Epstein-barr virus in multiple sclerosis

Multiple sclerosis [MS] is an inflammatory disorder of the central nervous system. Many diseases are associated with Epstein-Barr virus [EBV] infection, such as infectious mononucleosis and many types of malignancies, and it is thought to be related to some diseases of autoimmune origin, such as rheumatoid arthritis, systemic lupus erythematosis, and others. The present study aimed to assess EBV in patients with MS. This case-control study was conducted from October 2012 to September 2013 on 75 MS patients and non-MS controls. Both were tested quantitatively for immunoglobulin G [IgG] antibodies against Epstein-Barr nuclear antigen-1 [EBNA1] and viral capsid antigen [VCA] using the enzyme linked immunosorbent assay technique. Seventy MS patients [93.3%] were positive for EBNA1 IgG compared with 68 controls [90.7%]. In MS patients, the mean EBNA1 IgG serum level was 310.91 [ +/- 131.05] U/ml; meanwhile, among controls the mean serum EBNA IgG level was 177.81 [ +/- 104.98] U/ml. All patients with MS were positive for VCA IgG, whereas only 60 [80.0%] controls were positive. In the MS group, the VCA IgG mean level was 302.19 [ +/- 152.11] U/ml compared with 167.94 [ +/- 111.79] U/ml in controls. The differences in the serum levels of both markers between the two groups were statistically significant [P<0.001]. EBV proved to have a unique immunological pattern in MS patients when compared with non-MS controls. Further studies for more confirmation of the relation between EBV and MS on a large scale are recommended

Hepatitis C virus genotype distribution in Egyptian diabetic patients: a preliminary study

There is controversy regarding whether a specific hepatitis C virus [HCV] genotype is associated with diabetes mellitus. This study aimed to investigate HCV genotype distribution in diabetics and its relation to some clinical and laboratory variables in HCV-positive diabetic versus non-diabetic Egyptians in East Delta. The study included 100 HCV-positive patients of which 66 were diabetic in addition to 35 healthy adults as a control group. Clinical assessment, laboratory measurements of plasma glucose, insulin, C-peptide, C-reactive protein [CRP], tumour necrosis Factor-alpha [TNF-alpha] and liver functions [alanine aminotransferase [ALT], aspartate aminotransferase [AST] and gamma-glutamyltransferase [GGT]] as well as HCV genotype determination were done, and AST/platelet ratio index [APRI] and Homoeostasis Model of Assessment-Insulin Resistance [HOMA-IR] were calculated. The main results were the presence of HCV genotype 3, in 31.8% of the diabetic group and in 26.5% of the non-diabetic group, while the remainder of cases had genotype 4, the predominant genotype in Egypt. This is the first report of the presence of HCV genotype 3 in about 30% of an Egyptian cohort. However, there was no significant difference in genotype distribution between both groups. Further, there were significantly higher values of HOMA-IR, insulin and C-peptide in HCV-positive groups in comparison to the control group, while TNF-alpha was significantly higher in the HCV-positive diabetic group. However, there were no significant differences between both genotypes regarding these parameters. Although this study reveals for the first time the presence of HCV genotype 3 in a significant percentage of a group of Egyptian patients, where the majority were diabetic, the association between diabetes and certain HCV genotypes could not be confirmed on the basis of our findings. Hence, taking into consideration the impact of such a finding on the treatment decisions of those patients, further studies are warranted to explore these findings to a greater extent

Effects of thoracic epidural anesthesia on pulmonary venous admixture and oxygenation with isoflurane or propofol anesthesia during one lung ventilation

Thoracic epidural anesthesia [TEA] with local anesthetics during OLV is increasingly being combined with general anesthesia [GA] in our clinical practice for thoracic surgery. A combination of TEA with GA might maximize the benefits of each form of anesthesia. Furthermore, epidural anesthesia and postoperative epidural analgesia may improve outcome in high-risk patients. The present study was designed to compare the effects of thoracic epidural anesthesia on oxygenation and pulmonary venous admixture [Qs/Qt], when combined with isoflurane or propofol anesthesia, during one lung ventilation and to compare also between the effects of propofol with isoflurane on oxygenation and pulmonary venous admixture [Qs/Qt], during one lung ventilation. This study was carried out on 60 patients, [ASA classification I-II-III] in Tanta University Hospitals, scheduled for thoracotomies for pulmonary resections in the lateral decubitus position and one-lung ventilation. The patients were randomized into one of four groups, 15 patients in each group: Group I: propofol group [TIVA group], Group II: propofol combined with thoracic epidural anesthesia [TIVA-TEA group], Group III: isoflurane group [ISO group] and Group IV: isoflurane combined with thoracic epidural. The trachea was intubated with a doublelumen tube and its position was confirmed with auscultation. Anesthesia was maintained with propofol at continuous infusion in [Group I and Group II], and with isoflurane in [Group III and Group IV] and with increments of fentanyl and vecuronium. PaO[2], PaCO[2], SaO[2], PvO[2], SvO[2] and Hb, as well as the hemodynamic variables [HR and MAP] were measured. A right atrial blood sample was used to calculate the pulmonary venous admixture [Qs/Qt]. In epidural groups [Group II and Group IV] a 10-ml bolus of a solution of bupivacaine 0.1%+ 0.1 mg/ml morphine in saline was administered at least 30 min before the induction, followed by a 7 ml/h infusion of the same solution during the operation. In the other two groups [Group III and Group IV], no medication was applied via the epidural catheter in the preoperative and the intraoperative period. After preoxygenation, anesthesia was induced with fentanyl 3 microg/kg and propofol 2 mg/kg; tracheal intubation was facilitated with vecuronium 0.1 mg/kg. As regards PaO[2], it was significantly higher in Group I and Group II [propofol groups] than Group III and Group IV [isoflurane], in contrary, no significant effect of TEA [between Group I and Group II] nor between [Group III and Group IV] on PaO[2]. However; PaO[2] significantly decreased during OLV in all groups. As regards Qs/Qt, it was significantly lower in Group I and Group II [propofol groups] than Group III and Group IV [isoflurane], in contrary, no significant effect of TEA [between GI and GII] nor between [GIII and GIV] on Qs/Qt. However; Qs/ Qt significantly increased during OLV in all groups. The administration of thoracic epidural anesthesia, either combined with propofol or isoflurane, was not associated with a relevant impairment of oxygenation during OLV. Therefore Pre-emptive analgesia via an epidural thoracic catheter can be used safely as a standard in lung surgery, decreasing the anesthesia requirements when combined with GA, maximizing the benefits of each form of anesthesia and improving the outcome in patients with cardiopulmonary diseases, hence it was found that it has no effect on oxygenation during OLV, and it is associated with stable hemodynamics

Pharmacological and toxicological evaluation of the locally abused glue "Kolla" in rats

This work was devoted to study the physicochemical properties as well as the neuropharmacological and toxicological effects of the local glue "Kolla" which is commonly and widely abused by street children in Egypt. Chemical analysis showed that the main volatile solvent ingredient of "Kolla" is toluene and, thus, it was used as a reference toxic solvent in this study. Three different concentrations of each inhalant, glue and toluene, were investigated. Single inhalation [30 min] of both "Kolla" [1000, 4000 ppm] and toluene [5610, 22576 ppm] potentiated the sleeping time of pentobarbital. In their higher concentrations, "Kolla" [8000 ppm] and toluene [45153 ppm] antagonized the hypnotic action of pentobarbital. Single inhalation [30 min] of the tested substances produced motor incoordination and decreased locomotor activity of rats. The higher concentration of toluene [45153 ppm] increased this activity. Repeated daily inhalation [30 min/day for 10 days] of "Kolla" and toluene in the 3 tested concentrations increased locomotor activity of rats. Levels of Malondialdehyde [MDA.] in cortex and cerebellum increased after repeated inhalation of glue and toluene. Also, glutamate level in hippocampus increased after repeated inhalation of the two toxic inhalants. Extraction of liver, kidney and heart after 10 days of daily repeated inhalation showed some histopathological changes

Outcome of loupe assisted sub-inguinal varicocelectomy in infertile men

Sub-inguinal varicocelectomy has gained wide reputation among surgeons. The aim of this study was to evaluate outcome of varicocelectomy using a modified microsurgical method, specifically a loupe assisted one, and its effects on sperm parameters in infertile men. This study was carried out in 40 patients who presented with varicocele. All patients had at least a 1-year history of infertility with abnormal semen parameters and varicocele proven by physical examination and confirmed with color Doppler ultrasound. Routine investigations as required preoperatively were done. Semen analysis and hormonal profile was also done and repeated postoperatively for follow up. Half of the patients [20 patients] were treated by subinguinal approach assisted with loupe magnification [Group-A] and the other half was treated by the same approach but without magnification [Group-B]. To facilitate the procedure, an x3.0 loupe was used during the spermatic cord dissection at the level of the external inguinal ring. During dissection, the dilated veins were ligated and divided including vassal veins and external spermatic veins. A total of 40 patients were followed up for more than 6 months. Age of the patients varied from 25 to 38 years [mean 32.5]. No intra-operative complications occurred in both groups. As regard post-operative complications, group [A] [loupe assisted] showed only one patient [5%] who developed scrotal hematoma and two [10%] developed wound infection, while in group [B] complication rate was higher, two cases [10%] developed scrotal hematoma, two cases [10%] developed wound infection, three cases [15%] developed hydrocele, two cases [10%] developed recurrence and two cases [10%] developed scrotal edema. As regard to seminal parameters there was much improvement in sperm count, sperm motility and decrease in abnormal forms after surgery with significant differences in Group A [patients treated with a modified microsurgical method] but in Group B [patients treated with sub-inguinal approach without loupe assistant] there was improvement in sperm count, sperm motility and decrease in abnormal forms but without significant differences. Loupe-assisted sub- inguinal varicocelectomy is a safe, simple, and effective method for the treatment of sub-fertile men, especially in medical facilities without microscopic equipment and has significant improvement in sperm parameters

influence of general anesthesia when combined with epidural anesthesia in postoperative delirium in elderly patients undergoing hip replacement surgery

Cognitive impairment [e.g., delirium confusion] is a significant problem in elderly patients during the early postoperative period. Postoperative delirium, a transient mental dysfunction, can result in Increased morbidity, delayed functional recovery and prolonged hospital stay in the elderly. The aim of this study is to determine the effect of epidural anesthesia when combined with general anesthesia on the incidence as well as the recovery of delirium in elderly patients undergoing hip replacement surgery. The present study was carried out on sixty adult patients [ASA I-I1I] of both sex scheduled for hip replacement surgery. Patients were randomly allocated to one of two groups to receive either general anesthesia [GA group, n =30] or GA plus epidural anesthesia with 0.75% ropivacaine [GA-EDA group, n = 30]. All patients were tested for cognitive dysfunction [Delirium] using the Confusion Assessment Method [CAM] score preoperatively and for 24 hr postoperatively. This study showed a significant incidence of +ve CAM score [36.7% and 26.7%] in the GA group and GA- EDA groups respectively at 1hr postoperatively when compared with the preoperative baseline values. From the 2[nd] hr postoperatively, there were continuous reduction in the +ve CAM score patients throughout the study period. When comparing the two studied groups, there were no significant difference in the incidence of +ve CAM score throughout the study period. Epidural anesthesia in combination with general anesthesia does not affect the incidence as well as the recovery pattern of delirium in elderly patients undergoing hip replacement surgery

Possible pharmacodynamic interactions between the CNS stimulant [Nikethamide] and analgesic drugs in experimental animals

Recently, there has been striking increase in research on drug combinations that enhance analgesia in clinical populations as well as in experimental animals. These studies involve combinations of drugs that have been viewed, as effective analgesics in their own right, such as opioids and nonsteroidal anti-inflammatory drugs, and drugs that have not traditionally been viewed as analgesics. The purpose of this study was to investigate the possible pharmacodynamic interactions between a CNS stimulant [nikethamide] and opioid [morphine] and non-opioid [paracetamol] drugs. Also, this study assessed the rationale of these interactions in terms of efficacy and safety by using different models of analgesic and behavioral tests. Albino mice and rates were used, as experimental animals. The analgesic effect of drugs and their combination was evaluated using [hot-plate] [54 °C], [tail clip] and [writhing] [acetic acid, 1%. i.p.] tests. The behavioral effects of the drugs and their combinations were also determined. Nikethamide significantly diminished the analgesic effect of morphine [1-10 mg/kg, i.p.] in all tests [antagonism] and enhanced the analgesic effect of paracetamol [50-400 mg/kg. i.p.] in all tests [additive]. Coadministration of nikethamide [100 mg/kg, i.p.] with morphine [2.71 mg/kg, ED[50]] significantly decreased locomotor activity and impaired the acquisition on conditioned avoidance responses but did not affect motor coordination to any significant extent. On the other hand, coadministration of nikethamide [100 mg/kg, i.p.] with paracetamol [117.94 mg/kg, i.p, ED[50]] significantly increased locomolor activity and improved the acquisition on conditioned avoidance responses but did not affect motor coordination to any significant extent. We can conclude that the systemic coadministration of nikethamide significantely antagonized the analgesic effect of morphine and such combination was accompanied by increased side effects. In contrast, nikethamide significantly enhanced, the analgesic effect of paracetamol in an additive fashion and this combination was not accompanied by increased side effects

Liposomes as an ocular delivery system for fluconazole: in-vivo study

The purpose of this study was to formulate topically effective controlled release ophthalmic fluconazole liposomal formulations using the reverse-phase evaporation technique. Soya bean phosphatidylcholine [PC] and cholesterol [Ch] in specific weight ratios were used. Selected formulations were tested for their in-vivo ocular antifungal effect. These included the neutral, the positively [using stearyl amine] and the negatively [using dicetyl phosphate] charged liposomes. A reproducible model of Candida keratitis in rabbits was performed and the effects of the prepared liposomes were better than a solution of fluconazole. The order of fluconazole liposomal formulations according to the time to achieve complete healing is arranged in a descending order: negatively charged liposomes > positively charged liposomes > neutral liposomes [7:4] > neutral liposomes [5:5] > fluconazole solution. The frequency of instillation was decreased; also, the time of ulcer healing was decreased. It was concluded that the use of liposomes as a drug delivery system could contribute to the enhancement of the effect of fluconazole in the eye

Impact of some bio-insecticides on certain biological aspects of pulvinaria tenuivalvata [newstead] [fam.: Coccidae, order: Homoptera] infesting sugar-cane

The red-striped soft scale insect, [R.S.S.S] Pulvinaria tenuivalvata attacking sugar-cane at Attfieh region, Giza Governorate is recently considered an important economic insect pest of sugar-cane in Egypt. Laboratory evaluation of different extracts of the spicked centaury, Centaurium spicatum on the biological aspects of P. tenuivalvata was studied. Petroleum ether extract proved the most effective extract on all insect stages. The impact of the most effective extract, mineral oil, and biocide on the biological aspects of P. tenuivalvata under laboratory and field conditions was studied. The tested compounds are effective against soft scale insect, P. tenuivalvata on sugar-cane leaves and they increased sugar-cane yield significantly, at Attfieh region

Comparison of colloid versus crystalloid preload for prevention of hypotension during spinal anesthesia for elective cesarean section in women with positive supine stress test

If parturient prone to develop caval compression in the supine position were identified before delivery; this might be a method of predicting hypotension during cesarean section under spinal anesthesia. Colloid preloading is thought to be superior to crystalloid in reducing the risk for spinal anesthetic induced hypotension. It is postulated that parturients preoperalively susceptible to the supine position would benefit the most from colloid preloading. The aim of this study is to compare colloid versus crystalloid preload for prevenilon of hypotension during spinal anesthesia for elective cesarean section in women with positive supine stress test [SST]. Forty healthy women, with term singleton normal pregnandes presenling for elective cesarean section under spinal anesthesia were included in the study. All patients were positivefir supine stress test [SST], they were divided into 2 equal groups [20 palients each], crystalloid preload group [group I] and colloid preload group [group II]. IViaternal hypotension, nausea, vomiting or dizziness and ephedrine requirements were recorded during the study. Induction-to-uterotomy interval, uterotomy-to-delivery interval and inlraoperative blood loss, were also recorded. Moreover, Apgar score and umbilical artery add-base status at delivery were measured. Our results showed that in patients received crystalloid preload [group I] the frequendes of occurrence of decreased systolic blood pressure below 100 mmHg or 20% from baseline, occurrence of vomiting, nausea or dizziness were 14[70%], 7[35%], 9[45%], and 7[35%], respectively, while, in palients received colloid preload [group II] were 6[30%], 1[5%], 2[10%], and 1[5%], respectively. So, patients received crystalloid preload showed a higher frequency of hypotension, vomiting, nausea and dizziness compared to colloid group [P<0.05], and also a greater need for ephedrine, mean[+SD] was 21[11.4] in group I compared to 7.25.3]mg in group II[P<0.05]. Pregnant women with a positive preoperative supine stress test constitute a subset at increased risk for clinically significant hypotension during cesarean delivery under spinal anesthesia. These women seem more likely to benefit from prophylaclic colloid solution preload

Effects of sevoflurane and isoflurane on coagulation system a comparative study

Several studies of the effects of inhalational anesthetic agents on platelet function have been reported since Ueda demonstrated in 1971 that clinical concentrations of halothane inhibited ADP-induced platelet aggregation. Sevoflurane in particular has recently been the subject of several investigations; however, the results remain contradictory. Platelets play an important role in hemostasis during and after surgery. Among multiple factors, interactions of drugs used in anesthesia with platelet function have been implicated to aggravate the risk of perioperative bleeding. In this study, the aim was to assess the effects of sevoflurane and isoflurane on the coagulation system. Patients were randomly divided into two groups [30 patients each]: isoflurane group [group I] and sevoflurane group [group S] according to the inhalational anesthetic used for maintenance of anesthesia. Blood samples were withdrawn before induction, 1 hour after induction and 1 hour postoperatively to measure red blood cells count, hemoglobin level, platelets count, bleeding time, prothrombin time and activity, activated partial thromboplastin time, pH, body temperature and platelet aggregation tests. The results of this study showed that red blood cells count, hemoglobin level, blood pH values and vital signs measurements were insignificantly changed during the predetermined times of measurements. Sevoflurane had a significant inhibitory effect on intraoperative platelet aggregation. Also, it had a residual suppressive effect 1 hour postoperatively, whereas it had no significant effect on other coagulation parameters including platelet count, bleeding time, prothrombin time and activity and activated partial thromboplastin time. As regards isoflurane, it had no significant effect neither on platelet aggregation nor other coagulation parameters during the intraoperative and postoperative periods. The conclusion of this study is that sevoflurane has a significant inhibitory effect on intraoperative platelet aggregation, whereas isoflurane has no effect. There is also a residual suppressive effect 1 hour postoperatively with sevoflurane. Therefore, in patients at increased risk of intraoperative and postoperative bleeding, isoflurane may be preferred as an inhalational agent for maintenance of general anesthesia.

Immunological studies on a bivalent inactivated oil adjuvanted vaccine against turkey rhinotracheitis virus and pasteurella multocida

The immunogenecity of combined Turkey RhinoTrachitis Virus [TRTV] and Pasterella multocida inactivated oil emulsion vaccine were evaluated in comparison to both the monovalent [TRT] and [P. Multoocida] vaccines. Sixty turkeys poults were divided into four groups, group 1, 2, and 3 were vaccinated with [TRTV], Pasterella multocida and combined [TRTV + Pasterella multocida] vaccines respectively while group 4 was kept as non vaccinated control, obtained results of cellular [Detected by lypmphocyte blastogenesis assay] and Humoral [Detected by indirect haemagglutination IHA, Enzyme linked Immuno Sorbant assay ELISA, and Serum neutralization test S.N.T] immune responses of experimentally vaccinated poults revealed that 2 successive doses of the prepared vaccines with 21 days apart produce protective immune response started at 3 weeks post vaccination and lasted for 12 weeks covering the whole fattening period

Canine spirosercosis in Giza governorate: With a reference to esophageal and aortic pathology

A survey was done on 78 dogs of different ages and both sexes in Giza Governate to detect the incidence of the infestation with Spirocerca lupi in dogs. Fifty-eight cases were positively infected; only twenty-seven cases had the clinical disease with the master sign of vomiting. The characteristic Spirocerca lesions were encountered mostly in aorta, esophagus and in few cases stomach involvement was also noticed. The most pronounced P.M lesions were the tumor-like nodules in the last mentioned organs, those nodules contained cross-section of large number of the bright red worm in a yellow pus. Deformative degenerative spondylitis with associated aortic adhesive lesions was observed in 5 cases. Neoplastic reactions mainly fibrosarcoma was noticed in 11 cases which had the tendency to metastasise to the lung in two cases

Long-term follow up of superficial bladder tumors

Objective: To study the recurrence rate of superficial bladder tumors at Cairo university hospitals

Patients and Methods: Sixty-six patients with superficial transitional cell carcinoma who were treated by either Nd: YAG laser therapy [16 patients] or transurethral resection [50 patients] were followed for a mean of 5.5 years

Results: Local tumor recurrence at the same site of the original tumor occurred in 39% of patients while remote recurrence occurred in 33% of patients. The total recurrence rate was 59%. Tumor progression to invasive carcinoma occurred in 7 patients [11%], and 3 patients [4.5%] died of disease-related causes

Conclusion: The treatment of superficial TCC may be done by relatively minor endoscopic procedures, but the disease itself is a serious condition that merits close long-term follow-up

Coagulation profile in patients with liver cirrhosis: thrombosis versus bleeding

A variety of haemostatic abnormalities occur in patients with liver disease and, in general, the severity of these abnormalities reflects the degree of hepatic dysfunction. Aims of the study: 1- To study the haemostatic parameters among patients with liver cirrhosis. 2- To characterize the haemostatic differences among patients with liver cirrhosis and thrombosis and those with bleeding. Patients, Materials and This study included 36 patients with liver cirrhosis of various stages who were selected among those admitted to the department of Tropical Medicine and Gastroenterology. In addition 15 apparently healthy persons were selected as a control group. They were diagnosed as liver cirrhosis according to clinical, laboratory and ultrasonographic criteria. All the patients and control were subjected to the followings: history taking and clinical examination, abdominal ultrasonography and coloured - Doppler ultrasonography, laboratory investigations including: blood count, liver function tests, haemostatic parameters including: prothrombin time and concentration, activated partial thromboplastin time [aPTT], antithrombin III [AT III], fibrinogen, protein S and protein C, D- dimer, platelet aggregation tests. The patients were classified into three groups: Group I: included 11 patients with liver cirrhosis and evidence of thrombosis [portal, DVT or both], Group II: included 17 patients with liver cirrhosis and evidence of bleeding tendency and Group III: included 8 patients with liver cirrhosis and no evidence of either bleeding tendency or thrombosis. There was highly significant reduction of the mean levels of the AT III, protein C and platelets among patients with liver cirrhosis in comparison to the healthy control [P = 0.000, P = 0.001 and P = 0.000 respectively]. The mean PT and aPTT times were significantly longer among patients with liver cirrhosis in comparison to healthy controls [P = 0.000 and p = 0.003 respectively]. Similarly the mean values of serum fibrinogen and D-dimer were significantly higher among patients with liver cirrhosis healthy controls [p = 0.000 and p = 0.003 respectively]. On the other hand no significant difference was found between patients and controls regarding the mean value of protein S [p = 0.401]. Total bilirubin, PT and aPTT showed positive correlation with Child score [r = 0.465, 0.552 and 0.582 respectively], while serum albumin, ALT. AT III and protein S showed negative correlation with Child score [r = -0.813, -0.405, -0.389, and -0.415 respectively]. Fibrinogen showed negative correlation with both the serum bilirubin and PT. AT III showed positive correlation with serum albumin and negative correlation with serum bilirubin, ALT AST and PT Protein S showed negative correlation with serum bilirubin. Protein C showed positive correlation with serum bilirubin, ALT, AST and PT. D-dimer showed negative correlation with AST. aPTT showed positive correlation with serum bilirubin, AST and PT. The mean values of AT III protein S and C were significantly lower in group I in comparison to group II [p = 0.035, 0.034 and 0.021 respectively]. On the other hand, a PTT was significantly longer in group II than group I [p = 0.006]. The mean values of protein C was significantly lower in group I in comparison to group III [p = 0.030]. The mean values of protein S was significantly higher in group II in comparison to group III [p = 0.038]. On the other hand, aPTT was significantly longer in group II than in group III [p = 0.005]. Conclusions: 1- both the levels of coagulation factors and coagulation inhibitors decreased in patients with liver cirrhosis in comparison to controls and this decrease correlated with liver dysfunction. 2- The occurrence of bleeding or thrombosis among patients with liver cirrhosis depends on the balance between the degree of reduction of coagulation factors and coagulation inhibitors so screening of these factors is essential for prediction of each of them

Clinicoradiological evaluation of rare orbital injuries

AIM OF THE WORK: We aimed at recording rare cases with different orbital injuries and studying the difficulties in their diagnosis and management. PATIENT AND METHODS: A retrospective review of six cases of rare orbital injuries. All cases shared in visual impairment and some cases had either proptosis or enophthalmos. All cases underwent full history taking including type and mechanism of trauma, complete ophthalmic examination and computerized tomography [CT] examination. Clinical diagnosis was not conclusive. Accurate diagnosis was only achieved by CT. Management was different depending on each condition. One case had pure medial wall blow out fracture with the displaced globe traversing ethmoidal cells into nasal cavity, another one had bilateral medial wall blow in fracture with nasal fracture, two cases had intra orbital FBs; one of them had very large neglected woody FB and the other had gun shot passed through optic canal into middle cranial fossa, one had neglected orbital hematoma which changed into hematic cyst, and the last case had iatrogenic medial wall injury. CONCLUSION We concluded that in rare orbital injuries, we should not rely on clinical assessment only and CT is very essential diagnostic tool for such cases also there is no fixed role for surgery but it moulds itself according to each condition

Combined phacoemulsification and deep anterior vitrectomy with intravitreal triamcinolone infection for complicated cataract and vitreous opacities due to recurrent uveitis

To evaluate the influence of combined cataract surgery with deep anterior vitrectomy and intravitreal injection of triamcinolone on the visual acuity and the course of the disease in patients with recurrent uveitis. Eleven eyes of eleven patients with medically controlled recurrent uveitis with complicated cataract and vitreous esudates nderent a combined phacoemulsification [or hacoasiration in cases of soft cataract0 and deep anterior virectomy for removal of lens opacity and vitreous debris with intravitreal injection of long acting steroid as a prophylactic measure against recurrence. Visual acuity was significantly improved in 9 eyes [81.8%] at the end of first month postoperatively and remained stationary thereafter. Recurrence of uveitis was significantly reduced and was noted in three eyes [27.2%], all of them had mild to moderate attacks which were controlled medically. Central macular thickness was measured using OCT in 5 patients preoperatively with mean of 353.60 +/- 44.27 micro and at 3 and 6 months postoperatively and was 225.20 +/- 34.04 micro and 241.80 +/- 37.73 micro respectively. Intraocular pressure rise was detected at early postoperative period in only two eyes [18.2%]. Both had mild elevation and pressure was controlled medically. No other complications were recorded. Combined phacoemulsification and deep anterior vitrectomy with IVTA injection is relatively safe and effective procedure in the treatment of complicated cataract and vitreous opacities in uveitic patient, improving visual outcome and reducing recurrence of uveities

Host-plant preference of the red-striped soft scale insect, Pulvinaria tenuivalvata [Newstead]

Effect of five host plants on different biological aspects of the red striped-soft scale, Pulvinaria tenuivalvata [Newstead] was studied. The percentage of nymphs that succeeded to reach the adult stage differed on the different host plants. This percentage was maximum on sugar-cane and sweet sorghum followed by cogon grass, while the minimum was on maize. The shortest pre-oviposition period of the insects was recorded on sugar-cane and elephant grass plants, while the oviposition period was about twice greater on sugar-cane than on sweet sorghum. No significant difference existed between the oviposition period on sweet sorghum and maize. The maximum number of eggs was found on sugar-cane, but the minimum number was found on maize and sweet sorghum. Adult longevity on sugar-cane was about twice greater than that on maize, while it was one and half that on elephant grass. Thus, sugar-cane plant was more preferable to the insect than all other tested host plants

Elevation and depletion induced by cholesterol derivatives in the level of total lipids on the major brain parts of albino rat

Changes in the level of total lipids on albino rat's brain [cerebrum, cerebellum and brain stem] were evaluated following the administration of four Cholesterol derivatives 3 beta-Acetoxy-5-bromo-6 beta hydroxy-5 alpha-Cholestane A [I], 3 beta-Acetoxy-6-dimethyl amino-Cholest-5-ene B [II], 3 beta Chloro-5-bromo-6 beta-nitro-5 alpha-Cholestane C [III] and 6 beta-Aminopyrimidino-Cholest-4en-3-one D [IV]. Experiments were carried out on four groups of six male albino rats weighing 200 +/- 20 gm. Control albino rats were administered saline solution intraperitoneally [ip.], while the other experimental groups were given 0.3 mg/kg body weight of steroidal solutions which was prepared in peanut oil

Needle aspiration of breast abscess could be considered a standard practice?

The revolution, in surgery, of laparasopic cholecystectomy as the gold standard for the treatment of gall stone, has urged many surgeons to apply this minimally invasive technique in varieties of surgical problems including breast abscess. In this study the technique of needle aspiration, being a minimal invasive approach has been done for 24 patients aged between 18 and 40 years [median 27]. There were 22 abscesses in the right breast [9 1.6%] and 2 abscess in the left one [7.4%]. Twenty patients were lactating [83.3%] while 4 were non lactating [16.7%]. The total number of patients who benefited from aspiration was 21[87.5%] [11 needed once aspiration 45.8%, 6 needed twice aspirations 25% while 4 needed 3 aspirations 16.7%]. No complications as milk fistula were seen with incision and drainage. No distress for mother or baby as regard breast feeding [all lactating patients were encouraged to continue breast feeding]. No need for general anaesthesia with its hazards, hospital stay or post treatment dressing which in turn minimized the cost. In conclusion, needle aspiration is effective alternative to incision and drainage in management of breast abscess and may surpass it, being less painful, less distressing, less costly with minimal morbidity and could be considered a standard for treatment of breast abscess