Improvement of Na+-K+ ATPase Activity and Gene Expression Associated with Glomerular Ultrastructural Protection in Diabetic Nephropathy by Acacia senegal: Role of Oxidative Stress Disturbances / Mejora de la actividad Na+-K+ ATPasa y la Expresión Génica Asociada con la Protección Ultraestructural Glomerular en la Nefropatía Diabética por Acacia senegal: Papel de las Alteraciones del Estrés Oxidativo

SUMMARY: This study assessed the effects of Acacia Senegal (AS) combined with insulin on Na+/K+-ATPase (NKA) activity and mRNA expression, serum glucose, renal function, and oxidative stress in a rat model of diabetic nephropathy (DN). Sixty rats were equally divided into six groups: normal control, normal+AS, diabetic (DM), DM+insulin, DM+AS, and DM+insulin+AS groups. Diabetes mellitus (type 1) was induced by a single injection of streptozotocin (65 mg/kg), and insulin and AS treatments were carried until rats were culled at the end of week 12. Serum glucose and creatinine levels, hemoglobin A1c (HbA1c) were measured. Renal homogenate levels of NKA activity and gene expression, malondialdehyde, superoxide dismutase (SOD), catalase and reduced glutathione (GSH) were evaluated as well as kidney tissue histology and ultrastructure. Diabetes caused glomerular damage and modulation of blood and tissue levels of creatinine, glucose, HbA1c, malondialdehyde, NKA activity and gene expression, SOD, catalase and GSH, which were significantly (p<0.05) treated with AS, insulin, and insulin plus AS. However, AS+insulin treatments were more effective. In conclusion, combined administration of AS with insulin to rats with DN decreased NKA activity and gene expression as well as oxidative stress, and improved glycemic state and renal structure and function.

Este estudio evaluó los efectos de Acacia senegal (AS) combinada con insulina sobre la actividad Na+/K+- ATPasa (NKA) y la expresión de ARNm, la glucosa sérica, la función renal y el estrés oxidativo en un modelo de nefropatía diabética (ND) en ratas. Sesenta ratas se dividieron equitativamente en seis grupos: control normal, normal+AS, diabética (DM), DM+insulina, DM+AS y DM+insulina+AS. La diabetes mellitus (tipo 1) se indujo mediante una única inyección de estreptozotocina (65 mg/kg), y los tratamientos con insulina y AS se llevaron a cabo hasta que las ratas fueron sacrificadas al final de la semana 12. Se midieron niveles séricos de glucosa y creatinina, hemoglobina A1c (HbA1c). Se evaluaron los niveles de homogeneizado renal de actividad NKA y expresión génica, malondialdehído, superóxido dismutasa (SOD), catalasa y glutatión reducido (GSH), así como la histología y ultraestructura del tejido renal. La diabetes causó daño glomerular y modulación de los niveles sanguíneos y tisulares de creatinina, glucosa, HbA1c, malondialdehído, actividad y expresión génica de NKA, SOD, catalasa y GSH, los cuales fueron tratados significativamente (p<0,05) con AS, insulina e insulina más AS. Sin embargo, los tratamientos con AS+insulina fueron más efectivos. En conclusión, la administración combinada de AS con insulina a ratas con DN disminuyó la actividad de NKA y la expresión genética, así como el estrés oxidativo, y mejoró el estado glucémico y la estructura y función renal.

Fixation of Mallet Fractures Using a Modified Hook Plate Technique: A Prospective Case Series of 17 Patients / Fixação de fraturas em martelo com técnica de placa de gancho modificada: Uma série de casos prospectivos de 17 pacientes

Abstract Objective Various modalities have been suggested to manage mallet fractures; however, inappropriate treatment can lead to extension lag, a swan neck deformity, or arthritis of the distal interphalangeal joint (DIPJ). The current study aimed to evaluate the results (functional, radiological, and complications) of open reduction and internal fixation (ORIF) of mallet fractures using low-cost hook plates fabricated from low-profile titanium mini plates. Methods A prospective case series of 17 consecutive patients (average age of 32.3 years) with mallet fractures (six were Wehbe Type IB and 11 were Wehbe Type MB). Eleven (64.7%) were males. The affected hand was dominant in all patients, and the affected digit was the index in 6 (35.3%), the ring in 5 (29.4%), the small in 3 (17.65%), and the middle in 3 (17.65%) patients. The same fellowship-trained hand surgeon performed all surgeries. Results The average operative time was 37.65 minutes. After an average follow-up of 10.94 months (range 6-27), the average DIPJ motion was 50º º (range 20º-70º), the extensor lag was noted in 4 (23.5%) patients, and complications were reported in 6 (35.29%) patients. According to Crawford criteria, 6 (35.3%) patients achieved excellent results, 7 (41.2%) achieved good results, and 4 (23.5%) achieved fair results. Conclusion The modified hook plate technique for fixation of mallet fractures is a beneficiai, economical, yet demanding technique that adequately provides stable fixation to allow early DIPJ motion with acceptable functional outcomes.

Resumo Objetivo Diversas modalidades têm sido sugeridas para o tratamento de fraturas em martelo; no entanto, o tratamento inadequado pode causar retardo de extensão, deformidade em pescoço de cisne ou artrite da articulação interfalangiana distal (AIFD). Este estudo teve como objetivo avaliar os desfechos (funcionais, radiológicos e complicações) da redução aberta e fixação interna (RAFI) das fraturas em martelo com placas de gancho de baixo custo fabricadas com mini placas de titânio de baixo perfil. Métodos Série de casos prospectivos de 17 pacientes consecutivos (idade média de 32,3 anos) com fraturas em martelo (seis do tipo IB e 11 do tipo IIB de Wehbe). Onze (64,7%) pacientes eram do sexo masculino. A mão acometida era a dominante em todos os pacientes, com acometimento do dedo indicador em seis (35,3%), anelar em cinco (29,4%), mínimo em três (17,65%) e médio em três (17,65%) pacientes. O mesmo cirurgião de mão experiente realizou todas as cirurgias. Resultados O tempo operatório médio foi de 37,65 minutos. Após um acompanhamento médio de 10,94 meses (intervalo de 6 a 27), observou-se movimento médio da AIFD de 50º (intervalo de 20º a 70º), retardo de extensão em quatro (23,5%) pacientes e complicações em seis (35,29%) pacientes. De acordo com os critérios de Crawford, os desfechos foram excelentes em seis (35,3%), bons em sete (41,2%) e regulares em quatro (23,5%) pacientes. Conclusão A técnica da placa de gancho modificada para fixação de fraturas em martelo é benéfica e econômica, mas exigente; permite fixação estável e adequada para permitir a movimentação precoce da AIFD com desfechos funcionais aceitáveis.

Acacia senegal inhibits diabetic nephropathy ultrastructure alteration and renal biomarkers changes in rats / Acacia senegal inhibe la alteración de la ultraestructura de la nefropatía diabética y los cambios en los biomarcadores renales en rata

SUMMARY: Diabetic nephropathy (DN) is the most common complication of diabetes. Several studies have been done in a trial to protect against this problem at the ultrastructure level. This study investigates the protective effect of oral administration of Acacia senegal (AS) against the development of DN. Sixty male albino rats were randomly divided into six groups: control, Acacia senegal control, Diabetic untreated, diabetic insulin-treated, Diabetic AS treated, and Diabetic insulin and AS combined treated groups. Plasma glucose, HbA1c, serum Albumin, creatinine, urine creatinine was measured using specific kits. Determinations of creatinine clearance and blood pressure were done. The renal tissues of both kidneys were prepared to investigate under both light (LM) and electron microscope (EM). Ultrastructure examination of renal rats tissue of diabetic untreated rats showed the destruction of the glomerular basement membrane and endothelial cells together with hemorrhage in glomerular capsules (Bowman's capsules). On the other side, both LM and EM revealed improving the endothelial cells and the other glomerular capsules structures, especially with the combined treated group, which confirmed the improvement of the biochemical investigation in the study. In conclusion, from the present study, using the oral AS together with SC insulin could be protected against the development of DN.

RESUMEN: La nefropatía diabética (ND) es la complicación más común de la diabetes. Se han realizado varios estudios de ensayo para abordar esta dificultad a nivel de ultraestructura. Este estudio investiga el efecto protector de la administración oral de Acacia senegal (AS) contra el desarrollo de la ND. Se dividieron sesenta ratas albinas machos aleatoriamente en seis grupos: control, control de Acacia senegal, diabéticos no tratados, diabéticos tratados con insulina, diabéticos tratados con AS y grupos tratados con compuesto de insulina diabética + AS. Se midieron utilizando kits específicos, glucosa plasmática, HbA1c, albúmina sérica, creatinina en sangre y en orina. Se registraron la creatinina y la presión arterial. Los tejidos renales de ambos riñones se prepararon para investigar tanto con microscopio óptico (MO) como electrónico (ME). El examen de la ultraestructura del tejido renal de ratas diabéticas no tratadas mostró la destrucción de la membrana basal glomerular y las células endoteliales junto con hemorragia en las cápsulas glomerulares (cápsulas de Bowman). Por otro lado, tanto MO como ME revelaron una mejora de las células endoteliales y las estructuras capsulares glomerulares, en el grupo tratado con el compuesto, lo que confirmó la mejora de la investigación bioquímica. En conclusión, el uso de AS oral en combinación con insulina podría proteger contra el desarrollo de ND.

Protective effect of combined melatonin and alpha-tocopherol administration in spinal cord ischemia-reperfusion injury in rat / Efecto protector de la administración combinada de melatonina y alfa-tocoferol en la lesión por isquemia-reperfusión de la médula espinal en ratas

Oxidative stress and inflammation are the key players in the development of motor dysfunction post-spinal cord ischemic reperfusion injury (SC-IRI). This study investigated the protective effect of concomitant pre-administration of melatonin and alpha-tocopherol on the early complications (after 48 hours) of spinal cord IRI injury in rats. Melatonin or α-tocopherol were preadministered either individually or in combination for 2 weeks, then rats were exposed SC-IRI. Neurological examinations of the hind limbs and various biochemical markers of oxidative stress and inflammation in the SC tissue were assessed. Solely pre-administration of either melanin or α-tocopherol significantly but partially improved motor and sensory function of the hind limbs mediated by partial decreases in SC levels of MDA, AOPP and PGE2 levels and activities of SOD, partial significant decreases in plasma levels of total nitrate/nitrite and significant increases in AC activity of GSH-Px. However, combination therapy of both drugs resulted in the maximum improvements in all neurological assessments tested and biochemical endpoints. In conclusion, by their synergistic antioxidant and antiinflammatory actions, the combination therapy of melatonin and α-tocopherol alleviates SC-IRI induced paraplegia.

El estrés oxidativo y la inflamación son claves en el desarrollo de la disfunción motora posterior a lesión isquémica de la médula espinal (SC-IRI). Este estudio investigó acerca del efecto protector de la administración previa concomitante de la melatonina y alfa-tocoferol en las complicaciones tempranas (después de 48 horas) de la lesión de IRI de la médula espinal en ratas. La melatonina o el α-tocoferol se administraron individualmente o en combinación durante 2 semanas, luego las ratas fueron expuestas a SC-IRI. Se evaluaron los exámenes neurológicos de las miembros pélvicos y diversos marcadores bioquímicos de estrés oxidativo e inflamación en el tejido subcutáneo. Solo la administración previa de melatonina o α-tocoferol mejoró parcial y significativamente la función motora y sensorial de los miembros pélvicos mediadas por disminuciones parciales en los niveles de SC de los niveles de MDA, AOPP y PGE2 y las actividades de la SOD, disminuciones significativas parciales en los niveles plasmáticos del total nitrato / nitrito y aumentos significativos en la actividad de AC de GSH-Px. Sin embargo, se observaron los mejores resultados durante la combinación de ambos fármacos en todas las evaluaciones neurológicas y en los puntos finales bioquímicos. En conclusión, debido a sus acciones antioxidantes y antiinflamatorias sinérgicas, la terapia de melatonina y α-tocoferol alivia la paraplejía inducida por SC-IRI.

Impact of Aluminum Oxide and Silica Oxide Nanocomposite on Foodborne Pathogens in Chicken Fillets

Nanotechnology is an innovative technology for improving food quality and safety. Aims: The aim of this study was to evaluate the efficacy of hydroxy propyl methyl cellulose (HPMC) films containing nanoparticles against three foodborne pathogens. Design of the Study: *This study was designed using two nanoparticles i.e. (Al2O3-NPs and SiO2-NPs), edible film (HPMC), and three foodborne pathogens i.e. Bacillus cereus, Staphylococcus aureus, and Salmonella Typhimurium. Both nanoparticles were evaluated against foodborne pathogens as well applied in chicken fillets. Place and Duration: All experiments were done in the Food Technology Department, Benha University, Egypt; Nanomaterial Laboratory, Beni-Suef University, Egypt; and Agricultural Research Center, Egypt and were done within three months. Methodology: The preparation of edible films, the antimicrobial activity, mode of antimicrobial action, challenge study, and scanning electron microscopy had been carried out in different laboratories. As well the mechanical properties of the HPMC films were evaluated. Results: The results obtained from this study showed that the nanoparticles (~80 nm) at 80 ppm were active against Bacillus cereus, Staphylococcus aureus, and Salmonella Typhimurium compared with 20 and 40 ppm. The HPMC films including Al2O3-NPs were active against B. cereus than S. aureus and S. typhimurium, while the SiO2-NPs were more effective against S. typhimurium and B. cereus compared with S. aureus. In challenge studies, HPMC films including Al2O3-NPs and SiO2-NPs at 80 ppm decreased the viability of the three-foodborne pathogens associated with chicken fillets stored at 4±1°C for 15 days, as compared with the control sample. HPMC films incorporated with nanoparticles inhibited the microbial population ~ 2-3 log10 CFU/cm2 over the chicken fillets during storage period. Conclusion: This work indicated that, HPMC films incorporated with Al2O3-NPs and SiO2-NPs (~80 nm) at 80 ppm could be reduce the microbiological loads of the refrigerated chicken fillets.

Can Open Fracture Debridement Improve Postoperative Wound Infection?.

Damaged soft tissues provide an ideal environment for bacterial growth and subsequent infections. This study was to evaluate the spectrum of bacterial contamination of predebridment and postdebridment measures in patients with open fractures and to study the best timing suitable for eradication of the micro-organism in a tertiary hospital. These studies was conducted over 112 patients open fracture wound episodes with or without overt signs of infection were included in this study. A patient is considered to have an open fracture wound infection when clinical signs and symptoms of infection were present. Four swabs were taken for each patient, the first was taken as pre debridement swab, the second was post debridement swab, the third swab was after 3 days after debridement and the fourth was 7 days after debridement. Specimens were examined aerobically and anaerobically. Of the 112 wound specimens examined by Gram stain, 66.96% were positive for the presence of bacteria. The Gram-positive and Gram-negative bacteria accounted for 58.66% and 41.33%, respectively. S. aureus (44.2%) was the dominant isolate. The most effective drugs against the tested Gram-positive were amoxicillin/clavulonic acid, erythromycin, vancomycin, cefuroxime and ampicillin. Whereas, the most effective drugs against the tested Gram-negative bacteria were gentamicin, ciprofloxacin, tazocin, imipenem and aztreonam. Postoperative bacterial infection can be decreased if debridement was done at optimum time.

Nosocomial infections in neonatal intensive care unit in pediatric Assiut University Hospital: incidence and risk factors

Nosocomial infections [Nis] have become a matter of major concern in neonatal intensive care units [NICUs]. Nosocomial infections are the result of the interaction of several risk factors. To identify risk factors for nosocomial infections among neonates admitted to neonatal intensive care unit in Pediatric Assiut University Hospital [AUH]. Knowledge of modifiable risk factors could be used to guide the design of interventions to prevent the problem. Incidence [surveillance] study for identification of new nosocomial infections for one year and 9 days from [17 of April 2007 to 26 of April 2008]. The total population: All neonates attending NICU in pediatric AUH from the Obstetric Department of Maternal-Healthcare Assiut University Hospital. The target population is all neonates that developed nosocomial infections within 72 hrs of admission. The presence of risk factors was studied. A practical guide completed for each patient, which included: Demographic risk factors as age, birth weight, sex, single or multiple births, type of delivery, premature rupture of membranes, variables recorded daily as enteral feeding, parentral feeding, mechanical ventilation and indwelling catheter. Differences between patients with and without NI for discrete variables were estimated by the chi-square test. The association between risk factors and the presence of NIs were estimated by relative risk. From a total of 990 admitted neonates, the incidence rate and the incidence density rate were 16% and 24.45% infections per 1000 patient-days, respectively. Case fatality rate was 91.8%. The following risk factors were associated with Nis [P<0.05]: mechanical ventilation, umbilical catheter, prematurity, birth weight less than 1500 g, use of ryle, transport outside NICU, premature rupture of membrane and peripheral vascular catheter. The risk of NIs increases with increasing invasive devices, decreasing birth weight, and gestational age. There is an increased mortality rate associated with NI. Strategies to minimize the impact of risk factors must be identified

Knowledge, attitude and practice of secondary school students regarding obesity in Assiut City, Egypt

Adolescent obesity is a major public health problem and has important health, social and economic consequences for the adolescent. The aim of this study was to assess nutritional knowledge, attitude and practice [KAP] of secondary school students regarding obesity, in Assiut City, Egypt [2004]. The study was a cross-sectional one. The study sample was 883 secondary school students at age 14-19 years, randomly chosen from four schools representing different types of education [general and technical] for both boys and girls. Data were collected using two self-administered questionnaires. The first questionnaire included personal data, nutritional KAP and physical activity. The second questionnaire included data about the socioeconomic status. Each student underwent weight and height measurements. Then, they were classified according to body mass index- for age and sex percentiles into: non-obese, overweight and obese. It was found that, most of the students [86.3%] had poor knowledge regarding obesity [7.8% achieved zero nutritional knowledge score and 78.5% had low score]. Obesity is no longer a fashion as the majority of students [85.1%] found the obese person not attractive. Moreover, 87.1% of them perceived obesity as a health risk. Many students had poor practices as eating in-between meals [62.6%] and frequent consumption of fast foods [69.1%], snacks [35.4%] and soft drinks [18.8%]. About half of all students [47.8%] were not practicing any physical exercises. The majority of adolescent school students had poor nutritional knowledge, attitude and practice regarding obesity, which requires an appropriate intervention

Breastfeeding pattern in a village in Assiut, Upper Egypt

This cross sectional study was done to profile breast-feeding pattern in El-Boora Village, Assiut Governorate. It included 300 infants and young children of less than 24 months of age. Their mothers were asked about infant feeding practices, including breast-feeding and complementary feeding patterns. Only 35.7% of the sample was breast- fed within an hour after delivery, but the majority [84%] began breast-feeding within the first day. Colostrum was the first food given to 71.7% of the sample. The prevalence of breast-feeding was found to be 80.3%. Only a minority of infants were exclusively breast-fed throughout the first six months of life. Exclusive breast- feeding rate at four months of age was 7.9% and decreased to 4.4% at six months. The majority of infants were given liquids, mainly plain water. So, full breast-feeding was found to be 60.5% at four months of age and 51.5% at six months. Timely complementary feeding rate was 76.2%. Continued breast-feeding rate [one year] was found to be 83.8%, while continued breast-feeding rate [two years] was 38.7%. Insufficient milk was the main reason given by mothers for the termination of breast-feeding [44.1%]. Most of the mothers accept breast-feeding as the best for the infant. The major problem was that the great majority of the mothers do not breast-feed exclusively in the first six months of the infant's life. So, the exclusive breast- feeding rate is very low and an intervention was highly recommended to increase it. These problems can be effectively encountered by appropriate health education, training of health workers and effective lactation management