Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt

A study in Egypt determined the prevalence of hepatitis B and C virus infections among barbers [n = 308] and their clients [n = 308] in Gharbia governorate, and assessed knowledge, attitude and practices during hair-cutting and shaving. HBsAg was detected among 4.2% of barbers and 3.9% of clients [more urban than rural]. Anti-HC antibodies were detected in 12.3% of barbers and 12.7% of clients. HCV-RNA prevalence was 9.1% among both barbers and clients [more rural than urban]. Knowledge was high among the majority of participants and good practices during shaving and hair-cutting were observed for the majority of barbers. Barbers appeared to have no job-related risk of acquiring viral hepatitis

Circulating solube vascular cell adhesion molecule-1[SVCAM-1] concentration in patients with chronic active hepatitis [C] with and without bilharziasis

The Serum levels of circulating Soluble Vascular Cell Adhesion Molecule-1 [SVCAM] were estimated by technique in sixty patients with chronic active hepatitis type C infection with [Group A] and without Bilharziasis [Group B], in addition, twenty apparently healthy subjects as a control group [Group C]. The mean SVCAM-1 levels pg/ml were markedly elevated in sera of diseased groups compared to control group [Group C] P<0.01]. Moreover, the mean sera levels of SVCAM-1 were increased [P<0.05] in active bilharziasis [Group B1] compared to inactive bilharziasis [Group B2]. There was a higher proportion of patients with CAH post C with or without Bilharziasis at least grade 3 inflamations on liver biopsy who had serum SVCAM-1 levels above this mean level [P<0.01]. These results might help understanding of the pathophysiology of CAH type C with and without Bilharziasis and this parameter may be helpful as an immunological marker of HCV liver disease reflecting ongoing immune-mediated pathology

Clinco-biochemical, virological and histopathological evaluation of dimethyl biphenyl dicarboxylate [DDB] in treatment of chronic HCV infection in Egyptian patients

The present study was designed to evaluate the efficacy and safety of DDB and DDB- amantadine HCL combined therapy in treatment of patients with chronic HCV infection for 6 months. The study included 90 patients with chronic HCV were selected and divided into three groups: Group 1: [Control group] included 30 patients of chronic HCV infection treated by silymarin for 6 months in a dose of 420 mg / day in three divided doses. Group II: [DDB group] included 30 patients of chronic HCV infection treated by DDB for 6 months in a dose of 15 pilules bid, each pilule 1.5mg Group III: [Combined group] included 30 patients of chronic HCV infection treated by DDB and amantadine HCL for 6 months. Amantadine HCL was given in a dose of 100mg twice daily. Good history taking and clinical examinations, also laboratory investigations including complete liver functions [AST, ALT, S. Bilirubin, S. Albumin, alpha fetoprotein and prothrombin time and concentrations], kidney functions tests, Quantitative HCV RNA PCR and histopathological examination before and at the end of therapy for some selected cases. Follow up of these cases 3 and 6 months revealed that:- there was statistically significant in the main clinical symptoms [Fatigue, Rt hypochondrial pain and epistaxis] and in the mean serum, transaminasis [ALT and AST] more in group III than G II in comparison to the control group. In addition, there were no improvements statistically significant between groups in the mean serum albumin, alpha feto-protein, prothromibin time and concentration, serum bilirubin, hematological parameters and kidney function before and after treatment. The results showed that there was decrease in the viral load at the end of treatment in group III than group II in comparison to the control group but no patients turned negative for HCV RNA PCR. Also, there were improvements statistically at the end of treatment in the degree of the histological criteria [Steatosis, lymphocytes infiltration and bile duct injury] in g II than G II in comparisons to the control group. Finally, it has concluded that DDB is beneficial drugs for treatment of chronic HCV patients and the additive value of DDB as immunomodulorty to amantadine HCL as anti viral as a combined therapy in chronic HCV infections is a new beneficial strategy

Study of interferon-gamma in Egyptian patients with chronic active hepatitis [C] versus chronic active hepatitis [B]

Pro-inflammatory cytokines include many factors as interferon Gamma [INF-Y]. In this study, we estimate the serum levels of INF-Y in sixty cases and twenty controls by ELISA technnique. They were classified as follows: - [30] Cases with chronic active hepatitis post C [group I], [30] cases with chronic active hepatitis post B [group II] and [20] normal healthy subjects as control group [group III]. The obtained results revealed that the mean INF-Y levels were markedly elevated [P.<0.001] in diseased groups [GI and GII] compared to control group [GIII]. Moreover, the mean serum levels of INF-Y were increased in CAH post C compared to CAH post B. we conclude that viral specific activated T-cell response oceues in CAH type C or type B with subsequent release and elevation of INF-Y, Also, this increase of INF-Y is related to viral activity and vigorous progressive liver injury may follow CAH-post virus C more than CAH post virus B

Significance of circulating intercellular adhesion molecules [sICAM-1] and thrombopoietin [TPO] in hepatitis C vinis related liver cirrhosis

Chronic hepatitis C is a major health problem that causes mortality in the worldwide distribution. The systemic levels of many soluble adhesion molecules and cytokines are altered in autoimmune diseases and liver infection. Among mediators that show altered serum levels are sICAM-1 expressed by immunocompetent cells and thrombopoitin [TPO]. The aim of this study was to evaluate the serum sICAM and TPO and their correlations with clinical and laboratory data in patients with hepatitis C-related cirrhosis. 40 patients with HCV-related cirrhosis and 20 healthy subjects were enrolled in this study. They were subjected to the following investigations: complete blood picture, liver and kidney functions, prothrombin time[PT], abdominal sonography and estimation of serum TPO and sICAM-1. Compared to controls, the patients group showed significant increase in spleen size [P<0.025], portal vein diameter [P<0.0025], ALT, AST, bilirubin, sICAM-1 [P<0.0005], and PT [P<0.05]. However there was significant decrease in serum albumin levels [P<0.01], platelets count [P<0.0005], RBCs count, haemoglobin concentrations [P<0.025] and serum TPO levels [P<0.0025]. The serum creatinine levels and WBCS count showed insignificant changes with control. The serum TPO levels were negatively correlated to ALT [r=-0.97, P<0.0001], PT [r=-0.96, P<0.0001], spleen size [r=-0.95, P<0.0001], and portal vein diameter [r=-0.96, P<0.0001] and positively correlated to platelets [r=0.84, P<0.0005]. While serum sICAM-l were positively correlated to ALT [r=0.99, P<0.0001], PT [r=0.94, P<0.0005], spleen size [r=0.95, P<0.0001], and portal vein diameter [r=0.85, P<0.005] and negatively correlated to platelets count [r=-0.7l, P<0.005]. Our results suggested that impaired synthesis of TPO by cirrhotic liver may contribute to the development of thrombocytopenia and related to liver cirrhosis together with increased splenic sequestration of platelets by the enlarged spleen. So recombinant human TPO should be evaluated in the treatment of thrombocytopenia in HCV-related cirrhosis. In addition, sICAM-1 elevation in plasma of patients suffering from HCV-related cirrhosis was related to the degree of cirrhosis and portal hypertension. So, sICAM-1 may be used as a marker of the disease activity and may provide diagnostic and prognostic information. However this needs to be further studied to detect the cut off level of sICAM-1 in Egyptian HCV-related liver cirrhosis

Vitamin D level in children with rickets and protein-energy malnutrition

This study was performed on three groups of infants and children aged between 7-36 months including 35 rachitic cases, 35 cases with protein energy malnutrition [PEM] and 12 healthy controls. Rachitic process was assessed by X-ray wrist. The biochemical estimation included serum calcium, inorganic phosphorus, alkaline phosphatase and 25-hydroxy vitamin D, 1,25 [OH]2 vitamin D as well as serum total protein and albumin. From rachitic children, 16 cases were re- examined at 3 weeks after administration with 6000,000 IU vitamin D. The mean levels of [OH]-vitamin D3, 1,25, [OH]2 vitamin D calcium, phosphorous were significantly in a low concentration with a high activity of alkaline phosphatase activity in children with rickets as compared with the controls. Whereas, after vitamin D administration, there was an amelioration in all biochemical parameters indicating that these subjects were suffering from vitamin D deficiency. In addition, it seemed that PEM per se plays an important role in the etiology of vitamin D deficiency

Chlamydia trachomatis and cellular DNA content in cervical ectopy

The study was conducted on 68 women with cervical ectopy referred to the Early Cancer Detection Unit of Ain Shams University Maternity Hospital from November 1997 to October 1998 to study chlamydia trachomatis infection serologically in cases of cervical ectopy and its relation to DNA abnormalities. 38 out of 68 women were diagnosed cytologically to have chlamydia trachomatis. 36 of them were also confirmed by positive IgA antibodies of chlamydia trachomatis by solid phase ELISA technique so immuno-enzymatic and cytological methods were both accurate in the diagnosis. Chlamydia was found to be the commonest infections in cervical ectopy 55.8% followed by the HIPV 35.3%. 44% of patients with cervicalectopy had inflammatory atypia, 26.5% of which were found to be chlamydia positive, low grade squamous intraepithelial lesion [LSIL] was diagnosed in 35.2% of patients, 29.4% of which were chlamydia positive and 35.3% were associated with HPV infection. On DNA analysis of chlamydia positive smears, four had aneuploidy, two slides were suspicious for aneuploidy and the rest were diploid. It can be concluded that, the immuno-enzymatic method and cytological method are accurate in diagnosis of chlamydia trachomatis which was found to be the commonest infection in cases of cervical ectopy and there is no relation between chlamydial infection and DNA changes in cervical ectopy

Lower limb-lengthening by coloptosis-unilateral [uniaxial] versus circular frames

The results of limb-lengthening by callotasis technique using unilateral frames [Wagner or Kazem Ill distractors] were compared with those by using circular frames [Ilizarov fixator]. The method of lengthening was selected on the basis of the availability of the device at the time of the surgery. Unilateral frames were used in fourteen patients [fourteen procedures], while circular frames were used in seventeen patients [nineteen procedures]. There were l8 female patients and 13 male patients. The average age at the time of surgery was 12.4 years [range 9-28 years]. The rate of distraction in both systems was about one mm. per day divided on four increments after a latent period ranged from 5-15 days. The average gain in length was 5.8 centimeters in callotasis with the use of unilateral frames and 5.5 centimeters with the use of circular frames. The percentage of achievement from intended length was 94% in unilateral frames callotasis and 102% in circular frames callotasis. A total of 40 complications [24 mild, 12 moderate and 4 severe] were recorded in the fourteen patients managed by unilateral frames with an average 2.8 per case. For the seventeen patients managed by circular frames, the total complications were 14 [8 mild, 4 moderate and 2 severe] with an average 0.8 per case. From this study, it was found that although technically demanding, the circular fixation devices, being highly versatile system, provided a better grip for bone segments and allowed for correction of coexisting angulation or deformity with low complication rate. It was observed also that whatever the method of lengthening, there have been a significant complication rate. That necessitated great caution and consideration before embarking on the correction of limb discrepancy. This rat of complication declined as experience with the technique increased

Intertrochanteric osteotomy-a salvage procedure-in non-union of the femoral neck

A series of 22 patients with ununited femoral neck fractures were treated by a Pauwels intertrochanteric abduction osteotomy. All the patients were under 60 years of age, Bone scan was done for all patients before the surgery. Six of them showed radiological evidence of avascular femoral head necrosis before osteotomy, and 10 non-unions showd associated varus deformity. The average follow up was 3.6 years [range from 1.8 to 5.1 years]. Sixteen cases were consolidated without complications [72.7%] and six cases necessitated further surgical interference. We concluded that in young active patients under 60 years with ununited femoral neck fractures, intertrochanteric osteotomy provided a high proportion of good results even in the presence of avascular necrosis of the head provided that there has been no collapse. If osteotomy fails, prosthetic replacement is still possible

Nutritional evaluation of zabady

The nutritional value of Zabady produced by a modified method was compared with that produced by the traditional method. Caloric, amino acid, fatty acid and net utilizable calcium contents along with the digestibility of protein were estimated. Generally, it was observed that fermentation of milk during Zabady manufacture with the modified method caused considerable alteration of the chemical composition. Some of the more important changes were the clear increase of both content and the net utilizable calcium; 0.8 - 1.4% decrease of the caloric value due to fermentation of lactose to lactic acid and some increases in both amino and fatty acids. In vitro digestibility indicated that Zabady proteins were more digestible with both pepsin and pencreatine, each alone or together, than that of milk proteins. Also, digestibility of proteins in Zabady produced with the modified method was enhanced

combined action of CaCl2, pH and heat temperature on some rheological properties of rennet curd from buffalo's milk

Changes of clotting time, consistency and syneresis caused by different additions of CaCl2 [0,3, 0.6 and 2.0g/1000ml milk], different pH values [0.6, 6.2 and 6.4] and different heating temperatures of skimmilk[70, 80 and 90C] have been evaluated. Generally 27 combinations of the mentioned factors have been studied, and 6 investigations were carried out on each combination. The best rheological properties of the rennet curd from buffalo's skim milk was reached by the following combinations of these factors: temperature 70C, pH 6.2 and CaCl2 0.3g/liter milk. The interaction effects of these factors were statistically evaluated by the three factors dispersion analysis. Results indicated that the rheological properties of rennet curd were influenced not only by the direct factors but also by the interactions influence of the studied factors

Giant fibroadenoma of the breast

Two cases of giant fibroadenoma of the breast are presented. The pathology, diagnosis and treatment of these tumours are briefly discussed

Experience in the management of 9 cases of Cushing's syndrome

Nine patients, eight females and one male whose ages ranged from 14 to 57 years who have Cushing's syndrome of 6 months to 7 years duration. Plasma cortisol was elevated in all patients .C.T. scanning visualised a suprarenal adenoma in 6 patients and bilateral adrenocortical hyperplasia in 3. All patients were operated upon through an oblique lumbar incision. Resection of an adrenal adenoma in 6 patients, bilateral adrenalectomy were performed in 2 patients with adrenocortical hyperplasia while left adrenalectomy.was performed to a patient who was supposed to have a left adrenal adenoma but later proved to have bilateral adrenocortical hyperplasia. Wound infection occurred in 2 patients while there was one patient mortality

effect of 5-fluoro-uracil in heat stress situations on thermoregulation, serum cortisol and serum electrolytes

Fourty two male albino rats were divided into seven equal groups. The first group served as control, the second and third group were subjected to thermal insult for 15 minutes and 30 minutes respectively. The fourth and fifth group received 5 fluorouracil intraperitoneally. The sixth and seventh group were subjected to the combined effect of 5-F.U. and thermal insult. Rectal temperature was measured before and after experiment in all animal groups. The animals were sacrificed by decapitation and blood was collected and serum cortisol and serum electrolytes were estimated. Data were statistically analysed and the results were discussed

On some fish second intermediate hosts of prohemistomum vivax 1: prevalence studies

The prevalence of infection of Glarias lazera, Syndontis schall, Tilapia nilotica, Anguilla vulgaris, Bagrus bayad, Barbus benni, Labeo spp. and Lates niloticus was investigated. 18.23% of the examined fresh water fishes were infected with prohemistomatid encysted metacercariae. Seasonal incidence was nearly similar in summer, autumn and winter, while spring recorded the lowest prevalence. Long fishes of C. lazera, B. bayad and Labeo spp. were more infected than smaller ones with prohemistomatid encysted metacercariae. Among S. schall, T. nilotica, A. vulgaris and B. benni, the intermediate ones were more infected. In C. lazera, T. nilotica and B, bayad infection percentage increased by increase in fish weight, while in S. schall the reverse occurred. However, higher precentage occurred in intermediate weight group in A. vulgaris, B. benni and Labeo spp. Metacercarial maximal concentration occurred in head region in C. lazera and S. schall, while in the rest of fishes' species except for B. benni occurred in tail region and in the latter fish in trunk