Background and study aims: The pathophysiology of irritable bowel syndrome (IBS) remains elusive. In countries where enteric parasitic infection is common, its role in the development of IBS is controversial. Parasites induce the Th2 immune response that elaborates cytokines such as interleukin (IL)-5, which causes eosinophilia. Eosinophilic cationic protein (ECP) is one of the mediators released during the activation of eosinophils. This study aims to determine the relationship between symptoms suggestive of IBS and parasitic infection in IBS patients and to evaluate the serum levels of IL-5, ECP and eosinophilic count as potentially useful serological tests in those patients. Patients and methods: Thirty-five IBS patients fulfilling Rome II criteria with absence of intestinal helminthic infection by direct smear method and no history of associated allergic conditions were studied. Ten healthy controls were included. Microscopic examination of stools for intestinal parasites, eosinophilic count and erythrocyte sedimentation rate were done. Colonoscopy was performed to rule out inflammatory bowel changes. Serum levels of IL-5 and ECP were measured. Results: Intestinal parasitic infection was present in 37% (13/35) of IBS patients vs. 20% (2/10) in controls. Of the 35 IBS patients, 13 (37%) had protozoal infection. Mean eosinophilic count, IL-5 level and ECP were significantly higher in IBS patients than in controls. Eosinophilic count and ECP serum level were significantly high in IBS patients with parasitic infection. Conclusion: A significant number of patients with symptoms suggestive of IBS demonstrated evidence of parasitic infection in their stool samples. The IL-5 serum level, eosinophilic count and ECP serum level might be useful tests for detecting parasitic infection aetiology in IBS patients after exclusion of conditions inducing the Th2 response. Larger case-controlled studies are required to clearly define the parasitic pathophysiology in IBS.

Background and study aims: The pathophysiology of irritable bowel syndrome (IBS) remains elusive. In countries where enteric parasitic infection is common, its role in the development of IBS is controversial. Parasites induce the Th2 immune response that elaborates cytokines such as interleukin (IL)-5, which causes eosinophilia. Eosinophilic cationic protein (ECP) is one of the mediators released during the activation of eosinophils. This study aims to determine the relationship between symptoms suggestive of IBS and parasitic infection in IBS patients and to evaluate the serum levels of IL-5, ECP and eosinophilic count as potentially useful serological tests in those patients. Patients and methods: Thirty-five IBS patients fulfilling Rome II criteria with absence of intestinal helminthic infection by direct smear method and no history of associated allergic conditions were studied. Ten healthy controls were included. Microscopic examination of stools for intestinal parasites, eosinophilic count and erythrocyte sedimentation rate were done. Colonoscopy was performed to rule out inflammatory bowel changes. Serum levels of IL-5 and ECP were measured. Results: Intestinal parasitic infection was present in 37% (13/35) of IBS patients vs. 20% (2/10) in controls. Of the 35 IBS patients, 13 (37%) had protozoal infection. Mean eosinophilic count, IL-5 level and ECP were significantly higher in IBS patients than in controls. Eosinophilic count and ECP serum level were significantly high in IBS patients with parasitic infection. Conclusion: A significant number of patients with symptoms suggestive of IBS demonstrated evidence of parasitic infection in their stool samples. The IL-5 serum level, eosinophilic count and ECP serum level might be useful tests for detecting parasitic infection aetiology in IBS patients after exclusion of conditions inducing the Th2 response. Larger case-controlled studies are required to clearly define the parasitic pathophysiology in IBS.

Dementia is one of the most important public health problems as a result of the rapid increase in the number of elderly persons worldwide. Improvement of prevention strategies and caring for people with dementia should be undertaken. We performed a door-to-door study to screen all subjects aged 50 years and older (n=4,329 of 33,285 inhabitants) in Al-Quseir city. The screening was performed by 3 neuropsychiatrists, using a modified form of the Mini-Mental State Examination. Suspected cases were subjected to case ascertainment according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for dementia; full clinical assessment; psychometric assessment using Cognitive Abilities Screening Instruments, Hachinski Ischaemic Score, Instrumental Activities of Daily Living Scale and the Geriatric Depression Scale; neuroimaging (computed tomography and/or magnetic resonance imaging); and laboratory investigations for selected patients when indicated. The prevalence of dementia was 2.01% for participants aged 50 years or older and 3.83% for those aged 60 years or older. It increased steeply with increasing age to a maximum of 13.5% for those aged 80 years or older. Alzheimer’s dementia (48.3%) was the most common subtype, followed by vascular dementia (36.8%), dementia resulting from general medical conditions (11.5%), and last, dementia resulting from multiple etiologies (3.4%).

Dementia is one of the most important public health problems as a result of the rapid increase in the number of elderly persons worldwide. Improvement of prevention strategies and caring for people with dementia should be undertaken. We performed a door-to-door study to screen all subjects aged 50 years and older (n=4,329 of 33,285 inhabitants) in Al-Quseir city. The screening was performed by 3 neuropsychiatrists, using a modified form of the Mini-Mental State Examination. Suspected cases were subjected to case ascertainment according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria for dementia; full clinical assessment; psychometric assessment using Cognitive Abilities Screening Instruments, Hachinski Ischaemic Score, Instrumental Activities of Daily Living Scale and the Geriatric Depression Scale; neuroimaging (computed tomography and/or magnetic resonance imaging); and laboratory investigations for selected patients when indicated. The prevalence of dementia was 2.01% for participants aged 50 years or older and 3.83% for those aged 60 years or older. It increased steeply with increasing age to a maximum of 13.5% for those aged 80 years or older. Alzheimer’s dementia (48.3%) was the most common subtype, followed by vascular dementia (36.8%), dementia resulting from general medical conditions (11.5%), and last, dementia resulting from multiple etiologies (3.4%).