Genotyping of occult hepatitis B virus infection in Egyptian hemodialysis patients without hepatitis C virus infection

Background: occult hepatitis B viral infection is the presence of hepatitis B viral nucleic acids in the serum and/or liver in the absence of hepatitis B surface antigen

Aim: the study aimed to determine the prevalence of occult hepatitis B virus infection among hepatitis C virus-negative hemodialysis patients and to identify their genotypes

Methods: of 144 patients on maintenance hemodialysis, 50 hepatitis B surface antigen and hepatitis C virus nucleic acid-negative patients were selected according to strict inclusion criteria to avoid the effect of confounding variables. The following investigations were done: serum AST and ALT; HBsAg; HBcAb; HCV-Ab; HCV-RNA; and HBV-DNA

Results: positive hepatitis B viral nucleic acid was confirmed in 12/144 [8.3%] hemodialysis patients and 12/50 [24%] in our study group [occult infection]. Mean hemodialysis periods for negative patients and occult hepatitis B virus patients were 27.3 +/- 18.8 and 38.4 +/- 8.14 months, respectively, and this difference was significant [p-value = 0.02]. Mean alanine transaminase levels were 20.27 +/- 5.5 IU/L and 25.3 +/- 9.6 in negative patients and occult infection patients, respectively. This difference was non-significant. Aspartate transaminase levels were 21.4 +/- 10.2 IU/L and 27.3 +/- 4.6 IU/L, respectively, in negative patients and infected patients; this difference was significant [p-value = 0.03]. Half [6/12] of the positive samples belonged to genotype 'B', 33.3% [4/12] to 'C', and 16.6% [2/12] to genotype 'D'

Conclusion: OBI is likely among hemodialysis patients even without HCV coinfection [24%]. Genotype D cannot be the only genotype distributed in Upper Egypt, as the current study reported relatively new results that 50% of the patients with occult B carry genotype B, 33.3% carry genotype C and only 16.6% carry genotype D

[Treatment of industrial waste water from bacterial contamination by using ethanolic algae extract]

The effect of the ethanolic extract of two algae Nostoc linkia and Chara sp has been tested on the growth of bacteria Escherichia coli, Pseudomonas aeruginosa which was isolated from contaminated water under laboratory conditions of 37°C and treatment period of 72 hour for two algae. The extract of Nostoc linkia showed high efficiency in reducing the bacterial number at concentration 1 mg/I at removal rates 98.9% for Escherichia coli and 94.6% for Pseudomonas aeruginosa. Algaeal extract of Chara sp at concentration 1 mg/I caused a reduction in bacterial numbers at a removal rate of 87% for Escherichia coil and 87% for Pseudomonas aeruginosa with a significant differences at concentrations of 0.75 and 1 mg/I for two algael extract. Total bacterial number is reduced by concentration of 1 mg/I for two algael extract Nostoc linkia and Chara sp. at removal rates 90.8% and 82.4 respectively after 24 hour of treatment

effect of ramadan fasting on duedenal ulcer perforation

Fasting during the month of Ramadan is one of the five holy pillars in the Islamic faith and is an important annual ritual practiced by all Muslims. This involves fasting from dawn to dusk, followed by a break of fast at designated times. The length of fasting varies from ten to 19 hours, depending on the season in which the fasting month of Ramadan falls and the geographical locations. 1st to evaluate the relation between Ramadan fasting and duodenal ulcer perforations and 2nd to asses the risk factors of this complications. This is a prospective study in Baghdad Teaching Hospital - Medical City . Data from 231 consecutive patients with perforated duodenal ulcer from the period of October 2007 to December 2010 were collected and analyzed and all the patients were managed surgically after resuscitation in emergency unit. [96/231, 41.6%] of patients with perforated duodenal ulcer during Ramadan vs. [135/231, 58.4%] during the rest of the years. [96/490, 19.5%] of patients with perforated duodenal ulcer from the total number of all patients with acute abdomeninal surgeries during Ramadan. 43% of patients smoking and 47% of patients had a previous history of acid peptic disease in Ramadan. 54% of patients were in between [20 to 40] years age group and the male to female ratio was 6 :1 . 15% patients of perforated duodenal ulcer had history of regular use of non steroidal anti inflammatory drugs.. Erect chest x-ray demonstrated gas under the diaphragm in 86% . Only 2 patients had a previous surgery of duodenal ulcer perforation. This study suggests that the incidence of duodenal ulcer perforation is relatively high in Ramadan among the people, who are fasting and have predisposing factors [smoking, history of acid peptic disease, non steroidal anti-inflammatory drugs] and need special precaution during this month

Systemic humoral Anti Helicobacter pylori immune response in dyspeptic patients

Helicobacter pylori [HP] cause a continuous gastric inflammation virtually all infected persons. It induces a vigorous systemic and mucosal humoral and cellular immune response. In spite of these responses, the vast majority of infected hosts are unable to clear the infection and it persists for decades. Determination the humoral immune response to HP infection in dyspeptic patients. The immunological serological tests were evaluated in 80 dyspeptic patients divided into two groups: [HP +] and [HP-]. Levels of specific HP IgG antibodies were determined through a specific immunological non invasive Enzyme Linked Immuno Sorbent Assay [ELISA] test from Biohit PIC, Helsinki, Finland. Immunoglobulin levels and complement were done [IgG, IgA, IgM, C3 and C4] using single radial immune diffusion [BioMaghreb-Tunis]. About 62.5% of dyspeptic patients had HP + infection. There was no significant differences between two groups in the levels of [IgG, IgA, IgM, C3 and C4] and most of them were within normal values. Humoral immune response had an important role in the control and limits the inflammation of gastric mucosa

study on humoral immunity and oral bacterial diversity in patients with Trichomonas Tenax infection

Trichomonas tenax [T tenax] is a protozoan that inhabit the oral cavity of poor oral hygiene. It is found in the dental caries, tartar and periodontal area. It feed on the normal flora of the mouth. It had been found to cause pulmonary infection and respiratory diseases in immunocompromised patients and patients with advanced cancer. To determine the humoral immune response to Trichomonas tenax and studying if there is any relation with specific bacteria. Forty patients who consult Al-Kindy Teaching hospital -maxillofacial and dental department from June-2008 to January -2009.Two gingival swabs were taken from those patients, one examined directly for the presence of T tenax by light microscope and other swab was cultured on Blood, Chocolate and MacConkey's agar for isolation of oral bacteria. Blood was collected from patients for estimation of serum IgG, IgA, IgM, C3 and C4 levels by using radial immune diffusion method. The study group consists of forty individuals, their ages range from 6-65 years. Male more than female [22:18], thirty of them was smoker, 25% of them were positive for T tenax. The types of bacteria that were isolated are a normal flora of the mouth like Streptococcus viridans. In spite of the level of Immunoglobulins and complement in both groups lie within normal values, there was a significant increased in serum IgM level and significant decreased in serum IgG, IgA, C3 and C4 level. There was increased in the prevalence of T tenax infection due to low social class and low oral hygiene .There was no specific bacteria that was confected with it. Lastly, increased in T tenax infection when there is an immune suppression as in advanced cancer patients and on radiotherapy and or chemotherapy

Immunological non invasive blood tests to evaluate gastric mucosa in Iraqi dyspeptic patients

Dyspepsia is a common symptom in general practitioner. Using non invasive serological biomarkers would help to identify individuals at increased risk of atrophic gastritis and gastric cancer. In present study, the evaluation of the utility of a serological gastric panel test combining pepsinogen I [PGI], pepsinogen II [PGII], pepsinogenl/pepsinogenll ratio [I/II], gastrin-17 [G-17] [basal and stimulated] and Helicobacter pylori [HP] IgG antibodies as a screening method and to predict the state of gastric mucosa: non atrophic, atrophic gastritis and its sequel of developing gastric carcinoma and intestinal metaplasia. Prediction of gastric mucosa using non invasive immunological blood tests from dyspeptic patients. The serological gastro panel test was evaluated in [54] Iraqi dyspeptic patients divided into two groups: [HP+] and [HP-]. Levels of PGI, PGll, PGI/PGII ratio, G-l 7 basal and stimulated and HP IgG antibodies were determined through a specific immunological non invasive Enzyme Linked Immuno Sorbent Assay [ELISA] test from Biohit PlC, Helsinki, Finland. Using fasting and postprandial samples from those patients. 60% of dyspeptic patients complain from epigastric pain and 62.96% of them had HP+. There were significant increase in PGI, PGII [p<0.05] in NAG. ln case of I/II ratio, there was no significant difference between two groups of HP+ and HP-. The other parameter was done is basal 0-17 which is significantly increased in HP+ [p>0.05] and postprandial G-l7 showed no significant difference between two groups. Most of those Iraqi dyspeptic patients had non atrophic gastritis due to Helicobacter pylori infection that leads to increased in the PGI, PGII, G-17 through many mechanisms. If HP not treated properly this may leads to atrophic gastritis, peptic ulcer and gastric carcinoma. Gastric panel test was considered as a non endoscope immunological blood test in the diagnosis of atrophic gastritis and its outcome in dyspeptic patients

Malignant pediatric tumors in Najaf

Cancer is one of the leading causes of death in children. In young children, particularly infants, the aberrant genetic processes that fail to safeguard against the clonal proliferation of cell with unregulated growth potential occur very early in life and progress very quickly. To study the epidemiology of malignant pediatric tumors regarding age, sex, regional distribution and clinicpaothological findings in Najaf province 35 pediatric cancer cases were collected between January 2000 and January 2002. The cases were analyzed according to age sex, regional distribution, frequency of malignancies type of operation, and the histopathological results after operation. The peak age incidence was [4-8] years, male to female ratio was [1.06: 1] .The three most common malignancies were lymphoma [40%], Wilm's tumor [14,3%] and Neiiroblastoma [14,3%] .The abdominal viscera are the commonest sites followed by head and neck. Poorly differentiated tumors are more ignaling than well differentiated ones. Incisional. Biosy operations constitute about 65% of cases. To our knowledge this is the first study which highlight's the epidemiology pathology presentation and lines of treatment of pediatric tumors. Late presentation of cases was remarkable in this study so public education about early attendance to general practitioner and early referral to pediatric specialist or surgeon will improve the progress of pediatric cancer

Auto antibodies in Iraqi patients with spinal cord injury

Autoantibodies can be generated by different mechanisms and detected in different autoimmune diseases, neoplastic conditions and other diseases. These autoantibodies are important in the diagnosis and management of these disordered. Forty-eight patients with spinal cord injury, twenty-eight quadriplegics and twenty patients were paraplegics, resident in spinal cord accidents hospital [Ibn - AIgiff formerly] from 2002 to 2003. The other group was twenty-five apparently healthy individuals. Both groups were investigated for the presence of autoantibodies against nuclear, mitochondria and smooth muscle using indirect immunofluorescense test. There was no significant difference in anti nuclear antibody between patients and control group. Other autoantibodies, mitochondria and smooth muscle were not detected in both groups. Spinal cord injury did not lead to formation of autoantibodies in spite of damage to spinal cord and exposed sequestered neuronal antigens to immune system probably due to decreased MHC class II expression on neuronal tissues and corticosteroid effect neuroimmune interactions that administered immediately after traumatic injuiy or cortisol formation in the body. Autoantibodies [nuclear, mitochondria, smooth muscle] were not detected in both control and patients group. Other autoantibodies directed against neurological tissues by using other methods like western blot method

HLA antigens among Iraqi muslims Arabs and Kurds

The HLA system is a relevant tool in population genetics analysis. From the genetic point of view, the HLA system is of general interest because of the extreme polymorphism of all known HLA loci. The aiiele and haplotype frequencies have a wide diversity among human population and differ in geographically and racially among populations. Iraq had a high percentage of Muslims people that distributed in two groups [Arab and Kurd], These groups are ancient populations and affected by many settlement in many centuries ago. These ancient settlements had left marks on the genetic structure of the modern Iraqi populations. The later immigrations to other countries were high in later years. The aim of study is to estimate the gene frequency of HLA class i [A, B, Cw] alleies in Iraqi Arab Muslims and Kurd Muslims and determine the genetic differences between them. A total of unrelated 1400 Iraqi Arab Muslims [AM] and 705 Kurd Muslims [KM] healthy volunteers and individuals referred to Immunology and Tissue Typing Center in Al-Karamah Teaching Hospital for organ transplantation and Forensic medicine, were examined for HLA polymorphism using complement dependent cytotoxicity test from June-2003 to April-2004. The phenotypes of HLA typing of Iraqi Arab Muslims [AM] and Kurd Muslims [KM] were in agreement with Hardy-Weinberg equilibrium. Regarding HLA class I [A and Cw loci], there was a significant differences between these groups. Lasly, there was no significant difference between them inHLA-B. This may be due to their inhabitants different area in Iraq, and also due to their different origin as Arab and Kurd races with mild differences due to outbreedmg and migration The effects of invaders and settlements from out side the country and intermixing with them may play an important role in these differences

Prevalence of autoantibodies to various tissue antigens before and during S2-complex immunotherapy in head and neck cancer patients

A total of 63 terminal untreatable stage IV head and neck cancer patients were investigated for clinical responses and presence of autoantibodies to various tissue antigens before and during S2-complex immunotherapy. S2-complex is a new low molecular weight biological response modifier [BRM] with a potant immunostimulating and anti tumor activities. Autoantibodies detected at pretreatment period were those directed towards the following antigens nuclear, thyroid microsomal, epithelial cells, gastric parietal cells, smooth muscles, peripheral leukocytes, T-lymphocytes, B-lymphocytes, monocytes, thymus reticular epithelial cells and Hassall's corpuscles. Beside, autoantibodies with specificities to glomerular basement membrane and vascular endothelial cells were present at low incidence. Short term use of S2-complex induced a transient increase of the following autoantibodies: nuclear, thyroid microsomal, epithelial, parietal cells, smooth muscle, thymus reticuloepithelial cells, Hassal's corpuscles, thymocytes, peripheral blood leukocytes, 1, B-lymphocytes, monocytes, as well as kidney glomerular basement membrane and vasculr endothelial cells. In the later follow up period i.e. 2-6 months most of these autoantibodies responses returned to normal healthy control levels. Moreover, two exceptions were demonstrated which were the incidences of the antiglomerular basement membrane and vascular endothelial antibodies which remianed higher than the pretreatment frequencies. In addition, autoantibodies specific to mitochondria, thyroglobulin and red blood cells were only occasionally seen in our head and neck cancer patients both before and during S2-complex therapy

Comparative diagnostic methods of tuberculosis in blood samples

Despite the availability of effective preventive measures and chemotherapy, the prevalence of tuberculosis [TB] is increasing in the developing world and in much of the industrialized world as well. Children are among the most vulnerable and the most difficult to diagnose with tuberculosis. Early and precise diagnosis of childhood tuberculosis is necessary in order to prevent mortality and morbidity and unjustified chemotherapy. One of the main objectives of the research in the field of mycobacteriology is the development of new methods that will improve and expedite the diagnosis and treatment of tuberculosis and other mycobacterial infections. HealthTech, in collaboration with DynaGen, Inc., in the United States, developed the MycoDotTM serological assay. Several techniques have been developed to improve the diagnosis of tuberculosis including newer radiometric methods; DNA probes mycolic acid chromatography polymerase chain reaction. We aimed in our work to diagnose active tuberculosis either pulmonary or extra pulmonary by different new diagnostic methods. In this study included 58 children ranged from 5 to 7 years old and suspected to have tuberculosis, based on the findings of history taking, clinical examination, PPD skin test, chest X-ray, and sputum examination by Zeil-Nielsen staining for acid fast bacilli. These patients were classified into four classes class 0: no known recent exposure, no infection [PPDnegative], no disease; class I: latent infection as defined by a positive PPD [>/= 10 mm in duration] and no clinical or radiographic evidence of active TB; class II: active TB confirmed by positive clinical pictures and radiographic evidence of active TB with positive sputum staining; Class III: PPD-positive [>/= 5 mm in duration] with evidence of past disease by history or compatible chest radiograph [e.g., upper lobe fibronodular disease] but negative sputum smear [treated patients]. All patients sera were subjected to TB identification by rapid test and MycoDot tests and PBMC separated from blood for PCR reaction. The positive results of the three tests for diagnosis of TB in the four groups of classes were detected as followings: By PCR the four classes were diagnosed as: Class 0 [5.3%], Class I [50%], Class II [70%] and Class III [14.3%]. By MycoDot diagnosis of the four groups was as: Class 0 [0%], Class I [4.5%], Class II [50%] and Class III [0%]. Diagnosis of the four groups by +ve rapid test was as: Class 0 [0%], Class I [0%], Class II [30%] and Class III [0%]. As a conclusion, PCR is a sensitive and rapid method for detection of latent and active TB within few hours, while in anti-LAM IgG was quite specific detection of active disease. The assay can be performed without sophisticated instrumentation with minimal training, which make the assay for random detection of active TB

Prevelance of tuberculosis among children with type -1 diabetes mellitus attending El-Minia university hospital

Tuberculosis [TB] has been a cause of significant morbidity and mortality for mankind throughout history. Currently, there are tweenty million cases of TB worldwide with eight million new cases each year. Three million deaths annually are directly attributable to tuberculosis. Previous clinic-based studies in developed countries demonstrated an association between tuberculosis and diabetes but did not determine whether this is due to an increase in recently transmitted or reactivated infection of tuberculosis. We aim in this study to identify the epidemiological relationship between TB and diabetes in children by using a simple, rapid and reliable test which is MycoDot test. This study was a cross sectional study done on two groups, the first group was one hundred and ten cases of type -1 diabetic children aged from 5-10 years old who had a regular follow up in pediatric diabetes Mellitus out-patient clinic in El-Minya university hospital. The second group consisted of one hundred and ten children [as a control non-diabetic group] age and sex matched from pediatric out-patient clinic in El-Minya university hospital. The children were subjected to tuberculin skin test and Zeihl Nelseen staining on sputum. The diabetic children only were subjected to chest X -ray. The children's sera were subjected to MycoDot test. Among the one hundred and ten diabetic children, six cases [5.5%] assigned positive TB using MycoDot technique. On the other side the control cases assigned only one positive case [0.9%] using the same test. Among the diabetic children [110], four cases [3.8%] were found positive by Tuberculin skin test, whereas two cases [1.8%] were positive by Zeihl Nelseen staining on sputum. Many studies have explored the association between diabetes and tuberculosis. In developed countries, studies dating to the first half of the past century demonstrated considerable increase in the frequency of tuberculosis among patients with diabetes, although the proportion with comorbidity has ranged widely forn 1.0 to 9.3%. Other studies have shown a higher frequency of diabetes among individuals with tuberculosis. In our results, 5.5% of diabetic children suffered from active TB by MycoDot test which is a simple and reliable test, whereas only one positive case [0.9%] was found in the non-diabetic group by the same test. The formal indicates that risk of TB increases among diabetic children and this will give as an alarm to have regular searching for the presence of active TB among diabetic children

HLA typing and variant alleles in Iraqi Arab Muslims tribal origin compared with other HLA populations

The HLA region had been shown to be the most polymorphic genetic system in man. There is a variation in the frequencies of various HLA alleles between various populations. Estimating the gene frequency of HLA class I [A, B, Cw] and class II [DR and DQ] alleles in Iraqi Arab Muslims. Assessing the genetic relationship between Iraqi Arab Muslims and other Arabian, Asian and European populations. A total of 1400 unrelated Iraqi Arab Muslims [healthy volunteers and individuals referred to Immunology and Tissue Typing Center in Al-Karamah Teaching Hospital for organ transplantation and Forensic medicine] were examined for HLA polymorphism using complement dependent cytotoxicity test from June-2003 to April-2004. The distribution of HLA polymorphism [A, B, Cw, DR and DQ] was investigated in Iraqi Arab Muslims [AM]. It had been found that A2 was the most frequent allele in A Ioci [0.202], which is similar to other Arabian, Asian and European populations in the world. Other common allele was A1 [0.116]. The least frequent allele was A25 [0.003]. In case of B-locus, 851 was the most frequent allele [0.123]. This reflects the higher prevalence of Behcet's syndrome in Iraq and other Mediterranean countries. The other common allele was B35 [0.092] while rare alleles were B7, B8, B41, B44, B49, and B50. Those alleles showed shared comparable gene frequencies. Concerning HLA-Cw, the greater frequency was Cw4 and Cw7. Other class was class II, in this class; DR2 was the most frequent allele with a gene frequency was 0.153. It is a fortunately to have high level of this allele because it was a protective against insulin dependent diabetes mullets. The last locus was DQ; it had been found that DQ1 and DQ3 were the most frequent polymorphism [0.117 and 0.119, respectively]

Peripheral blood eosinophils [PBE] apoptosis and fas expression in asthmatic children

This study included three groups of children with matched age and sex. Group 1 consisted of 25 quick relief-treated asthmatic children [not treated with steroids], group 2 included 28 steroid-treated asthmatic children and group 3 consisted of 20 healthy children. All children were subjected to complete medical history, thorough clinical examination, pulmonary function tests [flow expiratory volume at 1 second [FEV1] and peak expiratory flow rate [PEFR]], absolute peripheral blood eosinophils [PBE] count, assessment of apoptosis and Fas expression of PBE by cytometry. It was concluded that there was a decrease of Fas receptors expression on PBE in quick relief treated asthmatic children, which may results in a delay of PBE apoptosis. The delay of PBE apoptosis may play an important role in the pathogenesis of bronchial asthma. The steroid treated asthmatic children may be associated with higher PBE apoptosis and Fas expression on PBE. The increase of Fas expression on PBE in steroid- treated asthmatic children is not the main mechanism of PBE apoptosis induction and other mechanisms must be considered

Neostigmine intrathecal and transdermal nitroglycerine augment intrathecal bupivacaine-fentanyl postoperative analgesia following lower limb surgery

Sixty patients were scheduled for lower limb operations. Their age ranged from 24 to 49 years [mean 41.7 +/- 6.4]. Patients were divided into four groups each group included 15 patients. All patients were given intrathecal bupivacaine - fentanyl, plus group [I] was given [non transdermal nitroglycerine patch] as placebo, group [II] transdermal nitroglycerine patch 5mg /24 hours, group [III] intrathecal neostigmine 10 ug and [non transdermal nitroglycerine patch] as placebo and group [IV] transdermal nitroglycerine patch 5mg /24 hours plus intrathecal neostigmine 10 ug. All groups were assessed for intraoperative and a period of postoperative 24 hours for vital parameters, postoperative analgesia and duration of effective analgesia as time from intrathecal drug administration to the patients first requested for analgesic medication, adverse side effects and total dose to control pain in 24 hours postoperative. Results of this study revealed multiple drug combination may be useful in extending postoperative analgesia of spinal bupivacaine - fentanyl associated with transdermal nitroglycerine patch and neostigmine intrathecal .Suggesting that transdermal nitroglycerine patch and neostigmine may enhance each other's antinociceptive effects at the dose studied

Computer aided diagnosis

The computers are now in common use in industry, commerce and in the sciences of mathematical base such as physics and engineering. In the medical field computers have been used in hospitals for records keeping and retrieval. The applications of computer in simulating some biological system, medical information systems and data banks, diagnosis of diseases and radiotherapy treatment are discussed