Sildenafil augments the beneficial hemodynamic and histopathological effects of amlodipine in nitric oxide-deficient hypertensive rats: role of nitric oxide-cyclic GMP pathway.

The association of erectile dysfunction (ED) with cardiovascular diseases is so common. This study was carried out to investigate possible impact of sildenafil; the prototype phosphodiesterase 5 inhibitor used for treatment of ED, on the beneficial hemodynamic and histopathological effects of the prototype third generation calcium antagonist, amlodipine, in nitric oxide (NO)-deficient hypertensive rats. Hypertension was induced by 4-weeks treatment with N(omega)-nitro-l-arginine-methyl ester (l-NAME). Animals were allocated into five groups: normal control, hypertensive control, amlodipine-treated group, sildenafil-treated group and combined treatment group. Drug treatment was started 2 weeks after l-NAME and continued together with l-NAME to the end of the treatment period. Systolic blood pressure (SBP), plasma nitrate/nitrite (NO(x)) and plasma cGMP levels were evaluated at the end of the treatment period. Aortic and renal structural alterations were also investigated. l-NAME treatment caused elevation of SBP, reduction in plasma NO(x) and cGMP levels as well as adverse histological alterations in the tissues studied. Amlodipine normalized SBP, restored plasma NO(x) and cGMP levels and ameliorated the adverse histological changes seen in NO-deficient rats. When combined with sildenafil, both hemodynamic and histopathological effects of amlodipine were augmented with an underlying enhanced elevation of both plasma NO(x) and cGMP levels to statistically higher values than amlodipine alone. These results show that sildenafil augments the beneficial hemodynamic and histopathological effects of amlodipine in NO-deficient hypertensive rats with a pivotal role being played by NO-cGMP pathway. Whether this pharmacodynamic interaction could exist in other models of hypertension that do not share such biochemical derangement warrants further investigations.

[Swimming programme for mentally retarded children and its impact on skills development]

People with Down syndrome suffer from many social, psychological and motor function problems. Current research has looked at swimming programmes to assess their impact on such problems. The programme described here was applied for a 3-month period, with music being used as one of the tools. The results were very positive and children showed significant improvement in agility, self-esteem and behaviour patterns. The programme is thus effective in enhancing the integrated development of children with Down syndrome

The clinical value of CYFRA21-1 in bladder cancer patients: Egyptian experience.

There are a wide variety of tumor markers now available that proved to be of value in the management of cancer patients. Of these markers, tissue polypeptide antigen (TPA) and tissue polypeptide specific antigen (TPS) are well known in the field of bladder cancer. TPA was found to be a mixture of cytokeratins 8, 18 and 19 and recent investigations proved that TPS is keratin 18. The aim of the present study was to assess the clinical value of urinary cytokeratin 19 (CYFRA21-1) in the differential diagnosis between bladder cancer and benign urinary tract diseases represented by bilharziasis. Two hundreds and seventy individuals were included in the present study: 186 with bladder cancer representing the different stages and grades, 44 with urinary tract bilharziasis and 40 normal healthy controls. CYFRA21-1 was evaluated in 24-hour urine samples by ELISA using the automatic set supplied by Boehringer Manheim, Manheim, Germany (ES 300). Results of this study revealed significant elevation of CYFRA21-1 in bladder cancer followed by bilharziasis. 82.3% (153/186) of bladder cancer patients and 11.4% (5/44) of bilharzial patients exhibited CYFRA21-1 levels above the upper limit of the control group (3 micrograms/24-hr). CYFRA21-1 was more sensitive in advanced than early stages of bladder cancer and in patients with positive than those with negative lymph nodes, but association of tumor with bilharziasis did not markedly affect its level.

Urinary gonadotropin peptide (UGP) in Egyptian patients with benign and advanced malignant urological disease.

Urinary gonadotropin peptide (UGP) levels were determined in urine samples from 450 Egyptian subjects to determine its relative level of expression in benign and malignant urological disease, and normal individuals. The mean UGP level in patients with bladder cancer was 44-fold higher than in patients with benign disease, and 81-fold higher than in normal individuals. At specificities of 95% and 100%, overall sensitivities of 73% and 60%, respectively, were observed for the detection of malignant disease. Mean UGP levels in patients with bladder cancer were significantly correlated with the stage and grade of malignant disease but did not vary significantly when stratified according to histological type of disease, nodal involvement or bilharzial association. UGP could be a potentially useful marker for the differentiation of benign from malignant urological disease.

Evaluation of an educational training programme for the development of trainers in child mental health in Alexandria

A six-day workshop was conducted to develop trainers in mental health by providing physicians participating in the programme with the necessary educational knowledge and skills. A significant improvement was observed in the participants' knowledge and skills after the workshop. A significant correlation was found between the increase in knowledge and that of performance. The increase was affected neither by the years of work experience nor by the postgraduate degree held. This observed benefit and the satisfaction expressed by participants encourage the replication of such a programme in order to develop qualified health personnel capable of expanding mental health services for children

Study of behavioral pattern among preschoolers in Alexandria.

A cross sectional study was done on (178) preschooler selected in a cluster technique. Matthews Youth Test of Health was completed by teachers for measurement of (type A) behavior pattern. (BCL) was chosen to assess behavioral problems among preschoolers. (type A) children in the study constituted 43.82% and those having behavioral problems were 29.21%. Boys were significantly more of (type A) and had more behavioral problems than girls (X2 = 4.9012 and 6.1730 respectively). Professional parents had children significantly more of (type A). Single children were significantly more of (type B). Children tended to be significantly more (type A) when their both parents were (type A).

Impact of a mental health program on the utilization of the psychiatric clinic in sporting students' hospital.

The evaluation of the multi-sectoral collaborative school mental health program conducted in Alexandria from 1987 to 1990 has to be done along various dimensions (Seif El-Din et al.). The aim of the present work is to investigate the trend change in utilization of the psychiatric clinic in the Students' Hospital (Sporting) through comparing pre-program years (1983/84-1987/88) trend with program years (1988/89-90/91) trend. The source of information about clinic utilization consisted of two registers; one for new cases and the other for return visits. The utilization trend of the psychiatric clinic for return visits showed an increased rate of referral through program years as compared to pre-program trend expected rates. Similarly, new visits trend of referral showed the same picture except for nocturnal enuresis. These findings lend further support for the positive impact of the previously mentioned program on the knowledge and detection skills of school physicians. Meanwhile, they highlight the need for further concern regarding their skills in management of mental disorders.

A study of depression among Alexandria preparatory school adolescents.

Using a constructed Arabic version of Children Depression Inventory (CDI), screening of a stratified random sample of 1% (1561) of Alexandria Preparatory school adolescents was carried out. The prevalence of depressive scorers was 10.25% of total sample. A sub-sample of depressed scorers (111 pupils) were compared with controls (non-depressed scorers) matched on age and sex to study a variety of personal, familial, medical and scholastic ecological variables. Pupils neuroticism scorers were most predictive of depressive scorers where they explained 59.79% of the variance. Other ecological factors including peer and sibling relationships, introversive and lie scale scorers and scholastic performance explained an additional 14.87% of the variance. Using Beck Depression Inventory (BDI) and Mother-Father relationship check list, a sub-sample of depressed pupils' mothers were compared with controls of non-depressed pupils' mothers (42 mothers for each). Results indicated a strong positive correlation between pupils, CDI scores and their mothers BDI scores. On the other hand poor mother-father relationship was significantly associated with depressive scores of pupils. Findings, pointed to the need for reconsideration of school mental health program, since the presented medical and social services to depressed pupils were very poor.

Urinary calculi and pattern of fertility among women. A retrospective study.

The aim of this study is to reveal the relationship between urolithiasis and pattern of fertility among women as indicated by the age at first pregnancy, the number of pregnancies and the use of contraceptive pills as well as to determine the lateralization of stone. The study was conducted on 250 female patients suffering from urinary stones and a similar number of control randomly selected from the same hospital. Data were obtained by an interviewing questionnaire. The study demonstrated that the mean number of pregnancies of cases is significantly higher than that of control (t = 3.5797). However, history of pregnancy, the age at first pregnancy and the duration of use of contraceptive pills are not significantly related to urolithiasis (X2 = 0.3415, 0.7688 and 1.5120 respectively). Right side stone are more encountered in cases with history of pregnancy than those who have never been pregnant.