EGYPTIAN EOSINOPHILIC AND INFECTIOUS MENINGOENCEPHA- LITIS AND THEIR IMPACT ON PSYCHOLOGICAL ASPECTS.

Meningoencephalitis is an acute inflammation of the brain and spinal cord & their covering protective membranes. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. The commonest symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an inability to tolerate light (photophobia) or loud noises (phonophobia). Children often exhibit only nonspecific symptoms, such as irritability and drowsiness. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal bacteria may be accompanied by a characteristic rash. A broad variety of allergic, infectious, neoplastic, and idiopathic diseases are associated with increased blood and/or tissue eosinophilia and range in severity from self-limited conditions to life-threatening disorders. Although accepted upper limits of normal blood eosinophil numbers vary somewhat, a value above 600 eosinophils /microL of blood is abnormal in the vast majority of cases. Generally speaking, there are several possible causes of eosinophils in the CSF; undoubtedly parasitic infection is one of the main causes.

Lupus nephropathy: clinical, immunohistochemistry and quantitative morphometric analysis studies.

Lupus nephritis includes a wide range of parenchymal injuries and severity. Better predictors to outcome are needed for patients newly diagnosed with lupus nephritis, so that an appropriate management strategy may be selected. This study aimed to determine whether the ratio of hepatocyte growth factor (HGF) to transforming growth factor beta 1 (TGF beta1) in lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at six months. Also, to determine whether a simple automated system for objective scoring of biopsies of lupus nephritis could be a prognostic factor for response to therapy with cyclophosphamide and steroids at 6 months. Consequently, renal biopsy findings and clinical parameters of thirty parasites-free patients with new onset lupus nephritis were recorded. Histopathologic, clinical, immune-histochemical and morphometric data at baseline served to define the predictive value for outcome after 6 months of therapy. The results showed a significant positive relationship between response to therapy and HGF IS (P= 0.007), HGF ES (P= 0.026), HGF IS/ TGFbeta1 IS ratio (P= 0.022) and HGF ES/ TGFbeta1 ES ratio (P= 0.001). A significant inverse relationship was proved between response to therapy and TGFbeta1 IS (P= 0.025) as well as TGFbeta1 ES (P= 0.017). Also, a significant inverse relationship was present between response to therapy and nuclear index, tubular index and matrix index (P = 0.03, 0.03 and 0.029 respectively).

Early development of osteoporosis in male smokers with hypoandrogenism due to fascioliasis with or without schistosomiasis added by life style.

The multifactor outcome of hypoandrogenemia with the impact of oxidative stress induced by glucose intolerance, fascioliasis with or without schistosomiasis and cumulative smoking influence on bone remodeling and the early development of osteoporotic manifestations were studied. The effect on vascular endothelium immune mediated mechanisms and antioxidant capacity were monitored in cases of youth aged selected male smokers involving 20 with hypoandrogenemia who were either subjected to sedentary life style, glucose intolerance fascioliasis hepatic fibrosis (FHF) (G1) or without (G2) and GI after following 6 months therapy (G3). Monitoring of clinical picture and biochemical assessments of osteoporotic indices (osteocolcin, bone alkaline phosphatase, parathyroid hormone, urinary cyclic AMP), hypoandrogenism (dehydroepiandrosterane sulphate or DHEAS & testosterone) glycemic determinant (insulin) immuno-inflammatory response (interleukein-6, tumor necrosis factor alpha, E-selectin, ceruloplasmin) smoking index (serum cotinine), total antioxidant capacity (AOC) and lipid peroxidation (malonedialdehyde) was done before and after 6 months therapeutic program involving supplement of DHEAS, mirazid, chromium picolinate, and megavit zinc alongside smoking cessation and physical exercise daily for at least 30 minutes. Treatment with Mirazid supplied as 10 mg/kg for 6 successive days resulted in 100% cure of fascioliasis whether single or combined with schistosomiasis.

New concept of schistosomiasis lesions of urinary bladder versus development of bladder cancer.

Schistosomiasis haematobium precancerous lesions of urinary bladder included group 1: preneo-plastic non papillary (flat) lesions [reactive atypia, flat hyperplasia, keratinizing squamous metaplasia, glandular metaplasia, dysplasia, carcinoma in-situ (CIS)] and group 2 preneoplastic papillary lesions (typical papillary hyperplasia, atypical papillary hyperplasia, papilloma). The present work studied the content of the schistosomiasis precancerous lesions of the urinary bladder using image analyzer, thereby shedding more light on the significance on the early diagnosis of the high risky group. A total of 140 previously diagnosed schistosomiasis urinary bladder lesions (124 precancerous and 16 cancers as controls) were stained by H & E, and Feulgen stain. The mean SPF was high in CIS (22.7), dysplasia (19.6) & low in atypia (7.91). DNA ploidy, non-diploidy DNA was high in CIS (53%), papilloma, dysplasia and atypical papillary hyperplasia than flat hyperplasia, glandular metaplasia, keratinizing squamous metaplasia and typical papillary hyperplasia that were diploid indicating more tendency and aggressiveness of the first group to turn malignant than the second group.

Geoparasites in rural Dakahlia Governorate, a preliminary based study for development of the community-based intervention programs.

A prospective study was carried out to detect the rural prevalence and intensity of geoparasites in Dakahlia Governorate, Egypt. A total of 1070 soil samples were collected; 571 (53.4%) were infected with one or more parasites. Only 24% of samples were infected with one parasite, 16.4% and 13% with two, and more than two parasites respectively, and the difference was statistically significant. The geoparasites in a descending order of their prevalence were: E. histolytica cysts (9.2%), Toxocara eggs (9.1%), Giardia cysts (7.9%), Cryptosporidium oocysts (6.1%), Trichostrongylus eggs and larvae (5.6%), Isospora oocysts (4.3%), Acanathamoeba cysts (4.1%), Naegleria cysts (3.6%), Dust mites (2.7%), H. diminuta eggs (2.7%), Strongyloides free living adults, rhabditiform and filariform larvae (2.3%), H. nana eggs (1.7%), S. mansoni eggs (1.2%), Ascaris eggs (0.6%), Ancylostoma larvae (0.5%), Taenia eggs (0.4%), Trichocephalus eggs (0.4%) and F. gigantica eggs (0.2%). The prevalence of parasitic infections was significantly higher (P<0.001) in fields (63.4%) than streets (47.7%) and indoor-yards samples (35.3%). The intensity of infections was significantly higher (P< 0.001) in streets than fields and indoor-yards (18.1, 9.7 & 1 parasite/10 gm of soil respectively).

Evaluation of two serological tests in diagnosis of human cases of biliary and ectopic fascioliasis.

In the present study, sera were examined using Fasciola-IHA, F-ELISA and Schistosoma-IHA. The sero-positive schistosomal patients were subjected to rectal snip, while the sero-positive fascioliasis ones were examined radiologically by plain chest X-ray and abdominal ultrasonography. Both F-IHA and F-ELISA gave 100% sensitivity. The specificity of both testes were 90.4% and 100% respectively. With the S-IHA, the parasitologically proven schistosomal mansoni patients gave 95% positivity, while the proven fascioliasis patients gave false positive (8%) with this S-IHA. The radiological findings of the fascioliasis patients confirmed ectopic pleuro-pulmonary infection in five patients. Ascitis was detected in one patient, the pleural effusion and ascitic fluids showed high eosinophils. However, Fasciola eggs were detected in three patients only. Two patients showed hepatic nodules, and another two had hepatic cystic lesions. Three patients had immature Fasciola worms in gall bladder. For diagnosis of human fascioliasis, serological and radiological means should be done side by side with the stool examination. This is particularly true in chronic cases and in schistosomiasis mansoni endemic areas.