Bleeding per rectum: aetiological factors and a study of loss of heterogenisity [LOH] of NF1 gene in cases of colorectal cancer

This prospective study was designed to identify etiological factors of lower gastrointestinal bleeding and study the [LOH] of NF1 gene in cases of colorectal cancer among the attendants of gastrointestinal tract [GIT] out-patient clinic in El-Minia University hospital in sex months interval. During the period between February and August 2004, [4500] patients presented to the GIT out-patient clinic, Eighty [80] patients of them were complaining of bleeding per rectum. These 80 patients subjected to history taking, clinical examination, abdominal ultrasound, stool analysis, trial of medical treatment and colonoscopy, and study of LOH of NF1 gene in cases of tumours. We found that: 30% of cases of bleeding per rectum showed internal piles, while 10% of patients showed ulcerative colitis and 13.8% showed non specific colitis and 1.3% showed solitary rectal ulcer. Colorectal polyps were found in 11.3% of cases, cancer colon was found in 10% of cases, while normal colonic mucosa was found in 10% of cases. Rectal varices represented 5% of cases, while stenotic lesions represented 1.3% of cases and angiodysplasia represented 1.3% of cases. Juvenile polyps were the commonest colorectal polyps as they were detected in 33.3% of all cases of polyps. Double colonic lesions were detected in 13.8% of cases in our study. LOH was studied in cancer cases and the polyps to detect if it is precancerous or not. Out of the 10% diagnosed as colon cancer, 7% had LOH of NF1 gene while out of 11.3% of the polyp cases only 2% showed LOH. The most common colorectal lesions were internal piles followed by colorectal polyps and inflammatory and ulcerative colonic lesions. A tumor suppressor gene which is NF1 play and important role in cancer development. Screening program for early detection of premalignant and [or] early malignant lesions are highly recommended

Ambulatory PH monitoring in patients with reflux laryngitis

In this study, 22 patients [group A] with reflux laryngitis detected by clinical evaluation and laryngoscope were examined by esophagoscope and ambulatory pH monitoring. Eight patients [group B] with heartburn without extraesophageal manifestations of GERD were taken as control group and underwent esophagoscopy and pH monitoring. The results of endoscopic examination revealed that only 40% of patients in group A had esophagitis evident by esophagoscope and only 37% had esophagitis in group B. Abnormal distal esophageal acid exposure was detected by pH-metry in 73% and 86% of patients in group A in both upright and supine positions, respectively, while there were 50% and 63% of patients having abnormal distal esophageal acid exposure in group B in upright and supine positions, respectively. There was significantly increased proximal and distal esophageal acid exposure time in supine position in group A than in group B. Total esophageal acid clearance time was significantly longer [median 2.3 minutes] in group A than in group B [median 1.1 minutes]

Hepatitis c virus among different social classes at El-Minia governorate; intra familial spread and psychosocial effects

The aim of the study was to evaluate the intra- familial spread of hepatitis C virus among different social classes and the psychosocial effects in patients with hepatitis C. Fifty patients with chronic hepatitis C were studied. They were classified into A, B and C classes according to their social levels based on the educational degrees, the jobs and the monthly income. All patients answered a questionnaire, which was specifically designed to evaluate the psychosocial effects of HCV infection. This questionnaire included the post infection mode of dealing with the family contacts, friends and colleagues, feelings, behavioral changes, personality changes, and psychosomatic disorders. On the other hand, the family contacts of the patients were subjected to anti HCV antibodies to evaluate the intra-familial spread and positive cases were subjected to HCV RNA [PCR] to reflect the existing viremia. The results showed that there was a significant increased incidence of HCV among the lower social classes. The intra-familial spread of HCV was evaluated among the family members of the 50 patients of the study. The overall positive anti HCV ratio was 8.42 [16/190] and all such positive familial contacts were tested for PCR to reflect the existing viremia. The total number of the positive spouses was 12 cases [24.5%] [five husbands and seven wives] of the total cases. The incidence of the positivity of spouses was significantly increased with the duration of marriage. The total number of sons was 75 of whom three were positive for HCV antibodies by ELISA, one of them showed a negative PCR. On the other hand, the total number of daughters was 66 of whom only one was infected with no significant difference between sons and daughters. Also, there were negative psychosocial effects on the patients reflected by the prevalent psychosomatic disorders