Detection of extensively drug resistant pulmonary tuberculosis

Introduction: The rise in human immune virus infections [HIV] and the neglect of tuberculosis [TB] control programs have enabled a resurgence of TB. The emergence of drug-resistant strains has also contributed to this new epidemic from 2000 to 2004, with, 20% of TB cases being resistant to standard treatments and 2% resistant to second-line drugs. The rate at which new TB cases occur varies widely, even in neighboring countries, apparently because of differences in health care systems

Aim of the work: The aim of the current study is to investigate susceptibility to anti-TB drugs in newly diagnosed and old TB patients [with persistent positive sputum smear after 2 months of anti-TB treatment] for detecting multi-drug resistance [MDR-TB] and extensively drug resistant TB [EDR-TB]. As well, find out risk factors associated with the development of MDR and XDR-TB

Patients and methods: The study included 40 strains of mycobacterium TB. These strains were divided into two groups: Group I: 20 strains isolated from new cases [patients who had never treated for TB or who have taken anti TB drugs for less than 1 month]. Group II: 20 strains isolated from old cases [Patients with persistent positive sputum smear after 2 months of anti-TB treatment]. After taking an informed consent, all subjects were subjected to: Detailed history taking, complete clinical examination, anthropometric measurements, routine laboratory investigations, erythrocyte sedimentation rate [ESR], chest X-ray, microbiological investigations [including, direct microscopy examination, isolation and identification of mycobacterium TB, and testing sensitivity for anti-TB drugs]

Results: MDR and XDR TB were more common among TB patients with persistent positive sputum despite anti TB treatment than newly diagnosed cases. Diabetes mellitus [DM], HIV and anemia were considered to be other risk factors for MDR-TB and XDR-TB. Management of MDR-TB and XDR TB is a challenge which should be undertaken by experienced clinicians at centers equipped with reliable laboratory service for mycobacterial culture and in vitro sensitivity testing as it requires prolonged use of expensive second-line drugs with a significant potential for toxicity

Conclusion: Emergence of MDR-TB and XDR TB has the potential to be a serious public health problem in Egypt and that strengthened TB control and improved monitoring of therapy is needed

Shear bond strength of three intra-oral metal ceramic repair systems

Replacement of a fractured metal-ceramic restoration is not possible in some cases.combination of different surface treatments and repair systems have been recommended for this purpose. The present study assessed the shear bond strength of three intra-oral metal-ceramic repair systems. In this in vitro study, 30 cylindrical metal specimens and 30 porcelain specimens were fabricated. The specimens were embedded in a ring, after surface treatment, the specimens received one of the following repair systems including Ultradent, Ivoclar Vivadent and Clearfil Multi-Purpose according to the manufacturers' instructions. The specimens were stored in incubator then thermal cycled. The shear bond strength of the specimens and failure types was determined. The data were analyzed. On porcelain substrate, the mean and standard deviation of shear bond strength using Ultradent, Clearfil and Ivoclar Vivadent repair systems were 12.16 [ +/- 4.59], 10.19 [ +/- 4.18] and 12.68 [ +/- 4.89] while the rates were 14.32 [ +/- 3.15], 24.66 [ +/- 3.25] and 13.32 [ +/- 3.83] in the metal substrate. The bond strength of Clearfil system was significantly higher than others in the metal substrate [both: p<0.0001] while no other significant differences was noted in the paired comparisons, all metal specimens showed adhesive failures while the porcelain specimens demonstrated more cohesive failures. Although, replacement of the fractured metal-ceramic restorations is the ideal treatment modality, in the porcelain substrate all repair systems can be used. Clearfil repair system was associated with higher bond strength in the metal substrate

Gall bladder contractility in children with beta-thalassaemia

We studied gall bladder contractility in 61 children with beta-thalassaemia who were asymptomatic for gall bladder disease and 51 sex- and age-matched controls in Cairo, Egypt, using real-time ultrasonography. Multiple gall bladder stones were present in 18.0% of thalassaemia patients and sludge in 6.6%. There were statistically significant differences between thalassaemia patients and controls in gall bladder fasting volume, residual volume, emptying time and contraction index. There was significant positive correlation between fasting and residual volumes and age, weight and height, and between fasting volume and body mass index and serum ferritin level. Contraction index was negatively correlated with serum total bilirubin. Impaired gall bladder motility was evident in patients with betathalassaemia and it may be related to disease duration, serum ferritin and total serum bilirubin level

Stereotaxic gamma knife surgery in treatment of critically located pilocytic astrocytoma: Preliminary result

Low-grade gliomas are uncommon primary brain tumours, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain [thalamic and brain stem] were treated with gamma knife surgery. Gamma knife surgery did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging studies of the solid part of the tumour and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the thalamic located lesion, and 22 months in the second case with the brain stem located lesion. Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially located

Protective effect of grape; seed, skin and leaf extracts on hypercholesterolemic rats

The hypocholesterolemic effect of grape seed, skin and leaf extract has been investigated in six groups of seven rats each weighing 75 +/- 5 g. The first group was a control [-ve] while the others were fed on hypercholesterolemic diet and reclassified into control [+ve], seed, skin, leaf and mixture of extracts rat groups. The extract was administered daily as aqueous solution using intragastric tube in the form of 105 mg extract/kg body weight for 30 days. Compared with the control [-ye] group, the control [-ve] group showed significant decrease in final weight, weight gain, food intake, FER, HDLc, total protein, globulin, GPx and SOD but the levels of TC, TG, LDL-c, VLDL-c, total lipid, phospholipids, atherogenic indices, ALT, AST, alkaline phosphatase and also liver TC, total lipids and MDA were significantly increased. On the other side, the levels of LDL-c, LDL-c/HDLc, ALT, AST and alkaline phosphatase were significantly increased in grape seed, skin, leaf and mixture extract groups while grape leaf extract group showed significant decrease in FER and phospholipids. In comparison with control [+ve] group, there were significant increase in final weight, weight gain, food intake, food efficiency ratio, serum HDLc, total protein, globulin, GPx and SOD but significant decrease of serum TC, TG, LDLc, VLDLc, total lipids, phospholipids, atherogenic indices, ALT, AST and alkaline phosphatase and liver TC, total lipids and MDA in grape seed, skin and leaf extract groups. Histopathological examination of rat liver and heart from grape seeds, leaf and mixture rat groups showed no histopathological changes

Association between hypertension and C-reactive protein in acute phase of ischemic stroke

High-sensitivity C-reactive protein [hs-CRP], an acute phase reactant, is an indicator of underlying systemic inflammation and a novel marker for atherothrombotic disease. This study was designed to evaluate serum levels of hs-CRP in acute ischemia stroke and its relation to stroke severity in the first 24 hours. Also, this study aimed to asses the relationship between hs-CRP levels and blood pressure [BP] in the acute phase of ischemic stroke. Sixty patients were recruited in three groups. Twenty patients with first ever ischemic stroke and history of hypertension were selected to represent group I. Group II included 20 patients with the first ever stroke, with no history of hypertension, with normal BP on regular measurements prior to stroke and presented with acute rise of BP. Twenty hypertensive patients with no history of stroke or ischemic heart diseases represented group III. For comparison, 20 healthy volunteers were included as control group. All subjects were submitted to detailed history taking, thorough general and neurological examination with paying special attention to BP. Stroke severity was assessed using the Canadian Neurological Scale [CANS]. The infarcts size was evaluated in CT and/or MRI. Serum levels of hs-CRP were measured using end point CRP-turbidoemetric assay. Serum levels of hs-CRP were significantly higher among patients of group I [t = 6.01, p<0.001], group II [t = 6.39, p<0.001] and group III [t = 2.91, p<0.01] in comparison with controls. The highest significant elevation was observed among stroke patients with acute rise of BP while; the modest was among patients with isolated hypertension. CRP levels showed significant negative correlation with the CANS score [r = -0.72, p<0.001], and significant positive correlation with the size of brain infarcts [r = 0.68, p<0.001]. There was highly significant positive correlation between hs-CRP levels and BP components; systolic BP [SBP], diastolic BP [DBF], mean arterial pressure [MAP] and pulse pressure [PP] in all patient groups. However, when displaying the multivariate adjusted logistic regression model assessing the association between all BP components and odds of having elevated CRP levels, only 10 mmHg rise in SBP significantly persisted to increase the odds of having an elevated CRP by 76% [odds ratio, 3.76; 95% confidence interval, 1.97-5.35; P<0.001]. Ischemic stroke can trigger an acute phase response expressed by elevation of circulating hs-CRP serum levels which may correlate with the size of infarcts and the severity of stroke. In the acute phase of ischemic stroke, hypertension, more specifically acute rise of BP, is associated with increased levels of hs-CRP which may correlate with BP components most prominent with SBP

Virtual versus fiberoptic bronchoscopy in the evaluation of tracheobronchial neoplasms

Lung tumours represent a true epidemic of the twentieth century. Patients with suspected tracheobronchial lesions typically undergo diagnostic evaluation consisting of CT scanning and fiberoptic bronchoscopy. Multislice CT is more than upgrade of single detector CT. Virtual bronchoscopy is the descriptive term given to representations of the bronchial tree and surrounding structures created from spatial information derived from imaging sources other than the bronchoscope itself. The present work aimed to assess accuracy of virtual bronchoscopy compared to fiberoptic bronchoscopy in evaluating tracheobronchial neoplasms. The studied group included 20 patients who were subjected to full history taking, clinical examination, routine laboratory investigations, radiologic evaluation using plain X-ray chest and Multidetector CT virtual bronchoscopy then fiberoptic bronchoscopy examination under local anesthesia. The mean age of the patients was 54.6 +/- 15.79 years. There were 14 male and 6 female patients. All patients were symptomatic at the time of presentation. Thirty-four airways were found by endoscopy to be obstructed. The mucosal descriptions of these lesions were described only by fiberoptic bronchoscopy. There were no significant differences between both bronchoscopes regarding the type of the lesion [endoluminal or extrinsic compression], the degree of obstruction [partial, near total or total], the origin of the masses and its extent. Exploration distal to the obstructing mass was possible in 61.8% of the airways by virtual bronchoscopy and only in 32.4% by fiberoptic bronchoscopy. Virtual bronchoscopy reported sensitivity of 82% and specificity of 87% in detecting extrinsic compression while in endoluminal masses, it reported sensitivity of 86% and specificity of 79%. However, regarding the degree of obstruction, virtual bronchoscopy reported in partial obstruction sensitivity of 85% and specificity of 75.9%. The sensitivity of virtual bronchoscopy in near-total obstruction was 80.5% and specificity was 78.9%, and for total obstruction, the sensitivity was 82.3% and the specificity was 80.2%. Virtual bronchoscopy using multislice CT is an accurate mean of estimating airway lesions. It is an easy complementary tool to fibroptic bronchoscopy

[Introduction of a technique for fabrication of an implant-supported fixed temporary prosthesis]

In fully edentulous patients, reconstruction with implant-supported fixed prosthesis is a complicated treatment. In conventional technique, after the placement of the implants, fixed temporary prosthesis is fabricated with no consideration of the removable prosthesis that the patient has used yet. Therefore, the logical relation of the phases of treatment is lost and the points such as vertical dimension occlusion and centric relation are not recorded exactly. The purpose of this article is to introduce a technique in which a fixed temporary prosthesis is fabricated by use of patient's full denture. In this study, a 60-year-old patient with complete edentulous in the mandible was referred to Dental School. He has used a complete jaw denture in the mandible. The complete denture especially in the lower jaw has caused destructions to the remaining ridge. Due to the patient's condition and the existing circumstances, the treatment design of implant-supported fixed prosthesis was accepted by the treatment team. Prior to the surgery, assessments of the bone quality and quantity, force factors, the number of the implants, their lengths and angles were done and the complete denture was converted to implant-supported fixed temporary prosthesis. The fabrication of conversion prosthesis was introduced with implant-supported metal ceramic restoration

Effect of feeding by three formulas of herbs and vegetables on the healing of gastric ulcer in male rats

The present article was carried out to investigate the effect of feeding by 3 formulas consisting of three herbs [licorice, thyme and chamomile]; two vegetables [cabbage and artichoke] and a combination of both on the healing of gastric ulcer induced with aspirin in male rats. The obtained results revealed that feeding rats with induced gastric ulcer on herbal or vegetable dried powdered formula or a combination both at 2% for 2 weeks caused significant decreases in the gastric ulcer index, volume and total acidity of gastric juice. The curative ratios from gastric ulcer due to feeding by herbal formula or vegetable formula or both were 43.0 or 22.1 or 57.7%, respectively. The corresponding ratios of the decrease in volume of gastric juice were 27.73 or 39.07 or 39.84%, and in total acidity of gastric juice were 37.07 or 37.09 or 54.83%, respectively. Feeding of these rats on herbal formula or vegetable formula or both of them did not significantly affect the body weight. Histopathological examination of stomachs of rats fed on the above mentioned formulations showed alleviation of gastric mucosal damage and ulceration induced by aspirin. Combination of both herbal formula and vegetable formula showed higher anti-ulcer activity than either of them alone. It can be concluded that feeding diet mixed with a formula consisting of licorice, thyme, chamomile, cabbage and artichoke at 2% to rats with aspirin induced gastric ulcer for 2 weeks produced a marked anti-ulcer effect. This study recommends conducting the experiment on patients suffering from gastric ulcer

Anatomical variations of the circle of Willis in males and females on 3D MR angiograms

The objective of the present work was to study the anatomical variations of the circle of Willis as regard its component vessels and their average diameters in a sample of adult Egyptians and to detect any sex-related differences in these variations. One hundred and twenty adult patients were observed [60 males and 60 females]. They all had problems unrelated to any ischemic or vascular diseases, so they were considered as healthy control, concerning the morphology of the circle of Willis. In addition, ten cadavers' brains were obtained from the Anatomy department, Faculty of Medicine Ain Shams University for examination of the circle of Willis and for detection of any variations. The anatomical variations of the anterior part, posterior part and completeness of the circle were inspected. Also, the diameters of all component vessels were assessed. The results indicated that, the anterior part of the circle was completed in 70% males and 75% females of the study sample. No statistically significant difference was detected between sexes. The most common variant of the anterior part was the single anterior communicating artery followed by the hypoplastic or absent anterior communicating artery. The posterior part of the circle was completed in 48% males and 58% females. The most common variant was the bilateral posterior communicating arteries, followed by the unilateral posterior communicating artery. An entirely complete circle was found only in 45% of the entire population; and it was higher in the females than in males. The vessels diameters were smaller in the females than in the males, except for the diameter of the posterior communicating artery. Cadavers' examination revealed six cases with complete circle, 3 cases of unilateral fetal posterior communicating and one case of absent posterior communicating artery. The present study showed the amazing great variability of the anatomy of the circle of Willis in asymptomatic persons. Nevertheless, there were no marked differences between both sexes in most of the components and the mean diameters of the circle. Therefore, these anatomical variations have to be considered during radiological interpretation and would be reported in the current anatomy text to be aware of all these normal variations

experimental study of the effects of nicotine on the intervertebral disc

Clinically it had been noticed that a large proportion of patients presenting with low back pain are smokers. Therefore, in this experimental study the histological effects of nicotine on the lumbar intervertebral discs of the rabbits was investigated. Eighteen rabbits were divided equally into 3 groups, Group I [a and b]; as control. Group 2 injected intraperitoneally by 5000 ng/kg nicotine daily for 4 weeks. Group 3 injected intraperitoneally by 5000 ng/kg nicotine daily for 8 weeks. The selected dose produced blood nicotine levels equivalent to those found in heavy smokers [30 cigarettes / day]. Light and electron microscopic studies revealed that nicotine injection showed a variety of histological changes, which were not observed in the control group. This includes appearance of spaces within the nucleus pulposus and separation from the adjacent fibrous lamellae in the annulus fibrosus. Also loss of the regularity of the multilayered structure of the annulus fibrosus, and excessive inclusions associated with vacuoles which continue with the rough endoplasmic reticulum within the chondrocytes. Disc degeneration was more marked in rabbits injected with nicotine for 8 weeks [G3] than in those injected for 4 weeks [G2]. It could be concluded that the disc degeneration is more common among smokers and is correlated with the duration of exposure to nicotine

Autoimmunity and predictors of autoimmune diseases in the first degree relatives of patients with primary biliary cirrhosis

Primary biliary cirrhosis [PBC] is a chronic autoimmune disease of unknown cause that leads to destruction of intrahepatic ducts leading to ductopenia, fibrosis and ultimate biliary cirrhosis. Autoimmunity and autoimmune diseases were reported in family members of PBC patients. The aim of the present study was to investigate the prevalence of biochemical and immunological abnormalities and autoimmune diseases in first degree relatives [FDR] of patients with PBC. This study included: [1] A female [45 years old] patient diagnosed as having PBC, [2] Five FDR [3 females and 2 males] and [3] Fifteen blood donors [3 females and 12 males] were taken as a control group. Blood samples were taken from all subjects for the detection of nitric oxide [NO], transaminases [AST and ALT], alkaline phosphatase [ALP], total protein and albumin by colorimetric methods. Indirect immunofluorescent techniques were used for the detection of anti-nuclear antibodies [ANA], anti-smooth muscle antibodies [ASMA], anti-actin antibodies [AAA], anti-liver/kidney microsomes antibodies [LKM-I] and anti-mitochondrial antibodies [AMA]. Serum IgM was detected by radial immunodiffusion. Anti-SSA, anti-SSB and IgM rheumatoid factor [IgM RF] were detected by enzyme linked immunosorbent assays. Our PBC patient had a marked increase serum ALP level and a mild elevation in transminases. After treatment, serum ALP level dropped markedly [but still elevated] while the transaminases did not show a remarkable change. A marked elevation was noted in the serum levels of total globulins before and after treatment. A detectable decrease in the level of serum IgM was found after treatment. NO level of our patient was elevated [7 micro moI/L] at presentation while after treatment the level of NO returned to the normal level. AMA titer of our patient was 1/20 which considered a low titer. ANA titer was the same [1/40] before and after treatment. HCV antibodies, HBsAgs and other autoantibodies were absent before and after treatment. The titer of ASMA dropped from 1/160 to 1/40 after treatment. The pattern of these ASMA was the Vessels [V] pattern. In the FDR, the level of NO was elevated in sister-2, son-1 and the daughter. The AST ALT, ALP, total protein and albumin were normal in all subjects. Serum total globulins and IgM were elevated in sister-1, sister -2 and son-1. The ANA titer was 1/40 with a speckled pattern in all FDR. AAA, anti-SSA, anti-SSB, AMA, HBs Ag were negative in all FDR with the exception of sister-2 while had a positive anti-SSB. The ASMA were positive with the same pattern with varying titers. HCV antibodies were positive only in son-1 while was also the only FDR- to have autoantibodies to LKM-1. Sister-1 and sister-2 were diagnosed as a seropositive rheumatoid arthritis [RA] about 2 and 2.5 years after the development of PBC in our patient. The 15 blood donors showed a normal results except subjects 6 and 11 who had ASMA with a titer of 1/20 and subject 7 who had a positive ANA [titer l/40]. An autoimmune disease [RA] developed in two sisters of the PBC patient. Predictors of autoimmune diseases like elevated NO, LKM-1 and SSB antibodies are common in the FDR of a patient with PBC. Follow up of such subjects with these autoimmune predictors is recommended

Anti cyclic citrullinated peptide antibodies in IgM rheumatoid factor positive patients: a new insight

The presence of IgM rheumatoid factor [IgM RF] is one of the clinical criteria for the diagnosis of rheumatoid arthritis [RA]. The cutoff point of IgM RF assays is usually based on a reference level obtained from normal subjects in the same population as the patients. However, raising the cutoff values increases the specificity of RF testing. The present study was undertaken to investigate this observation with the help of anti cyclic citrullinated peptide [CCP] antibodies to be of potential diagnostic value. Seventy six patients were chosen with arthritis and IgM RF titers > 20 units/ml. Subsequently, patients were classified according to their IgM RF titers: patients with titers 40 units/ml [group B] and patients [selected from group B] with titers >120 units/ml [group C]. Twenty one RA patients with IgM RF negative and positive anti CCP antibodies were also included in this study. In all serum samples, IgM RF, anti CCP, hepatitis C virus antibodies [HCV], anti-Smith and anti-ribonucleoprotein [anti-RNP] antibodies were determined by ELISA. PCR analysis was performed for all patients with positive HCV antibodies. Antinuclear antibodies [ANA] and anti-dsDNA were determined by indirect immunofluorescence. In patients of groups A, B and C, RA was detected in 28.6, 80.5 and 83.3% of all patients, respectively. Anti CCP antibodies detected RA in 22.85, 75.6 and 77.8% of all patients in groups A, B and C, respectively. IgM RF positive non RA patients were diagnosed in 71.4, 19.5 and 16.7% among all patients included in group A, B and C, respectively. In group A, anti CCP antibodies correctly classified 24/25 [96%] of patients with false positive IgM RF as non RA patients, they were positive in only one patient with rhupus. Anti CCP antibodies were positive in 2.8, 4.9 and 11.1% in non RA patients among all patients in group A, B and C, respectively. Anti CCP antibodies were present in 80, 93.9 and 93.3% of RA patients in groups A, B and C, respectively. The overall presence of anti CCP in seropositive RA patients was 90.6%. Kappa statistics showed an excellent agreement between IgM RF and anti CCP for the serodiagnosis of RA. Among the non RA patients of group A, it was found that 9/25 [36%] of patients diagnosed as having HCV infection. Anti CCP antibodies were negative in all HCV patients. Low positive titers of anti CCP antibodies were more prevalent [76.2%] in patients with seronegative RA than in patients with seropositive RA [17.9%]. Results demonstrated that: [1] anti CCP antibodies correctly classified about 24/25 [96%] of patients with false positive IgM RF [< 40 units/ml] as non RA, [2] high titers of IgM RF [>120 units/ml] are of similar high specificity to anti CCP antibodies and [3] anti CCP antibodies are able to differentiate between patients with HCV infection associated with arthritis and patients with RA

Gastric endosonography in non hodgkin lymphoma

Endoscopic ultrasound [EUS] examinations are necessary to determine the intramural and gastric lesions. The aim of the present study was to evaluate the role of EUS in detection of lesions in patients with Non Hodgkin Lymphoma [NHL], whether the patients have gastric or not. We evaluated gastric lesions in 2 groups of NHL, ten patients with gastric [group A] and 10 patients without gastric symptoms [Group B]. EUS was performed with 7.5 frequency oblique probe. EUS showed normal wail layers with multiple paragastric lymph nodes with malignant criteria in five patients in group A and 3 patients in group B, signs of chronic #ion with multiple malignant paragastric lymph nodes in four patients in group A and 2 patients group B and gastric involvement with lymphoma and malignant paragastric lymph nodes in one patient both groups. No abnormal findings were detected in 4 patients in group B. In conclusion: EUS is a reliable tool for detection of gastric involvement and staging of NHL even without gastric symptoms and endoscopic findings

Echocardiographic abnormalities and anticardiolipin antibodies in Egyptian patients with systemic lupus erythematosus

Systemic lupus erythematosus [SLE] is an inflammatory disease characterized by deposition of autoantibodies and pathogenic immune complexes in cells and tissues causing lesions. Cardiac involvement in patients with SLE has been described since the early 20th century. Echo-cardiography is time main instrument for investigating the anatomical and functional involvement of the heart in the great majority of systemic diseases. Antiphospholipid syndrome is an autoimmune disease characterized by antiphospholipid antibodies and at least one clinical manifestation, the most common being venous or arterial thrombosis and recurrent fetal loss. Anticardiolipin IgG antibodies have been linked to several cardiac manifestations in patients with SLE. -to study the cardiac abnormalities in Egyptian patients with SLE, to determine its relation to other clinical features of SLE and its association with anticardiolipin antibodies [IgG]. This study involved thirty patients with SLE. Patients were classified into two groups according to having any abnormal finding on echocardiography into Echo positive patients [23 patients] and echo negative patients [7 patients]. Patients were also classified into two groups according to ACL IgG seropositivity into Group I: ACL positive patients [18 patients] and Group II. ACL negative patients [12 patients]. Group I with ACL +ve were further classified according to ACL titer of antibodies into: Group IA: with high titer [10 patients] and Group IB: with low titer [8 patients]. The study involved also a control group of 15 age and sex matched apparently healthy individuals. For each one detection of anticardiolipin antibodies IgG, transthoracic echocardiography in addition to liver and renal function tests were done. Results were subjected for statistical analysis. This study revealed that cardiac involvement in SLE is very common and it is not related to other clinical features of lupus, age, disease duration or to activity of disease. 23 patients had echocardiographic abnormalities [76.60%], 11 patients had pericardial effusion [36.60%], 1 patient had LV diastolic dysfunction [3.3%], 3 patients had LV systolic dysfunction [10%], 3 patients had Pulmonary hypertension [10%] and 16 patients had Valvular abnormalities [53.30%]. The valvular abnormalities were affecting the mitral valve in 16 patients [53.3%], aortic valve in 2 patients [6.6%] and tricuspid valve in 7 patients [23.3%]. No pulmonary valve affection was detected. Valvular involvement - especially regurgitation and thickening of the mitral valve - is the most encountered forum of heart disease in SLE followed by pericardial effusion. Comparative study between anticardiolipin positive and negative groups regarding echocardiographic abnormalities showed no statistical significance [P > 0.05]. ACL shows a tendency towards a statistical significance with MV thickening [P = 0.06]. Comparative study between patients of ACL +ve SLE patients according to titer of anticardiolipin antibodies IgG revealed statistically significant difference between both groups as regards BUN, PTT creatinine clearance, SLAM score and number of valve regurgitation in each patient [P < 0.05] as well as echo abnormalities in general [P < 0.05]. Cardiac involvement in SLE specially valvular affection followed by pericardial effusion - is very common although, clinical involvement is not very common and it is not related to other clinical features of lupus. ACL IgG antibodies play a role in the pathogenesis of the severity of cardiac affection in general and valvular lesions in particular and in time pathogenesis of lupus nephropathy

Study of the correlation between risk factors and clinical manifestations in different ischemic stroke subtypes

The aim of the present work was to identify risk factors in different ischemic stroke subtypes, namely; cortical, large subcortical and lacunar infarctions and to correlate between clinical presentation and radiological findings in each of the previous stroke subtypes. Eighty one patients were included in this study. According to computed tomography and/or magnetic resonance imaging results, the patients were subdivided into cortical, large subcortical and lacunar infarct groups. Risk factors were studied according to Stroke Risk Assessment Form. The clinical picture was studied according to Mini-Mental Scale and Canadian Neurological Scale. In cortical infarctions, atrial fibrillation and high mean platelet count were more common. In large subcortical infarctions, oral contraceptives were more commonly used. Pure lacunar infarctions were more related to positive history of hypertension, and high mean systolic blood pressure. As regards Mini-Mental Scale; orientation, registration and total score were lower among cortical infarctions. There were no statistically significant difference between the three groups as regards the Canadian Neurological Scale; mentation score, total motor score with or without comprehension deficit. There are differences between different stroke subtypes as regards clinical picture and risk factors

Quality evaluation of yoghurt collected from the local market in some governorates of Egypt

The present study was carried out to evaluate quality of yoghurt collected from the local market in Cairo, Giza, Gharbia and Minufiya governorates and to compare it with the manufactured yoghurt using Bifidobacteria bifidum [B. bifidurn] added to normal starter. Physicochemical, microbiological and organoleptic properties of all yoghurt samples were determined during 12 days storage period in a refrigerator. The results showed that yoghurt collected from Cairo and Giza markets contained less content of total solids and fat than that collected from Gharbia and Minufiya markets as compared to the manufactured yoghurt using B. bifidum. Microbiological examination revealed that the total viable bacterial count was less in yoghurt collected from Cairo and Giza markets than that collected from Gharbia and Minufiya markets. The coliform, mold and yeast count was nil or ignorable in all yoghurt samples till 6 days of storage, then these microorganisms were detected on the 9[th] and the 12[th] day of storage period. Organoleptic properties showed that the yoghurt collected from Cairo and Giza markets has higher sensory scores and more acceptable than that collected from Gharbia and Minufiya markets. The manufactured yoghurt using B. bifidum has the best quality and high degree of acceptability by consumers

Effect of feeding some herbs on serum liver enzymes, total cholesterol, triglycerides and lipoproteins in hypercholesterolemic rats

The present work was carried out to study effects of feeding hypercholesterolemic rats with 3 herbs viz.: ginger, psyllium and coriander herbs, alone and in combination, mixed with the basal diet on serum liver enzymes, total cholesterol, triglycerides [TG] and lipoproteins. This study was conducted on 50 adult male rats divided into 10 equal groups. One group was fed on the basal diet only [control -ve]. The other group was fed on the basal diet mixed with 1.5% cholesterol [control +ve]. The remaining groups were fed on the basal +1.5% cholesterol + the studied herbs at 5% and 10%. After 6 weeks feeding on the experimental diets, all rats were weighed for calculation of body weight gain and food efficiency ratio. Blood samples were collected for estimation of liver enzymes, cholesterol, TG and lipoproteins in the serum. Histopathology of liver was also carried out. The obtained results revealed that feeding hypercholesterolemic rats on diets mixed with each of these herbs, alone or in combination at 5% and 10%, improves the liver function as it lowers the elevated serum. AST and ALT enzymes. It induces also hypocholesterolemic and hypolipidmic effects. Moreover, it alleviates the histopathological changes in the liver induced by cholesterol feeding. However, it reduces daily food intake, body weight gain, food efficiency ratio and liver weight in the tested rats. It was concluded that feeding combined formula of ginger, psyllium, coriander each or combined at 5% and 10% for 6 weeks may be useful in the management of cases suffering from hypercholesterolemia associated with elevated liver enzymes

Assessment of the influence of aging on the olfactory epithelium of rabbits: light and electron microscopic study

The present work was carried out to study the olfactory epithelium of rabbits in different ages and to compare age changes in the anterior and posterior areas of the olfactory mucosa. Twelve male Balady rabbits were used and they were divided equally into three age groups, group [1] 3 month old, group [2] 12 month old and group [3] 36 month old. The animals were sacrificed and the olfactory mucosa was peeled from two fixed parts in each group. Part 1: the posterior area of the roof of the nose and Part 2; the anterior upper area of the nasal septum. In group 1, the two examined parts of the olfactory mucosa were similar. The olfactory mucosa was composed of olfactory epithelium resting on a thin basal lamina and lamina propria that was characterized by the presence of Bowman's glands. The olfactory epithelium was composed of olfactory receptor neurons, supporting cells, microvillar cells that occupied the upper and the middle zones of the epithelium and basal cells in the basal zone of the epithelium. In group2, some degenerative changes were encountered in the olfactory epithelium of the two parts, but the anterior part was more affected than the posterior part. In the posterior part, the thickness of the epithelium and the cell population appeared within normal. However, in the anterior part, the thickness of the epithelium and the cell population demonstrated significant decrease. In group3, there were more degenerative changes than those of group 2. The olfactory mucosa from both parts suffered equally from severe degeneration. The most striking feature was replacement of wide areas of the olfactory epithelium with respiratory epithelium. Other areas showed many degenerated cells with significant reduction in the thickness of the epithelium. The presence of Bowman's glands was still characteristic to the olfactory epithelium. From the present study, it could be concluded that the olfactory epithelium was subjected to natural degenerative changes, which increased steadily with age. These changes began firstly in the anterior exposed areas of the epithelium and with the progress of age both areas were equally affected