Treatment of refractory diffuse diabetic macular edema with lntravitreal bevacizumab

To analyze the short term visual acuity and anatomic response after a single dose of off-label intravitreal injection of bevacizumab in diffuse diabetic macular edema [DME] not responding to conventional laser photocoagulation. Prospective analysis of consecutive case series of 45 eyes of 38 patients with refractory diffuse DME who had one intravitreal injection of 1 .25 mg of bevacizumab [Avastin] and followed up for 3 months. All patients passed at least six months since their last laser treatment before inclusion in the study. Patients underwent best corrected visual acuity determination, intraocular pressure measurement, stereoscopic biomicroscopy of the macula and measurement of the retinal thickness by optical coherence tomography [OCT] at base line and follow up visits. At 1 month post-injection, visual acuity improved by 1 line in 7 eyes, unchanged from the pre-injection levels in 24 eyes and deteriorated in 14 eyes. At 3 months post injection, visual acuity improved in 1 8 eyes, it remained unchanged in 13 eyes and deteriorated in 14 eyes. The mean logMAR visual acuities were 0.60 [SD +/- 0.34], 0.64 [SD +/- 0.31] and 0.61 [SD +/- 0.32] at pre-injection, at 1 month post-injection and at 3 months post-injection respectively; but this mean decrease in vision was statistically not significant [P value=0.099]. The foveal thickness on optical coherence tomography had decreased in 27 eyes and it increased in 1 8 eyes at 1 month post-injection. At 3 months following injection, foveal thickness was reduced in 34 eyes, but was increased in 11 eyes. The mean foveal thicknesses were 444.95 micro [SD +/- 1 27.36], 394.95 micro [SD +/- 138.03] and 378.32 micro [SD +/- 112.01] at pre-injection, 1 month post-injection and 3 months post-injection respectively. This decrease in the foveal thickness was statistically significant [P value<0.001]. Intravitreal bevacizumab is effective in patients with diffuse DME which is refractory to treatment with conventional macular laser photocoagulation

[Depolymerization and characterization of chitosan]

The depolymerization of chitosan could be carried out by acid hydrolysis using 2 M hydrochloric acid solution. The desired molecular weight could be obtained by changing the reaction time. IR spectrum spectroscopy demonstrated that there was no structure change during depolymerization. X-ray diffraction results indicate that the crystallinity of LMWCs is decreased compared to HMWC. The decomposition temperature of chitosan was molecular weight dependent. There is slight increase in the degree of deacetylation of depolymerized LMWC compared to the native high molecular weight chitosan. The solubility of chitosan increased with decreasing molecular weight. Chitosan has a positive zeta potential and its value affected by the pH, molecular weight, DDA, and concentration

cytogenetic study on leukemic Egyptian children

This study included forty newly diagnosed children with acute lymphoblastic leukemia [ALL]. On admission blood samples were taken from each patient for cytogenetic analysis by G-banding and it was successful in 37/40 patients [Gr. A] Normal karyotype was present in 20 cases [54.1%] out of 37.On the other hand numerical and structural aberrations were seen in 13 cases [35.1%] and 3 cases [8.1%] respectively; while both aberrations were detected in only one case [2.7%]. The study of the Giemsa banded chromosomes of the hyperdiploid cases showed that chromosome 21 was mostly added, followed by chromosomes [6,10 and X],chromosomes [4 and 14], number [15,17,and 18], [5 and 8], chromosome 16, and finally chromosomes [9 and 20] in that descending frequency. Hyperdiploid ALL have good prognosis on remission therapy as indicated by their chromosomal analysis. Hypodiploid karyotype was present in four cases of [Gr. A] one male and 3 females who showed poor prognosis and short duration of survival. Tetraploidy was encountered in only two male cases .One case died during his treatment period and other one showed bad prognosis as indicated by his blood analysis after treatment. Translocation t [4;l 1] [q21;q23] was found in one female and one male patients [5.4%]. The female died 3 weeks after diagnosis, while the male patient showed poor prognosis after one month of conventional chemotherapy. Another translocation t [l;19] [q23;p13] was found in 2 male patients [5.4%], they were alive after one month of treatment and they showed good prognosis during the remission induction stage. These findings imply that the accurate identification of chromosomal abnormalities in ALL patients is essential for diagnosis and may be of great value in predicting the prognosis of such cases. After 4 weeks of chemotherapeutic treatment, second blood samples from 32 cases [Gr. B] were cytogenetically normal. The remaining eight cases showed: four of them died 2 weeks after diagnosis [one teraploidy male; two hypoploid females; and one translocation [4; 11] female]; one case discontinued [hypodiploid male]; and three cases failed to remission induction [one hyper-diploid female, one tetraploid male, and one translocation [4;11] male]

Biochemical study on normal and leukemic Egyptian children

Leukemia is the most common malignancy of childhood [33%] where Acute Lymphoblastic Leukemia [ALL] is the most common type in children. is to study the effect of ALL on complete blood count [CBC] and on some important biochemical parameters as total protein, albomin, globulin, uric acid, lactate dehydrogenase [LDH], erythrocyte superoxide dismutase [eryth. SOD] and erythrocyte glucose-6 -phosphate dehydrogenase[eryth. G-6-PD]. Also to measure total DNA and RNA content in all the samples. Moreover to carry out a comparative study of these parameters before and after treatment in contrast to control group. This study included forty newly diagnosed children with [ALL] in National Cancer Institute [NCI], Cairo University. Blood samples on admission [Gr. IIA] and after 4 weeks of chemotherapeutic treatment [Gr. IIB] were analyzed. Four cases died 2 weeks from diagnosis, one case discontinued, and one case failed to remission induction. CBC revealed a significant remarkable decrease in the hemoglobin content, RBCs and platelet count in [Gr. IIA] and these parameters were improved in [Gr. IIB]. A significantly marked elevation in WBCs and blast cells were recorded in [Gr. IIA]. On remission they returned to their normal level in [Gr. IIB]. Total DNA and RNA contents revealed a significant remarkable elevation in [Gr. IIA], while after 4 weeks of treatment they returned to normal level [Gr. IIB]. G-6-PDH showed significant increase in [Gr. IIA] while SOD activity showed high significant decline in [Gr. IIA]. After treatment both G- 6-PD and SOD showed significant improvement [Gr. IIB]. One month of chemotherapeutic treatment is not enough to achieve complete hematological remission for Egyptian [ALL] children in contrast to European reports. Biochemical parameters returned to their normal level, yet G-6-PD and SOD activities were improved largely. Also measurement of G-6-PD and SOD activities and DNA and RNA contents are useful markers to follow up ALL children after chemotherapeutic treatment

T-lymphocyte helper 1 CD4 and T-lymphocyte helper 2 CD4 activities in active and remitant rheumatoid arthritis disease

This is an indirect study for the behaviour of T cell [T-Iymphocytes] particularly CD4+ T cell, in active and remitant rheumatoid arthritis disease, THl [cell mediated immunity] and TH2 [Antibody response] are the two major pathways of T cell differentiation and are mutually antagonistic. Their activities can be estimated through assessing the serum levels of their cytokines IL-2 and IL-I0 respectively. IL-2 and IL-I0 were estimated in the supernatant of Iymphocyte culture in the presence of phytohaemaglutinin before and after remission of the rheumatoid arthritis disease and it has been found a higher significant increase in IL-2 level in patients with active rheumatoid arthritis disease than the control group [P < 0.001], also there was a significant increase in IL-I0 level in patients group in comparison with the control group [P < 0.01], during remission of the disease, IL-2 level was significantly reduced [P < 0.001], while IL-I0 level showed no significant difference from its level prior to remission. It can be assumed that the effector cells in this disease are THl and measures designed to switch the predominant immune response from THl to TH2 might be effective in treatment of rheumatoid arthritis