Fixation of Mallet Fractures Using a Modified Hook Plate Technique: A Prospective Case Series of 17 Patients / Fixação de fraturas em martelo com técnica de placa de gancho modificada: Uma série de casos prospectivos de 17 pacientes

Abstract Objective Various modalities have been suggested to manage mallet fractures; however, inappropriate treatment can lead to extension lag, a swan neck deformity, or arthritis of the distal interphalangeal joint (DIPJ). The current study aimed to evaluate the results (functional, radiological, and complications) of open reduction and internal fixation (ORIF) of mallet fractures using low-cost hook plates fabricated from low-profile titanium mini plates. Methods A prospective case series of 17 consecutive patients (average age of 32.3 years) with mallet fractures (six were Wehbe Type IB and 11 were Wehbe Type MB). Eleven (64.7%) were males. The affected hand was dominant in all patients, and the affected digit was the index in 6 (35.3%), the ring in 5 (29.4%), the small in 3 (17.65%), and the middle in 3 (17.65%) patients. The same fellowship-trained hand surgeon performed all surgeries. Results The average operative time was 37.65 minutes. After an average follow-up of 10.94 months (range 6-27), the average DIPJ motion was 50º º (range 20º-70º), the extensor lag was noted in 4 (23.5%) patients, and complications were reported in 6 (35.29%) patients. According to Crawford criteria, 6 (35.3%) patients achieved excellent results, 7 (41.2%) achieved good results, and 4 (23.5%) achieved fair results. Conclusion The modified hook plate technique for fixation of mallet fractures is a beneficiai, economical, yet demanding technique that adequately provides stable fixation to allow early DIPJ motion with acceptable functional outcomes.

Resumo Objetivo Diversas modalidades têm sido sugeridas para o tratamento de fraturas em martelo; no entanto, o tratamento inadequado pode causar retardo de extensão, deformidade em pescoço de cisne ou artrite da articulação interfalangiana distal (AIFD). Este estudo teve como objetivo avaliar os desfechos (funcionais, radiológicos e complicações) da redução aberta e fixação interna (RAFI) das fraturas em martelo com placas de gancho de baixo custo fabricadas com mini placas de titânio de baixo perfil. Métodos Série de casos prospectivos de 17 pacientes consecutivos (idade média de 32,3 anos) com fraturas em martelo (seis do tipo IB e 11 do tipo IIB de Wehbe). Onze (64,7%) pacientes eram do sexo masculino. A mão acometida era a dominante em todos os pacientes, com acometimento do dedo indicador em seis (35,3%), anelar em cinco (29,4%), mínimo em três (17,65%) e médio em três (17,65%) pacientes. O mesmo cirurgião de mão experiente realizou todas as cirurgias. Resultados O tempo operatório médio foi de 37,65 minutos. Após um acompanhamento médio de 10,94 meses (intervalo de 6 a 27), observou-se movimento médio da AIFD de 50º (intervalo de 20º a 70º), retardo de extensão em quatro (23,5%) pacientes e complicações em seis (35,29%) pacientes. De acordo com os critérios de Crawford, os desfechos foram excelentes em seis (35,3%), bons em sete (41,2%) e regulares em quatro (23,5%) pacientes. Conclusão A técnica da placa de gancho modificada para fixação de fraturas em martelo é benéfica e econômica, mas exigente; permite fixação estável e adequada para permitir a movimentação precoce da AIFD com desfechos funcionais aceitáveis.

Safety and efficacy of omecamtiv mecarbil for heart failure: A systematic review and meta-analysis

Aim: To assess the safety and efficacy of omecamtiv mecarbil compared with placebo in heart failure (HF) patients. Methods: We searched PubMed, Web of Science, Cochrane Library, and SCOPUS until August 15th, 2021. We included all randomized controlled studies comparing omecamtiv mecarbil with placebo in heart failure patients. The meta-analysis was carried out using Rev Man software V5.4. Results: A total of eight studies were included in our systematic review. Pooled analysis showed that omecamtiv mecarbil is not associated with increased incidence of death, any adverse events, hypotension, heart failure, ventricular tachyarrhythmia, dyspnea, dizziness, and serious adverse events. Regarding the efficacy, omecamtiv mecarbil significantly reduced heart rate with some studies demonstrating its significant improvement in left ventricular ejection fraction and systolic function. Conclusion: Omecamtiv mecarbil is a well-tolerated drug in heart failure patients. The limited data regarding the efficacy suggested that it may improve ejection fraction and systolic function

Frequency and Risk Indicators of Periodontal Diseases in a Sample of Adult Egyptian Patients: A Hospital-Based Cross-Sectional Study

ABSTRACT@#This hospital-based cross-sectional study aimed at determining frequency and risk indicators/predictors of periodontitis in a sample of Egyptian adult population and to develop a prediction equation for classifying periodontal diseases. Seven hundred and fifty subjects were consecutively recruited from outpatient Diagnostic Center, Faculty of Dentistry, Cairo University. Validated oral health questionnaire for adults and oral health impact profile-14 (OHIP-14) questionnaire were filled by all patients. Diagnosis was made based on measurements of clinical periodontal parameters including plaque index, bleeding on probing, pocket depth, clinical attachment level and gingival recession. Radiographic examination was performed using digital periapical radiographs. Ordinal logistic regression analysis was used to determine significant predictors of periodontal diseases and discriminant analysis was performed to predict periodontal disease classification. Gingivitis was the most frequent periodontal disease (39.6%) followed by periodontitis stage I (38%), stage II (20.4%), stage III (1.6%) and stage IV (0.4%). The lowest OHIP-14 scores were in patients with periodontitis stages III and IV. Multivariate analysis showed that education (p < 0.001), OHIP-14 score (p = 0.003), non-smoking (p = 0.001) and non-alcohol drinking (p = 0.021) were significant negative predictors, while never to clean the teeth (p <0.001) and cleaning the teeth once a month (p < 0.001) were significant positive predictors of periodontal disease. Periodontitis stages III and IV were the least frequent on a sample of Egyptian adult patients. Education, frequency of teeth cleaning, smoking, alcohol drinking and OHIP-14 scores were significant predictors of periodontal disease. Through discriminant analysis this study could classify patients into different periodontal diseases with an overall correct prediction of 99.2%.

Impact of HCV Genome Structure on Responder to Pegylated Interferon Therapy in Egyptian Patients

This study aimed to investigate relationship of the HCV genome structure and treatment with Pegylated Interferonα/Ribavirin (peg-IFNα/RBV) Egyptian patient. Mutations in two sites of HCV genome; the internal ribosome entry site(IRES) and the interferon sensitivity determining region (ISDR) of HCV genotype 4a were studied in details including DNAsequences and mutations detection in response to treatment. Ninety patients, responders and non-responders, to treatmentwith peg-IFN α /RBV were included in this study. IRES and ISDR regions were amplified by RT-PCR using specific designedprimers, and amplified regions were sequenced. The data obtained were aligned with published sequences in GenBank usingBLAST program. Results of this study have revealed that there are different mutations in the studied sequences in both ISDRand IRES regions. The predicted amino acids sequences in the ISDR region showed significant differences ranging from oneup to more than eight mutations in the HCV Genome sequences. Although there was a significant difference betweensequences of HCV RNA isolated from responders and non-responders, these data were not able to give an absolute answerwhether response to interferon therapy is directly/relates to the structure of the HCV genome

Magnetic resonance imaging and 3-dimensional transperineal ultrasound evaluation of pelvic floor dysfunction in symptomatic women: a prospective comparative study

PURPOSE: The purpose of this study was to investigate magnetic resonance imaging (MRI) and 3-dimensional transperineal ultrasound (3D-TPUS) features of pelvic floor dysfunction (PFD) in symptomatic women in correlation with digital palpation and to define cut-offs for hiatal dimensions predictive of muscle dysfunction. METHODS: This prospective study included 73 women with symptoms suggesting PFD. 3D-TPUS, MRI, and digital palpation of the levator ani muscle were performed in all patients. Levator hiatal antero-posterior (LHap) diameter and area (LH area) were measured at rest and at maximum muscle contraction. RESULTS: The reduction in LHap diameter and LH area during contraction was significantly less in women with underactive pelvic floor muscle contraction (UpfmC) than in those who had normal pelvic floor muscle contraction by digital palpation (P<0.001). Statistically significant positive correlations (P<0.001) were found between the Modified Oxford Score and 3D-TPUS and MRI regarding the reduction in the LHap diameter (r=0.80 and r=0.82, respectively) and LH area (r=0.60 and r=0.70, respectively). A reduction in LHap of <6.5% on 3D-TPUS and <7.6% on MRI predicted UpfmC with sensitivities of 46.2% and 82.7%, respectively. A reduction in LH area of <3.4% on 3D-TPUS and <3.8% on MRI predicted UpfmC with sensitivities of 75.0% and 88.5%, respectively. MRI was more sensitive in detecting levator avulsion (63.4%) than 3D-TPUS (27.1%). CONCLUSION: MRI and 3D-TPUS had strong positive correlations with findings on palpation, and at certain cut-offs for hiatal dimensions, they can be used as complementary and objective tools to improve the accuracy of diagnosis and management planning of PFD.

Retrospective study of the corticosteroids administration in glioblastoma patients as a prognostic factor in the disease

Background: Glioblastoma multiforme [GBM] is the most common and most malignant of the glial tumors. Optimum management consists of maximal safe surgical resection, followed by concurrent chemoradiotherapy treatment then adjuvant chemotherapy with temozolomide. A considerable part from the care of patients with GBM involves general medical management, containing corticosteroids. Despite steroids common use, there is experimental and clinical evidence that corticosteroids have direct effects on tumor cell proliferation and apoptosis

Aim of the Work: was to discuss the clinical relation between corticosteroids usage in Glioblastoma Multiforme [GBM] patients and quality of life as well as the disease progression free survival according to the recorded data from the joined hospitals

Patients and Methods: Retrospective analysis of 66 adult patients diagnosed with GBM by surgery or imaging criteria. In order to assess the relation between corticosteroid dependence and the survival, patients were recruited into two groups [arms] according to dependency. Arm [A] was steroid dependent [34 patients] and arm [B] was steroid non-dependent [32 patients]

Results: Corticosteroids dependency was statistically significant correlated to both Overall Survival [OS] [median 2.5 in arm [A] vs. 13.1 months in the arm [B], p < 0.001], and Progression-free survival ratio [PFS] [median 2.3 in arm [A] vs. 9.4 months in arm [B], p = 0.035]. Also, steroid dependency was independent prognostic factor by doing the COX regression analysis

Conclusion: Dependence on corticosteroids during course of treatment is identified as a poor prognostic factor

Pain assessment after short course versus long course palliative radiation of painful bony metastasis

Background: the most common cause of pain in cancer patients is bone metastases. Objective: to evaluate the different fractionation schedules

Patients and Methods: this is a prospective cross sectional study conducted at Ain-Shams University Hospitals and Nasser Institute Cancer Centre, to assess the equivalence of two fractionation regimens [20 Gy over 5 fractions versus 30 Gy over 10 fractions] as regard pain relief in painful bony metastases. Over 6 months fifty patients were assigned to either fraction arms using consecutive sampling

Results: both fractionation regimens were effective at palliating pain from bone metastases. Pain score was consistently going down from week 0 to week 12, although maximum benefit was reached earlier in the shorter arm [at week 8], both comparison groups leveled a favourable response at week 12. At 3 months, the observed overall response rate was 88% versus 84% and complete response rate was achieved in 44% versus 36% in both short- and long fractionation course respectively, with no statistical difference was found in terms of pain relief. With the median time to pain progression was 79.0 days for the short arm versus 77.0 days for the protracted arm

Conclusion: lower dose of radiotherapy may provide equivalent outcomes to higher ones in palliating bone pain. So, the the surrounding normal tissue role in pain process caused by bone metastases as well as the effect of radiation in this environment has to be furtherly investigated, which may lead to pain control augmentation

A lipidomic concept in infectious diseases

Infectious diseases resemble a great threat to the human health according to World Health Organization where about 17% of all deaths (≈9.2 million deaths) in 2013 recorded are related to infectious diseases. The pathogenic microorganisms such as bacteria, viruses, fungi and parasites are the principle causes of infectious diseases. Ebola, AIDS, dengue, hepatitis, malaria, tuberculosis and schistosomiasis are among 216 infectious diseases found where the immunity represents the first line defense in infection. Lipidomic includes examination of different biological lipids in the biological cell. The lipidomic research covers all aspects of individual lipid molecule including its structure, function, connection with other cell constituents such as protein, lipid, and metabolite in both health and disease conditions. Details of cell biology obtained from different pathogens (viruses, bacteria, and parasites) provide a great data on molecular structure of host-pathogen relation and consequently on infection process. The lipids here play a very important role in many processes involved in host-pathogen relations. The role of lipid in host-pathogen link includes many processes in (1) structural host constituents, (2) host recognition, (3) intracellular transferring, and (4) energy and resource homeostasis during pathogen duplication. There are many lipid phosphatases, kinases, and lipases molecules that greatly involved in these processes and controlling pathogen expression and infection progress. The cell lipid metabolism depends on an adequate energy stores that push the infection to be accelerated and disease symptoms to be appeared. Consequently, future lipidomics studies are the basic for detecting the lipid role in host-pathogen relations which help in therapy advances and biomarkers development.

Corrigendum to “Multiple sclerosis: New insights and trends” Asian Pac J Trop Biomed 6 (5) (May 2016) 429–440 (S2221169117301703) (10.1016/j.apjtb.2017.02.001)

The authors regret for the article entitled “Multiple sclerosis: New insights and trends” that was published in 5th issue 2016 in Asian Pacific Journal of Tropical Biomedicine. The wrong version was sent to production at that time. The correct and final version follows. The authors would like to express deep apologies to the readers.

Corrigendum to ‘Multiple sclerosis: New insights and trends’ (Asian Pacific Journal of Tropical Biomedicine (2017) 7(5) (493–504) (S2221169116302453) (10.1016/j.apjtb.2016.03.009))

Multiple sclerosis (MS) is the most famous autoimmune disease attacking the central nervous system. It attacks people from age 20–50 years old and the females’ attacks double than males’ attacks. MS is an autoimmune disease affecting principally the central nervous system that causes nerve sheath demyelination, followed by axon damage and paralysis. MS symptoms include muscle weakness, weak reflexes, muscle spasm, difficulties in movement and unbalance. Many factors may be responsible for MS: microorganism, virus, smoking, stress, environmental toxins, contaminated diet and gout. MS is widely spread in the population in North Europe and this is related to lack of vitamin D due to decrease of sunlight exposure. MS biomarkers include nitric oxide, interleukin-6, nitric oxide synthase, fetuin-A and osteopontin. MS is not a genetic disease (not transferred from parents into next generations) but MS appears when leukocyte antigen system-related genes are changed in human chromosome 6. The physiology of MS patients is controlled by numbers of biological processes such as activation of immune-inflammatory, oxidative and nitrosative stress pathways. MS includes two main steps: (1) myelin sheath destruction and formation of lesions and, (2) inflammation. Four types of MS can be distinguished: relapsing-remitting, primary progressive, secondary progressive and progressive relapsing. Nine treatments have been accepted for relapsing-remitting MS type: interferon β-1a, interferon β-1b, mitoxantrone, natalizumab, glatiramer acetate, fingolimod, dimethyl fumarate, teriflunomide, and alemtuzumab. However, the only treatment used is mitoxantrone for progressive MS with many side effects. Complementary treatments are also used in MS treatments such as vitamin D, Yoga, medicinal plants, oxygen therapy, acupuncture and reflexology.

Protective effect of natural products and hormones in colon cancer using metabolome: A physiological overview

Globally, the third cause of males cancer and the fourth cause of females cancer is colon cancer (CC). In Egypt, high CC percentage occurs in children and in individuals below 40 years of age. The complete loss of biological enzyme function is the main cause of CC and consequently CC increased in smoking and pollution exposure. The aim of this review is to focus on the application of metabolome as a physiological tool that can play an important role in preventing CC incidence by natural products and hormones. The dietary factors, intestinal micro-flora and endogenously produced metabolites are the main three causes that produce free radicals in the colon. A correlation occurs between the enzyme activity and CC polymorphisms or property. Nowadays metabolome is applied with the progress of different analytical methods, data bases and tools for cancer predication and stimulation especially in CC cases. Metabolism is defined as intracellular chemical reactions that produce chemical substances and energies sustaining life. Metabolic pathway networks are also composed of links that are defined as transformation of chemical structures between two metabolites and an enzyme reaction. The most important advantage of metabolome is its ability to analyze metabolites from any source, regardless of origin, where the application of liquid chromatography combined with mass spectra in metabolome analysis to a series of cancer cell lines that were progressively more tumorigenic due to the induction of 1,2,3 or 4 oncogenes to cell lines could be a metabolome example application. In conclusion, natural products and hormones are very important in preventing CC in humans and animal models where both natural products and hormones play a significant and important effect in regulating physiological process especially in CC cases. In this situation, metabolome must increase in its application in the future for the diagnosis of CC cases.

Comparison between FEV1/FEV6 and FEV1/FVC as screening of chronic obstructive pulmonary disease

Objective: To compare FEV1/FEV6 to the standard spirometry (FEV1/FVC) as a screening tool for COPD. Methods: This cross-sectional study was conducted at Hospital Tuanku Fauziah, Perlis, Malaysia from August 2015 to April 2016. FEV1/FEV6 and FEV1/FVC results of 117 subjects were analysed. Demographic data and spirometric variables were tabulated. A scatter plot graph with Spearman’s correlation was constructed for the correlation between FEV1/FEV6 and FEV1/FVC. The sensitivity, specificity, positive and negative predictive values of FEV1/FEV6 were determined with reference to the gold standard of FEV1/FVC ratio <0.70. Receiver-operator characteristic (ROC) curve analysis and Kappa statistics were used to determine the FEV1/FEV6 ratio in predicting an FEV1/FVC ratio <0.70. Results: Spearman’s correlation with r = 0.636 (P<0.001) was demonstrated. The area under the ROC curve was 0.862 (95% confidence interval [CI]: 0.779 - 0.944, P<0.001). The FEV1/FEV6 cut-off with the greatest sum of sensitivity and specificity was 0.75. FEV1/FEV6 sensitivity, specificity, positive and negative predictive values were 93.02%, 67.74%, 88.89% and 77.78% respectively. There was substantial agreement between the two diagnostic cut-offs (κ = 0.634; 95% CI: 0.471 - 0.797, P<0.001) Conclusions: The FEV1/FEV6 ratio can be considered to be a good alternative to the FEV1/FVC ratio for screening of COPD. Larger multicentre study and better education on spirometric techniques can validate similar study outcome and establish reference values appropriate to the population being studied.

Multiple sclerosis: New insights and trends

Multiple sclerosis (MS) is the most famous autoimmune disease attacking the central nervous system. It attacks people from age 20-50 years old and the females' attacks double than males' attacks. MS is an autoimmune disease affecting principally the central nervous system that cause nerve sheath demyelination followed by axon damage and paralysis. MS symptoms include muscle weakness, weak reflexes, muscle spasm, difficult in move, miss-coordination and unbalance with others. There are many factors may be responsible for MS: microbial, viral, smoking, stress, environmental toxins, contaminated diet, and gout. MS is wide spread in the populations in North Europe and this related to lack of vitamin D due to decrease of sunlight exposure. MS biomarkers include nitric oxide, interleukin-6, nitric oxide synthase, fetuin-A and osteopontin. MS is not a genetic disease where MS occurs when human leukocyte antigen system related genes are changed in chromosome 6. The physiology of MS is monitored by activation of immune-inflammatory, oxidative, and nitrosative stress pathways. MS is including two main steps: (1) myelin sheath destruction and formation of lesions and, (2) inflammation. Four types of MS can be distinguished: relapsing-remitting, primary progressive, secondary progressive and progressive relapsing. Nine treatments have been accepted for relapsing-remitting MS type: interferon β-1a, interferon β-1b, mitoxantrone, natalizumab, glatiramer acetate, fingolimod, dimethyl fumarate, teriflunomide, and alemtuzumab, however, the only treatment used is mitoxantrone for progressive MS but many of MS treatments side effects are recorded. Complementary treatments also used in MS treatments such as: vitamin D, Yoga, medicinal plants, oxygen therapy, acupuncture and reflexology.

Approach to pharmacological and clinical applications of Anisi aetheroleum

Anisi aetheroleum is the oil obtained from Pimpinella anisum L. (P. anisum) by steam distillation. P. anisum seeds were air-dried, and then the dry seeds were crushed, pulverized, and weighed in sequence for anise oil preparation. P. anisum is one of the oldest medicinal plants that belong to family Apiaceae. The fruit of P. anisum is harvested in August and September. P. anisum is widespread in Asia, Africa and Europe. Local names of P. anisum include anise, anisoon, roomy, saunf, sweet cumin and yansoon. The anise oil odour is aromatic while the oil tastes sweet. The average daily dose of Anisi aetheroleum is 0.3 g. trans-Anethole is the major ingredient of the anise oil. Anisi aetheroleum also displays a protective action against neurotoxicity. In addition, Anisi aetheroleum increases glucose absorption and reduces urine output in the rat. The plant oil have pharmacological (antimicrobial, hepatoprotective, anticonvulsant, anti-inflammatory, antispasmodic, bronchodilator, estrogenic, expectorant and insecticidal) effects and clinical effects on nausea, constipation, menopausal period, virus, diabetes, obesity and sedative action. Owing to the wide application of Anisi aetheroleum in pharmacological and clinical fields, it is recommended for more clinical trails to discover a new medication from the active constituents of the plant oil in the future to treat human diseases especially chronic ones.

Antihyperlipidemic activity of the medicinal plants among Kadazan and Dusun communities in Sabah, Malaysia: A review

Sabah is one of the 13 states within the Federation of Malaysia and is located in the northernmost part of Borneo. It is the second largest state in Malaysia with a landmass of approximately 7.4 million hectares. The total forested area is 4.7 million hectares. Sabah, being part of Borneo, is rich in plant biodiversity. There is also an abundance of medicinal plants and other plants for everyday use. There is a great awarness regarding association between low density lipoprotein reduction and decreased cardiovascular disease mortality. The antihyperlipidaemic activity of herbs plays an important role in the reduction of cardiovascular diseases, which is the top disease that causes mortality all over the world. Lipid-lowering activity of medicinal plant for phytomedicine research and drug development for such a disease are now focused all over the world. A plant-based diet rich in fruit, vegetables, and legumes and low in saturated fat is an effective prescription for anyone with more severe atherosclerosis. Howerver, there are few herbs available that provide some protection for persons with the above disease. The antihyperlipidaemia property in plant plays a vital role to reduce atherosclerosis. Thus, there is an increasing search for the lipid lowering agents from natural origin. In this review an attempt has been made to give an overview of the antihyperlipidemic activity in traditional medicinal plants found widely in Kadazan and Dusun communities in Sabah, Malaysia. The antihyperlipidemic activity of the traditional medicinal plants in these communities is more helpful for the development of new drugs used in the protection against dyslipidemia or atherosclerosis.

Monitoring of parasitic cysts in the brains of a flock of sheep in Egypt / Monitoramento de cistos parasitários no cérebro de um rebanho de ovinos no Egito

Cerebral parasitic cysts constitute a major problem for livestock. Among these, coenurosis and toxoplasmosis are predominant. Here, a total number of 60 sheep obtained from a private farm in Suez province, Egypt, were examined postmortem to detect visible parasitic cysts, and microscopically to detect small-sized entities. Necropsy revealed bladder-like cysts measuring 0.5-6.5 cm in diameter that were filled with a translucent fluid containing a large number of protoscolices. Accordingly, the cysts were identified as the metacestode Coenurus cerebralis. Among the sheep examined, 11 animals (7 males and 4 females) (18.3%) were infected. Most of the cysts were located in the cerebral hemispheres, with numbers ranging from one to three per infected animal. The effect of the presence of cysts in the brain tissue was evaluated. Histopathologically, pseudocysts of the apicomplexan Toxoplasma gondii were found in two animals with no detectable inflammatory cell reactions. In conclusion, coenurosis and toxoplasmosis are serious parasitic problems that play a significant role in sheep management in Egypt, as a result of close contact between livestock and dogs and cats, which play a critical role in the life cycle of these parasites.

Cistos cerebrais parasitários constituem um grande problema para o gado. Entre estes, coenurosis e toxoplasmose são predominantes. Aqui, um número total de 60 ovelhas obtidas em uma fazenda particular na província Suez, Egito, foram examinadas post-mortem para a detecção de cistos parasitários visíveis e microscopicamente para detectar cistos de pequenas dimensões. A necropsia revelou cistos medindo entre 0,5-6,5 cm de diâmetro, preenchidos com um fluido transparente, contendo um grande número de protoscolices. Por conseguinte, os cistos foram identificados como o metacestóide Coenurus cerebralis. Entre as ovelhas examinadas, 11 animais (7 machos e 4 fêmeas) (18,3%) estavam infectados. A maior parte dos cistos estavam localizados nos hemisférios cerebrais, com números variando de um a três em ovinos infectados. O efeito da presença de cistos no tecido do cérebro foi avaliado. Histopatologicamente, pseudocistos de Toxoplasma gondii foram encontrados em dois animais sem reações inflamatórias detectáveis. Em conclusão, coenurosis e toxoplasmose são graves problemas parasitários que desempenham um papel significativo no manejo de ovelhas no Egito, como resultado do contacto íntimo dos animais com os cães e gatos, que desempenham um papel crítico no ciclo de vida desses parasitas.

Varicella-zoster infection in adult males: risk factors for varicella-zoster virus pneumonia

To study the risk factors for varicella pneumonia [VP] in adults and to predict the early progression to severe pneumonitis in order to establish early therapeutic intervention. Prospective study. Infectious Diseases Hospital. Fifty-two male patients with VP and 52 Varicella patients without pneumonia as control. Beside history taking and routine work-up, all cases were subjected to arterial blood gas analysis, and hypoxemic index [HI] was calculated as an indicator for severity of pneumonia. Arterial blood gas analysis. Occurrence of VP. Univariate analysis revealed significant associations between pulmonary findings, chronic diseases, severe varicella rash and smoking in patients with VP than those without pneumonia [p = 0.001, 0.03, 0.001, 0.03 respectively]. Blood gas analysis showed significantly lower mean values of PaO[2], SaO[2] and hypoxemic index in patients with VP than controls [p = 0.001]. However, the mean PaCO[2] was significantly higher in the same patient group [p = 0.001]. Multivariate analysis demonstrated that older age, clinical pulmonary findings, severe varicella rash, low PaO[2], low HI and FDPs > 1000 were significantly associated with VP. In adult males with VP, presence of HI < 150, generalized radiological pulmonary opacities, FDPs > 1000, low PaO[2] and SaO2% could be considered good predictors of progression to serve VP. These factors should alert the physician for an early intervention as VP is potentially lifethreatening

Cardiometabolic protective effects of some medicinal plants in diabetic albino rats

Background and aim of the study: DM represents an important independent risk factor for the development of and mortality from coronary heart disease [CHD], increasing the risk by 2 to 4 times. According to WHO data, more than 75% of patients with DM die due to vascular accidents. This study investigated the effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents and explores its metabolic effects

Material and Methods: One hundred fifty adult male Albino Rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella sativa and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds [100 mg / kg of body weight], while the fifth group was treated with the aqueous extract of Foenugreek seeds [100 mg / kg of body weight]. The sixth one was treated with the aqueous extract of Termis seeds [100 mg/kg body weight]. After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both Heamatoxylin and Eosin as well as special stain for demonstration of the different pancreatic cells in the Islet of the Langerhans

Results: The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group while the other pancreatic cells were not affected [alpha and delta cells]. The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. Also, improve dyslipidemia present in diabetic rats. The results showed that the activity of the mixture was better when compared with Nigella, Foenugreek or Termis seeds alone

Conclusions: The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on hematological parameters and lipid profile. Also, it can control most of the metabolic risk factors of CAD in diabetic rats. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required dose

Hypodectes propus (Acarina: Hypoderatidae) in a rufous turtle dove, Streptopelia orientalis (Aves: Columbiformes), in Japan

An adult male rufous turtle dove, Streptopelia (S.) orientalis (Aves: Columbiformes), was found dead in Yorii-machi Town, Osato District 369-1217, Saitama Prefecture, Japan, and subjected to necropsy. A large number of immobile hypopi (deutonymphs) of the hypoderatid mite, Hypodectes (H.) propus (Acarina: Hypoderatidae), were found individually encapsulated subcutaneously primarily in the adipose tissue. The mites were 1.43 mm in length and 0.44 mm in width on average, and had provoked mild inflammatory reactions that predominantly manifested as foamy macrophages and lymphoplasmocytes. PCR analysis using ribosomal DNA extracted from paraffin-blocked tissues produced a 240 bp band specific for hypoderatids. Based on the morphological features (distinct coxal apodemes, especially in the anterior portion) and PCR-based findings, the hypopi were identified as H. propus. To the best of our knowledge, this is the first case describing the subcutaneous mite H. propus in a rufous turtle dove, S. orientalis, in Japan. This study also highlights the use of paraffin blocks as a source of tissue DNA for molecular evaluation.

Arthroscopic anterior cruciate ligament reconstruction using quadrupled semitendinosus and gracilis tendon graft. A prospective study

The anterior cruciate ligament [ACL] is an important static stabilizer of the knee that prevents anterior translation of the tibia in relation to the femur. Several graft options exist for reconstruction of the deficient ACL. The semitendinosus/gracilis composite autograft [STG] is used widely for its potential advantages over the Patellar tendon graft. A recent increase in the popularity of the hamstring tendons has been fueled by techniques allowing the hamstring graft to be doubled or even quadrupled, theoretically improving the initial tensile strength and increasing the cross sectional diameter of the graft together with the improvement of fixation methods. This study included 24 patients 21 males [87.5%] and 3 females [12.5%] in the age group between 18 and 38 years [average 24 years]. Inclusion criteria of patients in this study were patients with symptomatic ACL deficiency manifested by repeated episodes of giving way of the affected knee with evident history of significant trauma, positive lachman's test, pivot shift tests and MRI evidence of torn ACL. The Hamstring tendon graft was harvested and prepared as quadrupled graft then sized and pretensioned. The tibial and femoral tunnels were drilled and then the graft was passed through the tunnels and fixed in the femoral tunnel using two biodegradable transfixing pins [Rigidfix] and tibial tunnel fixation was achieved using bioabsorbable interference screw. The results were assessed according to the International Knee Documentation Committee [IKDC] scale. There were 21 patients [87.5%] rated as normal or nearly normal [Grade A or B], while 3 patients [12.5%] were rated as abnormal [Grade C] and none were rated as severely abnormal [Grade D]. The difference between grades A and B [on one side] and grades C and D [on the other side] were statistically significant. There were 20 patients [83.3%] that returned to their pre-injury level of activity. Lachman testing demonstrated that 50% of patients had grade 0 laxity while 41.7% had grade I laxity with firm end point and only 8.3% had grade II laxity with firm end point while 79.2% had absent Pivot shift test. Arthroscopic anterior cruciate ligament reconstruction in ACL-deficient knees using quadrupled Semitendinosus and Gracilis tendon graft produce safe and reproducible results with low incidence of complications as harvest site morbidity, anterior knee pain and quadriceps atrophy