Hepatitis C virus genotype distribution in Egyptian diabetic patients: a preliminary study

There is controversy regarding whether a specific hepatitis C virus [HCV] genotype is associated with diabetes mellitus. This study aimed to investigate HCV genotype distribution in diabetics and its relation to some clinical and laboratory variables in HCV-positive diabetic versus non-diabetic Egyptians in East Delta. The study included 100 HCV-positive patients of which 66 were diabetic in addition to 35 healthy adults as a control group. Clinical assessment, laboratory measurements of plasma glucose, insulin, C-peptide, C-reactive protein [CRP], tumour necrosis Factor-alpha [TNF-alpha] and liver functions [alanine aminotransferase [ALT], aspartate aminotransferase [AST] and gamma-glutamyltransferase [GGT]] as well as HCV genotype determination were done, and AST/platelet ratio index [APRI] and Homoeostasis Model of Assessment-Insulin Resistance [HOMA-IR] were calculated. The main results were the presence of HCV genotype 3, in 31.8% of the diabetic group and in 26.5% of the non-diabetic group, while the remainder of cases had genotype 4, the predominant genotype in Egypt. This is the first report of the presence of HCV genotype 3 in about 30% of an Egyptian cohort. However, there was no significant difference in genotype distribution between both groups. Further, there were significantly higher values of HOMA-IR, insulin and C-peptide in HCV-positive groups in comparison to the control group, while TNF-alpha was significantly higher in the HCV-positive diabetic group. However, there were no significant differences between both genotypes regarding these parameters. Although this study reveals for the first time the presence of HCV genotype 3 in a significant percentage of a group of Egyptian patients, where the majority were diabetic, the association between diabetes and certain HCV genotypes could not be confirmed on the basis of our findings. Hence, taking into consideration the impact of such a finding on the treatment decisions of those patients, further studies are warranted to explore these findings to a greater extent

Clinicoradiological evaluation of rare orbital injuries

AIM OF THE WORK: We aimed at recording rare cases with different orbital injuries and studying the difficulties in their diagnosis and management. PATIENT AND METHODS: A retrospective review of six cases of rare orbital injuries. All cases shared in visual impairment and some cases had either proptosis or enophthalmos. All cases underwent full history taking including type and mechanism of trauma, complete ophthalmic examination and computerized tomography [CT] examination. Clinical diagnosis was not conclusive. Accurate diagnosis was only achieved by CT. Management was different depending on each condition. One case had pure medial wall blow out fracture with the displaced globe traversing ethmoidal cells into nasal cavity, another one had bilateral medial wall blow in fracture with nasal fracture, two cases had intra orbital FBs; one of them had very large neglected woody FB and the other had gun shot passed through optic canal into middle cranial fossa, one had neglected orbital hematoma which changed into hematic cyst, and the last case had iatrogenic medial wall injury. CONCLUSION We concluded that in rare orbital injuries, we should not rely on clinical assessment only and CT is very essential diagnostic tool for such cases also there is no fixed role for surgery but it moulds itself according to each condition

Combined phacoemulsification and deep anterior vitrectomy with intravitreal triamcinolone infection for complicated cataract and vitreous opacities due to recurrent uveitis

To evaluate the influence of combined cataract surgery with deep anterior vitrectomy and intravitreal injection of triamcinolone on the visual acuity and the course of the disease in patients with recurrent uveitis. Eleven eyes of eleven patients with medically controlled recurrent uveitis with complicated cataract and vitreous esudates nderent a combined phacoemulsification [or hacoasiration in cases of soft cataract0 and deep anterior virectomy for removal of lens opacity and vitreous debris with intravitreal injection of long acting steroid as a prophylactic measure against recurrence. Visual acuity was significantly improved in 9 eyes [81.8%] at the end of first month postoperatively and remained stationary thereafter. Recurrence of uveitis was significantly reduced and was noted in three eyes [27.2%], all of them had mild to moderate attacks which were controlled medically. Central macular thickness was measured using OCT in 5 patients preoperatively with mean of 353.60 +/- 44.27 micro and at 3 and 6 months postoperatively and was 225.20 +/- 34.04 micro and 241.80 +/- 37.73 micro respectively. Intraocular pressure rise was detected at early postoperative period in only two eyes [18.2%]. Both had mild elevation and pressure was controlled medically. No other complications were recorded. Combined phacoemulsification and deep anterior vitrectomy with IVTA injection is relatively safe and effective procedure in the treatment of complicated cataract and vitreous opacities in uveitic patient, improving visual outcome and reducing recurrence of uveities

Amniotic membrane transplantation for pseudophakic symptomatic bullous keratopathy

This prospective study included 12 eyes in 12 patients with symptomatic bullous keratopathy and poor visual potential. All patients underwent amniotic membrane transplantation. The study showed that AMT is a safe, effective and long-lasting treatment method for intolerable pain in those patients

Studies on nephrotoxicity aspirin and gentamicin in combination in rats

Aspirin [ASA] and gentamicin [GM] are widely used by many patients in Egypt. The aim of this work was to investigate the nephrotioxic effect GM and in combination with administration of ASA in rats. 28 adult male Sprague Dawley rats were used in the present work. They were divided ino 4 equal group. The second group was injected with ASA, third group was given GM and the fourth group was given combination of GM and ASA. The biochemical indices measured were body weight, urine volume, plasma creatinine and blood urea nitrogen levels. When ASA and GM were used in combination, a marked increase in the nephrotoxic parameters was observed. A signficiant increase in plasma creatinine, blood urea and urine volume. Electron microsopic examination confirmed the extensive renal damage following combined administration of ASA and GM. The intertubular spaces were greatly wide and loaded with thick bundles of collagen fibrils and many inflammatory interstitial cells. The cytoplasm of the severely affected tubular cells were loaded with heavy aggregations of many large myeloid bodies as well as heterogeneous lysosomes containing masses of electron-dense deposits and sequestrated organelles. Multivesicualr bodies and residual bodies containing lipid droplets were also noticed, however, the size and number of these inclusion were more frequently encountered than in any of the other treated group of animals. There were occasional thickening of the lamina densa of the capillary basement membrance and fusion of the foot preocesses of podocytes. The thickened endothelial lining of the glomerular basement membrane was observed to affect more expanded sections of the glomerular capillaries with more obliteration of its fenestrae. The capillary lumen and the urinary spaces also contained many cellular bedris. In conclusion, the results of this study clearly indicate that ASA potentiates the severity of GM nephrotoxicity within two weeks of treatment when both drugs were given concurrently; and the possibility that interaction might increase the nephrotoxic risk associated with gentamicin administration should be taken in consideration. So, these results recommend to aviod the use of this combination especially in high persons with compromised renal function