Hepatitis C virus infection at Sharkia Governorate, Egypt: Seroprevalence and associated risk factors

A sample of 1422 individuals was included in the study, using multistage sampling technique. Exposures and demographic characteristics were obtained through a pre-designed questionnaire. Antibody to HCV was assessed using micro-particle enzyme immunoassay [MEIA] enzyme assay by IMX and the HCV RNA was tested by real-time PCR technique using ABI Prism 7700 system. The seroprevalence of antibodies to HCV was 23.4% and 27.4% in urban and rural areas, respectively, with an overall prevalence of 25.8%. This reflected prior HCV infection, but not necessarily a current liver disease. The prevalence was higher among males than females and increased sharply with age, from 4.8% in those <20 years old to 41.9% in the older ages [>/40 years]. Those who were not educated and farmers had a significantly high prevalence. The significant predictors of HCV infection were previous parenteral therapy for schistosomiasis [OR = 4.3, 95%, CI = 3.6-7.9], among those over 20 years of age [3.5, 2.18-5.8], blood transfusion [4.1, 2.4-6.9], invasive procedures [surgery and endoscopy] and the use of contaminated syringes and needles. Also, shaving at community barbers added a significance to the model

New concept in histopathological grading and staging of chronic hepatitis C infection at Sharkia Governorate, Egypt

In this study, the Knodell histology activity index and the semi- quantitative reproducible description of the various morphological lesions of chronic hepatitis were applied on 109 liver biopsies taken from Egyptian patients infected with hepatitis C virus [HCV]. It was found that the presented histopathological features may be unusual for any of the known scoring systems. Therefore, a new system was suggested for grading and staging of liver diseases in Egyptian patients infected with HCV. Accordingly, the degrees of necro- inflammations are classified into 3 grades [1-3] and the progression of fibrosis is classified into 3 stages [1-3]. The reduced numbers of grades and stages proposed in this study may be attributed to the rapid course among Egyptians who differ in the environmental circumstances

Molecular cytogntic profiles of hepatitis C infection in patients at Sharkia Governorate, Egypt

In this study, 40 paraffin blocks liver tissues from HCV-PCR positive patients [HBV seronegative] were examined using DNA image cytometry to evaluate its role in diagnosing hepatocellular carcinoma [HCC] associated with hepatitis C virus [HCV] infection. Fluorescent in situ hybridization [FISH] technique using LSIZNF 217 chromosome 20q 13.2 probe was applied. The results showed a high percentage of S- phase fraction in cases of G2S2 and G3S3 with DNA diploidy. Only two cases of G3S3 showed DNA aneuploidy with a severe amplification of chromosome 20q 13.2. Consequently, DNA imaging cytometry is considered a good approach in differentiating dysplasia from well- differentiated HCC on the top of HCV infection. In conclusion, HCV has an acquired role in the development of HCC through the amplification of the aggressive tumor behavior oncogene LSIZNF 217 at chromosome 20q 13.2

HCV and associated concomitant infections at Sharkia Governorate Egypt

This study was performed on 109 cases divided into 6 groups according to the concomitant infection with hepatitis C virus [HCV]. The results proved that groups 1, 3 and 5 had a higher level of viremia than the other groups and a higher risk was found in these groups, as 56.4% and 34.6% were in G2S2 and G3S3, respectively. All cases of liver cell dysplasia and hepatocellular carcinoma in this study were seen in these groups. The study concluded that these factors play an important role in the progression of HCV infection. The death of the patients of this progressive condition occurs in younger age and due to liver failure more than to HCC

Non-invasive markers and predictors of severity of hepatic fibrosis in HCV patients at Sharkia Governorate, Egypt

This study included 109 patients with detectable hepatitis C virus [HCV] by real time PCR. The patients were classified into three different pathological stages and grades according to the new concept of histopathological staging and grading. The different clinical, biochemical, virological and ultrasonographic parameters were assessed and analyzed and the variables that showed a significant association with the histopathological staging and grading were included in the multivariate logistic regression analysis. The regression model revealed that platelet count, matrix metalloproteinase-9 [MMP-9], portal vein diameter, splenic longitudinal axis, alanine transaminase, aspartate transaminase and viral load added a significance to the model in a decreasing order of significance. From these findings, a new score ranged from 0-9 was generated. The score model was applied to the patients to assess its validity, where it proved to be accurate in discriminating patients with mild inflammation and fibrosis [sensitivity 81.8%, specificity 80.5% and accuracy 80.7%] and more accurate in detecting patients with cirrhosis [specificity 96.6%, sensitivity 80% and accuracy 93.6%], but less accurate in detecting patients with moderate to severe fibrosis [specificity 66.7%, sensitivity 68.7% and accuracy 67.9%]. Also, the results revealed that co-infection with schistosomiasis, old age >/45 years and positive history of blood transfusion as a source of infection were significantly associated with severe hepatic pathology

role of aflatoxin-contaminated food materials and HCV in developing hepatocellular carcinoma in Al-Sharkia Governorate, Egypt

In this study, the role of aflatoxin contamination in the onset of liver cancer in HCV-infected patients was studied. The quantitative identification of the possible aflatoxins contamination in six urban and eleven rural areas using high performance liquid chromatography technique revealed that corn, wheat, peanut, lupine "tennis", white rice, cowpea "lobiya", fava bean and brown rice showed a prevalence of AFB1 [64.7%, 53%, 53%, 47%, 47%, 41%, 29.4% and 29.4%, respectively]. A positive correlation was found between aflatoxin and positive HCV- PCR together with liver disease progression to G3S3, the indicative of hepatocellular carcinoma. Such correlation was not fully understood, but the oncogene amplification caused by HCV- infection may be aggravated by the consumption of aflatoxin contaminated raw food materials or their products

Assessment of knee alignment in osteoarthritic patients

This study was performed on 46 subjects [36 patients with osteoarthritis of the knees and 10 age and sex matched asymptomatic volunteers]. They were required to be "knee pain positive" ascertained using a previously standardized questionnaire and to have at least grade 3 radiographic changes using Kellgren and Lawrence criteria. All the 92 limbs were scanned at the level of distal femoral condyle, proximal tibial condyles and ankle joint. Rotation of the knee joint was measured as an angle between the tangent to the dorsal aspect of femoral condyles [proximal reference line] and the dorsal tangent to the tibial condyles. Tibial torsion was measured as an inclination between the dorsal tangent to the tibial condyles and the tangent of the distal tibial at the level of the medial malleolus

Synthesis and Hiv-1 activity of some novel 2,2 - diphenylamine derivatives

A number of new 2,2'-diphenylamine derivatives have been synthesized through reacting the dihydrazide 3 with acid anhydrides, carbonyl compounds, isothiocyanates, and CS2/KOH/hydrazine hydrate to give 4, 5, 7, and 10, respectively. Furthermore, cyclization of 5 and 7 have been achieved. 4b, 5g, 7a, and 9 have been shown to possess moderate anti-HIV activities. Compound 5a was pleaded active in the in vitro anticancer screening program. The intermediate 3 had been shown to fulfill the requirements of good synthones to design and synthesize new molecules

Role of ultrasound and doppler flow study in management of malignant gestational trophoblastic neoplasia

Forty four patients with malignant gestational trophoblastic neoplasia [GTN] were enrolled in the study. They were followed up by serum B-HCG and abdomino-pelvic ultrasound during chemotherapy. In addition, the last 6 patients recruited in the study were assessed by doppler flow study. The cure rate was 100% for patients with non metastatic GTN [n = 27] and low risk metastatic GTN [n = 12]. For patients with high risk metastatic GTN [n = 5], the cure rate was only 40%. Ultrasound failed to localize uterine lesions in 4 out of 44 patients [9%] one of them had brain metastatases. Positive findings were found in the other 40 Cases [90%] [e.g. enlarged uterus, focal uterine lesion, ovarian thecalutein cysts liver metastases]. There was also regression of the detected lesions with normalization of B-HCG titre in responding patients [33/38] patients while the lesions persisted in patients with resistance to chemotherapy [5 patients]. Doppler flow study diagnosed 6 out of 6 cases of malignant GTN [100%] and the uterine vasculature decreased in 5 cases who responded to chemotherapy and remained high [Low resistance index and high peak systolic velocity] in one case who was not responding to chemotherapy as indicated by persistently high B-HCG. In conclusion, utrasonography and pulsed doppler flow study of the uterus are complementary tools to serum B-HCG in diagnosis and follow up of malignant GTN during chemotherapy. They can help in selection of patients for more aggressive chemotherapy to minimize relapse rate and hence increase cure rate

Effect of larval trematodes on the gonads and antibody response of the freshwater snails, biomphalaria Alexandrina and bulinus truncatus

Infection of hermaphroditic freshwater snails with digenetic trematodes causes a strong reduction in gamete production and sexual maturation. The reduction in gamete production in infected snails coincides with the migration and establishment of larval stages of parasite in the gonad acini. The acini were abserved to be invaded with large numbers of rediae and cercariae and consequently the gonad of B, alexandrina [Ehrenberg, 1831] and B. truncatus [Audouin, 1827] following exposure to infection were investigated, to characterize the parasite-induced response and to understand its functional relevance. Infection provoked significant elevations in titres, but this elevation doesn't interfere or stop the fate of parasite. Thus, the functional relevance of the response remains enigmatic

Effect of haemo and peritoneal dialysis on blood indices in CRF patients

In the present work, hematological indices [H.I] [HB%, RBO count and hematocrit value] were studied in 45 patients with chronic renal failure [CRF] divided into 3 groups [15 patients for each group]. In addition, another 15 healthy volunteers served as controls. The first group of patients received only conservative treatment, while the second group undergo regular hemodialysis for 12-15 hours of treatment per week and the third group undergo intermittent peritoneal dialysis [IPD] for 36-40 hours of treatment per week [manual method]. It was found that all H.I. were significantly lowered in the three tested groups compared with control group and dialysis corrected these altered indices significantly compared with group of conservative treatment but still faraway from the control values. Peritoneal dialysis was better in correcting these H.I. So, it was concluded that CRF causes various and significant changes in hematological indices which were marked during conservative treatment without dialysis but were less with dialysis and peritoneal dialysis was better than hemodialysis in correcting these H.I

Placental villous maturation in patients with repeated abortions and chronic toxoplasmosis

The conceptions products obtained from 20 patients with repeated abortions and chronic toxoplasmosis were examined histopathologically comparing the results with those of ten Toxoplasma seronegative patients. The results showed significant association between chronic toxoplasmosis and diffuse failure of growth of placental villi

Comparative study of the Sabin-Feldman dye test and the indirect hemagglutination test in serodiagnosis of toxoplasmosis

200 women with history of abortion and 100 women with history of uneventual pregnancies were investigated serologically for anti-Toxoplasma antibodies using both the indirect haemagglutination test and the Sabin-Feldman dye test. Our results indicated a role for the first test in seroepidemiological surveys and for routine work. The second test may be reserved for cases with negative haemagglutination test in the presence of strong suspicion of toxoplasmosis

Histopathological studies of acute, chronic and congenital infections of toxoplasmosis in mice

The histopathological picture of Toxoplasma gondii RH strain [virulent] and Beverley strain [a virulent] was experimentally studied in mice. Nearly all the internal organs and tissues showed pathological changes ranging between the mild congestion to the severe degeneration. However, the changes were more serious in mice infected with RH strain than those infected with Beverley strain. The lungs showed massive consolidation and severe congestion. The heart showed hyaline degeneration of a cardiac muscle fibers.Focal areas of necrosis were seen in the liver, spleen and kidneys which were enlarged as well as in the cerebral cortex of the brain. The bone marrow and skeletal muscles were infiltrated by mononuclear inflammatory cells. The eyes showed mononuclear inflammatory cells in the retina consisted mainly of lymphocytes and the photo receptors were damaged. In congenital toxoplasmosis the brain showed perivascular mononuclear inflammatory infiltrate as well as multiple areas of necrosis. Microglial nodules were sometimes seen. The eyes showed no pathological lesion

Pathology of primary atrophic rhinitis and the results of middle turbinectomy in its treatment

Our data on 25 cases of primary atrophic rhinitis can be summarized as follow 7 The disease is more common in females and in adolescents. Abnormal large middle turbinate is a constant clinical feature. The epithelium of the inferior turbinate LS shows squamous metaplasia while the lamina propria shows chronic inflammatory cells, dilated capillaries, atrophic glands and variable degrees of fibres-is. The procedure of middle turbinectomy is described. The operation aims at removing the obstructing middle turbinates to prevent stasis of secretion and its sequelae. It is an easy operation, free from side effects and its result in Lybian patients is encouraging [80 percent]