Comparison between placental site injection of vasopressin and bilateral internal iliac artery ligation to reduce blood loss during cesarean section for placenta praevia, a randomized controlled trial

Background: placenta praevia is an obstetric complication in which the placenta is inserted partially or completely in the lower uterine segment, A significant proportion of these cases is associated with life threatening hemorrhage during delivery, often by caesarean section in the vast majority of cases, many procedures introduced to overcome this problems, none of them is completely successful

Aim of the work: this study aimed to compare between local vasopressin injection in the placental bed and bilateral internal iliac artery ligation on the blood loss during caesarean section for placenta praevia

Patients and Methods: this a randomized-controlled prospective trial included 60 pregnant women with a diagnosis of placenta praevia, they were categorized into 3 equal groups according to methods to control blood loss during cesarean section for placenta praevia. Group 1 included 20 pregnant women who underwent vasopressin injection at placental site. Group 2 included 20 pregnant women who underwent bilateral internal iliac artery ligation. Group 3 included 20 pregnant women who underwent caesarean section without internal iliac artery ligation or local injection of vasopressin [The control group], comparison between groups were done and statistically analyzed

Results: there were statistical significant differences between the intervention and the control groups as regard estimated blood loss, P value was <0.001; group 3[Control] had more amounts of blood loss, there were no statistical significant differences between group 1 and group 2 as regard estimated blood loss, P value was > 0.05 . Comparison between group1 and group 2 showed that internal iliac artery ligation was significantly associated with prolonged operative time than vasopressin injection[P value was <0.001]

Conclusion and Recommendation: local injection of vasopressin at placental site seemed to be a promising modality for reducing blood loss during cesarean delivery for placenta praevia and was associated with similar reduction of blood loss and less operative time when compared with internal iliac artery ligation, may be done first before trying internal iliac artery ligation and needs no experience

Potential protective effect of honey against paracetamol-induced hepatotoxicity

Paracetamol overdose causes severe hepatotoxicity that leads to liver failure in both humans and experimental animals. The present study investigates the protective effect of honey against paracetamol-induced hepatotoxicity in Wistar albino rats. We have used silymarin as a standard reference hepatoprotective drug. Hepatoprotective activity was assessed by measuring biochemical parameters such as the liver function enzymes, serum alanine aminotransferase [ALT] and serum aspartate aminotransferase [AST]. Equally, comparative effects of honey on oxidative stress biomarkers such as malondialdyhyde [MDA], reduced glutathione [GSH] and glutathione peroxidase [GPx] were also evaluated in the rat liver homogenates. We estimated the effect of honey on serum levels and hepatic content of interleukin-1beta [IL-1beta] because the initial event in paracetamol-induced hepatotoxicity has been shown to be a toxic-metabolic injury that leads to hepatocyte death, activation of the innate immune response and upregulation of inflammatory cytokines. Paracetamol caused marked liver damage as noted by significant increased activities of serum AST and ALT as well as the level of II-1beta. Paracetamol also resulted in a significant decrease in liver GSH content and GPx activity which paralleled an increase in II-1beta and MDA levels. Pretreatment with honey and silymarin prior to the administration of paracetamol significantly prevented the increase in the serum levels of hepatic enzyme markers, and reduced both oxidative stress and inflammatory cytokines. Histopathological evaluation of the livers also revealed that honey reduced the incidence of paracetamol-induced liver lesions. Honey can be used as an effective hepatoprotective agent against paracetamol-induced liver damage

Serum prohepcidin, iron and hepatic iron status in chronic hepatitis C in Egyptian patients

Patients with chronic hepatitis C [CHC] often have increased liver iron. Hepcidin has recently emerged as a key regulator for iron homeostasis. Therefore, we aimed to study the relationship between serum prohepcidin, serum iron indices, hepatic necro-inflammation, fibrosis and hepatic iron density and to determine the predictors of advanced fibrosis in these patients. Fifty CHC treatment naive patients and 20 healthy controls were enrolled in this study. Complete blood count, liver function tests, serum iron indices and serum prohepcidin were assayed. Liver biopsy was performed for all patients for assessment of necro-inflammatory activity, fibrosis and liver iron density. Thirty-four patients [68%] had mild fibrosis [stage 0, 1,2] and sixteen [32%] had advanced fibrosis [stage 3, 4]. All cases were positive for liver iron stain [68% mild, 32% advanced]. Mean serum prohepcidin level was significantly lower in CHC patients than healthy controls. In univariate analysis, prohepcidin was significantly associated with necro-inflammatory activity [P<0.05] and advanced fibrosis [P<0.05]. Multivariate analysis revealed that necro-inflammatory activity and liver iron density arc independently associated with stage of fibrosis. No significant correlations were found between prohepcidin and serum iron indices or liver iron score. Scrum prohcpcidin is reduced in CHC which may be one -not the only- factor leading to iron overload in these patients. Histological grading and hepatic iron density are independent predictors of advanced fibrosis. Further studies are needed to clarify the role of viral and host genetic factors in hepatic iron deposition

Can serum fibrosis markers predict medium/large oesophageal varices in patients with liver cirrhosis?

Non-invasive predictors of medium/large oesophageal varices [LOVs] could reduce the number of screening endoscopies. As portal hypertension is a consequence of liver fibrosis, serum fibrosis markers were evaluated together with other variables as possible non-invasive predictors of medium OV/LOV. A total of 154 cirrhotic patients with splenomegaly and 30 healthy control subjects were recruited in a prospective study in two gastroenterology centres in Upper Egypt. Clinical parameters assessed included Child-Pugh class, liver size and ascites. Laboratory parameters included complete blood count, liver function tests, and aspartate aminotransferase [AST]/platelet ratio. Transforming growth factor-p! [TGF-beta [1]], alpha2 macro globulin [A[2]M] and hyaluronic acid [HA] were assayed. Ultraso-nographic examination was done for assessment of liver span, portal vein diameter and detection of minimal ascites. Oesophageal varices were diagnosed and graded by oesophagogastroduodenoscopy. Fifty-four patients [35%] had no or small varices and 100 [65%] patients had medium OV/LOV by endoscopy. On multivariate analysis, the independent predictors of medium OV/LOV were the presence of ascites [beta = 0.258, p = 0.047] and serum HA [beta = 0.449, p = 0.009]. The receiver operating characteristic curve for HA showed the area under the curve to be 0.916. The sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of HA at a cut-off value of 207 micro g T[1] were 94%, 77.8%, 88.7%, 87.5% and 88.3%, respectively. The presence of ascites and serum HA level higher than 207 micro g T[1] can predict the presence of medium OV/LOV in cirrhotic patients. This would help physicians to identify patients who would most likely benefit from screening endoscopy and thus, reduce costs and discomfort from unnecessary endoscopic procedures

Leptin, osteocalcin, and bone mineral density in post-hepatitic liver cirrhosis

The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Some studies have found leptin to be a potent inhibitor of bone formation. The aim of this study is to investigate the relationship between leptin, osteocalcin and bone mineral density [BMD] in liver cirrhosis. Sixty patients with post-hepatitic liver cirrhosis were classified into three groups: group I, 20 pre-menopausal females; group II, 20 post-menopausal females; and group III, 20 males. In addition, 21 age- and sex-matched healthy subjects [seven for each group] were included as control subjects. Patients were classified according to Child-Pugh classification into grade A [n = 0], grade B [n = 38] and grade C [n = 22]. Serum osteocalcin, leptin and parathyroid hormone [PTH], in addition to liver functions test, hepatitis B surface antigen [HBsAg], anti-hepatitis C virus [HCV], serum phosphorus and calcium were measured. Bone mineral density [BMD] was measured by calcaneal ultrasound. Leptin was elevated in all groups [I, II and III] when compared with their control groups [p < 0.01, p < 0.001 and p < 0.01, respectively]. Further, it was high in female groups [I and II] compared to males [group III], [p < 0.01 each]. BMD and serum osteocalcin decreased in each group compared with the respective control [p < 0.001; p < 0.01 in group I, p < 0.05; p < 0.001 in group II and p < 0.001; p < 0.001 in group III, respectively]. In the Child-Pugh grade C group, BMD and osteocalcin were low [p < 0.001, p < 0.05, respectively], while serum leptin was elevated [p < 0.05], when compared with grade B group. Leptin correlated negatively with serum osteocalcin [r = -0.553; p < 0.001], BMD [r = -0.229; p < 0.05], albumin [r = -0.449; p < 0.001] and albumin/globulin [A/G] ratio [r = -0.661; p < 0.001], while positively correlated with both aspartate transaminase [AST] [r = 0.462; p < 0.001], and alanine transaminase [ALT] [r = 0.483; p < 0.001]. Osteocalcin negatively correlated with intact iPTH [r = -0.370, p < 0.001], while positively correlated with BMD [r = 0.418; p < 0.001], albumin [r = 0.659; p < 0.001] and A/G ratio [r = 0.444; p < 0.001]. Serum leptin was elevated in cirrhotic patients and may have a role in the pathogenesis of osteoporosis in liver cirrhosis

Effect of diminazine aceturate on the pharmacokinetic of a long acting oxytetracycline formulation in lactating goats

Oxytetracycline [OTC] and diminazene aceturate are commonly administered to diseased ruminants with mixed bacterial and protozoal infections. We were therefore interested in characterizing the pharmacokinetics of a new long acting OTC formulation after IV or IM administration, and whether concurrent administration of diminazene altered the pharmacokinetics. Ten clinically healthy lactating female Baladi goats were used in a sequential order. Goats received the treatments in sequential order with a 2 week wash out period between each study: 1] a single dose of OTC [30 mg/kg BW] by TV or TM injection in non-treated and diminazine aceturate pre-treated goats [3.5 mg/kg BW] 2 hours before OTC treatment. Blood, milk and urine samples were collected periodically and OTC concentration was assayed using a microbiological method. The extent of protein binding in serum and milk was determined using an in vitro ultra filtration method and assayed using the same method as serum Pharmacokinetic analysis indicated that serum OTC concentrations after IV administration could be fit to a two-compartment model, and that pre-treatment with diminazene aceturate increased serum OTC concentrations. Following IV injection [t[0.5] beta] was 25.9 +/- 5.1 and 24.5 +/- 2.7 hours, and [Vd[area]] was 22.0 +/- 0.8 and 23.7 +/- 0.4 L.kg[-1], in non-treated and diminazine pre-treated goats, respectively. The maximum OTC concentration after IM injection [1.25 +/- 0.02 micro g ml[-1] and 1.39 +0.04 micro g ml[-1] was obtained at 1.8 +0.3 hours and 2.4 +/- 0.4 hours in non-treated and diminazine pretreated goats, respectively. Moreover, effective milk concentrations were detected for 24 to 48 h, and effective urine concentrations were detected for 96 to 120 h after IM injection. The LA-OTC formulation was moderately bound to goat serum protein [46.0 +3.2% for OTC alone and 40.0 +/- 2.3% for OTC +diminazine]. The binding of the LA-OTC formulation was lower in milk [29.3 +/- 3.6%] than plasma. We conclude that concurrent administration of LA-OTC and diminazine aceturate alters the serum concentration-time profile and pharmacokinetics of a new long acting OTC formulation and could therefore potentially alter treatment efficacy

Colorimetric determination of non-steroidal estrogen level modifiers

Two simple, accurate and precise methods are described for the determination of some non-steroidal estrogen level modifiers in pure powder form and pharmaceutical dosage forms. The firs method is based on the reduction of ferric phenanthrolene [ferriin] to ferroin by Tamoxifen citrate [I] or Clomiphene citrate [II]. The obtained ferroin chelate has an orange red color [[lambda][max] 510.5nm] measurable in concentration ranges of 2-9 micro g/ml and 1-7 micro g/ml for I and II, respectively. The second method is based on charge-transfer complexation between 2,3-dichloro-5,6-dicyano-p-benzoquinone [DDQ] as electron acceptor and [I] or Raloxifene hydrochloride [III] as the electron donors. The produced red color can be measured at [lambda][max] 458.5 nm in the concentration ranges of 40-280 micro g/ml and 80-320 micro g/ml for I and III, in orders. Different factors affecting the color formation have been studied and optimized and the proposed methods were successfully applied for the determination of the named drugs in their pharmaceutical formulations

Deacidification of lampante olive oil

Deacidification of lampante olive oil by anion exchange resin and aluminum oxide was investigated. The experimental results proved that it is feasible to obtain a refined olive oil with free fatty acids less than 0.3% using anion exchange column. Efficiency of anion exchange resin as a deacidification material was 4 times as that of the aluminum oxide. Peroxides of the investigated olive oil were decomposed by heat treatment of the deacidified oil in presence of a stream of N[2]. K[232], K[270] and delta-K of the refined olive oil were 2.37,0.89 and 0.02, respectively. The results revealed that the untreated olive oil and the oil constituents that retained on the resin exhibited an efficient cytotoxicity against breast carcinoma cell line [MCF7] with IC[50] values of 61.1 and 70.5 micro g, respectively, while deacidified oil did not maintain this property

Does triplet chemotherapy [gemcitabine, oxaliplatin and etoposide] have an impact on treatment outcome in advanced/metastatic non-small cell lung cancer?

Non-small-cell lung cancer [NSCLC] is the leading cause of cancer-related death. The combination of Vinca alkaloid and cisplatin represents a standard option for the initial therapy of patients with advanced NSCLC. A number of new anticancer agents have been tested and approved for the treatment of advanced NSCLC. Triplet agent chemotherapy has entered clinical practice in treatment of advanced cases of NSCLC. 28 evaluable patients of NSCLC with stage III-B or IV were enrolled in this study. One group received doublet regimen of cisplatin [120mg/m 2 D1, 22] and etoposide [120mg/m 2 D1-3 and recycle every 21 days]. Other group received triplet regimen of gemcitabine [800mg/ m 2 D1, 8] then oxaliplatin [80mg/ m 2 D1] and VP16 [120mg/ m 2 D1-3] with recycling every 21 days. Evaluation of response, toxicity and survival was performed. Age ranged from 36-75 years with a median age of 61 years. The main side effects were nephrotoxicity, neurotoxicity and gastrointestinal tract toxicity in doublet regimen, while hematological toxicity, orthostatic hypotension and neurotoxicity in triplet regimen group. Febrile neutropenia occurred in 37.5% in triplet regimen compared to 8.3% in doublet regime. Partial response was higher in triplet agent chemotherapy group. It occurred in 25% and 50% of cases

Factors associated with gallstones in patients with chronic renal failure treated by haemodialysis in upper Egypt

Studies performed to date on the prevalence of gallstones in chronic renal failure [CRF] on haemodialysis [HD] have given contradictory results. to evaluate the frequency and percentage of gallstones and its main associated risk factors in a group of Egyptian haemodialysis patients. The study included 147 patients with CRF on HD randomly selected from Assiut and Sohag University renal dialysis units in Upper Egypt [102 males, 45 females]. The screening protocol included complete medical history, female parity, as well as, use of estrogen therapy by females. History of diabetes mellitus and duration of haemodialysis were also recorded. Body mass index [BMI] was calculated and a number of biochemical parameters [total cholesterol and triglycerides, serum calcium, phosphorus and uric acid] were estimated in fasting serum. An ultrasound scan of the gall bladder and biliary tract was performed with a 3.5 MHz linear probe after at least 12 h fasting. In addition, the prevalence of gallstones in the general population of the same geographical region was calculated after revising available data in ultrasonography reports. The mean age of CRF patients was 43 +/- 14.2 years and mean duration of dialysis was 30 +/- 30.5 months. Gallstones were diagnosed in 22.4% of HD patients and this was mildly significantly higher in women than men [31.1% in women vs 18.6% in men, P=0.05] and this percentage was significantly higher than that of the general population in the same geograbical region [1.6% of the total examined] [P=0.001]. The percentage of gallstones didnt increase significantly with increasing age or duration of dialysis. We noticed an insignificantly raised risk for gallstones with use of estrogen by females, diabetes mellitus and smoking in males [OR=3.2, 1.6, 1.2 respectively; P >0.05 for all of them]. No significant difference was noted between CRF patients with and without gallstones in the studied biochemical parameters except for mean serum calcium that was significantly higher in patients with gallstones [9.8 +/- 1.3 vs 8.1 +/- 1.1; P=0.04]. The percentage of gallstones in a group of Egyptian patients on HD is higher than that of the general population of the same area. Apart from female sex, the traditional risk factors associated with gallstones in the non-uraemic general population appear not to play a significant role in gallstone formation in HD patients. Estrogen use in females, presence of diabetes mellitus and smoking in males, have insignificantly raised the risk for gallstones in these patients. Changes in serum calcium appear to play a role. Our results suggest that other factors inherent to kidney pathology may contribute to this high percentage of gallstones in CRF patients on haemodialysis

Oral capecitabine in combination with gemcitabine in management of advanced pancreatic carcinoma

Preclinical studies indicate positive biochemical and synergistic effects between capecitabine, an oral fluorouracil, and gemcitabine, the standard treatment for advanced pancreatic cancer [APC]. The goals of this study were to investigate the efficacy and safety of such combination for patients with APC. Twenty-two eligible patients with APC were treated with oral capecitabine and gemcitabine [CapGem regimen]. Capecitabine was given in a dose of 750 mg/m2 BID daily from day 1 to day 14 followed by one-week rest. Gemcitabine was given on day 1 and day 8 in a dose of 1000 mg/m2/dose given as i.v. infusion in 250 ml normal saline for 30 minutes of each 3-week cycle. Tumor lesions were assessed for objective response by physical examination and abdominal CT every two cycles of chemotherapy. Adverse events were monitored continuously during treatment and for one month after the last dose of the study. Estimation of survival was done every two months alter completion of chemotherapy cycles. The results revealed that among the 22 studied patients, two patients achieved complete clinical response [9.1%] and five patients [22.7%] achieved partial response with overall objective response rate 31.8% [95% CI, 0.21 to 0.39]. The median response duration of all responders was 31 weeks [95% CI, 18 to 39 weeks]. CA-19-9 was dropped >50% in eight patients and dropped >90% in five patients. The median time to disease progression in all 22 patients was 32 weeks [95% CI, 21 to 40 weeks]. The median survival for the whole studied group was 36 weeks [95% CI, 27 to 48 weeks]. Treatment was generally well tolerated in the outpatient settings. In conclusion, capecitabine in combination with gemcitabine was well tolerated regimen with apparent efficacy in patients with APC. Therefore, the supra-additive antitumor effect of such combination regimen of CapGem plus the advantage of oral administration of capecitabine merits this protocol promising

Role of gemcitabine, oxaliplatin and prednisolone combination as first-line chemotherapy in non-Hodgkin's Lymphoma

Non-Hodgkin's lymphomas [NHL] are commonly treated with cyclophosphamide, doxorubicin, vincristine and prednisolone [CHOP]. The objective of the current study was to evaluate the efficacy and safety of gemcitabine, oxaliplatin and corticosteroids [GEMOX-P] as first-line treatment for patients with intermediate-high grade non-Hodgkin's lymphoma [NHL]. Thirty-three patients with intermediate/high grade NHL were randomized into two groups. First group received standard [CHOP] with prednisolone tablets 40 mg/m2/day for five days. The second group received gemcitabine 1000 mg/m2 D1, 8, then oxaliplatin 80 mg/m2 D1 and prednisolone tablets 40 mg/m2/day for five days with recycling every 21 days. The primary end point was response rate. The secondary end points were disease-free survival and overall survival. From the results of this study, it was concluded that the regimen of [GEMOX-P] had beneficial effects over [CHOP] regimen, that included higher complete response rate in high-risk cases and lower cardiac and hepatic toxicity, but there was no difference after 18 months in disease free or overall survival between both treatment arms. Selection of cases that may benefit from chemotherapy treatment either [CHOP] or [GEMOX-P] is needed balance between anticipated toxicities, treatment outcome and cost benefit aspect

Does Intermittent low weekly doses of docetaxel-estramustine have an impact on treatment outcome in hormone refractory prostate cancer?

Although the majority of men with metastatic prostate cancer respond initially to and rogen ablation, most of them will eventually develop hormone-refractory progressive disease; with generally median survival less than one year from that point. The management of hormone refractory prostate cancer [HRPC] is challenging, as there is no uniformly accepted strategy. Combinations of estramustine and taxanes produced objective responses in soft tissue, reductions in serum PSA levels, and relief from bone pains. Different dosing and frequency of palliative chemo-hormonal therapy [docetaxel-estramustine] was evaluated in HRPC in relation to overall response, toxicity and survival. 21 patients with progressive, metastatic HRPC were r and omized to receive either [I] estramustine 280 mg PO tid, [Dl-5] with docetaxel as 70 mg/m[2] [1 hour infusion- D2] and recycling 3 weeks or [II] docetaxel 35 mg/m[2] [1 hour infusion] weekly for 3 consecutive weeks and estramustine 140 mg PO tid on days [Dl-3], [D8-10] and [D15-17] with recycling every 4 weeks. Primary endpoint was time to progression. However secondary endpoints were response rate, toxicity and survival. Twenty one patients were presented with a median age of 69 years [range, 49-78 years], median Gleason score of 8 [range, 6-10]. Metastases to bones and lymph nodes were present in 85.7% and 38.1% of total cases respectively. PSA response was statistically higher in weekly regimen than conventional schedule [75% vs. 44.4%], while partial response and pain relief was [22.2% vs. 33.3%] in conventional schedule compared to [44.4% vs. 50%] in weekly regimen respectively [p>0.05]. Median time to progression was [6.1 months vs. 5.6 months]; median survival [18.2 months vs. 16.5 months] and overall 1 year survival [77.8% vs. 66.7%] in conventional schedule vs. weekly regimen respectively. Grade III/IV of neutropenia occurred in 44.4% vs. 25% in conventional schedule treatment and weekly regimen respectively [p<0.05]. Neutropenic fever occurred only in one patient [11.1%] in conventional schedule group. Docetaxel-estramustine is a good effective combination of chemo-hormonal treatment used for hormonerefractory prostate cancer. Even though administration of lower weekly doses of doctaxel-estramustine does not seem to have statistically significant effect on time to disease progression and survival, but criteria of objective response rate with increase PSA response and measurable disease response and subjective improvement of pain are promising. Hematological toxicity, fatigue, fluid retention, attacks of thrombosis and neurotoxicities were lower in weekly regimen compared to conventional schedule. Nevertheless, the data presented here suggest that additional larger r and omized studies of [docetaxel plus estramustine] in lower doses and intermittent schedule are needed to better evaluate the efficacy and survival outcome of this regimen in men with HRPC

Screening for human brucellosis in Sohag farms

Brucellosis is a zoonotic disease that exists worldwide. Several studies were conducted in different governorates, e.g. Menofia, Dakahlia, Giza, Assiut, to estimate the prevalence of brucellosis, but little is known about the problem in Sohag Governorate. The aim was to estimate the frequency of brucellosis in farm workers in Sohag Governorate using ELISA test and to treat positive cases. This study involved 141 persons [91 persons from three farms in Sohag Governorate [high risk group] and 50 persons, who have no contact to animals [control]]. Through this study complete clinical examination, ultrasound examination and complete blood count and ELISA test for brucellosis were done to all persons. The results revealed that the frequency of seropositivity to brucellosis was found to be 12% in the three farms as a whole [13.5% in Faculty of Agriculture Farm, 13% in El-Dyabat Farm and 0% in Shandaweel]. It was concluded that brucellosis is not uncommon among farm workers in Sohag Governorate. Animal vaccination and regular examination for detection of diseased animals was recommended. Health education of workers is of great importance to minimize the transmission of the disease

Ultrasonographic evaluation of internal derangement of the knee joint with MRI correlation

Controversies exist about the value of ultrasound in diagnosing internal knee derangement. This study was conducted to evaluate the efficacy of ultrasonography in diagnosis of internal derangement of the knee by comparing the ultrasound results with the magnetic resonance imaging findings. Forty-four patients clinically presented with suggestive signs and symptoms of internal derangements of the knee joint were examined by both ultrasonography and MR imaging which were reported separately and their results were compared with each others. Ultrasound was found sensitive for detection of knee joint effusion, lipohemoarthrosis, and baker cyst where 100% of cases were diagnosed by US. The sensitivity of ultrasound for detection of meniscal tears was 83.87% with false negative results of 16.12%, while false positive results were encountered in only 4.54% of the examined patients. The sensitivity of ultrasound to detect complete ACL tear was 85.71%, however unsatisfactory results were obtained in detection of partial or chronic ACL tears. Also, fairly high sensitivity of US to detect MCL tear was seen in the current study; approaching 80%. Ultrasonography can be a useful modality in diagnosing internal derangement of the knee; when MR equipments are not available, with fairly high sensitivity in detection of meniscal tears, ACL and collateral ligaments tears

Intravesical sequential chemo - immunotherapy in superficial transitional cell bladder cancer

Thirty-five patients of [Ta/Tl] bladder tumors that initially treated with transurethral resection were randomized into three groups. Group A included patients received intravesical 2 g of gemcitabine in 100 ml saline once weekly for six consecutive weeks. Group B received 150 mg of BCG diluted in 50 ml saline once weekly for six consecutive weeks. Group C received sequential combination of weekly intravesical 2 g of gemcitabine in 100 ml saline for six consecutive weeks, then six weekly intravesical 75 mg of BCG diluted in 50 ml saline. After median follow up of 17 months, recurrence of progression was assessed as terminal events of the study. High risk cases that may have either multiple bladder lesions or more than grade I or associated with CIS were present in 72.7% and 66.7% in arm A, B and C, respectively. The most common local side effects were dysuria, hematuria, frequency and cystitis either bacterial or chemical. Systemic toxicities included neutropenia, thrombocytopenia, fever and malaise. Patients treated with intravesical chemo-immunotherapy had higher incidence of systemic toxicities. 36.4%, 66.7% and 75% were disease-free cases; however recurrence was present in 45.5%, 25% and 16.7% of cases in groups A, B and C, respectively

Preparation and evaluation of newcastle disease virus inactivated vaccines adjuvanated with crude or fractionized Nigella sative oil

Different types of inactivated oil emulsion Newcastle disease vaccines were prepared using different extractions of the Nigella Sativa oil. The physical properties of emulsions were earned out and included emulsion type, emulsion stability and emulsion viscosity. The vaccinated chicks were bled at one-week intervals post-vaccination over six weeks and the collected sera were tested by the HI test. After that, they were challenged 21-days and 42-days post-vaccination by the intramascular inoculation with VVNDV. From this study we can conclude that the non-specific immunostimulant effect of Nigella Saliva oil is acquired when it is used as a crude oil and this improved its ability as a good adjuvant for viral vaccines

Study of Interleukin-16 in Bronchoalveolar lavage of Smokers with and without chronic bronchitis

The study included 30 subjects [10 case of healthy smokers with no chest symptoms, 10 cases of smokers with chronic bronchitis and ten healthy non smokers as control group]. The result of this study showed highly significant statistical increase in the level of IL- 16 in BAL and serum of smokers with or without chronic bronchitis compared to control group [P < 0.001, P < 0.0001 respectively] but no significant statistical difference in its level in BAL and serum of smokers with and without chronic bronchitis [P < 0.05, P > 0.05 respectively]. Also, there was no significant correlation between serum and BAL IL- 16 level in non smokers and smokers without chronic bronchitis [P< 0.05] but there was a significant correlation between them in smokers with chronic bronchitis [P< 0.05]. We concluded that, BAL and serum IL- 16 levels are significantly higher in smokers, [even if they are asymptomatic] than in non smokers, this fact must make us to focus on the danger of smoking in the community

Role of serum interleukin-18 in the assessment of activity of tuberculosis

This study is carried out to evaluate the role of interleukin-18 [IL-18] in the immune response against Mycobacterium tuberculosis [M. tuberculosis] and the reliability of its serum level in the assessment of tuberculous disease activity. It included 40 subjects who were classified into three groups, group I [included 20 patients with active pulmonary tuberculosis], group II [included 10 patients with active extrapulmonary tuberculosis], and group III [included 10 healthy subjects served as controls]. All subjects were investigated, before and 3 months after start of antituberculous treatment, by conventional methods to assess tuberculous disease activity [clinical features, ESR, sputum direct smear for acid fast bacilli and chest X-ray] and measurement of serum IL-18 level. In group I, 16 patients showed good response to treatment and became inactive and showed significant reduction in serum IL-18 level, while the remaining 4 patients showed poor response to treatment and still active and their serum IL-18 level did not change significantly. In group II, 9 patients showed good response to treatment and became inactive and their serum IL-18 level was reduced significantly. In conclusion, serum IL-18 plays an important role in the immune response against M. tuberculosis, as it was higher in patients than in the healthy controls. Serum IL-18 level is directly proportionate to the tuberculous disease activity and severity and it caries a prognostic value, where patients with high serum IL-18 level had good response to treatment, while patients with low serum IL-18 level had poor response to treatment

Sex determination in adult Egyptians from the second cervical vertebra: an anthropological and radiological study

Medico-legal investigations of unidentified human skeletal remains demand a variety of methods for accurate sex estimation [mainly depending on the skull and hipbones]. Physical anthropologists are frequently summoned to provide reliable sex estimation of unknown individuals represented by a few bones. Meanwhile radiology is also employed facilitate medico-legal identification. To evaluate sex prediction through examination of the second cervical vertebra in adult Egyptians by using a simple method and to formulate an equation to help in sex determination. Material and methods: Two groups were included in this study: i- The first group consisted of 50 second cervical vertebral bones [26 males and 24 females] from corpses. ii- The second group entailed 50 computerized tomography [CT] scans of second cervical vertebra [30 males and 20 females] performed for living individuals. For each second cervical vertebra, eight measurements were taken [Maximum Breadth Across the Superior Facet [SFB], Superior Facet Transverse Diameter [SET], Dense Transverse Diameter [DTD], Superior Facet Sagittal Diameter [SFS], Length of the Vertebral Foramen [LVF], Dense Sagittal Diameter [DSD], Maximum Height of the Dense [XDH] and Maximum Sagittal Length [XSL]. All the measurements used showed sexual dimorphism except for length of vertebral foramen [LVF] for both groups [bones and living individuals]. The probability of correct sex determination was calculated. Most measurements showed a probability above 80%. Dense Sagittal Diameter [DSD] from the first group and Maximum Breadth across the Superior Facet [SFB] in the second group showed low probability [76.3% and 70.03% respectively] and hence were excluded from the equation. The resultant equations were as follows: For sexing of the second cervical bone: Y= 8.45 + [O.67x SFB] + [0.36 x SET] + < [0.9 x DTD] + 0.68 x SFS] + [O.63 x XDH]+ [0.046 x XSL] Lf y <17 it is female / If y