Study of prevalence and effects of insulin resistance in patients with chronic hepatitis C genotype 4

There is strong epidemiological evidence linking hepatitis C virus [HCV] infection and diabetes. Our aim was to evaluate the prevalence of insulin resistance in Egyptian patients with chronic HCV genotype 4 infection, to assess factors associated with insulin resistance and to test the impact of insulin resistance on outcomes of treatment with pegylated interferon/ribavirin. Insulin resistance [homeostasis model assessmentinsulin resistance [HOMA-IR] score > 3.0] was detected in 31 of 100 nondiabetic patients. The relationship between elevated HOMA-IR and baseline viral load and degree of fibrosis was statistically significant [r = 0.218 and r = 0.223]. Follow-up of patients with complete early virological response until the end of treatment showed a statistically significant decrease in HOMA-IR score. Out of 29 liver tissue sections examined, 14 had a low level of expression of insulin receptor type 1 by immunohistochemical studies. This study confirms that insulin resistance affects treatment outcome, and thus HOMA-IR testing before initiation of therapy may be a cost-effective tool

Clinical, parasitological and social studies on Wuchereria bancrofti in Egypt

This study was conducted on patients attending AlHussein University Hospital and Mansura University Hospitals. Sheets were filled out on each patient [age, residence, occupation, family similar condition, travelling, disease duration, symptoms suggesting acute dermatolymphangitis attacks, frequency and duration. They were 25 lymphoedema patients and 8 controls [17 males and 16 females] and subjected to clinical and parasitological examinations. According to residence, five patients were from Giza Governorate [18.18%], four from Dakahlia G. [12.12%], four from Gharbia G. [12.12%], five from Menoufia G. [15.15%], four from Sharkia G. [12.12%], two cases from Kafr Elsheikh G. [6.06%] and one patient from Assiut G. [3.03%]. In controls, 6 were from Al Hussein Cairo G. [15.15%], and two cases [6.06] from Al Abbassia. They were 48% farmers [10 male and 2 female]; 4% grocers [1 male]; 8% carpenters [2 male]; and 40% house wife [10 female]. According to lymphedema site: 3 cases [12%] were bilateral lower limbs lymphedema [2 female and 1 male], 13 cases [52%] had right lower limb lymphedema [6 female and 7 male], and 9 cases [36%] had left lower limb lymphedema [4 female and 5 male]. They were 18 [72%] with below knee extension of lymphedema [10 male and 8 female] and 7 [28%] above knee extension of lymphedema [3 male and 4 female]. Grade of lymphedema was one case [male] with grade II lymphedema [4%], 13 cases [52%] with grade III [7 male and 6 female] and 11 cases [44%] with grade IV [5 male and 6 female]. Duration of lymphedema was one case with grade II lymphedema in a period of 3 years, 13 cases with grade III lymphedema and the durations of lymphedema for these cases were [one case with 5 years duration, 3 cases were>6-9 years, 6 cases were>9-12 years and 3 cases were>12 years] and 11 cases with grade IV lymphedema and duration of lymphedema for these cases were [one case with 6 years duration, 2 cases were>6-9 years, 3 cases were>9-12 years and 5 cases were>12 years]

Risk factors contributing to fascioliasis endemicity in a focus in Dakahlia governorate 1- human host

Zoonotic fascioliasis is a problem not only in Dakahlia Governorate, but also in other Egyptian Governorates. Two hundreds and twenty patients randomly selected with suggesting manifestations were examined for fascioliasis. A total of 23 [10.4%] were positive by Kato thick smears, of which 21 were from Kafr El-Hessah and two from Oweish El-Hager. The proven human fascioliasis was examined for anti -Fasciola antibodies by IHAT and ELISA [Fhes], haemoglobin level, eosinophils percent, serum bilirubin and liver function tests. IHAT gave 82.61% positive results [19/23], and ELISA gave 100% positive results [23/23]. The clinical signs ranged between splenomegaly and ascitis in 4.34% for each up to hepatomegaly in 73.91% and mild fever in 78.26% but 2 cases were asymptomatic. Mild eosinophilia and moderate anaemia were recorded with means of 11 +/- 5.8 and 10 +/- 1.3 respectively. Mean serum bilirubin was not elevated [0.91 +/- 0.51 gm/dl]. Liver function tests [AST within normal range in all cases; <40 unit /ml but one patient had ALT above normal; >45 unit/ml]

Kupffer cell count and plasma fibronectin level in hepatic schistosomiasis with and without virus hepatitis

The aim of this work was to study some kupffer cell receptors which influence their immunophagocytic capacity in relation to the levels of circulating immune complexes [CICs] and plasma fibronectin [PFN] in four groups of patients: early or late schistosomiasis and schistosomiasis associated with virus B or C infection as compared to a control group. Patients were diagnosed on clinical basis together with ultrasonography and various laboratory tests. Liver biopsies were obtained to confirm the diagnosis and provide Kupffer cells. After dispersion, total nucleated cells and liver macrophage counts were found to be elevated in early schistosomiasis compared to the other groups. The number and percent of Kupffer cells carrying Fc or complement receptors were significantly higher in early schistosomiasis as compared to all other groups, yet by referring to normal values as reported in the literature the percent carrying, receptors could be considered lower than normal. The CICs were higher in all groups than control. The levels were lower in early Schistosomiasis and highest in patients with mixed infection particularly in those with HBV. There was a negative correlation between CICs levels and the number and proportion of Kupffer cells carrying receptors. Plasma fibronectin [PFN] showed a significant increase in early schistosomiasis patients and a significant decrease in patients with schistosomiasis combined with virus hepatitis particularly HCV; compared to controls. Positive correlation was detected between PFN level and the number and percent of Kupffer cells carrying Fc and complement receptors. No correlation was found between PFN and CICs in all groups. It could be concluded that during early schistosomiasis, there is an increase in the immunophagocytic function of Kupffer cells. In chronic schistosomiasis a decreased activity was noted probably due to immunomodulation and fibrosis. In schistosomiasis associated with HBV or HCV, the function of Kupffer cells was markedly decreased. This is probably due to affection of the hepatocytes leading to lower FN level and increased CICs which may block the receptors. The marked lowering of PFN in schistosomiasis associated with HCV could be explained by the direct cytopathic effect of the virus