Prognostic impact of TEL-AML-1 fusion gene on acute lymphoblastic leukemia

The TEL-AML-1 fusion gene resulting from 12:21 chromosomal translocation is believed to be the most common molecular genetic abnormality in childhood acute lymphoblastic leukemia [ALL]. This study was conducted to investigate the frequency of this fusion gene in children suffering from ALL attending the oncology unit in the Basrah Hospital for Pediatric and Gynecology during the period May 2009 to April 2010, and point out the different laboratory features associated with this anomaly. A total of 120 blood samples were collected [60 early-diagnosed ALL children and 60 healthy children as control group]. The controls were matched with cases by age and sex. Ribonucleic acid [RNA] was successfully extracted from the fresh blood of 40 ALL cases used for the detection of TEL-AML-1 fusion gene by reverse transcriptase-polymerase chain reaction [RT-PCR]. Of the newly diagnosed ALL cases, 27.5% were positive for TEL-AML-1 fusion gene as well as 5% among the control group. All TEL-AML-1 positive cases showed an age peak between 3 and 6 years and tend to occur more frequently among females than males. The TEL-AML-1 positive cases were classified as the standard-risk group and accounted for 72.3%, while 27.3% were the high-risk group [P < 0.05]. According to the French-American-British classification criteria, 72.3% of the high-risk and 68% of the standard-risk groups belong to the L2 stage. The TEL-AML-1 fusion gene identifies a subset of pediatric ALL associated with a number of laboratory markers of good prognosis and should thus be considered in routine molecular work of ALL to confirm its impact on clinical outcome and to design a suitable therapy

Evaluation of cystatin capture ELISA and sodium metaperiodate antigen treated ELISA in diagnosis of toxoplasmosis

ELISA has become the mainstay for clinical serologic evaluation of toxoplasmosis. One of the major obstacles encountered in the evaluation of ELISA is the false-positive results due to immunological cross-reactions with other parasitic diseases that exhibit some lack of specificity. Evaluation of the diagnostic efficacy of two ELISA techniques: Cystatin capture ELISA and sodium metaperiodate treated antigen-ELISA [SMP-ELISA] compared to conventional ELISA, to detect IgG antibodies for crude T. gondii antigen in sera of toxoplasmosis patients. The study was carried out on 50 individuals categorized into three groups. Toxoplasmosis group included 30 patients confirmed by Sabin-Feldman dye test. Other parasitic diseases group included 10 sera from patients with amoebiasis [2], fascioliasis [2], hydatidosis [3] and schistosomiasis [3]. Control group included 10 healthy individuals. All sera under study were examined for the detection of T gondii IgG by three different ELISA techniques: Cystatin capture ELISA, SMP-ELISA amid conventional ELISA. The diagnostic performance of the three tests was statistically compared. Cystatin capture ELISA gave the best diagnostic results with 96.6% sensitivity, 95% specificity, 96.6% Positive Predictive Value [PPV], 95% Negative Predictive Value [NPV] and 96% diagnostic accuracy. In spite of the lower sensitivity and NPV of SMP-ELISA [86.6% and 82.6%, respectively] than the conventional ELISA, it had higher specificity [95%] and PPV [96.3%]. Cystatin capture ELISA improved the diagnostic performance of conventional ELISA in diagnosis of human toxoplasmosis

Florid Cemento-Osseous Dysplasia As A Possible Aggravating Factor In A Case Of Trigeminal Neuralgia

Differential diagnosis of orofacial pain is crucial, as the course of each process and its clinical management varies markedly. A case is illustrated here of trigeminal neuralgia in a 49-year-old Indian female whose complaint was initially diagnosed as dental pain leading to sequential extractions of her right mandibular and maxillary molars but with no pain abatement. Subsequent neurological assessment diagnosed her complaint as trigeminal neuralgia but pain remained poorly controlled even with high doses of carbamazepine and gabapentin. A dental referral and orthopantomographic examination revealed multifocal sclerotic masses in her jaws, suggestive of florid cemento-osseous dysplasia (FCOD). Right mandibular incisional biopsy confirmed the diagnosis. A decision was made to curette the right mandibular masses and lateralised the right inferior dental nerve. Follow-up disclosed considerable pain reduction. This case raises the issue as to whether the sclerotic bone masses in FCOD may have caused nerve compression which aggravated her neuralgic pain.

potential value of EGFR and P53 immunostaining in tumors of the urinary bladder

The expression of EGFR and p53 has not been adequately studied as a prognostic tool in urinary bladder tumors. We analyzed 74 bladder cancer samples from Egypt for EGFR and p53 expression using immunohistochemistry. The tumors were of different histological types, grades and clinical stages, and with established lymph node status. Almost 61% of the tumors showed positive membranous EGFR expression and 74.3% had positive nuclear staining of p53. Analysis of correlation of the IHC staining with clinical variables showed a significant correlation only between EGFR expression and histological type [p=0.002, ANOVA], in that the expression was higher in squamous cell carcinomas than in other histological types. There were no significant correlations between p53 or EGFR with the other clinicopathological variables, including age, sex, staging, grading, and lymph node status. Further studies are needed to determine if EGFR and p53 might be used as prognostic tools in bladder cancer

Allergic Contact Dermatitis in a private practice Dermatology Clinic in Ipoh: A Seven-Year Retrospective Study

Patch testing has been accepted as the most important investigative technique of assessing allergic contact dermatitis (ACD) and identifying the contact allergens. The epidemiology of ACD differs in different geographic region as the environmental allergens vary in different populations. In this study 59.8% of the patients had a positive patch test reaction to one or more allergens. The prevalence of ACD was 64.7% in women and 51.4% in men. The commonest causes of ACD were nickel (30.4%), fragrance mix (18.16%) and balsam of Peru (6.73%).

[Control of blood pressure morning surge in a lebanese hypertensive population]

The primary endpoint of this prospective clinical study is to ascertain the degree of blood pressure control in the early-morning hours after 8 weeks of treatment with telmisartan in hypertensive patients using home blood pressure measurements. Two hundred forty Lebanese patients with uncontrolled hypertension are enrolled in the study. The blood pressure is measured at the initial visit, then at week 4 of follow-up [optional visit] and after the 8 weeks period, by the physician at his office [with pulse rate] and by the patient at home in the morning. The blood pressure measured by the patient at home in the morning has a mean value of 129.7/79.1 mmhg, significantly less than 135/85 mmhg [P< 10[-5]], and it is reduced by 31.9/13.5 mmhg [P< 10[-5]]. At the physician's office, the reduction is 34.8/16 mmhg [P< 10[-5]. Heart rate is decreased by 4.7 +/- 0.5 bpm [P< 10[-5]. The drug was well tolerated. This study has demonstrated that Telmisartan, by his long half-life, protects the patients against the early-morning hours blood pressure surge, period during which coronary and cerebral events are the most frequent

Efficacy of muscle energy technique in treatment of chronic mechanical low back pain

This study was conducted to compare the effect of muscle energy technique versus combined spinal flexion-extension exercises on reduction of pain severity, functional disability; and increasing the range of motion of trunk flexion, extension, right, and left bending in mechanical low back pain patients. Forty male and female patients diagnosed as chronic mechanical low back pain participated in this study. Patients were divided randomly into two groups, the first group [Group A] consisted of 11 male and 9 female patients with a mean age 33 [ +/- 1.58] years treated with the combined spinal flexion-extension exercises program, the second group [Group B] consisted of 9 male and 11 female patients with a mean age 30.20 [ +/- 1.57] years treated with the muscle energy technique. Both groups were treated for 12 sessions, 3 sessions per week [each other day]. Patients were assessed before and after treatment by visual analouge scale, Oswestry disability index, and tape measurements. Both groups had significantly less low back pain severity and less functional disability after treatment. The improvement of pain and function in the muscle energy technique group was more than the combined spinal flexion-extension group. The combined spinal flexion-extension exercise were more effective in increasing lumbar flexion and extension motions than the muscle energy technique. There was no significant difference between groups regarding increasing the right and left trunk bending motions. The muscle energy technique is more effective than the combined spinal flexion-extension exercises in reducing low back pain severity and functional disability and is recommended to be used for patients with chronic mechanical low back pain. Spinal flexion-extension exercises are recommended to be used when increasing lumbar flexion and extension motions is an additional goal of treatment

TT-virus and occult hepatitis B virus infections in Egyptian hemodialysis patients

Hemodialysis patients are particularly vulnerable to infection by blood borne viruses including TT-virus and HBV. The continuous HBV infection in these patients in spite of the exclusion of HBs antigen positive patients to separate hemodialysis centers may be contributed by the presence of occult HBV [serum HBs antigen negative but HBV DNA positive]. This study was carried out on 116 chronic hemodialysis patients and 50 healthy controls. After collecting blood from each patient for routine virological assays [HBs antigen, HCV antibodies and HIV1, 2 antibodies], serum was collected and tested for TT-virus DNA by seminested PCR, anti HBc by ELISA and HBV DNA by PCR. In addition, healthy controls were tested for serum TT-virus DNA by seminested PCR. Thirty three [28.4%] hemodialysis patients were positive for TT-virus DNA compared to 8% of the healthy controls [P=0.004]. However, the prevalence of detection of HBV DNA, HBs antigen and anti HBc was 6%, zero% and 12.9%, respectively. In addition, a high prevalence of HCV seropositivity [65.5%] was detected. None of the patients was positive for HIV1, 2 antibodies. TT-virus DNA positive patients had higher mean number of previously received blood transfusions than TT-virus DNA negative patients [P=0.016]. No statistically significant differences were present between TT-virus positive and negative patients regarding age, sex, duration of hemodialysis, prevalence of HBV DNA, anti HBc and anti HCV positivity or mean ALT level and prevalence of elevated ALT. The eight patients with TT-virus infection alone [negative for HCV antibodies and HBV DNA] had normal ALT levels and no clinical evidence for hepatic disease. However, coinfection by HCV could account for ALT elevation in patients with TT-virus infection. We detected 7 [6%] hemodialysis patients with occult HBV infection. Among these patients, anti HBc seropositivity was detected in 5 patients [71.4% versus 9.2% in patients without occult HBV infection, P=<0.001]. No statistically significant differences were found between patients with and without occult HBV infection concerning age, sex, number of previously received blood transfusions, duration of hemodialysis, prevalence of TT-virus DNA and anti HCV positivity or mean ALT level and prevalence of elevated ALT. Only one patient with occult HBV infection had elevated serum ALT level. However, this patient was also positive for HCV antibodies. We concluded that TT-virus infection is common in Egyptian hemodialysis patients. Apart from the number of previously received blood transfusions, no demographic, clinical or virological factor was found to be significantly correlated with TT-virus infection. TT-virus does not seem to cause a significant liver disease. However, other studies are needed to investigate the possible enhancing effect of this virus on hepatic disease caused by HCV in these patients. Moreover, occult HBV infection occurs at a low frequency in Egyptian hemodialysis patients with no association with demographic or clinical findings, TT-virus or anti HCV positivity. Anti HBc testing does not seem to be valuable in detecting occult HBV infection. Screening of hemodialysis patients for HBV DNA is recommended for more strict control of HBV infection in these patients

Morbidity profile of elderly attended/admitted in Jeddah health facilities, Saudi Arabia

A cross-sectional study was conducted to determine morbidity profile and predictors of increased number of morbidities among 2264 elderly attended/admitted in Jeddah health facilities. About one-fourth of elderly reported poor self-perceived health, 37.3% were dependent on others in their activities and 32.1% utilized >3 drugs/day. Diminished vision was the commonest complaint while the most prevalent diseases were diabetes mellitus, arthritis and hypertension. The number of morbidities ranged from 1-6 with a mean of 2.11+/-1.16. In multivariate analysis, the predictors of increased morbidities were obesity [OR=1.83; 95% Cl=1.37-2.441, feeling depressed [OR=1.64; 95% Cl=1.26-2.13], advanced age, stop working, and female gender. It is recommended that there is a great need for increasing elderly medical and social care

Preparation of polyacrylic acid / pyrodextrins adducts and utilization in cotton sizing

Extremely high concentrated aqueous solutions of acrylic acid [AA] were polymerized in presence of British Gum [BG] using ammonium persulfate initiator. The reaction was carried out at different ammonium persulfate concentration [9.5x10[-3]- 38.1x10[-3] mol/l], temperature [65-95°C], degree of neutralization of AA [Na-form] [0-20%], and LR [0.6-3.6 l/k]. At optimal reaction conditions, the reaction was extended to include other pyrodextrins [PDs], namely Dexy 84 [D84] and Dexy 85 [D85] to prepare three polyacrylic acid [PAA/PD] adducts, namely PAA/BG, PAA/D84 and PAA/D85 adducts. These adducts were found to compose mainly of PAA-g- PDs and ungrafted PD with small amounts of PAA homopolymer and a very slight amount of AA. Rheological properties of aqueous solutions [8% w/v] of these adducts at 75 +/- 0.1°C showed that all were characterized by a non- Newtonian thixotropic flow. 15% and 100% neutralized [Na-form] adducts were utilized in sizing of gauzy cotton fabric. It was found that PAA/BG [100% neutralization] is the best amongst adduct studied in improving the mechanical properties of sized samples. Complete removal of size was observed upon using all adducts at a 100% degree of neutralization

Intrarenal resistive Index [Ri] changes in patients with liver cirrhosis

This study included 37 patients with cirrhosis and normal renal function tests divided into three groups based on a modified Child- Pugh classification [12 of Child's grade A, 12 of Child's grade B and 13 of Child's grade C], in addition to 12 healthy individuals of matched age and sex as controls. Renal ultrasound Doppler examination with an estimation of the mean intrarenal resistive index [RI] was done to all patients and controls. There was a significantly increased RI in the patient groups [A, B and C] versus the control. RI was 0.534 +/- 0.063, 0.681 +/- 0.279, 0.783 +/- 0.1075 and 0.459 +/- 0.106, respectively. Also, RI was significantly increased in grade C than A and B, respectively. So, the index showed a significant correlation with the increased Child-Pugh grading and the resistive index was closely related to the severity of cirrhosis and the degree of ascites. Therefore, it is considered a useful index of assessing renal hemodynamics in patients with cirrhosis

HTLV1/2 infection among renal dialysis patients in Egypt

Hemodialysis patients are one of the high risk groups for blood borne viral infection including HTLV1/2. This study was carried out on 171 chronic hemodialysis patients. From each patient, a serum sample and EDTA anticoagulated blood were collected. Serum was tested for anti HTLV1/2 antibodies by ELISA. Positive patients were confirmed by whole blood-PCR for detection of HTLV1/2 proviral DNA. Two [1.17%] patients were positive for both HTLV1/2 antibodies [by ELISA] and HTLV1/2 proviral DNA [by whole blood-PCR]. Interestingly, these two patients received more than 30 blood transfusions and were on hemodialysis for more than one year. Among patients who received 30 or more blood transfusions and those on hemodialysis for one year or more, the prevalence of HTLV1/2 positivity [by both ELISA and PCR] was 4.8% and 1.6%, respectively. A high frequency of HCV seropositivity [76%] was detected among our patients. Nevertheless, this frequency was not affected by the number of previously received blood transfusions [x[2] =3.48, P=0.481] or duration of hemodialysis [x[2] =3.21, P=0.073]. Two [1.17%] patients were positive for HBs antigen and they were transferred to the Fevers Hospital Hemodialysis Centre. This probably represents the tip of the iceberg as serum HBs antigen screening in the present setting is done every three months. Therefore, these two patients converted to HBs antigen seropositivity within the last three months only. Fortunately, none of our patients was anti HIV1/2 positive. These results suggest that HTLV1/2 infection occurs in hemodialysis patients in Egypt and the prevalence becomes more among those receiving 30 or more blood transfusions and those on hemodialysis for one year or more. Therefore, we recommend screening of blood for HTLV1/2 antibodies before transfusion to chronic hemodialysis patients. In addition, proper infection control should be stressed in hemodialysis centres. Interestingly, a high prevalence of HCV positivity occurred in our patients in spite of routine anti HCV screening of blood prior to transfusion. Therefore, exclusion of anti-HCV positive patients to separate hemodialysis centres is recommended to control the rapid spread of HCV infection among these vulnerable patients

Effect of long-term exposure to su-light on the ultrastructure of epidermal melanin unit of the human skin

The aim of the present work was to study the ultrastructural features of the melanocytes and related keratinocytes in chronically sun- exposed skin. 10 fair-skinned adult males, whose occupation required long exposure to sun light were chosen for this study. Chronic exposure to sun light enhanced the proliferative activity of the epidermal melanocytes accompanied by increased melanin content, variable dendritic morphology and appearance of numerous pinocytotic vesicles and vacuoles. Moreover, migration of melanocytes were demonstrated in the sun-exposed skin into suprabasal and subbasal [dermal] positions. Groups of melanocytes were demonstrated in the superficial part of the dermis denoting nest formation. In addition, chronic exposure to sun light induced marked proliferation of the epidermal keratinocytes leading to increased epidermal thickness. Also, their pigment content was increased due to enhanced melanin transfer from the nearby melanocytes. Moreover, there was concentric condensation of the excess melanin pigments and cytoplasmic tonofilaments around their nuclei forming a shield to protect the nuclear DNA against the harmful effect of solar ultraviolet rays

Histological changes of the remaining live donor's kidney in rat. A light microscopic, electron microscopic and morphometric study

Twenty adult male albino rats were used in this study. The results revealed a significant increase in all the parameters measured in the remaining kidney after 2 months. Their weight was increased by 160%, the glomerular surface area increased by 140%. The proximal tubules showed an increase of their diameter by 27% and the height of their lining cells increased by 30%. With PAS technique, focal and diffuse thickenings of glomerular basement membrane were evident together with increased mesangium. However, hydropic degeneration and tubular necrosis were detected in many tubular cells after 2 months. With PAS, their basement membranes showed focal thickenings and their brush borders were thin and interrupted. The electronmicroscopic examination of the renal cortex after one month displayed focal thickenings in the glomerular basement membranes mainly at lamina densa. Marked narrowing of the glomerular capillary lumina by the proliferating endothelium and mesangium was observed. Mitochondria were swollen, vacuolated and lost their parallel alignment, endoplasmic reticulum appeared swollen. Lysosmes and pinocytotic vesicles were increased

Histological and histochemical changes in the liver after injection of cisplatin in albino rat

The toxic adverse effects of cisplatin administration on the liver of male albino rats were investigated. Congestion of blood vessels in the portal tracts and hemorrhage together with dilatation of the hepatic blood sinusoids were noticed. Cytoplasmic vacuolation of the liver cells was evident and started in the peripheral and middle zones of the hepatic lobules. Patches of hepatocyte necrosis showing remnants of cells and nuclei were demonstrated. A picture of confluent liver necrosis was recorded in the third week group. Nuclear changes in the liver cells varied between pyknosis, karyorrhexis and karyolysis. These changes were confirmed with Feulgen staining of DNA and morphometric studies that showed significant reduction in the nuclear surface area. Mononuclear cellular infiltration and increased profiles of the bile ducts were observed in some portal tracts. Depletion of the liver glycogen was noticed after cisplatin injection. Mitochondrial damage was obvious after treatment with the drug. The collagen content and the reticular fibers were increased in the portal tracts 2-3 weeks following drug administration

strudy on the cardiovascular histaminergic receptors reactivity in experimental diabetes

This work was designed to investigate the reactivity of isolated hearts and aortic strips from normal rabbits and experimentally induced diabetic ones whether nontreated or treated with insulin or glybenclamide.In addition, the effect of cimetidine [H2 - blocker] and pheneramine maleate [HI - blocker] on the isolated rabbit hearts was studied in the 4 different groups.It was found that histamine induced a significant increase in the heart rate in a dose dependent manner in the control group with all doses used, and in the insulin and glybenclamide treated groups in the larger doses [50, 100 ug / ml]. Histamine also induced a significant increase in the amplitude of ventricular contraction in a dose dependant manner in the control and the insulin treated groups in all doses used and in the glybenclamide treated group with doses of 50, 100 ug/ ml but with a great significance In the diabetic group, this increase in the heart rate and the amplitude of ventricular contraction was found to be insignificant, However, there was a great significant reduction in the percentage of change in both parameters when compared to the control group. Histamine induced arrhythmia at a dose of 100 ug in the control, the insulin treated and the glybenclamide treated groups.With respect to the cardiac reactivity to hisamine antagonists, it was found that H2 blockers had a significant reduction in the heart rate and in the amplitude of ventricular contraction in the 4 groups studied without any significant change between them. Concerning the vascular reactivity to different doses of histamine, it was found that histamine induced a dose dependant increase in the tension developed, the time to reach maximum contraction and the time of maintained tone responses of aortic strips trom the 4 groups studied, No significant change was detected between the 4 different groups. However, it was clear that diabetes affected the vascular reactivity of rabbit aortic strips through significant prolongation in the time to reach relaxation in all doses used. In addition, insulin treatment decreased the time to reach relaxation response of the diabetic aortic strips, while glybenclamide treatment decreased it in one dose only, Therefore, it could be concluded that histamine has a positive inotropic and chronotropic effects while H2 blocking drugs have a cardiodepressant properties and that histamine in large doses causes arrhythmia and cardiac dysfunction. The.diabetic rabbit hearts have subnormal responsiveness to histamine stimulation and resist the occurrence of arrhythmia induced by histamine. This diabetic response can be completely normalized by insulin treatment, while glybenclamide treatment improves only the chronotropic response

Saponin from zygophyllum album and biological investigation

The aerial parts of the Zygophyllum album L. afforded nine glycosidal saponins of quinovic, oleanolic, ursolic acid and unidentified sapogenin. They identified by mass spectrometry and by co- chromatography. Their sugar moieties were identified as glucose, xylose, rhamnose and glucuronic acid by GLC and paper chromatography. The presence of the glycosides of oleanolic and ursolic is considered to be the first record in Zygophyllum album. The crude saponin as well as the oleanolic acid showed significant analgesia activity for the first time and some antimicrobial one

Saponins from Randia nilotica [STPF] and their biological evaluation

Two triterpenoidal saponins were isolated from R and ia nilotica Stem [Rubiaceae] for the first time. The genin of each saponin was established as oleanolic acid, identified by physical and chemical evidence. The saponin mixture exerted antimicrobial activity against Gram +ve and Gram -ve bacteria. Moreover, the molluscicidal test against Biomphalaria alexandria snails the intermediate hosts for the parasite Schistosoma mansoni was carried out, the LC50, LC98, slope function and the 95% confidence limits were determined

Protein content and amino acid composition of nelumbo nucifera seeds and its evaluation as hypoglycemic agent

The crude protein of the Nelumbo nucifera seeds were found to be 14.81%. The essential amino acids using the amino acid analyzer were threonine 2.43%, methionine 0.82%, leucine 3.33%, isoleucine 1.11% and phenylalanine 12.64%. The semi-essential amino acids were arginine 7.45% and histidine 10.79%. Other amino acids were found in adequate amount as glutamic 26.56%, proline 10.76%, aspartic 6.17%, tyrosine 4.65%, serine 4.27%, glycine 2.43%, alanine 2.77% and cysteine 3.71%. Moreover, the crude protein caused a significant decrease [44.80%] in the blood glucose level of diabetic albino rats after two weeks of treatment