Intestinal capillariasis as a cause of chronic diarrhoea in Egypt.
Anis MH. Shafeek H. Mansour NS. Moody A.
Harpur Memorial Hospital, Menouf, Egypt.
Intestinal capillariasis in humans is caused by a nematode- Capillaria philippinensis, which infects small fresh water or brackish fish and some fish eating birds. It has occurred in areas where people eat raw fish such as the Philippines and Thailand. This paper reports a case of a women with intestinal capillariasis in Menouf, in the Nile Delta of Egypt. It is the second case to be reported from the same area of Menouf. Microscopic examination of stool revealed eggs, larvae and adult male and female worms of C. philippinensis. This was successfully treated with Albendazole.
A study on the relation between proton pump inhibitor and gastric giardiasis.
Kader SA. Mansour AM. Mohran Z. el-Taoil A. Abdalla KF.
Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Thirty patients treated with proton pump inhibitor and still having symptoms related to gastritis or peptic ulcers were subjected to upper gastrointestinal endoscopy and gastric biopsy for detection of giardiasis in these cases. Results showed presence of 3 (10%) cases of gastric giardiasis, intestinal metaplasia and presence of H. pylori in these cases. It is concluded that there may be a relation between the presence of gastric giardiasis and the intake of proton pump inhibitor. The endoscopists have to search for gastric giardiasis especially in the presence of H. pylori and/or intestinal metaplasia.
Immediate endoscopic injection therapy of bleeding oesophageal varices: a prospective comparative evaluation of injecting materials in Egyptian patients with portal hypertension.
Omar MM. Fakhry SM. Mostafa I.
Division of Clinical Tropical Medicine, Theodore Bilharz Research Institute, Giza, Egypt.
The present study was conducted to compare usual sclerosants: polidocanol 1%, ethanolamine oleate 5% and the tissue adhesive: cyanoacrylate in the control of oesophageal variceal bleeding in Egyptian patients with portal hypertension in a prospective comparative trial. Sixty patients with portal hypertension due to schistosomal hepatic fibrosis and/or posthepatitic liver cirrhosis who had presented with acute oesophageal variceal bleeding were enrolled. Patients received balloon tamponade prior to injection were excluded. Resuscitation had been done before or during emergency endoscopy. Emergency endoscopy was conducted within 2 hours from the onset of hematemesis. Patients were immediately randomized during emergency endoscopy to receive polidocanol 1%, ethanolamine oleate 5% or tissue adhesive. Variceal rebleeding was managed by reinjection. The three groups were comparable for age, sex, etiology of portal hypertension, Child-Pugh class and findings at emergency endoscopy. No active bleeding was observed at the end of all injection sessions. Rebleeding had been occurred within the first 24 hours in 2 (10%) patients in polidocanol group and 3 (15%) patients in ethanolamine group (P > 0.05). Reinjection did control rebleeding in 2 (10%) patients in ethanolamine group with a total success rate of 95%. Exsanguinating rebleeding occurred in 2 (10%) patients in polidocanol group and one (5%) patient in ethanolamine group (P > 0.05). Postinjection large ulcers were diagnosed either in polidocanol (15%) or ethanolamine (10%) groups (P > 0.05). Other complications were minor and showed no significant differences between the three groups. In coclusion, polidocanol, ethanolamine and cyanoacrylate are equally safe and effective. For immediate endoscopic injection therapy an experienced team must be available.
Cyclospora: a newly identified protozoan pathogen of man.
Nassef NE. el-Ahl SA. el-Shafee OK. Nawar M.
Department of Parasitology, Faculty of Medicine, El-Menoufia University, Egypt.
A newly recognized protozoan human parasite, Cyclospora spp. has been incriminated as the cause of prolonged diarrhoea. It has been isolated from children, immunocompetent and immunocompromised adults. One hundred and thirty immunocompetent patients, 80 children and 50 adults; their illness was characterized by prolonged watery diarrhoea, were enrolled in this study. Stool sediments were examined as wet mounts and stained by both, modified Ziehl-Neelsen and aniline carbol methyl violet stains. The protozoan pathogen was identified as spherical bodies measuring 9-10 microns in diameter in about 9% and 10% in both children and adult groups respectively. The mean duration of illness was 28 +/- 8 and 37 +/- 12 days and the frequency of stool motions was > 5/day with normal mucosal pattern on colonoscopic studies for adults group. It is concluded from the present study that cyclosporiosis is quite similar to cryptosporidiosis and both oocysts have the affinty to acid fast stain so the present recommendations for all laboratories screening stool for cryptosporidia should measure the oocyst to distinguish between these different parasites and there is obviously a great deal more to learn about this emerging protozoon.