Association of HCV with diabetes mellitus: an Egyptian case-control study

<p>Abstract</p> <p>Background</p> <p>The highest Hepatitis C Virus (HCV) prevalence in the world occurs in Egypt. Several studies from different parts of the world have found that 13% to 33% of patients with chronic HCV have associated diabetes, mostly type II Diabetes Mellitus (DM). In Egypt the prevalence of DM is 25.4% among HCV patients. Therefore, it is important to identify the magnitude of the problem of diabetes in order to optimize the treatment of chronic hepatitis C.</p> <p>Methods</p> <p>The objective of this case-control study was to evaluate the prevalence of DM and other extrahepatic (EH) manifestations among patients with different HCV morbidity stages including asymptomatic, chronic hepatic and cirrhotic patients. In this study, 289 HCV patients older than 18 were selected as cases. Also, 289 healthy controls were included. Laboratory investigations including Liver Function tests (LFT) and blood glucose level were done. Also serological assays including cryoglobulin profile, rheumatoid factor, antinuclear antibody, HCV-PCR were performed.</p> <p>Results</p> <p>Out of 289 HCV cases, 40 (13.84%) were diabetic. Out of 289 healthy controls, 12 (4.15%) were diabetic. It was found that the diabetic HCV group mean age was [48.1 (± 9.2)]. Males and urbanians represented 72.5% and 85% respectively. Lower level of education was manifested in 52.5% and 87.5% were married. In the nondiabetic HCV group mean age was [40.7 (± 10.4)]. Males and urbanians represented 71.5% and 655% respectively. secondary and higher level of education was attained in 55.4% and 76.7% were married. Comparing between the diabetic HCV group and the non diabetic HCV group, age, residence and alcohol drinking were the only significant factors affecting the incidence of diabetes between the two groups. There was no significant difference regarding sonar findings although cirrhosis was more prevalent among diabetic HCV cases and the fibrosis score was higher in diabetic HCV patients than among the non diabetic HCV cases.</p> <p>Conclusion</p> <p>The diabetic patients in the HCV group were older, more likely to have a history of alcohol drinking than the non diabetic HCV cases. Age and alcohol drinking are factors that could potentially contribute to the development of type 2 diabetes. Logistic regression analyses showed that age and residence in urban regions were the predictive variables that could be associated with the presence of diabetes. Alcohol consumption was not a significant predictive factor.</p

Percutaneous correction of second toe proximal deformity: Proximal interphalangeal release, flexor digitorum brevis tenotomy and proximal phalanx osteotomy

AbstractWe report the results of a percutaneous technique to correct a proximal plantar flexion deformity of the second toe that combines several procedures: tenotomy of the Flexor Digitorum Brevis, plantar capsulotomy for release of the proximal interphalangeal joint and proximal phalangeal osteotomy. The goal of these procedures is to improve anatomical correction and preserve articular range of motion. From 2009 to 2011, 54 patients, mean age 64.4 years old (43–81) underwent surgery for a proximal deformity of the second toe. Associated tenotomy of the extensor digitorum longus and brevis was performed in the presence of an extension deformity of the metatarsophalangeal joint (24 cases). After a mean follow-up of 30.7 ± 8.9 months, the rate of satisfaction and morphological correction was high (89.5% in both cases), as well as the number of flexible toes (88%). Active plantar flexion was preserved in 86% of the cases. This seems to be an effective technique to correct proximal plantar flexion deformity of the second toe, while preserving active plantar flexion

Coke location in microporous and hierarchical ZSM-5 and the impact on the MTH reaction

The deactivation and reactivation of microporous and hierarchical ZSM-5 zeolites have been studied in the methanol-to-hydrocarbon (MTH) reaction. The hierarchical ZSM-5 was synthesized via the desilication reassembly technique using cetyltrimethylammonium bromide as a surfactant. The catalysts differed significantly in the catalytic behavior after the reactivation procedure. This is ascribed to a different coke location in the deactivated catalysts arising from the difference in the porosity. The microporous ZSM-5 showed a coke gradient over the particle with a stronger accumulation of carbonaceous species in the outer particle layers, whereas a homogeneous coke distribution was observed for the deactivated hierarchical ZSM-5. Due to the diverging coke distribution, the irreversible damage of the zeolitic structure caused by reactivation differs for both catalysts. This fact is assumed to be the reason for the different deactivation/reactivation behaviors of these two zeolitic systems

Reversible and irreversible deactivation of Cu-CHA NH3-SCRcatalysts by SO2 and SO3

Abstract Sulfur oxides are a common source for the deactivation of Cu-exchanged CHA zeolite based catalysts used for NOx reduction in diesel exhausts by selective catalytic reduction with NH3 (NH3-SCR). Since water and possible formation of SO3 affect the deactivation of Cu-CHA catalysts, the deactivation in the presence of SO2 or a mixture of SO2 and SO3 was studied by measuring the SCR activity in wet and dry gas at 200 and 550 °C. The estimated S-content in the catalysts before and after 4 h regeneration at 550 °C in NO, NH3, O2 and H2O was related to the deactivation. The deactivation can be divided into two parts: a reversible deactivation that is restored by the regeneration treatment, and an irreversible part. The irreversible deactivation does not affect the activation energy for NH3-SCR and display a 1:1 correlation with the S-content, consistent with deactivation by Cu-sulfate formation. The reversible deactivation results in a lower activation energy and a deactivation that is larger than expected from the S-content. The presence of SO3 at 200 °C leads to higher reversible and irreversible deactivation, but has no significant impact at 550 °C. Furthermore, the irreversible deactivation is always higher when exposed at 200 °C than at 550 °C, and in wet conditions, compared to a dry feed. The deactivation is predominantly reversible, making regeneration at 550 °C a realistic approach to handle S-poisoning in exhaust systems