No abstract

Cerebral palsy (CP) is the most frequent cause of motor handicap. The present door-to-door survey was conducted in Al-Quseir City, Egypt, to investigate the epidemiology of CP. All inhabitants were screened by three neurologists. Medical and neurological examinations were performed for all residents and suspected cases of CP were confirmed by meticulous neurological assessment, brain magnetic resonance imaging, electroencephalography, and testing with the Stanford-Binet Intelligence Scale. Forty-six of 12,788 children aged ≤18 years were found to have CP, yielding a childhood prevalence of 3.6 (95% confidence interval 1.48–2.59) per 1,000 live births. Five adults (aged 19–40 years) among 13,056 inhabitants had CP, giving an adult prevalence of 0.4 (95% confidence interval 0.04–0.72) per 1,000. The risk factors for CP identified in this study were premature birth, low birth weight, neonatal jaundice, neonatal seizures, and recurrent abortion in mothers of children with CP.

A total of 437 patients with epilepsy were identified, 30.7% of whom (n=134/437) were uncontrolled, with a prevalence of 2.1/1000. A total of 52.2% of uncontrolled patients (n=70/134) were inappropriately treated, while 47.8% (n=64/134) were compliant with appropriate treatments. Video monitoring EEG of compliant uncontrolled patients demonstrated that 78.1% patients (n=50/64) had definite epilepsy, while 21.9% (n=14/64) had psychogenic non-epileptic seizures (PNES). A logistic regression analysis revealed that status epilepticus, focal seizures, and mixed seizure types were risk factors for intractability.

A door-to-door survey, including every household, was conducted for all inhabitants of Al Quseir City (33,283), Red Sea Governorate, Egypt by three specialists of neurology as well as nine senior staff members of neurology and 15 female social workers to assess the epidemiology of major neurological disorders. Over six phases, from July 1, 2009 to January 31, 2012, screening of all eligible people in the population was carried out, by which case ascertainment of all major neurological disorders included in the study was done according to the accepted definitions and diagnostic criteria of the World Health Organization. The order of frequency of prevalence of the studied neurological disorders was dementia (3.83% for those aged > 60 years), migraine (2.8% for those aged > 8 years), stroke (6.2/1000 for those aged > 20 years), epilepsy (5.5/1000), Parkinson’s disease (452.1/100,000 for those aged > 40 years), cerebral palsy (3.6/1000 among children < 18 years), spinal cord disorders (63/100,000) dystonia (39.11/100,000), cerebellar ataxia (30.01/100,000), trigeminal neuralgia (28/100,000 for those aged > 37 years), chorea (21.03/100,000), athetosis (15/100,000), and multiple sclerosis (13.74/100,000). The incidence rates of stroke, epilepsy, and Bell’s palsy were 181/100,000, 48/100,000, and 98.9/100,000 per year, respectively.

An experimental, randomized, prospective study was performed in 64 dogs to evaluate the effect of fecal loading, solely, or in combination with induced peritonitis, on colonic anastomosis. The animals, none of which had bowel preparations, were randomized into four groups. Group I underwent sigmoid resection and standard open end-to-end anastomosis; Group II underwent sigmoid resection and an intracolonic bypass procedure; Group III underwent experimentally induced fecal peritonitis, sigmoid resection, and anastomosis; Group IV underwent induction of fecal peritonitis, sigmoid resection and an intracolonic bypass procedure. Using Fisher's exact test, results indicate a more statistically significant increased leak rate in Group III than in Group II (P = .04), and Group III than in Group IV (P = .03), but no statistically significant anastomotic leak rate between the peritonitis (III and IV) and the nonperitonitis (I and II) groups. A very significant statistical increase in leak rate (P = .002) was observed when comparing the 25 percent leak rate of Groups I and III (anastomosis subjected to fecal contact) with the 0 percent leak rate of Groups II and IV (anastomosis excluded from fecal contact) regardless of the peritonitis. This study suggests that the intraluminal contact of fecal loading at the colonic anastomosis is a more significant factor in anastomotic complications due to dehiscences than peritonitis per se. It follows, therefore, that if feces can be excluded from intraluminal contact with an anastomotic site, an anastomosis can be safely performed even in the presence of treated peritonitis.