The Therapeutic Potential of Extracellular Vesicles Versus Mesenchymal Stem Cells in Liver Damage

BACKGROUND@#The extracellular vesicles (EVs) secreted by bone marrow-derived mesenchymal stem cells (MSCs)hold significant potential as a novel alternative to whole-cell therapy. We herein compare the therapeutic potential of BMMSCsversus their EVs (MSC-EVs) in an experimental Carbon tetrachloride (CCl4)-induced liver damage rat model. @*METHODS@#Rats with liver damage received a single IV injection of MSC-EVs, 1 million MSCs, or 3 million MSCs. Thetherapeutic efficacy of each treatment was assessed using liver histopathology, liver function tests and immunohistochemistryfor liver fibrosis and hepatocellular injury. @*RESULTS@#Animals that received an injection of either MSCs-EVs or 3 million MSCs depicted significant regression ofcollagen deposition in the liver tissue and marked attenuation of hepatocellular damage, both structurally and functionally. @*CONCLUSION@#Similar to high doses of MSC-based therapy (3 million MSCs), MSC-EVs mitigated the fibrogenesis andhepatocellular injury in a rat model of CCl4-induced liver fibrosis. The anti-fibrinogenic effect was induced by attenuatinghepatic stellate cell activation. Therefore, the administration of MSC-EVs could be considered as a candidate cell-freetherapeutic strategy for liver fibrosis and hepatocellular damage.

The Therapeutic Potential of Extracellular Vesicles Versus Mesenchymal Stem Cells in Liver Damage

BACKGROUND@#The extracellular vesicles (EVs) secreted by bone marrow-derived mesenchymal stem cells (MSCs)hold significant potential as a novel alternative to whole-cell therapy. We herein compare the therapeutic potential of BMMSCsversus their EVs (MSC-EVs) in an experimental Carbon tetrachloride (CCl4)-induced liver damage rat model. @*METHODS@#Rats with liver damage received a single IV injection of MSC-EVs, 1 million MSCs, or 3 million MSCs. Thetherapeutic efficacy of each treatment was assessed using liver histopathology, liver function tests and immunohistochemistryfor liver fibrosis and hepatocellular injury. @*RESULTS@#Animals that received an injection of either MSCs-EVs or 3 million MSCs depicted significant regression ofcollagen deposition in the liver tissue and marked attenuation of hepatocellular damage, both structurally and functionally. @*CONCLUSION@#Similar to high doses of MSC-based therapy (3 million MSCs), MSC-EVs mitigated the fibrogenesis andhepatocellular injury in a rat model of CCl4-induced liver fibrosis. The anti-fibrinogenic effect was induced by attenuatinghepatic stellate cell activation. Therefore, the administration of MSC-EVs could be considered as a candidate cell-freetherapeutic strategy for liver fibrosis and hepatocellular damage.

Accuracy and outcome of rapid ultrasound in shock and hypotension (RUSH) in Egyptian polytrauma patients / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>"Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma.</p><p><b>METHODS</b>This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography (pan-CT) were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support (ATLS) guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome.</p><p><b>RESULTS</b>The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock (64%), followed by obstructive shock (14%), distributive shock (12%) and cardiogenic shock (10%) respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%.</p><p><b>CONCLUSION</b>RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.</p>

Unusual localization and presentation of non-visceral hydatid cysts: review article

Echinococcosis is a major parasitic zoonosis of public health importance worldwide. This is particularly true in sheep-raising countries including Egypt. Therefore, it is very important to identify the significant risk factors of the diseases by reviewing studies done in the region in the past decade to help policy makers design appropriate control strategies

Occurrence and characterization of staphylococcus aureus in meat and meat products marketed in Mansoura, Egypt

The present study aims to evaluate the occurrence and characterize Staphylococcus aureus in meat and meat products marketed in Mansoura, Egypt based on their antimicrobial-resistance pattern and production of enterotoxins. A total of 250 meat samples, categorized as 80 fresh beef samples besides 85 ground beef and 85 beef burger purchased from supermarkets and butchers' shops distributed in Egypt for isolation of Staphylococcus aureus. All isolates were screened for susceptibility to twelve antimicrobial discs. Minimal inhibitory concentration was carried out by twofold serial dilution in nutrient broth. Plasmid and genomic DNA| extraction were done. Polymerase chain reactions were performed for amplification of enterotoxin-encoding genes [sec and seg] Twenty five samples were isolated and identified as S. aureus. Sixty eight isolates were multidrug resistant since they were resistant to at least three different antimicrobial classes. Plasmids isolation from all isolates revealed that 76% of these isolates harbored plasmids. Fifteen isolates [60%] exhibited similar plasmid band size. The size of this plasmid was approximately 23 kbp. For seg gene, it was amplified in 8 isolates [32%] of S. aureus isolates at 550 bp. Five [63%] of the isolates harbored seg gene were multidrug resistant. On the other hand, none of the S. aureus isolates harbored sec gene. The present study confirmed the high prevalence of newly discovered enterotoxin genes [seg] in meat derived staphylococcus aureus and the association between the presence of this gene and multiple drug resistant phenomena

Effect of microcytic hypochromic anemia and parasitic infestations on stature in adolescents

Microcytic hypochromic anemia is the commonest form of iron deficiency anemia in adolescents. The occurrence of this type of anemia among adolescents is around 27% in developing countries. Clinical management should be based on a full knowledge of the prevalence of this disease in the age group mentioned. The present study reported the distribution of this type of anemia across age, anthropometric guides, and parasitic infestations in a sample of 300 adolescents attending various schools in Giza region, Egypt. Red blood cell size and iron concentration were assessed by mean corpuscular volume, hemoglobin levels, serum ferritin and total iron binding capacity from a venous blood sample. The adolescent was considered to have the microcytic form of anemia when their mean corpuscular volume was below 80 femtoliters [fL]. An adolescent with hypochromic anemia was defined as any subject with hemoglobin [Hb] below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged > 15 years. Also, hypochromic anemia included every subject having either serum iron < 50 microg/dL, or a serum total iron binding capacity [TIBC]> 400 microg/dL. The incidence of microcytic hypochromic anemia in this study was 53%. There were highly statistically significant differences between anemic and non-anemic groups as regards age and height [P 0.05]. Anemic adolescents also had significantly lower values for weight [P < 0.01], BMI [P < 0.01] and hemoglobin concentration [P<0.01] compared to non-anemic adolescents. Also, microcytic hypochromic anemia was more common in adolescents who did not have lunch regularly. Adolescents with current parasitic infestations showed a higher frequency of anemia compared to those who did not. There were no statistically significant differences between adolescents with parasitic infestation and adolescents without parasitic infestation as regards age, weight, height and BMI [P >0.05]. Signs of pallor were more common in adolescents suffering from microcytic hypochromic anemia. Subjects with a history of chronic conditions such as cardiac diseases, renal failure or cancer had a significantly higher incidence of anemia than adolescents who did not. It was concluded that the anemic group of adolescents enrolled in the study were susceptible to growth retardation. This type of anemia is more common in adolescents who do not have lunch, have a chronic disease or a parasitic infestation

Clinical and echocardiographic features of children with rheumatic carditis: correlation with high sensitivity C-reactive protein

Rheumatic fever [RF] and rheumatic heart disease [RHD] are leading causes of cardiovascular mortality and morbidity in developing countries. To describe the clinical and echocardiographic features of children with RF and RHD and compare these features with their serum C-reactive protein in 2 pediatric cardiology centers in Khartoum. It was a prospective cross sectional study. Patients were examined clinically and by echocardiography. Serum high sensitivity C-reactive protein [hsCRP] was measured from children with Acute RF as well as from healthy age and sex matched controls selected from children attending the clinics. Statistical Analysis Used: Mean and standard deviation, P value using Fisher's exact test. Sixty six patients [45% males] were enrolled. Mitral regurgitation [MR] was found in 65 patients [98%], it was severe in 42 patients [64%], combined with aortic regurgitation [AR] in 27 patients [41%] and with Mitral stenosis [MS] in 3 patients [4.5%]. For patients with carditis, hsCRP ranged between 1.10 and 15 mg/1 [mean 8.0817, SD 4.47]. In the control group it was 0.6-1.3 mg/1 [mean 0.93 SD 0.23] P<0.0001.Patients with Acute RF had hsCRP mean of 12.35 mg/1 [SD 2.11] while those with chronic RHD had hsCRP mean of 7.34 mg/1 [SD 4.16], P<0.0001. RHD is manifested in our patients with severe valve damage dominated by MR and there is evidence of an ongoing inflammation during the chronic phase. RHD is manifested in a severe form in Sudan. High sensitivity CRP is elevated in acute phase as well as in the chronic phase

Hypertension and hypoglycemia in a child with hepatoblastoma: a case report

Hepatoblastoma is the most common malignant tumor in the pediatric age group. It is treated with chemotherapy and surgery with excellent results. In majority of the cases ,the course of treatment is uncomplicated. Rarely there could be unexpected complications like hypertension due to hypersecretion of renin or severe hypoglycemia due to production of insulin like substances by tumor cells. These episodes can complicate the management of the case. We report a rare case of hepatoblastoma in an eight-year-old child who had both the complications. To the best of our knowledge, this is the first such case to be reported in literature

Ocular surface squamous neoplasia masquerading as superior limbic keratoconjunctivitis

To report a case of ocular surface squamous neoplasia [OSSN] masquerading as superior limbic keratoconjunctivitis [SLK]. A 62-year-old woman was referred with foreign body sensation, irritation, photophobia and decreased vision in the left eye. She was initially treated for 10 months with intermittent topical corticosteroids for a presumed diagnosis of SLK. She underwent excisional biopsy of the superior conjunctiva and was found, on histopathologic evaluation, to have OSSN with moderate to marked dysplasia. This is the first reported case of OSSN masquerading with signs and symptoms of SLK. Any ocular surface lesion refractory to standard medical treatment should raise suspicion for a malignant process and warrant further cytologic or histopathologic evaluation

Cryptosporidium and giardia in water in Alexandria: detection and evaluation of viability by flow cytometry and different stains

Cryptosporidium oocysts and Giardia cysts have become ubiquitous in surface waters worldwide. The number and extent of outbreaks of waterborne diseases indicate a significant risk for their possible transmission by drinking-water. Since many Egyptian cities depend on surface water as their main source of drinking water, knowledge of the prevalence of waterborne protozoa in water resources is important. The present study was designed to use flow cytometry to detect Cryptosporidium oocysts and Giardia cysts in water samples in Alexandria city in comparison with the standard staining techniques. Testing the viability of the encountered parasites was also carried out comparing flow cytometry and trypan blue vital stain. Thirty water samples were collected from water tanks from different districts of Alexandria city. Samples were subjected to staining techniques and flow cytometry. Stains used were modified Zeihl-Neelsen [MZN], safranin methylene blue [SMeB], modified trichrome, fluorescent stains [phenol auramine and acridine orange]. Viability was evaluated comparing trypan blue stain and flow cytometry using 4'-6-Diamidino-2-phenylindole immunostain [DAPI]. Flow cytometry proved to be much more sensitive than staining techniques with a sensitivity of 100% for both Cryptosporidium oocysts [30 samples] and Giardia cysts [11 samples]. Following flow cytometry, the fluorescent phenol auramine stain had the greatest sensitivity of 94.74% and 80% [18 and 4 samples, respectively]. The percent of live parasites present in each sample was always significantly higher by DAPI than trypan blue stain. The results of the present study clearly demonstrate that incorporation of flow cytometry can improve sensitivity of detection of Giardia cysts and Cryptosporidium oocysts in water samples. Although it is more expensive than the other staining methods, it is rapid, simple and accurate in estimating the quantity and viability of the parasites in each sample. Thus, flow cytometry can be recommended for detection of protozoa in water

possible role for gastroprotectives on aspirin-induced gastric ulcer in rats

Gastric ulcer is a discontinuity in the gastric mucosa that occurs due to imbalance between gastric mucosal protective factors and aggressive factors. The Aim of the present work was to test and compare the protective effects of an antisecretory H2 receptor blocker; ranitidine and other recently suggested gastroprotective drugs: L-arginine; a precursor of NO, zinc sulfate; an anti-inflammatory antioxidant agent and pioglitazone; a PPAR-gamma agonist, on a rat model of aspirin induced gastric ulcer. Acute gastric lesion was induced in rats by a single oral dose of aspirin 300mg/ kg body weight. L-arginine 200mg / kg b. wt, zinc sulfate 80 mg/ kg b. wt, and pioglitazone 10 mg / kg b. wt. were given alone and in combination with ranitidine 50 mg / kg b. wt for 3 days before induction of gastric lesion. Aspirin induced a significant increase in gastric mucosal lesion score and free and total gastric hydrochloric acid with a significant decrease in gastric nitric oxide and mucin levels as compared to normal group. A significant increase in gastric malondialdhyde and decrease in reduced glutathione as compared to normal group. L-arginine, zinc sulfate, and pioglitazone produced improvement of most of the measured parameters as compared to non-treated group. Combination of L-arginine and ranitidine was superior in prophylaxis against aspirin-induced gastric ulcer when compared to the effects of each drug used individually, and the other studied combinations. The role of HCl and NO seems more important in the pathogenesis of aspirin induced gastric ulcer, as evidenced by the better protective effects of combination of ranitidine and L-arginine in comparison to the ranitidine with either zinc sulfate or pioglitazone

Outcome of children with Hodgkin's disease. A 10-year experience from a single institution in Kuwait

To evaluate the outcome of children with Hodgkin's disease over a period of Loyrs from a Single instituhon in Kuwait Sixty-three children with previously untreated Hodgkin's disease, who were diagnosed at the Pediatric Oncology Unit of Kuwait Cancer Control Centre, Shuwaikh, Kuwait from January 1998 to December 2007 were included in the study. All cases were proved by histopathology, and staging was carried out according to the Ann Arbor system. Our series included 37 [59%] males and 26 [41%] females with a median age of 10 years [range 3-15 years]. B symptoms were present in 20 [32%] children. Bulky disease was noted in 28 [44%] children, with stages III in 8 [13%] and IV in 12 [19%] children. Chemotherapy was administered as a primary treatment in 63 children. The median number of chemotherapy cycles given was 6 [range 2-8]. Radiotherapy was used in 40 [63%] children. Grade III hematological toxicity was observed in 23[37%] and grade IV in 14 [22%] children. Hypothyroidism was observed in 20 [32%] children. Fifty-five children achieved a complete remission [87%] and 2 children achieved a partial remission [3%] with an overall response rate of 90%. Three children achieved a progressive disease [5%] and response could not be evaluated in 3 [5%] children. At a median follow-up of 67 months [5.5 years], the overall survival was 91%. With moderate toxicity, combined modality therapy is effective in the treatment of childhood Hodgkin's disease

What is central toxic keratopathy syndrome if it is not diffuse lamellar keratitis grade IV?

The Central Toxic Keratopathy [CTK] syndrome describes a rare, acute, self-limited, non-inflammatory process that yields central corneal opacification and significant hyperopic shift after refractive surgery. Despite being exceedingly rare, certain clinical features of CTK give the condition a striking resemblance to other more serious inflammatory conditions, including diffuse lamellar keratitis [DLK]. As the authors demonstrate in this article, despite the overlapping clinical features, CTK is a disease process that is distinct from DLK and, therefore, in need of distinct management interventions

Abdominal actinomycosis: about four cases

The abdominal actinomycosis [AA] is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic positive Gram bacteria; Actinomyces israeli Abdominal actinomycosis is responsible of pseudotumoral syndrome in the most of the time leading in the doubt of a neoplasia, to a large and mutilating extraction surgery whereas a prolonged treatment by antibiotics would have permitted to heal the illness. The diagnosis is obtained generally from anatomopathologic exam. We report 4 cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis has only been made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had recidivism of their actinomycosis. These 4 observations confirm the diagnostic and therapeutic difficulties already reported by other authors

Griscelli syndrome [GS]: clinical and MRI findings

Griscelli syndrome is a rare autosomal recessive disorder due to mutations in MYO5A, RAB27A, or MLPH. It was initially described by Griscelli and Prunieras, France in 1978. This defect results in pigmentary dilution of the skin and the hair [silver hair] as an isolated feature in GS type3, or with combined T-cell and B-cell immunodeficiency [GS type2] or neurologic signs [GS type 1]. Hemophagocytic lymphohistiocytosis may occur as a complication in GS type2 and is considered the major cause of mortality. Here, we describe a 2.5 years old child presented with repeated lower respiratory tract infections, convulsions and deteriorating neurologic manifestations. He had silver gray hair and eye brows, neurologic manifestations. Differentiation from Chediak-Higashi syndrome and Elejalde syndrome was warranted due to overlapping features. Laboratory studies showed immune deficiency disorder and in one stage peripheral blood pancytopenia, with absence of characteristic granules characteristic of Chediak-Higashi which was excluded. Elejalde syndrome patients do not have immunologic abnormalities. Both CT and MRI are used to assess OS. Usually, findings are normal at birth. When the disease manifests, imaging findings are abnormal. Skin biobsy showed characteristic hyperpigmented basal melanocytes and sparse pigmentation of adjacent keratinocytes. Different disorders and even subtypes of GS influence prognosis. Mortality is often related to uncontrolled hemophagocytic syndrome rather than infections due to immune deficiency. Bone Marrow Transplantation is the only curative option though it does not improve neurological damage

Some bone markers in children with type I diabetes mellitus

Diabetes mellitus and osteoporosis are chronic disease with great socioeconomic consequences, mainly due to the late complications and consequences disabilities. Type I diabetes mellitus [DM 1] has been related to a reduced bone mineral density [BMD] in childhood. In order to evaluate alternation in the one metabolism in type I diabetes we measured a urine osteocalsic marker for bone resorption; deoxypyridinoline [DPD] as well as, the circulating osteoblastic markers; serum osteocalcin and osteoprotegerin [OPG]. Further more, we evaluated their relation to the disease duration and severity. The influenced of sex and age on bone health were also assessed. Cross-sectional case-control study was conducted on forty children with DMI and twenty control subjects matched for age and sex with similar socioeconomic and cultural status. Serum levels of osteocalcin and osteoprotegerin were measured, also urinary levels of deoxypyridinoline [DPD] was measured. Children with DMI showed lower serum levels of osteoclacin and OPG and a rise in urinary level of [DPD] in comparison with control subjects. The osteoblast function significantly decreased in diabetic patients, which one best is characterized as a maturation defect. Altered bone mineral acquisition in children with DMI may limit peak bone mass acquisition and increase the risk of osteoporosis in later life. So the clinical management of diabetic osteopenia would become important for the reservation of quality of life in diabetic patients

Histological changes in the filiform and fungiform lingual papillae of streptozotocin-induced diabetic albino rats and the possible protective role of curcumin

It has been a growing interest recently in dietary intervention, particularly the use of traditional food derived from natural sources in management of diabetic complications as oral lesions. The aim of the present study was to elucidate the histological changes in the lingual papillae in an experimental model of induced diabetes in rats by streptozotocin and evaluate the possible protective effect of curcumin using light and scanning electron microscopes. Thirty adult male albino rats were divided into 3 equal groups: group 1; [control group], group II;[diabetic group]: diabetes was induced by a single intraperitoneal injection of streptozotocin in a dose of 65 mg/kg and group [Unprotected group] rats were treated as in diabetic group with simultaneous administration of' curcumin in a daily dietary dose of 15 mg/kg for 4 weeks. By the end of the 4 weeks all animals were sacrificed and the tongues of all rats were dissected and processed for light and scanning electron microscopic examination. Examination of dorsal surface of tongues of diabetic rats revealed numerous filiform papillae with evidently disturbed shape and orientation. Some of them depicted notched or bifurcated ends; others were severely destroyed with desquamation of their epithelial covering. There were hyperkeratosis and markedly reduced connective tissue papillae. Disfigured fungiform papillae with vacuolated taste buds depicting peripheral arrangement of the cells and empty center were also seen. Dorsal surface rats' tongues of the protected group with curcumin revealed almost normal direction, distribution and structure of the papillae except for few filiform papillae with serrated tips. The present study illustrated that diabetes has a deleterious effect on tongue papillae and taste buds. On the other hand, curcumin provided considerable protection against these effects most probably via its antioxidant, anti-inflammatory and neuroprotective effects

Fetus in fetu

Fetus in fetu is a rare abnormality secondary to the abnormal embryo genesis in a diamniotic, monochorionic pregnancy. To our knowledge fetus in fetu originally described by Meckel in the late J8th century [Senyuz et al, 1992], it is a rare pathological condition fewer than 100 cases were reported in the literature [Thakral et al, 1998,, we reported a 2 months old girl suffering from abdominal mass since birth, and referred to the Cancer Institute as suspicious of Wilms tumor, conventional radiograph of the abdomen revealed a mass containing numerous calcifications, C. T scan showed a heterogeneous retroperitoneal mass with well-defined calcified structures within the mass. The decision was made for surgical exploration, [he diagnosis was made intra-operatively and the mass was successfully excised, physical examination of the mass with review of literature confirmed the diagnosis of fetus in fetu. Although it is a rare condition imaging may play an important role in our ability to correctly diagnose cases in a prospective fashion. Surgical excision is the recommended treatment

Impact of an educational program based on evidence related to fever management

Quality care is dependent on best evidence. Children's nurses are no exception to this and their philosophy of [the child first and always] will ensure that their evidence base for practice is commensurate with stance. For this reason, this study was conducted to assess the impact of an educational program based on evidence related to fever management on nurses' evidence-based knowledge and reported practices. An Educational program based on evidence was designed according to nurses' needs and new evidence findings in fever management. Results of the study showed that at the pre program phase, nurses had lower level of evidence-based knowledge than at the first follow-up. Their means of knowledge scores related to fever, measuring temperature, nursing management, administration of antipyretics and documentation were 3.69 vs 8.00, 5.06 vs 7.49, 3.99 vs 6.94, 4.07 vs 7.33 and 6.81 vs 9.76 respectively. Also, there was no statistical significant difference between level of evidence-based knowledge for nurses at the first and second follow-ups. It was concluded that an educational program based on evidence promotes the quality of nursing care in fever management

Impact of supplemental feeding on pain in neonatal intensive care unit

Neonates can't report pain for a variety of reasons. Therefore, behavioral changes and physiological changes such as heart and respiratory rates, facial expression, reduction in crying, position in bed, activity and consolability were used to assess pain for 60 newborns [30 experimental and 30 control]. Neonates in the experimental group were provided supplemental feeding during painful procedures. Meanwhile, neonates in the control group were not provided any feeding while painful procedures were carried up by nurses. Results showed greater reductions in means heart rate [143.0 vs 158.2 b/m], respiratory rate [43.4 vs 61.2 c/m] and scores of observational checklist [2.3 vs 5.0] between newborns in the experimental group than in the control group. Therefore, it was concluded that supplemental feeding should be provided during painful procedures because it provides some form of pain reduction during painful procedures