Clinical features clusters in systemic lupus erythematosus

Background: Systemic lupus erythematosus [SLE] is a multi-systemic heterogeneous autoimmune disease. Attempts have been made trying to classify lupus into more homogenous subsets with pathogenic, therapeutic, or prognostic significance

Objective: was to evaluate the possibility of existence of the main clinical features of Systemic Lupus Erythematosus [SLE] in clusters

Patients and methods: The demographic data, cumulative clinical and laboratory features of 150 Egyptian SLE patients were studied. Some of the main clinical manifestations were then selected for cluster analysis using the K-means cluster analysis procedure

Results: Three distinct groups of patients were identified. Cluster 1 [n: 27] showed higher age at diagnosis and was characterized by high prevalence of mucocutaneous manifestations [malar rash, discoid rash, photosensitivity, oral ulcer] and arthritis but having low prevalence of serositis and hematologic manifestations [hemolytic anemia, leukopenia, and thrombocytopenia]. Patients in cluster 2 [n: 81] showed mainly renal and hematological manifestations but had the lowest prevalence of mucocutaneous manifestations and arthritis. Cluster 3 patients [n: 42] had the most heterogeneous features; they had a high prevalence of mucocutaneous manifestations, serositis, hematologic manifestations and renal involvement

Conclusion: patients with systemic lupus erythematosus could be divided into clusters of distinct patterns of clinical manifestations

Comparative study between computed tomography guided superior hypogastric plexus block and the classic posterior approach: a prospective randomized study

The classic posterior approach to superior hypogastric plexus block [SHPB] is sometimes hindered by the iliac crest or a prominent transverse process of L5. The computed tomography [CT] - guided anterior approach might overcome these difficulties. This prospective, comparative, randomized study was aimed to compare the CT guided anterior approach versus the classic posterior approach. Controlled randomized study. A total of 30 patients with chronic pelvic cancer pain were randomized into either classic or CT groups where classic posterior approach or CT guided anterior approach were done, respectively. Visual analog score, daily analgesic morphine consumed and patient satisfaction were assessed just before the procedure, then, after 24 h, 1 week and monthly for 2 months after the procedure. Duration of the procedure was also recorded. Adverse effects associated with the procedure were closely observed and recorded. Student's t-test was used for comparison between groups. Visual analog scale and morphine consumption decreased significantly in both groups at the measured times after the block compared with the baseline in the same group with no significant difference between both groups. The procedure was carried out insignificantly shorter duration in the CT group than that in the classic group. The mean patient satisfaction scale increased significantly in both groups at the measured times after the block compared with the baseline in the same group. The patients in the CT groups were significantly more satisfied than those in classic group from day one after the procedure until the end of the study. The CT guided approach for SHPB is easier, faster, safer and more effective, with less side-effects than the classic approach

Review of choroidal osteomas

Choroidal osteomas are rare benign ossifying tumors that appear as irregular slightly elevated, yellow-white, juxtapapillary, choroidal mass with well-defined geographic borders, depigmentation of the overlying pigment epithelium; and with multiple small vascular networks on the tumor surface. Visual loss results from three mechanisms: Atrophy of the retinal pigment epithelium overlying a decalcified osteoma; serous retinal detachment over the osteoma from decompensated retinal pigment epithelium, and most commonly from choroidal neovascularization. Recent evidence points to the beneficial effects of intravitreal vascular endothelial growth factor antagonists in improving visual acuity in serous retinal detachment with or without choroidal neovascularization

Role of multidetector computed tomography in the diagnosis of congenital thoracic vascular anomalies

Congenital vascular anomalies of the thorax represent an important group of entities that can occur either in isolation or in association with different forms of congenital heart diseases. CT scan is a non invasive and rapid technique used for evaluation of the pediatric vascular disease as an alternative to conventional angiography. To assess the role of MDCT scan in evaluation and its ability to diagnose congenital thoracic vascular anomalies as well as to recognize these anomalies early for proper treatment and post operative follow up. The studied group included 80 patients, who underwent MDCT angiography and had diagnosed of congenital thoracic vascular anomalies, post operative follow up or asymptomatic [incidentally discovered] were included in this study. CT angiography can diagnosis about 13% [n=6] of cases not seen very well by echocardiography [inconclusive] and 26% [n=12] of cases appear as different findings by CT scan than echocardiography. Three dimensions [3D] images allow excellent display of vascular anomalies that can be used as a vascular road map by surgeons. MDCT provides reliable diagnostic information on the normal anatomy of the aorta, pulmonary and vena cava as well as congenital anomalies in pediatric and adult patients. MPR and 3D VR images have increased the diagnostic value of CT. Furthermore, coronal and sagittal views of the vessels facilitate the orientation of a surgeon, and thus aid in planning surgery

Cluster bomb ocular injuries

To present the visual outcomes and ocular sequelae of victims of cluster bombs. This retrospective, multicenter case series of ocular injury due to cluster bombs was conducted for 3 years after the war in South Lebanon [July 2006]. Data were gathered from the reports to the Information Management System for Mine Action. There were 308 victims of clusters bombs; 36 individuals were killed, of which 2 received ocular lacerations and; 272 individuals were injured with 18 receiving ocular injury. These 18 surviving individuals were assessed by the authors. Ocular injury occurred in 6.5% [20/308] of cluster bomb victims. Trauma to multiple organs occurred in 12 of 18 cases [67%] with ocular injury. Ocular findings included corneal or scleral lacerations [16 eyes], corneal foreign bodies [9 eyes], corneal decompensation [2 eyes], ruptured cataract [6 eyes], and intravitreal foreign bodies [10 eyes]. The corneas of one patient had extreme attenuation of the endothelium. Ocular injury occurred in 6.5% of cluster bomb victims and 67% of the patients with ocular injury sustained trauma to multiple organs. Visual morbidity in civilians is an additional reason for a global ban on the use of cluster bombs

[ effect of intra abdominal wall infiltration with bupivacaine in reducing postoperative diclofenac need in elective cesarean sections]

Considering the side-effects of opiums and NSIADS drugs such as respiratory depression, apnea and GI effects, today it has been paid more attention to intra abdominal wall infiltration of local anesthetics for this purpose. The aim of this study is to determine the effect of intra abdominal wall infiltration with bupivacaine to reduce post operative diclofenac need in elective cesarean sections. In this double- blind, placebo-controlled trial, 60 healthy women with single term pregnancy underwent spinal anesthesia were randomized into two groups. Patients, then received a combination of 30cc of bupivacaine with 1.5cc of epinephrine as intra abdominal wall infiltration or equal volume of saline in cesarean section at the time of abdominal closure. Pain was assessed using a visual analogue scale 1, 2, 3, 4,8 and 12 h after the operation. Also mean diclofenac consumption was assessed during 12 h after the operation. The final analysis was done with statistical tests by SPSS [P<0.05 was considered significant]. Mean pain scores at 1 and 2 h after the operation was significantly lower in bupivacaine group than placebo [p<0.05]. Mean diclofenac consumption was lesser in bupivacaine group than placebo [p<0.05]. Also the time we prescribed diclofenac in bupivacaine group was later [p<0.05]. Intra abdominal wall infiltration with 30cc of 0.25% bupivacaine leads to less paid and less diclofenac consumption at the first hours after cesarean section

value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sjogren's syndrome

The conventional sialography [CS] and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjogren's syndrome [SS]. However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging [MRI] has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography [MRS] protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients

[Survey relationship between the severity of hyperemesis gravidarum and fetus sexuality]

Hyperemesis Gravidarum [HG] is the extreme amount of nausea and vomiting during pregnancy. The incidence of this problem is between 0.3- 2%. HG is multifactorial disorder which fetal sexuality is one of them and some studies indicated the relation between HG and female fetus. Survey the relationship between the severity of hyperemesis gravidarum and fetus sexuality. All medical cases of pregnant women who referred to Alzahra hospital from 1997 to 2007 were considered as a descriptive- analytical study. Known cases of HG were selected [separated] between them. Variables such as fetal sexuality, duration of hospitalization, age, parity, pregnancy trimester, biochemical tests were extracted and analyzed with SPSS 14 and Fisher exact test. Among 197 cases, 150 cases [76.14%] were selected because of their full information 80.2% of women with female fetus, stayed >/= 4 days at the hospital. This amount was 33.9% in women with male fetus [p< 0.0001]. Ketonuria >/= 3+ [P0.016], Hyponatremia [P0.035], Hyperuremia [P0.045] were 16.5%, 41.8%, 62.6% in the first group and this amount were 3.4%, 23.7%, and 3.61% in the second group. 84.6% of women with female fetus and 64.4% of women with male fetus hospitalized in their first trimester [p=0.006]. HG was sever in 79.1% of women with female fetus and 61% of women with male fetus [p= 0.025]. This study showed statistical relationship between fetus Sexuality and severity of HG. The severity of this problem get raised with ketonuria, Hyperurmia, Hypernatermia and hospitalization in the first trimester

Oseltamivir resistance mutation N294S in human influenza A [H5N1] virus in Egypt

In December 2006, three human specimens were received that were suspected positive for influenza A[H5N1]. The specimens were tested using real time PCR. And the presence of A[H5N1] virus was confirmed in 2 patients [16F and 26M], The NA sequence from A[H5N1] positive specimens collected before and after antiviral therapy revealed a mutation [N294S] [N295S according to N1 numbering], previously associated with resistance to oseltamivir. When tested with NA inhibition assays, the two N294S viruses from Egypt exhibited from 57 to 138-fold reduction in susceptibility to oseltamivir, depending on the assay. To our knowledge, this is the first time oseltamivir resistance has been detected in A[H5N1] infecting a human prior to treatment

Potential protective role of vitamins C and E administration on renal and retinal toxicity induced by organophosphorus compound chloropyrifos

The potential protective role of combined administration of vitamins C and E was sought to ameliorate the toxicity of chloropyrifos [organophosphorus compound]. Biochemical and histological effects were studied on blood, kidney and retina of rats. 40 Wistar strain rats were divided into 4 groups. Group I was the control group which received an equivalent volume of saline i.m and i.p daily for 7 days; group 11 was the model of toxicity which was induced by an oral administration of a single dose of 63mg/kg chloropyrifos dissolved in corn oil; group III was the model of toxicity treated daily for 7 days a single I.M. injection of vitamin C and I.P injection vitamin E and group IV was the positive control which received the vitamins without any toxicity induction, blood samples were taken at the 7[th] day of experiment, then erythrocytes reduced glutathione [GSH], serum malondialdehyde [MDA] and soluble FAS ligand [sFASL] concentrations were tested. The animals were then sacrificed and specimens of kidneys and retinas were collected and processed for paraffin sections and semithin sections to be examined by light microscope. The biochemical parameters showed significant improvement after vitamin C and E administration also the histological pictures of kidneys and retinas were improved as compared to the toxicity model rats. Combined administration of vitamins C and E can reduce oxidation, apoptosis and histopathological changes of kidney and retina induced by organophosphorus compound chloropyrifos toxicity

Toxoplasmosis among pregnant women in Qualyobia Governorate, Egypt

This study was conducted between August 2007 and October 2008 to identify the sero-prevalence of Toxoplasma gondii among pregnant women of different ages and stages of gestation. Latex agglutination test was used as screening test. ELISA-IgG and IgM tests measured for the Toxo-Latex positive cases to identify toxoplasmosis clinical status. The results indicated that the prevalence of T. gondii among pregnant women was relatively high in the rural [57.6%] than urban [46.5%] areas. The positivity was correlated, in general, with age as it was higher in the older age groups. No specific clinical pictures were noticed in different patients with variable proportions, as well as a less marked correlation between Toxo-latex positive cases and having toxoplasmic congenital babies. But, neither correlation was detected between the history of congenital toxoplasmosis, or contact with cats and the Toxo-latex out-come results. An acute newly infected pregnant women during their first trimester of pregnancy that represents the rate of incidence of T. gondii in which ELISA-IgM positive and ELISA-IgG negative, was 23 cases [27.05%] and v.v. was 20 [23.54]. The interpretation of IgM and IgG was given

Potential antidiabetic and hypolipidemic effects of propolis extract in streptozotocin-induced diabetic rats

Free radicals have been implicated in the pathogenesis of diabetes mellitus leading to various complications including atherosclerosis. Propolis was reported to have oxygen radical scavenging activity. The present study was designed to investigate the possible antidiabetic, hypolipidemic and antioxidant effects of ethanolic extract of propolis [EEP]. Type[2] diabetes was induced in rats by injection of streptozotocin [STZ] in a dose of 60 mg/kg bwt, i.p. for 3 consecutive days. After 5 weeks of STZ injection, there were an apparent reduction in the animal body weight amounting to 21% and significant increases in serum glucose [184%], triglycerides [63%], total cholesterol [43%] and low density lipoprotein-cholesterol [LDL-C] [148%] with a concomitant decrease in serum high density lipoprotein-cholesterol [HDL-C] [51%] as compared to the control normal group. In addition, there was significant elevation in pancreatic lipid peroxides measured as malondialdehyde [MDA] and serum nitric oxide [NO] amounting to 185% and 224%, respectively with marked reduction in serum reduced glutathione [GSH] andcatalase [CAT] [66% and 31%, respectively] and pancreatic superoxide dismutase [SOD] [54%] in STZ-treated rats. On the other hand, oral daily treatment of animals with EEP in a dose of 200mg/kg bwt for a period of 5 weeks ameliorated STZ-induced alterations in the animal body weight as well as in serum glucose, lipids, lipoproteins, NO, GSH and CAT and pancreatic MDA and SOD. In conclusion, propolis extract offers promising antidiabetic and hypolipidemic effects that may be mainly attributed to its potent antioxidant potential. Further studies will be needed in future in order to determine which one[or more] of its active constituents has the main antidiabetic and hypolipidemic effects

Hepatitis C virus infection and gene expression of hepatocellular carcinoma in Egyptian patients

Gene expression profiling of hepatocellular carcinoma [HCC] is promising for refining the diagnosis and prognosis as well as identifying potential therapeutic targets. Our study aimed to study the gene expression in 40 HCC patients infected with hepatitis C virus [HCV] using RT-PCR technique on surgical liver sample. Gene expression changes in HCV-positive group were compared with gene expression in HCV-negative group. Four genes were included in this study, AFP gene, CD10 gene, HGF gene and GRB2 gene. The expression of the four genes were slightly higher in HCV positive group than in HCV negative group, however, the difference between the two groups was non-significant. HGF gene was expressed in only 20% of HCC patients and GRB2 gene was expressed in 95% of HCC patients. AFP gene and CD10 gene were expressed in all patients. AFP gene, CD10 gene and GRB2 gene play an important role as diagnostic markers of HCC

Obesity and its relationship with glycemic control in type-2 diabetes

Obesity is central to the development of insulin resistance, leading to type 2 diabetes and cardiovascular disease, among other serious medical conditions. In patients with type 2 diabetes, the benefits of weight loss include both improved overall glycemic control and cardiovascular disease risk profile. The aim of the present work was to study the pattern of overweight and obesity in type-2 diabetes. The Specific objectives included determination of the prevalence of the overweight and obesity among type-2 diabetes and assessment of their effects on the glycemic control. A cross sectional design was used. The target population was type-2 diabetic patients in Ismailia City, Egypt. The study population was type-2 diabetics attending the family medicine clinic in Ismailia University hospital. The study included 220 type-2 diabetics who were screened for overweight and obesity. The present study illustrates that, only 14.5% of type-2 diabetics had BMI within the normal range, [35% of male patients and 8% of female patients], while 45.9% were overweight; the percentage of overweight male patients was higher [50%] than female patients [45%]. Obesity was found in 39.5% of the patients [15% of the male and 47% of the female patients]. Extreme obesity was detected only in females [18%]. The glycosylated hemoglobin [g%] of overweight [11.5 +/- 2.7] was significantly different from that of the obese patients [13.2 +/- 3.6]. The study demonstrates, also, that fasting blood sugar [mg/dL] of diabetic patients with normal BMI [155.9 +/- 70.5] was significantly different from each of the overweight [227.5 +/- 87.7] and obese diabetics [210.9 +/- 79.9]. Overweight and obesity are highly prevalent in type-2 diabetics. Also increase in the BMI is associated with poor glycemic control. These findings signify life style modifications that are immensely needed to decrease the bodyweight and improve the glycemic control

Isolation of cryptococcus, candida, aspergillus, rhodotorula and nocardia from meningitis patients in Egypt

Meningitis occurs throughout Egypt and is largely attributed to bacterial pathogens, but there is little information on fungal etiologies of meningitis. We, therefore, investigated fungal infections among Egyptian patients with acute and subacute meningitis who tested negative for bacterial and viral agents. A total of 1000 cerebrospinal fluid [CSF] samples collected from nine governorates of Egypt during 1998-2002 were initially stained with Gram's, India ink, and lacto-phenol cotton-blue stains, and examined under light microscope to detect fungal elements. All CSF samples were cultured on brain heart infusion, Wickerham and Staib agar media for fungus isolation. CSF with suspected Cryptococcus neoforntans infections were also tested by latex agglutination test for antigen detection. Species identification of selected isolates was carried out at the Mycotic Diseases Branch, CDC, Atlanta, Georgia, USA. Fungal agents were detected microscopically and by culture in 17 of 1000 [1.7%] CSF samples tested. Ten of 17 were identified as C. neoformans var grubii [serotype A], 4 as Candida albicans, and one each of Aspergillus candidus, Rhodotorula mucilaginosa [rubra] and Nocardia spp [actinomycetes]. Out of the 17 cases with fungal CSF infection, 8 died [Cryptococcus-3. Candida-2, AspergiUus, Rhodotorula and Nocardia] and 2 suffered neurological sequelae. Of the 10 cryptococcal meningitis patients, 4 were HIV positive and one was diagnosed with lymphoma. To our knowledge, this is the first study on isolation of fungi other than Cryptococcus from CSF of Egyptian patients with acute/subacute meningitis. Consideration must now be given to cryptococcosis and candidiasis as potential etiologies of meningitis in Egypt

Ginkgo biloba extract [EGb761] normalizes hypertension in 2K, 1C hypertensive rats: roles of antioxidant mechanisms, ACE inhibiting activity and improvement of endothelial dysfunction

In the 2 kidney, 1-clip [2K, 1C] experimental renovascular hypertension, the early phase of elevation of blood pressure is associated with increase in plasma renin activity, and circulating angiotensin II which exerts a vasoconstrictor effect and increases aldosterone production. However, the progression and maintenance of the elevated blood pressure is mediated, in part, by angiotensin II-induced production of reactive oxygen species [ROS] which may promote endothelial dysfunction. The aim of the present study was to examine the possible antihypertensive effect of a standardized extract of Gingko biloba [EGb 761] in 2K,1C renal hypertensive rats and try to correlate it with the effect of the extract on oxidant status, ACE activity and vascular reactivity towards several vasoactive agents. Hypertension was induced using silver clip on renal artery by surgery. Four weeks after surgery, two sets of experiments were preformed. In the first set five groups of rats were selected; Sham-operated control, hypertensive control, and three hypertensive groups treated with the EGb 761 extract at 3 dose levels [60, 90, and 180 mg/kg/day; po] respectively for three weeks. Systolic blood pressure [SBP], heart rate [HR], lipid peroxidation measured as malondialdehyde [MDA], gIutathione peroxidase [GSH-Px] activity, nitric oxide [NO] level and angiotensin converting enzyme [ACE] activity were determined in blood, the ischemic kidney and the non-clipped contra-lateral kidney homogenates. In the second set of experiments three groups of animals were selected; Sham-operated control, hypertensive control, and hypertensive group treated with the EGb 761 [180 mg/kg/day; po] for three week after which the animals were sacrificed, the thoracic aortae isolated and prepared as rings for testing their reactivity towards the vasoactive agents norepinephrine [NE], acetyicholine [Ach], and sodium nitroprusside [SNP]. Results showed that clipping of the renal artery significantly elevated the SBP which reaches a plateau after 4 weeks, without any significant change in the HR. MDA significantly increased in serum and the clipped kidney. GSH-Px significantly decreased in the ischemic kidney while it was significantly elevated in serum and the contra-lateral kidney. NO level as well as ACE activity significantly increased in both kidneys without being affected in blood. There was impairment in both endothelium-dependent and independent relaxation of aortic rings towards Ach and SNP respectively. Treatment with EGb for 3 weeks produced a dose-dependent reduction in the SBP of the hypertensive rats and succeeded to normalize it with the highest dose level [180 mg/kg/day]. This antihypertensive action was associated with recovery of GSHPx activity in the ischemic kidney, inhibition of ACE activity in both kidneys, reduction of elevated NO in the non-clipped kidney, decreased responsiveness to the vasoconstrictor NE and improvement of endothelial function as evidenced by restoration of endothelium-dependent vasorelaxation induced by Ach

Study of the antihypertensive effect of olea europea extract [EFLA 943] in renal hypertensive rats: roles of ACE activity, redox state, and vascular liorepinephrine responsiveness

Standardized extract from leaves of Olea europea [EFLA 943] constitutes a mixture of biologically active natural products with a broad range of pharmacological activities. It has received a great deal of attention recently with respect to its cardiovascular effects. The present work has been undertaken to assess the possible potential antihypertensive effect of the extract and try to correlate it with its effect on oxidant status, ACE activity and vascular reactivity in the 2-kidney, 1-clip [2K, 1C] renal hypertensive rats. Two sets of experiments were performed. In the first set 3 groups of rats were selected; Sham-operated control, hypertensive control, and EFLA 943-trcated hypertensive groups. Hypertension was induced using silver clip on the renal artery by surgery. Four weeks after surgery, a single daily dose of 180 mg/kg/day; po of EFLA 943 was given for three weeks. Blood pressure was measured by the tail-cuff method weekly. ACE activity, malondialdehyde [MDA], glutathione peroxidase [GSHPx], total protein thiols [Pr-SHs], and nitric oxide [NO] were determined in the clipped kidney non-clipped kidney and blood. A second set of experiments with 3 groups and similar treatment like the first one was conducted but at the end of the treatment period rats were sacrificed, the thoracic aortae isolated and prepared as rings for testing their reactivity towards norepinephrine [NE], acetylcholine [Ach], and sodium nitroprusside [SNP]. Results showed that clipping of the renal artery significantly elevated the systolic blood pressure [SBP] which reaches a plateau after 4 weeks. MDA significantly increased in serum and the clipped kidney GSH-Px significantly decreased in the ischemic kidney while it was significantly elevated in serum and the contra-lateral kidney. NO level as well as ACE activity significantly increased in both kidneys without being affected in blood. There was impairment in both endothelium-dependent and independent relaxation of aortic rings towards Ach and SNP respectively. Treatment with EFLA 943 produced a significant reduction in the SBP of the hypertensive rats. This antihypertensive action was associated with inhibition of ACE activity in the non-clipped kidney, reduction of serum MDA, decrease in total Pr-SHs normalization of NO in both kidneys, and recovery of GSHPx activity in the ischemic kidney, together with decreased responsiveness to the vasoconstrictor NE

effects of oral grape seed extract on cisplatin-induced cytogenotoxicity in mice

The present investigation was directed to study the possible chemoprotective activity of orally administered grape seed extract [GSE] against cisplatin-induced cytotoxicity and genotoxicity towards mouse somatic and germinal cells in vivo. Pretreatment of mice with GSE [100 mg/kg/day] for 7 days and simultaneously with a single dose of cisplatin [2.2 or 5.5 mg/kg, i.p.] for another day, significantly reduced the frequency of bone marrow micronucleated polychromatic erythrocytes by factors of 1.9 and 1.28, respectively. Furthermore, GSE caused a reduction in bone marrow suppression induced by cisplatin treatment, particularly before the lower dose. In male germline, orally administration of GSE [100 mg/kg/day] for 7 consecutive days before and 7 consecutive days after treatment with a single dose of cisplatin [2.2 or 5.5 mg/kg, i.p.], significantly elevated the levels of sperm motility reduced by cisplatin treatment. Furthermore, GSE significantly decreased the elevated levels of sperm head abnormality induced with cisplatine by factors of 1.6 and 1.2, respectively. Our results indicate that GSE plays a role in attenuating the genotoxicity induced by cisplatin and may provide decreases in the development of secondary malignancy and abnormal reproductive outcomes risks

Percutaneous coronary intervention in diabetics versus non diabetics

This study was conducted to compare the clinical outcome of percutaneous coronary intervention [PCI] in diabetics versus non diabetics. The study involved fifty three patients, thirty diabetic patients and twenty three non diabetic patients as a control group. All patients were subjected to thorough history taking, physical examination, electrocardiography, routine laboratory work up and echocardiography pre-catheterization .Sixty-four stents were inserted, thirty-eight of them in diabetic patients and twenty six in the non -diabetic patients. All patients had coronary angiography pre immediately post stenting and at follow-up within 6 months and the diameter of the vessel was calculated before, immediately post and at follow up angiography. Also the time of inflation and the maximum pressure, stent diameter, type, and length of stents were recorded. Statistical analysis of the results of this study showed a significantly higher incidence of stent restenosis among diabetic group compared to non diabetic group. 14 patients in the diabetic group had stent restenosis versus 6 patients in non diabetic group [P<0.05]. Also, the incidence of stent restenosis was significantly higher among patients presenting with unstable angina, left ventricular dysfunction, IDDM, total coronary occlusion and those who experienced coronary dissection during PCI. At follow up Coronary angiography, the mean TIMI flow of non diabetic patients was 2.6 +/- 0.82 and for diabetic group was 2.17 +/- 1.2 and the difference was statistically significant [P < 0.05]. Regarding complications during PCI 3 patients [10%] in diabetic group had acute coronary occlusion versus non of the non diabetic group. The results showed that stent restenosis was significantly higher among diabetic patiens than non diabetics and the incidence of restenosis was particularly higher amonge diabetic patients having unstable angina, left ventricular dysfunctton, ZDDM, type B or C coronary lesions and those who experienced coronary dissection during PCI