Analysis of Immunoglobulin G subclasses in Hepatitis C virus patients: Correlation with disease activity and viraemia

Hepatitis C virus antibodies are found in the serum of most patients with chronic hepatitis C. However, the significance of the humoral response is still uncertain. There is no reliable and simple diagnostic marker available to diagnose recent hepatitis C virus [HCV] infection. It has been shown that the avidity of specific IgG antibody is low in primary viral infection and increases with time. In this study, in vitro IgG anti-hepatitis C virus secretion by peripheral blood mononuclear cells of patients with hepatitis C was analyzed. To assess the effect of elicited HCV antigen-specific IgG antibody subclasses on the clinical outcome of HCV infection. The study protocol was approved in Damnhour National Medical Institute, and patients provided written informed consent. Forty-five [45] hepatitis C patients [5ml blood for each pt.] were divided into 3 groups: the first HCV Patients with variable degrees of viraemia [low-moderate-high], second: HCV patients with end stage complications [cirrhosis and hepatocellular carcinoma] third: HCV sero-positive individuals without viraemia or complications; 15 patients [5ml blood for each pt.] were randomized into the normal group [HCV sero-negative could subjects]. Hepatitis C patients with [in vitro] IgG anti-hepatitis C virus secretion had higher AFP and IgG levels in serum than did patients without such secretion in vitro [p<0.002]. Furthermore, there is correlation between IgG antibody secretion levels and activity and degree of HCV patients [p<0.001]. The mean-counts of IgG plasma cells in 3 studied groups hepitits C patient were significantly correlated with activity of disease. Whereas IgG plasma cells resulted more correlated with normal group. IgG plasma cells on hepatitis C can be a valuable parameter for better diagnosis of degree of hepatitis C disease and also for follow up the patients

Study of the immune effects in hemodialysis patients receiving erythropoietin

Recombinant human erythropoietin [rHuEpo] [Clinical Pathology Department] may affect the human immune system. Partial correction of anemia by erythropoietin improves hemodialysis [HD]-[Immunology Department]. associated immunosuppression. It is not known whether hemoglobin normalization improves immune status further. All in Damanhour National Numerous studies have investigated the immune effects Medical Institute, of recombinant human erythropoietin [rHuEPO] used in the treatment of anemia of ESRD to hematocrits of 28 to 31%, showing improvement in cell-mediated and humoral immunity. The aim of the study: In the present study, we compared prospectively the immune system parameters of hemodialysis [HD] patients who received rHuEPO and were randomized to normal hemoglobin versus anemic hemoglobin. The study protocol was approved in Damanhur National Medical Institute, and patients provided written informed consent. Each patient was followed for 12 months with serum sample obtained at 12 months. During the course of the study, the slope of CD8 cells increased significantly from baseline in the anemic group [P<0.0001], whereas there was no change in the normal hemoglobin group. Our study sought to determine whether the immune system of HD patients with normalized hemoglobin differed from that of HD patients with partially corrected anemia

Study of INF-gamma and IL-6 in patients with Helicobacter pylori

Helicobacter pylori evade host immune defenses and causes chronic gastritis. Immunity against intestinal pathogens is largely mediated by dendritic cells, yet the role of dendritic cells in acute H pylori infection is largely unknown. The current study was to determine the serum/plasma levels of inflammatory cytokines IL-6 and TNF-alpha in H pylori patients and explain the correlation with disease state, helicabacter pylori Ab IgG and 1gM and urea Breath test. We examined the levels of serum cytokines IL-6 and INF-gamma in 50 patients. Mean serum/plasma levels of IL-6 and INF-gamma in H. pylori patients were significantly higher than those in the healthy controls [P<0.05]. There was a statistically significant correlation between IL-6 levels and INF-alpha in group of positive and negative, IgM. levels of IL-6 and INF-gamma can be used as important parameters for clinical diagnosis and follow up of Helicobacter pylori cases. CRP and ESR is a useful marker ongoing infection but there is Correlation with disease state

Study of the Hemodialysis on Immunomodulation of TH1/TH2 balance

Patients on chronic intermittent haemodialysis [HD] show an impaired cellular and humoral immune response that clinically appears with frequent infectious complications and low vaccination responses. This immune defect strongly correlates with reduced in vitro proliferative responses of T cells. The defect is localized in antigen presenting cells, which show a decreased co-stimulatory activity. Furthermore, the impaired immune response correlates with an increased production of pro-inflammatory cytokines. In response to primary, activation, CD4 positive T helper [Th] cells mainly differentiate into either Th1 or Th2 cells. Th1 cells support cell mediated immunity whereas Th2 cells enhance humoral immune responses. Since both types of responses mutually inhibit each other, the impaired humoral immune response seen in HD patients could either be due to a reduced number of Th2 cells or to a predominant Th1 response. The current study was to analyze the outcome of the Th1 or Th2 cell responses in HD patients compared with healthy controls and to place them in the context of the altered cellular characteristics and impaired immune status seen in HD patients. The study protocol was approved in 50 Patients in Damnhour National Medical Institute. In HD patients, a significantly higher percentage of CD4 cells are characterized by a Th1-type cytokine secretion pattern compared with healthy controls. Our findings contribute to a better understanding of the pathogenesis of impaired cellular immune functions in dialysis patients. They provide a link between overproduction of pro-inflammatory cytokines [IL-12] and imbalanced T-cell activation

Evaluation of different Rheumatoid factors in patients with rheumatoid arthritis: correlation with disease activity and response to therapy

Antibodies to citrullinated proteins have been described in patients with rheumatoid arthritis [RA] and these appear to be the most specific markers of the disease. Our objective was to determine the frequency of antibodies to cyclic citrullinated [CCPs] in patients with RA and investigate that. Comparison of available serologic rheumatoid markers in patient with rheumatoid arthritis [anti-CCP and rheumatoid factor]and correlation of the relevance of these markers to disease activity and their sensitivity to anti rheumatoid drugs. Patients divide into two groups 1[st] group contain 30 patients with RA [Newly diagnosed], 2[nd] group contain 30 patients with RA [Receiving different therapies] and 10 consider as healthy control group, median age of patient 25 years, range [10-35 years]. This study was conducted in the outpatient rheumatology unit of Damanhour Medical Institute. There was no significant difference between the anti-CCP positive and negative patients with RA. There was also no significant correlation between anti-CCP antibody and ESR, CRP. A small but significant correlation was found between RF and anti-CCP antibody. Anti-CCP antibodies had a better diagnostic value than RF for RA. However the moderate sensitivity and high specificity of anti CCP antibodies for RA, along with the appearance of anti-CCP antibodies before disease onset, suggest that anti-CCP antibodies be included in the classification criteria for RA

Pattern of acute poisoning in Al-Qassim region: a surveillance report from Saudi Arabia, 1999-2003

We reviewed all registered cases of acute chemical poisoning reporting to the preventive medicine department in the Qassim Region of Saudi Arabia from 1999 to 2003. The number of cases increased from 66 to 114 during the study period. Mean age of patients was 17.7 years, and over 39% were children aged

Detection of hepatocyte growth factor/scatter factor receptor[c-Met] in axillary clearance after mastectomy for breast cancer using reverse transcriptase-polymerase chain reaction

The diverse biological effects of hepatocyte growth factor/scatter factor [HGF/SF] are mediated by c-Met which is preferentially expressed on epithelial cells. Met signaling has a role in normal cellular activities, and may be associated with development and progression of malignant processes. In this study presence of Met in the axillary drainage from patients who underwent conservative operations for breast cancer, and its prognostic significance was examined. Sixty-two consecutive patients with invasive ductal carcinoma of the breast which were suitable for breast-conserving treatment participated in the study. The output of the drain that had been placed in the axilla during the operation was collected, and the presence of Met and beta-actin were assessed by reverse transcriptase-polymerase chain reaction [RTPCR] assays. The data were compared with the pathological features of the tumor and the axillary lymph nodes, and with the estrogen and progesterone receptors status. RT-PCR of the axillary lymphatic drainage was positive for Met in 46 [74.2%] of the patients and positive assays were correlated with increase in tumor size and grade of capillary and lymphatic invasion, as well as with lymph node metastasis [P < 0.02, for all comparisons]. All 24 patients with axillary lymph node metastases in comparison with those without lymph node [57.9%] metastases had positive assays for Met. While all ten patients with tumor involvement in the margins of the resection had positive assays for Met in their lymphatic fluid, only 36 out of 52 patients [69.2%] were positive for met assay. Finally, Met showed negative correlations with positive estrogen and progesterone receptor assays [P<0.02]. From the results of this study it may concluded that Met can be detected in the axillary fluids of patients with breast cancer and its expression in the axillary drainage may be a potential prognostic factor. This finding might be useful in therapeutic considerations since a positive assay for Met in histologically node-negative patients might indicates the need to search for node microinvasion or involvement of the excision margins with tumor

Comparative study of human papilloma virus DNA detection and results of histopathological examination of cervical colposcopic biopsies

In our study, we investigated the factors that may participate to false-negative colposcopic biopsy results. It was a descriptive study. Damanhour National Medical Institute Hospital [DNMI] during the period from January 2004 to August 2006. A computerized search identified patients with ASC Pap test results and positive results of reflexive high-risk HPV DNA testing during the period of study. Patients who underwent subsequent colposcopic-directed biopsy and/or endocervical curettage with no histologic evidence of HPV infection or dysplasia were selected for the study. Three levels were obtained from each block and stained with H and E. The original H and E-stained glass slides were reviewed. For cases that still were diagnosed as negative for dysplasia or HPV cytopathic effect on review, 3 additional H and E-stained levels were obtained. For the few cases in which there was disagreement with regard to the original and reviewed diagnoses, the discrepancy was recorded, and no other tissue sections were ordered. Patients with atypical squamous cells of undetermined significance [ASC] in Papanicolaou smears, with positive HPV DNA results, but negative cervical histopathologic findings accounted for 4.5% of all ASC smears submitted for HPV DNA testing. We found 4% of the cases had focal HPV infection or mild dysplasia. When serial sectioning of the biopsy material were examined, we found that 31% had clinically significant lesions: HPV infection or cervical intraepithelial neoplasia [CIN] 1, 19%; CIN 2/3, 8%; and dysplasia, not otherwise specified, 3%. Of the remaining patients, follow-up revealed squamous abnormalities in 25%. About 5% of patients with positive HPV DNA results had a negative follow-up biopsy result. [False-negative] biopsies.We recommend that additional levels have to be obtained when initial histologic sections do not demonstrate evidence of dysplasia or HPV cytopathic changes after a cytologic diagnosis of ASC and a positive HPV DNA test result

comparison between the results of plating and intramedullary nailing for treatment of humeral shaft fractures

The aim of this study was to compare the results of intramedullary nailing [IMN] and plating in the treatment of humeral shaft fractures with a particular emphasis on the type and frequency of complications encountered with each technique. Thirty-seven patients were included in the study. Eighteen fractures were fixed with 4.5 mm, AO design, plates and 19 fractures were fixed with an antegrade humeralinter- locking nail. The main clinical assessment measures were shoulder and elbow functions, radial nerve recovery and presence of infection. The radiological assessment was based on fracture alignment, healing time, delayed and nonunion. It was suggested that both plating and IMN provide a satisfactory fixation for humeral shaft fractures with ultimate fracture healing, however IMN is associated with more complications

Anxiety among school age children suffering from asthma

This study was conducted on 146 asthmatic preparatory school students. A matching control of 223 non-asthmatic students from the preparatory school was also included in the study. The study was carried out through a cross-sectional approach. A structured self-administered questionnaire was used to collect data about the general characteristics of the sample, interpersonal and inter-parental relationships, school performance and the attitude and behavior of mothers towards their asthmatic children. The Arabic version of state-trait anxiety inventory [STAI] was used to identify children with anxiety state. The present result revealed that 24.7% of the asthmatic students were anxious with a higher preponderance among boys than girls. Bad interpersonal and inter-parental relationships had increased the risk of the occurrence of anxiety state among asthmatic children. Also, poor scholastic achievement was more encountered among asthmatics who had anxiety. The development of asthma education programs to increase parents', children's and teachers' awareness of asthma symptoms and asthma trigger events was recommended

Tamoxifen induced hypercalcaemia: a case report

The present case demonstrates the important of close observation of patients with cancer metastatic to bone, newly started on endocrine therapy. Nonspecific symptoms should alert the physician to the possibility of hypercalcaemia. The serum calcium is better monitored regularly during the first 2 weeks of tamoxifen therapy, especially in patients with renal impairment. Volume repletion with normal saline is the most important initial treatment for hypercalcaemia. Patients with serum calcium levels above 3.25 m mol/1 [13 mg/dl] required additional intravenous bisphosphonate treatment. Oral bisphosphonate given for two weeks may prevent possible recurrence of hyperercalcaemia when tamoxifen therapy is reinstitkuted

Post-operative pain control using a local anesthetic

30 patients subjected to operations for open cholecystectomy [15 patients] and inguinal hernia repair [15 patients] received postoperative pain analgesia through perfusing their wounds with bupivacaine via a catheter inserted in the wound. 83% of them experienced no pain all through the 72 hours of the trial. and one patient only had severe pain on the same day of operation and needed one dose a narcotic. It can be concluded that, this method is safe, easy and less expensive and could be applied for most cases

Effect of pirprofen on prostaglandins, norepinephrine, serotonin and dopamine content of rat brain

Estimation of prostaglandin E [2] [PGE [2]] level and of the chemical transmitters, serotonin [5-HT], norepinephrine [NE] and dopamine IDA content was performed in different parts of the brain of rats given pirprofen [36 mg/kg] by I.M. injection. The results showed a decrease in PGE [2] content in the thalamus and hypothalamus, and in dopamine content of the striatum with a significant increase in the nerotonin level of the mid brain, however, there was insignificant inecrease in the norepinephrine [NE] level of pons and medulla. 5-HT/NE and 5-HT/DA ratios were found to be raised by pirprofen. These data may help to explain the mechanism of activities of pirprofen as a non-steroidal anti-inflammatory drug

Evaluation of four serological tests for diagnosis of toxoplasmosis

Evaluation of four different serological tests for diagnosis of toxoplasmosis was tried on 60 female patients suspected of having toxoplasmosis beside 20 age-matched healthy controls. The results indicated that I. H. A. T. was the most sensitive test followed by D. A. T. whereas ELISA was the most specific one. Therefore, a combination of the two tests; I. H. A. T. and ELISA offers the most reliable serodiagnostic mean

Estimation of C-peptide level as a guide to treatment of maturity onset diabetes mellitus

This study was performed on 39 controlled diabetics with maturity- onset diabetes divided into three groups: 14 patients controlled by diet alone [group I], 14 patients controlled by diet and oral hypoglycemic drug [group II] and 11 patients controlled by insulin [group III]. Eleven normal individuals were selected as controls. The study showed that C-peptide levels, both fasting and 2- hour postprandial, in the diet-controlled and oral drug-controlled groups were higher than the corresponding levels in the control subjects, while these levels were lower in insulin-controlled group. When subdividing the diabetic groups into obese and non- obese patients, C- peptide levels in obese patients of all diabetic groups were higher than the corresponding levels in the control subjects. In non- obese patients of groups I and II, C-peptide levels were similar to the corresponding levels in the control subjects, while these levels were significantly lower in the non- obese patients of group III. So, maturity-onset diabetic patients with C-peptide levels higher than or similar to those in the control individuals could be treated with diet alone or with diet and oral hypoglycemic drugs, while patients with very low C-peptide levels [less than 0.54 ng/ml fasting] can not be controlled without exogenous insulin

Histopathological evaluation of endoscopically normal elderly patients with dyspepsia

The study was done to evaluate histopathological examination in endoscopically free elderly subjects complaining of dyspepsia. The study included 51 cases. They were divided into 3 groups. Group 1:18 cases aged below 40. Group II: 15 cases aged between 40 and 60. Group III: 18 cases aged above 60. All cases were subjected to thorough history, clinical examination, routine investigations and abdominal ultrasonography. Cases proved to be free of any associated disease were subjected to upper endoscopy. Only subjects who showed normal findings on endoscopy were biopsied from gastric fundus, body, antrum and duodenal bulb for histopathological assessment. Out of 51 subjects, 79% showed varying grades of acute superficial gastritis, chronic superficial gastritis or gastric atrophy, 46% of individuals had varying degrees of duodenitis. Post prandial fullness and epigastric pain symptoms were more indicative of serious chronic gastric mucosal lesions. Duration of less than one month was associated with mostly superficial lession, while duration more than one month was associated with chronic lesions. There was a negative correlation between eating salad more than 1/ 3 of month and presence of chronic atrophic gastritis and gastric atrophy which are potentially preneoplastic conditions. These individuals were more likely to have no abnormalities on biopsy. While individuals drinking more than 5 cups of tea or coffee/day or smoking heavily were more likely to develop chronic atrophic gastritis, gastric atrophy and duodenitis, those who ate canned meat food were more likely to have chronic atrophic gastritis and gastric atrophy, the relative risk was multiple and not additive