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Food contaminated with multiple antibiotic-resistant S.aureus can be a major threat to the public health. The purpose of this study was to isolate S.aureus from different food sources, determine their antimicrobial susceptibility as well as detection of mecA gene among some resistant isolates. Out of 125 samples, 19 S.aureus isolates were isolated, and the antimicrobial susceptibility testing showed high resistance against kanamycin, penicillin G, oxacillin, erythromycin and tetracycline were the most resistant antimicrobials agents. All the tested isolates isolates were multiple drug resistant (MDR).Eight out of 19 isolates were phenotypically resistant to oxacillin as well as they were carriers for mecA gene.

Aim: The aim of our study was polymerase chain reaction (PCR) detection of the genes responsible for the multiple antibiotic resistance S. aureus isolated from food of animal origin in Egypt. Materials and Methods: A total of 125 samples were randomly collected from milk, meat, and their products from Giza and Beni-Suef Governorates markets. The S. aureus isolates were subjected to antimicrobial sensitivity tests using four antibacterial disks (Oxoid), and then the polymerase chain reaction (PCR) was performed for detection of antibiotic resistance genes. Results: Out of 125 samples, 19 S. aureus isolates were detected. All detected isolates were multiple drug resistance (MDR). The penicillin-, erythromycin-, kanamycin-, and tetracycline-resistant isolates were examined by PCR for resistance genes blaZ, (msrA, ermB, and ermC), aac(6')aph (2''), and tetK. The isolates harbored these resistance genes with percentage of 100% (100%, 0%, and 100%), 62.5%, and 100%, respectively. Conclusion: Contaminated foods of animal origin may represent a source of MDR S. aureus that can be a major threat to public health.

Coagulase negative Staphylococci are the most prevalent cause of bovine subclinical mastitis. The current study were designed to study their occurrence, antibiogram and their ability to form biofilms. A total number of 95 CNS isolates were recovered from 400 lactating. S. xylosus (36.84%), S. chromogenes (12.63%), S. epidermidis (10.53%), S. saprophyticus (8.42%), S. haemolyticus (7.38%) were the most common recovered species. Disk diffusion method against 14 antimicrobials discs was used to detect their antibiogram. 100% were sensitive to Imipenem, 96.84% were sensitive to Enrofloxacin, 85.26% to Chlramphenicol and 84.21% to Vancomycin. But, 95.79% were resistant to Ampicillin, 77.9% resistant to Cefoxitin, 35.8% resistant to Cefuroxime, 32.63% resistant to Amoxycillin and 18.95% resistant to Clindamycin. Cultivation on Congo Red Agar (CRA) was carried out to detect biofilm formation. 47.37% were positive and S. epidermidis was the most biofilm positive species on CRA by the percentage of 70%. Haemolysins were studied by cultivating CNS on sheep blood agar. 25.26% were β-haemolytic, 71.57% (n=68) were γ-haemolytic and 3.15% were α- haemolytic.

Pasteurella (P.) multocida and Mannheimia (M.) haemolytica are the most two common pathogenic bacterial agents causing pneumonia in calves. Both bacteria are associated with significant economic losses in the cattle industry due to high morbidity and mortality rates, especially in the case of severe infections. The objectives of the present study were to perform serotyping and genotyping, as well as characterization of the virulence-associated genes in 48 bacterial isolates; 33 P. multocida and 15 M. haemolytica. All strains were isolated from pneumonic cattle calves showing respiratory manifestations such as fever, nasal discharges, and rapid breathing in North Upper Egypt governorates (Beni-Suef and El-Fayoum). PCR was applied as a confirmatory test using a specific universal gene, kmt1, and rpt2 for P. multocida and M. haemolytica, respectively. The results show that 29 (87.9%) P. multocida and 15 (100%) M. haemolytica isolates were positive for the corresponding universal gene. The results of serotyping indicate that 86.2% of P. multocida isolates belonged to serotype B:2, while 13.8% were untyped. Meanwhile, 60% and 40% of M. haemolytica isolates belonged to serotype 2 and serotype 1, respectively. Investigation of virulence-associated genes showed that all the tested P. multocida isolates harbored nanB, omp87, and toxA genes. Four M. haemolytica isolates harbored both gcp and lktC genes and of these, three isolates harbored the ssa gene. Sequencing of toxA gene of P. multocida and lktC gene of M. haemolytica in the current strains indicated a great homology with strains uploaded in gene banks from different hosts and localities worldwide.

The primary objective of this study was to ascertain the prevalence, antimicrobial susceptibility, and biofilm production of Staphylococcus aureusstrains isolated from sheep and goats affected with mastitis and endometritis in Beni Suef governorate, Egypt. In sheep and goats mastitic milk samples, the prevalence rate of S. aureus was found to be 26% (32 isolates out of 122 samples), while it was 7.75% (9 isolates out of 116 samples) in endometritis samples. The antibiogram for S. aureus isolates from sheep and goats mastitis cases revealed resistance to amoxicillin-clavulanic acid (78.1%), cefotaxime (75%), cephalexin (71.8%), amoxicillin (68.7%), and ceftriaxone (66.7%). On the other hand, the recovered S. aureus isolates from sheep and goats with endometritis revealed resistance to amoxicillin-clavulanic acid (88.9%), cefotaxime (77.8%), and ceftriaxone (66.7%). Phenotypic detection of biofilm on Congo Red agar revealed that 20 Staphylococci isolates (66.67%) formed biofilms, out of them, 16 isolates (53.33%) from mastitis and 4 isolates (13.34%) from endometritis. The results of molecular characterization showed that all the four tested S. aureus isolates were found to possess the mecA gene, while the tetK gene was found in three out of four isolates. In relation to genes associated with virulence, all four isolates were tested positive for coa and three out of four isolates tested positive for icaA. In conclusion, S. aureus stands as a prominent pathogen in cases of mastitis and endometritis in both sheep and goats. [ABSTRACT FROM AUTHOR]

Abstract Background Liver cancer (hepatocellular carcinoma “HCC”) remains a significant health issue without prompt detection and appropriate prevention. By interacting with each other, long noncoding RNAs (lncRNAs) and microRNAs (miRNAs) can form gene regulatory networks. Specifically, we aim to determine whether the lncRNAs (HOTTIP, H19, and HOTAIR) and miRNA-152 interact in a significant manner in the progression of Hepatitis C virus (HCV) patients to HCC. This is followed by the question of whether these biomarkers can be used to diagnose and prognose noninvasively. We used online computational techniques to predict which miRNA group is likely to affect the lncRNAs being examined. This study involved 133 participants. 103 patients with HCV were included in the study, which was divided into two groups: Group I, with 65 cases of chronic liver disease without HCC, and Group II, with 38 cases of chronic liver disease with HCC. In addition, 30 healthy volunteers served as controls. In this study, a qRT-PCR was used to test gene expression. Results A consistent reverse correlation has been observed between lncRNAs and miRNA-152 as the disease progresses. Conclusion According to our findings, the studied biomarkers may be useful as noninvasive biomarkers for prognosis in patients with HCV Genotype 4 who develop liver cirrhosis and HCC. Many miRNAs, including miRNA-19a and miRNA-106a, may interact with lncRNAs that have been investigated in addition to miRNA-152.

This study was focused on the prevalence of E. coli in mastitis and endometritis of sheep and goats in Beni-Suef government with a total number of 238 samples as follow; 122 of native breed lactating ewes (n=90) and does (n=32) from private farms suffered from mastitis and a total of 116 of native breed of ewes (n=83) and she-goats (n=33) from endometritis cases in which137 isolates of Escherichia coli (E. coli) categorized as 68 isolates were isolated from mastitis and 69 isolates from endometritis with a prevalence rate of 55.7 % and 59.5 %, respectively. Antibiogram for E. coli isolates recovered from ovine and caprine mastitic cases showed resistance to amoxicillin-clavulanic acid (67.65%), cephalexin (64.71 %), amoxicillin (58.82%), cefotaxime (57.42 %), ceftriaxone (54.42 %) and gentamicin (44.11%). On the contrary, the recovered E. coli isolates from endometritis of ewes and does showed resistance to amoxicillin-clavulanic acid (69.57%), cefotaxime (68.11 %), amoxicillin (66.66 %), cephalexin (65.22%), ceftriaxone (62.32 %), colistin (46.38%) and gentamicin (44.93%). Sixty E. coli isolates (27 isolates from ovine mastitis milk samples and 33 isolates from endometritis samples were inoculated onto Yeast extract-casamino acids Congo red agar (YESCA CRA) revealed that 39 of E. coli isolates showed positive biofilm formation. Multidrug resistance was detected in 70 E. coli isolates out of 137 isolates (51.09%) (31 E. coli isolates from mastitis milk samples and 39 isolates from endometritis samples). The prevalence of virulence and resistance genes of E. coli as fimH, iutA, qnrA and blaTEM was 100%, 25%, 50% and 100%, respectively. This work was designed for detection of virulence and antibiotic resistant E. coli isolates from mastitis and endometritis cases in sheep and goats. [ABSTRACT FROM AUTHOR]

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Toll-like receptor (TLR) genes play a crucial role in pathogen recognition and subsequent activation of the innate immune response. The role of TLR4in the initiation of inflammatory and immune response makes it a suitable candidate gene for marker-assisted selection to enhance disease resistance in dairy animals. The present study was undertaken to characterize the distribution of single nucleotide polymorphisms (SNPs) in TLR4 coding region, and to test their role as potential risk factor for the occurrence of endometritis in river buffalo Egyptian breed (Bubalus bubalis). The analysis of the entire coding sequences (CDs) enabled the identification of 13 non-synonymous SNP. A statistical correlation was observed between resistance to endometritis and the genotype CC at the 2464 C >A locus and AA genotype at the 2465 A > C. Moreover, a correlation was seen between susceptibility to endometritis and the heterozygous and recessive homozygous genotypes of these SNPs. Haplotype reconstruction of the TLR4 gene revealed a statistical significance of haplotype frequencies between healthy and diseased cases by performing a permutation test which retrieved significant association with the occurrence of the disease in the coding region of TLR4.PolyPhen 2 analysis revealed two amino acid substitutions which may have a potential structural and functional significance. The current study describes some novel SNPs in TLR4 gene of river buffalo Egyptian breed and their association with the endometritis disease, therefore suggesting a possible positional marker in the buffalo genome that may be related to such a disease. [ABSTRACT FROM AUTHOR]

This work was aimed to study the impact of some edible coatings; wheat flour, bread crumb and vegetar, on the quality of common carp fish nuggets stored at -18°C for three months. Results showed that major constituents of cooked fish nuggets were fluctuated during frozen storage. While the values of pH, total volatile basic nitrogen (TVB-N) and trimethylamine nitrogen (TMA-N), thiobarbituric acid (TBA) and total plate count (TPC) were decreased up to the end of storage. Concerning color density, vegetar improved both a* (red-green) and b*(yellow-blue) value, while flour improved L* (lightness) of cooked carp nuggets. In conclusion, carp fish as low price fish could be exploited as ready to eat products. Variation in different treatments is due to chemical composition of taken part from dorsal muscles as well as ingredients of each edible part and frozen storage periods too. [ABSTRACT FROM AUTHOR]

Abstract Background Long non-coding RNAs (lncRNAs) homeobox (Hox) transcript antisense intergenic RNA (HOTAIR) and HOXA transcript at the distal tip (HOTTIP) have been suggested to be implicated in liver cancer tumorigenesis and progression; however, little is known about the role of the plasma HOTAIR and HOTTIP in liver cancer diagnosis and prognosis. The current study aimed at measuring the plasma levels of long non-coding RNAs (HOTAIR and HOTTIP) expression in chronic liver disease (CLD) due to HCV genotype 4 infection with/without cirrhosis and HCC patients in an attempt to evaluate the potential benefits of these new circulating as non-invasive diagnostic biomarkers and a novel therapeutic strategy for liver cirrhosis and carcinogenesis of Egyptian patients. Hundred subjects were included in this study, divided into two groups; group I (50 patients) were classified into subgroup Ia (CLD without cirrhosis, n = 25) and subgroup Ib (CLD with cirrhosis, n = 25), group II (CLD patients with HCC, n = 25), and control (healthy volunteer, n = 25). The expression of lncRNAs (HOTAIR and HOTTIP) genes was analyzed by real-time PCR. Results LncRNAs (HOTAIR and HOTTIP) showed upregulation in all diseased groups, which was in consistent with the progression of the disease toward the HCC stage. In addition, HOTAIR and HOTTIP showed a diagnostic ability to discriminate between cases of cirrhosis and HCC compared with healthy control (p < 0.001), while HOTAIR and HOTTIP did not show a discrimination significant differences between cirrhotic cases and non-cirrhotic cases. By using receiver operating characteristic curve (ROC) analysis, it was found that LncRNAs (HOTAIR and HOTTIP) could diagnose liver cancer with 64.0% sensitivity and 86.0% specificity and 48.0% sensitivity and 88.0% specificity. Furthermore, both genes can be considered as the predictor and prognostic parameters for cirrhosis (OR = 1.111, p = 0.05) and (OR = 1.07, p = 0.05) respectively, and HCC (OR = 1.047, p = 0.01) and (OR = 1.05, p = 0.003). The increased HOTAIR and HOTTIP expression were associated with advanced tumor stages and higher grades. Conclusion These results strongly prompt us that HOTAIR and HOTTIP genes can be used as non-invasive prognostic biomarkers and new therapeutic targets for HCV genotype 4-induced HCC.

The experiment was designed to investigate the immunomodulating effect of lector 50 on general health and immune response of broiler chicks to Mycoplasma gallisepticum vaccination in commercial broiler chicks. the obtained results reveled significantly higher effects on body weight ,bursal, and thymic index on lector treated group of chickens, while no effects on spleen index. Also significant improvement in total and differential leukocytic count as well as significantly higher antibody titer was detected by ELISA in lector 50 treated groups.

Abstract: Concepts surrounding the mechanisms of thrombocytopenia in ITP have shifted from the traditional view of autoantibody mediated platelet destruction to more complex mechanisms in which impaired platelet production, T-cell-mediated effects, and disturbed cytokine profiles play a role. Interleukin 27 (IL-27) plays pleiotropic roles in immunomodulation and autoimmune diseases.We aimed to determine the level of IL-27 in patients with ITP and its relationship to patient and disease characteristics as well as disease chronicity and response to treatment.Sixty childrens with primary immune thrombocytopenia were consequetively enrolled in this study as well as 20 age and sex matched healthy controls.ITP patients had significantly higher levels of IL-27 than controls (770.6 and 373.8 pg/ml, respectively). Patients with acute ITP had the highest levels of IL-27 among patient groups, while patients in remission had the lowest IL-27 levels (860.1and 622.9 pg/ml, respectively). Patients who received IVIG and combined steroids plus IVIG had significantly higher IL-27 levels than others. Patients who received Eltrombopag had significantly lower IL-27 levels than others.IL-27 seems to play a role in pathogenesis of childhood ITP. IL-27 can be used as a predictor for disease occurrence as well as responsiveness to treatment., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objectives: To explore the ability to use urinary level of plasmin as an indicator for renal affection and activity in systemic lupus erythematosus (SLE) patients., Patients and Methods: Between April 2020 and October 2020, urine samples from 50 SLE patients (2 males, 48 females; mean age: 35.5±8.1 years; range, 22 to 39 years) and 20 age- and sex-matched healthy controls (2 males, 18 females; mean age: 34.1±6.5 years; range, 27 to 38 years) were collected. The patients were divided into two groups according to the presence or absence of renal manifestations as those with renal disease (n=28) and those without renal disease (n=22). The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), renal activity (rSLEDAI), and Systemic Lupus International Collaborating Clinics Damage Index (SLICC-DI) scores were calculated. Renal biopsy was performed to patients with active lupus nephritis (LN). The activity index (AI) and Chronicity Index (CI) were scored., Results: There was a highly statistically significant difference in the mean urinary plasmin levels between SLE cases and the control group (88.9±42.6 ng/mL vs. 21.3±26.8 ng/mL, respectively; p<0.001). A significant elevation was observed (p<0.05) in patients with LN (97.9±46.6 ng/mL) than without (42.7±12.7 ng/mL), particularly in patients with active renal involvement (82.9±26.6 ng/mL) than patients with inactive renal disease (63.2±15.5 ng/mL). There were significant positive correlations between the mean urinary plasmin levels and inflammatory markers, SLEDAI, and rSLEDAI scores., Conclusion: Urinary level of plasmin is significantly elevated among SLE cases, particularly in those with active LN. The remarkable association between urinary plasmin level and various activity status implies that urinary plasmin can be used as a beneficial marker to monitor lupus nephritis flare., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2022, Turkish League Against Rheumatism.)

Background: Although family caregivers (FCs) play an important role in the care provided to incurable cancer patients in our region, little is known about the burden they experience. This study was conducted to determine the prevalence of caregiver burden (CB) among FCs of incurable cancer patients in two Eastern Mediterranean countries and to identify factors that may be associated with significant CB., Methods: The study included 218 FCs, 165 from Egypt and 53 from Saudi Arabia. The 22-item Zarit Burden Interview (ZBI-22) was used to assess caregiver burden CB. Significant CB was defined as a ZBI-22 score ≥ 21. The assistance with basic ADLs was classified into 3 levels according to FCs' assistance with early/middle/late-loss basic ADLs. The relationship between CB and the assistance with ADLs and other factors was studied., Results: The mean (SD) ZBI-22 score among FCs was 23.4 (9.3) and the majority (128/218, 59%) had significant CB. Eighty-nine percent of FCs assisted with at least one basic ADL. Assistance with late-loss basic ADLs, best supportive care treatment plan and poorer performance status were associated with higher CB (p < 0.0001, =0.018 and = 0.005). However, in logistic regression analysis, only assistance with late-loss ADLs was independently associated with significant CB (OR = 3.4 [95%CI:1.2-9.7], p = 0.024)., Conclusion: A substantial proportion of FCs of incurable cancer patients in our region experience significant CB. Family caregivers assisting with late-loss basic ADLs are at risk of significant CB and should be routinely screened for CB., (© 2021. The Author(s).)

The planning target volume (PTV) depends on the method of radiotherapy guidance. This study aimed to measure the systemic and random errors using an online marker matching and offline bone structure matching to estimate PTV marker , PTV bone , or PTV laser for treatment verification and radiotherapy guidance, especially in centers lacking radiotherapy fiducial markers (FMs). Thirty patients with localized prostate cancer who were treated with FM-based dose escalation protocol were included. The initial set-up was done with laser marks and daily megavoltage images were acquired. The systematic and random errors were calculated. PTV marker , defined as the sum of maximum marker migration, and PTV calculated to compensate for the difference between online marker matching and offline analysis of marker matching. PTV marker was added to estimated PTV from online marker matching to obtain PTV laser . PTV skin marks migration , was calculated and deducted from PTV laser to acquire PTV bone . The mean maximum marker migration was 2 ± 1.2 mm. The resultant values of PTV marker were 2.7 ± 0.6 mm, 3.3 ± 1.1 mm, and 4.4 ± 2.2 mm, in the lateral (lat.), longitudinal (long) & vertical (vert.) directions, respectively, whereas values of PTV laser were 13 ± 0.6 mm, 17.7 ± 1.1 mm, and 15.8 ± 2.2 mm, and PTV bone were 5.9 ± 0.6 mm, 8.6 ± 1.1 mm, 7.2 ± 2.2 mm, respectively, in the lat., long., and vert. directions. Our results show that PTV needed with FM-based image guidance ranged between 3 and 4 mm in the three cardinal directions, was 10 mm smaller than that required with laser skin marks guidance, and narrower by 5 mm compared to that obtained by offline bone structure image matching.

Surgical interventions in the anterior region of the human mandible are associated with many complications. Some anatomical structures like the median perforating canal were discovered in mammals. Such canals may be a cause of concern that needs attention in human mandible. The purpose of the present study was to evaluate the occurrence, location, and course of median perforating canal and its associated extensions in the anterior segment of the human mandible in cone beam computed tomography scans (CBCT). Data were collected from 160 CBCT scans, and evaluated. The incidence was 23.75% for median perforating canal with wide anatomical variations concerning the related lingual and labial extensions. Median perforating canal and their associated lingual and labial foramina are frequently seen in human mandible. A thorough investigation of the symphyseal region using CBCT must be taken into account when targeting surgical intervention in this area.

Background and Purpose: Drug interaction management is essential in pharmacy practice. The purpose of this study was to evaluate student pharmacists' ability and confidence using drug information databases to investigate a drug-drug interaction previously unencountered in the curriculum., Educational Activity and Setting: A cross-sectional study was conducted where didactic students were presented with three cases, each containing an interaction. Students were asked to select a drug information resource and determine the mechanism, clinical effects, severity, level of documentation, and course of action for each interaction. Overall performance was assessed on a 15-point scale (one point for each assessment item for each interaction), and students were asked to rate their confidence on a five-point scale for each interaction, yielding a 15-point confidence scale., Findings: For the 187 participants (90.8% response rate) who completed each interaction assessment, overall median performance score was 14 out of 15 possible points (IQR 12-15); 58 (31.0%) earned the maximum score of 15 points. Median confidence score was 13 out of 15 possible points (IQR 12-14)., Discussion: This study uniquely assessed students' competency in interactions by focusing on analysis, as opposed to recall of basic facts. Although most students performed well, a significant minority earned an overall performance score of 80% or less, suggesting need for continued practice and improvement., Summary: This cross-section of student pharmacists earned generally high performance scores when assessed on their ability to use a drug information resource to analyze interactions, and were mostly highly confident., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background/objectives: Ventilator associated pneumonia (VAP) is a leading cause of death. Nebulized hypertonic saline solution (HSS) has been used to improve pulmonary clearance and reduce infection in intubated patients. This study examines whether nebulized HSS may reduce VAP in intubated premature infants., Methods: We analyzed results of 100 intubated premature infants who completed the study. Infants were divided into: (a) the "Control" group, where VAP prevention protocol was implemented and (b) the "Intervention" group, where nebulized HSS twice daily was added to the package of care. Clinical, radiologic, and laboratory evidence of VAP, endotracheal aspirate and blood cultures, and days on mechanical ventilation were compared between groups., Results: VAP occurred in 18% in the intervention group compared to 52% in the control group, relative risk 0.35 (CI:0.18-0.66, p = .001). VAP incidence density was 16/1000 patient-ventilator days in intervention group versus 30/1000 in control group. There was a significant reduction in the days of mechanical ventilation in the intervention group (10.7 ± 8.6 and 16.9 ± 3.4, p < .001)., Conclusions: Nebulized HSS may help preserving lung clearance mechanisms and therefore reduce VAP in premature infants. Multi center, double blinded, randomized, controlled, trial is needed to confirm safety and efficacy of such intervention.

Aim: The aim of our study was polymerase chain reaction (PCR) detection of the genes responsible for the multiple antibiotic resistance S. aureus isolated from food of animal origin in Egypt., Materials and Methods: A total of 125 samples were randomly collected from milk, meat, and their products from Giza and Beni-Suef Governorates markets. The S. aureus isolates were subjected to antimicrobial sensitivity tests using four antibacterial disks (Oxoid), and then the polymerase chain reaction (PCR) was performed for detection of antibiotic resistance genes., Results: Out of 125 samples, 19 S. aureus isolates were detected. All detected isolates were multiple drug resistance (MDR). The penicillin-, erythromycin-, kanamycin-, and tetracycline-resistant isolates were examined by PCR for resistance genes blaZ , ( msrA, ermB , and ermC) , aac(6')aph (2") , and tetK . The isolates harbored these resistance genes with percentage of 100% (100%, 0%, and 100%), 62.5%, and 100%, respectively., Conclusion: Contaminated foods of animal origin may represent a source of MDR S. aureus that can be a major threat to public health.

Background: Neurokinin-1 receptor antagonists, such as aprepitant are currently emerging as powerful prophylactic agents for chemotherapy-induced nausea and vomiting (CINV). Therefore, it is important to adjust the anti-emetic regimens based on personal risk factors of the patient, duration of the chemotherapy regimen and cost-effectiveness., Purpose: To determine the efficacy of the 3-day aprepitant along with ondansetron and dexamethasone in controlling CINV in patients with large B cell lymphoma receiving multiday-cisplatin regimen chemotherapy., Methods: This is a pilot prospective cross-over trial. Patients were allocated to either aprepitant 125mg on day 1 and 80mg on days 2 & 3 or placebo in the first 2 cycles, with crossover to the opposite treatment in the 3rd and 4th cycles. The primary end point was complete response (CR) of both acute (days 1-5) and delayed (days 6-8) CINV. CR means neither to develop emetic episodes nor to use rescue anti-emetics medication., Results: Twelve of the 15 patients recruited for the study were fully evaluable and completed 4 cycles of ESHAP regimen with a total of 48 cycles given. In the cycles with aprepitant and those without the CR were 83.3% and 0% respectively (p<0.05). Patients receiving aprepitant in the first 2 cycles recorded less nausea in subsequent cycles that were given without aprepitant. This was not statistically significant., Conclusion: This triple anti-emetic regimen showed efficacy in controlling the multi-day cisplatin-induced nausea and vomiting. Further randomized controlled trials are needed to compare between 3-day and 7-day aprepitant for multi-day cisplatin regimens., (Copyright © 2017. Production and hosting by Elsevier B.V.)

Background: Given the burden and poor outcome of end-stage renal disease in sickle cell disease (SCD), early markers of sickle cell nephropathy (SN) are desirable. Disordered angiogenesis underlies many complications of SCD. We aimed to determine the relationship between serum FMS-like tyrosine kinase-1 (sFLT-1) and other biomarkers of renal damage for the early diagnosis of SN., Methods: Forty-seven SCD patients and 49 healthy controls were enrolled. Microalbuminuria was determined in patient urine samples. Blood samples were tested for sFLT-1, serum creatinine, and various hemolysis and inflammation markers. Peripheral blood monocyte expression of sFLT-1 was measured using real-time polymerase chain reaction (PCR)., Results: The serum level of sFLT-1 (pg/ml) in SCD patients was higher than controls (median/range/IQR = 142/ 60-1300/61 pg/ml vs. 125/ 110-187/52 pg/ml, respectively) (p = 0.006). Median (range) of sFLT-1 level was higher in SCD patients with microalbuminuria compared to SCD patients with normoalbuminuria, 185 (140-1300) vs. 125 (60-189) mg/g, respectively) (p = 0.004). There was a significant positive correlation between serum sFLT-1 and microalbuminuria, lactate dehydrogenase (LDH), and indirect bilirubin (r = 0.59, 0.39, 0.30, and p = <0.001, 0.007, 0.041, respectively). sFLT-1 sensitivity in early detection of renal affection in SCD was 93.6%, while specificity was 68.6%. Finally, peripheral blood monocytes (PBM) sFLT-1 expression was significantly higher in SCD patients compared to controls (p = 0.05)., Conclusions: sFLT-1 may contribute to pathogenesis of albuminuria in SCD patients and constitute a novel renal biomarker of SN.

Objectives: The fear of using tramadol for pain control (tramadolophobia) by Egyptian patients with cancer is a frequent problem in our practice. This study was conducted to explore the prevalence of and the reasons behind tramadolophobia among Egyptian patients with cancer., Methods: A structured interview including open-ended and closed questions. The study included 178 adult patients with cancer from two cancer centers in Cairo and Sharkia, Egypt., Results: The source of information about tramadol was a non-healthcare-related source in 168 (94 percent) patients, mainly the media (50 percent). The believed uses of tramadol were abuse related in 94 (53 percent) patients, stimulant (physical, sexual, and to boost alertness) in 59 (33 percent), and analgesic in 55 (31 percent). Twenty-six (15 percent) patients gave history of tramadol use, largely (69 percent) as a stimulant. In case tramadol was prescribed for pain control, 90 (51 percent) patients refused to take it, 59 (33 percent) patients agreed to take it with concern about addiction, and only 29 (16 percent) patients agreed without concerns. Among those who refused taking tramadol for pain, the mentioned reason of refusal was addiction-related fears in 57 percent., Conclusions: The stigmatization and misconceptions about tramadol may have resulted in tramadolophobia among the majority of Egyptian patients with cancer. This further complicates the barriers to cancer pain control in Egypt. Being the only available World Health Organization step-II analgesic in Egypt, interventions to overcome tramadolophobia should be taken.

Mutations of the HAMP gene and HFE gene have a role in iron overload. We assessed the frequency of the G71D mutation of the HAMP gene and the H63D mutation of the HFE gene and the correlation between these mutations as well as the correlation between them and the iron overload in sickle cell disease (SCD) patients. Genotyping of G71D of HAMP and of H63D of HFE variants was performed by polymerase chain reaction-restriction fragment length polymorphism on 47 SCD patients and 45 controls. The iron status was assessed by serum ferritin and transferrin saturation. We found 61.7% of the patients had a wild genotype in both genes, 14.9% had a variation in HAMP-G71D, 27.7% had a variation in HFE-H63D, and 4.3% had variations in both. Patients with either HAMP-G71D or HFE-H63D variants did not show significant difference in iron status in comparison to patients with wild type genotypes. Multivariate regression analysis revealed that the number of mutations harbored by the patients tends to affect the serum ferritin level; p=0.07. Thus, The HAMP-G71D and HFE-H63D variants are not uncommon among the Egyptian SCD patients; neither of them alone was found to be a major determinant of iron overload in the studied patients. Nevertheless, the number of harboured mutations may increase the probability of iron overload in these patients., (© 2014 by the Association of Clinical Scientists, Inc.)