Primary hepatic amyloidosis with severe cholestasis: a case report

Despite the fact that hepatic involvement is frequently seen in systemic primary amyloidosis, major hepatic symptoms as primary manifestation and severe impaired liver function are rare. Herein, we report a 38-year-old woman with primary hepatic amyloidosis, and severe portal hypertension. The patient had ascites and markedly elevated alkaline phosphatase level at presentation. She had a rapid downhill course resulting in death. In case of an unexplained intrahepatic cholestasis or portal hypertension the possibility of amyloidosis should be considered and a Congo red staining should be performed

[Investigation of relationship between expression of lewis b antigen and helicobacter pylori induced peptic ulcer in Sari]

Background and Objectives: It has been indicated that some blood groups act as receptors for pathogens. There is a controversy over the relationship between Lewis blood group antigens and H. pylori infection which is one of the main causes of peptic ulcer. The aim of this study was to investigate the relationship between Lewis blood group antigens and H. pylori induced peptic ulcer

Material and Methods: Blood and saliva samples from 60 patients with peptic ulcer caused as a result of H. pylori infection and 44 healthy individuals [control group] were collected. Types of Lewis antigens and secretory state of subjects were determined using direct agglutination and saliva tests, respectively. In order to find the relationship between Lewis blood group antigens and H. pylori induced peptic ulcer, Chi-Square test using SPSS statistics software version 17.0 [SPSS Inc., U.S.A.] was applied

Results: Seventy two percent of the patients and sixty one percent of the healthy individuals were secretor and expressed Lewis B antigen. No significant relationship was observed between Lewis blood group antigens and H. pylori induced peptic ulcer

Conclusion: No significant correlation was found between Lewis B antigen and presence of H. pylori induced peptic ulcer. Further studies for identification of the role of other factors like Lewis X and Sialyl Lewis X in binding, colonization and virulence of H. pylori infection are recommended

Central retinal artery occlusion following orbital tumor resection: Is rapid intervention effective.

A 52‑year‑old male patient presented at our hospital with unilateral proptosis and vision loss in his left eye. Imaging evaluations showed orbital tumor, so the patient underwent surgery. About an hour later after tumor removal, patient developed sudden vision loss and became no light perception. Fundus evaluation revealed central retinal artery occlusion (CRAO). The patient was treated immediately with ocular massage and anterior chamber paracentesis as well as systemic therapy with mannitol and intravenous administration of acetazolamide. After thirty minutes, he recovered perception to light and then hand motion and 2 h later, it was improved to 1 m counting finger. CRAO following orbital tumor has not been reported before. We recommend ocular examination in all patients that undergo orbital surgery immediately to 2–3 h after surgery.

[Screening study of changes which have occurred in the prevalence of intestinal parasites species in Syria between 2006-2011]

The aim of the study was to evaluate the changes which have occurred in the prevalence of intestinal parasites species in Syria between 2006-2011. This study was carried on in seven cities in Syria on primary school students in the years 2006-2011. The number of student's fecal samples examined was 4152 from seven Syrian areas included: Damascus and its countryside, Idlib and countryside, countryside of Daraa, Kalamoon, Hama and countryside, countryside of Alraqa and countryside of Tartous. The results showed that there were 1290 stool samples with positive parasites [31.07%], 481 samples of them have pathogenic human's parasites [37.28%]. The pathogenic parasites which have been seen in this study according to their prevalence rate were as follows: Protozoa: Giardia lamblia 8.48%, Chilomastix mesnili 1.06%, Entamoeba histolytica 0.14%. Helminthes: Hymenolepis nana 1.20%, Enterobius vermicularis 0.43%, Strongyloides stercoralis 0.17%, Trichuris trichuria 0.05%, and Ascaris 0.05%. Where the non pathogenic parasite which have been seen in this study according to their prevalence rate were as follows: Blastocystis hominis 13.15%, Entamoeba coli 5.73% and Iodamoeba butschili 0.60%. It was observed that Giardia lamblia and Hymenolepis nana which regarded as pathogenic parasites were the most prevalent in Syria, bt the other types of parasites were very rare

Effect of zirconium dioxide nanoparticles on glutathione peroxidase enzyme in PC12 and N2a cell lines

Today, special attention is paid to the use of zirconium dioxide nanoparticle [nano-ZrO[2]], a neutral bioceramic metal, particularly for drug and gene delivery in medicine. However, there are some reports implying that use of nano-ZrO[2] is associated with cytotoxic effects like inhibiting the cell proliferation, DNA damage and apoptosis. In the present study, we examined whether nano-ZrO[2] alters cell viability and glutathione peroxidase [GPx] activity in two neuronal cell lines. The PC12 and N2a cells were cultured in the absence or presence of varying concentrations [31.25-2000 micro g/mL] of nano-ZrO[2] for 12, 24 or 48 h. The cell viability was evaluated using 3-[4, 5-dimethylthiazol-2-yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazolium [MTS] assay and GPx activity was determined by quantifying the rate of oxidation of the reduced glutathione to the oxidized glutathione. Nano-ZrO[2] caused a significant reduction in cell viability and GPx activity after 12, 24 and 48 h, as compared with control group. These effects were concentration dependent and started from 250 micro g/mL. The present study demonstrated that nano-ZrO[2], at concentrations of > 250 micro g/mL, has antiproliferative effects via reducing the cell defense mechanism against oxidative stress

[Detection of Toxoplasmosis antibodies among Arab International University female students in Syria Screening study by direct agglutination latex]

There are no sufficient studies about the prevalence of Toxoplasmosis in Syrian females, so our aim in this paper were 1] Screening study of Toxoplasmosis antibodies among Arab International University female students in Syria, 2] determination of positive percentage to spread the disease, 3] set up a health educational program for prevention means of sero-negative cases. A total of [313] blood samples were collected from female students [age 19-23]. Blood was separated and serum was collected and kept in small labeled eppendorf tubes and stored at -20 degree C until analyzed. A direct agglutination test was used for detection of Toxoplasma antibodies. [Kits from human Ref 50023]. The positive prevalence of Toxoplasmosis antibodies was 47% among female students, while 53% was negative. A health educational program was set up for sero-negative students to explain the risk of this disease. Toxoplasmosis is still making a high pathogenic risk factor in Syria. Food, weather and environment help to spread of this parasite, and infection increases with aging

overview on inflammatory bowel disease treatment

Inflammatory bowel disease [IBD] is a chronic relapsing, idiopathic disorder of the gastrointestinal tract of an unknown etiology. Ulcerative colitis [UC] and Crohn's disease [CD] have become important health problems. Current medical therapy of IBD has advanced dramatically with the introduction of new biologic therapies in addition to the optimization of conventional therapies that include drugs such as immunosuppressors and 5-aminosalicylic acid [5-ASA], and a better identification of factors involved in the pathogenesis of IBD. The aim of this review is to provide a brief historical perspective of the available evidence for the use of various medications in IBD followed by a recent literature update. The intent is to enhance the clinician's perspective regarding IBD treatment.

Lymphoid follicular hyperplasia as a cecal mass: a case report and review of the literature

We described a case of lymphoid follicular hyperplasia that arose from the ileum of a 52-year-old woman. Her colonoscopy revealed a large mass in the cecum associated with multiple polypoid lesions in the ileum. Histologic examination demonstrated severe lymphocytic infiltration and lymphoid follicles with regular germinal centers, without evidence of malignancy. A right hemicolectomy was performed, which confirmed the diagnosis of lymphoid follicular hyperplasia

Protective effect of pomegranate seed oil against acute toxicity of diazinon in rat kidney

Diazinon is an organophosphate which is extensively used in trade and agriculture. Due to its widespread application, its toxicity is common. Several studies have shown that organophosphates are able to induce oxidative stress by generating free radicals and depletion of endogenous antioxidants. Pomegranate seed oil [PSO] possesses anti-inflammatory and antioxidant effects. In this study, the effect of PSO was evaluated on diazinon-induced nephrotoxicity in rat. Wistar male rats were randomly divided into four groups, 6 each. Group one received saline, 1 mL/kg, group 2 received diazinon 100 mg/kg. Groups 3 and 4 received PSO, 0.32 and 0.64 mg/kg, one hour before diazinon 100 mg/kg respectively. After 24 h, animals were anesthetized. Blood samples were taken out by cardiac puncture for measuring the level of serum urea and creatinine. 24 h urine samples were also collected for measuring glucose and protein concentration. The right kidney was removed and homogenized for measuring malondialdehyde and thiol content. Compare to control group, DIZ increased urea and serum creatinine, urinary glucose, and malondialdehyde, but did not modify significantly urinary protein and thiol content. In groups received PSO+ DIZ, serum creatinine, urinary glucose and MDA were significantly decreased. DIZ induced acute nephrotoxicity and oxidative stress. Probably, increasing of serum creatinine and urinary glucose are appropriate markers for diagnosis of kidney damage. In addition increasing of MDA level emphasizes that DIZ plays role in pathogenesis of kidney via oxidative stress mechanism. PSO reduced DIZ toxicity by antioxidant activity

unusual presentation of Vanek's tumor: a case report

We report the case of a 54-year-old Iranian man who presented with melena from three months prior to admission. Esophagogastroduodenoscopy and colonoscopy were normal. Double balloon enteroscopy showed a pedunculated tumor located in the jejunum. He underwent laparotomy and resection of a 9.5 cm tumor from the distal jejunum. Histopathologic evaluation confirmed the diagnosis of an inflammatory fibroid polyp [IFP].

Update on the management of ulcerative colitis

The present treatment goals for inflammatory bowel diseases [IBD] especially ulcerative colitis [UC] include rapid induction of clinical remission, steroid-free maintenance of clinical remission, mucosal healing and improvement of quality of life in UC patients. Immunomodulators have been reserved for steroiddependent or steroid- refractory UC patients. Among these agents, azathioprine/6-mercaptopurine should be used for maintenance of remission in quiescent UC. Calcineurin inhibitors can be prescribed as a short-term rescue therapy in steroid- refractory UC patients, but the long term efficacy of these agents remains unclear. According to retrospective studies, methotraxate is not recommended for inducing and maintaining remission in UC. Novel biological therapies targeting different specific immunological pathways continue to be developed and introduced for a variety of clinical scenarios in IBD. Infliximab is currently used for induction and maintenance therapy in patients who have moderately to severely active UC with an inadequate response to conventional agents such as aminosalicylates, corticosteroids, or immunomodulators. Other anti-TNF agents and biologic therapies are undergoing evaluation in clinical trials for their efficacy in IBD. Most patients who start biologics should continue treatment for the foreseeable future and potential consequences of discontinuation should be discussed with individual patients. Currently, data do not exist to administer biologics as first-line therapy in UC. Emerging data suggest that biologics may have the potential to prevent complications and limit disease progression. If such benefits are proven, biologics may be used in the future to modulate subclinical inflammation and to prevent the development of clinical disease

[Liver enzyme alteration]

Liver enzyme alteration may be an incidental finding in asymptomatic individuals who have undergone routine laboratory tests. lsolated alteration of liver enzymes in a healthy individual often represent a challenge even for experienced clinicians. In this article we decide to provide a guide to interpreting alterations to liver enzyme levels. Liver enzyme alterations are classified to predominantly hepatocellular or predominantly cholestatic patterns. We review abnormal enzymatic activity within the 2 subgroups, and suggested initial investigations.

Comparison of pre- vs. post-incisional caudal bupivacaine for postoperative analgesia in unilateral pediatric herniorrhaphy: a double-blind randomized clinical trial

This study was designed to evaluate the pre- vs. post-incisional analgesic efficacy of bupivacaine administered caudally in children undergoing unilateral hernia repair. Fifty children aged 6 months to 6 years were included in the study. Children were divided blindly between the two groups to receive pre- vs. post-incisional caudal bupivacaine. The preincisional group received 1 ml/kg of 0.125% bupivacaine caudally after induction of anesthesia and the postincisional group received the same dose caudally at the end of surgery. Heart rate, SaO 2, end tidal CO 2, and noninvasive arterial blood pressure were recorded every 10 min. The duration of surgery, extubation time, and duration of recovery period were also recorded. The pain scores were measured with using an Oucher chart in the recovery room, 2, 4, 6, 12, and 24 h after surgery. Time to first analgesia, numbers of supplementary analgesics required by each child in a 24-h period and total analgesic consumptions were recorded. Any local and systemic complications were recorded. Quantitative data were compared using a two-tailed t-test. Sex distribution and frequency of acetaminophen consumption were measured using ?[2] test. P<0.05 was considered statistically significant. The Oucher pain scale at 4, 6, 12, and 24 h after surgery, the total analgesic consumption and the numbers of demand for supplemental acetaminophen were lower statistically in preincisional group [P<0.05]. Extubation time and duration were higher in preincisional group [P<0.05]. Mean changes of heart rates were statistically lower during the anesthesia period and recovery time in preincisional group [P<0.05].Preincisional caudal analgesia with a single injection of 0.125% bupivacaine is more effective than the postincisional one for postoperative pain relief and analgesic consumption in unilateral pediatric herniorrhaphy

How to break bad news: physicians' and nurses' Attitude

Bad news disclosure is one of the most complex tasks of physicians. Recent evidences indicate that patients' and physicians' attitude toward breaking bad news has been changed since few years ago. The evidence of breaking bad news is different across cultures. The aim of this study is to evaluate the attitude of medical staff toward breaking bad news to provide a clinical guideline in Iran. A descriptive study was conducted during 2008-2009 on a sample of 100 medical staff [50 physicians and 50 nurses] at Cancer Institute of Imam Khomeini hospital. The subjects' demographic characteristics and their attitudes toward the manner of revealing the diagnosis were registered in a questionnaire. The majority of the physicians [86%, n=43] and nurses [74%, n=37], mostly the older and more experienced, tended to reveal the diagnosis to patients. Only a few physicians [8%, n=4] had been trained how to disclose bad news, which discloused diagnosis more than non trained ones. Physicians and nurses preferred to inform the patients about the diagnosis when either the patients were alone or in the presence of their spouse respectively. Only a few physicians [14%] and nurses [24%] agreed to explain life expectancy to patients. Compared to past, physicians and nurses are more willing to share cancer diagnosis with patients. However, lack of adequate communication skills in caregivers, and their concerns about managing patients' emotional reactions reduce their tendency to disclose bad news to the patients. Therefore, training physicians and nurses to expose bad news to the patients seems to be necessary

[ relationship between oral and dental health and quality of life based on DIDL index]

Oral health status could be affected the quality of life, hence recognition of related variables, might be a significant aid in recognition of biological, functional and psycho-social aspects of oral diseases. The aim of this study was to evaluate oral health status of 30-45 years old individuals and its effects on their quality of life. In this descriptive study 150 people referring to khorasgan dental branch, Isfahan Islamic Azad University, were selected. Oral health status was measured by DMFT and CPITN indexes according to WHO. Also quality of life in regard to oral health was measured with DIDL index, data was analyzed by Mann-whitney test and Pearson coefficient test. The average score and standard deviation of DMFT, CPITN and DIDL were 12.27 +/- 6.79, 0.36 +/- 0.5, 0.52 +/- 0.6 respectively. Average score of restoration numbers in woman was higher than men. CPITN in men was higher than women. With decreasing socio-economic class, DMFT and CPITN indexes were increased and quality of life was decreased. According to the results of this study, there is a significant relation between DMFT, CPITN, and socioeconomic factors and the quality of life

Effect of commercial [vimang] and hydroalcoholic extract of Mangifera indica [mango] on gentamicin-induced nephrotoxicity in rat

Mangifera indica [Mango] is used in folk medicine for treatment of different types of diseases, and its anti-inflammatory and free radical scavenging activities have been demonstrated. The present study evaluated the effects of commercial [vimang] and hydroalcoholic extract of Mango on gentamicin-induced nephrotoxicity in rat. Female Wistar rats were treated with vimang [50 and 100 mg/kg] for 18 days, or hydroalcoholic extract [200 and 400 mg/kg] for 18 days as preventive groups and others with vimang [100 mg/kg] for 8 days, or hydroalcoholic extract [400 mg/kg] for 8 days as treatment groups and also gentamicin [GM] was used at 80 mg/kg/day for eight days, starting from day 10. At the end of treatment, blood and urine samples were taken for measurement of creatinine [Cr] and BUN. The kidney was prepared for histological evaluation. Serum Cr and urea concentrations as well as renal tissue injury increased significantly in GM group compared with the control group. Hydroalcoholic extract of Mango at 200mg/kg was able to reduce plasma Cr and urea concentrations significantly as well as kidney tissue necrosis. Vimang [50 and 100 mg/kg] and hydroalcoholic extract of Mango [200mg/kg] also prevented kidney tissue damage compared with the control group. Mango products were able to improve kidney function in an established model of GMinduced nephrotoxicity in the rat. The beneficial effects of Mango on the rat kidney seem to be dose and time-dependent. However, more investigations are needed to elucidate Mango action on GMinduced renal toxicity

[Diagnosis and treatment of demodectic belpharitis, the first case in Syria]

Demodex is an acarina parasite belongs to family of Tromidiformes, It is worm-like, with a length of 100-400 micron. There are many kind of Demodex affect on animals, and just two types infect humans and they are: Demodex folliculorum and Demodex brives. This mite, living in the hair follicle, in sebaceous gland of human, on the face, nose, neck and lids. Its complete the whole lifecycle, which is approximately 15 days in hair follicle and it spreads via direct contact. Many researches have shown that Demodex is involved in many kinds of dermatitis especially acne rosacea, and a lot of cases have been diagnosed in our country, that were published in scientific journals. Recently, it has been reported that Demodex mites play an active role in the pathogenesis of Blepharitis. It has been suggested that this parasite cause acne, pityriasis folliculorum, papullo-pustular rosacea, granulomatous rosacea, inflammatory papule and folliculitis. This study is about a female case in twenty year old, explained of a huge dropping of her eyelashes, thick squamous in the base of eyelashes and oedema in the edge of the lids. The case was treated with metronidazole ointment and it is recovered within two months

Prevalence of intestinal parasites in children of elementary educational level in rural of daraa Governorate- Syria

Is to know the prevalence of intestinal parasites among children in elementary educational level in rural ofDaraa - Syria. A total of 766 stool samples were examined, they were collected from children in elementary educational level from 62 villages in rural ofDaraa in the period from July to October, 2009. Of 261 [34.7%] samples positive for parasites, 160 samples of them contained human pathogenic parasites. The pathogenic parasites according to their prevalence were: Giardia lambilia [12.66%], Candida sp. [5.74%], Chilomastix mesnili [1.96%], Hymenolepis nana [1.94%], Strongyloides stercoralis [0.9%] and finally Enterobius vermicularis [0.39%]. Strongyloides stercoralis was detected for the first time in this area. The prevalence of nonpathogenic parasites was: Entamoeba coll [9.4%], Blastocystis hominis [8.62%], Enteromonas intestinalis [0.65%], and Endolimax nana [0.39%]. It is worth mentioning thatAscaris lumbricoides and Entamoeba histolytica were not detected in any of the study samples. Giardia lamblia is the most common pathogenic protozoa in rural area of Daraa in Syria; while Hymenolepis nana is the most common intestinal helminthes in this area followed by Enterobius vermicularis then Strongyloides stercoralis