Impact of Coronavirus Disease 2019 Lockdown on Back Pain Intensity, Prevalence and Associated Risk Factor Among Adults in Malaysia

@#Introduction: Low back pain (LBP) is a common musculoskeletal disorder (MSD) that leads to a variety of negative consequences. The prevalence of LBP was found to be high worldwide. Individuals have been forced to remote studying or working conditions during the coronavirus disease 2019 (COVID-19) pandemic, exposing them to the risk factors of LBP to a greater extent. This is a cross-sectional study conducted among 623 adults and aimed to assess LBP intensity and prevalence among adults in Malaysia before and during the COVID-19 lockdown and to identify the association between demographic, physical and psychological factors with LBP. Methods: A self-administered questionnaire composed of 36 questions regarding demographic characteristics, physical activities and psychological aspects was distributed to the public. Pearson’s Chi-square and Fisher Exact tests were performed using collected data to assess the association between LBP intensity and various risk factors. Results: The prevalence of LBP increased from 64.4% before the lockdown to 83.5% during the lockdown. LBP intensity significantly increased during the lockdown. Before lockdown, factors associated with LBP intensity included gender and stress level. While during the lockdown, age, gender, occupation, time spent on computer use, ergonomics as well as stress level affected the intensity of LBP. Conclusion: The present study showed that the COVID-19 lockdown has contributed to the increase in both the prevalence and intensity of LBP among Malaysians. The identified risk factors include age, gender, occupation, duration of sitting and computer use, adherence to ergonomic recommendations, and stress level.

Fibrofast and fibrosis-4 versus fibroscan as indicators of hepatic fibrosis in non-alcoholic fatty liver disease patients: A cross sectional Study

Aims: Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that includes simple steatosis, which can proceed to non-alcoholic steatohepatitis, cirrhosis, and, finally, hepatocellular carcinoma. Owing to the invasive nature of liver biopsy, the need for non-invasive tools were required for diagnosis. Objective: To compare the performance of simple biochemical scores (fibroblast) FIB-5 and (fibrosis-4) FIB-4 with fibroscan to differentiate mild to moderate fibrosis (MF; F0 to F2) from advanced fibrosis (AF; F3 to F4) in patients with NAFLD. Patients and methods: This cross-sectional study was done on 116 NAFLD patients. All patients were scanned with the FibroScan examination. FIB-5 and FIB-4 were calculated for all patients. Results: The mean kPa score (liver stiffness measurement score) of the patients belonging to advanced fibrosis [9.53 ± 1.05]. The FIB-4 score was significantly higher in patients with advanced fibrosis (1.54 ± 0.38) compared with patients with mild to moderate fibrosis (1.18 ± 0.44), p-value = 0.001, whereas the FIB-5 score was insignificant between patients. Conclusion: FIB-4 is superior to FIB-5 as a non-invasive simple marker in diagnosing advanced fibrosis in NAFLD patients.

Adding autogenic drainage to chest physiotherapy after upper abdominal surgery: effect on blood gases and pulmonary complications prevention. Randomized controlled trial

ABSTRACT BACKGROUND: Hypoxemia and pulmonary complications are common after upper abdominal surgery (UAS). OBJECTIVE: To examine whether inclusion of autogenic drainage (AD) in chest physiotherapy after UAS confers additional benefits in improving blood gases and reducing postoperative pulmonary complications (PPCs). DESIGN AND SETTING: Randomized controlled study conducted at Kasr Al-Ainy teaching hospital, Egypt. METHODS: A randomized controlled trial was conducted on 48 subjects undergoing elective UAS with high risk of developing PPCs. The study group received AD plus routine chest physiotherapy (deep diaphragmatic breathing, localized breathing and splinted coughing) and the control group received routine chest physiotherapy only. The outcomes included arterial blood gases measured at the first and seventh postoperative days, incidence of PPCs within the first seven days and length of hospital stay. RESULTS: Baseline characteristics were similar between groups. In the AD group, SaO2, PaO2, PaCO2 and HCO3 significantly improved (P < 0.05) while in the physiotherapy group, only SaO2 and PaO2 significantly improved (P < 0.05). Nonetheless, significant differences in post-treatment SaO2 and PaO2 between the groups were observed. The overall incidence of PPCs was 16.66% (12.5% in the AD group and 20.8% in the physiotherapy group) (absolute risk reduction -8.3%; 95% confidence interval, CI, -13.5 to 29.6%), with no significant difference between the groups. The AD group had a significantly shorter hospital stay (P = 0.0001). CONCLUSION: Adding AD to routine chest physiotherapy after UAS provided a favorable blood gas outcome and reduced the length of hospital stay. It tended to reduce the incidence of PPCs. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04446520.

Attitude towards problem-based learning and its relationship with locus of control and academic self-concept among medical students / 한국의학교육

PURPOSE@#This study aimed to assess the degree of acceptance of problem-based learning (PBL) among phase one medical students and its association with academic self-concept (ASC) and internal locus of control (ILOC).@*METHODS@#A 5-point Likert scale valid and reliable questionnaire assessing the attitude towards PBL, ASC, and ILOC was given to phase one medical students at MAHSA University. Data were analysed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).@*RESULTS@#Out of 255 participants, there were 84 males and 171 females, 175 Malaysians and 80 non-Malaysians. The results showed an overall acceptance of PBL with a mean of 3.7±0.07, ASC of 3.5±0.05 and ILOC of 2.9±0.05. Females showed a higher significant acceptance of PBL, ASC, and ILOC as compared with males. There was no difference between Malaysians and non-Malaysians in any of the variables measured. Simple regression analysis revealed a significant predictive effect of acceptance of PBL on ASC and ILOC (r=0.44 and r=0.88, respectively).@*CONCLUSION@#The higher the acceptance of PBL among students, the higher is the ASC and ILOC. This reflects the importance of PBL as a teaching method as well as the importance of increasing the level of appreciation of PBL amongst students.

Attitude towards problem-based learning and its relationship with locus of control and academic self-concept among medical students / 한국의학교육

PURPOSE: This study aimed to assess the degree of acceptance of problem-based learning (PBL) among phase one medical students and its association with academic self-concept (ASC) and internal locus of control (ILOC). METHODS: A 5-point Likert scale valid and reliable questionnaire assessing the attitude towards PBL, ASC, and ILOC was given to phase one medical students at MAHSA University. Data were analysed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA). RESULTS: Out of 255 participants, there were 84 males and 171 females, 175 Malaysians and 80 non-Malaysians. The results showed an overall acceptance of PBL with a mean of 3.7±0.07, ASC of 3.5±0.05 and ILOC of 2.9±0.05. Females showed a higher significant acceptance of PBL, ASC, and ILOC as compared with males. There was no difference between Malaysians and non-Malaysians in any of the variables measured. Simple regression analysis revealed a significant predictive effect of acceptance of PBL on ASC and ILOC (r=0.44 and r=0.88, respectively). CONCLUSION: The higher the acceptance of PBL among students, the higher is the ASC and ILOC. This reflects the importance of PBL as a teaching method as well as the importance of increasing the level of appreciation of PBL amongst students.

Colloid co-load versus colloid pre-load in a parturient undergoing caesarean delivery with spinal anaesthesia and its effects on maternal haemodynamics

Background: cesarean section is the surgical delivery of a baby that involves making an incision in the mother's abdominal wall and uterus. Spinal anesthesia is considered the "gold standard" technique for cesarean section. Hypotension is the most common side effect of neuraxial blocks in the obstetric patient with an incidence rate reported as high as 83%. This has remained a significant concern for the anesthesiologist during management of this patient

Aim of the work: This study will be performed to compare the effects of colloid pre-load and colloid co-load on maternal haemodynamic changes during spinal anaesthesia for cesarean section

Patient's and Methods: A comparative cross sectional study was conducted at Ain Shams Maternity Hospital. After obtaining approval of research ethical committee and patients' informed consents at which 105 women with full term singleton pregnancies were scheduled for elective cesarean section and received spinal anesthesia. The patient's age were between 18 -42 years, of ASA physical status. In our study 3 groups of patients were compared; each group is formed of 35 patients Group 1; patients were pre-loaded with 500 ml of 6% HES[hydroxyethyl starch 130/0.4] 20 minutes before induction of anesthesia. Group2; patients were co-loaded with 500ml of 6% HES [hydroxyethyl starch 130/0.4] during injection of bupivacaine. Group 3; patients were pre-loaded with 500ml lactated ringer solution 20 minutes before induction of anaesthesia

Results: There was a decrease in SBP, DBP,MAP and HR in the 3 groups where the lowest values were recorded in group 3 between 6-15 minutes and there was a high statistical difference p<0.0001 while the intergroup comparison of the groups 1 and 2 showed no statistical significance as regards SBP,DBP,MAP and HR

Conclusion: In this study it was found that colloid co-load was somewhat how equal to colloid pre-load in prevention of hypotension in a parturient undergoing cesarean section under spinal anesthesia in addition it was found that crystalloid pre-load was inferior to colloid co-load or pre-load in maintaining blood pressure during spinal anesthesia in parturients

Rice bran oil ameliorates hepatic insulin resistance in fructose fed-rats

Background: Insulin resistance is a pathological condition characterized by inadequate peripheral tissue metabolic response to circulating insulin. High dietary fructose causes insulin resistance syndrome, primarily due to simultaneous induction of genes involved in glucose, lipid and mitochondrial oxidative metabolism. Rice bran oil [RBO] is a rich source of antioxidants which contribute to higher oxidative stability and longer shelf life than other edible oils

Aim of the work: The current study investigated the effects of the daily intake of RBO on insulin resistant rat liver, as a central organ in carbohydrate metabolism

Materials and methods: Rats were allocated in 5 groups. Animals in groups 1 and 2 received standard diet and standard diet containing RBO, respectively. Group 3: animals fed high fructose diet [HFD], which was categorized into: rats fed HFD either for one month [HFD1] or for 2 months [HFD2]. Group 4, rats were fed HFD containing RBO for one month [HFD1+RBO], while rats in group 5 were fed HFD for 30 days then RBO was added to the diet for another 30 days [HFD2+RBO]

Results and conclusion: addition of RBO to this model improved insulin sensitivity in liver

Dendritic Cells in Hepatitis C Virus Infection

Background: The global prevalence of chronic hepatitis C is estimated at 2.8%. There is markedly higher prevalence in the Middle East about 14.7% in Egypt. Dendritic cells (DCs) are one of the major Antigen presenting cells in the body. They bridge innate and adaptive immunity and impact priming of HCVspecific immune responses. The current study was aimed to investigate the DC activation status, and their role in interaction with natural killer (NK) cells utilizing different setups with healthy NK and HCV+ DC, HCV+ NK and healthy DC, healthy DC and healthy NK and finally HCV+ NK and HCV+ DC in the presence of HCV peptides and a ratio of 5 NK: 1DC. Results: DC-NK interaction in chronic HCV infection is mainly affected by the affection of DCs by HCV leading to a maturation defect (decreased expression of HLA DR, CD 86 and CD 83). Healthy NK cells were able to stimulate the maturation of DCs particularly with core peptide whereas NS3-4 had no effect. When DCs were healthy, all peptides were able to produce significant maturation of DCs even when cocultured with HCV+ NK cells. Co-cultured HCV+ NK cells and HCV+ DCs showed significantly higher apoptosis of both cells. This could be attributed to the immature moDCs more with chronic HCV infection due to the fact that immature DCs typically under express HLA-class I molecules that would protect from NK-mediated lysis. Conclusion: Cross-talk between DCs and NK cells plays an important role in the induction of both the innate and adaptive immune systems. HCV infection was found to impair the maturation of DCs. Thus consequently affecting its antigen presentation and T cell allostimulatory capacity and rendering them more liable to NK mediated lysis which could explain the persistence of infection and chronicity

Microrna 192 gene expression in type II diabetic nephropathy

Background: diabetic nephropathy [DN] is the common cause of kidney failure in patients with diabetes mellitus. MicroRNAs [miRNAs] are short non-coding RNAs of about 22 nucleotides which recently have been shown to play vital roles in mammalian gene expression

Aim of the study: was to investigate the role of miRNA-192 in the pathogenesis of diabetic nephropathy and disease progression. Patients and Method: Sixty five patients with uncontrolled diabetes mellitus, they were subdivided into; thirty nine patients with normoalbuminuria [<20mg/L]; their ages ranged between 48-67 years and the onset of disease between 1-5 years; twenty six patients with microalbuminuria [20-200 mg/L], their ages ranged between 47-66 years and the onset of disease between 5-15 years, in addition to twelve apparently healthy individuals as control; their ages ranged between 51-67 years. Serum Transforming growth factor beta [TGF-beta], Interleukin 18 [IL-18] were determined using ELISA technique, the expression level of miRNA-192 in whole blood using [RT-PCR] was determined, other biochemical parameters as fasting plasma glucose [FPG], glycated haemoglobin [HbA1c], lipid profile and creatinine were estimated using commercial available kits. Patients were given written contest

Results: the level of miRNA-192 expressions was significantly lower in microalbuminuria group when compared to normoalbuminuria group. Serum level of IL-18 and TGF-beta were significantly higher in both patient groups when compared to control group and their levels were significantly higher in microalbuminuria group than normoalbuminuria group

Conclusion: together with TGF-beta1 and IL-18, miRNA- 192 may not only be used as molecular biomarker in diabetic microvascular complications but also as early marker of alterations in specific biological processes in the kidney

Influence of age on aluminum-induced hepatotoxicity in the male albino rat

Background: aluminum is the third most common element in the earth's crust and is about 8% of its total mineral components. It is widely used in antacid drugs, food additives and tooth pastes. Moreover, it is added to the drinking water for purification purposes. It is also the metal of choice in making several household cookware and storage utensils despite its toxic effects

Aim of the work: this study aimed to describe the histological changes which occurred in liver of rats exposed to aluminum and also to clarify whether those changes were related to the age of the experimental animals or not

Material and methods: 32 male albino rats were used in this study, 16 adults and they were weighing 150-180 gm and 16 senile and they were weighing 400-450 gm. Group I: was consisted of 16 adult male rats. This group was categorized into two equal subgroups; subgroup IA and subgroup IB. Group II: was consisted of 16 senile male rats. This group was categorized into two equal subgroups; subgroup IIA and sub group IIB. Subgroups IA and IIA were served as control and received distilled water. Subgroups IB and IIB received aluminum chloride in a dose of 475 mg/kg body weight by gastric gavage once daily for three weeks. At the end of the experiment, liver specimens were collected, processed for paraffin blocks and semithin sections and examined by light microscope

Results: liver sections obtained from adult rats received aluminum chloride showed disrupted and discontinuous liver capsule, disorganized hepatic architecture, affection of the hepatocytes especially those under the liver capsule which had small darkly stained nuclei and dilated, distorted and slightly congested central veins. Most of the blood sinusoids appeared either narrow and obliterated or congested. The portal triads showed vascular congestion and dilatation, proliferation of the bile ducts with slight increase in the collagen deposition around the portal triads. Sporadic positive PAS reaction within the cytoplasm of the hepatocytes was also noticed in liver sections stained with PAS stain. Semithin sections stained with toluidine blue showed well circumscribed vacuoles of different sizes inside and outside the hepatocytes. On the other hand, liver sections obtained from senile rats received aluminum chloride showed the same previous changes that occurred in the adult group, but they were exaggerated and there were additional changes such as the presence of irregular homogenous materials and tiny vacuoles in the cytoplasm of most of the hepatocytes

Conclusion: oral administration of aluminum chloride in rats resulted in degenerations in the liver and that was conclusive of toxic hepatitis. These changes were exaggerated among the senile rats which proved that senile rats are more susceptible to the hepatoxicity induced by aluminum. Therefore, it is advised to create awareness among people especially the senile ones about the hazards of extensive use of aluminum

Isolation of flavonoids from Delonix elata and determination of its rutin content using capillary electrophoresis

Delonix elata [L.] Gamble [Fabaceae] is an important, traditionally used plant in Saudi Arabia. It is used to relieve rheumatic pain, flatulence and the seeds are employed as purgatives. The aim of the present study was to isolate chemical constituents of the n-butanol fraction [BF] of D. elata and to find out, by capillary electrophoresis [CE], percentage of rutin present in this BF. Three quercetin glycosides and one kaempferol rutinoside were isolated from the BF of aerial parts of D. elata; namely, Quercetin 3-O-rutinoside-7-O-glucoside [1], Quercetin 3,7-diglucoside [2], Quercetin 3-0-rutinoside [RUT] [3] and Kaempferol 3-0-rutinoside [4]. Rutin, an active constituent has been reported to possess good pharmacological as well as therapeutic potentials. A sensitive and rapid procedure for quantitative determination of RUT by capillary electrophoresis was developed and its content was found to be 7.349 mg/gm, relative to n-butanol fraction and 18.373 mg%, relative to the dry powder of D. elata. The method could be recommended for approval and use in the pharmaceutical and food industries

Immunohistochemical studies in mice liver immunized by attenuated Schistosoma Mansoni Schistosomules by gamma radiation

Background: Schistosomiasis is an important cause of hepatic fibrosis in man. As etiological therapy alone is not enough to treat hepatic fibrosis, finding other strategies that can control the disease is important. Considering the dominant role of vaccination, research on gamma radiation- attenuated vaccine has become a new focus and has very promising value

Aim of the work: The objective of this study was to detect the effect of vaccination with attenuating dose of gamma radiation of schistosomules in controlling immunohistochemical changes in mice model of human schistosomiasis mansoni

Materials and methods: Forty mice were divided into four groups [ten each]. Group A served as normal control, group B was infected by subcutaneous [S. C.] injection with 100 S. mansoni cercariae/mouse [infected control], group C was vaccinated by [S.C.] injection with 500 schistosomulae irradiated with 20 Krad gamma- radiation [vaccine control] and group D was vaccinated by [S.C.] injection with the same dose of irradiated schistosomules and then challenged after 4 weeks by S.C. injection with 100 S. mansoni cercariae. Expression of alpha-smooth muscle actin [alphaSMA], desmin, collagen type-1 and transforming growth factor-beta1 [TGF-beta1] in the extracellular matrix [ECM] using immunohistochemistry were done

Results: exhibited in infected control group B marked expression of alpha-SMA, desmin, collagen type-1 and TGF-beta1. These changes were moderate in vaccinated-control group C while few changes were detected in vaccinated-challenged group D

Conclusion: It was concluded that using 20 Krad-gamma irradiated schistosomules as vaccine is effective in controlling liver pathology and reduces immunohistochemical changes

Adherence of Irradiated Slime Producing Bacterial Pathogens to Biomaterial Surface and their Antimicrobial Susceptibility Associated with Catheter Infection in Bladder Cancer Patients.

Aims: To detect the prevalence of biofilm producers among Gram negative bacilli and Gram positive cocci bacterial pathogens along with their antimicrobial susceptibility pattern. Growth and adherence on catheter eluates and in the presence of antibiotics. Methodology: From laboratory of microbiology, one hundred samples (100 urinary catheters and 100 urine samples from the attached drainage bags) of bladder cancer patients collected in National Cancer Institute in Cairo, Egypt, were identified to species level. Slime production was investigated by the quantitative and qualitative methods. Qualitative method was carried out by tube method. Adherence assay and quantitation of biofilm was performed by spectrophotometric method by measuring the optical densities of stained bacterial films adherent to plastic tissue culture plates. Hydrophobicity was evaluated by adhesion to P-xylene. Identification and minimum inhibitory concentration (MICs) of 26 antimicrobial agents against gram negative and 24 against gram positive bacterial isolates were determined using microscan walk away 96 SI system. Plasmid profile analysis was carried out by plasmid isolation kit. Scanning electron microscopy studies for growth, adherence and biofilm formation. Impact of gamma irradiation at a dose level of 24.41Gy was studied. Results: From the processing of 100 samples, 98 cases were positive. Out of them 110 isolates of gram negative bacilli and 13 of gram positive cocci. They were belonging to 15 and 6 species respectively. Among them, 117 isolates showed positive results for adherence assay and biofilm/slime production. They were identified as; Escherichia coli, Klebsiella spp., Enterobacter spp., Acinetobacter, Proteus spp., Citrobacter, Alcaligenes, Empedobacter (104 strains) Staphylococcus spp. and Enterococcus (13 stains). The results obtained by different methods correlated well with strain to strain variation. Gamma irradiation resulted in changes in slime production and adherence ability for all the tested strains. Cell surface hydrophobicity (CSH) showed a hydrophobic reaction and these with increase in its value after irradiation in case of Escherichia coli. On the other hand, Staphylococcus epidermidis was moderate hydrophobic before irradiation changed to strictly hydrophilic after irradiation. All the slime producers showed reduced susceptibility to majority of antibiotics. They exhibited highest percentage susceptibility before and after in vitro gamma irradiation at a dose level 24.41Gy for both Amikacin and Imipenem. Scanning electron microscopy (SEM) confirmed growth and biofilm formation in the presence of catheter eluates only with halos surrounding the cells and visible erosion zones on catheter surfaces. The antimicrobial and adherence activity of Amikacin and Imipenem at the MIC level showed marked abnormalities in cells shape and size with significant reduction in adherence ability. Plasmid profile analysis of irradiated strains showed more extra-plasmid bands and / or difference in molecular weight. Conclusion: The biofilm assay strategy applied in this study may constitute a tool in biomaterial related infection and antimicrobial resistant research for further studies for biomaterial modification. Early detection of biofilm forming organisms can help in appropriate antibiotic choice.

Therapeutic Effects of Allium sativum and Allium cepa in Schistosoma mansoni experimental infection / Efeitos terapêuticos do Allium sativum e Allium cepa na infecção experimental pelo Schistosoma mansoni

The effects of both garlic (Allium sativum) and onion (Allium cepa) on some biochemical parameters in Schistosoma mansoni infected mice individually and mixed either with or without the currently used drug, praziquantel (PZQ) were investigated. These involved some immunological parameters, namely IgM, IgG, interleukins 2 and 6 (IL-2 and 6) and tumor necrosis factor (TNF-α), some antioxidant enzymes [catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPX)]. In addition, parasitological and histopathological investigations were performed. No changes were observed in the normal control mice treated with dry extract of onion or garlic, individually or mixed, with or without PZQ, compared to the normal healthy control group. Infection with S. mansoni showed an increase in IgG, IgM, IL-2, IL-6, TNF-α and catalase enzyme, accompanied with a decrease in GPX and SOD antioxidant enzyme activities. Remarkable amelioration was noticed in the levels of all the measured parameters in S. mansoni infected mice after administration of the studied extracts. Moreover a significant reduction in worm burden, hepatic and intestinal eggs and oogram count was noticed which was reflected in normalization of liver architecture.

Os efeitos do alho (Allium sativum) e cebola (Allium cepa) em parâmetros bioquímicos de camundongos infectados pelo Schistosoma mansoni individualmente e misturados seja com ou sem as drogas correntemente usadas como o Praziquantel (PZQ), foram investigados. Isto envolveu parâmetros imunológicos tais como IgM, IgG, Interleucina 2 e 6 (IL-2 e 6), fator de necrose tumoral (TNF-α) e algumas enzimas anti-oxidantes [catalase, super-óxido dismutase (SOD) e glutationa peroxidase (GPX)]. Em adição foram realizadas investigações parasitológicas e histopatológicas. Nenhuma alteração foi observada nos camundongos controles normais tratados com extrato seco de cebola ou alho, individualmente ou misturado, com ou sem PZQ, comparados com os controles normais sadios. Infecção com o Schistosoma mansoni revelou um aumento em IgG, IgM, IL-2, IL-6, TNF-α e catalase, acompanhados de diminuição do GPX e atividade enzimática do anti-oxidante SOD. Melhora acentuada foi notada nos níveis de todos os parâmetros medidos em camundongos infectados com Schistosoma mansoni após administração dos extratos estudados. Mais ainda, significante redução na quantidade de vermes, e ovos no fígado e intestino e na contagem do oograma foi notada refletindo a normalização da arquitetura do fígado.

Role of ginkgo biloba extract on jejunal mucosal changes induced by laparotomy in adult albino rat: histological, immunohistochemical and scanning electron microscopic study

The intestine is extremely sensitive to surgical stress. Surgical manipulation of the intestine generates oxygen free radicals resulting in mucosal damage. To evaluate the role of Ginkgo biloba in protection and restitution of mucosal damage of jejunum after laparotomy. Twenty four adult albino rats were divided into three groups. Group I as a control, group II subjected to laparotomy with mild intestinal handling and group III was injected I/P with as a single dose of 50 mg/kg of Ginkgo biloba solution 1 hour before laparotomy. All animals were sacrificed after 48 hs and jejunum specimens were extracted and processed for light and scanning electron microscopic study. Revealed that laparotomy induced shortening of the villi with mucosal damage and ballooning of Paneth cells. Some epithelial cells with atypical appearance were seen aggregated towards the luminal surface. Strong P53 reaction was observed in enterocytes. SEM revealed eroded luminal surface with wide gaps of epithelial loss. On the other hand, Ginkgo biloba showed a favorable protective effect with rapid healing of the damaged jejunal mucosa. Laparotomy induced jejunal mucosal damage, which was not repaired after 48 hs. Ginkgo biloba could be used as a protective agent against intestinal mucosal damage with a rapid recovery after surgical operation

lipoprotein lipase hind III polymorphism and the susceptibility to hypertension

Lipoprotein lipase [LPL] enzyme plays a central role in lipid metabolism. The primary function of LPL enzyme is the hydrolysis of the core triglycerides of circulating chylomicron and very low density lipoprotein [VLDL]. It releases monoglycerides and free fatty acids, which are taken up by skeletal muscle or adipose tissue. The present work aimed to study the association of the common variant of LPL HindlII [H+] and hypertension. Hindlll [+] variant allele of LPL were determined by polymerase chain reaction restriction fragment length polymorphism [PCR-RFLP] assay in 150 hypertensive patients and 150 normotensive as a control group. Serum lipoproteins were also observed in both groups. Allele frequencies were H+ = 0.733 and H- = 0.267 for LPL Hindlll in the hypertension group compared to H+ = 0.683 and H- = 0.317 in the control group. Individuals with homozygous [H+/+] genotype were at higher risk of developing hypertension compared to the [H-/-] genotype [Odds Ratio OR = 2.13, 95% Confidence Interval CI = 0.937-4.8]. Serum TG level were also higher in the individuals with [H+/+] genotype compared to the [H-/-] genotype, while HDL showed negative correlation with the presence of [H+/+] genotype. It can be concluded that the LPL Hindlll [H+] variant of LPL may influence the blood lipid metabolism and increase risk for hypertension

Apoptosis suppressing protein Bcl-2 expression in rheumatoid synovium

It has been suggested that defective apoptosis plays a role in the development of autoimmune. The aim of this study is to investigate the apoptosis suppressing protein Bcl-2 in the rheumatoid synovum. Twenty synovium biopsy specimens were studied histopathologically and immuno-histochemically. Positive immunoreactivity was observed in 16 cases [80%] the infiltrated lymphocytes and in 11 cases [55%] in the lymphoid follicles, while, in 8 cases [40%] deep synovial fibroblasts showed marked Bcl-2 positively. The superficial synovial cell lining was only positive in 5 cases [25%].The apoptotic process is suppressed in rheumatoid arthritis as triggered by Bcl-2 oncoprotein. The defective control of apoptosis. [programmed cell death] as well excessive proliferation may he of central importance in the pathogenesis of rheumatoid arthritis

protective effect of antioxidants on renal ischemia-reperfusion injury in the rat

Renal ischemia-reperfusion [I/R] is of clinical interest because of its role in renal failure and also in renal graft rejection. There is increasing evidence to suggest that reactive oxygen species [ROS] play a role in the pathogenesis of I/R injury in the kidney. This study was designed to investigate the protective effect of some dietary antioxidants [garlic, vitamin E or vitamin A + Se [+2]] against the damage inflicted by [ROS] during renal I/R. Five groups of male albino rats were used in this study each composed of 10 rats. Group I: Sham-operated control group. Group II: I/R group [not treated] unilaterally nephrectomized after subjection of the left renal pedicle to 60 minutes of nontraumatic occlusion followed by 24 hours of reperfusion. Group III: the same procedure as group II but animals were preconditioned by adding garlic powder to their diet 80 mg kg[-1] daily for one month. Group IV: like group III but vitamin E [6.5 mg kg[-1]/d for one month] was supplemented to diet. Group V: like the two previous groups III and IV but vitamin A [7.9 mg/kg[-1]] and Se[+2] [50 microg/kg[-1]] were added daily to the rats' diet for one month. At the end of the reperfusion period, the rats were sacrificed. Malondialdehyde [MDA], Reduced glutathione [GSH] concentrations, superoxide dismutase [SOD], glutathione reductase and glutathione peroxidase enzymatic activities were determined in plasma and kidney homogenates of all groups. Serum creatinine and blood urea concentrations, were measured, for the evaluation of renal function. Also Na[+]-K[+]-ATPase was determined in kidney homogenates. Ischemic reperfused [l/R] animals demonstrated severe detonation of renal function and a significant renal oxidative stress. Pretreatment of animals with garlic, vitamin E or vitamin A + Se [2+] markedly attenuated renal dysfunction and oxidative stress as manifested by reducing blood urea, serum creatinine, MDA and restored depleted renal antioxidant enzymes. Na[+]-K[+]-ATPase activity, which was decreased in the I/R group, increased in the animals preconditioned with vitamins E and A + Se[2+]. From this it can be concluded that ROS play a causal role in I/R induced renal injury and supplementing the animals with garlic and/or other dietary antioxidants exerts protective effects. Therefore, it is recommended to supply patients expected to suffer from I/R renal injury with these antioxidants

Visual function evaluation of Egyptian beta-thalassemia major patients on long-term desferal therapy

The success of the iron chelator desferal [DFO] in the treatment of beta - thalassemia is limited by its lack of bioavailability. Also, high dosage has been associated with toxicity of the eyes, ears and others. To investigate a possible subclinical visual neurotoxicity, 30 Egyptian p-thalassemia major [BTM] patients on long-term, recommended DFO dosage were studied using visual evoked potentials [VEPs] and electroretinogram [ERG]. We also aimed to clarify the relation of the possible abnormalities to various clinical, hematologic and biochemical parameters. Ten healthy age - matched individuals were enrolled as controls. Sixteen/30 [53.3%] patients showed subclinical abnormalities using VEP and/or ERG. Nine/30 [30%] had VEPs abnormalities, 10 [33.3%] had ERG abnormalities and 3 [10%] revealed abnormalities by both methods. An interesting observation was the significant association of abnormal VEP and MALE sex [P=0.0002]. No significant correlation was found between neurophysiologic abnormalities and all data studied as: age, frequency of blood transfusion, DFO dosage/ duration, splenectomy, CBC values; S. ferritin, Serum Copper, S. Zinc and S. vitamin E. A single patient could have subclinical DFO-induced visual toxicity using VEP as his "toxicity" index [TI] was high [0.078]. the abnormalities can not be mostly attributed to long-term DFO therapy. Serial visual monitoring [including VEP and ERG] of all BTM patients is warranted. It is worthwhile to compare the long-term toxicity of the oral chelating agents [e.g. L 1 and ICL670] with that of DFO before definite conclusions are drawn on any visual neurotoxicity and its relation with the disease state or drug therapy

Knowledge and practice of adolescent student girls regarding premenstrual syndrome

Premenstrual syndrome [PMS] refers to a cluster of physical, psychological and behavioral symptoms that occur during the Luteal phase of the menstrual cycle and end with the onset of menstruation. The very high prevalence of PMS might be related to lack of proper knowledge about menstruation and associated changes among girls. This study aims at evaluating the knowledge and practice of female students regarding premenstrual syndrome. A descriptive cross-sectional design was used in carrying out the study in four different general and technical governmental secondary schools for girls in Mansoura city. 600 student girls were selected through stratified random sampling, selecting, one general and one technical school from each zone. A structured interviewing questionnaire sheet, and modified version of menstrual distress questionnaire [MDQ] were used for data collection during period from 9/2005 to 3/ 2006, three days per week. Results: The results have shown that the mean age at menarche was 12.8 +/- 1.2 years, menstrual flow mean was 5.3j1.1 days, and 66.2% had regular cycles. The most prevalent premenstrual physical symptoms were backache [85.2%], and vaginal discharge [72.5%], while anxiety was the most common psychological symptom [72.2%]. Only 13% had severe PMS symptoms, and 14.8% had total satisfactory knowledge. Mothers were the main sources of information [73.8%]. The most common self- care practices to relieve PMS were bathing [75.5%], avoiding non- prescribed medications [64.5%], and taking hot drinks [535%]. The practice of physical exercise was only 16.2%. A higher percentage of students in general schools had satisfactory knowledge, compared to technical schools, 21.1% and 8.6%, respectively [p<0.001], and students with illiterate mothers had the lowest percentage of satisfactory knowledge [7.6%], compared to secondary and university education [18.9% and 18.0%, respectively], p=0.020. The highest level of satisfactory knowledge was associated with the mother as a Source of information [7.9%], p=0.015. It is concluded that female secondary school students in Mansoura suffer from mild PMS symptoms. They have a lack of knowledge about PMS, and their mothers were the main source of information. Knowledge was better in general schools girls, with educated and working mothers. It is recommended to conduct educational sessions discussing menstruation and related issues for mothers in outpatient clinics or schools. The school nurse role should be fostered