UN Office for the Coordination of Humanitarian Affairs

Key communication skills and how to acquire them

Apolipoprotein E (apoE) is the major risk factor, besides aging, for Alzheimer's disease (AD). Many hypotheses have been proposed to explain the mechanism whereby one of the isoforms of apoE, apoE4, could cause AD. We have been conducting studies on the pathogenic roles of apoE from the viewpoint of its physiological function. We previously reported that one detrimental effect of apoE4 on neuronal viability can be induced by alteration in intracellular cholesterol metabolism. In brains of patients with AD, there is a common pathological process, called the amyloid cascade. Therefore, one of the central questions regarding the pathogenic roles of apoE in the development of AD is how apoE4 enhances deposition of amyloid b-protein (A beta). In relation to this issue, evidence is now accumulating to show that the metabolism of amyloid precursor protein (APP) and A beta can be modulated by cellular cholesterol. Our recent studies revealed that a novel A beta with a unique ability to accelerate fibril formation of soluble A beta is generated in the presence of cellular cholesterol. These lines of evidence suggest that the alteration of cholesterol metabolism in neurons due to aging and/or expression of apoE4 may be a prerequisite for the development of AD.

[Risk factors for Alzheimer's disease].

Background: Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has...

Adolescent tramadol use and abuse in Egypt.

Tramadol: Understanding the Risk of Serotonin Syndrome and Seizures.

An increasingly alarming phenomenon of tramadol drug abuse has been demonstrated in the Egyptian community. The alleged usages of tramadol had also contributed greatly to its popularity and massive use especially among Egyptian youth as a remedy for premature ejaculatory function and for extended orgasm and increase sexual pleasure as promoted through many online drug stores and media. 1 Aim of the work To study the impact of tramadol and its increasing rates of drug abuse widely spread among Egyptian youth on the observed association with recently increasingly noted variable forms of aggression and accidents. Patients and methods This study was carried out on the patients who presented to (PCC-ASU) Hospitals, Egypt in the year 2010 (January–December). Results The total number of studied cases was 640 with the adult (67.9%), males (77.2%). Abuse form of drug intake was the highest (50.8%). Oral intake (96.8%). The most frequent forms of injuries were cerebral edema (55.9%). Conclusions The significantly notable increasing violence forms are closely related to drug abuse. Tramadol’s prevalence is the mostly noted due to its wider availability and cheaper prices than other types of abused drugs. The unplanned indirect media advertising for tramadol abuse through movies and show series also played a remarkable role in promoting tramadol abuse. Recommendations Drug screening for tramadol should be added to all forms of basic toxicological screening. Especially in cases of patients involved in violent crimes and road traffic accidents, also for those applying for drivers’ license fitness program.

Some medicolegal aspects concerning tramadol abuse: The new Middle East youth plague 2010. An Egyptian overview

An increasingly alarming phenomenon of tramadol drug abuse has been demonstrated in the Egyptian community in the last four years. Although the issue of drug abuse is not a newcomer to the Egyptian society, tramadol has been associated with a wide range of drug abuse and its illegal drug transactions had made it easily accessible and readily provided at cheap costs despite of its being a scheduled drug. The alleged usages of tramadol had also contributed greatly to its popularity and massive use especially among Egyptian youth as a remedy for premature ejaculatory function and for extended orgasm and increase sexual pleasure as promoted through many online drug stores and media. Aim of the work: To study the impact of tramadol increasing rates of drug abuse on the observed association with forms of aggression and accidents. Patients and methods: This study was carried out on the patients who presented to Poison Control Center of Ain Shams University Hospitals, Egypt in the year 2010 presented with trauma with suspected associated drug toxicity for toxicological assessment. RESULTS: Number of studied cases was 640 with the adult population showing a higher prevalence (67.9%). The prevalence was higher in males (77.2%). Abuse form of drug intake was the highest (50.8%). The oral route of intake is the highest (96.8%). Patients abusing tramadol presented with any clinical finding denoting involvement in an act of violence or giving history of it (36.3%), forms of accidents whether road traffic accidents (18.7%), acts of violence as fights and domestic violence (33%) and accidental fall and unintentional self-induced injuries (48.3%).The most frequent forms of injuries were cerebral edema (55.9%) and the least being inter cerebral hemorrhage (5%) both diagnosed both clinically and as a CAT SCAN brain finding. Whilst as forms of injuries were lacerated wounds (38.9%), contusions (35.3%), abrasions (31.3%), cerebral concussion (22%), and bone fracture (17.8%), and polytrauma (11%). Conclusions: The significantly notable increasing violence forms are closely related to drug abuse. Tramadol's prevalence is the mostly noted due to its wider availability and cheaper prices than other types of abused drugs. Recommendations: Drug screening for tramadol should be added to all forms of basic toxicological screening. Especially in cases of patients involved in violent crimes and road traffic accidents, also for those applying for drivers' license fitness program. Keywords: Abuse-Tramadol-Egypt-Youth-Violence.

Medicolegal aspects concerning tramadol abuse. the new Middle East youth plague: an Egyptian overview 2010

Medical ethics educational improvement, is it needed or not?! Survey for the assessment of the needed form, methods and topics of medical ethics teaching course amongst the final years medical students Faculty of Medicine Ain Shams University (ASU), Cairo, Egypt 2010

Background: The plant Henna (Lawsonia inermis, family Lythraceae) is a naturally grown or cultivated plant allover Africa and Asia. Marketed Henna is a natural powdered material derived from dried and crushed leaves of the plant. Henna is very popular in many parts of Egypt as it is part of the culture and traditions, and it recently became very popular in touristic areas as Sharm El Sheikh-Egypt being used as a tattooing agent. This makes detection of heavy metal content and, other toxic ingredients in Henna marketed in Egypt of crucial importance.
Objective: To investigate heavy metal content and, other toxic ingredients as para-phenylenediamine (PPD) in Black Henna marketed in Egypt.
Methods: Fifteen Black Henna samples were collected randomly from Sharm El Sheikh-Egypt market and, analyzed for metal content by atomic absorption spectrophotometry (ICP-MS) after microwave acid digestion, also the presence of PPD in henna samples was determined qualitatively and quantitatively using High Performance Liquid Chromatography (HPLC).
Results: PPD was detected in all the black henna samples at concentrations ranging between 1.75% and 32.1%, which is higher than that recommended for hair dyes. The mean concentration of some studied metals as Aluminium, Lead, copper, nickel, and zinc were higher than permissible levels for cosmetics in some of the studied samples.
Conclusion: In conclusion, PPD is a common ingredient in black henna dye in the developing world. Physicians must be aware of the potential toxicity of this chemical and of the clinical signs of systemic poisoning. High concentration of some metals as Aluminium, lead, copper, nickel, and zinc might be encountered in some Henna products. Considering popular use of henna, the hazardous cumulative effects of prolonged exposure to low concentrations of such metals, especially in children, cannot be ruled out. Further studies are recommended.

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Determination of Heavy Metals and Other Toxic Ingredients in Henna(Lawsonia inermis)

Background: The regulated upon activation, normal T cell expressed and secreted (RANTES) production in psoriatic lesions may amplify the inflammation in these lesions. Narrow band ultraviolet B (NB-UVB), a therapeutic modality for psoriasis, affects the expression of inflammatory cytokines and chemokines. Objective: Our aim was to evaluate RANTES mRNA expression in skin lesions of psoriasis before and after NB-UVB phototherapy. Methods: This study included 25 psoriatic patients who received 24 sessions of NB-UVB. Skin biopsies were taken before and after phototherapy for real time PCR evaluation of RANTES mRNA. Results: The relative quantitation values (RQ) of RANTES mRNA expression was significantly reduced after treatment. A significant negative correlation was found between pre-treatment RQ RANTES mRNA expression and post-treatment PASI score. We found a significant negative correlation between dRQ RANTES mRNA expression (difference between RQ RANTES mRNA expression before and after phototherapy) and PASI score after phototherapy. We found significant negative correlations between pre-treatment RQ RANTES mRNA expression and both initial response session number and total NB-UVB dose at the end of phototherapy. Conclusion: NB-UVB reduces RANTES mRNA expression in psoriatic lesions. Pre-treatment RQ RANTES mRNA expression could be considered as a marker for clinical improvement and NB-UVB phototherapy efficacy.

Marwa M Fawzi

Papers

Some medicolegal aspects concerning tramadol abuse: The new Middle East youth plague 2010. An Egyptian overview

Medicolegal aspects concerning tramadol abuse. the new Middle East youth plague: an Egyptian overview 2010

Medical ethics educational improvement, is it needed or not?! Survey for the assessment of the needed form, methods and topics of medical ethics teaching course amongst the final years medical students Faculty of Medicine Ain Shams University (ASU), Cairo, Egypt 2010

Determination of Heavy Metals and Other Toxic Ingredients in Henna(Lawsonia inermis)

Reduction of RANTES expression in lesional psoriatic skin after narrow band ultraviolet therapy: a possible marker of therapeutic efficacy