyloma and 10 with glaucomatous optic nerve cupping were identified. Horizontal and vertical approaches for optic disc excavations were evaluated using B-scan echography. Specific echographic criteria for excavation configurations were successfully estimated. High-resolution contact B-scan echography may provide useful differentiation for optic disc excavations in eyes with opaque media

Acceptance and discomfort from atraumatic restorative treatment in secondary school students in Egypt

To assess the level of acceptance and discomfort experienced by secondary school students when undergoing an atraumatic restorative treatment [ART] restoration. Ninety secondary school students, aged 14 and 15 years, were included in the study. The ART restorations were prepared in 90 cavities and restored using an encapsulated high-viscosity glass ionomer. The depth of the cavities was judged from radiographs and clinically into outer, middle and inner third of dentine. Using a graded periodontal probe, cavity size was measured, into approximately half the width of the mesiodistal and buccolingual/palatal distance of the occlusal surface. The students were asked about the level of sensation experienced during cavity preparation immediately after completion of restoration. X2-Test was used to test the effect of cavity depth and size on sensitivity from the teeth. Of the 90 students, 6 [6.6%] and 26 [29.2%] experienced pain and discomfort, respectively, during cavity preparation, more often in large than in small cavities [p = 0.003] and in cavities extending into the inner third than in the middle and outer third of dentine [p < 0.0001]. Only 1 student reported postoperative sensitivity. The ART approach to treat dental cavities was well accepted by this group of secondary school students. Only a few reported pain during cavity instrumentation, and this was more prevalent in large cavities and in cavities with the floor close to the pulp

Factors affecting child mortality in Saudi Arabia

To estimate levels and trends, gender differentials, effect of modes of living, regional differentials, and the effect of parental educational on infant and child mortality. A nationwide stratified random sample was used to estimate levels, trends and differentials of infant and child mortality in Saudi Arabia. The study was executed during the period February 2006 to June 2006 and covered all the 20 health regions of Saudi Arabia. The randomly selected sample was limited to ever married Saudi women in the reproductive age group [15-49 years]. The findings show a continuous and considerable infant and child mortality decline during the 1994-2004 period. The infant mortality rate has decline from 22 per 1000 live births in 1994 to 17 per 1000 live births in 2004; while the child mortality rate has declined from 34 to 22 per 1000 live births in the same period. There is a strong relation between infant and child mortality and the mode of living and parental education. The study proves the continuous decline of infant and child mortality during the study period and affirms the effect of parental education on these indicators

pathophysiology of hemodialysis-induced hypotension in end stage renal [ESRD] disease patients

The upsurge in the renal failure patients undergoing haemodyalisis has attracted the researcher to figure out the possible mechanism of the haemodyalysis associated with hypotension. the purpose of this study was to determine plasma levels of ghrelin, leptin, insulin, and nitric oxide in renal failure patients with and without haemodialysis-induced hypotension, and to examine the potential correlation between these parameters and mean blood pressure in those patients. Sixty-four renal patients were included in the study and, were divided into three groups The first group consisted of 21 patients with renal insufficiency who were not on dialysis [NHD], the second group consisted of 23 patients on regular maintenance hemodialysis with normal blood pressure [HDNT] and, the third group consisted of 20 patients on regular maintenance hemodialysis with hypotension [HDHT]. The control group consisted of 20 healthy volunteers. Body mass index [BMI] and waist-hip ratio [WHR] were assessed. Blood pressure was measured three times within an interval of 5 min and the average was estimated. Mean blood pressure [MBP] was calculated. Nitric oxide metabolites [nitrates + nitrites, NO[X]], plasma ghrelin, leptin and insulin levels were assayed. BMI was significantly lower in HDHT group than the control, NHD, and HDNT groups. While the waist/hip ratio was significantly higher in HDHT group than NDH group. Both systolic and diastolic blood pressures were significantly lower in HDHT group than the other groups. Regarding the HDNT group, the systolic blood pressure was significantly lower than control and NHD group, while the diastolic one was significantly lower than the NDH group. Serum albumin was significantly lower in both HDHT and HDNT groups compared with NHD and control groups, however, it was significantly lower in HDHT compared with HDNT group. In addition, serum urea and creatinine, were significantly higher in the both HDHT, and HDNT groups compared with NHD and control groups, and it was significantly lower in HDHT compared with HDNT group. Plasma levels of Ghrelin, nitrate/nitrite [NO[X]] and leptin were significantly higher in patients compared with the control groups. Moreover, they were significantly higher in HDHT than HDNT and NHD groups, and in HDNT than NHD group. Regarding plasma levels of insulin it was significantly higher in the renal patients compared with the control group. However, there was no significant difference in insulin level between NHD and DHNT groups, while it was significantly higher in HDHT group compared with the two other renal patient groups [NHD, and HDNT. There was a significant negative correlation between changes of mean artrial blood pressure and ghrelin, leptin, insulin levels in both HDNT and HDHT patients. Our data suggest that excessive production of ghrelin, leptin, insulin and NOX contributes to HD-related hypotension in renal dialysis patients. The significantly elevated plasma levels of leptin and ghrelin is probably, at least in part, caused by impairment of their clearance by the kidney. Although being produced by the kidney, the physiological role of ghrelin in the kidney under normal and pathological conditions remains not fully elucidated. The elevated plasma insulin level may be caused by impaired glucose metabolism in uremic patients with alterations in insulin degradation and insulin secretion. The elevated NO[X] may be due to elevated serum leptin that modulates endothelial NO production, and /or elevated serum insulin that enhances NO release. However, we need to study the correlation between NO production and leptin and insulin levels in HD-related hypotension in renal dialysis patients to confirm this hypothesis

Synthesis and fungicidal activity of some new imidazoles from 2-[chloromethyl]-1H-benzimidazole

A series of substituted 2-thiomethylbenzimidazoles 2-4, 2-phenoxy-methylbenzimidazoles 5 and 2-aminomethylbenzimidazoles 6 and 7 were synthesized by reactions of 2-chloromethylbenzimidazole 1 with dithiocarbamate, pyrirnidine-2-thiols, phenol derivatives as well as primay aromatic and heterocyclic amines, respectively. Most of the synthesized compounds were screened for their antifungal activity against Botrytis sinerea, Fusarium, solani and Rhizocionia solani fungi. Some of the tested compounds showed 100% inhibition for the fungal growth at concentration ranges from 200-1000 ppm

Ureteral segmental replacement using peritoneal graft in a dog model

Ureteral replacement has always been a challenge. In this article, we tried to assess the outcome of segmental ureteral replacement using a free peritoneal tubal graft in a dog. Transperitoneal exploration of the upper urinary tract of 6 Mongrel dogs was performed and creating a free peritoneal graft. A 2cm segment of right upper ureter was excised, while the left ureter was left as a control. This segment was replaced by a peritoneal tube around a 6 F double-J ureteral stent which was removed after one month. Follow up intravenous urography [IVU] and abdominal ultrasonography were done prior to autopsy. All animals were sacrificed 3 months after the initial procedures for gross and histopathological assessment. All animals survived the entire follow up of 3 months without serious complications. Two months after stent removal, follow-up IVU and abdominal ultrasonography revealed that variable degrees of hydroureteronephrosis were noticed on the right kidney and ureter with normal left side. At the time of sacrifice, there was moderate to severe hydroureteronephrosis above the level of the periotoneal tube in all animals. Abdominal adhesions and narrowing of the ureteral lumen at the site of the graft were observed. Histopathological interpretation showed that the urothelium was creeping over the mesothelial graft with focal inflammation and fibrosis in all cases while local osseous metaplasia of the graft was noticed in three dogs. Ureteral replacement by peritoneal tube was unsatisfactory despite the usage of ureteral stent. Further studies are needed to evaluate the use of peritoneal patch graft or other biomaterials for ureteral reconstructions

Synthesis and investigation of novel shelf-stable, brain - specific chemical delivery system

A 1,4-dihydropyridine - pyridinium salt type redox system is described as a general and flexible method for site-specific and sustained delivery of drugs into the brain. Monoamine oxidase inhibitors [MAOIs] were used as a model example to be delivered into the brain. Chemical and biological oxidations of these compounds were investigated. The prepared 1,4-dihydropyridines were subjected to various chemical and biological oxidation to evaluate their ability to cross blood brain barrier [BBB], and to be oxidized biologically into their corresponding quaternary compounds. 1-[Ethoxy-carbonylmethyl]-3,5-bis[N-[2-fluoro-benzylideneamino] carbamoyl]-1,4-dihydropyridine [31] proved to cross BBB in adequate rate and converted by the oxidizing enzymes into the corresponding quaternary salt N-[ethoxycarbonylmethyl]-3,5-bis [N-[2-fluorobenzylideneamino] carbamoyl] pyridinium bromide [20]. Stability studies of the synthesized chemical delivery systems [CDSs] at various pH values and temperatures showed that the shelf life time of a solution containing compound 31 is 20.53 days at 5°C, which recommend a lower storage temperature for such solutions. The prepared CDSs proved to be fairly stable for powder form storage. The stability of the prepared compounds is attributed to the conjugation of the two carboxylic functions at C3 and C5 of the pyridine ring with their adjacent double bonds. These results are in consistency with the original rationale design

Immunocapture RT-PCR detection and partial nucleotide sequence of the coat protein gene of citrus psorosis virus from Egypt

Citrus psorosis virus [CPsV] is a multipartite virus with ssRNA genome present in very low concentration in infected citrus tissues. Diagnosis is made by biological indexing an indicator trus seedling but it is time consuming and expensive procedure; therefore it is not used generally. Direct tissue blot immunoassay [DTBIA] technique which requires very little sample manipulation, has been used for rapid detection of CPsV proved to be more sensitive and cheaper than ELISA. Attemptes for the detection of CPsV by DTBIA technique using flower explant tissues from CPsV infected isolates with a conjugate CPsV polyclonal antibody showed high signals especially with the ovary referring to the high titre of the virus in the ovary. A high reliable sensitive immunocapture reverse transcription-polymerase chain reaction [IC-RT-PCR] assay followed by nested-PCR was developed for the detection of CPsV. Two sets of primers were used to amplify the all length coat protein ORF [1365 bp] and a core region of 600 bp of the viral coat protein. The 600 bp core-CP fragment from the isolate, CPsVE1, was cloned and sequenced. The sequence Comparative analysis of nucleotides showed 98% similarity with CPV4 and CPV-4e isolates belonging to Argentina and Florida, respectively. Therefore, the CPVE1 isolate is probably considered the type strain of CPV especially citrus ring spot virus

Acute effects of lobectomy on right ventricular ejection fraction and mixed venous oxygen saturation

Traditional methods of assessing the operative risk for lung resection provide only a modest ability to predict postoperative morbidity and mortality. The aim of this study was to evaluate the effect of lobectomy on pulmonary hemodynamic and gas exchange variables using the RV thermodilution ejection fraction/oximetric catheter. We evaluated the acute postoperative effects of lung resection on hemodynamic and gas exchange parameters in 30 patients. Anesthesia was induced with thiopentone sodium and maintained with midazolam, fentanyl and pipecuronium. Intubation was performed with a double-lumen, left-sided endobronchial tube for one lung ventilation. The hemodynamic and gas exchange parameters were recorded before and after induction of anesthesia, and two hours after lung resection. These parameters were also recorded after the classification of the patients according to the underlying lung pathology. Lobectomy was associated with significant hemodynamic changes and good maintenance of gas exchange variables. SVI, LVSWI and RVEF were significantly decreased in the early postoperative period after lung resection. MPAP, COP, CI, SVRI, PVRI, RVSWI, and RVEDVI showed no significant changes during the perioperative period. SVO2 showed a significant increase after lung resection when compared with preinduction values, while VO2 significantly decreased. SaO2, a-A PO2, QS-QT, DO2, and O2ER showed no significant changes during the perioperative period. We conclude that in the acute post-resection period [up to 2 hours postoperatively] there is right and left ventricular dysfunction with good maintenance of gas exchange

Western blot in comparison with ELISA for detecting antibodies against foot and mouth disease virus

Western blot technique is described for visual detection of foot and mouth disease virus [FMDV] antibodies in sera of infected, vaccinated and field cattle using FMDV fragments separated by SDS-PAGE and blotting onto nitrocellulose membrane. The interaction between FMDV antibodies and blotting virus fragments revealed dark blue bands, which is considered a positive result by Western blot. All sera of infected, vaccinated bulls and 10 out of 38 field animals had antibody titers ranged from 1.7 to 3.1 by ELISA. All ELISA positive sera demonstrated dark blue bands against the different FMDV fragment by Western blot. The use of Western blot as a rapid specific and sensitive technique for detecting FMDV antibodies was discussed

effect of maternally derived antibodies on the response of calves to vaccination against Kabete O rinderpest vaccine

A study was undertaken to find out the age at which calves borne to repeatedly vaccinated dame could be vaccinated against rinderpest [RP]. Eight vaccination regimes on eight groups of colostrums fed calves were implemented using a local live attenuated cell culture RP vaccine. The animals of regimes 1,2,3,4,5,6,7 and 8 were primary vaccinated at the age of 1,2,3,4,5,6,7 and 8 month respectively and boosted at the age of 6,7and 9 month in regimes 1 to 5 and at 9 months in regimes 6,7 and 8. Maternally derived antibody [MDA] and vaccine-induced antibody against rinderpest antigen were assessed using competitive ELISA and the detected antibodies are expressed as percent inhibition [PI] values. The sera that had P1 below 42 tested negative. Two days following feeding colostrum calves revealed highest PI [94.5-92.2]. MDA gradually declined to undetectable levels by the age of 4 to 6 months. Early vaccination regimes before the age of 6 months were ineffective ligier antibody levels were detected at the age of 7 months in the animals of regimes I,2,3,4,5 and one month after primary vaccination in regimes 6,7 and 8. Based on the above finding, it is recommended that the colostrum fed calves could be vaccinated against Rinderpest when they are at 6 to 7 months of age

Evaluation of voiding dysfunction in patients suffering from parkinsonism using the international prostatic symptoms score [IPSS]

Parkinson's disease is one of the neurological diseases that show voiding dysfunction as a manifestation. The reported incidence of voiding dysfunction in patients with Parkinson's disease ranges from 37% to 70% [1, 2, 3, 6, 9]. Voiding dysfunction is one of the important health problems facing urologists and neurologists every now and then. It is rather a manifestation of a disease than a disease by itself.In this series a quantitative estimation of patients with voiding dysfunction was done on the unselected bases using IPSS to find out its incidence in Parkinsons disease. In this series 83 patients suffering from parkinson's disease were the material of the work. The patient's age ranges between 40 and 82 mean [63.6]. 37 were males while the remaining 46 were females. The patients were attending neurological and urological out patient's clinics or AI-Azhar Hospital of Damiatta.The lower urinary symptoms in a form of dysuria, frequency, difficulty and drippling were the main presenting symptoms in all patients. Quantitative evaluation of the patients was done for every patient, A full history was taken, clinical examination and some laboratory and radiological investigations. The duration of this work was 10 months from January 2000 to October 2000. 20 patients [77%] had irritative symptoms alone in a form of dysuria, frequency, and precipitancy while obstructive symptoms in a form of difficulty, drippling and, hesitancy were encountered in 2 patients [7.6%]. In 4 patients [15.4%] irritative and obstructive symptoms were concomittant. Quality of life [QOL] was affected by obstructive and irritative symptoms and this disturbance parallels the severity of the disease. Obstructive symptoms were dominant in a male patients, while irritative symptoms noticed to be independent of sex. The effect of antiparkinsoinian drugs was uncertain on the LUTS. The severity of the symptoms was directly proportional to the severity of the disease rather than the disease duration. The international prostatic symptoms score is not only refIecting prostatism but can be used successfully in evaluation of voiding dysfunction of neurodegenerative diseases as Parkinsonism in both males and females. Voiding dysfunction in parkinson's disease was found to be increasing as the severity of the disease increases

Study of the deleterious effect of varicocele on both testicular volume and consistency matched with spermiogram and FSH

Male subfertility is a very common health problem facing urologist, dermatologist and general surgeons every now and then. In addition to its importance as a health problem, it presents also a big social problem hence the great deal for early detection and treatment. Varicocele is a common treatable cause of male subfertility. It is more frequent and larger in taller men and usually first appear at the time of puberty [1]. Testes associated with large varicoceles are smaller and may be soft with more severe disturbances of spermatogenesis [2]. Men with varicoceles have poorer semen quality than those without varicoceles indicating adverse effects of varicocele on testis [3]. In this study we investigate 32 infertile patients with different grades of varicocele for evaluation of the effect of varicocele on testicular volume, consistency and seminogram the results showed epsilateral reduction of testicular volume and consistency plus poor seminogram parameters. Another 10 normal fertile volunteers were subjected to the same investigation and showed significant difference between both groups as regards to testicular volume, consistency and seminogram variables

Early detection of prostatic disorders men above fifty in Damietta governorate

To study the prevalence of prostatic disorders among men above 50 years of age in the out patient urology service .This study includes 400 male patients more than 50 years of age [range 50 - 81] with the mean of 65.5 in every patient a thorough urologic history was obtained stressing upon the items of the international prostatic symptom scores [IPPS], clinical assesment was performed including digital rectal examination and the laboratory investigations including serum PSA. urine analysis, s.creatinine, KUB and TRUS with or without biopsy. Out of the 400 screened patients. 152 [38%] were complaining of lower urinary disorders mainly irritative in 100 patients [25%] and obstructive in 52 patients [13%]. The irritative symptoms were mainly dysuria, frequency and precipitancy while obstructive symptoms were difficulty, drippling and hesitancy.87 patients [22%] were complaining of symptoms related to sexual dysfunction, out of them 26 patients [6.5%] were diabetics while 16 patients [4%] were hypertensive under medications and the remaining 32 patients [11%] were of unexplained causes digital rectal examination [DRE] showed evidence of prostatic enlargement of benign feeling in 100 patients [25%], 45 patients had an evidence of urinary tract infection furthermore vesical stones were encountered in 7 patients [1.9%]. PSA was more than 4ng/ml in 20 patients [5%] including 10 patients out of 12 had suspecious prostate in DRE. Transrectal ultrasound [TRUS] was performed in 30 patients [7.5%], where suspecious of malignancy was in 11 patients [2.7%.]. Transrectal 6 core biopsy revealed prostate cancer in 3 patients [0.74]. Although the number of screened patients is small. However, it gives an impression of the importance of screening in early detection and then treatment of prostatic disorders