The burden of rotavirus infections greatly affects the low-income African countries. In the absence of epidemiological data on pediatric diarrhea in São Tomé and Príncipe (STP), a study was conducted from August to December 2011. Rotavirus antigen was detected in 36.7 % of the collected fecal samples (87/237). G8P[6] was identified as the predominant genotype (71.1 % detection rate), while G1P[8] represented only 8.4 %. Phylogenetic analysis of VP7 G8 strains showed clustering within lineage G8d, while VP4 P[6] strains clustered within lineage 1a. Our results represent the first report on rotavirus from STP and show one of the highest detection rates of G8 rotaviruses worldwide.

Background: The Murine double minute 2 (MDM2) gene is overexpressed in several human tumors. The oncogenic potential of MDM2 is partially explained by inhibition of the activity of the tumor suppressor protein P53 (negative regulator of the P53 tumor suppressor protein). A single nucleotide polymorphism (SNP) in the promoter region of MDM2 gene (T to G exchange at nucleotide 309) and TP53 gene (codon 72 exon 4, rs1042522 encoding either C or G) have been independently associated with increased risk of several cancer types. Few studies have analyzed the role of these polymorphisms in the development of hepatocellular carcinoma among Egyptian patients with chronic hepatitis C virus infection. Methods: The study consisted in the comparison of the genotype distribution of TP53 and MDM2 SNP309 in 100 viral hepatitis C-related hepatocellular carcinomas (HCC) cases and 100 controls without HCC matched for age, gender and ethnicity. PCR-RFLP (restriction fragment length polymorphism) and real time PCR methods were used to determine the genotype at the MDM2 SNP309T>G locus and TP53 rs1042522. Results: Overall, our results indicate that frequencies of TP53 alleles (C and G) were not significant different between HCC cases and healthy controls (p=0.093) (Odds Ratio, OR=1.361,95% Confidence Interval, 95% CI=0.949 – 1.951). A significant increase of MDM2 SNP309 G/G and T/G genotypes were observed among HCC cases (Odds Ratio, OR=4.868, 95% Confidence Interval, 95% CI= 2.873 – 8.251). Conclusions: Our finding suggest that people who have G allele increase the risk by 4.868 folds for developing HCC among Egyptian patients, consequently the MDM2 309T>G polymorphism is an important modulator of hepatocellular carcinoma development in Egyptian patients.

Objectives: Much less attention has been given to the right heart and pulmonary circulation compared to the left heart and systemic circulation in patients with pre-eclampsia (PEC). We used transthoracic echocardiography (TTE) to estimate pulmonary artery pressure and right ventricular function in women with PEC. Methods: A case-control study at a tertiary care academic center. Ten early PEC (<34 week gestation) and nine late PEC (≥34 weeks gestation) patients with eleven early and ten late gestational age-matched controls. Two dimensional TTE was performed on all patients. The estimated mean PA pressure (eMPAP) was calculated based on pulmonary artery acceleration time (PAAT). Pulmonary vascular resistance (ePVR) was estimated from eMPAP and right ventricular (RV) cardiac output. RV myocardial performance index (RV MPI), tricuspid annular plane systolic excursion (TAPSE), tissue tricuspid annular displacement (TTAD) and lateral tricuspid annular tissue peak systolic velocity (S’) were measured. Results Compared to early controls, in early PEC the eMPAP and ePVR were elevated, PAAT was reduced, RV MPI was increased, TTAD was reduced and TAPSE and TV S’ were unchanged. Compared to late controls, in late PEC, estimated MPAP and estimated PVR were elevated, PAAT was reduced and RVMPI was increased, while TAPSE, TTAD and TV S’ were unchanged. Conclusions: Early PEC is associated with increased eMPAP and ePVR. A subclinical decrement of RV function is noticed. TTE is a useful screening tool for early detection of PH and RV dysfunction in PEC.

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Background Pulmonary arterial hypertension (PAH) is a disease of the pulmonary circulation with resultant effects on the right heart. Conceptually, left heart anatomy and function should be normal in patients with PAH. However, the RV and left ventricle (LV) do not function in isolation, sharing a common pericardial sac and inter-ventricular septum which in turn refers to the significance of assessment of both ventricles which has implications for patient prognosis with PAH. Aim Study the correlation between echocardiographic hemodynamic parameters and functional capacity in patients with pulmonary hypertension due to congenital heart disease and detection which parameter is the most independent predictor of functional capacity in patients with PAH-CHD. Methodology The study was conducted in the period from November 2016 to September 2017 including 34 patients who had been diagnosed with pulmonary arterial hypertension associated with congenital heart diseases (PAH-CHD). All of them were recruited from the congenital heart diseases unit at Ain Shams University hospital. The studied group was divided into two groups in a cross-sectional study: Group I: This included 21 patients with functional capacity according the 6MWT less than 330 m as an average for all subjects. Group II: This included 13 patients with functional capacity more than 330 m. Patients’ participation was voluntary and the subject had the right to withdraw from the study at any time without affecting his/her further medical care. Results The whole study population was divided according to the 6MW distance into two groups less than 330 and more than or equal 330 m. Comparing the 6MWD of each patient with the different Echocardiographic variables of systolic & diastolic dysfunction revealed that the group of shorter 6MW distance had higher RVSP, MPAP, E/e’ ratio, LVMPI and RVMPI, while they had lower LV e’ TDI, LV GRS, RV FAC and RV GLS (less negative value). Multivariate analysis of these Echocardiographic variables revealed that MPAP is independent predictor of 6MWD & thus an independent predictor of functional capacity in PAH-CHD patients. Conclusion Assessment of RV and LV function in PAH-CHD patients is important. Strain measurement by STE provides valuable information on the quantitative RV and LV functional assessment in the setting of volume and pressure overload. The MPAP and saturation were found to be the most independent predictors affecting the functional capacity of the patients with PAH-CHD. Recommendations Assessment of functional capacity in patients with PH using the 6MWT is recommended as a routine investigation from diagnosis and during follow-up and correlated with the echocardiographic variables, it has been shown to be practical and feasible and provides an easy and not expensive tool for clinical and prognostic assessment.