The Effect of Aqueous Garlic Extract on the Growth of Dermatophytes

ABSTRACT: The effect of aqueous garlic extract on the growth of different medically important dermatophytes was studied. The extract proved to have an inhibitory effect on the growth of Microsporum gypseum, Trichophyton verrucosum, Trichophyton violaceum, Trichophyton rubrum, Trichophyton schoenleini, Trichophyton mentagrophytes and Epidermophyton floccosum. The inhibitory concentration ranged from 130-200 mg/1. Experimental infection was induced in guinea pigs and rabbits. Treatment of the produced lesions included topical application or injection of the extract. The topical treatment was very effective, producing complete healing in 14 to 17 days following twice daily application of the extract for one week.     

Spontaneous cerebrospinal fluid rhinorrhea through clival defect

Spontaneous cerebrospinal fluid fistula secondary to clival defect is a very rare condition. Only 2 cases are reported previously in the literature. We report a case of clival defect in a young male patient presenting with spontaneous cerebrospinal fluid rhinorrhea which failed detection by conventional CT and MRI. The patient was referred to our center after failed anterior cranial fossa repair. Thorough radiological investigations successfully detected the defect in the posterior wall of the sphenoid sinus 5 mm distal to the posterior limit of the floor of the sella just on the midline. The fistula was managed successfully through an endonasal transsphenoidal approach. We present the case reviewing the literature concerning the pathophysiology of spontaneous cerebrospinal fluid fistula through the sphenoid sinus.     

Angiosarcoma of the of scalp with calvarium involvement in a 50-year-old African-American man

BACKGROUND: Angiosarcoma of the scalp is a rare, aggressive, and deadly cancer that affects mainly elderly Caucasian men. OBJECTIVES: The insidious and masquerading presentation of angiosarcoma poses enormous diagnostic challenges for primary care providers. PATIENTS/METHODS: We present a case of a 50-year-old black man referred for evaluation of a 3.7-cm-x-5.4-cm ulcerated, fluctuant scalp lesion that had failed to respond to different antibiotics and proper wound care. RESULTS: Surgical excision and subsequent histopathology revealed angiosarcoma. CONCLUSIONS: This case report highlights the importance of high index of suspicion for early diagnosis of cancerous lesions in wounds and stresses the need to include angiosarcoma in the differential diagnosis for all face and scalp lesions, as early detection may save lives. A comprehensive literature review is also presented.     

Autologous blood donation in total knee arthroplasties is not necessary

BACKGROUND: This study intends to prove the hypothesis that preoperative autologous blood donation in total knee arthroplasties (TKA) is dispensable. PATIENTS AND METHODS: The study comprises a prospective analysis of 81 consecutive TKA without preoperative autologous blood donation (AB-donation). Guidelines for blood retransfusion were used. Surgery, as well as the pre- and postoperative procedures were identical for each patient. In the analysis of the data, the consecutive TKAs were divided into patients who were eligible for preoperative autologous blood donation (group 1, n = 46) and those with relevant risk factors not permitting preoperative autologous blood donation (group 2, n = 35). RESULTS: None of the patients in group 1 needed a blood transfusion. 14 of 35 patients in group 2 needed an allogenic blood transfusion. INTERPRETATION: Total knee arthroplasty can be managed without preoperative AB-donation if it is performed using a tourniquet, if a postoperative collection and direct retransfusion system is used for the wound blood, and if the transfusion algorithm is defined according to compulsory and practical guidelines.     

Ovulation induction using laparoscopic ovarian drilling in women with polycystic ovarian syndrome: predictors of success

BACKGROUND: Although laparoscopic ovarian drilling (LOD) hasbeen widely used to induce ovulation in women with polycysticovarian syndrome (PCOS), predicting the clinical response tothis treatment remains to be elucidated further. This studywas carried out to identify factors that may help to predictthe outcome of LOD. METHODS: This retrospective study included200 patients with anovulatory infertility due to PCOS who underwentLOD between 1990 and 2002. The influence of the various patients'pre-operative characteristics on the ovulation and pregnancyrates after LOD was evaluated. In addition, women were dividedinto two or three categories according to the severity of eachof the various clinical and biochemical parameters of PCOS.The success rates were compared between the categories of eachfactor using contingency table analyses. Multiple logistic regressionanalysis was used to identify independent predictors of successof LOD. RESULTS: Women with body mass index (BMI) 35 kg/m²,serum testosterone concentration 4.5 nmol/l, free androgen index(FAI) 15 and/or with duration of infertility >3 years seem tobe poor responders to LOD. In LOD responders, serum LH levels>10 IU/l appeared to be associated with higher pregnancy rates.CONCLUSION: Marked obesity, marked hyperandrogenism and/or longduration of infertility in women with PCOS seem to predict resistanceto LOD. High LH levels in LOD responders appear to predict higherprobability of pregnancy.     

Thrombotic thrombocytopenic purpura following cardiovascular surgery: a case report

Thrombotic thrombocytopenic purpura, a rare clinical syndrome characterized by thrombocytopenia and microangiopathic hemolytic anemia, was almost uniformly fatal until the introduction of plasma exchange in 1970. The thrombotic thrombocytopenic purpura following cardiovascular surgeries is relatively a new entity with high mortality if untreated. Plasma exchange is the most important therapy in this disease with good clinical outcomes. With the addition of this report, there are now 13 cases of thrombotic thrombocytopenic purpura in association with coronary artery bypass graft reported in the literature.     

Methadone-induced torsade de pointes in a patient with normal baseline QT interval

Torsade de pointes (TdP) is a life threatening cardiac arrhythmia that is typically associated with prolongation of the QT interval. A wide variety of nonantiarrthymic medications may trigger TdP in patients with prolonged QT interval, only a few reports have described an association between TdP and methadone. We report a case of TdP caused by a large dose of methadone in a patient with presumably normal QT interval at baseline prior to his presentation at the hospital.     

Prevention of fumonisin-induced maternal and developmental toxicity in rats by certain plant extracts

In earlier work we have reported that garlic and cabbage extracts can protect laboratory animals from the toxic effects of different mycotoxins. Previous research demonstrated that fumonisin (FB) induced developmental effects in mice, rats and hamsters. The objectives of the present study were to utilize the pregnant rat as an in vivo model to compare the potential of garlic and cabbage seed extracts to prevent the developmental toxicity of FB and the effects of these extracts on sphingolipid metabolism in dam and foetus livers. Six treatment groups included a control group, a group fed on an FB-containing diet (150 mg kg(-1) feed) and groups treated orally with garlic or cabbage extracts (5 mg kg(-1) body wt.) with or without FB during gestation days 6-15. Evaluations of toxicity were performed on day 20. These include: maternal (mortality, body weight, feed intake and litter weight), developmental (embryonic resorption, foetal body weight, foetal soft-tissue anomalies and foetal skeletal examinations) and maternal and foetal sphingolipid metabolism. Fumonisin alone resulted in significant decreases in feed intake, body weight gain, litter weight, number of live foetuses and foetal body weight, whereas it increased significantly the number of resorbed foetuses and the number of skeletal malformations (30.4% for skull and 26.08% for sternebrae) and also increased the sphinganine/sphingosine (Sa/So) ratio in dam but not fetus livers. Garlic alone or plus FB was comparable to the control regarding all the tested parameters. On the other hand, cabbage seed extract alone or plus FB resulted in 10% maternal mortality and a decrease in maternal body weight and litter weight. It resulted in 4.65% skull malformations in foetuses but it was comparable to the control with regard to the other tested parameters. It could be concluded that both garlic and cabbage seed extracts have protective effects in pregnant rats. Moreover, garlic extract was found to have a greater protective effect than cabbage seed extract.