Serum levels of leptin and adiponectin in patients with nonalcoholic fatty liver disease: potential biomarkers

Nonalcoholic fatty liver disease [NAFLD] occurs in 60% -95% of people with obesity. Understanding the pathogenesis of NAFLD is of great importance in ultimately finding a treatment, cure or prevention of this disease. The present study aimed to investigate the role of adipocytokines [leptin and adiponectin] in NAFLD and correlate them with different anthropometric and clinical variables as well as to investigate the relationship between high-sensitivity C-reactive protein [hs-CRP] and NAFLD. Thirty patients [9 males and 21 females] with NAFLD [their diagnosis was based on ultrasonographic finding of bright liver]. Their age was [Mean +/- SD] 38.00 +/- 10.42 years. A control group included fifteen healthy volunteers, who was gender, age and BMI matched. Serum levels of leptin, adiponectin, [hs- CRP], and lipid profile were assayed. NAFLD patients showed significantly higher BMI, AST/ALT ratio, serum levels of total cholesterol, triglycerides, LDL-C, serum NEFFA levels, serum hs-CRP levels and significantly lower serum HDL-C and adiponectin levels in comparison to controls. Among NAFLD patients; these changes were significantly high in females than male patients. Serum leptin levels showed no significant difference between patients and controls. NAFLD patients with BMI >/= 30 and those with AST/ALT ratio >/= 1 showed significantly higher serum levels of NEFFA, leptin, hs-CRP and significantly lower serum levels of adiponectin in comparison to those with BMI<30 and AST/ALT ratio <1. To date adiponectin and hs-CRP has yielded the most promising results. Serum leptin has contradictory results so can not be used as a marker of NAFLD

suggested algorithm for using serum biomarkers for the diagnosis of liver fibrosis in chronic hepatitis C infection

Hepatitis C virus infection [HCV] is endemic in Egypt. Liver biopsy is the gold standard for diagnosis and staging of fibrosis in chronic hepatitis C patients. However, it is invasive, associated with sampling error and poses potential complications. A non-invasive alternative is needed. This assessed the accuracy of certain biochemical markers and ultaronography in predicting the stage of fibrosis in chronic hepatitis C patients. Sixty five patients with chronic HCV were enrolled. Ultrasonographic examination, complete blood count and liver function tests were done. Serum levels of hyaluronic acid [HA] and YKL-40 [a 40-kDa glycoprotein produced by stellate cells] were determined. Liver biopsy was done. Fibrosis was correlated with biochemical markers and ultrasonographic findings. Histopathological examination showed that 39 patients [60%] had F1, nine [14%] had F2, 17 [26%] had F3 and none had F0 or F4 scores. A value of alanine aminotransferase [ALT] index <0.38, HA <9.7 ng - ml[-1] or portal vein [PV] cross-sectional area <25.8 mm[2] excluded significant fibroses [>/= F2]. A value of aspartate aminotransferase [AST] + ALT<39.5 or ratio of AST index to the platelet count [APRI] <0.235 or HA x 100 per platelet [Plt] < 9.534 excluded the presence of advanced fibrosis with 100% negative predictive value [NPV]. Using these values, advanced fibrosis could be excluded in 72% of our patients. An APRI value of >/= 1.1 can diagnose advanced fibrosis with 100% positive predictive value [PPV] in 10%of our patients. Hence, only 18% of our patients in whom liver biopsy was recommended were not classified by these parameters. YKL-40 did not help in the diagnosis of advanced fibrosis. Applying a simple algorithm based on ALT, AST, platelet count, PV cross-sectional area, in addition to HA level may eliminate the need for liver biopsies in more than 80% of chronic HCV patients

Psychiatric profiles in patients with liver cirrhosis

Psychiatric disorders are common comorbidities in patients with liver cirrhosis that may impair patients' quality of life. The purpose of this study was to evaluate the common psychiatric disorders in cirrhotic patients in our locality. Subjects and Psychiatric disorders were prospectively assessed by administration of Symptom Checklist-90 revised [SCL-90-R], Hamilton anxiety rating scale, and Hamilton Checklist of Symptoms of depressive illness to 200 patients with liver cirrhosis and 200 control volunteers of matched age. In addition, clinical data, abdominal ultrasonography and laboratory data [liver function tests for patients] were collected. Results. Compared with controls, cirrhotic patients were significantly more likely to have depression [43.5% versus 14%, P< 0.001], anxiety [16.5% versus 5.5% P< 0.001] and increased mean scores of SCL-90-R subscales ['e.g. somatizalion, depression and hostility,]. Increasing severity of liver cirrhosis [based on the Child-Pugh score] was associated with increased frequency of Psychiatric disorders. Compared with the control group, patients with liver cirrhosis showed significantly higher frequency of comorbid psychiatric disorders which is increased by worsening disease severity

Screening for human brucellosis in Sohag farms

Brucellosis is a zoonotic disease that exists worldwide. Several studies were conducted in different governorates, e.g. Menofia, Dakahlia, Giza, Assiut, to estimate the prevalence of brucellosis, but little is known about the problem in Sohag Governorate. The aim was to estimate the frequency of brucellosis in farm workers in Sohag Governorate using ELISA test and to treat positive cases. This study involved 141 persons [91 persons from three farms in Sohag Governorate [high risk group] and 50 persons, who have no contact to animals [control]]. Through this study complete clinical examination, ultrasound examination and complete blood count and ELISA test for brucellosis were done to all persons. The results revealed that the frequency of seropositivity to brucellosis was found to be 12% in the three farms as a whole [13.5% in Faculty of Agriculture Farm, 13% in El-Dyabat Farm and 0% in Shandaweel]. It was concluded that brucellosis is not uncommon among farm workers in Sohag Governorate. Animal vaccination and regular examination for detection of diseased animals was recommended. Health education of workers is of great importance to minimize the transmission of the disease