Captopril versus enalapril in the protection of the gastric mucosa against NSAID induced gastric mucosal injury in rats

Background: Different mechanisms have been suggested for the development of nonsteroidal antiinflammatory drugs (NSAIDs) induced gastropathy. Angiotensin converting enzyme inhibitors have been suggested to have gastroprotective effects. This study investigates the gastroprotective effects of Angiotensin converting enzyme inhibitors, captopril and enalapril on indomethacin induced gastric mucosal damage in rats . Materials and methods: The study was conducted on 50 adult male albino rats, divided into 5 groups, the first served as a control received the vehicle , the second received indomethacin orally of 60mg/kg. The third and fourth groups were pretreated orally 30 minute prior indomethacin with either captopril or enalapril. In order to study the possible role of nitric oxide (NO) in the gastroprotective effect of captopril; intraperitoneal NG-L-Arginine Methyl Ester (L-NAME) a nitric oxide synthase inhibitor was given 30 minutes prior to captopril administration followed by indomethacin and this served as fifth group. The rats were then sacrificed after 4 hours and their stomachs were isolated and submitted to macroscopical assessment and for the measurement of the gastric prostaglandinE2 (PGE2), and myeloperoxidase (MPO). Results: Captopril in a dose of 15 mg/kg produced a significant reduction (p <0.05) in the gastric damage score .These protective effects were associated with a significant increase (p <0.05) in gastric PGE2 levels and marked decrease (p <0.05) in MPO activity, L-NAME pretreatment didn't abrogate the effects of captopril. Enalapril pretreatment failed to show the gastroprotective effects of captopril. Conclusions: The prophylactic use of captopril in this study prevented indomethacin induced gastropathy .This protective effect was associated with PGE2 upregulation and decreased oxyradical generation reflected by a decrease in MPO activity .Enalapril failed to produce the gastroprotective effects of captopril

The effect of topical administration of sildenafil in acute ocular hypertension model in rabbits.

Background: Nitric oxide ( NO) is a physiological mediator of many processes in the eye including regulation of aqueous humor dynamics. Compounds acting via NO dependent mechanisms may enhance aqueous humor outflow and reduce intraocular pressure (IOP) . Objective: Sildenafil a cGMP specific phosphodiesterase 5inhibitor that potentiates NO production and increases cyclic GMP is tested in this study for its effects on intraocular pressure in an acute ocular hypertension model in rabbits. Materials and methods: Newzealand albino rabbits of either sex weighing 2–2.5 Kg , were used in this study. Sildenafil was prepared in a vehicle of phosphate buffer and diluted to the required strength of 0.5%. Intraocular pressure (IOP ) was measured after 45 seconds of one drop of proparacaine topical anesthesia by using schiotz indentation tonometer. Basal IOP was obtained for both eyes using 12 rabbits .One drop of sildenafil (0.5%) was then topically instilled in the left eye while the right eye received the vehicle and served as a control. After 30 minutes of drug and vehicle administration the IOP was measured in both eyes and acute ocular hypertension was induced by the administration of 15ml/kg 5% glucose. The IOP was then recorded every 15 min for 180 minutes. Results: Topical 0.5% sildenafil administration had no effect on the basal IOP levels. However sildenafil significantly (p < 0.05) attenuated the acute rise in IOP induced by 5% glucose infusion. The IOP levels returned to their basal values in shorter time with sildenafil compared to the control Conclusion: Topical sildenafil pretreatment reduces IOP in acutely induced intraocular hypertension

Prevalence of Congenital Heart Disease in Infants of Diabetic Mothers in Children Welfare Teaching Hospital

Background: Women with diabetes in pregnancy (type 1, type 2 and gestational) are at increased risk for adverse pregnancy outcomes which also include infant development of congenital heart disease and even fetal death. Adequate glycemic control before and during pregnancy is crucial to improve outcome. Aim of the study: to observe the significance of the cardiac complication seen in new born of diabetic mother and its relation to glycemic control. Patients and methods: This prospective study was conducted in the nursery care unit in children welfare teaching hospital from the period 1st of July 2014 till 30th of June 2015 where one hundred newborns of diabetic mother were collected and screened by echocardiography for congenital heart disease. Those mothers were classified according to White classification, and the babies were classified according to their maturity to (full term, pre term and post term), in reference to their mode of delivery (Spontaneous vaginal delivery or caesarian section) and to their body weight. Results: One hundred newborns where collected, 61 male and 39 female. Male to female ratio was 1.5:1; 60% were normal with no cardiac complication, 40% had congenital heart disease, hypertrophic cardiomyopathy  23%, atrial septal defect 7 %, patent ductus arteriosus 3% and ventricular septal defect 2%, 1% Transposition of great arteries, 1% Trancus arteriosus, 1% Double outlet right ventricle, 1% Tricuspid atrasia and 1% coartication of aorta, it was found that there is a significant relationship between the type of diabetes of the mother and the development of congenital heart disease in infants (p value 0.02); the degree of glycemic control according to HBA1c of the mother  and development of congenital heart disease in infants (p value 0.005); birth weight of the infants and the congenital heart disease (p value 0.023), death was reported in only 2%. Conclusions: Hypertrophic cardiomyopathy was the most common type of congenital heart disease in infants of diabetic mothers. Most of infants of diabetic mothers were full term, delivered by caesarian section and their birth weights were more than 4 kg; Congenital heart disease in infants were more common in mothers with uncontrolled diabetes during pregnancy. Pregestational diabetes mellitus mothers are more liable to deliver babies with congenital heart disease than those with gestational diabetes mellitus. Keywords: Congenital heart disease, Hypertrophic cardiomyopathy, Type 1 diabetes, Type 2 diabetes, Gestational diabetes

Histological findings of ascending urinary tract infections in experimental rats caused by Proteus mirabilis

Proteus mirabilis has previously been shown to be capable of persisting in the rat kidney for up to 8 weeks and induces many physiological changes following a single inoculation of the urinary bladder. The present study examined kidney tissue from infected animals for evi-dence of renal damage. The earliest histologic changes seen on the 2nd and 4th days, consisted of mild cellular sloughing and edema associated with mononuclear infiltration in the me-dulla and to a lesser extent in the cortex. On the 1st and following weeks, tubular atrophy, interstitial fibrosis, and a mononuclear infiltrate had advanced in the renal parenchyma re-sulting in chronic pyelonephritis. The observed renal degenerations with a corresponding ascending bacterial infection in the intra-renal reflux suggest that Proteus mirabilis is capa-ble of producing chronic pyelonephritis in the rats after a single reflux challenge

Upper Gastrointestinal Bleeding In Children

BACKGROUND:Gastrointestinal bleeding (GIB) in infants and children is one of the more alarming conditions encountered in pediatrics. It is nonetheless an anxiety-provoking complaint. Most etiologies are self-limited and benign. AIM OF STUDY:To review the causes of upper gastrointestinal bleeding and its clinical presentations in children and evaluate the role of endoscopy for diagnostic and therapeutic purposes. PATIENTS AND METHOD:Fifty eight patients from 4 days old up to the age of 18 years who referred with upper gastrointestinal bleeding to the Gastro intestinal&Hepatology unit in the Children Welfare Teaching Hospital/ Medical City/Baghdad, in the period from 1st of April 2010 to 1st of November 2010. RESULTS: there were 58 patients (34 males and 24 females) with male to female ratio (1.4:1), 58.5% presented with hematemesis, 5.2% had melena and 31.1% had both, 5.2% of patients presented with hematochezia . The most common causes of upper GI bleeding among all patients were esophageal varices (39%), gastric erosions (19.6%), duodenal ulcer (7.4%), gastric ulcer (9.7%), (4.9%) for Mallory Weiss syndrome and also (4.9%) for oesophagitis. The causes of bleeding could not be ascertained in (30%) of cases. (15.3%) of patients, there was a history of consumption of medications predisposing them to upper GI bleeding. Fifteen patients (25.8 %) had comorbid disease. There were three deaths (5.1%) in this study. CONCLUSION: oesophagealvarices were the common cause of upper GI bleeding. Most patients presented with hematemesis. In children with upper GI bleeding, upper GI endoscopy provides an accurate diagnostic tool and also provides therapeutic intervention when neede

Eccrine porocarcinoma of the head: An important differential diagnosis in the elderly patient

Background: Eccrine porocarcinoma is a rare malignant tumor of the sweat gland, characterized by a broad spectrum of clinicopathologic presentations. Surprisingly, unlike its benign counterpart eccrine poroma, eccrine porocarcinoma is seldom found in areas with a high density of eccrine sweat glands, like the palms or soles. Instead, eccrine porocarcinoma frequently occurs on the lower extremities, trunk and abdomen, but also on the head, resembling various other skin tumors, as illustrated in the patients described herein. Observations: We report 5 cases of eccrine porocarcinoma of the head. All patients were initially diagnosed as having epidermal or melanocytic skin tumors. Only after histopathologic examination were they classified as eccrine porocarcinoma, showing features of epithelial tumors with abortive ductal differentiation. Characteristic clinical, histopathologic and immunohistochemical findings of eccrine porocarcinomas are illustrated. Conclusion: Eccrine porocarcinomas are potentially fatal adnexal malignancies, in which extensive metastatic dissemination may occur. Porocarcinomas are commonly overlooked, or misinterpreted as squamous or basal cell carcinomas as well as other common malignant and even benign skin tumors. Knowledge of the clinical pattern and histologic findings, therefore, is crucial for an early therapeutic intervention, which can reduce the risk of tumor recurrence and serious complications. Copyright (c) 2008 S. Karger AG, Basel

Complex reconstructions in head and neck cancer surgery: decision making

Defects in head and neck after tumor resection often provide significant functional and cosmetic deformity. The challenge for reconstruction is not only the aesthetic result, but the functional repair. Cancer may involve composite elements and the in sano resection may lead to an extensive tissue defect. No prospective randomized controlled studies for comparison of different free flaps are available. There are many options to cover defects and restore function in the head and neck area, however we conclude from experience that nearly all defects in head and neck can be closed by 5 different free flaps: radial forearm flap, free fibula flap, anterior lateral thigh flap, lateral arm flap and parascapular flap

Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study.

The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL