Effect of helicobacter pylori eradicationon the pathogenesis of minimal hepatic encephalopathy in egyptian patients with liver cirrhosis

Hepatic encephalopathy is one of the complications of liver cirrhosis. Ammonia is implicated as a precipitating factor for HE, minimal hepatic encephalopathy cannot be detected clinically and impairs quality of life, indicated that H. pylori infection is associated with high blood ammonia levels by urease enzyme and can lead to causation of HE. This study evaluated the effect of H. pylori eradication therapy on MHE. A total of 60 cirrhotic patients were selected from al-Hussein University Hospital. They were GI: 30 patients with MHE and GII; 30 patients without MHE. All patients were subjected to H. pylori stool antigen and blood ammonia level. Positive H. pylori patients received triple therapy for 14 days, then 4 weeks later were revaluated regarding, H. pylori stool antigen, serum ammonia level and NCT. Helicobacter pylori infection was found 63.3% of GI versus 40% in GII; serum ammonia levels were significantly higher in patients with GI and H. pylori positive. Treatment was successful in 78.9% of GI patients versus 89.4% of GII. Number connection test and serum ammonia level were significantly improved in GI patients and positive H. pylori after eradication therapy

Role of right liver lobe diameter/serum albumin ratio in esophageal varices assessment in cirrhotic patients

Background: Liver cirrhosis is a pathologic condition characterized by fibrosis of the liver parenchyma and evidence of regenerative activity, resulting in portal hypertension. Portal hypertension plays a crucial role in the transition from the pre-clinical to the clinical phase of the disease. Bleeding from ruptured esophagogastric varices is the most severe complication of cirrhosis and is the cause of death in about one third of cirrhotic patients. Cirrhotic patients frequently undergo screening endoscopy for the presence of varices. These recommendations imply a considerable burden of endoscopies and related costs

Objective: the aim of the study was to determine the predictive value of noninvasive parameters [Rt. lobe diameter/ serum albumin ratio] in the prediction of esophageal varices

Subjects and Methods: This study was done on 120 patients divided into four groups: Group A: includes 30 cirrhotic patients with esophageal varices [OVs] grade I to II. Group B: includes 30 cirrhotic patients with OVs grade III to IV. Group C: includes 30 cirrhotic patients without OVs. Group D: includes 30 none cirrhotic patients presented for esophagogastroduodenoscopy [EGD] screening because of other etiologic factors that are not associated with liver cirrhosis. All participants were subjected to clinical examination; laboratory investigations [CBC, Liver function tests including serum albumin concentration, prothrombin time and concentration, modified Child-Pugh score and abdominal ultrasonography [studying the right lobe and left lobe diameter, the presence of periportal thickening, the splenic longest axis and the presence of ascites and Portal vein diameter, Right liver lobe diameter/albumin ratio were calculated for all patients]. Upper endoscopy was done for detection and grading of esophageal varices

Results: This study revealed that The predictors that showed statistically significantly associated with the presence of varices were increased right lobe diameter/Albumin ratio, shrunken Rt. hepatic lobe, splenomegaly, thrombocytopenia, and the more advanced liver disease [according to child class scoring of the patients], the more likely the presence of varices

Conclusion: Right lobe diameter/Albumin ratio is good predictor for the presence and grading of esophageal varices

Combined maternal serum C3 activation and uterine artery Doppler at 14-20 weeks as predictors for pre-eclampsia in primigravida

Background: Preeclampsia is a multisystem disorder of pregnancy, which complicates 3%-5% of pregnancies in the western world. It is a major cause of maternal morbidity and mortality worldwide. The cardinal clinical features of the condition are hypertension and proteinuria occurring after 20 weeks gestation in women who were not previously known to be hypertensive

Objective: This study was aimed to assess the efficacy of C3 estimation and measurement of bilateral uterine artery Doppler before 20 weeks of pregnancy for prediction of preeclampsia in primigravida

Methods: The study was performed at the Antenatal Care Unit, Obstetrics and Gynecology Department, Sayed Galal Hospital, Al Azhar University on 131 pregnant women at 14-20 gestational weeks during period from July 2017 to December 2017 gestation attending

Results: On follow up the population of the study 131 pregnant women had completed the study that were classified to 119 [90.8%] with no pre-eclampsia and 12 [9.2%] developed preeclampsia, As regards the Patients characteristics there was no statistical significant difference between the two groups as regard age, height, weight, gestational age, SBP and DPB at enrollment [p-value>0.05]. There was a significant difference regarding BMI as [p value < 0.05], with more increasing BMI and decreasing gestational age at delivery in preeclampsia group in comparison with the no preeclampsia group. As regards the C3, there was statistically highly significant difference between the two groups regarding serum C3 level as p value <0.05, with lower levels of C3 serum levels in preeclampsia group. Receiver operator characteristics [ROC] curves were constructed for estimating the association between pre-eclampsia and serum C3 level. A significant association was found with serum C3 level being a significant predictor with lower values in cases with pre-eclampsia than in normal cases [area under the curve [AUC] = 0.935, 95% CI [0.878 to 0.9711.35], best cut off [

Conclusion: This study demonstrates that lower level of maternal serum C3 in the early second trimester [14-20 weeks gestation] and abnormal increasing in uterine artery indices [PI and RI] are associated with developing pre-eclampsia several months later in pregnancy

Tinea capitis in Assuit governorate: [a clinical and mycological study]

Tinea capitis is a common condition seen by clinician in all setting through out the world. Several investigations of the various superficial mycosewere carried out in Egypt, but they were mainly confined to urban areas. In the present work, the predominant species causing dermatophtosis in Assuit Governorate were investigated, this is represented in rural and partially suburban communities. A clinical and mycological study was done for hundred patients attending the Dermatology Out-patient Clinic in Al- Azhar University Hospital in Assuit City. The ages of patient ranged from 3 to 20 years. 60% of cases were between 6-10 years of ages. Males were affected more than females in a ratio of 3: 1. - 60% of cases were from rural areas. Positive history of contact with animals was present in 40%. - The most common clinical variety was scaly type 55% followed by black dot 22%, kerion 20%, and lastly favus 3%. - Direct microscopic examination was + ve in 80% of cases. Positive culture results were obtained in 90% of cases. - The results indicated that Zoophilic dermatophytes was the predominant causative species in these regions. Five dermatophytes were identified namely: M.canis was the most frequently isolated organism from the clinical varieties of dermatophytosis [55%]. followed by T. violaceum [20%]. T. rubrum 12.8%, M. gypseum [10%] and lastly T.soudanense [2.2%]

Modified parameters of phacoemulsification in high myopia

Phacoemulsification is more challenging in high myopia than in other eyes because the globe is superelongated and the sclera is thinned out. This study aimed at overcoming the technical difficulties encountered in high myopic eyes by modifying the parameters of phacoemulsification. This study included 30 eyes of 20 patients, 13 males and 7 females [ranging in age from 44 to 62 years]. Their axial lengths ranged from 28 to 32 mm., they had posterior cortical and nuclear cataract [nuclear hardening were grade II and grade III]. The incision was clear corneal tunnel starting posteriorly limbal, the technique of choice was divide and conquer phacoemulsification keeping the bottle height constant at 70cm. in all phacoemulsification steps phaco I, phaco II and irrigation- aspiration [I / A]. Phacoemulsification of high myopic eyes with standard phaco parameters is associated with many difficulties, like fluctuation of anterior and posterior chambers and impairement of good visualization, also there is increased risk of posterior capsule rupture and zonular dialysis. Our results on using the new phaco parameters were very promising, there was no fluctuation of anterior and posterior chambers encountered, the visualization of the nucleus during emulsification and the posterior capsule during I / A was very good in all cases and no cases of posterior capsule rupture or zonular dialysis were recorded. In conclusion phacoemulsification of high myopic eyes with modified parameters offered us better visualization, reduction of the load on the lens ligaments apparatus and facilitated the manipulations made oh the lens nucleus and cortical matter cleaning out

Circulating schistosomal antigens among neonates of mothers infected with schistosoma mansoni

This study was carried out to evaluate the possibility of circulating schistosomal antigens transfer from mothers to their neonates and the time of antigen clearance on 20 full-term newborns to mothers infected with Schistosoma mansoni and passing viable eggs in their stools. The results revealed that the antigen capture ELISA could detect 17 infected mothers with active Schistosoma mansoni infection. A significant direct increase in mean antigen levels was found with infection intensity evaluated by egg counting and the progress of the clinical stages of the disease. A positive correlation was found between newborn serum antigen and the severity of infection in their mothers. A significantly higher antigen levels were found in neonates of antigen positive mothers compared with that of infants at three months of life and the antigen level was decreased gradually with advancement of age. All infants at six month had completely free antigenemia. This study documented the possibility of antigen transfer through placenta even alone or incorporated in immune complex form

Histologic and histochemical studies on the bone marrow, spleen and liver in experimentally-induced chronic renal failure in the rat

Albino rat has been used as an animal model for adenine induced chronic renal failure. Animals were fed a diet containing 0.75% adenine in a dose of 250-350 mg/kg body weight/day for one month. Histologic and histochemical changes of bone marrow, spleen and liver were investigated. Bone marrow smear showed a hypocellularity in the from of a marked decrease of different stages of development of RBCs, leucocytes and megakaryocytes. This was associated with a marked increase in acid phosphatase enzyme activity and a decrease in succinic dehydrogenase enzyme activity. Numerous mast cells were also observed. With the spleen, lymphocytic depletion was observed in the periarteriolar lymphatic sheath, the rest of lymphatic follicle and the red pulp. Macrophage number was apparantely increased in the red pulp. Haemosiderin granules showed a marked increase in the red pulp. Like with the bone marrow, an increase in activity of acid phosphatase enzyme and a decrease in succinic dehydrogenase enzyme activity were noticed in the red pulp. In the liver, hepatocyte vacuolation and increased number of von Kupffer cells were noticed. An increase in acid phosphatase enzyme activity and a decrease in succinic dehydrogenase enzyme activity were observed. There was a patchy depletion of glycogen granules