Effect of microcytic hypochromic anemia and parasitic infestations on stature in adolescents

Microcytic hypochromic anemia is the commonest form of iron deficiency anemia in adolescents. The occurrence of this type of anemia among adolescents is around 27% in developing countries. Clinical management should be based on a full knowledge of the prevalence of this disease in the age group mentioned. The present study reported the distribution of this type of anemia across age, anthropometric guides, and parasitic infestations in a sample of 300 adolescents attending various schools in Giza region, Egypt. Red blood cell size and iron concentration were assessed by mean corpuscular volume, hemoglobin levels, serum ferritin and total iron binding capacity from a venous blood sample. The adolescent was considered to have the microcytic form of anemia when their mean corpuscular volume was below 80 femtoliters [fL]. An adolescent with hypochromic anemia was defined as any subject with hemoglobin [Hb] below the WHO cutoff for age and sex: 12.0 g/dl for girls and for boys aged 12.5-14.99 years and 13.0 g/dl for boys aged > 15 years. Also, hypochromic anemia included every subject having either serum iron < 50 microg/dL, or a serum total iron binding capacity [TIBC]> 400 microg/dL. The incidence of microcytic hypochromic anemia in this study was 53%. There were highly statistically significant differences between anemic and non-anemic groups as regards age and height [P 0.05]. Anemic adolescents also had significantly lower values for weight [P < 0.01], BMI [P < 0.01] and hemoglobin concentration [P<0.01] compared to non-anemic adolescents. Also, microcytic hypochromic anemia was more common in adolescents who did not have lunch regularly. Adolescents with current parasitic infestations showed a higher frequency of anemia compared to those who did not. There were no statistically significant differences between adolescents with parasitic infestation and adolescents without parasitic infestation as regards age, weight, height and BMI [P >0.05]. Signs of pallor were more common in adolescents suffering from microcytic hypochromic anemia. Subjects with a history of chronic conditions such as cardiac diseases, renal failure or cancer had a significantly higher incidence of anemia than adolescents who did not. It was concluded that the anemic group of adolescents enrolled in the study were susceptible to growth retardation. This type of anemia is more common in adolescents who do not have lunch, have a chronic disease or a parasitic infestation

Assessment of regulatory T lymphocytes in different clinical presentation of chronic hepatitis C virus infection

CD4CD25[+] regulatory T lymphocytes are a subset of circulating CD4 T cells with suppressive properties. CD4CD25[+] regulatory T cells suppress HCV-specific T cell responses and it has been suggested that they may play a role in viral persistence. Our aim was to assess the frequency of regulatory T cells in the different clinical presentation of chronic hepatitis C virus infection in Egyptian population. Peripheral blood CD4[+]CD25[+] regulatory T cells from patients with chronic HCV [n=20], patients with HCV related liver cirrhosis [n=20], patients with HCV related-HCC [[n=20], and from normal control subjects [n20], were analyzed by flow cytometry. A higher frequency of CD4CD25 regulatory T cells were found in chronic HCV [3 +/- 0.9%], Hey related liver cirrhosis [3 +/- 0.8%], HCV related-HCC [3.9 +/- 1.6%], when compared with normal controls [2.3 +/- 0.8%]. No statistical significant differences were found when comparing HCV related cirrhotic patients with chronic HCV infected patients [p=0.95]. Meanwhile, a significant increase was detected when comparing HCV related HCC patients with chronic HCV patients [p=0.047]. Our results indicated the presence of higher than normal frequency of peripheral blood CD4CD25 regulatory T cell among Egyptian patients with different clinical presentation of chronic hepatitis C virus infection and in particular HCC

Selection of microencapsulation method to improve antimicrobial agents production by some lactobacillus species and propionibacterium thoenii in dairy products

The aim of this research is to select the agreeable encapsulation method to improve antimicrobial production from Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus rhamnosus and Propionibacterium thoenii. The effect of different organic acid concentrations [1 and 2 w/v], different pH values [3, 4, 5, 6. 7 and 8], different temperature degrees [0, 7, 25, 37 and 45°C] and storage temperature on viability of encapsulated bacteria were investigated. Also, the efficiency of microencapsulated methods [alginate + NaCI, alginate + oil and K-carrageenan] on enhancement of antimicrobial production were studied. Microencapsulation with alginate + NaCI offered greater production in extreme conditions [low pH, low temperature and in the presence of organic acids]. In addition, this method was more effective against pathogenic bacteria by enhancement of antimicrobial production, thus it may be effectively used to increase the safety and the shelf- life of dairy products

Synthesis and characterization of porous carbons by the sol-gel method from resorcinol-formaldehyde resin

Nine carbon xerogels were synthesized from resorcinol formaldehyde resin [RF], under increasing resorcinol/catalyst, Na2CO3, [R/C] molar ratios [50, 500. 1000], followed by pyrolysis at temperatures of 500, 600 and 700°C, under no external flow of gases. One organic xerogel was included for the sake of comparison. Drying of the RF hydrogels was carried out by the conventional evaporation technique in static air to get the RF xerogel Obtained carbons were characterized by CHO content, TEM, and N2/77K adsorption. Porosity characteristics were calculated by applying the well established alpha s plots to get various textural parameters. It was found that an increase in surface area, and pore volume was associated with corresponding rise in the R/C molar ratios. Most porosity, mainly, existed within the micropore size range, particularly for xerogels developed at 600 or 700°C, Thus. well-developed porous activated carbons could be obtained from an organic RF-xerogel by pyrolysis at 700°C and at high R/C-precursor ratios [500 and 1000]. The described simple conditions of preparation might encourage the pilot-scale production of porous carbon xerogels, suitable as adsorbents in liquid-phase environmental treatment processes

Pulmonary hypertension in thalassemic children: does endothelial dysfunction play a role?

The thalassemia syndromes are a heterogeneous group of inherited hemoglobin disorders resulting from impaired production of either the alpha or beta globin chain subunits of the hemoglobin tetramer. Heart failure is the most common cause of death in thalassemia. Thalassemic heart disease involves mainly left ventricular dysfunction caused by transfusion- induced iron overload. However, recent studies suggest that TM patients have a unique hemodynamic pattern consistent with right ventricular cardiomyopathy, and pulmonary hypertension in addition to the LV abnormalities. Pulmonary hypertension in beta-thalassemia could represent a common, yet less well-explored complication in the cardiopulmonary spectrum of the disease. The aim of this study is to determine serum levels of cholesterol, triglycerides, nitric oxide [NO], endothelin-1 [ET-1], lnterlukin-6 [lL-6] and the soluble forms of vascular cell adhesion molecule [sVCAM-1] as well as intercellular adhesion molecule [sICAM-1] in transfusion-dependent beta-thalassemia children and to correlate these markers with the echocardiographic findings as well as serum ferritin of these patients. The study included 32 transfusion-dependant children with beta-thalassemia aged 5 to 15 years and 40 apparently healthy children as a control group. Serum levels of cholesterol, triglycerides, NO, ET-1, lL-6 and the soluble forms of vascular cell adhesion molecule [sVCAM-1] as well as intracellular adhesion molecule [sICAM-1] were determined for patients and controls. In addition echocardiography was also done. Serum levels of ET-1, lL-6 and the soluble forms of vascular cell adhesion molecule [sVCAM-1] as well as intracellular adhesion molecule [sICAM-1] were significantly higher in the studied cases than the controls while serum levels of cholesterol and NO were significantly lower. Echocardiographic evidence of pulmonary hypertension was detected in 68.75% of the cases. The lassemic cases with PHT had significantly higher values of ET-1, lL-6, VEGF, sICAM and sVCAM than those without PHT. Pulmonary hypertension in beta-thalassemia could be an additional complication in the cardiopulmonary spectrum of the disease due to NO deficiency as a result of iron overload and endothelial dysfunction. Therapeutic interventions that decrease hemolytic rate, improve, enhance NO effects, or act as NO donors are of potential benefit and may alter the progression of the disorder

Serum matrix metalloproteinase-9 and tissue inhibitor of 3tetalloproteinase-1 in Egyptian patients with chronic liver disease: correlation with liver fibrosis

Chronic liver disease of different etiologies leads to cirrhosis. The main pathological mechanism of progression to cirrhosis is fibro genesis. Recognition of liver fibrosis or cirrhosis is difficult without liver biopsy. There is an urgent demand for a noninvasive reliable serum marker for liver fibrosis. Alterations in circulating matrix metalloproteinase-9 [MMPs] and tissue inhibitor of metalloproteinase-1 [TIMPs] concentrations and their correlation to the inflammatory activity and the histological changes are fairly well established, thus, the rationale of the present study was to evaluate the relationship between serum MMP-9, and TIMP-1 to liver status in patients with chronic liver disease. This study included 50 patients with chronic liver disease, 18 patients with chronic hepatitis, 22 patients with liver cirrhosis and 10 patients with hepatocellular carcinoma [HCC]. Twenty matched age and sex healthy volunteers were enrolled as control group. The obtained data showed that the lowest serum level of MMP-9 was found in chronic hepatitis patients compared to the control [P<0.05]. The MMP-9 serum level decreased during progression of chronic hepatitis to cirrhosis showing the least level in cirrhotic group. The serum TIMP-1 level was significantly higher in cirrhotic group compared to chronic hepatitis [P<0.05] and control [P<0.001] groups. Serum MMP-9 was negatively correlated to both the TIMP-1 level and to the histological severity of chronic hepatitis. There was a positive correlation between serum TIMP-1 and degree of fibrosis [r= 0.73, P< 0.001]. There were a statistically significant increase of MMP-9 [Pc0.001] and TIMP-l [P

Aluminum and cadmium levels in maternal and umbilical cord blood in Assiut University Hospital

In this study, aluminum and cadmium concentrations were determined in maternal and umbilical cord blood from urban and rural areas [n = 20 in each group] in Assiut Governorate. The present results showed that the level of aluminum in maternal and umbilical cord blood was highly statistically significant in both urban and rural areas. However, its concentration was higher in rural area in both maternal and cord blood and the maternal blood aluminum was highly statistically significant when comparing rural and urban areas. The cadmium in maternal and umbilical cord blood was highly statistically significant in both urban and rural areas. However, the cord blood level of cadmium was statistically significant when comparing between rural and urban and cadmium level was higher in urban areas

Serum transferrin receptor and transferrin receptor/ferritin ratio distinguish iron deficiency in anemia of chronic disorders in children

This study included 44 anemic children: 20 children were iron deficiency anemia [group I], 14 children suffering from iron deficiency anemia in the presence of acute infection [group II] and 10 children had anemia of chronic disorders [group III]. In addition, 20 healthy children were included as a control group. Complete blood count, serum iron, total iron binding capacity, serum ferritin and serum transferrin receptor [sTfR] were assayed in all patients groups. It was concluded that the increase in sTfR among patients with anemia of chronic disease reflects the increased demand for iron in the erythroid cells; thus sTfR level can be used in distinguishing the coexistence of iron deficiency anemia in anemia of chronic inflammatory diseases

Plasma trace element levels in infants and children with refractory epilepsies

To study the effect of long term use of antiepileptic drugs [AED] on plasma trace elements and the evolution of refractory seizures. Twenty three children were chosen to have persistent disabling seizures despite trials of all major anticonvulsants, alone and in combination, and with the highest doses the patient can tolerate. They were 13 males and 10 females with age range 2-14 years. Preliminary investigations were done to exclude cases with secondary seizures and those with low plasma levels of antiepileptic drugs. All of the patients were subjected to: thorough clinical and neurological evaluation, neuroimaging studies and assessment of plasma trace elements levels [Selenium, Copper, Magnesium and Zinc] using the atomic absorption spectrophotometry. According to the clinical and electroencephalographic patterns, the selected patients were subdivided into: cases with partial seizures including those with secondary generalization [group I] and cases with primary generalized seizures [group II]. Ten healthy children of matched age and sex were tested for plasma trace elements as a control group. Then after all of the patients were supplemented with trace elements medications [3-5ug/kg/day related to selenium] for three weeks and the response was followed up for 12 weeks. Plasma trace elements showed no significant differences between the 2 patients' groups [unpaired t-test, p>0.05]. Meanwhile, one way ANOVA showed significantly lower levels of selenium in all of the patients compared to the controls [p<0.001]. Correlation studies revealed a highly significant negative correlation between selenium levels and duration of AED [r = -0.81 and p=0.00]. Response to trace elements therapy was variable: complete response [cessation of seizures] in 25% of group I vs 33% of group II, partial or no response in 75% of group I vs 67% of group II. Response to trace elements has no significant associations with the type of sex, frequency and severity of seizures. The long-term use of AED may lead to trace element deficiencies with subsequent neuronal damage and evolution of resistant states. We recommend trace element supplementation especially selenium in patients under long term use of antiepileptic drugs

Involvement of interleukin-13 and soluble Inter leukin-2 receptors in the clinico-pathological presentation of pediatric nephrotic syndrome

54 children with nephrotic syndrome and 17 healthy controls were included in the study, among cases studied 40 were males and 14 were females, 36 had history of hypertension and 12 cases had oedema at the time of sampling. Patients were divided into 4 groups, GP 1:10 cases were. steroid responsive in remission, GP 11:12 cases were steroid resistant during activity, GP III:18 cases were steroid dependent of low dose steroids and GP IV:14 cases were steroid dependent on high dose steroids. For all patients' full history, clinical examination and estimation of urinary proteins as well as serum level of IL-13 and sIL-R11 were done. The level of serum JL-13 was significantly lower in cases, compared to control, interquartile range [IQR] was II and 28 respectively [p<0.005] Comparison of the 4 groups revealed a highly significant correlation between groups II and I [p<0.0054]. groups II and IV [p<0.010], there was also a significant difference in serum IL-I 3 level in both sexes but no significant relation to presence of oedema or hypertension. There was a significant negative correlation between IL-13 and serum protein level [r =-0.2686, p<0.05]. On the other hand the serum level of slL-2R was significantly higher in children with NS compared to controls [1Q11=5000, 1244 respectively, p<0.005]. There was a significant difference between patients in GPI vs OP IV [p<0.0 126] and between OP II vs OP Ill [p<0.029] and a highly significant difference between OP II vs OP IV [p<0.0012]. There was no significant difference as regards sex, but a significant difference in children with oedema [p<0.0090] and a highly significant difference in those with hypertension [p<0.0015]. There was also a significant negative correlation between sIL-2R and steroid intake [r =-0.49, 2 0.03]. Results of renal biopsy had no significant correlation with either IL-13 or sIL-2R. In conclusion TL-13 was significantly lower in all studied groups compared to the control, indicating involvement of IL-13 in the pathogenesis of NS. SIL-2R is involved in pathogenic mechanisms involved in activation of NS so it can be used as a clue for disease activity. The exact role of inflammatory cytolcines in pathogenesis of NS in childhood needs further research work to reach proper understanding of the pathogenesis of this syndrome

SFAS/APO-1/CD95 in SLE and its relation to disease activity

Fas/Apo-1/CD95 is membrane receptor that signal apoptosis to several types of cells. Triggering of Fas by its ligand or certain anti Fas monoclonal antibodies results in apoptosis. Fas occurs in a soluble from sFas devoid of a Trans membrane region. Defective Fas pathway and / or elevated sFas levels have been reported in patients with auto-immune diseases sFas prevents cells from undergoing Fas / ligand induced apoptosis. This study was carried out on thirty patients with SLE diagnosed according to the 1982 revised criteria of the American Collage of Rheumatology [ACR] for diagnosis of SLE. They were attending out patient clinic of Rheumatology and Rehabilitation Department of Benha University Hospitals, Ten healthy individuals age and sex matched were taken as a control group. All patients were subjected to full history taking. complete clinical. laboratory and radiological examination. The level of sFas in serum of SLE patients and the control were determined by ELISA technique. The activity of SLE disease was measured, according to SLE disease activity index [SLEDAI]

Eosinophil cationic protein [ECP] and skin prick tests in children with steroid-responsive nephritic syndrome [SRNS]

To assess the atopic state in patients with SRNS, serum ECP levels were measured by chemiluminescent enzyme immunornetric assay and skin prick tests were done in 32 children with SRNS and 10 age- and sex-matched healthy children without evidence of atopy. Out of the nephrotic patients, 19 children had active disease [Group I] and 13 were in remission [Group II]. Among group I, 7 children were frequent relapsers [FR] while 12 were infrequent relapsers [IR] or non-relapsers [NR]. We found that 37.5% of our patients had positive skin prick tests. Serum ECP levels were elevated in group I patients [= 25.3 and Interquartile range [IQR] = 13.8-33.6 ng /ml] and group II patients [median = 14.2 and IQR = 12.0-20.2 ng/ml] compared to controls [median = 9.1 and IQR = 7.2-13.5 ng/ml, P < 0.0001 and 0.006 respectively]. Similarly, patients with negative skin prick tests in group land group II had higher ECP levels compared to controls [P = 0.007 and 0.07 respectively]. Among group I, ECP levels were higher in patients with positive skin prick tests to those with negative tests [P < 0.0001] and in FR compared to IR and NR [P = 0.05]. Moreover, there was an association between the development of frequent relapses and positivity of skin prick tests [Fishers Exact = 0.07 relative risk = 6.4 and confidence interval = 1.0-41.2]. In conclusion, serum ECP levels are elevated in children with active SRNS. ECP could be considered as one of the neutralizing cations involved in the pathogenesis of proteinuria in these patients. Atopy could be assumed as a risk factor for the development of frequent relapses, so the value of a course of non-steroidal anti-inflammatory drug [as ketotifen] infrequently relapsing nephrotic children should be evaluated

Intraocular lens implantation in childhood in upper Egypt

The aim of this study was to evaluate the results of primary intraocular lens implantation [1 ry IOL] and secondary intraocular lens [2 ry IOL] in young age in Upper Egypt. Thirty patients were included in this study, their age ranged from three to 16 years. Extracapsular cataract extraction [ordinary or phaco] with 1 ry IOL was done for 26 eyes of 20 patients [six bilaterally and 14 cases unilaterally, the other eye was normal in six cases]. Secondary IOL was done for 14 eyes of ten patients [four bilaterally and six cases unilaterally, the other eye was normal in three cases]. The results have shown the development of vision in most of cases. Complications were more liable to occur with 2 ry IOL. Vision was limited by amblyopia in some patients, opacification of posterior capsule averagely occurred within two years after surgery regardless of patient age. It was concluded that primary intraocular lens implantation was safe in the selected children. Complications were more liable to occur with 2 ry IOL, posterior capsule opacified within two years after surgery regardless of patient age. Primary posterior capsulectomy is preferable in young patients who are not expected to be cooperative to do YAG laser within two years after surgery

use of nigella sativa oil as a natural preservative agent in processed cheese spread

Nigella sativa oil as a natural preservative agent was added at concentrations ratio of 0.1, 0.2 and 0.3% to processed cheese spread. Microbial count, chemical composition, and organoleptic properties of the processed cheese were investigated. The oil used had acid number of 29.5%, saponification value of 176.8% and iodine value of 129.5. Physical properties of the oil were 0.9251 specific gravity, refractive index of 1.472 at 25 degrees, and 0.55 polenske number. The fatty acid composition of the oil were 48.54% linoleic, 38.35% oleic, 13.2% palmitic, 3.25% stearic, 1.9% linolenic and 0.18% myristic acids. Nigella sativa oil had no effect on the chemical properties of processed spread. The treatment of processed cheese spread with sodium bisulfite or Nigella sativa oil at different concentrations led to reduce the microbial groups investigated, the reduction depended upon the concentration of preservative used and the resistance nature of the microbial groups

Breast changes in workers engaged in the manufacture of sex hormones

Numerous studies have established an association between sex hormones and the risk of developing neoplastic disease. It is of course, well known that both the risk of certain tumours occurring in women such as cancer of the breast and the endometrium and the prognosis in the event of their occurrence, are strongly related to endogenous hormones. It is quite justifiable to ask questions about the significance of exogenous hormones in relation to such diseases. This work was performed in one of the companies engaged in manufacturing of sex hormones. All workers already present and those transfered from this section have been examined for the presence of any breast mass or scar of previous operation. Pathological reports have been reviewed and correlated with the duration of exposure; age of workers, parity, and family history. Hormonal assay was performed for all exposed workers

Monitoring heparin effect in patients at risk of DV thrombosis

This work was designed to find out the optimal investigation [s] for monitoring heparin therapy. 50 patients, 25 males and 25 females, suffering from various cardiopulmonary diseases having or at risk of deep venous thrombosis admitted to ICU of Ain Shams University hospitals were treated with intermittent [4 hourly] I.V. heparin therapy. Blood samples were withdrawn before, 1, 2, 3 and 4 hours after heparin injections and the samples were analysed for ACT, APTT, IT and factor X[a] assay as well as protamine sulphate titration for heparin level and in vitro estimation of heparin level in plasma by APTT and IT. We found that ACT is the most practical and reliable test for monitoring heparin effect as it correlated significantly with heparin level using protamine titration test. It is especially useful when APTT and TT were paralyzed. On the other hand, factor X[a] assay is very unreliable as it measures mainly the anti-X[a] activity of heparin without the antithrombin effect. It was also found that therapeutic levels 3 hours after heparin injection were not significantly different from pre - injection levels denoting increase risk of thrombosis. Thus intermittent schedule for heparin injection is unreliable method of anticoagulation in patients at risk of D.V.T, pulmonary, or coronary embolism

Study of some acute phase proteins in type I diabetic patients with and without ketoacidosis

Five serum acute phase proteins: haptoglobin [HG], transferrin [TF]. alpha 1 glycoprotein [AGL], alpha 2 macroglobulin [AMG] and C reactive protein [CRP] were studied together with random serum glucose [RSG].total and differential white cell count and erythrocytes sedimentation rate [ESR] in 14 type I diabetic patients during ketoacidosis. They comprised 8 males and 6 females with a a mean age of 21 +/- 4.2 years. Ten apparantly healthy subjects: 6 males and 4 females with a mean age of 22 +/- 5 years served as controls. Ketoacidosis was controlled, then diabetes was treated properly with insulin and dieting. 14 to 18 days after ketoacidosis control [end of study], 12 out of the 14 patients were reexamined and resampled. AMG was significantly higher [S: P<0.05] during ketoacidosis than at the end of study with non significant [NS: P>0.05] difference between patients with and without infection. NS difference was found between levels of HG, TF and AGL during ketoacidosis and at the end of study. Similarly NS difference was found between their levels in patients [either during ketosis or at end of study] and controls. However TF level was significantly lower in patients with infection than those without together with a concomitant significantly higher ESR, neutrophilic and positive CRP. A strong positive correlation was found between AMG and RSG values [p<0.001], while, a strong negative correlation [p<0.001] was found between TF and both neutrophil count and ESR. This suggests that AMG value is directly proportional to the degree of hyperglycaemia, while, both low TF level and positive CRP are mainly related to occurrence of infection in type I DM

Faecal carcinoembryonic antigen in chronic colorectal disorders and colonic malignancy

Fecal carcinoembryonic antigen [CEA] was estimated by ELISA method in 10 normal control, 13 patients with chronic bowel disorders and 15 colorectal carcinoma patients [pre- and postoperatively after surgical resection], to determine its diagnostic value and follow up in various chronic colonic disorders and colorectal carcinoma. Large bowel cancer patients had a statistically significant higher value compared to chronic bowel cancer patients had a statistically significant [P <0.05] higher mean value of fecal CEA compared to the control, while a non significant higher value compared to chronic bowel disorder patients was observed. Preoperative fecal CEA fall significantly [P <0.05] in cancer patients by surgical resection from 11.97 +/- 2.14 mug/g to 3.86 +/- 0.59 mug/g. Also, benign chronic colorectal diseased subjects showed a statistically significant diseased subjects showed a statistically significant [P <0.05] higher mean value of fecal CEA compared to the control. Fecal CEA in cancer colon was significantly [P <0.05] high in comparison to cancer rectum patients. Finally, a significant [r= 0.51, P <0.01] positive correlation was elicited between fecal CEA and age of patients with large bowel carcinoma. So, fecal CEA may be used as a useful adjuvant in diagnosis and follow up in various chronic colonic disease and colorectal carcinoma

Eye findings in some blood and reticuloendothelial diseases

Ophthalmic examination was performed over a period of one year on one-hundred patients in Assiut University Hospital diagnosed clinically and by laboratory investigations as cases of blood and reticulo-endothelial diseases. The ocular findings in these diseases were studied and their incidence was compared with that of other authors