Downstream processing of mosquitocidal toxins from solid state fermentation of Lysinibacillus sphaericus and Bacillus thuringiensis israelensis

Aims: The aim of this study was downstream processing of moquitocidal toxins produced by Lysinibacillus sphaericus (L. sphaericus) and Bacillus thuringiensis israelensis (Bti) under solid state fermentation. Methodology and results: Two mosquitocidal strains (L. sphaericus and Bti) were grown separately in trays under solid state fermentation for toxin production. The best conditions for extraction of crude toxins from fermented solids of both cultures were tap water at 5-50 °C, for 10 min under static conditions. Also, concentrated mosquitocidal toxins were efficiently extracted from fermented solids by 4 constitutive additions of 500 mL tap water to 1 kg of fermented culture at room temperature (25 °C) for 5 min each under static conditions. Both extracted toxins were formulated with talcum powder and they were stable for 8 months at room temperature. Conclusion, significance and impact of study: It is very important to study the operating conditions for mosquitocidal toxins extraction from solid state fermentation (SSF) and its formulation in cost effective manner.

Bioactive Betulin produced by marine Paecilomyces WE3-F.

Objective: Marine fungi play an important role in human and animal health, leading compounds to new drug discoveries and prospects for their bioactivity potential. Materials and Methods: Paecilomyces WE3-F was isolated from marine sediment (Red Sea, Shalateen, Egypt). Fungal isolate was screened for their antagonistic activity against four Gram-positive (Bacillus cereus, Lesteria monocytogenes, Micrococcus luteus and Staphylococcu aureus) and four Gram-negative (Aeromonas hydrophila, Flavobacteruim sp, Pseudomonas aeruginosa and Vibrio cholera,) pathogenic bacteria. Paecilomyces WE3-F was identified using 18S rRNA technology. Seven factors were chosen to be screened for bioactivity using the Placket Burman experimental design: sucrose, yeast extract, Na NO3, temperature, initial pH, inoculum size, and incubation period. Results: Among conditional factors, acidic pH and 1.5 ml inoculum size favored the bioactive metabolites. Furthermore, a number of solvents have been experimented for the extraction of the bioactive metabolite(s). Dichloromethane (DCM) crude extract from the fermentation broth of a marine Paecilomyces WE3-F showed the highest activity with averages of 26 and 24 mm against G-ve and G+ve, respectively. Under optimal culture conditions, the maximum extractable compound concentration in a 10-L culture medium reached 83.4 mg/L. Based on data obtained by thin layer chromatogram (TLC), gas chromatography - mass spectrum (GC-MS) and Fourier Transform Infrared (FTIR) the major compound, betulin was structurally identified. Conclusions: The isolated marine Paecilomyces WE3-F, therefore, showed the ability to produce a betulin yield after optimal operating conditions for antibacterial potential.

Sildenafil reduces ischemia/reperfusion testicular injury after torsion/detorsion in rats.

This study was conducted to investigate the protective effects of sildenafil citrate on testicular injury after testis torsion/detorsion (T/D) in rats. Forty adult male Wistar rats were randomly allocated into four equal groups of ten rats each. Group 1 (Sham-operated); Group 2 (torsion for 2 hours and detorsion for 2 hours); Group 3, (torsion for 2 hours, sildenafil injection and detorsion for 2 hours), and Group 4 (sildenafil injection, torsion for 2 hours and detorsion for 2 hours).The levels of lipid peroxidation (P<0.001) and nitric oxide (P < 0.01) were significantly increased in in the testis of group 2 rats. Testicular reduced glutathione and serum inhibin B levels were decreased significantly (P<0.001) after T/D. Administration of sildenafil either before or after torsion prevented the increase in lipid peroxidation and nitric oxide, and alleviated glutathione and inhibin B levels. Sildenafil also prevented ischemia/reperfusion cellular damage and histological alterations in testicular tissue. These results suggest that treatment with sildenafil citrate 2 hours before or after torsion could induce protective effects against ischemia/reperfusion injury.

lsolation and characterization of marine-derived actinomycetes with cytotoxic activity from the Red Sea coast

Objective: To isolate and evaluate the cytotoxic activity of different actinomycetes species isolated from the Red Sea coast in Sharm el-Sheikh, Egypt. Methods: Forty actinomycetes strains were isolated from different sediments and seawater samples collected from the Red Sea coast in Egypt. Actinomycetes were recognized by morphological and microscopic examinations. Cell viability and cyto-toxicity induced by the crude extracts on breast cancer cell lines MDA-MB-231 were assessed using methylene blue assay. The strains with promising cytotoxic activity were identified by sequencing and amplifying the 16S rRNA genes. The antibacterial activities of the crude extracts were performed using Kirby-Bauer disc diffusion method. Results: The results indicated that five ethyl acetate extracts exhibited cytotoxicity to-wards breast cancer cell lines MDA-MB-231. The highest cytotoxic activity was found for the ethyl acetate extracts of EGY2 and EGY39. The isolate EGY3 was identified as a new Streptomyces species, while the actinomycete EGY22 was found to be a member of the genus Nocardiopsis sp. The crude extract of the isolate EGY8 showed slightly high antimicrobial activity against different test microorganisms. Conclusions: The results of the present study reveal that marine sediments of the Red Sea are a potent source of novel species of actinomycetes. The isolates may be useful in discovery of novel bioactive compounds and an important step in the development of microbial natural product research.

Resultados do uso de stents de nitinol superflexíveis na artéria femoral superficial / Outcomes after implantation of superflexible nitinol stents in the superficial femoral artery

As intervenções endovasculares na artéria femoral superficial para o tratamento da doença arterial oclusiva periférica têm crescido nas últimas décadas. A primeira e a segunda geração de stents na artériafemoral superficial falharam em demonstrar a melhora da perviedade do vaso tratado, devido às altas taxas defratura. O objetivo deste estudo foi avaliar os desfechos clínicos no curto prazo com o uso de stents de nitinolsuperflexíveis de terceira geração no tratamento de lesões ateroscleróticas na artéria femoral superficial. Métodos: Trata-se de um estudo retrospectivo, realizado em único centro, no período de junho de 2013 a maio de 2014. Um total de 27 pacientes foi submetido à angioplastia com stents de nitinol superflexíveis de terceira geração em lesões ateroscleróticas da arterial femoral superficial. Resultados: A média de idades foi de 68 ± 12 anos, 55,6% eram do sexo feminino e 74,1%, diabéticos. Os pacientes foram classificados em TASC B e C em 77,7% dos casos. O sucesso técnico foi de 100%. Houve aumento do índice tornozelo-braquial de 0,35 ± 0,1 pré-intervenção para 0,75 ± 0,2 na alta hospitalar. O seguimento médio dos pacientes foi de 6,7 ± 2,3 meses. A taxa de patência primária foi de 96,3%. A taxa de salvamento de membro foi de 100%. Não ocorreram fraturas de stent documentadas por raios X. Conclusões: A angioplastia com uso de stent de nitinol superflexível de terceira geração demonstrou ser efetiva no tratamento das lesões ateroscleróricas da artéria femoral superficial...

Endovascular interventions in the superficial femoral artery for the treatment of peripheral arterial occlusive disease have increased over the last decades. The first- and second-generation stents in the superficial femoral artery have failed to demonstrate improved patency of the treated vessel due to high fracture rates. The aim of this study was to evaluate the clinical, short-term outcomes of using third-generation superflexible nitinol stents in the treatment of atherosclerotic lesions in the superficial femoral artery. Methods: This was a retrospective study carried out in a single center, from June 2013 to May 2014. A total of 27 patients underwent angioplasty with third-generation superflexible nitinol stents in atherosclerotic lesions of the superficial femoral artery. Results: The mean age was 68 ± 12 years, 55.6% were females, and 74.1% were diabetics. Patients were classified as TASC B and C in 77.7% of cases. Technical success was 100%. There was an increase in the anklebrachial index from 0.35 ± 0.1 before the intervention to 0.75 ± 0.2 at hospital discharge. The mean followupof patients was 6.7 ± 2.3 months. The primary patency rate was 96.3%. The limb salvage rate was 100%. There were no stent fractures documented by X-rays. Conclusions: Angioplasty with third-generation superflexible nitinol stent placement was shown to beeffective in the treatment of atherosclerotic lesions of the superficial femoral artery...

Doppler ecografia das artérias carótidas: critérios de velocidade validados pela arteriografia / Doppler Ultrasonography of Carotid Arteries: Velocity Criteria Validated by Arteriography

Introdução: Doppler Ecografia (DE) é largamente utilizada no diagnóstico das estenoses carotídeas. Em 2003, a Sociedade Americana de Radiologia divulgou um consenso propondo critérios para graduação das estenoses da Artéria Carótida Interna (ACI). Em 2009, um grupo do Reino Unido apresentou recomendações para realização da DE das artérias carótidas.Objetivo: Avaliar a acurácia dos critérios velocimétricos utilizados na graduação das estenoses da artéria carótidainterna por Doppler Ecografia comparados à arteriografia.Métodos: Em 73 pacientes (146 ACI), foram avaliados: Pico de Velocidade Sistólica (PVS), Velocidade DiastólicaFinal (VDF) da ACI e razão PVS ACI/Artéria Carótida Comum (ACC), para detecção de estenoses < 50%, 50% - 69% (PVS: 125 - 230 cm/s), 70% - 99% (PVS > 230 cm/s). A correlação entre DE e arteriografia foi feita pelo método de Spearman e p < 0,05 considerado estatisticamente significativo. Resultados: A idade média dos pacientes foi 69 anos, 47 (64%) homens, 27 (37%) com acidente vascular encefálico, e 13 (18%)ataque isquêmico transitório. O melhor critério para estenoses de 50% - 69% foi PVS ACI ≥ 141 cm/s (sensibilidade: 94%, especificidade: 90%, acurácia: 93%) (AUC 0,97). Para estenoses entre 70% ‑ 99%, PVS ACI ≥ 176 cm/s mostrou sensibilidade: 92%; especificidade: 87%; acurácia: 90%; PVS ACI ≥ 230 cm/s teve sensibilidade: 89%; especificidade: 89%; acurácia:89% (AUC 0,96); e a razão PVS ACI/ACC≥ 4,0 teve sensibilidade: 70%; especificidade: 100%; e acurácia: 81% (AUC 0,96). Seis oclusões de ACI foram detectadas à DE e arteriografia. A correlação DE e arteriografia foi: PVS (0,81 – p < 0,001); VDF (0,78 – p < 0,001) e razão PVS ACI/ACC (0,81 – p < 0,001). Conclusões: Doppler Ecografia é um método confiável na detecção das estenoses carotídeas, correlacionando-se bem com a arteriografia, sendo importante validar os critérios DE que melhor se aplicam a cada serviço.

Introduction: The Doppler Ultrasonography (DU) is largely used to diagnose carotid stenoses. In 2003, the American Society of Radiology issued a consensus establishing criteria for gradating the stenoses of the Internal Carotid Artery (ICA). In 2009, a group in the United Kingdom presented recommendations for performing DU of carotid arteries. Objective: Evaluating the accuracy of the velocimetric criteria used to gradate internal carotid artery stenoses by Doppler Ultrasonographycompared to arteriography. Methods: We evaluated 73 patients (146 ICA): Peak Systolic Velocity (PSV), End-Diastolic Velocity (EDV) of ICA and the ICA/Common Carotid Artery (CCA) PSV ratio to detect stenoses < 50%, 50% - 69% (PSV: 125-230 (cm/s), 70% - 99% (PSV > 230 (cm/s). The correlation between DU and arteriography was ascertained with the Spearman’s method and p < 0.05 deemed statistically significant.Results: The patients’ average age was 69 years, 47 (64%) men, 27 (37%) with cerebrovascular accident, and 13 (18%), transient ischemic attack.The best criterion for stenoses of 50% - 69% was ICA PSV ≥ 141 cm/s (sensitivity: 94%, specificity: 90%, accuracy: 93%) (AUC 0.97). For stenoses between 70% - 99%, ICA PSV ≥ 176 cm/s presented sensitivity: 92%; specificity: 87%; accuracy: 90%; ICA PSV ≥ 230 cm/s presented sensitivity:89%; specificity: 89%; accuracy: 89% (AUC 0.96); and ICA/CCA PSV ratio ≥ 4.0 presented sensitivity: 70%; specificity: 100%; and accuracy:81% (AUC 0.96). Six ICA occlusions were detected by DU and arteriography. The DU and arteriography correlation was: PSV (0.81 – p < 0.001);EDV (0.78 – p < 0.001) and ICA/CCA PSV ratio (0.81 – p < 0.001).Conclusions: The Doppler Ultrasonography is a reliable method for detecting carotid stenoses, having a good correlation with arteriography.In this respect, validating the DU criteria which better suit each service is important.

Tratamento endovascular dos aneurismas de artéria poplítea / Endovascular treatment of popliteal artery aneurysms

Introdução: Com os recentes avanços nas técnicas endovasculares e com o surgimento de endopróteses mais flexíveis, o tratamento das lesões aneurismáticas da artéria poplítea tem se tornado mais frequente. O objetivo desse estudo foi avaliar os desfechos clínicos a curto e médio prazos do tratamento de lesões aneurismáticas da artéria poplítea com o uso de endopróteses flexíveis. Métodos: Estudo retrospectivo, longitudinal, realizado em dois centros, no período de janeiro de 2011 a fevereiro de 2014. Foram avaliados características populacionais, dados do procedimento e imagens radiológicas no seguimento médio de 1 ano, sendo obtidas as taxas de morbimortalidade, complicações e perviedade da endoprótese. Resultados: Treze pacientes do sexo masculino, com idade de 66 ± 9 anos, foram submetidos ao tratamento de aneurismas de artéria poplítea em 15 membros. Na avaliação do leito de deságue, a maior parte dos pacientes possuía pelo menos duas artérias da perna pérvias (92,3%). O implante do stent ocorreu no segmento médio em 57,1% e, no segmento distal da artéria poplítea, em 42,9% dos procedimentos. Foi possível realizar a revascularização da lesão-alvo em todos os casos, sendo que, em quatro membros, foi necessário o uso de dois stents. Foram utilizados 17 stents Viabahn® e 2 stents Multilayer®. Durante o seguimento de 12 meses, não ocorreram fraturas de stents. A taxa de perviedade primária foi de 53,3% e a de salvamento de membro de 100%. Conclusões: O tratamento endovascular do aneurisma de artéria poplítea demonstrou ser eficaz no seguimento de médio prazo...

Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen ViabahnTM and two MultilayerTM stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up...

Resultados do Uso de Stent de Nitinol Superflexível em Artérias Poplíteas / Outcomes of the Use of a Superflexible Nitinol Stent in the Popliteal Artery

Introdução: As taxas de patência primária no longo prazo para a angioplastia transluminal percutânea, com implante de stents de primeira e segunda gerações, no tratamento da artéria poplítea, têm sido desapontadoras. No entanto, resultados com novos stents de nitinol parecem promissores. Nosso objetivo foi avaliar desfechos clínicos no curto prazo do uso de stents de nitinol superflexíveis no tratamento de lesões ateroscleróticas nos segmentos poplíteos. Métodos: Estudo retrospectivo, longitudinal, realizado no período de abril a dezembro de 2013. Foram avaliados as características populacionais, os dados do procedimento e os exames de imagem aos 6 meses, sendo obtidas as taxas de patência do stent e de salvamento de membro. Resultados: Incluímos, nesta análise, 14 pacientes, com idade de 73 ± 11 anos, 50% do sexo masculino e 64,3% diabéticos. Todos os pacientes apresentavam lesão trófica nos membros tratados. As lesões arteriográficas foram classificadas pelo critério Trans-Atlantic Inter-Society Consensus (TASC) em B e C em igual proporção. Na avaliação do leito de escoamento, 78,6% dos pacientes possuíam apenas uma artéria pérvia, sendo a artéria fibular a mais frequentemente observada. As zonas de aterrissagem dos stents foram o segmento médio da artéria poplítea em 57,1% dos casos e, nos demais, o segmento distal da artéria, cruzando a articulação do joelho. Durante o seguimento de 6 meses, não foram observadas fraturas dos stents. A taxa de patência primária foi de 85,7% e a de salvamento do membro foi de 100%. Conclusões: A angioplastia com uso de stent de nitinol superflexível demonstrou ser segura e efetiva no tratamento das lesões ateroscleróticas da artéria poplítea...

Background: The long-term primary patency rates for percutaneous transluminal angioplasty using first and second generation stents for the treatment of the popliteal artery have been disappointing. However, results with the new nitinol stents seem promising. Our objective was to evaluate short-term clinical outcomes using the superflexible nitinol stent in the treatment of atherosclerotic lesions in popliteal segments. Methods: Retrospective longitudinal study conducted from April to December 2013. Population characteristics, procedure-related data and imaging tests were assessed at 6 months. Stent patency and limb salvage rates were obtained. Results: A total of 14 patients with mean age of 73 ± 11 years were included, of which 50% were male and 64.3% diabetic. All patients had trophic lesions in the treated limbs. The arteriographic lesions were classified according to the criteria of the Trans-Atlantic Inter-Society Consensus (TASC) criteria as TASC B and C inequal proportions. In the assessment of below-the-knee runoff, 78.6% of the patients had only one distal pervious artery, of which the fibular artery was the most frequently observed. The stent landing zone was the mid segment of the popliteal artery in 57.1% of the cases and the distal segment, crossing the knee joint, in the remaining patients. During the 6 month follow-up there were no stent fractures. The primary patency rate was 85.7% and the limb salvage rate was 100%. Conclusions: In our study, angioplasty using the super flexible nitinol stent demonstrated to be safe and effective for the treatment of atherosclerotic lesions of the popliteal artery...

Aneurisma venoso gigante de veia ilíaca externa secundário a fístula arteriovenosa traumática: relato de caso / Giant external-iliac-vein aneurysm secondary to traumatic arteriovenous fistula: a case report

Aneurismas venosos abdominais são raros. Os localizados nas veias ilíacas externas estão entre os mais infrequentes aneurismas venosos publicados na literatura. Relatamos o caso de um paciente jovem com aneurisma venoso gigante de veia ilíaca externa secundário a uma fístula arteriovenosa adquirida há 20 anos, tratado pelos métodos convencional e endovascular com sucesso.

Venous abdominal aneurysms are rare entities, especially at the external iliac vein. We report the case of a young male patient who presented with a giant external-iliac-vein aneurysm secondary to an arteriovenous fistula acquired 20 years earlier, and treated successfully by conventional and endovascular methods in our service.

Experiência inicial com o sistema de reversão de fluxo em pacientes submetidos a angioplastia carotídea / Initial experience with the flow reversal system in patients undergoing carotid angioplasty

Introdução: O tratamento endovascular da doença aterosclerótica carotídea vem evoluindo continuamente, embora possam ocorrer complicações embólicas ou isquêmicas, mesmo com o uso dos sistemas de proteção cerebral. Este estudo teve como objetivo avaliar os resultados de uma série inicial de pacientes que utilizaram o sistema de reversão de fluxo durante angioplastia carotídea. Métodos: Estudo prospectivo, não-randomizado, não-controlado, realizado em um único centro. Foram incluídos pacientes assintomáticos com lesão > 70% ou sintomáticos com lesão > 50% em artéria carótida interna. Foi utilizado o sistema de reversão de fluxo, com pré-dilatação em casos selecionados e uso de stents de células abertas em todos os casos. Avaliou-se a ocorrência de acidentes vasculares encefálicos (AVEs) maiores e menores, ataques isquêmicos transitórios (AITs), infarto agudo do miocárdio (IAM) e óbito até 30 dias pós-procedimento. Resultados: Entre setembro de 2010 e fevereiro de 2011 foram realizadas angioplastias carotídeas em 17 pacientes, a maioria do sexo masculino (70,6%), com médiade idade de 66,7 + 8 anos, sendo 17,6% diabéticos. Cerca de metade dos pacientes era sintomática, 5 pacientes tinham história de AVE prévio (29,4%) e 3, de AIT (17,7%) prévio. Sucesso técnico foi obtido em 100% dos casos. Houve um caso de óbito (5,9%), 24 horas após o procedimento, em paciente de alto risco cirúrgico tratado na fase evolutiva de IAM por apresentar AITs de repetição. Não ocorreram casos de AVE maior ou menor ou AIT durante o período de acompanhamento. Conclusões: Neste estudo, o sistema dereversão de fluxo mostrou ser eficiente e seguro em pacientes submetidos a angioplastia carotídea.

Background: The endovascular treatment of carotid atherosclerotic disease has continuously evolved, although ischemic or embolic complications may occur even with the use of cerebral protection systems. This study was aimed at evaluating the perioperative results of an initial series of patients using the flow reversal system during carotid angioplasty. Methods: This was a prospective, non-randomized, non-controlled, singlecenterstudy. Asymptomatic patients with lesions > 70% or symptomatic patients with lesions > 50% in the internal carotid artery were included. The flow reversal system was used with pre-dilation in selected cases and open-cell stents were used in all cases. We evaluated the occurrence of major and minor strokes, transient ischemic attacks (TIAs), acute myocardial infarction (AMI) and death within 30 days after the procedure. Results: Between September 2010 and February 2011 carotid angioplasty was performed in 17 patients, most of them male (70.6%), with mean age of 66.7 +8 years, of which 17.6% were diabetic. Approximately half of the patients were symptomatic, 5 patients had a prior history of stroke (29.4%) and 3 had TIA (17.7%). Technical success was achieved in 100% of the patients. There was one death (5.9%), 24 hours after the procedure in a high surgical risk patient treated in the evolution phase of an AMI due to repetitive TIAs. There were no cases of major or minor strokes or TIAs during the follow-up. Conclusions: In our study, the flow reversal system proved to be effective and safe in patients undergoing carotid angioplasty.

O impacto da cirurgia bariátrica na função endotelial, variáveis ecocardiográficas e perfil inflamatório / The impact of bariatric surgery on endothelial function, echocardiographic variables and inflammatory profile

A obesidade está relacionada ao risco aumentado de numerosas doenças, que podem levar à alteração da função endotelial, do perfil inflamatório e de aspectos estruturais do coração. O tratamento cirúrgico tem sido a única alternativa para muitos pacientes obesos...

Assessment of Existing Practices in the Operating Theatre in the Khartoum North Teaching Hospital; Sudan

This study; assessing existing practices in the operating theatre regarding hand washing; disinfection and sterilisation; was conducted at Khartoum North Teaching Hospital. As far as we know; this is the first study of its kind since the inauguration of the hospital in 1950. A total of 55 health personnel working in the operating theatre participated in the study. These included nurses and environmental service personnel (housekeepers and sterilisation and disinfection personnel). Knowledge and practice were evaluated using multiple choice and direct interview questions. Operation theatre sterilisation and disinfection practices were monitored using checklists modified from World Health Organization recommendations. A marked lack of knowledge and defective attitudes and practices were observed among a large number of personnel. It was observed that 51 of the nurses were 46 years of age or older and that two-thirds had only a primary and intermediate school level education. The study recommends the upgrading of the operating theatres and additional training and education of staff. Theatres should be provided with facilities for proper disinfection and waste disposal. Qualified nurses should be employed. We also recommend the establishment of an infection control committee. The role of the committee would include the planning and execution of hygiene policies. In addition; planning and organising training courses in infection control should be seen as a priority

Triphasic spiral CT imaging of hepato-cellular carcinoma in the cirrhotic liver

Hepatocellular carcinoma [HCC] is responsible for a large proportion of cancer deaths worldwide and derives its blood supply predominantly from the hepatic artery. The imaging modalities used in diagnosis of HCC include ultrasound [US], multiphase spiral CT [MsCT], magnetic resonance imaging [MRI], angiography, positron emission tomography [PET], and imaging-guided biopsy. The aim of this study was to clarify the role of triphasic spiral CT in evaluation of patients with hepatocellular carcinoma developed on top of cirrhosis. This study included 30 male patients with evident cirrhosis and suspected clinically and/ or by real time ultrasonography [US] to have hepatocellular carcinoma [HCC]. All of them were subjected to the followings: 1]-Full history taking and clinical examination.2]-Laboratory investigations including: hepatic function tests and serum alfa-feto-protein level. 3]-Real time ultrasonography of the liver [US]. 4]-Triphasic spiral CT of the liver [TsCT]. 5]-Finally, the results were confirmed by CT-guided biopsy in 15 cases, US-guided biopsy in 10 cases, and follow up in the remaining 5 cases. The mean age of the studied patients was 57 years. Their commonest clinical presentation was right upper quadrant abdominal pain. All of them showed elevated liver function tests and the alfa-feto-protein level was elevated in 73.3% of these cases. All of the detected lesions were solid and/or predominantly solid on real time US study and 20/30[66.7%] lesions showed non-homogenous echo texture pattern. Their outlines were ill-defined in 20/30[66.7%] lesions and halo sign was noted in 15/30[50%] lesions. The lesions commonly affected the medial segment of left hepatic lobe in 12/30[40%] cases. On triphasic spiral CT [TsCT], the mean size of the examined lesions was 7.1cm. 15/30[50%] lesions showed faint, non-homogenous enhancement, 10/30[33.3%] lesions showed intense, and homogenous enhancement and 5/30[16.7%] showed peripheral enhancement on the arterial phase. 66.7% and 83.3% of the studied lesions appeared isodense compared with the adjacent cirrhotic hepatic parenchymal tissue on both portal venous and delayed phases. Associated findings included splenomegaly in 66.7% of the cases, ascites was noted in 20% of the patients and portal vein thrombosis was seen in 13.3% of the cases. Real time US is the preliminary imaging modality for evaluation of patients with suspected HCC on top of cirrhosis, as it gives a good idea about the morphological characteristics of these lesions. In addition, US-guided needle biopsy is frequently required for their diagnosis. Triphasic spiral CT is valuable for further characterization of these lesions, determination of their vascular supply and guides their percutaneous biopsy

Incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death in Sudanese patients with acute myocardial infarction

Ventricular arrhythmias [VAS], including ventricular tachycardia [VT], ventricular fibrillation [VF] and Brady-arrhythmias, are life-threatening complications of acute myocardial infarction [MI]. To study the incidence of ventricular arrhythmias, brady-arrhythmias and Sudden Cardiac Death [SCD] in Sudanese patients with acute MI. This is a prospective cross sectional, hospital based study, conducted at Elshaab Teaching Hospital Khartoum Sudan. One Hundred Sudanese patients with acute MI were enrolled in the study in the period between August 2006 and December 2006. A questionnaire was constructed in sections to address the different aspect of the study group. ECG Monitor was used to confirm the complication in every patient. Of the study group forty seven [47%] patients were 55-65 years old, twenty eight [28%] were more than 65 years old and twenty five [25%] were less than 55 years old. Sixty nine [69%] were males. Twenty patients [20%] developed complications [ventricular arrhythmias [VAS], Brady-arrhythmias and SCD]. The incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death following acute myocardial infarction were significantly high in Sudanese patients. The increased incidence is even in all age groups. DM, smoking and past history of IHD are the commonest associated risk factors. Thrombolysis is under used and had no significant impact

effect of sesame seed oil on major immunoglobulins among young adult females

Folk medicine claims that sesame-seed oil has some medicinal properties and may improve the immune system functions. This study aimed to investigate the effect of sesame seeds oil on major immunoglobulin concentrations. A group of thirty healthy female students aged 20.7 +/- 0.47 yr were chosen from Minufiya University - Egypt, and classified into three groups; first group is control [CG]; second group fed sesame seed oil [SG]; and third group fed mixture of sesame seed oil and yogurt [SYG]. The trial continued for four consecutive months. The blood parameters including hemoglobin, RBC, PCV, WBC count, IgG, IgM, and IgE were determined at baseline and after dietary supplementation. The results showed that the majority of students were from moderate socioeconomic class, and their body weight was 66.4 +/- 8.0 kg and BMI was 22.9 +/- 2.8 kg/m2. The dietary supplementation resulted in decrement of hemoglobin, but the highest and significant [P<0.001] decrease was among SYG that decreased by -11.7%. The WBC count was also decreased among CG, SG, and SYG by -13.3, -19.8, -8.1% respectively. The dietary supplementation with sesame oil resulted in significant decrement [P<0.01] of lymphocytes by -14.3%, while the mixture of sesame oil and yoghurt increased it significantly [P<0.01] by 37.6%. Unfortunately, the sesame oil decreased IgG significantly [P<0.001] by -31.1%, whereas the mixture of sesame oil and yogurt decreased it by -34.1%. For IgM, the sesame oil decreased it significantly [P<0.01] by -16.0%. In conclusion, sesame seed oil decreased IgG and IgM that may impair the immune system response among normal people, while it may be valuable and healthful for some patients