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Objective(s): The testis is the male reproductive gland or gonad having two vital functions: to produce both sperm and androgens, primarily testosterone. The study aimed to investigate the effect of tramadol and boldenone injected alone or in combination for 2 months in rats on testicular function.Materials and Methods: Group 1, normal control; Group 2, tramadol HCl (TRAM) (20 mg/kg bwt.) (IP); Group 3, boldenone undecylenate (BOLD) (5 mg/kg bwt) (i.m); Group 4, combination of TRAM (20 mg/kg bwt.) and BOLD (5 mg/kg); respectively for 2 months. Results: TRAM and BOLD alone and in combination showed deteriorated testicular functions, lowered serum steroid levels (FSH, LH, and testosterone), elevation in oxidative biomarkers (MDA & NO) and reduction in GSH and SOD, down-regulation of StaR and HSD17B3 as well as histopathological testicular assessment using H&E staining revealing massive degenerative changes in the seminiferous epithelium and vacuolar changes of most of the spermatogenic stages in both TRAM and BOLD groups. PAS stain showed an intensive reaction in the interstitial tissue between the tubules in the TRAM group. Masson trichrome stain showed abundant collagen fiber deposits in the tunica albuginea with congested BV in the TRAM group. Conclusion: The study illuminated the hazard of administration of these drugs for a long period as well as the prominent deleterious effects reported on concurrent use of both drugs.

Multidrug-resistant tuberculosis (MDR-TB) represents 5% of TB cases globally. In Egypt, it represents 11.4% of TB cases (2.2% of new and 38.2% of previously treated). Our objectives were to evaluate the treatment outcomes and determine the associated prognostic factors among the first national treatment cohort of MDR-TB from 2006 to 2010. Methods: All patients diagnosed with MDR-TB from July 2006 to December 2010 who were admitted to Abbassia Chest Hospital, the first Egyptian national center established for MDR-TB treatment, were included. They were followed up clinically, radiologically, and bacteriologically by sputum smear, culture, and drug-susceptibility testing at regular intervals. Individualized treatment regimens were prescribed according to each patient's drug-susceptibility testing and the drug treatment history. Patients received at least five effective drugs. Outcome rates, and crude and adjusted odds ratios of unsuccessful outcomes were calculated. Results: The number of bacteriologically proven MDR-TB patients was 228, of which 225 were pulmonary cases. Half of the cases showed moderate or extensive lung lesions, and 15.8% were diabetics. A total of 158 (119 cured and 39 completed treatment) patients achieved successful outcome (69.3%), 16 (7.1%) failed treatment, 27 (11.8%) were lost to follow up, and 27 (11.8%) died. Predictors of unsuccessful outcome were delay in sputum culture conversion to 2 months or more, moderate or extensive lung lesions, and a history of diabetes. Conclusion: A treatment success rate of approximately 69% was achieved with the first national treatment cohort of MDR-TB under the Egyptian program. Predictors of unsuccessful treatment were delayed culture conversion, moderate or extensive lung affection, and diabetes.

Background: The COVID-19 pandemic is one of the worst pandemics of recent times. Getting vaccinated against COVID-19 is a preventative strategy that helps in the prevention of the infection and reduces its severity. This study aimed to measure the reinfection and vaccination rates among COVID-19 patients who were admitted to Ain Shams University (ASU) Hospitals during the pre-vaccination era (April 2020-March 2021) and correlate their vaccination status with the incidence and severity of the reinfection. Methods: A retrospective cohort study was conducted that includes patients diagnosed with SARS-CoV-2 infection and admitted to ASU Hospitals during the prevaccination era. Data about the first COVID-19 infection were extracted from the patient's records and then a random sample of patients was selected and data about vaccination and re-infection rates were collected from them through an interview questionnaire. Results: 340 out of the 400 included subjects received COVID-19 vaccination (85%); 4.41% received incomplete doses; 67.06% received full vaccination; and 28.23% received full vaccination with an additional booster dose. 53.61% of booster vaccinations used the same vaccine each time, while 46.39% received different vaccines. Regarding the reinfection rate, it was higher among the unvaccinated group compared to the vaccinated (20% versus 13.82%) but this difference was not statistically significant. Also, the length of stay in hospital during the reinfection was 6 days in both groups. Conclusion: Although our results revealed no statistically significant difference between the vaccinated and unvaccinated groups regarding the reinfection rate. But it may show a piece of evidence that COVID-19 vaccination plays an important clinical role in reducing the severity of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Background: A significant proportion of individuals, including those who were hospitalized, through the global pandemic of the novel 2019 coronavirus disease (COVID-19), experienced residual symptoms following acute COVID-19 infection. Accordingly, it has impacted the patient's Health-Related Quality of Life (HRQoL) resulting in negative effects on one or more domains of their quality of life. Objective: To assess the HRQoL of COVID-19 patients discharged from Ain Shams University Isolation Hospitals, 2021. Methods: We conducted a cross-sectional study including a total of 550 adults discharged from Ain Shams University Isolation Hospitals. Data was collected using a phone-based interview questionnaire including questions about socio-demographic characteristics, clinical information, and Short-form 8 (SF-8) to assess the 8 domains of HRQoL; general health, physical functioning, Role physical, bodily pain, vitality, social functioning, mental health, and role emotional. Univariate analysis was done to investigate the relationship between the study variables and the total mean score of HRQoL. Results: Participants' mean age was 53.71 ± 13.17, and 53.1% of them were females. We found that 63.5% had co-morbidities. The mean of the total days of hospital stay was 12.37 ± 7.22 and about fifth was admitted to the intensive care unit (ICU) (22.2%). The mean of the total score of the 8 items of SF-8 in discharged patients was 69.96 ± 23.31. The Role physical domain was more affected among the other domains (51.55±40.03). The following variables were significantly associated with lower mean of the total score of HRQoL as: age≥50, female gender, having co-morbidities, length of hospital stay and ICU admission. Conclusion and Recommendation: COVID-19 is associated with negative effect on HRQoL of hospitalized COVID-19 patients especially the physical domain. Follow up service after COVID infection is recommended, especially for people with existing comorbid conditions. [ABSTRACT FROM AUTHOR]

Background: Opioids are considered the cornerstone of pain management: they show good efficacy as a first-line therapy for moderate to severe cancer pain. Since pharmacokinetic/pharmacodynamic information about the tissue-specific effect and toxicity of opioids is still scarce, their quantification in post-mortem autoptic specimens could give interesting insights. Methods: We describe an ultra-high-performance liquid chromatography coupled with tandem mass spectrometry method for the simultaneous quantification of methadone, morphine, oxycodone, hydrocodone, oxymorphone, hydromorphone and fentanyl in several tissues: liver, brain, kidney, abdominal adipose tissue, lung and blood plasma. The presented method has been applied on 28 autoptic samples from different organs obtained from four deceased PLWH who used opioids for palliative care during terminal disease. Results: Sample preparation was based on tissue weighing, disruption, sonication with drug extraction medium and a protein precipitation protocol. The extracts were then dried, reconstituted and injected onto the LX50 QSight 220 (Perkin Elmer, Milan, Italy) system. Separation was obtained by a 7 min gradient run at 40 °C with a Kinetex Biphenyl 2.6 µm, 2.1 × 100 mm. Concerning the analyzed samples, higher opioids concentrations were observed in tissues than in plasma. Particularly, O-MOR and O-COD showed higher concentrations in kidney and liver than other tissues (>15–20 times greater) and blood plasma (>100 times greater). Conclusions: Results in terms of linearity, accuracy, precision, recovery and matrix effect fitted the recommendations of FDA and EMA guidelines, and the sensitivity was high enough to allow successful application on human autoptic specimens from an ethically approved clinical study, confirming its eligibility for post-mortem pharmacological/toxicological studies.

Background/purpose: Multidrug-resistant tuberculosis (MDR-TB) represents 5% of TB cases globally. In Egypt, it represents 11.4% of TB cases (2.2% of new and 38.2% of previously treated). Our objectives were to evaluate the treatment outcomes and determine the associated prognostic factors among the first national treatment cohort of MDR-TB from 2006 to 2010.Methods: All patients diagnosed with MDR-TB from July 2006 to December 2010 who were admitted to Abbassia Chest Hospital, the first Egyptian national center established for MDR-TB treatment, were included. They were followed up clinically, radiologically, and bacteriologically by sputum smear, culture, and drug-susceptibility testing at regular intervals. Individualized treatment regimens were prescribed according to each patient's drug-susceptibility testing and the drug treatment history. Patients received at least five effective drugs. Outcome rates, and crude and adjusted odds ratios of unsuccessful outcomes were calculated.Results: The number of bacteriologically proven MDR-TB patients was 228, of which 225 were pulmonary cases. Half of the cases showed moderate or extensive lung lesions, and 15.8% were diabetics. A total of 158 (119 cured and 39 completed treatment) patients achieved successful outcome (69.3%), 16 (7.1%) failed treatment, 27 (11.8%) were lost to follow up, and 27 (11.8%) died. Predictors of unsuccessful outcome were delay in sputum culture conversion to 2 months or more, moderate or extensive lung lesions, and a history of diabetes.Conclusion: A treatment success rate of approximately 69% was achieved with the first national treatment cohort of MDR-TB under the Egyptian program. Predictors of unsuccessful treatment were delayed culture conversion, moderate or extensive lung affection, and diabetes. [ABSTRACT FROM AUTHOR]

Background and purpose: Staphylococcus aureus (S. aureus) produces various toxins. One of the most important toxins is enterotoxin. Enterotoxin A and B play a major role in food poisoning. This research was conducted to determine the enterotoxin A and B genes in S. aureus strains. Materials and methods: In this study, 223 specimens were collected from the skin and nose of patients, medical personnel and kitchen staff in Imam Khomeini and Bouali Sina hospitals, Sari, Iran. Culture of samples and biochemical tests were used to detect S. aureus. Polymerase Chain Reaction (PCR) was used to detect enterotoxin A and B genes. Results: Out of 223 specimens, 49 (21.97%) were positive for S. aureus, from which 17 (34.7%) isolates were positive for enterotoxin A gene, while none contained enterotoxin B gene. Conclusion: In this study, isolates of S. aureus were positive for presence of enterotoxin A gene. This bacterium has a major role in causing food poisoning, therefore, its prevalence in hospital strains can lead to secondary infections in patients and should be regarded as a serious threat to community health.

Acute renal failure (ARF) is a common clinical problem with grave prognosis and limited therapeutic modalities. Current therapeutic options for ARF are limited to supportive procedures and preventive care, none of which have been definitively shown to alter mortality.The purpose of this study was to assess the therapeutic effect of human umbilical cord blood progenitor CD34+ cells in experimentally induced renal failure in adult albino rats.Twenty-eight adult female albino rats were included in this study. The animals were divided equally into four groups: group I (the control group): Animals of this group received a single intramuscular injection of 10 ml/kg per body weight of normal saline. group II (the ARF group): Animals received a single intramuscular injection of 10ml/kg per body weight of glycerol and saline solution 1:1 (v/v). group III (the PBS-treated group): Animals of this group received intravenous injection of 0.1ml of PBS 24h after inducing ARF. group IV (the CD34+-treated group): Animals of this group received intravenous injection of 0.1ml of PBS containing 2 × 105 CD34+ cells (obtained from the human umbilical cord blood of male babies) per rat 24h after inducing ARF with glycerol. Animals were sacrificed 28 days after the end of the experiment, and their right and left kidneys were excised. The specimens were subjected to different histological techniques and immunohistochemical staining for detecting expression of proliferating cell nuclear antigen (PCNA) in the nuclei of renal tubules. Real-time PCR was carried out to demonstrate the presence of Sry gene (on Y chromosome). For statistical analysis, slides were examined to assess the frequency distribution of different histopathological changes and PCNA index. Optical density of PAS-positive material was also ascertained.The renal cortex of group II (ARF group) revealed cellular degenerative changes in the form of cytoplasmic vacuolation and cellular necrotic changes in the form of pyknotic, karyorrhectic, and karyolitic nuclei of renal cortical tubules. At the same time, tubular cell loss was marked in most animals of this group, in addition to the presence of intratubular casts. Loss of brush borders of the proximal convoluted tubules was also observed. Immunohistochemical study of this group revealed very few positive immunoreactive cases for PCNA in tubular cells. Y chromosome-containing cells from male donors were not present in any animal of this group. Group IV (the CD34+-treated group) displayed normal appearance of the renal cortical tubules. Positive immunoreaction for PCNA was observed in many tubular cells compared with other study groups. At the same time, Y chromosome-containing cells from male donors were present in all animals of this group.It could be concluded that treatment with CD34+ cells improved most of the histological changes produced by the experimentally induced ARF. Therefore, clinical trials are recommended to evaluate its efficiency in patients with ARF. [ABSTRACT FROM AUTHOR]