Evaluation of the therapeutic effect of propolis on Fasciola gigantica and Clostridium novyi type B infections in sheep

@#The use of natural products for disease control is a promising approach to solving the problem of drug resistance. The aim of the research reported here was to evaluate the fasciolicidal and anti-Clostridium novyi type B activities of propolis administered orally to sheep infected with Fasciola gigantica and C. novyi type B. Sheep infected with both pathogens were divided into two groups: an infected treated group and an infected non-treated group. The treatment was oral administration of 50 mg propolis extract/kg daily for 15 days. The body weight of the sheep, fecal egg counts of F. gigantica, serum levels of F. gigantica IgG, concentrations of cytokines (IL-2, IL-10, and IL-17), and bacterial counts of C. novyi were evaluated. Following treatment, the sheep had increased body weight and a significant decrease in the egg count, which was reduced by 54.54% at 15 days post treatment. The level of anti- Fasciola IgG increased, whereas levels of IL-2, IL-10, and IL-17 decreased in propolistreated sheep. Treatment of sheep with propolis produced a significant reduction in fecal count of C. novyi, from 8 × 109 to 3 × 103 colony units per gram at 15 days post treatment. This research highlights the therapeutic potential of Egyptian propolis extract as a treatment against F. gigantica and C. novyi type B infections, and investigated its mode of action through its effect on some cellular and humoral responses in sheep with both infections.

Detecting Latent Tuberculosis Infection Prior to Kidney Transplantation in a Tertiary Hospital in Saudi Arabia: Comparison of the T-SPOT.TB Test and Tuberculin Test.

Background: Tuberculosis (TB) remains a major worldwide public health problem with over 8.8 million newly diagnosed cases in 2010. Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have a significantly higher incidence of Mycobacterium tuberculosis infection or disease than healthy individuals. Most cases of active tuberculosis (TB) in patients with ESRD are due to the reactivation of a latent infection, and this patient group is at roughly 10- to 25-fold higher risk for reactivating TB infection than the general population. Candidates for solid organ transplantation are routinely screened for latent tuberculosis infection (LTBI). In this study we aimed to compare Tuberculin Skin Test (TST) with T-SPOT.TB, for the detection of LTBI in candidates for kidney transplantation. Methods: Prospective study of 133 HD Patients who did not have a diagnosis of active TB diseases or LTBI previously referred, through a 5-month period, to our institutions. Forty four kidney donors without evidence of renal insufficiency or immunocompromising conditions by medical history served as control group. All patients were tested with tuberculin (TST), and T-Spot.TB and the results were compared. Results: In donors, the concordance between the T-SPOT and the TST was moderate (90.9 %, к=0.46). Forty of 44 donors (90.9%) had concordance results between the T-Spot TB and TST.In hemodialysis patients, the concordance between the T-SPOT.TB and the TST was poor (60.15 %, к=0.07). Fifty three of 133 patients (40%) had discordant results between the T-SPOT.TB and TST. Of these, 13 patients had a positive TST but negative T-SPOT.TB and 40 had a positive T-SPOT.TB but a negative TST. Conclusion: Our data strongly argue against the use of TST in screening of LTBI in HD patients. T-SPOT.TB test in dialysis patients correlated better than TST with the risk of TB infection (e.g. increased age and low body mass index). It is a more reliable and powerful diagnostic tool than TST. However, further studies should be carried out to determine the tests with higher sensitivity and most permitted specificity.

Testicular microlithiasis: report of two cases and overview

Testicular microlithiasis is a rare asymptomatic disease of the testis. It is associated with testicular tumors and a wide variety of other pathologies. The sonographic image which is the main tool for diagnosis is characteristic. Because of its high association with malignant testicular tumors incidentally discovered cases of testicular microlithiasis should be followed up

Management of TB in the Private Sector in Khartoum; Sudan: Quality and Impact on TB Control

Introduction: Sudan has a large and growing private health sector. No survey was done in Sudan to show the extent of the use of private health care services by the population. Also precise data on tuberculosis (TB) diagnosis and treatment in the private sector are not available. Material and methods A facility-based cross-sectional survey was carried out during February2007-June 2007 in Khartoum state; whereby consented private physicians working in the all private clinics (n=110) were interviewed. Results This study showed that a large private sector exist in the country and deliver care to TB patients and reported the non-adherence of this sector to National Tuberculosis Program (NTP) guidelines. 59.1of the interviewed physicians correctly mentioned the TB treatment regimens; only 8(12.3) physicians that reported management of TB patients actually prescribed these regimens to their patients. Similarly; only 10(15.4) physicians requested sputum smear examination for TB diagnosis. Conclusion A considerable proportion of cases is inadequately managed by the private sector and is not notified to NTP. The information delivered by this study can be used to develop a workable Public-private mix (PPM) model with the private sector

Upper gastrointestinal endoscopy findings at Riyadh Armed Forces Hospital

To analyze the results of upper gastrointestinal endoscopic findings performed at Riyadh Armed Forces Hospital over a period of 15 years in 18,829 patients who were entered in the computer at the endoscopy unit. A retrospective study based on data of 18,829 patients who underwent upper gastrointestinal endoscopy. The data was entered into a computer with special codes for symptoms and endoscopic findings. Eighteen thousand eight hundred and twenty nine upper gastrointestinal endoscopy results were analyzed. Oesophagitis was found in 16.45%, Hiatus Hernia in 10%, Oesophageal varices in 7%, Oesophageal Cancer in 1.14%, Gastritis in 22%, Gastric erosions in 13.6%, Benign gastric ulcer in 3.29%, Gastric malignancy in 1.22%, Duodenal Ulcer in 14%, Duodenal erosions in 3.7% and Duodenitis in 12.7%. Only in 5.15% endoscopic findings were normal. In our analysis only 5.15% had normal upper gastrointestinal endoscopy findings while majority of patients had abnormal findings

Comparison of helicobacter serum

The objective of the study is to compare the helicobacter pylori high molecular weight cell associated protein, IgG enzyme immunoassay [HM.CAP, IgG EIA] with the campylobacter-like organism preformed urease campylobacter-like-organism [CLO test] as an indication of the presence of H.pylori among patients with dyspepsia. One hundred and six Saudi patients with dyspepsia or abdominal pain who had gastroscopy between July and September 1993, at the Gastroenterology Department of the Riyadh Armed Forces Hospital, were included in the study Antral biopsy was collected from each patient for CLO test, while a serum sample was obtained for H.pylori immunoassay test using the HM.CAP immunoassay kit from Enteric Products Inc. Specimens were sent to the microbiology laboratory blind without indicating the clinical findings or the result of the CLO test performed in the Gastroenterology Department. In 60 of these patients [56.6%] both tests were positive and in 12 cases both tests were negative. The concordance of the two tests was 68%. The most common abnormal gastroscopic findings were gastritis or gastric erosion in 24 patients and in 12 [50%] of them, both the CLO test and serology were positive. Both tests were found useful for screening for the presence of H.pylori. A screening strategy based on serology could play an important role in reducing endoscopy workload and for follow-up of patients with H.pylori infection

Causes of upper gastrointestinal bleeding: Experience at a major hospital in Riyadh

Over a period of 14 years, 1246 patients had emergency gastroscopy because of upper gastrointestinal tract [UGIT] bleeding. The endoscopic findings in these patients showed duodenal ulcer disease [DUD] in 364 [29.2%] was the most common followed by esophageal varices in 302 [24.2%], erosive gastritis in 198 [15.9%], gastroesophageal reflux disease [GERD] in 156 [12.5%], gastric ulcer in 69 [5.5%], and normal [negative] endoscopy in 132 [10.6%]. Only 65 [21.5%] patients with varices had active bleeding from the esophageal varices, 10 [3.3%] from the gastric varices and in 34 other patients with varices [11.3%], the bleeding was mainly from associated gastropathy. Eighty-six patients [23.6%] with DUD had active bleeding at endoscopy; 66 [80.5%] of these had ulcers showing stigmata of recent hemorrhage. Of those who had active bleeding, the source of the bleeding could not be identified in only five

Synthesis of some new 4 [3H] -Quinazolines as potential anticonvulsants

Condensation of various 4H-3.1 benzoxazin-4-ones [III] with homoslfanilamide afforded some new derivatives of 3-[p-sulfamoylbenzyl]-4 [3H]-quinzolinone [V]. Some o-amido-N- [p-sulfamoylbenzyl]-benzamides [IV] were isolated as reaction intermediates. Structures of the newly synthesized compounds were confirmed by IR, 1H-NMR, MS and elemental analyses. Several target compounds [V] exhibited good anticonvulsant effects against pentylentetraxol -induced convulsions in frogs. Compound [V-4] was 2.33 times as potent as phenobarbitone

Helicobacter pylori: Prevalence in 352 consecutive patients with dyspepsia

At the Riyadh Armed Forces Hospital [RAFH], 352 patients had gastroscopy and from each, antral gastric biopsies were taken for identification of Helicobacter pylori, by urease test and histopathology. In 217 [61.64%] of these 352 patients, the histology specimens showed Helicobacter pylori in 73.68% of patients with duodenal ulcer, 70% of patients with gastric ulcers and gastric erosions, 61% of patients with duodenitis and 52% of patients with gastritis. The urease test was positive at six hours in 164 [49.59%] of these 352 patients. The urease test was positive in 60% of each group of patients with endoscopic findings of gastric erosions, gastric ulcers and duodenal erosions

Albendazole in hydatid disease: results in 22 patients

A prospective study to evaluate the effect of albendazole in the treatment of echinococcus granulosus was conducted at the Gastroenterology Unit, Armed Forces Hospital, Riyadh since April 1985 to present involving 22 patients mainly with liver hydatid disease. Of these patients, 30% had a previous history of surgery for recurrence of previously operated hydatid cysts. The duration treatment and follow up period ranged from two months to three years. The only side effect was hair loss in two patients which was fully reversible on the termination of treatment. The following results were achieved: Radiological disappearance of the liver cysts were achieved in eight patients. Four of eight patients were treated only with albendazole and the other four patients with ruptured liver cysts to the biliary tree were treated with a combination of non-surgical endoscopic method, hypertonic saline irrigation and albendazole. In the remaining 14 patients, 5 [22.72%] had a 30% to 60% reduction in cyst size. Intracystic change was noted in five patients [22.72%], in two patients the cyst ruptured and there was no change in the cyst size in two patients [9.9%]. This study demonstrates that albendazole is a promising drug for the treatment of hydatid disease

Endoscopic biliary drainage of postoperative biliary fistulae and leak

Five consecutive patients with postoperative biliary fistulae or leak were diagnosed and treated successfully by endoscopic intervention The development of the fistulae were related to distal common bile duct obstruction by stones in four patients and in one patient by hydatid daughter cysts. Endoscopic sphincterotomy with stone or cyst extractions achieved decompression of the biliary system and initiated closure of the fistulae. In two patients, nasobiliary tube was used and endoscopic endoprosthesis was needed to close the fistula in another patient. In such cases, endoscopic management seems to be superior to surgical re-intervention for repair of fistulae or leak

Endoscopic choledochoduodenostomy [ECDT]: a practical approach to management of impacted papillary gallstones and ampullary tumors

We report five cases of impacted papillary stones and two cases of ampullary carcinoma treated by endoscopic choledochoduodenostomy [ECDT] at Riyadh Armed Forces Hospital [RAFH]. The procedure was carried out successfully in all five cases with impacted stones and in one of the two cases of ampullary carcinoma. No complications were noted. In the presence of the necessary endoscopic expertise and in cases of impossible cannulation of the papilla of Vater due to stone impaction or the presence of a papillary tumor, we recommend endoscopic choledochoduodenostomy [ECDT]. This approach provides an access to the common bile duct thus allowing appropriate therapeutic procedures on the biliary system to be performed

Endoscopic management of bile duct stones at Riyadh Military Hospital: an eight-year experience

Over a period of eight years, 161 Saudi patients with biliary stones underwent 200 endoscopic retrograde cholangiopancreatographic studies at the Armed Forces Hospital, Riyadh, Saudi Arabia. Endoscopic sphincterotomy was performed in 93.2% of these patients and not attempted in the remainder who were referred for surgery because of biliary stones in both the common bile duct and gallbladder. All patients were symptomatic and the most common presenting symptom was biliary colic, seen in 42.2% of these patients. Either acute gallstone pancreatitis or cholangitis was seen in 14.2%, and this resolved completely following gallstone extraction. Endoscopic extraction of common bile duct stones was successful in 138 [85.7%] patients. Failure of stone extraction occurred in nine patients, three of whom received extracorporeal shockwave lithotripsy, which was successful in only one. Complications from endoscopic sphincterotomy and stone extractions occurred in 12 patients, of which bleeding was the most common

Incidence of colorectal cancer and colonic polyps in Saudi patients

Of 1600 Saudi patients who underwent lower gastrointestinal tract endoscopy at the Riyadh Armed Forces Hospital, 40 [2.50%] had adenomatous polyps, 12 [0.75%] had colorectal cancer, 149 [9.31%] had Schistosoma mansoni, and 5 [0.31%] had schistosomal polyps but with no associated malignancy. Despite the high incidence of S. mansoni, there was no increase in the incidence of colorectal cancer in these patients. Of 1846 Saudi patients seen at the oncology department, 346 [18.74%] had gasterointestinal malignancy [307 in the upper gastrointestinal and 39 in the lower gastrointestinal tract]. This distroibution of neoplasms in the alimentary tract is almost the reverse of the seen in the West. There is a low incidence of adenomatous polyps and colorectal cancer in Saudi patients compared to the Western population. This might be due to genetic, dietary, and environmental factors. The present study also confirms previous studies from Egypt that S. mansoni infestation dose no play a role in or predispose to large lowel malignancy

Endoscopic dilatation in the management of benign and malignant esophageal strictures: results of 203 consecutive dilatations

Eighty-three patients with benign or malignant strctures underwent 203 endoscopic esophageal dilatations using different type of dilators. Of these, 36 patients [78.2%] with benign strictures become free of symptoms after one to three dilatations, during a mean follow-up period of 8.5 months. Thirty-seven patients had malignant strictures; in 14 dysphagia abated after the initial dilatations without the need to insert feeding or Atkinson tubes. Seventeen patients [20.5%] had dysphagia following esophageal surgery and their condition improved followed following endoscopic dilatations. Dilatation failed in four patients and esophageal perforation occurred in one patient with malignant stricture. There was no mortality among our patients that was directly related to endoscopic dilatations

Trans-papillary endoscopic naso-biliary drainage of a hepatic abscess - presumably hydatid in origin

This is a report on a 60-year-old diabetic female with hepatic abscess and obstructive jaundice with cholangitis which was treated endoscopically with sphincterotomy and naso-biliary drainage resulting in complete resolution of cholangitis and substantial decrease in the size of the abscess cavity. We presume that the pathology of the cavity was a ruptured hydatid cyst with secondary obstruction and infection. To our knowledge this is the first case reported from Saudi Arabia

Sclerotherapy for bleeding esophageal varices in schistosomiasis

A prospective study to evaluate the role of sclerotherapy in bleeding oesophageal varices secondary to different aetiological factors in 96 patients was conducted at the Gastroenterology Unit, Armed Forces Hospital, Riyadh, between December 1980 and March 1986. Fifty of these patients had proven schistosomal liver disease, 62% of which were in Group A Child's Classification. Sclerotherapy has a special place in schistosomal liver disease as liver function is usually well preserved. Oesophageal varices have been eradicated in 25[50%] during the mean follow-up period of 38 months [range 3-64 months]. Six patients were referred for surgery because of bleeding gastric varices, three of whom died following operation. Forty-three patients had no recurrence of bleeding following sclerotherapy. Surgical procedures for oesophageal varices carry the risk of peri-operative and post-operative morbidity and mortality, while in our study complications following sclerotherapy were minor. We believe that sclerotherapy is the treatment of choice for bleeding Oesophageal varices in schistosomiasis