Comparison of two assays in the diagnosis of toxoplasmosis: immunological and molecular

Serological tests for Toxoplasma gondii are inadequate because antibody production either fails or is significantly delayed. This study in eastern Iraq investigated the IgG-avidity ELISA test for detecting recent T. gondii infections among pregnant women and compared immunological methods and PCR as molecular assays in the diagnosis of T. gondii. Serums samples were taken from 130 pregnant women at risk of toxoplasmosis and a control group of 25 women with normal pregnancy. Of 50 IgM- and/or IgG-positive samples, only 15 showed low IgG-avidity antibodies. PCR was performed on 25 selected samples. Toxoplasma DNA was detected in 15/15 IgM-positive with low IgG-avidity and 1/3 IgM-positive with high IgG-avidity. None of the IgM-negative with high IgG-avidity showed any Toxoplasma DNA. ELISA IgG-avidity when used in combination with ELISA IgG/IgM is a valuable assay for the exclusion of ongoing or recently acquired T. gondii infection in pregnant women

Tobacco control efforts in the Gulf Cooperation Council countries: achievements and challenges

This paper reports a review into the current state of tobacco use, governance and national commitment for control, and current intervention frameworks in place to reduce the use of tobacco among the populations of the Gulf Cooperation Council [GCC] member states and Yemen. It further reviews structured policy-oriented interventions [in line with the MPOWER package of 6 evidence-based tobacco control measures] that represent government actions to strengthen, implement and manage tobacco control programmes and to address the growing epidemic of tobacco use. Our findings show that tobacco control in the GCC countries has witnessed real progress over the past decades. These are still early days but they indicate steps in the right direction. Future investment in implementation and enforcement of the Framework Convention on Tobacco Control, production of robust tobacco control legislation and the establishment of universally available tobacco cessation services are essential to sustain and strengthen tobacco control in the GCC region.

predictive value of Intima-media thickness of the common carotid artery in the prevention of stroke

Non invasive measrument if intime-media thickness [IMT] of the common carotid aretery by high reolution ultrasonography and its important in stroke patient.The study was designed to study this relation in our locality.Thirty patients with ischemic stroke that were admitted in the medical department of Al Yarmook teaching hospital were tested by the aid of echocardiology department to measure intima-media thickness of the common carotid artery and they were compared with 20 persons[matching age and sex] without history of stroke or trasnient ischemic attack. The mean ot IMT of common carotid artery in stroke patients was 1.24mm while in control group the mean was 0.765 mm. There is a significant relation between the increased IMT of common carotid artery and stroke

Diabetes or war? Incidence of and indications for limb amputation in Lebanon, 2007

Chronic diseases such as diabetes and vascular disease are a major public health problem in Lebanon, where primary care is not well developed. This study aimed to describe the incidence and indications for limb amputation in Lebanon and identify associated factors [age, sex, level of surgery, length of hospital stay]. There were 1.6 amputations per 10 000 persons. The rate of amputation was highest in southern Lebanon at 3.8 per 10 000. The most important indication for surgery was diabetes [59%]. Diabetic patients were older [mean age 73 years versus 30 years], more likely to have major surgery [OR = 7.87; 95% CI: 2.83-21.9] and stay in hospital longer [RR = 4.56, 95% CI: 2.41-8.64] than patients with trauma-related amputation. Diabetes prevention, detection and management should be prioritized in any attempt to reduce the current incidence of amputation in Lebanon

incidence and spectrum of central nervous system malformations in newborns over a decade [2001-2010] in the Central Region of Saudi Arabia

To study the incidence and spectrum of central nervous system [CNS] malformations confirmed by computerized tomography [CT], or magnetic resonance imaging [MRI] in a Saudi newborn population of Riyadh over a 10-year period, and to compare our findings with those in the published literature. This is a retrospective analysis of prospectively collected data on all inborn babies admitted to the Neonatal Intensive Care Unit in Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia that underwent CT or MRI of the brain and spine from January 2001 to December 2010. Out born babies, babies who sustained birth asphyxia, and premature babies were excluded from the study. During the study period, 849 imaging studies were carried out, and from these 248 babies with CNS malformations were identified. Specific syndromes associated with CNS malformations occurred in 58 [23.4%]. Dysraphism was found in 42 babies [16.9%] [25 spinal and 17 cranial]. Hydrocephalus was present in 30 [12.1%], cortical malformations occurred in 31 [12.5%], which was dominated by abnormal cell migration in 20. Cerebellar and posterior fossa abnormalities were diagnosed in 44 [17.7%], Dandy-Walker syndrome in 15, and Joubert syndrome in 12. Prosencephalic pathology was seen in 39 [15.7%], commissural abnormalities in 29, while there was holoprosencephaly in 12. Vascular malformations were found in 4 babies [1.4%]. This study showed a wide spectrum of malformations, with all CNS malformations confirmed by advanced imaging techniques

Pattern of neonatal and postneonatal deaths over a decade [1995-2004] at a Military Hospital in Saudi Arabia

To describe and monitor the causes of neonatal and postneonatal deaths in the Neonatal Intensive Care Unit [NICU] over a 10-year-period. This is a descriptive study of all infants who died in the NICU from January 1995 until December 2004 at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. Data were collected prospectively on all infants admitted to NICU. The cause of death for each infant was discussed and determined by at least 2 consultant neonatologists. Deaths were classified according to the modified Wigglesworth's classification of perinatal death. During the study period, there were 79871 live births and 526 deaths, in which 446 84.2% were inborn deaths and 80 15.8% were outborn. Of the inborn deaths, 251 infants died between 1-6 days, 103 died between 7-27 days, and 92 died after 27 days. Lethal malformations led to death in 36%, prematurity and its complications in 42%, hypoxic ischemic encephalopathy in 5%, while other specific diagnoses, combined, led to death in 17% of the cases. Prematurity and its complications followed by congenital malformations were the leading causes of death

Clostridial wound infection following reconstruction of the anterior cruciate ligament using bone- patella- bone autograft

A 27-year-old rugby player underwent anterior cruciate ligament [ACL] reconstruction, using autograft. Postoperatively, septic arthritis was missed due to atypical presentation but diagnosed 2 days later and underwent open arthrotomy and lavage, He received antibiotics for 5 weeks. Aspirate showed clostridium perfringens. Later, extension lag was developed, which improved by arthroscopic excision of fibrous tissue and adhesions. The source of clostridial contamination remained a mystery. Skin preparation can be ineffective in eradicating clostridium perfringens prior to procedures. Routine prophylactic use of metronidazole would be controversial. In patients with postoperative infections, we suggest that samples should be routinely sent for anaerobic cultures

Somatic embryogenesis in wild relatives of cotton (Gossypium Spp.) / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Wild cotton species can contribute a valuable gene pool for agronomically desirable cultivated tetraploid cultivars. In order to exploit diploid cotton a regeneration system is required to achieve transformation based goals. The present studies aimed at optimizing the conditions for regeneration of local varieties as well as wild species of cotton. Different callus induction media were tested with varying concentrations of hormones in which sucrose was used as nutritional source. Different explants (hypocotyls, cotyledon, root) were used to check the regeneration of both local cotton plants and wild relatives using T & G medium, BAP medium, CIM medium, EMMS medium, and cell suspension medium. Different stages of embryogenicity such as early torpedo stage, late torpedo stage, heart stage, globular stage and cotyledonary stage were observed in wild relatives of cotton. The results of this study pave the way for establishing future transformation methods.

Assisted reproductive technology. What is needed in the Kingdom of Saudi Arabia?

In 1978, the first in vitro fertilization baby was born. Since then, we have seen the introduction of several new modalities of assisted reproductive technologies ART, and the spread of ART procedures throughout the world. The number of ART units in the Kingdom of Saudi Arabia is increasing rapidly. The associated complications of ART procedures include fetal, maternal and childhood

Prescription pattern of benzodiazepines for inpatients at a tertiary care university hospital in Pakistan

To determine the point prevalence of benzodiazepine prescriptions for inpatients at a tertiary care university hospital in Pakistan and to correlate it with prescription patterns of various specialties, indications and demographic variables of the patients. This 24-hours point prevalence study was done at The Aga Khan University Hospital, Karachi. By convenient random sampling, 208 inpatients were interviewed. Patients' files were also studied to record the drugs administered. Data was entered into questionnaires and analyzed by SPSS 10.0. The point prevalence of the benzodiazepines was 21.2%. It was higher among males than females and among surgical than non-surgical patients. Midazolam was the most commonly used benzodiazepine, followed by Alprazolam and Lorazepam. Pre-anesthesia and psychiatric symptoms were the two most common indications. Oral route was used in 84% patients for drug administration and mean Valium equivalent dosage was 4.86mg/day. Mean length of prescription was 3 days. Longer duration of hospitalization was a significant predictor of the requirement of benzodiazepine prescription [p-value=0.020]. Prescription pattern of benzodiazepines at a tertiary care university hospital is similar to that reported in the developed countries through monitoring at various levels by physicians, clinical pharmacist and nursing staff. Data regarding the prescription pattern of benzodiazepines is scarce, and it needs to be expanded to formulate clear guidelines regarding their prescription

New evidence of the oxidation theory in breast cancer, the interrelationship between tissue antioxidant enzymes levels and their corresponding trace elements

The relationship between antioxidant enzyme levels and their corresponding trace elements have been extensively studied in the sera of the patients with different types of malignant tumors while few studies were reported for that relationship in the tissues of malignant tumors. To the study of the interrelationship between tissue antioxidant enzymes levels and their corresponding trace elements in different types of breast tumors. The intracellular levels of catalase, super oxide dismutase, the intracellular levels of Cu, Zn, Mn, Se and the intracellular level of malondialdehyde were determined in 29 tissue samples of patients inflicted with infiltrative ductal carcinoma and fibro adenoma. A highly significant differences were noticed in the level of the up-mentioned components in the cancerous tissues in comparison with the benign ones of the corresponding cases. The results confirmed the biochemical foundation of the oxidation theory of carcinogenesis and tumor progression On the other hand, the increase in the intracellular enzyme levels and a concomitant increase in trace elements levels can be used as a diagnostic tool in breast cancer progression and transition to malignancy

Role of video assisted thoracoscopy in management of empyema thoracis

The hospital based Cohort study was carried out over a period of 21 months to analyze and evaluate the out come of patients who had presented with acute stage of empyema thoracis and were treated by video assisted thoracoscopy. 30 patients with acute empyema thoracis received treatment by video assisted thoracoscopy in Combined Military Hospital Rawalpindi from March 2000 to December 2001. Both civilians as well as military personnel were included in the study out of which 22 were males and 8 were females. Majority of the patients were of 30 years and above age group. The most common etiology was respiratory tract infection with pneumonia and tuberculosis making the largest proportion. The leading presenting symptoms included low grade pyrexia, breathlessness, loss of weight and chest pain. One third of patients had some other associated systemic illness. Video assisted thoracoscopy was used in all 30 patients with only 2 patients requiring open thoracotomy. Post operative wound infection was the most commonly encountered complication. In most of the cases the procedure was over within an hour and in majority of patients hospital stay was upto 2 weeks. There was one death, which was not due to procedure but due to septicemia. These results are similar to those found elsewhere in the world

Kawasaki disease in Jordanian children

Nineteen children with signs and symptoms suggesting Kawasaki Disease [KD] were admitted to the pediatric ward at Jordan University Hospital in the period from February 1997 to September 2001. To evaluate our experience in diagnosing and managing children with KD, the clinical notes, investigations including ESR, platelets count, ECG, echocardiogram and drugs used for those children were studied. Their ages ranged from 40 days to 12 yrs, and 70% were aged up to 2 years. Male to female ratio was 8 to 1. Seventeen patients fulfilled the diagnostic criteria of KD and two had atypical KD. All received 2 gm/kg IV infusion of gamma globulin over 12 hrs, and 80-100 mg /kg/ day aspirin. One patient, received prednisone, 52% had cardiac involvement, 26% had coronary artery aneurysms and four had pericardial effusion. All except three had complete recovery, two continued to have coronary artery aneurysms and one died [5%]. Early management is important for good prognosis in KD. Further national multi-center studies are recommended to evaluate the incidence and the outcome of KD in Jordan

Familial mediterranean fever mutation frequencies and carrier rates among a mixed Arabic population

Familial Mediterranean Fever [FMF] is an autoinflammatory periodic disorder characterized by febrile and painful attacks due to inflammation involving the serosal membranes. The gene implicated in this disorder, MEFV, has been cloned and mutations in its coding regions have been identified. We aimed at identifying the frequency of MEFV, mutations and carrier frequency in a mixed Arabic population. We identified 29 prob and s from 29 unrelated sibships segregating the disorder and representing the affected individual cohort. We screened 200 anonymous deoxyribonucleic acid [DNA] samples, representing a healthy adult cohort, for the mutations found to be common in the affected individual cohort. We also, screened anonymous DNA samples from 4 Arabic countries, namely, Egypt [231], Syria [225], Iraq [176] and the Kingdom of -Saudi Arabia [107] thus enlarging our healthy adult cohort. The study was carried out between 1999 and 2002 at Jordan University of Science and Technology, Irbid and the University of Jordan, Amman, Jordan. Out of the 58 alleles of the 29 prob and s, only 31 mutations were identified and M694V and V726A are the most common. The mutation E148Q was the most common among the healthy adult cohort, but was not present in affected individuals. The collective mutant allele frequency "q" was 0.101. The expected carrier rate was 18.1% [one in 5.5] while the observed carrier rate was 18.4% [one in 5.4]. E148Q has reduced penetrance and thus, a proportion of the individuals genetically affected with FMF remain asymptomatic. M694I and M680I are more prevalent in the affected individuals cohort, which points to their higher penetrance. The overall carrier rate is one in 5, but the selective heterozygote advantage could not be demonstrated in this study due to the relatively small sample size

Role of CO2 laser in the management of recurrent respiratory papillomatosis [RRP], A2 Yr experience at combined military hospital, rawalpindi

The Papilloma is one of the most common benign neoplasms of the Larynx. Laryngeal Papillomatosis is a disease of widespread papilloma formation that most commonly affects the larynx but may involve multiple areas of the aero-digestive tract. Typically, the onset of disease during childhood is associated with more aggressive disease. The etiology of this disease is the human papillomavirus [HPV] especially types 6 and 11. Diagnosis is often delayed because the symptoms mimic a variety of other diseases. This article reviews the statistical analysis about age, sex and site of the tumour and analyses the role of carbon dioxide laser as a modality of treatment, in a series of eleven patients with respiratory papillomatosis

Recurrent episodic fever. A presenting feature of familial mediterranean fever

Objectives to study the natural course and outcome of recurrent episodic fever without serositis as a presenting feature of familial Mediterranean fever [FMF]. Patients: of 309 children with FMF seen over a period of 5 years, 8 presented with recurrent episodes of fever without serositis, imposing a difficult diagnostic problem. Results the age at onset of fever ranged between 5 months and 8 years with a mean of 2.5years. five patients eventually developed serositis. The duration between onset of fever and onset of serositis ranged between 1.5-3 years with a mean of 2 years. Of the 3 patients who did not develop serositis, 2 had a family history of FMF. Therapeutic response to colchicines was dramatic in 7 children [one refused colchicines prophylaxis]. Conclusion episodic fever alone without serositis is a presenting feature of FMF. In patients from Mediterranean ancestors and / or the presence of family history of FMF, a therapeutic diagnostic test with colchicines could be rewarding