Comparative study of different methods of diagnosis of invasive fungal infection in immunocompromised patients

Fungal infection is still a major cause of morbidity and mortality in cancer patients. Our study was conducted on 50 patients attending Al-Hussein university hospital complaining from different types of cancer were suffering from low grade fever, night sweat, weight loss, lassitude and easy fatigability. The cases were matched with 10 healthy controls of the same age and sex. Blood samples were collected and cultured to isolate fungal pathogens using conventional methods and BACTEC system. Positive cases were subcultured on Sabouraud dextrose Agar [SDA]. We describe a multiplex polymerase chain reaction [PCR] based approach to the detection and identification of pathogenic fungi which has potential for the diagnosis of invasive mycoses. PCR allowed the detection [universal PCR] and identification [species-specific PCR] of a fungal pathogen within 6 h from blood samples. Fungal isolates detected and identified using conventional and confirmatory methods were 7 cases [14%], while fungal isolates detected using PCR were 8 cases [18%]. Sensitivity and specificity of conventional methods in relation to PCR was; sensitivity [87.5%] and specificity [98.1%]. In our study Candida species were the only fungal pathogens with different frequency; Candida albicans [4 isolates], Candida tropicalis [2 isolates], Candida glabrata [1 isolate] and Candida parapsilosis [1 isolate]

Waiting time for emergency surgeries in a tertiary care public hospital - a performance audit

To find out the waiting time for emergency surgeries and to identify causes responsible for this delay in a tertiary care public hospital.Settings: Surgical Unit IV, Civil Hospital, Karachi.Patients and Patients admitted through emergency for immediate emergency operations during the month of November and December, 2003 were included in the study. For data collection a proforma was made which included diagnosis, operation performed, time of planning immediate surgery, time of surgery, causes responsible for delay apart from demographic information.Main outcome measures: Waiting time for emergency surgeries, different causes responsible for the delay. A total of 45 patients were enrolled in the audit study. Majority of patients 14 [31.1%] were suffering from acute appendicitis. 33 [73.3%] of patients had to wait for more than 3 hours before their emergency surgery. Major cause of this delay in 33.6% of patients was due to surgical team doctor's inefficiency. In 7 [21.2%] patients surgery was delayed due to late night admission and in 6 [18.1%] due to non-availability of cross matched blood. In 5 [15.1%] patients surgery was delayed due to unavoidable causes like busy theatre and arrival of more serious patients. A substantial number of patients needing emergency surgery waited too long for the surgical management. Majority of delays were due to causes which can be addressed to improve the patients care

Strangulated spigelian hernia

Spigelian hernia is a rare ventral hernia. Strangulation in Spigelian hernia is common but still seen very rarely in clinical practice. We report a case of strangulated Spigelian hernia in an elderly women which was managed satisfactorily and the patient discharged on ninth post operative day

Regular attendance at theoratial and practical classes for bachelor grades' students at the Faculty of Medicine [male] Al-Azhar University - an exploratory study

This study was designed to identify reasons that led to students' irregular attendance at their theoretical and practical classes. The total number of the studied samples was 200 university staff members and 300 students from bachelor grades. The results revealed that attending distinguished lectures at other colleges and students' commitment to private lessons were the most important reasons for students' irregular attendance with 70.3% and 61.7%, respectively, particularly among the 6th grade students. It was indicated that 81.7% of the students stated that expatriation and repeated traveling helped in students' irregular attendance. The study also indicated that not using MCQ method in examination, expanding of regulations of facilitating success and not specifying a part of total scores for regular attendance were among the most important reasons for students' irregular attendance. A statistical significant difference between staff members was detected regarding expanding of regulations of facilitating success

Evaluation of knowledge, attitudes and practices of pregnant women towards antenatal care in Qualioubia governorate

295 pregnant women were selected by systematic random sample from the Meet-Halfa Village, Qalyoubia Governorate. A specially designed questionnaire was used to collect data. After data collection statistical analysis was done. The results indicated a poor level of maternal knowledge regarding the importance of antenatal care and good knowledge levels regarding both the providing sites of antenatal care and the alarming signs during pregnancy. The majority of the studied women had good levels of knowledge about the regularity of antenatal care visits. As regard attitudes, 75.9%, 15.3% and 8.8% of the studied women had favorable, indifferent and unfavorable positive attitudes, respectively, towards certain instructions that should be followed during pregnancy. Concerning maternal practices, it was found that 58% of the studied sample were not attending antenatal care clinics during pregnancy, and only 6.7% of the attendants started antenatal care visits in the first trimester. Also, 61.4% of mothers used to increase the quantities and/or the qualities of their meals during pregnancy

leading causes of under utilization of M.C.H services in Alexandria

The aim of the study is identifying reasons for underutilization of MCH services and necessary equipments and supplies needed to permit doctors to deal with obstetrical management. The main instrument of data collection was interviewing household mothers and health personnel in the area of work. The results revealed that the majority of household mothers [55%] used the available MCH services. The main causes of underutilization of health services were inconvenient accessibility, lack of specialists and lack of free drugs. Most of deliveries [67%] were carried out by private physician due to lack of necessary supplies and equipments needed for obstetrical managements

Health profile of food handlers in Oman

This study was done to show the health profile of workers working in restaurants, catering establishments and other food shops in Oman, Muscat Governorate. A total 180 food handlers were examined for parasites and other health problems during the period from 1st March to 31st May 1996. The results revealed that a total of 30 [16.6%] workers were positive for different intestinal parasites. E. Histolytica and G. Lamblia with overall incidence of 6.7% and 5% respectively. Skin and respiratory diseases represents 54.4% and 41.6%, respectively. Results were tabulated according to the percentage of positivity of individual parasites. Follow up studies were recommended to investigate the prevalence of infectious diseases among workers

Knowledge of nurse about breast milk in different health services in Sharkia Governorate

The aim of this study was to measure the level of knowledge of nurses about breast milk. The main instrument of data collection was interviewing nurses working in different systems of health services. The results of the study revealed that nurses working in University Hospital had good level of knowledge about colostrum, while nurses working in Ministry of Health Hospital had good level of knowledge regarding composition of breast milk. Knowledge of nurses who are working in different health services about benefits of breast milk was good, while knowledge about general character of breast milk was relatively low

Factors affecting utilization of contraceptive methods in rural areas in Giza Governorate

The aim of this study was to identify the factors affecting utilization of contraceptive methods in Embaba District, Giza Governorate. The total sample of the study was 400 married females in child bearing period aged 15-49 years. The most commonly used methods were pills and IUDs. Regarding the effect of education on the usage of contraceptive methods the result was significant. The level of education has a significant effect on the use of contraceptive methods while occupational status has insignificant effect

C-reactive protein: an aid to assessment of suspected acute appendicitis

In a series of 50 patients who were admitted to hospital with suspected acute appendicitis, serum C-reactive protein [CRP] was measured to determine the value of its assessment in management of such cases. 39 patients subsequently underwent operation. In 32 patients the diagnosis of acute appendicitis was confirmed and in another 4 significant intra-abdominal pathology was found. This group of 36 patients had significantly higher C-reactive protein levels than the 3 patients who had a negative laparotomy and the remaining 11 who had no operation. C-reactive protein assay is simple, rapid and may be of value as a diagnostic aid in assessing acute abdominal pain

Tumor necrosis factor and in pre-eclamptic patients

65 women with preeclampsia defined as a diastolic blood pressure >/ 90 mmHg and proteinuria > 0.3 g/L, occurring after 20 weeks of gestative. 18 women had hemodialysis, elevated liver enzymes and low platelet count [HELLP syndrome], other 25 pregnat women who remained normotensive and norproteinuric throughout pregnancy. Tumor necrosis factor alpha was determined in all patients by the colorimetric MTT assay. TNF alpha was detectable in 52 preeclamptic patients compared with 11 normotensive pregnant women [P <0.001]. TNF alpha was detectable in all patients with HELLP syndrome, and plasma concentration were significantly higher than in patients with preeclampsia without HELLP and in normotensive pregnant women [P <0.001]

Plasma atrial natriuretic peptide concentrations during the normal menstrual cycle in healthy volunteers

This study investigated whether the concentration of atrial natriuretic peptide [ANP] changes during the normal menstrual cycle and whether the changes parallel the known fluctuation of aldosterone and female sex hormones or not. Plasma ANP concentrations rose from 19.83 +/- 9.56 [range 10-58 pg/ml] in the menstrual phase to 24.94 +/- 17.21 [range 10-81 pg/ml] in the follicular phase [p = 0.1605] and decreased to 15.04 +/- 8.74 [range 5.8-44 pg/ml] in the luteal phase [p = 0.0067] in 30 normal menstruating healthy volunteers. The reduced level of ANP in the luteal phase could be a compensatory response to the natriuretic effect of the increased progesterone. Aldosterone value was highest when ANP value was lowest