Silver-Silica nanoparticles induced dose-dependent modulation of histopathological, immunohistochemical, ultrastructural, proinflammatory, and immune status of broiler chickens.

Silver nanoparticles (AgNPs) are a powerful disinfectant, but little information is available on their potential use as a growth promoter and the safety margin of this. In this study, 480 1-day-old Cobb chicks were assigned to one control and three treated groups. The treated groups were supplemented with silver-doped silica nanoparticles (SiO2@AgNPs) at three dietary levels (8, 16, and 20 mg/kg diet) for 35 days. The results revealed no significant changes in the growth performance and oxidative parameters, and in most of the hematological and biochemical parameters among the control and treated groups. In contrast, dose-dependent adverse effects were exerted on the histopathological structure and immunohistochemical expression of CD45 in liver, kidneys, and lymphoid organs (spleen, bursa, and thymus). In addition, the relative weight of lymphoid organs and the serum levels of immunoglobulins M and G were significantly diminished. Moreover, the gene expression of proinflammatory cytokines (IL-ß1 and TNF-α) and the ultrastructural morphology in breast muscle showed significant dose-dependent alterations. It could be concluded that the dietary supplementation of SiO2@AgNPs at a level of 8 mg/kg diet or more has dose-dependent proinflammatory and immunosuppressive effects on broiler chickens.

Aging-Related Functional and Structural Changes in Renal Tissues: Lesson from a Camel Model.

Renal aging is a progressive, physiological, and anatomical change that naturally occurs in all animal species. To date, no information is available concerning the aging-related structural and functional changes in camel kidneys. A total of 25 healthy male camels (14 aged 4­6 years and 11 aged 18­22 years) were included in this study. After the camels were slaughtered, samples were collected from all the camels' kidneys and prepared for histopathological, immunohistochemical, and gene expression evaluations. The most striking observation was the significant decline in the immunohistochemical abundance of podocin and the significant upregulation of smoothening in the aging camels' kidneys. However, the nonsignificant changes have reported for nephrin, calbindin, autophagy 5 (ATG5), aquaporin 1, and toll-like receptor 9. Furthermore, the mRNA expressions of sirtuin 1, superoxide dismutase 1, superoxide dismutase 2, peroxisome proliferator-activated receptor alpha, B-cell lymphoma 2 (Bcl-2), and erythropoietin were significantly decreased in the aging camels' kidneys. While the significant upregulation of Bcl-2-associated X protein and the nonsignificant increase in ATG5 expression levels were reported in the aging camels' kidneys. The present findings provide better understanding of the complex events and initiating factors of aging, allowing for the development of a future therapeutic strategy to preserve adequate renal function throughout life.

Thymoquinone and Curcumin Defeat Aging-Associated Oxidative Alterations Induced by D-Galactose in Rats' Brain and Heart.

D-galactose (D-gal) administration causes oxidative disorder and is widely utilized in aging animal models. Therefore, we subcutaneously injected D-gal at 200 mg/kg BW dose to assess the potential preventive effect of thymoquinone (TQ) and curcumin (Cur) against the oxidative alterations induced by D-gal. Other than the control, vehicle, and D-gal groups, the TQ and Cur treated groups were orally supplemented at 20 mg/kg BW of each alone or combined. TQ and Cur effectively suppressed the oxidative alterations induced by D-gal in brain and heart tissues. The TQ and Cur combination significantly decreased the elevated necrosis in the brain and heart by D-gal. It significantly reduced brain caspase 3, calbindin, and calcium-binding adapter molecule 1 (IBA1), heart caspase 3, and BCL2. Expression of mRNA of the brain and heart TP53, p21, Bax, and CASP-3 were significantly downregulated in the TQ and Cur combination group along with upregulation of BCL2 in comparison with the D-gal group. Data suggested that the TQ and Cur combination is a promising approach in aging prevention.

Transcriptomic and biochemical effects of pycnogenol in ameliorating heat stress-related oxidative alterations in rats.

BACKGROUND: Heat stress is a condition that is due to extreme heat exposure. It occurs when the body cannot keep its temperature healthy in response to a hot climate and associated with oxidative stress. Testicular hyperthermia can induce apoptosis of sperm cells, affect sperm production and decrease sperm concentration, leading to sperm disorder, for this reason, we examined the protective impact of pycnogenol that it has a wide range of biological benefits, including antioxidant, anti-inflammatory and anti-cancer activities against the oxidative alterations that happen in testicular and brain tissues due to heat stress in rats. STUDY DESIGN: Forty-eight Wistar male rats, approximately around 6 weeks age were allocated randomly into four groups (12 in each) of control, HS (subjected to heat stress and supplemented orally with 50 mg of pycnogenol/kg b. w./day dissolved in saline for 21 days), and pycnogenol (rats supplemented orally with 50 mg of pycnogenol/kg b. w./day dissolved in saline for 21 days). RESULTS: Data revealed a promising role of pycnogenol as an antioxidant, natural product to successfully reverse the heat-induced oxidative alterations in testicular and brain tissues of rats through significant upregulation of superoxide dismutase-2, catalase, reduced glutathione, and anti-apoptotic gene, while downregulating pro-apoptotic, and heat shock protein70. Pycnogenol treatment also reversed the reproductive hormone level and spermatogenesis to their normal values. CONCLUSION: Pycnogenol as a natural protective supplement could recover these heat stress-induced oxidative changes in testes and hypothalamus.

Quercetin Attenuates Pancreatic and Renal D-Galactose-Induced Aging-Related Oxidative Alterations in Rats.

Aging is an oxidative stress-associated process that progresses with age. Our aim is to delay or attenuate these oxidative alterations and to keep individuals healthy as they age using natural compounds supplementation. Therefore, we conducted the present study to investigate the protective potentials of quercetin against D-galactose (D-gal)-associated oxidative alterations that were induced experimentally in male Wistar rats. Forty-five rats were randomly allocated into five groups of nine rats each. The groups were a control group that was reared on a basal diet and injected subcutaneously with 120 mg D-gal dissolved in physiological saline solution (0.9% NaCl) per kg body weight daily and quercetin-treated groups that received the same basal diet and subcutaneous daily D-gal injections were supplemented orally with 25, 50, and 100 mg of quercetin per kg body weight for 42 days. Pancreatic and renal samples were subjected to histopathological, immunohistochemical, and relative mRNA expression assessments. Aging (p53, p21, IL-6, and IL-8), apoptotic (Bax, CASP-3, and caspase-3 protein), proliferative (Ki67 protein), antiapoptotic (Bcl2 and Bcl2 protein), inflammatory (NF-κB, IL-1ß, and TNF-α), antioxidant (SOD1), and functional markers (GCLC and GCLM genes and insulin, glucagon, and podocin proteins) were determined to evaluate the oxidative alterations induced by D-gal and the protective role of quercetin. D-gal caused oxidative alterations of the pancreas and kidneys observed via upregulations of aging, apoptotic, and inflammatory markers and downregulated the antiapoptotic, proliferative, antioxidant, and functional markers. Quercetin potentially attenuated these aging-related oxidative alterations in a dose-dependent manner. Finally, we can conclude that quercetin supplementation is considered as a promising natural protective compound that could be used to delay the aging process and to maintain human health.

Thymoquinone Defeats Diabetes-Induced Testicular Damage in Rats Targeting Antioxidant, Inflammatory and Aromatase Expression.

Antioxidants have valuable effects on the process of spermatogenesis, particularly with diabetes mellitus (DM). Therefore, the present study investigated the impact and the intracellular mechanisms by which thymoquinone (TQ) works against diabetes-induced testicular deteriorations in rats. Wistar male rats (n = 60) were randomly allocated into four groups; Control, Diabetic (streptozotocin (STZ)-treated rats where diabetes was induced by intraperitoneal injection of STZ, 65 mg/kg), Diabetic + TQ (diabetic rats treated with TQ (50 mg/kg) orally once daily), and TQ (non-diabetic rats treated with TQ) for 12 weeks. Results revealed that TQ significantly improved the sperm parameters with a reduction in nitric oxide (NO) and malondialdehyde (MDA) levels in testicular tissue. Also, it increased testicular reduced glutathione (GSH) levels and superoxide dismutase (SOD) activity. Interestingly, TQ induced downregulation of testicular inducible nitric oxide synthase (iNOS) and nuclear factor kappa-B (NF-κB) and significantly upregulated the aromatase protein expression levels in testicles in comparison with the diabetic rats. In conclusion, TQ treatment exerted a protective effect against reproductive dysfunction induced by diabetes not only through its powerful antioxidant and hypoglycemic effects but also through its downregulation of testicular iNOS and NF-κB along with upregulation of aromatase expression levels in diabetic rats.

Does local infiltration analgesia in total joint arthroplasty offer any protection from prosthetic joint infections? An invitro experimental study.

Many local anaesthetic agents are now reported to have anti-microbial properties in various studies, and this ability to inhibit microbial growth is not uniform. As local anaesthetics are commonly infiltrated into the surgical field for perioperative pain management, it is very important to know if this practice offers any protection against surgical site infections. METHODS: In this study, three of the most common prosthetic joint infection-causing organisms, namely, Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli, were chosen and tested against the commonly used local anaesthetics. The suspension of each organism was inoculated onto three different Mueller-Hinton agar plates and a drop of an undiluted solution of each local anaesthetic agent is inoculated onto one of the three culture plates; vancomycin and gentamicin discs were used as controls. RESULTS: The local anaesthetic agents tested could not inhibit the growth of any of the microorganisms. As there was no inhibition of bacterial growth in the experiment with the above three agents, further experiment with a diluted mixture was not performed. CONCLUSIONS: It can be concluded that local infiltration of anaesthetic agents is less likely to provide any perioperative protection against prosthetic joint infections but may interfere with some diagnostic tests for microbiology.

Growth performance, blood lipids, and fat digestibility of broilers fed diets supplemented with bile acid and xylanase.

This study aimed to show the effect of bile acid (BA) and xylanase (Xyl) supplementation on the growth, fat digestibility, serum lipid metabolites, and ileal digesta viscosity of broilers. A total of 720 1 d old male broilers were allocated to one of nine treatments with four replicates in each under a factorial design arrangement of three levels of BA (0 %, 0.25 %, and 0.50 %) and three levels of Xyl (0 %, 0.05 %, and 0.10 %) supplementation. The duration of the experiment was 35 d (7-42 d). Growth performance, blood lipids, fat digestibility, and ileal digesta viscosity were determined. The experimental treatments did not affect feed intake (FI) and weight gain (WG). Supplementation of BA or Xyl did not significantly ameliorate the feed conversion rate (FCR) (p<0.05). The addition of BA linearly increased fat digestibility. At 7-21 d of age, the addition of BA or Xyl had a significant (p<0.05) increase in serum cholesterol (Chol) but no significant difference for other serum lipid parameters in broiler chickens fed with Xyl in the starter and grower periods. However, the supplementation of 0.5 % BA at 7-21 d of age significantly increased the Chol and low-density-lipoprotein (LDL) levels. The results of this trial revealed that the supplementation of xylanases had a great effect on the degradation of arabinoxylan from wheat, which led to a relatively greater reduction in ileal digesta viscosity; it was also found that supplementation of BA significantly increased the concentration of serum lipid metabolites, whereas BA and Xyl supplementation linearly increased the fat digestibility of the birds fed wheat and tallow diets.

High numbers of COVID-19 patients transit through non-COVID wards, and associated healthcare workers have high infection rates: An observational cross-sectional study.

Infection risk is high in healthcare workers working with COVID-19 patients but the risk in non-COVID clinical environments is less clear. We measured infection rates early in the pandemic by SARS-CoV-2 antibody and/or a positive PCR test in 1118 HCWs within various hospital environments with particular focus on non-COVID clinical areas. Infection risk on non-COVID wards was estimated through the surrogate metric of numbers of patients transferred from a non-COVID to a COVID ward. Staff infection rates increased with likelihood of COVID exposure and suggested high risk in non-COVID clinical areas (non patient-facing 23.2% versus patient-facing in either non-COVID environments 31.5% or COVID wards 44%). High numbers of patients admitted to COVID wards had initially been admitted to designated non-COVID wards (22-48% at peak). Infection risk was high during a pandemic in all clinical environments and non-COVID designation may provide false reassurance. Our findings support the need for common personal protective equipment standards in all clinical areas, irrespective of COVID/non-COVID designation.

Soybean Oil Replacement by Poultry Fat in Broiler Diets: Performance, Nutrient Digestibility, Plasma Lipid Profile and Muscle Fatty Acids Content.

Continuous genetic improvements of commercial broiler strains has led to the necessity of using fats in their rations to fulfill a large portion of the energetic requirements. Several fat sources have been introduced in poultry nutrition, such as rendering poultry fat (PF) an available and cheap lipid source compared to conventional sources such as soybean oil (SO). The present study investigated the effect of partial or full replacement of SO by PF on performance, nutrient digestibility, blood lipids, and fatty acids (FAs) content of pectoral muscle. Four hundred and eighty one-day-old male Ross-308 chicks were distributed into four experimental groups (12 replicates each): the first group (control) was fed a diet formulated with soybean oil as a fat source while the second to fourth groups (PF25, PF50, and PF100) were fed diets formulated with 25, 50 and 100% of PF as a fat source instead of SO. Results revealed no synergistic effect between SO and PF in any of the studied parameters. Replacing SO by PF did not alter birds' growth, carcass characteristics, and plasma indices of birds. Abdominal fat% was increased (p < 0.01) in PF50 and PF100. Dry matter digestibility was improved (p < 0.05) in PF50 and PF100, while crude fat and protein digestibility was not affected. Contents of palmitic and docosahexaenoic acids in the pectoral muscle of PF50 and PF100 were reduced (p < 0.01) while concentrations of oleic and linolenic acids, total unsaturated FAs, and polyunsaturated FAs/Saturated FAs ratio were elevated (p < 0.05) in the same groups. Liver thiobarbituric acid reactive substances (TBARS) and muscle vitamin E contents were not altered. The dietary addition of PF greatly improved economic parameters. In conclusion, PF can be used as a lipid source in broiler diets to produce inexpensive meat while maintaining its growth performance.

Prevalence of intestinal parasitic infections and their associated risk factors among preschool and school children in Egypt.

Intestinal parasitic infections (IPIs) are among the major public health problems globally, particularly in developing countries like Egypt. This study aimed to evaluate prevalence and risk factors associated with IPIs among preschool and school children in Egypt. A cross-sectional study was conducted on 996 randomly selected preschool and school-aged children in Gharbia governorate during January to April 2018. Stool specimens were examined for the presence of the parasite by direct smear and the formol-ether concentration methods. The overall prevalence of IPIs was 46.2%. Entamoeba histolytica and Ascaris lumbricoides were the most predominant parasites (12.7% per each). This is followed by Enterobius vermicularis (8.6%), Giardia lamblia (7.1%), Cryptosporidium parvum (1.5%), Heterophyes heterophyes (1.4%), Hymenolepis nana (0.7%), Hookworms (0.6%), Fasciola hepatica (0.5%) and Dipylidium caninum (0.4%). Infected children with no symptoms (26.8%) were significantly (P < 0.001) more frequent than those with medical complaint (19.4%). Socio-demographic predictors of IPIs were preschool age (OR = 4.9; P < 0.001; 95%CI 3.3-7.3), living in rural dwellings (OR = 1.96; P < 0.001; 95%CI 1.5-2.5), and belonging to a low-income family (OR = 4.7; P < 0.001; 95%CI 2.3-9.3). The absence of safe drinking water, lack of hand washing (after soil contact, or before meals, or after toilet usage), and eating unwashed vegetables were risk factors for IPIs in the study region (OR = 1.3-6.9, P < 0.001 -P = 0.05). Higher odds for exposure to potential zoonotic parasites were evident in children with pets in their homes for G. lambia and D. caninum (OR = 2.1-8.3; P = 0.02 -P = 0.04), children having household reared ruminants for C. parvum (OR = 10.4; P < 0.001), and children that play with stray animals for E. histolytica and Hookworm (OR = 1.8-6.3; P = 0.04 -P = 0.05)compared to other children with no animal contact. The present study highlights the importance of periodic screening and treatment of IPIs in children, deworming companion animals, and public education for effective prevention of IPIs in children in Egypt.

Comparative expression of cell adhesion molecule1 (CADM1) in the testes of experimental mice and some farm animals.

Cell adhesion molecule1 (CADM1) is a member of the immunoglobulin superfamily (IGSF) that has been found in mammalian testis and plays a substantial role in cell-to-cell interaction via either hemophilic (between spermatogenic cells) or heterophilic (between spermatogenic and somatic Sertoli cells) binding. The present study investigated the immunohistochemical localization of CADM1 in the testes of adult mice (Mus musculus), as well as sexually mature bull (Bos taurus), camel (Camelus dromedarius), and donkey (Equus asinus), using immunohistochemical techniques. The results revealed that CADM1 expression was observed in the spermatogonia and early spermatocytes as well as elongated spermatids in the mice testes; however, in the bull testis, its expression was restricted to the elongated spermatids. This expression was found in some of the early spermatocytes and elongated spermatids of the rutting camel testis but only found in the elongated spermatids of the non-rutting camel testis. Interestingly, CADM1 expression was detected in the spermatogonia, early spermatocytes, and elongated spermatids of the donkey testis. On the other hand, there was no expression of CADM1 observed in the Sertoli or interstitial cells. In conclusion, the expression of CADM1 during spermatogenesis differed among species and between rutting and non-rutting camel. Accordingly, this study emphasized the crucial role of CADM1 in the process of spermatogenesis and how it is related to sexual activity in both experimental and farm animals.

ß-glucan administration improves growth performance and gut health in New Zealand White and APRI rabbits with different breed responses.

This study investigated the effects of oral administration of ß-glucan 1,3 (pharmaceutical grade 10%) on growth performance and carcass traits in two breeds of weanling rabbits adapted to survive in Egypt, New Zealand White (NZW) and Animal Production Research Institute (APRI) rabbits, with special attention to relative mRNA expression of interleukins and antioxidant enzyme genes, biochemical, and histological alterations. Oral administration of ß-glucan with doses 0.25 and 0.5 ml per one-liter of drinking water significantly accelerated body weight gain (BWG) in both rabbits' breeds, reduced total feed consumption (FC), and reduced feed conversion ratio (FCR), especially the 0.5 ml per one-liter dose in both rabbit breeds. There are remarkable differences in all the growth performance traits due to breed effect. The interaction effect between ß-glucan and breed significantly improved BWG, FC, and FCR. There were non-significant differences in all carcass traits studied due to oral administration of ß-glucan with both doses, except in dressing percentages. The highest of the dressing percentages were observed at doses 0.25 ml per one-liter (51%) and 0.5 ml per one-liter (52%) compared with control (50%). Our findings show significant variations in the final BW, total daily gain, feed consumption, and total feed conversion ratio between NZW and APRI rabbits. Absence of significant differences in the hot carcass weight and dressing percentage between the genetic groups had been reported in this study. Supplementing NZW and APRI rabbits with ß-glucan increased blood total protein and globulin. The duodenal villi dimensions, splenic lymphoid diameter, muscular fiber diameter, and muscular glycogen areas were significantly increased by ß-glucan administration. Expression of intestinal interleukin-18 (IL-18) in NZW rabbits treated with 0.25 and 0.5 doses of ß-glucan was significantly upregulated and enhanced the immune response. ß-glucan upregulated the expression of intestinal occludin mRNA particularly at dose 0.5 ß-glucan as well as upregulated intestinal superoxide dismutase 1 (SOD1) and glutathione peroxidase 1 (GPx1), which modulates anti-inflammatory and antioxidant properties. In conclusion, oral administration of ß-glucan at a dose of 0.25 or 0.5 ml per one-liter drinking water provided beneficial effects in the growth performance and health status of rabbits.

Graviola (Annona muricata) attenuates behavioural alterations and testicular oxidative stress induced by streptozotocin in diabetic rats.

Oxidative stresses intensify the progression of diabetes-related behavioural changes and testicular injuries. Graviola (Annona muricata), a small tree of the Annonaceae family, has been investigated for its protective effects against diabetic complications, oxidative stress, and neuropathies. This study was planned to investigate the effects of graviola on behavioural alterations and testicular oxidative status of streptozotocin (STZ; 65 mg/kg)-induced diabetic rats. Forty adult male Wistar rats were equally allocated into four groups: control (received normal saline 8 ml/kg orally once daily), diabetic (received normal saline orally once daily), graviola (GR; received 100 mg/kg/day; orally once daily), and diabetic with graviola (Diabetic+GR; received 100 mg/kg/day; once daily). Behavioural functions were assessed using standard behavioural paradigms. Also, oxidative statuses of testis were evaluated. Results of behavioural observations showed that diabetes induced depression-like behaviours, reduction of exploratory and locomotor activities, decreased memory performance, and increased stress-linked behaviours. These variations in diabetic rats were happened due to oxidative stress. Interestingly, treatment of diabetic rats with graviola for four weeks alleviated all behavioural changes due to diabetes. Also, rats in graviola-treated groups had greater testicular testosterone and estradiol levels compared with diabetic rats due to significant rise in testicular acetyl-CoA acetyltransferase 2 expression. In the same context, graviola enhanced the antioxidant status of testicular tissues by significantly restoring the testicular glutathione and total superoxide dismutase that fell during diabetes. In addition, Graviola significantly decreased the expression of apoptotic (Bax) and inflammatory (interleukin-1ß) testicular genes. In conclusion, these data propose that both the hypoglycemic and antioxidative potential of graviola are possible mechanisms that improve behavioural alterations and protect testis in diabetic animals. Concomitantly, further clinical studies in human are required to validate the current study.

Thymoquinone Attenuates Cardiomyopathy in Streptozotocin-Treated Diabetic Rats.

Diabetic cardiomyopathy is a diabetic complication due to oxidative stress injuries. This study examined the protecting influence of thymoquinone (TQ) on diabetes-caused cardiac complications. The intracellular means by which TQ works against diabetes-caused cardiac myopathy in rats is not completely understood. In this study, Wistar male rats (n = 60) were assigned into four groups: control, diabetic (diabetes induced by IP infusion of streptozotocin, 65 mg/kg), diabetic + TQ (diabetic rats given TQ (50 mg/kg) administered once per day by stomach gavage), and TQ (50 mg/kg) for 12 weeks. TQ supplementation appreciably recovered the cardiac parameters alongside significant declines in plasma nitric oxide concentrations and total superoxide dismutase (T.SOD) activities. Importantly, TQ downgraded expression of cardiac-inducible nitric oxide synthase in addition to significantly upregulating vascular endothelial growth factor and erythropoietin genes and nuclear factor-erythroid-2-related factor 2 (Nrf2) protein. TQ normalized plasma triacylglycerol and low-density lipoprotein-cholesterol and significantly improved the high-density lipoprotein-cholesterol levels. Additionally, TQ administration improved the antioxidant ability of cardiac tissue via significantly increased cardiac T.SOD and decreased cardiac malondialdehyde levels. Oral supplementation with TQ prevented diabetic-induced cardiomyopathy via its inhibitory effect on the E-selectin level, C-reactive protein, and interleukin-6. The TQ protecting effect on the heart tissue was shown by normalization of the plasma cardiac markers troponin I and creatine kinase. This experiment shows the aptitude of TQ to protect cardiac muscles against diabetic oxidative stress, mainly through upregulation of Nrf2, which defeated oxidative damage by improvement of the antioxidant power of cardiac muscle that consequently protected the cardiac muscles and alleviated the inflammatory process.

A curious cause of appendicitis.

A previously healthy 10-year-old boy presented to the emergency department with central abdominal pain, loose stool and vomiting. He was diagnosed with gastroenteritis, but was well enough to be discharged. The next day he reattended with ongoing diarrhoea and vomiting, with the pain now localised to the right iliac fossa (RIF). Acute appendicitis was suspected, and he was taken for laparoscopic appendicectomy. At surgery, a gangrenous appendix was found, with pus extending from the pelvis up to the liver. The appendix was excised and thorough peritoneal washout performed. Postoperatively, he received 48 hours of intravenous antibiotics and was discharged home. Unfortunately the boy presented again 11 days later with right lower quadrant pain and fever. Ultrasound revealed a collection in the RIF, and he returned to theatre for washout. His recovery was slow until the peritoneal pus sent for bacterial culture grew Salmonella enteritidis, identification of which facilitated appropriate antibiotic treatment.

Strongyloides stercoralis hyperinfection presenting as subacute small bowel obstruction following immunosuppressive chemotherapy for multiple myeloma.

We report the case of a 59-year-old Afro-Caribbean woman who presented with symptoms of anorexia, lethargy, abdominal distension and vomiting on the background of newly diagnosed multiple myeloma, treated with one cycle of cyclophosphamide-thalidomide-dexamethasone chemotherapy 20 days previously. A diagnosis of subacute bowel obstruction was made; however, the aetiology of the obstruction remained elusive. Common electrolyte abnormalities were excluded and a midline laparotomy revealed minimal intra-abdominal adhesions. Histological examination of a small bowel mesentery biopsy showed inflammatory cell infiltrate composed of lymphocytes, eosinophils and occasional plasma cells with a foreign body giant cell reaction suggestive of worm infection. A postoperative stool sample revealed heavy infestation with the rhabditiform larvae of Strongyloides stercoralis. The patient recovered following ivermectin treatment. In the absence of other causality, we attribute the subacute bowel obstruction to S stercoralis hyperinfection, triggered by immunosuppression secondary to chemotherapy and multiple myeloma.