Role of higher levels of post-challenge antibodies in protective vaccination against Leishmania tropica infection of BALB/c mice

Objective: To study the role of antibodies in protection against Leishmania tropica (L. tropica) infection in the experimental model of BALB/c mice.Methods: BALB/c mice were vaccinated against L. tropica by soluble Leishmania antigen or recombinant L. tropica stress-inducible protein-1 (LtSTI1) of L. tropica, and against Leishmania major (L. major) by soluble Leishmania antigen. Monophosphoryl lipid A was used as an adjuvant. The L. tropica- or L. major-vaccinated mice were challenged by L. tropica or L. major, respectively. The levels of anti-Leishmania antibodies (IgG1 and IgG2a) were determined after vaccination and after challenge. Results: All vaccinated groups caused a higher antibody response in comparison with the control group. The L. major-vaccinated group showed lower IgG1 response than the control group after the challenge. Conversely, in L. tropica-vaccinated mice, the levels of antibodies were higher than the control group. Moreover, the group receiving rLtSTI1 and monophosphoryl lipid A showed higher levels of antibodies than those of the rLtSTI1 group. In vaccinated mice, antibody responses against L. tropica remained high until 16 weeks after the challenge. Conclusions: The higher levels of post-challenge antibodies are associated with protective vaccination against L. tropica infection of BALB/c mice. Our findings provide new insight into the association of antibody with vaccine-induced protective immunity against L. tropica infection. More studies are needed to clarify the role of antibody in protection against L. tropica.

Leishmania tropica: The comparison of two frequently-used methods of parasite load assay in vaccinated mice

Objective: To compare limiting dilution assay and real-time PCR methods in Leishmania tropica parasite load measurement in vaccinated mice.Methods: BALB/c mice were vaccinated by Leishmania tropica soluble Leishmania antigen or recombinant Leishmania tropica stress-inducible protein-1 with/without adjuvant. After three vaccinations, mice were challenged by Leishmania tropica promastigotes. Two months after challenge, the draining lymph nodes of mice footpad were removed and parasite load was assayed by limiting dilution assay and real-time PCR methods. Limiting dilution assay was done by diluting tissue samples to extinction in a biphasic medium. For real-time PCR, DNA of the lymph nodes was extracted, equal dilutions of each sample were prepared and hot-start real-time PCR was done using appropriate primers. The data of the two methods were compared by appropriate statistical methods. Results: Both methods were able to measure different levels of parasite load in vaccinated/unvaccinated mice. In addition, wherever parasite load of a group was estimated high (or low) by one method, the estimated parasite load by another method was the same, although statistically significant differences were found between some groups. Conclusions: Both methods lead to approximately similar results in terms of differentiating parasite load of the experimental groups. However, due to the lower errors and faster process, the real-time PCR method is preferred.

[Epidemiological profile and management of rectal cancer: what changed in 20 years?]

The incidence of rectal cancer is increasing in Western countries. What is it for us, do we have more rectal cancer? The change of our way of life, the aging population could be risk factors. Furthermore the management of rectal cancer has considerably progressed. The purpose of this study is to compare the epidemiological profil and the management of rectal cancer between two series collected to 20 years of interval. It is about two retrospective cases, the first one, collected from 1981 to 1985 [série A], includes 80 patients. The second one, recent, collected from 2005 to 2011 [série R], includes 94 patients. We analyzed for the epidemiological profile, the middle number of case per year, age, sex, seat of the tumor, histological type, metastatique stage. We analyzed for the management: operability rate, resection rate, type of intervention. The middle number of cancer of the rectum hospitalized per year in our formation is respectively 16 +/- 4.06 and 18 +/- 4.14 in serie A and the serie R [p = 0.91]. The mean age of patients was 49.5 +/- 14.7 for serie A and 48.6 +/- 13.3 for serie R [p = 0.674]. There is a masculine predominance in the two series [p = 0.7]. The three segments of the rectum are reached in the same proportions in the two series [p = 0.8]. The low rectum represented half of the cases [54.5% serie A, 56.9% série R]. The metastatique stage is more frequent in série R [32 [22.7%] vs 18 [34%] [p = 0.14]. Resection rate represents respectively in série A and série R, 68.9% and 84% [p = 0.428]. Abdomino-perineal amputation has been achieved in 45% of the cases in serie A and 30.3% of the cases serie R [p = 0.003]. The study found that the incidence of rectal cancer has not increased in our training in the space of 20 years, however, in two series, 25% of patients are aged less than 25. The management of this cancer was marked by systematic preoperative radiotherapy in the serie R for low rectal cancers, by reducing the safety margin to 2 cm and by reducing the number of abdominoperineal resection. Eidemiological profile did not change. However, the management of rectal cancer been influenced by the new data of the rectal surgery. This study showed that rectal cancer in Morocco had different characteristics than that in West country. Environmental and genetic studies may explain this difference

[Bladder inguinoscrotal hernia]

The incarceration of the bladder in the ininguinal hernia is rare. Often asymptomatic, the diagnosis is made during surgery or postoperatively due to complications. We report the case of a patient with a right inguino-scrotal hernia associated with urinary symptoms and whose retrograde urethrocystography [UCR] showed an bladder totally intra scrotal. Incarceration of the bladder in the hernial sac is found only in 1-4% of inguinal hernias, the total extra abdominal bladder migration is even more exceptional. The association of inguinal hernia and urinary irritative and obstructive signs should suggest the diagnosis, however it is most often done during surgery. Confirming diagnosis is provided by the opacification of the lower urinary tract [cystourethrography or retrograde intravenous urography] or by CT. The treatment includes the cure of the hernia with bladder reintegration. Resection of the herniated bladder portion is needed only in case of large hernia or narrow neck. The preoperative diagnosis avoids postoperative complications

Gender differences in the attitude and strategy towards weight control among government employees in Penang, Malaysia

This was a cross-sectional study on the gender differences in weight-control behavior. The strategies used, weight status, weight satisfaction, and proportion of individuals attempting to lose weight among 233 government employees [104 men and 129 women] working in the Federal Government Building in Penang, Malaysia, were assessed. Anthropometric indicators such as body mass index, waist-to-hip ratio, and body fat percentage were measured to determine the subjects' body weight status. A questionnaire covering the following items was used to assess weight-control behavior: social support, self-monitoring, self-efficacy, outcome expectations, planning, preparation/buying, portion control, social interactions, and cognitive behavioral strategies. About 50% of the subjects were classified as overweight. Based on percent body fat percentage. 70% of them were classified as having unhealthy levels of body fat. Women were found to be more dissatisfied with their current weight, and were more likely to attempt weight reduction compared to men. Women reported higher levels of social support for dieting and had better expectations for diet and exercise [P< 0.05]. They also reported higher use of weight control strategies. For self-monitoring, although no gender-dependent differences [P > 0.05] were observed, women reported more frequent self-monitoring of diet, whereas men reported more frequent self-monitoring of exercise. Health care professionals and researchers should be aware of the different strategies used by men and women in order to plan and/or implement community-wide weight management programmes

Relationship between DNA polymorphisms at the BCL11A and HBS1L-MYB loci in beta-Thalassemia patients with increased fetal hemoglobin levels

High fetal hemoglobin [HbF] levels have a major impact on the hemoglobin disorders, i.e. beta -Thalassemia. Increased HbF production ameliorates the disease severity. Three loci-HBS1L-MYB intergenic region on chromosome 6q23, BCL11A on chromosome 2pl6, and the chi-globin gene on chromosome 11 account for up to 50% of the variations in HbF levels in patients with sickle cell anemia, thalassemia and healthy adults. In the present study, we evaluated the relationship between some polymorphisms on HBS1L-MYB BCL11A loci and increased HbF levels in thalassemia patients and normal subjects. In this case-control study, three common polymorphisms among 50 beta-thalassemia patients with increased HbF and 47 healthy individuals with normal HbF by using PCR-RFLP were genotyped: rs4895441, rsl 1886868, and rs28384513. Enzymatic digestion was performed by Rsal, MboII, and BstXI, respectively. Correlations with high levels of HbF were performed with a Chi-square test by using SPSS 16 and SNP analyzer2. Mutant allelic frequencies were 0.245, 0.521 and 0.309 in healthy and 0.3, 0.52 and 0.28 in patient for rs4895441, rsl 1886868 and rs28384513, respectively. Significant relationship was not observed among three polymorphisms studied in healthy volunteers and beta-Thalassemia major patients with increased HbF levels and P-value allelic and genotypic was higher than 0.05 at three SNPs. In spite of previous reports, evaluation of polymorphisms at the BCL11A and HBS1L-MYB loci in this study did not show up a significant correlation with increased HbF. Other polymorphisms might have a role in increasing HbF in our population

Frequency and magnetic resonance imaging patterns of tuberculous spondylitis lesions in adults

To find out the frequency and patterns of various lesions in tuberculous spondylitis in adults on magnetic resonance imaging [MRI]. Case series. Radiology Department, Military Hospital [MH] Rawalpindi, from September 2006 to March 2007. Patients with features suggestive of tuberculous spondylitis underwent plain T1-weighted and T2-weighted images and T1-weighted contrast enhanced images in both axial and sagittal sections. The data was analyzed in terms of frequency and patterns of various lesions of tuberculous spondylitis causing abnormal signals in spinal and paraspinal areas. Mean +/- standard deviation were calculated form numerical data using SPSS version 15. Out of 75 patients, 39 were females. The mean age was 42.4 years. Involvement occurred through SV1 vertebral levels. Most common involvement was seen in the thoracic vertebrae [40%] followed by lumbar vertebrae. The most common MRI feature was abnormal signal intensities appearing hypointense on T1W and hyperintense on T2W sequences with heterogeneous enhancement of the vertebral body in all patients. The characteristic findings of spinal tuberculosis included destruction of two adjacent vertebral bodies and opposing end plates, destruction of intervening disc, and occurrence of paravertebral and epidural abscesses. MR imaging of spinal tuberculosis, characteristically showed contiguous involvement of two vertebrae along with the intervening disc, skip lesions, and paraspinal collections and provides critical information about the involvement of spinal cord and the extent of the disease

Aggression in adolescents as a function of parent-child relationship

The present study primarily focused on the nature of perceived parent-child relationship quality as determinant of aggression in adolescents. The test sample included 512 boy and girl students of secondary and higher secondary level falling within the age range of 14-18 years. The nature of perceived parent-child relationship was examined as constituting two categories i] loving, object reward, protecting, symbolic reward; and ii] demanding, indifferent, neglecting, object punishment, rejecting, and symbolic punishment. Pearson correlation revealed a negative correlation between perceived quality of parent-child relationship and level of aggression in adolescents. Multiple regression analysis showed symbolic punishment aspect of parent-child interaction to be the strongest predictor of aggression

Patient controlled intravenous analgesia [PCIA] in postoperative surgical patients: an audit

We conducted an audit for the evaluation of the effectiveness, adverse effects and degree of patient satisfaction with Patient Controlled Intravenous Analgesia [PCIA] for postoperative pain control in surgical patients. This was an observational study. Patient, scheduled for different surgical procedures, were informed about PCIA a day before surgery and were offered PCIA for pain control after surgery. All the patients were asked to fill a questionnaire 24 hours after the start of PCIA, that contained the relevant questions reflecting the objectives of the study. Seventy-six patients participated in the study of whom 91% had a visual analogue pain score of <3 at rest and 83% had a score of <3 at movement on visual analogue scale of 0-10. Eighty% of patients rated the convenience of pain control as being excellent, whereas 92% stated that the dependence on nursing staff for pain management was nil. The incidence of drowsiness and nausea was 28% each, while 21% of the patients complained of restricted mobility. Patient controlled intravenous analgesia is an excellent method of postoperative pain relief, which provides a high degree of satisfaction to the patients

Follow-up of the effects of splenic irradiation on some splenic and peripheral blood cells measurements: a contreolled study in patients with hypersplenism secondary to periportal fibrosis

Nineteen patients with hypersplenism secondary to compensated periportal fibrosis [ten patients received splenic irradiation [SI], group 1 and nine patients on supportive therapy [ST] group 2]] were included in this study. The follow up period was 9-18 months in group 1 and 4-6 months in group 2. SI course was administrated twice weekly for three weeks to a total dose of 9 Gy. Initial and follow up blood counts and peripheral hemogram including red cell and platelet indices were measured in each visit; while, spleen size, splenic vein diameter were measured by duplex Doppler ultrasound initially and after three and six months. The study concluded that SI is a promising new low toxic type of treatment for patients with hypersplenism. Dose and schedule of SI should be modified according to the patients clinical condition. Changes in splenic vein diameter are correlated with the degree of platelet and red cell turnover. Its predictive value for hypersplenism should be studied

Study of arterial blood gases and pulmonary systolic pressure of children with adeno-tonsillar hypertrophy

Fifty cases with adeno-tonsillar hypertrophy were included in this study, these patients were in the waiting list for adeno-tonsillectomy. Their ages ranged from 2 to 12 years [33 males and 17 females]. The study aimed at evaluation of changes of arterial blood gases [ABG] and pulmonary systolic pressure [PSP] of these cases. Thorough history and physical examination was done with special emphasis on cardiac and chest condition, patients proved to have cardiac or chronic chest problems were excluded. These patients were subjected to: plain x-ray lateral view on the head and neck, electro-cardio-gram [ECG], colored echo-Doppler and arterial blood sample for ABG study. Ten healthy children of matched age were included as a control group, among the attendant of pediatric surgery clinic and listed for surgical intervention. The consent of parents was taken.. As regards to ABG results of the study versus control group were PH [7.33 +/- 0.05 versus 7.38 +/- 0.01], PaCO2 [38.51mmHg. +/- 1.84 versus 37.3mmHg +/- 1.73], PaO2 [77.26mmHg +/- 8.99 versus 78.9mmHg +/- 7.3] and O2 saturation [95.8% +/- 5.89 versus 96.9% +/- 1.11]. The difference of ABG between study and control group was not statistically significant [P value < 0.1,

Effect of colchicine on schistosoma induced hepatic amyloidosis in Syrian golden hamsters

This study comprised 80 Syrian Gold hamsters, 70 of them were infected with Schistosoma mansoni and 10 uninfected hamsters served as negative controls. Of the schistosome infected hamsters, 10 served as positive controls [infected but untreated] and the rest [60 hamsters] received treatment for 9-week duration. In 30 hamsters treatment was given early [9 weeks after infection], before the appearance of hepatic amyloidosis, and in the other 30 hamsters treatment was given late [15 weeks after infection] after the appearance of hepatic amyloidosis. Each treatment group was subdivided into three subgroups [ten hamsters each], in which treatment was either colchicine alone, combined colchicine and praziquantel, or praziquantel alone. All hamsters were sacrificed nine weeks after treatment, liver biopsies were taken and evaluated semiquantitatively for amyloid deposits. In the group with combined therapy there is significant reduction in hepatic amyloid deposits, together with reduction of proteinuria serum bilirubin, SGPT with an increase of total serum protein and serum albumin. This improvement was nearly complete with early treatment and only partial when treatment was given late. When colchicine was given alone, a partial, but insignificant reduction of hepatic amyloid deposits was documented. It was concluded that, colchicine is effective for the prevention and reduction of schistosome induced hepatic amyloidosis in Syrian Gold hamsters

Octreotide infusion plus emergency sclerotherapy versus sclerotherapy alone for the control of bleeding oesophageal varices: a prospective randomized clinical trial

In a prospective trial, 189 patients with acute variceal bleeding were underwent emergency sclerotherapy of them, 93 patients were randomly assigned to receive a continuous infusion of octreotide [25 microgram per hour] for 5 days [group II]. The rest of patients [96 patients] treated with only sclerotherapy [group I]. After 7 days of follow up, the proportion of patients who had survived without re-bleeding was higher in group II patients who treated with both urgently sclerotherapy and octreotide [89 of 93 patients or 95.7%] than in patients treated with emergency sclerotherapy alone [group I]. The mean number of units of blood transfused was lower in group II than in group I. Also, bleeding was controlled rapidly in group II [2.26 +/- 0.8 days] versus group II [2.84 +/- 0.84 days]

Prevalence of hepatitis C in patients with bleeding oesophageal varices: clinical significance and impact on the outcome of sclerotherapy

The aim of the work was to find out the prevalence of hepatitis C in patients with bleeding varices and its clinical significance. 200 patients with bleeding esophageal varices were included. Viral markers for hepatitis B and for hepatitis C were done by ELISA and confirmed by RIBA test for all patients with Anti-HCV positive ELISA. Endoscopic sclerotherapy is done for all patients every week until complete eradication then every 3 months for one year. The prevalence of anti-HCV was 55% and HBsAg 8%, both viruses 5.5%. There was a significant number of patients positive to hepatitis markers categorized under child B and C than in patients negative to hepatitis markers. Moreover, most patients positive to both markers were child B and C mainly. Re-bleeding from esophageal varices was more in patients positive to viral markers when compared to negative patients. Patients with both viruses had the highest rate of re-bleeding

DR polymorphism in chronic active hepatitis C

The aims of this study were to evaluate the association between DR antigens and chronic active hepatitis patients [CAH] and to seek correlations between these antigens and chronicity, disease severity and auto- antibodies in this condition. The frequency of different HLA-DRB I alleles was studied in 30 patient with chronic active hepatitis C [CAH] and 15 cross-matched control group. Both groups were subjected to HLA-DRBI typing using reversed hybridization technique, detection of Sjogren Syndrome Antibody RNA-A [SSA] and Sjogren syndrome antibody RNA-B [SSB] antibodies and detection of ANA, ASMA and AMA antibodies by immunofluorescent technique. Results showed that chronic hepatitis C may be genetically determined as DR3 is significantly higher in patients as compared to controls and DR5, DR2 and DR52 may be protective genes being more frequent in controls. The presence of auto-antibodies with HCV infection may also be genetically determined as it is associated with certain DR alleles. Certain auto-antibodies SSA and ANA are associated with disease severity being more common in patients with chronic active hepatitis C associated with cirrhotic changes

Efficacy of different dosage schedules of praziquantel in active intestinal schistosomiasis

This study is conducted on 420 patients with active intestinal bilharziasis, their age range from 16-60 year. 380 are males and 40 are females. Bilharzial activity was diagnosed after urine and stool analysis and/or rectal and colonic mucosal biopsy. All of them received praziquantel orally as anti-bilharzial drug. They were divided into 4 groups according to the dose of praziquantel given. From the results, it was found that there is insignificant increase in hemoglobin concentration in the first and second groups and significant increase in the third and fourth groups. The increase in hemoglobin concentration after praziquantel therapy may be attributed to improvement of appetite and increased degree of intestinal absorption. Also, it may be attributed to stoppage of bleeding per rectum following treatment

Prothrombotic markers in NIDDM

The present work comprised the study of 50 cases besides 10 controls. The necessary clinical and laboratory investigations had been carried out for all subjects. In addition, PC was assayed. A significant prolongation of PT, APTT has been observed in all diabetic group as compared to the control group. Insignificant decrease in fibrinogen level has been observed in all diabetic group as compared to control group. Insignificant increase in PC activity has been observed in all diabetic group as compared to control group. This may be an attempt by the body to overcome hypercoagulability [Vigano et al. 1984]. Significant decrease in PC activity has been observed in diabetic bilharzial group as compared to the diabetic non bilharzial group

Duodenal varices and its treatment by endoscopic sclerotherapy

This study comprised 8 patients with different stages of hepatosplenic schistosomiasis presented with haematemesis and melena or melena alone, proved by endoscopic examination to have bleeding duodenal varices Because of the critical condition of the patient, injection sclerotherapy was tried and the results were very successful as no further bleeding occurred and by follow up endoscopy, the varices completely disappeared. In three cases superficial ulcerations were noticed but completely healed on follow up after one month treatment by sucralfate 4 gm/day

Accuracy of per rectal ultrasound in the diagnosis of focal prostatic lesions

One hundred patients diagnosed clinically as senile enlargement of the prostate were subjected to transrectal ultrasonography. Forty cases showed focal lesions by ultrasound. Of these, fourteen cases were diagnosed as benign nodular hyperplasia of the prostate, twelve cases were diagnosed as chronic prostatitis, ten cases had prostatic calcifications and four cases were diagnosed as carcinoma of the prostate. Biopsy studies of operative biopsy specimens proved the diagnosis of cases with benign nodular hyperplasia and of calcifications, whereas per rectal ultrasound was less accurate in detecting early stages of prostatic carcinoma. Therefore, per rectal ultrasound is a great development of noninvasive methods of imaging the prostate which can overcome the limitations inherent to digital evaluation of the prostate