Impact of conflict in Syria on Syrian children at the Zaatari refugee camp in Jordan

This paper describes a study performed to investigate the impact of the conflict in Syria on Syrian refugee children. The Zaatari refugee camp in Jordan was chosen for this task. Two control (comparison) groups of children were selected: one from the Jordanian Ramtha district, which is just across the border from Syria, and that indirectly feel the consequences of the Syrian conflict, and the other from Amman, the capital of Jordan, which is far away from the border. The study compared the Zaatari, Ramtha and Amman groups in terms of expressed anxiety and depression symptoms. They were also compared with respect to their gender and age. The Zaatari children were more distressed than the others, and the symptom ‘thoughts of ending your life’ was expressed only by this group. The Ramtha group also expressed some distress. The fact that this group indirectly experiences the consequences of violence emphasises the dire circumstances of children inside Syria who are trapped between fighting groups.     

Study on combined effects of blanching and sonication on different quality parameters of carrot juice

This study was conducted to evaluate the combined effects of blanching and sonication on carrot juice quality. Carrots were blanched at 100?°C for 4?min in normal and acidified water. Juice was extracted and sonicated at 15?°C for 2?min keeping pulse duration 5?s on and 5?s off (70% amplitude level and 20?kHz frequency). No significant effect of blanching and sonication was observed on Brix, pH and titratable acidity except acidified blanching that decreased pH and increased acidity significantly. Peroxidase was inactivated after blanching that also significantly decreased total phenol, flavonoids, tannins, free radical scavenging activity, antioxidant capacity and ascorbic acid and increased cloud and color values. Sonication could improve all these parameters significantly. The present results suggest that combination of blanching and sonication may be employed in food industry to produce high-quality carrot juice with reduced enzyme activity and improved nutrition.     

Immune responses induced by BCG recombinant for human papillomavirus L1 and E7 proteins

Recombinant bacille Calmette-Guerin (BCG) based vaccine delivery systems could potentially share the safety and effectiveness of BCG. We therefore prepared recombinant BCG vaccines which expressed the L1 late protein of the human papillomavirus (HPV) 6b or the E7 early protein of the HPV 16. The two recombinants were evaluated as immunogens in C57BL/6J and BALB/c mice, and compared with a conventional protein/adjuvant system using E7 or L1 mixed with Quil-A adjuvant. rBCG6bL1 and rBCG16E7 primed specific immune responses, represented by DTH, T-proliferation and antibody, and rBCG16E7 induced cytotoxic immune response to E7 protein. The magnitude of the observed responses were less than those elicited by protein/adjuvant vaccine. As recombinant BCG vaccines expressing HPV6bL1 or HPV16E7 persist at low levels in the immunised host, they may be beneficial to prime or retain memory responses to antigens, but are unlikely to be useful as a single component vaccine strategy.     

Hypopharyngeal pH monitoring artifact in detection of laryngopharyngeal reflux

Hypopharyngeal pH artifacts have been a concern in the detection of laryngopharyngeal reflux. Our purpose was to analyze and quantify artifacts from dual-sensor hypopharyngeal pH monitoring. In all, 42 hypopharyngeal and 58 esophageal pH studies were reviewed. Type 1 (out of range), type 2 (pH drift), and type 3 (isolated pH drop) artifacts were identified. The proportion of proximal-sensor pH drop to <4 that was artifactual was determined. The median number (range) of artifacts was 1 (0–17) and 2 (0–28) for hypopharyngeal and esophageal pH studies, respectively (P = NS). The median proportion of artifactual pH drop to <4 was 1% (0–84%) and 2% (0–74%) for hypopharyngeal and esophageal pH studies, respectively (P = NS). The diagnosis did not change in any patient after excluding pH artifacts. In all, 19% of the combined 2432 hypopharyngeal pH drops of <4 were artifacts. In conclusion, hypopharyngeal pH artifacts per study were uncommon but can be prominent in a few patients. One can identify these artifacts and exclude them from analysis.     

Punica granatum (pomegranate) flower extract possesses potent antioxidant activity and abrogates Fe-NTA induced hepatotoxicity in mice.

Most pomegranate (Punica granatum Linn., Punicaceae) fruit parts are known to possess enormous antioxidant activity. The present study evaluated antioxidant and hepatoprotective activity of pomegranate flowers. Alcoholic (ethanolic) extract of flowers was prepared and used in the present study. The extract was found to contain a large amount of polyphenols and exhibit enormous reducing ability, both indicative of potent antioxidant ability. The extract showed 81.6% antioxidant activity in DPPH model system. The ability of extract to scavenge reactive oxygen species (ROS) and reactive nitrogen species (RNS) was tested and it was found to significantly scavenge superoxide (O(2)(.-)) (by up to 53.3%), hydrogen peroxide (H(2)O(2)) (by up to 30%), hydroxyl radicals (()OH) (by up to 37%) and nitric oxide (NO) (by up to 74.5%). The extract also inhibited (.)OH induced oxidation of lipids and proteins in vitro. These results indicated pomegranate flower extract to exert a significant antioxidant activity in vitro. The efficacy of extract was tested in vivo and it was found to exhibit a potent protective activity in acute oxidative tissue injury animal model: ferric nitrilotriacetate (Fe-NTA) induced hepatotoxicity in mice. Intraperitoneal administration of 9 mg/kg body wt. Fe-NTA to mice induced oxidative stress and liver injury. Pretreatment with pomegranate flower extract at a dose regimen of 50-150 mg/kg body wt. for a week significantly and dose dependently protected against Fe-NTA induced oxidative stress as well as hepatic injury. The extract afforded up to 60% protection against hepatic lipid peroxidation and preserved glutathione (GSH) levels and activities of antioxidant enzymes viz., catalase (CAT), glutathione peroxidase (GPX) glutathione reductase (GR) and glutathione-S-transferase (GST) by up to 36%, 28.5%, 28.7%, 40.2% and 42.5% respectively. A protection against Fe-NTA induced liver injury was apparent as inhibition in the modulation of liver markers viz., aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin and albumin in serum. The histopathological changes produced by Fe-NTA, such as ballooning degeneration, fatty changes, necrosis were also alleviated by the extract. These results indicate pomegranate flowers to possess potent antioxidant and hepatoprotective property, the former being probably responsible for the latter.     

Biological and immunological properties of haemagglutinin and neuraminidase expressed from cloned cDNAs in prokaryotic and eukaryotic cells

To study the biological and immunological properties of influenza virus surface glycoproteins, cDNA copies of the haemagglutinin (HA) and the neuraminidase (NA) genes of A/WSN/33 influenza virus were cloned and expressed in prokaryotic and eukaryotic cells. In Escherichia coli, maximum expression of HA is obtained only as a fusion protein in which the NH₂-terminal portion is provided by a bacterial protein (i.e. βgal or trpLE′). The HA expressed in bacteria (bacterial HA) is recognized by polyclonal anti-WSN antibodies but not by neutralizing monoclonal antibodies. The antibodies made against the bacterial HA bind to the detergent-treated viral HA, intact virus and live influenza infected cells, but fail to show either haemagglutination inhibition (HI) or virus neutralization. These results suggest that the three-dimensional structure as well as the antigenic epitopes of the bacterial HA are different from that of native viral HA. HA, expressed from cDNA in cultured animal cells, is shown to possess the structural features of the native viral HA. It is glycosylated, transported to the apical domain of the plasma membrane of polarized cells, causes haemadsorption and can induce cell to cell fusion at low pH after proteolytic cleavage. An attempt was made to define the structural features of HA required for sorting and directional transport by making chimeras with vesicular stomatitis virus G (VSV G) protein either by switching the amino terminus or the carboxy terminus of HA with that of VSV G. These chimeric proteins were translocated across the rough endoplasmic reticulum (RER) but were blocked in transport between the RER and cell membrane. These preliminary results indicate that the three-dimensional structure, in addition to specific sequences, may play a critical role in the transport process. More precise constructions are in progress to delineate the functions of the different domains of HA molecule. HA has been expressed in the lower eukaryote Saccharomyces cerevisiae (baker's yeast). The HA expressed in yeast (yeast-HA) is glycosylated and membrane-bound. It is recognized by both the polyclonal and neutralizing monoclonal antibodies made against the native HA. These results suggest that the yeast-HA retains the antigenic epitopes present in the native viral HA and therefore may be of significance in the development of a subunit vaccine. NA, the other influenza glycoprotein, has been expressed from the cloned cDNA in cultured monkey kidney cells and the expressed NA, like the native viral NA, is glycosylated and enzymatically active. Furthermore, it has been shown that the NH₂-terminus of NA, in addition to providing the anchor function, also provides the signal function for translocation across the rough endoplasmic reticulum (RER). Like HA, NA expressed from cloned cDNA is preferentially transported to the apical domain of the plasma membrane of polarized epithelial cells.     

Pre-pyloric versus post-pyloric feeding

Optimal management of the critically ill patient involves the initiation and rapid advancement of early enteral nutrition (EN). Compared to parenteral nutrition or no nutritional support, early enteral feeding favorably impacts patient outcome by reducing infectious morbidity and shortening hospital length of stay. Controversy exists over the true risks and benefits of pre-pyloric versus post-pyloric feeding. Placement of nasogastric tubes is easier than nasojejunal tubes, initiation of EN is more expedient, and intragastric feeds may provide greater physiologic benefits. Post-pyloric feeding, on the other hand, is associated with fewer interruptions once EN has been started, may reach goal calorie provision sooner, and may reduce risk for gastroesophageal reflux and aspiration. Overall differences in outcome between the two methods of feeding, however, are minimal. Thus, the final choice for the practicing clinician on the level of infusion of enteral feeding is based on institutional factors (related to protocols and available expertise) and the degree of risk and potential tolerance of the individual patient.     

Reconstruction of complex facial defects after radical resection of advanced skin cancers

Management of patients with extensive facial skin cancers is a challenge. We present a series of nine patients with extensive facial skin cancers and our experience with managing these patients.