Diagnostic utility and complications of flexible fiberoptic bronchoscopy in Assiut University Hospital: a 7-year experience

Few studies with small number of patients reported their experience with flexible fiberoptic bronchoscopy [FFB]. We aimed to report our 7-year experience with the diagnostic yield and complications of FFB at Assiut University Hospital. A retrospective review of bronchoscopy reports and corresponding patients' charts over 7 years from January 2006 to December 2012 performed at the Department of Chest Diseases, Assiut University Hospital, was done. Indication for procedures, suspected diagnosis, final diagnosis, and complications were reported. Of 3980 bronchoscopies, 3660 [92%] were diagnostic. Mean age was 45 +/- 18 years and 68% were males. Malignancy and infection, including tuberculosis [TB], were the 2 main indica-tions for FFB [47% and 23.8%]. The overall diagnostic yield was 67%. A total of 1690 broncho-alveolar lavage [BAL], 1303 brushing, 188 transbronchial biopsies [TBB], and 645 bronchial biopsies [BB] were performed. Malignancy was confirmed in 70% of suspected cases. Tuberculosis was diagnosed in 58.5% of suspected cases, whereas bacterial pneumonia was diagnosed in 48.5%. Bronchoscopy diagnosed 38.4% of patients with interstitial lung disease. The diagnostic yield was 55% for sarcoidosis and 33% for usual interstitial pneumonia. The overall complication rate was 1.61%. Mortality rate was 0.05%. Our results confirm that flexible fiberoptic bronchoscopy is a valuable diagnostic tool, with a low rate of complications, particularly in patients with lung cancer. The diagnostic yield in our locality is almost similar to that reported in other series

Echocardiography in mitral stenosis

Echocardiography plays a major role in diagnosis, etiology and severity of Mitral Stenosis [MS], analysis of valve anatomy and decision-making for intervention. This technique has also a crucial role to assess consequences of MS and follow up of patients after medical or surgical intervention. In this article we review the role of conventional echocardiography in assessment of mitral stenosis and future direction of this modality using 3D echocardiography

Echocardiographic atlas of the mitral regurgitation

Mitral regurgitation [MR] is defined as the loss of the smooth and adequate trimming closure of the mitral valve, which results in the reflux of blood from the left ventricle into the left atrium during systole. The functional competence of the mitral valve relies on the proper and coordinated interaction of the following structures: the mitral annulus, and leaflets, chordate tendineae, papillary muscles, left atrium and the left ventricles. This article will describe the echocardiography assessment of the mitral valve regurgitation with special emphasis on the trans-esophageal and 3D echocardiography. The echocardiography images were all original with special attention to the unique surgical view of the images

Determinants of maternal adaptation to mentally disabled children in El Minia, Egypt

This study was carried out in a governmental school for mentally disabled children in El Minia. We assessed maternal adaptation and the relationship between maternal sociodemographic factors and adaptation as well as examining maternal distress. All 100 mothers with children aged 6-18 years attending the school were recruited in the study. Three tools were used: demographic data sheet, adaptation scale to assess the nature of mothers' interaction and patterns of psychosocial adaptation and depression scale to detect the presence of psychiatric disorders among the mothers. Only 35.0% of the mothers adapted positively to their child's condition; 62.9% of those had female children. Negatively adapted mothers were slightly older than positively adapted mothers and had more children. Maternal education and occupation were significantly associated with psychosocial adaptation. Knowledge of mothers about their child's condition significantly affected adaptation as well as the dependency of children in eating, drinking and sleeping. Two-thirds of mothers had high levels of psychopathology

Echocardiography of the mitral valve

Mitral valve disease is the second most common valvular heart disease after the aortic valve worldwide. Mitral valve has historically been a structure of interest by pioneers in echocardiography. One of the earliest applications of echocardiography was in the diagnosis of valvular heart disease, particularly mitral stenosis. In this review we wish to take the reader through the structural and hemodynamic evaluation of the normal mitral valve

Spectrometric, thermal and electron microscope studies of iron complexes of adrenaline hydrogen tartrate and catecholamine

Iron was found to form coloured stable complexes with both adrenaline hydrogen tartrate and catechol as inhibitors for iron corrosion in aqueous solutions of different pH values [2.0-11.5]. The electrochemically formed complexes on the surface of the iron electrode in different media were separated and studied in comparison with the same complexes prepared by chemical method in the same media. The prepared complexes were studied using micro-, electro-and thermal analyses together with electron ionization mass [EI-MS] and IR spectral methods. Both chemically and electrochemically prepared complexes were found to be of the same structures. The electrochemically formed complex in different media was found to be as a chemisorbed layer on the surface of iron electrode. The aim of the present work is to compare the results of chemical and electrochemical techniques in preparation of stable iron chelates of both adrenaline hydrogen tatrate [AHT] and Catechol [Cat.] as inhibitors for iron corrosion. The morphology of the chemisorbed complex layers on the electrode surface was also tested by electron microscope [EMS] and characterized as an amorphous or crystalline adsorbents

Microwave mediated facile synthesis of some novel pyridine, pyrimidine, pyrazole, pyrazolo [1,5-a] pyrimidine and triazolo[1,5-a]pyrimidine pendant to pyrrole

The synthetic potency of E-3-[dimethylamino]-1-[1H-pyrrol-2-yl]prop-2-en-1-one towards some nitrogen nucleophiles was investigated under microwave irradiations as a convenient route for the synthesis of some novel pyridine, pyrimidine, pyrazole, pyrazolo [1,5-a] pyrimidine and Triazolo[1,5-a] pyrimidine derivatives

Socio-cultural determinants and impact of HIV infection in the Sudan

Sudan, among the Subsaharan African countries has a low prevalence of HIV infection particularly in the North of the predominantly Muslim population. The peace agreement [2005] which stopped the civil war in the South opened the boarders with the HIV-high prevalence countries of Central and West Africa. This is expected to increase the transmission of HIV in the whole of Sudan. The present study interviewed 635 HIV positive individuals reporting for testing in three voluntary counseling and treatment [VCT] centres in Khartoum. Socio-cultural determinants of the infection showed that the young adults less than 50 years constitute 66.1% of all infected, with 60% males, 40% females and majority 64.9% are either illiterate or had minimum level of education. 61% of them were Muslims and 39% were Christians or non believers, 50.1% were married. The quality of life changed in 89% of individuals. It is concluded that the infection with HIV in Sudan may increase and health education messages need to be tailored according to the sociocultural determinants of the infection in a multicultural, multi-religious country like the Sudan. Muslims will not be protected against HIV infection unless they adhere to the code of Islam

In-vitro studies of prednisolone pre-formulations released from various ointment-bases, factors affecting penetration rate and penetrated amount

In this pre-formulation study, the effect of individual factors influencing the penetration rate of drugs incorporated in various topical vehicles has been in-vitro investigated. The water poor soluble prednisolone is chosen as a model drug. To increase the dissolution behavior of prednisolone [P], co-precipitates of it with polyvinyl-pyrrolidone[25] [P/PVP[25]-coprs], polyethylene glycol[6000], [P/PEG[6000]-coprs] and adsorbents with Aerosil[200] [P/A-[200]-adsrob] were prepared and in-vitro tested. A significantly increased dissolution in purified water was obtained with the co-precipitate F[1], consisting of 10-wt% prednisolone and 90-wt% PEG[6000]. As F[1] was incorporated in various model-vehicles insignificant penetration profile was achieved. This effect was in fact due to the high concentration of PEG[6000] in the vehicles, which has increased the bulk viscosity of the ointments, that resulted on the one hand in restricted drug particles movement between the phases and on the other between the external phase and the artificial membrane. In contrast, F[2] consisted of 50-wt% Prednisolone and 50-wt.%/ PEG[6000]-copr, showed a slight increase in drug solubility compared to the corresponding physical mixture as well to pure P. As F[2] was incorporated in aqueous emulsifying wool wax-base, [WHES] a greater penetration rate into the synthetic membranes has resulted, and no change in the crystal form of P could be observed throughout the study time period of 70 hours. All other pre-formulations, [prefs] showed negligible increase in the solubility of P. X-ray diffractions studies of prednisolone-PVP[25]-coprs and those of drug/Aerosil[200]-adsorbent, indicated changes in the crystal form of P into monohydrate, which probably happened during the co-precipitation and adsorption of the drug and also during the incorporation of the pre-formulations into ointments. This change was specifically due to the very few amount of water present in ethanol 96%v/v used as solvent for the preparation of the P-co-precipitates and adsorbents [= pref]] and due to water available in the external phase of all used o/w-emulsions type ointment-base

Studies on infectious laryngotracheitis in chickens I. isolation and identification of infectious laryngotrachitis from some chicken flocks

Infectious laryngotracheitis virus [ILTV] was detected in chicken laryngeal and tracheal samples from outbreaks in 4 governorates in Egypt [Kalubia, Sharkia and Gharbia]. The viral antigen was detected by AGPT and FAT in 7 isolates, which subjected to physicochemical, biological characterization and pathological investigations. Isolated ILTV produced characteristic pock lesions on CAM of Embryonated Chicken Eggs [ECEs] and characteristic intranuclear inclusion bodies by direct FAT and histopathological examination in infected CAM and tracheal smears. The isolate S3 was the most pathogenic strain [by pathogenicity test of the isolates on ECEs and susceptible chickens] and had one more protein band than the other isolates as compared to the standard virus [by SDS-PAGE]. Ether sensitivity and thermo-stability of the isolated viruses at 56[degree sign]C indicated that the local isolate loss its infectivity to ECEs after treatment with ether for 24 hours and 15 min. at 56 [degree sign]C as well as the standard control ILTV. By cross neutralization, the results revealed that the isolated strains appeared to be related to the standard ILTV through neutralization index between each other. Infectivity titre of the virus was increased by passaging it in SPF eggs till reaching the highest titre by the 5th passage

Tissue levels of platelet-derived endothelial cell growth factor[thymidine phosphorylase], vascular endothelial growth factor and cathepsin-D in patients with bronchogenic carcinoma

1] To acquire more information about the important role of platelet derived-endothelial cell growth factor thymidine phosphorylase [PD-ECGF/TP], vascular endothelial growth factor [VEGF] and cathepsin-D [Cath-D] as angiogenic factors in the pathogenesis, progression and prognosis of lung cancer. 2] To investigate the correlation between these biochemical indices and the clinico- pathologic status of the patients. Patients: The study included histopathologically confirmed lung biopsies of 37 patients with bronchogenic carcinoma, 12 patients with benign chest diseases and 12 non inflammatory non malignant biopsies as a control group. Bronchogenic carcinoma cases were classified histopathologically into squamous cell carcinoma [14 cases], adenocarcinoma [10 cases], large cell carcinoma [6 cases] and small cell lung carcinoma [7 cases]. Design: A randomized, group comparative, single center study. Setting: Assiut University Hospital. The present study showed a significant increase in the tissue levels of PD-ECGF/TP, VEGF and Cath-D in patients with lung cancer in comparison to patients with benign chest diseases and controls. Significant higher tissue levels of the studied bioindices were observed in patients with inoperable cancer, advanced stages, bulky tumors and with lymph node metastasis. Significant higher tissue levels of VEGF and Cath-D were also demonstrated in lung adenocarcinoma compared to other pathologic types of lung cancer. Significant positive correlations were found between the studied bioindices in the lung cancer patients. The present study indicates the importance of PD-ECGF/TP, VEGF and Cath-D as angiogenic factors in the malignant progression and prognosis of lung cancer. Therefore the development of new therapeutic agents with an anti angiogenic action like PD-ECGF/TP and VEGF inhibitors may be of great importance in the management of patients with lung cancer

Crest syndrome in a male patient. A case report

A 65-years-old male patient presented with arthritis, dyspnoea,, dysphagia, tight skin, Raynauds phenomenon, telangiectasis of the palms, positive antinuclear antibody [ANA], anticentromere antibodies [ACA] and bilateral basal pulmonary fibrosis. We report a rare condition and to the best of our knowledge, this is the first case of Crest syndrome in male patient with pulmonary involvement to be reported from North Africa

Study of larvivorous fish for malaria vector control in Somalia, 2002

An intervention study was conducted on the introduction of the larvivorous fish Oreochromis spilurus spilurus as a method of malaria vector control in Kalabeydh village, northern Somalia. This species is resistant to chlorine in water up to a concentration of 1.0 mg/L. Fish were introduced into 25 berkit [reservoirs]. After 1 month the number of larvae in each berkit was reduced by between 16.5% and 78.6% [mean 52.8%]. Community acceptance and participation was good. The introduction of larvivorous fish is a cheap method of malaria vector control, but its sustainability needs special consideration and education of the community is important, especially to cover the dry season, when most of the berkit dry up

electronic structure of group IV p-Block chalcognides

Abinitio molecular orbital calculations were performed for the chalcognides and the corresponding positive ions of the group IV p-block elements [Ge, Sn and Pb] at HF and MP levels using the Effective Core Potential with the appropriate d-functions on each atom. The theoretically predicted molecular parameters, bond lengths and dipole moment, agreed with experimental data. Calculations revealed that the bond lengths of the investigated molecules were greater than those of corresponding positive ions, while values of the dipole moment, bond order, and the stability of the HOMO and LUMO were less. The calculated stabilities, according to the total energy [E[T]], the bond length [R[e]] and the dissociation energy [D[e]], followed similar trends as the oxides, i.e., in the order GeO > SnO > PbO

Comparative study of the retina in albino rat and rabbit during the embryonic life

A comparative study was carried out in the retina of albino rat and rabbit embryos. The age of albino rat embryos in this study was 13, 14, 15, 16, 18 and 20 days. In the rabbit embryo we used the ages of 6,7,8,9, 16 and 22 days. The retina of the different ages was examined by the light microscope and the followings was found: 1- The optic vesicle arises from the wall of the diencephalon by the 6[th] days in the rabbit embryos and by 13 days of albino rat embryos. 2- The pigmentation of the outer layer of the optic cup takes place by the day 8 in rabbit embryos but not present in the outer layer of the optic cup in albino rat embryos. 3- The retina completes its differentiation and formation its 10 layers by the day 20 in albino rat and by the day 22 in the rabbit embryos

Accuracy of sonohysterography in detecting intrauterine pathology and in distinguishing endometrial polyps from submucosal myomas

To determine the accuracy of sonohysterography to detect intrauterine pathology and to distinguish endometrial polyps from submucosal myomas. 40 women with suspected intrauterine pathology that suggested a submucosal myoma or an endometrial polyp on transvaginal ultrasonography underwent sonohysterography followed by hysteroscopy. The final diagnosis was established by operative hysteroscopy and its guided biopsy. El-Minis University Hospital. Hysteroscopy confirmed 39 [97.5%] out of the 40 diagnoses of intracavitary lesions made on sonohysterography. In the remaining case a fibroid suspected to be submucosal was actually intramyometrial at hysteroscopy. Endometrial polyps were detected by sonohysterography in 16 cases, 14 [87.5%] of these cases showed polyps at hysteroscopy. The remaining two cases had submucous fibroids at hysteroscopy. Submucous myomas were also detected by sonohysterography in 20 cases, 18 [90%] of these were accurate, one was a polyp and one was intramyometrial myoma at hysteroscopy. There were 4 cases in whom sonohysterography has detected an intracavitary lesion but could not detect whether it was a polyp or a fibroid. Two of these cases were endometrial polyps and two were submucous myomas at hysteroscopy. In only 8.3% of cases was a fibroid diagnosed incorrectly by sonohysterography to be a polyp or vice versa. The nature and site of the mass could be predicted accurately by sonohysterography in 80% of the studied women. Taking hysteroscopy as a gold standard for the detection of endometrial polyps and submucosal myomas, sonohysterography showed a sensitivity of 82.3%, a specificity of 91.3%, a positive predictive value of 87.5%, a negative predictive value of 87.5% and a diagnostic accuracy of 87.5% in detecting endometrial polyps compared with a sensitivity of 81.8%, a specificity of 88.8%, a positive predictive value of 90%, a negative predictive value of 80% and a diagnostic accuracy of 85% in detecting submucosal myomas. Sonohysterography is an accurate tool in detecting intrauterine pathology and in distinguishing endometrial polyps from submucosal myomas. In addition, it is easy to perform, well accepted by the patient and inexpensive

High-voltage pulsed galvanic stimulation versus exercises on acceleration of recovery in Bell's palsy

The purpose of this study was to assess the effect of high-voltage pulsed galvanic stimulation [HVPGS] on improving functional activity of facial muscles and facilitation of facial expression in Bell's palsy. The study included 20 patients from both sexes with age ranged from 11 to 13 years [mean = 9.97 +/- 1.59 years], they were selected on basic criteria to confirm the absence of contractures and to detect the stage of Bell's palsy. Strength duration curve [SDC] with different durations [0.05, 0.1, 0.2, 0.3, 0.4 and 0.5 msec] and muscle grading scale for the orbicularis oris muscle were measured pre and post the suggested period of treatment. Patients were randomly divided into two equal groups; the study group received a suggested program of HVPGS on the paralyzed facial muscles, followed by traditional physiotherapy treatment and the control group received traditional physiotherapy treatment only. Treatment was conducted for two successive months for both groups. Results collected at the end of treatment from the study group revealed a valuable reduction in the mean values of SDC of the orbicularis oris muscle which was concomitant with a significant increase in the active range of motion of the facial muscles. These results were statistically highly significant in relation to the results collected from the control group which might be due to the effect of HVPGS. The benefits afforded from this study indicated that the application of HVPGS in cases of Bell's palsy may facilitate the facial muscles, which was concomitant with the improvement in facial expression

Role of aerobic exercises on controlling blood sugar in juvenile diabetes

The purpose of this study was to assess the effect of aerobic exercises on controlling blood sugar in juvenile diabetes. The study included eighteen patients from both sexes, with age ranged from nine to twelve years. They were selected on basic criteria to confirm the blood sugar. They were randomly and divided into two groups of equal number, control and study groups. Patients in the control group received medical treatment [insulin] and diet control only, while those belonging to the study group received a suggested program of aerobic exercises in addition to the previously mentioned regimen. Blood glucose and body weight analysis was done pre and post the suggested period of treatment. Treatment was conducted for ten successive weeks. The collected data after termination of the suggested period of treatment of both groups revealed significant improvement in the study group, utilizing aerobic exercises, compared to those in the control group. Furthermore, a similar improvement was also noted in comparing the results of the study group, before and after treatment. Such an improvement included reduction of blood glucose and body weight. So, it should be stressed that utilization of aerobic exercises in combination with insulin therapy and diet control is effective in treating juvenile diabetes