value of clinical and pathological profiles of gastric cancer in Egypt

Stomach cancer is the 4[th] common cancer but the 2[nd] cause of cancer related death. This prospective study has been completed on 25 patients with invasive gastric cancer at Bab-Elsharea University Hospital and Beni-Suef University Hospital. Fifteen of them were males and 10 were females, their ages ranged from 31 to 68 years with an average of 57 years. All cases were clinically laboratory and radiologically assessed. Subtotal gastrectomy was performed for 17 patients [68%], while total gastrectomy was done for 8 patients [32%].In this study we reevaluate the surgical management of stomach cancer, the extent of gastric resection and the lymphadenectomy, hoping to answer the following questions is 4 cm safety margin applicable to all stomach cancer patients? is D3 gastrectomy should be done for every stomach cancer patient? And what is the clinicopathological factors affecting PN stage and infiltration length of the tumour?. The inclusion criteria includes differentiated gastric tumours, T2, local or locoregional disease with no ascites or peritoneal deposits, radical gastrectomy is done [total, proximal or lower] according to the site of the primary tumour, with lymphadenectomy one level beyond the level of palpable lymph node [D2 or D3]. Patients are classified according to the pathological lymph node stage [Japanese classification] "PN" into PNI when LN metastasis is confined to NI, PNII when LN metastases is confined to N2 and the patient are classified PNIII when LN metastasis are present in the N3. From all clinicopathological criteria studied; sex, smoking, tumour morphology, tumour grade, serosal invasion, T-stage and tumour size have significaht relation to the lymph node metastasis and PN stage other factors as age of the patient, presentation, histopathological type of the tumour, gastric mucosal abnormalities as presence of peptic ulcer, gastritis or metaplasia and the site of the tumour show no significant relation to the PN stage. The studied group are also classified according to the microscopic infilteration length into patient with infilteration length less than 2 cm and patient with infilteration length between 2 and 4 cm and the last group of patient have infiltration length more than 4 cm. The clinicopathological factors are compared in the above groups. Age of the patient, tumour morphology tumour grade, Laurence tumour classification, tumour size, lymphatic vessel invasion and serosal invasion, all these factors are significantly correlated to the microscopic infiltration length while patient sex. presentation, tumour size tumour histopathological type, gastric mucosal abnormality and other organ infiltration, all these factors are not significantly correlated to the microscopic infiltration length

Multidrug resistant typhoid fever in Egypt

Typhoid fever is a global health problem, with an estimated 20 million cases and 700.000 deaths annually. In Egypt, since the beginning of the 1980s, there has been an increase prevalence of multidrug resistance to the first line antimirobials, such as chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole [TMP-SMX], shifting the drug of choice for the treatment of typhoid fever to fl uoroquinolones and third generation cephalosporins. Was to detect if multidrug resistant [MDR] typhoid fever is still a problem in Egypt after two decades of its widespread. Also, we studied if resistance had appeared to quinolones and third generation cephalosporins which were widely used for treatment of typhoid fever in the last fi fteen years. In the period between March 2006 and March 2007, thirty seven patients with positive blood culture for Salmonella typhi were included in this study. They were 23 [62%] males and 14 [38%] females with age range from 3 to 45 years [mean 19 +/- 8.2 years]. Drug sensitivity tests showed that 34 [92%] of Salmonella typhi isolates were sensitive to chloramphenicol and 24 [65%] and 23 [62%] isolates were sensitive to ampicillin and TMPSMX, respectively. Only one [3%] isolate was MDR to chloramphenicol, ampicillin and TMP-SMX. All isolates were sensitive to ciprofl oxacin and ceftriaxone. Forteen [38%] patients were treated with chloramphenicol and twenty three [62%] patients were treated with ceftriaxone. All patients were cured. The mean time of defervescence for ceftriaxone and chloramphenicol was 3.7 +/- 1.2 and 5.8 +/- 1.2, respectively. Ceftriaxone was signifi cantly associated with a shorter time of defervescence compared with chloramphenicol. There is marked reduction of prevalence of MDR Salmonella typhi isolates and marked increase of susceptibility of these isolates to chloramphenicol, returning it to be one of the drugs of choice for treatment of acute typhoid fever. No drug resistance to ceftriaxone and ciprofloxacin was reported after many years of using for treatment of acute typhoid fever. Ceftriaxone was significantly associated with short time of defervescence making it the drug of choice for treatment of severe and complicated cases of typhoid fever. Due to high degree of resistance to ampicillin and TMP-SMX they should not be used as first line drugs for treatment of acute typhoid fever

Haemophilus influenzae meningitis at the Abbassia Fever Hospital 1982 to 2001

The aim of this work was to study the prevalence, clinical presentation, outcome of patients with H. influenza meningitis and to determine the efficacy and safety of new therapeutic regimens that could be used in the treatment of the disease and test the susceptibility of the isolates to different antibiotics. During the period from January 1982 to December 2001, 472 children with H. influenza meningitis were admitted to El-Abbassia Fever Hospital, Meningitis Ward in Cairo. The study indicated that H. influenzae is the main causative organism in Egypt accompanied high morality and morbidity rates. Although there has been no increase in the number of cases over the year, a steady increase in the resistance to the traditional drugs has occurred. Thus, it was recommended to use third generation cephalosporins for treatment and Hib vaccines in children

Evaluation of slide agglutination and widal agglutination tests in the diagnosis of acute enteric fever in Cairo

This study we compared the sensitivity, specificity, positive predictive and negative predictive values of Widal tube agglutination test and slide agglutination test, which was used in many fever hospitals for diagnosis of acute typhoid fever because of its simplicity and cheapness. This study included 25 normal controls, 153 diseased control patients [non-typhoidal] and 36 acute typhoid fever patients. The sensitivity, specificity, positive and negative predictive values for Widal tube agglutination test were 91.7%, 100% and 98% and for slide agglutination test were 86%, 83%, 55.4% and 97.7%, respectively. It was concluded from this study that Widal agglutination test is a valid test for diagnosis of acute typhoid fever in Egypt and that slide agglutination test is a rough screening test for suspected typhoid diagnosis which is valuable for exclusion and not for diagnosis

Pneumococcal meningitis: drug resistance and prognostic factors

Sixty-seven patients with cerebrospinal fluid [CSF] culture positive for Streptococcus pneumoniae were included in this study. Out of the sixty-seven S. pneumoniae isolates, thirty-three were penicillin resistant, four were chloramphenicol resistant, three were resistant to penicillin and chloramphenicol and twenty-seven were sensitive to both penicillin and chloramphenicol. In patients with penicillin resistance to S. pneumoniae strains, chloramphenicol was used in the treatment of seventeen patients with a mortality rate of 12%. The poor prognostic factors in patients with pneumococcal meningitis depended on patients age, duration of illness [two days or more prior to hospital admission], coma on hospital admission and associated diabetes mellitus