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Diabetic Autonomic Neuropathy, a Co-factor related to Recurrent Urinary Tract Infections In Type2 Diabetic females, a Study in an Egyptian Population.

¹ Ashraf A. El-Sheikh, ¹ Nora A. El-Sheikh, ² Manal M.Badawi, ² Magda H. Mahran and ³ Nirvana A. Khalaf

¹Abou Seifein Diabetes Center, Cairo, Egypt

²Microbiology & Immunology Department (RIO), Research Institute of Ophthalmology, Giza, Egypt.

³Clinical Pathology Unit (RIO), Research Institute of Ophthalmology, Giza, Egypt.

adc_elsheikh@hotmail.com

Abstract: Bacterial infection is a common finding in diabetics presenting in outpatient clinics. It may occur in many organs, although urinary tract infection (UTI) is the most frequent. Women are significantly likely to develop UTI then men (1). Diabetic Autonomic Neuropathy (DAN) is a serious complication of diabetes (2). It is among the least recognized and understood complications despite its significant negative impact on survival (2,4). Aim of Study: The aim of our study is to correlate the occurrence of recurrent UTI with DAN in a female diabetic type2 population. Materials & Methods: We recruited 60 female patients suffering from recurrent UTI, age range from 30 – 50 years, diagnosed as type2 diabetes since a period of less than 5 years with average HbA1c of 7.5% range (7.2-8.1). All patients were subject to SudoScan test to diagnose DAN, Clinical examination and Laboratory assessment. Results: patients were categorized into three groups: group A: 20 patients suffering from mild DAN (40-50-uS) and mild UTI (pus cells 30-50 /HPF) - group B: 24 patients with moderate DAN (25-39 uS) and moderate UTI (pus cells 51-80 HPF) and (group C: 12 patients with severe DAN (< 25 uS) and severe UTI (pus cells > 100 /HPF). Culture & Sensitivity results demonstrated a variety of micro-organisms mainly Escherichia coli, Staphylococcus saprophyticus, Klebsiella spp., group B streptococcus and Candida albicans. A combination of 2 to 3 antimicrobial agents was selected for every patient to be used for about 1-2 weeks. 28cases - half from every group - were randomly selected for adding anti-neuropathy agents. After 2 months, all patients presented for a second urine analysis, culture and HbA1c. The Results were as follow: 24 patients among the 28 selected for anti-neuropathy treatment showed negative results of culture & sensitivity compared to12 patients among the other 28 patients who received only antibiotic therapy (P<0.005). HbA1c decreased on average of 0.5%. Conclusion: These results along with the matching results of the Sudoscan prove the correlation between the presence of DAN and UTI and highlight its role as a co-factor with hyperglycemia in the pathogenesis of recurrent UTI.

[Ashraf A. El-Sheikh, Nora A. El-Sheikh, Manal M. Badawi, Magda H. Mahran and Nirvana A. Khalaf. Diabetic Autonomic Neuropathy, a Co-factor related to Recurrent Urinary Tract Infections In Type2 Diabetic females, a Study in an Egyptian Population. J Am Sci 2015;11(2s):1-5]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 1

doi:10.7537/marsjas1102s15.01

Key words: Urinary Tract Infection in diabetics, Sudoscan, Type 2 Diabetes Mellitus, Diabetic Autonomic Neuropathy.

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The effect of a training tool in Score level and some physiological Parameters of butterfly swimmers

Wael Abdel Moati Khalafalla

Department of Swimming, Faculty of Physicsal Education, El Azhar University. Egypt.

wwaa702000@hotmail.com

Abstract: Research aims: 1. knowing the changes in score levels of butterfly swimmers before and after monofin training program. 2. Knowing the changes in some physiological parameters under investigation of butterfly swimmers before and after monofin training program. Research Methods: Experimental approach was used, by experimental design of one group of swimmers in a pre and post measurement. Participants: After a full explanation of the aim of the study and of the experimental procedures, 8 male swimmers from El Azhar University in the year (2013-2014), Procedures: Before experiments, swimmers were asked to abstain from smoking or medicament and caffeine. They were participating in training using Monofin at Saraya El Kobba youth center in swimming pool. They started with warming up for 10 minutes, trained using Monofin for 60 minutes at the end of the training they were practise cooling down for 10 minutes. The training period was between 1/10 – 31/12/2013 for 12 weeks, during the training they were always motivated and encouraged to finish their task. A the end of the training program, 100 meters butterfly swim was timed and the record level was assessed and recording the time of each participant. Blood samples were drawn at rest and after 100 meters butterfly swim, before and after the 12 weeks training course, together with B/P, pulse rate and Vo₂ max, which was performed using the Ergometer and Astrand Nomogram. Results: Hemoglobin, RBCs, hematocrit revealed an increased levels after the training program, which means that the Monofin training increased oxygen capacity of the participants. The increased WBCs and cortisol levels after the training period indicated a better immunity and health change following Monofin training, this result was also recorded in case of the increased CD4, CD8 after Monofin training. CD8 occurs on the surface of cytotoxic T cells, while CD4 occurs on he surface of helper T cells. Both foster Lymphocite development and immunity Vo2 max increased after monofin training program and land exercise from 38.2 ± 1.9 to 45.4 ± 1.7 ml/kg/min. Conclusion: 1. Monofin enhance swimmers speed, performance and score levels. 2. Monofin led to positive results affecting VO2 max, pulse rate, B/P. 3. The training program affect positively Hemoglobin, RBCs, Hematocrit and increased oxygen carriers. 4. The training program affect positively the immunological variables and health state of the swimmers.

[Wael Abdel Moati Khalafalla. The effect of a training tool in Score level and some physiological Parameters of butterfly swimmers. J Am Sci 2015;11(2s):6-12]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 2

doi:10.7537/marsjas1102s15.02

Keywords: effect; tool; Score; physiological Parameter; swimmer

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Clinical Usefulness of Telomerase Assay in Patients with Ewing's Sarcoma

Alaa Fayed¹, Ashraf Abd Eldayem ² and Amal F. Gharib³

Departments of ¹ Clinical Oncology & Nuclear medicine, ² Orthopedic Surgery, ³ Medical Biochemistry, Faculty of Medicine, Zagazig University, Egypt

Fayed_alaa@yahoo.com

Abstract: Purpose: This study was designated to investigate whether telomerase is reactivated in Ewing’s sarcoma and whether it has a prognostic significance. Patients and Methods: Thirty-two patients with localized Ewing's sarcoma of bone were treated with four VACA blocks, each block lasted 9 weeks and consisted of three courses of treatment each, administered at 3-week intervals. Local therapy was scheduled to be given before the second block and was individually planned for each patient. Telomerase activity was determined using a modified-TRAP assay, hTERT mRNA Expression was performed by quantitative real-time polymerase chain reaction and the telomere length was determined based on the telomere restriction fragment (TRF) – Southern blot analysis. Results: Fourteen patients (44%) had a complete response or very good partial response (VGPR). Fifteen patients (47%) had either a partial response or stable disease. Telomerase activity (TA) was detected in 84% of patients. No significant correlation was found between any of the clinical parameters and TA. High expression of human telomerase reverse transcriptase (hTERT) (≥100 copies) was identified in 59% of patients and it was significantly correlated with high TA. Twenty-one of 32 patients exhibited changes in telomere lengths: eight longer and thirteen shorter. No significant correlation was found between telomere length and TA. Nineteen (83%) of 23 patients with high TA relapsed, while none of the nine patients with low TA did. Highly significant correlation was observed between TA and progression free survival (PFS). Low TA patients had 100% PFS, while high-TA patients had 36% PFS (P < .0001). 58% of patients expressed high hTERT relapsed versus 15% of those expressed low hTERT. PFS comparing patients with high and low hTERT expression was statistically significant (P = .0321). All samples that were tested for hTERT were also analyzed for TA and correlated significantly (P =^.0.0357). Conclusion: Our results showed that telomerase activity could be used as a prognostic factor in patients with Ewing's sarcoma.

[Alaa Fayed, Ashraf Abd Eldayem and Amal F. Gharib.^. Clinical Usefulness of Telomerase Assay in Patients with Ewing's Sarcoma. J Am Sci 2015;11(2s):13-21]. (ISSN: 1545-1003). http://www.jofamericanscience.org. 3

doi:10.7537/marsjas1102s15.03

Key words: Ewing's sarcoma, chemotherapy, telomerase assay.

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