Assessment of orbital hemodynamic changes in primary open angle glaucoma by color Doppler imaging.

PURPOSE: To assess changes in orbital vessels by Color Doppler Imaging (CDI) in patients with Primary Open Angle Glaucoma (POAG). METHODS: This cross-sectional study included 120 subjects - 60 patients with POAG and 60 controls, all of whom underwent full ophthalmological examinations and orbital CDI. The Ophthalmic Artery (OA), Central Retinal Artery (CRA) and Ciliary Arteries (CA) were identified, and for each of them, we measured Peak Systolic Velocity (PSV), End Diastolic velocity (EDV) and Resistivity Index (RI). RESULTS: The PSV of the OA and CRA were significantly lower in patients with POAG compared to normal controls (P<0.0001, < 0.009 respectively). The EDV in the OA, CRA and CA were significantly lower than in normal controls (P<0.0001). The RI of the OA, CRA and CA were significantly higher in patients with POAG compared to controls (P<0.0001). The EDV of the OA showed significant negative correlation with duration of glaucoma (r=-0.37, P<0.042). The EDV of the CA showed significant negative correlation with intraocular pressure (IOP) (r=-0.86 and P value 0.0001). The PSV and EDV of the CRA showed significant negative correlation with IOP (r=-0.45, r=-0.73, P values 0.011, and 0.0001 respectively), and the RI of the CRA showed significant positive correlation with IOP (r=0.42 and P value 0.021). CONCLUSION: CDI is a feasible, noninvasive, safe tool for the assessment of hemodynamic changes in the orbital arteries of POAG patients. The orbital arteries showed significantly lower flow velocities and increased resistivity indices in patients with POAG compared to the control group, and these changes were correlated with glaucoma duration and IOP.

Incidence and Risk Factors of Rachitic Genu Varus in Preschool Children in a Paediatric Health Institute in Egypt as One of the Developing Countries.

BACKGROUND: Rachitic genu varus is one of the common conditions among the Egyptian children, despite the shinning sun of Egypt all the year. PURPOSE: The aim of the study was to estimate the incidence of rachitic genu varus among the Egyptian children, and to assess the risk factors contributing to it. PATIENTS AND METHODS: This prospective study recruited a total of 250 consecutive children, being 130 males and 120 females, with rachitic bow legs or genu varus, between 2 - 4 years of age, together with 250 controls of the same age group, out of a total number of 1900 children with other types of rickets, and other children's orthopaedic diseases, who presented to the National Institute of Neuromotor System in Egypt between September 2014 to September 2015. The cases and the controls were subjected to clinical, laboratory biochemical, and plain radiographic examinations. Their parents were subjected to epidemiological, maternal, and nutritional questionnaires. RESULTS: The calculations revealed high incidence (13.1%) of rachitic genu varus. The risk factors were low socioeconomic status, insufficient family income, poor housing conditions, lack of exposure to sunlight due to cultural practices, sole breast feeding, and inadequate supplementation of vitamin D to the children and the pregnant women. The p value was <0.05. CONCLUSION: Vitamin D deficiency rachitic genu varus is a multifactorial condition in Egypt. Raising the standard of living, level of education, housings, and dietary supplementation of vitamin D to the pregnant women and infants are the solution.

Bancroftian filariasis: clinical parasitologic and serologic evaluation after 4 years applying two antifilarial regimens.

In August 1 997, 124 individuals out ot 1,110 were selected as being seropositive for circulating filarial antigen OG4C3 (CFA). Ten healthy children proven negative for CFA were used as controls. The patients were classified into: G1 28 patients; 20 asymptomatic microfilaraemic and 8 symptomatic amicrofilaraemic (AMF), G2 80 patients, 22 asymptomatic MF, 48 asymptomatic AMF and 10 symptomatic AMF and G3 16 asymptomatic AMF. G1 was treated by single annual dose of diethyl carbamazine (DEC) (6mg/kg), G2 by single annual dose of albendazole 400 mg and DEC 6mg/kg and G3 untreated. Four years later (2001), patients Were re-evaluated. Microfilaraemia prevalence in MF patients was lowered to 20% (G1) and 9.1% (G2). Antigenaemia prevalence was lowered to 46.4%, 17.5% and 87.5% in the three groups respectively. The disease became manifested among the asymptomatic in 5% (G1) and 10% (G2), but 25% (G3). The four years lowered the prevalence of microfilaraemia, but it was not sufficient for its elimination from the blood. So, a program to eliminate filariasis should be extended beyond this period to achieve no transmission and minimizes newly cases.

Pulmonary function tests, high-resolution computerized tomography, alpha1-antitrypsin measurement, and early detection of pulmonary involvement in patients with systemic sclerosis.

OBJECTIVE: Pulmonary disease represents a major complication of systemic sclerosis (SSc). However, pulmonary involvement is commonly silent. In this study, we investigated the relationship between serum alpha1-antitrypsin and other means of assessing pulmonary involvement. METHODS: Twenty-two patients affected by SSc were studied (mean age 37.6+/-14.3 years, mean duration of disease 9.9+/-11.9 years). Fourteen had the diffuse form of disease (dSSc) and eight had the limited form (lSSc). All patients underwent pulmonary function tests, high-resolution computed tomography (HRCT) of the lungs, echocardiography, and serum assessment of alpha1-antitrypsin. RESULTS: Mean percentage of predicted values of forced vital capacity was lower in patients with dSSc than with lSSc (72.3+/-17.8 vs 74.5+/-8, P=NS). Mean percentage of predicted values of forced expiratory volume in 1-s forced vital capacity (FEV1/FVC) was lower in patients with lSSc (79.8+/-7.5 for lSSc vs 84.4+/-7.8 for dSSc, P= NS). The overall HRCT score was 5.6+/-5.9 with no significant difference between disease subgroups. Pulmonary hypertension was detected in two cases, both with dSSc. Alpha1-antitrypsin was significantly higher in patients than in controls (P < 0.01), with no significant difference between disease subgroups, and correlated significantly with ground glass opacities in H RCT (P < 0.05) and the detection of diffusion defects (r= -0.61, P<0.01). No significant correlation was observed between skin score or degree of dyspnea with HRCT score, lung volume, or carbon monoxide diffusing capacity. CONCLUSION: Restrictive lung disease was more pronounced in patients with dSSc. Alpha1-antitrypsin levels correlated significantly with ground glass opacities, an early finding of pulmonary involvement in SSc. Extent and severity of skin involvement and degree of dyspnea were not related to pulmonary involvement.

Studies on flea fauna in El Fayoum Governorate, Egypt.

This paper dealt with the studies of flea fauna as collected on the rodent hosts over one year. The collected rodents (499) in a descending order of abundance in the collection were Rattus rattus, R. norvegicus, Mus musculus, Gerbillus pyramidum and Arvicanthis niloticus. The collected fleas in a descending order in the collection were X. cheopis, P. irritans, N. jasciatus, C. felis, L. segnis and E. gallinacea. The total flea index reached the maximum (0.76) in May and it was zero in December and January. The highest number of fleas was on R. norvegicus and A. niloticus and the lowest was on G. pyramidum. The highest number of rodents and their flea ectoparasites was during the Spring and the lowest was during Autumn. The medical importance of the collected fleas and the whole results were discussed.

Relation between weaning and gastroenteritis.

PIP: More than 50% of Egyptian children who die before reaching age 2 years perish as a result of acute infantile diarrhea. Most health experts in Egypt recommend that weaning foods be given to infants beginning at age 4-6 months, the point at which breast milk alone cannot meet an infant's nutritional needs. Findings are reported from an evaluation of the relationship between the weaning period and the possible incidence of diarrheal attacks. 60 cases aged 6-24 months presented with diarrhea after the early introduction of foods during the weaning period. 100 healthy infants matched according to age, sex, and socioeconomic status served as controls. 46.6% of cases were among infants under 1 year old. Only 30% of the children were originally breast-fed. Isonatremic dehydration accounted for 75% of all dehydration among the subjects, while E. coli caused 28.3% of cases, E. histolytica 21.6%, and Giardia lamblia 16%. The presence of polymorph nuclear leucocytes in the stool was a predictive test for the bacterial etiology of diarrhea with a positive predictive value of 87%. Finally, the band/neutrophil ratio of the bacterial group was significantly different from that of the control group, although no statistically significant difference was identified when comparing the parasitic diarrheal group to the control group.^ieng