Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain / 대한해부학회지

Healthy knees require full range squatting movements. Vastus medialis (VM) muscle regulates and adjusts the extensor apparatus that inf luences the patellofemoral function. This work was designed to investigate the anatomy and morphometry of vastus medialis oblique (VMO) muscle by widely used imaging techniques and investigate how VMO muscle participates in anterior knee pain. Ten dissected cadaveric specimens were examined, focusing on fiber orientations, origin, insertions and nerve supply of VMO muscle. Magnetic resonance imaging and ultrasound of VMO muscle were recorded. Anatomical cross-sectional areas of VMO muscle were determined in painless and painful knees and statistically analyzed. In cadaveric specimens, there was distinct separation between VM longus and VMO (change in fiber angle or fibrofascial plane). VMO inserted directly into the medial proximal margin of the patella, capsule of the knee joint and continuous with the patellar tendon. Separate branch of femoral nerve run along the anteromedial border of the muscle. Anatomical cross-sectional area was significantly decreased in painful knee by –17.2%±11.0% at lower end of shaft of femur, –21.1%±6.0% at upper border of patella, –36.7%±11.0% at mid-patellar level. VMO is distinct muscle within quadriceps femoris group. VMO muscle would track the patella medially and participate in last phase of knee extension. Assessment of the VMO muscle anatomical cross-sectional area by ultrasonography may constitute promising and reliable tool to evaluate patellofemoral pain syndrome staging.

Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain / 대한해부학회지

Healthy knees require full range squatting movements. Vastus medialis (VM) muscle regulates and adjusts the extensor apparatus that inf luences the patellofemoral function. This work was designed to investigate the anatomy and morphometry of vastus medialis oblique (VMO) muscle by widely used imaging techniques and investigate how VMO muscle participates in anterior knee pain. Ten dissected cadaveric specimens were examined, focusing on fiber orientations, origin, insertions and nerve supply of VMO muscle. Magnetic resonance imaging and ultrasound of VMO muscle were recorded. Anatomical cross-sectional areas of VMO muscle were determined in painless and painful knees and statistically analyzed. In cadaveric specimens, there was distinct separation between VM longus and VMO (change in fiber angle or fibrofascial plane). VMO inserted directly into the medial proximal margin of the patella, capsule of the knee joint and continuous with the patellar tendon. Separate branch of femoral nerve run along the anteromedial border of the muscle. Anatomical cross-sectional area was significantly decreased in painful knee by –17.2%±11.0% at lower end of shaft of femur, –21.1%±6.0% at upper border of patella, –36.7%±11.0% at mid-patellar level. VMO is distinct muscle within quadriceps femoris group. VMO muscle would track the patella medially and participate in last phase of knee extension. Assessment of the VMO muscle anatomical cross-sectional area by ultrasonography may constitute promising and reliable tool to evaluate patellofemoral pain syndrome staging.

Anti-diabetic effect of balanites aegyptiacea leaves extract [HEGLIG] by regulation of erythrocyte glucose uptake in diabetic patients type 2 in vitro

Background: in Diabetes, the increase in the oxidative stress and decrease in the antioxidant defense may elevate he susceptibility of diabetic patients to many pathological complications, oxidative induced cell damage has been proposed to play an important role in the etiology of numerous pathological conditions. So, the aim of the present study was to investigate the antioxidant potential of Alcoholic Leaves extract of Balanites aegyptiacea [Heglig] due to the presence of phenolic and flavonoids compounds on uptake of glucose in vitro by erythrocytes of diabetic patients

Results: in hyperglycemic patients, erythrocytes malondialdehyde level was highly significantly increased [P<0.0001] than that of control. However, the erythrocytes glutathione content was highly significantly decreased [P< 0.0001] when compared to that of corresponding control values. The glucose uptake by erythrocytes of diabetic patients was highly significantly decreased [P < 0.0001] with increasing hyperglycemia [Fasting Blood glucose], while it was highly significantly elevated [P< 0.0001] after addition of Balanites aegyptiacae leaves extract to the incubation medium. On the other hand, the malondialdehyde concentration was highly significantly reduced [P < 0.0001] on adding the extract. So, it could be concluded that, an appreciate support for enhancing Antioxidant supply from natural sources such Balanites aegyptiace leaves extract may help control blood glucose levels and prevent pathological complications of diabetes

Zoonotic cutaneous leshmaiasis three years fever hospital records: with general discussion

Leishmaniasis is widely present in more than 88 countries worldwide, resulting in up to 80,000 deaths annually. Leishmaniasis occurs as visceral, cutaneous, or mucocutaneous variants. Mucosal involvement can occur secondarily to the cutaneous or visceral varieties

Human babesiosis: a general review with special reference to Egypt

Babesiosis is a tick-borne malaria-like illness caused by species of the intra-erythrocytic protozoan Babesia. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, Africa and the northwestern and northeastern United States. Human babesiosis was first described in 1957 but is now known to have worldwide distribution. The increase in reported cases is likely due to increases in actual incidence as well as increased awareness of the disease. Despite the diagnostic and preventive advances resulting from extensive research and a greater understanding of the disease, babesiosis continues to have significant medical impact as a confounding variable in the diagnosis and treatment of Lyme disease and as a potential threat to the blood supply, especially in the United States. Diagnostic advances, like the development of PCR assays, have resulted in increased sensitivity for detection as well as the discovery and characterization of new babesial species. Further studies using the molecular tools now available and those to be developed will lead to a better understanding of the natural history of these organisms, including the transmission cycle and the potential role of Babesia parasites themselves as immunomodulator. Human babesiosis is usually an asymptomatic infection in healthy individuals. Several patients become symptomatic, and, within these subpopulations, significant morbidity and mortality occur, especially in elderly, immunocompromised, or asplenic patients. It is difficult to diagnose. Although the index of suspicion should be high in rural Babesia endemic areas, patients with babesiosis have few, if any, localizing signs to suggest the disease. Diagnosis confirmation depends on the parasitemia degree, the expertise and well trained laboratory personnel. Most patients infected by B microti who are otherwise healthy appear to have a mild illness and typically recover without specific chemotherapy, however, treatment is recommended for all diagnosed cases to prevent sequelae and potential transmission through blood donation. In addition, patients should be advised to take precautions against tick exposure and to refrain from donating blood until completely cured of babesiosis

Evaluation of real time polymerase chain reaction and enzyme immunoassay in diagnosis of clostridium difficile infection

Background: Clostridium difficile infection [CDI] is the most common cause of antibiotic associated diarrhea [AAD]. Rapid diagnosis of CDI is essential to prevent hospital spread of infection

Objectives: The aim of this work were to determine the prevalence of CDI among cases of AAD in Zagazig University Hospitals, identify risk factors, and evaluate real-time polymerase chain reaction [PCR] and enzyme immunoassay [EIA], against toxigenic culture [TC]

Methodology: Stools were collected from 150 patients with AAD

Results: They were tested for TC, toxin A/B EIA, and C. difficile tcdA/tcdB genes. Thirty four toxigenic C. difficile isolates were obtained [22.7%] out of the 150 patients and those patients were considered positive for CDI. On the other hand, 6 non-toxigenic C. difficile isolates were obtained [4%], while culture of the remaining 110 patients [73.3%] did not yield C. difficile. The later 116 patients [77.3%] were considered negative for CDI. Analysis of risk factors revealed that advanced age, prolonged hospitalization, long duration of antibiotic intake, potentiated penicillins, 3rd generation cephalosporins, antibiotic combined therapy, liver cirrhosis, malignancy, proton pump inhibitors, enteral tube feeding, and cancer chemotherapy were significantly associated with CDI. Sensitivitiy, specificitiy, positive predictive value, negative predictive value, and accuracy of real-time PCR against TC were all 100%, however, values of EIA were 79.4%, 100%, 100%, 94.3%, 95.3%, respectively

Conclusions: CDI is an underappreciated nosocomial infection predisposed by many risk factors. Real-time PCR proved superior diagnostic performance to toxin A/B EIA

Chitosan microspheres as potential carriers for colon targeting

Chitosan microspheres have been in the focus of increasing interest as polymeric drug carriers due to their appealing properties such as biocompatibility, biodegradability, low toxicity, mucoadhesion and relative low cost of production. Gel formation can be obtained by interactions of chitosan with low molecular we. counter-ions such as polyphosphates. However, one drawback of using this natural polysaccharide for oral controlled release dosage forms is its fast dissolution rate in the stomach. Since chitosan is positively, charged at low pH values [below its pKa value], it spontaneously associates with polyanions to form polyelectrolyte complexes [PEC]. These PEC these PEC exhibit favorable physicochemical properties with preservation of chitosan's biocompatible. characristics. These complexes are therefore good candidates for the design of colon-targeted dosage forms. Various techniques are used for preparing chitosan microspheres which have been reviewed. This review also includes factors that affect the release characteristics of drugs from chitosan microspheres

Effects of iron chelating therapy and / or HBV-vaccination on beta-thalassemia major patients

Thalassemia is a genetic inherited blood disorder in which the body makes abnormal hemoglobin with excessive destruction of red blood cells, which leads to anemia. For many years, hepatitis B virus was a major problem for patients with thalassemia substantially contracted from blood transfusions. The development of effective vaccine has further reduced the magnitude of the problem of hepatitis B. Iron chelators are used to remove excess iron that accumulates due to repeated blood transfusion. To compare thalassemic patients either have or haven't HCV with healthy persons as regards biochemical indices taking in consideration effect of vaccination against HBV or not and using iron chelating therapy or not by the studied persons. A case control study in which 40 thalassemic, blood transfusion dependent patients were chosen randomly to act as a case group from thalassemic patients attending the VACSERA Company. The cases [40 patients] they were classified to patients having HCV, patients were HBV vaccinated, other non vaccinated, using iron chelating therapyor don't use it. Another 10 healthy and non thalassemic persons were chosen randomly among persons attending the same company as a control group to be matched with the case group. 50% of studied thalassemic patients had HCV seropositivity. Biochemical blood indices which were found to be significantly elevated among thalassemic patients than controls were ALT, AST, ALP, GGT and LDH enzymes in addition to serum iron, ferritin and globulin mostly in HBV non-vaccinated and iron chelating therapy non dependent patients while, other biochemical indices which were significantly decreased among thalassemic patients compared to controls included: total cholesterol, total protein, albumin and albumin/globulin ratio mostly in HBV vaccinated and iron chelating non dependent patients. This study illustrated the effectiveness of iron chelators agentsand the importance of vaccination for reduction of morbidity and mortality

Influence of adipose tissue derived mesenchymal stem cells in combination with injectable bone substitute on osteoclastogenesis in osteoporotic rats.

The present study was designed to evaluate the influence of adipose tissue derived mesenchymal stem cell (ASCs) with or without calcium phosphate composite on osteoclastogenesis in osteoporotic rats. Mesenchymal stem cells (MSCs) were harvested from adipose tissue of both the omentum and the inguinal fat pad of male rats, as the sex mismatch, to track the MSCs fate and to ensure their homing to the injured females' femurs. The isolated ASCs were characterized via the morphological appearance, multilineage potential and the PCR detection of CD29, CD44, CD106, CD14, CD34 and CD45 surface markers. Fifty adult female albino rats were enrolled in the current study. The rats were classified into five groups: group 1 was the gonad intact control, group 2 served as untreated ovariectomized (OVX) rats, group 3 was OVX rats treated with ASCs, group 4 was OVX rats treated with ASCs with injectable bone substitute (IBS) and group 5 was OVX rats treated with IBS. The serum levels of osteoprotegerin (OPG) and receptor activator of NF-қβ ligand (RANKL) were assayed using ELISA procedure. In addition, nuclear factor-κβ (NF-κβ) gene expression level was estimated in femur bones using real time –PCR. The isolated ASCs proved their MSCs identity via their morphological appearance and multilineage potential. In addition, the isolated ASCs showed positive expression for CD29, CD45, CD44 as well as CD106 and negative expression for CD34 and CD14. Besides, the positive expression of the Y-chromosome (sry) gene detected in the ASCs treated groups indicated that the systemically delivered single dose of undifferentiated ASCs was able to home at the females' femur bones. Adipose tissue derived mesenchymal stem cells (ASCs) injection with or without calcium phosphate composite in OVX rats reversed the effect of ovariectomy on the studied biomarkers causing significant increase in serum OPG level accompanied with significant decrease in serum RANKL level. Also, significant down regulation of NF-κβ gene expression in femur bones was detected in the treated groups compared with untreated OVX group. These results clarified the good influence of ASCs against osteoclastogenesis. In addition the combination of ASCs injection with osteoinductive material injectable calcium phosphate composite (IBS), may be useful to achieve the significant antiosteoporotic effects.

Pharmaceutical and clinical evaluation of intravenous admixture of dobutamine and dopamine used in treatment hypotension in neonatal intensive care units

The aim of this study was to evaluate compatibility and stability of the maximum concentration used for binary admixture containing dobutamine and dopamine in 5% glucose. The maximum concentration of each drug was 5.76 mg/ml of dobutamine and 2.88 mg/ml of dopamine in 50 ml of 5% glucose. The physical compatibility of binary admixtures was assessed using visual inspection and pH determination immediately after preparation [at 0 time] and after 24 hrs. The chemical stability was assessed using high performance thin layer chromatoghraphy [HPTLC]. The method is based on HPTLC separation of the two drugs followed by densitometric measurements of their spots at 254 nm using Camag TLC Scanner 3. The mobile phase comprised ethyl acetate: n-propanol: water: glecial acetic acid [60:24:9:3, v/v/v/v]. The results revealed that no precipitation, gas evaluation, color change, pH change or chemical incompatibility were observed over the entire time of mixing of two drugs in 5% glucose solution

Neonatal screening for absolute lymphopenia

Background: Blood counts with manual differentials could diagnose nearly all cases of severe combined immune deficiency [SCID] at birth

Objective: The aim of this study was to outline the prevalence of neonatal lymphopenia among newborns of Obstetrics and Gynecology Hospital, Ain Shams University as an entry to neonatal screening for SCID

Methods: Complete blood counting [CBC] with manual differential was performed in the cord blood of 500 newborns. Absolute lymphopenia was considered if the count was less than 2500 lymphocytes/mm3. Parents of lymphopenic infants were advised not to give them any live attenuated vaccines before doing further investigations. The lymphopenic infants were followed up by another CBC after one month

Results: In the present study, absolute lymphopenia was found in 8 [1.6%] neonates at delivery. Among our series 44.4% were primigravida and 55.6% were multigravida. Also, 84 [16.8%] experienced pre-mature rupture of membrane, 89 [17.8%] reported maternal diseases and maternal drug intake was reported in 73 [14.6%]. Three neonates had congenital anomalies, one only experienced dysmorphic features and 8 [1.6%] had family history of unexplained death but these data could not be linked to the presence of lymphopenia in the studied sample. APGAR scores at 1 and 5 minutes were significantly lower in neonates with lymphopenia [p = 0.001]. A significant positive correlation was elicited between the absolute lymphocyte count [ALC] and maternal age, total leukocyte count, and HCT [p = 0.003, 0.001 and 0.031 respectively]. Also a significant negative correlation was found between ALC and gestational age, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration [p = 0.013, 0.003 and < 0.001 respectively]

Conclusion: Lymphopenia is not an uncommon finding among neonates at screening and is noted to be associated with a lower Apgar score. Serial counting and follow up is needed before considering the diagnosis of SCID

intervention of vitamin a, iron and zinc deficiencies among school children through an enriched biscuits

An intervention to fight the deficiencies of iron, zinc and vitamin A was conducted in /I 60 school children aged < 6years old, 7-10years old and 10-12years old. Selection was randomly assigned to receive daily fortified biscuits in a period of 6 months. Children in the intervention group received biscuits fortified with vitamin A [456IU/60 gm], iron [3mg/60gm] and zinc [1.8 mg/60gm]. Anthropometric data and chemical indicators before and after were collected and compared at base line and follow up process for the intervention group. The prevalence of low serum iron, zinc were increased to reach the normal level, however, vitamin A increased, but not able to reach the normal level. Studies of the relationship of hemoglobin, serum iron, zinc and retinol were undertaken and discussed

Immunohistochemical expression of vascular endothelial growth factor receptors FIt1 and KDR in the endometrium during the estrus cycle in albino rats

Angiogenesis is an important process in endometrial development and embryonic implantation and is regulated through vascular endothelial growth factor [VEGF]; its receptors Flt1 and KDR. This work aimed to study the immunoexpression of VEGF receptors [VEGF-Rs] in the endometrium at different ages and reproductive phases and correlate them with the histological profiles in these phases. Seventy female albino rats were included in this study. They were divided into seven groups of 10 rats each: one group consisted of rats in the prepubertal period at age 4-6 weeks; five groups consisted of rats in the reproductive period at age 6-10 months, which were divided according to estrus cycle phases into proestrus, estrus, metestrus, diestrus, and pregnant groups; and the sixth group consisted of rats in the postmenopausal period at age 15-18 months. The uteri of all rats were removed and processed for staining with H and E and were subjected to immunohistochemical staining for Flt1 and KDR. For morphometric measurements, uterine wall thickness and Flt1 and KDR optical density in the endometrial surface epithelium, glandular epithelium, stromal cells, and endometrial endothelial cells were measured using image analysis. Results were statistically compared. The expression of VEGF-Rs was highest in the pubertal age group with marked expression of these receptors in the proestrus phase followed by the estrus phase. This supports the role of sex hormones, especially the estrogen hormone, in regulating VEGF-R expression. The Flt1 receptor was predominantly expressed in endometrial and stromal cells as well as in blastocysts, whereas the KDR receptor was predominantly expressed in endometrial endothelial cells. Comparison among all groups and then between each two groups revealed statistically significant differences in the measured morphometric parameters. The upregulation of Flt1 and KDR could be involved in the regulation of endometrial endothelial cell proliferation and in increase in endometrial vascular permeability, especially at implantation sites

Penile autotransplantation in rats: an animal model

Penile allotransplantation might be a viable option for patients who need penile reconstruction. A successful autotransplantation rat model is the first step toward proceeding for allotransplantation. We here in evaluate autotransplantation following transaction of the rat penis just distal to the urethral bulb. Experimental animal study. Five Sprague-Dawely rats weighing 520 g [SD 19] were used. Utilizing a magnification of 6-40, transection and immediate anastomosis of the tunica albuginea, urethra, dorsal vein and nerves were carried out. Vesicostomy was made to divert urine. The glandular skin was sutured to the perineum and the abdominal wall was closed in layers. Descriptive statistics. Average surgery time was 8 h. The first two rats had no vesicostomy and died in the first postoperative day from retention. Three rats tolerated well the procedure and survived to the end point. One rat was sacrificed at day 10 and histopathology showed 30-50% necrosis of the implanted penis. Another rat was sacrificed at day 20 and showed normal cavernous tissue. The fifth rat was sacrificed 3 months postoperatively and showed evidence of moderate corporal fibrosis. Urethral fistula and necrosis of corpus spongiosum, dorsal nerve necrosis and dorsal vein occurred in all animals. Penile autotransplantation in rats is feasible and provides the basis for evaluation of the corpora cavernosa in an allotransplantation model. Long-term urethral continuity and dorsal neurovascular bundle survival in this model is difficult to establish

Volatile oils, lipid constitutes and the antimicrobial activity of Daucus syrticus growing in Libya

Apiaceae is a large plant family; it comprises about 60 annual and biannual species mostly distributed in Europe, Africa, West Asia, and Australia. The Daucus genus is one of the most common genera of this family in which Daucus syrticus [DS] is a common member, growing mainly in the Sirt region [Libya]. It is locally known as wild carrot. This study aims to investigate volatile oils, lipid constitutes, and the antimicrobial activity of DS extracts. The herb of DS was collected from Wadi Telal, Sirt region [Libya], during January and April 2011. About 250 g of different parts from fresh plant material [aerial parts, roots, and seeds] of DS were subjected to hydrodistillation. Extraction of lipid constituents was carried out as follows: About 1500 g of dried powdered plant material of DS were extracted with petroleum ether in a soxhlet. The antimicrobial activity was determined using the disk diffusion method, and the inhibition zone [IZ] was measured for each extract under study against Escherichia coli, Bacillus subtilis, Aspergillus niger, and Candida albicans. Results of Gas chromatography/Mass spectrometry GC/MS analyses of the volatile oils of the aerial parts [January and April collections] proved that they contain a mixture of 47 and 33 compounds, respectively, whereas the roots [April and July] were found to contain a mixture of 32 and 20 compounds, respectively. In addition, the seeds [July] were found to contain 18 compounds, with beta-asarone [26.23%] as the main compound. Investigation of the lipid fraction of the herb revealed the presence of a mixture of fatty alcohols; the major contents of the unsaponifiable fraction were identified as a series of n-alkanes C[8]-C[28] [84.85%], four steroidal compounds, triterpene, and a mixture of fatty acid methyl esters consisting of eight different acids. The antimicrobial evaluation of DS extracts exhibited different IZ values against the tested microorganisms. The main constituents of the different volatile oils of the aerial parts, the roots, and the seeds were identified. The fraction of total fatty acid had the highest activity against E. coli [IZ = 2.7, minimum inhibitory concentration = 250 mg/ml]

Compatibility and stability of ternary admixture of midazolam, dobutamine and dopamine in 5% glucose or 0.9% sodium chloride solution

The aim of this study was to evaluate compatibility and stability of the maximum concentration used for ternary admixture containing midazolam, dobutamine and dopamine in 5% glucose and 0.9% sodium chloride solutions. The maximum concentration of each drug was 0.144 mg/ml of midazolam, 5.76 mg/ml of dobutamine and 2.88 mg/ml of dopamine in 50 ml of 5% glucose or 0.9% sodium chloride solutions. The physical compatibility of ternary admixtures was assessed using visual inspection and pH determination of ternary admixtures immediately after preparation [at 0 time] and after 24 hrs. The chemical stability was assessed using high performance thin layer chromatoghraphy [HPTLC]. The method is based on HPTLC separation of the three drugs followed by densitometric measurements of their spots at 254 nm using Camag TLC Scanner 3. The mobile phase comprised ethyl acetate: n-propanol: water: glecial acetic acid [60:24:9:3, v/v/v/v]. There were no visual changes [such as precipitation, gas evaluation or change in color] during 24 hrs after preparation of admixture. Also, there was no change in pH values of admixtures during that time. The results revealed chemical stability of midazolam, dobutamine and dopamine over the duration of mixing [24 hrs] in 5% glucose or 0.9% sodium chloride solutions

Effect of Ficus sycomorus and Azadirachta indica extracts on liver state of mice infected with Schistosoma mansoni

The potential role of hepatoprotective and antipathological effect of Ficus sycomorus and Azadirachta indica extracts was evaluated for scavenging the reactive oxygen species [ROS] and reduced the oxidative damage and pathological changes in the liver of S. mansoni infected mice. The levels of alanine aminotransferase [ALT], asparate aminotransferase [AST] and gamma glutamyl transferase [GGT] were evaluated in the infected mice and treated orally with each plant extract 12 weeks post infection [P.I.] in a dose of 500 mg/kg of each plant extract for five consecutive days and sacrificed two weeks P.I. The infection of mice showed an elevation of ALT, AST and GGT. Treatment of mice with 70% methanol extract of each plant extract reduced significantly ALT, AST and GGT elevation. The highest reduction was with the methanolic extract of F. sycomorus [42%, 35% and 44% for ALT, AST and GGT respectively]. Fractionation of the methanolic extract of each plant was carried out. The effect of ethyl acetate and butanolic fractions of each plant was also evaluated. The result showed that the two fractions lowered the levels of the tested enzymes and decreased the number and size of granuloma diameters with an increased in the percentage of degenerated ova

Cytotoxic activity of vitex trifolia purpurea extracts

Defatted 85% crude hot aqueous methanol extract of Vitex trifolia purpurea [AME] successively extracted with, chloroform and ethyl acetate. Cytotoxicity of [AME], chloroform methanol extract [CE], ethyl acetate methanol extract [EE] and the residue obtained from methanol extract after successive extraction [RME] have been evaluated on brine shrimp [Artemia salind] and Hep-G2 cell lines as well. In brine shrimp lethality bioassay the results revealed that the [RME] is the most potent one with LC[50] value 173 microg/ml while LC[50] values of [AME], [CE] and [EE] was 180, 199 and 286 |microg/ml, respectively. As well as the results of cyto-toxic assay against Hep-G2 cell lines are in full agreement with previous results, with IC50 values 6, 10.7, 20.8 and 65.8 microg/ml for [RME], [AME], [CE] and [EE], respectively

Non-organ-specific autoantibodies in chronic hepatitis c patients: association with histological activity and fibrosis

The interaction between HCV and the human immune system has attracted great interest in the last decade for two main reasons. Immune system related manifestations include a myriad of conditions ranging from sub-clinical cryoglobulinemia to overt lymphoproliferative malignancy. [Landau et al 2007]. Among the various immune system disorders associated with HCV infection is the auto immunity. Chronic hepatitis C virus [HCV] infection is, indeed, associated with a range of autoimmune manifestations, including increased expression of non organ-specific autoantibodies. There is ongoing debate as to whether the presence of autoantibodies provides additional information about the disease process or is simply an epiphenomenon. Aim to assess the prevalence, type of NOSA in chronic hepatitis € patients and to determine whether a relationship might exist between the presence of NOSA and the severity of liver disease in chronic hepatitis C. Methodology A total of one hundred patients with chronic hepatitis C who are treatment naive presented to the department of Hepatology; Ain Shams University hospitals between the years 2009 and 2011 were enrolled. Non-organ specific autoantibodies namely ASMA, ANA and LKM autoantibodies were assessed in the sera of all patients. A liver biopsy was also done to determine the histological degree of liver injury using Metavir score. We found that NOSAs were present in 14% of our cohort. ASMA was the most frequently detected autoantibody [13%] in this study and LKM was the least [4%] with predominately low titres [1:40]. NOSA was more common in females and the presence of autoantibodies was associated with higher level of transaminases and more advanced fibrosis and necroinflammatory scores on liver biopsy independent of the degree of viremia. NOSAs were associated with the most severe forms of chronic HCV infections

Factors affecting quality of life for patient with leukemia

Leukemia is a chronic and life-threatening illness. The symptoms and side effects from leukemia and its treatment, such as chemotherapy, affect every aspect of quality of life of patients with leukemia. The present study aims to identify factors affecting quality of life for patient with leukemia. The research question is; what are the factors affecting quality of life for patient with leukemia? The study subjects consisted of 37 patients diagnosed with leukemia, at the Hematology Unit, in Ain Shams University Hospital. The tools of data collection were;l] Patient assessment sheet; to assess patient's socio-demographic characteristics, disease characteristics and family history as well as smoking habits and level of knowledge regarding to leukemia.2] Activities of daily living scale; to assess patient's ability to perform activities of daily living. 3] Quality of life scale, to determine the effect of leukemia on physical, social, psychological and spiritual conditions of patients under study. The results of the study revealed that more than three quarters of patients had satisfactory level of knowledge regarding to their condition, most of them were independent, and the majority had moderate quality of life, while the majority of patients who had high level of quality of life were nonsmoker, had leukemia for less than 6 months and on chemotherapy. The study concluded that, factors affecting quality of life for patients with leukemia are age, marital status, educational level, socio-economic level, residency, smoking habits, duration of illness and being on chemotherapy treatment. The study recommended that, tailored counseling program is a must and essential to help patient with leukemia to cope with his physical, social, and psychological conditions