A Comparative Study between Pharmacoinvasive Strategy and Primary Percutaneous Coronary Angioplasty on Left Ventricle Function in Patients Presenting by Acute ST Segment Elevation Myocardial Infarction

Background: Ischemic heart disease is considered the most common cause of death, worldwide. It accounts for 1.8 million deaths annually in Europe alone. According to the center for disease control (CDC) it’s the most common cause of deaths in Egypt accounting for more than one fifth of the total death count per year (21%), followed by stroke, then cancer. Aim: This work aimed to study and assess the efficacy of a pharmacoinvasive strategy compared with a primary PCI strategy on the left ventricle function in treatment of patient with myocardial infarction. Methods: Our study was prospective non randomized which compares between two groups, both of which had first time acute STEMI admitted to our Tanta University Hospital within the accepted time, which are (group 1) patients who had primary PCI for the infract related artery as a reperfusion therapy and (group 2) patients who had thrombolytic followed by coronary angiography with a window to PCI (pharmacoinvasive technique). Coronary angiography was performed either immediately in case of failed thrombolytic therapy or within 3-24 hrs. Following thrombolytic in case of successful thrombolytic. Both groups presented to the hospital within the accepted time window for reperfusion therapy either (thrombolytic or primary PCI), within 12 hrs. Results: The study compared between the two groups in the acute stage during hospitalization of the patients and after discharge according to Clinical outcomes: (mortality, major adverse cardiac events (MACE) as heart failure symptoms, re-infarction and Cardiac death),angiographic findings (base line TIMI flow score and final TIMI score, single or multi-vessel disease), angiographic complications as dissection and no-reflow, occurrence of contrast induced nephropathy and cerebrovascular events and LV systolic function assessment by echocardiography. Conclusion: In this study, we highlighted the importance of total ischemic time and importance of patient and system related delays in influencing outcomes of STEMI.

The Effect of Dietary Supplement on Glutathione Level in Rats

Background: Oxidative stress occurs due to decreased glutathione inside the body. Some supplements may promote and stimulate glutathione production in the liver. This article aims to investigate the impact of different supplements on enhancing glutathione synthesis in rats’ livers. For this purpose 42 rats (male albino) were separated into 7 groups, each including 6 animals with average weights ranging between 150 and 160 g. Group 1 (control) and different groups consumed a basal diet for 8 weeks, whereas group 2 received 500 mg/kg bw of L-cysteine daily. Group 3 received 250 mg/kg bw of methionine, while group 4 got 250 mg/kg of L cysteine plus 125 mg/kg of methionine daily. Spirulina (20 mg/kg bw), turmeric (500 mg/kg bw), and dried garlic (500 mg/kg bw), respectively, were given to groups 5, 6, and 7. Results: Utilizing the various dietary supplements decreased levels of liver function enzymes, bilirubin, urea, creatinine, and malondialdehyde while enhancing levels antioxidant enzymes of liver, and increased glutathione of kidneys and liver. However, cysteine alone at 500 mg/kg bw decreased glutathione formation in the liver and kidneys. Compared to the amino acid supplements (group 2, 3, 4) used, spirulina, turmeric, and dried garlic had a significant impact on reducing liver function enzymes, bilirubin, uric acid, creatinine, urea, and malondialdehyde and increasing antioxidant enzymes, and glutathione while turmeric supplement showed the best influence. Using dietary supplements did not result in any pathological modifications in the liver tissues, but there were some unsatisfactory minor alterations. However, group 2 showed considerable pathological developments in the liver tissues. Conclusion: According to the findings, using the suggested dietary supplement except for cysteine alone can promote and encourage glutathione synthesis in different organs, especially the liver, hence alleviating the effects of oxidative stress associated with several illnesses.

Predictive Value of TIMI Risk Index for Angiographic No-reflow after Primary Percutaneous Coronary Intervention

Objective: In patients with acute coronary artery disease, the TIMI risk index (TRI), the thrombolysis in myocardial infarction (TIMI) risk score, and the global registry of acute coronary events (GRACE) risk score (GRS) have all been documented. The aim of this study was to determine the relationship between no-reflow (NRF) and admission TRI, major cardiac events (MACE), and in-hospital mortality in patients undergoing primary percutaneous coronary intervention (P-PCI). Methods: Between March and December 2019, 100 consecutive patients diagnosed with STEMI and treated with PPCI at Tanta Main University Hospital in Tanta, Egypt, were included in the research population. Each patient consented following a thorough history taking, evaluation of coronary risk factors, clinical examination, and electrocardiogram analysis. Additionally, all instances were classified using the Killip method. The GRS, TRS, and TRI values were examined. Results: The GRS, TRS, and TRI scores were significantly associated with increased NRF, MACE, and hospital mortality in STEMI patients treated with P-PCI, suggesting that TRI is a straightforward indicator with fewer parameters that accurately reflects P-PCI success. Conclusion: TRI has been demonstrated to enhance the risk of in-hospital mortality and MACE. TRI uses straightforward and cost-effective ways to test patients who have experienced a STEMI. Additionally, a high TRI may assist in identifying high-risk individuals and developing suitable treatment solutions.

Predictors of Left Ventricular Dysfunction after Percutaneous Primary Coronary Intervention in Acute Anterior Myocardial Infarction

Background: Primary percutaneous coronary intervention (PCI) has revolutionized the outcome and management of acute myocardial infarction. However, the occurrence of left ventricular dysfunction remains relatively common event following acute myocardial infarction and in associated with an adverse prognosis in these patients. this work aimed to investigate to the left ventricular dysfunction predictors following PCI for anterior myocardial infarction (AMI) using different parameters: Tissue Doppler imaging (TDI), Biomarkers (Troponin, CK-MB) and Echocardiography Methods: This research was conducted prospectively on 50 patients aged from 40 to 70 years old, presenting by first anterior myocardial infarction and treated with PCI. All cases were subjected to full history, full clinical examination, laboratory investigations, resting 12 leads electrocardiography, two dimensions echocardiography and tissue doppler imaging. Results: Highly statistically significant between EF baseline with EF on discharge and EF on discharge with after 3 months p-value was <0.001. Pre balloon dilatation, S wave of tissue Doppler imaging on discharge and S wave tissue Doppler imaging after 3 months were predictors for left ventricular systolic function. Conclusions: Persistent LV dysfunction following successful primary PCI is infrequent and is related to poor clinical outcomes at 3 months clinical follow-up. Tissue Doppler on discharge and after three months after myocardial infarction are independent predictors of LV dysfunction after anterior STEMI and can be used to predict occurrence of LV remodelling after 6 months.

Miocarditis aguda tras una infección por el virus de la varicela-zóster en un adolescente inmunocompetente: una complicación poco frecuente / Acute myocarditis following varicella zoster infection in an immunocompetent adolescent: An uncommon complication

La miocarditis es una complicación grave de la infección por el virus de la varicela-zóster. Un varón de 15 años ingresó a la sala de emergencias debido a dolor torácico, taquicardia e hipotensión. En el electrocardiograma se observó taquicardia sinusal. Los biomarcadores cardíacos estaban elevados. En el ecocardiograma se notó hipocinesia apical, septal, e inferolateral del ventrículo izquierdo e insuficiencia mitral. Los anticuerpos IgM en suero para el virus de la varicela-zóster eran positivos. El paciente recibió el alta sin secuelas.

Myocarditis is a serious complication of varicella zoster virus infection. A 15 year-old boy was admitted to the Emergency Department for chest pain, tachycardia and hypotension. An electrocardiogram showed sinus tachyicardia. Cardiac biomarkers were elevated and echocardiography revealed left ventricular apical, inferolateral, septal hypokinesis, and mitral regurgitation. Varicella zoster virus serum immunoglobulin M antibody was positive. The patient was discharged without any sequelae.

GSK3β: A plausible molecular target in the cytokinemodulating effect of exogenous insulin in a murine model of malarial infection

@# Malaria is a life-threatening disease caused by the Plasmodium sp. parasite. Infection results in heightened pro-inflammatory response which contributes to the pathophysiology of the disease. To mitigate the overwhelming cytokine response, host-directed therapy is a plausible approach. Glycogen synthase kinase-3β (GSK3β), a serine/threonine kinase plays a pivotal role in the regulation of inflammatory response during pathogenic infections. The present study was conducted to investigate the chemo-suppressive and cytokine-modulating effects of insulin administration in malaria-infected mice and the involvement of GSK3β. Intraperitoneal administrations of 0.3 and 0.5 U/kg body weight insulin each for four consecutive days into Plasmodium berghei NK65 (PbN)-infected mice resulted in chemo-suppression exceeding 60% and improved median survival time of infected mice (20.5 days and 19 days respectively compared to 15.5 days for non-treated control). Western analysis revealed that pGSK3β (Ser9) intensity in brain samples from insulin-treated (0.3 and 0.5 U/kg body weight) infected mice each were 0.6 and 2.2 times respectively than that in control. In liver samples, pGSK3β (Ser9) intensity from insulin-treated infected mice were significantly higher (4.8 and 16.1 fold for 0.3 and 0.5 U/kg bw respectively) than that in control. Insulin administration decreased both brain and liver pNF-κB p65 (Ser536) intensities (to 0.8 and 0.6 times for 0.3 U/kg bw insulin; and to 0.2 and 0.1 times for 0.5 U/kg bw insulin respectively compared to control). Insulin treatment (0.5 U/kg bw) also significantly decreased the serum levels of pro-inflammatory cytokines (TNF-α (3.3 times) and IFN-γ (4.9 times)) whilst significantly increasing the levels of anti-inflammatory cytokines (IL-4 (4.9 fold) and IL-10 (2.1 fold)) in PbN-infected mice. Results from this study demonstrated that the cytokinemodulating effects of insulin at least in part involve inhibition of GSK3β and consequent inhibition of the activation of NF-κB p65 suggesting insulin as a potential adjunctive therapeutic for malaria.

Patient Dose Assessment for Common Digital Diagnostic Radiology Examination in Hamad Medical Corporation Hospitals in the State of Qatar.

The aim of this study was to estimate radiation doses to patients undergoing standard radiographic examinations using Computed Radiography (CR) and Direct Digital Radiography (DDR) in two hospitals within Hamad Medical Corporation (HMC) in Qatar, and compare the results with regional and international Diagnostic Reference Levels (DRLs). Data on 3391 patients were recorded from different X-ray rooms in HMC hospitals. Entrance Skin Dose (ESD) was measured for 1046 patients for the most five common X-ray examinations (a total of 7 projections) namely: Skull, Chest, Abdomen, Lumbar Spine and Pelvis. Exposure factors such as kV, mAs and Focal to Skin Distance (FSD) were recorded for each patient. Tube Output was measured for a range of selected kV values. ESD for each individual patient was calculated using the tube output and the technical exposure factors for each examination. The ESD values were compared with some international DRLs for all types of examinations. HMC patient demographic data evaluated from this study were: average age of 39 years, average weight of 60-80 kg and mean height of 165 cm. The most procedure performed during the time of this study was chest PA (52%), and the least procedure performed was skull AP/LAT (1%) examination. The mean ESD values found to be generally lower than the published values. With exception of abdomen examinations at Hamad General Hospital (HGH), mean ESD values were found to be within the established IAEA (DRL). The mean ESD values at HGH were found to be much higher than that at Al Khor Hospital (AKH) for abdomen, Lumbar spine AP, Lumbar Spine LAT and pelvis, but generally lower than the published values.

Evaluation of Mean Glandular Dose from Digital Mammography Exams at Qatar and Compared with International Guidelines Levels.

The primary objective of this study was to measure the mean glandular dose (MGD) from craniocaudal (CC) and mediolateral oblique (MLO) views from mammography patients in Hamad Medical Corporation (HMC) in the state of Qatar and to compare them with the international guidelines levels as well as to establish Dose Reference Level (DRL) for the country by applying the quality control (QC) protocol for the Digital mammography units and to reduce the patient dose and improve the image quality. All patients data was taken from two Selenia digital mammography units for 18 months period. Quality control was implemented for the two mammography machines and corrective actions have been done for the image quality evaluation with rejected film analysis. The total number of collected patient data was 4085 mammography exams which considered as around 93% of the overall mammography procedures done in Qatar during that period. Based on the IAEA selection criteria of breast thickness between 2-7 cm and kV machine value from 26 to 33 kV, only 3280 mammography procedures satisfies the above criteria and are analysed accordingly, National Centre for Cancer Care & Research (NCCCR) 949 and Hamad General Hospital (HGH) 2331 exposures. The present study revealed that there were significant differences between the MGD values for the CC and MLO views (p <0.006). Referring to the limiting dose values in the European guidelines, the results from the two mammography units showed that 94.5% and 99.7% of the mean glandular doses are acceptable from NCCCR and HGH respectively. Due to compression devise error in the NCCCR mammography machine, the MGD for some patients became more than the acceptable values especially at small breast thickness values (0-3 cm) which it seems 0% in the acceptable range.

Presence of Fragmented QRS Complexes in Patients with Obstructive Sleep Apnea Syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Obstructive sleep apnea syndrome (OSAS) is a disease with increasing prevalence, which is mainly characterized by increased cardiopulmonary mortality and morbidity. It is well-known that OSAS patients have increased prevalence of cardiovascular diseases including coronary heart disease, heart failure, and arrhythmias. The aim of this study was to evaluate the presence of prolonged and fragmented QRS complexes, which have previously been associated with cardiovascular mortality, in OSAS patients.</p><p><b>METHODS</b>Our study included 51 patients (mean age 41.6 ± 10.1 years) who were recently diagnosed with OSAS (apnea-hypopnea index [AHI] ≥5 events/h) and never received therapy. The control group consisted of 34 volunteers (mean age 43.1 ± 11.6 years) in whom OSAS was excluded (AHI <5 events/h). The longest QRS complexes was measured in the 12-lead electrocardiogram (ECG) and the presence of fragmentation in QRS complexes was investigated.</p><p><b>RESULTS</b>Fragmented QRS frequency was significantly higher in patients with OSAS (n = 31 [61%] vs. n = 12 [35%], P = 0.021). QRS and QTc durations were also significantly longer in OSAS patients than controls (99.8 ± 13.9 ms vs. 84.7 ± 14.3 ms, P < 0.001; 411.4 ± 26.9 ms vs. 390.1 ± 32.2 ms, P = 0.001, respectively). Analysis of the patient and controls groups combined revealed a weak-moderate correlation between AHI and QRS duration (r = 0.292, P = 0.070). OSAS group had no correlation between AHI and QRS duration (r = -0.231, P = 0.203).</p><p><b>CONCLUSIONS</b>In our study fragmented QRS frequency and QRS duration were found to increase in OSAS patients. Both parameters are related with increased cardiovascular mortality. Considering the prognostic importance of ECG parameters, it may be reasonable to recommend more detailed evaluation of OSAS patients with fragmented or prolonged QRS complexes with respect to presence of cardiovascular diseases.</p>

Radioiodination and Biological Evaluation of Epinephrine as a Possible Adrenergic Receptors Imaging Agent.

An adopted method for the preparation of high radiochemical purity [125I] iodoepinephrine was developed in order to characterize the binding properties of adrenergic receptors. Direct radioiodination of epinephrine was carried out using chloramine-T as oxidizing agent. The reaction proceeds well within 15 min at ambient room temperature up to 25+1ºC and afforded a radiochemical yield up to 94%. Different chromatographic techniques (electrophoresis and paper chromatography) were used to evaluate the radiochemical yield and purity of the labeled product. Biodistribution studies were carried out in normal Albino Swiss mice and the results showed rapid and high cardiac uptake of 125I-epinephrine. The result indicates the possibility of using radioiodinated epinephrine as myocardial imaging agent.

Gossypiboma: Twelve Years There-After.

Gossypiboma is used to describe a retained cotton matrix surgical material in the body after an operation. Retained intra-abdominal surgical sponge is an uncommon surgical error. Among retained foreign bodies, a surgical gauze or sponge constitutes the most frequently encountered object because of its common usage, small size and amorphous structure. We report a case of a 32-year-old female patient who presented a left sided abdominal mass 12 years after an exploratory laparotomy. The policy of prevention coupled with use of several adjunct technologies which accounts for sponge use will help to reduce the incidence of gossypibomas.

Prevalence characteristics of COPD in never smokers

Chronic obstructive pulmonary disease [COPD] is currently the 4th leading cause of death all over the world. Smoking is by far the most important documented [and preventable] cause for COPD. However, COPD can still be recorded among a good percentage of non smoker patients, due to other different causes. This study was performed in the Chest Department, Menoufiya University, in the period from April 2009 to August 2011, on randomly selected 300 COPD patients, 230 patients [76.66%] were men and 70 patients [23.34%] were women. The mean age of the patients was 60.7 +/- 5.35 years [range 42-83 years], and all patients were diagnosed as having COPD [FEV1/FVC < 70%], with the use of spirometry [prebronchodilator and postbronchodilator inhalation], according to the GOLD criteria. For each patient, the personal history [including his or her education level], smoking history, health status, and exposure to risk factors for COPD, were assessed according to a prewritten questionnaire. Out of the 300 COPD patients included in this study, 120 [40%] were never smokers and 180 [60%] were ever smokers. Women made up 41.7% of the never smokers [50 of 120] and 11% of the ever smokers [20 of 180]. Never smokers were significantly older than smokers [65.08 +/- 5.03 years vs 56.33 +/- 5.67 years [P < 0.001]] and were more likely to be women [41.7% vs 11% [P < 0.001]]. Never smokers made up to 40% [120/300] of all COPD cases: 78% [70/90] of all GOLD stage II cases, 45.5% [50/110] of all GOLD stage III cases. Among never smokers, 58.3% [70/120] fulfilled the criteria for GOLD stage II and 41.7% [50/120] fulfilled the criteria for GOLD stage III and no patients fulfilled the criteria of either GOLD stage I or GOLD stage IV. Never smokers were shown to have more occupational exposure to organic and inorganic dust and irritant gases at work place [41.7% [50/120] vs 27.7% [50/180], P < 0.05], more biomass exposure [41.7% [50/120] vs 0% [0/180], P < 0.001], less education [41.7% [50/120] vs 72.2% [130/180], P < 0.001], more exposure to passive smoking [75% [90/120] vs 22.2% [40/180], P < 0.001]. When compared with never smoker patients with moderate COPD [GOLD stage II], never smokers with severe COPD [GOLD stage III] were older in age [70.6 +/- 2.44 years vs 61.14 +/- 1.25 years, P < 0.001], have a higher female percentage [60% vs 28.6%, P < 0.001], lower BMI [21.2 +/- 0.76 vs 26.14 +/- 2.43, P < 0.001], more occupational exposure [27.5 +/- 2.56 years vs 13.33 +/- 2.39 years, P < 0.001], more biomass exposure [35 +/- 4.15 years vs 20 +/- 10 years, P < 0.001], less education [0% vs 71.4 educated, P < 0.001], more exposure to passive smoking [29 +/- 2.02 years vs 13.75 +/- 4.19 years, P < 0.001]. This study revealed that never smokers constitute a significant proportion of the Egyptian COPD patients. When dealing with COPD management, clinicians must be oriented with the different risk factors, other than tobacco smoke, that play a key role in the development and pathogenesis of COPD, because despite smoking is the most important risk factor, its absence doesn't exclude COPD diagnosis

Treatment outcomes among patients with multi-drug resistant tuberculosis in Abbasia chest Hospital from July 2006 to June 2010

Tuberculosis despite being treatable and preventable disease, it continues to be a major health challenge in many parts of the world. The emergence of drug-resistant tuberculosis has made the current epidemic worse. This retrospective study included 200 MDR-TB patients admitted to Abbassia Chest Hospital in the period between July 2006 and June 2010. Their files had been analyzed including medical history, chest examination and investigations. Drug regimens of resistance used for treatment and the fate of treatment were reported. Patients were 148 males [74%] and 52 females [26%]. Their ages ranged from 15 to 76 years [37.83 +/- 12.78 years]. 81.5% of them lived in rural areas, 2.5% were tobacco smokers and were diabetics. Defaulters were 44.5%, treatment failure patients were 44%, relapse patients were 4%, and new cases constituted 7.5% of the studied patients. Acquired resistance was 92.5% and primary resistance was 7.5%. The duration for sputum conversion ranged from 2 to 9 months [4.19 +/- 1.28 months]. The fate of MDR-TB treatment was favorable outcome in 132 cases [66%] and unfavorable in 68 cases [34%] [28 patients were defaulters [14%], 21 patients died [10.5%] and 19 patients had treatment failure [9.5%]]. The prevalence of defaulter patients was significantly higher among unfavorable outcome patients while the prevalence of treatment failure patients was significantly higher among favorable outcome. Successful treatment could be achieved in 66% of MDR-TB patients treated in Abbassia Chest Hospital between July 2006 and June 2010

Pleurodesis using different agents in malignant pleural effusion

Malignant pleural effusions [MPE] are characterized by rapid reaccumulation, after tapping, and many symptoms related. Pleurodesis, for the management of MPE, is intended to achieve symphysis between parietal and visceral pleura, and to prevent relapse of pleural effusion. Many chemical agents are tried to induce abrasion and damage of the pleural mesothelial layer to achieve this symphysis. The aim of this study is to compare the results of medical pleurodesis, using 4 different chemical agents in these cases, to reach an efficient one with minimal complications. Between July 2010 and July 2012, 40 patients with MPE, divided into 4 groups, underwent medical pleurodesis using 4 chemical agents in comparison: bleomycin, doxycycline, povidone iodine and 5-fluorouracil. Immediately and for 3 months after the procedure, the results of pleurodesis were assessed and the final reported success rates were 70% for bleomycin, 80% for doxycycline and 80% for povidone iodine, while 5 fluorouracil had the lowest success rate [50%] [P-value < 0.05]. Bleomycin, doxycycline and povidone iodine are nearly equally effective and safe pleurodetic agents when used in the optimal dose, while 5-fluorouracil had a much higher failure rate. Although povidone iodine and doxycycline are as effective and safe as bleomycin, they are cheaper alternatives and more available chemical agents for pleurodesis in cases with MPE

Sleep pattern changes in patients with liver cirrhosis

Liver cirrhosis is considered as a major cause of mortality worldwide and is the most common non-neoplastic cause of death among hepatobiliary and digestive diseases. One of the least studied complications of liver cirrhosis is the disturbed sleep pattern, which is being increasingly recognized as a major health problem affecting the quality of life. This study included two groups; the first group consisted of 30 patients diagnosed as liver cirrhosis based on abdominal ultrasound and liver biopsy and the second group consisted of 10 healthy subjects served as controls. ESS was calculated for every patient and all patients were subjected to complete overnight polysomnography to detect sleep disturbances among all participants. Our results showed that cirrhotic patients had ESS, AHI and OSA significantly higher than the control group [16.4 +/- 2.6 vs 11.1 +/- 1.8, P = 0.0001; 10.9 +/- 8.5 vs 2.4 +/- 1.6, P = 0.005 and 3.1 +/- 3.1 vs 1.1 +/- 0.9, P =0.03, respectively]. The percentage of sleep efficiency was significantly lower in cirrhotic patients than the control group [61.9 +/- 12.9 vs 73.1 +/- 7.6 [P = 0.02]]. Also, the percentages of S1, S3-S4 and REM sleep in relation to the total sleep time were significantly higher in the cirrhotic patients than the control group [P = 0.01, 0.02 and 0.06, respectively] while the percentage of S2 was significantly lower [P = 0.02]. Cirrhotic patients of Child class C had ESS, AHI and OSA significantly higher and sleep efficiency significantly lower than cirrhotic patients of classes A and B [P = 0.001 for all]. Cirrhotic patients with tense ascites had ESS, AHI and OSA significantly higher and sleep efficiency lower than patients with mild, moderate, or no ascites. This study revealed that cirrhotic patients had disturbed sleep pattern, correlating with the degree of cirrhosis

Diabetes knowledge among patients with diabetes mellitus at King Hussein Hospital

To assess Diabetes Knowledge among patients with Diabetes mellitus at King Hussein Hospital. This study was conducted at King Hussein Hospital. Descriptive research design during the period between September 2010 to October 2010, was used to recruit a convenient sample of 100 hospitalized adult patients with Diabetes mellitus. Data was collected through face-to-face interview using the Brief Diabetes Knowledge Test [Fitzgerald et al, 1998]. This test is composed of 23 multiple choice questions that assess General Knowledge and Insulin Knowledge as well as Total score for Total knowledge. Simple descriptive statistics [frequency, mean, percentage] was used to describe the study variables One hundred diabetic patients participated in this study [50 men and 50 women]. Their age ranged from 19 to 86 years [mean +/- SD 57.8 +/- 10.9 years]. The majority [90%] were married. The overall scores of the total sample were low; Total knowledge was [49.8 +/- 13.4]; General Diabetes Knowledge was [54 +/- 14] and Insulin Knowledge was [43 +/- 19.6]. Men scored higher than women in the total Knowledge [52.9 vs. 46.7]; General Diabetes Knowledge [56.8 vs. 51.1]; and Insulin Knowledge [46.9 vs. 39.8]. Moreover, there were no differences found between patients with type 1 and type 2 Diabetes in study group. Diabetic patients in this study had Diabetes Knowledge deficit about their disease, which in turn will limit their involvement in the management of the disease

Protein profile analysis of Malaysian snake venoms by two-dimensional gel electrophoresis

Snake venoms comprise a highly complex mixture of proteins, which requires for their characterization the use of versatile two-dimensional electrophoresis techniques. In the present study, venoms obtained from eight snakes (Ophiophagus hannah, Naja kaouthia, Naja sumatrana, Bungarus fasciatus, Trimeresurus sumatranus, Tropidolaemus wagleri, Enhydrina schistosa and Calloselasma rhodostoma) commonly found in Malaysia were separated based on two independent properties, isoelectric point (pI) and molecular weight (MW). Many differences in snake venoms at the inter-family, inter-subfamily, inter-genus and inter-species levels were revealed. Notably, proteins from individuals of the Viperidae family – Trimeresurus sumatranus, Tropidolaemus wagleri and Calloselasma rhodostoma – were found to be numerous and scattered by the two-dimensional gel electrophoresis (2DE) specifically in regions between 37 and 100 kDa compared to the Elapidae venom proteins. The latter were clustered at the basic and lower molecular mass region (less than 20 kDa). Trains of spots were commonly observed, indicating that these proteins may be derived from post-translational modifications. Ophiophagus hannah (Elapidae) revealed a great amount of protein spots in the higher molecular mass range when compared to Enhydrina schistosa, Naja kaouthia, Naja sumatrana and Bungarus fasciatus. Overall 2DE showed large differences in the venom profile of each species, which might be employed as an ancillary tool to the identification of venomous snake species.

Protein profile analysis of Malaysian snake venoms by two-dimensional gel electrophoresis

Snake venoms comprise a highly complex mixture of proteins, which requires for their characterization the use of versatile two-dimensional electrophoresis techniques. In the present study, venoms obtained from eight snakes (Ophiophagus hannah, Naja kaouthia, Naja sumatrana, Bungarus fasciatus, Trimeresurus sumatranus, Tropidolaemus wagleri, Enhydrina schistosa and Calloselasma rhodostoma) commonly found in Malaysia were separated based on two independent properties, isoelectric point (pI) and molecular weight (MW). Many differences in snake venoms at the inter-family, inter-subfamily, inter-genus and inter-species levels were revealed. Notably, proteins from individuals of the Viperidae family - Trimeresurus sumatranus, Tropidolaemus wagleri and Calloselasma rhodostoma - were found to be numerous and scattered by the two-dimensional gel electrophoresis (2DE) specifically in regions between 37 and 100 kDa compared to the Elapidae venom proteins. The latter were clustered at the basic and lower molecular mass region (less than 20 kDa). Trains of spots were commonly observed, indicating that these proteins may be derived from post-translational modifications. Ophiophagus hannah (Elapidae) revealed a great amount of protein spots in the higher molecular mass range when compared to Enhydrina schistosa, Naja kaouthia, Naja sumatrana and Bungarus fasciatus. Overall 2DE showed large differences in the venom profile of each species, which might be employed as an ancillary tool to the identification of venomous snake species.(AU)

Erythema multiforme under the treatment with amoxicillin/clavulanate: a case report and review of the literature

To report a case of Erythema Multiforme [EM] in a boy who was treated with oral Amoxicillin/Clavulanate for upper respiratory infection. A 14-years-old boy with upper respiratory infection was treated with amoxicillin/calvulanate 625 milligram every eight hours for a week for his symptoms. Four days later, he developed erythematous rash all over the body plus genital lesion, and mouth ulceration. The skin biopsies confirmed Erythema Multiforme [EM]. The drug was immediately stopped and he was given a corticosteroid orally and supportive therapy for his symptoms. Within a few days, his skin and mouth lesions were dramatically improved and he was discharged on prednisone tapering dose for additional ten days. Erythema multiforme [EM] is an acute mucocutaneous hypersensitivity reaction that occurs in response to certain types of drugs, chemicals or infections. The severity of the skin lesions is variable. A Medline search from 1984 to October 2007 revealed only five cases of amoxicillin/clavulanate induced EM. The Naranjo algorithm score was 4 for EM in our patient, representing a possible relationship of amoxicillin/clavulanate treatment. We described the case of a 14-year-old boy who developed EM while on amoxicillin/clavulanate. The patient completely recovered after stopping the offending drug and treated with oral prednisone and supportive therapy

In vitro tests of thyroid function and triple screening marker during pregnancy

In this study, sera of healthy pregnant females collected during the 1st, 2nd and 3rd trimesters were analyzed for total thyroxine [TT4], total triiodothyronine [FT3] and thyroid stimulating hormone [TSH] utilizing radioimmunological assays [RIA]. Beta-human chorionic gonadotropin [beta HCG], alpha fetoprotein [AFP] and estradiol [E3], which are interesting hormones related to the mother-fetal relationship and the safety of the fetus, were also determined in the same sera. As a function of pregnancy duration, there was an increase in each of serum T4 and T3 and no appreciable changes could be noticed in TSH. On the contrary, FT4 decreased gradually with the progress of pregnancy. On the other hand, FT3 showed no significant difference between the different intervals of pregnancy. The feto-mother markers [AFP and E3] showed a remarkable increase with the progress of pregnancy. A correlation coefficient was found between each two parameters at each interval of pregnancy and revealed interesting relationships which clarified the findings