Post-COVID syndrome: analysis of the prevalence of chemosensory dysfunction and predictive factors of recovery in COVID-19 long-haulers in Jordan

OBJECTIVE

One of the major concerns of the post-COVID-19 era is elucidating and addressing the long-term complications of COVID-19.

SUBJECTS AND METHODS

A web-based questionnaire was distributed in Jordan to assess the prevalence and recovery from chemosensory dysfunction among COVID-19 long-haulers in Jordan.

RESULTS

A total of 611 respondents complained of chemosensory dysfunction (age range = 18-68 years), and the majority of the respondents were female (88.4%). Parosmia was the most prevalent olfactory dysfunction reported (n = 337, 33.3%), and parageusia was the most frequently reported gustatory dysfunction (n = 239, 36.4%). Medications were not reported to be associated with a better perception of smell or taste by nearly half of those who had been treated (n = 146, 46.1%). Among participants who had received olfactory rehabilitation/training (n = 215, 35.2%), 43.7% (n = 94) reported modest improvement, with the most frequently helpful scents being coffee (n = 80, 24.8%), aromatic oils (n = 74, 23%), and perfumes/colognes (n = 73, 22.7%). Age was found to have a significant negative correlation with complete recovery. In addition, age (p < .05), anosmia (p < .001), hyperosmia (p < .001), ageusia (p < .05), and duration of olfactory dysfunction (p < .001) were all independent predictors of complete recovery.

CONCLUSIONS

Chemosensory dysfunctions are largely subjective; therefore, more objective examinations are required to draw more definite conclusions.

Frequency of Post Endoscopic Retrograde Cholangiopancreatography Acute Pancreatitis in an Academic Hospital of Bangladesh

Post-ERCP acute pancreatitis (PEP) is a common and serious complication with high morbidity and mortality rates. There is a paucity of data on the frequency of PEP in a resource constraint setting like Bangladesh. Hence we have conducted a prospective study to determine the frequency of PEP and the factors associated with its occurrence. This prospective, observational study was carried out in Gastroenterology Department of Dhaka Medical College & Hospital, Dhaka, Bangladesh from April 2018 to December 2018 on the consecutive patients who underwent ERCP. PEP and its severity were diagnosed according to consensus definition. Serum lipase was done in all patients before procedure and 24 hours after procedure or if patient develops abdominal pain after the procedure which became earlier. Total 168 patients were included (mean age 46.97±14.35 years; male 72(43.0%). The most common indication of ERCP was choledocholithiasis 97(58.0%) followed by malignant biliary obstruction 45(27.0%), recurrent pyogenic cholangitis 8(5.0%), chronic pancreatitis 4(2.3%), biliary ascariasis 4(2.3%) and others 10(6.0%). Overall post ERCP complication rate was 46(27.3%) including cholangitis 29(17.3%), pancreatitis 16(9.5%), bleeding 12(7.1%), aspiration pneumonia 4(2.4%) and death 3(1.8%). Regarding the severity of PEP, 50.0%, 43.7% and 6.3% patients developed mild, moderate and severe pancreatitis respectively. Number of cannulation attempts >5 times [22(48%) vs. 17(14%); p=0.001], cannulation attempts duration more than 10 minutes [25(55%) vs. 27(22%); p=0.001], unintentional passage of guide wire into the pancreatic duct [8(17%) vs. 18(15%); p=0.001], pancreatic duct contrast injection [12(26%) vs. 2(1.6%); p=0.001] and pre-cut sphincterotomy [16(35%) vs. 6(4.9%); p=0.001] were significantly different between the patients who developed PEP compared to those who did not. In multiple logistic regressions analysis, pancreatic duct contrast injection was significantly associated with PEP [OR 25.523 with 95% CI (4.049- 100.0%)]. Around ten percent patients had developed PEP. Regarding the severity half of them were mild, 44.0% patients had moderate and 6.0% patient had severe type of pancreatitis. Difficult cannulation, unintentional passage of guide wire into the pancreas, pancreatic duct contrast injection and pre-cut sphincterotomy were associated with PEP. Among them pancreatic duct contrast injection had independent significance in the causation of PEP.

A novel potentiometric sensor based on ZnO decorated polyaniline/coal nanocomposite for diltiazem determination

Diltiazem (DTZ) is one of the most effective medications for treating cardiovascular diseases. It has been widely used for the treatment of angina pectoris, hypertension and some types of arrhythmia. The development and application of a modified carbon paste sensor with improved detection limits for the potentiometric determination of diltiazem are the main goals of the current study. Sensitivity, long-term stability, reproducibility and improving the electrochemical performance are among the characteristics that have undergone careful examination. A modified carbon paste sensor based on β-cyclodextrin (β-CD) as ionophore, a lipophilic anionic additive (NaTPB) and a ZnO-decorated polyaniline/coal nanocomposite (ZnO@PANI/C) dissolved in dibutyl phthalate plasticizer, exhibited the best performance and Nernstian slope. The ZnO@PANI/C based sensor succeeded in lowering the detection limit to 5.0 × 10-7 through the linear range 1.0 × 10-6 to 1.0 × 10-2 mol L-1 with fast response time ≤ 10.0 s. The prepared nanomaterial was characterized using X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM). The surface properties of the proposed sensor were characterized by electrochemical impedance spectroscopy (EIS). The selectivity behavior of the investigated sensor was tested against a drug with similar chemical structure and biologically important blood electrolytes (Na+, K+, Mg2+, and Ca2+). The proposed analytical method was applied for DTZ analysis in pure drug, pharmaceutical products and industrial water samples with excellent recovery data.

Short-term outcomes of reduced versus conventional ports in sleeve gastrectomy: A controlled clinical trial

Aim

The study aims to compare the short-term outcomes of reduced ports sleeve gastrectomy versus conventional five ports sleeve gastrectomy in postoperative weight loss, morbidity rate, pain, and resolution of obesity-related diseases.

Materials and Methods

One hundred forty patients were equally allocated to reduced ports (n = 70) and conventional ports (5 ports) Laparoscopic Gastrectomy groups. The primary outcomes are postoperative pain by numeric rating score, cosmetic visual analog score, satisfaction visual analog score, operative time, and hospital stay. The secondary outcomes are postoperative complications and comorbidity resolution.

Results

The numeric rating score for pain assessment was statistically significantly lower in the reduced ports group compared with the conventional ports group at 2, 6, 12, and 24 hours, postoperatively (P < .001). Cosmetic visual analog score was statistically significantly higher in the reduced ports group compared with conventional ports group at 2 and 3 months follow-up (P < .001 and P = .008, respectively). Patient satisfaction visual analog score was statistically significantly higher in the reduced ports group than the conventional ports group at 2 and 3 months follow-up (P < .001 and P = .032, respectively).

Conclusion

Reduced ports laparoscopic sleeve gastrectomy is safe and feasible in patients with body mass index (BMI) up to 50 kg/m2. It is cosmetically well appreciated with noticeable patient satisfaction. It should be practiced with regularity. Further trials should be considered in patients with high BMI (>50 kg/m2).

Silver diamine fluoride: A stem cell cytotoxicity and dentin growth factor release in-vitro study

AIM

To investigate the effect of 38% SDF and its serial dilutions on the Stem cells from Human Exfoliated Deciduous teeth (SHED) and its ability to release growth factors from deciduous dentine.

METHODS

The viability of SHED post-exposure to 38%, 3.8%, 0.38%, 0.038%, and 0.0038% SDF were assessed at 2, 5, and 7 days using the CyQuant assay, and results were validated using the MTT assay. The osteogenic differentiation of the cells was also investigated post-exposure to 0.0038% SDF. The release of the growth factors; TGF-β1, FGF-b, BMP-2, and VEGF from deciduous dentin discs exposed to 38% SDF, 0.0038% SDF, Ca(OH)2, MTA, and 17% EDTA were examined using ELISA. Statistical analysis was performed using means and standard deviations (p < 0.05). Two-way ANOVA compared the means of more than two groups with Tukey's multiple comparison test. The unpaired t-test was also used to compare the differences between the two data sets.

CONCLUSION

38% SDF released dentinogenic growth factors from dentin discs, potentially explaining its role in reactionary dentinogenesis. Moreover, 0.0038% SDF resulted in a non-cytotoxic concentration that enhanced cellular proliferation and released bioactive molecules from dentin comparable to the 38% concentration. After further investigations, the 0.0038% dilution of SDF could present itself as a clinical concentration.

Computer-based identification of olive oil components as a potential inhibitor of neirisaral adhesion a regulatory protein

In silico methods such as molecular docking and molecular dynamic (MD) simulations have significant interest due to their ability to identify the protein-ligand interactions at the atomic level. In this work, different computational methods were used to elucidate the ability of some olive oil components to act as Neisseria adhesion A Regulatory protein (NadR) inhibitors. The frontier molecular orbitals (FMOs) and the global properties such as global hardness, electronegativity, and global softness of ten olive oil components (α-Tocopherol, Erythrodiol, Hydroxytyrosol, Linoleic acid, Apigenin, Luteolin, Oleic acid, Oleocanthal, Palmitic acid, and Tyrosol) were reported using Density Functional Theory (DFT) methods. Among all investigated compounds, Erythrodiol, Apigenin, and Luteolin demonstrated the highest binding affinities (-8.72, -7.12, and -8.24 kcal/mol, respectively) against NadR, compared to -8.21 kcal/mol of the native ligand based on molecular docking calculations. ADMET properties and physicochemical features showed that Erythrodiol, Apigenin, and Luteolin have good physicochemical features and can act as drugs candidate. Molecular dynamics (MD) simulations demonstrated that Erythrodiol, Apigenin, and Luteolin show stable binding affinity and molecular interaction with NadR. Further Molecular Mechanics Poisson-Boltzmann Surface Area (MM-PBSA) analyses using the MD trajectories also demonstrated the higher binding affinity of Erythrodiol, Apigenin and Luteolin inside NadR protein. The overall study provides a rationale to use Erythrodiol, Apigenin, and Luteolin in the drug development as anti-adhesive drugs lead. Communicated by Ramaswamy H. Sarma.

Socio-demographic Profile of COVID-19 Patients and Difficulties Faced by Them while Testing RT-PCR: A Multi-center Cross-sectional Study

This study was aimed to find out the socio-demographic profiles as well as difficulties of Reverse transcription polymerase chain reaction (RT-PCR) testing faced by Coronavirus Disease 2019 (COVID-19) patients. This cross-sectional study was conducted from 10th August to 7th September 2020. Data were collected by telephone interview using a pre-designed questionnaire after taking verbal consent from the participants. Out of 281 COVID-19 patients, 279 were diagnosed by RT-PCR; 10.3% were asymptomatic. Off them 67.6%were males, 24% were hospital staffs. Majority (66.2%) were from the non-city corporation area. History of recent contact with known COVID-19 patients was present in 56.9% cases. Fever (78.3%) and cough (58%) were the most common symptoms. One third of the patients faced difficulty to test RT-PCR for COVID-19. Sixteen percent patients complained of difficulty of getting serial for testing, the maximum waiting time was one week before giving samples. Thirty patients (10.8%) had to wait longer than usual time after reaching the center before giving sample. Hospital staffs were unable to co-operate in 2.5% of the patients while difficulty of managing transport to the hospital for suspected COVID-19 patient was an issue in 2.2% of the patients. Though testing was more difficult in city corporation areas (p=0.028), delay of getting test result was less (p<0.001). Maximum delay of getting test result was 10 days. Finding out the difficulties of COVID-19 testing will help to point out the issues behind these and will help to take necessary steps to tackle this matter. Testing rate can be increased to contain this highly contagious virus in this densely populated country.

Frequency of Eosinophilic Esophagitis among Patients with Gastroesophageal Reflux Symptoms in an Academic Hospital of Bangladesh: A Cross Sectional Study

Eosinophilic esophagitis (EoE) is a disease of modern era. It was first described 40 years back. Since then it has drawn an immense interest among the clinicians. It is diagnosed by the presence of eosinophils count ≥15/HPF on esophageal biopsied mucosa in patients with symptoms of esopohageal dysfunction. It is more prevalent among patients with gastroesophageal reflux disease. As its symptoms overlap with that of gastroesophageal reflux disease (GERD), it is frequently overlooked & misdiagnosed which increases patients' sufferings. No data is available in Bangladesh. The objective of the study was to find out the frequency of eosinophilic esophagitis among patients with gastroesophageal reflux symptoms. The study was conducted at the Outpatient department of the department of Gastroenterology of Dhaka Medical College Hospital, Dhaka, Bangladesh from September 2018 to April 2019. One hundred and thirty three (133) consecutive patients with symptoms suggestive of gastroesophageal reflux disease based on validated questionnaire underwent upper GI endoscopy. Biopsies were taken from proximal and distal esophagus as well as any other endoscopically abnormal esophageal mucosal lesion. Among 133 patients with gastroesophageal reflux symptoms, 7 patients (5.3%) were found to be positive for eosinophilic esophagitis. Mean age at diagnosis was 37.28±13.38 years. It was more common in younger age group. Female patients (56%) were more than male patients (44%). Heart burn was the major symptom followed by acid regurgitation. Nocturnal cough showed statistically significant relationship with eosinophilic esophagitis. Although the frequency is low, it may be considered as a differential diagnosis among patients with GERD.

Apparent metabolizable energy of cereal grains for broiler chickens is influenced by age

The current study was conducted to investigate the influence of broiler age on the AME and AMEn of 4 common cereal grains (wheat, sorghum, barley, and corn). Four experimental diets with the same inclusion (962 g/kg) of each grain were developed and fed to groups of broiler chickens aged 1 to 7, 8 to 14, 15 to 21, 22 to 28, 29 to 35, or 36 to 42 d post-hatch. Each diet, in pellet form, was randomly allocated to 6 replicate cages in each age group. Except for the 0 to 7 d age group, the birds were fed a starter (d 0-21) and/or a finisher (d 21-35) diet before the introduction of experimental diets. The number of birds per cage were 10 (d 1-7) and 8 (d 8-42). Excreta were collected over the last 4 d of each age period. The AME and AMEn of the grains were determined by the total excreta collection. Bird age influenced (P < 0.001) the AME and AMEn of all cereal grains. The AMEn of wheat declined quadratically (P < 0.01) with advancing age, from 3,461 kcal/kg in wk 1 to 3,219 kcal/kg in wk 2 and then plateaued. The AMEn of sorghum grain declined linearly (P < 0.001) with advancing age, from 3,762 kcal/kg in wk 1 to 3,614 kcal/kg in wk 2, plateaued to wk 5 and then declined to 3,556 kcal/kg in wk 6. A quadratic (P < 0.001) reduction in the AMEn of barley was observed as birds grew older, with the AMEn decreasing between wk 1 (3,286 kcal/kg) and wk 2 (2,988 kcal/kg), increasing in wk 3 (3,117 kcal/kg) and then plateauing. The AMEn of corn declined quadratically (P < 0.05) with advancing broiler age; the highest AMEn was observed in wk 1 and 5, the lowest AMEn in wk 2, with the other weeks being intermediate. In conclusion, the present results showed that broiler age has a substantial impact on the AME and AMEn of cereal grains and the effect varied depending on the cereal grain. These data suggest that age dependent AME and AMEn values may need to be considered when formulating broiler diets to improve the precision of feed formulation and production efficiency.

Gastrointestinal Manifestations among COVID-19 Patients in Bangladesh: A Cross Sectional Study

This study was done to find out the frequency of gastrointestinal manifestations among adult COVID-19 patients in Bangladesh. This descriptive cross sectional retrospective study was conducted from 27 May till 20 June 2020. Data were collected retrospectively from three different hospitals of Dhaka, Bangladesh. Patients were interviewed over telephone and verbal consents were taken. Their demographic and clinical profiles were put in the questionnaires by the investigators themselves. Statistical analysis was done thereafter. Out of 226 patients diagnosed with COVID-19, 145(61.4%) patients had gastrointestinal symptoms. Five of them had none other than gastrointestinal symptoms. Twenty six patients were asymptomatic. Mean age of the patients with were 41.6±14.8 years. Males were affected almost equally as the females (51.72% vs. 48.27%) (Ratio 1.1:1). Anorexia (44.7%) followed by diarrhoea (35%) and nausea (22.6%) were the predominant symptoms. Patients with co-morbidities (74.7%) were more prone to develop GI symptoms. Family members (71.6%) of COVID-19 patients with GI symptomatic patients were more affected than the others. Hospitalizations (77.6%) were more among GI symptomatic patients than the others. Thirty Five percent (35%) patients had diarrhoea. Mean duration of diarrhoea was 2.7±1.7 days with a frequency of were 4±1.8 days per day. Gastrointestinal manifestations are common among patients with COVID-19. Clinicians need to be aware of the GI features amongst COVID-19 patients so that they can be addressed and treated effectively and immediately. Further large scale study is needed to predict the disease outcome among COVID 19 patients with GI symptoms.

Measurement of ileal endogenous energy losses and true ileal digestible energy of cereal grains for broiler chickens

Two experiments were conducted to determine the ileal endogenous energy losses (IEEL) and nitrogen-corrected apparent metabolizable energy (AMEn) and true ileal digestible energy (TIDE) of 4 cereal grains (corn, sorghum, wheat, and barley) for broilers. In experiment 1, a glucose-based purified diet was used to determine the IEEL for correcting the apparent ileal digestible energy (AIDE) values to TIDE. The diet was randomly allocated to 6 replicates (6 birds per replicate) of male broilers and fed from 18 to 21 d after hatch. The jejunal and ileal digesta were collected on day 21. The results showed that glucose absorption continued beyond the jejunum but was complete in the terminal ileum demonstrating that endogenous energy losses can be quantified in the ileal digesta of birds by feeding a glucose-based diet. The IEEL were determined to be 347 ± 29.4 kcal/kg DM intake. In experiment 2, 4 experimental diets with similar inclusion (957 g/kg) of grains were developed to determine the AMEn, AIDE, and TIDE. Titanium dioxide (5.0 g/kg) was added to all diets as an indigestible marker. Each diet was randomly allocated to 6 replicates (8 birds per replicate) and fed from 14 to 21 d after hatch, and the ileal digesta were collected on day 21. The AIDE was corrected to TIDE using the IEEL value determined in experiment 1. The TIDE of corn, sorghum, wheat, and barley were determined to be 3,920, 3,650, 3,138, and 2,885 kcal/kg DM, respectively, and was higher (P < 0.05) than the corresponding AMEn values of 3,439, 3,284, 2,576, and 2,371 kcal/kg DM, respectively. No differences were observed between the AMEn and AIDE. The AMEn:TIDE ratio tended (P = 0.06) to be lower for viscous cereals (wheat and barley) than that for nonviscous cereals (corn and sorghum). The apparent ileal digestibility of DM, nitrogen, and starch was positively correlated (P < 0.001) with TIDE (r = 0.990, 0.703, and 0.705, respectively) and the AMEn (r = 0.873, 0.483, and 0.656, respectively). Further studies are warranted to determine the TIDE of a range of ingredients and to investigate the application of TIDE as a potential available energy system in poultry feed formulations.

Preparation and characterization of novel MWCNTs/Fe-Co doped TNTs nanocomposite for potentiometric determination of sulpiride in real water samples

Novel multiwalled carbon nanotubes/ Fe-Co doped titanate nanotubes nanocomposite (MWCNTs/Fe-Co doped TNTs) facilitated the charge transfer and enhanced sensitivity and selectivity. Herein, three novel modified carbon paste sensors (CPSs) based on MWCNTs (sensor I), Fe-Co doped TNTs (sensor II) and MWCNTs/Fe-Co doped TNTs composite (sensor III) were fabricated for a simple, low cost and high accuracy electrochemical method for the potentiometric determination of sulpiride (SLP). The sensors exhibited excellent Nernstian slopes 57.1 ± 0.4, 56 ± 0.5 and 58.8 ± 0.2 mV decade⁻¹ with detection limits (DL) 7.6 × 10⁻⁷, 1.58 × 10⁻⁶ and 8.7 × 10⁻⁸ mol L⁻¹, quantification limits (QL) 2.5 × 10⁻⁶, 5.2 × 10⁻⁶ and 2.9 × 10⁻⁷ mol L⁻¹ for a long lifetime 20, 18, and 25 weeks for sensors (I), (II), and (III), respectively. The modified sensor (III) was applicable by measuring the concentration of spiked SLP in pure solutions, pharmaceutical products, human urine, and real water samples. The proposed method can be used as an important analytical tool in the quality control of the pharmaceutical industry.

Modified carbon paste and polymeric membrane electrodes for determination of hydroxychloroquine sulfate in pharmaceutical preparations and human urine

This article describes characteristics, performance and application of hydroxychloroquine (HCQ) polymeric membrane (PMEs) and modified carbon paste (CPEs) electrodes which are based on sodium tetraphenylborate (NaTPB) or ammonium reineckate (Rt) as sensing materials.

Absorbing capacity of alluvial soils eastern part of Nile delta

Studies have shown that the highest absorbency characterized by alluvial meadow soils, lower rates have alluvial meadow carbonate and the smallest alluvial cespitos carbonate soils. According to soil profile the depth the sum of exchangeable cation in the Soil absorbing complex changed depending on the availability of the clay fraction in the particle size distribution, the processes occurring in the alluvial soils and geomorphological - hydrogeological conditions.

Pattern of congenital heart diseases

This prospective observational study was done to find out the frequency of various forms of congenital heart disease (CHD) diagnosed by echocardiography. During the study period (January 2002 to December 2005) 2050 patients were screened by echocardiography. All patients were evaluated by cardiologists and had chest radiograph, electrocardiogram and echocardiography. Total 2050 patients were studied and among them 1071 had congenital heart disease. Male was 561(52.38%) and female was 510(47.62%). Atrial septal defect (ASD) was 374(34.92%), ventricular septal defect (VSD) was 318(29.69%), patent ductus arteriosus (PDA) 83(7.75%), pulmonary stenosis (PS) 58(5.42%), tetralogy of Fallot 162(15.13%), transposition of great vessels (TGA) 16(1.49%), Ebstein anomaly 5(0.4%), coarctation of aorta 1(0.09%) and single ventricle 2(0.19%). This distribution is more or less similar to that reported in studies at home and abroad. In this study atrial septal defect (ASD) was the commonest in acyanotic CHD and tetralogy of Fallot was the commonest cyanotic CHD.

Outcome of pregnancy in patients with congenital heart diseases

This prospective study was conducted to evaluate the outcome of pregnancies in women with congenital heart diseases. In this study 50 pregnant women age between 20-45 years with congenital heart diseases were included. Twenty two (44%) were presented with atrial septal defect, 12(24%) with ventricular septal defect, 5(10%) were with patent ductus arteriosus, 6(12%) with Fallot's tetralogy, 2(4%) with pulmonary stenosis, 2(4%) with Eisenmenger syndrome, 1(2%) with dextrocardia. Shortness of breath (60%) was the main presenting complaint. Normal vaginal delivery (52%) was done in majority of cases. Spontaneous abortion occurred in 16% of pregnancies. Major complications were heart failure 16%, arrhythmias 21%, cardiovascular mortality 4%, preeclampsia 4%, and eclampsia 2%. Premature birth 16%, fetal demise 4%, neonatal death 2% and cardiac anomaly at birth 2% were also observed. The outcome of pregnancy in women with congenital heart diseases is favourable with considerable maternal and neonatal complications.

Topography and morphometry of the common bile duct and major duodenal papilla of man and principal domesticated animals

A comparative topography and morphometry of the common bile duct and major duodenal papilla was studied on the extrahepatic biliary apparatus of human and major domesticated animals such as horse, ox, Black Bengal (BB) goat, sheep, dog and cat of local breed. In Black Bengal goat, sheep, dog and cat, the extrahepatic biliary system seemed to be the continuation of the cystic duct, which was found to continue as the common hepatic/common bile duct into which all the hepatic/lobar ducts open. In man, the mean length and the mean diameter of the common bile duct were 7.67+/-0.58 cm. and 7.27+/-0.77 mm. respectively. In the ox, these values were 1.57+/-0.72 cm. and 11.82+/-0.79 mm. respectively; in the Black Bengal goat, 7.23+/-0.74 cm. and 4.45+/-0.72 mm. respectively; in the sheep, 5.27+/-0.66 cm. and 3.75+/-0.79 mm. respectively; in the dog, 4.72+/-0.67 cm. and 6.43+/-0.55 mm. respectively and in the cat, 3.26+/-0.87 cm. and 5.63+/-0.43 mm. respectively. In man, the mean length and the mean diameter at the base of the MDP were 4.37+/-0.56 mm. and 3.97+/-0.72 mm. respectively. In horse, these were 52.36+/-0.67 mm. and 12.47+/-0.63 mm. respectively; in ox, 12.53+/-0.73 mm. and 8.83+/-0.68 mm. respectively; in Black Bengal goat, 14.36+/-0.55 mm. and 5.23+/-0.57 mm. respectively; in sheep, 11.27+/-0.69 mm. and 4.51+/-0.74 mm. respectively; in dog, 17.43+/-0.82 mm. and 6.72+/-0.64 mm. respectively and in cat, these values were 12.36+/-0.47 mm. and 7.12+/-0.87 mm. The distance of the Major Duodenal Papilla (MDP) form the pyloric end of the stomach was proportionately shorter in the meat-eaters, i.e., the omnivorous man (9.76+/-0.88 cm), and the carnivores, dog (6.37+/-0.73 cm) and cat (2.75+/-0.87 cm.) when compared to that of the herbivores, i.e., ox (55.37+/-0.68 cm.), BB goat (23.27+/-0.89 cm.) and sheep (25.62+/-0.77 cm.). In the horse, the major duodenal papilla was perpendicular to the duodenal mucosal surface with the largest mean length and the mean diameter. In all other animals, it was obliquely placed on the duodenal surface with its opening directed aborally.

Isolation, functional properties and potential use of protein preparations from lupin

Protein isolates were prepared by extraction with diluted NaOH (resulting the highest yield) and precipitation with HCl from lupin seeds grown in Egypt and Hungary. Protein content, amino acid composition, biological value and functional properties of isolates were studied. The proteins were high in lysine but relatively low in sulfur-containing amino acids. Good solubility and moderate emulsifying, foaming and gel-forming properties of isolates were observed. Enrichment of fruit- and vegetable-based baby foods with these isolates resulted in products with excellent organoleptic properties and moderate biological value. Additional enrichment with small quantities of methionine increased significantly the biological value without any negative changes of organoleptic characteristics.

Effect of soaking, germination, autoclaving and cooking on chemical and biological value of guar compared with faba bean

Raw, soaked, germinated, autoclaved and cooked both of guar and faba bean were chemically and biologically evaluated. Crude protein, crude fiber and ash contents of guar and faba bean decreased as a result of all treatments with the exception of protein content in both germinated guar and faba bean. A slight decrease in lipid content was noticed during germination, while there were no changes in lipids after soaking, autoclaving and cooking. Protein content of guar was higher than of faba bean, and showed higher values for all amino acids than faba bean protein except for lysine and tryptophan. Germination caused a slight increase in total essential amino acids, while soaking caused a slight decrease in both of guar and faba bean. There was a slight decrease in the mineral contents by the heat processes with the exception of Mg and Mn for guar and Na, Mn for faba bean due to the cooking process. Germinated guar and faba bean showed noticeable decrease in Na, K, Cu, Mn and Mg and a slight increase in Fe and Zn than the raw materials. Germination was more effective in reducing phytic acid than heat treatment, and therefore it improves the nutritional quality of both guar and faba bean. Protein efficiency ratio (PER), true digestibility (DT) and biological value (BV) were estimated in all treatments under study using rat bioassay procedures. Data revealed pronounced improvements of the nutritive value as a result of all processes under study especially germination being the most effective.

Spectro- and electrochemical studies of some ruthenium and osmium complexes of 2-(2'-pyridyl)benzimidazole; complexes with intra-molecular charge transfer

Reaction of Ru3(CO)12, with 2-(2'-pyridyl)benzimidazole (HPBI) resulted in the formation of Ru(CO)3(HPBI) (I) complex. In presence of pyridine or dipyridine, the two derivatives [Ru(CO)3(HPBI)].Py (II) and [Ru(CO)3(HPBI)].dpy (III) were isolated. The corresponding reactions of Os3(CO)12 yielded only one single product; Os(CO)2(HPBI)2 (IV). Spectroscopic studies of these complexes revealed intramolecular metal to ligand CT interactions. Reactions of RuCl3 with HPBI gave three distinct products; [Ru(HPBI)2Cl2]Cl (V), [Ru(HPBI)(dipy)Cl2]C1 (VI) and [Ru(PBI)2(py)2]Cl (VII). The UV-vis studies indicated the presence of intramolecular ligand to metal CT interactions. Electrochemical investigation of the complexes showed some irreversible, reversible and quasi-reversible redox reactions due to tautomeric interconversions through electron transfer.

Biochemical and technological studies on the production of isolated guar protein

Guar seeds contain 32% crude protein. Therefore, attempts were made to prepare protein isolates from guar seed flour (GSF) by extraction in different media (distilled water, salt solution, alkali solution alone or in combination) followed by a precipitation at acid pH. From the four technologies adopted, mixed salt-alkali solution was found to be the most satisfactory for extraction of protein from GSF. The highest amount of product was obtained in the mixed technology along with the highest amount of protein (87.5%). Protein isolates were also nutritionally evaluated following well-established rat bioassay procedures in a comparative study with casein as standard. The protein isolates are rich in lysine but poor in sulphur-containing amino acids such as methionine and cysteine. Protein isolates obtained by mixed salt-alkali solution showed high water and oil absorption as well as good emulsifying and foaming stability. The results indicate that protein isolates can be used as a supplementary source of protein in different food industries.

Socioclinical profile of children with asthma in Al-Majmaah Health Province

OBJECTIVE

Although asthma in children constitutes a major health problem, there is a dearth of literature on different aspects of asthma in rapidly developing countries. This cross-sectional research aims to study the socioclinical profile of asthmatic children and the impact of asthma symptoms on their life style.

METHODS

The sample of this study, drawn from pediatric clinics of a general hospital and primary health care centers during a period of six months, comprised of children under 13 years of age who met the operational diagnostic criteria for asthma. The data collected from multiple sources on a semistructured questionnaire was analyzed by using different statistical tests.

RESULTS

The results showed that male children represented 69% of the sample and children under one year of age manifested significantly severe degree of asthma. The frequency of asthma symptoms decreased in most of the studied children with increasing age. Further, they have insignificant family history of asthma (48.5%) but a significant smoking at home in severely affected children (59%). Moreover, most of them (88%) were mainly characterized by a combination of asthmatic symptoms of variable severity that adversely affected their sleep pattern and significantly resulted in school absences and increased days stay in hospital.

CONCLUSION

The revealed socioclinical profile of studied children with asthma has adverse impact on certain components of their life style, which shows the need for re-activating relevant treatment modalities including health education and changing certain habits like parental smoking at home, which adversely affects asthma.

Phacotrabeculectomy versus two-stage operation: a matched study

BACKGROUND AND OBJECTIVE

To evaluate the efficacy and safety of phacoemulsification and foldable intraocular lens, combined with trabeculectomy (phacotrabeculectomy) in patients with coexisting cataract and glaucoma.

PATIENTS AND METHODS

A total of 53 consecutive eyes which underwent phacotrabeculectomy and posterior chamber intraocular lens (PCIOL) were matched and compared with 53 eyes that had trabeculectomy followed by phacoemulsification and posterior chamber intraocular lens (mean interval 3.2 month). The 2 groups were first matched by diagnostic group and subsequently for the closest possible match with other successive variables, including age, gender, race and preoperative glaucoma medications. Mean intraocular pressure (IOP) reduction, visual acuity, antiglaucoma medications, and surgical success as well as complications were compared in both groups.

RESULTS

Mean IOP reduction was 14.5+/-4.1 mmHg in the two-stage group compared to 15.1+/-3.9 in the phacotrabeculectomy group at 6 months follow-up (P<0.1) and 13.8+/-3.9 and 14.6+/-3.7 respectively at 1 year (P<0.1). Visual acuity and complications were comparable.

CONCLUSION

Phacotrabeculectomy provides IOP control statistically comparable to two-stage surgery with earlier visual rehabilitation.

Electrocardiographic changes in obstructive sleep apnoea syndrome

Obstructive sleep apnoea syndrome (OSAS) has acute and chronic effects on the cardiovascular system. Both right and left sides of the heart are affected. Electrocardiographic pattern was studied in 190 OSAS patients. One or more of the following were found: persistent deep S in lateral chest leads V5, V6 (79%), left anterior hemiblock (71%), RS pattern with deep S wave in leads aVf, I, II and III (71, 55, 26 and 22% respectively), right axis (6%), right bundle branch block RBBB (5%), QRS voltage criteria of left ventricular hypertrophy (4%), QR pattern in V1 (4%) and none of the above (11%). The most common patterns were deep S wave in leads I, aVf, V6 with left axis (27%), deep S wave in leads II, III, aVf and V6 with left axis (12%), and deep S wave in leads I, II, III, aVf and V6 with left axis (11%). There was statistically significant difference in polysomnographic data and daytime PaO2 between OSAS patients with and without ECG findings. The latter had the mildest evidence of disease (P < 0.01). The findings suggest prevalence of late depolarization of hypertrophied right outflow tract and/or left anterior fascicular block. With progression of OSAS, there is evolution of an ECG pattern that is peculiar for the disease, and helpful in diagnosing OSAS patients when other disease entities are excluded.

Micronuclei, chromosomal aberrations and aflatoxin-albumin adducts in experimental animals after exposure to aflatoxin B1

Rats and mice differ markedly in sensitivity to aflatoxin B1 (AFB1) hepatocarcinogenicity, the former being sensitive and the latter resistant. Animals were treated with single doses of different concentrations of AFB1, between 0.01 and 1.0 microgram AFB1/g body weight. The frequency of chromosomal aberrations and micronuclei in the bone marrow was measured and compared to the level of AFB1 bound covalently to albumin in the peripheral blood. Both chromosomal aberrations and micronuclei were significantly increased in treated rats compared to the control group at doses above 0.1 microgram/g. In contrast, in mice, a slight increase in chromosome aberrations was seen in the highest dose group (1.0 microgram/g) but no increase in micronuclei was observed at any of the doses. The level of chromosomal aberrations was about 10 times higher in rats than in mice at the highest dose of AFB1. AFB1-albumin (AF-alb) adducts did not show a strong dose-response increase after treatment in mice, whereas in rats the levels increased linearly with dose of AFB1 and there were strong correlations at the individual rat level with both chromosomal aberrations (r = 0.92; p < 0.0001) and micronucleus frequency (r = 0.86; p < 0.0001). These data suggest that the AF-alb may reflect the level of genetic alteration resulting from the initial binding of this carcinogen to cellular DNA. Therefore, this adduct used as a biomarker in studies of human exposure to aflatoxin may provide information not only on exposure but also on the risk of genetic alterations consequent to that exposure.