Protective effect and potential mechanisms of propolis on streptozotocin-induced diabetic rats

Objectives: The objective of this study was to determine the protective effects of propolis supplementation against the toxic effect of streptozotocin [STZ] on pancreatic beta-cells and to identify the possible mechanism of actions underlying this effect

Methods: Forty-five rats were randomly divided into three groups, with each group containing 15 rats. Group I consisted of normal rats fed a normal chow diet. Group II included diabetic rats induced with STZ. Group III consisted of rats treated with 0.3 g/Kg/day propolis for 2 weeks before the induction of diabetes by STZ. At the end of experimental period, blood samples were collected for the measurement of fasting blood glucose [FBG] and lipid peroxidation activity. Pancreatic tissues from the dissected rats were processed for morphological and immunohistochemical studies

Results: The findings of this work showed that the treatment of rats with propolis before the induction of diabetes mellitus is associated with significantly decreased FBG levels compared to the diabetic rats. The lipid peroxidation products were significantly increased in group II compared to group I. However, these products were significantly decreased in group III compared to group II. The histopathological and immunohistochemical analysis of the pancreatic tissue showed an increase in the size of the islets of Langerhans and the enhanced staining of beta-cells of the pancreas with beta-cell antibodies in group III compared to group II

Conclusion: Propolis showed protective and preservative effects on pancreatic beta-cell integrity in STZ-induced diabetic rats. This study suggests the need for further research to elucidate the exact mechanism of this effect

Protective effect of fish liver oil and propolis on anticonvulsant drugs-induced osteoporosis

Osteoporosis is a major health problem and its prevalence increases the risk of bone fracture. It is classified into primary [postmenopausal or age related] and secondary [related to chronic diseases, drug therapy, or life style]. There is accumulating evidence that patients on antiepileptic drugs [AEDs] are at an increasing risk of developing osteoporosis. The present study aimed at investigating the protective effect of dietary natural products, fish liver oil, and propolis on osteoporosis caused by anticonvulsant drugs. A total of 105 albino rats were used, divided into seven groups of 15 rats each. Group 1 was used as a control group. In group 2, rats were injected intraperitoneally with pilocarpine [300 mg/kg body weight]. The pilocarpine-induced epileptic rats in the other five groups were orally treated with valproate [400 mg/kg body weight], a combination of valproate and fish liver oil [0.4 ml/kg body weight/day], a combination of valproate and propolis [50 mg/kg body weight/ day], fish liver oil, and propolis, respectively. At the end of the experiment [6 months treatment], animals were sacrificed, femur shafts were extracted, decalcified, and processed into paraffin blocks for histopathological and image analysis and morphometric studies. Rats treated with the antiepileptic valproate alone showed a decrease in the thickness of shaft cortical bone, with a marked decrease in the number of osteocytes, increase in Haversian canals, and decrease in bone trabeculae, disruption of normal architecture, and widening of bone marrow spaces compared with the control group. Treatment with the dietary natural products, fish liver oil, and propolis along with the AED valproate might improve histopathological changes and morphometric parameters in bone associated with AED-induced osteoporosis

accuracy of FNAC for diagnosis of breast carcinoma in Gezira state, central Sudan

Breast cancer is a leading cause of death in many countries worldwide and breast lesions remain a common diagnostic dilemma. Fine-needle aspiration cytology [FNAC] has been suggested as the most important, first line, minimally invasive procedure in the management of patients with breast lesions. The aim of this study is to assess the diagnostic efficacy of breast FNAC in patients with breast lesions compared with that of the definitive histological diagnosis. This is a hospital-based retrospective study of 112 breast FNAC samples were carried out at Cancer Institute in Medani Gezira state. FNAC findings were correlated with data from histopathology records to determine the sensitivity and specificity of FNAC. Age group of the patients ranged from 26 to 80 years with mean of 42 years. Among the study subjects [112 case], ductal carcinoma is the common hitological linding 83/88 [94%]. According to the cytology, 79% were malignant, 4% were benign and 2% were suspicious. Histological correlation was done in 68 cases. The overall diagnostic accuracy of FNAC was 92.3%, with sensitivity and specificity of 89.2% and 66.5% respectively. FNAC of breast is asimple, cost effective and less traumatic method for diagnosing breast cancer. It is highly sensitive and accurate, and can reduce the needs for open biopsies. It is recommended that FNAC should be used as a first line method for determining the nature of breast lumps

Evaluation of heat shock protein 70 in psoriasis

Psoriasis is a common chronic, relapsing, noninfectious inflammatory skin disease. The concept that psoriasis has a genetic basis has been accepted for many years and it is commonly thought of as a complex trait. Heat shock proteins [HSPs] are group of proteins whose expression is increased when the cells are exposed to elevated temperature or other stress.These proteins can be induced by a range of cellular stressors including increased temperature, oxidative stress and nutritional deficiencies. Hsps have been proposed to play an important role in the pathogenesis of psoriasis. The aim of this work is to detect the expression of HSP70 in psoriasis and its correlation to the disease severity and to review potential role of HSP70 in pathogenesis and therapy of psoriasis. Skin biopsies were taken from 20 patients with different severity of untreated chronic plaque-type psoriasis and from 20 healthy volunteers. Antibodies to HSP70 were analyzed immunohistochemically. Immunoreactivity intensity distribution index [IRIDI] scores including the proportion of immunoreactive cells and their staining intensity were calculated in the basal, suprabasal, superficial as well as the whole epidermal layers of patients and controls. Results of our study revealed that differential and total IRIDI scores for HSP70 expression showed highly significant higher values in psoriatic patients compared to controls. Statistical differences were found between the different groups of patients; according to their disease severity and controls. Positive correlations also existed between IRIDI scores of patients and disease severity. Our study provides further evidence on the importance of Hsp70 in the pathogenesis of psoriasis and shows increased Hsp70 expression in psoriatic epidermis correlated to increased severity of psoriasis. To our knowledge no previous studies made correlation with HSP70 expression in psoriasis and disease severity. Finally, we are looking forwards to the application of a new therapy that targets Hsp70 or its receptor CD91 and helps in treatment of psoriasis

Efficacy of acupressure on pain intensity during first stage of labor

Pain management may actually help to shorten labor and secure natural delivery. Safe and painless labor is a dream for the future rather than a reality today. This study aimed to explore the efficacy of acupressure on pain intensity during the first stage of labor. The study was conducted on 120 parturient attending in two hospitals in Tanta city, where 60 women were chosen from each setting. Four tools were used [1] a specially designed interview schedule was used to collect basic data such as general characteristics, medical history, women's experience of pain and their expectations about labor pain. [2] Physiological and behavioral responses to pain sheet: Physiological responses to pain including: vital signs, gastrointestinal tract responses and skin responses. Behavioral responses to pain were measured using a modified Chamber Price Pain Rating Scale which includes posture, gross motor activity, facial expression and verbalization. [3] A modified version of "Johansson Pain-o-meter" for measuring the intensity of sensory and affective components of pain. It is composed of 11 affective and 12 sensory pain word descriptors. [4] Visual Analogue Scale. The results revealed that the application of acupressure to women during the first stage of labor was related to their physiological responses to pain. In addition, it was showed that both those who received the acupressure and those who did not receive it had an increase in their blood pressure. Regarding pulse rate it was observed that three nursing intervention had led to a decrease in it among the laboring women within the experimental groups. As regards the respiratory rate, the present study showed that the application of acupressure was related to its increase. In addition, a decrease of nausea and vomiting was seen after the application of acupressure. Physiologically, the activity of the sympathetic nervous system is expected to increase in response to labor pain, resulting in pallor and diaphoresis. The study revealed a change in the behavioral response to labor pain after the application of acupressure. In addition, acupressure is sign significantly related to an increase in assuming a guarded position, and decrease in frowning and grimacing, groaning, moaning, crying out, decrease in quality and intensity of labor pain. The mean score of labor pain had been reduced after acupressure application

outcome of pregnancies associated with intrauterine contraceptive devices

In this retrospective study we sought to determine the outcome of pregnancies associated with intrauterine contraceptive devices. Medical records of 2000 women, who used IUCD, were reviewed in detail. All IUCDs were inserted either post menstrual, post delivery or post miscarriage. 1196 [60%] IUCDs were inserted by doctors and the remaining 804 [40%] by midwives. The cohort was divided to four groups on the basis of their age. There were 300, 950,300 and 450 women in 18-22,23-27,28-32 and 33-37 years groups respectively. They were also divided to three groups on the basis of their parity with 300 Para 1 women, 1100 Para 2-4 women and 600 Para 5 or more. 37 [1.85%] unintended pregnancies occurred, including 35 intrauterine pregnancy and 2 ectopic pregnancies. 9 [3%] of these pregnancies occurred in 18-22 year group, 16 [1.68%] in 23-27 age group, 8 [2.67%] in 28-32 age group and 4 [0.89%] in 33-37 age group [Figure 1]. 19 [1.59%] of the pregnancies occurred in women whose IUCDs were inserted by medical staff and 18 [1.51%] in those whose IUCDs were inserted by midwives. The outcome of intrauterine pregnancies included 19 [51%] term pregnancies, 9 [24%] miscarriages, no septic abortions, 7 [19%] Preterm labour including 2, 26-28 weeks and 5 29-32 weeks. No puerperal sepsis or congenital abnormalities were reported [Figure 2]

Relationship of arterial compliance and glycosylated haemoglobin as a predictor of vascular damage in diabetic patients

Accelerated arterial stiffness has been linked in diabetes to hyperglycaemia, hyperinsulinaemia, and impaired glucose tolerance. In this work, we studied two groups: Normotensive diabetic patients Group [A] and non diabetic age and gender matched controls group Group [B]. We excluded those with hypertension, hypercholesterolemia, smokers or ex-smokers and patients with history of or complaining of peripheral vascular disease or coronary artery disease. The aim of work was to study the relationship between arterial compliance and diabetic status in normotensive diabetic patients. The two groups [A and B] were compared as regards the clinical data, laboratory investigations, echocardiographic studies, carotid duplex evaluation [intima-media thickness and incidence of atherosclerotic plaques], pulse wave velocity measurements. On comparing both groups we found that diabetic patients had average pulse wave velocity, higher incidence of diastolic dysfunction and had lower fractional shortening values and E/A ratio on echocardiographic evaluation. Correlation of glycosylated haemoglobin with the other study parameters showed a significantly positive correlation with pulse wave velocity [PWV] among the whole population and with mean intima-media thickness [Mean IMT] among the whole population and in diabetics. Correlation of pulse wave velocity with the study parameters revealed a statistically significant positive correlation with mean-intima media thickness among the total population as well as in diabetics. In this study we concluded that early vascular damage and arterial stiffness is independently related to glycaemic status in diabetic patients even before evident clinical manifestations of macrovascular affection such as hypertension, increase in intima-media thickness, development of atherosclerotic plaques, symptoms or signs of peripheral vascular disease or coronary artery disease. We don't know if tight glycaemic control could reverse these early changes of vascular compliance or not and that needs further investigation. Pulse wave velocity is a non invasive, inexpensive and feasible method for early detection of vascular damage and impaired arterial function, so that therapeutic interventions can be evaluated, in order to reduce future cardiovascular complications and thereby increase both duration and quality of life.

Evaluation of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women

Osteoporosis is a major global health problem affects mainly elderly and postmenopausal women with increased risk of bone fractures. The value of different biochemical markers of bone turnover as diagnostic tool for osteoporosis is still debated. The aim of this study is to assess the value of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women. We measured fasting urinary calcium [Uca], total ALP, inorganic phosphorus [Pi], urinary deoxypyridino-line [DPD], carboxyterminal telopeptide of collagen type I [ICTP] and serum N-terminal telopeptide [NTX] in 40 postmenopausal females [diagnosed by DEXA as osteoporotic, | mean age, 60.2 years], 16 preimenopausal non-osteoporotic females [mean age, 39.1 years] and 24 healthy controls [mean; age, 29.2 years]. The postmenopausal osteoporotic group showed significantly higher levels of ALP, DPD, NTX and ICTP compared to controls [p<0.001] and only ALP was significantly higher in preimenopausal group compared to controls [p<0.001]. However, there was no significant difference of Uca and Pi among the three groups. On comparing peri and postmenopausal groups together, DPD, NTX and ICTP were the only markers that clearly discriminate the two groups being higher in the osteoporotic postmenopausal group. There were significant negative correlations between bone mineral density [BMD] and each of ALP, DPD, NTx, and ICTP. The clinical utility of DPD, NTx and ICTP in identifying patients with osteoporosis was assessed by ROC [receiver operating characteristic] curve analysis. This revealed that the best diagnostic cut-off level for DPD was 6.8nM DPD/mM creatinine. This gave a diagnostic sensitivity of 100% and specifity 100%, whereas NTx at a level 17.0 nM BCE had a diagnostic sensitivity of 100% and specifity of 98%. Regarding ICTP at cut-off level of 3.6 microg/L its sensitivity was 88% and specifity was 65% which considered the lesser better sensitivity and specifity among the three studied parameters

profile of high-risk pregnancy in El-Mansoura City

Proper screening techniques should be used for all pregnant women attending antenatal clinics to pick up the factors that qualify the pregnant women for a risky pregnancy. High-risk pregnancy identification is a challenging work. This study aimed to describe the profile of high-risk pregnancy in El-Mansoura city. The study was conducted on 750 pregnant women attending antenatal clinics in three hospitals in El-Mansoura city, where 250 women were chosen from each setting. A modified version of Morrison and Olsen [1979] high risk scoring inventory tool was used to collect the socioeconomic, biological, medical, reproductive and current pregnancy risk factors in the study sample. It also assessed the risk level whether low, moderate or high. The results revealed that among all women, 63.8% of the sample were at a high-risk, while 25.0% of them were at a moderate-risk and only 11.2% were at low-risk. About 70.0% of the high-risk pregnant women were in their third trimester followed by 23.0% in the second trimester and only 7.1% were in the first trimester. About 5.9% of the women were at a high-risk because of polluted housing condition, 1.9% because of heart diseases Class I or II, 5.2% because of diabetes mellitus, 4.2% because of hypertension and 14.9% because of previous cesarean section. On the other hand 14.8% women were at moderate risk because of their illiteracy, 29.2% of them for being short, 14.7%, 10.6% of them because of being teenagers or over 35 years of age, respectively, 12.6% of because they had a history of gestational diabetes and 32.8%of them because of anemia, 23.2% because urinary tract infection, 16.9% because of albuminuria, and 12.0% because of glucoseuria,. Finally identifying the profile of high-risk pregnancy women is mandatory

presence of multiple autoantibodies and its relation to the control of diabetic patients under therapy

The presence of multiple autoantibodies to different islet cell antigen including those to insulin autoantibodies [IAA] islet cell cytoplasm [ICA] and glutamic acid decarboxylase [GAD-Ab] were studied in 70 diabetic patients [30 cases of type I diabetes [IDDM], 30 cases of type II [NIDDM], 10 cases shifted from oral hypoglycemic therapy to insulin, in addition to 20 normal healthy controls]. All were subjected to fasting and postprandial plasma glucose, C-peptide level, glycosylated hemoglobin, insulin antibodies, islet cell cytoplasmic antibodies and glutamic acid decarboxylase antibodies. The obtained results showed that in IDDM group, 23.3% were positive for ICA, 40% were positive for GAD-Ab and 60% were positive for IAA. In NIDDM group, 23.7% were positive for ICA, 36.7% positive for GAD-Ab and 50% were positive for IAA. In the group of patients who shifted recently to insulin therapy, 30% were positive for ICA, 30% positive for GAD-Ab and 90% were positive for IAA. There was a positive correlation between glycosylated hemoglobin with the number of positive antibodies. Cases with no positive antibodies had a significant lower glycosylated hemoglobin level than those with one or more positive antibodies. It was concluded that the presence of both ICA and GAD-Ab was a stronger predictor of rapid B cell loss; hence, there was a more need for insulin therapy

Rationale of percutaneous nephrostomy in malignant obstructive uropathy

Percutaneous nephrostomy [PN] was done for 28 patients presenting with malignant obstructive uropathy and impaired renal function. The mean serum creatinine was 15.3 mg% +/- 4.9 mg%. The procedure was performed under local anaesthesia with ultrasound guidance. The renal function improved in 23 patients [82%] with significant decrease in serum creatinine to 3.5 mg% +/- 1.3 mg% [P < 0.001]. There were no serious complications related to PN in any of the patients. Minor complications occured in 8 patients [28.6%] and managed successfully. After improvement in renal function 11 patients underwent radiotherapy and 8 patients underwent chemotherapy for the primary malignancy. 19 patients out of 24 patients [79%] followed up survived more than 2 months. In conclusion, percutaneous nephrostomy in patients with malignant obstructive renal failure is a minimal invasive procedure that improves the renal function and if further treatment is available, the survival may be improved

Serum leptin level and diabetic retinopathy

Neovascularization is the hallmark of proliferative diabetic retinopathy but its exact pathogenesis is still undefined. Recently, leptin was shown to possess an angiogenic action in vitro and to induce neovascularization in vivo. The present study was conducted to investigate the possible relation between serum leptin levels and diabetic retinopathy especially the proliferative form.The study included 50 patients with type 2 diabetes mellitus [22 males, 28 females, mean age 52.88 +/- 4.85 years, body mass index [BMI] 27.31 +/- 3.2 kg/m[2], and waist/hip ratio, 0.84 +/- 0.23]. They were classified into three groups according to the stage of their diabetic retinopathy [20 without retinopathy, 17 with nonproliferative retinopathy, and 13 with proliferative retinopathy]. In addition, 15 apparently healthy subjects who matched with the diabetic patients for age, sex, BMI and waist/hip ratio served as controls. All participants were subjected to full history taking, thorough clinical examination, ECG, echocardiography, direct and indirect ophthalmoscopy, and the following laboratory investigations: fasting blood glucose, glycosylated hemoglobin, blood urea, serum creatinine, detection of microalbuminuria, lipid profile, and serum leptin that measured with immuunoradiometric assay. No significant difference in the mean level of serum leptin was found between diabetic patients and control subjects. In patients with proliferative retinopathy, the mean level of serum leptin [18.27 +/- 0.88 ng/ml] was significantly higher than that in patients with nonproliferative retinopathy [11.96 +/- 1.08 ng/ml, P< 0.001] or patients without retinopathy [7.17 +/- 1.18 ng/ml, P< 0.001]. Also, patients with nonproliferative retinopathy had significantly higher leptin level than patients without retinopathy [P<0.001]. Serum leptin levels were strongly correlated with BMI in diabetic patients [r=0.77, P< 0.001]. The differences in leptin levels between the groups of diabetic patients were still significant after adjusting leptin level for BMI. The estimated threshold of serum leptin for diabetic retinopathy was 8.7 ng/ml. In conclusion, the more advanced the diabetic retinopathy, the higher the serum leptin levels, even after adjusting the levels for BMI. With recently observed role of leptin in promotion of angiogenesis, the possibility that leptin may play a role in diabetic retinopathy especially the proliferative form can not be excluded. Further studies are needed to confirm this possibility

Free radicals and hyaluronic acid relationship in rheumatoid arthritis and the effect of corticosteroid therapy

Oxygen-derived free radicals [ODFRs] are important inflammatory mediators. Evidence of ODFRs contribute to rheumatoid disease, include changes in the activities of antioxidant compounds. In the present study, acute phase proteins concentrations; C-reactive protein [CRP], haptoglobin alpha 1-antitrypsin and alpha 1-acid glycoprotein [AGP] were estimated as indicators for inflammation. Antioxidant activities, ferroxidase activity of caeruloplasmin and iron-binding of transferrin against organic oxygen radicals, iron-binding and iron-oxidizing proteins, chain-breaking substances and superoxide dismutase against inorganic oxygen radicals were measured as the protective response to tissue injury. Hyaluronic, uronic acids and mucin-clot test were also determined in the synovial fluid of rheumatoid arthritis [RA] and osteoarthritis [OA] patients. These parameters were measured in blood and synovial fluid of four groups: normal subjects, OA and RA patients treated with non-steroidal anti-inflammatory drugs [NSAIDs] or steroid drug in an attempt to explain the cause of inflammation which which might account for disease activity of RA. Serum increase of CRP, AGP and haptoglobin levels can serve as an indicator of increase RA disease activity. Corticosteroid treatment may suppress inflammation, where their effects include inhibition of lysosomal proteinase enzyme release, which indicated by lowering alpha1-antitrypsin level in the steroid treated RA patients than in NSAIDs treated ones. The serum antioxidant activity against organic oxygen radicals was significantly higher in the OA and RA patients than that in the normal subjects. This may be a part of the inflammatory response of the body and may also involve protection against lipid peroxidation. Red blood cells [RBCs] superoxide dismutase [SOD] activity was significantly lower in the RA patients than that in the normal subjects or OA patients. Therefore, it would seem that the red blood cells in patients with active RA were easily damaged by exposure to oxidative stress. The increase of iron-binding, iron-oxidizing proteins and chain-breaking substances as antioxidant activities against inorganic oxygen radicals in the RA synovial fluid than OA may be indicator of oxidative damage and reflect major differences in the synovial fluid of patients with RA and those with OA. However, it would appear, that these defense mechanisms are inadequate in fully protection of hyaluronic acid [HA] in the synovial fluid, which was manifested by HA in RA was fragmented and depolymerized than that in the OA synovial fluid. Absence of SOD activity in the synovial fluid RA and OA patients indicated that these patients have less protection against O[2]

Apo-lipoproteins A-I and B and lipoprotein [A] in recent myocardial infarction with and without diabetes

In this study, the plasma lipids [total cholesterol [TC], low density lipoprotein cholesterol [LDLc], high density lipoprotein cholesterol [HDLc] and triglycerides]], apo A-1, apo B, Lp[a], TC/HDLc, LDLc/HDLc and apo B/apo A-1 ratios were measured in 120 males, aged 25-65 years, 40 normal controls and 80 patients with recent MI [45% of them had non-insulin-dependent diabetes mellitus]. Each group was divided into four subgroups according to age: Group 1 [>25-35 years], group 2 [>35-45 years], group 3 [>45- 55 years] and group 4 [55-65 years]. From the results obtained, it was concluded that lipid abnormalities might be considered an independent risk factor for development of MI. Apo-B, Lp[a] and the ratio apo-B/apo-A may be better predictors to the risk of atherosclerosis than other lipid abnormalities, especially when total cholesterol level is within normal Lp[a]

comparative study of lipoproteins, apolipoprotein A-I and B and lipoprotein [A] between Egyptian males and females in different age groups

Eighty normolipidemic healthy normal persons aged 25-65 years were chosen and divided into two groups, a male group [n=40] and a female group [n=40]. Each group was subdivided according to age into four subgroups: Group 1 [>25-35 years], group 2 [>35-45 years], group 3 [>45-55 years] and group 4 [>55-65 years]. For all cases, total cholesterol [TC], low-density lipoprotein [LDLc], high-density lipoprotein [HDLc], triglycerides [TG], apolipoproteins A-1 and B [Apo-A-1 and Apo-B] and lipoprotein [a] [Lp[a]] were measured. It was concluded that age and sex dependent reference normal range is important when assessing atherosclerotic risk by lipoprotein assay and it must be followed, better for each community separately

Serum gastrin alteration in colorectal cancer patients before and after resection

Fasting and postpr and ial serum gastrin levels [SGL] were measured in 15 patients with resectable colorectal cancer [CRC] [group 1], in 10 patients with irresectable CRC [group 2], and in 10 otherwise healthy subjects, controls [group 3]. In group 1, postoperative SGL was measured 10 days after tumor resection. The highest SGL was recorded in group 2. The differences between measurements in groups 1, 2 and 3 were all statistically significant both in fasting and postpr and ial values. Moreover, postoperative SGL in group 1 showed a statistically significant reduction both in fasting and postpr and ial values. There was no correlation between clinical data and SGL except for tumor extensiveness [Duke's staging]. The fall in postoperative SGL may be at least hypothetically, taken as an indicator of gastrin tumor production. Serial postoperative SGL estimation may be used as a tumor marker should tumor recurrence is anticipated