Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Cardiac Parameters and Interleukin-6 Differences between Adolescents with Hepatitis B Infection versus those Complicated with Hepatocelluar Carcinoma6873873810.21608/aeji.2018.8738ENWaleed MohamedElguindyPediatrics Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptSameh MAbdel MonemTropical Medicine Department, Faculty of Medicine,Zagazig University, Zagazig, EgyptHosam El Din MostafaSeleemTropical Medicine Department, Faculty of Medicine, Menofia University, EgyptThoraya HosnyClinical pathology Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20180706<strong>Background and study aim: </strong>Hepatitis B virus (HBV) is a major risk factor of hepatocellular carcinoma (HCC) in all age groups. There is a need to differentiate between them in the adolescence age by laboratory and physical examination for assessment of different outcomes of both diseases.
<strong>Subjects and Methods: </strong>Cross sectional study that included Session [UserIDID] adolescents with HBV, another Session [UserIDID] with HCC with age ranging from 12 and up to 17 years. They were selected from those admitted to Tropical Medicine Department, Menofia University and Tropical Medicine Department, Zagazig University. All patient underwent laboratory assessment of interleukin6 (IL6) and were further examined at the Cardiology Unit in Pediatric department of Ain Shams University hospitals for complete echo-cardiographic and anthropometric evaluation.
<strong>Results: </strong>Twenty four patients have HCC were examined with mean age (14.15± 3.01) years and another Session [UserIDID] are having HBV (14.64±3.13) years. Differences were found between both groups as regards IL6 as mean values were (13.29 pg/ml) in HBV and (77.63 pg/ml) in HCC group while no differences were detected as regards cardiac and anthropometric evaluations.
<strong>Conclusion: </strong>IL6 seems to be a useful marker to compare between HBV and HCC in adolescent patients instead of depending on clinical cardiac evaluation or growth parameters that showed no differences.
<strong> </strong>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601The Relation between Interstitial Lung Disease and Chronic HCV Infection7480873910.21608/aeji.2018.8739ENEl Saed GEl BadrawyTropical Medicine Department, Faculty of Medicine, Zagazig University,Zagazig, EgyptTaghrid MohamedAbdallaTropical Medicine Departments, Faculty of Medicine, Zagazig University, Zagazig, EgyptHanan MohammedEl ShahatChest Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptJournal Article20180706<strong>Background and study aim: </strong>Interstitial lung disease (ILD) includes a variety group of about 200 conditions that insult the lung parenchyma with different patterns of inflammation and fibrosis. Hepatitis C virus (HCV)is Flavivirus with diverse hepatic and extrahepatic diseases. Its direct and indirect pathogenic association with many pulmonary manifestations-including interstitial lung disease-has been suggested yet needs more elucidation.
<strong>Patients and Methods: </strong>A case control study was conducted with a total of 50 chronic hepatic patients. They were equally divided into two groups, HCV positive group (group 1= 25 patients) and HCV negative group (group 2= 25 patients). Group 1 was subdivided into two subgroups, without-idiopathic interstitial pneumonias patients (without IIPs subgroup A= 13 patients) and with idiopathic interstitial pneumonias patients (IIPs subgroup B = 12 patients). Both groups were subjected to thorough history taking, clinical examination, and routine investigations. The diagnosis of HCV was confirmed by viral markers including HCV antibodies and PCR. Other chronic hepatic liver diseases were confirmed by abdominal ultrasound and ultrasound- guided liver biopsy. Arterial blood gases, auto antibodies, Computerized pulmonary function tests and radiological studies including plain X ray chest and heart and HRCT scanning were also done. All patients with idiopathic pulmonary fibrosis (IPF) had fulfilled the ATS/ ERS diagnostic guidelines. Both groups were matched according to age, sex and body mass index.
<strong>Results: </strong>The HCV positive group was found to have a significantly higher frequency of ILD than the HCV negative group with also more restrictive pattern hypoxemia and higher scores of IPF (by computed tomography).
<strong>Conclusion: </strong>ILD is more frequent in patients with chronic HCV infection with higher grades of fibrosis and hypoxemia. HCV infection may be predisposing factor for IPF.Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Inflammatory Bowel Diseases Prevalence in Patients Underwent Colonoscopy in Zagazig University Hospitals8187874010.21608/aeji.2018.8740ENEhab FMostafaInternal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt.Ashraf MetwallyTropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, EgyptSafa AHusseinCommunity Medicine Department, Faculty of medicine, Zagazig University, EgyptJournal Article20180706<strong>Background and study aim: </strong>Colonoscopy is recommended by many international gastroenterology and cancer societies as the initial diagnostic modality for colorectal cancer. It is considered the most accurate diagnostic tool in inflammatory bowel disease. These are two identified subtypes of the disease, ulcerative colitis (UC) and Crohn's disease. The previous studies on Egyptian patients said that the incidence of IBD increased significantly in the past ten years. The aim of this study was to calculate the prevalence of IBD among patients referred to endoscopy units to perform colonoscopy and define the most common presenting symptoms of IBD. We also wanted to shed light on the most common presenting complaints that lead to referral to colonoscopy and the common colonic lesions that were diagnosed by colonoscopy.r
<strong>Patients and Methods: </strong>Cross sectional study involved 250 patients who underwent colonoscopy in the period from November 2014 to November 2015, the presenting complaint was recorded as well as the results of colonoscopy.
<strong>Results: </strong>Bleeding per rectum was the commonest indication for colonoscopy (46%) followed by chronic abdominal pain (20%), then chronic diarrhea (17%). The commonest pathological conditions were internal hemorrhoids in 27.6% followed by nonspecific colitis in 20.4%, ulcerative colitis in 10.4%, carcinoma in 10.4%, Crohn's in 0.8% then polyps in 0.4%. UC/CD ratio was 13:1.
<strong>Conclusion: </strong>In a group of Egyptian patients undergoing colonoscopy the most frequent diagnosis were internal piles, non-specific colitis followed by inflammatory bowel disease with a prevalence of 11.2% and predominance of UC over CD.Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Assessment of Cancer Antigen 125 in Post-HCV Chronic Liver Disease and Hepatocellular Carcinoma Patients8893874110.21608/aeji.2018.8741ENRania FEl-FollyTropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptHeba HAliClinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, EgyptNevien FEL-FoulyTropical Medicine, Department of Health Research, National Center for Radiation Research and Technology, Atomic Energy Authority, Cairo, EgyptJournal Article20180706<strong><span style="font-size: small;">Background and study aim: </span></strong><span style="font-size: small;">Most of the morbidity and mortality of chronic liver diseases is due to its progression and complication of cirrhosis as ascites. The cancer antigen (CA) -125 is a high molecular mass glycoprotein produced both by ovarian cancer cells as well as by normal cells derived from coelomic epithelium. This study was conducted to assess the serum and/or ascitic fluid level of CA125 in HCV cirrhotic patients (decompensated or not) with or without Hepatocellular Carcinoma (HCC).</span>
<strong>Patients and Methods: </strong>Group I: Session [CurrentTestPartID] post HCV liver cirrhosis cases; (A) 30 cases without ascites, (B) 30 cases with ascites. Group II: Session [CurrentTestPartID] HCC of post HCV liver cirrhosis cases; (C) 30 cases without ascites, (D) 30 cases with ascites. Serum and ascetic fluid level of CA-125 as well as serum AFP were assessed in all cases<strong>.</strong>
<strong>Results: </strong>Serum level of CA-125 between group A&B being higher in group B (P<0.01), however between groups C&D being higher in group D (P<0.01). There was a positive correlation between serum level of CA-125 and AFP level in group A and C (P>0.05). Regarding Group B and D, there was a positive correlation between serum level of CA-125 and each of AFP level (P>0.05) and ascitic level of CA-125 (P<0.01). Concerning the ascitic level of Ca 125, being higher in group D than B (P<0.01). Only AFP had a significant diagnostic performance (P<0.01) in differentiating HCC groups from non-HCC groups.
<strong>Conclusion: </strong>Elevated serum and ascetic level of CA125 in decompensated cirrhosis with or without HCC. AFP had a diagnostic performance in HCC diagnosisZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Study of Diagnostic Role of Urine Malaria Test in Patients with Falciparum Malaria Admitted in Abbassia Fever Hospital94102874210.21608/aeji.2018.8742ENHossam IbrahimMohamedTropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, EgyptIsmael MahmoudMoharamParasitology Department, Faculty of Medicine, Menoufia University, Menoufia, EgyptAhmed RagabEl-GazzarahTropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, EgyptHesham El-SaeedSallamAbbasia Fever Hospital, Ministry of Health, Cairo, EgyptJournal Article20180706<strong>Background and study aim: </strong>Malaria morbidity and mortality can be prevented or minimized by rapid diagnosis and treatment. Blood based rapid diagnostic tests (bRDT) for malaria are currently in use but other body fluids specific diagnostic test kits are being developed. One of these tests is Urine Malaria Test (UMT) dipstick, it is a one-step test used to detect Histidine Rich Protein 2 (HRP2), a polyhistidine antigen of plasmodium falciparum (Pf) in urine of affected patients. The aim of the present study was to evaluate the role of UMT in diagnosis of Pf malaria and its ability to detect the limits of Pf parasitemia in febrile patients admitted to Abbasia Fever Hospital, Egypt.<br /> <strong>Patients and Methods: </strong>This study was conducted on<strong> </strong>52 Pf malarial patients who were admitted to Abbassia Fever Hospital. Patients were subjected to meticulous history taking, clinical examination, routine laboratory investigations, abdominal ultrasound, blood film microscopy for malaria, rapid blood test (RBT) and UMT. Confirmed Pf malaria in the studied patients was based on the presence of positive parasite-based tests (+ve blood film microscopy with/without RBT for Pf malaria).<br /> <strong>Results: </strong>The UMT was positive in 50% of cases with 50% false negative results in parasitologically confirmed Pf malarial patients. Sixteen patients presented with parasitemia ≤0.5% (ranged between 0.1% to ≤0.5%) in thick blood film and there was non-significant difference between positive and negative UMT in these patients [43.75% of cases were +ve versus 56.25% -ve test (p=0.280) with sensitivity (55.56%), specificity (71.43%) and accuracy (62.5%)]. The +ve UMT results were significantly related to higher parasitemia, lower Glasgow coma scale, lower platelet count and severe disease.<br /> <strong>Conclusion: </strong>The UMT is simple, easy, self-performed and promising test in diagnosis of Pf malaria, however the sensitivity and specificity were apparently low.Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Cytomegalovirus Retininis in a Patient with Waldenstrom Macroglobulinemia103104874310.21608/aeji.2018.8743ENFelipe TavaresRodriguesGraduate Student of Escola de Medicina e Cirurgia do Rio de Janeiro- UNIRIO, BrazilAlexandre De CarvalhoPaivaPhysician at Hospital Universit?rio Gafrée e Guinle- UNIRIO, BrazilCatherine Da CalValdezPhysician at Hospital Universit?rio Gafrée e Guinle- UNIRIO, BrazilCleonice AlvesDe Melo BentoProfessor of Universidade Federal do Estado do Rio de Janeiro – UNIRIO, Brazil.Regis MarianoDe AndradeProfessor of Universidade Federal do Estado do Rio de Janeiro – UNIRIO, Brazil.Journal Article20180706<span>A 62-years-old woman presented with <span>microcytic hypochromic anemia, diffuse</span> <span>adenopathy, , and hepatosplenomegaly</span>, was diagnosed as having Waldenst?m Macroglobulinemia by blood serum electrophoresis which detected a IgM-KAPPA monoclonal gammopathy, besides the results of immuno-<span>phenotypic characteristics of neoplastic</span> <span>B-lymphocytes present in bone marrow</span> positive for CD19, CD20, FMC7, CD79; and not reactive for CD23, CD5 and CD38.<span> MYD88 mutation was absent.</span> The patient underwent a week intermittent chemotherapy (oral scheme: Predinisone Session [CurrentTestPartID] mg and Chlorambucil 2 mg during 5 months) <span>and then, without adequate therapeutic</span> response, it was reset including intra-venous <span>anti-CD20 </span>monoclonal immunoglobulin (Rituximab, for 4 months). The patient had a good response to the therapy. However, almost a year after Rituximab scheme started, patient complained of sudden decrease of visual acuity (20/200) according to the Snellen chart with <span>floaters, only in the left eye. CD4 T <span>cell count was </span></span><span>205 cells/mm<sup><span>3</span></sup><span>, relatively</span></span><span> reduced when compared to a health person because of the chronic use of immunosuppressant drugs and the down modulation due to the inflammatory stress state seen at a hematological </span>lymphoproliferative<span> disease.</span><span> Fundoscopy findings were compatible with CMV retinitis , confirmed by CMV-DNA PCR in plasma samples with a high viremia (3.102 copies/mL). Plasma cytokines were measured to see the inflammatory response </span></span><span>Intravenous </span><span>Ganciclovir 500mg every <span>12 hours for 2 weeks was administered</span>. </span><span><span>Granulocyte colony-stimulating factor</span> <span>was used to manage neutropenia. Visual</span> acuity improvement was observed (20/40).</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76138220180601Mean Platelet Volume may not be a Diagnostic Marker for Hepatocellular Carcinoma due to Chronic Hepatitis C Infection105106874410.21608/aeji.2018.8744ENCengiz BEYANUfuk University Faculty of Medicine, Department of Hematology, Ankara, TurkeyEsin BEYANUniversity of Health Sciences, Kecioren Training and Research Hospital,Department of Internal Medicine, Ankara, TurkeyJournal Article20180706We read with a great interest the article of Omar et al. about mean platelet volume (MPV) and hepatocellular carcinoma (HCC) due to chronic hepatitis C (CHC) infection . They found that MPV was sensitive and specific in diagnosis of HCC. We would like to comment on this study.
Notwithstanding that MPV is a platelet parameter of routine blood count; its measurement has not standardized . The MPV is dependent on a number of variables including time of analysis after venipuncture, method of analysis, anticoagulant used and specimen storage temperature . The MPV increases with EDTA depending on the measurement time after veni-puncture. This increment generally occurs up to 30-45% within 2 hours exposure to EDTA . Also, the various technologies for measuring the complete blood count cause to variable MPV results . MPV variations up to 40% were noted with comparison of the different instruments. Beyan & Beyan performed a meta-analysis using the data of 181 studies containing a healthy control groups within 1181 studies about MPV indexed PubMed database . The MPV measurements varied up to 17.8% by the instruments and maximum deviations in MPV measurements by the MPV measurement times after venipuncture plus the instruments used varied up to 27.7% in this meta-analysis . Because the instrument/s used in automated blood cell counting and the MPV measurement times after venipuncture were not specified in this study, the reliability and validity of the data were questionable.
On the other hand, it has been suggested that MPV varies according to age and sex . In fact, some studies did not identify significant differences of MPV in men and women, while some others detected MPV higher in women or in men. Discordant results were also reported about the correlation with age . There were statistically significant differences in terms of sex and gender between control group and HCC group in this study and probably, the differences of MPV values might be originated from sex- and age- mismatch groups. As a result, MPV may not be a diagnostic marker for HCC due to CHC infection.