Circulating apolipoprotein alpha1, haptoglobin and alpha2 macroglobulin as fibrosis markers in chronic hepatitis c patients

Hepatitis C virus [HCV] infection is one of the commonest chronic liver diseases worldwide. Progression to chronic disease occurs in the majority of HCV infected patients. The aim of the present work was to study serum levels of alpha2 macroglobulin [alpha2-MG], Apolipoprotein A1 [Apo-1] and Haptoglobin [HP] as non-invasive index of the presence of cirrhosis in chronic hepatitis C patients in relation to the histopathological findings. The study was carried out on 20 patients with chronic HCV and liver cirrhosis [Group I], 20 patients with chronic HCV without liver cirrhosis [Group II] and 10 healthy subjects of mathing age and sex as controls [Group III]. Quantitative estimation of alpha2-MG, HP and Apo AI in serum was done using turbidimetry. The mean serum level of alpha2-MG was significantly higher in group I than in groups II, III [F=12.8] [p=0.00]. On the other hand, Serum Apo A1 and HP were significantly lower in group I than in groups II, III [F=5.9 and 26.3] [p=0.005 and 0.00]. On the other hand, no significant difference was found between groups II and III. Significant positive correlation was observed between serum alpha2-macroglobulin and Child Pugh score, Grading and staging of liver pathology [P<0.05]. On the other hand, significant negative correlation was noticed between serum Apo-1, HP and Child Pugh score, histopathological grading and staging [P<0.05]. Elevated serum levels of alpha2 macroglobulin in addition to low levels of apolipoprotein A1 and haptoglobin might be considered as valuable non invasive parameters for predicting the occurrence of cirrhosis in chronic hepatitis C patients

Study of the serum level of Interleukin-IS (IL-18) in patients with chronic hepatitis C virus infection

Background: One of the most important factors affecting HCV pathogenesis are cytokines. Up till now most of the researches revealed enhanced hepatic expression of the Th1 cytokines in individuals with chronic HCV. However this is not enough to explain the pathogenesis of HCV. Therefore, studying of more advanced mechanisms of recently discovered cytokines may be helpful in solving this problem

Objective: The aim of the present work was to study the serum level of IL-18 in patients with chronic hepatitis C. Virus infection with and without liver cirrhosis and in hepatocellular carcinoma

Methods: The study was conducted on fifty subjects classified into four groups Group I: included twenty patients with chronic HCV virus infection without liver cirrhosis. Group II: enrolled ten patients with chronic HC V virus infection with liver cirrhosis. Group III: compromised of ten patients with hepatocellular carcinoma on top of chronic HCV, Group IV: ten healthy subjects with matching age and sex were enrolled as controls. IL-18 was measured in serum by ELISA

Results: Mean Serum IL-18 [pg/ml], were 383.12 +/- 87.93 , 710.5 +/- 212.92, 836.5 +/- 116.83 and 197 +/- 14.37 pg/ml in the four groups respectively The results revealed that serum IL-18 increased significantly in patients with hepatocellular carcinoma more than chronic HC V patients [ with and without cirrhosis]. Moreover, patients with cirrhosis had significantly higher levels of serum IL-18 than in non-cirrhotics and controls. A positive correlation was found between serum IL-18 and Child Pugh scoring in groups II and 111 patients [r = 0.86, 0.94 respectively] [p = 0.00 in both groups], as well as with histopathological [necroinflammatory] grading in groups I and II [r=0.82, 0.98 respectively ][ p=0. 00]

Conclusions: From the previous results we can conclude that IL-18 is involved in the activity of the disease process and might have a prognostic value in the progression of liver cirrhosis and HCC

Transit time, bacterial growth and electron microscope study of the small intestine in schistosomal hepatic fibrosis with portal pressure changes

Transit time and bacterial groth together with both light and electron microscopic changes of small intestine were studied in relation to different portal pressure levels in 23 patients with schistosomal hepatic fibrosis. Schistosomal patients were divided into two groups: the first group included those without ascites or elevated portal pressure [100-150 mmH[2]O] while the second group comprised patients with ascites and a portal pressure varying between 180 and 400 mmH[2]O. All findings were within normal in the first group patients yet those of the second group showed delayed intestinal transit time [80%], small bowel bacterial overgrowth whether aerobic or anaerobic [80%], along with mild, moderate or marked light and electron mocroscopic pathological changes which seemed to depend on the extent of the rise of the portal pressure

Transit time, bacterial growth and electron microscope study of the small intestine in schistosomal hepatic fibrosis with portal pressure chances

Transit time, bacterial growth together with both light and electron microscopy of small intestine were studied in relation to different portal pressure levels in 23 patients with schistosomal hepatic fibrosis Schistosomal patients were divided into two groups: the first included those without ascites or elevated portal pressure [100-150 mm H[2]0] while the second group comprised patients with ascites and a portal pressure varying between 180 and 400 mm H[2]0. Although all findings were within normal in the first group patients, yet those of the second group showed delayed intestinal transit time[80%], small bowel bacterial overgrowth whether aerobic or anaerobic [80%] along with mild, moderate or marked light and electron microscopic pathological changes which seemed to depend on the extent of rise of the portal pressure. In spite of the fact that all studied parameters seem to be of importance, yet further attempts should be made in order to clarify the role and sequence of event, each of these factors play, in induction of altered intestinal functions in hepatic schistosomiasis patients

Bacterial meningitis: Laboratory profile and computed tomographic findings

Twenty patients with acute bacterial meningitis were subjected to thorough history taking, full clinical and neurological examination, CSF studies, blood analysis and CT brain scan. Blood and CSF examinations were repeated ten days later following starting of treatment and follow up CT after one month. The results showed positive bacteriological studies in all cases. The main initial CT findings, in addition to diffuse meningeal enhancement were ventricular dilatation in seven cases. Low density lesions in six, subdural collection in four, brain edema in three, atrophy in one patient and abscess in another one

Comparison between diazepam and midazolam as a sedative during colonoscopy

In the present study, intravenous diazepam 10 mg and midazolam 5 mg were compared in two groups each of 15 patients undergoing colonoscopic examination. Midazolam was found to be more potent than diazepam. Its onset of action was faster than diazepam. It provided a greater degree of sedation, more intense amnesia, better endoscopic conditions and no pain on injection. The cardiovascular, respiratory blood gas and hepatic effects of both drugs caused no significant changes. Recovery time was more prolonged after midazolam than diazepam

Serum transferrin in patients with schistosomal hepatic fibrosis before and after splenectomy

The present work was carried out on 22 patients suffering from schistosomal hepatic fibrosis to estimate the level of serum transferrin before and one month after splenectomy using the radial immunodiffusion technique. The level of this protein revealed a significant reduction before splenectomy which could be attributed to hemodilution and /or increased catabolism. Serum transferrin showed no alteration of significance after splenectomy denoting that factors responsible for its preoperative level were still present and were not affected by the removal of the spleen

Complement C1q in serum and ascitic fluid in cases of hepatic schistosomiasis with ascites

C1q levels were estimated by radial immunodiffusion in sera and ascitic fluids of 15 patients suffering from advanced schistosomal hepatic fibrosis. Ten healthy individuals were also included as controls. Lower C1q values were observed in patients compared with the controls. However, the difference was statistically nonsignificant. This denotes that the classic complement pathway may not be involved in cases with advanced schistosomiasis