Cryptosporidium species in HIV patients in Alexandria, Egypt: distribution and associated clinical findings

@#Cryptosporidium sp. cause opportunistic infections in HIV patients. Molecular differentiation provides a better understanding of the epidemiology and clinical variations of cryptosporidiosis. The present work studied the species of Cryptosporidium in HIV patients and their associated demographic and clinical features. The study included 100 adult HIV patients receiving antiretroviral therapy in Egypt. Cryptosporidium infection was diagnosed by modified ZiehlNeelsen (MZN) stain and PCR amplification of COWP gene. The infecting species were molecularly identified by restriction fragment length polymorphism (RFLP) and DNA sequencing. Data were analyzed using Kappa (K) agreement, Mann–Whitney U, odds ratio and the 95% confidence interval, Chi-squared and Monte Carlo significance (MCp) tests. The statistical significance was judged at the 5% level. A total of 16 Cryptosporidium positive cases were detected (16%), with good agreement between PCR and MZN (K = 0.763). Among 11 PCR positive samples, RFLP identified C. hominis in five samples, C. parvum in three samples, C. meleagridis in two samples, and mixed C. hominis and C. meleagridis in one sample. Eight samples were successfully sequenced and the results confirmed the RFLP classification. C. hominis was found mainly in urban residents while C. parvum and C. meleagridis were significantly associated with rural areas (MCp =0.01). Diarrhoea and nausea/vomiting were recorded only in the presence of C. hominis infection while abdominal pain was the main symptom in C. parvum and C. meleagridis infections. Drinking water sources, contact with animals, and CD4+ count were not related to infection with a particular species. In conclusion, infection with Cryptosporidium sp. is common and frequently symptomatic in HIV patients in Egypt. The predominant species, C. hominis, C. parvum, and C. meleagridis show a distinct distribution in urban and rural residents.

Gill morphology in two bottom feeder Mediterranean Sea fishes: Grey Gurnard Fish (Eutrigla gurnardus, Linnaeus, 1758) and Striped Red Mullet Fish (Mullus barbatus surmuletus, Linnaeus, 1758) by scanning electron microscopy / Morfología de las branquias en dos peces que se alimentan en el fondo del Mar Mediterráneo: Gurnard Grises (Eutrigla gurnardus, Linnaeus, 1758) y salmonete rojo rayado (Mullus barbatus surmuletus,Linnaeus, 1758) por microscopía electrónica de barrido

The purpose of the current investigation was to describe the gill morphology of two bottom feeders Mediterranean Sea fishes: Striped red mullet fish (M. surmuletus) and grey gurnard fish (E. gurnardus) that showed the same feeding habits. The gill system of the grey gurnard consisted of four pairs of gill arches while consisted of three pairs of gill arches in the striped red mullet. Our study focused on the scanning electron microscopical (SEM) features of the gills, where some differences in the gill arches and gill rakers surface in both species were observed. Our results marked that there was an interbranchial septum carrying a four transverse elevated crest in grey gurnard while in striped red mullet carrying a median longitudinal elevated crest. There are some similar structure on the gill arch of two fishes as; no angle between a ceratobranchial part and epibranchial part and also the gill arch has a region of many longitudinal microridges demarcated the region between gill rakers and gill filaments. By SEM, in striped red mullet, the smooth surface of gill arch and gill rakers was characterized by the presence of high number of taste buds. By SEM in grey gurnard, gill raker appeared as a round short projected body with high number of curved apex spines. Furthermore, in striped red mullet, gill raker appeared as short projected body with high number of rod-like spines. Gill filaments were long at middle and short at extremities of gill arch in both species.

El propósito de este trabajo fue describir la morfología de las branquias de dos peces que se alimentan en el fondo del mar Mediterráneo: Gurnard grises (E. gurnardus) y salmonete rojo rayado (M. surmuletus) los cuales mostraron los mismos hábitos alimenticios. El sistema de branquias del E. gurnardus gris consiste en cuatro pares de arcos branquiales, mientras que en el salmonete rayado son tres pares. El estudio se centró en la observación de las características de las branquias por microscopía electrónica de barrido (MEB), donde se visualizaron algunas diferencias en ambas especies tanto en los arcos branquiales, como en la superficie de las ramas branquiales. Nuestros resultados marcaron la presencia de un septum interbranchial que presentaba cuatro crestas elevadas a nivel transversal en el E. gurnardus gris, mientras que el salmonete rayado presentaba una cresta elevada mediana longitudinal. Hay una estructura similar en el arco branquial de los dos tipos de peces, pero no hay ángulo entre una parte ceratobranquial y la parte epibranquial. Además, el arco branquial tiene una región de muchas microrredes longitudinales que delimitan la región entre las ramas branquiales y los filamentos branquiales. Por MEB, en el salmonete rayado, la superficie lisa del arco branquial y el de las ramas branquiales se caracterizaron por la presencia de un alto número de papilas gustativas. Por MEB en E. gurnardus gris, las branquias aparecieron como un cuerpo corto proyectado con un alto número de espinas de vértice curvo. Además, en el salmonete rojo rayado, el rastrillo de las branquias apareció como un cuerpo corto proyectado con un alto número de espinas tipo bastón. En ambas especies los filamentos branquiales eran largos en el centro y cortos en los extremos del arco branquial.

Morphological and scanning electron microscopy studies of the stomach of the Egyptian fruit bat (Rousettus aegyptiacus) / Estudios morfológico y de microscopía electrónica de barrido del estómago del murciélago egipcio de la fruta (Rousettus aegyptiacus)

This study was performed to investigate the histomorphological characters of the Egyptian fruit bat stomach using the light and scanning electron microscope. The stomachs of fourteen adult normal healthy Egyptian fruit bats of both sexes were used. Stomach was tubular with an elongated fundic part and a long narrow pyloric part. Internally, the superficial epithelium was disposed in filiform form, the longitudinal rugaes extended throughout the length of the stomach, their numbers were high but they were thin and branched in the fundic region, while in the cardiac and pyloric region reached to 3 or 4 thick longitudinal and not branched rugaes. Under the scanning electron microscopy, we found differences in the appearance of middle part with the peripherical part of the fundic region, like the appearance of honeycomb buildings in the middle part different to round elevated formations at the periphery of fundic region. At high magnification of cardiac region, there was an aggregation of epithelial cells without regular shape, while there were elevated mountains areas in the pyloric region. We concluded that the stomachs of Egyptian fruit bat had special characters different to other mammals.

En este trabajo se estudiaron las características histomorfológicas del estómago del murciélago egipcio de la fruta, a través de microscopía electrónica de barrido. Para el estudio se utilizaron 14 estómagos de murciélagos egipcios de la fruta, adultos sanos y de ambos sexos. El estómago era tubular con una región fúndica alargada y una región pilórica larga y estrecha. Internamente, el epitelio era filiforme y las rugas longitudinales se extendían a lo largo del estómago, su número era alto, delgado y ramificado en la región fúndica, mientras que en las regiones del cardias y pilórica alcanzaban un número de 3 o 4, gruesos, longitudinales y no ramificados. Al microscopio electrónico de barrido se encontraron diferencias en la apariencia de la parte media respecto a la parte periférica de la región fúndica, al igual que la aparición de estructuras en nido de abeja en la parte media, diferente a las formaciones redondas elevadas observadas en la periferia de la región fúndica. A mayor ampliación de la región del cardias, se observó una agregación de células epiteliales sin forma regular, mientras que en la región pilórica, se encontraron áreas elevadas. Concluimos que los estómagos del murciélago egipcio de la fruta presentan caracteres especiales diferentes a la de otros mamíferos.

Morphological Studies on the Gills of Puffer Fish (Lagocephalus sceleratus, Gmelin, 1789) / Estudios Morfológicos en Branquias del Pez Globo (Lagocephalus sceleratus, Gmelin, 1789)

In the present study, we focused on the morphology of L. sceleratus gills using gross anatomy, scanning electron microscopy as well as light microscopy. Results of this study revealed that the gill openings appeared as simple slits anterior to the pectoral fin without distinct opercular cover. The gill system consisted of three pairs of gill arches carrying two rows of gill rakers on its concave border and gill filaments on its convex border. SEM showed that all surfaces of the gill arch were characterized by the presence of the longitudinal ridges with many taste buds in addition to many spines around the rakers. Histologically, the gill arch was composed of curved bar of hyaline cartilage with slightly elevated area corresponding to the sites of gill rakers. Each filament was formed of a thin central cartilaginous core surrounded by peripheral cartilaginous matrix and covered by primary epithelial layer with abundant mucous cells. The chloride cells appeared mainly near to the base of secondary lamellae. Each gill filament gave rise to a very large number of secondary lamellae on both sides. The epithelial lining of the secondary lamellae comprised epithelial pavement cells, few mucous cells and pillar cells. The latter interposed the enriched blood capillaries. These findings suggest that L. sceleratus gills have characteristic morphological features that are related to adaptive functions for feeding habits, osmoregulation and respiratory mechanism with in their living environment.

El objetivo fue estudiar la morfología de las branquias de Sceleratus L. desde la anatomía macroscópica, microscopía electrónica de barrido, así como la microscopía de luz. Los resultados revelaron que las aberturas branquiales aparecían como simples rendijas por delante de la aleta pectoral sin una cubierta opercular distinta. El sistema branquial consistió en tres pares de arcos branquiales con dos filas de branquiespinas en sus filamentos branquiales frontales y cóncavos en el margen. La microscopía de barrido mostró que todas las superficies del arco branquial se caracterizaron por la presencia de crestas longitudinales con muchas papilas gustativas, además de una cantidad importante de espinas alrededor de los rastrillos. Histológicamente, el arco branquial se compone de una barra curva de cartílago hialino con una zona ligeramente elevada, correspondiente a los sitios de branquiespinas. Cada filamento se formó por un delgado núcleo central cartilaginoso rodeado de matriz cartilaginosa periférica y cubierto por una capa epitelial primaria con abundantes células mucosas. Las células de cloruro aparecieron principalmente cerca a la base de laminillas secundaria. Cada filamento de las branquias en ambos lados dio origen a un gran número de laminillas secundarias. El revestimiento epitelial de laminillas secundarias estaba formado de células epiteliales, algunas células mucosas y células sostenedoras. Estos hallazgos sugieren que las branquias de L. sceleratus tienen características morfológicas que están relacionadas con las funciones de adaptación de los hábitos de alimentación, la osmorregulación y el mecanismo respiratorio de acuerdo a su entorno.

Morphological investigations of the cervicothoracic sympathetic system in the horse (Equus ferrus caballus) in Egypt / Investigaciones morfológicas del sistema simpático cervicotorácico en el caballo (Equus ferrus caballus) en Egipto

The current study was performed on twelve healthy adult horses (E. ferrus caballus) collected from Egypt were dissected to provide anatomical descriptions of bilaterally cervicothoracic sympathetic system macroscopically. On the left side, cervicothoracic sympathetic system is represented only by the caudal cervical ganglion, which presents on lateral surface of esophagus, cranial to the level of first rib. On right side, cervicothoracic sympathetic system is represented by the caudal and middle cervical ganglion. Caudal cervical ganglion was consisted of the fusion of eighth cervical and first three thoracic nerve ganglia. Caudal directed continuation branch of left ansa subclavia gave off a pericardial branch and then gave branch for ligamentum arteriosum. There are special sympathetic­parasympathetic communicating branches; on left side, there is only one branch that was present on lateral surface of esophagus, while on right side, there were four branches; two from caudal cervical ganglion and two from middle cervical ganglion. The most suitable site of ganglion blocks from both sides; needle was placed medioventrally between the articulation of first and second rib.

Doce caballos (E. ferrus caballus) adultos sanos, procedentes de Egipto, fueron disecados para realizar descripciones anatómicas macroscópicas del sistema simpático cervicotorácico bilateralmente. En el lado izquierdo, el sistema simpático cervicotorácico estuvo representado sólo por el ganglio cervical caudal, en la superficie lateral del esófago, craneal en relación a la primera costilla. En el lado derecho, el sistema simpático cervicotorácico estuvo representado por los ganglios caudal y cervical medio. El ganglio cervical caudal consistió en la fusión del octavo ganglio cervical y el primero de los tres ganglios torácicos. Se observaron ramos comunicantes entre los sistemas simpático y parasimpático; en el lado izquierdo, sólo hubo una rama presente en la superficie lateral del esófago, mientras que en el lado derecho, se observaron cuatro ramos: dos del ganglio cervical caudal y dos del ganglio cervical medio. El sitio más adecuado para la ejecución de los bloqueos ganglionares de ambos lados es a nivel medioventral, entre la articulación de la primera con la segunda costilla.

Morphological comparison of the filiform papillae of New Zealand white rabbits (Oryctolagus cuniculus) as domestic mammals and Egyptian fruit bat (Rousettus aegyptiacus) as wild mammals using scanning electron microscopic specimens / Comparación morfológica de las papilas filiformes de conejos blancos Nueva Zelanda (Oryctolagus cuniculus) como los mamíferos domésticos y los murciélagos de la fruta egipcios (Rousettus aegyptiacus) como los mamíferos salvajes utilizando muestras de microscopía electrónica de barrido

This paper presents a comparison of the morphological structure of the filiform papillae in New Zealand white rabbits as domestic mammals and Egyptian fruit bats as wild mammals. This study was carried out on the tongues of adult healthy New Zealand white rabbits and Egyptian fruit bats of both sexes. There were four types of lingual papillae in both animals. In the Egyptian fruit bats, there were six subtypes of the filiform papillae; three on the anterior part (small, conical and giant), two on the middle part (cornflower and leaf-like papillae) while the posterior part contain rosette shape filiform papillae, in addition to transitional papillae and conical papillae. In New Zealand white rabbits, there were four subtypes of filiform papillae; spoonful conical (on the lingual anterior part), processed (at the anterior edge of lingual prominence), leaf-like (on the posterior area of lingual prominence) and triangular filiform papillae (on the lingual root). The shape, size, number and orientation of the lingual papillae itself and its processes varied according to their location within the tongue (region-specific) in relation to the feeding habits, strategies for obtaining food, climate conditions, and types of food particles.

Se comparó la estructura morfológica de las papilas filiformes de un mamífero doméstico (conejo neozelandes) y de un mamífero silvestre (murciélagos de la fruta egipcio). El estudio fue realizado en animales de ambos sexos. Se observó cuatro tipos de papilas linguales, en ambas especies de animales. En los murciélagos de la fruta egipcio se observaron seis subtipos de papilas filiformes; tres en la parte anterior (pequeño, cónico y gigante), dos en la parte media (aciano y hojas como papilas) mientras que en la parte posterior se observaron papilas filiformes y papilas de transición cónica. En los conejos se observaron cuatro subtipos de papilas filiformes; cónica cucharada (en la parte anterior lingual), procesado (en el margen anterior de la prominencia lingual), tipo hoja (en la zona posterior de la prominencia lingual) y papilas filiformes triangulares (en la raíz lingual). La forma, tamaño, número y orientación de las papilas linguales y sus procesos varían de acuerdo a la función y a la ubicación en la lengua (específicos de la región) en relación con los hábitos de alimentación, las estrategias para la obtención de alimentos, las condiciones climáticas y tipos de partículas de alimentos.

High Performance Liquid Chromatographic Determination of the Ternary Mixture of Caffeine, Dipyrone and Drotaverine Hydrochloride in Tablet Dosage Form.

This work describes a simple, rapid, and reliable HPLC method for the simultaneous determination of caffeine (CAF), dipyrone (DIP) and drotaverine hydrochloride (DRV). Chromatographic separation was achieved using a reversed phase Waters Symmetry C18 (3.9×150 mm, 5 μm particle size) column with gradient elution of the mobile phase composed of 0.05 M orthophosphoric acid and acetonitrile. The gradient elution started with 15% (by volume) acetonitrile ramped up linearly to 60% in 3 min then kept at this percentage till the end of the run. The flow rate was 1mL/min. Quantification was based on measuring peak areas at 210 nm. The analytes were resolved with retention times 1.47, 2.39 and 7.17 min for DIP, CAF and DRV, respectively. Analytical performance of the proposed procedure was validated with respect to system suitability, linearity, ranges, precision, accuracy, robustness, detection and quantification limits. The linearity ranges were 10-200, 5-100 and 5-100 μg/mL for DIP, CAF and DRV, respectively. The validated HPLC method was applied to the simultaneous determination of the three drugs in several laboratory-prepared mixtures of different ratios. Finally, laboratory made tablets containing the three drugs were assayed using the developed procedure where no interfering peaks were encountered from the tablet additives.

Evaluation of the role of presepsin [soluble cd 14 subtype] in the diagnosis of neonatal sepsis in preterm newborns

Objective: The present study was conducted to evaluate the role of presepsin as an early and rapid predictor of bacterial infection in newborn infants

Methods: This study was carried out on 50 preterm newborn infants with clinically suspected early onset sepsis admitted to the neonatal intensive care unit at Alexandria University Maternity Hospital, All studied newborns were subjected to History taking, detailed physical examination and sepsis work -up, including complete blood count, blood culture, CRP, CSF analysis if indicated and quantitative measurement of preseason

Results: The mean birth weight of the studied newborn infants was 1520 g and the mean gestational age was 32.7 weeks with no statistically significant difference as regard the preseason results. Virginities was the main maternal risk factor for EOS, present in 80 % of the studied newborn infants. The majority of cases of positive culture for Klebsiella were negative for preseason, and this was statistically significant, Presence of toxic granules had the highest incidence among laboratory markers in the CBC in the studied group, Preseason was positive in 48% of newborns and the mean value of preseason was 1397.6 ng/L, Most cases with positive initial CRP readings were positive for preseason and this was statistically significant. There was no significant difference in preseason results as regard clinical score, total laboratory score and both laboratory and clinical scores. All cases that had meningitis were positive for preseason, and most cases that didn't have meningitis were negative for preseason and this was statistically significant. There was no statistically significant difference between preseason results and duration till admission, Apgar score or hospital stay

Conclusion: We concluded that preseason is a useful, quickly and easily performed marker for diagnosis of neonatal, sepsis. Its results are comparable to the CRP and seemed to be superior to conventional CBC tests. Furthermore, presepsin is a promising prognostic marker that could identify high risk newborns to severe sepsis, but it may not be elevated in response to infections caused by organisms like Klebsiella

Diagnostic utility and complications of flexible fiberoptic bronchoscopy in Assiut University Hospital: a 7-year experience

Few studies with small number of patients reported their experience with flexible fiberoptic bronchoscopy [FFB]. We aimed to report our 7-year experience with the diagnostic yield and complications of FFB at Assiut University Hospital. A retrospective review of bronchoscopy reports and corresponding patients' charts over 7 years from January 2006 to December 2012 performed at the Department of Chest Diseases, Assiut University Hospital, was done. Indication for procedures, suspected diagnosis, final diagnosis, and complications were reported. Of 3980 bronchoscopies, 3660 [92%] were diagnostic. Mean age was 45 +/- 18 years and 68% were males. Malignancy and infection, including tuberculosis [TB], were the 2 main indica-tions for FFB [47% and 23.8%]. The overall diagnostic yield was 67%. A total of 1690 broncho-alveolar lavage [BAL], 1303 brushing, 188 transbronchial biopsies [TBB], and 645 bronchial biopsies [BB] were performed. Malignancy was confirmed in 70% of suspected cases. Tuberculosis was diagnosed in 58.5% of suspected cases, whereas bacterial pneumonia was diagnosed in 48.5%. Bronchoscopy diagnosed 38.4% of patients with interstitial lung disease. The diagnostic yield was 55% for sarcoidosis and 33% for usual interstitial pneumonia. The overall complication rate was 1.61%. Mortality rate was 0.05%. Our results confirm that flexible fiberoptic bronchoscopy is a valuable diagnostic tool, with a low rate of complications, particularly in patients with lung cancer. The diagnostic yield in our locality is almost similar to that reported in other series

Predictors of asymptomatic cardiac events and prognostic value of cardiac biomarkers in chronic kidney disease patients

Patients with chronic kidney disease [CKD] are at increased risk of cardiovascular events; cardiovascular disease is a leading cause of death in patients with chronic kidney disease; Circulating biomarkers play a major role in the early detection of cardiovascular disease in those patients. To clarify the prevalence of asymptomatic different cardiac events in CKD and to explore the degree of elevation of N- terminal-pro-B-type Natriuretic Peptide [NT-pro-BNP] in asymptomatic cardiac patients with varying degree of CKD and the relationship between the elevation of this biomarker and the occurrence of these cardiac complications. This case-control study included 40 CKD patients and 40 controls; patients were recruited from nephrology unit of internal medicine department; Assiut university hospital; known to have chronic kidney disease in different grades [grade I- grade V]. Resting transthoracic echocardiography [TTE] and plasma NT-pro-BNP concentrations were measured in patients who were asymptomatic for clinical evidence of any cardiac events, [n=40; mean age 47.63 +/- 17.93 years; 52.5%were males] as well as healthy volunteers n=40; mean age 42.00 +/- 13.25; 62% were males]. In addition, the correlation between plasma NT-pro-BNP concentration and parameters of echocardiography was examined. Increased prevalence of left ventricular hypertrophy [LVH] [70%]; left ventricular diastolic dysfunction [77.5%], left ventricular systolic dysfunction [17.5%] and coronary artery disease [27.5%] in CKD patients as well as serum NT-pro-BNP levels in the patients were significantly higher [6703.75 +/- 2947.68 pg/ml] than those in healthy volunteers [124.83 +/- 140.40 pg/ml] [p=0.000]. NT-pro-BNP level was higher also in patients who had hypertension [p=0.002]; anemia [p-0.004]; hypoalbuminamia [p=0.000];left ventricular hypertrophy [LVH] [7873. 57 +/- 2719. 31 pg/ml] [p = 0.000], diastolic dysfunction [7524. 52 +/- 2824.74 pg/ml] [p= 0.000]; systolic dysfunction [10371.43 +/- 2771.71] [p=0.000] and patients who had segmental wall motion abnormality [SWMA] [8709.0.9 +/- 3512.3.9] [p=0.000] and correlate Positively with C reactive protein [CRP] level [r-0.751 p=0.000]; left ventricular mass [LVM] [r=0.772 p=0.000] and left ventricular mass index [LVMI] [r=0.715 p=0.000] and negatively with ejection fraction [EF] by echocardiography [r=-0.483 p=0.000]. NT-pro-BNP level elevation in asymptomatic patients with CKD reflects underlying cardiac dysfunction, ischemic heart disease and hypertrophy independent of renal function

Toxicokinetics versus pi-tarmacokinetics of oral anabolic steroids abused in doping practice

Despite the high prevalence of toxicological profile of oral anabolic steroids, laboratory investigations on toxicokinetic profile of anabolic steroids overdoses have been largely unknown and underestimated. In the present study toxicokinetics of methyltestosterone and testosterone undecanoate were studied in male adult rats after oral administration of single toxic dose to explore possible alteratiolls in their pharmacokinetic behavior in comparison to their corresponding parameters at therapeutic doses. The extraction methods adapted for plasma samples showed mean recoveries of 87.4+0.19% and 103.5 +/- 0.1% for methyltestosterone and testosterone undecanoate respectively. Inter- and intra-day precision were 2.4 -8.7% coefficient of variance [CV.], and 4.3 -2.8% [CV.] for methyltestosterone and testosterone undecanoate respectively. Plasma concentrations measured by high performance liquid chromatography method was applied for the analysis of both methyltestosterone and testosterone undecanoate with high sensitivity and low detection limit of 1ng/ml. The pharmacokinetic parameters were estimated using non-compartmental method. Both drugs showed non-linear pharmacokinetic behavior represented in disproportional increase in C[max], AUC[0-infinity] and increase in V, CI, t1/2 and lambda. The present data indicate accumulation of steroids in tissues leading to severe toxicological consequences

Comparative in vivo and in vitro hepato-toxicity studies for oral anabolic steroids abused in sports

Studies on hepatotoxicity of anabolic- androgenic steroids in experimental animals and in controlled clinical studies were based on the use of doses at substantially lower level than those practiced by the abusers. the aim of this study was to investigate acute hepatotoxic effects after administration of suprapharmacological doses to experimental animals as well as to isolated hepatocytes suspension to reflect any hepatic dysfunction caused by anabolic steroid abuse. Male adult albino rats were administered daily oral doses of methyltestosterone [175mg/Kg], testosterone-undecanoate [420 mg/Kg], and their combination for 7 days. In vivo results showed significant increase in serum aspartate aminotransferase [AST] and lactate dehydrognease [LDU]. While both steroids did not affect serum levels of alanine aminotransferase [ALT], thiobarbituric acid reactive substances [TBARS], reduced glutathione levels and total protein, when administered either individually or in combination. Leakage of ALT, AST and LDH was observed in any vitro studies in addition to increase in TBARS content. All treatments did not result in any significant difference in reduced glutathione content compared to the respective control. Histopathological examination of the liver revealed inflammatory and degenerative lesions in addition to focal necrosis. The histopathological findings confirm the biochemical studies [both in vivo and in vitro] and show clear toxic manifestations of suprapharmacological doses of theses anabolies on the liver

Nutrition Education intervention in dyslipidemic children and adolescent with insulin-dependent diabetes mellitus [IDDM]

Diabetes mellitus is the most common endocrine metabolic disorder of childhood and adolescence with important consequences for physical and emotional development. This study was designed to detect the effect of diet therapy [through nutrition education program] on lipid profile and blood glucose level in diabetic children. The study was carried on 45 diabetic children aged between 8-15 years old at diabetic nutrition clinic of nutrition institute in Cairo from 2003-2005. Children included in the study were divided into two groups: insulin dependent dyslipidemic group [IDDM] [diet control/ group] and insulin dependent non dyslipidemic [control group]. All were subjected to full dietetic history by the 24 hour recall for 3 days, thorough clinical examination, they were evaluated for plasma lipids, lipoproteins, fasting blood glucose [FBG] and glycated hemoglobin [HbA[12] levels. The dyslipidemic were measured after three months for the previously measured parameters. The nutrition education process was performed and continued on weekly intervals for three months. There was significant decrease in serum cholesterol and triglyceride levels in the study group after the program, and insignificant increase in serum HDL and decrease in serum LDL. Also, there was insignificant decrease in FBG but there was statistically significant decrease in HbAl after the program. These changes occurred in parallel with increases in intakes of protein and total calories with adequate carbohydrate and sometimes a reduction in intakes of total fat. Nutrition therapy for children with IDDM is essential to improve measures of glycemic control and lipoprotein mediated risk for dyslipidemia. More innovative approaches to achieve lifestyle changes are required to meet current recommendations which are likely to produce greater beneficial changes than those observed in this study

Simvastatin reverses cyclosporin A-induced endothelial damage in rats: lipid-lowering-dependent and -independent effects

Cydosporin A [CyA] is the immunosuppressant most frequently used in transplant surgery and in the management of autoimmune diseases. CyA-induced oxidative stress together with dyslipidemia have been implicated in the pathogenesis of vascular dysfunction associating CyA therapy. The present study investigated the possible protective effect of simvastatin, a lipid-lowering drug with potent antioxidant properties, against CyA-induced endothelial damage in male rats. Eighteen male Wistar rats were used. They were divided into 3 groups: control, CyA and CyA + simvastatin. In the control group, rats were administered the vehicle, olive oil; in the CyA group, rats were administered CyA [20 mg/kg/day, s.c. for 14 days] and in the CyA+simvastatin group, rats were co-administered simvastatin [2.5 mg/kg/day, s.c. for 14 days] and CyA. Administration of CyA [20 mg/kg/day, s.c. for 14 days] in male rats resulted in a significant increase in the lipid peroxidation product, malondialdehyde [MDA], and a significant decrease in superoxide dismutase [SOD] activity in plasma. CyA treatment was also associated with a significant increase in plasma nitrite level as well as an elevation in plasma cholesterol, triglycerides [TGs], low density lipoproteins [LDL] and a reduction in high density lipoproteins [HDL] levels. CyA-induced vascular dysfunction was further confirmed by the attenuation of endothelium-dependent relaxations produced by carbachol in rat isolated aortic rings. Co-administration of simvastatin [2.5 mg/kg/day, s.c. for 14 days] with CyA significantly reversed the deleterious biochemical and functional vascular effects that accompanied CyA treatment. The present study provides good evidence that both oxidative stress and dyslipidemia underlie the CyA-induced vascular damage, an effect that could be reversed by simvastatin co-administration

Taking off antibiotic prophylaxis in children with vesicoureteral reflux, Is it possible and save?

To evaluate the outcome of taking off antibiotics prophylaxis in children with persistent vesicoureteral reflux.48 children with primary vesicoureteral reflux were taken off prophylactic antibiotics in Shebin Al Koom Teaching Hospital Between 1996 and 2007. The criteria for discontinuing antibiotics were children older than 4 years with a normal voiding pattern, no significant hydronephrosis or renal scars and a minimal history of urinary tract infection [UTI]. Exclusion criteria were neurogenic bladder, severe voiding dysfunctions, posterior uretheral valve and ectopic ureter. Routine follow up included duration of on and off antibiotic, grade of reflux at the time of stopping antibiotics, the occurrence of UTI and renal sonography. Sex distribution was 6 boys [12.5%] and 42 girls [87.5%]. The mean patient age when stopping antibiotic was 7.2 years. VUR was bilateral in 22 patients [45.8%], on the right side in 10 patients [20.8%] and on the left side in 16 patients [33.4%]. Reflux was grade I in 8 patients [16.7%], grade II in 36 patients [75%] and grade III in 4 patients [8.3%]. UTIs was found in 6 patients [12.5%] after antibiotic stopping, four of them had cystitis and the other two had febrile UTIs. None of our study developed new renal scars. Taking off antibiotic prophylaxis is possible, safe and acceptable option in a selected patient population with VUR

Hypolipidimic effect of some medicinal plants on diabetic rats

Our aim was to evaluate the hypolipidimic effect of aqueous extract of a famous mixture used in Saudi Arabia folk medicine that consists of Nigella sativa, Commiphora myrrha, Boswellia carterii Birdw, Ferule assa-foetida and Aloe vera and also the extract of each plant alone on alloxan induced diabetic rats. The present study was carried out on 80 adult male albino rats [120 +/- 20 g.b.wt.], the rats were divided randomly into 8 groups, the first group served as control group, the second group as alloxan induced diabetic rats, the third group was diabetic rats treated with mixture of folk medicinal plant [0.01g /100 g b. wt.] ,the fourth group: diabetic rats treated with Nigella sativa [0.01g /100 g b. wt.], the fifth group: diabetic rats treated with Aloe vera [0.005g /100 g b. wt.], the sixth group: diabetic rats treated with Ferule assa-foetida [0.01 g /100 g b. wt.], the seventh: diabetic rats treated with Boswellia carterii Birdw [1ml/100 g b. wt.] and the eighth group: diabetic rats treated with Commiphora myrrha [0.01 g ml/100 g b. wt.]. Serum total lipid, serum total cholesterol, LDL-cholesterol, and triglyceride recorded significant increases in diabetic, Nigella sativa, Commiphora myrrha, Boswellia carterii birdw and Aloe vera treated group. While the mixture and Ferule assa-foetida treated group, showed insignificant changes in serum total lipid, triglyceride, serum total cholesterol and LDL-cholesterol. On other hand, the mixture treated group and Ferule assa-foetida treated group showed significant decreased in the previous parameters. The serum HDL cholesterol was significantly reduced in diabetic group throughout the experimental periods, otherwise, all treated group revealed insignificant changes till the end of experiment when compare with undiabetic rats. The aqueous extract of a mixture consists of Nigella sativa, Commiphora myrrha, Boswellia carterii Birdw, Ferule assa-foetida and Aloe vera are useful for improvement of the lipid profile of alloxan induced diabetic rats from each plant alone

Prescribing patterns for acute respiratory infections in primary health care, Aseer region, Saudi Arabia

The objective of this study was to identify the patterns of prescribing for Acute respiratory infections in patients attending primary health care centers in the Aseer region, southwestern Saudi Arabia . This study was conducted at primary health care centers in the Aseer region during November 2003. A master sheet designed by the investigator was distributed to all the working physicians in the primary health care center in the Aseer region. The master sheet included the age, sex, complaints, signs, clinical diagnosis and the type of medications prescribed. Physicians were asked to include all patients attending on 17[th]P November 2003, and send the master sheet to the Technical Supervision Unit at Primary Care Department, General Directorate of Health Affairs. Data of the master sheet was entered and analyzed by using SPSS. The total number of patients attending with acute respiratory infections [ARIs] was 3000 which represented 25% of the patients attending primary health care centers that day. Children formed 60% of the total number of cases. Regarding symptoms and signs, it was found that 70% had a cough, 59% had a runny nose, and 43% had a sore throat. The common cold was the most common diagnosis [42%]. Antipyretics, antihistamines, antibiotics and antitussives were prescribed for 78%, 48%, 45% and 25% respectively. Statistical analysis using logistic regression revealed that the higher the temperature, the more severe the throat congestion and the presence of exudates on pharynx, the higher the likelihood to prescribe antibiotics. In this study, it was found that the prescription of all drugs for ARIs was still high in spite of the fact that these conditions are self-limiting. To rationalize prescribing for ARI, implementation of the national protocol for diagnosis and treatment of ARIs is mandatory. Further studies to explore the physician's knowledge, attitudes and behavior concerning prescribing for ARI is strongly recommended

Growth patterns and antigenic analysis of Egyptian trichomonas vaginalis isolates

In this study, the vaginal washouts from symptomatic and asymptomatic patients were examined by wet mount examination and culture on modified TYM medium. Among the 320 examined cases, 10 were positive for T. vaginalis trophozoites by wet mount examination and culture. Modified TYM medium proved to be very satisfactory for the isolation as well as the maintenance of the ten T. vaginalis isolates. The comparison between the growth patterns of all isolates, by counting the number of viable organisms every 24 hours for 7 days, showed that there is a wide variability in the growth characteristics, as regards lengths of log phase, growth peaks reached, generation times, division rate and number of divisions. The antigenic differentiation of the ten T. vaginalis isolates through sodium dodecyl sulfate- polyacrylamide gel electrophoresis [SDS-PAGE] demonstrated a total of 34 bands using 10% resolution gel. The bands ranged in molecular weight from 12-189 kDa. Most of the bands were common among several isolates, while isolate 2 appeared different than other isolates with two characteristic bands, one at 136 kDa and the other at 25 kDa. Also, isolates 4 and 8 had characteristic bands at 163 kDa and 189 kDa, respectively

Surgical interference in cases of infective endocarditis [results and outcome]

Many patients with infective endocarditis [IE] present with serious and complicated courses that lead to significant morbidity and mortality. We followed up 39 cases of IE who were referred to surgery. Our patient population was comprised of 30 males and 9 females [aged between 7 and 52 years, mean 26.8 +/- 12.9 years]. Congenital heart disease was present in 7 of the patients while rheumatic heart disease was present in 32. The patients presented with congestive heart failure [CHF] in 26, and systemic embolization in 5. Blood cultures were positive in 30 [76.9%] of the patients, while vegetations were detected by 2-dimensional echocardiography in 28 patients [71.7%]. Elective surgery was performed in 36 patients and emergency operation for systemic arterial embolizalion and/or intractable CHF in 3 patients. Four patients required re-operation for post-operative bleeding. All patients were followed up for 6 months with no evidence of re-infection. Four patients died, 2 due to intracranial bleeding from the use of anticoagulation for the mechanical valve implanted, and 2 died due to septicaemia. The remaining patients resumed normal activity. The encouraging outcome of our study suggests that surgical intervention for IE, is a relatively safe procedure for patients with complicated IE, early diagnosis and early intervention are expected to improve the morbidity and mortality of patients with IE