Analytical evaluation of hepatitis c virus core antigen detection as a diagnostic test in diagnosis of HCV infection

The aim of the present study was to evaluate the efficacy of hepatitis C virus [HCV] core Ag assay by comparing it with anti-HCV antibodies and PCR-based technology for measuring viral load in diagnosis of HCV. HCV core Ag by ELISA in serum, in the presence or absence of anti-HCV antibodies was compared to HCV- RNA by PCR on total number of 100 subjects, divided into 3 groups; including 80 patients and 20 volunteers. The sensitivity of the test was [72.5%]] and the specificity was [86.6%]. Also positive predictive value of the test was [78.3%] and negative predictive value was [82.5%]. Core antigen detection by ELISA can be used as a reliable test for detection of vireamia in HCV infection

Assessment of rhomboid flap technique as compared with midline closure for the management of chronic pilonidal sinus

Different procedures have been advocated for the management of chronic pilonidal sinus [PNS], none of which is perfect. This study was conducted to compare between the Limberg flap technique and conventional midline closure in patients with chronic PNS. The onset of PNS is rare both before puberty and after the age of40.Males are affected more frequently than females, probably due to their more hirsute nature [Sondenaa etal [1995]]. In a population study of 50,000 students, the incidence in males was 1.1%, ten times more than in females [Dwight and Maloy [1953]], although many of these were asymptomatic. This study included 20 patients with chronic pilonidal sinus admitted to the department of surgery between Feb 2005 and June 2006. Good history as regarding, duration, number of sinuses and their location, previous management operative technique and time, hospital stay, return to normal activity, morbidity, and recurrence of disease. Patients were categorized into 2 groups. Patients in-group 1 [n = 10] were treated with the rhomboid flap, whereas those in-group 2 [n = 10] were treated with the standard midline closure technique, with a follow up period ranging from 12m-18 months. Twenty patients underwent with this technique, mean age 23.4 years [range 18 to 34]. Mean follow-up was 13 months. The mean time of patients discharge was 3 days [range, 2-5 days] postoperative. Complication was noticed more with midline closure [3 of 10 [30%]] as compared with rhomboid flap technique [1 of 10[10%]]. Recurrence was observed in 2 cases [20%] with midline closure while no recurrence was observed with patients treated with rhomboid flap technique. Rhomboid flap is recommended for patients with chronic PNS as it is a simple, nonlengthy procedure that has less overall complications and a lower recurrence rate than the conventional midline closure method. Chronic pilonidal sinus [PNS] is a common disabling disorder among young adults. It has a high and rising incidence in some countries, particularly so in the Mediterranean and Gulf region as a result of differing hair characteristics and growth patterns [Aldean etal [2005]], [Sakr etal [2006]]. The treatment of the symptomatic pilonidal sinus is surgical with one of the most extensive being excision of the diseased tissue down to the sacral fascia. The closure of the defect is the matter of debate. An operation that results in reliable primary wound healing and few complicate and recurrence, a short period of hospitalization, minimal postoperative pain and morbidity, rapid return to normal daily activity, and low risk of recurrence are seen as requirements to optimal therapy [Berry [1992]], [Karydakis [1992]]. This study compare the result of rhomboid flap technique and the midline closure for the management of chronic pilonidal sinus as regard duration of wound healing, home stay, complication and recurrence of the disease [Katsoulis etal. [2006]]

Urinary leukotriene E[4] in asthmatic children with and without nocturnal exacerbations

Nocturnal exacerbations of bronchial asthma are very common and disturbing signs with serious consequences on patient's quality of life. The exact mechanism of these exacerbations is not known but inflammatory mediators may play an important role. To study the role of leukotriene E[4] [LTE[4]] in the pathogenesis of nocturnal exacerbations of bronchial asthma. The study was conducted on 50 asthmatic children who used to attend the outpatient clinics of the Pediatric and Chest Departments of Tanta University Hospital. Their ages ranged 8-14 years. The study was carried out over 10 months from October 1, 2000 to July 31, 2001. They were classified into two groups. Group A included 25 asthmatic children without nocturnal symptoms, and group B comprised 25 children who used to have nocturnal asthma exacerbations. Twenty non-asthmatic children of comparable ages were included in the study as controls. All of the children were subjected to full history taking, clinical examination, pulmonary function tests [PFTs], methacholine bronchial challenge test, and measurement of LTE[4] in urine. Values of morning drop of peak expiratory flow [PEFR] in children with nocturnal symptoms [Group B] was significantly higher than those in the asthmatic children without nocturnal exacerbations [Group A] [P<0.05]. The PC[20] FEV[1] was significantly lower in group B than in group A [P<0.05]. Urinary LTE4 levels were found to be significantly higher in group B than in group A [P<0.05]. In asthmatic children with nocturnal exacerbations [group B], urinary LTE[4] levels were found significantly higher at night more than at day hours [P<0.05]. Also, in this same group B, there were significant positive correlations between urinary LTE[4] levels and morning drop in PEFR values and significant negative correlation between urinary LTE[4] levels and PC[20] FEV[1] [P<0.05]. There was no significant difference in urinary LTE[4] levels between atopic and non-atopic asthmatic children. Measurement of urinary LTE[4] levels may represent a non-invasive method for assessment of airway inflammation and for predicting the outcome of nocturnal exacerbations that disturb the life of asthmatic children

HLA gene polymorphism and susceptibility for stroke in children with sickle cell anemia

Stroke occurs in 8-10% of children with Sickle Cell anemia [SCA] and is a major cause of morbidity. Prevention of first stroke would be preferable because even one stroke can cause irreversible brain injury. The association of HLA type with stroke provides the first evidence of a multigenic involvement in a specific manifestation of SCA. We investigated eleven children with SCA with magnetic resonance imaging [MRI] abnormalities consistent with cerebral infarcts [group I] and fourteen asymptomatic children with SCA with normal MRI scans [group II] to determine whether HLA type was associated with risk of stroke with SCA. Comparison, of the results of HLA typing between the SCA patients with a positive and those with a negative MRI revealed significant difference in distribution of alleles at the class II loci. For DRB1, the DR3 alleles, DRB1*0301and*0302 appeared to be associated with susceptibility to stroke. The DR15 alleles, DRB1* 1501 and 1503, were protective for stroke. For the DQB1 locus, DQB1 0201 was associated with stroke, while DQB1*0602 appeared protective. Documentation of an association between HLA alleles and risk of stroke in patients with SCA suggests that HLA system plays a role in the pathophysiology of vascular changes leading to stroke

prognostic value of congestion index in patients with portal hypertension due to schistosomal hepatic fibrosis with and without chronic hepatitis C: a clinico-pathological and hemodynamic study

We intended to assess the value of congestion index of portal vein [Cl PV] [derived from the ratio between the cross-sectional area of the portal vein and the mean velocity of portal flow] in assessing the severity of portal hypertension and its correlation with North Italian Endoscopic Club [NIEC] index and risk of bleeding in patients with schistosomal hepatic fibrosis with and without chronic hepatitis C. We studied 64 patients with portal hypertension who were categorized into three groups based on histological diagnosis: group I [19 with pure schistosomal hepatic fibrosis], group II [22 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C] and group III [23 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C with cirrhosis]. All patients were of the Child class A.They were subjected to; clinical examination, stool and serological examinations for schistosoma infection, serum transaminases and alkaline phosphatase, serum albumin, prothrombin activity and virological markers. Upper endoscopy, abdominal Ultrasonography with duplex as well as liver biopsies were performed to all patients. The results showed that the mean value of Cl PV was found to be higher in groups II [0.155 +/- 0.05] and III [0.179 +/- 0.04] than in group I [0.134 +/- 0.04], which reached a significant level only between groups III and I [P<0.05]. The mean values of NIEC index and NIEC risk of bleeding were found to be significantly higher in group III [28.5 +/- 4, 18.3 +/- 6.3] respectively than in groups I [23.6 +/- 5, 10.6 +/- 7.8] and II [23.5+4, 11+6.5] [P<0.05] with no significant difference between groups I and II. The Cl PV was found to have a significant positive correlation with the degree of fibrosis as assessed by both the sonographic and the histopathologic examinations. It was also significantly correlated with NIEC risk of bleeding. We concluded that the congestion index of portal vein is a valuable non invasive parameter in assessing the severity of portal hypertension and in predicting bleeding in schistosomal patients with and without chronic hepatitis C

Helicobacter pylori mitigates upper gastrointestinal haemorrhage: trick or truth?

Upper gastrointestinal haemorrhage [UGIH] constitutes a serious health problem arising mainly from bleeding oesophageal varices [OV] or peptic ulcer disease [PUD] in Egypt.Conflicting results concerning antagonism or synergism between Helicobacter pylori [H.pylori] and UGIH deserves paramount interest .In the present case-control study 300 patients [150 bleeders and 150 non bleeders crossly-matched for age, sex, residence and endoscopic findings] were examined clinically, endoscopically and investigated for H. pylori infection in an essay to identify the relationship of H. pylori to UGIH. OV [37.3%] followed by duodenal ulcers [DU] [26%], gastric erosions [GE] [24.7%] and gastroesophageal reflux [GOR][12%] were the causes of UGIH which yielded positive connection to each of nonsteroidal antiinflammatory drugs [NSAIDs] [33/150=22%], chronic liver disease [CLD] [86/150=57%], and HCV [39/150 =26%] [P<0.05]. Strikingly H. pylori showed only an eminent inverse association with UGIH due to PUD [Z = 2.09] and NSAIDs consumption [P<0.05]. After controlling for confounders-logistic regression analysis presented H. pylori, NSAIDs and HCV as powerful effective independent factors with significant negative impact of H. pylori on UGIH [OR = 0.4, Cl = 0.4-0.86] and a positive one of NSAIDs [OR = 2.1, Cl = 1.2-3.4] and HCV [OR = 1.6, Cl = 1.1-4.0]. In conclusion our study confirmed the principal role of OV followed by PUD in causation of UGIH in addition to the increased risk of UGIH associated with NSAIDs, HCV and CLD. On the contrary H. pylori behaved as if a protective weapon against UGIH arising only from PUD [DU and GE]. No relation was found between H. pylori and UGIH from OV. In the meanwhile ulcer-like dyspepsia [ULD] and dysmotility like dyspepsia [DLD] might be a striking clinical presentation of H.pylori infection

effect of schistosoma mansoni infection on testicular lipid in mice

This study was performed to establish the changes in the level of some serum hormones [follicle stimulating hormone, FSH, leutinizing hormone, LH, and testosterone], as well as to determine the changes in the concentrations of some testicular lipid parameters [viz., total cholesterol and total triacylglycerols] of infected mice with Schistosoma mansoni for different periods of time. Electron microscopical studies were also performed to define any histological changes in the testis upon infection with S. Mansoni. The serum levels of gonadotropins [FSH, LH] showed no significant changes in infected as compared with control mice. On the other hand, the serum level of testosterone showed a significant decrease [P <0.001] in infected as compared with control mice starting from the 14th week post infection. Testicular lipids showed a significant increase [P <0.01] in the concentration of total cholesterol and a significant decrease [P <0.005] in the concentration of total triacylglycerols in infected as compared with control mice, especially at late stages of infection [14 - 20 weeks post infection]. However, electron microscopical studies showed nonsignificant histological changes in the testicular tissues of infected mice at different stages of infection

relative solubility of four glass ionomer cements

The purpose of this investigation was to determine and compare the relativesolubility of four different types of glass-ionomer cement. A sample size of20 samples [five samples for each cement] was employed in the present study. From the results obtained, it was concluded that the glass cement demonstratedthe least solubility values, followed by anhydrous and visible light curedglass ionomer cements. On the other hand, the conventional glass ionomercement was found to be the most soluble one, also it was found that, there isno significant difference in the solubility values between anhydrous andvisible light cured glass-ionomer cements

Some factors affecting the compressive strength of the gypsum-bonded investment

Gypsum-bonded investments have been widely used in dentistry for reproducing precious and semi precious cast restorations. Meanwhile, the casting of high fusing non-precious alloys such as nickel- chromium and cobalt-chromium alloys is usually performed with phosphate-bonded investments. However, some gypsum-bonded investments are used for casting nickel-chromium alloys with a relatively low fusing temperature. The main disadvantage of the phosphate- bonded investments is the reaction with the molten alloys during casting resulted in reaction products that are difficult to remove and take much effort in the finishing of the cast restorations. A sample size of 105 gypsum-bonded investment blocks [5 cm diameter and 5 cm in length] was employed in this study. The first 6 groups were mixed mechanically under vacuum while the last one was mixed by hand. After mixing, the molds were filled with the different investment mixes using the vibrator for 5 seconds, then the surface of each mold was covered by a flat smooth glass slide in order to standardize the length of each sample as well as to assure that, the base and the top surface are parallel to each others. Results revealed that, the compressive strength values decreased with the increases of burnout temperature at different treatments. Furthermore, vacuum mixing increase the compressive strength value when compared to hand mixing. Samples obtained by proper mixing under vacuum with low W/P ratio provided the maximum compressive strength values at 900 degree F. burnout temperature. On the other hand, the maximum strength values were obtained at 1100 degree F. burnout temperature when samples were prepared with paper water/ power ratio and short mixing time under vacuum. Vacuum performed before, during and after mixing resulted in the maximum compressive strength values at 1350 degree F. High W/P ratio reduced the compressive strength of the gypsum-bonded investment at various burnout temperatures