Psychometric properties of the Arabic version of the Mini-Balance Evaluation Systems Test in patients with neurological balance disorders.

OBJECTIVE: This study aimed to translate and cross-culturally adapt the Mini-Balance Evaluation Systems Test (Mini-BESTest) to Arabic (Mini-BESTest-Ar) and evaluate its psychometric properties in patients with neurological balance disorders. PATIENTS AND METHODS: The translation and adaptation followed the established guidelines. Validity, internal consistency, test-retest reliability, standard error of measurement (SEM), minimal detectable change (MDC95), and limits of agreement (LOA) were examined in 56 patients. The sensitivity was investigated using the receiver operating characteristic curve. RESULTS: The Mini-BESTest-Ar significantly correlated with the Berg balance scale (BBS) (r = 0.80; p < 0.001) and dynamic gait index (DGI) (rho = 0.75; p < 0.001). All domains showed moderate to very good correlations with BBS (r = 0.62-0.81; p < 0.001) and fair to very good correlations with DGI (rho = 0.4 -0.79; p < 0.05). The internal consistency and test-retest reliability of the total score and all domains were excellent (Cronbach's α = 0.96-0.81, ICC = 0.95-0.81, and r = 0.92-0.68). The SEM, MDC95, and MDC% for total score and domains were 1.19-0.31, 3.29-0.86 points, and 16.5%-66.8% respectively. The LOA revealed no systematic error. A cut-off point of 21.5/28 (Area under the curve = 0.85, sensitivity = 75%, specificity = 75%) was specified. CONCLUSIONS: The Mini-BESTest-Ar has appropriate psychometric properties supporting its usefulness for research and clinical purposes.

Alternative therapy to manage otitis media caused by multidrug-resistant fungi.

During the last few decades, the increase in the incidence of multidrug-resistant (MDR) fungal infections has become an emerging threat to public health. Therefore, it is important to illuminate the usage of alternative therapy to treat MDR fungal infection. This study was carried out to elucidate the usage of plant extract and essential oil, either alone or with other antifungal drugs to treat otitis media caused by MDR fungi. Medicinal plant is a safe and cheap source when compared with chemical antifungal drugs. Twenty-one fungal isolates out of 104 ear swabs from patients suffering from otitis media were characterized using both phenotypic and genotypic methods. The antibiogram typing was used to determine the MDR isolates. The sensitivity of MDR fungal isolates was tested against several plant extracts and essential oils, either alone or with other antifungal drugs. Thyme oil and clove extracts proved to have synergistic effects suggesting their use in the treatment of fungal infections, especially otitis media caused by MDR fungi. The ultrastructure of MDR fungal isolates exhibited a complete destruction post exposure to the used materials when observed under the transmission microscope (TEM). Thyme oil and clove extract were found to be the most effective agents against MDR fungal isolates and they constitute a promising tool for the management of fungal infection causing the otitis media.

Risk and predictors of suicide in colorectal cancer patients: a Surveillance, Epidemiology, and End Results analysis.

BACKGROUND: The risk of suicide is higher for patients with colorectal cancer (crc) than for the general population. Given known differences in morbidity and sites of recurrence, we sought to compare the predictors of suicide for patients with colon cancer and with rectal cancer. METHODS: Using the U.S. Surveillance, Epidemiology, and End Results database, adult patients with confirmed adenocarcinoma of the colon or rectum during 1973-2009 were identified. Parametric and nonparametric tests were used to assess selected variables, and Cox proportional hazards regression models were used to determine predictors of suicide. RESULTS: The database identified 187,996 patients with rectal cancer and 443,368 with colon cancer. Compared with the rectal cancer group, the colon cancer group was older (median age: 70 years vs. 67 years; p < 0.001) and included more women (51% vs. 43%, p < 0.001). Suicide rates were similar in the colon and rectal cancer groups [611 (0.14%) vs. 337 (0.18%), p < 0.001]. On univariate analysis, rectal cancer was a predictor of suicide [hazard ratio (hr): 1.26; 95% confidence interval (ci): 1.10 to 1.43]. However, after adjusting for clinical and pathology factors, rectal cancer was not a predictor of suicide (hr: 1.05; 95% ci: 0.83 to 1.33). In the colon cancer cohort, independent predictors of suicide included older age, male sex, white race, and lack of primary resection. The aforementioned predictors, plus metastatic disease, similarly predicted suicide in the rectal cancer cohort. CONCLUSIONS: The suicide risk in crc patients is low (<0.2%), and no difference was found based on location of the primary tumour. Sex, age, race, distant spread of disease, and intact primary tumour were the main predictors of suicide among crc patients. Further studies and interventions are needed to target these high-risk groups.

Tenofovir disoproxil fumarate significantly decreases serum lipoprotein levels compared with entecavir nucleos(t)ide analogue therapy in chronic hepatitis B carriers.

BACKGROUND: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are first-line treatments for chronic hepatitis B (CHB). Studies suggest lipid lowering effect of TDF in human immunodeficiency virus positive (HIV+) individuals, but the effect on lipids and cardiovascular disease (CVD) risk in CHB is unknown. AIM: To compare TDF vs ETV effects on lipid levels in CHB. METHODS: In this retrospective cohort study, data on serum lipids and CVD risk factors at baseline and ~1 year on TDF or ETV were collected from CHB carriers. We used propensity score matched models to assess the effect on total cholesterol (TC), LDL-C, HDL and triglycerides (TGL). RESULTS: In 348 patients, median age was 57 (IQR: 47-65 years), 63% were male, 77% were Asian, 19% were cirrhotic, 25% were HBeAg positive at baseline, and 72% received TDF vs 28% ETV. ETV-treated patients were older (median age: 60 vs 55, P<.01), had similar smoking and hypertension rates, but diabetes and dyslipidemia were more prevalent (19% vs 9%, P=.01; 14% vs 6%, P=.05, respectively). In propensity score matched models for age, gender, usage of lipid lowering agents, dyslipidemia and diabetes, TDF-treated patients were more likely to show a 20% decrease in TC (95% CI: 3%-25%), LDL-C (95% CI: 1%-25%) and HDL-C (CI: 10%-30%) levels compared with those on ETV. No change in TGL was observed in either group. CONCLUSIONS: A greater decline in TC, LDL-C and HDL was observed in CHB carriers receiving TDF compared with ETV. These data may influence anti-viral choice in CHB carriers at risk for CVD.

Ozone ameliorates age-related oxidative stress changes in rat liver and kidney: effects of pre- and post-ageing administration.

The ageing process is known to be accompanied by increased oxidative stress and compromised antioxidant defenses. Controlled ozone administration has been shown to be effective in various pathophysiological conditions with an underlying oxidative burden. However, its effect on the biochemical alterations associated with the ageing process has been rarely studied. Therefore, the present work was carried out to study the role of ozone in counteracting the state of oxidative stress associated with ageing in rat liver and kidneys using two experimental models. In the pre-ageing model, ozone was administered prior to the onset of ageing at adulthood and continued after the start of the ageing process (3-month-old rats until the age of 15 months). While in the post-ageing model, ozone was administered after ageing has begun and lasted for one month (14-month-old rats until the age of 15 months). The pre-ageing ozone administration effectively reduced lipid and protein oxidation markers, namely, malondialdehyde and protein carbonyl levels and decreased lipofuscin pigment deposition in rat liver and kidneys. Moreover, it significantly restored hepatic and renal reduced glutathione (GSH) contents and normalized cytosolic hepatic glutathione peroxidase activity. Similar but less pronounced effects were observed in the post-ageing ozone-treated group. Nevertheless, in the latter model ozone administration failed to significantly affect liver and kidney lipofuscin levels, as well as kidney GSH contents. These data provide evidences for potentially positive effects of pre-ageing ozone therapy in neutralizing chronic oxidative stress associated with ageing in rat liver and kidneys.

Autoantibodies to GW bodies and other autoantigens in primary biliary cirrhosis.

Autoantibodies to intracellular targets in mitochondria and nuclei are serological hallmarks of primary biliary cirrhosis (PBC). One of the most recently identified cellular targets of PBC autoantibodies is a novel cytoplasmic structure referred to as GW bodies [GWB, G (glycine) W (tryptophan)-containing bodies (GWB)]. GWB are indentified as discrete cytoplasmic domains that are involved in mRNA processing via the RNA interference (RNAi) pathway. Key components of GWB include the proteins GW182, Ago2, RNA-associated protein 55 (RAP55) and Ge-1/Hedls. The primary objective was to study the frequency and clinical association of antibodies directed to GWB components, in 109 PBC patients. Autoantibodies to mitochondrial antigen-pyruvate dehydrogenase complex (M2), branched-chain 2-oxo-acid dehydrogenase complex and 2-oxo glutarate dehydrogenase complex (3E-BPO), gp210, sp100, promyelocytic leukaemia cell antigen (PML) and liver kidney microsomal-1 antigen (LKM-1) were detected by a line immunoassay and antibodies to GWB (GW182, RAP55, Ge-1, GW2, GW3) and glutamate receptor interacting protein (GRIP)-associated protein-1 (GRASP-1), by an addressable laser bead immunoassay (ALBIA). The most common GWB autoantigen targets were: RAP55-28%, GW182-12%, GW2-2% and antibodies to GRASP-1-17%. By comparison, the frequency of reactivity to established PBC autoantigens was: gp210, 27%; sp100, 27% and PML, 17%. None of the autoantibodies were associated with differences in Mayo risk score or liver decompensation. This study is the first study to show that antibodies to RAP55, GW182 and GRASP-1 are the most common GWB targets in PBC.

Unintended pregnancy in Egypt: evidence from the national study on women giving birth in 1999.

The current study aimed to estimate the prevalence and correlates of unintended pregnancy among ever-married women. The study sample was 2349 ever-married women aged 15-49 years who gave birth in 1999. Unintended pregnancy was defined as unwanted and mistimed pregnancies. Of these, 431 (18.5%) women reported unintended pregnancy: 137 were mistimed (5.9%) and 294 were unwanted (12.6%). Women of older age, living in frontier governorates, with poor knowledge of the ovulatory cycle, having a more than ideal family size, using contraceptive methods and having 4 or more children were at increased odds of reporting unintended pregnancies. Fewer antenatal care visits and low child weight at birth were significantly associated with unintended pregnancy.

Unintended pregnancy in Egypt: evidence from the national study on women giving birth in 1999

The current study aimed to estimate the prevalence and correlates of unintended pregnancy among ever-married women. The study sample was 2349 ever-married women aged 15-49 years who gave birth in 1999. Unintended pregnancy was defined as unwanted and mistimed pregnancies. Of these, 431 [18.5%] women reported unintended pregnancy: 137 were mistimed [5.9%] and 294 were unwanted [12.6%]. Women of older age, living in frontier governorates, with poor knowledge of the ovulatory cycle, having a more than ideal family size, using contraceptive methods and having 4 or more children were at increased odds of reporting unintended pregnancies. Fewer antenatal care visits and low child weight at birth were significantly associated with unintended pregnancy

Cytodiagnosis of nipple discharge: a study of 602 samples from 484 cases.

To find out the gross and microscopic differentiating features between nipple discharges (ND) due to various breast lesions, smears of 602 ND samples from 484 cases were reviewed by one of the investigators (D.K.D.). The reviewed cytodiagnoses were as follows: benign nipple discharge (59.1%), inflammatory ND (6.5%), ?papillary lesions (2.5%), papillary lesions (20.6%), papillary lesions with atypia (3.8%), duct cells with atypia (0.2%), suspicious for malignancy (0.5%), malignant ND (1.2%), and inadequate (5.6%). Following review, samples with epithelial abnormalities (?papillary lesion, papillary lesion with and without atypia, duct cells with atypia, suspicious for malignancy, and malignancy) increased from 16.6% to 30.4% of adequate samples (P < 0.0001). 37.9% unilateral ND samples showed epithelial abnormalities, as opposed to 18.9% of bilateral ND samples (P < 0.0001). Bloodstained ND showed epithelial abnormalities in 41.5% samples, as compared to 22.1% of ND with other specified gross characteristics (P < 0.0001). The samples with epithelial abnormalities differed significantly from benign and inflammatory ND in respect of frequency of benign duct cells, duct cells with atypia, papillary clusters with or without atypia, malignant cells, columnar cells, red blood cells, inflammatory cells, and background lipid vacuoles (P < 0.01 to < 0.0001). The ND samples with suspicious and malignant cytology, besides the presence of malignant cells (P < 0.0001), differed significantly from rest of the lesions in respect of foam cells (P < 0.0001), red blood cells (P < 0.01), and inflammatory cells (P < 0.05). When compared with histopathological diagnosis in 20 cases, the benign or malignant nature of the lesion was correctly identified in ND in 80% cases. The ND cytologies in 7 histologically proved malignant cases were malignancy (3 cases), suspicious for malignancy (1 case), papillary lesion with atypia (1 case), papillary lesion (1 case), and benign ND (1 case).

Influence of verapamil on the efficacy of vitamin E in preventing the ischemia-reperfusion-induced biochemical dearrangement in cerebral cortex of rat.

The possibility that verapamil (CAS 52-53-9) may intensify the efficacy of vitamin E in preventing the ischemia-reperfusion-caused biochemical dearrangement in rat cerebral cortex was investigated. A daily injection of vitamin E at i.m. dose of 175 mg/kg b.wt. for 7 days prior to subjecting the rats to 1 h bilateral occlusion of the common carotid arteries followed by reperfusion for another 1 h, moderately diminished the ischemia-reperfusion-induced increase in the activity of lactate dehydrogenase and in formation of conjugated dienes as well as in the conversion of xanthine dehydrogenase-->xanthine oxidase in cerebral cortex of rats. However, concomitant injection of verapamil at i.m. dose of 0.68 mg/kg b.wt. 15 min prior to ischemia-reperfusion together with vitamin E pretreatment afforded an elegant combined therapy that effectively abolished the dearrangement caused by ischemia-reperfusion in the above parameters. These results indicated that the protective efficacy of vitamin E against ischemia/reperfusion-induced biochemical dearrangement in cerebral cortex was intensified by concomitant use of verapamil.

Effect of various stressors on the level of lipid peroxide, antioxidants and Na+, K(+)-ATPase activity in rat brain.

The level of malondialdehyde (MDA), an index of lipid peroxidation, and the antioxidants superoxide dismutase (SOD) and glutathione (GSH), as well as the activity of Na+, K(+)-ATPase, were assessed in whole rat brain after immobilization, anemic hypoxia (NaNO2) and 72 h starvation. The effect of these stressors on plasma glucose and corticosterone levels was also observed. Hypoxia and starvation stimulated the lipid peroxide formation in brain as indicated by an increase in the level of MDA, being higher after starvation than hypoxia. Brain SOD activity was also increased in response to hypoxia and starvation while GSH content was only diminished in hypoxia. However, neither MDA nor antioxidants were affected by immobilization. On the other hand, the activity of brain Na+, K(+)-ATPase was significantly increased by immobilization and hypoxia but decreased in starvation. A similar pattern of change was also observed in plasma glucose and corticosterone levels in response to these stressors. These results elucidate differences in the biochemical response of animals towards various types of stress, with increased lipid peroxide formation in hypoxia and starvation.

Effect of calcium channel antagonists in modifying the inhibitory influence of adenosine on insulin secretion.

The present work was performed to study the effect of two calcium channel antagonists, namely verapamil (CAS 52-53-9) and nifedipine (CAS 21829-25-4) in modifying the inhibitory influence of adenosine on insulin secretion from isolated rat pancreatic islets. The combined effect of adenosine and these agents on serum insulin and glucose levels in vivo was also investigated. Both verapamil and nifedipine at 100 mumol/l and 1 mumol/l, respectively, produced a significant inhibition of glucose-stimulated insulin secretion from pancreatic islets. Combination of these agents with adenosine 10 mumol/l did not modify the inhibitory effect of adenosine on insulin secretion. Verapamil (21.6 mg/kg b.wt.) and nifedipine (5.4 mg/kg b.wt.) intraperitoneally injected prior to glucose loading produced a significant increase in serum glucose with an accompanied decrease in serum insulin levels. Concurrent administration of verapamil with adenosine neither affected the hyperglycaemic nor the hypoinsulinaemic effects of adenosine, whereas combined administration of nifedipine and adenosine decreased the hyperglycaemic effect of adenosine but not its hypoinsulinaemic effect. These results may indicate that these calcium channel antagonists do not interact with adenosine receptors which mediate its inhibitory effect on insulin secretion.

Effect of dietary zinc on lipid peroxidation, glutathione, protein thiols levels and superoxide dismutase activity in rat tissues.

Dietary zinc deficiency can cause increased lipid peroxidation while zinc supplementation inhibited this process. The aim of this study was to investigate the effect of dietary zinc on malondialdehyde (MDA) product as an index of endogenous lipid peroxidation, glutathione (GSH) and protein thiols (PrSHs) as well as superoxide dismutase (SOD) activity in rat blood, liver and pancreas. Young male rats were fed a zinc deficient (ZD) basal diet containing congruent to 0.5 ppm zinc or were fed ad libitum (AL) a zinc adequate diet (30 ppm zinc) for 3 weeks. The ZD rats were then fed the basal diet supplemented with either 100 ppm zinc or 1000 ppm zinc for another 3 weeks. The zinc concentration of the investigated tissues reflected the dietary zinc content. Plasma, liver and pancreas MDA measurements from ZD rats revealed significant increases (P < 0.05, < 0.001) as compared to AL control values, the highest increase was in pancreas. ZD rats also displayed significant decreases in their blood and liver GSH content (P < 0.001, < 0.05) and SOD activity (P < 0.001) as well as serum PrSHs (P < 0.001) as compared to AL control values. However, these measurements in pancreas were insignificantly changed except GSH content was significantly increased (P < 0.05). Feeding ZD rats a diet containing 100 ppm or 1000 ppm zinc resulted in a significant reduction of the endogenous MDA formation (P < 0.05, < 0.001) in their tissues with the reversal of changes in the other parameters, so that their levels were nearly restored to AL control values especially in response to 1000 ppm zinc.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of vitamin A in modulating the radiation-induced changes in intestinal disaccharidases of rats exposed to multifractionated gamma-radiations.

PURPOSE: The aim of this investigation was to determine whether pre- or post-administration of vitamin A will be effective in reducing the radiation-induced alterations in intestinal disaccharidases in rats. MATERIAL AND METHODS: Rats were subjected to fractionated whole-body irradiation (20 x 0.5 Gy). Intestinal lactase activity as well as maltase and sucrase activities were assessed. Vitamin A was administered at daily intraperitoneal dose of 15,000 IU/kg body weight for 7 days prior to radiotherapy and thereafter twice weekly throughout therapy up to 7 days post irradiation. RESULTS: In irradiated rats a marked decrease in intestinal lactase activity to about one-fourth of those in non-irradiated rats was observed. In addition, a significant reduction in maltase and sucrase activities to one half of the control group was observed. The application of vitamin A significantly improved the radiation-induced inhibition of intestinal enzymes. Pretreatment application of vitamin A is more efficient to protect against radiation injury than a posttreatment application. CONCLUSIONS: The usage of vitamin A for modulation of radiation-induced changes in intestinal enzymes provides sufficient protection against treatment side effects induced by large volume radiotherapy.

Combined effect of adenosine, alpha adrenergic and adenosine antagonists on serum insulin and insulin secretion from rat pancreatic islets.

1. The effect of adenosine separately or in combination with alpha-1 adrenergic antagonist prazosin and alpha-2 adrenergic antagonist yohimbine as well as adenosine antagonists 8-phenyltheophylline and xanthine amine conjugate on glucose-induced insulin secretion from isolated rat pancreatic islets was studied. 2. Their in vivo effects on serum glucose and insulin levels were also investigated. Adenosine at 10 and 100 microM inhibited significantly, insulin secretion from the isolated islets whereas at 10 mM slightly increased the secretion of insulin. 3. Prazosin used at 100 microM inhibited insulin secretion. When it combined with adenosine (10 microM) it augmented the inhibitory effect of adenosine. 4. In vivo prazosin (21 mg/kg body wt) caused a hyperglycaemia which was accompanied by hypoinsulinaemia. 5. Concurrent administration of this drug with adenosine neither affect the hyperglycaemic nor the hypoinsulinaemic effects of adenosine. 6. On the other hand, yohimbine (100 microM) has no effect neither separately nor in combination with adenosine (10 microM) in modulating the inhibitory effect of adenosine on insulin secretion. 7. When Yohimbine administered at 19.5 mg/kg body wt it did not alter serum glucose but it markedly increased the serum insulin level. Its combined administration with adenosine reduced the hyperglycaemic effect of adenosine with a remarkable increase in serum insulin. 8. Both adenosine-antagonists were ineffective in alteration of insulin secretion. 9. However, combination of 8-phenyltheophylline with adenosine (10 microM) totally blocked the inhibitory effect of adenosine on insulin secretion while xanthine amine conjugate failed to prevent this effect of adenosine.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of praziquantel treatment on lipid peroxide levels and superoxide dismutase activity in tissues of healthy and Schistosoma mansoni infected mice.

The elevated levels of lipid peroxide product as malondialdehyde (MDA) in plasma, liver, spleen, intestine and kidney of Schistosome-infected mice were differently ameliorated by treatment with praziquantel (EMBAY 8440, CAS 55268-74-1) (2 x 500 mg/kg body wt.) being nearly normalized in plasma and intestine, moderately improved in liver and slightly affected in spleen and kidney. However, the drug failed to affect the MDA levels in the different organs of healthy mice. Moreover, the increased hepatic superoxide dismutase (SOD) activity in infected mice was normalized while the decreased activities in the other tissues were further decreased than normal values in response to praziquantel treatment. Interestingly, in healthy mice, the drug similarly inhibited SOD activities in blood, spleen and kidney. The specificity of this action remains to be clarified. Possible explanations of these findings are given.

Effect of pretreatment with vitamin E or diazepam on brain metabolism of stressed rats.

The effect of vitamin E (VE) or diazepam (DZ) pretreatment on some carbohydrate metabolic aspects in the brains of stressed rats was studied. DZ and VE were given i.p. at doses of 5 mg/kg body wt for 6 days prior to subjecting the animals to single swimming stress (SSS). Pretreatment of the rats with DZ or VE diminished the stress-induced increases in plasma corticosterone and glucose levels and reversed the decrease due to stress on brain ATP, glucose, glycogen and pyruvate contents. The increase in brain ADP and lactate was brought back to levels which approached the pre-stressed values. Moreover, DZ and VE pretreatments helped in attenuating the stress-induced alteration in brain mitochondrial and cytosolic hexokinase as well as sodium, potassium adenosine triphosphatase (Na+,K(+)-ATPase) activities. The change in these metabolic parameters produced by VE pre-treatment was less than that exhibited by DZ. The effects of VE were explained in light of its antioxidant property in preventing the free radical production and lipid peroxide formation which are important factors in the pathogenesis of stress.