Effect of High-intensity Laser Therapy on Carpal Tunnel Syndrome Patients: A Systematic Review and Meta-analysis

OBJECTIVE

To provide a strong foundation for the use of high-intensity laser therapy (HILT) in carpel tunnel syndrome (CTS,) we conducted a systematic review and meta-analysis to investigate the outcomes of short- and long-term follow-up studies.

DESIGN

Systematic review and meta-analysis.

RESULTS

Sample sizes of included studies ranged from 16 to 98 patients (total N = 308). Overall, a significant difference between the treatment and control groups were found across majority of the measures. Studies using a four-week follow-up period, however, only found significantly greater benefits for HILT in visual analogue scale (VAS) compared to placebo (p = 0.0191), Transcutaneous electrical nerve stimulation (TENS) (p = 0.0026), and low-intensity laser therapy-20 J/cm2 (p < 0.0002), and exercise (p < 0.0001). For improvement in VAS score over a long treatment period, HILT was also preferred over control group (p < 0.0071). Insufficient evidence exists to determine effect of HILT on nerve conduction examinations. The only statistically significant differences observed in examinations were in relation to sensory nerve action potential (p = 0.0083) and sensory nerve conduction velocity (SNCV) (p = 0.0468).

CONCLUSION

Moderate evidence exists regarding efficacy of HILT compared to placebo, HILT + wrist splint, and exercise in a short period of follow-up time but evidence on long-term follow-up is limited.

Comparative efficacy of difloxacin and nano-emulsion difloxacin as antibacterial agents against Salmonella enterica Serovar enteritidis in chickenss

Background

Avian salmonellosis is a group of diseases caused by bacteria from the genus Salmonella with a negative impact on poultry, particularly chickens. In addition, salmonellosis is a global food-borne infection.

Aim

The aim of this study was to evaluate the effect of nano-emulsion difloxacin (NED) and commercial difloxacin (CD) water supplement on broiler's growth, feed intake, and body weight, weight gain, growth rate, feed conversion ratio (FCR), and mortality rate (MR). The antibiotic sensitivity was determined both in-vivo and in-vitro for NED against Salmonella enterica Serovar enteritidis in chickens.

Methods

1500 one-day of age chicks were grouped into five groups as follows: group 1 (G1) control negative group, G2 control positive group (infected and not treated), G3 (infected and treated with CD, and G4 and G5 (infected and treated with NED at different doses). Samples, including the intestine, liver, and spleen were collected. Agar well diffusion test and minimum inhibitory concentrations were adopted. Histopathological lesions on different tissues were studied. During 35 days of the experiment, the feed intake, growth rate, growth gain, FCR, and MR were recorded daily. In addition, a variety of analytical techniques including transmission electron microscopic analysis, dynamic light scattering, UV-visible spectroscopy, and zeta-potential analysis were applied to characterize NED.

Results

The agar well diffusion test indicated that NED was in-vitro effective against S. enteritidis isolates than CD. The minimum inhibitory concentration was recorded as NED inhibited bacterial growth till well 8 at a concentration of 0.78 µg/ml; on the other hand, the CD inhibited bacterial growth till well 6 at a concentration of 0.62 µg/ml. Growth performance and MRs in the groups treated with NED are significantly reduced.

Conclusion

Treatment of broiler's drinking water with NED at doses of 0.5 and 1 ml instead of pure CD was able to enforce a new perspective, antibacterial efficacy, enhancing the productive performance, and reducing the MRs of broilers.

Prevalence, molecular characterization, and antimicrobial resistance among Escherichia coli, Salmonella spp., and Staphylococcus aureus strains isolated from Egyptian broiler chicken flocks with omphalitis

Background

Bacterial Omphalitis has been reported as a significant cause of mortalities in newly hatched broiler chicks.

Aim

This study aimed to assess the occurrence of omphalitis among broiler chickens in Gharbia governorate in Egypt. In addition, the bacteria associated with the occurrence of omphalitis in broiler chickens were also investigated and characterized.

Methods

For this purpose, 43 farms in that area were surveyed. The comparative levels of omphalitis caused by Escherichia coli (E. coli), Salmonella spp., and Staphylococcus aureus (S. aureus) were screened in 129 chicks. The drug resistance to eight commonly used antimicrobials in Egyptian poultry farms was screened using the disk diffusion method.

Results

The overall incidence rate of omphalitis was 37.21%. In birds with omphalitis, the co-prevalence of S. aureus, Salmonella spp., and E. coli was 87.5%. When compared to healthy flocks, broiler chicks with omphalitis caused by Salmonella spp., E. coli, and S. aureus had a greater mortality rate in the first week of life. However, there were no significant differences in the mortality cases caused by these pathogens. Eighty-seven percent of the cases of omphalitis were linked to E. coli and 75% to Salmonella spp. and S. aureus. From the yolk sac of broiler chicks with omphalitis, E. coli, Salmonella spp., and S. aureus were isolated at rates of 87.5%, 62.5%, and 45.8%, respectively. The isolates of E. coli and Salmonella spp. exhibited great sensitivity to gentamycin and Tetracycline; however, the strongest drug resistance was observed toward cefpodoxime, sulphamethoxazole and trimethoprim, ampicillin, and amoxycillin and clavulanic acid. The recovered isolates of S. aureus showed susceptibility to chloramphenicol (72.37%), oxytetracycline (81.82%), and erythromycin (81.82%). However, every S. aureus isolate that was found resistant to amoxycillin and clavulanic acid, penicillin G and oxacillin. of blaTEM, blaSHV, and blaCTX-M genes has been proposed as the genetic cause of β-lactam antibiotic resistance in Salmonella spp. and E. coli. MecA and blaZ; however, were found in every strain of S. aureus.

Conclusion

The frequency of omphalitis and its associated mortalities was comparatively high in Gharbia governorate. More efforts should be made to adopt strict hygienic standards for controlling and preventing such disease and this will consequently lead to minimizing the use of antimicrobials in poultry farms.

Cytokines, Serological, and Histopathological Assessment of Recombinant Vaccination Strategies for Combatting Infectious Bursal Disease in Broiler Chickens

Infectious bursal disease (IBD) represents a greatly transmissible viral disease found worldwide, causing significant health and production challenges in young chickens. The aim of this research was to assess the immune reaction induced by different vaccines targeting IBD. These vaccines included recombinant (Vac1; HVT-IBD vector), immune complex (Vac2; Bursa-Plex®), and intermediate plus (Vac3; Bursine plus) IBD vaccines. Our assessment relied on serological and histopathological analyses, as well as the pattern of immune-related cytokine expression in the bursal tissue. The vaccinated groups, along with a control positive (CP) group, were subjected to a vvIBDV challenge on their 28th day of life, while the control negative (CN) group received a mock vaccination with PBS. Our study revealed that Vac1 resulted in the most favorable growth performance, as well as maintained normal liver and kidney function, mitigating the impact of IBDV infection. Serological analysis using VP2 ELISA kits indicated that Vac1 induced the strongest immunological response among all vaccines. Histopathological examination demonstrated that Vac1 caused minimal lymphoid depletion observed in the lymphoid organs, followed by Vac2. Analysis of cytokine expression profiles showed significant upregulation in all vaccinated groups, particularly Vac1, during the pre-challenge period. Following IBDV infection, Vac1 resulted in a noteworthy increase in the expression of IL2 and IFN-γ, Vac2 showed a significant upregulation in TNF-α and granzyme, and both Vac1 and Vac3 exhibited increased levels of IL1β and IL10. In conclusion, our study suggests that the various vaccines triggered immune responses against IBD through both humoral and cell-mediated immunity. However, recombinant followed by immune complex vaccines appeared to induce more robust immunity while also being safer for broiler chickens in contrast to the intermediate plus vaccine.

Strabismus Surgery in Hemophilia: A Novel Surgical Technique and Guideline Recommendations

Hemophilia is a serious X-linked inheritance coagulation factor deficiency. Clinically, prolonged bleeding or delayed clotting in any area of vascular disturbance is the main manifestation of all hemophilia. We presented a 23-year-old male with a history of left sensory esotropia since the age of three. The patient had not undergone any previous eye surgery and refused to wear glasses. Hematologic studies confirmed a diagnosis of hemophilia A. Upon ophthalmologic examination, the patient's visual acuity was 20/20 in the right eye and 20/120 in the left eye, with deep amblyopia. The patient exhibited left inferior oblique overaction and a V pattern. The ophthalmologic examination otherwise revealed no abnormalities. Preoperative correction of factor VIII was deemed necessary, and the recommended dose was administered to raise the factor VIII level to 52%. The patient underwent bilateral medial rectus recession, left lateral rectus plication, and left inferior oblique myectomy. A new technique utilizing viscodissection with subconjunctival injection of a viscoelastic solution was employed to minimize intraoperative bleeding, resulting in reduced bleeding compared to standard strabismus surgery. No unusual bleeding occurred during the procedure. No postoperative bleeding was observed. The patient was discharged on the fourth postoperative day, having achieved satisfactory cosmetic alignment in the primary position with no complications related to hemophilia. In conclusion, strabismus surgery can be performed safely in strabismic patients with hemophilia. Viscodissection is a helpful novel surgical technique to decrease the risk of bleeding during surgery, and we recommend using this technique in patients using anticoagulants. A multidisciplinary team approach and strict post-operative monitoring are essential in order to achieve optimal results.

Synthesis of Cu and CuO nanoparticles from e-waste and evaluation of their antibacterial and photocatalytic properties

Waste printed circuit boards (WPCBs) contain a plethora of valuable metals, considered an attractive secondary resource. In the current research, a hydrometallurgical process combined ammonia/ammonium chloride leaching and reduction (using L-ascorbic acid) to recover copper and its oxide (CuO) as nanosized particles from WPCBs was investigated. The results of leaching indicated that 96.7% of copper could be recovered at a temperature of 35 °C for a leaching duration of 2 h with ammonium chloride and ammonia concentration of 2 mol/L at a solid:liquid ratio of 1:10 g/cm3. The synthesized particles exhibit spherical and distorted sphere morphology with average particle size of 460 nm and 50 nm for Cu and CuO NPs, respectively. The antibacterial activity of Cu, CuO, and a (1:1) blend of both (Cu/CuO) has been examined against five different bacterial and fungal strains. The highest zone of inhibition was measured as 21.2 mm for Cu NPs toward Escherichia coli and 16.7 mm for Cu/CuO blend toward Bacillus cereus bacteria. The highest zone of inhibition was measured as 13 mm and 13.8 mm for Cu/CuO blend toward Fusarium proliferatum and Penicillium verrucosum fungi. Cu/CuO blend showed notable photocatalytic activity towards Rhodamine B dye under visible light irradiation with 96% degradation rate within 120 min. Using the process developed in this study, copper and its oxide as nanoparticles can be produced from WPCBs and used for multifunctional applications.

A century of "anticoccidial drugs": bibliometric analysis

Publications are an important measure of scientific and technological progress. The quantitative examination of the number of publications in a certain research topic is known as bibliometrics. Bibliographic studies are widely used to analyse the condition of research, future potential, and current growth patterns in a certain topic. It can serve as a basis for making decisions and implementing strategies to achieve long-term development goals. To our knowledge, no research has been conducted in these domains; so, this work aims to employ bibliometric analysis to provide comprehensive data on publications related to anticoccidial drugs. As a result, the current study uses bibliometric analysis to track the evolution of anticoccidial drugs and its consequences in the academic and public worlds via a survey of relevant scientific and popular publications. The Dimensions database was used to retrieve the bibliographical statistics, which were then cleaned and analyzed. The data was also loaded into the VOS viewer, which generated a network visualization of the authors with the most joint articles. The investigation discovered three stages of publications and citations since the first article on anticoccidial drugs in 1949. The first stage, which ran from 1920 to 1968, was characterized by a scarcity of research articles on anticoccidial drugs. From 1969 to 2000, the second stage was marked by a stable and marginally increased number of articles. The scientific field was characterized by an increasing trend in the number of publications and their citations from 2002 to 2021. The study gave a complete list of the top anticoccidial drugs funding agents, countries, research institutes, most cited publications, and important co-authorship and partnerships. The outcomes of the study will help veterinary practitioners and researchers understand the trends and best sources of knowledge in the field of anticoccidial medications.

Isolation, Identification, and Genetic Characterization of Antibiotic Resistance of Salmonella Species Isolated from Chicken Farms

Salmonella is a major cause of foodborne outbreaks. It causes gastroenteritis in humans and animals. This micro-organism causes severe illness in chickens and has a major impact on chicken productivity and the poultry industry. This study aimed to address the prevalence of Salmonella infection in broiler chicken farms in Kafrelsheikh, Gharbia, and Menofeya provinces in Egypt during 2020-2022. This work also aimed to evaluate the genetic characterization and antibiotic resistance of the isolated Salmonella strains. Clinical signs and mortalities were observed and recorded. In total, 832 samples were collected from 52 broiler flocks, including 26 from both one-week-old and 6-week-old chicken farms from different organs (liver, intestinal content, spleen, and gallbladder). The prevalence of Salmonella infections was reported in the study region to be 36.54%. Of the 26 one-week-old farms surveyed, 11 (42.31%) and 8/26 (30.77%) of the six-week-old broiler chicken farms had Salmonella infections. Recovered isolates were serotyped as 9 (47.37%) S. enteritidis O 1,9,12, ad monophasic H: g, m: -, 6 (31.58.%) S. shangani 2, (10.53%) S. gueuletapee 1, (5.26%) S. II (salamae), and 1 (5.26%) untypable. The results showed that Salmonella infection was predominant in one-week-old chicks compared to infection in six-week-old and uninfected flocks. All Salmonella isolates were resistant to ampicillin and erythromycin, while all isolates were sensitive to ciprofloxacin, chloramphenicol, and levofloxacin. The isolates also contained 10.53% (2/19) streptomycin, 10.53% (2/21) gentamicin, 15.79% (3/19) doxycycline, and 26.32% (5/19) lincomycin and colistin. The phenotypically resistant Salmonella samples against ampicillin, erythromycin, and macrolide harbored bla _TEM , bla _SHV , ermB, ereA, mphA, and ermB, respectively. This baseline data on Salmonella spp. prevalence, serotyping, and antibiotic profiles are combined to define the antimicrobial resistance to this endemic disease. Elucidation of the mechanisms underlying this drug resistance should be of general importance in understanding both the treatment and prevention of Salmonella infection in this part of Egypt.

Compatibility of Al-doped ZnO electron transport layer with various HTLs and absorbers in perovskite solar cells

Perovskite solar cells (PSCs) have shown a significant improvement in cell performance in photovoltaics technology. The commonly used light absorbing material of halide-based perovskite in PSCs has produced high efficiency cells with low cost and a simple fabrication process. However, it contains the harmful substance of Pb, which affects the environment, and the cell still suffers from instability in the long run. Therefore, this work presents a theoretical study of the Pb-free absorber layer of CH₃NH₃SnI₃ that is paired for compatibility with various types of hole transport layers (HTLs). Several key parameters of the absorbent layer and HTL have been optimized to produce the highest power conversion efficiency (PCE) using 1D-SCAPS software under AM 1.5 illumination. It was found that the combination of Cu₂O and CH₃NH₃SnI₃ used as the HTL and absorbent layer, respectively, has resulted in great PCE as high as 27.72%. These findings prove that the use of inorganic HTLs and Pb-free perovskite layers is promising for use in PSCs.

Advanced methods for missing values imputation based on similarity learning

The real-world data analysis and processing using data mining techniques often are facing observations that contain missing values. The main challenge of mining datasets is the existence of missing values. The missing values in a dataset should be imputed using the imputation method to improve the data mining methods' accuracy and performance. There are existing techniques that use k-nearest neighbors algorithm for imputing the missing values but determining the appropriate k value can be a challenging task. There are other existing imputation techniques that are based on hard clustering algorithms. When records are not well-separated, as in the case of missing data, hard clustering provides a poor description tool in many cases. In general, the imputation depending on similar records is more accurate than the imputation depending on the entire dataset's records. Improving the similarity among records can result in improving the imputation performance. This paper proposes two numerical missing data imputation methods. A hybrid missing data imputation method is initially proposed, called KI, that incorporates k-nearest neighbors and iterative imputation algorithms. The best set of nearest neighbors for each missing record is discovered through the records similarity by using the k-nearest neighbors algorithm (kNN). To improve the similarity, a suitable k value is estimated automatically for the kNN. The iterative imputation method is then used to impute the missing values of the incomplete records by using the global correlation structure among the selected records. An enhanced hybrid missing data imputation method is then proposed, called FCKI, which is an extension of KI. It integrates fuzzy c-means, k-nearest neighbors, and iterative imputation algorithms to impute the missing data in a dataset. The fuzzy c-means algorithm is selected because the records can belong to multiple clusters at the same time. This can lead to further improvement for similarity. FCKI searches a cluster, instead of the whole dataset, to find the best k-nearest neighbors. It applies two levels of similarity to achieve a higher imputation accuracy. The performance of the proposed imputation techniques is assessed by using fifteen datasets with variant missing ratios for three types of missing data; MCAR, MAR, MNAR. These different missing data types are generated in this work. The datasets with different sizes are used in this paper to validate the model. Therefore, proposed imputation techniques are compared with other missing data imputation methods by means of three measures; the root mean square error (RMSE), the normalized root mean square error (NRMSE), and the mean absolute error (MAE). The results show that the proposed methods achieve better imputation accuracy and require significantly less time than other missing data imputation methods.

Avian Paramyxovirus Type 1 in Egypt: Epidemiology, Evolutionary Perspective, and Vaccine Approach

Avian orthoavulavirus 1, formerly known as avian paramyxovirus type-1 (APMV-1), infects more than 250 different species of birds. It causes a broad range of clinical diseases and results in devastating economic impact due to high morbidity and mortality in addition to trade restrictions. The ease of spread has allowed the virus to disseminate worldwide with subjective virulence, which depends on the virus strain and host species. The emergence of new virulent genotypes among global epizootics, including those from Egypt, illustrates the time-to-time genomic alterations that lead to simultaneous evolution of distinct APMV-1 genotypes at different geographic locations across the world. In Egypt, the Newcastle disease was firstly reported in 1947 and continued to occur, despite rigorous prophylactic vaccination, and remained a potential threat to commercial and backyard poultry production. Since 2005, many researchers have investigated the nature of APMV-1 in different outbreaks, as they found several APMV-1 genotypes circulating among various species. The unique intermingling of migratory, free-living, and domesticated birds besides the availability of frequently mobile wild birds in Egypt may facilitate the evolution power of APMV-1 in Egypt. Pigeons and waterfowls are of interest due to their inclusion in Egyptian poultry industry and their ability to spread the infection to other birds either by presence of different genotypes (as in pigeons) or by harboring a clinically silent disease (as in waterfowl). This review details (i) the genetic and pathobiologic features of APMV-1 infections in Egypt, (ii) the epidemiologic and evolutionary events in different avian species, and (iii) the vaccine applications and challenges in Egypt.

Accuracy of the Potential Acuity Meter in Predicting the Visual Outcome in Cases of Cataract Associated with Macular Degeneration

In order to ascertain the accuracy and specificity of the Potential Acuity Meter (PAM) in the preoperative evaluation of likely postoperative visual acuity in cases of cataract associated with age-related macular degeneration (ARMD), we studied the results in 130 cases, 54 of whom had preoperatively proved or suspected ARMD associated with a cataract. All of them were operated with extracapsular extraction and implantation of an intraocular lens (IOL), and final visual acuity was established when all the patients were visited three months postoperatively. A positive linear correlation was found between normal ocular fundus and PAM prediction (r = 0.77), and in the group of patients with preoperatively confirmed ARMD (r = 0.77). No difference was found between the preoperative PAM estimation and the final visual acuity in both groups. The PAM prediction was less accurate in cases with doubtful preoperative ARMD (r = 0.58) for whom showed PAM the highest score of false negatives in favor of the final visual acuity. Our results show that PAM is a reliable clinical technique for the prediction of visual results after cataract surgery in cases with preoperatively proved or doubtful macular pathology. To the best of our knowledge, this is the first report regarding the sensitivity and specificity of the PAM in diseased or suspicious maculas associated with cataract.

Profitability analysis of a femtosecond laser system for cataract surgery using a fuzzy logic approach

AIM

To define the financial and management conditions required to introduce a femtosecond laser system for cataract surgery in a clinic using a fuzzy logic approach.

METHODS

In the simulation performed in the current study, the costs associated to the acquisition and use of a commercially available femtosecond laser platform for cataract surgery (VICTUS, TECHNOLAS Perfect Vision GmbH, Bausch & Lomb, Munich, Germany) during a period of 5y were considered. A sensitivity analysis was performed considering such costs and the countable amortization of the system during this 5y period. Furthermore, a fuzzy logic analysis was used to obtain an estimation of the money income associated to each femtosecond laser-assisted cataract surgery (G).

RESULTS

According to the sensitivity analysis, the femtosecond laser system under evaluation can be profitable if 1400 cataract surgeries are performed per year and if each surgery can be invoiced more than $500. In contrast, the fuzzy logic analysis confirmed that the patient had to pay more per surgery, between $661.8 and $667.4 per surgery, without considering the cost of the intraocular lens (IOL).

CONCLUSION

A profitability of femtosecond laser systems for cataract surgery can be obtained after a detailed financial analysis, especially in those centers with large volumes of patients. The cost of the surgery for patients should be adapted to the real flow of patients with the ability of paying a reasonable range of cost.

On the spectroscopic analyses of 3-(4-Hydroxy-1-methyl-2-oxo-1,2-dihydro-quinolin-3-yl)-2-nitro-3-oxo-propionic acid (HMQNP)

In the present work, a combined experimental and theoretical study on molecular structure and vibrational frequencies of HMQNP were reported. The FT-IR spectrum of HMQNP is recorded in the solid phase. The equilibrium geometries, harmonic vibrational frequencies, thermo-chemical parameters, total dipole moment, nuclear repulsion energy and HOMO-LUMO energies are calculated by DFT/B3LYP utilizing 6-311G(d,p) basis set. Results showed that HMQNP possesses a high dipole moment value of 9.3 Debye. HMQNP spin is doublet state which enhances frontier molecular orbitals to split into alpha (spin ↑) and beta (spin ↓) molecular orbitals with two different energy gaps 4.2 and 2.7 eV, respectively. HMQNP is highly recommended to be a more promising structure for many applications in optoelectronic devices such as solar cells.

Detection of cytogenetics abnormalities in chronic lymphocytic leukemia using FISH technique and their prognostic impact

INTRODUCTION

Chronic lymphocytic leukemia (CLL) is a clonal lymphoproliferative disorder characterized by progressive accumulation of morphologically and immunophenotypically mature lymphocytes. Characterization of genomic aberrations may help to understand the pathogenesis of CLL and may give prognostic information independent from conventional clinical markers for a risk-adapted management of CLL patients.

AIM

The aim of the present study is to determine the most common cytogenetics abnormalities between patients with CLL and its prognostic impact.

PATIENTS AND METHODS

The present study was carried out on 20 adult patients presented with chronic lymphocytic leukemia. The patients were diagnosed on the basis of standard clinical (lymph node involvement and/or hepatosplenomegaly), hematological and immunophenotypic criteria for diagnosis of B-CLL. All cases were studied at the time of their diagnosis. FISH technique was successfully performed on PB samples using CLL LSI probes for ATM (11q22) / GLI (12q13) and 13q14/ p53 (17p13).

RESULTS

For comparative statistical studies, the patients were divided into group I (patients with favorable outcome) and group II (patients with unfavorable outcome). All patients showed one or more cytogenetic abnormality with the prevalence of p53 in 16 patients out of 20 that perfectly correlated with the poor outcome of the patients. This is followed by deletion in the 13q14 and to a lesser extent deletion in ATM gene, but no one has exhibited amplification in the 12q13 locus.

CONCLUSION

p53 deletion as a sole abnormality has a higher prognostic power than other cytogenetics abnormalities. The cytogenetics study using FISH panel for CLL patients in a complementary fashion to the other clinical and laboratory findings may overcome the pitfalls in the diagnosis and may also assess the assignment of therapeutic protocols for CLL patients according to the results of their cytogenetic analysis at the time of diagnosis.

KEYWORDS

FISH, chronic lymphocytic leukemia, CLL, p53, cytogenetics, Egypt.

Closed kinetic chain exercises with or without additional hip strengthening exercises in management of patellofemoral pain syndrome: a randomized controlled trial

BACKGROUND

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor. Isolated open kinetic chain hip abductors and lateral rotators exercises were added by many authors to the rehabilitation program. However, Closed Kinetic Chain (CKC) exercises focusing on hip and knee muscles were not investigated if they can produce similar effect of hip strengthening and decreasing pain without the need of isolated exercises for hip musculature.

AIM

The aim of the present study was to determine the effect of a CKC exercises program with or without additional hip strengthening exercises on pain and hip abductors and lateral rotators peak torque.

DESIGN

Prospective randomized clinical trial.

SETTING

Patients with patellofemoral pain syndrome referred to the outpatient physical therapy clinic of the faculty of physical therapy, cairo university.

POPULATION

Thirty two patients who had patellofemoral pain syndrome with age ranged from eighteen to thirty years.

METHODS

Patients were randomly assigned into two groups: CKC group and CKC with hip muscles strengthening exercises as a control (CO) group. Treatment was given 3 times/week, for 6 weeks. Patients were evaluated pre- and post-treatment for their pain severity using VAS, function of knee joint using Kujala questionnaire, hip abductors and external rotators concentric/eccentric peak torque.

RESULTS

There were significant improvements in pain, function and hip muscles peak torque in both groups (P<0.05). However, there was no statistically significant difference between groups in hip muscles torque (P<0.05) but pain and function improvements were significantly greater in the CO group (P<0.05).

CONCLUSION

Six weeks CKC program focusing on knee and hip strengthening has similar effect in improving hip muscles torque in patients with PFPS as a CKC exercises with additional hip strengthening exercises. However, adding isolated hip strengthening exercises has the advantage of more pain relief.

CLINICAL REHABILITATION IMPACT

CKC exercises with additional hip strengthening could be more beneficial in decreasing pain in PFPS than CKC exercises alone.

FT-IR spectroscopic analyses of 4-hydroxy-1-methyl-3-[2-nitro-2-oxoacetyl-2(1H)quinolinone (HMNOQ)

In the present work, a combined experimental and theoretical study on molecular structure and vibrational frequencies of 4-hydroxy-1-methyl-3-[2-nitro-2-oxoacetyl-2(1H)quinolinone (HMNOQ) was reported. The FT-IR spectrum of HMNCQ is recorded in the solid phase. The equilibrium geometries, harmonic vibrational frequencies, thermo-chemical parameters, total dipole moment and HOMO-LUMO energies are calculated by density functional theory DFT/B3LYP utilizing 6-311G(d,p) basis set. Results showed that HMNOQ is highly recommended to be a promising structure for many applications in optoelectronic devices due to its high calculated dipole moment value (9 Debye) which indicates its high reactivity to interact with the surrounding molecules. The HOMO-LUMO energy gap of HMNOQ is 4 eV.

Socio–economic and behavioural factors affecting the prevalence ofAscarisinfection in a low-country tea plantation in Sri Lanka

The identification of the factors that affect the prevalences of geohelminthiases should help to maximize the effectiveness of programmes for the control of these diseases. In the present study, the relationships between the prevalence and intensity of human infection with Ascaris and the availability of sanitary facilities, socio-economic status and personal health habits have been explored in Sri Lanka. The 176 subjects, who lived on a low-country tea plantation, were aged 2-50 years (median = 13 years) and were investigated between the July and December of 2000. When the prevalence and intensity of Ascaris infection were determined, using Kato-Katz smears, 50.0% of the subjects were found to be secreting the eggs of the parasite. Almost all (96.6%) of the subjects lived in terraces of one-room houses built by the plantation owners, and only 30.7% had access to a latrine. Most (90.3%) obtained their drinking water from common taps, and 48.8% boiled their drinking water. The subjects who only drank water that had been boiled and those who washed their hands before meals were relatively unlikely to be infected (P < 0.05 for each). In congested living conditions with poor sanitary facilities, the level of faecal contamination of the environment is invariably high. Even under these conditions, however, good hygiene and the boiling of all drinking water can reduce the risks of Ascaris infection. In the study setting and in similar environments, regular anthelmintic therapy, improvements in housing conditions and sanitary facilities, and health education, to promote risk-reducing patterns of behaviour, would all be beneficial.

Growth advantage of CD34+ cells in trisomy 8 high-risk myelodysplastic syndrome despite enhanced apoptotic signals

This study examined haematopoietic stem cells of 19 high-risk cases of myelodysplastic syndrome (MDS) for apoptotic and anti-apoptotic signals and cellular proliferation and correlated these with clinical and cytogenetic subtypes, particularly trisomy 8. The aim was to identify cellular and cytogenetic markers of prognostic relevance to survival of high-risk MDS cases. High-risk MDS cases had a significantly higher percentage of apoptotic CD34+ cells and anti-apoptotic survivin+ cells than controls, particularly for trisomy 8 cases. Trisomy 8+ cells showed a significant positive correlation with apoptotic CD34+ cells and capacity for colony formation. The latter was significantly lower in trisomy-8-negative cases than normal controls, while that oftrisomy 8 cases was comparable to controls. Our results suggest that although trisomy 8 cells are in a pro-apoptotic state, they are checked by the enhanced expression of anti-apoptotic signals which provide them with their proliferative advantage.

Disposition kinetics of doxycycline in chickens naturally infected with Mycoplasma gallisepticum

1. The pharmacokinetic properties of doxycycline were determined in healthy chickens and chickens naturally infected with Mycoplasma gallisepticum after a single intravenous (i.v.) and oral administration of the drug at 20 mg/kg body weight. Tissue residues of the tested drug after an oral dose of 20 mg/kg given twice daily for 5 consecutive days were also estimated in diseased chickens. 2. The plasma concentrations of doxycycline following single i.v. and oral administration were higher in healthy chickens than in diseased ones. Following i.v. injection, the elimination half-life (t1/2beta), distribution half-life and mean residence time (MRT) were longer in healthy chickens than in diseased birds. The values of total body clearance (ClB) and volume of distribution (Vdss) were larger in healthy chickens than in diseased birds. 3. After single oral administration, the absorption half-life (tl/2ab) and the elimination half-life were longer in normal birds than in diseased ones. The maximum plasma concentration of the drug was higher in normal chickens than in diseased ones. 4. Following repeated oral administration, the concentration of doxycycline in all tissues except muscle was higher than the corresponding concentrations in plasma. Concentrations of doxycycline in different tissues were in the following order: kidney > liver > lung > muscle. The drug was detected in liver and kidney in substantial concentrations on d 5 post administration of the last dose whereas, on d 7, its concentration in all tissues was below the lower limit of the sensitivity of the assay method used. Because of the low sensitivity of the microbiological assay method used in this study, a safe withdrawal time for doxycycline in diseased birds could not be estimated for the meanwhile.

Prognostic value of daily cardiac surgery score (CASUS) and its derivatives in cardiac surgery patients

BACKGROUND

We aimed to validate the usefulness of CASUS derivatives for cardiac surgery patients and their reliability for daily decision making.

METHODS

We included, prospectively, the data of all adult cardiac surgery patients who had an ICU stay of at least 12 hours between 20 January 2003 and 14 October 2005 in the Department of Cardiothoracic Surgery of the University of Cologne, Germany. Data were collected until ICU discharge and included initial, maximum, mean, and total CASUS values. δ CASUS (difference from initial value) was calculated at 48 and 96 hours postoperatively. The predictive efficacy of the derivatives was tested with calibration and discrimination statistics.

RESULTS

2372 patients were included with a mean age of 66.2 ± 11.2 years. ICU mortality was 3.6 % (n =85). Mean ICU stay was 3.0 ± 6.1 days. The discrimination was very good for all derivatives (area under the curve ranged between 0.988 and 0.926). The calibration was also good except for the total CASUS, which showed a significant difference between the expected and observed mortality. Increased δ CASUS at 48 hours (1038 patients) and 96 hours (435 patients) correlated with an increase in mortality (23.1 % and 42.9 %, respectively), and conversely a decreased mortality rate was observed with decreasing values (1.9 % and 3.8 %, respectively).

CONCLUSION

CASUS derivatives including δ CASUS have a good prognostic value for cardiac surgery patients with regard to the prediction of mortality and survival during ICU stay, with the exception of total CASUS which was not informative.

Cardiotoxicity of Freon among refrigeration services workers: comparative cross-sectional study

BACKGROUND

Freon includes a number of gaseous, colorless chlorofluorocarbons. Although freon is generally considered to be a fluorocarbon of relatively low toxicity; significantly detrimental effects may occur upon over exposure. The purpose of the present study is to investigate whether occupational exposure to fluorocarbons can induce arterial hypertension, myocardial ischemia, cardiac arrhythmias, elevated levels of plasma lipids and renal dysfunction.

METHODS

This comparative cross-sectional study was conducted at the cardiology clinic of the Suez Canal Authority Hospital (Egypt). The study included 23 apparently healthy male workers at the refrigeration services workshop who were exposed to fluorocarbons (FC 12 and FC 22) and 23 likewise apparently healthy male workers (unexposed), the control group. All the participants were interviewed using a pre-composed questionnaire and were subjected to a clinical examination and relevant laboratory investigations.

RESULTS

There were no significant statistical differences between the groups studied regarding symptoms suggesting arterial hypertension and renal affection, although a significantly higher percentage of the studied refrigeration services workers had symptoms of arrhythmias. None of the workers had symptoms suggesting coronary artery disease. Clinical examination revealed that the refrigeration services workers had a significantly higher mean pulse rate compared to the controls, though no significant statistical differences were found in arterial blood pressure measurements between the two study groups. Exercise stress testing of the workers studied revealed normal heart reaction to the increased need for oxygen, while sinus tachycardia was detected in all the participants. The results of Holter monitoring revealed significant differences within subject and group regarding the number of abnormal beats detected throughout the day of monitoring (p < 0.001). There were no significant differences detected in the average heart rate during the monitoring period within subject or group. Most laboratory investigations revealed absence of significant statistical differences for lipid profile markers, serum electrolyte levels and glomerular lesion markers between the groups except for cholesterol and urinary beta2-microglobulin (tubular lesion markers) levels which were significantly elevated in freon exposed workers.

CONCLUSIONS

Unprotected occupational exposure to chlorofluorocarbons can induce cardiotoxicity in the form of cardiac arrhythmias. The role of chlorofluorocarbons in inducing arterial hypertension and coronary artery diseases is unclear, although significantly elevated serum cholesterol and urinary beta2-microglobulin levels raise a concern.

Anthelmintic prescribing patterns of a sample of general practitioners from selected areas in the Colombo district of Sri Lanka

General Practitioners (GPs) provide first contact care of children and pregnant mothers in the community. This study ascertained the prescribing pattern of anthelmintics to children and pregnant women by a sample of GPs from the district of Colombo. Two hundred medical practitioners engaged in full-time General Practice (100 urban and 100 rural), were selected randomly. A pre-tested interviewer-administered questionnaire was used to collect data. A total of 183 GPs aged between 26 and 72 years (median 38) participated with 94 coming from urban areas. Seventy percent of the GPs were male. Almost 13% of GPs from urban areas had a Postgraduate degree in comparison to 4.5% from the rural areas (P < 0.05). Over 50% of GPs had 6-20 years of service and over 30% treated 16-30 patients daily. Seventy-three percent of GPs from rural areas accessed health-related reading material either daily or weekly in contrast to only 40% from urban areas (P < 0.001). All GPs prescribed anthelmintics to children. Pyrantel pamoate was the preferred anthelmintic used for children by both groups. Approximately 55% and 64% of GPs from urban and rural areas, respectively, prescribed anthelmintics during pregnancy. A majority of GPs prescribed drugs after the first trimester. However, 25% from urban areas gave drugs during any trimester (P < 0.001). Regression analysis revealed that GPs with postgraduate qualifications, those having frequent access to health-related material and those seeing more than 30 patients daily, prescribed anthelmintics to pregnant women more often. Although routine de-worming of pregnant women and children should occur through government antenatal and well-baby clinics, and through the schools de-worming programme, it may not happen due to various reasons. Thus, GPs play a vital role in achieving good coverage of anthelmintics among children and pregnant women. Making available clear national guidelines on prescribing anthelmintics in Sri Lanka would improve the prescribing patterns of anthelmintics among GPs.

Impact of the 2004 mass drug administration for the control of lymphatic filariasis, in urban and rural areas of the Western province of Sri Lanka

Lymphatic filariasis is targeted to be eliminated globally, at least as a public-health problem, by 2020. The comprehensive strategy for achieving this goal includes the interruption of the transmission of the causative parasites, by drastically reducing the prevalences of microfilaraemia in at-risk communities. In a descriptive, comparative, cross-sectional and community-based study, the impact of the 2004 mass drug administration (MDA) on filarial infection, in selected areas of the Western province of Sri Lanka, has now been assessed 1-2 and 11 months after the administration of the diethylcarbamazine-albendazole combination employed. Using the cluster-sampling method, urban study populations were selected in the Colombo districts and rural ones were selected in the Gampaha district. After obtaining informed written consent, 2 ml venous blood were collected, between 20.00 and 24.00 hours, from each subject. Personal details and drug compliance in the 2004 MDA were recorded. The samples of 'night' blood were checked for microfilariae, using membrane filtration, and for filarial antigenaemia, using commercial (NOW) immunochromatographic test kits. Eighty-four (4.10%) of the 2034 subjects examined 1-2 months after the 2004 MDA but only four (0.20%) of the 1974 subjects checked 11 months after the MDA were found antigenaemic and/or microfilaraemic (P<0.001). Between the two follow-ups, the overall prevalences of both antigenaemia (4.03% v. 0.15%; P<0.001) and microfilaraemia (0.20% v. 0.05%; P=0.38) fell, although only the reduction in antigenaemia was statistically significant. The prevalence of infection (as indicated by antigenaemia and/or microfilaraemia) fell significantly within each of the two study districts (P<0.001). Although, when the prevalence of infection was high, drug compliance appeared to be an important determinant of the reduction of antigenaemia (P=0.04), the 20% difference in compliance between urban and rural areas had no apparent effect on the corresponding prevalences of infection recorded at either follow-up.

Immunodiagnosis of bancroftian filariasis

The development of immunodiagnostic tests (IDTs) for bancroftian filariasis must be aimed at defined objectives, such as the determination of exposure rates, the detection of microfilaraemia and the diagnosis of clinical filariasis. Assays for both antibody and antigen detection are necessary. Antigen determination may be more appropriate in the detection of microfilaraemia, but for clinical filariasis, antibody determination may prove more useful. The microfilarial surface antigens are very good candidates for this purpose. Determination of antibody to larval antigens may be the best way of establishing exposure rates for epidemiological purposes. An important prerequisite for IDT development is the characterization of antigens at epitope level. Sharing of antigen epitopes with host antigens could be a major limitation in IDT development. An understanding of the parasitological and immunological background of the endemic locality is also necessary. It is recommended that all IDTs are evaluated in follow-up case studies.

Correction of hyperopia by intracorneal lenses: two-year follow-up

PURPOSE

To assess the safety and efficacy of intracorneal lenses as a surgical alternative for the correction of hyperopia.

SETTING

Al-Azhar University and El Magrabi Eye Hospital, Cairo, Egypt.

METHODS

Twenty-three eyes of 21 patients who had a mean hyperopia of 4.3 diopters (D) +/- 0.71 (SD) (range +2.5 to +6.0 D) received Permavision lenses (Anamed Inc.), which are made of a highly permeable hydrogel with a water content of 78% and a refractive index close to that of corneal tissue (1.376). The Moria M2 microkeratome was used to make a 160 microm corneal flap with a diameter of +/-8.5 mm. The intracorneal lens was placed beneath the flap after minimal interface irrigation.

RESULTS

Clinical examination showed mild corneal edema and a myopic shift during the first week postoperatively. In 17 eyes (73.9%), the postoperative uncorrected visual acuity was similar to the preoperative best corrected visual acuity (BCVA); 1 eye (4.3%) lost 1 line of preoperative BCVA. In 5 eyes (21.7%), various degrees of lens opacification with some degree of corneal haze were seen after uneventful follow-up. Decentration of 0.5 to 1.0 mm was seen in 2 eyes (8.6%), 1 of which had the lens explanted because of significant opacification. Induced astigmatism was evident in 1 eye (-1.5 D). A total of 16 eyes (69.6%) were within +/-0.5 D of target, and 20 eyes (86.9%) were within +/-1.0 D (87%). No flap melting or extrusion of the lens was recorded in 24 months of follow-up. Night halos and glare were reported in 3 eyes; all had a lens diameter of 5.0 mm.

CONCLUSIONS

Intracorneal hydrogel lenses were tolerated relatively well by stromal tissue, providing a reasonably stable and predictable way to correct moderate hyperopia. However, induced astigmatism, stromal opacification, decentration, and night halos and glare occurred in a significant number of eyes. To ensure safety, deep flap cuts are preferred and these eyes should be watched carefully to avoid decentration of the lens in the early postoperative period.

Synthesis and evaluation of 2,6-piperidinedione derivatives as potentially novel compounds with analgesic and other CNS activities

New 2,6-piperidinediones 2(a-g) and 4(a-d) were prepared by initial condensation of aromatic aldehydes or cycloalkanones with cyanoacetamide to give alpha-cyanocinnamides l(a-g) or cycloalkylidenes 3(a,b) which underwent Michae1 addition with ethyl cyanoacetate or diethylmalonate. Compounds 4(a-d) were alkylated by various alkyl halides to produce the N-alkylated 2,6-piperidinedione derivatives 5(a-m). Some new selected compounds 2(a-c,f), 4(a-d) and 5(e,h,j) were pharmacologically evaluated for potential anticonvulsant, sedative and analgesic activities. These compounds exhibited significant anticonvulsant and analgesic effects after a single I.P. administration 100 mg/kg b.wt. On the other hand all the investigated compounds induced hypnotic activity and prolonged the phenobarbital sodium- induced sleep as compared with the control group and the most potent compound was found to be 2(f).

LASIK Using the NIDEK EC-5000 for the Correction of Hyperopic Astigmatism

PURPOSE

To assess the refractive outcomes of LASIK for the surgical correction of hyperopic astigmatism using the NIDEK EC-5000 excimer laser.

METHODS

LASIK was performed on 46 eyes from 26 patients (19 men and 7 women) for the correction of congenital hyperopic astigmatism. The NIDEK EC-5000 excimer laser and the Moria M2 microkeratome were used in all procedures. Cylindrical ablations were performed on the negative axis out to a 6-mm diameter.

RESULTS

The mean preoperative cylindrical refraction was +3.15+/-0.70 diopters (D) (range: +1.75 to +4.50 D), and the mean 24-month postoperative refraction was +1.27+/-0.78 D (range: +0.50 to +3.25 D). Vector analysis showed a 2.17+/-1.27 D reduction in the equivalent cylinder. Preoperative mean uncorrected visual acuity (UCVA) was 20/100, and 24-month postoperative UCVA was 20/30. One eye lost one line of best spectacle-corrected visual acuity at 24 months postoperatively. Complications related to the LASIK flap occurred in 2 (4.3%) eyes. Partial regression of the astigmatic effect began at 4 to 6 months but stabilized by 1 year.

CONCLUSIONS

LASIK is a safe but limited alternative for the correction of astigmatism in eyes with hyperopic astigmatism. Early regression of the astigmatic effect in the first 6 months seems to be the primary disadvantage of this technique.

Effects of climatic, socio-economic and behavioural factors on the transmission of hookworm (Necator americanus) on two low-country plantations in Sri Lanka

The climatic, socio-economic and behavioural factors influencing hookworm (Necator americanus) infection in Sri Lanka were explored between February 2000 and June 2001. In February 2000, a single stool sample was collected from each of the 477 subjects investigated, who were aged 2-74 years (median = 13 years) and lived on the 'lowcountry' Maliboda and Ayr plantations. The 'baseline' prevalence (28.5%) and intensity of hookworm infection (0- 4828.5 eggs/g faeces, with a mean of 128.4 eggs/g) were then determined by examining these initial samples, as Kato-Katz smears. Subsequently, each participant was treated with a single, 500-mg dose of mebendazole and then followed-up, at monthly intervals, for the next 15 months. Whenever a subject was found smear-positive for hookworm eggs at one of the monthly follow-ups, he or she was treated again with mebendazole. This approach allowed the monthly incidence of hookworm infection to be determined for each subject, assuming that subjects became smear-positive approximately 6 weeks post-infection. During the study period, rainfall and mean temperature were recorded daily and then converted to monthly values so that the relationship between the incidence of infection over each month and the rainfall and mean temperature over the same period could be explored. In addition, potentially relevant data on the socio-economic status and behaviour of each subject were collected, in questionnaire-based interviews with the adult subjects and the caregivers of the children investigated. Odds ratios (OR) and their 95% confidence intervals (CI) were then calculated for each factor that might increase the risk of hookworm infection. The monthly incidence of hookworm infection showed three peaks -- in September 2000 (21.3%), January 2001 (20.8%) and May 2001 (17.5%) -- at Maliboda, and two peaks -- in September 2000 (25.0%) and February 2001 (29.2%) -- at Ayr. With the data for all subjects combined, incidence showed a statistically significant correlation with mean temperature (r = -0.468; P = 0.018). The results of a multivariate analysis also revealed that mean temperature was significant (beta = -5.296; P = 0.01) in hookworm incidence. Bathing and washing with water from rock-pools formed by waterfalls (OR = 1.33; CI = 1.35-4.01), the use of wells (OR = 2.35; CI = 1.29-4.30), and a lack of toilets (OR = 1.60; CI = 1.01-2.53) each appeared to increase the risk of hookworm infection significantly. Those living on the two study plantations, and perhaps many other similar plantations in Sri Lanka, would clearly benefit from improved access to the public water supply (especially to pipe-borne water) and toilets.

Development of antigen-capture enzyme-linked immunosorbent assay and RT-PCR for detection of turkey astroviruses

Turkey astrovirus (TAstV) is an important agent of poult enteritis. The diagnosis of astroviruses has been dependent mainly on electron microscopy (EM) or immune EM (IEM). To develop other simple, rapid, and reliable diagnostic assays, two antigen-capture enzyme-linked immunosorbent assays (AC-ELISAs), polyclonal AC-ELISA and monoclonal AC-ELISA, were developed in this study. Monoplex and multiplex reverse transcription-polymerase chain reactions (RT-PCRs) were also developed using nondegenerate primer sets specific to the capsid region and degenerate primer pairs specific to the polymerase area of two TAstV. EM was included for comparison. Fecal or intestinal contents samples from naturally and experimentally infected poults with enteritis were examined using the developed assays. The polyclonal AC-ELISA had higher sensitivity and wider detection spectrum than the monoclonal AC-ELISA with group-specific monoclonal antibody (MAb), whereas the monoclonal AC-ELISA had very high specificity but lower sensitivity, which was estimated at 0.06 microg of viral proteins. Small round viruses (SRV) that could be astroviruses or other small viruses were detected in 34.4% of the samples examined by EM. The monoplex RT-PCR results amplified with primers SRV-1-3 and SRV-1-5 revealed that the positive rate of astroviruses was 45.3%, which was 10.9% higher than that of EM even if other SRVs were not excluded. Multiplex RT-PCR with SRV-1-3 and SRV-1-5 and AFCP-F1 and AFCP-R1 and the monoplex RT-PCR with degenerate primers verified that the positive rate of astroviruses was 59.4%, which was 25% higher than that of EM. Both RT-PCRs showed good specificity and wider detection spectrum compared with earlier published data.

Pharmacokinetics, Urinary and Mammary Excretion of Ceftriaxone in Lactating Goats

The pharmacokinetic properties of ceftriaxone were investigated in 10 goats following a single intravenous (i.v.) and intramuscular (i.m.) administration of 20 mg kg(-1) body weight. After i.v. injection, ceftriaxone serum concentration-time curves were characteristic of a two-compartment open model. The distribution and elimination half-lives (t(1/2alpha), t(1/2beta)) were 0.12 and 1.44 h respectively. Following i.m. injection, peak serum concentration (C(max)) of 23.6 microg ml(-1) was attained at 0.70 h. The absorption and elimination half-lives (t(1/2ab), t(1/2el)) were 0.138 and 1.65 h respectively. The systemic bioavailability of the i.m. administration (F %) was 85%. Following i.v. and i.m. administration, the drug was excreted in high concentrations in urine for 24 h post-administration. The drug was detected at low concentrations in milk of lactating goats. A recommended dosage of 20 mg kg(-1) injected i.m. every 12 h could be expected to provide a therapeutic serum concentration exceeding the minimal inhibitory concentrations for different susceptible pathogens.

Disposition kinetics, bioavailability and renal clearance of cefepime in calves

The pharmacokinetics of cefepime were studied following intravenous and intramuscular administration of 6.5 mg/kg in four female Friesian calves. Following single intravenous administration, the serum concentration-time curves of cefepime were best fitted using a two-compartment open model. The elimination half-life (t(1/2)beta) was 2.38+/-0.16 h, volume of distribution at steady state (Vdss) was 0.21 +/- 0.01 L/kg, and total body clearance (ClB) was 1.1 +/- 0.08 ml/min per kg. Following intramuscular administration, the drug was rapidly absorbed with an absorption half-life (t(1/2)ab) of 0.29+/-0.02 h; maximum serum concentration (Cmax) of 21.7 +/- 1.1 microg/ml was attained after (Tmax) 1.1 +/- 0.08 h; and the drug was eliminated with an elimination half-life (t(1/2)el) of 3.02 +/- 0.18 h. The systemic bioavailability (F) after intramuscular administration of cefepime in calves was 95.7% +/- 7.44%. The in vitro serum protein-binding tendency was 10.5-16.7%. Following administration by both routes, the drug was excreted in high concentrations in urine for 24 h post administration.

Wet-days: are they better indicators of Ascaris infection levels?

Seasonal variation in a particular area may influence the occurrence of helminth infections and determining such fluctuations may help to maximize the beneficial effects of mass treatment. This study determined the seasonal variations in infection levels of Ascaris lumbricoides between March 2000 and June 2001 in two selected low-country plantations. Four hundred and seventy seven persons aged between 2 and 74 years (median 13) participated. Stools were tested using the Kato-Katz method and the prevalence and intensity of infection determined. All persons were treated with a single dose of mebendazole. Monthly follow-ups were undertaken with similar stool examinations and treatment given if found positive. Infection and re-infection rates were calculated each month. Rainfall and temperature were recorded each day. Total rainfall, number of wet-days and mean temperature was calculated for each month. The prevalence of Ascaris infection was 53.4% and 51.0% at Maliboda and Ayr estates respectively. Highest infection and re-infection rates at Maliboda (37.7%, 37.2%) occurred in June and at Ayr (13.3%, 25.9%) in October 2000 respectively. During the study period, the mean rainfall was 28.1 cm (range 7.4-63.9 cm) and mean temperature 27.6 degrees C (range 22.1 degrees -34.4 degrees C). Significant correlations (P<0.05) were found between the re-infection rate and rainfall, temperature and the number of wet-days. Similar correlations were observed with the infection rate and temperature and the number of wet-days. Ascaris infections were found to correlate significantly only with the number of wet-days in a month (P<0.01). Thus, the number of wet-days appears to be a better indicator of Ascaris infections than total rainfall or mean temperature.

Pathogenicity of turkey coronavirus in turkeys and chickens

We designed this study to compare the replication potential of turkey coronavirus (TCV) and its effect in chickens and turkeys and to study the effect of singleand combined infection of turkey poults with TCV and astrovirus. We studied the pathogenicity of TCV in experimentally inoculated turkey poults and chickens by observing the dinical signs and gross lesions. Two trials were conducted with 1-day-old and 4-wk-old specific-pathogen-free turkey poults and chickens. One-day-old turkey poults developed diarrhea at 48 hr postinoculation. Poults euthanatized at 3, 5, and 7 days postinoculation had flaccid, pale, and thin-walled intestines with watery contents. The 4-wk-old turkeys had no clinical signs or gross lesions. One-day-old and 4-wk-old chicks developed no clinical signs or gross lesions although the TCV was detected in gut contents of the birds throughout the experimental period (14 days). In another experiment, mean plasma D-xylose concentrations in 3-day-old turkey poults inoculated with TCV, turkey astrovirus, or a combination of both viruses were significantly lower than in the uninoculated controls.

Correction of hyperopia with intracorneal implants

PURPOSE

To evaluate the safety and efficacy of intracorneal lenses as a surgical alternative for the correction of hyperopia.

SETTING

Al-Azhar University, Cairo, Egypt, and Louisiana State University Eye Center, New Orleans, Louisiana, USA.

METHODS

PermaVision lenses (Anamed Inc.) were implanted in the left eye of 20 albino rabbits that were followed for 6 months by confocal microscopy. The lenses are made of a highly permeable hydrogel with 70% water content and a refractive index close to that of corneal tissue (1.376). The Carriazo-Barraquer microkeratome (Moria) was used to create a 150 microm corneal flap with a diameter of 8.5 mm or larger. The intracorneal lens was placed under the flap after minimal interface irrigation.

RESULTS

At 3 days, confocal microscopy showed interface edema that resolved after 1 week. No flap melting or excursion of the lens was noted. In 1 eye, a deep lamellar keratitis was seen. At 6 months, the edge of the lens showed excellent compatibility, with no keratocytic activity or intrastromal fibrosis.

CONCLUSIONS

Intracorneal hydrogel lenses were well tolerated by stromal tissue in rabbits. They are potentially safe and can be considered as an alternative for the correction of hyperopia. Further clinical studies are required to confirm their safety in humans.

Antigenic and genomic relatedness of turkey-origin coronaviruses, bovine coronaviruses, and infectious bronchitis virus of chickens

In earlier studies in our laboratory, we found that bovine coronavirus (BCV) was pathogenic for 1-day-old turkey poults. This finding prompted us to study the antigenic and genomic relatedness of turkey origin coronaviruses (TOCVs) to BCV. A one-step reverse transcription (RT)-polymerase chain reaction (PCR) targeting a 730-base pair fragment of the nucleocapsid (N) gene of BCV and a nested PCR targeting a 407-base pair fragment of the N gene were used in an attempt to detect TOCV from North Carolina, Indiana, and a prototype turkey coronavirus (TCV) obtained from the American Type Culture Collection. Both the one-step RT-PCR and the nested PCR amplified cell culture-passaged isolates of calf diarrhea strains of BCV but none of the 15 tested TOCVs or transmissible gastroenteritis coronavirus of swine. TOCVs also did not cross-react in a BCV antigen-capture (AC) enzyme-linked immunosorbent assay (ELISA) system with monoclonal antibodies (MAbs) against N, spike glycoprotein, and hemagglutinin esterase glycoprotein proteins of BCV as coating antibodies. The same TOCVs could be detected with primers designed from the genome of infectious bronchitis virus (IBV) of chickens. These primers amplified a 1082-base pair region spanning portions of the membrane glycoprotein (M) and N protein genes of IBV and TCV. The TOCVs also cross-reacted in an AC-ELISA with MAbs against the M and subunit 2 of spike glycoprotein of IBV.

An analysis of the safety of the single dose, two drug regimens used in programmes to eliminate lymphatic filariasis

This review of the safety of the co-administration regimens to be used in programmes to eliminate lymphatic filariasis (albendazole + ivermectin or albendazole + diethylcarbamazine [DEC]) is based on 17 studies conducted in Sri Lanka, India, Haiti, Ghana, Tanzania, Kenya, Ecuador, the Philippines, Gabon, Papua New Guinea, and Bangladesh. The total data set comprises 90,635 subject exposures and includes individuals of all ages and both genders. Results are presented for hospital-based studies, laboratory studies, active surveillance of microfilaria-positive and microfilaria-negative individuals, and passive monitoring in both community-based studies and mass treatment programmes of individuals treated with albendazole (n = 1538), ivermectin (9822), DEC (576), albendazole + ivermectin (7470), albendazole + DEC (69,020), or placebo (1144). The most rigorous monitoring, which includes haematological and biochemical laboratory parameters pre- and post-treatment, provides no evidence that consistent changes are induced by any treatment; the majority of abnormalities appear to be sporadic, and the addition of albendazole to either ivermectin or DEC does not increase the frequency of abnormalities. Both DEC and ivermectin show, as expected, an adverse event profile compatible with the destruction of microfilariae. The addition of albendazole to either single-drug treatment regimen does not appear to increase the frequency or intensity of events seen with these microfilaricidal drugs when used alone. Direct observations indicated that the level of adverse events, both frequency and intensity, was correlated with the level of microfilaraemia. In non microfilaraemic individuals, who form 80-90% of the 'at risk' populations to be treated in most national public health programmes to eliminate lymphatic filariasis (LF), the event profile with the compounds alone or in combination does not differ significantly from that of placebo. Data on the use of ivermectin + albendazole in areas either of double infection (onchocerciasis and LF), or of loiais (with or without concurrent LF) are still inadequate and further studies are needed. Additional data are also recommended for populations infected with Brugia malayi, since most data thus far derive from populations infected with Wuchereria bancrofti.

Long-term efficacy of single-dose combinations of albendazole, ivermectin and diethylcarbamazine for the treatment of bancroftian filariasis

In a 'blinded' trial (in Sri Lanka, 1996-98) of 47 male asymptomatic microfilaraemic subjects with Wuchereria bancrofti infection, the safety, tolerability and filaricidal efficacy of 3 single-dose combination regimens were compared: albendazole 400 mg with ivermectin 200 micrograms/kg, albendazole 400 mg with diethylcarbamazine citrate (DEC) 6 mg/kg or albendazole 600 mg with ivermectin 400 micrograms/kg. Treated subjects were followed-up for 24 months. This represents the first long-term study using combinations of albendazole with DEC or ivermectin in the above doses against bancroftian filariasis. All subjects had pre-treatment microfilaria (mf) counts over 100/mL. All 3 treatments significantly reduced mf counts, with the albendazole-DEC-treated group showing the lowest mf levels at 18 and 24 months post-treatment. Filarial antigen tests suggested that all 3 treatments had significant activity against adult W. bancrofti; albendazole-DEC combination had the greatest activity according to this test, with antigen levels decreasing to 30.5% of pre-treatment antigen levels, 24 months after therapy. All 3 treatments were clinically safe and well tolerated. These results suggest that a single dose of albendazole 400 mg together with DEC 6 mg/kg is a safe and effective combination for suppression of microfilaraemia of bancroftian filariasis that could be considered for use in filariasis control programmes based on mass treatment of endemic populations.

Protective effect of folinic acid on low-dose methotrexate genotoxicity

INTRODUCTION

Methotrexate (MTX) is an antineoplastic agent widely used in low dose to treat patients with rheumatoid arthritis (RA). Its side effects can partly be explained by folate antagonism. Folinic acid (Leucovorin) is generally administered with MTX to decrease MTX-induced toxicity. However information regarding the inhibitory effect of folinic acid against cytogenetic damage caused by MTX is limited. The aim of this study was to assess the protective effect of folinic acid against MTX-genotoxicity.

METHODS

This study was done on Wistar albino rats and in patients with RA. Forty rats of both sexes were randomized into four equal groups and dosed in the following way: Group-I, distilled water vehicle; Group-II, 0.5 mg/kg folinic acid; Group-III, 0.5 mg/kg MTX; Group-IV, 0.5 mg/kg folinic acid plus 0.5 mg/kg MTX. Doses were given i.p., once daily for 8 consecutive days. A bone marrow chromosomal study and a micronucleus test were performed for each rat. Twenty patients with RA (5 males and 15 females) on a 10 mg weekly dose of MTX, i.m., for one month, were administered the same dose of MTX in addition to 10 mg of folinic acid as a single dose 4 hours after MTX administration, i.m., every week for another 4 weeks. Chromosomal studies as well as a micronucleus test were evaluated for each patient.

RESULTS

MTX produced a significant genetic injury as proved by the increased incidence of chromosomal aberration and micronuclei formation in Group-III animals. Inversely, folinic acid (group IV) produced a significant protection against genetic damages induced by MTX. In RA patients, folinic acid provides satisfactory improvement of MTX-induced genetic damage.

CONCLUSION

Folinic acid has a protective affect against MTX genotoxicity in human as well as in animal models.

Experimental bovine coronavirus in turkey poults and young chickens

The DB2 calf strain of bovine coronavirus (BCV) was used to inoculate 1-day-old specific-pathogen-free (SPF) turkey poults in three trials. In all trials, the birds developed clinical signs of enteritis at 48-72 hr postinoculation. Birds euthanatized at 3, 5, and 7 days postinoculation (DPI) had flaccid, pale intestines with watery contents, and the ceca were markedly enlarged with frothy contents. Coronavirus particles were detected by immune electron microscopy with BCV antibodies from the intestinal contents of birds killed at 3, 5, 7, and 12 DPI. Body weights of inoculated poults killed at 3, 5, and 7 DPI were significantly reduced as compared with controls. Hemagglutinating antibodies were detected in sera of convalescent birds at 12 DPI. However, experimental inoculation of 1-day-old SPF chicks in two trials with the same virus resulted in no clinical signs or macroscopic or microscopic lesions. No coronaviruses were detected from intestinal contents, and there were no significant differences in body weights of inoculated and noninoculated control chicks.

[Experimental corneal histological study after thermokeratoplasty with holmium laser]

PURPOSE

To analyze the histological results after application of LTK (Laser Thermal Keratoplasty). These changes explain the considerable regression of the refractive effect obtained.

METHODS

This is an experimental study in 25 eyes of albino rabbits after application of LTK, using the contralateral as a control. The histopathological evaluation was done at 12 hours, one week, one month, 3 months and 6 months of LTK spot application using various corneal stains.

RESULTS

At 12 hours there appears an intense intercellular edema and basophylia on the impact area, covering 100% of the stroma. After the first week a hyperplasia of the epithelium was found. At the first month there exists a gradual decrease of the basophylia, but the abnormal stromal structure remains. Over the third month, the collagen becomes acidophilous and with a laxer structure, thus showing the formation of new collagen. These changes remain constant at the 6th month.

CONCLUSION

The non-contact LTK induces an intense tissular damage associated to an inflammatory reaction, prior to the formation of new collagen tissue, changing the anatomic image of the cornea. These changes cause the regression of the effect produced by the holmium laser.

A preliminary analysis of Wuchereria bancrofti microfilarial antigens for potential use in diagnosis

Several antigens from the microfilarial stage of Wuchereria bancrofti have been identified using immunoblots of microfilarial antigens and screening with immune sera and tropical pulmonary eosinophilia (TPE) sera. This analysis revealed an array of antigens with apparent molecular weights of 14kDa, 35kDa, 42kDa, 63kDa, 88kDa, 97kDa and 200kDa. Among these only the 14kDa and 42kDa antigens were consistently recognized by most of the immune sera. A 132kDa antigen was recognized only by TPE sera. Analysis of rabbit immune sera revealed that the 42kDa antigen was shared by two developmental stages of W. bancrofti, namely L3 and mF. This antigen could become a potential vaccine candidate. The 14kDa antigen seems specific for the microfilarial stage and therefore could be a diagnostic marker for active infection. The 132kDa antigen could aid in the diagnosis of TPE.

Viral agents associated with poult enteritis and mortality syndrome: the role of a small round virus and a turkey coronavirus

Intestinal samples from turkey poults affected with poult enteritis and mortality syndrome (PEMS) were examined for viruses by immune electron microscopy and double-stranded RNA virus genome electropherotyping. Turkey coronavirus (TCV), avian rotaviruses, reovirus, and a yet undefined small round virus (SRV) were detected. The SRV and TCV were isolated and propagated in turkey embryos. Challenge of specific-pathogen-free turkey poults with SRV, TCV, or both resulted in mortality and clinical responses similar to those of natural PEMS. Our experiments indicate that SRV and TCV are possibly important agents in the etiology of PEMS and the combination of these infections might result in outbreaks with high mortality. The severity of clinical signs and mortality of PEMS are postulated to be partly related to the virus agents involved in individual outbreaks.

A novel synthesis of dibenzo[c,f]chromenes, dibenzo[c,h]chromenes and benzo[7,8]chromeno[3,4-f]isoindoles as antimicrobial agents

Naphtho[2,1-b]pyranone (3) was allowed to react with arylmethylenemalononitriles to yield 4-amino-5-oxo-2-aryl-5H-dibenzo[c,f]chromene-3-carbonitriles (4a,b); with ethyl 3,4-dichlorobenzylidene cyanoacetate to furnish dibenzo[c,f]chromene (5) and with elemental sulfur in dioxane containing piperidine to give thieno[3,4-d]naphtho[2,1-b]pyranone (6). Similarly, naphtho[1,2-b]pyranone (7) was reacted with arylmethylenemalononitriles and elemental sulfur to furnish dibenzo[c,h]chromenes (8) and thieno[3,4-d]naphtho[1,2-b]pyranone (10), respectively. Compound 10 underwent cycloaddition with N-arylmaleimides to yield benzo[7,8]chromeno[3,4-f]isoindoles (11a-c). Some of these compounds were screened in vitro for their antimicrobial activities.

Randomly amplified polymorphic DNA (RAPD) polymerase chain reaction assay for identification of Schistosoma mansoni strains sensitive or tolerant to anti-schistosomal drugs

The genetic differences between Schistosoma mansoni strains from different geographic areas that were reportedly resistant or sensitive to anti-schistosomal drugs were studied with randomly amplified polymorphic DNA (RAPD) and simple sequence repeat (SSR) polymerase chain reaction (PCR) assays. Of the 20 RAPD primers we chose, 19 showed the capacity to produce a medium to high level of amplification and 6 revealed difference PCR bands between drug-resistant and drug-sensitive strains. One particular primer, 5'-CAGCGACAAG-3', showed 2 major difference bands between praziquantel (PZQ)-resistant and PZQ-sensitive strains from the endemic area of Egypt. These results demonstrate that defined sequence primers could be applied as a useful tool for differentiating drug-resistant and -sensitive schistosome parasites in the field.

Re-examination of the diagnostic criteria of tropical pulmonary eosinophilia

There is no agreement on the minimum absolute eosinophil count essential for the diagnosis of tropical pulmonary eosinophilia (TPE) at present. The aim of this study was to determine this figure as well as to evaluate the other diagnostic criteria of TPE. The response to diethylcarbamazine (DEC) was tested in 98 patients [of whom 79 (80.6%) completed the study] be means of clinical scores, lung function tests and the absolute eosinophil counts. The minimum absolute eosinophil count necessary for the diagnosis of TPE was found to be 3300 for two reasons. Firstly there was a marked fluctuation in the mean percentage change of the absolute eosinophil count after treatment with DEC, when it was below 3225 cells mm-3, while the mean percentage reduction showed a remarkable stability when the eosinophil count exceeded 3600. Secondly there was a marked difference in the response to DEC in patients whose eosinophil counts were above and below these values. All patients who had eosinophil counts greater than 3600 responded to DEC and were diagnosed as cases of TPE. All of them were from filarial endemic areas. The total eosinophil count decreased by a mean of 92.5%, 3 months after administration of DEC. The sensitivities of the following tests in TPE were as follows: filarial antibody test (FAT) 30%, radiological changes 45.5%, erythrocyte sedimentation rate (ESR) 80%. The radiological changes and the ESR, but not the FAT, were helpful in differentiating TPE from those patients with TPE-like symptoms but with lower eosinophil counts, e.g. those with asthma. Patients with cough who had eosinophil counts of between 53 and 2000 cells mm-3, showed elevated filarial antibody levels in a significant number of cases when compared to asymptomatic subjects. (P < 0.001). Five of them responded to DEC. Three of these had filarial antibody in their serum and one had bilateral mottling on chest X-ray. These results suggest that atypical cases of TPE may exist. Our study has shown that the diagnosis of TPE rests on the following criteria: cough worse at night; residence in a filarial endemic area; the eosinophil count greater than 3300 cells mm-3, clinical and haematological response to DEC. The diagnosis is supported by radiological changes and elevated ESR. The FAT is of little value. The clinical benefit and the improvement in lung function which follows the administration of DEC was sustained up to a minimum period of 15 months.