Detection of rotavirus infection among children with acute diarrhea in Assiut pediatric university hospital: genotying and comparison between strips, EIA and RT-PCR

Background: Group A rotavirus has been recognized as a leading cause of severe diarrheal disease in infants and young children worldwide and accounts for 20-25% of children diarrheal deaths per year. Defining the viral agents related to diarrhea will assist in providing an accurate estimate of disease burden within a community and will also be useful to assess the impact of vaccination whenever they become available. Epidemiological and molecular studies in many countries show complex patterns of change from year to year in the genotype of rotaviruses that cause diarrhea in children from the same geographical area. These data can be useful to select areas for vaccine trials and to serve as a baseline for identification of new strains, should they emerge

Objectives: To investigate the role of group A rotavirus in acute diarrhea among infants and children under three years of age attending or admitted to Assiut Pediatric University Hospital and to compare between the strip test and Enzyme Immune Assay [EIA] in diagnosis of rotavirus infection using the Reverse Transcriptase-Polymerase Chain Reaction [RT-PCR] as a gold standard, beside defining the genotype of the detected strains using multiplex-PCR

Methods: 88 children under the age of three years, presenting with acute diarrhea to Assiut Pediatric University Hospital between December 2005 and April 2006, were examined for group A rotavirus antigen in stool by a quick strip test and EIA. RT-PCR was also performed as a reference test. Twelve children of matched age and sex, without diarrhea, were also included [control group]. All rotavirus positive samples by RT-PCR were also subjected to genotyping by multiplex PCR using a cocktail of primers specific for the most common genotypes of rotavirus in human [G1, G2, G3, G4, G8 and G9]

Results: Out of the 88 patients, 33 were rotavirus positive by strips [37.5%], 42 were rotavirus positive by EIA [47.7%] and 44 were positive by RT-PCR [50%]. All control samples were negative by the three methods. 28 samples were positive by both strips and EIA and 44 samples were negative by both methods, whereas discordant results were obtained in 19 samples. Using the RTPCR as a reference test, it was found that the strips failed to detect 13 out of 44 positive samples, while the EIA failed to detect nine out of these 44 positive samples. The sensitivity and specificity of strips versus RT-PCR were 70.5% and 95.5%, respectively, whereas those of EIA were 86.4% and 91%, respectively. Genotyping by multiplex PCR revealed that all the detected strains belong to G3 genotype

Conclusion: The rate of infection with group A rotavirus among children with acute diarrhea differs according to the method used for detection [37.5% by strips, 47.7% by EIA and 50% by RTPCR]. The strips are more rapid, simple and specific than EIA, yet the EIA remains more sensitive in detecting rotavirus antigen in stool. All rotavirus strains detected belong to G3 genotype

comparison study in the management of ectopic pregnancy between state of Qatar and Kingdom of Bahrain

Ectopic pregnancy is of increasing concern to gynecologists since it is a major cause of maternal mortality and morbidity in reproductive age women. It occurs when the conceptus implants in an abnormal position other than the uterus. Although the incidence of ectopic pregnancy during the 20 years studied increased five-folds, the risk of death from ectopic pregnancy declined by 90%. This decline might be related to the increase awareness of this condition that accompanied improved diagnostic technology and thus improved management and care. However, ectopic pregnancy remains the leading cause of maternal mortality in first trimenster. This study was to evaluate the management of ectopic pregnancy in the State of Qatar and the Kingdom of Bahrain in a time period from January 1, 2000 to August 31, 2003. Statistical analysis showed high incidence of ectopic pregnancy with increase in age and abortion. Etiological factors including contraceptive usage, infertility treatment and previous ectopic pregnancy were shown to increases ectopic pregnancy rates. In the Kingdom of Bahrain, management of ectopic pregnancy was carried by surgical salpingectomy and Laparoctomy and to a lesser extend medical Methotrexate management was also carried on. While in the State of Qatar it was the opposite as Methotrexate was mainly used rather than the surgical treatment. It is recommended that further investigations are needed to enhance this data and to prove the benefits of medical management over the surgical management

[Comparative dissolution study of drugs using protein hdrolysates]

Kneaded mixtures as well as physical mixtures, of an acidic drug, indomethacin, a basic drug vincamine, and a neutral drug, prednisolone, with gelatin and casein hydrolysates were prepared. Their in vitro dissolution profiles were examined. The dissolution of drugs from the kneaded mixtures was significantly increased compared to the drugs alone as well as their physical mixtures. This increase was most prominent for the acidic drug indomethacin. The casein and gelatin hydrolysates enhanced the dissolution of the three drugs by improving the wettability of the drug particles. Solubility also contributes to the enhancement of dissolution of indomethacin and prednisolone. Buffering was an additional reason in case of indomethacin

Comparative dissolution study of drugs using protein hydrolysates

Kneaded mixtures as well as physical mixtures, of an acidic drug, indomethacin, a basic drug, vincamine, and a neutral drug, prednisolone, with gelatin and casein hydrolysates were prepared. Their in-vitro dissolution profiles were examined. The dissolution of drugs from the kneaded mixtures was significantly increased compared to the drugs alone as well as their physical mixtures. This increase was most prominent for the acidic drug indomethacin. The casein and gelatin hydrolysates enhanced the dissolution of the three drugs by improving the wettability of the drug particles. Solubility also contributed to the enhancement of dissolution of indomethacin and prednisolone. Buffering was an additional reason in case of indomethacin

Effect of some physiological changes on the binding of tenoxicam to human serum albumin

The influence of some physiological changes due to age or disease on the binding of tenoxicam to human serum albumin [HSA] was studied. Increasing HSA concentration within the range of 0.04% to 0.4% decreased the binding parameters, K1, n1 and n2. The presence of fatty acids decreased the affinity of HSA binding to tenoxicam at low protein concentrations. Urea as well as glucose increased the binding affinity of HSA to tenoxicam. The values of n1 and n2 were not significantly changed except when glucose was elevated to 500 mg/dL causing n1 and n2 to be nearly halved. Binding of tenoxicam to HSA increased as pH increased within the tested values of 6.8, 7.4 and 8. Consequently, tenoxicam was preferably bound by B rather than N form of HSA

Formulation and pharmaceutical evaluation of sulindac suspensions

Sulindac has been introduced in suspension dosage form which has suited its low aqueous solubility, its use in the fields of pediatrics and geriatrics, and its requirement of dose flexibility. A wettability study showed that 0.05% tween 20 was the wetting agent of choice. Controlled flocculation was adopted to prepare the flocculated suspensions. 32 deflocculated as well as 20 flocculated suspension formulations were prepared using different classes of suspending agents. The parameters used for evaluation were the sedimentation volume ratio [Vu/Vo], easiness of sediment redispersibility, clarity and color of supernatant, the time of the suspension has remained dispersed after being shaken, degree of flocculation, pH stability, conductivity, specific gravity, rheological properties, and dissolution. The deflocculated formula of choice was formula 18 containing 0.5% xanthan gum. The best flocculated suspension was formula 19 containing 10% glycerin, 10% propylene glycol, and 40% sorbitol as density modifiers

Preparation and biopharmaceutical evaluation of khellin coprecipitates

Aiming at increasing khellin dissolution and consequently improving its bioavailability, its hydrophilic solid dispersions were prepared. Several amino acids of different nature as well as aspartame gentisic acid ethanol amide [GAEA], certain bile salts and Eudragit polymers were utilized in different techniques. Dissolution studies revealed that most of the additives used gave enhanced khellin dissolution which increased with increasing vehicle concentration with few exceptions, e.g. solid dispersions with L-proline and DL- methionine were additive concentration independent. Most of the coprecipitates prepared were dissolution profile stable for one year while, others are not, e.g. coprecipitate with L-tryptophan. Although most of the products chosen for in vivo studies gave about 60-70% dissolution of khellin dose within the first half hour, in vivo data showed variable increases of khellin bioavailability, especially products FIII and FV. Formula V proved to be superior to product FIII, since it attained, in addition to higher [AUC]08 value [2.46 times that of plain khellin], a comparatively high absorption rate [t max = 30 min.]

In-vitro and in-vivo evaluation of cinnarizine solid dispersions

To solve the problem of cinnarizine dissolution, its solid dispersions with certain amino acids, aspartame, gentisic acid ethanolamide [GAEA], and Eudragit E100 were prepared in different ratios. The prepared solid dispersions were subjected to dissolution rate studies in comparison to plain cinnarizine as well as the drug treated in the same way without additives. Effect of aging on drug dissolution was also investigated. Selected cinnarizine coprecipitates containing 2: 1 w/w Eudragit E100 [FII], 1: 5 M aspartame [FIII] and 1: 3M Dl-phenylalanine [FIV] were subjected to in vivo bioavailability testing compared to plain cinnarizine [FI]. HPLC method was used to quantitate cinnarizine in rabbits' serum