Comparative Study on Acellular Dermal Graft Versus Propylene Mesh Both Either Loaded or Unloaded with BM-MSCs in Healing of Skull Bone Defect in Rats: Histological and Immunohistochemical Study

Bone defect occurs as a consequence of many conditions. Diseased bones don’t heal properly and defects in face area need proper bone reconstruction to avoid psychological and social problems. Tissue engineering is an emerging new modality of treatment. We thought to study different methods to fill skull bone defect in rats in order to find the most safe and effective method. So, this study was designed to evaluate the efficacy of acellular dermal graft (ADM) versus propylene mesh both either loaded or unloaded with bone marrow derived mesenchymal stem cells (BM-MSCs) in healing of skull bone defect of a 5 mm diameter. The study included 36 adult male Wistar albino rats that were divided into three groups according to the way of filling skull bone defect. Group I: Ia (sham control), Ib (negative control). Group II: IIa (unseeded propylene), IIb (seeded propylene) and Group III: IIIa (unseeded ADM), IIIb (seeded ADM). The trephine operation was done on the left parietal bone. Specimens were collected four weeks postoperative and processed for H&E, osteopontin immunohistochemistry and scanning electron microscope. Morphometric and statistical analysis were also performed. After studying the results of the experiment, we found that propylene mesh and ADM were suitable scaffolds that could support new bone formation in clavarial bone defect. Healing of skull bone defect was better in rats that received seeded scaffolds more than rats with unseeded scaffolds. The seeded ADM showed significant increase in bone forming activity as confirmed by histomorphometric and statistical results.

Detection of latent tuberculosis infection among laboratory personnel at a University Hospital in Eastern Saudi Arabia using an interferon gamma release assay

Background/aims: A few recent reports have demonstrated an elevated prevalence of latent tuberculosis infection [LTBI] among laboratory personnel. We sought to evaluate the prevalence of LTBI among laboratory personnel using the QuantiFERON-TB Gold In-Tube [QFT-GIT] assay and to assess the risk factors associated with positive test results

Methods: The study population included laboratory personnel who were working in the routine diagnostic laboratories of different departments of a university hospital. Subjects were interviewed using a standardized questionnaire that assessed information related to risk factors for LTBI and underwent the QFT-GIT assay

Results: Positive QFT-GIT tests results were detected in 19.4% [26/134] of the laboratory personnel. The following factors were significantly associated with positive QFT-GIT results: age >/= 30 years [odds ratio [OR]: 4.741, 95% CI: 1.41-17.50, P = 0.004]; duration of employment in the healthcare profession >10 years [P < 0.0001]; and non-Saudi nationality [OR: 21.67, 95% CI: 6.69-73.94, P < 0.0001]

Conclusion: These data highlight the need for effective institutional TB infection control plans. Additionally, our data reinforce the necessities of pre-employment and regular LTBI screening of laboratory personnel and the importance of offering preventive therapies to positive subjects to prevent the progression to active disease

Preparation of an acellular dermal matrix using the freeze-thawing technique with and without gamma irradiation

An acellular dermal matrix [ADM] is a dermal substitute in which the skin is treated to remove epithelial and dermal cellular components. To compare the histological and immunohistochemical structures of ADMs prepared using the freeze-thawing technique with or without gamma irradiation. Twenty-one human skin specimens were used and divided into three equal groups: group I [control group], group II, in which skin specimens were subjected to three repeated freeze-thawing cycles, and group III, in which skin specimens were subjected to three repeated freeze-thawing cycles and subsequent exposure to 5000 rad gamma irradiation. Skin specimens from the previous groups were examined histologically and immunohistochemically for laminin. A morphometric study was carried out for the determination of the number of cells per high-power field [hpf] in both the papillary and the reticular dermis. Both methods of ADM preparation resulted in extensive extraction of cellular components with preservation of the basic dermal architecture as there was a highly significant decrease in the number of cells/hpf in both layers of the dermis in groups II and III as compared with the control group [P<0.001]. However, there was further decellularization in group III as there was a highly significant decrease in the number of cells/ hpf in both the papillary and the reticular dermis in group III as compared with group II [P<0.001]. Immunohistochemical stain of laminin revealed preservation of the epidermal basement membrane in groups II and III. A combination of irradiation and a freeze-thawing technique is recommended in the preparation of ADM for efficient decellularization

Immediate- and medium-term effects of balloon pulmonary valvuloplasty in infants with critical pulmonary stenoses during the first year of life: a prospective single center study

Balloon pulmonary valvuloplasty [BPV] represents the standard of management for all patients with severe pulmonary stenosis [PS] irrespective of their age. Nevertheless neonates and infants with critical PS represent a high-risk group that needs to be studied. The study population included 72 infants with severe congenital valvular PS and four infants with imperforate pulmonary valve [PV] who were subjected to detailed history taking, full clinical examination, resting 12-lead ECG, Chest roentgenogram and transthoracic echocardiography. BPV was attempted in all infants with a peak-to-peak gradient across the PV of 50 mmHg or greater at catheterization-laboratory. Full echocardiographic evaluation was done 24 hours after the procedure as well as 3 and 6 months later. Seventy-six infants with severe PS or imperforate PV with a mean age of 5.63 +/- 2.99 months were subjected to BPV with or without wire perforation. Immediately after the procedure patients had a significant reduction of the right ventricular systolic pressure [RVSP] [104.69 +/- 24.98 mm Hg Vs 43.6 +/- 13 mm Hg, p < 0.001] and RV-PA systolic pressure gradient [PG] [82.5 +/- 23.76 mm Hg Vs 17.35 +/- 8.96 mm Hg, p < 0.001]. The immediate success rate defined as the drop in the RVSP to less than or equal to 50% of the baseline measurement was achieved in 85% of the cases. There was a progressive drop in the PG across the PV by Doppler echocardiogram throughout a follow-up period of six months from a mean of 93.3 +/- 28.2 mm Hg to a mean of 17.4 +/- 10.42 mm Hg [p < 0.001]. There was a significant increase of the mean PV annulus diameter after balloon dilatation [p < 0.001]. There was also a highly significant inverse correlation between the growth of the pulmonary annulus and the annular size at the baseline before dilatation [r = -0.74, p value <0.001]. The incidence of PR significantly increased immediately after BPV to 64% followed by a progressive decline over a 6 months period of follow-up to 20%. There was a significant decrease in the incidence of tricuspid regurgitation [TR] over the same period of follow-up [from 55.6% at baseline to less than 20% at follow-up]. BPV is safe and effective to relieve critical PS in infants during the first year of life. The balloon promotes advantageous changes in both, pulmonary annulus and PG across the RVOT. In addition, the Doppler gradient observations during the follow-up support the expectation that BPV is a "curative" therapy

Psychological stress among chronic hemodialysis patients at el-minia university hospital

The individual with End-stage renal disease on hemodialysis is facing multiple and potentially overwhelming stressors which impact the level of social, psychological, and physical functioning. The study aimed to assess psychological stress related to hemodialysis patients. The studied sample included 250 patients; this study was conducted in El-Minia University hospital at Dialysis Unit. They were assessed through Psychological stress scale taken from Depression, Anxiety, and Stress scale. Conclusion of this study revealed that, males represent 55.2% of the studied sample, and more than half of the studied sample resided in rural area. Concerning level of stress among studied sample, 36% of patients had moderate level of stress while 14% of them suffered from severe level of stress

Exploring public knowledge and attitude towards hepatitis B infection in Tripoli, Libya

The aim of the present study was to assess the knowledge and attitude towards hepatitis-B among general population in Tripoli city, Libya, and their sources of information. A further aim was to assess whether people's knowledge and attitude differ according to their demographic characteristics. A cross-sectional study was conducted in Tripoli city from May 2004 up to August 2004. A structured questionnaire of 10 different sections concerning basic knowledge about hepatitis B, particularly modes of transmission and risk behaviors, natural history and sequels of infection, availability of preventive vaccine, and about their attitude towards the need for diet modification, and towards infected people. The questionnaire was distributed to 4000 person aged 18 years and older, of different educational levels. Data was analyzed using SPSS program. The study showed that the majority of respondents had correctly identified most of the routes and risk behaviors for HBV transmission; there was a big deficiency in their knowledge about the natural history and sequel of the disease. Their attitudes towards HBV and infected persons were improper. Talk with non medical personnel and television were the commonest sources of their information. Despite the good HBV public knowledge about most of the routes and risk behaviors for HBV transmission, some important misconceptions in their knowledge and attitude need to be corrected. Nationwide health education programme is recommended

Relation between postmenopausal histological changes in the human iliac bone and osteoprotegerin protein expression

Postinenopausal bone resorption is influenced by a variety of factors that result in increased activation of osteoclasts. Osteoblasts were reported to secrete an osteoclast inhibiting protein named osteoprotegerin and this secretion was found to be influenced by the estrogen hormone level. So, the aim of this study was to investigate osteoprotegerin protein expression in human female bone and assess its relation to structural bone changes occurring after menopause. This study was conducted on 34 specimens from the iliac crest of female subjects undergoing bone grafts after taking their consent. They were divided into 3 groups. Females of group. I were in the premenopausal period. Those of group II were um the early postmenopausal period while those of group ill were in the late postmenopausal period. Osteoprotegerin protein expression was seen mainly in the cytoplasm of osteogenic cells and osteoblasts lining the bone trabeculae of the iliac crests. This expression was significantly higher in the premenopausal women as compared to both postmenopausal groups with no significant difference between early and late postmenopausal groups. Specimens taken from postmenopausal women showed significant decrease in the trabecular thickness together with significant increase in the trabecular separation and eroded surface. These changes were more prominent In late postmenopause. There was a significant positive correlation between osteoprotegerin expression amid serum estradiol, bone volume and trabecular thickness. Meanwhile, there was a significant negative correlation between osteoprotegerin protein expression and trabecular separation and eroded surface. It was concluded that decrement of osteoprotegerin plays an important role in the pathogenesis of postmenopausal osteoporosis and it is recommended to use osteoprotegerin in future therapeutic interventions in osteoporosis

toxic effect of prolonged ultram administration on cerebral cortex of albino rats. Toxicological and histological study

Ultram [Tramadol] is a widely used opioid analgesic effective in treating both acute and chronic pains and has acceptable adverse effects. The aim of the present study was to evaluate the cerebrocortical toxicity resulting from one month and two month Ultram administration in to albino rats using biochemical and histological parameters. The study was carried out on 25 adult male albino rats divided into: control group received 0.5 ml /day saline orally by orogastric tube for two months, a short-term Ultram-treated group that received a dose of 30 mg/kg/day [1/10 LD50] for one month orally and a long-term Ultram-treated group that received the same dose for two months. The study revealed that Ultram administration caused a significant elevation of serotonin level in the cerebral cortical tissues of rats which was directly proportional to the duration of Ultram admistration. Histologically, there were many changes in the organization and ultrastructure of neurons in the different layers of cerebral cortex associated with an increased response of the supporting neuroglial cells. Intense neurological tissue lesions were more evident with the two months Ultram dosing than with one month. The correlation between the biochemical results and the histological findings proved that Ultram induced neuronal lesions could be mediated by the elevated cerebrocortical serotonin level which gives serious alarms for reconsidering the rush towards the excessive use of ultram

Changes in the proliferative activity of the sigmoid colon with aging in comparison with normal mucosa bordering adenocarcinomas

Epithelial lining of the crypts of the sigmoid colon is in continuous renewal and has a high proliferative activity and it is documented that the incidence of colon cancer increases with age. Therefore, the aim of this study was to investigate the changes in the proliferative activity of the normal sigmoid colon with aging and to compare it with that of the normal mucosa taken at least 10 cms from the edge of the adenocarcinoma lesions. This is study was done on twenty human subjects that were divided into 2 group: GI aged 20-35 years aged GII aged 55-70 years. Each group was divided into 2 subgroups: subgroups A where specimens were taken from colonoscopically normal individuals that also showed no microscopic abnormalities and subgroup B where specimens were taken from normal mucosa at least 10 cms from the edge of adenocarcinoma lesions. Proliferative activity was estimated using PCNA index and the apoptotic activity was estimated by examining the anti-apoptotic Bcl-2 protein expression. Restilts showed hyperplasia in the epithelial lining of the crypts of the aged sigmoid colon. There was a highly significant increase in the PCNA index and in the anti-apoptotic Bcl-2 protein expression with aging in normal human subjects. PCNA index was significantly higher in normal mucosa of adenocarcinoma patients than in mucosa of normal individuals of the same age group. There was a significant increase in the alcian blue positive acid mucins with aging with no detectable difference between mucosa of normal individuals and normal mucosa of adenocarcinoma patients of the same age group. It was concluded that there is enhanced proliferation and decreased apoptosis in the epithelial lining of the sigmoid colon with aging and these changes may be partly responsible for the increased rate of colon cancer with aging. Also, the normal mucosa in patients with adenocarcinoma has higher proliferative and less apoptotic activities than the mucosa of normal individuals

Reasons and factors affecting women's choice of birth place

The present study identified the profile of women who choose a home, hospital and/or MCHC beds for birth. It also examined the factors and reasons for choice of place of delivery. A total sample of 114 women recently delivered. Each 38 women were selected randomly and who planned to deliver at home, hospital and the MCHC beds in Tanta. Home births were chosen from health offices. Data was collected by a specially designed interview schedule. The findings of this study revealed that 44.7% of women who delivered at home delivered by TBAs and 47.4% of them delivered by a midwife. No significant difference was observed between the three groups of women who were at risk regarding the age factor X[2]=0.49. Only medical risk and the incidence of complications among women delivered at hospital had influenced the women's choice of birthplace X[2]=12.47 and 6.25. Women who were at risk regarding their parity were more likely to have poor knowledge regarding principles of safe motherhood and maternity care. The psychological and social factors were found to be the main reasons for to plan for home and MCHC delivery. While on the other hand the medico-obstetrical risks were the main reason toward hospital birth. Results of this study reflect the need for increasing the awareness of women of risk factors that may enlighten them for deciding the best place of birth as well as reinforce women with free choice of the maternity care which best Suits their needs

Recommendations: Wrapping and elevation of the legs should be used in addition to traditional measures to control post-spinal hypotension as a non- pharmacological technique

PTSD, does it really exist in Alexandria out-patient clinic?

Posttraumatic stress disorder [PTSD] was observed to be clinically under diagnosed in the psychiatric outpatient clinic in Alexandria University Main Hospital. Because of the significant implications of PTSD on the sufferers and the whole community, so the aim of this work was to estimate the actual one-month rate of PTSD and to identify the causes of under diagnosis. All patients attended the clinic during one month were assessed by using a list of traumas [Kessler 's et al 1995] and DSM-IV PTSD criteria. Demographic characteristics, trauma and other clinical correlates of PTSD diagnosis were also examined. Out of 570 patients, 11.2% had PTSD; two-thirds of them had partial syndrome. Only 20% of the cases presented with PTSD manifestations. Ninety-four percent experienced one traumatic event and witnessing was the most common reported trauma. The majority [97%] had acute onset and the main duration of illness was more than 10 years. PTSD was strongly associated with other psychiatric disorders with major depression being the commonest comorbid disorder [20% of cases]. The rate of PTSD in the out-patient clinic in Alexandria University is relatively high. Patients' failure to acknowledge the traumatic experience, the presentation of PTSD patients with other psychiatric or somatic manifestations, the high rate of partial syndrome rather than full syndrome and the high comorbidity rate might be the possible factors behind the under diagnosis of PTSD

Age identification in Egyptian children by mandibular dimensions. A comparative radiological study with bones of the hand and wrist

One of the major problems in forensic science is personal identification of living persons, dead corpses or skeletal remains. A number of techniques exist for age estimation, depending upon the material available for analysis and the maturation stage that the individual had reached at the time of his / her demise. The current methods of children and young adults aging, are based on dental eruption, long bones length and bones of the wrist have their limitations. The mandible may provide an accessible and accurate tool for estimation of age, due to its dense nature and unique shape. The objectives: The objectives of this study are; to assess the reliability of the mandible as a tool for age estimation, to develop an equation specific for Egyptian children obtained from their mandibular dimensions, and to compare the age estimated from their mandibles with age estimated from their bones of the hand and wrist region. Subject and methods: This study was carried out on standardized X-ray of the mandible and bones of the hand and wrist for 50 Egyptian children [consent has been taken from their guardians]. Seven measurements were applied to each mandible [Length of the Mandibular Body [LB], Full Length of Half the Mandible [LHM], Height of the Mandibular Body [HM], Minimum Ramus Breadth [MiRB], Maximum Ramus Breadth [MxRB], Maximum Ramus Height [MxRH], Gonial Angle [GA]]. The estimated age from mandibles was compared with that estimated from primary ossification centers of the bones of the hand and wrist. All mandibular measurements showed significant statistical values except for the gonial angle [GA]. Regression analysis on the measurements was done and two equations for age determination were obtained: The first depends on the mandibular body variants mainly [in case of partial erosion of ramus] as follows: Y = -12.72 + [2.19 x LB] + [0.23 x LHM] + [0.85 x HM] Y = age in years, LB [length of the body of the mandible], LHM [full length of half the mandible] and HM [height of the mandibular body]. The mean error was 0.065 year. The second equation was applied if the mandible as a whole was intact: Y = -12.73 + [2.21 x LB] + [0.86 x HM] + [1.097 x MiRB] Y = age in years, LB [length of the body of the mandible], HM [height of the mandibular body], Mi RB [Minimum ramus breadth]. The mean error was 0.02 year. Age was estimated from X-ray of the wrist and hand then, compared to age estimated from mandibular equations, where the last method was more accurate. The mandibular equations can be used for accurate age estimation in Egyptian children

Psychometric study of dysthymic patints and their first-degree relatives

Psychometric evaluation of severity of depression and personality characteristics of 20 dysthymic patients [mean age 29.05 +/- 7.08 ys.] was carried out using Hamilton Depression Rating Scale [HDRS] and Eysenck Personality Questionnaire [EPQ] and was compared with that of 20 major depressive patients [mean age 33.60 +/- 7.7ys.] and 20 normal controls [mean age 32.85 +/- 6.17 ys.]. Psychosocial stressors that might trigger depression were also looked for. All first-degree relatives [118 persons] were subjected to clinical interview for detection of dysthymia. EPQ was also applied to assess their personality characteristics. Depression among dysthymic patients was mainly of mild degree. Severe depression was found in about 55% of major depressive and none of dysthymic patients. Application of EPQ revealed high neuroticism among dysthymics and high psychoticism among major depressives. Lie scale was high for both groups. Psychosocial stressors were more reported by dysthymic patients; however they were of mild or moderate degrees. Stressors reported by major depressive patients were mainly acute and severe. Assessment of the first-degree relatives revealed that 66% of dysthymics relatives had dysthymia or high EPQ scores compared to 36% of major depressives and 22% of normals