Serological detection of rotavirus among children with diarrhea in relation to different environmental conditions

Rotaviruses are the single most important etiologic agents of severe diarrhea of infants and young children worldwide. In the present study, serological detection of rotavirus was done using an enzyme linked immunosorbent assay [ELISA], on 247 stool specimens. These were collected from children with acute diarrhea attending the outpatient clinic of Alexandria University Children's Hospital at El-Shatby, from October 2005 to April 2007. Rotavirus was detected in 33.6% of the collected samples; no specific age group or sex predilection was observed. It was presented with a marked seasonal peak during autumn and winter [58.3% and 40.5%, respectively]. Rotavirus was found to be infecting most commonly under-weight children [46.9%] resulting into fluid loss and severe dehydration [80%]. Rotavirus acute gastroenteritis was found to be associated with fever [38.8%], vomiting [39.9%], watery stools, and long duration of diarrheal episodes lasting from one up to six days. The appearance of convulsions among rotavirus-positive cases even in the absence of fever [84.6%] was an important finding. Exclusive formula-fed infants appeared to exhibit the highest disease incidence [50%] while exclusive breast-fed infants had a lower incidence level [35.2%] of the disease. The virus was found to be significantly affecting children living in rural areas of Egypt [43.8%] rather than urban ones [26.1%]. Environmental factors that were shown to affect the disease incidence include: the presence of impurities in water [41.6%], broken pipes [58.1%] and water tanks [58.7%] at the residence place. On the other hand, neither the kind of water source nor the presence of a sewage-disposal network was significantly related to the disease. Therefore the study recommended to screen for rotavirus in children with diarrhea in order to avoid the use of unnecessary medications. In addition, encouragement of breast feeding practices and improvement of environmental conditions are important means of prevention of rotavirus infection

Histological evaluation of local verapamil hydrochloride injection in the prevention of keloid recurrence after excision

Keloids occur as the result of an exaggerated wound healing of skin following various types of injury. In addition to presenting a cosmetic concern, they are extremely difficult to treat. The aim of the present work was to assess histologically the efficacy of verapamil hydrochloride [a calcium channel blocker] local injection on prevention of recurrence of surgically excised keloid. 40 keloid subjects divided into two equal groups: Group I; subjected to only surgical excision of their keloids. Group II; subjected to intradermal verapamil injection for 2 months after surgical excision of keloid. Skin biopsies from the healed wound of both experimental groups were taken after 3 months [subgroups Ib, IIb] and 6 months [subgroups Ib, IIb] postoperatively. Tissue specimens were also collected from the excised keloids. Informed consents were taken from subjects of both groups including all steps of the study. The obtained specimens were further processed for light microscopic study by haematoxylin and eosin [H and E] and trichrome stains. Semithin sections and electron microscopic examination were also done. Examination of the healed skin after keloid surgical excision [group Ia. Ib], showed prominent neutrophils and mast cells. Large spindle- shaped fibroblasts with dilated cisternae of endoplasmic reticulum were frequently encountered among coarse collagen bundles denoting accelerated rate of collagen production. This appearance may point to local histological recurrence of keloid. On the other hand, verapamil- injected skin after keloid excision [verapamil- injected group IIa, IIb] revealed little collagen in the dermal interstitium forming thin dispersed fibrils. Ultrastructuraly, the dermal fibroblasts of this group exhibited oval to rounded outlines and showed few narrow cisternae of endoplasmic reticulum. The verapamil- induced cell rounding is related to the calcium- dependent change in the cytoskeleton of fibroblasts. This appearance is associated with decreased synthesis and secretion of the extracellular matrix. Verapamil injection provided a satisfactory tool for prevention of recurrence of surgically excised keloid