First report of MIRU-VNTR genotyping of Mycobacterium avium subsp. paratuberculosis isolates from Egypt

Mycobacterium avium subsp. paratuberculosis [MAP] is the causative agent of Johne's disease, an economically important disease in ruminants worldwide. It was first isolated in Egypt in 2005. Since then, the pathogen has been detected in different Egyptian provinces. In order to trace the source of infection, genotyping using simple methods of high discriminatory power such as mycobacterial interspersed repetitive unit-variable number tandem repeats [MIRU-VNTR] were carried out in different countries. Until now there is no published information about MIRU-VNTR genotyping of MAP isolates in Egypt. To address that point, 100 faecal samples were collected and cultivated from 3 different suspected dairy farms. Fourteen isolates belonging to one farm were identified as MAP and subjected to genotyping using 8 different MIRU-VNTR loci PCRs. Two different genotypes were recognized based on size polymorphism observed in one locus [VNTR-7] that was confirmed by sequencing. Our work provides a preliminary basis of constructing a MIRU-VNTR genotyping database of MAP in Egypt

Maternal and fetal leptin level correlation with fetal macrosomia

Leptin seems to be a critical factor for overall fetal development. Macrosomia may place the mother and fetus or neonate at risk for adverse outcomes. To test if leptin level is implicated in macrosomia. The sample comprised 25 cases delivered full term normal weight infants, and 25 cases delivered full term macrosomicinfants. Maternal serum samples and fetal cord samples were withdrawn immediately after birth of the full term infants. Fetal leptin level was higher in macrosomic infants than normal weight infants. No difference in maternal leptin level between both groups was observed. Leptin levels related directly to quantity of body fat tissue in fetal macrosomia as there is leptinresistence causing elevated leptin levels

Green tea extract administration protects against the nephrotoxicity induced by gentamycin and amikacin in rats

Despite their beneficial effects, aminoglycosides including gentamycin [GEN] and amikacin [AK] have considerable nephrotoxic side effects. This study investigaged the effects of green tea [GT] extract on biochemical and morphological kidney damage induced by GEN and AK in rats. Sixty male albino rats were used in this study and divided into 6 groups each contains ten rats. The first group was the control group injected with 0.4 ml saline. Each rat of the second group was given 12.5 ml of green tea extract [3%] twice daily to drink it orally for 25 days. The 3[rd] group received GEN [80mg/kg] once daily intraperitoneally for 10 days. The 4[th] group was administered AK [180 mg/kg] once daily intraperitoneally for 10 days. The 5[th] group received GT extract for 15 days then concomitant with GEN for 10 days. The 6[th] group received GT extract for 15 days then concomitant with AK for 10 days. GEN and AK groups showed significant increase in serum urea and creatinine [Cr] which was significantly decreased in green tea consuming rats before GEN and AK administration. GEN and AK treated rats showed significant decrease in the activity of calalase enzyme and reduced glutathione level in kidney tissues which were significantly increased in GT consuming rats prior to GEN and AK injection. Light microscopic examination of kidney tissues of GEN and AK groups revealed tabular necrosis and degenerative changes which were modulated by the consumption of green tea prior to GEN and AK administration. In conclusion green tea ameliorates and modulates GEN and AK induced-nephrotoxicity and oxidative damage by enhancing the antioxidant defense system

Determination of postmortem fluoxetine concentration in blood, liver, hair and in different regions of brain of albino rats

Fluoxetine is a selective serotonin reuptake inhibitor [SSRI]. Measurements of postmortem levels of the drug are helpful to demonstrate its usefulness in. forensic toxicology. For this reason, a rapid and sensitive high- pressure liquid chromatographic method has been developed for determination of the antidepressant fluoxetine in postmortem samples for 50 rats given intraperitoneal fluoxetine hydrochloride at the therapeutic levels. The postmortem samples were including blood, hair, liver, and discrete brain regions [raphenucleus, hypothalamus, and brain striatum].Fifty rats weighing from 200-250 gm. Rats were divided into 5 groups 10 rats per each group: group [1] was given ordinary rat diet, group [2] received 1ml/kg distilled water, group [3] was given fluoxetine hydrochloride once at a dose of 20mg/kg 30 minutes before killing and collection of samples, group [4] was given 10mg/kg fluoxetine hydrochloride once daily for 15 days and killed 30 minutes after the last dose, group [5] was given 10mg/kg. fluoxetine hydrochloride once daily for 9 days then killed on the 10th day after 30 minutes of 20mg/kg fluoxetine hydrochloride. Rats were sacrificed by decapitation and samples were collected immediately after death. In group III, the highest postmortem levels were observed in the raphenucleus followed by brain striatum, then the blood. In group IV, the highest postmortem levels were in hair followed by raphenucleus, then striatum followed by the liver. Meanwhile, in Group V, hair showed the highest postmortem levels followed by brain striatum then raphenucleus and lastly the liver. In conclusion, while blood is still the preferred matrix to link concentration and effect, analysis of hair, liver, and brain tissue can provide additional valuable information, not only in pure overdose cases

Gall stone in a port-site hernia sac: incidential finding

Gall bladder perforation during laparoscopic cholecystectomy with spillage of bile and gall stones is relatively common. Herein, we present a very rare case of incidentally found gall stone in an umbilical port-site hernia sac. A 45 years old emirates lady was admitted to Ghayathi general hospital for repair of port site hernia in the umbilical region 2.5 years after laproscopic cholecystectomy. lntraoperatively, the hernia sac was found to contain a freely mobile faceted stone of about 1 x 1.5 x 1 cm in size over the surface of the contained omentum. Stone was retrieved and the hernia was tackled. Literature was reviewed along with med-line search over the past 15 years where we could find 4 cases only reported

New treatment of hyperemesis gravid arum a randomized study

A randomized study was undertaken to assess efficacy of micronizedprogesterone as a new treatment ofhyperemesis gravidarum compared with anti-emetics, anti-histaminics, liver support, vitamin B6 and intravenousfluids.The study was conducted on 40 pregnant ladies diagnosed as hyperemesis gravidarum. They wererandomized into 2 groups:Group [I] includes twenty cases where intravenous fluids [5-6 L], sodium bicarbonate, liver support, vitamin B6,anti-emetics and anti-histaminics were given.Group [II] includes twenty cases were treated with micronized progesterone, intravenous fluids and sodiumbicarbonate were given.Both groups were subjected to complete blood picture [CBP], liver and kidney function tests, serum sodium [Na] and potassium [K], serum estrogen and progesterone estimations.This study indicated that significant differences were found on both groups between CBP, liver and kidneyfunction tests, serum Na and K levels, serum estrogen and progesterone levels after treatment than before.Signiflcnt differences were found between the two groups after treatment as regard kidney and liver function testsand also, seum progesterone levels.Intavenous fluid hydration and electrolytes correction is essential in the management of hyperemesisgravidarum. Micronized progesterone is an effective therapy as anti-emetics, anti histaminics, vitamin B6 and liversupport in controlling hyperemesis gravidarum

Current practices of normal and cesarean delivery at Shatby Maternity University hospital as compared to evidence-based practices

The study was undertaken to assess current obstetric practices of both normal vaginal and Cesarean delivery at Shatby Maternity University Hospital in Alexandria as compared to evidence-based obstetric practices. A cross-sectional approach was used to assess 250 women having normal vaginal deliveries and 500 women undergoing Cesarean deliveries. Practices performed during normal labour were assessed including: the first stage: perineal shaving, enema, intravenous cannula insertion, position, amniotomy and oxytocin infusion. -During the second stage: position, timing of pushing, fundal pressure, and perineal sutures. -During the third stage: placental delivery and uterine exploration. Practices performed during Cesarean deliveries were assessed including: -Practices performed before the operation [whether or not a doctor ordered to give: Prophylactic antibiotics, thromboprophylaxis, antacids, antiemetics. -Practices performed during the operation [if the surgeon used double gloves, the use of separate surgical knives to incise the skin and the deeper tissues, the use of 5 IU oxytocin by slow intravenous drip to encourage uterine contraction and decrease blood loss, the mode of placental delivery; cord traction or manual removal, intraperitoneal repair of the uterine wound, uterine repair in two or single layers, closure or not of the visceral and parietal peritoneum, closure or not of subcutaneous tissue, timing of removal of urinary catheter and start oral feeding.] Shatby Maternity University Hospital in Alexandria is the largest Obstetric hospital with nearly 15,000 admissions per year and 9,000 deliveries [2002]. A questionnaire was done the morning following delivery and before discharge. Data were obtained from cases themselves in comparison to data from the files and attending obstetricians. Various procedures and techniques of normal vaginal delivery and C.S performed and compared to evidence-based practices. Almost all the cases had pubic shaving at home [94.0%]. 8% of cases had a rectal enema done, furthermore, intravenous infusions was administered to 83.2% and 25% had their membranes artificially ruptured in pre-labor ward. 49.6% of the sample mentioned that, there was a lot of fundal pressure applied to them during the second stage of labour. 95.2% of the studied sample stated that, uterine exploration was performed to them after delivery of the placenta. This figure is to be taken with caution as most of the women could not differentiate between uterine exploration and vaginal exploration. The reality is a much less number of uterine exploration as according to attending obstetricians, uterine exploration is rarely done. As regard Cesarean deliveries: Almost all the mothers did not receive antibiotics nor thromboprophylaxis. As regards intraoperative procedures; the surgeons were not wearing double gloves in 90.0% of cases, nor used separate surgical knives to incise the skin and the deeper tissues in 100.0% of the cases. Nearly all cases [98.1%] had their uteri repaired after exteriorization and 96.1% of cases had a double layer closure of the uterus. In 95.0% of cases closure of the visceral and parietal peritoneum was done. It seems that current practices of normal vaginal delivery and C.S at Shatby Maternity University Hospital are not that far of the evidence-based practice. Some modifications when applied can make such practices up to the evidence-based practice

Management of premature rupture of the membrane [PROM] in Shatby Maternity University Hospital as compared to evidence-based management

The study was undertaken to assess current obstetric practices of both diagnosis and management of premature rupture of membrane at Shatby Maternity Hospital in Alexandria as compared to evidence-based obstetric practices. A cross sectional approach was used to assess 200 women having PROM where: I- Practices of diagnosis were assessed including history of gush of water, bleeding, smoking and recurrence of rupture of membranes in the previous deliveries, also the mode of examination were assessed including using dry clean sterile speculum, regional swab as well as the use of ultrasound for the diagnosis. II- The practices of clinical management were assessed in all cases where antibiotics, tocolytic and/or corticosteroids were taken or not. The mode of delivery whether expectant or active one were assessed also the foetal outcome of delivery in the term of Apgar score were assessed. Shatby Maternity Hospital in Alexandria is the largest and main obstetric hospital, with nearly 15,000 admissions per year and 9,000 deliveries. A questionnaire was done the morning following delivery and before discharge. Data obtained from cases themself, files and attending obstetricians were assessed; where 98% of cases were complaining of gush of water and 58% of them had a history of recurrent PROM. Almost all cases were subjected to ultrasound examination which is the main tool of diagnosis, during the clinical management antibiotics, tocolytics and corticosteroids were taken 90%, 40% and 54% respectively, most of cases were subjected to induction of labour [70%] failed, only in 20% of cases. Only 2% of newly born were admitted to neonatal unit suffering from infection and prematurity. It seems that current practices of diagnosis and management of PROM at Shatby Maternity University Hospital are not that far of the evidence-based practice, some modifications, when applied can make such practices up to the evidence based practice

effect of vitamin E administration on cisplatin-induced oxidative and histopathological damage of kidney, liver and lens tissues in albino rats

Cisplatin is one of the most active cytotoxic agents in the treatment of cancer but its clinical use is associated with toxicity. The present study evaluated biochemically and histologically the effect of vitamin E as a line of prevention of cisplatin toxicity in rats. Its was carried out on 90 adult male albino rats divided into 6 groups each contains 15 rats, the first group was used as-ve control, the second group received distilled water 1ml/animal intraperitoneally [IP], the third group received corn oil 0.25 ml/animal orally,the fourth group received vitamin E 100 mg/kg orally. Animals of groups II, III and IV served as +ve controls. The fifth group received cisplatin 5 mg/kg IP and the sixth group received vitamin E 100 mg/kg orally 24 hours prior to IP cisplatin 5 mg/kg. After 7 days of treatment, rats were sacrificed,then Malondialdehyde [MDA], reduced glutathione and glutathione perioxidase were measured in kidney, liver and lens tissues. Also kidney, liver and lens tissues were prepared for light microscopic examination. The results revealed significant increase in kidney, liver and lens MDA levels in rats treated with cisplatin in comparison to the-ve control group. Reduced glutathione and glutathione perioxidase levels in kidney, liver and lens were significantly lower in cisplatin group than in the-ve control group. Histopathological examination revealed renal and liver necrosis and cataract changes in cisplatin treated rats. The increased MDA levels, the decreased antioxidant enzymes and histopathological damage in the kidney, liver and lens of rats administered cisplatin were significantly improved with vitamin E administration. So, it is concluded that, vitamin E may play a role in preventing cisplatin induced nephrotoxicity, hepatotoxicity and cataract formation in cancer patients

Medicolegal aspects of blunt splenic trauma with special reference to delayed rupture/presentation [a prospective study]

Deaths due to splenic rupture are still reported in hospital statistics. It is either acute or delayed rupture. Delayed splenic injury includes either true delayed rupture that represents an actually delayed development of an initially latent, insignificant, splenic injury [i.e. injury in evolution] minor enough to go undetected on initial CT scans of the abdomen, or delayed presentation which represents an initially missed injury [i.e. delay in diagnosis]. We had encountered a number of patients presented with splenic rupture days after blunt abdominal trauma. We conducted this study to review the experience with this clinical entity of blunt splenic rupture with special emphasis on delayed rupture/presentation for patients presented 48 hours or more after trauma. Ninty five emergency examinations were performed for the sole purpose of detecting splenic rupture in patients who had experienced blunt abdominal trauma during a period of 8 years. Twenty three patients out of the ninty five underwent urgent laparotomy and splenectomy within 48 hours from the occurrence of the trauma [24.2%] due to hemodynamic instability as a result of continuously bleeding splenic injury. Left rib fracture was encountered in 47.8% of the cases and bowel and mesenteric injury was found in 17.4% of the cases. Nine patients presented with delayed rupture/presentation of spleen 48 hours or more after the initial trauma [9.4%] were analyzed and formed the basis of this study. The mechanisms of injury and accompanying injuries were documented. The time lag from trauma to operation and the cause of delay were also documented. Regarding the cases of delayed rupture, abdominal computed tomography [CT] was performed in eight hemodynamically stable patients, as the 9[th] patient presented in shock with acute abdomen and emergency laparotomy was performed after positive diagnostic peritoneal lavage. CT demonstrated hemoperitoneum in 7 patients, 2 had subcapsular hematoma, 2 had grade II injury, 2 had grade III injury and one patient had grade IV injury with multiple pseudoaneurysms. Emergency laparotomy was performed for 2 patients due to hemodynamic instability. Three patients were operated upon after a brief period; the reaons for operating were hemodynamic instability or they showed manifestations of diffuse peritoneal irritations. Two patients were diagnosed to have true delayed rupture of sleen and managed initially conservatively; unfortunately, nonoperative management failed because of deterioration of clinical condition in one patient and repeated blood transfusions in the other patient. Splenectomy was performed in 8 patients. The last patient was managed nonoperatively and followed with repeat CT scans. In conclusion, Splenic rupture is frequently associated with collapse and other organ injury specially left rib fractures. This may be a useful marker for suspecting cases of delayed rupture. Also, delayed splenic rupture/presentation represents either an actually delayed development of an initially latent, minor splenic injury or an initially missed injury with late presentation. Patients may be displaced from one grade to another within few days. So, a high index of suspicion, observation, follow up of hematological parameters and liberal utilization imaging techniques are essential for the identification of delayed splenic rupture, which may be hazardous to patients life, and an actual challenge for physicians to avoid being condemned with negligence or malpractice

Role of zinc in hepato- and nephrotoxic effects of chlorpyrifos. A biochemical, trace elemental and histological study

Chlorpyrifos [CPF] is one of the most potent broad-spectrum organophosphates used frequently against cockroaches and other structural pests. Repeated exposure to chlorpyrifos may endanger many populations with resultant toxic effects on many organs. Recent studies revealed that zinc might modulate these toxic effects. This work was carried out to ascertain the toxic effects of CPF on the rat liver and kidney. Also, the possible protective role of zinc had been evaluated. The study was conducted on 70 adult male albino rats divided into seven equal groups. Group I: negative control, group II: distilled water, group III: zinc, group IV: low dose CPF, group V: high dose CPF, group VI: zinc and low dose CPF and group VII: zinc and high dose CPF. The duration of the study was eight weeks then hepatic, renal profiles, plasma zinc, copper, MDA, SOD, GSH, GSSO were measured. Also, histological examination of liver and kidney was done. The obtained biochemical and histological results revealed hepatic and renal toxic effects induced by CPF in a dose dependent manner. Zinc supplementation resulted in a remarkable protective effect at the biochemical and histological levels. Further studies on zinc supplementation to either patients or workers exposed to CPF are recommended

Role of Omega-3 essential fatty acids in pregnancy induced hypertension

Pre-eclampsia is a major health problem contributig largely to maternal and neonatal morbidity and mortality which is of obscure etiology. It is characterized by vasoconstriction and platelet aggregation which is attributed to imbalance of thromboxane A2 and prostacyclin A2. This imbalance could be corrected by polyunsaturated fatty acids of n-3 class by competing with arachidonic acid for cyclooxygenase enzyme producing inactive prostanoid. To study the relation of omega-3 fatty acids and the severity of pre-eclampsia. 10 mild pre-eclamptic, 10 severe pre-eclamptic and 10 eclamptic patients were compared to a control group of 20 normal pregnant patients for their plasma levels of omega-3 fatty acids using high performance liquid chromatography. pre-eclamptic patients were significantly lower in their plasma levels of fatty acids than in control group

pharmacognostical study of Myrtus communis L. cultivated in Egypt

The macro- and micromorphology of the root, stem, leaf, flower, fruit and seed of Myrtus communis L. are presented with view of finding out the diagnostic characters for the identification of these organs in both the entire and powdered forms. The major constituents among components of the volatile oil of the leaf were phellandrene [20%], alpha-thujene [12.8%], cismyrtanol [10%], trans-farnesene [5.9%] and bornyl acetate [5.9%], while beta-caryophyllene [17.8%], methyl eugenol [12.5%], camphor [12.2%], trans-anethole [11.8%] and 1,8-cineole [4.3%] were the major compounds identified in the volatile oil of the flower. Seasonal variation of the volatile oil of the leaf and antimicrobial activity were also investigated

Identification of functioning viable and non-viable myocardium using GBP-NTG and angiography

The study included 41 patients with coronary artery disease evaluated using Tl-201 re-injection with NTG for assessment of myocardial viability. Correlation of viable segments [107] and non-viable segments [91] by angiography and radionuclide ventriculography [resting and following 10 mg sublingual NTG]. The addition of NTG lead to significant changes in ejection fraction [EF], peak emptying rate [PER] and peak filling rates [PFR]. Similar normal segmental wall motion in 64% and 65% of viable segments was observed in both GBP and angiography as well as 46% and 47% of non-viable segments using the same techniques. GBP had a better detection for hypokinetic segments in 36% and 42% in viable and non-viable segments versus 24% and 34% in angiography in the same groups respectively. Also, GBP had higher detection rate of dyskinesia in 12% in non-viable segments as compared to 2% in angiography. Viability index > 50% had significant correlation with mean degree of coronary stenosis [p < 0.001], whereas it had no significant correlation with haemodynamic variables as EF, PER and PFR. Radionuclide ventriculography [GBP] with NTG is a better technique in assessment of wall motion changes among viable and non-viable segments, whereas the mean coronary stenosis is the main factor correlated with viability index

Role of cytogenetic study in diagnosis and management of primary gonadal failure

The present study investigates the clinical, cytogenetic and hormonal features of patients with primary gonadal failure aiming to define the role of cytogenetic study in their diagnosis and management. 30 patients were included in this study. They all had hypogonadism, elevated gonadotropin levels and streak or hypoplastic gonads by sonography. From the results obtained it was concluded that karyotyping is most useful in any patient with delayed sexual development, elevated serum gonadotropins and streak gonads

Psychosocial and biochemical correlates of hirsutism among Egyptian females

Thirty nine hirsute women [mean age 27.3 +/- 6.7] and 40 non-hirsute controls, matched for age, were the subjects of this study. Cases were subjected to history taking, clinical and endocrine assessment as well as abdominal and pelvic sonography. Total and free testosterone levels were measured by radioimmunoassay. Cases and control had a careful psychiatric interview. Taylor anxiety scale and Guilford battery scale were applied to test for anxiety and masculinity/femininity version, respectively. A questionnaire was interviewed for cases to assess reaction of husband, family members and friends, patients' reaction to their problem and any social restrictions practiced by them

Otitis media and aural myiasis

Myiasis is a diseased condition caused by larvae of myiasis producing flies. Still little is known about such an important subject in Egypt. In this paper, the author described three human cases of otitis media associated with aural myiasis. The causative larvae were those of W. magnifica and S. falculata

relation between intestinal troubles and parasitic infection in Cairo

Stool and urine from 320 subjects in Ain shams region, and 200 subjects in Nasr city were collected and examined for parasites. All these subjects were suffering from abdominal troubles. The results revealed a marked relation between parasitic Infection and abdominal troubles, especially in Ain shams region [80%], and to a lesser extent in Nasr City [51%]. The commonest parasite in Ain shams was Giardia lamblia [20.3%], and in Nasr city was E. histolytica [13%]

Precautions on using eggs of schistosoma haematobium as an antigen in COPT

The circumoval precipitin test was performed on 60 male patients with active bilharziasis and 20 control normal subjects. Both types of S. mansoni and S. haematobium eggs were used as an antigen. The percentages of positivity, egg reactivity, and the refraction's precipitation intensity were lower on using S. haematobium eggs than with S. mansoni

Comparison of direct immunofluorescence [DIF] and enzyme immunoassay [ELISA] for detection of chlamydia trachomatis infection in cases of abortion and premature rupture of membrane

Genital Chlamydia trachomatis [C. trachomatis] in the endocervix was investigated among 90 pregnant women [60 women applying for spontaneous abortion and 30 women with premature rupture of membrane [PROM]; The incidence of infection with this sexual transmitted pathogen was 1.67% among asymptomatic low risk group and 23.33% among the group presenting with symptomatic endocervitis [high risk group] with a total incidence among the 90 pregnant women of 8.89%. C. trachomatis was found more associated with greater sexual activity so it's incidence was high among younger age group and early marriage. The diagnosis of genital C. trachomatis was done by non culture immunological detection of Chlamydial antigens. We applied tuo different methods for diagnosis, direct immunofluorescence and enzyme immunoassay. The sensitivity and specificity of DIF in our study was 88.89% and 100% respectively while the sensitivity of ELISA was more than DIF [100%] and the specificity was slightly lower [98.7%]. The percentage of over all agreement between the two antigen detection assays were 98.8%. Neither test is ideal for diagnosis of Chlamydial infection but still they can provide an alternative to the cost, time consuming and technique dependent cell culture. The effect of C. trachomatis on the outcome of pregnancy is still speculative. There is a significant [P<0.05] association between spontaneous abortion and endocervical carriage of Chlamydia. Other adverse pregnancy outcomes as PROM were not associated with Chlamydia positive women