Detection of Helicobacter pylori vacA, cagA and iceA1 virulence genes associated with gastric diseases in Egyptian patients

Background: Helicobactor pylori [H. pylori] virulence markers would be useful to predict peptic ulcer disease [PUD] or gastric cancer

Aim: In Egypt, since inadequate data are present regarding H. pylori virulence-related genes in different age group patients with gastro-duodenal diseases, it becomes crucial to study the clinical status of cagA, vacA and iceA1 genotypes of H. pylori strains recovered from patients with dyspepsia

Subjects and methods: The study included 113 dyspeptic patients who were exposed to upper gastrointestinal endoscopic examination. Four antral biopsies were obtained from each patient for the analysis of H. pylori infection by rapid urease test and detection of 16S rRNA

Results: Sixty [53.1%] patients were confirmed to be infected with H. pylori. Upon endoscopy, gastritis was revealed in 27 patients [45%] and10 patients [16.7%] had PUD. Of the 60 H. pylori strains, 39 [65%] had at least one virulence gene. Six different genotypic forms were recognized; vacA [9/60], iceA1 [1/60], vacA/cagA [7/60], vacA/iceA1 [13/60], vacA/cagA/iceA1 [8/60] only one of cagA/iceA type and we could not detect cagA. The overall vacA, iceA1and cagA genes identified were 61.6%, 38.8%, 26.6% respectively, by PCR-based molecular testing. The vacA gene status was highly significant related to gastritis patient [P ? 0.036]. The vacA s1m1 and s2m2 alleles were significantly found in 50% of H. pylori infected patients with PUD and with gastritis 57.1% respectively [P

Conclusion: In conclusion, the main genotype combinations in the studied Egyptian patients were; vacAs2m2/iceA1, vacAs1m1/cagA, mostly associated with gastritis, and vacAs1/cagA/icA, mainly in PUD. The less virulent [s2, s2m2] H. pylori genotypes were found in patients aged over 43 years

Tarsal tunnel syndrome in patients with rheumatoid arthritis, electrophysiological and ultrasound study

Tarsal tunnel syndrome [TTS] is an entrapment neuropathy of the tibial nerve at the ankle. Rheumatoid arthritis is one of the systemic causes that has been responsible for TTS. In this study thirty feet of patients diagnosed as rheumatoid arthritis with complaints of burning pain or paresthesia on the plantar aspect of the foot and toes with 15 feet of age and sex matched control subjects were included. The aim of this study: To detect TTS among patients with rheumatoid arthritis. All patients included in this study were subjected to history taking, clinical examination [general and local], nerve conduction studies and ultrasonography of both tarsal tunnels. In this study, we detected the presence of TTS in rheumatoid arthritis patients group and none was found in the control group. A total of 28 cases were confirmed as having TTS. In the patients group a strong statistically significant correlations were found between ultrasonographic and electrodiagnostic findings. So it is concluded that TTS is detected in patients suffering from rheumatoid arthritis and that the use of both methods could lead to more reliable confirmed diagnosis which could lead to better management

Sling materials for management of congenital ptosis - a major review

Blepharoptosis affects individuals of all ages, races and genders. It has a significant impact on a patient's functional and psychological status and may cause poor visual development in childhood. Since the Italian anatomist and surgeon Antonio Scarpa's publication of Practical Observations on the Principle and Disease of the Eye in 1806, ptosis surgery has undergone many revolutions as the knowledge of anatomy and physiology progressed and as types of materials expanded. It is essential that a multidisciplinary approach, encompassing pediatric ophthalmology, oculplastics surgeon, and orthoptic department work closely to optimize patient management. Correction of congenital ptosis is one of the most difficult challenges ophthalmologists face. Ptosis surgical correction techniques depend on the degree of ptosis and the levator muscle action. Multiple surgical procedures are available including frontalis sling, levator advancement, Whitnall sling, frontalis muscle flap, and Mullerectomy. In cases with severe levator muscle dysfunction, the choice of surgery is a sling procedure. Materials which have been used for this purpose are widely variable and divided into non synthetic and synthetic. Non synthetic include fascia lata [both autogenous and allogenic], palmaris longus tendon and temporalis fascia, while synthetic include mersilene mesh, silicone rods and sutures [prolene, nylon, silk and Gortex]

Complex regional pain syndromes: clinical characteristics and pathophysiological factors

To study relationship between clinical pattern of complex regional pain syndromes [CRPS] and inflammatory and sympathetic parameters. Twenty one CRPS patients and 15 healthy controls were examined. Clinical data, sympathetic skin response [SSR], TNFalpha and normetanephrine were evaluated. Fourteen patients had increased serum TNFalpha which showed significant relationship with some clinical parameters. Three patients had increased normetanephrine. Mean SSR latency was shortened in patients. No significant relationship between SSR and sweating manifestations and no correlation between serum normetanephrine, SSR, and serum TNFalpha were found. Inflammation plays a major role and SSR is enhanced in CRPS

Hormonal, sonographic, and body composition changes in Egyptian adolescent girls with hyperandrgenie manifestation

This study was conducted to assess the prevalence of hyperandrogenic disorders especially polycystic ovary syndrome [PCOS] in a random sample of adolescent girls in our locality, as well as to identify the clinical; hormonal, ultrasonic, and body composition characteristics associated with such disorders. Two hundred school girls [15-18 years old] were selected by multi-stage random sampling from different secondary schools, and screened for hyperandrogenic disorders by a validated questionnaire. Thorough history taking, physical and gynecologic examination, complete hormonal, pelvi-abdominal pulse inversion harmonic imaging [PlHl], and body composition assessment by bioelectrical impedance [BIA] were done for students presenting with menstrual dysfunction and/or clinical hyperandrogenism and 8 controls from the 4th to the 7th day of the menstrual cycle. Twenty-five out of the 200 students were thoroughly evaluated. Eighteen adolescents of the examined students [72%] were finally diagnosed as PCOS, 5 [20%] as idiopathic hyperandrogenism and 2 [8%] s non-classic congenital adrenal hyperplasia [CAH]. Despite normal weight percentiles and body mass index [BMI] for age and sex in 83.3% and 88.9% of students with PCOS respectively, fat mass, trunk fat percentage, trunk fat mass, and trunk free fat were significantly higher in PCOS patients compared to controls. PCOS was the most common hyperandrogenic disorder in this study. Combined menstrual dysfunction and clinical hyperandrogenism had adequate sensitivity and high specificity in the prediction of PCOS. PIHI is an adequately sensitive preferential diagnostic tool of PCOS in virgin adolescents who may have central adiposity. Body composition assessment by BIA in PCOS is valuable in detecting central adiposity which could be correlated to parameters of insulin resistance

Un producto WEB sobre Metodología de la Investigación para estudiantes y profesionales de Salud / A Web product on Research Methodology for Medical students and professionals

El incremento de las especializaciones en todas las ramas de las Ciencias de la Salud, la colaboración internacional, y el desarrollo de las investigaciones socio médicas, entre otros, supone el empleo cada vez más riguroso de los procedimientos científicos de la investigación en las Ciencias de la Salud. Se confeccionó un sitio Web, utilizando fundamentalmente los siguientes sistemas: Dream Weaver y Photo Show; a partir de una página principal se crearon hipervínculos a otras dos páginas principales: Pregrado y Postgrado, la primera recoge los diferentes contenidos que permitirá el desarrollo con calidad de los contenidos contemplados en el Programa de Formación de los profesionales de la Salud y la segunda con vínculos a objetivos y orientaciones a los programas científicos técnicos, movilización de recursos, elevación de capacidades y proceso de categorización científica. En la comprobación del mismo se evidenció que se logra una mayor solidez y durabilidad de los conocimientos relativos a Metodología de la Investigación.

The increase of the specialization in all the branches of the medical sciences, the international colaboration, and the development of socio-medical researches, among other facts, implyes the more and more rigurous use of the scientific procedures of the researches in Medical Sciences. We made a Web site, using mainly the following systems: Dream Weaver and Photo Shop; beggining from a main page we created hyperbonds with two other pages: Pregrade and Postgrade; the first one includes the diferent contents allowing the qualitative development of the contents integrated in the Formation Program of Medical Professionals, and the second binded with objectives and guidelines to techno-scientific programs, resources mobilization, capacities rising and the process of scientific categorization. When testing it, we showed the achievement of bigger strenght and durability of the knowledge on Research Methodology.

Secular trend is not only acused for the increased incidence of pet, but also for its severity

To determine the role of secular trend in preeclampsia. Both at puberty and in the 3rd trimester of 65 singleton-primigravid preeclapmtics [Group I] and 867 comparable healthy, pregnants [Group II], body mass index [BMI], serum testosterones [total and free], dehydroepiandrosterone sulfate, estradiol and sex hormone-binding globulin levels were measured. Also, the ages at menarche, umbilical S/D ratio, fetal sex and small muscular arteries/high power field [SMA/HPF] were detected. In group I menarche occurred earlier [p<0.001] with higher BMI [p<0.001]. Also, testosterones were significantly higher [p<0.001 for both] both at puberty and during pregnancy, irrespective of fetal sex. Also, S/D ratio was higher with smaller SMA/HPF [p<0.001 for both]. Also, BMI at puberty and testosterone levels; on one hand showed strong +ve correlation to diastolic blood pressure and S/D ratio and strong -ve correlation to SMA/HPF on the other hand. Preeclamptic primigravid showed earlier puberty, significant increase in BMI with significantly higher levels of testosterones than comparable normotensive women, which were associated with more severe disease. This may indicate a significant role for androgens both in the pathogenesis and the severity of PET

Cytogenetic study in juvenile myoclonic epileptic patients

The association of chromosomal imbalance and neurological abnormalities is well known. These chromosomal abnormalities may indicate that chromosomal sites where atypical neurological characteristics could be mapped. The purpose of our study was to search for cytogenetic abnormalities in patients with juvenile myoclonic epilepsy. This work was carried out on fifteen patients presenting to Epilepsy Centerof Neurology Department of Alexandria Main University Hospital. The age of juvenile myoclonic patients ranged from 16 to 38 years. Ten patients have myoclonic and generalized Tonic-Clonic seizures, 3 patients have myoclonic, absences, and generalized tonic-clonic seizures, and 2 patients have myoclonic seizures only. All patients were cytogenetically normal as all of them had normal karyotypes

Plasma ghrelin hormone concentrations in patients with type 2 diabetes mellitus with and without complications

The aim of this study was to measure fasting plasma ghrelin in patients with type 2 diabetes mellitus [DM] and to study the possible role of ghrelin hormone in the pathogenesis of micro and macrovascular complications of DM. The study was performed on 60 patients with type 2 diabetes, 20 of them were obese [group I], 20 patients with normal weight [group II] and 20 diabetic patients with complications [group III], in addition to 20 normal healthy controls. Full history and clinical examination with special emphasis on measurements of body mass index [BMI], waist hip circumference ratio [WHR]. Laboratory investigations include, lipid profile, kidney function tests, urine analysis, fasting blood suger [FBS], HbA1c, fasting serum insulin, measurement of insulin resistance [IR] and measurement of fasting plasma ghrelin by radioimmunoassay for all subjects. The results clarified that, there was a significant decrease regarding fasting plasma ghrelin hormone in all studied diabetic patients [either obese or non obese and in patients with complications] than control group. However, ghrelin hormone was more decreased in obese type 2 diabetic patients than non obese. Also, there was a significant decrease in plasma ghrelin in non obese diabetic patients with complications than non obese diabetic patients without complications. There was a significant, negative correlation between fasting plasma ghrelin hormone and fasting insulin hormone, HBA1C, fasting blood glucose and insulin resistance. There was a negative correlation between fasting plasma ghrelin hormone and BMI, weight and waist circumference. There was negative correlation between plasma ghrelin and both systolic and diastolic blood pressure. From these results, we concluded that, ghrelin secretion may be suppressed by long - term poor glycemic control and that obesity may influence the regulation of ghrelin secretion. Decrease of ghrelin hormone in patients with diabetes mellitus may be risk factor for micro - macrovascular complications

Application of prolene hernia system in the management of adult umbilical hernia

This study included 20 patients with adult umbilical hernia, admitted in the surgery department Assiut University Hospital in the period between September 2002 and September 2004, 19 females and one male, their ages ranged from 29 to 54 years with mean age 44.6 their average weight was 65.2kg [range from 52 kg to 80 kg], and the average height was 158 cm [range from154 to 163 cm]. Through sub-umbilical smile incision, the sac and the contents were dissected and then restored into the abdominal cavity, the peritoneum was dissected off posterior rectus sheath to accommodate the Oval layer of the Prolence Hernia System without suturing, the defect was narrowed snugly around the connecting cylinder by absorbable interrupted sutures, the circular layer was then fixed to the anterior rectus sheath as onlay mesh by 4 to 6 prolene No [0] stitches. Closure of the skin and subcutaneous tisse with suction drain was done. Prophylactic antibiotic was instituted [3 does only]. Suction drain was removed after 1-2 days. Patient was discharged 3-6 days after the operation. After a mean period of follow up of one year, no recurrence was recorded. We concluded that prosthetic hernioplasty in the treatment of adult umbilical hernia is satisfactory and we recommend the use of Prolene Hernia System "PHS" as it has no recurrence [0%] with low morbidity

Comparative study between open, closed and stapled haemorrhoidectomy

In spite of different modifications to decrease pain after haemorrhoidectomy were applied such as lateral internal sphinectrotomy, closed haemorrhoidectomy, anal dilatation and sphincter relaxants, all of these techinques failed to decrease pain to gain universal acceptance [Seow- Choen, 2001]. Stapled haemorrhoidectomy dramatically decreases the postoperative pain and stay in hospital [longo, 1998]. The purpose of this article is to compare between different techniques of haemorrhoidectomy [open, closed and stapled] types

Urinary glutathione transferase [G.S.T]: a marker for post transplant cytosporine A induced renal tubular lesions

In this study, 50 renal transplant patients [RTx] and ten normal controls were investigated for the urinary GST-pi levels. All RTx were on cyclosporine A and were classified according to the duration of post transplant into group I [11 patients], group II [23 patients], group III [nine patients] and group IV [seven patients]. The data showed a significant increase of GST pi in RTx compared with the controls. RTx subgroups showed a significant increase in GST compared with the controls. Comparing RTx subgroups together showed nonsignificant changes in GST between GI and GII, GIII and GIV despite a significant decrease in CyATL and nonsignificant changes in SCr

Nosocomial infection in neonatal intensive care unit at Al-Hussein University Hospital

This study was performed on three groups: Group I included fifty- one full-term and preterm neonates selected from 256 patients admitted at NICU, group II included thirty-three personnel and group III included fifty environmental sites. Swabs were taken from throat, nasal, nipple and paraumbilical area of the patient's group, from throat and finger tips of the personnel group and from the tips of the ventilator tubes, incubators and other equipment of the environmental group. They were inoculated on different culture media and growth was identified by colonial morphology, Gram-stained film, biochemical reaction and antibiogram

Histopathological study and treatment results in management of pleural mesothelioma

Nineteen patients with malignant pleural mesothelioma seen at the Alexandria University Hospitals between 1987 and 1991 were the material of this study. The tumours were classified as epithelial, sarcomatous or of mixed type, also four samples from pleural effusion were subjected to routine cytological examination as well as electron microscopic studies. Most of the patients presented with locally advanced disease, the overall response to irradiation and chemotherapy was 55.3% with complete response rate of 33.3%. The response to treatment was correlated to some prognostic factors. The duration of response ranged between three and fifteen months and the median survival for responders was twenty months