Exponential fed-batch strategy for enhancing biosurfactant production by Bacillus subtilis.

Surfactin produced by Bacillus subtilis BDCC-TUSA-3 from Maldex-15 was used as a growth-associated product in a conventional batch process. Maldex-15 is a cheap industrial by-product recovered during manufacturing of high fructose syrup from corn starch. Surfactin production was greatly improved in exponential fed-batch fermentation. Maldex-15 and other nutrients were exponentially fed into the culture based on the specific growth rate of the bacterium. In order to maximize surfactin yield and productivity, conversion of different quantities of Maldex-15 into surfactin was investigated in five different fermentation runs. In all runs, most of the Maldex-15 was consumed and converted into surfactin and cell biomass with appreciable efficiencies. The best results were obtained with the fermentation run supplied with 204 g Maldex-15. Up to 36.1 g l(-1) of surfactin and cell biomass of 31.8 g l(-1) were achieved in 12 h. Also, a marked substrate yield of 0.272 g g(-1) and volumetric reactor productivity of 2.58 g 1(-1) h(-1) were obtained, confirming the establishment of a cost-effective commercial surfactin production.

Preparation of different types of miso with mixture of starters and their effects on endogenous antioxidant of liver and kidney of mice.

The present study was undertaken to evaluate the effects of feeding the male mice with miso that was prepared with a mixture of microbial starters on the level of lipid peroxidation as a marker of oxidative stress, antioxidant power of hepatocytes, the enzymatic and non-enzymatic antioxidant. The starters that were used in the preparation of miso were Aspergillus oryzae and Pleurotus ostreaus or A. oryzae and Bacillus subtilis. The miso that was prepared with A. oryzae and Bacillus subtilis has more effect on suppressing the oxidative stress and enhancement of endogenous antioxidant of hepatocytes and renal tissue of mice.

IL-4 and reactive oxygen species are elevated in Egyptian patients affected with schistosomal liver disease.

UNLABELLED: Schistosomiasis is a chronic liver disease that is endemic in rural areas of Egypt. Some patients may acquire infection and develop minimal complications while others may develop severe complications and progress to portal hypertension and cirrhosis especially if co-infected with hepatitis C virus (HCV). The reasons for this are poorly understood. Previous studies suggested an independent role for Th2-biased cytokine responses to schistosomal antigens in persistent hepatic fibrosis and development of complications. Studies in murine schistosomiasis demonstrated that the development of fibrosis requires the production of the profibrotic cytokines such as IL-4. On the other hand, previous studies have suggested that reactive oxygen species may play an important role in schistosomal granuloma formation and disease progression AIM: To investigate the status of the profibrotic IL-4 cytokine, oxidative stress (as indicated by thiobarbituric acid reactive substances), the antioxidants enzymes catalase and red blood cells glutathione content in a cohort of Egyptian patients affected with schistosomal hepatic disease and or hepatitis C infection. MATERIALS AND METHODS: The current study included four groups: patients with isolated HCV infection (HCV), comprised of 22 patients aged (mean +/- SD) 51.3 +/- 4.7 years; patients with HCV and schistosomal hepatic fibrosis (SHF) (Co-infected patients), comprised of 22 patients aged 49.6 +/- 4.0 years, patients with pure chronic schistosomiasis comprised of 22 patients with chronic schistosomiasis aged 53.7 +/- 5.6 years and a control group, comprised of 22 control subjects aged 48.5 +/- 5.4 years. Thiobarbituric acid reactive substances (TBARS), Catalase activity and red blood cells glutathione contents were determined using chemical methods while plasma IL-4 was determined using a commercially available ELISA kit. RESULTS: A significant reduction in erythrocyte catalase activity in patients with isolated HCV infection, isolated SHF and those co-infected with SHF and HCV compared with the control group was found (P < 0.05). A similar pattern was found regarding erythrocyte glutathione content. Conversely TBARS level were significantly increased in patients with HCV, SHF and mixed groups compared with the control group (P < 0.05). Plasma IL-4-values were significantly increased in the three groups compared to the control subjects group. Furthermore, plasma IL-4 was significantly higher in patients with isolated SHF and those with SHF + HCV compared to the HCV alone patient group. Plasma IL-4 also correlated positively with portal vein diameter in SHF and SHF . HCV groups. (r = 0.54 and P < 0.05). Furthermore when all patients were analysed collectively, there was a positive correlation between plasma IL-4 and right lobe of the liver and plasma TBARS concentration. CONCLUSION: Schistosomal infection triggers a Th2 type immune response as indicated by the high plasma IL-4. It also triggers an increase in reactive oxygen species levels. These effects especially IL-4 lead to more reduction in the level of antioxidants enzymes (that may be already compromised in malnourished schistosomal patients) with the resultant disease progression and development of complications.

Quality assessment of primary health care services provided for diabetes mellitus control in Alexandria.

Diabetes is a growing health problem worldwide. It is recognized as a particular threat to public health of the third world communities, particularly those living in rapidly developing countries. Therefore, the present study was conducted aiming at: assessment of the quality of primary health care (PHC) services provided for the control of diabetes mellitus (DM) in Alexandria; and opportunistic screening of high risk individuals attending PHC facilities for DM. Accordingly, the availability of human and nonhuman resources for DM control in two rural and two urban PHC centers in Alexandria (one of them was serving a desert area) was assessed by a pre-designed checklist 920 adult PHC attendants were screened for risk factors of DM. Individuals having more than one of the following risk factors: age above 50 years, overweight (body mass index > or =27 kg/m2), family history of DM in first degree relatives, history of hypertension, hypertension (systolic blood pressure > or =140 mm Hg and /or diastolic blood pressure > or =90 mm Hg), history of hyperlipidemia and history of gestational diabetes or birth of a large sized baby in females- were subjected to random capillary blood glucose (RCBG) testing. Cases were considered likely diabetic if RCBG was >200 mg/dl The performance of all PHC physicians examining and managing 560 diabetic patients was observed over a period of two months. One fourth of the diabetic cases were checked for the level of glycaemic control by fasting capillary blood glucose testing. The results revealed that 61.7% of the studied PHC attendants were at risk of developing DM and 14% were likely diabetic, with an urban: desert ratio of 2:1 The following factors were found to be independently associated with an increasing risk of DM occurrence among males: overweight (about 14 folds), family history of DM (9 folds), age above 50 years and history of hypertension (4 folds each). Whereas, among females the following risk factors were found: family history of DM (8 folds), history of gestational diabetes (6 folds) and overweight (4 folds). The majority of diabetic patients were poorly examined, investigated and managed; and an optimal level of glycaemic control was achieved in only 12.9% of the cases, as the PHC physicians didn't follow a model treatment plan for DM and due to unavailability of some equipment, laboratory facilities and essential drugs.

The role of primary health care in patient education for diabetes control.

The major components of diabetes management are dietary therapy, exercise and drug treatment. Therefore, education of people with diabetes is the cornerstone of management. The aim of the present work was to study the role of primary health care (PHC) in patient education for diabetes control in Alexandria. Accordingly, the knowledge and perception concerning diabetes and its management of all 88 PHC physicians and 104 nurses working in the two rural health centers and two randomly chosen urban health centers of Alexandria governorate were assessed by pre-designed self-administered questionnaire. All diabetic patients over 20 years of age attending the study health facilities over a period of two months were assessed for their knowledge and attitude concerning diabetes and self-management and asked about their degree of satisfaction with the provided PHC services by a pre-designed interview questionnaire. They amounted to 560 diabetic patients. The results revealed that the PHC physicians had sufficient knowledge about causes and complications of the disease, but insufficient knowledge about diagnosis and management, as only 10.2% & 4.5% of the physicians recognized the importance of regular exercise and patient education for diabetes management. Some misconceptions and false beliefs were observed among PHC nurses, as many of them considered diabetes a contagious disease or primarily caused by stress; that liver failure, hearing impairment and splenomegaly are among the complications of diabetes and that young age and immunodeficiency disorders are among the risk factors for developing diabetes. Moreover, most of them believed that the amount of carbohydrates given to diabetic patients should be reduced or even completely restricted; that vitamins are essential for all diabetic patients and that hot-water bottles are good for providing warmth to the diabetic feet. They also disagreed on the use of artificial sweeteners as sugar substitutes. Most of the diabetic patients had poor knowledge about diabetes and its management (85.7%) and a negative attitude towards self-management (61.6%) and only 23.6% of them were satisfied with the services provided by the PHC facilities for diabetes control. They were mainly dissatisfied with the role of PHC physicians in patient education. Some misconceptions and false beliefs were also recognized among diabetic patients. Many of them considered diabetes a contagious disease or primarily caused by stress. They didn't know the importance of regular exercise in diabetes control. They also believed in the efficacy of herbal therapy in diabetes control; that vitamins are essential for all people with diabetes; that water intake should be decreased when passing large amounts of urine, that anti-diabetic drugs should be stopped during associated illnesses and that patients on insulin treatment can't be shifted to oral drugs. Moreover, they believed that the amount of carbohydrates in diet should be reduced or even restricted and that the amount of proteins should not be reduced. They also refused the use of artificial sweeteners as sugar substitutes. Thus, it may be concluded that there is a serious gap in the provision of basic educational services to the majority of diabetic patients attending PHC facilities in Alexandria.