Fecal lactoferrin as a new marker of disease activity in inflammatory bowel diseases

Background: Inflammatory bowel diseases [IBD] including ulcerative colitis [UC] and Crohn's disease [CD] are organic inflammatory diseases, caused by chronic mucosal inflammation of the gasrtointetinal tract. As the presenting manifestations of IBD and other diseases are similar, obtaining a clinical diagnosis can be difficult, and further invasive diagnostic procedures may be required in order to obtain a confirmed diagnosis. The aim of this study is to evaluate the diagnostic utility of measuring fecal concentrations of lactoferrin as a simple and noninvasive indicator of disease activity in patients IBD and to be correlated with endoscopic findings and disease activity index and acute inflammatory response including leucocytic count, high sensitive CRP, ESR

Methods: This study was carried on 40 patients with IBD; 24 patients with active IBD [16 UC patients and 8 CD patients] and 16 patients with inactive IBD [10 UC patients and 6 CD patients] versus 40 healthy controls. All patients underwent blood and stool sampling as well as an interview to assess the disease severity utilizing UC activity measured by the Truelove and Witts Severity Index and Crohn's Disease Activity Index. Measurement of FLA levels at different stages of inflammatory bowel disease activity to detect its role in assessment of disease severity

Results: This study showed that FLA levels were highest in patients with IBD in comparison with healthy group. FLA levels also correlated significantly with disease severity in patients with IBD where higher levels of FLA were found in patients with severe UC or Crohn's disease. At cutoff value 9.68 ug/ml FLA showed 100% sensitivity and specificity in identification of patients with IBD from healthy subjects

Conclusions: FLA is a sensitive and specific biochemical marker of inflammation for use in the diagnosis of suspected IBD cases, and its level correlates well with both clinical disease activity indices

Effect of follicular flushing during oocyte retrievalon clinical outcome of assisted reproductive technology

Is to determine whether follicular aspiration and flushing increase the number of oocytes yield and pregnancy outcome over aspiration alone in women undergoing ICSI. Prospective randomized controlled trial. One hundred eighty five infertile women who underwent ICSI were included in the study. They were randomized into two groups 92 cases in [aspiration and flushing group] and 93 cases in [aspiration only group],during the period from September 2011 to September 2013. Controlled ovarian hyperstimulation using long GnRH agonist was the standard protocol, hCG administrated 10000 iu when three or more follicles were at least 18 mm in largest diameter, Trans-vaginal follicular aspiration performed 34-36 hours after hCG trigger. In the aspiration alone group, a 16 gauge single lumen needle used, with suction continue until a small amount of blood stained fluid appeared in the tubing or flow stop, When flushing accompany aspiration of follicular fluid in the study group, the same needle used with a double-way tap allowing flushing of [2 ml] of embty follicleby Earl's medium till oocyte retrieved or maximum two times. The study observed 60.5 % oocyte recovery rate with aspiration only compared with 80.9 % with follicular aspiration and flushing.Operative time [minutes] was significantly longer among flushing group, the retrieval time was 1.3 fold higher among those undergoing follicular flushing. Pregnancy was non-significantly more frequent among flushing. Implantation rates non-significantly more frequent among flushing group than non-flushing group [31.6% versus 26.3%, P= 0.424] and ongoing clinical pregnancy non-significantly more frequent among flushing group [27.4% versus 21.1%, P= 0.31]. Conclusion, flushing non-significantly increase implantation and clinical pregnancy outcome and associated with a significant increase in the procedure time for oocyte retrieval, so patient groups where a small number of oocytes are available for retrieval may represent patients most likely to benefit from follicle flushing as only one extra oocyte may affect the outcome

Computerized image cytometric analysis of: KI-67 and BCL-2 markers in: benign endometrial hyperplasia and endometrial carcinoma

The normal endometrium is a tissue subjected to rapid cycling proliferation and differentiation followed by breakdown under hormonal influences .Endometrial hyperplasia [EH], which is a frequent disorder seen in majority of endometrial biopsy samples, embraces a group of lesions with different biological potential with tendency to progress into endometrial adenocarcinoma [EC]. The reproducibility of the histopathologic diagnosis of endometrial hyperplasia is poor as regarding intra and inter observer errors as well as the over and under diagnosis of malignant changes. Strict criteria, good sampling and use of additional ancillary molecular techniques are expected to improve the sensitivity and accuracy of this diagnosis. To evaluate the immnohistochemical expression of Ki-67 and Bcl-2 in various types of endometrial hyperplasia versus endometrioid variant of endometrial adenocarcinoma. 2-To correlate the immunohistochemical expression with grade and stage of EC and 3-To evaluate the prognostic value of morphometric D-score in prediction of endometrial hyperplasia- cancer progression. Paraffin embedded-tissue specimens obtained from 57 female patients were studied. Cases were categorized into the following groups: Control group [5 cases of normal proliferative endometrium], fifteen cases of various degrees of hyperplastic lesions including 10 cases of [EH] and 5 cases of intra epithelial neoplasia [EIN]. Fifteen cases of combined lesions [EH+EIN+grade 1EC] and lastly 22 cases of various grades of endometrioid variant of EC. All 57 studied cases were subjected to:Immunohistochemical staining for Ki-67 and Bcl-2 markers. The percent of positivity was calculated using computerized image cell analysis. In addition computerized morphometric analysis for D-score calculation were performed on standard diagnostic hematoxylin and eosin [H and E] stained sections of all cases of endometrial hyperplasia. Normal proliferative endometrim [5 cases, 100%] expressed high score of both Ki-67 and Bcl-2 markers. Also, in the hyperplastic group; the peak immunoreactivity for Ki-67 was seen in the EIN subgroup [5/5,100%]. In contrast, Ki-67 immunoreactivity was seen in only 80% of EH subgroup. However, the difference was statistically insignificant [p>0.05]. KI index was higher in carcinoma compared to EH. The difference between both groups was statistically significant [p=0.001]. Bcl-2 immunopositivity was seen in three cases of EIN [60%] and eight cases of EH cases [80%].Endometrial carcinoma showed Bcl-2 expression in [11 out of 22 cases50%]. Bcl-2 was expressed in the majority of cases of EH [8 cases out of 10 cases 80%] and showed uniform glandular positivity, but it was diminished in EIN subgroup [2 out of 5 cases, 60%]. Ki-67 was expressed in the majority of endometrial adenocarcinoma [20/22 cases, 90.9%]. Bcl-2 expression was decreased as the grade increased but this relation was statistically insignificant [p=>0.05]. Ki-67 and Bcl-2 scores were found to be negatively correlated in the same histologic group and this inverse relation was statistically significant [p=0.00]. Finally, D-score calculation revealed that: D-score value was more than 1 in cases of EH and less than 1 in EIN cases and the cut off value was 2.33. Normal proliferative endometrium expressed high levels of both Ki-67 and Bcl-2. It was shown also, that Ki-67 was sequentially increased from EH through EIN to EC. In contrast, Bcl-2 positivity was decreased significantly in cases of EC mainly the high grades. Such inverse relation between both markers [Ki-67and Bcl-2] was proved to be statistically significant. The imbalance between proliferation and apoptosis may be an important factor in the development of different endometrial lesions; benign and malignant. Precancerous endometrial lesions [EIN] could be identified, by using morphometric analysis for D-score calculation based on combination of architecture and cytological features with consideration to volume percentage stroma parameter

Genetic and environmental factors in different types of age-related cataract among Egyptians

The present study included 280 patients with age-related cataract [153 males and 127 females] and 296 controls with similar age and sex distribution. All cases and controls were subjected to thorough personal and family history taking including consanguinity, occupation, residency, diabetes mellitus, hypertension, smoking, family history of age-related cataract and family pedigree analysis. Full clinical examination also included complete ophthalmological evaluation to determine the type of cataract using slit-lamp examination and visual acuity measurement. Seventy-five patients and 25 controls were subjected to the following investigations: Estimation of serum total protein, serum albumin and globulin levels, albumin/globulin [A/G] ratio, hemoglobin [Hb] level and red blood cells [RBCs] count. Statistical analysis was conducted using SPSS program for calculating t test, X2 test and multiple logistic regression analysis. The present study revealed that mixed cataract [i.e. presence of more than one type of cataract] was the commonest type of age-related cataract in Egypt [48.9% of cases]. Positive family history, consanguinity and exposure to ultraviolet irradiation were universal risk factors for all types of cataract among Egyptians. Diabetes mellitus was associated with nuclear and posterior subcapsular types of cataract, while hypertension had its effect on both cortical and posterior subcapsular types. Biochemical analysis revealed that the risk of age-related cataract increases with decreased level of serum total protein, decreased serum albumin and globulin levels, decreased RBCs count and hemoglobin level

Comparison between different types of fissure sealants

The purpose of this study was to compare different types of pit and fissure sealant Ketacbond [Conventional Glass ionomer cement] GIC, Vitremer [Resin modified glass ionomer] RMGI, and Delton Resin sealant [RS] for retention and caries prevention after 6, 12 and 18 Months. Two hundred and ninety three sound first permanent molars in children six to eight years of age, children were divided into three groups Group I, [n = 98] teeth were sealed using ketacbond GIC. Group II: [n= 97] teeth were sealed using Vitremer RMGI, Group III: [n = 98] teeth were sealed using Delton [RS]. All teeth were free from caries, unsealed, and the sealing materials were selected randomly. All teeth were sealed after prophylaxis of the occlusal surfaces, washing for 20 seconds, dried for 30 seconds, and isolated using cotton rolls to prevent salivary contamination. The three sealing materials were prepared and applied to the conditioned teeth according to instruction of the manufactures. The collected data of the three groups were calculated using qui-square test to evaluate and the retention and prevalence of caries between the different groups after 6, 12 and 18 Months. The results of the three groups were 4.1, 23.5, and 96.9% respectively, while it was 6.2, 12.2 md 3.1% for partial retention 1, and 9.3, 12.2, and zero% for partial retention 2, at the same time interval the total loss of sealant were 80.4, 34.7, and zero. A statistical significant difference was found on the prevalence of retention level after 18 months between the three groups. One carious lesion was detected in group 3, two in-group 1 after 18 month, while no carious lesions were detected in group 2. From the results of this study it can be concluded that pit and fissure sealant is safe, preventive, effective, non-surgical, and non-expensive procedure, and should be applied specially to molars at risk to caries. Delton a resin based sealant [RS] presented better retention rate than Vitremer [RNIGI] and followed by Ketac-bond [GIC]. Glass ionomer cement and modified resin glass ionomers can be used as pit and fissure sealant especially when caries prevention is needed

comparative study of antimicrobial efficacy of glass ionomer cement and reinforced zinc oxide eugenol cement on causative microorganisms of early childhood caries: an in vitro study

The aim of the present study was to compare antimicrobial efficacy of Glass Ionomer Cement GIC and Reinforced Zinc Oxide Eugenol Cement ZOE; IRM on Strepeptococcus mutanas, lactobacillus and veillonella which is the causative microorganisms of early childhood caries. A marked bacterial inhibition of streptococcus mutans, lactobacillus and veillonella were detected after one and three days for both materials. At the same time, it was clear that the inhibition effect of GIC and ZOE were increasing with time. Moreover, GIC showed a higher percentage of bacterial inhibition. From the results of our study, it could be concluded that both Glass ionomer cement and zinc oxide eugenol cement had marked inhibitory effect on streptococcus mutans, lactobacillus and veillonella which believed to be the causative microorganisms of early childhood caries [ECC]

Casein derivatives complexed with calcium phosphate efficacy as a mouth moistener in young patients with severe xerostomia secondary to radiotherapy

The purpose of this study was to evaluate casein derivatives coupled with calcium phosphate [CD-CP] as a mouth moistener and its effect on the oral hygiene status in a group of young patients with severe xerostomia. A randomized control trial design was used. Participants had had radiotherapy for head and neck cancer. Baseline data collection was followed by re-examination one month later. A total of 60 patients. 30 in the CD-CP group and 30 used their usual moistening strategies. The baseline characteristics of the two groups did not differ. Patients used Topacal C-5 [CD-CP] and the responses to here compared with the responses to their other mouth moistening strategies. The outcome indicated that Topacal C-5, when used as a mouth moistening and lubricant provided satisfactory results moreover, it has enhanced the oral hygiene status as well as the gingival health status through reduction of plaque, papillary bleeding, and gingival indices

Multileaf collimator versus tray mounted cerrobend blocks in head and neck cancer irradiation

The objective was to perform a direct comparison of cerrobend blocks to "Best fit" single field Multileaf collimator [MLC] shapes. Output measurements were made on a primus Linear Accelerator [Siemens], 29 leaves per side for Photon beam energy 6MV at source-to- axis distance [SAD 100cm]. The data was measured for different field sizes at different depths. The field sizes dependent factors were measured at the maximum depth 1.6cm for this energy. The penumbra widths were measured at 10cm depth in solid phantom by using Kodak films, their values were 5-6mm for isodose lines [80%-20%] and 16- 17mm for isodose lines [90%-10%]. The average MLC factor [MLC reading divided by block reading] was found to be 1. Also the comparison between the isodose mapping was obtained by the Multidata system for shaping treatment field in Head and Neck Cancer with both MLC and Cerrobend blocks at clinical depth 5cm

Glomerular changes in the fetal kidneys of diabetic rat treated with insulin and melatonin

Free oxygen radicals, easily formed in the diabetic patients, were thought to play an important role in the development of diabetic complications. This study investigated the effects of the diabetic milieu on the weight and renal glomeruli of the fetuses of the pregnant diabetic albino rats. It also evaluated the protective role of melatonin, as an antioxidant, and the insulin on the fetal developing glomeruli. Diabetes was induced in the virgin adult female rats by a single dose of alloxan [160 mg / Kg BW] intraperitoneally. The study was done on five groups of pregnant albino rats: 1] control group, 2] diabetic untreated group, 3] diabetic group treated with insulin [crystalline insulin, 2 - 6 IU / day, subcutaneously, from the start of pregnancy to GD 20], 4] diabetic group treated with melatonin [9 mg / Kg BW / day, intragastrically, from the start of pregnancy to GD 20] and 5] diabetic group treated with both melatonin and insulin. Thirty-eight fetuses were collected randomly form each group on GD 20; their weights were recorded then their renal glomeruli were evaluated histologically, immunohistochemically and morphometrically. The results revealed that in group 2 there was a significant increase in fetal weight accompanied by an increase in the glomerular number and surface area. Also the incidence of thickening of glomerular basement membrane, expansion of mesangial matrix and deposition of collagen IV in the fetal kidney were the highest in this group. In group 3, all the above mentioned parameters were shifted towards the control side. In group 4, only the number of glomeruli and the incidence of glomerular basement membrane thickening were improved. In group 5, the addition of melatonin to insulin did not improve, as expected, the evaluated parameters when compared to insulin alone in group 2. These results indicate that a mechanism rather than free radical pathway leads to the pathogenesis of fetal nephropathy and that melatonin antagonizes the beneficial effects of insulin