Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study / Associação de polimorfismos do gene do receptor de vitamina D com diabetes mellitus tipo 2 na população Taif: um estudo de caso-controle

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Natural regulatory T cells increase significantly in pediatric patients with parasitic infections: Flow cytometry study

Background: The most accepted definition of regulatory T cells (Tregs) relies on the expression of several biomarkers, including CD4, CD25, and transcription factor, Foxp3. The Tregs maintain tolerance to self-antigens and prevent autoimmune diseases. Aim: The purpose of this study was to determine the difference in natural Treg levels in Entamoeba histolytica, Schistosoma mansoni, Giardia lamblia, Enterobius vermicularis, and Hymenolepis nana infected patients. Setting and Design: Fifty-one pediatric subjects (29 males and 22 females) were recruited from a tertiary care hospital, and were divided into infected and non-infected (control) groups. The mean age of the subjects was 8.7 years. Materials and Methods: Blood samples were collected from infected and non-infected groups, and change in the level of Tregs in these subjects was investigated by flow cytometry. Statistical Analysis Used: The statistical analysis of data was performed by SPSS software. Quantitative data used in this study included mean and standard deviation. Data from the two groups were compared by the Student's t-test. The age of the patient and infection status were used for multivariate logistic regression analysis. Odds ratios (ORs) were estimated within a 95% confidence interval, and a P value of <0.05 was considered significant. Results and Conclusions: The levels of natural regulatory T cells, indicated by the biomarkers, CD4+, CD25+, and Foxp3+, increase significantly in patients infected by Entamoeba histolytica, Schistosoma mansoni, Giardia lamblia, Enterobius vermicularis, and Hymenolepis nana as compared to controls. They also increase in cases of mixed infection as compared to infection by a single parasite.

Molecular detection of hepatitis E virus in feces and slurry from swine farms, Rio Grande do Sul, Southern Brazil / Detecção molecular do vírus da hepatite E em fezes e chorume de propriedades suinícolas, Rio Grande do Sul, Sul do Brasil

Hepatitis E virus (HEV) is highly disseminated among swine herds worldwide. HEV is also a threat to public health, since particularly genotypes 3 and 4 may cause acute hepatitis in human beings. No previous studies were done on the occurrence of HEV in environmental samples in Rio Grande do Sul, Brazil. In the present study, reverse transcriptase-polymerase chain reaction (RT-PCR) was employed to detect the presence of HEV in swine feces and in effluents from slurry lagoons in farms located in the municipality of Teutônia, inside the area of swine husbandry in the state. Pooled fecal samples from the floor of pig barns from 9 wean-to-finish farms and liquid manure samples were collected from the slurry lagoons from 8 of these farms. From the pooled fecal samples, 8/9 were positive for the HEV ORF1 gene by RT-PCR; all the slurry lagoon samples were positive for HEV RNA (100%). The identity of the HEV ORF1 amplicons was confirmed by sequencing belonging to HEV genotype 3, which was previously shown to be circulating in South America.

O vírus da hepatite E (HEV) é altamente disseminado entre rebanhos suínos no mundo todo. O HEV é também uma ameaça à saúde pública, já que os genótipos 3 e 4 podem causar hepatite aguda em seres humanos. Não há estudos anteriores sobre a ocorrência de HEV em amostras ambientais no Rio Grande do Sul. No presente estudo, empregou-se transcrição reversa e reação em cadeia da polimerase (RT-PCR) para detectar a presença de HEV em fezes de suínos e efluentes de lagoas de chorume em fazendas localizadas no município de Teutônia, representativo da região de maior produção de suínos no estado. Pools de amostras fecais foram coletadas a partir do chão de galpões de suínos provenientes de 9 propriedades de terminação; outra amostra de esterco líquido foi coletada das lagoas de chorume de 8 dessas fazendas. A partir das amostras fecais reunidas, 8/9 foram positivas para o gene ORF1 de HEV por PCR convencional; todas as amostras de lagoas de chorume foram positivas para RNA de HEV (100%). A identificação dos produtos de amplificação de HEV ORF1 foi confirmada por sequenciamento pertencente ao HEV genótipo 3, o qual foi previamente detectado na América do Sul.

Tegumental alterations of Fasciola gigantica due to in vitro treatment with Ro-354

Triclabendazole is the drug of choice against Fasciola infections in humans and animals. However, parasite resistance against triclabendazole is spreading in veterinary field, and there are no drugs of comparable activity currently available for the treatment and control of fascioliasis. The efficacy of a new rhodanine derivative Ro-354 against adult Fasciola gigantica in vitro was investigated. One hour post incubation, scanning and transmission electron microscopic examination revealed an evident disruption of the tegument of F. gigantica as blebbing, swelling and furrowing. Moreover, an increase in severity of tegumental damage as sloughing and absence of spines was observed. In conclusion, Ro-354 shows potent activity against F. gigantica in vitro, and, the authors recommend carrying out more studies to detect its efficacy in vivo.

Comparison of fentanyl, clonidine and tropisetron effect on agitation after sevoflurane anaesthesia in children

One hundered ASA physical status I and II children aged 3-6 years were included in this study. After inhalation induction with sevoflurane, patients were randomly assigned to receive either saline [group I, n=25], fentanyl 1 mic/kg IV [group II, n=25] or clondine 3 mic/kg IV [group III, n=25] tropisetron [0.1mg/kg] 10 minutes before discontinuation of anesthetics. There was no significant difference [p>0.05] between the four groups regarding time to eye opening, modified Aldrete recovery scores and post operative complication. The time of first postoperative analgesic dose was significantly shorter in group I compared with other three groups. The incidence of agitation was significantly higher in group I compared with other three groups, the incidence of agitation was 60% in Group I, 30% in Group II, 20% in Group Ill and 25% in Group IV. The dose of fentanyl 1 mic/kg iv or clonidine 3 mic/kg iv or tropisetron [0.1mg/kg]iv that is administered 10 minutes before the termination of anesthesia reduces the postoperative agitation in children with no adverse effects. There was no significant difference [p>0.05] between the four groups regarding age, weight, duration of surgery and discontinuation of anesthetics

effect of intraoperative use of esmolol and nicardipine on splanchnic perfusion in functional endoscopic sinus surgery

There are many techniques for reduction of mean arterial blood pressure [MAP] and heart rate [HR] during anesthesia. We designed this prospective, randomized, double-blinded study to test the effect of this technique for maintaining hemodynamic stability during general anesthesia and their influences on splanchnic perfusion. Sixty healthy consenting patients undergoing functional endoscopic sinus surgery [FESS] were randomly assigned to 1 of 3 treatment groups: Group I [control n = 20] received normal saline 5 mL and 1 mL, followed by a saline infusion at a rate of 0.005 mL kg[-1] min[1]; Group 2 [n = 20] received esmolol 50 mg and saline 1.mL, followed by an esmolol infusion 5 micro g kg[-1] min[-1]; and Group 3 [n = 20] received esmolol 50 mg and nicardipine 1 mg, followed by an esmolol infusion 5 micro g kg[-1] min[-1]. The study drugs were administered after the induction of anesthesia with fentanyl 1.5 micro g/kg, and propofol 2 mg/kg IV. Tracheal intubation was facilitated with vecuronium 0.12 mg/kg IV. Anesthesia was initially maintained with sevoflurane 2% end-tidal and N[2]O 50% In oxygen in all 3 groups. After induction of anesthesia a gastric tonometer [TRIP] NGS Catheter and a radial catheter were inserted. Baseline values of gastric intramucosal pH [pHi] were determined before induction of hypotension. The [pHi] values were calculated every 30 min until hypotension was discontinued .The CO2 -gap [i.e., the difference between arterial and gastric Pco2] was registered. Arterial blood lactate levels also were measured. During surgery, the mean arterial blood pressure [MAP] was maintained within +/- 15% of the baseline value by varying the study drug infusion rate and the inspired concentration of sevoflurane. In addition to MAP and heart-rate values, were recorded throughout the perioperative period. Recovery times and postoperative side effects were assessed. None of the [pHi] values calculated was less than 7.35 in the three studied groups. Arterial blood lactate levels did not increase in any of the patients. Compared with the control group, adjunctive use of esmolol and nicardipine attenuated the increase in heart rate [in Group 2] and MAP [in Group 3]. after tracheal intubation. Furthermore, the use of an esmolol infusion as an adjunct to sevoflurane to control the acute autonomic responses during the maintenance period significantly decreased emergence times [4 +/- 2 versus 7 +/- 4 min], decreased the need for postoperative opioid analgesics [35% versus 60%], and reduced the time before discharge [209 +/- 89 versus 269 +/- 100 min]. We conclude that the adjunctive use of esmolol alone or in combination with nicardipine during the induction of anesthesia reduced the hemodynamic response to tracheal intubation. It did not compromise splanchnic tissue oxygen balance in healthy patients nor increased blood lactate. Furthermore, use of an esmolol infusion as an adjuvant to sevoflurane- N[2] O anesthesia for controlling the acute hemodynamic responses during the maintenance period improved the recovery profile after functional endoscopic sinus surgery

Epidemiological Review of Human and Animal Fascioliasis in Egypt

One of the neglected food-borne-diseases in the international public health arena is fascioliasis. It is a serious infectious parasitic disease infecting humans and animals worldwide and tops all the zoonotic helminthes. Human cases are being increasingly reported from Europe; the Americas; Oceania; Africa and Asia. Hence; human fascioliasis is considered now as a zoonosis of major global and regional importance. In Egypt; animal and human fascioliasis is an endemic clinical and epidemiological health problem. Doubtless; understanding the epidemiology of the parasitic diseases and factors affecting their incidence provides the foundation upon which effective prevention and control programs should be established. This article reviews the history; life cycles; transmission; incidence; geographical distribution; and environmental and human determinants that contribute to the epidemiological picture of fascioliasis with special reference to Egypt

Elevation of liver enzymes after laparoscopic cholecystectomy versus open cholecystectomy

Laparoscopic cholecystectomy [LC] has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gall bladder diseases. However, it has been noticed that following LC, the serum level of certain liver enzymes rises markedly, in patients who had preoperatively normal liver enzyme value. We measured serum values of hepatic alcohol dehydrogenase [AD] and glutathione S-transferase [GST] alanine aminotransferase [ALT] and aspertase aminotransferase [AST], in 80 patients who underwent open cholecystectomy or laparoscopic cholecystectomy, they were divided randomly into two groups. Group 1[40 patients] underwent laparoscopic cholecystectomy [LC]. Group 11[40 patients] underwent open cholecystectomy [OC]. To assess the liver function, serum liver enzymes of AD, GST, ALT, and AST were measured before operations and at 1, 3, 7, and 10 days postoperative. Pre operative AD, GST, ALT, and AST were insignificantly different between the two groups. Twenty four hours after the procedure. AD, GST, ALT and AST increased significantly in the LC group [AD 8.1 +/- 2.2 U/L, GST 82.2 +/- 19.1 U/L, ALT 87.1 +/- 24.2 U/L, and AST 95.1 +/- 7.7 U/L but in [OC] group these enzymes were [AD 4.8 +/- 1.9 U/L, GST 35.3 +/- 3.9 U/L, ALT 27.8 +/- 11.9 U/L, and AST 5.3 +/- 0.9 U/L]. A further increase in serum AD, GST, ALT and AST value in LC group at the 3 [rd] day after the operation [AD 9.3 +/- 1.5 U/L, GST 103.5 +/- 21.6 U/L, ALT 99.3 +/- 19.4 U/L, and AST 120.9 +/- 10.4 U/L] but in [OC] group these enzymes were [AD 5.6 +/- 3.4 U/L, GST 47.9 +/- 1.4 U/L, ALT 38.6 +/- 3.4 U/L, and AST 17.9 +/- 1.4 U/L]. Slow return to normality occurred 7-10 days after the procedure in the LC group. Alterations in hepatic function occur after LC and appear to be clinically insignificant. These alterations in hepatic function return to normal levels within ten days. CO2 pneumoperitoneum seems to be the main reason for these changes but other factors may also contribute

Reconstruction of the knee extensor mechanism after wide excision of intramuscular hemangiomas affecting the quadriceps femoris muscles

The wide excision of intramuscular hemangioma, which affects the quadriceps femoris muscle, usually is followed by inefficient knee extension, and patellar instability. The surgeons with this problem in their minds sub-totally excised it, and this is usually followed by high recurrence rate. Five patients with large symptomatic intramuscular hemangioma affecting the quadriceps femoris muscles, constitute the material of this study from September 1996 to June 2001; in 2 of them the hemagioma were previously incompletely excised and recurred. Three patients were males and two were females. Their ages ranged from 6 to 24 with average 12.4 years. The right side was affected in 3 patients, while the left in 2 patients. The vastus medialis was affected in 3 patients and the lateralis in 2 patients. Wide excision with reconstruction of the extensor mechanism was done for every patient. The shortest follow up period was 3 years, and the longest was 8 years. The results obtained were excellent in all patients [100%], no good or poor cases [zero%]

Mineralization of 14C-carbofuran in soil under aerobic and anaerobic conditions

The mineralization of 14C-carbofuran in clay loam soil was determined during a three months laboratory incubation period under anaerobic and aerobic conditions. 14C-activity in solution was directly determined by liquid scintillation counting. Unextractable soil residues were determined by combustion. Evolution of 14CO2 increased with time and reached to 7.5% and 12.0% of the initial 14C-concentration, within 90 days in case of anaerobic and aerobic conditions, respectively. At that time, soil contained about 58% of the applied dose as extractable residues under anaerobic conditions and 59% under aerobic conditions. The unextractable pesticide residues were gradually increased with time and the highest binding capacity of about 5.3% and 13% in case of anaerobic and aerobic conditions, respectively were observed after 90 days of incubation. Chromatographic analysis of methanolic extracts revealed the presence of labelled carbofuran, carbofuran phenol and 3-hydroxycarbofuran as main products. Radiorespirometiy was used to evaluate the effect of carbofuran on soil microbial activity for 14 days. Both 3 and 9 mg carbofuran/kg soil depressed 14CO2 evolution from 14C-glucose and microbial activity was significantly inhibited especially in case of the high dose

Effect of experimental acute Ischemic renal injury on hepatoprotective parameters in rats

This study evaluated the effects of DHEA on the oxidant [malondialdehyde [MDA]] and antioxidant [superoxide dismutase [SOD], glutathione penoxidase [GPx], catalase [CAT], and glutathione [GSH] systems in liver after renal-ischemia reper fusion [IR] injury in rats. Thirty rats were randomly assigned to 3 groups of 10: group I [Sham operation], group II [renal IR group], and group III [DHEA, 25 mg/kg, sc, 15 min pre-ischemia]. Renal IR injury in group II caused a decrease of SOD [25%], GPx [36%] and CAT [26%] activities and GSH levels [32%] and increases of MDA [30%] in liver and of ALT and AST activities in serum, compared to group I. DHEA administration decreased the hepatic MDA level [19%] and serum ALT activity [30%] [P < 0.01 and P < 0.05, respectively], and considerably increased hepatic GSH levels and GPx activities [P < 0.01 for both] in group III, compared to group II. These results suggest that DHEA treatment has beneficial effects on antioxidant defenses against hepatic injury after renal IR in rats, possibly by augmenting GSH levels and lowering MDA production

Evaluation of subtotal splenectomy in the management of hereditary spherocytosis

To evaluate the clinical and hematological response to subtotal splenectomy in children with hereditary spherocytosis [HS]. The authors analyzed the main clinical and hematological features in 18 patients with HS treated by subtotal splenectomy. The average age at the time of operation was 4 years. The indications for subtotal oplenetomy were hypersplenism and severe anemia. The diagnosis of HS was made according to standard methods. The lower three fourth of the spleen were removed and the upper pole was preserved. The effect on hemolytic rate was assessed by comparing the presurgical and postsurgical values of hemoglobin, reticulocyte number and RBC life span. The residual splenic phagocytic function was assessed using technetium 99m scan and number of pitted red cells. The splenic regrowth were measured by ultrasonography. There were no complications related to the surgical procedure in any of the 18 children. The mean follow up period was 30 +/- 8 months. At the end of follow up hemoglobin increased on the average by 3 gm/dl, reticulocyte count decreased by 300x10[6]/L, and bilirubin level decreased. Normal technetium uptake was noted in the splenic remnant. Splenic regrowth were noted in 4 patients, two of them still need more than 2 transfusion/ year. No postoperative overwhelming infection occurred. Subtotal splenectomy can be performed without major blood loss in patients with HS. Up to 95% of the spleen can be safely removed. It is effective in decreasing the hemolytic rate while maintaining residual splenic function

Prevalence of tinea capitis among school children in Minoufiya governorate

Dermatophytes are a group of clsoely related keratinophilic fungi representing about well defined 40 strains placed under 3 species, Trichophyton, Epidermophyton and Microsporum. They are responsible for a group of diseases termed dermatophytoses. Of these, tinea capitis which is one of the most common infection in pediatric age. Its importance emerges from that it is highly contagious, so it is an important source of population suffering. This work aimed at determing the prevalence of tinea capitis in school children in Menoufiya Governorate, the causative organisms, the risk factors and methods of control. To achieve the purpose of this work, six schools were selected randomly in rural, semi urban and urban regions. Three schools were primary and three were preparatory. They were mixed for males and females. The age of the studied children ranged from six to thirteen years. The result of these work showed that tinea capitis is a relatively common infectious dermatological disease in our Governorate with a prevalence of 1.125%, with a male to female ratio of 5:1. it is more common among age group from 6 to 10 years than the age group from 11 to 13 years. T. mentagrophytes was the most prevalent organism below the age of 10 years, while M. audouinii was the most prevalent organism above the age of 10 years. T. soudanese were determined in black dot lesions. It is more common among rural school children than semi urban and urban schools. We concluded that Mycological culture is the best method for diagnosis of tinea capitis infection, mixed dermatophytic infection is rare due to lipids found in some dermatophytes and possess an antimycotic activity and isolation of new organism as T. soudanese may explain resistant cases for treatment

Intrathecal neostigmine versus intrathecal morphine, their combination for postoperative analgesia in patients undergoing herniorrhaphy

We designed this study to evaluate the postoperative analgesic efficacy and safety of intrathecal [IT] neostigmine, intrathecal [IT] morphine, and their combination in patients undergoing herniorrhaphy under spinal anesthesia. Eighty adult patients were randomly divided into four groups to receive isotonic sodium chloride solution 0.5 ml, neostigmine 100ug, morphine 0.3 mg or the combination of IT neostigmine 50 ug and morphine 0.15 mg with IT 0.5 0/0 hyperbaric bupivacaine 15 mg. There were no significant differences among the four groups with regard to spinal anesthesia, age, heart rate, or mean arterial blood pressure. Postoperative analegisa was provided by IM diclofenac. Compared with the saline group, the time to first use of analgesic was significantly longer in neostigmine group [p= 0.02], with lower 24 h analgesic consumption [p=0.001]. Nausea and vomiting were the most common side effects of IT neostigmine 60 0/0. Analgesic effectiveness was similar between the neostigmine and morphine groups. Compared with the neostigmine group, the combination group had significantly longer analgesic effects [P=0.02] with less incidence of nausea and vomiting [p=0.04]. Compared with the morphine group, the combination group tended to have prolonged times to first use of analgesic [p=0.02] with lower incidence of pruritus [p=0.03]. the combination of IT neostigmine 50 ug and IT morphine 0.15 mg produce longer postoperative analgesia with fewer side effects than IT neostigmine 100ug or IT morphine 0.3 mg alone. Intrathecal [IT] neostigmine 100ug produced postoperative analgesia for herniorraphy similar to [IT] morphine 0.3mg, but with high incidence of nausea and vomiting, morphine group had high incidence of pruritus. Thus, combination of both has higher analgesic effects with lower side effects than single drug alone

Splenectomy and extraperitoneal splenic slice grafting in the treatment of thalassemia

The risk of total splenectomy in children with thalassemia is septicemia and overwhelming infection. Splenectomy with splenic slice grafting is an alternative in patients with thalassemia. 16 transfusion-dependent, high risk thalassemic patients [10 boys and 6 girls] underwent splenectomy and splenic slice grafting by the same surgeon from March 1998 to September 2001 at Health Insurance Hospital for children [Abu-Elrish Pupil Hospital], and El Hussein University Hospital. The patients age ranged from 4 to 8 years. The need for splenectomy in these cases was determined by the increasing need for blood transfusions and hypersplenism. Follow-up was from 1 to 4 years. Pre-and postoperative blood transfusions, length of operation, postoperative complications, fate of the grafts and their immune status before and after operation were evaluated. The procedure had good advantages of splenectomy and immunoconservation. Functioning splenic slice grafting which is detected by immunological assay and normal radionuclide splenic scan. Postoperatively there were no systemic infections or overwhelming post splenectomy sepsis. There was no incidence of death or rejection of the grafts during the follow-up period in our series. Splenectomy with splenic slice grafting greatly reduces and in some cases eliminates, the need for blood transfusions

Study of urethral stricture in children after repair of hypospadias

The objective of this study was to evaluate the different modalities in the treatment of symptomatic urethral stricture after repair of hypospadias depending upon clinical picture and uroflowmetry. A total of 480 boys aged 12-72 months [mean 36 months] underwent surgical correction of hypospadias were included in this study. Symptomatic stricture rate was 6.25%, the presenting symptoms of urethral stricture was difficulty voiding [26.6%], weak stream [33.3%], fistula [10%], dysuria [10%], incidental [difficult catheterization] [6.6%], spraying [10%] and retention [3.3%]. 22 of 30 patients underwent initial attempts of urethral dilation, 14 patients were symptom free after dilation and eight patients required open urethroplasty. The study recommended routine uroflowmetry to monitor the functional status of the urethra after complex hypospadias repairs, so that strictures can be diagnosed at the earliest possible stage

Repair of common bile duct defects with stented autologus vein graft: an experiemental study

This experimental study was done to investigate the effectiveness of using an autologus vein graft and stent in the repair of large defects of the common bile duct [CBD] in a canine model. A 3-cm segment of the great saphenous vein and a 2 - cm segment of the [CBD] were removed from five healthy dogs with normal blood biochemistry levels. A stent was passed through the vein segment, and one end was introduced into the proximal end of the [CBD] while the other end was introduced into the distal end. The venous graft was then sutured to the [CBD]. A liver biopsy was taken for histopathological examination during laparotomy and relaparotomy. Blood samples were obtained on postoperative days 7,14 and 20 for biochemical examinations. The defect was effectively repaired by the autologus vein graft and stent in all the five dogs. No change in blood biochemistry was observed postoperatively, and no histopathological change in the liver was found in the preoperative or postoperative periods. These findings indicate that the use of an autologus vein graft and stent to repair [CBD] injuries could be a feasible and an alternative method of treatment

Study of antioxidants defense system, lipid pattern and left ventricular geometry in hypertensive patients

Free radical activity oxidative stress has been implicated in the pathogenesis of a variety of human diseases. In an attempt to define the role of oxidative stress, dyslipidemia and geometric changes in hypertensive patients [HT], we studied 44 patients, 20 [45.5%] Essential hypertensive [EH], 14 [31.8%] diabetic hypertensive [DH] and 10[22.7%] renal hypertensive [RH]. They were assessed by measurement of some free radicals and antioxidants, serum lipids and echocardiography, the data was compared with 10 age and sex matched normal subjects. There was a significant decrease in important natural antioxidant vitamins C, E, A and reduced glutathione [RG] and a significant increase in lipid peroxide level [LPO] in all groups of hypertensive patients as compared to control. The mean value of cholesterol [C] concentrations in all the hypertensive patients was significantly higher than in controls [P<0.001] Triglycerides [TG] were significantly higher in diabetic hypertensive patients in comparison to controls [P<0.001], HDL-C mean values were reduced significantly in [EH], [RH] groups. LDL-C mean values in all groups of hypertensive were significantly increased [P<0.01]. 38.6% of our patients had concentric left ventricular hypertrophy [CLVH], 13.6% had eccentric left ventricular hypertrophy [ELVH], 13.6% had concentric remodeling [CR] and 34% had normal geometry. We conclude that oxidative stress was observed in all groups of hypertensive patients and we recommend the use of antioxidants as an adjunct to antihypertensive therapy

role of hyperbaric oxygen in ventricular fibrillation in dogs

The protective effects of hyperbaric oxygen has been studied in 75 dogs. For the first time in experimental surgery the study is conducted in wakeful unanaesthesised dogs under control and hyperbaric conditions using our especially devised remote occlusion. Under hyperbaric oxygenation the early [1 hr.] and late [48 hrs] survivals have increased from 60 to 90% and from 30 to 80% respectively. The survival of dogs vulnerable to ventricular fibrillation, as assessed by test remote occlusion, after resuscitation has risen from 0 to 57%