Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Prevalence of Non Organ-Specific Auto Antibodies and its Effect on Response to Antiviral Therapy in Patients with Chronic Hepatitis C Virus Genotype 4
34
42
EN
Mohamed
Abd El-Maksoud
Tropical Medicine Unit, Mansoura University Hospital, Mansoura Faculty of Medicine, Egypt
mohamedmaksoud2010@hotmail.com
Hatem
Elalfy
Tropical Medicine Unit, Mansoura University Hospital, Mansoura Faculty of Medicine, Egypt
Maha
Ragab
Habeeb
Internal Medicine, Mansoura University Hospital, Mansoura Faculty of Medicine
Abd-Elmohsen
E
El-desoky
Internal Medicine, Mansoura University Hospital, Mansoura Faculty of Medicine
Ziyad
M
Tawhid
Clinical Immunology Unit, Clinical Pathology Department, Mansoura Faculty of Medicine,Egypt
Basem
S
Eldeek
Public health and community Medicine King Abdulaziz University faculty of medicine ,Jeddah, and Mansoura university, Egypt.
10.21608/aeji.2013.17306
<strong>Background and study aim:</strong>: Immunological disorders have been frequently described in the course of hepatitis C virus (HCV)–related chronic hepatitis. Our aim was to determine the prevalence of non-organ-specific autoantibodies (NOSAs) and evaluate its impact on the response to combined antiviral therapy in patients with chronic HCV genotype-4<br /> <strong>Patients and methods:</strong> A total of 134 adult patients with chronic HCV genotype-4 were investigated for the presence of serum Antinuclear antibody (ANA), anti–smooth muscle antibody (SMA), and anti liver/kidney microsomal antibody type 1 (LKM1). 109 out of 134 HCV patients were treated naive and received combined antiviral therapy (pegylated interferon–ribavirin). The presence of these autoantibodies was studied in relation to the patient’s characteristics and the outcome of antiviral therapy.<br /> <strong>Results :</strong>Thirty-six (26.9%) patients were positive for at least one autoantibody. Various autoantibodies were presented as follows: ANA in 29 (21.6%) patients, SMA in 9 (6.7%) and anti-LKM-1 in 2 (1.5%). In two patients, both ANA and anti-SMA were positive, and in other two cases both ANA anti-LKM-1 were positive. Female patients had a higher prevalence of positive autoantibodies (P=0.005). Chronic hepatitis C (CHC) patients with positive autoantibodies had higher serum ALT, AST and GGT levels. The rate of sustained virological response to combined antiviral therapy was similar between autoantibody-positive and -negative groups (46.9% vs. 53.2%).<br /> <strong>Conclusion :<em> </em></strong>Autoantibodies can be induced in the course of CHC. Autoantibody-positive CHC patients are older and have higher disease activity and severity. However, the presence of these autoantibodies did not influence the response to combination antiviral therapy.
Hepatitis C virus,Autoantibodies,Antiviral therapy
https://aeji.journals.ekb.eg/article_17306.html
https://aeji.journals.ekb.eg/article_17306_86d0397b7d8b5f27792b50d4fad8d646.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Prevalence and Predictors of Diabetes Mellitus in Chronic Hepatitis C Patients with and without Cirrhosis
43
48
EN
Sahar
A
El Gharabawy
Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
drselgharbawy@yahoo.com
Monir
H
Bahgat
Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Amira
K
El Hawary
Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
10.21608/aeji.2013.17308
<strong>Background and study aim:</strong>: The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. The frequency of type 2 diabetes mellitus tends to be high in patients infected with HCV especially those with cirrhosis. We conducted this study to define the prevalence and predictors of diabetes mellitus (DM) in chronic hepatitis C patients with and without liver cirrhosis.
<strong>Patients and methods:</strong> Four hundred patients with HCV were enrolled (200 without cirrhosis [group I] and 200 with cirrhosis [group II]).Two hundred non hepatic disease subjects were enrolled as a control group [group III]. All patients were subjected to thorough history taking and physical examination. Investigations include liver function tests, viral markers (anti-HCV anti-bodies and polymerase chain reaction (PCR) for HCV), liver biopsy and abdominal ultrasound. Multiple logistic regression analysis was used to adjust for potential confounders.
<strong>Results :</strong>Prevalence of Type 2 diabetes was 30.25% in HCV patients as opposed to only 6.5 % of control group (p <0.0001, odds ratio [OR] = 2.7).Moreover the prevalence is significantly higher in HCV patients with cirrhosis than in non cirrhotic patients (51% vs. 9.5%), (OR= 9.9, P < 0.001). Partial correlation of prevalence of diabetes mellitus in HCV patients remain highly significant after adjustment for age, sex, family history of diabetes and BMI (r=0.291, P< 0.0001). Using logistic regression; older age, positive family history of diabetes, higher BMI, lower serum albumin level, higher activity and fibrosis score ( OR= 1.3,19.4,1.8, 6.6,1.3 and 2.1 respectively) in patients with chronic hepatitis C were found to be associated with higher prevalence of DM (P <0.05), while activity by fibrosis was insignificant.
<strong>Conclusion :<em> </em></strong>Chronic HCV is associated with increased risk of diabetes to 2.7-fold.Development of cirrhosis in patients with chronic HCV increases risk of diabetes to 10-folds. This association seems not to be related to the known risk factors for diabetes. Potential predictors for this association might include older age, positive family history of diabetes, higher BMI, lower serum albumin level, higher activity and fibrosis score.
Chronic hepatitis C,Diabetes mellitus,prevalence,predictors and cirrhosis
https://aeji.journals.ekb.eg/article_17308.html
https://aeji.journals.ekb.eg/article_17308_ceb5ea229142029401f27ee6e89674d0.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Ascitic Fluid Lactoferrin as a Diagnostic Marker for Spontaneous Bacterial Peritonitis
49
55
EN
Naglaa
Ali
Khalifa
Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
drhassan_h99@yahoo.com
Abdel-Azzez
A
Abdel-Azzez
Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
Ahmad
M
Hassaneen
Clinical Pathology Department, Faculty of Medicine, Zagazig University, Egypt
Eman
A
El-Shami
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
ahmadsakr65@yahoo.com
Hassan
Mahmoud
Hassanin
Internal Medicine Department, Faculty of Medicine, Zagazig University, Egypt
10.21608/aeji.2013.17309
<strong>Background and study aim:</strong>: Spontaneous bacterial peritonitis (SBP) is an important cause of morbidity and mortality in patients with cirrhosis and ascites. The diagnosis of SBP is established when the ascitic fluid polymorphonuclear leukocyte (PMN) counts is ≥250 cells/ mm3 with or without a positive ascitic fluid culture but this test lack sensitivity. The objective of this study was to evaluate the possible role of lactoferrin in diagnosis of SBP.
<strong>Patients and methods:</strong> The study included seventy patients with liver cirrhosis and ascites admitted to hospital. Patients were classified into SBP group and control group by ascetic fluid PMN count. Aspirated ascitic fluid samples were examined for bacteriological culture, biochemical assay, and cytological count. Ascitic fluid lactoferrin was measured by ELISA technique
<strong>Results :</strong>Ascitic fluid lactoferrin was significantly increased in SBP patients compared to control group. There was a statistically significant positive correlation between lactoferrin levels and PMN counts in SBP patients (p<0.001). ROC curve was used to determine a cutoff value for lactoferrin in diagnosis of SBP. At lactoferrin level ≥270 ng/ml, the sensitivity was 96%, specificity was 95%, positive predictive value was 97.96%, negative predictive value was 90.5%, and accuracy was 95.7% in diagnosis of SBP.
<strong>Conclusion :<em> </em></strong>Measurement of ascitic fluid lactoferrin could serve as a rapid and reliable screening tool for diagnosis of SPB.
ascitic fluid lactoferrin,Spontaneous Bacterial Peritonitis,Liver cirrhosis
https://aeji.journals.ekb.eg/article_17309.html
https://aeji.journals.ekb.eg/article_17309_7534ea8d08d9efcf2bda04631dc661f6.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Utilization of Abdominal Ultrasonography in AIDS Patients
56
64
EN
Ahmed
Abdelrahim
Alzaiem Alazhari University, Faculty of Radiological Sciences & Medical Imaging,
Sudan
Amin
Elzaki
Alzaiem Alazhari University, Faculty of Radiological Sciences & Medical Imaging,
Sudan
aminzaki2000@yahoo.com
Hamid
Osman
Taif University, College of Applied Medical Science, Radiological Science
Department, KSA
A
Karar
Alzaiem Alazhari University, Faculty of Radiological Sciences & Medical Imaging,
Sudan
10.21608/aeji.2013.17310
<strong>Background and study aim:</strong>: The acquired immunodeficiency syndrome AIDS is a destructive disease ,which become a major out-break in the community affecting both adult and young people, causing not only ill-health but affect both the economy, and the psychology of the patient. The abdomen is the largest cavity in the body. Ultrasound is most cheap, available and non invasive tool that can be used in diagnosing abdominal diseases. The aim of the current study was to detect the ultrasonographic findings of prevalent non-specific abdominal abnormalities associated with AIDS.
<strong>Patients and methods:</strong> 200 patients with confirmed positive HIV were scanned at the Voluntary and Counseling Testing Centre in Omdurman Teaching Hospital, Sudan. with an international scanning guideline and protocols for abdominal ultrasonography. A two ultrasound scanners (Shimadzu SDU-350XL and KIAXIN) were used for scanning.
<strong>Results :</strong>The most affected age group was the 4th decade (36 %) which were in the active and product period and most of them (72%) were married. The most frequent abdominal ultrasonography findings were splenomegaly, enlarged lymph nodes, hepatomegaly and increased liver echogenicity (31.25%), (13.54%), (43.75%), (26.04%) respectively. The low frequent occurring were focal lesions in parenchymal of the organs and nephromegaly (1.04%), ascites (4.17%), portal hypertension (1.04%) and abscesses (1.04%).
<strong>Conclusion :<em> </em></strong>Abdominal ultrasonography revealed that (48.0%) of the patients developed abnormal abdominal findings supporting the use of abdominal ultrasonography as a diagnostic tool in AIDS.
AIDS,Abdominal Ultrasonography,HIV
https://aeji.journals.ekb.eg/article_17310.html
https://aeji.journals.ekb.eg/article_17310_e1e062e69e5a5c53c8e9255a58aedbe5.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Prevalence of HCV Antibodies and HBV Surface Antigen among Workers of Zagazig Faculty of Medicine and its Hospitals
65
72
EN
Sahar
G
Zaghloul
Internal Medicine Department, Faculty of Medicine, Zagazig University ,Egypt
Magda
M
Sherif
Internal Medicine Department, Faculty of Medicine, Zagazig University ,Egypt
magyakm2000@yahoo.com
Hoda
Abd El-Aziz
El-Hady
Internal Medicine Department, Faculty of Medicine, Zagazig University ,Egypt
Sahar
A
El-Nemr
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt
alnimrsahar@yahoo.com
10.21608/aeji.2013.17311
<strong>Background and study aim:</strong>: Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Egypt due to the lack of health education, poverty, and and illiteracy. So this study was conducted to determine the prevalence of HCV antibodies and HBsAg and possible risk factors of transmission of these infections among workers of Zagazig Faculty of medicine and its hospitals.
<strong>Patients and methods:</strong> This study was conducted on two hundred workers (non medicals) All were randomly selected from all clinical and academic Departments of Zagazig Faculty of Medicine and its Hospitals. Their age was above 18 years and up to 60 years. Possible associated factors with infections by the viruses were collected from patient using questionnaire Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies.
<strong>Results :</strong>Out of two hundred 39 (19.5%)of workers had Hepatitis C virus (HCV) antibodies and 7 (3.5%) of workers had Hepatitis B surface antigen and one worker 1 ((0.5%). had dual hepatitis B and C virus coinfection . The prevalence of chronic HCV and HBV is higher among males (20.2% and 4% respectively ) than females (17.3% and 1.92% ) and both HBsAg and HCV Abs was ( 0.7)% in males and negative in females. The prevelance of HCV Abs was high among workers with past history of barbering (69.23%) while prevalence of HBV was high in workers with a history of blood transfusion (28.57%).Multivariate regression was used to estimate independent effects of risk factors on seropositivity of both virsus . A highly significant association was found between workers with history barbering (OR 4.58 ) and those with seroposiotivity of HCV abs. While there was no significant association between workers with a history of dental procedure(OR 1.44), operation (OR 1.2) and blood transfusion(OR 1.5) and those with acquired seropositivity of HCVAbs. And a highly significant association was found between workers with history of blood transfusion and those with acquired seropositivity of HBV ( OR 8.18), while there was no significant association between workers with a history of dental procedure(OR 0.2), barbering(OR 0.59) and operation (OR 0.63) and those with acquired seropositivity of HBs.
<strong>Conclusion :<em> </em></strong>We can conclude that he prevalence of HBV and HCV infections among workers of Zagazig Faculty of Medicine and its hospitals in this study is high . Barbering has 4 times risk of HCV infection and blood transfusion has 8 times HBV infection. and working in operation units was associated with increase the risk of HBV and HCV infections, but working in other units like surgical and non surgical , administration and ICU was associated with increase HCV transmission. For prevention the spread of HBV and HCV, people must be educated about these infections and modes of transmission , better infection control practices in hospitals, healthcare and barbering facilities.
Hepatitis C virus antibodies (HCV Abs),Hepatitis B surface antigen (HBsAg),intensive care unit (ICU)
https://aeji.journals.ekb.eg/article_17311.html
https://aeji.journals.ekb.eg/article_17311_7ef387183d4f7c0e86ab94575eb0cc30.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Lyme Borreliosis - a Multisystem Disease
73
78
EN
Angela
Revelas
Pathological Department of St.Nicolaos-Crete, Greece
donnoiko@gmail.com
Emmanuel
Liannos
Urological Department of St.Nicolaos-Crete, Greece
Dimitrios
Arvanitakis
Neurosurgery Clinic of Venizeleio General Hospital-Crete, Greece
10.21608/aeji.2013.17312
<span>Lyme borreliosis, due to the tick-borne spirochete Borrelia burgdorferi sensu lato (Bb.sl), causes significant morbidity throughout the world. Preliminary studies have indicated the presence of the arthropod vector and the pathogen in North Africa. A few clinical cases have been reported. Our objective is to evaluate whether Lyme borreliosis constitutes a threat to public health. To access our objective, we plan to establish a map of the tick distribution, to evaluate the prevalence of Borrelia infection in ticks, to identify Borrelia strains and to determine their genetic diversity, to identify reservoirs used to maintain Bb.sl, and to evaluate the incidence of the disease in the human population. The knowledge of the natural enzootic cycle involving arthropods and wild vertebrates in the maintenance of Bb.sl should permit to develop prevention strategies to counter any public health threat.</span>
Disease,tick bite,forestry workers,public health,vaccine
https://aeji.journals.ekb.eg/article_17312.html
https://aeji.journals.ekb.eg/article_17312_739d7b2d0a323ca896686d211880bb14.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
How Morocco Succeeds in Eliminating Schistosomiasis
79
82
EN
Zineb
Tlamçani
University Hospital Center Hassan II, Fes, Morocco
tzineb@hotmail.fr
10.21608/aeji.2013.17313
<span>Schistosomiasis is an endemic parasitic infection very linked to poverty. It is considered a world health problem since it infects people from 76 different countries especially tropical and subtropical regions. For many years, Morocco was endemic for shistosome infection. The unique form is urinary schistosomiasis and the first case was described in 1914. After an alarming prevalence rate (13 416 cases) in 1973, Morocco decided to establish a strategy to control and then to eliminate schistosomiasis through three major phases (control, elimination and consolidation). Since 2004 and until now, it isn’t reported any new indigenous case. Morocco achieves the goal and succeeds in decreasing the prevalence of infection to a level of zero so eliminating schistosomiasis in all endemic geographic areas.</span>
Schistosomiasis,elimination,Morocco
https://aeji.journals.ekb.eg/article_17313.html
https://aeji.journals.ekb.eg/article_17313_bd4b454ffa72981e25ed227d97de4967.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Video Case: Granulommatous Esophagitis: Uncommon Cause of Iron Deficiency Anemia
83
83
EN
Mohamed
I
Radwan
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
10.21608/aeji.2013.17314
<span>A 29-year old female patient presented by microcytic hypochromic anemia with parameters of iron deficiency. She was examined by diagnostic upper GIT endoscopy 12 months earlier and it showed GERD grade B. The patient continued to experience anemia and began to feel burning sensation behind the lower end of the sternum besides manifestations of reflux. Then she was re-examined by upper endoscopy and the lower esophagus showed diffuse ulcerations and marked tissue necrosis in a circumferential pattern, multiple biopsies were taken for histopathological examination (video) that revealed granulommatous inflammation of the esophagus.</span>
https://aeji.journals.ekb.eg/article_17314.html
https://aeji.journals.ekb.eg/article_17314_49ac025126a6e8ddeee71474cf087675.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Image Case: Irregular Stricture of The Lower Esophagus: Differential Diagnosis
84
84
EN
Ahmed
Farouq
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
farouqmail2000@yahoo.com
10.21608/aeji.2013.17315
<span>A A 56 years old male patient presented by progressive dysphagia to solids and fluids. Barium swallow shows long segment lower esophageal irregular stricture (Figure1). The differential diagnosis of this condition includes cancer esophagus, corrosive stricture and esophageal motility disorder. Further investigations are needed to reach the final diagnosis mainly upper GI endoscopy. In case of cancer esophagus the patient is usually of old age, may be young but with history of long standing GERD, usually associated with anorexia, cachexia and weight loss and may also bleeds, endoscopy usually clinch the diagnosis and take biopsy. Corrosive stricture usually follows an acute insult after ingestion of corrosive material. Motility disorder may occur at any age and upper endoscopy as was seen in this case may be irrelevant.</span>
https://aeji.journals.ekb.eg/article_17315.html
https://aeji.journals.ekb.eg/article_17315_ca47ddac47f4b5ec7c48c8f0e3e34662.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
3
2
2013
06
01
Case 1-2013: Filarial Lymphoedema of Upper and Lower limbs
85
88
EN
Talaat
Fathy
Tropical Medicine Department, Zagazig University Hospitals
Ashraf
Metwally
Tropical Medicine Department, Zagazig University Hospitals
Amal
A
Gouda
Tropical Medicine Department, Zagazig University Hospitals
dr.amaljouda@yahoo.com
Mona
Abdelmaksoud
Tropical Medicine Department, Zagazig University Hospitals
10.21608/aeji.2013.17316
<span>Twenty two-year-old house wife from Sharkeya, Egypt presented to the outpatient clinic of Tropical Medicine Department with fatigue and bilateral heaviness and swelling in her lower limbs as well as her left upper limb that started at the dorsum of her feet and progressed gradually to affect both limbs asymmetrically (the left lower limb was swollen more than the right) up to the knee and then appeared in the left upper limb starting from the hand and gradually progressing to reach level of the elbow. The patient had normal general examination.</span><br /><br /><span>Examination of the affected limbs revealed normal color, temperature and hair distribution. No visible or dilated veins were noted. The examination revealed no ulceration or any skin lesions in the affected limbs. The oedema was partially pitting with spongy sensation (stage 2). The circumferences of the affected limbs were measured to observe the response to therapy. The oedema level was up to knee in both lower limbs and up to elbow in the upper limb (grade 1). The pulsation of dorsalis pedis, posterior tibial, popliteal, and femoral arteries in both lower limbs were intact as well as radial, ulnar, brachial and axillary arteries pulsations in the affected upper limb. There were no palpable inguinal or axillary lymph nodes. The patient was admitted to Tropical Medicine Department, Zagazig University Hospitals for evaluation of her condition. The patient received broad spectrum antibiotic and diuretic therapy and was advised to elevate her lower limbs and wear an elastic band over the affected upper limb. The previous measures gave minimal improvement of the swelling. The patient's routine laboratory investigations were normal. The patient performed Doppler evaluation for the venous systems in the affected limbs which was normal. The nocturnal peripheral blood film was negative for W. bancrofti microfilaria. The lymphiscintigraphy for lower limbs revealed patent lymphatics.</span>
https://aeji.journals.ekb.eg/article_17316.html
https://aeji.journals.ekb.eg/article_17316_193db6cdcec8ab7f4ed94a3a1f7074ee.pdf