Nutrient Digestibility, Ruminal Fermentation Activities, Serum Parameters and Milk Production and Composition of Lactating Goats Fed Diets Containing Rice Straw Treated with Pleurotus ostreatus.

The study evaluated replacement of Egyptian berseem clover (BC, Trifolium alexandrinum) with spent rice straw (SRS) of Pleurotus ostreatus basidiomycete in diets of lactating Baladi goats. Nine lactating homo-parity Baladi goats (average BW 23.8±0.4 kg) at 7 d postpartum were used in a triplicate 3×3 Latin square design with 30 d experimental periods. Goats were fed a basal diet containing 0 (Control), 0.25 (SRS25) and 0.45 (SRS45) (w/w, DM basis) of SRS. The Control diet was berseem clover and concentrate mixture (1:1 DM basis). The SRS45 had lowered total feed intake and forages intake compared to Control. The SRS25 and SRS45 rations had the highest digestibilities of DM (p = 0.0241) and hemicellulose (p = 0.0021) compared to Control which had higher (p<0.01) digestibilities of OM (p = 0.0002) and CP (p = 0.0005) than SRS25 and SRS45. Ruminal pH and microbial protein synthesis were higher (p<0.0001) for SRS25 and SRS45 than Control, which also had the highest (p<0.0001) concentration of TVFA, total proteins, non-protein N, and ammonia-N. All values of serum constituents were within normal ranges. The Control ration had higher serum globulin (p = 0.0148), creatinine (p = 0.0150), glucose (p = 0.0002) and cholesterol (p = 0.0016). Both Control and SRS25 groups had the highest (p<0.05) milk (p = 0.0330) and energy corrected milk (p = 0.0290) yields. Fat content was higher (p = 0.0373) with SRS45 and SRS25 groups compared with Control. Replacement of BC with SRS in goat rations increased milk levels of conjugated linoleic acid and unsaturated fatty acids compared with Control. It was concluded that replacing 50% of Egyptian berseem clover with SRS in goat rations improved their productive performance without marked effects on metabolic indicators health.

Improvement of steatosis after interferon therapy in HCV genotype 4 is related to weight loss.

INTRODUCTION: Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection, and its occurrence may be related to both host and viral factors. Relationship between improvement in steatosis and response to anti-viral treatment remains unclear. This study assessed the factors associated with steatosis in patients infected with genotype 4 HCV, and to correlate degree of changes in steatosis with host factors and response to treatment. METHODS: Records of 175 patients with chronic genotype 4 HCV infection, who had received interferon and ribavirin combination therapy, were reviewed retrospectively to extract data on body mass index (BMI), presence of diabetes mellitus, and liver histology findings. Paired BMI data and liver biopsies (pre- and 24-weeks post-treatment) were available in 86 patients. Baseline steatosis and its changes (before and after treatment) were the dependent variables in a univariate and multivariate analyses. RESULTS: Steatosis was found in 88/175 (50.3%) of baseline biopsies. Its presence was related to baseline BMI (r=0.33, P<0.01), but not with viral load, or grade of liver inflammation or fibrosis. On follow up, improvement in steatosis was significantly associated with degree of weight loss but not with response to anti-viral treatment. CONCLUSION: Steatosis is common in genotype 4 HCV infection, and its presence appears to be related to high BMI, but not to viral load or degree of liver injury.

Optic nerve glioma and colonic polyposis: report of a new association.

AIM: The authors describe the clinical, radiological and histopathological features of an optic nerve glioma associated with colonic polyposis. The association between colonic polyposis and neuroepithelial tumours of the central nervous system has been previously described, but no association with optic nerve gliomas has ever been reported. METHODS: We report a 14-y-old girl with colonic polyposis and unilateral proptosis for whom an excisional biopsy of the orbital lesion was performed. RESULTS: Histopathological evidence of juvenile pilocytic astrocytoma grade 1 was detected. Correlation with criteria for Turcot's syndrome was established. CONCLUSION: Optic nerve tumours should be included in the spectrum of central nervous system lesions associated with colonic polyposis.

Anterior commissure carcinoma: I-histopathologic study.

OBJECTIVES: To study the behavior of anterior commissure carcinoma regarding its tendency for cartilage invasion. METHODS: Histopathological examination of the region of the anterior commissure (AC) was done with whole organ section in 30 randomly selected specimens. Serial sections were prepared and examined histopathologically for evidence of microscopic cartilage invasion in the region of the AC. RESULTS: Microscopic involvement of the thyroid cartilage was detected in the 30 sections studied. CONCLUSION: Whether recurrence was de novo or initiated by residual malignant cells, it is mandatory to excise the anterior portion of the thyroid cartilage with the tumor-bearing mucosa.

Human portal serum stimulates cell proliferation in immature Schistosoma mansoni.

Schistosomula of Schistosoma mansoni were incubated in RPMI 1640 medium containing 10% fetal calf serum, 10% human portal venous or 10% human peripheral venous sera in the presence of bromodeoxyuridine (BrdU) in order to measure differences in cell proliferation. The rates of cell proliferation as expressed by BrdU labelling indices (BLI) were determined as a function of time of incubation by immunohistochemistry using monoclonal antibody to BrdU. Compared to schistosomula cultured in the presence of RPMI plus 10% fetal calf serum, BLIs were increased by 60% in the presence of human portal, but not in peripheral serum. This stimulatory effect was substantially reproduced by a fraction of portal serum with a molecular weight range between 1 and 50 kDa. However, in the presence of human peripheral venous serum, either whole or fractionated, schistosomula showed no significant difference compared to RPMI plus 10% fetal calf serum alone. Furthermore, human portal serum fractions of molecular weight greater than 50 kDa also revealed no significant difference relative to control. The results indicate that portal venous serum component(s) of a molecular weight range higher than most simple nutrients can greatly stimulate the rate of cell proliferation of Schistosoma mansoni schistosomula.

Women's health problems in the Arab World: a holistic policy perspective.

The paper reviews key health problems of women in the Arab World. It relies on data and information from international yearbooks, regional data bases, and small scale field studies. The relevant context in which women live; of lingering illiteracy rates, lack of access to cash income, and increasing poverty is described. Reproductive health is reviewed within this context pointing to trends of delayed marriage and declining fertility in some countries while other countries maintain high levels. Similar variability is observed in contraceptive use rates and the interaction of contraception and health is discussed. Evidence points to high levels of reproductive morbidity. The socio-cultural context is found particularly relevant to pregnancy and childbirth, seen as natural processes by women, to experiences of menopause, and to violence against women, particularly female circumcision. A holistic policy perspective is suggested to address these problems.

Intestinal parasitic infections in immunosuppressed patients.

Hundred immunosuppressed patients and 50 apparently healthy individuals as control were subjected to stool examination for parasitic infections by the direct smear method and the merthiolate iodine formal-dehyde (MIF) concentration technique. The modified Ziehl-Neelson stain and the aniline carbol methyl violet stain were used to detect Cryptosporidium oocysts. 27 Patients were found positive using the MIF technique while only 13 of them were positive by the direct smear method. Cryptosporidium oocysts were detected in 7 cases using the aniline carbol methl violet stain while only 5 of them were positive by the modified Ziehl-Neelson stain.

Toxoplasma antibodies in clinically suspected cases of toxoplasmosis.

One hundred and seven cases, 35 males and 72 females aging from 3 months to 32 years old were divided into 4 groups: ocular, neurological, cases with abortion and cases having Down's syndrome. 47 apparently healthy individuals were taken as control. All were serologically tested for Toxoplasma antibodies using IFAT and ELSA for detection of IgG. The positive cases as well as cases below one year old were tested by ELISA IgM for the detection of acute or congenital toxoplasmosis. Toxoplasma antibodies (IgG) were found in 28 (26%) and 43 cases (40%) by IFAT and ELISA respectively. ELISA IgM was positive in 12 (20%) out of 60 serum samples. Two cases (11%) among 27 patients below one year old positive. Statistical significance was reported concerning the positive cases in the ocular group as well as patients with abortions. Results revealed that ELISA is more sensitive and specific than IFAT.

[Hepatocellular carcinoma in asymptomatic primary biliary cirrhosis]. / Carcinome hépatocellulaire sur cirrhose biliaire primitive asymptomatique.

Hepatocellular carcinoma is an uncommon complication of primary biliary cirrhosis. Hepatocellular carcinoma occurs generally in the end stage of the disease. We report a case of asymptomatic primary biliary cirrhosis complicated by a hepatocellular carcinoma in a 66 year-old man.

Schistosoma mansoni: egg granuloma reduction in challenged mice after vaccination with irradiated-attenuated cercariae.

Response of Swiss albino mice vaccinated with irradiated-attenuated cercariae or repeatedly infected with normal cercariae of Schistosoma mansoni were known to develop resistance to reinfection. The mean (+/- SD) of the hepatic granuloma numbers and diameters for vaccinated-challenged group (I) were 2 +/- 0.89/1mm2 and 116 +/- 11.5 microns, for repeatedly infected group (II) were 2 +/- 0.63/1mm2 and 2 +/- 0.89/1mm2 and 195 +/- 11.8 microns and for control group (III) were 4 +/- 1.36/1mm2 and 140 +/- 12.3 microns respectively. Mean of the diameter of the granulomas were significantly smaller in the group vaccinated with irradiated cercariae than the other two groups. Most of the granulomas in groups I and II were fibro-cellular while all granulomas in group III were cellular. Predominent cell types of the granulomas were lymphocytes in groups I and II and eosinophils in group III. The incidence of focal hydropic and fatty degenerations, necrosis and prominent kupffer cell hyperplasia were lower in group I. These results supported that granuloma size reduction in all vaccinated animals were apparently effective in sequestering egg toxins and reduced hepatocytes damage. The present study gives encouragement that a vaccine to enhance protection against disease in human schistosomiasis is possible.

Comparing women's reports with medical diagnoses of reproductive morbidity conditions in rural Egypt.

This article is based on a survey of a random sample of 509 ever-married nonpregnant women residing in two villages in the Giza Governorate of Egypt, each of whom responded to a questionnaire on symptoms of gynecological conditions and then was accompanied to the village health center for a gynecological exam. A response rate of 91 percent was achieved. The article focuses on reproductive tract infections and genital prolapse, highly prevalent conditions in the community. The women's reports of symptoms are compared with the medical diagnoses, using indicators of sensitivity, specificity, positive and negative predictive values, and percentage of agreement. The findings show that women's reports of vaginal discharge agree moderately well with the physicians' observations but are not good predictors of the occurrence of reproductive tract infections. Women's reports of the symptoms of prolapse do not agree well with medical diagnoses of the condition. The findings are analyzed, taking into account the social context of the lives of the women surveyed to arrive at conclusions as to how to improve ways of learning from women themselves about gynecological problems in the community.

PIP: During November 1989 to July 1990 in two villages in Giza Governate, Egypt, medical and social scientists compared self-reports of 509 ever married women with medical diagnoses to determine the feasibility of using a questionnaire for a community diagnosis. The assumption was that a questionnaire is an inexpensive data collection method to identify women's health problems in developing countries. Based on self-reports, 77% of the women had vaginal discharge. 68% of these women considered the discharge as unusual. When the researchers compared self-reports with medical diagnoses of the presence of reproductive tract infection (RTI), they found a relatively high sensitivity (79%) but a low specificity (26%) for presence of discharge. The positive predictive value and percentage of agreement were 53% and the Kapp statistic was only 5%, indicating little agreement between self-reported symptoms and clinical or laboratory diagnostic status. Comparison of self-reports of at least one of the two symptoms of genital prolapse with clinical diagnoses of genital prolapse revealed a rather low sensitivity (36-50%, depending on severity of the prolapse) and relatively high specificity (76%). The positive predictive value and percentage of agreement were 66% and 54%, respectively, and the Kapp statistic was 11%, indicating poor agreement between self-reported symptoms and clinical or laboratory diagnostic status. 90% of the 40 women with uterine prolapse had first degree prolapse, but all 40 also had some vaginal prolapse. Women with more severe anterior vaginal prolapse or posterior and anterior vaginal prolapse plus uterine prolapse were more likely to report symptoms than those having posterior vaginal prolapse and uterine prolapse (56% vs. 17%; p 0.05). These findings show that vaginal discharge, considered as a symptom or sign, is not a good predictor of RTIs.

A community study of gynecological and related morbidities in rural Egypt.

This study assesses the prevalence of gynecological and related morbidity conditions in a rural Egyptian community. A medical examination was conducted on a sample of 509 ever-married, nonpregnant women. For gynecological morbidities, genital prolapse was diagnosed in 56 percent, reproductive tract infections in 52 percent, and abnormal cervical cell changes in 11 percent of the women. For related morbidities, anemia was present in 63 percent of the women, followed by obesity (43 percent), hypertension (18 percent), and urinary tract infection (14 percent). Regression analysis of risk factors demonstrated the contribution of social conditions and medical factors to these diseases. Reproductive tract infections were shown to occur more frequently with uterovaginal prolapse, IUD use, presence of husband (regular sexual activity), and unhygienic behavior. Genital prolapse increased with age and number of deliveries. Age, recent pregnancy, education, socioeconomic class, and workload showed significant associations with related morbidity conditions. This evidence challenges national health programs to go beyond safe motherhood, child survival, and family planning in its services to women, and to consider the social context of health as well.

PIP: The prevalence of gynecological and related morbidity in a rural Egyptian community was assessed as part of the Program of Research and Technical Consultation in Family Resources. Child Survival, and Reproductive Health. A medical examination was conducted on a sample of 509 ever-married, nonpregnant women from November 1989 to July 1990. A logistic regression using Generalized Linear Interactive Modeling was performed for each type of morbidity. For gynecological morbidities, genital prolapse was diagnosed in 56%, reproductive tract infections in 52%, and abnormal cervical cell changes in 11% of the women. For related morbidities, anemia was present in 63% of the women, followed by obesity (43%), hypertension (19%), and urinary tract infection (14%). Most of the women were suffering from at least 1 morbidity, with only 3% free of all the morbidity conditions considered. Gynecological morbidity, together with urinary tract infection and syphilis, showed that 35% of the women had 1 morbidity, 34% had 2, and 17% had 3 or more morbidities. Regression analysis of risk factors demonstrated that social conditions and medical factors contributed to these diseases. Reproductive tract infections occurred more frequently with uterovaginal prolapse, IUD use, presence of husband (regular sexual activity), and unhygienic behavior. Genital prolapse increased with age and number of deliveries. Age, recent pregnancy, education, socioeconomic class, and workload revealed significant associations with related morbidity conditions. The risk of anemia was significantly related to age and to a pregnancy within the previous 2 years. With every increase of 1 year of age, the risk of hypertension increased by 9%. For every increase of 1 year of age, the risk of obesity increased by 7%. Women with the highest level of education had a 3 times greater risk of urinary tract infection than did uneducated women, while women of low-middle socioeconomic status had almost 4 times the risk of women in the lowest class.

Concepts and measures of reproductive morbidity.

This paper presents a conceptual and methodological framework developed by an interdisciplinary group of researchers to diagnose reproductive morbidity at the community level. The paper also presents a determinants structure that delineates the health and social factors hypothesized to influence reproductive morbidity. The high prevalence of reproductive-morbidity conditions revealed by implementation of the study framework in two villages of Giza in Egypt is reported. Based on this research experience and the process of presenting its results to the larger professional community, the paper discusses policy implications of the study in terms of reproductive-health services, education and training programs and research efforts for measurement of reproductive ill-health at a community setting.

PIP: An interdisciplinary group of researchers developed a conceptual and methodological framework to determine the extent of the problem of reproductive morbidity at the community level in Middle Eastern society and then, in turn, to improve reproductive health conditions in women. It conducted an exploratory study in a family planning clinic in Cairo, Egypt; a medical workshop on clarification of the symptomatology of reproductive morbidity; and a focus group in a village in Giza, Egypt, to ensure that the reproductive morbidity questions of interview questionnaires were appropriate and complete. The group tested the accuracy of the questionnaires in 2 villages in rural Giza (509 women). Field workers went to the women's homes to administer the questionnaire on characteristics of the household during the first visit. During the second visit, they administered the questionnaire on reproductive morbidity, and then the social researcher went with the women to the health center so the women could undergo a gynecological examination. 50% of the women had reproductive tract infections, especially vaginitis. 56% had prolapse, and prevalence increased significantly with age. 63% had anemia, especially 14-19 year olds (76%). Just 24 women (5%) had no reproductive morbidity. About 50% had at least 3 reproductive conditions. The leading problems reported by the women were vaginal discharge (77%), dysmenorrhea (71%), perceived delay in conception (48%), stress incontinence (37%), and pain during intercourse (36%). Feeling of heaviness below, probably indicating prolapse, was the only symptom which increased with age (p = .03). 41% had been pregnant in the last 2 years. 77% delivered at home. Leading conditions during pregnancy were headache (59%) and discharge (45%), and those after delivery were fever and discharge/inflammation (30% for both). The interdisciplinary group proposed 3 mechanisms which are of utmost importance to policy: conducting similar research in other communities, expansion of reproductive health services at the community level, and implementing changes in the education and training programs of health professionals and social scientists.

Naturally occurring toxoplasma antibodies in serum and milk of lactating women.

Serum and milk of lactating women were tested for toxoplasmosis using specific-IgG IFAT. Apparently healthy 70 women were selected: 54 from rural and 16 from urban areas. Serum and milk were simultaneously collected from each one. Sera were positive in 22 (31.4%) of the total 70; including 16 (29.6%) and 6 (37.5%) of rural and urban groups respectively. No statistical significant difference was found for positivity and titre levels between the two groups (P greater than 0.05). Milk was positive in 12 (17.1%) of the 70 women; including 10 (18.5%) and 2 (12.5%) from rural and urban groups respectively, having no statistical significant difference (P greater than 0.05). Comparing serum and milk for positivity and titre levels, also there was no statistical significant difference (P greater than 0.05). It is concluded that relatively low antibody levels in serum could be excreted in milk and may be protective for suckling babies. Occurrence of antibodies in serum and milk are homogeneously distributed between rural and urban inhabitants.

Parasitic infections associated with mental retardation in Egypt.

Examination of 150 mentally retarded patients for parasitic infections by urine and stool analysis revealed that 115 (76.67%) were positive. The most prevalent parasites found were T. trichiura in 56%, A. lumbricoides in 40.6% and A. duodenale in 21.33%. Double infection was present in 30.67%, triple infection in 15.33% and quadriple infection in 6%. Eosinophilia was detected in 91 (64.08%) of 142 examined cases, all were suffering from intestinal parasites. S. stercoralis was present in 11.33% by stool examination and culture and in 24 (60%) out of 40 examined cases by the IFAT. Toxocara antibodies were present in 38 (56.72%) out of 67 examined cases by the IFAT. Toxoplasma antibodies were present in 106 (74.65%) out of 142 examined cases by the IFAT.

Immunodiagnostics of Toxocara canis in suspected ocular and visceral manifestations.

Sera from patients with ocular and visceral manifestations of toxocariasis were tested by precipitin absorption (PAT), counter-immunoelectrophoresis (CIEP), indirect fluorescent antibody (IFAT) and ELISA. The ocular cases revealed a percentage of positivity of 36% by PAT, 0% by CIEP, 32% and 28% by IFAT with embryonated egg (EE) and frozen section antigens (FS) respectively and 40% by ELISA. The visceral cases revealed 44% positively by PAT, 24% by CIEP 52% and 48% by IFAT with EE and FS respectively and 52% by ELISA. Statistical evaluation was done to interpret the results.

Concomitant Toxoplasma and Toxocara infections.

Toxoplasmosis being to a large extent a soil transmitted infection is acquired in the same manner and often at the same time as toxocariasis, the source being concomitantly infected cats. 110 sera of patients suspected of toxoplasmosis and found positive by the indirect fluorescent antibody test (IFAT), were also tested for Toxocara antibodies by the IFAT. Seropositivity was found to be 18.1%. On the other hand, 12 sera from patients presenting with toxocariasis and proved serologically positive, were tested to detect Toxoplasma antibodies and only one was positive (8.3%). Association of antibodies of the two parasites was found in 21 sera (17.2%).

Immunodiagnostics of visceral toxocariasis.

Twenty five suspected cases of visceral toxocariasis and 25 apparently healthy controls, were tested in four serological tests, namely precipitin absorption test (PAT), counter immunoelectrophoresis (CIEP), indirect fluorescent antibody test (IFAT), and enzyme linked immunosorbent assay (ELISA). Adult Toxocara worm antigen was used in PAT & CIEP as saline extract and as frozen sections (FS) in IFAT while the embryonated eggs (EE) were used as saline extract in ELISA and as a whole in IFAT. The percentages of positivity reported were 44% by PAT, 24% with CIEP, 52% with IFAT (EE), 48% with IFAT (FS), and 52% in the ELISA. In the apparently healthy control group, only one subject gave positive result with PAT, and ELISA at titres of 1/16 and 1/64 respectively. The EE antigen proved to be more sensitive than adult worm antigen, where it was used in IFAT & ELISA and gave the highest percentage of positivity and the highest titre (1/256 & 1/4096 respectively). It was noticed that the children below the age of 10 years, were statistically significant (P less than 0.05) by all tests except CIEP.