Exploring human mammaglobin: as a possible diagnostic and prognostic indicator in breast cancer tissue

Breast cancer is a major global health issue, with high diagnosis rates worldwide, especially in less developed areas, leading to significant mortality rates. This review focuses on the molecular characteristics of breast cancer, emphasizing the role of human mammaglobin-A (hMAM-A) as a diagnostic and prognostic marker. hMAM-A, a dimeric protein from the secretoglobin family, is produced exclusively by breast tissue and shows elevated levels in breast cancer cases, making it a highly accurate marker for disease detection. The review also examines various factors influencing breast cancer, such as age, tobacco use, menopausal status, and hormone replacement therapy (HRT). Younger age at diagnosis is associated with poorer outcomes, highlighting the importance of early detection. Tobacco smoke increases mortality rates in breast cancer patients. Menopausal status affects molecular subtypes and risk factors, impacting treatment and prognosis. HRT has a complex relationship with breast cancer risk. The review concludes by discussing the need for novel biomarkers, including hMAM-A, to improve breast cancer diagnosis and management.

Mycosynthesis of thermostable silver nanoparticles by the endophytic Albifimbria verrucaria with antimicrobial and antiproliferative activities

Aims@#This study was aimed to screen and isolate soil and endophytic fungi with the ability to biosynthesize stable silver nanoparticles (SNPs) with antimicrobial and antiproliferative activities.@*Methodology and results@#A total of 60 fungal isolates isolated from soil and plant samples were screened for their ability to biosynthesize SNPs. Among which, 21 isolates have supported the biosynthesis of SNPs. Furthermore, the endophytic isolate PRR2.1 synthesized highly thermostable SNPs with long shelf life. The PRR2.1 isolate was identified as Albifimbria verrucaria by morphological and molecular means. The synthesis of SNPs was initially monitored by UV-Vis spectroscopy. Further characterization by transmission electron microscopy, X-ray diffraction and dynamic light scattering revealed well-dispersed spherical crystalline in nature SNPs with a mean size of 14 nm and zeta potential of –24.47 mV. Fourier transform infrared spectroscopy showed the presence of biomolecules adsorbed on the surface of biosynthesized SNPs responsible for their synthesis and stability. The mycosynthesized SNPs exhibited stronger antifungal activity against pathogenic strains of Aspergillus niger, A. flavus, A. fumigatus and Candida albicans with respect to its antibacterial activity against Escherichia coli, Staphylococcus aureus, Bacillus cereus and Klebsiella pneumoniae compared to standard antifungal itraconazole and antibiotic cefadroxil with mostly consistent minimum inhibitory concentration of 5.31 μg/mL. The biosynthesized SNPs demonstrated dose-dependent in vitro antiproliferative activity against cancerous HeLa cell line with IC50 value of 2.52 μg/mL and less cytotoxic activity against WI-38 (normal human lung fibroblasts) cell line with CC50 value of 10.2 μg/mL.@*Conclusion, significance and impact of study@#These results show the potential of endophytic fungi biosynthesized SNPs as possible biofriendly, safe and efficient antimicrobial agents with promising antiproliferative activity and low cytotoxicity, which can be furtherly implemented in various biomedical and biotechnological applications.

Morphology and molecular phylogeny of Heterobothrium lamothei (Monogenea: Diclidophoridae), a gill parasite infecting the tiger puffer fish Lagocephalus sceleratus (Tetraodontidae) / Morfologia e filogenia molecular de Heterobothrium lamothei (Monogenea: Diclidophoridae), um parasita das guelras que infecta o peixe tigre pufferLagocephalus sceleratus (Tetraodontidae)

Members of the family Diclidophoridae are potentially dangerous species for the puffer fish aquaculture worldwide. They are parasitic polyopisthocotyleans, with a posterior haptor equipped with clamps for attachment to the host's surface, allowing the worm to resist the flow of water to maintain its position on gills. The anterior body of the worm is deformable, allows the worm to feed on blood sucked from fish gills. The present study is the first description of a Heterobothrium species from the gills of the tiger puffer Lagocephalus sceleratus (Tetraodontidae) from the coasts of the Arabian Gulf at Jubail, Saudi Arabia morphologically by light microscopy as well as by molecular analysis of the parasite partial 28S rRNA through multiple sequence alignments and phylogeny by maximum likelihood analysis which is provided for the first time for the described species. Seventeen tiger puffer fish were captured alive from marine water off Saudi Arabia; gills were separated and further examined for parasitic infection. Nine fish were found infected with a monogenean parasite which was robust, equipped by two buccal organs at the tapered anterior end; the posterior haptor was rectangular with four symmetrically arranged clamps, with no isthmus. Marginal hooks absent. Ovary elongated, U-shaped, testes numerous, irregularly shaped and extended from the posterior part of the ovary to the anterior margin of the haptor. Copulatory organ muscular, as a spherical cup armed with 12 to 15 genital hooks. The molecular analysis of the parasite 28s rRNA and phylogeny revealed a percentage of identities between 87.47-89.09%, with Diclidophoridae species within the monophyletic clade of Mazocraeidea where a maximum percentage of 89.09% were obtained for the morphologically different sister taxon H. okamotoi. The results obtained from molecular analysis are consistent with the conclusions drawn from morphological classification where that the parasite recorded was morphologically similar to H. lamothei which was not characterized by molecular analysis before. The recovered sequences were deposited into the GeneBank under accession number MT322610.(AU)

Os membros da família Diclidophoridae são espécies potencialmente perigosas para a aquicultura de peixes puffer em todo o mundo. Eles são parasitas poliopisthocotyleans, com uma hélice posterior equipada com pinças para fixação na superfície do hospedeiro, permitindo que o verme resista ao fluxo de água para manter sua posição nas brânquias. O corpo anterior do verme é deformável, e permite que o verme se alimente de sangue sugado das guelras dos peixes. O presente estudo é a primeira descrição de uma espécie Heterobothrium das guelras do tigre Lagocephalus sceleratus (Tetraodontidae) das costas do Golfo Arábico em Jubail, Arábia Saudita, usando morfologia por microscopia leve, bem como análise molecular do rRNA parcial do parasita 28S através de alinhamentos de sequências múltiplas e filogenia por análise de máxima verossimilhança que é fornecida pela primeira vez para as espécies descritas. Dezessete peixes tigre puffer foram capturados vivos da água marinha da Arábia Saudita; as brânquias foram separadas e mais tarde examinadas para detecção de infecção parasitária. Nove peixes foram encontrados infectados por um parasita monogênio robusto, equipado por dois órgãos bucais na extremidade anterior afilada; o hortetor posterior era retangular com quatro pinças dispostas simetricamente, sem istmo. Ausência de ganchos marginais. Ovário alongado, em forma de U, testículos numerosos, de forma irregular e estendido desde a parte posterior do ovário até a margem anterior do hortelino. Órgão copulatório muscular, como um copo esférico armado com 12 a 15 ganchos genitais. A análise molecular do parasita 28s rRNA e filogenia revelou uma porcentagem de identidades entre 87,47-89,09%, com espécies Diclidophoridae dentro do clade monofilético de Mazocraeidea onde uma porcentagem máxima de 89,09% foi obtida para o táxon-irmão morfologicamente diferente H. okamotoi. Os resultados obtidos da análise molecular são consistentes com as conclusões tiradas da classificação morfológica onde o parasita registrado era morfologicamente semelhante ao H. lamothei que não era caracterizado pela análise molecular antes. As sequências recuperadas foram depositadas no GeneBank sob o número de acesso MT322610.(AU)

Loofah immobilized with Cladosporium cladosporioides CEL14 is a potential bioremediating agent for hexavalent chromium in tannery wastewater

Aims@#Chromium salt possesses unique characteristics that render it useful in numerous applications in several industrial processes, especially tanning of animal hides which act as a major source of hexavalent chromium toxicity in environment. This study aimed to evaluate the efficiency of loofah immobilized Cladosporium cladosporioides CEL14 in remediate tannery wastewater which contains hexavalent chromium. @*Methodology and results@#A total of 18 fungal species were isolated from three different sites of tannery wastewater in Egypt, of which C. cladosporioides CEL14 was the most capable species of chromate remediation with 81% after 7 days of incubation as free cells. The experiments were conducted in minimum salt medium supplemented with 200 ppm chromate in the form of potassium dichromate. Different process parameters studies demonstrated that chromate was completely removed at 30 °C, pH 6, 0.1% malt extract and 0.2% glucose after 7 days of incubation with 20% inoculum size. After that, C. cladosporioides was immobilized on a natural support material (loofah). The removal ability of chromate was enhanced through permanent viable immobilization on loofah pieces, which showing complete removal of chromate within 3 days. The toxicity assessment of treated tannery effluents revealed that 74% of Brassica napus seeds were germinated upon exposure to the treated effluent.@*Conclusion, significance and impact of study@#This study revealed that C. cladosporioides CEL14 isolate has high potential as bioremediating agent against toxic hexavalent chromium. The removal ability of toxic chromate was enhanced through permanent viable immobilization on loofah pieces. This technology is simple, cost effective, efficient and environmentally friendly. The loofah immobilized with C. cladosporioides CEL14 has potential to be applied in wastewater treatment of small-scale tanneries after onsite trials.

study of intratympanic dexamethasone injection in Meniere's disease [continuation study]

Background: Meniere's disease is a condition that is thought to arise from abnormal fluid and ion homeostasis in the inner ear. The disease is named for Prospere Meniere, a French physician who was first known victim of this disease and reported that the inner ear could be the source of a syndrome manifesting episodic vertigo, tinnitus and hearing loss. The origin of Meniere's disease is presently controversial. While, in the past, it was felt that endolymphatic hydrops [excess fluid] in the inner ear were responsible for the disease, the most current opinion is that hydrops are just a marker for the Meniere's disease, rather than absolutely being responsible for the symptoms

Aim of the work: this study aimed to follow up [2 and 2.5 years] the effect intratympanic [IT] dexamethasone in the prognosis of Meniere's disease [MD] with two different concentrations [4 and 10 mg/ml]

Patients and methods: twenty patients with unilateral Meniere's disease received intra tympanic dexamethasone injection were included in this study .The studied subgroups were categorized according to the concentration of dexamethasone [4 and 10 mg/ml] used into two subgroups. Detailed history was taken from all patients. They were exposed to Dizziness Handicap Inventory scale, basic audiological evaluation and cervical-vestibular evoked myogenic potential assessment. The presence or absence of spontaneous, post-head-shaking, and positional nystagmus was evaluated using a video-nystagmography system. The patients in the two groups were followed -up for 2 and 2.5 years

Results: the dosage of 10mg/ml dexamethasone showed more stability in signs and symptoms of Meniere's disease than the dose of 4 mg/ml dexamethasone in follow up study. The long term study of intratympanic [IT] dexamethasone injection in both subgroups shows nearly no improvement as regard pure tone average, speech reception thresholds, word discrimination scores, subjective hearing loss, tinnitus, aural fullness, vertigo interruption with daily activities and vertigo associated symptoms compared to the previous study thesis

Conclusion: the long-term study of intratympanic [IT] Dexamethasone injection in both subgroups showed nearly no improvement in most assessments performed

Evaluación del comportamiento de los indicadores de productividad y rentabilidad en las empresas prestadores de salud del Régimen Contributivo en Colombia / Behavioral Assessment of productivity and profitability Indicators in Health Provider companies from the Contributory Schemein Colombia

Resumen Objetivo: Analizar el comportamiento que han tenido los indicadores de productividad y rentabilidad financieros en las empresas prestadoras de salud del Régimen Contributivo en Colombia entre 2008 y 2010. Materiales y métodos: Investigación aplicada, cuantitativa e inductiva con utilización de Análisis Discriminante (ADM), que permitió analizar el comportamiento de los indicadores seleccionados. Resultados: Se pudo evidenciar y demostrar en el trabajo de investigación que el análisis de las medias del indicador Utilidad Operacional / Valor agregado (IP2) este presentó diferencias significativas. Para el análisis de la función discriminante mejoraron los indicadores Utilidad Bruta / Ingresos Operacionales (MB) y Utilidad Operacional / Valor agregado (IP2) durante los periodos 2008 y 2010 en las entidades de salud del Régimen Contributivo. Conclusiones: A través de método utilizado se pudo analizar el comportamiento relacionado con los indicadores analizados en los años estudiados y concluir que estos presentaron diferencias relevantes. Así mismo, se puede predecir el análisis de la población con un 61,1 % de probabilidad.

Abstract Objective: To analyze the behavior that profitability and productivity financial indicators have had in Health Provider Companies from the contributory scheme in Colombia, between 2008 and 2010. Materials and Methods: Applied, quantitative and inductive research using discriminant Analysis (ADM), which allowed to analyze the behavior of the selected indicators. Results: It was evident and demonstrated in the research work that the analysis of the Operating Income/Value Added Tax (IP2) indicator presented significant differences. For the analysis of the discriminant function, indicators Gross Profit/Operating Revenues (MB) and Operating Income/Value Added Tax (IP2) improved during the periods 2008 and 2010 on the Health Entities from the Contributory Scheme. Conclusions: Through the method used, it was able to analyze the behavior related to the analyzed indicators in the years studied and conclude that these had significant differences. Likewise one can predict the analysis of population with 61.1 % probability.

Studies on Aedes AegyptI resistance to some insecticides in the Jazan district, Saudi Arabia

The present study provided information on the susceptibility status of the adult and larvae of Aedes aegypti mosquitoes in Jazan region of Saudi Arabia. Bioassay tests were performed on adults and larvae by using WHO recommended concentrations and test kits. Adults of Ae. aegypti mosquitoes were exposed to test papers impregnated with Lambda-cyhalothrin [0.05%], Cyfluthrin [0.15%], Deltamethrin [0.05%], Permethrin [0.75%], Fenitrothion [1%], Bendiocarb [0.1%] and DDT [4%] insecticides. Ae. aegypti mosquitoes were found to be susceptible only to Cyfluthrin; [mortality rate was 100%], whereas variable resistances were observed from the rest of the other insecticides tested [mortality rates ranged between 93.6 and 17%]. Larvae were subjected to different concentrations of Diflubenzuron, Methoprene [IGRs] and Temephos [Organophosphate]. Adult emergence inhibition [IE50 and IE95] values for the IGRs and the [LC[50] and LC[95]] for Temephos were determined by log-probit regression analysis. Ae. aegypti larvae were resistant to Temephos [LC[50] 61.8 - LC[95] 35600.1 mg/l] and showed high susceptibility to Methoprene than Diflubenzuron [IE[50] 0.49 - IE[95] 10.9 mg/l] and [IE[50] 0.86 and IE[95] 93.8 mg/l], respectively. Larvae were more susceptible to Methoprene than Diflubenzuron by 1.8 folds

Study of gonadal hormones in Egyptian female children with sickle cell anemia in correlation with iron overload: single center study

Objective/Background: Sickle cell disease is a hereditary hemoglobinopathy characterized by abnormal hemoglobin production, hemolytic anemia, and intermittent occlusion of small blood vessels, leading to tissue ischemia, chronic organ damage, and organ dysfunction including endocrine organs. The aim of this work was to evaluate some gonadal hormones in female children with sickle cell anemia [SCA] in correlation with iron overload

Methods: This study was conducted on 40 female children with SCA with a serum ferritin of > 1000 ng/mL, who were attendants at the Hematology Unit, Pediatric Department, Tanta University, Tanta, Egypt in the period from May 2012 to April 2014. Their ages ranged from 11 years to 15 years and the mean age value was 12.63 +/- 1.36 years [Group I]. Forty female children with SCA of matched age with no iron overload served as a control Group [Group II]. For all patients in Groups I and II the following were performed/assessed: complete blood count, hemoglobin electrophoresis, serum iron status, serum estrogen, luteinizing hormone [LH], and follicle-stimulating hormone [FSH]

Results: There were significantly higher serum ferritin and serum iron levels and significantly lower total iron binding capacity, FSH, LH, and estrogen levels in Group I compared with Group II [mean serum ferritin was 2635.1 +/- 918.9 in Group I vs. 292.55 +/- 107.2 in Group II with a p value of .001; mean serum iron was 196.3 +/- 55.6 in Group I vs. 120 +/- 16.57 in Group II with a p value of .001 and mean serum total iron binding capacity was 247.3 +/- 28.6 in Group I vs 327.8.7 +/- 21.96 in Group II with a p value of .001; mean FSH level was 1.36 +/- 0.22 mIU/mL in Group I vs. 2.64 +/- 0.81 mIU/mL in Group II with a p value of .021; mean LH level was 0.11 +/- 0.006 mIU/mL in Group I vs. 1.78 +/- 1.12 mIU/mL in Group II with a p value of .003; mean estrogen level was 21.45 +/- 10.23 pg/mL in Group I vs. 42.36 +/- 15.44 pg/mL in Group II with a p value of 0.001] with significant negative correlation between serum gonadal hormones and serum ferritin [r = 0.835 and p value of .01 for FSH and serum ferritin; r = 0.597 and a p value of .01 for LH and serum ferritin; and r = 0.624 and p value of .01 for estrogen and serum ferritin

Conclusion: Female patients with SCA with iron overload may have gonadal hormone deficiency with significant negative correlations between gonadal hormones including FSH, LH, estrogen, and serum ferritin. Recommendations include regular iron chelation for prevention of irreversible damage of the ovaries and attaining normal sexual maturation, and regular follow up for females with SCA with assessment of puberty as they are more vulnerable to develop hypogonadism and may require hormonal replacement therapy

Silymarin Supplementation Attenuation of the Lipopolysaccharide-Induced Metabolic Changes in Protein Malnourished Rats

Protein malnutrition increases the sensitivity to septic shock by impairing antioxidation and immune response. Based on the potent antioxidant effects of silymarin, the putative protective role of silymarin against sepsis-induced oxidative damage in protein malnourished rats was investigated. Methods: Adult male Wistar rats were subjected to protein malnutrition via a low-protein diet (8% protein), with and without silymarin supplementation (30 mg/kg/day) for four weeks, and compared to a control group on a 18% protein diet At end of the experiment, the animals received intraperitoneal injections (i.p.) of 0.1 mg/ kg lipopolysaccharide (LPS) derived from Esdieridtia coil, and decapitation 24 h later. Albumin, C-reactive protein (CRP), total protein (TP), alkaline phosphates (A/CP ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-a (TNF-a), interleultine-lp (IL-1p) and interleukine-6 (IL-6) levels were measured in serum. In the lungs and liver, thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) concentrations, superoxide dismutase (SOD), catalase (CAT), and glutathione-s-transferase (GST) activities were measured. Results: oxidative and inflammatory processes were significantly increased by the LPS injection and these changes were to a greater extent in the low-protein dietary group compared to control group. Silymarin supplementation in both dietary groups showed marked inhibition in these activities, although the affect was more prominent in the control group compared to the rats fed a low-protein diet. Conclusions: The study showed that silymarin protected against the impairment of antioxidation and immune response in protein malnourished rats, particularly in septic shock conditions.

Silymarin Supplementation Attenuation of the Lipopolysaccharide-Induced Metabolic Changes in Protein Malnourished Rats

Introduction: Protein malnutrition increases the sensitivity to septic shock by impairing antioxidation and immune response. Based on the potent antioxidant effects of silymarin, the putative protective role of silymarin against sepsis-induced oxidative damage in protein malnourished rats was investigated. Methods: Adult male Wistar rats were subjected to protein malnutrition via a low-protein diet (8% protein), with and without silymarin supplementation (30 mg/kg/day) for four weeks, and compared to a control group on a 18% protein diet At end of the experiment, the animals received intraperitoneal injections (i.p.) of 0.1 mg/ kg lipopolysaccharide (LPS) derived from Esdieridtia coil, and decapitation 24 h later. Albumin, C-reactive protein (CRP), total protein (TP), alkaline phosphates (A/CP ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-a (TNF-a), interleultine-lp (IL-1p) and interleukine-6 (IL-6) levels were measured in serum. In the lungs and liver, thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) concentrations, superoxide dismutase (SOD), catalase (CAT), and glutathione-s-transferase (GST) activities were measured. Results: oxidative and inflammatory processes were significantly increased by the LPS injection and these changes were to a greater extent in the low-protein dietary group compared to control group. Silymarin supplementation in both dietary groups showed marked inhibition in these activities, although the affect was more prominent in the control group compared to the rats fed a low-protein diet. Conclusions: The study showed that silymarin protected against the impairment of antioxidation and immune response in protein malnourished rats, particularly in septic shock conditions.

Practical identification of photovoltaic module parameters

The amount of energy radiated to the earth by the sun exceeds the annual energy requirement of the world population. Making use of this ine- xhaustible energy source for our everyday electricity requirement is the great challenge of the present and the future. The generation of electric energy from the sun via photovoltaic [PV] generation is one of the most eligible candidates in this regard. For PV applications, the accurate simulation of the PV module performance, which is an important point in the accurate design of these systems, depends mainly on the electrical parameters of the PV module [series resistance, reverse saturation current, short circuit current temperature coefficient, and ideality factor]. Also, knowledge of the effect of ageing on the PV module's performance after a certain period requires an accurate identification of these parameters. This paper presents accurate methods to obtain the PV module electrical parameters through practical measurements for its current-voltage [I-V] characteristics under dif- ferent operating conditions [different solar radiation intensity and module tem- perature] using an accu- rate data acquisition system. The paper then compares the theoretical performance of the PV module using the identified parameters with the measured curves to work out the accurate determination of the PV module parameters

The Knowledge and Attitude of Practicing Dentists towards the Antibiotic Prescription: A Regional Study.

Aims: To assess dentist’s knowledge and practice in relation antibiotic prescription and to investigate if they follow the current international guidelines. Methodology: In this cross sectional study a structured and pretested questionnaire was sent to 202 licensed dental practitioners in UAE, Iran and Jordan took place in period between December 2011 and January 2012 by e-mail and physical delivery. Results: Of 160 responding dentists 93.1% would prescribe antibiotics for dentofacial infections with systemic signs but many prescribe antibiotics for conditions where antibiotic therapy is not required according to good practice. Amoxicillin was the most frequently prescribed antibiotics. The non-clinical factor that may affect decision of the majority of dentists to prescribe antibiotics was perception of the effectiveness of those antibiotics in previous cases they treated with same agent (61.25%). Most of the respondents (84%) prescribe prophylactic antibiotics for patients at risk of infective endocarditis. Conclusion: This study reveals that antibiotics were still being prescribed by dental practitioners where recent guidelines suggest there is no indication.

Knowledge and attitude of healthcare professionals toward medication pregnancy category systems in Saudi hospitals

To assess the knowledge and attitudes of healthcare professionals [HCPs] toward systems used in describing the safety of medications use during pregnancy. A cross-sectional self-administered survey was conducted in 4 tertiary hospitals in Riyadh, Saudi Arabia between March and May 2012. The targeted HCPs were physicians and pharmacists. The survey was validated and contained 4 main sections. Descriptive statistics were used to report responses to the survey's questions. A total of 393 HCPs responded to the survey, with a response rate of 97%. Half of the respondents were physicians. Of the participants, 60% were males. Most respondents [66%] stated that they have prescribed/dispensed a drug that may cause teratogenicity. Moreover, 87% of the respondents [48% pharmacists and 39% physicians] were aware of the Food and Drug Administration [FDA] pregnancy category, and most [72%] found it helpful. Only 11% of the participants strongly agree to use the European Medicine Agency [EMA] system for pregnancy category system as their main reference. In general, HCPs in Saudi Arabian hospitals have good knowledge of and attitudes toward pregnancy category systems, with more familiarity with the FDA system. The FDA system is preferred over the EMA system

Efficacy of implementation of a 5 scale pediatric triage and acuity scale in pediatric emergency, Saudi Arabia

To evaluate the effectiveness of implementation of the pediatric Canadian Triage and Acuity Scale [Ped-CTAS] for children visiting the pediatric emergency department [ED]. This cross-sectional study evaluated all children presented to the ED during a 9-day period in March 2010. The Ped-CTAS triage system was used. Triage performance was analyzed on the basis of quality indicators, rate of admissions, rate of referral, observation duration, and relationship between investigations requested and CTAS level. During the study period, 3,337 patients were triaged. Overall, 4 patients [0.1%] were in triage level 1, 356 [[12%] were level 2, 655 [22%] were level 3, 1810 [60%] were level 4, and 189 [6%] were level 5. The left without being seen rate was 6.25%. A triage duration of 5 minutes or less was carried out for 97% of cases. Within the CTAS time objectives, the waiting time to nurse and physician was 100% for cases triaged to level 1. The proportion of cases who needed observation was 100% for level 1, 85% for level 2, 53% for level 3, 33% for level 4, and 26% for level 5. The proportion of patients admitted to the hospital was 100% for level 1. The lower the level [more acute and emergent the condition] the more use of the laboratory and radiological investigations. The pediatric CTAS triage system is a good tool for categorizing pediatric patients attending the ED. Stratified by triage level, triage indicators can be used as indicators of ED performance

Biochemical evaluation of renal osteodystrophy in uraemic patients

Renal osteodystrophy is a multifactorial disorder of bone remodelling that develops in patients with chronic renal failure [CRF]. Biochemical markers of bone turnover have been proposed for the noninvasive diagnosis of renal osteodystrophy. The purpose of this study was to evaluate intact parathyroid hormone [iPTH] and some markers of bone disease in predialysis [preD] and haemodialysis [HD] CRF patients and correlate them with bone mineral density [BMD]. Several biochemical markers were measured in the serum of 74 CRF patients [38 preD patients and 36 patients on regular HD]. In addition, 30 healthy volunteers were included as controls. BMD of all patients was measured by means of calcaneal ultrasonography. BMD was measured by means of ultrasound. BMD was significantly decreased in both patient groups when compared with controls. Also, it was significantly lower in patients with osteoporosis than in those with osteopenia. iPTH, total alkaline phosphatase [ALP] and osteocalcin [OC] levels were significantly elevated in both patient groups when compared with controls. Ionized calcium [Ca[2+]], free carnitine and insulin-like growth factor-1 [IGF-1] levels were significantly decreased in patients compared with controls. There was a significant inverse correlation of BMD with iPTH, ALP and OC and a significant positive correlation with Ca[2+] and IGF-1 in HD patients. PreD patients showed significant inverse correlation of BMD with iPTH and ALP and significant positive correlation with Ca[2+]. The results of the present study suggested that ultrasound is a useful method for evaluating BMD and provides information about diverse regional skeletal changes in CRF patients. iPTH, ALP, OC and Ca[2+] can predict renal osteodystrophy in preD and HD CRF patients. PreD and HD CRF patients often have low serum concentrations of free carnitine and IGF-1

Acute hemiplegia as a rare presentation of infantile Guillain-Barre syndrome

Guillain-Barre syndrome [GBS] usually presents in a symmetrical ascending fashion of weakness. We present a 6-month-old male infant who presented to our emergency room with acute left-sided limb weakness and head lag 3 days after a febrile upper respiratory tract infection. A diagnosis of GBS was established by confirming high cerebrospinal fluid protein, motor nerve reduced amplitude, and prolonged conductions, and MRI T2 high signal intensity affecting the ventral roots of the spinal cord. He showed remarkable clinical and neurophysiological improvement after intravenous immunoglobulin and intensive physiotherapy. The occurrence of infantile acute hemiplegia as a presentation of GBS is rare. This report highlights the importance of considering GBS in the differential diagnosis so that early effective treatment may be started

Occult HCV in Egyptian volunteer blood donors

The study aims to investigate the risk of post-transfusion transmission of hepatitis c virus [HCV] in the circumstances of occult HCV when anti-HCV is undetectable by ELISA and HCV-RNA is detected by RT-PCR in the plasma and or in peripheral blood mononuclear cells [PBMCs] of donor blood and the recipients are immunocompromised. The study covered 18 chronic renal failure patients [CRF] [12 males [66.7%] their age ranged from 28 to 65 years and 6 females [33.3%] their age ranged from 15 to 55 years] undergoing hemodialysis in Nile Hospital as part of their therapy have to receive blood transfusions [275 blood units] for the first time. Commercial ELISA kits for anti-HCV and nested-RT-PCR [N-RT-PCR] kits were used. Anti-HCV was positive in one serum from the eighteen [5.5%] poly transfused CRF patients at the end of the study while the seventeen sera were negative. This serum was also positive for HCV RNA by N-RT-PCR. Out of the 20 transfused blood units, one blood unit [three components] were tested by blood banking anti-HCV negative by ELISA, were positive for HCV RNA by N-RT-PCR. The collective markers of this blood unit represent an occult HCV. The risk of acquiring post-transfusion HCV infection from an occult HCV blood unit is 5%. Real time PCR showed variation in the viral load of the serum of the infected CRF patient, the plasma of blood unit, the PBMCs of this blood unit whether activated by PHA-M or not

Comparison between quantiferon-TB-gold test and tuberculin skin testing in diagnosis of both latent and active tuberculosis infections

Introduction: Tuberculosis [TB] is an infectious disease affecting mostly the respiratory system with or without affection of other organ-systems caused mainly by infection with Mycobaterial tuberculosis [MTB]. However, not all cases of infection with any of the TB bacilli are converted to active or manifested infection and most cases are called latent tuberculosis infection [LTBI] which can be later on converted to active infection. There are several factors that underline the conversion from latent to active TB infections. Previously LTBIs was diagnosed by tuberculin skin testing [TST] but now there is new test formats which measures the released interferon-y [INF-y] after stimulation ofT-cells contained in whole patient blood by specific antigens obtained from MTB. These tests are called interferon gamma release assays [IGRAs] which are more sensitive and specific than TST one of these tests is the QuantiFERON-TB Gold In-Tube [QFT-G] which measures the released IFN-y by ELISA method

Aim of study: The aim of the current study was to compare the TST and QFT-G in diagnosing LTBIs in some groups of participants including TB contacts, HIVpatients, HCWs, prisoners in comparison to patients with active TB infection

Materials and methods: the study included 163 of close contacts to household TB cases, 32 healthcare workers in King Saud Chest hospital, 52 prisoners from Riyadh region, 25 HIVpatients, and 158 patients with active TB as a control group. History and general examination was done to all participants. Then TST was done using 2 IV by intradermal injection using Mantoux technique. Whole blood samples were taken for measuring the released interferon y using Quantiferon TB Gold In Tube [QFT-G] method

Results: TST was positive in 52.8% of TB contacts, 21.9% of HCWs, 34.6% of prisoners, 28% in HIV patients and in 97.5% of active TB patients, while QFT-G was positive in 56.4%, 12.5%, 57.7%, 24%, and 98.7% in previous groups respectively. The overall mean results for QFT-G [67%] were higher than that for TST [63.3%] with statistically insignificant results

Conclusion: QFT-G is more sensitive than TST in diagnosing LTBIs and further studies upon larger population number is need to investigate it specificity

Hormonal, metabolic and clinical profile of Saudi women with polycystic ovary syndrome

Objective: To establish the hormonal, metabolic and clinical profile for Saudi women with polycystic ovary syndrome [PCOS]

Design: This is a prospective, cross-sectional study conducted at the University Hospital. All women were seen at the gynecology clinic. One hundred women aged between 18 and 45 years were included in the study; 50 women with polycystic ovary disease [PCOS] comprised the study group and 50 women without PCOS comprised the control group. The hormonal, metabolic and clinical profiles were assessed for both groups

Results: There are significantly higher levels of luteinizing hormone, prolactin, free testosterone dehydroepianosterone sulfate, 17 alpha-hydroxy progesterone and fasting insulin in the study group. There were no differences in the levels of total testosterone, estradiol and cortisone levels between both groups. The levels of follicular stimulating hormone and sex hormone binding globulin were significantly lower in the study group. There were no differences in the blood sugar level, cholesterol, triglycerides and low- and high-density lipoproteins. The womens' ages, body mass index, blood pressure, uterine dimensions and endometrial thickness were similar in both groups. The size of both ovaries was significantly greater in the study group. There were more follicles in the ovaries of the study group

Conclusion: Hormonal profile of Saudi women with PCOS was similar with what is already published in the medical literature. But, despite the fact that Saudi women with and without PCOS are overweight, they do not suffer from raised blood pressure and metabolic syndrome; this may be due to the fact that women included in this study were relatively young and the sample size might be too small to draw effective conclusions

microbiology of vaginal discharge and the prevalence of bacterial vaginosis in a cohort of non-pregnant women in Kuwait

To examine the microbiology of vaginal discharge and to estimate the prevalence of bacterial vaginosis and its association with sexually transmitted infections in a cohort of non-pregnant women in Kuwait. Retrospective study conducted during a six-month period [November 2009 - April 2010]. The gynecology outpatient clinic at the South Ardyia Health Unit, Farwania, Kuwait. Retrospective evaluation of medical records of 668 women, who attended the gynecology outpatient clinic at the South Ardyia Clinic, Farwania, Kuwait complaining of vaginal discharge during the study period. Retrospective review of the files for complaints, history, clinical examination and investigations of the vaginal discharge. A retrospective microbiological study of the infective etiology of vaginal discharge, the prevalence of bacterial vaginosis and its association with sexually transmitted infections. Microbiological causes of vaginal discharge accounted for 43.4% of cases. The commonest causes were bacterial vaginosis [prevalence = 18.9%] and candida infections [prevalence = 11.8%]. There was no significant association of bacterial vaginosis and sexually transmitted infections. Bacterial vaginosis is the commonest microbiological cause of vaginal discharge. Bacterial vaginosis is not a sexually transmitted disease