Formulation and Dissolution enhancement of Meloxicam tablets using Polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer and Povidone in combination

Meloxicam is a poor water soluble drug mostly prescribed in various rheumatic diseases. The present research study was design to formulate and increase the solubility of meloxicam in the tablet dosage form. A 32 full factorial design was employed to optimize meloxicam formulations. Polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer [PVCL-PVA-PEG graft copolymer] and Povidone were taken as independent variables while cumulative drug release at 90 minutes was selected as dependent variable. All trial formulations complied with official standards. Multiple regression by Microsoft Excel on cumulative drug release of the selected formulations [F1, F2, F6- F9] showed the positive effect of PVCL-PVA-PEG graft copolymer [[alpha] = 0.05] and a negative effect of Povidone [[alpha] = 0.05]. Formulation six [F6] [PVCL-PVA-PEG graft copolymer 3 mg and Povidone 22.5 mg / tablet] was considered as the optimal formulation based on its cumulative drug release. Dissolution kinetics by model dependent analysis predicted Weibull [R[2]=0.99] as the best fit model in describing meloxicam dissolution kinetics. The role of PVCL-PVA-PEG graft copolymer should be explored with other solubilizers in future studies

Serum and urine levels of magnesium in adult males with type 2 diabetes mellitus in Jeddah, Saudi Arabia

The present study aimed to investigate the association of serum and urine magnesium [Mg] levels of the patients living in Jeddah, Saudi Arabia, with type 2 diabetes mellitus [T2 DM] without complications. The effect of Mg deficiency on the prevalence of DM and its related complications has received great attention. Serum and urine Mg, fasting serum glucose [FSG], glycated hemoglobin [HbA1c], and urine creatinine [Creat] levels were determined in 68 diabetic subjects and 62 age-matched nondiabetic subjects [controls] using auto-analyzer and atomic absorption spectrometer. Body mass indices [BMI] of the subjects were also determined. The serum Mg levels in the patients with T2 DM were significantly lower than that in controls. BMI and the levels of FSG, HbA1c, and urine Mg were significantly higher and urine Creat level lower in diabetic subjects compared with nondiabetic subjects. Significantly lower serum Mg and significantly higher urinary Mg levels were observed in diabetic subjects with poor glycemic control [HbA1c >7%] compared with the nondiabetic population. The present correlation study revealed a highly significant correlation between FSG and HbA1c [r = 0.846, P = 0.000]. Aging and increasing duration of DM alter the metabolism of Mg by decreasing its serum concentration and increasing its urinary excretion. This study also showed a significant negative association between serum Mg and FSG [r = -0.408, P = 0.039 and HbA1c [r = -0.478, P = 0.043]. Also, a significant negative association was observed between serum Mg and age of both patients with T2 DM [r = -0.787, P = 0.044] and controls [r = -0.798, P = 0.041]. Again, a significant negative correlation [r = -0.452, P = 0.018] was observed between serum Mg and urine Mg levels of the diabetic population of the study. DM and poor glycemic control alter the metabolism of Mg by increasing its urinary excretion and lowering its serum levels. Its clinical implications were discussed in this study

Quantification of some trace elements in the scalp hair of patients with type 2 Diabetes Mellitus in Jeddah, Saudi Arabia

Type 2 diabetes mellitus [DM] is one of the major global health challenges of the 21st century. Owing to their diversified metabolic characteristics and functions, various metals such as zinc [Zn], copper [Cu], chromium [Cr], manganese [Mn], iron [Fe], and magnesium [Mg] are considered to be essential for human health. Deficiency of some essential trace elements may lead to the development of DM. The present study aimed to evaluate the contents of Zn, Cu, Cr, Mn, and Mg in the scalp hair samples of patients with type 2 DM from Jeddah [Saudi Arabia]. The hair samples were collected from 55 patients with DM aged 45-65 years. Also, 55 age-matched nondiabetic healthy subjects were selected from the same city for a comparative analysis. Zn, Cr, Mn, and Mg levels in hair were found to be significantly lower [P < 0.05] in the group of patients with type 2 DM than in nondiabetic subjects. However, the Cu level in hair was significantly higher [P < 0.05] in patients with type 2 DM than in nondiabetic subjects. The results revealed that hair Cu concentrations in patients with DM were positively related to body mass index [BMI], whereas Zn, Cr, Mn, and Mg concentrations were inversely related to BMI. Finally, the concentrations of these trace elements in the scalp hair and serum samples of patients with DM were compared

Transforming growth factor-beta1 gene expression in hepatocellular carcinoma: a preliminary report

The transforming growth factor [TGF]-beta signalling pathway plays a dual role in hepatocarcinogenesis. It has been recognised for its role as a tumour suppressor as well as a tumour promoter depending on the cellular context. The aim of this study was to investigate the clinical significance of serum TGF-beta1 level and TGF-beta1 messenger RNA [mRNA] in the peripheral blood of liver cirrhosis and hepatocellular carcinoma [HCC] patients as noninvasive biomarkers in diagnosing HCC. Twenty patients were allocated to each of the liver cirrhosis and HCC groups, in addition to 20 healthy volunteers. TGF-beta1 gene expression in peripheral blood was quantitated using real-time polymerase chain reaction [PCR], while serum TGF-beta1 was analysed using enzyme-linked immunosorbent assay [ELISA]. TGF-beta1 gene expression was significantly lower in HCC patients [median 0.401 [0.241-0.699] fold change] than in liver cirrhosis patients [median 0.595 [0.464-0.816]] [p = 0.042] and normal controls [median 1.00 [0.706-1.426] fold change] [p = 0.001]. TGF-beta1 gene expression showed significant positive correlation with serum TGF-beta1 [r = 0.272, p = 0.036] and significant negative correlation with alpha-fetoprotein [AFP] [r = ?0.528, p = 0.001]. Receiver operating characteristic [ROC] analysis was conducted for TGF-beta1 gene expression in comparison with AFP. The area under the curve for TGF-beta1 gene expression was 0.688 [95% CI = 0.517-0.858] [p = 0.042] and AFP was 0.869 [95% CI = 0.761-0.976] [p = 0.001]. The sensitivity and specificity of TGF-beta1 gene expression were 65% and 75%, respectively, at a cutoff value of 0.462 fold change. TGF-beta1 gene expression in the peripheral blood may be used as a molecular marker for the diagnosis of HCC. Additional studies on a large-scale population are necessary to gain greater insight into the impact of TGF-beta1 gene expression in the pathogenesis of HCC

Infants of diabetic mothers a cohort study

To determine the outcome of infants born to diabetic mothers at Security Forces Hospital, Riyadh, Saudi Arabia, and compare the complications seen in these infants with infants of non-diabetic mothers. This is a concurrent prospective cohort study of a population of newborn infants delivered at Security Forces Hospital, Riyadh, Saudi Arabia for diabetic mothers between January 2011 and November 2011. A total of 601 infants were enrolled in the study consisting of 319 infants of non-diabetic mothers, and 282 infants of diabetic mothers. Infants of diabetic mothers showed significantly higher rates of associated complications and prolonged hospital stay reflected in their admission to the neonatal intensive care when compared with infants of non-diabetic mothers. There was no difference in rate of complications between infants of gestational diabetics and pre-gestational diabetics. Our study showed that diabetic pregnancies are associated with an increased incidence of neonatal complications. These seem to be related to the degree of maternal glycemic control. The higher rates of complications among our infants of diabetic mothers, particularly major congenital malformations call for those involved in the care of diabetic mothers to consolidate their efforts to facilitate early booking in specialist clinics

Trace mineral status related to levels of glycated hemoglobin of type 2 diabetic subjects in Jeddah. Saudi Arabia

Diabetes mellitus [DM] is of major and increasing global public health importance. People with diabetes are at increased risk of premature disability and death associated with vascular, renal, retinal, and neuropathic complications. Direct association of trace elements in both type 1 and type 2 diabetes has been observed in many research studies. An alteration in the metabolism of these minerals has been demon- strated in diabetes. The aim of the present study was to investigate zinc [Zn], copper [Cu], chromium [Cr], manganese [Mn] and magnesium [Mg] levels in the serum of patients with type 2 diabetes and age-matched healthy subjects and also to assess the association between these elements and glycated hemoglobin [HbA1c]. The study population consisted of 55 type 2 diabetic patients and 55 age-matched non-diabetic healthy subjects within the age range of 45-65 years. In this study, we found significantly higher Cu levels [P < 0.001], lower Zn levels [P < 0.05], and also lower Cr, Mn, Mg levels [P < 0.05] in patients with DM in comparison with healthy subjects. Statistical analysis showed a positive correlation between serum levels of Cu and Zn in the group of healthy subjects [r = 0.97, P < 0.0001]. In contrast, we found a negative correlation between these metals [r = -0.59, P < 0.0001] in patients with DM. We also found significant higher levels of HbA1c [P< 0.001] in the DM group than in the healthy group. Positive correlations between levels of HbA1c and Cu [r= 0.71, P < 0.001] as well as Cr [r = 0.54, P < 0.0001] and negative correlations between levels of HbA1c and Zn [r = -0.65, P < 0.001] and also Mg [r = -.52, P < 0.001] in the DM group were obtained. Patients with DM had altered metabolism of Zn, Cu, Cr, Mn, and Mg, and this may be related to increased values of glycated hemoglobin. We concluded that imbalance in the levels of studied metals may play an important role in the pathogenesis of DM

Enhancement of radon exposure in narghile [water pipe] smoking areas

Narghile, one of the names for water pipe, is an instrument for tobacco smoking that has become a trend among the youth in Saudi Arabia. The mistaken opinion that smoking narghile is not as dangerous as smoking cigarettes makes the youngsters and their parents take it lightly and contributes to the expansion of its use. The link between tobacco smoke and cancer has long been established. Smokers are ten times at greater risk of developing lung cancer than that of non-smokers. Narghile smoking has become fashionable worldwide. Its tobacco pastes generally contains 30-70% tobacco. Tobacco contains minute amounts of radiotoxic elements which are inhaled via smoking. Radim-226 is a significant source ofradon-222, an inert radioactive gas, which enters buildings through soil, construction materials or water supply. When tobacco smoke is present, the radioactivity attached to airborne smoke particles and the radioactivity concentration in the room, increases very much compared to a smoke-free room. It remains suspended and available until inhaled as 'secondhand'smoke by anyone in the room. Thus, smoking indoors greatly increases lung cancer risks to all inhabitants. To investigate whether the narghile tobacco itself is a potential source of indoor radon, the level of radon and thoron from radioactive decay were measured in fifteen different brand narghile tobacco paste samples using CR-39 solid state nuclear track detectors [SSNTDs]. The results showed that the [222]Rn and [220] Rn concentrations in these samples ranged from 129 to 273 Bqm[-3] and 55 to 142 Bqm[-3] respectively

Relation between frailty and common geriatric problems in elderly

There is a high prevalence of common geriatric problems [falls, urinary incontinence, visual and hearing impairment] among frail elderly leading to more disability and functional impairment. The aim of this study is to compare the prevalence of common geriatric problems between frail and non-frail elderly. A Case control study. 90 participants aged 60 years and above. They were selected from Ain Shams University Hospital from inpatient wards and outpatient clinics. The studied sample was divided into 2 groups: Group A [30 frail elderly females and 30 frail elderly males] and Group B [30 healthy elderly subjects; 15 males and 15 females]. Comprehensive geriatric assessment, including detailed history of common geriatric problems as mentioned above, physical examination, and also assessment of frailty using modified Fried criteria]. Hearing impairment, incontinence and falls were more prevalent in frail elderly with a highly difference between the two groups, with p values< [0.001,0.009,0.006] consequently, visual impairment was statistically significant in cases more than controls with p value [0.012]. There is a significant positive relationship and high prevalence of common geriatric problems especially falls, urinary incontinence, visual and hearing impairment among frail elderly

association between serum glucose and serum lead and selected trace elements in type 2 diabetes mellitus patients in Jeddah, Saudi Arabia

Diabetes mellitus [DM] is a chronic metabolic disorder affecting carbohydrate, lipid, and protein metabolism. A number of studies have reported an association between DM and alterations in the metabolism of several trace minerals. In this study, serum zinc [Zn], chromium [Cr], manganese[Mn], magnesium [Mg], and lead [Pb] were estimated in 55 diabetic patients attending the clinic of King Abdulaziz University, Jeddah [Saudi Arabia], and the results were compared with those of apparently healthy, nondiabetic volunteers of comparable age and social status. The serum glucose level of diabetic subjects [10.21 +/- 3.56 mmol L-1] was significantly [p < 0.05] higher than the value obtained for the nondiabetic subjects [4.23 +/- 0.15 mmol L-1]. The mean serum levels of Zn [96.25 +/- 24.32 microg/dl], Cr [4.13 +/- 0.52 microg/dl], Mn [3.37 +/- 0.38 microg/dl], and Mg [17.76 +/- 0.96 microg/dl] were significantly [p < 0.05] lowered in diabetic subjects. The mean serum Pb level of diabetic patients was [17.38 +/- 5.06 microg/dl] and significantly higher [p < 0.05] than that of control subjects. In the present study, the age of the diabetic patients did not show any significant correlation with serum glucose [r = 0.124]. The serum levels of glucose were found negatively correlated with serum levels of Zn, Cr, Mn, and Mg of diabetic subjects. A positive relationship was observed between concentrations of serum glucose and Pb [r = 0.438, p < 0.01]. The low serum levels of Zn, Cr, Mn, and Mg in diabetic patients compared to that of control subjects may be due to the poor glycemic control

In vitro/in vivo correlation of fast release mephenamic acid microspheres in humans

The objectives of this study were to assess the bioavailability of an optimized mephenamic acid [MFA] microspheres [test] against a Ponstan[R] capsule [reference] in healthy volunteers, and to establish a correlation with in vitro parameters. Four subjects received the test and reference [250 mg MFA each] in a randomized crossover design, separated by a 1-week washout period. The drug was analyzed in plasma by a specific high-performance liquid chromatographic method. The relevant pharmacokinetic parameters [maximum plasma concentration [C[max]], time of peak concentration [T[max]], area under plasma concentration-time curves from 0 to 12 h [AUC[0-12]] and area under plasma concentration-time curves from zero to infinity [AUC[0-infinity]] were calculated from the plasma drug concentration-time data. The test product exhibited faster absorption [T[max] of 1.87 +/- 0.482 vs. 2.14 +/- 0.20 h; C[max] of 5.91 +/- 0.604 vs. 3.58 +/- 0.671 micro g/ml] when compared to the reference. The relative bioavailability of the test compared to the reference capsule was 172%. Good correlations were established between the in vitro 90% dissolution [T90] and each of the AUC[0-12] and T[max], as well as between the percentage of drug released and plasma concentrations. The formulation of MFA microsphere with polyethylene glycol improved the dissolution rate and bioavailability of MFA, as evidenced by a higher C[max], AUC[0-12] and AUC[0-infinity], and shorter T[max] values. Good correlations between T90 and both AUC[0-12] and T[max] as well as between the percentage of drug released and plasma concentrations were achieved

study on the radon concentrations in tobacco in Jedda [Saudi Arabia] and the associated health effects

Radon and cigarette smoking have synergistic, multiplicative effect on lung cancer rates. Smokers and nonsmoking residents of smoking households are at increased risk for lung cancer even when radon levels are relatively low. People who inhale tobacco smoke are exposed to higher concentrations of radioactivity. Ever since studies on the relation of smoking to cancer-particularly the lung cancer-has been established, there had been a great interest in studies concerned with the monitoring of the alpha radioactivity in tobacco. Radium-226[226Ra] is a significant source of radon-222 [[222]Rn], which enters buildings through soil, construction materials, or water supply. When cigarette smoke is present, the radon daughters attach to smoke particles. Thus, the alpha radiation dose to a smoker's lungs from the natural radon daughters is increased because of smoking. To investigate whether the cigarette tobacco itself is a potential source of indoor radon, the levels of radon and thoron from radioactive decay were measured in tobacco samples of 15 different brands using CR-39 solid state nuclear track detectors [SSNTDs]. The results showed that the [222]Rn [and [220]Rn concentrations in cigarette tobacco samples ranged from 97 to 204 Bqm[-3] and 38 to 104 Bqm[-3], respectively. The radon concentrations emerged from all investigated samples were significantly higher than the background level. The annual equivalent doses from use of these tobaccos were determined. The measurement of the average indoor radon concentrations in 30 caf‚ rooms was, significantly, higher than 30 smoke-free residential houses. The result refers to the dual [chemical and radioactive] effect of smoking as a risk factor for lung cancer

Isolation of a cytolytic component from Naja nigricollis nigricollis [spitting cobra] venom

A cytolytic compound [Vlb] was isolated by fractionation of crude venom from Egyptian Cobra Snake, Naja nigricollis nigricollis using Sephadex G-75, followed by CM- Sephadex. The isolated protein has a cytolytic effect on red cells, stable at different temperatures [25 °C-100°C] and at different pH ranges [5-9]. It is partially pure as indicated by SDS-PAGE, with molecular weight approximately 10 kDa. It has no protease or phospholipase activity. It is a glycoprotein, with maximum absorbance at 280nm. It is non antigenic, with LD50 1.83 mg/ kg body weight. DNA extraction from mouse liver tissue and from hepatocellular carcinoma cell line [HEPG2] gave a single intact band after invitro incubation with Vlb, indicating that apoptosis is not involved in the cytotoxic mechanism. Small doses of Vlb induced lysis in breast, colon and hepatocellular carcinomas cell lines in tissue culture plates

Effect of aluminium metal on glutathione [GSH] level in plasma and cytosolic fraction of human blood

Aluminium is being used in the medicines in the form of antacids. The Aluminium metal can be leached from our utensils and can harm the body for its side effects, if become available to the systemic circulation. So it is important to check the effect of Aluminum on the Glutathione in vivo condition. Ellman method was used to determine the effect of Aluminum on GSH level in whole blood spectrophotometerically. 5,5-Dithiobis, 2-Nitrobenzoic Acid, Glutathione, Aluminium sulphate, phosphate buffer, HC1 [Hydrochloric acid] and other laboratory instruments were used to conduct the research work. Time dependent effect of Aluminum on Glutathione level in whole blood was also checked and decrease was observed. This study also shows the effect of Aluminum as helping agent for the Glutathione to enhance the antioxidant system of the body or a cause for depletion of reduced Glutathione

Asymmetric dimethylarginine [ADMA]: an emerging contributor to endothelial dysfunction in hyperthyroidism

Cardiovascular manifestations are frequent findings in patients with hyperthyroidism. Nitric oxide [NO], a key regulator of endothelial function, is synthesized from L-arginine by nitric oxide synthase [NOS]. Evidence has accumulated that asymmetric dimethylarginine [ADMA] is an endogenous competitive inhibitor of NOS. To measure plasma L-arginine and dimethylarginines [ADMA and SDMA] in patients with hyperthyroidism in order to assess their contribution to endothelial dysfunction and their relationship to plasma NO. The study was conducted on 50 newly diagnosed patients with overt hyperthyroidism as well as 30 age and sex matcned healthy controls. Plasma L-arginine, ADMA and SDMA were analyzed by HPLC. Plasma NO was measured by a colorimetric method based on Griess reagent. L-arginine, ADMA and SDMA were significantly increased, while NO and L-arginine/ADMA ratio were significantly decreased in hyperthyroid patients compared to controls. Serum freeT4 and free T3 were negatively correlated with plasma NO and L-arginine/ADMA ratio and positively correlated with L-arginine, ADMA and SDMA. Moreover, NO was significantly negatively correlated with each of the L-arginine and ADMA and significantly positively correlated with T.arginine/ADMA ratio. Results provide evidence of the presence of endothelial dysfunction in hyperthyroidism. The decrease in NO, and the increase in ADMA emphasizes that ADMA is an emerging contributor of endothelial dysfunction in hyperthyroidism

Effect of lithium metal on the chemical status of glutathione [GSH] present in whole blood [especially in plasma and cytosolic fraction in human blood]

Lithium remains a mainstay in the acute and prophylactic treatment of bipolar affective disorder. It is used in the augmentation of antidepressant treatment and, less frequently, in the augmentation of antipsychotic treatment of schizophrenia. It is reported to have specific anti-suicidal effects. Thus the effect of Lithium was interesting to study on the glutathione [GSH] level in vivo conditions. Ellman's method has been used to see the effect of lithium on glutathione [GSH] level in whole blood. The time dependent effect of Lithium on the chemical status of glutathione [GSH] was determined in the whole blood [Plasma and cytosolic fraction] of human. The concentration of Glutathione was drastically decreased. The decrease in the glutathione level was concentration and time of interaction dependent, probably due to oxidation of glutathione [GSH] to corresponding disulphide [GSSG]. In this paper the effect of Lithium on the Thiol/GSH level was discussed in vitro, which in principal may present a model of in vivo reaction

Lifestyle related risk factors of type 2 diabetes mellitus in Saudi Arabia

To assess the impact of diet and physical activity on the risk of type 2 diabetes mellitus [T2DM] in the Kingdom of Saudi Arabia [KSA] after adjusting for family history of diabetes. We conducted a case-control study in Al Qassim, KSA to test the hypothesis that dietary practices and physical activity modify the risk of type 2 diabetes regardless of family history. Male and female Saudi citizens 30-70 years of age were eligible to participate. The sample included 283 cases [T2DM patients] and 215 non-diabetic controls randomly selected from patients visiting the primary health care centers from September to November 2009. We collected information on demographic variables, family history, dietary habits, and physical activity. Using logistic regression, we estimated adjusted odds ratios [AOR] for dietary habits and physical activity after controlling for the effects of gender, age, education, and family history of diabetes. There is strong association between diabetes and maternal history of diabetes, education, lack of exercise, and dietary habits. The AOR for regular eating of Kabsa was 5.5 [95% confidence limits [CL]: 2.3-13.5]; for vegetables an AOR of 0.4 [95% CL: 0.2-0.7]; for dates an AOR of 1.8 [95% CL: 1.0-3.3] ;and the AOR for sedentary lifestyle was 2.5 [95% CL: 1.2-5.0]. Healthy diet and active lifestyle may significantly decrease the risk of T2DM in spite of having a family history of diabetes. Effective health education programs promoting healthy diet and regular exercise are needed to reduce the burden of diabetes in Saudi Arabia

Levels of trace elements in commercial fruit juieces in Jeddah, Saudi Arabia

Potable water, fruit juices and soft drinks are some of the most widespread beverages in the habitual diet, and they can contribute to trace element dietary intake. Heavy metals 'toxicity is the result of their interactions with the enzymatic systems from the animal cells or some constituents of cells' membranes. Population can be contaminated with heavy metals by ingestion of contaminated or polluted food and water. The concentration of heavy metals in food products is varied, depending on their origin, storage conditions and processing technologies

Gynecological cancer in Indonesia / 부인종양

To overview the status of gynecologic cancer in Indonesia. Information regarding Indonesia obtained from World Bank Report and Statistical Yearbook of Indonesia 2007, epidemiological data obtained from Histopathological Data of Cancer in Indonesia 2002, Department of Health-Registry Body of Indonesian Specialist of Pathology Association-Indonesian Cancer Society; Various Hospitals in big Cities in Indonesia. Indonesia is an Archipelago with a total area of 1,922,570.00 km2, the population is 222,192,000 (2006), the fourth world rank. Female is 49.86% with life expectancy 69 years. Gross National Product per Capita is 690.00 USD. Histopathological report in 2002 revealed that cervical cancer, ovarian cancer and uterine cancer were the most frequent cancer among female, which were the first (2,532 cases), the third (829 cases) and the eighth (316 cases) rank respectively. The peak age for cervical, uterine and ovarian cancer was 45-54 years. HPV 16, 18 were found in 82% of invasive cervical. Data from various academic hospitals in 2007 showed that cervical cancer is the most common malignancy followed by ovary, uterus, vulva and vagina. Five-year survival rate of stage I, II, III, IV cervical cancer were 50%, 40%, 20%, and 0% respectively. Overall five-year survival rate of carcinoma of the ovary was 54.8%. If sub-classified by stage, five-year survival rate are 94.3%, 75.0%, 31%, and 11.7% for stage I, II, III, and IV respectively. Five-year disease-free survival rate of endometrial cancer was 71.9%. Indonesia is the biggest Archipelago with a dense population but the income per capita still low (poor country). The most common gynecologic cancer is cervical cancer, followed by ovarian and uterine cancer. These cancers are included in top ten cancers in Indonesia. HPV 16, 18 were the most cause of cervical cancer. The five-year survival rates are comparable with world report.

Assessment of exhaled breath condensate ph in asthmatic children

Assessment of the Exhaled breath condensate [EBC] constituents has proven to be useful and non invasive method for monitoring airway changes. On the other hand, active airway inflammation was postulated to change the pH of the airway lining fluid. This work was conducted to study EBC pH in children with bronchial asthma compared to other airway inflammatory markers in those children. Methods: Thirty asthmatic children were recruited for this study while attending the Chest Clinic of Paediatric Hospital -Ain Shams University-Cairo, Egypt. Their ages ranged between 5-16y with mean value of [8.93 +/- 4.14 years]. Age and sex matched 10 normal children were selected as controls. All the children were subjected to history taking, thorough clinical examination, spirometric pulmonary function testing [for FEV1, FVC, FEF25-75%], collection of EBC was done to assess its pH and induction of sputum to determine differential cell counts. Our results showed that the mean values of EBC pH were significantly lower in asthmatic group when compared to controls with cut off value = 7.35 [specificity=70%, sensitivity= 89%]. The mean values of EBC pH showed significant positive correlations with pulmonary function measured parameters - FEV1, FVC, and FEF25-75%- [p<0.05, p<0.001, p<0.05 respectively] and significant negative correlations with sputum cell counts; total leucocytic counts, oesinophilic counts and neutrophilic counts [p<0.05]. Exhaled Breath condensate [EBC] pH is a simple, inexpensive and non invasive promising tool to evaluate pediatric asthma

Juvenile systemic lupus erythematosus in Bahrain. A tertiary referral center experience

To analyze the clinical and serological features of children with systemic lupus erythematosus [SLE] in a major referral center in Bahrain and to assess the comorbidity, its morbidity, and mortality. We retrospectively reviewed the medical charts of children with SLE treated in the Pediatric Rheumatology Clinic at Salmaniya Medical Complex, Kingdom of Bahrain from 1998 to 2007. The ethical approval for the study was obtained from the Research Health Committee, Ministry of Health, Kingdom of Bahrain. Thirty-two children with SLE were identified. Thirty-one [96.8%] were Bahrainis. The mean age was 14 +/- 4 years, the mean age of disease onset was 9 +/- 4 years and the mean duration of illness was 7 +/- 5 years. The female to male ratio was 2.5:1. Twenty-five percent of the cases had relatives with SLE. Eight patients [25%] had sickle cell anemia [SCA]. Systems involved were as follows: skin [93%], kidney [81%], musculoskeletal system [65%], blood [56%], gastrointestinal tract [31%], central nervous system [31%], lungs and cardiovascular system [21%]. Serological tests showed: positive antinuclear antibody in 90.6%, and positive anti double-stranded DNA antibody in 65%. The morbidity rate was 21% [n=7] due to complication and 12.5% [n=4] died. Clinical and serological results were comparable with the international studies. Nephritis was the primary cause of morbidity and mortality. Coexistence of SLE with SCA was also reported in other studies and may need further investigation with genetic studies