Deciphering emerging Zika and dengue viral epidemics: Implications for global maternal-child health burden

Since its discovery in 1947 in Uganda and control and eradication efforts have aimed at its vectors [Aedes mosquitoes] in Latin America in the 1950s, an absolute neglect of Zika programs and interventions has been documented in Aedes endemic and epidemic-prone countries. The current unprecedented Zika viral epidemics and rapid spread in the Western hemisphere pose a substantial global threat, with associated anxiety and consequences. The lack of safe and effective drugs and vaccines against Zika or dengue epidemics further buttresses the realization from the West Africa Ebola outbreak that most emerging disease-prone countries are still poorly prepared for an emergency response. This paper examines knowledge gaps in both emerging and neglected arthropod-borne flavivirus infectious diseases associated with poverty and their implications for fostering local, national and regional emerging disease preparedness, effective and robust surveillance-response systems, sustained control and eventual elimination. Strengthening the regional and Global Health Flavivirus Surveillance-Response Network [GHFV-SRN] with other models of socio-economic, climatic, environmental and ecological mitigation and adaptation strategies will be necessary to improve evidence-based national and global maternal-child health agenda and action plans

mosquito borne west nile virus infection: is it threating to Egypt or a neglected endemic disease?

West Nile virus [WNV] is a mosquito-borne zoonotic arbovirus belonging to the genus Flavivirus in the family Flaviviridae. The virus is found in temperate and tropical regions worldwide, but first identified in the West Nile sub-region in the East African nation of Uganda in 1937. Prior to the mid-1990s WNV infection was sporadically and considered a minor risk for humans, until an outbreak in Algeria in 1994, with cases of WNV-caused encephalitis, and the first large outbreak in Romania in 1996, with a high number of cases with neuroinvasive disease. WNV has now spread globally to Europe beyond the Mediterranean Basin and the United States, is now considered to be an endemic pathogen in worldwide especially in Africa. The WNV transmission is mainly by various mosquitoes species, also ticks were incriminated. The birds especially passerines are the most commonly infected animal and serving as the prime reservoir host In Egypt more than 110 mosquito species and subspecies and more than 32 genera of ticks were identified. Besides, not less than 150 species of migratory birds visit Egypt annually in addition to 350 resident ones. This review provided an overview of the current understanding flaviviruses mainly WNFV. Primary care physician and senior nurse should be able to include the disaster diseases in differential diagnosis of various clinical conditions. They should take a thorough history to request specific dependable laboratory test[s] as soon as possible, and positive patient should be transferred to the fever hospital

Potency and persistence of the bacterial mosquitocide bacillus sphaericus against culicine mosquitoes under field conditions

The biopesticide Bacillus sphaericus represents one of the important tools used in the control of mosquito larvae after chemical insecticides. The present study was conducted to investigate the efficacy B. sphaericus 2362 [VectoLex] in two different technical powders, ABG-6232 and ABG-6491 against larvae of two mosquitoes, Culex pipiens and Aedes caspius in El-Arish city, North Sinai, Egypt. The mosquito larvae were collected from polluted and fresh water [Cx. Pipiens] and saline water [Ae. Caspius]. The physicochemical characteristics of larval breeding water sites were measured as salinity, conductivity, pH values and temperature. Susceptibility bioassays showed that Cx. pipiens larvae from polluted water sites have high susceptibility to B. sphaericus 2362 formulation ABG-6232 [LC[50] 0.15-0.33 ppm, LC[90]: 0.73-9.68 ppm]. In case of ABG-6491 formulation, the values were LC[50]: 0.15-0.33 ppm and LC[90]: 1.73-9.83 ppm. Cx. pipiens larvae collected from fresh water habitat in El-Qusiema, outside El-Arish city, susceptibility to B. sphaericus 2362 ABG-6232 had LC[50] values ranging between 0.12 and 0.28 ppm, while LC[90] ranged between 1.59 and 4.13 ppm. In case of ABG-6491, the LC[50] values ranged between 0.13 and 0.28 ppm, while LC[90] values ranged between 1.46 and 8.93 ppm. For Ae. caspius larvae from saline water and treated with B. sphaericus 2362 ABG-6232, LC[50] values ranged between 0.31 and 1.36 ppm, while LC[90] ranged between 1.92 and 9.75 ppm. In case of ABG- 6491, the LC[5o] values ranged between 0.34 and 0.59 ppm, while LC[90] values ranged between 1.79 and 11.56 ppm

biological effects of the insect growth regulators; pyriproxyfen and diflubenzuron on the mosquito Aedes aegypti

The biological effects of two insect growth regulators [IGRs], pyriproxyfen and diflubenzuron against larvae of the mosquito Aedes aegypti [L.] have been evaluated. Mosquitoes were collected from Jeddah governorate, west of the Kingdom of Saudi Arabia and maintained in the laboratory. According to IC[50] values obtained [concentrations which inhibit the emergence of 50% of adults], diflubenzuron [0.00036 ppm] proved to be more effective by 11.4 fold of pyriproxyfen [0.0041ppm]. In addition to the delayed lethal action, larval treatment with the two IGRs, pyriproxyfen and diflubenzuron led to pronounced reduction in the reproductive potential of mosquito adults that emerged from these treatments. Pyriproxyfen caused a 33.2% decrease in egg production compared to 25.5% for diflubenzuron. The reduction in egg hatchability was by 40.6 and 36.2 % for pyriproxyfen and diflubenzuron, respectively, with up to 4 fold higher reduction rates than in the control tests. These results shed light on the extended biological effects of IGRs on mosquitoes and encourage further testing of IGRs for wider use in the control of Ae. aegypti and other important disease vectors in Arabia and the world

Potential of medicinal plants in mosquito control

Medicinal plants have long history as important components in traditional medicine, and food of humans since ancient Egyptians and Chinese. Naturally occurring botanical compounds contain a broad range of chemical active ingredients can intervene in all biological processes of the mosquito, thus interrupt its life cycle and dispersal and reduce harms to humans and animals. Many medicinal plants were tested for their pesticide and repellent potential, as crude material, essential oils or individual active ingredients. This article reviewed studies on the efficacy of many well known and commonly used safe medicinal plants or their products in controlling the mosquitoes; Aedes aegypti, Anopheles gambiae, An. stephensi and Culex quinquefasciatus and the ticks, Dermacentor variabilis, Amblyomma americanum, Ixodes scapularis and I. ricinus. Promising and encouraging results were obtained against these arthropod-vectors of zoonotic diseases

comparative study on some immunodiagnostic techniques currently used for the diagnosis of lymphatic filariasis in Egypt

Since 2002, the Egyptian Ministry of Health and Population in collaboration with the WHO implemented a lymphatic filariasis elimination campaign in Egypt. Yet, surveillance and follow-up measures detected asymptomatic microfilaraemic cases among the at risk population. The present work aimed to evaluate and compare tile diagnostic value of filarial immunoassays currently used in clinical as well as research institutions in Egypt regarding their sensitivity, specificity and reliability. Accordingly, Dirofilaria immitis adult crude antigen was evaluated as a capture molecule for anti-human filarial antibodies in serum of patients with occult as well as overt infections. A comparative study was done on a total of 82 subjects. Serum samples from all subjects were tested for the presence of anti-fliarial antibodies, utilizing reagents currently used for the diagnosis of lymphatic filariasis in Egypt. Tile commercially available Dirofilaria immitis adult crude antigen was used to detect serum IgG by indirect ELISA, lgG4 ELISA, Dot-ELISA and dipstick ELISA techniques. Among 18 microfilaraemic cases, indirect ELISA, IgG4 ELISA, Dot-ELISA and dipstick ELISA techniques were positive in 61.1%, 100%. 77.8% and 77, respectively. Corresponding figures among 20 symptomatic amicrofilaraemic cases were 95%, 0%. 85% and 80% with 75%, 95.5%, 88.6% and 88.6% specificity, respectively. Although IgG4 ELISA was more sensitive and specific in detection of microfilaraemic asymptomatic group than other ELISA techniques, Dot ELISA was found to be relatively more sensitive than other techniques among all groups of patients examined. The use of Dirofilaria immitis adult worm crude antigen in ELISA tests revealed an acceptable degree of sensitivity and specificity, in addition to its commercial availability. It is a reliable reagent with high immunodiagnostic potential

Histological and histochemical study of testicular tissue used in cases of [ICSI] [intra cytoplasmic sperm injection]

The advances in the technology of in vitro fertilization [IVF] increases the incidence of success in treatment cases of infertile patients with non-obstructive azoospermia. Evaluation of the microscopic changes in the obtained testicular samples was one of the main aims in this study for better prognosis of the results. In this study one hundred human testicular biopsies were obtained from Islamic reproductive centre and Department of Urology Al-Hussein University Hospital. Cases in this study were classified into 4 groups: Group I includes 5 cases of normal fertile persons free of any medical problems and with normal seminal parameters. Patients consent was performed before sampling. Group II includes 35 cases of infertile obstructive azoospermic patients. All of the rest of cases [60] were considered infertile non-obstructive azoospermic cases and were included in both the third and the fourth groups. Group III: includes 20 cases of infertile non-obstructive positive patients. Group IV: includes 40 cases of infertile non-obstructive negative patients. Cases were either of normal sized testis or of hypoplastic testis and were subdivided into the following subgroups: I- Cases with normal sized testes [30] infertile patients: Group IV A: Normal sized testis with arrested spermatogenesis; Group IV B: Normal sized testis with SCOS; Group IVC: Normal sized testis with mixed atrophy. II- Cases with hypoplastic testes [10] infertile patients: Group IV D: Hypoplastic testis. The testicular samples were prepared for Histological and Histochemical examination. Different staining techniques were used: 1- Haematoxylin and Eosin stain; 2- Mallory's trichrome stain; and 3- Histochemical techniques: a- Periodic acid Schiff [PAS] technique. B- Methyl green pyronin. The obtained results showed no Morphological changes in group II except mild vascular dilation and congested peritubular capillaries. Cases of non-obstructive positive azoospermia showed reduced number of spermatogenic layers while cases of group IVa showed reduced size of the tubules and lined only by Sertoli cells and there was marked reduction in the number of leydig cells. In this study there were definite histochemical changes observed in both the PAS positive material and the nucleic acid in the different elements of the obtained testicular samples, Clinical and microscopic evaluations in this study could be of complementary importance and may increases of the incidence of success

Detecting depression among open cardiac surgery patients: pre and postoperative evaluation of changes

Objectives: this study aimed at evaluation of changes in the pre- and post-operative depression by simple method among open cardiac surgery patients that may help in further psychiatric intervention to improve outcomes

Methods: it included eighty four patients of those that subjected to open cardiac surgery over one year period. They were evaluated prior to the surgery, at the tenth postoperative day and at three to four months later. Assessments were done using the WHO [Ten] Well-Being Questionnaire, the Major Depression Rating Scale [ICD-10 version], the PCASEE Quality of Life Scale, and the New York Heart Association Functional Classification [NYHA]

Results: high concordance rate in diagnosing de in pression was found in this study between the surgeon and the psychiatrist. More than one third [36%] of patients who subjected to open cardiac surgery had preoperative depression. At the follow up; there were increased levels of depression more than the preoperative stage. Low scores of the quality of life were related in the post-operative stages to the depression in spite of the marked improvement the functional disability

Conclusion: there are decrements in both the quality of life and depressive scores in open cardiac surgery patients even after surgical interference independent of the improvement in the physical functional disabilities that needs further psychiatric intervention to mini mize the further physical consequences of depression

Opportunistic intestinal parasites among children with chronic liver disease

Two hundred children were included in this study; 80 patients showing clinical and/or biochemical evidence of chronic liver disease, 80 children immunocompromised due to causes other than chronic liver disease and 40 healthy controls. All were subjected to detailed history, thorough clinical examination, investigated by liver function tests and stool examination by special techniques for opportunistic intestinal parasites. Autoimmune chronic hepatitis represented 12.5% of cases with chronic liver disease, 30% of hepatic schistosomiasis, 25% of congenital cholestasis, 20% of chronic viral hepatitis and 12.5% of metabolic liver diseases. The incidence of opportunistic intestinal parasites with chronic liver disease [92.5%] was nearly similar to the immunocompromised patients [90%] and significantly higher than the controls [30%]. Mixed infection was not detected in the controls, while 57.5% of patients with chronic liver disease and 35% of the immunocompromised ones were infected by two parasites and 12.5% of each group was infected by more parasites

Value of transvaginal sonography in the detection of pelvic pathology in Ain Shams university gynecological clinic

This study was done to evaluate the value of adding transvaginal sonography [TVS] as a part of routine pelvic examination, either to replace or to be an adjunct to clinical examination. For this study 30 women recuruited from the Gynecological out - patient clinic and were divided into premenopausal [20] and postmenopausal [10] groups, where all cases subjected to double blind study where results of vaginal examination, TVS and histopathology of D and C biopsy or hysterectomy samples were compared and statistically analyzed. It was found that TVS can detect pelvic pathology much better than clinical examination in both premenopausal women, and it was concluded that although TVS detect pelvic pathology in premenopausal women better than clinical examination, yet histopathological examination in this age group remains the gold standard for diagnosing the pathology

Effect of juvenile hormone and ecdysone on initiating blood meal-dependent vitellogenic ovarian cycles in autogenous and anautogenous culex pipiens [Diptera: culicidae]

The effect of juvenile hormone [JH] and ecdysone on initiating blood meal - stimulated ovarian cycles was studied in autogenous [2[nd] ovarian cycle] and anautogenous [1[st] ovarian cycle] Cx. pipiens. Although vitellogenesis was initiated in both mosquitoes in response to ecdysone, JHI and sequential JHI-ecdysone treatments induced vitellogenesis in anautogenous females only. JHI treatment initiated vitellogenesis in Ca. 30% of anautogenous females and only half of those were able to form mature eggs. Sequential JHI- ecdysone treatment triggered vitellogenesis in 10 out of 25 anautogenous females and mature eggs were formed in three females only. In response to ecdysone, vitellogenesis in 10 out of 18 autogenous females and mature eggs were formed in two individuals. In Ca. 70% of anautogenous siblings vitellogenesis was initiated and in most of those females mature eggs were developed. Our data suggests that differences in hormone - dependent events of vitellogenesis in autogenous and anautogenous Cx. pipiens seem to be related to the regulation of ecdysteroide release

Molecular structure of 15-dipheny1-3-acethlformazan as predicted from spectra and normal coordinate analyses

The 1,5- diphenyl-3- acetylformazan was prepared and characterized by elemental analysis, IR, MS, [1]H NMR and [13]C NMR spectra. The results of IR and NMR spectra indicate the presence of a strong intermolecular hydrogen bond in the formazan molecule. Moreover, the two phenyl rings are equivalent and the ketonic C=Q is not involved in a hydrogen bond. It was concluded that formazan exists predominantly in the syn, s-cis form and not as resonance hybrid. This assumption was further supported by calculating the frequencies normal coordinate analysis and force constant refinement

rmogravimetric studies of lanthanide complexes with some razoxane S dyes

Olid complexes of four derivatives of azoxine S with lanthanide metel ions were prepared and characterized by elemental and thermogavimetric analyses. The proposed formula of these complexes is [ML[2]-OH [H[2]O][n] EtoH] x H[2]o where HL=azoxine S dyes, n=o-3, x= 0-4 and M= trivalent lanthanide ion. TG gave information about the water of hydration, coordination chemistry and thermal stability of these complexes and a general mechanism for their thermal decomposition is suggested. A coordination number of 9 is proposed for the lanthanide metal ions in these complexes, this decreasing to 6 in the heavier lanthanide complexes

Coordinate compounds of trivalent lanthanides with 7-Phenylazo-8-Hydroxy-quinoline-5-Sulphonic acid and its halo derivatives

Trivalent Pr, Nd, Sm, Gd, Ho, Er, Yb and Y form MLn [n= 1-3] complexes in solution with 7-phenylazo-[I], 7[p-chlorophenylazo]-[II], 7 [p- bromophenylazo]-[III] and 7 [p-iodophenylazo]-8-hydroxyquinoline-5- sulphonic acid [IV]. The stability constants of the complexes were determined potentiometrically and correlated to the ionic potential, atomic number, ionization potential and electronegativity of the central metal ion. Solid complexes of [I] with the lanthanide ions have been prepared and their structure is studied by elemental and thermogravimetric analyses, IR spectroscopy and conductance measurements

Predictive value of plasma fibronectin level in pregnant women destined to have preeclampsia

Plasma fibronectin level of 41 normotensive primigravida was measured repeatedly during their antenatal visits, with total 76 samples. Plasma fibronectin of 12 normotensive primigravida who subsequently developed preeclampsia was found to be significantly higher if compared with those who did not develop preeclampsia [P< 0.001]. The results of this study indicate that if an increase of plasma fibronectin more than 400 micro g/ml [used as cut off level], subsequent development of preeclampsia within an average of 3.3 weeks could be predicted with sensitivity of 92.3% and specificity of 96.8%

Chlamydia trachomatis infection with ectopic pregnancy

Thirty patient with tubal ectopic pregnancy were enrolled in the study. An additional thirty fertile women were randomly selected and served as a control group. A peripheral venous blood sample was obtained in the preoperative period and also from the control subjects and examined to detect immunoglobulin G antibodies [IgG] against Chlamydia trachomatis using indirect immunofluorescence technique. Histopathological examination of the fallopian tubes removed during laporotomy was also done. The prevalence rate of Chlamydia IgG antibodies was significantly higher in the group of women with ectopic pregnancy than in the control group. Positive Chlamydial infection was defined as IgG titre of 1: 64 or greater. Nine [30 percent] of the patients had IgG liters equal to or greater than 1:64 while all the controls had IgG titres less than 1: 64 [P<0.05]. Histopathological examination of sections of fallopian tube tissue distant from the site of ectopic implantation revealed odema, congestion, and cellular infiltration in the plicae with adhesions and fusion between them. All the fallopian tubes [30] showed cellular infiltration while only 28 [93.33 percent] plasma cell infiltration could be identified. There was a significant correlation between the degree of plasma cell infiltration and IgG antibody titre against Chlamydia trachomatous [P < 0.05]. The study indicate by antibody titre and histopathological examination that Chlamydia trachomatous infection is considered to be one of the important etiological factor of salpingitis and subsequent ectopic pregnancy. The use of anti chlamydial therapy in ectopic pregnancy with elevated IgG antibodies to reduce the chance of another tubal pregnancy in the future needs further investigation

Predictive value of plasma fibronectin levels in pregnant women destined to have preeclampsia

Plasma fibronection level of 41 normotensive primigravida was measured repeatedly during their antenatal visits, with total 76 samples. Plasma fibronectin of 12 normotensive primigravida who subsequently developed preeclampsia was found to be significantly higher if compared with those who did not develop preeclampsia [P<0.001]. The results of this study indicate that if an increase of plasma fibronectin more than 400 microgram/ml [used as cutoff level], subsequent development of preeclampsia within an average of 3.3 weeks could be predicted with sensitivity of 92.3 percent, and specificity of 96.8 percent

Magnesium load test in pregnancy hypertension

Magnesium load test was performed on twenty hypertensive pregnant subjects [DBP>90 mmHg] in their late trimester and on twenty normotensive pregnant controls, with similar maternal age and gestational age. All subjects were attending antenatal clinic at Shoubra El-Khaema, and half of each group was primigravidae. Hypertensive subjects were heavier than controls. Significantly lower mean basal plasma Mg++ level was observed in hypertensive [11.7-5.4 mg/l] compared to normotensive [16.4-1 0.4mg/l] subjects. The difference was only observed in primigravidae. Moreover, significantly higher basal urinary Mg++ excretion was found in hypertensive [113.6-10.8 mg/l] compared to normotensive subjects [55.1-38 mg/l], which reflects increased intestinal Mg++ absorption and thus increase Mg++ demand in hypertensive subjects. After Mg++ load, Mg++ retention was high ie >20 percent, in both hypertensive and normotensive subjects, with no significant difference between both groups. In conclusion, our study demonstrates lower Mg++ stores in our studied population and lower mean Mg++ plasma level in hypertensive compared to normotensive pregnant subjects

Spectrophotometric determination of cobalt using some schaffer acid azo dyes

Three highly sensitive organic reagents for the Spectrophotometric deter-1 ruination of cobalt are l-nitroso-2-naphthol, 2-nitroso-l-naphthol and nitroso-R-salt. They are specific for cobalt under some conditions. The first two reagents are used in extractive spectrophotometric methods, while the third enables cobalt to be determined in aqueous media. The thiocyanate method, either with or without an extraction step is suitable for the determination of relatively large amount of cobalt. In recent years there has been a remarkable growth in the number of sensitive methods for cobalt determination based on azo compounds e.g. PAN, PAR and some other pyridine azo compounds. Most of the developed methods applied extractive methods to achieve selectivity. Schaffer acid [2-hydroxynaphthalene-6-sulphomc acid] azo dyes were used as Spectrophotometric reagents for copper and tungsten [VI]. The ionization constants of substituted phenyl-azo-schaffer acid were determined spectrophotometrically in aqueous buffer solutions