Can brucellosis influence the course of chronic hepatitis C in dual infection?

Hepatitis C and brucellosis are infectious diseases that occur worldwide, and both are endemic in Egypt. Co-infection with both agents is possible, and this can involve the liver in various ways. In this study, we investigated serum tissue inhibitor metalloproteinase-1 (TIMP-1), viral load, and liver functions in patients co-infected with hepatitis C virus (HCV) before and after brucellosis treatment. Over 3 years, 241 consecutive HCV patients (before interferon therapy was received) with recurrent fever who had occupational contact with animals were tested for brucellosis co-infection by a standard tube agglutination test. In patients with dual infection, viraemia (RT-PCR), TIMP-1 measured by ELISA, and liver functions were assessed and re-evaluated 2 months after brucellosis treatment. The number of patients with HCV/brucellosis co-infection was 32 out of 241 (13.3%). TIMP-1, viraemia, AST, ALT and bilirubin showed significant decrease (improvement) after brucellosis treatment (p < 0.001) but an insignificant difference (p > 0.05) with regard to serum albumin and prothrombin concentration. The study revealed that brucellosis is an important infection in HCV-infected patients and can aggravate the course of disease, suggesting that early treatment and prevention are important.     

Proinflammatory cytokines, soluble Fas receptor, nitric oxide and angiotensin converting enzyme in congestive heart failure

We measured serum interleukin-2 receptor (sIL-2R), tumor necrosis factor-a (TNF-a), Fas receptor (sFas), nitric oxide (NO), and angiotensin converting enzyme (ACE) activity in 45 patients with congestive heart failure (CHF) of different etiologies. The relatioship between these bioindices and the severity of heart failure was analysed. Patients were classified according to the etiology of heart failure into: 15 patients with rheumatic valvular heart disease (RHD), 17 with ischemic heart disease (IHD) and 13 with idiopathic dilated cardiomyopathy (DCM). Patients were further classified according to severity of CHF following the New York Heart Association classification (NYHA) into: NYHA class II (n= 7), NYHA class III (n=20) and NYHA class IV (n=18). Eighteen healthy subjects were included as controls. Serum sIL-2R, TNF-alpha and sFas levels were determined by ELISA while serum NO and ACE levels were measured by colorimetric methods. Doppler Echocardiography was performed for all participants. Levels of sIL-2R, TNF-alpha, sFas, NO, and ACE were significantly higher in CHF patients than controls. Levels of the bioindices varied according to the CHF etiology. TNF-a level was the only one that had significant differences among different subgroups (RHD, IHD and DCM). The levels of sIL-2R, TNF-alpha, NO and sFas in patients with NYHA class IV were significantly higher than class II or III. Moreover, sIL-2R, TNF-alpha and NO levels were significantly higher in patients with diastolic dysfunction than patients with normal diastolic function. A significant positive correlations were found between sFas and both TNF-alpha and sIL-2R and between TNF-alpha and both NO and diastolic function. In addition, significant positive correlations were found between TNF-alpha and sIL-2R in both IHD and RHD patients and between sIL-2R and both ACE in IHD patients and diastolic function in DCM patients. It is concluded that a relationship exists between immune system activation, apoptosis and renin- angiotensin system in CHF and this may play a significant role in the pathophysiology and prognosis of the disease.     

Outcome of focused pre-Ramadan education on metabolic and glycaemic parameters in patients with type 2 diabetes mellitus

Background

Ramadan fasting is associated with the risk of acute complications including hypoglycaemia. Therefore, patients' education before Ramadan and follow up during Ramadan is essential for safe fasting.

The Flavonoid Constitunts of Leucaena Leucocephala. Growing in Egypt,and Their Biological Activity

Background

Leucaena leucocephala is native to Southern Mexico and Northern Central America, but is now naturalized throughout the tropics. The phyto-chemical data of L. leucocephala revealed the presence of terpenes, flavonoids, coumarins and sterols. Various parts of L. leucocephala have been reported to have medicinal properties.

Materials and Methods

Flavonoids were isolated from the aerial parts of L. leucocephala. Antioxidant activity of the extracts and the isolated compounds was evaluated using (DPPH), as well as their cytotoxic activity using a single tumor [Ehrlish ascites carcinoma cells].

Results

The flavonoidal constituents isolated from chloroform, ethyl acetate and n-butanol fractions of the aqueous alcoholic extract of aerial parts of Leucaena leucocephala were identified as Caffeic acid, Isorhamnetin, Chrysoeriol, Isorhamnetin 3-O-galactoside, Kaempferol-3-O-rubinoside, Quercetin-3-O-rhamnoside and Luteolin-7-glucoside. Chemical structures of the isolated compounds were identified by TLC, PC and spectral techniques (UV, ¹H-NMR and MS). The ethyl acetate fraction and the isolated flavonoidal compounds showed high antioxidant activity compared to Trolox (standard antioxidant compound). The different fractions and isolated compounds of Leucaena leucocephala exhibited no cytotoxic activity against Ehrlich-ascitis carcinoma cell line at the tested concentrations.

Conclusion

This is the first record of the flavonoids in the aerial parts of Leucaena leucocephala (L.) except Quercetin-3-O-rhamnoside.     

Alcohol Use and Associated Environmental Factors Among Middle and High School Students in Sfax (Tunisia)

Our objective was to investigate the prevalence and the environmental determinants of alcohol use among students in the region of Sfax in Tunisia. We carried out a cross-sectional study among 315 middle and high school students. We used the Alcohol Use Disorders Identification Test (AUDIT) to identify risky alcohol consumption, and we used the Parenting Styles and Dimensions Questionnaire (PSDQ) to assess the students’ perceptions of their parents’ parenting styles. The results show that 19.7% reported drinking alcohol at least once in their lifetime. Among them, 21% scored as dependent alcohol users, according to the AUDIT. Those who drank alcohol at least once were more likely to have parents with a permissive parenting style (p < 0.001; Cramer’s V = 0.287), and a father (p < 0.001; Cramer’s V = 0.258), a mother (p = 0.025; Cramer’s V = 0.158), or a friend (p < 0.001; Cramer’s V = 0.341) who drinks. Students perceiving their parents’ parenting style as permissive had the highest AUDIT score (p = 0.005; partial η² = 0.132). The authoritarian style score was significantly higher for students who were current alcohol users (p = 0.028; Cohen’s d = 0.57). Our study highlights the influence of peers, family drinking, and parenting styles on alcohol use among middle and high school students. Therefore, particular attention should be given to students that are at risk of having the abovementioned environmental determinants of alcohol use. And, prevention strategies should involve parents, as well as enhanced guidance and counseling for these students.

     

Epidemiologic profile of Haemophilus influenzae infection in Tunisia

Haemophilus influenzae, a commensal bacteria, is frequently incriminated in broncho--pulmonary surinfections and severe diseases as meningitis, pneumonia and septic arthritis, particularly in young children. A multicenter study was conducted to establish the epidemiological profile of Haemophilus influenzae diseases, to determine the rate of antibiotics resistance for guide therapeutic and preventive strategies. The identification was based on the requirements for X and V factors, and the serotype b determined by agglutination. The betalactamase production was done by nitrocefin test. Antimicrobial susceptibility testing was determined on Muller Hinton chocolate agar with isovitalex. During the two year period, (January 1998 December 1999), 192 isolates of H. Influenzae were collected, 61% were recovered from invasive infections (44 meningitis, 8 bacteremia, 2 arthritis). The serotype b was identified in 55.7% of cases, 67.3% were invasive strains. 24.5% of isolates were producing betalactamase particularly invasive serotype b strains. All isolates of H. influenzae were susceptible to cefotaxim and to ofloxacin. Resistance rates to other antibiotics were: erythromycin 56.2%, tetracyclin 10.3%, rifampin 12%, chloramphénicol 1%, cotrimoxazole 16.5%, 11.5% amikacin and 20% gentamicin. The incidence of meningitis remained frequent in our country, involving the introduction of the vaccination in official calendar. Nevertheless, the surveillance of H. influenzae invasives infections and the serotyping of isolates were necessary to evaluate the impact of the immunization.     

Sexual fantasies and impotence. Apropos of 2 cases

Sexual fantasies, drawn of the erotic memory that constitutes himself the long of the sexual history of each, are indispensable, for the good sexual working. Some authors tend to consider the imagination like a "veritable intra psychic erogenous zone". However, people who, for a reason or an another, persisted to avoid all sexual activity before the marriage and to separate all erotic velleity, don't they risk to have an erotic imaginary atrophied, who could sound negatively once on their sexual behaviour, after the marriage, when all is suddenly authorized for them? Through two clinical observations of secondary sexual impotence, we are going to try to show the ominous consequences of such a relentlessness (imposed by the education, the social morals or the religion), against sexual stimulation, on the sexuality. These consequences are more easily observable in men, of the fact of their active role, in the sexual activity. Our purpose is to insist on the necessity to explore the sexual history owing all sexual dysfunction, and to place it in the biographic setting of the impatient; but also and especially to attract the attention on the importance of a precocious sex education, adapted to age, to the personal maturation and the cultural and educational context.