Prevalence of skin diseases among students with disabilities in Mansoura, Egypt

Children with disabilities may be particularly susceptible to skin disorders, therefore the aim of this study was to estimate the prevalence of skin disease among such children in Mansoura, Egypt. A total of 636 students with disabilities [76 blind, 446 deaf-mute and 114 mentally retarded] and 720 sex and age matched students [control] who did not have these disabilities were given a thorough dermatological examination. We found 89.5% of blind students, 99.3% of deaf students and 100% of mentally retarded students had 1 or more skin diseases [both infectious and non-infectious] in comparison to 24.2% of the control group. Strict hygienic measures, periodic skin examination and health education of persons caring for students with disabilities are recommended

Assessment of severity and outcome of head injuries using a new serum marker [S-100 B protein]

Head injury is recognized as a major public health problem that is a frequent cause of death and disability in young people and makes a considerable demands on health services. The aim of the present study was to assess the severity and outcome of patients with head injuries using a new serum marker which is the level of S-100 B protein, in addition to the use of Glasgow Coma Scale [GCS], brain computed tomography [CT] findings and the Glasgow Outcome Scale [GOS]. The study was conducted on fifty patients with head injury [moderate and severe] who were admitted to the Critical Care Medicine Department [CCMD] at Alexandria Main University Hospital [AMUH] during the period from 1[st] March till the end of June 2004. Ten healthy adult individuals of both sexes were chosen and matched with patients of the present study as regards age and sex. They served as a control group when measuring S-100 B protein level. All patients were subjected to complete history taking with emphasis on causes of head injury, and clinical examination especially neurological examination using Glasgow Coma Scale [GCS]. Serum level of S-100 B protein was measured within six hours from the onset of head trauma, using ELISA technique. Radiological assessment included X-ray skull and computed tomography [CT] of the brain. The outcome of the patients was determined using the Glasgow Outcome Scale [GOS]. The present study revealed that the age of patients with head injuries ranged from 15-60 years with a mean age of 33.7+14.2 years. Male to female sex ratio was 5.25: 1. Road traffic accidents [RTAs] constituted the main cause of head injury [74.0%]. More than half the patients [58%] had open head injuries, while 42.0% had closed head injuries. Severe head injury [GCS=3-8] was encountered in 84.0% of patients, while moderate head injury [GCS=9-12] was evident in 16.0%. More than one quarter of the patients [26.0%] had skull fractures. Brain lesions demonstrated by CT scan was found in 86.0% of the patients while normal CT brain was reported in 14.0%. In patients with head injuries, S-100B protein level ranged from 0.7 to 4.5 mirco g/L with a mean level 1.8 +/- 1.5 mirco g/L, which was significantly higher than the mean serum level of the control group [0.1 +/- 0.02 mirco g/L]. A significant rise of serum S-100B protein level was related to severe head injuries assessed by GCS, posttraumatic amnesia [PTA] more than one week, absence of spontaneous ventilation, abnormal brain findings demonstrated by C T scan, and associated injuries especially thoracic trauma. More than half the patients showed poor outcome by GOS [60.0%], while those with good outcome [good recovery. and moderate disability] accounted for 40.0%. Serum S-100B protein level was significantly higher in patients with poor outcome than in those with good outcome using GOS. The study concluded that the admission level of S-100B protein is a useful early predictive marker in determination of the outcome [disability and mortality] after head injury

Neutrophil chemotaxis and killing function in patients with recurrent furunculosis

Furuncle is an acute, usually necrotic, infection of a hair follicle with Staph. aureus. Chemotaxis in one of the initial host responses to staphylococcal invasion. Disorders of PMNs motility are rare but when present are associated with recurrent infections. In the present study, PMNs chemotaxis and killing function were assessed in 40 patients with recurrent furunculosis and 10 controls. This study revealed that, the chemotactic response of PMNs to zymosan activated serum was significantly higher in patients with active furunculosis than controls. However, there was no significant statistical difference between neutrophil killing function of patients and controls. Therefore, it was concluded that there is no basic cellular defect of the neutrophil in the studied patients

Minimally invasive treatment of menorrhagia

Eighty women with menorrhagia were recruited in this study. All patients had been treated unsuccessfully with medical therapy. Vaginal ultrasonography and endometrial sampling via endometrial Pipelle, as an outpatient procedure, were carried out to exclude local pathology. Half of the patients have had a preoperative danazole while the other half did not. After proper counselling, transcervical endometrial resection [TRCE] was carried out under general anesthesia. Total resection was done in 72 patients [90%] while 6 patients [7.5%] had partial resection depending on patients wishes. The procedure failed in 2 patients [2.5%] due to perforation, both of whom were needed laparotomy and hysterectomy. The average fluid balance was 560 ml and operating time was 54.2 minutes. Excessive intraoperative bleeding requiring tamponade with a Foley's catheter for 6 hours occurred in 2 patients [2.5%]. The average postoperative hospital stay was 0.8 day. The average duration of postoperative bleeding and discharge were 10.7 and 10.1 days, respectively. Follow-up results at 6 months showed that total resection has resulted in amenorrhea in 63.9%, overall menstrual improvement in 27.8% and no improvement in 8.3% of patients. Partial resection has resulted in amenorrhea in 33.3% and overall menstrual improvement in 66.7% of patients. In conclusion, TRCE is an advance in the management of menorrhagia. The technique produces a very high rate of amenorrhea with a low complication rate but adequate training is required. Postoperative morbidity, length of hospital stay, time taken for return to work and normal daily activities are obvious advantages of TRCE over hysterectomy

Percutaneous radiofrequency facet denervation for low back pain- percutaneous neurectomy

Attempted denervation of the facet joint with radio- frequency coagulation technique has been proposed as a method for treatment of pain of spinal origin. Twenty patients were treated by such a procedure. 80% achieved satisfactory relief. Patients were followed up for three months

Computed tomography as a possible aid in diagnosis and grading of intracranial glimos

In this study, 49 cases of intracranial gliomas were studied by CT scans in an attempt to find out the difference in CT appearance of the various subtypes. The criteria considered in each CT picture were site,attenuationvalue, regularity and margin, calcification, character of enhancement, perifocal edema and mass effect.The predictive value of CT scan for preoperative correct diagnosis of glioma was 75.5% of cases. It was not always possible to put forward the exact pathological subtype of glioma in question, however it is feasible to recognize high and low grade malignancy of the tumor from its CT appearance

Surgical aspects in spontaneous cerebral haemorrhage

Twenty-two patients were admitted to Riyadh Central Hospital with the clinical diagnosis of cerebrovascular accident [CVA]. All cases were presented to the hospital with disturbed conscious level. CT scanning was performed to all of them and the results were very helpful in their management. Surgery was performed for 54.5% of the cases with very good results. Clinical and operative data were documented. The beneficial line of treatment and the indications of surgery were discussed