Cucumis sativus and Cucurbita maxima extract attenuate diabetes-induced hepatic and pancreatic injury in a rat model

Diabetes is usually associated with oxidative stress that causes hepatic and pancreatic tissue injury. This work was carried out to evaluate the effect of Cucumis sativus and Cucurbita maxima methanol extracts on the streptozotocin-induced diabetic hepatic and pancreatic injury in rats. Diabetes was induced in seven equal groups of rats by a single intraperitoneal injection of streptozotocin (40 mg/kg), in addition to the non-diabetic control group. Two diabetic groups were treated with Cucumis sativus methanol extract and two were treated with Cucurbita maxima, each at 200 and 400 mg/kg for 21 days after streptozotocin-induced diabetes. Another diabetic group was treated with both Cucumis sativus and Cucurbita maxima at 200 mg/kg of each. Another group was treated with metformin (200 mg/kg orally). The plant extracts normalized serum liver enzymes activities, oxidative stress markers, and restored serum proteins and lipid profile. They also significantly reduced blood sugar to values comparable to non-diabetic rats. The hypoglycemic effect is also confirmed by the improvement of the immunohistochemical expression of insulin in β-cells of islets of Langerhans. Hepatic and pancreatic protection was also confirmed by the improvement of the histopathological picture as compared to STZ-diabetic rats. The GC-MS analysis revealed the presence of 35 and 34 compounds in the methanol extract of cucumber and pumpkin, respectively. Finally, the methanol extract of cucumber and pumpkin could be beneficial acting synergistically in the protection of the liver and pancreas against diabetes-induced tissue damage.

Effect of caffeinated energy drinks on the structure of hippocampal cornu ammonis 1 and dentate gyrus of adult male albino rats

Energy drinks are available worldwide and frequently consumed to increase energy level and compensate lack of sleep. Energy drinks consumers aim to improve their cognitive functions. Red Bull is the most popular energy drink consumed in Egypt. However, the link between the impact of energy drinks on the structure of hippocampal cornu ammonis 1 (CA1) and dentate gyrus (DG), a highly vulnerable brain regions to various insults, has not yet documented. To study the effect of energy drinks on structure of hippocampal CA1 and DG of adult male albino rats. Twenty one adult male albino rats were divided into three groups; group I control group, groups II and III received Red Bull, with a dose of 3.75 ml/kg/day orally using gastric tube for four and eight consecutive weeks respectively. At the end of the experiment, brains were dissected and hippocampal specimens were processed for histopathological and immunohistochemical studies. Histopathological examination of hippocampal sections in group II revealed vacuoles, decrease thickness of pyramidal cell layer with irregular dark or ghost nuclei. However, changes were more severe in group III with cracks in pyramidal cell layer, massive vacuolation and signet ring cells. Moreover, star shaped astrocytes and glial fibrillary acidic protein immuno-reactivity were more abundant in group III than in group II. Caffeinated energy drinks produced neurodegenerative changes and reactive astrocytosis in hippocampal CA1 and DG of adult male albino rats. These changes were duration-dependent being more severe in longer duration of intake.

Abdominal aortic aneurysm in a neonate

This is the second reported case of abdominal aortic aneurysm in neonates to be presented in the English language literature. The first case was reported by Howorth in 1967. In addition to the presence of abdominal aortic aneurysm, this neonate has nesidioblastosis and sequestration of the lungs. The combination of these three rare anomalies in one infant is fascinating and has not been reported.

Effect of fetal sex and race on amniotic fluid lecithin concentration

Amniotic fluid lecithin phosphorus concentration (AF-Lec) was measured in 209 healthy women at 31.7-42.7 weeks gestation. The patients were divided into four groups according to race and fetal sex. No differences in AF-Lec between black and white nor between male and female fetuses were found. The relationship of AF-Lec to gestational age and the incidence of "mature" AF-Lec was not different among the four groups. We conclude that there is no effect of fetal sex, race, or the interaction between them on fetal lung development as measured by AF-Lec.

Fetal lung maturity in diabetic pregnancies: relation among amniotic fluid insulin, prolactin, and lecithin

Insulin, prolactin, and lecithin phosphorus levels were measured in 97, 62, and 44 amniotic fluid samples from third trimester normal, gestational diabetic, and insulin-dependent diabetic patients, respectively. There was no difference in lecithin phosphorus concentration (index of fetal lung maturity) among the three groups. The amniotic fluid insulin level was significantly higher in insulin-dependent diabetic patients, whereas there was no difference in amniotic fluid prolactin levels among the groups. Correlations of amniotic fluid prolactin levels with both lecithin phosphorus and insulin levels were not statistically significant in any of the groups. This is probably because amniotic fluid prolactin is decidual, rather than fetal, in origin. Even though amniotic fluid insulin levels, which reflect fetal levels, were significantly higher in insulin-dependent diabetic patients, there was no difference in the amniotic fluid lecithin phosphorus concentration in diabetic pregnancies compared with that in normal pregnancies. Moreover, there was a positive, and not a negative, correlation between amniotic fluid insulin and amniotic fluid lecithin phosphorus levels in diabetic pregnancies. These results do not support the theory that fetal hyperinsulinemia results in delayed pulmonic maturation in diabetic pregnancies.

Bile-plug syndrome

A case of bile plug syndrome in a 6-week-old male infant is described. The clinical, radiological and pathological appearances suggested the preoperative diagnosis. Confirmation and correction of this condition was made surgically.

The reliability and clinical use of a rapid phosphatidylglycerol assay in normal and diabetic pregnancies

Lecithin phosphorus concentration, the standard fetal lung maturity test in our institution, and phosphatidylglyercol were assayed in 69, 29, and 45 amniotic fluid samples from normal (GI), gestational (GII), and insulin-dependent diabetic (GIII) women by means of thin layer chromatography and Amniostat-FLM, respectively. Lecithin phosphorus concentration greater than or equal to 0.1 mg/dl and positive or strong positive Amniostat-FLM results were considered mature. The results of both assays were concordant in 79% of the samples. The discordance rate was highest in GIII patients. In our experience, respiratory distress syndrome did not develop in neonate infants of diabetic women delivered after a mature lecithin result. With lecithin phosphorus concentration as the reference standard, the predictive value of a mature Amniostat-FLM result was 96.2%, whereas that of an immature result was 58.5%. Respiratory distress syndrome occurred in only two GIII neonates who were delivered within 72 hours of both immature lecithin and Amniostat-FLM results. These findings support the use of Aminostat-FLM as a screening test for fetal lung maturity in both normal and diabetic pregnancies. Additional tests will be necessary to evaluate further fetal lung maturity only if the results are negative.

Effect of maternal-fetal disorders on lung maturation. I. Diabetes mellitus

Amniotic fluid for fetal lung maturity studies was obtained from 287 healthy and 198 diabetic women. Classes of diabetes were as follows: Class A, 111; Class B, 58; Class C, 13; Class D, 11; Class F, 4; and Class R, 1. The regression lines representing the relationship of amniotic fluid lecithin phosphorus concentration to gestational age at amniocentesis in each of the groups of diabetic patients were not statistically different from those of the control subjects. Each of the diabetic patients was then matched with a control subject of the same race, sex of newborn infant, and gestational age at amniocentesis. The regression lines of the nonhypertensive, hypertensive, and all diabetics were not different from those of their respective matched control subjects. Also there was no difference in the proportion of mature lecithin phosphorus concentrations at different weeks between diabetic and normal women. The absence of a significant influence of diabetes on fetal lung maturation is probably due to improvement in diabetic control resulting in normalization of the fetal metabolic environment.

Management of intractable and extensive tracheal stenosis by implantation of cartilage graft

A variety of methods have been developed to solve the problem of extensive tracheal stenosis. Endoscopic resection with injection of steroids was performed with some success. Resection with end-to-end anastomosis has been attempted in localized tracheal stenosis, but it is not practical in extensive tracheal stenosis. As an alternative to the above procedures, we performed a simpler operation to increase the diameter of the narrow trachea. We treated three children (a 7-month-old, a 2-year-old, and a 3-year-old) who had severe tracheal stenosis. The trachea was explored through a cervical transverse incision. The anterior wall of the trachea at the level of the stenosis was opened longitudinally and the scar in the tracheal lumen was resected. A free-cartilage graft measuring 1 X 4 cm was taken from the third costochondral junction and was wedged and sutured in place into the tracheal opening. This resulted in increasing the internal diameter of the stenotic trachea. A nasotracheal tube was left in place at the end of the procedure for 48 hours. The children are still asymptomatic 19, 10, and 8 months postoperatively. The careful selection and preparation of the patients for this procedure is discussed.

The role of the physician's assistant in a university-based pediatric surgical service

Physician's Assistants (P.A.), recent additions to the health profession, have proved valuable as "extenders" for primary physicians in relatively remote rural areas. More specialized surgical assistants have been trained for the community-practicing surgeon. The introduction of physician's assistants into university centers has been proceeding at a slower pace. A need has existed for an accurate assessment of the role of the P.A. in a residency-training program. In subspecialties, such as pediatric surgery and thoracic surgery, an increasing patient load has usually required a corresponding increase in junior resident staff. This resident coverage is usually dependent upon the availability of general surgical house staff since pediatric surgical trainees are currently fixed in number. Foreign medical graduates are no longer available in large numbers and general surgical programs themselves are being reevaluated and the number of trainees decreased. In this setting physician's assistants can be used to augment patient coverage by acting as junior surgical residents.

Esophageal perforation in an infant: repair with a pleural flap

Most esophageal perforations regardless of cause, should be treated surgically. Since anatomic features of the esophagus make even small rents difficult to close, a variety of technics have been developed. Flaps of pleura have been used in adults, but to our knowledge this technic has not been previously described in infants. We used a local pleural flap for successful closure of a large esophageal perforation in a 2-week-old infant. Rapid healing occurred without stricture.

Clinical implications of blood gas analysis of chest tube drainage

Blood gas analysis of chest tube drainage following thoracostomy for experimental and clinical penetrating chest injuries was evaluated to determine its usefulness in predicting the etiology of the injury. Twenty dogs were divided into four groups and sustained right chest injury as follows: Group I--closed chest lung laceration; Group II--open chest lung laceration; Group IIII-gunshot wounds; Group IV--thoracotomy and injection of autologous, mixed venous blood. All animals and 14 patients who sustained penetrating chest injury were made simultaneously from chest tube draininage, systemic artery, and central vein in all dogs and patients. Eight patients (Group A) had pneumothorax; six patients (Group B) did not. Mean control canine aortic PO2 and pulmonary arterial PO2 values in Group I did not differ significantly from those in the other three canine groups, nor from the two human groups. Group II dogs exhibited chest tube PO2 which was significantly (p less than 0.01) above aortic PO2. In Group IV, chest tube PO2 was increased significantly above pulmonary arterial blood. Patients without pneumothorax had values for PO2 in chest tube drainage and aorta which were not significantly different, whereas when pneumothorax was present, PO2 of chest tube drainage was significantly higher than that of aortic PO2. Thus blood gas determinations on chest tube drainage may reflect the nature of the injury; however, the presence of air in the pleural space can result in oxygenation of contained blood well above systemic arterial levels.

Traumatic hematocele of the gallbladder with hemobilia

An unusual case of traumatic hemobilia in which blood reached the bile duct through transhepatic penetration of the gallbladder is reported. The salient features of this variant of traumatic hemobilia are described: antecedent subcapsular liver injury; variant time interval to GI hemorrhage and episodic hemorrhage; and necrosis or hematoma at the bleeding site.

Tracheostomy in children without heart disease

A series of 27 patients less than 15 years of age who had tracheostomies from 1968--1975 showed that only two of these patients had cardiac disease as the primary lesion. Only three pneumothoraces could be definitely attributed to the tracheostomy, while sepsis in two patients and pneumonia in one patient might possibly have been related to the tracheostomy itself. One death was due to the performance of the tracheostomy. In patients who have tracheostomy for noncardiac conditions, performance of the tracheostomy in the operating room with an endotracheal tube in place, the use of plastic or silastic body contour conforming tubes, and proper intensive care nursing immediately after tracheostomy have reduced complications to a minimum and made the performance of tracheostomy in this age group a safe and effective procedure when oro- or nasotracheal intubation is inadequate.