Comparative study between intravitreal ranibizumab and triamcinolone treatment of diabetic macular edema as regard to optical coherence tomography changes and visual acuity / Estudo comparativo entre o tratamento intravítreo com ranibizumabe e triancinolona do edema macular diabético quanto às alterações na tomografia de coerência óptica e na acuidade visual

Abstract Objectives: To compare the effect of intravitreal Ranibizumab (0.3mg) and Triamicinolone (4mg) on different parameters in spectral domain OCT and their relation to visual acuity of patients with diabetic macular edema. Methods: This study is designed as a prospective randomized study. Patients were randomly divided into 2 groups receiving either Pro re nata intravitreal Ranibizumab (0.3mg) or Triamicinolone acetonide (4mg), to whom Spectral Domain OCT was done as well as best corrected Log MAR visual acuity. Results: 40 patients were included in this study. Comparison and correlation of mean BCVA and mean CMT among and within treatment groups of our study revealed strong and significant relationship between both parameters and showing equal effect of both treatment types regarding them with the consideration that Triamicinolone acetonide treated group (Group B) showed statistically significant lower CMT compared to Ranibizumab treated group (Group A) at three and six months. Also both showed equal effectivity regarding improvement of the photoreceptors integrity and in turn the improvement of the BCVA. Meanwhile the association of CMT and IS/OS integrity was found to be significant only at six months in both groups (p =0.009 in Group A; p =0.031 in Group B). The fading initial effect of a single ranibizumab injection on macular edema can be augmented by following that one injection with two injections of the loading dose. Triamicinolone effect after single injection began to fade at 3 months. Conclusion: Both treatment types had good effect on reduction of CMT and improvement of BCVA and the IS/OS junction with difference in sustainability of their effects due to difference in their pharmacokinetics and need for repeated injections.

Resumo Objetivos: Comparar o efeito do ranibizumabe intravítreo (0,3mg) e triacmicinolona (4mg) em diferentes parâmetros do domínio espectral da OCT e sua relação com a acuidade visual de pacientes com edema macular diabético. Métodos: Este estudo foi concebido como um estudo prospectivo randomizado. Os pacientes foram divididos aleatoriamente em 2 grupos que receberam Ranibizumab Pro rata intravitreal (0,3mg) ou acetonido de Triamicinolona (4mg), a quem foi realizada a Spectral Domain OCT, bem como a melhor acuidade visual de Log MAR corrigida. Resultados: Quarenta pacientes foram incluídos neste estudo. A comparação e a correlação da acuidade visual média e CMT média entre e dentro de grupos de tratamento do nosso estudo revelaram uma relação forte e significativa entre ambos os parâmetros e mostrando um efeito igual de ambos os tipos de tratamento, considerando que o grupo tratado com acetonido Triamicinolona (Grupo B) apresentou significância estatística. menor CMT comparado ao grupo tratado com Ranibizumab (Grupo A) aos três e seis meses. Também ambos mostraram igual efetividade em relação à melhoria da integridade dos fotorreceptores e, por sua vez, a melhora do BCVA. Enquanto isso, a associação de CMT e IS / OS integridade foi significativa apenas aos seis meses em ambos os grupos (p = 0,009 no Grupo A; p = 0,031 no Grupo B). O efeito inicial enfraquecido de uma única injeção de ranibizumabe no edema macular pode ser aumentado seguindo-se aquela injeção com duas injeções da dose de ataque. O efeito triamicinolona após injeção única começou a diminuir aos 3 meses. Conclusão: Ambos os tipos de tratamento tiveram bom efeito na redução da CMT e melhora do BCVA e da junção IS / OS com a diferença na sustentabilidade de seus efeitos devido à diferença em sua farmacocinética e necessidade de injeções repetidas.

Induction of sub-G arrest and apoptosis by seed extract of Moringa peregrina (Forssk.) Fiori in cervical and prostate cancer cell lines / 中西医结合学报

OBJECTIVE@#This study investigated cytotoxicity and induction of apoptosis in human cervical cancer cells (HELA) and prostate cancer cells (PC-3) using the most active fraction of Moringa peregrina seed extract.@*METHODS@#Dried and powdered seeds were extracted using 95% ethanol. The total ethanolic extract was further dissolved in distilled water and separated into petroleum ether, chloroform, ethyl acetate and aqueous extracts. Based on the results of in vitro anticancer studies of all extracts, the most highly active extract was selected for evaluation of apoptosis induction and cell cycle analysis on HELA and PC-3 cells at its half maximal inhibitory concentration using flow cytometry; DNA fragmentation by agarose gel electrophoresis and the expression of protein were measured by Western blot.@*RESULTS@#The chloroform fraction from the ethanolic extract of M. peregrina (CFEE) was the most active antitumor fraction. The selectivity index, determined using the normal Vero cell line, indicated that CFEE had a high degree of selectivity against HELA and PC-3 cells. CFEE induced apoptosis, confirmed by cell cycle arrest at sub-G phase and DNA fragmentation. CFEE induced an increase in mRNA expression of caspase-3, a decrease in Bcl-2 mRNA expression, and decreased ATP levels. CFEE increased protein expression of caspase-3 and decreased protein expression of poly-ADP-ribose polymerase-1 (PARP-1). Flow cytometric analysis showed an appreciable increase in the number of cells in the early apoptotic stage in CFEE-treated HELA and PC-3 cells. CFEE treatment significantly increased lipid peroxidation (malondialdehyde level) in HELA and PC-3 cells.@*CONCLUSION@#Seed extract of M. peregrina displayed a significant antitumor effect through apoptosis induction in HELA and PC-3 cells.

protective effect of insulin against isoflurane and sevoflurane induced hepatocellular apoptosis

Several studies deducted that inhalational anesthetics induce apoptosis in human cells. Insulin is believed to have an antiapoptotic action so it is widely used as cardioprotective agent against ischemic reperfusion injuries. This study compared the apoptotic effect of inhalational anesthetics and figuring out the antiapoptotic effect of insulin against perioperative induced hepatocellular apoptosis using immune histochemical study of liver biopsy. Eighty [ASA I] patients scheduled for laparoscopic cholecystectomy were randomly allocated into 4 groups [20 patients each]. Two groups were anesthetized using isoflurane and the other two were anesthetized using sevoflurane. The control groups [IC, SC] received normal saline and the insulin groups [II, SI] received glucose, insulin and potassium [GIK] infusion. Infusions were given 2 hours before induction of anesthesia. Liver biopsy was taken before the umbilical port closure. In liver biopsy Caspase 3, 7, 9 and Akt activity were evaluated. Liver function tests were estimated before infusion and one day after surgery. Serum K and blood glucose levels were closely monitored all through the study. The results showed that in the isoflurane groups, the percentage of caspase 3 and 7 positive cases decreased while Akt positive cases increased significantly in II compared to IC respectively [p < 0.05]. In the sevoflurane groups, the percentage of caspase 3 positive cases decreased significantly in SI compared to SC group [p < 0.05]

Isolation of flavonoids from Delonix elata and determination of its rutin content using capillary electrophoresis

Delonix elata [L.] Gamble [Fabaceae] is an important, traditionally used plant in Saudi Arabia. It is used to relieve rheumatic pain, flatulence and the seeds are employed as purgatives. The aim of the present study was to isolate chemical constituents of the n-butanol fraction [BF] of D. elata and to find out, by capillary electrophoresis [CE], percentage of rutin present in this BF. Three quercetin glycosides and one kaempferol rutinoside were isolated from the BF of aerial parts of D. elata; namely, Quercetin 3-O-rutinoside-7-O-glucoside [1], Quercetin 3,7-diglucoside [2], Quercetin 3-0-rutinoside [RUT] [3] and Kaempferol 3-0-rutinoside [4]. Rutin, an active constituent has been reported to possess good pharmacological as well as therapeutic potentials. A sensitive and rapid procedure for quantitative determination of RUT by capillary electrophoresis was developed and its content was found to be 7.349 mg/gm, relative to n-butanol fraction and 18.373 mg%, relative to the dry powder of D. elata. The method could be recommended for approval and use in the pharmaceutical and food industries

Endothelial progenitor cells in peripheral blood of cardiac catheterization personnel

The aim of the present study was to evaluate the rejuvenation capacity among cardiac catheterization technicians occupationally exposed to ionizing radiation. The individual annual collective dose information was measured by thermoluminscent personal dosimeters [TLD] for those technicians and found to be ranging between 2.16 and 8.44 mSv/y. Venous blood samples were obtained from 30 cardiac catheterization technicians exposed to X-ray during fluoroscopy procedures at the National Heart Institute in Embaba. The control group involved 25 persons not exposed to ionizing radiation and not working in hospitals in addition to 20 persons not exposed to ionizing radiation and working in hospitals. Blood samples were assayed for total and differential blood counts, micronucleus formation [FMN] plasma stromal derived growth factor-1alpha [SDF-1 alpha] and cell phenotype of circulating endothelial progenitor cells [EPCs], whose surface markers were identified as the CD34, CD133 and kinase domain receptors [KDR]. SDF-1alpha [2650 +/- 270 vs. 2170 +/- 430 pg/ml] and FMN [19.9 +/- 5.5 vs. 2.8 +/- 1.4/1000 cells] were significantly higher among cardiac catheterization staff compared to those of the controls respectively. Similarly, EPCs: CD34 [53 +/- 3.9 vs. 48 +/- 8.5/10[5] mononuclear cells], CD133 [62.4 +/- 4.8 vs. 54.2 +/- 10.6 /10[5] mononuclear cells] KDR [52.7 +/- 10.6 vs.43.5 +/- 8.2 /10[5] mononuclear cells] were also significantly higher among cardiac catheterization staff compared to the values of controls respectively. Smoking seemed to have a positive effect on the FMN and SDF-1 but had a negative effect on EPCs. It was found that among cardiac catheterization staff, the numbers of circulating progenitor cells had increased and accordingly there was an increased capacity for tissue repair. In conclusion, the present work shows that occupational exposure to radiation, well within permissible levels, leaves a genetic mark on the somatic DNA of the cardiac catheterization technician. On the other hand, exposure of workers to ionizing radiation stimulates regenerative processes as indicated by the increase in EPCs numbers and SDF-1 levels. This regenerative process is decreased by smoking as evidenced by increased levels of SDF-1 and decreased numbers of EPCs. The technicians who work in cardiac catheterization laboratories should therefore carefully follow radiation protection procedures and should minimize radiation exposure to avoid possible genotoxic effects

Does emergency cerclage prolong pregnancy and affect neonatal outcome?

Cervical cerclage has been used as an emergency or 'rescue' suture in women presenting with dilated cervices in the mid-trimester attempting to prolong pregnancy and improving fetal Outcome. This study was conducted to assess efficacy of cervical cerclage in pregnancy prolongation and improving fetal/neonatal outcome in patients with cervical changes and/or herniation of the fetal membranes. During the period from January 2000 to December 2007, twenty seven women between 18 and 24 weeks pregnancy presented with cervical dilation and fulfilled the inclusion criteria underwent emergency cerclage. Two patients, however, were lost during follow-up and therefore the case group included 25 patients while the control group included 19 patients, who refused the procedure and were managed conservatively with bed rest alone. The 2 groups were compared with regard to duration of pregnancy prolongation, gestational age at delivery, and neonatal birth weight. In the cerclage group, the mean prolongation of pregnancy was 69.28 days, the mean gestational age at delivery was 30.71 weeks, and the mean birth weight was 1843gm. These measures were significantly different from those of the control group [39 days, 26.43 weeks, and 1064gm, respectively]. Twenty of the 25 pregnancies in the cerclage group ended in live births, while 10 of the 19 pregnancies in the control group ended in live births [P>0.05]. Emergency cervical cerciage in the presence of bulging fetal membranes can be carried out safely. It resulted in prolongation of pregnancy, increased gestational age at delivery and improved neonatal outcome