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We present two cases of pediatric acute myeloblastic leukemia complicated by hemophagocytic lymphohistiocytosis often of poor prognosis, this rare combination highlights the lack of specific therapeutic Protocol as well as diagnosis and prognosis difficulties associated with it
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The present study was conducted to evaluate the potential gastric protective and therapeutic effects of ranitidine mucoadhesive hydrogel formulae against ethanol induced gastric ulceration in rats. Adult female albino rats weighing between 200-220 g ,75 rats for evaluation of mucoadhesiveness of hydrogel and 70 rats for evaluation of protective and therapeutic effect of ranitidine hydrogel. The seventy rats were randomly divided into two experiments, protective and therapeutic effects of newly developed ranitidine mucoadhesive hydrogel formulae containing polymer mixture of Chitosan and Hydroxypropyl methyl cellulose [HPMC] at ratio 9:1 [F1] or mixture of Sodium carboxymethyl cellulose [NaCMC] and HPMC at ratio 9:1 [F2]. Each experiment has five groups, seven rats each; group 1 serves as control and group 2 serves as ulcer control since received a single oral dose of absolute ethanol [5ml/kg body weight]. Group 3 ulcer group received an oral dose of ranitidine [27mg/kg], while groups 4 and 5 ulcer group received newly formulae of ranitidine F1and F2 respectively. In the present study some gastric parameters as ulcer index, total acidity, gastric volume and pH besides some biochemical parameters as alanine aminotransferase [ALT], aspartate aminotransferase [AST] and total antioxidant capacity [TAC], total protein [TP] level and alkaline phosphatase [ALP] activity were carried out at the end of the experimental period.The present study showed that F1 revealed more protective and therapeutic potency than F2 as it was significantly reduced ulcer index, total acidity, gastric volume and pH in comparison to ulcerated group [p<0.05]. Also, the biochemical markers ALT, AST and TAC were decreased significantly compared to ulcerated group in both experiments. TP level and ALP activity were altered among different treatments. Moderate improvement in mucus secretion was recorded for F1 and F2 treatments than the reference drug. The present results were confirmed by the histopathology findings. Collectively, the current study confirmed the better therapeutic action of formulae 1 and 2 over the pure drug and that F1 was the most potent formula. Also, it encouraged the use of F2 as a curative agent of ulceration rather than a protective one
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The use of medicinal plants for management of diabetes mellitus is an old practice which has become even more relevant in modern perspective. The present work was designed to evaluate the effect of a mixture of five medicinal plants which used in folk medicine in Egypt especially in Sinai as hypoglycemic agents on the adult male diabetic rats. These plants are Cleome droserifolia [Samwah], Ambrosia maritima [Damsissa],Artemisia judaica [Shih kharasani], Chiliadenus montanus or Jasonia Montana [Neheda] and Artemisia annua [Kaysom]. Thirty male albino rats were divided equally into three groups including control, diabetic and diabetic treated with a mixture of aqueous extract. A single dose of alloxan [120 mg/kg body weight] was used to induce diabetes in rats. Diabetic rats were given plant mixture extract orally twice daily for 30 days [28.5 mg/kg body weight [b. wt.] twice/day]. There was a marked decline [p<0.01] in levels of serum insulin, body weight [4.98 %], total proteins, albumin, globulin and high density lipoproteins [HDL] accompanied with marked elevation [p<0.01] in levels of fasting blood glucose, homeostasis model assessment of insulin resistance [HOMA_IR], aspartate aminotransferase[ASAT], alanine aminotransferase [ALAT], gamma-glutamyltransferase [GGT], urea, creatinine, uric acid, serum total lipids[TL], total cholesterol [TC], triglycerides TG, low density lipoproteins [LDL], and very low density lipoproteins[VLDL],risk ratios of TC/HDL and LDL/HDL in diabetic rats as compared to the control rats. While administration of aqueous extract of plant mixture to alloxan diabetic rats significantly ameliorated the disturbed biochemical parameters. These results proved that this plant mixture extract has a significant hypoglycemic effect and ameliorating metabolic abnormalities induced by diabetes mellitus
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Animales de Laboratorio , Plantas Medicinales , Diabetes Mellitus Experimental , Hipoglucemiantes , Antioxidantes , Extractos Vegetales , Ratas , Aloxano , InsulinaRESUMEN
Diabetes mellitus is one of the common and widely distributed metabolic diseases all over the world. This disease is characterized by hyperglycemia that results from defects in insulin secretion, insulin action or both. In Asia, different medicinal plant species are used as a traditional treatment for diabetes mellitus e.g. Jasonia montana [Neheda] was one of these plants that was used in a mixture to treat diabetic patients long times ago. This work was aimed to investigate the antidiabetic, hypolipidemic and antioxidant effects of the aqueous extract of Jasonia montana [Neheda] on the alloxan-induced diabetic male albino rats. This study was performed on thirty male albino rats with an average 100-110 g body weight. The animals were divided into three groups [10 /cage]; Group I [Control untreated group], Group II [Alloxan-induced diabetic group] and Group III [diabetic group treated orally with "28.5 mg/ kg body wt. twice/ day" of the plant extract]. The biochemical results showed marked decline [p<0.01] in levels of the serum insulin, body weight, total proteins, albumin, globulin and HDL accompanied with marked elevation [p<0.001] in the levels of fasting blood glucose, levels of HOMA_IR, AST, ALT, GGT, urea, creatinine, uric acid, serum TC, TG, LDL, VLDL and ratios of TC/HDL and LDL/HDL [risk factors] in diabetic rats in comparison with the control group. Daily management of diabetic rates with aqueous extract of Neheda showed significant improvement in most of these parameters. Histologically, considerable improvement in the morphological changes that was observed in diabetic groups had been detected after treatment with Neheda in liver, kidney and pancreatic tissues in comparison to the control group. It could be concluded that Jasonia montana [Neheda] can be used as an antidiabetic drug that can lower blood glucose concentration and guard against the negative effects of diabetes
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Masculino , Animales de Laboratorio , Sustancias Protectoras , Medicina Tradicional , Fitoterapia , Asteraceae/efectos adversos , Resultado del Tratamiento , RatasRESUMEN
Diabetes mellitus is one of the common and widely distributed metabolic diseases all over the world. This disease is characterized by hyperglycemia that results from defects in insulin secretion, insulin action or both. Different medicinal plant species are used as a traditional treatment for diabetes mellitus e.g. Ambrosia maritima, L. [Damsissa] which is one of these plants that its extract was used to treat diabetic patients long times ago. This work was aimed to investigate the antidiabetic, hypolipidemic and antioxidant effects of the aqueous extract of Ambrosia maritima, L. [Damsissa] on the alloxan-induced diabetic male albino rats. This study was performed on thirty male albino rats with an average 100-110 g body weight. The animals were divided into three groups [10 /cage]; Group I [Control untreated-group], Group II [Alloxan-induced diabetic group] and Group III [diabetic group treated orally with "28.5 mg/ kg body wt. twice/ day" of the plant extract]. The biochemical results showed marked decline [p<0.01] in the levels of the serum insulin, body weight, total proteins, albumin, globulin and HDL accompanied with marked elevation [p<0.001] in the levels of fasting blood glucose, levels of HOMA_IR, AST, ALT, GGT, urea, creatinine, uric acid, serum TC, TG, LDL, VLDL and ratios of TC/HDL and LDL/HDL [risk factors] in diabetic rats in comparison with the control group. Daily management of the diabetic rates with aqueous extract of Damsissa showed significant improvement in most of these parameters. Histologically, considerable improvement in the morphological changes that was observed in diabetic groups had been detected after treatment with Damsissa in liver, kidney and pancreatic tissues in comparison to the control group. It could be concluded that Ambrosia maritima, L. [Damsissa] can be used as an antidiabetic drug that can lower blood glucose concentration and guard against the negative effects of diabetes
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Masculino , Animales de Laboratorio , Sustancias Protectoras , Ambrosia/efectos adversos , Ratas , Hígado/ultraestructura , Riñón/ultraestructura , Páncreas/ultraestructura , Resultado del TratamientoRESUMEN
Pancreatic carcinoma is one of the leading cancer morbidity and mortality worldwide. Endoscopic Ultrasound [EUS] provides good direct visualization of the pancreas and EUS-FNA raises the accuracy for diagnosing pancreatic malignancies. US-FNA is another established method for diagnosing pancreatic malignancies. To determine the Role of Percutaneous US-FNA and EUS-FNA in diagnosis of pancreatic lesions. 131 patients with pancreatic masses were included in the study and sub-classified into 2 groups according to the imaging tool used, US-FNA [group I] and EUS-FNA [group II]. Using the appropriate statistical tools, sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV] and diagnostic accuracy were calculated for both groups. It was 88.2%, 93.9%, 96.8%, 97.5% and 90.1% respectively in group I. It was 77.8%, 100%, 100%, 75% and 86.7% respectively in group II. US-FNA/EUS-FNA are safe reliable tools for diagnosis of pancreatic lesions
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Humanos , Masculino , Femenino , Cabeza/patología , /métodos , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
This study was done to assess the value of purified Schistosoma snails antigens in diagnosis of schistosomiasis. Five antigens were used, S.mansoni adult worm crude antigen, snails antigens [foot and visceral hump of B.alexandrina and B.truncatus]. Specific hyperimmune mice sera versus each antigen were prepared. Known positive and negative human sera and uninfected mice sera were used as control. Two ELISA techniques [conventional and sandwich] were performed. There was high similarity between S.mansoni crude antigen and B.alexandrina foot antigen in detecting S.mansoni antibodies [100% and 80% respectively] at serum dilution 1:50. B.alexandrina visceral hump antigen detected only 33.3%. Both B.truncatus antigens gave negative results. Sandwich ELISA technique proved to be more species specific than conventional ELISA. B.alexandrina foot antigen was found to be the best antigen among the tested antigens that can replace S.mansoni adult worm crude antigen in diagnosis of schistosomiasis
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Caracoles/inmunología , Antígenos/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática/métodosRESUMEN
Acute lung injury [ALl] or acute respiratory distress syndrome is a serious clinical problem with high mortality. Oxidative stress was found to play a major role in mediating lung injury and antioxidants have been shown to be effective in attenuating ALI. In this study, we determine the effects of tempol, a membrane-permeable radical scavenger, in lipopolysaccharide [LPS] induced ALl and the underlying mechanism. ALl was induced by intraperitoneal injection of LPS [lmglkg] and mice were treated with tempol 30 mm before injection of LPS. One hour later, bronchoalveolar lavage fluid [BALF] was collected and subjected to estimation of total and differential cell counts as svell as the proinflammatory cytokines; tumor necrosis factor-alpha [TNF-alpha], interleukin-1beta [IL-1beta] and interferon-gamma [IFN-gamma]. Lung tissue damage was confirmed by histopathological changes and by immunohistochemical analysis of myeloperoxidase [MPO]. Moreover, lipid peroxidation, reduced glutathione [GSH] and nitric oxide [NO] were investigated in the lung tissue. Pretreatment with tempol produced significant attenuation of LPS-induced lung injury as well as inhibition of LPS mediated increase in MPO immunostaining, MDA and NO levels in lung tissue. Elevated cytokines levels in both BALF and lung tissue homogenates of ALl mice were significantly decreased after administration of tempol. These findings confirmed significant protection by tempol against LPS-induced acute lung injury and that superoxide anion scavenging appears to be a potential target for new potential therapy in pulmonary disorders
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Animales de Laboratorio , Lipopolisacáridos , Ratones , Estrés Oxidativo , Óxidos N-Cíclicos , Pulmón/patología , Histología , InmunohistoquímicaRESUMEN
In childhood acute lymphoblastic leukaemia [ALL], the eye would represent a pharmacological sanctuary, source of unexpected relapse. Three boys aged of 13 years, 4 and 5 years presented after the complete remission, a lymphoblastic relapse in the anterior segment of the eyes in the first two cases, and in the posterior segment of the left eye in the third case. The treatment was a systemic chemotherapy and orbital radiotherapy of 12 Gray. The patients died after they experienced bone marrow and/or central nervous system relapses within the first year. The outlook for children with ocular relapse remains poor. Only radiotherapy doses superior then 30 Gray can eradicate lymphoblastic cells and improve the prognosis
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Pancreatic Cancer is a very aggressive tumor with an extremely poor prognosis. Early diagnosis, accurate preoperative staging and better adjuvant treatment remain a challenge. Abdominal ultrasound, abdominal CT, EUS and ERCP are common tools used for imaging of pancreatic cancer. Fine needle aspiration has made significant contribution to the diagnosis of cancer pancreas. The aim of the present work was to evaluate the role of ultrasound guided fine needle aspiration cytology [FNAC] in the diagnosis of pancreatic masses and in the differentiation of cancer pancreas from benign lesions. In addition to that, the level of serum CA 19-was measured to assess its accuracy in differentiating cancerous from benign lesions. This cross sectional study included forty patients with pancreatic lesions. They were subjected to full clinical examination, laboratory tests [including serum level CA 19- 9], abdominal ultrasound, percutaneous sonar guided FNAC of pancreatic lesions, endosonography and surgical interference [was done to 32 patients]. Thirty three patients proved to have pancreatic malignancy while seven patients proved to have pancreatitis. Ultrasonography [US] showed a sensitivity of 70%, specificity of 86% and accuracy of 73% for malignancy detection. Adding CAI9-9 to ultrasound raised the sensitivity to 94%, specificity remained 86% and accuracy to 93%. Adding FNAC to US raised the sensitivity to 85%, specificity remained 86% and accuracy to 91%. EUS showed a sensitivity of 90%, specificity of 100% and accuracy of 91%. Adding CA to EUS showed a sensitivity of 94%, specificity of 100% and accuracy of 91%. Adding FNAC to EUS showed a sensitivity of 97%, specificity of 86% and accuracy of 97%. The combination of EUS, serum CAI9-9 level and sonar guided fine needle aspiration showed an accuracy of 97% in the diagnosis of pancreatic lesions. These investigatory tools are cheap and available and thus may be an excellent alternative to EUS guided fine needle aspiration which is expensive and available in only a few centres
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Humanos , Masculino , Femenino , Abdomen/diagnóstico por imagen , Endosonografía , Antígeno CA-19-9/sangre , Biopsia con Aguja Fina , Sensibilidad y Especificidad , Estudios TransversalesRESUMEN
Ureteral replacement has always been a challenge. In this article, we tried to assess the outcome of segmental ureteral replacement using a free peritoneal tubal graft in a dog. Transperitoneal exploration of the upper urinary tract of 6 Mongrel dogs was performed and creating a free peritoneal graft. A 2cm segment of right upper ureter was excised, while the left ureter was left as a control. This segment was replaced by a peritoneal tube around a 6 F double-J ureteral stent which was removed after one month. Follow up intravenous urography [IVU] and abdominal ultrasonography were done prior to autopsy. All animals were sacrificed 3 months after the initial procedures for gross and histopathological assessment. All animals survived the entire follow up of 3 months without serious complications. Two months after stent removal, follow-up IVU and abdominal ultrasonography revealed that variable degrees of hydroureteronephrosis were noticed on the right kidney and ureter with normal left side. At the time of sacrifice, there was moderate to severe hydroureteronephrosis above the level of the periotoneal tube in all animals. Abdominal adhesions and narrowing of the ureteral lumen at the site of the graft were observed. Histopathological interpretation showed that the urothelium was creeping over the mesothelial graft with focal inflammation and fibrosis in all cases while local osseous metaplasia of the graft was noticed in three dogs. Ureteral replacement by peritoneal tube was unsatisfactory despite the usage of ureteral stent. Further studies are needed to evaluate the use of peritoneal patch graft or other biomaterials for ureteral reconstructions
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Animales , Peritoneo , Perros , Estudios de Seguimiento , Ultrasonografía , Complicaciones Posoperatorias , Insuficiencia del Tratamiento , Uréter/patología , Modelos AnimalesRESUMEN
To review the clinical features and outcome of all cases of stage 4S neuroblastoma treated at our center. We retrospectively reviewed the files of all patients [n=75] with neuroblastoma treated at King Abdul-Aziz Medical City, Jeddah, Kingdom of Saudi Arabia between 1986 and 2005. We studied the clinical features and outcome of patients with stage 4S neuroblastoma. Six patients [8%] were confirmed to have stage 4S neuroblastoma. Three were boys with a median age at diagnosis of 4.5 months [range 28 days - 11 months]. Four patients required no intervention. The remaining 2 patients were treated with chemotherapy due to progressive hepatomegaly and respiratory distress. No patient required radiotherapy or surgical intervention. With a median follow up of 4 years [range 9 months - 15.5 years], all patients are alive and well. Two patients continue to have a residual abdominal mass, while complete resolution occurred in the others. Stage 4S neuroblastoma is a special tumor that carries excellent prognosis. Spontaneous regression may occur and intervention is only required in symptomatic patients
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Humanos , Masculino , Femenino , Estadificación de Neoplasias , Regresión Neoplásica Espontánea , Pronóstico , Neoplasias Cutáneas/secundario , Neoplasias Hepáticas/patología , Factores de Edad , Estudios de Seguimiento , Protocolos de Quimioterapia Combinada Antineoplásica , Análisis de Supervivencia , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
The cancer of infant is a rare event. The differences of infant cancer types lead to a different approach of diagnosis and treatment. This study is a retrospective analysis of all cases of cancer in infants less than 1 year-old in the Paediatric Oncology Unit of Rabat Children Hospital. From January 1992 to December 2002, 90 infants were followed-up for cancer. Neuroblastoma was the most frequent tumour [34%], followed by nephroblastoma [15%], leukaemia [13%], sarcoma [11%] and retinoblastoma [8%]. Germinal cell tumours were found in 6 cases and hepatoblastoma in 3 cases. Treatment consisted in chemotherapy in 73 cases. Surgery alone was done in 7 cases and radiotherapy in 5. The event free survival rate at 130 months was 47.2% +/- 9% and the overall survival 66.8% +/- 7%. In conclusion, the distribution of cancer in the young infant is different of the older child. The diagnostic and therapeutic approach must take these characteristics into account
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Humanos , Masculino , Femenino , Lactante , Estudios Retrospectivos , Neuroblastoma , Tumor de Wilms , Leucemia , Sarcoma , RetinoblastomaRESUMEN
Child malignant lymphoma involving the gastrointestinal tract is common, but that of the rectum is rare. Incidence and prognosis are difficult to assess. We present a case of primary malignant lymphoma of the rectum in an 11 year-old boy who had rectal bleeding, altered bowel habits and a bad general status during 3 months before. Proctosigmoidoscopy and histology revealed the presence of B lymphoid cells. Our patient was treated by chemotherapy with GFALB 2001 protocol. We obtained a complete remission after 5 months of treatment with 13 months of backward. We stress the importance of a fast diagnosis in case of a rectal syndrome in a child
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Humanos , Masculino , Neoplasias del Recto/patología , Niño , Linfocitos BRESUMEN
Hodgkin's disease can be associated to autoimmune disorders including autoimmune hemolytic anemia. This association is rare. We report a Hodgkin's disease revealed by haemolytic anaemia in two children. Case 1: a 13 year-old boy presented acute hemolysis one month before with abdominal lymph nodes. The Coombs test and IgG were positive. In spite of corticosteroid therapy during two months, the hemolysis has persisted. Abdominal lymph nodes biopsy was achieved. This biopsy revealed a Hodgkin's disease. The chemotherapy has permitted a complete remission of the Hodgkin's disease and the cure of hemolysis. The follow-up is 27 months. Case 2: a 11 year-old girl presented an hemolytic anemia two months before. She had an abdominal mass and a splenomegaly. The Coombs test and IgG were positives. The abdominal mass biopsy diagnosed a Hodgkin's disease. The chemotherapy cured the hemolysis. The Hodgkin's disease was in complete remission after a follow-up of 26 months. This patient developed a vitiligo in the beginning of the treatment. Hodgkin's disease is a possible diagnosis when auto-immune hemolytic anemia is associated with lymphoproliferative syndrome, and only chemotherapy can stop the hemolysis