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<i>In-Vitro</i>Comparison of Antifungal Activity of Herbs (Darehald and Pomegranate) with Azoles

International Journal of Clinical Medicine 2018年第9期9卷 703-715页

作者： rabeea rizwan Shehla Shaheen Zahida Memon Faisal Afridi Mubarak Zaib Department of Pharmacology Ziauddin Medical College Karachi Pakistan Department of Microbiology Ziauddin University Hospital Karachi Pakistan

Aim: Candida, an opportunistic organism is one of the commonest causes of hospital acquired infections among fungi. Currently available antifungal drugs have numerous adverse effects and drug-drug interactions (DDIs) along with increase in resistance over the time. Therefore, it is highly emergent to consider alternative treatments for candidal infections, having fewer adverse effects and is cost-effective. The current in-vitro study is undertaken to assess and compare the antifungal effects of the herbs, Berberis aristata (B. aristata, Darehald/Darhald) and Punica granatum (P. granatum, Pomegranate) with fluconazole and voriconazole, based on culture and sensitivity of candidal isolates. Materials and Methods: Ethanolic extracts of herbs (Berberis aristata and Punica granatum) and concentrations were formulated as per standard procedure. 130 samples were obtained for the study from in and out patients reported in clinical subsets of Ziauddin Hospital, Karachi from March to May, 2018. Samples were collected and grown according to the standard procedures like, wet mount test and gram’s staining. Species were identified by CHROM agar candida and API 20 C AUX methods. Sensitivity tests were performed by Kirby Bauer’s disc diffusion method according to CLSI guide lines M-44 A2, 2009. Data analysis was done by one-way ANOVA to compare the antifungal activities of drugs and herbs. Results: Mean inhibitory zones of herbs, B. aristata and P. granatum were highly significant against clinical candidal isolates with respective p-values of 0.00 and 0.02. Both of the herbs, B. aristata and P. granatum were found to be more sensitive, 98.5% and 97.7% respectively in comparison to fluconazole showing 42.3% and voriconazole showing 29.2% sensitivity against candidal isolates. The most resistant candidal specie was C. tropicalis that showed resistance against both fluconazole and voriconazole, contrary to that, this specie was highly sensitive to both of the herbs, showing sensitivi

关键词： Candida Fungi Azoles Antifungal Sensitivity Antifungals Berberis aristata Punica granatum Pomegranate Darhald Darehald

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Prevalence and Sensitivity Patterns of Candidal Infections in Various Tertiary Care Health Subunits of Karachi

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International Journal of Clinical Medicine 2018年第9期9卷 645-659页

作者： rabeea rizwan Zahida Memon Shehla Shaheen Faisal Afridi Mubarak Zaib Department of Pharmacology Ziauddin Medical College Karachi Pakistan Department of Microbiology Ziauddin University Hospital Karachi Pakistan

Mostly candida resides as an opportunistic organism on epithelial surfaces of human being. However, under auspicious conditions can cause infections including serious life threatening invasive candidiasis with subsequent mortality particularly in immune deficit and hospitalized patients having co-morbids. Limited data are published on the prevalence of candidiasis, based on the researches conducted at few tertiary care settings which are not representing the overall disease burden in our country, Pakistan. Therefore, this study was conducted to evaluate the frequency and sensitivity patterns of candidiasis in our community. Methods: Out of total 1020 specimens, 130 clinical samples were identified as candidal positive, obtained from March to May 2018. These samples were isolated from vagina, oropharynx, urine, tracheal aspirates, pus, blood, tips of the intubations, wounds and fluids of the body cavities. Identification of candida, its species and antifungal sensitivity screening was done by Kirby Bauer’s disk diffusion method according to CLSI guide lines’ (M - 44 A2 series, 2009). Results: A significant majority, 80 (61.5%) of candidal strains were isolated from females with female to male ratio 8:5 and most of these isolates were obtained from high vaginal swabs (43.75%). Four candidal species (Candida albicans 80%, Candida tropicalis 10%, Candida glabrata 9.2% and Candida ciferrii 0.8%) were isolated from all positive specimens. Maximum number of the positive samples 52 (40%) were obtained from ICU patients. Sensitivity test of candidal positive samples revealed that commonly used azole antifungal drugs, fluconazole and voriconazole were highly resistant, with respective 57.7% and 70.8% resistance. Conclusion: Candidiasis is highly prevalent in our clinical set up and more frequently infecting females in comparison to males as most of the positive isolates were retrieved from HVS (high vaginal swabs). Still, C. albicans was found to be the most prevalent specie

关键词： Candida Candidiasis Antifungal Drugs Fluconazole Voriconazole C. albicans Candidal Infection Sensitivity Resistance

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Magnet Attract Shell during Head and Neck Surgery

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第5期8卷 171-179页

作者： Ahmed Khalaf rabeea M.B.CH.B High Diploma Otolaryngology Department of Otolaryngology Salahaden General Hospital Tikrit Iraq

Objective: New method to use magnet for localization and extraction of shell during head and neck surgery. Method: Series of 3 cases study all are boy’s 17_15_5 years old respectively. All are with penetrating shell injuries to head and neck in Salahaden General Hospital-Tikrit city-Iraq from 25-Oct.-2016 to 30 March 2017. This hospital is a central general governmental hospital that receives referral cases from region distal to the center of Salahaden province at north of Baghdad city (capital of Iraq) and plays a major rule in management of injured patient during war. The cases are selected after explanation of this new method to the patients, it is expected result, risk, possible complication, and unexpected sequelae that may happen after surgery. Prior consent from patients and their families about this sort of surgery has been got. These patients are from families of low socio economic group except the last one he is medium class. All are undergoing surgical management with the aid of magnet. Result: we have 3 cases of shell injuries to head and neck magnet is used successfully for identification of shells and helps in their extraction. Our trial is limited for metallic objects and limited depth. Conclusion: These results suggest that magnet aid removal of shell during head and neck surgery, is less invasive technique, minimal trauma to the surrounding tissues and reducing time of surgery.

关键词： Magnet Shell Injuries Head and Neck

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Application for Superconvergence of Finite Element Approximations for the Elliptic Problem by Global and Local L<sup>2</sup>-Projection Methods

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American Journal of Computational Mathematics 2012年第4期2卷 249-257页

作者： rabeea H. Jari Lin Mu Department of Applied Science UALR Little Rock USA

Numerical experiments are given to verify the theoretical results for superconvergence of the elliptic problem by global and local L2-Projection methods.

关键词： Finite Element Methods Superconvergence L2-Projection Elliptic Problem

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雷公藤红素在去势抵抗型前列腺癌中潜在应用的研究

雷公藤红素在去势抵抗型前列腺癌中潜在应用的研究

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作者：拉别（Hussein Wahhab Salh rabeea）哈尔滨工业大学

学位级别：硕士

前列腺癌(Prostate Cancer,PC)是严重威胁男性健康的重大疾病之一。美国癌症学会每年发布的全国卫生统计数据显示,男性PC的死亡率仅次于肺癌及支气管癌,连续高居各年龄段男性癌症患者死亡率的第二位。雄激素(Androgen)及其受体(Androgen... 详细信息

前列腺癌(Prostate Cancer,PC)是严重威胁男性健康的重大疾病之一。美国癌症学会每年发布的全国卫生统计数据显示,男性PC的死亡率仅次于肺癌及支气管癌,连续高居各年龄段男性癌症患者死亡率的第二位。雄激素(Androgen)及其受体(Androgen Receptor,AR)在前列腺癌的发生与演进过程中发挥重要作用,因此,通过手术或药物去势抑制AR转录活性的雄激素剥夺治疗(Androgen Deprivation Therapy,ADT)一直是前列腺癌治疗的标准方法。尽管雄激素被剥夺可以暂时延缓患者的生存期,但大部分患者会在几年内发生癌症复发,发展为浸润性更强的前列腺癌,即去势抵抗性前列腺癌(Castration Resistant Prostate Cancer,CRPC)。AR基因包含8个外显子和7个内含子,全长约90kb,编码约919个氨基酸残基,一般由四个结构域组成。其中NTD(N-Terminus domain)为外显子A编码的低保守的氨基端结构域,又称转录激活域(transcription activate domain,TAD)。DBD(DNA-binding domain)为一个相对较小的结构域。此区域包括3个α螺旋组成的两个锌指结构。AR的DBD区与其他类固醇受体的结合区域具有高度的同族性,通过此区AR识别并结合ARE,结合后的受体/激素复合物便可刺激转录起始位点附近的起始前复合物形成同时使该复合物稳定,进而将其与RNA聚合酶Ⅱ连接,活化信息核糖核酸mRNA的转录。LBD(ligand binding domain)与DBD区之间由一个含有核定位信号的铰链区(flexible hinge)相连,主要功能为决定配体/受体之间的特异性结合,同时LBD区与NTD区为两个完成AR活化调节转录的两个主要结构域。除此之外,LBD区还包含与热休克蛋白(heat shock protein,HSP)相互作用区,二聚体化区域以及一个转录激活功能区AF2(activation function 2)。在体内没有雄激素存在时,LBD区一般与不同分子量的HSP等分子伴侣结合,使构象维持在一种激素高亲和状态,以寡聚体的形式存在于胞浆中,此时AR不具有转录活性。一旦AR与雄激素结合后,其空间构象就发生了改变,同时与HSP解离,进一步磷酸化,进而使其与DNA的亲和力增高,发生AR的活化。活化以后的AR头头尾尾相接,形成同源二聚体,然后进入靶细胞核,与靶基因启动子中特定的DNA序列——雄激素反应元件(androgen response element,ARE)相结合,再在TIF-2、CBP/p300、ARA70、ARA54、BAG-IL等共调节因子(coregulator)的作用下开启转录调控,激活一系列与细胞生长发育、自动平衡、生殖代谢等活动相关的靶基因,如前列腺特异性抗原(PSA)、SLP、probasin等基因的表达,进而发挥其生物学效应。这种ar的活化被称之为配体(激素)依赖性ar的活化(ligand-dependentactivation),还有研究表明,在没有发生基因突变的情况下,ar的活化还可以通过配体非依赖性(ligand-independentactivation)机制进行。可见,ar的转录调节功能对于引发靶基因的有效转录,指导特定蛋白质的合成及细胞的生长和分化具有重要意义。去势抵抗的形成源于ar被重新激活。在crpc中,ar仍持续高表达且有转录活性;利用crpc动物模型证实crpc的生长依赖于ar的重新激活;去势后crpc患者体内有雄激素残留,在crpc患者的肿瘤样品中发现高水平的与雄激素合成相关的酶,说明肿瘤细胞内可以合成雄激素。恩杂鲁胺(enzalutamide)和阿比特龙(abiraterone)是美国食品与药物管理局(fda)新批准的第二代雄激素/雄激素受体(ar)拮抗药物,分别抑制雄激素的合成及雄激素与受体的结合。abiraterone抑制雄激素合成必须的cyp17a1酶活性,enzalutamide是一种更有效的雄激素与ar结合的拮抗剂。以enzalutamide和abiraterone为代表的第二代荷尔蒙治疗药物进入了iii期临床试验。临床试验表明,去势抵抗性前列腺癌患者表达ar剪接变异体ar-v7。ar-v7由第3外显子变异剪接形成。由于ar-v7缺少lbd,使得恩杂鲁胺和阿比特龙作用脱靶,造成前列腺癌演进为转移型去势抵抗前列腺癌(mcrpc)。此外,arlbd的体细胞突变(f876l),使得enzalutamide的作用由雄激素拮抗转变为雄激素激活。以tok-001(galeterone)为代表的第三代雄激素剥夺治疗最近进入了临床试验,其作用不仅是雄激素拮抗,还引起ar降解,因此避免了因ar突

关键词：雄激素受体雄激素受体剪接变异体-7 雷公藤红素细胞凋亡

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Role of Nurse in Administrating Induction of Ovulation Medications at Assisted Reproduction Center versus at Home

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 118-134页

作者： Mona rabeea Ahmed Manal Farouk Mostafa Ghadah Abdelrahaman Mahmoud Ahmed N. Fetih Esraa Badran Tarek A. Farghaly Faculty of Nursing Assiut University Assiut Egypt Faculty of Medicine Assiut University Assiut Egypt

Background: The response of ovaries during controlled ovarian stimulation is the most important factor for evaluating the pregnancy outcome in assisted reproductive techniques. Aim: The study is to assess the role of a nurse in giving induction of ovulation medications at assisted reproduction university center versus home medications by private In Vitro Fertilization and infertility center on clinical outcomes and patient satisfaction. Subjects and Methods: Case-control research design, conducted at two centers (Banon private center for IVF and Assisted Reproductive Unit at Women health hospital, Assiut University) during the period from February 2018 to November 2018. The sample size included 150 women undergoing IVF for each group. Results: There is no statistically significant difference between women given IVF medications by the nurse at the public IVF center and women take IVF medication in the home at Banon IVF center as regards the outcome of IVF. Majority of infertile patients are satisfied with the care, they received and nearly third of them are satisfied with outcome of IVF in both groups, and there is statistically significant difference between satisfaction in public IVF center and satisfaction in private center in relation to information provided about IVF procedure, staff willingness to listen carefully and help patients;regular progress update on condition is in place with p value (0.000, 0.005, 0.003) respectively. Conclusion: IVF outcome isn’t significantly related to where induction medication was taken either at IVF center or at the home because infertile couples are keen to comply with all instructions on how to take medications with correct route, correct dose and on time. Recommendations: Empower the role of nurse as a health educator for women undergoing IVF about importance of stage of induction and take medications with correct route, correct dose and on time on outcome of IVF;other studies should also be conducted in other centers to furt

关键词： Induction of Ovulation IVF Patient’ Satisfaction

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