Publications by authors named "Mohamed Nabil"

38 Publications

Surgical outcome of children with medulloblastoma: a retrospective study of a 405-patient series from Children's Cancer Hospital Egypt (CCHE-57357).

Childs Nerv Syst 2021 Feb 18. Epub 2021 Feb 18.

Neurosurgery Department, Children's Cancer Hospital Egypt (CCHE, 57357), Cairo, Egypt.

Purpose: To analyze the impact of increasing the extent of resection (EOR) on the survival rates and on the surgical outcome of children with medulloblastoma.

Methods: A series of consecutive 405 children operated for medulloblastoma between July 2007 and April 2018 was identified. The details of pre-operative data, surgical interventions, post-operative complications, and survival rates were analyzed.

Results: The Kaplan-Meier (KM) analysis showed no advantage of gross total resection (GTR) over near and subtotal resection regarding over all (OS) (p=0.557) and progression free survival (PFS) (p=0.146). In the same time, increasing the EOR was not associated with higher morbidity. Tumor dissemination at onset correlated to worse OS (KM: p=0.003, OR 1.999, 95% CI: 1.242-3.127; p = 0.004) and PFS (KM: p<0.001, Cox: OR 2.171, 95% CI: 1.406-3.353; p<0.001). OS was significantly affected in patients < 3 years old (KM: p=0.011, OR 2.036, 95% CI: 1.229-3.374; p = 0.006), while PFS was worse among patients who had pre-op seizures (KM: p=0.036, Cox: OR 2.852, 95% CI: 1.046-7.773; p=0.041) or post-op pseudomeningocele (KM: p=0.021, Cox: OR 2.311, 95% CI: 1.123-4.754; p=0.023).

Conclusions: Although surgical excision of medulloblastoma is the standard of care, there was no significant benefit for GTR over near or subtotal resection on the OS or PFS rates that are mainly influenced by the patient's age and tumor dissemination. However, GTR should be targeted, as it is not associated with increased incidence of mutism or other surgery-related complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00381-021-05082-2DOI Listing
February 2021

Applying machine learning on home videos for remote autism diagnosis: Further study and analysis.

Health Informatics J 2021 Jan-Mar;27(1):1460458221991882

Arab Academy for Science and Technology, Egypt.

Autism Spectrum Disorder (Autism) is a developmental disorder that impedes the social and communication capabilities of a person through out his life. Early detection of autism is critical in contributing to better prognosis. In this study, the use of home videos to provide accessible diagnosis is investigated. A machine learning approach is adopted to detect autism from home videos. Feature selection and state-of-the-art classification methods are applied to provide a sound diagnosis based on home video ratings obtained from non-clinicians feedback. Our models results indicate that home videos can effectively detect autistic group with True Positive Rate reaching 94.05% using Support Vector Machines and backwards feature selection. In this study, human-interpretable models are presented to elucidate the reasoning behind the classification process and its subsequent decision. In addition, the prime features that need to be monitored for early autism detection are revealed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1460458221991882DOI Listing
February 2021

Gastro-Protective Effects of Leaf Extract on Indomethacin-Induced Gastric Ulcer in Wistar Rats: In Silico and In Vivo Studies.

Antioxidants (Basel) 2021 Jan 26;10(2). Epub 2021 Jan 26.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt.

We have previously reported that the leaf extract of exhibited substantial antioxidant, anti-inflammatory, analgesic, and antipyretic properties in vivo. We also comprehensively characterized the active phytoconstituents and found several flavonoids and galloyl glucosides derivatives. In the current work, we explored the gastroprotective effects of the leaf extract in an indomethacin-induced ulcer model and the mechanisms involved. The rats being pretreated with the tested extract (100 and 200 mg kg) significantly prevented gastric lesions by 87.4% and 92.3%, respectively, and they had no structural derangements in the gastric mucosa. The extract significantly reduced the elevated levels of IKκB, NF-κB, TNF-α, IL-6, iNOS, and lipid peroxidation; increased the reduced level of glutathione peroxidase (GPx) activity; and reduced glutathione (GSH) in the indomethacin-induced ulcer model. The protective activities of the extract were similar in most aspects to those exerted by the known anti-ulcer drug famotidine. These activities might be attributed to the anti-inflammatory and antioxidant activities, and the reduction of iNOS levels. In conclusion, is a potential candidate for management of gastric ulcers with antioxidant properties.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/antiox10020176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911069PMC
January 2021

Evaluating efficacy of intravenous carbetocin in reducing blood loss during abdominal myomectomy: a randomized controlled trial.

Fertil Steril 2021 Mar 16;115(3):793-801. Epub 2021 Jan 16.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Objective: To evaluate the efficacy of carbetocin versus placebo in decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy.

Design: Randomized, double-blind, placebo-controlled trial.

Setting: Tertiary university hospital from September 2019 to February 2020.

Patient(s): A total of 138 women with symptomatic leiomyoma who were candidates for abdominal myomectomy (n = 69 in each group).

Intervention(s): We randomized the study participants in a 1:1 ratio to carbetocin and placebo groups. Intravenous 100 μg carbetocin or placebo was administered slowly after induction of anesthesia.

Main Outcome Measure(s): Intraoperative blood loss, need for blood transfusion, postoperative hemoglobin, operative time, length of hospitalization, and drug side-effects.

Result(s): The baseline characteristics were similar among all groups. Carbetocin had significantly lower intraoperative blood loss compared with placebo (mean difference 184 mL). Hemoglobin level 24 hours after surgery was significantly lower in the placebo group than in the carbetocin group (9.1 ± 0.8 vs. 10.3 ± 0.6 g/dL). Eight women in the carbetocin group needed blood transfusion compared with 17 in placebo group. Operative time, length of hospitalization, and side-effects were similar in both groups.

Conclusion(s): A single preoperative intravenous dose of 100 μg carbetocin is a simple, practical, and effective method of decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy, with tolerable, few, nonsignificant side-effects.

Clinical Trial Registration Number: NCT04083625.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.fertnstert.2020.09.132DOI Listing
March 2021

Hepatocellular Carcinoma Multidisciplinary Clinic-Cairo University (HMC-CU) score: A new simple score for diagnosis of HCC.

Arab J Gastroenterol 2020 Jun 18;21(2):102-105. Epub 2020 May 18.

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background And Study Aims: The risk of hepatocarcinogenesis depends on background liver factors, of which fibrosis is a major determinant. Serum markers and scores are of increasing importance in non-invasive diagnosis of hepatic fibrosis. Our aim was to predict the occurrence of hepatocellular carcinoma (HCC) using a non-invasive fibrosis score calculated using routine patient data.

Patients And Mthods: Our retrospective study included 1,291 hepatitis C related-HCC Egyptian patients (Group 1) recruited from the multidisciplinary HCC clinic, Faculty of Medicine, Cairo University in the period between February 2009 and June 2016 and 1072 chronic hepatitis C-naïve patients (Group 2) with advanced fibrosis (≥F3) and cirrhosis (F4). King score, Fibro Q score, Aspartate aminotransferase-to-platelet ratio index (APRI), AST to ALT ratio (AAR), LOK score, Göteborg University Cirrhosis Index (GUCI), Fibro-α and Biotechnology Research Center (BRC) scores were calculated for all patients. Regression analysis and receiver operating characteristics (ROC) were used to calculate the sensitivity, specificity and predictive values for significant scores with the best cut-off for predicting HCC. A regression equation was used to calculate predicted probabilities of HCC using the following variables; age, gender, haemoglobin, international normalised ratio (INR), albumin and alpha fetoprotein. The appropriate score cut-off points yielding optimal sensitivity and specificity were determined by ROC curve analysis.

Results: There was a highly significant difference between the two groups for all calculated scores (P = 0.0001). Our new score, the Hepatocellular Carcinoma Multidisciplinary Clinic-Cairo University (HMC-CU) score (Logit probability of HCC =  - 2.524 + 0.152*age - 0.121*Hb - 0.696*INR - 1.059*Alb + 0.022*AFP + 0.976*Sex. Male = 1, Female = 0), with a cut-off of 0.559 was superior to other scores for predicting HCC, having a sensitivity of 90% and specificity of 80.6%.

Conclusion: The HMC-CU score is a promising, easily calculated, accurate, cost-effective score for HCC prediction in chronic HCV patients with advanced liver fibrosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajg.2020.04.001DOI Listing
June 2020

Prolonged overnutrition with fructose or fat induces metabolic derangements in rats by disrupting the crosstalk between the hypothalamus and periphery: Possible amelioration with fenofibrate.

Eur J Pharmacol 2020 Jul 28;879:173136. Epub 2020 Apr 28.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt. Electronic address:

Metabolic Syndrome (MetS) increases the risk of developing type 2 diabetes mellitus and cardiovascular complications. The crosstalk between the hypothalamus and periphery is vital for regulating food intake and energy homeostasis. However, it is impaired during MetS. The present study aimed to compare the distinct central and peripheral metabolic derangements induced by a high-fructose drink or high-fat diet, as well as the possible intervention by fenofibrate. Rats were divided into five groups: standard chow diet (SCD) group, high-fructose group (FR), high-fat group (HF), FR plus fenofibrate group (FR-F), and HF plus fenofibrate group (HF-F). FR and HF groups showed hyperglycemia, hyperinsulinemia, hypertriglyceridemia, hyperleptinemia, steatosis, and adipocyte hypertrophy. This was associated with elevated circulating levels of proinflammatory cytokines and free fatty acids (FFAs). The latter mediators are involved in the hypothalamic inflammation and dysregulation of signaling cascades that control food intake and glucose homeostasis. The effects were more pronounced in the HF group than FR group, which were matched with the observed higher levels of plasma FFAs and cytokines. Fenofibrate administration improved not only the peripheral metabolic disturbances, but also the central disturbances associated with insulin resistance induced by FR or HF diet. This study sheds light on the pivotal role of the hypothalamus in diet-induced MetS. Furthermore, the study suggests the utmost importance of developing a standardized model of metabolic syndrome in place of the great diversity between available models, which can induce different effects and negatively impact the validity of prospective studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejphar.2020.173136DOI Listing
July 2020

Thrombectomy-Related Emboli: Direct Aspiration versus Stent Retriever Thrombectomy for Acute Ischemic Stroke: Our Experience and Literature Review.

World Neurosurg 2020 Mar 21;135:e588-e597. Epub 2019 Dec 21.

Department of Neuroradiology, Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland.

Objective: Thrombectomy-related emboli (TRE) represent a potentially dangerous complication of thrombectomy procedures for acute ischemic stroke. The aim of this study was to compare the rate of TRE in aspiration thrombectomy (ASP) and stent retriever thrombectomy techniques.

Methods: We retrospectively compared clinical and radiologic outcomes of 2 groups of consecutive patients with stroke, ASP group and SRT group, with TRE rates as the primary study endpoint. Emboli were classified as either affected territory emboli or unaffected territory emboli (uTRE). Relevant literature was also reviewed.

Results: The ASP group had better rates of successful recanalization (97.1% vs. 77.1%, P = 0.02), mean number of passes per case (2.0 vs. 3.3, P = 0.04), and mean operative time (34.1 minutes vs. 84.8 minutes, P < 0.0001). Thrombectomy technique (ASP vs. SRT) did not appear to predict rates of either affected territory emboli (odds ratio [OR] = 1.24, 95% confidence interval [CI] 0.33-4.63, P = 0.74) or uTRE (OR = 5.67, 95% CI 0.60-53.42, P = 0.13). Longer operative time was linked to higher uTRE rates (OR = 1.03, 95% CI 1.01-1.05, P = 0.02). ASP technique (OR 0.1, 95% CI 0.01-0.88; P = 0.04) and shorter operative time (OR = 0.98, 95% CI 0.97-0.99, P = 0.03) were linked to better rates of successful recanalization.

Conclusions: The applied thrombectomy technique (ASP vs. SRT) is not an independent predictor of TRE rates. Operative time tends to affect the rates of uTRE and successful recanalization. The ASP technique offers higher rates of successful recanalization in less operative time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.wneu.2019.12.071DOI Listing
March 2020

A COMPARATIVE STUDY OF CORE MUSCULATURE ENDURANCE AND STRENGTH BETWEEN SOCCER PLAYERS WITH AND WITHOUT LOWER EXTREMITY SPRAIN AND STRAIN INJURY.

Int J Sports Phys Ther 2019 Jul;14(4):525-536

Southwest Minnesota State University, Marshall, MN, USA.

Background: Lower extremity sprain and strain injury constitutes a large percentage of lower extremity injuries experienced by soccer players. Yet, very limited data exists on the association between core strength and endurance and this injury.

Purpose: The purpose of this study was to compare core muscle endurance and hip muscle strength between soccer players who experienced non-contact lower extremity sprain and/or strain injury during their season and those who did not. Additionally, the frequency of injury was correlated with core muscle endurance and hip strength, and endurance was used for predicting the risk for injury.

Study Design: Prospective cohort.

Methods: Twenty-one (35.59%) athletes experienced non-contact lower extremity sprain and/or strain injury during the season. Fifty-nine male athletes (mean age 20.92 ± 4.08 years, mass 77.34 ± 12.02 kg and height 1.79 ± 0.06m) were tested. Prior to the start of the season, prone-bridge, side-bridge, trunk flexion and horizontal back extension hold times were recorded for endurance assessment and peak hip abductor and external rotator isokinetic torques for strength assessment.

Results: Prone-bridge and side-bridge hold times were significantly longer in the non-injured players when compared with the times of the injured players (p=0.043 & 0.008 for the prone-bridge and side-bridge, respectively). There were significant negative correlations between the frequency of injury and both prone-bridge (r=-0.324, p=0.007) and side-bridge (r=-0.385, p=0.003) hold times. Logistic regression analysis revealed that side-bridge hold time was a significant predictor of injury (OR=0.956, CI=0.925-0.989).

Conclusion: Soccer players with non-contact lower extremity sprain and/or strain have less core endurance than non-injured players. Reduced core endurance is associated with increased incidence of injury. Improving side-bridge hold time, specifically, may reduce the risk for injury.

Level Of Evidence: 1b.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6670058PMC
July 2019

Restoring the Taxol biosynthetic machinery of Aspergillus terreus by Podocarpus gracilior Pilger microbiome, with retrieving the ribosome biogenesis proteins of WD40 superfamily.

Sci Rep 2019 08 8;9(1):11534. Epub 2019 Aug 8.

Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig, 44519, Egypt.

Attenuating the Taxol yield of Aspergillus terreus with the subculturing and storage were the technical challenges that prevent this fungus to be a novel platform for industrial Taxol production. Thus, the objective of this study was to unravel the metabolic machineries of A. terreus associated with attenuation of Taxol productivity, and their restoring potency upon cocultivation with the Podocarpus gracilior microbiome. The Taxol yield of A. terreus was drastically reduced with the fungal subculturing. At the 10 subculture, the yield of Taxol was reduced by four folds (78.2 µg/l) comparing to the original culture (268 µg/l), as authenticated from silencing of molecular expression of the Taxol-rate limiting enzymes (GGPPS, TDS, DBAT and BAPT) by qPCR analyses. The visual fading of A. terreus conidial pigmentation with the subculturing, revealing the biosynthetic correlation of melanin and Taxol. The level of intracellular acetyl-CoA influx was reduced sequentially with the fungal subculturing, rationalizing the decreasing on Taxol and melanin yields. Fascinatingly, the Taxol biosynthetic machinery and cellular acetyl-CoA of A. terreus have been completely restored upon addition of 3% surface sterilized leaves of P. gracilior, suggesting the implantation of plant microbiome on re-triggering the molecular machinery of Taxol biosynthesis, their transcriptional factors, and/or increasing the influx of Acetyl-CoA. The expression of the proteins of 74.4, 68.2, 37.1 kDa were exponentially suppressed with A. terreus subculturing, and strongly restored upon addition of P. gracilior leaves, ensuring their profoundly correlation with the molecular expression of Taxol biosynthetic genes. From the proteomic analysis, the restored proteins 74.4 kDa of A. terreus upon addition of P. gracilior leaves were annotated as ribosome biogenesis proteins YTM and microtubule-assembly proteins that belong to WD40 superfamily. Thus, further ongoing studies for molecular cloning and expression of these genes with strong promotors in A. terreus, have been initiated, to construct a novel platform of metabolically stable A. terreus for sustainable Taxol production. Attenuating the Taxol yield of A. terreus with the multiple-culturing and storage might be due to the reduction on main influx of acetyl-CoA, or downregulation of ribosome biogenesis proteins that belong to WD40 protein superfamily.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-019-47816-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687737PMC
August 2019

Effect of Low-Level Laser Therapy versus Electroacupuncture on Postnatal Scanty Milk Secretion: A Randomized Controlled Trial.

Am J Perinatol 2020 10 21;37(12):1243-1249. Epub 2019 Jul 21.

Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt.

Objective: Postnatal scanty milk secretion is a common complaint. Some physical and medical interventions were advocated to help milk production. These interventions should be effective and safe for the mother and the infant. This study aimed to compare the effects of low-level laser therapy and electroacupuncture on postnatal scanty milk secretion.

Study Design: A randomized controlled study conducted on 60 healthy primiparous mothers with insufficient lactation. They were randomly divided into three equal groups: group A (control), group B (those who received low-power He-Ne laser beam on both breasts), and group C (those who received faradic current stimulation at Spleen 6, Liver 3, and Small Intestine 1 acupuncture points on both sides). All participants received 10 mg Domperidone three times a day and were given advice about lactation, nutrition, and fluid intake. Evaluation was done before and after the treatment program.

Results: The mean serum prolactin, infant weight, and visual analog scale (VAS) score were significantly increased in the three groups posttreatment when compared with their corresponding levels pretreatment. Posttreatment serum prolactin was significantly elevated in group C more than the other two groups ( = 0.001 and 0.012, respectively). Also, it was significantly elevated in group B more than in group A ( = 0.001). The mean value of infant weight was significantly elevated in group C when compared with its corresponding values in both groups A ( = 0.001) and B ( = 0.029). The VAS score was significantly increased in both groups B and C when compared with group A ( = 0.001).

Conclusion: Electroacupuncture is more effective than low-level laser therapy in increasing postnatal scanty milk secretion.

Clinical Trial Registration: NCT03806062.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0039-1693428DOI Listing
October 2020

Modified cesarean hysterectomy technique for management of cases of placenta increta and percreta at a tertiary referral hospital in Egypt.

Arch Gynecol Obstet 2019 03 4;299(3):695-702. Epub 2019 Jan 4.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Giza, Egypt.

Purpose: To evaluate the effect of a modified type II radical hysterectomy on maternal morbidities and mortality in cases with abnormally invasive placenta (AIP).

Methods: 63 cases with AIP were managed at one of the largest referral centers in Egypt in a prospective study design. This technique entails devascularization of the uterus laterally on both sides and to clamp the uterus at the lowest possible point just below the level of the placenta while sparing the ureters.

Results: The difference between pre- and post-operative hemoglobin was only about 1 gm/dl, and the mean blood loss was 1673 ± 958 ml. There was a significant drop in the post-operative need for blood and blood product replacement, packed red blood cells (p = 0.013), fresh red blood cells (p < 0.001), and plasma units (p = 0.012). Operative time (skin to skin) averaged 190 ± 58.2 min as the technique is slow and utilizes meticulous hemostatic steps. ICU admission was 4.8% with a mean total hospital stay of 8.6 ± 3.6 days. Histopathological examination revealed 58 cases of placenta increta and five percreta cases. We also had 16 bladder injuries (25.4%) and two ureteric injuries, and no maternal mortalities.

Conclusion: This technique reduces maternal morbidity and mortality while performing cesarean hysterectomy for cases with AIP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00404-018-5027-7DOI Listing
March 2019

MicroRNA-150 down Regulation in Acute Myeloid Leukaemia Patients and Its Prognostic Implication.

Open Access Maced J Med Sci 2018 Nov 19;6(11):1993-2000. Epub 2018 Nov 19.

Department of Clinical and Chemical Pathology, Medical Division, National Research Centre, Cairo, Egypt.

Background: MicroRNAs (miRNAs) are small, non-coding RNAs that are important for post-transcriptional gene regulation in both healthy and morbid conditions. Numerous miRNAs promote tumorigenesis, while others have a tumour suppressive effects. Acute myeloid leukaemia (AML) is a heterogeneous group of genetically diverse hematopoietic malignancies with variable response to treatment.

Aim: Our study aimed to investigate the possible role of miR-150 in de novo adult AML and the impact of its level on survival, and we used analysis to predict the main target genes involved in miR-150 mediated cancer pathway.

Material And Methods: We evaluated miR-150 expression profiling assay using TaqMan primer probes RT-PCR in the plasma of 50 adult AML patients, before the start of treatment and at day 28 of treatment, along with 20 normal adult control samples. miR-16 was used as an endogenous reference for standardisation. Follow-up of patients during treatment at day 28 of induction chemotherapy and after one year was done.

Results: In this study, we found a significantly lower level of miR-150 in AML patients when compared to controls (p = 0.005) with 0.62 fold change than in healthy controls. Patients were divided into two groups: the low miR-150 group (miR-150 < 1) and the high miR-150 group (miR-150 > 1). A statistically significant difference was found between the two groups regarding initial total leukocytic count and initial PB blast count while for the TLC, HB and PLT count at follow up. No difference in the overall survival between the low and the high miR-150 groups could be demonstrated.

Conclusion: Our results suggest that miR-150 functions as a tumour suppressor and gatekeeper in inhibiting cell transformation and that its downregulation is required for leukemogenesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2018.420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290449PMC
November 2018

Tumor behavior of hepatocellular carcinoma after hepatitis C treatment by direct-acting antivirals: comparative analysis with non-direct-acting antivirals-treated patients.

Eur J Gastroenterol Hepatol 2019 01;31(1):75-79

Endemic Medicine Department.

Introduction: Scarce reports have commented on hepatocellular carcinoma (HCC) behavior after direct-acting antivirals (DAAs).

Aim: To analyze differences in tumor behavior between patients with hepatitis C virus (HCV)-induced HCC and were either treated or not using DAAs.

Patients And Methods: This case-control study includes patients with HCV-related HCC who received generic DAAs (group I) and all non-DAA treated patients with HCC who presented to our clinic during the same period (group II). Patient and tumor characteristics, treatment types and outcome were compared between the two groups.

Results: Group I included 89 patients and group II included 207 patients. No significant difference was detected between groups regarding HCC number or size. Group I showed a more infiltrative HCC pattern, whereas group II had more circumscribed and delineated lesions. The incidence of portal vein thrombosis and significant lymphadenopathy was significantly higher in group I (P=0.03 and 0.03, respectively). Serum levels of α-fetoprotein were significantly higher in group I (P=0.02). These factors significantly affected the response to HCC management (P=0.03). Incidence of complete responses were 47.2 and 49.8% for groups I and II, respectively, whereas incomplete responses were 12.4 and 25.1%, respectively. Supportive treatment was applied to 40.4% in group I and 25.1% in group II.

Conclusion: HCC behavior was more aggressive in DAA-treated patients regarding portal vein thrombosis, malignant lymphadenopathy, and HCC imaging characteristics, which affected the chance of ablation and the treatment response.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MEG.0000000000001264DOI Listing
January 2019

Evaluation of liver steatosis, measured by controlled attenuation parameter, in patients with hepatitis C-induced advanced liver fibrosis and hepatocellular carcinoma.

Eur J Gastroenterol Hepatol 2018 11;30(11):1384-1388

Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Benha, Egypt.

Introduction: Steatosis is a documented feature of chronic hepatitis C (CHC). There is an association between steatosis decrease and fibrosis progression. The association between steatosis and advanced fibrosis versus hepatocellular carcinoma (HCC) development has not been precisely evaluated. The controlled attenuation parameter (CAP) was applied as an immediate and efficient process to detect and quantify hepatic steatosis with adequate accuracy.

Aims: The aim of this study was to assess the difference in liver steatosis between patients with hepatitis C virus-related advanced hepatic fibrosis versus HCC.

Patients And Methods: This cross-sectional study included 130 patients with HCC, attending the multidisciplinary HCC clinic, Cairo University, and 54 patients with CHC between October 2015 and June 2016. Clinical and laboratory characteristics were recorded. Liver stiffness and CAP were obtained by using the FibroScan 502, touch.

Results: All included patients had genotype 4. The mean CAP value was significantly lower in HCC (209.5±57.1 dB/m) versus CHC (259.9±54.9 dB/m). Receiver operating characteristic curve revealed an area under the curve of 0.75 for the differentiation between groups. At a cutoff value of 237 dB/m, sensitivity was 72.3%, specificity was 70.7%, positive likelihood ratio was 2.5, and negative likelihood ratio was 0.4 in the differentiation between CHC versus HCC. Logistic regression analysis revealed an odds ratio of 6.4 for the diagnosis of HCC with CAP of less than 237 dB/m. Multivariate analysis, controlling for age, sex, BMI, triglycerides, and cholesterol levels, revealed a significantly increased odds for HCC diagnosis (odds ratio: 4.3, P=0.006).

Conclusion: The progression of CHC is associated with a decrease in steatosis, particularly toward advanced fibrosis and HCC. Steatosis reduction less than 237 dB/m is likely to be associated with HCC.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MEG.0000000000001196DOI Listing
November 2018

Measurement of the fetal occiput-spine angle during the first stage of labor as predictor of the progress and outcome of labor.

J Matern Fetal Neonatal Med 2019 Jul 7;32(14):2332-2337. Epub 2018 Mar 7.

c Department of Obstetrics and Gynecology , Fayoum University , Fayoum , Egypt.

Background: Fetal head attitude has a substantial impact on labor progress and outcome. Fetal head deflexion is basically diagnosed by digital vaginal examination during labor.

Objectives: To assess the effect of the fetal occiput-spine angle (OSA) measured through transabdominal ultrasound during the first stage of labor on the progress and outcome of labor.

Material And Methods: A prospective cohort study conducted on 400 women with term uncomplicated singleton pregnancy with occipitoanterior position during active labor. The angle between two tangential lines to occipital bone and the vertebral body of the first cervical spine was measured during active labor. Follow up till delivery was done. The primary outcome parameter was the labor duration. Secondary outcomes included the mode of delivery, occurrence of maternal and fetal complications.

Results: There was a significant longer duration of both first and second stage of labor among women with OSA <126° when compared to those with OSA ≥126° (6.8 ± 2.1 and1.89 ± 0.85 versus 4.16 ± 1.63 and 0.92 ± 0.43, respectively). Women with OSA <126° had higher incidence of CS (46.3 versus 5.7%), perineal tears (10.4 versus 5.1%), vaginal tears (22.4 versus 6.3%), need for oxytocin augmentation (47.8 versus 21.3%) when compared to those with OSA ≥126. OSA at cutoff value of 126° had a sensitivity, specificity, and accuracy of 8264.6 and 78.4% and 93.79 and 92% in prediction of mode of delivery and overall complications, respectively.

Conclusions: There was a significantly longer duration of both first and second stages of labor with higher rates of CS and maternal and fetal complications in women with OSA <126.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2018.1432589DOI Listing
July 2019

A new prognostic score can predict survival after hepatocellular carcinoma treatment in a cohort of 1302 Egyptian hepatocellular carcinoma patients.

Eur J Gastroenterol Hepatol 2018 May;30(5):514-519

Departments of Endemic Medicine and Hepatogastroenterology.

Introduction: Survival of hepatocellular carcinoma (HCC) differs between regions and countries according to the different underlying factors and the degree of standard of care that enables early diagnosis and management. Our aim was to identify the most potent predictive factors of survival in Egyptian HCC patients receiving curative or palliative treatments.

Patients And Methods: This retrospective study included 1302 HCC patients attending the HCC multidisciplinary clinic, Cairo University, between February 2009 and December 2016. Clinical, laboratory, tumor characteristics, and treatment data were collected. Prognostic scores for each of the treatment categories, curative or palliative, were developed using routine laboratory tests.

Results: Patients were predominantly men, mean age 57.79±7.56 years. All cases developed HCC in addition to cirrhosis, mainly hepatitis C virus-related (88.2%). Most of the patients were Child-Pugh A (56.8%) or B (34.4%) and had single lesions. Transarterial chemoembolization was the most common line of treatment (42.08%). The overall median survival was 18.3 months from the date of diagnosis. Cigarette smoking, Child-Pugh score, performance status, number and size of the focal lesion, α-fetoprotein, and application of a specific treatment, particularly curative treatment, were the significant independent prognostic factors for survival. We found no impact of diabetes mellitus or hypertension on survival. Multidisciplinary HCC clinic predictive scores of survival after palliative and curative treatments were developed including independent prognostic factors, age, and portal vein status.

Conclusion: A new Egyptian prognostic score of tumor and patients factors can predict the survival of patients with HCC after palliative and curative treatments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MEG.0000000000001085DOI Listing
May 2018

Effect of subcutaneous tissue closure technique in cesarean section on postoperative wound complications in obese Egyptian women.

J Matern Fetal Neonatal Med 2019 Aug 20;32(15):2452-2459. Epub 2018 Feb 20.

b Department of Obstetrics and Gynecology , Kasralainy, Cairo University , Cairo , Egypt.

Subcutaneous tissue closure technique is a wide area of interest for obstetricians who perform cesarean section especially on obese women while many observers studied in an extensive manner postoperative pain and wound cosmetic results.

Aim Of The Work: The main goal of our work was to display the differences in wound outcome results as regard postoperative wound complications comparing the two widely implemented techniques in subcutaneous tissue closure (interrupted versus continuous methods).

Results: A comparative analysis between continuous and interrupted techniques regarding wound complications (gapping, seroma, erythema, and infection) showing statistical significant differences in all four wound complications presented with p values = .019, .011, .015, and .001, in consecutive order with odds ratio in wound gapping = 5.239, wound seroma OR = 9.429, wound erythema OR = 3.709, and wound infection OR = 6.136.

Conclusions: Subcutaneous wound closure using interrupted technique of suturing in obese patients is superior to continuous technique as regard wound complications. Clinical trials.gov ID Identifier (NCT03354078).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2018.1438399DOI Listing
August 2019

De-novo versus recurrent hepatocellular carcinoma following direct-acting antiviral therapy for hepatitis C virus.

Eur J Gastroenterol Hepatol 2018 Jan;30(1):39-43

Departments of Endemic Medicine and Hepato-gastroenterology.

Introduction: A recent appearance of direct-acting antivirals (DAAs) led to a surge in hepatitis C virus (HCV) management. Nowadays, a large proportion of treated patients have cirrhosis with a retained possibility to develop hepatocellular carcinoma (HCC) even after complete cure. We aimed to study tumoral differences between patients who developed HCC after DAAs as either a recurrence or de-novo HCC.

Methods: We retrospectively analyzed 89 patients who presented to our HCC multidisciplinary clinic with HCC lesions following DAA therapy. A total of 45 patients had complete response to HCC according to the modified Response Evaluation Criteria in Solid Tumors before DAAs intake. Another 44 patients developed de-novo lesions after DAA treatment. Both groups were compared regarding their baseline characteristics, tumor criteria, response to DAAs as well response to HCC treatment.

Results: Both groups showed no significant difference regarding their baseline characteristics (age, sex, Child-Pugh score, and performance status) or response to DAAs (P=0.5). No significant difference was present between groups according to number, site, and size of lesions. However, time elapsed between the end of DAAs therapy and first diagnosis of HCC was significantly longer in de-novo group (15.22±16.39 months) versus recurrence group (6.76±5.1 months) (P=0.008). In addition, response to ablation was significantly better in de-novo lesions compared with recurrent HCC (P=0.03).

Conclusions: Although de-novo HCC lesions significantly developed later than recurrent lesions in DAAs-treated patients, their response rates were significantly better. No differences were detected between both groups in their response to DAAs and their tumoral characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MEG.0000000000001004DOI Listing
January 2018

A 24-Month Follow-Up of a Custom-Made Suture-Button Assembly for Syndesmotic Injuries of the Ankle.

J Foot Ankle Surg 2017 Jul - Aug;56(4):744-747

Senior Lecturer and Consultant Orthopaedic Surgeon, Department of Orthopaedic Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

In the present retrospective analysis, we introduce a custom suture-button fixation device for acute ankle syndesmotic injuries that allows for early weightbearing without another planned operation for hardware removal. We evaluated 87 consecutive ankles in 87 patients (49 males [56.32%] and 38 females [43.68%]). Of the 87 patients, 15 (17.24%) withdrew or were lost to follow-up, leaving 72 patients (82.76%) in the present study. Their mean age was 35.2 (range 17 to 67) years. Nineteen patients (26.39%) presented with a pure syndesmotic disruption, and 53 (73.61%) had associated malleolar fractures. The American Orthopaedic Foot and Ankle Society scale score improved significantly from 31.2 ± 4.2 preoperatively to 88.5 ± 5.3 at an average of 24 months postoperatively (p < .0043). Revision was undertaken because of implant failure in 4 ankles (5.56%). Two revisions (2.78%) were performed in 2 ankles because of early weightbearing in the first 2 weeks after surgery. The third patient (1.39%) underwent revision at 5 weeks postoperatively. This syndesmotic reduction failure was attributed to failure of the threads, which was noted at the second surgery. The fourth patient (1.39%), a 66-year-old male, underwent revision at 5 months postoperatively because of persistent infection. An 18-month postoperative radiograph was available for all patients. The medial clear space had significantly decreased, from 8.2 ± 3.1 mm preoperatively to 3.5 ± 2.2 mm at 18 months postoperatively (p < .0344). Likewise, the tibiofibular clear space had decreased significantly, from a mean of 8.8 ± 3.7 mm preoperatively to a mean of 3.7 ± 2.2 mm at 18 months postoperatively (p < .0322). In conclusion, suture-button fixation described in the present report delivered satisfactory functional outcomes and anatomic reduction at minimum of 18 months after surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jfas.2017.02.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7111150PMC
April 2018

Vascular endothelial growth factor G1612A (rs10434) gene polymorphism and neuropsychiatric manifestations in systemic lupus erythematosus patients.

Rev Bras Reumatol Engl Ed 2017 Mar - Apr;57(2):149-153. Epub 2016 Dec 14.

Cairo University, Faculty of Medicine, Rheumatology Department, Cairo, Egypt.

Aim: To investigate the relation between vascular endothelial growth factor (VEGF) gene polymorphism in systemic lupus erythematosus (SLE) patients and lupus related neuropsychiatric manifestations.

Patients And Methods: Sixty adult SLE patients recruited from the Rheumatology and Neurology departments of Cairo University hospitals were classified into two groups; Group A: 30 patients with neuropsychiatric manifestations (NPSLE) and Group B: 30 patients without. For both groups the SNP G1612A (rs10434) of the VEGF gene was genotyped by real time polymerase chain reaction (RT-PCR).

Results: Statistically significant difference was found in genotype and allele frequencies between both groups (AA [70% vs 13.3%, p<0.001] and GG [10% vs 66.7%, p<0.001]).

Conclusion: Polymorphism in the gene coding for VEGF may be associated with increased incidence of neuropsychiatric lupus in SLE patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbre.2016.11.007DOI Listing
September 2019

Cementless Total Hip Replacement for the Management of Severe Developmental Dysplasia of the Hip in the Middle Eastern Population: A Prospective Analysis.

Front Surg 2016 30;3:31. Epub 2016 May 30.

South West London Elective Orthopaedic Centre , Epsom , UK.

Introduction: In the Middle East, severe developmental dysplasia of the hip with subsequent high dislocation is often seen. We assessed the efficiency of total hip replacement (THR) with subtrochanteric shortening femoral osteotomy and trochanteric advancement in this population.

Methods: This prospective study assessed 25 female patients with symptomatic and severe (Crowe IV). Pre- and postoperative Harris hip score (HHS) and Oxford hip score (OHS) were performed alongside assessment of leg length discrepancy (LLD) and the ability to sit in a cross-legged position.

Results: The mean HHS and OHS improved pre-operatively at 1 and 10 years, respectively (p-value < 0.001). The mean postoperative LLD was 3 mm (0-8 mm). Functionally, 22/25 patients were able to sit cross-legged. None of the 25 hips underwent revision during this period.

Conclusion: Total hip replacement with subtrochanteric shortening osteotomy in combination with trochanteric advancement is sufficient for the management of Crowe type IV hips in this population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fsurg.2016.00031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885598PMC
June 2016

Probable Levofloxacin-associated Secondary Intracranial Hypertension in a Child With Multidrug-resistant Tuberculosis.

Pediatr Infect Dis J 2016 Jun;35(6):706-8

From the *Desmond Tutu TB Centre, Department of Pediatrics and Child Health, ‡Department of Pediatrics and Child Health, and §Department of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University; and †Brooklyn Hospital for Chest Diseases, Cape Town, South Africa.

Fluoroquinolones are a key component of multidrug-resistant tuberculosis treatment. We describe the first reported case of probable levofloxacin-associated intracranial hypertension in a 6-year-old girl with pulmonary multidrug-resistant tuberculosis. The case highlights the potential risk of secondary intracranial hypertension in multidrug-resistant tuberculosis patients who require prolonged fluoroquinolone therapy and the need for ophthalmologic screening in children with suggestive signs and symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/INF.0000000000001137DOI Listing
June 2016

A minimum three-year clinical and radiological follow up of the utilisation of a Cementless Multihole Mega cups in conversion hip arthroplasty--a prospective analysis.

Acta Orthop Belg 2015 Mar;81(1):100-6

Unlabelled: The introduction of multihole mega cup has proposed innovative answers in the management of acetabular impediments that ensued from the use of bipolar hemiarthroplasty. This study bestows a prospective analysis of the outcome of conversion surgery from bipolar hemiarthroplasty to total hip replacement in patients with acetabular complications.Forty-two patients, 22 men and 20 women, with a mean age of 59 years (range 46-69 years) who experienced complex acetabular deficiencies following bipolar hemiarthroplasty, were converted to total hip replacement between January 2008 and June 2010. Pain was the main complaint in all cases. It was primarily confined to the groin region. Limping due to shortening of the affected limb was the second main complaint (30 cases). All cases had erosion of the acetabulum with varying degrees of protrusion. Cementless mutihole cups with augmentation by autogenous bone graft from the iliac crest and large metal heads' sizes were used for conversion in all cases. After a minimum follow-up of 36 months, Harris hip scores (HHS) improved from a mean of 36.8±6.8 (range 21-59) preoperatively to a mean of 85.9±5.6 (range 71 to 94) postoperatively. Thirty six (85.7%) patients experienced no groin pain postoperatively while six patients (14.3%) described limited improvement. Postoperative complications included: dislocation in two cases which were reduced and did not result in a poor outcome later on. No patients were lost to follow-up.

Conclusions: Short-term results at minimum three years follow-up of multihole mega cup were encouraging regarding high capability of acetabular reconstruction with less morbidity of recipient site. Significant pain and functional improvement were noticeable, however further longer term studies are consequently recommended.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2015

Mitral Annular Plane Systolic Excursion-Derived Ejection Fraction: A Simple and Valid Tool in Adult Males With Left Ventricular Systolic Dysfunction.

Echocardiography 2016 Feb 14;33(2):179-84. Epub 2015 Jul 14.

Cardiology Department, Ain Shams University Hospital, Cairo, Egypt.

Objectives: Validation of a mitral annular plane systolic excursion (MAPSE)-derived formula to calculate the ejection fraction where EF = 4.8 × MAPSE (mm) + 5.8 in adult males with left ventricular (LV) dysfunction.

Background: Echocardiographic assessment of LV function generally requires expert echocardiographer and is somewhat subjective and prone to reader discordance. MAPSE has been suggested as a surrogate measurement for LV function.

Methods: Prospective analysis of 170 male patients with systolic dysfunction by two-dimensional transthoracic echocardiography was carried out. MAPSE and ejection fraction measured by qualitative visual inspection, M-mode, and biplane modified Simpson's rule were measured. MAPSE-derived EF was compared against other conventional methods to measure EF using Bland-Altman analysis and independent t-test.

Results: There was a significant positive correlation between average MAPSE and EF measured by M-mode (r = 0.554, P < 0.001), Simpson's rule (r = 0.585, P < 0.001), and visual inspection (r = 0.611, P < 0.001). An average MAPSE cutoff value <= 5 provided the best balanced sensitivity (67.1%) and specificity (76.5%) to predict EF < 30%. The mean difference between MAPSE-derived EF and EF measured by visual inspection and by Simpson's method was 3.86 ± 5.24% and 3.57 ± 5.97%, respectively. The least mean difference of 0.5 ± 5.69% was present between MAPSE-derived EF and M-mode-measured EF (P value 0.2).

Conclusion: MAPSE-derived EF using the equation EF = 4.8 × MAPSE (mm) + 5.8 is a valid technique in adult males with severely impaired LV EF.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/echo.13009DOI Listing
February 2016

Interferon-γ and Interleukin-10 Gene Polymorphisms are not Predictors of Chronic Hepatitis C (Genotype-4) Disease Progression.

Asian Pac J Cancer Prev 2015 ;16(12):5025-30

Clinical and Chemical Pathology Department, Faculty of medicine, Cairo University, Egypt E-mail :

Immunoregulatory cytokines have an influence on hepatitis C virus (HCV) infection outcome. This study aimed to determine whether single nucleotide polymorphisms (SNP) in IFN- γ and IL-10 genes are associated with susceptibility and/or are markers of prognosis regarding chronic hepatitis C outcomes. IFN γ (+874T/A) and IL-10 (-1082G/A) genotypes were determined in 75 HCV genotype 4 patients with different disease severities (chronic hepatitis, n=25, liver cirrhosis and hepatocellular carcinoma (HCC) on top of liver cirrhosis, n=50) and 25 healthy participants using allele-specific polymerase chain reaction. No statistical differences in allele or genotype distributions of IFN γ and IL-10 genes were detected between patients and controls or between patientgroups. No significant difference in the frequency of IL-10 SNP at position -1082 or IFN-γ at position +874T/A was found between chronic HCV genotype 4 and with progression of disease severity in liver cirrhosis or HCC. In conclusion; interferon-γ and interleukin-10 gene polymorphisms are not predictors of disease progression in patients with chronic hepatitis C (Genotype-4).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7314/apjcp.2015.16.12.5025DOI Listing
April 2016

Functional and morphological myocardial changes in hepatitis C virus patients with end-stage liver disease.

Scand J Gastroenterol 2015 25;50(9):1135-43. Epub 2015 Feb 25.

Endemic Medicine Department , Kasr El Ainy Hospital, Cairo University , Cairo , Egypt.

Background And Objectives: Cardiovascular complications are common in liver transplant recipient. This study aims to evaluate functional and morphological myocardial changes in hepatitis C virus (HCV) patients with end-stage liver disease (ESLD) by cardiac magnetic resonance (CMR).

Methods: This cross-sectional study included 84 patients with HCV-related ESLD. They were subjected to 2D-echocardiography and CMR. The presence, distribution, and percentage of delayed myocardial enhancement (DME) were estimated.

Results: The mean Model for End-Stage Liver Disease score was 21.5 ± 6.3. In CMR, all patients showed good global left ventricular (LV) systolic function (mean ejection fraction = 66.5 ± 8.6%; range: 55-80) with normal wall thickness and motion. Left ventricle was mildly dilated in 25 patients (30%). Grade I and grade II diastolic dysfunction was detected in 81 patients (96.4%) with dilated left atrium in 25 patients (30%). Variable degrees of DME were detected in 70 patients (83.3%) with mean percentage of DME (%DME) being 19.5 ± 16% (range: 4-52). A significant negative correlation was found between %DME and LV ejection fraction (r = -0.7; p < 0.001), cardiac output (r = -0.5; p = 0.013), cardiac index (r = -0.5; p = 0.02), and serum albumin level (r = -0.5; p = 0.01). The %DME ≥19% was associated with 85.7% sensitivity and 85.7% specificity for detection of LV ejection fraction <60% as assessed by echocardiography (area under curve = 0.89; p = 0.001).

Conclusion: DME with CMR is a common finding among patients with HCV-related ESLD. The extent of DME is significantly associated with global LV systolic function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/00365521.2015.1019559DOI Listing
March 2016

Assessment of immunological changes in Epstein-Barr virus co-infection in Egyptian chronic HCV patients.

Mem Inst Oswaldo Cruz 2014 Sep 22;109(6):722-7. Epub 2014 Aug 22.

National Liver Institute, Menufia, Egypt.

Epstein-Barr virus (EBV) plays a major role in liver pathology. Similar to other members of the herpesvirus family, EBV establishes a persistent infection in more than 90% of adults. The aim of this study was to evaluate the impact of EBV and chronic hepatitis C co-infection (HCV) on biochemical and immunological responses in patients. The study was conducted in 62 patients and 33 apparently healthy controls. Patients were divided into three groups: group I, consisting of 31 patients with chronic hepatitis C infection (CHC), group II, consisting of eight patients with EBV infection and without HCV infection and group III, consisting of 23 patients with EBV and chronic HCV. The percentage of CD3⁺ cells, helper CD4⁺ cells and CD19⁺ B-cells was measured by flow cytometry. Human interferon-γ (IFN-γ) and interleukin (IL)-15 levels were measured by an ELISA. The levels of liver alanine aminotransferase and aspartate aminotransferase enzymes were higher in EBV/HCV patients compared to that in EBV and HCV mono-infected patients. EBV/HCV patients had significantly reduced percentages of CD3⁺ and CD4⁺ cells compared to EBV patients. Serum IFN-γ levels were significantly reduced in EBV/HCV patients (3.86 pg/mL) compared to CHC patients (6.76 pg/mL) and normal controls (4.69 pg/mL). A significant increase in serum IL-15 levels was observed in EBV/HCV patients (67.7 pg/mL) compared to EBV patients (29.3 pg/mL). Taken together, these observations suggest that HCV and EBV co-infection can potentiate immune response dampening in patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238763PMC
http://dx.doi.org/10.1590/0074-0276140049DOI Listing
September 2014

Interleukin 1beta level in human colostrum in relation to neonatal hyperbilirubinemia.

Egypt J Immunol 2012 ;19(2):1-7

Department of Pediatric, Faculty of Medicine, El Menia University, El Menia, Egypt.

Breast-fed infants have higher bilirubin level than formula-fed infants which is of undetermined etiology. The cholestatic effect of cytokines (e.g. IL-1beta, IL-6) is believed to result from the repression of genes that normally mediated the hepatic uptake, metabolism, and biliary excretion of bile salts and bilirubin. The present study aimed to assess the level of interleukin 1beta (IL1beta) in early milk of nursing mothers and its relation to neonatal jaundice. Sixty full term neonates and their mothers were included. They were classified into two groups; group I included Forty neonates patients with physiological jaundice and group 11 included twenty age and sex matched controls neonates without jaundice. Milk samples were collected from mothers for estimation of serum IL-1beta level by ELISA, and blood samples were collected from the neonates for measuring total serum bilirubin (TSB) level. A significant difference (P < 0.01) in the level (pg/dl) of IL-1beta was found in early milk between group I (10.25 +/- 4.23) and group II (3.75 +/- 2.07). The total serum bilirubin level was higher in group I than group II (10.91 +/- 3.25 mg/dl versus 3.88 +/- 0.78 mg/dl) (P < 0.01). A significant positive correlation was found between of IL-1beta in breast milk and total serum bilirubin levels (r = 0.494, P < 0.001). It is concluded that Elevated levels of IL-1beta in the colostrum provide additional data to understand one of path physiologic mechanisms of breast milk jaundice.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2013