d:\skydrive\Jor\vol44_1 The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 258 ­ 271

Depression among type 2 diabetic patients

Taghreed Mohamed El-Shafie
, Entesar Omar A. El-Saghier and Iman
Kamal Ramadan
Psychiatry Department , Endocrinology Department and Community
Department, Faculty of Medicine for Girls, Al-Azhar University


Abstract

Background & Objectives:
Diabetes and depression are highly prevalent conditions and
have significant impact on health outcomes. The combination of depression with type 2
diabetes is a public health problem. Therefore, we aimed to assess some socio-demographic
characteristics of type 2 diabetes and to investigate the relationship between type 2 diabetes
and depression among patients aged from 40 to 60 years old.

Methods:
125 patients diagnosed with type 2 diabetes attending diabetes clinics in the Al-
Zahraa hospital were invited to participate in this cross-sectional study. Patients were
interviewed using structured questionnaires to gather data on socio-demographics, clinical,
self care compliance, medication usage, and diabetes complications. The MADRS was
administered as a screening tool for depression level evaluation. Binary logistic regression
model was used to examine association between predictor variables and risk of depression
among diagnosed type 2 diabetes at 95% C.I. and P < 0.05.

Results:
One hundred and twenty five participants completed the interview. More than half of
participants were females (58.4%) and the mean age was 48 (sd = 5.9), 47.2% hypertensive,
and 59.2% on insulin. More than two third (74.4%) of patients were depressed; (24.8% mild,
37.6% moderate and 12% severely depressed). Almost four out of five patients (88.8%) had
diabetes complications, Depression was strongly associated with neuropathy, age,
retinopathy, sex and cardiac complications. However, the likelihood of depression was not
associated with nephropathy, hypertension and sexual dysfunction.

Conclusion:
The current study demonstrates a strong correlation between depression and
diabetes particularly complications. In particular, patients who are depressed tended to have
poorer self-care, more severe physical symptoms and were less likely to adhere to prescribed
care regimens. These findings raise the possibility that improving the mental health as part of
a comprehensive management plan for diabetes may improve the overall long term outcomes
of these patients.

Key Words:
depression · diabetes mellitus. MADRS

Introduction



DM is a major emerging clinical public
Associations between depression and
and health problem in Egypt (Herman et
diabetes
have
been
described
by
al., 1997).The combined prevalence of
physicians for several hundred years.
diagnosed and undiagnosed diabetes in the
Thomas Willis, an early English
Egyptian population 20 years of age was
physician and anatomist, wrote during the
9.3 (Herman et al., 1995).
mid-1600s that, diabetes is caused by

sadness or long sorrow and other
By the 2025, Egypt is expected to be
depressions .In recent years; researchers
among the top ten country that have the
have posited that there is a bidirectional
highest prevalence rates of diabetes in the
link between depression and diabetes
world, notably Type 2 diabetes mellitus
(Katon, 2010).
(T2DM) (King et al 1998). Also it is
258


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The effect of the non-steroidal anti-inflammatory drug diclofenac sodium on the fetuses of albino mice The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 272 ­ 283
The effect of the non-steroidal anti-inflammatory drug diclofenac sodium on the
fetuses of albino mice

Mohamed A. Shahin, Ramadan A. Ramadan, Samia M. Sakr and Sahar A. Sabry
Department of Biological and Geological Sciences,
Faculty of Education, Ain Shams University

Abstract

Introduction:
The present study was carried out to evaluate the effect of the non-steroidal anti-
inflammatory drug diclofenac sodium (DS) on the fetuses of albino mice from the morphological and
skeletal points of view.

Material and methods:
Sixty adult pregnant female mice were used in the present study. They were
allocated into 6 groups (10 mice each). The first two groups served as control and were injected
intraperitoneally (i.p.) with the solvent of the drug, and the 3rd and 5th groups were treated with 1.5 and
3mg/kg body weight of diclofenac sodium for 6 days ( gestation days 1-6 ), respectively ; the 4th and 6th
groups were treated with 1.5and 3mg/kg body weight of the drug for 8 days ( gestation days 7-14),
respectively.

Results:
The morphological examination of the fetuses of treated groups showed conspicuous decrease in
the average body weight and body length in all treated groups. The fetuses maternally treated with the
drug showed noticeable external morphological malformations and their skeletons exhibited mild
retardation in skeletal elements.

In conclusion:
The non-steroidal anti-inflammatory drug diclofenac sodium had exerted marked
morphological malformations and mild skeletal alterations in mice fetuses maternally treated during
different periods of gestation.

Keywords:
Diclofenac sodium- Morphology ­ Skeleton- Fetuses of albino mice.

Introduction
others have not found an association (Nielsen et

al., 2001). The experimental studies showed that
The non-steroidal anti-inflammatory drugs
these drugs could increase post-implantation
(NSAIDs) have three major therapeutic actions:
loss, decrease fetal number, induce skeletal, and
reduce inflammation (anti-inflammatory), pain
heart defects as well as fetal growth retardation
(analgesic), and fever (antipyretic). However,
(Cappon et al., 2003; Cook et al., 2003;
they differ in their anti-inflammatory, analgesic
Ostensen and Skomsvoll, 2004). The bone
and antipyretic activities (Laurance et al., 1997).
and/or cartilage examination showed that in
Cyclooxygenase (COX) exists as two isoforms,
utero exposure to COX inhibitors (NSAIDs)
COX-1 and COX-2, and inhibition of COX-2 is
may disturb skeletal formation (Ostensen and
the mechanism responsible for the therapeutic
Skomsvoll, 2004). Higher incidence of bone
anti-inflammatory NSAID characteristics (Vane
developmental variations was seen in fetuses
et al., 1998).
whose mothers were treated with high toxic
Siu et al. (2000) reported that diclofenac crosses
doses of non-selective COX inhibitors (Burdan,
the human placenta readily during the first
2004). It is well known that NSAIDs may cause
trimester. Some case studies have linked aspirin
miscarriage, intrauterine growth retardation
(acetylsalicylic acid [ASA]) and indomethacin
(IUGR) and ductus arteriosus constriction in
use with a higher risk of congenital
human (Ostensen et al., 2006). Burdan et
abnormalities and low birth weight, whereas
al.(2009) reported that piroxicam, ibuprofen and
272

Full Paper (vol.44 paper# 2)


Effect of noise stress and /or sulpiride treatment on some physiological and histological parametars in female albino rats The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 284 ­ 294

Protective effects of sulpiride treatment on kidney functions of female
albino rats exposed to noise stress.

Eman G.Helal*, Fatma Eid**,Neama M.Taha.

Zoology Department ,Faculty of Science,Al-Azhar University.
( Physiology*,Histology**)

Abstract

Background: Noise is the most stressful factor for experimental animals. So these studies
aim to clarify its effect on some physiological and histological parameters.

Material and methods: 36 Female rats were divided into four groups (6/each):1-control, 2-
treated with sulpiride drug,3- noise exposure (90db/3h per day for 30days), 4-noise + drug

Results: drug recorded no significant change in all the studied parameters. Noise stress
recorded a significant increase in creatinine, total lipids, TG, Cholesterol, HDL-C, LDL-C
and no significant changes in urea, uric acide.
It has been detected that sulpiride drug ameliorated most of these parameters.Concerning the
histological and histochemical studies sulpiride treatment showed no detectable changes in
the kidney tissue with exception of increased lymphocytes. Exposure to noise showed many
dystrophic changes in the kidney tissue, but drug treatment improved all the previous changes
and this indicates the protective effect of sulpiride against noise exposure.

Conclusion: It is useful to use sulpiride drug in people who exposed to noise stress.

Key words: Noise,Sulpiride drug , Albino rats, Physiological parameters, Histopathalogy and
histochemistery.

Introduction

According to Samson et al .(2006) noise

exposure over 90 decibel (db) becomes a
Stress as noise is a part
stressor and contributes to the genesis
life every day. From getting kids ready for
and manifestation of several multifactor
school to fighting traffic to the demands of
diseases,
chronic
annoyance
and
work, the average person goes up against
permanent behavioral alterations.
the nemesis called stress multiple time
Antidepressant drugs are the most
daily .From waking up to sleeping our
successful drug in patients with clearly
bodies are in a constant battle to maintain
characteristics
including
psychomotor
the balance. Noise is a kind of stresses
retardation, sleep disturbance, poor
which is defined as unwanted sound.
appetite and weight loss. However, a
Noise is a pervasive aspect of many
variety of different chemical structures
modern
community
and
work
have been found to have antidepressant
environments .Acute noise exposures
activity. Their number is constantly
activate the autonomic and hormonal
growing, but as yet no group has been
systems, leading to temporary changes
found to have a clear therapeutic
such as increased blood pressure,
advantage over the others (Katzung,
increased heart rate and vasoconstriction
2008) .Sulpiride is the most favorite drug
.After prolonged exposure, susceptible
which used to tolerate stress symptoms
individuals in the general population may
(Panzani et al., 2011).
develop permanent effects, such as
People exposed to stress take one or some
hypertension and ischemic heart disease
drugs to avoid the effect of stress even
that are associated with exposures to high
without a doctor prescription. So, in this
sound pressure levels. (Tomoyuki, 2004).
study we try in to illustrate the effect of
284

Full Paper (vol.44 paper# 3)


Effect of noise stress and /or sulpiride treatment on some physiological and histological parametars in female albino rats The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 295 ­ 310

Effect of noise stress and /or sulpiride treatment on some physiological and
histological parameters in female albino rats.

Eman G.E.Helal*, Fatma Eid**,Neama M.Taha.
Zoology Department ,Faculty of Science,Al-Azhar University.
( Physiology*,Histology**)


Abstract

Background:
Noise is the most stressful factor and human being. So these studies aim to
clarify its effect on some physiological and histological parameters.

Material and methods: 24
Female rats were divided into four groups (6/each):1-control, 2-
treated with sulpiride drug,3- noise exposure (90db/3h per day for 30days), 4-noise + drug

Results: drug recorded a significant increase only in the percentage of body weight gain but
the other parameters showed no significant changes. Noise stress recorded a significant
increase in glucose, ALT, GGT, TP, globulin.
A significant decrease in percentage of body weight gain and A/G ratio were also detected . It
has been detected that Sulpiride drug ameliorated most of these parameters.
Concerning the histological and histochemical studies sulpiride treatment showed no
detectable changes in the liver tissues with exception of increased lymphocytes. Exposure to
noise showed many dystrophic change in tissue, but drug treatment improved all the previous
changes and this indicates the protective effect of sulpiride against noise exposure.

Conclusion: it is useful to use sulpiride drug in people who expose to noise stress.

Key words:
Noise ,Sulpiride drug , Albino rats, Physiological parameters, Histopathalogy
and histochemistery.

Introduction

that are associated with exposures to high

sound pressure levels. (Tomoyuki, 2004).
Stress as noise is a part of everyone's life
According to Samson et al .(2006) noise
every day. From getting kids ready for
exposure over 90 decibel (db) becomes a
school to fighting traffic to the demands of
stressor and contributes to the genesis
work, the average person goes up against
and manifestation of several multifactor
the nemesis called stress multiple time
diseases,
chronic
annoyance
and
daily .From waking up to sleeping our
permanent behavioral alterations.
bodies are in a constant battle to maintain
Antidepressant drugs are the most
the balance. Noise is a kind of stresses
successful drug in patients with clearly
which is defined as unwanted sound.
characteristics
including
psychomotor
Noise is a pervasive aspect of many
retardation, sleep disturbance, poor
modern
community
and
work
appetite and weight loss. However, a
environments .Acute noise exposures
variety of different chemical structures
activate the autonomic and hormonal
have been found to have antidepressant
systems, leading to temporary changes
activity. Their number is constantly
such as increased blood pressure,
growing, but as yet no group has been
increased heart rate and vasoconstriction
found to have a clear therapeutic
.After prolonged exposure, susceptible
advantage over the others (Katzung,
individuals in the general population may
2008) .Sulpiride is the most favorite drug
develop permanent effects, such as
which used to tolerate stress symptoms
hypertension and ischemic heart disease
(Panzani et al., 2011).
295

Full Paper (vol.44 paper# 4)


Abstract: The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 311 ­ 317
Biochemical Markers Of Bone Turnover in Egyptian Women at Different
Ages

Olfat A Khalil &Kholoud S Ramadan
Department of Biochemistry Faculty of Science (Girls)
King Abdul Aziz University Jeddah KSA


Abstract:

Osteoporosis is a metabolic bone disease characterized by bone remodeling .This study was
done for the detection of some blood and urine markers in cases of osteoporosis among
Egyptian women at different ages .The study included 100 women divided into three groups.
The first group included 33 women their ages ranged between 35-45 years old, the second
included 33 women their ages ranged between 45-55 years old and the third group included
34 women their ages were above 55 years old. Fore all subjects DEXA densitometry was
performed. Serum calcium, phosphorous, alkaline phosphatase, Osteocalcin and urinary
hydroxyproline, deoxypyridinoline and creatinine were estimated. Results: In osteopenic
and osteoporotic women there was elevation in serum alkaline phosphatase and osteocalcin
and in urinary pyridinoline and hydroxyproline, while there was decrease in serum calcium
.Conclusion: The Egyptian women subjected to the study were suffering from osteopenia
from the age of 35 years old or may be earlier Above the age of 55 (postmenopausal) it was
found that 50% of women were osteopenic and osteoporotic.

Introduction




Throughout life, bone is formed and

resorted (degraded) in a dynamic process
variation between patients and within the
called "bone remodeling". Early in life,
same patient from day to day and are
this process leads to bone growth and
affected by food intake and time of day,
ultimately peak bone mass is achieved by
and lack assay standardization, limiting
30 to 35 years of age. In contrast, the later
their clinical utility (North American
years of life are characterized by a shift
Menopause Society, 2010).
towards increasing bone resorption,
Their application should be reserved for
which contributes the risk of fracture and
individuals at high risk as a way of
osteoporosis,
particularly
in
monitoring therapeutic effect on bone
postmenopausal women (Delmas et al.,
turnover. The bone turnover marker
2009).
response pattern with denosumab, a human
Osteoporosis is a condition in which an
monoclonal antibody to RANkL, is unique
imbalance
appears
between
bone
and should be appreciated by physicians to
resorption and formation, with bone
monitor this treatment effectively (Eastell
resorption exceeding formation (Mora,
et al., 2011).
1999).

Biochemical markers of bone turnover
Clinical questions that might be answered
allow clinicians to evaluate the risk of
by bone markers include diagnosing
bone loss and provide insight into
osteoporosis, identifying fast bone losers,
response to therapy (Millar et al., 2008).
and patients at high risk fracture, selecting
A National Osteoporosis Foundation
the best treatment for osteoporosis and
Clinian`s guide to the prevention and
providing an early indication of the
treatment of osteoporosis (2008) states
response to treatment (Brown et al.,
that biochemical markers of bone
2009).
remodeling (resorption and formation) can
The aim of this work was the detection of
be measured in the serum and urine in
some blood and urine markers of
untreated patients to assess risk of fracture.
osteoporosis among Egyptian women at
These markers can demonstrate wide
different ages.
311

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d:\skydrive\Jor\vol44_6 The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 318 ­ 324
Adiponectin and interlukin-10 in patients with liver diseases before and after liver
transplantation
Abdelgawad A. Fahmi 1, Mohamed A. El-Desouky2, Mohamed M. El Gamal3, Azza E.
Zidan3*.
Determents of Organic Chemistry1 and Biochemistry 2 Faculty of Science, Cairo University,
Determents of Immunology and Microbiology, Military Medical Academy3, Egypt.

*Corresponding author E-mail: azza_icwater@yahoo.com


Abstract


Background/Aims: Hepatitis C virus (HCV) infection is a global blood-borne disease with the highest
prevalence in Egypt. This study was carried out to evaluate the prevalence of adiponectin, Interleukin-10
levels in liver diseases and to identify the potential role of adipocyte derived adiponectin in patients with
end stage before and after liver transplantation.

Subject & method:
The study population included 69 subjects classified as follow: Control group (G1)
healthy individuals, group (G2) Anti HCV +ve & HCV RNA +ve by PCR, group (G3) Anti-HCV +ve
&HCV RNA­ve by PCR and liver transplantation group (G4) patients underwent orthotropic liver
transplantation; before liver transplantation (G4b) and after one week of liver transplantation (G4a).

Result:
Adiponectin levels showed highly significant decrease in G2 (P <0.002), G3 showed insignificant
decrease (P<0.6), G4b showed highly significant increased (P <0.0001) and G4a showed insignificant
decrease (P<0.08) compared with control group G1. IL-10 levels showed highly significant increase in
patients groups (G2, G3, G4b and G4a) as compared with control group (P<0.0001).

Conclusion:
Adiponectin and IL-10 may be used as biomarker and/or a mediator of inflammatory states in
liver diseases in patients with chronic hepatitis C. We suggest that high adiponectin and IL-10 levels in
chronic liver disease before liver transplantation might reflect one of the body's anti-inflammatory
mechanisms in chronic liver diseases.

Keywords: Chronic hepatitis C, Hepatitis C virus, adiponectin, Interleukin-10, liver transplantation.

Introduction
amino acid adipokine that has been shown to


improve insulin sensitivity in muscle and liver by
Hepatitis C virus (HCV) has chronically infected
enhancing free fatty acid oxidation (Perdo et al.,
more than 3% world population especially in
2010). Adiponectin was considered to be
developing countries. HCV infection accounts for
synthesized exclusively by adipocytes; however,
approximately 15­20% cases of acute hepatitis
recent data show that it is also produced by other
and 50­80% cases of chronic hepatitis with viral
cell types (Crawford et al., 2010). Adiponectin is
persistence being at risk to develop liver
also known as 30KD adipocyte complement-
inflammation, fibrosis, cirrhosis and HCC. In 40­
related protein; Acrp30 (Kaser et al., 2005). Two
60% of HCV infected individuals persistent
adiponectin receptors types were recently
infection is mainly associated with liver cirrhosis
identified adipoR1 abundantly expressed in
and steatosis leading to HCC with mortality rate
muscle, whereas adipo R2 is predominantly
of 2­5% per year (Saba et al ., 2011). Liver
expressed in the liver (James, 2008). Interleukin-
transplantation is widely accepted as an effective
10 (IL-10) is produced by various cell types
therapeutic modality for a variety of irreversible
including T and B cells, monocytes, and
acute and chronic liver diseases for which no
macrophages. This cytokine is highly pleiotropic
satisfactory therapy is available (Kuno & Pierre-
in its biological activity that includes: inhibition
Alain, 2010). Adipose tissue, besides serving for
of the synthesis of several cytokines, including
energy storage, actively secretes adipokines such
IL-1, IL-2, IL-3, IL-6, IL-8, IL-12, tumor necrosis
as leptin and adiponectin. Adiponectin is a 247
factor (TNF-), and interferon (IFN-
318

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d:\skydrive\Jor\vol44_7 The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 325 ­ 343
Structural and laboratory changes in the liver of female albino rats in cases
of experimental high fat diet and curative role of some medicinal plants.

Ezz-Eldin E. Abdalla, Gamal S. Elgharabawi and Moustafa E. Elsawy
Histology Departments, Faculty of Medicine (Domiatta and Cairo)
Al-Azhar University

Abstract

High fat diets as well as hyperlipidemia represent an important clinical and social problem. It is
referred to increased concentration of lipids (Triglycerides, Cholesterol and Fatty acids) in the
blood. Such increase may lead to metabolic risks affecting blood vessels and paranchymatous
organ mainly the liver.

Material and methods:
Forty five adult female albino rats were used and divided into 9 equal
groups. The first group was considered as a control group. The second group was of high fat
diet (25% fat and 2% cholesterol) for 3 weeks. Groups 3,4 and 5 were similar to the second
group but received three medicinal plants respectively Oat ,Fennel and Triphala. The sixth
group
was also of high fat diet but for 6 weeks. Groups 7, 8 and 9 were treated with same
medicinal plants as groups 3, 4 and 5.
Two main parameters were performed; the first was microscopic study of the liver tissue while
the second was laboratory evaluation of liver functions.

Results:
The hepatic tissue greatly affected by the induction of high fat diet in the form of
variable grades of fatty infiltration and vascular congestion either after 3 or 6 weeks of induction.
Fibrous content and PAS +ve material were also affected. Structural changes were confirmed by
laboratory data.

Conclusions: Medicinal plants and regulation of diet quality plays a good role in limiting the risk
of fatty liver and atherosclerosis.

Keywords:
High fat diet, Medicinal plants, Albino rat, Structural and Laboratory findings.


Introduction
Cholesterol plays an important role in the

control of metabolic pathways such as bile
High fat diet and hyperlipidemia represent
acids metabolisms and steroid hormones and
an important social and clinical problem.
vitamins syntheses, finally the third form of
This is referred to increased concentration of
lipid is triglycerides which represent the
lipids (Triglycerides, Cholesterol or both) in
main source of energy in most mammalian.
blood. Such increase may lead to serious
Bernard 2008, reported that the primary
metabolic disorder as diabetes mellitus Mori
lipid abnormality is hyperlipidemia which
et al 2010. Increased lipid level in the blood
may lead to the initiation and progression of
may be of genetic factor Hansen et al 2009.
atherosclerotic syndrome Harrison et al.,
Reihner et al 1990 and Haines 2001, Stated
2003.
three forms of lipids , the first one was fatty
Many medicinal plants can be used as
acids which is simple lipids , the second
hyperlipidemic lowering agents in Egypt as
form was sterols mainly cholesterol which
Oat, Fennel and Triphala.
may be of external source as from material
Oat
(Avena
sativa),
contain
high
syntheses in liver and other tissues .
concentration of proteins, lipids, vitamins,
325

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Randomised controlled trial of LigaSure versus conventional suture ligature for vaginal hysterectomy The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 344 ­ 353

LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a
Randomized Controlled Trial

Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria, a, d
a (Al-Azhar University, Cairo, Egypt), b Al-Kharj University Hospital (KSA), c Enjab Hospital
(UAE) and d Gulf Medical College and Research Centre (UAE).


Abstract

Introduction:
Vaginal hysterectomy is considered to be the method of choice for removal of the
uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate
structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of
methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical
vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and
bipolar electrical energy and is able to seal vessels up to 7 mm in diameter.

Objective:
To assess the safety and efficacy of using the LigaSure vessel sealing system for securing
the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the
pedicles by suture ligation.

Design: Prospective randomized controlled trial.

Setting: Obstetrics and Gynecology departments (Al-Kharj University Hospital- KSA, Enjab Hospital
- UAE and Gulf Medical College and Research Centre- UAE).
Methods: 80 patients undergoing vaginal hysterectomy for benign conditions were randomized to
either LigaSure group (n=40) or Suture group (n=40).

Main outcome measures: The primary outcome measures were the operative time and blood loss
while the secondary outcome measures were the hospital stay and intra- and post-operative
complications.

Results: Patients in the LigaSure group had a significantly reduced operating time (37.1 ± 8.9 min
vs. 63.8 ± 10.9 min; P < 0.001), operative blood loss (125.5 ± 33.2 mL vs. 264.6 ± 70.4 mL; P <
0.001), requirement of surgical sutures(1.2 ± 0.4 units vs. 8.2 ± 0.4 units; p < 0.001), pain status (2.0 ±
0.6 vs. 3.7 ± 0.7; P < 0.001), and hospital stay (30.3 ± 2.5 h vs. 45.7 ±10.5 h; P < 0.001) compared to
the control group. The overall complication rate in the study was 10 % (8/80), and did not differ
between patients of the LigaSure and control group.

Conclusion: The use of LigaSure device can reduce operative time. It allows faster, safe and effective
hemostasis compared with the conventional suture ligature. It also reduces the operative blood loss,
pain status and hospital stays.

Key Words: LigaSure (Electro-surgical vessel sealing).


Introduction




Vaginal hysterectomy is considered to be the
hospital stay and faster recovery than
method of choice for removal of the uterus
abdominal hysterectomy, recent studies have
(Richardson et al 1995& Doucette et al 2001).
shown
that
less
than
one-third
of
Although it has been shown to be associated
hysterectomies are performed vaginally
with significantly fewer complications, shorter
(Maresh et al 2002& Farquhar et al 2002).
344

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d:\skydrive\Jor\vol44_9 The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 354 ­ 370

Modulation of the Pharmacological and Biochemical Actions of Leiurus
quinquestriatus (L.q) Scorpion Venom by Exposure to Gamma Radiation

Heba A. Mohamed*, Esmat A. Shaaban* , Aber M Amin** and
Sanaa A. Kenawy
Department of Pharmacology and Toxicology ­ Faculty of Pharmacy- Cairo University
*Department of drug radiation research ­ National Center for Radiation Research and
Technology
**Department of labeled compound ­ Hot Lab Center
­ Atomic Energy Authority


Abstract

Back ground
This study was undertaken to evaluate the effect of gamma radiation (1.5 KGy & 3 KGy) on L.q
scorpion venom. This was carried out by studying the toxicological, biochemical & immunological
properties of the venom before and after exposure to gamma radiation.

Material and methods
Animals, venom, antivenin, gamma radiation, 125I.

Results
Data revealed that the toxicity of irradiated venom (1.5 KGy & 3 KGy) decreased as compared to that
of the native one. LD50 of irradiated venom were 3.5 mg/kg & 7.5 mg/kg respectively while, that of
the native venom was (0.39 mg/kg). Moreover, the distribution of 125I-labeled L.q venom was studied
in male Swiss mice tissue using chloramine-T method by being injected intravenously. At various
time intervals, urine and blood were collected and the animals were sacrificed. Brain, lungs, heart,
liver, kidneys, spleen, intestine, bone and muscle were isolated in order to determine the radioactivity
content. The highest contents of 125I-labeled L.q venom were found in the liver and kidney that were
quickly excreted into the urinary tract. Trial to label irradiated (1.5 & 3 KGy) L.q venom was
unsuccessful due to its decomposition. For that reason the utilization of the labeled irradiated L.q
venom is of no meaning. In immunodiffusion technique, both irradiated and native venoms exhibited
prominent precipitin bands indicating high concentration of specific antibodies against polyvalent
antivenin with venom. Furthermore, the effect of half the LD50 of native or irradiated (1.5 KGy) L.q
venom was studied on the activities of certain enzymes: ASAT, ALAT, LDH, CPK, CPK-MB, and
the levels of total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and the oxidative stress
biomarkers (plasma MDA & blood GSH). Biochemical measurements showed that scorpion venom
envenomation caused significant (p < 0.05) elevation in serum ASAT, ALAT, LDH, CPK as well as
CPK-MB activities, blood GSH level while, caused significant (p < 0.05) reduction in triglyceride,
HDL-cholesterol. In contrast, the 1.5 KGy gamma irradiated L.q venom showed no alterations except
in HDL-cholesterol that significantly decreased compared to that of the non-envenomated normal rats.

Conclusion
These results indicated that 1.5 KGy gamma irradiation of venom offer an effective method for
reducing the toxic effect of venom.

Key words:
gamma radiation, Leiurus quinquestriatus scorpion venom (L.q), LD50, 125I-labeled L.q,
double immunodiffusion, liver and cardiac enzymes, lipid profile, oxidative stress biomarkers.


354

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Profile of childhood Epilepsy in prince Hashem Bin Al Hussein Hospital The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 371 ­ 379

Electroencephalogram in Childhood Neurological Disorders

Wael Hayel Khreisat , Pediatric Neurologist
Queen Rania al Abdullah Hospital for Children
King Hussein Medical Center
Royal Medical Services
Amman. Jordan



Abstract

Aim of the study:
The present study was done to obtain a baseline for clinical indications of EEG in
children and to evaluate the Electroencephalography (EEG) findings in children with various acute,
chronic CNS disorders and non epileptic events.

Patients and methods:
The Electroencephalography (EEG) records of 250 patients were studied, which
was done at neurophysiology departments of Queen Rania AL-Abdullah Hospital for children in Jordan.
For each patient underwent EEG record the following data were recorded, age, sex, source of referral ( in
patient department or out patient ) , reason for Electroencephalography (EEG) , diagnostic impressions
and clinical presentation , the result of the EEG examinations and clinical correlation between the seizure
type and EEG finding .

Results:
Males slightly outnumbered females: 55% males. The majority of cases sent for EEG fell
between 6-12 years , Total of 63.2 % of all referrals for EEG were from outpatient clinic while in patients
account for 36.8%. pediatric neurology department referrals being highest 28.8 %, the majority of
diagnosis at referral were suspected epilepsy (80%), epileptiform EEG abnormalities was detected in (
32%) , Over all 64 % the EEG records were normal , All EEG records of children with syncope , headache
were normal .

Conclusion and recommendation:
We conclude that there are many unnecessary routine EEG
recordings in children; Investigation of epilepsy and acute encephalopathies appear to be the most
valuable indications for routine pediatric EEG. EEG can help in classified of the seizure, finding a way to
reduce EEG requests is request

Keywords
: Epilepsy; Electroencephalography; paroxysmal event

Introduction



A huge number of publications have documented
Although the diagnosis of seizures and epileptic
the
type
and
frequency
of
syndromes is primarily clinical, EEG often
Electroencephalography (EEG) abnormalities in
provides supportive evidence and helps in
many
different
childhood
disorders
seizure classification (Sundaram et al., 1999).
(Goldensohn, 1997). EEG is a very important in
Many episodic events may simulate epilepsy
investigating children with various neurological
including breath holding spells, syncope, tics,
disorders, particularly epilepsy. The EEG is also
migraine related phenomena (e.g. benign
a sensitive marker of diffuse cortical dysfunction
paroxysmal vertigo), and psychogenic seizures
as seen in toxic, metabolic, or hypoxic
(Barron, 1991 ). These events associated with
encephalopathies
(Saunders

and
normal neurological examination and interictal
Westmoreland , 1997 ).
EEG, however, although EEG is requested, a
371

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Protective role of Peanut oil in rats exposed to two different doses of irradiation that produced oxidative stress and bone injury The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 380 ­ 391

Protective role of Peanut oil in rats exposed to two different doses of gamma
radiation that produced oxidative stress and bone injury

Tamer M. M. Saad and Amal A. A. Ammar
Medical and Radiation Research Department,
Nuclear Materials Authority,Cairo, Egypt


Abstract

Introduction: Exposure to ionizing radiation represents a genuine, increasing threat to mankind
and our environment. The steadily increasing applications of radiation in clinical practice,
industrial and agricultural activities, on top of residual radioactivity resulting from nuclear test
explosions, have a measurable impact contributing to possible radiation hazards in humans.
Control of radiation hazards is considered as one of the most important challenges in order to
protect our lives from radiation damages.
The trans-3,4,5-trihydroxystibeneis a phyto-chemical present in peanuts and grapes with
beneficial effects such as protection against cardiovascular disease and cancer prevention.

Purpose: The present study aims to clarify the role of peanut oil as a radioprotector in male
albino rats against oxidative stress and bone injury induced by two different doses of gamma
irradiation.

Material and Methods: Rats were subjected to a dose of 5 Gy (group 3) or 10 Gy ( group
4 ) ( single dose/ whole body ) in comparison with control group ( group 1 ). Prior to the two
doses of gamma radiation, rats received peanut oil subcutaneously, ( 0.75 ml/kg ) over one month
period, on three days/week ( group 5 and 6 ). Group 2, rats received peanut oil subcutaneously, (
0.75 ml/kg ) as group 5, but without exposure to radiation.

Results: The results showed that whole body gamma irradiation revealed significant acceleration
in the level of lipid peroxide (MDA), with significant depletion in glutathione content (GSH),
superoxide dismutase (SOD) and catalase (CAT) activities. Meanwhile. Also, the study showed
significant increase in serum calcium with concomitant decrease in the bone calcium and
significant increase in serum inorganic phosphorous concomitant with a decrease in bone
phosphorous after radiation exposure.
Administration of peanut oil pre-irradiation has significantly ameliorated the radiation induced
disturbance in all the investigated parameters.

Conclusion: Metabolism can be controlled to some extent by peanut oil administrated prior to
irradiation.

Keywords: Peanut oil - Ionizing radiation - Antioxidants ­ Calcium - Phosphorous.

Introduction
of residual radioactivity resulting from

nuclear test explosions, have a measurable
Exposure to ionizing radiation represents a
impact contributing to possible radiation
genuine, increasing threat to mankind and
hazards in humans. Control of radiation
our environment. The steadily increasing
hazards is considered as one of the most
applications of radiation in clinical practice,
important challenges in order to protect our
industrial and agricultural activities, on top
lives from radiation damages.
380

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paper 12.doc The Egyptian Journal of Hospital Medicine (July 2011) Vol., 44: 392 ­ 402

Protection Against Schistosoma Mansoni In Mice By using UV-Irradiation In
Comparing With Soluble Adult Worm Antigen (SWAP)


Tamer, M.M.S. ; Amal, A.A.A. and Hazem, K.A.S.
Medical and Radiation Research Dept., Nuclear Material Authority


Abstract

Background: The present study aimed to investigate the dynamics of immunoregulatory factors implicated
in the murine model of soluble adult worm antigen preparation (SWAP) and UV-irradiated adult worm
extract-induced granulomatous hypo-responsivness.

Material and Methods:
Native male mice were classified into four groups. The first negative control (non-
infected) group, the second positive control (infected) group, the third SWAP-vaccinated group and the
fourth UV-irradiated adult worm extract-vaccinated group. The last two groups were injected subcutaneous
by 0.2 ml (contained 100 µg protein) of the two used vaccines SWAP or UV-irradiated adult worm extract
respectively, four weeks prior to infection. The 2nd, 3rd and 4th mice groups were infected by subcutaneous
injection with 100 cercariae of Egyptian strain of S. mansoni. All mice groups were sacrificed 8 weeks post-
infection.

Results:
Parasitological parameters such as worms count, eggs/gram tissues of liver and intestine were
studied. Biochemical parameters such as the activities of liver function tests (AST, ALT, ALP and GT)
were measured. The cellular immune responses were assessed by studying the cytokine measurement.
Hepatic histopathological criteria and the morphological changes of adult worms were studied through the
scanning electron microscope.

Conclusion:
The present results revealed that the UV-irradiated adult worm extract have high efficacy than
SWAP as immunizing antigens as shows in our data, which reported that irradiation associated vaccine
antigen was shown to achieve a higher protection in mice.

Key words:
Schistosomes-Radiation-Liver enzymes.

Introduction

irradiated cercariae or schistosomula (Santos et
Schistosomes are
parasitic
platyhelminths
al., 1999) or immunization with crude or purified
(flatworms) of birds and mammals. As a parasitic
antigenic extracts of various life cycle stages
disease of humans, schistosomiasis ranks second
(Wynn and Hoffmann, 2000). UV-irradiated
to malaria in global importance. Schistosome
and
gamma-irradiated
schistosomula
of
larvae (cercariae) must invade and penetrate skin
Schistosoma mansoni induce high levels of
as an initial step to successful infection of the
resistance to challenge infection in experimental
vertebrate host. Proteolytic enzymes secreted
hosts (Wales et al., 1992). It seems that the adult
from the acetabular glands of cercariae contribute
worm antigenic preparation (SWAP) possesses
significantly to the invasion process (McKerrow
several different molecules responsible for
et al., 2008).
inducing the heterogeneity in cell mediated

responsiveness (Hirsch and Goes, 1996).
The best long-term strategy to control

schistosomiasis is thought to be the immunization
Since schistosomes do not multiply within the
with an anti-schistosomiasis vaccine (Berquist et
final host, a vaccine that induces even a partial
al., 2002). There is no vaccine against
reduction in worm burdens could considerably
schistosomiasis
is
yet
available.
Some
reduce pathology, limit parasite transmission and
achievements has been developed in experimental
be less expensive than repetitive drug treatment
vaccination as demonstration of a strong and
(Berquist et al., 2002).
specific immunity following immunization with

392


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