Molecular characterization of Cryptosporidium isolates from humans by nested polymerase chain reaction – restriction fragment length polymorphism (nPCR-RFLP) analysis in Egypt

@#Cryptosporidium species is a group of protozoan parasites recognized as a cause of diarrhea with significant morbidity and mortality in industrialized and developing countries. Cryptosporidium hominis and Cryptosporidium parvum seem to be the most common causes of human cryptosporiodosis, however, other species are also found. Hence, the present study aimed to determine Cryptosporidium spp. infecting humans by nested PCR-RFLP targeting 18 sRNA gene in Minia Governorate, Egypt. A total of 300 diarrheic stool samples have been collected from inpatient and outpatient clinics of University Hospitals and Tropical Hospital, Minia Governorate, Egypt. One hundred twelve positive samples for Cryptosporidium infection (37.3%) were detected by nPCR while, 60 positive samples (20%) were detected by routine microscopy (p-value < 0.0004). The one hundred twelve positive samples detected by nested PCR were processed to RFLP. The RFLP yielded a typical restriction patterns for C. hominis in 73 (65.2%) cases, C. parvum in 25 (22.3%) cases, and C. meleagridis in 14 (12.5%) cases. C. hominis was more prevalent among cases of urban areas with negative history of animal contact in comparison to cases of rural areas (95.5% vs. 21.7%; p-value < 0.001). Moreover, there was a statistically significant association between C. hominis infection and drinking tap water. C. parvum was more prevalent among cases of rural areas than among those of urban areas (47.8% vs. 4.5%; p-value < 0.001) While C. meleagridis was only present among cases live in rural areas (30.4%; p-value < 0.001).

Chikungunya outbreak in Al-Hudaydah, Yemen, 2011: epidemiological characterization and key lessons learned for early detection and control

Little is known about the occurrence of chikungunya fever in the Eastern Mediterranean Region of the World Health Organization [WHO]. In January 2011, the Ministry of Public Health and Population [MoPH and P] of Yemen reported to WHO an increasing number of "dengue-like" acute febrile illnesses of unknown origin from one of its coastal governorates. An epidemiological investigation was conducted in Al-Hudaydah governorate between 23 and 26 January 2011 by a joint team of WHO, the MoPH and P of Yemen and the U.S. Naval Medical Research Unit [NAMRU-3] in Cairo, Egypt. The investigation led to the detection of an outbreak of chikungunya in Yemen which was the first time ever from any of the 22 countries in the Eastern Mediterranean Region of WHO. Appropriate public health control measures were strengthened following the investigation, and the outbreak was contained. This paper provides a short description of the outbreak and its epidemiological characteristics and highlights the important lessons that were learned for early detection and control of chikungunya in countries where competent vectors for transmission of the virus exist

Arsenic and Cadmium in Food-chain in Bangladesh—An Exploratory Study.

Arsenic contamination of tubewell water is a major public-health problem in Bangladesh. In the recent years, the use of shallow and deep tubewell water for irrigation and the use of excess amount of cheap fertilizers and pesticides containing cadmium pose a serious threat of contamination of arsenic and cadmium in food. In an exploratory study, arsenic and cadmium were measured in foods from Matlab, a rural area in Bangladesh, that is extensively affected by arsenic and the economy is agriculture-based. Raw and cooked food samples were collected from village homes (households, n=13) and analyzed to quantify concentrations of arsenic and cadmium using atomic absorption spectrophotometry. Washing rice with water before cooking reduced the concentration of arsenic in raw rice by 13-15%. Rice, when cooked with excess water discarded, showed a significant decrease in arsenic concentration compared to that cooked without discarding the water (p<0.001). In contrast, concentration of cadmium did not decrease in cooked rice after discarding water. Cooked rice with discarded water had significantly lower concentration of arsenic compared to raw rice (p=0.002). Raw rice had higher concentration of arsenic compared to raw vegetables (p<0.001); however, no such difference was found for cadmium. Compared to raw vegetables (e.g. arum), concentration of arsenic increased significantly (p=0.024) when cooked with arsenic-contaminated water. Thus, the practice of discarding excess water while cooking rice reduces the concentration of arsenic but not of cadmium in cooked rice. However, water generally not discarded when cooking vegetables to avoid loss of micronutrients consequently retains arsenic. The results suggest that arsenic and cadmium have entered the food-chain of Bangladesh, and the cooking practices influence the concentration of arsenic but not of cadmium in cooked food.

Prevalence of somatisation and psychologisation among patients visiting primary health care centres in the state of Qatar

Medically unexplained somatic complaints are among the most common clinical presentations in primary care in developing countries and they are considerable burden for patients and health care system. The aim of this study was to determine the prevalence of somatisation in comparison to psychologisation among a sample of Qatari patients who were visiting primary health care [PHC] centres and to investigate the clinical and socio-demographic characteristics of somatisers [STs] and psychologisers [PGs]. Method: The survey was conducted among PHC Qatari patients during the period from January to July 2007. About 2,320 patients were approached, of whom 1,689 agreed to participate and responded to the questionnaire. Among the studied Qatari patients, 404 patients were identified for clinical interview. The first stage of the study was conducted with the help of general practitioners, using the 12-item General Health Questionnaire. The second stage was carried out by a consultant using the Clinical Interview Schedule. A specific operational criterion was used to identify STs and PGs. The prevalence rate of STs among the total studied sample was 12.4%, while the PGs were 11.5%. Among the identified psychiatric cases, the proportion of STs [52%] was higher than PGs [48%]. Most of the diagnostic categories were more prevalent among PGs. The dissatisfaction at work and stressful life events within 12 months before the onset of the presenting symptoms were the three postulated determinants which were significantly more among STs than PGs. The prevalence of somatised mental disorder was little higher than the psychologised mental disorder. The prevalence of somatisation and psychologisation is comparable with other reported studies from the Middle-East and Western countries. Dissatisfaction at work and stressful life events were significantly higher among STs than PGs

Nocturnal attacks, emergency room visits and ICU admission of pediatric asthma: frequency and associated factors

Asthma is the most frequent cause of chronic illness in childhood and emergency department visits. This study aims to determine the frequency of emergency room [ER] visits, intensive care unit [ICU] admission, and nocturnal attacks among asthmatic children and to identify associated factors. Records of asthmatic children in the pediatric chest clinic, Ain Shams University during 1995-2004 were reviewed. Asthmatic children with documents of ER visits, ICU admission, or nocturnal attacks were compared with asthmatic children without previously mentioned events. Out of 691 asthmatic patients, 302 [43.7%] had nocturnal attacks, 258 [37.3%] had emergency room visits, 39 [5.6%] were admitted to ICU, and 249 [36%] had no reports of previous events. ER visits and nocturnal attacks were more in children above 4 years. ER visits and ICU admission were higher among those with positive family history of asthma [p< 0.01], those exposed to environmental tobacco smoke [ETS] [p< 0.01], and those who had previous respiratory infections [p< 0.05]. Attacks of nocturnal asthma were associated with the previous factors in addition to animal contact [p<0. 01] and living in bad housing conditions [p<0.05]. Logistic regression showed that family history [OR= 2.87, CI= 1.9-4.1] and bad housing conditions [OR= 2.65, CI= 1.3-5.3] were the significant factors for ER visits, while respiratory infections [OR= 5.24, CI= 2.1-12.0] and family history [OR= 3.48 CI, 1.3-9.2] were the significant factors for ICU admission. For nocturnal attacks, all factors were significant. Control of respiratory infections, limitation of ETS exposure and good housing conditions are needed to limit severe asthmatic attacks

Scalp burns: evaluation of electrical versus thermal scalp injury

Scalp bums present as functional and aesthetic problems. The line of management depends mainly on the depth of burn wound and the presence or absence of underlying bone involvement. We demonstrate the differences between thermal and electrical scalp injuries regarding depth and management. Records of all burned patients admitted to Hilla General Teaching Hospital between April 2004 and June 2006 were reviewed. Ten patients with electrical scalp injuries were identified and compared with twenty patients with thermal scalp burn. The incidence of calvarial bone involvement was 100% in electrical scalp injured patients while all patients with thermal scalp burn were partial thickness [bone free] during the study period. The mean age was eighteen years for the electrically injured patients [ranged from 14 to 30 years] and four years for the thermally burned patients [ranged from 2 to 8 years].Treatment was achieved with early bone debridement and immediate local scalp flaps coverage for electrical scalp injured patients while most of thermal scalp burned patients were healed spontaneously. Debridement of the electrically injured scalp with flap coverage is advisable to be performed with in 3[rd] to 5[th] day after the injury rather than waiting for the settlement of the progressive necrosis, the known unique effect of electrical current