Management of hepatitis C virus genotype 4: recommendations of an international expert panel.

HCV has been classified into no fewer than six major genotypes and a series of subtypes. Each HCV genotype is unique with respect to its nucleotide sequence, geographic distribution, and response to therapy. Genotypes 1, 2, and 3 are common throughout North America and Europe. HCV genotype 4 (HCV-4) is common in the Middle East and in Africa, where it is responsible for more than 80% of HCV infections. It has recently spread to several European countries. HCV-4 is considered a major cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma, and liver transplantation in these regions. Although HCV-4 is the cause of approximately 20% of the 170 million cases of chronic hepatitis C in the world, it has not been the subject of widespread research. Therefore, this document, drafted by a panel of international experts, aimed to review current knowledge on the epidemiology, natural history, clinical, histological features, and treatment of HCV-4 infections

Oral versus rectal misoprostol in the treatment of menorrhagia

Introduction: Excessive menstrual loss is a major problem. Effective medical treatments exist and may provide an alternative to surgery. Objective: Evaluation of the effects of oral and rectal misoprostol in the treatment of excessive blood loss in cases of menorrhagia and comparison between both routes. Subjects and methods: Sixty patients with heavy, but however, regular periods (menorrhagia) were included in the study. They were randomly divided into two equal groups. Both groups were evaluated in two consecutive menstrual cycles. First without the treatment (baseline value) and the second cycle by either rectal misoprostol tablets (three times daily for the first 3days of the bleeding) or by oral misoprostol tablets (one tablet three times daily for the first 3days of the bleeding). For both the groups the estimated menstrual blood loss was assessed before and after treatment using subjective and objective assessments. Results: A highly statistical significant reduction in menstrual blood loss occurred by treatments in both groups (p=0.000). Rectal misoprostol produced the highest reduction in the menstrual blood loss with a percent change of 53.45%, while oral misoprostol was less effective in reducing the menstrual blood loss with a percent change of 36.15%. Both routes were effective in improving dysmenorrhea and reducing the number of cycle days with no significant differences between them. Conclusions: Both rectal and oral misoprostol are safe and effective routes for reducing excessive menstrual blood loss (menorrhagia), but the rectal route is more effective

Histopathological changes in diseased and treated catfish (Clarias gariepinus) by ciprofloxacin and clove oil

Bacteria pathogens may cause a serious loss in aquaculture and also health hazards to humans. On the basis of biochemical characteristics and API-20E system, all isolates of pathogens from diseased fish were identified as Aeromonas spp, the most predominant bacterial species were A. sobria 46.7%, A. caviae 19.03%, A. jandaei 8.6 % and A. veronii 8.6 %. One hundred and twenty Nile catfish Clarias gariepinus were divided into four equal groups (1,2,3 and 4) were challenged with Aeromonas sobria which predominant isolates, Gp. (1) was challenged only, while Gps. (2, 3 and 4) were treated after challenged with ciprofloxacin, clove extract and ciprofloxacin and clove extract in combination, respectively. The antibacterial activity of antibiotic and clove extract in their therapeutic doses decrease the mortality rate as (20, 16 and 13%) respectively compared with non-medicated Gp. (1) which recorded mortality 83%. Internal signs of infection with Aeromonas sobria in African catfish (Clarias gariepinus) include congestion of the hepatic blood vessels, areas of coagulative necrosis in the liver and hydropic degeneration of renal tubules according to the histopathological examination. In-vivo the combination of ciprofloxacin and clove extract was the choice as alternative bacterial therapeutic agent in infected Clarias gariepinus with Aeromonas sobria. Moreover histopathological changes have been widely used as biomarkers in the evaluation of the health of fish exposed to contaminants