RESUMEN
BACKGROUND: Different therapeutic modalities have been tried for hypertrophic scar treatment. To our knowledge, intense pulsed light (IPL) has not been previously evaluated in comparison with cryotherapy as a stand-alone treatment for hypertrophic scars. OBJECTIVE: We aimed to evaluate the efficacy of IPL as a monotherapy for hypertrophic scar treatment as compared with cryotherapy both clinically and histopathologically. METHODS: This study included 28 patients with hypertrophic scars. Patients were divided randomly and equally into two groups; group I patients received cryotherapy while group II patients received IPL. All patients received treatments for a total of six sessions or until resolution of the lesion whichever was nearer. The outcome was evaluated clinically and histopathologically. RESULTS: Scar height showed a significant decrease and scar color and pliability showed a significant improvement in group I. No significant changes were detected in group II except in scar pliability. Vancouver scar scale (VSS) mean decreased by -53.7% in group I versus -11.5% decrease in group II. Histopathologically, group I showed a significantly increased epidermal thickness and decreased dermal and collagen bundle thickness, while group II showed insignificant histopathological changes. Group I exhibited a statistically significant clinical and histopathological improvement compared to group II, yet with more complications. CONCLUSION: Cryotherapy is more effective than IPL in the treatment of hypertrophic scars both on clinical and histopathological level yet with more complications.
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Cicatriz Hipertrófica , Terapia por Luz de Baja Intensidad , Cicatriz Hipertrófica/patología , Cicatriz Hipertrófica/terapia , Crioterapia , Humanos , Resultado del TratamientoRESUMEN
Various therapeutic modalities have been tried for female pattern hair loss (FPHL) treatment. To our knowledge, no previous studies had evaluated the therapeutic effect of lyophilized growth factor (L-GF) intralesional injection in FPHL. The current study aimed to evaluate the efficacy and safety of intralesional L-GF injection in FPHL by clinical and trichoscopic evaluation. This study included 20 patients with FPHL. All patients received three treatment sessions of intralesional injection of L-GF 4 weeks apart. Patients were followed-up for further 3 months. The outcome was evaluated by trichoscopy, photography score, patient's satisfaction score and side effects were reported. Trichoscopic evaluation showed significant posttreatment increase in all hair parameters associated with a significant decrease in vellus hair count. Ludwig's grade II showed posttreatment significant differences in all trichoscopic parameters from the baseline. No significant differences were detected regarding all trichoscopic parameters between the two Ludwig's grades posttreatment. 80% of patients showed photography score improvement that was significantly higher in Ludwig's grade II than in grade I. 100% of patients showed improvement in patient's satisfaction score with insignificant difference between Ludwig's grades. Intralesional injection of L-GF is safe and improved various trichoscopic hair parameters and clinical scores in FPHL.
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Alopecia , Cabello , Alopecia/diagnóstico , Alopecia/tratamiento farmacológico , Femenino , Humanos , Inyecciones Intralesiones , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , FotograbarRESUMEN
BACKGROUND: Different studies had evaluated the efficacy of fractional CO2 laser and platelet-rich plasma (PRP) in treating striae distensae (SD). Lyophilized growth factors (LGF) represent another form of delivering growth factors similar to PRP with a more standardized method. To the best of our knowledge, no previous trials have been reported using LGF in SD. AIMS: We aimed to compare the efficacy of ablative fractional CO2 laser vs intralesional injection of LGF vs combination of both modalities for SD treatment. METHODS: This study included 20 female patients with SD. All patients received three modalities of treatment in separate three areas: area A: received fractional CO2 laser, area B: received combination of fractional CO2 laser and intradermal injection of LGF, and area C: received intradermal injection of LGF. Each area received three sessions with 6-week intervals. The outcome was evaluated clinically and histopathologically before treatment and six weeks after the last session. RESULTS: There was a statistically significant clinical and histopathological improvement of SD both in areas A and B after treatment. Area C exhibited nonsignificant clinical and histopathological improvement. Area B showed the best improvement results as compared to areas A and C. CONCLUSION: We reported that fractional CO2 laser combined with LGF injection was more effective than fractional CO2 laser alone in SD treatment based on clinical and histopathological assessment. We do not advocate LGF as a monotherapy for SD treatment; instead, LGF can be used as a combined therapy with fractional CO2 laser to improve its outcome.
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Dióxido de Carbono , Estrías de Distensión , Femenino , Humanos , Inyecciones Intralesiones , Péptidos y Proteínas de Señalización Intercelular , Satisfacción del Paciente , Estrías de Distensión/terapia , Resultado del TratamientoRESUMEN
BACKGROUND: Few studies have evaluated facial photoaging by dermoscopy. Only one study has been performed among Egyptians. OBJECTIVE: To study and compare the dermoscopic features of facial aging in males and females and to relate these features to clinical criteria. METHODS: This study included 217 subjects divided into two groups; 117 males and 100 females. Each group was classified into three subgroups according to age. The dermoscopic features were reported according to dermoscopy photoaging scale (DPAS) criteria besides diffuse erythema and seborrheic keratosis and were related to significant clinical factors. RESULTS: The most prominent DPAS features in males were yellowish discoloration, hypo-hyperpigmented macules, superficial wrinkles, criss-cross wrinkles, and deep wrinkles. The most prominent DPAS findings in females were yellow papules, hypo-hyperpigmented macules, solar lentigo, and superficial wrinkles. A significant difference between males and females was detected regarding yellowish discoloration, white lines, hypo-hyperpigmented macules, senile comedones, telangiectasia, all wrinkle types, and DPAS score besides diffuse erythema and seborrheic keratosis. The DPAS score and the dermoscopic features were more prominent with male gender, increase in age, sun exposure, Glogau's scale, and smoking and were detected early in skin phototypes II and III. CONCLUSION: We found a significant difference in various dermoscopic features in males compared to age-matched females. Also, we detected increase in DPAS features and score with male gender, aging, sun exposure, Glogau's scale, and smoking. Therefore, dermoscopy is an objective technique that detects selectively photoaging in males and females that aids in proper choice of various targeted treatment modalities.
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Dermoscopía , Envejecimiento de la Piel , Pigmentación de la Piel/fisiología , Piel/diagnóstico por imagen , Adulto , Estudios Transversales , Egipto , Cara , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores SexualesRESUMEN
Four microsized graphite and platinum wire poly(vinyl chloride) matrix membrane electrodes responsive to some drugs affecting cardiovascular system, Metoprolol tartrate (MT) and Hydrochlorothiazide (HZ) were developed, described and characterized. These sensors were constructed by using (2-Hydroxypropyl)-ß-cyclodextrin (2HP ß-CD) as an ionophore which has a significant influence on increasing both membrane sensitivity and selectivity. The four sensors were fabricated in a polymeric matrix of carboxylated polyvinyl chloride (PVC-COOH) and dioctylphthalate (DOP) as a plasticizer, based on the interaction between the drugs and the dissociated COOH groups in the PVC-COOH. Fast and stable Nernstian responses of 1.0 × 10-6-1.0 × 10-2 M for MT (sensors 1 and 2) and of 1.0 × 10-7-1.0 × 10-3 M for HZ (sensors 3 and 4) over pH range 3.0-9.0 and 3.0-7.0 for the MT and HZ sensors respectively were obtained. Nernstian slopes of 56.2, 54.6, 19.0 and 20.8 mV/decade for electrodes 1-4 respectively were observed. The proposed method displayed useful analytical characteristics for the determination of MT and HZ in their pure powder forms with average recoveries of 99.11 ± 0.357, 99.21 ± 0.389, 100.08 ± 0.459 and 100.28 ± 0.438% for sensors 1-4 respectively. The lower limit of detection (LOD) were 5.5 × 10-6, 4.5 × 10-6, 4.8 × 10-8 and 5.0 × 10-8 M for sensors 1-4 respectively indicated high sensitivity. The four sensors displayed a good stability over a period of 6 weeks. The selectivity coefficients of the developed sensors indicated excellent selectivity. Results obtained by the four electrodes revealed the performance characteristics of these electrodes which evaluated according to IUPAC recommendations. The method was successively applied for the determination of MT and HZ in presence of each other, in presence of Salamide (SA), the main degradation product of HZ, in their pharmaceutical formulations and in human plasma samples. Statistical comparison between the results obtained by this method and those obtained by the official methods of the drugs was done and no significant difference was found.
RESUMEN
In the present work, different spectrophotometric methods and one spectrofluorimetric method have been developed and validated for the determination of mosapride citrate in the presence of its acid-induced degradation products. The drug was subjected to stress stability study including acid, alkali, oxidative, photolytic, and thermal stress degradation. The developed spectrophotometric methods included the use of first order derivative ((1)D), derivative of ratio spectra ((1)DD), mean centring of ratio spectra (MC) and H-point standard additions (HPSAM) spectrophotometric methods. For (1)D method, the peaks amplitudes at 282.8 and 319.6 nm were measured, while for (1)DD method those at 308 nm and 323 nm were measured. Mean centring of ratio spectra method used the values at 317 nm for calibration, while for HPSAM the absorbance at 273 and 288.6 nm were used. These methods were successfully applied for determination of mosapride in the concentration range of 5-70 µg.ml(-1). The spectrofluorimetric method was based on measuring the native fluorescence of mosapride in 0.1 M NaOH using λ(excitation) 276 nm and λ(emission) 344 nm and 684 nm with linearity ranges of 50-3000 ng.ml(-1) and 50-9000 ng.ml(-1), respectively. All the developed methods were validated according to the International Conference on Harmonization (ICH) guidelines and were applied for bulk powder and dosage form. The results obtained were statistically compared to each other using one-way ANOVA testing.
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Benzamidas/análisis , Fármacos Gastrointestinales/análisis , Morfolinas/análisis , Espectrometría de Fluorescencia/métodos , Espectrofotometría/métodos , Ácidos/metabolismo , Benzamidas/metabolismo , Benzamidas/normas , Estabilidad de Medicamentos , Fármacos Gastrointestinales/metabolismo , Fármacos Gastrointestinales/normas , Hidrólisis , Morfolinas/metabolismo , Morfolinas/normas , Preparaciones Farmacéuticas/química , Preparaciones Farmacéuticas/metabolismo , Preparaciones Farmacéuticas/normas , Control de Calidad , Estándares de Referencia , Sensibilidad y Especificidad , Espectrometría de Fluorescencia/economía , Espectrofotometría/economíaRESUMEN
In this work two well known oral hypoglycemic drugs that are administered in combination for patients with type-II diabetes were simultaneously determined. Several spectrophotometric methods were developed and validated for the determination of metformin hydrochloride (MET), pioglitazone hydrochloride (PIO) and pioglitazone acid degradate (PIO Deg). Derivative, ratio derivative, isosbestic and chemometric-assisted spectrophotometric methods were developed. The first derivative (D(1)) method was used for the determination of MET in the range of 5-30 microg x mL(-1) and PIO in the range of 10-90 microg x mL(-1) by measuring the peak amplitude at 247 nm and 280 nm, respectively. The concentration of PIO was calculated directly at 268 nm. The first derivative of ratio spectra (DD(1)) method used the peak amplitudes at 238 nm and 248.6 nm for the determination of MET in the range of 5-30 microg x mL(-1). In the isosbestic point method (ISO), the total mixture concentration was calculated by measuring the absorbance at 254.6 nm. Classical least squares (CLS), principal component regression (PCR) and partial least squares (PLS-2) were used for the quantitative determination of MET, PIO and PIO Deg. The methods developed have the advantage of simultaneous determination of the cited components without any pre-treatment. Resolution and quantitative determination of PIO degradate with a minimum concentration of 3 microg x mL(-1) in drug samples was done. The proposed methods were successfully used to determine each drug and the acid degradate in a laboratory-prepared mixture and pharmaceutical preparations. The results were statistically compared using one-way analysis of variance (ANOVA). The methods developed were satisfactorily applied to the analysis of the two drugs in pharmaceutical formulations.
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Metformina/análisis , Espectrofotometría/métodos , Tiazolidinedionas/análisis , Análisis de Varianza , Combinación de Medicamentos , Hipoglucemiantes/análisis , Hipoglucemiantes/química , Análisis de los Mínimos Cuadrados , Metformina/química , Pioglitazona , Análisis de Componente Principal , Análisis de Regresión , Tecnología Farmacéutica/métodos , Tiazolidinedionas/químicaRESUMEN
The splicing mutation in intron 1 of beta-globin gene (IVS1-110) is the most common mutation in Egyptian thalassemics that causes aberrant splicing of pre-mRNA and deficient beta-globin chain synthesis. Antisense oligonucleotides (ASONs) are compounds that redirect pre-mRNA splicing and modify gene expression. Our aim was ex vivo correction of the aberrant splicing of beta-globin110 pre-mRNA by ASON against the 3' aberrant splice site. Peripheral blood mononuclear cells of 10 thalassemic patients with IVS1-110 mutation were duplicated and 1 was treated with 20 micromoL/mL morpholino ASON targeted against the 3' aberrant splice site. The level of total hemoglobin (Hb), fetal Hb, and mRNA were estimated in the duplicate samples. Five cases (50%) showed correction with ASON treatment, of which 2 cases showed the appearance of corrected mRNA band with absence of the aberrant band and 3 cases showed an increased ratio of the corrected to the aberrant mRNA band from 2:1 to 3:1, and 4:1. The total Hb showed significant increase in the 5 corrected cases. In conclusion, ASON can restore correct splicing of beta-globin pre-mRNA leading to correct gene product in cultured erythropoietic cells. These results suggest the applicability of ASON for the treatment of thalassemia.
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Globinas/genética , Intrones , Mutación , Oligonucleótidos Antisentido/farmacología , Precursores del ARN/genética , Empalme del ARN , Talasemia beta/genética , Adolescente , Adulto , Empalme Alternativo , Niño , Preescolar , Egipto , Femenino , Homocigoto , Humanos , Masculino , Empalme del ARN/efectos de los fármacos , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
Patients with thalassemia major requiring regular blood transfusions accumulate iron that is toxic to the heart, liver, and endocrine systems. The following prospective, randomized trial was carried out to determine the effectiveness, in children and young adults, of combined deferiprone (DFP) and deferoxamine (DFO) in reducing transfusional iron overload compared to either drug alone and to assess the safety and tolerability of DFP. Sixty-six patients were randomized into three treatment arms: daily DFP combined with DFO twice weekly; daily DFP only; and DFO only 5 days/week. Fifty-six patients completed the 54 weeks and were assessed by different indices. A significant reduction of liver iron concentration and serum ferritin was observed in all three arms while significant reduction of liver iron score was observed in patients on combination therapy only. Cardiac function did not significantly change in any arm. Compliance improved in patients who received combined therapy. Toxicity of DFP was mild to moderate and acceptable; most commonly, transient arthropathy and nausea/vomiting were observed. Thus, combination therapy has shown to be effective in reducing iron overload in thalassemia patients.
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Terapia por Quelación/métodos , Deferoxamina/uso terapéutico , Quelantes del Hierro/uso terapéutico , Sobrecarga de Hierro/tratamiento farmacológico , Piridonas/uso terapéutico , Talasemia/tratamiento farmacológico , Adolescente , Adulto , Terapia por Quelación/efectos adversos , Niño , Preescolar , Deferiprona , Deferoxamina/administración & dosificación , Deferoxamina/efectos adversos , Esquema de Medicación , Quimioterapia Combinada , Egipto/epidemiología , Femenino , Ferritinas/análisis , Ferritinas/sangre , Humanos , Quelantes del Hierro/administración & dosificación , Quelantes del Hierro/efectos adversos , Sobrecarga de Hierro/etiología , Sobrecarga de Hierro/prevención & control , Hígado/patología , Masculino , Cooperación del Paciente , Estudios Prospectivos , Piridonas/administración & dosificación , Piridonas/efectos adversos , Talasemia/complicaciones , Talasemia/epidemiología , Reacción a la TransfusiónRESUMEN
Insecticide and resistance bioassays and microplate assays were performed on Culex pipiens mosquitoes to determine the level and mechanisms of resistance. Culex pipiens larvae were collected from three filariasis-endemic areas of Egypt and reared to adults for subsequent production and testing of F1 generation larvae and adults. Bioassays were performed using World Health Organization (WHO) methods with the diagnostic doses of 6 organophosphate insecticides for larvae and 1 organochlorine (OC), 4 pyrethroid, 2 organophosphate, and 2 carbamate insecticides for adults. Microplate assays were performed to measure levels of beta esterase, acetylcholinesterase, insensitive acetylcholinesterase, oxidases, and glutathione-S-transferase enzymes. Larval bioassay results showed clear indications of resistance to organophosphate insecticides. Adult bioassays also showed widespread, significant resistance to many insecticides from all four classes, including the OC, DDT. The Qalubiya larval population was susceptible only to malathion, whereas Sharkiya larvae were susceptible to malathion, temephos, and chlorpyrifos. On the other hand, larval specimens from Assiut were resistant to all insecticides tested. Larval bioassay results were supported by those of microplate assays in showing elevated levels of glutathione S-transferase in populations from all three areas. In general, microplate results confirmed patterns of resistance observed using bioassays, and mechanisms of resistance were evident for all three areas sampled. Mechanisms of resistance are discussed in relation to microplate and bioassay results for the areas sampled and pesticides used.
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Bioensayo , Culex , Resistencia a los Insecticidas , Animales , Culex/enzimología , Egipto , Femenino , Insecticidas , LarvaRESUMEN
The present study focused on dipterous flies, distribution and densities in 14 Egyptian Governorates. The abundance and distribution of flies was carried out in three phases. The first was in 1999 in 5 governorates, Qalyobia, Menoufia, Fayium, Behiera & Assuit included species of the families: Calliphoridae, Chloropidae, Drosophilidae, Milichiidae, Muscidae, Otitidae, Piophilidae, Sarcophagidae, Sepsidae, Sphaeroceridae and Syrphidae. The second was in 2000 in another five Governorates, Kafr-ElSheikh, Giza, Menia, Aswan and Sharkia included sp. of the families: Calliphoridae, Chloropidae, Drosophilidae, Milichiidae, Muscidae, Otitidae, Piophilidae, Sarcophagidae, Sepsidae, Sphaeroceridae and Syrphidae. The third phase was in 2001 in 4 Governorates: Kena, El-Wady El-Gedied, Da-kahlia and South Sinai included species of the families: Calliphoridae, Chloropidae, Drosophilidae, Milichiidae, Muscidae, Otitidae, Phoridae, Piophilidae, Sarcophagidae, Sepsidae, Sphaeroceridae and Syrphidae. Musca domestica was the most abundant sp. found throughout the work. The results are a step in drawing an update map for insect-vectors to help in the national control programs.
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Dípteros/crecimiento & desarrollo , Insectos Vectores/crecimiento & desarrollo , Animales , Demografía , Egipto , Femenino , Geografía , Masculino , Densidad de Población , Estaciones del Año , Especificidad de la EspecieRESUMEN
No identifiable cause can be found in more than half of the cases of portal vein thrombosis (PVT). Our aim was to assess the prevalence of factor V Leiden mutation and other thrombophilic factors as risk factors in the development of PVT in the pediatric age group. From March 2001 to January 2002, 40 children with PVT were enrolled in the study, in addition to 20 age-matched and sex-matched controls. Protein C, protein S, antithrombin III, and activated protein C resistance (APCR) were assayed. Molecular study of factor II and factor V mutations was carried out. Of the patients, 25 had detectable hereditary thrombophilia (62.5%), 12 had factor V Leiden mutation (30%), 11 had protein C deficiency (27.5%), 6 had factor II mutation (15%), 1 had antithrombin III deficiency (2.5%), and none had protein S deficiency. Five children had concurrence of more than one defect. Factor V Leiden mutation is the most common hereditary thrombophilia associated with PVT and the relative risk of factor V Leiden mutation, as a cause of PVT, was six times more than in controls (odds ratio=6). Concurrence of more than one hereditary thrombophilic factor was seen in 12.5% of our patients. Circumstantial risk factors (neonatal sepsis, umbilical sepsis, umbilical catheterization) were not more significantly prevalent among patients with hereditary thrombophilia than among those with no detectable abnormalities in anticoagulation.
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Proteínas Sanguíneas/genética , Factor V/genética , Mutación/genética , Vena Porta/patología , Trombosis/genética , Resistencia a la Proteína C Activada/genética , Adolescente , Antitrombina III/genética , Estudios de Casos y Controles , Niño , Preescolar , Egipto , Femenino , Heterocigoto , Hospitales , Humanos , Lactante , Masculino , Proteína C/genética , Proteína S/genética , Protrombina/genética , Trombosis/epidemiologíaRESUMEN
The present work studied the mosquito's identification, distribution and densities in fourteen Egyptian Governorates. The abundance and distribution of mosquito species monitored by three phases. The first was carried out in 1999 in five governorates, Qalyobia, Menoufia, Behaira, Fayium and Assuit. The second was in the year 2000 in Kafr El Sheikh, Giza, Sharkia, Menia and Aswan. The third was in the year 2001 in Kena, El Wady El Gadeed, Dakahlia and South Sinai. Culex species were the commonest mainly C. pipiens, C. antennatus and C. univittatus. C. thelerei was found only in El Kharga Oasis. Culiseta sp. was found in Qalyobia, Menofia, Behaira, Fayium, El Wady El Gadeed, Dakahlia and South Sinai and as larvae in Kafr El Sheikh, Giza, and Menia. Aedes detritus was found in Assiut, Fayium, Giza, Aswan, El Wady El Gadeed and South Sinai. Ae. caspius was found in Assiut and Aswan and as larvae in Kena and El Wady El Gadeed. Anopheles pharoensis was found in Behaira and Fayium, while A. algeriensis in Aswan. A. multicolor and A. sergentii were found in Fayium, Aswan and El Wady El Gadeed; but in Kena A. sergentii was found as larvae and A. multicolor as adults.
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Culicidae/fisiología , Aedes/fisiología , Animales , Anopheles/fisiología , Culex/fisiología , Culicidae/clasificación , Demografía , Egipto , Geografía , Insectos Vectores/clasificación , Insectos Vectores/fisiología , Densidad de Población , Estaciones del Año , Especificidad de la EspecieRESUMEN
Standard WHO test methods were used to determine the susceptibility of field population of housefly to four organophosphorous and two pyrethroid insecticides. Field population flies collected from nine governorates, Giza, Faiyoum, Suez, Behaira, Menoufia, Sharkia, Kafr El-Sheikh, Assiut and Aswan. The results indicated that, all tested insecticides were very effective on flies collected, from Sharkia, Kafr El-Sheikh and Aswan, but there was an evidence of increased vigor tolerance among those collected from Kafr El-Sheikh for bioresmethrin and tolerance for diazinon in Aswan. In Assiut, flies exhibited high sensitivity to diazinon, deltamethrin and bromophos while malathion was the least effective adulticide. Resistance to malathion, diazinon, fenthion and bioresmethrin was noticed in varying degrees at all governorates. The highest average resistance ratio was recorded for malathion in Behaira (55.3 folds) and in Suez (26 folds). Resistance was also more pronounced in Menoulia for diazinon (23.3 folds). As for bioresmethrin an apparent increase in the resistance ratio was detected in Suez (25 folds). In Giza. houseflies were resistant to fenthion (14.5 folds). Regarding the difference between the six insecticides used, deltamethrin was the most potent insecticide in all governorates.
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Moscas Domésticas , Insecticidas , Animales , Egipto , Femenino , Resistencia a los Insecticidas , Dosificación Letal Mediana , Compuestos Organofosforados , PiretrinasRESUMEN
Two spectrophotometric procedures are described for the determination of clobetasol propionate(I), halobetasol propionate(II) (corticosteroids) and quinagolide hydrochloride(III) (prolactin inhibitor). For corticosteroid drugs, the procedures are based on the formation of phenyl hydrazones of the corticosteroids which are subsequently subjected to charge transfer complexation reaction with either 2,3-dichloro-5,6-dicyanobenzoquinone (DDQ) as pi-acceptor or with iodine as sigma-acceptor. Prolactin inhibitor was reacted directly with the previous reagents. The molar ratios of the reactants were established and the experimental conditions were studied giving maximum absorption at 588 and 290 nm with DDQ and iodine methods, respectively for the three drugs. The concentration ranges were 20-150,50-300, and 20-80 microg ml(-1) in DDQ method for (I), (II), and (III), respectively and 13-20,15-40, and 8-32 microg ml(-1) in iodine method for (I), (II) and (III), respectively.