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Aim: Infections with Hepatitis B virus (HBV) and Hepatitis C virus (HCV) cause serious morbidity and mortality. This study was designed to determine the prevalence of Hepatitis B and C infections and their co-infections among blood donors in Minia governorate, Egypt. Study Design: A cross-sectional study. Place and Duration of Study: The study was conducted over a period of 6 months starting from May 2011 till December 2011 and it included 5410 samples from blood donors at the Regional Blood Transfusion Center in Minia governorate. Methodology: Both HBsAg and antibodies to HCV were detected by EIA in 5410 blood samples from potentially healthy asymptomatic blood donors. Detection of HBV DNA and HCV RNA was carried out by real-time PCR (RT-PCR). Results: Most individuals were males (4305; 79.6%) and were from rural areas (3695; 68.3%). The sero-prevalence of infections was 0.9% (48 cases) for HBV and 6% (322 cases) for HCV, and 0.1% (7 cases) for co-infection. Out of 7 samples with co-infection, only one (14.3%) was positive for HBV DNA and HCV RNA. The mean age of HCV-antibody positive donors (33.2 ±9.41 years) was significantly higher than that of the HBV-positive donors (27.3± 6.06 years) and co-infection (29.9± 10.21 years) (P<0.05). Prevalence of HBV and HCV was higher in males (1% and 6.6% respectively) while HCV was higher in rural areas (6.8%) unlike HBV which did not show any difference in residential distribution (0.9% for both rural and urban areas). Conclusion: The prevalence of both viruses is low and that of the dual infection is lower than any of the two viruses alone.
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Introduction Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection, and its occurrence may be related to both host and viral factors. Relationship between improvement in steatosis and response to anti-viral treatment remains unclear. This study assessed the factors associated with steatosis in patients infected with genotype 4 HCV, and to correlate degree of changes in steatosis with host factors and response to treatment. Methods Records of 175 patients with chronic genotype 4 HCV infection, who had received interferon and ribavirin combination therapy, were reviewed retrospectively to extract data on body mass index (BMI), presence of diabetes mellitus, and liver histology findings. Paired BMI data and liver biopsies (pre- and 24-weeks post-treatment) were available in 86 patients. Baseline steatosis and its changes (before and after treatment) were the dependent variables in a univariate and multivariate analyses. Results Steatosis was found in 88/175 (50.3%) of baseline biopsies. Its presence was related to baseline BMI (r=0.33, P<0.01), but not with viral load, or grade of liver inflammation or fibrosis. On follow up, improvement in steatosis was significantly associated with degree of weight loss but not with response to anti-viral treatment. Conclusion Steatosis is common in genotype 4 HCV infection, and its presence appears to be related to high BMI, but not to viral load or degree of liver injury.
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Congenital choanal atresia [CA] is a challenging surgical problem. Choosing between the transnasal and transpalatal routes is still a controversial feature in the surgical management of CA. The purpose of this study was to evaluate the results of transnasal endoscopic choanoplasty with versus without posterior septectomy. Thirteen patients were included in this study [8 females and 5 males] aged 3 days to 17 years [mean age 4.06 years], 7 cases with bilateral CA and 6 cases with unilateral CA who underwent surgical repair at Al-Azhar university hospitals between 2004 and 2008. All patients underwent transnasal endoscopic repair using powered instrument. The first 5 cases had repair without posterior septectomy, while the last 8 cases had repair with posterior septectomy. All cases were stented for 4 to 6 weeks and followed for at least 10 months. Postoperatively, 11 patients [84.6%] had successful repair, while 2 cases [15.4%] had restenosis which needed revision surgery. Restenosis occurred in 2 of the 5 cases who underwent repair without posterior septectomy. No restenosis in patients who underwent repair with posterior septectomy. One patient developed pressure necrosis of the palate few days after surgery, which healed after replacement of the stent by a smaller one
Subject(s)
Humans , Male , Female , Endoscopy , Postoperative Complications , Treatment Outcome , Tomography, X-Ray ComputedABSTRACT
The nasopalatine duct [NPD] in human adults is rarely patent and likely exists as a vestigial remnant. NPD is a common site for infection, tumors and cysts. This study was done to describe the location and gross anatomy of the nasal opening of the human NPD. A total of 100 volunteers, at Al-Azhar university hospitals, were examined by 30° telescope for the site and appearance of the nasal opening of NPD and photographs were taken and examined. Our results showed that the NPD was located 3 mm +/- 0.2 mm [mean +/- SD] above the nasal floor on the nasal septum, in both nostrils [90% bilateral], 2 cm +/- 0.03 cm dorsal to the columella. NPD was detected in 95% of the examined nostrils. The shape of the NPD fossa was oval [70%], and round [30%]. In the center of the fossa, a small, round aperture was visualized in 33% of fossae. In conclusion, the nasal opening of the NPD is an easily detectable bilateral and symmetrical structure, located at the junction of the nasal septum and floor of the nasal cavity. It can be potentially useful as an anatomical landmark
Subject(s)
Humans , Male , Female , Humans , Adult , Endoscopy , Hospitals, UniversityABSTRACT
Recurrent laryngeal nerve [RLN] iatrogenic injury is one of the most serious complications in thyroid surgery. Paralysis of vocal cords can repesents a srious complication inducing, when bilateral, serious functional sequelae such as phonatory, respiratory and psychological problems that limit working capacities and social relationships of patients. This work is to study the importance of searching, identification and exposure of the RLN surgically and confirming this by using a disposable nerve stimulator to avoid its injury.Design: prospective study. Patients and Records of forty patients who underwent thyroidectomy by the authers at several Hospitals were reviewed for RLN paralysis between January2001 and December 2003. Intraoperative determination of RLN function was evaluated with a disposable nerve stimulator [Xomed, Jacksonville, Florida] set at 0.5 milliamper [mA]. Without the use of neuromuscular blockade during anesthesia, RLN function was assessed by palpating of the cricoarytenoid joint and posterior cricoaryteniod muscle while the stimulus was applied directly to nerve after identificantion. Postoperative, assessment of RLN integrity was determined by using flexible nasolaryngoscopy 7 days after the procedure to visualize the vocal cord mobility. RLNs were identified and stimulated intraoperatively in all patients. Concerning the postoperative results, flexible nasolaryngoscopy was utilized in all patients one week after the procedure. All patients had bilateral mobile vocal cords after the first week postoperatively. Conclusions: The authors concluded that iatrogenic injury to the RLN or to its branches could be avoided by searching, identifying, and exposing the nerve itself and by following its course with care. In addition, using intraoperative disposable nerve stimulator is very helpful in confirming the location and function of the RLN
Subject(s)
Humans , Male , Female , Recurrent Laryngeal Nerve/injuries , Surgical Procedures, Operative , Vocal Cord ParalysisABSTRACT
In the present study, three of the widely practiced surgical procedures for the reduction of the size of the inferior turbinates, i.e. Partial inferior turbinectomy [PIT], submucous diathermy [SMD] and submucous turbinectomy or turbinoplasty [ST or TP] were assessed for subjective efficacy and morbidity. In all cases, turbinectomy was performed as an isolated procedure. The study was conducted on three groups of 90 adult patients [assigned into three groups of 30 patients each] with symptoms and signs of nasal obstruction due to enlargement of inferior turbinates. All patients were followed up for two weeks after surgery and after two months with subjective assessments of nasal breathing. The data obtained showed that the three procedures are relatively safe, effective, well-tolerated and do not require an expensive instrumentation. Nevertheless, when turbinectomy deemed necessary, the most conservative techniques are preferred