Showing papers by "Minia University published in 2008"

Epidemiology of rheumatic musculoskeletal disorders in the developing world

Abstract: The epidemiology of rheumatic musculoskeletal (MSK) disorders in the developing world is much less well known than it is in the developed world. We expect ethnicity, traditions, socioeconomics and lifestyles to have an impact, but overall data are sparse. This report focuses on the WHO-ILAR COPCORD (community-oriented programme for control of rheumatic diseases). COPCORD was designed to collect community data on pain and disability in the developing economies. Several countries in Asia-Pacific and Central South America have completed COPCORD surveys. Despite some limitations in methodology, COPCORD provides a fair estimate of the spectrum and extent of rheumatic MSK disorders. We digress from a general overview to highlight the scenario for rheumatoid arthritis, and draw a few parallels with known statistics from the developed world. Overall, the emerging spectrum and severity are not very different, but in the developing countries the burden of disease, worsened by dismal rheumatology services, is likely to be staggering.

An improved fault ride-through strategy for doubly fed induction generator-based wind turbines

Abstract: Keeping the generators operating during transient grid faults becomes an obligation for the bulk wind generation units connected to the transmission network and it is highly desired for distribution wind generators A proposed scheme is implemented to keep the wind-power DFIG operating during transient grid faults Challenges imposed on the generator configuration and the control during the fault and recovering periods are presented A comprehensive time domain model for the DFIG with the decoupled dq controller is implemented using Matlab/Simulink software Intensive simulation results are discussed to ensure the validity and feasibility of the proposed fault ride through technique The scheme protects the DFIG components, fulfills the grid code requirements and optimises the hardware added to the generator

Late Ordovician mass extinction

Abstract: ■ Abstract Near the end of the Late Ordovician, in the first of five mass extinctions in the Phanerozoic, about 85% of marine species died. The cause was a brief glacial interval that produced two pulses of extinction. The first pulse was at the beginning of the glaciation, when sea-level decline drained epicontinental seaways, produced a harsh climate in low and mid-latitudes, and initiated active, deep-oceanic currents that aerated the deep oceans and brought nutrients and possibly toxic material up from oceanic depths. Following that initial pulse of extinction, surviving faunas adapted to the new ecologic setting. The glaciation ended suddenly, and as sea level rose, the climate moderated, and oceanic circulation stagnated, another pulse of extinction occurred. The second extinction marked the end of a long interval of ecologic stasis (an Ecologic-Evolutionary Unit). Recovery from the event took several million years, but the resulting fauna had ecologic patterns similar to the fauna that had become extinct. Other extinction events that eliminated similar or even smaller percentages of species had greater long-term ecologic effects.

Effect of one session of ER:YAG laser ablation plus topical 5Fluorouracil on the outcome of short-term NB-UVB phototherapy in the treatment of non-segmental vitiligo: a left-right comparative study.

Abstract: Background: NB-UVB phototherapy is a very important modality in treating vitiligo but the treatment course usually exceeds 1 year. Skin ablation with mechanical dermabrasion with 5Fluorouracil (5FU) was introduced to treat vitiligo in 1983. This was modified replacing the mechanical dermabrasion by erbium-YAG (ER:YAG) laser ablation and resulted in better prognosis in periungual vitiligo. Purpose: In the present study, we are exploring the effect of the use of ER:YAG laser skin ablation and application of 5FU on the outcome of short-term NB-UVB therapy for patients with non-segmental vitiligo (NSV). Methods: This study included 50 adult patients with a total of 65-paired symmetrical NSV lesions in different body parts. One side was treated with ER:YAG laser ablation, followed by 5FU application before simultaneous NB-UVB therapy of both sides for a maximum period of 4 months. The outcome was then evaluated both qualitatively and quantitatively. Results: The overall response to therapy was better using the combination therapy. Fifty patients (78.1%) experienced a moderate-marked repigmentation response in the combination group compared with 23.4% in the mono-therapy group. The response was significantly higher when using the combination therapy in different body parts (P value is <0.05), except for feet lesions, which were better but not statistically significant (P value=0.15). Tolerable pain during ablation or at sites of 5FU application was reported in all cases. Transient hyperpigmentation occurred in 30% of cases and 3.1% of lesions healed by a transient slate blue color. Half of the treated periungual lesions showed a temporary tiny brownish spot on nail plates and Koebnerization was not detected in any patient. Conclusion: We concluded that prior use of ER:YAG laser skin ablation, followed by 5FU application before NB-UVB phototherapy for vitiligo is a safe and tolerable technique that improves the outcome of short-term NB-UVB therapy and is expected to increase patient compliance.

Association of anti-ribosomal P protein antibodies with neuropsychiatric and other manifestations of systemic lupus erythematosus.

Abstract: The objective of our study was to determine the prevalence of neuropsychiatric manifestations and anti-ribosomal P antibodies (aRP) in SLE and to examine the diagnostic utility and associations of aRP with neuropsychiatric and other disease manifestations. Thirty two consecutive SLE patients, diagnosed according to the updated 1997 ACR criteria, were studied. A full medical history, rheumatological, neurological, psychiatric examination, and psychometric evaluation, including a battery of tests for cognitive dysfunction and the Symptom Checklist-90-Revised depression and anxiety scales were administered to all patients. Disease activity was scored using the SLEDAI. Neuropsychiatric manifestations were diagnosed and categorized according to the 1999 ACR case definitions for 19 NPSLE syndromes. Laboratory and serologic tests including ANA, anti-ds DNA, anti-cardiolipin antibodies (aCL) and aRP (ELISA) were also carried out. Twenty six (81.2%) patients had one or more NP manifestations. Depression (59.4%), headache (46.9%) and cognitive dysfunction (37.5%) were the commonest NPSLE syndromes. Other less commonly detected manifestations included seizures, anxiety, acute confusional state, stroke, and psychosis. aRP was positive in seven (21.9%) patients, all of whom had one or more NPSLE syndromes. Patients with psychiatric manifestations in general and mood disorders in particular had significantly higher mean titers of aRP than patients without these disorders (p < 0.05). aRP were found to be significantly associated with a younger age at the onset of SLE, with more severe articular manifestations and with the presence but not the severity of depression. aRP were highly specific for NPSLE and depression, and they were highly sensitive for psychosis. Neuropsychiatric manifestations are found in 81.2% of unselected Egyptian SLE patients. The presence of aRP antibodies positively predicts patients with psychiatric manifestations in general and mood disorders in particular, for which aRP is specific, but not sensitive. However, aRP is sensitive for psychosis, so that its absence in patients with SLE may help exclude Lupus psychosis.

Genotoxic effects of waterpipe smoking on the buccal mucosa cells.

Abstract: Waterpipe smoking is popular in many parts of the world Micronuclei (MN) evaluation in the exfoliated oral cells of smokers is a non-invasive technique for evaluation of possible tobacco harm We aimed to assess whether MN levels are higher in waterpipe smokers than in never smokers We examined oral smears of 128 adult male waterpipe smokers and 78 males who never smoked tobacco in rural Egypt The total number of MN per 1000 cells per subject, and the number of MN-containing cells per individual were compared We observed a higher level of total MN in waterpipe smokers (10 +/- 4) than in never smokers (4 +/- 2, p < 0001) A similar difference was found for the mean number of affected cells per individual (8 +/- 3 vs 4 +/- 162, p < 0001) MN levels were not significantly dose related This study is among the first to assess the association between waterpipe smoking and a cytogenetic measure of tobacco harm The twofold increase in MN level is consistent with previous reports of MN in cigarette smokers More research is needed to determine if such MN levels are predictive of future health consequences

Chrome-spinels in serpentinites and talc carbonates of the El Ideid-El Sodmein District, central Eastern Desert, Egypt: their metamorphism and petrogenetic implications

Abstract: Serpentinites and talc-carbonate rocks of El Ideid-El Sodmein District (ISD), central Eastern Desert, Egypt, contain variably altered chrome-spinels. Back-scattered electron images and electron microprobe analyses of chrome-spinels and associated silicates are made to evaluate their textural and compositional variations with metamorphism. In most cases the chrome-spinel crystals are concentrically zoned with unaltered cores through transitional zone of ferritchromit to Cr-magnetite toward the rims. In talc-carbonate rocks chrome-spinels are extensively altered to Cr-magnetite. Compared to cores, the metamorphic rims are enriched in Cr# (0.83–1.0 vs. 0.58–0.63 for rims and cores, respectively) and impoverished in Mg# (0.05–0.29 vs. 0.57–0.63), due to Mg–Fe and Al(Cr)–Fe3+ exchange with the surrounding silicates during regional metamorphism rather than serpentinization process. Textural and compositional features of the chrome-spinels suggest transitional greenschist-amphibolite up to lower amphibolite facies metamorphism (at ∼500–600 °C), which is isofacial with the country rocks. The common preservation of unaltered chrome-spinel cores in the serpentinites, contrary to talc-carbonate rocks, implies that full equilibration has not been attained due to small metamorphic fluid–rock ratio. Microprobe analyses profile across a concentrically zoned grain confirms the presence of two compositional (miscibility?) gaps; one between chrome-spinel core and ferritchromit zone; and another one between ferritchromit zone and Cr-magnetite outer rim. Chrome-spinel cores do not appear to have re-equilibrated completely with the metamorphic spinel rims and surrounding silicates, indicating relic magmatic composition not affected by metamorphism. Core compositions suggest an ophiolitic origin and derivation by high degrees of melting of reduced, depleted harzburgite to dunite mantle peridotites in an oceanic supra-subduction zone (marginal-basin) tectonic environment.

Incidence and risk factors for hepatitis C infection in a cohort of women in rural Egypt

Abstract: A prospective cohort study of the incidence and risk factors for hepatitis C virus (HCV) infection was performed in 2171 pregnant women in three rural Egyptian villages who were HCV antibody (anti-HCV) and RNA (HCV-RNA) negative at baseline. During an average of 2.2 years follow up, 25 incident cases were observed, giving an estimated HCV incidence of 5.2/1000 person-years (PY). The infection rate correlated with community anti-HCV prevalence in pregnant women, while the perinatal incidence rate of 11.2/1000 PY was almost five times that of the non-perinatal rate (2.3/1000 PY). The data suggested iatrogenic perinatal risk factors were associated with infection in one village, while health education reduced infections in another. Among the 25 incident cases, eight were HCV-RNA negative when they were first found to be anti-HCV positive and one-third of the 15 viraemic cases with follow-up data available cleared their HCV-RNA after an average of 1.3 years. None of the 25 incident cases were jaundiced or had symptoms of hepatitis but elevated serum alanine aminotransferase levels confirmed hepatitis in nine. Our data suggest that asymptomatic HCV infections frequently occurred during the perinatal period but often cleared and that educating medical personnel on safe practices possibly reduced HCV transmission.

Effect of compositional variations on the optical properties of Sb?Ge?Se thin films

Abstract: Compositional dependences of the optical and physical properties of as-deposited amorphous SbxGe25?xSe75 films (x = 0, 5, 10, 15 and 20?at%), prepared by thermal evaporation, have been studied. The refractive index, n, and film thickness, d, have been determined from the upper and lower envelopes of the transmission spectra, measured at normal incidence, in the spectral range from 400 to 2500?nm. An optical characterization method for uniform films based on Swanepoel's ideas has been employed, and it has allowed us to determine the average thickness, , and the refractive index, n, of the films, with accuracies better than 1%. It has been found that the refractive index of the SbxGe25?xSe7 samples increases with increasing x, over the entire spectral range, which is related to the increased polarizability of the larger Sb atomic radius 1.38?? compared with the Ge atomic radius 1.22??. The dispersion parameters such as E0 (single-oscillator energy) and Ed (dispersive energy) were discussed in terms of the single-oscillator Wemple?DiDomenico model. The absorption coefficient, ?, and therefore the extinction coefficient, k, have been determined from the transmittance and reflectance spectra in the strong absorption region. The optical energy gap is derived from Tauc's extrapolation and a decrease in with increasing Se content. Finally, in terms of the chemical bond approach, cohesive energy has been applied to interpret the decrease in the glass optical gap with increasing Sb content in SbxGe25?xSe75.

Mechanisms of gastroprotective effect of eugenol in indomethacin-induced ulcer in rats

Abstract: Possible mechanisms underlying the gastroprotective effect of eugenol against indomethacin-induced ulcer in rats were investigated. Pyloric ligation was performed for collection of gastric juice, and gastric ulceration was induced by a single intraperitoneal (i.p.) injection of indomethacin (30 mg/kg). Pretreatment with a single dose of eugenol (100 mg/kg, orally), 1 h before indomethacin administration caused significant reductions in gastric mucosal lesions, gastric acid outputs and pepsin activity associated with a significant increase in mucin concentration. Additionally, eugenol significantly attenuated the elevations in gastric mucosal malondialdehyde and total nitrite, and the decrease in reduced glutathione observed with indomethacin. The protective effect afforded by eugenol was significantly inhibited by prior administration of glibenclamide, the ATP-sensitive potassium (KATP) channel blocker, but not by prior use of ruthenium red, the transient receptor potential vanilloid 1 (TRPV1) antagonist. The results indicate that the anti-ulcer effect of eugenol is mediated by opening of KATP channels, scavenging free radicals, decreasing acid-pepsin secretion, increasing mucin production, and preventing the deleterious rise in nitric oxide level. Copyright © 2008 John Wiley & Sons, Ltd.

Formulation of controlled-release baclofen matrix tablets. II. Influence of some hydrophobic excipients on the release rate and in vitro evaluation.

Abstract: The aim of this study was to investigate the influence of polymer level and type of some hydrophobic polymers, including hydrogenated castor oil (HCO); Eudragit RS100 (E-RS100); Eudragit L100 (E-L100), and some fillers namely mannitol [soluble filler], Dibasic calcium phosphate dihydrate (Emcompress) and anhydrous dibasic calcium phosphate [insoluble fillers] on the release rate and mechanism of baclofen from matrix tablets prepared by a hot-melt granulation process (wax tablets) and wet granulation process (E-RS100 and E-L100 tablets). Statistically significant differences were found among the drug release profile from different classes of polymeric matrices. Higher polymeric content (40%) in the matrix decreased the release rate of drug because of increased tortuosity and decreased porosity. At lower polymeric level (20%), the rate and extent of drug release was elevated. HCO was found to cause the strongest retardation of drug. On the other hand, replacement of Emcompress or anhydrous dibasic calcium phosphate for mannitol significantly retarded the release rate of baclofen, except for E-L100 (pH-dependent polymer). Emcompress surface alkalinity and in-situ increase in pH of the matrix microenvironment enhanced the dissolution and erosion of these matrix tablets. The release kinetics was found to be governed by the type and content of the excipients (polymer or filler). The prepared tablets showed no significant change in drug release rate when stored at ambient room conditions for 6 months.

Glenotemporal osteotomy and bone grafting in the management of chronic recurrent dislocation and hypermobility of the temporomandibular joint.

Abstract: Chronic recurrent dislocation of the temporomandibular joint (TMJ) is rare and has many causes. Although it is possible to start treating it conservatively, these treatments are usually unsuccessful. Over the years, many operations have been done including operating on the muscles, the articular capsule, the articular meniscus, and the condyle. At present, the most widely accepted techniques are those used on the articular eminence. It may be reduced (eminectomy), favouring free movement of the condyles, or an obstacle may be interposed to prevent excessive movement of the condyles. These later techniques include Norman's (glenotemporal osteotomy with interpositional bone grafting). Other techniques include Dauterey's procedure, on which onlay bone grafts or bone substitutes are inserted in a subperiosteal pocket inferior to the articular eminences. We report a prospective study of 60 patients who had a bilaterally modified glenotemporal osteotomy, 40 who had chronic dislocations of the temporomandibular joints and the other 20 who had severe hypermobility of the joints. Bone grafts, iliac or calvarial, were inserted at the osteotomy between the zygomatic arch and the articular eminence, and fixed either by wires, mini-plates or microplates, and screws. Stable results were obtained and retained during long-term follow up of 1-8 years.

Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C.

Abstract: Objectives: To determine the clinical, biological, virological and histological predictive factors associated with a sustained virological response (SVR) to combined interferon therapy among Egyptian patients infected by genotype 4 hepatitis C virus (HCV) Patients and Methods: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR Results: A sustained virological response was achieved among 137/250 (548%) patients Baseline factors independently and negatively associated with SVR were serum α-fetoprotein (AFP) level (above 03 upper limit of normal) [odds ratio (OR)=05, 95% confidence interval (CI): 02–08], severe fibrosis (Metavir score >F2) (OR=04, 95% CI: 02–08), presence of steatosis (OR=05, 95% CI: 03–097) and standard interferon treatment (OR=04, 95% CI: 02–08) Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response

The significance of Epstein Barr Virus (EBV) & DNA Topoisomerase II alpha (DNA-Topo II alpha) immunoreactivity in normal oral mucosa, Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (OSCC)

Abstract: Background Head and neck cancer including oral cancer is considered to develop by accumulated genetic alterations and the major pathway is cancerization from lesions such as intraepithelial dysplasia in oral leukoplakia and erythroplakia. The relationship of proliferation markers with the grading of dysplasia is uncertain. The involvement of EBV in oral carcinogenesis is not fully understood.

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction.

Abstract: Depression and hypogonadism are associated with erectile dysfunction (ED). We evaluated the prevalence of both conditions in men presenting to an ED specialty clinic, and tested whether hypogonadism correlated with the presence of depressive symptoms using a validated questionnaire. From July 2001 to June 2003, 157 men referred to an ED specialty clinic prospectively filled the Center for Epidemiologic Studies Depression Scale (CES-D), the abbreviated International Index of Erectile Function (IIEF-5) and had testosterone serum levels drawn. Median age was 53 (range=21–85 years). Hypogonadism, defined as serum T (testosterone)<300 mg/dl, was present in 36% of patients. This proportion was higher in men over the median age compared to younger patients (45 and 26%, respectively, P=0.002). Overt depression symptoms, defined as a CES-D⩾22, were found in 24% of men. Mean age of men with overt depression was 49.9±10.1 years vs 55.1±15.8 years for those with CES-D<22 (P=0.02). Hypogonadal men were more likely to have overt depression scores compared to eugonadal counterparts (35 vs 18%, P=0.02). This association was statistically stronger after correcting for age in a multivariate linear model (P=0.005). The relative risk of having overt depression was 1.94 times higher in men with hypogonadal testosterone level (95% confidence interval: 1.13 to 3.7). We conclude that in an ED referral population, symptoms of hypogonadism and depression symptoms are fairly prevalent, and that overt depression symptoms are strongly associated with hypogonadism. Clinicians should consider testosterone measurements in all men with high depression symptom scores.

Chinese cupping: a simple method to obtain epithelial grafts for the management of resistant localized vitiligo.

Abstract: Background The introduction of surgical techniques provided a major development in the management of resistant vitiligo and replaced other conventional unsuccessful therapies. Most of these procedures require special devices and experience that prevent many dermatologists from utilizing them. Objectives The aim of this work is to evaluate the introduction of a new simple technique that can be used in epithelial grafting for recalcitrant patches of vitiligo. Methods Twenty vitiligo patients, nonresponding to classic phototherapy, were candidates in this study. A simple Chinese cupping device was used to induce blisters on the inner aspect of the thighs of the patients and the resulting blister roofs were used for grafting on dermabraded vitiliginous patches. The patients were followed up for 1 year. Results Blister roofs induced by Chinese cupping were able to repigment vitiliginous patches in 80% of the patients with admirable coloring match, and the donor areas did not show any cosmetic disfigurement at the end of the study. Conclusion In conclusion, Chinese cupping is a simple and easy-to-use method to obtain epithelial grafts for vitiligo management. The author has indicated no significant interest with commercial supporters.