Antiphospholipid antibodies in leprotic patients: a correlation with disease manifestations

OBJECTIVES: Previous studies showed that antiphospholipid antibodies (aPL) are frequent in the sera of leprosy patients and are most probably directed against body tissue cardiolipins. Some groups have demonstrated differences between the binding specificity of "autoimmune-aPL" and "non-autoimmune-aPL". It is widely accepted that a plasma protein, beta 2-Glycoprotein I (beta 2-GPI), is required for the binding of autoimmune anticardiolipin antibodies (aCL) to cardiolipin. However, some reports suggested heterogeneity of leprosy aCL with respect to their beta 2-Glycoprotein I (beta 2GPI) dependency, although no thromboembolic complications have been reported. This study was designed to assess the specificity of aPL by investigating the prevalence of aCL, anti-phosphatidylserine (aPS), anti-phosphatidylinositol (aPI), anti-beta 2GPI and antiprothrombin (aPT) antibodies, and evaluate their clinical significance in a group of patients with lepromatous leprosy. PATIENTS AND METHODS: 35 lepromatous leprosy patients were selected randomly from an Egyptian leprosarium as a study group. 35 normal household contact controls were selected matching the study group for both sex and age. aCL, aPS, aPI, aPT, anti-beta 2GPI and beta 2-dependent aCL antibodies were investigated by ELISA in all patients and controls. RESULTS: aCL antibodies were more frequent in leprosy patients than in controls [13/35 (37%) vs. 3/35 (9%), respectively, p = 0.02] and significantly correlated with Raynaud's phenomenon, skin nodules, chronic skin ulcers and urticarial skin rash. No association was found with hypopigmentation, hyperpigmentation and saddle nose. None of the patients presented aPS nor aPI. Only 1 subject from the control group presented aPI along with aCL. aPT were present in 2/35 (5.7%) and anti-beta 2GPI in 1/35 (2.9%) leprotic patients. None of the individuals from the control group presented aPT nor anti-beta 2GPI. CONCLUSIONS: An association was found between the presence of aCL and certain dermatological manifestations of leprosy, such as Raynaud's phenomenon, skin nodules, chronic skin ulcers and urticarial skin rash. As in other infectious diseases, there was a lack of beta 2GPI-dependency and an absence of thrombotic complications.     

Effect of Sago Starch Modifications on Polystyrene/Thermoplastic Starch Blends

The preparation of polystyrene/thermoplastic starch (PS/TPS) blends was divided into three stages. The first stage involved the preparation of TPS from sago starch. Then, for the second stage, PS was blended with TPS to produce a TPS/PS blend. The ratios of the TPS/PS blend were 20:80, 40:60, 60:40, and 80:20. The final stage was a modification of the composition of TPS/PS blends with succinic anhydride and ascorbic acid treatment. Both untreated and treated blends were characterized by their physical, thermal, and surface morphology properties. The obtained results indicate that modified blends have better tensile strength as the adhesion between TPS and PS was improved. This can be observed from SEM micrographs, as modified blends with succinic anhydride and ascorbic acid had smaller TPS dispersion in PS/TPS blends. The micrograph showed that there was no agglomeration and void formation in the TPS/PS blending process. Furthermore, modified blends show better thermal stability, as proved by thermogravimetric analysis. Water uptake into the TPS/PS blends also decreased after the modifications, and the structural analysis showed the formation of a new peak after the modification process.     

Genetic polymorphisms of HbE/beta thalassemia related to clinical presentation: implications for clinical diversity

Annals of Hematology - HbE/Beta thalassemia (HbE/β-thalassemia) is one of the common genetic disorders in South East Asia. It is heterogeneous in its clinical presentation and molecular...     

Floating left atrial mass in a patient with mitral stenosis

Mobile masses within the left atrial cavity are commonly caused by organized thrombi or left atrial myxoma. The use of transesophageal echocardiography has provided means for differentiation between the 2 conditions. We report a case of a left atrial mass in a female patient who presented with mitral stenosis and atrial fibrillation, and was diagnosed by transthoracic echocardiography (TTE). The mass appeared freely mobile but did not prolapse between the mitral leaflets due to the tightly stenosed valve orifice. In the presence of mitral stenosis, atrial fibrillation and dilated left atrium, the appearance of the mass was in keeping with mobile thrombus. Consequently, the patient was referred for surgical treatment and the mass removed through left atriotomy. Microscopic examination revealed a highly organized thrombus. We conclude that TTE is still a reliable tool in the diagnosis of large mobile atrial thrombi; TEE is needed when differentiation from atrial myxoma is difficult.     

Susceptibility of sand flies to selected insecticides in North Africa and the Middle East

The purpose of this study was to determine the baseline susceptibility of 4 species of phlebotomine sand flies from North Africa and the Middle East to various insecticides. Susceptibility was determined using the World Health Organization test kits for measuring resistance in mosquitoes exposed to insecticide-impregnated papers. Fifty, 90, and 99% lethal doses were calculated for bendiocarb, cyfluthrin, DDT, malathion, permethrin, and resmethrin on Phlebotomus bergeroti, P. langeroni, P. papatasi. and P. sergenti. The least toxic insecticide to all species was DDT, followed by malathion and permethrin in order of increasing toxicity. Cyfluthrin was the most toxic to P. langeroni and P. papatasi, followed by resmethrin and bendiocarb in order of decreasing toxicity. Resmethrin exhibited the highest toxicity to P. bergeroti followed by cyfluthrin and bendiocarb, whereas bendiocarb was most toxic to P. sergenti, followed by cyfluthrin and resmethrin in order of decreasing toxicity. An attempt was made to obtain data for deltamethrin, but close response data were insufficient to determine regression lines for this insecticide on these species. However, analysis of preliminary data indicated that deltamethrin is highly toxic to these sand flies.     

Pulmonary embolism in sclerotherapy for a venous malformation in a child under general anesthesia

We report a case of pulmonary embolism associated with percutaneous sclerotherapy (absolute ethanol: 0.5 mL.kg-1) of a venous angioma, performed under general anaesthesia in a 13 year-old child. The diagnosis of pulmonary embolism, suspected on the clinical setting and symptoms, was supported by the pulmonary scintigraphy obtained 4 hours later, showing 3 minimal pulmonary defects. The outcome was rapidly favourable without sequelae under heparin administration and the pulmonary scintigraphy, performed on day 7, was normal. The role of absolute ethanol, for explaining the apparent contrast between the severity of the symptoms and the minimal obstruction noted on pulmonary scintigraphy is discussed. Also discussed are the prophylactic and curative therapeutic issues of this severe complication.     

Molecular systematics of the phlebotomine sandflies of the subgenus Paraphlebotomus (diptera, psychodidae, phlebotomus) based on ITS2 rDNA sequences. Hypotheses Of dispersion and speciation

Phylogenetic Paraphlebotomus relationships are inferred by a study based on the sequences of ITS2, which has been sequenced in nine Paraphlebotomus species: P. alexandri, P. andrejevi, P. jacusieli, P. kazeruni, P. mireillae, P. mongolensis, P. saevus, P. sergenti and P. similis and in two out-groups species of the subgenus Phlebotomus: P. papatasi and P. duboscqi. Paraphlebotomus alexandri appears as the sister group of all other Paraphlebotomus sandflies. Among the other species, three groupings are clearly highlighted: andrejevi and mongolensis; mireillae and saevus; jacusieli, kazeruni, sergenti and similis. These groupings are related to speculations about the migration of Paraphlebotomus from a centre of dispersion located in the Middle East sometime from the early Eocene to the late Miocene.     

Lysine acetyl salicylic acid in acute renal pain

The effect of repeated doses of 1.8 g lysine acetyl salicylic acid (LAS) i.v. on severe pain secondary to acute renal colic (ARC) was studied in 45 consecutive patients. Clinically acceptable analgesia was obtained in 65% of the cases. No additional pain relief was achieved with the combination of pethidine 100 mg i.v.+metoclopramide 10 mg, i.m. (narcotics). Pain relief occurred within five minutes in one third of the patients while in the rest within 30 minutes. Significant reduction of systolic blood pressure (mean±S.D.) 23.8±19.5, pulse rate (mean±S.D.) 19.5±10.1 and vomiting were noted in patients who had pain relief. The incidence of nausea has increased after LAS administration. No other side effects were observed. LAS might therefore be applied as a first-hand alternative to narcotics for the treatment of ARC.