Nutritional rehabilitation of malnourished children detected by Screening Tool for Assessment of Malnutrition in Pediatric: Urban versus rural settings.

BACKGROUND: Malnutrition presents a major global health burden. In Egypt, it remains an important issue in children under 5 years especially in rural communities. AIM OF THE STUDY: The aim of the study was to screen 2-5 years old children enrolled from Egyptian hospitals in rural and urban areas for the risk of malnutrition using Screening Tool for Assessment of Malnutrition in Pediatric (STAMP) and to evaluate the effectiveness of nutritional intervention programs. SUBJECTS AND METHODS: This cross-sectional study was conducted on 90 patients recruited from two hospitals in urban and rural Cairo, Dietary history and anthropometric measurements were assessed. Patients at intermediate and severe risk of malnutrition according to STAMP were given tailored nutritional programs. RESULTS: In the rural hospital, 4.4% of the screened children were underweight, 22.2% were marginally underweight, and 73.3% had normal weight. Regarding the urban hospital, 15.6% were marginally underweight, 84.4% had normal weight and no underweight patients. Among the rural group 35.6% were at high risk according to STAMP score results compared to 20% in the urban group. Nevertheless, the only significant differences were the more stunting and higher BMI in rural hospital patients. After nutritional intervention, high-risk category patients decreased in both groups coupled by significant improvement in the anthropometric parameters and nutrition data with no significant differences between them. CONCLUSION: Nutritional education and prompt implementation of nutritional rehabilitation program for malnourished children detected by screening tools result in improvement in their nutritional status disregards their location whether urban or rural.

Treatment of congenital clasped thumb in arthrogryposis.

We report the result of treatment of 69 complex clasped thumbs in 39 patients with distal arthrogryposis. The mean age at surgery was 30 months. Surgical reconstruction included skin augmentation of the first web using modified dorsal rotation advancement flap (Abdel-Ghani flap), a la Carte release of tight structures of the first web, and chondrodesis of the thumb metacarpophalangeal joint. The mean follow-up was 4 years. We prefer chondrodesis because of the presence of global instability, abnormal joint structure, abnormal articular surfaces, and inefficient muscles for transfer. Also, chondrodesis shortens the thumb and may alleviate the need for release of deficient palmar skin and lengthening of a short flexor pollicis longus. The Abdel-Ghani flap provides ample skin that gives a wide rounded web. It is a simple procedure with minimal donor site morbidity. Surgical reconstruction significantly improved the cosmetic appearance and function of the thumb. LEVEL OF EVIDENCE: IV.

Saudi Arabia experience trial of fluvastatin (Lescol) in the treatment of hyperlipidemia.

This study was carried out to assess the efficacy, safety and tolerability of fluvastatin as monotherapy in the treatment of primary hypercholesterolemia. This multicenter study started with 467 patients but only 315 subjects completed 12 weeks treatment. Patients followed a standard lipid-lowering diet for 3 weeks before entering and throughout the study. Every patient received fluvastatin 20 mg once daily with the evening meal for the first 6 weeks, from week 7 to week 12 the daily dose was changed to one capsule 40 mg daily in the evening. Results showed that the mean percent changes in lipid parameters between baseline and endpoint was as follows: LDL-C (-32.7%); total cholesterol (-29.42%), triglycerides (-19.7%) and HDL-C (16.6%). Meanwhile, the mean percent increase in liver enzymes between baseline and endpoint was 17.2% for ASAT and 20.3% for ALAT, respectively, but the mean values of both enzymes at the endpoint were within normal range. The most frequent side effects being gastrointestinal (4.3%) including dyspepsia, nausea, flatulence and diarrhea. In conclusion, fluvastatin as monotherapy in the treatment of hypercholesterolemia among Saudis was found to be safe, well tolerated and produced a significant improvement in the overall lipid parameters.

Glycosylation, sugar hydrazones, and antimicrobial evaluation of some 6-substituted-1,2,4-triazines.

Hydrazinolysis of 4-amino-6-[2-(4-methoxyphenyl)vinyl]-3-thioxo-3,4-dihydro-2H-[1,2,4] triazin-5-one (1) gave the corresponding hydrazino derivatives (2) Cyclocondensation of (2) with carbon disulfide furnished 8-amino-6-[2-(4-methoxyphenyl)vinyl]-3-thioxo-2,8-dihydro-3H-[1,2,4]triazolo[4,3-b][1,2,4]triazin-7-one (3) which was treated with 2,3,4,6- tetra-O-acetyl-alpha-D-glucopyranosyl bromide (4) in pyridine to give the corresponding N-glucosyl derivative 5, which deblocked to give 8. Compound 2 was reacted with isatin 9 and/or isatoic anhydride 10 to afford 11 and 12. Treatment of 11 and 12 with (4) in pyridine gave the corresponding mono glucosyl derivatives 13 and 14, which were deblocked by ammonia and afforded 15 and 16. Condensation of 2 with aldoses afforded the corresponding cyclic products 17a-f and with D-fructose furnished 18. Acetylation of 17b, d afforded the corresponding polyacetyl derivatives 19b,d. Compound 2 condensed with some aromatic aldehydes in boiling methanol and gave 20a-f. The newly synthesized compounds were tested as antimicrobial agents.

Diagnosis of gastrointestinal nematodes infecting sheep in Qalubia Governorate by infective thrid stage larvae.

A total of 300 faecal samples obtained from living sheep in Qalubia Governorate, 128 (42.66%) harboured eggs of nematodes. The gastrointestinal nematodes had been differentiated through the infective third stage larvae. Details of the general and differential categories of each were given. The recovered species were Trichostrongylus axei, T. colubriformis, Ostertagia circumcincta, Haemonchus contortus, Bunostomum trigonocephalum and Oesophagostomum venulosum.

Differential modulation of interleukin-6 and interleukin-10 by diclofenac in patients undergoing major surgery.

BACKGROUND: Prostaglandins modulate cytokine release though increases in cAMP, regulating interleukin (IL) 6 and IL-10. Diclofenac inhibits cyclo-oxygenase activity and hence prostaglandin production. We hypothesized that diclofenac would affect release of IL-6 and IL-10 and modulate the immune response. METHODS: In a randomized, double-blind, placebo-controlled study, we investigated the effect of diclofenac in patients undergoing major urological surgery. Patients were randomized to receive either diclofenac (50 mg orally every 8 h the day before surgery and 75 mg i.m. every 12 h on the day of surgery, n = 23) or placebo (n = 23). Standardized combined general anaesthesia and epidural analgesia was administered. Serum IL-6, IL-10 and cortisol were measured before surgery and 30 min and 2, 6, 12 and 24 h after skin incision. Temperature, leucocyte count and C-reactive protein concentration were measured before surgery and after 24 h. RESULTS: IL-6 and IL-10 concentrations increased, reaching peak levels at 12 and 6 h respectively in both groups. At 12 h, the IL-6 concentration was significantly lower in patients receiving diclofenac than in those receiving placebo (P = 0.003). In contrast, IL-10 concentration at 6 h was higher in diclofenac-treated patients (P = 0.008), and this was associated with less pyrexia (P = 0.03), a lower leucocyte count (P = 0.0002) and a lower C-reactive protein concentration (P = 0.0039). Serum cortisol concentration was similar in the two groups of patients until 24 h, when the concentration was lower in patients who received diclofenac (P = 0.002). Cortisol concentration correlated with IL-6 concentration at 24 h. CONCLUSIONS: Administration of diclofenac was associated with lower IL-6 and higher IL-10 concentrations, and lower leucocyte count, C-reactive protein concentration and temperature. Diclofenac may have an anti-inflammatory role in major surgery.