Systemic inflammatory response syndrome in patients with liver cirrhosis

Patients with liver cirrhosis present an increased susceptibility to the systemic inflammatory response syndrome [SIRS], which is considered the cause of hospital admission in about 10% of patients and is present in about 40% of those admitted for ongoing complications. We tried to assess the prevalence of the SIRS with the possible effects on the course of the disease during hospital stay. Two hundred and three patients with liver cirrhosis were examined and investigated with close monitoring during hospital stay. The main clinical endpoints were death and the development of portal hypertension-related complications. Eighty-one patients met the criteria of SIRS [39.9%]. We found significant correlations between SIRS and jaundice [p = 0.005], bacterial infection [p = 0.008], white blood cell count [p < 0.001], low haemoglobin concentration [p = 0.004], high serum creatinine levels [p < 0.001], high alanine aminotransferase levels [p < 0.001], serum bilirubin levels [p < 0.001], international normalised ratio [p < 0.001], serum albumin levels [p = 0.033], high Child-Pugh score [p < 0.001]. During the follow-up period, 26 patients died [12.8%], 15 developed portal hypertension-related bleeding [7.3%], 30 developed hepatic encephalopathy [14.7%], and 9 developed hepatorenal syndrome type-1 [4.4%]. SIRS showed significant correlations both to death [p < 0.001] and to portal hypertension-related complications [p < 0.001]. The systemic inflammatory response syndrome occurs in patients with advanced cirrhosis and is associated with a bad prognosis

Protenuria after kidney transplantation its relation to hepatitis C virus and graft outcome

Chronic Hepatitis C Virus [HCV] infection has been associated with glomerular disease in native and transplanted kidneys. We evaluated the presence of HCV infection at the time of transplantation and occurrence of proteinuria in Egyptian kidney transplant patients and their link with graft survival. This retrospective study was done on 273 patients with end-stage renal disease transplanted in Mansoura Urology and Nephrology Center Between 1993 and 1996. Their sera were routinely assayed for anti-HCV antibodies at the time of transplantation. The relationship between the HCV and the development of posttransplantation proteinuria was evaluated, along with the possible effects of proteinuria on long-term graft survival. A total of 169 kidney recipients [61.9%] were positive for anti-HCV antibodies. The mean durations of post-transplant follow-ups were 87.73 +/- 26.79 months [range, 19 to 123 months] and 84.29 +/- 28.55 months [range, 11 to 123 months] for the patients with and without anti-HCV antibodies, respectively. The patients in these groups were comparable regarding the incidence of proteinuria [33% and 32%, respectively] and its quantity [median, 0.6 g/d and 0.4 g/d, respectively]. Irrespective of the HCV infection, patients with nephrotic-range proteinuria showed a worse graft survival [P < .001] and a higher frequency of chronic allograft nephropathy [P = .03] compared with nonproteinuric patients. There is a high prevalence of HCV infection in our patients with end-stage renal disease awaiting kidney transplantation. The incidence and quantity of proteinuria do not increase by HCV infection, and nephrotic-range proteinuria is independently associated with chronic allograft nephropathy and a poorer graft outcome

Study of the biocompatibility of Egyptian made aluminum oxide ceramic in experimental animals

The ossicular chain reconstruction has been a challenge to the otologist since a long time. In Egypt, we can manufacture with the cooperation of National Research Center a high Purity form of aluminum oxide ceramic which is nearly non porous. The aim of this study is to test the biocompitability of this Egyptian made aluminum oxide ceramic in experimental animals before using it clinically. Our results showed that, the material is suitable for implantation in experimental animals without including foreign body reaction or rejection. It is nondegradable, not affected with infection and does not fix to surrounding structures. So, Egyptian made aluminum oxide ceramic is suitable for using it in reconstruction of ossicular chain. However, the clinical evaluation of its use in human being will be done in further study

Ossiculoplasty using Egyptian made aluminum oxide ceramic prostheses

The reconstruction of ossicular chain in patients with chronic suppurative otitis media has been a challenge to the otologists. We used the different forms of Egyptian made aluminum oxide ceramic prostheses [IA, ISA, PORP and TORP] for ossiculoplasty in patients with chronic suppurative otitis media, the biocompatibility of Egyptian aluminum oxide ceramic was tested in experimental animals in previous study. The aim of this work is to evaluate the results of aluminum oxide ceramic prostheses in ossiculoplasty and to compare them with the commonly used autografts [incus and cartilage columellae]. Aluminum oxide ceramic prostheses showed good results in hearing improvement and the total percentage of success was 76 percent. The extrusion rate was 3.4 percent. The good hearing improvement was better than those achieved with autograft cartilage and nearly the same as achieved with autograft incus. Aluminum oxide ceramic prostheses are not degradable and stable in the body for more than one year [period of our follow up study]

Bullous myringitis: etiology and hearing loss

A prospective study was planned to evaluate the nature, site and prognosis of hearing loss in bullous myringitis. Thirty five patients were seen over a 4 year period. Audio-logical lest battery was obtained within 1 - 3 days from the onset of pain. Seventeen patients [48.69%] had sensorineural hearing loss [SNHL] of cochlear origin. Fourteen patients [40%] had mixed hearing loss, 76% of patients who came for follow up showed complete recovery of hearing after one month. Complement fixation titres were obtained for 5 different organisms in twelve patients. None of tested organisms was found to be causative agent for bullous myringitis. The findings of this study suggest that SNHL is an integral part of the disease. The manifestation of bullous myringitis may be nonspecific reaction related to infection by many agents. The implications of this study are discussed with review of the pertaining literature