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   Table of Contents - Current issue
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January-June 2018
Volume 13 | Issue 1
Page Nos. 1-78

Online since Thursday, July 19, 2018

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ORIGINAL ARTICLES  

A new insight into the immune regulatory functions of vitamin A in children and adolescents p. 1
Azza Abd El-Shaheed, Reham F Fahmy, Salwa Refat El-Zayat, Hiba Sibaii, Nermine N Mahfouz, Rehab S.I Moustafa
DOI:10.4103/jasmr.jasmr_30_17  
Background/Aim Vitamin A deficiency (VAD) is a serious and widespread public health problem. Vitamin A has an important role in regulating human immune function. It increases rates and severity of infections in young children mainly in developing countries. The present study aims to assess the effect of vitamin A on cluster of differentiation 4 (CD4) and thymosin β4 (Tβ4) levels as indicators of adaptive immunity. Moreover, we evaluate the association between serum vitamin A concentration and BMI among Egyptian children and adolescents. Patients and methods This cross-sectional survey was conducted on 46 apparently healthy participants, including 19 girls and 27 boys aged from 3 to 17 years. We assessed weight and height using standard techniques. Serum vitamin A, CD4, and Tβ4 concentrations were assessed by using enzyme-linked immunosorbent assay kits. We planned to divide the participants into vitamin A-sufficient and vitamin A-deficient groups according to its level. Results Cutoff for VAD was 44 μg/dl. It was detected in 56.6% of the enrolled participants. Vitamin A was significantly lower in teenagers comparative with children (P=0.04). Vitamin A and Tβ4 levels were significantly decreased in deficient group in comparison with sufficient one at P values of 0.002 and 0.017, respectively, whereas CD4 level was nonsignificantly decreased in vitamin A-deficient patients compared with the sufficient ones. A significant positive correlation was detected between vitamin A and both of CD4 (r=0.348, P=0.018) and Tβ4 (r=0.392, P=0.007). A significant positive correlation was found between vitamin A and BMI (r=0.311, P=0.035). Conclusion Vitamin A may influence Tβ4 and CD4 levels. This study is the first to explore the effect of vitamin A on Tβ4 level in children and adolescents and correlate it with CD4 level. This finding must be verified using large-scale studies.
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Fat pattern and its relation to glycated hemoglobin in Egyptian diabetic children p. 8
Wafaa A Kandeel, Aya Khalil, Khaled E Wakeel, Ahmed S Ismail, Mona A.M Awad, Azza M Sarry El Din, Naiveen A Helmy, Noha Arafa, Marwa F Mira
DOI:10.4103/jasmr.jasmr_15_18  
Background/aim Obesity and type 1 diabetes mellitus are the two most common conditions of altered metabolism in children and adolescents. We aimed to assess the fat distribution in diabetic children using different anthropometric measures and indices (mid-upper arm circumference, waist circumference, waist/hip and waist/height ratios) and their correlation with glycated Hb (HbA1c). Patients and methods This is a cross-sectional observational study conducted on 100 diabetic children aged 7–18 years, with established type 1 diabetes mellitus. Their mean HbA1c is less than 12.0% during the year before the study visit. Anthropometric measurements (weight, height, BMI, and waist and hip circumferences), BMI, and waist/height and waist/hip ratios were calculated as well as body composition. Results The mean age of the whole sample was 10.88±2.55 years, with a mean HbA1c of 8.83±1.61. The mean age at onset was 8.10±3.51 years, with a mean duration of disease of 2.85±2.45 years. According to the BMI percentiles, 10% of children were overweight, 10% were underweight, and 80% were normal weight. Fat% in the uncontrolled group was insignificant higher than those of the controlled group. Waist and hip circumferences showed higher values in the uncontrolled group than those of the controlled group. The waist/height ratio was on the borderline to develop central obesity (waist/height ratio ≥0.5). Conclusion Onset at earlier age and longer duration of the disease are considered risk factors to have uncontrolled diabetes with HbA1c greater than 7.5. It is not mandatory to become overweight or obese in diabetic children. Fat% was higher in uncontrolled than controlled group. Waist and hip circumferences as anthropometric tools are better indicators of central obesity than waist/hip ratio in diabetic children.
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Carotid intima–media thickness assessment in obese patients with chronic renal failure p. 18
Sahar A El-Masry, Hosneya A Mohamed, Ashraf M Enaite, Manal M Ali, Ibrahim A Ibrahim
DOI:10.4103/jasmr.jasmr_16_18  
Background/Aim Measurement of carotid artery intima–media thickness (CIMT) is reliable for early detection of atherosclerosis, one of obesity’s complications, which is a leading cause of mortality among patients with end-stage renal disease. The study aimed to evaluate CIMT in relation to obesity, chronic renal failure (CRF) and both, for the early prevention of cardiovascular problems. Patients and methods This cross-sectional study included 118 adult individuals of both sexes, aged 30–60 years. Patients with CRF were gathered from the renal dialysis unit of King Fahd Hospital-Kasr El Einy Hospital, and the obese without CRF from the ‘Management of Visceral obesity Unit’, in ‘Medical Excellence Research Center (MERC)’, National Research Centre, during the period spanning from June 2015 to April 2016.They were grouped into three groups: a case group, which included 45 obese individuals with CRF, and two control groups: one comprised 39 nonobese patients with CRF and the other group comprised 34 obese patients without CRF. Anthropometric assessment, lipid profile, and ultrasound measurement of CIMT were performed for each patient. Results CIMT was greater in all groups than the normal range (0.06–0.08 cm), particularly in the obese group without renal failure. CIMT had a highly significant correlation with waist circumference and insignificant correlation with BMI and lipid profile in different groups. Conclusion The increase in CIMT was related to obesity and renal failure, but it was more prominent with obesity. CIMT had highly significant correlation with central obesity in cases wherein obesity and renal failure were coexisting together and insignificant correlation with lipid profile.
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Photobiomodulation therapy for diabetic macular edema: Fourier transform infrared spectroscopy study p. 25
Salwa A Abdelkawi, Aziza A El Saeid, Ahlam M El-Rashedi, Maha S Abd-Eldaiem
DOI:10.4103/jasmr.jasmr_32_17  
Background/Aim Photobiomodulation (PBM) is the application of low-level light that has a beneficial biological effect, such as to relieve pain, to heal existing tissue damage, and to inhibit the development of tissue pathology. The aim of the current study is to evaluate the effect of PBM therapy on diabetic macular edema (DME) in albino rats as assessed by Fourier transform infrared spectrum. Materials and methods Twenty-five albino rats with the same sex (200±20 g) were involved in this study. Diabetes was induced in albino rats after intraperitoneal injection of 55 mg/kg streptozotocin. The experimental animals were divided into three main groups: (i) control group, (ii) DME group that did not received any treatment, and (iii) DME group that was exposed to two sessions/week of 660-nm low-level laser source for a period of 2 weeks. The rat’s eye received a power of 5 mW/cm2 for 90 s, with a total energy of 450 mJ, in each session. Fourier transform infrared spectrum analysis was applied after 2 weeks for comparison between the diabetic and PBM-treated groups. Results The results confirmed that DME was associated with changes in the retina structure that appeared after receiving a single dose of streptozotocin 55 mg/kg. These changes obviously appeared in the NH–OH as shown in strO–H (P<0.05), strO–Hsym (P<0.01), C–Hring (P<0.01), CH stretching, fingerprint, and amide I regions. Treatment with PBM significantly improved most of the amide I components except the first peak of β-turn and formation of new bands corresponding to β-sheet. Conclusion The treatment with PBM by using low-level diode laser was associated with different beneficial effects on the retina constituents, as showed by the obvious improvement in the retinal protein secondary structure using Fourier transform infrared analysis. More PBM sessions and long-term follow-up are needed for use of the PBM therapy as a treatment method.
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Caffeine and nifedipine effect on cataract induced by selenite in rats p. 32
Mona S Taalat, Eman M Aly, Eman S Mohamed, Mervat A Ali, Heba A Gaber
DOI:10.4103/jasmr.jasmr_6_18  
Background/aim Cataract is one of the major causes of visual impairment globally and the first cause of bilndness. The present study analyzed the impact of caffeine and/or nifedipine in a model of cataract caused by selenite. Materials and methods A total of 75 albino Wistar rats were alienated into five groups (15 each): group I served as control and group II was subcutaneously injected with 30 nmol/g body weight of sodium selenite. Group III received an intraperitoneal injection of 5.15 μmol of caffeine; group IV received 0.1 mg/kg of nifedipine; and group V received the two treatments in the same dose after selenite injection. Groups were decapitated after 5, 15, and 25 days of selenite injection. Comet assay to lens epithelium, refractive index, and ultraviolet absorption spectra for lens proteins were studied. Results The results indicated very high significant increase (P<0.001) in comet assay parameters and refractive index. Also variation of ultraviolet spectra for all groups injected with selenite was observed. Partial recovery was observed after treatment with caffeine or nifedipine but there were no significant differences in groups treated with a combination of caffeine and nifedipine. Conclusion The study stated that to achieve attenuation or delay of lens cataract formation, a calcium channel blocker must be used in addition to antioxidants.
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Autologus serum and sodium hyaluronate role in alkali corneal burn healing p. 39
Eman S Mohamed, Mervat A Ali
DOI:10.4103/jasmr.jasmr_13_18  
Background/aim Corneal burn wound healing includes a sequence of difficult processes that are focused on improving the outcomes, in particular, the healing time and the feature of the scar. Bodily fluids such as natural tears and autologus serum were used in the treatment of corneal burn. The aim of the study was to investigate the cure of corneal burn alkali injury by autologous serum (AS) and/or sodium hyaluronate. Materials and methods A total of 50 Wister rats (200–250 g) were distributed into five groups: group I acted as the control, group II had alkali burn (AB) with sodium hydroxide, group III had AB treated with AS, group IV was AB treated with sodium hyaluronate, and group V had AB with sodium hydroxide treated with autologus serum and sodium hyaluronate. Comet assay analysis was applied for cornea to determine DNA damage. Malondialdehyde, superoxide dismutase, glutathione peroxidase, and catalase were measured to estimate the balance between oxidants and antioxidants in the cornea. Results The data indicated a significant increase (P<0.05) in all comet assay parameters and malondialdehyde level in addition to a significant decrease (P<0.05) in superoxide dismutase, glutathione peroxidase, and catalase activity owing to AB. Enhancements of measured parameters were observed in all other treated groups. Conclusion AS accelerates the AB healing process, but the process was faster when diluted by sodium hyaluronate.
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VELscope versus toluidine blue for detection of dysplastic changes in oral keratotic lesions: diagnostic accuracy study p. 45
Mostafa Belal, Wesam A Elmoneim, Sherine Nasry, Basma Mostafa, Shereen Ali
DOI:10.4103/jasmr.jasmr_2_18  
Background/aim Various techniques have been implemented in the early detection of oral potentially malignant disorders including commonly occurring hyperkeratotic lesions. The objective of the present study was to assess the efficacy of visually enhanced lesion scope (VELscope Vx) versus toluidine blue (TB) with reference to histopathological examination in the detection of dysplastic changes in oral keratotic lesions. Patients and methods A total of 30 patients having oral keratotic lesions were clinically diagnosed and subjected to VELscope Vx and TB examination. Histopathological assessment of biopsied lesions was also done. Sensitivity, specificity, positive and negative predictive values were obtained for both VELscope and TB and were compared with histopathological examination. Results VELscope Vx was able to identify four out of seven cases with mild dysplasia and a case of oral squamous cell carcinoma, while TB was able to identify five cases and the oral squamous cell carcinoma case as true positive cases. Thus, sensitivity was 62.5 and 75% for VELscope Vx and TB, respectively. Regarding the specificity of VELscope Vx, it was 71.4% while TB had a specificity of 85.7%. Conclusion The sensitivity and specificity of TB examination outweighed those of VELscope Vx in detecting dysplastic changes within keratotic lesions.
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Comparing pomegranate extract and chlorhexidine mouthwashes in treatment of recurrent intraoral herpes p. 53
Mai Zakaria, Basma Mostafa
DOI:10.4103/jasmr.jasmr_5_18  
Background/aim Herpes simplex virus is a frequently encountered contagious infectivity causing several diseases. The aim of the present study was to compare the effect of pomegranate peel extract and chlorhexidine (CHX) mouthwashes in the treatment of recurrent intraoral herpes (RIOH), a clinical form of herpes simplex virus infection. Patients and methods A total of 12 immunocompetent patients aged from 18 to 35 years with RIOH lesions affecting their keratinized mucosa were selected. The participants were randomly divided into two groups: group I (pomegranate group, n=6) was treated using pharmacologically prepared pomegranate peel extract mouthwash and group II (CHX group, n=6) was treated using CHX mouthwash. Both treatment modalities were used three times per /day for 10 days. Pain and erythema scores were recorded at 2, 4, 6, and 8 days from baseline in both study groups to assess the effect of mouthwashes used. Results Pain and erythema scores showed statistically significant decrease by time in both groups. A higher mean score was recorded in group II, with statistically significant difference in pain scores, but this difference did not reach the level of significance as regarding the erythema score. The percentage of change in both pain and erythema scores revealed better and superior improvement in group I than group II. Conclusion Pomegranate peel extract mouthwash was more effective in reducing pain and accelerating wound healing when compared with CHX as topical treatment for RIOH.
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Ameliorative role of ethanolic extract of Moringa oleifera leaf on aflatoxin B1-induced genotoxicity and biochemical alterations in rats p. 60
Ibrahim M Farag, Hanaa M Roshdy, Hasnaa A Radwan, Inas S Ghaly, Sherifa H Salah, Emam A Abdel-Rahim, Aboelfetoh M Abdalla
DOI:10.4103/jasmr.jasmr_33_17  
Background/aim The present study was conducted to assess the ameliorative role of Moringa oleifera leaf extract (MOLE) on genotoxicity and biochemical alteration of aflatoxin B1 (AFB1) in rats. Materials and methods The rat groups involved negative control, control of DMSO, positive control that received AFB1 in DMSO (0.7 g/kg, body weight) four times weekly for 1 month, groups 4–6 that received the same dose of AFB1 in DMSO at the same period plus MOLE doses (3.3, 4.0 and 4.7 g/kg) daily for 1 month, and groups 7–9 that received MOLE alone at the same doses for 15 days after cessation of AFB1 treatment. Molecular genetic, cytogenetic, sperm, and biochemical studies were documented. Results Genetic and sperm results revealed that AFB1 treatment induced significant elevation of genetic alterations and sperm abnormalities as compared with normal control. Biochemical studies showed that the treatment with AFB1 disturbed the parameters of liver functions, where aspartate-transaminase, alanine-transaminase, and alkaline phosphatase were activated and bilirubin contents as well as the rate of malondialdehyde were increased significantly, but the endogenous antioxidative system (catalase, superoxide-dismutase activities and glutathione as well as total antioxidant capacity) and protein profile were reduced significantly. Moreover, kidney functions (urea, uric acid, and creatinine contents) were elevated under AFB1 administration. The treatment with MOLE significantly minimizes the genetic alterations, sperm abnormalities, and biochemical destruction. These ameliorations were increased by increasing the dose level. Better findings were seen by using MOLE as a therapeutic agent than its using as a protective agent. Conclusion This study revealed that MOLE contains therapeutic factors used in curing of genotoxicity induced by AFB1 in rats, and treatment of animals that were exposed to AFB1 with MOLE significantly ameliorated the genetic, sperm, and biochemical parameters as compared with animals treated with AFB1 alone.
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Expression of estrogen receptors in epithelial ovarian carcinoma p. 71
Sonia L El-Sharkawy, Wafaa E Abd-Aal, Sahar M Talaat, Hafiza A Sharaf, Amal A Hareedy, Rofanda M Bakeer
DOI:10.4103/jasmr.jasmr_14_18  
Background/aim Epithelial ovarian cancer accounts for ∼3% of female cancers. Steroid hormones such as estrogen and progesterone are thought to play an important role in the process of carcinogenesis of ovarian tumors. There are two subtypes of the nuclear estrogen receptor (ER-α and ER-β) encoded by separate genes. This work aimed to evaluate the expression pattern of ER-α and ER-β in epithelial ovarian carcinoma and their correlation with tumor histopathological parameters and proliferating cell nuclear antigen expression as a proliferation marker. Materials and methods A total of 50 cases of epithelial ovarian carcinoma were included in this study. All cases were female patients who underwent oophorectomies or subtotal or total hysterectomies with oophorectomies. Surgical specimens were sent to Pathology Department at Kasr El-Aini hospitals and to private laboratories. The cases were graded and staged according to WHO systems. The cases were stained by hemotoxylin and eosin for histopathological grading, and they were immunohistochemically stained for ER-α, ER-β, and proliferating cell nuclear antigen using streptavidin–biotin technique. Results In this study, 56% of cases were positively stained for ER-α. It is significantly correlated with both of the tumor histological type and proliferative state of the tumors. There was a significant inverse correlation between ER-α expression and the tumor histological grade. Approximately 62% of cases were positively stained for ER-β. There was a significant inverse correlation between ER-β positivity and both of the tumor stage and proliferative state of ovarian carcinoma cases. Conclusion The loss of ER-β, not ER-α, expression in ovarian tumors may be a feature of malignant transformation suggesting its potential role as tumor suppressor gene. Determination of ER subtypes may improve response to hormonal therapy using a selective ER modulator in selected cases of ovarian carcinoma.
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