This study was designed to compare the effect of the prebiotic and antimicrobial growth promoter (AGP) on the growth performance, blood constituents, intestinal bacteriology and histomorphometric parameters as well as humeral immunity of broiler chicks. A total of 90 unsexed commercial Cobb chicks were randomly assigned to 3 dietary treatments (control, AGP and prebiotic groups), each group contains 30 chicks. Each group subdivided into 3 replicates, 10 chicks each, and was reared for 42 days. The prebiotic supplemented group showed a significant improvement in growth performance parameters in comparison to the control and AGP-supplemented groups. Total leukcocytic count, lymphocyte percent, total protein, total globulin and gamma globulin were significantly increased in the broilers fed on prebiotics. Moreover, prebiotics supplementation significantly reduced heterophil percent, heterophil/ lymphocyte ratio (H/L ratio), albumin/globulin ratio, aspartate and alanine aminotransferase (AST and ALT), uric acid and creatinine compared to the AGP-supplemented and control groups. The AGP-supplemented group exhibited a significant reduction in the total aerobic count when compared to the control and prebiotic-supplemented groups. However, the prebiotic supplemented group showed a significant reduction in the coliform count when compared to the control and antibiotic supplemented groups. The prebiotic supplemented group induced a significant increase in the villus height (VH) all over the small intestine. In addition, it induced a significant increase in villus height: crypt depth ratio in the duodenum and jejunum in comparison to the control and antibiotic supplemented groups. However, there were no significant differences among the different groups regard to the crypt depth (CD) in the duodenum and jejunum. Prebiotics could be considered as safe and effective antimicrobial alternatives for broiler chicks' growth performance, immunity and intestinal bacteriology and morphology.

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Arab partners launched an eight-month intervention in Libya. This was said to be necessary because Mu'amar Gaddafi, Libya's longtime ruler, was responding to mass protests against his over forty-year dictatorial reign by waging war on his own people. As President Barack Obama explained, without international intervention "the calls of the Libyan people for help would go unanswered. The democratic values that we stand for would be overrun. Moreover, the words of the international community would be rendered hollow." 1 Initially, this operation was "hailed as a model intervention." 2 With minimal losses and virtually no boots on the ground, the intervention prevented what many feared would be a humanitarian catastrophe. Six years later, however, it is widely recognized that the Libyan intervention was a failure. As President Obama put it, in a model understatement, "Libya is a mess." 3 Instead of transitioning into even a semifunctioning state, Libya has devolved into a lawless vortex of terrorists, refugees, human traffickers, and arms traders. 4 This was the result of a series of political miscalculations. As a report by the British House of Commons concluded:[T]he Government failed to identify that the threat to civilians was overstated and that the rebels included a significant Islamist element. By the summer of 2011, the limited intervention to protect civilians had drifted into an opportunist policy of regime change. That policy was not underpinned by a strategy to support and shape post-Gaddafi Libya. The result was political and economic collapse, inter-militia and inter-tribal warfare, humanitarian and migrant crises, widespread human rights violations, the spread of Gaddafi regime weapons across the region and the growth of ISIL in North Africa. 5

The present study was planned to evaluate the influence of synbiotic and enramycin on the broiler immunity and growth performance. In a complete randomized design, 90 unsexed day old Cobb broiler chicks were randomly assigned into three treatments with three replicated. The first control group fed basal diet only, the 2 nd group consumed basal diet plus enramycin (0.5g/kg diet), and the 3 rd group fed basal diet fortified with synbiotic (0.5g/kg diet) up to 42 days. The results revealed a significant (P<0.05) improvement of the growth performance considerations, phagocytic index, and phagocytic percentage in synbiotic fortified group in comparison with other groups. Oral supplementation with synbiotic resulted in up regulation of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in cecal tonsils and spleens when compared with the control and enramycin groups. However, the antibody titers against Newcastle disease (ND), Avian Influenza (AI), and Infectious Bronchitis (IB) viruses were not obviously changed between the tested groups at both 28 and 42 days. Moreover, the enramycin caused a significant (P<0.05) adverse effect on the liver function enzymes as compared with other groups. In conclusion, the synbiotic can be considered as a potential feed additive alternative to antibiotic with desired effect as an enhancer for both cellular and gut immunity, as a growth promoter without adverse effect on the liver healthiness.

Background:Fatigue is a prevalent and fundamental phenomenon in psoriatic arthritis (PsA) patients. It often interferes with physical and social functions and may lead to social withdrawal, long-standing sick leave, disability and loss of work productivity. Fatigue is a prevalent symptom in patients with chronic rheumatic diseases. Cytokines as interleukin IL-23/17 play a pivotal role in the pathogenesis of PsA.Objectives:To assess fatigue in PsA patients and determine its relation to serum IL 23 levels, disease activity, Skin severity, physical function and quality of life (QoL).Methods:Fifty PsA patients and 46 matched healthy controls were included in this study. Skin severity based on the Psoriasis Area and Severity Index (PASI), the Disease Activity index for Psoriatic Arthritis (DAPSA) and the Functional Assessment of Chronic Illness Therapy (FACIT-F) were assessed. Physical function was assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI) and health-related QoL was assessed using the Short Form Health Survey (SF-36), Psoriatic Arthritis QoL (PsAQoL) and the Dermatology Life Quality Index (DLQI). Serum IL-23 levels were measured in the studied groups.Results:The study included 23 (46%) females and 27 (54%) males with a mean age of 42.78±12.33 years. The mean serum IL-23 level was significantly higher in PsA patients (50.89 ±13.86 pg/ml) than in controls (43.88 ± 6.34 pg/ml) (p=0.006). The FACIT score ranged from 2-41. Severe fatigue (score <30) was reported in 27 (54%) PsA patients. There were significant correlations between FACIT-F and (DAPSA, PASI, HAQ-DI, PsAQoL, DLQI and SF-36). No significant correlations could be detected between FACIT-F and serum levels of IL-23 and CRP.Conclusion:Fatigue was a frequent complaint in PsA patients. There was a mutual negative impact between fatigue and each of PsA joint disease activity and physical function and it worsened the QoL. Fatigue was worsened with increased severity of skin PsO. Although serum level of IL-23 was significantly elevated in PsA patients than the controls, it wasn’t correlated with fatigue score. Hence IL-23 can’t be considered a biomarker for fatigue severity.References:[1]Chandran V, Bhella S, Schentag C, Gladman DD. Functional Assessment of Chronic Illness Therapy-Fatigue Scale is valid in patients with psoriatic arthritis. Ann Rheum Dis 2007; 66(7):936.[2]Mortada M, Abdul-Sattar A, Gossec L. Fatigue in Egyptian patients with rheumatic diseases: a qualitative study. Health Qual Life Outcomes 2015; 13:134.[3]Krajewska-Wlodarczyk M, Owczarczyk-Saczonek A, Placek W. Fatigue - an underestimated symptom in psoriatic arthritis. Reumatologia 2017; 55(3):125-30.[4]Strand V, Mease P, Gossec L, Elkayam O, van den Bosch F, Zuazo J, et al. Secukinumab improves patient-reported outcomes in subjects with active psoriatic arthritis: results from a randomised phase III trial (FUTURE 1). Ann Rheum Dis 2017; 76(1):203-7.[5]Reygaerts T, Mitrovic S, Fautrel B, Gossec L. Effect of biologics on fatigue in psoriatic arthritis: A systematic literature review with meta-analysis. Joint Bone Spine 2018; 85(4):405-10.Table.Correlation between FACIT-F score and different parameters in patients groupFACIT-FrspDAPSA-0.365*0.009*PASI-0.424*0.002*HAQ-DI-0.464*0.001*PsAQoL-0.633*<0.001*DLQI-0.492*<0.001*SF-360.600*<0.001*CRP-0.1670.247Serum IL-23 levels-0.1830.204rs: Spearman coefficient, *: Statistically significant at p ≤ 0.05Figure. Correlation between FACIT-F and DAPSA in the studied PsA patients.Acknowledgments:I am deeply indebted to my late Professor Abdelmoniem Helal for his expert guidance and keen interest throughout the work.Thanks to My parents and Husband.Disclosure of Interests:None declared

Background:Psoriatic arthritis (PsA), causes inflammation in joints and enthesis, emotional instability and poor quality of life (QOL).1Fibromyalgia (FM) may coexist with PsA, complicating its diagnosis and management.2The effect of FM on the QOL and fatigue in PsA patients has not been vastly studied.3Objectives:Assess the effect of FM on PsA patients’ disease activity indices, QOL and fatigue.Methods:This study included Group I: 37 PsA only patients (61.7%), 48.38 ± 11.69 years and group II: 23 FM-PsA patients (38.3%), 50.78 ± 11.8 years, according to classification criteria for PsA and 2016 Revisions to 2010/2011 FM diagnostic criteria. Psoriasis area severity index (PASI), disease activity in PsA (DAPSA), composite PsA activity index (CPDAI), PsA QOL and multidimensional assessment of fatigue (MAF) were assess in both groups. The severity and impact of FM was assessed in group II.Results:Patients with FM-PsA had a statistically higher PsA disease activity in subjective measures only but not in objective measures. Table 1Table 1.Comparison between the studied groups according to disease activityGroup I(37)Group II(23)Test ofSignificancePMean ± SDtCPDAI8.68 ± 3.3311.26 ± 2.033.735*<0.001*Median (Minimum – Maximum)UPASI8.3 (0 – 45.7)14.4(0.9 – 49.6)292.5*0.043*DAPSA29 (14 – 89)45.5 (20.5 – 99)226.0*0.002*C-reactive protein (mg/dl)6.3 (0.3 – 72)6 (0.8 – 61.6)409.50.80268 Tender joint count7 (2 – 64)23 (8 – 68)112*<0.001*66 Swollen joint count2 (0 – 23)4 (0 – 10)300.50.055Leeds enthesitis index2 (0 – 6)6 (3 – 6)76.5*<0.001*Dactylitic count0 (0 – 8)0 (0 – 7)4210.924U: Mann Whitney testt: Student t-testp: p value for comparing between the studied categories*: Statistically significant at p ≤ 0.05Patients in both groups had similar functional level by health assessment questionnaire (HAQ) (U=339, p=0.188) and QOL by PsAQOL (U=306, p=0.068). While, MAF was statistically higher in group II patients 34 ranging from 28 to 48.7 in group II vs 26.5 ranging from 0 to 49.5 in group I (U=172.5, p<0.001).In group II patients: the mean tender point count was 16.50 ± 1.84, fibromyalgia severity scale (FSS) was 20.7 ± 3.99 and fibromyalgia impact questionnaire (FIQ) was 57.22 ± 7.30. There was a statistically significant correlation between FSS and DAPSA (rs=0.59, p=0.003), PsAQOL (rs=0.64, p=0.001) and HAQ (rs=0.613, p=0.002), and between FIQ and PASI (r=0.488, p=0.018), PsAQOL (r=0.576, p=0.004), HAQ (r=0.557, p=0.006) and MAF (r=0.619, p=0.002).Conclusion:These results might highlight the importance of considering FM as a contextual factor in disease activity assessment in patients with PsA, especially in those with discrepancies in TJC/patients reported outcomes versus SJC/inflammatory markers or persistently high disease activity indices.References:[1]Turkiewicz AM, Moreland LW. Psoriatic arthritis: Current concepts on pathogenesis-oriented therapeutic options. Arthritis Rheum 2007;56(4):1051-66. 2. Husted JA, Thavaneswaran A, Chandran V, Gladman DD. Incremental Effects of Comorbidity on Quality of Life in Patients with Psoriatic Arthritis. J Rheumatol 2013;40(8):1349-56. 3. Brikman S, Furer V, Wollman J, Borok S, Matz H, Polachek A, et al. The effect of the presence of fibromyalgia on common clinical disease activity indices in patients with psoriatic arthritis: a cross-sectional study. J Rheumatol 2016;43(9):1749-54.Acknowledgments:Our sincere gratification to our mentor the late Prof. Dr. Abdel Moneim Helal.Disclosure of Interests:None declared

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