Left cor triatriatum in an elderly patient: a brief review

We report a case of incidental asymptomatic cor triatriatum that was diagnosed in the 7[th] decade of life. The patient had progressive renal failure secondary to obstructed left kidney. He had hypertension. Routine transthoracic echocardiography revealed a septum in the left atrium. Transesophageal echocardiography confirmed the diagnosis of cor triatriatum. We present our case, along with a review of this rare congenital cardiac anomaly

Effect of green tea, curcumin and ginger extracts and its combination on liver and kidney functions in rats after carbon tetrachioride exposure

Oxidative stress is a major factor in the pathogenesis of diabetic complications. We studied the effects of green tea, curcumin and ginger extracts or its combinations on the kidney and liver function for rats exposure to CCL[4] injection. The results indicated that, all treated groups with low and high concentrations of ginger extract had uric acid and urea nitrogen lower than untreated group [control positive groups]. Moreover green tea had the most significant protection for kidney function against CCI[4]. In additional, there was a significant difference in serum glucose level between the low [10 gm] and high [20 gm] concentration of each individual herb or herbal combinations. The high concentration of the herb or its combinations resulted in a significantly lower serum AST and ALT levels than the low herbal concentration. But, all investigated herbs had significant protection for liver function against CCI[4]. It was concluded that, concurrent treatment of investigated herbs extract gave significant protection against CCI[4] though the values did not reach the normal levels

Effect of green tea, curcumin and ginger extracts on serum lipid profile in rats after carbon tetrachloride exposure

Oxidative stress is a major factor in the pathogenesis of diabetic complications. The current study aimed to investigate the effects of green tea, curcumin and ginger extracts or its combinations on the kidney and liver function for rats exposure to CCL4 injection. The results indicated that, green tea reduced food intake and body weight in rats. The food intake did not show any important variation between both dosage of tested herbs and aqueous extract of green tea, ginger and curcumin. Body weight gain percentage of the control positive group and other groups treated with herbs decreased significantly at [p< 0.05] as compared to the control negative group. The results observed that, rats suffering from CCL4 and treated with of green tea, curcumin and ginger or its combination were associated with decreased serum concentrations of total cholesterol and triglyceride, an increase in the proportion of high-density-lipoprotein cholesterol, and a decreased proportion of low and very-low-density-lipoprotein cholesterols, as compared to positive control group

Protective effect of thymoquinone against leiurus quinquestriatus scorpion envenomation - induced free radicals in mice

Oxidative stress has been implicated in several diseases, and extensive evidence indicates that antioxidants help to prevent organ functional damage. The present study was conducted to through light on the oxidative stress induced by Leiurus quinquestriatus [Lqq] scorpion venom and the ability of the thymoquinone [TQ], the main active constituent of the volatile oil of the black seed Nigella sativa, in ameliorating venom-induced biochemical alterations indicative of cellular injury. The present study was initiated by the determination of the LD50 of Leiurus quinquestriatus [Lqq] venom. It was found to be 34 micro g /100 g b. wt. 60 Swiss albino mice of both sexes were randomly divided into 5 groups [n = 12/group] as follows: Control group [I], Sublethal group [II] injected i.p with 25 micro g/100g.b.Wt [Lqq] venom, Lethal acute group [III] injected i.p. with 34 with micro g/100g.b.Wt of the venom, TQ pretreated sublethal group [IV] and TQ pretreated lethal acute group [V]. TQ was administrated orally by 100 micro g/kg.b.wt for one week before injection with the venom. The results showed that [Lqq] venom led to a significant increase in GSH, heart malondialdebyde [MDA] and Superoxide dismutase SOD in envenomed mice compared to the control group. On the other hand, the [Lqq] venom led to a significant decrease in glutathione peroxidase [Gpx], vitamin C and vitamin E [P value ranged between, < 0.05-0.001] in envenomed mice. The present work revealed that TQ is effective in ameliorating Leiurus quinquestriatus [Lqq] venom-evoked free radical generation and the involvement of oxidative stress in the Lqq envenomation

Investigation of the vasodilator effect of the new synthesized compound 2-alkylthio-4-ethyl-4-methyl-4,5dihydro-lh imidazolin-5-one oxime [Oxime] on the ischaemic rat hind limb by using laser doppler flowmetry technique

The potential vasodilator effect of the novel compound 2-alkylthio-4-ethyl-4-methyl-4,5 dihydro-lH-imidazolin-5-one oxime [oxime] was investigated in a model of hind limb ischaemia induced in rats by unilateral ligation of the right femoral artery using Laser Doppler Flowmetry. The effect of oxime was compared with that of isoprenaline or L-arginine. Test drugs and oxime were injected systemically into the femoral vein or applied locally on the planter surface of the rat hind paw. Serum level of nitrite [NO[2] and nitrate [NO[3] were measured by ELISA. Immediately after operative induction of right hind limb ischaemia, blood flow ratio [Right/Left limb ratio: BFR] decreased to 0.33-0.39 in different groups. The intravenous [i.v.] administration of oxime increased BFR in a dose-dependent manner. Compared with pre-drug BFR, oxime administered at doses of 0.064, 0.128 or 0.256 mg/kg increased BFR by 78.8, 228.9 and 605.9%, respectively. Meanwhile, L-arginine given i.v. at 100 mg/kg increased BFR by 460%. Isoprenaline given i.v. at 1 micro g/kg increased BFR by 174.3%, while isoprenaline combined with oxime [0.064 mg/kg] increased BFR by 302.7%. Similarly, after topical application of oxime, BFR increased by 13.5, 161.1 and 333.3%, respectively. L-arginine given at 1000 mg/kg increased BFR by 389.7%. Isoprenaline given at 10 micro g/kg increased BFR by 131.6%, while isoprenaline administered in combination with oxime [0.064 mg/kg] increased BFR by 208.3%. The concentration of NO in serum was significantly increased after systemic or topical administration of either 0.128 and 0.256 mg/kg oxime or 100 and 1000 mg/kg L-arginine, respectively. It is concluded that systemic or topical oxime results in marked enhancement of blood flow in the rat ischaemic hind limb. This effect of oxime is likely to be mediated through the release of NO

Effectiveness of indirect autofluorescent laryngoscopy in the diagnosis of cancerous and precancerous lesions of the larynx

Autofluorescent diagnostics are based on the ability of oxidized flavin mononucleotide [FMN] in normal cells to emit green fluorescence when exposed to blue light. Neoplastic cells have significantly lower concentrations of FMN and do not emit green fluorescence. Autofluorescent endoscopy is designed for early, accurate and minimally invasive diagnostics for laryngeal pathology. The aim of the present study was to evaluate the diagnostic potential and limitations of this imaging technique in comparison to laryngomicroscopy. In our investigation we used the System of Autofluorescent Endoscopy [SAFE 1000] designed by Pentax. We examined 32 patients using the SAFE 1000 system, and then all of the patients underwent indirect laryngomicroscopy [LMS]. In LMS, a biopsy was taken, and the diagnostic sensitivity of these two methods was compared according to the pathohistological diagnosis. For statistical evaluation we used Fisher's exact test. Comparable to indirect autofluorescence images, normal laryngeal mucosa showed a typical green fluorescence signal. Moderate and high epithelial dysplasia, carcinoma in situ and cancer displayed a diminished green fluorescence. False negative results were related to extreme hyperkeratosis. According to our results, the presented technique seems to be a promising diagnostic tool for the early detection of laryngeal cancer and its precursor lesions. It has the ability to give information about the nature of laryngeal lesions without devastation of the tissues. We believe that autofluorescent endoscopy in addition to laryngomicroscopy gives a more accurate diagnosis of laryngeal pathology than laryngomicroscopy alone

role of vascular endothelial growth factor [VEGF] in development of diabetic micro vascular complications

The aim of this study to determine serum level of VEGF in patients with Diabetic Micro vascular and macrovascular complication as Diabetic Nephropathy, retinopathy and cardiovascular insufficiency mainly acute myocardial infarction. Fifty individuals were investigated. 10 apparently healthy persons [4 females and 6 males] as control group, 20 maturity onsets diabetic patients [non-insulin dependent] with diabetic nephropathy [8 females and 12 males], 10 maturity onset diabetic patients [non-insulin dependant] with diabetic retinopathy [4 female and 6 males] and 10 maturity onset diabetic patients [non-insulin dependant] with acute myocardial infarction [4 female and 6 male]. Serum level of VEGF was measured in those patients and correlated with different clinical and laboratory investigations. Serum level of VEGF was significantly high in diabetic patient with micro-vascular complication "629.75 +/- 317.07' compared with healthy control 139.75 +/- 12.97". Serum level of VEGF was significantly high in patients with Diabetic riephropathy "553 +/- 232.03", compared with healthy control "139.4 +/- 12.97". Serum level of VEGF was significantly high in patients with diabetic retinopathy "507 +/- 327" compared with healthy control "139.4 +/- 12.97". Serum level of VEGF was significantly high in diabetic patients with acute myocardial infaction "807 +/- 316.01" compared with healthy control "139.4 +/- 12.97". There was significant positive correlation between serum VEGF, serum creatinine and microablumjnuria. These Data suggest that VEGF plays control role in mediating micro vascular pathology in Diabetes. VEGF may be one of the markers and risk factors for micro-albuminuria and incipient diabetic Nephropathy. There was significant correlation between VEGF level and recent acute myocardial infarction, which may postulate that VEGF serve a salutary role in hypoxic myocardial tissue of coronary artery disease by promoting development of collateral circulation

Antimicrobial activity of bifidobacteria isolated from baby faeces

Bifidobacteria strains, isolated from baby faeces, were examined for their antibacterial activity by deferred agar spot [DAS] test. A number of thirteen isolates were investigated using test strains from two different genera [Salmonella typhimurium and Escherichia coli]. The isolates were morphologically characterized and molecularly identified via polymerase chain reaction [PCR]. The different random amplified polymorphic DNA [RAPD] patterns were able to identify three groups of Bifidobacteria. All isolates showed an inhibition zone diameter with a mean of 10 mm against S. typhimurium and 6 mm against E. coli

Low avidety IgG antibodies in diagnosis of recent human Schistosomasis

One hundred and thirty schoolchildren from a schistosomiasis endemic area in Sharqia Governorate were selected on parasitological findings. Seventy persons were negative on the first screen and turned positive after three months of the screening [recently infected]. Stool examination, ELISA [IgG and IgM], low avid IgG and circulating antigens were performed for all patients and controls. ELISA detected IgM in all cases. IgG and circulating antigens were in 90% of schistosomiasis patients. Low avidity IgG detected in 85.71% of recent cases. The specificity of ELISA appeared to be >99%. The IgM/IgG ratio was >1 in patients with recent infection. The percentage of fall of OD readings of IgG after addition of six molar urea was high among cases with recent infection. Low avid IgG appears to be good and valuable in diagnosis of recent schistosomiasis in man

Spectrophotometric determination of phenylephrine using P-aminophenol and potassium periodate

A fast and sensitive method has been developed for the determination of Phenylephrine hydrochloride [PE] in pharmaceutical preparations. The method is based on the reaction between PE and p-aminophenol [PAP] in presence of KIO[4] at pH 10. The absorbance of solution is measured at [lambda [max]] 640 nm. Beer's law is obeyed over the concentration range from 15 to 100 micro g ml[-1], and the extinction coefficient was calculated to be 1.01 x 10[3] 1 mol[-1] cm[-1]. The different analytical parameters have been investigated. The method has been successfully applied to determine PE in some pharmaceutical preparations

Incidence of cardiac ischemia during weaning from mechanical ventilation and its impact on weaning outcome

This study was carried out to find out the frequency of cardiac ischemia during weaning from mechanical ventilation [MV] and to predict the possible relation between it and weaning outcome. It included 61 patients who required MV. 33 patients of them had history of coronary artery disease [CAD]. Continuous ST segment analysis of lead I, lead II and V2 was done, arterial blood pressure, heart rate, pulse oximetry O[2] saturation, respiratory rate and minute volume were also measured at initiation and after 30 minutes of weaning. The respiratory rate to tidal volume ratio [RVR] and heart rate-systolic blood pressure product [RPP] were computed at each interval. 5 patients only [8.2%] showed cardiac ischemia during weaning, all of them had CAD. 4 of them [80%] failed initial weaning and successfully weaned after proper management of ischemia. 20 patients of those had CAD [32.8%] were weaned successfully and 15 patients without CAD [24.5%] were weaned successfully. RPP was significantly increased during weaning [P<0.001] and O[2] saturation was significantly reduced [P<0.00l] but RVR showed no significant change [P>0.05]. Risk ratio and 95% CI showed significant increased in the risk of weaning failure in patients with cardiac ischemia [RR= 1.19 and 95% Cl = 1.2 - 5.11] and in patients with O[2] desaturation [RR= 3.07 and 95% Cl = 1.85 - 5.06] but there was no significant increased risk of weaning failure with CAD, RPP or RVR. Also there was no significant increased risk of ischemia and the presence of CAD, RPP, O2 saturation or RVR. This study concluded that cardiac ischemia was relatively unfrequent [8.2%] in medical patients who needed weaning from MV but was more frequent [15.45%] among patients who had CAD. The incidence was greatest among those who had CAD and failed to wean, so continous ST segment monitoring may be useful in detecting cardiac ischemia that may be a cause of weaning failure as proper management of ischemia leads to successful weaning

Susceptibility of enterococcal isolates from Riyadh city hospitals to some antimicrobial agents

A total of 138 clinical enterococcal isolates were collected from three major hospitals in Riyadh city, namely King Khalid University Hospitals [KKUH, 59]. King Faisal Specialist Hospital and Research Center [KFSH and RC, 25] and King Fahad National Guard Hospital [KFNGH, 54]. The identity of the genus was checked and the isolates were identified to the species level to E. faecalis [108], E. faecium [26] and other Enterococcus species [4]. Using agar disk diffusion method, the isolates demonstrated high susceptibility to ampicillin [99.3%], sulfamethoxa.zole-trimethoprim [95%], vancomycin [89.1%], chloramphenicol [86.2%], and penicillin G [85.5%]. Moderate susceptibility was shown to rifampin [58.7%]. Low susceptibility was expressed to ciprofloxacin [37.7%] and tetracycline [30.4%], whereas very low susceptibility was shown to erythromycin [7.2%]. Except for rifampin which showed higher efficacy against E. faecium, the latter had relatively lower susceptibility to antimicrobials compared with E. faecalis isolates Minimum inhibitory concentration [MIC] data showed that 4 E. faecalis [3.7%] and 12 E. faecium [46.15%] isolates had MIC > 16 micro g/ml for penicillin. Among these, only one E. faecalis isolate and two E. faecium isolates had MICs of 16 micro g/ml for ampicillin. None of the 16 penicillin resistant isolates could be identified as beta-lactamase positive. Three [2.8%] of E. faecalis isolates and 10 [38.5%] of E. faecium isolates with an overall percentage of 9.4% had MICs of vancomycin greater than the breakpoint of resistance [32 micro g/ml]. All these 13 isolates were also resistant to teicoplanin, expressing Van A phenotype. MICs data revealed no susceptible isolates to ciprofloxacin and erythromycin and resistance the rates were 28.2% and 44%, respectively. For these two antimicrobial agents, discrepancy between the results of the two methods with respect to the susceptibility and resistance was evident. The MIC results, confirm the very high susceptibility of the isolates to sulfamethoxazole-trimethoprim combination. The results were discussed in the light of the available literatures and demonstrate the usefulness of ampicillin as a drug of choice and the alarming situation for vancomycin that needs attention

Response of high level gentamicin resistant enterococci to penicillin and gentamicin combination

In the present study the incidence of high level resistance [HLR] to gentamicin [MIC >/= 500 micro g/ml] was determined for 138 clinical enterococcal isolates, representing 108 E. faecalis, 26 E. faecium and 4 other Enterococcus spp. A 28.3% of the isolates, comprising 42.3% of E. faecium and 25.9% of E. faecalis isolates were found to be HLR to gentamicin. A 5% of the isolates were resistant to 2000 micro g/ml of gentamicin, representing one [0.9%] of E.faecalis isolates and 7[23%] of E. faecium isolates. Eight selected isolates were used to evaluate the bactericidal activity of penicillin-gentamicin combination by the time-kill curve method. Bactericidal synergy for the combination was obtained for two E. faecium isolates [No. 16 and 32] whereas a synergistic bacteriostatic activity was observed for a third E. faecium isolate [No.35], despite their resistance to penicillin alone. No synergy was obtained for the other two E.faecalis isolates [No.19 and 32]. No synergy was obtained for the other non-E. faecium isolates. Although penicillin alone was bactericidal, the two E. faecalis isolates [No.2 and 137] did not show synergistic bactericidal activity for the combination, irrespective of the level of resistance to gentamicin [No. 2 is not HLR but 137 is]. For the other Enterococcus raffinosus [isolate], although it was not HLR to gentamicin and being susceptible to penicillin neither bactericidal effect for penicillin nor for the combination was observed

Endothelial dysfunction in IDDM; Relation to plasma homocystein levels

This work has been designed to evaluate the relationship of plasma homocystein [HCY] levels to the presence and development of diabetic microvascular complications in IDDM. Plasma levels of homocystein and thrombomodulin [TM] markers of endothelial cell damage, were measured before and 3h after oral methionine loading in 45 IDDM patients and 25 healthy control subjects matched for sex and age. IDDM patients had higher pre-and postload plasma levels of homocystein than did healthy control subjects [15 vs 6.8 umol/l and 28 vs 13 umol/I, p<0.001]. Of 45 IDDM patients, 17 had plasma homocystein levels above the normal range [means +/- 2 S.D. of values obtained of the normal control group]. These IDDM patients with hyper homocysteinemia had higher plasm TM levels [66 vs 36.5 ng/ml p<0.001], higher albumin excretion rates [390 mg vs 110 mg/dl p<0.001], and a higher prevalence of late diabetic complications [nephropathy, 65 vs 30% Neuropathy 53 vs 39%, retinopathy, 70 vs 43% and macroangiopathy, 59 vs 30%] compared with IDDM patients with normal homocystein, hyperhomocysteinemia is common in nephropathic diabetic patients and may contribute to enhanced morbidity and mortality from cardiovascular diseases characteristically observed in IDDM patients with diabetic nephropathy

Effects of chronic nicotine administration on male fertility in albino rats [an experimental study]

This work was designed to investigate the effects of intraperitoneal administration of nicotine in different doses over a period of 60 days on the fertility of adult male albino rats. Ninety-four adult male albino rats were used in this study and divided into four groups: A control group of ten rats received saline only and three test groups each containing 28 rats. Each of the test groups received a different dose of nicotine [0.5, 0.75 and 1.0 mg/kg b. w., respectively, every other day for 60 days]. Each group was further subdivided into three subgroups; the first [14 rats] was sacrificed immediately after 60 days, while the second and third subgroups [seven rats each] were sacrificed one and two weeks after stopping nicotine therapy. By the end of the experiment, blood samples were obtained from sacrificed rats and used for hormonal assay [testosterone and leutinizing hormone levels]. Then, the rats were subjected to epididymal spermatozoal examination and histopathological study of their testes. The results were presented and discussed

Breast conservation therapy in treatment of cancer breast

Breast conservation therapy [B.C.T.] comprises local excision, axillary dissection and post operative radiotherapy. Numerous studies have now shown that although local recurrence may be slightly more common after breast conservation than mastectomy, disease-free survival and overall survival are the same. The primary goals of breast conservation therapy are tumour control and acceptable appearance of the breast. Twenty female patients were included in this study. All patients were suitable for B.C.T. Their ages ranged from 25 to 60 years [mean age 41.3 +/- 8.8 years]. All patients were subjected to mammography, fine needle aspiration cytology [FNAC] and metastatic work up [chest x -ray, abdominal ultra sonography and bone scans].The study included 4 patients [20%] in stage I, 14 patients [70%] in stage II and 2 patients [10%] in stage III One patient showed positive safety margin of the lumpectomy specimen and for whom mastectomy was done. The remaining 19 cases were followed up for two years. The study showed an excellent cosmetic appearance however, local recurrence occurred in 3 cases [15.78%]. The higher incidence of total recurrence in the present study may be related to the histopathological nature of the tumour, the biological behavior of breast cancer in Egypt or even the sample is so small in number

Effect of anti-schistosomal treatment on schistosomal hepatic pathology: an experimental study in Syrian golden hamsters

30 Syrian Golden hamsters were infected with Schistosoma mansoni and 10 were used as negative controls. Hamsters were infected by 100 cercariae, 15 were treated by praziquantel in doses of 100 mg/kg at 12, 13, 14 and 15 weeks post-infection, and 15 hamsters were left as positive controls. 5 from each subgroup were sacrificed at 24, 28 and 32 weeks after infection. Animals were subjected to weekly analysis for total plasma protein, serum albumin and urinary total protein excretion. At the end point, animals were sacrificed and the mesenteric venous plexus was explored for adult worms. Liver and splenic specimens were examined by light microscopy and immunofluorescence microscopy. Complete parasite eradication was achieved in the treated animals. Although, there were significantly higher plasma total protein and albumin in the treated group, there was no significant differences in proteinuria. Histopathological examination of liver specimens showed highly significant reduction of granulomas, CAA and CCA; while amyloid deposition showed minimal reduction in the treated animals

Schistosoma mansoni hepatic fibrosis in Syrian golden hamsters: effect of dose and duration of infection as shown by Immunohistopathological studies

In this work, 180 Syrian golden hamsters were infected with Schistosoma mansoni and 30 cross matched for age and sex served as control. Infected hamsters were divided into 6 main groups according to the number of infected cercariae [20, 50, 100, 150, 200 and 250 cercariae]. Each group was subdivided into 5 subgroups, according to the duration of infection after which animals were sacrificed [4, 6, 8, 12 and 24 weeks]. Control and infected hamsters were subjected to laboratory evaluation of serum albumin, S. globulin and A/G ratio and histopathological examination of the liver and splenic tissues. Histopathologic evaluation showed appearance of the circulating schistosome antigens, circulating anodic antigen [CAA], and circulating cathodic antigen [CCA] deposits in the liver by the 14th week after infection; liver granuloma, amyloid deposits, fibrosis, Schistosoma pigments as well as inflammatory infiltration was observed at 8 - 12th week and amyloid deposits, CAA and CCA in the spleen was observed nearly at the same time. There was a significant correlation between the pathological changes and the duration of infection and the number of recovered adult worms from the mesenteric circulation

Patterns of cardiac disease among pregnant women in Bahrain during the period 1986-1993

This is a retrospective study of all cardiac pregnant women who delivered from 1st January 1986 to 31st December 1993 in Government Maternity Hospitals and Units in Bahrain. The prevalence of heart disease in this series is 0.69% with a trend towards increase in the incidence. The cardiac related maternal mortality was one per 80988 deliveries and perinatal mortality was less than the national average 18/1000 for this period. The leading cause of heart diseases in pregnancy is rheumatic heart disease 51.07% followed by congenital heart 20.35% arrhythmias 6.2%, and mitral valve prolapse 9.46% and ischaemic heart disease 4.6%. Other causes such an inflammatory, hypertensive, thyroid and auto-immune factors are only occasionally diagnosed in 5.1% of cardiac women

Computerized surveillance of schistosomiasis, El-Minya governorate model

The objective of this study was to develop a comprehensive medical information network. This objective can be achieved through developing a national questionnaire, using the international classification of diseases by WHO, ICD-9, maintaining high validity of data internally and externally: Immediate access time, higher accuracy, and minimum error. In developing the new system, the investigators are guided by a relevant automated system for diseases surveillance by CDC in U.S.A. The results indicated that the prevalence of Schistosomiasis hematobium was different among different health districts, as well as among different school grades. The lowest rate was recorded among first grade [6.8%] and the highest was among fifth grade [10.2%] in both sexes. Also, the figures showed a matching pattern between the availability of schools, health units, and prevalence of disease. It was concluded that this preliminary report showed the potential of the new Schistosomiasis electronic surveillance system model in El-Menia Governorate. Also, it showed its limitations as regarding lack of information of Schistosomiasis mansoni because either the information is not available or not reliable. However, the new experience acquired from the El- Menia model can be used to exp and the system to other governorates