2009 H1N1 influenza A in children: a descriptive clinical study

The 2009 H1N1 was a new influenza virus causing illness in people. Especially those younger than 5 years of age and those who have high-risk medical conditions are at increased risk for influenza-related complications. In the present study, we describe the clinical presentation of the H1N1 cases attending Jeddah Clinic Hospital-Al Kandarah [JCH-K] in the time period from October 2009 to January 2010, and identified the high-risk age groups. Prospective study at JCH-K from October 2009 through January 2010. All pediatric patients [up to 15 years old] presenting with influenza-like illnesses in the clinics during the specified period were clinically examined and tested using reverse transcriptase polymerase chain reaction. Only confirmed H1 N1 cases were included in the study. Over a 4-month period, 89 cases of laboratory-confirmed H1N1 were reported in JCH-K. Thirty-four patients [38.2%] were younger than 5 years of age. Forty-six [51.6%] cases were males. Thirty-three cases were Saudis [37.1%]. The most commonly reported symptom was fever, which was noted in all cases. Twenty-eight cases [31.5%] had pneumonia. Fourteen cases [15.7%] were known asthmatics. Fifty-two [58.4%] cases were lymphopenic and 32 [35.9%] cases were leucopenic. Sixty-five [73%] patients were hospitalized, and five of them were treated in the intensive care unit. Even though the majority of cases of the 2009 pandemic influenza A H1N1 were mild, a severe disease does occur in children. In view of delayed PCR results, clinical presentation and lymphopenia were used as diagnostic criteria to start antiviral treatment as early as possible. No deaths were attributed to the 2009 pandemic

[Multi slice computerized tomography of the heart and coronary arteries]

Due to the recent technological progress, multislice computerized tomography [MSCT] allows visualizing the heart and coronary arteries. Multislice computed tomography is non invasive and provides high quality images.Its main limits are arythmia, tachycardia and coronary calcifications. But the main drawback with MSCT is the radiation dose. Report of usefuluess and indications of multislice CT scanner. Review of literature. Although the indications of MSCT did not reach a guideleness level yet, some trends can be stated. The advantages and limitations of MSCT in cardiac exploration are summarized in this article. The indications are mainly based on the excellent negative predictive value of MSCT regarding coronary artery disease. Hence, patients at low to moderate risk of coronary artery disease mostly benefit of the technique. MSCT can be an alternate examination in case of non feasible or non contributive ischemic test. MSCT is highly contributive in the ostial analysis, in detecting abnormal congenital coronary anomalies or in analysing bypass grafts. MSCT remains limited in patients with heavily calcified coronary arteries, and in patients with stented distal arteries. Multislice CT scanner should not be considered as equivalent to invasive coronary angiography bu it is a additional diagnostic tool

Alveolar sarcoidosis with lacrimal gland involvement

A 44 -year- old male presented with orbital pain and lid swelling for 3 weeks. He complained of pain, redness, and irritation in both eyes and received medical treatment with mild improvement. Three days latter he experienced acute onset of diminution of vision. He had no systemic complaints. Slit lamp examination revealed no abnormality. The upper lids of both eyes were swollen and a firm mass was felt on the supero-lateral aspect of the orbits. The lid swelling was secondary to orbital mass. The mass was immobile and non-tender. Therefore, the patient underwent Computerized Tomography [CT] scan of the orbit that showed bilateral almost symmetrical lacrimal gland enlargement, operative biopsy was recommended. Prior to biopsy, chest X-ray was performed and showed bilateral pulmonary opacities, though there was no clinical respiratory abnormality. Consequently CT scan of thorax was done that revealed multiple alveolar opacities. Laboratory investigations showed a normal haemogram, erythrocyte sedimentation rate 70-mm at first hour, serum angiotensin converting enzyme [ACE] level was 42 units [normal: 14-70 units], intradermal purified protein derivative test for Mycobacterium tuberculosis was negative [3-mm induration], rheumatoid factor, uric acid and thyroid hormone levels were normal

Biological aspect of dates suplementation in lactating rats` diet

In the current study on lactation in rats' dates [D] ratio in diet was examined in supporting this physiological case. Dates were used both at 25 or 50% with another food sources such as dimmed milk [SM] at 10 or 30% plus a source for CHO such as sweet potatoes [SP] at a variable ratio of 10, 25, or 35%. A special herbal mixture of extract as additives [AD] was added to all groups except the NC. The NC control composition was 46% both SM and corn starch [S], wherein the ratio proteins in diet, almost 17.5%, was corrected using 10 or 20% of a plant-rich protein antioxidant semimodified food [AC]. Date has been found to be preferable up to 25% in a special combination as Iactating diet. The food component of the best diet under the condition of this experiment, i.e., the et met the most healthy both mothers and infants, were the skimmed milk [SM] of 10% plus sweet potatoes [SP] at a high ratio of 25%. It seems that little higher ratio of proteins, i.e., 18%, most of which are plants with plenty amount of vegetable CHO and less than 10% fat in oily form with an adequate amount of minerals and vitamins, particularly found in D and SP, are important food toleration for those rats. This is formally seen in pregnancy. Fortunately, the diet of choice according to the above mentioned role gave also the optimal 8W measurement. However, rapid weight loss through diet or medication should not be attempted during lactation. Under the light of blood cell counts, blood analysis and both liver and kidney histopathology, the special extract used seemed to be important as source for some minor elements. The conjugation of those micronutreints and the macronutreints provided by the food system mentioned above has strongly supported that sort physiological nutritional requirements. Lactation is a special physiological case with a specific metabolic hormonal balance. This is an adapted hormonal shift [HS] follows this particular physiological status. It is such a hormonal program that strongly connected to feeding category. The present data show an alternative food combination that support mother health based on biological evaluation used, i.e., liver function and histology was group 4 of 25 D, 10 AC, 30 SM, and 25 SP. More investigation is needed to observe the role of the food additives used in the presence of main nutrients on this profounded kind of hormonal status

Immunohistochemical study of biomarker "P53" in premalignant lesions

Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. This study was conducted to investigate P 53 protein expression in cancerous, precancerous conditions and adjacent normal mucosa using an immunohistochemical technique, in an attempt to study its role in the progression of oral premalignant lesions. The immunohistochemical results were further correlated with the clinicopathological parameters of the studied patients. This study included 6 cases of oral squamous cell carcinoma [OSCC], 6 cases of oral lichen planus [OLP] and 6 cases of leukoplakia. The results revealed that P53 accumulation was more strongly observed in OSCC than OLP and leukoplakia. A positive significant correlation was found between the severity of P53 immunoreactivity and smoking, and the frequency of samples showing dysplastic changes. While no significant correlation was found between P53 severity and the age of the patients or lesion duration. It appears that immunohistochemical evaluation of P53 expression may be a practical tool to select cases of oral lichen planus and leukoplakia with a high risk of neoplasia

Clinical and radiographic comparison between enamel matrix derivative [emdogain] and autologous platelet gel in management of furcation defects in patients with chronic periodontitis

This study was carried out to evaluate and compare clinically and radiographically the efficacy of enamel matrix derivative [EMD] and autologous platelet gel [APG] in management of furcation defects in patients with chronic periodontitis. A total of 14 defects were chosen from 10 patients for this study. All patients were subjected to thorough clinical examination in selected sited including plaque index, gingival index, probing depth and probing attachment level. All these clinical parameters were taken prior to surgery and at 3 and 6 months post-surgically. The furcation defects were divided into two groups, the first group was treated with APG, while the second group was treated with EMD. Chemical root biomodification was performed in both groups using EDTA. The selected sites were subjected to densitometric evaluation before and at 3 and 6 months post-surgery. The results of the present study showed that both treatment modalities resulted in a significant reduction in probing depth and attachment loss throughout the follow up period, however, no significant difference between both groups was observed. A more favorable clinical outcome was noticed in furcation defects treated with APG as evidenced by the greater percentage of change in this group. An improvement in mineral content was detected in both treated groups. On comparing both groups, no significant difference in optical densities was observed at various periods of follow up, however, the percentage of change was in favor of group I treated with platelet gel

Gingival crevicular fluid osteocalcin before and after treatment of human periodontal osseous defects with collagen membrane [biomend] alone or in combination with alendronate

The objective of this study was to evaluate the effect of Biomend as GTR alone or in combination with local application of alendronate in management of interproximal osseous defects in chronic periodontitis. Furthermore, to investigate the effect of these modalities of treatment on the crevicular fluid levels of osteocalcin. A total of 14 matched defects were chosen from 8 patients with severe chronic periodontitis. Seven defects were treated with collagen membrane in combination with local application of alendronate sodium, while 7 defects were treated with collagen membrane only. All patients were subjected to thorough clinical examination in selected sites, including gingival index, probing depth and probing attachment level. These parameters were taken before surgery and at 3 and 6 months post-surgically. These patients were also subjected to densitometric evaluation before and at 3 and 6 month post-surgically. Gingival crevicular fluid [GCF] was collected from selected sites presurgically and at 3 and 6 months post-surgically. An enzyme linked immunoassay kit [Gla type Osteocalcin Ela Kit] was utilized for the detection of osteocalcin. The results of the present study showed that both treatment modalities were effective in management of interproximal osseous defects, however, the adjunctive use of alendronate to GTR offered a more favorable clinical outcome as well as better improvement in bone density. A significant increase in GCF osteocalcin was noticed after both treatment modalities, particularly in the alendronate group. However, on comparing both groups, no significant difference was observed at various periods of follow up. Also, a significant correlation was found between GCF osteocalcin and bone density at the end of follow up period. This increase in GCF osteocalcin might be a result of bone remodeling associated with an increased osteoblastic activity which occurred during healing. It appears that osteocalcin acted as a bone formation marker during this stage of healing

matigated role of selective Cox.2 inhibitors against the early effects of accumulated doses of gamma-irradiation in mice

Clinical and experimental studies of the early and late effects of radiation on cells have led to optimization of radiotherapy schedules and to more precise modes of radiation delivery, radiation induced-injury on normal tissue can present either during or after the completion of radiotherapy. Early effects of small accumulated doses of gamma-irradiation in mice were studied at the present work. Fifty four mice were classified as the following negative control group I, distilled water subgroup Iia, etodolac subgroup IIb, subgroup IIIa was irradiated by accumulated dose of 0.5 Gy, subgroup IIIb received etodolac half an our pre-0.5 Gy irradiation, subgroup IVa was irradiated y accumulated dose of 1Gy, subgroup Ivb received etodolac pre-1 Gy irradiation, suroup Va was irradicated by accumulated dose of 2 Gy and the last subgroup Vb received etodolac pre-2 Gy irradiation. Analysis of bone marrow and jejunal cell cycle kinetic was carried out using flowcytometery and histochemical studies. The results revealed hat there was significant dose-dependant alternation of cell cycle kinetic of bone marrow and jejunal samples in the form of increase in GI and CVGI and decrease in percent SPE, percent G2 and PI. Mitotic delay, reduction in DNA content and chromatin condensation underneath the nuclear membrane of the cells in both cypts and villi of the jejunal sections could be also observed. Etodolac adminisration to the mice half an hour pre-irradiation could offer a great radioprotective effect. Research opportunities may help future clinical application of selective cyclooxygenase-2 inhibitors as chemopreventive drugs