[High exposure to polycyclic aromatic hydrocarbons may contribute to high risk of esophageal cancer in northeastern Iran]

The northeastern region of Iran has some of the highest rates of esophageal squamous cell carcinoma [ESCC] in the world. To investigate the role of polycyclic aromatic hydrocarbons [PAHs] in the etiology of ESCC in northeastern Iran, we measured urine 1-hydroxypyrene glucuronide [1-OHPG], a stable PAH metabolite, in 99 inhabitants of this area. Results: The median urine 1-OHPG in participants of this study was 4.2 pmol/ml. Forty-two subjects [42%] had levels ranging from 1 to 5 pmol/ml, indicative of moderate PAH exposure, and 41 [41%] had levels above 5 pmol/ml, indicative of very high exposure. Further analysis showed that 1-OHPG levels were high in all subgroups of our study subjects, including both sexes; rural and urban dwellers; and smokers and non-smokers. Only 15% of the variance in 1-OHPG was explained by age, sex, residence, smoking, nass, or opium consumption. This pattern of PAH exposure parallels with the ESCC incidence pattern seen in this area. We conclude that people in northeastern Iran are exposed to widespread and very high levels of PAH, largely from unknown sources, and this may contribute to the high rates of ESCC observed in this area

Value and limitations of polymerase chain reaction and diffrent serological markers in diagnosis of single and mixed acute viral hepatitis

Introduction: Hepatitis viruses are endemic in Egypt, Many studies were performed in order to study the pattern of acute viral hepatitis [AVH] and all of them were hospital-based. The frequency of viral agents causing hepatitis in the previous studies were conflecting. Aim: to evaluate the value and limitations of polymerase chain reaction [PCR] and different seromarkers in diagnosis of single and mixed AVH. Patients: This study was performed in Sallam village near Assiut city. Active surveillance was performed on 1400 cases using house to house survey and frequent visit to rural health unit. 105 patients with AVH 60 males and 45 females with age ranged from 2 months to 65 years were included in the study. All patients had full history, general and abdominal examination including ultrasound, liver funtion test and different seromarkers. Anti hepatitis A virus [anti-HAV] IgM and IgG, HBs Ag, anti HBc IgM anti HEV IgM and IgG and dithiothreitol [DTT] anti-HCV IgM, cytomegalovirus [CMV] and Epstein Barr virus [EBV] IgM antibodies. Reverse transcriptase polymerase chain reaction RT-PCR] were performed for HCV and HEV. HA V was the most frequent cause of AVH 34 [32.4%], followed by AVE 29 [27.6%], AHB in 9 [8.6%]. Acute hepatitis C [AHC] was diagnosed only in 3 cases [2.9%] one single and two mixed with E virus. Hepatitis C RWA may be suppressed in mixed viral infection as it occurred in two of our cases who had mixed C/E viruses. Two cases were diagnosed CMV and one case mixed CMV/EB V. 70 [66.7%,] had single viral infection, while 14 [13.3%] had mixed viral infection and 16 [15.2%] were negative for all viral markers and diagnosed as non A-E hepatitis. 19 cases had clinical and laboratory evidence of AVH however they had positive anti-HCV Ab six months prior to inclusion, so they were diagnosed as chronic HC. 6 cases were excluded from the study and diagnosed as drug and toxin induced hepatitis. PCR aid variant seromarkers have an important role in diagnosis of AVH, however they have many limitations particularly in acute hepatitis C and mixed infection