Neuromuscular Electrical Stimulation and Strength Recovery of Postnatal Diastasis Recti Abdominis Muscles

OBJECTIVE: To assess the effect of neuromuscular electrical stimulation (NMES) on the recovery of abdominal muscle strength in postnatal women with diastasis of recti abdominis muscles (DRAM). METHODS: Sixty women, 2 months postnatal, participated in this study. They were divided randomly into two equal groups. Group A received NMES in addition to abdominal exercises; group B received only abdominal exercises. The intervention in both groups was for three times per week for 8 weeks. The outcome measures were body mass index (BMI), waist/hip ratio, inter recti distance (IRD), and abdominal muscle strength in terms of peak torque, maximum repetition total work, and average power. RESULTS: Both groups showed highly significant (p<0.05) improvement in all outcomes. Further, intergroup comparisons showed significant improvement (p<0.05) in all parameters in favor of group A, except for the BMI. CONCLUSION: NMES helps reduce DRAM in postnatal women; if combined with abdominal exercises, it can augment the effects.

Impact of the methylenetetrahydrofolate reductase [MTHFR] C677T gene polymorphism on clinical outcomes of HLA-matched sibling allogeneic hematopoietic stem cell transplantation

Background: allogeneic hematopoietic stem cell transplantation [HSCT] is widely used to treat various hematological malignant and non-malignant diseases. The occurrence of complications following HSCTas graft versus host disease[GVHD], hepatic veno-occlusive disease [VOD], oral mucositis [OM], drug induced hepatic and renal adverse events- is highly variable and dependent on a multitude of host, donor, and treatment factors. Identifying important genetic variables will allow for better prediction of HSCTrelated outcomes, and in the process of identifiing these susceptibilities, that could help to develop targeted interventions

Objectives: to evaluate impact of the C677T polymorphism of 5,10-methylenetetrahydrofolate reductase [MTNFR] on the clinical outcomes of patients treated using human leukocyte antigen-matched sibling stem cell transplantation as acute gruff versus host disease [GVHD],oral mucositis ,drug induced hepatic and renal toxicity, transplant related mortality[TRM] and overall survival[OS]

Patients and Methods: we examined the association of a single nucleotide polymorphism [SNP] at position 677 in the MTHFR gene of patients with outcomes of allogeneic HSCT. MTHFR genotyping was performed by po2ymerase chain reaction-restriction fiagment length polymorphism [PCR-RFLP]

Results: 46 Patients with complete clinical records were recruited. Median age at the time of HSCT was 22 years [range 3-42 years]; 32 patients [69.6%] above >/=18 years, and the median follow-up period of survivors was 21 months. 212efrequencies of the MTHFR C677T genotypes in patients were 43.5% [20 patients] for 677CC, 50% [23 patients] for 677CX and 6.5% [3 patients] for 677TT; the allelic frequency of the 677T was 31.5%. Recipient MTHFR677 in CT or TT versus CC showed non-statistically significant higher incidence of acute GVHD [7/26] 26.9% versus [2/20] 10%; p=0.15, hepatic toxicity [11/26] 42.3% versus [5/20] 25%, p= 0.22 and TRM [5/26] 19.2% versus [2/20] 10%; p=0.45. Recipients with variant allele MTHFR 677T were associated with lower non statistically signijicant overall survival; p=0.281. Conclusion: Genofyping for WHFR C677T before HSCT could have clinical significance, not statistically proven in our study, in prediction of patients at high risk of developing poor outcomes. Larger studies with homogeneous HSCT cohort are needed to identifi such potential phar]nacogenetic markers with suflciently strong evidence to be used in clinical practice

Nrf2 and P73 polymorphisms in Egyptian women with breast cancer

The aim of the study was to assess the role of Nrf2 promoter and P73 G4C14 to A4T14 polymorphisms in breast cancer and the potential relation to the onset of the disease. Eighty six female patients with breast tumor were included in this study. Nrf2 [rs6721961] and p73 [G4A] genetic polymorphisms in promoter and exon2 region respectively were investigated using PCR-CTPP assay. The genotype frequencies of the three genotypes of Nrf2 promoter SNP [CC, CA, AA] showed no significant difference between benign and malignant groups. Genotype frequencies for P73 G4A SNP [GG, GA] showed no significant difference between benign and malignant groups, no patient have the AA genotype. Regarding the onset of disease, the three Nrf2 genotypes in pre - and post-menopausal patients, showed that the distribution differ significantly in the 2 patients groups and that the AA genotype is significantly higher in the pre-menopausal patients compared to post-menopausal patients. Nrf2 [rs6721961] AA genotype might be related to early breast cancer onset. P73 G4A polymorphism shows no relation to both disease risk and disease onset. Therefore Nrf2 [rs6721961] promoter genotyping might be related to the risk of pre-menopausal breast cancer

Protective effects of onion oil and selenium against cisplatin-induced nephrotoxicity and oxidative stress in rats

Nephrotoxicity is an inherent of certain anticancer drugs. This study aimed to assess the protective effect of onion oil and selenium against cisplatin-induced nephrotoxicity in male rats. Cisplatin [5 mg/kg, i.p.] caused significant increases in serum sodium, blood urea nitrogen, serum creatinine, total sodium and potassium excreted in urine, urine volume and lipid peroxides measured as the malondialdehyde content of kidney, with significant decreases in serum total protein, creatinine clearance, reduced glutathione content of kidney and kidney superoxide dismutase activity as compared to the control group. On the other hand, administration of onion oil [100 mg/kg, p.o.] or selenium [1 mg/kg, p.o.] for 14 days with a single cisplatin dose on the 10[th] day ameliorated the cisplatin-induced nephrotoxicity as indicated by the restoration of kidney function and oxidative stress biomarkers. Onion oil and selenium showed protective effects against cisplatin-induced nephrotoxicity

Genotype characterization of occult hepatitis B virus strains among Egyptian chronic hepatitis C patients

Chronic hepatitis C virus [HCV] infection combined with occult hepatitis B virus [HBV] infection has been associated with increased risk of hepatitis, cirrhosis and hepatocellular carcinoma. This study aimed to determine the prevalence of occult HBV infection among Egyptian chronic HCV patients, the genotype and occurrence of surface gene mutations of HBV and the impact of co-infection on early response to treatment. The study enrolled 162 chronic HCV patients from Ismailia Fever Hospital, Egypt, who were HBV surface antigen-negative. All patients were given clinical assessment and biochemical, histological and virological examinations. HBV-DNA was detectable in sera from 3 patients out of the 40 patients who were positive for hepatitis B core antibody. These 3 patients were responsive to combination therapy at treatment week 12; only 1 of them had discontinued therapy by week 24. HBV genotype D was the only detectable genotype in those patients, with absence of [a] determinant mutations among those isolates

Phenotypic characterization of Acinetobacter baumannii isolates from intensive care units at a tertiary-care hospital in Egypt

Multi-drug resistant [MDR] strains of Acinetobacter baumannii are responsible for an increasing number of opportunistic infections in hospitals. This study determined the prevalence of MDR A. baumannii isolates from intensive care units in a large tertiary-care hospital in Ismailia, Egypt, and the occurrence of different beta-lactamases in these isolates. Biotyping and antimicrobial susceptibility profile was done for isolated strains. Respiratory, urine, burn wound and blood specimens were collected from 350 patients admitted to different units; 10 strains [2.9%] of A. baumanniiwere isolated. All isolates showed resistance to more than 3 classes of antibiotics. Among the isolates, 6 isolates were carbapenemase producers, 2 were AmpC beta-lactamase producers and no isolates were metallo-beta-lactamase producers. Despite the low prevalence of A. baumannii infection in this hospital, the antibiotic resistance profile suggests that prevention of health-care-associated transmission of MDR Acinetobacter spp. infection is essential

Lack of association of CTLA-4 + 49 A/G polymorphism with predisposition to type 1 diabetes in a cohort of Egyptian families

Type 1 diabetes is one of the most common chronic childhood illnesses. Interplay between genetic susceptibility and environmental factors is thought to provide the fundamental element for the disease. Apart from the Major Histocompatibility locus which is the main contributor to risk susceptibility, more than 40 loci are recognized. One among these is the CTLA-4, however data from the literature are controversial. The aim of our study was to investigate the role of CTLA4 49 A/G as a risk susceptibility factor for the development of type 1 diabetes in a cohort of Egyptian families. This is a case control study including 88 Egyptian families with one or more index cases [< 18 years]. The control group comprised 369 healthy unrelated subjects with no family history of diabetes or autoimmune disease. Using PCR-RFLP methodology, CTLA4 49 A/G was analyzed in 738 samples representing 88 families [88 patients, 125 siblings and 156 parents] and 369 control. The age of onset was 6 days-12.5 years with a mean of 5.3 +/- 3.6 and a median of 5 years. The mode of presentation was classic symptoms in 51 and diabetic ketoacidosis in 37 cases. Twenty-two cases had a history of viral infection or exanthematous disease and four had associated autoimmune diseases. No significant differences were encountered between the different groups with regard to CTLA4 +49 A/G genotype or allele frequencies. Neither was there a relation between the various genotypes and age of onset or the mode of presentation. CTLA4 49 A/G polymorphism was not recognized as a risk susceptibility factor in our cohort. This may be attributed to the low co-incidence of autoimmune diseases. Up to our best knowledge, this is the first study involving families. We recommend that all studies performed on risk susceptibility to type 1 diabetes should include proper investigation for other autoimmune diseases to exclude their confounding effect on data analysis

Prevalence of venous thrombo-embolism in acute exacerbations of chronic obstructive pulmonary disease

Objectives: To determine the prevalence of venous thrombo-embolism in patients with acute exacerbations of COPD

Subjects and methods: This was a cross-sectional study involving 105 patients hospitalized with exacerbations of COPD. Clinical and hematological parameters on admission were collected. Multislice computed tomographic pulmonary angiography [CTPA] and ultrasonographic examination of lower limbs, for pulmonary embolism and deep vein thrombosis respectively were done. Wells and Geneva scores were calculated

Results: This study was conducted on 105 COPD patients with acute exacerbations. All of them were males with mean age 49.3 + 8.43. Pulmonary embolism was found in 28.6% of COPD patients who were definitely diagnosed by CTPA while DVT was found in 26.7% of positive cases of pulmonary embolism detected by venous duplex. Wells and Geneva scores were calculated, high probability Wells score was found in 83.3% while Geneva score was likely in 90% of COPD patients proved to have pulmonary embolism. D-dimer and CBC were done; D-dimer was found negative in 90.0% in patients proven not to have pulmonary embolism while was positive in 100% of the diagnosed patients. Regarding CBC; polcythemia was found in 73.3% of diagnosed cases

Conclusion: VTE appeared to be a common problem in COPD patients with exacerbations. The role of CTPA is the cornerstone in the diagnosis of pulmonary embolism. DVT of lower limbs was not essential in all cases of proven pulmonary embolism. Serum D-dimer, Wells criteria and Geneva score are useful bedside criteria that may help to assess the occurrence of VTE in such patients

Expression of MMTV-like env gene in Egyptian breast cancer patients

Mouse mammary tumor virus [MMTV] causes breast cancer in mice. DNA sequences related to MMTV-like env gene is detected in human breast cancer [EC] tissue suggesting its etiology in human BC. The objective of our study was to assess the significance of MMTV-like env gene in Egyptian BC women. One hundred and fifty archival formalin-fixed paraffin embedded breast tissues were used and divided into 2 groups; group one included 100 malignant, group two included50 benign tissues. To amplify the MMTV-like env gene, semi-nested PCR was used and to confirm the homology with the MMTV genome direct sequencing was used. MMTV-like env was efficiently detected in36%ofmalignantand 4% of benign breast tissues. Sequence analysis was evident revealed 96% homology with the MMTV genome, but no other significant similarities with the human genome

The presence of the viral sequences was associated significantly with estrogen and progesteron positive cases and insignificantly the other pathological parameters studied. The molecular analysis of breast cancer tissue confirmed the presence of MMTV-like env sequences with significant high percentages in cancerous tissues than in benign one. These data raising the possibility that MMTV viral infection may be involved in the neoplastic process

Endobronchial ultrasonography for lung cancer staging in negative mediastinum on computed tomography

Lung cancer is the most common cause of cancer -related deaths. Chest CT scan is fre-quently unreliable in staging mediastinal lymph node metastases of lung cancer, since interpretation relies on lesion size. EBUS offers a unique way of imaging and parabronchial structures. The pro-cedure is safe, minimally invasive and does not require general anesthesia or hospitalization. The complication rate is extremely low. This study was conducted on eleven patients who were found without CT evidence of enlarged mediastinal lymph nodes. Bronchoscopy and EBUS were performed for the diagnosis of lung cancer. TBLB of detected mediastinal lymph nodes was performed. CT guided biopsies were done for non-diagnosed cases. In this study bronchogenic carcinoma was diagnosed by bronchoscopic biopsy in 6 cases [54.5%], by EBUS-TBNA in 2 cases [18.2%], and by CT guided biopsy in 3 cases [27.3%]. From the eleven patients with negative CT scan, EBUS of mediastinal L.N was positive in four cases [36.4%]. The first case showed 2 small subcarinal L.N station [7] and 2 right hilar lymph node stations[10R]. In the second case EBUS detected 2 subcarinal lymph node stations [7] and one left hilar station [10L] In the third case there was one subcarinal lymph node station [7]. The fourth case showed a left hilar lymph node station [10L]. EBUS is safe and minimally invasive technique in the detection of mediastinal lymph metastasis. EBUS in combination with conventional radiologic tools may contribute to improve diagnosis and staging of lung cancer

Skin diseases in patients with primary psychiatric conditions: a hospital based study

Although the relationship between skin diseases in patients with primary psychiatric conditions is important for patient management, studies on this issue are limited. To detect the frequency and type of cutaneous disorders among patients with primary psychiatric conditions. This analytic cross-sectional study was conducted on a total of 400 subjects - 200 patients with primary psychiatric disorders and 200 age and sex matched individuals free from primary psychiatric disorders. Patients included in the study were diagnosed according to The Diagnostic and Statistical Manual of Mental Disorders [DMS IV] Criteria. A specially designed questionnaire including socio-demographic data, medical history, family history and dermatological examination was applied. The data were statistically analyzed. There was a significant statistical increase in the prevalence of skin diseases in general and infectious skin diseases in particular in psychiatric patients compared with non-psychiatric patients [71.5% versus 22%, P < 0.001] and [48% versus 11%, P < 0.001], respectively. Parasitic infestations [42.7%] were the most common infectious skin diseases in psychiatric patients [P < 0.001]. Infectious skin diseases in psychiatric patients were seen most in patients diagnosed with schizophrenia [83.6%] and least in obsessive compulsive disorders [30%][P < 0.001]. Psychogenic skin disorders were found in 8.4% of psychiatric patients with skin diseases; delusional parasitosis was the most common [50%]. Health education of psychiatric patients and/or of their caregiver and periodic monthly inspection of psychiatric patients are highly indicated for the prevention and control of infectious skin diseases in primary psychiatric patients

Nebulized magnesium sulphate versus nebulized sallbutomol in acute bronchial asthma

The aim of this study is to investigate the efficacy of nebulized magnesium sulphate as a bronchodilator in acute asthma as compared to nebulized salbutamol. This was a randomized controlled study conducted in El-Giza Chest Hospital Emergency Department between January 2010 and June 2011. Randomization was achieved by closed envelope technique. This study involved 48 known bronchial asthma patients presenting with acute or subacute exacerbations. Patients were divided into Control group [A] and Study group [B]. Initial assessment of all patients included history, clinical examination [auscultation, respiratory rate [RR], heart rate [HR] and working of accessory muscles]. In addition to measurement of peak expiratory flow rate [PEFR] and oxygen saturation [SO2]. Patients received standard treatment for their acute attacks in the form of Sodium hydrocortisone hemisuccinate 100 mg every 6 hours, Supplemental oxygen and nebulized bronchodilator which was salbutamol in group [A] in the form of 4 doses of nebulized solution 0.5 gm% [each dose 1 ml containing 5 mg salbutamol] twenty minutes apart and Magnesium sulphate in group [B] in the form of 4 doses of nebulized solution 10 gm% [each dose 1 ml containing 100 mg magnesium sulphate] twenty minutes apart. Reassessment of the patients was performed after 2 hours to detect improvement. The percent change in PEFR in Group A was significantly higher than that in Group B [58.90% and 13.92% respectively, p value 0.00]. There was a statistically significant reduction in the final mean HR in Group B compared to Group A [85 bpm and 96.1 bpm respectively, p value 0.011]. There was a significant reduction in mean final RR in Group A compared to Group B [22.17 bpm. and 25 bpm respectively, p value 0.002].There was a significant increase in oxygen saturation [SO2] in both groups. The use of MgSO4 by nebulization in patients with acute asthma attacks results in improvement of clinical condition, increase in peak expiratory flow rate [PEFR], reduction in heart rate [HR], reduction in respiratory rate [RR] and improvement in oxygen saturation [SO2]. The increase in PEFR [bronchodilatory effect] was significantly less than that achieved in patients receiving the usual treatment with Short acting beta 2 agonists, e.g. salbutamol, when either agents were used alone

Role of quantiferon TB gold assays in monitoring the efficacy of antituberculosis therapy

The impact of antituberculous treatment on [IFN]-gamma response to mycobacterial tuberculosis antigens have been widely investigated but the results have been controversial. To evaluate the role of Quantiferon TB gold assays as one of the interferon-gamma release assays [IGRAs] for monitoring the efficacy of antituberculosis therapy in patients with active disease. Thirty patients with active pulmonary TB were enrolled in this cross-sectional study where they were subjected to history taking, clinical examination, chest X-ray, direct smear examination of sputum samples for AFB using Ziehl-Neelson stain performed on three visits; up on enrollment, 2 and 6 months later. Lowenstein Jensen medium cultures of sputum samples were done for isolation of Mycobacterium tuberculosison first visit. All patients in the study group were subjected to QuantiFERON-TB Gold estimation on the three visits. The mean sensitivity and specificity of QFT-G test was 85.9% and 62.6% respectively. Using [2] analysis, there was a statistically significant association between QFT-G results and culture results upon enrollment and Acid fast bacilli positivity on second and third visits. Studying the changes in QFT-G results throughout the whole study period revealed a statistically significant decrease in number of QFT-G positive cases from 24/29 patients [82.8%] at first visit to 4/25 patients [16%] at the third visit. All 21/25 patients [84%] who became QFT-G negative at the end of the study had a complete clinical and microbiological recovery of the TB disease. The analysis of QFT-G assay results showed that in the majority of our TB patients there was a correlation between clinical treatment outcome and changes of IFN-gamma response to M. tuberculosis-specific antigens

Diagnostic value of ultrasound guided biopsy in patients with malignant pleural effusion

To study the diagnostic value of ultrasound guided biopsy in patients with malignant pleural effusion. This study involved 40 patients with malignant pleural effusion of indeterminate aetiology. All patients had a contrast CT chest performed and were divided into 3 Groups according to their radiologic appearance: GROUP 1: 10 patients having pleural effusion only. GROUP 2: 15 patients having pleural effusion and pleural thickening. GROUP 3: 15 patients having pleural effusion and pleural mass lesions. All 3 groups of patients underwent ultrasound examination in the Radiology department. In patients of Groups 2 and 3, ultrasound fluid aspiration and ultrasound guided core biopsy of the pleura were attempted. Patients of all 3 Groups performed Medical thoracoscopy in the interventional pulmonology unit. In Group 1 patients, US guided biopsy was contraindicated and could not be performed due to absence of pleural thickness, nodulation or masses. Thoracoscopy was performed in them all with a sensitivity reaching 90%. In Group 2, a malignant aetiology was reached in 5/10 cases whom had adequate tissue retrieval [sensitivity 50%]. In Group 3, 12/15 patients were diagnosed by US guided biopsy [sensitivity 80%]. The mean sensitivity of US guided biopsy in both Groups was 65%. Thoracoscopy was then performed successfully in all of patients in Groups 2 and 3 with a diagnostic sensitivity of 100% each. The mean diagnostic sensitivity of thoracoscopy for all 3 Groups was 96.7%. The US guided pleural biopsy with a Tru-cut needle is simple, safe and well tolerated. It is especially useful for patients with pleural tumour, thickened pleura, small amounts of pleural effusion or loculated pleural effusion

Role of multislice computed tomography in evaluation of colo-rectal neoplasm

Computed tomographic [CT] colonography is a noninvasive, rapidly evolving technique that has been shown in some studies to be comparable with conventional colonoscopy for the screening of colorectal cancer. The addition of intravenous contrast material to CT colonography can aid differentiation of true colonic masses from pseudolesions such as residual stool and improves the depiction of enhancing masses that might otherwise be obscured by residual colonic fluid. The aim of this study is to assess the role of multi detector computed tomographic colonography in staging of colo-rectal neoplasm and detection of synchronous lesons such as adenomatous polyp. The study included fifty-five patients with suspected colo-rectal neoplasm and underwent MDCT colonography and fibro-optic colonoscopy on the same day. The MDCT colonography with IV contrast media has 94% accuracy for identifying tumor wall invasion by colorectal carcinoma and 71% accuracy for identifying regional lymph nodes involvement and the sensitivity of both MDCT colonography and fibro-optic colonoscopy equal in detection of polyps more than 5 mms. The contrast enhanced MDCT colonography is an excellent investigating tool in staging of colo-rectal neoplasm in detection of synchronous adenomatous polyps more than 5 mms

Alveolar hemorrhage in systemic lupus erythematosus: an overview

Alveolar hemorrhage [AH] is a rare, but serious manifestation of SLE. It may occur early or late in disease evolution. Extrapulmonary disease may be minimal and may be masked in patients who are already receiving immunosuppressants for other symptoms of SLE. The capacity of AH to occur and recur despite ongoing immunosuppressive therapy is emphasized. Reporting our experience with alveolar hemorrhage in patients with systemic lupus erythematosus. Records of SLE patients admitted between years 2000 and 2008 were reviewed. Seven patients with SLE admitted with nine episodes of AH were found. For all study subjects, the pertinent demographic, clinical, laboratory, histologic, therapeutic and outcome data were abstracted and chest X-ray reviewed. The disease activity was assessed using SLEDAI. The seven patients were females. Their age ranged from 17 to 35 years and disease duration ranged from 4 to 48 months. AH occurred within 4 months of SLE onset in two patients. All patients presented with hemoptysis, new pulmonary infiltrates and hemoglobin drop. Glomerulonephritis was the most common extrapulmonary SLE manifestation [85%]. Initial treatment included IV methylprednisolone in all cases [100%], with cyclophosphamide in four episodes. Plasmapheresis [one session] was done in only one episode. Survival rate was 14%.Alveolar hemorrhage is a rare but lethal complication of SLE and represents a remarkable challenge. It should be diagnosed promptly with falling red cell indices and new infiltrates on chest radiograph. It occurs in vicinity of active disease. Lupus nephritis is most associated manifestation. Alveolar hemorrhages frequently recur despite ongoing immunosuppressant therapy. Early treatment with intra venous [IV] pulse methylprednisolone and IV cyclophosphamide should be instituted for a better outcome

Formulation and evaluation of albendazole solid-dispersion

A solid-dispersion of the drug can be formulated using a polymer carrier to improve its solubility. Solid dispersions were prepared using different polymers [polyethylene glycol [PEG] 4000, 6000, 8000, polyvinylpyrrolidone K30 [PVP K30], hydroxypropylmethylcellulose [HPMC], hydroxypropyI-beta- cyclodextrin [HP beta CD], poloxamer [PXR] 188 and 407], with drug: polymer ratios [1.1, 1:2, 1:4] by the solvent evaporation as well as the spray drying techniques to improve dissolution rate of albendazole [ABZ]. It was found that the dissolution rate of the drug was affected by both the polymer type and the ration of ABZ to polymer. Spray drying technique showed enhanced dissolution compared to the solvent evaporation method. The highest dissolution of ABZ was obtained with HP beta CD followed by HPMC and PVP K30 in drug: polymer ration 1:4, 1:4 and 1:2 respectively, prepared by the spray drying technique. Morphology and characteristics of albendazole alone as well as its microparticles from the spray drying technique with the highest dissolution result were studied and photographed. Smooth surface and spherical microparticles of ABZ were detected that indicates the possible coating of the drug crystals by the polymers. Physicochemical properties of the drug alone and its spray dried microparticles were investigated using Fourier transform infrared spectroscopy [FTIR], differential scanning calorimetry [DSC] and X-ray powder diffraction [PXRD]. These investigations showed that ABZ transformed from the crystalline state to amorphous state by the spray drying using the polymers mentioned as confirmed by disappearance of its melting peak and the characteristic crystalline peaks. The transformation of ABZ from the crystalline to the amorphous state by the spray drying and the hydrophilic coating of drug particles by the polymers are considered among the factors that enhance the improvement of ABZ dissolution

Sub-antibiotic doses of erythromycin as a prokinetic in abdominal surgeries: reviving the old

All patients undergoing major abdominal procedures have some degree of gastric atony in the immediate postoperative period, presenting mainly with vomiting. Many prokinetic agents have been used in the past, but none is a universal remedy. Studies showed that subantibiotic doses of erythromycin, a macrolide. antibiotic and motilin agonist, accelerates gastric emptying. This study investigated whether preoperative subantibiotic dose oral erythromycin [250 mg], altered residual gastric volume and postoperative adverse effects in patients scheduled for abdominal surgeries. Erythromycin was compared with the commonly used prokinetic metoclopramide and antiemetic ondansetron, in terms of prokinetic efficacy, cost and adverse effects. In a double-blind study, eighty patients [20 each] were allocated randomly to receive orally, either erythromycin 250 mg [E250] or erythromycin 500 mg [E500], or 10 mg metoclopramide [M], or 4mg ondansetron [Z], an hour pre-induction of anesthesia. Preoperative oral erythromycin in subantibiotic dose 250mg elicited a significantly lower residual gastric volume [P<0.001] and a lower VAS for vomiting, compared with ondansetron. As for metoclopramide and erythromycin 500, residual gastric volume was comparable, but E 250 had a lower VAS for vomiting than both groups. Rescue remedy for vomiting was required for groups E500, M and Z [100, 10 and 10 %] compared to 0% in group E250. Ultimately, subantibiotic oral dose of erythromycin [250 mg], given1 hr preoperatively, is an inexpensive prokinetic alternative with a promising post-operative profile which may be superior to the inexpensive prokinetic metoclopramide with known adverse effects, and the expensive antiemetic ondansetron

[Ear nose sarcoma. Reprt of 3 cases]

Head and neck sarcoma are very rare malignant tumors which can occur on any different ENT localization. The authors report tree different variety of ENT sarcoma diagnosed and treated at the oto-rhino-laryngological department of military hospital of Tunis. We intend to remind of clinical and histological particularities, therapeutic modalities and finally to evaluate the follow-up. From 2001 to 2007, three cases of head and neck sarcomas were diagnosted in ENT department of military hospital of Tunis. the study concerned a women [22 years old] and two men 36 and 76 years old. It deals with an orbital rhabdomyosarcoma, a carcinosarcoma of submandibular gland and a maxillary chondrosarcoma. In each case, diagnosis was validated by the immunohistochemistry. All patients had surgical removal of their tumor. External irradiation or/and chemotherapy was also indicated for all cases. ENT sarcomas are aggressive neoplasm. Long-term survival is bad with high potentialities of local recurrence and distant metastases

Synthesis of some new 2-[[E]-2-furan-2-yl-vinyl]- 3H- quinazolin-4-one derivatives of expected biological activity

A new series of 2-[[E]-2-furan-2-yl-vinyl]-3H-quinazolin-4-ones incorporated into diverse N, O and S heterocyclic moieties of bioavailability as.5-oxo-4,5-dihydropyrazole 4, 3,5-dimethylpyrazole 5, 5-mercapto-1,2,4-triazole 6, substituted thiazolidinones 8 and 1,3,4-thiadiazole 10, were synthesized by cyclization of the starting quinazolinone acid hydrazide 3 or the acid hydrazide Schiff bases 7 using ethyl acetoacetate, acety I acetone, ammoniumthiocyanate, thioglycolic acid and/or phosphorus pentasulphide, respectively. Other related derivatives such as quinazoline thiosemi - carbazides II and 1,3,4-oxadiazoles 12 were also synthesized. The acid hydrazide 3 showed moderate antimicrobial activity While the starting benzoic acid ethyl ester 2 showed promising anti-inflammatory activity but has no effect on liver carcinoma [HePG2] or brain carcinoma [U251] cell lines