Detection of Virulence Factors from Candida spp. Isolated from Oral and Vaginal Candidiasis in Iraqi Patients.

Yeast-like fungi (YLF) of the genus Candida are unicellular microorganisms of relatively large size and rounded shape, aerobes, and belong to conditionally pathogenic microorganisms. The genus Candida includes approximately 150 species, which are classified as Deuteromycetes due to the absence of a sexual stage of development. This study aimed to identify virulence factors from Candida spp. isolated from oral and vaginal candidiasis. Fifty-eight oral and vaginal swab specimens were collected from patients, including (28) oral swabs from children and (30) vaginal swabs from different infected women. All isolates were subjected to direct examination, Morphological tests, Germ tube formation, growth at 45ºC, CHROM agar Candida culture, and VITEK 2 Compact system to ensure this diagnosis. (31) isolates were identified as Candida spp., including (21) (C. albicans (14), C. glabrata (1), C. guilliermondii (2), C. dubliniensis (3), C. parapsilosis (1)) were isolated from oral swabs and (10) isolates includedC. parapsilosis (4), C. albicans (6) were isolated from vaginal swabs. Moreover, these isolates had been detected to have some virulence factors, including phospholipase, esterase, proteinase, coagulase, hemolysin, and biofilm formation. Different species of Candida were isolated and identified from oral and vaginal. Phospholipase (Pz), Esterase (Ez), and Proteinase (Prz) were produced by 19 (61.29%), 16 (51.61%), and 26(83.87%), respectively, out of 31 isolates, whereas. All isolates produce coagulase enzyme except C. dubliniensis, which did not produce coagulase enzyme. All Candida spp. isolates produce hemolysin and biofilm formation in different percentages.

Gastric outlet obstruction secondary to spontaneous intramural haematoma as a complication of warfarin treatment.

A 73-year-old lady presented with clinical features of gastric outlet obstruction. It was found to be secondary to a spontaneous haematoma in duodenal wall as a complication of warfarin therapy given for atrial fibrillation. The diagnosis was confirmed by abdominal CT scan and upper G I endoscopy. Warfarin was stopped and blood transfusions given. She recovered completely after three weeks of conservative treatment. Repeat CT scan and upper G I endoscopy done after two months showed complete resolution.

Stump appendicitis. A diagnostic dilemma.

A case of stump appendicitis in a 41-year-old man is presented. Initial appendicectomy for suppurative appendicitis had been performed 14 months earlier. An ultrasound scan suggested the diagnosis of stump appendicitis despite the hindsight of previous appendicectomy. A literature review on the subject is provided. Stump appendicitis should be considered in the differential diagnosis of recurrent lower abdominal symptoms any time following initial appendicectomy. Knowledge of a difficult approach at initial surgery may raise the level of suspicion.

Snaring of submucosal tumors of gastric fundus.

Submucosal tumors of the stomach are not uncommon. We present two cases of iatrogenic perforation after snaring large polyps in the gastric fundus. We discuss the probable etiology and review the literature regarding iatrogenic perforation in this location. Submucosal polyps situated in the fundus may produce pseudopedicle. Therefore, we recommend these be treated with caution, and a combined endoscopic and laparoscopic approach is suggested.

Anatomical variations of the inguinal nerves and risks of injury in 110 hernia repairs.

The aim of this study was to identify the anatomical variations in the inguinal course of the ilioinguinal nerve (IIN) and the iliohypogastric nerve (IHN) during operative repair of inguinal hernias. A consecutive series of 110 primary inguinal hernias were repaired by the mesh technique. Particular attention was paid to early identification and recording of the course of both the IIN and IHN and preserving them throughout the operative procedure. The course of both nerves was found to be consistent with that described in anatomical texts in only 46 of 110 explorations (41.8%). The course of one or both nerves was found to be a variant in the other 64 of 110 (58.2%) explorations and often rendered them susceptible to injury. These variations included: (1) acute infero-lateral angulation of the IIN at its exit behind the superficial inguinal ring (SIR) fibers in 20 of 64 cases; (2) similar direction of the IIN but in a plane superficial to the external oblique aponeurosis (EOA) and proximal to the SIR in 18 of 64 cases; (3) a single stem for both nerves over the spermatic cord in 24 of 64 cases, with variation in the subsequent course; (4) absence of one or both nerves in 8 of 64 cases; (5) accessory IIN or IHN in 3 of 64 cases; and (6) aberrant origin of the IIN from the genitofemoral nerve (GFN) in 2 of 64 cases. None of 68 of 105 patients seen at 3 months postoperatively (compliance rate 65%) complained of sensory disturbances or pain in a dermatome distribution of the IIN or IHN. It is concluded that anatomical variations in the inguinal course of the IIN and the IHN are extremely common but readily identifiable. Their early identification and preservation is likely to abolish, or considerably decrease, the incidence of postoperative sensory changes and/or neuralgia pain.

Necrotizing proctitis caused by Streptococcus pyogenes.

We report the case of a 65-year-old patient with peritonitis, septicaemia and toxic shock syndrome in whom the primary focus of infection was acute purulent proctitis with necrosis. Streptococcus pyogenes serotype T28R28 was isolated from blood culture and peritoneal pus. The patient recovered after a prolonged period of intensive therapy and four abdominal operations including anterior resection of the rectum. We believe this to be the first clinical description of streptococcal necrotizing proctitis.

Infant and child safety practices of parents.

OBJECTIVE: Accidental injuries are the leading cause of death among children. Many of these injuries could be prevented if the parents took additional safety precautions. We aimed to study the parent's safety practices and explore the possible correlating and contributing factors to unfavorable safety behaviors. METHOD: Prospective interviews with the parents of infants seen consecutively during a routine well baby clinic visit were conducted using a structured 38-item questionnaire. RESULTS: Two hundred and eighty nine structured interviews were conducted and the mother was interviewed in 88% of cases. Only 4% of families had a smoke detector at home and 8% reported using an infant car seat. Most families owned an infant crib, however, 75% of the mothers reported sleeping next to the infant in the mother's bed. Most families (74%) had other older children. Up to 74% of the families reported keeping detergents and medications in a high or locked cabinet. Only 10% of the parents reported that their children use bicycle helmets and 24% use car seat belts. Use of car seat belts was more common in higher income families or if the father's age was >30 years (p=0.01). Twenty four percent of the parents reported allowing their children to play unsupervised in the street. These mothers were more likely to be non-educated (29% versus 5%, p=0.009) and 3 times more likely to have 4 or more children (95%, confidence interval 1.5-6, p=0.001). CONCLUSION: The infant and child safety practices of many families living in Jeddah needs further improvements. Our data identifies certain areas that can be targeted by health promotion interventions including education, environmental modification, and legislation.

Evaluation of the sonographic features of malignant breast masses.

Breast sonography is a common technique in the assessment of breast masses. By this modality 114 patients (age 23-75 years) with breast masses were studied and 107 of them were suspected to have malignancy. The diagnosis was based on common sonographic features which included wall contour, echogenicity, echo pattern, posterior-attenuating shadow and lesion length-to-width ratio. Eighty-four and seven-tenths percents of the masses had jagged wall contour, 84.7% were echo-poor, and 76.6% had a heterogenous echo pattern. Sixty-five and eighty-tenths percent had posterior-attenuating shadows. Eighty-two and nine-tenths percent were spherically shaped or anteroposteriorly elongated. Using these features, the positive detection rate for malignancy was 91.2%. In conclusion, sonographic diagnosis of breast malignancies can be used in the assessment of breast masses.

The radiographic features of pulmonary tuberculosis observed for the western region of Saudi Arabia.

The radiographs of 714 patients (486 males, 228 females) with proved pulmonary tuberculosis (PTB) were studied. Most were between 15 and 44 years of age, and most (86.8%) exhibited the usual radiographic appearance of PTB. All had extensive bilateral lung disease, with the right upper lobe the most commonly involved. Parenchymal opacities, cavitation, and atelectasis were common. Many radiographic patterns were encountered, and these varied from one radiograph to the next and even within the same radiograph, with two or more patterns seen together. Unusual radiographic manifestations were found in 13.2% of the patients. These included isolated opacities in the lower lobe, middle lobe, or lingula; normal chest radiographs; isolated pleural effusions; isolated mediastinal or hilar lymphadenopathy, and mass-like lesions. Permanent lung damage could be avoided if the various radiographic features of pulmonary tuberculosis were promptly recognized, thus leading to early treatment.

Electronically simulated loss of frequency resolution.

Circuitry has been developed which degrades speech signals by reducing the spectral resolution available to the listener: each single frequency component in the original speech signal is replaced by a band of noise in the processed output. Measurements were made on the speech perception of normally hearing adult subjects listening to monosyllabic words via such a processing system. The effective resolution bandwidth available to the listener was increased by approximately 100 to 800 Hz, giving a drop of up to approximately 60% in whole-word scores. A three-channel design allowed different degrees of processing in the frequency regions 0 to 2 kHz, 2 to 4 kHz and 4 kHz upwards. Results show that speech frequencies in the range 0 to 2 kHz are more susceptible to this type of degradation than higher frequencies. Future development of this circuitry may allow simulation of the loss of frequency resolution associated with sensorineural hearing loss.

Fluoroscopic assessment of bilharzial ureteropathy.

This paper reports a fluoroscopic study of ureteric peristalsis during intravenous pyelography in 32 patients with urinary bilharziasis and 13 non-bilharzial controls with normal intravenous pyelograms. Ureteric peristalsis is reduced in parallel with urographic signs of involvement. The role of fluoroscopic examination of the ureters in staging bilharzial ureteropathy is discussed.

Primary lymphoma of Meckel diverticulum: a case report.

A case of a primary lymphoma of Meckel's diverticulum in a 6-year-old Iraqi boy presenting clinically as acute appendicitis is reported. Exploration revealed a ruptured gangrenous Meckel's diverticulum with an ileo-ileal intussusception at the diverticulum origin. A fairly comprehensive search through the English language literature has failed to reveal any other report of a primary lymphoma of Meckel's diverticulum leading to acute intestinal obstruction.