The role of infection in irritable bowel syndrome The Egyptian Journal of Hospital Medicine Vol., 18 : 1- 7 March 2005

1687 - 2002

The role of infection in irritable bowel syndrome

Hani Abu Zeid* Magdi Abdel Karim* Mahmoud M. Bazid*
Mostafa M. Al Sayed* and Mostafa Yousef El- Mishad**

Internal Medicine Department * & Microbiology and Clinical
Immunology Department ** ­ Al Azhar University ­ Cairo.

A clinically distinct subset of Irritable Bowel syndrome (IBS) could be induced or
exaggerated by bowel infection that is called post-infective IBS (PI-IBS) which is characterized
by diarrhea predominant symptoms with less psychiatric illness. The purpose of this work was
to study whether some bowel infections contribute to the pathogenesis of IBS and whether the
treatment of such infections reduces IBS symptoms.
100 patients with symptoms suggestive of IBS according to Rome II Criteria were chosen
from Internal Medicine outpatient clinic-Al Hussein university hospital. They were 64 females
and 36 males, aged 18-52 years old with mean age 38,2 3,6 years. They were submitted to:
full clinical examination and frequent stool examinations (direct smear and culture) before, soon
after and six months after administration of drug therapies for common stool-positive associated
bowel infections (diloxanide for E. histolytica, metronidazole for Giardia lamblia, Ketoconazole
for Candida, ciprofloxacin for Salmonella and neomycin for Pseudomonas).
Results obtained showed that 24% of patients had diarrhea predominant symptoms, 13
patients (54%) out of them had history suggestive of acute gastroenteritis.
80 patients had initial positive stool examination and continued the post treatment six
months follow up study. Out of them, 13 patients had stool positive for Salmonella typhi mixed
with E. histolytica; ten of them (76.9%) showed a statistically significant persistent clinical and
laboratory improvement after ciprofloxacin therapy (P < 0.01). So Salmonella typhi may be
implicated in IBS pathogenesis.
Six patients showed isolated Giardia lamblia infection; four of them (66.7%) showed a
statistically significant persistent clinical and laboratory improvement after metronidazole
thereby (P < 0.05). Giardia lamblia parasite may be considered in triggering or exaggerating
IBS symptoms.
24 patients had isolated E. histolytica infection; only one of them (4.2%) showed sustained
clinical and Laboratory improvement after diloxanide therapy -statistically insignificant result-
(P > 0.05). This finding makes the correlation between E. histolytica infection and IBS is
20 patients had isolated Candida overgrowth on stool examination; eight of them (40%)
showed a statistically significant clinical and laboratory improvement after Ketoconazole
therapy (P < 0.05). Therefore Candida overgrowth may induce or exaggerate IBS symptoms.
Finally, no growth was noticed for shigella sp. or E. coli, this may exclude the role of such
organisms in IBS pathogenesis.

Introduction and Aim of the Work:
Irritable bowel syndrome (IBS) is a
from diarrhea to constipation. Symptoms
group of symptoms of multidetermined
are variable in intensity from one patient to
pathogenesis. Its symptoms seem to be
another and from one time to another in the
generated by gut abnormalities in motility,
same patient. (Neal, et al., 2002). IBS
epithelial function and sensory perception
represents 30 ­ 40% of GIT outpatient
(Tornblom et al., 2003). These symptoms
visits. It is prevalent among middle age
include abdominal pain, cramps, bloating
individuals particularly females (Mark et
and eccentric bowel movement ranging
al., 2000).

Full Paper (vol.18 paper# 1)

Analysis of bone density of the human first metarsal bone T
he Egyptian Journal of Hospital Medicine Vol., 18 : 8 - 15 March 2005

1687 - 2002

Analysis of bone density of the human first metatarsal bone

Nabil Amin* ; Abd El Hakim Rozeek** and Naglaa Dabees***

From Department of Urology,Mansoura General Hospital*;Al-Gomail Hospital Libia**
and Department of Radiology , Tanta University***

This study was performed on 38 Pairs of cadaveric human 1st metatarsal bones in an
attempt to establish the pattern of bone mineral density and to correlate it with the
biomechanical function of the bone. The results show that the head is denser than the base, the
dorsal portion of the whole metatarsal is denser than the planter portion and the lateral portion
of the whole metatarsal is denser than the planter portion and the lateral portion of the whole
metatarsal is denser than the medial aspect. The same pattern of bone density with respect to
dorsal vs planter and Lateral vs medial was also seen in the head and compared with same
portions of the metatarsal as a whole. The relation-ship between the bone density distribution of
the 1st metatarsal bone and their biomechanical function in the gait cycle was discussed.


Bone tissue in the appendicular skeleton is
important biomechanical function withen
actively model and remodel during
the foot, being a major weight bearing
development and throughout the life to
structure. Because it is a long bone, it has a
resist the repeated mechanical loads to
different architecture than the calcaneus
which it is exposed (1). The mechanical
loads result in both pressure and tension

changes within the bone which will
Material and Methods
stimulate bone formation and remolding

(2), which include changes in bone density
Human Specimens
Thirty-eight pairs of cadaveric 1st
Measurement of bone density has
metatarsals were selected from a larger
been an important tool in the assessment of
sample cadavers available in a medical
bone strength. A well established method of
gross anatomy laboratory. After removal
assessing areal bone mineral density
from the cadavers, the 1st metatarsals were
(BMD) has been dane through the use of
stored for two weeks prior to testing in a
dual energy x­ray absorptiometry (DEXA)
1% Phenoxyethanol in water solution to
retain moisture. Medical histories and
Camacho et. al. (12) related the
causes of death were available on the
densitometric profile across the human
cadavers and they were screened and
calcaneus to the previously described
eliminated if they had a premortem history
distribution of trabecular bone strength
of prolonged immobilisation, or endocrine
within that bone (13). They found that
and metabolic disorders and other
regions of highest BMD correlated with
conditions affecting bone. All soft tissue
regions of greatest trabecular bone strength.
except cartilage, was carefully removed
The present study was undertaken to
from the metatarsals.
analyse the densitometric pattern of the

human 1st metatarsal bone. The 1st
metatarsal bone was chosen because of its

Full Paper (vol.18 paper# 2)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 16 - 22 March 2005
I.S.S.N: 12084
1687 - 2002

Protective Effect Of Ascorbic Acid On Cisplatin Genotoxicity In
Male Mice Bone Marrow Cells

Nada, H.A. Al- Twaty
Department of Biology, King Abdelaziz Universiy


Cisplatin (cis-diamminedichloroplatinum II) is an effective antitumor agent with a wide
spectrum of activity against varies solid tumors, but it has serious side effects on nontumour
cells. Cisplatin produces intra- and interstrand DNA cross-linking effects and chromosomal
aberrations in mammalian cells. Vitamin C (ascorbic acid) is an antioxidant that can scavenge
free radicals and protect cellular macromolecules, including DNA, from oxidative damage
induced by different agents. Pretreatment administration of ascorbic acid on cisplatin induced
chromosome aberrations has been determined in bone marrow cells of Swiss albino mice.
Results showed that cisplatin (7.5 & 10mg/kg bw)IP injection to male mice induced significant
increase in the frequencies of chromosomal aberrations. The results of pre-treatment with
ascorbic acid (66mg/kg bw) showed a significant decrease in the number of chromosomal
aberrations induced with cisplatin tested doses. Ascorbic acid did not exhibit any clastogenic
effect in male mice bone marrow cells. We concluded that ascorbic acid has a protective role
against the genotoxicity induced by antitumor drug cisplatin.

Key words : Cisplatin- Antioxidants- Ascorbic Acid-Chromosomal Aberration- genotoxicity -
Bone Marrow Cells- Mice.


Cisplatin (cis-diamminedichloroplat-
2001) and in erythrocytes in bone marrow
inum II) is an effective antitumor agent
cells of mice (Nakagawa et al.,1995).
with a wide spectrum of activity against
Identification and analysis of agents with
varies solid tumors, but it has serious side
anticlastogenic activity that reduce the
effects on nontumour cells, including free
frequency of chromosomal aberrations and
radical generation (Masuda et al.,1994).
possibility of practical application of
Cisplatin produces intra- and interstrand
natural protectors against the clastogenic
DNA cross-linking effects (Costa et al.,
(and mutagenic/ carcinogenic) action of
1996). This cytostatic induces chromosomal
chemical mutagens have a great importance
aberrations in cultured mammalian cells
( Nefic, 2001). Ascorbic acid (AA) is an
(Nefic, 2001) mouse bone marrow cells
essential micronutrient for man, with many
(Wiencke et al.,1979) and peripheral blood
biological roles. It is a powerful antioxidant
lymphocytes in patients (Osanto et
both directly via scavenging of reactive
al.,1991) and sister-chromatid exchanges in
oxygen species and indirectly through
human lymphocytes in vitro (Wiencke et
regeneration of other antioxidant systems
al.,1979 ; Bradley et al.,1979) and in vivo
(Griffithsa and Lunecb, 2001). Many in
(Wiencke et al.,1979). The frequency of
vivo assays found that Vitamin C
occurrence of cells with micronuclei is
successfully reduced the clastogenic effects
increased by cisplatin in human lympho-
of many antitumour agents. Vitamin C
cytes in vitro (Gebel et al.,1997 ; Nefic,
inhibited tumor cell growth, binding of the

Full Paper (vol.18 paper# 3)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18: 23 - 28 March 2005
I.S.S.N: 12084
1687 - 2002

Clastogenic Effect of Azadirachtin of Neemix-4.5
On SWR/J Mouse Bone Marrow Cells

F. M. Abou-Tarboush1; H. M. El-Ashmaoui2;
H. I. Hussein3, D. Al-Rajhy3 and M. Al-Assiry3.
1King Saud University, College of Science, Department of Zoology, P.O. Box 2455, Riyadh
11451, Saudi Arabia. 2National Research Center, Cell Biology Dept., Giza, Egypt. 3King Saud
University, College of Sciences of Foods and Argriculture, Plant Protection Dept, P.O. Box
2460, Riyadh 11451, Saudi Arabia.


The clastogenic effect of azadirachtin of neemix-4.5 was investigated in SWR/J mouse
bone marrow cells. Males and females, 5 each per treatment time, aged 10­12 weeks and
weighing 31.7­33.8 g, were orally administrated 9.0 mg/kg (1/10 LD50) of azadirachtin solution.
A control group (5 males and 5 females) received only sterile distilled water. The animals were
sacrificed 6, 12, 24, 48 or 72 h post- treatment. The chromosome preparations were obtained
from bone marrow cells. Chromatid and chromosomal aberrations were investigated in 50
metaphases per animal.
No significant differences in the frequency of chromosomal aberrations or in the
percentage of mitotic index were observed between the treated male and female mice at any
time intervals used. Hence, data from the two sexes were pooled when analyzed statistically. In
the prersent study, the dose level 9.0 mg/kg body weight of azadirachtin of neemix-4.5 did not
induce any significant (p>0.05) changes in the percentages of mitotic indices or in chromosomal
aberrations in the bone marrow cells of treated animals at all time intervals tested compared
with the control group. As the pharmacokinetics of azadirachtin is unknown, the essentially
negative results in the present study may be due to a lack of genotoxic potential .

Key Words :
Neemix-4.5, Azadirachtin, Clastogenic effect, Bone Marrow Cells, Mice


Potential problems associated with
played an important role in crop protection
(Liang et al., 2003). Azadirachtin proved to
insecticides including pest resistance and
be the dominating and most effective
negative impact on natural enemies
among several related limonoids (Ley et al.,
(Magaro and Edelson, 1990; Liang et al.,
1993 ; Adel and Sehnal, 2000). The use of
2003). Moreover, increasing documentation
azadirachtin as an insecticide is well
of negative environmental and health
documented (Rembold et al., 1989 ;
impact of synthetic insecticides and
Schmutterer, 1995 ; Kreutweiser et al.,
increasing stringent government regulation
2002), and it is known to affect feeding,
of pesticides has resulted in renewed
growth, metamorphosis and reproduction in
interests in the development and use of
insects. However, little is known about its
toxicity, mutagenicity and clastogenicity in
(Ascher, 1993; Liang et al., 2003).
mammalian species (Jongen and Koeman,
Neem-based insecticides containing
1983; Stewart, 1998; Akudugu et al., 2001;
azadirachtin that was derived from extracts
Awasthy, 2001; Salehzadeh et al., 2003).
of neem tree, Azadirachta indica, have
Hence, the aim of the present study was to

Full Paper (vol.18 paper# 4)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 29 - 36 March 2005
I.S.S.N: 12084
1687 - 2002

Survey For Detection and Determination of Aflatoxins M1 and B1 in
local Milk and Certain Dairy Products by Thin Layer
Chromatographic Method.

T.A. Nassib *,S.N. Guergues** , M.M. Motawee**

*Faculty of Agriculture Mansoura Univ, **National Organization for Drug
Control and Research.


90 different type of milk samples, 10 Yogurt Samples, 110 different type of cheese
samples and 10 ice cream samples were collected randomly from Giza Governorate during the
summer of 1998 ­ 1999, for detection and determination of Aflatoxins M1& B1 by using thin
layer chromatographic method. Results revealed that the average range of Aflatoxin M1 in milk
samples amounted from 0.144 to 0.378 ng/ml. About 20 % of cows and buffaloes milk samples
contained form 0.378 to 0.342 ng/ml of AFM1, whereas about 10% of other milk samples were
contaminated with 0.162, 0.288, 0.324, 0.234, 0.144 and 0.162 ng/ml for skim , Pasteurized ,
sterilized, UHT, powder, and baby milk, in the same order. Concentrations of AFM1 detected in
cheese samples, furthermore, varied due to the type and age of cheese being examined. 20% of
cheese samples were contaminated with AFM1 being 5.1, 3.2, 2.99, 2.099, and 2.34 ng/gm for
fresh Domiati, aged Domiati, Processed and Karish cheese, respectively, whereas, 30% of the
other types of cheese contained 5.88, 6.3 and 3.4 ng/gm for Roquefort, fresh Romi, and
Cheddar cheese, respectively. The lowest concentration of AFM1, of 0.116 ng/gm was detected,
however, in 10% of yogurt samples. Meanwhile, 20% of ice cream samples were found to be
contaminated with 2.7 ng/ml, and 10% of Feta cheese samples contained 3.3 ng/gm. It could
also be appeared from results that both of cream and spread cheese were found completely free
from this Aflatoxin, the lowest content of Aflatoxin detected in all of the above examined
samples was 0.116, 0.162, 0.162 and 0.216 (ppb) in yogurt, skim, baby milk and cream,
respectively. On the other hand, results also indicated that all milk samples were free from
Aflatoxin B1 except one sample of skim milk (out of 10) which gave positive result.


Aflatoxin is a collective term that
potent hepatocarcinogens in several species
refers to a group of highly toxic and
of animals (Eaton and Callagher, 1994).
Aflatoxin M1 is a major metabolite of
produced by some common molds as
AFB1 found in milk animals that have
parasiticus during their growth on foods
aflatoxin B1 (Blanco et al., 1993; Govaris et
and feeds or laboratory media (Marth,
al., 2001 and Ciapara et al., 1995).
1979 , Rhona et al., 1982 , Wood, 1989 and
Aflatoxin sometimes can appear in
Piva et al; 1995 ).
milk, cheese and other dairy products. That
Aflatoxins B1 and M1 are known as
aflatoxin can appear in milk has been
hepatotoxins and hepatocarcinogens and the
recognized since 1962
deleterious effects in humans, especially
Carnaghan.,1962 and De Iongh et al. 1964).
children, of consuming AFM1-contaminated
Usually some of the ingested AFB1 is
milk are of considerable concern (Qian et
converted to AFM1 by the liver of the cow
al., 1984, Chu, 1991). furthermore, they are
and this form of aflatoxin is excreted in the

Full Paper (vol.18 paper# 5)

Study of the single and combined genotoxic effects of chlorpyrifos and quercetin in Saccharomyces cereviciae T
he Egyptian Journal of Hospital Medicine Vol., 18 : 37 - 42 March 2005

1687 - 2002

Study of the single and combined genotoxic effects of chlorpyrifos and
quercetin in Saccharomyces cereviciae

Nada, H. A. Al-Twaty
Department of Biology, King Abdelaziz University

The genotoxic effects of chlorpyrifos and quercetin either single or combined were tested
in terms of their ability to induce reverse mutation, gene conversion and mitotic crossing over in
Saccharomyces cereviciae D7. The results indicated that all single and combined treatments
induced reverse mutation, gene conversion and mitotic crossing over in Saccharomyces
D7. Combined treatment was more effective than the single treatment of quercetin.
The insecticide (chlorpyrifos and quercetin which are common flavonoids) proved to be
mutageneic in Saccharomyces cereviciae.


In many genetic investigation the
mutagenic in a variety of genotoxicity tests
organophosphorus insecticides has been
(Muller et al., 1991 and Caria et al., 1995).
reported as a potent genotoxic agents
The conflicting inform-ations on the
(Abdallah et al. (1973); Villani et al.
genotoxicity of chlorpyrifos and quercetin
(1983); Nafei et al. (1984); Salam et al.
from previous studies reported in the
(1984); and Mansour et al. (1988)). The
literature led to us to study the genotoxic
induction of mitotic crossing over in diploid
effects of both of them in single and
yeast Saccharomyces cereviciae is strongly
combined forms.
correlated with the mutagenic effects.

These tests very sensitivity react with
Materials and methods
substitution as well as from-shift mutations.

This system has revealed the genetic
1- Yeast strain:
activity of large number of carcinogens,
The D7 strain of Saccharomyces
pesticides, radiation and many other
cereviciae was used as a test oragnism
(Courtesy of F. K. Zimmermann. Darmstad,
Elsenbrand, (1974); Zimmermann et al.,
Germany). This strains has the following
(1975); Altwaty, (1999); Anjaria and Rao,
genotype: ade2-40 / ade2-119, trp5-12 /
(2001) and Buschini et al., (2003 and
trp5-27, ilvl-92 / ilvl-92. It is used for the
simultaneous detection of induced reverse
Quercetin is one of the most common
mutation, mitotic gene conversion, and
flavonoids in plants, widely distributed in
mitotic crossing over (Zimmermann et al.,
natural foods, consumed by humans in a
range of 50 mg per day (Brown and

Dietrich, 1979 and Caria et al., 1995).
2- Chemicals
Quercetin was shown to be mutagenic in

the Ames assay (Bjeldames and Chang
a. The insecticide chlorpyrifos was obtained
1977; MacGregor and Jurd 1978; Brown
from Hanoo Agricultural, the sole agent in
and Dietrich 1979 and Rueff et al., 1986).
K.S.A.,P.O. Box.4894 Riyadh 114412.
Also it has been shown to be carcinogenic
Manufactured by Chemac-Agriphar / Rue
in rats (Pamukcu et al., 1980), to be
De Renory, 261B-41020 Ugree/Belgium.


Full Paper (vol.18 paper# 6)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 43 - 47 March 2005
I.S.S.N: 12084
1687 - 2002
Comparison between some different methods for determination of
Aflatoxin M1 in milk and some diary products

T.A. Nassib *,S.N. Guergues** , M.M. Motawee**
*Faculty of Agriculture Mansoura Univ, **National Organization for Drug
Control and Research.


Seven TLC methods for evaluate the incidence of Aflatoxin M1 in milk and dairy products
were used, Pons et al. (1973); Fukayama et al. (1980); Stubblefield (1979); Official Method of
Analysis (1995); Van Egmond and Stubblefield (1981); Official Method of Analysis (1984) and
Official Method of Analysis (1990) , to detect the sensitive method among them for
determination of Aflatoxin M1 (AFM1). Results show that, the Official Method of Analysis,
1995 (AOAC, 1995) was the sensitive method for determination of AFM1 among the all tested
methods, where it gives the highest recovery percentage for liquid milk, Cheese, and Powdered
milk, 106.2%, 95.99% and 104.4% respectively. While Stubblefield, (1979) method gave about
75% AFM1 recovery for Yogurt, but when we made a slight modification on it gave 92%
AFM1 recovery.

Aflatoxin M1 is 4-hydroxy-aflatoxin
Seven TLC methods were used during
B1 and Aflatoxin M2 is 4-dihydroxy-
the course of the present work to evaluate
aflatoxin B2. Aflatoxin M1 appears in milk
the incidence of Aflatoxin in milk and dairy
or dairy products as direct result of the
products. These methods are indicated as
ingestion of feeds contaminated with
Aflatoxin B1 by cattels. The carry-over of
1- Pons et al. (1973).
AFB1 also to milk may vary largely from
2-Fukayama et al.(1980)
animal to animal, from day to day, and from
3-Stubblefield (1979)
one milking to the next (Van Egmond and
4-Official Method of Analysis (1995)
Dragacci, 2001). According to the U.S
5-Van Egmond and Stubblefield (1981)
Food and Drug Administration (FDA),
6- Official Method of Analysis (1984)
AFM1 should not exceed 0.5 ppb (Stoloff
7-Official Method of Analysis (1990)
1980 and Van Egmond 1989 a,b). Many

chromatographic method of analysis have
Extraction Of Aflatoxin In Milk And
become available for the determination of
AFM1 in milk and milk products. Most of
The thin layer chromatography
these were developed for the analysis of
method (AOAC,1995, official method
milk and milk powder, but they can often
980.21) was adopted.
be used for other dairy products as well,
a-Extraction ( According to AOAC,1995 )
with minor modifications (Stubblefield and
b-Column chromatography. ( According to
Van Egmond, 1990).
AOAC,1995 )
The aim of this experiment is to detect
c- Thin layer chromatography. ( According
the sensitive method among 7 different
to AOAC,1995 )
methods used for determination of

Aflatoxin M1 (AFM1)
Visual analysis (Milk)

( According to AOAC,1995 )
Material and methods
Visual Analysis (Cheese):
Evaluation of the TLC Methods Used
( According to AOAC,1995)
for the Detection of Aflatoxins in Milk and
Densitometric measurements:
Dairy Products:
( According to AOAC,1995 )

Full Paper (vol.18 paper# 7)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 48 - 65 March 2005
I.S.S.N: 12084
1687 - 2002
Response Of Mice Tissues To Intranasal Bacterial Lysate
Vaccination: Immunohistopathological Study

Hanaa A. Mansour

Pharmacology department (Medical microbiology and immunology unit), National
Organization for Drug Control And Research (NODCAR), Giza, Egypt


Effective protection against pathogenic bacteria requires both mucosal and systemic
immune responses. Intranasal administration of antigens induces these responses. The protective
effect of intranasal immunization with different formalin-inactivated bacterial lysates in albino
mice was evaluated. This study used formalin inactivated lysate of each of the following
Escherichia coli , Pseudomonas aeroginosa ,Salmonella typhi , Shigella flexeneri ,
Staphylococcus aureus , Bacillus subtilis
and mixed bacterial lysates. The lysate was
administered intranasally (5µl/ nostril) once daily for seven consecutive days. The results of
this study recorded some changes in peripheral blood total and differential leucocytic counts ,
peritoneal fluid and bone marrow lymphocytic percentages . Spleen and thymus weight changes
were reported under the effect of Salmonella typhi lysate, Shigella flexeneri lysate and Staph.
aureus lysate.
The level of immunoglobulin G (Ig G) was assessed in serum, bronchial lavage
and nasal bed harvest. The levels of Ig G were significantly elevated in the three determinants,
suggesting an efficient immunostimulatory effect of bacterial lysates. Some of these levels were
exceeding 2-3 folds of that of the control group. Histopathological studies recorded changes in
some reticuloendothelial system organs including the liver, spleen and thymus gland, besides,
some changes were also observed in the lung and bronchi under the effect of intranasal
vaccination. This study supports the immunoprotective effect of intranasal vaccination, using
bacterial lysates.


Effective protection against respira-
immunostimulant activities of whole cell
tory tract pathogens requires both mucosal
bacterial lysates.
and systemic immune responses. Intranasal
Bacterial vaccines can be applied
administration of antigens induces these
effectively through the intranasal route (Orr
responses. Intranasal immunization is more
et al., 1993 and Ambrosino, 1996).
effective than oral immunization, as it
Bonenfant et al. (2001) mentioned that the
generates an earlier and stronger mucosal
ability for increasing systemic and mucosal
immune response (Hirabayashi et al.,
responses may be of great importance for
1990). Inactivated whole bacterial cell
the development of an efficient vaccine.
suspensions are probably the most common
Furthermore, the intranasal route requires
type of vaccine used in domestic animals.
less antigen than the oral route because
These vaccines proved to be extremely
there is much less proteolytic activity in the
effective and safe to use even in young or
nasal cavity. This route effectively
pregnant animals (Bey et al., 1997).
promotes the production of both systemic
Havlasova et al. (2002), have detected more
and mucosal immune responses to the
than 80 different immunorelevant antigens
antigen (Wu and Russell, 1997). Di-
came from whole cell bacterial lysate of
Tommaso et al. (1996) and Partidos et al.
Francisella tularenis. Such antigens are
(1999), showed that bacterial enterotoxins
act as appropriate mucosal adjuvants


Full Paper (vol.18 paper# 8)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 66 - 72 March 2005
I.S.S.N: 12084
1687 - 2002

Ambivalent property of bilirubin in human bile juice

Anna Blázovics, Péter Sípos, Ferenc Örsi,* Mervat Abdel Rahman**
Semmelweis University, Budapest, Hungary, *Technical University of Budapest,
Hungary, ** Student Hospital, Cairo University, , Giza

Gallstones are formed as a result of many metabolic disorders e.g. chronic haemolytic
anaemia, diabetes mellitus, ileal diseases, short bowel syndrome, gluten sensitive enteropathy,
elevated serum lipids or Crohn's disease. The relationship between gallstone disease and free
radical reactions is not known exactly even today. Free radicals are involved in many clinical
conditions e.g. in hyperlipidemia and in fatty liver. Oxygen free radicals are produced and
accumulated while the function of mitochondrial and microsomal electron transport or in
peroxisomes and the activated arachidonic acid cascade. Spontaneous lipid peroxidation and
oxygen free radical products of respiratory burst of Kupffer cells can be added to peroxide pool
of liver tissue. Tissues, cells and subcellular particles exhibit different specific defence activities
in pathological processes, which involve free radicals.
The activity of microsomal P450 enzyme system and the microsomal structure are
changed during pathological free radical attack and the cholesterol/bile acid ratio in bile juice
is also altered. At the same time bilirubin metabolism can also be modified.
Bile samples of 88 cholecystectomysed patients in both sexes (male: 29, female: 59) were
examined. HPLC analysis (HP1090 liquid chromatograph with diode array detector) was used
for the detection of free bilirubin and bilirubin derivates. HP5890 gas chromatograph and flame
ionization detector was used for fatty acid analysis. The induced chemiluminescence intensity
was also determined in bile juice with (Berthold Lumat 9501) luminometer.
As results show, the occurrence of C18:1 9, C18:2 6, C20:4 6 fatty acids were in high
percentage in gallbladder bile in every case of randomly chosen 17 cholecystectomysed patients
in both sexes suffered from cholecystitis chronica with gallstone. Lipid peroxidation products
(diene conjugates and malondialdehyde) were detected in all cases of bile as well. Mathematical
statistical analysis showed, that positive significant correlation was between low concentration
of total bilirubin of gallbladder bile and chemiluminescent intensity in hydrogen peroxide -
luminol system. Extra high chemiluminescence light could be detected in bile samples of
patients with severe clinical state. Bilirubin pro-and antioxidant forms are justified in human
gallbladder bile.

Key words:
bilirubin, human bile, gallbladder, gallstones, free radicals.


Due to deranged liver structure and function
nucleation process (Levy et al.,1984, Cohen
both mechanism of biliary passage and
et al.,1985 Carey 1988, Trotman 1982).
composition of bile juice are changed
Supersaturation of bile with calcium
significantly (Cohen and Soloway 1985,
hydrogen bilirubinate is essential for
Abdel Rahman 1995, 1996, Sipos 2001,
Bosma et al., 2003).)
gallbladder bile in brown or black pigment
Cholesterol supersaturation, gallbald-
gallstone diseases is usually not saturated
der hypomotility and mucin hypersecretion
with cholesterol and contains an increased
are essential for the formation of cholesterol
proportion of mono-and unconjugated
bilirubin IX.. Bilirubin hypersecretion can
stimulates the formation of gel matrix lining
be observed in haemolytic disorders or
the gallbladder wall and accelerates the
enterohepatic cycling in nonhaemolytic

Full Paper (vol.18 paper# 9)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 73 - 87 March 2005
I.S.S.N: 12084
1687 - 2002

Female Breast Cancer: Epidemiological And Clinical Study Of Some
Risk Factors Among Egyptian Females- Multi Clinics Study

E. A. El-Moselhy; M. A. S. Ahmed*; A. M. Abdel-Fattah*; A. Y.
Mohammed*; T. A. Selmy*; H. M. Sakr**; A. Abusrie***;
M. A. Fahmy***And A. S. Salem****
Departments Of Community Medicine; General Surgery*; Radiation Oncology**;
Medical Biochemistry*** And Pathology****
Faculty Of Medicine, Al-Azhar University And The Teaching Hospital Institute

This study was conducted on 390 female breast cancer patients and an equal number of
females as controls. The patients were attending some University and Teaching Hospitals in
Cairo and Assuit. Ninety of them were newly operated. A retrospective, case-control, clinic
based study was chosen to carry out this research. The aim of the study was to describe the
sociodemographic, characteristics and clinical features of female breast cancer and to determine
its risk factors among Egyptian women. All the patients and the controls had undergone
physical examinations. Laboratory investigations were done for the newly operated patients and
their controls. The most important characteristics of breast cancer patients were breast mass as
the main presenting symptom (92.1%) and treated by modified radical mastectomy (77.2%).
Low means level of serum vitamin D and high levels of serum cholesterol and triglyceride were
found more among the patients. Age at first full term pregnancy 30 years, age at menopause
45 years, pregnancy termination and/or abortion and never married were important
gynaecological and reproductive risk factors (OR=4.44, 3.14, 2.84 and 2.67, respectively). Also,
exposure to radiation and/or environmental factors, history of benign breast disease and alcohol
use were important associated risk factors (OR=5.05, 4.63 and 4.10, respectively). Moreover,
the sister as the nearest female relative with breast cancer, total number of female relatives with
breast cancer 2 and relative(s) age at diagnosis <50 years were important family history risk
factors (OR=9.19, 8.84 and 7.91, respectively). Lastly, high consumption of canned foods, fat
rich foods and low consumption of fresh fruits and vegetables were important dietary risk
factors (OR=3.39, 1.76 and 1.51, respectively).

Cancer is the nation's leading health
woman's chance of surviving breast cancer
concern (Smith et al., 2004). Breast cancer
(Parker et al., 1997).
affects one in every eight women during
It must be translated to public health
their entire life in United States (US)
and clinical interventions that reach all
members of our society and achieve our
Prevention, 2001). It is the leading cause of
mission of diminishing suffering and saving
cancer among women in US with 203,500
lives. We still may not be able to `cure'
new cases expected annually and it is the
cancer, but we have made significant
second cause of cancer death, 39,600 deaths
advances in cancer prevention (Vance et al.,
per year (American Cancer Society, 2002a).
2004). Reducing cancer incidence through
Also, 17.5% and 27.4% reported increase in
primary prevention is the most desirable
incidence and mortality rates between 1970
goal, chemoprevention and vaccines hold
to 2000 (Thun and Jemal, 2003). Moreover,
the greatest promise (Ford et al., 2003).
it represented 31.0% and 15.0% of all
Organized screening programs with high
cancers and cause of cancer death among
rates of attendance can greatly reduce breast
women in US, respectively (American
cancer mortality (Smith et al., 2003).
Cancer Society, 2002b). Better detection
Breast cancer is typically a disease,
and treatment modalities have improved a
which occurs with advancing age (Feuer et

Full Paper (vol.18 paper# 10)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 88 - 115 March 2005
I.S.S.N: 12084
1687 - 2002

Modifying effects of Soybean and Nigella Sativa against Experimental
Hepato-carcinogenesis induced By Nitrosamine Precursor in Rats.
(Histopathological and electron microscopically study)

*Hanaa F. Waer, **Abdel Baset EL Asser, ***Hamdy A. Ibrahim,
***Maher M. Khalifa, **Saad M Elgendy, and**** Khaled I. Magrabi
*National center for radiation research and Technology Atomic Energy Authority Cairo Egypt
**Cancer Biology Depart. Cancer Institute, Cairo University ***Zoology Depart. Faculty of
science Mansora and Cairo University Cairo ****Zoology Depart Faculty of Medical
Technology Alfatah University Libya

Cancer has become an important topic in medicine since it is a major cause of death in the
developing countries and it is now only secondary to that of myocardial infraction. Nitrosamines
precursors are known to be carcinogenic to humans, in various organs at relatively low levels of
exposure. It induces benign and malignant tumors especially liver tumors following its
administration by various routes, including ingestion and inhalation. Humans may be exposed to
Nitrosamines through the ingestion of food that contains it, such as cured meat products, and
smoked fish. Other exposures to Nitrosamines may be from drinking contaminated water and
from breathing cigarette smoke and contaminated ambient air. Individual are most likely to be
exposed to Nitrosamines in occupational settings such as in the rubber, tannery, fish processing,
dyes, and surfactant industries. The prevalence of liver tumors throughout the world makes in
imperative to seek chemo preventive agents.
Vegetables, natural products of plant origin and numerous non-nutritive dietary
constituents have been shown to play a salutary role in cancer chemoprevention. The present
study aims to evaluate the chemo preventive efficacy of soy bean and Nigella sativa on hepato-
carcinogenesis induced by dibuty1 nitrosamine (DEN).
It could be observed that both soy bean and Nigella sativa have a good effect of
amelioration against liver hepatoma induced by nitrosamine. Soy bean more or less showed
more prerogative effect than Nigella 9 and 12 months after administration.

Nitrosamine is volatile, clear yellow
of laboratory animals (Magee & Barnes,
oil that is soluble in water, alcohol, ether,
1967). There is growing concern with
other organic solvents, and lipids. The
regard to certain nitrosamines as etiological
compound is sensitive to light, especially
agents for cancer in the human environment
ultraviolet light, and undergoes relatively
(Lijinsky & Epstein, 1970). It is generally
rapid photolytic degradation. When heated
accepted that the use of nitrite as a food
to decomposition, N-nitroso-dibutylamine
preservative may be associated with the
emits toxic fumes of nitrogen oxides (NO).-
formation of nitrosamines in foods as well
N- nitroso-dibutylamine is used primarily
as in the animal organism. The nitrosamines
as a research chemical. It is used as a
vary in their carcinogenic potential. They
gasoline and lubricant additive, antioxidant,
can induce malignant tumors at very low
stabilizer, fiber industry solvent, copolymer
levels, such as 2 ppm (0.0002%) in the diet
softener and starting material for synthesis
of rats (Terracini et al., 1967), equivalent to
of 1, 1- diethyl hydrazine. It is also used to
daily doses of 0.1 mg/kg bw. A single oral
increase constants in condensers.
dose of 30 mg/kg BW of nitrosamine
proved to be carcinogenic in the rat
carcinogenic property of nitrosamine many
(Druckrey et al., 1969). Tumors of the
other nitrosamines have been found to
trachea developed in the offspring of
induce malignant tumors in various species
hamsters treated either during pregnancy or

Full Paper (vol.18 paper# 11)

Effects of food preservatives and food coloring agent on some physiological and hematological parameters in albino rats The Egyptian Journal of Hospital Medicine Vol., 18 : 116 - 123 March 2005


1687 - 2002

Effect of food preservative and food coloring agent on some
physiological and hematological parameters in albino rats and the
protective role of garlic

Eman G.E. Helal* and Mervat Abdel- Rahman**

*- Zoology Department, Faculty of Science, Al- Azhar University (Girls).
**- Clinical Pathology Lab., Student Hospital, Cairo University.


Most children, in the age of nursery consume food that contains both colorants and
preservatives with great amount. This observation led us to study the interaction between
sodium nitrite as a food preservative and sun set yellow as a coloring agent. The mixture of the
two agents at the limited dose of each was found to be a lethal dose. So, 1/10th of this dose was
used daily for 30 days. Animals were divided into three groups. The first group served as a
control, while the second group was orally administered a mixture of 10 mg sod.nitrite
(NaNO3)/kg mixed with 0.5 mg/kg/day sun set yellow (S.S.Y). The third group received garlic
(5 mcg/kg) in addition to the above mentioned mixture. After 30 days of treatment, half of the
animals from each group were decapitated. The other half of the animals was left for another 15
days without any additional treatment as a recovery period.
Ingestion of the mixture of (NaNO3 and S.S.Y) significantly decreased rat body weight,
RBCs and WBCs counts, Hb%, Hct%. No changes were recorded for organ/ body weight,
respiratory rate, heart rate, rectal temperature.
A complete recovery from the abnormalities of most physiological and hematological
parameters was observed after the recovery period or when garlic was administered.
Key Words: Garlic, antioxidant, preservatives, colorants.


such food, the percentage of nitrite content
internationally added to food. They may be
of the daily food ratio may be higher than
natural or synthetic (Harris, 1986). The
the admissible level (Bilczuk et al., 1991).
principal classes of food additives are
Apparently very little nitrites are formed by
coloring agents, preservatives, flavors,
endogenous synthesis and most, if not all,
emulsifiers and stabilizers (Lindsay, 1985).
are of dietary origin (Bartholomew and Hill,
include sodium nitrate, sodium nitrite, sulp-
Food colorants may often be
her dioxide, sodium bisulphate, potassium
considered simply cosmetic in nature, but
bisulphate, ect and disodium EDTA.
its role is very significant. Both food quality
One of the principal preservatives are
and flavor are closely associated with color.
the nitrites which are used in the form of
Consumers are conditioned to expect food
salts or free acids (HMSO, 1987). The use
of certain colors and to reject any deviation
of sodium nitrate as a preservative is
from their expectations (Amerine et
common in cooked meat, sausages and the
milk used for some types of cheese.
Every food designer knows that
Because of the use of more than one type of
consumers judge a product not only on its

Full Paper (vol.18 paper# 12)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 124 - 132 March 2005
I.S.S.N: 12084
1687 - 2002

Serological And Haematological Responses To Experimental
Fascioliasis And Treatment

Nour El Din H. Sherif1, Ismail M. Shalaby1, Maha F. Soliman1,
Mohamed G. Hassan2
1Zoology Department, Faculty of Science, Suez Canal University, Ismailia, Egypt.
2Parasitology Department, Faculty of Veterinary Medicine, Suez Canal University,
Ismailia, Egypt.

This study was established to evaluate and monitor both the humoral and haematological
responses to Fascioliasis and its treatment in rabbit model. Rabbits were orally inoculated with
viable F. gigantica metacercariae and then divided into four groups. Infected rabbits were orally
administered a single dose of Triclabendazole (TCBZ) (10 mg kg-1) at week 4, 8 or 12 post-
infection (pi), respectively. Antibody (Ab) response against infection was monitored using
enzyme linked immunosorbant assay (ELISA). Total red blood cell counts (Rbcs), haemoglobin
content (Hb) and total and differential white blood cells (Wbcs) were also determined. Infected
rabbits were found to produce Ab against excretory-secretory products (ESP) of adult flukes
two weeks pi where ELISA enabled the early diagnosis of infection. Ab level reached to the
peak at week 10 pi. In TCBZ-treated groups, the early Ab responses prior to treatments were
similar to response of infected-untreated rabbits. But, after different treatment regimens, Ab
levels showed a significant decreases that were depended mainly on both time and hence
efficacy of the treatment. In addition, significant reductions in both Rbcs and Hb values
accompanied with mild anemia were found among infected group at week 12 &10 pi,
respectively. TCBZ-treatment prevented the development of anaemia. Eosinophil numbers
significantly increased starting from week 2 pi and peaking at week 4 or 6 pi in all groups.
Hence, both eosniophilia and anaemia might be characteristic aspects for experimental

Key words: Fascioliasis, Triclabendazole, enzyme linked immunosorbant assay, haematology

Fascioliasis is a well-known parasitic
successfully allover the world. According to
disease because of its veterinary importance
WHO (1998), Triclabendazole (TCBZ), a
and the great losses it causes in livestock
benzimidazole compound, has recently
production (Mas-Coma & Bargues 1997).
been registered in Egypt for the treatment
Fascioliasis is also now an important human
of human fascioliasis. TCBZ has been used
parasitic disease, with estimated ranging
in veterinary practice for fascioliasis since
from 2.4 to 17 million people infected.
1983. However, time was not too far to
(Mas-Coma et al., 1999). The number of
recognized that TCBZ resistant liver flukes
cases of human fascioliasis reported in
generated in buffaloes would be transmitted
Egypt has increased drastically during the
to other ruminant species as well as human
past years (Curtale et al., 2003).
(Sanyal, 1998).
At present, it is essential that methods
Many literatures have been cited
to control the disease involve a chemothe-
about the role of enzyme-linked immunos-
rapeutic strategy based on epidemiological
orbent assay (ELISA) in diagnostic purpose
knowledge. It is therefore necessary to
for fascioliasis (Levine et al., 1980,
develop methods for early diagnosis and to
Cornelissen et al., 1992; Guobadia &
assay drugs which are effective against
Fagbemi, 1996; Martinez et al., 1996). On
developmental stage of Fasciola (Martinez,
the other hand, little is known about the
et al., 1997). In this regards, large numbers
various mechanisms of immunomodulation
of fasciolicides are available and used
that occur either during fascioliasis or

Full Paper (vol.18 paper# 13)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 133 - 141 March 2005
I.S.S.N: 12084
1687 - 2002
Developmental and Histological Studies of Fungiform Papillae
in Fetal Human Tongue

Lotfy Sayed *, Atef Ibrahim *, Esam Abdelhady *, Hosam El-Din
Hussin * and Ghassan Ahmed **
*Departments of Anatomy and Histology-Faculty of Medicine Al Azhar University
** Catalyst, USAID (United States Agency for International Development)

This study was designed to evaluate the histological development of fungiform papillae of
human tongue during the prenatal period.
Lateral Sagittal sections were taken at autopsy from the anterior two-third of 18 aborted
fetuses of 8, 10, 12, and 20 weeks of gestations and 2 stillborn infants at 40 weeks of gestation.
Twenty specimens were prepared in paraffin and stained for histological study. The gestational
ages were calculated after measuring the Crown Rump Length [C.R.L.]. It was found that the
first appearance of fungiform papillae was nearly about the 10th week of gestation, before the
appearance of filiform papillae, most of the developed fungiform papillae were cylindrical in
shaped with appearance of nerve plexus, at 12th week they reached mushroom shaped with
narrow base and broad apex and became differentiated into primary and secondary papillae, also
presumptive taste buds were noticed at this age in the form of multiple local thickening of
papillary epithelium. At 20th week of gestation the taste buds became more developed, the
papillae appeared more vascular. At full term (40th week) the fungi form papillae reached full
It is concluded that this study suggests that the development of fungi form papillae
requires an epithelial and mesenchymal interaction during morphogenesis

Microscopic studies have been made
indication of tongue development. Soon,
on the prenatal developing fungiform
two oval distal tongue buds (lateral lingual
papillae and Innervations in human fetal
swellings) developed on each side of the
tongue. Their relation to vascularization
median tongue bud. The two lateral
and Pansky (1982) explained that the
elevations rapidly increased in size, merged
development of the tongue from the
with each other and overgrew the median
branchial arches and explained its nerve
tongue bud. The merged distal buds formed
supply. The sensory nerve supply to the
the anterior two thirds or oral part of the
mucosa of almost the entire anterior two
tongue. The median tongue bud formed no
thirds of the tongue was from the lingual
recognizable portion of the adult tongue.
branch of the mandibular division of the
Romanes (1993) stated that the
trigeminal nerve (the nerve of the first
branchial arch mesenchyme formed the
branchial arch). Although the facial nerve
connective tissue, the lymphatic tissue and
was the nerve of the second branchial arch,
blood vessels of the tongue and probably
its chorda tympani branch supplied the
some of its muscle fibers. Most of the
anterior two thirds of the tongue except for
tongue musculature was derived from
the vallate papillae.
myoblasts that migrated from myotomes of
Moore (1982) stated that around the
the occipital somites.
end of the fourth week, a median somewhat
triangular elevation appeared in the floor
tuberculum impar arose from the caudal end
of the pharynx just rostral to foramen
of the first branchial arch and the lateral
caecum. This elevation, the median tongue
lingual swellings resulted from proliferation
bud (tuberculum impar) gave the first
of mesenchyme in the ventromedial parts of

Full Paper (vol.18 paper# 14)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 142 - 170 March 2005
I.S.S.N: 12084
1687 - 2002

Histological and Ultrastructural Changes of the Brain, Pancreas and
Ileum of diabetic and nondiabetic mice under heat stress with special
reference to heat shock proteins.

Hamdy Hamed Swelim
Department of Zoology , Faculty of ScienceAin Shams University


The current study was designed to evaluate the thermal stress effect on brain, pancreas and
ileum in normal and alloxan-diabetic mice by studying the structural changes at both light and
electron microscopical levels and by studying the molecular changes expressed through the
examination of protein banding pattern in the electrophorograms of the different groups . The
animals were divided into four main groups; control mice, alloxan diabetic mice, heat-stressed
nondiabetic mice and heat-stressed diabetic mice.
No remarkable changes could be detected in nonstressed diabetic animals except the
ultrastructural changes noticed in B cells of islets of Langerhans in pancreas. The heat-stressed
nondiabetic animals displayed various cellular and subcellular changes in the organs of study,
which were focal in most of the cases. Signs of restitution were also noted in the three selected
organs in this group . On the other hand, heat stress was so much destructive in diabetic mice
and that was so clear specially in pancreas. The difference in degree of cellular injury between
diabetics and nondiabetics is correlated with data of protein studies which demonstrated more
expression of heat stress proteins (HSPs) in nondiabetics and attenuation of this expression in
diabetics. These stress proteins are suggested to play an important role in protection against
thermal stress injury. Consistent with this, the brain which showed more expression of HSPs
was the least affected of the three organs. Moreover, the attenuated expression of these HSPs in
diabetics highlights the suggestion that diabetes deranged the stress response and delayed the
expression of the protective HSPs.
In conclusion further studies are needed to characterize the molecular structure of the
HSPs and the genes responsible for the expression of these proteins in these tissues and the
other body tissues .


The exposure of human being to heat
Rousseaux, 1991). On the other hand,
stress is widespread specially among the
nonlethal heat stress causes subcellular
military people during military maneuvers,
changes in macromolecules, destabilization
in various industries, specially those using
of multimolecular structures, and induction
high temperature furnaces like metallic
of increased rates of metabolic reactions
industries, in ordinary bakeries (specially
followed by disregulation of these reactions
those in rural areas), also in hot storms
(Kelty et al., 2002). All these reactions are
during the summer and sometimes during
named stress response, which is a universal
mechanism developed by all organisms to
deal with adverse changes in environment,
hyperthermia in a time-temperature-depe-
which lead to synthesis of stress proteins.
ndent manner and cell death occurs within
Moreover, exposure of cells to nonlethal
hours. Therefore, a considerable current
heat shock results in transient resistance to
interest in combining hyperthermia with
subsequent exposures at elevated temper-
various ionizing radiation protocols in order
atures (Gabriel et al., 2002). The complic
1 -42
to increase the effectiveness of radiotherapy
ations which usually develop in humans
is greatly increasing (Haschek and
and in animals after thermal injury are

Full Paper (vol.18 paper# 15)

Default Normal Template The Egyptian Journal of Hospital Medicine Vol., 18 : 171 - 185 March 2005
I.S.S.N: 12084
1687 - 2002

Systemic Correlative Study between Systemic Lupus Erythematosus,
Osteoporoses And Dehydroepiandrosterone-S(DHEA-S)level In
Premenoposal Egyptian Women

*El Shafaey M. ,**Eman G.E. Helal, ***Abeer S.M. Gawish,
**Hala H. Elsayed
*Internal Medicine Department. Faculty of Medicine, Ain Shams University
**Zoology Department. Faculty of science Al Azhar, University.
***Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of
dentistry (girls) Al Azhar, University.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease commonly occurs in of
childbearing age, with connective tissue inflammation particularly joints and causes
characteristic rashes.
Subjects & Methods: the present study includs30 premenopausal females, they were
divided into 3 groups. Group I consists o ten premenopausal females without SLE, Group II
include ten premenopausal females had SLE,disease duration less than three years, Group III
include ten premenopausal females had SLE,disease duration more than three years. Bone
mineral density (BMD) in the heel of right foot by Achilles Express in all groups had been
performed. Estimation of the serum level of Dehydroepiandrosterone Sulphate (DHEA-S)
hormone and serum level of calcium, phosphorous ,sodium and potassium.
Results: the results of the present study showed that in group II the BMD was 10% with
osteoporotic , 40% with osteopenic and 50% with normal BMD, group III the BMD was 10%
with osteoporotic , 60% with osteopenic and 30% with normal BMD. The correlations were
done between BMD and serum minerals calcium, phosphorous, sodium and potassium in SLE
patients ( Group II&III). Statistically high significant increase was found among osteopenic
versus control women. Moreover a significant increase of serum calcium and sodium while
there was a significant decrease in serum DHEA-S, phosphorous and potassium.
Conclusions: There is a relationship between level of DHEA and the progression of
SLE. Moreover there is relation between the decline in serum levels of DHEA-S and
phosphorous , and the elevation of serum levels of calcium and the occurrence of osteoporosis
in SLE.
Treatment with DHE is beneficial in controlling of the disease activity in LES patients.


Systemic lupus Erythematosus (SLE)
is the prototypical autoimmune disease
classified into SLE , Discoid lupus
characterized by the production of
Erythematosus (DEL) , chronic cutaneous
numerous autoantibodies (Arkrachaisiri &
lupus erythematosus , neonatal lupus
lehman, 1999)
erythematosus and drug-induced LE
The particular etiology of SLE is
unknown, but immunocomplexes autoa-
SLE affect female who is 20 to 40
ntibodies , genetic ,environmental and
years of age, it is a disease with
endocrinal factors may play significant
multiorgan involvement. According to the
roles (Rubin,1999). About 98% pf SLE
American Rheumatism Association the
patients have positive antinuclear antib-
diagnosis of SEL requires to fulfillament
odies (ANA) test, which are circulating
of four of eleven criteria (Dieppe et
and playing a role in the damage of several
al.,1985) which are :Cutaneous malar rash,
organs involvement (Evans,1998).
Discoid scaly rash , Alopecia ,Raynud's

Full Paper (vol.18 paper# 16)