Role of herpes simplex virus-1, cytomegalovirus and Epstein-barr virus in atherosclerosis

Infectious agents such as herpes viruses may be implicated in the inflammatory atherosclerotic process. The aim of this study was to assess the levels of IgG antibody specific for Herpes simplex virus-1 [HSV-1], Cytomegalovirus [CMV] and Epstein-Barr virus [EBV] among patients with atherosclerotic vascular diseases and to examine the relation between the levels of these antibodies and lipid profile, high-sensitive C-reactive protein [hsCRP] in these patients. Seventy five patients [20 with acute coronary artery disease [ACAD], 20 with chronic coronary artery disease [CCAD], 20 with cerebral stroke and 15 with peripheral arterial disease [PAD]] along with 15 healthy individuals as a control group. The studied individuals were subjected to complete history taking, thorough physical examination, and assessment of the blood glucose level, lipid profile, creatine kinase [CK], hsCRP by nephlemetry and virus-specific IgG antibodies by enzyme immunoassay [EIA]. Results showed that the levels of cholesterol, triglycerides, LDL-c and hsCRP were significantly higher, while HDL-c was significantly lower among patients compared to that of the controls. A significantly [P<0.05] higher perecentage of patients had CMV-specific IgG as compared to the controls. Higher percentage of patients had HSV- and EBV-specific IgG antibodies, however, there was no significant difference between the 2 groups. Individuals who had CMV-specific IgG were more liable to have vascular disease compared to those without [OR= 4.10, CI= 1.07-15.75]. The levels of CMV- and EBV-specific IgG antibodies were significantly [P<0.01 and < 0.05 respectively] elevated among patients with atherosclerotic vascular diseases when compared to those of the controls. There was no significant correlation between the levels of virus-specific IgG and lipid profile or hsCRP. In conclusion, the level of CMV- and EBV- specific antibodies are elevated among vascular disease patients and the presence of CMV-specific IgG is associated with development of the disease. Serum lipids and hsCRP were increased among the studied patients; however, no significant correlation was detected between antiviral IgG levels and lipid profile or hsCRP

Concepts in leptin and liver disease

Leptin is a cytokine l6kd peptide hormone. Its crucial role is regulation of appetite and the body fat mass mainly through action on the hypothalamus. It is produced mainly in adipocytes of white fat, as well as from other tissues e.g. placenta, skeletal muscles, fundus of the stomach and activated hepatic stellate cell [HSC] and recently reported that leptin is produced from B cell of islands of the pancreas. The gene responsible for production is present on chromosome 7 called obse gene [ob/gene]. Leptin receptors [OB-R] were present in two forms short [OB-Ra or OB-RS] and long one [OB-Rb or OB-RI]. The main action of leptin depends on long form [OB-Rl], where very little evidence is available implicating a role for the short form in the action of leptin. One of the unconventional areas in which leptin is now receiving great attention is liver diseases as several published studies indicate that circulating leptin level are increased in cirrhosis, hepatitis C virus [HCV] and non-alcoholic steatohepatitis [NASH]

Comparative long term results of first line surgical therapies for bulbar and posterior urethral strictures

We present our long term comparative results in the management of buldar and posterior urethral strictures using various first line surgical techniques. From January 1983 to January 2000 and with a mean follow-up of 58 months and a median of 34 months, 120 males with bulbar and posterior urethral strictures were managed in our tertiary care hospital. Only first line; therapies, selected by the respective treating urologist, were included in order to assess their efficacy and cost benefit value. Results of endoscopic management of bulbar strictures were correlated to ecology, the length of the stricture and previous urethrotomies. Optical urethrotomy was successful in 40% of the patients. However, when the stricture was short less than 2cm with no history of previous urethrotomy, the relapse rate was only 33%. Holmium laser urethrotomy was successful 60% of selected cases. Perineal and transpubic urethroplasties were highly successful in the management of bulbo-membranous and membranous strictures, with a success rate of 85% and 88% respectively, There was no difference in surgical results according to the etiology of the stricture. Optical and internal urethrotomy and Holmium - YAG laser urethrotomy are highly successful as first line therapies for short [less than 2cm] bulbar urethral stictures with no previous urethrotomies. They may also be indicated in older people with one failed internal urethrotomy. Perineal and transpubic urethroplasties are the gold standards for the management of bulbar, bulbo-membranous and membranous strictures. Treatment should be tailored to each individual case for optimal results

Hepatitis A in Eastern Saudi Arabia

The prevalence of hepatitis A [HAV] or infectious hepatitis has not been characterized in the population of Saudi Arabia. We reviewed all laboratory records of tests for antibody to hepatitis A virus [anti-HAV] at the Armed Forces Hospital, King Abdul Aziz Airbase, Dhahran, and discovered a high prevalence [over 90%] in 225 samples. This prevalence is consistent with other developing countries and should stimulate longitudinal, cross-sectional and geographical studies of HAV in the Saudi population