impact of omega-3 polyunsaturated fatty acids supplementation on children with bronchial asthma

Objective: the present study was conducted to evaluate the impact of oral omega-3 supplementation on asthmatic children attending Alexandria University Children's Hospital [AUCH]

Subjects: the present study was carried out on 60 children with mild to moderate persistent asthma attending the Asthma Clinic at AUCH

Methods: a randomized controlled trial for 4 months during which subjects were divided equally into 2 groups: - Group [A]: received a daily dose of 1000 mg triglyceridic oil containing about 30% EPA/DHA in addition to their ordinary asthma treatment for 4 months. - Group [B]: received their ordinary asthma treatment only. During the 4 months study, children and their primary caregivers [usually a parent] attended the clinic on another 2 occasions [after 2 and 4 months]. At each visit the child completed the Asthma Control Questionnaire [ACQ] followed by spirometry to evaluate the effectiveness of the developed intervention

Results: the mean age of studied children was 8.19+/- 2.22 years and male children constituted 78.3% of the study sample. 60% of cases were living in urban areas. The positive family history was positive in 45% of the studied cases. There was a significant improvement of ACQ score of omega-3group at 2 and4 months after the study when compared to the start of the study, while there is no significant improvement in ACQ score of control group

Conclusion: the current study shows that supplementation of asthmatic children with omega3 significantly improved ACQ score

Molecular surveillance of Plasmodium Falciparum chloroquine resistance transporter variant T76 in Jazan area, Kingdom of Saudi Arabia

The development of chloroquine as an antimalarial drug and the subsequent evolution of drug resistant Plasmodium strains had major impacts on global public health in the 20th century. In P. falciparum, the cause of the most lethal human malaria, chloroquine resistance is linked to multiple mutations in PfCRT, a protein that likely functions as a transporter in the parasite's digestive vacuole membrane. Rapid diagnostic assays for PfCRT mutations are already employed as surveillance tools for drug resistance. However, several reports have been published demonstrating cases with CO resistance. Sporadic cases have been reported as well as one large scale study demonstrated 12.4% resistance. However, all these reports were based on treatment failure [in vivo]. rather than in vitro or molecular bases. Evidence suggests a crucial role for a point mutation in the P. falciparum chloroquine resistance transporter [pfcrt] gene on chromosome 7 in conferring CQ resistance. The mutation in the K76 codon in 3 cases out of 60 [5%] using ApoI restriction enzyme was detected. Although the percentage of drug resistance was not quite disturbing, but represented the possible establishment of chloroquine-resistant P. falciparum in Saudi Arabia, or the beginning of resistant strains by labors coming from abroad. Cross-border importation of resistant strains from neighboring countries must be considered. In vivo tests must be conducted parallel with the molecular markers to estimate more precisely the actual prevalence of resistance. Validation of molecular markers is urgently required and needs strong collaborative partnerships between subregional and regional networks

Comparison of two commercial assays and microscopy with PCR for diagnosis of malaria

This study compared conventional PCR with microscopy and 2 rapid detection methods, the pLDH which detected lactic dehydrogenase enzyme produced by actively metabolizing organisms and the malaria antibody tests. The sensitivity of PCR was 1 parasite/micro l, i.e.: 50 times more sensitive than microscopy. When PCR was compared with microscopy, the sensitivity and specificity were 90% and 100% respectively. The sensitivity recorded was pLDH test in comparison to PCR [95%]. The malaria antibody test recorded the least sensitivity [68%] PCR proved as the gold standard for evaluation of applied tests and the newly introduced ones. In absence of an expert microscopist, the pLDH test could substitute for microscopy. The test proved valuable to assess clinical cure, and predict drug resistance. Its advantage over microscopy was the ability to diagnose infection with low parasitemic patients. Antibody rapid tests might be not valuable in acute cases, but still accepted as a tool in epidemiological studies and in screening patients in blood banks in malaria endemic areas

Evaluation of a real-time polymerase chain reaction assay for the diagnosis of malaria in patients from Jazan area, Saudi Arabia

A real-time PCR assay with conventional microscopy by Giemsa-stained blood films was used. PCR was completed in an hour and identified the Plasmodium species in a single reaction. Blood was collected, and DNA was extracted. A genus-specific primer set corresponding to 18S ribosomal RNA was used to amplify target sequence. Fluorescence resonance energy technology hybridization probes were designed for P. falciparum over a region containing base pair mismatches allowed Plasmodium species differentiation. Microscopically positive patients [n=60] were positive with real-time assay [100% sensitivity]. 58 were single-species infections caused by P. falciparum; mixed infections [P. falciparum and P. vivax] were shown by real-time assay. Six out of 30 negative microscopy specimens were positive by real-time PCR [80% specificity,]. The discrepant results could be due to the subjective nature of microscopy and analytical objectivity of PCR, and high analytical sensitivity of real-time assay [1 parasite/micro l] compared to microscopy [50 parasites /micro l]. Six patients were retested with ICT malaria test and 4 were positive showing that PCR results were correct. There was low correlation between parasitemia by microscopy and gene copy number for P. falciparum [r = 0.2; P =0.05 [Spearman]

Anemia, interleukin-10, tumor necrosis factor alpha, and erythropoietin levels in children with acute, complicated and uncomplicated malignant malaria in Jazan, Saudi Arabia

To gain insight into potential relationships between tumor necrosis factor alpha [TNF-alpha], interleukin 10 [IL-10], erythropoietin [EPO], and anemia in acute malaria, 90 children 3 to 11 years with acute malaria were studied. According to parasitemia and hemoglobin levels, they were divided into 3 groups: Gl [mild]: asexual low-density Plasmodium falciparum parasitemia <8000 parasites/ul and hemoglobin levels >8g/dl. G2 [high-density uncomplicated]: asexual high-density parasitemia [>8000 parasites/ul, with hemoglobin levels >8 g/dl. G3 [anemia]: with severe malaria symptoms and parasitemia with anemia [hemoglobin levels <8 g/dl]. Hospital controls included 10 children with matching age group who required inpatient management but had no malaria parasitemia. Good marrow response was in Gl and G2 showed by elevation of serum EPO and soluble transferring receptors [sTfR] and increased red cell distribution width [RDW]. In G3, bone marrow suppression was in spite of increased EPO level in response to anemia. TNF-alpha level was significantly higher G2 and G3 [P.05]. IL-10 levels in Gl were significantly higher than in hospital control group [P<0.05]. The highest level of IL-10 was in G2. The mean EL-10 to TNF- alpha ratio in G2 [4.64] was significantly higher [P<.005] than in G3 [mean ratio, 1.77]

Endoscopic Management of symptomatic maxillary retention cysts

The objective of this study was to present an experience in endoscopic management of symptomatic mucus retention cyst of the maxillary sinus during the period of March 2000 to November 2002. Seventy-four patients with symptomatic large cysts that filled at least 50% of the maxillary sinus space were included in the study. Most of the cysts were removed through the natural sinus ostium by a rigid nasal endoscope [59 patients]. The inferior meatal approach was used in 11 patients; in 4 patients, the sinus was entered through the canine fossa. The results showed that cysts recurred in only 4 patients during the first postoperative year. There were no complications from the procedure

Role of serum interleukin-18 in the assessment of activity of tuberculosis

This study is carried out to evaluate the role of interleukin-18 [IL-18] in the immune response against Mycobacterium tuberculosis [M. tuberculosis] and the reliability of its serum level in the assessment of tuberculous disease activity. It included 40 subjects who were classified into three groups, group I [included 20 patients with active pulmonary tuberculosis], group II [included 10 patients with active extrapulmonary tuberculosis], and group III [included 10 healthy subjects served as controls]. All subjects were investigated, before and 3 months after start of antituberculous treatment, by conventional methods to assess tuberculous disease activity [clinical features, ESR, sputum direct smear for acid fast bacilli and chest X-ray] and measurement of serum IL-18 level. In group I, 16 patients showed good response to treatment and became inactive and showed significant reduction in serum IL-18 level, while the remaining 4 patients showed poor response to treatment and still active and their serum IL-18 level did not change significantly. In group II, 9 patients showed good response to treatment and became inactive and their serum IL-18 level was reduced significantly. In conclusion, serum IL-18 plays an important role in the immune response against M. tuberculosis, as it was higher in patients than in the healthy controls. Serum IL-18 level is directly proportionate to the tuberculous disease activity and severity and it caries a prognostic value, where patients with high serum IL-18 level had good response to treatment, while patients with low serum IL-18 level had poor response to treatment

Apoptosis in type 2 diabetic patients with micro vascular complications

Type 2 diabetes mellitus results from an inadequate adaptation of the functional pancreatic beta cell mass in the face of insulin resistance. Apoptosis is programmed cell death or cell suicide, it is an energy-requiring process that involves de novo protein synthesis. Apoptotic mechanisms could explain insulin deficiency through a reduction in absolute beta cell mass. This study was conducted on 49 patients with type 2 diabetes mellitus from Internal Medicine Department, Kasr- El Aini hospital. They were classified into group A [10 patients] without micro vascular complications, group B [39 patients]with micro vascular complication [peripheral neuropathy, retinopathy and nephropathy] and 10 healthy persons served as control group[group C].All subjects were subjected to full Clinical assessment and routine laboratory investigations, 24 hours urinary albumin, ECG, fundus examination and quantitative assay of proapoptotic markers [Fas, FasL, and Bcl2 proteins] There was significant correlation behveen fasting blood glucose and Fas, FasL, and Bcl2 [P value

Leukotrienes and essential fatty acids patterns in children with severe protein energy malnutrition

The objective of this study is to investigate the roles of leukotrienes [LTs] and essential fatty acids [EFA] in the pathophysiology of severe protein energy malnutrition [PEM]. Plasma cysteinyl LTs [LTC[4], LTD[4], LTE[4]] and plasma EFA levels were measured by ELISA and gas liquid chromatography after plasma extraction respectively, in 40 severely malnourished children with kwashiorkor [n=20] and marasmus [n=20]. Ten well nourished children of matching age served as control. The cysteinyl LTs level was significantly higher in kwashiorkor group than in marasmic or control groups [p<0.05]. The plasma fatty acid patterns in malnourished children indicated changes characteristic of EFA deficiency, with lower linoleic acid [LA], alpha-linolenic acid [alpha LNA], arachidonic acid [AA] and docosahexaenoic acid [DHA] levels, accompanied by significantly higher oleic acid levels in both malnourished groups. The lowest values of LA and alpha-LNA were detected in marasmic group and the lowest levels of AA and DHA were in kwashiorkor group [p<0.05]. There was an inverse correlation between AA and LTs levels in children with kwashiorkor. Clinical problems associated with kwashiorkor such as hair and skin changes, edema, psychomotor alteration and hepatomegaly were significantly correlated directly with LTs and in versely with AA levels. The findings of this study suggest that cysteinyl LTs and EFA deficiency are involved in the pathophysiology of PEM particularly kwashiorkor and that severe PEM is associated with impaired FA desaturation and elongation pathways

Rotavirus infection and persistent diarrhea in young children

This study aimed at determining the role of rotavirus in the etiology of persistent diarrhea in young children. Stool samples from 96 children up to 5 years old suffering from persistent diarrhea and 70 matched controls suffering from acute diarrhea were examined for EPEC, salmonella, shigella and rotavirus. Rotavirus was detected in 8.3% and 25.7% of the cases of persistent and acute diarrhea respectively with significant difference in the rate of detection [P < 0.01]. This shows a more important role of rotavirus in the etiology of acute diarrhea, however its detection in cases of persistent diarrhea suggests its role as an underlying cause. Prospective studies are needed to clarify if there is a direct correlation between acute rotavirus infection and persistence of diarrhea

immune status of young adult in Ismailia to rubella virus infection

Serum samples from 400 young adult females aged 14 - 25 years old in Ismailia were screened for rubella antibodies using the hemagglutination inhibition test [HIT] and latex particle agglutination [LP A]. in an attempt to evaluate the need of mass immunization. The percentage of susceptible adult females was 5% and 4% with both HIT and LPA respectively, the two technique correlated well. The incidence of congenital rubella infection is probably low because the vast majority of the female population is immune due to natural immunization