Human leukocyte antigen DRB1 and the response to pegylated interferon/ribavirin therapy with chronic hepatitis C in children

Background: Egypt has the highest prevalence of hepatitis C virus [HCV] infection in the world [15%-25%] and the main [90%] genotype is type 4. Prevalence in Egyptian children was found to be 3% in Upper Egypt and 9% in Lower Egypt. Various human leucocytic antigen [HLA] alleles have been linked either persistence or clearance of the hepatitis C virus [HCV]. Several studies have aimed to identify the involvement of HLA with different outcomes of HCV infection, but the results have not been consistent

Aim of the work: To identify HLA association with different outcomes as regard treatment of chronic HCV [CHC] in Egyptian children with pegylated interferon-alpha2b [Peg-IFN-alpha-2b] and ribavirin [RBV]

Patients and methods: Forty clinically and laboratorial children diagnosed as CHC genotype 4 [ages 3-18 years, 14 females and 26 males]. Patients were treated using Peg-IFN-alpha 2b [Peg Intron] at a dosage of 60 ug/m[2] per week subsutaneously and RBV 15 mg/kg per day orally for 48 weeks. Serum HCV ribonucleic acid [RNA] was measured at the baseline, at the 12[th], 24[th] and 48[th] weeks during treatment, and after 24 weeks of post-treatment [study weeks 72]. Sustained virologic responders [SVR] were defined as patient with undetectable HCV-RNA in the serum at 24 weeks post-treatment, while non-responders defined as HCV-RNA remains detectable throughout the treatment phase. Genomic DNA was extracted from 1 ml peripheral blood in tubes containing EDTA. HLA typing was performed by polymerase chain reaction followed by detection using sequence-specific oligonucleotides probes

Results: Twenty-nine out of forty patients [72.5%] showed a sustained virological responders to Peg-IFN/RBV therapy, whereas eleven [27.5%] non-responders did not. The frequencies of DRB1[asterisk]11 was significantly higher in sustained virological responders than non-responders. On the other hand, DRB1[asterisk] 07 allele was significantly higher in non-responders than SVR. We also found that no statistically significant difference between SVR and non-responders as regards the demographic, laboratory and liver histopathology characteristics of patients

Conclusion: There is a trend of association between certain HLA alleles and the response to Peg-IFN/RBV in HCV infected children and a study on large number of patients to confirm this association is worthy

Anti-C1q antibody as a predictor of chronic HCV genotype 4 response to treatment in Egyptian children

Background: Hepatitis C virus [HCV] infection has been reported to be the most common blood born pathogen all over the world. The prevalence of HCV in children in developed countries ranges between 0.1 and 0.4%, and is generally lower than in adults. Combinedpegylated interferon and ribavirin is still the only standard of care treatment in spite of its side effects, high costs and low sustained virological response [SVR] rates. Hence, this provides a compelling reason for the identification of biomarker predictors of disease response to treatment

Objective: To evaluate anti-C1q antibody as a predictor of chronic HCV response to treatment with combined pegylated interferon alpha-2b and ribavirin in Egyptian children

Methodology: This study was conducted on forty-four chronic HCV-infected children [Male/Female: 30/14; aged 12.02 +/- 3.1 years] from the outpatient clinic, Pediatric Hepatology Department, National Liver Institute, Menoufiya University. They were given combined pegylated interferon alpha-2b [Peg-IFN-alpha-2b] and ribavirin [RBV] for 48 weeks and a quantitative polymerase chain reaction [PCR] for hepatitis C virus Ribonucleic acid was performed at 12, 24, 48 weeks during treatment and after another 24 weeks post-treatment. Anti-HCV antibody and Real-time PCR for HCV-RNA was performed [the detection limit was 15 IU/mL]. Anti-C1q antibodies were performed by enzyme-linked immunosorbent assay [ELISA]

Results: Serum levels of Anti-C1q antibodies were significantly higher [P = 0.001] in the Non-responders group [mean = 14.61 +/- 6.749ng/ml] compared to the SVR one [mean = 2.27 +/- 3.77ng/ml]. No statistically significant difference [P > 0.05] had been found between SVR and Non-responders regarding the age, ALT, viral load, or hepatic necroinflammatory activity and liver fibrosis. Anti-C1q at a cutoff value of 9.05 ng/ml, had sensitivity and specificity of 84.6% and 75% respectively and 92% positive predictive value. No significant correlation between the serum level of anti-C1q antibodies and the age, sex or HCV viral load, liver enzymes, and the degree of fibrosis and necroinflammatory activity was found [P> 0.05] for all parameters

Conclusion: Anti-C1q could be a good predictor for HCV treatment and should be included in pretreatment laboratory assessment for proper choice of chronic HCV children patients who will benefit from combination therapy

Comparative effects of flaxseed, sesame seed and pumpkin seed on health of hypercholesterolemic rats

Hypercholesterolemia is a major risk factor for the development and progression of atherosclerosis and related cardiovascular diseases The purpose of this study was to investigate the effect of some seeds, flaxseed [Linum usitatissimum], sesame seed [Sesamum indicum L.] and pumpkin seed [Cucurbita pepo L], a rich source of unsaturated fatty acids on improving health of hypercholesterolemic rats. Thirty albino rats were divided into two main groups, the first is normal group [n=6], the second groups were fed on diet containing cholesterol [1.5%] and bile salts [0.25%] from basal diet for 15 consecutive days to induce hypercholesterolemia. The hypercholesterolemic group [n=24] was divided into 4 subgroups, 6 rats each. First subgroup is positive control was fed on basal diet, the second, third and fourth subgroups were fed on the diet containing 5% flaxseed, sesame seed and pumpkin seed powder for 6 weeks respectively. At the end of the experiment, blood was obtained and the serum was separated for analysis. Lipid profile, lipoprotein cholesterol, atherogenic index [Al], HDL/TC ratio [HTR%], TC/HDL and LDL/HDL ratio were determined. Beside liver and kidney function were determined. The result showed that hypercholesterolemic rats health were improved by adding the studied seeds

Evaluation of multiplex pcr based test in comparison with culture method for detection of mycoplasmosis in infected chickens

A total of 94 chicken samples were examinedfor Mycoplasma gallisepticum and Mycoplasma syjzoviae either by culturing procedure or by using the multiplex PCR. The comparative analysis of the obtained results indicated that the multiplex PCR was more sensitive and reliable in the detection of both organisms, where the multiplex PCR detected Mycoplasma gallisepticum in 20.21% of the tested samples while it gave 5.319% prevalence forMycoplasma synoviae. Moreover isolation and culturing procedures detected Mycoplasma gallisepticum and Mycoplasma synoviae in a prevalence rate of 15.956% and 2.127% of the tested samples comparatively. So these results concluded that, the multiplex PCR has become a valuable and easy test aiding in diagnosis of M. gallisepticum and M. synoviae infection in chickens

Thyroid functions on hemodialyzed patients

Abnormalities in thyroid function tests are frequently encountered in uremic patients. Disturbance in endothelial dysfunction and inflammatory processes are common in individuals with chronic renal failure. This may predispose to accelerated atherosclerosis with all its complications. The study was performed to investigate relationship between thyroid function and markers of endothelium damage and inflammation in patients with regular hemodialysis [HID]. The study was performed on 50 patients with end stage renal diseases [ESRD] on regular ND for at least 10 months. All patients and control were subjected to complete history and clinical examination and measurements of thyroid function tests, marker of inflammation [CRP], marker of endothelial damage, [intracellular adhesion molecules [ICAM]], in addition to renal function, CBC, lipid profile, total protein and serum albumin. Out of 50 patients under hemodialysis, had cardiovascular events. The following parameters were significantly higher in patients under HD than control; blood urea [p < 0.001], serum creatinine [P <0.001], CRP [p <0.001], ICAM [p <0.001] and triglycerides [P <0.01]. The following parameters were significantly lower in patients under HD than controls; serum albumin [p < 0.001], FT3 [p <0.01, but still within the normal range] and hemoglobin [p < 0.01]. Using multiple regression analysis serum FT3 negatively correlated with, duration of RD [r=-0.830, p < 0.001], albumin [r=-0.770, p <0.001], CRP [r=-0.840, p < 0.001], ICAM [r=-0.500, p < 0.01], triglycerides [r=-0.540, p <0.01], and total protein [r=-0.520, P <0.01]. Logistic regression analysis and after adjusted for age, sex, BMI, hypertension, FT3 levels were independently related to CRP [OR 206, 95% CI 1.6-5.4, P < 0.001], followed by duration of dialysis [OR 2.58, 95% CI 1.7-5.2, P <0.001], lastly serum albumin [OR 2.32, 95% CI 1.6-3.9, p <0.001]. Interestingly, and serum albumin were significantly lower, while CRP and duration of dialysis were significantly higher in patients with vascular complications than the rest of patients [P < 0.01]. We can conclude that thyroid dysfunction in HID patients related to inflammation, duration of dialysis, malnutrition and to a lesser extent endothelial dysfunction. All these factors lead to accelerated atherosclerosis and cardiovascular complications and a clinical significance of these findings merits further studies

C-reactive protein an D-dimer as a prognostic factors of ischemic stroke

Inflammatory processes have a fundamental role of atherosclerotic lesion and increased risk of vascular disease especially cerebral ischemia. The study was performed to assess the prognostic influence of inflammatory markers, C - reactive protein [CRP] and D-dimer on outcome of ischemic stroke. The study includes 100 patients with first-ever ischemic stroke. The study was performed at Al-Azhar University Hospitals from May 2005 to January 2006, followed by one-year follow up. All patients were suspected to complete history and clinical examinations, CT or MRI in the first day and one week latter. CRP and D-dimer were measured within the first 24 hours of ischemic stroke. In addition to routine investigations such as; fasting and post prandial blood sugar, lipid profile, CBC, ECG, echocardiography and body mass index [BMI]. The primary end-point was either, death of any causes [vascular or non-vascular] or any non-fatal vascular events [transient ischemic attack, recurrent stroke, unstable angina, acute myocardial infarction or peripheral ischemia]. Multiple logistic regression analysis was used to evaluate the association between end-point and risk factors of stroke. The incidence of diabetes, hypertension, hypercholesterolemia and obesity were significantly higher in patients than control [p < 0.01] and in patients with fatal and non-fatal vascular events than those survival free vascular events [p <0.01]. Serum levels of CRP and D-dimer were significantly higher in patients with first-ever stroke than control [p <0.001] and in patients with fatal and non-fatal vascular events than those survival free vascular events [p < 0.01]. Kaplan-Meier analysis showed an increased incidence of new vascular events during follow-up with increased levels of CRP especially in high tertiles [64%] compared to intermediate [29%] and low tertiles [18.5%], [OR 9.1, CI 3.9-18.4; p <0.001]. Also Kaplan-Meier analysis showed an increased incidence of new vascular events during follow-up with increased levels of D-dimer especially in high tertiles [44.4%] compared to intermediate [34%] and low tertiles [30%], [OR 1.95, CI 0.95-2.1; p <0.01]. However, logistic regression analysis between, risk factors and outcome during 1-year follow-up proved that CRP is the most risk factor predictive for recurrent vascular events independent to other risk factors for stroke [OR 2.57, CI 1.34-5.10; p <0.001]. We can conclude that increased serum levels of CRP are related with a worse outcome in patients with first-ever stroke more than D-dimer independent to other risk factors of ischemic stroke. Therefore, addition of CRP to standard initial screening will generate an improved method for identifying persons at high risk of future vascular events

Role of CT virtual colonoscopy in colonic neoplastic lesions in comparison with conventional colonoscopy

Cancer colon is one of the commonest neoplasms all over the world and is considered a leading cause of death among different neoplasms. Virtual Colonoscopy is one of the recent advances in the field of mutidetector CT post processing technique. It represents a type of 3D reconstruction technique which is capable of elaborating endoscopic endoluminal display of the colon without use of real endoscope and hence it was named virtual colonoscopy. The aim of work is to evaluate the role of virtual colonoscopy in colonic neoplasia. Results were compared to conventional colonoscopy and documented by histopathology in all cases. Our study included 35 patients; 25 of them had positive colonic neoplasia. They ranged in age from 22 to 79 years. The results in our study showed that conventional colonoscopy is relatively of virtual colonoscopy, yet the results are more or less comparable to each other. We discussed the advantages and limitations of conventional and virtual colonoscopy

Lithium clearance and sodium lithium counter transport in insulin dependent diabetes mellitus

Our study was conducted on 24 insulin dependent diabetic patients in comparison to 10 normal healthy control subjects. the group of the patients were classified according to the results obtained into 3 groups. The list was eight diabetic patients without nephropathy, the second was eight diabetic patients with nephropathy and the third was eight diabetic hypertensive patients, Both diabetics and control were subjected to full clinical examination and laboratory investigations [plasma lithium, lithium clearance, fractional Iithium clearance [FcLi] and sodium-lithium counter transport [Na [+] /Li [+] CT]. The results showed mild elevation of serum sodium in IDDM groups compared to control. FcLi showed a highly reduction in IDDM groups compared to control group. Na [+] /Li [+] CT showed a statistically significant elevation in IDDM groups compared to control group

Oxidative stress in smokers, asthma and COPD

An imbalance between oxidants and antioxidants is proposed in smokers, and in patients with airways diseases. We tested this hypothesis by measuring the plasma levels of oxidants [MDA, N. O]* and antioxidants [SOD* and Catalase] in three different groups. Healthy control group [30], divided to healthy smokers [15] and healthy non smokers [15]. Asthmatic group [30] divided to chronic persistent [15] and acute asthma [15 cases]. COPD* group divided to stable COPD [15 cases] and acute exacerbation of COPD [15 cases]. The plasma oxidants was markedly increased with reduced levels of antioxidant, in healthy smokers, as compared with healthy non smokers, [p < 0.001], Plasma oxidants was also increased in patients presenting with asthma, and COPD [p <0.001 and <0.05], and even higher in those with acute exacerbation of these conditions, with reduced the plasma antioxidant products. There was a negative correlation between oxidants and antioxidants with respect on MDA and SOD in asthmatic and COPD patients, [r = -0.16. p<0.001 and r=- 0, 72, p <0.05 respectively]. There was no significant correlation between plasma antioxidant and age, [r = 0.35, p >0.05]. Our data also demonstrate a positive correlation between Pa02 and plasma antioxidant [SOD] in patients with acute exacerbation of COPD. In summary, our results provide new evidence for profound oxidant -antioxidants imbalance in smokers, patients of COPD and asthma, associated with evidence of increased oxidative stress. The relationship between the decrease in antioxidant products in plasma and the pathogenesis of acute exacerbation of these conditions may result from different mechanisms and require further study. *MDA = malondialdehyde-*N. O = nitric oxide-*COPD - chronic obstructive pulmonary disease-*SOD = sodium oxide dismutase

Comparative study of rocuronium and vecuronium on the neuromuscular activity in experimental animals

Rocuronium is one of the newest non depolarizing neuromuscular blocking drugs. In this study, the effects of rocuronium and vecuronium as neuromuscular blocking agents on isolated rat phrenic nerve diaphragm and intact gastrocnemius sciatic nerve preparation in the cat were compared. The effect of gradually increasing doses of rocuronium [3-48 mu g /ml] and vecuronium [0.58 mu g/ ml] on the amplitude of contraction of isolated muscle in response to indirect electrical stimulation was recorded. Also, the effect of rocuronium [0.06-0.12 mg / Kg] and vecuronium [0.01-0.02 mg / kg] on the electrically induced gastrocnemius sciatic nerve was studied. Both drugs produced significant dose dependent reductions in the amplitude of rat phrenic nerve diaphragmatic contractions, but the effect of vecuronium was more than rocuronium. On cats gastrocnemius sciatic nerve preparations, the pattern of neuromuscular blockade [magnitude on set to maximum blockade and duration of block] of both drugs was also dose dependent. The results of this study demonstrated that rocuronium had significantly shorter time of onset, less potent with shorter duration of motor block than vecuronium

Histopathological study of three leishmania major strains

Amastigotes count in inoculated foot pad and histopathological study of infected mice were performed to study three Leishmania major strains: the Senegalese strain MHOM/SN/00/DKI[SN], the Sudanese strain MHOM/SD/89/UG8[SD], and the Saudi strain MHOM/SA/84/JISH[SA]. Eight-week-old male BALB/c mice were divided into three groups. Each group was infected with one of the studied strains. Amastigotes in the inoculated foot of infected. mice in the three groups were counted at 30 and 45 days using modified fluorescence diacetate/ethidium bromide viability test. The number of amastigotes in the SA group was found to be significantly lower than that of the other two groups at both durations. There was no significant difference between the number of amastigotes in the SN and SD strains at 30 days. but it was significantly higher in the SN group than that of the SD group at 45 days post-inoculation. In the animals studied, tissue samples were obtained from the skin, liver, spleen, and testes for gross pathological changes and histopathological evaluation. The SD strain started earlier and led a more aggressive course. The SN and SA strains were less aggressive. The SA strain showed changes at an earlier time and resulted in a more aggressive course of the disease. The SN and SA strains were less aggressive. The SA strain showed the most chronic course of the three

Transmission of HCV among maintenance hemodialysis patients

Prevalence of antibodies to hepatitis C virus [anti-HCV] was determined in the dialysis unit, King Faisal Hospital, Taif, for adult Saudi patients with end stage renal disease, who are on regular hemodialysis, and became anti-HCV positive during hemodialysis. The overall prevalence rate was 83.5%, which is comparable to the previous high figure of 80.9% reported in this unit before. The possible reasons for this high prevalence are considered and suggestions made for its control

Influence of chromium on the corrosion behaviour of stainless steels in sulphuric acid containing halide ions

The passivation of iron in aqueous media has been investigated over a number of years [1-4.] Bartlett and Stephenson [5] and Froment et al. [6] pointed out that, the anodic deposition of FeSO[4] on iron in sulphuric acid solutions. Krstulonic et al. [7] reported the anodic passivation of Armco iron I in a wide range of sulphuric acid concentration

Electrochemical behaviour of stainless steel in acidic water-ethylene glycol mixture

The corrosion behavior of stainless steel type 304 in acidic solutions of water-ethylene glycol mixtures have been studied by both potentiostatic polarization and weight loss methods at 25. The active passive transition depends strongly on the acid concentration and water content of the medium. The results are interpreted in terms of the dependence of corrosion rate of the metal on the properties of the medium such as viscosity, dielectric constant, solvation and Hammett acidity function

Corrosion and galvanic corrosion of steels in distilled, tap and sea water

Galvanic interaction of 3 G-steels with titanium has been studied in distilled, tap and sea water using current and weights loss measurements for 7 days. The results showed that Ti was a very corrosive resistant material in these solutions and this behavior was not affected by coupling with the different steels. Potentiostatic method was also used to study the effect of chloride on the corrosion behavior of the above steels in the 3 solutions at different temperatures

effect of molybdenum on the corrosion behaviour of stainless steel in acid solution containing halide ions

The corrosion rate of different types of stainless steels in sulphuric acid [1-7N] with and without different additions of 1-, BR-has been measured using potentiostatic and gasometric methods. The results indicated that halide ions adsorbed on the metal surface inhibit the dissolution reaction. The inhibition capacity is more for 1- than Br- than Cl-ions. The addition of Molybdenum to 17 cr. ferritic st. steel significantly decrease the critical current density [Icr] and increase the stability of the passive film

Medium effect on the corrosion behaviour of stainless steel in acidic water-organic solvent mixtures I, st.st. /430 in acidic water-methanol and water-ethanol mixtures

Electrochemical behavior of stainless steel type 430 in acidic solutions of methanol, ethanol and in their binary mixtures with water [covering the whole range from 0 to 100% alcohol] at 25C have been studied. Potentiostatic polarization and weight loss methods were used. The corrosion rate of the metal was influenced by the physicochemical properties of the media such as, viscosity, state of solvation, molar volume contraction, proton availability and dielectric constant. It was demonstrated by the potentiostatic study that the active-passive transition depends strongly on the concentration of the acid, and the water content of the media

Physico-chemical studies of alcohol-water binary systems at different temperatures

Density and viscosity measurements carried out in aqueous binary mixtures of n-propanol, and iso-propanol at different temperatures. The volume contraction either [Delta] or [Delta V] for these systems revealed occurrence of a minimum at X [alc approximately 0.31 indicates the probability of the existence of [1 alcohol: 2 water] molecular complex. Calculation of the deviation of the molar viscosity [Delta neta [M12]] for both mixtures at different compositions gives negative values with a minimum at the same mole fraction of alcohol which supports the existence of the suggested molecular complex. The Eyring's equation for the temperature dependence of viscosity is used to predict enthalpy [Delta H degree] and entropy [Delta S degree] of activation for the flow process. The conclusion is that the behaviour of each alcohol when mixed with water is dependent mainly on its structure