Serum OX40 ligand: a potential marker of atopic dermatitis disease severity in children

OX40 ligand [OX40L] and OX40 are members of the tumor necrosis factor [TNF] and TNF receptor [TNFR] super families respectively. Recent studies have indicated the critical involvement of OX40/OX40L nteraction in the pathogenesis of atopic dermatitis. To our knowledge, no data could be cited in literature concerning OX40L levels in serum or in other biological fluids of atopic dermatitis children. This study was done to explore the expression of OX40L in the serum of atopic dermatitis children with respect to disease activity and severity. This follow-up, case-control longitudinal study was conducted on 64 children as a stratified non-random sample; 34 with atopic dermatitis and 30 healthy children. Serum concentrations of OX40L were measured by and wich enzyme immunoassay. The severity of atopic dermatitis was assessed according to the Leicester Sign Score [LSS], Simple Scoring System [SSS], Scoring Atopic Dermatitis [SCORAD] index, and Objective SCORAD. Serum OX40L levels [pg/ml] in atopic dermatitis patients were significantly elevated as compared to controls [176.6 +/- 45.9] whether during flare [1007 +/- 241.5] or quiescence [699 +/- 198.5]. There were significant positive correlations between serum OX40L levels and each of the LSS, SSS and SCORAD indices of atopic dermatitis disease severity, while it was insignificant regarding the objective SCORAD. However, when atopic dermatitis children were classified according to the objective SCORAD index of severity into mild, moderate and severe, it was found that the mean serum level in the severe group was significantly higher than the corresponding values of the mild or the moderate group. OX40L levels did not correlate with serum total IgE or absolute eosinophils count. Serum total LDH levels correlated positively with each of the serum OX40L levels and the LSS and SCORAD indices of severity. Serum OX40L level is an objective reliable marker of atopic dermatitis severity in children. It may be useful for follow up and may help to improve research and management of this disease. Blockade of interactions between OX40 on Th2 cells and OX40L on activated dendritic cells using an OX40L-specific monoclonal antibody could represent a novel strategy for the treatment of atopic dermatitis

effects of chewing QAT leaves on psychotic patients

Chewing leaves of the Qat plant [Catha edulis] for their pleasurable central stimulant effect is a habit widespread in the Yemen and certain areas of East Africa. Their use is believed to Cause a variety of central nervous system [CNS] complaints /symptoms. We studied the effects of chewing Qat leaves on psychotic patients. 65 male psychiatric in-patients were recruited in this study. 40 of them were regular Qat chewers and 25 were rare chewers. Also, for purpose of comparison 50 age and weight matched healthy subjects 25 regular and 25 rare Qat chewers, as controls, were included in the study. They were interviewed using a structured questionnaire for assessing the effects of chewing Qat leaves. The study revealed that the prevalence of mood changes in the form of anxiety and/or depression, aggressive and / or hyperactivity behaviour, delusion symptoms and auditory hallucination were significantly higher [P<0.0l] among psychotic patients either regular or rare Qat chewers than those in regular and rare Qat chewing control subjects. This study confirms that Qat chewing can induce elevated mood, aggressive behaviour, delusions and auditory hallucination symptoms among psychotic patients who chew Qat leaves resulting in treatment difficulties. These effects are believed to be caused by the central effects of cathinone in Qat leaves, which is known to have amphetamine like effects

Detection of human papilloma virus DNA in skin tags

Human papilloma virus [HPV] has been suggested to be one of the factors involved in the pathogenesis of skin tags. This study explored the presence of HPV-DNA by polymerase chain reaction [PCR] in biopsies from lesional and perilesional skin of 30 patients and the normal skin of 20 age- and sex-matched control. The results revealed the presence of HPV-DNA in 77% of skin tags, which was statistically significant compared to perilesional skin [53%] and controls [20%]. It was, therefore, concluded that HPV virus has an important role in the pathogenesis and progression of skin tags as previously reported for laryngeal papillomas

Trichomonas vaginalis is not a rare sexually-transmitted disease among Egyptian men

The objective of this work was to determine the etiological role of Trichomonas vaginalis in urethritis among Egyptian men. Urethral swabs were obtained from 90 male patients presenting with urethritis and from 60 patients presenting with sexual dysfunction or infertility as controls. The swabs were examined by wet mount examination, culture on CPLM medium and polymerase chain reaction [PCR] to detect the presence of Trichomonas vaginalis. The results revealed that Trichomonas vaginalis was found in 16.7% of patients with urethritis and in 8.3% among the controls. In conclusion, Trichomonas vaginalis is an important consideration in urethritis among Egyptian men

Is Lupus Miliaris Disseminatus Faciei of Tuberculous or Non-Tuberculous Mycobacterial Origin?

There has been controversy as to the etiology and pathogenesis of lupus miliaris disseminatus faciei [LMDF]. It was thought to be associated with tuberculous or non-tuberculous mycobacteria due to its histopathological similarity. Recently, this association has been doubted. Seven patients with the clinical and histopathological features of LMDF were included in this study. Skin biopsies were obtained from active lesions and were analyzed by polymerase chain reaction [PCR] using pan-mycobacterial and M. tuberculosis complex specific primers to detect the presence of tuberculous and non-tuberculous mycobacteria. No M. tuberculosis complex or non-tuberculous mycobacteria were detected in any of the LMDF patients. In conclusion, no association was present between LMDF and tuberculous or non-tuberculous mycobacteria

Variability of cardiopulmonary response to upper limb exercise after coronary artery bypass grafting

To assess the usefulness of addition of upper limb exercises to the pulmonary rehabilitation program in order to improve the cardiopulmonary function and hand grip strength after undergoing coronary artery bypass grafting CABG. Ten patients who underwent CABG, with age range 47 to 63 years, were chosen randomly from the physical therapy department of the National Heart Institute. They received the routine physiotherapy program including, sustained maximal inspiratory manouver, incentive spirometer and upper limb with hand grip strength training through the first ten postoperative days. The respiratory rate RR, heart rate HR, blood pressure BP, inspiratory capacity IC, arterial oxygen saturation PO[2] hand grip strength HG and rate. pressure product R.PP were measured and calculated pre and postraining [l0[th] postoperative day]. For control purposes, the same variables were measured in 10 age-and sex matched patients at two different times without performing the additional upper limb and hand training. At the end of the tenth postoperative day both groups showed statistically significant difference regarding the measurable variables. Ecxept in the R.PP and HG which did not statistically improved in the control group, unlike the other patients, who were performed upper limb exercies training. On the other hand, there were statisticalIy significant in the study group in all variables [p<0.05] ecxept in the blood presure [p<0.5].Post cardiac surgery exercise increase the lung and cardiac efficiency by decreasing the respiratory rate, heart rate, myocardial oxygen consumption at a given workload and increasing the inspiratory capacity. The addition of upper extremity exercises improve the upper limb and hand grip sterngth as welI which reflect improvement in exercies tolerance of those patients

Brain mapping and level of ammonia in hepatic encephalopathy

This study was conducted on 26 patients suffering from liver cirrhosis. They were divided into two groups. Group I, 11 patients with hepatic encephalopathy [HE] and group II, 15 patients without HE, and 8 persons were served as a control group. They were subjected to routine liver functions, blood urea, serum creatinine, sodium, potassium, blood ammonia and brain mapping. From the results it is concluded that the brain mapping was more sensitive than the ammonia level in detection of HE and correlated significantly with the severity of the case. It is helpful in cirrhotic patients with coma to differentiate between traumatic encephalopathy and a metabolic disorder. Also, patients in class B and C [according to modified Child's classification] should be recommended to avoid driving cars and dangerous jobs such as working in front of machines

Esophageal dysfunction in chronic renal failure patients

Esophageal motility studies were conducted on 48 individuals, 32 of them were patients with chronic renal failure and 16 volunteers as normal controls. Patients with chronic renal failure were divided into 2 groups. Groups A representing chronic renal failure patients on continuous regular haemodialysis [16 patients] and group B representing chronic renal failure patients on conservative therapy [16 patients]. Significant motility disorders were found in patients of group A and B when compared to the control group. But these motality disorders were more evident in group B regarding the decrease in the resting pressure of the lower esophageal sphincter, while in group A there was more evident decrease of the esophageal sphincter while in group A there was more evident decrease of the esophageal body pressure in both pressure in both the resting and contraction states. Patients on haemodialysis had esophageal body motility disorders in the from of decrease in resting pressure frequent secondary and tertialy contraction waves and spontaneous non propulsive contraction

Value of serum alpha-1-antitrypsin and alpha fetoprotein in the diagnosis of Hepatocellular Carcinoma in cirrhotic patients

Biochemical tumor markers have attracted more and more attention in the diagnosis of malignant diseases. Searching for a new marker useful in the initial diagnosis, staging, and monitoring of hepatocellular carcinoma [HCC] is the focus of many recent studies. This study was carried out to clarify the value of assay of alpha fetoprotein [AFP] and alpha-1-antitrypsin [AAT] for the diagnosis of HCC. Also to evaluate potential benefits of combined assay of AFP and AAT. The study was carried out on three groups; Group [1], consisted of 15 healthy persons, Group [2], consisted of 30 patients with liver cirrhosis [LC] and Group [3], that consisted of 30 patients with HCC, all on top of LC. As regards AFP, sensitivity, specificity, positive predictive value, negative predictive value, and total accuracy were found to be 56.67 percent, 90 percent, 67.5 percent and 73.33 percent respectively in diagnosing HCC in cirrhotic patients. Regarding AAT, these figures were found to be 53.33 percent, 90 percent, 84.2 percent, 65.85 percent, and 71.67 percent respectively in diagnosing HCC. Combined assay of AFP and AAT had raised the total accuracy to 83.33 percent and the sensitivity to 86.67 percent

study of serum magnesium and calcium in Egyptian diabetics

Serum magnesium [Mg] and serum calcium [Ca] were measured by spectrophotometery in 10 healthy volunteers, 10 patients with insulin-dependent diabetes mellitus [IDDM], 20 patients with non-insulin-dependent diabetes mellitus [NIDDM] treated with insulin and 20 NIDDM patients treated with oral hypoglycemics and finally 10 newly diagnosed NIDDM patients [

Ascitic fluid cholesterol in malignant ascites a tumor marker and diagnostic tool

The present study was undertaken to evaluate the use of ascitic fluid cholesterol determination in the differentiation between malignant and cirrhotic ascites. Again, the aim of our study was to further illustrate the value of estimating serum-ascites albumin gradient in differentiating ascites due to cirrhosis from that due to malignancy. This study was carried out on two groups of ascitic patients, the first with cirrhotic ascites and included 13 patients, the second with malignant ascites and included 19 patients. Ascitic fluid cholesterol level was found to be significantly higher in malignant group than in cirrhotic group. Ascitic fluid cholesterol above 48 mg percent was found to have high sensitivity [77.81 percent], high specificity [92.85 percent] and to have the highest diagnostic accuracy [84.37 percent] among all chemical tests used for diagnosis of malignant ascites [namely total proteins; LDH and s-a albumin difference. In evaluating the serum ascites albumin difference, it was found to be significantly lower in malignant than cirrhotic group [P < 0.01]. The diagnostic accuracy with s-a albumin difference < 1.1 gm percent was higher than that with total proteins >3 gm percent. Pare et al, 1983 reported that s-a Albumin was a useful tool in differentiating ascites due cirrhosis from that due to malignancy. Hoef [1981 b] reported stability of the gradient during diuresis

value of ascitic fluid fibronectin in the differentiation of malignant and cirrhotic ascites

The differentiation of malignant and cirrhotic ascites is of considerable importance for further diagnostic and therapeutic approaches. This work was carried out to evaluate the use of ascitic fluid firbronectin concentration to differentiate between malignant and cirrhotic ascites in comparison with two conventional tests namely: ascitic fluid total proteins and ascitic fluid LDH. Eighteen patients with malignant ascites and fourteen patients with cirrhotic ascites were included in this work. Ascitic fluid samples were subjected to the following tests: culture and sensitivity, cytologlc examination, total proteins, LDH, and firbronectin concentration using radial immunodiffusion technique. Total proteins, LDH and firbronectin showed significant differences between both groups with firbronectin having higher diagnostic accuracy than total proteins and LDH