ORIGINAL_ARTICLE
The Effect of Pioglitazone on Matrix Metalloproteinase-9, Matrix Metalloproteinase-2, Tumor Necrosis Factor-α, Vascular Endothelial Growth Factor and E-Selectin in Skin Lesions in Psoriatic Patients with and without Psoriatic Arthritis
Background: Psoriasis is a common inflammatory skin disease characterized by infiltration of inflammatory cells into the epidermis and altered keratinocyte differentiation. The aim of the present study was to investigate the role of MMP-9 in the development of psoriasis by assessing the presence of MMP-9 in lesional skin and in sera of psoriatic patients with & without psoriatic arthritis, the association of MMP-9 with the activity of the disease, the relationship between MMP-9 and TNF-α production as well as to evaluate the effect of pioglitazone (one of the agents thiazolidinediones) on TNF-α, MMP-9, MMP-2, VEGF and E-
selectin production and in treatment of psoriasis. Subjects and Methods: Thirty-five psoriatic patients (28 males, 7 females) were included
in this study. They were divided into 2 groups. Group I (PsA) included 15 psoriatic patients, clinically presenting joint symptoms associated to the cutaneous disease (PsA). Group II (Ps) included 20 psoriatic patients, clinically presenting cutaneous disease without psoriatic arthritis (PsA). Each psoriatic patient received pioglitazone 30 mg/day orally for 10 weeks. Lesional tissue specimens were taken, in the same skin area before and after 10 weeks pioglitazone treatment. Tissues were kept in short term cultures and production soluble mediators such as TNF-α, MMP-9, MMP-2, VEGF and E-selectin, which include angiogenic molecules associated to the development of plaque psoriasis, were measured in the culture supernatants by ELISA. MMP-9 concentrations were also measured in the sera. The cutaneous activity of disease was evaluated by the Psoriasis Area and Severity Index (PASI).
Results: Clinical and laboratory assessment indicated that all patients had a significant improvement of the PASI score after 10 weeks of pioglitazone therapy. The clinical improvement was associated to a significant decrease of TNF-α, MMP-9, MMP-2, VEGF& E- selectin levels (P< 0.05) , spontaneously released by lesional biopsies before and after therapy. A significant decrease of MMP-9 (P< 0.01) in the sera, associated to the clinical improvement was also found. In addition, significant positive correlations (P< 0.01) were found between the TNF-α and PASI score, MMP-9, MMP-2, VEGF& E-selectin (r=0.85, 0.84, 0.58, 0.63, 0.67 respectively), as well as between the MMP-9 and PASI, MMP-2, VEGF& E-selectin (r=0.82, 0.39, 0.69, 0.41 respectively) of patients with PsA after pioglitazone treatment. In psoriatic patients without psoriatic arthritis after pioglitazone treatment there were also significant positive correlations between the TNF-α and PASI score ,MMP-9, MMP-2, VEGF& E- selectin(r=.0.87, 0.68, 0.53, 0.61, 0.51 respectively), as well as between MMP-9 and PASI, MMP-2, VEGF& E-selectin (r=0.95, 0.51, 0.58, 0.45 respectively).
Conclusion: The current study shows the existence of a direct relationship between MMP- 9 and TNF-α production strongly suggesting that MMP-9 may play a key role in the skin inflammatory process. Our findings also demonstrated that pioglitazone could be considered as an efficacious and safe agent for the treatment of psoriasis. The optimum dose and duration of pioglitazone therapy remain to be determined.
https://ejhm.journals.ekb.eg/article_17797_a22a0cc9d41b24b1e94d0d071dbdf2bf.pdf
2006-10-01
564
577
10.21608/ejhm.2006.17797
Psoriasis . Psoriatic arthritis . Matrix metalloproteinase-9 . Pioglitazone
Seham M. S
EL – Nakeeb
1
Biochemistry Dept. Faculty of Medicine for Girls AL – Azhar University
AUTHOR
Sahar
Fawzy
2
Dermatology and Veneriology Dept. Faculty of Medicine for Girls AL – Azhar University
AUTHOR
Magda H
Osman
3
Clinical Pathology Dept. Faculty of Medicine for Girls AL – Azhar University
AUTHOR
ORIGINAL_ARTICLE
Nasal Mucosal Morphology after Altera tion of Air Stream
Introduction The nocturnal application of nasal continuous positive airway pressure is used for treatment of sleep apnoea. The study of the histopathological changes that accompany its application is needed for proper evaluation.
Subjects and Methods: Fifteen adult rabbits were used in this study, 14 were the subject of the experiments and one animal used as control. Under combined general and local anaesthesia, ring of skin and epithelium was removed from the left nostril, the margins of the wound were undermined, averted and brought together with mattress sutures, effectively closing the nostril. The animals were sacrified at intervals. The duration of surgical closure of one nostril was four days in 7 animals and three months in 7 others. Strip of bony and cartilaginous septum was removed after marking the closed side with a silk stitch. In each interval 4 animals were used for transmission electron microscope (TEM) and 3 for scanning electron microscope (SEM).
Results: On the side with sealed nostril the number of goblet cells increased, while the number of ciliated cells decreased. In contrast, on the open side of the nose disappearance of the ciliated cells and a transformation of the respiratory epithelium into thickened multilayered squamous epithelium with no goblet cells.
https://ejhm.journals.ekb.eg/article_17798_4ca79feeccdef94bd52a1bcf906c63de.pdf
2006-10-01
578
585
10.21608/ejhm.2006.17798
Abdulsalam
Hussein
1
ENT Al-Azhar Faculty of Medicine
AUTHOR
Reda
Awadalla
2
Anatomy Department, Al-Azhar Faculty of Medicine
AUTHOR
ORIGINAL_ARTICLE
Plasma Retinol, Thyroid Stimulating Hormone and Zinc as Predictors of Bone Mineral Density Status
Background: Conflicting results on the association between serum retinol level and bone mineral density (BMD) have been published. Thyroid hormones are essential for skeletal development and have direct effect on bone formation and resorption. Bone has one of the highest concentrations of zinc of all tissues, and has been shown to release zinc during deficiency for soft tissue metabolism. Objective: The objective of this study was to assess the relation between plasma levels of retinol, thyroid stimulating hormone (TSH) & zinc and BMD of Egyptian adolescents and adults. Method: The study was a part of a cross sectional national survey conducted by National Nutrition Institute. The sample was a multistage stratified random. Target individuals were classified into two age groups (10- ≤ 18 and 28-≤ 59 years). Bone mineral density and plasma levels of retinol, TSH and zinc were determined. Results: Low and high plasma retinol levels were more prevalent among osteoporotic adolescent and adult males respectively than in normal subjects.. The reverse was observed in adult females. Bone mineral density correlated negatively with plasma retinol level in adult males and females and positively in adolescent males, while among females the association was significant (P = 0.030) and stronger. The highest deficiency of TSH was found among adult and adolescent osteoporotic males, followed by osteopenic adult males and adolescent females. Highly statistically significant difference (P < 0.001) existed between osteoporotic and normal adult males concerning TSH deficiency. The prevalence of zinc deficiency ranged from 5.7% to 9.5% for all target individuals. Plasma Zn levels were correlated negatively with bone mineral density in adult males and females. Conclusion: The results of this study reflects the controversy on the association of plasma retinol and BMD. However, the predominant finding revealed that both low and high plasna retinol levels compromise bone health. Bone status and thyroid function support the adverse effect of hyperthyroidism upon either bone osteoporosis or osteopenia and subsequently upon fracture risk. Plasma zinc deficiency correlated negatively with BMD in adult osteoporotic men.
https://ejhm.journals.ekb.eg/article_17799_0de098f5e69b4ab2a3100f657978c9c1.pdf
2006-10-01
586
596
10.21608/ejhm.2006.17799
Human BMD. Osteoporosis. Osteopenia. Fractures Plasma. Retinol. TSH. Zinc
Shawkia S. A.
El-Sherbeny
1
Nutritional Biochemistry Department. National Nutrition Institute.
AUTHOR
Effat A. A.,
Afifi
2
Food hygiene Department. National Nutrition Institute
AUTHOR
Wafaa M. A.
Saleh
3
Food hygiene Department. National Nutrition Institute
AUTHOR
Asmaa, M.
Abdallah
4
Clinical Nutrition Department. National Nutrition Institute.
AUTHOR
Lobna M. S.
Hadidy
5
Nutritional Requirement and growth Department. National Nutrition Institute
AUTHOR
ORIGINAL_ARTICLE
Influences of Short -term Aerobic Exercise and Supplementation of Carnitine With or Without Choline on Body Weight, Serum Leptin and Carnitine as Well as Lipid Status In Male Rats
Background: Carnitine is essential for fatty acids translocation, muscles function and exercise performance. Choline is a lipotropic agent that prevents deposition of fat in the liver. The studies concerning the effects of carnitine and choline supplementation with exercise on carnitine status and serum leptin are rare. The aim of the present study was to study the effect of carnitine and its combination with choline, with or without exercise on body and total fat pad (TFP) weights, serum carnitine, leptin, β-hydroxy butyric acid (β-HBA), triacylglycerols (TAG) and Free Fatty acids (FFA). Also, total lipids (TL) and TAG content of TFP and urinary carnitine were investigated. Material and Methods: 48 male rats were equally divided to the following groups: control (C), carnitine (5 g/Kg diet) supplemented, carnitine plus choline (5 and 11.5 g /Kg diet respectively) supplemented. Half of each group was subjected to short term aerobic exercise on manual treadmill, in which the speed and duration were gradually increased via the course of the experiment, to be 10 m/min for 20 min/day, 5 days/week in the last 2 weeks. Body weights were recorded weekly. After 6 weeks, The 24 hours urine was collected then the fasted rats were sacrificed and blood and the total fat pad (TFP) were collected for analysis.
Results: Carnitine supplementation, tended to decrease body weight, TFP, TAG content and serum FFA, and significantly decreased the TL content, serum leptin, TAG (P<0.0005). Carnitine feeding resulted in a significant elevation of serum carnitine, β-HBA and urinary carnitine (P<0.0005), compared to sedentary control rats. These values became more pronounced on choline addition to the diet except for serum and urinary carnitine that reversed (i.e. decreased) by choline addition. Exercise intervention resulted in a significant decrease in body weight, TFP, TL content and serum leptin, TAG and FFA. These values were more pronounced in both supplements with exercise, specially serum carnitine. However, exercise caused reduction of urinary carnitine in non-supplemented and carnitine supplemented groups and this was reversed by choline and exercise.
Conclusion: Our study demonstrated that the beneficial effects of carnitine supplements is promoted by choline with or without mild exercise to reduce body weight, body fat, serum leptin and promote fat loss by increasing lipolysis as indicated by increased serum β-HBA. These results may or may not be applicable to humans, so further research is recommended to determine whether similar effects would result in humans or not.
https://ejhm.journals.ekb.eg/article_17801_155437a4a1e434d5dd6adb31008fe451.pdf
2006-10-01
597
609
10.21608/ejhm.2006.17801
Carnitine . choline . leptin . β-hydroxy butyric acid . total lipids . exercise
Neamat E.
Hishem
1
Physiology Departments, Faculty of Medicine for Girls, Al- Azhar University
AUTHOR
Bushra H.
El-Zawahry
2
Physiology Departments, Faculty of Medicine for Girls, Al- Azhar University
AUTHOR
Seham M.S.
El Nakeeb
3
Biochemistry Departments, Faculty of Medicine for Girls, Al- Azhar University
AUTHOR
Layla A.
Ahmad
4
Biochemistry Departments, Faculty of Medicine for Girls, Al- Azhar University
AUTHOR
ORIGINAL_ARTICLE
Serum Leptin in Patients with Chronic Renal Failure on Different Modes of Management
Aim:Tostudyserumleptinlevelinchronicrenalfailure(CRF)patientsondifferent modesofmanagementandtoanalyzetheimpactofthemodeoftherapyonserumleptinlevel.
SubjectsandMethods:Thisstudywasconductedon64patients(33males&31females) withchronicrenalfailuredividedintothreegroups:groupI:Twenty-sixpatientstreated conservativelyanddidnotstartdialysisyet(predialysis),groupII:Twenty-fourpatientstreated byhemodialysis,groupIII:Fourteenpatientstreatedbycontinuousambulatoryperitoneal dialysis(CAPD).Twentyhealthysubjectswereincludedascontrolgroup.Allpatientsand controlsweresubjectedtofullclinicalexaminationincludingheightandweighttocalculate bodymassindex(BMI).Bloodureaandserumcreatinineweremeasuredasrenalfunctiontests. SerumleptinwasmeasuredbyEASIAandsoseruminsulin.
Results:InpredialysisandCAPDgroups,thereisasignificantincreaseinleptin,leptin/ BMIandinsulininpatientsincomparisontocontrolsubjects.Inhemodialysisgroup,thereisa significantincreaseinleptinandleptin/BMIandanon-significantincreaseininsulinlevelin patientsincomparisontocontrolsubjects.Insulinissignificantlycorrelatedwithleptininthe firstgroup,whileinthesecondandthirdgroupsthereisnocorrelation.Thehighestleptinlevel isfoundintheCAPDgroupofpatientsfollowedbythepredialysisonethenthehemodialysis group.
Leptinlevelissignificantlyhigherinfemalesthanmalesinallgroups.Thisdifference remainedafteradjustingleptinleveltoBMI.
Nocorrelationwasfoundbetweenleptinlevelandageorbetweenleptinlevelandrenal functioninthethreegroupsofpatients.Nocorrelationwasfoundbetweenleptinlevelandthe durationofdialysisinthehemodialysisandCAPDgroups.
Conclusion:SerumleptiniselevatedinCRFpatientsirrespectiveofthetypeof managementtheyareundergoing.Dialysis,hasnosignificanteffectonleptinlevel.Thetwo mainpredictorsofserumleptinlevelaresexandBMIinCRFpatientsandinhealthysubjects.
Leptinlevelmayserveasavaluableclinical Introduction
Leptinisa16KDproteinhormone producedmainlybywhiteadiposetissue (Kuwaharaetal.,2003).Itisinvolvedin energyhomeostasisthatactstoinhibitfood intake,tostimulateenergyexpenditureand influenceinsulinsecretion,lipolysisand sugartransport(Mistriketal.,2004).
Theactionofleptinismediated throughtheleptinreceptor(Ob-R),whichis encodedbythediabetes(db)gene.Leptin receptorsisoformshavebeenreportedin widevarietyoftissues:heart,lung,
markerforbodyadiposity.
https://ejhm.journals.ekb.eg/article_17803_bc3a852bc284681158ae5da9dfa65526.pdf
2006-10-01
610
619
10.21608/ejhm.2006.17803
Hala M.
EL-Mougi
1
Departments of Medical Biochemistry Faculty of Medicine (Girls), AL-Azhar University
AUTHOR
Samiha
Abo EL-Yazeed
2
Internal Medicine Faculty of Medicine (Girls), AL-Azhar University
AUTHOR
Zeinab A.
Yousry
3
Internal Medicine Faculty of Medicine (Girls), AL-Azhar University
AUTHOR
Abir
Abdel Fattah
4
Internal Medicine Faculty of Medicine (Girls), AL-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Assessing the Nutritional Status and Blood Glutathione Level for Preschool Children.
This study was designed to assessment nutrition status and blood glutathione (GSH) level for preschool children. Subjects and methods: The study included 70 (boys and girls preschool children) at aged from 2-5 years. Children was randomly selected from the out patients clinic at the National Nutrition Institute Cairo. Weigh and height were measured for them to evaluate the effect of nutrients on bodies, dietary intake was collected for the children were subjected to estimation of (Energy, Protein, Fat, Carbohydrate, vitamins A, folic acid and minerals iron, zinc and selenium) in their daily diet. Blood samples were collected to determine hemoglobin, glutathione and total protein concentration. Results: The dietary analysis showed that, every nutrient was lower than the requirement except total protein was higher than the recommend. Stunting showed (25.5%) of boys and (20%) of girls, underweight (23%) of boys and 14% of girls were the problems among preschool children. A glutathione deficiency was found among 97% of boys and 100% of girls. The hemoglobin ratio 77.1% from children was equal or less than normal concentration. Total protein noticed 82.9% of boys and 85.7 of girls in normal value. Conclusion: There was little quantity of nutrients intake, glutathione level and growth. The study can be recommended to improve their daily dietary intake and nutrition habits by education programs for their parents or supplement of studied cases with special ferrous and protein specially contains sulphur amino acids in daily diet to cover Recommended Dietary Allowances and can improve tissue GSH concentration.
https://ejhm.journals.ekb.eg/article_17805_77cc157310f5adb147eb29282802c7d5.pdf
2006-10-01
620
629
10.21608/ejhm.2006.17805
Preschool Children –Glutathione – dietary intake – growth
Hanaa H.
Elsayed
1
Chemistry of Nutrition and Metabolism Department, National Nutrition Institute.
AUTHOR
Amr
Abd El-Hafez
2
Hotel Department Higher Institute for Tourism & Hotel in 6th October City.
AUTHOR
ORIGINAL_ARTICLE
Efficiency of Immunization of Mice with Irradiated Antigen Against Schistosoma mansoni Infection in Comparison with Praziquantel
Introduction: The present study is an attempt to evaluate the protective effect of schistosomula antigen and the current antischistosomal drug praziquantel (PZQ) as a reference drug on mice infected with S. mansoni.
Material and Methods: Mice were vaccinated by irradiated or non-irradiated schistosomula antigen, both at a dose of 100 ug protein/mice once weekly for 3 weeks, before infection with alive cercariae and compared with the treatment with i.m. injection of praziquantel at a dose of 40 mg/kg b.wt. 4 times once weekly for 4 weeks after infection. The degree of resistance or protection induced by immunization and chemotherapy was assessed 45 days post–infection and evaluated by physiological, parasitological, immunological as well as histological parameters.
Results: The results indicated that immunization with γ-irradiated antigen at 20 Krad or the treatment with PZQ resulted in significant reduction in ova count in liver and intestine tissues more than those vaccinated with non-irradiated antigen compared with infected group. Immunized group with irradiated antigen and the group treated with PZQ showed a significant decrease in liver enzymes activity (ALT, AST and γ-GT), while in immunized group with non- irradiated antigen, there was a significant increase in AST and γ-GT as compared to infected group. The level of alkaline phosphatase enzyme was significantly increased in all investigated groups compared to infected one. Treatment with PZQ or immunization with irradiated or non- irradiated schistosomula antigen induced amelioration in serum IL-10 and TNF-α. Scanning electron microscope demonstrated normal mature worms in infected group after 45 days from infection. In contrast, many changes were detected in the rest groups as alterations in the tegument, implosion of tubercles which appeared pealed and sloughed off and most of the spines were detached and separated.
Histological examination of liver sections of infected mice revealed lobular cellular infiltration and cloudy swelling in hepatocytes with occurrence of necrotic foci. Also, granuloma of infiltrating cells was noticed around the portal structures and inbetween the degenerated cells. Congested portal vein could be seen lodged with adult worms and the portal tracts showed fibrous thickening. Whereas, the lung revealed destructed bronchioles which appeared surrounded by intense inflammatory foci. Thickened interalveolar septae were also marked, however many alveoli appeared with shed destroyed epithelium. Moreover, peribronchiolar and perivascular fibrosis was quite prominent. Gross pathological alterations were observed in both liver and lung of immunized groups with non-irradiated antigen. In controversy, immunization with irradiated antigen can reduce the granulomatous reaction and collagen deposition. There are also little inflammation and less congestion, however the hepatic and pulmonary architectures appeared otherwise normal. The present histological findings proved that PZQ has a valuable schistosomicidal effect but some pathological changes are still detectable.
Conclusion:On the whole, it could be concluded that irradiated antigen produced marked protection against S.mansoni infection and this may reflect its possible beneficial effect on the diseased liver and lung.
https://ejhm.journals.ekb.eg/article_17806_a0901adeb555e97442d8eec34137a76d.pdf
2006-10-01
630
655
10.21608/ejhm.2006.17806
Mona A.
El-Gawish
1
National Center for Radiation Research and Technology. Faculty of Science Al-Azhar University
AUTHOR
Manar N.
Hafez
2
National Center for Radiation Research and Technology. Faculty of Science Al-Azhar University
AUTHOR
Fatma A.
Eid
3
National Center for Radiation Research and Technology. Faculty of Science Al-Azhar University
AUTHOR
Maha G.
Soliman
4
National Center for Radiation Research and Technology. Faculty of Science Al-Azhar University
AUTHOR
Shymaa M.
Khalil
5
National Center for Radiation Research and Technology. Faculty of Science Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Sodium Barbital Induced Biochemical, Histological and Histochemical Changes in the Liver of Albino Mouse
Introduction:The present work was planned to assess and evaluate some physiological parameters, histopathological and histochemical impacts of sodium barbital on the liver of adult male albino mice. Material and Methods :The mice were divided into 3 groups, the first group served as a control group, while the other two groups were treated with the therapeutic dose (60 mg/kg b.wt., i.p.) for 7 days (short-term group) and 21 days (long-term group) as repeated daily doses. Results: Biochemical analysis showed a significant increase in serum glucose level (hyperglycaemia), AST, ALT and bilirubin, in all treated groups. Also, total lipids and triglycerides showed a significant increase in the long-term group and non significant change in the short-term group. On the other hand, alkaline phosphatase ALP, showed a significant decrease in both treated groups. Total cholesterol level showed a significant decrease in the short-term group but exhibited a significant increase in the long-term group. The results obtained from the present study showed marked alterations in the liver tissue. Histopathological changes in liver tissue were congestion of the central veins, wedening of the blood sinusoids, activation of the phagocytic küpffer cells and cytoplasmic degeneration (fatty and hydropic) with nuclear lesions. Histochemical changes in liver tissue revealed depletion of polysaccharides and total proteins in both short-term and long-term groups. ConclusionSotheseresultscametoconclusionthat barbituratesshouldbeprohibitedand carefully used specially when prescribed as tranquilizer.
https://ejhm.journals.ekb.eg/article_17807_e9a96fd71093abad643fae64c90728e7.pdf
2006-10-01
656
671
10.21608/ejhm.2006.17807
Barbital
serum
Liver functions
histopathology
histochemistry
Shadia Ali
Radwan
1
Department of Biological Sciences, Faculty of Education, Ain Shams University, Cairo, Egypt.
AUTHOR
Aziza M.
El-Wessemy
2
Department of Biological Sciences, Faculty of Education, Ain Shams University, Cairo, Egypt.
AUTHOR
Samia M.
Sakr
3
Department of Biological Sciences, Faculty of Education, Ain Shams University, Cairo, Egypt.
AUTHOR
Samira E.
El-Harras
4
High Institution of Applied arts, 6th October City
AUTHOR
ORIGINAL_ARTICLE
Combined Spinal Epidural versus Epidural Sufentanil and Bupivacaine in Labour (Clinical and Histological comparative Study)
Introduction:- Regional analgesia provides excellent pain relif in labour. This study was designed to compare combined spinal eqidural (CSE) versus epidural block using a narcotic (sufentanil) and local anaesthetic bupivacaine regarding their effects on progress of labour, method of delivery, pain relif, side effects and neonatal outcome.
Patients and Methods :-Forty pregnant women ASA I and II were enrolled in this study. The women were randomly allocated to receive either CSE or epidural ( 20 patient of each ). In CSE group analgesia was initiated with 10ug sufentanil with 2mg bupivacaine. In epidural group 10ml bupivacaine 0.125%.and 10ug sufentanil injected epidurally. In both groups the continuous infusion of 0.83% bupivacaine with 0.33ug/ml sufentanil at 10ml/hr adjusted as required. Maternal haemodynamics, analgesia characteristics VAPS, degree of motor block, were measured. Duration of labour, cervical dilation, maternal satisfaction and mode of delivery were assessed. Foetal outcome was assessed by 1 and 5 min. Apgar score and umbilical venous blood gases. Maternal and neonatal side effects were observed.
The experimental study was done on 30 rats divided into 3 groups 10 rats of each. Control group (A) injected intrathecally with saline, group (B) injected intrathecally with 1.5ug/kg sufentanil (low dose), and group (C) injected intrathecally with 7.5ug/kg sufentanil (high dose), the pervious doses were injected every 2hr. for 3 times then the spinal cord was obtained and stained for histological evaluation.
Results:- The clinical study showed that no difference between the 2 groups for the degree of motor block or adequacy of analgesia, mode of delivery and Foetal outcome. The onset of analgesia was faster with CSE technique, more patient satisfaction and more pruritis.
The histological results revealed that no detectable significant neurotoxic changes with the use of small dose of intrathecal sufentanil but mild changes occurred with high dose. Conclusion :- So the study concluded that both CSE and epidural analgesia with sufentanial and bupivaine can provide effective labour analgesia with minimal or no side effects.
https://ejhm.journals.ekb.eg/article_17808_6e478856721a2a3e025c84ce8e9d477f.pdf
2006-10-01
672
690
10.21608/ejhm.2006.17808
Nagia M.
Abd El Moeti
1
Anaesthesia department Faculty of medicine Al-Azhar university
AUTHOR
Zinab B.
Youssef
2
Anaesthesia department Faculty of medicine Al-Azhar university
AUTHOR
Soaad S.
Abd El Aal
3
Anaesthesia department Faculty of medicine Al-Azhar university
AUTHOR
Mahmoud Ahmed
Abd El Haliem
4
Histology department Faculty of Medicine Al Azhar university
AUTHOR
ORIGINAL_ARTICLE
Ropivacaine versus Bupivacaine for Inter Scalene Block Clinical and Pharmacological Comparative Study
Introduction : The interscalene approach to the brachial plexus for shoulder surgeries provides excellent anaesthesia with remarkable safety and minimal or no systemic disturabances.
Material and Methods : 60 abult patients ASA I-II undergoing elective shoulder surgery. Patients were randomly allocated into 3 groups. The patients recived 20ml of either ropivacaine 1% GI (20 patients), ropivacaine 0.75% GII (20 patients) and bupivacaine 0.5% GIII (20 patients). Onset time of sensory and motor block, duration of analgesia and the need for supplementary analgesics were recorded. Pain was assessed by using VAPS. Haemodynamic parameters, oxygen saturation and respiratory rate were recorded. Unwanted side effects, cardiovascular, neurological, nausea and vomiting etc were recorded. Also, patients satisfaction were noted.
The pharmacological study was done on pentobarbitone cats to determine the effect of different doses of ropivacaine (0.35-2.8mg/kg) versus buipvacaine (0.5-4mg/kg) on arterial blood pressure, ECG and respiratory rate.
Results: The mean onset time of analgesia was faster in ropivacaine groups than bupivacaine group (p‹0.005). The studied groups were comparable regarding the duration of analgesia, motor and sensory block, cadio vascular and respiratory effects. The incidence of paraesthesia was more frequent in bupivacaine group than both ropivacaine groups (30% vs 10%) There was more patient satisfaction in ropivacaine groups than bupivacaine groups.
On the other hand the pharmacological study showed that ropivacaine had more less toxic effects on cardiovascular and respiratory systems.
Conclusion : This study concluded that interscalene block performed with either 0.75% or 1% ropivacaine allows for a prolonged postoperative pain relief similar to bupivacaine 0.5%
with shorter onset time, more cardiovascular
Introduction :
Interscalene brachial plexus block (ISB) is used to provide anaesthesia and analgesia for shoulder surgery. Single injection interscalene brachial plexus block is an effective anaesthetic; however it is limited by the duration of action of local anaesthetic. Bupivacaine and ropivacaine have been compared both at different an equal volumes and concentration for ISB. Kinnard and Lirette, (1996).
Bupivacaine is a long-acting local anaesthetic which has been reported to be associated with slower onset time for nerve blockade compared with other intermediate
stability and higher patient satisfaction.
https://ejhm.journals.ekb.eg/article_17809_355e7e30282b68376f90cad5337f9f09.pdf
2006-10-01
691
702
10.21608/ejhm.2006.17809
Nagia M.
Abd El Moeti
1
Anaesthesia Department Faculty of Medicine Al-Azhar University
AUTHOR
Zinab B.
Youssef
2
Anaesthesia Department Faculty of Medicine Al-Azhar University
AUTHOR
Soaad Said
Abd El Aal
3
Anaesthesia Department Faculty of Medicine Al-Azhar University
AUTHOR
Enas Abd El Aaty
Ouda
4
Department of Pharmacology Faculty of Medicine Al-Azhar University
AUTHOR
ORIGINAL_ARTICLE
Cd 34 Glycoprotein as A Differentiating Marker Between Basal Cell Carcinoma and Trichoepithelioma
Trichoepithelioma (TE) is a benign skin tumor with follicular differentiation, which is sometimes difficult to distinguish clinically and histologically from basal cell carcinoma (BCC). One of the most helpful differences is the histologic appearance of the stroma. CD34 is an antigen known to stain the spindle shaped cells located around the middle portion of normal hair follicles. We selected twenty clinically confused cases. After routine histopathological staining by haematoxylin and eosin, all cases showed typical diagnosis in seventeen cases (9BCC& 8TE) while the remaining three cases revealed overlapped features. Immunoperoxidase technique using anti-CD34 antibody carried out in all cases displayed two out of the three overlapped cases had a staining pattern similar to the typical BCC cases; the immediate tumor stroma together with the spindle cells intermixing the tumor nests were CD34 negative. Moreover, the remaining uncertainly diagnosed case had a pattern resembling the typical TE cases; the immediate tumor stroma as well as the spindle cells surrounding the tumor islands were focally CD34 positive.
From our study, we concluded that the CD34 staining pattern can be considered as a helpful tool in differentiation between TE and BCC particularly when these lesians are in doubt about the clinical or routine histologic diagnosis.
https://ejhm.journals.ekb.eg/article_17810_7bbc3f22ae523f2830d5723112f2ad52.pdf
2006-10-01
703
710
10.21608/ejhm.2006.17810
Key words: CD34 antigen-Immunohistochemistry
Amr M.
Zaky
1
Department of Dermatology, Venereology & Andrology Al-Azhar University (Cairo)
AUTHOR
Ahmed H.
Abdel-Rahman
2
Department of Pathology Al-Azhar university (Assuit)
AUTHOR
ORIGINAL_ARTICLE
Prehospital Thrombolytic Therapy Prior to Percutaneous Coronary Intervention a Comparative Study with Conventional Approach in Acute ST-segment Elevation Myocardial Infarction
Background: early revascularization post MI is the corner stone in the therapy of acute myocardial infarction. Primary PCI proved itself in the management of STEMI with patency rate more than 90%.However, not every hospital has PCI facility. New thrombolytic agent (tenecteplase) is now available which can be given easily outside hospital (Prehospital) to facilitate PCI and preserve the cardiac muscle.
Aim of the work: comparing primary PCI results in patients with STEMI when tenecteplase was given prior to intervention as early as possible (Prehospital), with those who had only PCI without thrombolytic therapy.
Patients and Methods: the presenting study included 60 patients, divided into two equal groups, group I patients received tenecteplase followed by primary PCI and group II underwent primary PCI only in acute STEMI. 12 leads ECG, cardiac enzymes, echocardiographic study, and coronary angiography were done for all patients. PCI results were recorded in addition to immediate and 6 month follow up. All patients received the same adjuvant medical therapy (aspirin, clopidogrel, heparin and tirofiban if needed).
Results: both groups showed non significant differences in peak cardiac enzymes, ejection fraction before and after PCI, and angiographic success post PCI. The hard end points (death, MI) did not show statistical difference between both groups both inhospital and on follow up. However group I showed significant difference (P<0.05) in more direct stenting, less procedure time, and more recurrence of chest pain post PCI compared with group II. There were highly significant differences( P<0.001) in favor of group I in more TIMI 3 flow, less thrombus burden, and less pathological Q waves; and in favor of group II in more clinical success post PCI without complications. The call to balloon interval was shorter in group II (P<0.05). No major bleeding was seen in both groups.
Conclusion: facilitated PCI has the advantages of decreasing thrombus burden in acute STEMI, decreasing procedure time and achieving more TIMI 3 flow; however the hard end points are not different from primary PCI and the recurrence of chest pain is significantly more with facilitation. Tenecteplase use is not associated with major bleeding before PCI.
https://ejhm.journals.ekb.eg/article_17811_7be1a1b5edf67a90b3c614c0fde11d6a.pdf
2006-10-01
711
724
10.21608/ejhm.2006.17811
tenecteplase facilitated PCI
Prehospital thrombolysis
Hussein
Shaalan
1
Ain Shams University - Cardiology Department
AUTHOR
ORIGINAL_ARTICLE
Protective Effect of Simvastatin Against Adriamycin-Induced Nepherotoxicity in Rats; Biochemical and Histological Study
Introduction: The usefulness of adriamycin (ADR), a potent anti-tumor antibiotic, is limited by the development of life-threatening cardiomyopathy and nephropathy. The cellular changes leading to these toxicities are suggested to be mediated by increased free radicals and lipid peroxidation
Aim of the study: The current study was aimed to investigate the protective role of simvastatin (SIM) on adriamycin-induced nephrotoxicity in rat using biochemical, and histological approaches.
Material and methods: Twenty eight healthy male Swiss albino rats were used and divided into four groups : CONT (control), ADR (adriamycin treated), SIM (simvastatin treated), and SIM+ADR (simvastatin plus adriamycin treated). Blood samples were collected and used to determine the serum urea, creatinine, albumin, and total protein levels. Both kidneys were removed ,one of them was prepared for histological examinations and the other was stored at −70 °C for subsequent measurement of malondialdehyde (MDA), glutathione (GSH) contents and phase II antioxidants enzymes activities.
Results: Glutathione (GSH) level, glutathione-s-transferase (GST) and DT-diphorase activities were decreased, while the lipid peroxidation was increased in kidney tissue. Administration of SIM (cumulative dose, 60 mg/kg body wt) in 12 equal injections (PO), before and concurrent with ADR, more or less prevented these nephropathic changes, normalized kidney function, and eliminated ascitis. Treatment with SIM was also accompanied by an increase in kidney GSH level as well as DT-diphorase activities with a concomitant decrease in lipid peroxidation. Histological examination revealed extensive and marked tubular necrosis in the ADR-treated kidney. Administration of Simvastatin reversed kidney damage with a marked reduction in tubular damage induced by ADR
Conclusion: These data show that SIM can provide coma protection against ADR nephropathy. This protective effect of SIM may be related to the antioxidant status on the kidney
https://ejhm.journals.ekb.eg/article_17812_31b355b42a1922c4f80fffdd25206a57.pdf
2006-10-01
725
739
10.21608/ejhm.2006.17812
Adriamycin
Nephrotoxicity
Simvastatin
Antioxidant enzymes
DT diaphorase
Nayira A.
Abd Elbaky
1
Department of Pharmacology Faculty of Pharmacy (girls),
AUTHOR
Lamiaa N.
Hammad
2
Department of Biochemistry, Faculty of Pharmacy (girls)
AUTHOR
Tarek A.
Atia
3
Department of Histology, Faculty of Medicine (boys). Al-azhar University, Cairo, Egypt.
AUTHOR