Phenotypic Changes of Trichinella Spiralis Treated By Commiphora Molmol,Lepidium Sativum, and Albendazole: in Vitro Study.

Trichinellosis is a nematode-causing disease distinguished by its continuous transmission in the carnivores and omnivores. Despite effective eradication of the enteral forms, conventional drugs fail to eliminate the migrating and muscle ones. Over the past years, researchers intensified the work on herbal medicines as alternatives or aids to albendazole, the reference drug. This research hypothesizes that the therapeutic agent absorption route could be an evidence-based carrier molecule or auxiliary drug to albendazole. Accordingly, this in vitro study was designed to investigate mainly the phenotypic changes induced by a mono-treatment of albendazole, Lipidium sativum (garden cress), and Commiphora molmol (myrrh). Incredibly, no data were reported on the morphological alterations of T. spiralis larvae treated by any of these drugs. The experimental design tested various concentrations (25, 50, 100, and 200 µg/ml) of each herbal medicine for the lethal effects on the parasite forms for a day (1, 12, and 24h). The data showed that the highest significant mortality rate of the parasite forms was in favor of the concentration 200 µg/ml of both plant extracts in a time-dependent manner. Therefore, albendazole at 200 µg/ml dose was tested in parallel, and all experimental groups were compared to non-treated muscle larvae and worms. Albendazole-treated worms accounted for the least significant (p<0.001) survival rate (2 %), followed by myrrh (5 %), and the adverse was valid for the survival rate of the muscle larvae at that time. None of the larvae/worms was alive after 24 hours of incubation with the 200µg/ml of either treatment. The scanning electron microscope investigation of the experimental groups provided a shred of evidence for different routes of taking up the candidate drugs by the parasite. In conclusion, the results of the previous work in vivo and current in vitro study recommend myrrh over garden cress as a complementary agent of albendazole.

Ovarian hydrobursitis in female camels (Camelus dromedarius): the role of Chlamydophila abortus and a trial for medical treatment.

The occurrence of Chlamydophila abortus in female camels affected with ovarian hydrobursitis and a trial for medical treatment were studied. A total of 111 cases were included in two experiments. In Experiment 1, sera from 51 affected cases were tested for C. abortus antibody using enzyme-linked immunosorbent assay (ELISA). In Experiment 2, 60 female camels affected with bilateral ovarian hydrobursitis were divided into treated and control groups (n = 30 each). Based on the bursal diameter, females of both groups were subdivided into those having small (< 5 cm), medium (5-7 cm) or large (> 7 cm) bursae. Treated group received 20 mg/kg body weight oxytetracycline intramuscular, 4% lotagen intrauterine, and 500 µg cloprostenol intramuscular. Controls did not receive any treatment. All females were observed for 90 days non-return rate (NRR) and calving rate (CR). Antibodies against C. abortus were observed in 44/51 (86.3%) of the affected females. The 90 days NRR of the treated and control groups were 13/30 (43.3%) and 0/30 (0.0%), respectively, (P = 0.001), while the CR were 10/30 (33.3%) and 0/30 (0.0%), respectively, (P = 0.01). Based on bursal size, the 90 days NRR were 11/15 (73.3%), 2/7 (28.6%) and 0/8 (0.0%) for treated females having small, medium and large bursa, while the CR were 9/15 (60%), 1/7 (14.3%), and 0/8 (0.0%), respectively, (P = 0.01). In conclusion, it seems that C. abortus may be responsible for the spreading of the ovarian hydrobursitis syndrome in dromedaries. Small sized bursa could be medically treated.

Ovarian hydrobursitis in female camels (Camelus dromedaries): biochemical, bacterial and protozoal evaluation.

The aim of this study was to evaluate female camels affected with ovarian hydrobursitis (n = 31) for hematological and biochemical findings and for bacterial and protozoal infections. Blood samples were obtained and surgical ablation of the affected bursa was performed. Bursal fluid, follicular fluid, and serum were subjected to hormonal and biochemical analyses. Bursal fluids were cultured and colonies were identified using BioMérieux Vitek two compact system. Passive haemagglutination test was used for detection of Trypanosoma evansi. Indirect ELISA technique was carried out for detection of anti-Hydatid cysts anti-bodies. Neutrophilia was found in the affected animals (P = 0.01) with tendencies for monocytosis (P = 0.06) and eosinophelia (P = 0.05). Bursal fluid had a tendency for high estradiol-17ß concentration compared to blood serum (P = 0.07). Progesterone and cholesterol concentrations were similar in bursal fluid, follicular fluid and serum. Total protein, phosphorus, and magnesium concentrations were greater (P < 0.05) in the bursal fluid than in serum. Oligella urethralis, Alloiococcus otitis, Granulicatella adicens, Escherichia coli, Sphingobacterium thalpophilum, Streptococcus sanguinis, Aeromonas salmonicida, Pseudomonas stutzeri, Staphylococcus warneri, Staphylococcus hominis, and Rhizobium radiobacter were isolated from 46.7% of bursal fluids. T. evansi was positive in 9.7% of cases. None were positive for hydatid cyst. Accordingly, we suggest that the ovarian hydrobursitis syndrome is initially an inflammatory process and the accumulated bursal fluid is partially originated from follicular fluid.

Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt.

Few studies have evaluated the epidemiology and risk factors of hepatitis C virus (HCV) infection in children in Egypt. This study of 465 children attending Assiut University Hospital measured the rates of anti-HCV positivity by 3rd-generation ELISA test and of HCV-RNA positivity by PCR, with analysis of some relevant risk factors. The rate of HCV-RNA positivity among ELISA-positive cases (n = 121) was 72.2% overall: 100% in the subgroup with hepatitis, 70.8% in those with a history of multiple transfusions and 58.3% in those without hepatitis or multiple transfusions. History of blood transfusions, frequent injections, hospitalization or surgical procedures were significant risk factors for anti-HCV positivity by ELISA.

Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt

Few studies have evaluated the epidemiology and risk factors of hepatitis C virus [HCV] infection in children in Egypt. This study of 465 children attending Assiut University Hospital measured the rates of anti-HCV positivity by 3rd-generation ELISA test and of HCV-RNA positivity by PCR, with analysis of some relevant risk factors. The rate of HCV-RNA positivity among ELISA-positive cases [n = 121] was 72.2% overall: 100% in the subgroup with hepatitis, 70.8% in those with a history of multiple transfusions and 58.3% in those without hepatitis or multiple transfusions. History of blood transfusions, frequent injections, hospitalization or surgical procedures were significant risk factors for anti-HCV positivity by ELISA

Quasi-empirical Bayes methodology for improving meta-analysis.

This article addresses the problem of heterogeneity among various studies to be combined in a meta-analysis. We adopt quasi-empirical Bayes methodology to predict the odds ratios for each study. As a result, the predicted odds ratios are pulled toward the estimated common odds ratio of the various studies under consideration. With strong heterogeneity among the studies, we jointly consider the display of the 95% CIs of the ORs and a Dixon's test (1950) for "outliers" to exclude the "extreme" estimated ORs. We demonstrate the effectiveness of our methodology based on the data analyzed by Thompson and Pocock (1987) demonstrating the power of the new approach to meta-analysis to find statistical agreement in what looks like great disagreement via a chi-squared test. We believe our technique (i.e., minimum mean-square sense) will go a long way toward increasing the trustworthiness of meta-analysis.

Association analysis of tissue inhibitor of metalloproteinase2 gene polymorphisms with COPD in Egyptians.

Proteinase/antiproteinase imbalance is recognized to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). A relative increase in the activities of matrix metalloproteinases might be caused by mutations of tissue inhibitor of metalloproteinase2 (TIMP2). Recently, two polymorphisms of the TIMP2 gene, +853 G/A and -418 G/C (+551 and -720 from the translation initiation site), have been shown to be associated with the development of COPD in the Japanese population. In this study, a case-control association analysis for these polymorphisms was conducted in the Egyptian population using 106 COPD patients and 72 healthy controls. The genotype frequency of +853 G/A was significantly different between the patient and the control groups (P = 0.029), although no significant difference was detected in the allele frequency between the two groups. These results suggest that the +853 G/A polymorphism of the TIMP2 gene might be associated with COPD across ethnicities. In contrast, neither the distributions of genotype nor allele frequencies of -418 G/C were significantly different between the two groups, raising the possibility that a combination of different genetic factors contributes to the development of COPD in different ethnic groups.

Phototherapeutic keratectomy for recurrent erosion syndrome in anterior basement membrane dystrophy.

PURPOSE: To determine the outcome of patients who received phototherapeutic keratectomy (PTK) for recurrent erosion syndrome due to anterior basement membrane dystrophy (ABMD). DESIGN: A retrospective, noncomparative case series. PARTICIPANTS: Forty-eight eyes of 43 consecutive patients who underwent PTK for recurrent erosions occurring in ABMD at the Hunkeler Eye Center from 1991 to April 1995. All patients had previously failed at least one method of medical or surgical treatment for recurrent erosions and had slit-lamp findings of ABMD on initial evaluation. INTERVENTION: The eyes each underwent manual superficial keratectomy and PTK with the Summit Omnimed excimer laser. MAIN OUTCOME MEASURES: Data were analyzed by a retrospective chart review for 1, 3, 6, and 12 months for the 36 eyes with at least 12 months of follow-up data available. They were analyzed for preoperative and postoperative visual acuity, change in spherical equivalent, recurrence rate, and patient satisfaction. RESULTS: The preoperative mean visual acuity was not statistically significantly different at 1 month after PTK. Statistically significant improvement in mean visual acuity was present at 3, 6, and 12 months. Recurrence of symptoms of recurrent erosion was present in 5 (13.8%) of 36 eyes during the 12-month follow-up period, which was managed with repeat PTK over the area of the cornea initially treated with PTK; 1 of 5 required a third PTK treatment. All recurrences presented within 6 months of PTK or repeat PTK. The mean dioptric change in spherical equivalent was not statistically significant. Patient satisfaction levels after PTK for recurrent erosions in ABMD were assessed in 21 (58%) of 36 patients on a scale of 0 to 5 (5 = most satisfied); the mean response was 4.14 of 5. CONCLUSIONS: Phototherapeutic keratectomy is an effective treatment for recurrent erosions occurring in the setting of ABMD, is well tolerated, and may improve visual acuity. The rate of recurrence of erosions in ABMD treated with PTK is low during a 12-month follow-up period.

Very long survival in pediatric cancer between 1944 and 1993.

OBJECTIVE: To identify factors associated with very long survival among all cancer cases diagnosed at age 19 years or younger registered by the Cancer Data Service at the University of Kansas Medical Center in Kansas City, Kansas, U.S.A. in the 40-year period between 1944 and 1983, with follow-up to 1993. METHODS: There were 2720 pediatric patients with 2750 cancers who were studied. Forty-four types of cancer were grouped into 11 diagnostic categories. Diagnosis years spanned four eras: 1944-1953, 1954-1963, 1964-1973, and 1974-1983. Cases were compared using specific characteristics and were divided into short-term and long-term survivors with the division generously set at seven years. The proportions of the long-term survivors were compared by specific characteristics. RESULTS: Among the diagnostic categories, leukemias were the most common (29.8%), followed by CNS tumors (15.2%), and Hodgkin's disease (9.0%). Male to female ratio was 4:3; average age at diagnosis was 8.83 +/- 6.08 years. Long-term survivors totaled 1148 (41.7%). Prognosis was better in cases diagnosed in earlier stages and in later eras. Proportion of long-term survivors increased from 18.7% in era I to 52.6% in era IV. Improvement of survival was statistically significant in most diagnostic categories. CONCLUSIONS: This study shows continuing improvement of survival during four consecutive eras for childhood and adolescent cancer. Early diagnosis was associated with better survival. Unstaged cases decreased over time reflecting progress in diagnostic techniques. Many patients died before seven years after diagnosis. Those who survived more than seven years had excellent survival. Pediatricians can expect to participate in the care of these patients long after the original dianosis and treatment.

A simulation of hand impairments: effects on upper extremity function and implications toward medical impairment rating and disability determination.

OBJECTIVES: To determine whether simulation of significant impairment of the hand will have a predictable impact on degree of functional loss at the wrist and hand. DESIGN: Single subject repeat measures using before-after trial comparisons and healthy volunteer subjects. SETTING: Occupational therapy section of a large academic medical center. OTHER PARTICIPANTS: Twenty adult volunteer student subjects from an occupational therapy education (OTE) department were included. All were between ages 18 and 43 years, right hand dominant, and in excellent general health. There were 19 women and 1 man, reflecting gender distribution of the OTE student body. INTERVENTION: A simulated fusion of the carpometacarpal (CMC) joint of the thumb was achieved by immobilization in an individually fabricated splint designed to maximally restrict motion at the first CMC joint. Impairment ratings (baseline vs splinted) according to the AMA Guides were obtained by Greenleaf testing, and upper extremity function was quantitatively assessed before and after splinting. MAIN OUTCOME MEASURES: Measures of upper extremity function included grip and pinch strength, wrist torque, and speed of performance on the Valpar Small Tools test, Jebsen Hand Function test, and an exploratory measure, the Functional Life Activity Test (FLAT). RESULTS: Significant impairments were achieved for all subjects after splinting and according to Greenleaf testing. Splinting resulted in significant reductions in grip and pinch strength, wrist torque, and significant slowing of performance on the Valpar, Jebsen, and FLAT tests. Regressions of degree of impairment on degree of functional loss after splinting, and according to each of the above measures, were not significant. CONCLUSIONS: Impairment of the hand was simulated to a mild-to-moderate degree as measured according to the AMA Guides. This imposed significant reductions in motion at key joints of the wrist and hand as well as significant reductions in grip and pinch strength and wrist torque. A corresponding and significant slowing of performance on a variety of measures of upper extremity function of an industrial and nonindustrial nature was also seen. However, and for the first time, correlation and regression reveals that it is not possible to predict degree of functional loss attributable to degree of impairment for the hand. It thus appears that, for mild-to-moderate clinical impairments, the associated impairment rating is a poor estimator of functional loss at the hand and should be used cautiously, if at all, as a criterion for disability determination.

Detection of Crimean-Congo haemorrhagic fever virus antibodies in humans and imported livestock in Saudi Arabia.

A survey of Crimean-Congo haemorrhagic fever virus antibody, using the reversed passive haemagglutination inhibition test, was carried out in Saudi Arabia on sera from imported livestock at Jeddah seaport, as well as humans who had contact with imported animals on farms and in quarantine stations. Antibodies were detected in 3/354 (0.8%) humans, 88/2162 (4.1%) sheep, 14/432 (3.2%) goats and 1/182 (0.6%) cattle. Camel and horse sera were negative. The Sudanese small ruminants had the highest seropositivity rate, strongly suggesting that the virus was introduced from Sudan into Saudi Arabia. Contact with imported animals was not an apparent risk factor for virus transmission to humans.

Slit-lamp needle revision of failed filtering blebs using mitomycin C.

PURPOSE: The purpose of the study is to determine the efficacy and safety of Mitomycin C (MMC) augmented slit-lamp needle revision of failed filtration surgery. METHODS: The authors retrospectively reviewed the charts of 62 patients (62 eyes) (age, 72 +/- 15 years) with failed filtration surgery who underwent needle revision using MMC. A mixture of 0.01 ml of MMC (0.4 mg/ml) and 0.02 ml of bupivacaine with epinephrine was injected subconjunctivally. Twenty to 30 minutes later, a 30-gauge needle was used to perforate the area of subconjunctival fibrosis and re-establish flow. RESULTS: Overall, 118 needing procedures (mean, 1.9 +/- 1.4 revisions per eye; range, 1-7) were performed on 62 eyes (mean follow-up, 9.9 +/- 3.7 months; range, 4.5-20.1 months). Thirty-six patients (58.1%) were needled once and 26 patients (41.9%) underwent more than 1 needling procedure. Intraocular pressure decreased from 24.1 +/- 6.4 mmHg (range, 18-44) before surgery to 11.5 +/- 4.8 mmHg (range, 1-26) at last follow-up (P = 5.51 x 10(-21)). Antiglaucoma medications decreased from 1.6 +/- 1.0 to 0.3 +/- 0.6 (P = 3.8 x 10(-14)). Successful single-needling procedure was highly correlated with race (white) and past conventional glaucoma filtration surgery of more than 4 years. Complications included serous choroidal detachment (10 eyes), suprachoroidal hemorrhage (1 eye), bleb leak (5 eyes), iris blocking sclerostomy (2 eyes), hyphema (2 eyes), corneal abrasion (2 eyes), and hypotony (1 eye). CONCLUSION: Mitomycin needle revision appears to be an extremely effective way to revive failed filtration surgery. The incidence of complications compares favorably to trabeculectomy with MMC.

Transmission of Toxoplasma gondii in Panama City, Panama: a five-year prospective cohort study of children, cats, rodents, birds, and soil.

A cohort of more than 500 children from Panama City, Panama was studied prospectively over five years for acquisition of antibody to Toxoplasma gondii. The direct agglutination test showed that 72 of 571 children seroconverted between one and six years of age, for a cumulative incidence of 12.6%. Children were examined by pediatricians quarterly, and illnesses that had occurred in the interval and their activities were noted on questionnaires. Thirty-eight variables were examined for their role as risk factors for seroconversion. There was a higher correlation between children's seroconversion and contact with dogs than with cats. Combinations of significant predictors without dogs explained only 67% of the seroconversions, but the same factors with dogs explained 90%. On the other hand, ingestion of raw or rare meat or eggs appeared to play no role in transmission. Cats were examined and 110 (45.6%) of 241 had Toxoplasma antibody on the first bleeding. Only two (0.5%) of 383 cat fecal specimens, when tested in mice, resulted in seroconversion. Ten (1.1%) of 924 soil samples resulted in seroconversion in mice that had been injected. Antibody to Toxoplasma was found in 52 (23.3%) of 226 rats (Rattus norvegicus) and two (0.035%) of 571 mice (Mus musculus). Two hundred sixteen birds of 16 different species were bled. Antibody to Toxoplasma was found in 13.4% of these birds, mostly in grackles, blue-gray tanagers, and doves. The rate of isolation of Toxoplasma was low: one of 23 in rats and three of 201 in birds. High relative risks (RRs) of transmission to children were predicted by contact histories with nursing dogs (RR = 5.8), weaned dogs (RR = 4.7), many flies (RR = 3.6), 6-12-month-old dogs (RR = 3.4), weaned cats (RR = 3.0), 6-12-month-old cats (RR = 2.7), nursing cats (RR = 2.5), much garbage (RR = 2.4), and many roaches (RR = 2.2). The high statistical correlation of dog contact with seroconversion in children suggests the possibility that dogs, by eating and rolling in cat feces, are instrumental in mechanically transmitting Toxoplasma infection. In addition, flies, and to a lesser extent, cockroaches, may have practically important roles in transmission.

Relation of visual symptoms to topographic ablation zone decentration after excimer laser photorefractive keratectomy.

BACKGROUND: The authors used computer-assisted videokeratoscopy to analyze the relation of photorefractive keratectomy ablation zone decentration to subjective patient assessments of disturbing visual symptoms. METHODS: Ablation zone decentration was measured 1 month postoperatively. The study population was divided into two groups: group 1, patients whose ablation zone decentrations were less than 0.50 mm; group 2, patients whose ablation zone decentrations were greater than 0.50 mm. Visual symptoms including glare, rings or halos around lights and problems with night driving were scored preoperatively and 6 months postoperatively. The Hotelling T-square and chi-square tests were used. RESULTS: The mean decentration from the center of the ablation zone to the pupillary center was 0.30 mm and 190 degrees for group 1 compared with 0.66 mm and 198 degrees for group 2. The Hotelling T-square test showed a significant statistical preoperative/postoperative difference in group 1 (P < 0.03) for the halo symptom category. No other symptom category showed a significant statistical difference in either group for the mean scores. The Hotelling T-square test did not show a statistically significant difference between the two groups preoperatively to postoperatively regarding the mean scores of the individual patient differences for the three symptoms. The only significant statistical difference for the individual patient ratings preoperatively to postoperatively was for the halo symptom category (chi-square = 7.756; P < 0.03). CONCLUSIONS: Multivariate analysis did not show a significant statistical difference preoperatively between the two groups or postoperatively except for group 1 with regard to the halo symptom category. It appears from this study that ablation zone decentrations less than 0.89 mm from the pupillary center do not necessarily produce unwanted visual symptoms 6 months postoperatively.

Further studies on the electrodiagnosis of diabetic peripheral polyneuropathy using discriminant function analysis.

Discriminant function analysis can be useful when applied to multiple nerve conduction parameters for diabetic and nondiabetic subjects to reveal the essential dimension along which key neuropathic differences occur between these groups. In this study, 19 electrophysiologic parameters were used in a stepwise discriminant function analysis to reveal a highly significant dimension of intergroup differences between 67 diabetic and 75 normal adult Japanese-American males. The classification functions thereby derived are more sensitive and specific than those reported previously for this population. Furthermore, when 72 additional subjects with impaired glucose tolerance were examined, they showed considerable overlap with the normal and separation from the diabetic groups, respectively. Their intermediate position between normal and diabetics in the key discriminant dimension indicates that essential neuropathic change is, at most, incipient in this latter group.

Comparison of rapid versus slow tissue expansion on skin-flap viability.

The effect of rapid versus slow tissue expansion on random-pattern skin-flap survival lengths was evaluated in two groups of pigs. Each group (group 1--slow; group 2--rapid) was further evaluated for the effect that delay (A), delay plus expansion (B), expansion only (C), and acute flap elevation (D) had on flap length viability. Intergroup and intragroup comparisons were made. In the slowly expanded group, significantly greater flap length viabilities were demonstrated in the slow expansion flaps as compared with the delay plus expander flaps and the delayed flaps, respectively. In the rapidly expanded group, the flap length viabilities of flaps C, B, and A were statistically equal. However, the flap length viability of the rapidly expanded flaps was statistically equal to that of the slowly expanded flaps (C1 = C2). The effect tissue expansion has on improving flap length viability as compared with the delay phenomenon may be related to the combination of a delay effect plus increased nutrient flow density that slow expansion produces. This combined metabolic enhancement is preserved with rapid tissue expansion.

The effect of sulfinpyrazone on treadmill exercise-induced angina pectoris.

Suspecting that platelet thromboemboli could play a role in the pathogenesis of myocardial ischemia, we have done a random-order, double-blind, crossover study of the effect of the platelet-active drug sulfinpyrazone on treadmill exercise-induced angina pectoris in 30 men with coronary artery disease. The mean duration of exercise before onset of angina was 43 s longer after taking sulfinpyrazone than before and 11 s shorter after taking placebo than before. Analysis of variance for crossover design showed that the mean difference between the values obtained before and after sulfinpyrazone was significantly different (p < 0.01) from the mean difference between the values before and after placebo. Sulfinpyrazone had no effect on the mean heart rate-blood pressure product at onset of angina, change in ST segment during exercise, or preexercise platelet aggregate ratio and bleeding time. Exercise until angina occurred did not affect the platelet aggregate ratio.

Antiidiotypic antibodies against anti-DNA antibodies in sera of families of lupus patients.

We searched for antiidiotypes directed against anti-DNA in sera of healthy family members of lupus patients. Controls were healthy individuals without a personal or family history of lupus. No significant differences were noted between the family members' and the control group's sera with respect to binding to DNA or to non-anti-DNA F(ab')2 fragments. Family members' sera had higher binding to anti-DNA F(ab')2 and to normal IgG F(ab')2 fragments (P less than 0.01). Sera of the family members had significantly higher binding to anti-DNA F(ab')2 than to normal IgG F(ab')2 fragments (P less than 0.0036). Inhibition experiments have shown that the antiidiotype is directed against the framework determinants and not against the antigen binding sites of the idiotype. The antiidiotypic antibodies were directed against cross-reactive anti-DNA idiotypes and were not restricted to the idiotypes of the lupus proband. Age, sex, and blood relationship to the lupus patient did not influence the presence of antiidiotypes in the family members. The possible role of environmental factors in the induction of antiidiotypes and the role of the latter in regulating anti-DNA antibodies are discussed.