Effect of uncontrolled type-II diabetes mellitus and Its duration on nerve conduction parameters in adult Sudanese patients in Khartoum State

Background: Peripheral neuropathy is a serious complication of diabetes, which has socioeconomic consequences as well as a reduced quality of life. Early neuropathic process recognition and management could alter its course and considerably reduce the associated morbidity and mortality. This study determines the effect of long-term glycemic control on diabetic peripheral neuropathy in people with type 2 diabetes (T2DM). Methods: A hospital-based study was carried out at the National Centre of Neurosciences and Ibrahim Malik Hospital in Khartoum. All individuals who were older than 18 years and have had T2DM for less than 10 years were recruited. Using accepted techniques, the BMI, HbA1c level, and nerve conduction studies (NCS) were measured. Data were analyzed using the Statistical Package for Social Sciences (SPSS), version 25.0 software. P-value ≤ 0.05 was considered significant. Results: Of the 95 patients with T2DM, 52 were male patients. Our findings showed that as the duration of diabetes increased, the sensory velocity reduced from 64.07 ± 3.22 to 54.00 ± 5.34 and the motor nerve from 63.39 ± 2.38 to 53.87 ± 2.08 (P = 0.05, P = 0.003, respectively). Additionally, with increased duration of diabetes, a significant decrease was seen in both motor nerve amplitude from 8.79 ± 3.11 to 6.94 ± 1.84 (P = 0.05) and sensory nerve amplitude from 25.71 ± 5.70 to 19.51 ± 6.51 (P = 0.003). Also, all parameters of NCS (velocity and amplitude) decreased when Hb A1c was >6 ­ sensory velocity from 63.96 ± 2.36 to 55.49 ± 2.43 (P = 0.03) and motor velocity from 63.00 ± 2.59 to 51.44 ± 1.66 (P = 0.02). And sensory amplitude decreased from 26.91 ± 1.26 to 20.85 ± 2.1 (P = 0.05), while motor amplitude decreased from 6.88 ± 3.55 to 6.61 ± 3.29 (P = 0.05). Additionally, there is a substantial (P = 0.05) correlation between sensory and motor amplitudes and the BMI. Conclusion: High BMI and poorly controlled (high HbA1c) long-term diabetes had a negative impact on all nerve conduction study parameters

Treadmill Exercise as a Preventive Measure Against Age-Related Anxiety and Social Behavioral Disorders in Rats: When Is It Worth Starting?

Objective@#To determine the appropriate time points to start regular exercise which could reduce age-related anxiety and impaired social behavior. @*Methods@#For this study, 8-week-old male Wistar rats were divided into three groups: no exercise (NoEX), short-term exercise (S-Ex), and long-term exercise (L-Ex) groups. S-Ex-group rats started treadmill exercise at 12 months of age, while L-Ex rats started from at 2 months of age. Exercise rats were forced to walk on the treadmill three times per week, with 1- to 2-day intervals for 10 minutes during the first 2 weeks, at 10 m/min until 17 months of age, and at 8 m/min thereafter. At 19 months of age, behavioral tests were performed to assess the effects of exercise on age-induced behavioral change as well as quantitative polymerase chain reaction were done to uncover the mechanism behind the behavioral changes. @*Results@#Anxiety-like behavior was improved by long-term exercise. Additionally, rats belonging to the S-Ex and L-Ex groups showed improved social behavior and increased curiosity about interesting objects. The qPCR data showed that treadmill exercise suppressed the expression of immediate-early genes in the prefrontal cortex of the aged rats. @*Conclusion@#This study suggests that long-term exercise represses early response genes, and in this way, it increases resistance to stress, diminishes anxiety-related behavior, and improves social behavior. These findings underscore the need to consider appropriate time to start exercise to prevent stress induced anxiety related behavior.

Serine protease inhibitor, serpin, is a biomarker following Schistosoma mansoni re-infection in mice

@#Schistosomiasis is a chronic parasitic disease affecting mostly low income and resourcelimited countries. Despite the distribution of the curative medicine, praziquantel (PZQ), the frequency of re-infection is commonly reported, thus, making a difficulty to discriminate treatment failure after re-infection. Therefore, assessing Schistosoma mansoni re-infection after praziquantel administration is crucial to prove the treatment efficacy and to break the transmission of infection in endemic areas. The evolution of highly sensitive and specific diagnostic markers, reliable to detect the re-infection and to evaluate the treatment efficacy, is required to control schistosomiasis. In this study, the potential role of serpin recombinant antigen of S. mansoni as a biomarker of re-infection and chemotherapeutic efficacy has been assessed. Therefore, 20 mice were experimentally challenged and re-challenged with 50 S. mansoni cercariae and divided into 4 equal groups; the first included infected mice (control positive), the second group was twice infected with S. mansoni and left untreated, the third included mice twice infected then treated with praziquantel following the last challenge, and the forth one remained uninfected and untreated (control negative). The current findings demonstrated that high levels of IgG and IgG1 bound to serpin were detected following the re-infection and rapidly declined post treatment. In summary, S. mansoni recombinant serpin could be used as a promising marker to discriminate S. mansoni re-infection and evaluated the efficacy of treatment. The translation of such a potential tool in endemic areas will provide a significant support for the elimination and control programs against schistosomiasis.

Challenges of Engineering Biomimetic Dental and Paradental Tissues

BACKGROUND@#Loss of the dental and paradental tissues resulting from trauma, caries or from systemic diseasesconsidered as one of the most significant and frequent clinical problem to the healthcare professionals. Great attempts havebeen implemented to recreate functionally, healthy dental and paradental tissues in order to substitute dead and diseasedtissues resulting from secondary trauma of car accidents, congenital malformations of cleft lip and palate or due to acquireddiseases such as cancer and periodontal involvements.METHOD: An extensive literature search has been done on PubMed database from 2010 to 2019 about the challenges ofengineering a biomimetic tooth (BioTooth) regarding basic biology of the tooth and its supporting structures, strategies,and different techniques of obtaining biological substitutes for dental tissue engineering. @*RESULTS@#It has been found that great challenges need to be considered before engineering biomimetic individual parts of thetooth such as enamel, dentin-pulp complex and periodontium. In addition, two approaches have been adopted to engineer aBioTooth.The first one was to engineer a BioTooth as an individual unit and the other was to engineer a BioToothwith its supporting structures. @*CONCLUSION@#Engineering of BioTooth with its supporting structures thought to be in the future will replace the traditionaland conventional treatment modalities in the field of dentistry. To accomplish this goal, different cell lines and growthfactors with a variety of scaffolds at the nano-scale level are now in use. Recent researches in this area of interest arededicated for this objective, both in vivo and in vitro. Despite progress in this field, there are still many challenges ahead andneed to be overcome, many of which related to the basic tooth biology and its supporting structures and some others related tothe sophisticated techniques isolating cells, fabricating the needed scaffolds and obtaining the signaling molecules.

Challenges of Engineering Biomimetic Dental and Paradental Tissues

BACKGROUND@#Loss of the dental and paradental tissues resulting from trauma, caries or from systemic diseasesconsidered as one of the most significant and frequent clinical problem to the healthcare professionals. Great attempts havebeen implemented to recreate functionally, healthy dental and paradental tissues in order to substitute dead and diseasedtissues resulting from secondary trauma of car accidents, congenital malformations of cleft lip and palate or due to acquireddiseases such as cancer and periodontal involvements.METHOD: An extensive literature search has been done on PubMed database from 2010 to 2019 about the challenges ofengineering a biomimetic tooth (BioTooth) regarding basic biology of the tooth and its supporting structures, strategies,and different techniques of obtaining biological substitutes for dental tissue engineering. @*RESULTS@#It has been found that great challenges need to be considered before engineering biomimetic individual parts of thetooth such as enamel, dentin-pulp complex and periodontium. In addition, two approaches have been adopted to engineer aBioTooth.The first one was to engineer a BioTooth as an individual unit and the other was to engineer a BioToothwith its supporting structures. @*CONCLUSION@#Engineering of BioTooth with its supporting structures thought to be in the future will replace the traditionaland conventional treatment modalities in the field of dentistry. To accomplish this goal, different cell lines and growthfactors with a variety of scaffolds at the nano-scale level are now in use. Recent researches in this area of interest arededicated for this objective, both in vivo and in vitro. Despite progress in this field, there are still many challenges ahead andneed to be overcome, many of which related to the basic tooth biology and its supporting structures and some others related tothe sophisticated techniques isolating cells, fabricating the needed scaffolds and obtaining the signaling molecules.

Characteristics of adhesive bonding with enamel deproteinization

ABSTRACT Objective: To evaluate the effect of using sodium hypochlorite (NaOCl) on the bond characteristics of orthodontic metal brackets bonded to enamel surface using three adhesive systems. Methods: One hundred twenty premolars were selected and randomly divided into two equal groups of 60 teeth/ each (Groups I and II). The teeth of Group I were left untreated while those of Group II were exposed to 5.25% NaOCl for 1 minute. The teeth in either group were randomly subdivided into three equal subgroups of 20 teeth/ each (A, B and C), according to the type of adhesive system used to bond the brackets. In Subgroup A, phosphoric acid + Transbond XT primer and adhesive were used. In subgroup B, Transbond Plus self-etching primer (SEP) + Transbond XT adhesive were utilized. In subgroup C, phosphoric acid + SmartBond LC adhesive were used. The shear bond strength (SBS) and the degree of adhesive penetration to enamel surface were assessed. Data analyses were performed using ANOVA, post-hoc (LSD), t and chi-square test. Results: Transbond XT had significantly higher SBS than SmartBond LC (p< 0.05). Phosphoric acid provided significantly higher SBS and degree of adhesive penetration than SEP (p< 0.05). NaOCl significantly increased SBS and degree of adhesive penetration in Subgroups B and C (p< 0.05). Conclusion: Adhesion quality of Transbond XT adhesive is better than SmartBond LC. Phosphoric acid is more effective than SEP. NaOCl enhances the bond characteristics.

RESUMO Objetivo: avaliar os efeitos do uso de hipoclorito de sódio (NaOCl) sobre as características de colagem de braquetes ortodônticos metálicos na superfície do esmalte, utilizando três sistemas adesivos. Métodos: cento e vinte pré-molares foram selecionados e divididos aleatoriamente em dois grupos iguais, cada um com 60 dentes (Grupos I e II). Os dentes do Grupo I não foram tratados, enquanto os do Grupo II foram expostos ao NaOCl a 5,25% por 1 minuto. Os dentes de ambos os grupos foram subdivididos, aleatoriamente, em três subgrupos iguais, cada um com 20 dentes (A, B e C), de acordo com o tipo de sistema adesivo utilizado para colar os braquetes. No Subgrupo A, foi utilizada a combinação ácido fosfórico + Transbond XT (primer e adesivo). No Subgrupo B, foi utilizada a combinação Transbond Plus autocondicionante (SEP) + Transbond XT (adesivo). No Subgrupo C, foi utilizada a combinação ácido fosfórico + SmartBond LC (adesivo). Foram avaliados a resistência ao cisalhamento e o grau de penetração do adesivo na superfície do esmalte. A análise dos dados foi realizada utilizando-se os testes ANOVA, post-hoc (LSD), t e qui-quadrado. Resultados: o Transbond XT teve uma força de adesão significativamente maior do que o SmartBond LC (p< 0,05). O ácido fosfórico propiciou força de adesão e grau de penetração do adesivo significativamente maiores do que o SEP (p< 0,05). O NaOCl aumentou significativamente a força de adesão e o grau de penetração do adesivo nos Subgrupos B e C (p< 0,05). Conclusão: a qualidade da adesão do adesivo Transbond XT é melhor que a do SmartBond LC. O ácido fosfórico é mais eficiente do que o SEP. O NaOCl melhora as características da colagem.

Assessment of Thrombin Generations in Patients with Chronic Liver Diseases

Background/objectives: The area of hypercoagulability in cirrhosis and its potential contribution to certain clinical aspects have received a lot of attention. The clinical manifestations of the hemostatic disorders of cirrhosis have been traditionally related to bleeding due to multiple procoagulant factor defects, excessive fibrinolysis, and thrombocytopenia. Aim: Assess the function of blood coagulation in patients with chronic liver diseases and improve the knowledge of the pathophysiology of haemostasis. Patients and methods: This is a prospective case-control study which was conducted at outpatient clinic of internal medicine dept., Minia University Hospital, Minia Governorate, during the period from March 2017 to August 2018. Results: Protein C and S concentrations decreased significantly in Group (II A, II B, and IIC) compared to control and also, Group (II C) decreased significantly than Group (II A, II B). Regarding Thrombin fragments (F 1+2), Child score A patients had significantly higher concentration compared to the other three groups. However, as regards, Thrombin-antithrombin (TAT), Child score C group had a significantly higher level compared to other groups. Conclusion: Thrombin fragments and thrombin antithrombin complex are considered as the main specific markers for thrombin generations which were elevated strongly depending upon the pathogenesis and the severity of the liver diseases.

Three-dimensional evaluation of extended pour alginate impression materials following variable storage time intervals and conditions

The purpose of this study was to assess and compare the dimensional accuracy of the stone casts made of three extended pour alginate impressions materials (Cavex Colorchange, Kromopan, and Neocolloid) following storage under different storage conditions and pouring at different time intervals. Materials and Methods: A maxillary Frasaco (dentulous) model was selected as a standard model. Index holes of 1 mm depth and 1 mm diameter were made on the palatal cusp tips of right and left first premolars, mesiopalatal cusp tips of right and left third molars and in the midline of the palate, perpendicular to a line joining the index holes made on cusp tips of the first premolars as reference points for measurement. A single uniformly spaced custom tray was fabricated with heat-cure acrylic resin and used to make impressions for the entire study. A total of 210 impressions of the master model were made, seventy impressions were made from each of the alginate material brands and were subjected to three storage conditions (open air, uncontrolled humidity, and 100% controlled humidity) for three different storage time intervals (0, 1, 6 h). Since no storage was done in the immediate-pour group, it contained 10 specimens from each brand. Following the designated storage time interval, all impressions were poured in type IV gypsum. Measurements of stone casts were done in three dimensions, anteroposterior, lateral using Measuroscope and vertical by Dial Gauge. Data were organized in tables and statistical analyses were performed. Three-way ANOVAs were used to check if the material brands, storage time intervals, and conditions affect the measurements. Tukey HSD post hoc tests were used for the multiple comparisons if ANOVA is significant. One sample t-test was used to compare between the casts made of alginate brands and the master model. Significance level was set to α < 0.05 for all tests. Results: Results showed that the material brands, storage time intervals, and conditions do affect the measurements in all three dimensions (all P < 0.05). In addition, all two-way and three-way interactions were significant for all measurements except the interaction of storage time intervals and conditions for B–C (lateral) measurements, and interaction of material brands and storage time intervals for C–D (anteroposteriorly) measurements. When stone casts were compared to the master model, immediate pour, and storage for 1 h in 100% controlled humidity resulted in statistically insignificant changes among all three alginate impression brands. In addition, the specimens made of Cavex Colorchange and Kromopan following storage in uncontrolled humidity condition for 1 h showed statistical insignificance when compared to the master model. Conclusion: Within the limitations of this study, it can be extrapolated that, although this class of alginate impression materials was manufactured for extended pour purposes, clinicians should avoid storage of the studied brands for 6 h. Whenever 1 h to pour is necessary, 100% controlled humidity is the ideal and standardized environment for all three alginate brands. Perhaps, Cavex Colorchange, and Kromopan can be safely stored in uncontrolled humidity condition while maintaining their optimal dimensional accuracy.

Efficacy of Human Platelet Rich Fibrin Exudate vs Fetal Bovine Serum on Proliferation and Differentiation of Dental Pulp Stem Cells

BACKGROUND AND OBJECTIVES: The imperative role of dental pulp stem cells (DPSCs) in regenerative therapy demands an in-vitro expansion which must deal with the safety and ethical problems associated with fetal bovine serum (FBS). The primary aim of this study was to compare the effects of human platelet rich fibrin (hPRF) exudate Vs FBS on proliferation and osteodifferentiation of human dental pulp stem cells (hDPSCs). The secondary one was to determine the optimum concentration of hPRF exudate inducing hDPSCs proliferation and osteodifferentiation. METHODS: The direct method was used to prepare hPRF exudate. hDPSCs were isolated from impacted mandibular third molars of twelve donors by the outgrowth method. For cell viability and proliferation rate testing, 96 well plates were used and the assay was done in duplicate and the trial repeated four times under the same conditions. Six wells were used to contain 10% FBS, serum free media, 1%, 5%, 10% and 20% concentrations of hPRF exudates, respectively. The proliferation assay was carried out by MTS tetrazolium cell proliferation assay kit and Elisa reader. The study design for osteodifferentiation protocol was exactly as the proliferation one and instead the assay was carried out by alizarin red with Elisa reader. RESULTS: Compared to 10% FBS, 10% hPRF exudate was the optimum concentration for hDPSCs proliferation, while 1% hPRF exudate was the optimum concentration for osteodifferentiation of hDPSCs. CONCLUSIONS: Avoiding the risk of zoonosis which may be occurred with FBS, it is recommended to use 10% hPRF exudate for proliferation and 1% for osteodifferentiation.

Serum Sclerostin Levels in Patients with Human Immunodeficiency Virus Infection and Their Association with Bone Turnover Markers and Bone Mineral Densitometry

BACKGROUND: The aim of the study was to compare serum sclerostin levels in human im-munodeficiency virus (HIV)-infected patients and healthy controls, and to evaluate their relationship with bone turnover markers (BTM) and bone mineral density (BMD). METHODS: We prospectively studied 33 HIV treatment-naive patients and 63 healthy individuals; matched for age and sex. Serum sclerostin levels, BTM, BMD were measured. Viral load and cluster of differentiation 4 (CD4) levels were also assessed in HIV-infected patients. RESULTS: The mean+/-standard deviation (SD) age of sample was 37.6+/-10.3 years (range, 19 to 59 years). Of the 96 subjects, 58 (60.4%) were male and 38 (39.6%) were female. Infection with HIV is associated with significant reduction in serum sclerostin levels (HIV-infected: 39.4+/-28.3 vs. non HIV: 76.6+/-15.7 pmol/L; P0.05). CONCLUSIONS: These findings suggest that untreated HIV and the resulting immune deficiency and/or systemic inflammation could be an important regulator of serum sclerostin in this population.

Study of non-organ specific antibodies in children with genotype 4 chronic hepatitis C

Adult studies established a relationship between hepatitis C virus [HCV] infection and the presence of non-organ specific antibodies [NOSAs]. Most studies were carried out on genotypes 1 and 2. Only a few studies addressed that issue in pediatrics. No studies have been carried out on autoimmunity and genotype 4 in children. We aim to investigate NOSAs in 80 Egyptian children with chronic HCV infection along with studying the underlying genotype of HCV, and correlating autoimmunity with the epidemiological, clinical, biochemical, and virological features. HCV RNA was assayed by the polymerase chain reaction and viral genotypes were determined. NOSAs were measured and liver biopsies were taken for histopathological examination. Genotype 4 was the only detected genotype in the included 80 patients. Anti-smooth muscle antibodies [ASMA] were the only detected antibodies in 32 [40%] patients, always with V specificity [vessels only] at titers ranging from 1:20 and 1:160. Anti nuclear antibodies [ANA] and liver-kidney microsomal antibodies 1 [LKMA 1] were not detected in any of our patients. Epidemiologic and clinical features did not significantly differ between autoantibody positive and negative patients. Among biochemical features, significantly high levels of total bilirubin, albumin, immunoglobulins, alkaline phosphatase, and gamma glutamyl transpeptidase were found in the antibody positive group. Genotype 4 HCV is the prevailing genotype in Egyptian children with chronic HCV infection. A consistent proportion of these children with chronic HCV infection circulate non-organ specific autoantibodies. The prevalence of ASMA and the absence of ANA and LKMA 1 might be related to the unique situation in Egypt with unique prevalence of genotype 4. More studies are warranted on larger pediatric population to validate these findings.

Evaluation of asthma management in the acute setting

Asthma prevalence is increasing worldwide and its management continues to be challenging in the acute setting. The aim of this study is to evaluate asthma management in the emergency department in view of the recommended guidelines. A random sample of 72 adult asthmatic patients attending the emergency room in Ribat University Hospital [RUH] was selected. Management of each patient was observed. A questionnaire based on the recommended guidelines was filled [history, examination, use of pulse oximeter, use of peak flow meter/fev1, types of medications used for treatment and mode of discharge] for each patient. All patients [100%] were initially assessed with brief history and clinical examination. Peak expiratory flow rate and oxygen saturation were measured in only 13% and 10% of the patients respectively. All patients received salbutamol by nebulizer whereas only 8 patients received oxygen therapy, with significant relation to asthma severity [P<0.05]. A significant relation was also found between asthma severity and both steroid and antibiotic prescription. More than one fifth of the patients discharged themselves without or against doctor advice, which may be a major cause of relapse. These findings indicate that initial assessment of asthmatic patients in the ER of RUH is mainly subjective and their treatment is not consistent with recommendations of the international guidelines for asthma management, which necessitate the provision of acute asthma management pathway

Interactions of rosiglitazone and anti-arrhythmic drugs in animal model

Background: Diabetes increases the risk of vascular problems by two times compared with a healthy individual, with deposition of fats in blood vessel and this includes cardiovascular disease. The treatment regimens for patients suffering from both diseases generally include prolonged use of anti-diabetic drugs for diabetes and anti-arrhythmic drugs for cardiac arrhythmias.Aim:The aim of the study is to compare the influence of Mexiletine and Disopyramide on the pharmacodynamics (PDs) of Rosiglitazone in normal and diabetic rats.Materials and Methods:The study was conducted in normal rats and diabetic induced rats (with Alloxan monohydrate 100 mg/kg body weight). Albino rats weighing between 160 and 280 g were administered oral doses of Rosiglitazone 0.72 mg/kg, Mexiletine 36 mg/kg, or Disopyramide 18 mg/kg of bodyweight and their combination, with 1 week of washout between treatments. Eighteen rats were divided into three sub-sets with six rats in each sub-set. After 4 days, the blood glucose was estimated to confirm the diabetes. The Analysis of Covariance (ANCOVA) using MedCalc® software Version 11.6.1.0 was performed to analyze mean change in blood glucose between treatments with body weight as co-variable and treatment as factor for normal and diabetic rats.Results:No statistically significant difference in mean change in blood glucose between Rosiglitazone in comparison with Rosiglitazone + Mexiletine or Rosiglitazone + Disopyramide was observed in normal and diabetic rats (P = 0.606). The maximum mean change in blood glucose for Rosiglitazone and Rosiglitazone + Mexiletine or Rosiglitazone + Disopyramide was observed at 1 h and 8 h in normal and diabetic rats. The post hoc analysis showed baseline correction method has increased the reliability of the results (P < 0.001).Conclusion:The study concludes that PD activity of Rosiglitazone was not affected by the anti-arrhythmic drugs. This study introduced a new statistical methodology for analyzing the blood glucose endpoint

Interchangeability and comparative effectiveness between micronized and non-micronized products of glibenclamide tablets

During the last few years there was wide debate about the interchangeability and effectiveness between circulated products containing Glibenclamide in the market. This study aimed to compare the effectiveness of this product "non-micronized" to the originator's product of Glibenclamide tablets "of micronized" sulfonylurea. 12 volunteers received a dose of 5mg of Glibenclamide [from test and standard products] under fasting conditions in two separate sessions using randomized crossover design. Blood glucose level for the volunteers was monitored to avoid the development of hypoglycemia. Plasma samples were collected over 24 hours and analyzed using HPLC. The maximum concentration Cmax for the test and reference products were 2.508 +/- 0.104 and 3.526 +/- 0.118 [micro g/ml] respectively and the area under the curve AUC0-[were 3.511 +/- 0.153 4.572 +/- 0.202 [micro g.h/ml] for these products respectively, with a difference of about 24% between the test and reference products in its AUC. The results indicate that the test product is not bioequivalent to reference product. The difference in formulation between micronized product and non-micronized product of Glibenclamide tablets has impact on clinical outcomes

Assessment of the stability of novel antibacterial triazolyl oxazolidinones using a stability-indicating high-performance liquid chromatography method

To evaluate the stability of 12 triazolyl oxazolidinone [TOZ] derivatives in simulated gastric and intestinal fluids as well as in human plasma at 37 +/- 1°C. A stability-indicating high-performance liquid chromatography [HPLC] procedure with a C8 column [250 +/- 40 mm, 5 micro m particle size] and a mobile phase of acetonitrile/H2O [50/50 v/v] at 1.0 ml/min was used. Accelerated stability studies were conducted at 37 +/- 1°C in 0.1 M HCl solution as simulated gastric fluid and in phosphate buffer solution [pH about 7.4] as simulated intestinal fluid. The stability of TOZs in human plasma at a simulated biological temperature of 37 +/- 1°C was evaluated as well. The stability studies indicated that the examined TOZs were stable in the above media, with the exception of compounds 1a [tert- butyl 4-[4-[[R]-5-[[1H-1,2,3-triazol-1-yl]methyl]-2-oxooxazolidin-3-yl]-2-fluorophenyl]piperazine-1-carboxylate] and 1b [tert-butyl 4-[2-fluoro-4-[[R]-5-[[4-methyl-1H-1,2,3-triazol- 1-yl]methyl]-2-oxooxazolidin-3-yl]phenyl] piperazine-1-carboxylate], which underwent degradation in simulated gastric fluid. The degradation kinetics revealed degradation parameters [kdeg, t1/2, t90] of 0.180 h-1, 3.85 h, and 0.58 h for 1a and of 0.184 h-1, 3.76 h and 0.57 h for 1b, respectively. Furthermore, the degradation products were identified by mass-spectrometric analysis at mass-to-charge ratios 347.5 and 361.5, respectively, and proton nuclear magnetic resonance analysis. With the exception of compounds 1a and 1b, the TOZs are stable in simulated gastric and intestinal fluids as well as in human plasma. Being carbamate derivatives, compounds 1a and 1b underwent fast and complete degradation in simulated gastric fluid. The obtained results should be considered for future studies of formulation of structurally related TOZs in oral dosage forms

Effect of sodium fluoride-induced toxicity on the renal cortex of lactating mice and their offspring: a light and electron microscopic study

Fluoride is commonly added to drinking water for its clarification and to reduce tooth decay. However, fluoride was shown to have cumulative toxic effects on various organs, including the kidneys. To investigate the impact of sodium fluoride toxicity of drinking water on the histological structure of the renal cortex of lactating mice and their suckling offspring. Forty mice [20 mothers and 20 of their offspring] were used in this study and divided equally into four groups: group I [control mothers]: allowed ad libitum access to tap water without any added sodium fluoride during pregnancy and lactation, group II [treated mothers]: drinking tap water containing NaF [0.5 g/L] from day 15 of pregnancy until day 14 after parturition, group III: [suckling offspring of control mothers] and group IV: [suckling offspring of treated mothers]. All mice were killed on postnatal day 14. Specimens were prepared for light microscope examination [hematoxylene and eosin and periodic acid-Schiff] and electron microscope examination. In addition, tubular epithelial height and tubular diameter were measured morphometrically and analyzed statistically. Examination of the renal cortex of treated mothers [group II] showed atrophic glomeruli with widened glomerular spaces. Tubules appeared dilated with decreased epithelial height as proved morphometrically. Tubular cells had a vacuolated cytoplasm and pyknotic nuclei. The apical brush border of many proximal tubules showed a weak and disrupted periodic acid-Schiff reaction. Ultrastructurally, some proximal lining cells showed heterochromatic nuclei, numerous cytoplasmic vacuolation of variable sizes and small scattered rounded mitochondria associated with loss of basal infoldings. However, the distal tubules maintained their basal infoldings and organized mitochondria. Podocyte foot processes were distorted and rested on a thickened glomerular basement membrane. The suckling offspring of the treated mothers showed less severe tubular injury than observed in their mothers as the tubular dilatation and the epithelial height were not affected significantly. Sodium fluoride induced various degrees of damage to the structure of renal cortex. The lactating mice renal cortices were severely affected compared to those of their suckling offspring. Thus, it is recommended to adjust the fluoride content in the municipal water supply and to avoid excess fluoride intake especially for lactating mothers

Eosinophilic esophagitis in Saudi children: symptoms, histology and endoscopy results

Eosinophilic esophagitis [EE] is a clinicopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate currently defined as >15 eosinophils per high power field in the appropriate clinical context. This is the first pediatric study in Saudi Arabia to give the experience with EE and examine its symptom, histology and endoscopy results. Retrospective chart review of all patients diagnosed with EE at National Guard Hospital, Jeddah Between 2007 and 2009. The authors identified EE on histologic criteria [>15 eosinophils per high-power field] together with their clinical context. The authors reviewed medical records for details of clinical presentation, laboratory data, radiologic, endoscopic, and histologic findings, and the results of treatment. We identified 15 patients in our database in the last three years. 100% of the patients were males. The median age at presentation was 10 years [range, 3-17 years]. The commonly reported symptoms were failure to thrive [86%], epigastric abdominal pain [53%], poor eating [40%], dysphagia with solid food [26%], food impaction [13%], and vomiting [20%]. Asthma was reported in 46% and allergic rhinitis in 40%. Peripheral eosinophilia [>0.7 x 10/1] was found in 66%. High serum IgE Level [>60 lU/ml] was found in 60%. Upper endoscopic analysis revealed esophageal trachealization in 46%, esophageal erythema in 46%, white specks on the esophageal mucosa in 33%, esophageal narrowing in 13%, and normal endoscopy in 13%. The mean eosinophils per high-power field was 30.4 [range, 20-71]. Histologic characteristics included degranulated eosinophils [86%], basal cell hyperplasia [93%] and eosinophils clusters [micro-abscess] in 73%. The treatment of EE revealed that they used swallowed corticosteroid in 50%, proton pump inhibitors in 66%, elemental diet/ food elimination in 13% and systemic corticosteroid in 13%. Failure to thrive and abdominal pain in a male, atopic school-aged child was the most common feature of EE. Peripheral eosinophilia, high serum IgE and endoscopic esophageal erythema and trachealization should significantly raise the clinical index of suspicion for the diagnosis of EE

Role of partial splenic arterial embolization for hypersplenism in patients with liver cirrhosis and thrombocytopenia.

Background Hypersplenism is traditionally treated by surgical splenectomy. Transcatheter ablation of splenic parenchyma is an alternative treatment modality. Methods We evaluated the efficacy and safety of partial splenic arterial embolization in 10 patients with chronic liver disease and hypersplenism with thrombocytopenia (platelet count <80,000/μL). Results At six months follow up, median (range) platelet counts (134.5 [71.5-164] × 103/μL) were significantly higher than those before treatment (33.5 [23-39] × 103/μL; p<0.05]). All patients developed post-embolization syndrome. Left-sided pleural effusion and increase in amount or new development of ascites occurred in six and five patients, respectively. Conclusions Our data suggest that partial splenic arterial embolization leads to an increase in platelet count in patients with thrombocytopenia due to chronic liver disease and hypersplenism. However, it is often associated with complications.

Arachnoid cyst of the posterior fossa

Arachnoid cysts of the posterior fossa are uncommon. Our case of a 49-year-old man presented with a 2 month history of headaches, nausea, and vertigo associated with walking instability. An MRI revealed a median well-circumscribed cystic lesion of the posterior fossa, with similar signal characteristics to CSF, and without connection to the fourth ventricle. This aspect suggested either arachnoid or hydatid cysts. Direct open surgery was performed allowing complete removal of the cyst wall, with a good outcome

Periarthropathies: clinical spectrum and patterns

The aim of this study is to review the spectrum of primary periarthropathies. Rheumatology clinic, Ibn Sina teaching hospital, Mosul, Iraq. Prospective non-experimental clinical study. Two hundred patients having primary periarthropathy were included in the study. Secondary cases of periarthropathy were excluded. Patients with multiple periarthropathy were recorded. Two hundred patients were studied, 114 were females and 33 were males who had one type of periarthropathy; the remaining had combinations of periarthropathies. The mean age for periarthropathy was more than 40, except for tendinitis [36.8 +/- 10.5]. The most common periarthropathies is the shoulder 93 [46.5%], followed by Carpal tunnel syndrome 57 [28.5%] and planter fasciitis 34 [17%], history was significantly high in these three conditions. Various combinations of periarthropathies were seen in the study group. Shoulder periarthropathies and CTS were the most common, 46.5% and 28.5% respectively. The concept of oligoarthropathy and possibly poly-periarthropathy needs further research. Constitutional factors, for example, gender and pro-inflammatory mechanisms need further studies