Effect of Agaricus blazei Murill on exploratory behavior of mice-model

Abstract Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).

Resumo O aumento da ansiedade e dos sintomas depressivos têm relatado sua associação com doenças de longa duração. Por causa dos efeitos indesejáveis dos novos medicamentos disponíveis, os pacientes que administram medicamentos ansiolíticos geralmente interrompem o tratamento antes de estarem completamente recuperados. Portanto, há uma necessidade séria de desenvolver novos medicamentos ansiolíticos. Foi avaliado o efeito ansiolítico do extrato hidroalcoólico de Agaricus blazei em modelos animais. Vinte e quatro camundongos machos (gênero Mus musculus) foram incluídos no estudo. Quatro grupos foram preparados, e cada grupo continha seis animais. Os grupos foram controle de veículo, controle positivo (diazepam 1,0 mg/kg, i.p.), bem como dois grupos de tratamento recebendo extrato hidroalcoólico de Agaricus blazei na dose de 136,50 mg/kg e 273,0 mg/kg por via oral. O teste de enterrar Marble, o teste de retalhamento Nestlet e o teste de caixa clara e escura são usados para avaliar a atividade ansiolítica. Camundongos foram administrados com diazepam 1,0 mg/kg, i.p., enquanto o extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) foi administrado por via oral, que exibiu redução acentuada no número de mármores enterrados em comparação com o grupo de controle de veículo. Camundongos administrados com diazepam 1,0 mg/kg, i.p. e a administração oral de extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) exibiu diminuição significativa na trituração de ninhos em comparação ao grupo de controle de veículo. A administração oral de extrato hidroalcoólico na dose de 136,5mg/kg e 273mg/kg mostrou elevação no tempo gasto na caixa de luz e foi comparável ao grupo tratado padrão, enquanto o tempo gasto por camundongos após a administração oral de extrato hidroalcoólico de Agaricus blazei na dose de 273,0 mg/kg também mostrou elevação e foi mais próximo do grupo tratado padrão (diazepam 1 mg/kg, ip).

Effect of Agaricus blazei Murill on exploratory behavior of mice-model / Efeito de Agaricus blazei Murill no comportamento exploratório de modelo de camundongo

Abstract Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).

Resumo O aumento da ansiedade e dos sintomas depressivos têm relatado sua associação com doenças de longa duração. Por causa dos efeitos indesejáveis dos novos medicamentos disponíveis, os pacientes que administram medicamentos ansiolíticos geralmente interrompem o tratamento antes de estarem completamente recuperados. Portanto, há uma necessidade séria de desenvolver novos medicamentos ansiolíticos. Foi avaliado o efeito ansiolítico do extrato hidroalcoólico de Agaricus blazei em modelos animais. Vinte e quatro camundongos machos (gênero Mus musculus) foram incluídos no estudo. Quatro grupos foram preparados, e cada grupo continha seis animais. Os grupos foram controle de veículo, controle positivo (diazepam 1,0 mg/kg, i.p.), bem como dois grupos de tratamento recebendo extrato hidroalcoólico de Agaricus blazei na dose de 136,50 mg/kg e 273,0 mg/kg por via oral. O teste de enterrar Marble, o teste de retalhamento Nestlet e o teste de caixa clara e escura são usados ​​para avaliar a atividade ansiolítica. Camundongos foram administrados com diazepam 1,0 mg/kg, i.p., enquanto o extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) foi administrado por via oral, que exibiu redução acentuada no número de mármores enterrados em comparação com o grupo de controle de veículo. Camundongos administrados com diazepam 1,0 mg/kg, i.p. e a administração oral de extrato hidroalcoólico de AbM (136,50 e 273,0 mg/kg, respectivamente) exibiu diminuição significativa na trituração de ninhos em comparação ao grupo de controle de veículo. A administração oral de extrato hidroalcoólico na dose de 136,5mg/kg e 273mg/kg mostrou elevação no tempo gasto na caixa de luz e foi comparável ao grupo tratado padrão, enquanto o tempo gasto por camundongos após a administração oral de extrato hidroalcoólico de Agaricus blazei na dose de 273,0 mg/kg também mostrou elevação e foi mais próximo do grupo tratado padrão (diazepam 1 mg/kg, ip).

Histopathological evaluation of the effect of Salvadoria persica and Nigella sativa on the healing of tooth extraction socket in animal

To assess the effects of Salvadoria persica and Nigella sativa combination in tooth socket healing after extraction that can be a novel remedy for tooth extraction socket. Methods: Forty rabbits were included in this study, divided into two groups (control and experimental) with 20 rabbits. Upper right central incisors were extracted for all animals, the tooth sockets of the experimental group were dressed using an admix of Salvadoria persica and Nigella sativa immediately after irrigation with normal saline. In contrast, the extraction sockets of the control group were left without dressing. Biopsies were taken after euthanizing the animals at 1, 3, 7, and 14 days after treatment, histological examination was done for the samples at the given periods respectively. Results: On day 1 post-treatment, histological examination of the experimental group sections showed less acute inflammatory reaction than the control group. This continued to be reduced until the seventh day. The amount of granulation tissue formation was more in the experimental group along the different periods of the study, while new bone formation was observed after 1 week as woven bone, increased after 2 weeks and appeared as woven and lamellar bone in both experimental and control groups. Conclusions: A mixture of Salvadoria persica and Nigella sativa has an anti-inflammatory effect and accelerate bone healing by stimulating bone formation in the tooth extraction socket

Modified Early Warning Score como preditor de readmissão à unidade de terapia intensiva dentro de 48 horas: um estudo observacional retrospectivo / Modified Early Warning Score as a predictor of intensive care unit readmission within 48 hours: a retrospective observational study

RESUMO Objetivo: Avaliar a hipótese de que o Modified Early Warning Score (MEWS) por ocasião da alta da unidade de terapia intensiva associa-se com readmissão, e identificar o nível desse escore que prediz com maior confiabilidade a readmissão à unidade de terapia intensiva dentro de 48 horas após a alta. Métodos: Este foi um estudo observacional retrospectivo a respeito do MEWS de pacientes que receberam alta da unidade de terapia intensiva. Comparamos dados demográficos, escores de severidade, características da doença crítica e MEWS de pacientes readmitidos e não readmitidos. Identificamos os fatores associados com a readmissão em um modelo de regressão logística. Construímos uma curva Característica de Operação do Receptor para o MEWS na predição da probabilidade de readmissão. Por fim, apresentamos o critério ideal com maior sensibilidade e especificidade. Resultados: A taxa de readmissões foi de 2,6%, e o MEWS foi preditor significante de readmissão, juntamente do tempo de permanência na unidade de terapia intensiva acima de 10 dias e traqueostomia. A curva Característica de Operação do Receptor relativa ao MEWS para predizer a probabilidade de readmissão teve área sob a curva de 0,82, e MEWS acima de 6 teve sensibilidade de 0,78 (IC95% 0,66 - 0,9) e especificidade de 0,9 (IC95% 0,87 - 0,93). Conclusão: O MEWS associa-se com readmissão à unidade de terapia intensiva, e o escore acima de 6 teve excelente precisão como preditor prognóstico.

ABSTRACT Objective: To evaluate the hypothesis that the Modified Early Warning Score (MEWS) at the time of intensive care unit discharge is associated with readmission and to identify the MEWS that most reliably predicts intensive care unit readmission within 48 hours of discharge. Methods: This was a retrospective observational study of the MEWSs of discharged patients from the intensive care unit. We compared the demographics, severity scores, critical illness characteristics, and MEWSs of readmitted and non-readmitted patients, identified factors associated with readmission in a logistic regression model, constructed a Receiver Operating Characteristic (ROC) curve of the MEWS in predicting the probability of readmission, and presented the optimum criterion with the highest sensitivity and specificity. Results: The readmission rate was 2.6%, and the MEWS was a significant predictor of readmission, along with intensive care unit length of stay > 10 days and tracheostomy. The ROC curve of the MEWS in predicting the readmission probability had an AUC of 0.82, and a MEWS > 6 carried a sensitivity of 0.78 (95%CI 0.66 - 0.9) and specificity of 0.9 (95%CI 0.87 - 0.93). Conclusion: The MEWS is associated with intensive care unit readmission, and a score > 6 has excellent accuracy as a prognostic predictor.

Antiproliferative and apoptotic effects of the natural alkaline water (Zamzam) in breast cancer cell line MCF-7

Background: Zamzam water (ZW) is a natural alkaline water that contains several minerals that may represent a powerful tool for cancer therapy. Objectives: In this research, in vitro antiproliferative and apoptotic effects of ZW were investigated in the human breast cancer cell line MCF-7. Materials and Methods: This study was conducted between January 2015 and February 2016. The effects of ZW on the morphology and the cell viability of human breast cancer cell line MCF-7 were determined. The cell death type and cell cycle changes were investigated using flow cytometry. Finally, reactive oxygen species (ROS) were also measured by fluorometric technique. Results: MCF-7 cells treated with either ZW with adjusted pH at 7.2 or unadjusted pH at 8 showed reduced cell viability of cancerous cells. The cell death occurred through the apoptosis pathway under both treatment conditions. The treated MCF-7 cells were arrested in the G2/M phase and decreased in the G1 phase. Only the unadjusted pH ZW sample demonstrated an increase in the production of both cytoplasmic and mitochondrial ROS in MCF-7 cells. Conclusion: All the results in the present study indicated, for the first time, that ZW might have anticancer and apoptotic effects on breast cancer cell line

Comparison of ostene and bone wax on bone healing: a comparative experimental study in rabbits

Introduction: Ostene is a new synthetic bone hemostatic wax-like inert and biocompatible material that dissolves within two days after application. bone wax is a well- known topical hemostatic agent, easy to use, and its application is very simple. wound healing is a complex biological process; bone is a dynamic tissue that is continuously resorbed, renewed, and remodeled. materials and methods: twenty domestic rabbits were divided into four groups (day 1, day 3, day 7, and day 14). each rabbit was anaesthetized and three holes were drilled in the mandible: one was filled with Ostene, another with bone wax, and the other was left unfilled as control. sites of intervention were assessed by histopathology. results and Discussion: Ostene and bone wax showed osteoinductive property in bone healing with no inflammatory reaction. our study revealed new bone formation within 14 days in Ostene group. after histopathological analysis and scoring was finished, analysis by SPSS 14 software showed a significant difference between the use of Ostene and bone wax. conclusion: Ostene showed superiority over bone wax in bone healing, and it can be used in the same way as bone wax with no interference with bone healing and osteogenesis. Ostene has no side effects following application.

Diversity, physiochemical and phylogenetic analyses of bacteria isolated from various drinking water sources

Objective: To evaluate the indigenous bacterial strains of drinking water from the most commercial water types including bottled and filtered water that are currently used in Saudi Arabia

Methods: Thirty randomly selected commercial brands of bottled water were purchased from Saudi local markets. Moreover, samples from tap water and filtered water were collected in sterilized glass bottles and stored at 4[degree]C. Biochemical analyses including pH, temperature, lactose fermentation test [LAC], indole test [IND], methyl red test [MR], Voges-Proskauer test [VP], urease test [URE], catalase test [CAT], aerobic and anaerobic test [Ae/An] were measured. Molecular identification and comparative sequence analyses were done by full length 16S rRNA gene sequences using gene bank databases and phylogenetic trees were constructed to see the closely related similarity index between bacterial strains

Results: Among 30 water samples tested, 18 were found positive for bacterial growth. Molecular identification of four selected bacterial strains indicated the alarming presence of pathogenic bacteria Bacillus spp. in most common commercial types of drinking water used in Saudi Arabia

Conclusion: The lack of awareness about good sanitation, poor personal hygienic practices and failure of safe water management and supply are the important factors for poor drinking water quality in these sources, need to be addressed

In Vitro Cytotoxic and Anticancer Effects of Zamzam Water in Human Lung Cancer (A594) Cell Line

Background: Zamzam water is naturally alkaline and rich in a variety of minerals which may represent a powerful tool for cancer therapy. In this research, the cytotoxic effects of Zamzam water were investigated in human lung cancer (A549) cell line and compared with human skin fibroblasts (HSF). Methods: Two different preparations of Zamzam water were used: Z1, with pH adjusted to 7.2 and Z2, with no pH adjustment. The effects of both treatments on the morphology of the A549 and HSF cell lines were investigated. The cell viability of HSF and A549 cells was identified by the MTT assay and trypan blue exclusion. Detection of apoptotic cells and cell cycle analyses were determined using flow cytometry. Moreover, reactive oxygen species (ROS) were measured for both cell lines. Results: Both Zamzam water treatments, Z1 and Z2 showed reductions in the cell viability of A549 cells. Cell death occurred via necrosis among cells treated with Z2. Cell cycle arrest occurred in the G0/G1 phases for cells treated with Z2. Cellular and mitochondrial ROS productions were not affected by either treatment. Conclusion: Our findings indicate that Zamzam water might have potential therapeutic efficacy for lung cancer.

Treatment-induced copper deficiency in two patients with Wilsons disease

Copper is an essential trace element that is vital to the health of all living cells. However, like all essential elements, its serum level must be kept within normal values; otherwise, conditions of toxicity or deficiency can result, each of which has its own unique set of adverse health effects. Wilson's disease [WD] is an inherited disease of copper accumulation that can cause liver and neurological affection. Its management depends on removal of excess copper using copper chelators such as D-penicillamine or trientine, which increase the urinary excretion of copper. In a more recent approach, zinc has been used to decrease copper accumulation. We present two WD cases that developed copper deficiency as a result of their treatment. These cases improve our understanding and management of copper deficiency in WD and highlight the importance of copper-level monitoring in WD

Another hazard to laboratory workers

Needle-stick injuries, unfortunately, are a common occurrence during blood extraction and handling of specimens in the laboratory, which often lead to the contraction of blood-borne viral diseases. Mycobacterium tuberculosis infection also poses a threat to healthcare workers, especially laboratory workers in areas with endemic levels of tuberculosis infections. We present in this report, a case of primary inoculation of tuberculosis of the skin transmitted following a needle-stick injury, which was successfully treated. Reports of such an occurrence are few, and our report further underlines the need to take greater precautions against these accidents. In addition, our case draws attention to the possibility of prophylactic anti-tuberculous treatment in high-risk patients to prevent the progression of an overt illness

Possible teratogenic effects of antiepileptics in albino rats: comparative study between old and new generations: part I

All of the antiepileptic drugs [AEDs] are either known or suspected of being teratogenic. The possible mechanism of teratogenicity is likely to be multiple for the same drug. This is of major concern for all women with epilepsy using these drugs are delicately balanced between seizure control and the adverse effects the AEDs. The use of conventional AEDs eg. Carbamazepine control more than two thirds of the epileptic patients. In recent years, the number of commercially available AEDs has steadily increased eg. lamotrgine and levetiracetam.160 pregnant female albino rats were used in this study. Animals were classified randomly into eight groups; each group contained 20 pregnant female rats. Negative control group received nothing and positive control group received normal saline. Treated groups: each group received either the therapeutic dose or 1/4 LD50 of carbamazepine, lamotrigine or levetriacetam. The drugs were given by gastric tube from 6[th] day up to the 19[th] day of gestation. Teratological evaluation:the fetuses [both living and dead] in each group were weighted their crown rump length measured and morphological examination included: Head size and shape, orofacial development, vertebral column tail and abdomen, umbilicus and external genitalia Maternal findings showed high death rate in 1/4 LD50 of lamotrigine treated group; weight gain was dose dependant with highest effect in the lamotrigine treated groups. The fetal findings showed highest embrolethality and least litter siza in lamotrigine treated groups; while the fetal growth determined by weight gain and crown rumplength was retarded more in carbamazepine and lamotrigine treated groups than in levetiracetam treated groups. The morphological findings revealed that the highest percentage of congenital anomalies were in the dose of 1/4 LD50 of lamotrigine followed by carbamazepine and levetiracetam. The AEDs are potentially teratogenic and in utero exposure can increase the risk of adverse outcomes in off springs born epileptic mothers. The new AED lamotrigine caused gross fetal retardation even in therapeutic dose. Levetiracetam caused growth retardation in the therapeutic dose more than carbamazepine in the corresponding dose although it had the best effect on maternalparameters. As regard the congenital anomalies lamotrigine was the safest durg in the therapeutic dose

Acute ocular complications from self-administered topical kermes

To report severe ocular complications and their management after self-administered topical kermes dye eye drops. A case report of a 55-year-old man who suffered severe ocular surface damage after application of topical kermes eye drops to his left eye. Active compounds of the kermes eye drops were studied for their composition. Patient reported decreased vision in the affected eye and the external eye examination revealed complete corneal abrasion, cicatrization of the conjunctiva, and symblepharon formation. The patient required immediate cleansing of the ocular surface along with irrigation. He was treated with topical corticosteroids and frequent lubrication. Gas chromatography/mass spectrometry analysis of the retrieved topical material revealed the presence of acid. The patient's visual acuity improved from 20/200 before treatment to 20/25 after treatment.Topically administered kermes eye drops may cause severe ocular injuries. Public education, early recognition of such injuries, and timely intervention may prevent permanent damage to the ocular adnexae

Aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone

Secondary aneurysmal bone cyst in fibrous dysplasia is exceedingly rare, especially in the skull and particularly in the frontal bone. We present a case of aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone in a 15-year-old male patient presenting with headache and euphoria with an uncharacteristic imaging appearance and treated successfully by total resection

Survey of perceived stress-inducing problems among dental students, Saudi Arabia

This study was conducted to assess the problems related to stress encountered by Saudi dental students. One thousand and thirty questionnaires were distributed in four dental schools to all students from 2nd year level up to the internship level. The questionnaire contained 66 items organized into four categories: personal and administrative, theoretical, preclinical and clinical. The relationship between the demographic variables and students' academic performance with the investigated items was also assessed. The response rate was 53%. Saudi dental students showed high levels of perceived stress. The clinical training issues imposed the highest level of stress on the students. Some significant relationships between the investigated variables and the level of the perceived stress were found. Female students had higher mean overall problem scores compared to male students, and second-year students showed lower perceived problems compared to other students

review of community-acquired methicillin-resistant Staphylococcus aureus for primary care physicians

Community-acquired methicillin-resistant Staphylococcus aureus [CA-MRSA] infections among young people without healthcare-associated risk factors have emerged during the past decade. Reported prevalence rates of CA-MRSA vary widely among studies, largely because of the different definitions employed and different settings in which the studies have been performed. Although the majority of CA-MRSA infections are mild skin and soft tissue infections, severe life-threatening cases have been reported. CA-MRSA infections have mostly been associated with staphylococcal strains bearing the staphylococcal cassette chromosome mec type IV element and Panton-Valentine leukocidin genes. These strains are more frequently susceptible to a variety of non-beta-lactam antibiotics. Clinicians must be aware of the wide spectrum of disease caused by CA-MRSA. Continued emergence of MRSA in the community is a public health problem, and therefore warrants increased vigilance in the diagnosis and management of suspected and confirmed staphylococcal infections

Characteristics of pulmonary tuberculosis and extrapulmonary tuberculosis in immunocompetent adults

Objective: While tuberculosis is primarily considered a pulmonary disease, it has the potential to infect almost every organ via lymphohematogenous dissemination during the initial pulmonary infection. The aim of this study was to explore the importance of demographics, clinical characteristics and the various patterns of extrapulmonary tuberculosis among Saudi and non Saudi patients presenting to King Fahd Hospital of the University, Alkhobar, in the Eastern Province of Saudi Arabia. <br>Methods: Prospective study of all adult patients (13 years of age and above) with tuberculosis over a period of 9 years between 1997 and 2005. <br>Results: A total of 390 cases of tuberculosis were diagnosed during the 9-year period. There were 221 Saudis (57%), and 169 non-Saudis (43%). Pulmonary tuberculosis (PTB) was diagnosed in 132 cases (33 %), extrapulmonary tuberculosis (EPTB) in 244 cases (63%), and both pulmonary and extrapulmonary in 14 cases (4%). The proportion of EPTB was similar among Saudi and non Saudi patients. Constitutional symptoms were more common among PTB than EPTB patients. Lymphadenopathy was the most frequent site of involvement. Of the 244 EPTB patients, 113 (45%) had lymphadenopathy and more than half were located in the cervical region. Osteoarticular tuberculosis noted in 41 patients (17%) was the second most frequent involvement. Pleural, peritoneal, miliary, genitourinary, and central nervous system tuberculosis, each accounted for 2%10% of the total number of cases of EPTB. Co-morbidities were found in 56 patients, 12% from EPTB, and 16% from PTB. Human immunodeficiency virus test results were available for 234 patients; all were found to be seronegative. <br>Conclusion: Extrapulmonary tuberculosis remains frequent even in patients lacking risk factors. Dealing with EPTB has been hampered by the absence of a quick and accurate diagnostic tool. Because the clinical presentation of EPTB is extremely variable, a high level of suspicion is required to diagnose and treat EPTB in a timely and health-preserving manner.

Breast carcinoma during pregnancy

The medical records of patients with pregnancy associated breast carcinoma were critically reviewed to identify the tumor characteristics, maternal details, type of treatment delivered, and disease outcome. Over the last 5 years, there were 5 patients out of 220 giving a percentage prevalence of 2.27%. The median age at presentation was 33 years. Three patients were diagnosed by the sixth week of gestational age. Three out of 5 presented with stage IIIA. Four patients has >/= 6 positive axillary lymph nodes and grade III disease. So in spite of the discovery of the tumor in the early weeks of pregnancy, our patients presented with advanced disease, which is consistent with the presentation of breast carcinoma in non-pregnant women in this part of the world. So it could be an ignored disease, which became evident with the pregnancy. We highly encourage the obstetricians to perform thorough breast examination during the prenatal period with prompt referral of any suspicious cases

Seroprevalenc of HIV/AIDS among pregnant Sudanese women

The prevalence of HIV/AIDS in the Sudan is 1.6-6.0%. With the advent of peace, the disease is expected to be on the rise. The objective of the study is to assess the prevalence of HIV/AIDS in pregnant Sudanese women so as to prevent Mother-to-Child Transmission. In a pilot study conducted at antenatal clinics in 5 Sudanese Teaching Hospitals, five teams were trained in the basic skills of counseling, diagnosis and management of HIV/AIDS. Rapid Test [Uni-gold HIV-1/HIV-2], Serodia HIV-1/2, and Western blot [INNP-LIA HIV-1/2 SCORE] tests were used. The prevalence of HIV/AIDS was found to be 0.8%. This pilot study led to establishment of seven Antenatal clinics for prevention of mother_to-child transmission in different parts of the country. Qualified teams composed of an Obstetrician, Paediatrician, pharmacist, Social worker, Health visitor, midwife, Laboratory Technician and a counselor provided counseling, testing and management for pregnant women and children of HIVpositive mothers. 57793 pregnant women attended antenatal clinics during the period August 2007-August 2008. Out of these 25941 [44.9%] were counseled; however only 5959 [23.0%] accepted to be tested for HIV. 39 positive cases were found, making the prevalence rate of 0.65%. Patients were managed and the babies were given antiretroviral treatment. Breast feeding was advised. Although the prevalence of HIV/AIDS is about 1.6-6% in the country, it is still low in pregnant women. A great effort should be done on Voluntary Counseling and Testing [VCT]; and effective preventive measures should be taken

Breast infections in non-lactating women

Breast infection in lactating mothers is a common entity which in the majority of cases can be explained by ascending infections. However, it has been noticed that the number of non- lactating women presenting with breast abscesses is rising. This study attempts to explore the sensitivity pattern of organisms and underlying cause of breast infections in non-lactating women. Materials and Methods: This review was undertaken at King Fahd of the University, Alkhobar, Saudi Arabia between 1991-2003. All patients presenting with breast infections were included. Medical records, operative notes, cultures, histopathology reports and outcome were reviewed. Results: The number of patients presenting with breast infections accounted for 179[3.5%] out of the total number of patients 6314 with variable breast complaints. Infection occurred in 136[76%] lactating women [Group I] ,while Non lactating [Group II] breast infections accounted for 43[24%]. Age ranged from 24 years to 52 years. Underlying clinical conditions were found in 26 patients[60%] in Group II namely granulomatous mastitis13[50%], duct ectasia4 [15.3%], pregnancy3[11.5%], fat necrosis1[3.8%], diabetes3 [11.5%] and breast cancer 2[7.6%]. The pattern of culture results was different in the two groups, from differing causative organisms namely staphylococcus aureus as the commonest organism in both groups, in comparison to such uncommon organisms as Klebsiella pneumonae, Peptococcus magnus, Streptococcus group B, Entro-bacter cloacae, Methicillin resistant staphylococcus aureus [MRSA] and Mycobacterium tuberculosis occurring in group II only. Fortunately, all organisms were sensitive to antimicrobial therapy. Breast infection in non-lactating women is an infrequent but recognized clinical entity that deserves special attention. An underlying clinical condition should always be sought and treated. Indeed, in addition to cultures, radiological modalities such as ultrasonographic imaging may provide specific diagnosis and aid the management

Gastroesophageal reflux in bronchial asthma patients. A clinical note

The objective is to correlate the symptoms of gastroesophageal reflux with the results of esophageal reflux with the results of esophageal pH metry in asthmatic patients. A prospective study was carried out in King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia [KSA], during the period January 2000 through to February 2001, whereby 50 patients [34 females and 16 females] with primary diagnosis of bronchial asthma were consecutively enrolled, their mean age + SD was 38.01 + 9.8 years. Twenty-two subjects who were not suffering from asthma or gastroesophageal reflux [GER] [13 females and 9 males] constituted the control group. A questionnaire was administered to all participants and demographic data; asthma and GER symptoms were obtained. Esophageal manometry was performed, whereby the location, length and resting pressure of the lower esophageal sphincter [LES] were determined, pH catheter was inserted nasogastrically, and ambulatory pH data over 24 hours were collected. Pulmonary function tests were also performed. Twenty-two [44%] patients with asthma had a Demeester score greater than 14.7 and were therefore diagnosed as having pathological GER. Accordingly, the asthma patients were divided into 2 groups, asthma patients with GER [n=22] and those without GER [n=28]. Multiple logistic regression analysis revealed that age did not significantly influence occurrence of GER, but it indicated that hoarseness of voice and nocturnal symptoms were significant predictors for the presence of GER in asthmatic patients, hence, the probability of having GER in an asthma patient is nearly 8 times if he/she has nocturnal symptoms and about 7 times if they have hoarseness of voice. However 36.4% of asthmatic patients diagnosed by esophageal ph metry as having GER did not complain of heartburn and hoarseness of voice; such as the reflux was silent. The frequency of GER among 50 patients with asthma reporting to KFHU, Al-Khobar, KSA is 44%. The presence of nocturnal symptoms and hoarseness of voice are significant clinical predictors of GER in asthmatic patients. Patients with difficult to treat asthma should be subjected to esophageal pH metry since a substantial proportion of them may have silent reflux