Outer membrane proteins of Salmonella typhimurium as an adjuvant in rabies vaccine

Purpose@#The objective of the present study was to evaluate the immune-enhancing potential of Salmonella typhimurium outer membrane protein (OMP) and alum as adjuvants towards inactivated Vero cells rabies vaccine (FRV/K2). @*Materials and Methods@#Six groups of female Sprague Dawley albino rats (10/group) were used in the evaluation of immunogenicity and safety of vaccines and adjuvants. Total immunoglobulin G secreted interferon-gamma (IFN-γ), and the percentage of proliferated CD4+ and CD8+ T cells were measured. Biochemical analysis and histopathological examination were used to test safety profiles. @*Results@#OMP adjuvanted rabies vaccine (FRV/K2+OMP) (OMP combined locally prepared vaccine) induced significantly higher neutralizing antibodies on day 21 post-vaccination relative to free (FRV/K2) vaccine and alum adsorbed vaccine (FRV/K2+alum) (alum adsorbed locally prepared vaccine). (FRV/K2+OMP) induced a significantly higher level of IFN-γ on day 14 post-vaccination. CD8+ T cells were significantly higher post-vaccination with reference (RV), free (FRV/K2), and (FRV/K2+OMP) than (FRV/K2+alum). On the contrary, CD4+ T cells were significantly elevated post-vaccination with (FRV/K2+alum) at p<0.05. Biochemical analysis and histopathological examination revealed that OMP could be used safely as an adjuvant for the development of more effective rabies vaccines. @*Conclusion@#Outer membrane proteins adjuvanted rabies vaccines would be beneficial to induce rapid neutralizing antibodies and essential cytokines.

Serum hepcidin level and disease course of acute leukemia in children

Acute leukemia [AL] is a heterogeneous group of hematopoietic neoplasms and it is the most common childhood malignancy. Many patients with AL develop severe anemia that requires multiple blood transfusions. Hepcidin expression may play a role in anemia which is often seen in these patients. The aim of this study is to evaluate the role of hepcidin in acute lymphoblastic leukemia in children in Egypt. 60 patients with acute lymphoblastic leukemia [ALL] and 20 age and gender matched healthy children, taken as control group, were included in the study. Complete blood count [CBC], Serum ALT and serum AST were measured by colorimetric methods. Serum hepcidin and ferritin were measured by ELISA. The study showed a significant difference between newly diagnosed ALL cases and other groups regarding all CBC parameters. There was a significant difference in serum levels of hepcidin and ferritin between studied groups. A significant negative correlation was found between serum level of hepcidin and ferritin and each of hemoglobin level and reticulocytic count%, while significant positive correlation was found between hepcidin and ferritin serum levels. From this study, it could be concluded that serum hepcidin level is elevated in ALL children patients at time of diagnosis and correlates with the disease extent. Hepcidin may be one of the serum markers that accounting for anemia associated with ALL in children

Sleep Problems in children with Down syndrome

Background:sleep problems are significant source of distress for families with a case of Down Syndrome [DS]. Parental perception of sleep problems is an important contributor to a family quality of life

Aim of the Work: the aim of the present work was to study the sleep problems in children with Down syndrome

Subjects and Methods: this study was carried out on 50 children with DS attending the neurology clinic in Alexandria University Children Hospital together with 50 apparently by healthy children with matched age and sex. Parents were interviewed in order to collect data using predesigned questionnaire. Sleep problems were assessed using the Children's Sleep Habits Questionnaire [CSHQ]

Results: total sleep score was significantly higher among children with DS than among those of the control group. The mean differences between case and control groups were significant regarding all subscales except that for sleep onset delay

Conclusion: sleep problems are more common among children with DS as compared with those in control group

Water dissection technique: experience at Assiut University Hospital

Water dissection technique [WDT] represents a minimally traumatic surgical method to cautiously open neurosurgical cleavage planes such as interhemispheric space or Sylvian fissure, and the interfaces between extraaxial masses and the adjacent brain such as meningiomas, AVMs and aneurysms. This study was performed to evaluate the clinical application of this technique as an adjunct to everyday microneurosurgical procedures, such as meningioma surgery. One hundred patients with meningioma, aneurysm and arteriovenous malformations were treated surgically with the aid of water dissection in combination with conventional neurosurgical procedures. Water is injected under microscopic control by a handheld syringe with a blunt needle. The irrigation pressure is hand-controlled according to the microscopical view of the ongoing dissection. The WDT of Toth has been used in Assiut in 100 microsurgical cases, in removal of meningiomas and to open Sylvian and interhemispheric fissure. This technique does not need special equipment, and it is easily adapted to everyday microsurgical practice with no noticeable intraoperative complications

Chemical and biological assessment for Egyptian surface freshwater environment with reference to human activities

The Egyptian freshwater was assessed in the River Nile, branches, main canals and certain drainages in eight Governorates, over eight successive seasons starting from spring 2008. Chemical assessment was made through ten parameters and the biological one was made through macro-invertebrates information. Results showed that means of Cd, Pb, Cu, Hg, Mn, Fe, Ni, Na, K and Ca varied in watercourses seasonally within somewhat narrow ranges, which may exceed the level of concern but with some elevations in branches, Rayahs and canals during certain seasons. Sites showed chemical levels over the permissible one or those gain total points

L-Carnitine ameliorates the iron mediated DNA degradation in peripheral leukocytes of beta-thalassemic children

Iron overload is a common complication in beta-thalassemia that induces intracellular oxidative stress producing lesions in the DNA including double strand breaks. The aim of this study was to evaluate DNA damage in peripheral leukocytes of-thalassemic children and to investigate its association with the iron overload and the role of L-carnitine therapy upon this damage. Fifty beta-thalassemic children [25 TM and 25 TI] with 20 age and sex matched apparently healthy children [control group] were included. Serum ferritin level was measured by ELISA. DNA damage was evaluated by the Gel electrophoresis to determine the total DNA genomic damage [TGD]. The intensity of DNA nucleoprotein was measured by software Gel Pro analyzer computer program as maximum optical density [max.OD] values of apoptotic fragments of DNA at 200bp, 400bp and 600bp. The smear shape pattern on gel electrophoresis and Pro-Gel analyzer chart indicating double strand breakage of the DNA was detected in 76% of the thalassemic children. The thlassemic patients [the whole group and each of TM and TI groups] had significantly higher prevalence of DNA double-strand breaks in their leukocytes with significant higher values of max. OD at 200,400and 600 bp compared to the control group. The thalassemic children on regular L-carnitine therapy [50 mg/kg/d for at least 6 months] had significantly lower prevalence and degrees of DNA breaks [TGD] with significant lower max. OD values at 200,400 and 600 bp compared to those not on L-carnitin therapy. There was significant positive correlation between the mean serum ferritin levels and the values of max. OD at 200 and 400bp. The data obtained from the Roe Curve shows that, the best sensitivity of 95% and specificity of 75% for the mean serum ferritin were at the cut off point of 820 ng/ml to predict the ocurrence of TGD in thalassemic leukocytes. Thalassemic children had significant DNA double-strand breaks in their leukocytes that was positively correlated to their iron overload reflected by serum ferritin level and can be ameliorated by L-carnitine supplementation

Haemochromatosis gene mutation H63D is a risk factor for iron overload in Egyptian beta- thalassemic children

Iron overload is the main cause of morbidity and mortality in patients with beta-thalassemia. The aim of this study was to evaluate the prevalence of genetic markers [HFE mutations C282Y and H63D] among Egyptian beta-thalassemic Children and its effect on their iron status. 59 beta-thalassemic children attending the pediatric hematology clinic in Menoufiya University Hospital [23 thalassemia major, 23 thalassemia intermedia and13 thalassemia trait] with 50 apparently healthy, Egyptian children [control group] were screened for the prevalence of these two mutations by digestion of PCR products [RFLP]. Serum ferritin level was measured by ELISA. Neither carrier status for the C282Y allele nor homozygous status for the H63D allele were detected in any of the thalassemic children or the 50 controls. The H63D heterozygous state was detected in 15 [25.4%] thalassemic patients with an allele frequency of 12.71% and in 11 [22%] controls with an allele frequency of 11%. with no significant difference between the thalassemic groups and the controls. The prevalence of carriers for the H63D mutation was 26.1% with an allele frequency of 13.04% in patients with either beta- thalassemia major or intermedia, while in beta- thalassemia trait the prevalence of this mutation was 23.1% with an allele frequency of 11.54%. There were significant higher levels of the mean yearly serum ferritin in both beta-thalassemia major and intermedia patients who are heterozygotes for the H63D mutation compared to those without this mutation. The mean serum ferritin levels were positively correlated with the age of the patients. On the other hand, the prevalence of iron -induced complications was not statistically different between patients carrying or not carrying this mutation [among TM and TI]. There is no difference in the prevalence of H63D mutation between beta-thalassemic patients and the normal children and the presence of a heterozygous H63D status and older age are two risk factors for iron overload in Egyptian beta-thalassemic children. RFLP= Restriction Fragment Length Polymorphism, HCV=Hepatitis C Virus, ALT = Alanine aminotransferase, AST =Aspartate aminotransferase

Detection of hepatocyte growth factor/scatter factor receptor[c-Met] in axillary clearance after mastectomy for breast cancer using reverse transcriptase-polymerase chain reaction

The diverse biological effects of hepatocyte growth factor/scatter factor [HGF/SF] are mediated by c-Met which is preferentially expressed on epithelial cells. Met signaling has a role in normal cellular activities, and may be associated with development and progression of malignant processes. In this study presence of Met in the axillary drainage from patients who underwent conservative operations for breast cancer, and its prognostic significance was examined. Sixty-two consecutive patients with invasive ductal carcinoma of the breast which were suitable for breast-conserving treatment participated in the study. The output of the drain that had been placed in the axilla during the operation was collected, and the presence of Met and beta-actin were assessed by reverse transcriptase-polymerase chain reaction [RTPCR] assays. The data were compared with the pathological features of the tumor and the axillary lymph nodes, and with the estrogen and progesterone receptors status. RT-PCR of the axillary lymphatic drainage was positive for Met in 46 [74.2%] of the patients and positive assays were correlated with increase in tumor size and grade of capillary and lymphatic invasion, as well as with lymph node metastasis [P < 0.02, for all comparisons]. All 24 patients with axillary lymph node metastases in comparison with those without lymph node [57.9%] metastases had positive assays for Met. While all ten patients with tumor involvement in the margins of the resection had positive assays for Met in their lymphatic fluid, only 36 out of 52 patients [69.2%] were positive for met assay. Finally, Met showed negative correlations with positive estrogen and progesterone receptor assays [P<0.02]. From the results of this study it may concluded that Met can be detected in the axillary fluids of patients with breast cancer and its expression in the axillary drainage may be a potential prognostic factor. This finding might be useful in therapeutic considerations since a positive assay for Met in histologically node-negative patients might indicates the need to search for node microinvasion or involvement of the excision margins with tumor

Assessment of association of lobular neoplasia in tru-cut needle biopsy specimens with a low risk of ductal carcinoma on subsequent excision

To determine the rate of duct carcinoma in situ and invasive carcinoma in subsequent excisions for lobular neoplasia alone on core needle biopsy. It was an analytical study. Damanhour National medical Institute, Egypt from July 2004 to August 2006. Result of 117 cases of breast core needle biopsy diagnosed as lobular neoplasia were reviewed over a period of 2 yrs. Additional lesions were also identified including the presence of ductal carcinoma in situ [DCIS] or invasive carcinoma and atypical ductal hyperplasia [ADH] Tissue follow-up was obtained from hospital records. Statistical analysis was performed using a 2-tailed fisher exact test. Lobular carcinoma was diagnosed by core needle biopsy in 117 women; in 25 [21.6%], invasive carcinoma [IC] or ductal carcinoma in situ [DCIS] was diagnosed concurrently. Two patients had previous diagnoses of IC or DCIS, and 4 [3.6%] had a concurrent diagnosis of contra-lateral IC or DCIS. Of 92 patients without a concurrent diagnosis of IC or DCIS, subsequent tissue diagnoses were available for 39 eases [42.6%]. Of 15 cases of lobular neoplasia and atypical ductal hyperplasia on the biopsy, 1 had IC and 3 had DCIS on the excision. Of the women with lobular neoplasia and a mucoeele-like lesion on the biopsy, none had IC or DCIS on excision. Of 23 with lobular neoplasia alone on the biopsy, 2 had IC on excision. As lobular carcinoma is associated with a high overall rate of IC and DCTS [30%], women in whom biopsy sites are excised are still at risk for subsequent DCIS and IC

Comparative study of human papilloma virus DNA detection and results of histopathological examination of cervical colposcopic biopsies

In our study, we investigated the factors that may participate to false-negative colposcopic biopsy results. It was a descriptive study. Damanhour National Medical Institute Hospital [DNMI] during the period from January 2004 to August 2006. A computerized search identified patients with ASC Pap test results and positive results of reflexive high-risk HPV DNA testing during the period of study. Patients who underwent subsequent colposcopic-directed biopsy and/or endocervical curettage with no histologic evidence of HPV infection or dysplasia were selected for the study. Three levels were obtained from each block and stained with H and E. The original H and E-stained glass slides were reviewed. For cases that still were diagnosed as negative for dysplasia or HPV cytopathic effect on review, 3 additional H and E-stained levels were obtained. For the few cases in which there was disagreement with regard to the original and reviewed diagnoses, the discrepancy was recorded, and no other tissue sections were ordered. Patients with atypical squamous cells of undetermined significance [ASC] in Papanicolaou smears, with positive HPV DNA results, but negative cervical histopathologic findings accounted for 4.5% of all ASC smears submitted for HPV DNA testing. We found 4% of the cases had focal HPV infection or mild dysplasia. When serial sectioning of the biopsy material were examined, we found that 31% had clinically significant lesions: HPV infection or cervical intraepithelial neoplasia [CIN] 1, 19%; CIN 2/3, 8%; and dysplasia, not otherwise specified, 3%. Of the remaining patients, follow-up revealed squamous abnormalities in 25%. About 5% of patients with positive HPV DNA results had a negative follow-up biopsy result. [False-negative] biopsies.We recommend that additional levels have to be obtained when initial histologic sections do not demonstrate evidence of dysplasia or HPV cytopathic changes after a cytologic diagnosis of ASC and a positive HPV DNA test result

Mitomycin C enhanced endocsopic dacryocystorhinostomy

To investigate the safety and efficacy of Mitomycin C enhanced endoscopic dacryocystorhinostom [DCR] in patients with complete nasolacrimal obstruction. Twenty six endoscopic DCR with mitomycin C application were performed in 23 patients between January and May 2004. Of these cases, 5 were males and 18 were females. The mean age was 53 [ +/- 9] years with a range from 28 to 68 years. Only patients with patent canaliculi, normal eye lid function, no suspected lacrimal sac neoplasia, and acquired complete nasolacrimal obstruction due to chronic dacryocystitis and with duration of symptoms for more than 1 year were included in this study. Regular follow up settings were done at l[st] week, then monthly after that to document the patient's subjective improvement, to judge ostium patency on irrigation, and to record any complications. The operation was classified as successful by the subjective disappearance of patient symptoms. A significant success [P < 0.001] was demonstrated in our cohort of patients. The success rate, 6 months after removal of the silicon tube, was 24 [92%] of 26 procedures on subjective basis of disappearance of patient symptoms and 23 [88%] on objective basis as tested by irrigation. No major complications occurred during or after surgery. Mitomycin C enhanced endoscopic DCR is a safe and effective alternative in the management of complete nasolacrimal obstruction. Being efficient, minimally invasive, devoid of any serious complications and safely performed under local anesthesia, it should be considered the DCR procedure of choice

Early experience with endoscopic assisted balloon catheter dacryocystorhiostomy

To conduct a pilot study investigating the safety and efficacy of balloon catheter dacryocystorhinostomy [DCR] in adult patients with acquired complete nasolacrimal obstruction. Nine balloon catheter DCR were performed in 9 patients [2 males and 7 females]. The mean age was 42 [ +/- 9] years with a range from 24 to 59 years. Only patients with patent canaliculi, normal eye lid function, no suspected lacrimal sac neoplasia, and acquired complete nasolacrimal obstruction due to chronic dacryocystitis and with duration of symptoms for more than 1 year were included in this study. Regular follow up settings were done at 1[st] week, then monthly after that to document the patient's subjective improvement, to judge ostium patency on irrigation, and to record any complications. The operation was classified as successful by the subjective disappearance of patient symptoms. A significant success [P < 0.05] was demonstrated in our cohort of patients. The success rate, 6 months after removal of the silicon tube, was 5 [71%] of 7 procedures on subjective basis of disappearance of patient symptoms and objective basis as tested by irrigation. No major complications occurred during or after surgery. Balloon catheter DCR is a simple, safe and effective alternative in the management of simple cases of acquired complete nasolacrimal obstruction in adults. It, provides a new standard in less invasive treatment of complete nasolacrimal duct obstruction and should be considered a first line management when DCR is considered. We do not recommend this technique in complicated cases such as lacrimal fistula and pyoceles since these cases would require a more extensive approaches with removal of the medial sac wall and a considerable widening of the naso-lacrimal osteotomy

Clinical significance of anigogenic marker in Egyptian bladder cancer patients

Vascular Endothelial growth factor [VEGF] is a principle growth factor mediating angiogenesis. The high expression of VEOF within bladder tumors is associated with a poor prognosis. We determined tissue, plasma and urinary levels of VEGF in patients with bladder cancer to study their correlation with the classical clinicopathological factors and to assess its potential role in the evaluation of bladder cancer patients. Materials and VEGF was measured by enzymeimmunoassay in the tissue, plasma and urine of 100 bladder cancer patients and in corresponding 40 healthy volunteers. Tumor tissue samples were standardized to the protein content and urine samples were normalized for creatinine content. Tissue, plasma and urinary VEGF levels were significantly elevated in bladder cancer patients compared to healthy controls [p < 0.001]. The highest VEGF levels were noted in patients with invasive and poorly differentiated bladder cancer compared to those with superficial and well or moderately differentiated individuals followed by healthy controls. Similarly, we detected the same observation in patients with lymph node metastases signifying that VEGF increases with tumor progression. Also, VEGF levels for schistosomal bladder cancer patients were elevated compared to non-schistosomal patients [although they were insignificantly different] and healthy controls as they correlated significantly together suggesting that bilharziasis may participate in angiogenie switch. VEGF sensitivity was superior to urine cytology and combined sensitivity between them was the highest [100%] when urine cytology combined with plasma or urinary VEGE Tissue, plasma and urinary VEGF were significantly correlated together implying that the tumor is the source of plasma and urinary VEGF. Our study demonstrates that strongly expressed VEGF may be relevant for diagnosis of bladder cancer patients, and it is implicated in the pathogenesis of bladder cancer progression. Quantification of urinary VEGF may provide a novel noninvasive marker for the early detection of bladder cancer as well a therapy target

Role of non invasive biomarkers in the assessment of liver condition in chronic hepatitis C Egyptian patients and if they correlate with the severity of liver affection

Hepatitis C virus [HCV] is considered the most common etiology of chronic liver disease in Egypt. Anti-HCV-positive patients are more likely to have elevated liver enzymes, liver cirrhosis, portal hypertension and spleen enlargement. Schistosomal liver disease in Egypt is commonly associated with HCV infection. Concurrent infection results in much more severe liver affection than that seen in either disease alone. Chronic hepatitis C is a slowly progressive inflammatory disease that can lead to cirrhosis with all its complications. Thus, repeated assessment of liver condition is always required. Assessment of liver damage has been primarily done by liver function tests as well as by histological evaluation. Meanwhile, assessment of liver affection is mainly done by liver biopsy with histological analysis which always remains the "reference standard" used by physicians to assess the presence as well as the degree of liver fibrosis in patients with chronic liver diseases and also to determine the appropriate management. However, many physicians are cautious to perform liver biopsy because of the relative risks associated with this procedure, particularly in patients with coagulation abnormalities. Among the possible alternatives, imaging is informative mainly for cirrhosis but not for lesser stages of fibrosis. In addition, it is nonquantitative and thus cannot track progression. Unfortunately, there are few reliable noninvasive methods for detecting liver fibrosis and its progression. Thus, a noninvasive test detecting hepatic fibrosis has become a priority in the context of hepatitis C evaluation and treatment. Therefore, identifying hepatic biomarkers that correlate with the severity of the liver pathology is an important issue in the follow up of such cases. Few serum markers such as hyaluronic acid, ferritin, and soluble interleukin-2 receptor [sIL-2R] have been reported to be useful in detecting fibrosis in liver disease. The aim of this study is to clarify the diagnostic value of serum hyaluronic acid, ferritin, and soluble interleukin-2 receptor levels as non-invasive biomarkers in the assessment of the liver condition in chronic hepatitis C Egyptian patients with and without concurrent Bilharzial affection and moreover, to evaluate whether their serum levels correlate with the histological severity of the related liver injury. One hundred and twenty Egyptian subjects were included in this study. They were divided into three main groups. Group A [n=30] included patients with chronic hepatitis C and with liver fibrosis as assessed by abdominal ultrasonography, Group B [n = 60] included patients with chronic hepatitis C and with liver cirrhosis and/or history of antibilharzial treatment and positive rectal snips for bilharzial ova, and Group C [n = 30] included apparently normal age and sex-matched subjects taken as a control group. Group B was further subdivided into two subgroups according to liver cirrhosis staging as performed by abdominal ultrasonography, where Subgroup B1 [n = 30] included patients with early cirrhotic changes while Subgroup B2 [n = 30] included patients with advanced cirrhotic changes. Patients were diagnosed as having hepatitis C by detecting HCV antibodies using a third generation enzyme immunoassay, ELISA. Biochemical blood tests were carried out to evaluate liver functions in the form of serum transaminases [AST and ALT], alkaline phosphatase [ALP], gamma glutamate [GGT], total bilirubin, as well as serum albumin. In addition, serum hyaluronic acid, ferritin, as well as sIL-2R levels were measured by EL1SA. Our study detected impaired liver functions in all patient groups compared to the controls. Liver functions were also detected to be more impaired in each of subgroup B1 early cirrhosis as well as in B2 advanced cirrhosis patients compared to group A fibrosis patients and this was statistically significant. Meanwhile, our study also demonstrated statistically significant difference on comparing both subgroups B1 and B2 together showing more impairment in subgroup. B2 advanced cirrhosis patients. The above findings denote that as the liver condition progresses from fibrosis to early then to advanced cirrhosis, the liver enzymes as well as the bilirubin concentrations increase progressively and the serum albumin concentrations decrease progressively, thus indicating more deterioration in liver functions and more liver injury. Not only this, but also our study detected more deterioration in liver functions occurring in the presence of bilharzial infection concurrent with hepatitis C infection than without it. This was shown clearly from comparing group B patients, whether subgroup B1 or B2, with history of bilharziasis to group A patients without, denoting that concurrent bilharzial infection adds more to the liver affection. As regarding the hepatic biomarkers, namely, serum hyaluronic acid, ferritin, and sIL-2R, our study detected statistically increased serum levels in each of the patient groups compared to the controls. A progressive increase in their serum levels was detected as the liver condition progressively deteriorates. Meanwhile, more serum level elevations occurred with the presence of bilharzial infection concurrent with hepatitis C infection than without it. In addition, our study reported that in advanced cirrhosis subgroup B2 patients; there was a significant positive correlation detected between each of serum hyaluronic acid, ferritin, and sIL-2R and each of ALT and GGT serum levels. A positive correlation was also detected between serum hyaluronic acid and ALP. Meanwhile, a significant negative correlation was detected between each of the above three biomarkers and serum albumin level. In conclusion, our study reported that in chronic hepatitis C Egyptian patients, as the liver affection progresses, the liver functions deteriorate progressively, thus indicating more liver injury. Not only this, but also more deterioration in liver functions was detected in the presence of concurrent bilharzial infection than without it. As regarding the serum biomarkers: serum hyaluronic acid, ferritin, and sIL-2R, a progressive increase in their serum levels was detected as the liver condition progressively deteriorates. In addition, more elevations occurred in the presence of concurrent bilharzial infection. Moreover, our study detected that in advanced cirrhosis, these biomarkers correlate significantly with the liver functions denoting not only their diagnostic value as non-invasive biomarkers in the assessment of the liver condition, but also that their levels correlate with the histological severity of the related liver injury, and thus can be used in the prognostic follow up to assess the degree of liver pathological progression especially when liver biopsy is contraindicated, thus, protecting the patient from its hazards especially in cases of hepatic coagulopathy which is well known to occur in this category of patients

Effect of infection with fasciola gigantica on protein, lipid contact and some enzymes of the intermediate host snail lymneae natalensis

Total protein and lipid contents were estimated in hemolymph of Lymnaea natalensis snails infected with Fasciola gigantica. There was significant reduction in total protein content, while the lipid content in infected snails showed a significant elevation. Also, there was a significant increase in the activity of hexokinase [HK] by 48.9% and glucose phosphate isomerase [GPI] by 40% and a decrease in lactate dehydrogenase [LDH] by 53.7% in infected snails when compared to control snail group

Double-blind randomized comparison of epidural co-analgesics on the postoperative analgesic consumption

Pain mediators are responsible for the peripheral and central sensitization. Preempetive treatment will prevent the establishment of hypersensitivity by blocking the sensory input that induces the central sensitization. This prospective double blind study was carried out on 45 adult patients who underwent upper abdominal operations. All patients were assigned into 3 groups according to the drug injected epidurally. [Plain bupivacaine [group I], Ketamine + plain bupivacaine [group II]. and clonidine + plain bupivacaine [group III]],. 15 minutes before the general anesthesia. The purpose of this study was to evaluate and compare the effects of epidural ketamine and clonidine as co-analgesics on postoperative analgesic consumption for upper abdominal surgery Measurements for efficacy of preemptive analgesia evaluated by visual analogue scale [VAS] and Prince Henry score [PHS]. sedation score, mood state, cumulative postoperative analgesic consumption and the time of the first need of fentanyl Monitoring of vital signs and recording of possible side effects were performed on the postanesthesia care unit VAS was significantly less in group III at most times of measurements until 2 hr postoperatively. PHS showed less significant reading in groups I and III compared to group II at 15 min and 6 hr postoperatively. Sedation score was significantly higher in group III compared to group II, I and II at 15, 30 min. respectively. Mood score was significantly high in group II and III. No significant side effects and respiratory rate, oxygen saturation, and ECG were within normal range in the three groups. The total amount of fentanyl requirements in the first 24 hrs postoperatively was significantly less in group III compared to group I and II. The time of first need of fentanyl was't changed significantly between the three groups. In conclusion the preemptive analgesic effect of epidural clonidine combined with plain bupivacaine with lack of vcnak ventilatory effects makes clonidine a potenlially useful drug for the reduction of postoperative narcotic consumption or in other words for the postoperative pain management

Short form - 36 questionnaire for assessing quality of life in bronchial asthma patients

This aim of the present study was to apply the short form -36 [SF- 36]questionnaire in patients with bronchial asthma and to assess the relationship between symptom score and ventilatory pulmonary function, with the scores of the nine component of the SF-36. This study was carried out on one hundred and forty two patients with stable bronchial asthma of variable severity [forced expiratory volume in 1[st] second FEV[1] ranged from 55 to 73% of predicted], they were 60 males and 82 females with their ages ranged from 16 to 49 years. All patients were subjected to: ventilatory pulmonary function measurements using computerized sensor medics 2450 apparatus before and 20 minutes after inhalation of 200 micro g of salbutamol using metered dose inhaler. The clinical severity of asthma was assessed according to the symptom frequency score of Reddel et al., [15]. Every patient completed SF-36 questionnaire which is composed of 36 items, measuring three major health attributes and nine health concepts. The result of this study showed that the older patients had the severe asthma score. Most SF-36 scores were significantly higher in men than in women. The symptom score showed significantly negative correlation with all items of SF-36 scores. While the FEV[1]% predicted was significantly positively correlated with five of the nine health components of the SF-36 questionnaire, the forced expiratory flow at 25-75% of vital capacity% predicted [FEF[25-75%]] and the forced expiratory flow at 75-85% of vital capacity% predicted [FEF[75-85%]] showed only significantly positive correlation with three of the nine health component of the questionnaire. In conclusion, the SF-36 questionnaire can be used as a tool to measure health related quality of life [HQL] in asthmatics. The severity of symptom score but not the ventilatory pulmonary function was a significant predictor of various component of HQL [SF-36]

Evoluation of some biochemical alterations in neonatal hypoxic ischemic encephalopathy [HIE]

The main objective of this work was to study the evolution of serum L- carnitine and other metabolic derangements that may contribute significantly to the severity of hypoxic ischemic encephalopathy [HIE] including serum aspartate aminotransferase [AST], alanine aminotransferase [ALT], creatinine and electrolyte levels as well as acid-base status. It was conducted on 23 full-term newborns that fulfilled the clinical criteria of hypoxic ischemic encephalopathy in addition to ten healthy full-term newborns of matched weight, gestational and post-natal ages as a control group. It was concluded that L-carnitine may be a useful marker for the severity of HIE. Serum creatinine, AST and ALT levels were significantly increased in all grades of HIE