Study of the Effects of Cordia myxa Fruit Extract on Induced Animal Model of Depression in Male Rats.

Depression is one of the most common mental illnesses. Herbal medications such as ginseng and peony have recently gained popularity in treating depression due to their safety, efficacy, and cost-effectiveness. Therefore, the present study aimed to evaluate the actions of Cordia myxa (C. myxa) fruit extract on the model of chronic unpredictable mild stress (CUMS) and antioxidant enzymes system in male rats' brains. Sixty male rats were divided into six groups (n=10). Group 1 (control) was neither exposed to CUMS nor received any treatment, while group 2 was exposed to CUMS for 24 days with normal saline treatment for 14 days, group 3 was exposed to CUMS for 24 days and received 10 mg/kg fluoxetine daily on day 10 for 14 days, and group 4, 5, and 6 were exposed to CUMS for 24 days and received C. myxa extract (125, 250, and 500 mg/kg, respectively) on day 10 for 14 days. The antidepressant effect of fluoxetine and C. myxa extract was evaluated using a forced swim test (FST). At the end of the experiments, animals were sacrificed by decapitation; and antioxidant enzyme levels, catalase (CAT), and superoxide dismutase (SOD) were determined by enzyme-linked immunosorbent assays kits (ELISA) on rats' brain tissues. All groups subjected to CUMS showed a significant rise in duration of immobility on the tenth day compared to day zero. The CUMS showed a decrease in antioxidant enzyme levels, and groups treated with extract showed significant rise in enzyme levels (SOD and CAT) compared to group 2. According to this recent study, C. myxa may have an antidepressant-like action.

A prospective audit of the quality of documentation of gynaecological operations.

There is a paucity of audits in the speciality of Obstetrics and Gynaecology to estimate the standard of documentation of operation notes. Evidence from several audits across all specialities indicates the overall standard of reporting and documentation in medicine is poor, with many reports failing to contain important and pertinent data. Various attempts have been made to address these shortcomings. To estimate the degree of non-compliance in gynaecological practice, we set out to prospectively audit the standard of documentation of operation notes in a busy District General Hospital serving the largest Borough in terms of population in the city of London. An initial prospective audit was carried out in July 2008; and this was re-audited after 12 months using a standardised proforma based on the Royal College of Surgeons of England guidelines. There was evidence of significant improvement with the use of a standardised proforma.

Lack of an association between candidate gene loci and idiopathic generalized epilepsy in Kuwaiti Arab children.

Idiopathic generalized epilepsies (IGEs) are the most common types of epilepsy in childhood and adolescence. A variety of data suggest that IGEs have a predominant genetic etiology. Recently, a number of gene mutations have been found to be associated with various types of epilepsy in mainly the Caucasian populations. The objective of this study was to investigate the association of three different candidate genes with IGE in Kuwaiti Arab children. This study includes 123 Kuwaiti patients with a confirmed diagnosis of epilepsy. Most of the patients have had a diagnostic EEG with generalized spike-wave discharges (GSWs). All patients were evaluated by using a validated seizure questionnaire. The clinical type of epilepsy was determined by a trained neurologist/pediatrician. The study also include 100 controls, the control subjects were children which did not have any history of neurological disorders. Blood samples were collected from all patients and control subjects after taking informed consent. DNA was isolated and analyzed by molecular methods. A FokI polymorphism in neuronal nicotinic acetylcholine receptor alpha-4 subunit (CHRNA4) gene was detected by PCR-RFLP method. A missense mutation (Ser248Phe) in CHRNA4 gene was analyzed by PCR-RFLP using HpaII. A C121W mutation in sodium-channel beta-1 subunit (SCN1B) gene was screened by a PCR-RFLP method using HinPI. A 2-bp deletion in Cystatin B gene was detected by PCR-RFLP using XcmI. The incidence of three FokI polymorphism genotypes in Kuwaiti IGE patients was 1,1 (85%), 1,2 (14%) and 2,2 (1%) respectively. The missense mutation Ser248Phe of CHRNA4 gene was not detected at all in Kuwaiti IGE patients. The C387G transversion resulting in C121W change in third exon of the SCN1B gene was detected in 3/123 patients (2%). The patients carrying this mutation also exhibited febrile seizures. The incidence of 2 bp deletion in the cystatin B gene was found to be 4% (5/123 IGE patients). The data obtained from molecular analysis show a lack of association between three candidate genes and clinical expression of IGE in Kuwaiti Arab children. This is completely different from the findings reported from Caucasian populations of France, Australia and USA in which case a strong association has been reported between IGE and these genes.

Multi-minicore disease: a report of 5 patients from Kuwait.

OBJECTIVE: To describe the characteristic clinical features and the diagnostic findings in muscle histochemistry of multi-minicore disease in 5 children from two unrelated families in Kuwait. CLINICAL PRESENTATION: The 5 children who presented with muscle weakness, 2 siblings from family 1 and the remaining 3 from the other (family 2), represent the classical type of multi-minicore disease; however, the two families differ in the course of the disease. Family 1 had the non-progressive form while family 2 had progressive weakness with respiratory complications and scoliosis. The diagnosis was confirmed in the index patients by muscle histochemistry, which demonstrated the typical minicores, which are devoid of oxidative enzyme activity. CONCLUSION: Both families represent the classical form, however, clinical variability in the course of the illness was demonstrated in these two families.

Lactic acidosis and developmental delay due to deficiency of E3 binding protein (protein X) of the pyruvate dehydrogenase complex.

Pyruvate dehydrogenase deficiency is an important cause of primary lactic acidosis. Most cases occur as a result of mutations in the gene for the E1 alpha subunit of the complex, with a small number resulting from mutations in genes for other components, most commonly the E3 and E3-binding protein subunits. We describe pyruvate dehydrogenase E3-binding protein deficiency in two siblings in each of two unrelated families from Kuwait. The index patient in each family had reduced pyruvate dehydrogenase activity in cultured fibroblasts and no detectable immunoreactive E3-binding protein. Both were homozygous for nonsense mutations in the E3-binding protein gene, one involving the codon for glutamine 266, the other the codon for tryptophan 5.

Silent brain infarcts are rare in Kuwaiti children with sickle cell disease and high Hb F.

Overt stroke is rare among sickle cell disease (SCD) patients in Kuwait. However, there are no previous studies of silent cerebral infarcts, which have been described in up to 20% of American children with Hb SS. We have carried out a prospective brain MRI study among otherwise normal SCD patients, who were consecutive patients seen in a 1-year period to document the prevalence of silent cerebral infarcts in children with sickle cell disease in Kuwait. Any patient with a previous seizure or other neurological abnormality was excluded. MRI was done with a 1.5 Tesla unit with super-conducting magnet. T1- and T2-weighted sagittal and axial sections and proton density axial images were obtained in 5-mm thick sections. The study group consisted of 30 (23 SS and 7 Sbeta(0)Thal) patients-19 males and 11 females-whose ages ranged from 6 to 17 (mean of 9.8 +/- 3.5) years. Hb F ranged from 11% to 35% with a mean of 22.8% +/- 5.7%. Only one patient, a 10-and-a-half-year-old boy with Hb SS, showed hyperintense signals in the parietal white matter, consistent with small infarcts, thus giving a prevalence of 3.3%. Silent brain infarcts are uncommon in our patients, and the protective factors remain to be fully elucidated.

Paediatric neurobrucellosis: case report and literature review.

Neurological complications are rare in childhood brucellosis: there are only 33 reported cases. In children, neurobrucellosis is usually of acute presentation involving the central nervous system. We report our experience with an 8-year-old boy with brucella meningitis who demonstrated a Jarisch-Herxheimer-like reaction, i.e. initial clinical deterioration following the commencement of antibrucella treatment, associated with increased pleocytosis and shift from lymphocytic to polymorphic predominance and an already increased CSF lactate. These CSF findings have not been previously described. The patient recovered completely after 3 months' therapy consisting of rifampicin, doxycycline and gentamicin. Paediatric neurobrucellosis therapy should be a combination of three antibrucella antibiotic that include an aminoglycoside; for a period of 8-12 weeks, steroids may be added to treat complications. The prognosis of neurobrucellosis in children is usually good.

Toxocariasis as a cause of renal disease in children in Sharkia Governorate, Egypt.

Eighty four children (40 males and 44 female) suffering from renal troubles were chosen as well as 20 healthy children as a control group. Urine and stool of patients were examined and chosen to be free from parasitic infections other than Toxocara. Each child was subjected to history taking, full clinical examination, urine analysis, kidney function tests and differential leucocytic count, examination of sera and urine by ELISA and microprecipitin tests for Toxocara antibodies. ELISA revealed 10.7% of patients to be seropositive for toxocariasis versus 5.3% in control group. This difference was statistically insignificant P > 0.05. In urine, ELISA revealed 2 positive cases out of the 84 patients, while it was negative in control group. These 2 cases were suffering from nephrotic syndrome. Microprecipitin test in sera was positive in 9.5% of patients and negative in control group. It was also negative in urine of patients and control group. Eosinophilia was found in 66.6% of seropositive patients. IgG antibodies to Toxocara were detected in males more than females between the age of 2-7 years, but insignificant (P > 0.05). It was also found in 77.7% of rural compared to 22.2% of urban areas. This difference was statistically significant (P < 0.05). It was concluded that toxocariasis should not be missed in the differential diagnosis of such renal diseases especially those who are not responds to the traditional management.

Serological diagnosis of extraintestinal Sarcocystosis.

The present study was carried out on eighty patients attending Zagazig University Hospitals. Forty cases suffered idiopathic cardiac diseases (28 with cardiomyopathy, 8 with myocarditis & 4 with valvular lesions) and forty cases suffered idiopathic rheumatic diseases (30 with musculoskeletal complaints and 10 with myositis). Sera were investigated by enzyme-linked immunosorbent assay (ELISA) and indirect fluorescent antibody technique (IFAT) using Sarcocystis fusiformis antigen in order to detect the role of Sarcocystis in initiation of these diseases. Twenty positive toxoplasmic sera and sera from twenty normal individuals were considered as control group. The sera of the investigated cases were tested against Toxoplasma gondii antigen to exclude it as one of the causative agents of these idiopathic lesions. No statistical difference was found between IFAT and ELISA in diagnosis of sarcocystosis (P < 0.05). Also, there was no cross reaction between Sarcocystis and Toxoplasma. This study showed that Sarcocystis can be considered as one of the possible causes of some idiopathic diseases.

Prevalence of congenital and acquired toxoplasmic uveitis as evidenced by two serologic methods.

Anti Toxoplasma antibodies were sought in 34 patients with uveitis and 20 healthy individuals by IHAT and IFAT. The total sero-positivity rate was 26.5%. The prevalence was significantly higher among patients with posterior (42.9%) than with anterior uveitis (7.1%) and control (10%) indicating significant role of Toxoplasma as an aetiologic agent of posterior uveitis. 14.4% of patients with seropositive uveitis were considered to be due to primarily acquired Toxoplasma infection as evidenced by their significant higher IFAT mean titre (576.7 +/- 322.1) than IHAT (48 +/- 18.5). The reported toxoplasmic anterior uveitis case is most probably secondary to posterior involvement.

Echinococcosis in camels as revealed by indirect haemagglutination test in Belbas.

This study aimed to estimate the prevalence of Echinococcus antibodies in camels using the indirect haemagglutination test (I.H.A.T.). Out of 100 camels, 27 camels were seropositive.