STUDY IN THE EPIDEMIOLOGY OF SARCOCYSTOSIS SARCOCYSTIS CAMELI IN CAMELS IN AI-QADISIYAH PROVINCE

The aim of study was to investigate the prevalence of macroscopic and microscopic sarcocystosis of 312 camels slaughtered in Al-Qadisiyah province abattoirs. The developmental stages were studied in experimentally infected dogs with Sarcocystis cameli. For macroscopic sarcocystis naked eye examination was done while for microscopic type, the methods were employed (peptic muscular digestion, trichinoscopy, squeezing and histological examination) for the detection of infection in esophagus, heart, diaphragm and skeletal muscles. The percentage prevalence of macroscopic cysts were first recorded (0.64%) among the different organs examined. The rate of microscopic infection was (83.3%) in peptic digestion method followed by squeezing and trichinoscopy were 78.47 % and 58% respectively The highest rate of infection was recorded in the esophagus and the lowest in the heart. Histological examination revealed two different morphological cysts, the first one with thin wall and the other thick striated wall. The pre patent periods were 8-9 and 10-12day respectively, each infected dog-shed total about 32 * 10* sporocysts per gram of faeces. The peak of shedding reached 326*10* sarocystis per gram of faeces day12 post infection histological development stages of the parasite were detected in the small intestine mucosa of dog in days 6 and 12 post infection.

The Effect of the Cytoprotector Rebamipid on the Activity of Disaccharidases in Patients with Enteropathy with Impaired Membrane Digestion

ENMP (enteropathy with impaired membrane digestion) is a new nosological form of pathology of the small intestine, which is based on a decrease in the activity of small intestine carbohydraz. The clinical picture of ENMA is very similar to irritable bowel syndrome, but it differs in the etiotropic relationship of symptoms with intolerance to products containing a lot of fermentable oligo -, di- and monosaccharides and polyols. The basis of the treatment of this pathology is the FODMAP diet, but this therapy only allows you to reduce the load on the enzymatic transport complexes, and not restore them. A new direction in the treatment of patients with EMF is our proposed system for restoring the activity of enzymes of the small intestine mucosa under the influence of the cytoprotector rebamipid. The use of rebamipid in the complex therapy of INMP contributes to an increase in the activity of small intestine carbohydraz and a decrease in symptoms associated with intolerance to short-chain carbohydrates FODMAP. The persistent positive effect of the drug is observed gradually over 8 weeks in patients who received the drug at a dose of 300 mg/day. With this treatment regimen, patients have an improvement in the tolerability of carbohydrate-containing foods, a decrease in flatulence, pain syndrome, and a tendency to normalize the stool has also been noted.

Dietary Lysine Requirements of Colossoma Macropomum (Cuvier, 1818) Based on Growth Performance, Hepatic and Intestinal Morphohistology and Plasma Biochemistry

This study aimed to determine the dietary lysine requirements of juvenile Colossoma macropomum tambaqui based on growth performance. We also evaluated gut and hepatic histomorphometry as well as blood metabolites in accordance with the increased levels of dietary lysine. The juveniles (33.88 ± 2.47 g) were fed until apparent satiation with diets containing 6.60, 9.72, 12.84, 15.96, 19.08 and 22.20 g/kg of lysine. Fish were randomly distributed in groups of 10 fish per tank and assays were performed in triplicate, during 90 days. Tambaqui fed with 15.96 g/kg dietary lysine showed higher final weight (p = 0.001) and optimized feed conversion ratio (p = 0.001). Morphohistological modifications were present in livers of fish fed with low levels of lysine. In the proximal intestine, mucosa layer density was greater at the level of 15.96 g/kg (p = 0.001). In the middle intestine, height (p = 0.001) and perimeter (p = 0.001) of the villi were greater at low levels of lysine (respectively, 9.72 and 12.84 g/kg dietary lysine). Tambaqui fed with 15.96 g/kg of lysine achieved higher plasma protein concentrations (p = 0.01). Using the second-order polynomial regression analysis as support, and based on protein efficiency rate and body weight gain, dietary lysine requirement for juvenile tambaqui was calculated as 15.4–15.6 g/kg of diet (5.7–5.8% of dietary protein).

OP08 Automatic detection of enteric ulcers and erosions in capsule endoscopy using a convolutional neural network

Background Capsule endoscopy (CE) is recommended for the diagnosis and assessment of disease extension in patients with suspected or known inflammatory bowel disease, particularly Crohn’s disease. Ulcers and erosions of the enteric mucosa are prevalent findings in these patients. They frequently occur together, and their identification in CE is crucial for an accurate evaluation of disease severity. Nevertheless, reviewing CE images is a time-consuming task, and the risk of overlooking lesions is significant. Over the last decade, artificial intelligence (AI) has emerged as a mean for overcoming these pitfalls. Of all AI methods, convolutional neural networks (CNN), due to their complex multilayer architecture present the best results in image analysis. We aimed to develop a CNN for the automatic identification of ulcers and erosions in the small bowel mucosa. Methods A total of 1483 CE exams (PillCam SB3®) performed at a single centre between 2015–2020 were analyzed. From these exams, a sum of 11588 frames of the enteric mucosa were obtained, 3163 containing enteric ulcers and erosions, and the remaining containing normal mucosa or other findings. Ulcers and erosions were stratified according to the Saurin’s classification for bleeding potential: P1E – erosions with intermediate bleeding risk; P1U – ulcers with intermediate bleeding risk; P2U – ulcers with high bleeding risk. For automatic identification of these lesions, these images were inserted into an CNN model with transfer learning. Subsequently, the performance of the network assessed using an independent set of images. The output provided by the CNN was compared to the classification provided by a consensus of specialists (Figure 1). Results After optimizing the neural architecture of the algorithm, our model was able to automatically detect and distinguish ulcers and erosions (any bleeding potential) in the small intestine mucosa with an accuracy of 96.7%, precision of 95.9%, sensitivity of 91.7% and a specificity of 97.8% (Figure 1). The mean processing time for the validation dataset was 23 seconds (approximately 101 frames/second). Conclusion We developed and tested a deep learning model based on a CNN for the automatic detection of enteric ulcers and erosions in CE images. Our system revealed extraordinary performance marks. We believe that our study lays the foundation for the development and application of effective AI tools to clinical practice. These techniques should improve diagnostic accuracy and reading efficiency.

The role of a combined probiotic in the treatment of lactase deficiency

Aim. To study the effectiveness of the combined probiotic Bifiform and the enzyme lactase in the treatment of secondary lactase deficiency (SLD). Materials and methods. We examined 79 patients with SLD, isolated from the group of patients with post-infectious irritable bowel syndrome (IBS) with a predominance of diarrhea. The age of patients reached 273.5 years, women predominated by gender 62%. Diagnosis of SLD was carried out in biopsies of the small intestine mucosa using a color rapid test. To diagnose small intestinal bacterial overgrowth (SIBO) all patients underwent lactulose breath test (LBT) during 2 hours by gas analyzer. All patients with lactase deficiency (LD) were divided into 2 groups: group 1 included 54/79 patients who received the combined probiotic Bifiform (1 capsule per day), group 2 was treated with the enzyme lactase [1 capsule (3450 ME) 3 times a day]. The effectiveness of therapy was evaluated by the dynamics of clinical symptoms, indicators of LBT and the detection of hypolactasia in biopsies of the small intestine mucosa twice, before and 2 weeks after treatment. Results. In the group of patients with LD, as a result of 14-day therapy with the combined probiotic Bifiform, 85.2% showed positive clinical dynamics, the values of SIBO in the small intestine decreased from 5814 to 219 ppm, p0.05, and the activity of the lactase enzyme was completely restored. In 14.8% of patients, LD was preserved against the background of persistent SIBO. In the second group of 25 patients, 84% of patients did not achieve a positive dynamics of the disease as a result of taking the lactase enzyme, and hypolactasia and changes in the lumen microflora of the small intestine were preserved after repeated examination of small intestine biopsies. Recovery of the activity of the lactase enzyme was observed in a small percentage of patients, which was 16%. Conclusion. In 85.2% of patients, as a result of therapy with the combined probiotic Bifiform, the activity of the lactase enzyme was restored, due to the suppression of bacterial contamination in the lumen of the small intestine. Replacement therapy with the enzyme lactase only led to remission of LN in 14.2%, while in the majority 85.8% hypolactasia and SIBO remained. Pathogenetic therapy of LN in the adult population includes the appointment of a combined probiotic Bifiform 1 capsule 3 times a day, a course of at least 14 days. As a symptomatic therapy for LN, replacement therapy with the enzyme lactase can be prescribed.

Pathomorphological features of clinical forms of ulcerative colitis in children

Background. Ulcerative colitis is a chronic inflammatory disease of unknown origin, characterized by a clinically recurrent course with periods of bloody diarrhea and pathomorpholo­gical-diffuse inflammatory process in the colon. The problem of ulcerative colitis requires further study of the clinical features of the disease, taking into account the localization, degree of activity of the inflammatory process, changes in the structure of the mucous membrane that will help increase the efficiency of ulcerative colitis diagnosis in childhood. Materials and methods. On the basis of clinical and statistical analysis of 116 case histories of children aged 4–18 years with ulcerative colitis, the features of its clinical forms — total, segmental and distal — were studied during the period of exacerbation of the disease. Four hundred and forty-five biopsy specimens obtained during colonoscopy were histologically examined. After biopsy sampling, specimens were fixed in 10% formalin and were processed according to the generally accepted histological method with section staining using hematoxylin-eosin and according to Van Gieson. Results. Changes in the architecto­nics of the large intestine mucosa, which reduce the resistance of the mucous barrier, as well as impaired blood supply — a factor in the development of hemic hypoxia — are significant for the mechanisms of ulcerative colitis exacerbation.

Ultrastructural study of mucous cells of rat colon in long-term hypergastrinemia

Gastrin is considered one of the most important hormones regulating physiological processes. Trophic and proliferative effects of high gastrin levels on gastric mucosa are well known. Butinformation about gastrin effects on the colon is rather fragmentary and contradictory. In this study, ultrastructural changes in the proximal part of the colon induced in rats by chronic hypergastrinemia were analyzed by transmission electron microscopy. Experimental omeprazole-induced hypergastrinemia was reproduced using daily injections of proton pump inhibitor omeprazole in rats, resulted in hypersecrestion of gastrin by G-cells of stomach. Growth of gastrin level in the blood plasma was checked using radioimmunoassay method. Prolonged hypergastrinemia has been shown to be associated with increased cell proliferation and appearance of cellular atypia in the large intestine mucosa. The number of undifferentiated cells increased prominently. Intercellular contacts between such cells are altered, the space between them is unevenly expanded. Their organelles were observed significantly reduced, mitochondria contained destroyed crysts and signs of edema. Endocrinocytes did not contain their typical secretory granules. Cell nuclei were small, electron-dense, with invagination. In addition, numerous microorganisms were revealed in the intestinal lumen, as well as their invasion into the mucosa. Those ultrastructural changes were indicate increased hyperplastic processes and impaired cell differentiation in the epitheliocytes of large intestine. Therefore, long-term experimental hypergastrinaemia causes dysplastic changes in the large intestine mucosa of rats.

An Unusual Case of Cholestatic Hepatitis due to Light-Chain Deposition Disease

Light-chain deposition disease (LCDD) is a rare paraproteinaemia characterized by the deposition of monoclonal immunoglobulins with a non-fibrillar structure and hence Congo red negative deposits. Kidney disease is the more frequent manifestation, but other organs may also be involved. A 70-year-old man with hypertension and mild chronic renal failure showed a hepatomegaly without splenomegaly. His renal and liver test rapidly got worse. A serum electrophoresis and immunofixation isolated monoclonal kappa light-chain gammopathy, with serum free kappa light chain excess. The bone marrow biopsy showed the presence of interstitial infiltration of plasma cells like multiple myeloma type at initial phase. Periumbilical fat biopsy was negative. Echocardiography demonstrated an infiltrative cardiac disease. The biopsies of the duodenum small intestine mucosa showed flaps with eosinophil material (Masson’s staining) with atrophic crypts and chronic inflammation at chorion level. Amyloid substance was negative. There was a strong positivity for light chains kappa compatible with LCDD. A liver biopsy confirmed this finding. Therapy with dexamethasone and bortezomib improved clinical state and hepatic and renal laboratory tests. Chemotherapy based on novel anti-myeloma agents should be rapidly considered in LCDD patients with severe organ involvement.

Influence of sapropel on the activity of intestinal peptidases of broiler chickens

At the beginning of the experiment, the weight of weekly cockerels of the Hisex White egg cross (n = 90) was 64.6 ± 0.47 g. At the age of one week old, 3 groups (30 birds in each group) were formed. They received complete feed. The first group served as a control. The chickens of the second and third groups received combined fodder, in which 3% and 5% of the feed weight was replaced with dry sapropel. The dry sapropel (3% of the daily feed weight) increased the activity of casein-lytic and hemoglobin-lytic peptidases in the chyme by 1.5 (Р<0.05), in large intestine mucosa by 1.3 (Р<0.05) and in small intestine mucosa by 1.7 times (Р<0.01) compared with the control. The increase of sapropel concentration in feed up to 5% did not lead to a further increase in the activity of peptidases. The activity of peptidases were minimal at pH 5 and pH 12 and reached maximal at pH 7–8. The optimal dose of dry sapropel introduced into the diet of chickens to that stimulated the digestive processes is 3% of the mass of feed.