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1.
Case Rep Surg ; 2021: 8877671, 2021.
Article in English | MEDLINE | ID: mdl-33859859

ABSTRACT

BACKGROUND: Foreign body ingestion is very common among specific groups, especially children. However, appendicitis and perforated appendix caused by a foreign body is rare. Case summary. A 40-year-old female presented with abdominal pain in the right lower quadrant of 10 days duration after accidentally ingesting a drilling bit during a dental procedure. She had right iliac fossa tenderness on physical examination. X-ray showed a pointed long metal object in the right lower quadrant. A contrast-enhanced computed tomography scan of the abdomen revealed a pointed metal object in the pelvis with inconclusive location. Diagnostic laparoscopy showed an inflamed appendix with the tip of the metal object perforating it. Appendectomy was performed. Histopathology showed an inflamed appendix. CONCLUSION: Foreign bodies that cause appendicitis are rare. However, they may become lodged at any site of the gastrointestinal tract and cause inflammation or perforation. This is a bizarre case of foreign body-induced appendicitis with perforation.

2.
Med Princ Pract ; 27(5): 415-419, 2018.
Article in English | MEDLINE | ID: mdl-30064141

ABSTRACT

BACKGROUND: Arterial myointimal hyperplasia (MIH) has a significant impact on the long-term outcomes of vascular procedures such as bypass surgery and angioplasty. In this study, we describe a new and innovative technique to induce MIH using a dental flossing cachet in Wistar rats. METHODS: The intimal damage in the common carotid artery was induced by inserting the tip of the dental flossing cachet through the external carotid artery into the common carotid artery and turning it on for 3 rounds of 20 s each (n = 10). After 2 weeks, the rats were anesthetized and the common carotid arteries of the experimental side and the contralateral side (control) were harvested and preserved for histopathological studies. RESULTS: The experimental carotid arteries showed significant intimal proliferation and thickening compared to the controls. The intima/media ratio of the experimental and normal (control) common carotid arteries were 1.274 ± 0.162 and 0.089 ± 0.023 (mean ± SEM), respectively (p < 0.001). CONCLUSION: This technique is simple, inexpensive, and highly reproducible and it induces sufficient MIH to study this phenomenon in animal models.


Subject(s)
Carotid Arteries/surgery , Dental Devices, Home Care , Tunica Intima/surgery , Animals , Carotid Arteries/physiopathology , Disease Models, Animal , Hyperplasia , Rats , Rats, Wistar , Tunica Intima/physiopathology
3.
World J Surg ; 42(9): 3015-3020, 2018 09.
Article in English | MEDLINE | ID: mdl-29508023

ABSTRACT

BACKGROUND: Post-hemorrhoidectomy anal stenosis though rare is very disturbing and devastating complication. Many surgical procedures have been described, but despite good results, many complications can ensue like flap necrosis, mucosal ectropion, and restenosis. OBJECTIVE: We report a new simple technique for repair of severe/moderate anal stenosis which requires no extensive flap mobilization or many sutures. PATIENTS AND INTERVENTIONS: This is a personal series of 65 patients treated over a period of 20 years. The data were prospectively recorded by the author. The essence of this simple procedure is mobilizing the anal mucosa to the dentate line via a vertical incision and mobilizing the adjacent perianal skin and subcutaneous fat to allow a completely tension-free approximation of the perianal skin and the anal mucosa which are sutured together transversely. A tension-releasing incision is made in the perianal region which is left to heal by secondary intention. RESULTS: Fifty-nine patients (90.8%) continued the 5-year follow-up, and 6 patients left the country after 2 years of follow-up. There was only one case of recurrence after 2 years, which was treated by a second anoplasty. Four patients (59-66 years old) developed transient urine retention after surgery. One patient developed partial dehiscence of the suture line which was treated conservatively. No mucosal ectropion or perianal skin necrosis was observed. Complete healing of the perianal tension-releasing wound was within 2-3 months. By the third week after surgery, all the patients discontinued use of stool softeners or laxatives and were able to defecate comfortably. CONCLUSIONS: This procedure is simple and requires little dissection and only a few sutures with minimal complications. It is suitable for low severe and moderate anal stenosis.


Subject(s)
Anal Canal/pathology , Anal Canal/surgery , Hemorrhoidectomy/adverse effects , Postoperative Complications/surgery , Adult , Aged , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Defecation , Dermatologic Surgical Procedures/adverse effects , Female , Follow-Up Studies , Humans , Intestinal Mucosa/surgery , Male , Middle Aged , Postoperative Complications/etiology , Recurrence , Subcutaneous Fat/surgery , Surgical Wound Dehiscence/etiology , Suture Techniques/adverse effects , Wound Healing , Young Adult
4.
Photomed Laser Surg ; 35(9): 498-504, 2017 Sep.
Article in English | MEDLINE | ID: mdl-28727952

ABSTRACT

BACKGROUND AND OBJECTIVES: Although laser lithotripsy for fragmentation of gallbladder stones has been applied successfully in many clinical situations, this approach has two major limitations: (1) the potential to damage or perforate the bile duct and (2) the efficiency can be affected by the chemical composition of the gallstones. The present study evaluated the use of time-resolved laser-induced fluorescence spectroscopy to classify stone types and distinguish stone from tissue. MATERIALS AND METHODS: Ex vivo time-resolved laser-induced fluorescence analysis (excitation wavelength λex = 400 nm and emission wavelength = 450-700 nm) of 54 gallbladder stones and seven gallbladder tissue samples was conducted. The spectral and temporal parameters were analyzed using linear discrimination analysis (LDA) to differentiate stone from tissue and to classify different stone types using two wavelength regions (λ1 = 510-530 nm and λ2 = 550-570 nm). RESULTS: Examination of 54 gallbladder stones and seven gallbladder tissue samples showed a significant difference in spectral- and temporal-derived parameters. The data were classified using LDA, and the overall accuracy was 94.88%, 84.39%, and 85.79% for both spectral and temporal parameters, only spectral parameters, and only temporal parameters, respectively. CONCLUSIONS: Our findings establish the feasibility of using time-resolved laser-induced fluorescence spectroscopy as a tool to identify gallbladder stone types and as a stone-tissue detection system to improve the effectiveness of laser lithotripsy procedures and reduce the risk of damaging biliary tract tissues.


Subject(s)
Gallstones/chemistry , Gallstones/diagnostic imaging , Lithotripsy, Laser/methods , Spectrometry, Fluorescence/methods , Surgery, Computer-Assisted/methods , Female , Gallstones/surgery , Humans , In Vitro Techniques , Lasers, Solid-State , Male , Sampling Studies , Sensitivity and Specificity
5.
Med Princ Pract ; 26(4): 343-350, 2017.
Article in English | MEDLINE | ID: mdl-28273667

ABSTRACT

OBJECTIVE: The aim of this study was to understand whether or not the protective effect of green tea after fasting-induced damage in the jejunal mucosa of rat is dependent on cell proliferation and the stimulation of specific growth factors. MATERIALS AND METHODS: Sixty adult male Wistar rats were used in this study. The animals were divided randomly into 5 groups, with 12 in each group (G1-5). The animals in G1 (control group) were fed a rat chow diet and water ad libitum. The animals in G2 (fasting group) were fasted for 3 days. The animals in the G3, G4, and G5 groups were fasted for 3 days as G2, but were given water (G3), green tea (G4), or a vitamin E (G5) solution, respectively, for another 7 days. The animals were euthanized, and the jejunum was removed and processed for histological and immunohistochemical analysis. RESULTS: Compared to the G3 group, the jejunal mucosa of G4 rats showed a 70.6% higher level (p < 0.001) of expression of proliferating cell nuclear antigen and 98% higher level (p = 0.0001) of the expression of transforming growth factor-ß1 (TGF-ß1), whereas the level of fibroblast growth factor-1 (FGF-1) and insulin-like growth factor-1 (IGF-1) expression was 22 and 11% lower, respectively, in G4 animals as compared to G3 rats. These differences in the expression of FGF-1 and IGF-1 in G4 animals were not statistically significant. CONCLUSION: In this study, green tea repaired the fasting-induced damage in the jejunal mucosa of rats, mainly by inducing a significant expression of TGF-ß1 in the jejunal mucosa.


Subject(s)
Receptor, Fibroblast Growth Factor, Type 1/drug effects , Receptor, IGF Type 1/drug effects , Tea/metabolism , Transforming Growth Factor beta1/drug effects , Analysis of Variance , Animals , Cell Proliferation , Euthanasia, Animal , Fasting , Immunochemistry , Intestinal Mucosa/drug effects , Male , Random Allocation , Rats , Rats, Wistar
6.
BMC Cardiovasc Disord ; 16(1): 202, 2016 10 26.
Article in English | MEDLINE | ID: mdl-27784271

ABSTRACT

BACKGROUND: Ankle-brachial pressure index-systolic (ABI-s) can be falsely elevated in the presence of calcified lower limb arteries in some diabetic patients and therefore loses its value in this cohort of patients. We aim at investigating the feasibility of using the diastolic (ABI-d) instead of ABI-s to calculate the ABI in diabetic patients with calcified limb arteries. METHODS: A total of 51 patients were chosen from the diabetic foot clinic. Twenty six of these patients had calcified leg arteries by Duplex scan (Group A) and 25 patients did not have calcifications in their leg arteries (Group B). Twenty five healthy volunteers were enrolled in the study for group C and they were matched with other participants from group B and A in age and sex. ABI measurement was performed using "boso ABI-system 100 machine". Systolic ABI (ABI-s) and diastolic ABI (ABI-d) were calculated based on bilateral brachial and ankle oscillometric pressures. ABI is considered normal when it is ≥0.9. Repeated measures ANOVA test was used to test for comparing mean scores for ABI-s and ABI-d across the three groups. Statistical significance is considered when P < .05. RESULTS: The mean age of all participants (±SD) was 64.30 ± 7.1 years (range, 50-82 years). ABI-s mean ± SD was 1.3 ± 0.10 (range, 1.18-1.58) in group A patients, 1.07 ± 0.05 (range, 1-1.16) in group B patients, and 1.06 ± 0.05 (range, 1-1.16) in group C volunteers. While ABI-d mean ± SD was 1.07 ± 0.05 (range, 1.1-1.17) in group A patients, 1.06 ± 0.05 (1-1.14) in group B patients, and 1.05 ± 0.04 (range, 1.01-1.14) in group C volunteers. In group A, repeated measures ANOVA test showed statistical significant difference between ABI-s and ABI-d (P < 0.001) whereas in group B & C was not (P > 0.05). CONCLUSIONS: ABI-d may be helpful and can be used as a complementary measure instead of ABI-s in falsely elevated ABI caused by partial incompressible vessel.


Subject(s)
Ankle Brachial Index/methods , Brachial Artery/physiopathology , Calcinosis/physiopathology , Diabetic Foot/physiopathology , Lower Extremity/blood supply , Oscillometry/methods , Ultrasonography, Doppler, Pulsed/methods , Aged , Aged, 80 and over , Blood Pressure , Brachial Artery/diagnostic imaging , Calcinosis/diagnosis , Diabetic Foot/diagnosis , Diastole , Feasibility Studies , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiopathology , Follow-Up Studies , Humans , Male , Middle Aged , Popliteal Artery/diagnostic imaging , Popliteal Artery/physiopathology , Systole
7.
BMJ Case Rep ; 20162016 Jul 28.
Article in English | MEDLINE | ID: mdl-27469382

ABSTRACT

Gastrointestinal stromal tumours (GISTs) are solid tumours of the gastrointestinal tract, mostly found in the stomach and intestine. They rarely present as cystic lesions. A 74-year-old woman referred to the hepatopancreaticobiliary unit, with 3 months history of upper abdominal discomfort. Abdominal ultrasound scan showed a large cystic lesion in the epigastric region suggestive of a pancreatic pseudocyst. The CT-scan showed a 6.6×6×6.3 cm size cyst related to the pancreas and extending to the hepatogastric omentum. Endoscopic ultrasound (EUS) scan was suggestive of a pancreatic pseudocyst. Aspirated Cyst fluid via EUS showed benign cytology with normal amylase, lipase and tumour markers (CEA, CA-19.9 and CA-125). She was referred as a case of pancreatic pseudocyst. After surgical excision, the histopathology confirmed the presence GIST in the wall of the cystic lesion. The possibility of GIST should be kept in mind in the presence of unusual features of a cyst on abdominal imaging.


Subject(s)
Gastrointestinal Neoplasms/diagnosis , Gastrointestinal Stromal Tumors/diagnosis , Pancreatic Pseudocyst , Aged , Diagnosis, Differential , Endosonography , Female , Gastrointestinal Neoplasms/diagnostic imaging , Gastrointestinal Neoplasms/therapy , Gastrointestinal Stromal Tumors/diagnostic imaging , Gastrointestinal Stromal Tumors/therapy , Humans , Pancreas/diagnostic imaging , Tomography, X-Ray Computed
8.
Int J Clin Exp Pathol ; 8(1): 649-54, 2015.
Article in English | MEDLINE | ID: mdl-25755758

ABSTRACT

BACKGROUND: The aim of this study was to investigate the effect of epigallocatechin gallate (EGCG) on uncoupling protein 2 regulation in an acute liver injury-animal model. METHODS: Twenty seven male Wistar rats were divided into three groups: control group (n = 9), TAA group (n = 9): acute liver injury was induced by the intraperitoneal injection of thioacetamide (200 mg/kg) and EGCG/TAA (n = 9 rats): Epigallocatechin gallate was given two weeks prior to the induction of acute liver injury by thioacetamide. The levels of uncoupling protein 2, CRP, TNF-α and interleukins (IL) 6 and 18 were analyzed in the liver using PCR analysis. RESULTS: Q-PCR analysis showed that the genetic expression of UCP2, TNF-α and CRP in the EGCG/TAA group was the least in comparison to other groups (P ≤ 0.005). The IL-6 and IL-18 were upregulated after induction of acute liver injury, but this upregulation was significantly less in the group that received epigallocatechin gallate (EGCG/TAA) compared to the TAA group. In addition, histological examination showed a reduction in hepatocyte injury in EGCG/TAA compared to the TAA group. CONCLUSION: Epigallocatechin gallate administration prior to induction of acute liver injury down-regulates uncoupling protein 2 expression and reduces IL-6, IL-18, TNF-α and CRP.


Subject(s)
Antioxidants/pharmacology , Catechin/analogs & derivatives , Chemical and Drug Induced Liver Injury/metabolism , Ion Channels/biosynthesis , Mitochondrial Proteins/biosynthesis , Animals , Catechin/pharmacology , Disease Models, Animal , Enzyme-Linked Immunosorbent Assay , Male , Rats , Rats, Wistar , Reverse Transcriptase Polymerase Chain Reaction , Thioacetamide/toxicity , Uncoupling Protein 2
9.
J Vasc Surg Venous Lymphat Disord ; 3(2): 147-53, 2015 Apr.
Article in English | MEDLINE | ID: mdl-26993832

ABSTRACT

OBJECTIVE: The aim of this study was to monitor the changes that develop in leg veins of primigravida women during pregnancy. METHODS: Sixty primigravida women volunteered to undergo clinical evaluation and duplex ultrasound examination of both lower limb veins to monitor changes in vein diameter and valve closure time (VCT) during pregnancy and 3 months postpartum by duplex ultrasound. A total of four readings were taken for each subject, one reading for each trimester and the last reading at 3 months postpartum. RESULTS: The mean (± standard deviation) age of participants was 26.82 ± 2.47 years; 39 limbs (32.5%) and 65 limbs (54.2%) developed C1-C3 venous changes during the second and third trimesters, respectively. Three months post partum, 36 limbs (30%) continued to have C1-C2 changes. Only four limbs in four subjects developed varicose veins along the great saphenous vein, and their VCT was more than 1 second. These subjects were found to have a family history of varicose veins. Duplex examinations showed that there was a gradual increase in the diameter and VCT from the second trimester through the third trimester of pregnancy in all examined venous segments. These changes were statistically significant by Friedman and related-samples Wilcoxon signed rank tests within the same legs (P = .001) but not between legs in the same subject (P > .05), even with adjustment for body mass index (P = .001-.049). CONCLUSIONS: In primigravida women, lower limb veins showed gradual increase in vein diameter and in VCT starting from the second trimester. These changes reverted to baseline in most cases 3 months after delivery.


Subject(s)
Saphenous Vein/pathology , Female , Femoral Vein/pathology , Humans , Leg/blood supply , Pregnancy , Pregnancy Complications, Cardiovascular/diagnostic imaging , Pregnancy Complications, Cardiovascular/pathology , Pregnancy Trimesters , Saphenous Vein/diagnostic imaging , Ultrasonography, Doppler, Duplex , Varicose Veins/diagnostic imaging , Varicose Veins/pathology , Veins/pathology
10.
BMC Res Notes ; 7: 769, 2014 Oct 31.
Article in English | MEDLINE | ID: mdl-25361816

ABSTRACT

BACKGROUND: Adrenocortical carcinoma is a rare and aggressive malignancy. Patients usually present early with manifestation of abnormal hormone secretion. However, adrenocortical carcinoma can also be nonfunctioning, and such patients present late with a mass effect or distant metastases. CASE PRESENTATION: We herein report a case of a 30-year-old Sri-Lankan woman who presented with a 3-month history of left flank pain associated with nausea, vomiting, and weight loss. Imaging revealed a large left upper quadrant mass with a 1.8-cm left lung nodule. The differential diagnoses included a left adrenal mass, left upper pole renal mass, and retroperitoneal sarcoma. A functional adrenal work-up revealed no abnormal findings. Surgical excision of the mass was uneventful with no postoperative complications. Pathological analysis revealed a nonfunctioning adrenocortical carcinoma measuring 16 × 14 × 10 cm. To our knowledge, a mass of this size is among the largest nonfunctioning adrenocortical carcinomas reported in the published literature. The investigations and approach to treatment were consistent with those in the published literature. CONCLUSION: Large nonfunctioning adrenocortical carcinomas pose a diagnostic and therapeutic challenge, and most are diagnosed at a late stage. Appropriate imaging and functional work-up of the mass are vital before treatment. Surgical excision is safe, even for large adrenocortical carcinomas; excision in patients with advanced disease has been shown to have the best outcomes.


Subject(s)
Adrenal Cortex Neoplasms/pathology , Adrenocortical Carcinoma/pathology , Tumor Burden , Adrenal Cortex Function Tests , Adrenal Cortex Neoplasms/chemistry , Adrenal Cortex Neoplasms/surgery , Adrenalectomy , Adrenocortical Carcinoma/chemistry , Adrenocortical Carcinoma/surgery , Adult , Biomarkers, Tumor/analysis , Biopsy , Female , Humans , Immunohistochemistry , Predictive Value of Tests , Tomography, X-Ray Computed , Treatment Outcome
11.
BMC Complement Altern Med ; 14: 322, 2014 Aug 30.
Article in English | MEDLINE | ID: mdl-25175005

ABSTRACT

BACKGROUND: Cancer immunotherapy requires proper manipulation of the immune system, lymphocytes in particular, in order to identify and destroy the cancer cells as non-self. In this study we investigated the effect of the flavonoid present in green tea, namely epigallocatechin-3-gallate (EGCG), on the proliferation of, and IFN-γ production by, peripheral blood mononuclear cells (PBMC) from breast cancer patients stimulated with a mitogen, anti-CD3 and the common breast cancer peptides Her-2/neu, and p53. METHODS: Blood samples were collected from 25 patients with breast cancer at the Kuwait Cancer Control Centre (KCCC). The patients were newly diagnosed, and had not undergone any treatment or surgery at the time of sample collection. The control group consisted of 25 healthy women age-matched (±5 years) to the patients. PBMC were isolated from the patients and controls, and were cultured separately with the mitogen PHA, anti-CD3 antibodies, and Her-2/neu and p53 in the presence or absence of standardized doses of EGCG. The degree of proliferation and interferon-γ [IFN-γ) release were then analyzed. RESULTS: EGCG significantly suppressed the proliferation of PBMC in response to stimulation separately with (i) the mitogen, (ii) anti-CD3, and (iii) the cancer antigen peptides. IFN-γ production was also significantly suppressed by EGCG in vitro. CONCLUSIONS: EGCG appears to have an immunosuppressive effect on the proliferation of PBMC, indicating that EGCG is worth exploring for immunomodulatory effects in autoimmune diseases and tissue transplantation.


Subject(s)
Breast Neoplasms/physiopathology , Camellia sinensis/chemistry , Catechin/analogs & derivatives , Cell Proliferation/drug effects , Leukocytes, Mononuclear/drug effects , Plant Extracts/pharmacology , Adult , Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Breast Neoplasms/metabolism , Catechin/pharmacology , Cells, Cultured , Female , Humans , Interferon-gamma/genetics , Interferon-gamma/metabolism , Leukocytes, Mononuclear/cytology , Leukocytes, Mononuclear/metabolism
12.
J Ultrasound Med ; 33(5): 803-9, 2014 May.
Article in English | MEDLINE | ID: mdl-24764335

ABSTRACT

OBJECTIVES: The purpose of this study was to determine the changes (if any) in the diameter and valve closure time of the lower limb veins in healthy young nulliparous women at different phases of the menstrual cycle. METHODS: Fifty-three young nulliparous women were asked to undergo clinical evaluations and duplex ultrasound examinations of both lower limb veins to monitor changes in the vein diameter and valve closure time at different phases of their menstrual cycles. The vein diameter on B-mode imaging and valve closure time on pulsed Doppler tracing were calculated at days 1 to 4, 14 to 16, and 25 to 28 of the menstrual cycle. Freidman and related samples Wilcoxon signed rank tests were used to determine time-related changes in venous function. RESULTS: The volunteers' mean age ± SD was 20.60 ± 1.90 years, and their mean body mass index was 23.90 ± 4.90 kg/m(2). There was a gradual increase in the vein diameter and valve closure time at the specified phases of the menstrual cycle. Friedman and related samples Wilcoxon signed rank tests for venous segment diameter and valve closure time changes between the different phases of the menstrual cycle were performed and showed statistical significance for each venous segment within each limb (P = .003-.025). Also, when adjusted for body mass index, statistical significance existed for the same venous segments in the same limbs (P =.001-.049). There was no statistical significance for the same venous segments at the same phase of the menstrual cycle between limbs (related samples Wilcoxon signed rank test: P =.079-.97). CONCLUSIONS: During the menstrual cycle, the lower limb veins show an increase in their diameter and valve closure time. These changes are probably mediated by the female sex hormones.


Subject(s)
Leg/blood supply , Leg/physiology , Menstrual Cycle/physiology , Ultrasonography, Doppler, Duplex/methods , Vascular Resistance/physiology , Venous Valves/diagnostic imaging , Venous Valves/physiology , Female , Humans , Leg/diagnostic imaging , Reproducibility of Results , Sensitivity and Specificity , Young Adult
13.
Med Princ Pract ; 23(2): 160-6, 2014.
Article in English | MEDLINE | ID: mdl-24457986

ABSTRACT

OBJECTIVES: The aim of this study was to introduce the concept of non-operative management (NOM) for blunt liver trauma by establishing a protocol and a prospective Liver Trauma Registry in Kuwait. SUBJECTS AND METHODS: A prospective Liver Trauma Registry was started in 4 hospitals and it included 117 patients who had sustained blunt liver trauma (94 men and 23 women). Unstable patients were taken to surgery while stable patients were managed conservatively regardless of the grade of liver injury. High-grade (III-VI) liver injuries were managed in collaboration with the liver surgery specialist. RESULTS: The mean age of the 117 patients was 29.02 ± 11.18 years (range 7-63). NOM was successful in 94 (96%) patients and failed in 4 (4%) (these 4 then underwent successful surgery). Nineteen (16.2%) were unstable and underwent surgery immediately; 15 (79%) of them survived (they had had grade III-V injuries) and 4 died (2 with grade V injuries and 2 with grade VI injuries). Perihepatic packing was necessary in 8/19 (42%) patients. The overall mortality was 3.4% (4/117). CONCLUSIONS: This study showed that NOM was successful in a majority of patients with blunt liver trauma. In addition, it confirmed that the magnitude of liver injury and haemoperitoneum did not preclude NOM as long as the patient was haemodynamically stable.


Subject(s)
Liver/injuries , Wounds, Nonpenetrating/therapy , Adolescent , Adult , Child , Clinical Protocols , Female , Humans , Kuwait , Male , Middle Aged , Practice Guidelines as Topic , Prospective Studies , Registries , Retrospective Studies , Trauma Severity Indices , Wounds, Nonpenetrating/surgery , Young Adult
14.
Neuropharmacology ; 77: 100-19, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24071567

ABSTRACT

Spinal cord injury (SCI) causes severe and long lasting motor and sensory deficits, chronic pain, and autonomic dysreflexia. (-)-epigallocatechin-3-gallate (EGCG) has shown to produce neuroprotective effect in a broad range of neurodegenerative disease animal models. This study designed to test the efficacy of intravenous infusion of EGCG for 36 h, in acutely injured rats' spinal cord: within first 4 h post-injury and, in chronically SC injured rats: after one year of injury. Functional outcomes measured using standard BBB scale, The Louisville Swim Scale (LSS) and, pain behavior assessment tests. 72 Female adult rats subjected to moderate thoracic SCI using MASCIS Impactor, blindly randomized as the following: (I) Acute SCI + EGCG (II) Acute SCI + saline. (III) Chronic SCI + EGCG. (IV) Chronic SCI + saline and, sham SCI animals. EGCG i.v. treatment of acute and, chronic SCI animals resulted in significantly better recovery of motor and sensory functions, BBB and LSS (P < 0.005) and (P < 0.05) respectively. Tactile allodynia, mechanical nociception (P < 0.05) significantly improved. Paw withdrawal and, tail flick latencies increase significantly (P < 0.05). Moreover, in the EGCG treated acute SCI animals the percentage of lesion size area significantly reduced (P < 0.0001) and, the number of neurons in the spinal cord increased (P < 0.001). Percent areas of GAP-43 and GFAP immunohistochemistry showed significant (P < 0.05) increase. We conclude that the therapeutic window of opportunity for EGCG to depict neurological recovery in SCI animals, is viable up to one year post SCI when intravenously infused for 36 h.


Subject(s)
Catechin/analogs & derivatives , Neuroprotective Agents/therapeutic use , Pain/drug therapy , Spinal Cord Injuries/drug therapy , Spinal Cord/drug effects , Animals , Behavior, Animal/drug effects , Catechin/administration & dosage , Catechin/therapeutic use , Female , Neurons/drug effects , Neurons/physiology , Neuroprotective Agents/administration & dosage , Pain/physiopathology , Pain Measurement , Pain Threshold/drug effects , Pain Threshold/physiology , Rats , Rats, Sprague-Dawley , Recovery of Function/drug effects , Spinal Cord/physiopathology , Spinal Cord Injuries/physiopathology
17.
Nutrition ; 28(10): 1016-21, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22673594

ABSTRACT

OBJECTIVE: Effective diabetic management requires reasonable weight control. Previous studies from our laboratory have shown the beneficial effects of a low-carbohydrate ketogenic diet (LCKD) in patients with type 2 diabetes after its long term administration. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. These studies have indicated that, in addition to decreasing body weight and improving glycemia, LCKD can be effective in decreasing antidiabetic medication dosage. Similar to the LCKD, the conventional low-calorie, high nutritional value diet is also used for weight loss. The purpose of this study was to understand the beneficial effects of LCKD compared with the low-calorie diet (LCD) in improving glycemia. METHODS: Three hundred and sixty-three overweight and obese participants were recruited from the Al-Shaab Clinic for a 24-wk diet intervention trial; 102 of them had type 2 diabetes. The participants were advised to choose LCD or LDKD, depending on their preference. Body weight, body mass index, changes in waist circumference, blood glucose level, changes in hemoglobin and glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, uric acid, urea and creatinine were determined before and at 4, 8, 12, 16, 20, and 24 wk after the administration of the LCD or LCKD. The initial dose of some antidiabetic medications was decreased to half and some were discontinued at the beginning of the dietary program in the LCKD group. Dietary counseling and further medication adjustment were done on a biweekly basis. RESULTS: The LCD and LCKD had beneficial effects on all the parameters examined. Interestingly, these changes were more significant in subjects who were on the LCKD as compared with those on the LCD. Changes in the level of creatinine were not statistically significant. CONCLUSION: This study shows the beneficial effects of a ketogenic diet over the conventional LCD in obese diabetic subjects. The ketogenic diet appears to improve glycemic control. Therefore, diabetic patients on a ketogenic diet should be under strict medical supervision because the LCKD can significantly lower blood glucose levels.


Subject(s)
Blood Glucose/metabolism , Caloric Restriction , Diabetes Mellitus, Type 2/diet therapy , Diet, Carbohydrate-Restricted , Diet, Ketogenic , Obesity/diet therapy , Weight Loss , Adult , Body Mass Index , Creatinine/blood , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Energy Intake , Female , Glycated Hemoglobin/metabolism , Hemoglobins/metabolism , Humans , Lipids/blood , Male , Middle Aged , Obesity/blood , Obesity/complications , Urea/blood , Uric Acid/blood , Waist Circumference
18.
Biol Trace Elem Res ; 141(1-3): 96-109, 2011 Jun.
Article in English | MEDLINE | ID: mdl-20495889

ABSTRACT

This study aims at investigating the blood level of Cu, Zn, Se, and Cd in breast cancer patients and the association between such level and the frequency of micronucleated lymphocytes. Fifty stage I breast cancer patients were recruited for this study at the time of diagnosis and before receiving any treatment or surgery. The control group consisted of 150 normal females matched to the patients for age (± 5 years). The whole blood level of Cu, Zn, Se, and Cd was determined using spectrophotometry. The frequency of micronucleated lymphocytes in the blood was determined using the cytokinesis-block micronucleus assay. The level of Cu, Zn, and Se was significantly lower (p = 0.0006, <0.0001, and <0.0001, respectively) in breast cancer patients, as compared to controls. The level of Cd was significantly (p < 0.0001) higher in the patients, as compared to controls. The frequency of lymphocytes with one micronucleus was significantly (p < 0.0001) higher in the patients, as compared to controls. In breast cancer patients, the frequency of micronucleated lymphocytes showed different associations with different levels of these trace elements. High Cd, low Zn, low Se, and both high and low Cu levels were significantly associated with micronucleus formation in lymphocytes. A similar association was found in the normal control group only in relation to high Se and Cd levels. Breast cancer patients seem to have abnormal levels of Cu, Zn, Se, and Cd, and such abnormality is associated with micronucleus formation in lymphocytes.


Subject(s)
Breast Neoplasms/blood , DNA Damage/drug effects , Metals/blood , Metals/toxicity , Trace Elements/blood , Trace Elements/toxicity , Adult , Breast Neoplasms/epidemiology , Case-Control Studies , Female , Humans , Kuwait/epidemiology , Middle Aged
19.
J Environ Pathol Toxicol Oncol ; 27(1): 61-75, 2008.
Article in English | MEDLINE | ID: mdl-18551897

ABSTRACT

Nongenetic breast cancer risk factors have never been evaluated in Kuwait. Accordingly, we aimed at examining these factors as well as the immune profile of the patients. Fifty stage I breast cancer patients and 50 age group-matched normal controls were assessed for the level of their peripheral blood lymphocyte subsets and for risk factors associated with their demographic and reproductive characteristics and with diet. The percentages of CD4+ T lymphocytes, CD4+:CD8+ ratio, and CD19+ B lymphocytes were significantly higher in the patients as compared to controls, while the percentages of CD8+ T lymphocytes and natural killer (CD56+) cells were significantly reduced. Risk factors associated with the disease included higher BMI, lack of regular exercise and physical activity in the past 5 years, early age at menarche, late age at first pregnancy, lack of previous information about breast cancer, hormonal therapy, and presence in Kuwait during the invasion/liberation. Other parameters included significantly more frequent consumption of carbohydrate, sweets, animal fat, and vegetable oil (margarine) and less frequent consumption of fresh vegetables and olive oil. This is the first study to highlight the environmental risk factors associated with breast cancer among the Kuwaiti women. We recommend introducing a nationwide campaign to further investigate these factors and to address them accordingly.


Subject(s)
Breast Neoplasms , Practice Patterns, Physicians' , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Case-Control Studies , Data Interpretation, Statistical , Female , Humans , Kuwait/epidemiology , Nutrition Assessment , Nutritional Status , Obesity, Morbid/complications , Pilot Projects , Surveys and Questionnaires
20.
Urology ; 71(5): 897-900, 2008 May.
Article in English | MEDLINE | ID: mdl-18455630

ABSTRACT

OBJECTIVES: Hyperhomocysteinemia (HHcy) is associated with cardiovascular disease such as coronary arteriosclerosis and stroke. However, its role in the development of vasculogenic erectile dysfunction (ED) is still putative. In this study, we evaluated the relationship between plasma total homocysteine (tHcy) and the presence of vasculogenic ED in men with adult-onset diabetes mellitus. METHODS: This was a case-control study of 97 adult-onset diabetics with vasculogenic ED and 97 concurrently sampled control diabetics, who were free from ED. We obtained risk estimates of odds ratios (ORs), both crude and adjusted, using logistic regression models. We then determined cardiovascular risk factors and HbA1c levels in both groups of patients. RESULTS: Plasma tHcy was significantly higher in cases compared with controls. The mean +/- standard deviation plasma tHcy in cases was 11.2 +/- 3.5 micromol/L versus 8.8 +/- 2.6 micromol/L in controls (P <0.001). Moreover, those with HHcy had 5.2 times the odds of vasculogenic ED compared with men without HHcy (OR 5.2, 95% confidence interval, 1.4 to 18.9). Although the risk of ED did not vary significantly according to body mass index, serum cholesterol, triglycerides, C-reactive protein, and blood HbA1c levels, it was significantly affected by smoking status and hypertension. CONCLUSIONS: High plasma tHcy appears to be associated with ED in patient with adult-onset diabetes mellitus.


Subject(s)
Diabetes Complications/complications , Hyperhomocysteinemia/complications , Impotence, Vasculogenic/etiology , Case-Control Studies , Humans , Impotence, Vasculogenic/epidemiology , Male , Middle Aged , Prospective Studies , Risk Factors
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