Diagnosis and Antimicrobial Susceptibility of Mycobacterium Tuberculosis in a Tertiary Care Hospital in Bangladesh

Background: Tuberculosis (TB) is a common condition all over the world but more common in developing countries like Bangladesh38. This is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. In 2013, 9 million people fell ill with TB and 1.5 million died from the disease globally. Approximately 15-20 % of total TB cases are extrapulmonary in non-HIV patients. Among extrapulmonary TB, abdominal tuberculosis (ATB) accounts for 11%-16%. Abdominal TB is difficult to diagnose because of its lack of specific symptoms, low yield of acid-fast bacilli (AFB) on smear and culture due to paucibacillary lesion; and variable manifestations depending upon anatomical localization of the disease. The diagnosis of abdominal TB classically requires histopathological, microbiological and culture confirmation of Mycobacterium tuberculosis. Investigations like Imaging (Ultrasound, Barium X-Rays, and CT scan) and the Mantoux test have only supportive value. Aim of the study: The aim of the study was to diagnose modalities and antimicrobial susceptibility in abdominal tuberculosis patients.Material & Methods:This cross-sectional hospital-based observational study was carried out among 73 adult patients with the diagnosis of abdominal TB who met the selection criteria and attended in Gastroenterology department of DMCH through either admission or referral from May 2015 to April 2016.Results:The most frequent symptoms were weight loss (96.9%), abdominal pain (75%), and fever (75%). The most frequent signs were anaemia (34.4%), followed by ascites (27.9%). Basis of diagnosis in abdominal tuberculosis was histolopathogy in 37.5%, Gene Xpert in 28.1%, Positive AFB on culture in 9.4%, ADA value in ascitic fluid (Cutoff >40 IU/L) in 25%, and good clinical response (Based on weight gain and general improvement in wellbeing) to a therapeutic trial of anti-TB treatment in 18.7% patients. Drug sensitivity pattern was analyzed in all three AFB culture-positive patients; resistance was detected in one which showed multidrug resistance (MDR TB).Conclusions:The result of this study highlighted the diagnostic yield of various investigation modalities, particularly newer modalities (Gene Xpert, culture sensitivity in Bactec MGIT 960) and basis of diagnosis in abdominal TB. This study also determined the MTB culture positivity from tissue biopsies in patients with abdominal TB and demonstrated drug-resistant MTB in culture-confirmed abdominal TB.

Adalimumab induction and maintenance therapy achieve clinical remission and response in Chinese patients with Crohn's disease

BACKGROUND/AIMS: This was a Phase 2 study (NCT02015793) to evaluate the pharmacokinetics, safety, and efficacy of adalimumab in Chinese patients with Crohn's disease (CD). METHODS: Thirty, adult Chinese patients with CD (CD Activity Index [CDAI] 220-450; high-sensitivity [hs]-C-reactive protein [CRP] ≥3 mg/L) received double-blind adalimumab 160/80 mg or 80/40 mg at weeks 0/2, followed by 40 mg at weeks 4 and 6. An open-label extension period occurred from weeks 8-26; patients received 40 mg adalimumab every other week. Serum adalimumab concentration and change from baseline in fecal calprotectin (FC) were measured during the double-blind period. Clinical remission (CDAI <150), response (decrease in CDAI ≥70 points from baseline), and change from baseline in hs-CRP were assessed through week 26. Nonresponder imputation was used for missing categorical data and last observation carried forward for missing hs-CRP/FC values. No formal hypothesis was tested. Adverse events were monitored. RESULTS: Mean adalimumab serum concentrations during the induction phase were 13.9-18.1 µg/mL (160/80 mg group) and 7.5-9.5 µg/mL (80/40 mg group). During the double-blind period, higher remission/response rates and greater reductions from baseline in hs-CRP and FC were observed with adalimumab 160/80 mg compared to that with 80/40 mg. Adverse event rates were similar among all treatment groups. CONCLUSIONS: Adalimumab serum concentrations in Chinese patients with CD were comparable to those observed previously in Western and Japanese patients. Clinically meaningful remission rates and improvement in inflammatory markers were achieved with both dosing regimens; changes occurred rapidly with adalimumab 160/80 mg induction therapy. No new safety signals were reported.

Dual Burden of Underweight and Overweight among Women in Bangladesh: Patterns, Prevalence, and Sociodemographic Correlates.

The discourse of dual burden caused through underweight and overweight is well-documented globally but this issue and its connection with women’s health in Bangladesh is yet to be explored widely. To enrich the current debate, this study, in the context of Bangladesh, examines the patterns, prevalence, and socioeconomic factors influencing the ever-married women of being underweight and overweight over normal weight. Data used in this study have been extracted from the most recent 2011 Bangladesh Demographic and Health Survey. To achieve results connected with the research objectives, both bivariate and multivariate statistical analyses have been employed. In bivariate analysis, we used seven categories of BMI cutoff points for Asian countries as prescribed by World Health Organization (WHO). Multinomial logistic regression model was constructed to investigate the net effect of socioeconomic factors on underweight, pre-overweight, and overweight over normal weight. The results confirm the co-existence of underweight and overweight among women as we found the prevalence of underweight, normal weight, pre-overweight, overweight, and obesity to be 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Compared to the richest, the women from the poorest households were significantly (p<0.001) most likely to be underweight (OR=2.75, 95% CI 2.27-3.35) and least likely to be overweight (OR=0.15, 95% CI 0.12-0.19) over normal weight. The urban women, compared to their rural counterparts, were significantly (p<0.001) less likely to be underweight (OR=0.80, 95% CI 0.71-0.91) and more likely to be overweight (OR=1.33, 95% CI 1.18-1.51) than normal weight. The other socioeconomic grades that were most marked to be underweight and overweight are age, women’s education, marital status, age at first childbirth, parity, number of children aged ≤5 years at the household, and food security. The findings confirm the dual burden of both under- and overweight. Systematic and regular monitoring and surveillance of the social trajectory of nutritional status of women and men in Bangladesh is crucial to develop apposite strategy that addresses the persistent and chronic problem of underweight and the emerging problem of overweight. The dual existence of both types of malnutrition among women in Bangladesh must be taken into consideration so that public health interventions may be adopted through appropriate policy.

Detection of Helicobacter antigen in stool samples and its relation to H. Pylori positive cholecystitis in Egyptian patients with chronic calcular cholecystitis

Evidences supporting the association between H. pylori infection and chronic cholecystitis could be found by using direct culture or staining of H. pylori in gallbladder tissues as well as indirect techniques. Stool antigen test has been widely used due to its non-invasive nature. Various stool antigen tests were developed to detect H. pylori using an enzyme immunoassay [EIA] based on monoclonal or polyclonal antibodies This study evaluated the frequency of H. pylori antigen in stool samples of patients with chronic calcular cholecystitis as regard gall bladder histopathological changes. -Fifty patients were included presented with symptomatic cholecystolithiasis recruited from the outpatient clinic of National Hepatology and Tropical Medicine Research Institute during 2014-2015. Full history and clinical examination and abdominal ultrasonography were performed. Stool samples were collected, prepared and examined for detection of H. pylori antigen. Cholecystectomy was done for all patients; 45 patients [90%] by laparoscopic Cholecystectomy and 5 patients [10%] by open surgery and removed gallbladders were submitted to pathology department for detection of H. pylori in tissue under microscope using Giemsa stain. The results showed that [82%] were females with mean age [42.6+1years]. The mean BMI was [29+7.2] H. pylori-specific antigen in stool samples was detected in 40% of patients and38% were detected in patients; tissue, with significant correlation between H. pylori-specific antigen in stool and in tissue. Histopathological pictures infection in tissue were 68.4% mucosal erosions, 63.2% mucosal atrophy, 57.9% mucosal hyperplasia, 26.3% metaplasia, 42.1% musculosa hypertrophy, 26.3% fibrosis, but lymphoid aggregates were in 42.1% of cases

Preference for Institutional Delivery and Caesarean Sections in Bangladesh.

In Bangladesh, preference for place of delivery and socioeconomic factors associated with caesarean section are not well-understood. This paper examines the socioeconomic correlates of preference for institutional delivery and caesarean sections in Bangladesh. The study used data from the nationally-representative 2007 Bangladesh Demographic and Health Survey. Both bivariate and multivariate binary logistic regression models were constructed to assess the effect of sociodemographic factors on the use of medical facilities and caesarean section for childbirth. Overall, 15% of women underwent institutional delivery, and 8% deliveries were performed by caesarean sections. Both institutional deliveries and caesarean sections have increased in recent years. The bivariate and multivariate analyses both confirmed that place of residence, religion, birth order, frequent pregnancy, antenatal care-seeking, and wealth index were important predictors of the use of medical facilities and caesarean sections for childbirth. Women’s education appeared as the most single significant determinant for the use of both services. The findings underlie the importance of monitoring caesarean section as well as professional attendance for safe motherhood. Programmes should aim to inform women highlighting the benefits of the use of skilled maternal healthcare services and demerits of home-delivery practices.

Study of neurological soft signs in attention deficit hyperactivity disorder

This study was performed to provide data on the prevalence of neurological soft signs in children with Attention Deficit hyperactivity Disorder [ADHD] and detect its correlation with intellectual function and age of the child. Fifty patients with ADHD according to the DSM-IV criteria [mean age, 9.3 years, SD= 1.51 years] participated in the study. They were referred from the outpatient clinic of psychiatry at Assiut University hospital and from the private clinics of the staff members of neuropsychiatry, were evaluated with the Cambridge Neurological Inventory to assess neurological soft signs and Stand ford Binet 4th edition to assess the intellectual and cognitive functions. Fifty healthy controls matched with patients groups in Age, sex and socioeconomic state were assessed using the same tools. A significantly high incidence of neurological soft signs was fund in the patient's group and statistically insignificant among ADHD subtypes with significant negative correlation with IQ and age of the child. The Spearman correlation coefficient between NSS score and IQ and age are 0.672 and 0.283 respectively [p=<0. 001, 0.009]. Presence of neurological soft signs in ADHD is a non-specific marker of neurological abnormality but indicate poor intellectual and cognitive Junctions of ADHD

Effects of some antidiabetic medicinal plants on pancreas and liver of diabetic albino rats

Diabetes is a chronic metabolic disease which affects large number of population all over the world. More than 400 traditional medicinal plants have been recorded for helping in controlling such disease. This study investigated effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents. One hundred fifty adult male Albino rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds, while the fifth group was treated with the aqueous extract of Foenugreek seeds. The sixth one was treated with the aqueous extract of Termis seeds with the administered dose of the plant extracts [100 mg/kg body weight].After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both heamatoxylin and eosin as well as a special stain for demonstration of the different pancreatic cells in the Islet of Langerhans. The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group, while the other pancreatic cells were not affected [alpha and delta cells]. The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. The present results showed that the activity of the mixture was the best when compared with Nigella, Foenugreek and Termis seeds. The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on the liver and texture, hematological parameters, and lipid profile. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required doses

Bone disease in upper Egyptian transfusion dependent pediatric B-thalassemia major

Thalassemia and the blood transfusion complications associated with it predispose children to poor bone health. This study was conducted to determine the prevalence of bone-related abnormalities within this population. Forty two transfusion-dependent beta thalassemic subjects 5-19 years old in Assiut, Egypt, participated in this cross-sectional study. Medical history by interview and review of medical records, physical examinations including anthropometric measures and puberty assessment, and bone densitometry using DEXA and height adjustment were performed. The incidence of underweight and short stature was 73.8% and 69%, respectively, which were indicators of malnutrition among thalassemic subjects in this study. Low bone density [BMD Z-scores < -2] was detected in the lumbar spine and femoral region in 54.7% and 95.2% of subjects, respectively. But after height adjustment they became 11.9% and 64.3%, respectively. Forty-seven percent of patients had a history of fractures and the cumulative risk for which increased almost with age. Seventy-eight percent of patients reported bone pain, whilst back/hip pain was present in 69% of thalassemic children and adolescents. Genu valgus deformity and scoliosis were seen in 40.5% and 11.9% of patients. High incidence of low bone density and deficit in other aspects of bone health among thalassemia patients makes routine bone health assessment necessary for this vulnerable group. Considering influencing factors, dietary counseling and preventive supplementation therapy for this high risk group of children and adolescents may be necessary, although this should be assessed by intervention studies

Domestic violence, unwanted pregnancy and pregnancy termination among urban women of Bangladesh

This paper explores the relationship between domestic violence against women inflicted by husbands, unwanted pregnancy and pregnancy termination of Bangladeshi urban women. The study used the nationally representative 2007 Bangladesh Demographic and Health Survey [BDHS] data. The BDHS covered a representative sample of 10,996 ever married women from rural and urban areas. The BDHS used a separate module to collect information from women regarding domestic violence. The survey gathered information of domestic violence from 1,013 urban women which are the basis of the study. Simple cross tabulation, bivariate and multivariate statistical analyses were performed to analyzing data. Overall, the lifetime prevalence of domestic violence was 47.5%. Of the most recent pregnancies, 15.6% were unwanted and 16.0% of the women terminated pregnancy in their marital life. The multivariate binary logistic regression analyses yielded quantitatively important and reliable estimate of unwanted pregnancy and pregnancy termination. The regression analyses yielded significantly [p<0.05] increased risk of unwanted pregnancy only for physical violence [OR=2.35, 95% CI=1.28-4.32] and for both physical and sexual violence [OR=2.27, 95% CI=1.02-5.28], and higher risk of pregnancy termination for only physical violence [OR=1.41, 95% CI=0.95-2.10] and for both physical and sexual violence [OR=1.81, 95% CI=1.07-3.04] than women who were never abused. Current age, higher parity and early marriage are also important determinants of unwanted pregnancy and pregnancy termination. Violence against women inflicted by husbands is commonplace in Bangladesh. Any strategy to reduce the burden of unwanted pregnancy and induced abortion should include prevention of violence against women and strengthening women's sexual and reproductive health

Socioeconomic correlates of contraceptive use among the ethnic tribal women of Bangladesh: does sex preference matter?

To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter. The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data. The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women. The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones

New formulations from Acacia nilotica L and Glycyrrhiza glabra L. for oral ulcer remedy

This study addresses the innovation of a stable new pharmaceutical formulation comprising natural botanical extracts of Acacia nilotica L. and Glycyrrhiza glabra L., which are therapeutically effective in the treatment of oral ulcer and possess high patient acceptability. The pastes are prepared, characterized, and subjected to physical and chemical stability studies and then evaluated for therapeutic efficacy regarding ulcer size. The novel adhesive paste is prepared and when applied to the oral mucosa, it remains on it for a considerable period of time. The stability tests of all the samples in the analysis showed satisfactory physical and chemical stability evaluated by the Normal Stability Test. The muco adhesive paste incorporating the active; A. nilotica L, when applied to oral ulcer, could promote the healing process, leading to a decrease in diameter of the inflammatory halo of the ulcer. However, the effect of liquorice extract on recurrent aphthous ulceration [RAU] was found even better than that of acacia extract. A combination of the two plants presented a synergism of both, leading to better healing with favorable reduction of the diameter of inflammatory halo of the ulcer together with a prolonged action. Therapeutically, effective and stable oral pastes are dispensed with cost-effective benefits

Decline in Child Marriage and Changes in Its Effect on Reproductive Outcomes in Bangladesh.

This paper explores the decline in child marriage and changes in its effect on reproductive outcomes of Bangladeshi women, using the 2007 Bangladesh Demographic and Health Survey data. Chi-square tests, negative binomial Poisson regression and binary logistic regression were performed in analyzing the data. Overall, 82% of women aged 20-49 years were married-off before 18 years of age, and 63% of the marriages took place before 16 years of age. The incidence of child marriage was significantly less among the young women aged 20-24 years compared to their older counterparts. Among others, women’s education appeared as the most significant single determinant of child marriage as well as decline in child marriage. Findings revealed that, after being adjusted for sociodemographic factors, child marriage compared to adult marriage appeared to be significantly associated with lower age at first birth (OR=0.81, 95% CI=76-0.86), higher fertility (IRR=1.45, 95% WCI=1.35-1.55), increased risk of child mortality (IRR=1.64, 95% WCI=1.44- 1.87), decreased risk of contraceptive-use before any childbirths (OR=0.56, 95% CI=0.50-0.63), higher risk of giving three or more childbirth (OR=3.94, 95% CI=3.38-4.58), elevated risk of unplanned pregnancies (OR=1.21, 95% CI=1.02-1.45), increased risk of pregnancy termination (OR=1.16, 95% CI=1.00-1.34), and higher risk of the use of any current contraceptive method (OR=1.20, 95% CI=1.06-1.35). Increased enforcement of existing policies is crucial for the prevention of child marriage. Special programmes should be undertaken to keep girls in school for longer period to raise the age of females at first marriage in Bangladesh and thereby reduce the adverse reproductive outcomes.

Detection of fluoroquinolone resistance in mycobacterium tuberculosis clinical isolates as determined by gyrA / B gene mutation by using PCR technique

Fluoroquinolones are broad-spectrum antimicrobial agents that have been used with increasing frequency over the past decade. Fluoroquinolones have in vitro and in vivo activity against Mycobacterium tuberculosis. However, resistance to fluoroquinolones in cases of tuberculosis is not routinely assessed. Mutations in a small region of gyrA, called quinolone resistance-determining region [QRDR] and, less frequently, in gyrB are the primary mechanism of FQ resistance in M. tuberculosis. PCR-based techniques provide new possibilities for the rapid diagnosis of first- and second-line drug resistance. There were 40 consecutive adults, who had culture confirmed pulmonary tuberculosis during the study period. Mutations were observed in the QRDRs of both gyrA and gyrB in 22 isolates [55%]. Only gyrA +ve in 7[17.5%] isolates. Only gyrB +ve in 5[12.5%] isolates. Total gyrA +ve in 29[72.5%] and total gyrB +ve in 28[70%] isolates. Both gyrA and gyrB -ve in 6 [15%]. The incidence of FO-resistant M. tuberculosis is gradually increasing to alarming levels this may be due to wide spread use of this vital groups of drugs in community-acquired pneumonia and urinary tract infections

Phytochemical and biological study of vangueria edulis cultivated in Egypt

Fractionation and purification of the alcoholic extract of the leaves and stem -bark of Vangueria edulis cultivated in Egypt afforded thirteen compounds identified as: p-sitosterol acetate [1], stigmasterol [2], palmitic acid [3], scopoletin [4], p-coumaric acid [5], protocatechuic acid [6], esculetin [7], ethyl I-O-glucosyi-4-O-[E] caffeoyl quinate [8], kaempferol 3-O-rhamnoside, 7-O-rutinoside [9], p-sitosterol [10], ceryl alcohol [11], vanillic acid [12] and p-sitosterol-3-Q-beta-D-glucopyranoside [13]. Identification of these compounds has been established by physical, chemical and spectral data as well as comparison with authentic samples. Compounds 8 and 9 are firstly reported from a natural source while the rest of the compounds have been isolated for the first time from the genus Vangueria. The LD[50] antibacterial antifungal anti-inflammatory, antipyretic and the effect on CNS were studied

Assessment of Thrombolytic & Cytotoxic Activity of Herbal Preparations Originated from Botanical Source of Bangladesh.

An in vitro thrombolytic model was used to check the clot lysis effect of four herbal extracts viz., Honey, Nigella sativa, Capsicum frutescens, Brassica oleracea, combination of Honey & Nigella sativa and Honey & Capsicum frutescens along with Streptokinase as a positive control and water as a negative control. And also brine shrimp lethality bio-assay was done using brine shrimp Nauplii and 5% of DMSO as a solvent for the ethanol extracts of Nigella sativa & Capsicum frutescens and Honey. Using an in vitro thrombolytic model, Honey, Nigella sativa, Capsicum frutescens, Brassica oleracea, combination of Honey & Nigella sativa and Honey & Capsicum frutescens showed 26.82%, 47.13%, 57.40%, 62.44%, 56.58% and 44.54% clot lysis effect respectively. From our study we found that Brassica oleracea, Capsicum frutescens, and combination of Honey & Nigella sativa showed significant % of clot lysis effect with reference to Streptokinase. Again from in vitro brine shrimp lethality bio-assay, we found that the LC50 of Honey, Capsicum frutescens & Nigella sativa were 129.62 μg/ml, 83.33 μg/ml & 45.45 μg/ml respectively.

Simple and rapid HPLC method for simultaneous determination of atenolol and chlorthalidone in spiked human plasma

A simple, sensitive and rapid chromatographic method was developed and validated for the simultaneous quantification of atenolol and chlorthalidone in human plasma using hydrochlorothiazide as internal standard [IS]. The method utilized proteins precipitation with acetonitril as the only sample preparation involved prior to reverse phase-HPLC. The analytes were chromatographed on Shim-pack cyanopropyl column with isocratic elution with 10 mM KH2PO4 [pH 6.0] - methanol [70:30, v/v] at ambient temperature with flow rate of 1 mL min-1 and UV detection at 225 nm. The chromatographic run time was less than 10 min for the mixture. The calibration curves were linear over the range of 0.1-10 mg mL-1. The method was validated in terms of accuracy, precision, absolute recovery, freeze-thaw stability, bench-top stability and re-injection reproducibility. The within- and between-day accuracy and precision were found to be within acceptable limits <15%. The analytes were stable after three freeze-thaw cycles [deviation <15%]. The proposed method was specific for the simultaneous determination of atenolol and chlorthalidone in human plasma where there was no interference from endogenous biological substances

Characteristics of rheumatoid arthritis patients with concomitant hepatitis C virus infection

Hepatitis C virus [HCV] is frequently associated with rheumatic autoimmune manifestations including rheumatoid-like arthritis. This work is aimed to study the impact of concomitant HCV infection on rheumatoid arthritis [RA] patients. 110 RA patients [mean age 44.6 +/- 12.7, disease duration 7.92 +/- 6.56 years] were included. HCV infection was diagnosed by HCV-antibody [HCV-Ab] and polymerase chain reaction. Disease activity was assessed using the disease activity score 28 [DAS28] and radiological damage by a modified Larsen method. Functional disability was assessed by the Modified Health Assessment Questionnaire [MHAQ]. HCV-Ab was detected in 20% and viremia in 12.7% of RA patients. HCV-Ab positive patients were significantly older [p < 0.001] and had a longer disease duration [p = 0.02]. No differences were found between HCV-Ab positive and -negative patients in DAS28 and modified Larsen's scores, however, HCV-Ab positive patients had a higher frequency of deformities [p < 0.005] associated with older age [p < 0.001] and higher MHAQ scores [p = 0.002], independent of age and disease duration. They also had a higher frequency of hepatomegaly [p < 0.001] and vasculitis [p < 0.001]. Hepatomegaly was associated with older age [p = 0.004] and longer disease duration [p = 0.003] while vasculitis was associated with older age [p = 0.02]. Concomitant HCV infection in RA patients is associated with significant disability and comorbidities in the form of hepatomegaly and vasculitis. Hepatomegaly and vasculitis were associated with older age. Hepatomegaly was also associated with longer disease duration. Screening for HCV infection is recommended in Egyptian RA patients

Effect of plant growth promoting substances from rhizo- and cyano -bacteria on sugar beet growth, yield and yield quality in saline soil

The production of plant growth promotors [indole acetic acid, gibberellic acid and abscissic acid] by rhizobacteria and cyanobacteria has been taken as a main criterion in the selection of the microbial strains used in this study. A field experiment was conducted at Sahl El Hussinia Station, El Sharkia Governorate, during the winter season of 2008/2009 to investigate the effect of rhizobacteria and cyanobacteria either individually or in combination on growth, yield and yield quality of sugar beet under salinity stress. Soil biological activity in terms of dehydrogenase activity was significantly affected by the biological treatments. The dehydrogenase recorded its highest value when the combined inoculum of rhizobacteria and cyanobacteria was applied. Inoculation with rhizobacteria and/or cyanobacteria in saline soil alleviated the salinity effects on the sugar beet and enhanced photosynthesis [leaves chlorophyll content], proline and phenoic accumulation in roots, along with, increasing the concentrations of N, P and K and decreasing Na[+] concentrations in roots. This physiological positive response of the plant growth promoting rhizobacteria and/or cyanobacteria resulted in significant increases in sugar beet root yield and yield quality [TSS, sucrose and purity%]. Best results were obtained by the combined mixture of bacteria and cyanobacteria followed by the individual treatments of either. This investigation pointed out that plant growth promoting substances secreted by rhizobacteria [PGPR] and cyanobacteria could be used as a good tool to alleviate salinity stress and promote sugar beet productivity and yield quality as it provides an ceo-friendly biological approach under saline soil conditions

Influence of beneficial microbes and proline treatments on sugar beet under nitrogen limitation in saline-sodic soil

A field experiment on sugar beet [Beta vulgaris L.] yield and yield quality under saline-sodic soil conditions was conducted at Sahl El Hussinia Res. Station, El Sharkia Governorate, Egypt, during the winter season of 2008/2009. The influence of cyanobacteria and N[2]-fixing bacteria were compared either individually or in combination to supplementation with proline amino acid under two levels of mineral nitrogen fertilization [50 and 75% of nitrogen recommended dose]. Soil enzymatic activities [dehydrogenase and nitrogenase], total bacterial counts, total cyanobacteria counts and total nitrogen fixing bacteria counts were enhanced by the biofertilizers compared to proline treatment and controls, particularly when the combined inoculum of cyanobacteria and N[2]-fixing bacteria was applied in the presence of 75% N. In addition, inoculation with cyanobacteria and N[2]-fixing bacteria, either individually or in combination with 75%N, led to a slight decrease of pH and EC values of saline soil, while there was an increase in the availability of NPK as compared with control plots. Proline and biofertilizers showed a significant positive impact on some physiological properties of plants drown at 75% nitrogen level, such as chlorophyll in leaves, proline and phenolic compounds in roots. The highest responses for these traits were in proline-treated plots followed by the combined inoculation of cyanobacteria and N[2] fixing bacteria, while, there was no significant difference in root yield productivity between proline treatment and the combined inoculum of cyanobacteria and N[2] fixing bacteria with 75% nitrogen fertilizer. The combined inoculation positively increased N, P and K uptake and decreased the uptake of Na in roots. Also, the combined inoculum of cyanobacteria and N[2] fixing bacteria with 75% nitrogen led to a significant increase in shoot and root dry weight as well as root yield quality [sucrose and purity]. Results suggest that the beneficial effect of the cyanobacteria and N[2] fixing bacteria on sugar beet growth, yield and yield quality was attributed to the biologically active substances produced by these microbial strains besides the nitrogen fixation of the diazotrophs which compensate the reduction of the costly and the environmentally polluted mineral nitrogen fertilizers in the new reclaimed saline-sodic soil