case of parasitic leiomyoma with serpentine omental blood vessels: an unusual variant of uterine leiomyoma

Leiomyoma is considered as the commonest benign tumor of the genital tract. This case represents a multiparous woman who presented with a history of progressive abdominal distension. On examination, a mobile ill-defined centrally located intra-abdominal mass was noticed. At laparotomy a parasitic fibroid attached to the greater omentum was seen. Resection of the mass and partial omentectomy was performed which was reported as leiomyoma by the histological examination. The patient had an uneventful post-operative recovery. She has been followed up for twelve months with no evidence of recurrence or residual disease

Genome pattern of Salmonella Enteritidis from reproductive organs and eggs from Egyptian laying hens

The present study sought to determine whether Salmonella entehtidis isolated from freshly laid eggs and / Salmonella colonized-reproductive tissues of naturally infected hens had same genome pattern. Ninety layer hens from three different farms [coded farm-1, -2 and -3] were used as following: 30 from farm-1, 25 from farm-2 and 35 from farm-3]. In addition to 145 laid eggs randomly collected from the same farms. Both tissue samples and Eggs were examined for presence of Salmonella by bacteriological, scological and molecular methods. The results revealed 8 out of 90 hens were positive for genus Salmonella. Salmonella enteritidis was identified based on OMPC and ENT genes-based Multiplex PCR. Determination of strain specific pattern of isolated Salmonella was carried out by ERIC test. Out of 90 layer hens tissue organs, Salmonella Enteritidis detected in ovaries, oviduct, forming eggs and intestine of layer hens were 5, 2, 1 and 7 cases respectively. Out of 145 laid eggs, Salmonella Enteritidis was detected in 2 and 1 of outer egg shell and internal eggs contents respectively. That [hot strain] infected the ovary, intestine, forming egg of naturally infected laying hens proved to have unique DNA alles by ERIC- PCR

Antigenic variations of infectious bronchitis virus from broiler flocks in Al-Beheira governorate

Seventeen avian infectious bronchitis virus [IBV] isolates were isolated from broiler chickens showing respiratory and renal lesions. The isolated strains were characterized by real time reverse transcriptase polymerase chain reaction used for N gene, and then RT-PCR and sequence analysis of the hypervariable region 3 of the S1 spike glycoprotein gene of six isolates. Six isolates showed 87.15% to 89.71% and 87.27% to 90.82% amino acid sequence identity and 87.61% to 89.19% and 87.91% to 89.72% nucleotide sequence identity to the Egyptian variant 1 and the IS/885 strains, respectively. The six isolates formed a distinct phylogenetic group with the Ck/Eg/BSU-2/2011 and Ck/Eg/ BSU-3/2011 [Var 2]. Amino acid and nucleotide identities between the six Egyptian isolates and variant 2 [Ck/Eg/BSU-2/2011 and Ck/Eg/BSU-3/2011] ranged from 97.27% to 100% and 97.88% to 99.38%, respectively. The results indicate that the six isolates IBV/CK/Beh/101/013/S1, IBV/CK/Beh/204/013/S1, IBV/CK/Beh/105/013/S1, IBV /CK/Beh/1011/013/S1, IBV/CK/Beh/1017/013/S1, IBV/CK/Beh/2020/013/S1 can be considered a variant 2 as Ck/Eg/BSU-2/2011 and Ck/Eg/BSU-3/2011. This study demonstrates a constant evolution of IBV in Egypt that necessitates continuous monitoring to control the spread of infections, and the development and use of vaccines based on indigenous viruses

Molecular epidemiology of FMDV in northern Egypt [2012-2014]

From 2012 to 2014, foot-and-mouth disease outbreaks have struck cattle and buffaloes in different localities of Egypt exerting sever economic losses to livestock industries. Thirty-five representative specimens [thirty-one tongue epithelium and four vesicular fluid samples] were collected from different governorates [Behera, Kafrel-sheikh and Alexandria]. By using Antigen detection ELISA on these specimens revealed that twinty-six of them were positive and serotyped as [two samples were detected as serotype A, eleven samples were serotype SAT2 and thirteen samples were serotype O that was responsible for outbreaks during end of 2013 and beginning of 2014 in the three governorates] then the viral suspension cultivated on BHK-21 cell lines and obtaining on five isolates and these isolates identified as FMDV by using Real time RT-PCR using universal probe of FMDV and then serotyped by RT-PCR using Serotype-specific primers into [one isolate of serotype A, one of serotype SAT2 and three of serotype O] followed by sequencing and phylogenetic analysis revealing that the isolate of serotype A was closely related to [type A - EGY 1/2012-KC440882 with identity 93%, type A - A/IRQ/24/2009-KF112909 with identity 93% and type A isolate A/SIN/PAK/L758/2009] that of Asia topotype with Iran05 lineage that differ phylogenetically from vaccinal strain [A/EGY/2006] of Africa topotype with G-VII[KEN-05] lineage, the isolate of serotype O was closely related to [type O isolate SUD/8/2008 with identity 93%, type O isolate SUD/12/2004 with identity 92% and type O isolate O/Denizli/TUR/441/11/03 with identity 89%] that of East Africa-3 [EA-3] topotype that not detected in Egypt before and differ phylogenetically from vaccinal [O/EGY/93] of ME-SA topotype with Sharqia-72 lineage confirming that it is introduced through uncontrolled transboundary movements of animals and isolate of serotype SAT2 was closely related to [type SAT 2 isolate EGY/9/2012 and type SAT 2 isolate EGY 3/2012] of topotype VII with Ghb-12 lineage which distinct from contemporary SAT2 lineage of the same topotype of libya indicating that the disease source not through un controlled boundaries. The present study conclude and recommend that these new isolates especially O/SUD origin should be included in the locally produced vaccines to induce complete protection against circulating viruses

Thrombocytosis at time of hospitalization is a reliable indicator for severity of CAP patients in ICU

Clinicians have always evaluated the degree of leukocytosis in patients with pneumonia as an indication of systemic inflammatory response and severity of disease. But platelets have been increasingly recognized as inflammatory cells with an important role in host defenses. To evaluate if abnormal platelet count in hospitalized patients with CAP was associated with severity of CAP comparing it with abnormal leucocytes' count. The study enrolled 66 patients with community acquired pneumonia admitted to respiratory ICU of Ain Shams University and Ain Shams University specialized hospitals. Data were collected from each patient including demographic data, clinical findings, comorbidities, laboratory data, arterial blood gas results, chest radiographic findings; pneumonia severity index [PSI] and CURB-65 were calculated. Simple correlations between variables were examined by calculating Pearson's product correlation coefficient. Four models of multiple linear regression analysis was performed to study the simultaneous effects of the different data variables on PSI, CURB-65 score, need for mechanical ventilation and length of stay in ICU as dependent variables respectively indicating pneumonia severity. There were significant correlations between the following: personal data, clinical findings, arterial blood gas findings, laboratory results, radiological findings and data of severity which are [PSI, PSI class, CURB-65 score, length of stay in ICU, mechanical ventilation] [p < 0.001]. Thrombocytosis was strongly associated with CAP severity parameters and was more significant than abnormal leucocytic count in predicting the severity of CAP as studied on their effect on PSI, CURB-65 score and need for mechanical ventilation; while leucocytosis was more significant in predicting the length of stay in ICU than thrombocytosis. Thrombocytosis can be used as a marker of severity in patients with community-acquired pneumonia better than leucocytes' count

Effect of geranium [P-elargonium graveolens] leaf extract on hepatic and renal functions in mice

Pelargonium graveolens L'Herit is a perennial herb used for many medicinal treatments as staunch bleeding, heal wounds and antibacterial properties. Its common English name is geranium. In this study we follow up the effect of a high dose of this plant extract on two vital organs [liver and kidney] following treated and recovery period. Animals were divided into two major groups, a control and an experimental group. Animals of the experimental group received geranium extract orally day by day in a dose of 869 Amg/ kg/ day for 20 days. Animals were sacrificed after treated [20 days] and recovery periods [10 and 20 days]. Blood samples were collected for hematological tests and biochemical analysis. Liver and kidney specimens were obtained and fixed in 10% formol saline for histological and histochemical study. AST, ALT, GGT, LDH, urea, createnine, total lipid and cholesterol were significantly increased after treated and recovery period of 10 days. However, glucose level, total protein, albumin and globulin were significantly decreased in animals after treated period. Histological changes in treated sections of the liver showed evidence of degeneration, necrosis and mononuclear cellular infiltration and in kidney sections, tubular degeneration and glomerular atrophy were observed. Degenerative changes in both proximal [WBCs casts] and medullary tubules [hyaline casts] were also observed at recovery periods. Masson's trichrome stained sections in liver showed increased collagen fibers around congested central veins, blood sinusoids and portal areas. While in kidney sections, the extract could not induce any change in the collagen fibers in the connective tissue. Some parameters of the previous physiological and histological changes which were observed after treatment disappeared after a recovery period of 20 days. Histochemical studies revealed a significant decrease in PAS positive material in liver aft the recovery periods. However DNA content showed non-significant difference in all the experimental periods. The over dose of geranium extract caused liver and kidney damage. So, it is well recommended to use this plant at a suitable dose for clinical therapy and if it is used for long time, kidney and liver functions must be tested periodically

Effect of alocasia macrorrhiza extract on hepatorenal functions in mice

Alocasia macrorrhiza [L] Schott and Endl is an ornamental perennial herbaceous plant which grows in coastal wetlands and valleys. Its common English name is Giant Elephant's Ear. The study planned to follow up the effect of the plant extract of Alocasia macrorrhiza on hepatorenal functions in mice following treated and recovery periods. Animals were divided into two major groups, a control and an experimental group. Animals of the experimental group received Alocasia extract orally day by day in a dose of 144.6mg / kg /day for 20 days. Animals were sacrificed after treated and recovery periods of 10 and 20 days respectively, blood samples were collected for hematological tests and biochemical analysis. Liver and kidney specimens were obtained and fixed in 10% formol saline for histological and histochemical study. RBCs, Hb were significantly decreased after treated period. Total protein, albumin and globulin were significantly decreased, while, AST, ALT, GGT, LDH, urea, creatinine, total lipid and cholesterol were significantly increased after treated and recovery period of 10 days. Histological changes in treated sections of the liver showed evidence of cellular degeneration and necrosis and in Kidney sections, tubular necrosis, glomerular shrinkage and atrophied glomerular tuft of capillaries were prominent. Mallory stained sections in liver showed increased collagen fibers around congested central veins, blood sinusoids and portal areas. While in kidney sections, the extract could not induce any change in the collagen fibers in the connective tissue. The changes which were observed after treatment disappeared after a recovery period of 20 days. However, the vascular congestion persisted. Histochemical studies revealed a significant decrease in PAS positive material in kidney after treated and a recovery period of 10 days. However DNA content showed non significant difference in all the experimental periods. The high LD[50] of the reversible action of the plant need more studies in different suitable doses before recommendation to use it safety as medicinal plant

randomized controlled trial of oral misoprostol for the third stage of labor

To compare oral misoprostol with conventional oxytocics in the management of the third stage of labor. In a controlled trial, 1574 women were randomized into four groups, as follows: Group 1 received intravenous infusion of oxytocin 10 IU plus oral misoprostol 400 micro g. followed by two doses of oral misoprostol 100 micro g 4 hours apart: Group 2 received oral misoprostol 404 micro g, followed by two doses of oral misoprostol 100 micro g 4 hours apart; group 3 received intravenous infusion of oxytocin 10 lU; and group 4 received intravenous infusion of oxtytocin 10 lU plus intramuscular administration of methylergonovine maleate [Methergine] 0.2 ma. The incidence of postpartum hemorrhage and decrease in hemoglobin concentration from before delivery to 24 hours postpartum were the main outcome measures. The primary outcome measures were similar in groups 2 and 3. The incidence of postpartum hemorrhage was 9% in group 2. compared with 3.2% in group 1 and 3.5% in group 4 [P<.01, and P = .01, respectively]. There were no significant differences among the four groups regarding hemoglobin concentrations. Significantly more women needed additional oxytocin in group 2, when compared with group 4 [5.9%, versus 2.2%: P = .01]. The proportion of women requiring additional methylergonovine maleate was 4.8% in group 2, compared with 0.7% in group 1 and 1% in group 4 [P < .01 and P = .01, respectively]. Oral misoprostol alone is as effective as oxytocin alone for the prevention of postpartum hemorrhage; it is less effective than oxytocin plus methylergonovine maleate and oral misoprostol plus oxytocin

Functional endoscopic sinus surgery [FESS] in patients with hyperreactive airway disease

This Study was conducted as prospective study on 36 asthmatics with evidence of chronic rhinosinusitis. The aim of this study is to study the effect of chronic sinusitis and polypoidal sino-pathy on the lower airways and to elucidate the effect of functional endoscopic sinus surgery [FESS] on the hyperreactive airway disease and asthma associated with chronic sinusitis. The results of this Study 3 months and 6 months postoperativley showed a significant improvement of all major nasal symptoms [P<0.05] [Table 1] except for hyposmia which did not show the same improvement [P>0.05]. In both allergic and non allergic patients 3 months and 6 months postoperatively, there was a significant improvement in the mean asthma symptoms [P<0.05] [Table 2 and Fig. 1], asthma exacerbation [P<0.05] [Table 3, 4]. We concluded that, sinus disease is an aggravating and exacerbating factor in asthma rather than an inducer of asthma and this was proved by improvement of severe asthma markedly after elimination of the offending sinusitis by FESS and by observation of airway hyperresponsiveness in non asthmatic subjects with chronic sinusitis, and by the observation of improvement of airway hyperresponsiveness after FESS due to relief of nasal symptoms and sinus lesions

Ultrasonographic findings of gall bladder in acute viral hepatitis

Thirty patients with acute viral hepatitis were studied for ultrasonographic findings of the gall bladder [GB] and for detection of patients with cholecystitis-like presentations within the first week of diagnosis. Patients were subjected to full history taking, clinical examination, laboratory and serological investigations, in addition to real time abdominal ultrasonography. Serologically, patients were classified into 3 groups: hepatitis-A virus [HAV] group; 16 patients [53%], hepatitis-B virus [HBV] group; 8 patients [27%], and hepatitis-C virus [HCV] group; 6 patients [20%]. The commonest ultrasonographic finding was increased GB wall thickness [GBWT], in 23 / 30 patients [76.7%]. It was more evident in patients with HAV. Twenty out of 23 patients [86.9%] with GBWT,exhibited clinical presentation similar to that of acute noncalcular cholecystitis, the so called; cholecystitis-like presentations. It was concluded that; GB wall thickening with cholecystitis - like presentations seemed to be more common in patients with acute viral hepatitis, particularly; HAV infection. Acute viral hepatitis must be considered as an underlying cause in patients with ultrasonographic diagnosis of acute non-calcular cholecystitis. Ultrasonography follow-up of GB changes associated with acute viral hepatitis is recommended

Post-hepatectomy glucose tolerance curve in a rat model

Background: The liver is the main site where most of glucose metabolic processes take place. It is suspected that partial hepatectomy will alter the glucose homeostasis, so it is mandatory to study the effect of partial hepatectomy on the glucose metabolism. Introduction: the liver exerts multiple complex metabolic functions. Partial hepatectomy, reduces the functioning liver cell mass. The body responds to surgery both locally and generally. The general one includes endocrinal and metabolic response

Aim of the Work: To determine the effect of partial hepatectomy on the glucose metabolism, by performing Glucose tolerance curve

Materials and Methods: 32 rats were included in this work, divided into 4 groups, 8 rats per each [5 were subjected to actual resection and 3 were subjected to sham operation]. First group: glucose tolerance curve [GTC] was done 24 hours after hepatectomy, 2[nd] group the GTC was done 48 hours after hepatectomy, 3[rd] group the GTC was done 72 hours after hepatectomy, and 4[th] group the GTC was done 96 hours after hepatectomy. Two blood samples were taken, pre-operative and post-operative, for determination of blood sugar and liver enzymes. For determination of the GTC, blood glucose was determined 4 times: at [0] time fasting sample, then [1/2 an hour] after an oral glucose meal then at [1 1/2 hours] and at [2 1/2 hours]

Results: There was weight loss in the post-operative period in various groups, that was minimal [8 grams] in the 1[st] group, and maximal [13 grams] in the 4[th] group. The resected segments varied from 30% to 60% of the whole liver mass. The mean liver weight was 3.67% of the whole body weight. In the P.O. period there was elevation of the ALT and AST, which was greater in the 1[st] group and least in the 4[th] group. There was low grade hyperglycemia, and the blood glucose level failed to return to baseline, 2 1/2 hours after the oral meal, in all groups. There were slight changes in the level of the B. sugar between various groups and between the individuals of each group, but not to the significant level

Conclusion: There was postoperative glucose intolerance manifested by low grade hyperglycemia in the early postoperative period with mild diabetic curve despite the reduced functional liver cell mass

Vaginal reconstruction with bilateral pudendal-thigh flaps in vaginal atresia

Patients with vaginal atresia require vaginal reconstruction with sensate pliable tissue. Although many procedures using skin grafts, skin flaps and intestinal segments have been described, they all have disadvantages. In the present study, 8 patients with vaginal atresia underwent surgery using the pudendal-thigh flap based on the posterior labial artery. This technique has proved to be simple and reliable with satisfactory functional and cosmetic results

role of interleukin -I inhibitors in patients with bilharzial hepatic fibrosis

This work was designed to assess the partial reversibility of hepatic fibrosis in human after the use of colchicine through its immunomodulation mechanism. Twenty patients were given colchicine at a dose of 0.5 mg twice daily, five days a week for a period of nine months. Patients were assessed before and after therapy by clinical evaluation, parasitological assessment, abdominal ultrasonographic scanning and estimation of serum interleukin-1B. Colchicine was proved to be of value as an antifibrotic agent when used in early cases of schistosomal hepatic fibrosis [grades I and II]] as evidenced by a decrease in liver size and significant reduction in IL-1B level among all patients. Also, estimation of serum IL-1B can be used as a noninvasive, relatively sensitive parameter to assess the fibrinogenic process in the liver and to evaluate the effect of drug therapy

Non-Secretion of blood group antigens and susceptibility to urinary tract infection

The material of the present study comprised 103 patients of urinary tract infection confirmed by bacterial examination of urine, [64] out of them had chronic renal failure, due to recurrent urinary tract infection these patients underwent determination of blood group [ABO and Lewis] and secretor status, to find out if there is relation between it and susceptibility to urinary tract infection. There was a predominance of blood group AB and non secretor status [Se Se] which proves that the absence of A and B antibodies and also absence of Se gene combine to give an increased risk to urinary tract infection. The appearance of increased frequency of Lea [a-b] in non secretors confirms the consumption of Le antigen as receptors for pathogenic organisms.There is no predominance of special blood groups in patients not confirmed to be recurrent

Echocardiographic left ventricular functions after diltiazem in patients with Friedrich's ataxia

Oral therapy with diltiazem [180 mg/day] for one month, in patients with Friedrich's ataxia, produces nonsignificant improvement in the diastolic L.V. functions, and non-deterioration of L.V. systolic function or heart failure. Long-term follow up, or increasing the dose of diltiazem may be the subject of further work

value of C-reactive protein in children with meningitis

A 6-years prospective study was carried out on 339 infants and children with clinical suspicion of meningitis of febrile convulsion where C-reactive protein [CRP] determination was done for all patients. The patients were divided into four groups. The serum CRP was positive in 16 of 111 children with viral meningitis, in 50 of 65 with culture-proved bacterial meningitis, in 10 of 17 with partially treated meningitis, and in two of 146 with a first attack of febrile convulsion. The test was nonspecific for routine application, and it was not sensitive for the early differentiation of bacterial, viral, and partially treated meningitis although CRP assay may be a useful additional parameter in the differentiation of various type of meningitis