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Pipercillin-tazobactam is a frequently used antibiotic that has a broad spectrum of antibacterial activity. The development of severe thrombocytopenia following the use of piperacillin-tazobactam is unusual. Several mechanisms have been proposed for the pathogenesis of thrombocytopenia in this setting which include immune and non-immune causes. Multiple case reports have shown the ability of piperacillin-tazobactam to cause drug-induced immune thrombocytopenia, likely through formation of antibodies that recognize platelets in the presence of soluble piperacillin. However, severe and rapid development of thrombocytopenia that occurs in association with reexposure to piperacillin-tazobactam has not been clearly demonstrated in the literature. We present two cases in whom severe and rapid development of thrombocytopenia has occurred subsequent to administration of piperacillin-tazobactam with a prior history of recent exposure to the drug. In both cases, thrombocytopenia improved immediately and dramatically following withdrawal of piperacillin-tazobactam with initiation of steroids and intravenous immunoglubulins, suggesting and immune related drug-induced thrombocytopenia.

The Gabal Marwa area is located in the southeastern part of Sinai, Egypt. It comprises gneisses and migmatites, granodiorites and monzogranites. Field, petrographic, mineralogic and chemical investigations indicated that the Gabal Marwa granites are classified as granodiorites and monzogranites. The monzogranites constitute the most predominant rock unit exposed in the study area. They have been subjected to hydrothermal alterations, especially along the shear zones. Sericitization, desilicification, nametasomatism and development of spotty or dendritic manganese oxides are the most pronounced alteration features. These alterations resulted in the increase of TiO the decrease of SiO 2 , P 2 O 5 , Ni, Zn, Ba and Nb. Radiometric studies indicated that the altered granites belong to high thorium, high uranium granites. The U, Th, U and Th, Th/U, Th and U-K variation diagrams suggested that magmatic processes controlled the distribution of these elements but the effect of hydrothermal alteration processes were clearly distinct. The Scanning Electron Microscope and X-ray Diffraction analyses indicated that the most important radioactive minerals include uranothorite, thorite, zircon, monazite and samarskite. Cinnabar and Mn minerals were also found. From the U, Th, Ra and K activity concentrations obtained for all the studied granitic samples, radium equivalent activity (Ra eq ), external hazard index (H ex ), and internal hazard index (H in ), were calculated to assess the radiation hazard to human beings living in dwellings made of the studied granites. Altered monzogranites have radioactivity above the proposed acceptable level and, therefore, caution must be taken when these granites are used as building materials.

Background: The molecular mechanism associated with remission of primary gastric lymphoma post helicobacter pylori eradication is still unclear. Aim of the study: to evaluate Microsatellite (MSI) instability at markers adjacent to Chromosomal loci involved in primary gastric lymphoma in relation to helicobacter eradication therapy. Methods: 107 primary gastric lymphoma patients included 30 low grade Mucosa Associated Lymphoid Tissue Gastric lymphoma (MALT), 36 Diffuse large gastric lymphoma with MALT component (MALTDLBCL) and 41 DLBCL gastric lymphoma (DLBCL) were treated with anti Helicobacter pylori therapy as fi rst line treatment and to asses for Microsatellite instability (MSI) Results: the incidence of complete remission post helicobacter pylori eradication was higher in Low grade MALT in comparison to MALTDLBCL and denovo DLBCL. The incidence of MSI is decrease post helicobacter pylori eradication in all subtypes Conclusion: Remission of gastric lymphoma post Helicobacter eradication may associate with correction of MSI level.