The Prognostic Implication of CD49d Expression by Flow Cytometry and Trisomy 12 Detection by Fluorescent in situ Hybridization in Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is the most common chronic lympho‑proliferative disorder. This study done to detect the level of cluster of differentiation (CD)49d in CLL patients by flow cytometry and itscorrelation with the prognosis (survival) and with (trisomy12) detected by fluorescent in situ hybridization (FISH).Methods:Clinico-hematological profiles done to fourty CLL patients. CD49d tested by flow cytometry and trisomy12 was detected by FISH.Results:CLL patients classified according to modified Rai staging system into: low risk 12.5%, intermediate risk 22.5% and high risk 65%. CD49d and trisomy12 positivitywere detected in 29Original Research Article patients (72.5%) and 22 patients (55%), respectively. There was a significant positive correlation between the percentage of trisomy12 and of CD49d cells in CLL patients (P =0.034). And also, between CD49d and CD38 (P =0.034). On the other hand, there was no significant relation between both CD49d and trisomy12 expression and modified Rai staging system.As regard to overall survival (O.S) and disease free survival (DFS), both CD49d, trisomy12 positive cases were associated with shorter disease free, and overall survivals compared to the negative cases.Regarding to the relation between the use of combination of fludarabine, cyclophosphamide, and rituximab (FCR) as a standard treatment in CLL and OS and DFS of patients in our study, we found that FCR account for the better outcome associated with its use.Conclusion:CLL B-cell membrane expression of CD49d as measured by flow cytometry is a powerful prognostic parameter in patients with CLL. Its positive correlation with the trisomy12 and CD38 and the association of both CD49d and trisomy12 with short survival times indicate that they may have roles in the prognosis of CLL

A randomized, comparative study of dual therapy (doxycycline-rifampin) versus triple therapy (doxycycline-rifampin-levofloxacin) for treating acute/subacute brucellosis

Abstract Aim The aim of this study was to compare both the efficacy and safety profile of the WHO-recommended, dual therapy (doxycycline–rifampin) to a quinolone-based, triple therapy (doxycycline–rifampin–levofloxacin) for treating acute/subacute brucellosis. Patients and methods We studied 107 consecutive, naïve patients with acute/subacute brucellosis admitted to Assiut University Hospital. Patients were randomly allocated to receive the dual therapy of doxycycline–rifampin (group-A) or to receive the triple therapy of doxycycline–rifampin–levofloxacin (group-B). Acute/subacute brucellosis was diagnosed based on the presence of: (1) contact with animals or fresh animal products, (2) suggestive clinical manifestations of less than one-year duration, and (3) positive antibody titer (1:160) by standard tube agglutination test. Results There was no significant difference between the two groups regarding their demographic data. Fever was the most frequent manifestation (96.3%). Epigastric pain was the most frequent adverse effect of treatment (12.1%). Group-A patients had a significantly higher relapse rate compared to group-B patients (22.6% versus 9.3%, p-value = 0.01). The rate of treatment adverse effects was higher among group-B patients, although not reaching statistical significance (20.4% versus 11.3%, p-value = 0.059). Conclusions Adding levofloxacin to the dual therapy for acute/subacute brucellosis (doxycycline–rifampin) may increase its efficacy in terms of lowering the relapse rate of the disease. Further, larger scale studies are needed before considering modifying the standard, dual therapy for brucellosis.

In vitro Antimicrobial Activity of Five Egyptian Plant Species.

In this study, five Egyptian species were tested for their In vitro antimicrobial activities. The antimicrobial screening was carried out via disc diffusion method toward four strains of the clinical antibiotic resistant pathogens including Escherichia coli, Staphylococcus aureus, Candida albicans and Aspergillus niger. Among the methanolic extracts screened, Azadirachta indica, Tectona grandis and Ficus sycomorus showed a broad antimicrobial spectrum against three strains with inhibition zones between 13-27 mm followed by Gmelina arborea and Ficus microcarpa with inhibition zones between 11-17 mm, all plants showed no activity against Aspergillus niger except Gmelina arborea with inhibition zones 12 mm. Penicillin G was used as positive control at concentration of 100 μg/disc with inhibition zones (Staphylococcus aureus 28mm, Escherichia coli 22mm, Candida albicans 25mm and Aspergillus niger 0mm). Owing to the high activity of the methanolic extracts, these extracts were defatted via petroleum ether then were fractionated via; chloroform, ethyl acetate and n-butanol. The n-butanol of Azadirachta indica was the most active against Candida albicans (25 mm), ethyl acetate of Ficus sycomorus against Staphylococcus aureus (18 mm), n-butanol of Gmelina arborea against Staphylococcus aureus (17 mm) and n-butanol of Ficus microcarpa against Staphylococcus aureus (15 mm). These results suggest that the tested plants may be effective potential sources of natural antimicrobials, and are potent inhibitors of antibiotic resistant pathogens.

Biological studies on Biomphalaria alexandrina snails treated with Furcraea selloa marginata plant (family: Agavaceae) and Bacillus thuringiensis kurstaki (Dipel-2x).

Effect of the dry leaves powder water suspension of the plant Furcraea selloa marginata, belonging to family Agavaceae and Bacillus thuringiensis kurstaki (Dipel-2x) was evaluated against non-infected and Schistosoma mansoni-infected Biomphalaria alexandrina snails as well as their efficacy against the free larval stages of S. mansoni. The obtained results indicated that the LC50 and LC90 values after 24 hrs exposure were 53.66 & 84.35 ppm for F. selloa marginata and 392.3 & 483.64 ppm for B. thuringiensis kurstaki against adult B. alexandrina snails, respectively. The plant F. selloa marginata and B. thuringiensis kurstaki have a larvicidal activity against S. mansoni larvae (miracidia and cercariae), the plant F. selloa marginata was more toxic against larvae than B. thuringiensis kurstaki, the miracidia were more sensitive towards the toxic action of the tested agents than cercariae and the mortality percent of miracidia and cercariae is directly proportional to the time and the tested concentrations. The results revealed that the tested sub-lethal concentrations (LCo, LC10 and LC25) reduced the survival, growth rates and egg laying capacity of both non-infected and S. mansoni-infected snails during 12 weeks of exposure in comparison with their control group. The hatchability percent of B. alexandrina eggs of one, three and six days old exposed to LCo, LC10, LC25, LC50 & LC90 concentrations of F. selloa marginata and B. thuringinesis kurstaki, significantly decreased by increasing their age and the tested concentrations. Exposing B. alexandrina snails to sub-lethal concentrations of the tested agents for 24 hours either pre-, during or post exposure of snails to S. mansoni miracidia caused a marked reduction in the infection rate and decreased the mean total number of shedding cercariae/snail. Also, elongated their prepatent period (cercarial incubation period) and shortened the duration of cercarial shedding in comparison with their control group. Under semi-field conditions the more time of exposure to the concentration (LC90= 84.35 ppm) of the plant F. selloa marginata the more mortality among snails. The mortality rates of the snails were 0%, 2%, 18% and 30% at 3, 6, 12 and 24 hrs post exposure, respectively.