A novel polyherbal formulation containing thymoquinone attenuates carbon tetrachloride-induced hepatorenal injury in a rat model

Objective: To evaluate a novel polyherbal formulation (BSVT) containing the standardized extracts from the leaves of Boerhavia diffusa, Solidago virgaurea, Vitex negundo, and thymoquinone in CCl4 induced hepatorenal toxicity in rats. Methods: A total of 36 rats were divided into six groups including normal control, CCl4 (2 mL/kg, i.p.), CCl4 (2 mL/kg, i.p.) + Cystone? (750 mg/kg p.o.), CCl4 (2 mL/kg, i.p.) + BSVT (25 mg/kg, p.o.), CCl4 (2 mL/kg, i.p.) + BSVT (50 mg/kg, p.o.), and CCl4 (2 mL/kg, i.p.) + BSVT (100 mg/kg, p.o.). All treatments were given for four weeks. Serum levels of aspartate transaminase, alanine transaminase, alkaline phosphatase, cholesterol, total protein, serum urea, blood urea nitrogen and creatinine were assessed. Superoxide dismutase, malondialdehyde, and glutathione peroxidase were evaluated in tissue homogenate. The histopathological study of liver and kidney tissues was also done. Results: Aspartate transaminase, alanine transaminase, alkaline phosphatase, cholesterol, serum urea, blood urea nitrogen and creatinine were significantly elevated (P<0.001) while total protein was considerably reduced in the CCl4 group as compared to the normal control (P<0.001), which indicated hepatorenal toxicity. In addition, superoxide dismutase and glutathione peroxidase activities were significantly decreased (P<0.001) while malondialdehyde levels were increased markedly (P<0.001). Treatment with BSVT formulation recovered these parameters towards a normal level in a dose-dependent manner. Conclusions: BSVT formulation ameliorates the hepatorenal toxicity in a dose-dependent manner. Furthermore, clinical studies are required to confirm its efficacy.

Impact of the methylenetetrahydrofolate reductase [MTHFR] C677T gene polymorphism on clinical outcomes of HLA-matched sibling allogeneic hematopoietic stem cell transplantation

Background: allogeneic hematopoietic stem cell transplantation [HSCT] is widely used to treat various hematological malignant and non-malignant diseases. The occurrence of complications following HSCTas graft versus host disease[GVHD], hepatic veno-occlusive disease [VOD], oral mucositis [OM], drug induced hepatic and renal adverse events- is highly variable and dependent on a multitude of host, donor, and treatment factors. Identifying important genetic variables will allow for better prediction of HSCTrelated outcomes, and in the process of identifiing these susceptibilities, that could help to develop targeted interventions

Objectives: to evaluate impact of the C677T polymorphism of 5,10-methylenetetrahydrofolate reductase [MTNFR] on the clinical outcomes of patients treated using human leukocyte antigen-matched sibling stem cell transplantation as acute gruff versus host disease [GVHD],oral mucositis ,drug induced hepatic and renal toxicity, transplant related mortality[TRM] and overall survival[OS]

Patients and Methods: we examined the association of a single nucleotide polymorphism [SNP] at position 677 in the MTHFR gene of patients with outcomes of allogeneic HSCT. MTHFR genotyping was performed by po2ymerase chain reaction-restriction fiagment length polymorphism [PCR-RFLP]

Results: 46 Patients with complete clinical records were recruited. Median age at the time of HSCT was 22 years [range 3-42 years]; 32 patients [69.6%] above >/=18 years, and the median follow-up period of survivors was 21 months. 212efrequencies of the MTHFR C677T genotypes in patients were 43.5% [20 patients] for 677CC, 50% [23 patients] for 677CX and 6.5% [3 patients] for 677TT; the allelic frequency of the 677T was 31.5%. Recipient MTHFR677 in CT or TT versus CC showed non-statistically significant higher incidence of acute GVHD [7/26] 26.9% versus [2/20] 10%; p=0.15, hepatic toxicity [11/26] 42.3% versus [5/20] 25%, p= 0.22 and TRM [5/26] 19.2% versus [2/20] 10%; p=0.45. Recipients with variant allele MTHFR 677T were associated with lower non statistically signijicant overall survival; p=0.281. Conclusion: Genofyping for WHFR C677T before HSCT could have clinical significance, not statistically proven in our study, in prediction of patients at high risk of developing poor outcomes. Larger studies with homogeneous HSCT cohort are needed to identifi such potential phar]nacogenetic markers with suflciently strong evidence to be used in clinical practice

Parasitological studies on some intestinal parasites in primary school children in Aswan Governorate, Egypt

This cross sectional study in Aswan Governorate determined the prevalence of intestinal parasites and to identify the risk factors for infection in primary school children in this geographical area. The results would facilitate evaluation of the endemic level of different intestinal parasites and the determination of whether widespread or focal measures of parasite control are required. After obtaining official permission from the school administration, information and consent forms were given to the parents of all the schoolchildren. They were three-hundreds children aged between 6-12 year were enrolled; a detailed questionnaire, complete clinical assessment complete as well as stool analysis was done The study showed that the over-all infection was 31%, single parasitic infection was 26% and mixed one was 5%.The commonest helminthic infection was E. vermicularis 6.6% followed by H. nana 3% Ascaris lumbricoides 1%, The commonest protozoa infection was E. histolytica 8.3% followed by Giardia lamblia 3.7% and Cryptosporidium parvum 1.7%. Mixed infection was E. vermicularis plus E. histolytica [23.4%], E vermicularis plus G. lamblia [17.6%], E. vermicularis plus C. parvum [11.8%], E. histolytica plus H. nana [11.85%], A. lumbricoides plus E. histolytica [17.6%] and G. lamblia plus E. histolytica. in [11.8%]. Parasitic infection was more prevalent in boys [53.8%] than girls [46.2%] and more prevalent in rural children [39.73%] than urban ones [20.13%] among age ranged from to 12 years [8.97+/-1.72]

Immunohistochemical and light and electron microscopic study of the basement membrane in photoaged skin

The basement membrane plays an important role in maintaining a healthy epidermis and dermis, and repeated damage destabilizes the skin and accelerates the aging process. This study was carried out to detect the changes in human skin basement membrane in sun-exposed skin compared with sun-protected skin. Skin biopsies were taken from sun-exposed and sun-protected skin of 10 male individuals aged between 50 and 60 years and processed for light and electron microscopic examination of the changes of the basement membrane. Immunohistochemical assessment of laminin and matrix metalloproteinase-1 [MMP-1] expression in skin biopsies was also carried out. Histological examination of sections of sun-exposed skin revealed that the basement membrane was discontinuous and the collagenous fibers of the underlying connective tissue were discrete in comparison with sun-protected skin. Immunoreactivity for laminin was decreased, whereas that for MMP-1 was markedly increased in sun-exposed skin as compared with sun-protected skin. The results of the current study revealed that the structure of the basement membrane was affected in sun-exposed skin as regards thickness, continuity, and structure. Increased activity of MMP-1 accounts at least in part for the disruption of the basal lamina and degradation of collagenous fibers of the dermis

Real-time PCR versus phenotypic diagnostic methods in detection of methicillin and vancomycin resistant staphylococci

Staphylococci are the most frequently isolated bacteria from blood. The prevalence of antibiotic resistance has dramatically increased. Real-time PCR offers rapid, accurate, and sensitive method to detect the presence of antimicrobial resistance. This study is mainly aimed to detect uethicillin [oxacillin] and vancomycin resistant staphylococci isolated from blood of patients with significant bacteremia in Assiut University Hospital using both real-time PCR and phenotypic agnostic methods. Sixty Staphylococcal isolates were included. These isolates were collected from positive blood culture bottles [BACTEC 9050 System] of patients with significant bacteremia in Assiut University Hospital. Identification of staphylococcal species was performed by subculture on Mannitol Salt Agar [MSA] and by Microscan system, while antibiotic sensitivity testing was performed by Microscan system, Epsilometer test [E- test], Disc diffusion [DD] method, Oxacillin Resistance Screening Agar Base [ORSAB] and by real-time PCR for mec A and van A genes. Seven S. aureus isolates and fifty three Coagulase-negative staphylococci [CoNS] were detected by both MSA and Microscan system. The most effective antibiotics for staphylococcal isolates were in order. Vancomycin, Linezolid, Synercid, Rifampicin, Chloramphenicol, Gentamycin, Tetracycline, Trimethoprim/Sulphamethoxazole, Clindamycin, Ofloxacin, Ciprofloxacin, Azithromycin and Erythromycin. Concerning methicillin resistance, Real-time PCR which is the gold standard method detected mecA gene in 57 isolates. Accordingly, sensitivity and specificity of E-test were 964% and 100% respectively, DD method showed 87.7% sensitivity and 100% specificity, ORSAB media showed 92.9% sensitivity and 100% specificity while Microscan showed 100.0% sensitivity and 100.0% specificity. Concerning vancomycin resistance, E-test which is the gold standard method detected vancomycin resistance in 6 staphylococcal isolates. Therefore, the DD method showed 66.7% sensitivity and 100.0% specificity while Microscan showed 83.3% sensitivity and 100.0% specificity. Real-time PCR detected van A gene in only one staphylococcal isolate. CoNS organisms are more implicating than S. aureus in bloodstream infections [BSIs]. About 95% of staphylococcal isolates were resistant to methicillin and 10% were resistant to vancomycin. Real-time PCR was more accurate and rapid method for detection of methicillin resistance than phenotypic methods and it could be considered a confirmatory method for detection of vancomycin resistance in staphylococcal isolates suspected to have the van A gene

Ocular manifestations of behcet's disease in Jordanian patients

To study the prevalence, manifestations and severity of ocular involvement of Behcet's disease in Jordanian patients. The study population consisted of 43 patients diagnosed to have Behcet's disease through Rheumatologist's examinations conducted at Jordan University Hospital between January 2002 and July 2009. The sample involved patients who displayed ocular manifestations. This included 18 patients; 12 males and 6 females with a mean age of 35 years [SD = 17.26]. Ophthalmological examinations and retrospective analysis of medical files were carried on. Ocular manifestations were seen in 41.9% of patients. The most common manifestation for Behcet's disease was vitritis with a prevalence of 55.6%, followed by anterior uveitis and retinal vasculitis [50% for each]. On the other hand, the most frequent complications involved were cataract, cystoid macular edema [CMO], posterior synechiae and glaucoma with a prevalence of [44.4%], [33.3%], [11.1%] and [5.6%], respectively. The prevalence and severity of ocular lesions in Behcet's disease is relatively low in Jordanian patients. This result indicates that early diagnoses and intervention might delay or even prevent vision loss for those patients.

Microtomes And Microtome Knives ' A Review And Proposed Classification

Microtome is a mechanical instrument used to cutbiological specimens into very thin segments formicroscopic examination. Biological specimens can bepresented in many ways. But more often, thesespecimens are embedded in paraffin wax blocks andthe commonest way of sectioning these specimens canbe achieved by the microtome. The earliest form of themicrotome enabled free hand sectioning of fresh orfixed material using a sharp razor. Modern microtomesare precision instruments designed to cut uniformlythin sections of a variety of materials for detailedmicroscopic examination. Central to the production ofgood sections is the microtome knife. Microtomyvirtually begins and ends with a sharp, blemish-freecutting edge. The introduction of disposable blades hasmade easier the production of good quality, thinsections, but they are often unsatisfactory forsectioning harder tissues, especially bone. A sharp knifeedge free from imperfections is essential for theproduction of good sections. Since many types ofmicrotomes are commercially available in the market,choosing the right microtome is essential forproducing the best result as required. A classificationis proposed that unifies and organizes the variousmicrotomes based on the mode of operation.

Evaluation of elderly patients' awareness regarding risk factors of recurrent chest infection

This study aimed to enhancing optimal life capacity for the elders by reducing morbidiy and mortality rates from chest infections. This study carried out in two settings as follows: chest department and chest out patient clinic of Minia University hospital and Minia Chest Hospital in Minia Governorate. The sample included 250 elderly patients. Suffering from chest infection. Data was collected in a period of 6 months starting from September 2009 to the end of February 2010.Three tools were used in this study. First tool; is an interview questionnaire schedule included personal characteristics, and medical data and the elderly patients awareness regarding chest infection disease and risk factors of recurrent chest infection. Results of this study illustrated that [45.2%] of the studied sample aged between [60< 75ys]. The mean age +/- SD was [70.7 +/- 9.92]. Also [60%] of the studied sample were males. [67.2%], illiterate. [34.0%] of the studied sample were farmers, [56.4%] had overcrowded index and [76.7%] of males were currently cigarette smokers. The source of indoor air pollution in present study was oven [50%], followed by Coal, wood smoke [33.6%]. Moreover the highest frequency of outdoor air pollution the result illustrated that car exhaust [34.4%], followed by oven smoke [18.0%]. Also [85.6%] had negative awareness score regarding chest infection disease and [90.4%] had negative awareness score regarding risk factors of recurrent chest infection.[100%] of illiterate studied sample had negative score of awareness regarding risk factors. The study, showed that [97.7%] who live in rural areas and had negative awareness regarding chest infection. The study recommended that. Patients with chest infection should be educated about good hygiene, home ventilation, measures necessary to prevent further transmission, importance of compliance to the course of treatment, and the balanced diet. This can be achieved through mass media, health classes in different health agencies

Options of the treatment in steroid resistant nephrotic syndrome in children in central child teaching hospital-Baghdad

The therapy of steroid resistant nephritic syndrome [SRNS] is still a matter of controversy. To assess the options of treatment in SRNS. A retrospective study to 50 patient randomly selected in the Central Child Teaching Hospital during study period from Jan. 2006 till July 2008. The patient age was between 6 months - 18 years. All patients who had failed to achieve an improvement in proteinuria after minimum of 4 weeks [up to 8 weeks] of prednisolone [PDN] in a dosage 2 mg/kg/day were taken. Only the patients with idiopathic nephritic syndrome [45 patients] were involved in the study but the patients with secondary nephritic syndrome and congenital neprosis were excluded from the study. Each patient were individualized to the type of pathology and to the type of medication used. Forty five patients were included in the study, the age range between 6 months -18 years. Twenty eight patients were male and 17 were female, M: F ration 1.64: 1 regarding the type of pathology, 20 patients with focal segmental glomerulosclerosis [FSGS], 11 patients with minimal change nephritic syndrome [MCNS], 8 patients with diffuse mesagnial proliferation [DMP] and 6 patients were unknown biopsy [not down biopsy]. The drugs that used were methyl prednisolone [MP] in 17 patients. Every other day steroid [EODS] in 10 patients, cyclosporine A [CsA] plus EODS in 16 patients [10 patients as first option and 6 patients as second option, cyclophosphamide [CYS] used in 8 patients [6 patients as first option and 2 patients as second option] and chlorambucil wee used in 2 patients only. The response was higher in patients who received EODS [50%], followed by the patients who received CsA plus EODS [25%] then the patients who received MP [23.5%] and the patients who received CYS [12.5%] and chlorambucil [zero%]. The response to treatment was higher in females than males, 11 out of 28 males [39.28%] responded to treatment while 7 of 17 female [41.17%] responded to treatment. The patients with early presentation responded to treatment higher than those with late presentation, so 12 of 19 patients [63.15%] presented early while 10 of 26 patients [38.46%] presented ate. According to histopathology, the patients with unknown etiology had higher rate of response, 3 out of 6 patients [50%] responded to treatment followed by 7 of 20 [35%] patients with FSGS, then 2 of 8 [25%] patients with DMP, then 2 of 11 [18.18%] patients with MCNS. The drugs used are the common drugs and EODS is preferable type of medication used in SRNS

need for a comprehensive response to HIV/AIDS in north-western Somalia: evidence from a seroprevalence survey

The prolonged civil strife in the North-West Zone of Somalia [Somaliland] has hampered the development of social infrastructure and public health services. There are limited data on HIV/AIDS. In 2004, a sentinel HIV seroprevalence survey was conducted. Blood samples were collected from 1561 women attending antenatal care clinics, 249 tuberculosis [TB] patients and 243 people attending sexually transmitted disease [STD] clinics. Samples were tested for syphilis and HIV. Overall HIV prevalence was 1.4%, significantly higher than that observed in many other countries in the Region. Prevalence was 1.2% among pregnant women 15-24 years, 12.3% among patients with STD and 5.6% among TB patients. The prevalence of syphilis was 1.3% in the pregnant women

Sanjad-Sakati syndrome/Kenny-Caffey syndrome type 1: a study of 21 cases in Kuwait

We studied 21 patients with Sanjad-Sakati syndrome [SSS] from 16 families. Parental consanguinity was recorded in 2 families [12.5%]. All patients had severe intrauterine growth retardation, short stature, small hands and feet, blue sclera, deep-set eyes, microcephaly, persistent hypocalcaemia and hypoparathyroidism. Medullary stenosis was detected in 2 patients. Cytogenetic and fluorescent in situ hybridization studies were normal. All affected persons had homozygous deletion of 12 bp [155-166del] in exon 3 of the TBCE gene. All of the parents were heterozygous carriers of this mutation. The high frequency of SSS and low frequency of consanguineous marriages in this study may reflect a high rate of heterozygous carriers

Clinical course of children and adolescents with primary focal segmental glomerulosclerosis and the predictors of their outcome

The aim of this retrospective study is to report the clinical course of children and adolescents with primary focal segmental glomerulosclerosis [FSGS], and to study their outcome and to identify the predictors of progression to end stage renal disease [ESRD]. This is a retrospective study of 50 patients with biopsy-proven primary FSGS who were admitted from April 1995 - January 2007, during the study period from May 2005 - June 2007. Clinical, Laboratory and histopathological data were recorded. The median follow-up time of 4.5 year. The commonest age and sex group is male between 1 - 5 year. At presentation all patients had nephrotic-range proteinuria, hypertension was noted in 22 [44%] of patients, microscopic haematuria was detected in 20 [40%] of patients, five patients had evidence of abnormal renal function. The distribution of patients according to steroid responsiveness show that the steroid sensitive patients were 21 [42%], 8 [38.09%] of them were frequent relapsers and 11 [52.38%] of them were steroid dependant and 2 [9.52%] of them developed secondary steroid resistance. But those who had steroid resistance from the start of treatment were 29 [58%] patients. During followup 30 [62%] patients had complete remission, 15 patients [30%] developed chronic kidney disease [9 of them stage 5].At the end of follow-up, 24 [80%] of 30 patients with normal renal function had short stature. The univariate analysis identified the presence of hypertension [P=0.0027], heamaturia [P=0.0107] and presence of abnormal renal function [P=0.0001] at presentation, also presence of initial steroid resistance [P=0.0383], resistance to cytotoxic therapy [P=0.0032], capsular adhesions in renal biopsy [P=0.0066], tubular atrophy [P=0.0027], interstitial fibrosis [P=0.0010], all expect to be significant predictors of progression to ESRD. Considering the clinical and histological characteristics of studied patients, apparently our results are comparable to other published series. The progression to chronic kidney disease [CKD] occurs in 30% of patients after 5 years follow-up, must of them with ESRD, this is relatively good out come compared to other studies

Anemia in surgical patients

To find out prevalence of surgery related anemia in the patients routinely admitted in a general surgical ward. Prospective Cohort Study. Surgical Unit II, Jinnah Hospital, Lahore. 100 studied patients included males and females of all age groups from 13 years to 70 years. They were assessed for the effect of surgery on the preoperative hemoglobin levels and causes of anemia in relation to socioeconomic status. Total of 100 patients were randomly selected for the study but after applying exclusion principles, 95 patients were left with mean age of 33 years, mean hemoglobin concentration of 8.66 in all and 8.79 after excluding the patients with massive blood losses post trauma/gunshot. Mean postoperative hemoglobin excluding trauma patients was 8.71. 52% of patients had anemia due to nutritional deficiency, of which 82% were females; followed by 31% related to chronic diseases and the rest due to acute blood loss. Anemia is still one the major co-morbidities in preoperative patients and we found that surgical procedures did not cause significant difference to hemoglobin levels postoperatively. Almost all the patients followed by chronic diseases. They are more prevalent in people from socioeconomically deprived groups of society

Hormonal parameters of the serum and saliva in patients with androgenetic alopecia

Hair growth and developments are influenced by androgens. Androgens are important in hair growth and patterning in men. Reports on hormone analysis in androgenetic hair loss in females show partly contradicting results elevated as well as normal-range androgens levels have been found. To determine the nature of the hormonal status in patients with AGA and to evaluate the saliva as new clinical tool in hormonal parameters, this study was carried out on 30 subjects with AGA and 20 subjects without AGA as controls. FT and DREA-S in the serum and saliva were measured in all subjects There was significant increase in both hormone levels in the serum of bald men while no significant changes were noted in the serum of bald women. Also saliva FT showed significant increase in bald men and women; while saliva DHEA-S showed significant increase only in the bald women in comparison to control. [1] Men with higher levels of androgens are more likely to have AGA. [2]-increased response of androgen receptors in the skin despite normal androgens levels seems to play a causal role in female patients with AGA [3] The saliva/plasma relationship is not yet sufficiently understood to assess the value of salivary measurements in patients with AGA-Further investigations are recommended to find answers to these problems

Evaluation of cerebral blood flow during laparoscopic cholecystectomy using transcranial doppler ultrasonography

Laparoscopic procedures are common nowadays. They have many advantages, however, they carry special risks in certain cases due to the associated cardiac and pulmonary dysfunction as well as CO2 retention. The aim of this work is to evaluate the effect of one of these procedures; namely laparoscopic cholecystectomy; on cerebral blood flow [CBP] using transcranial Doppler [TCD] ultrasonography to determine the right middle cerebral artery velocity [MCAV] which is proved to correlate well with CBF. Sixteen patients classified as American Society of Anaesthesiologists [ASA] physical status I, and II were included in the study. Their heart rate [HR], mean arterial pressure [MAP], end-tidal carbon dioxide concentration [PETCO2], arterial carbon dioxide tension [PaCO2], and MCAV were recorded before CO2 insufflation, then 10, 20, 30 and 40 minutes after insufflation, and again 10 minutes after peritoneal deflation. Significant increase [P<0.01] in MCAV in all the recorded values was found. This increase was attributed mainly to the accompanying rise in PaCO2. The present study concluded that CBF was increased significantly in laparoscopic procedures utilizing C02 as the insufflation gas. ft is recommended to avoid pneumoperitonium or to use it with extreme caution in patients with suspected or documented intracranial injuries due to the potential for significant increase in intracranial pressure [ICP] and alterations in cerebral perfusion pressure [CPP]

Primary prevention of non insulin dependent diabetes mellitus

This work was conducted aiming at early prediction of individual at high risk of development of type 2 diabetes mellitus and evaluation of the efficacy of primary prevention of type 2 DM in such individual by diet control and /or metformin therapy. It was conducted on 100 individuals at high risk of development of type 2DM. Subjects were classified into 3 groups: Group I [Individuals with positive family history of DM], 30 cases, subdivided into two equal subgroups, Group la used as control and left without diet control and Group Ib were on diet control. Group II [individuals with upper body segment obesity], 40 cases, subdivided into 3 subgroups: Group II a, 10 cases, left without neither diet control nor metformin therapy, Group II b, 15 cases, were on diet control only while Group IIC, 15 cases, were on both diet control and metformin treatment. The third group [Group III] were females with history of gestational diabetes, 30 cases, subdivided into two equal subgroups, Group IIIa used as control and left without diet control, while Group IIIb were on diet control. All cases were subjected to through history taking, complete physical examination, liver function tests, renal function tests, fasting and two hours post-pr and ial plasma glucose estimation, glycosylated haemoglobin [Hb A[1]c] and complete lipid profile. Results showed that individuals with family history of DM had a significant decrease of both FPG and 2HPG together with highly significant decrease in Hb A[1]C after one year of diet control together with significant decrease in total cholesterol, TG and LDL-cholesterol with increase in HDL-cholesterol levels compared to those individuals on free diet reigmen. As regard those with upper body segment obesity, there were significant decreases in both FPG, 2HPG and highly significant decrease in Hb A[1]c in those on diet control and those on both diet control and metformin therapy together with decrease in BMI after one year of follow up compared to those obese with free diet reigmen. This study also showed that females with history of gestational diabetes are more prone to develop type 2DM if left without any diet control since there were significant decrease of both FPG, 2HPG and HbA[1]c levels after one year of follow up. The results of this study showed that diet control has a significant role in preventing or at least delaying the occurrence of type 2DM in those studied high risk groups. Similar effect was obtained by metformin therapy on subjects with upper body segment obesity in preventing the development of type 2DM. Nevertheless, this role need large scale research for long term follow up period to be cleared. The results of this study showed also that, diet control and /or metformin therapy have a significant effect on modification of the different parameters of lipid profile in those individuals which may subsequently have a beneficial effect on reducing or delaying the appearance of the diabetic vascular complications