Study of prevalence of abnormal glucose tolerance in transfusion-dependent thalassemia patients

Beta Thalassemia is a chronic hemolytic anemia in which treatment by regular transfusion of packed Red blood cells [RBC] is the mainstay of patient's care. The resulting iron overload is the major cause of morbidity for these patients. Deposition of iron in the liver, endocrine glands and in the heart results in hemochromatosis in these organs. Type 2 diabetes is a common complication of iron overload. The development of diabetes in hemochromatosis is related to the magnitude of excess iron. The aim of the present work was to study the prevalence of abnormal glucose tolerance in thalassemia patients and detect whether increased echogenicity of the pancreas is correlated to the magnitude of iron excess, and to study the relation between hemosiderosis and pancreatic dysfunction. For this work, we first examined forty four patients with thalassemia major attending the Hematology Unit of Damanhour Medical National institute [DMNI]. Later on the number of patients enrolled in the study extended to ninety. Laboratory assay included fasting serum glucose level [FSG], 2 hours post prandial serum glucose level [PPSG], serum ferritin [S-Fe] and abdominal ultrasound [U/S]. The study showed that hemochromatosis was associated with increased pancreatic echogenicity and abnormal glucose level. Serum ferritin concentration and hepatitis C infection are risk factors for abnormal glucose found in transfusion-dependent thalassemia patients. Early aggressive iron chelation therapy and prevention of infections are the most important issues in managing glucose intolerance in transfusion-dependent Beta thalassemia patients

study of the association between delayed type hypersensitivity reaction to Mycobacterium tuberculosis and atopy in asthmatic children

The purpose of this study was to investigate if there is an inverse association between Mycobacterium tuberculosis infection and atopy among children living in rural and semi urban areas in El Behira governorate, Egypt. All the studied children were BCG vaccinated in their newborn period. In Tuberculin testing, indurations greater than or equal to 5 mm were accepted as positive. For atopy, the most common aeroallergens were used in skin intradermal testing, and reactions >/= 3 mm were accepted as positive. Among 150 studied children whose ages ranged from 4-8 years, 89 patients were purified protein derivative [PPD] negative whereas in 61 patients PPD was positive. Among the PPD negative patients skin intradermal test was positive for atopy in 51.6% [n = 46], while among the PPD positive patients skin intradermal test was positive in 52.4% [n = 32]. As the two groups were compared for having positive intradermal skin test reaction, no statistically significant difference was detected between them [P>0.05]. Conclusions: In this study no statistically significant difference was detected between Mycobacterium tuberculosis infection as indicated by positive PPD positivity and atopy tested by skin intradermal injection of common aeroallergens

study of neonatal morbidity and mortality at Damanhour teaching hospital newborn unit

Newborns in Behira governorate represented 2.5% of total Behira population in 2000. In Damanhour teaching hospital 4040 live births were delivered during one year from 1[st] January 1995 to 31[st] December 1995. During this period an observational study of morbidity and mortality of the newborn unit [NBU] attendants was performed. The total number of admitted neonates to the newborn unit were 557, of those 307 were borne in hospital [representing 7.6% of total hospital deliveries] and 250 were admitted from outside the hospital.The number of eligible neonates for the study were 544, they spent 2355 days in the unit, thirteen neonates were excluded from the analysis. The low birth weight [< 2500 gm] were 218 [40% of studied cases]. According to Dubowitz score, Infants were classified as appropriate for gestational age [AGA] 60.7%, small for gestational age [SGA] 27.6% and large for gestational age [LGA]11.8%. Neonates with birth weight < 1500 gm and gestational age

Ramadan fasting: relation to atherogenic risk among obese muslims

Increased platelet aggregation as well as changes in coagulation factors have an important effect on the occurrence of atherogenicity and cardiovascular diseases. Fasting in general has been used in medicine for medical purposes when other measures fail. Since Ramadan fasting is different from total fasting, the present work was conducted to study the effect of Ramadan fasting on lipid pattern, some blood coagulation parameters, blood pressure and body mass index [BMI] - as atherosclerotic risk factors - in one hundred and three apparently healthy obese volunteers [15 men and 88 women] aged 15-52 years. The study comprised an initial visit for assessment V1 [before Ramadan] and three other follow up visits: V2 [at the end of Ramadan], V3 [4 weeks after Ramadan] and V4 [8 weeks after Ramadan], Targets were subjected to an interview questionnaire, complete physical and clinical examination, anthropometric measurements, dietary profile, and laboratory assay of complete blood picture [CBC], fasting serum glucose level [FSG], serum lipid pattern: total cholesterol [TC], triglycerides [TG], high density lipoproteins [HDL-c] and low density lipoprotein [LDL-c], lipoprotein a Lp [a], apolipoprotein A1 [APA], and apolipoprotein B [APB] levels; bleeding [BT] and clotting time [CT], prothrombin time [PT], activated partial thromboplastin time [APTT], fibrinogen and plasma factor VII activity. Statistical analysis was performed using Chi squared, Fisher exact, Student t test, paired t test and Pearson's correlation coefficient. Statistical significance was defined at P<0.05. The study showed that by the end of Ramadan fasting, there was a significant improvement in the mean levels of hemoglobin [Hb], TC, TG, HDL-c, LDL-c, TC/HDL, LDL/HDL, Lp [a], APA, APB, PT and systolic [SBP] and diastolic blood pressure [DBP] that persisted for four weeks after fasting [P<0.05]. Ramadan fasting has not adversely affected leucocytic count or coagulation parameters [P>0.05]. There was also a significant association between dietary intake, SBP, DBP, weight, BMI, percent body fat and waist, fibrinogen and factor VII activity and TC, TG, HDL-c, LDL-c, LDL/HDL, Lp [a] and APB [P<0.05]. The model of Ramadan fasting could be followed as a behavior modification program to control or prevent atherogenicity because of its positive impact on the lipid pattern, blood count and coagulation parameters

Pattern of antimicrobial utilization among hospitalized patients in a general hospital

A retrospective study was conducted from January 2000 to December 2000. A total of 732 medical records was selected by a systematic random sample from the inpatient medical records of all departments of the General Hospital, Damanhour. Prescribing pattern was analyzed using WHO basic drug indicators. The average number of antimicrobials during hospital stay was 1.7 and 80.6% of all prescriptions contained at least one antimicrobial. About one fourth of the prescriptions entailed the repetition of the same antimicrobial group. The most frequently used antimicrobial groups were cephalosporins [42.7%], followed by penicillins [23.6%] and aminoglycosides [13.2%]. The majority [88.64%] of antimicrobials used were bactericidal. The average cost/patient for all antimicrobials during hospital stay was LE 82.78. Almost 70% of antimicrobials were prescribed as injections. Prophylactic use of antimicrobial was found in about two-thirds of the prescriptions. In the majority of cases [96.4%], antimicrobials were given without a bacteriological proof. After controlling confounding, the most important predictors of antimicrobials use were operative interference, longer duration of hospital stay [>1 week], younger age of the patient [less than 1 year] and paid treatment. Rational antimicrobial policy, infection control committees and educational programs for prescribers on a rational use of antimicrobial are recommended