Bisphenol A effects on the host Biomphalaria alexandrina and its parasite Schistosoma mansoni.

Bisphenol A (BPA) is one of the most potent endocrine-disrupting chemicals (EDCs) that adversely affect aquatic organisms. The present investigation explored the effects of exposure to BPA at 0.1 and 1 mgL-1 concentrations on the fecundity of Biomphalaria alexandrina, snail's infection with Schistosoma mansoni, and histology of the ovotestis and topographical structure of S. mansoni cercariae emerged from exposed snails. The 24 h LC50 and LC90 values of BPA against B. alexandrina were 8.31 and 10.88 mgL-1 BPA, respectively. The exposure of snails to 0.1 or 1 mgL-1 BPA did not affect the snail's survival. However, these concentrations caused an increase in the reproductive rate (Ro) of infected snails. A slight decrease in egg production was observed in snails exposed to 0.1 mgL-1 BPA after being infected (infected then exposed). However, a significant increase in egg production was noted in snails exposed to 1 mgL-1 BPA after infection with S. mansoni. Histopathological investigations indicated a clear alteration in the ovotestis tissue structure of exposed and infected-exposed groups compared to the control snails. Chronic exposure to BPA caused pathological alterations in the gametogenic cells. SEM preparations of S. mansoni cercariae emerged from infected-exposed snails showed obvious body malformations. From a public health perspective, BPA pollution may negatively impact schistosomiasis transmission, as indicated by the disturbance in cercarial production and morphology. However, it has adverse effects on the reproduction and architecture of reproductive organs of exposed snails, indicating that B. alexandrina snails are sensitive to sublethal BPA exposure.

Invasion biology meets parasitology: a case study of parasite spill-back with Egyptian Fasciola gigantica in the invasive snail Pseudosuccinea columella.

The liver fluke Fasciola gigantica is a trematode parasite of ruminants and humans that occurs naturally in Africa and Asia. Cases of human fascioliasis, attributable at least in part to F. gigantica, are significantly increasing in the last decades. The introduced snail species Galba truncatula was already identified to be an important intermediate host for this parasite and the efficient invader Pseudosuccinea columella is another suspect in this case. Therefore, we investigated snails collected in irrigation canals in Fayoum governorate in Egypt for prevalence of trematodes with focus on P. columella and its role for the transmission of F. gigantica. Species were identified morphologically and by partial sequencing of the cytochrome oxidase subunit I gene (COI). Among all 689 snails found at the 21 sampling sites, P. columella was the most abundant snail with 296 individuals (42.96%) and it was also the most dominant species at 10 sites. It was not found at 8 sites. Molecular detection by PCR and sequencing of the ITS1-5.8S-ITS2 region of the ribosomal DNA (rDNA) revealed infections with F. gigantica (3.38%), Echinostoma caproni (2.36%) and another echinostome (7.09%) that could not be identified further according to its sequence. No dependency of snail size and trematode infection was found. Both high abundance of P. columella in the Fayoum irrigation system and common infection with F. gigantica might be a case of parasite spill-back (increased prevalence in local final hosts due to highly susceptible introduced intermediate host species) from the introduced P. columella to the human population, explaining at least partly the observed increase of reported fascioliasis-cases in Egypt. Eichhornia crassipes, the invasive water hyacinth, which covers huge areas of the irrigation canals, offers safe refuges for the amphibious P. columella during molluscicide application. As a consequence, this snail dominates snail communities and efficiently transmits F. gigantica.

Zoonoses from cats: with special reference to Egypt.

A zoonosis is an animal disease that is transmissible to humans. Humans are usually an accidental host that acquires disease through close contact with an infected animal, who may or may not be symptomatic. Children are at highest risk for infection because they are more likely to have close contact with pets. Cats are responsible for transmission of an extensive array of bacterial, fungal, and parasitic zoonotic pathogens. The route of transmission can be through the saliva (e.g., bites or contaminated scratches), feces, respiratory secretions, direct contact, or by the cat acting as a vehicle and source of tick or flea exposure. Although cats have been implicated in transmission of zoonosis to their owners, risk of transmission from contact with cats is low and may be further reduced by simple precautions. There is a need for education on zoonotic disease prevention practices for pet-owning households with individuals at higher risk of infection, and to educate future veterinarians during their early years in veterinary school about the risks associated with their future jobs. Also, zoonotic disease awareness training is a valuable service to animal shelter workers.

Coarse and fine culturable fungal air concentrations in urban and rural homes in Egypt.

The main objective of the present study was to assess culturable airborne fungal concentrations, and types in different seasons. Two-stage viable impactor samplers were used with malt extract agar medium as the collection media. Culturable airborne fungal concentrations were collected indoors and outdoors of 43 homes in urban and rural environments from November 2008 to October 2009 in Egypt. Fungal concentrations were significantly higher in the rural environment than the urban environment. The median indoor and outdoor total fungal concentrations were 608 and 675 CFU/m3 in the urban environment and 1,932 and 1,872 CFU/m3 in the rural environment, respectively. The greatest concentrations were found in the autumn and spring season. Indoor and outdoor concentrations were significantly correlated (P < 0.001). The highest concentrations were observed in the fungal size range of <8 µm (fine fraction). The indoor/outdoor (I/O) ratios were not statistically different between seasons. Alternaria, Aspergillus, Cladosporium, Penicillium and yeasts were the predominant genera indoors and outdoors, and the abundance of genera varied by season and region. This study is of a potential interest as little reported research on the indoor fungal air quality from Egypt.

Seasonal evaluation of fine and coarse culturable bacterial aerosols from residences within a rural and an urban city in Egypt.

Non-complaint Egyptian homes were examined to determine the residential culturable airborne bacterial concentrations so that these could be used as comparisons in indoor air quality investigations. Concentrations of airborne bacteria were investigated in 26 urban flats across Cairo and 17 rural flats in the Dakahlia governorate. Air samples were collected using a two-stage viable cascade impactor sampler, dividing particles into coarse (>8 µm) and fine (<8 µm) sizes. For urban flats, the year's median indoor and comparison site concentrations were 9133 CFU/m(3) and 9423 CFU/m(3), respectively. For rural flats, the year's median indoor and comparison site concentrations were 15,915 CFU/m(3) and 10,859 CFU/m(3), respectively. The median indoor bacterial concentrations increased in winter and spring compared to autumn and summer. Winter months had the greatest median concentration for coarse indoor organisms, whereas spring had the largest for the fine indoor organisms. Fine bacterial concentration composed more than 60% of the indoor bacterial fraction.

Zoonoses from dogs with special reference to Egypt.

A zoonosis is an animal disease that is transmissible to humans. Humans are usually an accidental host that acquires disease through close contact with an infected animal, who may or may not be symptomatic. Children are at highest risk for infection because they are more likely to have close contact with pets. Dogs are responsible for transmission of an extensive array of bacterial and parasitic zoonotic pathogens. The route of transmission can be through the feces, urine, saliva (eg, bites or contaminated scratches), or respiratory secretions of the animal, or by the dog or cat acting as a vehicle and source of tick or flea exposure or reservoir for vector borne disease. Although dogs have been implicated in transmission of zoonoses to their owners, risk of transmission from contact with dogs is low and may be further reduced by simple precautions.

Study on some factors affecting survivability of airborne fungi.

The aim of the present study was to investigate the effect of some air pollutants and meteorological parameters on the survivability of airborne fungi. Fungi were collected by using a slit impactor sampler calibrated to draw 20 L/min, for 3 min. Nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), particulate matter (PM), relative humidity (RH %), temperature (T °C) and wind speed (WS) were also measured. Air samples were taken during the period from March 2006 to February 2007. Fungal concentrations ranged between 45 and 451 CFU/m(3) with an annual mean concentration of 216 CFU/m(3). The lowest fungal concentration was found in the summer, however the highest one was found in the autumn. NO(2,) SO(2) and PM averaged 83.66 µg/m(3), 67.01 µg/m(3), and 237.69 µg/m(3), respectively. T °C was positively and negatively correlated with Aspergillus (P = 0.000) and Penicillium (P = 0.007), respectively. RH% was positively correlated with total fungi (P = 0.001), Aspergillus (P = 0.002) and Cladosporium (P = 0.047). Multiple regression analysis showed that T °C and RH% were the most predicted variants. Non-significant correlations were found between fungal concentrations and air pollutants. Meteorological parameters were the critical factors affecting fungal survivability.

Diurnal distribution of airborne bacteria and fungi in the atmosphere of Helwan area, Egypt.

Airborne bacterial and fungal composition in an industrial town of Helwan, Egypt, was studied using a slit impactor sampler during the period from March 2006 to February 2007. Airborne bacterial concentrations were usually higher than fungi. Bacteria and fungi had similar diurnal variation patterns. Airborne microorganisms reached their concentration peaks in the evening and gradually decreased during the night time. The hourly concentration peaks of the bacteria and fungi appeared at 20:00h. A significant difference (P < or =0.05) was found between the hourly mean concentrations of airborne fungi in winter compared to other seasons. Fungi concentrations were significantly higher (P< or =0.05) on working weekdays than weekends. Aspergillus, Penicillium, Alternaria and Cladosporium were the most predominant airborne fungal genera. Aspergillus showed double peak patterns whereas Penicillium, Alternaria and Cladosporium showed one peak pattern. The diurnal variations of the bacteria and fungi could be divided into four periods: 1) the morning maximum concentration (6:00h-10:00h), 2) midday to afternoon pattern (10:00h-16:00h), 3) the evening concentration peak (18:00h-20:00h) and 4) the gradual decrease of night time concentration (22:00h-24:00h). Geographical location, human activity, growth cycle of organisms and meteorological factors were the main criteria controlling the temporal variations of the air microorganisms in the Wadi Hof area.

Clinicoepidemiologic study of posttransplant diabetes after living-donor renal transplant.

OBJECTIVES: We sought to evaluate posttransplant diabetes mellitus with regard to its incidence, risk factors for occurrence, complications, impact on graft function, and impact on patient and graft survival rates. MATERIALS AND METHODS: A total of 1,580 patients received living-donor renal allografts at Mansoura University, Egypt, between March 1976 and November 2004. Of these, 286 recipients developed diabetes after transplant (diabetic group). These patients were matched with 316 kidney transplant recipients who did not develop diabetes after transplant (control group). A complete clinical history was obtained and a clinical examination was done. Laboratory analyses including urine analysis, complete blood count, total serum cholesterol, fasting and 2-hour postprandial plasma glucose, Hb A1c, serum creatinine, and creatinine clearance were obtained in all patients. In each patient, presence of hepatitis B and C was determined with polymerase chain reaction, and a graft biopsy was obtained to diagnose renal allograft rejection. RESULTS: The onset of diabetes mellitus among our recipients occurred primarily during the first 6 months after transplant (in 52.4% of the patients). Significant correlations were found between posttransplant diabetes mellitus and the recipients' age (P = .0001), obesity (P = .001), positive family history of diabetes mellitus (P = .001), hepatitis C virus infection (P = .039), cumulative dose of steroids in the first 3 months (P = .047), and calcineurin inhibitor-based immunosuppressive therapy (P = .001). Moreover, posttransplant diabetes mellitus significantly affected rates of coronary heart disease (P = .001), hypertension (P = .02), and hypercholesterolemia (P = .001). Graft survival was similar in both groups until 15-year follow-up, at which time graft survival began to decrease in patients with diabetes mellitus compared with those without diabetes mellitus (43.5% vs 53.6%, P = .013). Similarly, patient survival was similar until 8-year follow-up, at which time survival rates began to decline in patients with diabetes as compared with patients without diabetes (79.9% vs 86.1%, P = .001); this trend continued to the 15-year follow-up (60.6% vs 77.8%, P = .001). CONCLUSIONS: Posttransplant diabetes mellitus is a major problem that endangers patient and graft survival. In our population, the incidence of posttransplant diabetes mellitus was 18.2%. Further studies are recommended to screen for patients with impaired fasting glucose and impaired glucose tolerance for prediction, early detection, and better management of posttransplant diabetes mellitus.

Indoor air quality during renovation actions: a case study.

A temporary renovation activity releases considerably high concentrations of particulate matter, viable and non-viable, into air. These pollutants are a potential contributor to unacceptable indoor air quality (IAQ). Particulate matter and its constituents lead, sulfate, nitrate, chloride, ammonium and fungi as well as fungal spores in air were evaluated in a building during renovation action. Suspended dust was recorded at a mean value of 6.1 mg m(-3) which exceeded the Egyptian limit values for indoor air (0.15 mg m(-3)) and occupational environments (5 mg m(-3)). The highest particle frequency (23%) of aerodynamic diameter (dae) was 1.7 microm. Particulate sulfate (SO(4)(2-)), nitrate (NO(3)(-)), chloride (Cl(-)), ammonium (NH(4)(+)) and lead components of suspended dust averaged 2960, 28, 1350, 100 and 13.3 microg m(-3), respectively. Viable fungi associated with suspended dust and that in air averaged 1.11 x 10(6) colony forming unit per gram (cfu g(-1)) and 92 colony forming unit per plate per hour (cfu p(-1) h(-1)), respectively. Cladosporium(33%), Aspergillus(25.6%), Alternaria(11.2%) and Penicillium(6.6%) were the most frequent fungal genera in air, whereas Aspergillus(56.8%), Penicillium(10.3%) and Eurotium(10.3%) were the most common fungal genera associated with suspended dust. The detection of Aureobasidium, Epicoccum, Exophiala, Paecilomyces, Scopulariopsis, Ulocladium and Trichoderma is an indication of moisture-damaged building materials. Alternaria, Aureobasidium, Cladosporium, Scopulariopsis and Nigrospora have dae > 5 microm whereas Aspergillus, Penicillium and Verticillium have dae < 5 microm which are suited to penetrate deeply into lungs. Particulate matter from the working area infiltrates the occupied zones if precautionary measures are inadequate. This may cause deterioration of IAQ, discomfort and acute health problems. Renovation should be carefully designed and managed, in order to minimize degradation of the indoor and outdoor air quality.

Antimalarial drug resistance in the Eastern Mediterranean Region.

Studies done between 1997 and 2003 are reviewed to give an overall picture of antimalarial drug resistance in the Eastern Mediterranean Region of the World Health Organization (WHO). The situation in 8 countries where resistance has been reported is detailed. It has been difficult to abandon chloroquine as first-line treatment even though resistance to it is widespread. Resistance to sulfadoxine-pyrimethamine has also been detected. The spread of resistance could be slowed down by the adoption of effective national policies and control programmes. Coordination between counties and with other WHO regions, as opposed to working in isolation, could further reduce the spread of resistance.

Antimalarial drug resistance in the Eastern Mediterranean Region

Studies done between 1997 and 2003 are reviewed to give an overall picture of antimalarial drug resistance in the Eastern Mediterranean Region of the World Health Organization [WHO]. The situation in 8 countries where resistance has been reported is detailed. It has been difficult to abandon chloroquine as first-line treatment even though resistance to it is widespread. Resistance to sulfadoxine-pyrimethamine has also been detected. The spread of resistance could be slowed down by the adoption of effective national policies and control programmes. Coordination between counties and with other WHO regions, as opposed to working in isolation, could further reduce the spread of resistance

Sentinel posts for monitoring therapeutice efficacy of antimalarial drugs against Plasmodium falciparum infections in the Sudan.

A protocol for assessment of the therapeutic efficacy of chloroquine against Plasmodium falciparum malaria was evaluated in Sudan. An in vivo test was implemented in five sentinel posts in areas of unstable malaria during the transmission season. A standard dose of oral chloroquine was administered to a random sample of patients with uncomplicated falciparum malaria attending primary health care units and they were followed-up for clinical and parasitological response for 14 days. Designations of "early treatment failure", "late treatment failure" and "adequate response" were based on clinical and parasitological criteria. Data analysis for prevalence of resistance was done for each individual sentinel post, using two-stage Lot QualityAssurance Sampling. At 95% confidence level and 80% power, the prevalence of chloroquine resistance was found to be 25% in all five posts. It is concluded that the protocol was simple and easily applicable at the peripheral level and could be the basis for sentinel post's for continuous monitoring of malaria drug resistance in the whole country.

Household expenditure on malaria case management in Wad-Medani, Sudan.

This study was done in Wad-Medani town in the central Sudan. A household survey and a hospital survey were conducted using structured questionnaires to assess household expenditure on malaria case management. A total of 360 cases of malaria were reported in the household survey. They were assessed by a questionnaire focused on household income daily expenditure and resources), with special attention to treatment and cost incurred. Also, a random sample of malaria cases hospitalized in the medical, obstetrical and paediatric wards in Wad-Medani hospitals were interviewed, comprising 75 adult patients and 75 children. Cases in the house survey were treated in health centers, private clinics, health insurance facilities or by self-medication. The mean expenditure on diagnosis and treatment of an episode of malaria was US dollars 5.12 for home-treated cases and US dollars 17.2 for a hospitalized case, representing a significant economic burden to family income. This cost varied according to type of treatment, type of health care provider and in hospitalized versus home-treated cases.

Malaria case management at the community level in Gezira, Sudan.

This study was done to investigate malaria case management at the community level in Gezira, Sudan, which is an area of unstable malaria predominantly due to Plasmodium falciparum. Questionnaire surveys were conducted at four consecutive weekly intervals in October 1995. A sample of 400 households (3062 persons) including 200 rural and 200 urban households was studied. Use of antimalarials was assessed in terms of diagnosis, types of antimalarial used, self-medication and compliance. During the four weeks of observation, 25.1% of the rural population and 35.6% of the urban population received at least one course of antimalarial drugs. Diagnosis was confirmed microscopically in 81.7% of treated persons in the urban community and in only 34.3% those treated in the rural community. Chloroquine is the most frequently used antimalarial in both communities with notable overuse of injections in rural patients and in patients treated by paramedical health workers. Self-medication was commoner in rural than in the urban population (41.2% versus 23.9%). Compliance with the standard therapeutic doses was poorest with quinine and best with sulfadoxine/pyrimethamine. It is suggested that interventions to improve the use of antimalarials should include health education, training of health workers and dissemination of national treatment policies.

Organic dust and gaseous contaminants at wood working shops.

Airborne dust bioaerosols, ammonia and formaldehyde levels were determined inside two different (ventilated and unventilated) wood working shops. Airborne dust was found at mean values of 4.3 and 3.01 mg m(-3). These levels were higher than that recommended by Egyptian environmental law [1 mg m(-3) indoor maximum allowable concentration (MAC) for hard wood]. The highest frequency of aerodynamic size distribution of airborne wood dust was detected at a diametre of 4.9 microm which was recorded during a machining operation. Total viable bacteria were recorded at a mean value of 10(4) colony-forming units (cfu) m(-3), whereas Gram-negative bacteria were found at very low counts (10(1) cfu m(-3)). Fungi levels were recorded at mean values of 10(3) and 10(2) cfu m(-3) in ventilated and unventilated shops, respectively. Penicillium, Aspergillus, Cladosporium and yeast species were dominant isolates. Moreover, actinomycetes were found at a mean value of 10(3) cfu m(-3) at both workshops. Ammonia was detected in relatively low concentrations (mean values of 457 and 623 microg m(-3)), whereas formaldehyde was found in relatively moderate concentrations (mean values of 0.42 and 0.64 ppm).

Evaluation of airborne lead in the welding working environment.

Manual and automatic welding machines (which use leaded alloys) are considered to be important sources of the emission of lead fumes into the general air of the working environment. Three workplaces at a television factory were selected for the present study, to determine the control class of the working unit. The concentrations of conventional measurements ("A" sampling points) were lower than the administrative control level (statutory standard of lead, 150 microg m(-3)), whereas the maximum concentration of 264.1 microg m(-3) ("B" sampling point) was higher at one working unit than the administrative control level. However, the control classes varied between class III (bad) and class I (good).

Indoor and outdoor formaldehyde concentrations in homes in residential areas in Greater Cairo.

Indoor and outdoor measurements of formaldehyde were conducted at seven flats located in residential areas in Greater Cairo, during spring and summer seasons 1999. The mean daytime formaldehyde concentrations in kitchens, bedrooms and living rooms were 89, 100 and 100 ppb, respectively, in the seven flats. Significant positive correlations were found between the concentrations of formaldehyde found in these three rooms. On the other hand, no significant differences were found between the mean formaldehyde concentrations in these three rooms. The maximum mean concentration of formaldehyde (147 ppb) was recorded in a new flat, while the minimum concentration (43 ppb) was observed in an old flat. The maximum hourly and daytime concentrations were 350 and 225 ppb, respectively. Air temperature, relative humidity and the age of the flat are factors affecting the emission and concentration of formaldehyde. The maximum indoor and outdoor formaldehyde concentrations were recorded during the summer season. During the spring, 38% of the samples indicated that the concentration of formaldehyde in the seven flats exceeded 0.1 ppm, the American Society of Heating, Refrigerating, and Air Conditioning Engineers' (ASHRAE) standard; in the summer, this figure increased to 53%.

Student assessment in community settings: a comprehensive approach.

Student assessment in community settings presents problems for medical teachers, e.g., difficulties in assessing the contribution of individual members to group work, and lack of test standardization due to varying field conditions. The Faculty of Medicine, University of Gezira, Sudan is a community-oriented, community-based medical school which has adopted a comprehensive approach to student assessment in community settings using various methods, including peer assessment, a supervisory checklist, community feedback, reports from students, short essay questions (SEQs) and multiple choice questions (MCQs). Each method focuses on a specific aspect of the objectives of the community-based programme and is weighted in the final grade according to the extent to which objectives were covered. This assessment programme contrasts with the conventional teacher-centred approach, and is continuously monitored and improved using a variety of sources of information. A total of 105 students participated in a study designed to measure the reliability and validity of this approach. The reliability of the methods was tested by computing the alpha coefficient and was found to range between 0.77 and 0.92. This was considered acceptable. The validity of the instruments was examined using confirmatory factor analysis, and their content validity was reviewed. The results show that the comprehensive approach used is fairly valid. It is suggested that the University's approach is successful in solving some of the problems of student assessment in community settings.