Erectile dysfunction in chronic renal failure patients undergoing hemodialysis in Egypt.

In clinical practice, the attention given to sexual problems in patients with end-stage renal disease is low. In order to evaluate the erectile function in chronic renal failure patients undergoing hemodialysis (HD) as a renal replacement therapy in upper Egypt, we used the abridged version of the International Index of Erectile Function (IIEF-5). In all, 75 HD patients were subjected to clinical and laboratory investigations. The controls were 948 healthy males representing the general Egyptian population. The prevalence of erectile dysfunction (ED) among the HD patients was 82.5% compared to 30% among controls. The prevalence of ED in HD group was significantly higher than in controls. The prevalence of ED in HD patients <50 y was 80% and it was 88% in those > or =50 y, while the prevalence of ED among controls was 28 and 69.8%, respectively. The prevalence of severe degree of ED was significantly higher in both groups compared to controls, while moderate degree of ED showed a statistical significance compared to controls in age groups <50 y and mild degree of ED showed a statistical significance compared to controls in age groups > or =50 y. [corrected] Age (r=-0.3368, P<0.01), serum urea (r=-0.5974, P<0.001), and creatinine level (r=-0.5804, P<0.001) have a significant negative correlation with the presence of ED among HD patients, while serum hemoglobin (r=0.3396, P<0.001) and years of HD age (r=0.3147, P<0.01) have a significant positive correlation with the presence of ED among the HD patients. In view of the observed high prevalence of ED among the HD patients, we believe that a complete health evaluation of male HD patients should include a discussion about erectile function in the standard clinical care program of patients with renal disease.

Alkaloids of Haloxylon salicornicum (Moq.) Bunge ex Boiss. (Chenopodiaceae).

Haloxylon salicornicum is a desert plant that contains several alkaloids. From the aerial parts a new piperidyl alkaloid, haloxynine, was isolated and characterized on the basis of mass spectrometry, 1H and 13C NMR. A GLC/MS analysis revealed the presence of 17 additional known alkaloids of which piperidine, halosaline, anabasine, hordenine, N-methyltyramine, haloxine and aldotripiperideine had been previously reported in this genus. Among the 18 identified alkaloids, ten alkaloids were recorded for the first time from this plant and the genus Haloxylon. Haloxynine, halosaline, haloxine, anabasine, and smipine figure as major alkaloids with a relative abundance of more than 5% of total alkaloids. Some of these alkaloids are known be strong agonists at nicotinic acetylcholine receptors and it is thus likely that they serve as chemical defencecompounds against insects and mammalian herbivores.

Impact of the current National Bilharzia Control Programme on the epidemiology of schistosomiasis mansoni in an Egyptian village.

In a population-based study in the Nile Delta of Egypt, the modified Kato thick smear technique was used to study the epidemiology of Schistosoma mansoni. After 2 years of implementation of the National Bilharzia Control Programme by the Ministry of Health, the general prevalence dropped from 47.2% to 21.9%. The peak prevalence rate has shifted downwards in magnitude (40.4% compared to 72.1%) and backwards over the age scale (5-14 in contrast to 15-19 years age group). Redistribution of various infection grades has taken place. More than three-quarters (75.6%) of the infected individuals have light infections in contrast to only one-fifth (20%) 2 years ago. The mean egg count for the entire sample population has dropped significantly (P < 0.05) from 128 to 17 eggs/g stools with no significant difference between males and females. This positive impact can be attributed largely to the case finding and treatment component of the programme. However, the incidence rate remained nearly the same before and 2 years after implementation of the programme (18.7 and 18.1%, respectively). The non-changing high incidence rate indicates that the knowledge, attitude and practice (KAP) of the population concerning water contact have not yet changed. Insufficient improvement in environmental sanitation may be a contributing factor. Continuation of serious efforts in case finding and treatment is recommended, with special emphasis on schoolchildren. This should be coupled with an intensive health education programme.

Comparative study of the essential oils and extracts of Achillea fragrantissima (Forssk.) Sch. Bip. and Achillea santolina L. (Asteraceae) from Egypt.

Essential oils obtained by steam distillation from the aerial parts of Achillea fragrantissima (Forssk.) Sch. Bip. and the flower, leaf and stem of A. santolina L. as well as their lipophilic constituents obtained by solvent extraction were analysed using GLC and GLC-mass spectrometry. Nineteen constituents in the essential oil of A. fragrantissima were identified, in addition to 41 compounds from its n-hexane-ether extract. The hydrodistilled oil and the solvent extract contain santolina alcohol, artemisia alcohol, artemisia ketone, cis-thujone and trans-thujone as major constituents. In A. santolina altogether 54 volatile components were detected. The major components were 1,8-cineole, fragranol, fragranyl acetate and terpin-4-ol. Furthermore, the essential oils and the n-hexane-ether extracts of the two plants were screened for their antimicrobial activity.

Changing pattern of fascioliasis prevalence early in the 3rd millennium in Dakahlia Governorate, Egypt: an update.

Fascioliasis is an important food- and water-borne parasitic zoonosis caused by liver flukes of genus Fasciola (Digenea: Fasciolidae) of worldwide distribution. In Egypt, fascioliasis was encountered in nearly all Egyptian Governorates, particularly in the Nile Delta and specifically in Dakahlia. All enrolled cases were subjected to complete history taking, clinical examination, routine investigations and abdominal ultrasonography. Stool analysis, IHA and ELISA were used for fascioliasis diagnosis. Rural areas showed highest prevalence of fascioliasis than urban areas, however, but.without significance (x2= 0.042 & P= 0.837). Regarding human fascioliasis in examined the centers, no statistically significant difference (x2 =2.824 & P=0.243) was detected. Regarding gender variation, the difference was statistically insignificant (x2= 0.166 & P= 0.683). The difference between the age groups was statistically insignificant (x2= 3.882 & P=0.274). Clinically, 7 cases (35%) were asymptomatic and another 13 cases (65%) had different clinical pictures. Abdominal pain, anemia, eosinophilia, and tender hepatomegaly were seen in 70%, 80%, 70%, and 10%; respectively. Of them, 1 1cases showed positive abdominal ultrasonographic findings suggestive of fascioliasis.

Evaluation of ELISA and IHAT in serological diagnosis of proven cases of human hydatidosis.

Cystic hydatid disease (Hydatidosis) is the most serious tape-worm infection prevalent in the cattle and sheep raising area of the world. Hydatidosis in man (as an accidental host) is caused by infection with the ova containing larval stage of Echinococcus granulosus. In the last decade, different techniques have been employed for sero-diagnosis of hydatidosis; as IHA, IFA, ELISA, CCLE (Counter Current Immuno-electrophoresis). This paper evaluated the validity of ELISA and IHA. Since whole hydatid cyst fluid was used as a source of antigen for serodiagnosis. Thirty surgical and pathological hydatidosis proven patients were examined. The sensitivity and specificity of ELISA were 96.7% & 97.5% respectively, and that of IHA were 86.7%, &95% respectively.

On the main reservoir host of Fasciola in Dakahlia Governorate, Egypt.

In the present work, a total of 4180 sheep were obtained from different localities at Dakahlia Governorate. One hundred and eighty male sheep were investigated for Fasciola worms (the adult and juvenile forms) at Mansoura governmental abattoir. Four hundred grazing sheep were screened by the coprological examination from ten centers. The mean number of eggs per gm in a group of ten sheep ranged from 2.9-10.8 egg/gm. The number of worms ranged from 5-84. In the Mansoura abattoir, it was found that 37 sheep were infected (20.56%). Fasciola worms were recovered from the livers in 100%, common bile ducts in 60%, gall bladder in 80%, two sites in 50% and three sites in 40% of infected biliary tracts. According to the coprological examination, the infection rate was the highest in El-Manzalla Center (15.75) and the lowest was in Mansoura Center (3.25%). According to the prevalence and egg output results, it is concluded that sheep are the main reservoir host for fascioliasis among the edible animals in Dakahlia Governorate. However, examination of the non-edible animals and the domestic and wild rodents are ongoing and will be published soon elsewhere.

Immunization against experimental trichinosis using T. spiralis larvae and hydatid fluid antigens.

Immunization of mice against T. spiralis infection using T. spiralis larval glycoproteins as homogenous antigen and crude hydatid fluid as heterogenous antigen showed a marked reduction in larvae burden and a significant rise of serum IgE in immunized mice infected with T. spiralis larvae as compared with control group. More reduction was observed with immunization with homogenous T. spiralis larval antigen compared with heterogenous hydatid fluid antigen. The reduction in larval burden with rise of serum IgE begins after the third week of immunization.

The effect of the initial inoculum dose and post-infection period on larval dispersal in experimental murine toxocariasis.

The distribution of Toxocara canis larvae throughout the tissues of mice was studied in three groups of fourty mice each using three inocula sizes, (200/500 and 1000 eggs/mice). The results obtained revealed a significant interaction between the duration of infection, the inoculum size and the dispersal rate of larvae through the examined organs of experimented with mice.

Malabsorption syndrome in patients with cryptosporidiosis.

Out of 130 patients presenting with gastroenteritis, oocysts of Cryptosporidium species were detected in the faecal samples of 10 persons (7.69%). The prevalence of the parasite was higher among rural inhabitants (11.47%) than city dwellers (4.35%), particularly in the young age. The parasite lead to impairment of the intestinal absorptive function as indicated by the significant change in the fat in stools and the decreased excretion of D-xylose.

A case of ectopic fascioliasis in a farmer from Mansoura City, Dakahlia, Egypt.

Human fascioliasis is a new parasitic health problem in Egypt. This paper reports a case of ectopic fascioliasis in the right side of the pleural cavity of a farmer.

Toxocara canis antibodies by counter immuno-electrophoresis.

Counter immunoelectrophoresis was used for anti-toxocaral antibodies in mice experimentally infected with Toxocara canis using adult worm antigen. The test seems to be valuable and gives good information about the infected rate.

A preliminary study on vaginal trichomonal antigens using CIEP and modified ELISA.

The enzyme linked immunosorbent assay (ELISA) and counter-immunoelectrophoresis (CIEP) were used to detect T. vaginalis antigens in vaginal discharge of 47 infected women and 35 controls. Rabbit antisera raised against T. vaginalis were used as antitrichomonal antibodies. The sensitivity of ELISA was 95.7% and specificity was 91.4 in contrast to 68.1 and 77.1% for CIEP. So ELISA could be applied for epidemiological study and immunodiagnosis of vaginal trichomoniasis.

The efficacy of IHAT, IFAT and Dot-ELISA in sero-diagnosis of toxoplasmosis in complicated pregnancies.

Studying of 72 pregnant women having congenital anomalies, stillbirth and repeated abortion of first and second trimesters showed Toxoplasma antibodies with high titre by IFAT and Dot-ELISA. Analysis of the results showed a positive correlation between IFAT and Dot-ELISA but not with IHAT. However, Dot-ELISA is simple, sensitive and specific.

Immune response in dogs infected with Ancylostoma duodenale.

The relation between the level of serum immunoglobulins (IgG, IgM, IgA and IgE) percentage of T-lymphocyte and egg counts was studied in dogs infected with Ancylostoma duodenale. The serum IgG levels were significantly high and a marked significance was noticed also in the levels of IgM and IgE. An inverse relationship between the concentration of IgG and egg count and a direct association between the percentage of T-lymphocyte and IgG level was proved.

Soluble adhesion molecules versus lymphoblast transformation in diagnosis of zoonotic cutaneous leishmaniasis.

Twelve parasitologically proven ZCL patients (one with non-ulcerative lesion and eleven with multiple ulcerative lesions) were subjected to estimation of the levels of lymphoblast transformation (LTT) and soluble adhesion molecules (sICAM-1 & sELAM-1 by ELISA). The results proved high percentage of LTT in relation to number and clinical picture of the ZCL lesions. As to the soluble adhesion molecules, sICAM-1 levels were significantly increased than in normal controls and correlated positively with the number of ulcerative lesions. sELAM-1 levels were not significantly increased than the normal controls, but correlated positively with the number of ulcerative lesions. Consequently, soluble adhesion molecules mainly sICAM-1 is a good marker of endothelial damage in ZCL as related to number and clinical type of lesions.

The pathogenesis of Demodex folliculorum (hair follicular mites) in females with and without rosacea.

In rosacea patients (ages 11-50 years old) 44% were infested with D. folliculorum as compared to normal controls (23.0%). The difference was significant. The mean +/-SD of mite density ranged between 13.2+/-0.9 to 18.2+/-1.2 as compared to normal controls with mite density ranged between 1.4+/-0.25 to 2.4+/-0.3. Demodex infestation in rosacea patients was 66.1% in squamous, 66.7% in erythemato-telangiectate and 83.3% in papulo-pustular rosacea. The highly infested site was check (27.3%) with mean mite density of 25.3+/-1.3, followed by the area around the orbit (23.4%) with a density of 19.0+/-1.2, the area around the nose (19.5%) with mite density of 7.1+/-1.5, then chin (15.6%) with a density of 8.2+/-1.4 and lastly the area around the mouth (14.1%) with a mite density of 14.2+/-1.3. Undoubtedly, infestation with D. folliculorum particularly in large number causes rosacea.

Histopathological picture of two cases of ectopic fascioliasis in Mansoura, Dakhalia.

Two cases of ectopic fascioliasis were reported. The first case was detected in a haematoma in the anterior abdominal wall in a diabetic patient, the second was in an abscess in the upper part of the thigh. The clinical and laboratory findings were discussed.

The prevalence of Toxoplasma gondii antibodies among cats from Mahalla El-Kobra, Gharbia Governorate.

Toxoplasma gondii antibodies were detected using indirect haemaggulination (IHA) and indirect fluorescent antibody (IFA) tests. Positive reactions were detected among 18.5% and 12.5% of stray (92) and owned cats (32) using IHA-test respectively. With IFA-test antibodies were 20.7% and 15.6% respectively.

Epidemiological, clinical and laboratory studies on parasitic infections as a cause of fever of undetermined origin in Dakahlia Governorate, Egypt.

Forty-three patients who fulfilled the international criteria for prolonged fever were exposed to thorough history taking, clinical and laboratory investigations. The latter included urine and stool examination, urine and blood culture, haemogram, liver and renal function tests, chest X-ray, tuberculin test, bone marrow, liver biopsy, blood films, serological tests including ELISA, IHA and IFA for detection of schistosomiasis, toxoplasmosis and malaria. Parasitic infections were detected in 30/43 (69.7%), 55.8% of whom had pure parasitic infection and 14% had in addition other causes. The majority of cases with positive etiology were coming from rural areas. The pattern of fever was predominantly intermittent especially with malaria and schistosomal cases. Fever of 21-41 days duration was noted in 70% of patients and 23.3% lasted up to more than 56 days. Visceromegaly (hepatomegaly and/or splenomegaly) was observed in all patients except one case. Lymphadenopathy was detected in ten cases, six of whom were visceral leishmaniasis. The IHA test for leishmaniasis detected ten cases at titres of 256, 512 and 1024 reciprocally. The dot-ELISA gave seropositivity in only 8/10 cases diagnosed by IHA test. So eight cases of VL were diagnosed by two serological tests at high titres. The detection of seropositive cases of visceral leishmaniasis in the studied area, suggests a focus or foci and warrants epidemiological study to establish the actual situation. Generally speaking, parasitic aetiology should be in mind in any case of FUO in Dakahlia. Serological tests are valuable, simple and safe tools for conforming the diagnosis of schistosomiasis, leishmaniasis, toxoplasmosis and malaria.