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.

AN OVERVIEW OF OSTEOMYELITIS WITH REFERENCE TO TREATMENT IN PARTICULAR MAGGOT DEBRIDEMENT THERAPY (MDT).

Osteomyelitis occurs either as a result of hematogenous seeding, contiguous spread of infection to bone from adjacent soft tissues and joints, or direct inoculation of infection into the bone as a result of trauma or surgery. Hematogenous'osteomyelitis is usually monomicrobial, while osteomyelitis due to contiguous spread or direct inoculation is, usually polymicrobial. Staphylococcus aureus, coagulase-negative staphylococci and aerobic grani-negative bacilli are the most common organisms; other pathogens including streptococci, enterococci, anaerobes, fungi and mycobacteria have also been implicated. Acute osteomyelitis typically presents with gradual onset of pain over several days. Local findings (tenderness, warmth, erythema and swelling) and systemic symptoms (fever, rigors) may. also be present. Chronic osteomyelitis tends to occur in the setting of previous osteomyelitis and presents with recurrent pain, erythema or swelling, sometimes in association with a draining sinus tract. Treatment of osteomyelitis often requires both surgical debridement of necrotic material and antimicrobial therapy for eradication of infection. The optimal duration of antibiotic therapy is not certain; but continuing parenteral antimicrobial therapy at least six weeks from the last debridement.. Maggot therapy is an effective and environmentally friendly treatment of complicated necrotic wounds that are resistant to conventional reatment and should also be considered in earlier. stages of treatment. The history of maggot therapy, and the mechanisms by which it works, is discussed..

Hydrocarbon insecticides: their risks for environment and human health.

Insecticides are used to control diseases spread by arthropods, but theys vary greatly in toxicity. Toxicity depends on the chemical and physical properties of a substance, and may be defined as the quality of being poisonous or harmful to animals or plants. Poisons have many different modes of action, but in general cause biochemical changes which interfere with normal body functions. Toxicity can be either acute or chronic. Acute toxicity is the ability of a substance to cause harmful effects which develop rapidly following absorption, i.e. a few hours or a day. Chronic toxicity is the ability of a substance to cause adverse health effects resulting from long-term exposure to a substance. There is a great range in the toxicity of insecticides to humans. The relative hazard of an insecticide is dependent upon the toxicity of the pesticide, the dose received and the length of time exposed. A hazard can be defined as a source of danger. The great majority of insecticides are poisonous to man and his beneficial insects and animals and are carcinogenic agents particularly, the halogenated hydrocarbons containing benzene ring.

Arsenic pesticides and environmental pollution: exposure, poisoning, hazards and recommendations.

Arsenic is a metalloid element. Acute high-dose exposure to arsenic can cause severe systemic toxicity and death. Lower dose chronic arsenic exposure can result in subacute toxicity that can include peripheral sensorimotor neuropathy, skin eruptions, and hepatotoxicity. Long-term effects of arsenic exposure include an in Due to the physiologic effects of the arsenic on all body systems, thus, chronic arsenic-poisoned patient is a major nursing challenge. The critical care nurse provides valuable assessment and interventions that prevent major multisystem complications from arsenic toxicity.

Phenolic content, antioxidant potential and Aedes aegyptii ecological friend larvicidal activity of some selected Egyptian plants.

Polyphenols constitute a distinct group of natural compounds of medicinal importance exhibiting wide range of physiological activities as antioxidant, immunestimulant, antitumor and antiparasitic. Yellow fever and dengue fever are mosquito-borne infectious diseases transmitted by Aedes aegyptii, the presence of yellow fever in Sudan and dengue fever in Saudi Arabia are threats to Egypt with the reemerging of Ae. aegyptii in Southern Egypt, larvae control is feasible than flying adults. This work was conducted targeting estimation of the relative levels of total phenolic content, antioxidant potential and larvicidal activity of 110 selected Egyptian plants. The highest total phenolic contents were estimated in aqueous extracts of Coronilla scorpioides L., Forsskaolea tenacissima L., Crataegus sinaica Boiss., Pistacia khinjuk Boiss. and Loranthus acacia Benth.; they were 916.70 +/- 4.80, 813.70 +/- 4.16, 744.90 +/- 4.93, 549.00 +/- 3.93& 460.80 +/- 4.02 mg% while those of methanol extracts were estimated in Coronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Loranthus acacia and Pistacia khinjuk, they were 915.60-4.86, 664.60 +/- 4.16, 659.30 +/- 4.80, 590.80 +/- 4.49 & 588.00 +/- 3.85 mg% respectively. Investigation of the antioxidant potentials revealed that the most potent plants were Co-ronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Pistacia khinjuk and Loranthus acacia with calculated values of 454.80 +/- 4.83, 418.4 +/- 4.16, 399.10 +/- 4.90, 342.5 +/- 2.72 & 239.7 +/- 2.91% for aqueous extracts and 452.9 +/- 4.94, 389.6 +/- 4.6, 378.48 +/- 3.84, 352.3 +/- 3.06 & 346.5 +/- 2.98% for methanol extracts respectively while screening of larvicidal activity proved that Coronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Pistacia khinjuk and Loranthus acacia exhibited highest potency calculated as 22.53 +/- 2.01, 23.85 +/- 2.07, 28.17 +/- 2.06, 31.60 +/- 2.93 & 39.73 +/- 4.58 mg% aqueous extracts and 18.53 +/- 1.95, 18.8 +/- 1.67, 20.17 +/- 1.85, 23.28 +/- 2.7 & 28.48 +/- 3.9 mg% methanol ones respectively.

Cutaneous leishmaniasis predisposing to human skin cancer: forty years local and regional studies.

Different types of association between leishmaniasis and cancer were established: leishmaniasis mimicking a malignant disorder, such as lymphoma; leishmaniasis arising as a difficult to diagnose and treat infection among patients receiving chemotherapy for various malignant disorders; simultaneous diagnosis of leishmaniasis and a neoplastic disorder in the same tissue samples of immunocompromised patients; and direct involvement of Leishmania spp. in pathogenesis/occurrence of malignant lesions, especially of the skin and mucous membranes. Cutaneous leishmaniasis (CL) is a protozoan skin disease occurring in all the Middle East countries. Only the cutaneous form is a self-curing, which may develop a certain degree of immunity against the parasite, resulting in healing of the lesion(s). However, the parasites probably never disappear completely, since in situations where immune system is compromised, as in AIDS, or suppressed by cancer chemotherapy or in organ transplantation, Leishmania spp. may suddenly reappear. The cell-mediated immunity is responsible for skin lesion healing but humeral response plays a protective role against the disease. Skin biopsies from 65 parasitological proven cutaneous leishmaniasis patients from Egypt, Saudi Arabia, Jordan and Libya were histopathologically studied. The results showed that cutaneous leishmaniasis especially in hot areas pave the way to the mutation and development of skin cancer.

Impact of fibrosis on response to interferon therapy in Egyptian HCV patients.

Hepatitis C virus (HCV) infection is a global health problem which can lead to liver cirrhosis or hepatocellular carcinoma in one-fifth of chronically infected patients. HCV-4 infection is common in the Middle East and Africa, with an extraordinary high prevalence in Egypt. Interferon is a cytokine, a specific protein that is no stranger to the human body. In fact, the human body is constantly making interferon, and makes even greater amounts when trying to fight off an intruder, such as a virus. This work studied the impact of liver fibrosis on the efficacy of interferon in treating HCV.

The impact of three anopheline mosquito species in Toshka, on the introduction of chloroquine resistant P. falciparum to Egypt.

Malaria still tops the prevalent human arthropod-borne diseases. In Egypt, sporadic cases of human malaria were reported with a focus in Al-Fayoum. Besides, many Egyptian Anopheles species were reported allover which are either malaria vectors or incriminated ones. This study recorded An. multicolor, An. sergentii, and An. algeriensis in Toshka. Many authors reported that A. sergentii is a malaria-vector and A. multicolor is a suspected vector. Consquently, the endemicity of Chloroquine resistant Plasmodium falciparum on the Egyptian-Sudanese border pave the way for malignant malaria transmission particularly among travelers returning back from Sudan.

Interrelation of antioxidant, anticancer and antilieshmania effects of some selected Egyptian plants and their phenolic constituents.

Medicinal plants are the most potential resource of new therapeutic agents. They are diverse, largely productive, biologically active and chemically unique; among their constituents "polyphenol compounds group" one of the main determinant factors in evaluating the pharmacological potentials i.e. polyphenols display an array of pharmacological properties such as antioxidant, immunostimulant, antitumor and antiparasitic effects. Cancer is a dreadful human disease, increasing with changing life style, nutrition and global warming while current available anticancer drugs cause serious side effects in most instances. Several reports suggested the relationship between antioxidant, anticancer and antiparasitic effects; they suggested that they act indirectly through promoting host resistance, restabilizing body equilibrim and conditioning body tissues in addition to their direct effect on certain parasites involved in cancer etiology. This work was conducted for estimation of total phenolic, flavonoids, phenylethanoid glycoside and iridoid content of twenty-three selected Egyptian plants as well as screening of their anticancer, antioxidant and antileishmanial effects, the overall gained results for suggest that the most suitable medicinal plant used as anticancer and antioxidant is Petrea volubilis L. which contain adequate mixture of total phenolic compounds 88.7 mg% and flavonoids 50.80 mg% and also suggest that flavonoid compounds are the category of phenolic compounds possess significant antioxidant and anticancer effects while the antilieshamnia screening revealed that Thymus decussatus Benth. extract exhibited the highest effect due to the presence of flavonoids and iridoids in adequate combination where iridoid compounds 201 mg% and flavonoid content was 128 mg%.

Cystic hydatidosis: a zoonotic silent health problem.

Examination of five hundred pet dogs revealed Echinococcus granulosus in nine dogs, Dipylidium caninum in twenty dogs, and Toxocara canis in thirty dogs. The risky role played by pet dogs in the transmission and spreading of zoonotic cystic hydatidosis was discussed.

An update review on Commiphora molmol and related species.

The origins of myrrh and frankincense are traced to the Arabian Peninsula. According to Herodotus (5th century BC): "Arabia is the only country which produces frankincense, myrrh, cassia, and cinnamon.., the trees bearing the frankincense are guarded by winged serpents of small size and various colors." Diodorus Siculus wrote, in the second half of the first century BC, that "all of Arabia exudes a most delicate fragrance; even the seamen passing by Arabia can smell the strong fragrance that gives health and vigor." He also mentioned gold mines so pure that no smelting was necessary. The Magi, carrying myrrh, frankincense, and gold, came from the East: Arabia. The frankincense trade route, with transport by donkeys and later by camel caravans, reached Jerusalem and Egypt from the Dhofar region of what is today Oman, through Yemen, turning north to follow the Red Sea coast. It is likely that the same or similar species of the resin-bearing plants grew across the Red Sea in the area that is now Somalia and Ethiopia, while the collection of the gum resins was initiated in Arabia. Myrrh contributed much in the human welfare. Schistosomiasis was known in ancient Egypt since remote times. Haematuria with urinary bladder disturbances was mentioned in four Papyrus papers dated back to 1950-1900 BC, and Schistosoma ova was detected in a cirrhotic liver of a mummy from 1200 BC (Ruffer, 1910). Also, Fasciola eggs were detected in a mummy (Looss, 1896). Fascioliasis infected over 17 million people worldwide causing marked morbidity and mortality (Haseeb et al., 2002). Schistosomiasis affected over 200 million people in 74 countries and territories worldwide (WHO, 1999) causing several chronic complications. Both were incriminated to predispose or accompanied human hepatitis and predisposed to HCV (Wahib et al., 2006). Most zoonotic helminthes induced immune response (Nutman, 2001) characterized by producing of type 2 cytokines, Ig G1, IgG2, IgE antibodies and eosinophil and mast cell activation (Hoffman et al., 2002). Treatment of fascioliasis required high or drug multiple doses with side effect (Farid et al., 1990). In schistosomiasis, praziquantel (PZQ) in use for > 20 years was faced with low efficacy (Leishout et al., 1998), or with increased resistance (Coles et al., 1986; Watt et al., 1988; Herrera et al., 1994; Ismail et al., 1994; 1999; Tonelli et al., 1995; Stelma et al., 1995; Fallon et al., 1997; Bennett et al., 1997; Boisier et al., 1998; Periera et al., 1998; Kusel and Hagan, 1999; Liang et al., 2000; King et al., 2000; N'Goran et al., 2003; Raso et al., 2004), potentiality of carcinogenicity, genotoxicity (Rosenkranz et al., 1995), mutagenicity (Montero et al., 1993), big dose lethality and enhanced clastogenicity of environmental pollutants (Anwar, 1994). On the other hand, Nomicos (2007) in USA reported that since antiquity, the genus Commiphora is composed of more than 200 species, and exploited as a natural drug to treat pain, skin infections, inflammatory conditions, diarrhea, and periodontal diseases. He added that in more recent history, products derived from C. myrrha and various other species of Commiphora are becoming recognized to possess significant antiseptic, anesthetic, and antitumor properties. Traditional practice and evidence-based research have supported that these properties are directly attributable to terpenoids (especially furanoses-quiterpenes), the active compounds present in myrrh essential oil. Very recently, current studies have focused on applying clinical trial methodologies to validate its use as an antineoplastic, an antiparasitic agent, and as an adjunct in healing wounds. Weeks and Simpson (2007) in USA presented the molecular phylogeny of Commiphora, a predominantly tropical African, arid-adapted tree genus to test the monophyly of its taxonomic sections and to identify clades to help direct future study of this species-rich and geographically widespread taxon. The multiple fossil calibrations of Commiphora phylogeny proved that it is sister to Vietnamese Bursera tonkinensis and that its crown group radiation corresponds with the onset of the Miocene. Auffray (2007) in France studied the impact of two types of antioxidant on sebum squalene peroxidation by UV irradiation. The first type was free radical scavenger (Butyl hydroxyl toluene and an olive extract rich in hydroxytyrosol). The second type was the essential oil of C. myrrha, a singlet oxygen quencher. These properties were confirmed using the 2,2-diphenyl-1-picrylhydrazyl test for anti-radical capacity and 1,3-diphenylisobenzofuran test for the capacity to quench singlet oxygen. Also, the author extended an ex vivo method to classify the efficacy of cosmetics to protect squalene by collecting sebum in vivo and irradiating it in a controlled way. The squalene monohydroperoxide formation was monitored by high performance liquid chromatography. This method compared the efficiency of 3 antioxidants at 0.6% in a cosmetic formulation to protect squalene from photo oxidation. The data showed that essential oil of C. myrrha gave the best protection against squalene peroxidation, and that squalene peroxidation during solar exposure was mainly because of singlet oxygen and not due to free radical attack, and that sun care cosmetics should make use not only of free radical scavengers but also of singlet oxygen quenchers. This study aimed to review more than 70 out of hundreds papers (Pub-med-indexed for Medline) on the medical importance and safety of Commiphora molmol and other Commiphora species.

Zoonotic hydatidosis in donkeys: post mortum examination in the Zoo, Giza, Egypt.

A total of 17 out of 160 donkeys slaughtered had hepatic hydatidosis as proved macroscopically and microscopically. The epidemiology of zoonotic echinococcosis/hydatidosis was reviewed and discussed.

Echinococcosis in dogs in urban and rural areas in Dakahlia Governorate, Egypt.

A sample of one hundred and ninety stray dogs was captured from Mansoura city (urban) and three hundreds and fifty stray dogs were captured from Meet El-Korama, Mansheit El-Badawy villages (rural). The total prevalence of E. granulosus was 5%, with a worm burden ranging from 4 to 1010 (mean = 421). The significant prevalence was 6% in the rural area and 3.2% in the urban one. E. granulosus showed higher prevalence in young than old dogs and in males than females but without significant difference in both variants. The overall Echino-ELISA sensitivity was 61.5% and specificity was 97.5%. The major cross reactivity was with Taenia spp., and Diplydium caninum, but neither with Toxocara canis or Trichurus vulpis nor Ancylostoma caninum. There was a negative correlation between ELISA and Echinococcus granulosus burden in dogs.

Echinococcosis granulosus/hydatidosis an endemic zoonotic disease in Egypt.

The hydatidosis patients were collected from Mansoura University's Hospitals and Dakahlia Public Health Hospitals. The patients were divided into three groups: GI: 74 patients with surgically confirmed cystic echinococcosis (CE), GII: 45 patients with other parasitic infections, GIII: 30 healthy parasite-free individuals. All were subjected to questionnaire and full clinical examination, imaging investigation, routine laboratory examination, and serum samples for antibody against CE by the specific ELISA. The hydatidosis was higher in females but without statistically significant difference (p = 0.309). There was no age predilection difference regarding hydatidosis infection. However, the hydatidosis granulosus was significantly higher in the shepherd followed by the farmers. All the questionnaires were positively correlated to hydatidosis infection except the availability of clean domestic water and personal knowledge about hydatidosis gave negative correlations. The ELISA-OD correlated positively with the imaging investigation (mainly U S stage). The sensitivity of ELISA was 86.7% and specificity was 81.4%. The results were evaluated regarding the local and regional data on echinococcosis/hydatidosis.

Human hydatidosis granulosus in greater Cairo, Egypt: with general review.

In this study, human cases (41) of proved hydatidosis granulosus were obtained from Al Kasr Al Aini University Hospitals from 2000-2006. They were 22 females with ages from 8 to 70 years and 19 males with ages from 5 to 75 years. The highly infected organ was the liver. Infection in other organs as lung, spleen, brain, eye, pelvic and bones of upper and lower limbs were reported. Most of the hydatidosis patients were from governorates of Giza (24 cases), Qalyobia (7 cases), Cairo (5 cases), Bani-Swef (3 cases), Sharkia (1 case) and Demiatta (1 case). Biopsies of infected liver and lung were processed for the histopathological studies and photographed. The results were discussed on the light of work done before Egypt.

Protozoal pollution of surface water sources in Dakahlia Governorate, Egypt.

Water samples were collected different water sources and different districts of Dakahlia G., from September 2005 to August 2006, were investigated for pathogenic protozoa. Water specimens were examined by concentration technique followed by modified Ziehl-Neelsen (MZN) and Truant auramine-rhodamine (AR) stains for Giardia sp. cysts, Cryptosporidium sp. oocysts, and other protozoa species. In the 1st survey, 94/480 (19.6%) water samples had protozoa. Prevalence rates were in summer 38/120 (31.6%), autumn 27/ 120 (22.5%), spring 20/ 120 (16.6%) and lastly winter 9/120 (7.5%). Protozoa were less common in treated potable water tanks 15/120 (12.5%), followed by River Nile (Demiatta branch) 22/120 (18.3%) and sub-branch Bahr-El-Saghear 24/120 (20%). The highest prevalence was in water of the main local draining 33/120 (27.5%). In the 2nd survey, 840 potable water samples from seven districts were examined. Prevalence in descending order was C. parvum (3.1%), G. intestinalis (2.1%), E. histolytica (1%), Blastocystis homi-nis (1%), Iodamoeba sp, (0.5%), Isospora belli (0.47%), E. coli (0.36%), Cyclospora cayetanensis (0.24%), and Chilomastix mesnilli (0.12%). Data suggested that C. parvum and G. intestinalis were the commonest disease-agent. The implementation of preventive measures to protect water system from protozoa contamination was given.

Echinococcosis (zoonotic hydatidosis) in street dogs in urban and rural areas, Dakahlia Governorate, Egypt.

A total of one hundred and ninety street dogs were captured from urban area, Mansoura district and three hundreds and fifty from rural area, Met El-Korama and adjacent villages (Manshet El-Badawy, Talka Center). The overall prevalence of Echinoccocus granulosus was 5%, with a worm burden ranging from 4 to 1010 (mean = 421). The prevalence was 6% in rural locality and 3.2% in urban locality. E. granulosus in dogs was significantly higher in rural areas but, without significant difference in puppies and males. The overall sensitivity was 61.5% and specificity was 97.5%. Apart from E. granulosus, dogs were also, infected with Taenia sp., Diplydium caninum, Toxocara canis, Trichurus vulpis and Ancylostoma caninum. The major cross-reactions were with Taenia sp., and D. caninum. Significantly, no correlation was found between ELISA on dogs' sera and E. granulosus burden.

Hydatidosis granulosus in Egyptian slaughtered animals in the years 2000-2005.

Hydatidosis was investigated among camels, sheep, goats, and pigs in Egyptian official abattoirs, from August 2000 to August 2005, and among cows and buffaloes were in Mansoura official abattoirs, in the year 2005. One hundred randomly chosen animals of each species were subjected to serologic and histopathologic examinations for infections. The overall five years hydatidosis prevalence was 2.53%, 0.3% & 0.68% in camels, sheep & goats, and pigs respectively. The 2005 year prevalence in cows and buffaloes was 6.4% in Mansoura. There was a significant difference between animals regarding liver infection, but the difference was highly significant for lung infection. A highly significant difference in hydatid cysts size was between pigs and other animals species (p< 0.000) and a significant difference between macroscopic findings in pigs and camels (p=0.018). A high significant difference was between histopathology in all animals species except pigs and sheep & goats (p=0.089). IHAT showed highly significant difference between camels and other animals species (p<0.000). A significant histopathologic positive correlation was between positive IHAT and fertility (Pearson correlation =0.148, p=0.003). The results were photographed and discussed.

Proliferative changes of epidermal cells in lesions of cutaneous leishmaniasis.

In 35 parasitologically proven zoonotic cutaneous leishmaniasis patients, the histopathological and immunohistochemical picture were studied. The haematoxylin and eosin stain, the monoclonal antibodies for T & B lymphocytes, peroxidase anti-peroxidase for P53 protein, and Feulgen staining for DNA imaging cytometry to DNA contents and S-phase (DNA synthesis of cycling cells were evaluated. The out-come results revealed that P53 and S-phase fraction and DNA content must be in mind when dealing with a human cutaneous leishmaniasis. Consequently, the early detection of any nuclear mutation and cellular proliferation in the skin leishmaniasis lesion(s) must be taken into consideration to avoid the miserable formation of the skin cancer.

The insecticidal activity of Eucalyptus globulus oil on the development of Musca domestica third stage larvae.

The insecticidal activity of Eucalyptus globulus oil (Camphor oil) against the larval maturation and adult emergency of the house-fly, Musca domestica 3rd stage was evaluated under controlled laboratory conditions. Concentrations of 100%, 70%, 50% 25%, 5%, 2%, 1%, 0.9 % and 0.7% showed 100% larval mortality rate. At concentrations of 0.5%, 0.3%, 0.2% and 0.1% the larval mortality rate was 90%. On the other hand, the developed pupae did not emerge to adults. Eucalyptus globulus oil is safe, cheap and widely used in Medicine. So, it is recommended to be use in controlling larvae of M. domestica.