Assessment of renal affection in opioid abusers admitted to Ain Shams university hospitals

Opioid abuse represents an often neglected risk factor for the development of wide spectrum of renal diseases. The aim of this study was to assess renal affection in opioid abusers. The current work was carried out on 25 adult opioid abusers admitted to Ain Shams University Hospitals in the period from April 2008 to October 2008, in addition to ten healthy adult individuals serving as controls. All subjects were subjected to sociodemographic study, full clinical evaluation and laboratory investigations that included assessment of serum creatinine, BUN, beta 2microglobulin [beta 2M] and CPK levels, screening for viral infections [HIV, HCV and HBV], detection of proteins in urine and urine screening for opioids. Results of this study revealed significant increase of both beta 2M and CPK serum levels in the studied opioid abusers compared to the control group with no significant difference between the two groups as regard serum creatinine and BUN. Proteinuria was detected in 40% of opioid abusers. Significant increase of infection was observed in opioid abusers including skin infection and viral infections. In conclusion, renal affection is a significant finding in opioid abusers. So, during treatment of opioid abusers it is recommended to assess beta 2M level and to test urine for proteinuria as they both are early and sensitive indicators of renal affection. Additionally, a campaign for awareness of the people about the complications of drug abuse should be carried out

Evaluation of honey protective effect on lead induced oxidative stress in rats

Lead toxicity is a worldwide health problem due to continuous exposure of the population to lead in the environment especially workers in industries. It affects many body organs especially the liver and kidneys. The aim of this study is to investigate the protective effect of natural honey against lead induced oxidative stress, hepatotoxicity and nephrotoxicity. Forty male albino rats were used in this study divided into 4 equal groups. Group [I] the control group were given distilled water orally for 4 weeks. Group [II] rats were given 1.5 ml/kg natural honey orally for 4 weeks. Group [III] rats were given lead acetate [0.2%] in drinking water for 4 weeks .Group [IV] rats were given lead acetate [0.2%] in drinking water and 1.5 ml/kg natural honey orally for 4 weeks. Blood and tissue samples were taken after four weeks. Lipid peroxidation product, malondialdehyde [MDA] in plasma, liver and kidney were determined, blood glutathione peroxidase activity [GPx] and serum nitric oxide [NO] levels were also measured, Liver function tests [serum alkaline phosphatase [ALP], aspartate transaminase [AST] and alanine transaminase[ALT] were measured. Kidney function tests [blood urea and s. creatinine] were estimated. Histopathological examination of liver and kidney sections was performed. showed significant [P>0.01] increase in the mean MDA of plasma. liver and kidney of lead acetate group [Group III] with decreased antioxidant enzyme activity [GPx] activity and [NO] and increase levels of AST, ALT, ALP, urea and serum creatinine together with histopathological changes in liver and kidney sections. Honey alleviated the increased MDA levels, and ameliorate the elevated AST, ALT, ALP, urea and serum creatinine in the combination group. The present study revealed that natural honey could diminish the adverse effects of lead acetate as shown in the histological analysis of rat livers and kidneys. The present results indicated that natural honey can modulate the damage in liver and kidney cells from oxidative stress induced by lead toxicity in tart

Neuroprotective effect of grape seed extract against the histopathological changes of the cerebral cortex of adult albino rats induced by aluminum chloride

Aluminum [Al.] is a neurotoxic metal and its exposure may be a factor in the etiology of various neurodegenerative diseases. Recently, a great awareness about the role of Al. in Alzheimer's disease [AD], which demonstrated increasing prevalence of AD in areas with relatively high content of Al. in drinking water. This experimental study tried to identify the histopathological changes induced by aluminum chloride and the possible protective role of grape seed extract against its neurotoxicity using histological and immuno-histochemical study. Material and In this study, 35 adult albino rats were used. The rats were divided into two main groups; control and experimental groups. 9 rats were used as a control group [group I]. The experimental group [group II]; consisted of 26 rats, which were equally subdivided into 2 subgroups; Subgroup [IIa]; each animal received aluminum chloride 100mg/kg.b.wt/day orally for 9 weeks and Subgroup [IIb]; each animal received the same dose of aluminum chloride with concomitant administration of 50mg/kg.b.wt./day grape seed extract orally for 9 weeks. Specimens of the cerebral cortex of the control and experimental groups were taken and prepared for histological and immuno-histochemical examinations. The differently stained sections of the subgroup [IIa] revealed that aluminum chloride induced obvious neuronal damage, where the cortical layers appeared disorganized. The most characteristic pathological feature was the necrosis of the pyramidal cells and appearance of neurofibrillary tangles in their cytoplasm with disappearance of the glutathione reductase enzyme from the cytoplasm of the damaged neurons. The neuropil appeared edematous with dilated blood capillaries containing amyloid collection. On the other hand, addition of grape seed extract in subgroup [IIb] alleviates the deleterious effects of aluminum chloride, where the cortical layers appeared organized with apparently normal blood capillaries. Many pyramidal cells appeared normal with central nuclei and basophilic cytoplasm. However, the neuropil appeared edematous. The immuno-histochemical stain showed reappearance of the+ve reaction to the glutathione reductase enzyme. This experimental study tried to hypothesize that aluminum chloride administration induces histopathological changes, which might be involved in the pathogenesis of AD. It also identified the protective role of grape seed extract against the Al induced neurotoxicity

Electroneurophysiological monitoring as an early severity predictor in acute anticholinesterase poisoned patient and the effect of oxime therapy manipulation

The neuromuscular transmission failure in acute anticholinesterases [e.g. organophosphorus compounds and carbamates] poisoning occurs because of inactivation of the enzyme acetylcholinesterase located in the neuromuscular junction, and is distinguished by single electrical stimulus induced repetitive responses and decrement response upon high rate repetitive nerve stimulation [RNS]. Oxime therapy with its action at different sites in the neuromuscular junction would alter the neuroelectrophysiological findings in acute anticholinesterases poisoning. The aim of this study is to evaluate the usefulness of RNS as a prognostic indicator of severity in acute anticholinesterase poisoning and the recovery process and its use as a guide for oxime therapy continuation or discontinuation. The study was conducted on 32 patients with acute organophosphorus poisoning admitted to the poison control center, Ain Shams University Hospitals during the period from January 2007 to June 2007. Patients were subdivided into group I [mild group n=6], group II [moderate group n=20], and group III [severe group n=6]. All the cases were clinically evaluated, pseudocholinesterase levels were estimated and RNS was done before and after oxime therapy. The patients were classified according to the decremental response into 3 categories, type 1 response [initial improvement and subsequent lack of improvement], type 2 responce [Initial improvement and subsequent normalization of neuromuscular transmission] and type 3 response [lack of improvement with initial dose of toxogonin]. RNS is a sensitive prognostic test which can be used as an early predictor of acute anticholinesterase poisoning for grading its severity, and assessment of obidoxime [Toxogonin] therapy. As therapeutic benefit of obidoxime is limited by its short duration of action, it is recommended to be administered for a longer period of time under neuroelectrophysiological guidance

Chemical constituents of jojoba oil and insecticidal activity against schistocerca gregaria and biochemical effect on albino rats

The present work deals with chemical constituents, insecticidal and biological studies of jojoba oil. Its saponifiable and unsaponifiable matters of the lipid were studied against Schistocerca gregaria. In addition, the effect of supplementation of jojoba oil and its defatted meal on albino rats. The chemical analysis of saponifiable matter showed that alpha-linolenic acid was found to be the major constituents, in fatty acids [37.1%] followed by nervonic acid [13.8%]. The main constituents of unsaponifiable matter were fatty alcohols, represent 53.84% and 9-octadecen-l-ol was detected with high quantity [41.35%]. The hydrocarbons were also detected in high quantity, 1, 21-docosadiene was the main hydrocarbons [20.64%]. The higher level of jojoba oil induced the lowest eaten area percentage [30.3%] of S. gregaria, followed by the unsaponifiable and saponifiable matters [39.5% and 47.4%], respectively. Antifeedant and protection activity percentage were increased by increasing the concentration. The highest mortality percentage [100%] of S. gregaria nymphs was recorded at 10% jojoba oil while it was [93.3%] in the case of unsaponifiable matter. The biochemical evaluation on albino rats showed that supplementation of 4% jojoba oil to an atherogenic diet [containing 1% cholesterol, 10% animal fat and 0.25% cholic acid] led to a reduction in serum cholesterol and triacylglycerols levels after three weeks; the decrease amounted to 33.1% and 20.8%, respectively. The remainder after oil extraction is referred to defatted jojoba meal. Rats fed diet supplemented with 10% defatted jojoba meal had [after 14 days] a significant reduction in mean values of body weight, food intake and faecal excretion compared to control group but showed no significant change in serum alanine and aspartate aminotransferases activity and creatinine levels

effect of rofecoxib administration on the rat submandibular gland: histological and immunohistochemical study

Nonsteroidal anti-inflammatory drugs [NSAIDs] possess anti-inflammatory, analgesic and antipyretic properties by inhibiting cyclooxygenase [COX] enzyme that exists in two isoforms, COX-1 and COX-2. Traditional nonsteroidal anti-inflammatory drugs [NSAIDs] inhibit both isoenzymes, resulting in damage to the mucosa of the stomach and duodenum. Rofecoxib [Vioxx] is a new generation NSAID, a cyclooxygenase [COX]-2 inhibitor that exhibits promising efficacy comparable with that of NSAIDs for relief of pain and inflammation in osteoarthritis, with decreased risk of gastrointestinal [GI] damage. Several investigators reported that COX-2 inhibitors would be a potential tool for the treatment and prevention of squamous cell carcinoma of the head and neck and are promising agents for the chemoprevention of prostate cancer. The present study aimed to investigate the effects of administration of variable doses of rofecoxib on the histology and the im-munohistochemical expression of COX-2 in different elements of the rat submandibular salivary gland. The animals were divided into five groups as follows; group I controls, groups II and IV received the minimum therapeutic doses of rofecoxib for one and four weeks respectively while groups III and V received the maximum therapeutic doses of rofecoxib for one and four weeks respectively. Results of the present investigation showed histological alterations in the acinar and ductal cells of the submandibular glands of animals in group II. Such alterations were more pronounced in glands of animals from group III who received the maximum dose for the same duration. A noticeable improvement in histological features was observed in submandibular glands from animals of group IV as compared to those of group II. On the other hand, the most pronounced histological changes were associated with the prolonged administration of the maximum dose as seen in submandibular specimens of group V.The Immunohistochemical results of the present work showed variable grades of positive expression of COX-2 in different elements of the submandibular gland of the control rats.On rofecoxib administration, the acinar cells showed redistribution of the COX-2 reactivity and reduced reaction in the connective tissue [CT] after one week administration of the minimum dose while the maximum dose for the same duration markedly inhibited the reaction in both. On the other hand, continued administration of the minimum dose for 4 weeks was associated with regain of the normal acinar and CT reactivity as that of the control. However, continued administration of the maximum dose for four weeks resulted in a reaction pattern similar to that of group III. The results were analyzed and discussed in view of the available literature. It was concluded that 1. Rofecoxibadministration dose dependently induced histological alterations in the submandibular gland. 2. Continued administration of the minimum dose of rofecoxib was associated with adaptive histological response while failure of such adaptation was seen on continued administration of the maxi-mum dose. 3. Changes in COX-2 expression in different elements of these glands seem to be reactionary and tissue specific

Angiogenic changes in experimental periodontitis in rats. evidence for a possible role of pulp and dentin

During the progression of periodontal disease, the periodontal vasculature is profoundly affected. There has been little research on vascular changes in the untreated lesion of periodontitis. Angiogenesis is defined as the process of sprouting of new blood vessels from preexisting capillaries. Angiogenesis is regulated by many cytokines and growth factors. Vascular endothelial growth factor [VEGF] is a potent inducer of angiogenesis and vascular permeability and may be related to periodontal disease. Higher levels of VEGF were detected in whole saliva from periodontitis patients, in comparison to whole saliva from healthy controls. The present study aimed to his-tomorphometrically and immunohistochemically investigate the angiogenic changes in the inflamed periodontal tissues and to probe the possible effect on the pulp tissues of the adjoining tooth. Twenty adult male Albino rats were used in the study and were Subjected to experimental periodontitis by ligature placement around the mandibular 2nd molars of left side while those of the right side were left unligated to serve as a control. Tissue specimens of the pulp and periodontal ligament [PDL] of both sides were histologically examined. Immunostaining with anti VEGF antibody was also done to investigate its expression in these tissues and the number and diameter of BVs were morpho-metrically assayed. Results of the present work showed that experimental periodontitis resulted in remarkable histological, vascular and immunohistochemical changes in VEGF expression both in the periodontal ligament [PDL] as well as pulp tissues. The histological and histomorphometric results presented a statistically significant increase in the mean number of blood vessels [BVs] throughout the PDL and the connective tissue [CT] adjacent to the pocket epithelium in the periodontitis side. In contrast to the control side PDL, there was increased evidence of small BVs in the cementum related zone of the periodontitis side. Similarly, there was increased vessel density [number and diameter] in the coronal pulp of 2nd molars of this side as compared to the control without any obvious changes in the radicular pulp tissues. Immunohistochemically, experimental periodontitis was associated with increased expression of VEGF in alveolar bone, PDL and limited areas of the coronal pulp tissues. On the other hand, the histologically altered junctional and sulcular epithelia of this side presented decreased expression of the reaction. In view of these data, the present investigation proved that vascular and angiogenic changes takes place as a consequence of experimental periodontitis. Such changes were not limited to the PDL, but it also affected the coronal pulp tissue of the adjoining tooth. The evidence for involvement of dentin as .a possible source of the VEGF is also discussed. It was concluded that periodontitis is associated with increased angiogenesis in the PDL as well as the coronal pulp tissue of the adjoining tooth. Bone and dentin matrices may participate in these angiogenic changes

Primary hyperparathyroidism presenting with skeletal lesions

Twenty one cases of primary Hyperparathyroidism are presented. The clinical presentations, radiological findings and biochemical studies are discussed. This series stresses the frequency of Incorrect first diagnosis. Three examples are presented. The surgical management of the patient as well as the post-operative course and follow up are outlined