Convalescent plasma in COVID-19: renewed focus on the timing and effectiveness of an old therapy

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has strained health care systems worldwide and resulted in high mortality. The current COVID-19 treatment is based on supportive and symptomatic care. Therefore, convalescent plasma (CP), which provides passive immunization against many infectious diseases, has been studied for COVID-19 management. To date, a large number of randomized and non-randomized clinical trials as well as many systematic reviews have revealed conflicting results. This article summarizes the basic principles of passive immunization, particularly addressing CP in COVID-19. It also evaluates the effectiveness of CP as a therapy in patients with COVID-19, clinical trial reports and systematic reviews, regulatory considerations and different protocols that are authorized in different countries to use it safely and effectively.An advanced search was carried out in major databases (PubMed, Cochrane Library, and MEDLINE) and Google Scholar using the following key words: SARS-CoV-2, COVID-19, convalescent plasma, and the applied query was “convalescent plasma” AND “COVID-19 OR SARS-CoV-2”. The results were filtered and duplicate data were removed.Collective evidence indicates that two cardinal players determine the effectiveness of CP use, time of infusion, and quality of CP. Early administration of CP with high neutralizing anti-spike IgG titer is hypothesized to be effective in improving clinical outcome, prevent progression, decrease the length of hospital stay, and reduce mortality. However, more reliable, high quality, well-controlled, double-blinded, randomized, international and multicenter collaborative trials are still needed.

Prognostic role of ALK-1 and h-TERT expression in glioblastoma multiforme: correlation with ALK gene alterations

Background@#Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase that is expressed in the developing central and peripheral nervous systems during embryogenesis. Human telomerase reverse transcriptase (h-TERT) protein resumption is the main process of preservation of telomeres that maintains DNA integrity. The present study aims to evaluate the prognostic role of ALK-1 and h-TERT protein expression and their correlation with ALK gene alterations in glioblastoma multiforme (GBM). @*Methods@#The current study is a retrospective study on a cohort of patients with GBM (n = 53) that attempted to detect ALK gene alterations using fluorescence in situ hybridization. ALK-1 and h-TERT proteins were evaluated using immunohistochemistry. @*Results@#Score 3 ALK-1 expression was significantly associated with male sex, tumor multiplicity, Ki labeling index (Ki LI), and type of therapeutic modality. Score 3 h-TERT expression exhibited a significant association with Ki LI. ALK gene amplifications (ALK-A) were significantly associated with increased Ki LI and therapeutic modalities. Score 3 ALK-1 protein expression, score 3 h-TERT protein expression, and ALK-A were associated with poor overall survival (OS) and progression-free survival (PFS). Multivariate analysis for OS revealed that ALK gene alterations were an independent prognostic factor for OS and PFS. @*Conclusions@#High protein expression of both ALK-1 and h-TERT, as well as ALK-A had a poor impact on the prognosis of GBM. Further studies are needed to establish the underlying mechanisms.

Prognostic role of ALK-1 and h-TERT expression in glioblastoma multiforme: correlation with ALK gene alterations

Background@#Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase that is expressed in the developing central and peripheral nervous systems during embryogenesis. Human telomerase reverse transcriptase (h-TERT) protein resumption is the main process of preservation of telomeres that maintains DNA integrity. The present study aims to evaluate the prognostic role of ALK-1 and h-TERT protein expression and their correlation with ALK gene alterations in glioblastoma multiforme (GBM). @*Methods@#The current study is a retrospective study on a cohort of patients with GBM (n = 53) that attempted to detect ALK gene alterations using fluorescence in situ hybridization. ALK-1 and h-TERT proteins were evaluated using immunohistochemistry. @*Results@#Score 3 ALK-1 expression was significantly associated with male sex, tumor multiplicity, Ki labeling index (Ki LI), and type of therapeutic modality. Score 3 h-TERT expression exhibited a significant association with Ki LI. ALK gene amplifications (ALK-A) were significantly associated with increased Ki LI and therapeutic modalities. Score 3 ALK-1 protein expression, score 3 h-TERT protein expression, and ALK-A were associated with poor overall survival (OS) and progression-free survival (PFS). Multivariate analysis for OS revealed that ALK gene alterations were an independent prognostic factor for OS and PFS. @*Conclusions@#High protein expression of both ALK-1 and h-TERT, as well as ALK-A had a poor impact on the prognosis of GBM. Further studies are needed to establish the underlying mechanisms.

A multi-component spectrophotometric method for simultaneous determination of total bilirubin, oxyhemoglobin, and methemalbumin in human sera

A new multi-component spectrophotometric method was developed experimentally and theoreticallyto determine the accurate serum concentrations of the total bilirubin (TB), oxyhemoglobin (HbO2), andmethemalbumin (Mha) in healthy human adults and neonates with hemolytic jaundice. With respect to theexperimental technique, the method of preparation of serum solution has been developed, like the use ofdistilled water as a solvent and centrifugation of serum solutions to clear the sample turbidity. The resultsof TB were compared to the diazo-assay. Theoretically, the formulas used for the calculation of the majorcomponents (TB, HbO2, and Mha) in human sera have been derived based on the theory of multi-componentspectrophotometric analysis and the mathematical Gaussian elimination method for matrix calculation. Themethod of multi-component spectrophotometry, suggested in this study for determination of TB, showed% error (3.1%–4.9%), indicating the high accuracy of the method. The small coefficients of variation(CV = 3.65%–5.1%) indicate the high precision of the method. The results showed higher values of serum TB(p < 0.00005), HbO2 (p < 0.001), and Mha concentrations (p < 0.00005) in neonates, when compared to adults.The method is highly sensitive and accurate. It is inexpensive, precise, reproducible, and has the advantages ofsimplicity, speed, and can be computerized.

Immunogenicity assessment for lung-stage and biomphalaria Alexandrina cocktail vaccine in schistosoma mansoni infected mice

The availability of a new vaccine is usually needed as an additional component to chemotherapy for control of schistosomiasis. Different strategies of different types of vaccines were assessed to decrease morbidity but did not give the best protection. The study assessed the efficacy of BAAP, SLAP and their combined preparations together with BCG adjuvant as an effective anti-schistosomal vaccine. Methodology: Six groups of Swiss albino mice were used [Gi] as a control, [G2] infected non immunized; [G3] infected and supported by Adj.; [G4] infected; vaccinated with BAAP and supported by Adj.; [G5] infected, vaccinated with SLAP and supported by Adj. and the target group [G6] infected, vaccinated with combined antigens [BAAP + SLAP] arid supported by Adjuvant. Mice were sacrificed 8 weeks post infection for assessment the effect of our vaccine through parasitological, histopathological, serological and immunohistochemical study. The vaccination of mice with BAAP, SLAP and Adjuvant followed by challenge S. mansoni infection resulted in highest reduction percentages [92% and 86%] for mean numbers of adult burdens and fecal egg counts respectively,[82.4%, 81%] for granuloma number and diameter respectively compared with other groups. The improvement % of all measured enzymes as higher in G6 than other groups.IL10 was significantly increased in G6 than other groups; also. TNF was significantly decreased in G6 than other groups

Assessment of multiple drug resistance and sensitivity to helicobacter pylori in patients with peptic ulcer disease

Helicobacter pylori [H.pylori] is implicated in acute superficial gastritis, chronic atrophic gastritis, gastric carcinoma and MALT [Mucosa Associated Lymphoid Tissue] associated lymphoma. Prevalence of H. pylori antibiotic resistance is increasing and affect the efficacy of treatment. Our aim was to improve infected patients with new generations of antibiotics. 88 peptic ulcer patients recruited from gastroenerology and endoscopy unit at Suez Canal University, 5 gastric biopsies were taken from each and were examined for H. pylori by histopathology, rapid urease test and culture. Antibiotic susceptibility test was performed to: metronidazole, clarithromycin, amoxicillin, amoxicillin calvulanic acid, levofloxacin, tetracycline, ciprofloxacin, ofloxacin, ceftriaxone, cefoperazone and ceftazidime. Night-two% were positive for H. pylori, while 20% of the studied population were positively cultured .The results of antibiotic sensitivity were:100% of patients were sensitive to clindamycin, 87.5% sensitive to erythromycin, 68.8% sensitive to amoxicillin and levofloxacin, 50% sensitive to azithromycin and tetracycline, 25% sensitive to clarithromycin and 18.8% sensitive to amoxicillin and cavulanic acid. H. pylori resistance towards different antibiotics has increased. new promising results regarding clindamycin and erythromycin

Bacteriological study of diabetic foot infection in Egypt

Foot infections are one of the major complications of diabetes mellitus and are a significant risk factor for lower extremity amputation. Providing effective antimicrobial therapy is an important component in treating these infections. This study assesses the microbial isolates of patients with diabetic foot infections and their antibiotic susceptibility pattern. A prospective study of 75 patients with diabetic foot infections admitted to Al-Azhar university hospitals was undertaken. Bacteriological specimens were obtained and processed using standard hospital procedure for microbiological culture and sensitivity testing. Overall, 40 [54%] patients had subcutaneous infections, 22 [29%] had infected superficial ulcers, seven [9%] had infected deep ulcers involving muscle tissue, and six [8%] patients had osteomyelitis. A total of 99 pathogens were isolated. Forty percent of patients had polymicrobial infection, 39 [52%] had single organism infections, and six [8%] had no growth. Gram-negative bacteria [67%] were more commonly isolated compared with Gram-positive bacteria [30%]. The three most frequently found Grampositive organisms were Staphylococcus aureus [10.2%], Streptococcus pyogenes [7.1%] and methicillin-resistant S. aureus [7.1%], and the most common Gram-negative organisms were Pseudomonas aeruginosa [19.4%], Klebsiella pneumoniae [15.3%], and Acinetobacter spp. [10.2%]. Vancomycin was found to be the most effective against Gram-positive bacteria, whereas imipenem and amikacin were most effective against Gram-negative bacteria on antibiotic testing. Forty percent of diabetic foot infections were polymicrobial. S. aureus and P. aeruginosa were the most common Gram-positive and Gram-negative organisms, respectively. This study helps us to choose empirical antibiotics for patients with diabetic foot infections

Skin diseases in patients with primary psychiatric conditions: a hospital based study

Although the relationship between skin diseases in patients with primary psychiatric conditions is important for patient management, studies on this issue are limited. To detect the frequency and type of cutaneous disorders among patients with primary psychiatric conditions. This analytic cross-sectional study was conducted on a total of 400 subjects - 200 patients with primary psychiatric disorders and 200 age and sex matched individuals free from primary psychiatric disorders. Patients included in the study were diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders [DMS IV] Criteria. A specially designed questionnaire including socio-demographic data, medical history, family history and dermatological examination was applied. The data were statistically analyzed. There was a significant statistical increase in the prevalence of skin diseases in general and infectious skin diseases in particular in psychiatric patients compared with non-psychiatric patients [71.5% versus 22%, P < 0.001] and [48% versus 11%, P < 0.001], respectively. Parasitic infestations [42.7%] were the most common infectious skin diseases in psychiatric patients [P < 0.001]. Infectious skin diseases in psychiatric patients were seen most in patients diagnosed with schizophrenia [83.6%] and least in obsessive compulsive disorders [30%][P < 0.001]. Psychogenic skin disorders were found in 8.4% of psychiatric patients with skin diseases; delusional parasitosis was the most common [50%]. Health education of psychiatric patients and/or of their caregiver and periodic monthly inspection of psychiatric patients are highly indicated for the prevention and control of infectious skin diseases in primary psychiatric patients

Impact of Interleukin-28B gene polymorphism [rs12979860] on Egyptian patients infected with hepatitis C virus genotype-4

Single nucleotide polymorphisms [SNPs] in the Interleukin [IL]-28B gene, namely rs12979860, could predict response to pegylated interferon-alpha-ribavirin [PR] therapy in hepatitis C virus genotype 1 [HCV-1]-infected patients. A similar role was investigated in a case-control study conducted on 93 Egyptian patients chronically infected with HCV-4 in comparison to 22 individuals with spontaneous HCV clearance and 70 healthy volunteers. The homozygous C allele genotype [CC] was associated with sustained viral response [SVR] to therapy compared with the homozygous T allele genotype [TT] and the heterozygous genotype [CT]. In the SVR group, the response rate was statistically significantly higher in CC genotypes [58.6%] compared with CT/TT [20.3%]. There was no correlation between SVR patients' genotypes and early response to therapy or HCV baseline viral load. Our findings describe how IL-28B SNP genotyping may guide appropriate selection of HCV-4-infected patients for PR therapy. We underscore IL28B genotyping as a tool that might increase PR cost-benefit in Egypt

Localization of estrogen receptor alpha in adult male albino rat reproductive tract: an immunohistochemical study

There is a considerable variation within and between species in reports of estrogen receptors' localization in the male reproductive tract. The aim of this work is to detect sites of estrogen receptor alpha [ERalpha] in different parts of the male rat genital system. Eight adult rats were anesthetized and scarified. Testis, efferent ductules, epididymis, vas deferens, and prostate specimens were taken; paraffin sections were prepared and stained with H and E and immunohistochemical stains for the detection of ERalpha. ERalpha was detected only in Leydig cells of testis. In efferent ductules, ERalpha was strongly expressed in epithelial cells whereas stromal cells were moderately positive. In epididymis, a few narrow cells of the head, some principal cells in the body showed a moderate positive reaction, and very few apical and basal cells in the tail showed a weak reaction. Stromal cells of the epididymis showed a strong positive immunoreaction in the head and body, whereas in the tail they were weakly positive. In the vas deferens, ERalpha immunopositivity was absent in epithelial cells but was detected in the stromal cells. Similarly, prostatic epithelium was ERalpha immunonegative, whereas stromal cells were immunopositive. The area% of ERalpha immunoexpression, the mean epithelial number, and the mean stromal number of immunopositive ERalpha cells showed a significant difference among different parts of the male genital tract. The highest area% of immunoexpression and the number of ERalpha-immunopositive cells in the epithelium were detected in efferent ductules. ERalpha was selectively expressed along the reproductive tract only by Leydig cells of testis, with the highest expression in the efferent ductules. Therefore, the present work reports the effects of exposure to environmental endocrine disruptors, and also provides potential targets for development of nonandrogen male contraceptive methods

Chlorpyrifos induced modulation in the activities of hepatic drug metabolizing enzymes of rats: role of garlic

Chlorpyrifos-ethyl [CPF] is an organophosphate insecticide most commonly used worldwide. Chlorpyrifos was evaluated for its effects on hepatic content of cytochrome bs, P[450], NADPH cytochrome-C reductase, amidopyrine-N-demethylase, aniline 4-hydroxylase activities, thiobarbituric acid reactive substance [TBARS], enzymes concerning liver damage, and the protective effects of garlic in albino rats. Pretreatment of rats with repeated doses of garlic prior to administration of CPF decreased the hepatic content of cytochrome b[5], the activities of NADPH cytochrome-C-reductase, amidopyrine-N-demethylase, aniline-4-hydroxylase and TBARS levels. The activity of glutathione-S-transferase [GST] was significantly inhibited after CPF administration, while, garlic augmented the reduction of GST activity affected by CPF. Liver AST, ALT, ALP and ACP were increased due to CPF administration to rats. Meanwhile, garlic afforded a significant protection against CPF intoxication. It is concluded that repeated doses of garlic may reduce the toxic effects exerted by CPF upon the liver through inhibition of cytochrome P[450] system that activates CPF into its active metabolite. Also, garlic reduces lipid peroxidation and restores the liver damage caused by CPF

Biological evaluation of fungal deteriorated archeological wood [Islamic period] and the impact of using some fungicides

EIGHTY SEVEN fungal isolates were obtained from the surface of biodeteriorated ceiling wood [No.1803, 1539] from the Islamic museum, Cairo. Egypt [Islamic period]. Isolates belonging to eight main genera of fungi were identified, in the following frequencies: Acremonium 2,3%,, Alternaria 11,5%, Aspergillus 37.8%, Botryotrichum 2.3%,, Epicoccum 3.5%,, Fusarium 6.9%,, Penicillium 29,9°/o and Stemphvlium 5.7%. In a series of trials cellulase production was maximal for all fungal strains when grown on medium containing 4-6% of wood straw [at pH 4.5-5 after 1015 days at 30°C, whereas the maximum production of pectinase was attained on medium containing 6% wood straw at pH 4.5-5 after 10-15 days at 30°C -35°C. Application of the fungicides dichioroxylenol, paracresol anc pentachiorophenol are recommended for use at 1000, 500 and 1000 ppm respectively, based on protection of artificially infected wood. Infected wood lost 40.1% of its bending strength, loss was attained increased density and water absorption compared with non infected wood. The lowest bending strength loss was attained with dichloroxylenol [14.5%] followed by wood treatment with pentachiorophenol or paracresol [34.2%]

biochemical and immunomodulatory effects of marbofloxacin in sheep vaccinated with live sheep pox vaccine

The study was performed to investigate the effect of marbofloxacin [2mg/kg body weight /day] on some immunological parameters in 9 sheep [35-40 kg. body weight] immunized with live attenuated sheep pox vaccine. Sheep were allocated into 3 equal groups. The first group was left as control; the second group was injected intramuscular [I/M] by marbofloxacin [2mg/kg body weight/day for 5 successive days] then vaccinated by intradermal [I/D] injection of 0.5 ml sheep pox vaccine/sheep. The third group was vaccinated with sheep pox vaccine only. The data revealed stimulation in the level of superoxide anion produced by neutrophil represented by detection of cytochrom C reduction level in the 2[nd] group [p<0.05] on the 1[st] day post vaccination, while there was significant depression in the level of lysozyme in the 1[st] two days post vaccination. The level of serum nitric oxide was not affected in the three groups. The lymphocytes transformation depressed significantly [p<0.05] in the 1[st] week post vaccination in the 2[nd] group as compared with the other two groups. It was concluded that marbofloxacin in its therapeutic level induced initial immunostimulant effect on the neutrophil followed by a transient immunosuppressive effect on other cells as macrophage when used before vaccination with live vaccine

Histological and immunohistochemical study of albino rat filum terminale at different postnatal ages

It is difficult to find accurate data on the normal histology of the filum terminale because the previous studies dealing with its structures are insufficient. The present work aimed to study the histological structure of the filum terminale of the albino rat at different postnatal ages. Thirty six albino rats at different ages were divided into six groups; full term, two weeks, one month, adult [three months], six months and one year. The filum terminale was cut in situ at the level of the iliac crest, excised from its attachment to the coccyx and fixed. The specimens were processed for light and immunohistochemical Study. All sections were examined by light microscope. Filum terminale of the albino rat consisted of ependymal canal surrounded by central and marginal zones. The canal was variable in site, shape and lining ependymal cells according to age. The central and marginal zones contained neuron and glial [oligodendrocyte, microglia and astrocyte] cells immersed in neuropil fibers which changed with the advance of age. Negative Glial-Fibrillary-Acidic Protein [GFAP] reaction in the full term filum terminale group. In two weeks group; there was positive reaction. In one month group there was strong reaction which persisted with gradual decline in three and six month groups. In one year, GFAP reaction was scanty positive or even negative. The albino rat filum terminale contains neurons, glial cells, GFAP-positive glial fibers and neuropil fibers. Structural changes occur in these constituents with age

Spectrophotometric determination of raloxifene in pure form and pharmaceutical formulation

Five simple and selective spectrophometric methods were developed for quantitative determination of raloxifene [RAL] in pure forms as well as in its pharmaceutical formulation. Method [A] is based on the nitration and subsequent complexation with a neuleophilic reagent forming a yellow colour with [lambda][max] at 389 nm, Beer's law was obeyed in the concentration range 1.5-9 micro g ml[-1]. LOD and LOQ were found to be 0,054 and 0.180 micro g ml[-1] respectively. Method [B] is based on the coupling of the drug as a phenolic compound with the diazonium salt of o-nitroaniline forming red azodye with [lambda][max] at 520nm. Good linearity obtained in the range of 6-48 micro g ml[-1]. LOD and LOQ were found to be 0.711 and 2.372, respectively. Method [C] is based on coupling with diazo reagent [method B] and subsequent chelation with copper sulphate and extraction of the resulting chelate into chrorofom and measuring the chloroformic layer at 388 nm. Beer's law was obeyed in the concentration range 6-42 micro g ml[-1]. LOD and LOQ were found to be 0.268 and 0.894 micro g ml[-1], respectively. Method [D] involves the reduction of follin ciocalteu's phenol reagent [FCP] by the drug to give a blue colored product which exhibites an absorption maximum at [lambda][max] 660 nm. Regression analysis of Beer's plot showed good correlation in the concentration rage of 1-8 micro g ml[-1]. LOD and LOQ were found to be 0.043 and 0.145 micro g ml[-1], respectively. Method [E] involves the determination of [RAL] by difference spectrometry, the absorbance of the acidic drug solutions were measured against the alkaline drug solutions at 240 nm and calibration graph was plotted which is rectilinear in the range of 1-8 micro g ml[-1]. LOD and LOQ were found to be 0.032 and 0.134 micro g ml[-1], respectively. The optimization of the reaction conditions is investigated, the methods were successfully applied to the analysis of RAL in its pharmaceutical formulation with good recovery

Evaluation of a blood conservation strategy in the intensive care unit: a prospective, randomised study

Anemia is a common problem in the ICU population. Most patients are anemic at admission, their hemoglobin concentrations declining further thereafter. The aim of the present study was to evaluate the effect of a combination strategy, involving closed arterial blood gas sampling and the use of pediatric vials for phlebotomy [Group A], on the sampling-induced blood loss and the rate of decline in hemoglobin in adult ICU patients. Combination [Group A] was compared to the current standard technique of arterial line sampling and adult vial phlebotomy [Group B] in a prospective, randomised, ethically-approved trial for the first 72 hours of their ICU stay. Peri-operative, oncology, coagulopathic and uremic patients were excluded. All other ICU patients with arterial cannulae and predicted to stay beyond 3 days, were enrolled. 39 patients entered the study, 20 in Group A, and 19 in Group B. Data collection was complete for all. There was a statistically significant difference in sampling-induced blood loss between the groups over the first 72 hours of treatment [mean +/- standard deviation: 15.16 +/- 5.3 ml Group A vs 45.11 +/- 14 ml Group B, p < 0.001]. There was a smaller decline in mean hemoglobin level, which was not statistically significant [0.79 +/- 0.6 g/dL vs 1.30 +/- 1.13, p = 0.09]. Overall, this strategy reduced measurable blood losses from phlebotomy. In larger trials it might also preserve hemoglobin levels

Potent protective effect of alpha -tocopherol and fish oil on in vivo paraquat induced oxidative damage in rats

The potential protective role of alpha-tocopherol and fish oil against oxidative damage induced by paraquat were investigated. Forty male albino rats with average body weight of 100-120 gm were housed in 8 groups of 5 rats each. The first group served as control and injected with saline, group 2 was injected with a single dose of paraquat [10 mg/kg, intraperittoneally] for 24 h prior to decapitation [P], group 3 was administered orally with vitamin E [100 mg/kg] five times a week [E]. group 4 was administered orally with fish oil [20 mg/kg] five times a week [FO]; group 5 received FO+E, groups 6, 7 and 8 were administrated with P+E, P+FO and P+E+FO respectively. The content of microsomal proteins, drug metabolizing enzymes and thiobarbituric acid reactive substances [TEARS] were determined in liver microsome after treatment. Vitamin E together with fish oil significantly decreased the content of cytochrome b[5] [p<0.01], c ytochrome P-450 [p<0.001]. glutathione-S-transeferase [p<0.001] and cytochrome C-reductase [p<0.001] when given before paraquat injection. Meanwhile, this combination of vitamin E and fish oil significantly [p<0.05] increased amidopyrine N-demethylase. On the other hand vitamin E and fish oil alleviated the paraquat induced increase in TBARS. In conclusion, oral administration of vitamin E and fish oil are effective in reducing the activity of selected drug metabolizing enzymes and are also effective in reducing lipid peroxidation process caused by paraquat. So, these combinations provide a potent protection against paraquat-induced oxidative toxicity in rats' liver

Impact of eversion technique in carotid endarterectomy: Mansoura experience

To review our experience in eversion technique in carotid enclarterectomy in patients with carotid artery stenosis with particular attention to restenosis, occlusion, recurrent stroke or TIA. This prospective study included 12 patients with symptoms of unilateral carotid artery stenosis who were investigated, operated and followed up in Vascular Surgery Unit of Mansoura University Hospital during the period from July 2004 to January 2008. Eversion carotid endarterectomy [ECEA] was carried out for all patients. Carotid restenosis rate [>50%] during follow up was [0%] after eversion CEA at the end of the study. The cumulative stroke free survival rate was 85.7% at the end of the study. ECEA is a feasible and safe alternative technique for management of extracranial carotid stenosis, an excellent technique for handling of the kink, spiral or redundant internal carotid artery. It can be performed while patients under local or general anesthesia according to the general condition and cooperation of the patient

effects of oral grape seed extract on cisplatin-induced cytogenotoxicity in mice

The present investigation was directed to study the possible chemoprotective activity of orally administered grape seed extract [GSE] against cisplatin-induced cytotoxicity and genotoxicity towards mouse somatic and germinal cells in vivo. Pretreatment of mice with GSE [100 mg/kg/day] for 7 days and simultaneously with a single dose of cisplatin [2.2 or 5.5 mg/kg, i.p.] for another day, significantly reduced the frequency of bone marrow micronucleated polychromatic erythrocytes by factors of 1.9 and 1.28, respectively. Furthermore, GSE caused a reduction in bone marrow suppression induced by cisplatin treatment, particularly before the lower dose. In male germline, orally administration of GSE [100 mg/kg/day] for 7 consecutive days before and 7 consecutive days after treatment with a single dose of cisplatin [2.2 or 5.5 mg/kg, i.p.], significantly elevated the levels of sperm motility reduced by cisplatin treatment. Furthermore, GSE significantly decreased the elevated levels of sperm head abnormality induced with cisplatine by factors of 1.6 and 1.2, respectively. Our results indicate that GSE plays a role in attenuating the genotoxicity induced by cisplatin and may provide decreases in the development of secondary malignancy and abnormal reproductive outcomes risks

Effect of recombinant growth hormone [rh-GH] on glycerol induced acute renal failure [ARF] in rats

Experimental studies showed that acute uremia is characterized by reduced GH and IGF-l messenger RNA expression and is manifested as resistance to human rh-GH. However the administration of high doses of several anabolic agents including rh-GH have been proposed as a potential therapy for several catabolic conditions including acute renal failure [ARF]. Therefore this study was conducted to reveal the renoprotective and ameliorating effects of GH on glycerol-induced ARF in rats, by exploring its effects on generating IGF-l, decreasing ROS, improving kidney function and its effect on the generation of the vasodilator nitric oxide [NO]. The present study included four groups of albino rats, the first group [control group] was injected with saline, the second group [AFR group], in which 50% of glycerol was injected intramuscularly [im]. The third group was injected with the vehicle of growth hormone and the fourth group was injected with rh-GH [2 mg/day] for 5 days subcutaneously [sc] 48 hr after induction of ARF. The results showed 3.79 and 4.09 folds increase in blood urea and serum creatinine, respectively for the ARF group compared to the control group. These values in group IV deceased by 79.5 and 49% after rh-GH hormone treatment compared to their controls [group III]. Also the increased mean value of plasma malondialdehyde [MDA] and deceased mean value of plasma nitric oxide [NO] in the ARF group as compared to controls were markedly corrected after rh-GH treatment. The greatly increased level of IGF-l after rh-GH injection suggests that it may be the actual player behind these ameliorating effects of rh-GH on glycerol-induced ARF in rats. The therapeutic uses of rh-GH in ameliorating the effects of ARF that has already happened [as early as possible] and its protective effects in expected cases is therefore recommended