incidence of HCV infection among type-II diabetic patients, is there an association?

To study the relationship between diabetes mellitus [DM] and hepatitis C virus [HCV] infection, this study included: 200 diabetic patients of type 2 and 185 apparently healthy blood donors as their controls. It included also 50 diabetic patients of type 1 and 42 blood donors as their controls. All patients and their controls were age and sex matched. Patients were attendants of Diabetic Out-Patients Clinic, Faculty of Medicine Menoufiya University. Fasting and postprandial blood glucose levels, glycosylated haemoglobin [Hb Al[c]], kidney function tests, liver function tests, viral hepatitis markers [hepatitis B surface antigen, HBs Ag and anti-HCV antibodies] were performed for all studied subjects. All anti-HCV positive cases were evaluated for HCV viraemia by RT-PCR for HCV-RNA. On comparing results of type 2 diabetic patients with their controls, results revealed a significant high prevalence of anti-HCV seropositivity in patients group as 67 out of 200 patients [33.5%] were anti-HCV seropositive vs. 32/185 [17.3%] in their controls [p<0.01]. It was found that 55/67 [82.1%] of anti-HCV positive cases were also HCV-RNA positive. HBs Ag seropositivity was significantly higher among type 2 DM [15.5% of 200 patients vs. 4.3% of 185 controls, p<0.01]. Statistically significant differences [p<0.01] in the levels of ALT and AST were observed between HCV-seropositive and HCV-seronegative patients with type 2 DM. Blood urea and serum creatinine showed significant elevated values [p<0.01] among type 2 diabetic patients. No significant correlation was observed between HCV-seropositivity and glycaemic control [Hb Alc]. In type 1 DM there was a significant high prevalence of anti-HCV seropositivity [42% of 50 patients vs. 19.04% of 42 controls, p<0.01]. It could be concluded that both HBV and HCV infections are equally frequent in diabetes; therefore, diabetes mellitus is considered as an important risk factor for acquiring chronic liver disease. These findings, although suggestive, don't establish a cause and effect relationship and are not consistent with the conjecture that diabetes leads to HCV infection, but instead favor hypothesis suggesting that persistent HCV infection is associated with the subsequent development of diabetes

efficacy of Hepatitis B Vaccine among previously vaccinated Egyptian children

Hepatitis B virus [HBV] infection is a serious global health problem, with 2 billion persons infected worldwide, and 350 million suffering from chronic HBV infection. Vaccination by hepatitis B [HB] vaccine has been implemented in the Egyptian Extended Program for Immunization since 1995. This work aimed to evaluate the efficacy of hepatitis B vaccine to previously vaccinated children after 5 years from vaccination, to study the effect of vaccine dose response [0.25ml/dose vs. 0.5ml/dose] as well as to study children's response to a booster dose. This study was carried out on 315 neonates immediately after birth, 173 out of them received 0.50 ml/dose of Engerix-B vaccine and the remaining 142 children received 0.25 ml/dose of the same vaccine. All studied children received vaccine at birth and later on at one month and at six months of age. After 5 years, these children were subjected to several investigations including qualitative and quantitative determination of antibodies to hepatitis B surface antigen [anti-HBs], qualitative determination of hepatitis B surface antigen [HBsAg], hepatitis B core antibodies [anti-HBc, IgG], hepatitis Be antigen [HBeAg], hepatitis Be antibodies [anti-HBe], antibodies to hepatitis C virus as well as antibodies to hepatitis D virus. After 5 years of vaccination 30 children retained anti-HBs seropositivity [9.5%] with anti-HBs titers >/= 10 mlU/mL while the other 285 children [90.5%] lost protective anti-HBs titers [non-immunized]. Eighty seven of the non-immunized children received 0.50 ml of the vaccine as a booster dose to detect their response. After 45 days from this booster dose they were retested for anti-HBs. Initially 30 of these children received 0.25 ml of the vaccine and the other 57 children received 0.50 ml in infancy. The results revealed that 44 [50.6%] children were converted to anti-HBs seropositive while the other 43 [49.4%] children remained anti-HBs seronegative, i.e., non-immunized. The titers of anti-HBs varied greatly in the converted group. Therefore, 90.5% of the vaccinated children showed non-detectable levels of anti-HBs after 5 years, and about 50% of them are in need of more than one booster dose. It could be concluded that our findings mandate an action towards providing booster dose/s to our children at the age of 5 years or earlier. Non responders may respond to a booster dose double the dose of the vaccine or respond to repeated booster doses. Vaccine dose, inspite of being effective in the primary response to the vaccine, no significant difference of children's response was observed towards the two used doses, they lost protective antibodies after 5 years of vaccination

Detection of HCV RNA in saliva of Egyptian children receiving frequent blood transfusions

Hepatitis C virus [HCV] infection is considered a major public health problem allover the world, especially Egypt. Blood is almost the only route for HCV diagnosis. It has been reported that HCV could be detected in other body fluids including saliva which represents an easier route than blood especially in infants and children. This study aimed to: 1] Assess the prevalence of HCV infection among high risk group of Egyptian children. 2] Evaluate the detection of HCV antibodies [anti-HCV] and HCV RNA in saliva against their detection in serum among HCV positive children. This study included 200 children [92 males and 108 females] who were attendants of Haematology Clinic at Abu El-Reish Hospital, Cairo University, for receiving frequent blood transfusions. Serum and saliva samples were analyzed for detection of anti-HCV by ELISA technique and for HCV RNA by a home made RT-PCR method. Liver function tests were performed also. Results of serum samples revealed that 134/200 [67%] children were anti-HCV seropositive, out of them 79/134 [59%] children had HCV RNA in their sera. Saliva samples of HCV infected children [n=79] showed that 53/79 [67.1%] and 31/79 [39.2%] were anti-HCV and HCV RNA positive respectively. Prevalence of HCV infection was 39.5% of 200 studied children [67% of 134 anti-HCV positive children]. It could conclude that: 1] Prevalence of HCV infection among the studied children is considered high. 2] Saliva could play a possible role of biological fluids as a non parenteral route of intrafamilial spread of HCV infection. 3] More sensitive techniques could be developed to use saliva as a reliable route for HCV detection

Circulating mage-1 andmage-3 transcripts as tumour-specific markers for hepatocellular carcinoma

The members of human Melanoma Associated Antigen [MAGE] gene family are highly expressed in human hepatocellular carcinoma [HCC]. The present study aimed to detect tumour cells in the peripheral blood of HCC patients by using mRNA of the MAGE-1 and MAGE-3 genes as specific tumour markers. This study was carried out on 100 subjects included in three groups; group I: HCC patients [n=50], group II: cirrhotic patients [n=25] and group III: apparently healthy subjects as controls [n=25]. Patients of groups I and II were attendants of the Out Patient Clinics of National Liver Institute, Menoufiya University. The mRNA of the MAGE-1 and MAGE-3 genes in peripheral blood mononuclear cells [PBMC] was detected by using nested RT-PCR. Results revealed that of the 50 HCC patients, MAGE-1 and MAGE-3 mRNA were positive in 56% [28/50] and 46% [23/50] of PBMC respectively and 64% [32/50] of HCC samples were detected to express at least one type of MAGE mRNA. The detection of MAGE transcripts in PBMC was correlated with the advanced stages and the tumour size of HCC as 92.9% [26/28] and 100% [23/23] of positive MAGE-1 and MAGE-3 transcripts respectively were detected in HCC cases in stages III and VI. Also, 100% of positive MAGE-1 and MAGE-3 mRNA detected were related to HCC cases having sizes > 4cm. In addition, expression of MAGE-3 was correlated to the evidences of metastasis. On the other hand, detection of MAGE-1 and/or MAGE-3 transcripts was not detected in the PBMC of cirrhotic patients or in the PBMC of healthy controls. No statistical significant correlation was observed between the expression of MAGE genes and the increased levels of alphafoeto protein [AFP], the presence of liver cirrhosis or viral hepatitis. Therefore, these tumour specific antigens can be used as molecular markers for early diagnosis and possible targets for immunotherapy for patients with HCC

Role of creatine kinase isoenzyme-BB and magnesium in the asphyxiated newborn infants

Birth asphyxia is the single most important cause of neurological morbidity in newborn infants. Damage to brain cells produces measurable amounts of creatine kinase isoenzyme [CK-BB] in the serum that is why CK-BB has attracted attention as a possible predictor of the extent of brain damage. One of the mechanisms that appear to be particularly relevant to the problem of birth asphyxia is the release of glutamate N-methyl-D-aspartate [NMDA] which is a glutamate receptor subtype that appears to be the most important in brain injury. NMDA receptor is coupled to Ca [2+] channel and its activation opens the Ca [2+] channels. Mg [2+] acts as a gate at the NMDA channel by blocking the Ca [2+] entry within the NMDA channel. Taken together, Mg [2+] acts as an important therapeutic approach to limit brain injury. The aim of this study is to assess the value of total CK and CK-BB as a marker of birth asphyxia, also, to examine the relationship between CK-BB and perinatal asphyxia both prior to the administration of Mg [2+] and after it, in order to evaluate the neuroprotective role of Mg [2+]. In the present study, the mean blood level of CK-BB at 6 h of life in the asphyxiated groups 11[98 +/- 7.3] and III [85 +/- 5.8] and at 24 h of life in group II [105 +/- 8.3] and group III [55 +/- 5.6] was significantly higher than that of the controls [p < 0.01]. At 24 h of age there was a statistical significant [p < 0.01] decrease in the level of CK-BB in group III [Mg [2+] treated] when compared to group II [no Mg [2+] treatment]. Therefore, CK-BB might be useful as an early marker of brain damage in the asphyxiated infants. The outcome of the patients with perinatal asphyxia was better in group III who received Mg [2+] [22% died] than in group II who did not received Mg [2+] [46% died] and this pointed to the neuroprotective role of Mg [2+]

prostingen gene is up-regulated by androgens through androgen receptors in breast cancer cell lines

In order to explore the possible involvement of prostinogen in the pathogenesis of cancer, the expression of prostinogen, at the mRNA level, was studied by real time quantitative RT-PCR in three different breast cancer cell lines with different receptor contents and activity. Prostinogen is up-regulated by androgens in breast cancer cell lines. Time course experiments were done as early as two hours. In addition, blocking experiments showed a significant decrease in the expression levels after adding receptor blockers. This evidence suggested that this regulation is directly mediated through the androgen receptor

Activated protein -0 C resistance [APC-R] and recurrent pregnancy loss

Activated protein - C [APC] is an anticoagulant which deactivates factors Va and VIlla and facilitates fibrinolysis by elevating plasminogen activator levels. Mutation of factor V gene renders factor V resistant to APC with increased incidence of thrombosis. There are several reports about the association between activated protein-C resistance [APC-R] and poor obstetric outcome. This work aimed to study the relationship between APC-R and first trimester pregnancy loss. Thirty pregnant women in the first trimester were categorized in this study into 3 groups: group [A] included 10 healthy women with no history of previous abortion as controtls. Group [B] and [C] included women with a history of first trimester recurrent abortion. Group B included 10 pregnant women. Their results at 8 and 10 weeks of pregnancy were categorized as subgroups Bl and B2 respectively. Group C included 10 women who had abortion at time of blood sample. General, pelvic and uterine ultrasound examinations were done. Liver function tests [ALT, and AST], kidney function tests [serum urea and creatinine], random blood sugar, prothrombin time, activated partial thromboplastin time and APC-R assay were measured to all subjects included in this study. Any case with a medical problem which could result in abortion was excluded. APC-R was significantly higher [p< 0.05] among groups B2 and C, than group A" controls", while no significant difference [P>0.05] was found between groups Bl and A. APC-R positive cases were significantly higher [P<0.05] among unfavorable outcome of pregnancy than those with favorable outcome in group B, while no significant difference [P>0.05] was observed among group A. APC-R positive cases were significantly higher [P<0.001] among those with positive family history of thromboembolism while no significant difference [P>0.05] was found in relation to past history of thromboembolism, gravidity or age. The most predictive risk factor to APC-R was family history of thromboembolism with odd ratio = 25. In conclusion, this study found an association between APC-R and recurrent pregnancy loss in the first trimester. So, it is recommended to measure APC-R to pregnant women with a history of first trimester pregnancy loss especially to those with a positive family history of thromboembolic events