PURPOSE: To review the epidemiology of serious ocular trauma presenting to Kasr El Aini Hospital, Cairo University.

METHODS: This is a prospective epidemiological and clinical study of ocular trauma patients admitted to Kasr El Aini hospital during a 6-month period; January-June 2000. Cases were analyzed with respect to: (1) demographics, (2) time, place and nature of trauma, (3) type of injury, (4) time to receive care, and (5) management and visual outcomes following primary repair.

RESULTS: One hundred and fifty three eyes of 147 patients (six bilateral injuries) sustaining serious ocular injury requiring hospitalization were included during the study period. Eighty percent of ocular trauma occurred in men (P < 0.001 chi-square test) with an average age of 22 years (ranging from 2 months to 76 years). There were 123 (80.4%) open globe injuries and 30 (19.6%) closed globe injuries. Of the open globe injuries, 48 eyes (31.4% of all eyes) were ruptured globes and 75 eyes (49% of all eyes) were lacerated globes (37 intraocular foreign bodies, 35 penetrating injuries and three perforating injuries, that is 24%, 23%, and 2% respectively of all injured eyes). Of the closed globe injuries, 5.9% had hyphema (33% of all patients), 4% lamellar lacerations, and 2.5% vitreous hemorrhage with retinal detachment. Most of the injuries occurred (39.5%) and presented (36.7%) between 12:00-5:59 PM: . Eighteen patients (12%) presented after 24 hours, and nine patients (6%) 1 week after the time of trauma. Presenting visual acuity in 123 patients (123 eyes) was as follows: 98 (80%), ten (8%) and 15 (12%) patients had poor, moderate and good visual acuity respectively. Ten eyes developed posttraumatic endophthalmitis (8% of open globe injuries). On leaving the hospital, 77.1% eyes had a visual acuity of less then 1/60 (poor), 3.9% were between 1/60 and 6/60 (moderate), and 19% were 6/36 and/or better (good). Fifty-two (35%) patients were lost in follow-up: at 1 month, 60%, 7% and 33% of the rest had poor, moderate and good visual acuity respectively.

CONCLUSION: The majority of ocular trauma in our population was due to assaultive injuries occurring mainly in males. Open globe injuries were more common than closed globe injuries, and globe lacerations were more common than ruptured globes. Open globe injuries, especially ruptured globes, had the worst visual outcomes. The initial visual acuity correlated well with the final visual acuity. Immediate and comprehensive medical care is mandatory for ocular trauma patients. Educating the public is essential if we wish to prevent eye injuries.

Background: Electrolyte abnormalities, especially when severe, may increase the symptomatic burden on the terminally-ill cancer patients. This study aimed at determining the pattern of electrolyte abnormalities in hospitalized cancer patients at the time of their referral to a palliative care team. Methods: We retrospectively reviewed the medical records of hospitalized adult cancer patients upon their first referral to a palliative care team. The study period covered 25 months. The electrolytes studied included potassium, sodium, calcium and magnesium. The most abnormal value observed on the day of referral ± 7 days is taken as the value of interest for a particular electrolyte for a given patient. The degree of abnormality in the level of electrolytes is classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 3.0. Results: From 1137 referrals, 750 (66%) patients were eligible for the study. Among these, 590 (79%) had at least one electrolyte abnormality and 163 (22%) had 3 or more electrolyte abnormalities. About 38% of patients had at least one electrolyte abnormality of grade 3 or 4. The most prevalent electrolyte abnormalities were hyponatraemia (59%), hypomagnesaemia (42%), hypokalaemia (41%) and hypercalcaemia (23%). Conclusions: Electrolyte abnormalities are common and often severe among cancer patients referred to palliative care. Further studies are warranted to correlate between electrolyte abnormalities and the clinical presentation of palliative care cancer patients and the potential impact of routine assessment and management of such abnormalities on their overall well-being.

BACKGROUND:
Congenital anomalies of the kidneys and urinary tract (CAKUT) comprise various entities of structural malformations that result from defects in morphogenesis of the kidney and/or urinary tract. These anomalies are the most common diagnosed malformations in the prenatal period and constitute the leading cause of end stage renal disease (ESRD) in children, worldwide. This prospective study was performed to report the patterns of clinical presentation and diagnosis of infants and children with such malformations.
METHODS:
Patients with suggestive features of CAKUT, presenting to Cairo University Children Hospital over one year duration were investigated and categorized based on underlying renal structural/functional malformation and associated extra-renal anomalies.
RESULTS:
One hundred and seven CAKUT children were enrolled in the study. Familial clustering was identified in 14% of the cohort and syndromic CAKUT accounted for 31.8% of cases. Different anomaly entities have been identified; posterior urethral valve (PUV) being the commonest detected abnormality (36.4%). Of note, 9.3% of cohort patients had ESRD at presentation, of which 60% had PUV as their primary renal disease. Obstructive cases were noted to present significantly earlier and attain advanced CKD stages rather than non-obstructive ones.
CONCLUSION:
CAKUT is a clinically heterogeneous group of diseases with diverse clinical phenotypes. More efforts should be aimed at improving antenatal detection as well as classification with comprehensive reference to the clinical, genetic and molecular features of the diseases. The high frequency of familial and syndromic CAKUT among studied patients is seemingly a convincing reason to pursue the underlying genetic defect in future studies.