Role of ginkgo biloba extract on jejunal mucosal changes induced by laparotomy in adult albino rat: histological, immunohistochemical and scanning electron microscopic study

The intestine is extremely sensitive to surgical stress. Surgical manipulation of the intestine generates oxygen free radicals resulting in mucosal damage. To evaluate the role of Ginkgo biloba in protection and restitution of mucosal damage of jejunum after laparotomy. Twenty four adult albino rats were divided into three groups. Group I as a control, group II subjected to laparotomy with mild intestinal handling and group III was injected I/P with as a single dose of 50 mg/kg of Ginkgo biloba solution 1 hour before laparotomy. All animals were sacrificed after 48 hs and jejunum specimens were extracted and processed for light and scanning electron microscopic study. Revealed that laparotomy induced shortening of the villi with mucosal damage and ballooning of Paneth cells. Some epithelial cells with atypical appearance were seen aggregated towards the luminal surface. Strong P53 reaction was observed in enterocytes. SEM revealed eroded luminal surface with wide gaps of epithelial loss. On the other hand, Ginkgo biloba showed a favorable protective effect with rapid healing of the damaged jejunal mucosa. Laparotomy induced jejunal mucosal damage, which was not repaired after 48 hs. Ginkgo biloba could be used as a protective agent against intestinal mucosal damage with a rapid recovery after surgical operation

Study of the effects of the DI-N-butyl phthalate on the adult albino rat epididymis

Phthalate esters are a large group of chemical agents used predominantly as plasticizers and solvents. Di-N-butyl phthalate [DBP,] ester is a commercially important plasticizer and ubiquitou5 environmental contaminant. These compounds are widely used in the daily life as in the production of food containers, packaging, toys, films, hand-bags, bottles printing inks and clothes. Many experimental studies were employed to clarify tile hazardous effects of tile DBP on the male genital tract. These studies were concerned in the effects of prenatal exposure to .DBP as well as during lactation, postnatal and adult life. A total number of 15 adult male albino rats, two months age were used in this work. These animals' were classified into three groups, control that received only olive oil and two experimental groups, first and second, which received 500 and 1000 mg/kg/day respectively of di-n-butyl phthalate dissolved in olive oil for successive 15 days. The specimens were collected, washed fixed in 2.5%cacodylate buffered glutraldihyde solution for one day and prepared for both semithin and ultrathin sectioning techniques. The results of the present work revealed obvious toxic effects of DBP on the duct us epididymis both on the level of light and electron microscopy. The first group showed severe fibrosis of the interductal connective tissue and the surrounding fibrous coat and mild to moderate degenerative changes of the epithelial wail. [The second group revealed severe destructive changes of the component cells of the duct wall in the form of multiple cytoplasmic vaculation, nuclear pykuosis and degenerated cytoplasmic organdies. These results approved a dose-dependent relation-ship of DBP toxicity on the adult rat epididymis and form a warning for humans about the potential hazardous toxic effects of it on their male reproductive tract

Endothelial dysfunction assessmentas a predictor of coronary arterydisease in egyptian patients

Background : Endothelial dysfunction appears to be a generalizedprocess that is not necessarily confined to vessels with overt atheroscle-rotic alterations. This assumption is strengthened by the finding of a cor-relation between coronary and peripheral endothelial dysfunction

Objective:To assess if flow-mediated vasodilation [FMD%] of the bra-chial artery, could be used as a diagnostic screening test in patients withcoronary artery disease.Patients: Three groups of patients will be included in the study:Group A:Twenty patients had no chest pain, normal ECG and neg-ative stress ECG.Group B: Twenty patients had chest pain, normal ECG, negativestress ECG and normal coronary angiogram.Group C:Twenty patients had documented coronary artery dis-ease [CAD] by coronary angiogram

Methods:Complete history taking and through clinical examination,laboratory investigation, ECG, stress ECG, coronary angiogram and B-mode ultrasound images of the brachial artery

Results:There was no statistically significant difference between thethree groups regarding age, sex, hypertension, hypercholesterolemia,presence of diabetes mellitus smoking and family history of CAD[P>0.05]. In comparing group A with group B, there was no statisticallysignificant difference between the two groups regarding flow mediateddilatation [FMD%, NTG mediated dilatation % and ratio of FMD to NTGmediated dilatation [P>0.05], but there was a highly statistically significant difference between group A and group C regarding FMD% and FMD:NTG ratio [P<0.01] and statistically significant difference between thetwo-groups regarding NTG% [P<0.05]. In comparing group B and C, therewas statistically significant difference between the two groups regardingFMD%, NTG% and FMD to NTG% ratio [P<0.05]. The sensitivity, specificityand positive predictive value of FMD% <4.5% in relation to coronary angiogram for detection of CAD was [75%, 80% and 88%] respectively. Re-garding the effect of risk factors on FMD%, FMD% was significantly de-creased in smokers, diabetic and hypertensive [P<0.05]. Also it wasdecreased in hypercholesterolemic [P<0.01]. However it was decreased inobese and those with positive family history but the difference was notstatistically significant [P>0.05]

Conclusion: The determination of endothelial dysfunction expressedby FMD% was found to be a sensitive and specific screening test to pre-dict the presence of CAD. Because this is non invasive, non-radioactiveand cost-effective approach, it warrant further evaluation to determine itis value in daily clinical practice as an additional screening test in diag-nosis of CAD

Prevalence of carotid atherosclerosis in patients with coronary artery disease

Many studies have identified the relationship between carotid atherosclerosis and coronary artery diseases. The rationale for testing carotid artery stenosis in patients with coronary artery disease, have several benefits for early detection of asymtomatic carotid stenosis. The aim of this study is to evaluate the prevalence of carotid artery patients with coronary artery disease. The study included 102 patients proved to be ischemic heart disease angiography, underwent carotid duplex. These patients classified into two groups according to carotid duplex result, group A [negative duplex] and group B [positive carotid duplex]. All patients were subjected to the following:-Full history taking, thorough clinical examination, laboratory investi-gation, 12 leads surface ECG, echocardiography, coronary angiography and carotid duplex. Age was significantly higher in group B than in group A. No statistically significant difference between both groups as regard EF% and history of myocardial infarction. There was close association between carotid atherosclerosis and multivessel coronary artery disease. Carotid atherosclerosis and degree of stenosis in. left carotid artery was significantly higher than in right one. From this study we concluded that there was a close relationship between coronary and carotid atherosclerosis both sharing more or Less, the same risk factors [smoking, diabetes mellitus, hypertension, hyperlipidemia and left ventricular hypertrophy], the degree of carotid atherosclerosis can be used as non invasive procedure for assessment of patients prepared for coronary angiogram

Left ventricular mass and systolic function in normotensive obese children

Background: obesity have been associated with a higher prevalence of cardiovascular diseases [CVD] risk factors and a higher CVD morbidity and mortality which manifested already in childhood and adolescence

Objectives: evaluating the effect of obesity on cardiac structure and function in normotensive obese children

Subjects: this cross-sectional case control study included 50 obese children divided according to age into 3 groups: Group A included 18 obese children [9 females - 9 males] their ages ranged from 3 to 6 years, their mean weight was 34.2 +/- 6.97 kg and their mean height was 114.6 +/- 9.12 cm. Group B included 10 obese children [4 females - 6 males] their ages ranged from 7 to 9 years, their mean weight was 44.6 +/- 9.45 kg and their mean height was 129.16 +/- 7.82 cm]. Group C included 22 obese children, [6 females - 16 males] their ages ranged from 10 to 15 years: their mean weight was 74.6 +/- 6.45 kg and their mean height was 149.16 +/- 13.12 cm. Blood pressure of the 3 groups. normal range for their ages

Methods: all cases were subjected to clinical examination, body weight, height, triceps skin folds [TSF] and sub scapular skin folds [SSF] assessments blood pressure measurement, 1aborutory investigations [serum cortisol cholesterol, triglycerides, low density lipoproteins and high density lipoproteins], X-ray head and wrist, and echocardiographic assessment

Results: the results of this study showed that obese children weight was ranged from 27 to 123 kg, height was ranged from 95 to 172 cm, body mass index [BMI] was ranged from 23.9 to 42.6, obesity index [O.I.] was ranged from 1.44 to 3.07, TSF was ranged from l6.8 to 66.1 and SSF was ranged from 14.3 to 29.9 cm .Left ventricular mass [LVM] was found to be significantly higher in obese children than in controls in group A and C [P <0.01 and P <0.05 respectively]. A significant positive correlation was observed between LVM and both O.I. and BMI, also a significant positive correlation was found between LVM and both SSF and TSF. LVM were higher in males than females, while B.M.I., O.I., TSS and SSF were higher in females than males

Conclusion: obesity in normotensive obese children is significantly correlated with an increase in LVM and impaired left ventricular systolic function even after controlling for age and blood pressure. Obesity affects LVM and geometry in children as young as 3 years. Further studies are recommended in order to detect the effect of weight reduction on these echocardiographic findings and the relation of these changes with the development of cardiac complications

Diagnostic, prognostic and predictive value of posterior chest leads in acute inferior myocardial infarction

The aim of this work was to study the diagnostic, prognostic and predictive value of posterior chest leads [PCL] V7- V9 in patients with acute inferior myocardial infarction [AIMI] and its correlation coronary angiography. 30 patients with AIMI were included in this study they were into 2 groups: group A, 11 patients with AIMI and ST-segment elevation [STE] in PCL group B, 19 patients with AIMI without STE in PCL. Routine laboratory investigation, creatine phosphokinse [CPK], 15 leads ECG, echocardiographic examination and coronary angiongraphy. The prevalence of STE in PCL in-patients with AIMI was 36.7% [group A], were older, more hyperlipidemic, had higher incidence of R/S>1 in V1-V2, more STD in V1-V3, taller upright T wave, higher CPK level, lower EF, higher incidence of MR and more complication [heart failure, MR, arrhythmia and postinfarction angina] than group B [P <0.05] they had more wall motion abnormalities [WMA] mainly posterolateral and inferolateral [P<0.01]. Left circumflex coronary artery was the infarct related artery in virtually all patients in group A while right coronary artery was in 89.5% of patients in group B there was a higher incidence of multivessel disease proximal and diffuse lesions in group A the sensitivity and specificity of STE in PCL, R/S >1 in V1-V2 and STD in V1-V3 in relation to PWMA in diagnosis of posterior myocardial infarction was 100%, 82.6%, 71.4%, 100%. 100% and 78.3% respectively. We recommend routine recording of leads V7 to V9 in all patients with an AIMI and suggest that STE identifies a group of big infarction who at higher risk

Intestinal ischemia - reperfusion injury: Could it affect intestinal anastamosis?

Revascularization of ischemic bowel may induce further local tissue damage due to reperfusion injury. Therefore, we aimed to investigate the effect of ischemia reperfusion injury on the healing of intestinal anastomosis in experimental models. Thirty rabbits were divided equally into three groups: a control group [Group 1]; an ischemia group [Group II], in which only the superior mesenteric artery [SMA] was occluded for 30 minutes and a profound ischemia group [Group III] in which SMA was occluded as well as collateral vessels for 30 minutes. The pulsations were seen to return to marginal vessels and the bowels began to appear pinker and healthier in all groups following the restoration of arterial flow. Then all animals underwent a 3-cm ileal resection and primary anastomosis, 10 cm proximal to the ileocecal valve. Within each group, animals were anesthetized on the fifth postoperative day. Abdominal wound healing, intra-abdominal anastomotic complications, anastomotic bursting pressure measurements and hydroxyproline content were recorded. Anastomotic dehiscence was found in 1 in group II and in 5 in group III. The mean bursting pressures of the anastomosis was 158 mmHg in group I [control group], 150 mmHg in group II and 106 mmHg in group III while the mean hydroxyproline value content was 3.09 micro-mole/g tissue in group I, 2.91 micro-mole/g tissue in group II and 1.51 micro-mole/g tissue in group III, so there was no significant difference between group I and II while there was significant difference between group I, II and group III. We conclude that, even when the intestines are well perfused and viable after revascularization, one must bear in mind that intestinal reperfusion injury may compromise anastomotic healing