Protein expression of metastasis-related genes in human bladder carcinoma

The discovery of genetic alterations in oncogenes and tumor suppressor genes that accompany tumor formation has encouraged the search for genes that may promote or suppress tumor metastasis. This study aimed to investigate, by immunohistochemical analysis, protein expression of the metastasis-related genes metalloproteinase-2 [MMP-2] and nm-23 in human bladder carcinoma. Their role as prognostic factors against established clinicopathological variables in bladder carcinoma was evaluated. A total of 60 specimens of bladder carcinoma were obtained by radical cystectomy with pelvic lymphadenectomy. In addition, 10 tissue samples from normal mucosa adjacent to tumors were examined and served as controls. Immunohistochemical expression of MMP-2 and nm-23 was correlated with histological grade, tumor stage, lymph node metastases, and the presence or absence of bilharziasis. MMP-2 was expressed in 63% of patients with human bladder carcinoma and was shown to be positively correlated with histological grade, lymph node metastasis, and tumor stage. In contrast, nm-23 was expressed in 61% of patients with carcinoma but with insignificant correlation between its expression and the previous variables. Both proteins showed insignificant correlation with the presence or absence of bilharziasis. The study revealed that nm-23 expression was nonsignificantly correlated with MMP-2 expression and that nm-23 does not behave as a metastasis suppressor gene in bladder carcinoma. MMP-2 overexpression seems to be related to more aggressive tumors with advanced stages and grades; therefore, it may be used not only as a promoting prognostic marker for bladder carcinoma but also as a novel target for clinical therapy

Epidemiology of workplace violence against nursing staff in Ismailia governorate, Egypt

Violence against health care workers [HCW] or workplace violence in general is a major problem affecting health and productivity of HCWs. To determine the prevalence and nature of workplace violence against nurses in Ismailia governorate, Egypt, and to identify its risk factors and how nurses manage it. Cross-sectional study, using a questionnaire for data collection, which includes demographic data, characteristics of workplace violence events, and risk factors contributing to workplace violence. All nursing staff in four hospitals and twelve Primary Health Care [PHC] Centers, randomly selected from Ismailia city were recruited. Out of 1600 distributed questionnaires, a total of completed 970 were returned [a 55% response rate]. 269 [27.7%] of nurses reported abuse of any kind, 187 [69.5%] verbal abuse; and 25 [9.3%] physical abuse. Males were more exposed to violence events during the past 12 months than females [35.3% versus 24.2%, p<0.05; OR=1.71]. Being single posed no higher risk of exposure to violence than being married [34.8% vs 31.2%, p=0.083]. Changing shifts to night time had a higher odds for being assaulted than working a morning shift [p=0.002, OR=1.58]. Working in a place crowded with colleagues was not protective and had a higher odds of being exposed to violence than working with low number of colleagues [p<0.001, OR=2.77]. The patients were the perpetrators in 62.8% of violence events, while their relatives committed 16.7% of events. Only 7.4% of nurses got physical injury because of the violence events. A considerable proportion of exposed nurses [55.8%] thought that the violence events were preventable. Workplace violence against nurses is a significant problem in health care settings all over the world and in Ismailia, Egypt. There is a need to increase awareness of the problem among health care workers as well as the general public. Further large-scale studies should be conducted to more closely examine the problem

Prevalence of latent TB among health care workers in four major tertiary care hospitals in Riyadh, Saudi Arabia

Tuberculosis [TB] infection represents a global health problem and a great risk to Health Care Workers [HCWs]. Identifying individuals, particularly HCWs with latent tuberculosis infection [LTBI] will support TB control through chemoprophylaxis and prevent cross-infection. This study aimed to identify prevalence of Latent TB among a two-year new hires of HCWs in 4 major tertiary care hospitals in Riyadh, Saudi Arabia. 2650 recently [2-years] hired HCWs were surveyed for latent TB using Tuberculin Skin Test [TST]. Data was collected from January 2008 to December 2009. Induration due to TST equal to or more than 10 mm. within 48-72 hours was considered positive. The results of TST were correlated with other variables such as age group, gender, job category, country of origin. as an overall rate, 291[11%] out of 2650 were positive for TST, with the highest significant positive rates among physicians [14.9%] and nurses [12.9%] compared to students as a reference group. No statistically significant difference was detected between both sexes. The highest significant positive TST rates were found among HCWs in the age group of 50 years and older [32.6%] compared to 10-19 years age group as a reference group, and among HCWs coming from sub-Saharan countries [61.1%] compared to Saudi HCWs with the lowest positive rates [5%] as a reference group. LTB is prevalent among newly hired HCWs in Riyadh tertiary hospitals. Standard programs for detection and treatment of LTB should be encouraged

Acute hydrogen cyanamide [Dormex] toxicity: an outbreak in El-Minia governorate; a prospective study

The aim of this study is to assess the acute toxic effects of Hydrogen Cyanamide, the active ingredient in Donnex which is a plant growth regulator, in human and to estimate the magnitude of hydrogen cyanamide-related illnesses in our locality [El-Minia govemorate- Upper Egypt]. Symptomatic cases involving acute Dormex exposure during the outbreak period [From January 2009 to March 2009] that were presented to the Poison Control Centre [PCC], El-Minia University Hospital and El-Minia general hospitals were included in this study. In each patient, a detailed history regarding age, sex, residence, route and mode of exposure, symptoms, signs and complications were taken at the time of presentation. A thorough clinical examination was then carried out. Laboratory investigations were done for random blood sugar [R.B.S], serum sodium and potassium levels, liver enzymes aspartate aminotransferase, and alanine aminotransferase [AST and ALT respectively], blood urea nitrogen [BUN], and serum creatinine. Chest X ray was also done for every case of this work. The study was conducted on 43 patients of both sexes with acute Donnex toxicity in addition to 10 healthy individuals of both sexes, representing the basic profile for the studied laboratory parameters. The majority of cases were below 20 years. Gender distribution revealed that a male to female ratio was about 2.6: 1. Patients from rural areas represent [83.7%] while [16.3%] were from urban areas. Exposures were either occupational [67.0%] or as a result of unintentional ingestion [30.2%]; and only one case were related to suicide attempt. All cases occurred from early January through March of the year 2009, which is the period when Dormex [CH2N2] was being applied to the grape trees in our district. The routes of exposure to Dormex CH2N2 were skin contact [60.5%], oral ingestion [32.6%], and inhalation [6.9%]. Most of the cases involved workplace exposure [67.5%]. Dermatological manifestations were evident in the vast majority of cases [67.4%], while ocular manifestations were noted in [39.5%] of the patients. [67.4%] of patients had systemic signs and/or symptoms, including GIT manifestations, CNS manifestations, pulmonary manifestations, and cardiovascular manifestations. Five deaths from the 43 cases were identified. Statistically significant hyperglycemia and elevation in hepatic enzymes profile were noted on admission in all patient groups in comparison to control group, while there were no statistically significant changes observed in serum electrolytes and renal function tests in all patients at time of admission in comparison with control subjects. Based on the current study, acute exposure to Dormex, either dermally in the workplace or by ingestion in those using this product, pose a major threat to human health in the form of hepatic dysfunction, prolonged coma, and severe respiratory and gastrointestinal affections. The study recommended that all efforts should be directed towards studying the possible acute and chronic toxic effects of Dormex on human health in more expanded, large scale clinical and experimental studies

Report of four cases of rhinocerebral mucormycosis in Loghman hospital in 1388

Rhinocerebral mucormycosis is an aggressive fungal disease that involves the nose, paranasal sinuses, orbit and central nervous system. It may rapidly be fatal. This infection usually occurs secondary to immune suppression, diabetic ketoacidosis, and prolonged use of antibiotics, steroids, and cytotoxic drugs. Management of the condition consists of treatment of the underlying disease and surgical debridement combined with intravenous amphotericin-B. We presented 4 cases of rhinocerebral mucormycosis with same presentation. They presented with coryza, erythema and swelling of periorbital area several days before admission. Symptoms progressed quickly and ptosis and chemosis developed. Paranasal CT scan showed opacification in ethmoid, frontal and maxillary sinuses. Diagnostic endoscope showed necrosis in orbit and nasal root. Orbital exenteration, necrotic tissue debridment was done. Smear of necrotic tissue showed branching nonseptated mycelium in favor of mucoral. Culture of necrotis tissue showed rhizopus. Amphotericin-B started for all the patients. Two patients expired in spit of extensive surgical debridment and medical therapy and two survived. The diagnosis of rhinocerebral mucormycosis should be considered in the clinical setting of necrotic sinusitis and acute neurologic deficit in diabetic patients. Early diagnosis and treatment are crucial factors leading to a good outcome

Road traffic injuries in Saudi Arabia, and its impact on the working population

This study aimed at describing the problem of Road Traffic Injuries [RTIs] in Saudi Arabia and it impact on the working population in terms of lost productivity. Registry review for Data on road traffic injuries and deaths were collected for the period of 1997 to 2002, and compared to population census during the same period. Potential Productive Years of Life Lost [PPYLL] was calculated. The total number of deaths due to RTIs was 21905 deaths and the total PPYLL due to RTIs was 459820.81. In all age groups, the losses in males were 1.91 to 8.52 times greater than in females, these differences were statistically significant. Males showed an increasing trend of PPYLL for 20 - 29, 10 -19, 40 - 49 and 30 - 39 years age groups as ordered in descending order and increasing trend of PPYLL for 20 - 29 and 30 - 39 years age groups in females as ordered in descending order. The increasing trend was more expressive in males. PPYLL average was 76636.8 years annually in the productive years of life on years 1997 to 2002, with about 26.46% increase in 2002. RTIs is a major health problem affecting all age groups, working population are more vulnerable due to commuting. Losses in productive years are more prominent and serious in productive age groups

[B] serum procalcitonin level may discriminate bacterial and viral meningitis in children

Acute childhood meningitis is a life threatening condition often leaving the survivors with neurological impairments. Latex agglutination test is negative in early meningitis cases and is unreliable in the detection of St. pneumoniae, Staphylococci, H. influenzae and Enteric bacilli. Antibiotic treatment should not be deferred until awaiting the result of CSF cultures, nor aggressive antimicrobials should be given unnecessarily in cases of viral meningitis. Procalcitonin [PCT] is a potentially sensititve and rapid marker for invasive bacterial infections but remains low in viral infections. We aimed to assess the reliability of serum PCT in differentiating bacterial from viral meningitis in children. We measured serum PCT and C-reactive protein [CRP] levels and cerebrospinal fluid [CSF] total protein [TP], and absolute neutrophil count [ANC] in fifty children admitted for meningitis. Bacterial cultures of CSF were positive in 17 children [group of bacterial meningitis] and 33 patients were diagnosed as acute viral meningitis. Serum PCT levels were measured by immunoluminometric assay: "BRAHMS Diagnostica, Berlin". CRP levels were determined by rate nephelometry. PCT and CRP levels and CSF ANC and TP were significantly higher [P< 0.001] in the group of bacterial meningitis than the group of viral meningitis. Assay of serum CRP and CSF proteins and cells showed a zone of overlapping values between the two groups. Receiver operating characteristic [ROC] curves were plotted for serum PCT and CRP levels to determine the optimal cut off points that maximized the sum of the sensitivity and specificity of each test. A serum PCT level of 2microg/l was retained as the diagnostic threshold since at this value both the sensitivity and negative predictive value [NPV] were 100%. Area under the receiver operating characteristic curve [AUROCC] was 1.0 for PCT which was significantly higher than that for CRP [0.93; P< 0.05]. These data suggest that serum PCT at the cut off value 2microg/l might be discriminant of bacterial and viral meningitis in children

[Prevalence of peripheral soft connective tissue lesions in patients referred to pathology department of Shahid Beheshti dental school, 1981-2006]

Peripheral soft connective tissue lesions are common in oral mucosa and despite their benign nature can make problems for patients. According to our knowledge, a comprehensive study for these lesions was not performed in Iran General practitioners are commonly encountered affected with these lesions. They have not enough information about their clinical prevalence, may make mistake in diagnosis and treatment plan. The aim of this study was to evaluate peripheral soft connective tissue lesions prevalence in patients referred to Pathology department of Shahid Beheshti Dental School during 1981-2006. In this descriptive retrospective study [existing data], cases were patients that referred to Pathology Dept. [1981-2006] with complete files recorded in the Dept. Questionnaires included age, sex, location of lesion and lesion type which were retrieved from patient's files. The incomplete files were excluded. Finally the collected data were analyzed descriptively by SPSS Ver 11.0 software. A total number of 900 cases had peripheral soft connective tissue lesions during 1981-2006 from 4529 files in the department. 29.7% [268 cases] were irritation fibroma, 21.9% [197 cases] were peripheral giant cell granuloma, 19.5% [176 cases] were pyogenic granuloma, 19.3% [174 cases] were epulis fissuratum, 8% [72 cases] were peripheral ossifying fibroma, 0.5% [5 cases] were giant cell fibroma, 0.4% [4 cases] were oral focal mucinosis and 0.4% were inflammatory papillary hyperplasia. The most prevalent age was 50-59 years [18.1%] and 20-29 years [16.3%]. The lesions were more prevalent in women [61.9%] and were 38.1% in men. The most prevalent site was gingival [54.3%] and the least prevalent site was floor of the mouth [0.1%]. 19.9% peripheral soft connective tissue lesions were reported, the most frequent lesion was irritation fibroma that was similar to other reports

expression of liver hepatocyte growth factor receptors [HGFR] in patients with chronic viral hepatitis: clinical, biochemical and pathological significances

The hepatocyte growth factor receptors [HGFR] are transmembrane proteins that mediate the mitogenic effect of hepatocyte growth factor [HGF] on liver cells. In this study, the expression of liver HGF receptors was assessed in sixty patients with chronic viral hepatitis in order to explore the clinical and pathological significances of their detection in such disease. Liver HGFR expression was demonstrated in 40% of patients and was found in parallel relationship to the degree of hepatic inflammation and necrosis and in negative correlation with the value of prothrombin time. It is concluded that in patients with chronic viral hepatitis the expression of liver HGFR tend to be higher in patients with chronic active hepatitis than in patients with hepatic cirrhosis and may promote better synthetic function of liver cells

Hepatorotective effect of garlic [Allium sativum] and vitamin E on experimental liver injuries induced by ultraviolet radiation

Previous researches have demonstrated that the garlic and vitamin E were able to exert preventive properties against sunburn, delay the onset of skin tumors and reduce radiation induced tissue damage. These compounds may act as antioxidants able to scavenge free radicals and lipid peroxidation. The aim of the present study is to investigate the possible protective effect of garlic and vitamin E against ultraviolet radiation induced liver damage. A total of 60 male albino rats weighing 180-200 g were used in this study. The rats were divided into six groups. Each group contained 10 rats. Group [1] Animals were kept as control. Group [2] Animals were exposed to ultraviolet C-rays 180-280 nm for 30 successive days. Group [3] was given ethanolic extract of garlic at dose level of 0.18 ml/100 g.15 min before exposure to ultraviolet C-rays 180-280 nm for 30 successive days. Group [4] was given vitamin E at dose level of 100 mg/kg b. w 15 min before exposure to ultraviolet C-rays 180-280 nm. The fifth and sixth groups were given garlic and vitamin E respectively for 30 successive days. Histopathological effects in liver were demonstrated as necrosis, fibrosis, fatty changes, inflammatory cellular infiltration and vacuolar degeneration. Deep nuclear basophilia and karyolysis were also seen in some hepatocytes. No pathological, histochemical and ultrastructural changes could be observed in rats treated with garlic or vitamin E. Histochemical results showed marked diminution of glycogen content, DNA, protein content and increase in collagen deposition. Ultrastructural changes were observed in irradiated rats in the form of areas of cytoplasmic dissolution, partial clumping of nuclear chromatin and partial disappearance of nuclear membrane. Mitochondria had dense matrix with proliferation and vesiculation of endoplasmic reticulum. The treatment of rats with ethanolic extract of garlic or vitamin E before exposure to ultraviolet C-rays alleviated the deleterious effects of ultraviolet radiation

Role of estrogens in the secondary hormonal manipulation of hormone refractory prostate cancer

To evaluate the role of Estrogens [Honvan] in the secondary hormonal manipulation of patients with hormone refractory prostate cancer [HRCP]. Twelve patients diagnosed as hormone refractory prostate cancer received intravenous estrogens for six days [Fosfestrol, a synthetic phosphorylated estrogen derivative], followed by a maintenance oral dose of 120 mg thrice daily as second line hormonal treatment. During the treatment they were given deep venous thrombosis prophylaxis. Their stage at initial presentation, primary treatment, mode of androgen ablation, prostate specific antigen [PSA] level, duration of remission prior of HRPC status, PSA doubling time before and after estrogen treatment were recorded. The morbidity and mortality of the treatment was also recorded. A drop in PSA of > 50% was classified as major responder. The drop of < 50% was defined as minor responders. Treatment failure was defined as a rise in PSA > the level prior to the start of treatment. The mean age at diagnosis of prostate cancer was 66.6 + 5.4 years [range 57-73]. At the time of initial diagnosis only 3 patients [25%] had localized disease and 9 [75%] had metastatic prostate cancer. Six patients each opted for surgical or medical castration [LHRH analogs] as the mode of androgen ablation. The mean initial PSA at diagnosis was 340 + 728.1 ng/ml [range 4.1-2375, Median 94]. After development of HRPC, six patients [50%] had major response, four [33%] had minor response to estrogen administration. Two patients [17%] did not respond to estrogens. The mean PSA before receiving Fosfestrol was 60.5 + 82 ng/ml [range 0.013-246]. The PSA [nadir] after treatment was 24.3 + 33.2 ng/ml [range 0.9-81.3]. One patient developed gynaecomastia and one had congestive cardiac failure. Two patients died of non cancer related deaths and one patient died of cancer related death. Synthetic estrogens are well tolerated, in-expensive agents and could be considered for palliative use against hormone resistant prostate cancer

prevalence of silent kidney stones - an ultrasonographic screening study

Silent and not yet discovered stones of the upper urinary tract are potentially dangerous, since in due course they may cause infection, obstruction and renal damage. The aim of this study was to determine the prevalence of such silent kidney stones in a representative Pakistani population of Karachi. Subject and We studied 201 consecutive subjects at our hospital who underwent additional kidney screening whilst undergoing abdominal ultrasound. All these subjects did not have a history or symptoms of urolithiasis. We found silent kidney stones in 3% of subjects. All stone bearers were males. Most stones were in the left kidney. Notably, multiple stones and stones of a considerable size went unnoticed. In addition to the usual figures of incidence and prevalence of stone disease drawn from patient data, there is a prevalence of 3% silent stones that may only be discovered incidentally or by screening. This is true for a '"stone country" like Pakistan. Figures for other regions have yet to be determined. Due to socio-economic reasons, we believe that a general kidney screening for urolithiasis is, however, not indicated, at least in our country

HIV / AIDS perceptions and risky behaviors in squatter areas in Cairo, Egypt

The aim of this work was to assess HIV/AIDS perceptions and risky behaviors of adults living in squatter areas in order to take decisions about the relevant messages and health education methods that should be used to prevent HIV transmission in the studied communities. Two methods were used to collect data in this cross sectional study, focus group discussion and structured interview. The study was carried out in six squatter areas in Cairo, four of them located in west Cairo and two in east Cairo. 237 community members and community leaders shared in the study, 44.7% were males and 55.3% females, 64.1% were married and 34% single. Community members represented two-thirds of the sample while one-third were community leaders. Participants expressed strong eagerness to know more about HIV/AIDS. Poor knowledge and misconception about HIV/AIDS was remarkable. The study revealed several misconceptions regarding modes of transmission and preventive measures that could be used to protect oneself from HIV/AIDS. Heterosexual extramarital relationships and IV drug transmission were the HIV/AIDS risky behaviors considered to be prevalent in these communities. AIDS risky behaviors appear to be more prevalent in the four squatter areas in west Cairo than in the two squatter areas located in east Cairo. Adolescents were considered at high risk of contracting AIDS because of the risky behaviors they practice. Social non-acceptance of females who practice HIV/AIDS risky behaviors is much stronger than non-acceptance of males who practice the same risky behaviors. TV movies were the main source of information about HIV/AIDS. Parents played no role in providing adolescents with information about AIDS. The possible role of teachers in HIV/AIDS education is unclear because of the negative attitude of people towards teachers

Immunohistochemical determination of HER-2 / new overexpression in invasive ductal carcinoma of breast with cervical nodal metastasis

This study was designed to determine the frequency of HER-2/neu overexpression, in invasive ductal carcinoma of breast and correlate it with various standard prognostic parameters. This study was performed on formalin fixed paraf n embedded blocks of 72 diagnosed cases of invasive ductal carcinoma of breast. The blocks were retrieved and the staining was done to see the HER-2/neu overexpression. Sections containing > 50% of tumour cells showing intense circumferential cell membrane staining scored as positive. The HER-2/neu overexpression was seen in 31% of cases. A significant relationship [P<0.05] was found between HER-2/neu overexpression and lymphnode status and size of the tumour. The overexpressivity of HER-2/neu oncoprotein suggests that Herceptin can be used as therapeutic measure on these cases

Rationale for surgical treatment as a primary management of hyperthyroidism

The aim of this study was to evaluate the results of the surgical treatment of all types of hyperthyroidism [Graves' disease, toxic nodular goitre, and toxic solitary adenoma] by a retrospective study. This study included 100 consecutive patients who were operated upon between 1995-1999. The results have shown no mortality, one patient developed postoperative bleeding, one patient developed permanent unilateral vocal cord paralysis and two patients had permanent hypoparathyroidism. In 6 of the 100 patients, a thyroid carcinoma was found in the resected specimen, no patient had persistent recurrent hyperthyroidism two to four years after operation. It can be concluded that the primary treatment of all types of hyperthyroidism should be surgical

Early diagnosis of mycosis fungoides by multiparametric image cytometry

In this study, image cytometry of DNA content, S phase and morphometric parameters were used as objective methods for the distinction between early mycosis fungoids [MF] and eczematous dermatitis. Ten cases of eczematous dermatitis and 20 cases of patch stage MF were studied. All the MF cases showed aneuploid histograms and all the eczematous dermatitis cases showed diploid histograms. A higher S phase fraction nuclear ploidy and DNA index and lower 2C fraction were detected in MF cases. All the 12 estimated morphometric parameters as well as the calculated nuclear contour index [NCI] were significantly higher in MF than eczematous dermatitis

Obstructive sleep apnea

Recently there has been considerable attention to the problem of sleep related breathing disorders. Snoring is an extremely prevalent disorder which often leads to medical problems. The OSAS is the most advanced stage of snoring and whereas snoring means partial obstruction of the upper airway, the apnea means total obstruction. 50 patients suffered from various consequences of snoring with respect to their marital and/or social relationships were evaluated. Each patient complaint's was evaluated through careful history, general examination, thorough otorhinolaryngologic examination and endoscopy of the upper airway. Due to the high cost and effort of the polysomnographic analysis of each snoring patient's pulse oximeter was used to screen apneic patients among heavy snorers. Patients with frequent arterial desaturation events, underwent complete polysomnographic assessment in sleep laboratory. This study revealed that snoring and apnea are more common in men and obese subjects. It was prevalent during the forth and fifth decades of life and in alcohol consumers. Heavy snoring was considered as a definite risk factor for developing sleep apnea. A narrow nose, with subsequent increased nasal resistance could be the primary area responsible for snoring and later on obstructive sleep apnea syndrome. Plain X-ray of upper airway is not useful in the preoperative evaluation of the OSA patients. UPPP was a safe and effective technique in treatment of problematic snoring in adults and to relieve oropharyngeal obstruction in apneic patients by excising soft tissues that involve the free margin of soft palate, uvula and posterior lateral pharyngeal wall. Expansion hyoidplasty relieve the symptoms of OSAS by eliminating collapsible redundant mucosa in the hypopharynx. Expansion hyoidplasty with hyoid suspension, and expansion hyoidplasty without hyoid suspension have the same efficacy in treating OSAS. Conventional surgery is easy and safe method and is recommended to be used. Laser surgery add nothing to the final result of the operation

DR polymorphism in chronic active hepatitis C

The aims of this study were to evaluate the association between DR antigens and chronic active hepatitis patients [CAH] and to seek correlations between these antigens and chronicity, disease severity and auto- antibodies in this condition. The frequency of different HLA-DRB I alleles was studied in 30 patient with chronic active hepatitis C [CAH] and 15 cross-matched control group. Both groups were subjected to HLA-DRBI typing using reversed hybridization technique, detection of Sjogren Syndrome Antibody RNA-A [SSA] and Sjogren syndrome antibody RNA-B [SSB] antibodies and detection of ANA, ASMA and AMA antibodies by immunofluorescent technique. Results showed that chronic hepatitis C may be genetically determined as DR3 is significantly higher in patients as compared to controls and DR5, DR2 and DR52 may be protective genes being more frequent in controls. The presence of auto-antibodies with HCV infection may also be genetically determined as it is associated with certain DR alleles. Certain auto-antibodies SSA and ANA are associated with disease severity being more common in patients with chronic active hepatitis C associated with cirrhotic changes

Laser surgery in management of rhino-larynogoscleroma

Scleroma is a real problem facing both the otorhinolaryngologist and his patient. CO2 laser was used for management of 32 patients with rhino and/or laryngoscleroma. Also, a comparative study was done between laser and conventional nasal surgery. Patients were followed up by photographs, clinically, and histopathologically up to one year. 12 patients needed resurgery. It was found that there was no significant differences between the results obtained after laser or conventional rhinological surgery. By laser surgery the granulomatous lesions showed more recurrence than fibrotic lesions. There was also no great differences between results obtained from clinical and histopathological follow up. Finally, laser surgery constitutes an excellent surgical tool due to its many advantages