impact and effect of liver insufficiency of HCV infection on patients with chronic obstructive pulmonary diseases

Hepatitis C virus [HCV] infection is associated with a wide series of extra- hepatic manifestations. Pulmonary involvement is one of the extrahepatic manifestations of chronic hepatitis C virus [HCV] infection. The objective of this study was to determine the impact of HCV; infection and the degree of liver dysfunction in patients with chronic obstructive pulmonary disease [COPD]. This study was conducted on COPD patients. They were selected from outpatient chest clinic in the Menoufia University Hospital. They were classified into 2 groups the first group COPD patients [n = 40] without hepatitis C and the second group COPD patients with chronic hepatitis C. Second group [COPD with HCV] classified into 3 subgroups according Child-Pugh classification to determine the degree of liver insufficiency. Group IIA: patients Child-Pugh [A], group IIB: patients Child-Pugh [B] and group IIC: patients Child-Pugh [C]. The following pulmonary function parameters were recorded: Forced Expiratory Volume in the first second [FEV1], Forced Expiratory Volume percent [FEV1/FVC%], Forced Expiratory Flow 25-75% [FEF 25-75%] and Maximal Voluntary Ventilation [MVV]. The study included 80 patients with COPD, 40 patients without chronic HCV infection [group I], and 40 patients with chronic HBV infection [group II].COPD patients with HCV infection have increased deterioration in pulmonary function [FEV1, FEV1/FVC, FEF 25-75% and MVV] than COPD patients without HCV infection. Also there were significant decreases in pulmonary function tests [FEV1, FEV1/FVC, FEF 25-75% and MVV] in group II subgroups IIA, IIB and IIC according to the degree of decompensation. Patients with COPD with HCV infection, have increased deterioration in pulmonary function than patients with COPD without HCV infection and the deterioration increases with hepatitis decompensation

Role of fibulin-3 in the diagnosis of malignant mesothelioma

Early detection of malignant pleural mesothelioma [MPM] is critical to survival, the use of pleural or blood fibuin-3 might allow this early detection. Studying the validity of measuring serum and pleural fibulin-3 in the diagnosis of MPM. Fibulin-3 levels were measured in serum and pleural fluid by enzyme-linked immunosorbant assay [ELISA] in 45 patients with exudative pleural effusion. Patients with non-conclusive cytology or microbiological examination had undergone medical thoracosope for histopathological examination. Twenty five was diagnosed as MPM, 11 cases as pleural metastasis of carcinoma [Mets] and nine cases with benign pleural effusions. Patients with MPM had significantly higher pleural effusion and serum fibulin-3 levels than those with metastatic effusion of carcinoma or benign pleural effusion [p-value < 0.001]. Using a cut-off point of pleural fluid fibulin-3 [150 ng/ml] with AUC of 0.878 [sensitivity 72.3%, specificity 80] and at a cut-off point of serum fibulin-3 [66.5 ng/ml], with AUC of 0.776 [sensitivity 88%, specificity 81.8%], discrimination between MPM and Mets occurred. Also, using a cut-off point of pleural fluid fibulin-3 [127.5 ng/ml] with AUC of 0.909 [sensitivity 88%, specificity 77.8%], and at a cut-off point of serum fibulin-3 [18 ng/ml], with AUC of 0.931 [sensitivity 100%, specificity 77.8%], discrimination between MPM and benign pleural effusion could occur. Fibulin-3 in the serum and pleural fluid is a good biomarker in the diagnosis of MPM and in differentiation between MPM from malignant pleural metastasis other than mesothelioma and also from benign pleural effusions

effect of dietary counselling on the health status of end-stage renal failure patients

Chronic renal failure is becoming one of the most impacting diseases on the Egyptian population, alongside with cardiovascular and hepatic diseases, diabetes mellitus and cancers. Studies support the importance of dietary management on different aspects related to end-stage renal failure [ESRF] and other studies also suggest that active nutritional counselling can improve certain important biochemical parameters and fluid overload problems in patients on maintenance haemodialysis [HD]. To assess the effect of dietary counselling on the overall health status of ESRF patients subjected to haemodialysis, particularly their renal functions. A pretest-posttest study was conducted through several phases; Phase 1: Pre-intervention assessment using; an interview questionnaire to collect socio-demographic, nutritional knowledge and dietary pattern data; Malnutrition Inflammation Score [MIS]; Karnofsky Performance Scale [KPS] and anthropometric measurements. Phase 2: Implementation of nutritional counselling sessions communicating evidence-based practices. All patients were given one-to-one nutritional counselling over a six-month period. Phase 3: Post-intervention reassessment of patients using phase one tools. A sex-stratified random sample of about 50% of all patients attending El-Harem Centre for Dialysis [82] during the period from October, 1[st] 2008 till March, 31[st] 2009 were included. Intervention participants totalled 41 ESRF patients. In this study, 97.5% of patients were considered mildly to moderately malnourished. Multiple malnutrition problems detected among these patients were protein-energy malnutrition, hypocalcaemia, anaemia and hyperphosphataemia. Nutritional counselling sessions resulted in statistically significant changes in the Malnutrition Inflammation Score [MIS] and Karnofsky Performance Scale [KPS] of the patients, the patients' nutrition related knowledge and to some extent their dietary practice. Providing one-to-one nutritional counselling is an effective intervention that can improve the ESRF patients' nutrition related knowledge and practice as well as their compliance to the dietary guidelines for the dialysis patients, which in turn can improve their health status and daily performance

Anaphylaxis and anaphylactoid reactions with intravenous anaesthetics a comparative study between thiopentone and propofol

Diprivan was the first formulation of a new i.v. anesthetic that is sparingly soluble in water. Its use was accompanied by an incidence of pain on injection, an episode of erythema, edema of the eyelids, hypotension and bronchospasm. This study was conducted to evaluate the anaphylactic and anaphylactoid reactions triggered by the two commonly used intravenous anesthetics, thiopentone and propofol. It was found that the incidence of occurrence of the anaphylactoid reactions following the administration of either thiopentone or propofol was very rare. Also, it was recommended to administrate the i.v. anesthetics slowly and in a large vein to reduce the possibility of any localized reactions

Study of serum cortisol, thyroid hormones and thyroid stimulating hormone in cases of hyperemesis gravidarum

Evaluation of the efficacy of local tromantadine hydrogel in recurrent herpes simplex orofacialis was the aim of this work. Significant shortening of subjective symptoms, duration of the vesicular stage and time required for complete healing were evident from the results. Also, the drug was well tolerated. It could be, therefore, concluded that local tromantadine hydrogel had a good therapeutic effect on herpes simplex orofacialis when compared with controls

Prevention of lactation in cases of recent intrauterine fetal deaths of still-born babies using long-acting bromocriptine

Twenty cases who had still-born babies or recent intrauterine foetal death have been studied for suppression of lactation. Ten cases given long-acting bromocryptine 50 mg injection showed rapid and dramatic inhibition of prolactin together with high tolerability and clinical efficacy. The other ten cases given ethenyl-oestradiol tablets for five days, showed less prolactin lowering effect as the drug acts directly on the mammary gland receptors, in addition to milk engorgement and breast pain and congestion. Accordingly the depo-injectable bromocriptine in a dose of 50 mg is highly recommended in early peurperium to prevent lactation

Correlation between the seminogram, cervical mucus and the post coital test in infertile couples

The post coital test [PCT] was performed in 100 cases of primary infertility having regular cycles and the seminal analysis of their partners was obtained. In cases with good cervical mucus, there is a very good correlation between the semen quality and the result of PCT. On the other hand in cases with good and passable seminograms, the PCT was significantly better in cases of high positive mucus than in cases of positive mucus. Therefore, the PCT has a very good correlation with the quality of the husband's semen and the character of the cervical mucus of the wife

Serum protein-bound hexosamine in tumours of the genital tract

Serum protein-bound hexosamine was estimated in one hundred and four women. In patients with fibroid uterus there was an increase in its level. In the malignancy group of patients there was a highly statistically significant increase in its mean than that of controls. Its level could be of value in early detection of cancer body

Serum protein-bound sialic acid in tumours of the genital tract

Serum protein-bound sialic acid was estimated in one hundred and four women. There is no statistical difference in patients with fibroid uterus. There is an increase in malignant tumours and this is more in inoperable cases. This might be of value in determining the extent of the malignat tumour

Recent trends in injectable contraception with a report on lynoestrenol phenyl propionate

Recent trends and opinions on injectable contraceptives were reviewed with reference to their advantages and disadvantages. A study was performed on a group of 25 patients who received 50 mg. Lynocstrenol Phenylpropionate as monthly injection for six months. Recording of any breeding or menstrual irregularity was done in children to periodic study of the endornetrial histology and vaginal cytology. No change in body weight or blood pressure were observed. Evaluation for the effectiveness was guarded but the acceptability of this drug was excellent. No lumps or any other changes in the breasts were seen during this study

Amniotic fluid creatinine in normal and abnormal pregnancy

Creatinine, an important constituent of the amniotic fluid that was recently used in clinical obstetrics to assess the foetal maturity in uterois it was found to increase progressively as pregnancy advances. To study the effect of hypertensive toxaemia of pregnancy on the amniotic fluid creatinine, 135 pregnant patients in their last trimester were included in this work: 35 cases of normal pregnancy and 100 cases of hypertensive toxaemia. All have had abdominal amniocentesis, and the creatinine content was estimated by the Coleman Junior spectrophotometer using the alkaline picrate method of Bonsnes and Tausky

glycoprotein, seromucoid in tumours of the genital tract

A specific glycoprotein, the seromucoid was studied in one hundred and four women. In patients with fibroid uterus it showed a highly significant statistical increase in its mean than that of the control group. In the malignant group of patients its level was more marked than that of fibroid cases. It was shown to be of value in the follow up of malignant cases after treatment

Serum protein-bound fucose in tumours of the genital tract

Serum protein-bound fucose was estimated in one hundred and four women. In patients with fibroid uterus there was a highly statistically significant increase in its level. This increase was more in small-sized than in big-sized fibroid. The malignant group showed a highly statistically significant increase in its level

Serum protein-bound hexose in tumours of the female genital tract

Serum protein-bound hexose was estimated in one hundred and four women. In patients with fibroid uterus no change was detected. A highly statistically significant increase was shown in malignant tumours. This increase was more in late inoperable cases which suggested its use in evaluating the extent of malignancy

Indications and complications of amniocentesis

In a total of 289 cases, amniocentesis was successfully carried out in 98% of the patients. Both abdominal and vaginal routes proved to be easy and safe. The procedure is useful to monitor foetal condition in utero. Minor side effects as sangenous taps or maternal syncope were rate but serious complications as intra-uterine, injection and premature labour were not encountered in this group