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Doxorubicin-induced cardiotoxicity in mice; protection by silymarin
Heba Abdelnasser Aniss a, Ashraf El Metwally Said b, Ibrahim Helmy El Sayed c, Camelia AdLy
Egyptian Journal of Hospital Medicine , 2012,
Abstract: Background: despite its vast utility in clinical oncology, the use of doxorubicin is limited by a potentially fatal cardiomyopathy and congestive heart failure. Free radical formation and antioxidants depletion are mechanisms proposed for this cardiomyopathy. The aim of this study is to compare the potential antioxidative protective effect of silymarin on doxorubicin-induced cardiotoxicity in experimental mice. Materials and methods: four groups (ten animals in each group) of experimental mice were used as follows: Group 1, mice received only saline (intraperitoneally) and served as a negative control group; Group 2, mice received doxorubicin (intraperitoneally, 5 mg/kg body weight) in three equal injections over a period of two weeks for a cumulative dose of 15 mg/kg body weight; Group 3, mice orally administrated silymarin (200 mg/day/kg body weight) respectively, through an intragastric feeding tube over a period of three weeks; Group 4, mice treated orally with silymarin plus intraperitoneally doxorubicin administration with the same protocol of groups 3 and 4. Serum lactate dehydrogenase (LDH), creatine phosphokinase (CPK), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), malondialdehyde (MDA), total nitric oxide (NO), cardiac reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were measured in all tested groups. Results: doxorubicin elevated the activities of LDH, CPK, AST, ALT, MDA and NO in the cardiac tissue. Cardiac antioxidant enzymes activities SOD and CAT also increased while GPx activity was decreased. Pre-co-treatment with silymarin prevented the changes induced by doxorubicin administration. These findings demonstrate the cardio-protective effect of silymarin on cardiac antioxidant status during doxorubicin induced cardiac damage in mice. Conclusion: silymarin could be recommended for further investigation as potentially new indication for clinical application.
Extensions to the Finite Element Technique for the Magneto-Thermal Analysis of Aged Oil Cooled-Insulated Power Transformers  [PDF]
Jehan Shazly, Amr A. Adly
Journal of Electromagnetic Analysis and Applications (JEMAA) , 2012, DOI: 10.4236/jemaa.2012.44022
Abstract: It is well known that the hot spot temperature represents the most critical parameter identifying the power rating of a transformer. This paper investigates the effect of the degradation of core magnetic properties on temperature variation of aged oil-cooled transformers. Within this work, 2D accurate assessment of time average flux density distribution in an oil insulated-cooled 25 MVA transformer has been computed using finite-element analysis taking into account ageing and stress-induced non-uniform core permeability values. Knowing the core material specific loss and winding details, local core and winding losses are converted into heat. Based upon the ambient temperature outside the transformer tank and thermal heat transfer related factors, the detailed thermal modeling and analysis have then been carried out to determine temperature distribution everywhere. Analytical details and simulation results demonstrating effects of core magnetic properties degradation on hot spot temperatures of the transformer’s components are given in the paper.
Policies for High-Skilled vs. Low-Skilled Migration inNorth America  [PDF]
Camelia Tigau
Open Journal of Political Science (OJPS) , 2013, DOI: 10.4236/ojps.2013.34022

High-skilled migration has always been given priority and even encouraged by international and national policy. At the same, international agreements for low-skilled migration tend to restrict it. Human capital is considered valuable according to educational levels and working abilities, which puts undocumented migrants in a difficult economic position. The NAFTA area is no exception: while the migration of professionals is given priority by mechanisms like the TN and H1 visas, there is still no agreement to relieve the situation of unskilled immigration across the border from Mexico to the US and Canada in search of a better life. At the same time, migration between Canada and the US is much freer, even though professionals are also given priority; after NAFTA, Canada has even experienced brain drain to the US. The main question is how to reduce unfair differences in policies that prioritize the mobility of certain individuals based on their qualifications. Method: This paper analyzes and compares NAFTA’s impact on policies for high- vs. low-skilled migration. It also uses the author’s ethnographic studies to express the view of migrants on how human capital should be managed internationally.

Effect of Nalbuphine as Adjuvant to Bupivacaine for Ultrasound-Guided Supraclavicular Brachial Plexus Block  [PDF]
Mohamed Mohamed Abdelhaq, Mohamed Adly Elramely
Open Journal of Anesthesiology (OJAnes) , 2016, DOI: 10.4236/ojanes.2016.63004
Abstract: Background: Nalbuphine is a derivative of 14-hydroxymorphine which is a strong analgesic with mixed k agonist and μ antagonist. Nalbuphine was studied several times as adjuvant to local anesthetics in spinal, epidural and local intravenous block. The aim of this study was to evaluate the effect of nalbuphine as an adjuvant to local anesthetics in supraclavicular brachial plexus block. Patients and Methods: Fifty-six patients undergoing elective forearm and hand surgery under supraclavicular brachial plexus block were allocated randomly into one of two groups of 28 patients each to receive either 25 ml (0.5%) bupivacaine with 1 ml of NS or 25 ml (0.5%) bupivacaine with 1 ml (20 mg) nalbuphine. Onset time and duration of both sensory and motor block, and post-operative analgesia were observed. Result: Nalbuphine group showed significant increase in the duration of motor block (412.59 ± 18.63), when compared to control group (353.70 ± 29.019) p-value < 0.001, also, there was significant increase in sensory duration in nalbuphine group (718.14 ± 21.04) when compared to control group (610.18 ± 26.33) p-value < 0.001, without affecting the onset time of the blockade. And also, there was a significant increase in the duration of analgesic effect in nalbuphine group (835.18 ± 42.45) when compared to control group (708.14 ± 54.57) p-value < 0.001. Conclusion: The present study demonstrates that addition of 20 mg nalbuphine to bupivacaine in supraclavicular brachial plexus block is associated with significant increase in the duration of both sensory and motor block and also prolong the duration of analgesia.
Effects of 17β-Estradiol on Growth, Primary Metabolism, Phenylpropanoid-Flavonoid Pathways and Pathogen Resistance in Arabidopsis thaliana  [PDF]
Pallavi Upadhyay, Camelia Maier
American Journal of Plant Sciences (AJPS) , 2016, DOI: 10.4236/ajps.2016.713160
Abstract: Mammalian sex hormones are spread in the environment from natural and anthropogenic sources. In the present study, the effect of estradiol on Arabidopsis thaliana growth primary metabolism, phenylpropanoid and flavonoid pathways and pathogen resistance were investigated. Treatments of Arabidopsis plants with 10 and 100 nM 17β-estradiol resulted in enhanced root growth and shoot biomass. In addition, treated plants had an increased rate of photosynthesis with a concomitant increase in carbohydrate and protein accumulation. Plants exposed to higher concentrations of 17β-estradiol (10 μM) had significantly lower root growth, biomass, photosynthesis rate, primary metabolite and phenylpropanoid and flavonoid contents indicating a toxic effect of estradiol. Treatments with increasing estradiol concentrations (10 nM, 100 nM and 10 μM) resulted in the downregulation of phenylpropanoid-flavonoid pathway genes (PAL1, PAL4, CHI and ANS) and subsequent decreased accumulation of phenolics, flavonoids and anthocyanins. Estradiol-treated plants were inoculated with Pseudomonas syringae pv. Tomato DC3000 and basal resistance was determined. Estradiol treatments rendered plants susceptible to the pathogen, thus compromising the plant defense mechanisms. These results indicate that at low concentrations, estradiol functions as a biostimulant of growth, yield and primary metabolism of Arabidopsis. However, estradiol functions as a potential transcriptional regulator of the phenylpropanoid pathway genes in Arabidopsis, having a negative effect on
Alleviation of Drought Stress in Arabidopsis thaliana by 17β-Estradiol Application  [PDF]
Pallavi Upadhyay, Camelia Maier
American Journal of Plant Sciences (AJPS) , 2016, DOI: 10.4236/ajps.2016.714186
Abstract: Animal steroidal hormones, including estrogens, are being introduced into the agricultural soil and water supply from increased pharmaceutical and farm waste. Considering the current levels of xenoestrogen contamination of plant environments in view of the climate change induced drought conditions, this study was designed to understand the effect of estradiol (ES) application on Arabidopsis drought stress responses. Estradiol treatment (10 nM, 100 nM) of plants subjected to drought stress conditions by withholding water for 7 days resulted in increased tolerance to drought stress reflected in the significantly higher plant survival rates of 74% and 78%, respectively compared to control plants’ survival rates of 36% (no treatment) and 40% (mock treatment). Estradiol application significantly increased the content of glutathione, proline and H2O2 and significantly enhanced the transcription of the stress responsive genes GSTU3, GER5, HSP101, and HSP70b. A high concentration of ES (10 μM) did not protect plants against drought stress and proved to be toxic. These results provide new insight into the effect of ES on drought-stress responses in Arabidopsis with possible practical agricultural applications regarding the effect of environmental estrogens on crop plants.
The Value of Continuous Noninvasive Hemoglobin Monitoring in Intraoperative Blood Transfusion Practice during Abdominal Cancer Surgery  [PDF]
Ahmed Mostafa Kamal, Mohamed Adly Elramely, Mohamed Mohamed Abd Elhaq
Open Journal of Anesthesiology (OJAnes) , 2016, DOI: 10.4236/ojanes.2016.63003
Abstract: Introduction: Patients undergoing major oncological surgery may suffer from severe bleeding. Sometimes, it is difficult to anesthesiologist to take decision about timing of administration blood products to such patients. The aim of this study is to evaluate the use of continuous noninvasive hemoglobin monitoring as a guide for blood transfusion practice. Methods: One hundred patients undergoing elective abdominal cancer surgeries were randomly allocated into two groups, Group I (n = 50): laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Group II (n = 50): The probe of Masimo for SpHb monitoring was applied immediately after induction of anesthesia at the index finger. Laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Results: A number of transfused units of RBC were significantly lower in SpHb group than in control group (p value < 0.05), and a number of saved RBC units were significantly higher in SpHb group than in control group (p value < 0.001). The correlation between Lab Hb and SpHb was highly significant between baseline Lab Hb and baseline SpHb (r = 0.698, p < 0.001). Similarly, Lab Hb before transfusion showed a significant correlation between SpHb before transfusion (r = 0.710, p < 0.001). On the contrary, there was a non-significant correlation between Lab Hb after transfusion and SpHb after transfusion (r = 0.045, p > 0.05). Conclusion: SpHb monitoring had clinically acceptable absolute and trend accuracy. SpHb monitoring altered transfusion decision making and resulted in decreased RBC utilization and decreased RBC costs while facilitating earlier transfusions when indicated.
Different Volumes of Local Anesthetics in Ultrasound-Guided Combined Interscalene-Supraclavicular Block for Traumatic Humeral Fracture  [PDF]
Mohamed Mohamed Abdelhaq, Ahmed Mostafa Kamal, Mohamed Adly Elramely
Open Journal of Anesthesiology (OJAnes) , 2016, DOI: 10.4236/ojanes.2016.64009
Abstract: Background: Procedures that require anesthesia of entire length of the arm should have combined Interscalene block (ISB) and Supraclavicular block (SCB) to ensure adequate block. However, dual block requires high dose of local anesthetic (LA). We examined if Ultrasound (U/S) guided block helps to decrease the required volume of LA by visualizing trunks, so we only need injection of LA toward cervical nerve roots C5 and C6 aiming to block branches escaped from supraclavicular block. Patients and methods: Ninety-three patients were randomly allocated into one of three equal groups, each included 31 patients. All patients received SCB 20 ml (10 ml Bupivacaine 0.5% plus 10 ml lidocaine 2%) and ISB with different volumes of LA according to the group as follow: group A: 20 ml, group B: 15 ml, and group C: 10 ml. Result: No significant difference in onset of block (sensory and motor) and duration of block (motor only) between the three groups (P value > 0.05). The duration of sensory block was significantly longer in group A (760.65 ± 30.87 minutes) than in either group B (740.48 ± 21.15 minutes, P value < 0.003) or group C (662.87 ± 31.28 minutes, P value < 0.001). Sensory block was significantly longer in group B than in group C (P value < 0.001). The duration of analgesia was significantly longer in group A (930.52 ± 22.04 minutes) than in either group B (899.35 ± 21.82 minutes, P value < 0.002) or group C (850.32 ± 20.65 minutes, P value < 0.001). Analgesia was significantly longer in group B than in group C (P value < 0.001). Conclusion: A reduced volume of LA can be used in ultra sound guided ISB in combined with SCB to give satisfactory level of anesthesia to entire length of the arm, but the sensory block duration and duration of post-operative analgesia will be decreased significantly with decreasing the volume.
Thoracic Epidural Analgesia versus Dexmedetomidine Infusion in Traumatic Flail Chest  [PDF]
Ahmed Abdelaal Ahmed Mahmoud, Mohamed Adly Elramely, Hatem Elmoutaz
Pain Studies and Treatment (PST) , 2016, DOI: 10.4236/pst.2016.42004
Abstract: Background: Traumatic flail chest is a serious injury that can impair ventilation and affect patient outcome. Thoracic epidural analgesia is the gold standard to provide adequate analgesia in flail chest, however, it may be unavailable in some patients due to coagulopathy, failure or difficult insertion. We compared between parenteral dexmedetomidine and thoracic epidural block with plain local anesthetic in flail chest cases. Patients and methods: fifty eight trauma patients with flail chest randomly allocated into either Group E (n = 29): epidural group, patients received mid-thoracic epidural analgesia using 6 ml mixture of 0.125% bupivacaine and 2 μg/ml fentanyl, which followed by continuous infusion of 6 ml/hour; Group D (n = 29): dexmedetomidine group, patients received loading dose of dexmedetomidine 1 μg/kg over 30 min, after a continuous infusion at a rate of 0.5 μg/kg/hr. The primary outcomes were to assess the effect of analgesic type on ventilation (PaO2/FIO2 ratio, PaCO2). The secondary outcomes were to compare analgesic effect, hemodynamics, the need for ventilation and ICU stay. Result: PaO2/FIO2 ratio was significantly higher in epidural group and PaCO2 was significantly lower in epidural group (p value < 0.05). The incidence of mechanical ventilation was significantly lower in epidural group than in dexmedetomidine group (6 patients group versus 13 patients, p value < 0.04). Mean arterial blood pressure was significantly lower in dexmedetomidine group than in epidural group (94.3 ± 6.84 mmHg versus 102 ± 5.72 mmHg, p value < 0.001). Moreover, heart rate was significantly lower in dexmedetomidine group than epidural group (89.97 ± 6.22 bpm versus 96.07 ± 9.3 bpm, p value = 0.004). VAS was significantly lower in epidural group (p value < 0.001). Throughout different measuring points, RAMSAY score was significantly higher in dexmedetomidine group. Conclusion: Epidural analgesia is more effective than parenteral dexmedetomidine in flail chest, but dexmedetomidine can represent a good alternative if epidural is not possible.
Detrusor instability responses to transvaginal versus posterior tibial nerve stimulation
Adly AS,Ali AT,Dalia MK,Sayed AT
theHealth , 2012,
Abstract: Background: This study aimed at comparing the effects of transvaginal electrical stimulation versus posterior tibial nerve electrical stimulation on urodynamic measurements in detrusor instability.Methods: Forty patients were randomly assigned to transvaginal electrical stimulation (Group A) and posterior tibial nerve electrical stimulation (Group B). All patients were assessed before and after the treatment course (36 sessions) according to the urodynamic parameters. These parameters included first sensation to void and bladder capacity.Results: Regarding first sensation to void, Group A showed improvement with 45.9% after the end of the treatment compared to the baseline while, Group B showed 2.72 % improvement. Regarding bladder capacity both groups showed highly significant (p>0.0001) increase in the bladder capacity. Group A showed significant improvement in the first desire to void and bladder capacity (p>0.0001& p>0.05) respectively compared to Group B.Conclusions: Both transvaginal electrical stimulation and posterior tibial nerve electrical stimulation restore normal detrusor capacity in cases of idiopathic detrusor instability. However, the transvaginal electrical stimulation seems to be more effective.
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