Impact of soil and groundwater corrosion on the Hierakonpolis Temple Town archaeological site, Wadi Abu Sufian, Idfu, Egypt.

Hierakonpolis, Greek for City of the Hawk, nearly 25 km NW of Idfu (Egypt), is an important and extensive archaeological discovery covering a large area. Its richness in archaeological artifacts makes it a valuable site. It has a valid claim to be the first nation state, as indicated by the Palette of Narmer discovered in its main mound. Geological and hydrogeological investigations at the Hierakonpolis Temple Town site documented nearly a 4.0-m water table rise from as early as 1892 to the present. In addition to the rising water levels, the increase of both subsoil water salinity and humidity threatens and damages fragile carvings and paintings within tombs in Kingdom Hill, the foundation stability of the site, and the known and still to be discovered artifact that recent pottery finds dates at least 4,000 BCE. Representative rock and soil samples obtained from drilled cores in the study area were chosen for conducting detailed grain size and X-ray analysis, light and heavy mineral occurrences, distribution of moisture and total organic matter, and scanning electron microscopy investigations. Mineralogical analysis of clays indicated that the soil samples are composed of smectite/illite mixed layers with varying proportions of smectite to illite. Kaolinite is the second dominant clay constituent, besides occasional chlorite. Swelling of the clay portion of the soil, due to the presence of capillary groundwater, in contact with buried mudbrick walls expands and causes severe damage to important exposed and buried mudbrick structures, including the massive ancient "fort" believed to date from the Second Dynasty (from 2,890 to 2,686 BC). The "fort" is 1.0 km south of the Temple Town mounds near to confluence of Wadi Abu Sufian. Groundwater samples from the shallow aquifer close by the intersection of Wadi Abu Sufian and the Nile flood plain were analyzed for chemical composition and stable isotope ratios. The groundwater in the upper zone (subsoil water) within fine-grained Nile alluvium is characterized by high salinity which varies from 415 to 4,500 mg/L total dissolved solids. In contrast, most of the groundwater samples in the lower zone (Quaternary aquifer) are characterized by a low salinity in the order of 164-792 mg/L. Values of δD and δO(18) obtained from this deep (9-20 m) aquifer ranged from 16.98 to 19.87 ‰ and from 1.67 to 2.99 ‰, respectively. These values indicated that the Quaternary aquifer waters are recharged directly from recent Nile water. Subsoil water is very shallow in the area; it ranged from 0 to 2.6 m with a mean of 1.1 m within the main mound of the Hierakonpolis Temple Town site by 2003, in contrast to its more than 4.5-m depth in 1897. The exposure of subsoil water to increased evaporation is expected, with a consequent increase in the concentrations of dissolved solids and usually large proportions of chloride and sulfate. Artifacts recovered from the Temple Town site are becoming damaged and destroyed by crystallization processes caused by repeated wetting and drying of salt and the accumulation of new salts.

Diagnosis of Ornithobacterium rhinotracheale infection in chickens by ELISA.

Specific Ornithobacterium rhinotracheale (ORT) antibodies were determined in serum samples of 24 clinically infected broiler flocks of different ages (1-42 d) and 11 broiler-breeding flocks (at ages between 26-56 w) by ELISA. Two commercially available kits were separately assessed. The BioCheck ELISA kit was used for testing 363 serum samples representing 12 broiler flocks, where 74 samples (20.3 %) were found to be positive and 49 (13.5 %) were suspected. The IDEXX ELISA kit was used for testing 148 serum samples representing different 12 broiler flocks, where 115 samples (77.7 %) were positive. Testing of additional 70 serum samples from 5 broiler- breeder flocks, associated with drop in egg production (1-4.5 %) at different ages, by BioCheck ELISA kit revealed that 78.5 % of the samples were positive and 21.4% were suspected. On the other hand, 338 serum samples representing 6 broiler-breeder flocks, associated also with egg drop, showed a 84.6 % rate of positive reaction, when tested by IDEXX ELISA kit. Positive serology correlated well with the clinical manifestations and isolation of the organism, which substantiates the reliability of the used kits in diagnosis of the disease.

The epidemiology of schistosomiasis in Egypt: Ismailia governorate.

A multi-stage stratified sample of 12,515 individuals from 1,941 households in 42 villages in the Ismailia governorate of Egypt were surveyed for schistosomal infection. A subset of 2,390 subjects were surveyed for morbidity by physical and ultrasonographic examination. The prevalence of Schistosoma mansoni infection in rural Ismailia was 42.9% and the geometric mean egg count (GMEC) was 93.3 eggs/gram of stool, with considerable variability between communities. Prevalence and intensity peaked in the 20-30-year-old age group and was higher in males than in females. Prevalence and intensity of S. haematobium was very low: 1.8% and 3.5 ova/10 ml of urine GMEC, respectively. Canal water exposure risk factors for S. mansoni infection were males bathing (odds ratio [OR] = 2.2), females washing clothes (OR = 1.9), and children playing or swimming (OR = 2.3). Presence of in-house piped water supply and latrine lowered infection rates (P < 0.001 and P = 0.002, respectively). Histories of S. mansoni infection (OR = 1.6) or treatment (OR = 1.5) and blood in feces (OR = 3.5) were associated with infection. Hepatomegaly (16.0%) was more frequently detected than splenomegaly (3.6%) by physical examination, with both being more frequent in older age groups. Splenomegaly, but not hepatomegaly, was associated with presence of S. mansoni ova in stools (OR = 1.4) and the community burden of infection (P = 0.02). Ultrasonographically detected hepatomegaly, splenomegaly, and periportal fibrosis (PPF) were detected in 43.0%, 17.4%, and 39.7% of the subjects, respectively. The higher grades of PPF were rare. Ultrasonographically detected splenomegaly, not hepatomegaly, was associated with S. mansoni infection, community burden of infection, and PPF. Risk factors for PPF were the same as for S. mansoni infection. There was a marginal association of PPF with infection and none (P = 0.33) with the intensity of infection in individuals or in the community. We conclude that in rural Ismailia, S. haematobium infection is rare but the prevalence and intensity of infection with S. mansoni is high. The risk of infection is associated with environmentally detected factors and behaviors. Hepatosplenic morbidity attributable to S. mansoni infection is low, presumably because of the favorable effect of wide application of praziquantel therapy.

HCV-RNA and anti-HCV IgM in Egyptian subjects bearing IgG anti-HCV antibodies.

The hepatitis C virus (HCV) infection is associated with a wide spectrum of clinical entities ranging from asymptomatic carriage to severe forms of chronic hepatitis. In Egypt, HCV infection has been shown to be highly prevalent. The aim of this study was to determine the frequency and significance of anti-HCV IgM in the sera of clinically healthy blood donors and chronic HCV patients, whose sera were also positive for anti-HCV IgG. Anti-HCV IgM was detected in the sera of 7 (46%) of the blood donors (n = 15), of whom 5 (71%) had a positive HCV-RNA. The corresponding results in patients with a chronic hepatitis C (CHC) infection (n = 19) were 8 (42%) and 5 (62%) respectively. The detection of anti-HCV IgM did not correlate with a positive test for HCV-RNA (R = 0.2) in the CHC patients. However, the levels of anti-HCV IgM in CHC patients were associated significantly with the level of serum transaminase, a finding that can be used in monitoring disease activity in such a group of patients. On the other hand, a significant association was evident between the detection of anti-HCV IgM and HCV-RNA in the sera of blood donors. Thus among the blood donors, viraemia correlates well with the detection of HCV-IgM Ab, but it cannot be excluded in its absence. The presence of HCV-IgM in some patients with CHC infection indicates that the antibody as a viral marker may not be unique to acute HCV infection.

Antibody to GBV-C second envelope glycoprotein (anti-GBV-C E2): is it a marker for immunity?

The clinical significance of GB virus C (GBV-C E2) antibody is under investigation. The prevalence rates of GBV-C RNA and antibody to GBV-C E2 glycoprotein were determined in a population of 123 Egyptian anti-hepatitis C virus (HCV)-positive patients with chronic liver disease (CLD) who had not been treated previously with interferon. Sera were tested for GBV-C RNA by the LCx assay (Abbott Laboratories, North Chicago, IL), and for GBV-C E2 antibody by enzyme immunoassay. GBV-C RNA was present in 11.4% of patients. GBV-C E2 antibody was detected in 55.9% of GBV-C RNA-negative patients and in 2.2% of GBV-C RNA-positive patients (P = 0.006). GBV-C RNA was associated significantly with a history of schistosomiasis (relative risk [RR] = 5.83, 95% confidence interval [CI] 1.99-17.14, P < 0.005) but not with parenteral risk factors. The presence of GBV-C E2 antibody was not associated with age, gender, parenteral risk factors, schistosomal infection, or HCV viremia. The HCV genotype and level of viremia were similar in GBV-C anti-E2-positive and negative patients. There was a trend toward more severe histological disease with anti-E2 seropositivity (RR = 1.45, 95% CI 0.89-2.45, P = 0.11), an association which was independent of the evidence of schistosomiasis. It is concluded that GBV-C infection is common among HCV-infected Egyptian patients with CLD due to HCV infection. A significant negative correlation between the GBV-C viremia and GBV-C E2 antibody suggests that an antibody response is associated with viral clearance. This antibody response presumably occurs spontaneously, as none of the patients had received antiviral therapy. The unexpected association between GBV-C RNA and schistosomiasis suggests that nonparenteral or occult parenteral routes of GBV-C infection are likely to be important.

Minoxidil selectively improves peritoneal ultrafiltration.

This cross-over randomized clinical trial was carried out to evaluate the effects of intraperitoneal (i.p.) administration of minoxidil on fluid removal and solute clearance during peritoneal dialysis. Twenty-one patients with endstage renal disease, awaiting enrollment in chronic hemodialysis therapy, were randomly allocated to receive i.p. minoxidil either in the first or the last nine cycles of a 24-cycle peritoneal dialysis session. Cycle-to-cycle data on fluid balance, blood pressure, and adverse effects of the drug were obtained. The dialysis fluid recovered in cycles 3, 6, 9, 18, 21, and 24 was analyzed, together with plasma, for creatinine, urea nitrogen, and protein content. The mean excess fluid volume collected in minoxidil cycles was 1123.8 +/- 1119 mL versus 145.2 +/- 743.6 mL in the minoxidil-free cycles (p = 0.004). The mean creatinine clearance, urea nitrogen clearance, and protein losses were comparable in minoxidil cycles and the minoxidil-free cycles. Six patients developed hypotension during the minoxidil cycles, corrected by normal saline, but no other important side effects were noted. It is concluded that i.p. minoxidil selectively increases ultrafiltration without influencing solute clearance in peritoneal dialysis.

High prevalence of hepatitis C virus among urban and rural population groups in Egypt.

Hepatitis C is a major health problem for Egypt. The aim of this study was to determine the seroprevalence of antibodies to hepatitis C virus among different population groups living in urban and in two different rural areas (Suez Canal and North Sinai) of Egypt. Secondary objectives were to study the possible association between multiple blood transfusions, haemodialysis or Schistosomiasis and the seroprevalence of antibodies to hepatitis C. A seroprevalence of hepatitis C virus in the urban blood donor population of 14.5% was found, confirming other reports. In the two rural areas of the Suez Canal and the North Sinai the seroprevalence was 14.4% and 15.5% respectively, showing a comparable seroprevalence in these three different populations. The seroprevalence was 70.4% in haemodialysis patients, 7.7% in health care workers, and 75.6% in thalassaemic children, thus a seroprevalence among multitransfused or haemodialysed patients comparable to the one described in many other countries. Schistomiasis does not seem to play a role in the seroprevalence of this disease in Egypt.

Ovarian cysts and tumours in infancy and childhood.

Cysts and tumours of the ovary are not uncommon in childhood. In 33 years between 1950 and 1982 106 patients were operated on at Alder Hey Children's Hospital and the Royal Liverpool Children's Hospital. Of these 71 were pre-menarchal. The mode of presentation, pathology and diagnostic difficulties of the pre-menarchal lesions are reviewed. The value of ultrasound scanning has become apparent in recent years. Most cysts and tumours are benign, but dysgerminomas are the most common malignant tumours encountered. Even when there is evidence of spread of the tumour the prognosis in these remains reasonably good.

Urinary catheters in spina bifida.

Since 1974, 56 children with a neuropathic bladder were selected for intermittent or indwelling catheterisation. Indications for catheterisation included incontinence, hydronephrosis, and/or difficulty with bladder expression. Good results were obtained in 70% of girls and 50% of boys. The catheter was abandoned in 7 children, mainly because of lack of cooperation from the parents. Deterioration occurred only in those children with both hydronephrosis and vesico-ureteric reflux prior to catheterisation. Of the latter group of children, 33% suffered upper tract deterioration, and we now consider vesico-ureteric reflux to be a relative contra-indication to catheterisation, except in those children with severe disabilities and deformities, in whom antireflux surgery or urinary diversion would be unacceptable or technically difficult. Indwelling penile catheters should not be recommended for boys, but catheterisation via a perineal urethrostomy may prove helpful in those unable either to catheterise themselves intermittently or to wear a penile appliance.