Evaluation of rumen-protected choline additive to diet on productive performance of male Zaraibi growing goats during hot summer season in Egypt.

Twenty Zaraibi goat bucks were used in this experiment which lasted 3 months during summer season of Egypt. The animals were divided randomly into two equal groups. The first group was kept without treatment as control while in the second group, rumen-protected choline (RPC) at the level of 20 g/buck/day was added to the concentrate feed mixture at the morning feeding. RPC additives to diet of Zaraibi goat bucks during the period of hot summer season increased (P < 0.01) total gain and average daily gain compared to the control group. RPC increased (P < 0.05) dry matter intake and feed conversion while water intake was not affected by RPC additives. RPC increased (P < 0.05) red and white blood cell (RBC × 106, WBC × 103) counts and hemoglobin concentration and hematocrit percentage. RPC increased total protein (P < 0.05), globulin, and γ-globulin (P < 0.01). On the other hand, total lipids, total cholesterol, and triglyceride concentrations decreased (P < 0.05 and P < 0.05) while phospholipids, glucose, and choline concentrations increased (P < 0.01) due to RPC supplementation. RPC increased (P < 0.01) thyroxin and triiodothyronine, increased (P < 0.05) testosterone levels, and decreased (P < 0.01) cortisol level compared with control bucks. It is concluded that dietary RPC at the rate of 20 g daily is required for growing male goats, especially, under heat stress conditions of summer season in Egypt and showed the best results concerning the growth, feed conversion, blood metabolites, and economic efficiency.

Juvenile systemic lupus erythematosus: onset patterns and short-term outcome in Egyptian children, a single-center experience.

OBJECTIVE: The objective of this article is to define disease onset pattern and understand the response to therapy in children with systemic lupus erythematosus (SLE) in Egypt. METHODS: A prospective cohort of 41 Egyptian children diagnosed with SLE was analyzed. SLE Disease Activity Index (SLEDAI) score was used to record disease activity at onset, and renal biopsy was performed to define the stage of lupus nephritis. Response to therapy over a follow-up period ranging from 10 to 50 months was evaluated. RESULTS: The mean age at diagnosis was 12.12 ± 3.45 years. Thirty-six (87.8%) patients were females. Most patients had multiple manifestations at onset. The most common presenting symptoms were pallor and fever (51.2% and 43.9%, respectively). Lupus nephritis was found in 27 (65.9%) children. International Society of Nephrology (ISN) classes I and III were the most common findings on renal biopsy. Neuropsychiatric manifestations were present at disease onset in 19 patients (46.3%) with a bad prognostic course. At diagnosis, high SLEDAI scores were recorded (mean: 29.95 ± 2.06). The mean renal SLEDAI score was 10.2 ± 4. At follow-up 16 (39.02%) patients were in complete remission, 10 (24.39%) were in partial remission, two (4.87%) had active disease, five (12.9%) had relapsed, four (9.75%) had died and four (9.75%) patients were lost to follow-up. CONCLUSIONS: Egyptian children with SLE appear to have severe disease on presentation with high SLEDAI scores and high prevalence of lupus nephritis, but respond well to therapy with a favorable short-term prognosis.

The epidemiology of schistosomiasis in Egypt: Gharbia Governorate.

Health questionnaires and parasitologic examinations of urine and stool were performed upon a stratified random sample of 14,344 individuals from 1,952 households in 34 rural communities in Gharbia Governorate of Egypt to investigate the prevalence of, risk factors for, and changing pattern of infection with Schistosoma sp. A subset, every fifth household, of 1,973 subjects had physical and ultrasound examinations to investigate prevalence of and risk factors for morbidity. Community prevalence of Schistosoma mansoni ranged from 17.9% to 79.5% and averaged 37.7%. The geometric mean egg count (GMEC) was 78.9 eggs/gram of feces. The prevalence and intensity of infection was 40-50% and 70-100 eggs/gram of feces in those > or =10 years of age. Schistosoma haematobium was detected in 5 of the 34 communities. The maximum infection rate was 2.8% and mean GMEC in the five communities was 2.1/10 ml of urine. The overall prevalence of S. haematobium in the governorate was 0.3%. Risk factors for infection with S. mansoni were male gender, an age >10 years, living in smaller communities, exposures to canal water, prior therapy for schistosomiasis, or blood in the stool (in children only). Morbidity detected by physical examination or ultrasonography did not correlate with S. mansoni infection in individuals with the exception of periportal fibrosis (PPF, odds ratio [OR] = 1.25). Periportal fibrosis was detected in more than half of the subjects by ultrasonography; 5.3% had grade II lesions and 1.0% had the most severe grade III changes. Risk factors for morbidity as manifested by ultrasonographically detected PPF were similar to those for infection. Periportal fibrosis had a negative relationship with abdominal pain (OR = 0.45) and hepatomegaly detected by physical examination and ultrasonography (ORs = 0.72 and 0.68), but it was associated with splenomegaly (ORs = 4.14 and 3.55). The prevalence of PPF, hepatomegaly, and splenomegaly increased with age. There was no relationship between community burden of schistosomiasis mansoni and any measurements of morbidity with the exception of splenomegaly detected by physical examination (r = 0.40). Schistosoma mansoni has almost completely replaced S. haematobium in Gharbia, which has a high prevalence and moderate intensity of S. mansoni infection. Periportal fibrosis was detected by ultrasonography in more than half of the subjects, and 1 in 16 had grade II and III lesions. The only relationship between PPF and other morbidity findings was its positive relationship with splenomegaly and negative association with hepatomegaly. Hepatic morbidity is common in communities in Gharbia but the role of schistosomiasis mansoni in this is uncertain.

Lactase deficiency in patients with intestinal schistosomiasis.

Sixty patients having schistosomiasis mansoni infection were studied for lactase deficiency by different methods including lactase assay in intestinal biopsies. Thirty patients suffering from simple intestinal (Group I) and 30 patients suffering from hepatointestinal (Group II) schistosomiasis were compared to 60 controls (Group III). Lactase deficiency was evaluated by symptoms of lactose intolerance, stool pH and osmolarity, oral lactose tolerance test (OLLT), oral lactose hydrogen breath test (OLHBT) and lactase activity (LA) in small intestinal biopsies. OLTT showed intolerance in 36.7% of Group I and 40% of Group II compared to 23.3% of the controls. OLHBT showed intolerance in 26.7%, 30% and 18% for the three groups respectively, indicating a significance in Groups I and II. Abdominal symptoms of hypolactasia had higher scores in the patient groups compared to the controls, and was even higher in Group I than Group II. The mean lactase activity measured by micromol/gm wet wt/min was not statistically higher in Group I but higher in Group II than the controls. No correlation was found between lactase activity in the mucosa and the symptoms of hypolactasia in Group I. Hence, other factors in intestinal schistosomiasis may affect lactose hydrolysis. The study showed also that OLHBT is the most sensitive, specific and efficient among the non-invasive tests.

Fibre-optic sigmoidoscopy compared with the Kato technique in diagnosis and evaluation of the intensity of Schistosoma mansoni infection.

450 patients in Riyadh, Saudi Arabia, complaining of chronic abdominal pain and, coming from different countries endemic for schistosomiasis, were examined endoscopically using fibre-optic colono- or sigmoidoscopes, and rectal biopsies were examined for Schistosoma mansoni ova. After a preliminary study showed that more than 6 biopsies did not increase the positivity rate, 6 biopsies were taken from the rectum and examined by transparency technique. 280 were positive for S. mansoni, 9 of them having in addition S. haematobium. 4 patients had polyps in the sigmoid colon and rectum. When these positive cases were examined using duplicate 50 mg Kato smears, only 160 (57.1%) were positive. There was a highly positive correlation between the intensity of infection as graded by the 2 techniques. We recommend examination of 6 rectal biopsies using fibre-optic sigmoidoscopy when available in small communities with a patchy distribution of schistosomiasis like Saudi Arabia. The method could also be used to exclude schistosomiasis in persons who have moved from rural to urban or non-endemic areas and are unlikely to be re-exposed to infection.

Plasma catecholamines in pulmonary tuberculosis.

Fifty pulmonary tuberculous patients (minimal; moderate and far-advanced), 18 TB-healed persons and 15 healthy control subjects were examined for plasma levels of adrenaline (AD), noradrenaline (NA), dopamine (DA), ACTH and cortisol. The estimated hormones were found to be increased significantly with the severity of the disease suggesting that the stress of infection plays a role in induction of enzymes responsible for catecholamines synthesis with subsequent stimulation of ACTH and cortisol secretion. Noradrenaline appeared the most effective in this respect.

Adenohypophyseal activity in relation to suprarenal function in tuberculosis.

This work was carried out on 150 subjects. They were classified into four groups: group I: Bronchogenic pulmonary T. B. (n = 96); group II: Haematogenous T. B. (n = 15); group III: Healed T. B. (n = 16), group IV: Healthy control (n = 23). Insulin tolerance test was done for each subject to assess the hypothalamo-hypophyseal axis. Glucose, ACTH, cortisol, GH, and PRL levels were estimated during fasting and over three hours after insulin administration. In group I and II the patients exhibited higher fasting levels of anti-insulin hormones and they respond greater than normals to insulin-induced hypoglycaemia. This might indicate early affection of the pituitary gland by TB infection, yet insulin-induced hypoglycaemia assured efficient function of the gland. In healed TB patients, no significant changes were obtained in the different hormonal behaviour, whether in the fasting state or after stimulation. This might be explained by improvement of the health condition of the patients, and relief of the stress induced by TB infection.

Calcium homeostasis in untreated pulmonary tuberculosis II--dynamic study.

Oral calcium tolerance test was done for 17 normal subjects and 26 pulmonary tuberculous patients. Ingestion of 1 gm calcium did not alter serum calcium levels significantly, while urinary calcium significantly increased in normal controls (p less than 0.001) and significantly decreased in tuberculous patients. The decrease in urinary calcium in untreated TB patients may be attributed to the associated decrease in serum concentration of 25-hydroxyvitamin D. Serum PTH and nephrogenous cAMP showed insignificant changes both in controls and TB patients. Meanwhile, these changes are antiparallel to serum calcium, denoting a normal response (function) of parathyroid gland to serum calcium alterations.

Calcium homeostasis in untreated pulmonary tuberculosis. I--Basic study.

This study has been done to evaluate serum calcium, phosphorus (P), magnesium, parathyroid hormone (PTH), calcitonin (CT), and cyclic adenosine monophosphate (cAMP) in recently diagnosed pulmonary tuberculous patient, (n = 61) and the results were compared with the healthy control group (n = 22). Twenty four hours urine was collected for estimation of these electrolytes as well as cAMP. Nephrogenous cAMP (NcAMP) was calculated. Serum Ca and PTH were significantly reduced in TB groups, but CT was elevated. Serum Mg, P and cAMP as well as urinary Ca and Mg in TB groups were similar to that of the control group. Urinary P, cAMP NcAMP were increased in patient groups compared with the control. The reduced serum Ca could be due to impaired intestinal absorption of Ca, or deficient intake as a result of anorexia, decreased plasma albumin, decreased active metabolites of vitamin D or elevated CT. The rise in serum CT in TB might be due to increased CT secreted from the bronchial K-cells. Increased NcAMP might be due to the associated increase in serum antidiuretic hormone (ADH). The elevated urinary P in TB could be attributed to tissue breakdown, decreased serum PTH or increased CT.