Technetium-99m Sestamibi Scintigraphy Pattern in Patients with Secondary Hyperparathyroidism

complications of end stage renal disease (ESRD). We aimed in this investigation to explore the role of Technetium-99m sestamibi (99mTc MIBI) scintigraphy in the pre-operative assessment of refractory hyperparathyroidism in hemodialysis (HD) patients. Methods: Dual-phase 99mTc MIBI parathyroid scintigraphy was performed for 23 patients with ESRD who have persistent intact parathyroid hormone (iPTH) levels exceeding 300 pg/ml. Based on scintigraphy results, 13 patients underwent neck exploration during which only glands with positive scintigraphy findings were removed. Results: Among the six patients who had iPTH levels < 800 pg/ml, only one patient had positive scintigraphy findings (16.7%). Among the 17 patients who had iPTH levels ≥ 800 pg/ml, 16 patients had positive scintigraphy findings (94.1%). 99mTc MIBI scan detected 23 positive sites of focal trace uptake in those 17 patients. Partial parathyroidectomy was performed for 13 patients, removing in total 19 glands, while four patients declined surgery. On histological examination, 12 glands showed diffuse hyperplasia, four glands showed nodular hyperplasia and three glands revealed parathyroid adenoma. The three glands with parathyroid adenoma were correctly identified prior to surgery by 99mTc MIBI scintigraphy. The long-term outcomes of these patients are now being monitored. Conclusion: ESRD patients with iPTH level ≥ 800 pg/ml are more likely to have positive sites of focal tracer uptake on MIBI scan than patients with lower iPTH levels. Dual-phase 99mTc MIBI scintigraphy has the ability to correctly identify parathyroid adenoma prior to surgical exploration in these patients. Keywords: Hyperparathyroidism, parathyroid adenoma, parathyroid hyperplasia, scintigraphy, 99mTc sestamib

Mangifera indica peels: A common waste product with impressive immunostimulant, anticancer and antimicrobial potency

The volatile components of 3 mango cultivars were investigated by means of GC, and GC-MS. Two hundred and forty compounds were identified, of which eighty five compounds were found for the first time in mango fruit. Terpene hydrocarbons were the major volatiles of all cultivars, the dominant terpenes in the 3 mango cultivars were ?-3-carene (2.784-14.904%), ?-terpinolene (4.825-15.879%), ?-copaene (2.281-8.097%), and caryophyIlene (3.390-10.897%). peel essential oils of M. indica cultivar zebdeya and M. indica cultivar cobaneya showed appreciable non specific immunostimulant activity measured by low Macrophage migration index. M. indica cultivar zebdeya and M. indica cultivar cobaneya had higher phagocytic indices up to 1.47and 1.06 respectively. The cytotoxicity of the essential oils were studied invitro against MCF-7, HCT-116 and Hep-G2 cancer cell lines using MTT assay showed significant effect with IC50 = 1.62-1.77, 2.95-5.56 and 2.76-3.14 µl/ml for respectively. Interestingly, M. indica cultivars zebdeya, cobaneya and hindi expressed a valuable cytotoxic effect on MCF-7 breast carcinoma cell line as compared to standard antitumor drug. The essential oils M. indica cultivars were tested by Kirby-Bauer method showing a wide range of antibacterial and antifungal activities. Generally, essential oils of the M. indica cultivars showed a moderate to high antibacterial activity with M. indica cultivar hindi being the most active showing broad spectrum activity against Gram-positive (18-21 mm) and Gram-negative bacteria (16-19 mm). It also showed significant antifungal activity against Candida albicans (16 mm); however, data revealed that all tested cultivars were ineffective and have no antifungal activity against Aspergillus flavus. The MIC of the three M. indica cultivars essential oils revealed that although essential oils didn’t show antimicrobial activities against Aspergillus flavus the peel essential oils demonstrated variability in the inhibitory concentrations of each essential oil for the given microorganisms. The essential oils of peels showed activities in the range (concentrations) from 116 to 142 ?l/ml for M. indica cultivar zebdeya, 58 to 89 ?l/ml for M. indica cultivar hindi and from 121 to 172 ?l/ml for M. indica cultivar cobaneya. The present investigation proved the possibility of using M. indica peel waste as a source of low-cost natural immunostimulant, anticancer and antimicrobial. Key words: Mangifera indica peels; waste product; immunostimulant, anticancer; antimicrobia

Association of ghrelin and leptin with reproductive hormones in constitutional delay of growth and puberty

<p>Abstract</p> <p>Background</p> <p>Constitutional delay of growth and puberty (CDGP) is a variation of the onset and timing of pubertal development without a defined endocrine abnormality. Recently published studies indicate that leptin and ghrelin play a role in puberty initiation and progress. They have been implicated in regulation of GnRH secretion, with ghrelin having inhibitory and leptin, facilitatory effects. We hypothesized that elevated ghrelin and reduced leptin concentrations could be implicated in altering the tempo of puberty in adolescents with CDGP. So in the current study we evaluate variations in leptin and ghrelin levels in adolescent boys with CDGP, the relationships between both hormones and reproductive hormones including LH, FSH and testosterone were also evaluated.</p> <p>Methods</p> <p>The study enrolled 23 adolescent boys with CDGP and 20 healthy controls matched for age and sex. Weight, height, BMI, testicular volume, bone age, bone age delay, serum FSH, LH, testosterone, leptin and ghrelin were assessed.</p> <p>Results</p> <p>Adolescent boys with CDGP had significantly lower leptin and higher ghrelin than normal controls. Leptin was positively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone and negatively correlated with delayed bone age and ghrelin. Ghrelin was negatively correlated with BMI, bone age, testicular volume, FSH, LH and testosterone. With multiple regression analysis BMI, FSH, LH, testosterone and ghrelin remained independently correlated with leptin while BMI, LH and testosterone remained independently correlated with ghrelin.</p> <p>Conclusion</p> <p>Elevated serum ghrelin and decreased leptin concentrations and their associations with reproductive hormones may explain the sexual immaturity in adolescent boys with CDGP.</p

Evaluation of horizontal ridge augmentation using beta tricalcium phosphate and demineralized bone matrix: A comparative study

Objectives: To evaluate the effectiveness of beta tricalcium phosphate (Beta-TCP) alone compared to Beta-TCP and Demineralized Bone Matrix (DBM) in regenerating localized horizontal maxillary alveolar ridge deficiencies prior to implant placement. Study Design: The study included 20 patients with horizontal maxillary ridge deficiencies limited to one or more neighbouring teeth and initial ridge width of . 5mmm. Patients were divided equally into two equal groups. Ridge augmentation was performed using Guided Bone Regeneration (GBR) principals. In group I GBR was performed using Beta-TCP only, while in group II both Beta-TCP and DBM were used. Following a 6 months healing period, bone cores from both groups were retrieved and implants were inserted. Specimens were examined histologically to calculate percentage of mineralized bone. Apical and crestal changes in ridge dimensions were calculated by digital subtraction using Cone Beam Computed Tomography (CBCT) immediately after graft placement and six months later. Results: There was a statistically significant difference between the mean area percentage of mineralized bone between both groups where it was 40.1 % (range: 27.76-% 66.29 %) for group I and 68.96 % (range: 60.07 % - 87.33 %) for group II. Radiograpically, the mean ridge width in group I increased crestally to 4.66 mm (range:3.5-5mm) and apically to 6.12 mm (range: 4.1-6.7 mm). In group II the mean ridge width increased crestally to 5.2 mm (range 4.9-5.4mm) and apically to 6.9 mm (range 6.0-7.8 mm). Group II showed more bone gain with a mean of 1.37 mm crestally and 2.44 mm apically. This difference however was not statistically significant Conclusion: Within the limitations of this study the combination of DBM and Beta-TCP can be used effectively in cases exhibiting minimal alveolar ridge defects

Metabolic profling of cytotoxic metabolites from five Tabebuia species supported by molecular correlation analysis

Tabebuia is the largest genus among the family Bignoniaceae. Tabebuia species are known for their high ornamental and curative value. Here, the cytotoxic potential of extracts from the leaves and stems of fve Tabebuia species was analyzed. The highest activity was observed for T. rosea (Bertol.) DC. stem extract against HepG2 cell line (IC50 4.7 µg/mL), T. pallida L. stem extract against MCF-7 cell line (IC50 6.3 µg/mL), and T. pulcherrima stem extract against CACO2 cell line (IC50 2.6 µg/mL). Metabolic profiling of the ten extracts using liquid chromatography–high-resolution mass spectrometry for dereplication purposes led to annotation of forty compounds belonging to diferent chemical classes. Among the annotated compounds, irridoids represent the major class. Principle component analysis (PCA) was applied to test the similarity and variability among the tested species and the score plot showed similar chemical profling between the leaves and stems of both T. pulcherrima and T. pallida L. and unique chemical profling among T. rosea (Bertol.) DC., T. argentea Britton, and T. guayacan (Seem.) Hemsl. leaf extracts and the stem extract of T. rosea (Bertol.) DC. Additionally, a molecular correlation analysis was used to annotate the bioactive cytotoxic metabolites in the extracts and correlate between their chemical and biological profles

CHEMICAL PROFILE OF TWO JASMINUM SAMBAC L. (AIT) CULTIVARS CULTIVATED IN EGYPT–THEIR MEDIATED SILVER NANOPARTICLES SYNTHESIS AND SELECTIVE CYTOTOXICITY

Objective: Evaluation of two Jasminum sambac L. (Ait) cultivars; Arabian Nights (JSA) and Grand Duke of Tuscany (JSG) ethanolic leaves extracts as reducing agents for the green synthesis of silver nanoparticles (AgNPs) and evaluation of their cytotoxicity against MCF-7 breast cancer and 5637 bladder cancer cell lines and chemical profiling of the two cultivars. Methods: The synthesis of silver nanoparticles (AgNPs) by the two cultivars and characterization of AgNPs by ultraviolet (UV)–visible spectroscopy, Transmission electron microscopy (TEM) and Fourier Transform Infrared&nbsp;Spectroscopy (FTIR). Additionally, the use of The high-performance liquid chromatography coupled with photodiode array-mass-mass-spectroscopy (HPLC-PDA-MS/MS) for chemical profiling of both cultivars and evaluation of total leaves extracts and corresponding nanoparticles towards MCF-7 and 5637 cell lines compared to aneuploidy immortal keratinocyte (Ha Cat) normal cells by neutral cell assay. Results: The green synthesized AgNPs (of an average size range of 8.83 and 11.24 nm for JSA and JSG, respectively) exhibited cytotoxicity against MCF-7 and 5637 cell lines. The IC50 was determined for each total extract JSA (15.29±2.16 μg/ml) and JSG (20.28±1.20 μg/ml) and corresponding AgNPs 17.32±2.22 μg/ml and 6.32±1.01μg/ml for JSA and JSG, respectively. The IC50 of JSA and JSG against 5637 bladder cancer cell line were 13.76±1.11 μg/ml and 50.69±3.75 μg/ml, while the corresponding AgNPs showed IC50 of 5.54±0.88 μg/ml and 27.89±2.84 μg/ml, respectively. The HPLC-PDA-MS/MS allowed the identification of 59 compounds; 10 simple phenols, 17 flavonoids; quercetin and kaempferol glycosides, 2 lignans, and 30 secoiridoids; oleuropein, molihauside, and sambacoside. Conclusion: This study proved that JSA is an excellent source for the synthesis of AgNPs with optimum characters and enhanced activities toward MCF-7 and 5637 cell lines in correlation to identified compounds

Nursing Perspectives on the Association between Human Capital Development and the Work Engagement: A Cross-Sectional Study

This study examined the impact of human capital development on the nurses’ work engagement. A questionnaire was adapted and distributed to a nursing convenience sample in different types of hospitals. The sample size was 286 male and female nurses who completed it. Structural Equation Modelling (SEM) was used to test the research hypothesis. Results revealed that human capital development had a direct impact on the nursing work engagement. Nursing work engagement give managers ability to improve the work environment, increase the work professional and institutional loyalty. Supporting the human capital development tools is very important for any healthcare organization

FORMULATION AND ASSESSMENT OF A HERBAL HAIR CREAM AGAINST CERTAIN DERMATOPHYTES

Objective: Developing an herbal antifungal formulation containing eruca and garlic oils against highly resistant dermatophytes (Malassezia fufur AUMC No. 5173, Microsporum canis bodin AUMC No. 5490 and Trichophyton mentagrophytes AUMC No. 5501. 5501) and assessment of garlic oil thiosulfonates during the ex vivo percutaneous permeation through albino rat skin.Methods: Assay of antifungal activity was performed by filter paper disc method and agar well diffusion method. The components of volatile constituents and fixed oil of eruca seeds were studied using GC/MS. Thiosulfinates in garlic oil were analyzed by HPLC/UV. Both oils were incorporated into hair cream using span 60 and brij 58 at three different concentrations (2, 4 and 6% w/w) and alliin, was ex vivo evaluated using albino rat skin mounted on Franz diffusion cells.Results: The two oils have a synergistic effect on the first and additive effect on the second and the third fungi. The main constituents in eruca are 4-(methyl thio) butyl isothiocyanate (82%) for volatile constituents and erucic acid (40%) for the fixed one. The highest flux for alliin (0.337±0.0015 mg/cm2/hr) was obtained at a 4% surfactant concentration.Conclusion: Combination of oils has a high activity on the selected dermatophytes. Formulation of an herbal hair cream using span 60 and Brij 58 with a concentration 4% gives the highest permeation rate for alliin in garlic oil.Keywords: Eruca, Garlic, Dermatophytes, Quantitative determination and Ex-vivo permeatio