Uncommon Complications of Cystoscopy: Presentations of Concurrent Perirenal Hematoma and Candida albicans Sepsis

Subcapsular hematoma (SRH) or perirenal hematoma (PRH) can be seen after trauma, interventional radiological procedures, urological procedures, anticoagulant medications, coagulation disorders, infections, and spontaneously in some patients. Within the urological procedures, PRH can occur after percutaneous nephrolithotomy and extracorporeal shortwave lithotripsy but has only been reported a few times after cystoscopy/ureteroscopy. Here, we present the case of PRH as a complication from cystoscopy with retrograde pyelography in a patient with underlying chronic kidney disease (CKD) and an extensive surgical history for nephrolithiasis. In addition to this, our patient had a further complication of sepsis by Candida albicans, of which the source is proven to be urinary, and it appears that the fungemia was triggered during the procedure as well. The diagnosis was confirmed by abdominal computed tomography (CT), and PRH was proven to resolve with conservative management on repeat imaging months later.

COVID-19 and hepatic injury: cellular and molecular mechanisms in diverse liver cells

The coronavirus disease 2019 (COVID-19) represents a global health and economic challenge. Hepatic injuries have been approved to be associated with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. The viral tropism pattern of SARS-CoV-2 can induce hepatic injuries either by itself or by worsening the conditions of patients with hepatic diseases. Besides, other factors have been reported to play a crucial role in the pathological forms of hepatic injuries induced by SARS-CoV-2, including cytokine storm, hypoxia, endothelial cells, and even some treatments for COVID-19. On the other hand, several groups of people could be at risk of hepatic COVID-19 complications, such as pregnant women and neonates. The present review outlines and discusses the interplay between SARS-CoV-2 infection and hepatic injury, hepatic illness comorbidity, and risk factors. Besides, it is focused on the vaccination process and the role of developed vaccines in preventing hepatic injuries due to SARS-CoV-2 infection.

Nickel-Catalyzed mesoporous biochar for enhanced adsorptive oxidation of aqueous Sulfide: An investigation of influencing factors and mechanisms

Biochar (BC) is a low-cost and electroactive adsorbent for removing sulfide in aqueous media, which toxifies aquatic organisms and corrodes water treatment facilities. However, it lacks a pore structure for sulfide ion (S^2-) mass transfer to active sites. Herein, it is shown that nickel-modified biochar (BC-Ni) adsorbed S^2- 2.72-fold faster than BC alone and attained a 1244 ± 252 mg-sulfide/g maximum adsorption capacity due to markedly increased mesopores, while BC attained 583 ± 250 mg-sulfide/g. Factors influencing S^2-sorption and theoretical sorption kinetics and isotherms models were evaluated. Structural and surface compositions of BC and BC-Ni were examined using state-of-the-art characterizations. The results suggest that S^2- was adsorbed via pore diffusion, pore filling, and cation bridging and oxidized to elemental sulfur and sulfate with quinone and hydrogen peroxide generated from dehydrogenation of hydroquinone on the BC-Ni by metallic nickel in the carbon matrix. This study would spur biomass valorization and desulfurization.

Efficacy and safety of different therapies of non-steroidal anti-inflammatory drugs against antibiotic monotherapy in the treatment of uncomplicated lower urinary tract infection: A systematic review

This systematic review aimed to evaluate the efficacy of different non-steroidal anti-inflammatory drugs therapy (monotherapy or combined with antibiotics) against antibiotics monotherapy to understand the possible role of non-steroidal anti-inflammatory drugs in managing uncomplicated urinary tract infections and reduce overall antibiotic prescription. We searched four databases: PubMed, EMBASE, Scopus, and Cochrane CENTRAL. We included randomized controlled trials, which had included non-pregnant females above 18 years, published from 2010 to 2020 AD in the English language. We assessed risk of bias (ROB) using COCHRANE ROB version 2.0. We synthesized the conclusion from low ROB studies. Among five included studies, four studies compared non-steroidal anti-inflammatory drugs monotherapy against antibiotics monotherapy, and one study compared non-steroidal anti-inflammatory drugs + antibiotic therapy against antibiotic monotherapy. All studies with low ROB showed significantly higher events of symptom resolution by day 7 with antibiotic monotherapy compared to non-steroidal anti-inflammatory drugs monotherapy. Overall, adverse events were not significantly different in two of three low risk of bias studies; however, one study reported significantly higher adverse effects with non-steroidal anti-inflammatory drugs. Non-urinary tract infection–related adverse events were more common than urinary tract infections–related adverse events in both non-steroidal anti-inflammatory drugs and antibiotic groups. Urinary tract infection–related adverse events were higher in the non-steroidal anti-inflammatory drugs group compared to antibiotics. For every 20–60 participants treated, one would develop pyelonephritis additionally in non-steroidal anti-inflammatory drugs compared to antibiotics. Antibiotics were superior to non-steroidal anti-inflammatory drugs for treating uncomplicated lower urinary tract infections. However, further studies regarding the characteristics of patients likely to develop pyelonephritis on non-steroidal anti-inflammatory drugs monotherapy, and the effectiveness and safety of a combination of non-steroidal anti-inflammatory drugs and antibiotics therapy are essential to reduce the burden of antibiotics and their associated problems.

Evaluation of memantine's efficacy and safety in the treatment of children with autism spectrum disorder: A systematic review and meta-analysis

BACKGROUND

The United States Food and Drug Administration has approved drugs that address only autism-related symptoms rather than the underlying impairments. N-Methyl-D-Aspartate  receptor antagonists have recently emerged as a promising treatment option for a variety of neurologic and developmental problems, including autism.

AIMS

To review (systematically), for the first time, the medical literature that explores the safety in and efficacy of memantine in autism.

METHODS AND PROCEDURES

A comprehensive electronic search for relevant randomized controlled trials was conducted in four databases. Using RevMan software, we extracted and pooled data as a risk ratio (RR) or normalized mean differences in an inverse variance strategy.

RESULTS

This systematic review and meta-analysis includes five trials. There was no difference in enhancing social responsiveness when compared to placebo, though memantine lowered the likelihood of anxiety (RR = 0.25; 95% Confidence interval: [0.07; 0.87], p = 0.03). However, memantine aggravated impulsive behaviors. Additionally, in another trial that compared memantine added to risperidone versus risperidone added to placebo, memantine was found to be effective and safe.

CONCLUSION

Memantine showed safety in reducing acute symptoms of anxiety and other symptoms encountered in pediatric patients with autism spectrum disorders. However, memantine does not improve the core symptoms of autism. Nevertheless, further long-term trials are needed to explore its potential efficacy.

Impacts of molybdate and ferric chloride on biohythane production through two-stage anaerobic digestion of sulfate-rich hydrolyzed tofu processing residue

Biohythane production through one-stage anaerobic digestion of sulfate-rich hydrolyzed tofu processing residue has been hampered by high H₂S production. Herein, two-stage anaerobic digestion was investigated with the addition of molybdate (MoO₄^2-; 0.24-3.63 g/L) and ferric chloride (FeCl₃; 0.025-5.4 g/L) to the dark fermentation stage (DF) to improve biohythane production. DF supplemented with 1.21 g/L MoO₄^2- increased hydrogen yield by 14.6% over the control (68.39 ml/g-VS_fed), while FeCl₃ had no effect. Furthermore, the maximum methane yields of methanogenic fermentation were 524.8 and 521.6 ml/g-VS_fed with 3.63 g/L MoO₄^2- and 0.6 g/L FeCl₃ compared to 466.07 ml/g-VS_fed of the control. The maximum yields of biohythane and energy were 796.7 ml/g-VS_fed and 21.8 MJ/kg-VS_fed with 0.6 g/L FeCl₃ when the sulfate removal efficiency was 66.7%, and H₂S content was limited at 0.08%. Therefore, adding 0.6 g/L FeCl₃ is the most beneficial in improving energy recovery and sulfate removal with low H₂S content.

Impact of Cotadutide drug on patients with type 2 diabetes mellitus: a systematic review and meta-analysis

BACKGROUND

The food and drug administration approved many drugs to treat diabetes mellitus, but those drugs do not have a noticeable effect on weight management. Recently, glucagon-like peptide 1 agonist known as Cotadutide serve as a potent drug in treating type 2 diabetes by reducing blood glucose levels and body weight indices. This study aimed to explore the safety and efficacy of Cotadutide as a treatment for type 2 diabetes individuals.

METHODS

A comprehensive literature search was done on different databases, including PubMed, Scopus, Web of Science, and Cochrane Library to capture all relevant articles using an established search strategy. The inclusion criteria were randomized controlled trials that assessed the safety and efficacy of Cotadutide versus placebo or any anti-diabetes drugs in patients with type 2 diabetes mellitus and a BMI between 22 kg/m2 and 40 kg/m2. We conducted the analysis using Revman software version 5.4.

RESULTS

We found 663 relevant articles. From which nine studies were included and subjected to qualitative analysis and eight for quantitative analysis. The pooled effect showed that Cotadutide was better than placebo in reducing body weight (kg) (Mean difference (MD) = 3.31, p < 0.00001), glycated hemoglobin (HbA1c) (MD = 0.68, p > 0.00001), glucose area under the plasma concentration curve (AUC [0-4 h]) (MD = 30.15, p < 0.00001), and fasting plasma glucose over time (mg/dl) (MD = 31.31, p < 0.00001).

CONCLUSION

Cotadutide is safe and effective in reducing plasma glucose levels, HbA1c and body weight in individuals with type 2 diabetes.

TRIAL REGISTRATION

The study protocol was registered on PROSPERO (CRD: CRD42021257670 ).

Impact of Cotadutide Drug on Obese Individuals with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.. [DOI: 10.21203/rs.3.rs-1236048/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Background: The food and drug administration approved many drugs to treat diabetes mellitus, but those drugs do not have a noticeable effect on weight management. Recently, glucagon-like peptide 1 agonist known as Cotadutide was estimated to serve as a potent drug in treating type 2 diabetes by reducing blood glucose levels and body weight indices. This study aimed to explore the safety and efficacy of Cotadutide as a treatment for type 2 diabetes individuals.Methods: A comprehensive literature search was done on different databases, including PubMed, Scopus, Web of Science, and Cochrane Library to capture all relevant articles using an established search strategy. The inclusion criteria were randomized controlled trials that assessed the safety and efficacy of Cotadutide versus placebo or any anti-diabetes drugs in obese and overweight people with type 2 diabetes mellitus. Data analysis was accomplished using Revman 5.4 software.Results: We found 663 relevant articles. From which nine studies were included and subjected to qualitative analysis and eight for quantitative analysis. The pooled effect showed that Cotadutide was better than placebo in reducing body weight (Mean difference (MD) = 3.31, p > 0.00001), glycated hemoglobin (HbA1c ) (MD = -0.68, p > 0.00001), glucose area under the plasma concentration curve (AUC [0-4h]) (MD = 30.15, p > 0.00001), and fasting plasma glucose over time (mg/dl) (MD = 31.31, p > 0.00001).Conclusion: Cotadutide is safe and effective in reducing blood glucose levels and body weight in individuals with type 2 diabetes.Study protocol registration: The study protocol was registered on PROSPERO (CRD: CRD42021257670).

Combination of ultrasonic and acidic pretreatments for enhancing biohythane production from tofu processing residue via one-stage anaerobic digestion

Tofu processing residues (TPR) have received more attention as a source of bioenergy. However, their low solubility has hindered biohythane generation. Consequently, the ultrasonic and H₂SO₄ pretreatments were combined and compared for the first time to improve the hydrolysis of organic matter and carbohydrate and increase free amino nitrogen generation from TPR. Besides, the impact of pretreatments on biohythane generation was investigated. Under the optimal conditions of 7.54% substrate level, 8% H₂SO₄ concentration, 80 °C and 50 min, the coincident ultrasonic-H₂SO₄ pretreatment enriched the contents of soluble chemical oxygen demand, reducing sugar, and free amino nitrogen to 49675 mg/L, 26 g/L, and 1721 mg/L, respectively, greater than individual pretreatments. Also, Biohythane yield increased by 4.24-13.61% over control (389.42 ± 23.7 ml/g-VS_fed). Furthermore, hydrogen yield at 42.5 ± 2.08 and 28.1 ± 1.07 ml/g-VS_fed and sulfate removal efficiency at 93 and 92% were significantly improved with ultrasonic-H₂SO₄ and H₂SO₄ pretreatments, respectively, indicating acidogenic and sulfidogenic activity enhancement.

Effect of Agaricus blazei Murill on exploratory behavior of mice-model

Increased anxiety and depressive symptoms have reported to be its association with long term illness. Because of having unwanted effects of newly available drugs, patients administering anxiolytic drugs usually discontinue the treatment before they are completely recovered. Therefore, there is a serious need to develop new anxiolytic drugs. The anxiolytic effect of hydro-alcoholic extract of Agaricus blazei in animal models was assessed. 24 male mice (Mus musculus genus) were included in the study. Four groups were prepared and each group contained six animals. The groups were vehicle control, positive control (diazepam 1.0 mg/kg, i.p.) as well as two treatment groups receiving Agaricus blazei hydro-alcoholic extract at a dose of 136.50 mg/kg and 273.0 mg/kg orally. The Marble burying test, Nestlet shredding test and Light and Dark box test used to assess anxiolytic activity. Mice administered with diazepam 1.0 mg/kg, i.p. while hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) was administered via oral route which exhibited marked reduction in number of marbles-burying as compared to vehicle control group. Mice administered with diazepam 1.0 mg/kg, i.p. and Oral administration of hydro-alcoholic extract of AbM (136.50 and 273.0 mg/kg, respectively) exhibited significant decrease in nestlet shredding in comparison to vehicle control group. The oral administration of hydro-alcoholic extract at a dose of 136.5mg/kg and 273mg/kg showed elevation in time spent in light box and was comparable to standard treated group while time spent by mice following oral administration of hydro-alcoholic extract of Agaricus blazei at a dose of 273.0 mg/kg also showed elevation and was found to be more near to standard treated group (diazepam 1 mg/kg, i.p.).

Amelioration potential of Moringa oleifera extracts against sodium arsenate induced embryotoxicity and genotoxicity in mouse (Mus musculus)

Previous studies have suggested that arsenic crosses the placenta and affects the fetus development. The study under consideration aims to show comparative ameliorative effect of Moringa oleifera leaf and flower extracts against sodium arsenate induced fetus toxicity of mice. Pregnant mice (N=44) were kept in lab and divided into eleven group from (A to K) and were orally administered the doses 6 mg/kg, 12 mg/kg for sodium arsenate, 150 mg/kg and 300 mg/kg for Moringa oleifera leaf extracts (MOLE) and 150 mg/kg and 300 mg/kg for Moringa oleifera flower extracts (MOFE) comparing with control. The investigation revealed evident reduction in the fetuses weight, hind limb, fore limb, tail and snout length, crown rump and head circumferences well as malformations in tail, feet, arms, legs, skin and eyes in the negative control group (only administered with sodium arsenate). Co-administration of sodium arsenate with MOLE and MOFE ameliorate the reversed effect of sodium arsenate on the shape, length, body weight and DNA damage of fetus significantly at 95% confidence interval. However, Moringa oleifera leaf extract showed more significant results in comparison to Moringa oleifera flower extract. Hence concluded that Moringa oleifera leaf extract ameliorated the embryo toxic effects of sodium arsenate and can be used against environmental teratogens.

Determination of Heavy Metals in Groundwater Around Al-Buraihi Sewage Station in Taiz City, Yemen

BACKGROUND

In recent years, mitigation of groundwater contamination resulting from the limited availability of freshwater for domestic use has become an important issue. The presence of heavy metals in water could have adverse effects on both plant and animal life.

OBJECTIVES

The main objective of the present study was to determine possible heavy metal contamination in groundwater around Al-Buraihi sewage station in Taiz, Yemen and to understand possible sources of contamination and their relationships with groundwater.

METHODS

Wastewater samples were collected from a wastewater stabilization pond from Al-Buraihi sewage station and borewell water samples were collected from the vicinity. The presence of heavy metals was quantified using inductively coupled plasma-optical emission spectrometry (ICP-OES). Pearson correlation test was performed to understand the relationship between wastewater and groundwater samples.

RESULTS

Physical variables including pH, electrical conductivity (EC), dissolved oxygen (DO) and temperature and elements such as silver (Ag), arsenic (As), aluminum (Al), barium (Ba), boron (B), cadmium (Cd), chromium (Cr), iron (Fe), molybdenum, nickel (Ni), selenium (Se) and zinc (Zn) exceeded the permissible limits recommended by international standards in wastewater samples.

CONCLUSIONS

Treated sewage wastewater in the study area is not suitable for irrigation as the elements/heavy metals are accumulated in soil and plants and may be accumulated in humans and animals through bio-accumulation. In addition, these heavy metals reach the water table and aquifers through percolation, thereby polluting groundwater.

COMPETING INTERESTS

The authors declare no competing financial interests.

Addition of Anti-thymocyte Globulin in Allogeneic Stem Cell Transplantation With Peripheral Stem Cells From Matched Unrelated Donors Improves Graft-Versus-Host Disease and Relapse Free Survival

Anti-thymocyte globulin (ATG) is commonly used to prevent graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). To evaluate the impact of ATG as part of the GvHD prophylaxis in our institution, we report the outcome of 415 patients with matched unrelated donors (MUD) transplanted for hematological malignancies with or without ATG from 2005 to 2019 at Oslo University Hospital, Norway. The following groups were compared: (1) 154 patients transplanted with peripheral blood stem cells (PBSC) without ATG 2005-2014. (2) 137 patients transplanted with bone marrow stem cells (BMSC) 2005-2019. (3) 124 patients transplanted with PBSC and ATG (PBSC + ATG) 2014-2019. Three years survival was similar in the groups, 61% following allografting with PBSC, 54% with BMSC, and 59% with PBSC + ATG. Acute GvHD grade III-IV was 14%, 14%, and 7%; chronic GvHD was 81%, 32, and 26%; and extensive cGvHD 44%, 15%, and 6% in the corresponding groups. Both acute and chronic GvHD were significantly reduced in the PBSC + ATG-versus the PBSC group (p < 0.05 and p < 0.001 respectively).Transplant-related mortality (TRM) was 33%, 25%, and 17% (p = 0.18). Graft versus host disease and relapse free survival (GRFS) at 3 years was 43 %, 43%, and 64% in the groups. Adding ATG to the GvHD prophylaxis regimen of MUD allo-HSCT with PBSC resulted in a substantial reduction of both acute and chronic GvHD without compromising the disease control, reflected in a superior 3 years GRFS.

Impact of cytokine storm and systemic inflammation on liver impairment patients infected by SARS-CoV-2: Prospective therapeutic challenges

Coronavirus disease 2019 (COVID-19) is a devastating worldwide pandemic infection caused by a severe acute respiratory syndrome namely coronavirus 2 (SARS-CoV-2) that is associated with a high spreading and mortality rate. On the date this review was written, SARS-CoV-2 infected about 96 million people and killed about 2 million people. Several arguments disclosed the high mortality of COVID-19 due to acute respiratory distress syndrome or change in the amount of angiotensin-converting enzyme 2 (ACE2) receptor expression or cytokine storm strength production. In a similar pattern, hepatic impairment patients co-infected with SARS-CoV-2 exhibited overexpression of ACE2 receptors and cytokine storm overwhelming, which worsens the hepatic impairment and increases the mortality rate. In this review, the impact of SARS-CoV-2 on hepatic impairment conditions we overviewed. Besides, we focused on the recent studies that indicated cytokine storm as well as ACE2 as the main factors for high COVID-19 spreading and mortality while hinting at the potential therapeutic strategies.

Nourin-Dependent miR-137 and miR-106b: Novel Biomarkers for Early Diagnosis of Myocardial Ischemia in Coronary Artery Disease Patients

Background: Although cardiovascular imaging techniques are widely used to diagnose myocardial ischemia in patients with suspected stable coronary artery disease (CAD), they have limitations related to lack of specificity, sensitivity and “late” diagnosis. Additionally, the absence of a simple laboratory test that can detect myocardial ischemia in CAD patients, has led to many patients being first diagnosed at the time of the development of myocardial infarction. Nourin is an early blood-based biomarker rapidly released within five minutes by “reversible” ischemic myocardium before progressing to necrosis. Recently, we demonstrated that the Nourin-dependent miR-137 (marker of cell damage) and miR-106b-5p (marker of inflammation) can diagnose myocardial ischemia in patients with unstable angina (UA) and also stratify severity of ischemia, with higher expression in acute ST-segment elevation myocardial infarction (STEMI) patients compared to UA patients. Minimal baseline-gene expression levels of Nourin miRNAs were detected in healthy subjects. Objectives: To determine: (1) whether Nourin miRNAs are elevated in chest pain patients with myocardial ischemia suspected of CAD, who also underwent dobutamine stress echocardiography (DSE) or ECG/Treadmill stress test, and (2) whether the elevated levels of serum Nourin miRNAs correlate with results of ECHO/ECG stress test in diagnosing CAD patients. Methods: Serum gene expression levels of miR-137, miR-106b-5p and their corresponding molecular pathway network were measured blindly in 70 enrolled subjects using quantitative real time PCR (qPCR). Blood samples were collected from: (1) patients with chest pain suspected of myocardial ischemia (n = 38) both immediately “pre-stress test” and “post-stress test” 30 min. after test termination; (2) patients with acute STEMI (n = 16) functioned as our positive control; and (3) healthy volunteers (n = 16) who, also, exercised on ECG/Treadmill stress test for Nourin baseline-gene expression levels. Results: (1) strong correlation was observed between Nourin miRNAs serum expression levels and results obtained from ECHO/ECG stress test in diagnosing myocardial ischemia in CAD patients; (2) positive “post-stress test” patients with CAD diagnosis showed upregulation of miR-137 by 572-fold and miR-106b-5p by 122-fold, when compared to negative “post-stress test” patients (p < 0.001); (3) similarly, positive “pre-stress test” CAD patients showed upregulation of miR-137 by 1198-fold and miR-106b-5p by 114-fold, when compared to negative “pre-stress test” patients (p < 0.001); and (4) healthy subjects had minimal baseline-gene expressions of Nourin miRNAs. Conclusions: Nourin-dependent miR-137 and miR-106b-5p are promising novel blood-based biomarkers for early diagnosis of myocardial ischemia in chest pain patients suspected of CAD in outpatient clinics. Early identification of CAD patients, while patients are in the stable state before progressing to infarction, is key to providing crucial diagnostic steps and therapy to limit adverse cardiac events, improve patients’ health outcome and save lives.

Elliptical metallic rings-shaped fractal metamaterial absorber in the visible regime

Achieving the broadband response of metamaterial absorbers has been quite challenging due to the inherent bandwidth limitations. Herein, the investigation was made of a unique kind of visible light metamaterial absorber comprising elliptical rings-shaped fractal metasurface using tungsten metal. It was found that the proposed absorber exhibits average absorption of over 90% in the visible wavelength span of 400-750 nm. The features of perfect absorption could be observed because of the localized surface plasmon resonance that causes impedance matching. Moreover, in the context of optoelectronic applications, the absorber yields absorbance up to ~ 70% even with the incidence obliquity in the range of 0°-60° for transverse electric polarization. The theory of multiple reflections was employed to further verify the performance of the absorber. The obtained theoretical results were found to be in close agreement with the simulation results. In order to optimize the results, the performance was analyzed in terms of the figure of merit and operating bandwidth. Significant amount of absorption in the entire visible span, wide-angle stability, and utilization of low-cost metal make the proposed absorber suitable in varieties of photonics applications, in particular photovoltaics, thermal emitters and sensors.

Prevalence and Common Risk Factors of Hypertension among School Children Aged 12-16 Years in Sylhet Metropolitan City, Bangladesh

Hypertension is a common disease associated with high mortality and morbidity. Hypertension could have its origin in childhood and go undetected unless specially looked for during this period. With globalization bringing more lifestyle modifications, adolescents are exposed to multiple risk factors including obesity, diet, academic stress, lack of physical work apart from hereditary risk factors. Early diagnosis of hypertension is an important strategy in its control, effective treatment and prevention of complications. This cross sectional descriptive study was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from January 2014 to June 2014. One thousand (1000) school children aged 12-16 years in Sylhet Metropolitan City were included according to inclusion and exclusion criteria. Inclusion criteria were all school children aged 12-16 years in Sylhet Metropolitan City. School children aged under 12 or above 16 years and with any systemic disorder were excluded. This study showed that prevalence of hypertension in school going children of Sylhet city was 0.70% and there was a significant relationship of hypertension with the obesity, family history of hypertension, dietary habit and physical activity. Among 7 (seven) hypertensive children, 3(42.8%) were over weight and 3(42.8%) obese (p=0.001). All of 7(100%) children had family history of hypertension (p=0.001). Dietary habit were found healthy in 1(14.3%) and unhealthy in 6(85.7%) (p=0.001). Among 7 positive respondent, 6(85.7%) was sedentary working and 1(14.3%) was inactive (p=0.001). While waist hip ratio among those, 2(28.6%) were excellent and 5(71.4%) were average; was not significant (p=0.745). Prevalence of hypertension in apparently healthy school going children of Sylhet city was 0.70% and this had a strong relationship with obesity, family history of hypertension, dietary habit and physical activity.

Brassinosteroid biosynthesis, stress resistance in plants, and application of brassinosteroids in plant biotechnology

Brassinosteroids (BRs) are newly discovered plant hormones that protect the plants from biotic and abiotic stress. Plants produce these hormones at all times, however, the quantity and location of their production vary. It has been demonstrated that BRs help the plants to regulate their response to stress conditions and make them more resistant to pest attack, extreme hot or cold environment, water scarcity, and salinity, among other types of stress. Manipulation of genes involved in the synthesis of BRs in different plants is a feasible strategy for genetic improvement of crop production and stress tolerance.

Statistical Evidence for the Role of Southwestern Indian Ocean Heat Content in the Indian Summer Monsoon Rainfall

This study examines the benefit of using Ocean Mean Temperature (OMT) to aid in the prediction of the sign of Indian Summer Monsoon Rainfall (ISMR) anomalies. This is a statistical examination, rather than a process study. The thermal energy needed for maintaining and intensifying hurricanes and monsoons comes from the upper ocean, not just from the thin layer represented by sea surface temperature (SST) alone. Here, we show that the southwestern Indian OMT down to the depth of the 26 °C isotherm during January–March is a better qualitative predictor of the ISMR than SST. The success rate in predicting above- or below-average ISMR is 80% for OMT compared to 60% for SST. Other January–March mean climate indices (e.g., NINO3.4, Indian Ocean Dipole Mode Index, El Niño Southern Oscillation Modoki Index) have less predictability (52%, 48%, and 56%, respectively) than OMT percentage deviation (PD) (80%). Thus, OMT PD in the southwestern Indian Ocean provides a better qualitative prediction of ISMR by the end of March and indicates whether the ISMR will be above or below the climatological mean value.

Molecular epidemiology, associated risk factors, and phylogenetic analysis of anaplasmosis in camel

Camel Anaplasmosis is caused by members of family Anaplasmatacae, a tick transmitted, obligate intracellular bacteria. The etiological bacteria are transmitted by ixodid tick species. The species have multi host range distribution that is why it is crucial to diagnose it timely. The aim of present study was to investigate the molecular epidemiology i.e. prevalence and risk factors analysis of camel anaplasmosis. Furthermore, variations in hematological standards were also evaluated. The study found an overall 13.33% prevalence in camels. The confirmation of PCR positive samples for Anaplasma spp. was made through sequencing, the study isolatesshowed high homology with Iranian, Chinese, Philippines and South African isolates of Anaplasmatacae (Accession numbers'; KX765882, KP062964, KY242456, LC007100 and U54806) on BLAST queries. The phylogenetic analysis revealedthree study isolates of present study clustered with each other and the cluster was found closer to Chinese isolate of A. phagocytophilum (KY242456), A. marginale (KU586048), and Mongolian isolates of A. ovis (LC194134). Two of the isolates resembled Iranian isolate of Candidatus Anaplasmacamelii (KX765882), while one isolate resembled with Chinese isolates of A. Platys (KX987336) and Croatian isolates of A. Platys (KY114935). The key risk factors odds ratio (OR>1) identified for occurrence of camel anaplasmosis using regression model found sex and age of animal, previous tick history, tick infestation and tick control status, housing type, cracks in walls, rearing system and other species in surrounding as the key risk factors. The hematological parameters like lymphocytes, monocytes, granulocytes and platelets count were significantly decreased (p < 0.05) in diseased camels than healthy. This is the first ever molecular data on camel anaplasmosis in Pakistan. The disease should be monitored unceasingly as the etiologies have multi host distribution. Prompt attention should be offered to animals because neutropenia, lymphopenia and thrombocytopenia can exacerbate the disease by making the animal predisposed to otherdiseases.

Tetramethylpyrazine inhibited hypoxia-induced expression of calcium-sensing receptors in pulmonary artery smooth muscle cells in chickens

Tetramethylpyrazine (TMP) is a biologically active ingredient, which is isolated from a popularChinese medicinal plant. It has been used effectively to treat ischemic heart problems, cerebrovascular and thrombotic vascular diseases. This study was designed to evaluate the effect of TMP on calciumsensing receptors in pulmonary artery smooth muscle in chickens. For this purpose forty day-old chicks were distributed into five groups: the control group, the hypoxia group (kept under low Oxygen treatment), and TMP groups (kept under low Oxygen treatment along with treatment of different concentrations of TMP). The pulmonary artery smooth muscle cells were also cultured on 6-well plates in high glucose culture medium and divided into the same five groups. We used in vivo and in vitro study models by applying immunohistochemistry, RT-qPCR assay and Western blotting analysis. Our results showed that pre-incubation with hypoxia markedly stimulated the activation of calcium-sensing receptor (CaSR) in pulmonary artery smooth muscle cells (PASMCs). The TMP decreased the mRNA and protein levels of CaSR. Treatment with TMP clearly inhibited the activation of all CaSR in a dose-dependent manner. Our data demonstrated that TMP can down-regulate the expression of CaSR. Therefore, these findings provide a new target to treat pulmonary arterial hypertension (PAH) under hypoxic conditions.

Effect of locally tailored labour management guidelines on intrahospital stillbirths and birth asphyxia at the referral hospital of Zanzibar: a quasi-experimental pre-post study (The PartoMa study)

OBJECTIVE

To evaluate effect of locally tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia.

DESIGN

Quasi-experimental pre-post study investigating the causal pathway through changes in clinical practice.

SETTING

Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital.

POPULATION

Facility deliveries during baseline (1 October 2014 until 31 January 2015) and the 9th to 12th intervention month (1 October 2015 until 31 January 2016) [corrected].

METHODS

Birth outcome was extracted from all cases of labouring women during baseline (n = 3690) and intervention months (n = 3087). Background characteristics and quality of care were assessed in quasi-randomly selected subgroups (n = 283 and n = 264, respectively).

MAIN OUTCOME MEASURES

Stillbirths and neonates with 5-minute Apgar score ≤5.

RESULTS

Stillbirth rate fell from 59 to 39 per 1000 total births (RR 0.66, 95% CI 0.53-0.82), and subanalyses suggest that this was primarily due to reduction in intrahospital stillbirths. Apgar scores between 1 and 5 fell from 52 to 28 per 1000 live births (RR 0.53, 95% CI 0.41-0.69). Median time from last fetal heart assessment till delivery (or fetal death diagnosis) fell from 120 minutes (IQR 60-240) to 74 minutes (IQR 30-130) (Mann-Whitney test for difference, P < 0.01). Oxytocin augmentation declined from 22% to 12% (RR 0.54, 95% CI 0.37-0.81) and timely use improved.

CONCLUSION

Although low human resources and substandard care remain major challenges, PartoMa guidelines were associated with improvements in care, leading to reductions in stillbirths and birth asphyxia. Findings furthermore emphasise the central role of improved fetal surveillance and restricted intrapartum oxytocin use in safety at birth. TWEETABLE ABSTRACT: #PartoMa guidelines aided in reducing stillbirths and birth asphyxia at a Tanzanian low-resource hospital PLAIN LANGUAGE SUMMARY: PartoMa guidelines help birth attendants in Tanzania to save lives Every year, 3 million babies die on the day of birth. The vast majority of these deaths occur in the poorest countries. If their mothers had received better care during birth, most babies would have survived. At Mnazi Mmoja Hospital, an East African referral hospital, the PartoMa study shows that use of locally developed guidelines helps birth attendants to deliver better quality of care, which has led to improved survival at birth. At the hospital studied, resources are scarce. Each birth attendant assists four to six birthing women simultaneously, and many have less than 1 year of professional experience. International guidelines are available, but they are often unachievable and seldom applied. The PartoMa guidelines were developed in close collaboration with the birth attendants and approved by seven international experts. The result is an 8-page pocket booklet providing locally achievable and simple decision support for care during birth. Use of the PartoMa guidelines began in February 2015. As the staff group frequently changes, quarterly seminars are conducted where birth attendants are welcomed after working hours to learn about the guidelines. The guidelines have been positively received, and seminar attendance remains high. Use of the PartoMa guidelines is associated with: A decrease by one-third in stillbirths (59 to 39 per 1000 total births) A nearly halving in the number of babies born in immediate poor medical condition (52 to 28 per 1000 live births) The results presented here derive from a comparison of births before using the PartoMa guidelines and during the 9th-12th month of use. Such a 'before-after' study cannot exclude the possibility of other causes of better survival at birth. However, the improved survival is consistent with improved care during birth, which is in line with the PartoMa guidelines.

Targeted Theranostic Approach for Glioma Using Dendrimer-Based Curcumin Nanoparticle

The delivery of anti-cancer agents to brain tumors represent a challenge because the blood-brain tumor barrier (BBTB) effectively limits the delivery of many agents. A new generation 3 (G3) dendrimer-based curcumin (Curc) conjugate was synthesized. The synthesized G3-Curc conjugate demonstrated full solubility in aqueous media. The in vitro study revealed that G3-Curc nanoparticles were internalized into glioma U-251 cells. Systemic delivery of G3-Curc conjugate led to preferentially accumulation in an orthotopic preclinical glioma model minimizing systemic toxic effect. Multicolor microscopy images of the tumor tissue showed that G3-Curc particles were internalized inside tumor cells selectively and further localized within nuclei. Enhanced bioavailability of G3-Curc conjugate was also observed with improved therapeutic efficacy against different cancers cells.

Are hypertensive disorders in pregnancy associated with congenital malformations in offspring? Evidence from the WHO Multicountry cross sectional survey on maternal and newborn health

BACKGROUND

Annually, around 7.9 million children are born with birth defects and the contribution of congenital malformations to neonatal mortality is generally high. Congenital malformations in children born to mothers with hypertensive disorders during pregnancy has marginally been explored.

METHODS

Country incidence of congenital malformations was estimated using data on the 310 401 livebirths of the WHO Multicountry Survey which reported information from 359 facilities across 29 countries. A random-effect logistic regression model was utilized to explore the associations between six broad categories of congenital malformations and the four maternal hypertensive disorders "Chronic Hypertension", "Preeclampsia" and "Eclampsia" and "Chronic hypertension with superimposed preeclampsia".

RESULTS

The occupied territories of Palestine presented the highest rates in all groups of malformation except for the "Lip/Cleft/Palate" category. Newborns of women with chronic maternal hypertension were associated with a 3.7 (95 % CI 1.3-10.7), 3.9 (95 % CI 1.7-9.0) and 4.2 (95 % CI 1.5-11.6) times increase in odds of renal, limb and lip/cleft/palate malformations respectively. Chronic hypertension with superimposed preeclampsia was associated with a 4.3 (95 % CI 1.3-14.4), 8.7 (95 % CI 2.5-30.2), 7.1 (95 % CI 2.1-23.5) and 8.2 (95 % CI 2.0-34.3) times increase in odds of neural tube/central nervous system, renal, limb and Lip/Cleft/Palate malformations.

CONCLUSIONS

This study shows that chronic hypertension in the maternal period exposes newborns to a significant risk of developing renal, limb and lip/cleft/palate congenital malformations, and the risk is further exacerbate by superimposing eclampsia. Additional research is needed to identify shared pathways of maternal hypertensive disorders and congenital malformations.

Introduction and enzootic of A/H5N1 in Egypt: Virus evolution, pathogenicity and vaccine efficacy ten years on

It is almost a decade since the highly pathogenic H5N1 avian influenza virus (A/H5N1) of clade 2.2.1 was introduced to Egypt in 2005, most likely, via wild birds; marking the longest endemic status of influenza viruses in poultry outside Asia. The endemic A/H5N1 in Egypt still compromises the poultry industry, poses serious hazards to public health and threatens to become potentially pandemic. The control strategies adopted for A/H5N1 in Egyptian poultry using diverse vaccines in commercialized poultry neither eliminated the virus nor did they decrease its evolutionary rate. Several virus clades have evolved, a few of them disappeared and others prevailed. Disparate evolutionary traits in both birds and humans were manifested by accumulation of clade-specific mutations across viral genomes driven by a variety of selection pressures. Viruses in vaccinated poultry populations displayed higher mutation rates at the immunogenic epitopes, promoting viral escape and reducing vaccine efficiency. On the other hand, viruses isolated from humans displayed changes in the receptor binding domain, which increased the viral affinity to bind to human-type glycan receptors. Moreover, viral pathogenicity exhibited several patterns in different hosts. This review aims to provide an overview of the viral evolution, pathogenicity and vaccine efficacy of A/H5N1 in Egypt during the last ten years.

SLE presenting as multiple hemorrhagic complications

A 24 year old female with hereditary spastic paraplegia presented with intermittent headache for one year. She also had lower abdominal pain and vomiting for two months. She was pale, had icterus and mild splenomegaly. On diagnostic evaluation she was found to have hemolytic anemia, thrombocytopenia and bilateral adrenal, subdural, soft tissue (scalp and orbit) hemorrhages due to systemic lupus erythematosus (SLE). However, antiphospholipid syndrome (APS) antibodies were negative. Bilateral adrenal hemorrhage without associated APS is a rare phenomenon in SLE. We describe a case of SLE presenting with sequence of rare hemorrhagic complications in concert.

Root canal revascularization. The beginning of a new era in endodontics

Endodontic management of immature anterior teeth with necrotic pulps is a great challenge. Although there are different treatment procedures to deal with this problem such as apexification by using calcium hydroxide dressings or applying a barrier of mineral trioxide aggregate and gutta-percha obturation, the outcomes are still unsatisfactory and the root might still be weak. Recently, a new treatment protocol by revascularization of immature non-vital, infected teeth was introduced to regenerate dental structure and complete the root maturation. However, larger case series with longer follow-up periods are required to accept revascularization as the standard protocol for management of immature non-vital, infected teeth. In this review, we discuss the concept of root canal revascularization, revascularization mechanisms, and the structure of the regenerated tissues.

Direct period measurement for fiber Bragg grating using an optical imaging technique

This paper proposes an approach based on an optical imaging technique for the period measurement of fiber Bragg gratings (FBG). The simple, direct technique involves a differential interface contrast (DIC) microscope and a high-resolution CCD camera. Image processing is performed on the microscope images to obtain low-noise grating profiles and then the grating periods. Adopting a large image sample size in the image processing can reduce uncertainty. During the investigation, FBGs of different grating periods are fabricated by prestraining the photosensitive fibers during the UV-writing process. A good linearity between the measured Bragg wavelengths and grating periods is observed and the measured strain-optics coefficient was found to be in agreement with reported literature.

Effect of age on slaughterhouse by-products of indigenous cattle of Bangladesh

The present study was conducted to investigate the effect of age on slaughterhouse by-products and their chemical composition of indigenous cattle of Bangladesh. Live weight, warm carcass weight and dressing percentage of different age group (T1= 0 Tooth, T2= 2 Teeths, T3= 4 Teeths, T4= 6 Teeths and T5= 8 Teeths) of indigenous cattle were estimated. Average live weight and warm carcass weight of indigenous cattle was 167.64±79.93 kg and 84.83±47.88 kg, respectively on which age has significant effect. The average dressing percentage of indigenous cattle was 48.99±4.84. The average weight (kg) of inedible by-products eg. blood, hide, tail, scrotum, penis, cannon, horn, ear and tail was 6.35±0.69, 14.02±1.66, 0.34±0.03, 0.27±0.02, 0.28±0.03, 2.74±0.22, 0.33±0.04 and 0.17±0.02, respectively on which age has significant effect. The average weight (kg) of edible by-products eg. liver, heart, kidney, lung, brain, spleen, empty stomach, empty intestine, head and tongue was 2.40±0.22, 0.55±0.06, 0.35±0.04, 1.43±0.14, 0.33±0.01, 0.46±0.04, 6.32±0.74, 4.77±0.52, 8.21±0.78 and 0.48±0.04, respectively on which age has significant effect. The chemical composition of edible by-products was more or less similar to the main products of meat industry. DOI: http://dx.doi.org/10.3329/bjas.v42i1.15784 Bang. J. Anim. Sci. 2013. 42 (1): 62-66

PCR applications in identification of saliva samples exposed to different conditions (streptococci detection based)

Oral streptococci represent about 20% of the total oral bacteria, so if it is possible to detect the presence of oral specific bacteria from a forensic specimen by Polymerase chain reaction, this could be used to verify the presence of saliva. Aim of this study is detection of Streptococcus salivarius which is one of the most common streptococci in oral bacteria and Streptococcus mutans which is common in cases of dental caries in various body fluids and skin swabs and assessment of which one of both organisms is more reliable in saliva identification, cross sectional study on Egypt population. Negative control samples (15 samples) were taken from various body fluids (urine, semen) and skin swabs. Mock forensic samples (85 samples) included fresh saliva, saliva, cotton fabrics contaminated with saliva, cigarette butts, bitten apple and semen mixed with saliva samples). DNA extraction was done using DNeasy blood and tissue kit (Qiagen, Tokyo, Japan). Polymerase chain reaction was done for DNA amplification using Polymerase chain reaction master mix then gel electrophoresis was done for samples qualification. Control bacteria were S. salivarius and Streptococcus mutans. Streptococcus salivarius was detected in 83.5% of all saliva contained samples and S. mutans was detected in 67% of saliva contained samples. Both bacteria were not detected in other body fluids and skin swabs, so S. salivarius is more reliable in saliva identification as well as differentiating it from other body fluids. Polymerase chain reaction is valuable in detection of saliva by detecting S. salivarius.

Neural networks for shortest path computation and routing in computer networks

The application of neural networks to the optimum routing problem in packet-switched computer networks, where the goal is to minimize the network-wide average time delay, is addressed. Under appropriate assumptions, the optimum routing algorithm relies heavily on shortest path computations that have to be carried out in real time. For this purpose an efficient neural network shortest path algorithm that is an improved version of previously suggested Hopfield models is proposed. The general principles involved in the design of the proposed neural network are discussed in detail. Its computational power is demonstrated through computer simulations. One of the main features of the proposed model is that it will enable the routing algorithm to be implemented in real time and also to be adaptive to changes in link costs and network topology.

Dual-channel photoplethysmography synchronization using a Barker sequence

A Barker sequence is employed for the synchronization of two photoplethysmogram (PPG) channels. The correctness of this technique is demonstrated by recording a PPG signal, injecting a Barker sequence at the start of this trace and producing a delayed version of it. After preprocessing, cross-correlation techniques are utilized for accurate time alignment of the two traces. The algorithm can correct for any time misalignment as long as the synchronization sequence appears on both channels.

Treatment of phosphogypsum waste using suitable organic extractants

Phosphogypsum (PG) is a residue of the phosphate fertilizer industry that has relatively high concentrations of harmful radioactive materials. The reduction in concentration of the radionuclides from PG was investigated. The removal process is based on leaching of radionuclides using suitable organic extractants. The studied radionuclides were ²²⁶Ra, ²¹⁰Pb, ²³⁸U and ⁴⁰K. The factors affect the leaching process such as type of leaching materials, contact time, concentration of the desired solvent, liquid to solid ratio, and temperature were studied. Based on the experimental results, about 71.1, 76.4, 62.4, and 75.7% of ²²⁶Ra, ²¹⁰Pb, ²³⁸U and ⁴⁰K respectively were successfully removed from the PG. The reduction in the concentration of radionuclides was accompanied by reduction in the concentration of rare earth elements (∑REE) equals to 69.8%. Using the desired organic extractant under optimum conditions for treatment of the PG waste leads to obtain a decontaminated product that can be safely used in many industrial applications.

Magnetic Resonance Imaging Estimation of Longitudinal Relaxation Rate Change (ΔR1) in Dual Gradient Echo Sequences Using an Adaptive Model

Magnetic Resonance Imaging (MRI) estimation of contrast agent concentration in fast pulse sequences such as Dual Gradient Echo (DGE) imaging is challenging. An Adaptive Neural Network (ANN) was trained with a map of contrast agent concentration estimated by Look-Locker (LL) technique (modified version of inversion recovery imaging) as a gold standard. Using a set of features extracted from DGE MRI data, an ANN was trained to create a voxel based estimator of the time trace of CA concentration. The ANN was trained and tested with the DGE and LL information of six Fisher rats using a K-Fold Cross-Validation (KFCV) method with 60 folds and 10500 samples. The Area Under the Receiver Operator Characteristic Curve (AUROC) for 60 folds was used for training, testing and optimization of the ANN. After training and optimization, the optimal ANN (4:7:5:1) produced maps of CA concentration which were highly correlated (r =0.89, P < 0.0001) with the CA concentration estimated by the LL technique. The estimation made by the ANN had an excellent overall performance (AUROC = 0.870).

Mannitol facilitates neurotrophic factor up-regulation and behavioural recovery in neonatal hypoxic-ischaemic rats with human umbilical cord blood grafts

We recently demonstrated that blood–brain barrier permeabilization using mannitol enhances the therapeutic efficacy of systemically administered human umbilical cord blood (HUCB) by facilitating the entry of neurotrophic factors from the periphery into the adult stroke brain. Here, we examined whether the same blood–brain barrier manipulation approach increases the therapeutic effects of intravenously delivered HUCB in a neonatal hypoxic-ischaemic (HI) injury model. Seven-day-old Sprague–Dawley rats were subjected to unilateral HI injury and then at day 7 after the insult, animals intravenously received vehicle alone, mannitol alone, HUCB cells (15k mononuclear fraction) alone or a combination of mannitol and HUCB cells. Behavioural tests at post-transplantation days 7 and 14 showed that HI animals that received HUCB cells alone or when combined with mannitol were significantly less impaired in motor asymmetry and motor coordination compared with those that received vehicle alone or mannitol alone. Brain tissues from a separate animal cohort from the four treatment conditions were processed for enzyme-linked immunosorbent assay at day 3 post-transplantation, and revealed elevated levels of GDNF, NGF and BDNF in those that received HUCB cells alone or when combined with mannitol compared with those that received vehicle or mannitol alone, with the combined HUCB cells and mannitol exhibiting the most robust neurotropic factor up-regulation. Histological assays revealed only sporadic detection of HUCB cells, suggesting that the trophic factor–mediated mechanism, rather than cell replacement per se, principally contributed to the behavioural improvement. These findings extend the utility of blood–brain barrier permeabilization in facilitating cell therapy for treating neonatal HI injury.

Cutaneous sarcoidosis: updates in the pathogenesis

Sarcoidosis is a multiorgan granulomatous disease in which the skin is one of the frequently involved target organs. Cutaneous involvement occurs in a third of patients with sarcoidosis and has protean manifestations. More than a century has passed since the initial description of sarcoidosis, but its cause continues to be an enigma. Recent studies have introduced several new insights into the pathogenesis of this disease. The aim of this literature review was to provide a comprehensive overview on the current updates in the pathogenesis of sarcoidosis. This review has revealed that several genetic polymorphisms are associated with an increased risk of developing sarcoidosis, suggesting that genetic susceptibility to sarcoidosis is probably polygenic. Environmental factors may also modify the susceptibility to sarcoidosis. Evidence favouring an infectious aetiology has been accumulating, but the results of studies are conflicting. The current concept is that the pathogenesis of sarcoidosis involves a T-helper-1-mediated immune response to environmental antigens in a genetically susceptible host. The studies carried out on sarcoidosis have largely focused on the pulmonary aspects and have been mainly conducted by respiratory physicians. In contrast, research conducted on the cutaneous aspects of sarcoidosis is comparatively limited. Although tremendous advances have been made, there is a significant gap between the vast knowledge accumulated on sarcoidosis in recent years and the understanding of this disease.

Apoptosis is the most efficient death-pathway in tumor cells after topoisomerase II inhibition

OBJECTIVE

To compare the efficiency of apoptosis and other modes of cell death in killing tumor cells after the induction of DNA damage by topoisomerase inhibitors like etoposide.

METHODS

This study was carried out in the Tumor Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt, from September 2005 to August 2007. The breast cancer MCF7, the cervix carcinoma, human cervical adenocarcinoma Hela, and the brain tumor U251 cell lines were exposed to etoposide. Apoptosis was detected using the flow cytometry and the DNA ladder formation methods. Cell viability was determined by a colorimetric assay, and the residual DNA double-strand breaks dsb were measured by gel electrophoresis.

RESULTS

The Hela cells were the most, the MCF7's were moderately, whereas the U251's were the least sensitive to etoposide. Apoptosis was detected only in Hela cells whereas the other 2 cell lines showed a very low level of apoptosis only 3% increase above the control cells. At equitoxic drug concentrations namely IC50, the Hela cells showed the lowest amount of non-repaired DNA dsb, and the MCF7's showed the highest amount, whereas the U251 cells showed a moderate amount.

CONCLUSION

These results indicate that although other modes of cell death exist, apoptosis is the most efficient and requires lower drug concentrations and fewer numbers of non-repaired dsb to give the same killing effect. Clinically, this means that tumors that can execute apoptosis may require lower doses of topoisomerase inhibitors than those that lost the ability to exercise apoptosis.

Generalized essential telangiectasia with conjunctival involvement

Generalized essential telangiectasia (GET) is a rare skin disorder characterized by generalized development of dilated venules, which start at the lower extremities and progressively spread to the rest of the body. Mucous and conjunctival involvement is rare. The diagnosis is based on clinical examination, after excluding other primary and secondary causes of telangiectasia.