SummaryIntestinal parasites may cause symptoms similar to acute appendicitis. Moreover, the diagnosis of parasitic infections is only done by post-operative histopathological examination of the appendices. Therefore, our aims are to assess the prevalence of intestinal parasitic infections among patients who were be appendectomized at Tanta Hospitals, Egypt and to investigate the possible association between these parasitic infections and appendicitis. To achieve these objectives, we performed a cross-sectional study including 65 patients chosen randomly who had undergone appendectomy over a period of one year from Oct 2015 to Oct 2016. Demographic data were retrieved. Complete blood picture was done. Moreover, appendiceal faecolith were examined macroscopically then by direct smear examination, formol-ether concentration technique, modifi ed Ziehl-Nelseen stain and rapid immunochromatographic test. Histopathological examination of resected appendices was done. We found that parasitic infections were detected in 24.6 % of examined cases. Most of parasitic infections were prevalent in patients belonging to the school age group. Different parasitic infections were detected in the faecolith specimens. Moreover, Enterobious vermicularis adult female and Schistosoma mansoni granuloma were detected in histopathological sections. Also, a spectrum of pathological changes in the appendices was found ranging from lymphoid hyperplasia to acute infl ammation with peritonitis. In conclusion, intestinal parasites may cause clinical picture similar to that of acute appendicitis. Therefore, careful attention to clinical history, stool examination and high eosinophilia may aid diagnosis and avoid unnecessary appendectomy. Moreover, the presence of different parasitic stages in the narrow lumen of the appendix may have a role in the development of appendicitis and this needs further studies.
Background: Cardiovascular diseases (CVDs) are on the rise owing to excessive fat consumption or hereditary factors. From infancy through old age, it is the leading cause of disease and mortality. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme mostly excreted by macrophages and neutrophils from atherosclerotic plaque, which subsequently circulates in the circulation. We aimed to evaluate the relation between plasma level of LP-PLA2 and severity of coronary artery disease (CAD). Methods: This retrospective randomized case control study was conducted on 60 cases aged ≥ 18 years, presented by any form of CAD than ten healthy adults to determine the relation between plasma level of LP-PLA2 and severity of CAD. All cases were subjected to the following: Full history taking such as Socio-demographic study including age, sex, occupation, complain, history of illness: Including family history of CAD, history of smoking, hypertension and diabetes mellitus (DM). Results: Significantly elevated LDL-C, LP-PLA2, and decreased HDL-C levels were also observed in patients with significant CAD. The HDL-C levels of individuals with CAD were significantly lower than those of healthy individuals. HDL-C levels in Control group (N=10) and CAD groups (SA=20, UA=20 and AMI=20) were 78.5, 38.95, 36.85, 32, respectively; there was highly significance relation between both group regarding HDL-C Level with (p-value=0.003). Plasma level of Lp-PLA2 was gradually elevated in parallel with the increased severity of CAD. There was highly significant difference among study groups regarding plasma level of Lp-PLA2. Lp-PLA2 plasma level in Control group (N=10) and CAD groups (SA=20, UA=20 and AMI=20) were 87.9, 216.95, 272.15, 379.95, respectively; (p-value=0.001) show gradually significant elevation. Lp-PLA2 level remained independently associated with coronary artery stenosis after adjustment for age, gender, smoking, diabetes, hypertension, LDL-C and HDL-C. Conclusions: An increased plasma level of Lp-PLA2 is related with an unstable phenotype of coronary atherosclerotic plaque and a greater degree of coronary artery stenosis in individuals with coronary artery disease (CAD). Dynamic Lp-PLA2 monitoring may be predictive of cardiovascular disease risk. In recent years, there has been great interest in the capacity of Lp-PLA2 to predict and evaluate the prognosis of CVDs. In addition, Lp-PLA2 has been identified as an independent risk factor for the development and progression of coronary heart disease.
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