Molecular and serological studies of Egyptian strains of rabbit haemorrhagic disease virus and their comparison with vaccine strains.

Vaccination is the major control measure for rabbit haemorrhagic disease virus (RHDV). The co-circulation of different RHDV genotypes in Egypt has led to the need to determine the most effective vaccine strain and the cross-protection between these genotypes. Rabbits seronegative for RHDV were vaccinated with the commercial GI.1a (RHDVa) vaccine strain Giza2006 and the GI.1d (G5) vaccine strain Giza97. The rabbits were challenged three weeks post vaccination with GI.1a (RHDVa) strains Giza2010 and Kal2012 and GI.1d (G5) RHDV Giza97 and RHDV2014 to determine the degree of cross-protection and evaluate immunity and cross-reactivity by haemagglutination inhibition (HI) and indirect enzyme-linked immunosorbent assay (iELISA). Both vaccines were fully protective three weeks post vaccination, with 95% protection for the GI.1a vaccine and 94.7% for the GI.1d vaccine, with no direct relationship between mortality rates and the genotype of the challenge strain. The antibody titres obtained using the HI test were one log higher for the GI.1a compared with the GI.1d vaccine, but post-challenge titres showed increased responses, expressed as 1?3 log2 higher titres, for the GI.1d vaccine. Sequence and phylogenetic analysis of the Egyptian strain RHDV2014 revealed its relatedness to the GI.1d genotype and showed no evidence of the presence of GI.2 in Egypt until 2014. In conclusion, both GI.1d (G5) and GI.1a (RHDVa)-based vaccines are protective against both RHDV genotypes present in Egypt but continuous monitoring of circulating strains is essential because the arrival of GI.2 in Egypt will require new vaccination strategies.

La vaccination est un outil majeur de lutte contre le virus de la maladie hémorragique virale du lapin (RHDV). Compte tenu de la circulation concomitante en égypte de plusieurs génotypes différents du RHDV, il a fallu déterminer quelle était la souche vaccinale la plus efficace ainsi que le niveau de protection croisée parmi ces génotypes. Des lapins séronégatifs au RHDV ont été vaccinés, en recevant soit la souche vaccinale commerciale Giza2006 du sous-type GI.1a (RHDVa), soit la souche vaccinale Giza97 du sous-type GI.1d (G5). Trois semaines après la vaccination, les lapins ont été soumis à une épreuve virulente, avec les souches Giza2010 et Kal2012 du sous-type GI.1a (RHDVa) et avec les souches Giza97 et RHDV2014 du sous-type GI.1d (G5) du RHDV. La protection conférée par les deux vaccins trois semaines après la vaccination était complète, avec un taux de protection de 95 % pour le vaccin GI.1a et de 94,7 % pour le vaccin GI.1d, et aucune relation directe n'a pu être établie entre les taux de mortalité et le génotype auquel appartenait la souche utilisée pour l'épreuve virulente. Les titres d'anticorps inhibiteurs de l'hémagglutination (HI) étaient supérieurs de 1 log chez les sujets ayant reçu des souches GI.1a par rapport à ceux ayant reçu des souches GI.1d, mais les titres post-inoculation d'épreuve ont révélé une réponse accrue, exprimée par des titres supérieurs de 1 à 3 log2 chez les sujets vaccinés avec des souches GI.1d. L'analyse des séquences et l'étude phylogénétique de la souche égyptienne RHDV2014 ont révélé sa parenté avec le génotype GI.1d et permis d'établir que le génotype GI.2 n'était pas présent en égypte avant 2014. En conclusion, tant les vaccins basés sur le génotype GI.1d (G5) que ceux basés sur le génotype GI.1a (RHDVa) sont protecteurs vis-à-vis des génotypes du RHDV présents en égypte, mais il conviendra d'exercer une surveillance continue des souches en circulation dans le pays car l'introduction du génotype GI.2 en égypte devra être suivie de nouvelles stratégies de vaccination.

La vacunación es la principal medida de lucha contra el virus de la enfermedad hemorrágica del conejo (RHDV). La circulación simultánea de diferentes genotipos del virus en Egipto ha hecho necesario determinar cuál de esos genotipos constituye la cepa vacunal más eficaz y hasta qué punto hay protección cruzada entre ellos. En primer lugar, a una serie de conejos seronegativos para el RHDV se les administró bien la vacuna comercial GI.1a (RHDVa), con la cepa vacunal Giza2006, o bien la vacuna GI.1d (G5), con la cepa vacunal Giza97. Tres semanas después, los animales fueron infectados con las cepas Giza2010 y Kal2012, del genotipo GI.1a (RHDVa), y con las cepas Giza97 y RHDV2014, del genotipo GI.1d (G5), a fin de determinar el grado de protección cruzada y de evaluar el nivel de inmunidad y reactividad cruzada por inhibición de la hemaglutinación y enzimoinmunoanálisis indirecto (iELISA). Ambas vacunas confirieron plena protección a las tres semanas de la administración, con un porcentaje de protección del 95% en el caso de la vacuna GI.1a y del 94,7% en el de la vacuna GI.1d, sin que se observara relación directa alguna entre las tasas de mortalidad y el genotipo de la cepa de infección utilizada. Los valores de títulos de anticuerpos obtenidos con la prueba de inhibición de la hemaglutinación que indujeron las vacunas GI.1a fueron superiores en una unidad logarítmica a los de las vacunas GI.1d, pero tras la infección, los títulos pusieron de manifiesto una respuesta más intensa, expresada en títulos 1?3 log2 veces más altos, en el caso de la vacuna GI.1d. El análisis filogenético y de secuencias de la cepa RHDV2014 egipcia reveló su parentesco con el genotipo GI.1d, sin indicio alguno de la presencia de GI.2 en Egipto hasta 2014. La conclusión es que tanto las vacunas a base de GI.1d (G5) como las de GI.1a (RHDVa) ofrecen protección contra los dos genotipos del virus presentes en el país, aunque no deja de ser imprescindible una vigilancia continua de las cepas circulantes, pues la llegada a Egipto de la cepa GI.2 hará necesarias nuevas estrategias de vacunación.

The effect of menopausal symptoms on the quality of life among postmenopausal Egyptian women.

Objective: The current study aims to assess the prevalence of menopausal symptoms among postmenopausal Egyptian women and their effect on the quality of these women's lives.Study design: A cross-sectional study was carried out in a tertiary university hospital between January and December 2017. We enrolled 350 postmenopausal women aged 45-70 years. All women were interviewed using the Menopause-Specific Quality of Life (MENQOL) questionnaire after translation into the Arabic language by a certified translation expert. The Mann-Whitney test and the Kruskal-Wallis test were used to compare MENQOL item scores.Results: Low backache was the most common complaint among the study participants (86%). The sexual domain imposed the greatest impact on quality of life (mean = 3.12 ± 1.66), followed by physical (mean = 3.18 ± 0.92), psychological (mean = 3.08 ± 0.98), and vasomotor (mean = 3.01 ± 1.78) domains. Moreover, we found a significant positive moderate correlation between body mass index (BMI) and the total score (r = 0.689, p < 0.001). Multivariable linear regression analysis found that the best-fitting predictors for the MENQOL score were age (p < 0.001), BMI (p < 0.001), and exercise (p < 0.001).Conclusions: Physical symptoms were the most prevalent symptoms in this study. In general, older women, housewives, hand workers, less physically active women, and those of low socioeconomic status had poor quality of life.

Modulatory effect of concomitant administration of sitagliptin and vitamin E on inflammatory biomarkers in rats fed with high fat diet: role of adiponectin.

Sitagliptin (SIT) is an antidiabetic used worldwide to ameliorate the hyperglycemia and insulin insensitivity induced dysmetabolism. In this study, we investigated the effect of sitagliptin and vitamin E on metabolic dysfunction in high-fat diet (HFD) fed rats. Sixty-four male rats were allocated into 8 groups (n = 8) as follow; control, control + vitamin E, control + sitagliptin, control + sitagliptin + vitamin E, HFD, HFD + vitamin E, HFD + sitagliptin and HFD + sitagliptin + vitamin E. Control groups were fed with chow diet for 15 weeks, while HFD groups were fed with HFD for the same duration. Vitamin E and sitagliptin were administered in the last 4 weeks of the study. At the end of the 15th week, body weight, liver weight/body weight ratio, weight gain, glucose, lipid profile, liver enzymes, adiponectin and pro-inflammatory cytokines as interleukin 6 (IL-6), high sensitive C reactive protein (hs-CRP) and tumour necrosis factor-α (TNF-α) were measured. Additionally, gene expressions of senescence marker protein 30 (SMP30), Bcl-2, and Bax were measured. Total antioxidant capacity (TAC) and thiobaribituric acid reactive substances (TBARS) were assayed. HFD increased TBARS, IL-6, hs-CRP and TNF-α significantly and decreased TAC and adiponectin. Sitagliptin produced a comparable result through increasing adiponectin, sitagliptin alone or in combination with vitamin E increased the TAC, and gene expression of SMP30 and Bcl-2 and decreased TBARS with downregulation of the overexpressed Bax. Vitamin E, as a natural antioxidant, ameliorates the oxidative stress with insignificant change in lipid profile and inflammatory cytokine levels. Concomitant sitagliptin and vitamin E reduced the hepatic dysfunction induced by HFD.

Vaginal progesterone for prevention of preterm delivery in women with twin pregnancy: a randomized controlled trial.

BACKGROUND: The aim of this study is to evaluate the efficacy of vaginal progesterone to prevent preterm delivery in twin pregnancies and its effect on perinatal outcome. MATERIALS AND METHODS: A randomized, open label, controlled trial (NCT02350231) was carried out over 70 women, in three different hospitals in Egypt, between February 2015 and January 2017. All eligible pregnant women with twin pregnancies were randomly allocated in a 1:1 ratio into two groups. Group I (Progesterone group) was dispensed, 400 mg of progesterone through a vaginal pessary, each day at bedtime, from the 28th week of pregnancy until delivery. Group II (Control group) received no treatment other than the normal tonics taken during pregnancy. The two study groups were followed until delivery. The primary outcome was the rate of preterm delivery <37 weeks. RESULTS: No significant differences were observed among both groups of women in terms of delivery <37 weeks (16.9% versus 25.4%; p=0.06) and mode of delivery (vaginal versus cesarean; p=0.31). The mean gestational age at delivery was comparable between both groups (p=0.09). Additionally, no difference, regarding the neonatal outcome, was observed between both groups. CONCLUSION: Dispensing vaginal progesterone [400 mg] after 28 weeks of gestation does not prevent preterm delivery in twin gestations.

Uterine exteriorization versus intraperitoneal repair: effect on intraoperative nausea and vomiting during repeat cesarean delivery - A randomized clinical trial.

OBJECTIVE: The current study aims to compare the rate of intraoperative nausea and vomiting after repeat cesarean delivery (CD) under two different approaches: by intraperitoneal incision repair or by uterus exteriorization for incision reapair. MATERIALS AND METHODS: We conducted a single-blinded randomized clinical trial (NCT03009994) at a tertiary University Hospital between the 1st of September 2016 and the 31st of December 2017. The study included pregnant women at term of gestation (>37 weeks) scheduled for repeat CD under spinal anesthesia. Women were assigned to either uterine exteriorization for incision repair (Group I) or intraperitoneal incision repair (Group II). The primary assessed was the rate of nausea and vomiting during CD. RESULTS: The study included 1028 women in the final analysis. The rate of intraoperative nausea and vomiting was significantly lower in the intraperitoneal repair group compared to the exteriorization group (24% versus 38.7%, p= 0.001). Likewise, occurrence of uterine atony and the need for additional uterotonics were significantly lower in the intraperitoneal repair group (p= 0.001 and 0.02 respectively). Postoperatively, the rate of nausea and vomiting (12.6 % versus 21 %; P=0.001), and the time to the first recognized bowel movement (12.3 hours versus 14.1 hours; P=0.003) were significantly lower in the intraperitoneal repair group compared to the exteriorization group. CONCLUSIONS: Intraperitoneal repair of the uterine incision during repeat CD is beneficial compared to exteriorization. Improvements in the rate of intra- and postoperative nausea, vomiting, uterine atony and time to the first recognized bowel movement were observed in patients operated with this technique.

Lack of pain relief during labor is blamable for the increase in the women demands towards cesarean delivery: a cross-sectional study.

BACKGROUND: This study aims to assess knowledge, attitude and acceptance of antenatal women for pain relief methods during labor and to know the effect of presumed availability of pain relief methods during labor on the attitude of women towards the mode of delivery. MATERIALS AND METHODS: A cross sectional study was conducted at a tertiary hospital between January and December 2016. A structured interview questionnaire had been administered including data related to current pregnancy, knowledge, attitude and previous experience of pain, labor analgesia, women's attitude toward the mode of delivery and its relation to the availability of adequate analgesia during labor. Visual analog scale (VAS) was used to assess pregnant women's attitude towards pain in general and that related to the process of labor (past and expected experience). RESULTS: Eight hundred and fourteen women were included in the study. The majority of our participants (82.9%) were unaware about the availability of labor analgesia. Sixty of the study participants preferred cesarean section (CS) to avoid labor pain. Availability of adequate pain relief during labor could decrease the women decision of CS by more than 50% in women expecting moderate and severe pain during labor compared to non-availability of pain relief (9.6% vs. 22.7% and 8.2% vs. 28.1% respectively). CONCLUSION: There is a great lack of knowledge regarding the availability of pain relief during labor. Lack of pain relief during labor can be responsible for more than half of women's intention to prefer CS as a mode of delivery.

A randomized controlled study of the efficacy of 4 weeks of supplementation with ω-3 polyunsaturated fatty acids in cases of unexplained oligohydramnios.

OBJECTIVE: To investigate the effect of ω-3 fatty acids on amniotic fluid volume and uterine artery blood flow after 4 weeks of treatment. STUDY DESIGN: A randomized clinical trial was conducted on 140 participants with unexplained oligohydramnios at Woman's Health Hospital, Assiut University, Egypt. Participants were randomly assigned to ω-3 plus capsules or placebo. Categorical variables were analyzed by means of the χ2 test, whereas continuous variables were analyzed by means of the independent-sample T-test between the two groups. RESULTS: One hundred and forty women were recruited. There was significant improvement in the amniotic fluid index (AFI) in the ω-3 plus group in comparison with the placebo group (P=0.001). Moreover, there were significant decreases in the systolic/diastolic ratio (P=0.01), resistance index (P=0.041) and pulsatility index (P=0.002) of the uterine arteries in the ω-3 plus group when comparing baseline values with those after 4 weeks. CONCLUSION: The results suggest that ω-3 fatty acids may have a role in the increase in AFI in cases of unexplained oligohydramnios. This effect may be secondary to the increase in uterine blood flow.

Therapeutic efficacy of differentiated versus undifferentiated mesenchymal stem cells in experimental type I diabetes in rat.

Selective MSCs differentiation protocol into pancreatic beta cells was conducted in the present study using exendin-4 and TGF-beta. Differentiated and undifferentiated MSCs were assessed in experimental type I diabetes in rats. Ninety female white albino rats were included in the study and divided equally (n=15/group) into 6 groups: healthy control, healthy control rats received acellular tissue culture medium, diabetic rats, diabetic rats received acellular tissue culture medium, diabetic rats received undifferentiated MSCs and diabetic rats received differentiated MSCs. Therapeutic efficacy of undifferentiated versus differentiated MSCs was evaluated via assessment of quantitative gene expressions of insulin1, insulin 2, Smad-2, Smad-3, PDX-1, PAX-4, neuroD. Blood glucose and insulin hormone levels were also assessed. Results showed that quantitative gene expressions of all studied genes showed significant decrease in diabetic rat groups. Use of undifferentiated and differentiated MSCs led to a significant elevation of expression levels of all genes with more superior effect with differentiated MSCs except smad-2 gene. As regards insulin hormone levels, use of either undifferentiated or differentiated MSCs led to a significant elevation of its levels with more therapeutic effect with differentiated MSCs. Blood glucose levels were significantly decreased with both undifferentiated and differentiated MSCs in comparison to diabetic groups but its levels were normalized 2 months after injection of differentiated MSCs. In conclusion, use of undifferentiated or differentiated MSCs exhibited significant therapeutic potentials in experimental type I diabetes in rats with more significant therapeutic effect with the use of differentiated MSCs.

Effect of fluoxetine and resveratrol on testicular functions and oxidative stress in a rat model of chronic mild stress-induced depression.

Our objective was to investigate the effects of chronic unpredictable mild stress (CUMS) with or without selective serotonin reuptake inhibitor (fluoxetine) and anti-oxidant (resveratrol) on testicular functions and oxidative stress in rats. Fifty male rats were divided into 2 groups; control and CUMS. CUMS group was further subdivided into 4 subgroups administered water, fluoxetine, resveratrol and both. Sucrose intake, body weight gain, serum corticosterone, serotonin and testosterone levels, sperm count and motility, testicular malondialdehyde, superoxide dismutase (SOD), catalase, glutathione (GSH), and gene expression of steroidogenic acute-regulatory (StAR) protein and cytochrome P450 side chain cleavage (P450scc) enzyme were evaluated. CUMS decreased sucrose intake, weight gain, anti-oxidants (SOD, catalase, GSH), testosterone, serotonin, StAR and cytochrome P450scc gene expression, sperm count and motility and increased malondialdehyde and corticosterone. Fluoxetine increased malondialdehyde, sucrose intake, weight gain, serotonin and decreased anti-oxidants, StAR and cytochrome P450scc gene expression, sperm count and motility, testosterone, corticosterone in stressed rats. Administration of resveratrol increased anti-oxidants, sucrose intake, weight gain, serotonin, StAR and cytochrome P450scc gene expression, testosterone, sperm count and motility, and decreased malondialdehyde and corticosterone in stressed rats with or without fluoxetine. In conclusion, CUMS induces testicular dysfunctions and oxidative stress. While treatment of CUMS rats with fluoxetine decreases the depressive behavior, it causes further worsening of testicular dysfunctions and oxidative stress. Administration of resveratrol improves testicular dysfunctions and oxidative stress that are caused by CUMS and further worsened by fluoxetine treatment.

Effect of vitamin E on cerebral cortical oxidative stress and brain-derived neurotrophic factor gene expression induced by hypoxia and exercise in rats.

Brain-derived neurotrophic factor (BDNF) is involved in the proliferation of neurons, and its expression increases significantly with exercise. We aimed to investigate the effects of chronic exercise (swimming) and sustained hypoxia on cortical BDNF expression in both the presence and absence of vitamin E. Sixty four male Sprague-Dawley rats were divided into two equal groups; a normoxic group and a hypoxic group. Both groups were equally subdivided into four subgroups: sedentary, sedentary with vitamin E, chronic exercise either with or without vitamin E supplementation. Arterial PO(2), and the levels of cortical malondialdehyde (MDA), antioxidants (reduced glutathione GSH, superoxide dismutase (SOD), catalase (CAT) and vitamin E) and BDNF gene expression were investigated. Hypoxia significantly increased MDA production and BDNF gene expression and decreased the antioxidants compared to control rats. Chronic exercise in hypoxic and normoxic rats increased MDA level and BDNF gene expression and decreased the antioxidants. Providing vitamin E supplementation to the hypoxic and normoxic rats significantly reduced MDA and BDNF gene expression and increased antioxidants. We conclude that sustained hypoxia and chronic exercise increased BDNF gene expression and induced oxidative stress. Moreover, vitamin E attenuated the oxidative stress and decreased BDNF gene expression in sustained hypoxia and chronic exercise which confirms the oxidative stress-induced stimulation of BDNF gene expression.

Effect of pregnancy-lactation overlap on the current pregnancy outcome in women with substandard nutrition: a prospective cohort study.

BACKGROUND: Pregnancy during lactation is common in Egypt and is often unplanned. Overlap between pregnancy and lactation could be associated with an increased risk for the pregnant mother, her fetus as well as her nursing child. AIM OF THE STUDY: The current study aims to compare the maternal and perinatal outcome of pregnancies occurred during lactation with those occurred after weaning in women with substandard nutrition. MATERIALS AND METHODS: A prospective-cohort study was carried out in six Maternal and Child Health Centers in Assiut-Egypt. Estimated sample size was 540 women divided equally into two groups; the first included women who got pregnant during breastfeeding (PDBF), while the second included women who got pregnant after weaning (PAW). Tools were consisted of structured interview questionnaire including personal history, obstetrical data, breastfeeding, family planning histories and dietary intake during pregnancy. Pregnant women had been followed up to delivery to assess different maternal and fetal outcomes. RESULTS: Miscarriage rate was not statistically significant between both groups (2.2% in PDBF and 0.4% in PAW, p = 0.284). Women in PDBF group had higher prevalence of maternal anemia (54.1% versus 30.7%), intrauterine growth restriction (16.7% versus 4.8%), cesarean delivery (43.7% versus 31.5%), prolonged labor (13.3% versus 11.1%) and low birth weight infants (15.7% versus 8.8%) compared to women in PAW group. CONCLUSION: Pregnancy during breastfeeding is associated with an increase in the overall complications of pregnancy as compared to PAW. Although it does not increase the miscarriage rate, it increases the prevalence of maternal anemia, delayed fetal growth, prolonged labor, cesarean section delivery and the prevalence of low birth weight infants.

A new scoring model for characterization of adnexal masses based on two-dimensional gray-scale and colour Doppler sonographic features.

OBJECTIVE: To determine the most discriminating two-dimensional gray-scale and colour Doppler sonographic features that allow differentiation between malignant and benign adnexal masses, and to develop a scoring model that would enable more accurate diagnosis with those features. METHODS: A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Woman's Health Center, Assiut University, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses combined with colour Doppler examination of their vessels. The final diagnosis, based on histopathological analysis, was used as a gold standard. RESULTS: One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring model was formulated combining these features together; Assiut Scoring Model (ASM). The cut-off level with the highest accuracy in detection of malignancy, was ≥6, had a sensitivity of 93.5% and specificity of 92.2%. CONCLUSION: Our Scoring Model; a multiparameter scoring using four gray-scale ultrasound and two colour Doppler features, had shown a high sensitivity and specificity for prediction of malignancy in adnexal masses compared with previous scoring systems.

Early corticosteroids requirement after the diagnosis of ulcerative colitis diagnosis can predict a more severe long-term course of the disease - a nationwide study of 1035 patients.

BACKGROUND: There are limited data regarding clinical outcomes in ulcerative colitis (UC) patients who require early corticosteroids (CS) use. AIM: To evaluate the rate of early CS utilisation (within 30 days of diagnosis) as a predictive marker for long-term outcomes, colectomy and CS dependency, in a population-based cohort of incident UC cases. METHODS: Nationwide data were obtained from the Veterans Affairs (VA) health care system for the period 2001-2011. Incident UC cases were identified. A retrospective cohort design and time-to-event survival analysis were used to track outcomes of interest. Cox regression multivariate analysis was employed. RESULTS: One thousand and thirty-five newly diagnosed patients with UC were identified and included in the analysis; 236 (23%) of those patients required early CS therapy. Patients were followed-up over a median time of 4.7 years (IQR 2.8-6.8) after UC diagnosis. The 5-year cumulative probability of requiring colectomy varied significantly by early CS use status (13% among early CS users compared to 4% among those who did not require early CS treatment, P < 0.001). Similar variation in the 5-year cumulative probability of CS dependency by early CS status was observed. Early CS users were more likely to require colectomy 2.9 (CI 1.7-5.0, P < 0.001) and to become CS dependent 4.5 (95% CI 3.6-5.7, P < 0.001) than non-users. CONCLUSIONS: Early CS use can help identify those patients who have a more active disease course of UC. Recognising this can be among the indicators that can help physicians identify patients who may require early initiation of more aggressive therapy.

Effect of age on the contractile response of the rat carotid artery in the presence of sympathetic drugs and L-NAME.

UNLABELLED: For evaluating the age-related change in noradrenaline (NA)-induced contraction of isolated rat carotid artery (CA), the effect of α and ß adrenoreceptor (AR) blockers and the role of nitric oxide (NO) were investigated. METHODS: Concentration-response curves to NA (10-10-10-4 M) and α1 agonist phenylephrine (PE; 10-10-10-5 M) were constructed in isolated CA rings from young and middle-aged rats. The effects of nitric oxide synthase (NOS) inhibitor (L-NAME; 100 µM), α1-AR antagonist (prazosin; 0.1 µM), α2-AR antagonist (yohimbine; 0.1 µM) and ß-AR antagonist (propranolol; 1 µM) on NA-induced contraction of isolated CA rings were examined. In CA rings preconstricted with NA, the responses to α2-AR agonist (clonidine; 10-7-10-5 M), ß-AR agonist (isoprenaline; 10-8-10-5 M),), sodium nitroprusside (SNP; 10-9-10-5 M) were assessed. RESULTS: The maximum contractile response of CA to NA and to PE was higher in younger than in middle-aged rats. Prazosin reduced the contractile response to NA in both groups, while propranolol, yohimbine and L-NAME did not affect NA-induced contraction in either of them. Clonidine, isoprenaline and SNP produced a dose-dependent vasorelaxation of CA rings, isoprenaline-induced vasodilatation was lower in middle-aged rats, while there was no difference in clonidine or SNP-induced relaxant effect between the two groups. CONCLUSIONS: NA-induced contraction of isolated rat CA rings is decreased in old rats, this is related to α1-AR. ß-AR mediated dilatation was compromised in middle-aged rats (endothelium-dependent). α2-AR and SNP-mediated dilator effect seems to be unchanged.

Long-term oral mesalazine adherence and the risk of disease flare in ulcerative colitis: nationwide 10-year retrospective cohort from the veterans affairs healthcare system.

BACKGROUND: Adherence is a major factor in determining disease activity in ulcerative colitis (UC). There are limited data on long-term nationwide adherence levels among patients with UC. AIM: To evaluate the long-term adherence levels to oral mesalazine (mesalamine) in the Veterans Affairs (VA) healthcare system, to determine the impact of non-adherence on the risk of flares, and to evaluate the different pharmacy data-based adherence indicators. METHODS: Nationwide data were obtained from the VA for the period 2001-2011. UC patients who started mesalazine maintenance during the inclusion period were included. Level of adherence was assessed using three different indicators: medication possession ratio (MPR), continuous single-interval medication availability (CSA) and continuous multiple-interval medication gaps (CMG). Cox regression modelling was used to predict disease flares and assess the predictive value of each adherence indicator. RESULTS: We included 13 062 patients into the analysis with median follow-up time of 6.1 years. Percentage of patients with high adherence was 47%, 43%, 31% as identified by CSA, MPR and CMG respectively. Low adherers had a significant increase in the risk of flares compared with high adherers (Hazard ratio: 2.8, 1.7 and 1.8, P < 0.001 for CSA, MPR and CMG, respectively). Compared with other adherence indicators, CSA offered the best trend in predicting disease flares. CONCLUSIONS: Long-term high-adherence level was lower than previously reported. Adherence was a significant factor in predicting disease flares. Pharmacy adherence indicators may be useful to healthcare providers in identifying patients at high risk of exacerbations.

A retrospective study of Rift Valley fever in Saudi Arabia.

A retrospective study was undertaken to examine domestic ruminant sera for Rift Valley fever (RVF) virus antibodies. The sera were collected between 1992 and 1995 from cattle, sheep and goats from various locations in Saudi Arabia. The standard capture enzyme-linked immunosorbent assay system was employed to detect specific RVF antibodies in the animals and the results indicated an absence of RVF antibodies. This finding confirms the assumption that Saudi Arabia was free from RVF up until at least 1995 and most probably before the 2000 epidemic. The finding also confirms that RVF was not endemic in Saudi Arabia.

The life span of sperm motility and pattern in cumulus coculture.

OBJECTIVE: To study the effect of cumulus cell coculture on human sperm motility, life span, and patterns. DESIGN: Controlled prospective study of 50 normal semen samples. Sperm motility and forward grade was observed in droplets of Ham's F-10 media with cumulus cell coculture and compared with sperm in droplets of Ham's F-10 only. SETTING: The Egyptian IVF-ET Center. MAIN OUTCOME MEASURES: Sperm motility, life span, and forward progressive pattern. RESULTS: The time course of loss of sperm motility in cumulus coculture was significantly slower than without cumulus. Also, the percentage of motile sperm with linear progressive motility of grade 4,3 was significantly higher in cumulus coculture. CONCLUSION: Cumulus cell coculture has a positive effect on prolongation of sperm motility life span and its forward progression.

Ovarian superstimulation and intrauterine insemination for the treatment of unexplained infertility.

OBJECTIVE: To evaluate the efficacy of controlled ovarian hyperstimulation (COH) and IUI in the treatment of unexplained infertility. DESIGN: The pregnancy rate (PR) in patients with unexplained infertility treated by COH and IUI (group A) was compared with a no-treatment control (group B). SETTING: The Egyptian IVF-ET Center. PARTICIPANTS: Four hundred ninety-two patients with the diagnosis of unexplained infertility. INTERVENTION: Controlled ovarian hyperstimulation and IUI. MAIN OUTCOME MEASURES: Cycle fecundity per treatment cycle and PR per patient. RESULTS: In group A cycle fecundity was 20.1% per treatment cycle, and the PR was 34.7% per patient. In group B the PR was 8.9% per patient. Pregnancy rate per patient was significantly higher in group A when compared with the spontaneous PR in group B. CONCLUSION: Controlled ovarian hyperstimulation and IUI significantly increased the PR in patients with unexplained infertility when compared with a no-treatment control group.