Serum lipid profile abnormalities of patients with chronic liver disease due to hepatitis C virus

Liver disease could be associated with abnormalities in plasma lipids and lipoprotein structure and metabolism. A relationship between chronic hepatitis C virus [HCV] infection and lipid metabolism has recently suggested. Although HCV targets the liver, it has become increasingly evident that HCV can induce diseases of many organs. Is to detect the effect of HCV infection on lipid profile in chronic hepatitis and cirrhotic patients. The study was designed as a case-control study that was carried out on 49 patients with an age ranging from 23 to 56 years of both sexes. They were selected from the outpatient clinic of the National Hepatology and Tropical Medicine Research Institute [NHTMRI] in the period from December 2004 to May 2005. Patients were classified into two groups: Group I: 25 cases with early liver disease. Group II: 24 cases with advanced liver cell failure. Twenty apparently healthy control subjects with matched age and sex were also included in the study. Serum lipid profile assay was done by a dry chemistry technique for both patients and controls. Group I and group II showed a significant decrease in serum cholesterol compared to control group [p <0.05], also, group I showed a highly significant difference in serum cholesterol compared to group II [p <0.001]. Group I showed a significant difference in serum TG and LDL compared to group II [P<0.05], also, group II showed a highly significant decrease in serum LDL compared to control group [p < 0.001]. No significant change was found in serum HDL and serum VLDL between the three studied groups [p>0.05]. Chronic liver disease due to HCV infection shows lipid profile derangement which will be more affected with progression of liver cirrhosis

Immunomodulatory therapy for hepatocellular carcinoma

Hepatocellular carcinoma is probably the most common solid human malignancy in the world and its incidence in Egypt has dramatically increased during the last decade. In spite of the availability of different strategies for treating hepatocellular carcinoma in the form of surgical resection, transarterial embolization, percutaneous ethanol injection therapy, radiofrequency wave ablation and chemotherapy, a considerable percentage of cases were found not fit to go into one of all these modalities. On the other hand, the aqueous extracts of the European mistletoe plant [Viscum album] have been used for years for systemic nonspecific stimulation of the immune system in cancer therapy. This study tried to assess the effect of mistletoe [Viscum album] on the natural history of unresected HCC, on one side, and its role in preventing postoperative recurrence after surgically resected cases, on the other side. Thirty-three patients with advanced unresectable HCC represented the first group in this study and 10 cases of post surgical resection were included in the second group. Mistletoe proved itself as a save medication easily tolerable with minimal side effects, it improves the quality of life through immunological pathway, but in this study it failed to demonstrate any significant effect in the progression or limitation of the size of the tumor nor on prevention of recurrence after postoperative resection

Risk factors for acute and recurrent urinary tract infection in children

Urinary tract infection [UTI] is a common problem in infants and children. This infection is mostly ascending Recurrent U.T.I. is mainly caused by bad hygiene and poor health education, and its incidence increased with enuretic children. Cases with episodes of U.T.I. must be followed up by urine culture monthly because may have a new episode without symptoms. The aim of this work it to identify the possible risk factors that may lead to acute and recurrent U.T.I. among children. This study included 100 children suffered from U.T.I. aged from 2-14 years and attended our pediatric clinic. No 29 cases of them had urinary symptoms, 28 cases were a symptomatic and proved to have infections during routine urine investigations, and 43 cases had one episode of U.T.I. and came for follow up which was monthly based on urine culture and during follow up they had recurrent U.T.I. These patients subjected to urine analysis and culture, stool analysis, renal function test, complete blood picture, erythrocyte sedimentation rate, C-reactive protein and ultra sonography for abdomen and pelvis to detect any abnormality, stones and to measure post voided bladder capacity. Our study showed no sex difference in U.T.I. 18% of boys were uncircumcised;. 21% with postponement of the start of potty-training, 61% had pinworm infection, 2% had bladder stones, 3% had bilharzial ova and 16% had enuresis. Urine cultures were positive for E-coli, Klebsiella, Staph. Aureus and Staph. Epidermidis. No, mixed infection was found. With measurement of post-voided bladder volume, we found 11% had voiding dysfuctions. These results proved the presence of multi-factorial risk factors for occurrence of U.T.I. U.T.I. is mainly affected by had hygiene, poor health education and negligence from doctors to follow up patients if they have no symptoms. We recommend routine follow up for U.T.I. cases based on urine culture to enhance early detection of recurrence and early proper treatment. Pediatricians should take urinary symptoms very seriously into account and should do routine wine workup to detect asymptomatic U.T.I

Des-gamma carboxy prothrombin: a useful reliable early marker for detection of hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most common cancers in the world. The early detection is important in the management of cancer. Des-gamma carboxy prothrombin also called protein induced by vitamin K absence or antagonist II [PIVKA II] has attracted attention as a marker for early diagnosis of HCC. to assess a diagnostic role of PIVKA II for early detection of HCC. The present case control study included 50 patients who fulfilled criteria for inclusion, with an age ranged from 30-60 years of both sexes. They were selected from outpatient clinic of the National Hepatology and Tropical Medicine Research institute [NHTMRI] from January 2003 to July 2004. Twenty age and sex matched subjects were used as controls. Patients were classified into 3 groups: Group I: 22 cases with HCC, Group EL: 15 late cases of decompansated liver cirrhosis, Group III: 13 early cases of liver cirrhosis. All patients were subjected to proper history taking, thorough clinical examination, and Laboratory investigations: complete blood picture [CBC], erythrocyte sedimentation rate [ESR], coagulation profile, liver function test and kidney function test. Determination of plasma PIVKA II, serum alpha fetoprotein [AFP] and serum ferritin were done by an ELISA technique. The collected data were computerized and analyzed statistically. The present study showed that level of- plasma PIVKA II was highly significantly increased in group I compared to the other groups [p < 0.01]. Group III showed a significant difference compared to control group [p < 0.05]. Serum AFP was highly significantly increased in group I compared with other groups [p < 0.01]. Also group II and group III showed a significant difference in serum AFP than control group. Serum ferritin was significantly higher in group I and group II than controls [p < 0.01]. Group II showed a significant increase in serum ferritin than group III [p < 0.05]. Plasma PIVKA II is a reliable marker of HCC that can be used with AFP as a complementry test for early detection of HCC in patients with cirrhosis