The effect of high-calorie diet on nutritional parameters of children with beta-thalassaemia major

BACKGROUND: Impaired growth accompanying thalassaemia major poses diagnostic and therapeutic problems. AIM: To test the hypothesis that impaired growth of children with thalassaemia major might be corrected, partially or totally, by increasing their caloric intake. PATIENTS AND METHODS: In a prospective controlled study, thirty selected children with thalassaemia major and 30 normal age and sex-matched controls were recruited. The dietary intake of both groups was evaluated. Nutritional status was assessed by measuring the weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (SFT) and serum albumin and insulin-like growth factor-I (IGF-I) concentrations. The thalassaemic group was then, randomly divided into two equal groups. One group was given 8 weeks of high-caloric diet (130-150% of the caloric recommendation for age and sex) and the other was given the normal caloric requirement. RESULTS: Initially the BMI, triceps SFT and MAC of children with thalassaemia were significantly decreased compared to those for the normal control group. IGF-I and albumin concentrations of thalassemic children before nutritional supplementation (69 +/- 20.5 ng/m and 3.65 +/- 0.67 g/dl, respectively) were significantly lower than those for normal age and sex-matched children (162.5 +/- 24 ng/ml and 4.29 +/- 0.66 g/dl, respectively). After nutritional supplementation for 8 weeks the MAC, SFT and BMI, IGF-I (88.4 +/- 27.3 ng/ml) and albumin concentrations (3.85 +/- 0.85 g/dl) increased significantly (P < 0.05) in the thalassaemic children given the supplementation compared to those without supplementation, however, they were still lower than normal children. CONCLUSIONS: Increased caloric dietary intake increased significantly IGF-I levels in thalassaemic children. This was accompanied with increased BMI, mid-arm circumference and skin fold thickness. Growth impairment of children with thalassaemia major, without endocrinopathy and/or cardiomyopathy, can be partially corrected by increasing caloric intake.     

Conductometric and indirect AAS determination of antimalarials

Two methods are described for the determination of amodiaquine hydrochloride, chloroquine phosphate and primaquine phosphate, based on the formation of their ion-associates with [Cd(2+), Co(2+), Mn(2+) and Zn(2+)] thiocyanate, ammonium reineckate and/or sodium cobaltinitrite. The molar combining ratio reveal that (1:1) (drug:reagent) ion associates are formed for all reagents except for ammonium reineckate which form (1:2) ion associates with all studied drugs. The optimum conditions for the ion-association have been studied. Conductometric method was applied for the direct determination of the suggested drugs in bulk powders, whereas indirect atomic absorption spectrometric method, depending on the measurement of the excess metal ion present in supernatant solutions after precipitation of the ion associates is used to calculate the drug concentration. Optimum concentration ranges for the determination of aminoquinoline antimalarial drugs under consideration were 0.46-12.90 and 0.155-3.87 mg using conductometric and indirect atomic absorption spectral methods, respectively. The proposed procedures have been applied successfully to the analysis of these drugs in certain formulations and the results are favourably comparable to the official methods.     

Salbutamol sulfate suppositories: influence of formulation on physical parameters and stability

PURPOSE: To prepare and evaluate a suppository dosage form of salbutamol sulfate. The prepared formulae with and without different concentrations of gels were tested for hardness, melting time, content uniformity, and drug release. The stability of some of the selected formulae was assessed. METHODS: Salbutamol sulfate was formulated as a rectal suppository with emulsifying fatty bases (suppocire and witepsol) and water-soluble bases (PEG) adopting the molding from a melt technique. Physical characteristics and dissolution profiles of the prepared formulations were determined as the responses. The effects of adding gels, methyl cellulose (MC), and Eudispert (Eud) and their concentrations (1, 3, and 6%) on these responses were also investigated. Formulations showing high rank order were scaled up for shelf-life stability study for one year. RESULTS: The results showed that all the investigated formulae have acceptable physical characteristics with respect to hardness, melting time (except F7), and uniformity of drug content. The amount of drug dissolved in 100 min of dissolution time was inversely affected by the melting point of the fatty base. The release from PEG bases was found to be molecular weight dependent. Addition of 1% MC or Eud gel increased the release from all the investigated formulae. Increasing gel concentration to 3% then to 6% showed different effects on the release. The degradation of salbutamol sulfate in the investigated formulae was found to be a first-order reaction. CONCLUSIONS: Rectal suppository of salbutamol sulfate could be prepared as an alternative to the oral dosage form to circumvent the first-pass metabolism.     

Synthesis and biological investigations of new thiazolidinone and oxadiazoline coumarin derivatives

Ethyl (coumarin-4-oxy)acetate 1 was prepared through the reaction of 4-hydroxycoumarin with ethyl bromoacetate. Compound 1 was allowed to react with hydrazine hydrate to produce coumarin-4-oxyacetic hydrazide 2. The synthesis of N-(arylidene and alkylidene)-coumarin-4-oxyacetic hydrazones 3-20 was performed. The preparation of 2-substituted-3-[(coumarin-4-oxy) acetamido]thiazolidinones 21-26 and 2-[(coumarin-4-oxy)methyl]-4-acetyl-5-substituted-delta2-1,3,4-oxadiazolines 27-33 was performed by the reaction of the hydrazones 3, 4, 7, 9, 12, 14 with mercaptoacetic acid and the hydrazones 3, 4, 5, 7, 12, 15, 16 with acetic anhydride, respectively. The antiviral activities, cytotoxicities and structure-activity relationship (SAR) towards different microorganisms of the prepared compounds were studied.     

Expression of cyclooxygenase-2 and peroxisome proliferator-activated receptor-gamma and levels of prostaglandin E2 and 15-deoxy-delta12,14-prostaglandin J2 in human breast cancer and metastasis

Cyclooxygenase-2 (COX-2) expression and peroxisome proliferator-activated receptor-gamma (PPARgamma) inactivation are linked to increased risk of human breast cancer. The purpose of our study was to examine the relationship between COX-2 (with the resulting prostaglandins E(2), PGE(2)) and PPARgamma (and its natural endogenous ligand 15-Deoxy-Delta(12,14)-prostaglandin J(2), 15d-PGJ(2)) at various stages during the development of human breast cancer and its progression to metastasis. Human breast tissue specimens were collected from normal breasts or from individuals with fibrocystic disease and served as controls (n = 22). Tissues were also collected from uninvolved (n = 25), tumor (n = 25) and lymph node metastasis (n = 15) regions from breast cancer patients. COX-2 and PPARgamma mRNA expression were increased and downregulated, respectively, in tissues from cancer patients compared to controls. Metastatic tissues tended to have higher alterations compared to non-metastatic tissues (p < 0.05). These altered expressions in COX-2 and PPARgamma were paralleled by increases in the tissue levels of PGE(2) and decreases in 15d-PGJ(2). A significant inverse correlation was found between PGE(2) and 15-d-PGJ(2) (r = -0.51, p < 0.05). Significant correlations (p < 0.05) were also obtained between COX-2 and PPARgamma mRNA (inverse, r = -0.72) and between COX-2 and PGE(2) (direct, r = 0.68). Increases in COX-2 mRNA expression and levels of PGE(2) and down-regulation of PPARgamma mRNA expression and 15d-PGJ(2) levels were characterized as predictors of breast cancer risk (p < 0.05). Our results suggest that the altered expression of COX-2 and PPARgamma and the subsequent modulation in the tissue levels of PGE(2) and 15-d-PGJ(2) may influence the development of human breast cancer and its progression to metastasis.     

Intrapartum prediction of macrosomia: accuracy of abdominal circumference estimation

OBJECTIVE: To evaluate the accuracy of abdominal circumference (AC) estimation of macrosomia early in labor and whether a cutoff value could be detected. DESIGN: A prospective clinical trial. SETTING: The Department of Obstetrics and Gynecology, Cairo University. PARTICIPANTS: One hundred pregnant females presenting in early labor with clinical impression of macrosomia were examined by ultrasound, and those babies with abdominal circumference more or equal to 35 cm were recruited for the study. INTERVENTIONS: Every woman was considered as her own control, and fetal weight was calculated using the formula of Shepard et al. The accuracy of abdominal circumference in prediction of macrosomia was evaluated using the Receiver operating characteristic curve. RESULTS: A cutoff value of AC > or =37 cm was found to have a sensitivity of 77%, a specificity of 75%, a positive likelihood ratio of 3.1 and a negative likelihood ratio of 0.3. CONCLUSION: Intrapartum ultrasonographic evaluation of abdominal circumference for suspected macrosomic babies in early labor is an easy, practical method that should be adopted in decision making.