Encapsulating peritoneal sclerosis in liver transplant

Encapsulating peritoneal sclerosis occurs due to chronic irritation of the peritoneal surface resulting in inflammation and fibrosis. Encapsulating peritoneal sclerosis usually occurs in patients requiring peritoneal dialysis (PD); however, it may also occur in liver transplant patients. The fibrosis in encapsulating peritoneal sclerosis could be severe enough to cause small bowel obstruction (SBO). Herein, we report a case of encapsulating peritoneal sclerosis secondary to liver transplantation that presented with SBO. The patient was started on Tamoxifen for encapsulating peritoneal sclerosis and evaluated at follow-up without any other intestinal obstruction episodes. This case demonstrates that encapsulating peritoneal sclerosis can occur as a liver transplant complication and present with small bowel obstruction.

Molecular mechanisms of the anti-obesity potential effect of Moringa oleifera in the experimental model

Objective To elucidate the molecular mechanisms of the potent anti-obesity effect of Moringa oleifera Lam. (M. oleifera) ethanolic extract and to clarify the link between these mechanisms and the associated metabolic and vascular risks in the experimental model of visceral obesity. Methods M. oleifera ethanolic extract was orally administered at 600 mg/kg body weight in obese female rats daily for 12 weeks. At the end of treatment, body weight was determined, and the atherogenic index, coronary artery index, glucose level, insulin resistance status, liver and kidney functions were assessed. Also, the mRNA of leptin, adiponectin and resistin in visceral adipose tissue was determined by quantitative real time-PCR. Results The results showed that M. oleifera extract down-regulated mRNA expression of leptin and resistin, while it up-regulated adiponectin gene expression in obese rats relative to untreated obese control counterparts. This amelioration of genes expression was paralleled by a reduction in body weight and improvement of the atherogenic index and coronary artery index, as well as glucose level and insulin resistance value without adverse effects on liver or kidney functions, versus the untreated obese control ones. Conclusions It is reasonable to assume that the anti-obesity, anti-atherogenic and anti-diabetic properties of M. oleifera are mechanistically achieved via working directly on the adipokines of the visceral adipose tissue. Therefore, M. oleifera may be a good therapeutic candidate for the symptoms of metabolic syndrome.

Safety and efficacy of Achilles tenotomy under local anaesthesia: as part of the Ponseti clubfoot management -experience at the Sudan clubfoot clinic

Introduction: Ponseti method of treatment of clubfoot is a gold standard method. It includes serial casting to be followed by percutaneous tenotomy of the Achilles tendon under local anaesthesia. In the current study the safety and efficacy of tenotomy under local anaesthesia following serial casting will be studied

Patients and Methods: 89 patients who were seen at the Sudan Clubfoot clinic at Soba University Hospital between 2011 and 2012. All underwent serial casting according to Ponseti method and that was followed by Achilles tenotomy under local anaesthesia using a single stab using a size 15 scalpel

Results: there were 89 patients [135 feet], 64 [71.9%] males and 25 [28.1%] females. 46 patients [51.1%] had bilateral involvement. Familial history was there in 11 [11.2%] babies. Tenotomy was performed in all feet after an average of 6.2 casts [range, 3 to 11]. All were discharged 2 hours after the tenotomy. No adverse events were related to local anaesthesia and/or the procedure itself, and there was no delay in discharge in any of the operated babies. All patients had an uneventful course. Only one patient [1.12%] had previous conservative treatment before coming to the clinic. Pressure sores were observed as a result of casting in one foot. Residual equinus deformity after the tenotomy was experienced in 5 feet. 86 of the parents were satisfied with the correction. The rest; 3 patients [3.37%] were not satisfied because of the residual equines

Conclusion: tenotomy procedure using local anaesthesia is an effective and safe procedure

Flavonol glycosides from euphorbia microsciadia bioss. with their immunomodulatory activities

Four known flavonoids: quercetin 3-O-beta-D-rutinoside [Q3Rut], myricetin 3-O-betaD-galactopyranoside [M3Gal], quercetin 3-O-beta-D-galactopyranoside [Q3Gal] and quercetin 3-Obeta-D-glucopyranoside [Q3Glc], for the first time were isolated from aerial parts of Euphorbia microsciadia. The chemical structure of them was elucidated on the basis of 1 and 2 D-NMR spectra and different spectroscopic techniques. The immunomodulatory activities of isolated compounds were compared using standard T-cell proliferation assay. These data showed that lymphocyte suppression activity of flavonoids [1-4] were comparatively lower than prednisolon as a standard drug. Immunosuppressive activity of flavonoids with hydroxyl groups at both 3'-and 4'-positions in their B-ring [Q3Gal] were more than those with 3'-, 4'-and 5'-hydroxyl substitution [M3Gal]. In these compounds, Q3Gal showed the most inhibitory activity, whereas M3Gal showed the least lymphocyte antiprolifeartive activity

Expression of TGF-β1 in the blood during fracture repair in an estrogen-deficient rat model

OBJECTIVES: Previous studies have reported that osteoporosis due to estrogen deficiency influences fracture healing. Transforming growth factor (TGF-b) has been found to be involved in fracture healing via the regulation of the differentiation and activation of osteoblasts and osteoclasts. The current study aimed to determine the effects of estrogen on the expression of TGF-β1 during fracture healing in ovariectomized rats. METHODS: Thirty female Sprague-Dawley rats weighing 200-250 g were assigned to: (i) a sham-operated group that was given a normal saline; (ii) an ovariectomized control group that was given a normal saline; or (iii) an ovariectomized + estrogen (100 mg/kg/day) group that was treated with conjugated equine estrogen. The right femur of all rats was fractured, and a Kirschner wire was inserted six weeks post-ovariectomy. Treatment with estrogen was given for another six weeks post-fracture. At the end of the study, blood samples were taken, and the right femur was harvested and subjected to biomechanical strength testing. RESULTS: The percentage change in the plasma TGF-β1 level before treatment was significantly lower in the ovariectomized control and estrogen groups when compared with the sham group (p<0.001). After six weeks of treatment, the percentage change in the plasma TGF-β1 level in the estrogen group was significantly higher compared with the level in the ovariectomized control group (p = 0.001). The mean ultimate force was significantly increased in the ovariectomized rats treated with estrogen when compared with the ovariectomized control group (p = 0.02). CONCLUSION: These data suggest that treatment with conjugated equine estrogen enhanced the strength of the healed bone in estrogen-deficient rats by most likely inducing the expression of TGF-β1.

Piper sarmentosum enhances fracture healing in ovariectomized osteoporotic rats: a radiological study

INTRODUCTION: Osteoporotic fractures are common during osteoporotic states. Piper sarmentosum extract is known to possess antioxidant and anti-inflammatory properties. OBJECTIVES: To observe the radiological changes in fracture calluses following administration of a Piper sarmentosum extract during an estrogen-deficient state. METHODS: A total of 24 female Sprague-Dawley rats (200-250 g) were randomly divided into 4 groups: (i) the sham-operated group; (ii) the ovariectomized-control group; (iii) the ovariectomized + estrogen-replacement therapy (ovariectomized-control + estrogen replacement therapy) group, which was supplemented with estrogen (100 μg/kg/day); and (iv) the ovariectomized + Piper sarmentosum (ovariectomized + Piper sarmentosum) group, which was supplemented with a water-based Piper sarmentosum extract (125 mg/kg). Six weeks after an ovariectomy, the right femora were fractured at the mid-diaphysis, and a K-wire was inserted. Each group of rats received their respective treatment for 6 weeks. Following sacrifice, the right femora were subjected to radiological assessment. RESULTS: The mean axial callus volume was significantly higher in the ovariectomized-control group (68.2 + 11.74 mm³) than in the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups (20.4 + 4.05, 22.4 + 4.14 and 17.5 + 3.68 mm³, respectively). The median callus scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups had median (range, minimum - maximum value) as 1.0 (0 - 2), 1.0 (1 - 2) and 1.0 (1 - 2), respectively, which were significantly lower than the ovariectomized-control group score of 2.0 (2 - 3). The median fracture scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups were 3.0 (3 - 4), 3.0 (2 - 3) and 3.0 (2 - 3), respectively, which were significantly higher than the ovariectomized-control group score of 2.0 (1 - 2) (p<0.05). CONCLUSION: The Piper sarmentosum extract improved fracture healing, as assessed by the reduced callus volumes and reduced callus scores. This extract is beneficial for fractures in osteoporotic states.

Toxic effects of diazinon on the reproductive system of male rats: the possible ameliorative role of vitamin C

Diazinon, an organophosphorous insecticide has been used in agriculture and domestic purposes for several years. The aim of this study was to analyze the reproductive toxicity induced by diazinon which caused biochemical and ultrastructural changes in adult male Wistar rats and to evaluate the possible protective effect of vitamin C. Vitamin C [200mg/Kg, once daily], diethyl-ether [0.02 ml/Kg, once daily], diazinon [10mg/Kg, once daily in] and vitamin C [200mglKg, once daily] + diazinon [10mglKg per day, once daily] combination were given to rats orally via gavage for 4 weeks. Testicular functions were assessed by testicular sperm count, sperm motility, biochemical studies and histopathology. By the end of the 4[th] week, rats given diazinon alone had significantly lower sperm count and sperm motility than the untreated control rats. Also, the rats given diazinon had significantly lower testosterone level, higher MDA [malondialdehyde] and lower catalase levels than the control group. Co- treatment of diazinon- exposed rats with vitamin C had an ameliorative effect on sperm count, sperm motility, testosterone, MDA and catalase levels. Light microscopic investigations revealed that 4 weeks of diazinon exposure was associated with marked testicular degenerative changes. Damage of spermatogenic cells and sertoli cells were observed by electron microscope. Mild degenerative changes were observed in the semineferous tubules andinterstitial tissues in the rats which received diazinon+ vitamin C. Thus, it appears that vitamin C ameliorates diazinon testicular toxicity but is not completely protective

Vaginal carriage and antibiotic susceptibility profile of group B Streptococcus during late pregnancy in Ismailia, Egypt

Group B Streptococcus [GBS] infection has long been recognized as a frequent cause of morbidity and mortality in newborn infants. The purpose of this study was to determine the colonization rate with GBS and the antibiotic susceptibility profile in pregnant women attending Gynecological clinics in Egypt. One-hundred and fifty vaginal swabs were collected from pregnant women at 35-40 weeks of gestation. In comparison to culture, direct latex agglutination testing revealed 100% sensitivity and 93.75% specificity. Thirty-eight specimens [25.3%] were found to be positive for GBS. Each isolate was tested for susceptibility to penicillin G, ampicillin, cefotaxime, erythromycin, clindamycin and vancomycin. Erythromycin-resistant isolates were further classified by double-disk method. All isolates were susceptible to penicillin G, ampicillin and vancomycin. Resistance to cefotaxime was detected in three isolates [7.89%]. Five isolates [13.15%] were resistant to erythromycin and nine isolates [23.68%] were resistant to clindamycin. Four [80%] isolates had constitutive macrolide-lincosamide-StreptograminB resistance [cMLSB[B]] resistance and one [20%] isolate had inducible resistance [Imls[B]] resistance. GBS colonization was found to be high in our region. Latex agglutination testing and Islam medium are reliable methods to detect GBS in late pregnancy; however, latex agglutination test is rapid and simpler. Penicillin G remains the first choice antibiotic for treatment of GBS infections

Patterns and frequency of female breast lesions encountered at secondary level of care: hospital records-based study

To describe the histopathological pattern of female breast lesions encountered at secondary level of care in, Saudi Arabia. It is a retrospective, hospital record-based descriptive study. All histopathology records for patients attended King Fahad Hospital in Hofuf, Al Hassa between January 2001 and December 2006, were revised and compiled using a structured compilation form. nine hundred-fifty four [954] histopathology reports were included Data regarding type of specimens, age, laterality of the lesions and the prominent cellular morphology were analyzed; the Data were expressed in proportions, percentage and other descriptive measures. The Malignant lesions in the form of infiltrating ductal carcinoma were the most dominant lesions where 62% diagnosed before the age of 50 years

Role of procalcitonin in assessment of bacterial infection and antibiotic guidance in patients with acute exacerbations of chronic obstructive pulmonary disease on mechanical ventilation

This study was designed to investigate the diagnostic and prognostic values of serum procalcitonin concentrations "PCT' in comparison with other bacterial infection markers e.g. C-reactive protein concentrations "CRP" and microbiological cultures of protected specimen brush "psb" in patients with respiratory failure due to acute exacerbations of chronic obstructive pulmonary disease "COPD". We deemed that PCT concentrations could be used as a guide to reduce antibiotic overuse in these patients. Fifty-nine patients with acute respiratory failure due to exacerbations of COPD on mechanical ventilation were divided into two groups. PCT group "30 patients" were given antibiotic only if PCT concentrations were above 0.5ug/L and standard group "29 patients" were given antibiotic according to the physician opinion regardless of PCT concentrations levels. PCT guided antibiotic use resulted in reduction of antibiotic use by 46% without worsening the outcome in comparison with the standard group. Also, PCT was a good tool in diagnosis of bacterial infection as reflected by a higher PCT concentrations in patients with positive bacterial cultures of psb of the lower respiratory tract. 29 of 59 patients [49%] had positive bacterial growth, of them 28 patients were had high PCT concentrations "more than 0.5 ug/L" and only one patient had PCT concentration less than 0.5 ug/L. Patients with high PCT concentrations were also had significant leucocytosis in comparison with patients with low PCT concentrations "white blood cell count [13.2 +/- 9.4 vs 8.2 +/- 6.71 x 109/L respectively". CRP was also higher in patients with high PCT concentrations in comparison with patients who had low PCT concentrations [99.4 +/- 96.5 vs 94.7 +/- 103.2mg/L respectively], but the difference was not statistically significant. Also, PCT concentrations declined earlier than CRP after proper treatment of bacterial infection. PCT levels reached physiological concentrations within 10 -15 days while CRP was still above normal range, which means that PCT was of better diagnostic and prognostic values in patients with acute exacerbations of COPD on mechanical ventilation

Effect Demographic Data on Entamoeba histolytica infection prevelance in acute diarrhea

The demographic data in E. histolytica infection were studied to propose some preventive measures to lower the incidence of infection. For that purpose; 100 patients presenting with acute diarrhea attending Kafr Daoud rural health center [Monofia-Egypt] were classified according to the presence of the amebic fecal GIAP antigen into two groups: 46[1 a] with positive GIAP and 54[1 b] with negative GIAP antigen, 182 individual living at the same circumstances were taken as control group. We found that the diarrhea in general [amoebic or nonamoebic] more prevalent in big families, using common tap and latrines, living in earth floor house, and monthly income <250 Egyptian pound. The amoebic diarrhea more prevalent in first decades of life, male genders and farmers [P<.05]. In conclusion; the E. histolytica infection is highly prevalent in low socioeconomic areas and with bad habit person

Study of anti-galactose inhibitable adherence lectin IgM as diagnostic tool in acute amoebic diarrhea

Humoral IgM, IgG and mucosal IgA response to recmbinant cystein rich portion [designated LC3] of the entamoeba histolytica galactose inhibitable adherence lectin 170KDa subunite were determined in pateints with acute diarrhea. One hundred subjects presented with acute diarrhea subdivided into two groups; 46 pateints with positive foecal GIAP antigen group la and 54 with negative foecal GIAP antigen group Ib. We found that the pateints with amoebic diarrhea group la had anti-LC3 IgM and IgG 68.75%; 69.2% respectively compared with zero percent* in non-invasive amaeba [E. dispar] infestation. Serum anti-LC3 IgG antibodies can differentiate subjects with invasive amoebiasis after one-week duration of illness from those with E. dispar and controls [9.9%]. However, the long life span of IgG led to false positive results especially in endemic areas like Egypt. In conclusion, the early detection of anti-LC3 IgM antibodies is helpful in diagnosis of recent E. histolytica infection

Incidence of astigmatism in Alexandria population

Astigmatism was studied in 1000 patients [500 Males and 500 females] using Nidek [AR 1100] Autorefractometer. The total incidence off astigmatism was found to be 95.4%. The incidence of significant astigmatism [above 0.5 diopters] was 56.5%. There was no statistically significant difference between males and females. The most common type of astigmatism was found to be compound myopic astigmatism was found to be compound myopic astigmatism [55.07%]