Intense intrafamilial transmission of HBV in a rural area in Egypt is a probable cause of non-response to vaccination: A cross-sectional-seroprevalence-community-study.

Background: Worldwide, the prevalence of hepatitis B virus (HBV) infection is decreasing particularly in the vaccinated population. However, there are foci of increased transmission particularly in localized communities and within families. Objective: This study aimed at identifying HBV infection status among family members (FMs) of a cohort of HBsAg positive index cases (ICs) living in a village near Ismailia City, North-East Egypt. Design and participants: The study targeted ICs with chronic hepatitis B and their FMs. All were inquired for socio-demographic data, previous vaccination, kinship, and risk factors. All were tested for hepatitis markers and in HBcAb positive sera, HBV DNA and ALT were added. Results: The study included 96 participants including 14 ICs, 51 (53.1%) were females and 73 (76%) self-reported receiving hepatitis B vaccine after birth. Among 82 FMs, HBcAb was found in 49 (59.76%) of whom overt and occult HBV were diagnosed in 24 (49%) and 18 (36.7%). HBs Ag and HBcAb were more frequent in unvaccinated compared to vaccinated FMs; being 60.9% vs. 32.9% for HBsAg (p < /em>=0.017) and 91.3% vs. 57.5% for HBcAb (p < /em>=0.003). Among the FMs, active HBV were more related to male than female ICs (54.9% vs. 45.2%, p < /em>=0.73) while among children, it is more related to females more than male ICs (38.9% vs. 25%, p < /em>=0.33). In all HBsAg positive participants, HBeAg was negative and HBV DNA load was higher among female than male ICs (median 3500 vs. 2594.5 IU/mL, p < /em>=0.82). Conclusion: The study shows a high rate of HBV transmission among FMs of HBsAg carriers living in a remote area in North-East Egypt. Both overt and occult HBV infections were frequent despite previous vaccinatio

Liver morbidity among haemodialysis patients negative for manifest HBV and HCV : A hospital-based study in an endemic area

Background: End-stage renal disease (ESRD) is an increasing health problem worldwide.  Older age, diabetes mellitus and hypertension, acute kidney damage are among some of the factors that play a role in ESRD. This study aims at exploring liver morbidity (LM) among Egyptian hemodialysis (HD) patients.  Methods: The study included 142 patients free from overt hepatitis B virus (HBV) or  hepatitis C virus (HCV); their data were retrieved from files and all were clinically assessed and tested for liver functions, serological markers and viremia of HCV and HBV. Results: Of 142 eligible HD patients, two seroconverted to overt HCV, and five showed occult HCV. According to the laboratory and ultrasonography (US) data, three patterns of LM were found in 62 (43.7%), non-alcoholic fatty liver disease (NAFLD) in 30 (48.4%), liver fibrosis in 19 (30.6%), and hepatitis in 13 (21%). The mean durations of renal impairment (7.6 ± 5.91), hemodialysis (9 ± 6.1269), and total dialysis sessions (976.26 ± 683.69) were significantly higher in patients with LM compared to others (6.78 ± 4.82, 5.38 ± 3.69, and 699.4 ± 467.1). Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels were elevated in 14 (22.6%) and 13 (21%) of patients with LM. However, the ROC curve revealed ALT and AST cut-off points of 16.5 and 25.5 IU/L to discriminate LM. Conclusion: LM is common among EDRD patients undergoing hemodialysis despite the low levels of ALT and AST. The use of the US and the new lower levels of ALT and AST could improve the screening approach of LM

Molecular insights into human transmembrane protease serine-2 (TMPS2) inhibitors against SARS-CoV2: homology modelling, molecular dynamics, and docking studies

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), which caused novel corona virus disease-2019 (COVID-19) pandemic, necessitated a global demand for studies related to genes and enzymes of SARS-CoV2. SARS-CoV2 infection depends on the host cell Angiotensin-Converting Enzyme-2 (ACE2) and Transmembrane Serine Protease-2 (TMPRSS2), where the virus uses ACE2 for entry and TMPRSS2 for S protein priming. The TMPRSS2 gene encodes a Transmembrane Protease Serine-2 protein (TMPS2) that belongs to the serine protease family. There is no crystal structure available for TMPS2, therefore, a homology model was required to establish a putative 3D structure for the enzyme. A homology model was constructed using SWISS-MODEL and evaluations were performed through Ramachandran plots, Verify 3D and Protein Statistical Analysis (ProSA). Molecular dynamics simulations were employed to investigate the stability of the constructed model. Docking of TMPS2 inhibitors, camostat, nafamostat, gabexate, and sivelestat, using Molecular Operating Environment (MOE) software, into the constructed model was performed and the protein-ligand complexes were subjected to MD simulations and computational binding affinity calculations. These in silico studies determined the tertiary structure of TMPS2 amino acid sequence and predicted how ligands bind to the model, which is important for drug development for the prevention and treatment of COVID-19

Assessment of postural balance in multiple sclerosis patients

Abstract Background Disturbance of balance and falls are commonly observed in people with multiple sclerosis (MS). Objectives The aim of this study is to assess the postural balance in patients with MS by using clinical and instrumental methods and to specify the most direction of balance instability among MS patients using Biodex stability system (BSS). Methods Fifty ambulatory individuals with MS [42 relapsing-remitting (RRMS) and 8 secondary progressive (SPMS)] were evaluated for balance using quantitative Berg balance scale (BBS) and BSS. Twenty healthy volunteers were selected as a control group. Results There was a statistically significant difference between the patient and control groups assessed by BBS. Moreover, patients with SPMS had worse postural balance when compared with RRMS. According to BSS, MS group showed more sway in the three limits of stability (mediolateral, antroposterior, and overall) when compared to the control group. The least stability level was observed in mediolateral direction in the patient group. The degree of tilt was higher in SPMS than RRMS as regard the three limits of stability. The BBS was significantly negatively correlated with age, Expanded Disability Status Scale (EDSS), duration of illness, and the Biodex tilt. Also, there were positive significant correlation between age, EDSS score, and the duration of illness of the disease with parameters of BSS (mediolateral, antroposterior, and overall). Conclusion BSS was significantly correlated with clinical balance measurement scale using BBS in MS patients. Moreover, BSS can provide more objective, quantitative measures of postural imbalance

Impact of the IL-18 gene polymorphism in response to antiviral therapy in chronic HCV genotype 4 patients

^a Introduction Interleukin (IL)-18 is a well-known major proinflammatory cytokine with broad biological effects. The major immunomodulatory functions of IL-18 include enhancing T cell and natural killer cell cytotoxicity. Serum levels of this cytokine were shown to increase in chronic hepatitis C patients compared to non-infected healthy people. An association between IL-18 gene promoter polymorphisms and pegylated interferon (PEG-IFN) and ribavirin treatment outcomes has been reported for individuals with chronic hepatitis C virus genotype 1 (HCV-1). In this study, HCV genotype 4 (HCV-4) patients were assessed for IL-18 gene polymorphisms and treatment outcomes or severity of liver disease because data concerning the impact of IL-18 gene polymorphisms on patients with HCV-4 infections are limited. Methods This study included 123 chronic HCV-4 Egyptian patients and 123 apparently healthy volunteer blood donors who served as a control group. HCV genotyping was performed using the line probe assay. IL-18 genotyping was performed using the TaqMan Real-Time PCR method in all 246 patient and control samples. Results In our study, all patients had HCV-4. IL-18 gene single nucleotide polymorphism (SNP) (-607C/A) genotype distributions and allele frequencies did not differ between HCV patients and normal healthy subjects or between patient groups when compared according to the therapeutic response. Moreover, the presence of an IL-18 SNP was not associated with histological disease severity. We conclude that the presence of the IL-18 SNP rs1946518 does not affect the outcome of chronic HCV-4 treatment in Egyptian patients. Conclusions The IL-18 SNP rs1946518 does not affect response to treatment in chronic HCV-4 patients

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods

Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study

Objective This study assessed perceived stress, anxiety and depression among healthcare workers facing the COVID-19 pandemic in Egypt.Setting This was an online study where a Google form was prepared including sociodemographic and occupational data as well as three validated questionnaires to assess perceived stress, anxiety and depression, respectively. The form was distributed online to all social media groups including healthcare workers all across the country, and responses were collected until the sample size of 262.Participants Healthcare workers (physicians, dentists, pharmacists, physiotherapists, nurses, technicians and administrators) working in governmental or educational hospitals from all Egyptian governorates who are members of social media groups. The mean age of participants was 33.4±5.9 years, 70% were women, about 70% were married and 66% were physicians.Outcomes The frequency of perceived stress, anxiety and depression observed among the study participants according to the results of their questionnaires. Then the frequencies were compared between different sociodemographic characteristics.Results Only 1.3% showed low perceived stress while 98.5% showed moderate to severe stress. About 9.5% did not experience generalised anxiety, while the remaining 90.5% had different degrees of anxiety as mild anxiety showed the highest per cent affecting about 40% of participants followed by moderate anxiety about 32% then severe anxiety, 18.5%. With regard to depression, 94% of participants showed mild to severe depression.Conclusion This study showed a high prevalence of perceived stress, anxiety and depression among healthcare workers during the COVID-19 pandemic that affected all workers regardless of different sociodemographic characteristics