Cross-genera amplification and identification of Colpodella sp. with Cryptosporidium primers in fecal samples of zoo felids from northeast China / Amplificação cruzada de gêneros e identificação de Colpodella sp. com iniciadores de Cryptosporidium em amostras fecais de zoofilia do nordeste da China

The protozoans include many intracellular human pathogens. Accurate detection of these pathogens is necessary to treat the diseases. In clinical epidemiology, molecular identification of protozoan is considered a more reliable and rapid method for identification than microscopy. Among these protozoans, Cryptosporidium considered being one of the important water-borne zoonotic pathogens and a major cause of a diarrheal disease named cryptosporidiosis in humans, domestic animals, and wild animals. This study was aimed to identify Cryptosporidium in zoo felids (N= 56) belonging to different zoo of China, but accidentlly Colpodella was encountered in the zoo felids sample and phylogenetic data confirmed this unexpected amplification from fecal samples using two-step nested-PCR. Phylogenetic analysis revealed the fact about the specific primers used previously by many researchers and cross-genera amplification. We came to know that genetically sequenced amplicon gives more accurate identification of species. This study suggests more investigation on Colpodella which has been neglected previously but gains the attention of researchers after identified from humans and animals and has been known to correlate with neurological symptoms in patients.

Os protozoários incluem muitos patógenos humanos intracelulares. A detecção acurada desses patógenos é necessária para tratar as doenças. Na epidemiologia clínica, a identificação molecular de protozoários é considerada o método de identificação mais confiável e rápido do que a microscopia. Entre esses protozoários, o Cryptosporidium é considerado um dos importantes patógenos zoonóticos transmitidos pela água e uma das principais causas de uma doença diarreica denominada criptosporidiose em humanos, animais domésticos e selvagens. Este estudo teve como objetivo identificar Cryptosporidium em zoofelídeos (N = 56) pertencentes a diferentes zoológicos da China, mas acidentalmente Colpodella foi encontrada na amostra de zoofelídeos e os dados filogenéticos confirmaram essa amplificação inesperada de amostras fecais usando nested-PCR em duas etapas. A análise filogenética revelou o fato sobre os primers específicos usados anteriormente por muitos pesquisadores e a amplificação entre gêneros. Ficamos sabendo que o amplicon sequenciado geneticamente fornece uma identificação mais acurada das espécies. Este estudo sugere mais investigação sobre Colpodella, que foi negligenciada anteriormente, mas ganha a atenção dos pesquisadores depois de identificada em humanos e animais e é conhecida por se correlacionar com sintomas neurológicos em pacientes.

Isolation and characterization of bacteria residing in the oral, gut, and fecal samples of different pheasant species / Isolamento e caracterização de bactérias residentes nas amostras orais, intestinais e fecais de diferentes espécies de faisão

There is a paucity of research conducted on microbial prevalence in pheasants. The microbiota of captive birds has zoonotic significance and must be characterize. Present study is therefore planned to assess the microbiota from oral, fecal and gut content of captive avian species. It will be helpful in characterization of harmful microbes. Different samples taken from oral, gut and feces of ring-necked pheasants (Phasianus colchicus), green pheasants (Phasianus versicolor), golden pheasant (Chrysolophus pictus) and silver pheasant (Lophura nycthemera). Samples were collected, diluted, and inoculated onto different agar plates (MacConkey, SS agar, MSA and nutrient agar) for cultivation of bacterial species. Colonies of E.coli, Staphylococcus spp. Brachyspira spp. and Campylobacter spp were observed based on colony morphology. Colony forming unit showed E. coli as frequently found bacteria in fecal, oral and gut contents of all the above pheasants. The overall significance difference was found among bacterial species of golden pheasants, green pheasant, ring-necked pheasant, and silver pheasants. It was concluded that E.coli is predominant isolated from heathy pheasants followed by Campylobacter, Staphylococcus and Brachyspira.

Há uma escassez de pesquisas realizadas sobre a prevalência microbiana em faisões. A microbiota de aves em cativeiro tem significado zoonótico e deve ser caracterizada. O presente estudo está, portanto, planejado para avaliar a microbiota do conteúdo oral, fecal e intestinal de espécies aviárias em cativeiro. Será útil na caracterização de micróbios nocivos. Diferentes amostras retiradas da boca, intestino e fezes de faisões de pescoço redondo (Phasianus colchicus), faisões verdes (Phasianus versicolor), faisões dourados (Chrysolophus pictus) e faisão prateado (Lophura nycthemera). As amostras foram coletadas, diluídas e inoculadas em diferentes placas de ágar (MacConkey, ágar SS, MSA e ágar nutriente) para o cultivo de espécies bacterianas. Colônias de E. coli, Staphylococcus spp., Brachyspira spp. e Campylobacter spp foram observados com base na morfologia da colônia. A unidade formadora de colônia mostrou E. coli como bactéria frequentemente encontrada no conteúdo fecal, oral e intestinal de todos os faisões acima. A diferença de significância geral foi encontrada entre as espécies bacterianas de faisões dourados, faisões verdes, faisões de pescoço anelado e faisões prateados. Verificou-se que a E.coli é predominantemente isolada de faisões saudáveis, seguida por Campylobacter, Staphylococcus e Brachyspira.

Cross-genera amplification and identification of Colpodella sp. with Cryptosporidium primers in fecal samples of zoo felids from northeast China

Abstract The protozoans include many intracellular human pathogens. Accurate detection of these pathogens is necessary to treat the diseases. In clinical epidemiology, molecular identification of protozoan is considered a more reliable and rapid method for identification than microscopy. Among these protozoans, Cryptosporidium considered being one of the important water-borne zoonotic pathogens and a major cause of a diarrheal disease named cryptosporidiosis in humans, domestic animals, and wild animals. This study was aimed to identify Cryptosporidium in zoo felids (N= 56) belonging to different zoo of China, but accidentlly Colpodella was encountered in the zoo felids sample and phylogenetic data confirmed this unexpected amplification from fecal samples using two-step nested-PCR. Phylogenetic analysis revealed the fact about the specific primers used previously by many researchers and cross-genera amplification. We came to know that genetically sequenced amplicon gives more accurate identification of species. This study suggests more investigation on Colpodella which has been neglected previously but gains the attention of researchers after identified from humans and animals and has been known to correlate with neurological symptoms in patients.

Resumo Os protozoários incluem muitos patógenos humanos intracelulares. A detecção acurada desses patógenos é necessária para tratar as doenças. Na epidemiologia clínica, a identificação molecular de protozoários é considerada o método de identificação mais confiável e rápido do que a microscopia. Entre esses protozoários, o Cryptosporidium é considerado um dos importantes patógenos zoonóticos transmitidos pela água e uma das principais causas de uma doença diarreica denominada criptosporidiose em humanos, animais domésticos e selvagens. Este estudo teve como objetivo identificar Cryptosporidium em zoofelídeos (N = 56) pertencentes a diferentes zoológicos da China, mas acidentalmente Colpodella foi encontrada na amostra de zoofelídeos e os dados filogenéticos confirmaram essa amplificação inesperada de amostras fecais usando nested-PCR em duas etapas. A análise filogenética revelou o fato sobre os primers específicos usados anteriormente por muitos pesquisadores e a amplificação entre gêneros. Ficamos sabendo que o amplicon sequenciado geneticamente fornece uma identificação mais acurada das espécies. Este estudo sugere mais investigação sobre Colpodella, que foi negligenciada anteriormente, mas ganha a atenção dos pesquisadores depois de identificada em humanos e animais e é conhecida por se correlacionar com sintomas neurológicos em pacientes.

Isolation and characterization of bacteria residing in the oral, gut, and fecal samples of different pheasant species

Abstract There is a paucity of research conducted on microbial prevalence in pheasants. The microbiota of captive birds has zoonotic significance and must be characterize. Present study is therefore planned to assess the microbiota from oral, fecal and gut content of captive avian species. It will be helpful in characterization of harmful microbes. Different samples taken from oral, gut and feces of ring-necked pheasants (Phasianus colchicus), green pheasants (Phasianus versicolor), golden pheasant (Chrysolophus pictus) and silver pheasant (Lophura nycthemera). Samples were collected, diluted, and inoculated onto different agar plates (MacConkey, SS agar, MSA and nutrient agar) for cultivation of bacterial species. Colonies of E.coli, Staphylococcus spp. Brachyspira spp. and Campylobacter spp were observed based on colony morphology. Colony forming unit showed E. coli as frequently found bacteria in fecal, oral and gut contents of all the above pheasants. The overall significance difference was found among bacterial species of golden pheasants, green pheasant, ring-necked pheasant, and silver pheasants. It was concluded that E.coli is predominant isolated from heathy pheasants followed by Campylobacter, Staphylococcus and Brachyspira.

Resumo Há uma escassez de pesquisas realizadas sobre a prevalência microbiana em faisões. A microbiota de aves em cativeiro tem significado zoonótico e deve ser caracterizada. O presente estudo está, portanto, planejado para avaliar a microbiota do conteúdo oral, fecal e intestinal de espécies aviárias em cativeiro. Será útil na caracterização de micróbios nocivos. Diferentes amostras retiradas da boca, intestino e fezes de faisões de pescoço redondo (Phasianus colchicus), faisões verdes (Phasianus versicolor), faisões dourados (Chrysolophus pictus) e faisão prateado (Lophura nycthemera). As amostras foram coletadas, diluídas e inoculadas em diferentes placas de ágar (MacConkey, ágar SS, MSA e ágar nutriente) para o cultivo de espécies bacterianas. Colônias de E. coli, Staphylococcus spp., Brachyspira spp. e Campylobacter spp foram observados com base na morfologia da colônia. A unidade formadora de colônia mostrou E. coli como bactéria frequentemente encontrada no conteúdo fecal, oral e intestinal de todos os faisões acima. A diferença de significância geral foi encontrada entre as espécies bacterianas de faisões dourados, faisões verdes, faisões de pescoço anelado e faisões prateados. Verificou-se que a E.coli é predominantemente isolada de faisões saudáveis, seguida por Campylobacter, Staphylococcus e Brachyspira.

Cross-genera amplification and identification of Colpodella sp. with Cryptosporidium primers in fecal samples of zoo felids from northeast China / Amplificação cruzada de gêneros e identificação de Colpodella sp. com iniciadores de Cryptosporidium em amostras fecais de zoofilia do nordeste da China

Abstract The protozoans include many intracellular human pathogens. Accurate detection of these pathogens is necessary to treat the diseases. In clinical epidemiology, molecular identification of protozoan is considered a more reliable and rapid method for identification than microscopy. Among these protozoans, Cryptosporidium considered being one of the important water-borne zoonotic pathogens and a major cause of a diarrheal disease named cryptosporidiosis in humans, domestic animals, and wild animals. This study was aimed to identify Cryptosporidium in zoo felids (N= 56) belonging to different zoo of China, but accidentlly Colpodella was encountered in the zoo felids sample and phylogenetic data confirmed this unexpected amplification from fecal samples using two-step nested-PCR. Phylogenetic analysis revealed the fact about the specific primers used previously by many researchers and cross-genera amplification. We came to know that genetically sequenced amplicon gives more accurate identification of species. This study suggests more investigation on Colpodella which has been neglected previously but gains the attention of researchers after identified from humans and animals and has been known to correlate with neurological symptoms in patients.

Resumo Os protozoários incluem muitos patógenos humanos intracelulares. A detecção acurada desses patógenos é necessária para tratar as doenças. Na epidemiologia clínica, a identificação molecular de protozoários é considerada o método de identificação mais confiável e rápido do que a microscopia. Entre esses protozoários, o Cryptosporidium é considerado um dos importantes patógenos zoonóticos transmitidos pela água e uma das principais causas de uma doença diarreica denominada criptosporidiose em humanos, animais domésticos e selvagens. Este estudo teve como objetivo identificar Cryptosporidium em zoofelídeos (N = 56) pertencentes a diferentes zoológicos da China, mas acidentalmente Colpodella foi encontrada na amostra de zoofelídeos e os dados filogenéticos confirmaram essa amplificação inesperada de amostras fecais usando nested-PCR em duas etapas. A análise filogenética revelou o fato sobre os primers específicos usados ​​anteriormente por muitos pesquisadores e a amplificação entre gêneros. Ficamos sabendo que o amplicon sequenciado geneticamente fornece uma identificação mais acurada das espécies. Este estudo sugere mais investigação sobre Colpodella, que foi negligenciada anteriormente, mas ganha a atenção dos pesquisadores depois de identificada em humanos e animais e é conhecida por se correlacionar com sintomas neurológicos em pacientes.

Isolation and characterization of bacteria residing in the oral, gut, and fecal samples of different pheasant species / Isolamento e caracterização de bactérias residentes nas amostras orais, intestinais e fecais de diferentes espécies de faisão

Abstract There is a paucity of research conducted on microbial prevalence in pheasants. The microbiota of captive birds has zoonotic significance and must be characterize. Present study is therefore planned to assess the microbiota from oral, fecal and gut content of captive avian species. It will be helpful in characterization of harmful microbes. Different samples taken from oral, gut and feces of ring-necked pheasants (Phasianus colchicus), green pheasants (Phasianus versicolor), golden pheasant (Chrysolophus pictus) and silver pheasant (Lophura nycthemera). Samples were collected, diluted, and inoculated onto different agar plates (MacConkey, SS agar, MSA and nutrient agar) for cultivation of bacterial species. Colonies of E.coli, Staphylococcus spp. Brachyspira spp. and Campylobacter spp were observed based on colony morphology. Colony forming unit showed E. coli as frequently found bacteria in fecal, oral and gut contents of all the above pheasants. The overall significance difference was found among bacterial species of golden pheasants, green pheasant, ring-necked pheasant, and silver pheasants. It was concluded that E.coli is predominant isolated from heathy pheasants followed by Campylobacter, Staphylococcus and Brachyspira.

Resumo Há uma escassez de pesquisas realizadas sobre a prevalência microbiana em faisões. A microbiota de aves em cativeiro tem significado zoonótico e deve ser caracterizada. O presente estudo está, portanto, planejado para avaliar a microbiota do conteúdo oral, fecal e intestinal de espécies aviárias em cativeiro. Será útil na caracterização de micróbios nocivos. Diferentes amostras retiradas da boca, intestino e fezes de faisões de pescoço redondo (Phasianus colchicus), faisões verdes (Phasianus versicolor), faisões dourados (Chrysolophus pictus) e faisão prateado (Lophura nycthemera). As amostras foram coletadas, diluídas e inoculadas em diferentes placas de ágar (MacConkey, ágar SS, MSA e ágar nutriente) para o cultivo de espécies bacterianas. Colônias de E. coli, Staphylococcus spp., Brachyspira spp. e Campylobacter spp foram observados com base na morfologia da colônia. A unidade formadora de colônia mostrou E. coli como bactéria frequentemente encontrada no conteúdo fecal, oral e intestinal de todos os faisões acima. A diferença de significância geral foi encontrada entre as espécies bacterianas de faisões dourados, faisões verdes, faisões de pescoço anelado e faisões prateados. Verificou-se que a E.coli é predominantemente isolada de faisões saudáveis, seguida por Campylobacter, Staphylococcus e Brachyspira.

Group B streptococcus infection in a sudden unexpected death of infancy – the importance of microbiological investigation at post-mortem

@#Group B streptococcus (GBS) is a common cause of infection in newborns and in early infants. However, GBS infection in an infant older than three months is infrequently reported in the literature. We reported a case of an apparently well six-month-old infant who died of sudden death due to GBS pneumonia, diagnosed at autopsy. The six-month-old, apparently well male infant was brought in dead to the Emergency Department. He underwent medicolegal autopsy four hours after death, as part of an overall sudden unexpected death in infancy investigation (SUDI). Apart from whitish froth oozing out of both nostrils, he appeared to be well-nourished infant without any deformity, syndromic features or obvious suspicious marks of injury externally. Internal examination showed generalized hyperinflated with patchy consolidation of upper and middle lobes of bilateral lung. Multiple matted mesenteric lymphadenopathy were also detected. Blood and lung tissue specimens collected under aseptic technique yielded growth of GBS. Post-mortem histology from consolidated lungs confirmed pneumonic features while mesenteric lymph nodes showed reactive changes inkeeping with underlying infective process. Death was attributed to GBS pneumonia. This case highlights the importance of a detailed autopsy in sudden unexpected death in infancy (SUDI) and the crucial role of post-mortem microbiological study in such cases. Relevant autopsy protocols that need to be employed during microbiological sampling are briefly discussed.

role of tonsillectomy in the treatment of obstructive sleep apnea

Background: Obstructive Sleep Apnea [OS A] is caused by a partial or complete obstruction of the upper airway. OSA is a very inconvenient and relatively common disorder with daytime and nocturnal symptoms. The intervention and management of OSR is dependent on the patients' case severity. The aim of this study was to evaluate the role and the optimal choice of Tonsillectomy for treatment of OSR. Methods: a systematic search in the scientific database [Medline, EMBASE, Google Scholer and Ovid] from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-control studies were analyzed and included based on the preset inclusion and exclusion criteria

Results: the search has yielded twelve studies to be included in the present SR [n = 206 patients, 34.4+/- 10.0 years and body mass index: 29.3 +/- 9.6 kg/m2] met criteria. Tonsils sizes were hypertrophied, large, enlarged, extremely enlarged, or grades 2 to 4. Apnea-Hypopnea Index decreased by 65.2% [from 43.73 +/- 21.7 /hour to 13.7 3 +/- 12.7 /hour] [n - 198]. The AHI mean difference [MD] was -30.2 per hour [95% confidence interval [CI] -39.3, -21.1] [P value < 0.00001]

The AHI SMD was -1.37 [-1.65, -1.09] [large effect]. Lowest oxygen saturation improved from 77.7 3 +/- 11.9% to 85.5 3 +/- 8.2% [n = 186]. Lowest oxygen saturation MD was 8.5% [95% CI 5.2, 11.8] [P value < 0.00001]

The Epworth Sleepiness Scale decreased from 11.6 3 +/- 3.7 to 6.1 3 +/- 3.9 [n = 125]. Individual patient outcomes [n = 52] demonstrated an 85.2% success rate [AHI < 20/hour and > 50% reduction] and a 57.4% cure rate. Conclusion: tonsillectomy is an effective and safe surgical intervention for treatment of OSA in adults, particularly among carefully selected patients with large tonsils and mild to moderate OSA severity

Umbilical cord blood gas and lactate levels as a marker of birth asphyxia in neonates with particular reference to resource limited countries

Birth asphyxia remains an important cause of neonatal mortality and morbidity in the developing world. Babies who suffer birth asphyxia may develop cerebral palsy, learning difficulties and epilepsy. Early diagnosis and prompt placement of rehabilitative measures would help to reduce the burden of complications arising as a result of birth asphyxia. Time and again effort has been made to develop markers that would help in predicting outcome of neonates who have had an asphyxial insult. One such parameter that is now routinely being used in the developed world is the measurement of umbilical cord blood lactate level measured from blood gases. This review highlights the importance of early diagnosis of birth asphyxia and the role of umbilical cord blood lactate level in identifying babies who have had birth asphyxia in resource limited countries with a particular reference to Pakistan

Neonatal sepsis in the very low birth weight preterm infants: part 1: review of patho-physiology

Over the last fifty years neonatal care has made tremendous progress; increasing survival, reducing morbidity, developing newer modalities of care and therapy for the very low birth weight [VLBW] and premature infant. However, mortality from neonatal sepsis in this group of infants has remained between 18-20% in the developed world and around 80% in the developing world for last three decades with little sign of decline. There is also clear evidence that VLBW infants who survive infection in the neonatal period are at significantly greater risk of neuro-developmental delay; making sepsis the most important cause of mortality and morbidity in this group of infants today. The objective of this review is to highlight the reasons for this lack of success in combating neonatal sepsis successfully. These can be attributed to four main reasons; 1] poor host defences, 2] clinician's inability to diagnose sepsis early and accurately [due to lack of or general availability of highly sensitive and specific markers], 3] clinician's poor understanding of the 'process' i.e. patho-physiology of neonatal sepsis, thus not being able to institute early 'goal' directed therapy, and 4] total reliance on killing the pathogen[s] with inadequate attention to correcting the consequences of the inflammatory process itself. This review presents a brief epidemiological background to neonatal infections in the VLBW infants, discusses host defence systems and how immune compromised VLBW infant combats infection by describing the pathophysiological 'process' of sepsis in detail. It is our belief that understanding the heterogeneity and complexity of host response and the defence systems is fundamental in formulating management strategies. By discussing patho-physiology, current available diagnostic tests and presenting an evidence based management 'care bundle' it is hoped to change clinician's paradigm to use more immune and molecular markers for diagnosis and monitoring of the infection process and in management considering adjunctive therapies that boost host defences. It is recognised that while this review is static i.e. it presents evidence as we understand it today, sepsis is a dynamic process. Our understanding, ability to diagnose and manage neo-natal sepsis is constantly changing and will continue to change and evolve. By presenting this review it is hoped that over a period of time more of our practices would become evidence based and dogma abandoned

Neonatal sepsis in the very low birth weight preterm infants: part 2: review of definition, diagnosis and management

Having presented brief epidemiology of neonatal infection and patho-physiology of neonatal sepsis in the first part of this review we now address the difficulties in defining, diagnosing and treating neonatal sepsis. The objective of this part of the review is firstly, to highlight the reasons for lack of consensus on the definition of neonatal sepsis despite a number of international conferences of experts on the subject. Secondly, to discuss the increasing sophistication of available laboratory tests and why they all lack the certainty desired by the clinician and thirdly to discuss the various evidence based treatment modalities available to treat neonatal sepsis. It is suggested that pragmatic definition of sepsis as suggested by us should be adopted. Greater use of biomarkers and molecular tests should be made to diagnose sepsis early and accurately. Lastly, it is hoped to change the clinician's paradigm by using evidence based management care bundle/package that includes adjunctive immune-modulatory and host defence boosting drugs

Use of intravenous immunoglobulin in the treatment of neonatal sepsis: a pragmatic review and analysis

To review literature and assess whether adjunctive therapy with polyclonal and or enriched intravenous immunoglobulin [IVIG] reduces mortality in neonates with sepsis. Data Source: MEDLINE, EMBASE and Cochrane systematic review. All studies published in English language evaluating IVIG treatment in neonatal sepsis. Data Synthesis: Effect of all cause mortality was quantified using fixed-effect meta-analysis. Fifteen studies published between 1986 and 2006 were identified of which fourteen reported mortality and were included in the analysis. Most studies involved small number of neonates, used different preparations and dosing regimens of IVIG, however, there was significant reduction in all cause mortality associated with use of IVIG in neonatal sepsis with pooled odds ratio of 0.41 [95% confidence interval 0.29-0.58] and a risk ratio of 0.52 [95% confidence interval 0.40-0.67; p < 0.00001]. There was no statistically significant difference between-study heterogeneity for the outcome of mortality in the two analyses. I2=0%. Number required to treat 7. This analysis shows that addition of polyclonal or enriched IVIG as adjunct to standard therapy significantly reduces all cause mortality in neonatal sepsis

Cardiac complications of homozygous beta thalassaemia

Homozygous - beta thalassaemia has frequently been reported to be associated with cardiac complications mainly due to the deposition of iron in the heart. To find effects of homozygous beta-thalassemia on cardiac functions and its relation with Haemosiderosis. Eighty patients with homozygous beta thalasscamia were included in the study. Thalassaemic center attach to Ibn-Alatheer paediatric hospital, Haematology unit, Coronary care unit and Echo unit in Ibn-Sina teaching hospital in Mosul [February to September 2005]. All patients were subjected to full clinical, laboratory, ECG and Echocardiographic evaluation. There were 50 males and 30 females. Age ranged between 11-35 years, their mean was 15.8 years. 18 [22.5%] patients had cardiac dysfunction, of them 12 [15%] had systolic dysfunction and 6 [7.5%] had diastolic dysfunction. ECG changes were present in 27[33.75%] patients and 31[38.75%] had valvular abnormalities. Congestive heart failure present in 3[3.75%] patients and 3[3.75%] patients had pulmonary hypertension. Cardiac Complications are common in Homozygous-beta Thalassaemia older than the age of 10 years. Further studies utilizing more advanced techniques to detect earlier cardiac dysfunction more accurately may be useful

Endoscopic third ventriculostomy - experience in Basrah, Iraq

Endoscope third ventriculostomy [ETV] has gained popularity over recent decades and has become the treatment of choice for certain paediatirc and adult hydrocephalic conditions. This is a review study of 61 patients with hydrocephalus treated by ETV which was successfully completed in 59 patients. Follow-up period ranged from one week to 26 months. Failure was defined by recurrence of symptoms and the need for shunting device which occurred in 3 patients. Those patients requiring shunt were treated within 4 months of the ETV procedure. These results are compared with previously published series of similar procedures

prevalence of neural tube defects among newborns delivered in Azadi hospital in Dohuk city, Kurdistan region, Iraq

The study was performed to highlight the prevalence of neural tube defects [NTDs] among newborns delivered in Azadi teaching hospital in Dohuk. Study lasted over one year period started from 1st of December 2004 to 30th of November 2005. Fifty six newborns [alive and stillbirth], 40 females and 16 males, were found to have different types of NTDs. The prevalence of NTDs was found to be 4.7 per 1000 live births, which was higher than similar rates estimated in other areas in the world. The mothers of the affected newborns were not consuming folic acid before conception, which may, to some extent, explain the high rate in this study. Further similar studies, however, are required in North of Iraq to document the findings of this study. All women should consume 0.4 mg folic acid daily during their reproductive years to protect against this defect

Brain abscess in children.

OBJECTIVES: Brain abscess is a serious life-threatening complication of several diseases. The objective of this study was to look at the clinical profile of patients, predisposing conditions, microbiology and outcome of children suffering from brain abscess. METHODS: Thirty children aged less than 15 years were reviewed. There were 15 males and 15 females. The mean age of presentation was 5.6+/-4.4 years. RESULTS: The duration of illness at the time of admission was 17.6+/-24.6 days. Typically patients presented with fever, vomiting, headache and seizures. The predisposing conditions found were cyanotic congenital heart disease in 11 (37%) of children, meningitis in 6 (20%), septicemia in 7 (23%) and no underlying cause was found in 5 (17%) children. The most common microbe in children with cyanotic congenital heart disease was of the Streptococcus milleri group (52%). Computerized tomography confirmed the diagnosis and the most common location of the abscess was the parietal lobe of the cerebral hemisphere. All abscesses were large, more than 2 cm in diameter and were aspirated surgically. Excision was performed in 6 children. Five children expired, one due to a intracranial bleeding and the others due to severe cerebral edema and tentorial herniation. Complications were seen in 20 children and 16 had sequelae, hemiparesis in 11 and seizure disorder in 5. CONCLUSION: Brain abscess is a serious infection with poor outcome if diagnosed late. Delayed surgical drainage has high morbidity and mortality. The threshold for diagnosis should be low, particularly in children with a predisposing condition like cyanotic congenital heart disease.

Gas-producing brain abscess

A case of a known psychiatric patient who presented with rapid neurological deterioration is reported. Neuroimaging revealed a gas-producing brain abscess in left parietal lobe with a contiguous focus of infection in the adjacent bone and scalp initiated by obsessive scalp scratching. On complete surgical excision of abscess, followed by culturebased antibiotic therapy, a good neurological recovery was achieved with minimal residual deficits at follow-up

Haematological response of chronic myeloid leukaemia to imatinib: [preliminary study]

To study the haematological response of patients with chronic myeloid leukaemia [CML] to Imatinib [glivec/gleevec]. A prospective study. Medical ward/Haematological unit, Out-patient clinic in Ibn Seena Teaching Hospital, Mosul [April1998-2003].AH patients were subjected to full clinical, and laboratory evaluation and Imatinib 400mg/day. Fourteen patients with chronic phase interferon [IFN] failure or intolerance CML were included in the study. There were 6 males and 8 females. Age ranged between 17-70 years, their mean was 46.15 years. All are in chronic phase of CML, the duration of illness ranged between 2 months to 5 years with a mean of 3.4 years. 13 [92.86%] patients had complete haematological remission [normalization of white blood cell count, and spleen size] two to four weeks after Imatinib. All patients developed arthralgia and muscle cramps [100%], 10 had nausea [71.4%], 5 had periorbital oedema [35.7%] and 1 patient with myelosuppression [7.14%]. These are the adverse effect due to Imatinib. The haematological response to Imatinib is 92.86% of patients with chronic phase interferon-failure CML. Further study is recommended to evaluate the cytogenetic response [effect of Imatinib on Philadelphia chromosome]. Additional research should help determine the optima] role for Imatinib, whether it is alone, in combination with IFN and cytarabine, or as first line therapy for CML