Atorvastatin: In-Vivo Synergy with Metronidazole as Anti-Blastocystis Therapy

Blastocystis is an enteric Straminopile in tropical, subtropical and developing countries. Metronidazole has been a chemotheraputic for blastocystosis. Failures in its regimens were reported and necessitate new studies searching for alternative therapeutic agents. Aim of current study is to investigate potential effects of Atorvastatin (AVA) compared to the conventional chemotherapeutic MTZ in experimentally Blastocystis-infected mice. Anti-Blastocystis efficacy of AVA was evaluated parasitologically, histopathologically and by transmission electron microscopy using MTZ (10 mg/kg) as a control. Therapeutic efficacy of AVA was apparently dose-dependent. Regimens of AVA (20 and 40 mg/kg) proved effective against Blastocystis infections with high reduction in Blastocystis shedding (93.4–97.9%) compared to MTZ (79.3%). The highest reductions (98.1% and 99.4%) were recorded in groups of combination treatments AVA 20–40 mg/kg and MTZ 10 mg/kg. Blastocystis was nearly eradicated by the 20th day post infection. Genotype analysis revealed that genotype I was most susceptible, genotype III was less. Histopathologic and ultrastructural studies revealed apoptotic changes in Blastocystis and significant improvement of intestinal histopathological changes more remarkable in combinational therapy groups. Thus, the present study offers AVA as a potential candidate for Blastocystis therapy combined with MTZ.

Study of prevalence and effects of insulin resistance in patients with chronic hepatitis C genotype 4

There is strong epidemiological evidence linking hepatitis C virus [HCV] infection and diabetes. Our aim was to evaluate the prevalence of insulin resistance in Egyptian patients with chronic HCV genotype 4 infection, to assess factors associated with insulin resistance and to test the impact of insulin resistance on outcomes of treatment with pegylated interferon/ribavirin. Insulin resistance [homeostasis model assessmentinsulin resistance [HOMA-IR] score > 3.0] was detected in 31 of 100 nondiabetic patients. The relationship between elevated HOMA-IR and baseline viral load and degree of fibrosis was statistically significant [r = 0.218 and r = 0.223]. Follow-up of patients with complete early virological response until the end of treatment showed a statistically significant decrease in HOMA-IR score. Out of 29 liver tissue sections examined, 14 had a low level of expression of insulin receptor type 1 by immunohistochemical studies. This study confirms that insulin resistance affects treatment outcome, and thus HOMA-IR testing before initiation of therapy may be a cost-effective tool

Study of the possible association between systemic lupus erythematosus and Epstein-barr virus

Background and systemic lupus erythematosus [SLE] is an autoimmune rheumatic disease with no known cure. In predisposed individuals, the initial stimulus is likely to be one or more of the environmental agents interacting with susceptibility genes. For many years, investigators have suspected that Epstein-Barr virus [EBV] might somehow by involved in the aetiopathogenesis of systemic lupus. Studies have examined this possibility from various angles and have arrived at different conclusions. The present work was carried out to evaluate the role of EBV as an environmental risk factor for lupus in our population and to assess the role of this virus in the clinical course of the disease. the study included 25 lupus patients satisfying the American College of Rheumatology criteria for diagnosis of SLE. Twenty age and sex matched healthy subjects were chosen as controls. All patients were subjected to complete history taking and full clinical assessment. Routine laboratory investigations were carried out as well as study of immunologic parameters including antinuclear antibodies, anti-double stranded DNA and complement components C3 and C4. in all study subjects, serology for EBV viral capsid antigen [VCA] IgG was performed using both enzyme linked immunosorbent assay [ELISA] and indirect immunofluorescence assay [IFA]. EBV DNA was detected in peripheral blood mononuclear cells by polymerase chain reaction using primers specific for EBV nuclear antigen-1 gene. Besides, interleukin-10 [IL-10] levels were determined in sera by ELSA. Results and twenty three lupus patients [92%] were positive for EBV DNA compared to 12 control subjects [60%], the difference being statistically significant [p= 0.14]. Virtually all study subjects had seroconverted against EBV. When antibody titres were expressed as the geometric mean titre [GMT] after logarthmic transformation, patients with SLE had a significantly higher GMT compared to control subjects [mean +/- SD 3.46 +/- 0.34 vs 2.93 +/- 0.25, t = 5.12, p < 0.001]. When the anti-VCA titre of lupus patients was correlated with different clinical and laboratory findings, a significant positive correlation was detected with disease activity as measured by SLE disease activity index [SLEDAI], while a significant inverse correlation existed with each of C3 and C4. IL-10 levels in SLE patient were significantly higher than those in controls [mean +/- SD 61.37 +/- 90.65 vs 9.73 +/- 20.33 pg/ml. p = 0.002]. Moreover, elevated IL-10 levels correlated significantly with SLEDAI and with titre of anti-VCA in lupus patients. This study provide evidence that EBV infection contributes to the aetiology and/or pathogenesis of SLE and that the presence of the virus may influence the clinical course of the disease

Evaluation of a rapid assay for detection of rifampicin resistance in my cobacterium tuberculosis; a microbiological, clinical and epidemiological study

The aim of the present study was to portray the clinical and epidemiological features of mycobacterium tuberculosis [MDR-TB] patients and to determine the ability of a commercial kit [fast plaque TB-RifTM test] to correctly identify, within 48 hours, rifampicin susceptibility on the strains of Mycobacterium tuberculosis cultured on solid media and compare it with a conventional method of susceptibility testing. Sputum specimens were collected from hospitalized patients with known or suspected pulmonary tuberculosis. They were examined microscopically after Ziehl-Neelsen staining. Specimens that were 1+ smear +ve were inoculated on LJ medium and incubated for eight weeks. Forty-five cultures were tested for rifampicin susceptibility, employing both the proportion and the fast plaque TB-RifTM test. The study concluded that fast plaque TB-RifTM test offers a performance comparable with the standard conventional method of rifampicin susceptibility testing. Furthermore, it has the advantage of quick results [within 48 hours] without the need for specialized equipment. This makes it a reliable rapid diagnostic tool in testing for rifampicin resistance and as an indicator of MDR in TB

Hepatitis E antibodies in Egyptian adolescent females: their prevalence and possible relevance

Hepatitis E virus has been implicated as a frequent cause of acute sporadic hepatitis among Egyptian children. Moreover, an extraordinarily high ear prevalence rate was previously reported in a semiurban Nile Delta population. A conspicuous feature of hepatitis E is the high morbidity and mortality it can cause among infected pregnant women. We therefore evaluated the prevalence of HEV antibodies in adolescent females using a solid-phase enzyme linked immunoassay based on two recombinant hepatitis E virus antigens. A high prevalence rate [38.9%] was found in 95 apparently healthy adolescent females. The mean age of the study subjects was 21.81 +/- 2.5 [SD] range 16-25 years. Eighty [84.2%] subjects resided in Alexandria, while 15 [15.8%] came from semiurban villages of Alexandria Governorate. An increased prevalence was noted with age, as anti-HEV antibodies were detected in 32.1% and 41.8% of study participants in the second and third decades of life, respectively, similarly, those illiterate or having received less than primary education exhibited a higher HEV prevalence than those with higher education [46.3% VS 29.3%]. The majority o subjects having serological evidence of HEV infection denied previous history of jaundice which shows that HEV infection was subclinical in those cases. Ten [55.6%] pregnant females participating in the study, as well as 48 [62.3%] non pregnant females lacked serological, evidence of HEV infection; i.e., 60.01% [10+48 out of 95] of women in the childbearing age may be susceptible to infection. This report suggests that HEV is endemic in Alexandria, Egypt; the epidemiologic risk factors associated with HEV infection need further exploration

Adjuvant tamoxifen versus radiation therapy after conservative surgery for elderly and frail patients with low risk breast cancer

Fourty seven postmenopausal women with primary early breast cancer were submitted to lumpectomy and axillary dissection. Twenty two patients received postoperative radiation therapy [Group A] and 25 patients were treated postoperatively with the antiestrogen tamoxifen only [group B]. The relapse-free-survival [RFS] was 95% and 100% for groups A and B, respectively, at 18 months, while at 22 months the RFS rate was 91% and 96% for both groups, respectively. At 32 months, the RFS rate was 86% and 84% for both groups, respectively. The difference was statistically insignificant. It was concluded that conservative breast surgery in elderly and frail patients presented with early breast cancer could be followed by postoperative tamoxifen with an almost equal results in maintaining a solid RFS as that achieved with postoperative radiotherapy provided they are low risk, having T1 or T2 tumors. No status and low pathology grade

problem of mandibular resection in intraoral tumours

A total of 50 patients with intra-oral carcinomas were examined and treated at the N.C.I. during the period 1979 - 1980. All these cases were treated surgically by traditional Commando's operation. The mandibular bone, its covering periosteum and neurovascular bundle were examined separatly. The study showed that 56% of the cases, under went bone resection without actual malignant invasion i.e the bone could be spared. This work stresses the fact that conservative mandibular resection can be done safely so long as there is normal tissue clearance even a few milimeters between tumour, bone and a negative X-ray results preopratively. This gives the patients a good functional and cosmetic results