association of single nucleotide polymorphism of interleukin-21 gene and serum interleukin-21 levels with systemic lupus erythematosus

Background: Systemic lupus erythematosus [SLE] is a common autoimmune disorder which commonly results from the combined effects of a large number of genes. Variations in the DNA sequence in the Interleukin-21 [IL-21] gene may lead to altered IL-21 production and/or activity which can affect an individual's susceptibility to SLE. IL-21 is a novel class I cytokine produced by activated CD4+ T cells, natural killer T cells and T helper [Th] cells. There is increasing evidence that IL-21 contributes to the pathogenesis of SLE due to its biological activity

Aim of the study: To investigate the association between single nucleotide polymorphism [SNP] of IL-21 rs2221903 gene and serum IL-21 levels with SLE and to detect the possible association between IL-21 serum levels and the pathogenesis of the disease

Subjects and methods: This study was conducted on 30 SLE patients and 20 age and sex matched healthy controls. Serum IL-21 levels were measured using enzyme-linked immunosorbent assay [ELISA] technique and SNP of IL-21 rs2221903 gene was detected by genotyping assay, using real time polymerase chain reaction[RT-PCR]

Results: Serum 11-21 levels were significantly higher in patients compared with controls [p < 0.001]

Patients with high activity index of SLE had significantly higher levels of serum IL-21 [p value < 0.001]

A statistically significant association was found between the T allele of SNP rs2221903 and SLE, whereas; no association between SNP of IL-21 rs2221903 genotypes and SLE or serum IL-21 levels could be detected

Conclusion: IL-21 plays an important role in the immune-pathogenesis of SLE and could be used as a possible target for novel immunotherapy. The T allele of SNP rs2221903 suggests that the IL-21 gene may contribute to an inherited predisposition to SLE

Effect of water on HEMA conversion by FT-IR spectroscopy

The use of HEMA as a biocompatible material in dentin bonding systems and its potential for clinical applications has been well established. Excess water can affect conversion of bonding resins. The aim of this study was to survey the effect of water on the degree of conversion of HEMA by Fourier Transform Infra-red Spectroscopy [FT-IR]. In this experimental study, distilled water was added in amounts of 0, 0.05, 0.1, 0.2, and 0.4 ml to 1 ml of curable HEMA solution. Six repetitions per water ratio were made and investigated. Each sample was polymerized for 60 seconds. Degree of conversion was obtained from the absorbance IR-Spectrum of the materials before and after polymerization by FT-IR spectroscopy. One way ANOVA and Tukey-HSD were carried out to compare and detect any differences among groups. Statistical analysis indicates highly significant difference between pairs of groups at level [P<0.001]. The results showed a trend of decreasing in HEMA conversion with increasing water. Degree of conversion changes significantly within the 0.05 ml to 0.2 ml water range. However, degree of conversion did not change after reaching 0.02 ml and before 0.05. Degree of conversion of HEMA decreased by increasing water. The most dramatic effect of water on the polymerization process occurs within a range which exists under clinical conditions. The reason that the degree of conversion did not show significant result before 0.05 ml may be related to the hydrophilic nature of HEMA

Bacterial infections complicating skin diseases

Secondary infection of skin lesions is a common and serious problem. They can be potentially life threatening and may progress rapidly; therefore, their early recognition and proper management are important.The study was conducted on 60 patients suffering from various skin diseases with secondary infection on top, "37 outpatients and 23 inpatients" attended Ain Shams University Hospitals from April-December 2005.Bacteriological examination of purulent exudates from the deeper part of secondarily infected lesions was done. Antibiotic sensitivity pattern and production of beta-lactamase "for Gram +ve cocci" and extended spectrum beta-lactamase [ESBL] "for Gram-ve bacilli" were tested.We found that S.aureus was the most common isolated organism [83.3%] of all cases, followed by Gram-negative enteric bacteria which were isolated from [21.7%] of cases. These were followed by Streptococcus pyogenes and Pseudomonas aeruginosa with an incidence of [15%] and [6.7%] respectively. Enterococci were detected in only [5%] of cases. Coagulase negative [CONS] and anaerobic gram-positive cocci were the least isolated organisms each found only in one case.Within the Enterobacteriaceae group; E.coli and Proteus species were the most commonly isolated organisms, each representing [30.8%] of the total isolated Gram-negative enteric bacteria.There was significant difference between in and/out- patients as regard the antibiotic sensitivity pattern of both S.aureus and the Enterobacteriaceae group. The S.aureus strains isolated from the inpatients showed more resistance to Amoxycillin+clavulonic acid, cefaclor, erythromycin, fusidic acid, methicillin, ofloxacin, tobramycin and vancomycin. The rate of MRSA in hospitalized patients was [26.3%] versus [9.7%] in outpatients. The Enterobacteriaceae bacteria strains isolated from the hospitalized patients were more resistant to cefaclor, levofloxacin and ofloxacin.All Enterococci isolates from both the in/ and outpatients were sesnsitive to chloramphenicol, ofloxacin and were resistant to oxacillin. No VRE were detected from the inpatients, while 50% of isolates were resistant to vancomycin in the outpatient group.P.aeruginosa isolates from both the in/ and outpatient groups were sensitive to amikacin, cefoperazone, and levofloxacin and were resistant to cefepime. Resistance to imipenem and piperacillin was more in the inpatient group, while resistance to cephazolin was more in the outpatient isolates.Sensitivity to aztreonam was more in the outpatient isolates.The incidence of beta-lactamase production by the Gram-positive cocci was [96%] which coincides with the high resistance of these organisms to penicillin and ampicillin. Whereas; the incidence of ESbetaL production by the Gram-negative bacilli was [29.4%] with no significant difference between inpatients and outpatients although it was higher in inpatients. In conclusion, this study showed that S.aureus is the most common cause of secondary infection in all skin lesions and was isolated from all body sites with nearly equal prevalence in inpatients and outpatients. The incidence of Enterobacteriaceae infection was more in inpatients with higher levels of ESbetaL production. Resistance of different bacterial isolates to antibiotics was also higher in inpatients

Upper arm muscle area by height: an indicator for growth and nutritional status of Egyptian children and adolescents

This study included 15223 [7710 girls and 7513 boys] children and adolescents from nurseries and private schools in Cairo and Giza governorates [Greater Cairo]. Excessively lean and fat individuals were excluded. For each subject, weight, height, mid-upper arm circumference and triceps and subscapular skinfold thickness were measured and upper arm muscle area by height [UAMAH] was calculated. Means and percentiles of upper arm muscle area were calculated for 3-cm increments in height for each sex separately. Pearson correlation showed highly significant positive correlations between UAMAH and both weight and height, where r for weight in girls and boys was 0.873 and 0.907, respectively, and r for height was 0.746 and 0.816, respectively