Studies on diarrhea in equine associated with Clostridiun difficile and Clostridium perfringens infection

Clostridium difficile and Clostridium perfingens play a significant role in diarrhea affecting equini. This study was designed to determine the role of Clostridium difficile and Clostridium perfingens in equine diarhhea, 380 animals were examined clicically, where 65 were suffering from diarrhea. Fecal samples were collected from diarrheic animals, and 10 samples from apparently healthy animals. Clostridium difficile and Clostridium perfingens were isolated from 19 and 11 samples respectively, while the two bacteria were isolated from 5 samples simultaneously. Moreover 4 samples from apparent clinical healthy animals had Clostridium difficile infection, indicating the high prevelance of these organisms in equine. Toxins of Clostridium difficile wasn't detected in diarrheic samples or culture of Clostridium isolates by ELISA and PCR-technique, while alpha and beta2 toxins of clostridium perfingens were detected in culture of clostridium

Species identification and antifungal susceptibility profile of candida isolates from ICU patients in Sohag University hospital, Upper Egypt

Background: Candida species are among the most common fungal pathogens in ICU patients. Candida albicans was the predominant species, but a shift toward non-albicans Candida species has been recently observed

Objectives: To detect the prevalence of different Candida species and determine their antifungal susceptibility profile in ICU patients using phenotypic methods, the Vitek 2 system compared with CHROMagar Candida agar and a genotypic method; PCR-RFLP

Methodology: Various clinical samples were collected from 248 ICU patients in Sohag University Hospital from the period between September 2014 and May 2015. Samples were cultured on CHROMagar Candida agar. Results were compared with those of Vitek 2 system and confirmed by PCR- RFLP method and antifungal susceptibility profiles were analyzed by disc diffusion and Vitek 2 antifungal susceptibility tests

Results: The study revealed an overall isolation rate of Candida species among ICU patients was 29% by PCR-RFLP. Candida albicans was the most frequent species isolated [40.3%]. Non- albicans Candida species including Candida tropicalis [22.2%], Candida glabrata [18%], Candida krusei [12.5%], C. parapsilosis [4.2%], C. dubliniensis [1.4%] and Candida guilliermondii [1.4%] were also isolated. The sensitivity of vitek 2 with regard to correct identification of Candida species was 96%; the specificity was 100%, also CHROMagar Candida agar enable the correct identification with sensitivity 89%, specificity 100%. Vitek 2 antifungal susceptibility tests results were found to be an accurate method as it was compared with the disc diffusion method for fluconazole, voriconazole and amphotracin B

Conclusion: CHROMagar Candida agar supported by Vitek 2 system is a valuable method for identification of common Candida species, these methods are easy to interpret and give rapid results in comparison with the expensive PCR-RFLP method. Although amphotericin B and fluconazole are widely used in clinical practice, there was no evidence of enhanced resistance. Moreover, voriconazole could be used in treatment of fluconazole-resistant Candida species

Trauma research in Qatar: a literature review and discussion of progress after establishment of a trauma research centre

A structured research programme is one of the main pillars of a trauma care system. Despite the high rate of injury-related mortalities, especially road traffic accidents, in Qatar, little consideration has been given to research in trauma. This review aimed to analyse research publications on the subject of trauma published from Qatar and to discuss the progress of clinical research in Qatar and the Gulf Cooperation Council countries with special emphasis on trauma research. A literature search using PubMed and Google Scholar search engines located 757 English-language articles within the fields of internal medicine, surgery and trauma originating from Qatar between the years 1993 and 2013. A steep increase in the number of trauma publications since 2010 could be linked to the setting up of a trauma research centre in Qatar in 2011. We believe that establishing a research unit has made a major impact on research productivity, which ultimately benefits health care.

Screening for urine abnormalities among preschool children in western Saudi Arabia

To estimate the frequency of urinary problems among preschool children. In this cross-sectional study, 1000 preschool asymptomatic children attending the outpatient clinics of the Children's Hospital, Taif, Kingdom of Saudi Arabia between August 2013 and December 2013 were subjected to dipstick urine analysis. Microscopic examination was performed for the abnormal dipstick samples, and children with hematuria were investigated for kidney function. Dipstick urine analysis revealed abnormal findings in 25.1% of the screened children. The most common dipstick abnormalities were positive nitrite test in 18.1%, hematuria in 16.9%, and positive leukocyte esterase test in 14.3% of the cases. The most common abnormality in microscopic urine examination was crystals in 13% of the cases. Pyuria were evident in 5% of cases and hematuria in 2.5%. The most common bacteria in positive urine culture samples was Escherichia coli in 62.6%.In view of these important findings, dipstick screening should be implemented in preschool children.

Teaching of major communicable diseases in Sudanese medical schools: a critical look

This descriptive, cross-sectional study of Sudanese medical schools aimed to describe and analyse the proportion of their curricula currently allocated for teaching of communicable diseases and to assess the teaching methods and student assessment tools. Qualitative and quantitative data were collected from heads of departments and students in 20 of the 27 medical faculties and from ministry of health staff at federal and state levels. Curriculum designs ranged from traditional to innovative, community-oriented programmes. Problems regarding student evaluations were identified. Major limitations included shortages of staff, reference materials and teaching aids. Poor knowledge of students about different aspects of diseases endemic in Sudan was found. Recommendations include curriculum development, staff recruitment and training, and improvement of teaching and training of students

Pattern and diagnosis of congenital heart disease in patients attending Ahmed Gasim Cardiac Centre

To study the pattern of Congenital Heart Diseases [CHD] in children referred to Ahmed Gasim Cardiac Center] in Khartoum. This is a prospective cross-sectional, clinic based study conducted over a six months period. The children were referred to the Cardiac Centre because of suspected heart problems. Cases of congenital heart disease were identified via history taking, clinical examination and echocardiography. Of the 180 patients suspected to have heart problems were seen in the centre, 37of them were excluded because they either had acquired heart disease [n=20] or innocent murmur [n=17]. Out of the 143 remaining patients, ventricular septal defect [VSD], was found to be the commonest [n = 49 [34.3%]] CHD, followed by tetrology of Fallot [TOF] [n = 19 [13.3%]]. The male to female sex ratio was 1.2:1.0. Males were predominant in VSD, multiple lesions, TOF and Coarctation of Aorta [COA]. Females were predominant in ASD, PS, PDA, Complete Atrio Ventricular Septal Defect [CAVSD] and Transposition of the Great Arteries [TGA] but there was equal sex distribution in Single Ventricle, Primary Pulmonary Hypertension [PPHTN] and Total Anomalous of Pulmonary Venous Return TAPVR. Down syndrome is the most common extra-cardiac anomaly associated with CHD [n =23[16.1%]] of the study group. The frequency of CHD reported in this study is in consistent with other studies done in Sudan and other part of the world. Although congenital heart diseases are diagnosed in the neonatal period, but a significant number of CHD [83.3%] presented throughout infancy and childhood. The association of CHD and extra-cardiac anomalies is found in a significant number [22.4%] of patients in this study. Echocardiography proved to be important for confirmation of CHD in this study. Early referral of suspected cases of congenital cardiac anomalies is mandatory for better management till establishment of cardiac centers at different regions of the country

Hypocalcemic tetany, growth failure, primary amenorrhea and iron deficiency in an adolescent girl

A 15-year-old pale and wasted prepubertal Yemeni girl presented with carpo-pedal spasms of the limbs and drowsiness after severe bilateral thigh pain and weakness for a few days. She denied any trauma or taking medications but complained of recurrent abdominal pains and distension with occasional diarrhea. Her height=119 cm and weight=19.5 kg, BMI=13.7. Her quadriceps were contracted bilaterally and there was exquisite pain on palpation of both thighs. Deep-tendon reflexes were brisk all over and Chvostek sign was positive. Abdomen appeared distended with no organomegaly. Tests showed hypocalcemia, hypophosphatemia, hypomagnesemia, high PTH and low vitamin D 25-hydroxy level, hypoalbuminemia, low B12 and low RBC folate, normal ESR with normal renal and hepatic functions. Tissue transglutaminase antibody was positive but stools negative for fat. Upper gut endoscopy revealed total villus atrophy. Bone age was nine years with osteomalacia. She was diagnosed with celiac disease plus multivitamin deficiency and was treated with vitamin D3 [600, 000 U] IM, calcium carbonate, B12 100 mcg IM, multivitamins, and Fe-sulfate. She was put on a gluten-free diet with increased calcium intake. Two months later, her weight had increased by 5 kg, height by 4 cm and her appetite improved markedly with disappearance of all abdominal symptoms and cramps. Adolescents with delayed puberty and short stature must be screened for celiac disease

role of medical students in patient education to promote home management of diabetes mellitus in Wad Medani town, Sudan 2003

Faculty of Medicine University of Gezira, utilized a community based educational strategy. In the module primary health care centre practice and family medicine [PHCCP and FM], each student is assigned a family for whom priority health problems are identified and education given accordingly. To provide, through medical students, health education to diabetics in the assigned families and to assess the impact of the students' intervention. This is longitudinal interventional study which was conducted in three stages: training of medical students, education to diabetic patients and evaluation of the intervention. There was a highly significant difference in the students' knowledge and skills including communication skills on the home management of diabetes mellitus. Diabetics in the families were 80 [3.3%], 42 [52.5%] females, 38 [47.5%] males. Their ages ranged between 22-78 years. Illiteracy rate was 9 [11.2%], most of the families' incomes ranged from low to middle, only 25% were of the high income bracket. More than half 47 [58.7%] of the diabetics reported complications of diabetes. Eye complications 6 [7.5%], peripheral neuropathy 15 [18.7%], foot sepsis 4 [4.5%], urinary tract infection 11 [13.7%], renal failure 2 [2.5%], others 9 [11.2%]. There was a highly significant improvement in the knowledge, attitudes and practices of the diabetics, as a result of the student intervention. These included compliance to treatment, adherence to diabetic diet, regular care of the feet, knowledge of major diabetic complications, knowledge of signs of hypoglycaemia, and home management of hypoglycemia. Ten cases with serious complications were referred to Wad Medani teaching hospital