Visceral leishmaniasis among hypersplenic patients in Dakahlia Governorate, Egypt.

Generally speaking, with rapid international travel, it is very common to diagnose infectious diseases in areas where they were not known before. Nowadays, visceral leishmaniasis (VL) is documented in Egypt mainly in Al Agamy, Alexandria. Another case of infantile visceral leishmaniasis was identified in an adult farmer (unusual host) in Banha. Other studies all over Egypt (based on clinical and or serological diagnosis rather than demonstration of the parasites) raised the possibility of adult affection with visceral leishmaniasis. The point is that visceral leishmaniasis, shares many clinical manifestations with other diseases known in Egypt as schistosomiasis mansoni, hepatic amoebiasis, toxoplasmosis, and malaria. In the present study, out of 22 human cases with hypersplenism and suggesting manifestations, four gave seropositivity for VL, by the indirect haemagglutination tests (128 & more). Two of these four patients gave seropositivity by dot-ELISA (1:8000). Amastigotes of Leishmania parasite were demonstrated in the splenic smears obtained during splenectomy. One culture obtained from these two cases grew promastigotes. Typing is ongoing. It was concluded that visceral leishmaniasis should be in mind and considered in the differential diagnosis of patients with hepatosplenomegaly or hypersplenism in Egypt.

Survey of mycoflora and mycotoxins in Egyptian soybean seeds.

After four months in commercial storage, 100 soybean samples from different places of Egyptian Governorates were assayed for filamentous fungal growth at two incubation temperatures (28 and 45 degrees C). 73 species and 8 varieties belonging to 32 genera were isolated by the dilution plate method. At 28 degrees C, the common species were Aspergillus flavus, A. fumigatus, A. niger and A. alutaceus, followed by A. terreus, Penicillium chrysogenum, P. citrinum, Mucor hiemalis, M. racemosus, Emericella nidulans, Rhizopus stolonifer, Nectria haematococca and Scopulariopsis brevicaulis. At 45 degrees C, A. fumigatus was the dominant species followed by Rhizomucor pusillus, Emericella nidulans and Neosartorya fischeri. Penicillium which was one of the most abundant genus at 28 degrees C, absent at 45 degrees C. The seeds were assayed for aflatoxin, ochratoxin A, sterigmatocystin, T-2 and zearalenone by thin layer chromatographic analysis. Aflatoxin was detected in 35% of soybean seed samples (5-35 micrograms/kg). The other mycotoxins were not detected.

Comparison of two methods of axillary brachial plexus anaesthesia.

Comparison of the trans-arterial and Winnie techniques of axillary brachial plexus block was made in two groups of patients. This study did not find any statistical difference between the two techniques.

Epidural fentanyl and monoamine oxidase inhibitors.

The successful use of continuous epidural fentanyl infusion to control postoperative pain in a patient treated with monoamine oxidase inhibitors is described. The use of epidural opioids may be a safe technique for the management of such patients.