Alphafetoprotein in screening for congenital hypothyroidism.

This study was conducted on 500 full-term neonates and 25 older patients with congenital hypothyroidism (CH), newly or previously diagnosed. Alphafetoprotein (AFP) was elevated in two neonates. In one, persistent elevation of AFP and thyroid stimulating hormone (TSH) with low thyroxine (T4) were found (congenital hypothyroidism). In the other, AFP, TSH and T4 levels normalized (transient hypothyroidism). The mean AFP level in new CH patients was significantly higher than in previously diagnosed patients, and was higher in CH patients than in controls. Significant relationships were found between AFP and T4, AFP and TSH, and AFP and age. AFP is a sensitive indicator of thyroid status and can be used as a screening test for hypothyroidism from the first day of life and in follow-up of CH patients.

Experience with interferon in chronic hepatitis B in Egypt.

Forty patients with compensated chronic active hepatitis B and elevated aminotransferases who were HBsAg and HBeAg positive were randomised to a treatment group receiving recombinant interferon alpha-2b (rIFN alpha-2b) or no treatment as a control group. The treated patients were divided into 2 groups, group I (n = 12) received IFN in a dose of 5 MU/m2 thrice weekly by subcutaneous injection for 16 weeks, and group II (n = 8) received the same dose daily for the same duration. Patients were followed up for 12 months after therapy ended. Initiation of IFN therapy was associated with an increase in aminotransferases, reaching a peak at 4-6 weeks in most patients, associated with clearance of HBeAg. At end of follow-up, 81% of the treated patients had cleared HBeAg vs 33% of the control group (p less than 0.01). Changes in other HBV markers were more frequent in the treated patients, though insignificantly. The type of response to therapy was significantly related to the duration of illness, being shortest in those who cleared HBsAg. A complete response to therapy with loss of HBsAg was associated with marked reduction in biochemical and histological activity. A partial response with clearance of HBeAg was associated with moderate improvement in biochemical parameters and ongoing activity in liver histology; whereas persistence of HBeAg was associated with elevated aminotransferases and histological deterioration in most cases. The rise in aminotransferases during seroconversion was associated with hepatic decompensation and death on 3 occasions: one during spontaneous seroconversion, and the other 2 during IFN therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

The pattern of antimicrobial use in general hospitals in Egypt.

This work was carried out to study the pattern of use of antimicrobial agents in Egypt. 2034 files were selected from two general hospitals by a systematic random sampling method, and the data concerning the antimicrobials were collected from each file. The results of this study showed that there was misuse of these agents both in therapy and prophylaxis. Antibiotics were prescribed to 80.17% of admitted patients. In most of the cases they were prescribed without documented proof of infection and were prescribed for conditions in which antimicrobial use is not justified for either therapy or prophylaxis. Among patients who received antibiotics, 30.8% received repeated courses, in most of whom there was no reasonable indication.

Interferon in chronic active hepatitis B. Preliminary results.

Twenty patients with documented chronic active hepatitis B were randomized in equal numbers to either an alpha-2b interferon treatment group or a control group with no treatment. Patients in the first group received 5 IU interferon three times weekly by subcutaneous injection for 16 weeks. All 20 patients were HBeAg positive at the beginning. All 10 patients in the interferon-treated group lost their initial e antigen while only 2 patients in the control group turned HBeAg negative. Six patients in the treated group acquired HBe antibodies in comparison with two patients only in the untreated group. Other markers of suppression of viral replication as well as a 24-month follow-up are ongoing at the moment for final assessment of the value of interferon therapy in chronic active hepatitis B.

Enhancement of dissolution rate of hydrochlorothiazide via solid dispersion.

Solid dispersions of hydrochlorothiazide (1) in mannitol (2) and in dihydroxypropyltheophylline (3) were prepared by melting and solvent methods. For both systems, phase diagrams of simple eutectic type were obtained. A significant increase in dissolution rate was observed for 1/2 and 1/3 physical mixtures and solid dispersion as compared to pure drug. Solubility of 1 in 2 and in 3 solution at 27 degrees C and 37 degrees C was studied. At 37 degrees C the water solubility of the drug increased 3.7 times using 0.4 mol X 1(-1) 3. The solubilization of the drug by 3 in water was due to the formation 1 : 1 soluble complex. 1 tablets from physical mixtures and solid dispersion were prepared. Effect of ageing on the physical properties of the prepared 1 tablets was investigated.