Laboratory studies on the possibility of Culex Quinquefasciatus to Harbor Hepatozoon SP. infecting cerastes cerastes cerastes viper in Egypt

A successful experimental infection of Culex quinquefasciatus with Hepatozoon sp. Infecting Cerastes cerastes cerastes viper was carried out under laboratory conditions of 24 +/- 3 C and 60-70% R.H..The period monitored for complete sporogonic cycle was 21 days. The effect of high parasitimic blood meal was nonsignificant [P>0.05] on preoviposition period and hatchability. Meanwhile a highly significant reduction was observed in oviposition rate, number of deposited eggs, number of hatched larvae and longevity [P<0.01]. On the contrary moderate infection with Hepatozoon revealed a great significant increase in fe- cundity [P<0.01] and a nonsignificant decrease in longevity [P>0.05]

Selected predictors of apoptosis in retinitis pigmentosa

The genetics of non syndromic retinitis pigmentosa [RP] is complex with numerous gene mutations. An attempt to overcome each individual mutation provides an overwhelming challenge. However targeting apoptosis which represents a final common pathway to photoreceptor cell death may provide a more practical approach. This study focused on some predictors of apoptosis in RP and their potential usefulness for patients' management and relatives' early diagnosis. Forty nine RP patients with thirty controls were evaluated genetically and ophthalmologicaly with assessment of plasma total nitrite and nitrate [as an index for nitric oxide], Plasma sFas as an index of apoptosis and plasma fatty acids levels. Autosomal recessive RP was the most common type of inheritance and the levels of plasma sFas and nitric oxide [NO] were significantly higher in retinitis pigmentosa compared to controls. Retinitis pigmentosa patients had significantly lower percentage of plasma omega3 fatty acids especially docosahexaenoic acid [DHA] relative to controls. sFas, NO, and DHA could differentiate between RP patients and control subjects with 100%, 100%, 97% sensitivity and 90%, 90%, 100% specificity respectively. sFas and nitric oxide levels were higher in cases of autosomal recessive [AR] type followed by X-linked, autosomal dominant, then simplex cases relative to the control group this may explain why AR and X-Linked forms are clinically more severe. In conclusion; diagnosis and treatment of RP could be aided by systemic markers or predictors of retinal degeneration. The consistent decrease in the plasma omega 3 fatty acids especially DHA, and increase sFas and nitric oxide levels may draw the attention upon the use of these markers as laboratory tests for relatives of affected patients who are at high risk for having retinitis pigmentosa. Also, omega 3 fatty acids in the form of DHA were recommended as possible supplements for the patients and their relatives

P53 expression and histopathological changes in primary and recurrent pterygia among Egyptian cases

The aim of this work is to assess P53 expression and histopathologic features in the epithelia of both primary and recurrent pterygia cases, searching for the pathogenesis of this common lesion. The pterygia specimens from 22 patients [twelve primary and ten recurrent cases] were studied by both routine hematoxylin and eosin stain and immunohistochemically using antibodies against P53 protein. Cases included in this study were 16 males and 6 females. Their ages ranged from 20 to 55 years. Positive family history was recorded in 18.2% of patients and positive parental consanguinity in 9.1% of them. Twenty cases [90.1%] had a history of chronic exposure to solar light i.e prolonged outdoor exposure time [8-12 hours/day] for more than 5 years. Epithelial hyperplasia was more common in recurrent pterygium samples [8 cases] than primary pterygium [only one case]. But, squamous metaplasia with mild dysplasia was more common in Primary pterygium samples [10 cases] than recurrent samples [2 cases]. Ten out of twelve studied specimens with primary pterygium [83.4%] were positive for abnormal P53 expression and two specimens [16.6%] were negative, while only 2 specimens [20%] of recurrent pterygium showed the abnormal positive expression and 8 cases [80%] were negative. Cases with marked and moderate P53 immunostaining [12 cases] showed squamous metaplasia with mild dysplastic changes, nine out of ten cases with negative immunostaining showed epithelial hyperplasia and the remaining sample showed squamous metaplasia without dysplasia. P53 protein is expressed at a high rate in primary pterygia as compared to cases of recurrence. Hence the possible role of P53 in the original development of pterygium, suggesting that pterygium could be a result of uncontrolled cell proliferation and unregulated cell apoptosis which can be proposed a type of benign tumour or even a precancerous condition and not as a degenerative lesion. It seems to be no correlation between P53 expression and recurrence. Recurrent pterygium was related to hyperplastic changes and this may explain the pathogenesis of recurrence especially if the pterygium was not excised completely and the remained epithelial cells continued to grow and formed a new pterygium

Influence of amphibian and reptile on the feeding preference, longevity and reproductive capacity of Egyptian culex [culex] pipens linneaus [dipera-culicidae]

Using Bufo regularis and ten reptile species as hosts for Culex pipiens under laboratory conditions revealed a great effect on feeding preference as a significant long feeding periods together with a significant reduction in the blood meal ratios were recorded. Female mosquitoes offered the experimental animals showed a short life span with different significant levels. A recognizable reduction in the reproductive fitness of Cx. pipiens females was recorded. Delayed oviposition and low ICI values was obtained. The percentage of egg hatching was not affected by the experimental animals

Laboratory studies on the possibility of culex [culex] pipiens L. to harbour and transmit hepatozoon matruhensis to the Egyptian snake psammophis schokari

A successful experimental infection of Psammophis schokari snake with Hepatozoon matruhensis through Culex [Culex] pipiens bites was carried out under laboratory condition of 20 +/- 1°C and 60-70% R.H. The period monitored for gametocyte maturation ranged from 38 to 42 days while the recorded prepatent period ranged from 28 to 35 days. The effect of infection was nonsignificant on longevity, incubation period and percenttage of egg hatching [P > 0.05]. Meanwhile a significant increase [P < 0.05] in the preoviposition period together with a significant reduction [P <0.001] in the number of eggs deposited of infected females were recorded

study of p53 protein and DNA ploidy in retinoblastoma

Retinoblastoma is the most common primary intraocular cancer in children. It arises from cells that are defective in both copies of the retinoblastoma susceptibility gene [RB I]. Loss of both RB1 and p53 functions may be required for cell immortalization and tumor development. The pattern of p53 expression in retinoblastoma appears to depend on the state of differentiation of the tumor. p53 and RB pocket proteins are important to control DNA ploidy, which may have a value in estimating the prognosis of retinoblastoma. The aim of this work was to assess p53 expression, DNA ploidy, and their relations with histopathologic features in retinoblastoma cases. The study was done on eight patients with retinoblastoma [seven males and one female]. Personal and family history with pedigree analysis were done for all cases. Ophthalmic examination with follow up of tumor regression rate during therapy was performed. Eight primary retinoblastoma samples were obtained from enucleated eyes of all patients. Retinoblastoma sections were stained by hematoxylin and eosin stain and scoring of histopathologic features was performed. Sections were immunohistochemically stained for the protein product of the tumor suppressor gene p53 and quantified for the extent and intensity of the staining. DNA ploidy was examined by assessment of type of DNA histogram and DNA index using cytometric analysis system [CAS 200] after feulgen staining. The proliferative activity was automatically expressed by the CAS 200 as the percentage of cells engaged in the S-phase of the cycle. Our results indicated that p53 protein was immunohistochemically detectable in most retinoblastoma cases [7/8 cases], and was only negative in one case. DNA was aneuploid in 6 out of 8 cases, while 2 cases [one of them was p53 negative, and the other showed weak positivity] were diploid with high proliferative activity. Histopathologic examination revealed that 3 cases were poorly differentiated and 5 cases showed intermediate differentiation with increased necrotic changes and mitotic figures. Retinoblastoma samples showed high degree of p53 protein expression and high degree of aneuploidy which were related to the aggressiveness of histopathologic changes of retinoblastoma. Thus both p53 expression and DNA ploidy have been shown to be markers of aggressiveness of tumor behaviour in retinoblastoma and can help in the prediction of its prognosis

Egyptian study of a rare autosomal dominant bilateral persistent hyperplastic primary vitreous

Persistent hyperplastic primary vitreous [PHPV] is an idiopathic congenital malformation confined to the eye that has no obvious cause and that is usually unilateral and sporadic. The clinical features of the classic PHPV syndrome include white, vascularized tissue covering some or all of the posterior surface of the lens; centrally dragged ciliary processes; secondary glaucoma caused by swelling of the lens or caused by contracture of the retrolental tissue, with anterior shifting of the lens-iris diaphragm; extensive intravitrael hemorrhaging; persistence of the hyaloid artery; and occasionally retinal detachment. In the present study we describe a patient with bilateral PHPV unassociated with other diseases. A normal milestone of development was reported. Family pedigree analysis revealed similarly affected father, grandfather, 2 aunts, 1 uncle from paternal side, also a grand uncle with 2 affected daughters. On examination; height, weight, skull circumference were in 5[th] percentile. Bilateral B and A eye scan ultrasonography for both the patient and the father revealed picture suggestive of persistent hyperplastic primary vitreous. Cytogenetics study by conventional culture technique using CTG banding technique revealed normal male karyotype [46, XY] for both of them. Review of London Dysmorphology Data Base [LDDB], OMIM, and recent medical literature revealed that this case to our knowledge represents the second report supporting autosomal dominant inheritance of PHPV unassociated with other anomalies

Clinical spectrum associated with some structural cerebellar abnormalities

To review the clinical, neuroimaging, cytogenetic, and biochemical studies obtained in 20 patients with different cerebellar structural abnormalities presenting at variable ages of onset with variable signs and symptoms. These patients visited the Clinical Genetics Department, National Research Center, Cairo, Egypt during the period from September 2002 to September 2003. All patients were subjected to complete personal and family history taking 3 generation family pedigree construction and full clinical examination, including complete eye evaluation. Metabolic screening, chromosomal examination and brain CT or MRI, or both, were also carried out. Patients with cerebellar structural abnormalities were broadly divided into those with cerebellar hypoplasia [15 patients; 75%], cerebellar atrophy [3 patients; 15%] and cerebellar white matter abnormalities [2 patients; 10%]. Further, cerebellar hypoplasia was subdivided into cerebello-vermal hypoplasia [4 patients; 20%], vermal-cerebellar hypoplasia [3 patients; 15%] and associated with involvement of other features such as brain stem [4 patients; 20%], posterior fossa [1 patient; 5%]; and intracranial calcification [3 patients; 15%]. This study showed that the type of cerebellar structural abnormality is not the main determining factor of the clinical outcome, but rather the underlying etiology. A high incidence of mostly autosomal-recessive inheritance was diagnosed in 65% of the patients with cerebellar structural abnormalities. Nevertheless, the high rate of consanguinity [18 cases; 90%] with mean inbreeding coefficient of 0.05312 and the similarly affected sibs highlights the role of the autosomal recessive gene in our country

Coagulation profile in patients with liver cirrhosis: thrombosis versus bleeding

A variety of haemostatic abnormalities occur in patients with liver disease and, in general, the severity of these abnormalities reflects the degree of hepatic dysfunction. Aims of the study: 1- To study the haemostatic parameters among patients with liver cirrhosis. 2- To characterize the haemostatic differences among patients with liver cirrhosis and thrombosis and those with bleeding. Patients, Materials and This study included 36 patients with liver cirrhosis of various stages who were selected among those admitted to the department of Tropical Medicine and Gastroenterology. In addition 15 apparently healthy persons were selected as a control group. They were diagnosed as liver cirrhosis according to clinical, laboratory and ultrasonographic criteria. All the patients and control were subjected to the followings: history taking and clinical examination, abdominal ultrasonography and coloured - Doppler ultrasonography, laboratory investigations including: blood count, liver function tests, haemostatic parameters including: prothrombin time and concentration, activated partial thromboplastin time [aPTT], antithrombin III [AT III], fibrinogen, protein S and protein C, D- dimer, platelet aggregation tests. The patients were classified into three groups: Group I: included 11 patients with liver cirrhosis and evidence of thrombosis [portal, DVT or both], Group II: included 17 patients with liver cirrhosis and evidence of bleeding tendency and Group III: included 8 patients with liver cirrhosis and no evidence of either bleeding tendency or thrombosis. There was highly significant reduction of the mean levels of the AT III, protein C and platelets among patients with liver cirrhosis in comparison to the healthy control [P = 0.000, P = 0.001 and P = 0.000 respectively]. The mean PT and aPTT times were significantly longer among patients with liver cirrhosis in comparison to healthy controls [P = 0.000 and p = 0.003 respectively]. Similarly the mean values of serum fibrinogen and D-dimer were significantly higher among patients with liver cirrhosis healthy controls [p = 0.000 and p = 0.003 respectively]. On the other hand no significant difference was found between patients and controls regarding the mean value of protein S [p = 0.401]. Total bilirubin, PT and aPTT showed positive correlation with Child score [r = 0.465, 0.552 and 0.582 respectively], while serum albumin, ALT. AT III and protein S showed negative correlation with Child score [r = -0.813, -0.405, -0.389, and -0.415 respectively]. Fibrinogen showed negative correlation with both the serum bilirubin and PT. AT III showed positive correlation with serum albumin and negative correlation with serum bilirubin, ALT AST and PT Protein S showed negative correlation with serum bilirubin. Protein C showed positive correlation with serum bilirubin, ALT, AST and PT. D-dimer showed negative correlation with AST. aPTT showed positive correlation with serum bilirubin, AST and PT. The mean values of AT III protein S and C were significantly lower in group I in comparison to group II [p = 0.035, 0.034 and 0.021 respectively]. On the other hand, a PTT was significantly longer in group II than group I [p = 0.006]. The mean values of protein C was significantly lower in group I in comparison to group III [p = 0.030]. The mean values of protein S was significantly higher in group II in comparison to group III [p = 0.038]. On the other hand, aPTT was significantly longer in group II than in group III [p = 0.005]. Conclusions: 1- both the levels of coagulation factors and coagulation inhibitors decreased in patients with liver cirrhosis in comparison to controls and this decrease correlated with liver dysfunction. 2- The occurrence of bleeding or thrombosis among patients with liver cirrhosis depends on the balance between the degree of reduction of coagulation factors and coagulation inhibitors so screening of these factors is essential for prediction of each of them

Agonist stop - antagonist, a new protocol for super - ovulation in poor responders

To analyze the value of adding Gn-RH antagonist to agonist stop protocol, and to compare agonist stop-antagonist protocol, in normal and low responders. 69 previously poor responders on long agonist protocol [group A], 63 normal responders who did not become pregnant after >/= 2 previous ICSI cycles on long agonist protocol [group B], and 14 women with premature progesterone rise on previous non-agonist cycles [group C]. Group A, and B patients were randomly allocated into either agonist stop protocol, agonist stop-antagonist, or HMG antagonist only protocol, while all group [ patients were stimulated using agonist-antagonist protocol. Duration of stimulation, number of ampoules, number of follicles, late follicular estradiol and progesterone, and cycle outcome. Agonist antagonist protocol was associated with significantly lower late follicular progesterone than the other protocols in groups A, and B, and than the previous attempts in group C. There was a trend toward lower cancellations and higher pregnancy rate using the new protocol. The use of agonist stop-antagonist protocol resulted in lower late follicular progesterone and trend toward a higher pregnancy rate

Estrogen receptor beta gene polymorphism and endometrial inadequacy

To correlate four estrogen receptor beta polymorphisms to endometrial thickness. 24 patients with consistently thin endometrium, in natural and stimulated cycles undergoing controlled ovarian hyper stimulation for ICSI for various indications and 50 control subjects with normal endometrium undergoing COH for ICSI for male factor infertility. Sonographic evaluation of endometrium, PCR on peripheral blood leucocytes using specific primers to detect the determined four polymorphisms, as well as hormone values in COH cycles and ICSI outcome, are recorded. The deletion polymorphism was not found in either groups. The second polymorphism [P846] was significantly more commonly detected in cases of normal endometrium [50% versus 8% in cases with thin endometrium]. The third polymorphism [P1082] was not found in control group and only one case [4%] with thin endometrium and this was not significant. The last silent polymorphism [P1421] was found in 8% of cases and surprisingly all subjects of control group and this was statistically highly significant. The presence of certain ER beta polymorphisms correlate with good endometrial thickness

Genetic and environmental factors in different types of age-related cataract among Egyptians

The present study included 280 patients with age-related cataract [153 males and 127 females] and 296 controls with similar age and sex distribution. All cases and controls were subjected to thorough personal and family history taking including consanguinity, occupation, residency, diabetes mellitus, hypertension, smoking, family history of age-related cataract and family pedigree analysis. Full clinical examination also included complete ophthalmological evaluation to determine the type of cataract using slit-lamp examination and visual acuity measurement. Seventy-five patients and 25 controls were subjected to the following investigations: Estimation of serum total protein, serum albumin and globulin levels, albumin/globulin [A/G] ratio, hemoglobin [Hb] level and red blood cells [RBCs] count. Statistical analysis was conducted using SPSS program for calculating t test, X2 test and multiple logistic regression analysis. The present study revealed that mixed cataract [i.e. presence of more than one type of cataract] was the commonest type of age-related cataract in Egypt [48.9% of cases]. Positive family history, consanguinity and exposure to ultraviolet irradiation were universal risk factors for all types of cataract among Egyptians. Diabetes mellitus was associated with nuclear and posterior subcapsular types of cataract, while hypertension had its effect on both cortical and posterior subcapsular types. Biochemical analysis revealed that the risk of age-related cataract increases with decreased level of serum total protein, decreased serum albumin and globulin levels, decreased RBCs count and hemoglobin level

Ocular and electro - ophthalmological studies in Egyptian patients with phenylketonuria

Ocular and electro-ophthalmologic abnormalities are common findings in phenylketonuria [PKU]. The aim of the present work was to study these changes associated with phenylketonuria; also in correlation to magnetic resonance imaging of the brain [MRI], intelligence quotient [IQ] and metabolic control [plasma phenylalanine level]. In addition, the study aimed to test the validity of visual evoked potential [VEP] as an early indicator of metabolic status. The present study was conducted on 20 patients [15 males and 5 females] presenting with phenylketonuria. The patients were subjected to complete history taking including dietary history and three-generation family pedigree analysis. Full clinical examination with complete eye evaluation including eye motility, anterior chamber and fundus examination was done. Electro-retinography [ERG] and VEP studies were performed for all patients. IQ assessment, serum phenylalanine levels evaluation, interictal electroencephalogram assessment [EEG] and MRI were performed. Statistical analysis of the data was done using Student t test

effects of lobarotory Hepatozoon gracilis infection on the fecundity, mortality and longevity of Culex [Culex] pipiens hinneans [Diptera: Culicidae] in Egypt

Laboratory observations on the effect of Hepatozoon gracilis on the egg production of the mosquito Cx. [Cx.] pipiens Linnaeus under laboratory conditions revealed that H. Gracilis infected mosquitos produced significantly fewer eggs than the uninfected ones. The egg production decreased as the parasite burdens increased. The reduction in blood meal size in infected females did not reduce fecundity. No size difference was detected between oocyst-infected and uninfected females, although sporozoite positive females were significantly large. The preoviposition period was significantly affected, while the incubation period and percentage of egg hatching showed no significant changes. The longevity of female infected mosquitos decreased insignificantly than in the uninfected ones

Tumor necrosis factor alpha, interleukin-10 and nitric oxide in patients with type 1 diabetes mellitus and their association with glycemic control an dsome complications of the disease

Type-1 diabetes mellitus is a disease that results from autoimmune destruction of insulin producing beta-cells. The autoimmune response against beta-cells is believed to result from a disorder of immune regulation. According to this concept tumor necrosis factor alpha [TNF-alpha], interleukin-10 [IL-10], nitric oxide [NO], urinary albumin excretion rate [UAER] and HbAIc in addition to serum glucose, kidney and liver function tests as well as lipogram were studied in sixty eight type-1 diabetic patients. Twelve healthy subjects were included as a control group According to disease duration patients were classified into three groups: group I [30 cases] patients with disease duration less than 5 years, group II [22 cases] patients with disease duration 5-10 years and group III [16 cases] patients with disease duration > 10 years. Also patients were classified according to UAER into 3 groups: group A [30 cases] normoalbuminuric patients UAER < 20 micro g/min. group B [35 cases] microalbuminuric patients UAER 20-200 micro g/min. group C [3 cases] macroalbuminuric patients UAER > 200 micro g/min. According to HbAIc levels, patients were classified into controlled group [HbALc < 6%] 20 patients and uncontrolled group [HbAIc > 6%] 48 patients. In whole patients group mean values of HbAIc, TNF-alpha and UAER showed significant elevations compared to controls [P <0.001, 0.001 and 0.05 respectively], while IL-10 revealed significant reduction. [P < 0.001]: NO mean value showed statistically insignificant elevation. Mean values of HbAIc in groups I, II, III, A, B revealed significant elevations compared to controls [P < 0.001 for all] also in group III versus group I [P < 0.05] and in group B versus A [P<0.05]. TNF-alpha showed significant elevation in groups I, II, III in comparison with controls [P < 0.001 for all]. While mean value of IL-10 showed significant reduction in groups I, III compared to controls [P < 0.01, P < 0.001 respectively] also in group III versus group I, II [P < 0.01 for both]. NO and UAER showed significant elevations in group III compared to controls [P < 0.05 and P < 0.01 respectively]. NO levels showed significant elevation in groups I and III compared to group II [P < 0.05 for both]. UAER in group III revealed significant elevation versus groups I and ii [P < 0.01, P < 0.001 respectively]. In normoalbuminuric and microalbuminuric groups [A, B] TNF-alpha showed significant elevation compared to controls [P < 0.001 for both]. IL-10 mean value showed significant reduction in groups A and B compared to controls [P < 0.001 for both]. NO levels revealed no significant differences. In uncontrolled group, level of IL-10 was significantly low, while UAER was significantly high [p < 0.05 for both]. TNF-alpha and NO showed no signifigant difference between controlled and uncontrolled groups. Positive correlations were found between TNF-alpha and serum glucose and HbAIc, also negative correlations were found between IL-10 and serum glucose, HBAIc, cholesterol, triglycerides and LDL-c. NO showed positive correlation with UAER level. From this study we concluded that increased TNF-a [proinflammatory cytokine of Th1] and decreased IL-10 levels [type 2 cytokine of Th2] may play a role in the pathogenesis of type-1 diabetes mellitus. TNF-alpha and IL-10 may be a predictor of glycemic control. Increased NO level may play a role in the pathogenesis and complications of diabetes

Soluble adhesion molecules for prediction of cardiac dysfunction in chronic renal failure patients

Beside cell-bound adhesion molecules, which are of fundamental importance to a large number of physiological and pathological processes, soluble forms of adhesion molecules have been detected in the circulating blood in recent years. Circulating soluble adhesion molecules appear to be biologically active, and raised levels have been reported in a variety of disorders. In the present study, we measure the serum levels of the soluble [s] molecules included vascular cell adhesion molecule 1 [sVCAM- 1] and sE-selectin in 26 patients on chronic hemodialysis [HD], 16 undialyzed patients with chronic renal failure [CRF], and 10 healthy controls having a similar mean and distribution of ages. The presence of hypoalbuminemia, inflammation [C-reactive protein,CRP] and dyslipidemia were assessed together with echocardiographic evaluation of cardiac dimensions, systolic and diastolic function in all studied groups. sVCAM-1 was found to be elevated in patients with chronic hemodialysis and undialyzed CRF [P < 0.001 each] compared with the controls but levels did not differ between both groups of patients. sE-selectin was also raised in both groups of CRF patients compared with controls [P < 0.001 each] with higher significant level in the undialyzed group [P < 0.05] compared with HD group. Both adhesion molecules are correlated positively to each other [r = 816, P<0.001]. The presence of hypoalbuminemia, inflammation, dyslipidemia together with left ventricular hypertrophy [LVH] and low ratio of E/A peak early LV filling velocity [E] /peak atrial filling velocity [A] by echocardiography were associated with higher sVCAM-1 and sE-selectin than in CRF patients without these findings. Both sVCAM and sE-selectin correlated significantly positive with CRP [P<0.01, P<0.001 respectively], left ventricular mass index [LVMI] [P<0.001, P<0.05 respectively], and significantly negative with high-density lipoprotein [HDL] [P<0.001 each], serum albumin levels [P<0.001 each] and with E/A ratio [P<0.001 each]. Elevated serum concentrations of soluble adhesion molecules [sVCAM-l and sE-selectin] are found in undialyzed and chronic hemodialysis patients who are malnourished inflamed, dyslipidemic and have echo findings of cardiac diastolic dysfunction and LVH

Bone turnover markers in relation to menopause in rhematoid arthritis patients

Biochemical markers of bone turnover are extremely useful for the management of generalized osteoporosis associated with rheumatoid arthritis [RA]. They provide information that is different and complementary to bone mass measurements. We assessed the effect of menopause and disease activity on bone turnover markers in RA patients by measuring two bone formation markers ;Bone Alkaline Phosphatase [BAP] and Osteocalcin [OC] as well as two bone resorption markers by measuring urinary pyridinoline [PYD] and deoxypyridinoline [D-PYD]. The present work was done on 80 females aged between 35-65 years. They were divided into two groups: Group I normal controls [NC] constituted 20 females; 10 premenopausal [Pre NC] and 10 postmenopausal [Post NC]. Group II RA patients: 30 premenopausal RA [Pre RA] and 30 postmenopausal RA [Post RA]. Among bone formation markers, both BAP and OC were significantly lowered in RA than in NC [p<0. 05 each] particularly in postmenopausal period. On the other hand bone resorption markers urinary PYD and D -PYD were increased in RA in comparison to NC during both premenopause and postmenopause [p<0. 05 each] and menopause exaggerated this condition. Meanwhile, RA activity altered bone formation markers with increased OC in premenopausal [p<0. 05] and decreased BAP in postmenopausal period [p<0. 05]. On the other hand, RA activity exaggerated the increased bone resorption markers PYD and D-PYD especially in the postmenopausal period [p<0. 05 each]. Both RA and menopause accelerated osteporosis by inducing a disequilibrium between bone formation markers [BAP and OC] and bone resorption markers [PYD and D-PYD]. While bone formation markers were reduced, bone resorption markers were exaggerated. RA activity further altered bone formation markers and exaggerated bone resorption markers which should be considered during management of osteoporosis. Furthermore, biochemical markers of bone turnover are simple, cost effective, non-invasive methods that offer an alternative to bone imaging techniques

IL-6 and IGFII in normal ovulatory; anovulatory pcos and controlled ovarian hyperstimulation cycles

Cytokine interleukin-6 [IL-6] and insulin like growth factor II [IGF-II] are polyfunctional regulatory peptides. They have a wide variety of biological activities including ovulation regulation of gonadal steroid secretion by the ovaries, corpus luteum function and embryo implantation. To investigate their role in normal ovulation, polycystic ovary syndrome [PCOS] and controlled ovarian hyperstimulation [COH] this study is conducted. Department of Obstetrics and Gynecology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt. Sixty women were included in this study from 3 groups of patients; 20 women in each group. First group includes women with normal ovulatory cycle and a second group includes women with anovulatory PCOS cycle and a third group of women prepared for assisted reproduction by [ICSI]. Three blood samples from each women were obtained at day 3 of the cycle day 12 or day of ovum pick up and day 22 of the cycle. Follicular Fluid [FF]collected at the day of ovum pick up from women undergoing [ICSI]. Blood and FFsamples were assayed for IL-6 and IGF-II as well as E2, FSH, LH and P, using [ELISA] technique. The mean values of IL-6 level in the early follicular phase in normal ovulatory, PCOS and COH groups were 12.93 +/- 0.77, 101.99 +/- 32.04 and 12.86 +/- 0.88 [pg/ml], respectively. There is highly significant increase in PCOS group in comparison to normal ovulatory and COH groups. IL-6 significantly increased in patients with increased number of follicles than those of low number of follicles in COH group. The mean values of IL-6 in late follicular phase were 11.4 +/- 0.88, 99.7 +/- 4.0, 27.3 +/- 8.0 in the three groups, respectively. The level is only significanlly increased in those patients with COH than the level in early follicular phase inside each group. The mean values of IL-6 in the mid luteal phase were 176.6 +/- 29.7 and 68.7 +/- 52.3 [pg/ml] in normal ovulatory and PCOS groups. There was highly significant increase in the ovulatory than the anvulatory cycle. There was a significant increase of IL-6 in FF at the time of ovum pick up over the serum samples taken at the same time. The mean values of IGF-II level in late follicular phase were 589.97 +/- 22.58, 466.4 +/.- 41.74 and 770.7 +/- 79.38 [ng/ml] in normal ovulatory, PCOS and COH group, respectively. The increase of IGF-II in cases of COH than normal ovulatory cycle shows its significant role in steroidogenesis which is important for the elevated E2 level in this group. IL-6 may be an early predictor for the ovarian responce and the development of ovarian Hyper stimulation syndrome [OHSS] with the othor hormonal and US parameters. IL-6 may be taken in consideration as a maker for corpus luteum function in conjunction with progesterone in day 22. The elevation of IL-6 in day 3 in PCOS patients than in the normal ovulatory cycle may partially explain the increased liability to OHSS in these patients. The significant reduction in IGF-II in cases of PCOS may play a role in anovulation

Genetic and biochemical aspects of retinitis pigmentosa among Egyptians

Retinitis pigmentosa is a group of inherited disorders of the retina that are characterized by constriction of the visual fields, night blindness, and fundus changes. Polyunsaturated fatty acids especially omega 3 fatty acid docosahexaenoic acid [DHA] is found in high concentration in the rod outer segment membranes of the retina. The aim of the present study is to evaluate the genetic aspects of retinitis pigmentosa among Egyptian patients in relation to fatty acids. Also to evaluate the associated ocular, systemic, and cytogenetic abnormalities aiming to give a proper genetic counseling. We examined 49 patients that attended the Research Institute of Ophthalmology seeking advice in loss of dark adaptation due to retinitis pigmentosa. Patients under study were submitted to full history taking, family pedigree construction, complete clinical and ophthalmic evaluation, cytogenetic studies and biochemical tests to determine plasma level of omega 3 fatty acids, malondialdehyde, and vitamin E. Retinitis pigmnentosa patients were classified into two groups: Primary retinitis pigmentosa group [93.9%], this group included autosomal recessive retinitis pigmentosa [47.8%], autosomal dominant retinitis pigmentosa [13%], X-linked retinitis pigmentosa [8.7%],and sporadic cases [30.5%], and secondary retinitis pigmnentosa group [6.1%], which included 3 male patients with Usher syndrome type I. Our study showed that autosomal recessive variant of retinitis pigmentosa is the most common and severest type in our country with a high rate of consanguinity [91%], so avoid consanguineous marriage may play an important role in preventing this type of retinitis pigmentosa in our society. Cytogenetic analysis for our patients revealed normal chromosomal complement in all patients with different types of retinitis pigmentosa apart from gap in chromosome 6q [chromatic gap] which was reported in 5/20 [25%] of metaphases studied in a male patient presented with autosomal recessive retinitis pigmentosa. Decrease plasma level of vitamin E, and increase plasma level of malondialdehyde was noticed in autosomal dominant and sporadic types of retinitis pigmentosa patients. Consistent decrease in the plasma omega 3 fatty acids especially docosahexaenoic acid [DHA], which was found in most patients with retinitis pigmentosa, may draw the attention upon the use of omega 3 blood level as a laboratory test for relatives of affected patients who are at high risk of having early stages of retinitis pigmentosa. We recommend DHA, and vitamin E supplement for those patients with decrease plasma level of omega 3 fatty acids

Heritability of strabismus among Egyptian population

The etiology of strabismus has long been observed to have a genetic component. Since strabismus is one of the major causes of an amblyobia, early detection and treatment is essential for restoration of proper alignment of the visual axes and establishment of binocular vision. We examined 100 patients with strabismus, 50 males and 50 females, attending the Research Institute of Ophthalmology, aiming to study the heritability and different factors predispose to strabismus for early intervention. Patients under study were submitted to full history taking, family pedigree construction, complete clinical examination, including eye evaluation, and cytogenetic study of the peripheral blood lymphocytes when indicated. Patients with strabismus were classified into two groups. The first group included 76 patients with esotropia [76%], winch subclassified into two groups: Isolated group [72%], included 66 patients with infantile esotropia [66%], 5 patients with Duane syndrome [5%], and 1 patient with congenital ocular fibrosis [1%]. And associated group [strabismus is a component of a genetic syndrome] which included 4 [4%] patients with Mobius syndrome. The second group included 24 [24%] patients with isolated exotropia. Our study revealed that heritability plays an important role in development of strabismus. Also low birth weight is an important risk factor. So young infants in families at high risk for developing strabismus, and low birth weight infants should be screened for early detection, better intervention and therapeutic trials, this allow normal development of binocular vision, depth perception, and prevent psychosocial dysfunction. There is limited evidence in support of an environmental causes of strabismus