Prevalence of tobacco usage and its effect on the periodontal health parameters in the mining employees and the general population - A comparative study

Objective: Comparison of the prevalence of usage of tobacco products and its effect on the periodontal health parameters of the mining laborers and the general population of Udaipur city, India. Materials and methods: the cross sectional study was performed on the sample of 980 adults including 500 mining employees and 480 subjects from the general population. The presence or absence of the tobacco products usage was noted. The ADA type III examination using the community periodontal probe was done. The data obtained was subjected to chi-square and Cramer' v statistical analysis. Results: 79.40% of the mining-employees and 61.67% of the general population used different tobacco products, the difference noted was statistically significant (p=0.000). The most common periodontal condition amongst the mining employees and the general population was the presence of calculus (39% and 35.63% respectively) followed by the 4-5mm periodontal probing depth (29.20% and 26.04% respectively). The difference spotted was significant (p=0.018). There was statistically significant difference between the tobacco users and non- users for the different periodontal conditions (p=0.000). Conclusion: the tobacco product usage was high in mining employees group. There was a positive correlation between the usage of tobacco products and the periodontal health parameters (AU)

Comparison between FEV1/FEV6 and FEV1/FVC as screening of chronic obstructive pulmonary disease

Objective: To compare FEV1/FEV6 to the standard spirometry (FEV1/FVC) as a screening tool for COPD. Methods: This cross-sectional study was conducted at Hospital Tuanku Fauziah, Perlis, Malaysia from August 2015 to April 2016. FEV1/FEV6 and FEV1/FVC results of 117 subjects were analysed. Demographic data and spirometric variables were tabulated. A scatter plot graph with Spearman’s correlation was constructed for the correlation between FEV1/FEV6 and FEV1/FVC. The sensitivity, specificity, positive and negative predictive values of FEV1/FEV6 were determined with reference to the gold standard of FEV1/FVC ratio <0.70. Receiver-operator characteristic (ROC) curve analysis and Kappa statistics were used to determine the FEV1/FEV6 ratio in predicting an FEV1/FVC ratio <0.70. Results: Spearman’s correlation with r = 0.636 (P<0.001) was demonstrated. The area under the ROC curve was 0.862 (95% confidence interval [CI]: 0.779 - 0.944, P<0.001). The FEV1/FEV6 cut-off with the greatest sum of sensitivity and specificity was 0.75. FEV1/FEV6 sensitivity, specificity, positive and negative predictive values were 93.02%, 67.74%, 88.89% and 77.78% respectively. There was substantial agreement between the two diagnostic cut-offs (κ = 0.634; 95% CI: 0.471 - 0.797, P<0.001) Conclusions: The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for screening of COPD. Larger multicentre study and better education on spirometric techniques can validate similar study outcome and establish reference values appropriate to the population being studied.

Safety and outcome of treatment of metastatic melanoma using 3-bromopyruvate: a concise literature review and case study / 癌症

3-Bromopyruvate (3BP) is a new, promising anticancer alkylating agent with several notable functions. In addition to inhibiting key glycolysis enzymes including hexokinase II and lactate dehydrogenase (LDH), 3BP also selectively inhibits mitochondrial oxidative phosphorylation, angiogenesis, and energy production in cancer cells. Moreover, 3BP induces hydrogen peroxide generation in cancer cells (oxidative stress effect) and competes with the LDH substrates pyruvate and lactate. There is only one published human clinical study showing that 3BP was effective in treating fibrolamellar hepatocellular carcinoma. LDH is a good measure for tumor evaluation and predicts the outcome of treatment better than the presence of a residual tumor mass. According to the Warburg effect, LDH is responsible for lactate synthesis, which facilitates cancer cell survival, progression, aggressiveness, metastasis, and angiogenesis. Lactate produced through LDH activity fuels aerobic cell populations inside tumors via metabolic symbiosis. In melanoma, the most deadly skin cancer, 3BP induced necrotic cell death in sensitive cells, whereas high glutathione (GSH) content made other melanoma cells resistant to 3BP. Concurrent use of a GSH depletor with 3BP killed resistant melanoma cells. Survival of melanoma patients was inversely associated with high serum LDH levels, which was reported to be highly predictive of melanoma treatment in randomized clinical trials. Here, we report a 28-year-old man presented with stage IV metastatic melanoma affecting the back, left pleura, and lung. The disease caused total destruction of the left lung and a high serum LDH level (4,283 U/L). After ethics committee approval and written patient consent, the patient received 3BP intravenous infusions (1-2.2 mg/kg), but the anticancer effect was minimal as indicated by a high serum LDH level. This may have been due to high tumor GSH content. On combining oral paracetamol, which depletes tumor GSH, with 3BP treatment, serum LDH level dropped maximally. Although a slow intravenous infusion of 3BP appeared to have minimal cytotoxicity, its anticancer efficacy via this delivery method was low. This was possibly due to high tumor GSH content, which was increased after concurrent use of the GSH depletor paracetamol. If the anticancer effectiveness of 3BP is less than expected, the combination with paracetamol may be needed to sensitize cancer cells to 3BP-induced effects.

Unsafe injection practices in Hodeidah governorate, Yemen

Unsafe injection practices are a major public health problem and can lead to the transmission of blood borne pathogens, including hepatitis B virus [HBV], hepatitis C virus [HCV] and human immunodeficiency virus [HIV]. The present study was conducted to determine the nature and magnitude of unsafe injection practices in healthcare facilities in Hodeidah governorate, Yemen. The study was conducted in two hospitals and a representative sample of the governorate's health centers. A total of 1600 injections were observed in these facilities. This study revealed several unsafe practices, particularly the recapping of needles after use, which occurred in 61.1% and 36.8% of the observations in the hospitals and the health centers, respectively. This study showed that most healthcare workers [HCWs] followed the proper injection protocols but performed some procedures that exposed themselves and the community to the risk of needlestick injuries [NSIs] and blood borne infections

Antibacterial activity of selected Egyptian ethnomedicinal plants

Aims: Medicinal plants have recently received the attention of the antimicrobial activity of plants and their metabolites due to the challenge of growing incidences of drug-resistant pathogens. The aims of this study were to determine the antibacterial activities of plant extracts used as ethnomedicinal in Egypt. Methodology and Results: Investigations were carried out to assess the antibacterial efficiency of 11 plant extracts used as ethnopharmacological among Egyptian native people against infectious diseases. Crude methanol, ethanol, chloroform, hexane, acetone and aqueous extract of plants were tested for antibacterial activity in vitro against ten bacterial isolates using the disc diffusion method test. Discs were impregnated with 2 mg/mL of different solvent extracts. Among all the crude extracts, the methanol extract showed the highest activity than other extracts. P. harmala and S. officinalis exhibited highest antibacterial activity against gram positive and negative bacteria while the remaining plants extracts showed less activity. All the plant extracts showed no significant effect against the Bordetella bronchisepta ATCC 4617 except the extracts of M. fragrans and L. sativum. E. coli is the most sensitive microorganism tested, with the lowest MIC value (0.5 mg/mL) in the presence of the plant extract of P. harmala and S. officinalis. Conclusion, significance and impact of study: Results obtained herein, may suggest that the ethnomedicinal Egyptian plants possess antimicrobial activity and therefore, they can be used in biotechnological fields as natural preservative ingredients in food and/or pharmaceutical industry.

Intestinal Bacterial Flora that Compete on the Haem Precursor Iron Fumarate in Iron Deficiency Anemia Cases

Aims: The study focused on finding if there is any possible relation between the intestinal bacterial population quantitative and qualitative and the deficiency of the most important iron compounds as haem precursors. Methodology and Results: Blood complete picture and stool analyses were done to 750 volunteer cases whom were asked for these analyses by their physicians. Analyses proved that 560 cases representing 75.2 % were anemic as the RBC(s) based on counts of the total studied cases of less than 263 x 104 and the haemoglobin amount ranged between 7.2 and 11.3 g/dl, while the remainder 24.8 % of the volunteer sample was not anemic. A high male/female ratio of anemic cases, 1:27 was also documented. Considering that all the studied stool samples should be completely free from any parasites or any other anemia-related diseases was a priority. Bacteriological analysis of stool samples of the anemic cases resulted in the detection of high counts of total viable bacteria, exceeded 42 x 109 cfu/g, while it was never more than 26 x 106 cfu/g and decreased to 4 x 106 cfu/g in many cases in this study. Identifying of the 361 bacterial isolates, were found to belong to 12 genera and 19 species, 6 of them; Pseudomonas putrefaciens, Micrococcus luteus, Erysipelothrix rhusiopathiae, Bacillus megaterium, Bacillus pumilus and Bacillus coagulans , were found and in high counts in the stool samples of only anemic cases. The ability of these isolates to compete for iron compounds such as ferrous fumarate alone or with glucose and phytate as activators or inhibitors to these abilities was investigated. Results proved 11 species out of the 19 identified species are capable to use and compete on ferrous fumarate as a haem precursor. Sensitivity test for the representatives of the 19 species and 6 of the most commonly used antibiotics in the Egyptian pharmacy, using standard disc method, revealed variable susceptibilities of almost all of them to more than one of the studied antibiotics, except Corynebacterium equatium, which was found very resistant to two antibiotics; colistin sulfate and erythrocin. Conclusion, significance and impact of study: The study finally concluded the strong role of intestinal bacterial counts and types as competitors on the haem precursor iron-containing compounds like ferrous fumarate.

Compromising bradycardia: management in the Emergency Department of National Heart Institute

The need to treat bradycardias is dictated primarily by the clinical Presentation of the patient [1]. Bradycardia may bean incidental finding in asymptornatic patients [2]. On the other hand, bradycardia may present with haemodynamic instability and loss of consciousness [3]. Out of the bradycardic rhythms to be encountered in these patients, high grade atrioventricular-block represents a significant portion [4]. Compromising bradycardia requires an effective diagnostic and therapeutic approach [1]. The goal of initial management is stabilization by increase of the ventricular rate by both pharmacological and non-pharmacological interventions, sometimes even cardiopulmonary resuscitation is required [5]. A careful clinical workup for potential causes, including ischacmic and non-ischaemic aetiologies, is crucial for successful management [6]. There are only a few reports available on the management and outcome of patients presenting with compromising bradycardia to the emergency department [ED] [1]. This study include 210 consecutive patients, with compromising bradycardia, admitted to the emergency department of National Heart Institute [tertiary Care hospital] within eight month period, 107 patients [51%] females, 103 patients [49%] males, whose age ranged from 25 to 89 years. The aim of this study is to report the incidence, symptoms, presenting rhythm, underlying mechanism, management, and outcome of patients presenting with compromising bradycardia to the emergency department and to assess the incidence of patients in need for temporary and permanent pacing. All patients were subjected to full history taking, general and local cardiac examination, resting 12-leads ECG and routine laboratory investigation

Clinical predictors and outcomes associated with acute return of pulmonary vein conduction during pulmonary vein isolation for treatment of atrial fibrillation

Radiofrequency ablation has become a common trend in management of cases of AF refractory to medical treatment. Recurrence of AF is a common observation both acutely and late during follow up. To determine the clinical predictors of acute reconnection of pulmonary vein potentials during PVI and late recurrence of AF on follow-up, respectively. A cohort of 14 patients referred to the EP labs of the NHI and Ain Shams University for PVI between January 2007 and February 2008 were studied. PVI of arrhythmogenic PVs was performed segmentally. PVI was defined as entry and exit block using a multipolar Lasso catheter. All veins were resampled to confirm isolation after 20-60niinutes. There were 14 patients who underwent isolation of 56 pulmonary veins during the study period. Acute reconnection of at least one vein occurred in 7 patients [50%] and 10 of the 56 pulmonary veins targeted [18%]. The left superior PV was most likely to acutely recover conduction compared with the other veins. Predictors of acute reconnection could not be accounted for given possible technical difficulties and the small sample size. During the three month follow up period, recurrence of AF occurred in 3 patients representing 21.4% of the cohort. It was found to be higher in female gender, left atrial size>or equal 4.Scms, age older than 50 years, non-paroxysmal type of AF and an EF of less than 50%. Many clinical criteria can affect acute reconnection of PVPs during PVI for patients with AF. According to previous studies large left atrium, older age, hypertension, non-paroxysmal type of AF are the most likely acute predictors. As regards short term follow-up, factors that could be considered include gender, age, left atrial size, EF and type of AF. The importance of detection of acute recurrence of PVPs and re-isolation has also become evident through this study

High frequency of alteration in PTEN expression in Egyptian patients with urinary bladder cancer

PTEN is a tumor suppressor gene which is involved in the pathogenesis of multiple cancers including urinary bladder cancer. Recent experimental evidence suggests that PTEN could be utilized as an effective targeted therapy. The aim of this study was to determine the frequency of PTEN alteration in Egyptian patients with urinary bladder cancer and to investigate potential role of PTEN in the pathogenesis of this tumor. We examined PTEN expression using immunohistochemistry in 19 unselected sporadic primary urinary bladder cancers from Egyptian patients. Of the 19 tumors, 6 [32%] showed no PTEN immunostaining, 9 [47%] showed weak or partial staining and the remaining 4 [21%] showed staining similar to the normal internal controls. The strength of immunostaining correlated with tumor grade with higher grade tumors showing more prominent PTEN loss. This study indicates the high frequency of PTEN alteration in urinary bladder cancer from Egyptian patients. The results of this study also suggest that PTEN is involved in the progression of these tumors. Finally these results may suggest the utility of PTEN as a potential target for therapy of urinary bladder cancers in Egyptian patients

Melatonin, the hormone of the pineal body: its role as an endogenous biological marker in major depression and breast cancer

The present study was designed to assess the relation of melatonin to two important pathological conditions namely; major depression [MD] and breast cancer [BC], with the intention of evaluating its role as an endogenous biological marker of both conditions and its potential clinical significance in follow-up of such cases. For this purposes 50 female patients with major depression [20 patients before treatment and 30 patients under treatment] in addition to 73 female patients with breast cancer [28 in stages I and II : early BC; 25 in stages III and IV late BC and 20 after radical mastectomy] were chosen for assessment of the serum melatonin levels. Nocturnal blood samples were collected from the MD group. whereas morning samples were collected from the BC group. Results were compared to those of an age-matched control group consisting of 20 healthy females. Nocturnal serum melatonin levels were significantly decreased in MD patients before the start of therapy as compared to the control group [P < 0.0001]. Meanwhile, the results of patients under antidepressant therapy [monoamine oxidase inhibitors and tricyclic antidepressants] showed no significant difference from the control group [P>0.05]. In cases of cancer breast, morning serum melatonin levels were significantly decreased in the early stages of the disease [P<0.0001], but became significantly elevated with progress of cancer and the occurrence of metastasis [P<0.0001]. Following radical mastectomy, the level of melatonin was insignificantly different from the control group [P >0.05]. Hence, we can conclude that decreased nocturnal melatonin could be considered an endogenous marker of major depressive illness, with such a decrease being masked by antidepressant therapy. Meanwhile, morning melatonin levels are of value in assessment and staging of breast cancer as well as post-operative follow-up of these patients. hopefully, aiming at early detection of recurrence