Clinico-laboratory study on children with auto-immune hepatitis in Upper Egypt

Background and study aimsAuto-immune hepatitis (AIH) in children is a rare chronic progressive liver disorder. It is characterised serologically by high aminotransferase levels, elevated immunoglobulin G (IgG) and the presence of autoantibodies. AIH is divided into two types according to the autoantibody profile. This study aims to assess frequency, clinical manifestations, biochemical features and outcome of AIH in children attending Assuit University Hospitals in Upper Egypt with acute icteric hepatitis and seronegative viral markers (anti-hepatitis A virus (HAV) IgM, HbsAg, anti-hepatitis C virus (anti-HCV) Ab).Patients and methodsThe study includes 34 children with AIH, diagnosed on the basis of the International Scoring Criteria of Auto-immune Hepatitis, recruited from Assuit University Hospitals, during the period from January 2005 to December 2009. All patients received prednisolone 2 mg kg^–1 day^–1. Follow-up was done for 1 year.ResultsAmong 34 children diagnosed as AIH, 24 were females (70.5%) and 10 were males (29.5%). Jaundice represented the most consistent finding in all patients. According to the autoantibody profile, 25 children were classified as type 1 and nine children were classified as type 2. Corticosteroid therapy was started. Complete remission was observed in 67.6% of patients and partial remission in 17.6%. There was no significant statistical difference in clinical and biochemical features of AIH in patients regarding the response to treatment. Mild side effects of steroid therapy were encountered in 48.2% of patients. After complete withdrawal of corticosteroids, six patients (20.7%) developed relapse.ConclusionAIH type 1 was the main form of AIH in children referred to Assiut University Hospitals. Girls were more affected than boys. AIH type 1 exhibited a more active, ongoing immunologic process. Steroid alone can be used successfully in most cases. Children with AIH type 2 had a higher frequency of relapse after corticosteroid withdrawal. Further studies on a larger number of cases and long-term follow-up are recommended.     

Thioctic acid protects against carrageenan-induced acute inflammation in rats by reduction in oxidative stress, downregulation of COX-2 mRNA and enhancement of IL-10 mRNA

Free radicals are highly reactive species which played an important role in the pathogenesis of acute inflammation. In this study, the protective role of the known antioxidant, thioctic acid, in carrageenan-induced acute inflammation in rats was assessed and was compared to the reference non-steroidal anti-inflammatory drug (NSAID) indomethacin. In addition, the roles of oxidative stress, nitric oxide (NO), inducible cyclooxygenase isoform (COX-2) and interleukin (IL)-10 mRNA expressions in thioctic acid-induced effects were also investigated. Inflammation was induced by injection of 0.1 ml of 1.5% carrageenan into the plantar side of right hind paws of the rats. Thioctic acid (50, 100 or 200 mg/kg), indomethacin (10 mg/kg), DMSO and saline were injected i.p. 2 h before carrageenan injection. The percentage increase in paw weight was calculated. Frozen hind paw were used for estimation of lipid peroxides (MDA), NO, GSH, COX-2 and IL-10 mRNA expression. Formalin fixed hind paw were used for histopathological examination. Thioctic acid (200 mg/kg) reduced both paw edema formation and lymphocytes infiltration more significant than indomethacin itself: Both thioctic acid and indomethacin reduced paw MDA and NO formation. In addition, both agents restored the depleted GSH contents in the paw. Thioctic acid decreased the elevated COX-2 mRNA while indomethacin, failed. Furthermore, thioctic acid increased IL-10 mRNA expression while indomethacin decreased its expression. Thioctic acid exhibited a potent anti-inflammatory effect on carrageenan-induced inflammation compared to the NSAID indomethacin. The mechanisms of thioctic induced protection were proved to be due to reduction of NO, MDA, COX-2 mRNA and induction of GSH, IL-10 mRNA.     

Novel facile synthesis of imidazo[1,2-<Emphasis Type="Italic">b</Emphasis>]-[1,2,4,5]tetrazines with potential antimicrobial activity

Starting from 1-amino-2-methylthio-4-phenylimidazole 2, a series of the title compounds have been synthesized via its reactions with various hydrazonoyl halides 3. The mechanism of the reactions studied is discussed. The structure of the compounds prepared were elucidated on the basis of their elemental analyses, spectral data and alternate synthesis. The antimicrobial activities of the compounds prepared were screened and the results showed that most of such compounds exhibit considerable activities.     

A STUDY COMPARING CHEMICAL PEELING USING MODIFIED JESSNER'S SOLUTION AND 15%TRICHLOROACETIC ACID VERSUS 15% TRICHLOROACETIC ACID IN THE TREATMENT OF MELASMA

Background:

Melasma is a symmetric progressive hyperpigmentation of the facial skin that occurs in all races but has a predilection for darker skin phenotypes. Depigmenting agents, laser and chemical peeling as classic Jessner''s solution, modified Jessner''s solution and trichloroacetic acid have been used alone and in combination in the treatment of melasma.

Objectives:

The aim of the study was to compare the therapeutic effect of combined 15% Trichloroacetic acid (TCA) and modified Jessner''s solution with 15% TCA on melasma.

Materials and Methods:

Twenty married females with melasma (epidermal type), with a mean age of 38.25 years, were included in this study. All were of skin type III or IV. Fifteen percent TCA was applied to the whole face, with the exception of the left malar area to which combined TCA 15% and modified Jessner''s solution was applied.

Results:

Our results revealed statistically highly significant difference between MASI Score (Melasma Area and Severity Index) between the right malar area and the left malar area.

Conclusion:

Modified Jessner''s solution proved to be useful as an adjuvant treatment with TCA in the treatment of melasma, improving the results and minimizing postinflammatory hyperpigmentation.     

Low frequency of deafness-associated GJB2 variants in Kenya and Sudan and novel GJB2 variants

A large proportion of non-syndromic autosomal recessive deafness (NSARD) in many populations is caused by variants of the GJB2 gene. Here, the frequency of GJB2 variants was studied in 406 and 183 apparently unrelated children from Kenya and Sudan, respectively, with mostly severe to profound non-syndromic deafness. Nine (2.2 %) Kenyan and 12 (6.6 %) of the Sudanese children only were carriers of variants within the coding sequence of the GJB2 gene. Variants in the 5'-adjacent region were detected in further 115 individuals. A total of 10 novel variants was recognized, among them four variants in the adjacent 5'-region of the GJB2 coding exon 2 (g.3318-6T>A, g.3318-15C>T, g.3318-34C>T, g.3318-35T>G), a 6 base-pair deletion (g.3455_3460del [p.Asp46_Gln48delinsGlu]), a variant leading to a stop codon (g.3512C>A [p.Tyr65X]), synonymous variants (g.3395C>T [p.Thr26], g.3503C>T [p.Asn62], g.3627A>C [p.Arg104]), and one non-synonymous variant (g.3816C>A [p.Val167Met]). In addition, the previously described variants g.3352delG (commonly designated 30delG or 35 delG), g.3426G>A [p.Val37Ile], g.3697G>A [p.Arg127His], g.3774G>A [p.Val153Ile], and g.3795G>A [p.Gly160Ser] were identified. With the exception of g.3318-34C>T and g.3352delG, all variants occurred heterozygously. For most of the variants identified in the Kenyan and Sudanese study population, a causative association with NSARD appears to be unlikely. Compared to many other ethnic groups, deafness-associated variants of the coding region of GJB2 are rare in Sudan and Kenya, suggesting a role of other genetic, or epigenetic factors as a cause for deafness in these countries.     

Oxidative modification of low-density lipoprotein in relation to dyslipidemia and oxidant status in children with steroid sensitive nephrotic syndrome

It has been proposed that nephrotic syndrome is a consequence of an imbalance between oxidant/antioxidant statuses. The present study aimed to assess oxidant and antioxidant status in relation to dyslipidemia in children during remission and relapse phases of steroid sensitive nephrotic syndrome (SSNS). The study dealt with 40 children diagnosed as SSNS. They were categorized into two subgroups. The first subgroup included 25 children during remission stage. The second subgroup included 15 children during relapse. Control group consisted of age and gender-matched 15 healthy children. Significantly higher serum levels of malondialdehyde, oxidized LDL, total cholesterol, LDL cholesterol, triglycerides, apolipoprotein A-I, and apolipoprotein-B were observed in patients with SSNS especially in the relapsers. The serum levels of albumin, glutathione peroxidase activity, vitamin C, A, and E, and HDL cholesterol were significantly lower in patients especially among relapsers. In conclusion, a strong relationship between the oxidant/antioxidant status and dyslipidemia is documented in patients with SSNS, especially among relapsers. No normalization of the biochemical indices was observed despite the use of glucocorticoids. Therefore, the combined use of steroid, antioxidant therapy, and lipid lowering therapy can be recommended in such children.