Chronic hepatitis C in children: clinical spectrum and histopathological study

Hepatitis C virus [HCV] is a major public health problem and a leading cause of chronic liver disease. An estimated 180 million people are infected worldwide. The prevalence of hepatitis C virus [HCV] infection is relatively low in children, with an anti-HCV prevalence rate of 0.2-0.4% in the Western world. Egypt has the highest prevalence of adult HCV infection in the world, averaging 15-25% in rural communities. The main [90%] HCV genotype is type 4. The magnitude of HCV infection in children is not well studied. Asymptomatic HCV infection is detectable in 2.02% of Egyptian children. To study the clinical presentation and histopathological features of the liver in children with chronic hepatitis C infection. The study population included 40 children from 2 to 16 years who had been diagnosed with chronic hepatitis C [HCV-RNA positive for 6 months or more by Real-time PCR] in the liver clinic at El-Shat by Children Hospital. Among the 40 patients' biopsies, 26 [65%] were stage 0, 10 [25%] were stage 1, 4 [10%] were stage 2-3 [HAI]. The grades of all 40 children ranged between 0 and 1 [HAI]. Developing fibrosis was significantly associated with age [P =0.015]. Children with chronic HCV infection are generally asymptomatic. Significant hepatic fibrosis was present in 10%of children with HCV infection. Fibrosis stage was significantly higher in older age children. There was no significant association between fibrosis stage and any biochemical parameter

Sphincter saving surgeries for locally advanced low rectal cancer after neoadjuvant chemoradiation

Rectal cancer accounts for the largest distribution within one anatomical region of the large bowel, with approximately one third of all CRC located within the rectum. The Golden standard treatment of primary rectal cancer is curative surgical resection; however, affine balance remains between disease cure and restoration of gastrointestinal continuity. Combined modality has proven efficacy in many malignant tumors with advantage of organ preservation. Forty nine [49] patients with low rectal carcinoma were included in a prospective study, between Jan 2007 and Jan 2012. Preoperative chemoradiation was administrated to all patients and subjected to different techniques of sphincter saving surgery. Stage I and Stage IV disease at diagnosis were excluded from the study. Forty nine patients were included in the study. 27 [55%] patients were male and 22 [45%] were female the age range from 23 years to 70 years with the median age 46 years. The main presenting symptoms were bleeding per rectum and tenesmus. Stage II 18 patients [36.7%,], stage III 31 patients [63.3%. Complete clinical and pathological response in 3 patients [6%], and complete clinical response with only microscopically residual carcinoma in 20 patients [41%], partial response in 18 patients [36.7%], and no significant response in 8 patients [16%] 7 from 8 were mucoid carcinoma. Low anterior resection [LAR] in 22 patients [44.9%], Hartman 's procedure in 4 patients [8.1%], Coloanal pull-through [COP] was done in 19 patients [38.9%] and perineal colostomy in 4 patients [8.1%]. For patients with cola-anal pull-through technique complete dehiscent and retraction observed in 2 cases, Major leakage in one case, stenosis in 4 cases. There is tendency of colorectal cancers to affect younger groups. Most patients presented in advanced stage. Neadjuvant chemo radiation is an excellent tool in sphincter saving surgery. Coloanal pull- through technique is not wide spread technique for low rectal cancer with good oncological safety and acceptable functional outcome

Study of neuropathic pain among patients with chronic low back pain

Chronic low back pain refers to pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal fold [with or without leg pain] of 3 months or more in duration. Identify the neuropathic pain among patients with chronic low back pain through application of LANSS scale, identify the different aetiogenesis, study the associated medical conditions and socio-demographic features of neuropathic pain among patients with chronic low back pain. The study was carried out at Neurology department of AL Azhar University Hospitals, between Nov., 2006 and Dec., 2008. Sixty consecutive patients were included in the study. All of them suffered from chronic low back pain of 3 months or more in duration. They were subjected to the following: Complete history taking, full general and neurological examination with application of LANSS scale for detection of the neuropathic group. Routine laboratory investigation. Lumbosacral Plain x-ray anteroposterior, lateral and oblique views. Neurophysiological examination [NCS, EMG, SSEP] for the neuropathic group. Lumbosacral MRI for the neuropathic group. Ten normal controls were selected to match patient of neuropathic group in age, height and sex, they were subjected only for neurophysiologic examination [NCS and EMG]. The most prominent clinical features of neuropathic pain among patients presented mainly with neuropathic LBP where paroxysmal pain, dysesthesia, allodynia and altered pin prick threshold. The MRI has highly sensitivity for identification of disc prolapse. The needle electrode examination [NEE] has highly specificity for identification of radicuolopathy. The neuropathic pain is a contributing factor among patients presented with chronic low back pain and was attributed to many factors in our study like compressive radiculopathy, radiculopathy, nonspecific and discogenic cause. LANSS Scale is good bedside diagnostic tool that evaluate the presence of a neuropathic component of the low back pain

Safety of patient meals in 2 hospitals in Alexandria, Egypt before and after training of food handlers

We assessed the food safety knowledge and food handling practices of 23 food handlers in 2 hospitals in Alexandria, Egypt [Gamal Abdel Nasser [GAN] and Medical Research Institute [MRI]] before and after a food safety training programme, and also the bacteriological quality of patient meals and kitchen equipment. There was a significant improvement in all knowledge-associated parameters except for personal hygiene in GAN. There was an improvement in the food safety practices in both hospitals. The bacteriological quality of most patient meals and food preparation surfaces and utensils improved after training. The bacteriological quality of patients' meals served in GAN was generally better than that in MRI

Detection of some toxic heavy metals in meat and offal of slaughtered cattle in Tanta abattoir, Gharbia governorate

A lot of one hundred and twenty random samples of meat, liver and kidney were collected from young and old slaughtered cattle [20 of each] at Tanta slaughter house, Gharbia governorate, Egypt, for detection of some heavy metal residues as Lead, cadmium and mercury by using Atomic absorption spectrometer. The results revealed that the highest mean value of lead concentration was recorded as 0.606 +/- 0.190 mg/kg wet weight in weight in old slaughtered cattle liver, while the lowest mean value of lead concentration was 0.036 +/- 0.016 mg/ kg wet weight in meat samples of young slaughtered cattle. More over, the highest mean value of cadmium concentration was recorded in as slaughtered cattle 1.752 +/- 0.469 mg/kg wet weight in kidney sample, while the lowest value of cadmium level in young slaughtered cattle was 0.858 +/- 0.133 mg/kg wet weight in meat samples. Regarding the mercury concentration in slaughtered cattle the highest level was recorded in liver of old aged cattle 0.499 +/- 0.171 mg/kg wet weight, whilemean the lowest results were recorded in meat sample of young aged slaughtered cattle as 0.218 + 0.041, All the obtained results of lead cadmium and mercury were compared with the permissible limsts of FAO/WHQ [1992] and ES [1993] and public health hazards of such toxic heavy metals were discussed. Hygienic measures and awareness programs were implemented to avoid contamination of meat and offal with such toxic heavy meals

Determination of mycotoxin residues in soya bean meatless burger, kofta and steak in comparison with resemble types of animal origin

Ninety samples of animal and plant origin food as 45, meat products [fifteen each of burger, kofta and meat steak], and 45 meatless products "plant origin" [fifteen each of burger, kofta and steak] were randomly collected from local markets "super markets and traditional grocery" in Giza and Cairo. Samples were analyzed for determination of some mycotoxin residues. Aflatoxins [AFs] [B1, B2, G1 and G2], Ochratoxin A [OA], and Zearalenone [ZEA] were detected. The highest percentage [40%] of AFB1 was present in Burger of plant origin, while the lowest percentage [6.67%] for AFB1 was present in Burger of Animal origin, AFB2 was present in kofta of plant origin, AFG1 was present in kofta of animal origin and AFG2 was present in kofta and steak of plant origin. OA was detected in all tested samples of plant origin; the highest percentage [33.33%] was detected in burger samples. On the other hand, OA was not detected in all tested samples of animal origin. ZEA was detected in all tested samples of animal and plant origin except steak of animal origin and the highest percentage [33.33%] was detected in Burger of plant origin and the lowest percentage [6.67%] was detected in kofta of animal origin. The levels of AFs, OA, and ZEA were estimated in animal and plant origin samples. The public health significance of mycotoxin residues and measures to prevent contamination of food products with mycotoxin were discussed

Association of insulin-like growth factor-1 [IGF-1], dietary intake and cognitive functions in normal school age children

Insulin-like growth factor I [IGF-I] is a hormone that mediates the effects of growth hormone and plays a critical role in somatic growth regulation and organ development. It is hypothesized that it also plays a key role in human brain development. The dietary determinants of circulating levels of components of the IGF system are of interest, as these may mediate some of the effects of diet on later health. However, few studies have examined the relationship between diet and IGF-1 levels in children, as well as the relationship between IGF-1 and mental development. To investigate the role of diet on levels of IGF-I and their relationships with measures of IQ in a group of healthy children. The study included 222 apparently healthy children [113 boys and 109 girls], their height for age and weight for age were between 10[th]-90[th] percentiles according to World Health Organization [WHO] growth standards, their age ranged 8-11 years and all were prepubescent. They were chosen randomly from primary schools located in urban Giza Governorate. Nutritional status was assessed by 24-hours dietary intake history and anthropometric measurements [weight, height]. Plasma IGF-1 was evaluated by radioimmu-noassay technique, growth hormone [GH] was determined by immuno-enzymatic assay. Intelligence quotient [IQ] was measured with the Arabic version of the revised-Wechsler Intelligence Scale for Children. Familial background was investigated through structured questionnaire. IGF-1 levels [mean +/- SD] were 142.6 +/- 43.3 ng/mL for girls and 139.4 +/- 39.6ng/mL for boys. GH level was within normal range. IQ scores [mean +/- SD] were 101.03 +/- 17.4 and 103.11 +/- 19.8 for boys and girls, respectively. IGF-1 levels were associated positively with IQ [r=0.81, p

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

Impaired glucose tolerance after acute stroke

The objective of this work is to determine the prevalence of disturbances in glucose metabolism in patients with acute stroke. Research design and methods-Consecutively admitted acute stroke patient [n=100] were screened for glucose tolerance according to the standardized World Health Organization protocol in the 1[st] and 2[nd] week after the stroke event. In addition, we repeatedly measured fasting capillary blood glucose during the first 10 days. Of the 100 subjects analyzed, 30 [30%] were classified as having newly diagnosed diabetes, 28 [28%] as having IGF or IGT, 29 [29%] as having transient hyperglycemia and only 16 [16%] were normoglycemia. Patients with newly diagnosed diabetes had more severe stroke National Institutes of Health Stroke Scale [NIHSS] on admission], hypertension and HbAIc than other studied groups [p<0.001], a higher rate of pneumonia and urinary tract infection during the admission [P0.001] and a worse outcome at discharge [mRS 0-1 at discharge]; [P<0.001] than nondiabetic patients. Patients with normal glucose regulation were more often men [more women among diabetic patients] and significantly younger than patients classified as having abnormal glucose regulation. In multivariate logistic regression model, National Institutes of Health Stroke Scale [NIHSS] on admission, female sex and urinary tract infection were independently associated with the classification of newly diagnosed diabetes. Age < 70 years and normotension were factors associated with normal glucose values in OGTT. It could be concluded that - The majority of acute stroke patients have disorders of glucose metabolism and in most cases this fact has been unrecognized. Diabetes worsens the outcome of acute stroke. Therefore, in the post-acute phase, an oral glucose tolerance test should be recommended in all stoke patients with no prior history of diabetes

Heavy metal residues in some fresh Egyptian fishes

A total of one hundred and twenty fresh fish samples were randomely collected from Giza and Cairo markets [60 of each; 20 of Tilapis nilotica, Mugil cephalus and Bagrus bayed] to estimate the concentration of Mercury [Hg], lead [Pb], cadmium [Cd], and zinc [Zn]. Residues in flesh of the above mentioned fresh water fishes were estimated by using Atomic Absorption Spectrophotometer [AAS]. The obtained results indicated that the mean values +/- S.E of Hg in examined Tilapia nilotica, Mugil cephalus and Bagrus bayed were [2.2 +/- 0.26 and 2.1 +/- 0.92, 2.01 +/- 0.71 and 1.1 +/- 0.88, 0.115 +/- 0.015 and 0.021 +/- 0.042 ppm] in Giza and Cairo Governorates respectively. Also Pb residues were [1.015 +/- 0.5 and 1.1 +/- 0.84, 1.8 +/- 0.61 and 1.9 +/- 1.01, 1.12 +/- 0 .13 and 0.321 +/- 0.14 ppm] respectively. While the Cd values were [0.85 +/- 0.11 and 1.09 +/- 0.416, 3.1 +/- 0.72 and 2 +/- 0.92 .2.51 +/- 1.51 and 0.62 +/- 0.32 ppm] respectively. Concerning Zn values, they were [12.72 +/- 1.21 and 10.2 +/- 0.51, 12.05 +/- 1.15 and 10.7 +/- 0.63, 11.02 +/- 0.5 and 10.86 +/- 0.119 ppm] respectively. The obtained data were evaluated according to the permissible limits of FAO/WHO [1992] and E.S.S No. 2360 issued by Egyptian Organization for Standardization and Quality Control [EOSQC] [1993]. The public health significance and suggested precautions for minimizing the level of such heavy metals in food were discussed

Proteinuria as a risk factor for stroke in type 2 diabetes mellitus

The study was designed to assess the relation between proteinuria and stroke in patients with type 2 diabetes mellitus. The study was conducted on two groups; Group I included 60 patients with type 2 DM with ischemic stroke, group II included 60 patients with type 2 DM without stroke. Both groups were matched by age, sex, body mass index and duration of diabetes. The study was performed at Al-Azhar University Hospitals from May 2005 to January 2006. The patients were evaluated clinically using Glasgow Coma Scale [GCS] for comatose patients and Canadian Neurological Scale [CNS] for conscious patients. Routine laboratory investigations as well as 24 hours urine protein were measured for both groups. CT scans were performed to all patients of group I within two days and after one week from the onset of stroke to determined site, depth and size of infarction. Systolic and diastolic blood pressures, prevalence of smoking and 24 hours proteinuria were significantly higher in group I than group II. On the other hand no significant changes were found on duration of DM, fasting and postprandial blood sugar, total cholesterol, LDL cholesterol, triglycerides, HbAlc, age and gender between two groups. In group I 38 patients were found to have proteinuria 38/60 [63%] versus 16 patients 16/60 [26.7%] had proteinuria in-group II, which was statistically significant. HDL-cholesterol only was significantly lower in-patients with proteinuria than those without proteinuria in-group I [p<0.01]. On the other hand no significant correlations were found between proteinuria and severity of strokes and CT findings. In multivariate logistic regression analysis, the ORs and 95% CLs for the variables identified as risk factors for stroke were as follow; SBP [OR 14.5, 95% CL 2.5-13.9], DBP [OR 13.1, 95% CL 2.4-15.9], proteinuria [OR 7.6, 95% CL 2.5-22.9], HDL cholesterol [OR 5.5,95% CL 2.1-23.5] and smoking [OR 4.89, 95% CL 1. 7-22.3]. Our results give evidence that proteinuria is an independent risk factor for ischemic stroke in patients with type 2 DM. Further support from additional prospective studies is recommended to confirm these findings

Pulmonary function tests in Parkinson's disease

The study was a cross-sectional and patient-control study. The study was performed at Al-Azhar university Hospitals from May 2005 to January 2006. The study was performed to document changes in respiratory pump and ventilatory function in idiopathic Parkinson's disease [PD] patients and its relationship with the main clinical presentation and the specific daily living activities [DLA] inthose patients. The study was conducted on 30 patients with PD and 10 healthy control volunteers. Patients were subjected to clinical evaluation by Unified Parkinson Disease Rating Scale [UPDRS] and respiratory pump function evaluation was done for patients and controls. Among patients group, 3 patients had normal pulmonary function [PF], 15 had obstructive PF pattern, 2 had restrictive PF pattern and 17 had upper airway obstruction. A significant disturbance in respiratory neuromuscular drive represent by the tracheal occlusion pressure after 100 m / sec from the start of quit inspiration [PO.l], decrease in respiratory muscle strength evaluated by maximum inspiratory pressure [PImax], marked respiratory muscle fatigue evaluated by [PO.l / PO.lmax]. A significant decrease in partial arterial oxygen pressure [PaO[2]] and increase in PaCO2 was found in patients group when compared to control group. Rigid / hypokinetic group patients 16/30 [53.3%] had significant [p<0.05] respiratory dysfunction rather than tremulous 14/30 [46.7%] group of patients. A significant negative correlation between the duration of disease, severity of illness, total daily living activity [DLA] and the severity of pulmonary dysfunction was found. Among the specific DLA, salivation and severe axial involvement was negatively correlated with maximum voluntary ventilation [MVV], PImax and PaO[2] Patients with Parkinsonis disease have impaired pulmonary function showing both obstructive and restrictive pattern, also abnormalities in mouth occlusion pressure and maximum inspiratory pressure were evident

Apoptosis and arterial thrombosis: expression of CD31 and CD146 in recent and old thrombotic disorders

Apoptosis [programmed cell death] of vascular lining endothelium is one of the causes of increased thrombogenicity. The Luminal release of apoptotic endothelium-derived microparticles can cause activation of tissue factor [TF], the most potent known inhibitor of the blood clotting system. The study was carried out at Al-Azhar University Hospitals on 70 cases of arterial thrombosis above the age of 25 years: Group 1: consisted of 15 apparently healthy subjects as a control group. Group 11: including 32 patients of recent thrombosis; 13 with cerebral infarction, 12 with acute myocardial in farction [MI] and 7 patients with peripheral arterial thrombosis. Group 111: including 38 patients with old thrombosis; 12 with cerebral infarction, 18 with MI and 8 patients with old peripheral arterial thrombosis. Endothelial-derived CD31 and CD146 were statistically higher in patients with recent and old arterial thrombosis than controls [p<0.005, p< 0.01] respectively and statistically higher in old than in recent arterial thrombosis [p<0.05]. Hypertension DM, smoking and lipid profile have no significant effect on CD31 and CD146. Finally, endothelial microparticle detection among cases of arterial thrombosis may indicate the persistence of the danger of re-thrombosis. Patients with acute and chronic ischemia have altered response of endothelial cells. It remains to be determined whether the reduction of the increased activity of CD31 and CD146 could provide an effective rationale for acute arterial thrombosis therapy

Correlation between transcranial doppler and magnetic resonance imaging of the brain in cerebral palsy

Cerebral palsy [CP] is a static encephalopathy that may be defined as non progressive disorder of posture and movement often associated with epilepsy and abnormalities of speech, vision and intelligence. The aim of our study was to assess haemodynamic alterations that might take place in children with CP using Transcranial Doppler [TCD] and to find out the correlation between Haemodynamic and structural abnormalities of the brain in CP. 40 patients with CP [age 1-10 years] were subjected to history, clinical examination and MRI brain and TCD was done for all patients and 20 children as control group to assess thmiddle cerebral artery [MCA] on both sides under sedation by chloral hydrate. Abnormal MRI findings were present in 92.5% of cases and normal MRI was found in 7.5% of cases. A significant correlation between MRI finding and clinical types was observed; atrophy was present in 50% of cases with spastic quadriplegia and periventricular leukomalacia diplegia. No significant difference between right and left side in both cases and control group in all parameters. A high statistical significant difference in the mean of flow velocities and indices was present between cases and control, the cases showed marked lowering of velocity in comparison to the control. No significant difference between different age groups of cases in TCD readings .No relation between clinical picture of CP and TCD readings. No relation between different MRI findings and TCD readings. All the hemiplegic cases showed reduction in the velocities at the affected side

Effect of training of bicycle ergometer on ventilatory functions for asthmatic children

Children with bronchial asthma, having obstructive ventilatory functions, may benefit from physical therapy besides the standard medical management they receive. Eighty-four asthmatic children were originally enrolled in this study to assess the value of such hypothesis. Children of the experimental group used bicycle ergometer. They practiced training three times/week for eight weeks. Also, they received medical management. A control group received only medical treatment. Only 31 children in both groups could be traced and analyzed to achieve the objective of the study; 20 of them from the experimental group with a mean age of 7.3 +/- 2.1 years and 11 children in the control groups with a mean age of 7 +/- 2.5 years. For both groups, initial ventilatory functions were done, as feasible, immediately after an asthmatic attack finished, then after the end of the scheduled management. The results showed a significant improvement at the end of physical therapy training program when compared with the group with no physical therapy. In spite of a follow up rate of 64.6% of the cases of asthmatic children, physical therapy training proved to be an effective as well as a safe modality, adjuvant to medical management

effect of isokinetic training for management of children with pleural diseases

Twenty-two children were included in this study having pleural effusion mostly consequential to pneumonic affection and managed medically. They were subdivided into two groups: An experimental group including 12 children with mean age of 10.4 +/- 1.5 years, who received medical treatment and physical therapy and a control group comprising ten children with a mean age of 10.2 +/- 1.7 years, who received medical management only. For both groups, initial ventilatory function assessment was done before the start of treatment in the form of forced vital capacity [FVC] ml, forced expiratory volume in the first second [FEV] ml, maximum voluntary ventilation [MVV] l/min. And peak expiratory flow rate [PEFR] l/min. The experimental group received physical therapy isokinetic training using low pulley, vertical chest/reverse fly and chest press/sated raw machines. This program was carried out for three times/week for six weeks, after which the same parameters of ventilatory functions were done. The results showed non significant changes in the control group after medical treatment and a significant improvement in the experimental group who received physical therapy. It can he concluded that physical therapy is safe and effective modality in the management of such cases

Diagnosis of endometriosis: a second look at the role of biochemical markers

To evaluate the accuracy of 3 markers CA-125, CA 19-9 and CRP in the diagnosis of endometriosis especially in virgins or unmarried women with dysmenorrheal and/or oleic pain. 50 no pregnant female patients in the reproductive age undergoing laparoscopy for infertility and/or chronic pelvic were included. Serum CA-125, CA 19-9 and VRP, were assayed twice; during the 1st 3 days of the menstrual cycle, and 7-10 days later. According to laparoscopic results, the study population was divided into: cases with early endometriosis group [I, 17 cases]; cases with advanced endometriosis included [group II, 19 cases]; cases with non-endometriotic pelvic inflammations/adhesions, [group III, 13 cases]; and cases with normal laparoscopic findings [group IV, II cases]. Serum levels of all markers were higher in endometriosis group compared to non-endometriotic inflammatory lesions and to controls. CA-125 was the most accurate when measured using during menstruation, CA 19-9 was the least accurate, while CRP menstrual/ preovulatory samples ratio was 100% accurate. Measurement of CRP during menstruation and it the revelatory period could provide an accurate marker for the diagnosis of endometriosis especially in airing or unmarried women with early disease

use of interleukin-6 in the diagnosis of chorioamnionitis in cases with intrapartum fever

Chorioamminitis occurs in 1-4% of labors and is responsible for significant morbidity and mortality in both mother and neonate, however, dependence on fever alone foe diagosis of the condition may be insufficient. To evaluate the potential use of measurement of IL-6 levels in maternal serum in the diagnosis of chorioamminotitis in cases with intrapartum fever. Patients and The study population consisted of 79 women with intrapartum fever, for each of them clinical charateristics were noted and recorded, IL-6 was measured using an ELISA technique, and the placenta was examined for histologic evidence of chorioamiontitis. IL-6 was detected in 75/79 cases [94.94%] Histologic evidence of Chorioamniotitis was found in 16/79 cases [20.25%]. IL-6 was detected in the 16 cases with histolgic chorioaminionitis and its level was significantly higher than in the 63 cases without histologic evidence chorioamnitis. The median value of maternal serum IL-6 in cases with histologic evidence of chorioamnionitis was 371 pg/ml [range: 156/667 pg/ml] while the mediam value of maternal serum IL/6 in cases with no histologic evidence of chorioamnionitis was 124 pg/nl [range: 0-289 pg/ml]. measurement of IL-6 in maternal serum of women with intrapartum fever could be a sensitive but not a specific marker for the diagnosis of chorioamnionitis

Application of hazard analysis and critical control point system in the dairy industry

This study aimed to assess the hygiene quality of some packaged milk [pasteurized or sterilized] and dairy products before and after application of a hazard analysis and critical control point [HACCP] system at a milk and dairy products company in Cairo, Egypt. The steps taken to put HACCP in place are described and the process was monitored to assess its impact. Assessment of the hygiene quality of the milk and dairy products before and after HACCP showed an improvement in quality and an overall improvement in the conditions at the company

Plasma adrenomedullin levels in patients with non-insulin dependent diabetes mellitus with and without complications

The present study was undertaken to determine plasma adrenomedullin [ADM] levels in patients with non-insulin dependent diabetes mellitus [NIDDM] to elucidate the potential involvement in the pathogenesis of diabetic complications. The patients were 31 males and 29 females with age ranging from 46-72 years [M +/- SD 57 +/- 12], the study were done at Al-Azhar University Hospitals and National Institute of Diabetes and Endocrinology between March 2000 and August 2000. Plasma ADM levels were 49.3 +/- 5.7 pg/ml in control subjects, 54.3 +/- 7.5 pg/ml in NIDDM patients without complications and 65.5 +/- 7.1 pg/ml in NIDDM with complications. Plasma ADM levels were significantly higher in NIDDM patients without complications than controls and in complicated vs non-complicated patients and their levels were not affected by plasma glucose concentrations. Plasma ADM levels increased dependently on the severity of diabetic complications and positively correlated with systolic blood pressure, serum creatinine, urinary excretion of albumin and fall in systolic blood pressure on standing up [sympathetic function]. In contrast, plasma ADM levels were reversely correlated with R-R interval on standing up 30:15 ratio [parasympathetic function] and conduction velocities of left ulnar nerves [peripheral neuropathy]. The results indicated that the increase in plasma ADM levels were closely related to diabetic complications, which may depend on the development of microangiopathy and play a certain role in protection against microvascular disturbance in diabetic patients