Successful medical management of a neonate with spontaneous splenic rupture and severe hemophilia A

Splenic rupture in neonates is a rare event, usually occurring in the setting of underlying predisposing conditions. Here, we present the case of a term neonate who presented with worsening anemia in the setting of known hemolytic disease during the newborn period and was later found to have a spontaneous splenic rupture. He was subsequently diagnosed with severe hemophilia A, and was managed medically with recombinant factor VIII replacement therapy without any surgical intervention. This is the first reported case of a neonate who had spontaneous splenic rupture and severe hemophilia A, and underwent successful medical treatment without any surgical intervention

Apoptosis and oxidative stress in b thalassemia major in children

In B thalassemia the synthesis of beta globin chains is decreased .This interferes with the assembly of normal Hb A,. Recently apoptosis has been noted to play a central role in regulation of hemopieosis. Excess iron could generate reactive oxygen species [ROS] that may be involved in turn in lie damage of cellular compartment adding to apoptosis . The aim of this work is to study apoptosis and oxidative stress in B thalassemia major in children and their relationship to the severity of the disease and to the use of chelation . A cross sectional study of 56 patients with B thalassemia major aged 8 M -13 y as well as 10 apparently healthy age and sex- matched control . Beside full history and examination all patients and controls had the following investigations done Hb, serum ferritin, ALT, AST, ALP, FAS, TBARS and DNA damage measurement. Correlation studies showed that fas and TBARS showed significant negative correlation with Hb and significant positive correlation with ferritin . Newly diagnosed patients [First admission] showed significantly less severe DNA damage than recurrent cases . Chelated patients scored significantly better lhan non chelated patients . Patients on chelation showed significant better outcome regarding apoptosis and oxidative stress, therefore we must be ready with early chelation in all B thalassemia cases

Hazardous effects of fried potato chips on the development of retina in albino rats

<p><b>OBJECTIVE</b>To evaluate the hazardous effects of fried potato chips upon the retina of two developmental stages of the albino rats aged 7 and 14 days from parturition.</p><p><b>METHODS</b>PREGNANT RATS WERE ARRANGED INTO TWO GROUPS: control pregnant rats and consequently their delivered newborns until reaching 7 and 14 days old from parturition and fried potato chips group in which pregnant rats at the 6th day of gestation maintained on diet formed of fried potato chips supplied from the market mixed with standard diet at a concentration of 50% per each till 7 and 14 post-partum. Three fold integrated approaches were adopted, namely, histological, ultrastructural and proteomic analysis.</p><p><b>RESULTS</b>Histological examination of the retina of the experimental offsprings revealed many histopathological changes, including massive degeneration, vacuolization and cell loss in the ganglion cell layer, as well as general reduction in retinal size. At the ultrastructural level, the retina of experimental offsprings exhibited number of deformities, including ill differentiated and degenerated nuclear layer, malformed and vacuolated pigment epithelium with vesiculated and fragmented rough endoplasmic reticulum, degenerated outer segment of photoreceptors, as well as swollen choriocapillaris and loss of neuronal cells. Proteomic analysis of retina of the two experimental developmental stages showed variations in the expressed proteins as a result of intoxication which illustrated the adverse toxic effects of fried potato chips upon the retina.</p><p><b>CONCLUSIONS</b>It can be concluded that the effect of fried potato chips on the development of retina in rats may be due to the presence of acrylamide or its metabolite.</p>

value of fibroscan as a non-invasive predictor of large esophageal varices in cirrhotic patients

Periodic endoscopic screening for esophageal varices [EV] is recommended in patients with cirrhosis, but might be limited to a subgroup of patients if a simple non-invasive test was available to select those at risk of bleeding. To assess the value of Fibroscan as a simple non-invasive test for selecting patients with cirrhosis at risk of bearing large EV. In 50 patients with cirrhosis, we studied the relation between the presence and grading of esophageal varices as assessed by endoscopy and liver stiffness measurement by Fibroscan, a non-invasive parameter related to liver fibrosis. Receiver operator characteristic curve was used to identify the best cut-off point for liver stiffness measurement. The identified best cut-off point for liver stiffness measurement [LSM] was 20.90 with sensitivity 71.4% and specificity 66.6% for prediction of the presence of esophageal varices while for prediction of the presence of large varices, the best cut off value was 26.00 with sensitivity 80% and specificity 60%. LSM is of higher diagnostic value in predicting the presence of large esophageal varices in patients with cirrhosis. and may help to select patients for endoscopic screening

Optimization of fibrinase productivity from Actinomycetes

Fibrinolytic enzymes that dissolve blood clots and show promise for thrombosis therapy have been successfully identified from various sources. A wide range of microorganisms has been screened for their fibrinolytic properties. A fibrinolytic protease has been isolated from Streptomyces violaceoruber and Streptomyces spiroverticillatus culture filtrate. The purification procedure involved ammonium sulphate fractionation, dialysis, calcium phosphate gel purification and gel filtration on Sephadex G-100. By using native polyacrylamide gel electrophoresis [Native PAGE] to determine molecular weight of the enzyme. The optimum temperature for the high production of fibrinase from S. violaceoruber was 30[degree] C and from S. spiroverticillatus was 35[degree] C and the optimum pH was 9.0. The best incubation period is 6 days. The incorporation of lactose as carbon source, yeast extract as nitrogen source and MnCl[2] to culture media highly increased the production of fibrinase from the two species. The molecular weight was about 30 KDa. It exhibited fibrinolytic enzyme activity. In vitro studies revealed that fibrinase dissolves clots made by blood

Role of rehabilitation of chronic obstructive pulmonary disease patients in intensive care unit

The COPD are the most common chronic lung disease and the major impetus for the development of pulmonary rehabilitation program. Poor endurance, dyspnea, and deconditioning are the hallmarks of the presenting symptoms. The key components of pulmonary rehabilitation are education, exercise training, psychosocial/behavioral intervention and outcome assessment. The present study was designed to study the effects of pulmonary rehabilitation on patient of COPD and compare between comprehensive rehabilitation program and progressive ambulation as regard some physiologic variables. This study included eighty COPD patients recovering from an episode of acute respiratory failure and admitted to RICU of Zagazig University Hospital. All of them fulfilled the American Thoracic Society criteria of COPD 1995, with the age ranging from 51 to 80 years. Evaluating measures were done as early as possible at admission, discharge and after 3 months and they include: arterial blood gases [ABG], pulmonary ventilatory tests [PVT], maximal inspiratory pressure [MIP], visual analog scale [VAS] and 6 min walking distance [6 m WD]. Rehabilitation program were usually begun as early as possible for clinically stable patients, it consists of daily session 30-45 min for each and of four different steps of increasing difficulty. Our results showed that pulmonary rehabilitation is of great beneficial effects for critically ill COPD patients admitted to RICU and early intervention give better results. Also comprehensive program was superior to ambulation program

Effect of different housing systems and route of vaccination on the immune response of birds against avian influenza vaccine

Immune response of birds reared under different housing systems and vaccinated against avian influenza [Al] was studied using 10 layer and 3 broiler-breeder flocks reared in either deep litter or cage systems. Blood samples were collected at intervals during rearing period and different production periods [start, peak and end of production], and haemagglutination inhibition test [HI] was carried out for all serum samples to determine antibody titers. All Birds reared in deep litter system recorded lower mean HI titers; [6.52 to 8.20 in layers, and 1.53 to 5.31 in breeders] than those reared in cages [8.69 to 10.38 in layers, and 3.27 to 8.83 in breeders]. However higher CV% were recorded in birds on deep litter [17.42 to 27% in layers, and 33.09 to 136.58% in breeders] than those in cages [7.90 to 8.84% in layers, and 10.16 to 8 1.25% in breeders]. During peak egg production all birds showed lower titers [6.52 and 10.12], with broiler-breeders showed the lowest titers [4.30 and 3.84]. On the other hand, the effect of the route of vaccination [I/M vs SIC] in broiler-breeders was also evaluated and results revealed that I/M vaccination induced better immune response [7.28] and more uniform titers [lower CV% 23.19%] than S/C route [3.86, 67.87%]. These results indicated that cage system provided better environment that enhanced the immune response of birds than those reared in deep litter system. However, the period of peak egg production could be considered as stress factor that reduce immune response. On the other hand, variation between I/M and S/C injection could be due to ill-trained vaccination teams in Egypt; who were more experienced with I/M administration of vaccines and antibiotics rather than the use of S/C route. It was concluded from this study that immune response of vaccinated poultry could be influenced by the type of housing provided for birds and also signifies the importance of the experience of team responsible for vaccine administration in order to achieve the best protective and hornogenous antibody titers in broiler-breeder birds, which will be transmitted to progeny

Effect of different durations of schistosoma mansoni infection on the levels of some antioxidents in mice

The levels of lipid peroxides, glutathione, vitamin C, vitamin E catalase and superoxide dismutase enzymes were measured in the livers of Schistosoma mansoni infected mice [CD strain weighing 20-25g] at different durations post infection [1,2,4,6 and 8 weeks]. Moreover, the liver weight, body weight, liver to body weight and total protein were studied in the same animal groups. Control non-infected groups were run simultaneously with each infected mice group. The data obtained showed that lipid peroxides were elevated throughout the different durations of infection while glutathione decreased with infection. On the other hand, both vitamins C and E showed a reduction in the livers of mice during the different durations of infection. The activity of catalase showed an insignificant change after one and two weeks and a high significant decrease in the livers of four, six and eight weeks S.mansoni infected mice, while, superoxide dismutase significantly decreased one and two weeks post infection with a significant elevation four, six and eight weeks post infection. Moreover, a significant reduction was observed in body weight after four, six and eight weeks of infection accompanied with an elevation in liver weight only after six and eight weeks. Consequently, liver weight/body weight showed an elevation after four, six and eight weeks of infection. Finally, the protein content was significantly lower at one, six and eight weeks post infection with S.mansoni. It could thus be concluded that host-parasite association results in production of free radicals as a result of an oxidative stress where the parasites struggle to overcome the immune response of the host and changes in host liver antioxidants occur as a means to scavenge these radicals

Measurement of retinal nerve fiber layer thickness in diabetic patients using optical coherence tomography [OCT]

The concern of this study is to measure the retinal nerve fiber layer thickness [RNFLT] in diabetic patients with different stages of diabetic retinopathy. Descriptive study. Sixty eyes of 48 of diabetic patients [type I and type II] attending the ophthalmology department, faculty of medicine, Suez canal university, a twenty aged matched normal subject was taken as control for RNFLT measurement by optical coherent tomography OCT. Patients were divided into three groups each consists of 20 eyes. Group 1 with mild and moderate background diabetic retinopathy [BDR], group 2 severe and very severe BDR and group 3 proliferative diabetic retinopathy [PDR]. The results of RNFLT in all stages of diabetic retinopathy indicate a marked loss mainly in the inferior and superior quadrants copared to the control group especially in all groups. Diabetes decrease RNFLT in all stages of diabetic retinopathy especially in the superior and inferior quadrants

Antimycotic denture adhesive in treatment of candida associated denture stomatitis

The effect of denture adhesive containing two different types of antimycotics [Nystatin and Miconazole] in treatment of denture stomatitis were evaluated and compared with the use of denture adhesive alone. Three groups of patients were evaluated, group one used denture adhesive containing Nystatin, group two used denture adhesive containing Miconazole, group three used denture adhesive alone [control group]. The patients were evaluated clinically and microbiologically at the beginning of the study, after one week, two weeks and four weeks. The results showed that the use of denture adhesive containing antimycotic is effective in inhibiting the candidal groups and improving the clinical condition of denture stomatitis patients

Study of significance of immunethrombocytopenia and platelet associated IgG in patients with chronic hepatitis Cand patients with liver cirrhosis

Background: Chronic hepatitis C virus infection are often associated with extra hepatic imrnunological manifestations including various autoimmune disorders . The aim of this study was to evaluate the significance of immune thrombocytopenia and platelet associated IgG in patients with chronic hepatitis C and patients with liver cirrhosis .Forty patients with chronic hepatitis C virus infection were chosen for this study . They were divided according to platelet cotmt into thrombocytopenic group and non thrombocytopenic group matched for age and sex .all patients were subjected to liver function tests , renal function tests , complete blood picture, bone marrow biopsy ,abdominal ultrasonography , liver biopsy with histopathological examination and platelet Ig G assay[PA Ig G]

Results: PA IgG was significantly high in thrombocytopenic group [15 out of 20 ; 75%] compared with non thrombocytopenic group [3 out of 20 ,15%][p< 0.01] . Moreover , in the thrombocytopenic group,when we compared PAIgG and child's grades we found that PAIgG was significantly high in patients with child's C grade [6 out- of 6 100%], when compared to child's B'[4 out of 7 ; 57%], and those with child's A [0 out of 7Also PAIgG was significantly high in patients with child's B when compared with those with child's A grade[p<0.05]. As regards histopathology index , we found that in the thrombocytopenic group , PAIgG was significantly high in patients with liver cirrhosis [8. out of 10;.80%] compared with chronic active hepatitis[2 out of 10 ;20%][p< 0.01]. Moreover , we found that histopathological activity index was significantly high in the thrombocytopenic group [9.1+ 2.5] comparing with non-thrombocytopenic group [7.35 +2.5][p,0.05] . Also fibrosis stage was significantly high in the thrombocytopenic group [2.5+0.96] , comparing to non thrombocytopenic group [2.05+0.876][p< 0.05]. the study

Concluded: that It is vitally important not to immediately conclude that the thrombocytopenia encountered in patients with chronic hepatitis C indicates cirrhosis with portal hypertension andhypersplenism, but autoimmune mechanisms may be the cause. PAIgG and immune thrombocytopenia can be used as prognostic marker from the clinical and pathological point of view in patients with chronic hepatitis C virus infection and in patients with liver cirrhosis passing from one stage to another

Comparison between percutaenous ethanol injection and radiofrequency ablation in treatment of hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is a common type of cancer with approximately 260000 new cases each year and liver cirrhosis could be a predisposing factor [Isselbacher and Dienstag 1998]. Management of HCC depend on the early detection of the tumor, the size and its site. Surgical management versus medical approaches were studied and gave different results in different situations. Radiofrequency ablation is a new minimally invasive technique, which must be evaluated properly. In the study comparison between results of percutaneous ethanol injection [PEI] and percutaneous rediofrequency ablation [PRFA] as a method of treatment of HCC of a diameter less than 3cm. 30 patients with HCC less than 3 cm in diameter either single or multiple lesion with a total number of 50 lesions were divided into 2 groups, group I: 15 patients having 22 lesions treated with PEI and group II 15 patients having 28 lesions treated with PRFA. Both groups were age, sex, histopathological type of tumor matched groups. The rate of complete success was detected as follows: in group I [PEI] 10 lesions [45.5%] of lesions showed complete success. In group II [PRFA] 21 lesions [75%] of lesions showed complete success, complications appeared more prominent in group I more than group II. We concluded that PRFA gave better results of treatment than PEI, less invasive less complications and less number of sessions

Effect of portal hypertensive gastropathy on electrogastrographic changes and gastric emptying time

Dyspepsia is a frequent symptom in cirrhotic patients. Congestive gastropathy or portal hypertensive gastropathy [PHG] was detected as a possible cause of sustained dyspepsia in 40% of these patients, and prolonged gastric emptying time [GE] with decrease gastric wall compliance were detected in cirrhoric patients. Electrogastrography [EGG] is a non-invasive method to study gastric myoelectrical activity from the body surface by electrodes. whereas, an ultrasonographic method can be used for the estimation of gastric emptying by measuring what so called half emptying and full emptying times with other parameters. Aim of this work is to study patterns of EGG and ultrasnographic GE. In cirrhotic patients with or without PHG. 45 patients were chosen for this study and were divided into 3 groups ; group 1 is cirrhotic patients with PHG negative upper gastrointestinal [U.G.I.T.] endoscopy and group 2 is cirrhotic patients with PHG positive and group 3 is healthy subjects taken as control. We found significant delay in GE in gp. 2 in relation to group 3 [p < 0.05]. EGG reveiled power ratio lower in gp. 1, 2 [2.01 - 1.93] respectively compared to group. 3 [2.63]. Also there was highly significint increase in "Dominant frequency" at rest [DF] in group.1 campared to group. 2 and 3 [p>0.01] where mean of group 1 was 2944.9, in group 2 was 2477 and in group 3 was 1934 and the power meal at DF was higher in group 1 than 2 , 3 but siatistically insignificant where the mean in group 1 was 5922.5 and in group. 2 was 4804.8 and was 5087.8 in group 3 [p>0.05]. Delayed gastric emptying by U.S, and changes in EGG records of cirrohotic patients especially in presence of portal hypertensive gastropathy may explain dyspepsia frequently occurring with portal hypertensive gastropathy

Iron deficiency: a new risk factor for febrile convulsions

This study was conducted on 72 patients with febrile convulsions. They were 45 males and 27 females. Their ages ranged between 6 and 48 months with a mean of 24.7 +/- 8.78 months. They were recruited from the patients attending the Emergency Department, Children's Hospital, Ain Shams University. A cohort of 40 healthy siblings of the patients was chosen as a control group. All cases and controls were subjected to detailed medical history taking, clinical examination and laboratory investigations including complete hemogram, total iron binding capacity as well as serum levels of iron, ferritin and lead. In addition, hemoglobin and iron indices of the cases were reassessed 6 months after institution of iron therapy. The study showed that iron deficiency anemia was more prevalent in febrile convulsive children compared to their controls. However the lead status was not different among the studied groups. The frequency of febrile convulsions correlated significantly negative with serum levels of iron and ferritin and positively with TIBC. However, neither the iron indices nor the frequency of febrile convulsions showed any correlation with the frequency of febrile illnesses. Responders to iron therapy demonstrated lower seizure frequency compared to non-responders, although they were not different regarding the frequency of febrile illnesses. So it can be concluded that iron deficiency anemia is a direct risk factor for the development and recurrence of febrile convulsions. This risk is primarily due to iron deficiency per se rather than due to increased risk of febrile illnesses. So we recommend iron therapy in iron deficient febrile convulsive children to minimize the risk of recurrent fits

Effect of carbohydrate increment on macro-and micro-nutrients accumulation in suger beet callus tissues

The use of sugar beet [Beta vulgaris] callus tissues for studying physiological processes provides a complete genetic homogeneity and exclude expected correlative relationships between different organs. In the present study, Mona - 1 and Mona - 2 [normal, diploid and monogerm lines], MS [male sterile line] and MN[fertile, diploid and monogerm line] were used representing four breeding lines with different genetic backgrounds. Callus tissues derived from the hypocotyl region of these four breeding lines were grown under varying sugar concentrations in complete media, arid tolerant tissues [6 - week old] were analyzed for macro - and micro-nutrients profiles. The results revealed that the abilities of sugar beet callus tissues to accumulate macro - and micro-nutrients are some what correlated with sucrose concentration in the media. In addition, the increases in sucrose concentration in sugar bed callus media are negatively correlated with some nutrient elements needed for growth, especially nitrogen, and at the same time are positively correlated with other elements involved in sugar storage, especially potassium and calcium

Determination of loratadine and its tablets by H1 NMR spectrometry

A new method, involving the application of 1H-NMR spectrometry for the assay of loratadine and its tablets, is proposed. The 1H-NMR spectrum of loratadine in DMSO [d6] has a well-defined triplet [around delta 1.3 ppm] and a quartet [near delta 4.3 ppm] which are chosen for quantitative analysis. The method is based on comparing the integral of these signals to that of the sharp singlet of maleic acid at delta 6.5 ppm which is used as internal standard. The proposed method is simple and rapid, giving accurate and reproducible results when applied for the analysis of both authentic loratadine and its tablets. In addition, the 1H-NMR spectrum obtained helps in confirming the identity and purity of the drug

Isozymal taxonomy of ten chlamydomonas strains isolated from Damietta county, Egypt

Ten strains of Chlamydomonas were isolated as unialgal, then axenic cultures, starting from algal samples collected from different sites and habitats of Damietta county. Biochemical taxonomy in the form of polyacrylamide gel electrophoresis of isozymal systems for malate dehydrogenase, glutamate dehydrogenase, alkaline phosphatase, acid phosphatase and alpha- esterase was employed in an attempt to improve the current taxonomic status of such microalgae depending mainly on morphological criteria. Data had been clustered in the form of similarity matrices and dendrograms. The eleecttrophoretic isozymal analysis of the ten Chlamydomonas species and strains showed the possibility of building up species groupings. Each grouping with an isozymal similarity which is good enough to tie its members together. These species groupings are suggested as follows: a] C.sphagnophfla I and C.isphagnophila II. b] C:asymmetrica, C.gloeogama and C.terricola c] C.sphagnophila III, C.debaryana and C.bicocca. Each of C.fimbryata and Ci.globosa didn't show isozymal similarity enough to fit to any of the above mentioned species groupings, and would rather stand as real independent genuine species by themselves. Although C.sphagnophila I and C.sphagnophila II showed strong isozymal relationships, they proved not to be identical and hence are suggested to be considered as two different varieties of the species sphagnophila. C.sphagnophila III, though it looks morphologically identical with C.sphagnofila I and C.sphagnophila II, its isozymal patterns showed to be dissimilar enough with them, so that it is better to split it as another different species rather than keeping it as a strain of the sphagnophila species. The present work shows the significance of biochemical tools to improve the taxonomy of microalgae and -necessity of using as many isozymal systems as possible and the risk of relying on one or two systems only

Mannose resistant adherence and serotyping of Escherichia coli causing recurrent urinary tract infection in pediatric age group

Urinary tract infection in the pediatric age group is a disease of major concern. Clinical diagnosis, if unaided, cannot be relied upon as the symptoms and signs are nospecific resulting in false diagnosis. Appropriate managemwent will depend primarily on microbiologic examination. The present study comparised 84 patients [33 Males and 15 Females] complaining of frequently recurrent urinary tract symptoms who underwent full microbiological investigations starting by repeated viable bacterial counts, including systematic bacterial identification of the isolates to the species level and finally focusing on the virulence characterization of the commonest causative species i.e. Escherichia coli [E.coli] by the mannose resistant aldherence power and serotypig. Using viable bacterial count only 46 cases [56%] showed positive significant bacterial growth. The commonest causative pathogen was, as predicated, E.coli [60.9%] followed by Klebsiella [19.6%]. Staphylococcus [15.2%] and Proteus spp., [4.3%]. Of the E.coli strains, 71.4% turned to be mannose-resistant adherent mainly with the diffuse pattern to hpp[-2] cells, a finding usually associated with uroadherence and attributed to P fimbriae. Serotypoing of E.coli did not conform to published literature as it did not correlate with uropathogenesis. These results highlight the role of adherence for an in invading orgarism but rather as an additional virulence factor in cases of frequently recurrent urinary tract infection. Further studies to illustrate the relative importance of such factors and/or markers in the patogensis and the immune mechanisms are therefore needed

new treatment modality proposed for the management of denture sore mouth

A study on chronic denture stomatitis was presented and two current methods of management were evaluated. The concept of use of hygenic regimen for dentures was discussed and proved to be helpful among 15 patients representing the control group. Bis-triazole, a new oral antifungal drug was used in the treatment of 15 patients suffering from denture sore mouth. Drug syrup used intra-orally under dentures was found to be effective in the treatment of denture stomatitis [50 mg on a divided dose of 5 mg/ml, 150 ml/bottle]; the daily dose for a fortnight was suggested as an adequate course of treatment. The achieved clinical improvement during the follow-up periods was proved to be statistically highly significant. For quantifying this improvement, st and ard subjective criteria were developed; namely, lesions, pain, duration and inflammation. C and ida albicans was isolated from all cases of denture sore mouth [30 patients]. Although mycological assessment showed a high rate of negativism at the 7th day of therapy, recolonization was observed in 2 patients at the end of 14th day of therapy, giving a satisfactory mycological cure. The drug therapy did not induce changes in blood picture as well as renal and liver function tests. The drug was well tolerated in almost all cases, mild and transient nausea and diarrhea were reported in only one patient. Finally, the disorders which may result from a persistent oral infection by C and ida should be considered the main target of management and underline the necessity for adequate treatment of this disease entity