Assessment of safety and quality aspects of boiling treatment of quail eggs.

A total of 300 quail eggs were collected randomly from different markets in Cairo and Giza Governorates. Five eggs were represented as one egg sample. Shell and content of each egg were examined for their microbiological contents, sensory evaluation and study of Escherichia coli O157 survival in artificially contaminated eggs. Moreover, qualitative detection of antimicrobial residues by seven plates microbiologically bioassay and confirmed by validated high-performance liquid chromatography (HPLC) methods for positively reacted antimicrobials in raw and boiled samples. There was a significant difference (P < 0·05) between the grading score of eggs after the boiling at 2-, 4-, 5- and 7-min. Based on the survival results, the refrigeration storage and boiling for 5 min of quail eggs was confirmed that such eggs are without E. coli O157. After the boil, the concentrations of oxytetracycline (OTC) and 4-Epi-OTC residues were significantly reduced, and there was no effect on the concentration of sulphadimidine (SDD), amoxicillin (AMO) and Diketo residues. Samples that exceeded the maximum residual limits (MRLs) were 17·0%, 12·0%, 10·0%, 16·0% and 14·0% for SDD, OTC, 4-Epi-OTC, AMO and Diketo, respectively. After boiling, no significant change was noted for SDD, AMO and Diketo, but all OTC and 4-Epi-OTC were completely below MRLs. Therefore, SDD and AMO with their metabolite (Diketo) are heat-stable antimicrobial residues with multiple human health hazards.

Immune investigation of the honeybee Apis mellifera jemenitica broods: A step toward production of a bee-derived antibiotic against the American foulbrood.

Keeping honeybees healthy is essential, as bees are not only important for honey production but also cross-pollination of agricultural and horticultural crops; therefore, bees have a significant economic impact worldwide. Recently, the lethal disease, the American foulbrood (AFB), caused great losses of honeybee and decline of global apiculture. Recent studies have focused on using natural insect-derived antibiotics to overcome recently emerged AFB-resistance to conventional antibiotics. In support of these studies, here we investigate the possibility of producing bee-derived anti-AFB antibiotics from an indigenous honeybee, Apis mellifera jemenitica. The immune responses of the third instar stage were first induced against the standards Micrococcus luteus and Escherichia coli compared with the indigenous Paenibacillus larvae (ksuPL5). Data indicated a strong immune response against M. luteus, E. coli and P. larvae 24 h post-P. larvae-injection as revealed by the detection of lysozyme-like, cecropin-like and prophenoloxidase (PO) activities in the plasma of P. larvae-injected third instars. Nodulation activity against injected P. larvae as early as 4 h and peaking 48 h post-P. larvae injection were observed. Potentially active anti-P. larvae immune peptide fractions purified by high-performance liquid chromatography (HPLC) showed significant in vivo therapeutic effects on P. larvae-infected first instars. Mass spectrophotometric analysis and Orbitrap measurements of P. larvae-injected plasma indicated the expression of PO (Mr: 80 kDa), beta-1,3-glucan-binding protein (Mr: 52 kDa) and serine protease 44 isoform X1 (Mr: 46 kDa). This suggests that one or all of these immune peptides contribute to significant survivorship of P. larvae-infected broods, and could be a valuable clue in the search for honeybee-derived anti-AFB natural therapeutic agents. Further molecular characterization and description of the functional roles of these predicted antimicrobial peptides from both broods and adult honeybee may enrich the arsenal of insect-derived antibiotics of therapeutic purposes.

Retraction: Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder.

The above article, published in print in the Jan 2018 issue of the Journal of Child Psychology & Psychiatry and online in Wiley Online Library (wileyonlinelibrary.com), has been retracted by the JCPP Editor-in-Chief, Edmund Sonuga-Barke, and John Wiley & Sons. Following a series of communications from readers highlighting concerns about the paper (now published on the journal website), the journal editors requested that the authors send them the raw data from the trial. In response the authors informed the editors that; (i) the electronic data base had been lost following a computer outage and (ii) that they could send only 95 out of 120 hard-copy participant data sheets as one site had closed and was no longer contactable. The substantial data loss in and of itself posed a serious difficulty in verifying the correctness of the data presented in the paper. The JCPP then analysed the data from the 95 cases itself. A number of significant discrepancies emerged between the re-analysis and the findings reported in the paper both in terms of means and standard deviations of key outcome variables across the trial. These involved very substantial differences that we judged to be extremely unlikely to have arisen due to variations in composition of the original and re-analysed samples. We also discovered previously unidentified/reported problems with missing data and recording irregularities regarding changes in treatment regimen and subject identifiers. As a result of these issues the Editors no longer have confidence in the findings reported in the original paper. Based on all these matters combined and following published guidance from the Committee on Publishing Ethics (COPE) and Wiley's Best Practice Guidelines on Publishing Ethics, we have decided that the only course of action available to us is to retract the paper.

Neglected Tibial Pilon Fractures: Can Arthrodesis Be Avoided?

OBJECTIVES: To evaluate the outcomes of neglected pilon fractures treated by the Ilizarov fixator and to determine whether this technique was successful in avoiding an ankle arthrodesis. DESIGN: Retrospective case series. SETTING: Level I university trauma center. PATIENTS: Between January 2003 and March 2015, 18 patients (mean age of 42.17 years) with an untreated pilon fracture with late presentation (>1 month) were evaluated. Six patients were women and 12 were men. The mean duration from trauma to management was 11.17 weeks (range: 7-15). All fractures were OTA/AO 43 type C. Four cases were open fractures. INTERVENTION: Closed fracture reduction, correction of deformity, and restoration of alignment by the Ilizarov fixator. MAIN OUTCOME MEASUREMENTS: The radiographs were evaluated for tibial alignment, quality of reduction, and development of arthrosis. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale was used for functional assessment. RESULTS: The follow-up period ranged from 18 to 168 months (mean; 38.00). The quality of reduction was excellent in 2 cases, satisfactory in 13 cases, and poor in 3 cases. The external fixator period averaged 29.06 weeks (range: 6.1-7.5 months). All fractures healed without deep infection. Ankle dorsiflexion and plantar flexion averaged 8.67 and 25.67 degrees, respectively, in 15 cases. Arthrodesis was performed for the remaining 3 cases. The mean AOFAS Ankle-Hindfoot score was 82.67. One case had mild anterior translation, and another 1 had a procurvatum of 5 degrees. Arthrosis developed in 6 ankles. CONCLUSIONS: A satisfactory outcome was achieved after management by the Ilizarov fixator while avoiding arthrodesis in most cases of this series of neglected pilon fractures. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Distraction osteogenesis of fourth brachymetatarsia.

BACKGROUND: Brachymetatarsia is a rare congenital or developmental condition that results in a short metatarsal. The condition most commonly affects the fourth metatarsal of young and adolescent females. It does not usually produce a functional problem. However, it may produce a significant cosmetic problem especially in young women. The authors present their experience in gradual distraction of the fourth metatarsal to tackle this problem in adults. METHODS: That was done using a monolateral frame in 11 feet of female patients with an average age of 23 years. Evaluation depended upon the achievement of the target length, angulation, pain, and satisfaction of the patient. RESULTS: There were eight excellent and three good results after an average follow up of 2.6 years. Aside from nine cases of mild pin-tract infection, complications were few and minor. CONCLUSIONS: We recommend distraction osteogenesis as the treatment of choice for brachymetatarsia of the fourth toe.

Pattern of use and impact of patient sitters on the quality of healthcare in Saudi Arabia.

OBJECTIVE: To assess the pattern of use and impact of patient sitters on the quality of healthcare in Taif Armed Forces Hospital, Taif, Kingdom of Saudi Arabia (KSA). METHODS: A cross-sectional survey was conducted at the Armed Forces Hospital, Taif Region, KSA from 1st January to 30th March 2008. The study included 203 admitted patients, 125 patient sitters, and 213 physicians and nurses. Three different questionnaires were specifically designed for each group of participants including information on the pattern and duration of patient sitting, and potential benefits and harm among sitters. RESULTS: Approximately 58.4% of the participating sitters were women, 88% were Saudis, with age range from 17-60 years old, and mean (+/-standard deviation) of 33.0 (+/-9.64) years. More than 73% of the sitters have regular jobs. Types of the room and patient's age were the significant predictors for the presence of sitters. Patient satisfaction was not significantly associated with the presence, or absence of patient sitters. CONCLUSION: Pattern and use of patient sitters in Saudi Arabia is unique where socio-cultural factors play the most important role. This study is another reminder to the healthcare system in KSA, as well as other Arab countries to develop policies that clearly specify patient criteria that support the decision of patient sitter use.

Introduction of the New World Squash leaf curl virus to Squash (Cucurbita pepo) in Egypt: A Potential Threat to Important Food Crops.

Squash plants showing leaf curling, yellow mottling, and reduced fruit set were observed in fields in Giza, Egypt in spring 2005. These particular symptoms had not been observed previously in zucchini squash plants in Egypt, but were reminiscent of those caused by begomoviruses (Geminiviridae) that are known to occur in the region, including Watermelon chlorotic stunt virus. Squash plants were heavily infested with the whitefly Bemisia tabaci (Genn.), the only known vector of begomoviruses. Total nucleic acids were isolated from symptomatic squash leaves using the cetyltrimethylammoniumbromide method, and extracts were subjected to polymerase chain reaction (PCR) analysis using two sets of PCR primers. One primer set (prAV2644 and prAC1154) was designed to amplify a fragment that contains the entire viral coat protein (Cp), while the second primer set (prBV1855 and prBC656) was designed to amplify the common region (CR) of DNA-B of begomoviruses (1). The expected size fragments were cloned and the sequence was determined for five clones each. Unexpectedly, the Cp and the CR-B fragments shared their highest nucleotide sequence (nt) identity among well-characterized begomoviruses to the bipartite Squash leaf curl virus (SLCV) native to the western United States. A third primer set (prAC344 and prAV1134) (1) was subsequently used to amplify the remainder of the putative SLCV DNA-A. The fragment was cloned and the DNA sequence was determined. Assembly of the overlapping DNA-A fragments resulted in a complete DNA-A component sequence of 2,636 nt, which is identical to the expected size of the SLCV DNA-A component (GenBank Accession No. DQ285019). Comparison with the latter sequence indicated that the Egyptian squash isolate shared 98% nt identity with SLCV. The sequence for the DNA-B fragment (1,162 nt) shared 94% nt identity with SLCV and was deposited in GenBank as Accession No. DQ285020. The high-shared nt identity with SLCV (2) from the United States suggests that this isolate, herein SLCV-EG, has been introduced into Egypt. The relatively low DNA-B nt sequence identity was a not a surprise since this component is normally less conserved even between strains of a single begomoviral species. Introduction of SLCV is not only potentially significant to the domestic production of crop species in the Cucurbitaceae but also for legume crops. SLCV has a broad host range that also includes members of the Fabaceae, which includes species that contribute significant sources of protein for much of Egypt's population. The virus thus far is thought to be present only in Lower Egypt, however, it could feasibly threaten legume and cucurbit crops if it spreads to Upper Egypt. To our knowledge, this is the first begomovirus of New World origin to become established in the Old World. References: (1) A. M. Idris and J. K. Brown. Phytopathology 88:648, 1998. (2) S. G. Lazarowitz. Virology 180:70, 1991.

Effects of tourniquet during total knee arthroplasty. A prospective randomised study.

The effects of using a tourniquet during total knee arthroplasty were studied in 80 patients randomly allocated to two groups, either with or without a tourniquet. The groups were similar in mean age, gender, preoperative knee score and radiographic grading and the patients were all operated on by the same surgeon using one type of prosthesis. There was no significant difference between the two groups in operating time or total blood loss but postoperative pain was less in the patients in whom a tourniquet had not been used. They achieved straight-leg raising and knee flexion earlier and had fewer superficial wound infections and deep-vein thromboses. Total knee arthroplasty can be safely performed without the use of the tourniquet with the benefit that several adverse effects associated with its use can be avoided.

Schistosomiasis as an important determining factor for the response of Egyptian patients with chronic hepatitis C to therapy with recombinant human alpha-2 interferon.

The aim of the present study was to compare the response to recombinant human alpha-2 interferon therapy in 2 groups of Egyptian patients having chronic hepatitis C with or without associated schistosomiasis. Group 1 included 36 patients with associated intestinal schistosomiasis, and group 2 included 24 patients without schistosomiasis. All patients had abnormal serum aminotransferase levels and were negative for hepatitis B surface antigen and anti-hepatitis core antibody, but positive for hepatitis C virus antibody in serum. All patients received interferon at a dose of 3 million units subcutaneously 3 times a week for 6 months and were followed up clinically, biochemically and haematologically during this treatment period and for 6 months thereafter. A second liver biopsy was obtained from every patient after the completion of interferon therapy. Both the percentage of complete response with return to normal of alanine aminotransferase levels during therapy and the overall response rate at 6 months (when patients with a partial response were also included as responders) were significantly lower (P < 0.001) in group 1 (14% and 33% respectively) than in group 2 (63% and 71% respectively). The liver histology also improved significantly in group 2 (46%) compared with group 1 (14%) after completion of therapy (P < 0.05). On the other hand the overall relapse rate in responders, by 6 months after cessation of therapy, was significantly higher (P < 0.05) in group 1 (92%) than in group 2 (59%). These results show that the presence of associated schistosomiasis has to be considered as an important factor in determining the response of Egyptian patients with chronic hepatitis C to therapy with interferon.

A new paradiscal injection technique for the relief of back spasm after chemonucleolysis.

Back spasm, or spasm of the back muscles, is the commonest adverse reaction encountered after chemonucleolysis. In order to overcome this troublesome complication, the authors present a new 'paradiscal injection technique'. After the injection of chymopapain into the affected disc, the needle is withdrawn to just outside the annulus. Bupivacaine is injected into the paradiscal 'space' which acts upon the paravertebral muscles. Eighty consecutive patients have been treated by chemonucleolysis with paradiscal injection for pain relief. All patients were discharged the same day or the following day and no immediate complications occurred. When reviewed 3 weeks later, only three (3.8%) patients complained of back pain (which was different in character to that present before the injection or was exacerbated by the injection). Pain persisted in the same patients until 6 months after the injection but was negligible. None of the remaining patients had developed back pain as a result of chymopapain. The authors suggest that the addition of paradiscal injection of bupivicaine after cymopapain injection can reduce the incidence of spasm of the back muscles. This technique is a major contribution to increasing the efficacy of chemonucleolysis for the treatment of herniated lumbar disc.

Detecting fractures of the scaphoid: the value of comparative X-rays of the uninjured wrist.

Pain or tenderness in the anatomical snuff-box following trauma suggests an injury to the scaphoid or surrounding soft tissues. It is often difficult to make a definite diagnosis since normal bone markings across the scaphoid can be misinterpreted as a fracture. To clarify whether a fracture is present or not, an X-ray of the uninjured scaphoid is taken in a comparable position to the most suspicious view. If bone markings are similar on both views, then a fracture can be excluded. Conversely, if the bone markings differ, then suspicion of a fracture may be confirmed. In combination with the clinical features, a more accurate diagnosis can be made and unnecessary out-patient and X-ray reviews can be avoided.

Management of the herniated lumbar disc: the outcome after chemonucleolysis, surgical disc excision and conservative treatments.

In the 11-year period from 1978 and 1988, myelography was performed on 624 patients with suspected herniated lumbar discs. Positive findings, defined as an indentation of the contrast-filled dural sac and/or lack of contrast filling of the nerve roots, were found in 508 (81.4%) patients. Patients with suspected spinal stenosis were excluded from the study. The choice of treatment was determined by the preference of the consultant in charge. In all, 146 patients were treated by chemonucleolysis, 152 patients underwent surgical excision of the disc via laminectomy/fenestration, while 210 patients were listed for further treatment (albeit chemonucleolysis or laminectomy) but sustained relief of symptoms whilst waiting for admission or refused further intervention and consequently continued conservative treatments (such as physiotherapy, manipulations under anaesthetic, epidural or local injections). Following a repetitive questionnaire and clinical review, 78% of those patients that had undergone chemonucleolysis were satisfied with their treatment (i.e. symptoms were either 'gone', 'much better' or 'better'). Significantly fewer patients were satisfied after surgical disc excision or conservative treatments (71% and 61%, respectively; P <0.001). Whereas patients with a short duration of symptoms (less than 1 year) achieved the best outcome after chemonucleolysis and laminectomy, patients with a prolonged history (greater than 2 years) benefitted most from conservative methods. Of those patients in whom symptoms were considered to be worse or the same following treatment, 46%, 51% and 42% were still working following chemonucleolysis, surgery and conservative treatment, respectively. The outcome did not depend upon the size of the disc involved. Although this is a retrospective study, it is the first report to compare the outcome following chemonucleolysis, surgery and conservative methods in patients with disc prolapse confirmed by myelography.

Internal fixation of closed tibial fractures for the management of sports injuries.

From 1985 to 1988, 90 closed tibial fractures were prospectively studied to assess the morbidity of such injuries to sports people and how this can be influenced by treatment regimens. All fractures were sustained during rugby or football matches. After random selection, 45 fractures were openly reduced and internally fixed (group A), and 45 fractures were manipulated under general anaesthesia and a long-leg plaster applied (group B). For patients in group A, below-knee plasters were used for 3 to 4 weeks, with immediate weight-bearing when tolerated. A total of 44 (98%) tibiae united clinically and radiologically within 14-18 weeks. Within 4 months of surgery 28 (62%) patients had returned to work and were able to play again by the following season. By 6 months 17 (38%) patients had resumed normal activities. In group B, only 24 (53%) tibiae united in a mean time of 16 weeks (range 12-40 weeks). Six (13%) patients required bone grafting for non-union, and one patient subsequently developed osteomyelitis. Only ten (22%) patients were back to work and playing sport again within 6 months of initial injury. It is concluded that internal fixation of closed tibial fractures as a primary procedure following low velocity sports injuries can be safely performed. It leads to a faster return to normal activities with fewer complications than does conservative treatment in plaster using contemporary methods.

Drivers' elbow: a cause of ulnar neuropathy.

The ulnar nerve is vulnerable to compression and vibration injury in drivers who have the shoulder abducted and elbow flexed with the arm lying against the lower edge of the window. Three cases of ulnar neuropathy at the elbow are described in vehicle drivers.

Upper limb fractures in rugby in Huddersfield 1986-1990.

Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported.

Experimental evidence for the existence of a vagino-uterine reflex.

The present study was done to investigate the effect of vaginal distention of the uterine myoelectrical activity of nonpregnant and nonlactating female dogs under general anesthesia in a trial to clarify the contradiction reported and to establish the nature of response. It was found that vaginal inflation increased the frequency and amplitude of the uterine basal electrical rhythm significantly (P less than 0.05). Moreover, the enhancement of the myometrial electrical activity recorded in this work was found to occur instantaneously with vaginal inflation (within 3.6 +/- 0.39 s) and decreased rapidly (within seconds) after vaginal deflation. This response was found to be reproducible. However, the excessive repetition of inflation was found to delay the occurrence of change and reduce the response proportionally. Our finding could be regarded as experimental evidence for the existence of a vagino-uterine reflex, in which nervous signals originating in the vagina as a result of stimulation of vaginal stretch receptors by vaginal distention produce a spinal reflex enhancement of the uterine activity. This reflex was abolished by atropinization.

Pathologic examination of the placenta in human cases of toxoplasmosis.

One hundred sixty one placentae were examined grossly and microscopically, 131 specimens belonged to seropositive patients and 30 specimens belonged to seronegative patients and used as control. 63.3% of the placentae of seropositive patients were macroscopically normal, 9% were hydropic, 21% were of mixed or partially hydropic pattern, 6% had areas of infarction & 0.7% showed areas of calcifications. The most consistent microscopic finding was focal low grade chronic villitis with mononuclear inflammatory infiltrate. In hydropic placentae villous edema was of very variable degree from one placenta to another and from one area to another in the same placenta. Nucleated red blood cells were demonstrated in villous capillaries. The patients had Rh positive factor in their blood.

Comparative study of the Sabin-Feldman dye test and the indirect haemagglutination test in serodiagnosis of toxoplasmosis.

200 women with history of abortion and 100 women with history of uneventful pregnancies were investigated serologically for anti-Toxoplasma antibodies using both the indirect haemagglutination test and the Sabin-Feldman dye test. Our results indicated a role for the first test in seroepidemiological surveys and for routine work. The second test may be reserved for cases with negative haemagglutination test in the presence of strong suspicion of toxoplasmosis.