Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76136420161201Dickkopf-1: As a Diagnostic and Prognostic Serum Marker for Hepatocellular Carcinoma156165997410.21608/aeji.2016.9974ENAhmed SharafTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptEl-Said El-BadrawyTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptNaglaa KhalifaClinical Pathology Department, Faculty of Medicine, Zagazig University, EgyptSameh Abdel MonemTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptHosam DawodTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20180731<strong>Background and study aim:</strong> Hepatocellular carcinoma (HCC) accounts for 70 - 80% of all liver cancers and the 5-year survival is only 3 - 5%. This bad prognosis is due to the lack of an effective method for early diagnosis. So, only 30 - 40% of patients with HCC are suitable for curative treatments at the time of diagnosis. Thus, there is a great need for tools to diagnose HCC early especially in cirrhotic patients. The aim of this work is to assess the validity of serum DKK1 as a diagnostic marker for HCC and to assess prognostic value of serum DKK1 in predicting treatment response, complication and survival in HCC patients.
<strong>Patients and Methods:</strong> This study included Session [CurrentTestPartID] Patients divided into two groups. Group A: consisted of 30 patients with post hepatitic C and/or B liver cirrhosis. Group B: consisted of 30 patients with HCC on top of post hepatitic C and/or B liver cirrhosis. Group B patients underwent either radiofrequency ablation or ethanol injection. Clinical assessment, routine laboratory evaluation, CT studies and measurement of serum alpha-fetoprotein (AFP) and DKK1 were performed to all patients and repeated to group B patients 1 and 3 months after treatment.
<strong>Results:</strong> The optimum cut off value of DKK1 for diagnosis of HCC was 4.3 ng/mL (AUC 0.89, sensitivity 66.7% and specificity 96.6%) (P<0.001). While, the optimum cut off value for AFP was > 101 ng/mL with 90% sensitivity and 75.9% specificity (p<0.001). Testing of both DKK1 and AFP increased the diagnostic accuracy for HCC (AUC 0.901, sensitivity 93.3%, and specificity 75.9) (P<0.001). Serum DKK1 level significantly decreases after HCC treatment with either radio-frequency ablation or ethanol injection (P<0.001).
<strong>Conclusion:</strong> Testing of both DKK1 and AFP significantly increased the diagnostic accuracy for HCC. Meanwhile, DKK1 can be used alone for HCC diagnosis even in HCC with inconclusive AFP. DKK1 has a promising prognostic value and can be used for follow up of HCC patients who underwent loco-regional treatment.
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76136420161201Monocyte Chemotactic Protein-1 Gene Expression in Blood and Ascitic Fluid of Cirrhotic Patients with Spontaneous Bacterial Peritonitis166174997610.21608/aeji.2016.9976ENMaha OmarDepartment of Hepatology ,Gastroenterology and Infectious Diseases, faculty of Medicine, Benha University , EgyptShuzan AMohammedDepartment of Medical Biochemistry, Faculty of Medicine, Benha University, EgyptJournal Article20180731<strong>Background and study aim:</strong> Cirrhotic patients with ascites show a higher susceptibility to bacterial infections, monocyte chemotactic protein-1 (MCP-1) secretion is up-regulated during chronic hepatitis and correlates with the severity of hepatic inflammation. The aim of this work is to determine the level of expression of MCP-1 gene in blood and ascitic fluid in cirrhotic patients with and without spontaneous bacterial peritonitis (SBP) to evaluate its role in pathogenesis of SBP and its role in diagnosis.
<strong>Patients and Methods:</strong> This study included 15 healthy subjects served as control group in addition to 35 cirrhotic patients due to HCV infection with ascites; classified into two groups, cirrhosis without SBP (15 patients) and cirrhosis with SBP (20 patients). All groups were subjected to quantitative estimation of MCP-1 gene expression in blood by real time PCR. In SBP and non SBP groups the gene expression were assessed in ascitic fluid also at diagnosis and reassessed in SBP group after treatment.
<strong>Results:</strong> Blood and ascitic fluid expression of MCP-1 gene were significant higher in SBP group than non SBP group and control group. SBP group showed a significant decrease in level of MCP-1 gene expression in blood and ascitic fluid after resolution of infection by appropriate treatment of SBP.
<strong>Conclusion:</strong> MCP-1 gene expression in both blood and ascitic fluid may be related to pathophysiology and course of SBP and can be used as a marker for diagnosis.
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76136420161201Prednisolone can Prevent Post-Herpetic Neuralgia in Post-Kidney Transplant Recipient175179997710.21608/aeji.2016.9977ENMohammad AhmedSarayaDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.Mariam AbdulrhmanAl-FadhliDepartment of Medicine, Infectious Disease Hospital, Ministry of Health, Kuwait.Jafar AbdulridaQasemDepartment of Applied Medical Sciences, College of Health Sciences, Public Authority for Applied Education and Training, (PAAET)Journal Article20180731<strong>Background and study aim:</strong> Post-herpetic neuralgia (PHN) is a neuropathic painful condition that is one of the most frequent complications of an acute herpes zoster infection. Till now, there is no general agreement on the definition of PHN. Some studies described a wide range of definitions, including any pain that comes after disappearing of the herpes zoster rash, whereas other studies applied the definition of pain that persist for more than one or two months after the onset of rash. The aim of this study was to assess the effect of oral prednisolone with antiviral therapy on prevention of post-herpetic neuralgia in post-kidney transplant recipient.
<strong>Patients and methods:</strong> 40 patients were divided into two groups, the first one (group A) involved 20 patients who had renal transplant within the past five years and have received oral prednisolone (10 mg/day) and the second one (group B) involved also 20 patients but they are immune-competent without co-morbidity. Follow up was done at one, three and six months to assess the pain.
<strong>Results:</strong> At time of admission and discharge, there was significant difference between group A and group B as regard zoster pain. The same significance was observed between two groups during follow up after one and three months and not observed after six months.
<strong>Conclusion:</strong> Oral corticosteroid can promote modest benefits in decreasing the pain of herpes zoster and the incidence of PHN in post-kidney transplant recipient.Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76136420161201Case Report 1 :Guillain Barré Syndrome Post Primary Varicella Infection180181997910.21608/aeji.2016.9979ENMariam AbdulrhmanAl-FadhliDepartment of Medicine, Infectious Disease Hospital, Ministry of Health, Kuwait.Saroj BalaGroverDepartment of Medicine, Infectious Diseases Hospital, KuwaitMohamed AhmedSarayaDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptJournal Article20180731<span>Guillain-Barré syndrome (GBS) is a critical condition that usually arises as a late complication of certain infections. Varicella zoster is (VZ) an extraneous antecedent infection that can cause GBS. We report a rare case of GBS following primary VZV infection in an adult.</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76136420161201Case Report 2 :Rabies Through Organ Transplant182184998010.21608/aeji.2016.9980ENMariam AbdulrhmanAl-FadhliDepartment of Medicine, Infectious Disease Hospital, Ministry of Health, Kuwait.Saroj BellaGroverDepartment of the Medicine, Infectious Diseases Hospital, KuwaitMohamed AhmedSarayaDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, EgyptJournal Article20180731<span>The rabies virus causes fatal encephalitis and can be transmitted through tissue or organ transplantation. In March 2015, a kidney recipient with no reported exposures to potentially rabid animals died from rabies after transplantation.</span>