Evaluation of in vivo and ex vivo pre-treated bone marrow-derived mesenchymal stem cells with resveratrol in streptozotocin-induced type 1 diabetic rats.

OBJECTIVES: To compare the therapeutic potential of rat bone marrow-derived mesenchymal stem cells (BM-MSCs) preconditioned ex-vivo with resveratrol (MCR) and BM-MSCs isolated from resveratrol-pre-treated rats (MTR) in type-1 diabetic rats. METHODS: Type-1 diabetes was induced by a single streptozotocin injection (50 mg/kg; ip) in 24 rats. Following the confirmation of T1DM, diabetic rats were randomly divided into four groups: diabetic control (DC), diabetic rats treated with insulin subcutaneous (7.5 IU/kg/day), diabetic rats treated with MCR cells (3 × 106cells/rat, intravenous) and diabetic rats treated with MTR cells (3 × 106cells/rat, intravenous). Rats were sacrificed 4 weeks following cellular transplantation. KEY FINDINGS: Untreated diabetic rats suffered from pancreatic cell damage, had high blood glucose levels, increased apoptotic, fibrosis, and oxidative stress markers and decreased survival and pancreatic regeneration parameters. Both MSCs preconditioned ex-vivo with RES and MSCs isolated from rats pre-treated with RES homed successfully in injured pancreas and showed therapeutic potential in the treatment of STZ-induced T1DM. MCR cells showed better efficiency than MTR cells. CONCLUSIONS: The pre-conditioning of BM-MSCs with resveratrol may be a promising therapeutic possibility in T1DM. Resveratrol-preconditioned BM-MSCs encouraged effects almost comparable to that of exogenous insulin with the advantages of cured pancreas and restored islets not attained by insulin.

Efficacy and safety of homologous autoinoculation in treatment of multiple recalcitrant warts of different types.

BACKGROUND: Homologous autoinoculation is a novel minimally invasive procedure that treats warts by stimulating specific immune response. AIM: To evaluate the efficacy and safety of autoinoculation in treatment of multiple recalcitrant warts of different types in relation to patient's age, gender, type, number, size, and duration of warts. PATIENTS AND METHODS: Two hundred patients with multiple recalcitrant warts of different types were treated with one autoinoculation session. Each patient was subjected to history taking, general and dermatological examination, and photographic documentation before and after treatment. Patients were followed up after 1 week, 2, 12, and 16 weeks to assess possible side effects, treatment response, and recurrence rate, respectively. Evaluation of treatment response was done through physician assessment according to change in size or number of warts or both. RESULTS: After 12 weeks of procedure, 66% of patients showed complete clearance, 26% showed moderate clearance, and 4% showed mild clearance while only 1.5% of patients showed treatment failure, with negligible side effects and no recurrence. There was negative correlation between treatment response and wart duration (P < .001). CONCLUSION: Autoinoculation is effective in treating multiple recalcitrant warts irrespective of their type, number or size, with minimal complications and no recurrence. The longer wart duration is, the less treatment response will be achieved.

Mutations in foot and mouth disease virus types A and O isolated from vaccinated animals.

Foot and mouth disease (FMD) is responsible for serious economic losses in Egypt. Although vaccination is practised as the main control strategy, failure of vaccination has been reported in many cases, which can be due to a number of factors. Selection of FMD antigenic variants under the immune pressure of partially immunised hosts has been previously recorded. This study was designed to isolate and characterise foot and mouth disease viruses (FMDVs) circulating in Egyptian vaccinated animals. Serotype O, A and Southern African Territories (SAT) 2 FMDVs were detected in different Egyptian governorates during 2015, 2016 and 2017. The successful isolation of 15 FMDVs of the three serotypes is reported in this paper. Phylogenetic analysis based on the viral protein (VP) 1 gene showed that all serotype O isolates had East Africa (EA)-3 topotypes. There was variation in 15-17 amino acids between the serotype O isolates of 2015 and those of 2016 and 2017. The serotype A isolates belonged to the A-Iran-05 lineage, with the exception of one isolate of 2016 which clustered with the African strains of G-IV. Serotype SAT2 FMDV was detected in two samples of 2017 and both were of lineage Alx-12 of topotype VII. The virus neutralisation test using sera raised against vaccine strains confirmed the serotyping of the isolates and determined the antigenic relatedness between the isolates and the currently used vaccine strains. A decrease in the neutralising antibody titre of some serotype O and A isolates could be attributed to mutation in critical amino acids in the neutralising antigenic sites. Hence, this work supports previous studies describing the significance of amino acid substitutions within the antigenic sites of the virus in antibody neutralisation and immune escape.

La fièvre aphteuse est à l'origine d'importantes pertes économiques en Égypte. Si la vaccination constitue la principale stratégie de lutte contre cette maladie, de nombreux échecs vaccinaux ont été rapportés, dus à différents facteurs. Il a été constaté par le passé que la pression immunitaire exercée par des hôtes partiellement immunisés contre la fièvre aphteuse entraînait une sélection de variants antigéniques du virus. La présente étude avait donc pour objet d'isoler et de caractériser les virus de la fièvre aphteuse présents en Égypte chez les animaux vaccinés. Les sérotypes O, A et Southern African Territories (SAT) 2 du virus de la fièvre aphteuse ont été détectés dans plusieurs gouvernorats égyptiens en 2015, 2016 et 2017. Les auteurs font état de 15 isolements réussis de souches virales appartenant à chacun des trois sérotypes. Il ressort de l'analyse phylogénétique basée sur le gène de la protéine virale 1 (PV1) que tous les isolats de sérotype O correspondaient au topotype East Africa (EA) 3. Une variation de 15 à 17 acides aminés a été observée entre les virus de sérotype O isolés en 2015 et ceux du même sérotype isolés en 2016 et en 2017. Les isolats de sérotype A appartenaient tous à la lignée A-Iran-05, à l'exception d'un isolat de 2016 qui était proche des souches africaines du lignage G-IV. Le sérotype SAT-2 du virus de la fièvre aphteuse a été détecté dans deux échantillons prélevés en 2017. Les deux souches isolées appartenaient à la lignée Alx-12 du topotype VII. La neutralisation virale utilisant des antisérums produits contre les souches vaccinales a permis de confirmer le sérotypage des souches isolées et de déterminer le degré de similitude entre les isolats et les souches vaccinales utilisées actuellement. La diminution du titre d'anticorps neutralisants dirigés contre certains isolats des sérotypes O et A est probablement imputable à une mutation d'acides aminés déterminants au sein des sites de neutralisation des antigènes. Ce travail corrobore les résultats d'études antérieures qui avaient révélé que les substitutions d'acides aminés au sein des sites antigéniques du virus peuvent avoir un rôle dans la neutralisation d'anticorps et dans l'échappement du virus au système immunitaire.

La fiebre aftosa es causante de graves pérdidas económicas en Egipto. Aunque la vacunación viene siendo la principal estrategia de lucha, se han descrito numerosos casos en los que ha resultado ineficaz, hecho que puede deberse a varios factores. Anteriormente ya se había observado que la presión inmunitaria de hospedadores parcialmente inmunizados conduce a la selección de determinadas variantes antigénicas de la fiebre aftosa. Los autores exponen un estudio encaminado a aislar y caracterizar los virus de la fiebre aftosa circulantes en los animales egipcios vacunados. En los años 2015, 2016 y 2017 se detectaron en diferentes provincias del país los serotipos víricos O, A y SAT (Southern African Territories) 2. Los autores dan cuenta del aislamiento de 15 virus de la fiebre aftosa pertenecientes a uno u otro de estos tres serotipos. El análisis filogenético basado en el gen de la proteína vírica (VP) 1 demostró que todos los virus del serotipo O aislados correspondían al topotipo EA (East Africa)-3, con diferencias localizadas en los aminoácidos 15 a 17 entre los virus aislados en 2015 y los de 2016 y 2017. Los virus del serotipo A pertenecían al linaje A-Iran-05, con la excepción de uno de los de 2016, que formaba un conglomerado con las cepas africanas del linaje G-IV. El serotipo SAT2, por su parte, estaba presente en dos muestras de 2017, pertenecientes ambas al linaje Alx-12 del topotipo VII. Empleando la prueba de neutralización vírica con sueros sensibilizados contra cepas vacunales se confirmó el serotipo de los virus aislados y se determinó el grado de parentesco antigénico entre esos virus y las cepas vacunales utilizadas actualmente. El decremento observado en el título de anticuerpos neutralizantes frente a algunos de esos virus de los serotipos O y A podría explicarse por la mutación de aminoácidos fundamentales de los sitios antigénicos neutralizantes. Este trabajo, por lo tanto, viene a corroborar anteriores estudios que señalaban la gran influencia de la sustitución de aminoácidos en los sitios antigénicos del virus en los procesos de neutralización de anticuerpos y escape inmunitario.

Assessment of serum leptin, insulin resistance and metabolic syndrome in patients with skin tags.

BACKGROUND: Skin tags are common cutaneous lesions with an indefinite aetiology. OBJECTIVES: To assess serum leptin, insulin resistance and metabolic syndrome in different body mass index (BMI) patients with skin tags. METHODS: Three equally distributed groups of patients with multiple skin tags: 30 normal BMI, 30 overweight and 30 obese were included. Controls were age-, gender- and BMI-matched healthy subjects. Serum leptin, insulin resistance based on homeostasis model assessment of insulin resistance (HOMA-IR) and metabolic syndrome were assessed in all groups. RESULTS: Number and extent of skin tags increase with the increase in BMI. Highest leptin levels were found in obese patients, with significant differences when compared to normal BMI and overweight patients. Similar findings existed in controls. Significantly higher leptin levels were found in obese patients compared to obese controls. HOMA-IR was significantly higher in all groups of patients compared to BMI-counterpart controls. Seventy-one per cent of patients fulfilled criteria of metabolic syndrome. Number of skin tags, leptin and HOMA-IR were significantly higher in patients with metabolic syndrome compared to patients without the syndrome. Positive correlations were found between serum leptin and HOMA-IR in obese patients and obese controls. Positive correlations were also found between number of skin tags and waist circumference in all groups of patients. CONCLUSIONS: Serum leptin displays an association with obesity and insulin resistance. Assessment of HOMA-IR in patients with skin tags may serve as a useful approach for diagnosis of insulin resistance. Waist circumference is the only criteria of metabolic syndrome that correlates with number of skin tags.

Environmental exposure to endotoxin in rural and urban Egyptian school children and its relation to asthma and atopy.

AIM: The environmental exposure of farm children to micro-organisms in dust has been related to a reduced prevalence of asthma and atopy. The aim of this study was to evaluate the relation between settled dust endotoxin and development of asthma and/or atopy in rural and urban school children. METHODS: A comparative study was conducted on 40 rural and 40 urban school children (6-12 years). Parental self-reported allergic symptoms questionnaires were distributed. Forced expiratory volume in the first second (FEV1), forced vital capacity (FVC) were measured using MIR spirobank and FVE1% was calculated. Skin prick testing with the most common aeroallergens was performed. Limulus amebocyte lysate endotoxin content was measured in settled dust samples. RESULTS: The rural group which has higher exposure to farm animals and feeding on farm milk has less allergic symptoms. Rural students showed highly significant FEV1, FEV1% and significant FVC versus urban students (110.9±19.7, 103.8±12.2, 105.8±24.3 vs. 92.3±24.2, 98.4±18.9, 92.7±23.2, respectively). Rural school dust contains significantly higher level of endotoxin (2-3 EU/mg) than urban school (0-0.1 EU/mg). Urban residence was associated with increase risk of asthma after age and sex adjustments ([ORadj], 5.16; 95% [CI], 0.95-28). CONCLUSION: Our results support the hygiene theory, i.e., endotoxin exposure could be protective to asthma and atopy in school children.

Tissue and blood superoxide dismutase activities and malondialdehyde levels in different clinical severities of acne vulgaris.

BACKGROUND: Acne vulgaris is one of the commonest dermatological diseases and its pathogenesis is multifactorial. OBJECTIVES: To determine the role of oxidative stress in acne vulgaris and to determine a possible link with the clinical severity. METHODS: Twenty-three patients with different grades of acne vulgaris and 23 age- and sex-matched controls were enrolled. Superoxide dismutase (SOD) activities and malondialdehyde (MDA) levels were measured spectrophotometrically at tissue and blood levels. RESULTS: There were no significant differences in SOD activities and MDA levels between patients and controls. However, significant differences were found in patients with severe acne in comparison with those with mild and moderate acne. Moreover, comparison between different patient subgroups and controls revealed statistically significantly higher SOD activities in patients with mild acne in comparison with patients with moderate and severe acne, and with controls. Furthermore, severe acne showed statistically significantly lower SOD activities and higher MDA levels when compared with other patient subgroups and controls. CONCLUSIONS: Oxidative stress exists in patients with acne vulgaris and may play a role in aetiopathogenesis and/or progression of the disease. The addition of drugs with antioxidative effects seems to be valuable in the treatment of acne vulgaris.

Small-community-based surveys.

Rapid, small surveys are routinely done in much of the developing world but are less common in the United States. We present as an example a rapid survey of immunization status and other factors in a predominantly Hispanic region in Los Angeles. The survey united county employees, students, and community volunteers, first to enumerate the eligible population and then to conduct in-person interviews. Sampling was done in two stages in a downtown region of Los Angeles. Over the course of two weekends and during clean-up the following week, volunteers and others enumerated 718 eligible children in 30 clusters (i.e. groups of blocks). At the second stage, also in two weekends with midweek clean-up, we selected by simple random sample 10 children per cluster. The parents or legal guardians of 270 children were interviewed about vaccination issues, including home presence of an immunization card. Nearly one fourth of the respondents did not have a home telephone number and thus would have been underrepresented in a telephone survey. Information from such rapid surveys is important for local program planning and evaluation.

Immunization coverage among predominantly Hispanic children, aged 2-3 years, in central Los Angeles.

PURPOSE: To assess the immunization status of young children in a predominantly Hispanic region in and around downtown Los Angeles, and factors associated with complete immunization by age 24 months. METHODS: The information was gathered in a two-stage cluster survey with probability proportionate to estimated size (PPS) sampling of 30 clusters at the first stage, and simple random sampling of a constant number of children at the second stage. Vaccination coverage was determined by a review of the home immunization (HI) card, or of clinic records. RESULTS: Of the 270 sampled children, 91.5% were Hispanic and 6.7% were Black. Home telephone numbers were not available in 24.8% of the homes, and 34.1% reported having no health insurance. Vaccination coverage was over 90% for the first three doses of Diphtheria, tetanus toxoids and pertussis/ diphtheria, tetanus toxoids and acellular pertussis vaccine (DTP/DTaP)/Diphtheria and tetanus toxoids vaccine (DT), first two doses of poliovirus (Polio) vaccine, first dose of measles, mumps and rubella (MMR) vaccine, and first two doses of hepatitis B (Hep B) vaccine. Yet, by age 24 months, only 72.2% of the children had received the combined series of 4:3:1 (i.e., four DTP/DTaP/DT, three Polio, one MMR). This was further reduced to 64.4% for the combined series of 4:3:1:3:3 (i.e., four DTP/DTaP/ DT, three Polio, one MMR, three Haemophilus influenzae type b (Hib), three Hep B). Factors associated with completed on-time vaccination were having an HI card available during the interview and being enrolled in Supplemental Nutrition Program for Women, Infants and Children (WIC). CONCLUSIONS: While vaccination levels for individual antigens were found to be high, more emphasis needs to be placed on getting preschool children vaccinated on-time according to the Recommended Childhood Immunization Schedule.

Patterns of hand fractures and dislocations in a district general hospital.

In a retrospective survey of patients with fractures and dislocations attending the Accident department of a District General hospital, comparison was made between patients with fractures and dislocations in the hand and fractures and dislocations of other sites. Patients with hand injuries accounted for 28% of the total patients seen. They were more likely than other fracture patients to be male and between the ages of 10 and 40 years. Almost a quarter of hand injuries attended on Monday. Leisure activities outside the home formed the commonest aetiological factor. Only 66% of patients with hand injuries attended the Accident department within 24 hours of injury. The little finger was the commonest site of injury. This survey emphasizes the differences between hand injuries and injuries of other sites, identifies the risk factors for hand injuries and has implications for the management of hand injuries in a District General Hospital.

Traumatic aseptic osteitis pubis.

We studied 78 cases of traumatic aseptic osteitis pubis among Saudi athletes to elucidate the clinical and radiological features of the condition as well as the outcome of management and the etiology. The most common presenting complaints were pain in the groin and lower abdomen, and tendernedd over the symphysis pubis. Widening and osteolysis of the symphysis pubis were the most frequent radiological changes. Routine laboratory tests showed no abnormalities in any of our patients. Conservative treatment, consisting of avoidance of sporting activity, use of nonsteroidal antiinflammatory drugs, and physiotherapy, effected cure in 75% of our patients. Further management was needed in the remaining 25%. The disorder is relatively common among Saudi football players, with trauma the likely cause. Conservative treatment is successful in most patients.

Patterns of accidental fractures and dislocations in Saudi Arabia.

A study of 4320 confirmed cases of accidental fractures and dislocations was conducted. The aims were to study and analyse the patterns of fractures and dislocations, age and sex distribution, and the cause of injury. It was found that dislocations are relatively uncommon, upper limb injuries are more frequent than lower limb and axial skeleton injuries, and the radius and ulna were the most commonly fractured bones. A young adult male was found to be the person most at risk of an injury, and children of both sexes were the second age group most commonly involved. The overall results showed that road traffic accidents accounted for 14 per cent of the cases, but this incidence increased in the young adult and the over 40 years age group, and this cause was more evident with the more serious fractures, such as those of the axial skeleton and lower limbs.

Lumbosacral plexus avulsion injury: clinical, myelographic and computerized tomographic features.

A rare case of lumbosacral plexus avulsion studied with computerized tomography (CT) in a 5-year old Saudi involved in a vehicular accident with resultant left lower limb monoparesis is presented. Myelography and CT were superior to electromyographic findings in this case. Such cases should be closely followed and surgical exploration and decompression offered if any evidence of cauda equina compression develops.

Bilateral simultaneous fracture of the femoral neck following electrical shock.

Simultaneous, bilateral fracture of the neck of the femur is rare; the number of reported cases does not exceed 10. Those fractures which occur as a result of electric shock, whether accidental or controlled, i.e. electroconvulsive therapy (ECT), account for almost 50 per cent of reported cases, while violent injury and epilepsy account for the remainder. This study combines a report of 1 case of bilateral fracture of the neck of the femur due to accidental electric shock with a review of the literature to discover the frequency of these fractures.