Serum level of Matrix metalloproteinase-9 in patients with systemic lupus erythematosus
The Egyptian Journal of Hospital Medicine Vol., 20: 1 7 September 2005
Serum level of Matrix metalloproteinase-9 in patients with systemic
Ghada A. Abd El-Aziz*, Hanan M.A. Darwish*, Amal A. Morsy **, and
Sabila Gomma Mousa ***
Departments of Dermatology *, Clinical pathology**, and General Medicine ***,
Faculty of Medicine for girls Al-Azhar university
Background: Matrix metalloproteinase-9 (MMP-9) was involved in inflammation and
immune system dysfunctions. Beside immunologic abnormalities, systemic lupus erythematosus
(SLE) also presents chronic inflammatory components. Therefore, a role of MMP-9 in SLE
pathology might be supposed.
Objective: To investigate the level of matrix metalloproteinase-9 in systemic lupus
erythematosus patients and to determine its value in monitoring disease activity.
Patients and methods: Twenty five SLE female patients were included in this study.
Ten healthy females where selected as controls. The activity of SLE was evaluated according to
SLAM scoring. Using quantitative ELISA Kit provided from R & D system INC. USA, to
quantitate the total levels of MMP-9 . These levels were then compared and correlated with the
ANA, anti-ds-DNA, lupus nephritis, Raynaud phenomenon, malar rash, photosensitivity,
alopecia, and mucosal ulcers.
Results: serum of MMP-9 were found to be significantly higher (P<0.01), in SLE patients
compared to the control group. Serum MMP-9 show statistical significant correlation with anti-
ds DNA, Lupus nephritis, Raynaud phenomenon, malar rash and photosensitivity and it did not-
show any statistical significant correlation with ANA, alopecia and mucosal ulcers
Conclusion : The data suggest that MMP-9 could be involved in the pathogenesis of SLE,
and serum MMP-9 can be used as marker to monitor disease activity, renal damage, disease
progression and amelioration in SLE.
Systemic lupus erythematosus (SLE)
may play a role in the pathogenesis of SLE
is a systemic autoimmune disease that
(Zhang et al., 1998).
exhibits various clinical manifestations,
Matrix metalloproteinases (MMPs)
including immune complex depositions in
are a family of highly homologous Zn2++
the kidneys and other organs (Hahn, 1993).
dependent enzymes , capable of degrading
The cause of the disease has not yet
the extracellular matrix (ECM) and bone
been defined yet. However, it involves the
marrow. They are present in healthy
production of a broad spectrum of autoa-
individuals and have been shown to play an
ntibodies against nuclear, cytoplasmic and
important role in physiological processes
cell-surface antigens, and different impair-
such as wound healing, bone resorption and
ments of B-and T-cell functions (winche-
pregnancy. (Brehmer et al. 2003).
The potential importance of the many
especially TNF- and IL-1, were shown to
activities of MMPs in inflammatory
play an important role in the pathogenesis
responses has been suggested by the
of SLE through direct induction of matrix
inhibitory effects of MMPs in several
metalloproteinases (MMPs). Thus MMPs
autoimmune diseases. Specific inhibitions
Relation of serum leptin level to hypertensive retinopathy
The Egyptian Journal of Hospital Medicine Vol., 20: 8 15 September 2005
Relation of serum leptin level to hypertensive retinopathy
Hoda Abd El-Baset Mohamed, Sawsan Abd El-Sabour Shalaby* and Amal
General Medicine, *Ophthalmology and **Clinical Pathology Departments
Leptin plays a promoting role in angiogenesis and the vascular endothelium express the
long form of leptin receptor, therefore, the aim of the work was to assess the plasma level of
leptin in hypertensive patients and to evaluate the relationship between its concentration and
hypertension. and hypertensive retinopathy, also to assess its relation to body mass index.
This study was carried out on 50 patients with essential hypertension and 25 normal healthy,
age and sex matched control subjects. Patients with essential hypertension were classified into
2 groups according to the presence or absence of retinopathy, 25 patients without hypertensive
retinopathy (Group II a) and 25 patients with hypertensive retinopathy (Group II b).
The study showed significantly very higher serum leptin in group II and its subgroups ( II
a and II b) compared to those of the control (Group I), despite no significant difference was
detected between the three groups (group I ,II a and II b) regarding age, sex and body mass
index. Also no significant deference was detected between hypertensive group without
retinopathy and hypertensive retinopathy group as regard mean blood pressure.
Positive correlation between serum leptin level and mean blood pressure among all groups
was found. Also positive correlation between serum leptin level and body mass index (BMI)
among all groups.
The pathophysiological mechanism of
Aim of the study:
hypertensive retinopathy is not fully
Is to evaluate the plasma leptin level
established. The autoregulation of retinal
in relation to the grades of hypertensive
circulation failed as the blood pressure
retinopathy and also to assess its level in
increased beyond the critical limit . Also
hypertensive patients and its relation to
humoral components may be involved as
their body mass index.
well (Lowenthel and Zimlichmun, 1993)
Leptin is a hormone (167 amino acid
Subjects and methods
protein) secreted primarily by adipocytes
mainly in adipose tissue, gastric epithelium
This study was done on 50 patients
and placenta. It plays an important role in
with essential hypertension (24 males and
regulation of blood intake and energy
26 females) with mean age of 45.54 ± 4.32
expenditure (Korbonits et al 2001).It
years compared to 25 healthy normotensive
increases the vascular permeability through
subjects age, sex and body mass index
stimulation of short form receptors (Cao et
matched as control group (12 males and 13
al 2001). Leptin induces endothelial cells
females). with mean age of 44.20±3.86
migration which is the key event in angiog-
enesis (Goetze et al 2002). Yamagishi et al
(2004). attributed the development and
classified into two groups:
progression of retinopathy to loss and
Group I: 25 healthy normotensive subjects
dysfunction of pericytes.
The Egyptian Journal of Hospital Medicine Vol., 20: 16 28 September 2005
The pathogenesis of cytokines in preportal fibrosis of human infected
with schistosomiasis and viral hepatitis
Abdel Atty M. Elgonimy*, Suzan M.Farouk**, Eman Abdel Rahman***
Department of Surgery*, Clinical Pathology**, Benha Teaching Hospital, Department
of Internal Medicine***, Faculty of Medicine for Girls, Al- Azhar university
Cytokines are polypeptides exhibiting a variety of biological activities including
metabolic, inflammatory, hematopoietic and immunologic properties.They play an important
role in the pathogenesis of various diseases.
Inflammation is commonly observed in liver diseases and is frequently complicated by
fibrosis and cirrhosis in end-stage disease. The only curative treatment for cirrhotic patients is
Cytokines play a key role in the regulation of immune responses. In viral hepatitis the
production of inappropriate cytokine level appears to contribute to viral persistence and to affect
response to therapy. The aim of this study is to investigate the level of endogenous IL-1B, IL-6
and IL-10 to determine their relation with liver fibrosis. Forty patients with chronic liver
disease and 10 normal adults as control group were studied.
Patients in this study were classified into four groups according to etiology of chronic liver
disease: Group I (10 patients with bilharzial liver disease),Group II (10 patients with chronic
hepatitisC), Group III(10 patients with chronic hepatitisB )and Group IV (10 patients with
chronic hepatitis B and C) .
All patients with chronic liver disease (n=40) showed highly significant elevation of serum
IL-1B, IL-6, IL-10 mean ± SD were (106.4±47.8) (P<0.01) (26.3 ±11.1) (P<0.01) (135.4± 73.9)
(P<0.01) respectively when compared to control group. After classifying the patients into 4
groups each group showed highly significant elevation of serum IL-1B, serum IL-6 and serum
IL-10 in each group when compared to control group( p < 5051).
Regression analysis showed negative significant correlation between serum IL-10 and IL-
1B (r=-0.64, P<0.05), highly negative significant correlation between IL-10 and IL-6 (r=-0.72,
P<0.01) in all patients with chronic liver diseases, also there was highly significant positive
correlation between serum IL-1B and serum IL-6 (r=0.83, P<0.01).
Ten patients with bilharzial liver disease (group I) showed highly negative significant
correlation between serum IL-10 and each of serum IL-1B and serum IL-6 (r=-0.9, P<0.01) (r=-
0.8, P<0.01) respectively, and there was highly significant positive correlation between serum
IL-1B and serum IL-6 (r=0.96, P<0.01) .There was significant correlation between prothrombin
concentration and each of serum IL-10, serum IL-1B and IL-6 (r=0.7, P<0.05), (r=0.68,
P<0.05), (r=0.74, P<0.05) respectively.
Ten patients with chronic hepatitis C virus (group II) also showed highly negative
significant correlation between serum IL-10 and each of serum IL-1B and serum IL-6 (r=-0.9,
P<0.01) (r=-0.9, P<0.01) respectively. There was highly significant positive correlation between
serum IL-1B and serum IL-6 (r=0.83, P<0.01) and significant correlation between serum IL-1B
and serum ALT(r=0.63, P<0.05).
As regard (group III) patients with chronic hepatitis B virus there was negative significant
correlation between serum IL-10 and IL-1B (r=-0.63, P<0.05), but no significant correlation
between serum IL-10 and serum IL-6 and there was highly positive correlation between serum
IL-1B and serum IL-6 (r=0.90, P<0.01).
Hypoglycemic Effect Of Concomitant Administration Of Erythromycin And Tolbutamide In Alloxan-Induced Diabetes In Rats
The Egyptian Journal of Hospital Medicine Vol., 20: 29 37 September 2005
Hypoglycemic Effect Of Concomitant Administration Of Erythromycin And
Tolbutamide In Alloxan-Induced Diabetes In Rats
Amr, A.H. Rostom*, Mohammed, H. El Bakry** and Al Sayed, A. Zaki*
Departments of Pharmacology, Faculties of Medicine, (Cairo* and Asuit**),
Erythromycin is among the antibiotics that have widespread use for treatment of
community and hospital-acquired infections. Although uncommon, hypoglycemia has been
reported with erythromycin and appears to occur most frequently in elderly patients with type 2
diabetes mellitus who are receiving therapy with oral hypoglycemics. The present study was
designed to explore the potential effects of erythromycin on glucose metabolism in
In the present work, alloxan was used to induce diabetes in a dose of 200 mg/kg
body weight, intraperitoneally, in rats. The blood glucose level after alloxan was measured.
Tolbutamide lowered blood glucose level in normal and hyperglycemic rats. Erythromycin
produced lowering of blood glucose level in non diabetic rats and also, significantly
potentiated the hypoglycemic action of tolbutamide in diabetic rats.
Key Words: Tolbutamide, erythromycin, alloxan, diabetes mellitus.
Diabetes mellitus is one of the
most common diseases in the world. It
subcutaneously). The intraperitoneal or
was estimated that 150 million patients
subcutanouse dose of alloxan should be 2 to
suffer from diabetes mellitus (Zimmet,
3 times higher than the intravenous one.
1982). Multiple drug-drug interactions have
The dose of alloxan required for inducing
been reported to potentiate the effect of
diabetes depends on the animal species,
sulfonylureas. These include anti-inflam-
route of administration and nutritional
matory agents, sulphonamides, bishydrox-
status (Szkudelski, 2001). Fasted animals
ycoumarin, and antidepressants. Other
are more susceptible to alloxan (Szkudelski
agents such as propranolol and tetracyclines
et al., 1998), whereas increased blood
have been reported to potentiate the
glucose provides partial protection (Bansal
hypoglycemic effects of insulin (Seltzer,
et al. 1980, Szkudelski et al., 1998).
1989). Erythromycin has been clinically
Tolbutamide is one of the sulfon-
reported to cause significant drug interac-
ylureas, it is characterized by its short
tions (Periti et al., 1992). It has been
duration, it can be detected in blood
reported to potentiate the effects of astem-
after 3 minutes of its oral administration.
izole, carbamazepine corticosteroids, cyclo-
Its peak concentration is reached within
serine, digoxin, ergot alkaloids, terfena-
3-5 hours and remains up to 10 hours
dine, theophylline, triazolam, valproate and
(Goodman and Gilman, 1996).
warfarin (Martell et al., 1986; Honig et al.,
Materials And Method
Alloxan exerts its diabetogenic action
through producing partial or total necrosis
of beta cells which is presented
Drugs and chemical agents
histopathologically by its degeneration
and nuclear pykinosis (Lazarow and Palay,
1949). It is administered parenterally
England): It is freely soluble in water.
EFFECT OF BOSWELLIA ON ALLOXAN-INDUCED DIBETES MELLETUS IN MALE ALBINO RATS
The Egyptian Journal of Hospital Medicine Vol., 20: 38 45 September
Effect Of Boswellia Carterii Birdw On Carbohydrate
Metabolism In Diabetic Male Albino Rats
Eman G. E. Helal*, Ashraf M. Mostafa**, Fawzy A. Ashour*** and
Anwaar A. Kahwash*
Departments of Zoology Faculty of Science*- Histology ** and Physiology***
Faculty of Medicine Al-Azhar University.
In the current study, thirty male adult albino rats were used to investigate the effect of
Boswellia Carterii Birdw (BCB) on carbohydrate metabolism in alloxan-induced diabetes. Rats
were divided into three equal groups, control, diabetic non treated and diabetic BCB treated
groups. After thirty days of treatment five rats of each group were sacrificed and the others were
left without any additional treatment for another 15 days (recovery period) then were sacrificed.
The body weight of each rat was determined at the beginning and the end of each period. Blood
glucose, serum insulin and liver glycogen were determined for each rat at the end of each
period. It was noticed that B.C.B treatment led to a significant improve in the decreased
body weight, hyperglycemia, hypoinsulinemia, decreased liver glycogen caused by alloxan.
And this improvement was also seen after the recovery period.
B.C.B treatment led also to marked improvement in the histopathological degenerative
changes in the cells of islets of Langerhans caused by alloxan after both the treated and
The incidence of diabetes mellitus in
(Zhang,2001). The plant resin was proved
the human population has reached epidemic
to have an anti-inflammatory effects so it
proportions worldwide, and it is increasing
is used in the treatment of ulcerative colitis
at a rapid rate (Gannong, 2003). Being a
(Gerhardt et al., 2001), chronic colitis
chronic disease it needs log term treatment
(Keila et al., 2005), Crohn's disease (Gupta
either with insulin or the traditional oral
et al., 2001), polyartheritis (Sander, 1998)
hypoglycemic drugs and these cause fina-
and osteoarthritis (Kimmatker et al., 2003).
ncial exhaustion of the patients. Diabetic
It also has apoptosis inducing effect and
poor patients always search for a cheaper
cytostatic effect , so it is used in treatment
substitute in the medicinal plants.
of acute non lymphocytic leukemia and
Since ancient times diabetes mellitus
tumors (Liu et al., 2003). In the folk
has been treated orally with herbal remedies
medicine Boswellia Carterii Birdw is
based on folk medicine. More than 400
prescribed either alone or in combination
traditional plant for treatment of diabetes
with other plants for diabetic patients and
have been recorded , but only few of them
many of them reported good benefit. The
have received scientific and medical
effect of BCB alone on diabetes has not
evaluation to assess their efficacy (Begman
been investigated previously, so this work
and Bari, 1985).
is a trial to investigated the relation between
Boswellia Carterii Birdw (BCB) is
BCB and treatment of diabetes mellitus.
one of the most important medicinal plants
which has been used for treatment of
Material And Methods
many diseases three hundred years ago
The Egyptian Journal of Hospital Medicine Vol., 20: 46 57 September 2005
Interleukin-10, Interleukin- 16 and Interferon- in serum of patients
with rheumatoid arthritis and correlation with disease activity
Eman.M.Abdel Rahman, Hamdia.Ezzat, Maha M Abdel Mohsen,
Clinical pathology& Internal Medicine Departments, Faculty of Medicine for girls,
Al Azhar University
Rheumatoid arthritis (RA) is a systemic inflammatory disease of unknown etiology. The
rheumatoid synovium is characterized by infiltration of T cells, macrophage, B cells, and
proliferating fibroblasts which aggressively invade cartilage and bone, thus destroying joints'
ability to function.
In rheumatoid arthritis (RA) both an imbalance between excessive production of the
proinflamatory and ant-inflammatory cytokines and skewing of the T cell to a T helper like
Cytokines have been shown to play a modulatory role in the pathogenesis of RA. The
imunoregulatory cytokine IL-10 increases autoantibody production by B cell stimulates its
survival, proliferation and differentiation. Moreover IL-10 inhibits the generation of
proinflamatory cytokines and proliferation of T helper lymphocyte.
Interleukin 16 might play a role in the pathogenesis of chronic inflammation in RA. It has
a proinflammatory properties by promoting recruitment of T cells into the rheumatoid
synovium. Also IFN- is of interest because of the role it plays in the initiation and perpetuation
of T helper cell .
Serum level of IL-10, IL-16, and IFN- were determined in patients with rheumatoid
arthritis in relation to disease activity.
All patients with RA (n=30) showed highly significant increase in ESR, CRP, IL-10, IL-
16, IFN compared to control group (p<0.01).
Positive correlation were found between IL-10 and each IL-16 and IFN- (p<0.001)
(r=0.63, 0.55) respectively, and highly significant correlation between IL-16 and IFN
(p<0.001) (r=0.89)were determined.
Results showed positive correlation between ESR and each IL-10, IL-16, IFN (p<0.001)
(r=0.67, 0.87, 0.75) respectively. And highly significant correlation between CRP and each IL-
10, IL-16, IFN (p<0.001) (r=0.0.71, 0.83, 0.73) which indicate relation between increase level
of cytokine with disease activity.
These data suggest that there is increased production of IL-10, IL-16, and IFN- in
patients with rheumatoid arthritis, and that it is correlated with the disease activity. These
cytokines are interesting for further research and novel therapeutic approach in this
Rheumatoid arthritis (RA) is inflam-
In RA, the cytokines resulting from
matory disease of unknown etiology chara--
this cellular infiltration greatly influence the
cterized by destruction of joints (Verhoef et
outcome of disease. Macrophage generally
al;2001). Activation and infiltration of
express higher levels of cytokines than
immunologic cells, including macrophage
lymphocyte in RA, while the lymphocyte
and lymphocytes, are prominent features of
contribution to inflammatory and/or joint
destructive process may be more indirect
arthritis (Scola et al;2002).
(Panayi et al;1992).
Effect of Licorice on Wound Healing In Rabbits
The Egyptian Journal of Hospital Medicine Vol., 20: 58 65 September 2005
Effect of Licorice on Wound Healing In Rabbits
Alsayed, A. Zaki*; Mohammed, H. El-Bakry** and Alaa, A. Fahmy***
Departments of Pharmacology, Faculties of Medicine Cairo* and Assiut** Branches,
Al-Azhar University & Department of Anatomy, Faculty of Medicine,
Ain Shams University ***, Cairo, Egypt
Licorice (Glycyrrhiza glabra) is one of the most widely used medicinal plants and is
included in numerous traditional and modern medical preparations. In the present study the
healing effect of licorice extract was investigated on open skin wounds in rabbits. Adult
Newzeland rabbits of both sexes weighing 1.5 - 2.5 kg were used. Hairs of lower back and left
flank of animal were shaved. Full-thickness wound (15x15 mm) was made on the shaved area.
Hydroalcoholic extract of licorice was prepared by maceration method. Creams of 5%, 10% and
15% (w/w) extract in eucerin base were prepared and applied 2 times daily. Dexpanthenol
ointment was used as standard control. Healing was determined by reduction in wound area.
The results of this study proved that licorice cream of 10% was a potent healing agent even
better than dexpanthenol cream.
Healing of wounds or restoration of
diseases. Human studies proved its curative
tissues integrity is a natural mechanism and
effect in infectious hepatitis (Chang,1986;
normal reaction to injury. Inflammation,
Tare et al., 2005), chronic hepatitis C, and
proliferation and remodeling, all are the
subacute hepatic failure (Acharya &
main steps of wound healing. Wound
Dasarathy, 1993; Fujioka et al., 2003), hae-
healing in animals and humans is relatively
mophilia and HIV-1 infection (Mori,1990;
similar (Champion et al., 1998). Many
Sasaki et al., 2003), gastric and duodenal
drugs of chemical or natural origin as dexp-
ulcers (Baker, 1994), and in herpes, ecz-
anthenol, Ginko biloba, phenytoin, zinc
ema, and psoriasis. The antibacterial effect
oxide, and others have been used topically
against Staph. aureus, Strept mitans, Myco-
to improve the rate of wound healing
bacterium smegmatis and Candida albicans
(Lawrence et al.,1995; Hemmati &
(Langmead & Rampton, 2001) was also
Mohammadian, 2000; Bairy & Rao,2000)).
documented. Accordingly, licorice is now
Licorice (Glycyrrhiza glabra) is a
used in a great variety of pharmaceutical
plant that grows wild in Western and
Eastern world and has long history of
However, up till now, the topical
therapeutic uses by cultures throughout the
effect of licorice on improvement of wound
world, including the Greeks, Egyptians,
healing has not been investigated. So, the
Chinese and Indians. It was tradionally used
aim of the present work was to evaluate the
in treatment of peptic ulcer, asthma, phary-
healing effect of topically applied licorice
ngitis, malaria, abdominal pain, insomnia,
on skin wounds using rabbits as the
infections, and many other diseases (Evans,
1989; Blumenthal et al., 2000; Wang &
Nixon, 2001; Chan et al., 2003). Licorice
Materials and Methods
was also valued in ancient Egypt that King
Tutankhamen was buried with a supply
The dried roots of licorice (purchased
(Fleming, 2000; Hart, 2001).
from Ramzy Bayrakdars and Sons, Syria)
Modern researches on licorice also
was powdered by a grinder. 100 g of the
reported its efficacy in treatment of various
powder were placed in a beaker and 1000ml
Epidemiological Study Of The Childhood Disabilities: A Household Survey In Four Egyptian Governorates
The Egyptian Journal of Hospital Medicine Vol., 20: 66 82 September 2005
Epidemiological Study Of The Childhood Disabilities: A Household
Survey In Four Egyptian Governorates
E. A. El-Moselhy; R. M. El-Azab; H. O. Khalifa; E. S. Abd-Allah*;
A. M. Ebrahim **; H. M. El-Masry***; T. S. El-Shorbgy****and
H. S. Abo Seif*****
Departments of Community and Industrial Medicine; Community Health Nursing*; Paychiatry
**; Paediatrics***; ENT**** and Ophthalmology*****
Faculty of Medicine and Nursing, Al-Azhar and Zagazig University
This study was conducted on 1403 children from four Egyptian governorates. These
governorates were; Alexandria, Al-Behira, Cairo and Al-Giza. The aim of the study was to define
different types of the childhood disabilities, to find out their prevalence's in the selected
governorates in Egypt, to define their distribution and to define their risk factors. A cross-
sectional study design was chosen to investigate the current research problem. All the children
had undergone complete physical examinations. Also, children's parents were interviewed. There
were specific inclusions criteria have been considered to include the child as a case in the study.
The overall prevalence of the childhood disabilities in these governorates was 8.8%. The most
common prevalent childhood disabilities were; visual, speech and hearing (4.5%, 2.1% and 1.9%,
respectively). While, the most common prevalent risk factors were mother delivered at home
and/or not received antenatal care (7.2% and 6.3%, respectively). Positive consanguinity and
baby not strictly received vaccination were the most important risk factors, odds ratio = 3.81 and
3.31, respectively. While, only positive consanguinity was significantly correlated with all types
of the childhood disabilities. Furthermore, positive consanguinity had the highest correlation with
all types of the childhood disabilities. Also, childhood disabilities tend to be common among
males (57.6%) and of congenital aetiology (61.8%). The main source of habilitation was the
private centers (79.2%).
With a dramatic decrease in infant
countries, the numbers are expected to be
mortality, a challenge facing modern
much higher. Difficult conceptual issues as
medicine is chronic disabling conditions in
well as social and cultural differences have
infants and young children (Chen and
inhibited the collection of the data needed to
Simeonsson, 1993). Childhood disability is a
properly estimate the prevalence of
major health problem that is pronounced in
disability in the world especially in
developing countries (Shawky et al., 2002).
developing countries. International efforts
Disability according to estimates of the
are now underway to improve the quality
United Nations affect lives of more than 600
and availability of data about disability
million people globally. This means that
about 10.0% of the world's population is
In Egypt, prevalence of childhood
disabled. Looking only at developing
disability was estimated to be about 8.0%,
Biochemical Effects Of Ribavirin (Antiviral) And Ddb (Hepato Protective) Drugs In Albino Rats
The Egyptian Journal of Hospital Medicine Vol., 20: 83 93 September 2005
Biochemical Effects Of Ribavirin (Antiviral) And Ddb (Hepato
Protective) Drugs In Albino Rats
Soliman S. Ibrahim, Amr Shalaby and Mahmoud Rabeh
Zoology Department, Faculty of Science, Zagazig University
The present investigation has been designed to through spot light on the efficiency of these
two drugs in treatment of hepatitis patients.
Cortisol, antigliadin (1gG) , total protein (TP) albumin (ALB) , Iron (Fe) , alanine
aminotransferase (ALT) , aspartic aminotransferase (AST) and alkaline phosphatase (ALP)
were determined in serum of normal mature male and female albino rats that injected
intraperitoneally day after day with 1mg/kg body weight of each drug separately for 3 months.
The cortisol level and ALP showed significant increase in each of ribavirin or DDB treated
animals, while the IgG concentration in ribavirin treated animals increased significantly, but it is
did not vary greatly from that of the control in DDB treated animals.
On the other hand both ribavirin and DDB treated male and female rats showed significant
decrease in the ALT in serum while serum AST elicited non significant decrease in each of
ribavirin and DDB treated male and female. With respect to serum TP and ALB levels the result
showed significant decrease in ribavirin and non significant decrease in DDB treated male and
female rats. Furthermore, the serum Fe level in ribavirin treated male and female rats increased
significantly but it is did not vary greatly from that of the control in DDB treated animal.
Ribavirin is a nucleoside analog that
may not be sufficient for antiviral activity
has demonstrated efficacy in treating viral
(Smith et al., 1984).
disease as monotherapy [(respiratory
Tam et al., 1999 stated that ribavirin
syncytial virus , lassa fever virus and foot
has multiple biologic properties that are
and mouth disease virus infection) Hall et
favorable for treating viral diseases, it can
al., 1983 ; Wyde 1998; Robert et al., 2000
directly inhibit the replication of many
and Saad and Fawzy 2004)] and is used in
DNA and RNA viruses, it can also act as an
combination with interferon to treated
immunomodulator and thus promote T- cell
hepatitis C virus infection (McHutchinson
mediated immunity against viral infection
et al., 1998 ; Davis et al., 1998 ; Reichard
(Hultgren et al., 1998, Martin et al., 1998,
et al., 1998; Shane crotty et al. 2000 and
Ning et al., 1998 and Tam et al., 1999).
Johnson et al., 2002).
The central focus of this effect of
Since the discovery of the broad
ribavirin is the augmentation of antiviral
spectrum antiviral activity of ribavirin in
type 1 cytokine expression, gamma interfer-
1972 (Sidwell et al., 1972), it has been
one and tumor necrosis factor alpha and
suggested that the active from of ribavirin is
concomitant supression of type 2 cytokine
the monophosphae, (RMP) (Streeter 1973).
level by activated T cells in both human
RMP inhibits inosine monophosphae dehy-
and murine system (Robert, et al., 2000)
drogenase (IMPDH), causing a decrease in
they also stated that ribavirin, alone or in
the intracellular concentration of guanosin
combination with interferon - , can lower
triphosphate (GTP) (Smith and Kirkpatrict
serum alanine aminotransferase (ALT)
1980 and Streeter 1973). This decrease
level during he course of treatment of
hepatitis C virus infection. Elevated serum
synthesis and limits replication of viral
ALT levels are a marker for liver damage
genomes. However, inhibition of IMPDH
and progressive hepatitis, and hence the
INHERITANCE OF DARK HEAD AND SIPHON IN THE LARVAE OF CULEX QUINQEFASCIATUS SAY
The Egyptian Journal of Hospital Medicine Vol., 20: 94 99 September 2005
Inheritance Of Dark Head And Siphon In The Larvae Of Culex
Badia a M. Al-chalabi and Ibrahim A. Ghaweel
Department of Environment Public Health Faculty Garyounis University, Libya
A new spontaneous mutation (dh) is described for Culex quinquefasciatus Say . This
phenotype was observed in the second generation to cause complete coloration of the head
capsule and the siphon of the larvae . This character is mainly detectable in the larval stage and
slightly in the adult stage .
The reciprocal mass matings between mutants from F2 generation and normal wild type
sibs , revealed that the mode of inheritance can be controlled by an autosomal recessive gene (s)
This happened for both sexes with slightly variability in their expression . No significant larval
mortalities were found in all the crosses .
Culex quinquefasciatus Say a species
Iraq only two mutants of this species were
of pipiens complex is well known,
found to affect larval growth ( Ouda et al. ,
medically important mosquito. It transmits
1986 and Ouda and Mehdi , 1988 ) .
virus diseases in several parts of the world,
The purpose of this study is to
also it is involved in the epidemiology of
describe a new spontaneously isolated for
Filariasis in many tropical area a swell as st.
this species and its mode of inheritance.
louis encephalitis .
Among mosquito species, Culex
Materials And Methods
quinquefasciatus is one of the widely
distributed one in the world . No records on
Several samples of mosquito larvae
diseases transmitted by this species has
were collected and brought from small
been reported for Libya so far .
stagnant pond near Bennina airport /
Several investigators, Cheng (1972),
Benghazi City in October 2000 . The
Guptavanij and Barr (1979 and 1982) and
samples then reared in the laboratory. The
Vandehey (1967) have studied relationship
dark head and siphon larvae were isolated
between the infection agent and the
from a second generation of an inbreed line.
genetics of Culex mosquitoes to provide a
This is considered as a mutant of the larvae.
basis of control for this species . In Culex
The later caused complete coloration of the
head capsule and the siphon . However, the
Barr (1975) listed 47 mutants
scape of the antenna and an area around the
affecting larval, pupal and adult stages.
eyes were pale in color . The head capsule
Others; Dubash et al. (1982), Sharma et al.
of the mutant larva was rather spherical and
(1977) and Subbaraw and Adak (1978)
wider than normal ( Fig. 1 ) .
have also found several mutants . Although
This character is mainly detectable in
a large number of mutations have been
the larval stage and slightly in the adult
reported for this complex there is a striking
stage , moreover the mutant larvae were
lack of phenotypic markers for Culex
easy to distinguish from normal individuals
quinquefasciatus which are essential in
. Although the larval instars of the mutants
many genetic studies . Mutants affecting
were all pigmented , separation of the
eye and body color extensively studied by
Sakai et al. (1980) , Shetty and Chowdaiah
accomplished with first instar due to their
(1976) and Subbaraw and Adak (1978) . In
Hepatic Hypertransaminasaemia of unknown Etiology
The Egyptian Journal of Hospital Medicine Vol., 20: 100 111 September 2005
Hepatic Hypertransaminasaemia of unknown Etiology
El Sayed El-Meghawry El Sayed*, Hany Abu Zeid*, Salah Mohamed
Korayem**,Gouda Mohamed Khalifa ** and Hazem Hassan El Khaleegy***
Department of Internal Medicine*, Radiology** and clinical pathology.*** Al Azhar-
Faculty of Medicine (Damietta & Cairo)
Hepatic aminotransferases are sensitive indicators of liver cell injury. In some patients
with persistent elevation of such enzymes; routine clinical, laboratory and serological data
cannot establish the underlying causes.
This study was designed to evaluate such patients both clinically and pathologically as a
trial to reach the underlying etiology.
Thirty patients with hepatic hypertransaminasaemia of unknown cause (18 females & 12
males), aged 18-50 years (mean age 37.7 4.6 years), together with ten controls (5 males & 5
females) [matched in age and body mass index with patients]; were included in this study. Both
patients and controls were subjected to full history taking, clinical examination, estimation of
blood glucose and lipid profile, liver function tests, serum iron & ferrtin estimation, hepatitis
viral markers (HBs Ag HCV-Ab), anti Epstien Barr (EBV) and cytomegalovirus (CMV)
antibodies, abdominal ultrasonography (U/S)and needle liver biopsy (done only for 15 patients
who approved undergoing it.
The study revealed that 18 patients had non alcoholic fatty liver disease NAFLD (bright
liver on U/S), eleven patients out of them underwent liver biopsy that showed simple hepatic
steatosis in four of them and non alcoholic steatohepatitis (NASH) in the other seven patients.
Most of the eighteen patients with NAFLD were obese, diabetic and hypertensive. Four patients
had positive serology for autoimmune hepatitis and two patients had positive serology for
cytomegalovirus infection. All patients had normally ranged serum iron & ferritin. The
remaining six patients had normal hepatic U/S and negative serology for different hepatic
viruses; four of them underwent liver biopsy that revealed simple hepatic steatosis in two of
them and non alcoholic steatohepatitis (NASH) in the other two patients. Conclusion &
recommendation: Non alcoholic fatty liver disease (NAFLD) was found to be the commonest
cause of unexplained hepatic hypertransamina-saemia. However, we must be minded with less
frequent causes like autoimmune hepatitis and cytomegalovirus infection. Needle liver biopsy
and possibly MR imaging of the liver are important investigational techniques for patients with
hepatic hypertransaminasaemia associated with normal serum iron & ferrtin levels, negative
serology of (autoimmune hepatitis & various hepatic viruses), normal hepatic ultrasonography;
to diagnose those with occult hepatic steatosis among them. Estimation of HBV-DNA & HCV-
RNA by (PCR) could be required for precise exclusion of HBV & HCV infection. Large-scale
studies are recommended to verify these findings
Introduction and Aim of the work:
Serum aminotransferases levels are
some patients the cause of persistent
sensitive indicators of liver cell injury (Pratt
elevation of liver enzymes cannot be
and Kaplan, 1999). In most patients routine
established on the basis of these data
clinical, laboratory and serological data
(Berasain et al., 2000).
allow identification of the disease entity
The presence of occult viral infection
responsible for liver damage. However, in
Risk Factors And Impacts Of Sexually Transmitted Diseases Among Adult Females In Cairo
The Egyptian Journal of Hospital Medicine Vol., 20:112 130 September 2005
Risk Factors And Impacts Of Sexually Transmitted Diseases Among
Adult Females In Cairo
E. A. El-Moselhy; H. O. Khalifa ; K. M. Abd-Allah; F. A. Hassan*; R. B.
Atallah*; H. M. Hassan*; A. G. El-Darwish**; A. M. Ebrahim ***;
A. M. Osman**** ; And M. A. Shatat*****
Departments of Community Medicine; Dermatology & Venereology*;
Obstetrics & Gynaecology **; Psychiatry ***; Microbiology**** and Parasitology*****
Faculty of Medicine, Al-Azhar University.
This study was conducted on ninety sexually transmitted disease (STD) adult female
patients, attending Dermato-Venereology and Gynaecology Clinics, Al-Hussein University
Hospital and an equal number of females as controls. The aim of the study was to determine
sociodemographic, sexual and health care behaviours risk factors for STDs and to determine
their impacts on the studied females. A retrospective, case-control, clinic based study was
chosen to perform this research. Vaginal, cervical and urethral swabs and smears were taken.
Also, scrapes from any suspicious lesions together with blood samples were taken from STD
patients for various laboratory examinations. The most common STD was candidiasis (35.6%).
Shared house and unskilled occupations were the most important sociodemographic risk
markers, odds ratio (OR) =11.62 and 2.92, respectively. While, vaginal douche use and divorce
were the most important gynaecological and reproductive risk factors, OR=7.16 and 4.06,
respectively. Furthermore, premarital sexual practice and non-vaginal sexual practice were the
most important sexual behaviours risk factors, OR=13.40 and 10.97, respectively. Also,
previous infection with STDs and no partner referral were the most important health care
behaviours risk factors, OR=6.45 and 4.93, respectively. Moreover, no religious obligation and
drugs and/or alcohol use were the most important life style risk markers, OR=12.89 and 6.77,
respectively. Lastly, history of pelvic inflammatory disease (18.9%) and pregnancy wastage
(17.8%) were the most important impacts of STDs.
Sexually transmitted diseases (STDs)
mainly STD, has led to change attitude to
are very common in most of the developing
STDs problem (Meheus and De Chryver,
world and are among the most common
1991). The need for the control of STDs has
causes of illnesses especially in women.
become more urgent since they have been
However, its actual incidence is not known
recognized as independent risk factors for
(Meheus and De Schryver, 1991). STDs are
the acquisition of AIDS (Richert et al.,
diseases that spread from person to another
1993 and Gertig et al., 1997). Moreover,
through intimate sexual contact. The
some of STDs have been shown to increase
reproductive tract is the most common site
the risk of transmission of AIDS by 24-fold
of infection, although, the mouth and anus
(Laga et al., 1994 and Gerbase et al., 1998).
may involved. There are more than 25
Political and economic conditions of
microorganisms (bacteria, viruses, fungi,
the world may lead to situations that
protozoa or arthropods) that can be sexually
challenge the established balance between
transmitted (Keersmaekers and Meheus,
the social forces that spread STDs and those
1998 & Gerbase et al., 1998). The
that limit their spread (Aral and Holms,
appearance of the acquired immuno-
1999). In most of the world, the investment
deficiency syndrome (AIDS), which is
in public health development in general is
Comparative studies on the corneal structural adaptation
The Egyptian Journal of Hospital Medicine Vol., 20: 131 147 September 2005
Comparative studies on the corneal structural adaptation
of two rodents inhabiting different environments
El-Sayed Fikri Ali El-Dawi 1 and Hamdy Aly 2
1- Department of Zoology, Faculty of Science, Ain Shams University, Cairo, Egypt.
2- Department of Anatomy, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
The corneas of Rattus rattus and Meriones shawi are composed of three main layers; an
outer epithelium, a middle stroma (basement membrane, total stroma and Descemet's
membrane) and an inner endothelium. The mean thickness of the epithelium, total stroma,
Descemet's membrane, and endothelium was about 52 ± 7.3 m, 275 ±18.7 m, 5.5 ± 0.7 m,
and 7.5 ± 0.23 m in R. rattus, whereas it was 38 ± 5.8 m, 124 ± 4.7 m, 4 ± 0.21 m, and
4.2 ± 0.17 m in M. shawi.
In R. rattus and M. shawi, the outermost cells of the corneal epithelium are mostly
polygonal and hexagonal in shape with nearly regular borders and show a dense pattern of
microplicae with different scatter electron that exhibits three and two polymorphic appearances,
respectively. Type A: numerous light cells with dense microplicae; type B: many dark cells with
a moderate density of microplicae, and type C: few dark cells with a less density of microplicae
are found in R. rattus; whereas, types A and B are found in M. shawi.
In both investigated species, the epithelial cells are characterized by some structural
components, such as glycocalyx, fibrous components and tight junction between these cells, to
resist the impact of the external stressed factors and to protect the underlying tissue, as well as
to maintain an excellent transparency of the cornea. Among these structures, the cytokeratin
filaments are the major components of the cytoplasm of the corneal epithelial cells (basal,
polygonal, wing and squamous cells). Actin filaments are also found in the corneal epithelial
cells, but they are prominent within the apical epithelial cells.
In R. rattus, the stroma is formed of an outer lamellar zone and an inner lamellar one; the
latter is thicker and characterized by its interfibrillar spaces between the bundles of wavy
dissociated collagen fibrils, which are arranged in an orthogonal manner. In M. shawi, however,
the stroma is formed of one lamellar zone of flattened bundles of highly wavy and branched
collagen fibrils, which are composed of perpendicular fibrillae alternating with longitudinal
In R. rattus, the SEM showed that the endothelial cell surfaces are slightly bulging with
many blebs, whereas in M. shawi, it showed that the surfaces of the endothelial cells are
flattened and nearly smooth.
In conclusion, the transparency of the cornea, may be highly attributed to the increase in
the thickness of the stroma, the presence of stromal interfibrillar spaces and the case of the
stromal swelling. These aforementioned features are found in the corneal stroma of R. rattus,
which live in different habitats of varying degrees of density such as water and dry or humid air,
whereas these features are lacking in M. shawi, which live only in arid zones.
Key words : Cornea , mammals, rodents, adaptation, environment, LM, SEM, TEM
The transparent nature of the cornea
disciplines, and their studies have added
and its importance in the visual pathway as
immeasurable knowledge to the underst-
a major refracting lens of the eye have
anding of the cornea in health and disease
intrigued the investigators in many different
of human (Svedbergh and Bill, 1972;
Effect of Commiphora myrrha extract on some physiological parameters and histological changes in diabetic albino rats
The Egyptian Journal of Hospital Medicine Vol., 20: 148 162 September 2005
Effect of Commiphora myrrha extract on some physiological
parameters and histological changes in diabetic albino rats.
Eman G.E. Helal*, Ashraf Mahmoud ** Essam E. El-Badawy *** and
Anwaar A. Kahwash*
*Zoology Department, Faculty of Science ,Al-Azhar, University.
**Histology Department, Faculty of Medicine, Al-Azhar, University.
***Anatomy Department, Faculty of Medicine, Tanta University.
The present study aimed to clarify the antidiabetic activity of Commiphora myrrha (CM)
aqueous extract on thirty adult male albino rats, which were divided into two groups; the first
served as a control group, the second was injected with alloxan (120mg/Kg body weight) and
divided into two subgroups the first served as diabetic group, the second treated with (CM)
water extract (0.05mg/100 gm bwt). After 30 days of the treatment half of each group was
sacrificed and the other half was left for other 15 days without any additional treatment
Our results revealed highly significant decrease (p< 0.01) in blood glucose level and
highly significant increase in body weight of the diabetic rats with different histological changes
in cells of islets of Langerhans. These histological and physiological changes were ameliorated
in rats treated with CM.
Water extract of CM has a definite hypoglycemic, hyperinsulinimic effect, on the other
hand, a significant increase in body weight, cell number and liver glycogen contents were
The results of the present study clarify the role of CM as an active antidiabetic plant and
suggest a relationship between drenching CM extract and insulin production. Other of
investigations want be done to detect effects of different doses and time intervals of CM in
Diabetes is possibly the world's fastest
high cost and poor availability of current
growing metabolic disease, and as know-
therapies for many rural populations,
ledge of heterogencity of this disorder incr-
particularly in developing countries (Marles
eases, so does the need for more appro-
and Farnsworth, 1995).
priate therapies (Baily and Flott, 1986).
Alloxan and streptozotocin (STZ)
Traditional antidiabetic plants might
were found to be selectively -cytotoxic
provide useful source of new oral hypogly-
agents in animals and extremely potent
cemic compounds for development count-
diabetogenic substances (Dunn et al., 1943
ries as pharmaceutical entities, or as simple
and Rakieten et al., 1963), so alloxan and
dietary adjuncts to existing therapies. A
STZ have been widely used to produce
scientific investigation of traditional herbal
remedies for diabetes mellitus may be
valuable and leads to development of an
Commiphora myrrha (Myrrh) Family
alternative drugs and therapeutic strategies.
(Burseraceae) is native to Northeastern
Alternatives are clearly needed because of
Africa, especially Somalia. Myrrh is one of
the inability of current therapies to control
the oldest known medicines and was widely
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The Egyptian Journal of Hospital Medicine Vol., 20: 163 176 September 2005
Stevioside as A low caloric sweetener to milky drink and its protective
role against oxidative stress in diabetic rats
Ayman M. Badawi* , Nadia A. El-tablawy*, Nahed S. Bassily**
Sami A. El-Behairy***
* Department of Biochemistry, ** Department of Histology,
*** Department of Food Evaluation and Food Science
National Organization For Drug Control And Research (NODCAR)
P.O. Box 29, Cairo, Egypt.
Stevioside is a natural sweetener extract from the plant Stevia rebaudiana Bertoni.
Stevioside was used in traditional medicine among Indian community in Brazil for the treatment
of diabetes. The present study aimed to investigate the safety of stevioside as natural sweetener
substitute sugar in a dairy product needed by those suffering from diabetes and its protctive role
against oxidative stress exerted by hyperglycemia.
The antibacterial activity of stevioside showed no effect on the pathogenic bacteria namely
S. aureus, S. typhomuium and E. coli as well as lactic acid bacteria. In the present study
hyperglycemia was induced by i.p. injection of alloxan in two successive doses (70 mg/kg b.w.
eash / day to rats preadministered stevioside in two different doses (640 mg/kg b.w. and 1.280
g/kg b.w.) for eight weeks.
The following investigations were carried out, glucose tolerance test, blood glucose, blood
glutathione, MDA, erythrocyte SOD and transminases. The histopathological examinations
were performed at the end of the experimental period. The results obtained in this study
assessed the safety and protective role of stevioside as a natural sweetener substitute sugar in a
Stevia (Asteraceae) is a woody shrub
ent-kaurene glycoside with stevioside being
that can reach 80 cm in height when it is
the major constituent (3-8% by weight of
fully matured. The stevia genus comprises
the dried leaves)
at least 110 species (Rajbhandari and
Stevia is used in many parts of the
Roberts, 1983). Different species of stevia
world as a low caloric sweetener. Stevi-
oside is 300 times sweeter than sucrose
compounds, with stevia rebaudiana Bertoni
(Matsui et al., 1996 and Maier et al., 2003).
being the sweetest of all (Soejarto et al.,
Many investigators have shown that
1982 and Kinghorn et al., 1984).
the administration of stevioside leads to
The complete chemical composition
antihyperglycemic effects by enhancing not
of stevia species is not yet completely avail-
only insulin secretion, but also insulin
able. However, a variety of stevia species
utilization in insulindeficient rats (Suzuki et
have been tested to their chemical compo-
al., 1977; Soejarto, et al., 1982; Jeppesen et
sition. The useful part of this shrub is the
al., 2003; Gregersen et al., 2004 and Chen
leaves Out of 100 species tested for sweet-
et al., 2005).
ness, only 18 were found to possess this
Oxidative stress is caused by a
characteristics (Soejarto et al., 1982). Eight
relative overload of oxidants i.e. reactive
entkaurene glycosides namely ducloside A,
oxygen species. This impairs cellular func-
rebaudiosides A-E, steviolbioside and stevi-
tions and contributes to the pathophy-
oside, produce the sweet taste sensation
siology of many diseases. Evidence have
(Kinghorn et al., 1984). According to
Melis, (1992) and Shibata et al., (1995)
patients are under oxidative stress and that
stevia Rebaudiana Bertoni, the sweetest
complications of diabetes seem to be
species, contains in its leaves all the eight
partially mediated by oxidative stress
Effects Of Mobile Phones Radiation On The Eeg And Emg
The Egyptian Journal of Hospital Medicine Vol., 20: 177 195 September 2005
Effects Of Mobile Phones Radiation On The EEG And EMG
Of Human Users.
The National Center for Social and Criminological Research,
This study focuses on the effect of mobile phone radiation emissions on the human
electroencephalograph (EEG) and electromyogram activity (EMG). EEG and EMG recordings
from 50 (male and female) awake subjects were taken during exposure to radiation emissions
from a mobile phone. Our results demonstrated that stimulation effects became apparent on
EEG at first, and changes varied strongly at the end of the experiment to depression. EEG and
EMG showed interesting changes.The results suggested that cellular phones may reversibly
influence the human brain, as their use induced abnormal slow waves in EEG of awake persons.
At present, the heads of many current
mobile phone and cordless phone-users.
phone users have been exposed to a
Benign brain tumors made up to 55% of
sequence of microwave fields modulated in
the total, and 35% were users of cordless
substantially different ways (Adey, 1997).
rather than cellular phones.
Initial transmission systems utilized 400
Stang et al. (2001) reported that the
MHz frequencies, but current systems
use of radio sets, mobile phones, or similar
generally transmit at 900 and 1800 MHz
devices at the workplaces for several hours
(Kuster et al., 1997). The Global System
per day, was associated with uveal
for Mobile Communication (GSM) system
(intraocular) melanoma. Of 118 individuals
employed throughout Europe, Egypt and in
with intraocular melanoma, 6 (5.1%)
much of the rest of the world is encoded at
reported that they were "probable or
certain" to have "ever been exposed" to
The following is a brief summary of
mobile phones at work. According to the
scientific research on the effects of
authors, this occupational mobile phone use
radiofrequency electromagnetic radiation
was 4 times higher than expected. Mobile
(RFR) exposure on human.
phone use outside of work was not
Kuster et al. (1997) reported that
assessed, and other risk factors (for
mobile phones when hand-held and oper-
example, UV exposure and light skin color)
ated close to the head, background levels
were not assessed. In the only other
are sharply distorted, with 40 percent of
comparable study found in the literature,
radiated phone energy absorbed in the hand
Johansen et al. (2001) found less melanoma
and the head . Frey (1998) and Oftedal et
and ocular cancer than expected in mobile
al. (2000) reported that mobile phones
phone users. Muscat et al.(2000) published
cause headaches. Chia et al. (2000)
a report on malignant brain tumors and the
reported that headaches were significantly
use of hand-held mobile phones, and found
more common among users of hand-held
that tumors were more frequent on the side
mobile phones than among non-users (65%
opposite to that used for where the phone ,
than on the same side where the phone was
Hardell et al.(2002 a&b,2003 a&b)
reported to be used.
published four separate analyses of a
Reiser (1995) reported a change in
follow-up study of 1617 brain tumor
EEG tracings on exposure to 900 MHz
patients. This study included both benign
radiation, but others have stated that similar
and malignant brain tumors, and both
changes can be seen when the level of
Toxic Effects Of Some Antispastic Drugs on the EEG: Some Biochemical And Immunological Studies on Rats
The Egyptian Journal of Hospital Medicine Vol., 20: 196 2 15 September 2005
Toxic Effects Of Some Antispastic Drugs on the EEG: Some Biochemical
And Immunological Studies on Rats.
Fathy El-Komey, Inass EL-Gaafarawi and Hanan Moustafa
The National Center for Social and Criminological Research, Zamalek,
P.O., P.C.11561, Cairo, Egypt.
The toxicity of tizanidine and baclofen was studied on male rats. The oral clinical dose of
tizanidine and baclofen( 0.216 and o.54 mg/ 100g body weight / day, respectively)was given
for one, two, three and four weeks. Chronic administration of the two drugs causes damage to
the lung and a significant reduction in serum and lung levels of GSH , Vit E , Vit C and SOD
activity . Four weeks treatment induced significant elevation of GPX activity and MDA levels.
The two drugs, also, caused inhibitory activity on proliferation of splenocyte triggered by Con
A, LPS and IL-2 production cell activities. They also produced several abnormal patterns in the
EEG including increased epileptiform discharges and synchronous rhythmic activity . Diffuse
slowing , with increased beta and delta activity and decreased alpha activity , with
superimposed beta activity were recorded. Tizanidine had more prominent effect on the EEG
than baclofen .
Antispastic drugs act on the CNS
et al., 2003). Also, tizanidine appears to be
either by suppression of excitation
a therapeutic alternative of baclofen in
(glutamate) enhancement of inhibition
changing treatment (Campistal, 2003;
(GABA, glycine), or a combination of both.
Darrio and Tomei, 2004). Hypertonicity
Three different categories of drugs are
from spasticity or dystonia with attendant
available: GABA- like (baclofen , benzod-
iazepine) , central alpha 2 agonists
Although, baclofen and tizanidine are
(tizanidine, clonidine) and peripheral
customarily preferred because of their
antispastics (dantrolene). Only four drugs
fewer side effects (Meythaler et al.,1999;
are currently approved by the US FDA as
Illum et al., 2003 ; Dario and Tomei, 2004
antispastic agents: baclofen, diazepam,
and David, 2005). Intrathecal baclofen is a
dantrolene sodium and tizanidine. It
newer approach with reported efficacy and
appears preferable to use centrally acting
minimal adverse effects (Hardman et al.,
drugs such as baclofen, tizanidine, and
1996; Meythaler et al., 1999; USPDI, 1999;
diazepam in spasticity of spinal origin
Drug Facts and Comparisons, 2001).
(spinal cord injury and multiple sclerosis).
Tizanidine and baclofen have been
Intrathecal administration of antispastic
chosen in the current study , as both drugs
drugs has been used mainly in cases of
are centrally acting, used in the treatment
muscle over activity occurring primarily in
of spasticity of spinal origin and both have
the lower limbs in nonambulatory, severely
attracted some interest in drug addiction
disabled patients but new indications may
field, as they decrease withdrawal syndro-
emerge in spasticity of cerebral origin
me of some drugs of abuse (Sos et al.,
(Gracies et al., 1997; Kuhn, 1998 ; Karch,
2000; Ahamdi-Abhari et al., 2001;
2000). Baclofen remains the most comm-
Colombo et al., 2002). In addition to the
only used antispastic for treatment of the
widespread use of tizanidine between
spasticity of spinal origin (Wagstaff and
addicts in Egypt (Guide book for controlled
Bryson, 1997; Brenner et al., 1998 ; Rode
and uncontrolled drugs, 2003).