Moringa oleifera leaf ethanol extract ameliorates lead-induced hepato-nephrotoxicity in rabbits

Objective: To evaluate the effect of Moringa oleifera leaf ethanol extract as an adjunct treatment on lead acetate induced hepato-nephrotoxicity in rabbits. Methods: Thirty-six male New Zealand White rabbits were assigned into two main groups. The first group (14 rabbits) served as normal control. The secondgroup (22 rabbits) was administered orally with lead acetate at a dose of 40 mg/kg/day, 5 days/week for 8 weeks. At the 4th and the 8th week of treatment, 6 animals (3 animals at each period) of the second group were sacrificed while the remaining animals (16 rabbits) were assigned randomly into 2 subgroups (8 rabbits each): treated and non-treated. The first subgroup was orally given 1 mL phosphate-buffered saline for further 4 weeks while the second subgroup was administered orally with Moringa oleifera leaf ethanol extract at a dose of 400 mg/kg/day for the same period. Blood samples were collected to determine hematological and serum biochemical indices. Tissue specimens were collected from the liver and kidney for evaluation of the oxidant/antioxidant markers and for histopathological examinations. Results: Lead acetate exposure decreased the mean body weight gain, hematocrit, hemoglobin, mean corpuscular volume, and lymphocytes count. Moreover, it markedly increased counts of monocytes and platelets, serum enzyme activity, levels of creatinine, total cholesterol, triglycerides, and low-density lipoprotein cholesterol. Malondialdehyde level was markedly increased while the reduced glutathione content was significantly decreased in liver tissue of lead intoxicated-rabbits. Histopathological alterations were also noticed in the liver and kidney of lead intoxicated rabbits. Moringa oleifera leaf ethanol extract significantly improved hematological and serum biochemical parameters and histopathological structure of the liver and kidney. Conclusions: Moringa oleifera leaf ethanol extract ameliorates hemato-biochemical and histopathological alterations caused by lead acetate and improveshepatic and renal functions.

Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic

Background: Depression, a common mental disorder characterized by persistent unhappiness and lack of interest in daily activities, is one of the major important public health problems that are often comorbid with other chronic diseases like diabetes and can worsen the effect of the disease outcomes. Depression alone and/or as a comorbidity with diabetes is a common condition in the community. Aim of the study: To identify the prevalence of Depression among Type 2 Diabetes Mellitus patients and relationship between Depression and its effect on Drug Compliance among Type 2 Diabetes Mellitus patients, to determine the severity of Depression among Type 2 Diabetes Mellitus patients and the extent to which it affects Drug compliance. Materials and methods: The study was to be conducted in Rajah Muthiah Medical College and Hospital, Chidambaram in the year 2018-2019. A hundred patients with diagnosis of T2DM attending Diabetic OPD above 20 years of age were randomly selected. The Hamilton rating scale for depression by Hamilton is the most widely used rating scale to assess the symptoms of depression. The Ham-D is an observer-rated scale consisting of 17-21 items. Ratings are based on clinical interview. The items are rated on either a 0 to 4 spectrum or a 0 to 2 spectrum. The HAM-D also relies quite heavily on the clinical interviewing skills and the experience of rater in evaluating individuals with depressive illness. The strength of HAM-D is its excellent validation/research base, K.H. Mohamed Ibrahim, R. Gandhi Babu, M. Senthil Velan. Prevalence of psychiatric morbidity (depression) and its effect on drug compliance among patients attending diabetic outpatient clinic. IAIM, 2019; 6(11): 19-28. Page 20 and case of administration. Its use is limited in individuals who have psychiatric disorders other than primary depression. Results: Analyzing with HAMD score, 40 had no depression, mild depression in 24 cases, moderate depression in 21 cases, severe depression in 15 cases. MAQ score scale- low adherence in 41 cases, medium adherence in 37 cases, high adherence in 22 cases. MMAQ score scale and HAMD scorelow adherence with no depression were 9 cases (22.5%) mild depression were 6 cases (25%) moderate were 11(52.4%) severe depression were 15 cases (100%). MMAQ score scale and HAMD score - medium adherence with no depression were 23 cases (57.5%) mild depression were 9 cases (37.5%) moderate were 5(23.8%) severe depression were not seen. MMAQ score scale and HAMD score - Medium adherence with no depression were 8 cases (20%) Mild depression were 9 cases (37.5%) Moderate were 5(23.8%) severe depression was not seen. Pearson Chi-Square = 35.344**, p<0.001. Conclusion: Further, there was a significant association between the depression in Type 2 diabetes patients and medication adherence, where patients with depression had poor medication adherence as compared to those without depression and severity of depression correlates with worse adherence to diabetic medications

Pam3CSK4 enhances adaptive immune responses to recombinant Mycobacterium bovis bacille Calmette-Guérin expressing Plasmodium falciparum C-terminus merozoite surface protein-1

Objective: To determine the effects of toll-like receptor 2 (TLR-2) agonist, Pam3CSK4, on cellular and humoral immune response against recombinant Mycobacterium bovis bacille Calmette-Guérin (rBCG) expressing the C-terminus of merozoite surface protein-1 of Plasmodium falciparum. Methods: Six groups of mice (n=6 per group) received intraperitoneal phosphate buffered saline T80 (PBS-T80), BCG or rBCG in the presence or absence of Pam3CSK4. Enzyme-linked immunosorbent assay was carried out to measure serum total IgG, IgG1, IgG2a, and IgG2b production. Spleens were also harvested and splenocytes were co-cultured with rBCG antigen for in vitro determination of IL-4 and IFN-γ via enzyme-linked immunosorbent assay. Results: The production of total IgG and the isotype IgG1, IgG2a and IgG2b was significantly higher in rBCG-immunised mice than in the BCG and PBS-T80-immunised mice, and Pam3CSK4 further enhanced their productions. A similar pattern was also observed in IFN-γ production. Moreover, there was no significant difference in IL-4 production in all groups either in the presence or absence of Pam3CSK4. Conclusions: We present evidence of the adjuvant effects of TLR-2 agonist in enhancing the production of total IgG, IgG1, IgG2a, IgG2b, as well as IFN-γ in response to rBCG. However, the presence or absence of Pam3CSK4 had no effect on IL-4 production.

Molecular and serological prevalence of Toxoplasma gondii in pregnant women and sheep in Egypt

OBJECTIVE@#To investigate molecular and serological prevalence of Toxoplasma gondii (T. gondii) in pregnant women and sheep in Egypt.@*METHODS@#Blood samples collected from healthy 364 pregnant women and 170 sheep were investigated for T. gondii antibodies and parasitemia using highly specific and sensitive surface antigen (TgSAG2) based enzyme linked immunosorbent assay (ELISA) and real time-polymerase chain reaction (RT-PCR).@*RESULTS@#Overall prevalence of T. gondii was 51.76%, 17.65% in sheep, 33.79%, 11.81% in pregnant women, using ELISA and RT-PCR respectively. Significant differences in T. gondii prevalence were observed on the basis of contact with cats or soil in pregnant women using either RT-PCR or ELISA. In pregnant women, a significant increase was detected in aged and those eating under-cooked mutton using simultaneous ELISA/RT-PCR.@*CONCLUSIONS@#Consumption of under-cooked infected mutton is an important source of human infection and the combination of the two assays provide accurate and precise data during infection.

Rosmarinic acid attenuates hepatic fibrogenesis via suppression of hepatic stellate cell activation/proliferation and induction of apoptosis

OBJECTIVE@#To investigate the antifibrotic role of rosmarinic acid (RA), a natural polyphenolic compound, on HSCs activation/proliferation and apoptosis in vitro and in vivo.@*METHODS@#The impact of RA on stellate cell line (HSC-T6) proliferation, activation and apoptosis was assessed along with its safety on primary hepatocytes. In vivo, rats were divided into: (i) normal; (ii) thioacetamide (TAA)-intoxicated rats for 12 weeks; (iii) TAA + silymarin or (iv) TAA + RA. At the end of experiment, liver functions, oxidative stress, inflammatory and profibrogenic markers, tissue inhibitor metalloproteinases type-1 (TIMP-1) and hydroxyproline (HP) levels were evaluated. Additionally, liver histopathology and immunohistochemical examinations of alpha-smooth muscle actin (α-SMA), caspase-3 and proliferation cellular nuclear antigen (PCNA) were determined.@*RESULTS@#RA exhibited anti-proliferative effects on cultured HSCs in a time and concentration dependent manner showing an IC of 276 μg/mL and 171 μg/mL for 24 h and 48 h, respectively, with morphological reversion of activated stellate cell morphology to quiescent form. It significantly improved ALT, AST, oxidative stress markers and reduced TIMP-1, HP levels, inflammatory markers and fibrosis score (S1 vs S4). Furthermore, reduction in α-SMA plus elevation in caspase-3 expressions of HSCs in vitro and in vivo associated with an inhibition in proliferation of damaged hepatocytes were recorded.@*CONCLUSIONS@#RA impeded the progression of liver fibrosis through inhibition of HSCs activation/proliferation and induction of apoptosis with preservation of hepatic architecture.

Rosmarinic acid attenuates hepatic fibrogenesis via suppression of hepatic stellate cell activation/proliferation and induction of apoptosis

Objective To investigate the antifibrotic role of rosmarinic acid (RA), a natural polyphenolic compound, on HSCs activation/proliferation and apoptosis in vitro and in vivo. Methods The impact of RA on stellate cell line (HSC-T6) proliferation, activation and apoptosis was assessed along with its safety on primary hepatocytes. In vivo, rats were divided into: (i) normal; (ii) thioacetamide (TAA)-intoxicated rats for 12 weeks; (iii) TAA + silymarin or (iv) TAA + RA. At the end of experiment, liver functions, oxidative stress, inflammatory and profibrogenic markers, tissue inhibitor metalloproteinases type-1 (TIMP-1) and hydroxyproline (HP) levels were evaluated. Additionally, liver histopathology and immunohistochemical examinations of alpha-smooth muscle actin (α-SMA), caspase-3 and proliferation cellular nuclear antigen (PCNA) were determined. Results RA exhibited anti-proliferative effects on cultured HSCs in a time and concentration dependent manner showing an IC

Molecular and serological prevalence of Toxoplasma gondii in pregnant women and sheep in Egypt

Objective To investigate molecular and serological prevalence of Toxoplasma gondii (T. gondii) in pregnant women and sheep in Egypt. Methods Blood samples collected from healthy 364 pregnant women and 170 sheep were investigated for T. gondii antibodies and parasitemia using highly specific and sensitive surface antigen (TgSAG2) based enzyme linked immunosorbent assay (ELISA) and real time-polymerase chain reaction (RT-PCR). Results Overall prevalence of T. gondii was 51.76%, 17.65% in sheep, 33.79%, 11.81% in pregnant women, using ELISA and RT-PCR respectively. Significant differences in T. gondii prevalence were observed on the basis of contact with cats or soil in pregnant women using either RT-PCR or ELISA. In pregnant women, a significant increase was detected in aged and those eating under-cooked mutton using simultaneous ELISA/RT-PCR. Conclusions Consumption of under-cooked infected mutton is an important source of human infection and the combination of the two assays provide accurate and precise data during infection.

Noncompaction cardiomyopathy: case presentation with cardiac magnetic resonance imaging findings and literature review

Left ventricular noncompaction cardiomyopathy is a very rare condition, yet believed to be often overlooked. It is thought to be caused by the developmental arrest in embryogenesis and characterized by an increase in the noncompacted, trabeculated myocardium adjacent to compacted myocardium in the left ventricular. The clinical presentations of this type of cardiomyopathy are of variable severity. Echocardiography used to be the diagnostic modality, but recent reports suggest that cardiac magnetic resonance imaging has higher sensitivity and specificity by showing a ratio of the noncompacted myocardium to compacted myocardium of > 2.3

Iron profile and dietary pattern of primary school obese Egyptian children

Poor iron status affects billions of people worldwide. The prevalence of obesity continues to rise in both the developed and developing nations. An association between iron status and obesity has been described in children and adults. The aim of the study was to assess the iron profile and dietary pattern in primary school-aged obese Egyptian children. A case-control study was conducted on 120 children, both obese [n=60] and control group [n=60], recruited from three primary governmental schools located in Dokki Sector, El-Giza Governorate, Egypt. Their ages ranged from 6 to 12 years. All children were subjected to full medical and dietetic history, anthropometric measurements, thorough clinical examination, and determination of complete blood count, serum iron, total iron-binding capacity, transferrin saturation [TS], and ferritin. Despite similar dietary iron intake in the two groups, obese children showed highly significantly decreased hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, serum iron, and TS, and increased mean corpuscular hemoglobin concentration and total iron-binding capacity when compared with the nonobese group. The obese group showed a highly significant increased rate of iron deficiency [ID] [TS<15% or mean corpuscular volume<76 fl] when compared with the nonobese group. Obesity was a significant risk factor for the development of ID [odds ratio: 7.09, 95% confidence interval: 3.16-15.92]. The association between ID and obesity may have important public health and clinical implications. For primary school children with elevated BMIs, screening for ID should be considered. Increasing awareness of the importance of physical activity and carrying out nutritional education programs are required

Biochemical evaluation of renal osteodystrophy in uraemic patients

Renal osteodystrophy is a multifactorial disorder of bone remodelling that develops in patients with chronic renal failure [CRF]. Biochemical markers of bone turnover have been proposed for the noninvasive diagnosis of renal osteodystrophy. The purpose of this study was to evaluate intact parathyroid hormone [iPTH] and some markers of bone disease in predialysis [preD] and haemodialysis [HD] CRF patients and correlate them with bone mineral density [BMD]. Several biochemical markers were measured in the serum of 74 CRF patients [38 preD patients and 36 patients on regular HD]. In addition, 30 healthy volunteers were included as controls. BMD of all patients was measured by means of calcaneal ultrasonography. BMD was measured by means of ultrasound. BMD was significantly decreased in both patient groups when compared with controls. Also, it was significantly lower in patients with osteoporosis than in those with osteopenia. iPTH, total alkaline phosphatase [ALP] and osteocalcin [OC] levels were significantly elevated in both patient groups when compared with controls. Ionized calcium [Ca[2+]], free carnitine and insulin-like growth factor-1 [IGF-1] levels were significantly decreased in patients compared with controls. There was a significant inverse correlation of BMD with iPTH, ALP and OC and a significant positive correlation with Ca[2+] and IGF-1 in HD patients. PreD patients showed significant inverse correlation of BMD with iPTH and ALP and significant positive correlation with Ca[2+]. The results of the present study suggested that ultrasound is a useful method for evaluating BMD and provides information about diverse regional skeletal changes in CRF patients. iPTH, ALP, OC and Ca[2+] can predict renal osteodystrophy in preD and HD CRF patients. PreD and HD CRF patients often have low serum concentrations of free carnitine and IGF-1

Ultrastructural study on biomphalaria alexandrina haemocytes infected with schistosoma mansoni in Egypt and its correlation with nitric oxide level

Some snails of Biomphalaria alexandrina can resist the infection of Schistosoma mansoni so this study aimed to clearly this mechanism by using light and electron microscopy [EM] and determine the role of Nitric oxide in this mechanism. B. alexandrina snails used in this study were exposed individually to S. mansoni infection according to their response they were classified into susceptible group [shed cercariae] and resistant group [failed to shed cercariae]. Snails not exposed to infection were included in this study as control group. Nitric oxide [NO] level was assayed directly in the soluble fraction of B. alexandrina haemolymph supernatants collected from each group of B. alexandrina snails were subjected to NO assay by the Greiss reaction. The level of NO in haemolymph of infected snails was significantly increased [p<0.001] than both control and non infected snails groups, however, in non infected snails group had significantly [p<0.05] compared to control group. This study when correlated the changes recognized by EM with NO level the pro apoptotic effect of high level of NO on the haemocytes. Characterization and identification of cell shape of haemocytes in both haemolymph and tissue were examined by light and electron microscopy. Examination of B. alexandrina snail's haemocytes revealed three types of different cells classified according to their shape and granular contents. These cells are granulocytes, amoe-bocytes and hyalineocytes. Electron microscope Study also revealed the important role of granulocytes and amoebocytes as defense mechanism against snail infection. NO is considered an important anti parasite molecule; intra-molluscan stages of parasites switch off host NO defense response

Role of thyroxin versus Brewer's yeast supplementation in amelioration of pancreatic alterations induced by hypothyroidism in adult male albino rats

Induction of hypothyroidism by carbimazole could affect many glands including the pancreas. Brewer's yeast, a herbal product, is recently under research for its possible uses. The aim of the study was to study the microscopic, morphometric, and biochemical changes in the pancreas of hypothyroid rats and to evaluate the role of thyroxin versus Brewer's yeast in amelioration of these changes. Sixty adult male albino rats were randomly divided into five groups. Group I rats served as a control group. Group II rats received carbimazole. Group III rats received carbimazole followed by thyroxin. Group IV rats received carbimazole followed by Brewer's yeast. Group V rats received only Brewer's yeast. At the end of the experimental period, specimens from the pancreas were processed for light and transmission electron microscopic examinations and immunostaining for Ki-67. Biochemical analysis for T3, T4, and insulin was performed. In addition, body mass gain and pancreatic mass were measured. All parameters were statistically analyzed. Group II specimens revealed congestion of blood vessels and cellular infiltration. Acinar cells showed pyknotic nuclei, hyalinization, and vacuolation of the cytoplasm, with few zymogen granules. beta Cells of the islets of Langerhans revealed depletion of organelles and small granules without their characteristic halo. Immunostaining revealed significant decrease in the percentage of Ki-67-positive nuclei. In group III, the acini revealed numerous secretory granules, few vacuoles, and euchromatic nuclei. beta Cells showed secretory granules with the characteristic halo. Group IV revealed less improvement in the histopathological changes as compared with group III. T3, T4, and insulin levels were significantly lower in hypothyroid rats in comparison with the control group, whereas administration of thyroxin showed restoration of these levels to near control values. Hypothyroidism showed a deleterious effect on the histological structure of rat's pancreas. Administration of thyroxin minimized these effects more than administration of Brewer's yeast

Hazards of nanotechnology: effect of titanium dioxide nanoparticles on the liver and renal cortex of albino rats. An electron microscopic study

Exposure to titanium dioxide nanoparticles [TiO[2] NPs] results from its wide use in the fields of medicine, industry, engineering, and environmental technology. To investigate the effect of administration of TiO[2] NPs on the ultrastructure of the rat liver and renal cortex. Rats were subdivided into two groups: group A [served as control] and group B [TiO[2] group]. TiO[2] was suspended in PBS and administered by an oral gavage to the rats of group B daily for 90 days at a dose of 5 mg/kg body weight. Thereafter, group B was subdivided into group B1 and sacrificed 24 h after the last dose of titanium. Group B2 was left untreated for 12 months and then sacrificed. Specimens from the liver and renal cortex were obtained and processed for examination by transmission electron microscopy. Histopathological changes were detected in the hepatocytes of group B1 in the form of dilated rough endoplasmic reticulum, numerous lysosomes, and abnormal mitochondria. Moreover, accumulation of large lipid droplets and wide cytoplasmic vacuoles was observed. The renal cortex was also affected. Numerous lysosomes were observed in the lining cells of the proximal tubules and the glomerulus showed an apparent increase in the number of mesangial cells. The interstitium was the site of excessive collagen bundles. These hepatic and renal cortical changes were partially ameliorated 12 months after the last dose of TiO[2]. Small doses of TiO[2] NPs for a long duration resulted in a variety of degenerative changes in the rat liver and renal cortex. Therefore, further studies are required to investigate the underlying mechanisms of this toxicity and to search for possible protective measures

new look at an old agent for pleurodesis

Background and objective: Malignant pleural effusion [MPE] is a common problem in patients with malignancies. Chemical pleurodesis is the most commonly used palliative option. Parenteral tetracycline [TET] and doxycycline [DOX] are cost-effective and safe in producing pleurodesis but mostly unavailable currently. We investigated whether oral doxycycline could produce an efficient and safe pleurodesis as does parenteral doxycycline, which is currently unavailable in many countries

Methods: A prospective study of 24 pleurodesis procedures in 22 patients with malignant pleural effusions were conducted over a 3-year period. All pleurodesis was performed with oral forms of doxycycline as the sclerosing agent, where about 1000 mg of doxycycline was taken and prepared from the oral preparation [vibramycin 100 mg/capsule] and mixed in 50 ml. Physiological saline was then administered via tube thoracostomy. We assessed the success or failure of pleurodesis in addition to the frequency of complications and survival. Post-pleurodesis postero-anterior [PA] radiographs were obtained after tube removal and 30 days following the procedure

Results: Twenty-two patients were included [6 women, 16 men], the mean age was [62.5 years]. Origins of MPE were: lung and pleura 8 [36.4%], breast 2 [9.1%], ovarian 2 [9.1%], digestive 3 [13.6%], lymphoma 3 [13.6%] and unknown 4 [18.2%]. No immediate perioperative complications were noted. Chest tube duration averaged 4.2 +/- 2.6 days. Immediate postoperative events included chest pain in 10 patients [45.5%], fever in 2 [9.1%] patients, pain and fever in 5 patients [22.7%]. Sixteen patients [72.7%] had successful pleurodesis and 6 patients [27.3%] had failed pleurodesis at 1 month

Conclusions: Pleurodesis with oral forms of doxycycline dissolved in sterile saline solution have a high success rate with a low incidence of complications and could be a good option as palliative therapy in patients with symptomatic malignant pleural effusions

Role of the quantiferon-TB gold in tube in ruling out tuberculosis in end stage renal disease patients receiving hemodialysis

It is difficult to diagnose tuberculosis [TB] in dialysis patients because of the high rate of extrapulmonary TB in these patients compared with the general population. Recently, a new diagnostic test called QuantiFERON[QFT] has been developed and shown promise as a diagnostic tool for active TB diseases and latent TB infection. The aim of the present study was to analyze the performance of QuantiFERON-TB Gold in tube [QFT-G] in end stage renal disease patients receiving hemodialysis. QuantiFERON Gold in tube [QFT-GIT] were prospectively performed in 50 end stage renal disease [ESRD] cases undergoing hemodialysis [HD], including 6 patients with active TB and evaluated the utility of this test in dialysis patients. Among 50 dialysis patients, positive QFT results occurred in 10 [20%], negative QFT results occurred in 25 [50%] and indeterminate QFT results occurred in 15 [30%]. All six active TB patients had positive QFT results, and none of the 25 patients with negative results had active TB. Among 7 patients with a history of active TB, 2 [28.5%] had positive results. Although the indeterminate rate was relatively high, no patient with an indeterminate result had active TB. Among 30 cases after excluding the patients with previous TB and indeterminate results, the sensitivity of the QFT is 100% [6 of 6] and the specificity is 91.6% [22 of 24 cases]. Our data suggest that the QFT test is a useful supplementary tool for the diagnosis of active TB even in dialysis patients. Negative and indeterminate results on this test may be used to exclude the presence of active TB

Procalcitonin as a diagnostic marker in acute exacerbation of COPD

Rational prescription of antibiotics in acute exacerbations of COPD [AECOPD] requires predictive markers. Acute phase reactants are capable of demonstrating the inflammation; however, they cannot be employed to make a difference between bacterial and nonbacterial causes of the inflammation. Recently, measurement of procalcitonin [PCT] levels appears to be useful in order to minimize this problem. We aimed to evaluate the diagnostic and prognostic role of procalcitonin in [AECOPD]. A total of 50 patients with AECOPD and 10 of apparently healthy individuals [control group] were studied. On presentation, serum PCT concentrations were measured, and quantitative sputum culture was performed for AECOPD. The patients were reevaluated when they had returned to their stable clinical state. Pathogenic bacterial microorganism [PBM] was only regarded as significant if they reached a growth 105CFU/ml, indicating the presence of bacterial exacerbation of COPD. The patients were classified into two subgroups: group A included patients with bacterial AECOPD [n = 20], group B included patients with nonbacterial AECOPD [n = 30]. On presentation, the levels of PCT for patients of group A [2.69 +/- 0.62 ng/mL] were significantly higher than group B [0.07 +/- 0.02 ng/mL] and control group [0.05 +/- 0.02 ng/mL] [p < 0.001]. When they had returned to their stable state, the levels of PCT for patients of group A decreased to [0.06 +/- 0.03 ng/mL], which was significantly lower than that in exacerbation [2.69 +/- 0.62 ng/mL] [p < 0.001]; But in patients of group B compared with exacerbation the levels of PCT did not changed [0.068 +/- 0.02 ng/mL] [p > 0.05]. In the stable state, there were no differences in the PCT measurement between the two subgroups as well as between patients and control. Furthermore, a significant correlation was recorded between PCT levels in group A at time of presentation and temperature [r = 0.898, p < 0.05], leucocytic count [r = 0.889, p < 0.05], FEV1% of predicted [r = 0.898, p < 0.05], ESR [r = 0.899, p < 0.05], CRP [r = 0.895, p < 0.05] and duration of hospital stay [r = 0.897, p < 0.05]. Procalcitonin is a good marker for differentiation between bacterial and nonbacterial AECOPD and could be used to guide antibiotic therapy and reduce antibiotic overuse in hospitalized patients with AECOPD

Levels of helminthic infections in the quails coturnix coturnix from kingdom of Saudi Arabia

The present study aims to clarify the difference of the intensity of parasitic infection between the domestic quails Coturnis coturnis and the migrant ones. A total of 60 domesticated and 60 migratory quails were investigated during the migration season September-November 2009 for intestinal parasites. Investigations revealed that both domestic and migrant quails were susceptible to infection with three helminth parasites; a nematode [Heterakis gallinaruni], and two cestodes [Choanotae-nia infundibulum and Hymenolepis sp.]. The prevalence of infection in the migratory males was higher than the female ones, the opposite results was obtained for the domestic birds. The differences in the prevalence were found to be statistically significant in case of the domestic birds. Single infection showed the highest prevalence followed by the double infection and finally the triple infection. The mean intensity of infection in the female domestic and migrant C. coturnix was higher than male

How effective is systematic care of diabetic patients? a study of four primary healthcare centers in Qatar

With the ultimate goal of improving medical care for diabetes, a study of four Primary Healthcare Centers [PHC] surveyed the composition of PHC population, completeness of patient data, changes in biochemical variables two years before and after establishing specialized diabetic clinics. Patients with diabetes of less than four years duration were excluded from the study. Most [71.7%] of 403 patients with Type II diabetes were aged 40-59 years. Diabetes regulation [HbA1C], lipid levels [total cholesterol], systolic blood pressure and creatinine improved significantly after inclusion in the specialized diabetic clinic demonstrating that the introduction of systematic care for diabetic patients was effective and lead to an improvement in the recorded process measures and outcome criteria

Assessment of factors affecting clinical teaching as perceived by nurse-teachers and nursing students in secondary technical nursing schools in Assiut City

Clinical training provides the nurse-students with knowledge skills and attitudes to provide patient's care with high quality in different settings. Clinical practice provides the opportunit for students to become skillful in the use of theories of action and provides a fertile experience in learning how to learn. The objectives of this study were to assess the factors affecting clinical teaching experience as perceived by nurse-teachers and nurse students. The study was done in three females' secondary nursing schools in Ass jut City. The subjects included in the study were 28 nurse teachers and 212 nurse-students. The data collection tool, which used consisted of questionnaire sheet for nurse-teachers and students, nurse. This questionnaire was aimed at identifying teachers and students perception about the factors that influence student's acquisition of clinical experience; the questionnaire was composed of three parts: 1-Structure factors: This part included hospital and external units [10 factors], school laboratory [6 factors], nursing team [13 factors], physician's team [8 factors] patients and their families [8 factors], and administration [7 factors]. The qualification needed for the clinical teaching [4 factors] and interpersonal traits of the clinical teacher [5 factors].2-Process factors: this part included interpersonal relationship of clinical teacher [6 factors], nursing competence of the clinical teacher [14 factors] and teaching competence of the clinical teacher [10 factors]. 3-Out come factors: this part included [12 factors]. In the light of the findings of this study, it can be concluded that the students and teachers gave priority to the importance of the process factors. There were statistically significant differences between students and teachers opinions regarding structure, process and outcome factor

Ultrastructural and histopathological changes in Giardia lamblia-infected hamsters following administration of two natural compounds and/or metronidazol

The use of combined treatment of metronidazole together with arthemisia and rosemary for controlling intestinal Giardia lamblia infection has been studied. Forty laboratory-bred male hamsters were used in the current experimental study. Each hamster was infected, orally, by 10.000 Giardia lamblia cysts. Animals were divided into the following groups: [1] control infected untreated, [2] infected treated with metronidazole, [3] infected treated with arthemisia and rosemary, [4] infected receiving combined treatment of metronidazole plus arthemisia and rosemary. Each treatment was applied three weeks post-infection. Two weeks later stool analysis was performed and the number of cysts/gm stool was counted, followed by scarification of all animals. The effect of the different drug regimens on the vegetative forms [trophozoites] of the parasite was also studied. There was a highly significant cyst reduction in all treated groups compared to control animals. The highest percentage trophozoite reduction [98.7%] was found in group 4 receiving combined treatment of metronidazole plus arthemisia and rosemary, followed by group 2 [94.8%] and group 3 [62.2%]. By histology, healing of mucosal ulcerations, preserved villi and reduced chronic inflammatory infiltrate in the lamina propria were detected with combined therapy. Ultrastructurual examination of the small intestine in animals of control group showed destructed intestinal cell projections by Giardia lamblia cysts with degeneration of the intestinal submucosa. With combined treatment, complete repair of the intestinal cell projections as well as healing of the mucosa and the submucosa were noticed. Meanwhile, partial healing of destructed intestinal cell projections was observed in group 2 receiving metronidazole alone. It was concluded that the best results were obtained following combined treatment of metronidazole together with arthemisia and rosemary. This might be useful in endemic areas where people tend to develop drug resistance to the commonly used anti-Giardia lamblia preparations