Flow cytometric evaluation of CD11b expression on peripheral blood neutrophils for early and rapid diagnosis of neonatal sepsis

Background: Neonatal sepsis is life-threatening disease; it represents a big problem duo to itsdifficult diagnosis. It is associated with high mortality rate if not treated promptly. It is therefore very critical to do early diagnosis and initiate adequate therapy

Objective was to make a flow cytometric evaluation of CD11b expression on peripheral blood neutrophils for early and rapid diagnosis of neonatal sepsis

Methodology: our study was carried out on 70 neonates and subdivided into 2 groups, study group consisted of 50 neonates and control group consisted of 20 apparent healthy neonates, three ml of blood were collected for evaluation of CD11b expression by flow cytometry, CBC, CRP determination, and for blood culture

Results: there was a significant increase in percentage expression of CD11b on peripheral blood neutrophils in group I [sepsis group] more than group II [control group] , CD11b expression level in % on peripheral blood neutrophils record the highest sensitivity and specificity for diagnosis of neonatal sepsis followed by CRP. Blood culture recorded the least sensitivity and specificity

Conclusion: flow cytometric detection of CD11b on peripheral blood neutrophils is a useful technique for early and rapid diagnosis of neonatal sepsis

Cocktail of Theileria equi antigens for detecting infection in equines

Objective: To use two diagnostic antigens belonging to the frequently associated in Theileria domain, Theileria equi (T. equi) protein 82 (Te 82) and T. equi 104 kDa microneme-rhoptry antigen precursor (Te 43), to diagnose T. equi infection in horses as compared with equi merozoite antigen-2 (EMA-2). Methods: In the current study, we applied a cocktail-ELISA containing two antigens (EMA-2 + Te 82) to diagnose T. equi infection either in experimentally infected horses or in field infection. Results: Our findings have revealed that a cocktail formula of EMA-2 + Te 82 provided a more practical and sensitive diagnostic candidate for diagnosing T. equi infection in horses as compared with Te 82 or Te 43 alone. Conclusions: The ELISA technique using a cocktail formula of EMA-2 + Te 82 offers a practical and sensitive diagnostic tool for diagnosing T. equi infection in horses and using of this promising cocktail formula will be applicable for epidemiological surveys and will help control the infection in horses.

26-year review of emergency peripartum hysterectomy in a tertiary teaching hospital in Kuwait - years 1983-2011

To identify the risk factors and study the incidence, indications and complications of emergency peripartum hysterectomy [EPH]. This was a retrospective case-control study. The cases consisted of all women who underwent EPH between January 1983 and January 2011. Two controls per case were randomly selected from the remaining deliveries by using a random number table. Case records were retrieved from the medical records. Among 150,993 deliveries, there were 59 EPHs [cases], giving a rate of 0.390 per 1,000. Of the 59 cases, only 56 were analysed because 3 files were unavailable. These women were older [mean age 36 +/- 5.7 vs. 22 +/- 5.3 years, p < 0.01] and had delivered more than 1 child [p = 0.02]. Thirty-seven [66%] cases had had previous caesarean sections [CSs] and the number of CSs in this group was greater than in the controls [21%, p < 0.01]. More index cases had a history of atonic postpartum haemorrhage [46 vs. 4%, p < 0.001] and placenta praevia [34 vs. 4%, p < 0.01]. More cases than controls were delivered by CS [73 vs. 29%; p = 0.003]. The leading indications for EPH were haemorrhage due to uterine atony and placenta praevia. Independent risk factors were older age, multiparity, history of one or more CSs and placenta praevia. There were 2 maternal deaths from coagulopathy following massive obstetric haemorrhage. The main complications of EPH were febrile morbidity: 12 [21%], wound infection: 8 [14%] and bladder or ureteric injury: 8 [14%]. CSs, especially repeat CSs in women with placenta praevia and persistent uterine atony, significantly increased the risks of peripartum hysterectomy

Development and impact of exercise program on postoperative pulmonary complications following lung resection

To develop and implement an exercise program for patients undergoing lung resection as well as to assess the impact of this exercise program on postoperative pulmonary complication following lung resection. 59 patients underlying lung resection were subjected to: preoperative assessment [including history taking, general laboratory tests, arterial blood gases [ABG], pulmonary function tests, 12-lead surface ECG and color Doppler echocardiography as well as postoperative pulmonary function [3 months postoperative] and hospital stay. Postoperative pulmonary complications were noted according to a precise definition. Thery were divided to two groups 35 as control and 24 as cases. Cases were subjected to preoperative two weeks physiotherapy. The risk of PPCs associated with selected factors was evaluated. The operations performed included 13 RUL, 9RML, 13RLL, 15LUL and 9 LLL. fifty-nine patients were studied [35 patients as control and 24 patients as cases]. They were age, sex, BMI, pulmonary function, ABG, and general lab matched. They were also matched regarding preoperative cardiovascular evaluation criteria. PPCs occurred in [12] cases of [35] patients [34.3%] in control group and [2] patients in intervention group [8.3%]. The number of days in the hospital postoperatively decreased with the intervention group. There was no significant difference between cases developed postoperative complication and non-complicated cases regarding pre and postoperative pulmonary function tests. Exercise program evaluated in this study can decrease PPCs and postoperative hospital stay. In addition preoperative pulmonary function tests do not appear to contribute to the identification of high-risk patients

Study of fit, microleakage and shear bond strength of CAD-CAM fabricated porcelain laminate

The aim of this work was to evaluate the Cerec 1, Cerce 2 and the conventional porcelain laminate veneers in terms of fit, microleakage and shear bond strength to the tooth surface. Thirty maxillary central incisors were used for the fit and microleakage tests. They received standardized preparations and were divided into three groups of ten each. Group 1, 2 and 3 were restored with Cerec 1 Cerce 2, and conventional laminate veneers respectively. Alter staining and thermocycling, the teeth with their bonded laminates were sectioned by two cuts [incisogingivally and misiodistally]. Fit and microleakage were evaluated by measuring the cement thickness and degree of dye penetration respectively using an image processing computerized stereomicroscope. For the assessment shear bond strength thirty other central incisors received flat preparations in enamel. Thirty porcelain specimens were fabricated using the above systems [ten specimens each] then bonded to the prepared enamel surface. After themocycling, a shear test was done using a universal testing machine. The debonded surface were then observed under a scanning electron microscope. Overall, the Cerec 2 CAD-CAM laminate veneers did overcome many of the disadvantages found in the Cerec 1 laminate veneers. The quality of the laminate veneers produced by the Cerec 2 CAD-Cam unit is comparable to the conventional laminate veneers

Gallstones in bilharzial hepatic fibrosis: relationship to gall bladder contractility, plasma cholecystokinin and portal hypertension

Background: defective gall bladder [GB] contractility has been proposed as a possible pathogen etic factor to explain the increased prevalence of gallstones in chronic liver diseases. However, GB contractility in bilharzial hepatic fibrosis has not been adequately studied

Aim of the work: to study the changes in GB contractility and plasma cholecystokinin [CCK] levels in patients with bilharzial hepatic fibrosis with and without gallstones. Also, the impact of portal hypertension on GB contractility was evaluated

Subjects and Methods: thirty-six patients suffering from bilharzial hepatic fibrosis [17 male, 19 female; aged 43.97+/-9.48 years] and 15 healthy control subjects matched in age and sex with the patients group were included in the study. All studied subjects were subjected to thorough medical examination and liver function tests. Fasting and postprandial CCK were assayed using radioimmunoassay. Fasting and residual GB volumes and GB ejection fraction were determined by ultrasonography as measures of GB contractility. Congestion index was estimated as a measure of portal hypertension

Results: patients with bilharzial hepatic fibrosis had significantly higher values of fasting and residual GB volumes and significantly lower values of GB ejection fraction than did control subjects [40.97+/-14.77ml Vs 24.4+/-5.87ml, P<0.001; 18.72+/-10.5ml Vs 7+/-2.33ml, P<0.001; 57.08%+/-13.78 Vs 71.26%+/-6.66, P<0.001, respectively]. There were significant increase in fasting and postprandial total CCK values in patients compared to control subjects. Bilharzial hepatic patients with gallstones exhibited significantly larger fasting and residual GB volumes and significantly reduced GB ejection fraction, in comparison to those without gall stones. Bilharzial hepatic patients with gallstones had significantly higher values of portal vein diameter and congestion index than did those without gallstones. For fasting and postprandial CCK, patients harboring gallstones had significantly higher levels than those without gallstones. GB ejection fraction correlated positively with serum albumin [r = 0.56, Pc0.001]. Postprandial CCK correlated positively with residual GB volume [r = 0.77, P<0.001] and negatively with GB ejection fraction [r = -0.58, P0.001]. Fasting and residual GB volumes correlated positively with both portal vein diameter and congestion index. GB ejection fraction correlated negatively with portal vein diameter [r= -0.47, P = 0.003] and congestion index [r = -0.56, P<0.001]

Conclusion: our study provides an objective evidence of impaired GB contractility in patients with bilharzial hepatic fibrosis in spite of higher CCK values especially in those harboring gallstones. Also, bilharzial hepatic patients with gallstones had significantly higher measures of portal hypertension than those without gall stones. The GB hypo contractility correlated to measures of portal hypertension. Therefore, our results suggest that defective GB contractility might contribute to the increased frequency of gallstones in patients with bilharzial hepatic fibrosis. Portal hypertension per se may have a role in the increased genesis of gallstones. Further researches are recommended to study whether portal decompressive drugs could decrease the incidence of gallstones in patients with bilharzial hepatic fibrosis

Increased tumor necrosis factor [TNF] level in patients with bronchogenic carcinoma with higher values in patients with bone marrow metastasis

TNF is a protein produced by various cell types, mainly monocytes, and has been originally shown to induce necrosis of tumors in vivo. Serum TNF-alpha levels were demonstrated by radioimmunoassay in 17 patients with bronchogenic carcinoma [9 cases with small cell carcinoma and 8 with squamous cell carcinoma]. TNF level was significantly increased in 14 patients [65 +/- 12 ng/L] in comparison with the control group [19 +/- 6 ng/L]. The highest TNF level was encountered in patients with small cell carcinoma, especially in those with bone marrow metastasis [3 cases]. The variation in the TNF level may be due to a variation in immunogenicity of different pathological types or a variation in the TNF receptor numbers of affinity on different cell types. TNF may have a role in the progress of the disease and the bone marrow Involvement