Marked Significant Reduction Research Articles

Can Erythropoietin Open a Novel Avenue for Periodontal Regeneration?

Periodontitis is a dramatic inflammatory disease, representing vigorous interactions between specific causative pathogens and host immune responses resulting in the activation of the destructive inflammatory cascade with the subsequent irreversible destruction of the teeth-supporting apparatus. This study aims to evaluate the effect of using erythropoietin (EPO) injectable hydrogel, as an additional therapeutic option to scaling and root planing (SRP) in the treatment of stage II periodontitis patients, and to assess its effect on the level of osteocalcin and interleukin (IL)-1β in the gingival crevicular fluid (GCF). A total number of 40 patients clinically diagnosed with stage II periodontitis were included. The participants were allocated into two equal groups: study and control groups. Patients in the control group received SRP, while those in the study group received SRP followed by injectable hydrogel containing EPO. Clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and two months post treatment. GCF samples were collected at baseline and two months post treatment from both groups to analyze GCF IL-1β and osteocalcin levels using enzyme-linked immunosorbent assay (ELISA). Significant reductions in all tested clinical parameters were revealed in both groups in comparison to baseline values. A marked significant reduction in GCF IL-1β level was detected in the study group. However, two months post treatment, the osteocalcin level was decreased significantly in both groups. This preliminary study shows great promise for the local application of EPO hydrogel as an adjunct to SRP for the management of stage II periodontitis.

Analysis of Blood Biochemistry and Pituitary-Gonadal Histology after Chronic Exposure to Bisphenol-A of Mice.

Bisphenol-A is an emerging pollutant that is widespread in the environment, and to which live beings are continuously and inadvertently exposed. It is a substance with an endocrine-disrupting capacity, causing alterations in the reproductive, immunological, and neurological systems, among others, as well as metabolic alterations. Our study aimed to assess its clinical signs, and effects on the most relevant blood biochemical parameters, and to evaluate pituitary and gonadal histology after a chronic exposure of adult mice to different BPA doses (0.5, 2, 4, 50 and 100 µg/kg BW/day) through their drinking water. The biochemical results showed that a marked significant reduction (p < 0.05) was produced in the levels of serum glucose, hypoproteinaemia and hypoalbuminemia in the groups exposed to the highest doses, whereas in the group exposed to 50 µg/kg BW/day the glucose and total protein levels dropped, and the animals exposed to 100 µg/kg BW/day experienced a diminution in albumin levels. In the case of the group exposed to 50 µg/kg BW/day, however, hypertriglyceridemia and hypercholesterolemia were determined, and the blood parameters indicating kidney alterations such as urea and creatinine experienced a significant increase (p < 0.05) with respect to the controls. Regarding the pituitary and gonads, none of the animals exposed presented histological alterations at the doses tested, giving similar images to those of the control group. These results suggest that continuous exposure to low BPA doses could trigger an inhibition of hepatic gluconeogenesis, which would result in a hypoglycaemic state, together with an induction of the enzymes responsible for lipidic synthesis, a mechanism by which the increase in the lipid and serum cholesterol levels could be explained. Likewise, the decline in the protein and albumin levels would be indicative of a possible hepatic alteration, and the increase in urea and creatinine would point to a possible renal perturbation, derived from continuous exposure to this xenobiotic. Based on our results, it could be said that chronic exposure to low BPA doses would not produce any clinical signs or histological pituitary-gonadal effects, but it could cause modifications in some blood biochemical parameters, that could initially indicate a possible hepatic and renal effect.

A Comparative Study of the Diagnostic and Prognostic Value of Macrophage Activation Marker Soluble CD163 and Alpha Fetoprotein in Cirrhotic Patients with Hepatitis C Virus-related Hepatocellular Carcinoma treated by Loco-Regional Therapy

Abstract Background hepatocellular carcinoma (HCC) shows an increasing incidence and represents the third most common cause of cancer-related death. Aim of the Work is to evaluate the diagnostic value of serum level of Macrophage activation marker soluble CD163 as a tumor marker for HCC and its prognostic value after transarterial chemo-embolization (TACE) or radiofrequency ablation (RFA), in comparison to alpha-feto protein (AFP). Patients and Methods this study was performed on 60 subjects from the outpatient Hepatology clinic and inpatient Gastroenterology and Hepatology Department at Ain Shams University Hospital. Group I includes 40 randomly selected cirrhotic patients with hepatitis C virus-related hepatocellular carcinoma (excluding BCLC class D) who underwent either RFA or TACE. Group II includes 20 patients with liver cirrhosis without hepatocellular carcinoma considered as control. Results soluble CD163 expression did not differ significantly between HCC group and liver cirrhosis group. This proves that soluble CD163 is not suitable for diagnostic use. On the other hand, soluble CD163 was associated with the severity of liver disease. Baseline soluble CD163 was significantly associated with disease progression independent of other risk factors known to be associated with an unfavorable course in HCC. Also the marked significant reduction of serum soluble CD163 levels in HCC patients subjected to either RF ablation or TACE proved that soluble CD163 may play a prognostic marker in HCC monitoring. Conclusion soluble CD163 is not suitable as a diagnostic marker for HCC but can be used as a prognostic marker for HCC.

Clinical characteristics and patient treatment satisfaction with Humalog U-200 in patients with type 2 diabetes mellitus: an observational study

Background There are limited data on the real-world evidence of Humalog 200 units/ml KwikPen (U-200) insulin. We assessed the use of U-200 insulin in UK routine clinical practice to provide information on clinical characteristics, treatment satisfaction and short-term clinical outcomes. Methods Nine patients with type 2 diabetes who initiated U-200 in secondary care and a further 12 identified from primary care electronic database were enrolled. A treatment satisfaction questionnaire was administered to the 19 secondary care patients. Follow-up data on clinical parameters were collected at 3 and 6 months following initial U-200 insulin administration and the data were used to assess changes in clinical outcomes from baseline. Results Secondary care patients had a mean age 60 ± 11 years, mean HbA1c of 8.6% ± 1.3% and a mean BMI of 39.7 ± 5.3 kg/m2 at baseline. Primary care database patients had a mean age 57 ± 13 years, mean HbA1c 10.3% ± 1.7 and a mean BMI 42.3 ± 3.8 kg/m2. The nine participants’ responses to the questionnaire suggested a high preference for U-200 over a previous mealtime insulin pen (PMIP). On average, the patients agreed that U-200 was quicker to inject, had a better controlled home blood glucose reading and less discomfort at the injection site compared to a PMIP. Patients were willing to continue with their U-200 treatment. No significant HbA1c reduction was observed at 3 months in the secondary care group (−0.5%), but marked significant reduction in HbA1c was seen at 3 months in the primary care dataset to (−2.8%; p < .0004). There was also some suggestion of weight loss in both the secondary and primary care groups. Conclusion Humalog U-200 insulin users were comprised mainly of older patients with diabetes complications and high HbA1c levels at the time of U-200 initiation. Overall, U-200 improved patients’ satisfaction with diabetes treatment and short-term metabolic outcomes.

Effect of Specific Nutritional Program on Patients with Chronic Renal Failure on Hemodialysis on El-keman Village Luxor Governorate

Background: Chronic renal failure is a universal community health problem. It is important to the patient to be on a specific healthy diet program. Objective: The present study was conducted to evaluate the effect of a specified nutritional program on the health status of renal patients on hemodialysis. Patients and methods: This was an interventional study that was conducted in the renal dialysis unit in El-keman village, Luxor Governorate. It included 60 patients with chronic renal failure on hemodialysis. An educational nutritional program was designed for the studied group. The patients were assessed pre- and post-intervention. The collected data were analyzed by using SPSS program version 19 with considering statistical significance when P value < 0.05. Results: The mean age of the studied participants was 46 years with age ranging from 20-60 years old. Nearly 56.7% of the patients were males and 51.7% of them were of low social class. Regarding the Mini Nutritional Assessment (MNA), there was highly statistically significant difference in MNA score before and after intervention (25.07 versus 22.45 respectively) and there was marked significant reduction in malnutrition percentage after the intervention. Creatinine, urea, AST, ALT and cholesterol significantly decreased after intervention compared to the levels before it. There was highly statistically significant improvement in hemoglobin level after intervention. Conclusion: It can be concluded that proper nutrition is important for patients on hemodialysis as good nutritional status of the patients affects greatly their quality of life and health status.

Effect of Specific Nutritional Program on Patients with Chronic Renal Failure on Hemodialysis on El-keman Village Luxor Governorate

Background: Chronic renal failure is a universal community health problem. It is important to the patient to be on a specific healthy diet program. Objective: The present study was conducted to evaluate the effect of a specified nutritional program on the health status of renal patients on hemodialysis. Patients and methods: This was an interventional study that was conducted in the renal dialysis unit in El-keman village, Luxor Governorate. It included 60 patients with chronic renal failure on hemodialysis. An educational nutritional program was designed for the studied group. The patients were assessed pre- and post-intervention. The collected data were analyzed by using SPSS program version 19 with considering statistical significance when P value < 0.05. Results: The mean age of the studied participants was 46 years with age ranging from 20-60 years old. Nearly 56.7% of the patients were males and 51.7% of them were of low social class. Regarding the Mini Nutritional Assessment (MNA), there was highly statistically significant difference in MNA score before and after intervention (25.07 versus 22.45 respectively) and there was marked significant reduction in malnutrition percentage after the intervention. Creatinine, urea, AST, ALT and cholesterol significantly decreased after intervention compared to the levels before it. There was highly statistically significant improvement in hemoglobin level after intervention. Conclusion: It can be concluded that proper nutrition is important for patients on hemodialysis as good nutritional status of the patients affects greatly their quality of life and health status.

CD147 mediates intrahepatic leukocyte aggregation and determines the extent of liver injury.

BackgroundChronic inflammation is the driver of liver injury and results in progressive fibrosis and eventual cirrhosis with consequences including both liver failure and liver cancer. We have previously described increased expression of the highly multifunctional glycoprotein CD147 in liver injury. This work describes a novel role of CD147 in liver inflammation and the importance of leukocyte aggregates in determining the extent of liver injury.MethodsNon-diseased, progressive injury, and cirrhotic liver from humans and mice were examined using a mAb targeting CD147. Inflammatory cell subsets were assessed by multiparameter flow cytometry.ResultsIn liver injury, we observe abundant, intrahepatic leukocyte clusters defined as ≥5 adjacent CD45+ cells which we have termed “leukocyte aggregates”. We have shown that these leukocyte aggregates have a significant effect in determining the extent of liver injury. If CD147 is blocked in vivo, these leukocyte aggregates diminish in size and number, together with a marked significant reduction in liver injury including fibrosis. This is accompanied by no change in overall intrahepatic leukocyte numbers. Further, blocking of aggregation formation occurs prior to an appreciable increase in inflammatory markers or fibrosis. Additionally, there were no observed, “off-target” or unpredicted effects in targeting CD147.ConclusionCD147 mediates leukocyte aggregation which is associated with the development of liver injury. This is not a secondary effect, but a cause of injury as aggregate formation proceeds other markers of injury. Leukocyte aggregation has been previously described in inflammation dating back over many decades. Here we demonstrate that leukocyte aggregates determine the extent of liver injury.

RETRACTED: Vaginal cleansing prior to caesarian section: To do or not to do?: A randomized trial

Purpose: To evaluate the efficacy of preoperative vaginal cleansing using povidone-iodine solution 10% on rates of post cesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection).Methods: This prospective randomized trial was conducted among 226 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization method. The study group had preoperative vaginal cleansing using povidone-iodine solution 10% for about 1 min, while the control group did not. All cases received the prophylactic antibiotics and the usual abdominal scrub. Adverse post CS infectious morbidities such as endometritis, febrile morbidity and wound infection were observed at the time of hospital discharge and weekly for 6 weeks postpartum.Results: Both groups were matched regarding the baseline patients’ characteristics. Overall, post-CS infectious morbidity was significantly reduced from 20.7% in the control group to 7.5% in the intervention group. Marked significant reduction was seen in the incidence of endometritis (11.8% in the control group versus 2.8% in the intervention group). However, maternal fever and wound infection showed no significant difference between both groups.Conclusion: Vaginal cleansing with povidone-iodine solution 10% prior to elective CS appears to be effective in reducing rates of post-CS infectious morbidity mainly endometritis.

Management of recurrent tonsillitis in children

ObjectiveTo compare azithromycin (AZT) and benzathine penicillin (BP) in the treatment of recurrent tonsillitis in children. MethodsThe study comprised of 350 children with recurrent streptococcal tonsillitis, 284 of whom completed the study and 162 children received conventional surgical treatment. The rest of the children, 122, were divided randomly into two equal main groups. Group A children received a single intramuscular BP (600,000IU for children≤27kg and 1,200,000IU for ≥27kg) every two weeks for six months. Group B children received single oral AZT (250mg for children≤25kg and 500mg for ≥25kg) once weekly for six months. ResultsBoth groups showed marked significant reduction in recurrent tonsillitis that is comparable to results of tonsillectomy. There were no statistical differences between group A and B regarding the recurrence of infections and drug safety after six-month follow-up. Group B showed better compliance. ConclusionAZT proved to be good alternative to BP in the management of recurrent tonsillitis with results similar to those obtained after tonsillectomy.

Calcium antagonist lercanidipine in hypertension

The article presents the results of studies on the effectiveness and safety of a III generation calcium antagonist lercanidipine in the treatment of hypertension. Lercanidipine treatment leads to a marked significant reduction in systolic and diastolic blood pressure without producing a significant effect on heart rate. The drug has organ-protective effect, reduces left ventricular hypertrophy, improves kidney function and has antiproteinuric action. Lercanidipine is well tolerated, less likely to cause peripheral edema compared with other calcium antagonists.

Effects of combined erythropoietin and epidermal growth factor on renal ischaemia/reperfusion injury: a randomized experimental controlled study

To investigate effects of combination of erythropoietin (EPO) and epidermal growth factor (EGF) on renal ischaemia and on reactive oxygen species in a rat model. In all, 90 male Sprague-Dawley rats were allocated into five groups of 18, designated: Sham; treated with right nephrectomy only; Control, subjected to left renal ischaemia for 45 min with no treatment; EPO-treated, as the control but with EPO pretreatment; EGF-treated, as the control but with EGF pretreatment; EPO + EGF-treated, as the control but with EPO and EGF pretreatment. Renal function, histopathology and malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione (GSH) levels in kidneys were assessed at 1, 2 and 7 days after ischaemia. All rats except the controls had a significant improvement in serum creatinine, creatinine clearance and fractional excretion of Na(+) ; all three were significantly better in EPO + EGF group than in all other groups Histopathological examination showed marked structural damage in control rats. The tubular damage was least in the EPO + EGF group. The control group had a significant increase in MDA level and a significant decrease in SOD and GSH, while the EPO + EGF group had a marked significant reduction in MDA and increase in GSH and SOD. The protection against ischaemia/reperfusion injury might be maximal when EPO and EGF are administered concomitantly, and their protective effect might be partly due to their antioxidant effects.

HEV, PGS, GABA, Chronic Tonsilitis

To compare azithromycin (AZT) and benzathine penicillin (BP) in the treatment of recurrent tonsillitis in children.The study comprised of 350 children with recurrent streptococcal tonsillitis, 284 of whom completed the study and 162 children received conventional surgical treatment. The rest of the children, 122, were divided randomly into two equal main groups. Group A children received a single intramuscular BP (600,000 IU for children ≤ 27 kg and 1,200,000 IU for ≥ 27 kg) every two weeks for six months. Group B children received single oral AZT (250 mg for children ≤ 25 kg and 500 mg for ≥ 25 kg) once weekly for six months.Both groups showed marked significant reduction in recurrent tonsillitis that is comparable to results of tonsillectomy. There were no statistical differences between group A and B regarding the recurrence of infections and drug safety after six-month follow-up. Group B showed better compliance.AZT proved to be good alternative to BP in the management of recurrent tonsillitis with results similar to those obtained after tonsillectomy.

Effects of oestrogens on erythrocyte enzyme efflux in normal men and women

In the normal female range for serum creatine kinase, the large diminutions associated with the reproductive period and with pregnancy are apparently related to oestrogen production. Specimens of heparinised blood from healthy men and women were stressed by chilling, and showed the predictably large efflux of erythrocyte aldolase and lactate dehydrogenase into plasma. In aliquots of the same specimens simultaneously stressed in the same way, previous substitution of the natural plasma with pregnant plasma rich in oestrogens gave a marked significant reduction in the efflux of both enzymes in women, but not in men. The significance of these findings is discussed.