Human papilloma virus in head and neck squamous cell cancer

Epidemiologic and molecular evidences have established a strong link between high risk types of Human Papilloma Virus and a subgroup of Head and Neck Squamous Cell Carcinomas [HNSCC]. We evaluated the frequency of HPV positivity in HNSCC and its relationship to demographic and some risk factor variables in an open casecontrol study. Fourteen recently diagnosed patients with squamous cell cancer of oropharynx, hypopharynx and larynx aged 18-50 years were examined from 2008-2010 in Tabriz, Iran. HPV DNA was extracted from paraffin-embedded blocks of each patient's sample for PCR evaluation. Saliva samples of 94 control cancer-free subjects were collected for DNA analysis. Multivariable logistic regression method was used to calculate odds ratio for case-control comparisons. High risk HPV was detected in 6[42.8%] patients, and 6[5.3%] control subjects which was statistically significant [p<0.0001]. HPV-18 was the most frequent type both in the cases and controls. HPV-16 DNA was detected in two patients of the case group, but it was not detected in any of the controls. The relation between demographic and risk factor variables was not statistically significant. HPV infection has a significant impact on HNSCC. Despite HPV-16 stronger impact, HPV-18 is more likely to cause malignant degeneration in such cancers amongst some communities. It is vital to introduce and conduct immunization schedules in health care systems to protect communities to some extent

Measurement psychiatric stigma in a general hospital in Saudi Arabia

The aim of this study is to measure the stigma of psychiatric illness in a general hospital setting, and to test the connection between common ideas people have of patients with psychiatric illness [personal responsibility, and dangerousness], and the generation of discriminatory behavior. A cross-sectional survey was carried out in all the hospital staff of king Abdulaziz Hospital in Al-Ashsa, Kingdom of Saudi Arabia. The Questionnaire was distributed on the 1[st] of February, and the study was finished on the 12[th] of March 2008. The sample size of 860 staff members was included for the study. Hospital staff had high scores [6.8/9] for caring attitude for patients with psychiatric illness. They had medium scores for fear [4/9], avoidance [4.8/9], and dangerousness [4.3/9]. They had low scores [3.1/9] for anger feelings toward these patients. Discriminatory behavior was found to be the result of feeling that these patients are dangerous, but not because they were held responsible for their illness. Our staff had a caring attitude towards patients with psychiatric illness. The idea that the patients with psychiatric illness are to blame for their illness did not hold, while the idea that these patients are dangerous showed positive relationship with discriminatory behavior

Modulation of immune response in asthmatic patients by using inhaled tuberculin

Bronchial asthma is a chronic immuno inflammatory reversible lung disease with airway responsiveness to various stimuli which relived by proper therapy using inhaled steroids or the highly expensive recombinant interferon gamma [IFN-gamma]. This study undertaken to investigate for the first time a novel treatment method using inhaled tuberculin [PPD] to determine whether PPD inhalation could be safely and effectively delivered into the airways of bronchial asthmatic patients in attempt to bring immune deviation away from atopy via inhaling an economic dose of tuberculin. Sixty patients suffering from mild atopic bronchial asthma along with twenty healthy volunteers were included in our study. Patients were randomly categorized into three equally-sized groups received 2, 5 and 10 PPD units respectively. Treatment doses taken every 72 hours for two weeks. Respiratory function tests were examined before and after treatment regime. Interleukin 2 [IL-2], IL-4 and immunoglobulin E [IgE] were measured by ELISA technique in serum and bronchoalveolar lavage fluid [BALF] samples before and after treatment regime. Eosinophil count in BALF was also examined. The results showed that PPD treatment doses caused a significant increase in lung function standards [FEV1 and FEV1/FVC ratio] as compared with before treatment values. Also, the different doses of PPD resulted in a highly significant increase in the levels of serum and BALF IL-2 with a concomitant significant decrease in BALF IL-4 levels when compared with before treatment values. A highly significant decrease in serum and BALF IgE along with eosinophil count was obtained with PPD inhaled doses as compared with before treatment values. To conclude, PPD treatment could be safely, economically and effectively used as a potential therapeutic drug for patients with atopic bronchial asthma. A marked improvement in our laboratory results was observed with 5 and 10 units of PPD

Hematological and parasitological effect of cyctein protease inhibitor on murine schistosomiasis

Cysteine protease enzyme [CP] is crucial for parasitic disease propagation, and inhibitors of such proteases are emerging with promising therapeutic uses in the treatment. This study was designed to evaluate the hematological and parasitological efficacy of one of the cysteine protease inhibitors [Sodium nitroprusside] that was administered alone as chemotherapy for murine schistosomiasis manosni in different schistosomal stages [shistosomula and mature worm]. Thirty mice were infected with 80 S. mansoni cercariae/mouse and were divided into 3 groups [10 mice each]. Group I: Infected untreated mice Group II and III. Mice were intraperitoneally treated with 100 mg/kg of cysteine protease inhibitor for 10 consecutive days three and six weeks post infection. Eight weeks post infection all animals were sacrificed and subjected for assessment of cysteine protease protein expression in liver tissue samples using immunoblotting technique [Western blotting], parasitological criteria and EM examination of buffy coat bone marrow and worms. Expression of cysteine protease protein was detected at the expected molecular weight [28 kDa] in 9 of the 10 [90%] infected untreated mice. After treatment protein expression returned negative in the treated groups. A highly significant reduction in worm burden was observed in all groups treated with inhibitor in comparison to infected control group [p<0.001]. However the greatest reduction in the worm burden was observed in treated group 6 weeks post infection in comparison to 3 weeks post infection [P<0.05]. Also, treatment could reduce egg count when given early in infection or significantly decreased egg burden when given late in infection. As regards EM examination sodium nitroprusside treated mice 3 and 6 weeks post the infection revealed degenerated tegument with completely implanted and degenerated spines. In addition 6 weeks post infection treated Schistosoma mansoni male worms showed vaculation and necrosis of spermatocytes. Buffy coat examination of Schistosoma mansoni infected untreated mice showed the inability of the eosinophil to be degranulated, while both treated groups revealed degranulation. In addition the group treated six weeks post infection showed hypodense eosinophils with large number of cytoplasmic vacuoles which represent an activated phenotype. Also in latter group activated lymphocytes were detected with marked dilatation of the endoplasmic reticulum. Bone marrow examination of Schistosoma mansoni - treated mice revealed degranulated eosinophils and eosinophilic myelocytes with activated phenotype in addition to degranulated platelets. Our findings indicate that the cysteine protease secreted by the different stages S. mansoni plays a crucial role in attenuating effector functions of eosinophils as it decreases the eosinophil's responses and inhibit its activation to the parasite resulting in diminished degranulation and reduced generation of superoxide. So, it is preferable to give CPI at any time post infection, with frequent observation of platelets function and different coagulation tests

Ankle-midtarsal arthrodesis for paralytic deformed ankle-foot in chronic poliomyelitis

Residual paresis and deformity of the ankle-foot is a common sequel of chronic poliomyelitis. Twenty patients with a mean age of 18.6 years [range 18 - 20 years] suffering paralytic flail deformed ankle-foot, but with adequate gluteus maximus muscle power and stable knee, secondary to chronic poliomyelitis acquired during infancy, had been treated with ankle-midtarsal arthrodesis using Charnley's external fixator-compression for the ankle and staples for the midtarsal joints. They were retrospectively evaluated for the results after arthrodesis at a mean interval of 3.8 years [range, 2 - 6 years] by physical examination and radio-graphs. All patients had a stable painless plantigrade resilient foot after arthrodesis. Neither nonunion [pseudoarthrosis] developed nor did talar avascular necrosis. Complications included wound slough [one], and reflex sympathetic dystrophy [one]. Four cases [20%] were classified as excellent, 10 cases [50%] as good, 5 cases [25%] as fair, and one case [5%] as poor. With the numbers available for study, it could be possible to show that the extent of the arthrodesis and involvement of hindfoot and midfoot joints sparing the subtalar joint affected functional outcome in a significant fashion. The principle, though applied to paralytic cases, can also be used in other non-paralytic ankle-foot deformity

Study of slow ultrafilteration as a therapeutic modality for chronic refractory congestive heart failure

Refractory heart failure usually represents the end stage of congestive heart failure in which hypotension and oliguria, lead to progressive generalized edema. The purpose of this study was to assess the efficacy of extracorporeal ultrafilteration [ECUF] as a modality for treatment of patients with refractory congestive heart failure who failed to respond to conventional anti failure measures. The study was carried out at a period for about six months and it included 40 patients, 18 men [45%] and 22 women [55%], they were selected from patients admitted to the intensive care of Internal Medicine Department and cardiology Department of Tanta University Hospital. Selection criteria were NYHA class III and IV heart failure, resting left ventricular ejection fraction [LVEF] <35, normal or mild elevated serum creatinine [patients with chronic renal failure were excluded from the study], lack of satisfactory response to conventional therapeutic regimen. All patients were subjected To ECUF ranged from 3 sessions in 12 patients and 4 sessions in 28 patients [mean 3.7 session/ptn] and between [4-6 hour/session]. It was initated at a rate of 0.5L/h to be readjusted subsequently according to the hemodynamic parameters available. Average amount of ultrafilterate/session ranged from 2.5-3 liters [mean2.6 +/- 0.4]. Both number and repition frequency were decided empirically on the basis of evolution of symptoms and response to drugs. All patients were subjected to the following assessment before and after ECUF: Daily morning checking of body weight [kg], hematocrit value [HTC%], urin output [ml/24h], serum electrolytes [Na[+], K[+]], blood urea and serum creatinine, hemodynamic monitoring including [heart rate, blood pressure and CVP], chest x-ray P-A view for measurment of CTR, E.C.G and transthoracic echocardiography for evaluation of cardiac function. Our results showed that there was significant increase of diuresis from [0.3410.14 to 2.0 +/- 0.7L/day] [p<0.001], significant reduction of mean H.R [120+5.0 to 98 +/- 11.0 beat/min] [p<0.001], significant CVP reduction [28.5 +/- 2.o to 15.5 +/- 7.0 cm water] [p<0.001], decrease of intravenous volume as assessed by significant increase of HCT value from [33.8 +/- 2.3% to 37.6 +/- 2.0%] [p<0.001] after ECUF, significant decrease of S. urea from [105.7 +/- 55.2 to 91.3 +/- 63.o4 mmol/L] and S. creatinine from [1.9 +/- 0.6 to 1.5 +/- 0.9 mmol/L] after ECUF. ECHO repeated after ECUF revealed highly significant reduction in the mean LVEDD from [7.0 +/- 0.2 cm to 6.4 +/- 0.6 cm] [p<0.001], reduction of LVESD from [6.5 +/- 0.4 cm to 5.5 +/- 0.8 cm] [p<0.001], reduction in mean LA dimension from [5.3 +/- 0.3 cm to 4.8 +/- 0.6 cm] [p<0.001], reduction of RV dimension from [4.7 +/- 0.4 cm to 4.0 +/- 0.8 cm] [p<0.001], significant increase of LVEF from [23.8 +/- 4.1 to 31.2 +/- 8.2] [p<0.001]: ECUF offers a reasonable effective and relatively safe method in the treatment of refractory heart failure. The relative ease of the procedure and low incidence of complications denote that this technique is a useful one in selected cases of heart failure, refractory to the conventional therapy with oliguria and fluid overload

Arthroscopic suture anchor repair for rotator cuff tears

Twenty six patients of rotator cuff tears were treated arthroscopically and the rotator cuff repair was done by using suture anchor technique, Thearthroscopic suture anchor repair for the rotator cuff tears has been accepted as a non aggressive technique with excellent [69%] and good 19%] results and rapid recovery; however the technique needs a long tine of well training

Comparative ultrastructural analysis of PBMCs isolated from patients with chronic hepatitis C and B: insights into the clinical outcome

Differences between chronic hepatitis C virus [HCV] and hepatitis B virus [HBV] infections have been established in incidence percentage and course of development of chronic liver disease as well as lymphoproliferative disorders. Lymphotropism has been regarded as one factor underlying persistence and chronicity of both diseases. However, this could not explain the variation in their clinical outcome which could be elucidated by a comparative study of the differential morphological behaviour of the peripheral blood mononuclear cells [PBMCs] harbouring the virus. An ultrastructural analysis by transmission electron microscopy [TEM] was hence performed on PBMCs isolated from patients with chronic HCV and HBV infections and from healthy subjects as controls. In this work, a morphological difference at the ultrastructural level was demonstrated in the PBMCs isolated from HCV and HBV- infected patients. Whereas minimal nuclear and cytoplasmic alterations and few intact forms of the virus were seen in hepatitis C patients, more aggressive degenerative and apoptotic features as well as more viral particles were viewed in cells of hepatitis B patients. These findings imply latency and quiescence of HCV in PBMCs leading to a state of chronic infection in most of the cases but with a very insidious course of progression towards cirrhosis or hepatocellular carcinoma [HCC]. In addition, stimulation and expansion of B cells could lead to various lymphoproliferative disorders. In the case of HBV infections, there is an earlier and more destructive effect of the virus on the infected cells which helps their rapid eradication with less propensity to persistence in the majority of cases. However in those patients where infection persists [possibly with lower immune response], chronicity could develop with rapid progression to cirrhosis due to the release of many viral particles from the uneliminated damaged PBMCs

Fish oil supplementation improves histological changes after sciatic nerve injury in rats

Peripheral nerve injury often leads to neuropathic pain. The potential effect of dietary supplementation with fish oil [Omega-3] fatty acids on the injured sciatic nerve was studied in albino rats. 25 adult male albino rats weighing 200g were divided into three groups. Group I consisted of five rats were fed a non purified diet supplemented with olive oil for six weeks, they were used as control group. Group II consisted of ten rats were undergone sciatic nerve crush injury and fed a non purified diet supplemented with olive oil for six weeks, they were used as the injured comparative group. Group III consisted of ten rats were undergone sciatic nerve crush injury and were fed a non purified diet supplemented with [Omega-3] fatty acid enriched fish oil concentrate at a dose of 0.5 g/kg/day for six weeks. Histological study showed partially intact neurolemmal sheath, absence of endoneural oedema and signs of regeneration in group three in contrast with group two in which there were apparent signs of degeneration. This beneficial effect of fish oil on injured sciatic nerve with attenuated histological damage suggested a treatment role for patients suffering from neuropathic pain

self-help group strategy on nursing students' assertiveness

This study aimed to assess the effectiveness of a self-help group on nursing students' assertiveness. It was conducted on 40 nursing students undergoing the psychiatric nursing experience at the Faculty of Nursing, Ain-Shams University during the academic year 2000-2001. They were divided into four groups of ten each. The first tool used in the study was an assertiveness scale covering rights awareness, work situations, self-expression and problem- solving techniques. It was applied pre and post the self-help group sessions. The second tool used was a self-assessment sheet that was used as a follow up for the students to evaluate themselves during the training sessions. The finding of the study revealed that the self-help groups had a positive effect on the participants' assertive behavior. The majority of the participants have been improved in their self-expression and problem- solving skills as a result of implementing the self-help group strategy. A little improvement was observed in the participants' interaction in their working situation. In general, there was an overall statistically significant improvement between the pre and post evaluation results in most items regarding the participants' assertiveness. It was recommended to implement the self-help group as a strategy to improve assertiveness

Safety and efficacy of Esmolol as add on therapy in acute unstable angina

The present study examined the hemodynamic and anti-ischemic effects of esmolol in 20 patients with unstable angina. Two patients required a termination of infusion at the titration period because of hypotension, but they recovered hemodynamic stability within 30 minutes of termination of the infusion. During esmolol infusion, two patients of those receiving intravenous nitroglycerin required a downward adjustment of nitroglycerin infusion rate to maintain systolic blood pressure >90 mm hg. These results suggested that esmolol safely and effectively lowered both arterial pressure and heart rate in patients with acute ischemia