Secondary inguinal hydatidosis mimicking irreducible inguinal hernia: report of a rare case.

Peritoneal hydatidosis secondary to liver hydatid disease is not uncommon but peritoneal hydatidosis herniating to the inguinal canal is rare, with fewer than five cases reported in the literature. We describe a 54-year-old man who presented with a progressively enlarging soft, cystic swelling in the right inguinal region. Clinical examination suggestive of irreducible right inguinal hernia and ultrasonography revealed it to be a cystic swelling within the hernial sac. The swelling was excised en bloc and open mesh hernioplasty was performed. Cyst biopsy revealed hydatid disease; hence, the patient was put on adjunctive albendazole chemotherapy for 3 months.

[Activity of B and D factors of complement alternative pathway in children with atopic dermatitis].

AIM: Development of enzyme immunoassay detection of B and D factors of complement alternative pathway functional activity for solving diagnostic and prognostic problems of patient therapy. Study activity of these factors in blood sera of children with atopic dermatitis before and after therapy for elucidation of the role of complement alternative pathway in pathogenesis of this disease. MATERIALS AND METHODS: Children aged 6 months to 18 years with atopic dermatitis were examined for functional activity of B and D factors in blood sera before and after therapy by the developed methods. RESULTS: The developed enzyme immunoassay methods for determination of functional activity of B and D complement alternative pathway showed high sensitivity and reliability. In children with atopic dermatitis factor B and D activity was significantly lower than normal before treatment. After treatment these activity increased significantly (p < 0.004) and in the case of D factor--up to normal. CONCLUSION: The data obtained in the study indicates the presence of complement alternative pathway activation in atopic dermatitis in children and the possibility of use of factor B and D functional activity analysis for diagnostic and prognostic purposes.

Tubercular etiology in a pilonidal sinus of the forehead: truth or myth?

Pilonidal sinuses are a well-described surgical condition first recognised in the 19th century. They have most commonly been reported in the intergluteal cleft; involvement of other sites is limited to isolated case reports. Association of this condition with tuberculosis is rare and how the two conditions affect each other's causation is poorly understood. We report a rare case showing tubercular pathology in a chronic pilonidal sinus on the forehead of a young lady. A careful review of the lesion was required before labelling it as non-tubercular. The histopathological similarity between a foreign body reaction and tuberculosis in such lesions may confuse the clinician, and therefore differentiation is important to prevent morbidity associated with anti-tubercular therapy.

[Masked deficiency of C4 component of complement in patients with chronic gastrointestinal tract diseases of different etiology].

AIM: Frequency of occurrence detection of C4A and C4B complement system deficiency in patients with chronic gastrointestinal tract (GIT) diseases including gastric ulcer (GU) and duodenal ulcer (DU). MATERIALS AND METHODS: 74 patients with chronic GIT diseases were examined. Endoscopy with stomach mucosa condition evaluation based on histobacterioscopic examination of gastroduodenal biopsy samples was used. Intestine microbiocenosis evaluation was performed by using microflora degree of manifestation according to Federal Standard of Russian Ministry of Health No 231 -91500.11.0004-2003. C4A and C4B isotypes in blood sera of patients were measured by using enzyme immunoassay. RESULTS: Chronic gastroduodenitis was diagnosed in 35.1%, pangastritis B--in 41.9%, GU and DU--in 23% of patients. Histological evaluation of biopsy samples revealed marked inflammatory changes in stomach and duodenum mucosa in 77% of patients. Stomach mucosa infection rate by Helicobacter pylori reached 85%. Microbiological disorders manifestation in microflora of patients matched endoscopic and histobacteriscopic changes in it and was the highest for GU and DU. In 76.0% of cases C4A and C4B isotype deficiency in blood sera matches the development of erosive-ulcerous process in stomach and duodenum mucosa with marked background dysbiotic GIT microbiota disorders. CONCLUSION: Patients with functional deficiency of C4A and C4B isotypes have a genetic burden to susceptibility to chronic GIT diseases whereas H.pylori infection deteriorate the disease.

[Enzyme immunoassay of masked complement component C4 deficiency in patients with urogenital Chlamydia infection].

AIM: Development of new method of C4B isotype functional activity evaluation in enzyme immunoassay by using pharmaceutical preparation derinat as a classical pathway complement activator and its use for blood sera isotyping in confirmed urogenital tract chlamydia infection. MATERIALS AND METHODS: Enzyme immunoassay was used to detect C4A and C4B isotype functional deficiency in blood sera of patients. Chlamydia etiology urogenital infection diagnosis was based on results of standard clinical-instrumental examination methods: vaginal clinical smear analysis, scrape sample light microscopy with consequent treatment by fluorescent monoclonal antibodies against Chlamydia trachomatis and PCR. RESULTS: In acute form of the disease C4A deficiency frequency of occurrence was 0.36, and C4B deficiency - 0.55. In chronic form of the disease deficiency frequency of occurrence was 0.38 for both isotypes. In the group of healthy people isotype deficiency was 0.08 and 0.25, respectively. CONCLUSION: Innate masked C4 deficiency interfere with the normal immune defense of organism against chlamydia infection, and antigen carbohydrate pathogenicity may possibly be more significant for the development of immune response to which C4B isotype activity is necessary.

Self-medication in urban and rural Zimbabwean communities.

1. A questionnaire examining the use of, and knowledge about over-the-counter (OTC) drugs was administered verbally to representatives from 200 urban and 200 rural households. Self-medication was common in both groups but there were more drugs present in rural (336 items) than urban homes (231 items) with the differences largely due to the more frequent presence of traditional medicines in rural homes. 2. Analgesics were the commonest items in the homes of both groups. A positive urine screening test for aspirin, chloroquine, or antibiotics was found in 25% of urban and 27% of rural samples tested. Respondents who elected to use an OTC drug for a particular symptom usually chose an appropriate drug. 3. Rural respondents were more likely to use traditional medicines particularly for the treatment of cough, abdominal pain, and diarrhoea. 4. Knowledge about dosages, the possibility of adverse reactions, and the seriousness of potential poisoning with OTC drugs was inadequate and needs to be corrected for more efficient self-medication.

Self-medication with chloroquine for malaria prophylaxis in urban and rural Zimbabweans.

Representatives of 200 urban and 200 rural households were interviewed to determine the extent and appropriateness of the use of chloroquine obtained over-the-counter for malaria prophylaxis. Malaria prophylaxis was taken by 38 urban and 65 rural respondents. Chloroquine was the only drug used and was found in 7 urban and 40 rural households. The presence of chloroquine was detected in 4/130 urban and 11/136 rural urine samples tested. Knowledge about chloroquine was unsatisfactory with 6 urban and 10 rural respondents aware that chloroquine could have harmful adverse effects. The doses of chloroquine taken for prophylaxis varied widely, and of the 103 respondents who took prophylaxis only 16% (urban) and 31% (rural) were taking the correct dose. Self-medication accounts for a substantial, little acknowledged, portion of chloroquine use. To limit appropriate use of a powerful, potentially dangerous antimalarial drug and perhaps extend the useful therapeutic life of chloroquine clear recommendations and population education are needed.