Background: Rhinitis is a global health problem that affects 20-40% of the population in developed countries and whose incidence is rising. Rising is characterized by one or more of the following symptoms: nasal congestion, rhinorrhea, sneezing and itching. It can be induced by different mechanisms and involves several etiological agents. Noninfectious rhinitis has traditionally been classified as allergic rhinitis (AR) and nonallergic rhinitis (NAR).Objective: To evaluate the prevalence and phenotypes of local allergic rhinitis in patients with clinical manifestations of AR without evidence of systemic IgE sensitization. Methods:This cross sectional, case-control, and nonrandomized study was conducted on 120 patients with clinical manifestations suggestive of allergic rhinitis (selected from the allergy outpatient clinic at Ain Shams university hospitals and 20 healthy controls.Results: Local allergic rhinitis was diagnosed in 80% of females and 20% of males. While the patients with systemic allergic rhinitis reached 37.5% for males, and 62.5% were females. Regarding the persistence of symptoms in local allergic rhinitis it reached 88% in comparison to 67.5% in systemic allergic rhinitis. The symptoms were intermittent in 12 % of cases with local allergic rhinitis in comparison to 32.5% in systemic allergic rhinitis. The severe symptoms outweighed the mild symptoms by nearly 50%. The skin prick test reached 80% positive in cases of LAR. Those with normal levels of total IgE level, the nasal provocation test was positive in 12.5% of cases and 7.5% negative. Conclusion:Local allergic rhinitis is a prevalent entity in patient evaluated with rhinitis.
Objectives Chronic kidney disease and atherosclerosis are considered to be inflammatory process in which T cells and cytokines participate. This study determines the effect of statin therapy as an anti-inflammatory agent on the level of CD4+CD28null T lymphocyte population, and subsequently on atherosclerosis in patients with chronic renal disease. Methods We recruited 90 chronic kidney disease patients. The patients were divided into three groups according to carotid intimal medial thickness (CIMT) as an indicator of atherosclerosis. Two groups (group A in whom CIMT above 0.95 mm and B in whom CIMT below 0.95 mm) were given statin (atorvastatin 20mg) while the third group (group C in whom CIMT below 0.95 mm) continue only on the conservative treatment for CKD patients. CD4+CD28null T cells was measured in the three groups at the beginning of the study and after 6 months of statin therapy. Results CD4+CD28null T cells was decreased in statin groups (group A and B) when compared to no-statin group (group C) at the end of the study. Multivariable regression analysis for the effect of statin therapy showed that statin can independently increase the percentage of decrease both CD4+CD28null cells at the end of our study (p-value <0.0001). Conclusion Our study demonstrates that statins reduce CD4+CD28null T cells in CKD patients especially with atherosclerosis suggesting that statins may help in altering the inflammatory process that lead to atherosclerosis.
Background Effects of the cytokine system, in which of tumor necrosis factor alpha (TNF-α) is a part, on serotonin metabolism as well as on the hypothalamic-pituitary-adrenal (HPA)-axis, may induce changes in the structure and function of the brain, possibly leading to the development of depression in SLE patients. For this purpose, we aimed to assess serum TNF-α levels in SLE patients, and to explore its possible relationship with depression among these patients.Methods: 60 SLE adult patients were enrolled in this study and further subdivided into two equal groups (30 with active SLE and 30 with inactive SLE) using SLEDAI score, in addition to 30 age and sex matched healthy controls. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to provide broad coverage of psychiatric diagnoses was done for all subjects, and severity of depression was assessed using Beck depression Inventory. TNF-α levels were measured using ELISA technique. Results: Depression was identified in 63.3% of active SLE group, 40% in the inactive SLE group and 16.7% in the control group with p value <0.001. TNF-α levels were higher significantly in the active group versus inactive group and control p value <0.001.In the multivariate analysis, sera TNF-α levels were independently associated with depressive symptoms odds ratio = 1.004, 95% CI = 1.001 to 1.006, p-value =0.020). Conclusions: Depression was more prevalent among SLE patients with active disease. Serum TNF-α was the only independent predictor of depression in SLE patients.
Background Celiac disease is an autoimmune disease which is underestimated over the world. Iron deficiency anemia can be the only presentable symptom for patients with celiac disease. Screening of patients with iron deficiency anemia of obscure origin by anti-tissue transglutaminase serum igA to diagnose celiac disease followed by upper GIT endoscopy is an important step. Objective to evaluate the prevalence of celiac disease in adult patients with iron-deficiency anemia of obscure origin. Methods The present study was a cross-sectional study which included 100 patients with a diagnosis of iron deficiency anemia recruited from Ain Shams University hospitals. All the patients were subjected to: Full history of gastrointestinal symptoms of celiac disease(CD), Age of onset of iron deficiency anemia, Complete blood picture, Serum iron, serum ferritin, transferrin saturation, Anti-tissue transglutaminase antibody immunoglobuline A, Upper gastrointestinal endoscopy and duodenal biopsy to patients who had positive serology. Results The present study showed that 8% of cases with iron deficiency anemia of obscure origin were ultimately diagnosed as cases of celiac diseases while 47% were diagnosed according to duodenal biopsy as potential celiac disease (where there was positive serology and intact villous architecture according to marsh classification) and 45%of cases were non-celiac disease. Conclusion Screening for celiac disease should be considered in patients with iron deficiency anemia of obscure origin
Background It is well known that Autoimmune thyroid disease is multifactorial with multiple genetic and environmental factors, immune malfunction also incriminated in the development of this disease, The exact pathogenesis of this disease remains unclear despite the fact that the production of autoantibodies destroys self-tolerance and agitate the adaptive immune system. Our study will answer the question is there a difference in Toll like receptor 9 (TLR 9) expression in peripheral blood mononuclear cell (PBMCs) from Grave’s disease patients. Objective to measure TLR9 percentage expression on peripheral blood mononuclear cells in patients with Graves’ disease. Methods 60 subjects were included in this study; 30 with Graves’ disease and 30 healthy individuals as control group. All the patients were subjected to the following: Full history, clinical examination, thyroid functions, Thyroid ultrasound, Radioisotope thyroid scan: to assess uptake of thyroid gland and Toll like receptor 9 (TLR 9) percentage expression on peripheral blood mononuclear cells will be analyzed using flow cytometry technique. Results The present study proved that patients with Graves’ disease had higher levels of percentage expression of TLR 9 on peripheral blood lymphocytes. Conclusion percentage expression of TLR9 on peripheral blood lymphocytes is higher in Graves’ patients.
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