Search

The outcome of hepatitis C virus (HCV) infection acquired in childhood is uncertain because of the diversity of the epidemiological and clinical features of infection and disease. The aim of this study was to determine the outcome of HCV infection in 105 Egyptian children who tested positive for HCV antibody (anti-HCV). The data of 105 anti-HCV-positive children presenting to the Pediatric Hepatology Unit, Cairo University Children's Hospital, between 1995 and 2002, were retrospectively analysed for risk factors. Seventy-four children with available polymerase chain reaction results were further analysed clinically, serologically and histologically. The age range was 1.3-22 years, with a mean of 11.2 +/- 4.9 years. History of blood transfusion was found in 81 children (77%). HCV RNA was detected in 58.1% of 74 children. Persistently elevated alanine aminotransferase (ALT) levels were present in 40 patients (54.1%). Hepatitis B virus markers (HBsAg and/or anti-HBc) were detected in 18 patients (24.3%). Twenty-six of the 43 HCV RNA-positive children underwent a diagnostic liver biopsy that showed chronic hepatitis in 19 patients (73.1%), cirrhosis in one case only (3.8%), and normal biopsy findings in seven children (26.9%). Blood transfusion remains a major risk of HCV transmission among Egyptian children. HCV infection is not always benign in the childhood period. ALT levels remain elevated in half of the children and histological abnormalities are detected in three quarters of HCV RNA-positive cases.

Objective: To determine the predictors of core temperature on arrival in the intensive care unit (ICU) after cardiac surgery. Design: Prospective, randomized trial. Setting: Tertiary care medical center, operating rooms (ORs), and ICU. Patients: 72 patients presenting for coronary artery bypass surgery. Interventions: Randomized assignment for ambient OR temperature (16–18°C vs. 21–23°C) and rewarming endpoint on cardiopulmonary bypass (CPB; nasopharyngeal and urinary bladder temperatures ≥36.5°C and 34.0°C, respectively, vs. nasopharyngeal and urinary bladder temperatures ≥37.5°C and 36.0°C, respectively) at the time of separation from bypass. Measurements and Main Results: The best (and only significant) predictor of core temperature on arrival in the ICU was rewarming endpoint at the time of separation from CPB ( p = 0.004). Patient weight, height, body habitus, and nitroprusside administration did not significantly predict core temperature. Ambient temperature affected only body temperature when the duration of time in the OR after separation from bypass was prolonged (>90 min). A weighted average body temperature was a better predictor of complete rewarming than was any single monitoring site. Conclusions: To reduce the incidence of hypothermia after cardiac surgery, the most important variable is rewarming endpoint achieved before separation from bypass. A warm ambient temperature (>21°C) may be beneficial if the duration of time in the OR after bypass is prolonged (>90 min).

Human fascioliasis (HF) is an increasingly recognized public health problem in Egypt. During the past two years we diagnosed HF in 40 Egyptian children. Diagnosis was based on some or all of the following criteria: fever, tender hepatomegaly and high eosinophilia (febrile eosinophilic syndrome), presence of Fasciola hepatica eggs in stools, and/or serodiagnosis using the indirect haemagglutination test (IHAT). Eight of the 40 children had failed to respond to previous treatment with praziquantel. All children were treated with triclabendazole in a dose of 10 mg/kg as a single oral dose. Within 2 months, 31 children (78 per cent) were cured as evidenced by clinical well-being, normalization of eosinophil counts, Fasciola antibody titres, and absence of Fasciola hepatica eggs in stools. The remaining nine cases achieved clinical and laboratory cure after a second dose of triclabendazole. No side-effects were encountered in any of the cases. We conclude that triclabendazole is an effective, well-tolerated, easy to administer drug that should be considered in HF.

There are many computer programs assisting in the landscape designing process of sites and projects that fall under the list of Computer-Aided Design (CAD) software. These programs aid designers in developing the urban design of sites particularly without affecting the other aspects of the design. In this paper, there is a comparative rating of the most commonly used computer programs to assist in this area, which is conducted through a set of scientific criteria for classification and rating. This will help landscape stakeholders to select the appropriate program depending on the nature and size of the project. The problem tackled in this research is the lack of knowledge and reluctance of some landscape designers to use CAD programs to assist in this field. This paper aims to introduce landscape designing CAD programs to assist in the site designing process and to help those interested in this field to select the appropriate program according to the nature of their projects.

The effect of premedication with an oral antacid (magnesium trisilicate), oral cimetidine or a combination of both was studied in 80 patients undergoing elective Caesarean section. Twenty patients served as untreated controls. Seventy per cent of the patients were in the high risk range for acid aspiration pneumonitis (pH less than 2.5 plus gastric content volume greater than 25 ml). Antacid therapy was effective in raising pH but the gastric volume remained high in 50 per cent of the patients. Cimetidine was effective in decreasing gastric volume and raising pH but the pH was still less than 2.5 in two patients. None of the patients given the cimetidine-antacid combination were in the high risk range for acid aspiration pneumonitis. The combination of an oral dose of cimetidine 400 mg, three to four hours before the operation followed by 20 ml of magnesium trisilicate one hour preoperatively proved to be the most efficacious regimen for prophylaxsis against Mendelson's syndrome in elective Caesarean section. Recent reports have suggested that non-particulate antacids (e.g., sodium citrate) may be preferable to particulate antacids such as magnesium trisilicate.

Summary Three groups each of 20 patients scheduled to undergo operations on hand or forearm, received supraclavicular brachial plexus blocks with 25 ml lignocaine 1.5%. Patients in the control group did not suffer from pain and were not asked to do muscular exercise. Patients with acute trauma of the upper limb formed the pain group and showed significantly decreased latency for onset of analgesia, partial and complete muscle paralysis. Patients in the muscle exercise group were free of pain and were asked to do muscular exercise for 5 minutes after injection of the lignocaine. Onset of analgesia, partial and complete muscle paralysis was significantly more rapid than in both control and pain groups. Changes in the duration of block were not significant. It is concluded that pain and muscular exercise enhance the onset of brachial plexus blockade.

The effect of premedication with an oral antacid (magnesium trisilicate), oral cimetidine or a combination of both was studied in 80 patients undergoing elective Caesarean section. Twenty patients served as untreated controls. Seventy per cent of the patients were in the high risk range for acid aspiration Pneumonitis (pH 25 ml). Antacid therapy was effective in raising pH but the gastric volume remained high in 50 per cent of the patients. Cimetidine was effective in decreasing gastric volume and raising pH but the pH was still