Medical Research

'Infectobesity' in egyptian adolescent women and its relations to carotid intima–media thickness Sahar A El-Masry, Hanan A El Gamal, Muhammad Al-Tohamy, Ayman Nada, Amany H Abdelrahman, Mohamed Kh. Metkees, Amany Ebrahim, Walaa Saad Journal of The Arab Society for Medical Research 2018 13(2):79-88 Background ‘Infectobesity’ is a new term to describe obesity of infectious origin, such as infection by human adenovirus-36 (Adv36). It appears to be a new concept, evolved over the past 20 years. Visceral obesity is associated with a higher risk of cardiovascular disease. Increased carotid intima–media thickness (CIMT), a marker of early-onset atherosclerosis, has been observed in obese children and adolescents. The present study aims to investigate the relationship between visceral obesity, CIMT, and Adv36 in female Egyptian adolescents. Patients and methods The present study included 90 women aged 12–15 years. It was conducted at the Medical Excellence Research Center of the National Research Centre, Cairo, Egypt, during the period between September 2016 and November 2017. Anthropometric assessment was done. Fasting blood samples were withdrawn for the measurement of Qualitative Human Adv36 antibody using a sandwich enzyme-linked immunosorbent assay. Fasting plasma glucose was determined calorimetrically, by the glucose oxidase method and insulin level using the solid-phase enzyme-linked immunosorbent assay and lipid profile. Visceral obesity was measured by an abdominal ultrasound. CIMT for both carotid arteries were measured by high-resolution echo Doppler. Results Girls with visceral obesity (n=26) had higher frequency of increased CIMT at left (96.2 vs. 75%), right carotid artery (84.6 vs. 73.4%) and Adv36 sero-positive antibody (69.2 vs. 56.2%) than among those without visceral obesity (n=64). Among the total samples, visceral obesity had significant positive correlations with BMI, waist and hip circumference, while it had insignificant correlations with age, blood pressure (BP), CIMT at right and left carotid arteries, adenovirus and laboratory findings. CIMT had a significant positive correlation with each other, insulin resistance and total cholesterol, and significant negative correlations with high-density lipoprotein and waist circumference. Adv36 had significant negative correlations with BP (both systolic and diastolic) and significant positive correlation with insulin level. Adv36 and CIMT had insignificant correlations with each other and with the anthropometric measurements, BP, visceral obesity, triglycerides, and low density lipoprotein. Conclusion The frequency of Adv36 and increased CIMT at left carotid artery were higher among girls with visceral obesity than among those without visceral obesity. However, visceral obesity, CIMT at both right and left carotid arteries, and Adv36 had insignificant correlations with each other.

Inhibitory effect of bee venom against potassium bromate causing genetic toxicity and biochemical alterations in mice Abeer H Abd El-Rahim, Omaima M Abd-El-Moneim, Heba A.M. Abd El-Kader, Amira Abd El Raouf Journal of The Arab Society for Medical Research 2018 13(2):89-98 Background/aim Bee venom (BV) therapy is a highly effective treatment, capable of improving one’s health. The present study attempts to assess the effect of BV on the toxicity of oral administration of potassium bromate (KBrO3) which has been widely used in food and cosmetic industries. Materials and methods Sixty adult male mice were gavaged with KBrO3 at two doses (100 and 200 mg/kg body weight) for 10 days. Afterwards, BV at a dose of 120 μg/kg body weight was injected subcutaneously three times per week for two successive weeks. The genetic study was performed using chromosomal aberration and micronucleus formation in the bone marrow, DNA fragmentation in liver cells and by sperm analysis. In addition, serum biochemical markers such as catalase and malondialdehyde, kidney, and liver functions were assessed. Results The results have shown that KBrO3 caused DNA damage that represented the increase in the frequencies of chromosome abnormalities, micronuclei formation, percentage of DNA fragmentation, and sperm morphological abnormalities. Meanwhile, the results showed that KBrO3 exhibited severe toxicity for antioxidant activities for liver and kidney functions. Conversely, BV significantly decreased the frequencies of DNA damage in all aforementioned parameters induced by KBrO3. In addition, it improved the antioxidant activities and the function of the liver and kidneys. Conclusion BV has a potent ameliorating effect against the KBrO3 hazard impacts in animal tissues especially at higher doses. This observation indicated that BV could be a potential therapeutic agent in the treatment of KBrO3 risk.

Impact of nano-TiO2 particles on water sorption and solubility in different denture base materials Wessam M Dehis, Sherihan M Eissa, Ayman F Elawady, Menatallah M Elhotaby Journal of The Arab Society for Medical Research 2018 13(2):99-105 Background/aim Denture base materials with all their diversities and the curing method have a massive impact on their physical, mechanical, and biological traits. This contemplate is aimed to both assess and relate water sorption and solubility of heat-cured and microwave-cured acrylic resin denture base materials with and without the addition of titanium oxide nanoparticles (TiO2 NPs). Materials and methods A total number of 80 circular specimens were fabricated for the two tested groups (n=40). Group I was divided into two subgroups: group IA and group IB (20 each) fabricated from heat-cured and microwave-cured acrylic resin, respectively. Another group (group II) was divided into two subgroups: group IIA and group IIB (20 each) as in group I with the addition of TiO2 NPs. Then, the degree of water sorption and water solubility was calibrated by using an electronic balance for all specimens and determined by the aid of a specific formula. Results The present results indicated that there is a significant difference between all groups using one-way analysis of variance test as the P value was less than 0.05. Moreover, Tukey’s post-hoc test was performed and revealed that there was a significant difference between all subgroups except (group IIA and group IIB) in which there was an insignificant difference regarding water sorption and water solubility. Conclusion Within the limitation of this consideration, microwave-cured acrylic resin is superior to the heat-cured one regarding both water sorption and solubility. Moreover, the addition of TiO2 NPs revealed the best outcome.

Clinical efficacy of nicotine replacement therapy in the treatment of minor recurrent aphthous stomatitis Mai Zakaria, Aliaa El-Meshad Journal of The Arab Society for Medical Research 2018 13(2):106-112 Background/aim Recurrent aphthous stomatitis (RAS) is a common and widely recognized disease involving the oral mucous membrane. Nicotine replacement therapy (NRT) is a dose-dependent safe method for encountering useful effects of nicotine. This study aimed to evaluate the clinical efficacy of NRT in the treatment of minor RAS. Materials and methods A total of 50 patients from Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, with active minor RAS lasting for less than 48 h were randomly allocated into two groups (25 each): placebo and nicotine groups. They were treated with placebo and 2-mg nicotine chewing gum, correspondingly, twice daily for 2 weeks. All participants were assessed for pain, erythema, and ulcer size sores at 4 and 6 days from baseline. Frequency of recurrence was evaluated at 1-month, 2-month, and 3-month intervals. Results Regarding pain and erythema scores, the nicotine group showed lower mean with significant difference after 6 days in comparison with the placebo group. A lower mean of ulcer size was recorded in the nicotine group, with a significant difference after 4 and 6 days. A lower mean of recurrence score was recorded in nicotine group, with nonsignificant difference compared with the placebo group. Conclusion Low-dosage NRT in the form of chewing gum may be considered as an innovative and safe alternate treatment modality for minor RAS.

Androgen receptor expression in hormone-negative breast cancers and its prognostic significance Dalia M Abouelfadl, Hebat Allah A Amin, Noha N Yassen, Marwa E Shabana, Amir M.H. Salem Journal of The Arab Society for Medical Research 2018 13(2):113-118 Background/aim Breast carcinoma is a common, yet heterogeneous aggressive disease affecting relatively young patients. The androgen receptor (AR) is expressed in majority of breast cancers and across the main breast cancer subtypes. The aim of this study was to evaluate AR expression in hormone-negative breast cancer subtypes. Materials and methods Sixty cases of breast cancer were involved in this study; the samples were received in the Department of Pathology of Kasr El-Aini Hospital, Cairo University, Egypt. The expression of AR and human epidermal growth factor receptor-2 receptors were studied by immunohistochemistry in 60 formalin-fixed paraffin-embedded selected hormone-negative breast cancer surgical specimens. The immunohistochemistry expression of the marker was correlated with the clinicopathological variables. Results Of the hormone-negative cases, 61.6% show positive AR expression, 89% of which are invasive duct carcinoma, 68.3% are associated with ductal carcinoma in situ, and 55% are human epidermal growth factor receptor-2-enriched subtype. A significant correlation was found between the AR expression and tumor type. There is no evident significant correlation with tumor grade, multicentricity or lymphovascular invasion. Conclusion The AR has recently emerged as a useful marker for the further refinement of breast cancer subtype classification. Antiandrogens are thought to markedly enhance treatments and to be the first targeted therapy in hormone-negative breast cancer cases.

Morphometric analysis and immunohistochemical expression of cytochrome C oxidase in colonic adenomas and adenocarcinomas Noha N Yassen, Dalia M Abouelfadl, Amina A Gamal elDin Journal of The Arab Society for Medical Research 2018 13(2):119-128 Background/aim Colorectal cancer is the seventh most common cancer in Egypt, constituting 3.47% of male cancers and 3% of female cancers. The aim of the current study is to evaluate the immunohistochemical expression of cytochrome C oxidase (CcO) as well as the nuclear morphometric measurements in colonic adenomas and adenocarcinomas. Materials and methods Sixty cases of colonic biopsies/specimens were involved in this study. The samples were received in the Department of Pathology of Kasr El-Aini Hospital, Cairo University, Egypt, and they were divided into three groups: 20 cases of normal control, 20 cases of colonic adenoma, and 20 cases of colonic adenocarcinoma. The expression of CcO was studied by immunohistochemistry in 60 formalin-fixed paraffin blocks. Nuclear morphometric parameters were evaluated using an image analysis system. The area percentage of the marker expression was correlated with nuclear morphometric parameters. Results Immunohistochemical study showed that 65% of control biopsies showed a significant difference with colonic adenocarcinoma cases in contrast and adenoma cases showed a nonsignificant difference with normal control biopsies. Mean areas percentages of CcO expression were significantly different between all three studied groups. The means of nuclear area, length, and perimeter showed a significant difference while means nuclear width and roundness showed a nonsignificant difference between all three studied groups. There was significant correlation between mean area percentage of CcO expression with mean nuclear area and perimeter in control, adenoma, and adenocarcinoma cases. Conclusion CcO protein is significantly expressed in the cytoplasm of normal colonic mucosa. It was significantly deficient in colonic adenocarcinoma. Nuclear morphometry can be introduced as a useful morphologic feature of patients with variable colonic lesions specially in combination with CcO.

The antifibrotic effect of Zilla spinosa extracts targeting apoptosis in CCl4-induced liver damage in rats Enayat A Omara, Sayed A El-Toumy, Marwa E Shabana, Abdel-Razik H Farrag, Somaia A Nada, Nermeen Shafee Journal of The Arab Society for Medical Research 2018 13(2):129-143 Background/aim Liver fibrosis and its end-stage cirrhosis are the main reasons of morbidity and mortality all over the world. The current study aimed to evaluate the efficacy of Zilla spinosa (Z. spinosa) on CCl4-induced liver fibrosis, apoptosis, and oxidative stresses in rats. Materials and methods Extract of aerial part of Z. spinosa was used in this study. Thirty male Sprague‑Dawley rats were enrolled in this study and divided into five groups (six each): group 1 served as control and groups 2–5 were treated with CCl4 (1 ml/kg intraperitoneal twice a week for 8 weeks), where group 2 served as a control positive, group 3 received silymarin (50 mg/kg) daily, and groups 4 and 5 were administrated with Z. spinosa (100 and 200 mg/kg, respectively) daily for 8 weeks. At the end of each experiment, liver function tests were analyzed in serum, whereas malondialdehyde (MDA), Nitric oxide (NO), Glutathione (GSH), and hydroxyproline (HA) were analyzed in liver tissues. Liver fibrosis was confirmed histopathologically, and collagen content, caspase-3, and α-smooth muscle actin (α-SMA) were assayed immunhistochemically. Results Alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, MDA, NO, and HA levels were increased (P<0.05), whereas total protein and GSH were decreased (P<0.05) in CCl4-administrated rats. Histopathological results showed loss of lobular structure, fibrosis with expansion of portal tract by fibrous tissue together with inflammatory changes confined to portal tract and central vein, and intense centrilobular necrosis and remarkable fatty hydropic degeneration. In addition, extensive accumulation of connective tissue, marked depletion of glycogen, strong expression of α-SMA, and increased of caspase-3 were found in CCl4-administrated rats. Oral administration of Z. spinosa at 100 or 200 mg/kg restored the normal levels of liver function parameters, MDA, NO and GSH; decreased HA; and reduced collagen, glycogen content, caspase-3, and α-SMA in liver tissue of rats. The high dose of 200 mg/kg showed more potent effect than low dose of 100 mg/kg when compared with silymarin treatment group. Conclusion The present study clarified that Z. spinosa extract has antioxidant and antiapoptotic properties in CCl4-induced liver fibrosis in rats, and may be able to exert a therapeutic effect on developing hepatic fibrosis; moreover, high dose of 200 mg/kg appeared to be more potent than low dose (100 mg/kg).

Image analysis and Ki-67 expression in urothelial dysplasia and carcinoma Manal A Badawi, Sonia L El-Sharkawy, Naglaa F Abbas, Wafaa E Abdel-Aal Journal of The Arab Society for Medical Research 2018 13(2):144-150 Background/aim Cancer of the urinary bladder is a worldwide disease in which transitional cell carcinoma is the most common histologic type. The diagnosis of dysplasia is particularly important, as it is the precursor of invasive carcinoma. The present study aimed to investigate the role of image analysis together with Ki-67 immunostaining in bladder dysplasia and invasive urothelial carcinoma. Materials and methods This study was carried out in 80 urinary bladder paraffin blocks that were selected from the Department of Pathology of Kasr El-Aini Hospital, Cairo University, Egypt. The studied cases were divided into four groups: six cases of normal bladder mucosa, 12 cases of chronic cystitis, 18 cases of epithelial dysplasia, and 44 cases with transitional cell carcinoma. Morphometric analysis and Ki-67 expression were studied in all cases using an image analysis system. Results All morphometric parameters, DNA index, and proliferating cells’ percent and Ki-67 index were increasing from normal, chronic cystitis, dysplasia to carcinoma cases. However, nuclear area, length, size, and epithelial stromal ratio showed significant differences between dysplasia and carcinoma cases (P<0.05). High-grade carcinoma showed significant enlargement of nuclear area and size, as compared with low-grade carcinoma. DNA index and proliferating cells’ % showed a significant difference between dysplasia and carcinoma cases. Both parameters were significantly higher in high-grade carcinoma. Normal bladder and chronic cystitis cases exhibited negative stain for Ki-67. However, all cases of dysplasia and carcinoma exhibited a positive stain for Ki-67. The carcinoma cases showed a significantly higher Ki-67 index (68%) than the dysplastic cases (34%). Conclusion The present study revealed the usefulness of image analysis together with Ki-67 expression in discriminating cases of bladder dysplasia and carcinoma.