CCR1 and CCR5 expressions on peripheral blood mononuclear cells from patients with liver cirrhosis and hepatocelluar carcinoma

Chemokine receptors [CCR1 and CCR5], have been implicated in hepatic inflammation and hepatocellular carcinoma [HCC]. The present study aimed to investigate the expressions of CCR1, CCR5 on peripheral blood mononuclear cells [PBMCs] of Egyptian patients with liver cirrhosis [LC] and HCC and their correlation to the severity of liver disease and the clinical features of HCC. Isolated PBMCs from 25 patients with HCC, 10 LC patients and 9 adult healthy controls were stained with monoclonal antibodies against CD4, CD8, CCR1 and CCR5, then detected by using a flow cytometry technique. Patients were diagnosed by abdominal ultrasound [US] and computed tomography [CT] scan findings, biochemical liver function tests, serum alpha-fetoprotein [AFP]. Our data revealed that CCR1 and CCR5 expressions in liver cirrhosis patients were significantly higher than healthy controls [P=0.008 and 0.053 respectively], as well as in HCC patients but the increment were not significant [P= 0.120 and 0.216 respectively]. The expressions of CCR1 and CCR5 were increased in liver cirrhosis than in HCC patients, but the increment were not significant [P=0.120 and 0.216 respectively]. However, both CCR1 and CCR5 were decreased with increasing number of liver tumor in a negative linear regression correlation. Patients with liver cirrhosis or HCC showed lower CD4 and CD8 T cells count compared with healthy controls. In Conclusion The up-regulations of CCR1 and CCR5 in patients with hepatic cirrhosis confirmed the activation of the CC chemokine system in human fibrogenesis and may play a role in recruitment of lymphocytes to the injured liver

Efficacy of some drugs and pathological studies on toxoplasma gondii infection in mice

The present investigation was conducted to study the effect of infection with Toxoplasma gondii and the efficacy of azithromycin and garlic tablets on treatment of acute murine toxoplasmosis in addition to study the histopathojogical changes due to infection. For this purpose, sixty Albino mice were used as experimental animals that equally divided into 6 groups. Estimation of survival rate, pathological studies, bioassay trial and immunofluorescent study were performed for each group of mice. High efficacy of azithromycin at a dose of 250 mg/kg/day on infected mice was shown, that increased survival rate [90% at the 7th day PI] and decreased the histopathological changes when compared with control groups. Garlic tablets at a dose of 500 mg/kg/day showed fewer efficacies in infected mice, survival rate [40% at the 6th and 7th day P.1] which was lesser than those groups treated with azithromycin Pathologically, group treated with azithromycin showed improvement in histological pictures compared with group treated with garlic. To identify the efficacy of the drug, at the end of the experiment subinoculation of healthy mice by visceral and brain suspensions from surviving mice treated with azithromycin or garlic was performed as compared with subinoculation of suspension of brain and visceral of infected non treated mice inoculated into healthy mice, that showed death of these mice after three days post-infection [survival rate 0%]. It was concluded that azithromycin has a significant effect in treatment of murine model toxoplasmosis, but it did not eradicate the parasite completely as few cysts remained in the brain, while garlic tablets had a limited effect for treating toxoplasmosis

Genetic heterogeneity in spondylo-epi-metaphyseal dysplasias: a clinical and radiological study

Spondylo-epi-metaphyseal dysplasias [SEMD] are a heterogeneous group of skeletal disorders characterized by defective growth and modeling of the spine and long bones. Different types are described in the literature. Accurate classification of SEMDs is essential for proper genetic counseling. This study included 20 cases of SEMDs diagnosed by clinical and radiological findings. Cases were classified based on additional associated clinical and/or radiological features into 7 subtypes. Different subtypes were discussed with review of the literature. The study illustrated the heterogeneity of SEMDs and emphasized the importance of detailed and meticulous clinical genetic and biochemical evaluation in addition to comprehensive radiological investigations for such group of disorders. It also recommends further molecular studies to identify the molecular bases of the different types

Effects of sphere size, polymer to drug ratio and plasticizer concentration on the release of theophylline from ethylcellulose microspheres

Theophylline sustained release microspheres were prepared by applying the non-solvent addition method. The in-vitro release of the drug from the prepared microspheres of different size ranges [

effect of propofol versus sevoflurane based anaesthesia on the electrically evoked stapedius reflex during cochlear implant surgery in paediatrics [comparative study]

Cochlear implantation is a widely used mean of treatment in deafness and severe hearing disorders in adults, children, and infants. Postoperative fitting of the externally worn speech processor is very important for successful use of the cochlear implant. In young children, this fitting process can be difficult because of limited communication capabilities. Investigators have used electrically evoked stapedius reflex threshold [ESRT] to predict maximum comfortable loudness [MCL]. During surgery the drugs used for general anaesthesia influence the values of the stapedius reflex. This study aims to compare two anesthetic regimens that can be used during cochlear implant surgery with the least effect on the evoked stapedius reflex threshold. This prospective r and om controlled study was done on 20 patients [n=20] ASA physical status I-II, scheduled for cochlear implant surgery. According to the maintenance agent patients were allocated randomly into two equal groups, each group is 10 patients. The propofol group [group Prop.], in which patients were maintained using propofol infusion [6mg.kg[1] hr[-1]]. The other group was maintained using sevoflurane [group Sevo.] at a concentration of 2%. Intra operative stapedius reflex testing was performed after implantation of prosthesis. The stimuli were generated by the nucleus diagnostic programming interface and reflex threshold was determined by observing the contraction of stapedius muscle. Two months later the MCL value was determined The mean amplitude of electric current [in mAm] used for induction of ESRT was significantly lower in the group Prop, than that required to induce the reflex in group Sevo. Regarding the ability of the electrically elicited stapedius reflex thresholds obtained under anaesthesia to predict the MCL in the post-operative setting. It was found that this was achievable in the propofol group and not sevoflurane. Compared to sevoflurane propofol has less inhibitory effect on the ESRT. The reflex threshold obtained under the effect of propofol can serve as a guide for postoperative MCL. This was not the case while using sevoflurane.

Genetic and anthropometric studies of Prader-Willi syndrome

This study included 26 Prader-Willi syndrome [PWS] cases. Full clinical examination, pedigree analysis and intelligent quotient [IQ]were carried out. Fifteen anthropometric parameters, including longitudinal and transverse body and head measurements as well as two derived indices, were taken. Cytogenetic studies using G-banding and high resolution techniques were performed. According to chromosomal profile, the cases were divided into three groups: Cases with 15q deletions, cases with normal chromosomes and cases with chromosome 15 rearrangements. The study showed that the most characteristic anthropometric finding of PWS was truncal obesity and the variability in chromosomal pattern had no marked influence on the anthropometric findings. The cytogenetic results suggested that PWS is due to chromosome 15 imbalance

new sonographic angle to predict developmental hip dysplasia

Ultrasonography has filled the imaging gap for hip dysplasia in infants. It became an essential part of neonatal hip screening in several countries. However, it did not prevent the appearance of late cases of developmental dysplasia of the hip [DDH]. I have examined 28 infants clinically and sonographically at an average age of 29.7 days. Examination was repeated after 3 months. All the cases were assessed in the standard plane of Graf to measure alpha angle, beta angle and a new acetabular angle. The relationship between the new angle and alpha angle was statistically significant with a correlation coefficient 0.524 [P < 0.05]. This angle records the direction of the whole acetabulum [bony and cartilaginous] and detects the earliest dysplastic changes

In-vitro and in-vivo evaluation of commercial and microencapsulated sustained release tablets containing diclofenac sodium

Diclofenac sodium microcapsules were prepared using the phase separation technique induced by non-solvent addition. Ethl1cellulose and Eudragit RS100 were used as well forming materials in two core: wall ratios [1: 1 and 1: 2]. The prepared microcapsules were compressed into tablets without excipients. The influence of tableting type of wall forming material and the core: wall ratio on the release pattern of the drug from microcapsules were determined in Ph 1.2 and pH 6.8. compression of the microcapsules significantly [p < 0.05] decreased the rate of drug release due to the reduction of the surface area. Less than 2.0% of the drug was released in 0.1N HC1 during the first two hours of dissolution from microcapsules before and after tableting. On the other hand, the dissolution results of the tableted ethy1cellulose microcapsules with 1:1 and 1:2 core: wall ratios showed that 88.6 and 70.6% of the drug were released to the phosphate buffer solution, while only 45.0 and 24.4% of the drug in the tableted eudragit microcapsules was released within 8 h of dissolution. The tableted ethy1cellulose microcapsules with 1:2 core: wall ratio showed almost identical release of the drug as that from commercial tablets therefore, it was chosen for bioavailability study in six beagle dogs. The in-vivo data showed that the tableted microcapsules gave bioavailability of 87.5% relative to that of the commercial voltaren retard tablets. The prepared tablets show that it is possible to use ethy1cellulose microcapsules to prepare tablets that are pharmaceutically and biologically equivalent to those of the commercially available voltaren retard tablets

Effect of deoxycholic acid, polycarbophil or both on the relative hyperglycemia of rectal insulin suppositories containing sodium salicylate in diabetic rabbits

The effect of insulin [50 u] suppositories containing sodium salicylate [50 mg] without and with 50 mg of either polycarbophil, deoxycholic acid or 50 mg of each on plasma glucose levels of hyperglycemic rabbits was studied. The hypoglycemia of these formulations was determined relative to that produced after s.c. injection of insulin suspension and were 45.6%, 46.7%, 48.2% and 39.5% respectively. Insulin suppositories containing sodium salicylate were effective in reducing plasma glucose levels which steadily decreased and reached 66% of the initial values by the 3rd h.the addition of polycarbophil to insulin suppositories containing sodium salicylate induced faster and higher rate of insulin absorption as indicated by the shorter Tmax and higher Cmax. addition of deoxycholic acid increased non significantly the Tmax MRT, AUC0-7 h of that of insulin suppositories containing sodium salicylate. The incorporation of both polycarbophil and deoxycholic acid in insulin suppositories containing sodium salicylate is not recommended as these additives reduced the Cmax and AUC0-7 h. accordingly, insulin suppositories containing sodium salicylate with and without the addition of polycarbophil or deoxycholic acid may be considered as a good alternative to insulin injection

treatment of infected non union of the tibia by compression distraction techniques using Ilizarov external fixator

The application of ilizarov techniques to diaphyseal infected non unions is very encouraging. It may prove to be an excellent technique for future management of resistant diaphyseal infections of bone. Circular external fixation using the Ilizarov apparatus combined with compression-distraction techniques were used to treat eleven patients with infected non union of the tibia. There were 8 males and 3 females with an average age of 27 years [range 17-51 years]. The average number of previous failed surgical attempts at union was two per patients [range one to four]. of the eleven patients there were 8 with chronic tibial defects; one with normal extremity length; 5 with shortening associated with bone fragment contact and two With bone loss in excess of the amount of shortening. There were three infected non union without shortening treated with complete resection of the non union site and conversion of the diaphysis into a segmental defect. In eleven patients, the infected extremities healed without the addition of a cancellous graft, microvascularfibular or soft tissue grafting. The average length of regenerate gain was 3.7 cm [range 1.5 to 4.9 cm]. Postoperative antibiotics were administered in. 3 out of the eleven patients for 10 days after en block resection of the diaphyseal sequestrae. Functional results were excellent in 5, [45.45%] good in 3, [2 7.2 7%] fair in 2 [18.18%] and poor in only one patient [9.10%] There were no additional bone grafting procedures, microvascular bone transplants, or other grafting techniques used in any patient

Pathological, immunopathological and virological findings in a field outbreak of mixed infection by bovine oiarrhea [BVD] and foot and mouth disease [FMD] in cattle and buffaloes

This study deals with the macroscopic, microscopic pathology, associated with the immunopathological and virological diagnosis of these field outbreaks. The results showed that the viruses caused variable degrees of erosions and ulceration throughout the different parts of upper and lower digestive tract. Also, hepatitis, bronchopneumonia, trachietis, glomerulonephritis and severe mycoarditis were seen. These pathological lesions were illustrated and fully discussed. Vesicular fluid and the suspensions prepared from vesicular epithelium of diseased animals were used as antigen in complement fixation test against antisera to each of the seven types of FMD virus. It was showed that the virus was 0 serotype. By application of agar gel immunodiffusion test, the thyroid and mesenteric lymph nodes gave clear precipitating b and s against the st and ard BVD antiserum. Results of the immunofluorescence showed that samples which gave positive AGID test gave strong specific fluorescent reaction. The previously mentioned results were confirmed by applying immunoperoxidase test on the tissue against FMD type 0 antiserum and BVD antiserum. The immunoperoxidase reaction revealed dense brown precipitate in the cells lining the tongue, intestine, rumen, liver, kidney, spleen and lymph nodes, against BVD and FMD viruses

Localization of non palpable breast lesions

Eighty patients underwent localization for non-palpable breast lesions. The indication for performing a localizing procedure before the excision biopsy were suspicious or grouped microcalcifications, stellate shadows with or without microcalcifications, rounded opacities larger than 1 cm of distorted breast parenchyma. The highest incidence of malignancy was found in patients with grouped microcalcifications. The procedure for localization of a non-palpable breast lesion is well-described and the various localizing needles were far also described. The advantages and disadvantages of the different needles were discussed. The only complication was a vasovagal attack which was of no clinical significance

Formulation and evaluation of sustained resase indomethacin suppositories

The release rate of indomethacin [Ind.] from suppositories formulated with sustained release [SR] granules of drug: polymer: aerosil of different ratios was studied. The release from polyethylene glycol suppositories containing different polycarbophil concentrations was also investigated. The effect of some formulation variables, e.g. aerosil content and molecular weight [MW] of polyethylene glycol, has been evaluated. The major controlling factor appeared to be the drug: polymer ratio for the release from polyvinylacetate [PVAc] and hydroxypropylmethylcellulose [HMPC] polymers. The decrease in aerosil content in SR granules resulted in a decrease in the release rate. As the MW of PEG increased, the release rate decreased. For suppositories containing 5, 10 and 20% of polycarbophil [PC], indomethacin release decreased as PC content increased. The results indicated that these suppositories had a better controlled release of indomethacin than those formulated with either PVAc or HPMC. Different scanning calorimetry [DSC] thermograms showed an interaction between PC and PEG, and also between PEG and indomethacin

Hospitalized patient's perception of comfort and safety measures in hospital environment

The study was done to determine hospitalized patients perception of hospitals environment in relation to safety and comfort and to identify the most common hazards occurring in Alexandria University Hospitals. It was carried out on sample of 135 patients at university hospitals of Alexandria [El Amery, El Shatby Maternity and El shatby Pediatric Hospitals]. A questionnaire about safety and comfort was used. The results were analyzed using number, percent and Z-test was used to determine the significance of the results. The findings revealed inadequate hospital environment as it was unsafe and uncomfortable wound infection, skin infection, loss of appetite, constipation, falling from bed and anxiety were the most common hazards for patients among the three hospitals. In-service education of nurses related to hospital hazards and appropriate methods of control was recommended

effect of planned patients' health teaching on enhancing wound healing and preventing post-operative wound complications

The study was conducted at the Main Alexandria University Hospital. The sample comprised 60 adult patients who had elective major abdominal surgery, to determine the effect of planned patient's health teaching on enhancing wound healing. The sample was divided equally into control and experimental groups. The experimental group received the planned health teaching. Three sheets were utilized for data collection and included: demographic data sheet, sheet including items of the planned teaching and the third one was concerned with wound follow-up "t" test was used to test the significance at 1% level. The study proved that preoperative planned instructions about measures the patient should perform postoperatively could enhance wound healing and reduce postoperative complications. It was recommended that nurses must incorporate these instructions into their teaching plan for surgical patients

need for continuing professional education for nurses

There is an obvious need of post basic education for nurses If high standard of nursing care is to be maintained. The aim of this study was to determine the degree of nurses awareness toward the need to continue their education beyond their initial years of training. The study was conducted at the Main University Hospital in Alexandria on 100 nurses worked in different hospital departments. Nugent questionnaire [1990] was translated into Arabic and used. The results concluded that, their was a significant positive responses in relation to the need for continuing education regardless of their qualifications. There was significant positive attitude among those who were young,-those with less experience and those who had inservice training. Also the results revealed lack of nurses knowledge about the meaning of continuing education

effect of particle size and concentration of polycarbophil on its physical properties and the pharmaceutical characteristics of prepared indomethacin tablets

The effect of varying the concentration of polycarbophil and particle size on its physical characteristics viz swelling, flowability and compressibility was investigated. The effect of using polycarbophil, in different concentrations of varying particle sizes, on the characteristics of indomethacin tablets prepared by direct compression was also studied. The swelling of polycarbophil increased as its particle size increased from <0.063 to 1 mm. The particles having particle size range 0.5-0.8, 0.8-1.0 and >1 mm showed excellent flowability. The amount of indomethacin released was found to decrease as the polycarbophil concentration and the particle size increase. The effect of polycarbophil particle size on the dissolution of indomethacin was more pronounced at 5% concentration. 20% polycarbophil, of particle size 0.18-0.8 mm, could be a useful additive in tablet formulation as disintegrant to its bioadhesive character