Helicobacter pylori and acne vulgaris: is there a relationship?

BACKGROUND: Helicobacter pylori (H. pylori) is a gastric Gram-negative, spiral-shaped microaerophilic pathogen. H. pylori may play a potential pathogenic role in extra-intestinal diseases such as hepatobiliary, respiratory, and dermatological disorders. The latter included chronic urticaria, psoriasis and rosacea. The first report in literature on the relationship between H. pylori and acne vulgaris (AV), found association between severe AV and H. pylori infection. There are very limited data in AV patients addressing the impact of H. pylori infection on various severities. In this context, the aim of the present work was to determine the association of H. Pylori infection among AV patients and correlate it with the disease severity. METHODS: This case-control study included 45 Patients with AV and 45 age and sex matched healthy volunteers as a control group. H. pylori antigen in stool and serum H. pylori antibody IgG using commercially available ELISA kits was tested in all included subjects. RESULTS: The percentage of participants with a positive H. pylori antigen in stool and positive H. pylori antibody in serum in the whole study population was 35/90 (38. 9%) and 41/90 (45. 6%). On comparing between the percentages of positive H. pylori antigen in stool and positive H. pylori antibody in serum between the patients with AV and healthy controls, a highly statistically significant difference was found between the two groups (P < 0.001, P = 0.006). On comparing between the percentages of positive H. pylori antigen in stool and positive H. pylori antibody in serum in the patients with different grades of acne severity and healthy controls, the rate of positive H. pylori antigen in stool and positive H. pylori Ab in serum was significantly associated with severity of acne comparing with healthy controls (p < 0. 001). CONCLUSION: The rate of H. pylori infection in patients with AV is high so it may influence the pathogenesis of this skin disease. Patients with severe AV had higher rates of H. pylori antigen in stool and H. pylori antibody in serum as compared to the patients with mild AV and healthy controls.

Can Serum Fetuin-A be Used as a Marker for Cardiovascular Involvement in Psoriatic Patients?

Background: Psoriasis is a systemic inflammatory disorder. It is associated with increased risk of developing other chronic health diseases such cardiovascular disorders. Fetuin A is a glycoprotein that is present in blood serum. It may prevent vascular calcification by forming calciprotien particles; which are formed from their attachment with phosphate and calcium complexes. Aim: The aim of this study was to measure serum Fetuin A in Psoriatic patients and correlate its level with cardiac events and risks in these patients using CT calcium (Ca) scoring. Patients and Methods: 24 psoriatic patients (healthy without apparent cardiac risks to detect subclinical events if present) and 24 age and sex matched controls were tested for serum Fetuin A and underwent coronary calcium scoring by multidetector computed tomography (CT) scan. Psoriasis area and severity index (PASI) score for each patient was measured and was correlated with serum Fetuin A and CT calcium (Ca) scoring. Serum Fetuin A was compared between cases and controls and was correlated with coronary calcium score. Results: There was highly statistically significant decrease in serum Fetuin A level in psoriatic group compared to control group (P-value < .001). There was highly statistically significant negative correlation between calcium score and the level of serum Fetuin A (P-value < .001). No statistically significant correlation was found between the serum level of Fetuin A and the psoriasis severity. Conclusion: Serum Fetuin A is a simple, easy diagnostic tool to evaluate subclinical atherosclerosis in psoriatic patients.

Polyethylene glycol capped gold nanoparticles ameliorate renal ischemia-reperfusion injury in diabetic mice through AMPK-Nrf2 signaling pathway.

The aim of this study is to investigate the protective effect of polyethylene glycol capped gold nanoparticles (PEG-AuNPs) on renal ischemia-reperfusion injury (I/R)-induced acute kidney injury (AKI) in diabetic mice via the activation of adenosine 5' monophosphate-activated protein kinase-nuclear factor erythroid-2-related factor-2 (AMPK-Nrf2) pathway. Diabetes was induced in male mice (12/group) by streptozotocin (50 mg/kg) for 5 consecutive days. After 4 weeks, the mice have intravenously received doses of PEG-AuNPs (40, 150, and 400 µg/kg body weight) for 3 consecutive days, and then animals were subjected to 30 min ischemia and 48 h reperfusion. Following the treatment with three different doses of PEG-AuNPs, the levels of blood urea nitrogen (BUN) and creatinine were reduced. Obvious reduction in renal tubular atrophy, glomerular damage, mitochondrial damage, and necrotic area were ultra-structurally detected, and renal interstitial inflammation and apoptosis were diminished. Moreover, PEG-AuNPs increased the recovering of damaged renal cells, suppressed significantly levels of malondialdehyde (MDA), downregulated significantly the level of inflammatory cytokines (TNF-α and IL-1ß), and upregulated the AMPK-Nrf2 pathway. PEG-AuNPs exhibited a promising alternative therapeutic target for diabetic renal I/R-induced AKI through upregulation of AMPK/PI3K/AKT path which additionally stimulated Nrf2-regulated antioxidant enzymes in a dose-dependent manner.

The Emerging Era of Interventional Imaging in Rheumatology: An Overview During the Coronavirus Disease-2019 (COVID-19) Pandemic.

Imaging has long been taking its place in the diagnosis, monitor, and prognosis of rheumatic diseases. It plays a vital role in the appraisal of treatment. Key progress in the clinical practice of rheumatology is the innovation of advanced imaging modalities; such as musculoskeletal ultrasound (MSUS), computerized tomography (CT) and magnetic resonance imaging (MRI). These modalities introduced a promising noninvasive method for visualizing bone and soft tissues to enable an improved diagnosis. The use of MSUS in rheumatology is considered a landmark in the evolution of the specialty and its ease of use and many applications in rheumatic diseases make it a forerunner instrument in the practice. The use of MSUS among rheumatologists must parallel the development rate of the excellence revealed in the specialty. Moreover, innovative interventional imaging in rheumatology (III-R) is gaining fame and key roles in the near future for a comprehensive management of rheumatic diseases with precision. This review article throws light on the emergence of these robust innovations that may reshape the guidelines and practice in rheumatology, in particular, efforts to enhance best practice during the coronavirus disease 2019 (COVID-19) pandemic are endorsed.

Taurine Upregulates miRNA-122-5p Expression and Suppresses the Metabolizing Enzymes of Glycolytic Pathway in Hepatocellular Carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is a complicated disease with a poor prognosis and high mortality rates. The prevention, control, diagnosis, and treatment of liver cancer have become vital focuses in healthcare research. AIM: This study aimed to evaluate the in vitro effect of taurine (Tau) on the expression of miR-122-5p that targets some limiting glycolytic enzymes and affects the overall glycolytic pathway in HepG2 cells. METHOD: IC50 and the inhibitory effect of Tau on cell proliferation were measured after 48 h by MTT assay. Then, the mRNA expressions of some apoptosis-related genes P53, BAX, Caspase-3, and Bcl-2 were measured using quantitative real-time (qRT-PCR) and the protein levels were confirmed by enzyme-linked immunosorbent assay (ELISA). The activities of some antioxidant's biomarkers were assessed. The gene expression of miR-122-5p that targets some limiting glycolytic enzymes; Aldolase and Lactate dehydrogenase (LDH), were evaluated after treatment with Tau for 48 h. RESULTS: A Significant inhibition in the proliferation of HepG2 was encountered after treatment with Tau in a dose-dependent manner. Moreover, the expression of apoptotic genes p53, Bax, and Caspase-3 exhibited a significant upregulation, while Bcl-2 showed a significant downregulation. These alterations in the expression levels were also confirmed on the protein level. The antioxidant activities of GPx, CAT, and NO were significantly elevated versus untreated control. Also, a significant increase in the expression level of miR-122-5p was observed after treatment with Tau affecting the metabolic activity of HCC cells. Concomitantly, a significant inhibition in ALDOA protein and the hallmark of glycolytic enzymes LDH and Aldolase were observed. CONCLUSIONS: These observations showed that taurine inhibits HepG2 cell proliferation and restores the expression of miR-122-5p which inhibits the hallmark glycolytic enzymes and ultimately the metabolic activity of HCC cells. Tau is assumed to be a promising and effective antitumor therapy of HCC.

Assessment of serum interleukin-19 in acne vulgaris patients of different clinical severities.

BACKGROUND: Acne vulgaris (AV) is a common chronic inflammatory disorder of the pilosebaceous unit among adolescents and young adults. Inflammation does have a central role in formation of both inflammatory and noninflammatory acne lesions with production of proinflammatory cytokines. AIMS: To measure serum levels of interleukin 19 (IL-19) in acne vulgaris patients with different severities, and compare it with healthy controls, to evaluate its role in pathogenesis of acne vulgaris and correlate it with acne severity. MATERIALS AND METHODS: This study included 120 subjects, aged 18-30 years, divided into four groups, 30 in each; mild, moderate, and severe AV patients groups according to acne severity as well as apparently healthy controls group of matched age and sex with no previous history of acne or active acne. Each patient was subjected to history taking, general and dermatological examination with assessment of acne severity. Serum IL-19 levels of both patients and controls were also measured using quantitative enzyme-linked immunosorbent assay (ELISA). RESULTS: Results revealed significant difference in serum IL-19 levels between acne patients and controls, being higher in the former group (P value is < 0.001). Moreover, the rise in serum IL-19 levels was significantly proportional to the increased acne severity (P value < 0.001). CONCLUSION: IL-19 is related to the etiopathological inflammatory process of acne vulgaris and correlates with acne severity. It could be proposed as a prognostic inflammatory marker for acne vulgaris.

Chitosan protects liver against ischemia-reperfusion injury via regulating Bcl-2/Bax, TNF-α and TGF-ß expression.

The study aimed to investigate the potential attenuation effect of chitosan in liver ischemia/reperfusion injury (I/R), and its relevant protective mechanisms. Chitosan (200 mg/kg) has been administered orally for 30 days, later animals underwent liver 45 min ischemia and reperfusion for 60 min. Following treatment with chitosan, the levels of serum aminotransferases and lactate dehydrogenase were significantly reduced. Similarly, hepatic (GSH, SOD, CAT, GST and GPx) were enhanced, and the level of tissue malondialdehyde (MDA) was decreased. In addition, inflammatory cytokinesis (TNF-α and TGF-ß) have recorded a significant decrease in their mRNA expression and protein levels using qPCR and ELISA respectively. Marked reduction of apoptosis has been indicated by the elevation in BCL2, and decreasing in BAX, Caspace-3 and Cytochrome-c expression levels, which furthermore confirmed by DNA fragmentation assay. The enhancement of the previous parameters resulted in a marked improvement in the liver architectures after chitosan administration. In conclusion, chitosan has proved its efficiency as an anti-inflammatory and antioxidant agent through its inhibitory effect of cytokines and reducing ROS respectively. In addition, chitosan could modulate the changes in histological structure and alleviate apoptosis induced by liver I/R, which recommend it as an efficient agent for protection against liver I/R injury.

Novel approach for pathogenesis of osteoporosis in ovariectomized rats as a model of postmenopausal osteoporosis.

BACKGROUND: Obesity and osteoporosis are two chronic conditions that have been increasing in prevalence. Menopausal transition years place women at high risk for visceral obesity as well as osteoporosis. This study was carried out to elucidate the effect of visceral adiposity on ovariectomy-induced osteoporosis in rats. METHODS: We studied female Wistar rats aged 12-14 months, divided into four groups: a) Sham-operated control (SHAM) rats (n = 12), rats were fed a control diet (59% of food intake from carbohydrates, 7% from fat, 21% from protein, 13% from minerals and ash) for 12 weeks, b) High fat diet-fed control (HFD) group (n = 9), rats were fed a high fat diet (49% of food intake from carbohydrates, 17% from fat, 21% from protein, 13% from minerals and ash)for 12 weeks, c) Ovariectomized (OVX) rats (n = 14), rats were fed a control diet as SHAM rats, d) High fat diet- fed ovariectomized (OVX- HFD) rats (n = 13), rats were fed a high fat diet as HFD group. At the end of the experiment, blood samples were collected for calcium, phosphorus, and alkaline phosphatase (ALP) assays. Unilateral left perirenal fats were surgically removed and weighed. Specimens from right perirenal fats and tibia were isolated and processed for histological examination. Histomorphometric analysis of the tibia and visceral adipose tissue was also performed. RESULTS: OVX, HFD, and OVX-HFD rats showed a significant increase in relative visceral fat weight, and plasma ALP, and a significant decrease in plasma calcium, and phosphorus levels compared to SHAM rats. Light microscopic examination of the tibia of the OVX rats revealed a significant decrease in the cortical bone thickness (CBT) and the trabecular bone thickness (TBT), and a significant increase in bone marrow adipose tissue compared to SHAM rats. In addition, there was a significant increase in the osteoclast number, and a significant decrease in the osteoblast number. The changes in bone marrow adipose tissue as well as osteoclast number were further accentuated in OVX-HFD groups. CONCLUSIONS: Visceral obesity played a crucial role in the development of osteoporosis in ovariectomized rats through effects that might involve both osteoblasts and osteoclasts.

Selenium and L-Carnitine Ameliorate Reproductive Toxicity Induced by Cadmium in Male Mice.

Cadmium (Cd) has been reported to reduce male fertility, impair reproductive capacity, and play a major role in the pathogenesis of infertility. This study was conducted to investigate the possible protective role of Selenium (Se) and L-carnitine (LC) against the adverse effects induced by Cd on the male reproductive system in mice. Animals were randomly divided into seven groups (n = 10); control group and six treated groups, as follows: Cd (0.35 mg/kg), Se (0.87 mg/kg), LC (10 mg/kg), and a combination of either Se or LC and then a combination of both with Cd, and all animals were injected for a period of 30 days. Exposure of Cd showed a significant decrease in enzymatic antioxidant activities, deficiency in reproductive performance, decrease serum testosterone level, severe changes in the histopathological architecture, and higher degree of damages and appearance of unblemished DNA strands. Treatment with Se and LC has the highly synergistic and ameliorates the damaging effect of Cd on the testis through the elevation of the enzymatic antioxidant and diminish histopathological abnormalities and DNA damage.

The dermoscopic features of facial aging among Egyptians: A comparative study between males and females.

BACKGROUND: Few studies have evaluated facial photoaging by dermoscopy. Only one study has been performed among Egyptians. OBJECTIVE: To study and compare the dermoscopic features of facial aging in males and females and to relate these features to clinical criteria. METHODS: This study included 217 subjects divided into two groups; 117 males and 100 females. Each group was classified into three subgroups according to age. The dermoscopic features were reported according to dermoscopy photoaging scale (DPAS) criteria besides diffuse erythema and seborrheic keratosis and were related to significant clinical factors. RESULTS: The most prominent DPAS features in males were yellowish discoloration, hypo-hyperpigmented macules, superficial wrinkles, criss-cross wrinkles, and deep wrinkles. The most prominent DPAS findings in females were yellow papules, hypo-hyperpigmented macules, solar lentigo, and superficial wrinkles. A significant difference between males and females was detected regarding yellowish discoloration, white lines, hypo-hyperpigmented macules, senile comedones, telangiectasia, all wrinkle types, and DPAS score besides diffuse erythema and seborrheic keratosis. The DPAS score and the dermoscopic features were more prominent with male gender, increase in age, sun exposure, Glogau's scale, and smoking and were detected early in skin phototypes II and III. CONCLUSION: We found a significant difference in various dermoscopic features in males compared to age-matched females. Also, we detected increase in DPAS features and score with male gender, aging, sun exposure, Glogau's scale, and smoking. Therefore, dermoscopy is an objective technique that detects selectively photoaging in males and females that aids in proper choice of various targeted treatment modalities.

Promising therapeutic effect of gold nanoparticles against dinitrobenzene sulfonic acid-induced colitis in rats.

Aim: The aim of this study is to evaluate the therapeutic effect of two different doses of naked gold nanoparticles (AuNPs) in the experimental colitis in rats. Materials & methods: Colitis was induced in rats by single intracolonic instillation of dinitro-benzene sulfonic acid (250 µl DNBS-25 mg/rat). 4 days later the rats were intravenously injected with a single dose of AuNPs 40 and 400 µg/kg of size 16-25 nm. Results: In comparison with dinitro-benzene sulfonic acid-colitis group, the exposure to AuNPs for 72 h ameliorated the liver and kidney functions, increased the regenerative capacity of damaged colon tissues, suppressed the inflammatory cytokine response and diminished the colonic malondialdehyde and myeloperoxidase activities. In addition, there was a remarkable improvement in the antioxidant defense system. Conclusion: Our study suggested a new therapy for experimental colitis without noticeable drawbacks.

Therapeutic efficacy of osthole against dinitrobenzene sulphonic acid induced-colitis in rats.

Several mediators were associated with the pathogenesis of inflammatory bowel disease such as oxidative stress through the production of reactive oxygen metabolites, neutrophils infiltration and release of pro-inflammatory cytokines. This study was designed to investigate the therapeutic efficacy of osthole against dinitrobenzene sulfonic acid (DNBS) induced-colitis in rats through its anti-oxidant and anti-inflammatory properties. Colitis was induced in rats by single intracolonic instillation of (250 µl DNBS-25 mg/rat). Then 4 days later, rats were received oral administration of either (osthole 50 mg/kg), (sulfasalazine 500 mg/kg) or both in combination for 7 consecutive days. Body weight, some hematological parameters, colonic malondialdehyde (MDA) and myeloperoxidase activity (MPO), antioxidant parameters, colon injury and mucosa architectures were assessed. T helper (Th1)-related cytokines [Tumor necrosis factor alpha (TNF-α) and interferon-gamma (INF-γ)], Th2-relarted cytokines (interleukin-4 [IL-4 and IL-10], and Th-17 related cytokines [IL-17] were determined by ELISA. Osthole significantly improved the loss in body weight. That was accompanied with a remarkable amelioration of the disruption of the colonic architecture as well as a significant improvement in the antioxidant defense system. A reduction in MPO and MDA was observed in flamed colon. Treatment with either osthole or combination therapy showed suppressive activities on pro-inflammatory Th2-related cytokines and upregulation of anti-inflammatory Th2-related cytokines The results of this study suggest that osthole exert beneficial therapeutic effect in experimental colitis and improved the efficacy of the synthetized drugs such as sulfasalazine. Therefore, osthole may have a valuable sound in the treatment of inflammatory bowel disease.

Protective effects of Balanites aegyptiaca extract, Melatonin and Ursodeoxycholic acid against hepatotoxicity induced by Methotrexate in male rats.

OBJECTIVE: To compare the degree of ameliorative effects of Melatonin (MEL), Ursodeoxycholic acid (UDCA) and Balanites aegyptiaca (BA) against hepatotoxicity induced by MTX for one month. METHODS: Eighty adult male rats (Sprague Dawely) weighing (190 ± 10 g), were randomly divided into eight equal groups: Control, MTX, MEL, BA, UDCA, MTX + MEL, MTX + BA, MTX + UDCA. Liver function biomarker enzymes, liver tissue oxidative stress parameters, together with total antioxidant capacity and tumor necrosis factor (TNF-α) were determined. Histopathological and immunohistochemistry examinations for TNF-α were also done. RESULTS: MTX showed significant increase in alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total and direct bilirubin, as well as TNF-α levels, oxidized glutathione (GSSG), malodialdehyde (MDA) and nitric oxide (NO). Whereas total protein, albumin, total antioxidant capacity, reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST), superoxide dismutase (SOD) and catalase (CAT) levels were significantly decreased in MTX treated group. These alterations were improved by MEL and BA treatment, whereas no improvement was noticed in UDCA treatment. CONCLUSIONS: BA may be as promising as MEL in the hepatoprotection against MTX toxicity through their antioxidant and radical scavenging activities. In addition, it is not recommended to co-administer UDCA with MTX as it enhanced inflammation and damage to the liver.

Mechanism underlying methyl eugenol attenuation of intestinal ischemia/reperfusion injury.

Intestinal ischemia/reperfusion (I/R) injury is associated with a high risk of mortality in the clinical situation. Many factors are involved in I/R, including reactive oxygen species, cytokine release, and apoptosis. We aimed to determine whether a pure methyl eugenol (ME) given before intestinal ischemia, protects against intestinal I/R injury and the possible mechanism involved in this protection. Rat received ME (100 mg/kg) for 30 days then underwent intestinal I/R with 30 min ischemia and 60 min reperfusion. Serum lactate dehydrogenase (LDH) level, tissue malondialdehyde (MDA), as well as some antioxidant biomarkers were assessed, while the serum level of tumor necrosis factor alpha (TNF-α) was determined by ELISA. The change in TNF-α and interleukin 6 (IL-6) gene expressions were evaluated and confirmed by assessing protein level of TNF-α in the intestinal tissue by immunohistochemistry. Apoptosis was evaluated using DNA-laddering assay and by detecting caspase-3 immunohistochemically. Administration of ME prior to I/R injury resulted in a modulation of the production of MDA, LDH, and nitric oxide and restoration of the tested oxidative stress biomarkers. Pretreatment with ME downregulated messenger RNA of TNF-α and IL-6 inflammatory cytokines and their protein expressions in I/R rats. Marked inhibition of the apoptotic DNA and improvement of the architectures of small intestine were observed after pretreatment with ME. ME exhibits a protective effect against intestinal I/R via amelioration of the oxidative stress and inflammatory cytokines gene expression. Therefore, the supplementation of ME prior to intestinal I/R might be helpful in the attenuation of I/R complications.

HIV stigma intervention in a low-HIV prevalence setting: a pilot study in an Egyptian healthcare facility.

This pilot study is the first to evaluate stigma-reduction intervention in a healthcare setting in Egypt and in the Middle East and North Africa region. It also contributes to knowledge on how to address stigma in low-HIV prevalence settings. A quasi-experimental study design was used to evaluate the effect of anti-HIV stigma intervention in one hospital in Egypt. A control hospital was selected and matched to the intervention hospital by type, size and location. The intervention focused on HIV-related stigma, infection control and medical ethics. Stigma was measured at baseline and at three months post-intervention. A standardized, 10-point scale was developed to measure stigmatizing attitudes and fear-based stigma among participants. Comparisons of overall and job-stratified stigma scores were made across the intervention and control hospitals, before and after the intervention, using two-sample t-test and multivariate regression analysis. Mean stigma scores did not reveal significant differences between the intervention and control hospitals at baseline. After intervention, the overall value-based and fear-based stigma scores were significantly lower in the intervention hospital compared to the control hospital (2.1 and 1.1 compared to 3.8 and 3.2, respectively; p < .001). Context-specific and culturally appropriate HIV stigma-reduction interventions in low-HIV prevalence settings can reduce fear-based and value-based stigma among physicians and nurses.

HIV Stigma Toward People Living With HIV and Health Providers Associated With Their Care: Qualitative Interviews With Community Members in Egypt.

We explored perceived HIV stigma by community members in a low-HIV-prevalence setting toward people living with HIV (PLWH) and physicians associated with HIV in order to develop operational stigma reduction recommendations for HIV referral hospitals. In-depth interviews (N = 30) were conducted with educated and less-educated men and women in Egypt. Thematic analysis was applied to identify drivers, manifestations, and outcomes of stigma. Stigma toward PLWH was rooted in values and fears, manifesting in reluctance to use the same health facilities as PLWH. Stigma toward physicians providing care for PLWH was caused by fear of infection and developed into unwillingness to use those physicians' services. Stigma toward physicians who refused to provide care was linked to perceptions of unethical behavior. HIV referral hospitals in low HIV prevalence settings could benefit from stigma reduction interventions with a special focus on addressing moral-based stigma and fear of casual transmission.

Antioxidant Effect of Sepia Ink Extract on Extrahepatic Cholestasis Induced by Bile Duct Ligation in Rats.

OBJECTIVE: The aim of our study was to assess the complications of hepatic fibrosis associated with bile duct ligation and the potential curative role of sepia ink extract in hepatic damage induced by bile duct ligation. METHODS: Rattus norvegicus rats were divided into 3 groups: Sham-operated group, model rats that underwent common bile duct ligation (BDL), and BDL rats treated orally with sepia ink extract (200 mg/kg body weight) for 7, 14, and 28 d after BDL. RESULTS: There was a significant reduction in hepatic enzymes, ALP, GGT, bilirubin levels, and oxidative stress in the BDL group after treatment with sepia ink extract. Collagen deposition reduced after sepia ink extract treatment as compared to BDL groups, suggesting that the liver was repaired. Histopathological examination of liver treated with sepia ink extract showed moderate degeneration in the hepatic architecture and mild degeneration in hepatocytes as compared to BDL groups. CONCLUSION: Sepia ink extract provides a curative effect and an antioxidant capacity on BDL rats and could ameliorate the complications of liver cholestasis.

Learning about Barriers to Care for People Living with HIV in Egypt: A Qualitative Exploratory Study.

The purpose of this study was to identify obstacles health care workers face in providing care for people living with HIV and AIDS (PLWHA). Based on these findings, health authorities can design interventions to support health care workers in providing better medical care for PLWHA. Thirty in-depth interviews were conducted with physicians and nurses in one 300-bed tertiary care public hospital in Giza, Egypt. Thematic analysis was conducted by 2 investigators. Five main themes were identified (1) fear of infection; (2) disbelief in effectiveness of infection control measures to protect against HIV; (3) misconceptions regarding medical care for PLWHA; (4) fear of secondary stigma; and (5) moral judgments toward PLWHA and negative connotations related to HIV. Interventions targeting health care workers should be multidimensional, including knowledge and skills building as well as value and attitude change. Reducing stigma among health care workers will improve access to care for PLWHA.

The role of adiponectin gene variants in glycemic control in patients with Type 2 diabetes.

The aim of this study was to investigate the association between glycemic control in Type 2 diabetes mellitus patients and common genetic variants of ADIPQO gene. A total of 427 Type 2 diabetes patients were recruited in the study and divided into two groups: 172 patients with good glycemic control and 249 with poor glycemic control. Genotyping of C11377G, G276T and T45G ADIPQO SNPs were carried out using restriction fragment length polymorphisms-polymerase chain reaction. The results showed that C11377G ADIPQO SNP is strongly associated with glycemic control in Type 2 diabetes patients. Patients with the GG genotype at adiponectin C11377G had better glycemic control than those with CC or CG genotypes. However, other examined SNPs were not correlated with glycemic control in Type 2 diabetes patients. Other parameters that impacted glycemic control include duration of the disease (p < 0.01), use of insulin therapy (p < 0.01) and presence of neuropathy complications (p < 0.01). However, no contribution was observed for gender, statin use, lipid profile and other oral medications to glycemic control (p > 0.05). Glycemic control among Type 2 diabetes patients might be affected by variants in ADIPQO gene.

Evaluation of serum 25-hydroxyvitamin D levels in vitiligo patients with and without autoimmune diseases.

BACKGROUND: Vitiligo is an autoimmune depigmentation disorder, commonly associated with systemic autoimmune diseases. Deficient serum 25-hydroxyvitamin D (25(OH)D) levels have been noted in some patients with autoimmune diseases. AIM: To evaluate serum 25(OH)D levels in vitiligo patients with and without systemic autoimmune diseases. METHODS: A case-control study was conducted on 40 vitiligo patients (20 patients with systemic autoimmune diseases and 20 patients without autoimmune diseases) and 40 age-, gender- and skin phototype-matched healthy controls. Serum 25(OH)D was measured in all subjects, divided into: normal or sufficient (≥ 30 ng/ml), insufficient (< 30-> 20 ng/ml) and deficient (≤ 20 ng/ml) levels. RESULTS: One patient with vitiligo (2.5%) versus 33 healthy controls (82.5%) have sufficient serum 25(OH)D levels while 39 patients (97.5%) versus 5 controls (12.5%) have deficient 25(OH)D levels with significantly lower serum 25(OH)D levels in patients compared to controls (P-value < 0.001). The other 2 healthy controls have insufficient 25(OH)D levels. Patients with vitiligo and autoimmune diseases have lower serum 25(OH)D levels than vitiligo patients without autoimmune diseases but with no significant difference. No significant correlations existed between age of the patients, duration of vitiligo, duration of associated autoimmune diseases, affected body surface area and serum 25(OH)D levels of patients. CONCLUSION: Deficient serum 25(OH)D levels are present in vitiligo patients with and without systemic autoimmune diseases. Accordingly, screening for vitamin D deficiency seems of value in vitiligo patients for the possibility of vitamin D supplementation.