Multidisciplinary approach for evaluation of neurocutaneous disorders in children in Sohag University Hospital, Upper Egypt

Neurocutaneous syndromes [NCS] are a broad term for a group of neurologic disorders that involve the nervous system and the skin. The most common examples are neu-rofibromatosis type 1 [NF-1] and type 2 [NF-2], tuberous sclerosis [TS], Sturge-Weber syndrome [SWS], ataxia telangiectasia [AT], and Von Hippel Lindau disease [VHL]. These disorders are characterized clinically by neurological manifestations such as convulsions, mental retardation and learning disabilities in addition to cutaneous manifestations, and lastly tubers [benign growths found in different organs of the body]. This study aimed to identify clinical, imaging, and neurophysiological profiles of neurocutaneous disorders. Children presented to the Pediatric neurology and Dermatology clinics, Sohag University Hospital who fulfilled the criteria for diagnosis of specific neurocutaneous syndromes were eligible for this study. All studied patients were subjected to thorough clinical history, full clinical examination, developmental assessment, and dermatological examination. Computed tomography of the brain [CT] and electroencephalography [EEG], ophthalmic, and phoniatric evaluation were also done for all children. Echocardiography was done for only twenty children. During the period of the study we diagnosed 27 cases with neurocutaneous disorders, tuberous sclerosis represented the majority of cases as it was detected in 12 cases [44.45%]. The main complaint was convulsions in 19 cases [70.37%], whereas skin pigmentation was detected in 18 cases [66.66%]. Developmental assessment showed that global developmental delay was found in 20 cases [74%]. CT of the brain showed that 15 cases [55.55%] had intracranial calcifications and abnormal EEG findings were detected in 23 cases [85.2%]. 85% of the studied children had various degrees of mental retardation. Echocardiography showed that three cases [15%] had ventricular wall tumor mostly rhabdomyoma Neurocutaneous disorders had multiple clinical presentations and required a team work approach including various specialties in their evaluation and management

Tissue culture versus PCR in diagnosis of female genital chlamydia trachomatis infection

Chlamydia trachomatis [C.trachomatis] is the most prevalent sexually transmitted pathogen worldwide. It is common among sexually active young women. Evaluate the sensitivity and specificity of tissue culture followed by antigen detection by immunoflurescencein comparison with nested PCR for diagnosis of genital C. trachomatis infection. This study was carried out on 50 women, among those attending the Gynecology Outpatient Clinics of Benha University Hospital during the period from May 2014 to March 2015. The participants suffer from symptoms suggestive of genital C. trachomatis infection, their ages ranged from 20 to 39 years old [mean +/- SD =29.80 +/- 4.647] .Two endocervical swabs were taken from each patient. One used for cytological examination, and the other used for tissue culture detected by, immunoflurescence as well as nested PCR. The result of tissue culture detected by direct immunoflurecence revealed that out of 50 patient, 24 [48%] were positive for C.trachomatis and 26 [52%] were negative .Result of nested PCR revealed that out of 50 patient, 34 [68%] were positive and 24 [32%] were negative . The result of cytological examination revealed that out of 50 patient, 17 [34%] were positive and 33 [66%] were negative. The sensitivity, specificity, Positive Predictive Value [PPV], and Negative Predictive Value [NPP] of tissue culture for detection of C.trachomatis were 70.6%, 100%, 100% and 61.5% respectively. Roc curve of tissue culture revealed that it is considered to be a good test compared to PCR in diagnosis of genital C.trachomatis. The tissue culture as detected by immunoflurescence is a good test in relation to nested PCR in diagnosis of genital C.trachomatis

[Comorbidity of learning disorders and attention deficit hyperactivity disorder in a sample of Omani Schoolchildren]

Objectives: The estimated worldwide prevalence of learning disorders [LDs] is approximately 2-10% among school-aged children. LDs have variable clinical features and are often associated with other disorders. This study aimed to examine the comorbidity of LDs and attention deficit hyperactivity disorder [ADHD] among a sample of schoolchildren in Oman

Methods: This study was conducted between January 2014 and January 2015 at the Sultan Qaboos University, Muscat, Oman. The Learning Disabilities Diagnostic Inventory [LDDI] and the 28- item version of the Conners' Teacher Rating Scale was completed by classroom teachers to determine the existence of LD and ADHD symptoms in 321 children in grades 1-4 who had been referred to a learning support unit for LDs from elementary schools in Muscat

Results: The mean age of the students was 8.5 years. Among the cohort, 30% were reported to have symptoms of ADHD, including conduct problems [24%], hyperactivity [24%] and inattentivepassive behaviours [41%]. Male students reportedly exhibited greater conduct problems and hyperactivity than females. However, there were no gender differences noted between LDDI scores

Conclusion: This study suggests that Omani schoolchildren with LDs are likely to exhibit signs of ADHD. The early identification of this disorder is essential considering the chronic nature of ADHD. For interventional purposes, multidisciplinary teams are recommended, including general and special educators, clinical psychologists, school counsellors, developmental or experienced general paediatricians and child psychiatrists

Evaluation of pan-dermatophyte nested PCR in diagnosis of onychomycosis in comparison with direct microscopy and culture

This work aimed to compare nested PCR using novel primers targeting the pan-dermatophyte-specific sequence of the chitin synthase 1 gene [CHS1] with KOH microscopy and culture isolation for diagnosis of clinically suspected onychomycosis. This study was conducted during the period from December, 2012 to October 2013. Forty patients attending Outpatient Dermatology and Andrology Clinic in Benha University Hospital. This study was done on forty patients 15 cases were female and the other 25 cases were males with abnormal nails. Their ages ranged from 22 to 77 years. As many as 19 patients were living in rural areas, while 21 patients came from urban areas. Nail scrapings were collected and examined using direct KOH microscopic examination, culture and PCR using double sets of primers. As regard direct microscopy by KOH examination; 33 [82.50%] cases were positive, while 7 [17.5%] were negative. Culture was positive only in 19[47.5%] of nail samples revealing different fungi. Dermatophytes were isolated from 15[37.5%] cases; most of them were T. mentagrophytes. And in 4 cases the only isolated non dermatophytic organism was Aspergillus Niger spp. [10.00%]. Nested PCR was positive in 26 [65.00%] nail samples. It is concluded that nested PCR targeting the CHS1 gene may be considered the gold standard for detection of dermatophytes in patients with onychomycosis and can aid the clinician in initiating prompt and appropriate antifungal therapy. PCR is a very powerful tool for microbiology and clinical mycology. It can detect very small amounts of nucleic acids. This technique may also play an important role in large-scale studies and in the management of problematic cases of onychopathies

Clinicolaboratory profile of phenylketonuria [PKU] in Sohag university hospital-upper Egypt

Phenylketonuria [PKU] is an autosomal recessive metabolic genetic disorder characterized by a mutation in the gene for the hepatic enzyme phenylalanine hydroxylase [PAH]. The disease may present clinically with seizures, albinism [excessively fair hair and skin], and a "musty odor" to the baby's sweat and urine. In the untreated classic case, mental retardation is severe, precluding speech and toilet training. Seizures are common in the more severely retarded, usually start before 18 months of age. This study aimed to identify clinical profile and impacts of newly diagnosed [untreated] PKU on children. Children presented to the Pediatric Department, or Pediatric Neurology Clinic, Sohag University Hospital in whom the diagnosis of Pheylketonuria was established based on measuring phenylalanine level in blood samples were eligible for this study. All studied patients were subjected to thorough history, full examination, and developmental assessment. Electroencephalography [EEG], computed tomography of the brain [CT], phoniatric and audiologic evaluations were also done. During the period of the study we diagnosed 24 cases with phenylketonuria, the main clinical presentations were global developmental delay, hyperactive symptoms, seizures, and autistic features. CT of the brain showed that 58.3% of cases had atrophic changes. EEG showed that 58.3% of cases had abnormal findings as generalized epileptic discharges, focal epileptic discharges, and hypsarrhythmia. We concluded that untreated phenylketonuria still represents a significant burden on children development and mental function in Upper Egypt. So we recommend establishment of national screening programs and pushing it forward as well as immediate development of specific metabolic centers in various universities and research institutes

Effect of dietary enzymes supplementation on growth performance, immune response, some blood parameters and carcass quality of broiler chicks

One hundred and twenty, day old age healthy cobb broiler chicks were used to study the influence of dietary supplementation of enzymes on growth performance, immune response, some blood parameters and carcass traits of broiler chickens. Broiler chicks were allotted into four groups; chicks of group 1 [the control] were fed on basal diet only, chicks of group 2 were fed on the basal diet supplemented by Deltazyme plus [registered sign] at 0.5 g/kg diet, chicks of group 3 received 95%basal diet +5% wheat bran and chicks of group 4 received the same diet of group 3 supplemented with Deltazyme plus [registered sign] supplementation improved significantly [P 0.05] increased in chicks of group 4 when compared with those of group 3. Dietary enzymes supplementation [groups 2 and 4] reduced daily feed intake when compared with those groups 1 and 3 respectively. Dietary supplementation of Deltazyme plus [registered sign] at 0.5 g/kg diet improved significantly [P

[Association between amino acid sequences in peptide binding region [BOLA-DRB3] and susceptibility or resistance to calf diarrhea]

The major histocompatibility complex genes [mhc] encode MHC I and II molecules which present peptide fragments to T cells. Therefore these polymorphic molecules critically influence susceptibility to infectious diseases. At present study potential relationship between amino acid sequences in the antigen binding groove of different BoLA-DRB3 alleles and susceptibility or resistance to calf diarrhea was investigated. Twelve different DRB3 alleles were found among 171 calves [84 diarrheic and 87 healthy] analyesd by PCR-RFLP method. Amino acid sequences of the encoded peptide binding region were compared. 26 polymorphic positions were detected in this region. A significant association [p<0.05] was shown between occurrence of diarrhea and the presence of glutamic acid and tyrosine inpocket 4 and valine, glutamine and leucine in pocket 9 of peptide binding region. Thus it can be concluded that pockets 4 and 9 of the BoLA-DRB3 molecule would be involved in conferring susceptibility of calf to diarrhea

incidence of malignancy in egyptian women presenting with nipple discharge

Nipple discharge causes a degree of anxiety in women because of fear of breast cancer. Commonly, the absence of palpable or mammographic abnormalities gives a false sense of security, causing delays in diagnosis. Mammography, ultrasound, and cytology are useful only when positive, but have a high rate of false-negative results and do not preclude histological diagnosis. The aim of this study is to detect incidence of malignancy in Egyptian women presenting with nipple discharge and protocol for their management. Forty patients with pathological nipple discharge were included in the study and offered operation. Patients with surgically significant nipple discharge only of 40 years and above are recommended to undergo radical subareolar duct excision [Hadfield's procedure]. Patients below 40 years of age, particularly if intending to breast feed, with persistent discharge are given the option of microdochectomy. All histopathology results were reviewed. Patients were divided into two groups - those with red blood cells [RBCs] present in the nipple discharge and those without. Forty consecutive patients underwent operation for isolated nipple discharge during the study period. Median age was 54 years [range, 32-79 years]: Analysis of nipple discharge revealed RBCs in 16 patients [40%]. The remainder, 24[60%], had no RBCs on analysis of nipple discharge. Thirty seven patients [92.5%] underwent radical subareolar duct excision [Hadfield's procedure] and 3 patients [7.5%] microdochectomy. Histopathology revealed all patients with RBCs -positive nipple discharge had benign disease -7 [43.75%] had an intraductal papilloma and 9 [56.25%] had duct ectasia. Most patients with RBCs negative nipple discharge had benign disease - 4 [16.6%] had intraductal papilloma and 18 [75%] duct ectasia while the remaining two [8.33%] had in situ carcinoma. Despite the various tests used in the assessment of pathological nipple discharge, this study highlights their limited help at predicting the cause. This, together with several other studies, demonstrates that ductal surgery remains the only reliable way of providing a diagnosis, in addition to being the ideal therapeutic measure

Serological and genomic detection of bovine leukemia virus in human and cattle samples

Bovine leukemia virus [BLV] is a retro virus responsible for lymphoproliferative disorders in cattle. Although infections of BLV in animals are well known, little is known about its capacity to infect humans. This study investigated the presence of anti-BLV antibodies and BLV pro viruses in human and cattle samples. An indirect enzyme-linked immunosorbent assay [ELISA] was used to detect anti-BLV antibodies while nested PCR was employed to identify BLV provirus sequences. The overall prevalence of anti-BLV antibodies in human and cattle samples were 12.50% and 16.73%, respectively. When using ELISA as a reference test, sensitivity and specificity for nested PCR were 0.625 and 0.970, respectively. The predictive value of a positive test was 0.862 and the predictive value of a negative test was 0.897. The percentage of cattle correctly classified by nested PCR assay was 89.1%. Nested PCR and Southern blot analysis, using primers specific for BLV gag sequences, revealed that BLV pro viruses were detectable in cattle and human samples. Our results highlight the risk of human exposure to BLV and the need for further investigations to determine whether BLV infection poses a health hazard for humans

[Study on interferon gamma gene polymorphism in shaul sheep]

Interferon gamma [IFN-gamma] is a cytokine produced by activated T lymphocytes and natural killer cells. It plays an important role in innate and adaptive immunity. IFN-g gene is polymorphic and its haplotype has been associated with resistance to nematode infestations which are the most important parasites of domestic sheep worldwide. To evaluate IFN-g polymorphism in Iranian Shaul sheep population, 136 blood samples were collected. Genomic DNA were extracted and amplified by PCR using specific primers for exon 3 of IFN-g gene. After gene amplification, SSCP and Heteroduplex mobility analysis carried out on polyacrylamid gel. Five unique SSCP patterns were detected in this population which 3 of them represent 3 alleles. Although heteroduplex mobility analysis demonstrated that all samples were homozygous, SSCP could reveal heterozygosity at frequency of 40. 4% in the studied population. Data obtained from the present study have revealed that IFN-g gene was a highly polymorphic in Iranian Shaul ecotype. This will be useful to study host-pathogen interaction and to evaluate association between resistance or susceptibility to disease with IFN-g in this ecotype

Typing of Ovar-DRB1 second exon with PCR-RFLP technique in Iranian Shaul Sheep

Several studies have focused on polymorphisms of major histocompatibility complex [MHC] in sheep, Ovar-MHC. This molecule plays a pivotal role in antigen presentation for eliciting immune responses against invading pathogens. The best-characterized genetic control of disease resistance and immune response in animals is associated with MHC. Numerous molecular genetic investigations have been undertaken to detect polymorphisms of MHC genes and their association with resistance to infectious diseases. We have examined Ovar-DRB1 in DNA samples of 82 Shaul Sheep using polymerase chain reaction [PCR] and restriction fragment length polymorphism [RFLP] method. Identities of 8 different patterns and 5 distinct DRB1 alleles among Iranian Shaul Sheep have been determined. PCR-RFLP analysis allows rapid identification of Ovar-DRB1 types and enables rapid discrimination between homozygotes and heterozygotes. Data obtained from the present study have revealed that the exon 2 region of Ovar-DRB1 was highly polymorphic in sheep. So PCR-RFLP can be applied to the analysis of this locus

Detection of tumor antigens in bovine viral lymphosarcoma by immunoprecipitation method

In this study one lymph node from cow with viral lymphosarcoma and one lymph node from healthy cow were analyzed by three different methods for protein extraction, include simple homogenizing in PBS, sonication and phenol extraction. Tumor antigen detection relies on immunoprecipitation followed by SDS-PAGE. In this experiment Streptococcus pyogenes was used for purification of immune complexes. Eletrophoretic patterns were obtained using reduced and non reduced buffers. In PBS homogenization 3 distinct antigens [39, 32 and 30 kDa] were observed. When sonication or phenol extraction were used, 5 [72, 48, 42, 32 and 30 kDa] and 6 [104, 77, 54, 32, 30 and 26, 5 kDa] distinct antigens were observed, respectively. This study showed that the ability of antigen detection mainly depends on protein extraction procedure and antigen-antibody equilibrium achieved by quantification of precipitins. Immunoprecipitation could be used successfully for study of tumor antigens in bovine leukosis

Estimation of antithyroid microsomal antibodies in Egyptian vitiligo patients of different age groups

Controversial reports about the incidence of autoimmune thyroid disease in children with non-segmental vitiligo prompted us to detect a possible relationship between the serum level of antithyroid microsomal [=antithyroid peroxidase] antibodies and the frequency of associated autoimmune thyroid disease in different age groups of vitiligo patients. Sixty vitiligo patients divided into four age groups [childhood, adolescence, early adulthood and middle adulthood] were included in the current study. Forty healthy controls of comparable age and sex were included. Estimation of serum antithyroid peroxidase [anti-TPO] antibodies, thyroid stimulating hormone [TSH] and free thyroxine [fT4] was done using ELISA method. Results of our study revealed that serum level of anti-TPO was significantly elevated in vitiligo patients [27%] compared to healthy controls [7.5%]. There was no significant difference in the serum level of TSH and fT4 between the two groups. There was a positive significant correlation among cases between serum anti-TPO and serum TSH. In addition, there was a positive significant correlation between the serum level of anti-TPO and the prevalence of auto immune thyroid diseases [AITD]. Although there was no significant correlation between serum anti-TPO and the age of vitiligo patients, a higher percentage of patients in the adolescence [40%] and early adulthood age groups [33.3%] had elevated anti-TPO compared to children [13.3%]. A significantly higher prevalence of elevated serum anti-TPO was detected among female cases [36.7%] compared to male cases [16.7%]. Vitiligo patients are more susceptible to develop anti thyroid antibodies. Periodical estimation of serum anti-TPO level and scanning for AITD is recommended especially in adolescent female vitiligo patients

Bone mineral density in chronic hemodialysis patients and its correlation to biochemical markers

Renal osteodystrophy may result in considerabli morbidity for patients with end-stage renal disease. Secondary hyperparathyroidism, adynamic bone disease and osteomalacia, the main bony problems in chronic renal failure, may all be responsible for a reduction in bone mineral density [BMD]. The aim of this study is to investigate the biochemical parameters and bone mineral density in patients undergoing regular hemodialysis and to assess their possible correlation to different variables, Patients and Methods: thirty nine patients with end-stage renal disease maintained on regular hemodialysis for variable intervals were participated in the study. Osteocalcin, type1-C terminal collagen propeptide [CICP], Osteoprotegrin [OPG], receptor activator of nuclear factor kB ligand [RANKL], parathyroid hormone [PTh], serum total calcium, inorganic phosphorus and alkaline phosphatase were estimated to all patients. Bone mineral density[BMD] was measured by dual energy X ray absorptiometry [DEXA] in lumbar spine and femoral neck with estimation of BMD t-score. Body mass index [BMI] was calculated. Assessment of correlation between clinical, laboratory data and BMD was done. There was a positive correlation between age, BMD and CICP, between BMI and RANKL and also between BMD hip and spine. BMD in both sites correlated inversely, with PTH [P< 0.01], there was a significant correlation between duration of dialysis and PTH [P< 0.001], calcium level and hip t-score were the most important variable for prediction of reduced BMD. Osteopenia was frequent in patients on hemodialysis and those with hyperparathyroidism and longer duration of hemodialysis were more susceptible to reduced BMD developing osteoporosis

Detecting the P24 antigen in lymph nodes of BLV infected cattle

In this study 19 BLV infected and 2 healthy lymph nodes were analysed by Western blotting to detect viral p24 antigen. Western blotting was carried out by Rabbit anti p24 serum and p24 monoclonal antibody. Rabbit serum in western blotting could detect 45, 50, 54, 58 and less than 19 kD bands of proteins and monoclonal antibody could detect 30, 32, 39, 45, 50 and 53 kD bands. Our results indicate polymorphism of proteins with p24 epitope in different BLVinfected samples. Otherwise, it could be concluded that BLVstructural proteins sharing p24 epitopes have high degree of phenotypic diversity

Health related quality of life among Egyptian patients on hemodialysis

The present research was carried out to evaluate the physical [PCS] and mental [MCS] component summary scales in hemodialysis patients as compared to healthy subjects at a baseline and two years later. 130 patients on hemodialysis [mean age 40.6 +/- 8.1 years] were enrolled in the study between February 2003 to February 2005. The short-form with 36 [SF-36] questionnaire was given every 6 months to hemodialysis patients. Results were compared to the general population and changes in QoL over time were determined. Mean PCS was 34 +/- 15.46 and mean MCS was 38.80 +/- 15.17 compared to the general population there were significant decline in PCS and MCS at baseline and two years later. There was no significant correlation between causes of End-Stage Renal Disease [ESRD] and Quality of Life [QoL], except for diabetes mellitus as regard MCS. High levels of serum albumin and hemoglobin was associated with highly significant quality of life. Serum albumin was a good predictor for quality of life in this study. Adequacy of dialysis treatment in hemodialysis patients was determined by serum albumin, hematocrit, KT/V and Urea Reduction Ratio [URR]. Present results showed the negative impact that ESRD and hemodialysis treatment have on self-assessed physical and mental health and it is important to treat all factors that induce hypoalbuminemia as well as anaemia

[Epidemiological survey of traumatic brain injury in hospitalized patients in Rasht]

Introduction: Traumatic Brain Injury [TBI] is a major cause of morbidity and mortality. Each year 50000 deaths in the United States are associated with TBI, representing more than 33% of all injury -related deaths. Motor- Vehicle accidents are the major causes of TBI that its occurrence has been increasing in our country in recent years

Objective: We decided to study TBI in our region to evaluate the Epidemiological features of this health problem

Materials and Methods: In a six- month period in 2001, we reviewed TBI-patients records in Rasht Poorsina hospital and data such as age, sex, mechanisms of trauma and Radiological findings were collected. We staged the severity of trauma by Glasgow – Coma - Scale. Data were analyzed by SPSS software. We used Chi-Square test and P-Value less than 0.05 was considered significant

Results: From the total of 715 patients, 79.3% were males and 20.7% were females with a male to female ratio of 2.6 to 1. The most common age group was 15-24 years. Majority of patients were students. The most frequent mechanism of trauma was motor-vehicle accident. 89.7% of injuries were mild in severity. There was a significant relation between C.T Scan findings and severity of injuries. [P<0.0001] Isolated brain injury was seen in 71.6% of patients

Conclusion: This study showed that we should pay more attention to TBI in young patients who are the most active potential forces of our society

Urinary bladder carcinoma; MR versus CT evaluation

Twenty patients with a clinical diagnosis of urinary bladder cancer were selected. Physical examination, cystoscopy, routine ultrasound examination and CT and MR were done to all patients. The most affected patients were, in the sixth and seventh decades. Painless intermittent profuse Hemadurea was the most presenting symptom [90%]. Transitional cell carcinoma was found in 12 patients [60%] while squamous cell carcinoma in only 5 patients. MRI was better than CT in determination of the site of the tumor with an accuracy of 100%. Sagittal sequences were the best in detection of the lateral wall masses. Calcification within the tumor which was present in 30% of cases was better detected in non contrast and immediate post contrast CT. It was found in six cases [30%]. Staging of the twenty cases of bladder cancer was made by clinical, operative, and pathological findings according to 1997 TNM staging system. Stage T1 was found in one case, stage T2a in five cases, stage T2 alpha in five cases, stage T3 in one case, stage T4 alpha in two cases, stage T4b in six cases. By immediate post contrast CT eleven cases were correctly staged, eight cases were over staged while one case was under staged with a total accuracy of 55%. By late post contrast CT ten cases were correctly stage, eight cases were over staged and two cases were under staged with a total accuracy of 50%. By MRI seventeen cases were correctly staged, no cases were under staged, and three cases were over staged with a total accuracy of 85%. MRI equaled CT in detection of muscle infiltration with the same accuracy, sensitivity, and specificity. Moreover, it can differentiate between superficial and deep muscle infiltration. T2 sequence was better than T1 and STIR sequences in differentiation between superficial and deep muscle infiltration with an accuracy of 76.9%, sensitivity of 62.5%, and specificity of 100%. T1 and STIR sequences sere equal in differentiation between superficial and deep muscle infiltration. For detection of perivesical fat infiltration, MRI detected the perivesical fat infiltration with no under or over estimation. The accuracy of CT was 95.2%, the sensitivity was 100%, and the specificity was 92.3%, while, the accuracy of MRI was 100%, the sensitivity was 100%, and the specificity was 100%. MRI was better than CT in detectioin of surrounding organ infiltration with an accuracy of 100%, sensitivity of 100%, and specificity of 100% [e.g. case numer 2]. T2 was beteer than T1 and STIR in detection of surrounding organ infiltration with an accuracy of 100%, sensitivity of 100%, and specificity of 100%. Accuracy of T1 was 75%, sensitivity was 83.3%, and specificity was 73.3%. Accuracy of STIR was 95%, sensitivity was 83.3%, and specificity8 was 100%. CT [Non contrast, immediate post contrast, and late post contrast] and MRI were equal in detection of pelvic bone metastases and all MRI sequences were equal in detection of pelvic bone metastases. Late post contrast CT and MRI were equal in identification of dilated lower ends of the ureters. The aim of this study was to evaluate the role of magnetic resonance imaging versus computed Topography in diagnosis and staging of urinary bladder carcinoma

Hypertension: awareness, knowledge, attitudes, treatment and control among hypertensive workers

This work aimed to assess awareness and knowledge of working hypertensive patients and study its relation to their attitude and practice. The study also aimed to assess level of knowledge post health education intervention.Two hundreds and fourteen hypertensive workers from the National Research Center participated in the present study. A questionnaire was designed to assess the characteristics o f the studied patients and their KAP towards hypertension and was filled during interview, Health education about hypertension was provided to 180 patients through face-to-face interview and their knowledge was reevaluated using the same questionnaire. About 90% of the studied patients were aware that they were hypertensives, over three-quarter of patients received their treatment, 59.7% were adherent to regular treatment and only 38.2% had controlled blood pressure. About half of the studied patients indicated that modifiable variables were the most common attribution believed to cause hypertension and over two thirds of the patients recognized changes in life style needed for controlling hypertension. Positive attitudes, good practices and adherence to medical treatment and controls were not found to be significantly associated with good knowledge score. Multiple logistic analysis revealed that the most important variables significantly predict a good knowledge score were male sex, patients living in semi urban areas and those with duration o f illness /< 7 years. The post HE level of knowledge was significantly higher among males than females and among those with university education than lower level of education. Comparing pre and post health education knowledge revealed highly significant increase in post HE level of knowledge

Hepatitis C virus-associated hypobetalipoproteinemia is correlated with plasma viral load, steatosis, and liver fibrosis

Aim: A relationship between chronic hepatitis C virus [HCV] infection and lipid metabolism has recently been suggested. The aim of this study was to determine the correlation between lipid profile and virology, and histologic lesions in noncirrhotic, londiabetic patients with hepatitis C. Subjects and Thirty patients with untreated chronic hepatitis C were studied to assess the effects of HCV viral load, steatosis, hepatic fibrosis, and body mass ndex [BMI] on lipid profile. The control group showed a significantly higher apolipoprotein B [apo B] concentration compared with patients with chronic hepatitis C. Hypobetalipoproteinemia [apo B <0.7 g/l] was found in 8 [26.6%] chronic HCV patients and in 1 [10%] control subjects [P=0.0002]. Levels of apo B were negatively correlated with steatosis and HCV viral ioad [r= -0.22, P=0.03]. In multivariate analysis, low apo B concentration was significantly associated with fibrosis grade 2 or 3 versus grade 0 or 1 [P< 0001], stetosis > 5% [P<0.001], low body mass index [P<0.001], and high HCV viral load [P< 0.014]. Conclusions: In chronic HCV patients, hypobetalipoproteinemia occurs already in the early stages of HCV infection before the development of liver cirrhosis. The correlation between apo B levels and HCV viral load seems to confirm the interaction between hepatitis C infection and Beta-lipoprotein metabolism