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Background: Cirrhosis is a great health problem worldwide and is associated with many complications. Portal hypertensive gastropathy (PHG) is one of its most common complications and in some patients may lead to gastrointestinal bleeding. The relationship between Helicobacter pylori (H. pylori) infection and PHG is not clearly identified. Objective: This work aimed to study a possible association between H. pylori infection and PHG and to correlate the severity of PHG with H. pylori infection in cirrhotic patients. Methodology:A cross sectional comparative study included 90 cirrhotic patients, who were classified into 3 groups. G1: included 30 age and sex-matched cirrhotic patients with no PHG. G2: included 30 age and sex-matched cirrhotic patients with mild PHG. G3: included 30 age and sex-matched cirrhotic patients with severe PHG. Endoscopic examination was done to evaluate the presence and severity of portal hypertensive gastropathy and for diagnosis of H. pylori infection. Results: H. pylori infection by histopathology was detected in 61 studied patients (67.8%). H. pylori infection was more prevalent among cirrhotic patients with PHG (78.3%) than patients without PHG (46.7%) (P=0.0029). H. pylori infection was detected in 26(86.7%), 21(70.0%), 14(46.7%) in patients with severe, mild and no PHG respectively. H. pylori infection was more prevalent in patients with severe PHG relative to patients with no PHG (p-value = 0.001). Conclusion: The current study showed a significant relation between H. pylori infection and PHG in cirrhotic patients and it might have a role in the pathogenesis of severe PHG.

Background and objective: IL28B-gene polymorphisms show inconclusive relationships with CHCV DAAs-treatment outcomes on evaluation by serum-PCR. Solitary intra-PBMCs HCV-RNA antisense-strands are independently found in naïve and experienced cases regardless to viremia or hepatic-parenchymal changes. We correlated frequencies of IL28B-gene SNPs and alleles with HCV induced liver-changes during SVR evaluation by PBMCs-PCR after DAAs-therapy. Methods: Twelve weeks after completing DAAs-therapy, the impacts of IL28B-gene-SNPs were evaluated in three groups of patients: group-I (n=25) with negative serum and PBMCs HCV-PCR, group-II (n=52) had solitary intra-PBMCs HCV-RNA, and group-III (n=25) had positive serum HCV-RNA. All cases were subjected to IL28B-gene-SNP analyses and correlated with their ultrasonographic liver changes.Results: IL28B-genotyping in post-DAAs-treatment HCV-SVR and viral relapse revealed: a) dominant CC-genotype and C allele in normal hepatic parenchyma in group-I compared to group-II (P=0.0047, 0.0007) and group-III (P=0.0564, 0.000003) b) frequent CT-SNP and T-allele in bright hepatic parenchyma in group-II when compared with group-I (P=0.0077, 0.002 ) and group-III (P=0.0363, 0.0005) c) increased TT-SNP and T-allele frequencies in coarse liver in group-III compared to group-I (P=0.02256, 0.000130) and group-II (P=0.08647, 0.004308). Conclusions: Outcomes of HCV treatment with DAAs are dependent on host IL28B-gene polymorphisms and HCV induced liver changes. SVR is achieved when wild type-CC-genotype and C-allele are dominant in normal hepatic parenchyma; solitary intra-PBMCs-relapse occurs in increased frequency of CT-genotype when liver tissues are fibrotic; serologic-relapse is dominant when TT-genotype and T-allele are frequent in cirrhotic liver. IL28B-gene SNP analyses in relation to hepatic parenchymal changes are recommended before treating CHCV-infection with DAAs.

Background and aim: Occult HCV infection (OCI) diagnosis by cellular-PCR encourages further research for more understanding of extrahepatic tissues affection during non-viremias. OCI among Egyptians recruits more attention because of the convenient diagnostic tools and the availability of direct acting antivirals (DAAs). Our study aims to recognize HCV-infection of bone marrow mononuclear cells (BMMCs) in antiviral IgG-antibody seropositive nonviremic subjects. Subjects and Methodology: Our case control study included 70 subjects who were divided into three groups: - I: non-viremic IgG-seronegative controls (n=25), II: naive HCV-RNA viremic IgG-seropositive controls (n=15), III: naive non-viremic IgG-seropositive patients (n=30). Sera of all study subjects were screened for anti-HCV IgGantibodies by ELISA and for HCV-RNA by PCR. BMMCs and peripheral blood mononuclear cells (PBMCs) of all study populations were tested for HCV-RNA infections by cellular-PCR. Results and conclusions: HCV-RNA viremias were seen when bone-marrow is functioning (P

Background: peripheral neuropathy is damage to or disease affecting nerves which may impair sensation, movement, gland or organs function or other aspects of health depending on the type of nerve affected. Peripheral neuropathy is a common complication of liver cirrhosis either due to viral (mostly HCV), NASH, Alcoholic or mixed. Objectives: the aim of this study was to define the prevalence of peripheral neuropathy in a sample of Egyptian patients with liver cirrhosis and to determine any etiologic correlation. Patients and Methods: this descriptive study was conducted on 47 Egyptian liver cirrhotic patients. Patients were subjected to history taking, detailed neurological examination and clinical and neurophysiological assessment. Results: viral hepatitis was the commonest cause of liver cirrhosis 59.6% while non viral causes 25.5% e.g. NASH, the main duration of liver cirrhosis was 10 + 3.98 yrs ranging from 3-23 yrs. The majority of patients were asymptomatic, 48.9%, while the most presenting symptoms were sensory symptoms 25.5%, the prevalence of PN among a sample of Egyptian patients with liver cirrhosis according to neurophysiological assessment was 72.3% mostly of mixed sensory and motor polyneuropathic pattern, not related to the cause of liver cirrhosis but affected by the duration and severity of liver cirrhosis determined by Child Pugh classification. Conclusion: peripheral neuropathy is a common complication of liver cirrhosis related mainly to the duration and severity of liver cirrhosis, but not affected by the causes of liver cirrhosis.

Background: Development of oesophageal varices is a major complication that may occur in up to 90% of cirrhotic patients. The endoscopic screening is an invasive procedure. This is why the selection of patients with large oesophageal varices at high risk for bleeding has become an issue of growing importance. In this respect, several clinical, biochemical, ultrasonographic and elastrogarphic (transient elastography-TE) methods have been proposed (and some of them validated) as noninvasive alternatives to endoscopy. Objectives: It was to evaluate transient elastography by fibroscan in the prediction and determination of the grade of esophageal varices in cirrhotic patients due to chronic hepatitis c virus (HCV) infection with or without bilharziasis. Patients and Methods: Sixty Egyptian patients with body mass index (BMI) 0.05). Conclusion: fibroscan is valuable in predicting the presence of esophageal varices and large esophageal varices in patients with post HCV liver cirrhosis with or without bilharziasis but couldnot predict the grade of esophageal varices.

HCV-infection is the main cause of chronic liver disease among Egyptians, the most commonly infected population with HCV genotype 4. Evidences of HCV-transmission that are associated with health-care settings have consistently accumulated over recent years worldwide. Therefore, healthcare workers (HCWs) are the target population of the current study. The study evaluated prevalence of HCV-infection among different sectors of HCWs at Al Azhar University Hospitals.The population (n=239) were divided into four groups. G1(n=59) included healthy controls who were not working at hospitals. Other subjects (n=180) consisted three equal groups (2, 3 & 4) who were working at Al-Azhar University Hospitals. Respectively, workers, nurses and physicians presented group 2, 3 & 4 (n=60 each) from different hospital wards. Based upon duration of employment at hospitals, subjects in each of the last three groups were subdivided into 3 subgroups (n=20 each). Risk-factors that were thought to have an impact on acquisition of HCVinfection were evaluated. The overall prevalence of HCV infection in study populations was 21.34% with the highest rate in nurses (38.3%) and workers (20%) when compared to controls (15.3%) and physicians (11.7%; P

This study evaluated the efficacy of rifaximin versus lactulose in the treatment of hepatic encephalopathy (HE). The study population included 50 patients who were diagnosed to have signs of the first to third degree HE, according to the West Haven criteria and classified into two groups. GI: included 25 patients who had HE and were treated with lactulose syrup (laxolac) 90 ml daily divided into 3 doses for 7 days. GII: included 25 patients who had HE and were treated with rifaximin 1200 mg daily divided into 3 doses for 7 days. Patients in both groups also received other measures of treatment of HE as daily enema and protein restriction. Rifaximin significantly improved various subjective and measurable components of HE including mental status, behavior, asterixis, and serum ammonia concentration. In acute HE of grade 1 to grade 3, rifaximin may be a good alternative to non-absorbable disaccharides as it is broad spectrum, non-absorbable antibiotic with rapid action and little side effects. It is better tolerated, associated with less frequent and shorter hospitalization in comparison to lactulose.

Background and aim The increasing use of nuclear technology has increased the risk of exposure to radiation. Exposure to radiation induces harms to human beings. The blood and blood-forming organs are one of the most sensitive to radiation. People exposed to high radiation doses had blood count changes, and death may occur owing to acute radiation syndromes. Therefore, radioprotective compounds are very important in clinical radiotherapy. The aim of this study was to examine the effect of penicillamine as a radiation protector agent against gamma radiation effects on complete blood count parameters of guinea pigs. Materials and methods Thirty healthy male guinea pigs were divided into three equal groups: treated irradiated (n=10), irradiated (n=10), and control (n=10) groups. The treated irradiated and irradiated groups were exposed to acute gamma radiation dose (9 kGy). The treated irradiated group received penicillamine (10 mg/kg) 1 h before exposure to radiation. Blood samples were collected soon after radiation and immediately placed in tubes containing EDTA, and these samples were used in the assessment of blood profile. Results Treated irradiated guinea pigs had significant higher red blood cell count, white blood cell count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration (P≤0.05). The treated irradiated guinea pigs had significant lower relative distribution width of red blood cells by volume coefficient of variation (%) and platelet count (P≤0.05). Relative width of the distribution of platelets in volume index of the heterogeneity of platelets (%) had no significant difference between the two groups (P>0.05). Conclusion Administration of penicillamine reduced radiation damage to red blood cell count, white blood cell count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration.

Non-human primates, such as baboons (Papio hamadryas anubis), are natural hosts for Entamoeba species; infections can be asymptomatic or result in invasive lethal disease. It was sought to determine whether following natural infection by Entamoeba. histolytica, baboon anti-amebic antibodies recognized native Gallectin, a recombinant portion of the lectin heavy subunit (designated LC3) and specific heavy subunit epitopes; we compared the specificity of anti-amebic antibodies from baboons to that of humans following asymptomatic E. histolytica infection or cure of amebic liver abscess (ALA). Female baboons (n=54), aged one to three years of age and living in captivity were screened for infection by real time PCR. E. histolytica infection was found in 37 baboons and was associated with serum anti-LC3 IgG (73%) and anti-LC3 IgA (46%) or intestinal anti-Gal-Lectin IgA antibody responses (49%), p0.021 for each compared to that observed with baboons having an E. dispar infection (n=10) or uninfected baboons (n=7). The ELISA OD reading for anti-LC3 or anti-lectin antibodies correlated strongly with the presence of a PCR CT value indicative of E. histolytica infection. In humans with asymptomatic E. histolytica infection or those recently cured of ALA, 63% and 57% had serum anti- LC3 IgA and 65% and 57% had serum anti-LC3 IgG antibodies respectively. Epitope- specific synthetic peptides were used as capture antigens in ELISA; for baboons that possessed anti-LC3 and anti-lectin antibodies, 74% had anti-peptide IgG or IgA antibodies, compared to 86% of asymptomatic humans and 92% of ALA subjects(P0.05).