Human papillomavirus (HPV) in Egyptian females: study by cytology, histopathology, colposcopy and molecular diagnosis of high risk types

Objectives: In Northern Africa, the region Egypt belongs to, about 10.7% of women are estimated to harbour cervical human papillomavirus (HPV) infection and 78.4% of invasive cancers are attributed to HPVs 16 or 18. We aimed at comparing HPV detection by ISH-PCR tissue with other conventional available cheaper techniques, finding which of them can be relied upon in a developing country like Egypt for HPV detection. Methods: Sixty patients were included. For them colposcopy, PAP smear, histopathology and detection of HPV using ISH PCR tissue and PCR swab were achieved. Results: PCR-ISH tissue was positive in 53.33%, 46.6% were negative. Pap smear was negative in 26 cases (43.33%) and 43 cases (56.67%) were positive. LSIL with perinuclear halo represented nearly half of the positive cases (16/34; 47.05%), 10 cases were diagnosed as HSIL, 4 cases as ASCUS and 4 as AGC. Histopathology was negative in 12 (20%) cases and 48 (80%) cases were positive. CIN I and CIN I+ koliocytosis represented half of the cases (30/60) and more than half of positive cases (30/48; 62.5%). Comparing the results of pap smear, histopathology, colposcopy and PCR swab with ISH PCR tissue, highly significant results were seen with sensitivity of 87.5%, 100%, 62.5% and 56.2% respectively but the specificity were 78.6%, 42.9%, 28.6% and 100% respectively. Conclusion: Conventional cytology and histopathology were sensitive tests for detection of HPV. This may help for early detection of cancer cervix in a developing country like Egypt. PCR swab showed the highest specificity and the lowest sensitivity.

Serum BAFF level and its correlations with various disease parameters in patients with systemic sclerosis and systemic lupus erythematosus

Interest in B-cells has been revived due to the description of new functions. Supporting a role for B-cells in the genesis of autoimmune diseases is the fact that the B-cell-activating factor of the TNF ligand family [BAFF] is essential in their physiology. The role of BAFF, a new cytokine, in autoimmune diseases has been highlighted. To assess serum BAFF level in systemic sclerosis [SSc] and systemic lupus erythematosus [SLE] to verify its role in these diseases and find any relation with the clinical manifestations, laboratory investigations, disease activity and damage. The study included 12 SSc and 40 SLE patients. The patients were subjected to full history taking and thorough clinical rheumatological and dermatological examinations and relevant investigations including autoantibodies and CT chest in SSc. In SSc, the total skin thickness score was scored according to the modified Rodnan skin score [MRSS] method. In SLE, the disease activity was assessed using the Systemic Lupus Activity Measure [SLAM] and organ damage using the Systemic Lupus International Collaborating Clinics/ACR [SLICC/ACR] index. The serum BAFF levels were measured using a specific ELISA. The BAFF level was remarkably elevated in SSc and SLE in a comparable percentage of patients, yet the level was highest in SLE and lower in the limited SSc subtype. The BAFF significantly correlated with the level with the MRSS in SSc and with both the SLAM and SLICC in SLE patients. The elevated level of BAFF in SSc further confirms the importance for new therapeutic targets for its inhibition to slow the disease progression, particularly skin fibrosis. The role of BAFF in the pathogenesis and disease activity in SLE is well-known and the novel noticeable correlation with the damage index high lightens on the utility of BAFF as an indicator of disease damage and predictor of poor outcome

Antioxidant enzyme activities in hepatic tissue from children with chronic cholestatic liver disease

To study the oxidative stress status in children with cholestatic chronic liver disease by determining activities of glutathione peroxidase [GPx], superoxide dismutase [SOD] and catalase [CAT] in liver tissue. A total of 34 children suffering from cholestatic chronic liver disease were studied. They were selected from the Hepatology Clinic, Cairo University, and compared with seven children who happened to have incidental normal liver biopsy. The patients were divided into three groups: extrahepatic biliary atresia [n=13], neonatal hepatitis [n=15] and paucity of intrahepatic bile ducts [n=6]; GPx, SOD and CAT levels were measured in fresh liver tissue using ELISA. In the cholestatic patients, a significant increase was found in mean levels of SOD, GPx and CAT in hepatic tissue compared to control children. The three enzymes significantly increased in the extrahepatic biliary atresia group, whereas in the groups of neonatal hepatitis and paucity of intrahepatic bile ducts, only GPx and CAT enzymes were significantly increased. Oxidative stress could play a role in the pathogenesis of cholestatic chronic liver diseases. These preliminary results are encouraging to conduct more extensive clinical studies using adjuvant antioxidant therapy

Fluvastatin increases insulin-like growth factor-1 gene expression in rat model of metabolic syndrome

Insulin-like growth factor- 1 [IGF-1] was found to have a role in both glucose homeostasis and cardiovascular diseases. The present study was designed to compare the effects of fluvastatin and metformin on IGF- 1 mRNA expression within the liver and on other individual components of the metabolic syndrome induced in rats by high fructose feeding. Rats fed 60% fructose in diet for 6 weeks were treated daily with fluvastatin [3.75mg/kg/day] or metformin [200mg/kg/day] during the last 2 weeks and were compared with untreated fructose fed group. Fasting levels of plasma cholesterol, triglyceride, glucose, insulin, nitric oxide products, IGF- 1 and IGF- 1 mRNA within the liver as well as systolic blood pressure and body weight were determined. Compared to control rats, the fructose fed group developed hypertension, hyperlipidemia, hyperinsulinemia, hyperglycemia and endothelial dysfunction as well as decreased levels of plasma IGF- 1 and its mRNA within the liver. Fructose fed rats treated with fluvastatin or metformin for 2 weeks showed significant decrease in plasma cholesterol, triglyceride, insulin and glucose levels compared to untreated fructose fed group. Also, both drugs increased significantly plasma levels of nitric oxide products and IGF-1 together with significant increase in IGF-1 mRNA within the liver. However, only metformin treated rats showed significant decrease in systolic blood pressure compared to fructose fed group. This study showed that in a rat model of insulin resistance, fluvastatin improves the metabolic profile and increases plasma level of IGF-1 and its gene expression as effective as metformin

Is hypo or hyper ferremia related to recurrent skin infections?

This study was conducted on 28 patients classified into two groups. Group I included 14 patients with recurrent herpes labialis [it was further classified into group A [active herpes labialis] and group B [in between attacks]]. Group II included 14 patients with recurrent furunculosis in addition to a control group including 12 healthy subjects. Serum iron was estimated. Group I showed higher serum iron than controls either in active or in between attacks, while group II showed lower serum iron than the control group. This denoted that iron deficiency or iron overload increased susceptibility to infection

Detection of chlamydia trachomatis deoxyribonucleic acid in prostatic tissue in chronic abacterial prostatitis by in situ polymerase chain reaction

The aim of this study was to assess the pathogenic role of Chlamydia trachomatis in chronic abacterial prostatitis by in situ polymerase chain reaction [PCR] using transrectal ultrasonic guided biopsy. Thirty-five patients with chronic prostatitis and five age-matched patients suffering from lower obstructive urinary symptoms served as controls were included in the study. In situ PCR detected Chlamydia trachomatis DNA in six out of five cases of chronic abacterial prostatitis and in none of the control group. Chlamydia trachomatis DNA was found in chronic inflammatory cells of all the six positive cases and in prostatic epithelial cells in only one patient. The results supported the hypothesis that Chlamydia trachomatis has an etiological role in chronic prostatitis patients

Detection of hepatitis C virus RNA in liver tissue of chronic hepatitis C conditions by reverse transcription-polymerase chain reaction in situ hybridization [TR-PCR-ISH]

Hepatitis C virus [HCV] infection of cells on liver tissue was determined by detecting HCV RNA using reverse transcription polymerase chain reaction in situ hybridization [RT PCR ISH] technique. Twenty wedge liver biopsy specimens from patient with chronic hepatitic conditions were studied; comprising eighteen cases of chronic active hepatitis [CAH] with cirrhosis, five of which were positive for HBsAg] and the rest were diagnosed as non A-non B [NANB] and two cases of CAH with bilharzial fibrosis were also diagnosed as [NANB]. Score activity of the 20 liver biopsies was done and features favorable of HCV infection were determined. Thirteen out of the 20 liver biopsy specimens were positive for HCV RNA which was located within hepatocyte cytoplasm for all thirteen cases, in nuclei for six cases and in bile duct epithelium for two cases. HCV RNA appeared as fine granules diffusely distributed in cytoplasm or concentrated in perinuclear zone. The positive hepatocytes were particularly related to periportal and midlobular zone in relation to lymphocytic infiltrate. A high proportion of hepatocytes appeared positive with variable intersity but there was no strong association with disease activity. HCV RNA was detected in one severe case of CAH with bilharzial fibrosis and three cases positive for ABsAgs. In this study, some histopathological characteristics of HCV infection were revealed and it was concluded that direct recognition of HCV in liver biopsy is mandatory for the establishment of the cause and effect of hepatitis and using RT-PCR-ISH technique would be the most reliable method of diagnosis of hepatitis C virus because it is more sensitive and specific