First study in Qatar to reveal high Legionella counts in cooling towers

Legionella spp. is transmitted from water to humans by aerosol-generating devices, including cooling towers [CTs]. There have not been published reports about Legionella in these systems in Qatar. Ten CTs in Qatar University were sampled on a monthly basis. Bacteria were recovered from 90 water samples by filtration and concentration. Legionella DNA copy number [CN] was assessed by quantitative RT-PCR. Legionella DNA was detected in 100% of the samples. The bacterial counts ranged from 0.006 to 199.56 CFU/mL, and critical counts were found in 51 [56.7 %] samples. Moreover, 7 [7.8%] samples showed a count of more than 100 CFU/mL. The highest counts were found in the months of May and June. These results suggest that this organism is found in high number in tested CTs, presenting a potential health risk to the local population

p15(Ink4b) Loss of Expression by Promoter Hypermethylation Adds to Leukemogenesis and Confers a Poor Prognosis in Acute Promyelocytic Leukemia Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The p15(Ink4b) gene exerts its influence as an inhibitor of cyclin-dependent kinases and is frequently associated with hematological malignancies. Inactivation of this gene through DNA methylation has been found to be the most prevalent epigenetic alteration reported, with a high frequency in all French-American-British subtypes of acute myeloid leukemias, including acute promyelocytic leukemia (APL). In this study,we investigated the prognostic significance of p15 gene promoter hypermethylation and its expression in APL patients of Kashmir (North India). MATERIALS AND METHODS: p15 gene promoter hypermethylation was conducted by methylation-specific polymerase chain reaction, while its subsequent expression analysis was carried out by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Of the 37 patients, 16 (43.2%) were found to have methylated p15 genes. Of these 16 cases, seven (43.8%) were methylated partially and nine (56.2%) were found to have complete methylation. Moreover, nine of the 37 patients (24.3%) who presented with leukocytosis at their baseline had complete p15 gene methylation as well (p < 0.05). Semiquantitative RT-PCR showed a complete loss of p15 expression in nine patients with complete methylation coupled with leukocytosis (p=0.031), while seven patients with partial methylation showed decreased p15 expression. Six patients relapsed during the maintenance phase of treatment and were found to have a completely methylated p15 gene and no p15 mRNA. CONCLUSION: Complete methylation and loss of p15 gene expression causes susceptibility to relapse and decreased survival in APL patients. Thus, p15 promoter hypermethylation is a prospective prognostic indicator and a reliable clinical aid in assessment of patients with APL.

p15(Ink4b) Loss of Expression by Promoter Hypermethylation Adds to Leukemogenesis and Confers a Poor Prognosis in Acute Promyelocytic Leukemia Patients / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The p15(Ink4b) gene exerts its influence as an inhibitor of cyclin-dependent kinases and is frequently associated with hematological malignancies. Inactivation of this gene through DNA methylation has been found to be the most prevalent epigenetic alteration reported, with a high frequency in all French-American-British subtypes of acute myeloid leukemias, including acute promyelocytic leukemia (APL). In this study,we investigated the prognostic significance of p15 gene promoter hypermethylation and its expression in APL patients of Kashmir (North India). MATERIALS AND METHODS: p15 gene promoter hypermethylation was conducted by methylation-specific polymerase chain reaction, while its subsequent expression analysis was carried out by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Of the 37 patients, 16 (43.2%) were found to have methylated p15 genes. Of these 16 cases, seven (43.8%) were methylated partially and nine (56.2%) were found to have complete methylation. Moreover, nine of the 37 patients (24.3%) who presented with leukocytosis at their baseline had complete p15 gene methylation as well (p < 0.05). Semiquantitative RT-PCR showed a complete loss of p15 expression in nine patients with complete methylation coupled with leukocytosis (p=0.031), while seven patients with partial methylation showed decreased p15 expression. Six patients relapsed during the maintenance phase of treatment and were found to have a completely methylated p15 gene and no p15 mRNA. CONCLUSION: Complete methylation and loss of p15 gene expression causes susceptibility to relapse and decreased survival in APL patients. Thus, p15 promoter hypermethylation is a prospective prognostic indicator and a reliable clinical aid in assessment of patients with APL.

Insulin-like Growth Factor Binding Protein-1/ alpha-fetoprotein versus Placental alpha microglobulin-1 for diagnosis of premature fetal membranes rupture.

Objectives: To compare insulin-like growth factor binding protein-1/alpha-fetoprotein (IGFBP-1/AFP) to placental alpha microglobulin-1 (PAMG-1) for diagnosis of premature fetal membranes rupture (PROM). Methods: 220 pregnant women ≥ 37 and < 39 weeks` gestation studied and classified into two groups; study group (PROM) and control group (no PROM). Examination of the studied women followed by abdominal ultrasound (TAS) and sterile vaginal speculum examination to visualize amniotic fluid leaking and for collection of samples for fern, nitrazine, AmniSure® and AmnioQuick® Duo+ tests on admission. Results: The sensitivity and specificity of AmnioQuick® Duo+ test to detect PROM was 93.6% and 86.4%; respectively compared to 95.5% and 89.1%; respectively for AmniSure® test, 72.7% and 80.9%; respectively for fern test and 76.4% and 83.6%; respectively for nitrazine test. PPV, NPV and accuracy of AmnioQuick® Duo+ test to detect PROM were 87.3%, 93.1% and 90%; respectively compared to 89.7, 95.1% and 92.3%; respectively for AmniSure® test, 79.2%, 74.8% and 76.8%; respectively for fern test and 82.4%, 77.97% and 80%; respectively for nitrazine test. AmnioQuick® Duo+ and AmniSure® tests had higher sensitivity, specificity, predictive values and accuracy to detect PROM compared to conventional diagnostic tests. Conclusion: AmnioQuick® Duo+ test for detection of IGFBP-1/AFP was rapid, accurate bedside test better than the individual conventional diagnostic tests and has same accuracy and performance like AmniSure® test.

Recovery of Schistosoma haematobium ovum from Labeo rohita: first report from Pakistan

Schistosomiasis, also known as bilharzia, is a parasitic disease caused by trematodes from the genus Schistosoma that can infect humans and animals. S. mansoni, S. japonicum, and S. mekongi all causes intestinal schistosomiasis except S. haematobium that causes urinary schistosomiasis. It is only specie which effects urinary system, it can affect liver, heart, lungs also but very rarely. Schistosoma haematobium is endemic to over 50 countries in Africa and the Middle East and Western Asia and may be fatal in HIV positive people. A number of reports from the African countries like Nigeria have been reported. A few cases are reported 9but in Pakistan it has never been reported before in native people. It is first time reported in Pakistan in the intestine of Rahu (Labeo rohita). The purpose of this study is to elaborate the approach of zoonotic agent by various other routes including the commonly available fish

Generalized review of the successes and challenges of medicine; An insight of the past, present and future prospects

Evidence from recent millennia demonstrates the progressive efforts of humans to prevent diagnose and cure diseases. Understanding diseases and developing cures has always been a challenge for various reasons, but the successes surpass the setbacks in terms of discoveries. Overcoming infectious diseases has shown the most successes as well as challenges, and still the case may be so. New technologies are bringing many opportunities for the future. While cures for cancer, heart disease, diabetes, AIDS, etc. still remain to be included in the successes, on the other hand regenerative medicine, nanotechnologies and point of care are very promising developments. In this review we have tried to cover the past, present and future expectation and challenges associated with medicine and surgery

[Evaluation of maximum levator resection in management of severe Blepharoptosis]

Objective: To study the efficacy of maximal levator resection in patients with severe ptosis with poor levator function [LF]

Patients and methods: 31 patients with severe ptosis underwent maximal levator resection.Palpebral fissure height and LF were assessed preoperatively and postoperatively. Results: All patients showed an excellent reduction in ptosis with a single intervention resulting in a clear visual axis. Palpebral fissure height improved from means [SD] 2.98 preoperatively to 7.70 postoperatively [P value <0.001], No patients underwent additional surgery because of cosmetic issues. All patients showed a marked, consistent, and lasting improvement in LF, going from mean [SD] 2.60 preoperatively to 7.82 postoperatively [P value < 0.001]

Conclusions: Maximal levator resection is an effective surgical technique in management of patients with severe ptosis with good cosmetic appearance in terms of ptosis reduction in the majority of cases and with a significant increase of the levator palpebrae superioris function

Nasal carriage of superantigen producing Staphylococcus aureus and its role in pathogenesis of allergic rhinitis and bronchial asthma

Staphylococcal enterotoxins can act as allergens and stimulate production of specific IgE with subsequent development of allergic manifestations. In addition, they act as superantigens that induce cytokine secretion with more increase of IL-4/IFN-gamma ratio causing augmentation of allergic reactions. Herein we tested the hypothesis that exposure to Staphylococccus aureus and its enterotoxins induces immunological changes that contribute to the pathogenesis of allergic rhinitis and bronchial asthma. This study included 45 air way allergic patients, and 45 controls. The following were done: intradermal allergy skin testing, invitro effect of staphylococcal enterotoxin B [SEB] on cytokine secretion from separated peripheral blood mononuclear cells, detection of nasal carriage of S. aureus and its enterotoxin production by ELISA and serum levels of total IgE, SEB-specific IgE and eosinophil cationic protein [ECP] were measured. We found that nasal carriage of enterotoxin producing S. aureus in allergic patients was significantly higher than in control. Blood eosinophilia, total IgEand ECP levels were significantly higher in S. aureus nasal carrier than non-carrier patients. On in vitro exposure of PBMCs to [SEB], IFN-gamma secretion was significantly less in patients than control and IL-4 secretion was significantly more in patients than control. SEB-specific IgE was detected in 15.6% of patients and not detected in control. There was a significant positive correlation between SEB-specific IgE level in patients and markers of severity of allergic reaction including blood eosinophilia, ECP and total IgE level. This study suggests that nasal carriage of enterotoxin producing S. aureus has a potential role in the development and severity of allergic airway diseases

Recognition of Arabic printed characters using structural features and contour methods

In this paper, a recognition system of Arabic printed text is presented, using structural features and contour methods. The structural features method is based on the detection of holes and concavities in four directions [up, down, left, and right] and the secondary characteristics of this method are used to differentiate between the characters of each class and to reduce the confusion encountered in the system. The contour method divides each character into a main part and numbers of secondary parts and, by the result of this division, four classes can be received of which each class can be deal with many characters, and to recognize these character, other features such as Cross-Points [Loop], Secondary Parts, Similarity of Secondary Parts, Bottom-Up Density Ratios[BUDR], Left-Right Density Ratios[LRDR], and Horizontal–Vertical Orientation [HVO] have been used. In this paper, the two methods are tested on isolated characters and on a block of text which has 266 characters. The tests are also passed on multi font and multi size. The experimental results showed a relatively high accuracy of recognizing Arabic characters by two methods. The recognition rate of structural features method was 90.01% and by contour method, it was 98.02%, giving a better result of the structural features method.

Natural ventilation considerations for radon prone areas of Ramsar

In Iran, architectures are often unaware of the risk of radon inhalation and how to reduce radon levels. Furthermore, radon considerations are not implemented in construction methods, construction materials and building utilization by regulatory authorities. In this study after reviewing the meteorological changes of Ramsar over the past 50 years [1955-2005], a novel design for constructing dwellings in radon prone areas is introduced. Out of building interventions such as planting wind-tunnel-making trees will be discussed in another paper. Ramsar soil samples with 4 levels of specific activities [extremely hot, severely hot, very hot, and hot] were placed in a model house. Radon level monitoring was performed by using a PRASSI portable radon gas survey meter. For extremely hot soil samples, the radon levels inside the model house when windows were closed for 24 hours were 1615 +/- 516 Bq/m3. When windows which were in the wind direction or opposite the wind direction were opened for 24 h, the radon level decreased to 89 +/- 286 and 139 +/- 314 Bq/m3, respectively. Interestingly, when crossed windows were opened for the same duration, Radon level was 144 +/- 92 Bq/m3. In cold seasons, when windows are usually closed, Chimney effect reduced the radon level to 323 +/- 641. For severely hot, very hot and hot soil samples, natural ventilation-based interventions effectively reduced the radon level. Results obtained in this study clearly show that natural ventilation-based simple cost-effective interventions can significantly reduce the radon concentration in radon prone areas of Ramsar

Bilateral massive angiomyolipomatosis associated with tuberous sclerosis

Angiomyolipoma is an uncommon tumor consisting of vascular, smooth muscle, and fatty elements. Angiomyolipoma can present in two forms; as an isolated unilateral lesion which occurs sporadically or as bilateral lesions associated with tuberous sclerosis and Von Hippel- Lindau syndrome. Bilateral massive angiomyolipomatosis is a very rare entity. Only three cases have been reported in medical literature. We present a case of bilateral massive angiomyolipomatosis associated with tuberous sclerosis

Development and Acceptance of a Nutrition and Lifestyle Education Booklet to Improve Mild Cognitive Impairment among Elderly / Jurnal Sains Kesihatan Malaysia

Mild cognitive impairment (MCI) is a common disorder among elderly and may worsen to dementia. The aim of this study is to develop a nutrition and lifestyle booklet to implement better lifestyle modification, as an effort to delay cognitive decline. A series of discussions with a research group comprising of dieticians, nutritionists, a geriatrician and a public health physician were conducted to ascertain the content of the booklet. There were seven guidelines in the booklet including; eat more fish, eat more foods rich in folic acid, eat more fruits and vegetables, exercise regularly, do activities to stimulate memory, stop smoking and alcohol drinking and stay cheerful and positive. Evaluation of acceptance for the booklet was carried out which comprised of assessment on content, graphic and design among elderly and health staff at health clinic in Cheras. The assessment involved 15 Malay elderly subjects aged 60 to 81 years (mean age 66.1 ± 6.6 years), with 60.0% men and 40.0% women and 10 health staff aged 36.6 ± 12.0 years, with range of 27 to 58 years, consists of 20.0% men and 80.0% women also participated. Most of elderly subjects (80.0%, n = 12) indicated they understood information in the booklet. Meanwhile, 20.0% (n = 3) of elderly expressed they did not fully understand the content of the booklet in particular on sentence and terminology. All health staff (100.0%) understood the information in the booklet. This booklet was well accepted by elderly subjects and health staff, however adding more graphics, simplifying sentence structures and minimizing scientific terminologies to improve understanding were suggested. The booklet has the potential to increase the nutritional and health knowledge of elderly specifically with MCI. This would motivate them to adopt healthy eating and lifestyle, thus reducing cognitive decline and prevent dementia.

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome presenting as unexplained chronic interstitial keratitis

Autoimmune polyglandular syndrome is a rare autosomal recessive polyendocrinopathy with variable combinations of mucocutaneous candidiasis, autoimmune destruction of endocrineglands, and ectodermal dystrophy. specificendocrine dysfunction can include hypoparathyroidism, Addison's disease, hypothyroidism, and diabetes. this syndrome is also known as autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy [APECED]. Ocular manifestations can be part of the disease and are often disabling. Here we describe the characteristics of APECED syndrome and its association with chronic interstitial keratitis, a rarely seen ocular manifestation with an early onset presentation

Complications of circumcision in male children: report of sixty-one cases

The aim of this study is to revise the complications of circumcision and measures of their prevention. Pediatric Surgery Unit, SMC. Prospective study. Sixty-one consecutive cases of circumcision with complications were reviewed prospectively during 18 months, from June 1997 to December 2008. The mean age at presentation was 20 months [range one week to eleven years]. The most common observed complications were redundant foreskin in 28 [46%], followed by minor bleeding in 17 [28%]. Five serious complications had been seen after clamp technique for circumcision [3 glanular trauma and 2 webbed penises]. Eleven minor complications were seen, nine occurred in pediatric surgery unit out of total of 600 circumcisions performed during the study period, 1.5%. Circumcision may be associated with serious complications especially with clamp technique. To prevent these complications, trained physicians should perform this procedure

Chorionic villus sampling and marked membrane separation

The major concern about the invasive prenatal diagnostic tests is the frequency of procedure induced pregnancy loss. Chorionic Villus Sampling [CVS] is the invasive test of choice in the first trimester after the 10th gestational week. Our experience suggests marked chorioamniotic separation is an uncommon finding after the 10th gestational week. This study assesses the rate of marked membrane separation in a 10 to 14-week gestational period and its effect on post CVS fetal loss. Forty-one patients [5.2%] were selected among 782 patients as cases with marked membrane separation [mean maternal age, 26.9 years]. CVS procedures were performed with a 20-gauge Chiba needle attached to a 20-ml syringe under ultrasound guidance. Follow-up was performed by phone call and clinical visits until 24 weeks of gestation. For the control group, the follow-up was performed for only 2 weeks. Early fetal loss in the first two weeks of post procedural period, and late fetal loss from 2 weeks after procedure till the 24th gestational week were considered as CVS complications. We detected 2.4% early fetal losses after the procedure. Fourteen cases voluntarily underwent therapeutic abortion due to beta-thalassemia or hemophilia. One fetus with microcephaly was spontaneously aborted in the 21st gestational week. Twenty-five neonates were delivered alive at term and one prematurely at the 32nd week. Marked membrane separation had no significant effect on early post CVS fetal loss rate. The procedure does not have a major impact on the early post CVS fetal loss in patients with marked membrane separation

Expression of NF-kB and COX-2 in Young Versus Older Patients with Sporadic Colorectal Cancer.

Aim: to distinguish the expression of NF-kB and COX-2 between young and older group of sporadic colorectal cancer patients. Methods: this was a comparative study between sporadic CRC patients aged 40 years or younger and patients aged 60 years or more. Expression of NF-kB and COX-2 were assessed by immunohistochemical method using rabbit polyclonal antibodies against human p65 NF-kB and COX-2 proteins. Results: there were 98 cases of sporadic colorectal cancers between 1999 and 2007 obtained from the Department of Anatomical Pathology, Faculty of Medicine University of Indonesia, Jakarta and Department of Anatomical Pathology, Faculty of Medicine Padjajaran University, Bandung. There were 60 patients aged 60 years or more and 38 patients aged 40 years or less. Most tumors were located in the distal colon. Positive expression of NF-kB was found in 72 (73.5%) cases, whereas COX-2 expression was found in 48 (49.0%) cases. No significant difference of NF-kB and COX-2 expression between young and older patients. Conclusion: the expression of nuclear factor kB (NF-kB) in Indonesian patients with sporadic colorectal cancer was high. However, cyclooxygenase-2 (COX-2) was only expressed in half of patients. There was no significant difference of NF-kB and COX-2 expressions between patients aged 40 years or less and patients aged 60 years or more. Further studies are needed to elaborate the role of inflammation in sporadic colorectal carcinogenesis.