Reduction of Plasma Adiponectin in Egyptian Obese Children with Nonalcoholic Fatty Liver Disease.

Background: Obesity, insulin resistance and dyslipidemia are the most significant risk factors of non-alcoholic fatty liver disease (NAFLD) in children, and a major cause of liver-related morbidity. The aim of this study was to evaluate the serum levels of adiponectin, leptin and fasting insulin in obese children with NAFLD to explore the role of adiponectin in the pathogenesis of this disease. Materials and Methods: The fasting serum levels of adiponectin, leptin, glucose, insulin, ALT, AST, total bilirubin, direct bilirubin, albumin, alkaline phosphatase, creatinine, cholesterol, triglycerides, HDL, LDL, GGT and CRP were measured in a group of 50 NAFLD children after making ultrasonography and 40 other participants were considered as a control group with comparable age, sex and body-mass index. Results: Plasma adiponectin was found significantly low in NAFLD children than its level in control group (3.23± 2.5 vs 11.0 ± 2.95 ng/dl). Moreover, NAFLD group had significantly higher insulin resistance, fasting insulin 11.4± 4.9 vs 4.7±3.1 mu/l levels in comparison with control group. Regarding serum leptin, there was no significant difference. An inverse correlation was observed between adiponectin and homeostatic model assessment (HOMA-IR), fasting insulin, leptin, triglycerides, ALT, AST, GGT and BMI. Conclusion: This data supports a role for low circulating adiponectin value in the pathogenesis of NAFLD and its association with insulin resistance.

Efficacy of pentoxifylline as an antifibrotic drug in experimental murine schistosomal hepatic fibrosis

This study evaluated the possible antifibrotic effect of pentoxifylline on experimentally induced schistosomal hepatic fibrosis and its effect on serum leptin and transforming growth fac-tor-pl levels as possible antifibrotic mechanisms in correlation with the hepatic fibrosis indices.A total of ninety clean laboratories bred, males Swiss, albino mice were included, of which ten mice served as a control non-infected, non-treated group and sacrificed at one time. Eighty mice, each was subcutaneously infected with 50 Schistosoma mansoni cercariae and classified into groups: GI [infected and non-treated], Gil [infected and treated with Mirazid], GUI [infected and treated with Pentoxifylline] and GIV [infected and treated with a combination of Mirazid and Pentoxifylline]. Each group was further subdivided into 2 subgroups; subgroup a' which started treatment at 6[th] week post-infection [P.I.] and sacrificed at the end of 9[th] week P.I and subgroup [b] which started treatment at 14[th] week P.I and sacrificed at the end of 17[th] week P.I. The efficacy of the treatment was assessed by histopathological examination of the liver with measurement of granuloma sizes, estimation of hydroxyproline content in the liver, and assessment of serum levels of leptin and transforming growth factor- 61 [TGF- 61]Mirazid [MZD] caused significant reductions in granuloma sizes and hepatic hydroxyproline content and caused non-significant reductions in serum levels of leptin and transforming growth factor- 61 at 9[th] and 17[th] weeks P.I [Gil]. Pentoxifylline [PTX] caused significant reductions in granuloma sizes, hepatic hydroxyproline, and serum levels of leptin and transforming growth factor- 61 at the 9[th]and 17[th] weeks P.I [GUI]. While combined therapy of both MZD and PTX in GIV caused more reductions in granuloma sizes, hepatic hydroxyproline, and serum levels of leptin and TGF- 61 at the 9th and 17th weeks P.I when compared to the other groups

Molecular classification of breast cancer: an overview with emphasis on ethnic variations and future perspectives

Morphologically identical breast cancers can display divergent clinical outcomes and responses to therapy. This can predominantly be attributed to molecular class differences that exist amongst histologically similar cancer types. Consequently, molecular classification can be more powerful than histopathology as a predictive factor for the different treatments. This article reviews the molecular classification of breast cancer and emphasizes that ethnic variations may exist in molecular class prevalence patterns. It also highlights key insights into the currently defined molecular classes as provided by ongoing research on primary breast cancers using recent state-of-the-art technology. Such research is revealing that significant molecular heterogeneity may exist within the molecular classes themselves. More diverse ethnic variations may also be unraveled. The results of ongoing and upcoming research may provide more precise prognostic and predictive information about breast cancer and perhaps a breakthrough step toward "personaliziation" of breast cancer treatment. Forty-one relevant articles [2000-2012] extracted through PubMed and Google advanced searches and at our institute's library were utilized to prepare the article, along with results of published and ongoing research hby the authors

Indeterminate cell tumor [histiocytosis]

Indeterminate cell tumor [ICT; histiocytosis] is a rare disorder characterized by accumulation of histiocytes that do not fulfill the phenotypic criteria designated for Langerhans cells [LC]. The cells classified as "indeterminate" exhibit overlapping features between dendritic cells and histiocytic cells by showing variable reactivity for CD1a and positivity for S-100 protein and CD68. Ultrastructurally, absence of Birbeck granules, a feature consistent with LC, epitomizes the lesional cells. Herein, we report a case of ICT in a new born emphasizing its histogenesis and clinical, morphologic, immunohistochemical, and ultrastructural features

Prevalence of cervical cellular abnormalities by liquid based cytology in Taif province: a hospital based study

The aim of this study was to determine the prevalence of the cervical cellular Abnormalities using liquid based thin-layer preparations as screening test for women who attended the gynaecology outpatient clinic at King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia. In this retrospective chart review study, we reviewed the records and data of all women for whom liquid base cytological studies were performed as screening test to detect the cervical cellular abnormalities at King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from June 2010 to June 2012. The total number of women for whom liquid base, thin-layer cytological studies were performedwas 2168 patients 79.9% of them were symptomatic. The mean age was 38.6 years. Liquid based thin-layer preparations were used for all patients. Cervical abnormality was seen in 25.6% of the patients, of which 6.5% were malignant or premalignant and 19.1% were of benign nature. Liquid-based, thin-layer cytology reduces sampling and preparation errors of the conventional smear; however, screening should include human papilloma virus [HPV], DNA testing to increase the sensitivity and specificity of primary screening

[Isolation of iron nanoparticle-producing magnetotactic bacteria from Arjin ore in Zanjan Province, Iran]

Iron nanoparticles are broadly used in medical science, particularly in synthesis of fluorescence biomarkers, cancerous tumor therapy by hyperthermia, and as a contrast agent in MRI. Physical and chemical synthesis methods currently used to produce nanoparticles cause environmental contamination. Certain bacteria are capable of synthesizing significant amounts of iron nanoparticles, quite in conformity with the principles of green chemistry. The objective of this study was to isolate iron nanoparticle-producing magnetotactic bacteria from Arjin ore in Zanjan Province, Iran. Serial dilutions were prepared from the soil of iron ore and inoculated on a combined solid agar culture medium specifically used to isolate magnetotactic bacteria. This was followed, after incubation at 30 degree for a week, by transferring samples of colonies to special liquid culture media. After three weeks of incubation, the samples were examined by Gram staining, XRD and of scanning electron microscope [SEM]. The existence of iron nanoparticles was confirmed by analysis of XRD graphs. Furthermore, scanning electron microscopy pictures proved the shape of bacteria and extracellular accumulation of iron nanoparticles produced by them. Magnetotactic bacteria isolated from Arjin ore in Zanjan Province, Iran are capable of biosynthezing iron nanoparticles.

Saudi women in academic medicine. Are they succeeding?

The main purpose of this study is to assess the achievements and barriers to advancement for Saudi women in a medical academic setup. We studied the career progression of female medical graduates, who were appointed an academic position in King Faisal University, Dammam, Kingdom of Saudi Arabia [KSA] between 1982 and 2003 and compared it to the male counterpart. The information was collected from the Dean's ship of admission and registration, employees and faculty affairs administration office, self completed and telephone surveys. The percentage of medical graduates who were appointed on an academic post in the University was 4.4% for females and 4% for males. The females specialized in various fields and progressed equitably with the males in their postgraduate studies. Academic promotion to higher ranks was slower for females in comparison to males. This was related to various reasons related to family responsibilities, social strains, lack of family friendly policies in the institutions, lack of mentoring relationship, and bias against females. Saudi women in academic medicine have succeeded at the junior level. They specialized in various fields and excelled. Their further academic progression needs the support of senior academic staff, the chairs and the institution administration

Maternal serum alpha fetoprotein among pregnant females in Alexandria

Maternal serum alpha fetoprotein [MSAFP] was introduced as a screening test for congenital malformations especially neural tube defects [NTDs] two decades ago. However, many factors were known to affect its level. From these are racial differences and maternal weight. The aim of the present work is to illustrate the normal distribution of MSAFP among working pregnant women in Alexandria in gestational age 16- 18 weeks, to identify some of its determinants, and to determine the specificity and sensitivity of MSAFP for the detection of congenital anomalies and adverse pregnancy outcome. A sample of 608 pregnant working women who were 16-18 week gestation was recruited for the study from the antenatal clinic affiliated to Gamal Abdel Nasser Health Insurance Hospital in Alexandria. The enrolled women were interviewed using a structured questionnaire and a blood sample was collected from each of them to measure the level of MSAFP. At the expected time of delivery, Gamal Abd el Nasser Health Insurance Hospital was visited to collect data about the outcome of pregnancy of the enrolled women. The median of MSAFP level for deliveries with no congenital anomalies were 25.5, 33.5, and 53.2 IU/ml, at gestational weeks 16, 17 and 18 respectively. The significant variables related positively to MSAFP level included abortion or stillbirth, congenital anomalies in the index pregnancy, gestational age, bleeding during pregnancy, gestational diabetes, twin pregnancy, consanguinity between maternal parents, history of congenital or genetic diseases in maternal family, and caesarian section deliveries. Fatigue score was negatively correlated to MSAFP level. Using MSAFP multiples of median [MOM], 42.9% of abortions and stillbirths, 57.1% of twin pregnancies, 31. 25% of preterm deliveries and 27.3% of low birth weight had levels of 3 MOM or more. One fourth of the congenital anomalies were below 0.5 MOM and 41.7% were at or above 3 MOM. The sensitivity of MSAFP test for the detection of NTDs [cutoff point 2.5+ MOM] or Down syndrome [cutoff point <0.5 MOM] among the study sample was 100% [Cl: 19.8-100%]. Specificity for NTDs was 92.7% [Cl: 90.3-94.6%], while the specificity for Down syndrome was 89.1% [86.3-91.4%]. The sensitivity for adverse pregnancy outcome [cutoff point <0.5 or 2.5+ MOM] was 41.6, and the specificity was 85.8%.In conclusion, the cutoff points of MSAFP of the study sample are different from those for other populations. Different factors affect the level of MSAFP including adverse pregnancy outcomes. It is recommended to introduce antenatal screening for congenital anomalies as a routine screening test during pregnancy using levels adapted from the local population for cutoff point determination

Value of routine frozen section diagnosis of thyroid lesions

The value of routine frozen section examination for intraoperative diagnosis of thyroid cancer is controversial and needs to be evaluated on an institution to institution basis. This paper highlights the local experience with frozen section and analyses its role, accuracy and limitation in diagnosing thyroid cancer. A retrospective study of 61 patients who underwent thyroidectomy with routine thyroid frozen section examination at King Fahd Hospital of the University, Al-Khobar, Kingdom of Saudi Arabia. Results were compared with the final diagnosis to evaluate its effectiveness in predicting malignancy. Frozen section diagnosis, proved to be benign in 44 [72%] specimens, malignant in 10 [16%] and the diagnosis deferred in 7 [11.5%] patients. After examination of the permanent sections of the specimens, 15 [28%] were found to be malignant including 3 [43%] out of 7 deferred cases. With an overall accuracy of >90% and a specificity of 100%, the sensitivity of frozen section diagnosis remains low. Only 60% of papillary carcinoma and 25% of follicular carcinoma were correctly diagnosed on frozen section. The low rate of diagnosis of follicular carcinoma is due to its encapsulated and minimally invasive nature. The inability to diagnose follicular carcinoma intraoperatively with frozen section is the most significant factor accounting for the relatively low sensitivity of frozen section diagnosis of thyroid malignant neoplasm. In our institution, frozen section is considered a complementary investigation to emerging fine needle cytopathology in the region

Study of nosocomial respiratory infections and nurses' performance related to infection control measures in artificially ventilated patients

This study was conducted on 30 ventilated patients and the 30 nurses who were responsible for their care. An observation checklist was used to assess nurses' practices regarding daily care activities, ventilator decontamination, use of universal infection control measures and the maintenance of the patients' care environment. A second sheet was developed to estimate the incidence of nosocomial respiratory infection and to identify the causative microorganisms. A third sheet was designed to help in the daily assessment of the patient's health condition. The study revealed a high incidence of nosocomial respiratory infections. Also, it was revealed that pseudomonas was the causative agents in more than one- fourth of the cases. Moreover, nurses' infection control practices were inadequate

Incidence of child abuse among primary school children in Menoufiya

This exploratory work aimed at studying the incidence of physical and emotional abuse of primary school children in Shebin EI-Kom, Menoufiya. The sample comprised 778 pupils, aged 6-12 years. Data were collected using a questionnaire sheet and the observation of the apparent signs of physical and emotional abuse. The results revealed that boys suffered from physical abuse more than girls as a result of cruel beating committed by their parents. Also, older children were exposed more to cruel beating by parents. Child abuse was more commonly encountered among educated parents and employed mothers. Mothers' neglect was found more among working mothers. Expressions of deep grief, shyness, and fear were shown by children while answering questions related to emotional abuse. It was concluded that an overlap exists among various forms of child abuse. It is recommended to conduct a program for prevention of all types of child abuse

Differential study of two strains of Toxoplasma gondii

This study aimed to differentiate between the virulent and avirulent strains of T. gondii by studying morphometric measurement using CIAS, determination of the relative DNA content and extract, SDS poly acrylamide gel electrophoresis and isoenzyme on cellulose acetate gel. Identifying these differences may be useful in studying different disease types and in pathogenic mechanisms. Besides, the presence of common proteins between them may be of value for diagnostic purposes and for formulation of vaccines

Epidemiological aspects of school dropouts in children between 7-15 years in rural Maharashtra.

A study on school dropouts from primary and secondary school children was undertaken in September '91 from 16 schools at the headquarters of 8 Primary Health Centres, where 172 school dropouts were identified. A home visit was paid and information about socio-economic and cultural aspects was collected and a psychological screening was undertaken. Although there was no significant difference in overall dropout rates for both sexes, it increased sharply at 11 years of age in girls. The majority of children dropped out due to financial problems or unsatisfactory scholastic performance, and 142 (82.5%) of the 172 children studied were poor performers in one or more function tests. Maximum difficulty was observed in concept formation 87 (50.5%), followed by numerical ability in 78 (45%). Identification of children with learning difficulties and intervention using special educational methods within the framework of existing network of primary and secondary schools in rural areas is suggested.

Social and environmental factors related to the prevalence of paramenstrual syndrome among Menoufia women

The paramenstrual syndrome was studied among 220 women in Monoufia governorate of 15-35 years of age. The modified Moos Menstrual Questionnaire was used to record the prevalence rates of the different symptoms. The most common somatic symptom was backache and psychological symptom was irritability. Somatic symptoms rates surpassed the psychological ones. Almost all symptoms subsided during the menstrual phase. Education, occupation, crowding index, high tension field, and menstrual cycle characteristics were associated more with the severity of nearly all symptoms. It was recommended that proper examination of women should be done to detect medical and legal problems related to this syndrome which would benefit from hormonal treatment and assurance. Further investigations have to be done to determine the prevalence rates of paramenstrual syndrome among the Egyptian women and the factors affecting their aggravation