Ageing and intergenerational family ties in Arab countries

This paper explores the dominant issues in intergenerational ties in Arab countries with a view to highlighting patterns, trends and challenges as well as policy implications. The data were drawn from a review of scholarly work and published literature in Arab countries and from a regional mapping of ageing policies and programmes in 2012. Social and health ageing policies in the region have been set with the premise that the family represents the core safety net for older Arabs. Yet demographic, sociocultural and economic transitions, as well as political conflict in the Arab world, are bringing profound changes to familial structures. This review feeds into efforts to promote health and social reforms that approach intergenerational solidarity from several fronts: providing equitable old-age income security, fostering cross-generational interactions, embracing caregivers and home-based care, promoting age-responsive actions in emergencies and conflicts, and prioritizing context- and country-specific research on the levels, types and trends in intergenerational and familial support

Aging in lebanon: perils and prospects

Lebanon is currently experiencing unique and dynamic demographic shifts towards an aging population: past and present fertility are among the lowest in the Arab region and crude mortality rates have decreased in the past few decades from 9.1 to 7.1 per thousand. Increased waves of emigration of youthful adults seeking better work opportunities elsewhere, as well as counter-waves of 'return migration' of older Lebanese workers from neighboring host countries contribute further to the 'rectangularization' of the population pyramid. These trends are accompanied by an epidemiolog-ical transition towards non-communicable diseases, mental disorders and degenerative diseases as the leading causes of mortality and morbidity in lieu of communicable diseases. We examine in this paper the implications of these transformations on the health profile of older persons and on the social and health care available to them. Findings are discussed within the prevailing conflicts and political strife in the country, family transformations and structural settings including pension systems, health coverage, family support channels and social fabric, and nursing home-care. The paper ends with recommendations and options for reforms

Lactulose and donepezil ameliorate thioacetamide-induced hepatic encephalopathy in rats

Hepatic encephalopathy [HE] is neuropsychological complication that is common in patients with acute or chronic liver disease as well as in porto-systemic shunting of blood flow. The pathophysiology of this disease is quite complex, as it involves overproduction and reduced metabolism of various neurotoxins, particularly ammonia. Thioacetamide [TAA]-induced HE is a reliable model of HE in which rats were given thioacetamide [TAA] 200mg/kg orally for 2 consecutive days. The TAA group showed lower motor activity than the normal group by using open field and forced swimming tests. Oxidative stress conditions were manifested by free radical production, lipid peroxidation, reduced glutathione and nitric oxide contents. Alterations in the metabolism of monoamine neurotransmitters have been proposed to be involved in the development of the HE associated with experimental and human liver failure. Pretreatment with lactulose or donepezil could counteract these effects. The protective effect of both lactulose and donepezil can be attributed to their antioxidant and neuromodulatory potential

Impaired bone formation and osteoporosis in postmenopausal elderly onset rheumatoid arthritis patients

Bone metabolism may be uncoupled in postmenopausal rheumatoid arthritis [RA]. Osteoporotic fracture in RA is highest for the hip especially in elderly women. To detect the bone mineral density [BMD] and markers of bone turnover in postmenopausal RA patients and study the influence of age at disease onset. Correlation with clinical and laboratory manifestations and disease activity were considered. Sixty postmenopausal RA patients were recruited into two groups, group I: 30 elderly onset [EORA] and group II: 30 young onset [YORA] patients. Thirty age and sex matched healthy subjects served as control. Full history taking, clinical examination, relevant investigations including calcium, phosphorus, total alkaline phosphatase [ALP], bone specific alkaline phosphatase [BALP], osteocalcin [OC], and N-terminal cross-linked telopeptides of type I collagen [NTX] were measured and BMD assessed by DEXA in all patients and control. Disease activity score in 28 joints [DAS-28] was calculated. The NTX was remarkably increased and the BMD decreased in RA patients. Osteocalcin in RA was 3.87 +/- 1.15 ng/ml being obviously lower in EORA patients compared to YORA and control. In EORA, a significant correlation was present between the ALP and OC [r 0.41, p 0.025] and the NTX and BALP [r 0.46, p 0.011] and a negative correlation between the hip BMD and DAS-28 [r -0.43, p 0.019]. Impaired bone formation and uncoupling of bone turnover are more evident in postmenopausal EORA patients which form a risk predictor of fracture hip in this subgroup of patients

Influence of malt extract and marjoram oil on the neurobehavioral changes of scopolamine -induced demented rats

Dementia can result from Neurodegenerative diseases: Alzheimer's disease, multiple sclerosis, toxic insults and sleep disorder. Alzheimer's disease [AD] is a progresstve degenerative condition that represents the most common cause of dementia. Scopolamine is a reference substance for inducing Alzheimer-like cognitive deficits in both man and animals Donepezil hydrochloride is highly selective for the CNS and is used for the symptomatic treatment of mild to moderately severe dementia in Alzheimer's disease. Malt extract and marjoram oil are natural products used in folk medicine for the treatment of some psychiatric disorders. The present work aims to study the influence of malt extract and marjoram oil on the behavioral responses, cholinesterase activity, brain monoamines, malondialdehyde and reduced glutathione of scopolamine induced demented rats. The results show that scopolamine decreased the ambulation and rearing frequencies in the open field test. Norepinephrine, dopamine and reduced glutathione contents were also decreased. However, cholinesterase activity and malondialdehyde content were increased significantly. Treatment of demented rats with donepezil, malt extract or marjoram oil individually could normalize the effect of scopolamine on these measured parameters. Data revealed that malt extract and marjoram oil could play an important role in treatment of demented rats by improving the changed behavioral parameters, altered brain neurotransmitters, cholinesterase activity and oxidative biomarkers

Study on the psychotherapeutic potential of marjoram oil on clonidine-induced depressed rats

Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. It interferes with a person's ability to participate in normal activities. Depression affects a person's thoughts and behavior as well as mood. The use of herbal medicine in psychiatry practice has increased tremendously in the past decade due to its fewer side effects and it can enhance the effects of conventional agents or be an alternative treatment. Marjoram is considered one of the most common herbs of Lamiaceae family. The therapeutic properties of marjoram oil are analgesic, antioxidant, calms nerves, anti-spasmodic, expectorant, hypotensive and sedative. This work aims to investigate the effect of marjoram oil on the brain neurotransmitters of clonidine-induced depressed rats as well as their behavioral responses using open field and forced swimming tests. The results show that marjoram oil treatment normalized the brain neurotransmitters content, the latency period and ambulation frequency in clonidine depressed rats. A decrease in the immobility time and an increase in the struggling time were observed in the forced swimming test. Treatment with fluoxetine or marjoram oil of the depressed rats decrease malondialdehyde content and increase the reduced glutathione content. It can be conclude that marjoram oil could play an important role in treatment of depression and alter behavior

Effect of malt extract on the neuron-behavioral changes in clonidine-induced depressed rats

Depression is a serious disorder that represents a major public disease often associated with symptoms at the psychological and physiological levels. Herbs and herbs-derived products have attracted much attention in relation to prevention of many diseases including psychiatric illnesses. Their therapeutic potential has been assessed in a variety of animal models, and the mechanisms of action have been investigated through neurochemical approaches. The aim of the present study is to investigate the possible antidepressant effects of malt extract using the open field and forced swimming tests and evaluation of brain neurotransmitters and oxidative stress biomarkers in the clonidine-induced depressed rats. Clonidine hydrochloride [0.8mg/kg] was injected intraperitoneally into rats daily for seven days in order to induce depression. Brain contents of serotonin, norepinephrine and dopamine as well as malondialdehyde and reduced glutathione were estimated. Effect of the antidepressant drug fluoxetine was also studied. Malt extract normalized the clonidine-induced altered behavior in the open field and forced swimming tests. Malt extract as well as fluoxetine normalized the reduced brain serotonin and dopamine contents winle fluoxetine increased the brain content of norepinephrine in the clonidine-induced depressed rats. In addition, both malt extract and fluoxetine normalized the altered oxidative biomarkers. The behavioral and biochemical results revealed that malt extract may have antidepressant activity which may he mediated through changes in the brain neurotransmitters and oxidative stress biomarkers

Utility of beta-aroyl acrylic acid in heterocyclic synthesis

Beta-[4-bromobenzoyl] acrylic acid has been reacted with nitrogen nucleophiles namely ethanolamine and o-aminophenol and yielded the corresponding adduct l a,b. On the other hand, beta-[3,4dichlorobenzoyl] acrylic acid has been reacted with carbon nucleophiles namely o-dichlorobenzene under Friedel-Crafts conditions and yielded the corresponding adduct Ic. Behaviour of compounds 1 toward hydrazine hydrate, hydroxylamine and acetic anhydride has been investigated. Acylation and alkylation of pyridazinone derivative also have been described

Influence of exposure to vapour of certain pyrethroids household mosquito repellant preparations on the neurobehavioral action of fluoxetin in rats

The environment includes increasing number of synthetic chemical compounds that cause environmental contamination . One of the most popular contaminating compounds are pyrethroids insecticides .Therefore, their wide spread use in agriculture and puplic health stimulated our attention for studying their possible toxic effect[s] on drug action .Fluoxetine is a selective inhibitor of serotonin reuptake which is widely used as an antidepressant . The aim of this work was to study the effect of inhalational exposure to vapour of two commonly used mosquito repellant preparations containing pyrethroids on the neurobehavioural action of fluoxetine . Sprague Dawley adult male rats were allocated into 3 main groups namely, control, and Ezalo and Ragon exposed groups .Exposure was performed 20 mm/day for 7 days in a static chamber . Twenty four hours later, i.p injection of fluoxetine [10 mg/kg] was performed . Contents of serotonin, norepinephrine and dopamine were determined in differtent brain regions one hour after fluoxetine injection . Behavioural parameters were also determined using open field and swimming test techniques.The obtained results showed that pre-exposure to Ezalo vapour induced significant increase in ambulation and rearing frequencies, while pre-exposure to Ragon vapour induced significant increase in ambulation, grooming and rearing frequencies as compared to fluoxetine-treated animals . Contents of serotonin and dopamine were also significantly altered in most brain regions .The obtained changes in the neurobehavioural parameters may be due to the effect[s] of pyrethroids and or the accompanying substances present in the mosquito repellant preparations on the biotransformation of fluoxetine

Medial canthus single injection a comparative study between articaine and prilocaine

To compare the efficacy of 4% articaine with 4% prilocaine for peribulbar anesthesia in ocular surgery using single medial canthus injection technique. One hundred patients scheduled for elective ocular surgery were randomly selected to receive 8ml of articaine 4% with 1:200,000 adrenaline [ultracaine D-S], or to receive 8ml of prilocaine 4% with 1:200,000 adrenaline [citanest fort]. Hyaluronidase 20IU/ml was added to both solutions. The end results were evaluated. Articaine had a more rapid onset of action as regards extra-ocular muscle paralysis, similar potency and less incidence of restoring to supplementary anesthesia. In comparison to prilocaine in single medial canthus peribulbar anesthesia. 4% articane is a good competitor to 4% prilocaine in peribulbar anesthesia

Potential prophylactic role of nitric oxide synthase inhibitors on experimentally induced cataract in rats

Nitric oxide [NO] has been related to numerous eye diseases such as cataract. In the present study, we investigated and compared the prophylactic role of selective and nonselective nitric oxide synthase [NOS] inhibitors on the development of selenite induced cataract in rats. The study comprised seven groups; of which four groups served as controls. Cataract was induced in three groups by a single subcutaneous injection of sodium selenite [4mg/kg] in 13-days old Lewis rats. One group was left untreated. The other two groups were treated with aminoguanidine or L-NAME [N G-nitro-L-arginine methyl ester] in a dose of 60mg/kg/day orally for nine days and treatment started two days before selenite injection. Slit lamp examination was done daily to detect lens opacity. Biochemical analysis of lenses was done seven days after selenite injection and included concentrations of nitrite, glutathione, calcium and soluble proteins, in addition to, Cellogel electrophoresis of soluble lens proteins. Ophthalmologic and biochemical results revealed a noticeable prophylactic role of both drugs on selenite cataract development after seven days of selenite injection. In addition, it was observed that aminoguanidine had a better protective role than L-NAME. It can be concluded that NO had an important role in the development of selenite induced cataract in rats since inhibitors of NOS could prevent the development of selenite cataract

Taurine level and field changes in different hereditary types of retinitis pigmentosa

This study was performed to detect if there is a correlation between various hereditary subtypes, taurine level and field indices. This correlation may help in the accurate diagnosis and management of different hereditary subtypes of retinitis pigmentosa cases. The study included 28 patients with retinitis pigmentosa [16 males and 12 females] and 25 controls with matched age and sex distribution. All patients and controls were subjected to clinical evaluation that included personal and family history taking, informative pedigree construction and full clinical examination to exclude the associated genetic syndromes. Field changes were detected in both eyes of 22 RP patients using Humphrey field analyzer 640 utilizing the 24-2 program. All patients and ten of the controls were examined for plasma taurine level by amino acid analyzer [Lc 3000 Eppendorf Biotronik]. A statistical analysis was done using statistical package for social science [SPSS] program. The results showed that taurine level can help in the diagnosis of different hereditary subtypes of retinitis pigmentosa, especially simplex cases that has no definite inheritance. This will improve the genetic counseling for RP families. Taurine can also be considered as a marker for the degree of severity of visual field affection in retinitis pigmentosa cases

Surgical management of hydatid liver cysts; inra-operative pair, cysto-pericystectomy and omentoplasty

Liver hydatid cysts caused by Echinococcus granulosus presents medical, veterinary and economic problems worldwide. In an attempt to eradicate liver hydatid cysts by eliminating the parasite, disappearance of the residual cavity, preventing complications and recurrence, the present study was done in Theodore Bilharz Research Institute on 36 patients. They were 11 females and 25 males with age ranging between 18-55 years old. All patients were sub to a full history taking and clinical examination, a full battery of hematological, biochemical, immunological and radiological investigations. Intra-operative Puncture Aspiration Injection and Re-aspiration [PAIR] was performed to all cysts before surgical intervention. Total cysto-pericystectomy [CPC] was done in 25 patients with both open and closed technique. Partial cysto-pericystectomy was done in 11 patients due to firm adherence of the cyst to the liver structures. Omentoplasty [OP] was performed to fill all cavities accompanied with external open system drainage tube. There were no mortalities in this study. Post operative complications were found in 7 patients. Cystectomy and omentoplasty related complication were found in 3 patients, General surgical complications were found in 1 patient. Biliary related complications occurred in 3 patients in the form of biliary leak in 2 patients and biliary fistulae in 1 patients. All these complications responded well to conservative management. A combination of different radical and conservative surgical modalities in the same sitting in the form of intra-operative Puncture Aspiration Injection and Re-aspiration, cystopericystectomy and omentoplasty could be considered the surgical method of choice with no mortality

Combination of a cyclooxygenase inhibitor and a nitric oxide synthase inhibitor in the treatment of experimental uveitis

Multiple factors and mediators interact to modulate the inflammatory process. In the present study, roles of nitric oxide [NO] and prostagl and in E[2] [PGE[2]] together with their simultaneous inhibition are investigated in a model of induced anterior uveitis in rabbits. Six groups of animals served as controls. Anterior uveitis was induced in 4 groups by intravitreal injection of 10 micro l complete Freund's adjuvant. One group was left untreated and the other three groups were treated three times daily for 14 days with N[G]-nitro-L-arginine methyl ester [L-NAME] 0.1% eye drops or with diclofenac 0.1% eye drops or with both drugs. Severity of uveitis was evaluated by clinical scoring at days 2, 7 and 14. On day 14, biochemical analysis of aqueous humor samples was performed for total proteins, albumin, nitrite and PGE[2]- Histopathological examination for iris and ciliary body was also done. Induction of uveitis caused elevation of clinical scores, elevation of the biochemically analyzed parameters and severe inflammatory signs by pathological examination. On day 14, both individual drugs and combination treatment produced significant decrease in intensity of uveitis compared to untreated animal model by all methods of evaluation. Combination treatment produced more reduction in clinical scores, more reduction in levels of total proteins, albumin and PGE[2] and also better histopathological picture compared to individual drug treatment. It can be concluded that both NO and PGE[2] are involved in the pathogenesis of Freund's adjuvant induced uveitis. Inhibition of production of both of them can improve the management of uveitis

Evaluation of the effect of four maternal positions on the duration of the second stage in nulliparous women

For centuries, there has been controversy around whether being.upright [standing, sitting, birthing stools, chairs, squatting] or lying down [supine, left lateral, lithotomy] have advantages for women delivering their babies To assess the benefits and risks of the use of different positions during the second stage of labor. The primary outcome was the duration of the second stage. Secondary outcomes were incidence of operative delivery, incidence of perineal and vaginal tears, estimated blood loss during the third stage and Apgar score This prospective randomized study was carried out at the Department of Obstetrics and Gynecology of the Shatby Maternity University Teaching Hospital in Alexandria, Egypt between 1998 and 2002. The study was carried out on 2080 nulliparous women who reached the second stage of labor with alive, full term, singleton fetus presenting with cephalic vertex presentation and with estimated average fetal weight. Women with medical or obstetric risk factors were excluded. Five hundred and twenty cases were randomly allocated into one of 4 groups. Group I cases used squatting position and group II cases used sitting position. Standing and lithotomy positions were the positions taken by cases in groups III and IV respectively There was no significant difference between groups concerning gestational age, estimated fetal weight by ultrasonography, head station and uterine activity. The shortest mean duration of the second stage was observed among cases in group I [30 [6 minutes] while the longest duration was observed among cases in group IV [100 [25 minutes]. In group II the second stage lasted 60 [15 minutes while in group III the second stage lasted 40 [12 minutes. A statistically significant decrease for the use of medical analgesia [p=0.0001] and oxytocin [p=0.0001] [was observed in women using the upright birth position. A significantly lower rate of operative delivery was detected in women who delivered in an upright position [groups I, II, III] compared with women delivering in lithotomy position [group 1V] [p=0.0001]. The frequency of perineal tears, and vaginal and labial trauma did not differ between the four groups [p>0.05]. When analyzing maternal blood loss in the third stage, no significant differences between all groups were found [p>0.05]. No differences in APGAR score <7 at 1 and 5 minutes or cord pH <7.1 were observed [p>0.05] between groups Maternal position during the second stage of labor definitely affects the duration of the second stage. Upright posture [squatting, standing, and sitting] were associated with shorter duration of the second stage in comparison to lying down [lithotomy position]. Also upright posture was associated with lower incidence of operative delivery

Longitudinal effect of health team education about geriatric health in Egypt

In Egypt, the number of people over 60 years old and over was 5.1% in the year 1986 census and is expected to increase to 7.7% by the year 2010 and 12.4% by the year 2025 [CAPMAS, 1996]. Increasing the number of elderly population added new health problems to the health authorities as the old people are more susceptible to many physical, mental, and social health problems [Kassem 2000]. the present study aimed to upgrade the knowledge, attitude and practice [KAP] of the PHC-providers towards the health needs and problems of the geriatric population in Egypt through implementation of health education course study [pre and post test] design. Analytical intervention study [pre and post test] was conducted in Five governorates in Egypt [Ismailia, Damietta, Al Dakahlia, Benisuef, and Assiuot]. Seven hundred and fifty PHC-providers, randomly selected from 5 govemorates in Egypt were invited to participate in the study, and after the pre-test they were engaged in the educational course [a self-directed learning package] on geriatric health needs and problems. The PHC-providers were 50 Physicians, 50 Nurses, and 50 Health educators from each governorate. A questionnaires of, 15 items for Physicians and Nurses and 17 items for Health educators based on current geriatric health needs and problems were used. The mean scores of knowledge, attitude and practice were calculated in pre and post tests for each group of physicians, nurses and health educators. A paired sample t-test was used to detect the differences between the means of knowledge, attitude and practice scores of pre-test and post-test. One way ANOVA test and Post Hoc test [Bonferroni test] were done to clarify the significant differences in [KAP] among the five govemorates at the pre-test and post-test and for the percentage of change between both tests. The SPSS [10.0] program was used for data analysis. The scores of knowledge, attitude and practice in the pre test were much lower than that in the post test scores and a statistical significant differences [P<0.05] were found among the participants PHC providers in all govemorates. Multiple comparisons [post Hoc tests] of knowledge, attitude and practice [KAP] of PHC providers in the five studied Govemorates revealed marked variations. 149. Tbis study displayed the important of ntinuing medical education, and also demonstrated the needs of PHC providers for medical education courses about geriatric health needs and problems

Herpes simplex 1,2 viruses as a risk factor in benign and malignant laryngeal tumors

The aim of this work was to study HSV1,2 as a risk factor in laryngeal tumors through the detection of the virus DNA using polymerase chain reaction [PCR]. The study group consisted of 40 patients presented by laryngeal masses. Biopsy was taken by direct laryngoscopy and each specimen was divided into two portions; one for histopathological study and according to its results the patients were divided into two groups: Group A, 20 patients, with mean age 58.7 years, having malignant laryngeal tumors and group B, 20 patients with mean age 34.4 years, having benign laryngeal tumors. The other portion of the specimen was examined using PCR for detection of herpes simplex 1,2 viruses DNA. The study showed that 55% of patients in group A [11 out of 20 patients with malignant laryngeal tumors] were positive for HSV1,2 DNA by PCR, while in group B [patients with benign laryngeal masses], all patients were negative for HSV1,2 DNA by PCR. The histopathological study showed that all malignant tumors in group A were invasive squamous cell carcinoma [SCC] with the highest percentage in grade I [40%]

Multileaf collimator versus tray mounted cerrobend blocks in head and neck cancer irradiation

The objective was to perform a direct comparison of cerrobend blocks to "Best fit" single field Multileaf collimator [MLC] shapes. Output measurements were made on a primus Linear Accelerator [Siemens], 29 leaves per side for Photon beam energy 6MV at source-to- axis distance [SAD 100cm]. The data was measured for different field sizes at different depths. The field sizes dependent factors were measured at the maximum depth 1.6cm for this energy. The penumbra widths were measured at 10cm depth in solid phantom by using Kodak films, their values were 5-6mm for isodose lines [80%-20%] and 16- 17mm for isodose lines [90%-10%]. The average MLC factor [MLC reading divided by block reading] was found to be 1. Also the comparison between the isodose mapping was obtained by the Multidata system for shaping treatment field in Head and Neck Cancer with both MLC and Cerrobend blocks at clinical depth 5cm

Zinc variation during liver regeneration following partial hepatectomy in schistosomiasis [experimental study]

This study aimed to estimate the serum level and hepatic content of zinc in experimental schistosomiasis as well as their alteration during liver regeneration following partial hepatectomy. The included animals were divided into two groups, schistosomal [40 hamsters] and non-schistosomal [33 hamsters]. The hamsters, either infested or not, were subjected to 35% partial hepatectomy [left lateral lobe hepatectomy]. Scarification of animals, collection of blood samples and regenerating liver tissue were done at two days, one, two and three weeks after hepatectomy. The serum level and hepatic content of zinc were estimated biochemically. The rate of hepatic regeneration was studied by histopathological examination and measurement of DNA content in the liver remnant. Hypozincemia with decreased hepatic zinc content was reported in schistosomal group preoperatively. Their DNA content [175.8 ug/g] had significant lower level when compared with the non-schistosomal group [335.75 ug/g]. During liver regeneration, serum zinc declined sharply; however the highest hepatic concentration and peaked DNA content were recorded in the first 48 hours following partial hepatectomy in schistosomal group. The mean liver weight reached a maximum of only 72.3% of its preoperative weight

Microscopic observation of broth cultures: a rapid and efficient method for detection and drug susceptibility testing of mycobacterium in sputum of children

We tried to develop a new, efficient, rapid, reliable and inexpensive method that permits mycobacteria detection and drug susceptibility for children and adolescents with pulmonary tuberculosis. Sputum samples were cultured by using [1]. the microscopic observation broth-drug susceptibility [MODS] method; [2]. radiometric culture technique by using BACTEC system; and [3]. culture on Lowenstein Jensen medium [LJ], in addition to Ziehl-Neelsen staining of sputum. Patients underwent tuberculin skin test. The results proved that the sensitivity of the different diagnostic tests was: MODS 79.3%, BACTEC 96.5%, and culture on LJ medium 55%. Specificity was high for BACTEC, MODS, and LJ medium as none of the 18 control sputum samples were positive by any method. The mean time of detection of mycobacteria was: MODS 10.4 +/- 3.79 days, BACTEC 9.1 +/- 3.1 days, and LJ medium 38.5 +/- 10.3 days. The mean time for doing susceptibility testing was: MODS 10.7 +/- 3.86 days, BACTEC 9.6 +/- 3.1 days, and LJ medium 38.9 +/- 10.6 days. Cost per sample for detection and susceptibility respectively was: MODS 2.7 and 17.5 L.E., BACTEC 25 and 77.5 L.E. and LJ 1.7 and 12.5 L.E. For diagnosis of tuberculosis, MODS method is a rapid, cheap, easy and efficient method for detection and performing susceptibility tests in Egypt