BackgroundTinea capitis remains a prevalent health problem among school-aged children.ObjectiveTo estimate the prevalence of tinea capitis among primary school students, in Fayoum, Egypt with identification of etiological agents in both public and private primary schools.MethodsA cross-sectional study was conducted in twelve primary schools. The students were selected from different grades with a total number of 12,128 students. Hair and scalp were clinically examined for any lesions that may suspect tinea capitis and mycological samples were collected for direct microscopy and culture.ResultsThe prevalence of tinea capitis in the study group was 0.4% and higher in public than private schools (73.5% versus 26.5% respectively). Boys were more affected than girls with boy to girls' ratio 5:1. Intrafamily history of infection was present in 40.8% of tested group while 51% showed low social standard profile. Mycological culture revealed that Microsporum canis was the predominant isolated organism followed by M. audouinii (52% and 36% respectively).ConclusionM. canis is replacing Trichophyton violaceum as an etiology for tinea capitis in Egypt with lower prevalence rate than reported previously.
Background: Alopecia areata (AA) is non-scarring hair loss resulting from an autoimmune disorder. Severity varies from patchy hair loss that often spontaneously resolves to severe and chronic cases that can progress to total loss of scalp and body hair. Aim of the work: To compare the efficacy of topical calcipotriol versus oral vitamin D in alopecia areata. Patient and Methods: Fifty patients having localized alopecia (<5 patches and <40% scalp involvement) were treated with topical calcipotriol 0.005% twice daily for 3 months (group 1) and oral vitamin D daily for 3 months (group 2). All cases were assessed by grading the degree of improvement of alopecia and dermoscopic evaluation. Estimation of serum levels of 25-hydroxy vitamin D in all patients before the treatment. Results: There was statistically significant difference with p-value < 0.05 between two study groups regarding to degree of improvement. Dermoscopic findings that explain signs of activity were decreased, and signs of improvement were appeared after 3rd months of treatment. In topical calcipotriol group terminal hair was more than oral vitamin D group, in which signs of activity was still present in some cases. Conclusion: In conclusion, topical calcipotriol (68% improvement) was better than oral vitamin D in the treatment of mild and moderate alopecia areata. There is no releation between serum vitamin D and efficacy of treatment. However, further studies on larger scales are required to identify the vitamin D receptor deficiency in alopecia areata.
Background Emphysematous cystitis is a well-described life threatening complication of urinary tract infection, most commonly seen in patients with diabetes and typically caused by gas forming bacterial or fungal pathogens. Pneumorrhachis is the rare finding of gas within the spinal canal, most commonly reported in the context of cerebrospinal fluid leakage secondary to trauma or spinal instrumentation. To our knowledge there is only one other reported case of pneumorrhachis in the setting of emphysematous cystitis. Case presentation This is a single case report of pneumorrhachis in the setting of emphysematous cystitis. An 82-year-old Asian female patient originally from East Asia, with no prior medical history besides hypertension, presented to hospital with a chief complaint of acute on chronic neck pain and functional decline. Examination revealed nonspecific neurosensory deficits and suprapubic tenderness. Laboratory investigations demonstrated leukocytosis and extended-spectrum beta-lactamase containing Escherichia coli bacteremia and bacteriuria. Computed tomography showed emphysematous cystitis with widespread gas within the cervical and lumbar spinal canal, as well as multiple gas-containing soft tissue collections in the bilateral psoas muscles and paraspinal soft tissues. Despite prompt antimicrobial therapy the patient passed away within 48 hours from septic shock. Conclusions Our case adds to a growing body of literature showing that the spread of air to distant sites, including the spine, may be a poor prognostic indicator in patients with gangrenous intraabdominal infections. This report highlights the importance of recognizing the causes and presentation of pneumorrhachis to facilitate early diagnosis and treatment of potentially life threatening and treatable causes.
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