Systemic Immune-Inflammation Index as a Predictor of Asymptomatic Organ Damage in Patients with Newly Diagnosed Treatment-Naive Hypertension

ABSTRACT Background: Low-grade inflammation is known to facilitate the development of hypertensive organ damage. The systemic immune-inflammation index (SII) is a new inflammatory index based on circulating immune-inflammatory cells. Objectives: The objectives of this study were to investigate the relationship between the SII and asymptomatic organ damage (AOD) in patients with newly diagnosed treatment-naive hypertension (HTN). Methods: A total of 500 participants (≥ 18 years) were enrolled in the study, including 250 patients and 250 healthy volunteers. Microalbuminuria of > 30 mg/day or proteinuria of > 150 mg/day, left ventricular mass index of > 95 g/m2 in women and > 115 g/m2 in men, and carotid intima-media thickness of > 0.9 mm or the presence of plaque in the carotid were evaluated as AOD indicators. AOD grade was classified as follows: Grade I - One organ involved, Grade II - Two organs involved, Grade III - Three organs involved, and Grade IV - Four organs involved. Results: SII values were higher among patients with HTN than in the control group. Positive correlations were found between the SII and AOD indicators and C-reactive protein levels. Increasing SII values were a common independent predictor of the presence and severity of AOD. The gradually increasing threshold values of the SII from no AOD to Grade III-IV exhibited high diagnostic performance. Conclusions: High SII values were independent predictors of the presence and severity of AOD in patients with newly diagnosed treatment-naive HTN. Considering the role of inflammation in HTN, the SII, which can be easily evaluated using blood parameters, can be an effective prognostic screening tool.

Association between interleukin-6 gene polymorphism and iron regulation in hemodialysis patients infected with HCV / Associação entre polimorfismo do gene da interleucina-6 e regulação do ferro em pacientes em hemodiálise infectados pelo HCV

ABSTRACT Backgrounds: Hepcidin is related to the pathogenesis of chronic renal failure anemia, which is considered a chronic inflammatory state as well as HCV infection. IL-6 stimulates the release of hepcidin from the liver, suppresses intestinal iron uptake, and releases iron from internal stores. Method: To detect the association between IL-6 gene polymorphism and anemia markers, 80 hemodialysis (HD) patients [40 negative HCV HD patients and 40 positive HCV HD patients] were studied by routine chemistry and complete blood count, in addition to the assessment of serum hepcidin, iron parameters [serum iron and serum ferritin], and hepatitis C markers. IL-6 polymorphism -174G/C was determined by MS-PCR, while IL-6 polymorphisms -597G/A and -572 G/C were detected by PCR-SSP. Results: Hepcidin was non-significantly elevated in HCV-positive compared with HCV-negative hemodialysis patients. A statistically significant difference was detected between the negative and positive HCV HD patients in frequencies of IL-6 -174 G/C and -597 G/A (P≤ 0.01 and P≤ 0.001, respectively). On the other hand, a non-significant difference was reported between negative and positive HCV HD patients in the frequencies of IL-6 -572 G/C. Conclusions: Our study indicated that IL-6 -174 G/C and -597 G/A polymorphisms may play a role in HCV susceptibility in HD patients. Additional prospective studies on a larger population are needed to confirm our findings.

RESUMO Introdução: A hepcidina está associada à patogênese da anemia por insuficiência renal crônica, considerada um estado inflamatório crônico e também infecção por HCV. A IL-6 estimula a liberação de hepcidina a partir do fígado, suprime a captação intestinal de ferro e libera ferro das reservas internas. Método: Para detectar a associação entre o polimorfismo do gene IL-6 e os marcadores de anemia, 80 pacientes em hemodiálise (HD) [40 pacientes em HD, negativos para HCV; e 40 em HD, positivos para HCV] foram avaliados por exames químicos de rotina e hemograma completo, além da avaliação da hepcidina sérica, parâmetros do ferro [ferro sérico e ferritina sérica] e marcadores de hepatite C. O polimorfismo da IL-6 -174G/C foi determinado por MS-PCR, enquanto os polimorfismos de IL-6 -597G/A e -572 G/C foram detectados por PCR-SSP. Resultados: A hepcidina não esteve significativamente elevada em pacientes com HCV em comparação com pacientes em hemodiálise negativos para HCV. Uma diferença estatisticamente significativa foi detectada entre os pacientes em HD HCV negativos comparados aos positivos nas frequências de IL-6 -174 G/C e -597 G/A (P≤ 0,01 e P≤ 0,001, respectivamente). Por outro lado, foi relatada uma diferença não significativa entre pacientes em HD HCV negativos e positivos nas frequências de IL-6 -572 G/C. Conclusões: Nosso estudo indicou que os polimorfismos de IL-6 -174 G/C e -597 G/A podem desempenhar um papel na suscetibilidade ao HCV em pacientes em HD. Ainda necessitamos de estudos prospectivos adicionais em uma população maior para confirmar nossos achados.

The significance of preoperative estimated glomerular filtration rate on survival outcomes in patients who underwent radical cystectomy and non-continent urinary diversion

ABSTRACT Purpose To evaluate the influence of preoperative renal function on survival outcomes in patients who underwent radical cystectomy (RC) with non-continent urinary diversion (UD). Materials and Methods A total of 132 patients with bladder cancer who underwent RC with non-continent UD due to urothelial carcinoma from January 2006 toMarch 2017 at our tertiary referral center were retrospectively evaluated. Patients were divided into 2 groups as those with estimated glomerular filtration rate (eGFR) <60mL/min/1.73 m2 and ≥60mL/min/1.73 m2 according to preoperative eGFR levels. Patients' characteristics, preoperative clinical data, operative data, pathologic data, oncologic data and complications were compared between the groups. Results The mean age was 64.5±8.7 (range: 32 - 83) years and the median follow-up was 30.9±31.7 (range: 1-113) months. There were 46 patients in Group 1 and 86 patients in Group 2. There was no difference in cancer-specific mortality (45.6% for group 1 and 30.2% for group 2, p=0.078) and survival (56.8±8.3 months for group 1 and 70.5±5.9 months for group 2, p=0.087) between the groups. Overall mortality was higher (63% for group 1 and 40.7% for group 2, p=0.014) and overall survival (43.6±6.9 months for group 1 and 62.2±5.8 months for group 2, p=0.03) was lower in Group 1 compared to Group 2. Conclusions Overall mortality was higher and overall survival was lower in patients with preoperative eGFR <60mL/s. More patients had preoperative hydronephrosis with eGFR< 60mL/s.

The Association of lymphocyte count, CRP, D-Dimer, and LDH with severe coronavirus disease 2019 (COVID-19): A meta-analysis

Background: The rapid progression of Coronavirus disease 2019 (COVID-19) and its increasing burden on health systems necessitate the identification of parameters of severe infection to help in monitoring, prognoses and development of treatment algorithms.Objectives: This review aims to investigate the association of lymphocyte count, CRP, LDH, and D-Dimer with the severity of COVID-19.Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), and ScienceDirect were used for the systematic search. Random effects model was used to estimate the pooled standardized mean differences (SMD) with the corresponding 95% confidence interval (CI), using OpenMeta Analyst software.Results: A total of 11 studies, with 2437 COVID-19 patients, which fulfilled the eligibility criteria were included in the meta-analysis. The analysis revealed that lymphocyte count was significantly lower in patients with the severe form of COVID-19 (SMD = - 1.025, P value <.001). Also, the analysis of SMD showed that patients with severe COVID-19 have a significantly higher serum levels of CRP (SMD = 3.363, P value <.001), D-Dimer (SMD = 1.073, P value <.001), and LDH (SMD = 3.345, P value <.001). Conclusion: Low lymphocyte count and high levels of CRP, LDH, and D-Dimer are associated with severe COVID-19. These laboratory markers could be used as clinical indicators of worsening illness and poor prognosis of COVID-19

Chemotherapeutic effect of Ulmus pumila leaves methanolic extract against N-methyl-N-nitrosourea-induced mammary carcinoma in female rats: An in vitro and in vivo study

Searching for a chemopreventive agent is an important approach for breast cancer management. The aim of the study was to evaluate the chemopreventive potential of Ulmus pumila (UP) leaves extract on breast tumorigenesis induced in experimental animals by N-methyl-N-nitrosourea. This target was undertaken through preparing several extracts from the fresh leaves of UP using different solvents against the breast adenocarcinoma cell line (MCF-7). Our in vitro results demonstrated that the methanolic extract of UP (UPME) showed the highest cytotoxic activity against the growth of MCF-7 cells. After determination of UPME safe dose (1/10) of a lethal dose, the in vivo results revealed that UPME treatment significantly decreased the activities of liver enzymes, kidney function, cancer antigen 15-3 (CA 15-3) level, urokinase plasminogen activator, heparanase, basic fibroblast growth factor, B-cell leukemia lymphoma 2, and cyclooxygenase-2. By contrast, total antioxidant capacity (TAC) was increased in therapeutic, protective, and prophylactic groups as compared to the tumor group. These improvements were supported with histopathological changes. These results indicated that the chemotherapeutic potential of UPME through stimulation of apoptosis and the suppression of angiogenesis, proliferation, and metastasis.

Mammographic screening patterns in Sokoto, Northwestern Nigeria

Background: Screening mammography is a radiographic examination of the breast performed for early detection of breast cancer in asymptomatic women. The American College of Radiology recommends that women should have mammography at the age of 40 years and annually thereafter. However, those who are at increased risk of breast cancer should start screening mammography earlier. These include patients with a strong family history of breast cancer or those who had radiotherapy to the chest wall.Objective: This study is aimed at evaluating the mammographic outcomes among 77 Nigerian females who had screening mammographic breast examination. Materials and Methods: From December 2010 and November 2012, 77 females had routine screening mammography in the department with the general electric alpha­RT machine with model number MGF­101 (manufactured 2010). All the participants had to fill a mammographic form consisting of variables such as age, sex, occupation, family history ofbreast cancer, tribe, contraception, parity and caffeine consumption, history of surgical intervention (lumpectomy, biopsy, and/or mastectomy), previous mammography, and last childbirth. Mediolateral­oblique and cranial­caudal views were done for the breast examination though additional were occasionally employed. Results: Seventy­seven females had screening mammography. The minimum age recruited was 40 years. The mammographic outcome for those who had screening was normal in 51 (66.2%) and abnormal in 26 (33.8%) participants. The abnormal mammographic outcomes were architectural distortion in either or both breasts in 13 (16.9%) participants, masses in either or both breast in 11 (14.3%) participants, while isolated calcification in either or both breast among 2 (2.6%) participants. Two (18.2%) of the subjects with masses had associated macrocalcification. No masses with malignant features were seen. Conclusion: Screening mammography was found out to be useful in detecting various forms of breast pathologies which were mostly breast masses, calcifications, and architectural distortions. Screening mammography is, therefore,advised yearly and routinely for women age 40 years and above

Awareness and knowledge of the general public at southern region of Saudi Arabia regarding dental implants

Aims: To assess the awareness, knowledge, and information sources regarding dental implants as anoption of treatment to replace missing teeth among patients in Jazan Province, Saudi Arabia.Materials and methods: The current study consisted of 14 questions used to assess the patients’awareness, expectations and level of knowledge of dental implants. Three categories of questionswere used, with the first one related to the patients’ knowledge and options for replacement of missingteeth, the second about dental implants and their providers, and the third on the techniques, materials,care, and durability of dental implants. The collected data was analyzed using Chi-square tests, and Pvalues less than 0.005 were considered significant. Results: A total of 380 subjects were divided intotwo groups, medical (40.3%) or non-medical (59.7%) related. We found that 85% and 71.0% of themedical and non-medical subjects, respectively know the importance of replacement of missing teeth,while 50% had known the different types of dental implants with no significance (P< .001) betweenthe two groups. Dentists were the sources of the information (43.3% and 34.8% for the medical andnon-medical groups respectively). Around 50% of the medical subjects thought that dental implantscame with a screw compared with 36.6% of non-medical subjects with value of P .025. In total, 60%-70% of respondents from both groups answered that dental implants should be provided by specialistsonly. Around 29% of all patients cited “lifetime” as the survival period of implants. Also, 52%-77%of the respondents related the implant site to the “the jaw bone,” with significant difference of P .000.Conclusions: The awareness and knowledge of the subjects were acceptable with higher percentageamong respondents in the medical group. Dentists followed by friends were the main sources ofinformation for dental implants. Dental implants are considered as the best choice for replacement ofmissing teeth with excellent durability and need of much more special care than natural teeth

Pattern and Outcome of Pediatric Leukemia and Lymphoma among Cancer Children Admitted to King Khalid Hospital in Hail Region, Saudi Arabia – Hospital Based Study

Background: Cancers form one of the major causes of mortality and morbidity in children between the ages of one and 15 years. Childhood cancers are histologically more diverse than adult cancers; they differ in type, distribution, etiology and prognosis from adult cancers. Childhood cancers are more influenced by genetic and environmental factors. The patterns of childhood cancers in America and Europe are almost similar, where leukemia tumors accounting for over one-half of cancer cases. In contrast, lymphoma is the most common prevailing cancer among children in Africa. The objective of this study is to determine the patterns of childhood tumors in Hail region, Saudi Arabia. Methods: This was a retrospective descriptive study conducted in king Khalid hospital, Hail, Kingdom of Saudi Arabia (KSA) during the period from October 2016 to March 2017. A full coverage of data regarding leukemia and lymphoma were retrieved from the hospital. Obtained data were filled in standard form prior to analysis. The study was approved by ethical committee at college of medicine, university of Hail. Data were analyzed using SPSS software version 16. P value < 0.05 was considered statistically significant. Results: The results showed a pattern of childhood leukemia as the most common cancer (60.8%). The prevalence of cancer was found to be higher among males (58.3.7%) than females (41.7%) with a rate of 1.3:1. Most of the children admitted with cancer were from Hail region (63.3%). Majority (41.7%) of cancer children had good prognosis and where discharged home. Conclusion: Hematological malignancies were the most common form of cancer among our patients. The pattern of childhood tumors showed wide variation during the study.

Lycopene Protects Against Spontaneous Ovarian Cancer Formation in Laying Hens

BACKGROUND: Dietary intake of lycopene has been associated with a reduced risk of ovarian cancer, suggesting its chemopreventive potential against ovarian carcinogenesis. Lycopene's molecular mechanisms of action in ovarian cancer have not been fully understood. Therefore, in the present study, we investigated the effects of lycopene on the ovarian cancer formation using the laying hen model, a biologically relevant animal model of spontaneous ovarian carcinogenesis due to high incidence rates similar to humans. METHODS: In this study, a total of 150 laying hens at age of 102 weeks were randomized into groups of 50: a control group (0 mg of lycopene per kg of diet) and two treatment groups (200 mg or 400 mg of lycopene per kg of diet, or ~26 and 52 mg/d/hen, respectively). At the end of 12 months, blood, ovarian tissues and tumors were collected. RESULTS: We observed that lycopene supplementation significantly reduced the overall ovarian tumor incidence (P < 0.01) as well as the number and the size of the tumors (P < 0.004 and P < 0.005, respectively). Lycopene also significantly decreased the rate of adenocarcinoma, including serous and mucinous subtypes (P < 0.006). Moreover, we also found that the serum level of oxidative stress marker malondialdehyde was significantly lower in lycopene-fed hens compared to control birds (P < 0.001). Molecular analysis of the ovarian tumors revealed that lycopene reduced the expression of NF-κB while increasing the expression of nuclear factor erythroid 2 and its major target protein, heme oxygenase 1. In addition, lycopene supplementation decreased the expression of STAT3 by inducing the protein inhibitor of activated STAT3 expression in the ovarian tissues. CONCLUSIONS: Taken together, our findings strongly support the potential of lycopene in the chemoprevention of ovarian cancer through antioxidant and anti-inflammatory mechanisms.

Immobilization of horseradish peroxidase on Fe3O4 magnetic nanoparticles

Background: Iron magnetic nanoparticles have attracted much attention. They have been used in enzyme immobilization because of their properties such as product is easily separated from the medium by magnetic separation. The present work was designed to immobilize horseradish peroxidase on Fe3O4 magnetic nanopraticles without modification. Results: In the present study, horseradish peroxidase (HRP) was immobilized on non-modified Fe3O4 magnetic nanoparticles. The immobilized HRP was characterized by FT-IR spectroscopy, scanning electron microscopy, and energy dispersive X-ray. In addition, it retained 55% of its initial activity after 10 reuses. The optimal pH shifted from 7.0 for soluble HRP to 7.5 for the immobilized HRP, and the optimal temperature shifted from 40°C to 50°C. The immobilized HRP is more thermostable than soluble HRP. Various substrates were oxidized by the immobilized HRP with higher efficiencies than by soluble HRP. Km values of the soluble and immobilized HRP were 31 and 45 mM for guaiacol and 5.0 and 7.0 mM for H2O2, respectively. The effect of metals on soluble and immobilized HRP was studied. Moreover, the immobilized HRP was more stable against high concentrations of urea, Triton X-100, and isopropanol. Conclusions: Physical immobilization of HRP on iron magnetic nanoparticles improved the stability toward the denaturation induced by pH, heat, metal ions, urea, detergent, and water-miscible organic solvent.

Decision-to-delivery time intervals in emergency caesarean section cases: repeated cross-sectional study from Oman

Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval [DDI] of

Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of <7 at five minutes, admission to the Special Care Baby Unit [SCBU] or a stillbirth

Results: In the initial cycle, a DDI of 60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores [P <0.001 each]. Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre

Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes

Comparison of apical extrusion of intracanal bacteria by various glide-path establishing systems: an in vitro study

OBJECTIVES: This study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems. MATERIALS AND METHODS: Sixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU). RESULTS: The manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria. CONCLUSIONS: All glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.

Reviews on Calcium Mediated Secondary Messengers in Chronic Opioids Exposure/Addiction.

Addiction and withdrawal are problems disturbing the health of the individual and also causes difficulties for society, raising the rates of divorce, unemployment and government spending on legal and medical systems. Opioids show an important pharmacological effect in the treatment of pain, with extremely addictive potential. Chronic opioid exposure is known to produce the complex behaviors of tolerance and dependence, a state exposed by opioid abstinence leading to withdrawal syndrome, as well as oxidative stress. Studies show that calcium mediated secondary messengers play a crucial role in the mechanism of addictive process and oxidative stress induced by chronic opioid usage. Calcium/calmodulin-dependent protein kinase II (CaMKII), is a major calcium regulated signal transducer that controls many neuronal systems and play important role in neuronal plasticity and can act as a key and direct promoting opioid tolerance and dependence and identifying such a direct mechanism may be useful for designing a pharmacology treatment for these conditions, recent studies, has been shown that calcium channels antagonist can be used in the treatment of withdrawal syndrome. Chronic opioid exposure associated with tolerance, dependence withdrawal syndrome and oxidative stress. Studies has shown that calcium mediated secondary messengers involved in the genesis of these conditions, better understanding of biological mechanisms underlie reduction in neuronal cell excitability could help in the identification of pharmacological targets for treatment.

Arthroscopic treatment of Synovial Osteochondromatosis of the elbow

A 40-year-old man presented with complaints of pain that continued to increase over a year. There was swelling and limitation of motion in his right elbow. There was an increase in the diameter of the right elbow, painful joint movements, and 30-degree extension loss in the physical examination of the patient. Direct radiography and computed tomography scans of the right elbow showed calcified joint mouses three in front and one at the back of the elbow. Magnetic resonance imaging [MRI] showed the increment of fluid and free hypodense objects in front of the elbow. Following an initial diagnosis of synovial chondromatosis, arthroscopic surgery was performed. Three dirty white colored free bodies were removed with partial synovectomy by reaching front and back of the elbow from standard inputs. Thediagnosis of synovial chondromatosis was confirmed with pathological examination. The patient's pain recovered in the first postoperative week, and the full range of motion reached in the third week. At the end of the 1-year follow-up, the patient's complaints completely disappeared, and there was no evidence of recurrence

In vitro antiplasmodial activity, macronutrients and trace metals in the medicinal plants: Phyllanthus spp. and Alpinia conchigera Griff

An antiplasmodial screening of Phyllanthus debilis and Phyllanthus urinaria was carried out. The medicinal plants were extracted and evaluated for in vitro antiplasmodial activity against D10 (chloroquine-sensitive, CQS) and Gombak A (chloroquine-resistant, CQR) strains of Plasmodium falciparum. The methanolic crudes from the soxhlet extraction were active against both strains however, P. urinaria (IC50 8.9 μg/ml with CQR strain) exhibited better anti-malarial activity compared to P. debilis (IC50 12.2 μg/ml with CQR strain). Furthermore, the methanolic crude of P. urinaria obtained by the cold extraction has good anti-malarial activity towards CQS (IC50 4.1 μg/ml). The concentration of macronutrients (calcium and magnesium) and trace metals (copper, manganese, iron and zinc) from three Phyllanthus species i.e. P. debilis Klein ex Wild., Phyllanthus niruri L., P. urinaria L. and Alpinia conchigera Griff. were determined using microwave digestion method and analyzed by Flame Atomic Absorption Spectroscopy. Standard Reference Material 1547 (peach leaves) was used to validate the method throughout this study. The recovery values were in the range of 80% to 120% which were in very good agreement with the certified values. The three Phyllanthus species and leaves of A. conchigera showed the highest concentration of calcium compared to other metals and macronutrients studied. The significant presence of all the important macronutrients and trace metals which are essential for human health and wellbeing substantiate their use medicinally in traditional practices.

Serum Levels of Interferon Gamma in Patients with Brucellosis in a Saudi Hospital.

Background: Brucellosis is a major zoonotic disease that is endemic in Saudi Arabia and it remains a major health problem that has not been eradicated in the country yet. Place and Duration of Study: This retrospective study was conducted in a Saudi Hospital at Al Madinah city during the period of 1 November, 2010 to 31 October, 2011. Methodology: All sera of patients suspected to have brucellosis (n= 65) and 18 healthy subjects were tested for brucella antibody using slide latex agglutination (SAT) and ELISA. Quantitation of IFN-ɣ was also done using ELISA. Results: Brucellosis was detected in all age groups but the incidence was higher and reached 33.3% in age group (40- <50) years with average of 43.9±2.53 years. Male to female ratio in infected patients was 2:1 by using SAT. The incidence of seropositive cases was high (80.1%) in the three months (April, May and June), with the highest peak in May (46.7%). Drinking raw milk was the most encountered risk factor with a prevalence of 66.1% followed by consumption of milk products (11.9%). The most prevalent species among the examined cases was B. melitensis (93.3%). Among the studied cases, 60 cases (92.3%) were serologically positive for brucellosis by SAT. Among the 60 cases yielding significant titers against brucella, 14 sera (23.3%) had agglutinin levels of 1:80, 34 sera (56.7%) had titers of 1:160 and 12 sera (20%) had titers of 1:320. By estimating IgM and IgG levels in the sera of examined cases using ELISA, 52 cases (80%) had brucellaIgM while 42 cases (64.6%) had brucella IgG. Sensitivities of SAT, IgM ELISA and IgG ELISA were 91.5%, 88.1% and 71.2%, respectively compared with combined ELISA. Mean IFN-ɣ levels ± SD in the subacute phase was 136.7±70.07pg/ml, 120.2±54.25pg/ml in the acute phase, and 121.3±51.09 pg/ml in the chronic phase of brucellosis. Conclusion: The sensitivity and specificity of ELISA to diagnose human brucellosis was higher when combined ELISA (IgM/IgG or both) was used. Mean IFN-ɣ levels were lower, but not significantly, in the chronic phase of the disease than in the sub acute phase and healthy subjects.

Qualitative and quantitative detection of Aflatoxin-M1 residues in white soft cheese

A total of 50 random samples of locally manufactured Egyptian soft cheese including [25 each of Damietta and fresh kariesh cheese] were collected from different markets and shopkeepers at Mansoura city, Egypt. Each sample was divided under complete hygienic measures with a clean sterile, knife into two parts; the first part was prepared for estimation of by qualitative lateral flow test [strip test] and the second one was subjected to quantitative estimation of by [Immune Affinity Column with Flurometric Assay]. The qualitative value for detection of Aflatoxine M1 revealed that 8[32%] and 12 [48%] of kareish and Damietta cheese were contaminated with Aflatoxin M1 respectively. Concerning the concentration of Aflatoxin M1 in examined fresh Kariesh cheese and Damietta cheese samples for the minimum was 1.95 and 1.54, the maximum were 6, 11 and 14.73 with a mean value 3.6 and 6.7 ppb, respectively. It had been emphasized that all results of this study exceeded the Egyptian regulations, European commission [EC] regulations and US regulations which recommend that cheese sample must be free from Aflatoxin M1, do not exceed 250 ng/L, and do not exceed 5 micro g/kg in milk, respectively. It was concluded that the qualitative method of detection of mycotoxin has great benefit in minimizing cost of regulations and monitoring and give a chance to easily set regulation for quality control. Also, quantitative methods with highly detectable limits give accurate results to estimate the level of impact

outcome of transvaginal sacrospinous colpopexy: King Hussein medical center short term experience

We have conducted this study to measure the outcome of vaginal sacrospinous colpopexy for the correction of vaginal vault and uterine prolapse regarding the success rate and safety. This is a descriptive study which was conducted at the Department of Obstetrics and Gynecology at King Hussein Medical Center during the period between March 2010 to September 2011. A total of 32 patients underwent vaginal sacrospinous fixation with preservation of the uterus, or combined with vaginal hysterectomy, vaginal repair and anti-incontinence procedure. The patients were re-evaluated after two weeks, two months and six months of the procedure. A specially designed medical record abstract form was used to collect the study data. Simple descriptive statistics [median, mean, frequency and percentage] were used to describe the study variables. The diagnosis of patients whom were operated included uterine prolpse in 23[72%] patients and vaginal vault prolapse in 9 [28%] patients. The operation was successful in 97% of the patients. During follow-up period, the operation was complicated with urinary tract infection in 3 [9%] patients and 2[6%] patients with low back pain. We had not encountered any intra-operative complications in relation to the procedure. The success rate for vaginal sacrospinous colpopexy operation was 97% in our series with minimal perioperative complications. It may be concluded that vaginal sacrospinous colpopexy may be safely combined with other vaginal surgeries for patients with uterovaginal prolapsed

Perinatal mortality rate as a quality indicator of healthcare in Al-Dakhiliyah Region, Oman

This study aimed to provide insight into the causes of stillbirths and early neonatal deaths and identify better intervention strategies. This was a retrospective study during a 7-year period [January 2003 to December 2009] of all stillbirths and early neonatal deaths at the Nizwa regional referral hospital in Al-Dakhiliyah region, Oman. Of a total 27,668 births, there were 244 stillbirths and 157 early neonatal deaths. The perinatal mortality rate [PMR] was 14.49/1,000 births. The period-specific rates were 17.23/1,000 in 2003, 18.33/1,000 in 2004, 15.20/1,000 in 2005, 12.20/1,000 in 2006, 12.46/1,000 in 2007 and 12.09/1000 in 2008. This decline in the death rate was significant [P = <0.005]. The rate rose in 2009 to 15.63/1,000, mostly from an increase in early neonatal deaths [congenital anomalies]. The most common identifiable cause of stillbirth was congenital anomalies [18.82%], in which central nervous system anomalies were most common. Other causes include abruption placentae [13%], cord accidents [12%], and intrauterine growth restriction [IUGR], while the cause remained unknown in 22.59%. Congenital anomalies accounted for 53.50% of early neonatal deaths followed by prematurity [23.56%] and birth asphyxia [5.73%]. Extremes of maternal age were related to higher PMRs. An overall improvement in the stillbirths and neonatal death rates was witnessed; however, further improvement is warranted for common avoidable fetal and maternal risk factors. Extra care needs to be provided for women who are at risk of developing complications such as gestational diabetes, pregnancy-induced hypertension, IUGR, etc

Genotoxicity of anticancer drug Azathioprine (Imuran): role of Omega-3 (ω-3) oil as protective agent.

Omega-3 (ω-3), is long-chain, polyunsaturated fatty acids (PUFAs) of plant and marine origin. The present study was conducted to evaluate the protective effect of omega-3 against cytotoxicity and genotoxicity of anticancer drug; Azathioprine (Imuran): Male albino mice were administrated two levels; therapeutic (5mg|kg) and double therapeutic (10mg|kg) doses. Azathioprine was intraperitoneally injected for 3 times at 48 hour interval. Omega-3 was orally administered with 2 ml/kg for ten consecutive days either before or after Azathioprine treatments. At the end of experimentation period, samples of bone marrow were collected from five mice within each group for micronucleus assay. The liver and testis tissue samples were removed and stored at – 80 °C until use for DNA extraction, and determination of glutathione contents. Another animal group was treated at the same regimen and were used for the determination of sperm abnormalities and sacrificed after 35 days. The results indicated that oral administration of omega-3 either before or after treatment of Azathioprine was effective in reduction of the frequencies of Mn-PCEs, decreased the DNA fragmentation, total sperm abnormalities and significantly increased sperm count, percentage of PCEs, and enhanced the ratio of PCEs to NCEs. However, random amplified polymorphism of DNA (RAPD) showed distinct differences in animal groups intoxicated with Azathioprine before and after omega-3 treatment, which reflected DNA protective effect of omega-3. Depletion in glutathione content in testis was also observed in Azathioprine treated mice, which was improved by oral administration of Omega-3 either before or after treatment with Azathioprine.