ASSOCIATION OF PLASMA NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN WITH METABOLIC SYNDROME.

This prospective hospital-based study conducted in Tikrit City aimed to investigate the role of Neutrophil gelatinase-associated lipocalin (NGAL ) and level of hemoglobin A1c and lipid profile concentrations in Metabolic syndrome (MetS) with hypertension and Diabetes mellitus (DM). Objective - estimate of serum Neutrophil gelatinase-associated lipocalin levels in Metabolic syndrome patients and the Control Group. The study included 60 patients with metabolic syndrome along with 30 healthy individuals as controls who were 18-50 years old; the samples were collected at a specific time (10 P.M. to 1 A.M.) from October 2023 to the end of November 2023 from Tikrit Teaching Hospital in Tikrit City and analyzed for various parameters. Patients with Metabolic Syndrome had their waist measured men as >102 cm (>40 in) and Women >88 cm (>35 in) and BMI >30 kg/m2 and/or waist ship ratio >0.9 in men and >0.85 in women. The mean serum level NGAL in patients with metabolic syndrome compared with the control group (523.12±271.8 versus 353.66± 151.0 pg/ml). The result was a significant difference (p<0.001). The study found that metabolic syndrome patients who had HbA1c% results were significantly different (p<0.001) compared with the control group. Also, the serum level lipid profile concentrations in patients with metabolic syndrome compared with the control group which was significantly different (p<0.001). The results of this research clearly indicate that a high level of NGAL associated with metabolic syndrome is a significant risk factor for the incidence and mortality of cardiovascular disease. Reducing the prevalence of cardiovascular disease in the general population should involve identifying, treating, and preventing the underlying risk factors of metabolic syndrome. Male obesity, diabetes, dyslipidemia, and hypertension are well-known main cardiovascular risk factors.

CHLOROQUINE INDUCED LESIONS IN LIVER OF ALBINO MICE.

A study was carried out to demonstrate the effects of chloroquine on liver of developing albino rats. In this study, 20 white albino mice were used, and distributed in 2 groups. They were kept in the animal house of the College of Veterinary Medicine, their ages ranged between (4-3) months and they were in good health. The first group (G1) was considered a control group, this group included 10 mice who were given regular food in addition to sterilized water daily for a period of (30) days, the second group (G2) included 10 mice, they were given food and water with chloroquine after mixing it in 1ml of distilled water at a dose of 1.2 mg/kg/day for each animal orally for a period of 30 days, it was found that chloroquine induced toxicity in liver tissue of albino mice which were exposed to chloroquine drug for longer during their life. Histological sections of stomach revealed that degenerative cases were present in the mucosa of it and the gastric glands also demonstrated sloughing of its mucus cells, and histological sections of small intestine indicated that the degenerative changes were present in the mucosa and submucosa reflected by sloughing of certain villi and the intestinal glands were also affected, lymphocytic infiltration was present in between the intestinal glands with plasma cells. The present study indicated that the liver tissue was affected by drug used via effect on the histological structure, as there was hypertrophy and degeneration of liver cells, hypertrophy of Kupffer cells in the blood sinusoids.

HISTOLOGICAL AND BIOCHEMICAL STUDY OF THE EFFECT OF FEXOFENADINE ON SALIVARY GLAND IN RATS.

Fexofenadine is a newly introduced oral non-sedating agent used for allergic diseases. We sought to investigate the effects of the use of fexofenadine on the salivary gland of adult male albino rats. 30 adult male albino rats were classified randomly into 3 groups, as follows: Group A (control group) which consisted of 10 healthy rats. Group B (treated group) which consisted of 10 rats received FEX 5mg/kg/day, and Group C (treated group) which consisted of 10 rats received FEX 10mg/kg/day. Blood samples were obtained to assess serum levels of Thioredoxin reductase (TRX) and malondialdehyde (MDA). Salivary glands were removed and prepared for histological examination. This study showed that significantly (p<0.05) higher TRX and MDA levels were observed in group B and group C, compared to group A. The histological examination for salivary tissues revealed degenerative changes in serous cells of acini were present with deep pyknotic nuclei. Vacuolar cytoplasmic degeneration is also seen in other certain cells. Blood congestion was present in the intralobular blood vessels, particularly around the striated ducts. The glandular secretion duct contained mucus and serous secretion and the wall of the duct was surrounded by many WBCs with macrophage. Fexofenadine hydrochloride use induces remarkable histopathological changes with dose-dependent response and remarkably linked to elevation of oxidative stress markers.

Comparison between Decompressive Craniectomy with Durotomy and Conservative Treatment in Spontaneous Supratentorial Intracerebral Hemorrhage.

Large Intracerebral hematoma (ICH), compounded by perihematomal edema can produce severe elevations of intracranial pressure (ICP). Decompressive craniectomy (DC) beneficially addresses mass effect. Therefore this study is aimed to prove that decompressive craniectomy with durotomy has better outcome in patients with spontaneous supratentorial ICH than conservatively treated patients. This Quasi-Experimental study was carried out in the Department of Neurosurgery, Dhaka Medical College & Hospital (DMCH), Dhaka, Bangladesh from July 2012 to December 2013 using purposive sampling procedure. A total of 80 admitted adult hypertensive patients with spontaneous supratentorial ICH were enrolled in the study population fulfilling all selection criteria. Of them 40 patients underwent decompressive craniectomy with durotomy was considered as surgical group and 40 patients were treated conservatively was considered as conservative group. All the cases were continuously followed up and GCS score at 7(th) day of treatment (D7) and at discharge was recorded. Mean±SD hematoma volume was 56.91±13.72ml in surgical patients and in conservative group 51.80±13.58ml. Outcome measured by modified Rankin Scale at 3 months. Sixty percent (60%) patients had good outcome (mRS 0-4) and 40% patients had poor outcome (mRS 5-6) in surgical group. On the other hand, 52.5% patients had good (mRS 0-4) and 47.5% had poor (mRS 5-6) outcome in conservative group. In logistic regression analysis, conservative group was 3.643 times more prone to develop poor outcome than surgical group which was statistically significant (95% CI, 1.040-13.047; p value <0.05) and volume of hematoma [OR (95% CI), 1.131(1.059-1.207); p value <0.001)] was the most important predictor of outcome. This study indicates that decompressive craniectomy with preservation of brain integrity in patients with spontaneous supratentorial ICH is feasible and safe. It can be a useful alternative surgical procedure in the treatment of spontaneous supratentorial ICH.

Surgery for primary intracerebral haemorrhage: is it safe and effective?

This prospective study was conducted to compare the outcome between medical and surgical treatment of primary intracerebral haemorrhage at the department of Neurosurgery, Dhaka Medical College Hospital from January 2006 to October 2007. All patients with primary intracerebral haematoma with Glasgow Coma Scale (GCS). 5-15 (on admission) and heamatoma volume 30 cc or above admitted at Neurosurgery department managed conservatively or surgically were included in this study. Total 60 patients were selected, of them 30 patients managed conservatively and 30 patients managed surgically. Conservatively managed patients regarded as control group (Group-A) and surgically managed patients regarded as experimental group (Group-B). Patients or attendants refused to operate were included in the conservative group. All the selected patients were evaluated on the basis of detailed history, clinical examination (general and neurological examination) and CT scan findings. Outcome was evaluated in term of Glasgow Outcome Scale (GOS). Best medical treatment was given for conservative group and operations were done for surgical group and followed up after surgery till discharge by observing GCS and GOS at discharge. Number of death were 15 (50%) patients in group-A and 13 (43%) patients in group-B. There was no significant difference in mortality rate between two groups but outcome was relatively better in group-B. According to Glasgow Outcome Scale, dependency in group-A and group-B was 26.6% and 23.4% respectively. So dependency were more in group-A. But there was no significant difference statistically. Seven (23.4%) patients were independent in group-A but 10(43.3%) patients were independent in group-B. However in relative terms of outcome of group-B was better than that of group-A. In our study we found no statistically significant difference in outcome between medical and surgical management of primary intracerebral haemorrhage.

Prevalence of retinopathy in hypertensive patients.

OBJECTIVE: To determine the prevalence of retinopathy in hypertensive patients referred to a teaching hospital in Yazd, Iran. METHODS: This cross-sectional study included 213 hypertensive patients referring to a teaching hospital in Yazd, Iran between November 2004 and June 2005. Data were collected using a questionnaire after an interview and ocular examination. Demographic variables, hypertensive retinopathy, familial history of hypertension, duration of diagnosis, and other hypertension side effects such as cardiac, renal, cerebro-vascular complications were analyzed. The Scheie's staging system was used for retinopathy grading. RESULTS: A total of 213 patients (95 men, 118 women) with high blood pressure aged between 25 and 85 years (mean age of 64.47 +/- 10.66 years) were enrolled in this study, wherein 39.9% of patients suffered from retinopathy. This rate was higher in women (45.6%) than in men (33%). The positive familial history of hypertension was reported in 47.8% of patients. The prevalence rate of retinopathy in patients suffering from mild hypertension was 25.3%, moderate hypertension was 34.5% and severe hypertension 84.6%. Of the patients with retinopathy, 42.36% had grade I, 20% had grade II and 2.35% had grade III retinopathy. The most common ophthalmoscopic findings were arteriolar narrowing (35.13%), arterio-venous nicking (17.12%) and cotton wool patches (9%). CONCLUSION: Positive family history of hypertension and target organs involvement are important risk factors for retinopathy. Early diagnosis and treatment of hypertension to prevent complications is essential.

Basal cell carcinoma of the eyelid associated with Gorlin-Goltz syndrome.

PURPOSE: To describe the ophthalmic and systemic features in a series of patients initially seen with eyelid basal cell carcinoma associated with Gorlin-Goltz syndrome. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Of 105 consecutive patients with eyelid basal cell carcinoma managed at an Ocular Oncology Center between January 1973 and December 1999, four patients with Gorlin-Goltz syndrome were identified. METHODS: The ophthalmic and systemic features, management, and outcome of patients with eyelid basal cell carcinoma associated with Gorlin-Goltz syndrome were analyzed. The published literature on Gorlin-Goltz syndrome, specifically related to genetics, systemic features, ophthalmic associations, and prophylactic management strategies, was reviewed. MAIN OUTCOME MEASURES: Response of the eyelid basal cell carcinoma to treatment and the final systemic condition were the main outcome measures. RESULTS: All four patients had a family history of Gorlin-Goltz syndrome. The systemic manifestations included multiple basal cell carcinomas in all the patients, frontal bossing or increased occipitofrontal circumference in three patients, palmar pits in two patients, odontogenic keratocyst in one patient, ectopic calcification in one patient, and bifid rib in one patient. The mean age at the detection of the first basal cell carcinoma was 30 years (range, 16-38 years). All four patients had multiple basal cell carcinomas on the face and elsewhere. The eyelid basal cell carcinoma was advanced with orbital infiltration in three patients, one of whom opted for palliative radiotherapy, whereas the other two underwent orbital exenteration. The fourth patient, who had localized recurrent basal cell carcinoma in the upper eyelid, was treated with excision and eyelid reconstruction. At the final follow-up (mean, 41 months), eyelid basal cell carcinoma was cured in three patients and stable in one patient. No patient had life-threatening sequelae of Gorlin-Goltz syndrome. CONCLUSIONS: Gorlin-Goltz syndrome is a rare autosomal dominant cancer predisposition syndrome that may be associated with eyelid basal cell carcinoma. The associated systemic findings may be a clue to the diagnosis of this condition. It is important to recognize Gorlin-Goltz syndrome when a patient has multiple basal cell carcinomas or when a young patient with eyelid basal cell carcinoma is seen by an ophthalmologist, because lifelong monitoring is essential for patient management.

A comparison of the effect of flurbiprofen, dexamethasone, and placebo on cyclocryotherapy-induced inflammation.

A double-blind study was performed to compare the effects of a placebo, a topical corticosteroid, and a topical non-steroidal prostaglandin inhibitor on the inflammation and the course of intraocular pressure that follows cyclocryotherapy. Flurbiprofen 0.03%, dexamethasone phosphate 0.1%, and a sterile vehicle placebo were used both pre and postoperatively. Less anterior chamber flare was seen in flurbiprofen-treated eyes than those receiving placebo, but only at four weeks after surgery. More erythema was seen in flurbiprofen-treated eyes than in those receiving dexamethasone. Significance was approached showing more anterior chamber cells in placebo-treated eyes than in steroid-treated eyes. Cyclocryotherapy produces inflammation which is difficult to control with topically administered medications.