Rapid rituximab infusion: local center experience

Rituximab, a chimeric monoclonal antibody [MoAb] targeting CD20 has been widely used in the management of B-cell lympho-proliferative disorders.[1-3] The usual recommended schedule of regular administration over 3 to 4 hours requires considerable healthcare resources and oftentimes inconvenient for patients. Literature shows the availability of published reports proving the safety and feasibility of rapid infusion of rituximab. This study explored the safety and tolerability of rituximab infusion over a shorter total infusion time. A total of 24 patients diagnosed with CD20+ Non-Hodgkin's lymphoma and planned to receive rituximab at a dose of 375mg/m2 in combination with standard chemotherapy regimens were included in the study from January 2009 to December 2009. The administration of first rituximab dose was unaltered and given as per standard practice of 3-4 hours infusion. The second and subsequent doses were delivered over a total infusion time of only 90 minutes [20% of dose in the first 30 minutes, remaining 80% over the next 60 minutes]. These patients, aged between 15 and 79 years, received a total of 152 rituximab infusions with an average of 6.33 [ +/- 2.37] infusions per patient. Grade 1 infusion related toxicity was reported in 5 infusions [3.2%], and there were no acute reactions or G3/4 toxicity in any infusion episode. A rapid infusion of rituximab is well tolerated, feasible and safe when administered as second and subsequent infusions in the course of therapy for those who tolerate the first dose without significant infusion related toxicity. This shortened infusion method results in a substantial reduction in resource utilization. Our institution has now adopted this as a routine practice

Modulating effect of peppermint and eucalyptus oils in infectious bursal disease immunocompromised chickens

The immunomodulatory effect of peppermint and eucalyptus essential oils in broiler chickens immunoconmpromised by either infection or vaccination with infectious bursal disease virus [IBDV] was investigated. No significant difference in HI titers was observed in volatile oils treated group over their untreated one at any interval. However, the protection percentage reached 35% in treated group and was 25% in untreated one as Compared with 0% in unvaccinated control group when challenged with velogenic viscerotropic Newcastle disease virus [vvNDV]. Significant increase in Bursa / body weight ratios was observed between IBDV vaccinated treated group as compared with untreated one at 3 and 10 days post-vaccination [PV]. In addition, significant increase was observed between IBDV infected treated birds versus infected untreated group at 3 days Post-infection [PI]. These findings indicate that treatment with volatile oil ameliorated the immunocompromised effects of IBDV vaccine or infection on immune system of treated birds. The positive effect of volatile oils on cell mediated immunity of treated birds revealed significant increase in phagocytic%, lysozyme and nitric oxide activities at 14 and 28 days of age in IBDV vaccinated and treated birds as compared with IBDV vaccinated and untreated birds. Moreover; the phagocytic index was higher in IBDV infected and treated birds over non treated ones at 42 days of age. Histomorphological examination of the major immune organs clarified lymphocytic necrosis and depletion, hyperplasia of reticuloendothelial cells, vacuolations of lymphoid follicles, interfollicular lyinphocytic cells infiltration and interfollicular connective tissue proliferation of bursa of Fabricius [B,F]. Lymphocytic depletion and hyperplasia of reticular cells of spleen. Lymphocytic necrosis, depletion, focal hemorrhage of thymus glands. Necrosis and depletion of caecal tonsils. The sum lesion scores were 0, 0, 2 and 1, 1, 5 in volatile oils treated and untreated chickens at 3, 7 and 10 days PV respectively. While the sum lesion scores reached 21, 23, 14 and 21, 23, 20 in volatile oils treated and untreated chickens at 3, 7 and 10 days PI respectively. On the other hand there was lymphoblast activation reached 1 score in BF in volatile oils treated group only at 3 and 7 days PV. No histopathological changes all over the experimental period could be detected in blank control group. In conclusion our study reveals that eucalyptus and peppermint oils have a potent immunomodulatory effects and are able to evoke the immune response in IBDV vaccinated or infected chickens

Effect of wheat germ oil and ascorbic acid supplementation on the immune response of broiler chicks to ND vaccines

In the present study, the effect of wheat germ oil as source of vitamin E and ascorbic acid as source of vitamin C on the immune response of broiler chicks to ND vaccine was determined. Four groups of chicks were used. Group 1 was vaccinated with 2 doses of ND vaccines [Hitchner then Lasota] and simultaneously supplemented with wheat germ oil via oral administration for 15 days. Group 2 was vaccinated with 2 doses of live ND vaccines [Hitchner then Lasota strains] and simultaneously supplemented with ascorbic acid via oral administration for 15 days. Group 3 was vaccinated with 2 doses of ND vaccines [Hitchner then Lasota strains]. Group 4 was kept non-vaccinated as control chicks. All birds were monitored weekly for the humeral and cellular immune response then challenged with the virulent NDV at 35 days of age. HI test for titration of antibodies for NDV, phagocytic activity, Nitric oxide, Lysozyme activity and total antioxidant in serum were used to determine the immune response of the chicks. Protective immunity induced in the vaccinated groups was varied. 80 and 60% protection were obtained in chicks vaccinated and supplemented with wheat germ [group 1] and ascorbic acid [group 2]; respectively. Live ND vaccinated group showed 60% protection. The present study reports the effect of supplementation of wheat germ [vitamin E] as immunostimulant in augmentation of the immune response ND vaccines

Protective immunity induced by co-injection of mixture of Mannan and B-glucan immunostimulant substances with the inactivated Bivalent Al-ND vaccine in broiler chickens

In the present study, the effect of a mixture of some immunostimulant substances on the immune response of broiler chicks to bivalent Al-ND vaccine was determined. Four groups of chicks were used. Group .1 was vaccinated with one dose of Al-ND vaccine and simultaneously injected with the mixture of immunostimulant substances. Group 2 was vaccinated with one dose of the bivalent AI.-ND vaccine. Group 3 was vaccinated with 2 doses of live ND vaccines [Hitchner then Lasota drains] and group 4 was kept none vaccinated control chicb. All birds were monitored weekly for the humoral and cellular immune response then challenged with the virulent NDV at 35 days of age. HI test was used for titration of antibodies for both AIV and NDV, phagocytic activity, Nitric oxide; Lysozyme activity and total antioxidant in serum were used to determine the cellular immune response of the chicks. Protective immunity induced in the vaccinated groups varied. The injected immunostimulant mixture demonstrates its effect on the immune response to the bivalent Al-ND vaccine in group 1 with 100% protection against the challenge NDV. Whereas, 80 and 60% protection were obtained in chicks vaccinated either. with Al-ND vaccine [group 2] or live ND vaccines [group 3]; respectively. The present study reports the effect of injection of some immunostimulant substances in augmentation of the immune response to the inactivated vaccines

one pot regioselective synthesis of new functionalized derivatives of [1, 2, 4] triazolo

Reaction of S-cyano-6-aryl-2-thiouracil 1A-C or its methylthio derivatives 2A-C with hydrazonoyl chlorides 3a-h led to the formation of 7-atyl-6-cyano-1, 2, 4-triazolo [4, 3-alpha] pyrimidin-5 [1H]-one derivatives 8. The mechanism and the regioselectivity of the studied reactions were discussed with the help of the given X-ray crystallographic data

Influence of the probiotic pediococcus acidilactici on chromosomal aberrations, clinicopathological alterations and immunological changes in aflatoxicated rabbits

The present work was carried out to evaluate the effectiveness of the probiotic Pediococcus acidilactici in alleviating the toxicity of aflatoxin B[1] [AFB[1]] in male New-Zealand white rabbits. Twenty four male New Zealand white rabbits, 800-1000 g body weight were used in the present work. Rabbits were randomly divided into four equal groups: Group [1] served as a control group. Group [2] was fed on crushed pellet diet mixed with the probiotic Pediococcus acidilactici at a dose of l00g/ton feed for six successive weeks. Group [3] was fed on crushed pellet diet artificially contaminated with 60 ug of AFB[1]/kg of diet for six successive weeks while Group [4] was fed on crushed pellet diet mixed with the probiotic Pediococcus acidilactici [the same dose mentioned in G2] and artificially contaminated with 60 ug of AFB[1]/kg of diet for six successive weeks. Evaluations were made for chromosomal aberrations, hemato-biochemical parameters, immunological changes as well as histopathological alterations. Our results showed that AFB[1] possesses a mutagenic effect. It significantly increases the frequency of chromosomal aberrations. AFB[1]induced significant decrease in the total leukocytic count associated with lympopenia. Serum biochemical analysis revealed significant elevation in ALT, AST, GGT activities and BUN concentration with a marked decline in total proteins, albumin and globulins concentration. Significant decrease was recorded in the phagocytic percent and phagocytic index of neutrophils of aflatoxicated rabbits. Supplementation of the probiotic Pediococcus acidilactici to the aflatoxicated diet inhibited the mutagenic effect of AFB[1] as it significantly decreased the frequency of chromosonial aberrations. Furthermore, Pediococcus acidilactic improved the hemato-biochemical alterations and nullified the phagocytic percent and phagocytic index of neutrophils of aflatoxicateci rabbits

Efficacy of some herbal preparations as hepatoprotective agents

In folk medicine, there are many herbal preparations used for their hepatoprotective activities. One of the most common recipes consists of equal parts [w/w] of decoction of [10% concentration]: Peumus boldus [leaves], Cichorium intybus [root] and Nigella sativa [seed] [Recipe 1]. Glycyrrhiza labell rhizome [root] replaced Cichorium intybus in [Recipe 2] or added to the Recipe 2 to form [Recipe 3]. Three groups of normal albino rats were orally administered 1.5 ml / 100 g of Recipe 1 [group 1], Recipe 2 [group 2] or Recipe 3 [group3] and the control group [group 4] was given 1.5 ml/ 100 g distilled water daily for 30 successive days. Results for normal groups of rats revealed that Recipe 1, Recipe 2 and Recipe 3 decreased plasma gamma-glutamyl transferase [GGT]: by -6.1, -26.7, -31.5%; ALT: by-3.8,-13.2, 17.6%; AST: by-5.9,-6.8-21.5%; triglycerides: by 1.8, 0, -13%; cholesterol: by -2.4, -1.2, -1.9% and, increased sleeping time: by 0.5, 1.4 and -0.9%, respectively, vs. control values. Second set of experiments, three groups of carbon tetrachloride-hepatic damaged rats were given the three recipes in the same above mentioned oral doses 2 weeks before carbon tetrachloride and continued for another 2 weeks after induction of the hepatic damage. A fourth group received CC14 for 4 weeks and served as control. The results indicated that there were significant decreases in GGT: [-70, -74.5, -82.0%]; ALT: [-30.1, -36.8, - 49.0%]; AST: [-9.9, -33.3, -43.8%]; triglycerides: [-11.8, -10.5, -17.0%]; cholesterol: [-17.4, -16.4, -24.4%] and sleeping time: [-24.0, -25.1, -37.9%], respectively, vs. carbon tetrachloride-hepatic damaged rats. Histopatholgical study revealed that the three recipes exhibited greater hepatoprotective effects in CCl[4]-induced liver injury by preventing development of hepatic lesions, including liver centrilobular inflammation, cell necrosis, fatty change, ballooning degeneration as compared to the 4[th] control group CCl[4]- intoxication. Also there was an improvement of hepatocytes- DNA contents. The modified recipe 3 was found to be more potent than recipe 1 or 2

Chemical modification of some cellulosic wastes for increasing their efficiencies as ion exchangers

The affinity of some agricultural wastes, e.g. sunflower stalks, cotton stalks and rice straw toward metal ions uptake is investigated. The effect of chemical modifications, e.g. phosphorylation, sulfonation and phosphosulfonation of these wastes on their efficiency as cation exchangers is also studied. Different variables which affect these chemical modifications, e.g. particle size of residues, quantity of pyridine in reaction medium and percent of chlorosulfonic in the used acid for chemical modification are also evaluated. The prepared cation exchanger from phosphosulfonated of alkali treated sunflower stalks [particle size 125micro m] in presence of pyridine [30 ml] and acids mixture [30% cholorosulfonic acid and 70% phosphorus oxychloride] has the highest efficiency towards metal ions uptake. Modified and nonmodified sunflower stalks have higher efficiency toward metal ions uptake than cotton stalks and rice straw. Infrared spectra of sunflower phosphorylated, sulfonated and phosphosulfonated sunflower stalks are also investigated. New bands at 1200 and 965 cm[-1] and at 1400 cm[-1] are characteristic to C-O-P and C-O-S, respectively. The fragments that obtained from mass spectra are characteristic of six carbon sugar mono ester which produces copious hydroxymethyl furfural group

Phenylthiourea derivatives as organic stabilizer for polystyrene against photodegradation

N-phenylthiourea derivatives have been prepared and investigated as photostabilizers for polystyrene by measuring the extent of weight loss [%], the amount of formed gel as well as the average molecular weights of the soluble fractions [M[v]] of the degraded polymers. The results indicated a reasonable stabilizing effect of these derivatives compared with phenyl salicylate UV-absorber. A synergistic effect is achieved when the investigated stabilizers are mixed with the phenyl salicylate in a weight ratio of 25% of the thiourea derivative and 75% of the reference stabilizer. A probable radical mechanism is proposed to account for the stabilizing action of the organic investigated materials

Photochemical synthesis and antimicrobial activities of 1 -phenyl-3-[2-thienyl]-pyrazoline derivatives

Irradiation of 2-phenyl-5-[2-thienyi]-tetrazole 1 with acrylate derivatives 2A-E [molar ratio 1:1] in anhydrous benzene gave the corresponding title compounds 1-phenyl-3-[2-thienyl]-pyrazoline derivatives 4A-E as end products. The mechanism and the regiochemistry of the studied reactions are discussed

Blunt abdominal trauma: conservative Vs surgical management

Blunt trauma to the abdomen is by far the most common mechanism of injury Possible investigative modalities include; Diagnostic peritoneal lavage [DPL], Focused Abdominal Sonography For Trauma [FAST], computed tomography [CT] scanning and laparoscopy. There is an increasing volume of data supporting the non-operative management of adult patients with solid organ injury from blunt abdominal trauma. Comparative study of conservative versus operative management for blunt abdominal trauma and assessment of the value of preoperative investigations in decision-making. This study included 50 patients with the clinical diagnosis of blunt abdominal trauma, admitted from October 2002 to July 2003. Haemodynamic stability of the patient is the key determinant for the choice of the appropriate investigation or management of solid organ injuries following blunt abdominal trauma. Unstable patients with positive DPL require laparotomy, while in haemodynamically stable patients; CT is the investigation of choice. Nowadays, conservative treatment in a circulatory-stable multiply injured patient is the standard modality of treatment

Effect of black seed oil on rabbits infected with some intestinal eimeria species

Black seed [Nigella sativa] is a herb used on large scale in veterinary practice for many purposes. The protective effect of black seed oil was studied on rabbits experimentally infected with some field strains of intestinal Eimeria species. For this purpose, 30 New-Zealand rabbits, 28 days old were divided into 6 groups. Group [1] was used as prophylactic, given N. sativa oil at a dose of 2.5 ml/ kg body weight orally for 3 weeks daily, then challenged with 6 x 104 Eimeria oocysts. Group [2] was treated with sulphadimidine 33% after being infected. Group [3] was treated as group [2], in addition to N.sativa oil for 2 weeks. Group [4] was as infected control one, while group [5]] was given N. sativa oil only. Group [6] was non infected and non treated. The results revealed a significant decrease of Eimeria oocysts in faeces of both prophylactic and treated groups. However, there were increase in phago-cytic activities of neutrophils expressed in phago-cytic percent and phagocytic index. Furthermore, N. sativa oil improved body weight gain and increased serum total protein, albumin and Albumin /Globulin ratio in treated rabbits. So, it was concluded that, N. saliva seeds which is cheap local plant, can be used as immune enhancing factor and growth stimulant in ration of animal

Laparoscopic diagnosis of contralateral patent processus vaginalis through the surgically opened sac in children with unilateral inguinal hernia

For more than two decades, the controversy has persisted as to what is to be done to the opposite side of an infant or child who has evidence of a unilateral inguinal hernia. Various methods have been advised for identifying the contralateral patent processus. Discussions on the subject intensified in recent years because of the use of laparoscopy to show the presence of a clinically undetectable contralateral hernia. Chu et al in 1993 and Groner et al in 1995 used a modified procedure in which the Laparoscope was introduced into the peritoneal cavity via the hernial sac to avoid a puncture wound. A random group of 53 patients with unilateral inguinal hernia in infants and children were studied to detect the presence of a patent processus vaginalis on the opposite side. The hernial sac was opened, and diagnostic laparoscopy was performed through the known hernia sac with C02 insufflation to 10 mm Hg. A 5 mm 30° telescope was used to inspect the contralateral inguinal region. A patent processus was diagnosed when an obvious opening through the internal ring was identified or if bubbles were seen on external manipulation of the scrotum and internal ring. Contralateral conventional exploration was then done in all cases of this series to confirm or disprove the findings of the laparoscope. Positive CPPV was diagnosed by laparoscopic exploration in 16 cases constituting 30.2%. On surgical exploration, 17 cases of CPPV were detected with an incidence of 32.1% CPPV. One patient with positive test proved to be negative on surgical exploration. Also two patients with negative tests proved to have CPPV on surgical exploration. It is worth mentioning that these three cases were early in the series. This constitutes a good degree of agreement between the two procedures with reasonable sensitivity [88.2%] and high specificity [97.2%] and total accuracy of laparoscopic diagnosis 94.3%. Laparoscopic evaluation of a contralateral patent processus vaginalis through the surgically opened sac in children with unilateral inguinal hernia is a safe and accurate procedure. This method helps avoid any unnecessary contralateral inguinal exploration. It can be performed without any complications

Screening of some pharmacological properties of Origanum majorana growing in Egypt

In the present study, hydroalcoholic extract of the aerial parts of Origanum majorana was prepared. Two oral dose levels [100 and 200 mg/Kg] were evaluated for the analgesic activity [using the hot plate test], the anti-inflammatory effect [using carrageenan-induced paw oedema test] and the antipyretic activity [on yeast-induced hyperthermia] in albino rats. Results revealed that in the hot plate test, O. majorana extract exerted a highly significant analgesic effect in a dose dependant manner similar to that obtained by paracetamol. The extract also reduced paw-oedema caused by carrageenan, this result was more obvious in rats treated with 200 mg/Kg. The tested extract in the two doses used exerted an antipyretic effect after 30 min of administration. More interesting results were observed in the group treated with 200 mg/Kg, in which their temperature was reduced significantly more than in paracetamol-treated group during 1 -2 hr post-drug administration. O. majorana extract also exerted a hepatoprotective effect in carbon tetrachloride liver -damaged rats. Both doses [100 and 200 mg /Kg] significantly reduced the elevated values of liver function tests [GGT, ALT and AST], triglycerides [TGs], and cholesterol. Kidney function tests [creatinine and urea] were also decreased significantly. O. majorana had an immuno-stimulating property, as it increased IgG levels in normal and liver damaged rats. It is concluded that Origanum majorana had many pharmacological activities including a novel immunostimulant effect, which warrants further detailed investigations

Assessment of propertide of type III procollagen in chronic liver diseases

Sixty-three hepatic patients [38 males and 25 females] with ages ranging between 25-75 years [mean 48.49 +/- 1.72] were included in this study. For comparison, 20 healthy age and sex matched volunteers were taken as controls. Patients with chronic liver diseases including hepatic cirrhosis [23 patients], bilharzial hepatic fibrosis [10 patients], hepatic malignancy [15 patients] and chronic viral hepatitis C [15 patients] were included in this study. All patients and healthy subjects were thoroughly clinically examined. Fasting blood sample was taken from each individual, divided into aliquots and analyzed for aminoterminal propeptide of type IIII procollagen and liver function tests [including prothrombin time, serum albumin, bilirubin, ALT and AST]. The severity of liver disease was graded by Pugh-Child scoring including the assessment of ascites, encephalopathy, bilirubin, albumin and prothrombin time. It was concluded that propeptide of type III procollagen [PIIINP] measurement is a good noninvasive marker of manifest fibrosis. Cirrhotic patients had the highest serum PIIINP levels of all studied patients

Protective effect of l-cysteine on ochratoxicosis in rats

Ochratoxin A [OA] is a toxic metabolite produced by Aspergillus ochraceus. OA is a potent agent causing kidney and liver damage, carcinogen, mutagen, immunosuppressive and teratogen. L-Cysteine [Cys] plays and important role in natural detoxification mechanisms by several ways inside the body; beside its effect and the related compounds [-SH group] could inhibit the toxin production by such fungi in vitro studies. In the present work, we studied the possible protective role of Cys against OA in rats. In a 7 days experiment, intraperitoneal [I.P] injection of Cys [300 mg/kg.b.wt.] has proven useful against OA toxicity [1/2] LD50] in rats. In more prolonged experiment, Cys, OA, or Cys prior OA with 15 min. [Cys+OA] were I.P injected for 30 successive days. Clinical symptoms, mortality rate, post mortum findings, weight gain, liver and kidney weights, hemograme, liver and kidney function tests were monitored weekly during the experimental time. No mortalities were detected in the groups treated with Cys+OA. Rats treated with OA were decreased significantly in body weight gain, liver and kidney weight than other treated groups. OA caused anaemia, leucopenia, neutrophilia, evaluation of ALT, AST and AP activities, mild hyperglycemia hypoproteinaemia and elevation of urea and creatinine values. Cys+OA treatment minimized the toxic effect of OA on liver and kidney as evidenced by the tested parameters. Administration of Cys only resulted in a slight deviations than normal expecially in RBC and lymphocytic count, ALT activity and total proteins

Immobilization of jack bean urease on cyanuric chloride-cellulose ether: preparation and properties

Jack bean urease was successfully immobilized on cyanuric chloride- cellulose ether with 72% activity relative to the free enzyme. Both free and immobilized enzymes exhibited pH optima values of 7.0, and Michaelis constant [Km] values for the substrate of 4.20 and 9.09 mM, respectively. Temperature stability of the immobilized enzyme was improved. At 65C, the free enzyme completely lost its activity after 105 min, while the immobilized enzyme retained 57.3%. All of the examined divalent metal ions at 1 mM concentration caused a partial inhibition of both free and immobilized enzymes on the other and 1 mM, Cu2+ as well as low concentrations [0.2 mM] of Co2+ and Ni2+ caused various degrees of activation of the immobilized enzyme. Except for Hg2+, the inhibitory effect of most divalent metal ions was reversible by intensive wash. The immobilized enzyme had good storage at 4C and good reusability

Effect of overdentures on the amount of the gingival crevicular fluid flow of the abutment teeth

The amount of GCF flow of the abutments of ten overdenture patients wasstudied and compared with that of control teeth prepared in the same way andleft uncovered on the opposite arches of the same patients. The GCF wascollected using a standardized filter paper placed in the gingival crevice for30 seconds. A gingival fluid meter was used to quantitated the gingival fluidflow. Data were statistically analyzed. The results indicated that theoverdenture increases the amount of GCF flow of the abutment teeth