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A survey of 179 animals (black rats, dogs, sheep, buffaloes, cattle, donkeys, weasels, and cats) for Leptospira infection was conducted in Mahalla City (Lower Egypt). Blood, urine, and kidney were collected and tested by culture, microscopic agglutination test (MAT), and/or polymerase chain reaction (PCR). Among rats, 26% were positive by PCR, including 7% that were also positive by culture for L. interrogans serovars Grippotyphosa, Pyrogenes, and Icterohaemorrhagiae. L. borpetersenii serovar Polonica was isolated for the first time in Egypt in three rats. MAT titers ≥ 1:800 were observed in 11% of rats and 12% of dogs. L. interrogans serovar Grippotyphosa was detected in one cat. Sheep and donkeys were negative for leptospirosis by all methods. Buffaloes and cattle were seropositive in 20% and 44% of animals, respectively. Data indicate that several pathogenic serovars are circulating in the animals, which may pose exposure risks and account for high rates of acute febrile illness.

Salmonella Enteritidis is a communicable zoonotic bacterium. The present investigation was done to evaluate the potential occurrence of Salmonella Enteritidis in laying hen farms and its contamination pathways. Samples were collected from 10 laying hen farms located in the Delta of Egypt. Cloacal swabs (n=300), eggshell swabs (n=400), and hand swabs from egg packagers (n=38) were collected. Pools of ovary and oviduct were obtained from 150 hens; all samples were examined for the presence of Salmonella Enteritidis. Results indicated that Salmonella Enteritidis may initially occupy in ovary, oviduct, and cloaca. The risk for eggshell contamination is highly impending from laying hen flocks infected with Salmonella Enteritidis with percentage of >30%. Farms having eggshell contamination percentage of >60% with Salmonella Enteritidis provided a high risk for packagers' hand contamination. Questionnaire of egg packagers specified that seven out of the eight smoker packagers suffered from repeated Salmonellosis. Thus, smoking during egg packing process could be considered as an exposure factor to contract the infection via hand-cigarette-mouth route.

Purpose: To report the visual results and complications of a new technique for scleral fixation of posterior chamber intraocular lenses (IOLs) without scleral flaps., Methods: Half-thickness 3 mm scleral grooves 1 mm behind the limbus were constructed opposite to each other. The straight needle with a double-armed 10/0 prolene suture was introduced at one end of the scleral groove to exit through the corneal incision then passed through the two holes of the IOL. It re-entered the globe through the corneal incision and then passed behind the iris to exit the globe at the other end of the scleral groove. The same was repeated on the other side. The corneal section was enlarged, the IOL was implanted, and the two ends were tied to each other to form a loop that was rotated and buried in the scleral groove., Results: The study included eight men and seven women. Their ages ranged from 7 to 69 years (mean 40+/-21.53 years). The preoperative best corrected visual acuity (BCVA) ranged from 3/60 to 6/9. The operation time ranged from 25 to 50 min (mean 34.55+/-7.66 min). Anterior vitrectomy was performed in nine (60%) cases. Ciliary bleeding during needle passage occurred in six (40%) cases and accidental suture cutting during section enlargement occurred in one (6.7%) case. There was no major IOL decentration. The final UCVA ranged from 6/24 to 6/18 and the final BCVA ranged from 6/24 to 6/9. Five cases (33.33%) showed postoperative glaucoma and three cases (20%) had mild to moderate vitreous haemorrhage. No cases of suture erosion, postoperative endophthalmitis, retinal detachment or IOL dislocation were detected., Conclusion: This technique of four-point scleral fixation of posterior chamber IOLs reduces the operation time, achieves good centration and stability of the IOL, and minimises postoperative suture-related complications.

Background: Deep amblyopia is a recognized cause of monocular visual deficit in children with a high rate of poor compliance with conventional occlusion therapy. This study evaluates a new occlusion technique that can be used for children with failed amblyopia treatment., Methods: In a prospective study, surgical silicone-eyelid closure was done for 15 children (age: 4 to 6 years; median age: 5.2 years) with a history of deep amblyopia and poor compliance with occlusion methods. In this technique, the good eye was closed by passing one limb of a double armed 5-0 polypropylene suture from one eyelid margin through a silicone sleeve and through the corresponding eyelid margin. The other polypropylene limb was passed behind the silicone sleeve and then through the opposite eyelid margin to form a barrier between the sleeve and the cornea. After 2 to 4 weeks, the suture was cut and the silicone sleeve was removed., Results: Preoperative visual acuity ranged between counting fingers at 1 meter and counting fingers at 4 meters. Following eyelid closure, visual acuity was improved to between 20/40 and 20/200 for 12 patients, whereas three patients did not improve. Complications were seen in 8 patients: marginal eyelid irritation and erythema in 6 and suture break in 2., Conclusion: Silicone-eyelid closure can be used safely and effectively for management of deep amblyopia. This technique affords a good option to restore vision in a deeply amblyopic eye and grants the child a lifetime of useful vision.

Reaction of 2,5-bis(arylmethylidene)cyclopentanones 1a-d with nitrilimines (generated in situ via triethylamine dehydrohalogenation of the corresponding hydrazonoyl chlorides 2a,b) in 1:2 molar ratio proceeds in a high regioselective manner affording monocycloadducts 3 and dicycloadducts in the form of two isomers 4, 5. Single crystal X-ray diffraction studies of the isolated crystalline form of 3c support the established structure and indicate that the formed product is 7E, 4S, 5R. Antimicrobial activity screening of the synthesized compounds 3-5, utilizing a variety of gram-positive (Staphylococcus aureus, Enterococcus fecalis and Streptococcus agalactiae), gram-negative bacteria (Escherichia coli, Klebsiella pneumoniae and Proteus vulgaris) and yeast (Candida albicans), exhibited that all the prepared analogues acquire promising activities against both gram-positive and gram-negative bacteria especially compounds 3b, 4a (antimicrobial active agents against gram-positive bacteria) and 3c (antimicrobial active agent against gram-negative bacteria).

We report the occurrence of concurrent infections with multiple acute febrile illness (AFI) pathogens during an ongoing prospective laboratory-based surveillance in four infectious disease hospitals in urban and rural areas of Egypt from June 2005 to August 2006. Patients were screened for Leptospira, Rickettsia typhi, Brucella, or Salmonella enterica serogroup Typhi by various methods including serology, culture, and PCR. One hundred eighty-seven of 1,510 patients (12.4%) evaluated had supporting evidence for the presence of co-infections; 20 (1%) of these patients had 2 or more pathogens based upon confirmatory 4-fold rise in antibody titer, culture, and/or PCR. Most coinfected patients lived or worked in rural agricultural areas. The high coinfection rates suggest that defining the etiologies of AFI is imperative in guiding proper disease treatment, prevention, and control strategies in Egypt.

The epidemiologic status of leptospirosis in Egypt has not been well defined because of difficulties in disease diagnosis. A retrospective study was conducted to detect leptospiral antibodies among undiagnosed acute febrile illness (AFI) and hepatitis cases. Approximately 16% of both AFI (141/886) and acute hepatitis (63/392) cases showed seroreactivity to Leptospira IgM by ELISA and microscopic agglutination test (MAT). Canicola, Djasiman, Grippotyphosa, Pyrogenes, Icterohemorrhagiae, and Pomona were the most commonly reactive serovars among patients with AFI. Djasiman, Grippotyphosa and Icterohemorrhagiae were the most reactive among patients with acute hepatitis. This study represents the first systematic report of Leptospira associated with patients with AFI and hepatitis in Egypt. Physicians need to have increased awareness about the importance of leptospirosis in the differential diagnosis of AFI and acute hepatitis in Egypt. In addition, laboratory capacity should be developed at fever hospitals to diagnose leptospirosis.

Burn injury is one of the most devastating injuries that may affect a patient. Even in economically deprived areas, burn care is largely driven by relatively plentiful resources equating quality of care with generous monitoring and clinical attention with little concern to management cost. Burn care costs have been the subject of very few investigations and are among the least studied by health services researchers. Nevertheless, it can be stated that local care of burn wounds accounts for a large proportion of the cost per day for treating patients. As economic times are changing and as market penetration of managed care contracts and stiff competition in the health care industry gains momentum, ways to reduce expenditures without adversely affecting the quality of care have become of primary importance. We report a randomized prospective comparative study analyzing the benefit-cost value of moist exposed burn ointment (MEBO) application, an exposed method for burn wound care without the need for a secondary covering dressing, as compared to conventional closed methods.