Correlation between Neutrophil Gelatinase-Associated Lipocalin and Endoscopic, Histopathologic and Clinical Activities of Ulcerative Colitis

Introduction:Detection of activity of ulcerative colitis (UC) is vital for predicting treatment outcome. The assessment depends on clinical, serologic, and endoscopic findings. One of the noninvasive biomarkers for disease activity detection is serum Neutrophil Gelatinase-Associated Lipocalin (NGAL). Aim:To assess the relationship between NGAL and endoscopic, histopathologic and clinical activity of UC.Methods:This study wasconducted on 50 cases with definitive diagnosis of UC and 15 cases with normal colonoscopyexamination as controls.UC cases were considered active if Geobes score was ≥3.1.Complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and liver and kidney function tests were done.Serum NGAL was estimated using ELISA technique. Results:UC caseswere classified into active group (n = 36) and inactive group (n = 14). In active UC cases, median value (IQR) of serum NGAL was significantly increased(101.15 (67.53 –156.40) ng/mL) compared to inactive cases (63.35 (60.98–65.20)ng/mL) and control group (24.80 (15.50 –31.50)ng/mL).Serum NGAL was well correlated with Geobes score, Mayo score, CRP and ESR.Serum NGAL at cut-off ≥ 63 can predict activity with sensitivity88.89%, specificity 85.71%, PPV 94.12% and NPV 75%.Conclusion:Serum NGAL is valuable noninvasive marker for assessment of UC disease activity

Prevalence and clinical correlations of acquired activated protein C resistance and antiphospholipid antibodies in patients with systemic lupus erythematosus

Systemic Lupus Erythematosus [SLE] is an autoimmune disorder affecting multiple organ systems. Antiphospholipid [aPL] antibodies are frequently found in plasma of SLE patients and venous thromboembolism VTE is common manifestation. This work was designed to assess the level of antiphospholipid antibodies [B2 glycoprotein I antibodies, anti prothrombin antibodies and lupus anticoagulant], protein C resistance and factor V Leiden in SLE patients and evaluate the correlation to thrombotic tendency in those patients. 50 SLE patients and 30 normal controls were included and subjected to measurement of antibodies to B2 glycoprotein I and antiprothrombin antibodies using ELISA technique, Lupus anticoagulant was estimated using diluted Russell Viper Venom Test [dRVVT], activated protein C resistance APC-R was measured by modified coagulometric technique and Factor V Leiden by PCR technique. Acquired APC-R was present in 17 out of 50 patients [34%] and all of them are not found to have Factor V Leiden mutations. The presence of acquired APC-R was a strong risk Factor for venous thromboembolism VTE. [OR 5.63 CI 1.8 - 11.2 P < 0.001] Raised level of all aPL antibodies found in patient group Anti B2GPI in 30%, anti PT in 50% and LA activity in 46% of SLE patients. A significant association was observed between APC-R and co-existence of anti- B2GPIAb and LA activity or of antiprothombin antibodies and LA activity. There was no association between APC-R and presence of anti-B2GPIAb, antiprothrombin Abs or LA activity alone. However, multivariate logistical regression analysis was performed it was clear that only the coexistence of antiprothrombin antibodies and LA activity was a significant risk factor for APC-R. [OR 3 - 53 95% CI 1.45 - 8.58.] There was no significant differences between SLE patient and control group as regard Protein C, Protein S or AT III levels. Coexistence of only antiprothrombin Abs and LA activity was a significant risk factor for APC-R and it may be important for pathogenesis of VTE in patients with SLE

Comparative study between trans vaginal sonography, saline infusion sonography and hysterosalpingography in diagnosis of uterine cavity diseases as compared to diagnostic hysteroscopy in infertile women

The purpose of this study was to evaluate the diagnostic accuracy of hysterosalpingography, saline infusion sonography and transvaginal sonography as compared to hysteroscopy in diagnosis of uterine cavity abnormalities in infertile women of more than one year. This study included 60 infertile patients with no malefactor, all patients were subjected to hysterosalpingography, saline infusion sonography, transvaginal sonography and hysteroscopic examinations post-mentsturally to evaluate the uterine cavity. Zagazig University Hospital and Cytogenetic unit. Eight patients were excluded from this study due to different causes and only 52 patients continued in this study. As regard to the polypoid lesions, hysterosalpingography [HSG] showed low diagnostic value 51% sensitivity with 28.7% positive predictive value [ppv], transvaginal sonography had intermediate diagnostic accuracy, sensitivity 75.3% and ppv was 75.3%, while saline infusion sonography had sensitivity and PPV of 100% .In cases with intrauterine adhesions poor results were obtained with transvaginal sonography, however the best results were obtained by saline infusion sonography as the sensitivity and ppv were 76.1% and 43.2% respectively. As Regard to uterine malformation, hysterosalpingography had low sensitivity 43.3% and high specificity 96.2%, while transvaginal sonography and saline infusion sonography demonstrated 100% specificity and 100% ppv. Saline infusion sonography had a diagnostic accuracy of 100% for endometrial hyperplasia while HSG had a poor value. Transvaginal sonoogaphy had sensitivity of 67.6% with PPV of 67.1% in diagnosis of endometrial hyperplasia. Saline infusion sonography was the most accurate diagnostic method for polypoid lesions and endometrial hyperplasia as compared to hysterosalpingography and transvaginal sonography. Its diagnostic accuracy was the same as that of hysteroscopy, but with limitted value in diagnosis of intrauterine adhesions

Impact of partnership for health promotion on rural women development

El-Tal El-Kibeer is one of the 4 districts of Ismailia Governorate, Egypt. Its community is a rural one with a long history of self development. At 1987, that community started a partnership project with Suez Canal University aiming to health promotion through community participation. Women at El-Tal El-Kibeer shared actively from the start of project. Young ladies were so enthusiastic in training and in performing many of the duties of community health workers as following up growth and development of babies of their village, sharing in surveys,etc. A class for training young ladies and girls on sewing, knitting, needle work, cooking, etc. was opened in collaboration with a NGO at one of the hamlets. That center is serving the whole district and would prepare young ladies and girls to be skillful wives who can earn money, from their work. A comparative study was done to evaluate the impact of different training programs on the knowledge and attitude of women community health workers. Young ladies who were trained as community health workers at different hamlets were interviewed, with another matching group of young ladies from the same hamlets. The study revealed that more community health workers identified of the concept health and all processes leading to health promotion. The most important indicator was that 81.5% of them expressed their active sharing in solving any health problem at their community compared to 45% of the other non community health workers of whom 35% mentioned that solving problems is the job of men

Bacterial vaginosis: diagnosis and associations in vaginal discharge

Bacterial vaginosis [BV], the commonest cause of vaginal discharge, is thought to be polymicrobial in origin. The objective of this study was to evaluate the prervalence of BV in obstetrics and gynecological clinics, its rapid diagnosis regimen and its possible associations. One thousand and eighty patients, 16-55 years old, attending the outpatient clinics were included. Patients, all complaining of vaginal discharge, were clinically examined and subjected to approved rapid diagnostic techniques, isolation and identification of Gardnerella vaginalis [G. vaginalis] and anaerobes and the detection of urological mycoplasmas. The overall prevalence of BV was relatively low, accounting for 17.1%. G. vaginalis was identified in 95% of those with BV i.e 170/1080 [15.7 of all cases] whereas no anaerobes could be identified. Mycoplasma hominis [M. hominis] and Ureaplasma urealyticum [U. urealyticum] were detected and identified in 29/460 cases, 9 of which were in Gardnerella negative cases adding a 1.4% to the overall prevalence. G. vaginalis was identified in 29% of intrauterine contraceptive device [IUCD] users, 57% of patients with pelvic inflammatory disease [PID], 33% of patients with infertility and 24% of patients presenting with preterm labour. On the other hand, no association could be found between g. vaginalis and other forms of vaginitis, namely trichomonas vaginitis and vaginal candidiasis. Rapid diagnosis using a vaginal discharge pH of > 5 and Gram stained smear was extremely easy and reliable showing acceptable degrees of specificity and sensitivity. In fact these hand tools might give clues to early diagnosis and better management before the results of any cumbersome sophisticated investigations

Mannose resistant adherence and serotyping of Escherichia coli causing recurrent urinary tract infection in pediatric age group

Urinary tract infection in the pediatric age group is a disease of major concern. Clinical diagnosis, if unaided, cannot be relied upon as the symptoms and signs are nospecific resulting in false diagnosis. Appropriate managemwent will depend primarily on microbiologic examination. The present study comparised 84 patients [33 Males and 15 Females] complaining of frequently recurrent urinary tract symptoms who underwent full microbiological investigations starting by repeated viable bacterial counts, including systematic bacterial identification of the isolates to the species level and finally focusing on the virulence characterization of the commonest causative species i.e. Escherichia coli [E.coli] by the mannose resistant aldherence power and serotypig. Using viable bacterial count only 46 cases [56%] showed positive significant bacterial growth. The commonest causative pathogen was, as predicated, E.coli [60.9%] followed by Klebsiella [19.6%]. Staphylococcus [15.2%] and Proteus spp., [4.3%]. Of the E.coli strains, 71.4% turned to be mannose-resistant adherent mainly with the diffuse pattern to hpp[-2] cells, a finding usually associated with uroadherence and attributed to P fimbriae. Serotypoing of E.coli did not conform to published literature as it did not correlate with uropathogenesis. These results highlight the role of adherence for an in invading orgarism but rather as an additional virulence factor in cases of frequently recurrent urinary tract infection. Further studies to illustrate the relative importance of such factors and/or markers in the patogensis and the immune mechanisms are therefore needed

Bacterial vaginosis: diagnosis and associations in vaginal discharge

The objective of this study was to evaluate the prevalence of BV in obstetrics and gynecological clinics, its rapid diagnosis regimen and its possible associations. 180 patients, 16-55 years old, were included. All patients complaining of vaginal discharge, were clinically examined and subjected to approved rapid diagnostic techniques, isolation and identification of Gardnerella vaginalis, anaerobes and the detection of urological mycoplasma. It was shown that no association could be found between G. vaginalis and other forms of vaginitis, namely, Trichomonas vaginitis and vaginal candidiasis. Rapid diagnosis using a vaginal discharge pH of >5 and Gram stained smear were extremely easy and reliable showing acceptable degrees of specificity and sensitivity. In fact, these handy tools might give clues to early diagnosis and better management before the results of any cumbersome sophisticated investigations

Eradication of helicobacter pylori after surgical or medical treatment of duodenal ulcer and its relation to relapse

Forty four selected ulcer patients invariably positive for Helicobacter pylori were included in this this study, 14 patients were subjected to surgical treatment by truncal vagotomy and gastrojujenostomy. Eight of these 14 became H. Pylori negative postoperatively after healing of the ulcer. No single ulcer relapse was observed among those 8 patients during a 12 months follow up period, while the relapse rate was high in the 5 patients who remained H. Pylori positive postoperatively. The remaining 30 patients were treated medically using colloidal Bismuth Subcitrate [CBS] with or without antibiotics. It was observed that the patients who received amoxycillin and metronidazole in addition to CBS showed a higher cure rate [13/14]and no ulcer relapse. The results of this study indicate that eradication of H. pylori by antibioics may help to increase the cure rate and decrease ulcer recurrence. Thus it may be advisable to add one or more antibiotics to eradicate H. pylori whether medical or surgical regimen is used for management of duodenal ulcer

monthly changes in the hepatopancreas index and its effect on moulting in lobster thenus orientalis [land, 1793]

Hepatopancrease and its storage of food matters has a direct action on moulting. The weight of hepatopancrease increases in the period between two moulting processes, while it suddenly decreases after moulting directly. By tracing the periods at which the hepatopancrease reaches its maximum or minimal value, the number of moulting process in the year can be detected. There are 3 moulting cycles for males and 2 for females per year in T. orientalis within the studied length range