Evaluation of asymptomatic venous disease by Doppler ultrasonography in Behçet’s disease patients

Aim of the work

Evaluation of asymptomatic venous disease in patients with Behçet’s disease (BD) using venous Doppler ultrasonography (US) and its relation to different disease manifestations and activity.

Does CMR have an additive role over echo in evaluating ischemic LV dysfunction?

Purpose

To emphasis the role of cardiac magnetic resonance compared to echocardiography in evaluating patients with ischemic cardiomyopathy to accurately assess global and regional Left ventricular function which is essential for prognosis and for evaluating therapeutic responses.

Methods and materials

The studied group included 37 patients already diagnosed as having ischemic cardiomyopathy. All patients were subjected to full history taking and radiological evaluation using a 1.5-T MR system and echocardiography. Comparison was made between echocardiography and cardiac magnetic resonance regarding segmental wall motion by using the 17-segment model of the American Heart Association. Agreement regarding segmental wall motion was assessed by using Cohen’s Kappa statistics. Also ejection fraction measurement by both modalities was compared. Detection of transmural extent of myocardial scar was also performed.

Results

Poor agreement between cardiac magnetic resonance and echocardiography regarding segmental wall motion with Cohen’s Kappa is 0.195, P value of <0.001. Mean ejection fraction by cardiac magnetic resonance was 33.3% and mean ejection fraction by echocardiography was 29% with a mean difference of 4.3%.

Conclusion

Cardiac magnetic resonance is superior to echo in evaluating segmental wall motion abnormality with echo underestimating segmental wall motion abnormality yet nearly similar ejection fraction values by both modalities were achieved. Moreover, cardiac magnetic resonance is better in evaluating associated cardiac abnormalities as well as extracardiac findings due to its higher spatial resolution. In addition, cardiac magnetic resonance is used in myocardial viability assessment in the same setting which if combined with segmental wall motion abnormality can lend a hand in evaluating the cardiac contractile reserve.     

DJ-1 and androgen receptor immunohistochemical expression in prostatic carcinoma: A possible role in carcinogenesis

Background and AimAndrogen plays a fundamental role in the growth and differentiation of prostate. Androgen receptor (AR) expression may represent a potential marker of prognosis in prostate cancer. However, there have been variable results regarding its ability to predict clinical progression. Despite the oncogenic properties of DJ-1, its significance in prostate cancer development and progression is not well understood. This research shed some light on the possible role of immunohistochemical expression of DJ-1 in clinically localized prostatic carcinoma in relation to the established role of AR and other clinicopathologic parameters.Materials and MethodsThe immunohistochemical expression of AR and DJ-1 was evaluated in 129 samples including benign hyperplasia (n = 60) and prostatic carcinoma (n = 69).ResultsThe mean value of AR immunostaining was significantly higher in prostatic carcinomas than in benign hyperplasia (P = 0.001). A significant inverse correlation was found between AR immunostaining and the grade of prostatic carcinomas. A significantly higher median DJ-1 score was found in prostatic carcinoma than in benign hyperplasia (P = 0.0001). There was a significant direct correlation between AR and DJ-1 score (P = 0.0001). AR is more sensitive in predicting prostatic carcinoma than DJ-1 but DJ-1 is more specific than AR.ConclusionAR nuclear expression was consistently present in benign and adenocarcinoma epithelium. But, there may be limited clinical use for AR expression in localized carcinoma due to its constant heterogeneity. DJ-1 with its oncogenic properties, specificity for prostatic carcinoma and homogenous expression gives an ideal complementary role to AR in the detection and treatment of prostatic carcinomas.     

Effects of honey,sucrose and glucose on blood glucose and C-peptide in patients with type 1 diabetes mellitus

This study was a case control cross sectional study that was conducted on 50 patients with type 1 diabetes mellitus and 30 controls without diabetes. The mean age of patients was 10.02 years. Oral sugar tolerance tests using glucose, sucrose and honey and measurement of fasting and postprandial serum C-peptide levels were done for all subjects in three separate sittings. The glycemic index (GI) and the peak incremental index (PII) were then calculated for each subject. Honey, compared to sucrose, had lower GI and PII in both patients and controls (P < 0.01). In both patients and controls, the increase in the level of C-peptide after honey was significant when compared with either glucose or sucrose (P < 0.01). Conclusion: Because of its possible stimulatory effect on diseased beta cells, honey might be considered in future therapeutic trials targeting beta cells of pancreas.     

Speech evoked auditory brainstem response findings in children with epilepsy

Objectives

Children with epilepsy are at a considerable risk of cognitive impairment and school failure. Previous studies have typically documented abnormal responses in children with epilepsy at cortical level using speech stimuli. Recent studies reported that abnormal neural encoding of a speech syllable could be detected at the level of the brainstem using speech-evoked auditory brainstem response (ABR). The aim of this study is to investigate speech-evoked (ABR) results in children with epilepsy.

Methods

The study group consisted of 38 recently diagnosed epileptic children; none of them has received antiepileptic therapy. They were 22 males and 16 females with age 9.1 ± 3.1 years. The control group consisted of 38 healthy normal hearing children with matched age and gender distribution. All subjects underwent full history taking, basic audiologic evaluation including pure-tone, speech audiometry and immittance testing. Click ABR response was recorded monaurally from both ears at 90 dB nHL then speech ABR was recorded monaurally from each ear at 80 dB SPL.

Results

Though the study group disclosed normal click ABR compared to age matched normative values, speech-evoked ABR revealed a delayed waves V and A latencies in both ears. These findings reflect abnormal neural encoding of speech at the level of brainstem. The younger the age of epileptic child the more prolonged wave A latency and increased V/A inter-latency values.

Conclusions

Speech-evoked ABR results denote abnormal timing in the brainstem; such brainstem abnormality could be detected by speech evoked ABR rather than conventional click evoked ABR.     

Hippocampus,caudate nucleus and entorhinal cortex volumetric MRI measurements in discrimination between Alzheimer’s disease,mild cognitive impairment,and normal aging

Background

Structural neuroimaging MR volumetric changes can predict progression of MCI to AD. Early effective treatment of MCI has been shown to delay institutionalization and improve cognition and behavioral symptoms.

Aim of the work

To evaluate the role of volumetric MRI to identify a pattern of regional atrophy characteristic in differentiation between Alzheimer’s disease, Mild Cognitive Impairment, and Normal elderly control.

Material and methods

The regional ethics committee approved the study and written informed consent was obtained from all participants. Between April 2012 and May 2013, prospective study was conducted on 25 patients (18 males and 7 females) and 15 healthy elderly controls (9 males and 6 females) referred to the Radiodiagnosis Department from the Neuropsychiatry Department that had clinical manifestations of suspected cognitive impairment, we used the Mini Mental State Examination (MMSE) as a measure of general cognitive function and the total learning from the Auditory Verbal Total Learning Test (AVTOT) as a measure of memory performance. One year follow up of patients was done to assess the disease progress.

Results

Twenty-five patients were included in this study {Alzheimer disease (10 cases), MCI (15 cases)} and 15 healthy elderly controls. Mean MMSE scores were significantly lower in patients with Alzheimer’s disease compared with MCI and control cases (P < 0.001). Positive correlation (except left caudate nucleus) between gray matter volume reduction in MCI and AD in relation to elderly control and MMSE score was observed. The Auditory Verbal Learning Test (AVTOT) was significantly lower in patients with Alzheimer’s disease compared with MCI and control cases (P < 0.001). No significant differences were found between groups as regards age, sex, education or dominant hand. Significant gray matter volume reductions were found in both AD and MCI compared to healthy elderly control however no significant differences were found among MCI patients or AD patients. Sensitivity, specificity, PPV and NPV of caudate nucleus and hippocampal volume reduction in AD and MCI in relation to elderly control were higher than entorhinal cortex.

Conclusion

Semi-automated MR volumetric measurements can be used to determine atrophy in hippocampus, caudate nucleus and entorhinal cortex which aided in discrimination of healthy elderly control subjects from subjects with AD and MCI and predict clinical decline of MCI leading to increase the efficiency of clinical treatments, delay institutionalization and improve cognition and behavioral symptoms.     

Determination of some histamine H1-receptor antagonists in dosage forms

Three simple and accurate methods are presented for determination of Cetirizine, Fexofenadine, Loratadine and Acrivastine in pure form and commercial dosage forms. The first method is based on the reaction of the above cited drugs with bromocresol purple dye to form ion-pair complex extractable with chloroform and subsequently measured spectrophotometrically. Secondly, eosin gives with these drugs ion-pair complex, measurable directly without extraction both spectrophotometrically and spectrofluorimetrically. The last method involves the base-catalysed condensation of mixed anhydrides of organic acids (citric acid/acetic anhydride) where as the tertiary amino group in the above-cited drugs acts as the basic catalyst. The product of condensation is measured spectrophotometrically. All the reaction conditions for the proposed methods have been studied.