Cortical lesions in a sample of egyptian multiple sclerosis patients

Background: multiple sclerosis is an inflammatory demyelinating disease with a neurodegenerative component mainly characterized by progressive accumulation of focal white matter [WM] lesions. The degree of cortical damage at baseline was associated with the progression of disability. Cognitive deficits could be better explained by cortical lesions [CLs] than by WM lesions. Fatigue in MS could be due to damage to the cortico striato thalamo cortical circuit

Aim of the Work: to detect [CLs] in MS patients and correlate these lesions with physical disability, cognitive dysfunction and fatigue

Subjects and Methods: a case-control study on 64 subjects including 44 known multiple sclerosis patients diagnosed according to revised McDonald's criteria 2017

Results: we observed a statistically significant difference between MS patients and healthy controls as regard number of [CLs], Symbol Digit Modality Test [SDMT], Fatigue Severity Scale [FSS] and P300 wave latencies and amplitudes. Secondary progressive [SPMS] subgroup was affected more than relapsing remitting [RRMS] subgroup. [CLs] were located mainly in temporal lobes

Conclusion: This study suggested that cortical affection is directly associated with physical and cognitive disability progression

Radiofrequency management of trigeminal neuralgia

Background: Trigeminal neuralgia [TN] is a unique disease. The first line of management in TN is medical treatment using antiepileptic drugs, when drugs failed to control the pain or when there is intolerability to them, surgical interventions are then indicated. Percutaneous Trigeminal rhizotomy [PTR] is recommended for elderly patients with higher operative risk factors

Objective: The aim of this work is to review the literature regarding the pathology, methods of investigations, operative techniques, complications of management of trigeminal neuralgia and eventually prognosis, also evaluation of the effectiveness of the radiofrequency percutaneous radiofrequency rhizotomy - for management of trigeminal neuralgia

Patients and Methods: This study included a total of 15 patients with trigeminal neuralgia presented predominantly in females. Female: male 1.7:1 and the mean age was 53 years. They were admitted and managed at the Neurosurgical Department of at Al-Azhar University Hospitals and other private centers between June 2017 and October 2018. Clinical follow-up was obtained in 15 [100%] patients

Results: follow up revealed that 11 patient [73.4 %] had favorable outcome and 4 patient [26.6%] had unfavorable outcome. The mean preoperative visual analogue scale[VAS] was 7.83 [range 7-10]. It dropped immediately postoperative to 2.33 [range 1- 4].], intraoperative complication was noted in 3 cases [18%]

Conclusion: Radiofrequency rhizotomy is the procedure of choice for most patients undergoing first surgical treatments and patients at high risk from general anesthesia [although not necessarily the elderly]

Molecular mechanisms of the anti-obesity potential effect of Moringa oleifera in the experimental model

Objective To elucidate the molecular mechanisms of the potent anti-obesity effect of Moringa oleifera Lam. (M. oleifera) ethanolic extract and to clarify the link between these mechanisms and the associated metabolic and vascular risks in the experimental model of visceral obesity. Methods M. oleifera ethanolic extract was orally administered at 600 mg/kg body weight in obese female rats daily for 12 weeks. At the end of treatment, body weight was determined, and the atherogenic index, coronary artery index, glucose level, insulin resistance status, liver and kidney functions were assessed. Also, the mRNA of leptin, adiponectin and resistin in visceral adipose tissue was determined by quantitative real time-PCR. Results The results showed that M. oleifera extract down-regulated mRNA expression of leptin and resistin, while it up-regulated adiponectin gene expression in obese rats relative to untreated obese control counterparts. This amelioration of genes expression was paralleled by a reduction in body weight and improvement of the atherogenic index and coronary artery index, as well as glucose level and insulin resistance value without adverse effects on liver or kidney functions, versus the untreated obese control ones. Conclusions It is reasonable to assume that the anti-obesity, anti-atherogenic and anti-diabetic properties of M. oleifera are mechanistically achieved via working directly on the adipokines of the visceral adipose tissue. Therefore, M. oleifera may be a good therapeutic candidate for the symptoms of metabolic syndrome.

protective effect of antioxidants on renal ischemia-reperfusion injury in the rat

Renal ischemia-reperfusion [I/R] is of clinical interest because of its role in renal failure and also in renal graft rejection. There is increasing evidence to suggest that reactive oxygen species [ROS] play a role in the pathogenesis of I/R injury in the kidney. This study was designed to investigate the protective effect of some dietary antioxidants [garlic, vitamin E or vitamin A + Se [+2]] against the damage inflicted by [ROS] during renal I/R. Five groups of male albino rats were used in this study each composed of 10 rats. Group I: Sham-operated control group. Group II: I/R group [not treated] unilaterally nephrectomized after subjection of the left renal pedicle to 60 minutes of nontraumatic occlusion followed by 24 hours of reperfusion. Group III: the same procedure as group II but animals were preconditioned by adding garlic powder to their diet 80 mg kg[-1] daily for one month. Group IV: like group III but vitamin E [6.5 mg kg[-1]/d for one month] was supplemented to diet. Group V: like the two previous groups III and IV but vitamin A [7.9 mg/kg[-1]] and Se[+2] [50 microg/kg[-1]] were added daily to the rats' diet for one month. At the end of the reperfusion period, the rats were sacrificed. Malondialdehyde [MDA], Reduced glutathione [GSH] concentrations, superoxide dismutase [SOD], glutathione reductase and glutathione peroxidase enzymatic activities were determined in plasma and kidney homogenates of all groups. Serum creatinine and blood urea concentrations, were measured, for the evaluation of renal function. Also Na[+]-K[+]-ATPase was determined in kidney homogenates. Ischemic reperfused [l/R] animals demonstrated severe detonation of renal function and a significant renal oxidative stress. Pretreatment of animals with garlic, vitamin E or vitamin A + Se [2+] markedly attenuated renal dysfunction and oxidative stress as manifested by reducing blood urea, serum creatinine, MDA and restored depleted renal antioxidant enzymes. Na[+]-K[+]-ATPase activity, which was decreased in the I/R group, increased in the animals preconditioned with vitamins E and A + Se[2+]. From this it can be concluded that ROS play a causal role in I/R induced renal injury and supplementing the animals with garlic and/or other dietary antioxidants exerts protective effects. Therefore, it is recommended to supply patients expected to suffer from I/R renal injury with these antioxidants

Significance of DNA study in childhood acute lymphocytic leukemia

Acute lymphoblastic leukemia [ALL] is the most common malignant disease affecting children, accounting for approximately 30% of childhood cancers. The potential for clinical cure is correlated with a number of prognostic variables. These variables include clinical parameters at the time of diagnosis [e.g. age and white blood cell count], and biologic features of leukemic cells [cytogenetics and DNA content]. This prospective study was conducted on 22 Egyptian leukemic patients. All patients were subjected to complete history and physical examination, chest X-ray, abdominal sonography, complete blood count, bone marrow examination and karyotypic study. Cases were classified into group I [group of good prognosis] and group II [group of bad prognosis] according to their follow up for one year after initiation of treatment. Group I consisted of 11 cases, 10 of them were of normal karyotype and one case showed hyperdiploid >/= 50 chromosomes. Group II consisted of 11 cases, where 2 of them were hyperdiploid [from 46 - 49 chromosome], 2 cases were hypodiploid, 6 cases showed translocations and one case showed deletion of the short arm of chromosome No. 9. One year survival rate was 100% to 10 patients with normal karyotype and 100% to 5 patients with numerical chromosomal abnormalities. Five cases with structural chromosomal abnormalities died [71.4%] out of the 7 detected cases. There is a strong association between certain chromosomal abnormalities and bad prognosis which can be of much benefit in dealing with leukemic children

prevalence of mitral valve prolapse among egyptian school children: clinical diagnosis versus colour/Doppler echocardiography

In this study, 51362 children [26538 males and 24824 females] were selected by systemic random sampling representing 4% from the total number of children in both primary schools [group I = 33297 children] and preparatory schools [group II = 18065 children] in Cairo. They were subjected to auscultation which revealed MVP criteria in only 221 children; 100 children in group I and 121 children in group II with a high statistical significant difference. Those 221 children were subjected to EGG, CXR and color/Doppler echocardiographic examination. It was found that only 120 children have MVP, 52 children from group I and 68 children from group II with a high statistical significant difference

relationship between intrapersonal, environmental, illness-related variables, functional status and hope level among cancer patients

This study was conducted to identify the relationship between intrapersonal, environmental, illness-related variables, functional status and hope level among cancer patients. A convenience sample of 60 adult oncology patients [30 males and 30 females] with varying diagnoses and in different stages of treatment was recruited. The results documented that the studied subjects had hope with variant levels. The results showed the presence of a statistically significant relation between intrapersonal, environmental, illness- related variables, functional status and hope level among cancer patients. Females with adequate income, independent, on surgical treatment and on secondary level of education had an increased hope level among cancer patients, while the teachers, on radiotherapy, dependent, suffering from pallor and anorexia had a decreased level of hope among the studied subjects

Testicular dysplasia in incompletely descended testis: a clinical histopathological and operative study

Fifty patients with incompletely descended testis have been subjected to testicular biopsy during their surgical treatment. 43 patients showed pathologic changes in their testicular biopsies [86%] while normal testicular tissue was seen in the remaining 4 cases [80%]. Testis was congenitally absent in 3 cases [6%]. The predominant pathological changes were in form of arrest of spermatogenic cells at varying stages in 38 cases [79%]. Testicular dysplasia is more common in older children above age of years. This makes it mandatory to interfere surgically in young aged boys as soon as possible

Soft tissue mammography in patients with discharge from the nipple: a clinical operative and histopathological study

Fifty [50] female patients with discharge from their nipples have been studied. Soft tissue mammography was performed to all of them before operative intervention. The results of soft tissue mammography were compared with the histopathological results. It was found that soft tissue mammography is available measure in detecting early carcinoma of the breast with palpable mass and in excluding in 90% of benign breast lesions