Background: Hepatitis C virus (HCV) is a leading cause of liver cirrhosis, and hepatocellular carcinoma (HCC) Noninvasive indicators for the diagnosis and follow-up of individuals with liver disorders may be found in circulating microRNAs. One such miRNA is miR-34a, which has been linked to the development of HCC. Hepatocellular carcinoma is a highly vascular tumor in which angiogenesis plays a critical role in its development. The best-known angiogenic factor, vascular endothelial growth factor (VEGF), has been proven to have a pivotal role in the development of HCC. Objectives: To evaluate the expression profile of miRNA-34a and the serum levels of VEGF both in patients and control group and to find their association with disease progression in HCV patients and evaluate their significance as novel markers for HCV induced HCC. Subjects and Method: Including 32 CHC, 23 CHC with liver cirrhosis (LC), 20 CHC with HCC patients, and 15 healthy controls, a total of 90 people participated in the study. Real-time PCR was used to examine the miR-34a expression profile. ELISA was used to assess VEGF concentrations in serum. Results: Serum miR-34a down-regulation was observed in patients' groups compared to control group, with lower expression in HCV infection with HCC and HCV infection with LC groups than the HCV infected group. Also VEGF level increased significantly in groups HCV infection with LC and with HCC compared to the control group, in groups HCV infection with LC and with HCC groups compared to the HCV infected group and in group HCV infection with HCC compared to HCV infection with LC group. Conclusion: Expression profile of miRNA-34a and serum levels of VEGF can be used as novel markers for HCV inducing HCC with prediction of disease progression in CHC patients.
Background: Spontaneous bacterial peritonitis is the development of an infection of the ascitic fluid in the peritoneum, with no identifiable source of the infection in patients with liver failure. ascitic fluid neutrophil count is more than 250⁄mm3. calprotectin in Ascitic fluid may help in detection of neutrophil count < 250 cells/mm3, it has an effective role in detection of SBP and this will be a rapid treatment and good prognosis. Objectives: Evaluation of the calprotectin in ascitic fluid as rapid marker for diagnosis of SBP. Methodology: our study was done on 40 patients in Hepatology and Gastroenterology Department of Benha University divided into 2 groups 20 patients were SBP group and other 20 patients were non SBP group. 5ml of ascitic fluid was collected from patient in sterile blood culture bottles under complete aseptic condition then cultured on automated blood culture system (Bact/ALERT 3D) .Serum Calprotectin was measured in ascitic fluid by using commercially available quantitative sandwich enzyme-linked immune sorbent assays. Results: SBP was in significant association with higher TLC in AF and higher frequency of positive culture results when compared to non SBP group (p<0.001 for each).Among all studied cases, median calprotectin level was 0.602 ng/dL. SBP was significantly associated with higher level of calprotectin when compared to non SBP group .Calprotectin showed positive significant correlation with TLC in ascitic fluid. Conclusion: calprotectin in ascitic fluid is an excellent rapid marker for diagnosis of spontaneous bacterial peritonitis in patients with chronic Liver disease.
Background: Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection of ascitic fluid. Generally, no source of the infecting agent is easily identifiable. The aim of this work was to identify the most suitable antibiotic to describe for empiric therapy of spontaneous bacterial peritonitis (SBP) in Egyptian patients with liver cirrhosis and ascites. Methods: This study was carried out on 80 cirrhotic patients from Benha university hospitals and Ahmed Maher Teaching hospital underwent ascetic fluid analysis for PMN cell count and culture\sensitivity, Thorough history taking, full general and local examination, full investigations, serological tests for viral markers, modified Child's Pugh classification, abdominal ultrasonography and diagnostic abdominal paracentesis. Results: PMN cell count of all studied patients was over 250 cells/µL, 30 patients (37.5%) their culture were negative (no growth organisms) which is a large variant of SBP called culture negative neutrocytic ascites,50 patients (62.5%) their culture was positive. For gram stain negative organisms 41 patient (82%), E. coli (53.66%) mostly sensitive to cefotaxime (80%), ceftriaxone (87.50%), cefoperazone (76.92%), out of the 22 E. coli 4 (18.18%) were multidrug resistant, 3 (13.64%) were extensive drug resistant. For gram stain positive organisms 9 (18%), Staphylococcus aureus (77.78%) mostly sensitive to trimethoprim\sulphamethoxasole (100%), vancomycin (85.7%), linezolid (100%), out of 5 staphylococcus aureus 4 (57.14%) were multidrug resistant, 1 (20%) was extensive drug resistant. Conclusion:If PMN cell count more than 250 cells/µL should start empirical third generation cephalosporin antimicrobial treatment for 10 to 14 days even if culture\sensitivity result is negative. Amikacin & cefepime should be considered in empirical antimicrobial therapy in spontaneous bacterial peritonitis with dose adjustment according to creatinine clearance.
Background: Systemic lupus erythematosus is an autoimmune disease. Parvovirus B19 infection can break tolerance to self-DNA and promote pathogenesis of autoimmunity and might induce either idiopathic SLE in a person who is genetically susceptibl or it might induce a SLE-like picture. Objectives: Detection of PV-B19 DNA and it ' s IgM and IgG antibodies in the serum of SLE patients and in apparently healthy volunteer in Benha University Hospitals. Methodology: The study was conducted on 60 subjects classified into 2 groups: Group I: Including 40 SLE patients fulfilling SLICC Classification Criteria , 20 of them were in exacerbation state and the other 20 cases were in remission state and Group II: Including 20 age and sex matched apparently healthy volunteers serve as a control group . All patients were subjected to full history taking, clinical examination and laboratory investigations. PV-B19 IgM and IgG were measured using anti PV-B19 ELISA kits and PV-B19 DNA was detected by using real time polymerase chain reaction (PCR). Results: PV-B19 DNA was detected in 9 cases (45%) with active disease, Out of the 9 patients with PV-B19 DNA, only 1 had positive PCR results alone , 1 had positive PCR and IgM results and 7 had positive PCR, IgM and IgG results. on the other hand, PV-B19 DNA was detected in only 1 case (5%) out of 20 remittent cases (p=0.003). Active cases were significantly associated with higher frequency of IgM and IgG when compared to remittent cases (p=0.010, 0.020, respectively).There was significant differences in SLEDAI between active and remitted cases (p<0.001). Conclusion: Combined use of PCR and ELISA are needed for accurate diagnosis of PV-B19 infection.
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