Clinical, Biochemical, Histological and Virological Effect of·Dimthylene Dioxy Biphenyle Dicarboxylate [DOB] in Patients with Compensated Chronic Hepatitis C

Background: chronic liver disease is a major cause of mortality and morbidity in Egypt. D.D.B. was found to improve the abnormal liver function tests in those patients. Since then it has been used in the management of chronic liver disease, yet clinical improvement and changes in the biochemical and pathological examination are still considered study questions

Objectives: to evaluate the efficacy and side effects of D.D.B. compared to Silymarine in wells compensated patients with chronic HCV infection

Method: the study population included 50 patients with compensated chronic HCV infection subdivided into two groups 25 patients each. One group received D.D.B. for 48 weeks and the other received Sily-marine for the same period of time. Each patient was subjected to assessment of the liver function tests, virological studies, abdominal ultrasound, isotope liver scan, liver biopsy and rectal snip before starting the treatment. Further evaluation was performed by repeating the liver function tests every 3 months, the abdominal ultrasound every 6 months, the rest of the tests and the liver biopsy were repeated after one year i.e. at the end of treatment

Results: sustained normalization of ALT level and transient normalization of the AST level was found in the DDB group. No significant effect on the. HCV RNA, level was detected after one year of D.D.B. therapy; in none of the patients did the HCV RNA become undetectable. The liver-splenic ratio in the iso-topic studies showed significant decrease after one-year therapy with D.D.B. The grade of inflammation was unchanged in 10 cases, worse in 11 cases and better in 3 cases while fibrosis was unchanged in 22 cases and worse in 2 cases. No major side effects were observed in either group of patients

Conclusion: DDB has no antiviral effect in patients with chronic HCV infection. It does not show a histological benefit [neither in terms of degree of necroinflammation nor stage of fibrosis] after 1 year of treatment and when compared to Silymarin. On the other hand it improves some biochemical parameters [ALT] as well as the general well being of the patients. It has no major side effects

Possible role of lead in liver cirrhosis

In this study, fifteen cirrhotics, thirteen cirrhotics with hepatic encephalopathy and ten normal control persons were subjected to clinical examinations, abdominal sonography, blood biochemistry examination and blood lead determination. Both cirrhotics and cirrhotics with encephalopathy showed symptoms. Physical signs and blood biochemistry changes pertinent with liver cirrhotics, Blood lead concentrations were significantly [p<0.05] higher in cirrhotics and cirrhotics with hepatic encephalopathy than in control persons. We suggest that altered permeability of the blood brain barrier may allow passage of lead into brain tissues contributing to the observed symptoms of hepatic encephalopathy. Chronic liver disease may alter toxicokinetics of lead leading to impaired elimination. Elevated blood lead concentrations would favour the progress of infective liver disease through its immunosupressive effect

Serum mineral changes in manganese exposed workers

In a group of Egyptian manganese of dry battery section from Kaha Company chemical production expounded to manganese fumes for periods of 22 years. The changes in serum minerals such as iron, cooper, zinc, calcium, magnesium, potassium and sodium were investigated. The results revealed an increased in blood manganese concentration association with a decrease in blood hemoglobin. A significant decrease were also observed in the levels of serum iron, calcium and zinc, while these of serum copper and magnesium were significantly elevated. However, no definite correlation could be found between the levels of serum sodium and potassium in the exposed non-exposed workers

Correlative study of fungal infections in peptic ulcer disease before and after treatment

25 patients were involved in this study, which showed the presence of fungal growth in 6 patients with duodenal ulcer before treatment. This number was reduced to 3 patients after treatment with H2-receptor blockers. Only one patient was negative before to turn positive after treatment. All positive cases with fungal growth proved to be yeast and among this Candida albicans was the most frequent. It was concluded from this study that the presence of fungal growth in patients with peptic ulcer disease was not related to the use of H2-Receptor blockers and that the healing rate and healing time were not affected by the presence of such growth

Factor VIII in rheumatoid arthritis

Factor VIII/Von Willebrand factor, has been reported to be elevated in several conditions including; Glomerulonephritis, Toxaemia of pregnancy, Diabetes Mellitus, Polymyalgia Rheumatica, Giant Cell Arteritis, Systemic Lupus Erythematosus, Vasculitis, Renal Failure, Respirator Failure, Scleroderma, Raynaud's phenomenon, Atherosclerosis and Myocardial infarction. Vascular injury is a common feature in all of these conditions. Rheumatoid Arthritis is a symmetrical peripheral polyarthritis characterized by synovitis often associated with rheumatoid nodules. Although arthritis is the most prominent manifestation, many other systems may be involved. In this study, we quantitated the two components of factor VIII/von Willebrand factor complex in the plasma of thirty patients with rheumatoid arthritis. We found that these levels were higher in the plasma of those patients than in the plasma of fifteen normal control subjects. The degree of elevation of both factors was directly proportional to the disease activity where highest levels were recorded. The longer the period of remission, the lesser the degree of elevation. Lower levels of factor VIII/von Willebrand factor indicated good prognosis of the disease while persistent elevation indicated bad prognosis and might indicate subclinical vascular involvement

Sulfur-containing amino acids as detection parameter in patients of uncompensated liver disease

The sulfur-containing amino acids [methionine, cystine and cysteine] are catabolized mainly in the liver. Their raised levels in the serum of patients with chronic liver disease probably result from impaired hepatic metabolism and porto-systemic shunting. In cirrhotic subjects a distinctive pattern of plasma amino acids concentration has been observed. This distorted pattern of sulfur-containing amino acids results in changes in amino acid availability to the brain. The role of methionine in pathogenesis of hepatic encephalopathy has been proved. In this study the level of sulfur-containing amino acids were measured in twenty patients with un-compansated liver disease and the results revealed a significant rise in the serum level of these ammo acids. A marked rise of sulfur-containing amino acids demanstrated in the patients with hepatic encephalopathy and those having foetor hepaticus, while no correlation can be seen with the degree of ascites