Protective role of ferulic acid against the damaging effect induced by electromagnetic waves on rat liver and intestine tissues

Background: the increasing use of mobile phones in daily life causes many concerns about their effects on human health. Therefore, this work was designed to study the effects of exposure to 1800 MHz electromagnetic waves [EMW] on the liver and intestine of male albino rats and the protective role of ferulic acid [FA] against these harmful effects

Materials and Methods: twenty-four male albino rats were randomly divided into four groups as follows: 1] control group, 2] treated group given FA, 3] irradiated group exposed to 1800 MHz EMW and 4] treatedirradiated group given FA then exposed to EMW. Biochemical analysis and histopathological examination were performed

Results: a significant increase in serum activities of alanine transaminase and aspartate transaminase, and serum levels of interleukin [IL]-6 and tumor necrosis factor-alpha was shown in the irradiated group, while IL-10 was significantly decreased. There was a significant decrease in lactate dehydrogenase and total antioxidant capacity in the tissues of liver and intestine of this group as well as some histopathological changes. All these serum and tissues parameters and histopathological changes were improved in the group treated with FA before exposure to EMW

Conclusion: prolonged exposure to EMW emitted from mobile phones might produce harmful effects in the liver and intestinal tissues of albino rats. These effects can be prevented by FA administration, which may be protective against tissue damage induced by EMW through the suppression of oxidative stress

Obesity may be erythropoietin dose-saving in hemodialysis patients

BACKGROUND: In dialysis patients, the obesity-survival paradox still requires an explanation. Anemia and high doses of erythropoiesis-stimulating agents (ESAs) are associated with worse outcomes in the hemodialysis (HD) population. In the present study, we explored the relation between obesity and anemia control in a sample of maintenance HD patients in Egypt. METHODS: This multicenter observational study included 733 patients on maintenance HD from 9 hemodialysis centers in Egypt. Clinical and laboratory data as well as average doses of ESAs and parenteral iron were recorded. The erythropoietin resistance index (ERI) was calculated. RESULTS: Obesity, defined as a body mass index (BMI) ≥ 30 kg/m2, was present in 22.6% of the studied population. The target hemoglobin level (10.0–11.5 g/dL) was achieved in 27.3% of non-obese and 25.3% of obese patients, with no significant difference. The median serum ferritin and the values of transferrin saturation index did not differ significantly between these two groups. The weekly ESA dose was significantly lower in obese than in non-obese patients (P = 0.0001). A trend toward higher ESA doses and ERI values was observed in patients with lower BMIs (P < 0.0001). Multiple linear regression revealed that the BMI and urea reduction ratio were the strongest predictors of the ERI. CONCLUSION: Our study adds more evidence to obesity-associated advantages in HD patients. BMI may determine ESA response, with better responses observed in patients with higher BMIs.

Multidetector CT [MDCT] Findings of primary hepatic lymphoma

Objective: The aim of this study was to describe the triphasic multidetector CT [MDCT] finding of primary hepatic lymphoma [PHL]

Materials and Methods: This retrospective study included eighteen patients. Each patient presented with primary hepatobiliary lymphoma without associated lymphadenopathy or other visceral involvement. Triphasic CT scanning was performed on one of two systems [64 MD CT] in 12 patients and [6 MDCT] in 6 patients. All eighteen patients underwent ultrasound percutaneous trucut liver biopsy using 18-gauge biopsy needle. Pathology was confirmed on all cases

Results: Four of eighteen patients presented with a single focal lesion. Thirteen of eighteen patients presented with multiple well defined focal lesions. One patient presented with a diffuse hepatic involvement. On triphasic CT, three patients showed gradual progressive contrast enhancement. Lesions remained isodense to the liver on the arterial phase with mild enhancement in the portal phase and showed washout on the delayed phase in two patients. The remaining thirteen patients showed multiple hypodense non-enhancing lesions

Conclusions: PHL presents a wide spectrum of imaging findings on triphasic MDCT with no characteristic imaging pattern. MDCT can be used for detection of the lesion and biopsy is used for diagnosis. PHL should always be considered in the differential diagnosis of a liver focal lesion either single or multiple

Comparison of endoscopic ultrasound and computed tomography for detecting and staging malignant pancreatic masses

Introduction: Endoscopic ultrasound [EUS] is now established as a valuable imaging test for diagnosing and staging pancreatic cancer. But, with significant recent improvements in spiral computed tomography [CT] scanners, particularly higher resolution and ability to reconstruct 3D images, spiral CT is now increasingly accepted as being better for pancreatic cancer staging. The debate continues, however, about the best diagnostic test or combination of tests in patients with suspected pancreatic cancer. Spiral CT is more readily available than endoscopic ultrasound guided fine needle aspiration [EUS-FNA], cheaper and, therefore, more frequently used In this study, we evaluated the use of EUS-FNA in comparison with spiral CT for detection and staging of malignant pancreatic massesMethods: This prospective study was carried in El-Ebrashi unit of Gastroenterology and Hepatology, Internal Medicine department, Cairo University over 3 years from 2011 to 2014. It included 68 patient with suspected pancreatic mass lesions based on abdominal ultrasound, CT or MRI and patients with obstructive jaundice due to common bile duct [CBD] stricture as proved by endoscopic retrograde cholangiopancreatography [ERCP] or Magnetic resonance cholangiopancreatography [MRCP]. The patients were subjected to dual phase pancreatic control multi-detector computed tomography [MDCT] to be followed by EUS-FNA, then cytopathological examination of the studied patients to determine the nature of pancreatic masses, normal and benign cases are followed up after 6 months by EUS for exclusion of malignancy

Results: The final diagnosis in this study was that, 61 patients were malignant and 7 benign cases. The sensitivity of CT was 75% compared to 100% for EUS. While the specificity for CT was 14% compared to 100% for EUS. The negative predictive value for CT was 6.25% compared to 100% for EUS. With an overall accuracy of MDCT was 69% compared to 100% for EUS for diagnosing pancreatic cancer. The sensitivity of CT for detection of small lesions

Conclusion: EUS is more accurate than CT for detection of pancreatic cancer especially in small tumors. EUS is more accurate than CT in staging of pancreatic cancer in early stages

Recommendation: Early diagnosis of pancreatic cancer is the most important step in the way of decreasing its mortality rate. For screening of patients with suspected pancreatic cancer, initially CT should be performed to be followed by EUS whether to exclude masses in negative CT patients or to confirm the mass and to provide a tool for sample/or cytopathological diagnosis in patients with positive CT We recommend a future study to correlate the accuracy of staging by EUS and CT with post-operative histopathological staging

Barriers to breast cancer screening among a sample of Egyptian females

Breast cancer [BC] is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services

Prevalence and risk factors for spousal violence among women attending health care centres in Alexandria, Egypt

We conducted a cross-sectional survey to determine the prevalence of, and factors affecting, spousal violence among 3271 ever-married women attending 12 randomly selected family health centres in Alexandria Governorate. More than three-quarters of the participants [77%] reported experiencing spousal violence during their marital life. Emotional violence was the most common type reported [71.0%], followed by physical [50.3%], economic [40.8%] and sexual [37.1%] violence. The study confirms the high prevalence of spousal violence across all socioeconomic strata. Logistic regression analysis indicated large family size, divorce or separation, low educational attainment of husband, smoking habit and drug use in husband, husband's psychological status and history of exposure to physical violence during adolescence were associated with spousal violence. This high rate of spousal violence highlights the urgent need for government and civil society to address the issue, which hinders progress toward Egypt's development goals

Fasting adiponectin in relation to the metabolic syndrome in patients with coronary artery disease

Metabolic syndrome and coronary artery disease [CAD] are increasing worldwide. The relationship between metabolic syndrome and fasting serum adiponectin concentration in CAD patients is not well elucidated. The aim of present study is to explore the relationship between serum adiponectin concentrations and the presence of metabolic syndrome [MetS] among patients with CAD. Sixty five patients with CAD; defined as more than 50% stenosis in any segment by coronary angiography, and twenty five matched controls, were enrolled in this study. The study was carried out in Cardiology Department Assuit University hospital between October 2009 and July 2010. Metabolic syndrome was defined according to International Diabetes Federation criteris. The blood samples including complete blood count, fasting blood glucose, liver function tests, creatinine, urea, adiponectin, high sensitive-C reactive protein [hs-CRP], insulin and lipids profile were obtained after overnight fasting. The homeostatic model assessment of insulin resistance [HOMA-IR] was calculated as: HOMA-IR = fasting blood glucose [mmol/l] x fasting serum insulin [micro U/ml]/22.5. Patients with CAD had significantly lower plasma adiponectin concentrations than those without CAD [P<0.013] and higher hs-CRP [P<0.009] and HOMA-IR [P<0.03]. Metabolic syndrome was present in 41 patients [63%] among CAD group. Fasting adiponectin values for these patients tended to decrease significantly in comparison to patients without metabolic syndrome [P value= 0.037]. Negative correlations were found between adiponectin and body mass index [BMI] [r=-0.205, P<0.05], waist circumference [WC] [r= -0.306, P<0.003], triglycerides [r= -0.222, P < 0.036] and hs-CRP [r= -0.223, P< 0.035] whereas a positive correlation was found between adiponectin and HDL [r= 0.273, P<0.003]. Also, adiponectin was significantly lower in patients with multi-vessel disease compared to other [P<0.05] whereas hs-CRP and HOMA-IR were significantly higher in patients with multi-vessel disease with [P<0.01 and 0.03] respectively. Serum adiponectin concentration is inversely correlated with metabolic syndrome among patients with CAD. Lower adiponectin concentration, and higher HOMA-IR and hs-CRP are associated with Cad and metabolic syndrome, and may be useful for risk stratification of CAD patients. The measurement of plasma adiponectin, HOMA-IR and hs-CRP levels may be useful for prediction of severity of coronary artery disease

Non HLA genetic markers association with type-1 diabetes mellitus

The currently available data identified IDDM1 and IDDM2 as 2 susceptibility loci for type 1 diabetes [T1D]. The major histocompatibility complex [MHC]/HLA region referred to as IDDM1 contains several 100 genes known to have a great influence on T1D risk. Within IDDM2, a minisatellite variable number of tandem repeats [VNTR] locus in the insulin gene [INS] promoter region is likely to represent the etiologic polymorphism. The aim of the present work was to study the association between genotypes and susceptibility to T1D among Egyptian diabetic children and their family members. Twenty-five nuclear Egyptian families with 27 children having T1D, aged 3-14 years, their nondiabetic 44 sibs, aged 3-15 years and their parents were included in our study. All studied children were subjected to: detailed history and family pedigree. Thorough clinical examination and anthropometric measurements. Laboratory work up of diabetes including random blood sugar [RBS] and HbA[1]C. Molecular genetics of INS was studied in four steps; nucleic acid purification, amplification, sequencing and haplotyping using flanking single nucleotide polymorphisms [SNPs] as surrogate markers for minisatellite alleles identification. Analysis of variant repeat distribution among Egyptian families combined with flanking haplotypes revealed that all our diabetic children had class I alleles of INS; 9 had class IC+, 9 had class ID+ and 9 had class ID-, while all non-diabetic family members had class III alleles of INS. Therefore the three class I alleles were considered to be equally predisposing to T1D, while class III alleles are dominantly protective. There was significant positive correlations between body mass index [BMI] and both HbA[1]C and AST liver enzyme among diabetic children with class IC+ but not other alleles; indicating that they need close monitoring of their diabetic control and liver functions beside following specific dietary regimens. It can be concluded that all class I alleles [IC+, ID+ and ID-] are equally important susceptibility factors for T1D among Egyptian children, while class III alleles [IIIA and IIIB] are dominantly protective. It is concluded also that our diabetic children with class IC+ are an especially endangered subgroup of diabetics. Genotyping for INS-VNTR alleles is recommended for diabetic children as an important step of diagnostic and follow up regimens and for their non-diabetic family members for family counseling and early identification of potential diabetics. Further studies of INS-VNTR alleles and HLA haplotypes all over Egypt are recommended to define the Egyptian susceptibility loci for T1D and their relations to the clinical and laboratory findings as an important national programs

Identification and supportive intervention programs of the problems of disabled children

According to International Classification of Diseases-Ninth Revision [ICD-9], neurodevelopmental disorders, asthma and physical disabilities are on the top of child disabilities .The aim of our study was to support families with disabled children and teach them how to deal with different difficulties. The present work was conducted on 85 disabled children [53 males and 32 females], aged 1-12 years allocated into 3 groups. Group 1 [neurodevelopmental group]: 45 patients subdivided into cases of cerebral palsy [CP], mental retardation [MR] and epilepsy [15 patients each].Group 2 [bronchial asthma] included 20 patients. Group 3 [physical disability] involved 20 diabetic children. All disabled children were subjected to thorough history taking, family pedigree, clinical examination and diagnostic investigations .The study was conducted in three steps. The first was a preparatory stage which lasted 6 months, an Initial three months of thorough training and evaluation of medical team and paramedical health providers was followed by an in formative and detailed pilot study which was conducted over the next 3 months .The second step lasted for 6 months and involved weekly visits and applying an in formative and standardized questionnaire to obtain their specific disability problems and to do a thorough family training to manage their problems. The third step [next 6 months]; involved bimonthly visits for assessment, reassessment and correction of the specific solutions taught to the parents. The most common problems encountered among cerebral palsy cases were high risk for injuries defective locomotor function, feeding difficulties and chronic constipation [100%, 73.3%, 40% and 33.3% respectively]. In mental retardation subgroup, the most common problems were delayed growth and development, defective family in formation and support for them and delayed socialization [100%, 73.3% and 46.7% in order]. Among cases of epilepsy we found high risk for injuries and inappropriate diets in 100%and inadequate self confidence in 40% of cases. In bronchial asthma group, most problems were related to: dealing with acute exacerbations [100%], indoor air [60%], molds [40%], and dust mites [35%]. While, among diabetic children, problems were related to insulin regimen and technique of injection, blood glucose monitoring, diet regimen and emotional support. The present work confirmed that well trained parents can improve the problems of their disabled children up to a satisfying extent .Feeding difficulties of CP improved in 66.6% and their defective locomotor function improved markedly in 6.7% and partially in 73.3%. Frequency and severity of bronchial asthma improved in 65%. Attitude of diabetics towards disease improved in 71.4%. Poverty, ignorance, non compliance of parents and presence of mixed types of disability were significant obstacles to our training programs. Hence; improvement of the surrounding environment will decrease the frequency and severity of many problems. Treatment of disabled children is a highly demanding task; it is not just a reflex prescription of medications for complications whenever they occur. Family counseling, team work [psychiatrists physiotherapists, pediatricians, etc.], good communications, improved family knowledge, well trained families and early intervention will ameliorate problems of disabled children. It is recommended to do our best to improve the quality of life of disabled children, to properly teach their parents how to deal with disabilities and to conduct research programs all over of Egypt to precisely establish the real problems and the optimal intervention programs for our disabled children

Heterogeneity and clinical relations of INS-VNTR alleles in Egyptian families of children with type i diabetes mellitus

The currently available data identified IDDMI and IDDM2 as 2 susceptibility loci for type I diabetes [T1D]. The major histocompatibility complex [MHC]/HLA region referred to as IDDMI contains several hundred genes known to have a great influence on T1D risk. Within IDDM2, a minisatellite variable number of tandem repeats [VNTR] locus in the insulin gene [INS] promoter region is likely to represent the etiologic polymorphism. Susceptibility effects of the 3 classes of INS, nature of the interaction of the products of HLA and INS-VNTR, the confounding population substructure and ethnicity are still unresolved issues. The aim of the present work was to study the heterogeneity of INS-VNTR alleles among Egyptian children with T1D and their families and to evaluate the clinical findings associated with different alleles. Twenty-four nuclear Egyptian families with 26 children having TID, aged 2-16 years, and their non-diabetic family members [74] as a control group, aged 1-15 years were studied. All studied children were subjected to: Detailed history and family pedigree. Thorough clinical examination and anthropometric measurements .Laboratory work up of DM including random blood sugar [RBS] and HbA[1]C. Molecular genetics of INS was studied in 4 steps; nucleic acid purification, amplification and genotyping, sequencing and haplotyping using flanking single nucleotide polymorphisms [SNPs] as surrogate markers for minisatellite alleles identification. Analysis of variant repeat distribution among Egyptian families combined with flanking haplotypes revealed that all our diabetic children had class I alleles of INS; 9 had class IC+, 9 had class ID+and 8 had class ID-, while all non-diabetic family members had class III alleles of INS [45 had class IIIA and 29 had class IIIB]. Therefore the 3 class I alleles were considered to be equally predisposing to T1D, while the 2 class III alleles are dominantly protective. It can be assumed that IDDM2 may have a multi-locus etiological basis and that racial differences and developmental plasticity with different phenotypes from a single genotype depending on the early environment are reasonable explanations for differences in between various studies. The present work revealed a markedly high familial occurrence of T1D, mild anemia and increased frequency of urinary tract infection [UTI] among all studied diabetic children. The 3 alleles of INS-VNTR had insignificant relations to demographic, clinical and laboratory variables prevailing among Egyptian children with TID .There was significant positive correlations between body mass index [BMI] and both HbA[1]C and AST liver enzyme among diabetic children with class IC+but not other alleles; indicating that they need close monitoring of their diabetic control and liver functions beside following specific dietary regimens. It can be concluded that all class I alleles [IC+, ID+and ID-] are equally important susceptibility factors for T1D among Egyptian children, while class III alleles [lIlA and 1118] are dominantly protective. It is concluded also that our diabetic children with class IC+are an especially endangered subgroup of diabetics. Genotyping for INS-VNTR alleles is recommended for diabetic children as an important step of diagnostic and follow up regimens and for their non-diabetic family members for family counseling and early identification of potential diabetics. Close monitoring and periodic assessment of diabetic control, anemia, urinary tract infection and liver function is recommended for diabetic children especially those with class IC+alleles. Further studies of INS-VNTR alleles and HLA haplotypes all over Egypt are recommended to define the Egyptian susceptibility loci for TID and their relations to the clinical and laboratory findings as an important national project

Towards an Egyptian guideline from screening to treatment of hepatocellular carcinoma [part I]

These recommendations provide a data-supported and based-evidenced approach to the screening, diagnosis, staging and treatment of Egyptian patients with hepatocellular carcinoma [HCC] in which we tried to construct an Egyptian algorithm for our Egyptian HCC patients in terms of type and timing of surveillance, readily available diagnostic tools that suit our means and the proper and efficient timely treatment that suits our resources. They are based on the experience of the authors in the specified topic and the AASLD Policy on the Development and Use of Practice Guidelines. These recommendations suggest preferred approaches to screening [for early detection of cases with hepatic nodule and/or elevated AFP], diagnosis [for accurate diagnosis of HCC cases], staging [for detection of specific category of treatment according the patient's general condition] and treatment [selection of the most suitable treatment option for the patient after his proper evaluation]. In an attempt to characterize the quality of evidence supported recommendations, the Egyptian Guidelines requires a category to be assigned and reported with each recommendation [Table I]

Towards an Egyptian guideline from screening to treatment of hepatocelhilar carcinoma [part II]

These recommendations provide a data-supported and evidence based approach to the screening, diagnosis, staging and treatment of Egyptian patients with hepatocellular carcinoma [HCC] in which we tried to construct an Egyptian algorithm for our Egyptian HCC patients in terms of type and timing of surveillance, readily available diagnostic tools that suits our means and the proper and efficient timely treatment that suits our resources. They are based on the experience of the authors in the specified topic and the AASLD Policy on the Development and Use of Practice Guidelines. These recommendations suggest preferred approaches to screening [for early detection of cases with hepatic nodule and/or elevated AFP], diagnosis [for accurate diagnosis of HCC cases], staging [for detection of specific category of treatment according the patient's general condition] and treatment [selection of the most suitable treatment option for the patient after his proper evaluation]. In an attempt to characterize the quality of evidence supported recommendations, the Egyptian Guidelines requires a category to be assigned and reported with each recommendation [Table 1]

Value of serum and synovial fluid activin A and inhibin A in some rheumatic diseases

Activin is a growth and differentiation factor of many cell types and has recently been implanted in inflammatory processes. Clinical data demonstrating roles of activin and its antagonist inhibin in inflammatory arthropathies, are lacking. The Study is to measure serum and synovial fluid levels of activin A and inhibin A in patients with rheumatoid arthritis [RA] systemic lupus erythematosus [SLE] and osteoarthritis [OA] and correlate them with disease activity parameters. This study included 60 patients with three rheumatic diseases [20 with RA, 20 with SLE and 20 with OA], as well as ten healthy subjects as a control group. All of them were subjected to complete history, physical and musculoskeletal examination and estimation of disease activity index [DAS- 28] for RA and [SLEDAI] for SLE. The following investigations were done for all subjects; serum and synovial activin A and inhibin A; in addition to complete blood picture, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP],rheumatoid factor [RF], antinuclear antibodies [ANA],anti-dsDNA, serum complement [C 3, 4] and Xrays on affected joints. The mean values of serum activin A were significantly higher in RA, SLE and OA than controls [P<0.001] also in RA and SLE versus OA [P<0.05 for both]. The mean values of serum inhibin A were significantly higher in all studied groups than controls [P<0.05 for RA and OA and P<0.001 for SLE]. Also serum inhibin levels were significantly higher in SLE versus OA P<0.001, but there was no significant differences between RA and SLE. Synovial fluid activin and inhibin A were significantly higher in RA than OA [P<0.05 for both]. Positive correlations were found between serum activin A and disease activity parameters of RA morning stiffness [MS], Ritchie index [RI], ESR, CRP and DAS 28] P<0.05, for all. Also positive correlation was found between serum inhibin A and RI in RA patient [P<0.05]. In SLE, positive correlations were found between serum activin A and inhibin A with ESR [P<0.001 for activin and P<0.05 for inhibin A and SLEDAI [P<0.001 for both activin and inhibin]. No correlation were found between synovial activin and disease activity and negative correlation between synovial inhibin and ESR. The significant increase of serum and synovial activin A and inhibin A in RA and SLE and their positive correlations with disease activity parameters of RA and SLE suggest pro-inflammatory action. However the lack of correlations or negative correlation of their synovial levels with disease activity may indicate their anti inflammatory action, We recommended further studies to detect the exact role of activin A and inhibin A

Effect of leflunomide [avara] drug on the lung of adult male albino rats: a histological and immunohistochemical study

Leflunomide is a newly developed disease-modifying antirheumatic drug. Recently, spontaneous reports of interstitial lung disease in patients treated with leflunomide have been reported. It is unclear whether leflunomide is directly related to the occurrence of such lung toxicity or whether other factors might be involved. This study was carried out to demonstrate the effect of leflunomide on the lung structure and the possibility of recovery after its withdrawal. Thirty adult male albino rats were used and were divided into three main groups [10 animals each]; a control group, leflunomide treated group which received 2 mg/kg body weight of leflunomide orally once daily for 8 weeks, and the third group received the same dose of leflunomide as the second group then the drug was stopped for 4 weeks. Lung specimens were processed for histological study by LM and EM and stained immunohistochemically by caspase-3 antibody for detection of apoptotic cells. In leflunomide treated rats the lung showed significant increase in the thickness of the inter-alveolar septa with mononuclear cellular infiltration associated with alveolar damage and many collapsed alveoli. Significant increase in caspase- 3 positive alveolar cells was detected. Type II pneumocytes were significantly increased in number with increase in the collagen content of the inter-ale veolar septa when compared with the control group. Ultrastructurally, degenerative changes were observed in the alveolar cells in the form of cytoplasamic vacuolation, mitochondrial degeneration and destruction of lamellar bodies. After stoppage of leflunomide treatment, these changes in lung structure showed partial recovery with persistence of lung fibrosis suggesting that the lung toxicity of leflunomide was partially reversible. Leflunomide could induce alveolar damage and pulmonary fibrosis and it is recommended that patients under leflunomide treatment should be regularly examined for early detection of interstitial pneumonitis

Traditional and new approaches in detection of invasive aspergillosis

The increasing incidence of invasive aspergillosis, this life thereatening infection in immunocompromised patients emphasizes the need to improve the current limited diagnostic tools. Invasive techniques are harmful in these cases so we tried in the present study to establish non invasive diagnostic methods to assist clinicians with the diagnosis of invasive Aspergillosis. We used the two new techniques, the nested PCR technique for detection of Aspergillus DNA in blood and the immunoenzymatic assay [ELISA] for detection of galactomonnan antigen in serum using platelia Aspergillus antigen kit. We evaluated their sensitivity and specificity in relation to culture technique of sputum samples for isolation of Aspergillus. Forty patients with underlying different hematological malignancy and forty control subjects were included in our study. Thirteen cases [32.5] were direct examination positive; four of them [10%] were culture positive while the entire control subjects were negative for both. We found that 13 [32.5] of the patient group were PCR positive and 28 [70%] were ELISA positive while in control group 4 [10%] were PCR positive and 2 [5%] were ELISA positive. The diagnostic performance of Aspergillus galactomannan detection and PCR for Aspergillus in comparison to Aspergillus culture showed high sensitivity of both techniques [100%] while their specificity were [89.3%] and [88.2%] respectively. Although the high sensitivity of both new techniques, the use and interpretation of them are yet of some limited value in the diagnosis of invasive aspergillosis in high risk group because of the high positive results. For a better evaluation of both new techniques in the diagnosis of pulmonary aspergillosis, a long-term study with a larger population sample is necessary with involvement of quantitative PCR assay that may give more knowledge about a particular PCR cut-off values and perhaps permitting better distinction between contamination, colonization and infection

Effect of apitherapy on diminishing the incidence, of pneumoenteric infections in buffalo calves

This study was designed to evaluate the prophylactic effect of bee venom apipuncture on diminishing the prevalence of pneumonenteric infections in newly born buffalo calves. During the period of the study which lasted 6 weeks, a marked significant decrease of diarrhea and respiratory infections was observed in the bee venom treated calf group [n = 40] compared to the control group [n = 44]. In the bee venom treated group 17.5% of the calves showed undifferentiated diarrhea, 15% suffered pneumonia while 67.5% of the calves remained healthy in contrast to the control calf group in which prevalence of diarrhea and pneumonia were 29.5% and 18.5% respectively, whereas 45.5% remained healthy. No deaths occurred in the bee venom treated group, on the other hand, three calves died in the control group. The immunological investigation showed an improvement in the immune system as a result of bee venom apipuncture giving maximum antibodies production represented by a significant increase of IgG level. Accordingly we can conclude that bee venom could be used as a novel medication to improve the health condition and immunological status of buffalo calves without producing any side effects or allergic reactions

Serum calcium and magnesium concentrations and therapy for retained placenta of cows

The purpose of the present study was to compare serum calcium and magnesium concentrations in different ages in cows with or without retained placenta [RP] and to evaluate treatment of cows with RP with oxytocin versus oxytocin combined with Cal- Bor- Mag solution. Blood samples were obtained within 12 hours of parturition from different breeds of cows with and without RP [n=38 and 30 respectively]. Serum Ca and Mg concentrations were analyzed by atomic absorption spectrophotometry. 38 cases of RP in different breeds of cows were treated by infusion of either oxytocin dissolved in normal saline solution or oxytocin dissolved in Cal-Bor-Mag solutions. The intervals between parturition and initiation of treatment between 12-24 hours P.P. RP is the failure to expel all or part of the fetal membranes up to 12 hours after parturition. The positive response to the treatment was considered as the expulsion of the entire placenta within 2 hours after infusion. Ca levels in cows with retained placenta were significantly lower than those in the control group [without RP]. Cows in the control group and those with retained placenta were divided into subgroups based on age [3-4, 5-7 years old]. The serum Ca concentration of 3-4 years old cows with retained placenta was significantly higher [p<0.05] than those of 5-7 years old. Serum magnesium levels showed no difference. Sixty percent of the cows treated with oxytocin in Cal-Bor-Mag solution responded positively to the treatment, compared to approximately thirty-nine percent of the cows treated with oxytocin in saline solution [p<0.05]

study of some clinical and biochemical markers of epileptic seizures

The adverse effects of anticonvulsant drugs, duration and expense of therapy and social implications make it essential for accurate discrimination of epileptic from non epileptic seizures [NES]. There is still no single biochemical marker for epileptic seizures and many patients being treated as epileptics are not actually so. Moreover, the coexistence of pseudoseizures with epilepsy is high. Recently few studies had investigated the neuroprotective erythropoietin [EPO] system in the central and peripheral nervous systems. However, the clinical importance of EPO as a specific biochemical marker for epileptic fits is not yet investigated. Sixty children divided into 3 groups were studied. Group I included 20 recently diagnosed epileptics, aged 3.5-15 years. Group II involved 20 children with recent NES, aged 2-14 years. Twenty children suffering fever of unknown origin with lumbar puncture as part of its diagnostic work up, aged 3-15 years represented group III [control group]. All children were suffering no other neurological, hematological or renal diseases. Thorough history, clinical examination and routine investigations, confirmed diagnosis and established exclusion criteria. CT brain, EEG and EMG were done for all patients. Peripheral white blood cells [WBCs], serum creatine kinase [CK] and serum and CSF albumin and erythropoietin [EPO] were measured 24 hours Post-ictally for all patients and on admission of control children. Family history was positive for epilepsy in 20% of epileptic children. Post-ictal symptoms followed more than a half of epileptic seizures and less than a quarter of NES. The most common types of epileptic seizures were generalized tonic-clonic [GTC], generalized tonic [GT], myoclonic then focal seizures. CT brain was normal among most epileptic and all non epileptic patients; with hemorrhage in two epileptics and calcification in only one. EEG showed focal [FEA], generalized [GEA] and multifocal epileptogenic activities [MFEA] among our recent epileptics. Peripheral WBCs, serum CK and CSF levels of EPO showed a significant elevation 24 hours Post-ictally following generalized tonic-clonic epileptic fits and to a lower extent following focal and non epileptic fits. The 3 parameters showed a significant positive correlation with seizure duration. Serum CK levels were markedly elevated [more than 200 U/L] and CSF levels of EPO increased by more than 2 standard deviations in a high percentage of epileptic seizures especially so; GTC seizures, with this marked degree of elevation as a more sensitive factor discriminating epileptic from non epileptic seizures. Post-ictal symptoms, peripheral WBCs, serum CK and CSF levels of EPO are important discriminative factors between epileptic and non epileptic seizures before proceeding to more sophisticated and expensive investigations

study of DNA damage and antioxidant defense in the peripheral leucocytes of diabetic mothers and their newborn infants

Oxidative stress plays a key direct and indirect role in the pathogenesis of several diabetes and pregnancy related complications in both diabetic mothers and their infants. Forty women and their newborn infants divided into two groups were studied. Group I included 20 diabetic women and their newborn infants. Group II consisted of 20 clinically healthy women and their twenty newborns as controls. All involved mothers and newborns were subjected to detailed history, thorough clinical examination, routine laboratory investigations, imaging studies, and specific laboratory investigations including assessment of glycosylated hemoglobin [HbA1C] for diabetic mothers, and erythrocyte antioxidant enzymes [superoxide dismutase, catalase and glutathione peroxidase] and DNA fragmentation assay for mothers and neonates of both groups. It was found that 25% of the diabetic women had diabetic complications. About 1/3 of the newborn infants of diabetic mothers were large for gestational age, 10% of them had major congenital anomalies [cyanotic heart disease and meningomyelocele] and 15% of them died. Levels of erythrocytes glutathione peroxidase and catalase were significantly lower in diabetic mothers and their infants than those in nondiabetic mothers and their infants. DNA damage, mainly in the form of apoptosis was present in diabetic mothers and their infants [60% and 50% respectively]. There was a significant difference between the values of maximal optical density at 200bp and 600bp between both groups. Comparison between diabetic mothers with and without diabetic complications as regards HbA1C, antioxidants and DNA damage showed that erythrocytes catalase was significantly lower in those with complications [means 366 +/- 54 units/g Hb, 426.3 +/- 45.7 units/g Hb respectively] as a possible explanation for complications in this group. There was a significant negative correlation between HbA1C of diabetic mothers [i.e. diabetic control] and glutathione peroxidase level [i.e. antioxidant defense] in their infants. A significant negative correlation was found between DNA damage and erythrocytes antioxidant [Superoxide dismutase in diabetic mothers, and glutathione peroxidase in their infants]. It can be concluded that hyperglycemia causes a significant reduction of antioxidant capacity [reduced catalase and glutathione peroxidase] in the diabetic mothers and their infants compared with controls and this may be the cause of increased DNA damage observed in these individuals which may lead to the development of diabetic complications in the pregnant mothers and congenital anomalies in their infants. It is recommended to maintain a good control of diabetes and combat oxidative stress to lessen diabetic complications in pregnancy and to avoid congenital anomalies

Monocytes expressing tissue factor as a diagnostic marker for neonatal sepsis

In neonatal sepsis, several clinical and laboratory parameters have been proposed for its diagnosis, however, with variable sensitivity and specificity. The bacterial products in sepsis including endotoxin induce the production of proinflammatory cytokines that evoke the expression of tissue factor [TF] on monocytes and endothelial cells. To estimate the percentage of monocytes expressing tissue factor [TF%] by flowcytometry in patients with neonatal sepsis and to delineate its significance to diagnose neonatal sepsis. Twenty-seven neonates with neonatal sepsis and positive blood culture were recruited and evaluated clinically for their risk factors. Laboratory investigations including complete blood picture, C-reactive protein [CRP] and estimation of the monocytes TF expression by flowcytometry were done. Twenty-four normal newborns were included as a control for the laboratory data. The monocytes expressing TF% of the studied patients was significantly higher than that of the controls, p-value = 0.0001. The level of TF% was significantly influenced positively by premature rupture of membrane [PROM], Multiplicity, WBC count, staff/segment ratio, CRP and negatively by gestalional age, body weight, and platelet count. The sensitivity and overall accuracy of the TF% were higher than those of the staff/segment ratio and the WBC count for diagnosing neonatal sepsis. The areas under the receiver operating characteristic curve [AUC] of TF%, staff/segment ratio and WBC count were 0.84, 0.79 and 0.60 respectively, 95% confidence interval]. The monocytes expressing TF% is a promising diagnostic and prognostic marker of infection in neonatal sepsis with high sensitivity and overall accuracy. Adding the estimation of monocytes expressing TF% to the sepsis screen may improve the diagnosis of neonatal sepsis