Correlation between platelet count and outcome of chronic HCV patients treated with direct-acting antivirals

Background: Egypt has the highest prevalence of chronic hepatitis C virus (HCV) infection. The direct acting anti-virus (DAAs) are available, with a reported 95% sustained virological response after treatment for 12 weeks (12w-SVR). Objectives: The current study aimed to assess the correlation between platelet count and the DAAs therapy outcome in chronic HCV (CHC) patients. Patients and methods: three hundred CHC patients, Child–Pugh grade A, both naïve and treatment experienced patients were enrolled in this study, from outpatient Clinic, Department of Gastroenterology, Hepatology and Tropical medicine, Qena university hospital, Qena, Egypt, treated with DAAs for 12 weeks, either dual or triple therapy, according to criteria recommended by the national committee for chronic viral hepatitis (NCCVH). Patients categorized into three groups: (1) Group I (non-thrombocytopenic group): included 100 CHC patients with platelet count ≥ 150 (109/L); (2) Group II (mild thrombocytopenic group): included 100 CHC patients with platelet count 100-149 (109/L); (3) Group III (moderate thrombocytopenia): included 100 CHC patients with platelet count 50–99 (109/L). Results: The Overall CHC patient's mean age were (48.2 ± 11), 226 (75.33%) were males and 74 (24.67%) were females. 97.6% (293/300)of CHC patients attainedSVR; 97 % in (Group I), and 98 % in both (Group II), and (Group III), after 12 weeks DAAs therapy with no significant difference between groups. Conclusion: both DAAs treatment modalities were efficient in the eradication of HCV; however, thrombocytopenia in CHC patients does not affect the DAAs therapy outcome

Frequency and risk factors for Hepatitis C virus seropositivity in blood transfusion-dependent thalassemic patients in Qena hospitals

Background: Beta-thalassemia major (BTM) is still mostly treated with routine blood transfusions. One of the most prevalent transfusion-transmitted infections (TTI) of clinical significance is the hepatitis C virus (HCV). Objectives: To estimate the prevalence of HCV infection among thalassemic patients in Qena hospitals, and to identify the possible risk factors associated with HCV infection. Patients and methods: a cross-sectional study involving 400 thalassemic patients with an age ranging from 1.5 to 29 years, a mean age of 12.8 ±7.3 years, 176 (44%) were male and 224 (56%) were female, and 75.5% were from rural areas. All are reviewed by a structured questionnaire. Results: The study revealed that the prevalence of HCV infection in the studied thalassemic patients was 9.5%. The most important risk factors were the duration of blood transfusion for more than 15 years, previous surgery, dental procedure, and splenectomy (P<0.001), followed by patient age of more than 18 years (P = 0.001), urban population, and a positive family history of thalassemia (P = 0.001), and frequency of blood transfusion (P = 0.054). Conclusion:The most important risk factors were the duration of blood transfusion for more than 15 years, previous surgery, dental procedure, and splenectomy. Thalassemic patients with older age were at higher risk for HCV infection. The risk increased with patients aged more than 18 years old. A family history of thalassemia was a risk factor for HCV infection

Impact of the follicular fluid Coenzyme Q10 level in women undergoing intracytoplasmic sperm injection (ICSI) on the pregnancy rate

Background: The most crucial problem with in vitro fertilization (IVF) cycles is still oocyte quality. The women age and the condition of their ovarian reserve are the primary determinants of oocyte quality. Objectives: to assess the effects of intracytoplasmic sperm injection (ICSI) on the result of pregnancies and the coenzyme Q10 (CoQ10) value in follicular fluid (FF) in the women who had the procedure. Patients and methods: this cohort investigation was conducted on 81 infertile patients (age between 20-42 years, both normal or poor responders’ patients and patients with unexplained infertility) who underwent ICSI cycles. Results: patients were divided into two groups: the pregnant group (n= 32) and the non-pregnant group (n= 49).There was a statistically insignificant difference in antral follicle count (AFC), number of retrieved oocytes, number of embryos, number of metaphase II (MII) oocytes, and maturation index between pregnant and non-pregnant females. CoQ10 level in FF was substantially greater in pregnant than non-pregnant females. Conclusion: FF CoQ10 levels were positively correlated with eventual embryo quality and rates of conception. Our findings might be in favour of CoQ10 supplementation in women undergoing IVF for enhancement of the ovum and embryo quality

Daclatasvir and Sofosbuvir Therapy Enhance Monocyte Phenotypic Changes in Naive Chronic Hepatitis C Patients: A Prospective Cohort Study

Background. Liver inflammation influences monocyte function, recruitment, and consequently inflammatory and fibrogenic responses. We aimed to investigate changes in the circulating monocyte phenotypes in response to Daclatasvir-Sofosbuvir (SOF/DCV) therapy in chronic hepatitis C (CHC) and relate findings to the viral kinetics and the fibrosis score. Methods. A longitudinal study involving 100 treatment-naïve patients and 30 healthy controls, tested for liver function, fibrosis scores (AST to platelet ratio index, FIB-4), and blood monocyte subsets based on CD14/CD16 expression by flow cytometer. Results. CHC patients had significantly lower albumin, higher ALT, AST, alkaline phosphatase, and increased fibrosis scores [Fib-4 (1.85±0.98) and AST to platelet ratio index (APRI) (0.6±0.35)], higher monocyte and eosinophil counts and lowered neutrophil to monocyte ratio (NMR), and lymphocyte to monocyte ratio (LMR) compared to week 12 and control. CHC patients had significantly increased median [classical (52.2% versus 25.8%, P=0.004) and inflammatory CD16+ monocytes (23.1% versus 13.58%, P=0.035)]. Therapy results in achievement of sustained virological response in 92% of cases, liver function improvement, and normalization of the inflammatory monocytes subsets. Monocyte counts showed positive correlation with viral load, calculated fibrosis scores (APRI and FIB-4 score), AST, ALT, ANC, and inverse correlations with serum albumin, leukocyte, eosinophil, NMR, and LMR. Multivariate regression found eosinophil count as predictors of CD16+ monocyte count in CHC patients. Conclusion. CHC infection promotes a proinflammatory and profibrotic monocytes profile. SOF/DCV therapy efficiently decreases viral load, reduces fibrosis potentials, attenuates monocyte activation, normalizes monocytes phenotypic abnormalities, and modulates monocyte subsets recruitment and differentiation later in the liver

Lipid Peroxidation and Antioxidant Status in Human Cervical Carcinoma

Reactive oxygen species (ROS), represented by superoxide, hydrogen peroxide and hydroxyl radicals, have been implicated in many diseases including cancer. ROS have been known to play an important role in the initiation and promotion of multistep carcinogenesis. The cellular antioxidants play a crucial role in protection against neoplastic disease. However, very little is known about the antioxidant defense in cervical carcinoma. This is addressed in the present study. Lipid peroxides, glutathione content and the activities of antioxidant enzymes, together with vitamin C and E content, were estimated in patients who had carcinoma of the cervix, and the values were compared with those of normal women. The results showed a remarkable reduction in the content of glutathione, vitamin E and C. Activities of glutathione peroxidase and superoxide dismutase were also reduced in cervical cancer compared to normal controls (P < 0.001). This reduction was more marked in late stages (III, IV) than in early stages (I, II) (P < 0.001). Glutathione was reduced more in poorly differentiated tumors (grade III) than in well and moderately differentiated ones (grade I, II) (P < 0.05). Levels of lipid peroxides were found to be significantly higher in malignant than in normal tissue samples and their levels were correlated with advanced clinical stage (P < 0.001). Our results suggest impaired antioxidant status in carcinoma of the cervix. This impairment is related to tumor progression

Assessment of peripheral blood lymphocyte subsets in children with iron deficiency anemia

Abstract Background Iron plays an important role in body defense and essential for normal immune system development where its deficiency may result in an inadequate immune response. We aimed to assess the lymphocyte subsets in childhood iron deficiency anemia (IDA) with their laboratory correlations. Methods Fifty IDA (< 18 years) and 25 age and sex-matched healthy children were enrolled and a complete history was obtained and clinical examination was performed. Complete blood count, serum iron, total iron binding capacity and serum ferritin, were performed. Flow cytometric determination of peripheral blood CD3+, CD4+, CD8+ T-lymphocytes and CD19+ B-lymphocytes and CD4/CD8 ratio were done. Results Patients had significantly lower hemoglobin, Serum iron, ferritin levels and higher lymphocytic count in patients compared with controls (p = 0.001, 0.03, 0.001, 0.001 respectively). CD3 count and percentage were significantly lower in IDA patients compared to controls (p = 0.007 and 0.005 respectively). There was a Significant reduction in the CD4 count, percentage and CD4/CD8 ratio in patients compared with controls (p = 0.001, 0.001 and 0.005 respectively) while there was no significant difference regarding CD8 count and percentage. No significant difference between the two studied groups regarding either CD19 count or percentage (p = 0.28 and 0.18 respectively) were found. Conclusions IDA is associated with impaired cell-mediated immune response specifically T-cell mediated immunity

Game-like interactive exercise versus visual feedback in patients with chemotherapy induced peripheral neuropathy post mastectomy: A randomized comparative study

Background Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects of antineoplastic agents, with a prevalence of 19 to 85%. In terms of clinical manifestations, CIPN is primarily a sensory neuropathy with motor and autonomic alterations of varying intensity and duration. CIPN consider as major problem for both cancer patients and survivors, as well as for their healthcare providers, possibly increasing the risk of falling. Objective: To evaluate the efficacy of game-like interactive exercise versus visual feedback training on the risk of falling and sensory integration in patients with chemotherapy-induced peripheral neuropathy after mastectomy. Methods: In this randomized comparative study, 30 female patients diagnosed with chemotherapy-induced peripheral neuropathy after mastectomy were randomly allocated into two equal groups; group (A) underwent game-like interactive exercise using the Biodex Balance System (BBS), while group (B) underwent a visual feedback training program using BBS. The treatment was applied for three sessions per week for four consecutive weeks. All subjects in both groups were assessed using the fall risk index and sensory integration test (sway index) in four sensory conditions at baseline and at the end of the study for both groups

Miconazole Mitigates Acetic Acid-Induced Experimental Colitis in Rats: Insight into Inflammation, Oxidative Stress and Keap1/Nrf-2 Signaling Crosstalk

Ulcerative colitis (UC) is the most common type of inflammatory bowel disease, characterized by oxidative stress and elevated pro-inflammatory cytokines. Miconazole is an azole antifungal that stimulates the expression of antioxidant enzymes via Nrf2 activation, which consequently inhibits ROS formation and NF-&kappa;B activation. Hence, the present study aimed to investigate the protective effect of miconazole, sulfasalazine (as a reference drug) and their combination on acetic acid (AA)-induced UC in a rat model which was induced by intra-rectal administration of 4% AA. Rats were pretreated with miconazole (20 and 40 mg/kg, orally) or sulfasalazine (100 mg/kg, orally), or their combination (20 mg/kg miconazole and 50 mg/Kg of sulfasalazine, orally). Pretreatment with miconazole significantly reduced wet colon weight and macroscopic scores, accompanied by a significant amelioration of the colonic architecture disorder. Moreover, the treatment also significantly decreased the malondialdehyde (MDA) level and prevented the depletion of superoxide dismutase (SOD) activity and GSH content in inflamed colons. Additionally, the treatment showed suppressive activities on pro-inflammatory cytokines, including tumor necrosis factor-&alpha; (TNF-&alpha;), interleukin-6 (IL-6) and C-reactive protein (CRP), and upregulated the anti-inflammatory cytokine interleukin-10 (IL-10). Moreover, the treatment upregulated the protein levels of Nrf-2 and heme oxygenase-1 (HO-1) in the colon tissue. Taken together, miconazole is effective in alleviating AA-induced colitis in rats, and the mechanism of its action is associated with the activation of Nrf2-regulated cytoprotective protein expression