Comparative biological activity of abamectin formulations on root-knot nematodes (Meloidogyne spp.) infecting cucumber plants: in vivo and in vitro.

The root-knot nematodes (Meloidogyne spp.) are considered one of the most destructive diseases in the world. In Egypt, farmers primarily rely on chemical nematicides, which have become costly to control. Currently, abamectin is a bio-based pesticide used as an alternative tool against Meloidogyne spp. on cucumber plants (Cucumis sativus L.). During the current research, four tested abamectin formulations were DIVA (1.8% EW), RIOMECTIN (5% ME), AGRIMEC GOLD (8.4% SC) and ZORO (3.6% EC) compared with two reference nematicides namely, CROP NEMA (5% CS) and TERVIGO (2% SC). The main results showed that, in vitro study elucidated that the most effective formulations of abamectin as a larvicidal were EW with LC50 value of 21.66 µg ml-1. However, in the egg hatching test, the formulations of abamectin SC (2%) and EW were the most effective in reducing egg hatching, with LC50 values of 12.83 and 13.57 µg ml-1. The calculated relative potency values showed diversity depending on the two referenced nematicides. On the other hand, in vivo study, the results indicated that, all tested formulations of abamectin recorded general mean reductions in root galls (23.05-75.23%), egg masses (14.46-65.63%). Moreover, the total population density declined by 39.24-87.08%. Furthermore, the influence of abamectin formulations, in the presence of root-knot nematodes, on the growth of cucumber plants parameters, such as root dry weight, root length, root radius, root surface area, shoot dry weight and shoot height, as well as the content of macro-elements (N, P and K) exhibited varying levels of response.

Concomitant administration of sitagliptin and rutin improves the adverse hepatic alterations in streptozotocin-induced diabetes mellitus in albino rats: an overview of the role of alpha smooth muscle actin.

BACKGROUND: Diabetes mellitus (DM), one of the commonest worldwide metabolic conditions, is believed to be associated with an imbalance between oxidants and antioxidants. Sitagliptin is an oral anti-hyperglycaemic drug that blocks dipeptidyl peptidase 4 (DPP4). Rutin is a polyphenolic natural flavonoid which has antioxidant and anti-proliferative activity. The aim of the present work is to elucidate the concomitant effect of sitagliptin and rutin on the deleterious alterations in the liver of experimentally induced diabetes in rats. MATERIALS AND METHODS: Fifty adult male albino rats, weighing 170-200 g were used. Rats were randomly divided into five groups (n = 10): group 1 (control group), the other four groups (groups II, III, IV and V) received a single i.p. injection of streptozotocin, 65 mg/kg body weight to induce diabetes; group II (diabetic), group III (diabetic and rutin administered), group IV (diabetic and sitagliptin administered), and group V (diabetic with sitagliptin and rutin concomitantly administered). Haematoxylin and eosin, Masson trichrome, periodic acid Schiff, immune-histochemistry: a-smooth muscle actin (a-SMA), histomorphometric analysis, liver enzymes and oxidants/anti-oxidants; malondialdehyde/glutathione and were done. RESULTS: Distorted hepatic architecture, dilatation, congestion of sinusoids and central veins as well as cytoplasmic vacuolations were remarkable changes in the diabetic group. There was extravasation of blood, diffuse fibrous tissue formation, increase in the mean values of liver enzymes, oxidative markers and a-SMA expression in the same group. The aforementioned changes were ameliorated in groups III and IV. Concomitant administration of sitagliptin and rutin resulted in marked enhancement of these hepatic alterations. CONCLUSIONS: Combination of sitagliptin and rutin has an ameliorating effect on the hepatic deterioration induced by diabetes, which is better than either sitagliptin or rutin alone.

3-(Bromoacetyl)coumarins: unraveling their synthesis, chemistry, and applications.

This review emphasizes recent developments in synthetic routes of 3-(bromoacetyl)coumarin derivatives. Also, chemical reactions of 3-(bromoacetyl)coumarins as versatile building blocks in the preparation of critical polyfunctionalized heterocyclic systems and other industrially significant scaffolds are described. Recent advances of 3-(bromoacetyl)coumarins as attractive starting points towards a wide scale of five and six-membered heterocyclic systems such as thiophenes, imidazoles, pyrazoles, thiazoles, triazoles, pyrans, pyridines, thiadiazins as well as fused heterocyclic systems have been reported. Additionally, this review covers a wide range of analytical chemistry, fluorescent sensors, and biological applications of these moieties, covering the literature till May 2021.

Effects of nicotine on rat adrenal gland: crosstalk between oxidative and inflammatory markers, and amelioration by melatonin.

Although the risks of smoking are well known, the effects of exposure to nicotine on endocrine functions remain unclear. We investigated the deleterious effects of nicotine on the adrenal gland and the mechanisms of these changes in rats. The role of melatonin in ameliorating pathological changes also was investigated. We used 24 rats divided into four groups of six: group 1, control; group 2, nicotine treated; group 3, nicotine and melatonin treated; group 4, melatonin treated. We used histology; immunohistochemistry of inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF) and tyrosine hydroxylase (TH); measured oxidative and antioxidative markers, malondialdehyde (MDA) and glutathione (GSH); and performed real-time PCR for NF-κB 65, IL1-B and IL6. We also performed histomorphometric analysis. Indentation and lamellar separation of the adrenal capsule, vacuolated degenerated cells and lymphocytic infiltration were observed in group 2. Vacuolated cells and cells with pyknotic nuclei also were detected in the zona reticularis and medulla of the same group. We observed improved shape and cellular lining of the gland in groups 3 and 4. Widespread expression of iNOS, VEGF and TH, increased area percent collagen, decreased GSH (56%) and increased MDA, NF-κB, IL1-B and IL-6 were observed in group 2. All parameters were ameliorated in groups 3 and 4. The effects of nicotine on the adrenal gland can be attributed to oxidative and inflammatory stress; melatonin ameliorates these effects.

N-acetylcysteine versus progesterone on the cisplatin-induced peripheral neurotoxicity.

BACKGROUND: Cisplatin-induced peripheral nerve neurotoxicity (CIPN) is the main obstacle in cisplatin treatment. The aim of this study was to compare the modulatory effects of N-acetylcysteine (NAC) and progesterone on CIPN, because there are scarce literature data on the protective effect of the proge-sterone on the CIPN. MATERIALS AND METHODS: Twenty-four rats were divided into four groups: control, cisplatin-treated, concomitant cisplatin-treated and NAC-treated, and concomitant cisplatin-treated and progesterone-treated. Electron microscopic, immunohistochemical, real time polymerase chain reaction and histomorphome-tric analysis; oxidative/antioxidative markers (MDA/GSH and SOD), neurotoxic/ neuroprotective markers (iNOS/nNOS), inflammatory mediators (TNF-a and NF-kB) and BAX were done. RESULTS: The myelin sheath in the cisplatin-treated group elucidated infolding. The myelin was disfigured, degenerated, and extensively split with areas of focal loss. The axoplasm was atrophic. Ballooning and vacuolations of the mitochon-dria with alterations of Remak bundles structures were observed. Fewer of these changes were noted in the NAC and progesterone-treated groups. Decrease of the antioxidant SOD and GSH (81% and 64%) and increase of the oxidant MDA (9 folds), increment of the neurotoxic iNOS (1.9 folds) and decrement of the neuroprotective nNOS (64%) and elevation of the inflammatory mediators' TNF-a and NF-kB (8.3 and 11 folds) in the cisplatin-treated group. Increase of the antioxidant SOD (1.3 and 2.5 folds) and GSH (120% and 79%) and decrease of the oxidant MDA (69% and 88%), decrement of the neurotoxic iNOS (56% and 68%) and increment of the neuroprotective nNOS (1.6 and one folds) and elevation of the inflammatory mediators' TNF-a and NF-kB were observed in the NAC and progesterone-treated groups, respectively. CONCLUSIONS: The toxic effect of CIPN might be attributed to either oxidative or severe inflammatory stress. Progesterone is efficient in ameliorating these effects; however, NAC is better. (Folia Morphol 2018; 77, 2: 234-245).

Optimization and characterization of the formation of oil-in-water diazinon nanoemulsions: Modeling and influence of the oil phase, surfactant and sonication.

Nanoemulsions are particularly suitable as a platform in the development of delivery systems for lipophilic functional agents. Current research describes the formation of oil-in-water (O/W) diazinon nanoemulsions using synthetic and natural additives by adopting a high-energy (ultrasound) emulsification method. The diazinon nanoemulsions were spontaneously formed by adding dropwise a mixture of diazinon, solvent and co-solvent in an aqueous solution containing a surfactant (tween or lecithin) with continuous stirring. The nanoemulsions were then formed by ultra-sonication. The effects of three levels of active ingredient, solvent, co-solvent, surfactant, sonication time and sonication cycle and power were performed by Minitab software to design the experiment. Effects of these factors on droplet size, polydispersity index (PDI), viscosity and pH of nanoemulsions were investigated. The results of the modeling showed that the experimental data could be adequately adapted in a second-order polynomial model with a multiple regression coefficient r2 of 0.821 for the prediction of particle size, PDI and viscosity. The long-term and thermodynamic stability of the prepared nanoemulsions were tested. The droplet size and morphology of the nanoemulsions were measured by dynamic light scattering (DLS) and transmission electron microscopy (TEM). On this basis, a water-insoluble insecticide diazinon was incorporated into 26 optimized nanoemulsion systems to demonstrate potential applications in pest control. The results of DLS and TEM measurements showed that most of prepared nanoemulsions had an almost monodisperse droplet size distribution (PDI < 200 nm). Incorporation of diazinon had no significant effect on the size and stability of the nanoemulsions and the formulated nanoemulsion remained stable after four months of storage.

POPULATION DYNAMICS OF CHAFF SCALE, PARLATORIA PERGANDII COMSTOCK IN COMPARATIVE ANALYSIS OF FLUCTUATING POPULATION DENSITIES ON THREE CITRUS VARIETIES IN EL-BEHEIRA GOVERNORATE, EGYPT.

Investigation throughout the subsequent years of 2011-2012 and 2012-2013 indicated that chaff scale, P. pegandii is an important economic pest on citrus trees in Abou El-Matamer area, El-Beheira Governorate, Egypt. It has been recorded in relatively high rates all over the year on three citrus varieties called Succari, Baladi and Navel oranges. Field observation and recorded data revealed that the common abundance was recorded for chaff scale on Succari oranges followed by Navel oranges then the least abundant on Baladi oranges. Generally, the calculated data on Succari oranges showed that, the population of P. pergandii reached the maximum during July and there were five highly variation periods in both the growing seasons of 2011-2012 and 2012-2013. The maximal percent of pre and adult females was observed during Spring and early Summer and reached 100% of the total counted individuals during October and December in the first year, but in the second one a higher population was recorded during Summer and early Winter months. The adult males were observed during Summer and Autumn months. Results showed also that the relationship between daily mean temperature and population density of chaff scale was weak, insignificantly negative in the two growing seasons (2011-2012 and 2012-2013) and also insignificantly but positive with relative humidity. That relationship with wind speed indicated weak positive significance in the first year and strong in the second season. The relationship between dew point and insect population was weak of positive significance in both growing seasons.

Fetal hemivertebra: associations and perinatal outcome.

OBJECTIVES: To assess the accuracy of antenatal diagnosis of hemivertebra, to quantify the association with coexisting anomalies and to determine the perinatal outcome. METHOD: This was a retrospective observational study of all cases of suspected fetal or neonatal hemivertebra identified via the UK Southwest Congenital Anomaly Register (SWCAR) between 2002 and 2012. RESULTS: From a total of 88 cases of hemivertebra identified during the study period, data were obtained for 67 of them: 45 (10 isolated and 35 with coexisting anomalies) cases were suspected antenatally and 22 (10 isolated and 12 with coexisting anomalies) were diagnosed postnatally. Of the cases detected postnatally, five (four with coexisting anomalies) were unsuspected and diagnosed at postmortem examination. The most commonly associated anomalies included additional skeletal abnormalities (n = 16), genitourinary abnormalities (n = 10), VATER/VACTERL association (n = 5), cardiac abnormalities (n = 4) and central nervous system abnormalities (n = 4). In cases with coexisting anomalies there was a 48% fetal/neonatal loss, compared to 19% in cases with isolated hemivertebra. CONCLUSIONS: Although antenatal diagnosis of hemivertebra was accurate, a third of the cases were diagnosed only postnatally. These data suggest a difficulty in antenatal diagnosis of the condition. The majority of cases of hemivertebra had coexisting anomalies, and in these cases the rate of perinatal loss was high. These data should be useful in providing additional information for counseling when a diagnosis of hemivertebra is made.

Management and outcome of pregnancies with parvovirus B19 infection over seven years in a tertiary fetal medicine unit.

OBJECTIVES: To determine rates of fetal anaemia and pregnancy outcome in susceptible pregnant women infected with human parvovirus B19 infection in a tertiary fetal medicine department over a 7-year period. Additional features enabling identification of fetuses that progress to severe anaemia were also investigated. METHODS: Forty-seven susceptible, pregnant women with confirmed parvovirus infection referred to a regional fetal medicine unit, over a 7-year period (1999-2006), were identified. Where possible maternal serum AFP measurements were obtained from second-trimester serum screening and the presence or absence of echogenic bowel noted. RESULTS: Of the 47 cases, one was excluded. Of the remaining 46 cases, 34 (74%) showed no signs of fetal anaemia and delivered at term. The remaining 12 (26%) showed signs of fetal anaemia. Eight of the 12 developed hydrops and underwent fetal blood sampling and transfusion (median pretransfusion Hb 3.6 g/dl). Seven of the 8 transfused fetuses were thrombocytopenic with a platelet count <150 x 10(9)/l, with 2 fetuses having platelet counts <50 x 10(9)/l. The median gestation age at transfusion was 22 weeks (range 18-27 weeks). The median number of weeks between seroconversion and transfusion was 6 (range 3-12). The signs of anaemia resolved after one transfusion in 5 of the 8 transfused fetuses and they subsequently delivered at term. There were 2 fetal deaths during or shortly after transfusion and one neonatal death following delivery at 28 weeks gestation due to severe pre-eclampsia, 5 days after successful transfusion. CONCLUSIONS: Following parvovirus seroconversion, the incidence of significant fetal anaemia requiring transfusion was 17%. Seroconversion after 21 weeks did not result in severe fetal anaemia. Significant anaemia requiring intervention did not occur 12 weeks after maternal seroconversion. We did not demonstrate a correlation with either maternal serum AFP or the presence of fetal echogenic bowel and the development of severe fetal anaemia. Because of the association between fetal anaemia and severe thrombocytopenia, it may be prudent to have compatible platelets available at the time of fetal blood sampling.

Free fetal DNA in maternal plasma in anembryonic pregnancies: confirmation that the origin is the trophoblast.

OBJECTIVE: To test the hypothesis that free fetal DNA (ffDNA) circulating in maternal plasma originates mainly from the placenta we studied ffDNA levels in anembryonic pregnancies. METHODS: Maternal blood samples were collected from 15 normal first-trimester pregnancies in which fetal sex was subsequently determined and nine patients with a diagnosis of anembryonic gestation (AG). The Y chromosome DYS14 gene was quantified by real-time quantitative PCR (RT-PCR) for the determination of fetal sex in both plasma and chorionic tissue samples. Fetal sex in chorionic tissue samples was also determined using quantitative fluorescence PCR (QF-PCR). RESULTS: The correct sex result was obtained from maternal plasma in all. Four AG pregnancies were female (DYS14 negative) results. In five of the AG cases, the chorionic tissue was found to be male (by both QF-PCR and RT-PCR which agreed) and positive male signal was found in maternal plasma by RT-PCR. There was no statistical difference between median free fetal DNA concentration in plasma between the AG male cases (148.3 GE/mL) and controls (145.8 GE/mL). CONCLUSION: Since ffDNA levels are normal in pregnancies without a fetus, the data support the hypothesis that the trophoblastic cells are the major source ffDNA in maternal plasma.

Comparison of different reference values of fetal blood flow velocity in the middle cerebral artery for predicting fetal anemia.

OBJECTIVES: To compare different normal reference ranges of fetal blood flow velocity in the middle cerebral artery for predicting fetal anemia. METHODS: Eight reference ranges of either middle cerebral artery peak or time-averaged mean velocities were compared using the area under the receiver-operating characteristics (ROC) curve for 113 fetal blood samples from 60 women at risk of fetal red blood cell alloimmunization. RESULTS: The areas under the ROC curves of the different ranges were not significantly different but there were marked differences in sensitivity (range, 7.14-91.78%) and specificity (range, 31.25-96.88%) with the currently used cut-offs. Except for Mari's range, the best theoretical cut-offs, defined as those having the best sensitivity with the best specificity, differed from those in current use, especially when using time-averaged mean velocity. CONCLUSIONS: Any of the previously reported reference ranges perform well in the non-invasive prediction of fetal anemia. However, with the exception of Mari's curve, the currently employed cut-offs for predicting fetal anemia should be changed, some of them markedly, in order to provide reliable support for clinical decisions.

Middle cerebral artery Doppler for the prediction of fetal anaemia in cases without hydrops: a practical approach.

The aim of this study was to assess the value of the middle cerebral artery (MCA) Doppler time-averaged mean velocity (TAMV) for the prediction of fetal anaemia in at-risk cases without ultrasound evidence of hydrops. The study included 35 pregnant women with non-hydropic fetuses and with known red cell antibodies, referred either because of a rapid increase in antibody levels or because of a previous history of a severely anaemic fetus or neonate. After full ultrasound examination of the fetus, MCA Doppler TAMV was measured and, if severe anaemia was suspected, fetal blood sampling by cordocentesis was performed with blood ready for intrauterine transfusion if necessary. Of the 35 fetuses, 28 were anaemic and 7 had a haemoglobin (Hb) value within the normal range. There was a strong negative correlation between the MCA Doppler TAMV and the Hb values (correlation coefficient r=-0.65, p<0.0001). The mean MCA Doppler TAMV (z score) for fetuses with normal Hb was 1.55+/-1.68, while that for the anaemic fetuses was 4.06+/-1.38, (p<0.001). The sensitivity of the increased MCA Doppler TAMV to predict fetal anaemia in these cases was 96.4% and the specificity was 71.4%. These data confirm that MCA Doppler TAMV is significantly correlated to fetal Hb. This non-invasive investigation can be reliable in predicting anaemia in cases in which the need to sample fetal blood is not certain, therefore delaying invasive testing until treatment is likely to be required.

Noninvasive diagnosis of anemia in hydrops fetalis with the use of middle cerebral artery Doppler velocity.

OBJECTIVE: The purpose of this study was to assess the value of the middle cerebral artery time-averaged mean velocity for the detection of anemia as the cause of fetal hydrops. STUDY DESIGN: We examined 17 pregnant women with fetuses with hydrops (with ascites as the main component of hydrops) and who were considered at risk for anemia because there was no obvious explanation for the hydrops on the initial scan. Assessment included the measurement of the middle cerebral artery time-averaged mean velocity by color flow Doppler scan, followed by fetal blood sampling for investigations that included fetal hemoglobin. We investigated the correlation between increased middle cerebral artery time-averaged mean velocity (>2 SDs for gestational age) and fetal anemia (<2 SDs for gestational age). RESULTS: Eleven fetuses had anemia; 3 of the fetuses had red cell antibodies, and 6 of the fetuses had normal hemoglobin. There was a strong negative correlation between the middle cerebral artery time-averaged mean velocity and the hemoglobin values (r = -.9; P <.0001). The mean (z score) of middle cerebral artery time-averaged mean velocity for fetuses with normal hemoglobin was 1.1 +/- 0.81 and for the fetuses with anemia was 4.71 +/- 2.16 (P <.001). The sensitivity for the increased middle cerebral artery time-averaged mean velocity to predict fetal anemia was 91%, and the specificity was 100%. CONCLUSION: The middle cerebral artery time-averaged mean velocity is significantly increased in cases of hydrops caused by anemia, including cases other than red-cell alloimmunization. These findings can be useful for counseling and treatment and allow the investigation of the cause of hydrops without awaiting blood for intrauterine transfusion in patients who are very unlikely to be anemic and often avoids 2 procedures in those patients who require transfusion. Larger studies are required to further confirm these findings.

Outcome of fetal talipes following in utero sonographic diagnosis.

OBJECTIVES: To examine the association between fetal talipes and other defects, and outcome in relation to postnatal surgery. METHODS: All cases of talipes presenting to the fetal medicine unit between 1993 and 1998 and cases of isolated talipes presenting to the ultrasound department between 1991 and 1998 were examined. The infants were followed-up to determine the number of cases that had structural or positional talipes and the number of cases requiring surgery. RESULTS: There were 76 cases, 59 of which attended the fetal medicine unit and 17 the ultrasound department. Postnatal follow-up details were available in 31 of the 40 live births. There were three neonates with unilateral talipes at birth who were thought to have bilateral talipes on prenatal ultrasound and one neonate had bilateral talipes at birth who had been thought to have unilateral talipes prenatally. In two (6.4%) neonates in whom talipes was not confirmed at birth the abnormality was diagnosed prenatally. Of the 29 neonates with confirmed talipes at birth, the defect was structural in 26 (90%) cases and positional in three. Surgery was necessary in 21 (72%) of the 29 cases and 18 (86%) of those undergoing surgery required only one operation. When live births with associated anomalies were excluded, there were 24 cases with confirmed isolated talipes and 18 (75%) required surgery. CONCLUSIONS: This study provides long-term outcome data which can be used to complement current prenatal counseling and shows that in cases of fetal talipes diagnosed prenatally, 90% have a structural rather than a positional deformity. For isolated talipes three quarters of children will require surgery and in the majority of cases only one operation on the foot is necessary. Parents should be made aware of the small possibility of a false-positive diagnosis and discrepancy between the ultrasound and postnatal diagnoses of laterality.

Alphafetoprotein in screening for congenital hypothyroidism

This study was conducted on 500 full-term neonates and 25 older patients with congenital hypothyroidism [CH], newly or previously diagnosed. Alphafetoprotein [AFP] was elevated in two neonates. In one, persistent elevation of AFP and thyroid stimulating hormone [TSH] with low thyroxine [T4] were found [congenital hypothyroidism]. In the other, AFP, TSH and T4 levels normalized [transient hypothyroidism]. The mean AFP level in new CH patients was significantly higher than in previously diagnosed patients, and was higher in CH patients than in controls. Significant relationships were found between AFP and T4, AFP and TSH, and AFP and age. AFP is a sensitive indicator of thyroid status and can be used as a screening test for hypothyroidism from the first day of life and in follow-up of CH patients

Correlation of prenatal ultrasound diagnosis and pathologic findings in fetal brain abnormalities.

OBJECTIVE: To determine the degree of agreement between prenatal ultrasound diagnosis of brain abnormalities and subsequent pathologic findings. METHODS: Between August 1993 and August 1999 there were 62 cases where a fetus with a prenatal ultrasound diagnosis of a brain abnormality other than neural tube defects underwent autopsy at the Regional Department of Pediatric Pathology. The cerebral diagnosis at ultrasound was compared with the findings at autopsy in all cases. RESULTS: In 47 of 61 (77%) cases the same defects were seen on ultrasound and at autopsy. The most common disparity was with the Dandy-Walker malformation or variant, where only six of the 14 (43%) cases prenatally diagnosed with this condition showed the same abnormality at autopsy. When fetuses with the Dandy-Walker malformation or variant were excluded, the scan findings correlated with autopsy in 41 of 47 (87%). In the main group with discordant findings, five of the seven cases where termination of pregnancy was undertaken had other fetal anomalies on ultrasound examination which were confirmed at autopsy. In the sixth case there was autolysis of brain tissue which affected detailed autopsy. CONCLUSIONS: A very high level of agreement between prenatal ultrasound and autopsy findings was found for all abnormalities of the fetal brain, except for the Dandy-Walker malformation or variant. Potential discrepancy in findings between ultrasound and autopsy should be explained to patients who are considering termination of pregnancy for the Dandy-Walker type of abnormality.

The effect of fetal hydrops on the rate of fall of hemoglobin after fetal intravascular transfusion for red cell alloimmunization.

OBJECTIVE: We aimed to assess whether there is a difference between hydropic and nonhydropic fetuses in the rate of fall of hemoglobin (Hb) following intravascular transfusions. METHODS: Eighty-three intravascular transfusions in 34 fetuses were analyzed. The pretransfusion and posttransfusion Hb values, the gestational age, the volume of blood transfused, the number of days between transfusions and the rate of fall of Hb per day following a transfusion were assessed. Hb levels were expressed as multiples of standard deviation from the normal mean for gestational age. RESULTS: Eleven fetuses were hydropic at presentation and 23 were not. Twenty-three transfusions were undertaken in the 11 fetuses while they were hydropic and 60 transfusions were performed in nonhydropic fetuses. Comparisons of transfusion variables between the two groups were performed both for the first transfusion only and also for the total number of transfusions. The rate of Hb fall per day following a transfusion was similar in the two groups on both comparisons. The posttransfusion Hb level tended to be lower and the intervals between transfusions were a little shorter in the hydropic group, but these differences were not statistically significant. CONCLUSION: The posttransfusion Hb tended to be lower in the hydropic fetuses, but the fall in Hb was not faster in these cases. Therefore, with a similar rate of daily Hb decline in both groups, the hydropic fetuses are expected to become anemic again sooner than the nonhydropic fetuses only because of the lower posttransfusion Hb. The timing of the next transfusion should therefore be based on the posttransfusion Hb and the normal predicted drop per day irrespective of the presence or absence of hydrops.

The prevalence of delta virus infection in chronic liver disease in Egyptian children in comparison with some other countries.

BACKGROUND: Hepatitis Delta Virus (HDV) infection has a worldwide distribution. The aim of this study was to establish its prevalence in Egyptian children with chronic liver disease, and its role in the development and progress of hepatic illness. METHODS: A prospective study of 45 Egyptian children who had liver cirrhosis (n = 24) or chronic hepatitis (n = 21) was done. They were consecutively chosen. Their ages ranged from 2-15 years (median = 5). Serological studies were performed to detect the presence of hepatitis B surface antigen (HBs Ag) and HDV infection IgG antibody (IgG anti-HD). RESULTS: Anti-delta antibody (IgG anti-HD) was detected in only four children with hepatic cirrhosis and non of the chronic hepatitis, with an overall prevalence of 8.9% (4/45). Three of them (75%) were hepatitis B surface antigen (HBs Ag) negative. Significant statistical association between delta infection and the state of hepatic illness was detected (p < 0.05). Whereas HBs Ag was detected in 54% (13/24) of liver cirrhosis and 52% (11/21) of chronic hepatitis, with an overall prevalence of 53% (24/45). There was no statistically significant association between HBs Ag positivity and state of hepatic illness. CONCLUSIONS: The prevalence of HDV infection is 8.9% of Egyptian children with chronic liver disease. HDV infection in children is associated with advanced chronic liver disease.

An assessment of the use of interphase FISH with chromosome specific probes as an alternative to cytogenetics in prenatal diagnosis.

We have assessed the effects that would have been observed if we had changed from standard prenatal diagnosis to interphase fluorescence in situ hybridization (FISH) on our amniocentesis samples. We aimed to estimate the number of cases with aberrations other than chromosomes 13, 18, 21, X and Y, which would not have been detectable by FISH and to assess the potential clinical implications for these cases. In 1687 prenatal diagnoses, 111 cases had abnormal cytogenetic reports (6.5% aneuploidy rate). Out of those 111 cases, 14 had chromosomal abnormalities not detectable by FISH but four of these had major structural abnormalities diagnosed on ultrasound, which would have lead to counselling of a very poor prognosis anyway. In 10 cases without abnormal ultrasound findings, if FISH had been used rather than cytogenetics, it appears that there may have had no detrimental effects on the clinical outcomes of the cases studied. Out of those 10 cases, two pregnancies were terminated because of abnormal cytogenetic results (one was due to maternal age and the second one was due to abnormal biochemical screening) (mosaic 46,XY, /47,XY,+mar and 46,X,del(8)(p21) respectively) and their post-mortem results also did not show any abnormalities. One pregnancy was continued in spite of a de novo chromosomal rearrangement and resulted in an apparently normal live birth. Five cases (including a set of twins) with inherited balanced translocations resulted in four normal live births and one unexplained intrauterine death at 32 weeks' gestation and post-mortem was declined. One case with a paternally derived abnormal chromosome 21, decided to continue the pregnancy and resulted in a normal live birth. The last case in this group resulted in a rhesus related intrauterine death in the second trimester, and although an abnormal chromosome 13 insertion (paternally derived known aberration) there was no abnormality found at post-mortem. Therefore, we suggest that it is reasonable to use FISH as an alternative prenatal diagnosis for indications such as advanced maternal age and abnormal maternal serum biochemical screening when high quality ultrasound scanning is performed, but FISH should only be used as an additional test to conventional cytogenetics for the other indications, especially when abnormalities are found on ultrasound scan.