The burden of HCV among prevalent hemodialysis patients after the National Egyptian HCV Eradication program.

In the first phase of its treatment program, Egypt aimed to treat 250,000 people annually until 2020, thereby reducing the number of viremic patients and limiting hepatitis C virus (HCV) transmission. Egypt strives to eradicate HCV and HCV-associated morbidity by 2030. This study aimed to determine the prevalence of HCV infection among end-stage renal disease patients and the reasons for non-treatment among those offered free medication. This multi-center cross-sectional study was conducted during the period from November 2022 to April 2023. The study included 500 patients receiving hemodialysis (HD) sessions on a regular basis for more than three months in Dakahlia Governorate. According to patients` medical history, we found that 23.4% of patients had previous HCV infection. Of these, 12.6% received treatment, and 10.8% did not receive treatment due to a variety of reasons. For instance, some patients were unaware of the drug's availability, five patients (1%) feared side effects, 43 patients (8.6%) did not require treatment, and five patients (1%) had other causes as contraindications of drugs, noncompliance and deterioration of health status. In addition, 20.4% of patients were reported to have fully recovered, while 0.8% had a recurrence. After investigations, 1% of patients had positive hepatitis B surface antigen (HbsAg), 23.4% positive HCV Ab, and 4.2% positive HCV by the polymerase chain reaction. In conclusion, the low prevalence of HCV among HD patients confirms that HCV infection is not currently a significant health concern among patients on maintenance HD.

Anti-inflammatory effect of high flux dialyzer surface area 2.6m2 in high flux hemodialysis and hemodiafiltration.

Dialysis therapy has remarkably evolved through the innovation in dialyzers and hemodialysis modalities, enhancing patients' quality of life. The efficacy of dialysis can be determined by measuring the reduction ratio (RR) of middle molecules such as Interleukin-6 (IL-6) and Procalcitonin. In our study, we tested a high-flux dialyzer, BIOPURE (Biorema) 260 HF, with a surface area (SA) of 2.6 m2, in terms of IL-6 and Procalcitonin removal while performing high-flux hemodialysis (HF-HD) and post-dilution online hemodiafiltration (OL-HDF). This crossover study comprised 25 patients who received a session of HF-HD using the BIOPURE (Biorema) 260 H, followed by a session of post-dilution OL-HDF. A washout period of 2 weeks was instilled between the two sessions, during which the patients received HF-HD using high-flux dialyzers (maximum SA 2.0 m2). All patients' pre/post dialysis concentrations of IL-6 and procalcitonin were measured. The dialyzer used in this study resulted in a significant IL-6 RR of 44.92±5.11% (p <0.001) with HDF and 32.48±5.72% (p <0.001) with HF-HD; and a procalcitonin RR of 50.32±3.94% (p <0.001) with HDF and 41.80±4.32% (p <0.001) with HF-HD. In conclusion, the dialyzer BIOPURE (Biorema) 260 HF (SA 2.6 m2) is efficient in eliminating IL-6 and procalcitonin, especially with OL-HDF compared to HF-HD, with acceptable albumin loss in the dialysate.

Amelioration of Diabetic Nephropathy by Targeting Autophagy via Rapamycin or Fasting: Relation to Cell Apoptosis/Survival.

Autophagy has been demonstrated to have a beneficial effect on diabetic nephropathy (DN). Rapamycin, an inhibitor of mTOR, was shown to stimulate ß-cell autophagy. However, its effects on preventing or ameliorating DN is unclear, and its effects are worth studying. As fasting is now an attractive protective strategy, we aim to compare its effect to rapamycin effects on pancreatic and renal cells. Twenty-eight adult male Wistar Albino rats were randomly divided into four groups, using streptozotocin (STZ) to induce diabetes mellitus (DM). Autophagy was induced by two ways; rapamycin or fasting. The extent of autophagy and apoptosis were investigated by measuring the level of LC3B and p53 proteins, respectively, in pancreatic and kidney tissues using Western blotting (WB) technique and imaging the renal cells under transmission electron microscope. The efflux transporter P-glycoprotein was quantified by WB as well. Rapamycin-induced autophagy occurred concurrently with apoptosis. On the other hand, fasting supported P-glycoprotein recovery and renal cell survival together with disabling ß-cells apoptosis. In conclusion, this study provides a potential link between rapamycin or fasting for the cross-regulation of apoptosis and autophagy in the setting of cell stress as DN. Unlike rapamycin, fasting enhanced the active expression of ABCB1 efflux protein, providing insights on the potential ameliorative effects of fasting in DN that require further elucidation.

Studies on the genus Stylocephalus ellis, 1912 (Apicomplexa: Eugregarinida: Stylocephalidae) in beetles (Coleoptera: Tenebrionidae) from El Fayoum Governorate, Egypt.

Four species of the genus Stylocephalus Ellis, 1912 were recorded and described from beetles in El Fayoum Governorate; S. longicollis, S. phalloides, S. variabilis and S. eastoni. Both S. phalloides and S. variabilis were recorded in Zophosis sp. and Pimelia angulata, respectively for the first time in Egypt. Out of 105 Blaps polychresta, 18 (17.14%) were infected with S. longicollis and 57 (54.29%) with S. eastoni. Out of 30 Pimelia angulata, 17 (56.76%) were infected with S. variabilis and all examined Zophosis sp. (n = 67) were infected with S. phalloides. Scanning electron microscopy on S. longicollis revealed morphological features not reported before; three pairs of longitudinal ribs extending from the second fifth till the posterior extremity of old sporont and a minute pore on the anterior tip of epimerite. In S. eastoni, the epimerite-host epithelium relationship revealed that the parasite invades host's gut with the distal part of epimerite. Regarding the gross pathological symptoms, heavily infected hosts showed a sluggish motility, short antennae, swollen abdomen, lack of fat accumulation, and putrid smell in dead beetles.