Incidence of influenza virus-associated severe acute respiratory infection in Damanhour district, Egypt, 2013

The epidemiology, seasonality and risk factors for influenza virus infection remains poorly defined in countries such as Egypt. Between 1 January and 31 December 2013, we used surveillance data on patients hospitalized with severe acute respiratory infection in three Egyptian government hospitals in Damanhour district to estimate the incidence rate of laboratory-confirmed seasonal influenza. Samples were taken from 1727 of 1856 patients; of these, 19% were influenza virus positive. The overall incidence of influenza virus-associated SARI during the study period was estimated to be 44 cases per 100 000 person-years [95% CI: 39-48]. The highest incidence of 166 cases per 100 000 person year [95% CI: 125-220] was observed in children aged 2 to 4 years. The incidence of influenza-virus associated SARI cases in pregnant women was estimated to be 17.3 cases per 100 000 person-years [95% CI: 6-54]. Majority of influenza virus-associated SARI occurred in autumn and early winter, and influenza A[H3N2] virus predominated. This was the first ever description of the epidemiology of seasonal influenza in Egypt. However, additional works are needed for greater understanding of influenza burden in Egypt

Influenza virus positivity and circulating subtypes among cases of influenza-like illness and severe acute respiratory infection, Egypt, 2012-2015

Information on the prevalence of influenza, circulating virus subtypes and seasonality is essential for selecting strains for annual vaccines and for planning immunization programmes. Data were obtained from the 13 sentinel surveillance sites throughout Egypt during 2012-2015. Laboratory-confirmed influenza was found in 13% of cases of influenza-like illness [ILI] and 18% of cases of severe acute respiratory infection [SARI]; positivity for influenza was similar in cases of ILI and SARI in patients up to 15 years of age but increased for SARI and decreased for ILI in people aged >/- 15 years . The most commonly observed influenza virus subtypes were B followed by A/H3 in ILI cases, and A/H1N1 followed by B in SARI cases. The seasonality of influenza in ILI cases was November-February, and that in SARI cases was November-March, peaking in January

Control of malaria outbreak due to Plasmodium vivax in Aswan governorate, Egypt

In 2014, after several years of maintaining zero malaria indigenous cases, Egypt had an outbreak of Plasmodium vivax: 21 confirmed cases during May-June 2014. In response to the outbreak, the Ministry of Health and Population [MoHP] launched an emergency response through early detection and prompt treatment of cases, vector control, public education and intersectoral collaboration. Twenty cases [95.2%] were residents of El-Sheikh Mostafa village, Edfu district, Aswan governorate, southern Egypt. All cases, consequent to the index case were identified through house-to-house surveillance visits. One P. falciparum-infected case was also identified in the same village. Treatment of all infected cases was initiated following laboratory confirmation. The MoHP's rapid response to and containment of the outbreak demonstrates the institutional capacity for detection and control of outbreaks which can occur after elimination

Highlights and conclusions from the Eastern Mediterranean Public Health Network [EMPHNET] Conference 2011

As a follow up of a short communication that the Eastern Mediterranean Health Journal published in December 2011, this article reports on highlights and conclusions from scientific abstracts, methodology workshops and plenary sessions that were presented as part of the Eastern Mediterranean Public Health Network [EMPHNET] conference held from 6 to 9 December 2011 in Sharm Al Sheikh, Egypt

Sjogren syndrome and fibromyalgia after radioiodine therapy in cancer thyroid patients

Salivary and lacrimal gland dysfunction is relatively frequent after radioiodine therapy. An association of Sjogren's syndrome [SS] and other autoimmune rheumatic diseases as fibromyalgia syndrome [FMS] has been reported. Thyroid autoimmunity in FMS patients is higher than normal subjects. To detect the occurrence of Sjogren syndrome [SS] and any rheumatologic association in cancer thyroid patients after radioactive iodine therapy [I -131] and evaluate the salivary and lacrimal glands function. Thirty-one patients with post-surgical differentiated thyroid carcinomas with a mean age 40.13 +/- 9.82 years, were referred for I-131 therapy [mean dose 212.9 +/- 101.63 mCi] and continued the follow-up study. All patients had no symptoms or signs of SS. Thorough rheumatological examination was performed for any musculoskeletal manifestation or associated fibromyalgia syndrome [FMS]. Before and 8-12 months after I-131 therapy, salivary glands function was estimated by sequential scintigraphy, while lacrimal gland function was assessed by Schirmer's test. Antinuclear antibody [ANA], anti-Ro [SS-A], anti-La [SS-B] and rheumatoid factor [RF] were performed. All patients had a normal salivary glands scintigraphy and Schirmer's test before I-131 therapy. On follow up, primary SS occurred in 8 patients [25.81%] while a significant decrease in salivary function occurred in 18 [58.1%] patients and significantly correlated with the I-131 dose. Schirmer's test was significantly abnormal in those with SS. Serum Anti Ro and Anti La levels became significantly higher in SS patients [18.25 +/- 11.61 and 25 +/- 13.06 U/ml] compared to the others [6.57 +/- 1.8 and 7.35 +/- 1.8 U/ml], respectively, [p 0.025 and 0.006]. Fibromyalgia syndrome was present in 12 patients [38.71%] and 6 of them developed SS. Assessment and follow up of salivary and lacrimal glands function is essential in patients receiving radioiodine therapy. Abnormal level of anti-Ro and Anti-La increase the risk for SS that should be closely monitored and fibromyalgia is a common association

Sentinel surveillance for patients with acute hepatitis in Egypt, 2001-04

Viral hepatitis is a major problem in Egypt. To define the epidemiology of the disease, sentinel surveillance was established in 5 hospitals in diverse areas of the country in 2001. Data were completed for patients meeting the case definition for viral hepatitis. Of a total of 5909 patients evaluated, 4189 [70.9%] showed positive antibody markers for hepatitis. Out of those, 40.2% had evidence of hepatitis A virus [HAV] infection, 30.0% hepatitis B virus [HBV] and 29.8% hepatitis C virus [HCV] infection. This surveillance system was useful in identifying the variable endemicity of acute HAV infection in different regions and for better understanding the epidemiology of HBV and HCV infection

Injection prescribing patterns in public health care facilities in Egypt

This study assessed the frequency of and rationale for use of injections at health care facilities in Egypt based on WHO core drug use indicators. We reviewed 1406 prescriptions in 43 randomly selected hospitals and primary health care clinics in 2 governorates in Upper and Lower Egypt in 2001. Patients received an injection at 18.1% of encounters. The most frequently prescribed parenteral drugs were anti-infectives [56.9% of injections] and analgesics [13.7%]. Injections were more often prescribed in hospitals than in primary health care clinics and in rural than in urban settings. Most injections [94.7%] could have been replaced by a suitable oral preparation. Further efforts are needed to enforce the essential medicines programme in Egypt to improve rational drug prescribing

Thyroid uptake versus thyroid salivary ratios: which is more reliable for post-operative thyroid functional assessment in patients with recurrent hyperthyroidism?

Tc-99m pertechnetate thyroid uptake has been introduced as a useful adjunct to measurement of hormonal levels in patients with recurrent hyperthyroidism after surgery for toxic goiter. A crude but relatively accurate estimate of thyroid function can be obtained by comparing thyroid to salivary gland activity at 20 minutes. We aimed in the current study to assess the value of Tc-99m pertechnetate thyroid uptake [TU] and thyroid-salivary ratios [both thyroid/salivary ratio: TSR and salivary/thyroid ratio; STR] in diagnosis of post-operative recurrent hyper-functioning thyroid tissue. The current study included 114 patients presented for thyroid scintigraphy 3-9 months post subtotal thyroidectomy for toxic goiter [73 Grave's disease and 41 toxic nodular goiter]. Ten patients proved to have hypothyroidism were excluded from the study. All patients were subjected to clinical history and examination, thyroid hormonal profile, Tc-99m pertechnetate thyroid scan with calculation of TU, TSR and STR 20mjn after injection of the radiotracer. Thyroid uptake per unit weight of residual thyroid tissue was also calculated. TU value was considered normal if it is in the range of 0.3 to 3.75%.According to thyroid hormonal profile, patients were divided into two main groups, Group 1: Included 25 patients with hyperthyroid state. The mean value of TU was 10.2%. The mean value of TSR and STR were 11.75 and 11.1%. Twenty-three patients had both indices pointing to hyperthyroidism. The sensitivity of the thyroid uptake value for diagnosis of hyperthyroidism in this group of patients was 68%, while the sensitivity for both TSR and STR was 92%, with a statistically significant difference between both figures [p<0.001]. Group 2: Included the remaining 79 patients with normal thyroid hormonal profile. Their mean uptake value was 1.58%, while the mean value of TSR and STR were 2.5% and 57%. All patients in this group had normal thyroid uptake level. The specificity of TU for diagnosis of recurrent hyperthyroidism was 100%. versus 97.5% for both TSR and STR. The mean thyroid uptake per unit weight of residual thyroid tissue in group 2 was 6.4, which is significantly less than that reported for group 1 [19.5%] [p<0.001]. Thyroid uptake value has lower sensitivity [68%] than thyroid salivary ratios [TSR and STR] [92%] in diagnosis of post-operative recurrent hyperthyroidism with comparable specificity. So, TSR and STR are more reliable than Tc-99m pertechnetate TU in diagnosis of recurrent hyperthyroidism post operatively and may be applied in this group of patients for assessment of the functional status of residual thyroid tissue. Thyroid uptake per unit weight of remaining thyroid tissue is significantly higher for recurrent toxic state compared to euthyroid state; this may represent a new useful functional index, warranting further randomized study on much larger number of patients to verify its exact value

Myocardial perfusion scintigraphy [Gated-SPECT] and coronary disease risk factors in Behcet's disease with metabolic syndrome

Behcet's disease [BD] is a multi-system vasculitis that can have a wide range of effects on the cardiovascular system. To determine the existence of myocardial perfusion defects caused by coronary microvascular dysfunction in asymptomatic BD patients with and with out metabolic syndrome and to evaluate coronary arterial distribution and left ventricular systolic function by gated single-photon emission computed tomography [G-SPECT]. The study population consisted of 20 [17 men and 3 women] patients with BD and 20 healthy controls of age and sex match. Technetium-99m methoxyisobutylisonitrile [Tc-99m MIBI] gated SPECT studies were performed using a 1-day rest-stress protocol. Stress and rest left ventricular ejection fraction [LVEF] were calculated. Using gated SPECT images myocardial perfusion scores [summed stress score [SSS], summed rest score [SRS] and summed difference score [SDS]] were determined. Echocardiography was performed for comparison. Carotid intima-media thickness [1MT] was recorded to detect the macrovascular involvement in BD and to detect if there is any possible correlation with the microvascular myocardial affection. Abnormal myocardial perfusion scintigraphy [MRS] was detected in 15 patients [2 with infarction, 13 with perfusion defects], 5 patients had normal perfusion pattern. Scmiquantitative scores [SSS, SRS and SDS] were significantly higher in the BD patients compared to control [p 0.000]. There was a statistically significant difference between BD patients and control regarding the carotid artery IMT by ultrasonography being increased in the patients. On the other hand, the G-SPECT and echocardiographic LVEF was significantly lower in the BD patients [p 0.001 and p 0.002 respectively]. On comparing the results of the BD patients with and without metabolic syndrome, the studied parameters for coronary risk factors as blood pressure, cholesterol, triglycerides and fasting blood sugar they were significantly higher in the metabolic syndrome group. On the other hand, the HDE was significantly lower in the metabolic syndrome group. Both the disease activity [BDCAF] and the myocardial perfusion gated SPECT [SSS] were significantly higher in those BD patients with metabolic syndrome [p 0.03]. On the contrary, the differences in results of the carotid artery IMT and the echocardiographic LVEF% in BD patients with and without metabolic syndrome did not reach significance. There was a tendency to increased disease duration in BD patients with more severe myocardial perfusion defect. The difference was only significant between patients with perfusion defect and those with old myocardial infarction involving the antero-septal wall [p 0.04]. There was a statistically significant difference among the three myocardial perfusion scan subgroups as regards the level of triglycerides, systolic and diastolic blood pressure [p 0.29, 0.38, 0.13 respectively]. The CRP level was higher in the infarct patients followed by the defective perfusion. A significant difference was only found when comparing the level of those with history of infarction [severe ischemia] with those with normal myocardial perfusion scan [p 0.047]. On comparing the carotid artery IMT, echocardiographic LVEF%, and myocardial perfusion G-SPECT parameters, they were all significantly different among BD patients with infarction, defective and normal myocardial perfusion. A significant positive correlation was present between the SRS and the disease duration [p 0.04]. CRP significantly correlated with both the SSS and SDS [p 0.04 and 0.00 respectively]. Furthermore, the SSS and SRS significantly correlated with the blood pressure, triglycerides and cholesterol levels. The BDCAF significantly correlated with the SSS and SDS [p 0.009 and 0.007 respectively]. Carotid artery IMT significantly correlated only with SRS [0.02]. However, the echocardiographic LVEF% significantly correlated with all the myocardial perfusion gated SPECT parameters. Myocardial perfusion and function are disturbed owing to influenced coronary microvascularity in BD with silent myocardial ischemia [SMI]. Gated SPECT is a non-invasive more reliable method compared to echocardiography that simultaneously evaluates the existence, extent and severity of myocardial ischemia or infarction in cardio-Behcet. Myocardial perfusion defects increase with increased disease activity and carotid artery IMT. Metabolic syndrome risk factors account for an augmented perfusion defect and should be considered a high risk group in BD patients

Body mass index and adiposity of Egyptian infants and preschools

Body mass index [BMI] is widely used to assess childhood obesity, and to infer risk of subsequent obesity-related disease. The present study aims to examine:1] age-and gender-reared patterns in BMI and the body fat component throughout infancy and preschool childhood periods 2] correlations between BMI and total body fat mass and fat percentage 3] hypothesis that BMI is valid gender-specific measure of fatness that is dependant/or independent on age in a pediatric population. It was a cross-sectional study of 410 healthy, Egyptian infants and 512 preschool children of both genders, aged from 1 month to 5 years. Anthropometric assessment; body weigh and length/ height; was performed. Body mass index [BMI] [[Weigh in kg/Height in m2]] was calculated. Each child was examined by the bioelectrical impedance apparatus [BMI]] to measure the total body fat mass body fat percentage. Results show progressive increase in BMI, total body fat mass and body fat percentage with age in both boys and girls. BMI is more strongly associated with total body fat mass than with body fat percentage for both genders. The association between BMI and total body fat mass in both genders found to be dependent on the age across the first two years of life, then become consistent across age range 3-5 years. While, the association between BMI and body fat percentage is weaker in infancy than preschools and independent on the age for both sexes. The study concludes that, BMI appears to serve a surrogate marker for total body fat mass of preschool children and with considering the exact age during infancy period. The study recommends that Egyptian gender-and age- specific BMI cutoffs for defining children's overweight and obesity are needed

Percentiles of blood pressure of Egyptian children and adolescents [3-17 years]

Blood pressure [BP] percentiles for Egyptian children and adolescents provide representative Egyptian BP levels and their use may be essential. The present study aimed to determine and describe levels of systolic blood pressure [SBP] and diastolic blood pressure [DBP] across age and gender of 22,072 healthy children and adolescents to drive reference percentiles for BP of Egyptian children and adolescents. It also aimed to assess the association between age, sex, height and BMI with BP in healthy Egyptian children and adolescents. The study is a cross-sectional one, including 22,072 healthy Egyptian children and adolescents [10997 boys and 11075 girls] at age range of 3 to 17 years from nurseries and private schools in Cairo and Giza Governorates. A questionnaire was designed including: Full medical and family history and full clinical examination and Height, weight and BP measurements for all subjects. The study results revealed that both systolic BPand Diastolic BP were significantly higher in Egyptian children compared to other ethnic groups and that BP is influenced by gender, age and height and body mass index [BMI]. The study recommends development of national strategy to reduce overweight and obesity during childhood

Blood pressure and body composition among Egyptian primary school children [6-11 years]

Many research spot on blood pressure levels during childhood to identify whom truly have high blood pressure reading or at high risk for the development of essential hypertension later in life. It is well known that body size and body composition are the most important risk factors and play a major role in blood pressure level determination. The aim of the present paper was to study the relationship between blood pressure with some anthropometric measurements and body composition [body fat percentage, fat free mass percentage, water percentage] among a sample of Egyptian primary school children of both sexes in Giza Governorate. This is a cross sectional study of 770 Egyptian children 524 boys and 225 girls, aged 6-11 years. Blood pressure [systolic and diastolic], weight, height, skin fold thickness [Triceps, biceps, subscapular and suprailiac] beside waist and hip circumference were measured. Body Mass Index [BMI], waist/hip ratio and sum of skin-fold thickness were calculated. Body composition was determined using bioelectrical impedance. The Egyptian systolic blood pressure were [90.61 - 115.91 mmHg] and the Diastolic Blood pressure [60.2 - 73.51 mmHg]. Blood pressure was age dependant and significantly correlated with weight, height, BMI and sum of skin fold thickness for both sexes. Moreover blood pressure showed highly positive significant correlation with body fat percentage while it was negatively and significantly correlated with fat free mass and Total body water/weight [TB W/Wt] for both sexes. Egyptian children have higher blood pressure levels than other populations. BMI, as well as body fat% were positively correlated with blood pressure. However, Fat Free mass and total body water/weight were negatively correlated with blood pressure. Recommendation: Blood pressure should be measured during childhood period for early exploration of diseased children. Assessment of body composition can be a useful tool for understanding the situation of children at risk of developing hypertension

Effects of pregnancy on chronic hepatitis "C" patients

Information available regarding the natural history and outcome of chronic HCV during pregnancy has been limited and inconclusive. Aims: To assess the effect of pregnancy on female infected with HCV. A review of 29 patients before and during pregnancy with established HCV-RNA positive attending our clinics between 2002 and 2004 for clinical presentation and laboratories. From 29 pregnant HCV-RNA positive women, 13 were spontaneously cleared from HCV during pregnancy, 9 with low vireamia, and 7 with moderate viaremia. The transminases reaching normal values during pregnancy. The above values remaining as that 3 months after delivery. completion of pregnancy in chronic HCV women is recommeded without any antiviral therapy, pregnancy is an immunological balancing act.

High leptin levels in women developing postpartum thyroiditis

There is experimental evidence that leptin is required for the development of T helper 1 [Th 1]-mediated autoimmune diseases. However, to our knowledge, there are no studies demonstrating such a role in human autoininiune thyroid disease. In the present study we have examined patients developing postpartum thyroiditis [PPT], as a model of autoimmune disease, for changes in serum leptin levels during the postpartum period. The study group included 36 women in the first month postpartum who were positive for thyroid peroxidase antibodies [TPOAb+ve]. Fourteen TPOAb-negative [-ve], age and body mass index [BMI]-matched, postpartum women were enrolled as the control group. All subjects were evaluated for BMI, serum leptin values, thyroid function [serum free-triiodiothyronine [FT3], free-thyroxine [FT4], thyrotropin [TSH]] and autoimmunity [TPOAb levels and complement activity index [C3 index]] at 4, 12, 16, 20 and 24 weeks' postpartum. During the postpartum period, 20 of 36 TPOAb+ve women [55.6%] showed one or more episodes of thyroid dysfunction [PPTD group], whereas the remaining 16 TPOAb+ve women remained euthyroid throughout the study period [PPTE group]. None of the control group developed thyroid dysfunction. Four weeks postpartum, TPOAb+ve women showed higher serum leptin values than TPOAb-ve women, despite comparable BMI. At this time, PPTE and PPTD patients showed no significant differences in leptin levels or leptin/BM I ratio. Throughout the postpartum period, PPTD patients maintained significantly higher leptin values and leptin BMI ratio compared to the healthy women. In PPTE women, however, a significant reduction in leptin levels and leptin/BMI ratio was seen at 12 weeks' postpartum. This decrease was transient and correlated negatively with the variation in C3 index at the same time. No significant correlation was found between serum leptin variations and FT4 or TSH levels. This study has demonstrated that women developing postpartum thyroiditis have higher leptin values compared to the healthy women. The higher levels were maintained for 6 months postpartum. This result would suggest an involvement of leptin in the pathogenesis of postpartum thyroid disease, although further studies are needed to characterize the reciprocal effects of leptin, immune system and thyroid hormones during the course of this disease

Chemical ablation of the bladder urothelium and intestinal de-epithelialization in augmentation cystoplasty: An experimental study

To determine the chemical de-epithelialization effect of protamine sulphate and urea treatments on the bladder epithelium and mucosa of the ileal segments used in augmentation cystoplasty using segment. Three groups of dogs [5 dogs in each one] were used in the study. All groups underwent augmentation cystoplasty using ileal segment. The first one [Group I] was a control group with no treatments after operation, the bladder was filled with normal saline and emptied after 30 minutes and the catheter was removed. The second group [Group II] was treated through infusion of the augmented bladder by 5 mg/ml protamine sulphate for 15 minutes. The bladder was emptied and filled with urea at concentration of 100 gm/L solution for 15 minutes then emptied, and the catheter is removed. The third group [Group III] was infused with the two drugs but in a double concentration. Biopsies from the intestinal and bladder segments were taken immediately after augmentation cystoplasty and after an interval of one month and evaluated microscopically for epithelial changes. At the same time, 24-hour urine was collected for determination of urine mucoprotins among the studied groups. Serum electrolytes; urea nitrogen and creatinine were within normal values in all groups of the study. The use of protamine sulphate and urea as chemical de-epithelialization agents for the bowel segment had led to atrophy of the mucosal villi and decrease number of goblet cells significantly so decreasing the absorptive capacity of the villi and secretory capacity of the goblet cells. Mucoprotein measurement immediate and at one month postoperatively showed that there was insignificant difference in mucoprotein in urine of 24 hours immediate postoperative between all groups. On the other hand, there was a significant difference between all groups after one month. Also, mucoprotein secretion in Group II was significantly less than that of Group I [P < 0.05]. While as regard mucoprotein secretion in Group III, the decrease was highly significant than that in Groups I and II [P < 0.001]. De-epithelializatjon of both the bladder and intestinal segments occurred promptly by using protamine sulphate and urea. This is supposed to be followed by reepithelialization by transitional epithelium later on. These results were confirmed by the decreased mucoprotein secretion in urine. This approach may be of possible use as a chemical ablation for the intestinal mucosa used in the augmentation cystoplasty or ileal neobladder and as a possible treatment alternate for bladder carcinoma in situ

Heterocyclic products from the oxidation of enamine and dienamine esters

N-alkylaminofumarates [1], Beta-aminocinnamates [2] and Beta-N-alkyl-aminocrotonates [3a] are oxidized by lead tetra-acetate [LTA] to give mixtures of acyclic oxidative dimers; in which enamine molecules are linked through their Beta-carbon atoms, as well as heterocyclic products : pyrroles, pyridones and others [1,2,3] The above results promoted the present investigation of similar oxidations of ethyl [Z]-Beta-aminocrotonate [3b] and the dienamine esters, ethyl [Z], [E]-5- amino-4-carbethoxy-2, 4-hexadienoate [4] and methyl [Z], [E] -5-amino-4- car-bethoxy-3-carbmethoxy -2, 4-hexadienoate [5]

Autogenous superficial femoral vein graft in trauma to large - sized arteries in dogs

The long saphenous vein [LSV] is the preferred vascular graft for arterial trauma to small- and medium-sized vessels. However, there may be a mismatching between LSV diameter and that of large-sized injured arteries. In such cases an alternate graft should be used instead. We had tried to evaluate the use of the autogenous superficial femoral vein [SFV] graft in arterial trauma in 11 dogs. In each dog we had excised a 4-cm segment from the femoral artery at one side and replaced it by an equal segment taken from the contralateral SFV after its reversal and irrigation with heparinized saline. Postoperative follow-up was done for one month when patency was confirmed by angiography. There was neither venous insufficiency in the donor limb nor infection in the recipient limb. We could conclude that the early results showed the SFV to be an acceptable and a feasible arterial substitute in vascular trauma to large-sized arteries without significant morbidity or mortality. However, we recommend a longer period of follow-up to detect any possible late complications such as aneurysmal dilatation or neointimal hyperplasia in the vein graft or late chronic venous insufficiency in the donnor limb

Effect of oral bromocriptine parlodel on the endometrium of the adult female albino rat I A light microscopic study

The response of the endometrium to oral bromocriptine administration in low and high doses for 30 days and the effect of the drug withdrawal, 15 days after the last dose, was studied in adult albino rat. Both doses increased the thickness of the endometrial epithelial lining due to focal transformation into the pseudostratified columnar or even the stratified columnar types. However, the latter type was seen only in high dose-given animals. Bromocriptine administration in its low and high doses markedly increased the size of the stromal cell which contained abnormally abundant cytoplasm and oval around vesicular nuclei. These cells were separated by markedly increased collagen fiber. This was accompanied by the presence of large numbers of eosinophilis deep in the stroma. The drug increased markedly the cytoplasmic RNA content and lowered the DNA density in all endometrial cellular elements. Very highly satistical significant increase in the overall endome trial thickness occurred in response to bromocriptine administration. 15 days after the last bromocriptine dose, the endometrium regained its more less normal structure

Effects of oral bromocriptine Parlodel on the endometrium of the adult female albino rat II- an electron microscopic study

The effect of bromocriptine on the endometrial ultrastructure was studied in specimens obtained form adult rats after receiving a single daily oral dose of "Parlodel" equivalent to the human either low or high dose, for 30 consecutive days. Both doses markedly increased the thickness of the uterine epithelial lining due to focal transformation of the normal simple cuboidal or low columnar epithelium into pseudostratified or even stratified columnar epithelium. Ultrastructurally, the epithelial lining in both the control and the low dose-given animals contained only one type of epithelial cells, but only in the high dose-given animals were these cells differentiated into two types the dark and the pale cells reflecting different degree of cellular protein synthesis activity. Both the low and high doses increased the cellular content of the organelles concerned with protein synthesis. The most striking cellular ultrastructural change, in response to the low and the high doses, was the presence of intracytoplasmic non-membrane bound huge vacuoles for which the term "autolytic vacuoles" was suggested, because they started as aggregates of primary lysosomes surrounded by autolysed cytoplasm most probably due to damaged leaky lysosomal membranes. With both doses, most of the stromal cells became abnormally large with an obvious increase in the amount of cytoplasm and its content of the organelles concerned with protein synthesis, The forementioned results suggest that, at least in rats, the bromocriptine increase the endometrial cellular activity probably through an estrogenic effect

Effect of long acting bromocriptine on the endometrium of adult female albino rat II an electron microscopic study

Long acting bromocriptine injections were intramuscularly administered to adult female albino rats. Each rat received a single dose equivalent to either the low or high human therapeutic dose. Uterine specimens were collected 2 and 15 days after the injection to study the effect of the drug on the endometrium. Both doses markedly increased the thickness of the uterine epithelial lining due to focal transformation of the normal simple cuboidal or low columnar epithelium into tall columnar, pseudostratified or even stratified columnar epithelium. According to their fine structure, both the epithelial lining and the glandular epithelium in the control animals contained only one type of cells. However, 2 days after the low dose injection the cells were differentiated into 3 types, the pale, the dark and the intermediate reflecting different degrees of cellular protein synthesis activity. Two days after the high dose injection both the lining and glandular epithelia were transformed into the pseudostratified columnar and tall columnar type, respectively