Clinical, Biochemical, Histological and Virological Effect of·Dimthylene Dioxy Biphenyle Dicarboxylate [DOB] in Patients with Compensated Chronic Hepatitis C

Background: chronic liver disease is a major cause of mortality and morbidity in Egypt. D.D.B. was found to improve the abnormal liver function tests in those patients. Since then it has been used in the management of chronic liver disease, yet clinical improvement and changes in the biochemical and pathological examination are still considered study questions

Objectives: to evaluate the efficacy and side effects of D.D.B. compared to Silymarine in wells compensated patients with chronic HCV infection

Method: the study population included 50 patients with compensated chronic HCV infection subdivided into two groups 25 patients each. One group received D.D.B. for 48 weeks and the other received Sily-marine for the same period of time. Each patient was subjected to assessment of the liver function tests, virological studies, abdominal ultrasound, isotope liver scan, liver biopsy and rectal snip before starting the treatment. Further evaluation was performed by repeating the liver function tests every 3 months, the abdominal ultrasound every 6 months, the rest of the tests and the liver biopsy were repeated after one year i.e. at the end of treatment

Results: sustained normalization of ALT level and transient normalization of the AST level was found in the DDB group. No significant effect on the. HCV RNA, level was detected after one year of D.D.B. therapy; in none of the patients did the HCV RNA become undetectable. The liver-splenic ratio in the iso-topic studies showed significant decrease after one-year therapy with D.D.B. The grade of inflammation was unchanged in 10 cases, worse in 11 cases and better in 3 cases while fibrosis was unchanged in 22 cases and worse in 2 cases. No major side effects were observed in either group of patients

Conclusion: DDB has no antiviral effect in patients with chronic HCV infection. It does not show a histological benefit [neither in terms of degree of necroinflammation nor stage of fibrosis] after 1 year of treatment and when compared to Silymarin. On the other hand it improves some biochemical parameters [ALT] as well as the general well being of the patients. It has no major side effects

Nitric oxide concentrations and its inducible synthase gene expression in nephrotic syndrome patients

Background: nitric oxide [NO] plays an important regulatory and modulatory role in a variety of inflammatory conditions. However, its role in nephritis is controversial. The aim of the present study is to assess nitrite levels and expression in nephrotic patients

Patients and methods: thirty-seven patients of both genders [9 males and 28 females] with mean age of 23.86 years who had nephrotic syndrome. We excluded diabetic patients and those who had secondary nephrotic syndrome apart from lupus nephritis. Ail patients were subjected to a thorough clinical and laboratory evaluation profile besides estimation of urinary and serum nitrite and determination of the expression of inducible NO gene in their blood. All of them were subjected to renal biopsy

Results: in comparison to a normal control, our patients showed statistically significant elevated levels of urinary and serum nitrite concentrations. Moreover, our patients showed inducible nitric oxide gene expression in the blood of 67.5 % of them compared to zero % in the control group [p<0.001]. Further analysis of idiopathic nephrotic syndrome group showed that steroid resistant patients had a statistically significant higher urinary nitrite level than steroid dependent ones with no significant difference in serum nitrite and blood iNOS gene expression

Conclusion: nephrotic syndrome patients had a significant inducible nitric oxide synthase mRNA gene expression and elevated urinary, serum nitrite levels. Prospective studies to evaluate therapies targeting NO may be warranted in this sector of patients

role of parenteral iron therapy in treating the chronic hemodialysis associated anemia, a comparative study between iron saccharate and gluconate

Anemia in hemodialysis patients is a complex syndrome and many factors other than absolute or relative erythropoietin [EPO] deficiency may contribute to it. The most important factor is the presence of iron depletion. The impetus of this study was to assess the safety and efficacy of iron saccharate complex [ISC] and sodium ferric gluconate complex [SFGC] as relatively new parenteral iron preparations in treating anemia in hemodialysis patients. Forty-eight adult anemic patients of both genders [33 males and 15 females] who had an adequate level of both hemodialysis and nutrition status and received neither EPO nor parenteral iron therapy during the preceding 6 months were randomized into two groups. The first group, comprised 22 patients who were treated with parenteral ISC, 100 mg twice weekly for two months and once weekly thereafter. The second group included 26 patients who received SFGC, 62.5 mg twice weekly for two months and once weekly thereafter. The patients were followed up for 6 months. Our results showed that iron stores had been adequately repleted by the use of both parenteral iron formulas. Repletion of iron stores was associated with a significant rise of both hemoglobin and hematocrit% in both groups at the end of follow up period in comparison to their initial values at the start of the study [P < 0.001]. Both parenteral iron therapy preparations were tolerated and comparable with no statistical difference between both groups. Parenteral iron saccharate and gluconate are effective and sale treatment of anemia associated with chronic hemodialysis patients provided that they had an adequate level of both dialysis and nutrition