Helicobacter pylori (H. pylori) is the most common human bacterial infection worldwide, infecting approximately half of the world's population. Although antibiotic use is indicated for H. pylori eradication, the recommended type of antibiotic varies from country to country according to the H. pylori resistance pattern; developing countries, such as Egypt, may have different patterns than developed countries. We evaluated the antibiotic resistance of H. pylori in Egypt. Methods: This cross-sectional study included 134 adult patients with upper gastrointestinal (GI) complaints. Patients with a history of PPI during the last 2 weeks or antibiotics during the last 4 weeks before endoscopy were excluded. Upper GI endoscopies were performed and biopsies were collected for histopathology and H. pylori culture. Demographic, clinical, and endoscopic data were also collected. Antimicrobial susceptibility testing for H. pylori was performed for nine therapeutically relevant antibiotics using the Kirby-Bauer disc diffusion method. Results: The H. pylori antibiotic resistance rates were as follows: moxifloxacin, 10%; doxycycline, 15%; levofloxacin, 20%; clarithromycin, 40%; azithromycin, 40%; erythromycin, 65%; rifampicin, 90%; amoxicillin, 95%; and metronidazole, 100%. Dual resistance rates were 40% for amoxicillin/clarithromycin, 40% for metronidazole/clarithromycin, and 95% for amoxicillin/metronidazole. Conclusion:In Egyptian patients, H. pylori had >90% resistance to metronidazole and amoxicillin; modest resistance to erythromycin, azithromycin, and clarithromycin; and low resistance to moxifloxacin, and levofloxacin (≤20%). Dual resistance was high for amoxicillin/clarithromycin and amoxicillin/metronidazole, which prefers using quinolones rather than clarithromycin or metronidazole for first-line treatment of H. pylori in Egypt.

The study's objective was to evaluate the clinical significance of sCD40L in HCV-associated hepatocellular carcinoma (HCV-HCC) patients. Sera concentration of circulating sCD40L and IL-10 were assayed using ELISA in 30 HCVpositive patients with HCC, 30 HCV-positive patients with liver cirrhosis and 30 age-matched healthy volunteers with negative anti-HCV-Ab as a control group. Serum sCD40Lshowed statistically-significant high levels in HCV-HCC patients compared to HCV-cirrhotic patients and normal controls (P < 0.001). Serum sCD40L had higher diagnostic value in HCC patients compared with serum AFP. High sensitivity and specificity of sCD40L was observed compared to AFP (90%, 86.7% and 83% and 80% respectively). Significant positive correlation was detected between serum sCD40L and IL-10(r = 0.85 P < 0.001), AFP (r = 0.62 P < 0.05) and tumour staging (r = 0.5 P < 0.05). The study concluded that sCD40L is a valuable diagnostic tool in early diagnosis and screening for HCV and HCC as well as routine follow up of HCV cirrhosis patients. Assessment of serum IL-10 levels in HCV patients may provide a possible predictive marker for disease progression.

Background: Helicobacter pylorus has been identified as a major cause of peptic ulcer disease, risk factor for gastric cancer and mucosa associated lymphoid tissue (MALT) lymphoma. There is an emerging increase in antimicrobial resistance and subsequently failing empiric H. pylori eradication therapies which increases need to asses antibiotic susceptibility for H. pylori in every country, this will be done after its culture. Culturing of H. pylori is affected by multiple factors. Aim of the work: To Identify factors affecting H. pylori culture. Patients and Methods: A group of 134 adult patients with upper gastrointestinal complaints were recruited excluding patients who received PPI in last 2 weeks and Antibiotic in last 4 weeks. Upper GIT endoscopy was done, biopsies were collected; histopathological examination and culture of H. pylori were done, we studied the relation between culture result, patients and bacterial factors. Results: Out of 134 studied biopsies, 20 had H. pylori culture positive (14.9%), the bacillary form of H. pylori was more cultivable (9/24, 37.5%) (P = 0.008). Positive culture results were associated with moderate infestation by H. pylori (14/20, 70%). Diabetes mellitus was associated with positive culture result (5/20, 25%) with (P = 0.04). Only one case of culture positive H. pylori had previous history of H. pylori treatment (1/20, 5%). Conclusion: H. pylori culture is affected by multiple factors besides technical factors include form of H. pylori organism and degree of infestation of tissue by H. pylori, other factors like DM and previous H. pylori treatment of the patient.

Background: Hepatocellular carcinoma is a worldwide health problem . It is considered the second most common cause of cancerassociated fatalities and it is the fifth major cause of cancer all over the world. Cluster of differentiation 166 is a cell surface member of the immunoglobulin super-family that plays an important role in many biological activities. The distribution of CD166 in specific cell and tissue offer their involvement in the maintenance and development of tissue architecture, in neurogenesis and in tumor progression . Aim and objectives : to evaluate the diagnostic value of serum-CD166 in patients with HCC. Methods: This study was conducted on 90 subjects attending Department of Hepatology , Gastroenterology and Infectious Diseases in Benha University Hospitals as a cross sectional study. Subjects were classified into three groups; Group I : included 35 patients with HCC, Group II: included 35 patients with liver cirrhosis, Group III: included 20 apparently healthy subjects served as a control group. Human CD166 and alpha fetoprotein were assessed in all groups , all laboratory investigations were done . Results: Serum CD166 concentrations were much higher in HCC than in cirrhosis and healthy individuals . A positive correlation was found between serum CD166 and AFP. The area under the ROC curve for serum-CD166 was 0.951, while in AFP (AUC-ROC, 0.943) , with a cut-off of 1357ng/ml (sensitivity: 94.3%, specificity: 97.1%) for CD166 . Conclusion : Serum CD166 may represent a potential diagnostic marker for HCC .

No abstract