Search

BACKGROUND: Simulation-based learning (SBL), an effective teaching strategy, is still questionable on whether it can be an alternative to didactic lectures in medical education. Our study aimed to evaluate the effectiveness of SBL versus traditional lectures in retention of knowledge. METHODS: A randomized controlled trial was conducted among medical students who were divided in two groups (36 students each). Each group received the same information about diagnosis and management of bronchial asthma, but with a different teaching method: didactic lecture or simulation. Knowledge level was tested before, immediately after the teaching sessions and 3 months later using multiple-choice questions. Student’s satisfaction was evaluated using feedback questionnaire. RESULTS: The simulation group scored higher than the lecture group in the post-test and the late test. However, these differences were not significant. Additionally, students’ satisfaction scores were significantly higher in the simulation group than in the lecture group (p

Inherited retinal dystrophies are caused by mutations in more than 250 genes, each of them carrying several types of mutations that can lead to different clinical phenotypes. Mutations in

Background Several biomarkers of gemcitabine effectiveness have been studied in cancers, but less so in hepatocellular carcinoma (HCC), which is identified as the fifth most common cancer worldwide. Investigation of human equilibrative nucleoside transporter‐1 (HENT‐1) and deoxycytidine kinase (DCK), genes involved in gemcitabine uptake and metabolism, can be beneficial in the selection of potential cancer patients who could be responding to the treatment. Aim To study HENT‐1 and DCK gene expression in HCC patients with different protocols of treatment. Methods Using real‐time PCR, we analyzed expression levels of HENT‐1 and DCK genes from peripheral blood samples of 109 patients (20 controls & 89 HCC patients) between March 2015 and March 2017. All the 89 HCC patients received the antioxidants selenium (Se) and vitamin E (Vit.E) either alone (45 patients) or in combination with gemcitabine (24 patients) or radiofrequency ablation (RFA) (20 patients). Results There was a significant increase in HENT‐1 expression levels in HCC patients treated with Se and Vit.E alone as compared to controls (P ˂ .0001), while there was no significant difference between HCC patients treated with gemcitabine or RFA as compared to controls. In contrast, expression of DCK was significantly increased in all groups of HCC patients as compared to controls (P ˂ .0001). Conclusions HENT‐1 and DCK mRNA expressions are important markers of HCC and for GEM effect and GEM sensitivity in patients with HCC. This could be beneficial in the selection of HCC patients sensitive to gemcitabine to avoid subjecting resistant patients to unnecessary chemotherapy., HENT‐1 and DCK expression in HCC groups and healthy control. HENT‐1 and DCK mRNA expressions are important markers of HCC and for GEM effect and GEM sensitivity in patients with HCC.

A total of 35 of raw milk samples were collected from street vendors and different supermarkets in Ismailia and Port Said cities and subjected to sensory, chemical and microbiological evaluation. The results showed that acidity % was 0.38+0.02 and Fat% was 2.76±0.07. Microbiologically the mean value of total Staph. aureus was 6.37±0.15 (Log10) cfu/ml,. Salmonellae failed to be detected. While the mean value of total Enterobacteriacaea count was 7.91±0.27 (Log10) cfu/ml. Also, the mean value of totalColiform count was 7.65± 0.35(Log10) c fu/ml, and the mean value oftotal yeasts and mold count was 3.26 ± 0.09 (Log10) cfu/ml. Finally, significance of food spoilage and poisoning isolates, possible sources of contamination and some recommendations to improve the quality of this product were discussed.

Differential expression of a panel of genes in psoriasis suggested that its pathogenesis is dependent on several cytokines and their related pathways. The Wingless-type MMTV integration site member 5a (WNT5a) is one of these putative molecules. We analyzed the WNT5A gene expression pattern in psoriasis and investigated its implication in different treatment modalities. Twenty-one patients were enrolled in the study. Psoriasis severity was evaluated according to the Psoriasis Area and Severity Index (PASI). Skin biopsies were taken from each patient (from uninvolved skin, diseased untreated plaque, and two from treated plaques with platelet-rich plasma (PRP) or topical calcipotriol/betamethasone dipropionate). RNA was extracted from skin tissues and WNT5A expression was quantified by RT-PCR. Psoriasis severity varied between mild to moderate lesions (57.2%) to severe chronic plaques (42.8%). WNT5A showed overexpression in all lesional plaques. Its expression declined toward normal after treatment with PRP and topical calcipotriol/betamethasone dipropionate. In the lesional skin, there was a moderate positive correlation between WNT5A expression and the PASI score. Nevertheless, there was no association of WNT5A expression with other clinical parameters of the disease. Ordination analysis revealed that WNT5A expression, PASI score and age were the main influencing factors along the ordination axes. Collectively, we concluded that WNT5A gene is upregulated in psoriasis and its expression decreases tremendously after treatment, though this is not related to the type of therapy.

Single nucleotide polymorphisms (SNPs) in the Interleukin (IL)-28B gene, namely rs12979860, could predict response to pegylated interferon-α-ribavirin (PR) therapy in hepatitis C virus genotype 1 (HCV-1)-infected patients. A similar role was investigated in a case-control study conducted on 93 Egyptian patients chronically infected with HCV-4 in comparison to 22 individuals with spontaneous HCV clearance and 70 healthy volunteers. The homozygous C allele genotype (CC) was associated with sustained viral response (SVR) to therapy compared with the homozygous T allele genotype (TT) and the heterozygous genotype (CT). In the SVR group, the response rate was statistically significantly higher in CC genotypes (58.6%) compared with CT/TT (20.3%). There was no correlation between SVR patients' genotypes and early response to therapy or HCV baseline viral load. Our findings describe how IL-28B SNP genotyping may guide appropriate selection of HCV-4-infected patients for PR therapy.

Hepatocellular carcinoma (HCC) incidence is fast-growing especially in countries highly prevalent with viral hepatitis. Its poor prognosis has driven the research toward the discovery of sensitive markers for early detection. We investigated the usefulness of serum Transforming growth factor-beta1 (TGF-β1), Glypican-3 (GPC3), and Golgi protein-73 (GP73) mRNAs as early biomarkers in HCC Egyptian patients chronically infected with hepatitis C virus (HCV) in comparison with serum alpha-fetoprotein (AFP). Using semi-quantitative RT-PCR and densitometry analysis, circulating TGF-β1, GPC3, and GP73 mRNAs expressions were estimated in 15 healthy adults, 15 chronic HCV (CHC) patients and 25 HCC patients. Serum GP73 expression percentage in HCC group was significantly higher than controls (100 vs. 40 %, P ≤ 0.001) and when compared to elevated serum AFP levels (100 vs. 36 %, P ≤ 0.001). TGF-β1 and GP73 expression means were also higher in HCC patients than controls and CHC patients (P

Background Allergic diseases, such as allergic rhinitis (AR) and atopic dermatitis (AD), affect a large proportion of people worldwide. Both have environmental and genetic predisposing factors. Single nucleotide polymorphisms (SNPs) in interleukin (IL)-18, may play a direct role in the disease pathogenesis. This study was designed to investigate the association of the IL-18 gene SNPs (-137 G/C [rs187238], and −140 C/G [rs360721]) with AR and AD, as well as their relations to the diseases’ severity. Methods Seventy-five individuals were enrolled in the study including, 25 AD children, 25 AR patients, and 25 unrelated healthy adult volunteers who served as controls. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism analysis. Results AR and AD patients showed no significant differences in the genotype distribution and allele frequencies of −137 G/C and −140 C/G SNPs when compared independently with the control group. However, the −140 GG genotype and the −140 G allele were more often associated with severe AD compared with mild and moderate phenotypes (p = 0.01 and 0.001, respectively; odds ratios [ORs], 14.25 [95% CI, 1.48–143.2] and 16 [95% CI, 2.8–90.46], respectively). Moreover, the −137 G allele was associated with moderate/severe AR (p = 0.019; OR, 6.1 [95% CI, 1.34–28.1]). Conclusion This preliminary study indicates that the studied polymorphisms do not confer susceptibility to allergy in Egyptian patients but may be related to the disease phenotype. However, the role of IL-18 in allergy may be too complex to be reflected in a simple association study.

BACKGROUND/AIM Proepithelin is a growth factor that may play a critical role in bladder cancer. Its over-expression in urine of bladder cancer patients gave us the impetus to evaluate its potential suitability as a biomarker for bladder cancer diagnosis and/or prognosis. METHODS proepithelin was estimated in 86 voided urine samples, including 59 bladder cancer patients and 27 healthy volunteers using quantitative sandwich enzyme immunoassay technique. Urinary proepithelin level was expressed in ng/100 mg creatinine. RESULTS Urinary proepithelin was significantly higher in bladder cancer patients compared to control subjects (means: 17.5 ± 10 and 8.9 ± 3.5 ng/100 mg creatinine, respectively; p < 0.001), and the test sensitivity and specificity to detect the presence of bladder cancer were 74.6 and 85.2%, respectively. Furthermore, patients with low-grade/non-muscle invasive stages bladder cancer showed significantly lower urinary proepithelin compared to high-grade/non-muscle invasive stages and high-grade/invasive stages ones (means: 11.6 ± 9, 20.2 ± 8.1 and 23.8 ± 11.9 ng/100 mg creatinine, respectively; p= 0.005 and 0.002, respectively). CONCLUSIONS This preliminary study suggests that urinary proepithelin may be considered as a non-invasive, sensitive, and specific urine-based test for bladder cancer diagnosis and/or prognosis.

Gehan H. Ibrahim Medical Biochemistry Department, Faculty of Medicine, Suez Canal University, 41111 Ismailia, Egypt. Tel.: +20 122 71 72 075; fax: +20 64 32 08 543. E-mail address: gehan_amer@med.suez.edu.eg To the editor – Kassem et al. [1] described a novel mutational deletion [del 1178 (A)] in the 30 untranslated region of NPM1 gene detected in a heterozygous form in seven de novo acute myeloid leukemia (AML) patients of their study population. The described nucleotide deletion is an NPM1 gene polymorphism recorded in dbSNP database (rs34351976; g28027: GenBank accession number NG_016018.1) (http://www.ncbi. nlm.nih.gov/projects/SNP/) and was described previously by Dohner et al. [2] and Chou et al. [3]. This variant accounted for 60–70% of AML patients with normal karyotype [2]. The putative deletion was also identified in healthy volunteers and persisted at complete remission and also at relapse of AML patients [3]. This deletion had no effect on the predicted amino acid sequence and is not in linkage disequilibrium with any previously identified NPM1 mutations [2,3]. Analysis of RNA folding at the region surrounding the rs34351976 in the presence or absence of the deletion using Mfold analysis software (http://www.mfold.rna.albany.edu) revealed no RNA folding change that may alter RNA splicing and subsequently gene expression. Furthermore, splicing motifs analysis using ‘‘Human Splicing Finder’’ software version 2.4.1 showed that the presence of the deletion does not abolish any recognition site of exonic or intronic enhancers or silencer motifs. In general, it seems that the impact of NMP1 polymorphisms on the molecular pathogenesis of AML is not clear yet and needs further investigation. Kassem et al. [1] describes the molecular aspect of de novo AML in the Egyptian population. The previously known NPM1 mutations mentioned in their study are less frequent compared to the figures recorded worldwide. Moreover, the

Familial Mediterranean fever (FMF) is a hereditary inflammatory disorder transmitted as an autosomal recessive trait. It predominantly affects people living in, or originating from, areas around the Mediterranean and was difficult to diagnose until mutations in the MEFV gene were identified. This study aims to analyse the five most common MEFV mutations in Egyptian patients diagnosed clinically as FME Thirty-eight unrelated patients were tested for the presence of the MEFV gene mutations V726A, M694V, M694I, M680I and E148Q, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and the amplification refractory mutation system (ARMS). Twenty-three patients (60.5%) had one or more mutations, whereas no mutation was found in the remaining 15 patients (39.5%). The most common mutation was M694I (42.5%), followed by V726A (22.5%), M680I (17.5%) and E148Q (17.5%). The M694V mutation was not detected. The profile of MEFV gene mutations in this study suggests that the origin of FMF in Egypt is heterogeneous, a finding in concordance with that for other Arab populations; however, some differences were observed as M694V, the most common mutation reported in Arabs, was not detected in this study.

Background Low serum vitamin D [25(OH)D] has been associated with different health problems worldwide. However, its causal role in several diseases remains unclear. We aimed to correlate vitamin D status with maternal and neonatal outcomes in pregnant females. Method One thousand pregnant women were recruited during early labour from the labour ward of King Khaled University Hospital, Riyadh, Saudi Arabia. Detailed medical data of all participants were collected from their records. Delivery events and birth outcomes were also documented. Serum 25(OH)D levels were measured using an enzyme-linked immunosorbent assay. A receiver operating characteristic (ROC) curve was constructed to evaluate the ability of vitamin D levels to predict complicated pregnancies. Regression analysis was used to test the correlation between serum 25(OH)D levels and different variables. Results Most of the participants were Saudis (89.9 %) and housewives (85.1 %) and 86.4 % of them had vitamin D deficiency (mean: 30.46 ± 19.6 nmol/L). Gestational diabetes mellitus (GDM) was the commonest complication detected (11.1 %) while the history of miscarriage was elevated (24.5 %). There was no association between GDM and low 25(OH)D. Yet, there was a significant negative correlation between serum 25(OH)D levels and fasting blood glucose among females older than 35 years (r = −0.2, p = 0.03). Hypertensive disorders of pregnancy and pre-existing hypertension were less than 1.5 % of frequency. Nevertheless, they were only recorded in women with insufficient and deficient vitamin D. ROC curve revealed that 25(OH)D levels were not able to discriminate between normal and adverse pregnancy outcomes (AUROC curve: 0.51; 95 % confidence interval (CI): 0.44–0.58; p = 0.8). Conclusion Hypovitaminosis D, a highly prevalent health problem among pregnant females in Riyadh, has no relation to adverse pregnancy outcomes except for a higher prevalence of miscarriage in women with low 25(OH)D. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0901-4) contains supplementary material, which is available to authorized users.