Occult hepatitis B virus infection in Egypt

The emerging evidence of the potentially clinical importance of occult hepatitis B virus (HBV) infection (OBI) increases the interest in this topic. OBI may impact in several clinical contexts, which include the possible transmission of the infection, the contribution to liver disease progression, the development of hepatocellular carcinoma, and the risk of reactivation. There are several articles that have published on OBI in Egyptian populations. A review of MEDLINE database was undertaken for relevant articles to clarify the epidemiology of OBI in Egypt. HBV genotype D is the only detectable genotype among Egyptian OBI patients. Higher rates of OBI reported among Egyptian chronic HCV, hemodialysis, children with malignant disorders, and cryptogenic liver disease patients. There is an evidence of OBI reactivation after treatment with chemotherapy. The available data suggested that screening for OBI must be a routine practice in these groups of patients. Further studies needed for better understand of the epidemiology of OBI among Egyptian young generations after the era of hepatitis B vaccination.     

Non Size Based Morphology Criteria for Assessment of Response in Patients with Liver Metastases of Gastrointestinal Origin Receiving Systemic Treatment

Background and Aim: Liver is the main site of metastases of gastrointestinal cancers, chemotherapy with orwithout targeted therapy is the standard treatment. Radiologic assessment of tumor response is usually done bythe use of Response Evaluation Criteria in Solid Tumor (RECIST) criteria. RECIST depends on tumor size changes butit does not address morphologic changes as overall attenuation, enhancement and tumor liver interface changes whichmay shown early before tumor size changes. We aimed to evaluate use of contrast enhanced computed tomography(CECT) new morphologic criteria in assessment of response in patients with hepatic metastases of gastrointestinalorigin. Methods: This study was carried out by cooperation between Clinical Oncology and Nuclear Medicine andRadiodiagnosis Departments, Faculty of Medicine, Menoufia University. During the period from April 2015 to December2016 forty patients with stage IV gastrointestinal cancers with hepatic metastases were included, CECT was donebefore and after systemic treatment, response evaluation was done by RECIST 1.1 and morphology response criteriac.Results: By RECIST, partial response (PR) observed in 57.5%, stable disease (SD) 22.5% and progressive disease (PD)in 20% of patients compared to Optimal response 42.5%, incomplete response 35% and no response in 22.5% of patientsby Morphologic response criteria. Regarding survival, patients with PR had median survival of 20 months (95% CI,17.988 to 22.012months) versus 11 months (95% CI, 1.235 to 8.580 months) in SD or PD by RECIST, (P=.002). whileby morphology response criteria the median overall survival of optimally responded patients 23 months (95% CI, 20.04to 27.81months) versus 16 months (95% CI, 5.590 to 5.044 months) in patients with incomplete or no morphologicresponse (P=.001). Conclusion: Morphologic response criteria are accurate method for assessment of response ofhepatic metastases and correlated well with patients’ survival and better to be incorporated to treatment evaluation.     

The Role of Diuretics in Treatment of Aromatase Inhibitors Induced Musculoskeletal Symptoms in Women with Non Metastatic Breast Cancer

Background: Around 50% of women receiving Aromatase Inhibitors (AIs) develop musculoskeletal symptomswhich may become severe causing interruption of treatment. Patients with AI-induced arthralgia had higher rates ofjoint effusions and fluid in the tendons, so use of diuretics may be helpful. Methods: This prospective phase II studywas conducted in department of clinical oncology and nuclear medicine, Menoufia University Hospital, Egypt, betweenJan. to Dec. 2015. Fifty Women with stage I,II and III breast cancer receiving AIs as adjuvant hormonal treatmentcomplaining of AIs related musculoskeletal symptoms received Lasilactone® 50 mg tablet; (an oral combination ofFrusemide 20mg/Spironolactone 50 mg), every other day for 4 weeks. Patients were assessed by modified WesternOntario and McMaster Universities osteoarthritis (WOMAC) index for lower limb and the quick Disabilities of theArm, Shoulder and Hand Score (DASH) scoring system for upper limbs, Arabic versions, at baseline and after 4 weeksof treatment. Results: The mean WOMAC pain score improved significantly (6.0 v 10; P < 0.001), the mean WOMACstiffness score improved (2.3 v 3.9; P = 0.002), the mean WOMAC functional score improved (8.7 v 15; P < 0.001),the total WOMAC score improved (17 v 29; P < 0.001), also a significant difference was noticed for the quick DASHscore; total score (16 v 25; P = 0.02) After use of diuretics for 4 weeks of treatment compared with baseline scores.Conclusions: The use of diuretics effectively reduces AI related musculoskeletal symptoms with good tolerance     

Protective effect of Hesperidin and Tiger nut against Acrylamide toxicity in female rats

Phytochemicals that have antioxidant effect play important role in protection against several diseases in humans. This study was carried out to evaluate the efficacy of hesperidin and tiger nut against the early changes that may be related to the toxicity of acrylamide in female rats. 72 Sprague Dawley female rats were divided into six groups (12 rat/group): control group (I); hesperidin (HES) treated group (II); tiger nut (TN) treated group (III); Acrylamide (ACR) treated group (IV); HES-ACR treated group (V); and TN-ACR treated group (VI). There was a significant increase in the levels of serum carcino embryonic antigen (CEA), malondialdehyde (MDA), protein carbonyls (CO), ALT, AST, LDH, urea and creatinine while no significant changes of serum total sialic acid, progesterone (prog) and estradiol (E2) levels, and significant decreases of body weights, catalase (Cat) activity, superoxide dismutase (SOD) activity, reduced glutathione (GSH) level, and glutathione peroxidase (GSH-Px) activity of ACR treated group compared with the control. Our results suggested that supplementation of a diet with hesperidin provided antioxidant defense more significant than tiger nut against the toxicity of ACR in breast, liver and kidney tissues.     

Conventional Narrow-Band Imaging Has Good Correlation with Histopathological Severity of <Emphasis Type="Italic">Helicobacter pylori</Emphasis> Gastritis

Background and Aim  

Narrow-band imaging (NBI) is an optical image enhancement technique that enhances the vessels and patterns of gastric mucosal surface. Here we aim to test the diagnostic role of conventional NBI (C-NBI) in identifying Helicobacter pylori (HP) infection, severity of gastritis, and gastric atrophy.     

Prognostic Factors for Hormone Sensitive Metastatic Prostate Cancer: Impact of Disease Volume

Background and Aim: The optimal management of metastatic hormone-sensitive prostate cancer has beencontroversial in recent years with introduction of upfront chemohormonal treatment based on results of several Westernstudies. This changing landscape has renewed interest in the concept “disease volume”, the focus of the present studyis the Egyptian patients. Methods: Patients with hormone sensitive metastatic prostate cancer presenting at MenoufiaUniversity Hospital, Egypt, during the period from June 2013 to May 2016, were enrolled. All received hormonaltreatment. Radiologic images were evaluated and patients were stratified according to their disease volume into high orlow, other clinical and pathological data that could affect survival also being collected and analyzed. Results: A totalof 128 patients were included, with a median age of 70 years (53.9% ≥70). About 46% had co-morbidities, 62% havinghigh volume disease. During the median follow up period of 28 months about half of the patients progressed and onethird received chemotherapy. On univariate analysis, disease volume, performance status (PS), prostate specific antigenlevel (PSA) and presence of pain at presentation were identified as factors influencing overall survival. Multivariateanalysis revealed the independent predictor factors for survival to be PS, PSA and disease volume. The median overallsurvival with 27 months was high volume versus 49 with low volume disease (hazard ratio 2.1; 95% CI 1.2 - 4.4;P=0.02). Median progression free survival was 19 months in the high volume, as compared with 48 months in the lowvolume disease patients (hazard ratio, 2.44; 95% CI, 1.42 – 7.4; P=0.009). Conclusions: Disease volume is a reliablepredictor of survival which should be incorporated with other important factors as; patient performance status andcomorbidities in treatment decision-making.     

Regular arrangement of collecting venules: Does patient age affect its accuracy?

AIM:To address the diagnostic value of the regular arrangement of collecting venules(RAC)among old age patients. METHODS:A total of 390 consecutive patients whose Helicobacter pylori(H.pylori)status was known and who received upper gastrointestinal endoscopy,were retrospectively studied for the presence or absence of RAC as well as gastric mucosal atrophy.The sensitivity, specificity,positive predictive value,negative predic-tive value and accuracy of RAC to detect normal gastric mucosa were assessed and were compared among two different age groups of patients. RESULTS:The mean age±standard deviation(SD)of included patients(n=390),was 62.9±13 years.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of RAC to detect normal gastric mucosa were 91.7%,66.1%,18.8%,99%and 68.1%respectively.Although the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of RAC among patients<60 years(n= 139)was 94.7%,71.2%,46.2%,98.1%and 76.1%,respectively,it was 80%,64.3%,5.1%,93%and 64.6%, respectively,among patients≥60 years(n=251). Younger Patients(<60 years),have highly significant rates of RAC sensitivity,positive predictive value,and accuracy(P≤0.001,≤0.001 and≤0.02,respectively).Older patients had highly significant rates of H. pylori infection and gastric mucosal atrophy(P≤0.01). CONCLUSION:Although RAC is a valuable sign for real-time identification of normal gastric mucosa,its accuracy seems to be affected by the patient’s age.     

Prevalence and patterns of female sexual dysfunction among overweight and obese premenopausal women in Upper Egypt; a cross sectional study

Objective

Obesity is a growing public health concern. Many reports link obesity to female sexuality. The purpose of this study is to assess the prevalence and patterns of female sexual dysfunction (FSD) among overweight and obese premenopausal women in Beni-Suef, Egypt.