Assessment of humoral immune response to different COVID-19 vaccines in patients undergoing maintenance hemodialysis / Avaliação da resposta imune humoral a diferentes vacinas contra a COVID-19 em pacientes submetidos à hemodiálise de manutenção

ABSTRACT Introduction: The immune response to different Coronavirus Disease 2019 (COVID-19) vaccines is under-investigated in end-stage kidney disease (ESKD) patients, especially in the Middle East and North Africa. We carried out this research to estimate the effectiveness of COVID-19 immunization in ESKD patients on regular hemodialysis (HD). Methods: In this prospective observational study, we enrolled 60 ESKD patients on regular HD who had completed COVID-19 vaccination and 30 vaccinated healthy participants. Serum levels of severe acute respiratory syndrome coronavirus 2 immunoglobulin G (SARS-COV2 IgG) were quantified 1 month after completing the vaccination schedule, and all participants were followed up from October 2021 to March 2022. The vaccines used in the study were from Pfizer-BioNTech, AstraZeneca, and Sinopharm. Results: The median level of SARS-COV2 IgG was lower in HD patients than in healthy participants (p < 0.001). Regarding the type of COVID-19 vaccination, there was no statistical difference in SARS-COV2 IgG levels among HD patients. During the observation period, none of the HD patients had COVID-19. Conclusion: COVID-19 vaccination appeared to be protective in HD patients for 6 months and the side effects of vaccines were tolerable.

RESUMO Introdução: A resposta imune a diferentes vacinas contra a doença do coronavírus 2019 (COVID-19) é pouco investigada em pacientes com doença renal em estágio terminal (DRET), especialmente no Oriente Médio e norte da África. Realizamos esta pesquisa para estimar a eficácia da imunização contra a COVID-19 em pacientes com DRET em hemodiálise regular (HD). Métodos: Nesse estudo observacional prospectivo, inscrevemos 60 pacientes com DRET em HD regular que haviam concluído o esquema de vacinação contra a COVID-19 e 30 participantes saudáveis vacinados. Os níveis séricos de imunoglobulina G da síndrome respiratória aguda grave do coronavírus 2 (SARS-COV2 IgG) foram quantificados um mês após a conclusão do esquema vacinal, e todos os participantes foram acompanhados de outubro de 2021 a março de 2022. As vacinas utilizadas no estudo eram da Pfizer-BioNTech, AstraZeneca e Sinopharm. Resultados: O nível mediano de SARS-COV2 IgG foi menor em pacientes em HD do que em participantes saudáveis (p < 0,001). Com relação ao tipo de vacinação contra a COVID-19, não houve diferença estatística nos níveis de SARS-COV2 IgG entre pacientes em HD. Durante o período de observação, nenhum dos pacientes em HD teve COVID-19. Conclusão: A vacinação contra a COVID-19 pareceu ser eficaz na proteção de pacientes em HD por 6 meses e os efeitos colaterais das vacinas foram toleráveis.

Novel biomarkers for Diagnosis of Pulmonary Tuberculosis and Tuberculous Pleural Effusion

Background: The present study aimed to evaluate the importance of serum, pleural adenosine deaminase (ADA), and Gene Xpert in Diagnosis of TB and TB Pleural Effusion (TB-PLE.).Material & Methods:The study was done with 75 TB cases, 50 cases of them were diagnosed as Pulmonary TB and 25 cases as TB pleural effusion, collecting also 50 non-TB pleural effusion, Malignant and acute bacterial infection comprise 21 and 29 cases respectively. Cases with transudative pleural effusion were excluded from the study. Finally, 75 were healthy control group.Results:There was a highly significant difference between the mean age of TB-PE Patients and Patients non-TB-PLE (P-value <0.001), while there was a non-significant difference with patients with P-TB (P-value >0.05). Mean of Serum ADA level were highest 53.16 U/L in TB-PE cases, shown to be statistically significant when compared to 43.2 U/L in P-TB and 25.4 U/L in non TBpleural effusion. With p-value of 0.02 and 0.001respectively.Conclusions:We concluded that GeneXpert can be a useful diagnostic method in patients with suspected pulmonary tuberculosis. Serum and pleural fluid ADA level is a very helpful test to rule out a TB and can help differentiate tubercular etiology from non-tubercular.

Partial anomalous pulmonary venous return [scimitar syndrome]: multislice computer tomography

New cardiovascular imaging techniques provide high resolution and better anatomical assessment of cardiovascular malformations. We present a three dimensional reconstruction of scimitar syndrome using multislice computer tomography. The scimitar syndrome, also called venolobar syndrome and hypogentic lung syndrome, is a rare congenital cardiovascular anomaly involving the right lung, in its complete form, the syndrome consists of ipsilateral anomalous pulmonary drainage of part or all of the right lung into the inferior vena cava, hypoplasia of the right lung, dextrorotation of the heart, hypoplasia of the right pulmonary artery and anomalous systemic arterial supply to the lower lobe of the right lung from the subdiaphargmatic aorta or its main branches

Histological study of the effect of methamphethamine on the cardiac muscle of albino rats

Abuse of methamphetamine has become a major world-wide health problem. Because of the limited work that had been done looking at the cellular toxicity of methamphetamine and because its cardiotoxicity is not experimentally well documented. The present work was conducted to study the effects of chronic administration of methamphetamine, as well as the effect of withdrawal on the cardiac muscle of albino rats using histological and ultrastructural examination. This study was conducted on 60 adult male albino rats. They were divided into three equal groups. Group I was used as control. Group II received daily subcutaneous injection of 1mg/kg body weight of methamphetamine hydrochloride for 8 weeks. The third group received the same daily dose of methamphetamine hydrochloride for the same duration then, the treatment was discontinued for the next 4 weeks. At the end of the experiment rats were sacrificed and specimens from the heart were taken and were subjected to light and electron microscopic study. Two degrees of myocardial lesions were revealed on examination of the chronic toxicity group ranging from wavy muscle fibers with deeply stained nuclei up to sarcolemmal rupture and extrusion of the organelles. Mitochondrial swelling with focal cristal loss was also revealed. After drug withdrawal, there was reversal of most of myocardial lesions depicted in the chronic toxicity group except for excessive fibrous tissue deposition. Chronic methamphetamine administration brings about various myocardial lesions. However, most of these lesions are reversible after drug withdrawal

Single lobe disease in endemic goitre

To describe the clinical, volumetric and cytological features of the contra lateral lobe in a series of patients with long standing unilateral endemic goitre. This study included 60 patients from the west of Sudan with clinically detectable and long standing unilateral simple endemic goitre that required surgery, with the simultaneous exploration of the contra lateral lobe. Out of 60 patients with unilateral goitre, 50 [83%] were found to have the disease on the ipsilateral lobe only [monolobar goitre]. The contra lateral lobe in these 50 patients showed normal size with nodularity. 20 patients with monolobar disease had intra-operative fine needle aspiration cytology [FNAC], of which 16 patients showed normal thyroid tissue. All patients with monolobar disease had lobectomy. Post-operatively they continued to have normal blood levels of T3, T4 and TSH. We report a series of patients with endemic goitre who had advanced forms of the disease that affect only one lobe in the presence of a structurally and functionally normal contra lateral lobe

Co-morbidity of age related cataract surgical patients in a tertiary care hospital in Saudi Arabia

The aim of this study is to assess the frequency of major systemic and ocular diseases among senile cataract surgical patients in a tertiary care hospital in Saudi Arabia. This study is a descriptive analysis of medical records of cataract patients who were operated at King Fahd Specialist Hospital [KFSH], Buraidah, during the year 2005. The records of senile cataract surgical patients were analysed for associated systemic and ocular co morbidities. A total of 292 cataract operations were performed during this 12-month period among persons aged 50 years or older. 147 [50.3%] were females. The overall mean [ +/- SD] age at the time of surgery was 67.6 + 9.2 years [range 50-96 years]. Systemic diseases affected 181 [62%] subjects, 158 [54%] patients exhibited coexisting ocular disease while 68 [23.3%] cases had no systemic or ocular co-morbidity. Frequent systemic co morbidities were, diabetes mellitus in 101 [34.6%] patients, hypertension in 89 [30.5%] followed by Ischemic Heart Disease 16[5.5%] and Asthma in 15 [5.1%] patients. Major ocular co morbidities detected preoperatively included CDK in 70 [24%],-Pseudo exfoliation in 35 [12%] and Trachoma in 35 [12%] patients. This study shows high frequency of systemic and ocular co-morbidity in senile cataract patients preoperatively

Toxic effects of some tricyclic antidepressant drugs on the heart: clinical and experimental study

This study was done due to increased potential risks of cardiotoxicity of acute tricyclic antidepressants intoxication in human. So this work was carried out to investigate the changes in SGOT, SGPT, CPK.MB, and electrocardiograms in human due to use of both imipramine hydrochloride and dothiepin hydrochloride in therapeutic and toxic doses. Also biochemical and histopathological changes that occur in rats receiving the same drugs in therapeutic and toxic doses. The human part was carried out on "100" persons [50 males and 50 females], the age ranges from 20-40 years. Biochemical analyses revealed that in comparing subjects received therapeutic doses of imipramine hydrochloride to the acutely intoxicated persons by the same drug, there was highly significant difference in SGOT, SGPT, CPK-MB levels. On the other hand, there was slight difference in the levels of SGOT, SGPT, CPK-MB in patient treated with dothiepin therapeutic doses and those received toxic doses of dothiepin hydrochloride where there was slight increase of enzyme levels in toxic doses more than therapeutic dose, but both still in normal range. On examination of electrocardiogram of persons that were treated with imipramine hydrochloride at therapeutic doses there were [30%] suffering from sinus tachycardia, [15%] presented with atrial extrasystole, and [5%] complains of atrial fibrillation. In those that were intoxicated with toxic doses of irnipramine hydrochloride, there were [80%] presented with sinus tachycardia, [40%] presented with atrial extrasystole, [15% ]suffering from atrial fibrillation, and there, were [10%] complained from ventricular tachycardia. Also there were [10%] with ventricular extrasystole and [5%] presented with ventricular fibrillation. Persons that were treated with dothiepin in therapeutic doses, only [20%] presented, with sinus tachycardia, and [10%] were presented with atrial extrasystole. While [50%] of subjects that were intoxicated with this drug presented with sinus tachycardia, [30%] presented with atrial extrasystole, [10%] suffering from atrial fibrillation, [5%] complained of ventricular tachycardia and [5%] presented with ventricular extrasystole. In comparison of animals that were injected with therapeutic doses of imipramine hydrochloride and that injected with toxic dose of imipramine hydrochloride group, there was a highly significant difference in SOOT, SGPT and CPK-MB levels. On the other hand the difference in the levels of SGOT, SGPT, CPK-MB in animals injected with dothiepin therapeutic doses and those injected with toxic doses of dothiepin hydrochloride was slight but both still in normal range. Histopathological examination of the heart of rats treated with therapeutic dose of imipramine revealed small areas of infarction. Histopathological examination of heart of rats treated with toxic dose of imipramine revealed massive infarction and the interstitial connective tissue was markedly infiltrated with lymphocytes, polymorphs, and histocytes. There are no histopathological changes in rats that treated with therapeutic doses of dothiepin hydrochloride while rats that treated with toxic doses of dothiepin hydrochloride showed moderate histopathological changes

Etiological agents of onychomycosis in Alexandria

Onychomycosis is accounting for approximately 50% of all nail problems. It is caused mainly by dermatophytes and yeasts, notably C. albicans and less frequently by moulds. Specimens were taken from 188 cases clinically diagnosed as onychomycosis by subungual scrapings of the nail debris in addition to swabbing of the nail folds in case of chronic paronychia only. Their direct microscopy and culture showed that females were more affected than males. The most frequently isolated fungi were yeast, followed by dermatophytes and mould. Gram negative bacteria were the most frequent type isolated in chronic paronychia. Most of the patients did not follow any therapeutic regimen before and even those used some forms of topical treatment before did not achieve a complete cure

Diabetes Mellitus in Al-Ain: the impact on hospital services

Patients with diabetes mellitus made up 5.8 per cent of all general medical admissions to the Al - Ain Hospital over a 5- year period ending October 1984. Of these 685 adults, the case records of 360 patients were available for review and are the material for the clinical part of this study. 40.6 per cent of these were of indigent nationality, and 61.8 per cent of patients in this group were female. Type II diabetes mellitus featured in 71.7 per cent of patients in this same group, whose ages ranged from 41 to 70 years. The larger expatriate patient group showed a male preponderance [67.2 per cent] and presented at a younger age [range 21 -50 years]. 43 per cent of patients in this group showed type I diabetes mellitus. Both groups of patients presented relatively low body weights [less than 70kg] and, although compliance to therapy was satisfactory, there was notably poor clinical control of their disease. Notwithstanding this, the rate of both acute and chronic complications was low and, although overall mortality was noted at 3.2 per cent, no deaths could be directly attributed to the metabolic derangements associated with the disease