Effect of bisphenol-A on the lung of adult male albino rats and the possible protective role of geraniol: a histological and immunohistochemiacal study

Concern is mounting regarding the human health and environmental effects of bisphenol A [BPA], a hormone-disrupting chemical used in plastic and epoxy resin industries. Geraniol [a plant-derived terpene] has cytoprotective and antioxidant potential. This work aimed to study the effect of BPA on the lung of adult male albino rats, assess different dose responses of BPA, and evaluate the possible protective role of geraniol supplementation using histological and immunohistochemical methods. Thirty-five adult male albino rats were divided into seven equal groups. All treatments were given by oral gavage for 8 weeks. Group I served as the untreated control group. Group II received corn oil [0.5 ml/day]. Group III was given geraniol [150 mg/kg body weight/on alternate days]. Groups IV, V, and VI received BPA [5, 50, and 500 mg/kg body weight/day, respectively]. Group VII was treated with BPA [500 mg/kg body weight/day] along with geraniol at a similar dose. Lung specimens were taken and processed for H and E, Masson's trichrome stains, and for immunohistochemical staining of alveolar macrophages [CD68] and inducible nitric oxide synthase [iNOS]. The area percentage of positive iNOS immunoreactivity and the count of alveolar macrophages in immunostained sections were morphometrically and statistically analyzed. Group IV revealed similar results to the control group. Groups V and VI showed disrupted lung architecture with collapsed alveoli, inflammatory cellular infiltration, congested thickened pulmonary vessels, extravasated red blood cells, and collagen fiber deposition. There was a significant increase in the area percentage of positive iNOS immunoreaction and in the count of alveolar macrophages, compared with the control group. These effects were more pronounced in group VI. Coadminstration of BPA and geraniol [group VII] preserved a near-normal lung structure. Long-term administration of BPA caused dose-dependent lung damage, which could be significantly ameliorated by concomitant treatment with geraniol

Role of novel cardiac biomarkers in prediction, diagnosis, and severity assessment of atherosclerotic coronary artery disease

Atherosclerotic cardiovascular disease is a major health problem around the world. Insulin resistance assessed by homeostatic model assessment of insulin resistance [HOMA-IR], triglyceride/ HDL, serum high sensitive C-reactive protein [hs-CRP], and HbA1c are probably associated with atherosclerosis. The aim of this study was to find if there was an association between HOMA-IR, triglyceride/ HDL ratio and their product as well as hs-CRP and HbA1c with the presence and the severity of coronary artery disease and to find the best cut off value for clinical practice. The study involved 170 consecutive patients with suspected or known CAD referred for coronary angiography divided into two groups; CAD group [Group I] and non CAD group [Group II] based on coronary angiography. The blood samples including HbA1c, hs-c-reactive protein, fasting blood glucose creatinine, urea, insulin and lipid spectrum were obtained after overnight fasting. Patients with CAD had higher HOMA-IR than those no CAD [4.47 +/- 4.26 vs. 2.49 +/- 1.99, p=0.002]. Stepwise multiple logistic regression analysis demonstrated that HOMA-IR > 2.66 was independently associated with CAD [odds ratio: 3.057 ; 95% confidence interval: 1.211-7.717; p=0.018] after adjustment for age, male sex, diabetes and waist circumference. HOMA-IR correlates positively with BMI [p=0.008 and r=0.227], waist circumference [p=0.002 and r=0.267] and HbA1c [p=0.015 and r=0.213]. Also HOMA-IRxTG/HDL was higher in patients with CAD compared to those no CAD [18.35 +/- 22.72 vs, 9.50 +/- 10.50, p=0.018]. However there were insignificant differences in levels of triglyceride/HDL, HbA1c, and hs-CRP among both groups [p= 0.124, 0.523, 0.250 and 0.764 respectively]. HOMI-IR was significantly higher in patients with DVD [Double-vessel Disease] and MVD [Milti-vessel Disease] compared to patients with no CAD [p=0.002 and 0.000 respectively]. Moreover HOMA-IR was significantly higher in patients with DVD and MVD compared to patients with SVD [Single-vessel Disease] [P=0.035, 0.001 respectively]. HOMA-IR x TG/HDL was significantly increased in DVD and MVD patients [P=0.012 and 0.001 respectively] compared to patients with no CAD and also when compared to patients with SVD [P=0.005 and 0.000 respectively]. HOMA-IR is considered as a marker for prediction of CAD and severity assessment

Quantitative analysis of naturally-occurring regulatory t cells in pediatric patients with systemic lupus erythematosus

Background: There is clear evidence that CD4+CD25[hl] naturally-occurring regulatory T cells [nTregs] are important component of the immune system in controlling tiutoimmunity. These cells exhibit powerful suppressive properties. Objectives: This study was conducted to determine [i] the percentage of CD4CD25[hl] nTregs in pediatric patients with systemic lupus erythematosus [SLE] before and after corticosieroid treatment, and [ii] the correlation between the percentage of nTregs and SLE disease activity index [SLEDAI]. Subjects and Methods: Thirty children with new-onset SLE were enrolled in this study. Patients were divided into 2 groups according to their disease activity. Further 24 children were included as a control group. Flow cytometric analysis was used for evaluation of the percentage of CD4+CD25[hl] nTregs in the peripheral blood of SLE patients, and control subjects

Results: A significant lower percentage ofCD4+CD25[hl] nTreg was detected in children with active SLE compared to those with inactive disease [0.59 +/- 0.27% versus 1.28 +/- 0.35%; p = 0.0001], and control subjects [0.59 +/- 0.27% versus 2.29 +/- 0.39%; p'= 0.0001]. A significant increase in the percentage of CD4+CD25[hl] nTregs was detected after corticosteroid therapy [p = 0.0001], but with no significant difference between patients with active and inactive disease [p >0.05]. Intriguingly, the percentage of nTregs was inversely correlated with SLEDAI [T = -0.6, p 0.001]. Conclusion: These results suggest that the quantitative defect of nTregs in pediatric patients with SLE may play a role in the patho genesis of this autoimmune disorder?

Lesional skin vascular endothelial growth factor levels correlate with clinical severity in patients with cement allergic contact dermatitis

Allergic contact dermatitis to cement is a delayed-type hypersensitivity reaction in which cytokines interferon-gamma [IFN-gamma] and vascular endothelial growth factor [VEGF] may be involved in persisting erythema and oedema. VEGF and IFN-gamma levels in serum and skin lesions were measured in 32 Egyptian building workers with chronic allergic contact dermatitis due to occupational exposure to cement and 20 healthy controls. Dermatitis patients had significantly higher levels of serum and lesional skin VEGF and IFN-gamma than controls. A significant positive correlation was found between tissue VEGF and the eczema area and severity index [EASI] score in dermatitis patients [r = 0.86]. VEGF and IFN-gamma may play a role in the pathogenesis of cement allergic contact dermatitis

Role of IL-6, sIL-6R, IL-1 beta, TNF-alpha, and B2M in pathophysiology and prognosis of multiple myeloma

Cytokines control myeloma cell proliferation, differentiation, apoptosis and tumor-induced bone marrow destruction. The present study was designed to estimate the serum levels of interleukin-6 [IL-6], soluble IL-6 receptor [sIL-6R], IL-1 beta, tumor necrosis factor-alpha [TNF-alpha], and beta-2 microglobulin [beta 2M] in multiple myeloma [MM] in an attempt to elucidate their role in the disease, to study their levels in different immunologic types of MM, and to evaluate the effect of therapy on these levels. The study included 40 patients with MM, 20 newly diagnosed [group I] and 20 patients receiving treatment [group II]. Ten patients received therapy for one year [group IIb]. Patients were subclassified according to beta 2M level into [patients with beta 2M < 6 mg/L and patients with beta 2M >/= 6 mg/L]. Fifteen healthy individuals were included as controls. Samples of all patients and controls were subjected to serum protein electrophoresis, immunofixation, serum cytokines [IL-6, IL-1 beta, TNF-alpha], sIL-6R, and beta 2-microglobulin estimation. Bone marrow aspiration [for patients only] and other laboratory chemical investigations were also performed. Serum immunofixation electrophoresis revealed that out of 40 patients, 25 were IgG myeloma, 12 were IgA myeloma, one case was light chain myeloma and 2 cases had biclonal gammopathy. Serum IL-6, sIL-6R, IL-1 beta, TNF-alpha and beta 2M showed significant increase in patient groups compared to controls, with no significant difference between groups I and II in both [IgG] and [IgA] myeloma. On the other hand, IL-6, sIL-6R, and beta 2M were significantly decreased in group IIb when compared with group I and group IIa. When beta 2M level was used for subgrouping, IL-6, sIL-6R, IL-1 beta, and TNF-alpha were significantly higher in group II patients with beta 2M >/= 6 mg/L than those with beta 2M < 6 mg/L. As IL-6, sIL-6R, IL-1 beta TNF-alpha, and beta 2M were elevated in all the studied myeloma patients, they might be involved in the pathophysiology of the disease irrespective of its immunologic type. IL-6 and sIL-6R could be used in monitoring the effect of therapy in MM especially in patients with impaired renal function. In addition of being known as a good prognostic marker, beta 2M could be used to monitor the response to therapy in MM

Lesional skin vascular endothelial growth factor levels correlate with the clinical severity in patients with cement allergic contact dermatitis

Allergic contact dermatitis to cement is a common occupational skin disease. It is a delayed-type hypersensitity reaction with Th1 type cytokine response. Interferon-gamma [IFN-gamma] is recognized as the main effector cytokine in contact hypersensitivity [CHS]. Vascular endothelial growth factor [VEGF] might be involved in persisting erythema and edema in eczematous skin. Human VEGF is a multifactorial cytokine that not only promotes angiogenesis but also enhances vascular permeability and participates in chronic inflammation. Thirty two building workers with chronic allergic contact dermatitis due to occupational exposure to cement and twenty healthy controls were included. The severity of eczema was assessed using the Eczema Area and Severity index [EASI]. VEGF and IFN-gamma in serum and skin lesions were measured in patients and healthy controls. Patients with cement allergic contact dermatitis showed significantly elevated levels of serum and lesional skin levels of VEGF compared to healthy controls [p=0.005 and p=0.001 respectively]. They also had significantly higher serum and tissue IFN-gamma levels compared to controls [p=0.007 and p=0.001 respectively. A significant positive correlation was demonstrated between skin tissue levels of VEGF and EASI score in patients with cement allergic contact dermatitis [r=0.86, p=0.001]. VEGF and IFN-gamma might play a role in the pathogenesis of cement allergic contact dermatitis. Lesional skin VEGF levels could be an indicator of the severity of eczema

Significance of antikeratin antibodies in discrimination between rheumatoid arthritis and polyarthritis associated with hepatitis C infection

Hepatitis C virus [HCV] injection is often associated with extrahepatic manifestations among which arthropathy is common. HCV-related arthritis commonly present as rheumatoid-like arthritis, with positive rheumatoid factor [RF]. In this study, we try to distinguish between rheumatoid arthritis [RA] and polyarthritis associated with HCV infection using a marker more specific to RA than the rheumatoid factor [RF] namely anitkeratin antibody [AKA]. Serum AKAs were evaluated [by indirect immunofluorescence technique] in two groups of patients ,all were RF seropositive. Group I. 25 patients with HCV associated polyarthralgia or arthritis. Group II: 25 patients with RA fulfilling the American college of Rheumatology [ACR] revised criteria. In addition 15 healthy individuals served as controls. All patients of group II as well as healthy controls were HCV seronegative. Other investigations were done for all groups such as erythrocyte sedimentation rate [ESR], C reactive protein [CRP] and antinuclear antibody [ANA]. Plain X ray of both hands were done for all patients to exclude the patients with bone erosion. The study revealed that anitkeratin antibodies were detected in 15/25 [60%] patients with true RA and only 3/25[12%] patients with HCV-related arthritis. AKA were not found in the sera of the healthy controls. The specificity and sensitivity of AKA in RA group were 88% and 60% respectively. Anitkeratin antibody is highly specific for RA and its estimation may increase the diagnostic performance of RA. AKA is a useful marker in discrimination between patients with true RA and those with HCV-associated arthritis

Anemia in systemic lupus erythematosus [SLE] patients; types, simple diagnosis and role of erythropoietin [EPO]

Anemia is a common hematological abnormality in Systemic lupus erythematosus and can easily be categorized with simple laboratory tests; the aim of this study was to investigate types and causes of anemia in SLE patients and to evaluate the role of EPO in different types of SLE anemia. Patients and methods; forty three male and female patients with SLE were investigated for types and possible causes of anemia among the follow up patients of the rheumatology outpatient clinic of Sohag university hospital in one year, blood and urine samples were obtained for laboratory investigations, patients with hemoglobin level less than 14 gm/dl for male and 12.3 gm/dl for female were consider anemic and enrolled in the study. Thirty nine patients [90.7%- 1 male and 38 females] were anemic, with mean age of 31 +/- 10 years, the types and incidence of anemia were; iron deficiency anemia [IDA] n = 22 [56.4%], anemia of chronic disease [ACD] n = 12 [30.8%] and autoimmune hemolytic anemia [AIHA] n=5 [12.8%], mean levels of hemoglobin were 10.4 +/- 1.3, 9.6 +/- 1.1 and 7.7 +/- 0.8, in the three groups respectively, low levels of complement C3 and C4 were observed in AIHA, and ACD, but not in patients with IdA. Anti-dsDNA antibodies were seen in all patients with AIHA, and in 10 patients with IDA, CRP concentrations were not related to severity of anemia in the three groups, higher levels of serum creatinine and proteinuria were detected in the three was no difference in the mean levels of EPO among different groups. Anemia in SLE can be easily diagnosed by simple methods, IDA is very common among SLE patients in our community, Erythropoietin [EPO] may have no role in SLE anemia and the presence of Anti Erythropoietin antibodies [AEA] and its role can not be ruled out

Endoscopic vs. percutaneous inguinal field block [IFB] for postoperative pain control after total extra-peritoneal [TEP] inguinal hernioplasty

Despite the proven merits of using inguinal field block in open hernia repair, there is little data examining its use in laparoscopic hernioplasty. Interestingly, complete field block can be approached endoscopically with minimal hazards. The objective of this prospective randomized study is to compare the outcome of two different approaches of inguinal field block [IFB] for postoperative pain control following endoscopic total extra-peritoneal laparoscopic [TEP] inguinal hernioplasty. Between January 2001 and December 2003, a total of 77 male patients attending Dhahran Health Center, underwent unilateral endoscopic TEP hernioplasties, were randomized to receive either preoperative percutaneous IFB [group A, n = 38] or intraopertive endoscopic IFB [group B, n = 39]: using 50 mls of levobupivacaine [0.25%]. Postoperative pain was assessed by visual analogue score on a scale from 0 to 6. The intraopertive anesthetic requirements, time from end of surgery till extubation, postoperative narcotic analgesia requirement; length of hospital stay and return to full activity were compared among the two groups. Comparison between the two groups showed that patients in group A had significantly less requirements of intraoperative [Fentanyl, analgesia 65.2 +/- 16.8 [micro g] and shorter recovemy time 7.3 +/- 1.7 [min] than patients in group B [98.4 +/- 27.9 [micro g and 8.4 +/- 2.l [min]]. Postoperative pain scores were slightly higher in group A in the first 4-6 hours [p = NS]. Postoperative IV morphine requirement was significantly higher in the first 12 hours [Day surgery cases] in group A [13.2 +/- 3 mg] than in group B [9.2 +/- 2.5 mg]. This difference was not significant among patients hospitalized within the next 24 hours. Almost one third of the patients were able to go home on same day of surgery [11 in group A and 15 in group B, p= NS] Inguinal field block for TEP hernioplasty provides merits for the patients regarding the postoperative pain control and short hospital stay. However, endoscopic IFB was shown to have better control of postoperative pain than the percutaneous IFB during the first 12 hours

Limited endoscopic septoplasty

Repair of nasal septal deviation [septoplasty] is a time honored treatment for nasal airway obstruction. Many techniques have been described previously to accomplish this goal. Often however, a minimal septal deviation that would normally be of little consequences in nasal airway congestion becomes an obstructing factor to successful functional Endoscopic sinus surgery [FESS] because of its location. With increasing numbers of FESS being done, the correction of the minimally deviated septum has also more frequently occurred, usually to facilitate adequate visualization and to allow room for Endoscopic instrumentation, as well as for postoperative care of the nasal/sinus cavities. Patients with chronic sinusitis often have nasal congestion, and many have nasal septal deviations. However, the exact cause of the nasal airway obstruction in patients with chronic sinusitis may be mulifactorial. It could be the result of septal deviation, reactive edema from the infected areas, allergic problems mucosal hypertrophy, other anatomic abnormalities, or combinations thereof. We will discuss the indication, limitation, steps of surgery and results

Toxic effects of two Egyptian snakes [naja haje and cerastes cerastes] venoms on normal and diabetic albino rats

The current study was designed to illustrate the toxic effects of two Egyptian snake venoms Naja haje [elapidae family] and Cerastes cerastes [vipridae family] on non- diabetic and diabetic rats. Seventy two male albino rats were utilized. They were divided into two main equal groups, non-diabetic group [G1] and diabetic group [G2]. Each main group was divided into three equal subgroups. The non-diabetic group was divided into G1a [control], G1b [injected by 1/2 LD50 of Naja haje venom [0.007 mg/20gm b.w. I.M.], G1c [injected by 1/2 LD50 of Cerastes cerastes venom [0.073 mg/100 gm b.w. I.M.]. Diabetes was experimentally induced by I.P. injection of 140 mg/kg alloxan monohyderate. The diabetic group was divided into G2a [control], G2b and G2c treated similar to non-diabetic G1b and G1c. All animals were sacrificed three hours after injection, their blood and serum were subjected to biochemical analyses, while tissue samples were obtained for histopathological study. The present study revealed that, mortality rate, blood glucose level and C P K and L D H enzymes activities were higher in Naja hale injected groups than Cerastes cerastes groups. Coagulation factors represented by an increased Pt and PTT on the other hand were increased in Cerastes cerastes than in Naja haje. Pathological changes on site of injection [skin and muscle] was prominent in case of Cerastes cerastes venom, where skin showed thinning of the epidermis with necrosis of sebaceous glands and edema of the dermis with severe subdermal hemorrhage. Skeletal muscle showed severe wide spread hemorrhage and edema among the destructed muscle cells with scattered leucocytic infiltration. While Naja haje venom affected mainly the cardiac muscle and brain tissue, as myocardial muscle showed vacuolar degeneration, congestion of blood vessels with focal hemorrhagic area, edema and hyalinization among degenerated muscle fibers. Brain tissue revealed increase in glia cells of cerebrum, edematous neuron and encephalomalecia. The toxic effect of both venoms was more severe in diabetic group than non-diabetic one

Are patients with polycystic ovary syndrome at risk for cardiovascular disease?

Polycystic Ovary Syndrome [PCOS] is considered not only a reproductive endocrinopathy but also a metabolic disorder associated with long term health risks, including diabetes mellitus and coronary artery disease and it shares some or all components of syndrome X. To assess and evaluate cardiovascular risk factors in patients with PCOS and to compare the various systolic and diastolic function indices hetween PCOS patients and regularly cycling control women. 45 patients with PCOS [mean age 26.16 +/- 6.47 years and mean BMI 28.18"5.47 kg/m[2]] were recruited for this study, in addition to 30 healthy volunteer women with regular menstrual cycles, their age and body mass index [BMI] matched with the patients group. A thorough history and clinical examination were performed. Transvaginal sonography was performed using a transvaginal probe 5 MHZ. Hormonal assay for [serum luteinizing hormone [LH], follicle stimulating hormone [FSH], prolactin and total testosteronel, lipid profile [high and low density lipoproteins [HDL and LDL], triglyceride [TG] and total cholesterol [T Chol]], uric acid, homocysteine and two hours post prandial serum glucose [PPSG] levels were determined for all studied participants. M-mode, two dimension and Doppler echocardiography were performed for evaluation of systolic and diastolic function parameters. We have studied indices of cardiac flow in women with PCOS in relation to BMI, blood levels of reproductive hormones [LH, FSH. testosterone and prolactin]. lipid profile, uric acid, PPSG and homocsteine levels. The mean serum levels of LH, total testosterone, T Chol, TG, homocysteine, uric acid, PPSG, LH/FSH ratio and T Chol./HDL ratio were significantly higher in patients with PCOS group [p <0.001] than control group. Patients with PCOS had significantly lower peak mitral flow velocity in early diastole [PEV], ratio between peak mitral flow velocity in early diastole [E] and late diastole [A] [B/A ratio], Ejection fraction [EF] and fraction of shortening [FS] [p < 0.001] and significantly longer isovolumic relaxation time [IVRT] and E-velocity deceleration time [EVDT] [p <0.001]. Patients with PPSG> 140 mg/dl had significantly lower B/A ratio [p < 0.05] and those with BMI > 25 kg/m[2] had significantly longer IVRT [p <0.01]. Moreover, we found significant negative correlation between E/A ratio and both PPSG [r = -0.349] and LDL [r = -0.382] and significant positive correlation between IVRT and BMI [r = 0.415]. We conclude that both diastolic and systolic dysfunction are common findings in population with PCOS and this dysfunction together with the increased serum homocysteine concentration, dyslipidemia and impaired glucose tolerance may contribute to increased risk of cardiovascular disease in these patients