PurposeIdentification of risk factors associated with antituberculosis drug-induced hepatotoxicity (anti-TB-DIH) is important, especially in endemic area for TB and liver disease. This study assessed the incidence and risk factors of anti-TB-DIH in upper Egyptian patients treated for active pulmonary and extra-pulmonary TB. Methods A total of 100 consecutive TB patients were prospectively followed up both clinically and biochemically before and during their course of anti-TB therapy with daily doses of isoniazid, rifampin, ethambutol, and pyrazinamide, or streptomycin. Results Anti-TB-DIH developed in 15 (15%) patients within 15-60 days (median: 30 days) from the onset of therapy. Liver function normalized in 10 (60%) patients within 2 weeks from cessation of therapy. No recurrence of DIH was observed after reintroduction of therapy. Only 1 patient died from fulminant hepatic failure despite discontinuation of all anti-TB drugs. By univariate analysis, patients with anti-TB-DIH had more pre-existing liver disease (P = 0.024; OR: 3.60; 95% CI: 1.16-11.18), lower body mass index (BMI; P = 0.037; OR: 3.73; 95% CI: 1.04-10.56), lower serum albumin (P = 0.035; OR: 3.31; 95% CI: 1.04-10.56), and more extensive disease (P = 0.033; OR: 3.50; 95% CI: 1.11-11). Age, gender, raised baseline transaminases level, inclusion of pyrazinamide, and inactive hepatitis B or C carrier state were not significant risk factors of DIH. Using multivariate regression analysis, only pre-existing liver disease and lower BMI of 20 kg/m 2 or less were independent predictors of DIH (P = 0.024 and P = 0.047, respectively). Conclusion Anti-TB-DIH is not uncommon, needs early recognition and treatment, and is more in patients with preexisting liver disease and low BMI.

The serosal cavities are frequent sites of tumor metastasis. The distinction between carcinoma cells, inflammatory cells, and reactive or malignant mesothelial cells can be difficult in cytology. Multicolor flow cytometry (FCM) provides the opportunity to evaluate multiple antigens simultaneously, making it possible to characterize various cell populations. In this study, we aimed to assess the diagnostic accuracy of FCM immunophenotyping and DNA in comparison with serum tumor markers and classic cytology for detection of malignant cells in pleural and ascitic fluids. One hundred and nineteen samples of body cavity fluids were analyzed. Immunophenotyping was performed by four-color immunofluorescent staining using monoclonal antibodies against Ber-EP4, cytokeratin, CD3, and CD45. The DNA analysis by FCM was also performed. In addition, serum CA19-9, CEA, AFP, and CA125 were analyzed. Ber-EP4 marker had the highest sensitivity (73%) and specificity (95.5%) in the detection of carcinoma cells in serous fluid and correlated with cytology in most of cases (73%). The mean of DI differed statistically in patients with malignant effusions than in benign one. DI showed no difference in fluids due to infiltration of malignant epithelial cells or hematopoietic malignancy or due to hepatocellular carcinoma developing in cirrhotic liver. Thus, flow cytometry appears to aid not only in the detection of malignant cells but also in the characterization of cell type. On the other hand, although DNA ploidy examination had better sensitivity; it had no advantage over conventional cytopathological examination in identification of malignant cells.

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Hepatitis C virus (HCV) is an emerging global epidemic disease. Egypt reported the highest incidence in the world. Aim of the study: To assess knowledge, attitudes and practices of barbers and their customers regarding HCV and HBV. Setting: The study carried out in Assiut District and City. Design: Descriptive research design. Sample: Included 350 participants (175 barbers and 175 customers). Tools of the study: Data collected by three tools; Tool (1): interview form included three parts; first part included demographic data; second part included assessment of medical and surgical history of barbers and customers and third part included assessment of knowledge regarding the HCV&HBV. Tool (2): Included Likert attitude scale. Tool (3): Observational checklist to assess practices of barbers and customers. Results: Majority of barbers and their customers (88.6% and 80.6% respectively) had poor knowledge regarding HCV and HBV. Conclusion: There was a statistical significant difference among customers' knowledge, their level of education and their residence. Moreover there was a significant difference between customers' attitude and their residence. Recommendations: Need for ongoing training and retraining programs for barbers regarding methods of prevention of parentally transmitted hepatitis. Increase public awareness about risk factors and prevention methods of HCV and HBV infection.