The Role of Oxidative Stress and Inflammation in Prediabetes: A Review

@#Prediabetes is a condition in which blood glucose level is above the normal but below the diagnostic value of diabetes mellitus. Hyperglycaemia can upregulate markers of chronic inflammation and contribute to the overproduction of reactive oxygen species (ROS), which ultimately causes increased oxidative stress. This leads to beta-cell dysfunction and insulin resistance, which are involved in the pathogenesis of prediabetes status. Proper treatment of hyperglycaemia, inhibition of ROS overproduction, and suppression of inflammation are crucial for delaying the onset of diabetes. Therefore, it is essential to determine and understand the mechanisms involved in prediabetes. This review discusses the relationship between oxidative stress and prediabetes, along with the inflammation’s role in prediabetes. Additionally, the effects of some biomarkers of oxidative stress in prediabetes, inflammatory markers, and their influence on chronic inflammation are also briefly reviewed. Finally, the role of antioxidant and anti-inflammatory markers are discussed.

Análisis de las interconsultas con dermatología pediátrica de pacientes hospitalizados en un hospital pediátrico universitario / Analysis of pediatric dermatology inpatient consultations in a pediatric teaching hospital

Introducción. Las dermatosis son frecuentes en niños. Nuestro objetivo fue describir las interconsultas con dermatología de niños hospitalizados. Población y métodos. Se analizaron las solicitudes de interconsultas con dermatología pediátrica de 539 pacientes consecutivos (de 0 a 18 años de edad) entre enero de 2004 y abril de 2010; para determinar en la interconsulta, el grupo de dermopatías, diagnóstico principal, departamento solicitante, patrón diagnóstico, modalidad de tratamiento y derivación a otro departamento. Resultados. De 539 niños hospitalizados, 310 (57, 51%) eran varones y 229 (42, 49%), mujeres. El departamento de pediatría general (37, 5%), fue el que consultó más frecuentemente, seguido por oncología (15, 6%) y cirugía pediátrica (11%). La mayoría (32%) habían sido hospitalizados por una dermopatía o enfermedad relacionada. Las alergias cutáneas (47%) fueron las principales dermatosis consultadas, seguidas por enfermedades infecciosas (14, 7%) y trastornos sistémicos con manifestaciones cutáneas (10, 2%). La dermatitis atópica (7, 4%) y el eccema sin clasificar (7, 4%) fueron las dermatosis más frecuentes, seguidos de la urticaria papulosa (5, 4%). En el 80% de los pacientes, el diagnóstico fue clínico; requirieron biopsia cutánea el 15, 9% y análisis de laboratorio el 4%. El 51% de los pacientes requirió tratamiento local, el 6%, tratamiento sistémico, el 31%, sistémico combinado y ningún tratamiento en el 11, 1%. Se derivó a otro departamento al 2% de los pacientes. Conclusiones.Este estudio obtuvo datos importantes sobre los trastornos de piel y su tratamiento en niños hospitalizados desde la perspectiva de la interconsulta.

Introduction. Although skin diseases are associated with low rate of hospitalization, dermatological manifestations are frequent in hospitalized patients. The aim of the study was to describe the inpatient dermatological consultations in a pediatric teaching hospital. Population and Methods. Recorded data from inpatient pediatric dermatology consultation requests on a total of 539 consecutive inpatients (aged 0-18 years) from January 2004 to April 2010 were analyzed for consult diagnosis, dermatological disease group, primary diagnosis, requesting department, diagnostic pattern, treatment modality and referral to another department. Results. Of the 539 inpatients, 310 (57.51%) were males and 229 (42.49%) were females. The most frequent requesting department was general pediatrics (37.5%) followed by oncology (15.6%) and pediatric surgery (11.1%). Most of the patients (32.1%) had been hospitalized for dermatological or related disease followed by acute lymphoblastic leukemia (4.1%), chronic renal failure (2.6%), bronchopneumonia (2.6%) and epilepsy (2.4%). Allergic skin diseases (47.1%) were the leading group of dermatoses, which were followed by infectious diseases (14.7%), and systemic diseases with cutaneous manifestations (10.2%). Atopic dermatitis (7.4%) and unclassified eczema (7.4%) were the most frequent dermatoses followed by papular urticaria (5.4%). Most of the patients (80.0%) had diagnosis on clinical basis, whereas skin biopsy was performed in 15.9% and laboratory investigation in 4.1% of the patients. Local treatment was applied to 50.8% of the patients, systemic treatment to 5.8%, local and systemic treatment together to 31.0% while no treatment was given to 11.1%. Only 1.9% of the patients were referred to another department. Conclusions. This study provided important data on the spectrum of skin disorders and their management in pediatric inpatients from the consultation perspective in a pediatric teaching hospital with multispecialty clinics.

Dermatopatología pediátrica: resena / Pediatric dermatopathology: an overview

La dermatopatología es una subespecialidad de la patología y la dermatología que implica la correlación de los datos clínicos y las observaciones microscópicas de las biopsias cutáneas para obtener información diagnóstica. La dermatología pediátrica es una subespecialidad de la dermatología para la cual es necesario conocer puntos específicos para la evaluación y el tratamiento de los trastornos cutáneos de los niños. Aquí revisamos el enfoque histopatológico y otros factores importantes para los diagnósticos definitivos en dermatopatología pediátrica. Las dermopatías en los niños no constituyen necesariamente versiones más pequenas de las que se presentan en los adultos; incluso algunas podrían estar limitadas el grupo etario pediátrico. Un equipo con experiencia en dermatología y patología incrementa el éxito de las biopsias cutáneas en dermatología pediátrica, además de contar con habilidades técnicas excelentes. Los hallazgos histopatológicos de lesiones cutáneas en niños deben ser evaluados por patólogos pediátricos, quienes tienen un interés específico en la dermatopatología pediátrica, en estrecha colaboración con dermatólogos pediátricos.

Dermatopathology is a subspecialty of pathology and dermatology involving correlation of clinical information with microscopic observations of skin biopsies to provide diagnostic information. Pediatric dermatology is a subspecialty of dermatology for which specific points need to be known for evaluating and managing skin disorders in children. The histopathological approach and other important factors for definitive diagnoses in pediatric dermatopathology are reviewed. Skin diseases in children are not necessarily smaller versions of those that develop in adults and some diaseases may be confined to pediatric age group. An experienced team of dermatology and pathology increases the success of skin biopsies in pediatric dermatology besides the excellent technical skills. The histopathologic findings of skin lesions in children should be evaluated by pediatric pathologists, who have a specific interest for pediatric dermatopathology, in close collaboration with pediatric dermatologists.

Chromogranin A as a biochemical marker for neuroendocrine tumors: a single center experience at Royal hospital, Oman

Objectives: To evaluate the significance of serum chromogranin A [CgA] status in patients with and without different neuroendocrine tumors [NETs] by conducting a retrospective assessment of the diagnostic utility and limitations of CgA as a biomarker for NETs in a tertiary care hospital in Oman

Methods: We conducted a retrospective analysis of CgA requests referred to the Clinical Biochemistry Laboratory, Royal Hospital, Oman over a 24-month period [April 2012 to March 2014]. During this time, 302 CgA tests for 270 patients [119 males and 151 females; age range 11-86 years and mean+/-standard deviation [SD] 44.0+/-18.0 years], were requested. Of these CgA tests, 245 tests were performed for 245 patients investigated for the diagnosis of NETs, and 57 CgA tests were performed for 25 patients with diagnosed NETs who were undergoing follow-up. Serum CgA levels were analyzed using the enzyme-linked immunosorbent assay based on a cut-off value of 22 IU/L

Results: Of the 302 CgA tests reviewed, 197 [65.2%] were within the quoted normal range; however, 105 [34.8%] had CgA > 22 IU/L. Of the 245 patients with first-line CgA, 38 patients [15.5%] had NET that included carcinoid, pheochromocytoma, pancreatic NET, adrenal adenoma, prostatic adenocarcinoma, gastrointestinal NET, medullary thyroid carcinoma, Schwannoma, lung small cell carcinoma, parathyroid adenoma, and pituitary macroadenoma. The mean+/-SD of CgA in these patients with NETs was 205.0+/-172.0 IU/L. Meanwhile, there were 45 [18.3%] patients with CgA > 22 IU/L [83.0+/-116.0 IU/L] who did not have NETs. The conditions/diseases included: essential hypertension, chronic kidney disease, heart failure, peptic ulcer, chronic diarrhea, use of proton pump inhibitors, and other chronic diseases [hypothyroidism, asthma, diabetes mellitus]. Of the 25 patients with known NET who were followed-up, there were 57 CgA results [29 with CgA 22 IU/L]. The overall clinical sensitivity of CgA in the diagnosis of NETs was 84.2%, overall specificity was 78.2%, positive predictive value was 41.5%, negative predictive value was 96.4%, and overall efficiency was 79.2%. In patients with individual NET, a good reflection in CgA was noticed in the follow-up period following surgery or therapy

Conclusions: Serum CgA is a sensitive and effective noninvasive laboratory test for the clinical detection and management of NETs. Awareness of the pitfalls of the tests in patients with non-NET conditions, particularly chronic diseases and use of certain drugs, is important to be considered during the interpretation of the CgA levels

Chemical composition, antimicrobial and antifungal activities of essential oils of the leaves of Aegle marmelos (L.) Correa growing in Egypt.

The essential oil obtained by hydro-distillation of Aegle marmelos (L.) Correa leaves were analyzed by GC/MS yield (0.9% v/w). Twenty seven components were identified representing 97.76% of the total oil composition. The major components were α-phellenderene (20.97%), α-pinene (17.76%) and δ-carene (16.37%) and other abundant components asγ-cadinene (8.01%), trans-2-hydroxycinnmic acid (6.85%) and β-myrcene (4.32%). The essential oil exhibited significant antibacterial activity against Gram-positive bacteria as Streptococcus faecalis with inhibition zone (30 mm) and Gram-negative bacteria as Pseudomonas aeruginosa (28 mm). Moreover, moderate activity was observed against Bacillus subtilis (23mm), Staphylococcus aureus (23mm), Sarcina lutea (20mm), Arthrobacter citreus (20 mm) and Escherichia coli (25mm) in comparison with antibiotics. The antifungal activity against Aspergillus niger (30 mm) and Candida albicans (30 mm) was higher than the antifungal antibiotics. Moreover, the oil inhibited the germination of Aspergillus niger and Fusarium oxysporum spores at different concentrations.

Chemical constituents of the Egyptian Plant Anabasis articulata (Forssk) Moq and its antidiabetic effects on rats with streptozotocin-induced diabetic hepatopathy.

This study investigated the possible antidiabetic role and therapeutic crucial action of the saponin fractions of the ethanolic extract of areal parts of the medicinal plant Anabasis articulata compared to currently available antidiabetic drug gliclazide (diamicron) against diabetic complications induced tissue injury in rats. Fractionation of hydro alcoholic extract from the aerial parts of Anabasis articulata (Chenopodiaceae) led to the isolation of Four known saponins: 3-O-glucopyranosyl of(stigmasterol, ß-sitosterol, sitostanol), 3-O-[ß-D- the glucopyranosyl] oleanolic acid , 3-O-[ß-D-glucopyranosyl -28-O-ß-D - xylopyranosyl] oleanolic acid, in addition to proceric acid. The isolated compounds were identified by means of chemical methods and spectrometric analysis as Rf values, UV Mass, 1H NMR and 13CNMR spectroscopy. Animals were divided into 4 groups. Group1, control rats (not received any medication). Group 2, rats injected intraperitoneally with single dose of streptozotocin (STZ)(40 mg/kg body weight). Group 3, rats orally administered with ethanolic extract of A. articulata (400 mg/ kg B.W.) after STZ injection. Group 4, rats orally administered with gliclazide (10 mg/kg B.W.) after STZ injection. Oral administration of the plant modulated the diabetic increase in blood glucose and cortisol levels revealing the antihyperglycemic effect of this medicinal plant. It effectively increases the blood hormone insulin concentration and α- fetoprotein. It is also significantly decrease blood tumor necrosis factor α (TNF-α). The current plant also effectively decreased blood fructosamine to their normal levels as well as the consequence diabetic decrease in the hemoglobin (Hb) and albumin levels. Furthermore, ingestion of the plant effectively modulated hepatic oxidative tissue damage. Supplementation of diabetic animals with gliclazide improved diabetic induced alteration in most of the above studied markers. These results suggest that Anabasis articulata has multi-beneficial actions in controlling diabetes and consequence complications induced in pancreas and liver and may candidate as natural antidiabetic drug.

Validity of serum testosterone, free androgen index, and calculated free testosterone in women with suspected hyperandrogenism

There are technical limitations for the currently available methods of measuring serum total and free testosterone in females. The study objectives were to evaluate the usefulness of serum total testosterone, sex hormone-binding globulin [SHBG], free androgen index [FAI], and calculated free testosterone [CFT] in the assessment of androgen status in women investigated for suspected hyperandrogenism. This is a case control study that was conducted during the period from 1[st] May 2011 to 31[st] October 2011 on 122 patients aged [18-45 years] whom were referred to the Clinical Biochemistry Laboratory from the Endocrinology and Gynecology Clinics, Royal Hospital, Oman. Women with no clinical feature or laboratory data indicative of hormonal dysfunction and with midluteal progesterone >30 nmol/L were selected as controls [group 1; n=18]. The patients were divided into subgroups based on the clinical/laboratory diagnosis of polycystic ovary syndrome [PCOS [group 2; n=19], hirsutism [group 3; n=18], menstrual disturbances [irregularities] or infertility [group 4; n=49], as well as combination of PCOS or hirsutism and menstrual disturbances or infertility [group 5;n=18]. Serum total testosterone and SHBG were measured, FAI was calculated as percentage ratio of total testosterone to SHBG values, and CFT was calculated according to Vermeulen equation. There was a statistically significant difference in the mean levels of testosterone, FAI and CFT in each patient group compared with the control group. For diagnosing hyperandrogenism, each indicator was selected at the recommended cut-off: testosterone >3.0 nmol/L, SHBG <30 nmol/L, FAI >5%, and CFT >32 pmol/L. In group 2, 89.5% and 94.7% of the patients had increased FAI and CFT, respectively; compared with 36.4% for increased testosterone. In group 3, 88.9% and 88.9% of the patients had similarly increased FAI and CFT, respectively; compared with 66.7% for testosterone. In group 4, patients had 63.3% and 73.5% elevated FAI and CFT, respectively; compared with 53.1% for testosterone, while in group 5, patients had 83.3% and 88.9% elevated FAI and CFT, respectively, compared with 61.1% for testosterone. The diagnosis of hyperandrogenism was most obvious when using CFT or FAI than testosterone alone. It is thus recommended to include these calculated parameters [CFT and/or FAI] in the routine investigation and assessment of women with disorders related to clinical or biochemical hyperandrogenism

Cardiac events and cardiac T2[*] in Egyptian children and young adults with beta-thalassemia major taking deferoxamine

Cardiac events and death are not uncommon in adults with beta-thalassemia [beta-TM] taking deferoxamine [DFO] monotherapy because of poor compliance and possibly the less effectiveness of DFO in controlling cardiac iron overload. We sought to assess compliance with DFO, the percentage of shift to other iron chelators, and the occurrence of cardiac siderosis, and cardiac events and death in beta-TM patients on DFO monotherapy. Prospective, observational, 10-year follow-up of patients attending Ain Shams Thalassemia Unit, Cairo, Egypt. For all beta-TM patients aged 2-1 8 years attending the unit during January 1998 and taking DFO, we recorded all cardiac events [whether fatal or not] during January 2008. All patients still on DFO monotherapy and with a normal EKG and not showing symptoms or signs suggestive of heart failure [HF] were evaluated for cardiac siderosis byT2[*]. Of 412 patients, only 126 [31%] were still taking DFO monotherapy [only 43% of those were compliant], 136 were taking combined DFO and deferiprone [DFP], 72 were taking DFP and 32 were taking deferasirox [DFX]. Twenty-one were lost follow-up and 25 died [10 cardiac]. Eight of ten cardiac deaths and 12 of 15 non-cardiac deaths were in the DFO monotherapy group. Those taking DFO monotherapy with no HF and left ventricular ejection fraction [LVEF] by T2[*] >56% had a median age of 19 years and 56% were males; cardiac T2[*] was <20 ms in 30 [22%]; 10-20 ms in 20 [14.7%] and <10 ms in 10 [7.3%]. LVEF ranged from 58%-76% [median 64%]. Forty percent of T2* patients <10 ms were compliant with DFO. Fifty-eight percent of patients on DFO monotherapy were noncompliant, but even compliance did not prevent severe cardiac siderosis and most cardiac events [whether fatal or not] that occurred in the DFO monotherapy group

Neutropenia in a tertiary hospital: epidemiology and culture isolates

To study the causes, severity, and the frequency of neutropenia. Retrospective medical chart review of patients with neutropenic episodes. King Khalid University Hospital, Riyadh, Saudi Arabia. Consecutive patients with a diagnosis of neutropenia were reviewed and analyzed between January 1995 and December 2006. Personal characteristics and absolute neutrophil counts were documented. Ninety-seven patients, 39 males and 58 females, with 113 episodes comprised the study group. Mean age was 38 +/- 24.8 years. Mean absolute neutrophil count was 1184 +/- 396 cells/ mm[3]. There were 88 [90.7%] with mild neutropenia and 9 [9.3%] had moderate neutropenia. An infective focus was identified in 75 [77.3%] patients. Patients with mild neutropenia were significantly younger compared to patients with moderate neutropenia [p=0.0185] and had foci of infection in 81.8% of cases. Moderate neutropenia was seen in cancer patients and in those receiving chemotherapy. Fever was present in 84.5% of patients, who were younger and with shorter duration of neutropenic episodes compared to those who did not have fever. However, mortality was significantly greater among non-febrile patients than those with febrile episodes were [p=0.0294]. There is a need to consider a variety of factors such as age, sex, infectious foci, presence of fever and even the duration of neutropenia for initiation of appropriate management protocols. The absence of fever may mislead physicians regarding the severity of the condition

Antioxidant, anti-inflammatory and analgesic effects of salsola inermis extract

Salsola plants are widely used in folk medicine. In an attempt to search for bioactive natural products exerting antinociceptive and anti-inflammatory activities, we have evaluated the effects of the ethanol and chloroform extract of Salsola inermis on total reducing activity, nitric oxide [NO] and superoxide [SO] radicals in vitro. The ethanol extract and chloroform partition were used in the in vivo studies. Antioxidant activity of the plant ethanol extract and chloroform partition was determined spectrophotometrically in vitro. Anti-inflammatory activity was determined by measuring the paw volume of rat using Plethysmometer [UGO-Basile, Italy- model no. 7410]. Analgesic effect was studied in mice using hot-plate apparatus. The obtained data indicated that the ethanol extract is a potent inhibitor for NO and SO radicals. The anti-inflammatory activity of chloroform fraction proved to be more potent than the 70% ethanol extract against carrageenan-induced rat paw edema while the ethanol extract showed a more potent an analgesic effect. Salsola plant possesses antioxidant activities as shown from in vitro studies. It also exhibits an anti-inflammatory and analgesic effect as revealed from the in vivo studies

Expression of epidermal growth factor receptor-1 in chronic schistosomal urinary bladder lesions

Over expression of growth factors including epidermal growth factor receptor [EGFR], have been implicated in bladder cancer biology. This study was conducted in a trial to a better understanding the genetic mechanisms underlying the proliferative, the premalignant and malignant changes frequently displayed in chronic schistosomal cystitis [ChSC] and schitosoma associated carcinoma of the bladder. The study included 58 Egyptian patients [15 ChSC and 43 bladder cancer], and 5 normal urothelial specimens as control. The bladder cancer specimens were selected included adjacent normal mucosa or dysplastic areas [27 squamous cell carcinoma SCC and 16 transitional cell carcinoma TCC]. Level of expression of EGFR was analyzed using an immunohistochemical approach and the results compared with histological pattern, grading and pathological staging. In normal epithelium EGFR expression was only limited to the basal layer, but in dysplastic epithelium adjacent to tumour tissue all cells stained for EGFR. Bilharzial associated TCC exhibit very low expression, EGFR expression was weak cytoplasmic or even absent. The majority of SCC expressed strong membrane staining for EGFR and almost all cells were positive for the receptor. However, the intensity of staining was increasing with a significant statistical correlation with grade [p < 0.01] and with invasiveness of the tumour [p < 0.001]. In conclusion over expression of EGFR [high intensity] in human bladder cancer may be associated with poor differentiation and with invasion that could be implicated in the pathway of oncogenesis for schitosoma associated SCC of the bladder

Comparison of underlying lesions in pediatric and adult ovarian torsion

To compare the pediatric and adult ovarian torsion and explore a quantitative value to predict a possible underlying tumor. This study included 32 pediatric and 33 adult female cases diagnosed with ovarian torsion and underwent surgical treatment in Dr. Behcet Uz Children's Research Hospital and Ataturk Education and Research Hospital, Izmir, Turkey between 1989 and 2005. We evaluated the properties of the cases statistically. The mean age of pediatric was 8 years and 3 months and adult cases was 39 years and 8 months. Six cases had an underlying tumor in both pediatric and adult group. The mean diameter and volume difference were 6.84 cm, 91 cc in pediatric and 12.69 cm and 1087 cc in the adult group. In statistical analysis, the diameter and volume increase were significantly higher in cases with underlying tumor in pediatric group. The cut-off value was 7 cm in diameter and 104 cc in volume increase. In the adult group, the diameter and volume increase were not significant in tumor positive and negative group. Torsion of the ovary requiring surgery, is rare and is the mot common reason of abdominal/pelvic mass. These cases are often difficult to decide for surgical procedure especially in pediatric cases. We conclude that an underlying lesion more commonly occurs in children with an increase in ovarian volume of more than 104 cc and a diameter more than 7 cm. Great care should be taken for laparoscopic conservative management especially in these cases. The quantitative analysis is not predictive for the underlying solid lesion in adult cases

Pharmacological effects of tramadol hydrochloride on blood pressure and on some isolated smooth muscles of experimental animals

Tramadol is a centrally acting synthetic opioid analgesic drug. It is an effective analgesic with a good tolerable profile in short term uses. The apparent lack of tolerance and dependence and the low incidence of respiratory depression associated with tramadol suggests that the drug may offer advantages over some of the other established analgesic drugs currently used for relief of moderate to severe pain. This work was carried to investigate tramadol effect on some isolated and intact animal preparations. In in-vivo experiments: Intravenous injection of tramadol in anaesthetized cats at doses 0.6 and 1.2 mg/kg caused a significant rise of mean arterial blood pressure which was revealed to be through an alpha1 adrenoceptor agonistic action. However, higher doses of tramadol, [2.4 to 19.2 mg/kg] produced a biphasic change in mean arterial blood pressure; a significant initial decrease followed by a significant increase. The initial decrease in blood pressure was proved to be mediated through a peripheral site of action. Presynaptic alpha2 adrenoceptors were also involved in the decrease of blood pressure. The second phase [increase in blood pressure] was abolished in spinal cat preparation denoting a central site of action. Tramadol [2.4-19.2 mg/kg] also produced a dose dependent and significant decrease in heart rate. Using the cat nictitating membrane preparation showed that tramadol may act partially through inhibition of norepinephrine [NE] reuptake. The drug also significantly potentiated the NE induced contractions of isolated rabbit aortic spiral strip. This potentiation may be attributed to inhibition of NE reuptake. On isolated guinea pig tracheal spiral strip and ileal preparations, tramadol caused a dose depended reduction of the histamine induced contractions. However, the drug caused a significant increase in the height of the contractions of isolated rabbit jejunum. This stimulant action, was proved to involve both serotonergic and opioid receptors. It can be concluded that inspite of tramadol being one of synthetic opioid drugs, it did not show a histamine potentiating effect on the isolated guinea pig tracheal spiral strip. On the other hand it reduced the histamine induced contractions of the preparation which may be of value in patients with tendency to bronchoconstriction. The experiments carried on anaesthetized cats revealed that tramadol produced an elevation of blood pressure accompanied by bradycardia which must be considered especially in patients with cardiovascular disorders

Leptin concentration during different trimesters of pregnancy and its relation to other pregnancy hormones

To determine the levels of leptin and other pregnancy hormones [progesterone, estradiol, folliculi stimulating hormone, luteinizing hormone and beta human chorionic gonadotropin] in pregnant females during different stages of pregnancy and to correlate these levels to maternal weight, body mass index [BMI], babies weight and babies BMI. Leptin level and other pregnancy hormones were measured in 36 pregnant females and 30 non-pregnant females followed at King Khaled University Hospital, Riyadh, Kingdom of Saudi Arabia in the year 2001 in a prospective study. Blood samples were collected at the first, 2nd and 3rd trimester and after delivery. Correlation analysis between leptin level and pregnancy hormones, in addition to maternal weight, BMI, babies weight and BMI. The mean leptin levels during pregnancy and postnatally were significantly higher in pregnant females compared to the non-pregnant controls. Serum concentration of leptin increased significantly [p=0.01] in the pregnant females from 21.24 +/- 9 ng/ml during the first trimester to 26.3 +/- 8.69 ng/ml during the 2nd trimester, but insignificantly decreased to 23.29 +/- 8.62 ng/ml during the 3rd trimester [p=0.073]. After delivery leptin concentration significantly decreased to 17.36 +/- 7.95 ng/ml [p=0.0025]. The changes in levels of leptin during pregnancy were independent to other pregnancy hormones which showed a different pattern of variation. The changes in levels of leptin during pregnancy were independent to other pregnancy hormones which showed a different pattern of variation

Multiple isoforms of protein kinase C in lymphocytes and airway smooth muscle of guinea pig.

The isoenzyme pattern of protein kinase C (PKC) in lymphocytes and airway smooth muscles (ASM) was examined by Western blot using commercially available monoclonal antibodies. The results showed the presence of PKC alpha, beta, gamma, epsilon, eta, mu and zeta in lymphocytes and PKC alpha, gamma, epsilon, eta and zeta in ASM. The unexpected feature was the presence of PKCgamma in both lymphocytes and ASM of guinea pigs. Expression of this PKC isoform is usually restricted to tissues in the central nervous system or spinal cord. Expression of PKC delta, theta, lambda and tau was not detected in either lymphocytes or ASM.

Rapid flow cytometric susceptibility testing of candida species

The present study was performed to establish a standardized rapid antifungal susceptibility method using flow cytometry [FCM]. Also, to detect the antifungal susceptibility pattern of Candida species isolated in Ain Shams University Hospitals. For this purpose, 50 Candida isolates from different patients' specimens [urine, sputum, pus, blood and ascitic fluid] were identified to the species level using Microscan Walkaway 40. Their in vitro susceptibility to amphotericin B [AMB], fluconazole and ketoconazole was performed using 2 reference broth microdilution NCCLS M27-A and FCM. Membrane permeability changes of Candida caused by antifungal agents were measured by FCM using propidium iodide. The most common isolates were C. albicans [48%], C. Tropicalis [40%], and others: C. parapsilosis, C. Lusitaniae, C. glabarata and C. Krusei [12%]. By both methods [M27-A and FCM], Candida species were 90% and 92% susceptible to AMB respectively; 80% and 4% susceptible to ketoconazole respectively and 84% and 88% susceptible to fluconazole respectively. On comparing results of both methods for antifungal susceptibility testing, it was found that by FCM, a 4 hrs incubation for azoles and 2 hrs incubation for AMB were aufficient to provide MICs comparable to the reference M27-A broth microdilution method developed by NCCLS. Subcommittee on antifungal susceptibility tests [correlation significance < 0.001]. Such work showed that FCM provides rapid and sensitive method for antifungal susceptibility of candida

Anew autosomal recessive syndrome. early onset of pancytopenia, distinct facial features, growth retardation and developmental delay

The association of dysmorphic features and failure of one or more bone marrow cell lines is well known. Examples are Fanconi's anemia and Diamond-Blackfan anemia. This report describes 3 similarly affected children from consanguineous parents, all showing low birth weight, severe growth retardation, distinct facial features, microcephaly, mental retardation and onset of severe pancytopenia in infancy without increased chromosomal breakage. We conclude that these cases represent a new familial autosomal recessive bone marrow failure syndrome

Weaning attitudes and practices in Baghdad community

This study was conducted on 150 infants in Al-Mansoor Children's Teaching Hospital, Medical City from Jan. - April 1992. The infants ages were 6-12 months. 62.6% were males; 75% were urban areas. Fifty six infants [37%] were breast fed. 60.7% of mothers gave weaning food to support breast milk. The mother's age had no significant effect on the time of weaning, mothers with secondary and high education prefer weaning at early age [3 months]. Weaning started at 4-6 months by 66% of mothers. Biscuits, soups, cereals, eggs, fruit juices and rice water were foods first introduced. The source of advice to 88 mothers [59%] about weaning was from the grandmother

Study of bacterial colonization and infection of the tracheobronchial tree in intubated patients in respiratory intensive paients in resiratory intensive care unit

In this study, serial bacteriological samples including oropharyngeal, endotracheal and lower respiratory tract samples were collected from 20 patients in the respiratory intensive care unit [ICU] who were intubated and mechanically ventilated for at least 3 days. The results of this study showed the prevalence of gram negative bacilli in all bacteriological samples. The lower respiratory tract specimens were collected by the protected specimen brush catheter [PSB catheter] which was useful in both the bacteriological culture and colony count of these specimens to differentiate between colonization and true infection. So, we may recommend its use routinely in bacteriological sampling of such specimens

Microbial factors in the pathogenesis of tuberculosis and their potential influence on the protective effect of B.C.G.

This study included 163 tuberculous patients and 43 persons of their healthy contacts. Seventy one strains of mycobacteria were isolated from sputum and only one strain from urine samples. Out of these; 46 strains have been identified as M. tuberculosis and 11 strains as M. bovis based on the results of niacin production, nitrate reduction and TCH susceptibility tests. Ten strains of M. tuberculosis were subjected to the invivo virulence assay of Mitchison. All tested strains were found to be highly virulent. Thus the prevalence of south Indian or low virulent variants of M. tuberculosis in Egypt is not a possibility. The results of tuberculin testing with PPD-B, in the patients and contacts under study, showed a very low prevalence of sensitization to environmental mycobacteria [26. 9% among patients and 27. 9% among contacts]. Accordingly. these findings suggest that the two hypotheses proposed to be among the important causes of failure of protective effect of BCG in the south Indian trial are not present in the Egyptian population sample studied