Ve Group Research Articles

Impact of Anti-Hepatitis B Core Following Allogeneic Bone Marrow Transplantation; Single Center Study of 489 Patients

▪Introduction:Hepatitis B core antibodies (Anti-HBC+) are virtually detected in all patients who have been exposed to Hepatitis B Virus (HBV), which make it a reliable serology marker for the previous infection. Anti-HBC+ patients undergoing hematopoietic stem cell transplant (HSCT) are at high risk of reactivation and may change the outcome especially during immunosuppression therapy (IST) phase which believed to enhance viral replications, as with withdrawal of IST which lead to the restoration of immune function making infected hepatocyte easier to destruction. The exact risk of (Anti-HBC+) post HSCT is not very well studied. In this study, we attempted to demonstrate the effect of (Anti-HBC+) positivity in the outcome post HSCT.Methods:Patients who were at least 14 years old receiving HSCT between year 2004 and 2010 at our center were reviewed. Patients with acutely infected hepatitis B (+ve hepatitis S antigen and IgM anti-HBC) were excluded from HSCT. A total of 489 patients were identified and included in the study. Patients were stratified into two groups: anti-hepatitis B core serology positive (Anti-HBC+) versus anti-hepatitis B core serology negative (anti-HBC -ve). After transplant, hepatitis B serology and PCR testing were performed at physician discretion at the time of unexplained elevation of liver enzymes. Prophylaxis use of antiviral medications was routinely given to all patients who are anti-HBC positive. Interpretation of hepatitis B serological test was based on Center for Disease Control and Prevention (CDC).Results:Median age for all patients is 22 years (range, 14 -62), 62% (n=304) were males. Matched related donor was used for majority of patients, 94.3% (n=461), while 18 patients (3.7%) underwent mismatched HSCT and 7 patients (1.4%) had umbilical cord transplantation. Diagnoses were ALL in 158 patients (32%), AML in 142 (29%) and CML in 58 patients (12%).GVHD prophylaxis was CSA/MTX for 83% (n=405), CSA/MMF for 4% and others for 13% (n=63). Conditioning regimen was Cyclophosphamide/TBI in 201 (41%), Busulfan/Cyclophosphamide in 181 patients (37%), Fludarabine/cyclophosphamide in 52 patients (11%) and others in 54 patients (11%). Bone marrow was the source of stem cells for 288 patients (59%).Anti-HBC serology at the time of HSCT was positive in 76 patients (15.5%) versus negative in 413 patients (84.5%). Donors' anti-HBC status was positive in 14% versus negative in (86%).A median follow-up of 5.4 years for anti-HBC+ survivors (range, 3 -5) showed 31 patients (41%) remain positive, 39 patients (51%) sero-converted to negative and six patients (8%) developed re-activation of hepatitis B. A median follow-up unreached for anti-HBC -ve survivors showed 396 patients (95.9%) remain negative, 6 patients (1.9%) became positive for anti-HBC and 3 patients (1%) developed acute hepatitis B after HSCT.Outcomes of HSCT showed overall survival (OS) rate at 5 years of 50% in anti-HBC+ group versus 58% in anti-HBC -ve group (p=0.30), suggesting a trend of lower rate of OS in anti-HBC+ group. The NRM and cumulative incidence of relapse at 5 years was 19% and 42% in anti-HBC+ group versus 17% (p=0.9) and 35% in anti-HBC -ve group (p=0.20), respectively.The cumulative incidence of overall acute GVHD at day 120 and overall chronic GVHD at 2 years were 42% and 47% in anti-HBC+ group versus 33% (p=0.1) and 46% (p=0.9) in anti-HBC -ve group, respectively, suggesting a trend of higher incidence of overall acute GVHD in anti-HBC+ group however it was statistically insignificant.Univariate analysis of risk factors for OS showed anti-HBC+ pre HSCT is an important factor however this was not confirmed in multivariate analysis.Conclusion:The present study suggested very low incidence of hepatitis B re-activation following HSCT for anti-HBC+ group (8%) if given proper anti HBV prophylaxis. Anti-HBC+ group does have a trend of lower overall survival and higher association with overall acute GVHD however this was not confirmed in multivariate analysis. Further studies are strongly warranted to confirm the prognostic role of anti-HBC in HSCT. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Effect of dietary protease supplementation on growth performance, water quality, blood parameters and intestinal morphology of Nile tilapia (Oreochromis niloticus).

This study was conducted to evaluate the effect of using protease in diets of Nile tilapia on growth performance, water quality, blood parameters and intestinal morphology. The cost of these diets and their return on fish performance was calculated. A total of 360 fish were randomly allocated into four groups with triplicates (30fish per replicate). Four diets were formulated; two controls (without protease supplementation) and two experimental diets (supplemented with protease). The first control diet contained the normal protein requirement (30% CP; control +ve), while the second control had a low protein content (29% CP; control -ve). The third diet was supplemented with protease at a dose of 500g/ton, and its CP content was reduced to 29.0%, by reducing the fish meal content. The fourth diet contained the same CP level as the first control (30%) and supplemented with 250g protease per ton feed. The experiment lasted for 14weeks. The results showed that body weight and length, weight gain, specific growth rate, feed intake and feed conversion efficiency in the control -ve group (low CP) supplemented with protease were similar (p>0.05) to that of the control +ve with normal CP content. However, these performance parameters were lower (p<0.05) in fish fed low CP diet without protease supplementation. Providing protease to the control +ve diet improved all measured performance indices. The ammonia and nitrite concentrations of the water were reduced (p<0.05) in control -ve and protease-supplemented groups. The height and width of intestinal villi were increased (p<0.05) in fish fed diets containing protease. The inclusion of protease reduced the diet cost and also the feed cost of fish weight gain. In conclusion, supplementation of protease can improve the productive performance of fish, spare dietary protein and produce economical diets. Moreover, it can help in improving the water quality of fish via lowering the ammonia and nitrite contents, or through increasing the degradation of dietary protein.

Audit of clinical use of blood products in a tertiary care hospital

Objectives: Blood and its components are an important part of patient management treatment protocols and like drugs have property to cause adverse reactions in the recipients. To maximize the effectiveness, safety and utility clinicians and intravenous therapists should be knowledgeable about the potential risk of blood component therapy. Hence, regular audit of blood and its component usage is essential to access the blood utilization pattern and set ideal policies in all the blood using specialties. Material and Methods: This is a prospective Study conducted in department of Transfusion Medicine at Vinayaka Mission Kirupananda Variyar Medical College &amp; Hospital for a period of one year. Source of data was blood bank requisition forms and blood bank registers of patients who underwent elective or emergency procedures in the hospital, for which blood was ordered. Results: The mean age of the study subjects was 41.8 years. The male : female ratio was 1.6 : 1. Majority of the study subjects were in the surgery department followed by Ortho and OBG. Majority of the study subjects belong to B+ve blood group followed by O+ve group and only 20% of the subjects belong to negative blood group. 70% of the subjects required blood transfusion for some kind of surgical intervention and only 28% had required blood transfusion related to medical causes. Majority required four units of PRC transfusion. Majority of the subjects had the haemoglobin levels in the range of 6–7 and the mean level was 6.56 gms%. Majority of the packed red cell was stored for 2 weeks or 5 weeks and the mean duration of storage was 4.3 weeks. A statistical significant improvement was observed in the mean haemoglobin levels in the post-transfusion period compared to the pre-transfusion haemoglobin. Only 5% of the times the reaction related to fever or anaphylaxis had occurred among the entire study subjects. 50% had completed the entire blood transfusion in less than 4 hrs and the mean duration was 4.3 hrs. 65.9% of the patients had appropriate blood transfusion based on the guideline and the remaining 34% had inappropriate blood transfusion. It is inferred from the table that the CTR, transfusion probability and the transfusion index was found to be above the guideline value to be considered as effective blood utilisation. Conclusion: Regular audit of blood components is crucial so that appropriate measures can be taken for proper usage. Continuous medical education regarding the transfusion services for the clinicians and staff nurses have major role in improvement for the clinical transfusion practices in the hospitals.

Role of fetal main pulmonary artery doppler indices in prediction of fetal lung maturity

Background: Accurate evaluation of fetal lung maturity is of utmost importance for determining the optimal time for pregnancy termination. Amniocentesis is an invasive procedure and is associated with a small but real risk to the pregnancy. So noninvasive sonographic techniques to evaluate lung maturity is most needed. Objective: To study the role of fetal main pulmonary artery Doppler (MPA) indices in prediction of Fetal Lung Maturity (FLM) and determine a cut point of Doppler indices with high sensitivity and specificity. Patients and Methods: Our prospective cohort study included 200 pregnant women 38 weeks fulfilling the inclusion and exclusion criteria, A number of different parameters were measured from the fetal pulmonary artery flow (FPAF) waveform (At/Et, S/D, PSV, PI and RI) for diagnosis of neonatal Respiratory Distress Syndrome (RDS) by comparing the Doppler findings with the clinical outcome. Results: About 46 (23%) fetuses were diagnosed as RDS (+ve) and 154 (77%) fetuses were without RDS(-ve). At/Et and PSV were positively correlated, whereas PI and RI were inversely correlated with RDS. S/D ratio did not change significantly. The strongest correlation was found with At/Et. AT/ET was significantly lower in the RDS +ve group and cutoff point of 0.32 predicted the development of neonatal RDS with a high sensitivity specificity, and accuracy (98.0%, 92.0%, and 95.0% respectively). Conclusion: FLM and Neonatal RDS can be predicted using the MPA At/Et with high sensitivity and specificity.

Ameliorative Effects of induced pluripotent stem cells on experimentally induced ovarian ablation in adult female rats

The current study designed to evaluate the role of pluripotent stem cells (iPSc) on experimentally-induced ovarian ablation (OA) by evaluating of hematological parameters, FSH and E2 changes, molecular and histopathological examination. 50 female rats were divided into five groups with 10 in each group. Group (1): control group. Group (2): rats injected with Doxorubicin (DOX) (3 mg/kg) and Cyclophosphamide (CYP) (50mg/kg) dissolved in sterile physiological saline injected I/P once a week for 5 weeks. Group (3): 10 rats undergo chemoablasion then injected with 5 IU of pregnant mare serum gonadotropin (PMSG) single s/c injection. Group (4): 10 rats undergo chemoablasion, then iPSc injected i/v single injection for 2 months. Group (5): 10 rats undergo chemoablasion then iPSc injected i/v combined with single s/c injection of 5 IU PMSG. Results revealed that rats injected with Dox and CYP showed asignificant decrease in RBCs, Hb and PCV, WBCs, lymphocytes, neutrophil, eosinophil, E2 level and Oct 4 while there was significant increase in MCV, MCH, monocytes and FSH level compared with control (-ve) group. While, rats treated with PMSG or IPSc or PMSG and IPSc revealed significant increase in RBCs count as well as MCHC, E2 level and Oct 4 with non significant changes in Hb and PCV, WBCs, lymphocytes, eosinophil with asignificant increase of neutrophil IPSc or PMSG and IPSc groups and asignificant decrease in monocytes compared with OA group and control (-ve) group.

Clinicopathological Effect of Induced Pluripotent stem cells and Hormonal Therapy on Premature Ovarian Failure

A b s t r a c t This experiment was designed to investigate the roles of induced pluripotent stem cells and hormonal therapy on experimentally-induced ovarian ablation (OA) by evaluating of hormonal, molecular, histopathological and immunohistochemical examinations. Fifty female rats classified into five main groups. Group (I):10 rats as control normal group. Group II (OA): 10 rats injecteded with (3 mg/kg) of DOX and (50 mg) CYP dissolved in clean physiological saline I/P once week for 5 weeks. Group (III): 10 rats go through chemoablasion, after that, rats were injected with 5 IU of PMSG single subcutaneous (S/C) injection. Group (IV): 10 rats undergo chemoablasion, after that induced pluripotent stem cells (iPSc) were injected intravenous (I/V) single injection for 2 months. Group (V): 10 rats undergo chemoablasion then iPSc were injected I/V combined with single S/C injection of 5 IU PMSG. Results revealed that rats injected with doxorubicin and cyclophosphamide showed a significant increase in FSH, LH levels while asignificant decrease in E2, PCNA, Oct4, Stra8 and Runx2 when compared with control (-ve) group. On the other hand, rats treated with PMSG or IPSc only or PMSG and IPSc revealed that there were increase in E2 level, PCNA, OCT4, Stra8 and Runx2 while there is decrease in FSH, LH levels when compared with chemoablated control group. Also, ovarian sections of chemoablated group showed degenerated surface epithelia, loss of secondary, and antral follicles. ovarian sections of group treated with PMSG and iPSc showed well observed primordial, primary and secondary follicles.

Antioxidant Statues, Growth and Some Physiological Performances of the Gimmizah Male Chickens Supplemented by Dietary Spirulina Platensis under Chronic Heat Stress.

The present study was carried out to study the effect of Spirulina supplementation on the growth and some physiological performances of the Gimmizah males exposed to heat stress (HS). A total number of 150 male 4 weeks old Gimmizah were randomly allocated in five groups (3 replicates, 10 chicks each). The first (positive control, PC) was reared under 22-24OC and PH 45-55% and fed unsupplied basal diet, B). Whereas, the other groups were reused under HS (38°C±1; 55-65 % RH) for three successive days /wk from 11.00 a.m until 15.00 p.m, through the experimental period (4 to 14 wks of age) in a battery brooders. The first HS group was used as a negative control (NC) and fed B. The 3rd and 4rd groups fed B plus 250 and 150 mg Spirulina /kg diet, respectively. The 5 group was fed the B plus 75 mg VE /kg diet. The feed consumption was significantly decreased for all groups under HS compared with PC group, while FCR for the groups under HS (supplied with Spirulina or VE) were significantly improved compared with NC. The differential of leukocytic count for the NC group recorded the significant increase on Lymphocyte, Heterophil and the ratio of H/L compared with other groups. The concentration of globulin and activity of GSH-PX were significantly improved for the groups supplied with both levels of Spirolina under HS compared with the NC group. The highest Infections Bronchitis titer was recorded for the group supplied with VE and PC group. In conclusion, addition of 150 and 250 mg Spirulina platensis /kg diet improved performance, immunity and can be decreased the adverse effect of heat stress for Gimmizah mail during growing period (4-14 wks of age).

Pre-treatment PET/MRI based FDG and DWI imaging parameters for predicting HPV status and tumor response to chemoradiotherapy in primary oropharyngeal squamous cell carcinoma (OPSCC)

ObjectivesTo determine the feasibility of pre-treatment primary tumor FDG-PET and DWI-MR imaging parameters in predicting HPV status and the second aim was to assess the feasibility of those imaging parameters to predict response to therapy. Material and MethodsWe retrospectively analyzed primary tumors in 33 patients with proven OPSCC. PET/MRI was performed before and 6 months after chemo-radiotherapy for assessing treatment response. PET Standardized uptake value (SUVmax), total lesion glycolysis (TLG), metabolic tumor volume (MTV), and apparent diffusion coefficient (ADC) from pre-treatment measurements were assessed and compared to the clinicopathological characteristics (T stages, N stages, tumor grades, HPV and post-treatment follow up). HPV was correlated to the clinicopathological characteristics. ResultsADCmean was significantly lower in patients with HPV+ve than HPV-ev, (P = 0.001), cut off value of (800 ± 0.44*10-3mm2/s) with 76.9% sensitivity, and 72.2% specificity is able to differentiate between the two groups. No significant differences were found between FDG parameters (SUVmax, TLG, and MTV), and HPV status, (P = 0.873, P = 0.958, and P = 0.817), respectively. Comparison between CR and NCR groups; ADCmean, TLG, and MTV were predictive parameters of treatment response, (P = 0.017, P = 0.013, and P = 0.014), respectively. HPV+ve group shows a higher probability of lymph nodes involvement, (P = 0.006) ConclusionOur study found that pretreatment ADC of the primary tumor can predict HPV status and treatment response. On the other hand, metabolic PET parameters (TLG, and MTV) were able to predict primary tumor response to therapy.

Is serum PSA a predictor of male hypogonadism? Testing the hypothesis.

Male hypogonadism (MH) is common among infertile men. Besides testosterone, limited MH biomarkers are available, while researchers have suggested the use of prostate-specific antigen (PSA) to help diagnose MH. Hence, we sought to evaluate the potential use of PSA to predict MH among relatively young men with infertility in Nigeria. The study included 707 male partners (35-44 years) in infertile couples seeking infertility evaluation at a third-level care center in Nigeria. MH was diagnosed using standard guidelines. Receiver operating characteristic (ROC) and regression analyses explored the potential of serum free PSA (fPSA) and total PSA (tPSA) in predicting MH and MH-related clinical features. In all, 29.7% of the patients had MH (MH+ve). The MH+ve group had lower mean values of fPSA and tPSA than the group without MH (MH-ve). The best fPSA threshold of < 0.25 μg/L compared with the best tPSA threshold of < 0.74 μg/L had higher accuracy (area under the curve [AUC] 0.908 versus 0.866, respectively), sensitivity (87% versus 83%, respectively), and specificity (42% versus 37%, respectively) for MH diagnosis. After adjustment for confounders, fPSA level ≤ 0.25 μg/L was more likely to predict MH-related decreased libido (odds ratio [OR] 2.728, p<0.001) and erectile dysfunction (OR 3.925, p<0.001) compared with tPSA ≤ 0.74 μg/L in the MH+ve group. For MH diagnosis, fPSA and tPSA had good sensitivity but very poor specificity, although fPSA had better potential for MH diagnosis and association with MH-related clinical features than tPSA. Hence, fPSA could complement other biomarkers for MH diagnosis in men 35-44 years, although we recommend further studies to confirm these findings.

Comparative Study Between Virgin Coconut Oil and Omeprazole Drug on Ulcerative Colitis in Experimental Rats

This study aims to identify the curative effect of virgin coconut oil on ulcerative colitis(UC),the present study was carried (24) adult albino male rats Sprague –Dawley strain weighting 180 ±10g were classified into four groups,(6 rats each) the first group rats were fed on basal diet only control negative(-ve) group and three rat groups were injured of ulcerative colitisby intra colonic administration of acetic acid 4% given rectally by single dose ( 1 ml/ rat ) and reclassified into control positive (+ve) group (fed on basal diet only), group treated with (20 mg/kg b.w) of omeprazole drug and group treated with (2 ml per/ rat) daily of virgin coconut oil . The results revealed that, the control (+ve) group showed a significant decrease in final weight(FW) ,weight gain(WG) feed efficiency ratio (FER), organs weight of heart, kidney, and liver , catalase (CAT), superoxide dismutase (SOD), glutathione reduced (GSH), Glutathione reductase (GSR),Glutathione peroxidase (GPx(, glutathione-S-transferees (GST) and significant increase in malondialdehyde (MDA) , hydrogen peroxide (H2O2), C-reactive protein (CRP), interleukin-6 (IL-K) and prostaglandin (PG2) compared with control (- ve) group. The virgin coconut oil group showed a significant increase in (FW),(WG),(FI),(FER),organ stomach,(CAT),(SOD),(GSH),(GSR (GPx), (GST) but significant decrease in (MDA),(H2O2),(CRP),(ILK), (PG2) compared with control (+ve) group . the study clearly showed that consumption virgin coconut oil has a role in treating rats with acetic acid-induced ulcerative colitis. It can be recommended that virgin coconut oil should be consumed daily to reduce the incidence of ulcerative colitis.

Supplementation of antioxidant micronutrients reduces stress and improves immune function/response in periparturient dairy cows and their calves

BackgroundPeriparturient period induces stress in cows which fluctuates hormonal and metabolic function and causes immune suppression. Apart from impairing the health, production, and reproduction of cows, it also influences the well-being of newborn calves by decreasing the colostrum quality. Micronutrients are known for optimal health and production and their effects on parturition stress, immune response in both cow and its calf need to be explored. AimThe aim of this study was to see the effect of oral supplementation of micronutrients during the prepartum period on the health status of crossbred dairy cows and subsequently on their newborn calves. MethodsA total of 42 healthy multiparous cows were selected and randomly divided into five groups with seven cows in each group, i.e. control (Basal Diet, BD), VA group (BD + vitamin A, 105 IU), Zn group (BD + zinc sulphate, 60 ppm), VE group (BD + vitamin E, 2500 IU), and combined supplementation (CS) group (BD + combination of VA, Zn, and VE). The supplements were offered in compounded concentrate DM (100 g) to individual cows once daily before the morning feeding and the remaining portion was incorporated in the TMR. Feeding was started one month before the expected days of calving till calving. Blood samples were collected from cows at days -15, -7, -3, 0, +3, +7, and +15 relative to the day of calving. Blood samples from newborn calves and milk samples of cows were collected at days 0, +3, +7, and +15. Milk somatic cell counts (SCC) were estimated using a cell counter. Cortisol was estimated by ELISA kit in blood and milk plasma of cows and in the blood plasma of their calves. Total immunoglobulins (Ig) were estimated in milk of cows and serum of calves using zinc sulphate turbidity method. Blood neutrophils from cows and calves were studied for phagocytic activity (PA) using nitro blue tetrazolium (NBT) assay.Data were analysed by repeated-measures two-way ANOVA using the mixed procedure of SAS, and the pairwise comparison was performed using a multiple comparison test (Tukey). ResultsCombined supplementation of micronutrients decreased (P < 0.05) maternal blood plasma (control vs. CS group, 5.98 ± 0.20 vs. 3.86 ± 0.23 ng/mL) and milk plasma (3.96 ± 0.13 vs. 2.71 ± 0.10 ng/mL) cortisol, milk SCC (3.05 ± 0.11 vs. 2.12 ± 0.10 × 105 cells/mL) and increased (P < 0.05) total milk Ig concentration (18.80 ± 0.11 vs. 23.04 ± 0.57 mg/mL) and the PA of blood neutrophils (0.84 ± 0.03 vs. 1.07 ± 0.03). Similarly, lower blood cortisol concentration (9.69 ± 0.35 vs. 6.02 ± 0.18 ng/mL) and higher (P < 0.05) total Ig (23.26 ± 0.11 vs. 30.34 ± 0.70 mg/mL) and PA of blood neutrophils (0.37 ± 0.02 vs. 0.52 ± 0.02) were observed in the calves born to CS group of cows as compared to the control. Highest (P < 0.05) positive effects (lower stress levels and higher immune response) of treatment were noticed in CS group followed by VE group and then Zn group. However, VA group didn’t differ from the control group. ConclusionOur results indicate that micronutrient interventions during the prepartum period can improve the health status of dairy calves and subsequently the well-being of their calves.

Quick Sequential Organ Failure Assessment Versus Systemic Inflammatory Response System in Early Detection of Sepsis in Emergency Department

Background: Sepsis is a life threating medical condition where infection leads to massive inflammatory response and eventually lead to organ dysfunction. It continues to pose a significant health threat despite remarkable developments in critical care medicine and extensive study of septic patients. Early recognition and treatment of sepsis in emergency department (ED) is important to reduce mortality, hospital length of stay and morbidity. Objective: This study was aimed to validate the performance of qSOFA scoring system and SIRS criteria in early sepsis diagnosis in the Emergency Department. Patient and method: This prospective observational clinical study was carried out in Emergency Department (ED) on 100 patients with suspected infection presented and admitted at o Mansoura University Emergency Hospital from February 2019 to February 2020. Patients were divided into two groups: infection group with qSOFA –ve criteria and sepsis group with qSOFA +ve group. We compare between qSOFA and SIRS scores in both groups. Results: The study demonstrated that organ dysfunction >2, 2ry to infection (according to sepsis definition by sepsis-3 task force) was more frequently reported among qSOFA + SIRS + group, compared to qSOFA - SIR – group. Moreover, both qSOFA and SIRS had comparable sensitivity (100%) in prediction of mortality within 1 week, while qSOFA demonstrated higher specificity (53.3%) in comparison with SIRS (20%). Both scores had comparable sensitivity for prediction ICU admission and of mechanical ventilation (86.67 and 88.9) whereas qSOFA demonstrated higher specificity than SIRS for ICU admission (94.29 versus 71.43) as well as mechanical ventilation (82.9 versus 63.41). Conclusion: It could be concluded that qSOFA is considered as specific not sensitive tool, while SIRS is more sensitive but not specific score for sepsis detection in emergency room.

Effect of Red Cabbage Leaves as Hypoglycemic and Antioxidant in Diabetic Rats Fed on HFT/HFR diet

Thirty six rats were used to study the effect of extract of red cabbage against diabetes induced by HFT/HFR diet. Rats were randomly distributed into 6 groups each containing (n=6). The first group kept as normal control fed standard diet only. The other six groups fed on basal diet and HFT/HFR diet and reclassified into positive control, red cabbage (RC) as powder and extract at levels groups (2.5% , 5% of the weight of basal diet), ( 250 mg/kg and 500 mg/kg weight of the rat) . Our results showed significant increase in weight gain, food intake and food efficiency ratio in all groups treated with RC as powder and extract groups comparing with (+ve) group, as well as significant reduction in serum glucose, HbA1c, lipid profile parameters, liver and kidney biomarkers and nitric oxide (NO) levels, moreover significantly increase in insulin, HDL-c, total antioxidant capacity (TAC) and superoxide dismutase (SOD) levels in treated all groups treated with RC powder at level 5% and extract 500 mg/kg groups comparing with (+v) group. This study suggests that treatment with red cabbage powder and extract has a beneficial effect against against diabetes and hyperlipidemia.

Incremental value of Late Gadolinium Enhancement by Cardiac MRI in risk stratification of heart failure patients with moderate and severe LV dysfunction

ObjectiveThis is a prospective study of patients with LVEF ≤40%, with the objective of correlating CV events to LGE detected and quantified by CMRI. MethodsHeart Failure (HF) patients with LVEF <40% who underwent CMRI were included. LGE volume of ≥6% of the myocardial volume was considered significant. Data of appropriate ICD shocks, CV hospitalizations and mortality were recorded. ResultsThere were 133 HF (72 ICM & 62 NIDCM) patients with a mean age of 54 ± 12 years, mean LVEF of 34 ± 6% and a follow up of 24 ± 3 months. Totally 46 CV events were recorded in 30 patients, 44 in LGE +ve & 2 in LGE -ve groups (HR 17.8, 95% CI-8.03-39.3, P = 0.000095). All the 7 deaths were in LGE +ve group. CV events were 22 (30.5%) in ICM group and 8 (13.1%) in NIDCM group (p = 0.03). All the 22 ICM patients and 6 of the 8 NIDCM with CV events were LGE +ve. The distribution of CV events amongst LGE +ve and LGE -ve were 35 vs 0 (ICM) and 9 vs 2 (NIDCM); p < 0.005.CV events in LVEF ≤ 30% group, were seen in 19 (47.5%) vs 1 (5.8%) in LGE +ve vs LGE -ve and no of events were 29 vs 1 (p = 0.003). In those with LVEF >30% the corresponding figures were 9 (22.5%) vs 1 (2.8%) and 15 vs 1 respectively (p = 0.02). ConclusionDemonstration of significant LGE by CMRI indicates high risk occurrence of CV events (CV hospitalization, appropriate shocks and total mortality) in NIDCM & ICM patients with LVEF < 40%.

BIOLOGICAL EFFECT OF TOMATO JUICE AND PASTE ON HEMOGLOBIN DEFICIENCY IN RATS

Tomato is a good source Phytochemicals and it may be important owning to their paternal use in traditional medicine. Anemia in association With iron deficiency has serious implications in long terms.The Study aimed to evaluate the effect of tomato Juice and Paste alone or with phenylhydrazine (PHZ) on the levels of hemoglobin (Hb), Red blood cells( RBCs) and White blood cells (WBCs) also effect on the levels of Thiobarbituric acid reactive substances (TBARS), glutathione reduced )GSH(, the activities of antioxidant enzymes and lipid profile of male rats 36 male rats were assigned to Six groups for (4) weeks. Feeding period, group (1) –ve control, group (2) treated with juice, group (3) treated with paste, group (4) treat with PHZ, + ve control, group (5) treated with combination of PHZ and juice, group (6) treated with combination of Phz and Paste . Results showed that consumption of Tomato juice and paste group showed improvement of hemoglobin values and had significant decrease in serum lipid profile and Thiobarbituric acid reactive substances (TBARS). Moreover, they showed significant increase in hemoglobin, blood picture and Antioxidant enzymes such as superoxide dismutase, glutathione-peroxidase ,catalase and glutathione S-transferase, compared with control +ve group. The best treatment effect of anemia injured rats group appeared in Tomato juice or paste groups. These results may be attributed to nutritional component and antioxidant activity of Tomato juice and paste. In conclusion, feeding rats with Tomato juice and paste may significantly reduce anemic. Key words, tomato, PHz, CBC, antioxidant enzymes, lipid profile, anemia, rats .

S1175 Clinical Response to Treatment for Acute Kidney Injury (AKI) in Patients With Cirrhosis

INTRODUCTION: The development of acute kidney injury (AKI) is associated with increase in morbidity/mortality in patients with cirrhosis. Revised ICA criteria now classify AKI into three stages (1: Cr increase by 0.3 mg/dl or 50–100% increase from baseline; 2: Cr increase by 100-200%;3: Cr increase by > 200% or Cr > 4 mg/dl) with management based on stage and response to therapy. AIM: To characterize cirrhotic patients admitted with AKI and response to therapy based on ICA AKI stages. METHODS: Retrospective study of inpatients with cirrhosis at single center from 1/2015–05/2019 who received treatment for AKI. Treatment was administered at the discretion of the treating hepatologist and included volume expansion (VE; albumin, lactated ringer, normal saline), vasoconstrictors (VC; midodrine or norepinephrine), and octreotide. Progression and regression of AKI and incidence of liver transplant were analyzed. RESULTS: One hundred seventy-nine patients (97M, 82F, mean age 59) were reviewed (40% Caucasians, 35% Hispanics, 9% Asians, 3% Black). Main cirrhosis etiologies included alcohol (36%), HCV (19%), NASH (11%), cryptogenic (8%) and others. At presentation mean MAP was 69 mmHg and mean Na MELD 31. Mean serum values included Na 130 mEq/l, TB 9 mg/dl, creatinine 2.0 mg/dL, INR 2.0. 135/179 patients had AKI present at admission. 104 (58%) patients developed Stage 1, 43 (24%) developed Stage 2, 32 (18%) developed Stage 3 AKI. 69 patients received VE only, 110 patients received VC and VE (Table 1). In VC group, 37% remained in same stage AKI as at admission, 45% progressed to higher stage AKI, 18% regressed to lower AKI stage (Table 2). Peak stages of AKI were Stage 1 (18%), Stage 2 (16%), and Stage 3 (66%). In VE group, 39% developed regression of AKI, 39% had no change, 22% had progression. Peak stages of AKI were Stage 1 (38%), Stage 2 (23%), Stage 3 (39%). 34% received liver transplant, 49% died, 4% were LTFU, 13% alive. Patients who received VE for AKI had higher response to treatment (P < 0.05) compared to VC group. Patients with AKI stage 2 and stage 3 at admission had higher odds of remaining in same stage of AKI regardless of receiving vasoconstrictors (table 3). Patients with lower MAP at presentation had higher mortality rate (P = 0.002). CONCLUSION: Development of AKI is associated with high rate of mortality and need for LT. Regression to lower stage of AKI noted in 20/179 (11%) of patients receiving vasoconstrictors. The lowest response rates to VC were seen in those with Stage 3 AKI.Table 1Table 2Table 3

Effects of vitamin E in a glucocorticoid induced cataract model in chicken embryos

ABSTRACT We investigated the antioxidant effects of vitamin E on a glucocorticoid (GC) induced model of cataracts in chick embryos. We used 70 fertilized eggs divided into seven groups as follows: phosphate-buffered saline (PBS) group, olive oil treatment (OO) group, hydrocortisone treatment (HC) group, olive oil and hydrocortisone treatment (OO + HC) group, 50 mg/kg vitamin E and hydrocortisone treatment (HC + VE (50)) group, 25 mg/kg vitamin E and hydrocortisone treatment (HC + VE (25)) group and 15 mg/kg vitamin E and hydrocortisone treatment (HC + VE (15)) group. On day 17, chick embryos were removed from the eggs and lens and liver tissues were excised. Cataract formation was evaluated and total antioxidant status (TAS), total oxidant status (TOS), malondialdehyde (MDA) and glutathione peroxidase (GPx) were measured in lens and liver tissues; MDA was measured only in liver. The lenses in the HC + VE (50) group exhibited significantly higher levels of GPx and TAS, and lower levels of TOS than for HC and OO + HC groups. The livers of the HC + VE (50) group exhibited significantly higher levels of GPx and lower levels of MDA than for the HC and OO + HC groups. The HC + VE (50) group lenses were evaluated as grade 1, because the nuclei were completely free of cataracts, likely due to the antioxidative effect of high dose VE. VE is an effective antioxidant agent that exhibits a dose-response effect, for ameliorating the negative effects of GCs.

The Necessity of Dissection of No. 14 Lymph Nodes to Patients With Pancreatic Ductal Adenocarcinoma Based on the Embryonic Development of the Head of the Pancreas.

Objectives: Pancreaticoduodenectomy (PD) followed by lymphadenectomy is performed for patients with pancreatic ductal adenocarcinoma (PDAC) located in the head of the pancreas. Because the head of the pancreas could be divided into dorsal or ventral primordium in relation to embryonic development, the metastasis of lymph node (LN) may differ. In this retrospective study, we evaluated the impact of extended or standard LN dissection for PDAC located in ventral or dorsal primordia of the pancreatic head.Methods: From February 2016 to November 2018, 178 patients who underwent PD for PDAC were enrolled at the Pancreatic Disease Center, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University. According to the tumor location and the range of LN dissection, all patients were divided into three groups: ventral primordium with extended lymphadenectomy (VE group), ventral primordium with standard lymphadenectomy (VS group), and dorsal primordium with extended lymphadenectomy (DE group). Clinical and pathological features were retrospectively analyzed as were the long-term survival outcomes.Results: More patients in the VE group were detected with metastasis in the lymph nodes around the superior mesenteric artery (LN14) than those in the DE group (LN along the right side of the superior mesenteric artery, LN14ab): 22.9 vs. 5.9%, p = 0.005; (LN along the left side of the superior mesenteric artery, LN14cd): 10.0 vs. 0.0%, p = 0.022. LN14 was involved in more patients in the VE group than in the VS group (22.9 vs. 5.0%, p = 0.015). For IIb-stage patients in the VE group, the overall survival time (18.3 vs. 9.3 months, p < 0.001) and disease-free survival time (12.2 vs. 5.1 months, p = 0.045) were longer in those with LN14cd (–) than those with LN14cd (+).Conclusion: This study suggested that patients with PDAC located in the ventral head of the pancreas had higher risk of LN14 involvement compared with those at dorsal. Thus, a thorough dissection of LN14 in PDAC located in the ventral head of the pancreas is recommended to optimize the regional extended lymphadenectomy.

Effectof Fermented Kefir Consumption Mixed with Different Cereals Formula on Obese Rats تأثیر تناول الکفیر المخمر المخلوط بترکیبات مختلفة من الحبوب على الفئران البدینة

This study investigates the ant obesity effects of fermented Kefir and germinated cereals mixed with fermented Kefir on high fat diet induced obese rats. 25male rats each weighting 75±3 gram were apportioned to five groups. Group 1 is the negative group. The rest rats were received high saturated fats (34%) in diet for 56 days to become obese rats. Obesity was confirmed by elevation of serum lipid profile and body weight. Group 2 is control +ve group which fed on high fat diet, Kefir group which fed on high fat diet supplemented with kefir at dose of 4ml /rat/day orally, formula 1 group which fed on high fat diet with 20 % of formula 1(wheat, barley, maize and millet mixture powder melt in 200 ml kefir)and formula 2 group which fed on high fat diet with 20 % of formula 2(wheat, barley, maize and oat mixture powder melt in 200 ml kefir) for four weeks. This study resulted in a marked improvement of nutritional indicator as kefir Formula 1 and 2 group administration could lower nutritional indicators. However, the administration of kefir, formula1 and formula 2 could reduce lipids parameters.Consumption of kefir significantly reduced the serum leptin, glucose, insulin resistance and progesterone levels but increased insulin and testosterone levels while consumption of formula 1 and 2 could lower serum leptin and insulin resistance and elevate progesterone and testosterone levels compared to control (+ve) group .It is concluded that germinated cereals mixed with kefir could manage treat obesity.

Prognostic value of late gadolinium enhancement in cardiac MRI of non-ischemic dilated cardiomyopathy patients

BackgroundThe role of late gadolinium enhancement (LGE) in cardiac MRI (CMR) as prognostic marker in non-ischemic dilated cardiomyopathy (NIDCM) is evolving. ObjectiveTo study the effect of LGE in the prognosis of NIDCM patients. Methods112 consecutive NIDCM patients, who underwent CMR, were prospectively followed up for 745 ± 320 days. Primary end point was occurrence of MACE {composite of all-cause mortality, resuscitated cardiac arrest, sustained ventricular tachycardia (VT)/appropriate ICD shock, heart failure (HF) hospitalization}. ResultsLGE was present in 44 out of 112 patients (39%). The primary end point (MACE) was significantly higher in LGE + ve group compared to the LGE –ve group (72.7% vs. 29.4%; p < 0.0001). Similarly, cardiac mortality (9.1% vs 2.9%; p < 0.049), VT (13.6% vs. 2.9%; p < 0.031), HF hospitalization (63.6% vs. 30.9%; p < 0.001) were significantly more in LGE + ve group. In univariate model, LGE demonstrated the strongest association with MACE (Hazard ratio [HR] = 2.96 [95% CI 1.685 to 5.201; p < 0.0001). LGE extent of >14% of LV predicted MACE with 90.6% sensitivity and 86% specificity. HR of LGE extent >14% of LV for MACE is 6.12; p < 0.01. LGE was associated with MACE irrespective of its location, pattern or distribution. Multivariate model showed LGE and its extent >14% of LV volume were strongest predictor of MACE. ConclusionLGE and its extent >14% predicts adverse cardiac events in NIDCM irrespective of LVEF and LGE location, pattern or distribution. This study emphasises the role of CMR in risk stratification of NIDCM patients and guiding therapy.