Preventive role of gum Arabic administration on STZ induced diabetic kidney disease in rats; renal antioxidant and histopathological evidence / Función preventiva de la administración de goma arábiga en la enfermedad renal diabética inducida por STZ en ratas; antioxidante renal y evidencia histopatológica

This study was set to investigate the effect of gum Arabic (G.A.) on diabetic kidney disease. We divided sixty male Sprague rats randomly into six groups. Normal control, normal rats treated with G.A., untreated diabetic rats, diabetic rats treated with insulin, diabetic rats treated with G.A., and diabetic rats treated with both insulin and G.A. Diabetes was induced by a single intraperitoneal injection of STZ. Forty eight hr post injections. Insulin was injected subcutaneously (1.6/IU/100g/day). We provided G.A. in drinking water (10 %w/ v).). At the end of the twelve weeks, blood was drawn for measurement of blood glucose, glycosylated hemoglobin (HbA1C), serum lipids, serum creatinine, and blood urea. Renal tissue oxidative stress (O.S.) was assessed by measuring the activities of superoxide dismutase (SOD) and catalase (CAT), and the concentrations of reduced glutathione (GSH) and malondialdehyde (MDA). For histological assessments, sections from segments of kidneys were processed and stained with hematoxylin and eosin (H&E) for assessment under the light microscope. STZinduced diabetes caused an elevation of blood glucose, HbA1c, urea and creatinine, triglycerides LDL and cholesterol, MDA with reduction of HDL, GSH level, and CAT and SOD activities. Histologically, kidneys from diabetic rats showed marked glomerular and tubular changes. Administration of G.A. alone to diabetic rats had a significant hypoglycemic, hypolipidemic, and antioxidant effect, although the levels achieved remained significantly abnormal compared with the untreated group with no effect on urea and creatinine levels. Co-administration of G.A. with insulin reversed the impact of D.M. on all parameters evaluated including the histological changes and led to normal urea and creatinine levels. We concluded that G.A., in combination with insulin, improves chemically-induced diabetes and its renal complications, possibly by modulation of oxidative stress.

En este estudio se evaluó el efecto de la goma arábiga (GA) en la enfermedad renal diabética. Dividimos sesenta ratas macho Sprague Dawley al azar en seis grupos. Control normal, ratas normales tratadas con GA, ratas diabéticas no tratadas, ratas diabéticas tratadas con insulina, ratas diabéticas tratadas con GA y ratas diabéticas tratadas con insulina y GA. La diabetes fue inducida por una sola inyección intraperitoneal de STZ. Cuarenta y ocho horas después se inyectó insulina por vía subcutánea (1,6 / UI / 100 g / día). A los animales se les dió GA en agua potable (10 % p / v)). Al final de las doce semanas, se extrajo sangre para medir la glucosa, la hemoglobina glicosilada (HbA1C), los lípidos en suero, la creatinina en suero y la urea en sangre. El estrés oxidativo del tejido renal (SO) se evaluó midiendo las actividades de la enzima superóxido dismutasa (SOD) y la catalasa (CAT), y las concentraciones de glutatión reducido (GSH) y malondialdehído (MDA). Para las evaluaciones histológicas, se procesaron secciones de segmentos de riñones y se tiñeron con hematoxilina y eosina (H & E) para análisis bajo microscopio óptico. La diabetes inducida por STZ causó una elevación de la glucosa en sangre, HbA1c, urea y creatinina, triglicéridos LDL y colesterol, MDA con reducción de las actividades de HDL, GSH y CAT y SOD. Histológicamente, los riñones de ratas diabéticas mostraron marcados cambios glomerulares y tubulares. La administración de GA solo en las ratas diabéticas tuvo un efecto hipoglucémico, hipolipidémico y antioxidante significativo, aunque los niveles alcanzados permanecieron significativamente anormales en comparación con el grupo no tratado, sin ningún efecto sobre los niveles de urea y creatinina. La dministración conjunta de GA con insulina revirtió el impacto de DM en todos los parámetros evaluados, incluidos los cambios histológicos y condujeron a niveles normales de urea y creatinina. Concluimos que GA en combinación con insulina, mejora la diabetes inducida químicamente y sus complicaciones renales, posiblemente mediante la modulación del estrés oxidativo.

Risk profiling in patients undergoing penile prosthesis implantation / 亚洲男科学杂志(英文版)

Penile prosthesis implantation is the gold standard of surgical therapy for patients with medication-refractory erectile dysfunction. However, this umbrella definition includes significant heterogeneity and associated risk profiles that should be candidly discussed and addressed perioperatively. Factors associated with operative success and patient satisfaction are often surgery specific; however, risk profiling via patient selection, preoperative optimization, proper device selection, and intraoperative consideration are highly correlated. Some examples of common risk profiles include comorbidity(ies) such as cardiovascular disease, diabetes mellitus, prior abdominal surgery, Peyronie's disease, and psychological risk factors. Similarly, integration of surgeon- and patient-amenable characteristics is key to decreasing risk of infection, complication, and need for revision. Finally, patient risk profiling provides a unique context for proper device selection and evidence-based intraoperative considerations.

Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea

There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for officebased cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating “the patient” into the surgical decision-making process through decision aids.

Evaluation of possible mechanisms of Cordia dichotoma fruits for hyperlipidemia controlling in Wistar albino rats

Objective: To investigate the antioxidant capacity of aqueous extract from Cordia dichotoma (C. dichotoma) fruits in-vitro and their effect on nutritional parameters in rats fed on high-fat diet. Methods: In-vitro antioxidant capacity of C. dichotoma extract were evaluated and compared to two standard materials, ascorbic acid and butylated hydroxytoluene. Metabolic experiments were set out using rats fed on high-fat diet. The extract was tested with two dosages: 0.5 and 1.0 g/kg body weight/ day for four weeks. Lipid constituents of diet and faeces and lipid profile of serum and liver were determined. Results: The administration of the C. dichotoma extract with two dosages caused a significant improvement in the lipid metabolism of rats, compared to the hyperlipidemic control which showed significant disturbance in lipid profile. C. dichotoma extract reduced total body weight gain and total feed intake, and enhanced the fresh and dry weight of faecal excretion. The superior effect was recorded with the high dosage of extract. C. dichotoma minimized fat and cholesterol intake significantly and maximized those in faecal excretions in comparison with hyperlipidemic control values, and low dosage was better than the high one. C. dichotoma extract at two dosages normalized the lipid profile of the serum and liver compared with hyperlipidemic control. Conclusions: The protective effect of C. dichotoma extract against hyperlipidemia may be attributed to the reduced ability of an animal to ingest and absorb fat and cholesterol, and enhanced ability to get rid of them in faecal excretion.

Concomitant Outbreaks of Yellow Fever and Hepatitis E Virus in Darfur States; Sudan; 2012

Introduction: Yellow fever (YF) is a vector-borne disease transmitted to humans by infected Aedes mosquitoes; while hepatitis E virus (HEV) is a waterborne disease that is transmitted through the fecal-oral route. Both diseases have very close clinical presentation; namely fever; jaundice; malaise; and dark urine; they differ in severity and outcome.Methodology: In this cross-sectional; laboratory-based study; an attempt was made to measure the correlation of concomitant YF and HEV infection in Darfur States during the previous YF outbreak in 2012.Results: Results found concomitant outbreaks of YF and HEV at the same time with very weak statistical correlation between the two infections during the outbreak period; with Cramer's V correlation 0.05 and insignificant p value of 0.86.Conclusions: This correlation indicates that clinicians and care providers in tropical areas have to deal with clinical case definitions used for disease surveillance very carefully since prevalence of HEV infection is relatively common and this increases the possibility of misclassification and missing YF cases; particularly initial index cases; in a season or outbreak

impact of cytomegalovirus infection on mechanically ventilated patients in the respiratory and geriatric intensive care units

Reactivation of cytomegalovirus [CMV] has been reported in critically ill patients [especially elderly] lying in the intensive care units. So identifying such patients to treat is important. To detect the frequency of CMV infection in mechanically ventilated patients, and its correlation with patients' risk factors, and outcomes. The present study was carried out on 51 mechanically ventilated patients admitted to the Respiratory [20] and Geriatric ICU [31] of the Ain Shams University hospitals over a 3 month period. Serum CMV load was measured by real-time PCR. The overall rate of active CMV infection by RT-PCR among the studied populations was [68.6%], [77.4%] in patients of geriatric ICU versus [55%] in respiratory ICU patients. Comparison between CMV positive and negative cases showed a significant difference in the duration of mechanical ventilation and mortality rate. A statistically higher CMV load was recorded in respiratory ICU patients admitted due to exacerbation of chronic respiratory disease or stroke and developing ventilator associated pneumonia [VAP] or septic shock. Also there was a significant direct correlation between CMV load and age of the patient, duration of mechanical ventilation and duration of ICU stay CMV infection is frequent in mechanically ventilated critically ill patients especially the elderly. It is associated with poor outcomes, leads to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections

Molecular fingerprinting of the Egyptian medicinal plant Cocculus pendulus

The genus Cocculus belongs to the family Menispermaceae which comprises about 35 species of shrubs or woody climbers. Only one species, Cocculus pendulus is found in Egypt. This plant is reported to have good medicinal values in traditional system of medicine. Despite the wide occurrence of C. pendulus in the Egyptian deserts, attention was paid only to its distribution and morphological description ignoring the biochemical constitution, the genome makeup and environmental aspects which are not given due consideration. Since no information about the genome of C. pendulus is available, the current study deals with molecular investigation of C. pendulus expressed by DNA fingerprinting of the young leaves of this plant using amplified fragment length polymorphism [AFLP] technique with four primer combinations. The obtained results revealed a total of 228 bands with an average of 57 bands for each primer combination, of which 61 bands were polymorphic [26.8%] ranging in size from 59 to 570 bp. The number of amplicons/primer pairs ranged from 48 [E-AGG/M-CAC] to 72 [E-AAC/M-CAG] while the number of polymorphic amplicons varied from 13 to 21 with polymorphism percentage of 22.03-29.17%. Thus the average number of polymorphic fragments/combinations was 15. In this regard, the combination E-AGG/M-CAC was more efficient as confirmed by computing the discriminating power [D] of all primer combinations. Also, the AFLP marker gives a complete informative and highly discriminative picture about C. pendulus as shown by [PIC = 0.99]

Non-invasive positive pressure ventilation versus invasive pressure support ventilation for post extubation respiratory distress in patients recovered from respiratory failure

Respiratory failure after a planned extubation is reported to be a common event, leading to reintubation and can occur in as many as 3-20% of extubated patients. It is crucial to identify the right time to extubate a patient, since re-intubation after pre-term extubation is associated with an increased risk for nosocomial pneumonia, prolonged intensive care unit [ICU] stay and death, and also accounts for substantially increased costs. This study was planned to assess the effectiveness of non-invasive pressure support ventilation [NIPPV] as a weaning technique in patients who develop respiratory distress after discontinuation of mechanical ventilation and extubation in comparison with conventional weaning through invasive pressure support ventilation. This is a randomized controlled study, sixty patients with either type I or II respiratory failure who developed post extubation respiratory failure were enrolled; they were randomly divided into two groups to receive either NIPPV or invasive pressure support ventilation. The primary outcome measure was the technique outcone; secondary outcome measures were incidence of complications, hemodynamic parameters, arterial blood gas parameters, ventilator parameters and length of ICU stay. Despite a longer time to failure observed with invasive pressure support ventilation, no statistically significant differences were observed in success rate, hemodynamic, and arterial blood gas parameters, although incidence of complications differs greatly according to the technique used. In a heterogonous group of patients; NIPPV is not superior to invasive pressure support ventilation in patients who developed post-extubation respiratory distress after successful weaning

Expanding the comprehensive national neonatal screening programme in the United Arab Emirates from 1995 to 2011

The national neonatal screening programme in the United Arab Emirates currently includes 16 disorders: congenital hypothyroidism, sickle-cell diseases, congenital adrenal hyperplasia, biotinidase deficiency and 12 amino acid, organic acid and fatty acid disorders. This paper reports data since the programme started in January 1995 up to December 2011 on the incidence of screened disorders and the molecular basis of positive screened cases. Screening used a combination of tandem mass spectrometry, molecular technologies and biochemical analysis. A total of 750 365 infants were screened and 717 babies saved from associated morbidity and/or mortality. The incidence of screened disorders were 1:1 873 for congenital hypothyroidism, 1:14 544 for phenylketonuria, 1:3 526 for amino acid, organic acid and fatty acid disorders, 1:9 030 for classical congenital adrenal hyperplasia, 1:8 300 for biotinidase deficiency, 1:2 384 for sickle-cell disease and 1:121 for sickle-cell traits. Coverage of neonatal screening in the population reached 95% in 2010

Immunohis1ochemical cyclooxygenase-2 [COX-2] and cd31 expression in breast carcinoma with correlation to clinico-pathological parameters

Breast cancer is the most'common cancer in Egyptian women. COX-2 seems to be involved in malignant transformation and tumor progression by affecting cell proliferation, mitosis, cell adhesion, apoptosis, immune surveillance, and angiogenesis. Angiogenesis is an important key step in tumor progression. Microvascular density [MVD], a surrogate marker of angiogenesis can be assessed by CD31 staining. This study aims to: 1. Evaluate COX-2 and CD31 expressions in breast cancer. 2. Determine the correlation between COX-2 and CD31 with the clinico-pathological parameters in ductal breast carcinoma. This study included 74 specimens of breast lesions. Patient's age, tumor size and local aggressive changes, history of recurrence and/or presence of distant metastasis were obtained. Hematoxylin and Eosin [HandE] stained sections were evaluated for histopathological tumor type, tumor grade, presence or absence of normal hyperplastic, in situ component, lymphocytic infiltration, lymphovascular invasion, and axillary lymph node status. COX-2 and CD31 immunostaining was done to detect their expression using the avidin-biotin peroxidase method. COX-2 increased with increasing grade of ductal carcinoma in situ [DC1S] and invasive ductal carcinomas [IDC] [P< 0.05 and P< 0.002 respectively]. COX-2 expression increased progressively along the continuum of neoplastic changes from normal breast epithelium to IDC [P< 0.01]. There was significant correlation between COX-2 and tumor size [P< 0.05], tumor grade [P< 0.002], lymphovascular invasion [P< 0.03] and lymph node metastasis [P< 0.02]. CD31 staining was observed along the cell membrane of endothelial cells of microvessels in all breast specimens. The median CD31 MVD count was 10 for normal breast, increased insignificantly to 17 in hyperplastic lesions, and reached 19 for DCIS, and 66.5 in IDC [P < 0.000]. There was significant increase in MVD between different grades of IDC [P < 0.01] but not in DCIS. Positive correlation was present between COX-2 and CD31 in DCIS and in IDC [P< 0.000 for each]. COX-2 was increased with poor prognostic parameters; tumor size, tumor grade, lymphovascular invasion and lymph node metastasis. CD31 increases with increasing grade of IDC. These findings might imply for new therapeutic strategies in order to prevent progression of DCIS to IDC and to improve cancer therapy

Maternal knowledge and use of folic acid among Saudi females

To explore and find out the level of awareness regarding folic acid's [FAs] importance, current use, and timing of administration among pregnant Saudi females. This is a cross-sectional study conducted randomly among women aged 18-45 years old, attending the Antenatal and Gynecology Clinics at the Maternity and Children's Hospital, Al-Qassim, Kingdom of Saudi Arabia from January to November 2012. A total of 1250 subjects were approached, and 1000 women expressed their verbal consent to participate. The questionnaire consisted of 17 items, and results were analyzed using univariate and multivariate analysis. A total of 88.4% of women were aware of FA. However, only 4.4% of them took FA before pregnancy. Compared to highly educated women [20.4%], only 5% of illiterate women use FA during the first trimester of their pregnancy. Univariate and multivariate analysis showed that educational level had a significant association with FA awareness and use [p=0.001; odds ratio: 0.000; 95% confidence interval: 1.001 to 1.080]. Most women recall hearing of FA from their doctors. Only 48 women reported a history of a previous child with congenital anomalies, and 4 of them [8.3%] of them used FA before pregnancy. We found that only 4.4% of the studied women use FA in their preconceptional period. The higher the educational level, the more the knowledge, and frequent use of FA. Poor level of awareness among lower educated woman requires medical authorities to broadcast the importance of FA, and there may be a need to fortify food with FA

Anticancer and antioxidant activities of Guiera senegalensis

Medicinal plants contain physiologically active principles that over the years have been exploited in traditional medicine for the treatment of various ailments. The ethanolic extract of Guiera senegalensis was tested in vitro as anticancer and antioxidant agent as well as for its phenolic and flavonoidal contents. The trypan blue technique was used for the anticancer activity against Ehrlich Ascites Carcinoma Cells [EACC] while the antioxidant activity of the plant extract was determined by 2, 2 diphenyl-1-picrylhydrazyl [DPPH] assay. The total phenolic and flavonoidal contents were estimated using colorimetric methods. The ethanolic extract at a concentration of 13 microg/ml caused 100% cytotoxic effect against EACC. Moreover, it possessed a considerable antioxidant activity against DPPH radical. Guiera senegalensis extract was found to contain appreciable amounts of phenolic and flavonoidal compounds. It can be concluded that Guiera senegalensis possesses sufficient in vitro anticancer and antioxidant activities to warrant further detailed study of its pharmacology and phytochemistry

Anthropometric evaluation of nutritional status for patients with end-stage renal disease in Sudanese patients

Malnutrition affecting 40 to 70% of patients with end-stage renal disease. Cause of malnutrition in patients with chronic renal disease include of a lower food intake, decreased intestinal absorption and digestion, and metabolic acidosis. The presence of malnutrition is usually suspected from anthropometry or the presence of hypoalbuminemia or decreased creatinine production. Anthropometric measurements provide a rapid, noninvasive, easy, and reproducible method for evaluating body fat and muscle mass. The objective of the study is to assess the nutritional status of patients with ESRD on regular hemodialysis using anthropometric measurements. Prospective, cross-sectional, study was conducted in Gezira Hospital for Renal Diseases and Surgery on June 2010. 202 patients were joined in this study. Body mass index [BMI], triceps skinfold thickness, subscapular skinfold thickness and mid-arm circumference [MAC] were measured. 70.79% of the patients were having normal or high BMI while other anthropometric measurements were below the standard values in 66.83% of the patients. This result could be attributed to fluid retention. Anthropometric measurements could be useful way for early detection malnutrition and follow up of nutritional status for patients on end-stage renal disease particularly in developing country

study on prevalence of drug resistance in drug default pulmonary tuberculosis

The emergence of resistance to drugs used to treat tuberculosis [TB], and particularly multidrug-resistant TB [MDR-TB], has become a significant public health problem in a number of countries and an obstacle to effective global TB control. This is a prospective randomized cross sectional study to estimate the magnitude of MDR tuberculosis in two hospitals in Khartoum, Sudan. 111 patients who had defaulted their tuberculosis treatment on previous occasions and had presented to the hospital with several symptoms were studied. All patients provided sputum, which was examined for the presence of acid fast bacilli [AFB] by Ziehl- Neelsen stain. Sputa were also sent to the reference laboratory for mycobacterial culture and drug susceptibility testing. All culture positive sputa had drug sensitivity tested to the first line anti-TB drugs used in Sudan namely Streptomycin, Isoniazid, Rifampicin and Ethambutol. Out of the 111 patients, 297% [n=33] were AFB sputum smear positive and 40.5% [n=45] were sputum culture positive for mycobacterium. Sensitivity testing revealed that 48.9% [n=22] were resistant to Streptomycin, 62.2% [n=28] were resistant to Isoniazid, 55.6 [n=25] were resistant to Rifampicin and 37.8% [n=17] were resistant to Ethambutol. 42% [n19] of the patients were resistant to Rifampicin and Isoniazid only, while 26.6% [n=12] were resistant to all the first line drugs [Streptomycin, Isoniazid, Rifampicin and Ethambutol] this study showed that the prevalence of MDR tuberculosis among the defaulters in Kartoum is much higher than what was reported previously. This study highlights the extent of the problem of drug resistance in Khartoum and emphasizes the need for proper treatment and strengthening of the short course direct observed therapy strategy

burden of ischemic heart disease at a major cardiac center in central Saudi Arabia

To estimate the direct medical costs associated with ischemic heart disease [IHD] at Prince Sultan Cardiac Center [PSCC] in Riyadh, Saudi Arabia. This is a prevalence-based prospective observational cost of illness study conducted in PSCC, Riyadh, Kingdom of Saudi Arabia between April and June 2009. All patients diagnosed or suspected of having IHD at admission were included. They were followed up until discharge, or performing coronary artery bypass graft [CABG], or changing diagnosis. Clinical data were extracted from the patients' computerized database, and combined with the unit cost of services to calculate costs. A total of 205 patients were recruited and diagnosed with stable angina [SA, 47.8%], unstable angina [USA, 24.4%], ST-segment elevation myocardial infarction [STEMI, 19.5%], and non-ST-segment elevation myocardial infarction [NSTEMI, 8.3%]. Most of the patients were Saudi males, aged between 40-75 years. Eighty-seven percent of patients had 2 or more co-morbidities, and 32% of the patients were obese. The average cost was 40,164 Saudi Riyals [SAR]/patient [US$10,710]. Medication contributed the lowest in the costs [3.2%]. A cost associated with SA was SAR33,991, USA was SAR35,107, NSTEMI was SAR46,585, and STEMI was SAR58,877 per patient. The lowest mean hospital length of stay was 6.5 days with SA. The average length of stay increased with the number of co-morbidities from 5.67 days [no co-morbidity] to 11.25 days [6 co-morbidities]. The IHD is of high economic burden in the country. Among IHD types studied, the resource consumption associated to STEMI was the highest in terms of costs, and hospital length of stay

Evaluation of two doses of triclabendazole in treatment of patients with combined schistosomiasis and fascioliasis

To determine the safety and efficacy of 2 consecutive doses of triclabendazole [TCBZ] in the treatment of Schistosoma mansoni infection in human cases infected with both S. mansoni and Fasdola spv we conducted afield survey involving 6314 individuals from 15 villages. The overall prevalence of schistosomiasis alone was 15.8%, of fascioliasis alone 2.2%, and of combined infection 0.7%. Treatment with 2 doses of TCBZ was given to the 49 cases with combined infection. Eight weeks after treatment, the cure rate was 96% for fascioliasis and was 32.7% for schistosorniasis. All schistosomiasis cases cured had a low intensity infection. Liver function tests done before I treatment and 8 weeks after substantiate the safety of 2 doses of TCBZ given to those with combined infection. Administration of TCBZ should precede praziquantel in treatment of combined infection, however TCBZ cannot be recommended for infection with S. mansoni alone

Detection of chronic typhoid carriers among food handlers in Wad Medani, Gezira state, Sudan

Typhoid fever remains a disease of major public health importance in the tropics. This cross sectional prospective descriptive study was carried out between July 2005 to July 2008 in Wad Medani Town. The objective of the study was to identify chronic typhoid carriers among food handlers in Wad Medani. To achieve this objective, Vi agglutination test was used to determine suggested typhoid carriers among food handlers then stool culture was performed on those with a positive Vi agglutination test. A questionnaire was designed to collect data from suggested typhoid carriers about hygienic practices during food handling and processing. The collected data were reviewed and coded. Data were analyzed using SPSS versions 10.0 software for tabulation and statistical analysis. The results showed that, ten percent of the examined food handlers were found positive typhoid carriers by Vi agglutination test, 48.5% of the suspected of typhoid carriers were found positive by stool culture, street vendors were more common among suspected typhoid carriers, all of whom had not received any health education about typhoid disease. The study suggested the following recommendations: Regular health authority inspection visitor food handling personnel specially street vendors to exclude typhoid carriers among them, education and training course in good hygienic practices should be provided to all food handlers specially typhoid carriers Food Control Department, Ministry of Health, Gezira State

Combination of oral vinorelbine and capecitabine in the treatment of metastatic breast cancer patients previously exposed to anthracyclines: a pilot study

Vinorelbine and capecitabine are both active in breast cancer with moderate toxicity. A pilot study conducted from December 2007 to January 2010 in patients with metastatic breast cancer [MBC] to the evaluate efficacy and safety of combination therapy with vinorelbine and capecitabine. The study included patients with MBC who were previously treated by anthracyclines either during the adjuvant phase or the metastatic phase. Patients were treated with oral vinorelbine [[60 mg/m[2]] on day 1+8 and capecitabine [1000 mg/m[2]] twice daily [VC] from day 1 to day 14 with both repeated every 3 weeks until progression, refusal or for a maximum of 8 cycles. A dose reduction was made in case of grade 3 and 4 toxicities. Of 31 women [median age, 51 years], 12 cases were first-line therapy and 19 cases were second-line therapy or greater, and 30 were evaluable for response. Two patients [6.4%] achieved complete response and 15 patients [48.4%] had a partial response giving an overall response rate of 54.8% [95% Cl, 42%-68%]. Time-to-disease progression was 7.8 months for patients receiving VC as first-line therapy versus 6 months for patients receiving VC as second-line therapy or more, while median survival time was 22 months and 10 months for the two groups, respectively. The oral VC regimen is effective and safe in patients with MBC previously exposed to anthracyclines, and offers a promising alternative to the intravenous route. Its role as a salvage therapy following anthracy-cline failure or as first-line chemotherapy requires further study

Ineffectiveness of myrrh-derivative Mirazid against schistosomiasis and fascioliasis in humans

The present study assessed the schistosomicidal and fasciolicidal actions of the myrrh-derivative Mirazid in an area of low schistosomiasis transmission. A total of 27 patients infected with Schistosoma mansoni and 16 with Fasciola spp. received the maximum recommended dose of Mirazid. Pretreatment egg counts in 4 Kato-Katz slides were compared with similar counts in stool samples collected 1 and 2 months after treatment. Standard procedures and quality control measures were followed. The results revealed that Mirazid used as schistosomicidal or fasciolicidal agent in the maximum recommended dose has a low cure rate and produced a negligible reduction in egg counts. Prescribing such an ineffective drug in Egypt might endanger the achievements of the schistosomiasis control strategy

Hypocholesterolemic effects of bitter and sweet lupin seeds in male rats

This study was designed to test bitter and sweet lupin seeds as lipid-lowering and their antioxidative activities on hypercholesterolemic rats. The levels of plasma lipid, malondialdehyde [MDA] and whole blood reduced glutathione [GSH], as well as the activities of transaminases [ALT and AST], lactate dehydrogenase [LDH] in plasma, superoxide dismutase [SOD], glutathione peroxidase [GPx] in erythrocytes and plasma glutathione reductase [OR], glutathione-S-transferase [OST] and catalase [CAT] were examined. The hypercholesterolemia-induced diet was manifested in the elevation of total lipids [TL], total cholesterol [TC], triglycerides [TO], LDL-C and MDA levels, ALT, AST, LDH activities and depletion of OSH and enzymic antioxidants. Supplementation of hypercholesterolemia-indUced diet with bitter and sweet lupin seeds significantly lowered the plasma levels of TL, TC, TG and LDL-C. ALT, AST and LDH activities slightly decreased in treated groups compared with hypercholesterolemic group [HC]. Furthermore, the content of GSH significantly increased while MDA significantly decreased in treated groups compared with HC group. In addition, bitter lupin seeds group improved enzymic antioxidants compared with HC group. In general, the results indicated that, the bitter lupin seeds supplements are better than sweet lupin seeds. These results suggested that the hypocholesterolemic effect of bitter and sweet lupin seeds supplements might be due to their abilities to lower plasma cholesterol level as well as to slow down the lipid peroxidation process and to enhance the antioxidant enzyme activity