d:\skydrive\Jor\vol43_1 The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 109 ­ 120

Effect of curcuma longa L. on fatty liver induced by oxytetracycline in albino rats.

Eman G.E. Helal , Samia M. Abd El-Wahab and Ghada A. Zedan
Zoology Department, Faculty of Science, Al-Azhar University, For Girls.

Abstract


Background: Curcuma longa has been shown to be a potent anti-inflammatory, antioxidant and
anticarcinogenic agent. The present investigation aimed at examining the possible potential protective
effect of curcuma against oxytetracyclin-induced fatty liver in an attempt to understand its mechanism of
action, which may pave the way for possible therapeutic applications.

Material and Methods:
Albino rats were divided into two major groups, 15 rats for each. The first
group was divided into three sub-groups: a) control, b) fatty liver group; that was injected
intraperitonealy with oxytetracycline ( 120mg/kg ) for three consecutive days resulting in steatosis and c)
curcuma treated group; which was treated with curcuma ( 0.4 % of diet ) for 30 days after fatty liver
induction . All animals were scarified after 33 days of the beginning of the experiment.
The second group was divided into three subgroups: a) control, b) fatty liver group and c) drug protection
group; which received curcuma for 15 days before induction of fatty liver, then sacrificed after induction
of fatty liver (3 days). Blood samples were collected for biochemical analysis. Liver specimens were
obtained and fixed in 10 % formalin for histological study.

Results: Fatty liver groups showed high significant increase in serum glucose, cholesterol, triglycerides,
LDL cholesterol, ALT, AST, GGT, LDH, total protein, albumin, globulin, urea and creatinine while HDL
cholesterol and A/G ratio were significantly decreased compared to control group.
Histopathological changes were detected in liver tissue of fatty liver rats. The treatment with curcuma
ameliorated the biochemical parameters and histological changes. The pre-treatment with curcuma before
the induction of fatty liver also ameliorated the results but they did not turn back to the normal values.

Conclusion: It is recommend to using curcuma as diet additive for fatty liver patients or those people
who have hyperlipidemic family history.

Keywords:
Fatty liver, curcuma, lipid profile, Albino rats, physiological parameters, histopathology.

Introduction:
1993; Kulkarni and Byczkowski, 1994). Second,

the liver has the ability to concentrate,
Any organ of body is a potential target for
biotransform and excrete chemicals, irrespective
injurious effects from chemicals but some
of routes of exposure (Plaa and Hewitt, 1982).
organs are more vulnerable to adverse effects

than others. The liver is often a target organ for a
Fatty liver is a reversible condition where large
number of reasons. First, most toxicants enter
vacuoles of triglycerides accumulate in liver
the body via the gastrointestinal tract and after
cells by the process of steatosis (Reddy and Rao,
absorption they are carried by the hepatic portal
2006).
vein to the liver. Thus the liver will be exposed

to the highest concentrations of these chemicals
Fat in liver usually causes no damage by itself.
(Reed, 1994; Lu, 1996). Chemicals encountered
However, it may be a sign of more harmful
by other routes of exposure may also reach the
condition (Angulo, 2000).
liver through its blood supply from the hepatic
Fatty liver can occur in diabetes mellitus,
artery as well as the portal vein (Stacey et al.,
obesity, pregnancy and induced by certain drugs
109

Full Paper (vol.43 paper# 1)


d:\skydrive\Jor\vol43_2 The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 121 ­ 133

Split ICSI/Insemination in Mild Male Factor Infertility: a Randomized
Controlled Trial

Ashraf Moawad, a,c Hanaa Abou-Ria, a,d Mohamed Abd Elzaher , a Mohamed
Farahat, b and Mahmoud Shaeer, c

a Assistant Professor of Obstetrics and Gynecology (Al-Azhar University, Cairo, Egypt), b
Lecturer of Obstetrics and Gynecology (Al-Azhar University, Cairo, Egypt), c Enjab
Hospital for infertility (Sharjah, UAE) and d Gulf Medical College and Research Centre
(Ajman, UAE).


Abstract

Introduction: Intracytoplasmic sperm injection (ICSI) is a widely used adjunct to in vitro
fertilization (IVF) for male-factor infertility when fertilization failure is suspected. In patients
with borderline semen, the decision to choose either IVF or ICSI is critical because the chance of
total fertilization failure after a conventional IVF or of performing an unnecessary ICSI procedure
is hard to predict.

Objective: The purpose of this study was to assess the value of the allocation of some eggs to
ICSI and others to conventional insemination (Split ICSI/insemination) in IVF cycles in which
semen parameters are subfertile.

Design: It is prospective study.

Materials and methods: Between August 2007 and April 2010, 190 patients had half of their
eggs inseminated with ICSI and the other half inseminated with conventional IVF.

Results: In this study, 76.3% of patients were fertilized by both IVF and ICSI, 21.6% of patients
were fertilized only by ICSI while 2.1% of patients were not fertilized either by IVF or ICSI.
Fertilization rate was significantly higher in oocytes injected by ICSI (63.7%) compared to oocyte
inseminated by IVF (44.3%). In patients fertilized by both IVF and ICSI, although ICSI
fertilization rate was higher (65.9%) than IVF fertilization rate (57.3%), yet there is no significant
differences were observed. High grade embryos were significantly higher in oocytes injected by
ICSI (75.9%) compared to oocyte inseminated by IVF (56.4%). Also, significantly more type 1
and 2 embryos developed after ICSI compared with IVF (77.3% vs. 56.4%) in the group of
patients with fertilization after both IVF and ICSI.

Conclusion: According to our findings, implementation of ICSI in couples with mild male factor
infertility could improve fertilization rates and decrease the risk of complete fertilization failure.
Additionally, split ICSI procedure provides valuable clinical information about fertilization
potential for the couple and unnecessary use of ICSI procedure can be avoided in future cycles for
patients who have achieved good fertilization in both IVF and ICSI.

Keywords:
ICSI(Intracytoplsmic
sperm
injection)-IVF(Invitrofertlization)-OCCs(Oocyte-
cumulus complexes).



121

Full Paper (vol.43 paper# 2)


Profile of childhood Epilepsy in prince Hashem Bin Al Hussein Hospital The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 134 ­ 144

Childhood Focal Epilepsies

Wael hayel khreisat
Pediatric neurologist,Queen Rania hospital for children,
King Hussein medical center
Royal medical services, Amman, Jordan



Abstract

Objective
: The present study was done in order to obtain a baseline profile of childhood focal
epilepsies

Patient and methods
: Subjects included in this study were children suffering from focal epilepsy
with age above 2 y. They were attending pediatric neurology clinic in Queen Rania Hospital for
children in Jordan . The study included 112 children with ages ranging from 2-14 years. The
following data were obtained: age, sex, detailed of seizures type, age at first unprovoked seizure,
family history of seizure disorders, history and type of febrile seizures, etiological factors,
socioeconomic class, history of consanguinity, additional neuro -impairment,
Electroencephalography and brain imaging finding and the use of antiepileptic drugs, the results
were recorded for further study.

Results
: A total of 112 consecutive cases of focal epilepsy were enrolled , 59 were male. The
commonest partial seizure recorded was simple partial type 52 (46.4%) while simple partial with
secondary generalization had 17 (16.9%) and complex partial seizure formed 36.8 %. ), In partial
onset seizures the peak age was between 11-14 years and complex partial seizures plateau was
seen between ages 6-10 years. Twenty six (23.2%) patients reported a family history of epilepsy,
91% of low socioeconomic class .11.5 % of cases have history of febrile seizures, idiopathic
epilepsy was 53.5 % . In most of epileptic patients have accessory neurological impairment, the
most common were learning difficulties Electroencephalography was normal in 20.4 %, mono-
therapy was used in 68.8 %

Conclusion
: the pattern of focal epilepsies in our country do not differ from that of developed
countries, further population ­based epidemiological research is indicated to confirm the
prevalence of seizure disorders in this locality

Keywords: partial seizure, complex partial seizure

Introduction:
Radhakrishnan et al., 2000 ) , Epilepsy has

a special place among long term illnesses,
Epilepsy is a worldwide health problem (
the highest prevalence is between birth and
Medina et al ., 2005 ). Study of the
puberty (Cowan,2008 ), it is potentially
prevalence of epilepsy from the developing
impending education , employment , social
world have shown prevalence rates of 2-25
relationships and development of a sense of
times higher than the prevalence rate of 5-6
self ­worth ( Blume , 2003) .
per 1000 in developed countries (
134

Full Paper (vol.43 paper# 3)


QUANTITATIVE AND ULTRASTRUCTURAL STUDIES OF TESTICULAR TISSUE USED IN CASES OF ICSI The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 145 ­ 161

Studies on Fetal response to Prozac Treatment

Nehal A, Abou Naja* , Fatma A. Eid * and Khadija Abdul jalil Fadladdeen**

*Zoology Department,Faculty of Science (Girls), Al ­ Azhar University.
**Zoology Department,Faculty of Science,King Abd El-Aziz University,KSA.


Abstract

Aim of the work
: :A variety of adverse effects are reported post-treatment with
Prozac(fluoxetine)especially during pregnancy.The percentage of these changes often
reflects increased rates with rising doses. This study aimed to study the possible
histopathological and histochemical changes in skin of fetuses maternally treated with
Prozac with 3 different doses(0.72&1.44&2.88 mg/kg b.wt.).

Material and methods: Mature male and virgin female albino rats of pure strain (Albino rattus
norvegicus
) ranging from 220-280 gm were used. Males were used only for mating. Pregnant
rats were categorized into the following groups: Group (1): control group. Group (2): 10
pregnant rats treated daily with 0.72 mg/kg. b.wt. Prozac (T1) (treatment started one month
before pregnancy and continued till day19 of gestation)

Group (3):
10 pregnant rats treated daily with 1.44 mg/kg. b.wt. (T2). Group (4):10 pregnant
rats treated daily with 2.88 mg/kg. b.wt. Prozac (T3). Pregnant mothers from all groups were
sacrificed on day 19 of gestation and small pieces of fetal skin were taken for the histological
and histochemical studies.

Results: Many histological and histochemical changes were observed in fetal skin of all the
treated groups compared with control ones. The severity of these changes increased with
increasing the doses.

Conclusion: Maternally Prozac treatment caused deleterious changes in the fetal skin, therefore
the use of this drug during pregnancy should be under strict precautions and further studies are
recommended due to the potential risks to the developing fetuses.
Key words: Prozac (fluoxetine),pregnant rats, pregnant women,fetus,skin.

Introduction



Pregnancy should be carefully
caused by stress, anxiety and depression
evaluated because it is a period during
(Richelson, 2001).
which women go through many physical,
Antidepressants are capable of
hormonal and psychic changes which, in
crossing the placental barrier, and their use
turn influence their mental health. It has
has been evaluated with respect to their
been recognized that gestation can be
biosecurity. Recent researches report the
complicated by emotional problems such as
use of tricyclic antidepressants and
depression, thus, heavily impacting both
serotonin reuptake inhibitors, especially
mother and fetus (Costei et al., 2002;
fluoxetine, in pregnant women (Chubak et
Crews and Frederic, 2007).
al., 2007, 2009, and 2011).
The use of medication during
Some authors have proposed new
pregnancy requires special attention due to
studies to assess the risk-benefit ratio of the
the potential risks to the developing fetus.
use of antidepressants during gestation.
Pregnant women often need psychiatric
Likewise, serotonin and noradrenaline are
treatment in face of emotional disorders
involved in the physiopathology of

affective disorders, Imipramine inhibits
145

Full Paper (vol.43 paper# 4)


d:\skydrive\Jor\vol43_5 The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 162 ­ 172

Protective Role of Pomegranate on Fatty Liver in Obesity: An Experimental
Chemical & Histopathological Study

Ahmed Hassan El-Rashedy1- Saeed Kamel Belal2- Hossam El-Din Osman3- Gaber
Mohamed Shehab4
Departments of Pathology 1, Anatomy 2&3, and Biochemistry 4 ,College of Medicine &
Medical Sciences, Taif University.

Abstract

Aim of the work: Fatty liver is the most common cause of abnormal liver function tests. Since
obesity and fatty liver can result in serious drawbacks and represent a considerable incidence
rate in Saudi Arabia. This country is a famous one of pomegranate. This study aimed at
investigating the ameliorating effects of pomegranate on hepatic lipid accumulation in rats with
severe fatty liver in order to provide a cheap natural protective medicine since this health
problem can affect the entire world economy.

Material and methods: Twenty-four male Zucker rats aged 13­15 weeks were used. Animals
were allowed free access to food and water for 1 week before starting the experiment. According
to the body weight (BW), plasma triglycerides (TG) and total cholesterol (TC) levels were
measured before treatment. The animals were divided into lean control, lean pomegranate
(PGF)-treated, fatty control and fatty PGF- treated groups (six animals per group). Finally, the
animals were weighed after a prompt dislocation of their neck vertebra. Then, the liver was
rapidly excised, washed with saline on ice and weighed. In addition, one part of it was cut into
slices for studies of lipid determination analysis. The right tibia length (TL) was measured for
calculation of the ratio of liver weight to TL. A portion of the liver was homogenized and the
lipids were extracted with isopropanol. Triglycerides and TC contents in the supernatant were
determined.

Results:
Fatty rats (ZF) had shorten TL but their BWs were increased compared to lean rats.
Also, ZF rats showed hepatomegaly reflected by increased liver weight and increased ratio of
liver weight to TL. Treatment with PGF extract did not change BW and TL, but it reduced liver
weight and the ratio in ZF rats. PGF did not affect these parameters in lean ( ZL) rats. Fatty rats
exhibited severe hepatic steatosis, reflected by a marked increase in hepatic TG as well as
hepatic TC contents and fatty droplets visualized by either light microscopy as large vacuoles
occupying the cytoplasm of hepatocytes pushing their nuclei to the periphery against the cell
membrane giving signet-ring appearance or by electron microscopy as membrane-bound
inclusions closely near the endoplasmic reticulum with indentation of the nuclei of the affected
cells. Interestingly, 6-week treatment of fatty rats with PGF extract reduced hepatic TG contents
and fatty droplets whereas it did not alter hepatic TC contents. This treatment showed minimal
effects in ZL rats.

Conclusion:
These findings are potentially important for supporting the effectiveness of
pomegranate in the treatment of obesity - induced fatty liver disease through the improvement of
abnormal lipid metabolism.

Key words:
Pomegranate - Obesity - Fatty liver - Serum Chemistry ­ Histopathology.

Introduction



elevated free fatty acids are present in the
Obesity is predictive of the presence of
majority of patients with metabolic
fibrosis potentially progressing to advanced
syndrome and type 2 diabetes mellitus and
liver disease. Non-alcoholic fatty liver
are strongly associated with hepatic insulin
disease (NAFLD), hypertriglyceridemia and
resistance (Stefanovic-Racic et al., 2008).
162


Full Paper (vol.43 paper# 5)


Profile of childhood Epilepsy in prince Hashem Bin Al Hussein Hospital The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 173 ­ 181

Clinical profile of patients with infantile spasms

Wael hayel khreisat
Queen Rania hospital for children
King Hussein medical center
Royal medical services
Amman, Jordan



Abstract

Objective: The present study was done in order to obtain a baseline profile of infantile spasms and
associated neurological disorders

Patient and methods
:. The study included 50 patients with infantile spasm in Queen Rania Hospital
for children in Jordan. The following data were obtained: sex, age of onset and presentation, details of
seizure , family history of epilepsy, significant pre-/peri/post-natal insults, neuro imaging evaluation ,
detailed neurological and neuro developmental ,assessment were done by. Broad categories of
possible etiologies were used the results were recorded for further study.

Results
: Age of onset of infantile spasm ranged from 1month to 1 year and 6 months , (mean 4.8
months). The mean time of presentation was 9.4 months . A male preponderance was noted (74 %).
flexor spasms (52%) were the commonest. Other types of seizures also accompanied infantile spasm in
44% children. (84%) were born of normal delivery, History of birth asphyxia was obtained in 48%, 3
(6%) had positive family history Developmental delay was recognized prior to onset of spasms in
52% . microcephaly was the commonest associated problem , Imaging studies of the brain revealed
abnormality in 18 patients. 78% patients symptomatic and 22 % as cryptogenic..

Conclusion
: The pattern of infantile spasm in our country do not differ from that of developed
countries, further researches is required to prevent both chronic epilepsy and psychomotor retardation
and .preventive measurement to prevent birth asphyxia is recommended

Keyword: infantile spasm , seizures , epilepsy

Introduction




Infantile spasms represent a seizure disorder
seizures . It has been classified in the category
with
unique
clinical
and
of generalized seizures with specific EEG
electroencephalographic features and a poor
characteristics. Focal seizures as well as focal
prognosis
including
chronic
intractable
lesions can also be present (Dulac et al , 1994
epilepsy and psychomotor retardation.; the
)
incidence of infantile spasms is considered to
Epileptic spasms (ES) are define as seizures
be 0.16 to 42 per 1000 live births (Cowan and
characterized by brief axial contraction, in
Hudson; 1991 ) , it associated with the
flexion ,extension or mixed, symmetric or
particular EEG pattern, hypsarrhythmia
asymmetric, lasting from a fraction of a second
(Shields ; 2006)
to 1-2 s (Fusco and Vigevano , 1993 ) it
Early diagnosis with a careful diagnostic
occurs almost exclusively during the first year
evaluation and proper therapy can obtain a
of life, mostly between four and seven months
normal development or a much improved
of age. It may be present in clusters do not
situation in some cases (Dreifuss 1981) ,This
appear generally after one to two years of age
spasm is also referred in literature as massive
(Gobbi , 1987 )although late onset up to seven
spasms, Salaam tics, infantile myoclonic
to eight years of age has been reported in rare

cases (Riikonen , 2001 )
173

Full Paper (vol.43 paper# 6)


Evaluation of CD4+CD25+ regulatory T cells in patients with hepatocellular carcinoma and liver cirrhosis The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 182 ­ 191
Evaluation of CD4+CD25+ regulatory T cells in patients with hepatocellular
carcinoma and liver cirrhosis

*Amal Abdel Aleem, ** Eman A Abdel Rahman and ***Abdel Aty M. Elgonimy
*Clinical Pathology, and ** Internal Medicine Departments, Faculty of Medicine for Girls, Al-
Azhar University ***Surgical Department, Banha Teaching Hospital


Abstract

The emergence of a Tumor results from the disruption of cell growth regulation as well as from
failure of the host to provoke a sufficient immunological anti-tumor response. Regulatory T cells
CD4+CD25+ (Tregs) play an important role in maintaining peripheral self-tolerance, thus preventing
autoimmune pathologies. However, in certain situations Tregs can impair effective immunity to some
pathogens and tumor cells. Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-
related death in the world, and in developed countries it is expected to continue to increase because of
the epidemic of chronic hepatitis C virus (HCV) infection. Previous studies also showed that Tregs
infiltrating HCC tumors were an indicator of poor prognosis.

Aim:
of this study was to evaluate CD4+CD25+ Treg cells in patients with HCC and liver cirrhosis
and their correlation with liver tumor markers and grading.

Patients and Methods
: The study included 30 patients, 15 patients had HCC (group I) and 15 were
cirrhotic patients (group II). In addition, 10 healthy subjects were used as controls. All patients were
subjected to clinical examination and laboratory investigations including liver function tests, hepatitis
B markers (HBs Ag, HBeAg and HBc-Ab) and HCV antibodies were detected by ELISA. and
Bilharzial Abs by indirect hemagglutination test. CD4+CD25+ Tcells were quantified in the blood by
flow cytometry, alpha feto protein by Cobas e 411, To evaluate HCC grading ,abdominal sonography,
C.T.and liver biopsy were done. Patients were categorized into mildely differentiated (grad 1),
moderately differentiated (grad 11) and poorly differentiated (grad 111).

Results:
There were significant increased in serum AFP, and CD4+CD25+% in patients with HCC,
and in patients with liver cirrhosis when compared to control group (p<0.05), and highly significant
increased in AFP, and CD4+CD25+ % in patients with HCC when compared to patients with liver
cirrhosis (p<0.001). In HCC patients there were 2 patients (13.3%) of grade I, 10 patients (66.7%) of
grade II and 3 patients (20% )of grade III .Regression analysis showed negative significant
correlation between CD4+CD25+% and ALT (p<0.05, r=-0.51), and positive significant correlation
between CD4+CD25+ and AFP (p<0.05, r=0.41) among patients with HCC. Also there was positive
correlation between CD4+CD25+ and ALT (p<0.05, r =0.46) among patients with liver cirrhosis.

Conclusion:
Our finding suggests that increased frequency of Treg cells might play a role in
modulation of the immune response in HCC and liver cirrhosis, through limitation of the efficacy of
anti-tumor response. Treg cells correlate properly with AFP and with tumor grades; this may play a
major role in the inflammatory activity in the liver. Better understanding of the underlying
mechanism of Tregs regulation may help to find immunotherapy for HCC and enhancing immunity
against cancer.

182

Full Paper (vol.43 paper# 7)


Endoscopic-Assisted Laparoscopic Management of Hepatic Hydatid Cyst The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 192 ­ 198

yEndoscopic-Assisted Laparoscopic Management of Hepatic Hydatid Cyst

Mohamed Ismail Seleem 1and Sameh M. Seif2
1-Department of Hepato-bilio-pancreatic Surgery
2-Tropical Medicine Department,
National Hepatology and Tropical Medicine Research Institute
Cairo-Egypt

Abstract

Background : Because of limited experience, controversies still exist about the laparoscopic
management of hepatic hydatid cysts. In this study, we are presenting our early experience
with this new technique of endoscopic-assisted laparoscopic management of hepatic hydatid
cyst compared with open surgery.

Patients and Methods:
Between January 2000 and July 2010 fifteen patients (12 males and 3
females) with hepatic hydatid cysts were referred from gastro-entrology unit at National
Hepatology and Tropical Medicine Research Institute. All patients had a single, large hepatic
hydatid cyst. Patients received a preoperative course of Albendazole for one month. Six
patients underwent open surgery and nine patients underwent EAL technique. All patients in
the EAL group had pre-operative ERCP to rule out any biliary communication. Operative
time, hospital stay, post-operative complications and follow-up were recorded.

Results:
Mean operative time was 206 minutes in the open surgery group compared with 110
minutes in EAL group. The mean hospital stay was 22.3days in open group and 8days in EAL
group. All patients required insertion of intra-abdominal drain. At a maximum follow-up of 9
years, only two patients developed post-operative bile leak in the open group and treated
conservatively.

Conclusion: We concluded that endoscopic-assisted laparoscopic technique is a safe, simple
and promising methods with a potentially low risk of intra-abdominal spillage compared with
open surgery.

Key words:
Hydatid cyst, hepatic, endoscopic, laparoscopic.


Abbreviations:

EAL (Endoscopic-Assisted Laparoscopic)
ERCP(Endoscopic retrograde cholangiopancreatography)
WHO(World Health Organization)
PAIR(percutaneous aspiration , injection & reaspiration)
192

Full Paper (vol.43 paper# 8)


Prevalence of thyroid dysfunction in Egyptian chronic hepatitis C patients treated with Pegylated interferon and Ribavirin The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 199 ­ 211
Prevalence of thyroid dysfunction in Egyptian chronic hepatitis C patients
treated with Pegylated interferon and Ribavirin

Sherif M. Naguib1, Ahmed M.Hashem1, Radi Hammad2,Mohamad A.Hassanein3,Niveen
E.Omran4
1- Internal Medicine Department,Faculty of Medicine,Cairo University.
2- Internal Medicine Department, National Hepatology and Tropical Medicine Research
Institute, Cairo, Egypt.
3- Tropical Medicine Department, National Hepatology and Tropical Medicine Research
Institute, Cairo, Egypt.
4-Clinical Pathology Department, National Institute of Hearing & Speech, Giza, Egypt.


Abstract


Background:
Hepatitis C is a major cause of liver-related morbidity and mortality and represents a
major public health problem in Egypt and worldwide. INF therapy is the most popular treatment for
HCV. INF has many side effects most of them still under study. The development of thyroid
dysfunction during IFN and Ribavirin combination therapy has been reported.

Aim:
The aim of this study is to assess the Prevalence of thyroid dysfunction in Egyptian chronic
hepatitis C patient treated with pegylated interferon and Ribavirin

Materials & Methods:
The study was conducted in cooperation between Internal Medicine
Department, Faculty of Medicine, Cairo University and Internal Medicine Department, out patients'
clinic of National Hepatology and Tropical Medicine Research Institute (NHTMRI) in the period
from January 2009 to June 2010. The current study included 200 patients who fulfilled the
predesigned inclusion criteria. TSH was done pre treatment, every 3 months during treatment and 3
months following termination of treatment also were done for all cases. Also, FT3 and FT4 were done
if there is abnormal TSH.

Results:
The prevalence of thyroid dysfunction in chronic hepatitis C patients treated with pegylated
INF and Ribavirin reaching 19% in this study.

Key words:
HCV- pegylated interferon-thyroid dysfunction.

Introduction:


(PEG-IFN) alfa by subcutaneous injection
Hepatitis C is a major cause of liver-related
once a week and oral ribavirin daily for
morbidity and mortality and represents a major
patients with contraindications to ribavirin
public health problem in Egypt and worldwide
(Rebetol, 2004).
Two PEG-IFN alfa
(Alberti and Benvegnu, 2003) and there is a
preparations are available (McHutchinson et
large underlying reservoir of HCV-caused
al., 2006 & Manns, 2001)
liver disease (Strickland et al., 2002). The
PEG-IFN alfa-2b, administered at a weight-
main goal of treatment is permanent
based. 1.5g/kg dose.
eradication of the virus, secondary goal is
PEG IFN alfa-2a, administered at a fixed 180-
histological
improvement
of
liver
g dose.
inflammation and fibrosis to delay cirrhosis
Randomized controlled trials (RCTs) have
and prevent decompansation and HCC
shown that combination PEG-IFN alfa and
(Strader et al.,2004). The current standard of
ribavirin therapy can achieve a sustained
care for the treatment of patients with chronic
virologic response (SVR) in 54%-56% of
hepatitis C is combination pegylated interferon
patients for genotype 1 and 4 and ( 76%-84% )
199


Full Paper (vol.43 paper# 9)


Biochemical, histological and histochemical studies of fennel (Foeniculum vulgare) on hyperlipidemic rats The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 212 ­ 225

Effect of fennel (Foeniculum vulgare) on
hyperlipidemic rats.


Eman G.E. Helal,Fatma Ahmed Eid and Amira M. Salah EL-Din Ahmed El-
Wahsh
Zoology Department, Faculty of Science, Al-Azhar University


Abstract

Hyperlipidemia (mainly increased level of total cholesterol (TC), triglycerides (TG) and low-
density lipoprotein(LDL) cholesterol with a decrease in high-density lipoprotein(HDL)-
cholesterol) is the predictor of coronary artery disease (CAD). Hyperlipidemia is an important
risk factor in the initiation and progression of atherosclerotic impasse.

Aim of the work:
Many people have fast food that contains large amount of lipids and leads to the formation of
free radicals which cause hyperlipidemia. The present study demonstrate the effect of the
fennel (Foeniculum vulgare) in the treatment of hyperlipidemia.

Material and methods:
Six groups (5rat/group) of female albino rats (Rattus albinus) were used. The 1st group used
as control, in the 2nd group hyperlipidemia (25% fat and 2% cholesterol) was induced for 3
weeks only then sacrified , the 3rd group was hyperlipidemic rats for 3 weeks then left for a
further 3 weeks without any additional treatment as a recovery period, the 4th group served as
hyperlipidemic group for 3 weeks then treated with Foeniculum vulgare for another 3 weeks
(10 mg/100 gm b. wt.), the 5th group was hyperlipidemic (25% fat and 2% cholesterol) for 6
weeks and the 6th group served as hyperlipidemic rats for 6 weeks, and at the same time given
Foeniculum vulgare (10 mg/100 gm b. wt.) by oral administration.

Results:
The biochemical parameters showed highly significant increase in the body weight, serum
glucose, ASAT, ALAT, GGT, LDH, total protein, albumin and total lipids in liver .Many
histopathological and histochemical changes were detected in liver tissue of the
hyperlipidemic rats. Meanwhile, the treatment with fennel ameliorated the biochemical
parameters, histological and histochemical results.

Conclusion:
It is recommend to use fennel in diets for hyperlipidemic patients or those people who have
hyperlipidemic family history.

Keywords:
Hyperlipidemia, Fennel, Lipid profile, Albino rats, Physiological parameters,
Histopathological and histochemical changes.

Introduction


with hepatic fat accumulation. Coronary
Hyperlipidemia : is an elevation of lipids
heart disease (CHD) is caused by the
in the blood stream and these lipids
narrowing of the artery that supplies
include: fats, fatty acids, cholesterol,
nutrients and oxygen to the heart. The
cholesterol esters, phospholipids, and
main reason for this narrowing is
triglycerides. Hyperlipidemia is associated
atherosclerosis. There is a relationship

212

Full Paper (vol.43 paper# 10)


Biochemical, histological and histochemical studies of fennel (Foeniculum vulgare) on hyperlipidemic rats The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 226 ­ 240

Hypolipidemic effect of triphala (Terminalia chebula, Terminalia belerica
and Emblica officinalis) on female albino rats.

Fatma Ahmed Eid , Eman G.E. Helal and Amira M. Salah EL-Din Ahmed El-
Wahsh
Zoology Department, Faculty of Science, Al-Azhar University


Abstract

Hyperlipidemia, hyperlipoproteinemia or dyslipidemia is the presence of elevated or abnormal
levels of lipids and / or lipoproteins in the blood. Lipid and lipoprotein abnormalities are
extremely common in the general population and are regarded as a highly modifiable risk factor
for cardiovascular disease due to the influence of cholesterol, one of the most clinically relevant
lipid substances in atheroscterosis.

Aim of the work:
This study aimed to evaluate the possible treatment and protective effect of triphala on
hyperlipidemic rats.

Material and methods:
Six groups (5rat/group) of female albino rats (Rattus albinus) were used. The 1st group used as
control, in the 2nd group hyperlipidemia (25% fat & 2% cholesterol) was induced for 3 weeks
only then sacrified , the 3rd group was hyperlipidemic rats for 3 weeks then left for other 3
weeks without any additional treatment as a recovery period, the 4th group served as
hyperlipidemic group for 3 weeks then treated with triphala for another 3 weeks (25 mg/100 gm
b. wt.), the 5th group was hyperlipidemic (25% fat & 2% cholesterol) for 6 weeks and the 6th
group served as hyperlipidemic rats for 6 weeks, and at the same time given triphala (25 mg/100
gm b. wt.) by oral administration.

Results:
The biochemical parameters showed highly significant increase in the body weight, serum
glucose, ASAT, ALAT, GGT, LDH, total protein, albumin and total lipids in liver .Many
histopathological and histochemical changes were detected in liver tissue of the hyperlipidemic
rats. Meanwhile, the treatment with triphala ameliorated the biochemical parameters,
histological and histochemical results.

Conclusion:
It is recommended to use triphala in diets for hyperlipidemic patients or those people who have
hyperlipidemic family history.

Keywords:
Hyperlipidemia, Triphala, Lipid profile, Albino rats, Physiological parameters,
Histopathological and histochemical changes.

Introduction

(LDL)-cholesterol and apolipoprotein B

(apo B) levels, and reduced plasma high-
Hyperlipidemia is a heterogeneous disorder
density
lipoprotein
(HDL)-cholesterol
involving
multiple
etiologies.
It
is
concentration, as a consequence of
commonly characterized by an increased
metabolic effects, or dietary and lifestyle
flux of free fatty acids (FFA), raised
habits (Kolovou et al., 2005; Feng et al.,
triglycerides,
low-density
lipoprotein
2011).
226

Full Paper (vol.43 paper# 11)


þÿ The Egyptian Journal of Hospital Medicine (April 2011) Vol., 43: 241 ­ 257


The Distribution of Certain Heavy Metals Between Intestinal Parasites and their
Fish Hosts in the River Nile at Assuit Province, Egypt.

Shahat, M.A.1, Amer, O.S.O.1, AbdAllah, A.T.2, Abdelsater, N.1 and Moustafa, M.A.1
1 Department of Zoology, Faculty of Science, AlAzhar University at Assiut, Egypt
2Department of Biology, Faculty of Science, Jazan University, KSA, Permanent
address:Department of Zoology, Faculty of Science, AlAzhar University at Assiut, Egypt

Abstract

The present investigation was carried out on two species of freshwater fishes Oreochromis niloticus
niloticus
and Clarias gariepinus collected from EL-Ibrahimia and EL-Malah canals at Assuit
province. Water samples were also collected for determination of some water quality parameters and
the concentration of certain heavy metals including Cu, Cd and Pb. The results of water quality
analysis indicated significant differences between the two selected sites. The examination of the
intestinal parasites in both investigated fish species indicated that O. niloticus niloticus harbors one
species of acanthocephalans, Acanthosentis tilapiae at the two investigated sites while, Clarias
gariepinus
was found harboring one species of nematodes, Paracamallanus cyathopharynx at site(1)
and one species of trematodes, Orientocreadium lazeri at the two sites. The results also indicated that
the mean concentration of the three heavy metals in water at site (1) are ranked as Cu > Cd > Pb, while
at site (2) they are ranked as Cu > Pb > Cd with a highly significant difference (P<0.01) between the
two investigated sites. The data also showed a differences between the fishes and their parasites from
heavy metal ranking point of view, where it is ranked as Cu > Pb > Cd in both infected and
uninfected fishes. In case of parasites heavy metals concentration at site (1) the investigated heavy
metals are ranked as Pb > Cu > Cd in both Acanthosentis tilapiae and Orientocreadium lazeri, while
they are ranked as Pb > Cd > Cu at site (2) in Acanthosentis tilapiae and Pb > Cu > Cd in
Orientocreadium lazeri. Also, a significantly higher concentration of heavy metals was recorded in
the parasites compared to their host fishes.

Key words: Heavy metals, Water quality, Oreochromis, Clarias, bioaccumulation, helminth
parasites.

Introduction
activities have introduced several polluting

substances such as organic matter, chemical
Heavy metal pollution in the aquatic
fertilizer, insecticides, etc. into the River Nile
ecosystem has attracted serious concern during
and drainage systems at Assiut Province.
the recent years. The development of human
Several methods were used for detecting and
activities; the increase of industrialization and
assessment
of
pollutants
in
water
the discharge of wastes to the environment
environments, from these, the use of fauna
might be the main sources of contamination
inhabiting these habitats.
especially in developing countries that might
In the recent years, there has been increasing
threatened biolife (McGlashan & Hughies,
interest in the interrelationship between
2001; Bishop, 2002; ECDG, 2002; Santos et
parasitism and pollution, especially in aquatic
al., 2005 and Saeed & Shaker, 2008).
habitat and the role of parasites as bioindicator
The River Nile is the principal freshwater
of heavy metals pollution (Huspeni &
resource for Egypt, meeting nearly all demands
Lafferty, 2004; Sures, 2006 and Vidal-
for drinking water, irrigation, and industry
Martinez, 2007). This relationship is not
(Mohamed et al., 1998). It receives many
simple and in essence involves a double edged
pollutants, including heavy metals with levels,
phenomenon, in which parasitization may
in water and sediments of some parts of the
increase host susceptibility to toxic pollutants
River Nile are higher than the tolerance levels
or in which pollutants may result in increase
or limits set by the Egyptian General Authority
(or in some decrease) in the prevalence of
for standards and Quality control (Anwar,
certain parasites.
2003). Modern industrial and agricultural
241

Full Paper (vol.43 paper# 12)