Assessment of fatigue in chronic hepatitis C Egyptian patients: relation to TNF-alpha, Leptin, IL-i and IL-6

Fatigue is a common symptom in chronic hepatitis C [CHC]; but it is not well understood and remains poorly investigated. One of the major obstacles to research is the highly non specific nature of fatigue. In 1994; the fatigue impact scale [FIS] was developed to improve our understanding of the effect of fatigue on quality of life. Recent attention has focused on the role of leptin and energy expenditure in chronic hepatitis C [CHC]. The importance of leptin in the regulation of energy balance, body composition and food intake has been demonstrated in both animal and human studies. 4herations in immune activation and cytokine release have been implicated in the occurrence of fatigue in CHC patients. The purpose of this study is to analyze fatigue in chronic hepatitis C Egyptian patients and to determine its relationship with the degree of underlying hepatitis, resting energy expenditure [PEE], circulating leptin and tumor necrosis factor-a [TNF-alpha], IL-1, and IL-6. Ninety patients were included in the study [61 males, 29 females], who were referred to the department of Tropical Medicine Al Hussein and Bab-Al-Sharyia University Hospitals during the period from March 2004 to March 2006. They were divided into two groups. Group I: 65 patients with chronic hepatitis C. Group II: 25 healthy persons, tested negative for hepatitis C [Control group]. All were submitted to history and clinical examination, liver function tests, HCV [Ab and PCR], the modified fatigue impact scale, resting energy expenditure, tumour necrosis factor [TNF-alpha], serum leptin. IL-alpha, and IL-6. FIS and REE, serum leptin, TNF-, IL-alpha and IL-6 were significantly elevated among HCV patients in comparison to controls. Fatigue didn't correlate with the degree of underlying hepatitis. Fatigue impact scale is a beneficial tool for subjective valuation of fatigue. Fatigue is present in CHC patients but it is not related to the degree of hepatitis. TNF-alpha, IL-1 and IL-6 may contribute partially to the occurrence of fatigue in these patients

Mitochondrial mutation in Egyptian patients with type 2 diabetes mellitus

Mitochondrial gene mutation plays a role in the development of diabetes mellitus. An A to G substitution at base pair 3243 in the mitochondrial tRNAleu[UUR] gene [mt3243] is commonly associated with maternally inherited diabetes and deafness and other diseases. The aim of this study is to detect A to G substitution at base pair 3243 in mitochondrial RNAleu[UUR] in the plasma of patients with type 2 diabetes mellitus, and to evaluate insulin sensitivity in all cases. This study, included 41 patients [Group I, 31 cases with type 2 diabetes mellitus and maternal history of diabetes mellitus-and Group II, 10 cases with type 2 diabetes mellitus, bilateral SNHL, maternal history of diabetes mellitus with or without SNHL. Other10 healthy control group was included. Patients and controls were subjected to full medical history and clinical examination. Serum measurements for liver and kidney function tests, fasting and postprandial blood glucose as well as C-peptide levels, in addition to lipid profile were collected. Audiological evaluation for all patients with SNHL was also done. Genetic investigation, for mDNA analysis, done by polymerase chain reaction restriction fragment length polymorphism [PCR-RFLP], to determine the mutation in the mitochondrial gene at position 3243. Results of the study showed that glycemic indices [FPG, 2hPPG and HbA1c], liver enzymes and blood urea were significantly higher among patient group compared to control group [P<0.05]. There was no significant difference for values of creatinine and uric acid between cases and controls. Lipid profile was significantly higher among patient group compared to controls [P<0.05], except for HDL-C which was higher in controls however, it did not reach statistical significance. C-peptide values were not significantly different between studied groups. Age at onset of diabetes was relatively earlier in group II than group I. mDNA was present in all plasma samples of patients and controls. mDNA 3243 mutation was detected in the plasma of three patients with diabetes and SNHL with a rate of 7.3% of all diabetic patients and 30% of diabetic patients associated with deafness. The presence of mDNA mutation allowed 294 bp product to be cleaved into 180 and 114 bp fragments and were seen as two bands. The A 3243 G mutation is present in Egyptian population and is considered as a cause of maternally inherited diabetes and deafness at a rate of 7.3% of all diabetic subjects and a rate of 30% of diabetics associated with deafness. mDNA mutation is present and detectable in plasma. Maternally inherited diabetes and deafness differs pathophysiologically from the more common forms of type 2 diabetes in that, insulin resistance does not seem to be a major factor

Acute pancreatitis: a clinical study in some toxicity with helical computed tomography

This study was conducted on 15, 48, 23 patients exposed to scorption sting, anticholinesterase insecticide, and methanol intoxication respectively with total number of 86 patients admitted to Poison Control Centre, Ain Shams University Hospitals, Cairo Egypt. On admission, and on discharge, serum amylase, and serum lipase, in addition to pseudo-cholinesterase [butyryl cholinesterase Bu-ChE], blood pH, and blood bicarbonate were determined and compared with those of normal control subjects. Abdominal ultrasonography and helical computed tomography [CT] were performed for cases with increased serum amylase and lipase. Acute pancreatitis was diagnosed in 6, 20, and 8 patients exposed to scorpion sting, anticholinesterase insecticide, and methanol intoxication respectively. All those patients demonstrated significantly elevated serum amylase, and lipase levels when compared with control group and other patients. Helical Computed Tomography [CT] showed findings suggestive of acute pancreatitis in 31 patients [91%]. There was a significant correlation between developing acute pancreatitis and severity of toxicity. Pancreatic necrosis, estimated on early, contrast-enhanced CT and seen only in patients with severe manifestations, was a specific predictor of morbidity. The present study showed that acute pancreatic injury might be more common than was previously thought. So, it is suggested that diagnosis of acute pancreatic injury should be considered in such cases to avoid deterioration and improve prognosis

Immunological markers of liver fibrosis in cirrhotic patients

Liver fibrosis occurs in response to chronic injury of any etiology. Kupffer cell [macrophage] activation accompanies liver injury with altered cytokine metabolism. This study aimed to investigate serum levels of tumour necrosis factor alpha [TNFa] and interleukin-6 [IL -6] as proinflammatory and profibrogenic cytokines in cirrhotic patients and relate them with the degree of liver disease and with the level of type -I plasminogen activator inhibitor [PAI-1] as a marker of fibrinolytic activity. The study included 20 cirrhotic patients and 15 healthy controls. After performing clinical and ultrasonic evaluation, liver function tests and hepatitis viral markers, patients were divided according to Child's Pugh classification of severity of liver disease into 3 groups, [group I] compensated cirrhosis, [group II] cirrhosis with ascites, [group III] decompensated cirrhosis. Serum levels of tumour necrosis factor alpha and interleukin-6 and plasma levels of type -I plasminogen activator inhibitor were measured. All patients showed significant positivity with hepatitis C virus antibodies. The Child-Pugh score of severity of liver disease was significantly increased in groups II and III compared to group I and control subjects. Serum TNFa. was significantly increased in all three groups of cirrhotic patients compared to control group. [P<0.05].Serum IL-6 was significantly increased in groups II and III [class B and C] compared to control group and there was significant difference between groups II and III and I and III So levels of IL-6 increased progressively with evolution of the disease. There was no statistical significant difference in plasma levels of PA1-1 between patients and controls. A positive significant correlation existed between TNFa and IL-6 in group II of patients [r= 0. 784 P=0.065] and between IL-6 and PAI-1 in groups II and III [r=0.78 P=0.067 and r= 0.000 P= 0.999 respectively]. In conclusion, this study revealed that in cirrhotic patients, serum levels of TNFa and IL-6 were significantly higher than control group, and IL-6 increased in advanced stages of the disease compared to early ones. There was positive correlation between TNFa and IL-6 in group II of patients. We suggested that the profibrogenic cytokines TNFa and IL-6 are implicated in fibrogenesis in cirrhotic patients and can be used as indicators for its progression. Further studies are needed to evaluate the use of their inhibitors as novel therapeutic agents to control undesirable fibrosis

Serum and follicular insulin growth factor [I G F -I] and insulin growth factor binding protein - I [I G F B P -I] In polycstic ovary syndrome

The present study comprised a total of 75 young women [45 polycystic ovary syndrome [PCOS] patients and 30 age and weight matched controls]. On the basis of their body mass index [BMI], the patients and controls were further subdivided into obese [BMI 27 kg/m2] and lean [BMI 25 kg/m2] groups. All participants in the study were subjected to medical as well as reproductive history. A clinical and gynecological examination including pelvic ultrasonography was done. BMI and WHR were also calculated. Hirsutism was examined and graded. Fasting plasma glucose, serum LH, FSH, testosterone, SHBG, insulin, IGF-1 and IGFBP-1 were measured. Fasting glucose/insulin ratio as an indicator of insulin resistance and free androgen index [FAI] as index of hyperandrogenemia were calculated. Moreover, follicular fluid samples were collected from 15 PCOS and 5 control subjects for the assessment of their IGF-1 and IGFBP-1 levels

Comparative study between circular stapled haemorroidectomy, and diathermy haemorroidectomy

In this study, 220 patients were randomized to either stapled hemorrhoidectomy [n = 110] or diathermy hemorrhoidectomy [n = 110]. Each patient received standardized postoperative analgesic and laxative regimens and completed a linear analogue pain score every six hours during the first postoperative day, at the time of the first motion and twice daily until discharge from hospital. Operating time, frequency of postoperative analgesic intake, hospital stay and postoperative complications were also recorded. The mean [range] age was 39.2 [30-63] years in group 1 and 41.1 [32-61] years in group 2. The stapled group had a shorter operating time, less frequent postoperative analgesia intake and shorter hospital stay. The postoperative complications were less frequent in the stapled group

Laparoscopic varicocelectomy offers a better alternative to high retroperitoneal [palomo] ligation of testicular vein in patients with bilateral varicocele

The efficacy of two modalities [high retroperitoneal [Palomo] ligation of testicular vein and varicocelectomy] in treating patients with bilateral varicocele was studied over a period of 18 months. Forty patients were randomly divided into two groups: Group I included 20 patients underwent bilateral high [Palomo] ligation of testicular veins and group II included 20 patients underwent laparoscopic varicocelectomy for bilateral varicocele. The mean anesthetic time was 50 minutes in group I and 40 minutes in group II. There was a significant reduction in analgesic requirements as well as hospital stay in the laparoscope group. The testicular artery was preserved in 30% in the open group, while it was preserved in all patients of the laparoscope group. It was concluded that laparoscopic varicocelectomy is a better alternative to high [Palomo] ligation of testicular veins in patients with bilateral varicocele minimizing the anesthetic time, analgesic requirement and hospital stay with the additional advantage of controlling collateral veins and preserving the testicular artery

Micronuclei in exfoliated cervical cells as a prospective indicator tool for cellular genotoxic damage in high risk cancer patients, cytohistologic study versus DNA ploidy

The present study is an attempt to shed led light on clinical significance of micronucleus test as part of cytopathologic examination. One hundred females from the attendants of Cyto Diagnostic Unit of Early Cancer Detection in Obstetrics and Gynecology Hospital, Ain shams University, were chosen for the present study from cases presented with unhealthy cervix. They were diagnosed cytologically as 69 cases had inflammatory disease, 26 had cervical intraepithelial neoplasia and 5 cases had cervical cancer. One hundred females with healthy cervix were chosen as a control group. The present study showed that the mean age of the study group was 35.5 +/- 8.5 years compared to 33.6 +/- 7.8 years in the control group with no statistically significant difference [P > 0.05]. The difference between cases of CIN and cancer and controls were statistically significant [P < 0.05] as regard early age of marriage, parity and past history of cervical erosion as risk factors for the occurrence of cervical intraepithelial neoplasia. The frequency of micronuclei was [1.5 +/- 1.4] among study cases compared with [1.3 +/- 1.7] in the controls. The difference was statistically significant in low SIL and HSIL [2 +/- 1.2, 3.4 +/- 0.8 respectively] [P < 0.05]. The micronucleus test was found to be more sensitive test [92.3%] than cytological examination [61.5%]. DNA image analysis was found to be more specific [90.5%] than the micronucleus test [70.3%] and cytological examination [77.1%]. MN test compared with DNA cytometry was highly sensitive parameter for detection of genotoxic chromosomal damage caused by HPV with sensitivity of 100% while specificity was 74%. Cytological examination is still the most common screening test used in early diagnosis of CIN. DNA image and MN test are important tests for early diagnosis of genetic damage but still not easily to be used on big scale. MN test should be part of routine cytologic examination of high risk patients to diagnose synergistic action of carcinogens. As the DNA image and MN test are prospective parameters so, cases with positive cytology, for SIL even if the pathology was negative must do MN test and DNA cytometry. If the two proved to be abnormal, these cases should be considered highly risk group and should be put under strict follow-up including invasive procedures

Clinicopathological study of ovarian tumours in the second decade of life

A study of 15 adolescents aged 10 - 20 years admitted with ovarian tumors during a 3-year period revealed that 11 of the 15 patients had malignant ovarian tumors, 1 case of borderline malignancy, while 3 patients had benign tumors. Histopathological study of the 11 malignant tumors revealed germ cell tumors in 8 cases, sex cord stromal tumor in 2 cases and epithelial tumor in 1 case. Tumors were found more frequently on the right side

Immunohistochemical localization of carcinoembryonic antigen in endocervical glandular lesions

Ten cases of microgl and ular hyperplasia and seven cases of adenocarcinoma of endocervical origin were studied by peroxidase- antiperoxidase method [PAP] for the presence of carcinoembryonic antigen [CEA]. Nine of the ten cases of benign lesions were negative and one was focally positive. Five of the seven adenocarcinomas were widely positive and two were focally positive. The results suggested that extensive immunohistochemical positivity for CEA in endocervical gl and ular lesions is indicative of malignancy

In medical application construction of thermocouple array with welding spot at the junctions using laser technique

Small invasive probes must be adopted for reliable, accurate measurement of tissue temperature. This invasive probe is the thermocouple which can be constructed with small sizes of wires. If the thermocouple probes are to remain in place in a tumor or at another site over several days or weeks between treatment sessions [treatment of cancer by thermal effect such as ultrasound or microwave], then the use of the solder spot at the junctions of the thermocouple would be unacceptable since solder contains tin and lead which are toxic. For this reason thermocouple array with welding spot at the junctions was needed

Influence of some preservatives on the bioactivity of digestive enzymes

The effect of seven commonly used preservatives on the biological activity of chymotrypsin, diastase, pepsin, pancreatin and trypsin were studied by the radial diffusion technique. The proteolytic activities of papain, pancreatin and chymotrypsin were reduced by the tested preservatives in descending order, while those of pepsin and trypsin were unaffected. Reductions in the amylolytic activity of pancreatin and diastase varied according to the preservative tested

Antimicrobial efficiency of preservatives in certain enzymes solutions

The efficiency of preservation of sterile solutions of pancreatin, papain, pepsin, trypsin and diastase, were assessed by challenge technique using mixed inoculum of E. coli, P. aeruginosa, S. aureus and C. albicans. The number of survivors was determined by viable count technique over a period of 28 days. Benzalkonium chloride, benzoic acid, chlorobutanol, methylparaben, phenethyl alcohol and phenylmercuric nitrate were used. The results obtained revealed that, the efficiency of preservative was dependent on the enzyme-preservative system involved. Benzoic acid, chlorobutanol and phenethyl alcohol were quite effective; while the other three preservatives were much less

Synergistic effect of subinhibitory concentrations of erythromycin, minocycline and norfloxacin on commonly used antibiotics

Subinhibitory concentration of erythromycin, minocycline and norfloxacin were individually incorporated into inoculated agar plates and 12 antibiotic discs were aseptically placed onto the surface. The diameters of the developed inhibition zones were compared with those obtained with similar discs on antibiotic-free plates. The increase in zone diameters on the base-antibiotic plate indicated synergy. The present study showed that traditional antibiotics can still be used more effectively in the presence of subinhibitory concentrations of erythromycin, minocycline and norfloxacin

Antimicrobial susceptibility of bacterial isolates associated with chronic prostatitis

Fifty-three strains were isolated from expressed prostatic secretion of patients suffering from chronic prostatitis, microscopically and biochemically identified. About 89% of the 53 strains were Gram- positive cocci, whereas 11% were Gram-negative rods. The susceptibilities of the isolates to 16 different antimicrobial agents were assessed by the disc-sensitivity test. This investigation showed that afloxacin [quinolone] and carpenicillin [beta-lactam] could be used as drugs of choice in treatment of chronic prostatitis due to Gram-positive and Gram-negative bacteria. For chronic prostatitis due to Gram-positive bacteria, erythromycin would be the best

Comparative evaluation of antigens used in immunofluorescence [IFAT] antibody test for serodiagnosis of schistosomiasis

The diagnostic value of antigens used in the IFAT for serodiagnosis of schistosomiasis has been evaluated. Cryosections of Schistosoma mansoni adults, formaline fixed cercariae and cryosections of infected liver, from gold hamster, which contained granuloma were used as antigens in this evaluation. The cryosections of adult worm were more reliable and more specific as an antigen for immunofluorescence [diagnostic efficacy was 95.52%]. The cercarial antigens gave the same results as the cryosection of adults. The IFAT using cryosection of infected liver contains granuloma was less reliable due to autofluorescence of eggs in the granuloma with negative sera [diagnostic efficacy was 49.01]

Mutagenic potentials of certain herbal extracts in mutant strains of salmonella typhimurium

Damage to DNA appears to be the major cause of most cancer and genetic birth defects and may contribute to aging heart diseases. The genetical damage can be caused by many substances used in medicine, industry, pest control and food preservatives. The present study investigated the mutagenic potentials of certain medicinal plants commonly used in traditional medicine, using five mutant strains of salmonella typhimurium/mammalian microsome in-vitro test [Ames test]. The histidine-dependent strains [TA 98, TA 100, TA 1535, TA 1537, and TA 1538] were used to detect DNA frame shifts and base-pair substitutions, which were recommended for preliminary screening of potential mutagens and carcinogens. Three different concentrations of each extract were used in the presence and absence of activated rat liver microsomal enzymes [S9 mix] to detect whether they produce direct or indirect genotoxic activity. Positive controls using diagnostic mutagens were also used to confirm the reversion properties and specificity of each strain and efficacy of the S9 mix. The results showed that extracts of the 16 herbs investigated did not induce mutations in the Salmonella mammalian microsome general mutagenicity test of Ames in concentrations up to 10 mg/plate

Studies on the Antimicrobial activity of the volatile oil of thymus vulgaris

The antimicrobial activity of the volatile oil of Thymus vulgaris was studied towards 6 different microorganisms. The oil was found to possess marked antifungal and antibacterial activities. The oil had a more inhibitory action against fungi than bacteria. The minimum inhibitory concentration [MIC] was 0.019% w/v with fungi, and ranged between 0.019 and 0.78% w/v with bacteria. Thymol, the main constituent of the oil, however, exhibited a weak activity towards the tested bacteria and fungi. The influence of pH and Tween 20 on the antibacterial activity of the oil was also studied

In vitro and in vivo microbiological evaluation of six mouthwashes manufactured in Egypt

Six antiseptic mouthwash, manufactured in Egypt, were microbiologically evaluated by in vitro and in vivo techniques. The level and type of microbial contaminants were determined. The mouthwash clinitol and citrolin were significantly contaminated, while Antiseptol, Betadine, Hexitol and Oraldene were not. Tube dilution and sub-culturing on solid media were used to assess the antimicrobial efficacies of the mouthwash against 24 clinical strains also kill times were determined for undiluted and half- concentrated mouthwash in presence and absence of human blood and saliva. Generally, the results varied not only between test strains but also mouthwash including those containing identical active principles thus implicating formulation factors