Schistosomiasis and inflammatory polyarthritis: a clinical, radiological and laboratory study of 96 patients infected by S. mansoni with particular reference to the diarthrodial joint

Patients with active Schistosoma mansoni infection attending a medical clinic in an endemic area, 100 miles from Cairo, were asked to participate in this study. Ninety-six patients are reported, 72 of whom presented with musculoskeletal complaints. Nine of these presented with an enthesitis alone; 16 had an inflammatory peripheral polyarthritis alone; the remaining 47 were suffering from the combination of both an arthritis and an enthesitis. Alpha-1-acid glycoprotein was significantly lowered in those patients with musculoskeletal manifestations.

The effect of vaginal administration of low-dose oral contraceptive tablets on human ovulation

The effect of vaginal administration of a low dose combined oral contraceptive pill containing 0.15 mg levonorgestrel and 0.03 mg ethinyl oestradiol was studied in twenty women for a total of 58 cycles. Ovulation was suppressed in all treatment cycles in women receiving two pills daily. Failure of suppression of ovulation occurred in four out of 26 treatment cycles in women receiving one pill daily. Only seven women complained of side effects; most of the side effects were mild and disappeared gradually within the first treatment cycle. Intermenstrual spotting was present in only one case receiving one pill daily. It is concluded that vaginal administration of low dose combined pills has a good ovulation suppression effect with minimal side effects and with good cycle control.

Vaginal administration of a combined oral contraceptive containing norethisterone acetate

The effects of vaginal administration of an oral contraceptive pill containing 1 mg of norethisterone acetate and 0.05 mg of ethinyl oestradiol were studied in 20 subjects for a total of 57 cycles. The results show effective ovulation suppression in the two dose regimens used. The lower dose regimen was associated with fewer side effects and no breakthrough bleeding. No significant change was observed in the serum concentration of glucose, total proteins, albumin, cholesterol and HDL after several cycles of treatment in both dose regimens used. It is concluded that vaginal administration of this preparation of oral contraceptives is an effective alternative method of hormonal contraception.

Academic difficulty among male Egyptian university students. I. Association with psychiatric morbidity

A survey was made of academic difficulties among undergraduate students at Ain Shams University, Cairo, during the academic year 1979-1980. Almost 6% of students dropped out before graduating and a further 8% required substantial extra time to complete their course of study: these figures were almost identical for both sexes. Psychiatric disorders were diagnosed in 42% of male students with academic problems (compared with 9% among the academically successful), with neuroses accounting for nearly half of the cases and schizophrenia for a quarter. Serious psychiatric illness was nearly four times as frequent among 3rd-year students as among 1st-year students.

Academic difficulty among male Egyptian university students. II. Associations with demographic and psychological factors

We compared 178 students with academic problems with 77 academically successful students. Academic difficulty showed highly significant associations with low socio-economic status, over-crowded housing, paternal behaviour problems and a poor relationship between the parents; also significant associations with family history of psychiatric disorder and living away from home. Academic achievement at school was no guide to university performance. Failed students had fewer friendships, especially with women, and more limited recreational activities. They also scored significantly lower on tests of verbal and non-verbal IQ, and worse on the Bender Gestalt and trail-making tests. EPQ results suggested that university students, particularly those with academic difficulties, are more neurotic and introverted than the general Egyptian population.

Bilharzial arthropathy

The joints of 124 young adult patients with bilharziasis were examined. Heels, sacroiliac joints, cervical spine, knee joint, dorsal spine, and tarsal joints were affected. Biopsy of the knee synovia showed synovitis, vasculitis, and the presence of bilharzial ova in three cases. Radiologically the heels and sacroiliac joints showed inflammatory changes. Schistosomiasis may cause an arthropathy.

Disc protrusion in the growing child

Long-term follow-up studies of surgically treated herniation of lumbar intervertebral discs demonstrate both similarities and interesting differences between the disorder in children and adults. Failure to respond to conservative treatment is relatively common in children. Long-term follow-up evaluation demonstrates a relatively high incidence of excellent clinical results.

Successful renal transplantation in a presensitized recipient after multiple blood transfusions

A presensitized uremic patient, initially considered unfit for transplantation, lost his cytotoxic antibodies during prospective multiple transfusion therapy. He subsequently received a graft from his brother, despite a previously positive crossmatch. Hyperacute rejection did not take place. A mild acute rejection episode on the fourth day readily responded to pulse doses of prednisolone. Graft function is excellent at one month. The possible value of intraoperative blood transfusion is discussed.

Psychiatric morbidity among university students in Egypt

During a nine-month period (1974-75), 1,050 students (846 male, 204 female) at Ain Shams University, Cairo, attended the Student Health Centre. Fifty-two per cent were referred there by their general practitioners, 5 per cent by their families and 3 per cent through their faculties; the remainder (41 per cent) were self-referred. Male patients represented 2-8 per cent of the male students, but female patients only 0-9 per cent of the female students. In faculties dealing with practical subjects the male-female ratio was higher than in those dealing with more theoretical subjects. The diagnoses included anxiety neurosis (36 per cent of the cases), schizophrenia (18 per cent), depression (15 per cent) and neurotic depression (12 per cent).

Value of serum copper measurement in acute leukaemia of childhood

Serum copper level (SCL) determination was carried out on sixteen normal children and on 16 with acute leukaemia. A significant increase in SCL was observed in cases of leukaemia than in normal controls. Drop of SCL occurs in cases who respond to quadruple chemotherapy, while those who failed to respond showed persistantly high serum copper level.

Effects of contraceptive pills and intrauterine devices on urinary bladder

The incidence of bacteriuria and cystoscopic changes in women on oral contraceptives or users of IUD (intrauterine devices) were evaluated compared with a control group. Subjects with bacteriuria accounted for 40.5 per cent of pill users, 20 per cent of women fitted with IUD, and 16 per cent of the control group. Bladder trabeculations were found in 50.5 per cent of the pill group, 8.7 per cent of the IUD group, and 8 per cent of the controls. Congested bladder trigone was observed in 24.6 per cent of women fitted with an IUD. The mode of action of ovarian hormones and their possible side effects on the bladder are discussed. The relation of IUD to pelvic inflammatory disease and its effect on the urinary bladder are evaluated.

A psychosocial study of accidental poisoning in Egyptian children

One hundred and twenty-seven accidentally poisoned children from the emergency room of the Islamic Girls College, Cairo, were compared with an equal number of controls. The highest age incidence for both sexes in poisoned children was 36 months. Males outnumbered females at a ratio of 3:2. Behavioural problems such as hyperactivity, temper tantrums, aggression, stubbornness, nocturnal enuresis and impulsiveness occurred more often in poisoned children than in controls and more often in those (24 patients) referred with accidental poisoning on more than one occasion. The families of poisoned children differed significantly from the controls in their large size, low level of education, disturbed home atmosphere and the accessibility to the child of the poisonous substance.

Renal prostaglandins for induction of labour-a dual clinical advantage in toxemia of pregnancy

Prostaglandin A is known to be an antihypertensive vasodepressor agent produced by the kidney and has the basic potentialities of a hormone. No information is available at present concerning its effect on the human pregnant uterus and whether it can be used as an oxytocic compound to induce labour. The uterine stimulating and labour inducing ability of PGA1 was evaluated in 10 cases; seven patients were suffering from pregnancy toxemia while three were normal pregnancies near full term. Cardiotocographic tracings showed that uterine activity was markedly stimulated to a degree sufficient to induce labour. Continuous i.v. infusions at a rate of 0.25-1.0 mug/Kgm/min given over a fixed period of only 6 hours resulted in delivery in all cases except one following the discontinuation of administration. Beneficial effects on blood pressure were observed in toxemic subjects. Potentially serious FHR patterns and occasional hypertonus during therapy were seen and stress the need for more information to evaluate the safety, optimum dosage and duration of infusion as well as the place of this approach in clinical practice for the management of pregnancy toxemia. The absence of antidiuretic effect, the hypotensive response and uterine stimulating property of PGA1 indicate a possible advantage in toxemia of pregnancy as compared to oxytocin infusions.

Bilharziasis of urinary bladder and ureter: comparative histopathologic study

The relative incidence and intensity of oviposition in schistosomiasis in different layers of both the urinary bladder and the ureter are presented. Histopathological changes in both organs are elucidated. Oviposition was heaviest in the submucosa of the urinary bladder, while the muscle layer was affected in 15% of specimens. Oviposition was mainly periureteral and in outer muscle layer of the ureter, and was present in only 22% in the ureteral submucosa. Epithelial changes, namely, Brunn nests, cystitis glandularis, cystitis cystica, and squamous metaplasia, were more marked in the bladder specimens than in the ureteral specimens. Squamous cell papilloma and squamous metaplasia associated with acanthosis of the bladder specimens were identified. Results indicate unanimously that the heavy deposition of ova in the submucosa of the bladder leads through its mechanical and toxic irritation to marked epithelial and premalignant changes which pave the way for the disturbing frequency of carcinoma of the bladder in the bilharzial patients which is not the case in the ureter.

The potentialities of some antihistaminics in preanaesthetic medication

A detailed study has been carried out on the potentialities of antazoline and chlorpheneramine (C.P.M.) in preanaesthetic medication. It included a determination of their sedative action, effects on cardiovascular system and any possible anticholinergic and antiarrhythmic properties. Both drugs depressed spontaneous activity in mice. Antazoline produced hypotension in chloralosed dogs and spinal cats (a peripheral action). Both produced a negative inotropic action on isolated rabbit's heart. On rat's auricle antazoline produced a positive chronotropic action while C.P.M. produced a negative chronotropic action. Both drugs could protect the heart against adrenaline induced arrhythmias during chloroform and halothane anaesthesia. Their anticholinergic properties were demonstrated by studies on isolated rabbit's heart and intestine as well as on isolated guinea pig's ileum.

The value of premedication in diminishing salivary secretions

A study has been carried out on the anti-sialogogue effect of some drugs used in premedication. Among different anaesthetic agents used in this study halothane appeared to be the least effective in stimulating salivary secretions. Pethidine-atropine combination proved to be very satisfactory as an anti-sialogogue. Atropine came next, where its intravenous route of administration was more satisfactory in short procedures than its intramuscular route.