Levetiracetam and lamotrigine effects as mono- and polytherapy on bone mineral density in epileptic patients / Efeitos do levetiracetam e lamotrigina, em mono e politerapia, na densidade mineral óssea de pacientes epilépticos

ABSTRACT The purpose of this study was to determine the effect of lamotrigine (LTG) and levetiracetam (LEV) as mono- and polytherapy on biochemical markers of bone turnover and bone mineral density in Egyptian adult patients with epilepsy. Methods Forty-eight patients were divided into four groups: two received monotherapy of either LTG or LEV, and the other two groups received polytherapy comprising (valproate [VPA] + LTG or VPA + LEV). Thirty matched healthy participants were included in the study. Participants completed a nutritional and physical activity questionnaire. Biochemical markers of bone and mineral metabolism and bone mineral density of the lumbar spine were measured at baseline and at six months. Results In the LEV monotherapy group, the bone formation markers showed a significant decrease in serum alkaline phosphatase and serum osteocalcin levels while the bone resorption marker showed a significant increase in urinary deoxypyridinoline levels. After six months of treatment, bone mineral density showed a significant decrease in all treated groups, while among monotherapy groups, this significant decrease was more prevalent in the LEV monotherapy group compared with the LTG monotherapy group. Furthermore, there was significant negative correlation between urinary deoxypyridinoline levels and bone mineral density in the LEV monotherapy group. Conclusion Using new generation antiepileptics, LEV monotherapies and polytherapy showed harmful effects on bone but LTG did not.

RESUMO O objetivo deste estudo foi determinar o efeito da lamotrigina (LTG) e levetiracetam (LEV) como mono e politerapia em marcadores bioquímicos de remodelação óssea e densidade mineral óssea em pacientes adultos egípcios com epilepsia. Métodos Quarenta e oito pacientes foram divididos em quatro grupos: dois grupos receberam monoterapia de LTG ou LEV e os outros dois grupos receberam politerapia (valproato [VPA] + LTG ou VPA + LEV). Trinta participantes saudáveis controle foram incluídos no estudo. Os participantes preencheram um questionário nutricional e de atividade física. Marcadores bioquímicos do metabolismo ósseo e mineral e densidade mineral óssea da coluna lombar foram medidos no início e aos seis meses. Resultados No grupo de monoterapia LEV, os marcadores de formação óssea mostraram uma diminuição significativa nos níveis séricos de fosfatase alcalina e osteocalcina sérica, enquanto o marcador de reabsorção óssea mostrou um aumento significativo nos níveis de desoxipiridinolina urinária. Após seis meses de tratamento, a densidade mineral óssea mostrou uma diminuição significativa em todos os grupos tratados, enquanto entre os grupos de monoterapia, esta diminuição significativa foi mais prevalente no grupo de monoterapia LEV em comparação com o grupo de monoterapia LTG. Além disso, houve correlação negativa significativa entre os níveis de desoxipiridinolina urinária e densidade mineral óssea no grupo de monoterapia LEV. Conclusão Utilizando antiepilépticos de nova geração, as monoterapias LEV e a politerapia mostraram efeitos prejudiciais no osso, mas a LTG não.

Study of structural changes in diabetic macular edema by spectral domain optical coherent tomography after intravitreal injection of triamcinolone acetonide

Purpose: is to study the morphological changes in Diabetic Macular Edema [DME] before and after intravitreal injection of triamcinolone acetonide using the spectral domain-optical coherence tomography [SD-OCT] parameters

Patient and methods: The study was held at Al-Zahraa University Hospital. It included 49 eyes of 40 patients with clinically significant diabetic macular edema [CSDME]. A single intravitreal injection of triamcinolone acetonide [IVTA] at the dose of 4 mg in 0.1 ml was administered. Best corrected visual acuity [BCVA], intraocular pressure [IOP] and OCT scanning of the macula were done before and 3 months after IVTA. The OCT study parameters included central foveal thickness [CFT], OCT pattern of DME, vitreomacular interface [VMI], presence or absence of serous macular detachment [SMD], hard exudates [HEs], hyper-reflective spots [HRS] and IS/OS junction [Foveal ellipsoid zone] and ELM integrity

Results: Mean BCVA +/- SD were [0.23 +/- 0.13] and [0.39 +/- 0.22] pre and 3 months after IVTA respectively. The initial mean CFT +/- SD was [424 +/- 127.1 um] while 3 months after IVTAit was [283.1 +/- 70.2 um]. Eighteen eyes showed SMD which was completely absent 3 months after a single IVTA. There was insignificant statistical difference of the VMI state before and 3 months after IVTA. Out of thirty-four eyes that showed the presence of HEs in this study, twenty-seven eyes showed diminution of these HEs size 3 months after injection. Forty-one eyes and forty-three eyes showed the presence of HRS before and after IVTA respectively. There was insignificant statistical difference in foveal ellipsoid zone and ELM integrity before and 3 months after IVTA. Complications were reported in 16 eyes [32.6%]. Cataract progression was noted in 6 eyes [12.2 %]. Steroid induced IOP elevation was reported in 10 eyes [20.4%]

Conclusions: The data collected from OCT macular B scan are effective in the prognosis and follow up of diabetic macular edema. IVTA remains a promising primary therapy for DME at least in short terms. It seems relatively safe, but not without complications

Prevalence of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) Infection and their Co-infection among Blood Donors in Minia Governorate, Egypt.

Aim: Infections with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious morbidity and mortality. This study was designed to determine the prevalence of Hepatitis B and C infections and their co-infections among blood donors in Minia governorate, Egypt. Study Design: A cross-sectional study. Place and Duration of Study: The study was conducted over a period of 6 months starting from May 2011 till December 2011 and it included 5410 samples from blood donors at the Regional Blood Transfusion Center in Minia governorate. Methodology: Both HBsAg and antibodies to HCV were detected by EIA in 5410 blood samples from potentially healthy asymptomatic blood donors. Detection of HBV DNA and HCV RNA was carried out by real-time PCR (RT-PCR). Results: Most individuals were males (4305; 79.6%) and were from rural areas (3695; 68.3%). The sero-prevalence of infections was 0.9% (48 cases) for HBV and 6% (322 cases) for HCV, and 0.1% (7 cases) for co-infection. Out of 7 samples with co-infection, only one (14.3%) was positive for HBV DNA and HCV RNA. The mean age of HCV-antibody positive donors (33.2 ±9.41 years) was significantly higher than that of the HBV-positive donors (27.3± 6.06 years) and co-infection (29.9± 10.21 years) (P<0.05). Prevalence of HBV and HCV was higher in males (1% and 6.6% respectively) while HCV was higher in rural areas (6.8%) unlike HBV which did not show any difference in residential distribution (0.9% for both rural and urban areas). Conclusion: The prevalence of both viruses is low and that of the dual infection is lower than any of the two viruses alone.

*Corresponding author: Email: saharkamal2003@hotmail.com; British Journal of Medicine & Medical Research 4(13): 2611-2620, 2014 SCIENCEDOMAIN international www.sciencedomain.org Hepatic Antioxidant Effect of Paroxetine in Rats Exposed to Chronic Restraint Model.

Depressed mood, with its accompanying mental and physical stresses, could affect the progression and severity of several diseases e.g. hypertension, myocardial infarction, gastritis, peptic ulcer. The present animal study was done to investigate the potential antioxidant effect of paroxetine, as a selective serotonin reuptake inhibitor, to protect against chronic restraint stress-induced oxidative damage in the liver. Thirty albino rats were divided into 3 equal groups. Group 1 was control, non-stressed non-treated group. Group 2 was exposed to chronic restraint model by placing them in wire mesh cages exactly fit to their size for 6 hours daily for 21 days. Group 3 were also exposed to chronic restraint model for 21 days while they were administered by paroxetine 1 mg/kg/day ip during the restraint period. At the end of the study, liver transaminases were determined by commercial kits. The hepatic levels of glutathione peroxidase, catalase and thiobarbituric acid reactive substance were also determined by spectrophotometric methods. Glutathione repletion ability by hepatic cells with and without paroxetine treatment was also determined in all tested groups. The results showed a significant (p<0.05) increase in serum levels of transaminases and liver anti-oxidant enzymes while levels of thiobarbituric acid reactive substance were significantly (p<0.05) reduced in paroxetine-treated group compared with non-stressed non-treated control rats. Glutathione repletion ability was also significantly (p<0.05) increased in treated group to a level comparable to the control non-stressed non-treated values.

Estradiol and/or Ibandronate Therapy Ameliorates Oxidative Status in Livers of Ovariectomized Rats.

Background: Overiectomized rats suffer from osteoporosis that mainly results from oxidative stress (OS). Studies revealed that the levels of antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione-S-transferase, catalase (CAT), and glutathione reductase could be used to determine and follow-up OP. The anti-oxidant activity of anti-osteoporotic drugs needs further investigations to be proved to add more confidence in the ability of these drugs to control the disease. Objective: To investigate the possible anti-oxidant effect of treatment with ibandronate, a highly potent nitrogen-containing bisphosphonate, on activities of catalase and glutathione peroxidase anti-oxidant enzymes, thiobarbituric reactive substance (TBARS), as a marker of lipid peroxidation and DEPPD free radicals in liver homogenates of ovariectomized rats. Methods: Fifty adult female albino rats were divided into five equal groups ( n=10 rats): Group (1): served as control injected with saline, 2nd group: rats were subjected to ovariectomy, 3rd group: rats were exposed to ovariectomy and treated with estradiol, 4th group: were ovariectomized and treated with ibandronate and 5th group: were ovariectomized and treated with both estradiol and ibandronate. Duration of therapy with either drug was 12 weeks. Results: Estradiol alone or in combination with ibandronate to ovariectomized rats showed significant increase in activities of anti-oxidant enzymes. Both drugs reduces hepatic TBARS and DEPPD free radicals in hepatic homogenates in this model of OP. Conclusion: The present study can conclude that ovariectomy leading to oxidative changes liver of tested rats. Co-administration of estradiol and ibandronate provides a kind of protection against alterations in anti-oxidative/oxidative balance. The results support the hypothesis stated by experimental studies that anti-osteoporotic treatment could also possess anti-oxidative protective property.

Validation of evidence-based clinical practice guideline: nursing intervention for newly diagnosed pulmonary tuberculosis patients at community setting

Tuberculosis is a major contributor to disease burden in the developing countries. It is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services. The nursing interventions of tuberculosis in community settings require a system of recommendations that ensure the consistency of care. The present study aimed at providing a valid evidence-based clinical guideline that assists nurses to intervene consistently to the newly diagnosed patient with pulmonary tuberculosis. The intended guideline was developed according to the criteria of the Scottish Intercollegiate Guidelines Network [SIGN] and the American Academy of Neurology. This guideline was developed based on the need for assessments of the intended users [nurses] and the end-point beneficiaries [newly diagnosed patients with pulmonary tuberculosis]. The development process of the guideline consisted of seven main steps. The SIGN appraisal tools were used for the critical appraisal phase of the retrieved studies, and the ''Appraisal of Guidelines for Research and Evaluation [AGREE] Instrument'', that was used for appraising the internal validity of the developed guideline. The developed guideline included thirty recommendations categorized into four main themes, which are assessment, nursing diagnosis, nursing care plan and implementation of care plan. The overall assessment of the guideline revealed that two-thirds of academic appraisers strongly recommended the guideline to be used in practice and most of practitioner nurses and practitioner physicians recommended the guideline to be in practice. The development of this guideline was based on the needs of the targeted users [nurses] and end-point beneficiaries [patients]. It was strongly recommended by the appraisers to be used in the outpatients chest clinics. The study recommended that this developed guideline should be disseminated to the policy makers to be approved for application

Mycotic eye infections in ophthalmic center, Mansoura University

Background and objectives: Fungal infections of the eye constitute a group of difficult clinical problems for both the ophthalmologist and infectious disease practitioner. Despite the uncommon occurrence of ocular fungal disease, the threat of blindness from conditions such as fungal keratitis or endophthalmitis makes it a serious problem. The incidence of ocular fungal infections has increased over the last few years. This study was conducted to estimate the rate of ocular fungal infections, identify the fungal species causing ocular mycoses, and find out the epidemiological features of mycotic eye infections in patients admitted to the Ophthalmic Center, Mansoura University, Egypt

Methods: Fifty four patients [50 with clinically suspected fungal keratitis and 4 with endophthalmitis] were included in this study. Samples were collected by ophthalmologist and subjected to direct examination with potassium hydroxide [KOH] 10% and culture on Sabouraud's dextrose agar [SDA] without actidion. Experimental fungal keratitis was induced in mice to compare different methods of diagnosis of fungal keratitis

Results: Out of 54 samples collected, four showed fungal growth on SDA from patients with keratitis, while no fungi were isolated from suspected cases of fungal endophthalmitis. Two isolates were Candida albicans and two isolates were Aspergillus fumigatus. Fungal keratitis was more common among female patients in the age group 21-50 years old from rural areas. Contact lens wear, corneal trauma, topical steroid use, and systemic disease [diabetes mellitus] were the most common risk factors for fungal keratitis in our patients. Comparison of different methods of diagnosis of fungal keratitis induced in mice revealed that polymerase chain reaction [PCR] and histopathological examination were the best methods [sensitivity, specificty, and accuracy 100%] followed by Calcofluor White stain [CFW], culture on SDA without actidion, and finally KOH 10% wet mount [86, 100, 93%], [74, 100, 87%], and [54, 100, 78%] respectively

Conclusion: It is important to know the exact aetiology of fungal eye infections to institute appropriate therapy in time. Laboratory confirmation should be undertaken and fungal infection should be ruled out before prescribing corticosteroids and antibiotics. PCR and histopathological examination are cosidered the most sensitive, specific, and accurate method for diagnosing fungal keratitis

Application of objective structured clinical examination in community health nursing course: experience of staff members and students

Objective Structured Clinical Examination [OSCE] is the most valid and reliable tool for evaluation of performance competency. There are different formats of OSCE to assess the cognitive and psychomotor skills as well as the knowledge recall and communication skills in an objective and consistent manner. It is important to involve students and examiners in changing or innovating of evaluation pattern. The present study aimed to investigate the perception and experience of staff members and students toward introducing OSCE as a new approach of assessment in community health nursing course. In addition to compare the applicability of using three different structured methods of simulated patient [Lay person with staff members, Staff members play double roles and two staff members], in order to find out the most appropriate simulated patient method. The study is a mix of quantitative and qualitative design. It was carried out at the fourth year community health-nursing students, totaling 160 students. All examiners [n= 16] and only 60 students participated at the focus group sessions. Results revealed that most of students and examiners were satisfied with the objectivity of OSCE and the variety of questions that increase the chance of gaining marks. The students' level of performance ranged from good to excellent in all stations for most of students. The study recommends introducing OSCE into the curriculum of community health nursing course and holding comprehensive training for staff members on being a simulated patient and examiner at the same time

Raising awareness' of risky women of osteoporosis towards healthy lifestyle

Osteoporosis is a major threat to public health today and the most common bone disease world wide. Osteoporosis is a disease in which the density and quality of bone is reducing and increasing the risk of fracture. There is an increased awareness that osteoporosis is an international health care concern that affects millions of individuals worldwide, women are four times more likely than men to develop the disease. Therefore, raising awareness of risky women of osteoporosis towards healthy lifestyle can help the maintenance of healthy behaviors and reduction of life style factors that inhabit bone density. So, the aim of this study was raising the awareness' of risky women of osteoporosis towards healthy lifestyle. A quasi experimental design was used. The study was conducted from September 2008 up to January 2009, and the sample included 130 women. Three tools were developed by the researchers to cover the actual life style and assess the knowledge about osteoporosis and its prevention before and after awareness session and evaluate these sessions by using 3 points lickert scale. Results revealed that 65.4% of women prefered fatty and starch food, 84.6% of them were drinking black tea, cola or coffee while 57.6% lacked of exercises. There was significant difference [P

Prevalence of bacterial vaginosis among asymptomatic women attending the family planning and antenatal outpatient clinics of Benha University Hospital

Bacterial vaginosis is a polymicrobial condition. It is currently the most prevalent infectious cause of vaginitis. It has a strong correlation with many infective gynaecological and obstetrical complications. The aim of this work is to estimate the prevalence of Bacterial vaginosis in women attending Benha University Hospital, family planning and antenatal care clinics, and to assess the diagnostic value of different methods. This study was carried out on 500 asymptomatic women in their reproductive age, from September 2007 to September 2008. They were divided into two groups: [Group A] included 250 pregnant women coming for antenatal care. [Group B] included 250 non pregnant women seeking contraception. Bacterial vaginosis was reported in 40.4% of cases in group A [101 out 250 cases], and in 36% of cases in group B [90 out of 250 cases]. A vaginal PH > 4.5 was the most sensitive [100% in both groups], while presence of clue cells in gram stained smear was the most specific clinical criteria [100% in both groups]. Clinical observation of the vaginal disgorge was both the least sensitive and the least specific clinical criterion in group A [94.1% and 83.2% respectively], and in group B [88.8% and 87.5% respectively]. The most important organisms in B.V are gardnerella vaginosis and areaplasma urealyticum. It is concluded, that the amine and clue cells in wet mount are the most sensitive and specific criteria among 4 Amsel criteria. Also, the microscopic examination of Gramstained vaginal smears should be considered the gold standard for the diagnosis of bacterial vaginosis because the clinical signs are subjective and affected by many factors not related to infection. However, still the 4 clinical criteria are excellent tools for guiding the diagnosis of B.V

validated clinical practice guideline for community health nurse working in tuberculosis out-patient clinics

Tuberculosis is a major contributor to disease burden in developing countries; it is considered the second fatal disease all over the world and the third most important public health problem in Egypt. The direct causes of increasing the burden of tuberculosis are the inconsistent and fragmented health services, The nursing interventions of tuberculosis in community settings require system of recommendation that ensures the consistency of care. The present study aimed at providing a valid clinical guideline that assist nurses to intervene consistently to the newly diagnosed pulmonary tuberculosis patient. The needs analysis of community health nurses working in out patient chest clinics in addition to the expectation of newly diagnosed pulmonary tuberculosis patient regarding nursing interventions. The guideline development process established according to the criteria of experts of guideline development organizations. The Scottish Intercollegiate Guidelines Network [Sign] research appraisal tools were used for the critical appraisal phase of the obtained evidence. AGREE instrument was used for assessing the internal validity of the guideline. The guideline and apprised for internal validity by academic nursing and medical staff, nursing, and medical practitioners. The scores of all appraisers in relation to scope and Purpose, stakeholder involvement, rigour of development ranged from [62.9-77.7%, 53.5-77.7%, and 66.6-76.2%], respectively. While the scores for the clarity and presentation were 50-76.4, applicability were 61.9-68.5, and editorial independence were 88-93. The four groups of revision strongly recommended the application of the guideline

new anti-rheumatic drug leflunomide [Avara] and the associated risk of pulmonary toxicity: a histological study on the alveoli of albino rats

Leflunomide [Avara] is a novel drug for the treatment of active rheumatoid arthritis. The controversy about the associated risk of respiratory infection in patients treated with leflunomide was the main drive for the present study. The present study aimed to demonstrate the histological changes that might occur in the alveolar structure of the lung in rats treated with leflunomide for 4 weeks and to investigate the effect of stoppage of drug administration for another 2 weeks. The present work was conducted on 30 adult male albino rats which were divided into 3 equal groups; group I [control group], group II [leflunomide treated group] which received leflunomide in an oral dose of 10mg/kg for 4 weeks. Group III [withdrawal group] the rats received the leflunomide treatment in a similar way to group II, then they were kept without treatment for another 2 weeks to test for possible spontaneous recovery. By the end of the experimental period, the animals were sacrificed and specimens from the lungs were taken, processed and examined by light and transmission electron microscopes. Examination of leflunomide treated group revealed marked alteration in the histological structure, as many alveoli appeared collapsed with evident thickening of the inter-alveolar septa which showed cellular infiltration and congested blood capillaries. Some red blood cells were seen extravasated in the alveolar spaces. Hyperplasia ofpneumocyte type II which appeared with empty lamellar bodies and pyknotic nuclei were depicted. Stoppage of drug administration for 2 weeks after treatment, did not succeed in restoration of the normal histological structure of the alveoli. On the contrary, severe cellular infiltration of the inter-alveolar septa were observed in the withdrawal group. The alveolar air spaces were seen obliterated surrounded with many pneumocytes type II which showed morphological changes including enlarged cells with swollen mitochondria. Plasma cells, lymphocytes, eosinophils, many degenerated ill-defined cells, multiple fibroblasts and excess collagen were seen. Trichrome stain also revealed excess collagen deposition in both leflunomide treated group and in the withdrawal group. The present results revealed that leflunomide induced lung toxicity with evident histological changes in the alveoli which mimicked that of interstitial pneumonitis. On the other hand, discontinuation of the drug for another 2 weeks did not succeed in spontaneous recovery or amelioration of these changes, most probably through its pharmacokinetics as regards the long half life of elimination of the drug and the increased risk of opportunistic infection

Assessment of nurses' knowledge and attitude toward infection standards precautions in primary health care settings

Standards precautions are designed to protect staff from risks resulting from exposure to blood and body fluids and to protect patients from potential cross infection. Knowledge of clinical infection control practices is continually growing and changing. The present study was conducted to assess nurses' Knowledge about Infection control standards precautions in primary health care settings. This study was cross sectional study that was conducted in six primary health care settings [PHC] in Manzala District affiliated to the Ministry of Health and Population. PHC settings were selected by stratified random sample method. 79 nurses were included in the study. Data were collected by using open ended questions sheet, which was self-administered. The nurses showed a poor level of knowledge regarding most categories of standard precautions. Mandatory regular base educational program must be planned to overcome the weak level of knowledge and improve and update the nursing performance regarding standard precautions

Histological And ultrastructural study on the effect of on the submandibular salivary gland and the role of transforming growth factor-alfa [in albine rats]

Tartrazine is a food colouring additive commonly used in Egyptian food industry. This study was done on 15 male albino rats divided into two groups. A control group and a study group. Rats of the study group were given a daily oral dose of tartrazine for 14 weeks. The study was done to investigate the effect of tartrazine on the structure of the submandibular salivary gland, by using light and electron microscopes. The results revealed ill formed vaculated and ruptured salivary acini together with abnormal salivary duct system in serous and mucous acini multicellular demilunes were seen. UItrastructur results showed close faced heterochromatic nuclei surrounded by irregular indistinct, nucleus envelop together with less folding and loss of cellular boundaries mitochondria and rough endoplasmic reticulum were decreased, TGFa activity was weak in the study group compared to their controls. This study recommended to limit the use of colouring food additives and to be used under control

Effect of panax ginseng on the activity of cholinesterase in different tissues of experimentally-induced diabetes in rats

In the present study cholinesterase [ChE] activity in seven brain regions [cerebral cortex, thalamus, hypothalamus, midbrain, cerebellum, pons and medulla oblongata], heart, liver and serum of adult male albino rats were determined following diabetes induction by a single subcutaneous injection of alloxan monohydrate [120 mg/kg body weight], oral administration of Panax ginseng extract [100 mg/kg body weight] for 12 consecutive days and the coadministration of both treatments. The enzyme activity was estimated after 2, 4, 8 and 12 days of alloxan and or Panax ginseng administration. Concomitant variation in blood glucose level and body weight of treated rats were also recorded. The results showed that injection of alloxan provoked a highly significant rise in blood glucose level coupled with failure of the treated animals to gain weight. Moreover, diabetes induction resulted in a general increase in ChE activity in most of the brain region studied. The increase was most prominent in the cerebral cortex while the cerebellum and pons were the less affected regions. This effect may be attributed to differences in the regulation of acetylcholine metabolism in these regions. In heart of diabetic rats, ChE activity exhibited a significant decrease after 12 days, however in the liver a significant increase was noticed after 4 days. Serum ChE was highly significantly elevated after 4 and 12 days. Administration of ginseng alone or following alloxan injection was associated with an elevation in ChE activity in the cerebral cortex and thalamus. Meanwhile, a reduction in the enzyme activity appeared in the midbrain, cerebellum, and pons of ginseng treated rats and to a lesser extent in the cerebellum and pons of rats treated with both alloxan and ginseng. In the heart tissue, administration of ginseng was characterized by an elevation in ChE activity, while combined treatment with alloxan and ginseng extract induced nonsignificant changes. Serum and liver ChE was markedly reduced in the ginseng treated rats and tended to be normalized in rats coadministered alloxan and ginseng thus showing an ameliorative effect of ginseng. It can be suggested that ginseng may possess a significant anti-hyperglycemic effect and may prove to be beneficial in improving the management of diabetes. Besides, it may have selective positive effect on the cholinergic system

Choline acetyltransferase activity in selected rat tissues following experimental diabetes and treatment with panax ginseng extract

The activity of the acetylcholine synthesizing enzyme, choline acetyltransferase [ChAT] in seven brain regions, heart, liver and serum of adult male albino rat was determined following diabetes induction by a single subcutaneous injection of alloxan monohydrafe, oral administration of Panax ginseng extract for 12 consecutive days and the co-administration of both treatments. The changes in the enzyme activity of the selected tissues were estimated after 2, 4, 8 and 12 days of alloxan and/or Panax ginseng administration. The induction of diabetes was associated with a marked increase in the ChAT of the hypothalamus, midbrain and cerebellum at all the time intervals examined, a less pronounced increase in the cerebral cortex and thalamus and a decrease in pons and medulla, A tendency towards a decreased ChAT activity in the heart, significant fluctuations in liver and nonsignificant changes in serum were also noticed. However, administration of ginseng extract alone or following alloxan injection revealed enhanced ChAT activities in the different brain regions and nonsignificant decreases in liver and serum. It was concluded that the changes in the ChAT activity and the consequent alteration in the concentration of the cholinergic ncurotransmitter may be the mechanism by which the organism copes with the crisis of hyperglycemia and that ginseng extract may have beneficial effects at improving cholinergic function beside organ-protective functions

Health complaints associated with prolonged computer use as perceived by computer users

Computers have become ubiquitous in the office work place and their use is growing. They have many advantages for inventory management, record management, electronic communication and office automation. Computerized jobs are more sedentary; require more cognitive processing, mental attention and less physical expenditure of energy. Man y jobs that require heavy daily computer use have been found to be stressful. The length of working in front of video display units [ VDT] may be a direct cause of reported health complaints among computer users. This study is conducted to relate the duration of exposure to health effects resulting from computer use. The present study was carried out in different computer workstations at Alexandria and Mansoura cities. These work Stations were chosen from technical schools and private computer offices. The study included 600 computer users [271 from technical schools and 329 from private computer offices]. A structured questionnaire sheet was developed and used to assess the personal data of participants, appropriateness of workstation environment, and ergonomic criteria of computer station in addition to health complaints of the studied computer users. The results indicate that the majority of the studied population complained of musculoskeletal and eye discomforts

Prevalence of lymphotropic virues among patients with lymphoproliferative disorders

The involvement of viruses in the pathogenesis of malignancies is one of the major fields of research. The lymphotropic: Epstein-Barr virus [EBV], Human Herpes virus-6 [HHV-6], and Human T-Lymphoma/Leukemia virus [HTLV-1] have some roles in the pathogenesis of diverse types of neoplasms. The human CD4+ T-lymphocytes and monocytes are the major targets for Human immunodeficiency virus type 1[HIV-1]. One of the most important clinical finding in AIDS patients is lymph node enlargement. In this study we evaluated the association between diverse pathological and etiological types of lymph node enlargements including nasopharvugeal carcinoma [NPC], and lymphotropic viruses as a lymphotropic virus-associated disorder. The presence of [EBV] / [HHV-6] and [HTLV-1], which are the most common lymphotropic viruses and may act as co-factors with HIV-1 infection, was also investigated. The lymphoproliferative disorders included: Non Hodgkin's lymphoma, Hodgkin's disease, Tuberculous Lymphadenitis, lymphatic reactive hyperplasia, and diverse types of non specific lymphadenitis. Enzyme immunoassays, for detection of antibodies to HIV-1, and HTLV-1 were used, while the indirect immunofluorescence assay was used to screen for antibody to EBV and HHV-6 in sera, western blot [WB] was used for HIV- results 1 and HTLV-1 confirmation. Results indicated that 0/133 patients with NEC or lymph node enlargement whether malignant or reactive was HIV-1 positive; 31/133 [36%] were EBV IgG viral capsid antigen positive by IFA, 26/133 [19.5%] were HTLV-1 positive by ELISA; one case only [0.75%] was confirmed by WB; 46/133 [34.5%,] were HHV-6 positive by IFA

Human cytomegalovirus immunoglobulin-G and immunoglobulin-M as serologic markers for human cytomegalovirus infection in immunocompromised children

Determination and estimation of levels of cytomegalovirus [immunoglobulin-G [IgG] and cytomegalovirus immunoglobulin-M [IgM]] in immunocompromised children suffering from leukemias and lymphomas will be of help in controlling the spread of infection of this virus among the community. One hundred and four children [74 immunocompromised patients and 30 control children] were enrolled in this study. Patients and control children were between 1-15 years old with a mean age of 8.6081 years [ +/- 3.9249 SD] and 7.5500 years [ +/- 3.3650 SD], respectively. All patients and controls were subjected to full history taking, complete blood picture, liver function tests and CMV markers [IgG and IgM] by ELISA technique. The results of this study concluded that immunocompromised children, especially those taking blood transfusion, are more liable to have CMV infection. The present study showed that, ELISA technique is highly sensitive method, easily to perform, reliable, not time consuming [takes only few hours] and simple in its interpretation

Staff nurses' perception of job empowerment and organizational commitment at Assiut Health Insurance Hospital [El-Mabarrah]

This study was conducted in an attempt to explore the relationship between the staff nurses [100] perceived job empowerment and their commitment to the organization based on Kanter's structural theory of the organizational behavior. Data were collected from Assiut Health Insurance Hospital [El-Mabarrah] using the demographic data sheet, organizational description opinionaire [ODO], organizational commitment questionnaire [OCQ] and a modified version of the condition of work effectiveness questionnaire [CWEQ]. The results revealed a strong positive relationship between the nurses' perception of access to the opportunities and their commitment to the organization. In addition, the overall empowerment was correlated positively with the nurses' perception of their immediate manager's power