Predictors of asymptomatic cardiac events and prognostic value of cardiac biomarkers in chronic kidney disease patients

Patients with chronic kidney disease [CKD] are at increased risk of cardiovascular events; cardiovascular disease is a leading cause of death in patients with chronic kidney disease; Circulating biomarkers play a major role in the early detection of cardiovascular disease in those patients. To clarify the prevalence of asymptomatic different cardiac events in CKD and to explore the degree of elevation of N- terminal-pro-B-type Natriuretic Peptide [NT-pro-BNP] in asymptomatic cardiac patients with varying degree of CKD and the relationship between the elevation of this biomarker and the occurrence of these cardiac complications. This case-control study included 40 CKD patients and 40 controls; patients were recruited from nephrology unit of internal medicine department; Assiut university hospital; known to have chronic kidney disease in different grades [grade I- grade V]. Resting transthoracic echocardiography [TTE] and plasma NT-pro-BNP concentrations were measured in patients who were asymptomatic for clinical evidence of any cardiac events, [n=40; mean age 47.63 +/- 17.93 years; 52.5%were males] as well as healthy volunteers n=40; mean age 42.00 +/- 13.25; 62% were males]. In addition, the correlation between plasma NT-pro-BNP concentration and parameters of echocardiography was examined. Increased prevalence of left ventricular hypertrophy [LVH] [70%]; left ventricular diastolic dysfunction [77.5%], left ventricular systolic dysfunction [17.5%] and coronary artery disease [27.5%] in CKD patients as well as serum NT-pro-BNP levels in the patients were significantly higher [6703.75 +/- 2947.68 pg/ml] than those in healthy volunteers [124.83 +/- 140.40 pg/ml] [p=0.000]. NT-pro-BNP level was higher also in patients who had hypertension [p=0.002]; anemia [p-0.004]; hypoalbuminamia [p=0.000];left ventricular hypertrophy [LVH] [7873. 57 +/- 2719. 31 pg/ml] [p = 0.000], diastolic dysfunction [7524. 52 +/- 2824.74 pg/ml] [p= 0.000]; systolic dysfunction [10371.43 +/- 2771.71] [p=0.000] and patients who had segmental wall motion abnormality [SWMA] [8709.0.9 +/- 3512.3.9] [p=0.000] and correlate Positively with C reactive protein [CRP] level [r-0.751 p=0.000]; left ventricular mass [LVM] [r=0.772 p=0.000] and left ventricular mass index [LVMI] [r=0.715 p=0.000] and negatively with ejection fraction [EF] by echocardiography [r=-0.483 p=0.000]. NT-pro-BNP level elevation in asymptomatic patients with CKD reflects underlying cardiac dysfunction, ischemic heart disease and hypertrophy independent of renal function

Distribution pattern and physical mapping of ccc plasmid-mediated multidmg-resistance in some g-ve bacteria recovered from hospitals and haemodialysis units wastewater at AI-Madinah AI-Munawarah

Investigation of the presence and distribution pattern of plasmid-linked antibiotic resistance amongst Gram-negative bacterial strains recovered from wastewater of hospitals and haemodialysis units. Drawing up a physical map of the most frequently distributed plasmids. Representatives G-ve bacterial strains; 59 isolates, were chosen from a previous study for the same authors, as of the most resistant ones [resist more than 3 up to 9 antibiotics to > 100 micro g/ml.]. Miniprep protocol and gel electrophoresis technique were adopted for the detection and isolation of ccc plasmid DNA from the differentially-isolated G-ve bacteria. Restriction analysis using 11 DNA restriction enzymes and "Plasp" computer program against lambda phage DNA digested with Hind III, for physical mapping of the most distributed plasmid. Results revealed the presence of seven different plasmids, distributed as 1-3 different types of plasmids in 68% [4Oj59] of the strains; chosen as representatives of the most resistant ones [resist more than 3 up to 9 antibiotics to > 100 micro g/ml.]. The detected plasmid sizes were estimated against HindIII-digested lambda phage and found ranged from 36,844 to 2,027 bp. Preliminary physical mapping was constructed for the plasmid [23130 bp] that was the most distributed amongst more than 90% of the plasmid-bearing strains and was the only found singly. The isolated, characterized and the mapped plasmid [s], suggest the possibility of high rate of both vertical and horizontal distribution of these plasmids amongst the isolated G- ve bacterial Genera and species

Biochemical effects of chronic abuse of ergogenic aids in rats

To investigate the potential health risks associated with recommended or overdoses of amino acids mixture such as Power Mix [PM], Branched Chain Amino Acids [BCAAs] or Ceratine [Cr] supplementation as ergogenic aids for short or long-term rats. Male Sprague Dawley rats were assigned into two major groups; the first group was orally treated with the above mentioned supplements for six weeks [short-term], and the second group was treated similarly but for twelve weeks [long-term]. Each of the short- and long-term group was subdivided into seven subgroups which were treated as follows: PM [0.8 g/kg/day], PM [2.4 g/kg/day], BCAAs [0.2 g/kg/day]. BCAAs 0.6 g/kg/day], Cr [2 g/kg/day], Cr [6 g/kg/day] and controls [kept without treatment]. Plasma amino acids levels beside renal, thyroid, adrenal, and hepatic functions were estimated. Significant elevation in total amino acids concentration was found as result of feeding with the three dietary supplements. Results showed significant increase in serum creatinine level in rats ingested with these ergogenic aids except the low dose of PM given for short- or long-term. High doses of the three supplements given for both short- and long-term and low doses of BCAAs and Cr given for long-term caused significant elevation in serum uric acid level. Significant increase in serum NAG activity was observed among the three dietary supplements. Also, significant rise in serum AST and ALT activities was obtained after feeding the three dietary supplements except the low dose of PM given for short-term. Serum T3 level was significantly increased by feeding BCAAs or Cr in high doses for long-term. None of the three supplements exerted significant change in serum TSH and T4 levels. High doses of PM, BCAAs or Cr given for either short- or long-term caused significant increase in serum corticosterone and significant decrease in plasma ACTH levels. The three dietary supplements resulted in significant increase in cytosolic AST and ALT activities except the low dose of PM given for short- and long-term as well as low dose of BCAAs and Cr given for short-term. The three dietary supplement except low dose of PM fed for short-term, caused significant rise in mitochondrial AST activity. This study showed that supplementation of high-dose of PM, BCAAs or Cr given for long-term as ergogenic aids induced renal and hepatic damage as well hormonal disturbances

Rapid and reliable HP-TLC detection of opium and opium alkaloids; fluorescence densitometric assessment of morphine in serum

To propose a rapid reliable Thin Layer Chromatography [TLC] detection of opium and opium alkaloids in seizures and to develop a micro High Performance Thin Layer Chromatography [HP-TLC] method of assessment of morphine in serum using CAMAG-TLC scanner. 3 Opium samples were provided from the central Medico-Legal Laboratory, Ministry of Justice, Cairo, Egypt. They were subjected to TLC using the standard conditions. The blood samples were admitted to the Department of Narcotics and Poisons, National Research Center. The serum samples were hydrolyzed, extracted and dansylated. The dansyl derivatives were submitted to HP-TLC and measured by fluorescence densitometry using CAMAG-TLC scanner. TLC showed the major and minor opium alkaloids. The densitomatric fluorescence of morphine in serum revealed that the concentrations of morphine in 3 samples were 40, 50 of 66 ng/ml. Being sensitive and reliable the proposed method proved its applicability where possession or ingestion of opium is to be assessed

Patterns of the drugs of abuse among educated Egyptian females

Screening of the urine samples of 448 educated Egyptian females forcannabinoids, amphetamines opiates and barbiturates revealed that only 22samples [4.9%] were positive at least for one of these drugs. The percentage of prevalence rates of the drugs-of-abuse was ranked as follows: Opietes[50%], cannabinoids [18.2], barbiturates [18.2%] and amphetamines [13.6]. Only 0.2% of samples contained more than one drug. The screening wasperformed utilizing the radioimmunoassay technique and the positive resultswere confirmed using thin layer chromatography

Drinking water qualities of different purification systems in Ismailia governorate

This study monitored ten drinking water treatment systems; three compact, two small filtration and five conventional. The bacteriological, chemical and physicochemical qualification of water was achieved at the inlet, pre-and post-chlorination. The counts of total viable bacteria, total coliform, fecal coliform, coliform streptococci, Salmonella, Shigella and Aeromonas were considered as the most reliable bacterial parameters for water potability. A total of 613 bacterial isolates was identified and found to belong to 18 genera and 21 species; most of them have pathogenic capabilities and free chlorine resistance reached 5 mg/l for 85 isolates. 30% of them represented Bacillus species, 15% Staphylococcus, 12% Escherichia and 10% Corynebacterium. Other 14 bacterial genera were distinguished in this survey

Immunological and chromatographic follow-up of 11-nor-carboxy-delta9 tetrahydrocannabinol in urine of single and multiple hashish smokers

The authentic COOH-THC was used as a reference in TLC and HPTLC study of the urinary excretion pattern of cannabis metabolites. Hemagglutination inhibition testing for COOH-THC on urine was directly carried out alongside with the chromatography. The results revealed that after occasional smoking of a single hashish cigarette urine samples will be positive for 1-3 days. After chronic smoking of several hashish cigarettes 2-3 times a week, the urine may be positive for 1-2 weeks after the last dose. After heavy daily smoking for more than one month, the urine samples may be positive for 1-3 months after the last dose

Asymptomatic bacteriuria in chronic haemodialysis patients

Symptomless bacteriuria could be considered as a dormant source of overt urinary tract infection [UTI] and possible bacteremia in maintenance haemodialysis [HD] population. The study was conducted to detemine the magnitude and pattern of asymptomatic bacteriuria among HD patients and show the effect of HD session on the bacterial counts. Forty-four patients with chronic renal failure on regular HD treatments [five hours twice weekly] for 5 to 57 months duration were included. Bacterial counts were performed twice for each patient before and after dialysis to determine the effect of HD on total viable bacteria [T.V.B.], Staphylococcus aureus, Streptococcus haemolyticus, E. coli, Proteus, Klebsiella and Pseudomonas areuginosa. It was found that thirty patients [72.7%] showed positive urine cultures, 18% of the patients showed. an increase of the bacterial counts in the post-dialysis urine samples and 24% showed decrease of the bactrial counts in the post-dialysis samples. The difference was not statistically significant [P > 0.05]. Urine volume and haemoglobin level were found to be significantly lower, while serum aspartate and alanine aminotransferase [AST and ALT] were significantly higher in bacteriuric group than those in nonbacteriuric group. Age, sex, clinical data and serum creatinine, urea, glucose, calcium, phosphorus and albumin did not significantly differ in the two comparison groups. The bacteria encountered in the asymptomatic bacteriuric HD patients were Staphylococcus aureus [86.8%], Streptococci spp. [52.7%], E. coli [37.2%], Klebsiella spp. [18.6%], Proteus [12.4%] and Pseudomonas spp. [12.4%]. There were no significant differences in bacterial counts of the various types of bacteria before and after dialysis. In vitro sensitivity to antibiotics showed that more than 80% of isolated strain; are sensitive to Norfloxacin

Quality of drinking water in El-Tall-El-Kabier region Ismailia, Egypt

Water samples collected from 28 water sources used for human consumption representing 24 producing wells, and 4 Nile- Water taps distributed in the villages streets, were bacteriologically and chemically studied. These drinking water sources in El-Tall El-Kabier region were evaluated and examined for safe potability. Data obtained revealed that water front wells of the depth 1.5 to 14 meters have a bacterial load that is potentially pathogenic regarding their coliform counts [2.2 x 104 cfu/100 mL]. Water samples from wells of the depth 16 meters and more; up to 39 meters, were found bacteriologically safe, having zero counts of faecal coliforms /100 mL, and not more than 3 cfu/100 mL coliforms, but with a high content of residual sulphates, chlorides, carbonates, and unsafe salinity levels. Sulfates 591.1 mg/L chlorides 934.6 mg/L, carbonate 740 mg/L, salinity levels 1792%. According to the health aspects, these contaminate are considered hazardous, and the water having them is unsafe for drinking, as recauneaded in the international standards