Neutrophil/lymphocyte and platelet/lymphocyte ratios and their relation with disease activity in systemic lupus erythematosus patients

Background: systemic lupus erythematosus [SLE] is a chronic disease which had diverse clinical manifestations, course and prognosis. Search for diagnostic markers is continuous process to enhance the diagnostic and treatment process

Aim of the study: this study aimed to investigate correlation between both of neutrophil/lymphocyte and platelet/lymphocyte ratios and disease activity in SLE patients who did not receive any treatment

Patients and Methods: a case control study involving 60 adult SLE patients and 40healthy controls was performed. NLR and PLR levels between SLE patients and healthy controls were compared, and correlations between these indices and clinical characteristics were analyzed

Results: increased NLR and PLR were observed in SLE patients. NLR was positively correlated with erythrocyte sedimentation rate [ESR] [r=0.621, p<0.001] , SLEDAI scores[r=0. 0.774, p<0.001] and SLICC score[r=0.638, p<0.001]. PLR was positively correlated with with erythrocyte sedimentation rate [ESR] [r=0.500, p<0.001], SLEDAI scores[r=0.445, p<0.001]. And SLICC score[r=0.377, p<0.001] SLE patients with nephritis had higher NLR and PLR levels than those without nephritis [p<0.001]

Conclusion: NLR and PLR could reflect inflammatory response and disease activity and disease damage in SLE patients

Bee Honey Modulates the Oxidant-Antioxidant Imbalance in Diethyl nitrosamine-Initiated Rat Hepatocellular Carcinoma.

Oxidative stress reflects the mechanism that contributes to initiation and progression of hepatic injury in a variety of liver disturbance. From here, there is a great demand for the expansion of agents with a potent antioxidant effect. The aim of this work is to approximate the efficiency of bee honey as a hepatoprotective and an antioxidant agent versus diethyl nitrosamine (DEN) motivate hepatocellular damage. The single intrapritoneal (IP) management of diethyl nitrosamine (50mg/kg followed by 2ml/kg CCl4) to rats, referred for the histopathological examination of liver sections of rats after induction and before treatment with honey showed that many well differentiated tumor cells were formed in the liver of rats also, the examined sections showed disorganization of hepatic lobular architecture and obvious cellular damage. A significant lift in the enzymatic activity of liver functions (AST, ALT, ALP), and gamma glutamyltransferase (GGT) which is a signal of hepatocellular damage. DEN stimulates oxidative stress, which was assured by increase lipid peroxidation level and hindrance in antioxidant enzymes (SOD, CAT, GPx, and GST) activities in the liver. The position of non-enzymatic antioxidants comparable reduced glutathione (GSH) was likewise set up to be slimmed down significantly in DEN inoculated rats. Also, we have studied the underlying mechanism and /or (s) of the therapeutic role of bee honey as hepatocarcinogenesis remediation through investigation the inflammatory biomarkers; α-fetoprotein (AFP) and α-fucosidase (AFU). The current results clearly showed that bee honey demonstrates good ameliorative and antioxidant capacity toward diethyl nitrosamine induced hepatocellular damage in rats.

Acanthamoeba contamination of hemodialysis and dental units in Alexandria, Egypt: a neglected potential source of infection

Ubiquitous free-living amoebae of the genus Acanthamoeba can be pathogenic and can serve as carriers of other pathogenic organisms. These amoebae are potentially dangerous when they contaminate health facilities, and these organisms may act as a source of infection for medical personnel and those seeking medical care. The purpose of the present study was to evaluate the extent to which Acanthamoeba species contaminate hemodialysis and dental units in Alexandria, Egypt. Seventy samples were collected aseptically from these systems and cultivated on non-nutrient agar at room temperature, followed by morphological confirmation of the identity of Acanthamoeba using trichrome-stained smears. This study revealed that 42.9% of water samples from the hydraulic systems of both hemodialysis and dental units were positive for Acanthamoeba, with no statistically significant difference between the two unit types or between pre- and post-disinfection samples for each type of unit. The surgical category of dental clinics had the highest contamination rate [72.7%], whereas no contamination was observed for water samples from pediatric dentistry clinics. In conclusion, the hydraulic systems of hemodialysis and dental units in Alexandria are contaminated withAcanthamoeba species, and to minimize the risk of human infections, there is an urgent need to implement effective preventative measures, such as the installation of water filtration units

Therapeutic Effects of Allium sativum and Allium cepa in Schistosoma mansoni experimental infection / Efeitos terapêuticos do Allium sativum e Allium cepa na infecção experimental pelo Schistosoma mansoni

The effects of both garlic (Allium sativum) and onion (Allium cepa) on some biochemical parameters in Schistosoma mansoni infected mice individually and mixed either with or without the currently used drug, praziquantel (PZQ) were investigated. These involved some immunological parameters, namely IgM, IgG, interleukins 2 and 6 (IL-2 and 6) and tumor necrosis factor (TNF-α), some antioxidant enzymes [catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPX)]. In addition, parasitological and histopathological investigations were performed. No changes were observed in the normal control mice treated with dry extract of onion or garlic, individually or mixed, with or without PZQ, compared to the normal healthy control group. Infection with S. mansoni showed an increase in IgG, IgM, IL-2, IL-6, TNF-α and catalase enzyme, accompanied with a decrease in GPX and SOD antioxidant enzyme activities. Remarkable amelioration was noticed in the levels of all the measured parameters in S. mansoni infected mice after administration of the studied extracts. Moreover a significant reduction in worm burden, hepatic and intestinal eggs and oogram count was noticed which was reflected in normalization of liver architecture.

Os efeitos do alho (Allium sativum) e cebola (Allium cepa) em parâmetros bioquímicos de camundongos infectados pelo Schistosoma mansoni individualmente e misturados seja com ou sem as drogas correntemente usadas como o Praziquantel (PZQ), foram investigados. Isto envolveu parâmetros imunológicos tais como IgM, IgG, Interleucina 2 e 6 (IL-2 e 6), fator de necrose tumoral (TNF-α) e algumas enzimas anti-oxidantes [catalase, super-óxido dismutase (SOD) e glutationa peroxidase (GPX)]. Em adição foram realizadas investigações parasitológicas e histopatológicas. Nenhuma alteração foi observada nos camundongos controles normais tratados com extrato seco de cebola ou alho, individualmente ou misturado, com ou sem PZQ, comparados com os controles normais sadios. Infecção com o Schistosoma mansoni revelou um aumento em IgG, IgM, IL-2, IL-6, TNF-α e catalase, acompanhados de diminuição do GPX e atividade enzimática do anti-oxidante SOD. Melhora acentuada foi notada nos níveis de todos os parâmetros medidos em camundongos infectados com Schistosoma mansoni após administração dos extratos estudados. Mais ainda, significante redução na quantidade de vermes, e ovos no fígado e intestino e na contagem do oograma foi notada refletindo a normalização da arquitetura do fígado.

Assessment of antibilharzial and biochemical effects of triclabendazol in experimental schistomiasis

Schistomiasis is one of the major public health problems, and for more than two decades Praziquntel [PZQ] has remained the drug of choice for its treatment. However, studies proved that reliance on one drug raised the concern of development of tolerance or even resistance. The present work aimed at studying the effect of different schedules of the flukicidal drug triclabendazol [TCBZ], in a dose of 120mg/kg body weight, on Schistoma mansoni worm load, female fecundity and egg deposition in liver and intestine of infected mice, and at studying its biochemical toxic effects on some liver enzymes activities. The present findings indicated that the administration of TCBZ to mice infected with Egyptian S. mansoni strain was not effective except when the drug was given after the start of egg shedding in the stools. However, the anti-schistosomal effect was moderate as the results showed 50% reduction in worm burden and around 40% reduction in liver and intestinal egg loads. On the other hand, the impact on oogram pattern was not clear except regarding the percentage of dead ova which was much higher than the corresponding control. As regards the biochemical parameters studied, no change in the activity of all tested enzymes was observed. However, animals which received two doses of the drug after the start of egg shedding exhibited 24% reduction in alanine transaminase [ALT] activity. Our results indicated that, still, there is no alternative to prazquantel and there is an urgent need for discovery of new antischistosomal drugs. In addition studying different combinations and schedules of the already available drugs as artemether and TCBZ is recommended

Role of the endothelial factors: Nitric oxide, substance P and endothelin, in mediating circulatory effects of halothane and isoflurane

Endothelial cells [ECs] contribute to the regulation of blood pressure and blood flow by releasing vasodilators such as nitric oxide [NO], substance P [SP], prostacyclin [PGI [2]] and adrenomedullin, as well as vasoconstrictors including endothelin [ET] and platelet-activating factor [PAF]. Several previous studies have discussed the relation between anaesthetics and the vascular endothelium in vitro only and demonstrated that volatile anaesthetics [halothane and isoflurane] can alter endothelium-dependant vasodilatation in vitro. In vivo studies are scarce in that field. This could be attributed to the radical nature of NO and its very short half-life and involvement of labor-intensive assay and handling of radioactive isotopes. Consequently, determination of the more stable end products of NO, nitrite and nitrate, was used as a measure for NO production. It is the aim of the current study to make use of this technique to ascertain whether NO, as well as SP and ET, is actually involved in the circulatory effects of isoflurane/halothane, in the clinical context. The study was conducted on 40 patients of [ASA classes I and II], scheduled for open abdominal and/or pelvic procedures of minimum 1 hour duration. Reduction of MBP more than 20% of the preoperative level was considered hypotension. Induction in both groups was done by IV fentanyl [2 micro g/ kg], sodium thiopentone [4-7mg/kg] followed by vecuronium [0.1mg/kg] for intubation and long acting muscle relaxation. Anaesthesia was maintaied using 100% oxygen and halothane 0.5-1%, or isoflurane 0.6-1-2%, in groups Land II respectively. Mechanical ventilation was adjusted to maintain normocapnia. Nitrous oxide was omitted and increments of fentanyl and vecuronium were titrated to the patients' needs. Monitoring of arterial blood pressure and heart rate was done every 5 minutes. Reversal was done using prostigmine [0.08mg/kg] and atropine sulphate [0.02mg/kg]. Venous blood samples were collected before induction, 15, 30 and 60 minutes after initiation of anaesthesia [T0, T1, T2, T3], at cessation of anesthesia and fifteen minutes later [T4 and T5]. Plasma endothelin concentration was determined by enzyme immunoassay technique. Plasma substance P was measured by radioimmunoassay. Determination of serum nitrite and nitrate was done by a colorimetric assay. We have succeeded in ascertaining the role of nitric oxide in isoflurane-induced hypotension, but not halothane. The hypotensive effect of isoflurane which is known to be basically related to peripheral vasodilator mechanism may be via its stimulatory effect on vasodilator mediator [NO]. The role of ET and SP could be related to the short-term changes, mediated by the endothelium, in vasomotor tone in response to alterations in shear stress, in face of the significant hypertension that follows cessation of isoflurane anaesthesia

Angibgemesis imbalance in systemic sclerosis

Objective: to identify angiogenesis imbalance in systemic sclerosis [SSc] by measuring serum level of the main angiogenic inducer marker [vascular endothelial growth factor VEGF] and the main angiogenic inhibitor marker [endostatin] in order to find out their possible role in the pathogenesis of the disease

Methodology: this study was conducted on twenty five SSc patients, 15 with limited SSc [LSSc] and 10 with diffuse SSc [DSSc]. They were further classified into early LSSc, late LSSc, early DSSc and late DSSc according to Medsger and Steen, 1996, as well as 15 apparently healthy controls participated to this study. Skin involvement was assessed using the modified Rodnan Skin Score, nailfold Video Capillaroscopy [NVC] and pulmonary function tests [PFTs] were done. Serum VEGF and endostatin levels were measured using enzyme linked immunosorbent assay [ELISA]

Results: there was a statistically highly significant increase in the mean values of both serum VEGF and serum endostatin in SSc patients compared to control subjects [p<0.001]. Early DSSc and early LSSc patients had a statistically highly significant increase in the serum levels of VEGF compared to late DSSc and late LSSc patients [p<0.001]. Late LSSc patients had a statistically significant increase in the mean value of serum endostatin compared to early LSSc patients [p<0.01], as well as late DSSc patients had a statistically highly significant increase in the mean value of serum endostatin compared to early DSSc patients [p<0.001]. A highly significant positive correlation was found between serum levels of endostatin and modified Rodnan Skin Score in SSc patients [r=0.69, p<0.001], while no significant correlation was found between serum VEGF and modified Rodnan Skin Score [r=0.293, p>0.05]. SSc patients without ischemic manifestations had a statistically significant higher level of serum VEGF compared to those with ischemic manifestations [p<0.01], while SSc patients with ischemic manifestations had a statistically highly significant increase in the mean value of serum endostatin compared to those without ischemic manifestations [p<0.001]. SSc patients with early NVC pattern had highly significant increase in the mean value of serum VEGF compared to those revealing late NVC pattern [p< 0.001], while SSc patients with late NVC pattern had highly significant increase in the mean value of serum endostatin compared to those revealing early NVC pattern [p<0.001]. SSc patients with restricted PFTs had a statistically significant higher level of serum endostatin in comparison to those without pulmonary affection [p<0.001], while no significant difference regarding mean levels of serum VEGF in patients with or without restricted PFTs [p>0.05]

Conclusion: we may conclude that angiogenic inhibitor [endostatin] is induced and outweighs angiogenic inducer [VEGF] in late disease. Increased serum endostatin level is associated with skin sclerosis severity, ischemic manifestations and pulmonary fibrosis in SSc patients. This angiogenesis inhibitor favors disease progression and it is a good candidate for further evaluation of disease severity and treatment purposes