Relation of hypoalbuminemia and liver cirrhosis to plasma tumour necrosis factor-alpha and interferon gamma among chronic active hepatitis C patients in Damanhour Medical National Institute

Tumour necrosis factor alpha [TNF-alpha] and interferon gamma [INF-gamma] are cytokines involved in natural immune responses and are important in antiviral modulation. INF-gamma is an immunostimulatory or growth-promoting factor that activates the macrophages and natural killer [NK] cells, while plasma TNF- alpha is a proinflammatory cytokine that participates with interleukine -1 [IL-1] and interleukine - 6 [IL-6] in the acute phase response and synergizes to mediate inflammation, shock and death. The World Health Organization has now recognized hepatitis C virus [HCV] as a major public health problem. The present study was conducted to assess the level of endogenous interferon [IFN-gamma] and tumor necrosis factor [TNF- alpha] to evaluate the immunological changes occurring among patients with HCV, and to study the relation of hypoalbuminemia and liver cirrhosis to plasma TNF-alpha and INF-gamma, in order to implement a nutritional care program appropriate for every patient according to his health status. The study was conducted on 2 groups of individuals. Group I comprised 40 patients infected with HCV, not treated with any antiviral medication, while group 2 comprised 20 healthy individuals who served as controls. Both groups were subjected to clinical examination, assessment of nutritional status and laboratory investigations including complete blood picture [CBC], liver function tests, plasma TNF- alpha, and IFN-gamma estimation. A significant increase in serum alanine transferase [s. ALT], Gamma giutamyl transferase [s. GGT], serum bilirubin [s. bil.], plasma INF -gamma and plasma TNF- alpha at P= 0.00. Meanwhile the levels of prothrombin activity, platelet count and s. albumin [s. aib] demonstrate a significant reduction at P= 0.00 when cirrhotic and non-cirrhotic HCV patients with or without hypoalbuminemia wee compared to controls. An inverse significant correlation was found between s. bilirubin level and plasma INF -gamma among cirrhotic patients, and between s. bilirubin level and plasma TN F- alpha, but a positive association between plasma TNF- alpha and s. alb and WBC count was found among patients with hypoaibuminemia. However, no significant correlation was detected between serum albumin and plasma TNF- alpha and plasma INF -gamma among cirrhotic or non-cirrhotic patients at P<0.00. Hypoalbuminemia and liver cirrhosis could probably affect the antiviral modular activity of plasma TNF- alpha and endogenous IFN-gamma among HCV patients

Evaluation of success of dental implants in diabetic patients

This paper was done to evaluate the success of different types of dental implants in diabetic patients. Thirty-four patients [type II non-insulin-dependent type] were selected for this research. Full clinical laboratory and radiological examinations were done before an insertion of any dental implants. All candidates for dental implants should be well controlled for glucose metabolic level in blood [glycosylated Hb not more 7%]. The success rate was unexpected, [94.1%]. A future application of dental implants in diabetic patients was recommended