[Assessment of liver fibrosis by magnetic resonance spectroscopy in asymptomatic children with Chronic Hepatitis C Viral Infection]

Background: Chronic hepatitis C is the most common cause of chronic liver disease and cirrhosis. Egypt is the highest affected country with a prevalence of 22%.In children, seroprevalence of HCV is 0.2% in children less than 11 years of age and 0.4% in children >/=11 years of age

Aim of the work: The purpose of this study was to assess the value of liver biopsy in diagnosis of activity grading and fibrosis staging in early asymptomatic children with chronic hepatitis C virus infection. We also aim to evaluate the use of 1H MRS and DW-MRI in assessment of some metabolic components [Glx/lipid, PME/lipid and Glyu/lipid ratios] and ADC of liver tissues and its correlation to the histopathological changes found in liver biopsy

Subjects and Methods: A cross-sectional study was conducted over a period of two years, included thirty children with asymptomatic chronic hepatitis C virus infection[mean age +/- SD 14.1 +/- 2.8years] and twenty healthy children as controls were included. Anti HCV antibodies, HCV RNA PCR, liver function tests, abdominal ultrasonography, MRS and DW-MRI were done for all cases and controls, Liver biopsy was done for all cases

Results: The results showed that HCV infection was more common in males [83.3%] and 16.7% of patients were obese. There were two significant risk factors for HCV infection in our patients: positive family history of HCV infection[56.7% ofpatients] and history of previous operation [26.7%].There were significant differences in the results of all liver enzymes [ALT, AST and ALP] in cases than controls. The results of METAVIR grades showed 29 cases [96.6%] had activity while 17 cases [56.7 %] had fibrosis and TGF-fbeta1 in liver tissues was positive in 19 cases [63.3%]. The results of MRS and DW-MRI showed significant differences between cases and controls and positive correlations between the results of 1H MRS with the results of liver biopsy [METAVIR Grades, METAVIR Stages and TGF-[beta1]

Conclusion: Early diagnosis of asymptomatic chronic hepatitis C is essential to prevent or delay end stage chronic parenchymal liver disease. TGF-1beta1 in liver tissue may be considered as a useful and better tool than METAVIR score in the assessment of hepatic fibrosis. 1H MRS may be a potential non-invasive helpful diagnostic tool in assessing the staging of asymptomatic chronic hepatitis C as the increase of its metabolites were correlated with histopathological changes. DW-MRI can be considered an effective method in evaluating liver disease activity in chronic hepatitis C

Recommendation: we recommend the use of larger sample size to assess different stages of liver fibrosis and the use of 1H MRS in monitoring treatments

Effect of various organic nutrients on the reproductive rates of bacterivorous hymnostomes in a fresh water Canal, Shibin El-Koum, Menoufia, Egypt

The effect of adding two different organic materials; wheat extract and bactopeptone, was studied on some of the most abundant bacterivorous hymnostomes collected from freshwater canal in Shebin El-Koum, Monoufia. It was found that some of these ciliates prefer plant protein as wheat, others prefer animal protein as bactopeptone, someone have the ability to accommodate with both organic materials. A significant positive relationship between log doubling times and log cell volumes of these hymnostomes was confirmed