Molecular prevalence of Anaplasma marginale in ruminants and Rhipicephalus ticks in northern Pakistan

@#Anaplasma marginale is the most prevalent tick-borne haemoparasite of cattle and causes huge economic losses to the dairy industry worldwide. This study aimed to determine the occurrence of A. marginale infection in blood and tick samples collected from livestock animals in the districts located in Khyber Pakhtunkhwa (KPK), Pakistan. A total of 184 blood and 370 tick samples were included in this study. It has never been reported that sheep, goats, and cattle in Tank, Ghulam Khan, Birmil and Miran Shah areas were infected with A. marginale. All samples of blood and ticks were collected through random sampling from March 2021 to January 2022 from cattle, sheep and goats and screened through PCR for anaplasmosis by using primer pairs of Anaplasma spp. Three hundred and seventy ticks were collected from infested hosts (120/184, 64.21%). Among the four morphologically identified tick species, the highest occurrence was recorded for Rhipicephalus sanguineus (n=138, 37.29%), followed by Rhipicephalus microplus (n=131, 35.4%), Rhipicephalus annulatus (n=40, 10.81%), Hyalomma anatolicum (n=31, 8.37%), and Hyalomma marginatum (n=30, 8.1%). The occurrence of female tick was highest (n=160, 43.24%), followed by nymphs (n=140, 37.38%) and males ticks (n=70, 18.9%). Among these ticks, A. marginale was detected in female ticks of R. microplus, and R. sanguineus. Molecular identification of A. marginale was confirmed in 120 out of 184 blood samples and 6 out of 74 tick samples. Overall, occurrence of A. marginale in blood and tick samples was found to be 65.21% and 8.1% respectively. Species-wise occurrence in blood samples of goats were 71.11% followed by sheep 68.31% and cattle 50%. Specie-wise occurrence of A. marginale in tick samples of cattle were 12.5% followed by goats 6.89%. The obtained sequence showed similarity with A. marginale reported from Kenya and USA. We report the first PCR based detection of A. marginale infection in blood samples and in R. sanguineus ticks of goats simultaneously.

Upper gastrointestinal bleeding in mechanically ventilated patients in medical ICU: A single-center study

Aims Upper Gastrointestinal bleeding (UGIB) in critically ill patients under mechanical ventilation (MV) is a significant cause of morbidity and mortality. Therefore, it aimed to study the incidence, predictors, and etiology of UGIB in critically ill patients under MV. Patients and Methods Three hundred and sixty critically ill patients were managed by mechanical ventilation. The patients were evaluated by complete clinical examination, APACHE II score, liver and kidney function tests, and abdominal ultrasound. In addition, upper gastrointestinal endoscopy was done for survived patients with UGIB during MV after weaning with a stable clinical condition for at least 48 hours. Results 41 patients (11.4 %) had UGIB; 15 patients (36.6%) survived and death occurred in 26 (63.4%). Upper endoscopy revealed large ulcers > 2 cm in the gastric antrum (n=1), multiple antral ulcers (n=2), large >2cm corporeal gastric ulcers (n=2) [all were Forrest Ib with oozing surface], bleeding small duodenal bulb ulcers < 2cm (n=1) [Forrest Ia with spurting], small ulcers in the lower esophagus with lower end esophagitis (n=2), black esophagus (n=1), ulcer on top of grade III oesophageal varices (n=2), severe portal hypertensive gastropathy (n=3), candida esophagitis and gastritis (n=1). Logistic regression analysis revealed that the independent variables of UGIB were elevated serum creatinine, APACHE II score >14, peak inspiratory pressure ≥ 30cmH2O, and prolonged aPTT. Conclusions : Mechanically ventilated patients had a high risk of upper gastrointestinal bleeding, which the postulated parameters can predict for adequate prophylaxis.

Kinetic modeling of the simultaneous production of ethanol and fructose by Saccharomyces cerevisiae

Background: Ethanol and fructose are two important industrial products that enjoy many uses. In this contribution, their production via selective fermentation of date extract using Saccharomyces cerevisiae was studied. Scaling up the process for possible commercialization was investigated in three fermentors with working volume ratio of 1:40:400. Results: Higher ethanol concentration was obtained in the larger fermentor due to conversion of fructose. Fructose yields in the 0.5-L, 7.5-L and 80-L fermentors were 99, 92 and 90%, respectively. Good fitting was obtained with the modified Monod kinetics; however, a better fit of cell mass was obtained with the modified Ghose­Tyagi model which accounts for ethanol inhibition. Conclusions: The modified Gompertz model was expanded to facilitate prediction of products' formation and fructose fractions in all three fermentors. Such expansion will be beneficial in industrial applications.

Bacterial and fungal keratitis in Upper Egypt: In vitro screening of enzymes, toxins and antifungal activity.

Purpose: This work was conducted to study the ability of bacterial and fungal isolates from keratitis cases in Upper Egypt to produce enzymes, toxins, and to test the isolated fungal species sensitivity to some therapeutic agents. Materials and Methods: One hundred and fifteen patients clinically diagnosed to have microbial keratitis were investigated. From these cases, 37 bacterial isolates and 25 fungal isolates were screened for their ability to produce extra‑cellular enzymes in solid media. In addition, the ability of fungal isolates to produce mycotoxins and their sensitivity to 4 antifungal agents were tested. Results: Protease, lipase, hemolysins, urease, phosphatase, and catalase were detected respectively in 48.65%, 37.84%, 59.46%, 43.24%, 67.57%, and 100% out of 37 bacterial isolates tested. Out of 25 fungal isolates tested during the present study, 80% were positive for protease, 84% for lipase and urease, 28% for blood hemolysis, and 100% for phosphatase and catalase enzymes. Thirteen fungal isolates were able to produce detectable amounts of 7 mycotoxins in culture medium (aflatoxins (B1, B2, G1, and G2), sterigmatocystin, fumagillin, diacetoxyscirpenol, zearalenone, T‑2 toxin, and trichodermin). Among the antifungal agents tested in this study, terbinafine showed the highest effect against most isolates in vitro. Conclusion: In conclusion, the ability of bacterial and fungal isolates to produce extracellular enzymes and toxins may be aid in the invasion and destruction of eye tissues, which, in turn, lead to vision loss.

Cyclic settlement behavior of strip footings resting on reinforced layered sand slope

The paper presents a study of the behavior of model strip footings supported on a loose sandy slope and subjected to both monotonic and cyclic loads. The effects of the partial replacement of a compacted sand layer and the inclusion of geosynthetic reinforcement were investigated. Different combinations of the initial monotonic loads and the amplitude of cyclic loads were chosen to simulate structures in which loads change cyclically such as machine foundations. The affecting factors including the location of footing relative to the slope crest, the frequency of the cyclic load and the number of load cycles were studied. The cumulative cyclic settlement of the model footing supported on a loose sandy slope, un-reinforced and reinforced replaced sand deposits overlying the loose slope were obtained and compared. Test results indicate that the inclusion of soil reinforcement in the replaced sand not only significantly increases the stability of the sandy slope itself but also decreases much both the monotonic and cumulative cyclic settlements leading to an economic design of the footings. However, the efficiency of the sand-geogrid systems depends on the properties of the cyclic load and the location of the footing relative to the slope crest. Based on the test results, the variation of cumulative settlements with different parameters is presented and discussed

effect of deep excavation-induced lateral soil movements on the behavior of strip footing supported on reinforced sand

This paper presents the results of laboratory model tests on the influence of deep excavation-induced lateral soil movements on the behavior of a model strip footing adjacent to the excavation and supported on reinforced granular soil. Initially, the response of the strip footings supported on un-reinforced sand and subjected to vertical loads [which were constant during the test] due to adjacent deep excavation-induced lateral soil movement were obtained. Then, the effects of the inclusion of geosynthetic reinforcement in supporting soil on the model footing behavior under the same conditions were investigated. The studied factors include the value of the sustained footing loads, the location of footing relative to the excavation, the affected depth of soil due to deep excavation, and the relative density of sand. Test results indicate that the inclusion of soil reinforcement in the supporting sand significantly decreases both vertical settlements and the tilts of the footings due to the nearby excavation. However, the improvements in the footing behavior were found to be very dependent on the location of the footing relative to excavation. Based on the test results, the variation of the footing measured vertical settlements with different parameters are presented and discussed

New Zealand green-lipped mussel Verna canaliculus possesses an anti-inflammatory activity in the rat adjuvant arthritis with no ulcerogenic effect: the role of cytokines and antioxidant mechanisms

This study investigated the possible prophylactic and therapeutic anti-inflammatory effect of New Zealand green-lipped mussel [NZGLM] in adjuvant arthritis [AA] as well as its probable ulcerogenic activity in comparison with other NSAIDs used in arthritic disorders and the likely mechanisms underlying these potential effects. Arthritis was induced by s.c. injection of Freund's complete adjuvant into the right hind paw of Wistar rats of all groups except the normal one. The adjuvant was injected in one of the footpads to allow study of the acute inflammatory reaction in that local area of the injected paw as well as the immunological reaction that develops approximately 9 days later in the contralateral paw. Treatments with diclofenac [2 mg/kg/po] and NZGLM [250, 1000 mg/kg/po] were initiated on day 0, which is the day of adjuvant injection [prophylactic model dosing] or day 9 [therapeutic model] and continued once daily till day 21. The normal group and a control arthritic group were given oral 1% Tween 80. Both the injected and the contralateral paws' volumes were measured before adjuvant inoculation and then every 2-3 days by volume displacement. After the last measurement, blood samples were collected and were used for serum determination of tumor necrosis factor-a [TNF-alpha], interleukin-1 p [IL-1[3], malondialdehyde and nitrite. In the ulcerogenicity study, rats were injected with the adjuvant in the hind paw and at day 16 post-induction, the A A rats were then divided into 3 groups, 2 groups were treated daily for 5 days with indomethacin [3 mg/kg/po] or NZGLM [1000 mg/kg/po], while the 3rd group served as control. The animals were fasted for 20 hrs on day 4 prior to the final dose and then sacrificed 4 hrs after the, final dose of drug and their stomachs were removed, and examined for the total lesion score. Gastric mucosal homogenates were used for the estimation of lipid peroxides and myeloperoxidase activity. NZGLM exerted a significant dose-dependent anti-inflammatory effect in the AA model, its higher dose being comparable to that of diclofenac and that this effect is likely to be mediated by inhibiting the proinflammatory cytokines; TNF-alpha and IL-lp and through its antioxidant properties. In contrast to indomethacin, NZGLM did not produce any significant ulcerogenic effect

Gamma-glutamyl transpeptidase and alpha-fetoprotein: are they predictors of treatment response in patients with chronic hepatitis C?

Hepatitis C virus is a leading cause of chronic liver disease. Elevated serum alpha-fetoprotein [AFP] has been used as a marker for hepatic regeneration after the destruction of hepatocyte in viral hepatitis. Recently, gamma-glutamyl transpeptidase [GGT] has also been taken into account in the evaluation of patients with chronic hepatitis C [CHC]. This study aimed to examine the association between serum AFP and serum GGT levels, and treatment outcome in patients with CHC treated with pegylated interferon and ribavirin. We examined the association between AFP and GGT levels and sustained virological response [SVR] in 150 patients with CHC in whom antiviral therapy was initiated. Serum AFP, GGT, and hepatitis C virus RNA were tested for patients completing 48 weeks of treatment and patients who responded to treatment after 6 months. AFP and GGT levels were lesser in patients who achieved SVR than in those who did not achieve a response. The logistic regression model [univariate analysis] of factors associated with SVR showed a significant increase in SVR when AFP ranged from 2.8 to 9.9 micro g/ml, GGT less than or equal to 50 U/l, and Ishak fibrosis score less than or equal to F2. Serum AFP and GGTwere strongly correlated in multivariate analysis; only GGT less than or equal to 50 U/l and AFP from 2.8 to 9.9 micro g/ml were independent predictors of SVR, whereas Ishak score of fibrosis was a dependent predictor for SVR. AFP and GGT can be used as independent predictors of treatment response in patients with CHC receiving pegylated interferon and ribavirin

Protective effect of L-carnitine against carbon tetrachloride-induced liver injury in rats

Oxidative damage is involved in the pathogenesis of various, hepatic injuries. In the present study the capacity of L-carnitine as an antioxidant to protect against carbon tetrachloride [CCl[4]]-induced oxidative stress and hepatotoxicity in rats was Cairo. Egypt investigated. Daily oral administration of CCl[4]100 mg/kg in corn oil for 4 weeks produced a marked significant elevation in serum, alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP], lactate dehydrogenase [LDH], and alpha fetoprotein [AFP]. Hepatic lipid peroxidation, quantified as malondialdehyde [MDA] was significantly increased, while the activity of the two antioxidant enzymes; glutathione peroxidase [GPx] and superoxide dismutase [SOD] in the liver were significantly reduced. Histopathological and histochemical analyses of the liver of rats treated with CCl[4] revealed centrilobular necrosis with lymphocytic infiltration between hepatocytes. The hepatocytes were damaged in the form of fatty degeneration, vacuolization, ballooning with bundles of fibrous tissue surrounding the portal tracts and dissecting the parenchyma. Concurrent administration of L-carnitine [50 mg/kg/day; s.c.] with CC!4 for 4 weeks produced a significant reduction of aminotransferases together with normalization of ALP and LDH activities as well as AFP level. The biochemical parameters of oxidative stress were improved. Hepatic MDA concentration was significantly reduced, while the activities of the hepatic antioxidant enzymes GPx and SOD were significantly increased. These effects were paralleled with an improvement of the histopathological changes induced by CCl[4], where the hepatic architecture was preserved by L-carnitine treatment. Therefore, the results of this study show that L-carnitine can be proposed to protect the liver against CCl[4]-induced oxidative damage in rats, and the hepatoprotective effect might be correlated with its antioxidant and free radical scavenger effects

Ginkgo biloba extract [EGb761] normalizes hypertension in 2K, 1C hypertensive rats: roles of antioxidant mechanisms, ACE inhibiting activity and improvement of endothelial dysfunction

In the 2 kidney, 1-clip [2K, 1C] experimental renovascular hypertension, the early phase of elevation of blood pressure is associated with increase in plasma renin activity, and circulating angiotensin II which exerts a vasoconstrictor effect and increases aldosterone production. However, the progression and maintenance of the elevated blood pressure is mediated, in part, by angiotensin II-induced production of reactive oxygen species [ROS] which may promote endothelial dysfunction. The aim of the present study was to examine the possible antihypertensive effect of a standardized extract of Gingko biloba [EGb 761] in 2K,1C renal hypertensive rats and try to correlate it with the effect of the extract on oxidant status, ACE activity and vascular reactivity towards several vasoactive agents. Hypertension was induced using silver clip on renal artery by surgery. Four weeks after surgery, two sets of experiments were preformed. In the first set five groups of rats were selected; Sham-operated control, hypertensive control, and three hypertensive groups treated with the EGb 761 extract at 3 dose levels [60, 90, and 180 mg/kg/day; po] respectively for three weeks. Systolic blood pressure [SBP], heart rate [HR], lipid peroxidation measured as malondialdehyde [MDA], gIutathione peroxidase [GSH-Px] activity, nitric oxide [NO] level and angiotensin converting enzyme [ACE] activity were determined in blood, the ischemic kidney and the non-clipped contra-lateral kidney homogenates. In the second set of experiments three groups of animals were selected; Sham-operated control, hypertensive control, and hypertensive group treated with the EGb 761 [180 mg/kg/day; po] for three week after which the animals were sacrificed, the thoracic aortae isolated and prepared as rings for testing their reactivity towards the vasoactive agents norepinephrine [NE], acetyicholine [Ach], and sodium nitroprusside [SNP]. Results showed that clipping of the renal artery significantly elevated the SBP which reaches a plateau after 4 weeks, without any significant change in the HR. MDA significantly increased in serum and the clipped kidney. GSH-Px significantly decreased in the ischemic kidney while it was significantly elevated in serum and the contra-lateral kidney. NO level as well as ACE activity significantly increased in both kidneys without being affected in blood. There was impairment in both endothelium-dependent and independent relaxation of aortic rings towards Ach and SNP respectively. Treatment with EGb for 3 weeks produced a dose-dependent reduction in the SBP of the hypertensive rats and succeeded to normalize it with the highest dose level [180 mg/kg/day]. This antihypertensive action was associated with recovery of GSHPx activity in the ischemic kidney, inhibition of ACE activity in both kidneys, reduction of elevated NO in the non-clipped kidney, decreased responsiveness to the vasoconstrictor NE and improvement of endothelial function as evidenced by restoration of endothelium-dependent vasorelaxation induced by Ach

Study of the antihypertensive effect of olea europea extract [EFLA 943] in renal hypertensive rats: roles of ACE activity, redox state, and vascular liorepinephrine responsiveness

Standardized extract from leaves of Olea europea [EFLA 943] constitutes a mixture of biologically active natural products with a broad range of pharmacological activities. It has received a great deal of attention recently with respect to its cardiovascular effects. The present work has been undertaken to assess the possible potential antihypertensive effect of the extract and try to correlate it with its effect on oxidant status, ACE activity and vascular reactivity in the 2-kidney, 1-clip [2K, 1C] renal hypertensive rats. Two sets of experiments were performed. In the first set 3 groups of rats were selected; Sham-operated control, hypertensive control, and EFLA 943-trcated hypertensive groups. Hypertension was induced using silver clip on the renal artery by surgery. Four weeks after surgery, a single daily dose of 180 mg/kg/day; po of EFLA 943 was given for three weeks. Blood pressure was measured by the tail-cuff method weekly. ACE activity, malondialdehyde [MDA], glutathione peroxidase [GSHPx], total protein thiols [Pr-SHs], and nitric oxide [NO] were determined in the clipped kidney non-clipped kidney and blood. A second set of experiments with 3 groups and similar treatment like the first one was conducted but at the end of the treatment period rats were sacrificed, the thoracic aortae isolated and prepared as rings for testing their reactivity towards norepinephrine [NE], acetylcholine [Ach], and sodium nitroprusside [SNP]. Results showed that clipping of the renal artery significantly elevated the systolic blood pressure [SBP] which reaches a plateau after 4 weeks. MDA significantly increased in serum and the clipped kidney GSH-Px significantly decreased in the ischemic kidney while it was significantly elevated in serum and the contra-lateral kidney. NO level as well as ACE activity significantly increased in both kidneys without being affected in blood. There was impairment in both endothelium-dependent and independent relaxation of aortic rings towards Ach and SNP respectively. Treatment with EFLA 943 produced a significant reduction in the SBP of the hypertensive rats. This antihypertensive action was associated with inhibition of ACE activity in the non-clipped kidney, reduction of serum MDA, decrease in total Pr-SHs normalization of NO in both kidneys, and recovery of GSHPx activity in the ischemic kidney, together with decreased responsiveness to the vasoconstrictor NE

Correlation of karyotype and immunophenotype in childhood acute lymphoblastic leukemia; experience at the national cancer institute, Cairo University, Egypt

To identify chromosomal pattern among the major immunophenotypic subgroups in Egyptian children with ALL, and its correlation with clinical presentation and disease free survival. Cytogenetic and immunophenotypic analysis were done for all patients. Patients received ALL-PNCI-III/98 chemotherapy protocol used at NCI, Cairo University. The frequency of pseudodiploidy and normal karyotype in the whole group was 42.9% and 33.3% respectively. The frequency of pseudodiploidy was 36.8% in CALLA positive early pre B, 30.7% in pre B cases, 71.4% in T cell cases and 100% in mature B cell cases. At 12 months, DFS was 50% for pseudodiploid group having pre B phenotype, compared to 16.6% for pseudodiploid group with CALLA positive early pre B ALL. Sixteen percent of the studied cases showed T cell phenotype, 71.4% of them showed pseudodiploid karyotype, all of them had high risk features. Hyperdiploidy was found in 31.5% of CALLA positive early pre B cases and was associated with favorable prognostic features and DFS of 66.6% at 12 months. Hyperdiploidy of >50 chromosome represented 62.5% of hyperdipoid cases, 80% of them were CALLA positive early pre B ALL carrying good risk features. Fifty percent of normal karyotypic patients showed pre B phenotype, while 42.8% showed CALLA positive early pre B ALL. Their age, TLC, DFS, were almost comparable. CALLA early pre B phenotype has a positive impact on chromosomal pattern having best outcome among patients with hyperdiploidy. The Pseudodiploid karyotype carries a better outcome with pre B phenotype

Laparoscopic treatment of common bile duct stones: [single stage] laparoscopic approach to cholelithiasis and choledocholithiasis

Treatment options of CBD stones include selective pre or postoperative ERCP, open choledochotomy and one-stage laparoscopic clearance. There are several disadvantages to ERCP including the additional invasiveness of endoscopic procedures, moreover large and/or multiple stones, or impacted stones in CBD may be difficult or impossible to retrieve at ERCP even with ES [endoscopic sphincterotomy]. Peroperative real time cholangiography has the advantage of addressing choledocholithiasis with a single procedure LCBDE [Laparoscopic Common Bile Duct Exploration] while leaving the sphincter of Oddi anatomically intact without added morbidity. The choice of treatment between immediate laparoscopic common bile duct exploration, open exploration of CBD and transsphincteric endoscopic retrieval depends on many factors. A prospective study was designed to visualize and examine the biliary ductal system by laparoscopic intra-operative cholangiography [IOC] during laparoscopic cholecystectomy [LC]. The aim was to visualize the ductal anatomy and any anomalies on filling with contrast [to avoid biliary injury], detect any CBD stones and assess the ductal emptying and patency of ampulla of Vater by immediate contrast flow through the papilla into the duodenum. Intraoperative cholangiography was performed for 302 patients underwent LC for chronic calcular cholecystitis [CCC] in Benha University Hospital from Dec. 1999 to Jan 2004. Among 302 patients underwent LC and intraoperative real-time cholangiography, 31 patients [11.3%] were harbouring silent CBD stones managed immediately for CBD clearance. LCBDE was feasible in 23/31 cases who had choledecholithiasis [74.2%], while 8 patients needed conversion to open choledochotomy. 28 patients [9.3%] had preoperative ERCP, endoscopic sphincterotomy [ES], stone retrieval Operative cholangiography during LC proved residual stones in CBD in 2 of them [7.1%] and were treated by open choledochotomy. LCBDE approach is safe, feasible and effective in management of CBD stones and carries low morbidity and mortality. It has the advantage of intraoperative diagnosis and treatment of choledocholithiasis as a [one step] procedure

Detection of immunoglobulin heavy chain gene rearrangement and Bcl-2-JH translocation [t [14 ; 18]] in patients with chronic hepatitis C virus infection

The mechanism of lymphomagenesis by HCV is still obscure. The present study was carried out on 64 untreated patients previously diagnosed as having chronic liver disease due to HCV infection, 30 patients with HCV negative chronic liver disease [CLD] and 30 healthy controls. Serum cryoglobulins were tested in all subjects. In addition, the presence of immunoglobulin heavy chain gene [IgH] rearrangement and Bcl-2-JH translocation in peripheral blood mononuclear cells [PBMC] were assessed by seminested and nested polymerase chain reaction [PCR], respectively. Percutaneous liver biopsies were performed in 61 of the 64 patients with HCV related CLD and 26 of the 30 patients with HCV negative CLD to determine the severity of chronic liver injury. None of the patients received immunomodulatory drugs or had hepatocellular carcinoma, lymphoma or other malignancies. Cryoglobulinaemic and non-cryoglobulinaemic chronic HCV infected patients had significantly higher rates of monoclonal IgH rearrangement than patients with HCV negative CLD [P=0.006 and 0.047, respectively] and healthy controls [P=0.001 and 0.005, respectively].There were no statistically significant differences between chronic HCV infected patients with and without monoclonal IgH rearrangement with respect to age, sex, mean ALT and AST levels. Furthermore, the frequency of monoclonal IgH rearrangement in PBMC did not differ significantly according to histologic severity of chronic liver injury. On the other hand, cryoglobulinaemic and non-cryoglobulinaemic chronic HCV infected patients had significantly higher rates of Bcl-2-JH translocation than non HCV infected CLD patients [P=0.0002 and 0.001, respectively] and healthy controls [P=0.0002 and 0.001, respectively]. There were no statistically significant differences between chronic HCV infected patients with and without Bcl-2-JH translocation with respect to age, sex, mean ALT and AST levels. Moreover, the frequency of Bcl-2-JH translocation in PBMC did not differ significantly according to histologic severity of liver injury. Interestingly, the frequency of coexisting monoclonal IgH rearrangement and Bcl-2-JH translocation was significantly higher in cryoglobulinaemic than non-cryoglobulinaemic chronic HCV infected patients [P=0.05], HCV negative CLD patients [P=0.009] and healthy controls [P=0.009]. We concluded that patients with chronic HCV infection are more liable to develop monoclonal IgH rearrangement or Bcl-2-JH translocation in PBMC. Moreover, coexisting monoclonal IgH rearrangement and Bcl-2-JH translocation is a frequent finding in cryoglobulinaemic patients with chronic HCV infection suggesting that these aberrations may be involved, at least in part, in the complex multistep mechanisms occurring in HCV infected patients ending in B cell lymphoproliferative diseases [LPD]. Further studies are needed to establish whether determination of these aberrations in PBMC of chronic HCV infected patients could be useful as non invasive molecular markers for the predisposition to acquire cryoglobulinaemia and/or other B cell LPD

Laparoscopic nissen fundoplication for gastroesophageal reflux disease

Laparoscopic antireflux surgery is the standard treatment for gastroesophageal reflux disease [GERD] in western countries. This study is to examine the effectiveness and our results with laparoscopic antireflux surgery. Between July 2001 and November 2004, 23 patients were included in this study to undergo laparoscopic Nissen fundoplication [LNF]. We examined the following 3 parameters pre- and postopertively: patients symptoms, barium swallow and endoscopic findings in symptomatic patients. Also the operation time, intraoperative complications and postoperative complications were evaluated. Laparoscopic NF was successfully completed in 20 patients with 3 patients requiring conversion to open. The mean operative time was 175 minutes and the mean hospital stay was 2.4 days. There were 4 [17%] intraoperative complications 3 of which required conversion to open. There were 8 postoperative complications in 6 patients [30%]. The patients were followed for 36 months with a mean of 15 months. Seventeen patient 85% had substantial improvement of their symptoms and needed no proton pump inhibitors drugs. Three patients 15% require occasional medications and 3 patients did not improve. Laparoscopic Nissen fundoplication is an effective and durable treatment for gastresophageal reflux disease

Different measures that antagonize the overproduction of superoxide in blood vessels in hypercholesterolemic rats

The present study was an attempt to find out best measures which may be used to antagonize the superoxide overproduction in experimentally induced hypercholesterolemia in rats through increasing superoxide dismutase enzyme [S.O.D] and preserving nitric oxide. In this regard, three measures were tried in the hypercholesterolemic rats that were divided into three groups. The first group was treated with L-arginine [the natural precursor of nitric oxide], the second group was treated with ACE inhibitor captopril [capoten] and the third group was subjected to exercise. In all groups, the following parameters were investigated after sacrifice of the animals. Blood samples were taken, centrifuged, and serum was collected for estimation of lipid profile [Cholesterol, Triglycerides, LDL and HDL] and superoxide dismutase enzyme. The results revealed that, in addition to improvement of lipid profile in all the three hypercholesterolemic groups treated with L-arginine, ACE inhibitor [captopril] or subjected to exercise, there was significant elevation of superoxide dismutase enzyme from [185.5 +/- 18.73] to [240.25 +/- 21.55] U/ml [+29.51%] in the group treated with capoten, and significant elevation in the group treated with L-arginine to [245.75 +/- 21.11] U/ml [+32.47%] and significant elevation in the group subjected to exercise to [270.25 +/- 4.47] U/ml [+45.68%] indicating that, exercise proved to be the best measure to do so, followed by L-arginine, and lastly came the ACE inhibitor capoten. However, all the three mentioned measures proved to have beneficial effects in hypercholesterotemic rats

Study of the cytokine transforming growth factor beta-1 in patients with chronic virus hepatitis

This work was conducted on 40 patients with chronic virus hepatitis [21 patients with chronic hepatitis C with bilharzial periportal fibrosis, 2 patients with combined chronic hepatitis B and C and 17 patients with chronic hepatitis C alone] in addition to 10 healthy age and sex matched control subjects. The objective of this work was to study the status of TGF- beta-1 among patients with chronic virus hepatitis and its relation to age and sex and to evaluate the effect of colchicine and oral enzyme therapy on the level of TGF- beta-1. Patients were divided into 2 groups, group I who received oral enzyme therapy and group II who received colchicine, plasma level of TGF- beta-1 was estimated by ELISA with [MEDGENIX TGF- beta-1, ELISA kit] before and after receiving the treatment. It was found that plasma TGF- beta-1 level was significantly higher in patients with chronic virus hepatitis than control group and this level is not related to age or sex. The plasma TGF- beta-1 level was significantly higher in patients with chronic hepatitis C infection with bilharzial periportal fibrosis of liver than in patient with chronic hepatitis C alone, also it was significantly higher in patient with ultrasonographic findings of cirrhosis than those without cirrhosis. The plasma TGF- beta-1 level had no correlation with liver function tests but had positive correlation with serum procollagen III. Before treatment there was no significant difference in clinical picture, laboratory investigations, serum procollagen III and plasma TGF- beta-1 level between group I and group H but after treatment, there was improvement in clinical picture, liver function tests and significant reduction of serum procollagen III and plasma TGF- beta-1 level in group I but not in group II. So it can be concluded that plasma TGF- beta-1 level is a good marker of liver fibrogenesis and oral enzyme therapy is anti-TGF- beta-1 and can reduce the hepatic fibrosis in patients with chronic viral hepatitis

Pattern of meningitis in kalyobia. Governorate Egypt in the last therteen years [1984 to 1996]

Total of 3822 cases of meningitis were reported to the central laboratories of Kalyobia Governorate [Egypt] from the first of January 1984 to the end of December 1996. The main trend of the disease showed peak incidence in the period from 1989 to 1991 [Epidemic wave]. Haemophilus influenzae [35.04%] and Nesseria meningitidis [24.23%] were the most common bacterial agents diagnosed. Meningococcal meningitis was mostly caused by group A [30.24%] and group B [13.17%] allover the period of the study, while other new groups were diagnosed during the epidemic period [CD, W 135, Y and Z], the later showed high frequency [28.94%]. 11.30% of the cases had purulent meningitis but without detectable aetiology owing to the early use of antibiotics. A govemomental fever hospital taken as a sample model, high frequency of cases was below 15 years with 1.22 male to female ratio, but epidemic period showed increase in the female frequency. Meningococci were the responsible agent during the epidemic and responsible for 23.07% of all the hospital mortalities. The highest case fatality rate was in the preepidemic period [15.7%]. From this study it is recommended to establish a preventive program aiming at reducing the disease incidence, morbidity and mortality through: increasing the immunization coverage, improve the vaccine quality, disease surveillance and proper management of the diagnosed cases

Trends in fetal mortality in the Kingdom of Saudi Arabia: lessons from 15 years of experience

Using data on hospital deliveries published by the Ministry of Health, trends in fetal mortality in the Kingdom were investigated in this study. The study spanned 1391H through 1405H, corresponding to 1970-71 to 1984-85. The number of hospital deliveries increased sevenfold during the period, and this trend appears to continue. Of al deliveries, a monotonically linear decline in the proportion of normal deliveries and a corresponding increase in the proportion of abnormal deliveries were observed in this study. Masculinity ratios in abnormal deliveries were substantially higher than those in normal deliveries. Examination of fetal death rates showed sharp declines during the15 years. Mortality for all deliveries declined by 63%, for normal deliveries by 58%, and for abnormal deliveries by 78%. Among abnormal deliveries, major reduction in fetal reductions in fetal mortality were observed for deliveries by caesarean section [88%] and vacuum extraction [87%]. Despite substantial reductions, fetal mortality in the Kingdom remains much higher than that in developed countries