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Abstract The modern process of new drug discovery and development is an exciting, yet a challenging, endeavor. Although it can result in significant financial income and meet the medical needs of patients, it ultimately may result in failure. To achieve a fast and successful new product discovery and development process, natural products which are evolutionarily optimized as drug-like molecules have gained great attention as better potential sources of new chemical entities. Historically, plant species containing berberine are used in various traditional phytotherapy. However, despite the various therapeutic effects it exerts, berberine is not yet developed into a drug product. Addressing the barriers that hinder its successful development and the efforts made to overcome them is thus crucial. The toxicological and pharmacokinetic properties of berberine are the main barriers towards its development into a marketed drug product. It has low aqueous solubility, poor absorption, fast metabolism, and wide tissue distribution which lead to low bioavailability limiting its clinical application. Synthetic berberine derivatives with improved properties are suggested as better alternatives for further development and future therapeutic application. Hence, this paper summarizes the preclinical research studies conducted in the last decade to reveal the therapeutic potential of synthetic berberine derivatives for the treatment of various diseases and hence achieve successful berberine-based drug development in the future. To exploit the value of natural products as a source of leads for the development of effective drugs, collaboration among the different discovery and development scientists is essential.
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Objective@#To assess diffusion tensor imaging (DTI) parameters of the hepatic parenchyma for the differentiation of biliary atresia (BA) from Alagille syndrome (ALGS). @*Materials and Methods@#This study included 32 infants with BA and 12 infants with ALGS groups who had undergone DTI.Fractional anisotropy (FA) and mean diffusivity (MD) of the liver were calculated twice by two separate readers and hepatic tissue was biopsied. Statistical analyses were performed to determine the mean values of the two groups. The optimum cut-off values for DTI differentiation of BA and ALGS were calculated by receiver operating characteristic (ROC) analysis. @*Results@#The mean hepatic MD of BA (1.56 ± 0.20 and 1.63 ± 0.2 x 10-3 mm2 /s) was significantly lower than that of ALGS (1.84 ± 0.04 and 1.79 ± 0.03 x 1010-3mm2 /s) for both readers (r = 0.8, p = 0.001). Hepatic MD values of 1.77 and 1.79 x 1010-3 mm2 /s as a threshold for differentiating BA from ALGS showed accuracies of 82 and 79% and area under the curves (AUCs) of 0.90 and 0.91 for both readers, respectively. The mean hepatic FA of BA (0.34 ± 0.04 and 0.36 ± 0.04) was significantly higher (p = 0.01, 0.02) than that of ALGS (0.30 ± 0.06 and 0.31 ± 0.05) for both readers (r = 0.80, p = 0.001). FA values of 0.30 and 0.28 as a threshold for differentiating BA from ALGS showed accuracies of 75% and 82% and AUCs of 0.69 and 0.68 for both readers, respectively. @*Conclusion@#Hepatic DTI parameters are promising quantitative imaging parameters for the detection of hepatic parenchymal changes in BA and ALGS and may be an additional noninvasive imaging tool for the differentiation of BA from ALGS.
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Objective@#To assess diffusion tensor imaging (DTI) parameters of the hepatic parenchyma for the differentiation of biliary atresia (BA) from Alagille syndrome (ALGS). @*Materials and Methods@#This study included 32 infants with BA and 12 infants with ALGS groups who had undergone DTI.Fractional anisotropy (FA) and mean diffusivity (MD) of the liver were calculated twice by two separate readers and hepatic tissue was biopsied. Statistical analyses were performed to determine the mean values of the two groups. The optimum cut-off values for DTI differentiation of BA and ALGS were calculated by receiver operating characteristic (ROC) analysis. @*Results@#The mean hepatic MD of BA (1.56 ± 0.20 and 1.63 ± 0.2 x 10-3 mm2 /s) was significantly lower than that of ALGS (1.84 ± 0.04 and 1.79 ± 0.03 x 1010-3mm2 /s) for both readers (r = 0.8, p = 0.001). Hepatic MD values of 1.77 and 1.79 x 1010-3 mm2 /s as a threshold for differentiating BA from ALGS showed accuracies of 82 and 79% and area under the curves (AUCs) of 0.90 and 0.91 for both readers, respectively. The mean hepatic FA of BA (0.34 ± 0.04 and 0.36 ± 0.04) was significantly higher (p = 0.01, 0.02) than that of ALGS (0.30 ± 0.06 and 0.31 ± 0.05) for both readers (r = 0.80, p = 0.001). FA values of 0.30 and 0.28 as a threshold for differentiating BA from ALGS showed accuracies of 75% and 82% and AUCs of 0.69 and 0.68 for both readers, respectively. @*Conclusion@#Hepatic DTI parameters are promising quantitative imaging parameters for the detection of hepatic parenchymal changes in BA and ALGS and may be an additional noninvasive imaging tool for the differentiation of BA from ALGS.
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Background: Anatomic variations of cystic ducts are common and continuously encountered during Surgical andradiological interventions. Failure to identify these clinically important variations may result in complicationsduring surgical or endoscopic procedures.Patients and methods: This is an observational descriptive cross-sectional study. 65 cadavers in the dissectingrooms of the medical colleges, in which the length and mode of insertion of cystic duct (CD) into common bileduct (CBD) were observed.Results: The mean length of the CD in the cadavers examined was (2.06 ± 1.03) with a minimum length of d” 0.5 cmand a maximum of 5 cm. Regarding the mode of insertion of CD into the CBD; 53.8% were found to have a lowjunction between the CD and common hepatic duct (CHD) which is considered the normal insertion. 46.2% foundto be abnormal variations of insertion; short CD (d”0.5 cm) observed in 10.8%; whereas in 13.8% of cadavers wefound that the CD is adherent to the CHD and runs in parallel to it. In 7.8% there was a high junction between theCD and CBD and in 9.2% we found that CD courses anterior or posterior to CBD and joins it medially.Conclusion: CD variations are not uncommon and it is important to identify these anatomical variations. Adetailed knowledge of the extra hepatic biliary tract, as well as of its variations, is important for the diagnosticand therapeutic success in many clinical situations since they allow the surgeon prompt identification ofcertain pathologies, making surgical procedures more accurate and affective.
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Good quality management for computerized Tomography [CT] scanners is essential to safe and efficient CT units, providing quality clinical images, maintaining patient and staff radiation doses as low as reasonably achievable. to evaluate the technical specifications of [CT] scanners in Jazan region in the period from 2011-2013. 13 CT scanners have been evaluated; 2 of them are in private sectors and the rest in public hospitals. The Technical specifications of CT scanners were assessed using template issued by ImPACT [Imaging Performance Assessment of CT scanners]. When comparing the 11 public scanners age with guidelines rules of European Coordination Committee of the Radiological and Electro medical Industries [ECCREI]; it showed that scanners of Jazan region are within lifecycle guidelines, the total cumulative number of scanners since 1984 to 2013 are 15 scanners, 4 of them were replaced and the rest under use, multi detector CT scanners replaced most of the single detector scanners. for public CT scanners ; results show that all of the scanners are 3rd generation, gantry bores are arranged between70-80cm, the x-ray tube inventory showed that there is no dual source CT scanner in the region and the anode storage heat capacity ranged from [3-8MHU] except Siemens 64slices and 20slices reached up to [30MHU]. All of scanners in the region are built in solid state, image reconstruction time display per second is ranged from 1-40slice/seconds, advance clinical application software are available among the scanners. Jazan region CT scanners have a high capability and their technical specifications are in a rapid pace in developments that impacting on performance which depends on trade-off between image quality and patient dose
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The Rift Valley fever [RVF] is a neglected, emerging, mosquito-borne disease with severe negative impact on human and animal health and economy. RVF is caused by RVF virus of the family of Bunyaviridae, genus Phlebovirus. RVF is an acute, febrile disease affecting humans and a wide range of animals. The virus is trans-mitted through the bites from mosquitoes and exposure to viremic blood, body fluids, or contact with tissues of infected animals or by inhaling natural virus aerosols, also possibly by consumption of infected unpasteurized milk. The RVF-virus replicate at the site introduction and in local lymphatic followed by viremia and spread to other organs as the liver and central nervous system, causing the hepatic necrosis and eosinophilia cytoplasmic degeneration. The main signs and symptoms are fever, headache, myalgia, arthralgia, photophobia, bradycardia, conjunctivitis and flushing face. Main complications include jaundice, hemorrhagic, meningoencephalitis and retinal lesions. Generally speaking, in the21[st] Century, the vector-borne infectious diseases, was accepted as the disaster issues with the considerable significant morbidity and mortality. These facts should be considered by the public health, veterinary and agricultural authorities
Subject(s)
Communicable Diseases/epidemiology , Rift Valley fever virus/isolation & purificationABSTRACT
This study aimed at assessing the thyroid status in Kordofan region [western Sudan] where the prevalence of goitre was not clearly defined. A cross-sectional, prospective study was conducted in Elobied regional health laboratory on 150 thyroid patients [136 female, 14 male] referred during the period between May-November 2003, their ages ranged between 6 to 65 years. A matching control group of 50 subjects [39 female, 11 male] without symptoms or signs of thyroid disease, were included for comparison. After clinical evaluation and data collection through a questionnaire, serum concentrations of TSH, total triiodothyronine [TT3], and total thyroxine [TT4] were measured by radioimmunoassay. The frequency of thyroid disorders was higher in females [90.7%] than in males [9.3%], among the age group between 25-34 years. The percentage of patients with euthyroid was significantly higher [62%] compared with 28.3% of hyper and 9.3% of hypothyroidism. 69.3% of the thyroid patients had stage II goitre. TT4, TT3 and TSH showed significant differences [P < 0.001] in hyper and hypothyroidism compared with the euthyroid patients and the control group. Serum TT[4] values correlated negatively with TSH [r = 0.272, P = 0.001], and positively with TT[3] [r = 0.693, P = 0.000]. The prevalence of thyroid diseases was found higher in this area, with strong association with the food intake and genetic background, a problem needing to be considered seriously
Subject(s)
Humans , Male , Female , Thyroid Function Tests , Thyroid Diseases/diagnosis , Goiter/epidemiology , Cross-Sectional Studies , Prospective StudiesABSTRACT
To perform genotyping of Toxoplasma gondii among pregnant women with toxoplasmosis in Central Sudan. The study group was presented by 94 pregnant women who had abortion between the second and fourth months of gestation, whereas the control group consisted of 64 full term normally delivered women. The study was conducted at Wad Medani Teaching hospital, Gezira State, Central Sudan during the period of March 2002 to May 2004. PCR test on aborted and placental tissue revealed positivity rate of 19.1% and 22.3%, in study and control groups respectively, with no significant difference between them [P=0.55]. This compared to a seroprevalence rate of 35.1% and 39.4% in study and control groups respectively. Genotyping form clinical samples using PCR/RELP revealed Toxoplasma gondii type II in 89% and 95% of the study and control group respectively, whereas, 11% and 5% were infected with type III. The most prevalent strain of T. gondii among the pregnant women was Type II followed by type III but type I was completely absent
Subject(s)
Humans , Female , Toxoplasmosis/diagnosis , Genotype , Abortion, Spontaneous/parasitology , Polymerase Chain Reaction , Polymorphism, Restriction Fragment LengthABSTRACT
This study aimed at assessing the clinical features and haematological parameters in sickle Sudanese patients attending El Obeid Hospitals in North Kordofan, Sudan. Eighty five patients with homozygous sickle cell [SS] disease, [both sexes] were included in this study. Their age ranged between 6 months to 42 years. Forty persons were used as control. Clinical manifestations were recorded at examination. Freshly obtained blood samples from patients and control were used to estimate haematological parameters which included: haemoglobin concentration [Hb], packed cell volume [PCV], red blood cell count [RBC], white blood cell count [WBC], mean corpuscular haemoglobin [MCH], mean corpuscular volume [MCV], and erythrocyte sedimentation rate [E.S.R]. The clinical investigations revealed that all patients presented with painful crisis, 96.5% had chronic anemia, 84.7% had recurrent malaria and 81.2% had different infections [76% was chest infection], 32.9% of the sickle cell disease [SCD] patients had no blood transfusion, while the rest had blood transfused once to five times. Haematological measurement indicate that all SCD patients in this study were reported anaemic, and their Hb, PCV and RBC count were significantly lower [P<0.001] compared with the control group, while WBC count of and MCV were significantly higher [P<0.001, P<0.01]. In this study the prevalence of SCD in Misseria tribe [24.7%] was highest compared to other tribes. This study affirmed the problem of sickle cell disease in Kordofan state, which should draw attention toward the need of further studies
Subject(s)
Humans , Male , Female , Hemoglobins , Hematocrit , Erythrocyte Count , Leukocyte Count , Erythrocyte Indices , Blood SedimentationABSTRACT
Aim and Background: hepatopulmonary syndrome [HPS] is defined ccs triad of chronic liver disease, arterial hypoxemia, and intrapulmonary vascular dilatation. Presence of HPS in pediatric age group is an indication liver transplantation. We investigated the presence of HPS in 25 children [13 boys and 12 girls], age ranged from 2-15 years, with cirrhosis [8 Child-Pugh class A, 10 class B, and 7 class C]
Methods: they underwent detailed clinical evaluation, x-ray chest, ECG, and contrast enhanced transthoracic Doppler Echocardiographic examination using saline, results were compared to a control group of 8 healthy matched children
Results: children with cirrhosis had increased heart rate, decreased, mean arterial blood pressure, peak velocity of aortic blood flow, and increased cardiac output that were statistically significant [p<0.03, p<0.003, p< 0 .002, and p<0.03] when compared to controls. Contrast enhanced Echo was positive in 4 patience with arterial P alfa O2 < 70 mmHg [Child-Pugh grade CI: HPS +ve group. and was negative in all other patients whom arterial P alfa O2 < 70 mmHg [Child-Pugh class A=8, class B=10. class C=3]: HPS -ve group. When compared to controls, HPS +ve group have statistically significant increase in Echo-derived aortic diameter [p<0.004] and cardiac output [p< 0.006]. In addition, there was significant difference as regards age [p< 0.01], Echo-derived aortic diameter [p> 0.004] and cardiac output [p> 0.001] between HPS group and rest of patients
Conclusion: children with cirrhosis have hyper-dynamic circulatory status ;as evidenced by decreased mean arterial: blood pressure and increased cardiac output. Contrast enhanced Echocardiography is a sensitive as well as specific tool to diagnose HPS in children. HPS in children is associated with advancement in age and in Child-Pugh classification
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Wilson's disease, hepatolenticular degeneration, is a rare inherited disorder of copper metabolism, which is transmitted through a specific genetic abnormality on chromosome 13. The disease results from the failure of the liver to excrete copper. Excessive copper is thus deposited in liver, basal ganglia, eyes, kidneys, and skeleton causing damage including cirrhosis of the liver and degeneration of the basal ganglia. The 30-year-old Sudanese male presented in this case study developed a severe Parkinsonian-like neurological picture along with chronic liver disease. The diagnosis of Wilson's disease was suspected clinically and seemed possible with the finding of a highly increased 24-hour urinary excretion of copper although Kayser-Fleischer rings were not detected. We would like to draw attention to this condition, which, in areas where chronic liver disease is common, may easily be missed without a high index of suspicion