Influence of Sulfonylurea and Insulin on Immunological Profile of Type 2 diabetic Egyptian Patients

Type 2 diabetes mellitus (T2DM) is a chronic, inflammatory disease caused by long-term imbalance in immune system, metabolic syndrome, or nutrient excess associated with obesity .Sulfonylurea and exogenous insulin have been used in the treatment of T2DM, and they have hypoglycemic and anti-inflammatory effects .The aim of this study to demonstrate the effect of sulfonylurea and exogenous insulin on some immunological parameters in Egyptian patients with T2DM and determine whether diabetes or the type of treatment would influence the levels of these parameters. Materials Methods: This study was performed on 150 outpatients with type 2 diabetes matched with age and gender with 40 healthy subjects was selected from the outpatient’s clinics of National Institute for Diabetes and Endocrinology. All studied patients and control were subjected to estimate Fasting blood glucose (FBG), Glycosylated heamoglobulin (HBA1c), White blood cells (WBCs), Interleukin-6(IL-6), Immunoglobulin G (IgG) and Immunoglobulin A (IgA). Results: The levels of FBG, HBA1c, WBCs, IL-6, IgG and IgA showed highly significant increase in the diabetic patient groups compared to controls. (P˂0.001).Treatment of T2DM patients with sulfonylurea and insulin caused highly significant decrease in the levels of FBG, HBA1c as compared to corresponding non -treated group (P˂0.001). Also, the level of IL-6 revealed a highly significant decrease in insulin treated patients  as compared to corresponding non -treated group(p0.001).While, non-significant change (p0.05) in the levels of WBCs, IgG and IgA was observed in treated patient groups with sulfonylureas and insulin as compared to corresponding non -treated group.Conclusion: Both sulfonylurea and insulin are immune- safe therapeutic agent in T2DM at dose achieve good glycemic control. 

Adrenal Hemangioma: Findings at Multidetector CT with Short Review of the Literature

We present the computed tomography (CT) imaging findings of a 44-year-old male with incidentally discovered right adrenal hemangioma displaying imaging pattern of nonadenomatous pattern, associated with multiple hepatic hemangiomata using 64-slice multidetector scanner with reviewing published CT imaging findings with short review of the literature

Drosophila Dynein Intermediate Chain Gene, Dic61B, Is Required for Spermatogenesis

This study reports the identification and characterization of a novel gene, Dic61B, required for male fertility in Drosophila. Complementation mapping of a novel male sterile mutation, ms21, isolated in our lab revealed it to be allelic to CG7051 at 61B1 cytogenetic region, since two piggyBac insertion alleles, CG7051c05439 and CG7051f07138 failed to complement. CG7051 putatively encodes a Dynein intermediate chain. All three mutants, ms21, CG7051c05439 and CG7051f07138, exhibited absolute recessive male sterility with abnormally coiled sperm axonemes causing faulty sperm individualization as revealed by Phalloidin staining in Don Juan-GFP background. Sequencing of PCR amplicons uncovered two point mutations in ms21 allele and confirmed the piggyBac insertions in CG7051c05439 and CG7051f07138 alleles to be in 5′UTR and 4th exon of CG7051 respectively, excision of which reverted the male sterility. In situ hybridization to polytene chromosomes demonstrated CG7051 to be a single copy gene. RT-PCR of testis RNA revealed defective splicing of the CG7051 transcripts in mutants. Interestingly, expression of cytoplasmic dynein intermediate chain, α, β, γ tubulins and α-spectrin was normal in mutants while ultra structural studies revealed defects in the assembly of sperm axonemes. Bioinformatics further highlighted the homology of CG7051 to axonemal dynein intermediate chain of various organisms, including DNAI1 of humans, mutations in which lead to male sterility due to immotile sperms. Based on these observations we conclude that CG7051 encodes a novel axonemal dynein intermediate chain essential for male fertility in Drosophila and rename it as Dic61B. This is the first axonemal Dic gene of Drosophila to be characterized at molecular level and shown to be required for spermatogenesis

Spinal vs. general anesthesia for percutaneous nephrolithotomy: A prospective randomized trial

Objective: To compare the efficacy and safety of general anesthesia (GA) vs. spinal anesthesia (SA) in percutaneous nephrolithotomy (PCNL). Methods: Two hundred patients were enrolled in a prospective randomized study to receive either GA or SA for PCNL. Patients’ characteristics, vital parameters, visual analog scale (VAS) and needs for additional analgesia were evaluated. Intraoperative and post-operative complications were recorded. Patients’ and surgeons’ satisfactions were also compared. Results: Vital parameters were maintained at safe values throughout procedures in both groups. Visual analog pain score was lower in SA group till 1 h postoperative in comparison with GA group (P < 0.05). Patients in SA group recorded lower consumption of analgesia in the 1st postoperative day in comparison with GA group (P < 0.05). Postoperative shivering was higher in SA group than GA group (8% vs. 2%) while nausea and vomiting was higher in GA group than SA group (5% vs. 2% and 4% vs. 1% respectively). Patients in GA group reported higher overall satisfaction scores than SA group (mean 9.6 ± 0.4 vs. 8.6 ± 0.8, P < 0.05). Similarly, surgeon’ satisfaction score was higher in favor of GA group compared with SA group (mean 10 ± 00 vs. 8.3 ± 0.4, P < 0.05). Conclusions: Both GA and SA are effective and safe in PCNL. SA has fewer complications and lower consumption of analgesia postoperatively. However, GA provides more satisfaction for patients and surgeon

Investigation of critical factors affecting cost overruns and delays in Egyptian mega construction projects

Construction projects are prone to cost overruns and delays that can significantly impact their profitability and quality. Identifying the root causes of these issues is critical to finding practical solutions. This study focuses on the Egyptian construction sector and identifies the top six factors that lead to cost overruns and delays in mega construction projects. These factors are inadequate project planning, poor communication and coordination, changes in project scope, lack of skilled labour, insufficient budget allocation, and payment delays. The study recommends strategies to mitigate these factors, such as involving all stakeholders in the planning process, using project management tools, and setting realistic timelines to improve project planning and scheduling. Regular meetings and clear communication channels can achieve effective communication and coordination. The study also suggests managing changes in project scope through effective change management processes and ensuring sufficient budget allocation by conducting accurate cost estimates and setting aside contingency funds. These recommendations can provide practical insights for practitioners and policymakers in the construction industry to mitigate the impact of cost overruns and delays. Overall, the study emphasises the importance of identifying and addressing the key factors contributing to cost overruns and delays in mega construction projects

Urinary biopyrrins: A new marker of oxidative stress in psoriasis

Background: Psoriasis is a common chronic, relapsing, immune-mediated disease involving skin and joints of genetically predisposed individuals. Oxidative stress has been found to play many important roles in cellular damage and loss of function in a number of tissues and organs and is believed to contribute to the pathogenesis of a variety of diseases. Urinary biopyrrin levels have gained attention as an indicator of oxidative stress. Aim and Objective: To measure urinary biopyrrins excretion as a marker of oxidative stress in psoriasis. Patients and Methods: This case–control study was carried out on 85 subjects; 55 cases with chronic plaque psoriasis and 30 age, gender and body mass index-matched normal subjects as a control group. Urinary biopyrrin levels were measured using enzyme immunoassay. Results: There was a highly significant difference between cases and controls regarding urinary biopyrrins level (P < 0.001). There was significant positive correlation between biopyrrins level and both the age of cases (r = 0.28, P = 0.01) and psoriasis area and severity index score (r = 0.99, P < 0.001). Conclusion: Urinary biopyrrins are increased in patients with psoriasis, and the level is correlated with disease severity. Further large-scale studies involving different ages and different clinical varieties of the disease are needed to expand and validate current findings. The clinical usefulness of antioxidants in psoriasis treatment needs to be evaluated in future research. Furthermore, the value of biopyrrins as biomarkers for monitoring response to therapy needs to be evaluated

Intravesical instillation of platelet-rich plasma for treatment of interstitial cystitis/bladder pain syndrome: A pilot study

Abstract. Objective. The aim of this study was to evaluate the feasibility of intravesical instillation of platelet-rich plasma (PRP) to treat interstitial cystitis/bladder pain syndrome (IC/BPS). Materials and methods. Twenty PRP samples were tested in vitro for stability after exposure to urine samples with different pH. A pilot study involving 21 female patients with IC/BPS was conducted, and 6 weekly doses of autologous PRP (50 mL) were administered. Patients were followed up at the 2nd, 4th, 8th, and 12th weeks after terminating instillation. The primary endpoint was the visual analog scale (VAS) for pain, and the secondary endpoints included the IC symptom index, IC problem index of the O'Leary-Sant questionnaire and global response assessment, urine culture, and uroflowmetry. Success was defined as a reduction in VAS by 30% or more compared with basal level, and adverse events were recorded. Results. The mean ± SD of VAS was significantly reduced compared with basal level (4.4 ± 2.6 vs. 8.8 ± 1.1, respectively, p = 0.001). Meanwhile, 80% of cases were considered successful, with a 50.1% reduction in the mean score compared with the basal level. The mean ± SD of IC symptom index and IC problem index significantly improved compared with the basal level. Global response assessment was markedly, moderately, and slightly improved in 2 (10%), 10 (50%), and 5 (25%) patients, respectively, and showed no change in 3 (15%). Three patients had positive urine cultures at follow-up, but 1 withdrew after 2 sessions because of a lack of efficacy. Conclusions. Repeated intravesical instillation of PRP could be considered an effective and safe approach for treating IC/BPS