Effect of nicotine on the structure of cochlea of guinea pigs / 대한해부학회지

Smoking has been positively associated with hearing loss in human. However, its effect on the cochlea has not been previously evaluated. Aim of work is to investigate the effect of nicotine, which is the primary pharmacological component of tobacco, on the structure of the cochlea of adult male guinea pigs. Fifteen male guinea pigs were classified into two groups: group I (control) and group II (nicotine treated group). Group II was further subdivided into two subgroups; IIA and IIB according to the dose of nicotine (3 mg/kg and 6 mg/kg, respectively). The cochlea was harvested and processed for light microscopy, transmission electron microscopy and scanning electron microscopy. Nicotine administration induced damage of outer hair cells which were distorted in shape with vacuolated cytoplasm and heterochromatic nuclei. Topography revealed damage of the stereocilia which included disorganization, bent and limp or complete loss and expansion of the surrounding supporting cells. These changes were more pronounced in the basal turn of the cochlea and mainly involved the outer hair cells. High dose induced more damage and resulted in protrusion of the apical poles of hair cells (blebing), particularly the outer two rows. Nicotine is proved to be harmful to the cells of the cochlea, particularly the outer hair cells of the basal turn. High doses induce blebing of hair cells.

Effect of genistein on the pancreas of streptozotocin-induced diabetic male rats: light and electron microscopic study

Diabetes mellitus is a worldwide serious health problem. The critical need for novel therapeutic approaches to treat diabetes mellitus is clear. Genistein, a natural soy isoflavone, have numerous health benefits attributed to multiple biological functions. To investigate the effect of genistein on the structure of pancreatic beta cells and acinar cells in streptozotocin-induced diabetic rats. Thirty adult male albino rats were classified into: group I [control], group II in which diabetes was induced by a single intraperitoneal injection of streptozotocin [STZ] [80 mg/kg] and group 111 in which the diabetic rats were injected subcutaneously with genistein [0.25 mg/kg/day] Alter 3 months, blood glucose concentrations were assessed and pancreas specimens were processed lor light and electron microscopic study. Immunohistochemical insulin reactivity and morphometric analysis of the islet diameter were also studied. STZ, in group II rats, caused shrinkage of the pancreatic islet and induced beta cell damage in addition to weak insulin immunoreactivity and elevated blood glucose level. Many Icinar cells of this group showed accumulated zymogen granules, pleomorphic mitochondria and small lipid droplets. Genistein, in group III rats, preserved beta cell mass as evidenced by the large islets with strong insulin immunoreactivity and the significant reduction in blood glucose level. Ultrastructurally, beta cells of group III rats had numerous secretory granules and well developed Golgi bodies. Iknvever, the acinar cells of genistein treated rats exhibited more structural changes than group II with loss of the normal polarity and marked damage of mitochondria. Zymogen granules exhibited low electron density with frequent docking to the lateral plasma membrane and granule-granule fusion. Genistein protected the beta cells against STZ-induced damage. However its deleterious effect on the pancreatic acinar cells might limit its benefit as a promising therapy for diabetes mellitus

Sex differences in dopaminergic neurons of substantia nigra pars compacta of adult and aged rats: a histological and immunohistochemical study

Substantia nigra pars compacta [SNC] is the main source of dopaminergic [DA] input to the striatum. Parkinson's disease is a neurodegenerative disease affecting DA neurons in SNC, with a higher incidence in men. To study the effect of sex on the structure of DA neurons in adult and aged rat SNC. The brains of 22 adult [11 males and 11 females] and 22 aged [11 males and 11 females] albino rats were processed for histological and immunohistochemical examination of DA neurons in the right SNC. Golgi-Cox staining of adult male SNC neurons showed more varicosities and less extension of their dendrites than adult female SNC. Adult male SNC showed a nonsignificant increase in tyrosine hydroxylase-positive neurons than adult female SNC. Aging-related changes were more marked in aged male rats. Aged SNC showed decreased packing density of neurons, some of which appeared irregular and deeply stained. A reduction in Nissl staining was observed. Golgi-Cox staining showed a marked decrease in extension and branching of the dendrites with loss of spines. Ultrastructurally, accumulation of lipofuscin pigment, membranous whorls, dilated Golgi bodies, decreased rough endoplasmic reticulum, and destroyed cristae of mitochondria were observed. A significant reduction in tyrosine hydroxylase-positive neurons was evident in aged SNC. Sex differences in DA neurons of SNC were more apparent in aged rats, with more degenerative changes in the aged male group, which may underlie the predisposition of males to Parkinson's disease

Effect of sildenafil citrate on the structure of rat liver: a histological, histochemical and immunohistochemical study

Sildenafil citrate [SC] is an effective drug for treatment for erectile dysfunction, which is a common symptom in patients with liver disease. The effect of SC on liver structure is elusive and has not been thoroughly studied. The aim of this study was to investigate the effect of SC treatment for different periods and its withdrawal on the liver structure in adult male rats. Twenty-four adult male albino rats were classified into four groups: group I [control], group II [rats treated with SC orally at a dose of 10 mg/kg/day for 4 weeks], group III [rats treated with 10 mg/kg/day SC for 8 weeks] and group IV [recovery group; rats treated similarly as group III and then left for 4 weeks without SC treatment]. Liver specimens were processed for histological, histochemical and immunohistochemical study. In group II, the liver revealed significant enlargement of many hepatocytes with clumping of cell organelles in their cytoplasm. There were frequent Kupffer cells, activated hepatic stellate cells and increased deposition of collagen fibers. In group III, these changes were more marked, in addition to reduced glycogen staining in hepatocytes. Dilated bile ductules and cellular infiltration were noticed in many portal tract areas. In the recovery group, most changes were relatively reduced but not reversed completely. SC exerted deleterious structural effects on the hepatic tissue that were more pronounced with longer duration of SC administration. Some of these deleterious effects were reversible after discontinuation of the drug

Effect of selenium in ameliorating the effect of induced perinatal hypothyroidism on postnatal rat cerebellar cortex development: a histological and immunohistochemical study

Background: Thyroid hormone plays a key role in the development of the cerebellar cortex. Selenium is a nutritional element with antioxidant and neuroprotective properties

Aim: The aim of this study was to investigate the effect of selenium on the structural impairment of postnatal rat cerebellar cortex development induced by perinatal experimental hypothyroidism

Materials and methods: Pups from 20 pregnant rats were divided into four equal groups: group I: negative control group, group II: methimazole-induced hypothyroid group, group III: selenium-supplemented hypothyroid group, and group IV: selenium-supplemented group [positive control]. Treatment continued from gestational day 14 to postnatal day [P] 14. At P7, P14, and P28, blood samples were collected for assessment of serum thyroid hormone and right cerebellar hemisphere specimens were processed for histological, immunohistochemical, and morphometric procedures

Results: Pups of hypothyroid group showed a retarded postnatal cerebellar cortex development, more apparent at P7 and P14, evidenced by increased thickness of the external granular layer and delayed alignment and differentiation of Purkinje cells in addition to reduced proliferating cell nuclear antigen and increased caspase 3-immunoreactivity. At P28, dark cell degeneration of most Purkinje cells was observed. A significant decrease in the thickness of the molecular and internal granular layers and of the number and surface area of Purkinje cells was observed in all postnatal ages studied. Glial fibrillary acidic protein immunostaining showed increased positive astrocytes with twisting and thickening of their glial fibers. Selenium caused a marked amelioration of most of these structural alterations

Conclusion: Perinatal hypothyroidism impaired postnatal cerebellar cortex development. Selenium should be used as a dietary supplement during pregnancy, particularly in hypothyroid conditions

Effect of all-trans-retinoic acid on the structure of thyroid gland and pituitary tyrotrophs in streptozotocin-diabetic male rats

Background: Diabetes mellitus, a chronic disease with increasing prevalence worldwide, is known to be associated with thyroid disorders. Retinoic acid, a metabolite of vitamin A, is currently used for the treatment of diabetes and obesity

Aim of the work: The present study aimed to evaluate the possibility of using all-trans-retinoic acid [atRA] in reducing the structural changes of the thyroid gland and pituitary thyrotrophs in streptozotocin-induced diabetic rats

Materials and methods: Thirty adult male albino rats were divided into three equal groups: group I, control; group II, which included rats in which diabetes was induced by a single intraperitoneal injection of streptozotocin [100 mg/kg]; and group III, which included rats in which diabetes was induced as in group II, followed by an intraperitoneal injection of atRA [2.5 mg/kg/day] from the third day. After 4 weeks, thyroid and pituitary specimens were processed for light and electron microscopic study

Results: Most thyroid follicles of diabetic rats were distended with colloid and lined with flattened thyrocytes with hyperchromatic nuclei and vacuolated cytoplasm that contained dilated rough endoplasmic reticulum, few colloid droplets, and few lysosomes. Some exfoliated cells were observed in the lumen. C cells had rarefied cytoplasm containing a few secretory granules. The number of mast cells showed a nonsignificant change. Thyrotrophs showed dilated rough endoplasmic reticulum, destroyed mitochondria, and decreased secretory granules. The atRA-treated diabetic group showed almost the same structural alterations in the thyroid gland, with even more changes in thyrotrophs

Conclusion: Despite its current use as a novel therapy for diabetes, atRA exerted no ameliorating effect on diabetes-induced histological changes in the thyroid gland and, moreover, exacerbated the changes of pituitary thyrotrophs

Effect of Nigella sativa oil on paracetamol-induced renal cortical damage in rats: light and electron microscopic study

Paracetamol or acetaminophen [IV-acetyl-p-aminophenol; APAP] is a widely used analgesic and antipyretic drug. Unfortunately, it is now reported as the most common cause of toxic ingestion in the world. Nigella sativa oil [NSO] is an extract of N. sativa having antioxidant properties. This study aimed to assess the possible role of NSO in ameliorating the toxic effect of APAP overdose on the rat renal cortical structure. Thirty male albino rats were divided into three equal groups. Group I was the control group. Group II comprised rats treated with APAP [750 mg/kg/day] orally for 7 days. Group III received NSO [2 ml/kg/day orally] 30 min before oral administration of APAP at the same dose as that of group II for 7 days. Kidney specimens were processed for light and electron microscopic study of the renal cortex. Plasma renin activity and arterial blood pressure were estimated. APAP-treated rats showed marked structural changes in the proximal convoluted tubules with dense nuclear staining, cytoplasmic vacuolization, increased peroxisomes, and partial loss of apical brush border and basal striations. Renal corpuscles revealed focal fusion of podocyte foot processes and irregular thickening of glomerular basement membranes. Juxtaglomerular cells contained few renin granules, reflecting an increase in renin exocytosis that coincided with increased plasma renin activity and increased arterial blood pressure. Concomitant administration of NSO with APAP revealed a noticeable amelioration of these histological and physiological changes. NSO exerted a protective effect against APAP-induced renal cortical damage

Effect of shark liver oil on renal cortical structure in hypercholesterolemic rats

Numerous studies reported the association between hypercholesterolemia and renal damage. Elevated plasma cholesterol is involved in the onset and progression of renal diseases. Shark liver oil is reported to be an antioxidant and hypolipidemic. This study was conducted to investigate the possible effects of two different doses of shark liver oil in reducing renal cortical changes associated with high cholesterol diet feeding in correlation with serum lipids. Forty rats were divided into two groups: control group [group 1 = 1 0 rats] and high cholesterol diet-fed group [group 2 = 30 rats]. Group 2 was further subdivided into three subgroups: group 2a, nonsupplemented with shark liver oil; group 2b, supplemented with 1 0% shark liver oil; and group 2c supplemented with 20% shark liver oil. Kidney samples were processed for general histological, immunohistochemical, and ultrastructural study of the renal cortex. Blood samples were collected for assessment of serum lipids. High cholesterol diet-fed group showed prominent podocyte injury characterized by de novo desmin staining and flattening and fusion of foot processes. Some renal corpuscles exhibited thickening and distortion of the glomerular basement membrane. Renal tubular cells showed intracellular vacuoles and mitochondrial degeneration. These structural changes were associated with altered serum lipids. Shark liver oil dietary supplement noticeably ameliorated renal cortical damage and corrected the changes in serum lipids with better improvement in the 20% shark liver oil-supplemented group. This study reveals the beneficial effect of shark liver oil, as a health supplement, in ameliorating the structural renal cortical damage and hypercholesterolemia associated with high cholesterol diet feeding

Evaluation of management of children with pulmonary hypertension secondary to congenital heart disease in Assiut University Children Hospital

The study included 30 cases with congenital heart disease [CHD] with left to right shunt and pulmonary hypertension. Nineteen cases for whom intervention was not available [group I] received diuretics, digoxin when indicated and sildenafil in a dose of 1mg/Kg/dose three times daily and 11 cases [group II] managed surgically. Full history and physical examination, standard 13-lead ECG, chest radiograph poster-anterior view and detailed echocardiographic examination were done for all patients. Patients on medical treatment were followed up clinically and by echocardiography every 2 weeks for 4 months. Those managed surgically were followed up in the postoperative period until their condition was stable and have no longer pulmonary hypertension. It was observed that isolated ventricular septal defect[s] [VSD] was the most common CHD associated with PHT representing 61% of the studied cases. In group I, it was observed that there was significant improvement in growth parameters: weight 10.06 +/- 6.32 Kg vs. 12.11 +/- 6.26 Kg and height 81.16 +/- 22.02 cm vs. 83.97 +/- 21.30 cm, P<0.001] for each. The number of cases >/= 5[th] centile for weight after treatment [7 patients] was significantly higher than those before treatment [3 patients] [P<0.05]. There was significant improvement in symptoms and functional class manifested by decrease in respiratory rate 53.42 +/- 8.71 b/m [breath/minute] vs. 37.26 +/- 8.22 b/m and New York Heart Association [NYHA] class 2.89 +/- 0.74 vs. 1.63 +/- 0.50 [P<0.001] for each. It was observed that there was statistically significant increase in left atrial [LA] diameter 34.99 +/- 6.24 vs. 37.82 +/- 7.09, left ventricular end diastolic diameter [LVEDD] and left ventricular fractional shortening [FS] after treatment [P<0.01, 0.05 and 0.01] respectively. Furthermore, there was statistically significant decrease in right ventricle diameter [RV] 26.75 +/- 4.87 vs. 23.65 +/- 7.76, [P<0.05]. In group II, it was observed that there was statistically significant improvement in growth parameters: weight 7.63 +/- 3.18 Kg vs. 9.86 +/- 2.89 Kg and height 75.55 +/- 12.28 cm vs. 78.272 +/- 11.74 cm, [P<0.001] for each. The number of cases >/= 5[th] centile for weight after treatment [9 patients] was significantly higher than those before treatment [3 patients] [P<0.01]. This improvement was significantly higher in group II than in group I. There was significant improvement in symptoms and functional class manifested by decrease in respiratory rate 46.91 +/- 4.85 b/m vs. 33.64 +/- 8.94 b/m and NYHA class 2.36 +/- 0.67 vs. 0.55 +/- 1.21 P<0.001 for each. It was observed that there was statistically significant decrease in left atrial [LA] diameter 38.41 +/- 7.19 vs. 29.68 +/- 6.75 and left ventricular end diastolic diameter [LVEDD] 55.99 +/- 12.14 vs. 48.00 +/- 1.53 after corrective surgical repair [P<0.001 and 0.05 respectively]. Furthermore, there was statistically significant decrease in right ventricle [RV] diameter 27.73 +/- 5.53 vs. 21.99 +/- 3.30 [P<0.001]. The peak systolic pulmonary artery pressure [PSPAP] was significantly higher in group I than in group II prior to [83.3 +/- 13.3 vs. 68.63+12.37 mm Hg, P<0.01] and after [57.9 +/- 10.9 vs. 38.0 +/- 16.25, P<0.001] management. The number of cases with controlled pulmonary pressure in group II[10 patients] was significantly higher than those in group I[3 patients], P<0.001. Sildenafil showed significant improvement in mean PSPAP in patients with unrepaired CHD [group I] from 83.3 mmHg to 57.9 mmHg [P<0.001]. There was statistical significant improvement in mean PSPAP in patients with repaired CHD [group II] from 68.63 mmHg to 38.0 mmHg after surgery [P<0.001]. It could be concluded that early definitive repair of congenital heart diseases is still the most important and effective strategy for treating PHT in children with congenital heart disease with left to right shunt. Sildenafil citrate may be safe, well tolerated in patients with pulmonary hypertension due to congenital heart disease and repaired congenital heart disease. The improvement in growth parameters, NYHA class and estimated pulmonary pressure associated with the use of Sildenafil helps children with CHD with left to right shunt PHT to tolerate the condition until definitive repair of the underlying defect

study of sexual and reproductive dysfunctions in juvenile onset diabetic men

Diabetes affects an increasingly large number of young men of reproductive age To determine fertility status and to evaluate semen parameters and sexual dysfunction in men having juvenile onset diabetes comparing them to fertile controls. 73 male patients having juvenile onset diabetes mellitus. The study included clinical evaluation, erectile capacity scoring with IIEF-5 score, urine analysis after masturbation, conventional semen analysis and sperm hypoosmotic swelling test of 73 diabetic men and 33 fertile controls. Comparison between diabetic patients and fertile controls in conventional sperm parameters and hypoosmotic sperm swelling percentage [HOS%]. Additionally, assessment of prevalence of infertility, erectile and ejaculatory dysfunction in diabetic patients. There was a significant decrease in percentage of normal sperm morphology among diabetic patients [41.37 +/- 12. 38] than controls [57.27 +/- 8.11] [P < 0.001]. Percentage of progressive sperm motility was significantly lower in diabetic patients [33.42 +/- 13.38] than controls [54.84 +/- 5.92] [P < 0.001]. There was a significant decrease in sperm HOS% among diabetic patients [62.55 +/- 11.69] in comparison to controls [77.36 +/- 8.23] [P < 0.001]. There was no significant difference in sperm concentration [in million sperm/ml] between diabetic patients [69.75 +/- 62.11] and controls [74.55 +/- 50.78]. Similar results were obtained on comparing between fertile and infertile diabetics. Prevalence of infertility was 40%, erectile dysfunction [ED] was 75%, premature ejaculation was 31% and partial retrograde ejaculation was 5%. Diabetic patients had significantly lower normal sperm morphology, progressive sperm motility and hypoosmotic sperm swelling percentages. They had higher round cell number. They also had increased prevalence of infertility, erectile and ejaculatory dysfunctions

Circulating soluble transferrin receptor and ferritin in polycystic ovary syndrome

The aim of this study was to determine serum ferritin and soluble transferrin receptor [sTfR] concentrations in poiycystic ovary syndrome [PCOS] women and to clarify their relationship to insulin resistance and metabolic features of PCOS. This cross-sectional study consisted of 20 obese patients with PCOS, 15 obese, normally menstruating, age and BMI matched women, and 10 healthy, age matched, lean women as control groups. Serum ferritin and soluble transferrin receptor levels were measured using an enzyme-linked immunosorbent assay. Additionally, participants were subjected to hormonal assays, lipid profile, fasting glucose, iron, total iron binding capacity and serum insulin levels as well as transvaginal ultrasonography. The homeostasis model assessment of insulin resistance [HOMA-IR], Free Androgen Index [FAI], Body mass index [BMI] and Waist to hip ratio [WHR] were also calculated for each participant. Serum ferritin level was significantly higher in obese PCOS patients compared to both obese and lean control subjects Also, serum ferritin level was significantly higher in obese compared to lean control subjects. On the other hand, serum sTfR level was significantly lower in obese PCOS patients compared to both obese and lean subjects. While, no significant difference was observed between obese and lean subjects as regard sTfR level, the fasting insulin level and HOMA-IR were significantly higher in obese PCOS patients compared to both obese and lean control subjects. In addition, obese subjects had significantly higher fasting insulin level and HOMA-IR compared to lean control subjects. Serum ferritin levels showed a significant inverse correlation with soluble transferrin receptor level in all of the studied groups. Obese PCOS women have lower soluble transferrin receptor levels compared to obese and normal controls. sTfR is highly correlated with ferritin. Furthermore, sTfR could serve as a sensitive marker for iron overload in obese, PCOS patients, or metabolic syndrome

Taurine protects transplanted liver against ischemia-reperfusion injury

Although liver transplantation as a treatment of end-stage liver disease has developed rapidly, the problem of ischemia-reperfusion injury [I/RI] to the liver graft remains an obstacle. After I/R, Kupffer cells were activated and generate reactive oxygen species [ROS] which play a central role in the pathogenesis of rejection. Taurine is a cysteine derivative known as being a conjugate to primary bile acids; besides oxidative regulation functions, it is supposed to have protective efficacy on ischemia reperfusion liver damage and its anti-hepatic injury may be mainly related to inhibiting lipid peroxides formation, regulating cellular calcium homeostasis and stabilizing biological membrane. To evaluate the effect of taurine injection before liver transplantation on the oxidant [MDA] /antioxidant [reduced glutathione and glutathione peroxidase] status, activation of Kupffer cell [tumor necrosis factor-alpha] and cell apoptosis [expression of hypoxia inducible factor-1 alpha [HIF-1 alpha] and caspase-3]. Forty patients undergoing liver transplantation were divided into two groups: Group I: Taurine group [n=20] were given [1 gm taurine intravenous bolus to the donor 30 min before hepatectomy and another 1 gm to recipient 15 min before graft reperfusion] .Group II: saline control group [n= 20] were given physiological saline of the same volume as taurine group. Liver biopsy was taken before the end of operation for the mRNA expression of HIF-1 alpha and caspase-3. Blood samples were taken from each participant at the beginning of the operation [T[0]], clamping of portal vein [T[1]], 1 h and 3 h after portal vein reperfusion [T[2] and T[3], respectively]. Serum levels of aspartate aminotransferase [AST], alanine aminotransferase [ALT], tumor necrosis factor-alpha [TNF- alpha], malondialdehyde [MDA], reduced glutathione [GSH] and whole blood glutathione peroxidase activity [GPx] were analyzed. TNF-alpha and MDA levels were significantly increased at T[1], significantly peaked at 1 h after reperfusion [T[2]] and significantly decline after 3h [T[3]]. However, this elevation of TNF-alpha and MDA levels were significantly higher in saline group compared to taurine group. On the other hand, the level of GSH and the activity of GPx were significantly higher in the taurine group than in the control group. HIF-1 alpha and caspase-3 mRNA were highly expressed in control group more than taurine group. Taurine can protect the liver against ischemia-reperfusion injury by downregulation of HIF-1alpha, caspase-3, decreasing the production of TNF-alpha and improvement of hepatic antioxidant capacity

light and electron microscopic study of the effect of dehydroepiandrosterone sulfate on myocardium and adrenal zona reticularis of aged male albino rats

Aging is associated with a progressive decline of plasma levels of dehydroepiandrosterone [DHEA] and dehydroepiandrosterone sulfate [DHEAS]. The present work studied the effect of DHEAS administration on the age related histological changes in the myocardium of the heart [being implicated in increased death rate from cardiovascular diseases in the elderly] and in the adrenal zona reticularis [being the major source of DHEA and DHEAS secretion]. Thirty male albino rats were divided into three groups; ten animals each. Group I was the control adult group [6-months age], group II was the control aged group [24-months age], and group III was the treated aged group [24-months age] that received DHEAS orally in a dose of 0.05 mg/rat/day for one month. Specimens from the left ventricle of the heart and from the suprarenal gland were taken from all groups and prepared for light and electron microscopic examination. In control aged group, the myocardium exhibited disorganization of cardiac myocytes and an increase in collagen fibers. Many cardiac myocytes had deeply stained nuclei with increased heterochromatin. Their sarcoplasm showed variable staining intensity, ill defined cross striations, marked degeneration of the mitochondria and increased intermyofibrillar spaces. Other cardiac myocytes appeared relatively with more or less normal light and electron microscopic structure. The cells of adrenal zona reticularis of control aged animals showed irregularity and deeply stained nuclei, in addition to decreased frequency of mitochondria and accumulation of lipid droplets in their cytoplasm. After DHEAS administration, there was a marked reduction in the age related histological changes of both the myocardium and adrenal zona reticularis. The myocardium of DHEAS treated aged animals showed regular arrangement of cardiac myocytes with comparative decrease in appearance of collagen fibers compared to the control aged group. Many cardiac myocytes had relatively normal appearance of their nuclei and sarcoplasm with prominent cross striations, regular organization of myofibrils and less degenerative changes in the mitochondria compared to those of the control aged group. Most zona reticularis cells of DHEAS treated animals had rounded nuclei and relatively normal appearance of their cytoplasm with increased frequency of mitochondria and decreased content of lipid compared to those of the control aged group. The mechanism of action of DHEAS as an antiaging steroid has been discussed. The preventive effect of DHEAS against age related structural changes [although incomplete prevention] is promising of its use as replacement therapy in elderly people to prevent, delay or attenuate the cardiac disorders which accompany aging and to improve the enzymatic activities and endocrine function of adrenal zona reticularis, thus, promote improvement of health with aging

Assessment of nutritional status of pre-school children in Assiut governorate, Egypt

Although the share of malnourished children have gradually been declining over the past 25 years, 167 million children under five years old almost one third of developing country children were estimated to be underweight. Malnutrition is directly responsible for 300,000 deaths per year in children younger than 5 years in developing countries and contributes indirectly to over half the deaths in childhood worldwide. Malnutrition in Egypt is one of the most important factors that affect Egyptian's health and development. For many years, malnutrition has been a severe blow on Egypt's population affecting individuals' production, which in turn affects its economy. The objectives are to identify the determinants of the nutritional status of the studied children and to measure the magnitude of malnutrition among preschool children in Assiut Governorate. A Cross sectional community based study design was applied. A representative sample from 3 districts of Assiut Governorate [Urban 30% and Rural 70%] in the form of cluster sampling technique, with a constant number of preschool children per cluster. A pre-structured questionnaire was used for collecting data, interviewing the mothers in order to collect socioeconomic factors, environmental factors, gastrointestinal and respiratory morbidity. Anthropometric measurements [height, weight, head circumference, mid upper arm circumference, and skin fold thickness] were recorded for each child. The total sample included 732 children aged 24-72 months with the mean age +/- SD [49.9 +/- 75. 7] months. The gender distribution was 363 [49.6%] males, and 369 [50.4%] females, illiteracy was 211 [41.5%] mothers and 141 fathers 27.7%].Working status of mothers 53 [10.4%] mothers were working outside the home. 499 mothers [98.0%] had piped water supply in their houses, By using weight/ age Z-score [WAZ] 11.1% were under weight, using height/age Z-score [HAZ] 28.4%.were stunted and using weight for height Z-score [WHZ] 6.2% were wasted. Stunting constitutes a significant public-health problem among the pre-school children in Assiut Governorate, while under-nutrition represents a relatively less common problem. Interventions to improve socioeconomic and environmental situations are recommended to overcome these problems

Cytokines and growth factors in children with burns, relation to burn surface area, sepsis and survival

Burn is a unique injury which is not only devastating for the patients but also puts a great burden on the society by consuming enormous health care resources. Despite improvements in burn wound care and treatment, understanding the role of pro-inflammatory, anti-inflamatory cytokines as well as the mechanisms responsible for the healing process remains to be clarified. Although leptin is regarded as a circulating hormone, it can exert direct effect on T cells and monocytes, causing the release of cytokines. It may induce angiogenesis or influence angiogenic factors. The aim of the present work is to determine serum levels of leptin, TNFalpha, IL-6, TGFalpha, and bFGF, PCT and CRP in a group of children with thermal burn and to determine the changes in these parameters in relation to the duration of hospital stay, the presence of infection and the total burn surface area. The study included 42 children with burns. They were 22 males and 20 females. Their ages ranged from 2 months to 7 years. The study also included 26 age matched controls. Beside full clinical assessment including assessment of total burn surface area [TBSA] and the presence or absence of sepsis, all the cases and controls had the following investigations done: CBC, C-reactive protein [CRP], IL-6, TNFalpha, procalcitonin [PCT], serum leptin, basic fibroblast growth factor [bFGF], and transforming growth factor alpha [TGFalpha]. The fatality rate in this study was 28.6%. Burn cases as a whole showed significantly higher values of WBC, CRP, PCT, TNFalpha, IL-6, leptin, bFGF, and TGFalpha than controls. Cases with sepsis showed significantly higher values of WBC, CRP, PCT, TNFalpha and lL-6 than cases without sepsis. They showed significantly lower values of TGFalpha than cases without sepsis. Patients with larger TBSA [>30%] showed significantly higher levels of WBC, CRP, PCT, TNFalpha and lL-6 and leptin than cases with smaller TBSA. They showed significantly lower levels of bFGF, and TGFa than cases with smaller TBSA. Nonsurvivors showed significantly higher levels of WBC, CRP, PCT, TNFalpha and IL-6 than survivors. They showed significantly lower levels of leptin, bFGF, and TGFalpha than survivors. Correlation studies showed significant positive correlation between TBSA and each of IL-6, TNFalpha and leptin. Cytokines and leptin were increased in severe burn cases, cases associated with sepsis as well as in fatal cases. bFGF and TGFalpha levels were lower in severe cases. This may point to the impaired healing and to the poor prognosis in such cases. Recommendations: It is highly recommended to monitor immunologic parameters such as PCT and/or IL-6 for early detection of infectious complications following thermal injury. Leptin can be regarded as a novel treatment modality to diminish burn induced inflammation, to reduce post burn immune dysfunction and to enhance burn healing

study on transfusion-transmitted viral infections in thalassemic children

Beta- thalassemia syndromes are the most common causes of chronic haemolytic anemia in Egypt. The disease appears early in life as a Variable degree of anaemia associated with splenomegaly, stunted growth, bone changes and mongoloid facies. Patients are usually treated with regular blood transfusion which leads to iron overload and therefore chelation therapy is very important to avoid iron overload and its complications. The patients may have immunological abnormalities mostly due to iron overload, repeated exposure to allogenic antigens and immunosuppressive viruses in blood transfusions, desferrioxamine chelation therapy and splenectomy. Infection has been reported to be one of the main causes of morbidity and mortality in beta-thalassemia. It is described as the second most common cause of death in these patients with a prevalence of 12-13%. Besides the well-known risks of blood-borne infections associated with multiple transfusions, a less familiar clinical problem is the increased susceptibility of these patients to infections, due to the coexistent immune deficiency. One of these infections may be parvovirus B19. Parvovirus B19 is a single-stranded DNA virus. The virus is classified as a member of the erythrovirus genus because replication occurs only in human erythrocyte precursors. This work was designed to study some transfusion related viral infections in thalassemic children attending the hematology unit of Pediatrics department of Assiut University and to discuss the possible predisposing and underlying factors. The study was carried out in the period between September 2004 and October 2005 in the departments of clinical pathology and pediatrics, Assiut university hospital, Egypt It included 50 individuals, 35 transfusion-dependant children with beta-thalassemia major, aged 2 to 15 years and 15 apparently healthy children as a control group. Patients recruited in the study had thorough history taking and complete clinical examination. In addition, the following laboratory investigations were performed for all cases and controls: complete blood picture including reticulocytic count and calculation of the reticulocytic index; liver functions, [iron status [including serum iron, TIBC and ferritin]; human parvovirus B19 IgG; Hepatitis C virus antigen by PCR and antibodies [HCV-Abs] by ELISA, hepatitis B virus surface antigen [HBsAg], and human immunodeficiency virus types 1 and 2 antibodies by ELISA. Thalassemic patients had significantly lower Hb, RBCs and TIBC and significantly higher reticulocytic count, reticulocytic index, serum iron, serum ferritin, serum bilirubin, AST and ALT than the controls. The studied patients had 83% positivity for Parvovirus lgG antibodies, 97% for Hepatitis C IgG antibodies, 80% for Hepatitis C antigen by PCR. Patients had significantly lower CD4 T lympocytes, higher CD8 T lymphocytes than the controls. CD4/CD8 ratio was also inverted in the patients. Parvovirus positive cases had significantly lower Hb, RBCs, reticulocytic count and index and significantly higher AST and ALT than parvovirus negative cases. Serum ferritin, parvovirus IgG, and CD8 T lymphocytes correlated positively with the number of blood transfusions. Parvovirus lgG correlated positively with AST and ALT and negatively with reticulocytic count. Infectious complications constitute an important part of the clinical spectrum of beta-thalassemia, being associated with significant morbidity and mortality. The recently recognized immune defects in these patients involve multiple components of the immune system and have been attributed to specific features of the disease, as well as to the therapeutic modalities applied. Iron overload, a primary complication of both thalassemia itself and transfusion therapy, is thought to be the main precipitating mechanism, due to the important immunoregulatory properties of iron and its binding proteins. Iron excess may derange the immune balance in favor of the growth of infectious organisms. Other factors include multiple transfusions, associated with constant allo-antigenic stimulation, as well as with transmission of immunosuppressive viruses including the parvovirus B19. Infection with this virus in thalassemic patients can lead to persistent anemia indicated by reticulocytpenia and decreased reticulocytic index. Surveillance for infections in patients with beta-thalassemia is crucial, while additional studies are required to establish more clearly the clinical significance of the suspected precipitating mechanisms, hence providing new methods for the further amelioration of the survival rate and quality of life. Blood or blood products intended for use in high-risk groups such as immunocompromised individuals and patients with underlying hematological problems should be screened for B19. New inactivation methods for blood or blood products should be implemented to reduce the transmission of the parvovirus B19 via blood transfusion. Screening of blood donors for B19 can be an alternative to viral inactivation. Regular chelation therapy is a must to prevent the effects of the iron overload on the immune response. lntroduction of parvovirus B19 vaccines particularly for the immunocompromised patients may be helpful in the near future

frequency of celiac disease, TB enteritis and giardiasis among children with chronic diarrhea

Chronic diarrhea is one of the most common causes of referral to a gastroenterology clinic. Chronic diarrhea may result from many different causes; celiac disease is one of them. Other important causes in our locality are infections such as TB and Giardiasis. This work was planned to determine the frequency of celiac disease, TB enteritis and Giardiasis among children referred to the gastroenterology unit with the complaint of chronic diarrhea and to evaluate the different methods used in the diagnosis of each disease. The study included 92 patients with chronic diarrhea. Their ages ranged from 6 months to 15 years. They were 56 males and 36 females, admitted to the Pediatric gastroenterology unit, Assiut University Hospital during the period from January 2005 to December 2006. Besides full history and thorough clinical examination, the following investigations were done for all cases: stool analysis for three consecutive days, CBC, ESR, total proteins and serum albumin, tuberculin test, accelerated BCG test [in tuberculin negative cases], serum antiendomysial antibodies. Upper GIT endoscopy with duodenal biopsy and aspiration and tissue staining by H and E and by immuno-histochemistry [anti-tTG moAbs] to detect tTG antigens in biopsy specimens. Lower GIT endoscopy with biopsy sampling and histopathological examination of biopsy specimens was also done. Out of the total patients, 18 cases [19.5%] were positive for celiac disease by AEM antibodies while 16 were positive by tTG immunostaining of biopsy specimens. Fourteen patients [15.2%] had tuberculous enterocolitis while 12 [13%] had biopsy proven Giardiasis. On the other hand 48 patients [52.1%] had other undiagnosed causes of chronic diarrhea. A very high index of suspicion for celiac disease should be maintained for patients who present with chronic diarrhea or iron deficiency anemia. The best method for diagnosis of celiac disease in such patients is serological testing followed by a small-bowel biopsy. The diagnosis of intestinal tuberculosis is difficult due to the lack of specific symptoms and signs. Colonoscopy with ileoscopy is a useful method for diagnosis of intestinal TB. Gastrointestinal endoscopy with biopsy examination is an important method of diagnosis and follows up of children with Giardiasis

histological and histochemical study of the gender variability of albino rat submandibular glands at different postnatal ages

The present work was done to study the histological, histochemical and morphometric gender changes in the rat submandibular salivery glands [SMG] at different ages including young adult and elderly. Histological study of the SMG of young male age showed secretory units [acini] and striated ducts. In young female glands, there were two types of acini, one with lightly stained cytoplasm and nuclei, while the other with darkly stained cytoplasm and nuclei. In adult age group, the male SMG showed larger and more frequent granular convoluted tubules [GCT], whereas, the acinar cells were smaller and less frequent in comparison with the adult female SMG. With aging, the acini and ducts showed signs of degeneration as distortion in the shape and reduction in the size. Their cells showed pyknotic nuclei and vacuoles in the cytoplasm. The morphometric study of the SMG revealed that the count of the GCT cells in males was significantly higher than that in females in the adult and elderly age groups. With aging, the collagen fibers increased while the elastic fibers decreased. Collagen fibers were much more in the female SMG than in the male SMG at all ages studied. Histochemically, mucosubstance in the acini was mainly of the neutral type in young and adult age groups of both sexes. It became of the type and reduced with aging, the intensity of the reaction for the mucosubstance was relatively less in the male acini than that in the female acini. The intensity of the alkaline phosphatas reaction was relatively more in young female SMG than that in the male. In adult and elderly groups, the intensity of the reaction was relatively the same in both sexes and it was reduced with aging

Epidemiology and risk factors of brucellosis in Alexandria governorate

This study aimed to describe the trend and to identify possible risk factors for brucellosis in Alexandria in northern Egypt. We enrolled 72 confirmed cases of brucellosis and 144 age-matched controls in this study. Participants were interviewed at home using a structured questionnaire. Working with animals, breeding goats and eating ice cream bought from street vendors were significantly associated [P < 0.05] with brucellosis by univariate and multivariate analysis. Contact with infected animals and their products was the most important method of transmission

Upper and lower gastrointestinal endoscopy in children attending Sohag University Hospital: indications and results

Gastrointestinal disorders in children represent a broad spectrum of acute and chronic conditions including congenital, infectious, inflammatory metabolic and rarely neoplastic disorders. The development of endoscopic instruments to evaluate different parts of the gastrointestinal tract improved significantly the information about diseases affecting the gastrointestinal tract and its management. The addition of endoscopic examination to the investigations of gastrointestinal disorders in children has greatly transformed the practice of pediatric gastroenterology. The present study included 197 children referred for endoscopic examination during the period of October 2002 to September 2005, aged from 3 months to 16 years [average 5.7 years] and 55% of them were males. Referral to the pediatric endoscopy unit was a part of investigating various gastrointestinal disorders. One hundred thirty two patients [67%] were referred for upper gastrointestinal endoscopy while 65 patients [33%] for lower endoscopy. The results showed that, out of 50 patients who presented with [UGIB, 34% had esophago gastric varices: 32% were esophageal and 2% fundal varices. Injection sclerotherapy was done successfully for 5 patients with varices. The second common endoscopic finding in patients with UGIB was erosive and/or hemorrhagic gastritis [28%] followed by duodenitis [8%] and esophagitis [6%]. A combination of esophago-gastro-duodenitis was detected in 6% of the patients. Out of the 30 patients presenting with unexplained vomiting gastritis was the most common endoscopic and histological findings followed by esophagitis and duodenitis. In patients with suspected malabsorption, upper endoscopy revealed pale mucosa in 32% and edematous mucosa in 28% of the cases. In 40% of the cases, no abnormalities could be found. Biopsy examination revealed villous atrophy in 64% and a picture compatible with Crohn's disease in 28%. However, in 8%, no histological abnormality was detected. In patients with unexplained recurrent abdominal pain, UGIE revealed abnormalities in 55% [30% gastritis, 15% duodenitis, and 10% duodenal ulcer]. However, in 45% no abnormality could be detected. Histological abnormalities were found in 90% of cases; 45% active gastritis and Helicobacter pylori [HP] organisms in the antral region, 30% active gastritis without HP and 15% active duodenitis with the HP in the antral region. Collectively, HP organisms were detected in 60% of cases with unexplained RAP. Esophagitis was detected endoscopically and histologically in all cases with dysphagia. In two cases, impacted foreign bodies [a coin and a hair pin] were detected and removed successfully during the same endoscopic examination. Bleeding per rectum was the most frequent cause to do colonoscopy in children. Endoscopically, polyps were the most common detected abnormality [47.37%] followed by colonic inflammation [31.58%]. Histologically, benign juvenile polyps were the most common [28.95%] followed by bilharzial polyps [18.42%], nonspecific colitis [15.79%] and lastly allergic colitis [15.79%]. Endoscopic examination of children with bloody diarrhea revealed various lesions including erythema, edema, mucosal ulceration and/or white exudate in the rectum and colon in 86.67% of the cases. Biopsy examination showed a picture of pseudo-membranous colitis in 53.33%, and ulcerative colitis in 13.33%. In 12 patients with unexplained lower abdominal pain, endoscopy revealed erythema, erosions and minute ulcers in 4 of them while biopsy examination revealed nonspecific proctocolitis in 8 cases. Pediatric gastrointestinal endoscopy is a valuable and informative diagnostic procedure and can be performed safely with the use of intravenous sedation. Therapeutic maneuvers can be also applied as foreign body removal, sclerotherapy and polypectomy. Gastrointestinal bleeding is the commonest indication for endoscopic examination in children. Variceal bleeding represents the major cause of upper gastrointestinal bleeding while colonic polyps are the commonest cause of lower gastrointestinal hemorrhage. Helicobacter pylori infection is increasingly recognized in children and needs further studies to identify its relations to different gastrointestinal complaints in such children. Antibiotics induced diarrhea and pseudo-membranous colitis represent a problem in pediatric practice particularly in infants. Hence, antibiotic prescription should be done according to standardized guidelines. Endoscopic examination can demonstrate definite organic lesions that are necessary for diagnosis. However, a negative endoscopy with normal findings has its role in either reassurance of parents and diagnosis of functional disorders