@article { author = {Ahmed, Mohamed and Ibrahim, Gehan and Bakr, Hoda and Meawed, Takwa}, title = {Assessment Of C-Reactive Protein And Macrophage Migration Inhibitory Factor In Diabetic Foot Infection}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {19-27}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9054}, abstract = {Background and study aim: : Diabetic foot ulcer is a universal health problem. Neuroischemic changes and infection are responsible for its occurrence and complications. Altered or complete loss of sensation and microvascular disease complicated by unchecked infection can precipitate tissue necrosis and gangrene. A threat for a rapid test predicting early infected foot ulcer emerges. C-reactive protein (CRP) and macrophage migration inhibitory factor (MIF) are involved in innate inflammatory response. We aimed at evaluation of the ability of C-reactive protein and macrophage migration inhibitory factor to differentiate between early infected and non infected diabetic foot ulcers and to detect risk factors of diabetic foot ulceration. Patients and methods: : 52 diabetic patients were selected, examined and classified into 3 groups : Group (I): Included 12 patients with non-infected diabetic foot ulcer (grade І), group (П): Included 30 patients with mildly infected diabetic foot ulcer (grade П) and group (ПI): Included 11 diabetic patients free from foot wounds used as a control group. In addition to routine laboratory investigations, serum CRP was measured using. Enhanced Immuno-tubidimetric Assay. MIF level was detected by ELISA. Swabs from the diabetic foot ulcers were taken for aerobic and anaerobic cultures. Results : Statistically significantly elevated Hb A1C%, MIF and CRP levels were detected in mild infected diabetic foot ulcer compared to studied groups (P <0.05). Dermatological changes were statistically significant risk factors for diabetic foot ulcers, accounted for 88.1% of ulcer cases. The most frequently isolated organism was E coli. The most common site for ulcers was the toes representing 50% of the cases. Conclusion : CRP and MIF can differentiate early infected from non-infected diabetic foot ulcers.}, keywords = {C-reactive protein,diabetic foot ulcer,Macrophage Migration Inhibitory Factor}, url = {https://aeji.journals.ekb.eg/article_9054.html}, eprint = {https://aeji.journals.ekb.eg/article_9054_c0071d4a7a3842bc1fd5bbafa0c478fc.pdf} } @article { author = {Bihery, Ahmed and El-Shamy, Mostafa and El-Mokadem, Talaat and Zaher, Tarik and Abd Eldayem, Waleed and Fathy, Talaat and Emara, Mohamed Hassan}, title = {Percutaneous Local Injection of Ethanol and Mitoxantrone in Treatment of Hepatocellular Carcinoma}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {28-36}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9057}, abstract = {Background and study aim: New therapeutic choices have been developed for hepatocellular carcinoma (HCC), including percutaneous ablation therapy, transarterial chemoembolization, radiation therapy and molecular target therapy. Ablation of liver tumors is currently the main alternative to formal liver resection. This work aimed at comparing percutaneous ethanol injection (PEI) with combined percutaneous ethanol and mitoxantrone injection (PIM) in treatment of HCC. Patients and methods: : This study included 125 patients with 131 HCC lesions which were randomly divided into two groups; group I composed of 68 lesions in 65 patients treated with PEI. Group II composed of 63 lesions in 60 patients treated with PEI and PIM. Clinical assessment, laboratory evaluation and CT studies were performed to all patients pre treatment and at 3, 6, and 12 months post treatment. Each focal lesion was considered as one subject. Results : : The percentage of ablation in both groups at 3, 6, 12 months were 60.3%, 48.5% and 39.7% in group I respectively versus 85.5%, 74.6% and 68% in group II respectively with a statistical significant difference between the two groups. There is an increased number of local recurrence in group I compared to group II. Side effects and complications are comparable in both groups. Conclusion : : Combination of PEI and PIM is better than PEI alone without additional complication and recurrence rate seemed to be better in combination therapy than PEI alone.}, keywords = {Hepatocellular carcinoma,ethanol,mitoxantrone,Ablation}, url = {https://aeji.journals.ekb.eg/article_9057.html}, eprint = {https://aeji.journals.ekb.eg/article_9057_7e2e9dfc4eb4d2f800133853fffc281c.pdf} } @article { author = {Emam, Mohamed and Abd El-dayem, Waleed and Elhawari, Soha and Heeba, Hayam and Emara, Amany}, title = {Interferon Therapy For Elderly Egyptian Patients With Chronic Hepatitis C of Genotype 4}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {37-44}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9058}, abstract = {Background and study aim: Hepatitis C (HCV) affects nearly one in every 5 Egyptians which is the highest incidence allover the world. Most of the Egyptian Chronic Hepatitis (CHC) patients are of genotype 4 where it represents 90% of all Egyptian HCV cases. The clinical utility of antiviral therapy in elderly patients in our locality is not clear, also little information is available in literatures allover the world on treatment of such group of patients with genotype 4. The present study aimed at evaluating the efficacy and safety of combination therapy (pegylated interferon alpha 2a (PegIFN-alph2a) and ribavirin) in treatment of elderly Egyptian patients with HCV genotype 4. Patients and methods: 60 elderly Egyptian patients (more than 55years) with chronic HCV (group 1) and another group of 72 younger (less than 55 years) age patients (group 2) were enrolled in the present study. Both group of patients were compensated and all of genotype 4. Both groups received 180 mcg PegIFN-alpha2a subcutaneously once weekly and ribavirin (1000-1200mg/daily) for 48 weeks. Patients were followed for 48 weeks and sustained virological response and safety were assessed in both groups. Results : A significant improvement in both end of treatment response (ETR) and sustained virologic response (SVR) was noted in both group, where ETR was achieved in 32 (53.3%) and 41 patients (56.9%) in both groups respectively, and 27 patients in group 1 (45.0%) and 38 (52.8%) in group 2 could retain negative viraemia SVR by the end of follow up period. SVR showed a non-significant negative correlation with age. Viral clearance after 4weeks of therapy was associated with high incidence of ETR and SVR (P <0.001), but without significant difference between both groups. Rate of discontinuation and periods of discontinuation and side effect and safety of therapy was not significantly different in both groups. Conclusion : Despite these challenges, the present study showed that HCV treatment was generally well tolerated by the elderly Egyptian patients (55-68 years) with a little or no significant difference in SVR as well as therapy discontinuation rates secondary to adverse effects compared to younger age groups. Therefore, we recommend that chronic HCV Egyptian patients of age 55 years and more should be included in trials of chronic hepatitis C treatment and old age is no more contraindication for interferon/ribavirin therapy and the risk-benefit of antiviral therapy should be assessed on an individual basis.}, keywords = {HCV,Elderly,interferon}, url = {https://aeji.journals.ekb.eg/article_9058.html}, eprint = {https://aeji.journals.ekb.eg/article_9058_7a192cecdeb22c67a1582236c8e66e34.pdf} } @article { author = {Elhawari, Soha and Hamed, Emad}, title = {Probiotics in Early grades of Hepatic Encephalopathy}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {45-52}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9106}, abstract = {Background and study aim: Modification of intestinal flora, through different mechanisms is regarded as a therapeutic option in management of hepatic encephalopathy. We conducted this study to test the ability of probiotics in treatment of early grades of hepatic encephalopathy in Egypt. Patients and methods: One-hundred educated cirrhotic patients without overt hepatic encephalopathy were included. Diagnosis of cirrhosis based on clinical, ultrasonographic and laboratory findings and patients were screened for grade I and minimal hepatic encephalopathy by psychometric tests. Hepatic encephalopathy was diagnosed if at least one of psychometric tests was abnormal. Thirty patients with abnormal psychometric tests were included in the final analysis. Acidophilus capsules and banana were given to all patients 30 minutes before meals 3 times daily for 2 weeks. Results : Minimal and grade I hepatic encephalopathy were found in thirty out of the one hundred screened patients (30%). Minimal and grade I hepatic encephalopathy were more common in Child class C, than in class B and A. Two weeks after Lactobacillus acidophilus intake, patients showed significant improvement in the performance of psychometric tests (P<0.001) while liver function tests and Child classes did not improve (P>0.05). Probiotics improved the clinical grades of hepatic encephalopathy; 96.7% (n=29) of patients showed improvement in clinical grade of hepatic encephalopathy and only one patient (3.3%) did not improve (P<0.05). Conclusion : Probiotics could be used to treat early grades of hepatic encephalopathy. Child classes and liver functions did not improve significantly after probiotic therapy.}, keywords = {probiotics,hepatic encephalopathy,psychometric tests,Lactobacillus acidophilus}, url = {https://aeji.journals.ekb.eg/article_9106.html}, eprint = {https://aeji.journals.ekb.eg/article_9106_ee3272028a44f1f4d8fbeb933f12ebc1.pdf} } @article { author = {Akinboro, Adeolu and Olasode, Olayinka and Onayemi, Olaniyi}, title = {The Pattern, Risk Factors and Clinico-Aetiological Correlate of Tinea Capitis Among the Children in a Tropical Community Setting of Osogbo, South-Western Nigeria}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {53-64}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9107}, abstract = {Background and study aim: Tinea. capitis is an important infective dermatologic disease of worldwide distribution among children. Its frequency is increasing especially in the developing world, and has become an endemic disease in some places. To determine the prevalence, the risk factors,pattern and clinico - aetiological correlate of tinea capitis among the children in Ilie community. Patients and methods: A total of 370 children aged 5 – 16 years; 185 with Tinea capitis as subjects and 185 relatively healthy children as controls . Multistage sampling method was employed, and house to house survey for Tinea capitis was conducted. The diagnosis of tinea capitis was made and scrapings were obtained for microscopy and culture. Results : The mean age was 7.31 + 2.52 years for the subjects and 7.40 + 2.43 years for the controls. The mean age of onset of T. capitiswas 5.2 + 2.039 years. The prevalence of T. capitis in Ilie Community was 43.5%. Contact with animals, soil and individuals with T. capitis were the prevalent risk factors for T. capitis. Large family size did contribute but not significantly to the spread of Tinea. Also, history of atopy did correlate but not significantly with disease chronicity. A total of 120 isolate representing 7 different dermatophytes including; T. metangrophytes (67.5%) as the leading organism were isolated. There was no case of mixed infection. Other isolates include T. tonsuran (13.3%), T. rubrum (10.8%), M. aodounii (2.5%), M. gypseum (2.5%), T. violaceum (1.7%), T. soudanence (1.7%). Trichophyton metangrophytes was the most frequent organism causing the predominant non – inflammatory type of T. capitis (Gray patch and Black dot type) though not exclusively among children age group 5-8 years and 9-12 years, followed by T. tonsurans. A bold step must be taken to effectively reduce contact with the sources of infection. Conclusion : Tinea capitis remains an endemic disease reaching variable epidemic proportion in some populations as seen in Ilie among the children. The non – inflammatory type (GPTC, BDTC) were the prevalent clinical types of T. capitis in Ilie.}, keywords = {Tinea Capitis,Clinical types, Dermatophytes, Risk factors}, url = {https://aeji.journals.ekb.eg/article_9107.html}, eprint = {https://aeji.journals.ekb.eg/article_9107_1e5c909ec4daf49bc2119e37a7530b9c.pdf} } @article { author = {Zaher, Tarik}, title = {Video Case :Extraction of a Coin from the Stomach of a 6 Months Infant}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {65-65}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9108}, abstract = {An Egyptian coin was accidentally ingested by a 6 months female infant . Repeated X rays over 2 weeks revealed the coin in the upper abdomen. Upper gastrointestinal endoscopy using Olympus GIF Q160 endoscope was performed. 1mg midazolam was administered intramuscularly . Endoscopy revealed impacted coin in the antrum of the stomach. Repeated attempts using shark tooth forceps were done. Finally the coin was successfully extracted.}, keywords = {Coin,Stomach}, url = {https://aeji.journals.ekb.eg/article_9108.html}, eprint = {https://aeji.journals.ekb.eg/article_9108_f960abfbc302de88e4d807406bef68a7.pdf} } @article { author = {Emara, Mohamed and Yousef, Salem}, title = {Esophageal Polyp in old man, is it common?}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {66-67}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9109}, abstract = {Esophageal polyps are abnormal growth of tissue within the esophageal lumen. Most are small and benign, while malignant polypoidal masses also do occur. We reported large polypoidal mass in old male that proved to be adenocarcinoma.}, keywords = {Esophageal polyp,old age,Adenocarcinoma}, url = {https://aeji.journals.ekb.eg/article_9109.html}, eprint = {https://aeji.journals.ekb.eg/article_9109_64b15475b8dd42afb336c45b4a95aafb.pdf} } @article { author = {Zaher, Tarik and Elgammal, Nahla and Mohamed, Dina}, title = {Case 1-2011: A 60 years Old Male with Coma and Fever with Recent Travel to South Sudan}, journal = {Afro-Egyptian Journal of Infectious and Endemic Diseases}, volume = {1}, number = {2}, pages = {68-71}, year = {2011}, publisher = {Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department}, issn = {2090-7613}, eissn = {2090-7184}, doi = {10.21608/aeji.2011.9110}, abstract = {A 60 years –old business man admitted to the intensive care unit of the Endemic and Tropical Medicine Department, Faculty of Medicine , Zagazig University , Egypt because of deep coma , fever and tachypnea.The patient had history of recent travel to Juba, south of Sudan 2 weeks befor admission. 5 days after return from Sudan , he noticed fatigue and mild fever.He was given non-specific treatment. 5 days later jaundice appeared on his skin , he was admitted to private hospital in Zagazig .The investigation showed total bilirubin :10 mg/dl , direct 7 mg/dl , ALT:150 , AST :120,Hg :10 gm/dl ,platelets :110000 / dl .The patient was managed as having acute liver disease. Later on malaria parasite test (MP test) was done and revealed P. falciparum in thick and thin blood films.The patient was referred to Zagazig Fever Hospital with deterioration of conscious level , quinine was given intravenously without improvement . In the next day , the patient was referred to Tropical Medicine Intensive Care Unit. The patient was deeply comatose ,deeply jaundiced and pale, splenomegaly was found , bubbling chest crepitations were auscultated.The urine was black and the skin showed echymosis .The investigations showed total bilirubin :32 mg /dl, direct bilirubin 22 mg/dl, Hg :6 gm /dl ,platelets : 15000/dl , creatinin: 6 mg/dl , INR :7 ,PH: 7.31 , bicarbonate :12 mmol/l and glucose : 350 mg/dl. Hemoglobin was found in urine. Quinine was given by intravenous infusion in the dose of 20mg /kg loading dose then 10mg/ kg every 8 hours. Doxycyclin 100 mg /12 hours was given through the Ryle . Intravenous frusemide was given as well as oxygen inhalation as a measure against pulmonary edema , also chest consultation for the possibility of mechanical ventilation was requested.Transfusion of platelets, fresh frozen plasma ,and backed red blood cells were given . Intravenous fluids as glucose 10% with 15 unit regular insulin and Ringer lactate solution were given according to the CVP. Regular insulin according to blood glucose level was given every 6 hours subcutaneously. The patient showed no response after one day of extensive care and death was the the end due to multiple organ failure .}, keywords = {Fever,South Sudan,Malaria}, url = {https://aeji.journals.ekb.eg/article_9110.html}, eprint = {https://aeji.journals.ekb.eg/article_9110_e0780d8f689631d929d62576fc634365.pdf} }