Interleukin-8 genetic polymorphism and its relation to Helicobacter pylori infection and Helicobacter pylori-associated gastric diseases.

Helicobacter pylori (H. pylori) infection has a variety of clinical outcomes, and host genetic factors play an important role in this process. Cytokines are important factors in mediating and controlling the inflammatory process during H. pylori infection. Interleukin-8 (IL-8) plays a critical role in the epithelial cell response to H. pylori infection and the development of H. pylori-related gastric disorders. The IL-8 gene has an A/T base pair polymorphism in the promoter region (-251), which has been linked to an increase in interleukin production by gastric epithelial cells. In this context, the goal of our study was to determine the polymorphism in the IL-8 gene and its relation to H. pylori infection and H. pylori-associated gastric diseases. Gastric biopsy specimens were collected from 44 patients with H. pylori infection and 29 patients without H. pylori infection. The rapid urease test and detection of the glmM gene were used to diagnose H. pylori infection. Polymerase chain reaction-restriction fragment length polymorphism was used to identify the polymorphism in the Il-8 gene (at position-251). The presence of the A/A and T/A genotypes of the IL-8 gene was found to be significantly associated with susceptibility to H. pylori infection (p = 0.012 and p = 0.004, respectively). Also, the IL-8 A allele was significantly associated with H. pylori infection in our study (p = 0.002). We did not find a significant association between IL-8 gene polymorphism and a higher risk of gastritis and peptic ulcer disease. In conclusion, IL-8 gene polymorphism at -251 position was significantly associated with H. pylori infection.

COVID-19 and diabetes in 2020: a systematic review.

Attempts were made to review the literature on diabetic patients who experience complications when they contract COVID-19, and to determine whether ethnicity and other risk factors play an important role in the development of symptoms and their severity, as well as responding to medications. A literature search was performed using five keywords, namely COVID-19, diabetes, ethnicity, medications, and risk factors between January 2019 and December 2020 using electronic databases such as PubMed, Science Direct, Google Scholar, Springer Link, and Scopus. Forty studies were included. The review indicated that diabetes was a significant risk factor for poorer outcomes and increased mortality associated with COVID-19. There were several risk factors for diabetic patients that increased their likelihood of poorer outcomes associated with COVID-19. These included black and Asian ethnicity, male sex with high BMI. In conclusion, patients with diabetes of black or Asian origin with high BMI, male sex, and older age had an increased risk of poorer outcomes associated with COVID-19. This highlights the importance of considering the history of the patient in prioritising care and treatment.

Characterization of Pathogenic Bacteria Isolated from Sudanese Banknotes and Determination of Their Resistance Profile.

BACKGROUND: Banknotes are one of the most exchangeable items in communities and always subject to contamination by pathogenic bacteria and hence could serve as vehicle for transmission of infectious diseases. This study was conducted to assess the prevalence of contamination by pathogenic bacteria in Sudanese banknotes, determine the susceptibility of the isolated organisms towards commonly used antibiotics, and detect some antibiotic resistance genes. METHODS: This study was carried out using 135 samples of Sudanese banknotes of five different denominations (2, 5, 10, 20, and 50 Sudanese pounds), which were collected randomly from hospitals, food sellers, and transporters in all three districts of Khartoum, Bahri, and Omdurman. Bacterial prevalence was determined using culture-based techniques, and their sensitivity patterns were determined using the Kirby-Bauer disk diffusion method. Genotypic identification was carried out using PCR and 16S rDNA sequencing. Antibiotic resistance genes of some isolates were detected using PCR technique. RESULTS: All Sudanese banknotes were found to be contaminated with pathogenic bacteria. Klebsiella pneumoniae was found to be the most frequent isolate (23%), whereas Bacillus mycoides (15%) was the most abundant Gram-positive isolate. There was a significant relationship between the number of isolates and the banknote denomination with p value <0.05 (the lower denomination showed higher contamination level). Our study has isolated bacteria that are resistant to penicillins and cephalosporins. Multidrug-resistant strains harboring resistant genes (mecA, blaCTX-M, and blaTEM) were also detected. CONCLUSION: All studied Sudanese banknotes were contaminated with pathogenic bacteria, including multidrug-resistant strains, and may play a significant role in the transmission of bacterial infections.

Evaluation of Non Invasive versus Invasive Methods for Diagnosis of Helicobacter pylori Infection among Patients with Gastroduodenal Disorders.

H. pylori, a spiral gram-negative bacterium, is associated with gastroduodenal diseases. All H. pylori diagnostic assays have limitations. Cytotoxin-associated gene A (cag A), a virulence marker, can be identified by PCR. We evaluated H. pylori diagnostic methods, invasive: rapid urease test (RUT), and histopathological examination (HE), and serology as non-invasive method. Positive cases were studied for presence of cag A gene. Upper endoscopies and gastric biopsies were performed on 67 dyspeptic patients for RUT, HE and PCR. Anti H. pyloriIgG were measured by ELISA. Of 67 dyspeptic patients, 23 (34%) had more than one endoscopic finding, 46 (68.7%) were H.pylori positive by HE, and 21(31.3%) were negative with variable grades of mucosal antral neutrophil infiltration. Of the 46 HE positives, PCR detected CagA in 22 (47.8%). Using HE as the gold standard test, the sensitivity of ELISA and RUT was 93.48% and 86.96%, respectively; and the specificity was 85.71% and 47.62%, respectively. In conclusion, IgG detection by ELISA is a suitable screening test for diagnosis of H. pylori associated gastroduodenal diseases. Histopathology should be performed in ELISA negative cases to exclude infection.

Glue versus suture fixation of mesh during open repair of inguinal hernias: a systematic review and meta-analysis.

BACKGROUND: Glue fixation of mesh has been explored for some time as a strategy for reducing postoperative chronic groin pain. Previous studies have come to different conclusions about the superiority of one method over another. We conducted a meta-analysis of randomized control trials comparing the performance of glue versus suture fixation of mesh in open inguinal hernioplasty. METHODS: Studies published up to November 2012 were searched using PubMed, EMBASE, MEDLINE, Cochrane Library, and the international standard randomised controlled trials number (ISRCTN) register. Mean differences (MDs) were derived from secondary continuous outcomes and pooled risk ratios (RRs) for categoric outcomes. Meta-analysis was conducted utilizing the random-effects and fixed-effects models as appropriate. RESULTS: Ten randomized controlled studies were selected, with a total of 1,623 patients. Glue fixation for open inguinal hernioplasty reduced chronic groin pain (RR 0.46, 95 % confidence interval (CI) 0.22-0.97), hematoma (RR 0.56, 95 % CI 0.34-0.90), acute postoperative pain (MD -7.92, 95 % CI, -13.17 to -2.66), and time taken to return to normal activities (MD -1.39, 95 % CI, -2.58 to -0.21). There was no evidence of an increase in adverse outcomes including recurrence with glue fixation (RR 0.83, 95 % CI 0.30-2.35). CONCLUSIONS: Glue fixation of mesh for open inguinal hernioplasty is superior in many outcomes including the reduction of chronic groin pain. Glue fixation was not associated with an increased risk of hernia recurrence.

Topical negative pressure in managing severe peritonitis: a positive contribution?

AIM: To assess the use of topical negative pressure (TNP) in the management of severe peritonitis. METHODS: This is a four-year prospective analysis from January 2005 to December 2008 of 20 patients requiring TNP following laparotomy for severe peritonitis. RESULTS: There were 11 males with an average age of (59.3 +/- 3.95) years. Nine had a perforated viscus, five had anastomotic leaks, three had iatrogenic bowel injury, and a further three had severe pelvic inflammatory disease. TNP and the VAC(R) Abdominal Dressing System were initially used. These were changed every two to three days. Abdominal closure was achieved in 15/20 patients within 4.53 +/- 1.64 d. One patient required relaparotomy due to residual sepsis. Two patients with severe faecal peritonitis due to perforated diverticular disease received primary anastomosis at second look laparotomy, as sepsis and their general condition improved. In the remaining 5/20 cases, the abdomen was left open due to bowel oedema and or abdominal wall oedema. Dressing was switched to TNP and VAC GranuFoam. Three of the five patients returned a few months later for abdominal wall reconstruction and restoration of intestinal continuity. Two patients developed intestinal fistulae. All 20 patients survived. CONCLUSION: The use of TNP is safe. Further studies are needed to assess its value in managing these difficult cases.

Autoantibodies in HCV infected patients at Sharkia Governerate, Egypt.

It is not clear whether HCV induces an autoimmune disease in infected patients or not. The aim of this study is to evaluate some immunological manifestations in chronic heapatitis C patients and to find out its relationship to liver pathology. The study included 109 positive HCV-RNA patients. They were classified according to liver histopathology into three groups: Group I included 22 patients (G1S1), Group II included 67 patients (G2S2) & Group III included 20 patients (G3S3), where G=The degree of necro-inflammatory process & S=Stage of liver fibrosis. All patients were investigated for the presence of: cryo-globulin, anti-neutrophil cytoplasmic (ANCA), anti-liver kidney microsomes (LKM), anti-double stranded DNA, (ds-DNA), anti-nuclear (ANA), anti-mitochondrial (AMA) and anti-smooth muscle (ASMA) auto-antibodies. The following results were obtained: ANCA, LKM, ds-DNA, ANA, ASMA, AMA and cryoglobulin were detected in 83/109 (76.1%), 32/109 (29.4%), 23/109 (21.1%), 38/109 (34.9%), 25/109 (22.9%), 5/109 (4.6%) and 60/109 (55%) of chronic HCV respectively. A highly significant positive correlation was found only between ANCA auto-antibodies and cryoglobulin versus grades of liver cirrhosis. Using ANCA, cryoglobulin, age and gender as covariates and by logistic regression analysis, Odds ratio (OR) revealed that these covariates were significant predictors of cirrhosis that add significance to the model according to the sequence: ANCA, cryoglobulin, age and gender suggesting that these covariates associate significantly with development of cirrhosis in HCV patients and that they are significant predictors of liver cirrhosis in HCV patients. The high prevalence of autoantibodies in chronic HCV patients suggests that HCV may trigger an autoimmune reaction, but most probably do not indicate a distinct autoimmune mechanism. Cryoglobulins and ANCA may be a useful prognostic indicator for increased risk of cirrhosis in chronic HCV patients. Follow up studies are recommended.

Haematologial manifestations in HCV infected patients at Sharkia Governerate, Egypt.

Hepatitis C virus (HCV) is a major cause of morbidity worldwide. The aim of this study is to evaluate hematological manifestations occurring in patients suffering from chronic HCV infection. Positive HCV-RNA cases (109) were subjected to the following C.B.C., P.T., P.T.T., B.T., C.T., detection of F.D.Ps., measurement of plasma AAT then B.M. aspiration and examination for 20 cases of them. Patients were classified into 3 groups according to the histopathological staging and grading of liver biopsy. Comparison between groups according to histopathological grading and staging for hematological and chemical parameters revealed significant statistical difference in platelets count, S. Albumin, ALT and AST levels. Comparison between groups according to histopathological grading and staging for coagulation profile, AAT level and FDPs revealed significant statistical difference regarding all parameters. Bone marrow aspiration and examination revealed mild hypocellularity with increased number of lymphocytes and relevance of plasmacytoid-lymphocytes. From this study we can conclude that patients with chronic HCV infection are in need for good observation and follow up before taking therapy because they have some hematological abnormalities which need more concern in order to decrease their progressive effect before starting therapy for HCV per se. They should be always screened and given liver and marrow supportive supplements.

Experimental demonstration of hepatitis C virus (HCV) in an Egyptian strain of Culex pipiens complex.

Reverse transcriptase (RT) polymerase chain reaction (PCR) was used to detect hepatitis C Virus (HCV) RNA among heads, guts, larvae and eggs of Culex pipiens complex. The mosquitoes were trapped from homes of hepatitis C patients or among the same organs of symbiotic (normal gut bacteria) and aposymbiotic (without gut bacteria) mosquitoes fed HCV positive blood by an artificial membrane feeder. The eggs and larvae resulted from symbiotic females fed HCV positive blood was tested for HCV-RNA. Hepatitis C virus RNA was detected only in heads of symbiotic mosquitoes collected from homes of HCV positive patients at 3h and 6h after feeding. The virus was detected at 3d and 8d after being fed on HCV-RNA positive blood in guts of the same group. The virus was not detected in the eggs or larvae resulted from female mosquitoes fed on HCV-RNA positive blood. The results raise the possibility of the mechanical and/or biological transmission of HCV by Cx. pipiens, and pave the way to the ongoing study on the effect of gut bacteria of Cx. pipiens in a trial to identify an anti-HCV agent.