Risk Factors and Effects of Infestation with PEDICULOSIS CAPITIS and
Scabies Among Primary School Students in Cairo, Egypt
Essam A. EL-Moselhy1*; Hassan M. Hassan2; Ayman S. Abdelhady1; Alaa Abdel-
Wahed1; and Abd-Elnaser S. Mohammed1
Departments of Community Medicine1 and Dermatology2 Faculty of Medicine, Al-Azhar University
*Corresponding author: Prof. Dr. Essam A. El-Moselhy (e-mail: dr_elmoselhy@ dr_elmoselhy@


Background: Pediculosis capitis (PC) and scabies are an important public health problem in
childhood. They have a worldwide distribution. Also, they have many effects on the infested students.
Objectives: To define the prevalence of PC and scabies, to find out the socio-demographic,
environment, and health care behavior risk factors, and to determine the effects on the studied students
in Cairo, Egypt. Subjects and Methods: A cross-section, analytical study design was chosen to
conduct this work. Three primary schools were the field of this study. Total number of the students
was 1987. The students were clinically examined; for each infested case with PC and/ or scabies a
control student was chosen. Results: Prevalence of PC and scabies was 10.2% and 3.4%, respectively.
These infestations were more common significantly among students in the public school. Significant
social risk factors of infested students were the low level of head of the family education, occupation,
and social status. Also, significant personal hygiene risk factors were poor hair, body, and environment
hygiene. While significant health care behavior risk factors were student never received skin
examination, no early consultation for skin diseases, and no compliance with therapy. Also; female
gender, the last birth order child, had previous infestation with PC, had sibling(s) with PC, and had
parents with history of infestation with PC were significant risk factors. On the other hand; male
gender, the last birth order child, had previous infestation with scabies, had sibling(s) with scabies, and
had parents with history of infestation with scabies were significant risk factors. Further, the PC cases
with crowding index >1, had no sun access, had shared water supply and bathing facilities, co-
sleeping, had no short cut hair, and sharing hair brushes were significant risk factors. On the other
hand, the scabitcs with crowding index >1, had no sun access, had shared water supply and bathing
facilities, and co-sleeping were significant risk factors. Lastly, presences of psychiatric, sleep, and
peers' relations disturbances were significantly more common among the infested students.
Conclusions: Many risk factors of PC and scabies can be manipulated, so these infestations can be
prevented, so many health hazards on the students could be prevented. Recommendations: Improving
students' hygiene, health education, and regular dermatological screening and treatment of students are
important essentiality. Also, dermatological health component should be integrated in school health
program. Lastly, further studies in different rural and urban areas in Egypt are recommended.
Key words
: Pediculosis capitis, scabies, prevalence, risk factors, primary schools.


School children are considered one of the most
developed countries. (5, 6, 7) Skin diseases are
important sectors of population. They are a
associated with environmental factors and
vulnerable group and great attention should be
public health approach is particularly
paid for them. (1) Also, school environment
important. (7) Further, infestations with
makes children vulnerable to cross transmission
ectoparasitoses are usually considered to be
of communicable dermatological diseases,
vexing disorders. These disorders do not attract
which can then be passed on to their family
much clinical attention, but they can cause
members. (2) So, coordinated school health
significant morbidity. (8)
programs in conjunction with community
Pediculosis capitis (PC) and scabies are
efforts can prevent many health problems
among students and help them to establish
parasitic dermatoses. They have been known
lifelong safety skills. (3, 4)
since antiquity and are distributed all over the
Dermatological disorders are among the most
world. (9, 10) Depending on the socioeconomic
frequently diagnosed conditions in school
setting, these infestations may affect a large
children all over the world, in developing and
proportion of a population. Ectoparasitic
DOI : 10.12816/0013785

Full Paper (vol.60 paper# 1)

c:\work\Jor\vol60_2 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 274-281

Studies on the Use of Aloe vera Extract as a Contraceptive in Female Rats
Eman G. E. Helal1*, Rasha A. A. El sayed1*, Hoda M.Abu-Taleb2
1Department of Zoology, Faculty of Science, Al-Azhar University (Girls), Cairo, Egypt.
2 Department of Environmental Research, Theodor Bilharz Research Institute, Cairo, Egypt.
*Corresponding authors: Eman G.E. Helal - Rasha A. A. El sayed,E-mail: -


Background: The study on the natural herbal contraception has become one of the main interests
of modern contraceptive studies. Herbs have been used by women since the beginning of time in an
attempt to control their fertility. The development of new fertility regulating drugs derived from
medicinal plants is an attractive proposition, Aloe Vera is a durable plant belonging to Sousanian
family. Aim of the work: This work was assessed to evaluate the probable contraceptive effect of the
aqueous extract of Aloe vera plant and its effect on the some vital organs in the female albino rats.
Materials and Methods: This study was performed on twenty female albino rats with an average 120-
140g body weight. The animals were divided into two groups (5 /cage); Group I (Control untreated
group) and Group II (Aloe vera group that supplied orally with 7 mg/kg body wt/day of the plant
extract for 30 ± 2 days).Results A prolonged proestrus and estrus phases of the estrous cycle were
observed in the Aloe vera group .The mean serum level of estrogen (estradiol) was significantly
increased in the Aloe vera group as compared to the control group (P<0.01) while non significant
difference was found for serum level of progesterone and the tumor markers, CA15-3 and CA-125.The
results also showed a marked decline (p<0.01) in levels of the serum calcium, creatinine, urea, total
proteins, albumin, globulin and ratio of TC/HDL accompanied with a marked elevation (p<0.01) in the
serum phosphorus, total lipid, TC, TG, HDL and LDL levels in the Aloe vera group in comparison with
those of control group. However, levels of uric acid, AST, ALT, GGT, VLDL and ratios of LDL/HDL
(risk factors) and A/G were approximately as that of the control group. Conclusion: It could be
concluded that Aloe vera can be used as a contraceptive drug that can increase the estrogen level due to
its phytoestrogen components such as beta sitosterol and without deleterious effects on the other vital
organ ( liver and kidney), however it's use is to be restricted with women suffering from low ca++level
as well as osteoporosis.
Keywords: Aloe vera, fertility, contraceptive, tumor markers, kidney function, liver function

literature of indigenous system of medicine(8).
One of the important concerns of today is
Several plants products inhibit male & female
the problem of overpopulation. Family

planning has been prompted through the use of

several synthetic steroidal contraceptives, but
fertility and may be developed into
the fear of cancer and cardiovascular disease
overshadows its continuous use among
One of the most important, world-famous herbs
women(1-5). Therefore, a great attention has
is Aloe. Aloe vera, derived from an Arabic
now been focused on indigenous plants for
word Alloeh means shinning bitter substance
their possible contraceptive effect. The goal of
and vera means "true". It is a succulent cactus
herbal remedy is to enable the body to readjust
like perennial plant originated from arid
excess levels of hormones, bring them to
climates of North Africa(11). Aloe vera is
'normal' and establish normal physiological
belonging to liliopsida class, liliales order, and
liliaceae genus, with over 275 species
Fertility regulation using plants or plant
worldwide(12,13). The fame that Aloe vera has
preparation has been reported in the ancient
acquired over a few years has been due to its
pharmacological benefits. Aloe gel or juice has
Received:1/4/2015 DOI: 10.12816/0013786

Full Paper (vol.60 paper# 2)

c:\work\Jor\vol60_3 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 282-290

Features of High Risk Pregnancy Among Women Attending a District
Hospital in Greater Cairo. A Case Control Study
1Ayman S. Abdelhady ,2Azza A. Howeedy & 3Esraa B. Abdelsalam
1Public Health Department, Faculty of Medicine, Al-Azhar University, Assiut.
2, 3 Gynecology & Obstetric Department, Abol-Monagga District Hospital (Ministry of Health),
Shobra El-Khema District, Greater Cairo.

Background: A high-risk pregnancy (HRP) refers to any medical condition or pathology that puts the
mother, fetus, or neonate at increased risk for morbidity or mortality during pregnancy or childbirth.
Objectives: The current study aimed to detect main features of high risk pregnancy among women
attending antenatal care clinics at a district hospital in Greater Cairo to achieve finally safe motherhood
and better outcome of the pregnancy. Methods: A case control study was used where pregnant women
attending antenatal care at gynecological outpatient clinics of (Abol-Monagga district hospital (MOH),
Shobra El-Khema district, Greater Cairo) were investigated three days weekly during January and
February 2015 for being at high risk pregnancy using a modified form of Morrison and Olsen scoring tool
to form the case group (141women), while women whose pregnancy was proved to be normal or at low
risk were included as a control group (181 women). Results revealed that the main current associated
morbidities of the high risk pregnancy women included anemia in (17%),gestational DM (14%),pregnancy
induced hypertension (13%)and gynecological disorders in(27%).The most prominent features which were
significantly related to development of HRP among studied women included obesity (31.2%), history of
previous pregnancy associated morbidities (24.8%), previous delivery with CS (24.1%), multigravidae
(32.6 %), multiparity (19.9 %), recurrent abortions (14.2 %) and complicated previous pregnancy outcome
in (31.9%), while insignificantly detected factors included un-optimal maternal reproductive age (<18 &
>35 years), working during pregnancy, illiteracy, (+ve) husband consanguinity, non practicing regular
physical activities during pregnancy, (+ve) past history of infertility and family history of morbidities.
Conclusion and recommendations: Comparing (HRP) women with normal and low risk group
revealed a higher prevalence of current morbidities such as anemia, DM and HTN among (HRP)
women in addition to other risk factors such as obesity, multigravidae, multiparity, past history of
delivery with CS, recurrent abortions and complicated previous pregnancy outcome. The study
recommended proper screening techniques to be used for all pregnant women attending antenatal
care clinics to pick up the factors that qualify the pregnant women to be at high risk.
Preconception assessment and counseling are strongly encouraged and should include the provision
of specific information concerning the risk factors which predispose to risky pregnancy.
Key words: High risk pregnancy, maternal morbidity, antenatal care

Every year nearly 5, 290,000 women die
Though pregnancy per se usually constitutes
globally due to pregnancy related causes. For
a heavy burden on women health as it places

additional physical and emotional stress on her
each death nearly 118 women suffer from life
body, yet health problems that occur before or
threatening events or severe acute morbidity.1, 2
during pregnancy may also increase the
With 99% of maternal deaths occurring in
likelihood for a high-risk pregnancy. A high-
developing countries, it is too often assumed
risk pregnancy (HRP) refers to any morbidity
that maternal mortality is not a problem in
or abnormal condition that puts the mother,
wealthier countries. Yet, statistics released in
fetus or neonate at increased risk for morbidity
September of 2010 by the United Nations place
or mortality during pregnancy or childbirth.
the United States 50th in the world for maternal
mortality -- with maternal mortality ratios
Accepted:2/2/2015 DOI : 10.12816/0013787

Full Paper (vol.60 paper# 3)

c:\work\Jor\vol60_4 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 291-302

Genetic Polymorphisms of Vascular Endothelial Growth Factor (VEGF) in
Egyptian Women with Breast Cancer
Hamdy AbdElhamid1, Ahmed Settin2, Risk El-baz3, Sobhy Hassab Elnaby4,
Sameh Roshdy5, Ahmed Noaman1
1(Department of physiology , Faculty of science , Mansoura University , Mansoura , Egypt), 2(Department
of Genetics , Faculty of Medicine , Children Hospital Mansoura University , Mansoura , Egypt),
3(Department of Genetics , Faculty of Medicine , Children Hospital Mansoura University , Mansoura ,
Egypt),4(Department of Cytogenetic& Molecular Biology, Faculty of science, Menoufiya University
,Menoufiya,Egypt), 5(Department of General Surgery & Oncology , Faculty of Medicine , Mansoura
University , Mansoura , Egypt)

:Vascular endothelial growth factor (VEGF) was considered to have an association with breast
cancer because it regulates endothelial cell proliferation, migration and differentiation.
Subjects and methods: One hundred and fifty two women with breast cancer were compared to 100
healthy control Egyptian women recruited from the same locality. VEGF gene polymorphisms were assessed
using the PCR-RFLP analysis of DNA samples obtained from peripheral blood.SNP scanning was performed
using MnII , BsmfI , CviAII , BsmfI , MnII restriction enzymes for VEGF1154 G/A, 634 G/C, 405 C/G, 936
C/T, 1612 G/A polymorphisms, respectively.
Results : Breast cancer among Egyptian women was strongly associated with the mutations related to
VEGF gene polymorphism as follows: VEGF 1154 G allele frequency was significantly higher than the A
allele (P = 0.0007,O.R =2.4) , VEGF 634 C allele frequency was significantly higher than the G allele (P =
0.012, O.R =0.62),VEGF 405 C Allele frequency was significantly higher than G Allele (P = 0.009, O.R
=1.67), VEGF 936 C Allele frequency was significantly higher than the T Allele (P = 0.0057, O.R =1.72),
VEGF 1612 G Allele frequency was significantly higher than A allele (P = 0.0148, O.R =1.62). For VEGF
1154 GA: AA vs. GA+GG (Recessive) P = 0.10, O.R = 6.23, C.I (1.0-38.9), GA vs. AA+GG (over dominant)
P= 0.01*, O.R = 2.13, C.I (1.2-3.8),AA+GA vs. GG (dominant) P= 0.0015*, O.R = 2.57, C.I (1.5-4.5). For
VEGF 634 GC : CC vs. GC+GG (Recessive) P= 0.1852, O.R = 0.64, C.I (0.4-1.2), GC vs. CC+GG (over
dominant) P= 0.2669 , O.R = 0.71, C.I (0.4-1.2), CC+GC vs. GG (dominant) P = 0.0002**, O.R=0.05, C.I
(0.0-0.2).For VEGF 405 CG : GG vs. CG+CC (Recessive) P= 0.0013*, O.R = NA,C.I =NA, CG vs. GG+CC
(over dominant) P= 0.877, O.R = 1.08, (0.6-1.9), GG+CG vs. CC (dominant) P = 0.0323*, O.R=1.93,C.I (1.1-
3.4).For VEGF 936 CT : TT vs. CT+CC (Recessive) P = 0.1833, O.R = 1.63, C.I (0.9-3.1), CT vs. TT+CC
(over dominant) P = 0.1379, O.R = 1.55, C.I (0.9-2.6), TT+CT vs. CC(dominant) P = 0.0075**, O.R=2.08,
C.I (1.2-3.5). For VEGF 1612 GA: AA vs. GA+GG (Recessive) P = 0.0000**, O.R = NA, C.I = NA, GA vs.
AA+GG (over dominant) P= 0.0002**, O.R = 0.36, C.I (0.6-0.2), AA+GA vs. GG (dominant) P = 0.9541,
O.R = 0.95, C.I (1.6-0.6).
Key words: Polymorphisms, Breast cancer, VEGF

cancer type among females.2In Egypt breast cancer
The breast tissue from the inner lining of milk
is the most common breast cancer among women
ducts or the lobules that supply ducts with milk are
representing 18.9% of total cancer cases (35.1% in
the main organs that develop the Breast Cancer
women) among the Egypt National Cancer Institute
(malignant breast neoplasm).1Lobular carcinomas
(NCI).3The mechanism and etiology of breast
are cancers of lobules. In the West, the Breast
carcinogenesis remain a mystery. The reasons of
Cancer represents 23% of the total cancer cases
having the Breast Cancer are not completely known
within women. It also represents 14% of the total
but they may includehereditary, environmental,
cancer cases in the whole world in 2008 within
dietary, racial and socioeconomic risk factors. They
women. Therefore, the Breast Cancer is the major

menopause,genetic reproductive history and

estrogen administration factors.4, 5, 6, 7, 8, 9, 10The
Received:8/1/2015 DOI : 10.12816/0013788

Full Paper (vol.60 paper# 4)

c:\work\Jor\vol60_5 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 303-313

Effect of Clarithromycin Administration during Late Gestational Period
on The Pregnant Albino Rats and Their Fetuses
Gabri M.S.*,Asmaa M. Kandil**, Maiada Moustafa* and Nehad Mohamed *
*Zoology and Entomology department, Faculty of Science, Helwan University
**Pharmacology Dep., National Organization for Drug Control and Research (NODCAR)


Clarithromycin, a new macrolide antibiotic, is effective in the management of a wide range of
clinical problems including outpatient treatment of community-acquired pneumonia, shortening the
course of peptic ulcer disease associated with Helicobacter pylori infection and curing previously
resistant respiratory infections in immune-compromised patients.
The present study is planned to study the effect of clarithromycin on the pregnant female rats and
their fetuses during the last gestational period stage. This study includes the effect of clarithromycin on
therate of abortion, malformation of fetuses, skeletal, histological changes and DNA fragmentation of
liver cells of pregnant rats and their fetuses. In the present study two groups of pregnant animals were
used. The first group received distilled water from 15th to 19th days of gestation and used as control and
sacrificed at 20th day of gestation. The other group is orally administered with 45mg/kgclarithromycin
from 15th to 19th days and sacrifices at 20th day of gestation (the therapeutic dose).
The obtained results showed a significant decrease in maternal body weight gain and increase in the
rate of abortion, resorption and growth retardation of fetuses.Fetuses of the treated group showed severe
lack of ossification on the skull bones, phalanges and sternum bone as well as shortness in the ulna and
radius bones. Histological studies of pregnant rats revealed congestion and dilatation of the central vein
of the liver lobules and fatty degeneration of the hepatocytes with severe DNA fragmentation.In 20 day-
fetuses, there were a marked increase of necrotic hepatocytes associated with increased average of
megakaryocytes and periportal leukocytic infiltration.
Key words: Macrolides, clarithromycin,fetogenesis, teratology, skeletal malformation, rat and
liver histopathology, DNA fragmentation.

erythromycin.Clarithromycin is generally well
In general, wide applications of the
tolerated, producing fewer gastrointestinal
antibiotics such as penicillins, cephalosporins

and macrolides, such as erythromycin revealed
complaints than its parent compound,
that they are safe.[1]However,less of works are
erythromycin. So, from 1994 through 2008,
concerned with the clarithromycin. The
there was a decreasing trend in erythromycin
treatment with clarithromycin was found
use and an increasing trend in use of non-
toexhibits no cytotoxicity in the non-small cell
erythromycin macrolides during pregnancy
lungcancer (NSCLC) cell lines. [1]
There are relatively limited data concerning
the safety of azithromycin, clarithromycin and
usedfrequentlyto treat mild to-moderately
roxithromycin during gestation.[4]The relatively
new macrolide antibiotics (clarithromycin,
azithromycin and roxithrimycin) are better
genitourinaryinfections. It showed potent
tolerated than erythromycin. [5]Clarithromycin
effects on gram ­negative bacteria.[2]
and azithromycin have also been helpful in the
treatment of toxoplasmosis during pregnancy.
macrolideantibiotics are often subdivided
intoerythromycinand non-erythromycin drugs.
Bar-Oz Bet al., (2008)[4]reported that the
The erythromycin is the first-introduced
new macrolides during the first trimester of
macrolidedrugs, whilethe non-erythromycin
pregnancy does not represent an increased risk
includes clarithromycin and azithromycin,
for congenital malformations but strongenough
to induce abortion after such an exposure.
Elective terminations of pregnancy because of
Received:8/1/2015 DOI : 10.12816/0013789

Full Paper (vol.60 paper# 5)

Relation between Non-Alcoholic Fatty Liver Disease (NAFLD) and Epicardial fat in Metabolic Syndrome as a Cardiovascular Risk The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 314-323

Relation between Non-Alcoholic Fatty Liver Disease and Epicardial Fat in
Metabolic Syndrome
Shendy Mohammed Shendy1, Mohamed Darwish El-Talkawy1, Abdel Aziz Ali
Saleem1, Wael Safwat1, Mona Adel4, Ashraf Abd El-Khalik2 and Hoda Abu Taleb3
1Hepatogastroenterology Department,2 Intensive Care Unit Department, 3Biostatistics &
Demography Medical Statistician,Department of Environment Research, Theodor Bilharz Research
institute, Warrak El Hadar, Imbaba, Egypt,4Cardiology Departement,Tanta University Egypt.

Non-alcoholic fatty liver disease (NAFLD) is becoming recognized as a component of the
metabolic syndrome and insulin resistance. There has been recent interest in the association between
epicardial fat and atherosclerotic disease with increased risk of cardiovascular mortality and morbidity.
Aim of the work: In this study we investigated the relationship between the metabolic syndrome with liver
involvement and epicardial fat. Patients and methods: 85 patients who had the criteria of metabolic
syndrome are subjected to thorough clinical evaluation. Abdominal circumference, body mass indexand
waist/hip ratio were recorded for all patients. Laboratory investigations including urine, complete blood
picture, fasting and postprandial blood glucose, uric acid, blood urea and creatinine,C-reactive protein (CRP) ,
lipid profile, liver enzymes and bilirubin were done to all patients. Ultrasonography was used to grade fatty
liver and measure the thickness of epicardial fat. Results: Patients with high ALT levels have significantly
higher (p<0.01) AST, fasting blood glucose (FBG), uric acid, triglyceride (TG) level, more epicardial fat and
waist circumference (p<0.05) compared to those with normal levels. Patients with high grade of fatty liver
have significantly higher total cholesterol, TG, FBG, AST, ALT, uric acid levels, more epicardial fat and
waist circumference (p<0.01) compared to those with mild and moderate. ALT, FBG and TG are significantly
higher in patients with detectable epicardial fat than those without (p<0.01). There were significant direct
correlations between epicardial fat thickness with FBG (r= 0.324; p<0.01), TG (r= 0.217; p<0.05), AST (r=
0.493; p<0.01), ALT (r= 0.561; p<0.01), and grade of fatty liver (r= 0.479; p<0.01). Also there were
significant direct correlations between FBG with waist circumference (r= 0.422; p = 0.01), TG level (r =
0.370; p<0.01), HDL-C (r = 0.284; p<0.05) and grade of fatty liver (r = 0.533; p = 0.01). There were
significant direct correlations between grade of fatty liver with waist circumference (r= 0.264; p<0.05), TG
(r= 0.407; p<0.01), uric acid (r= 0.288; p<0.05), and AST levels (r= 0.642 p<0.01). CRP was found
correlated only with liver enzymes (r = 0.481;p<0.05). Simple logistic regression analysis revealed that
epicardial fat thickness (mm) showed a trend in patients with NAFLD and metabolic syndrome. Conclusion:
Echocardiographic assessment of epicardial adipose tissue, abdominal ultrasound assessment of NAFLD and
transaminase level might serve as a reliable marker of visceral adiposity and more severe degree of metabolic
Key words: Non-alcoholic fatty liver disease (NAFLD), Metabolic syndrome, Epicardial fat.


The metabolic syndrome, which includes diabetes
ATP III criteria define the metabolic syndrome as
or prediabetes, abdominal obesity, unfavourable
the presence of any Abdominal obesity, (waist
lipid profile and hypertension, triples the risk of
circumference102 cm (40 in) in men and 88 cm
myocardial infarction or stroke and doubles
(35 in) in women), Serum TG 150 mg/dL (1.7
mortality from these conditions. It also increases
mmol/L) or drug treatment for elevated TG, Serum
the risk of developing type 2 diabetes, if not
high density lipoprotein cholesterol (HDL-C) 40
already present, fivefold.(1) There are several
mg/dL (1 mmol/L) in men and 50 mg/dL (1.3
definitions for the metabolic syndrome; The
mmol/L) in women or drug treatment for low
density lipoprotein cholesterol (LDL-C), Blood
(NCEP/ATP III) is the most widely used. Current
pressure 130/85 mmHg or drug treatment for

elevated blood pressure, Fasting plasma glucose
Received:8/1/2015 DOI : 10.12816/0013790

Full Paper (vol.60 paper# 6)

c:\work\Jor\vol60_7 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 324-335

Tumor Necrosis Factor-Alpha (TNF-) Gene Expression in
Chronic Hepatitis B Virus Infection
1Saadia Farid, 2Laila Rashed, 3Amal Ahmed and 4Samya Sweilam
Department Of Tropical Medicine, Biochemistry and Medical Biochemistry
National Hepatology and Tropical Medicine Research Institute and
Faculty of Medicine, Cairo University

Tumor necrosis-alpha (TNF-) is produced by macrophages, neutrophils, T-cells and NK-
cells after stimulation. In turn, TNF- can stimulate secretion, increase the expression of adhesion
molecules as well as active neutrophils. Hence, it fulfills the role as a principal mediator of cellular
immune response and inflammation, and may play an important role in non-cytopathic and cytolytic
clearance of hepatitis B virus (HBV). The clearance of HBV is a complex process which may be
influenced by many factors including polymorphisms in the tumor necrosis <alpha> (TNF-<alpha>) gene
Aim of the work: The study aimed to determine the TNF- as a gene expressed in chronic hepatitis B
virus infection and its role in outcome of the virus.
Patients and methods: Ninety four patients with chronic HBV infection, their age between 19 and 59
years, selected from the National Hepatology and Tropical Medicine Research Institute were included in
this study, during treatment and twenty healthy individuals were included to serve as controls. All the
patients and controls were subjected to the following; history, clinical examination, abdominal
ultrasonography and collection of blood samples for routine laboratory investigation, and serological
assay for HBsAg, HBsAb, HBeAg, HBeAb, HBV DNA (quantitative), and TNF- promoter
polymorphisms in two sites 238 and 308.
Results: The prevalence of the variant at position -308 GA was similar in all investigated groups (patients
and controls). An association was found between the TNF- promoter polymorphism at position -238 and
the development of chronic HBV infection with sensitivity of 93% and specificity of 75%.
Conclusion: TNF--308 GA was significantly associated with clearance, showing protective antibody
and persistent HBV infection. The promoter variant of TNF- at position 238 GA, GG appears to be
linked to defective viral clearance, controls had higher TNF--238 GG,GA, AA as compared to cases
with significant difference.
Recommendations: The variation in the genes governing the levels of constitutive and inducible TNF-
might be an important factor, which might explain the variable outcome of HBV infection.
Key Words: Hepatitis B virus (HBV), Tumor necrosis factor <alpha>, polymorphism, and "SNP" single
nuclueotide polymorphism at 238, and 308.


Hepatitis B virus (HBV) infection is a
of infected hepatocytes during acute hepatitis B
major global health problem. It is estimated that
virus infection. (2) The balance between viral
over 2 billion worldwide had been infected and
replication and immune responses seems to be
400 million are chronically infected (1). HBV is
the key to the outcome of infection. (3, 4) Recent
not directly cytopathic. The pathogenesis of
data suggest that HBV may trigger weak innate
HBV-related liver injury is determined by the
immune responses following infection and that
interactions between the virus and the host
HBV rapidly develops mechanisms to repress
immune response. (1) Cytokines such as tumor
these responses and establish a persistent
necrosis factor-alpha (TNF-) and interferon
infection. In chronically infected patients,
gamma (IFN-š) are important for the elimination
intrahepatic expression of innate response genes
Received:8/1/2015 DOI : 10.12816/0013791

Full Paper (vol.60 paper# 7)

Comparative Protective Effect of Moringa and Dandelion Extracts Against Hepatic Disorders and Oxidative Stress Associated with Prolonged Use of BrufenDrug in Rats The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 336-346

Comparative Protective Effect of Moringa and Dandelion Extracts Against
Hepatic Disorders and Oxidative Stress Associated with Prolonged Use of
BrufenDrug in Rats
**Hanaa A. Hassan ,Wafaa M. EL-Kholy, Nadine A. Galal
Physiology Division, Zoology Department, Faculty of Science, Mansoura University,
Mansoura, Egypt
**Corresponding author:,

The nonsteroidal anti-inflammatory drugs (NSAIDs) are the most frequently used
medications worldwide for the treatment of a variety of common chronic and acute inflammatory
conditions. The association between NSAIDs and liver disease is poorly documented. Aim: the current
study was carried out to investigate the hepatic disorders associated with prolonged use of Brufen drug
and evaluate the role of both moringa and dandelion extracts as hepatoprotective agents against these
disorders. Methods: rats were divided into six groups (six rats/ each) as follow: group 1: rats did not
receive any treatment and served as control; group 2 : rats orally administrated moringa extract
(300mg/kg b.wt) daily for 12 weeks; group 3: rats orally administrated dandelion extract (300mg/kg
b.wt) daily for 12 weeks ; group 4: rats orally administrated Brufen (18mg/kg b.wt) daily for 12
weeks;.group5: rats orally administrated moringa extract (300mg/kg b.wt) daily for one week alone then
concomitant with Brufen (18mg/kg b.wt) for 11 weeks ;group 6: rats orally administrated dandelion
extract (300mg/kg b.wt) daily for one week alone then concomitant with Brufen (18mg/kg b.wt) for 11
weeks.Results: the present results showed that the administration of Brufen led to significant increases
in the levels of TL, TC, TG, LDL-C, ALT, AST, ALP, GGT, MDA and XO. While significant
decreases in HDL-C, TP, ALP, GSH, TAC, SOD, CAT and GSH-Px, were recorded in Brufen treated
rats group. On the other hand, the administration moringa or dandelion extracts succeeded to alleviate
these abnormalities resulted from Brufen drug as indicated by the clear amelioration of occurred hepatic
metabolic disorders, oxidative stress and histopathological changes in addition to improvement of the
antioxidant status. Conclusion: it could be concluded that moringa or dandelion extracts have a
remarkable role in management the hepatic disorders and oxidative stress associated with prolonged use
of Brufen. Additionally it was recorded that moringa extract was more beneficial than dandelion extract
in alleviating the occurred adverse effects of Brufen.

Moringa, Dandelion, Hepatic disorders, Brufen drug.

TC,totalcholesterol;TG,triglycrides;HDL-C,highdenisity lipoprotein cholesterol;LDL-C,lowdensity
lipoprotein cholesterol; TP, total protein; Alb, albumin; AST, aspartate transaminase; ALT, alanine
transaminase; ALP, alkaline phosphatase; GGT, gamma-glutamyltranspeptidase.; MDA,
malondialdehyde; XO;xanthine oxidase GSH, reduced glutathione;TAC,total antioxidant capacity,
SOD, superoxide dismutase; CAT, catalase; GSH-Px, glutathione peroxidase; ROS, reactive oxygen
species; NSAIDs, nonseroidal anti-inflamatory drugs

acetylsalicylic acid (ASA), paracetamol and
naproxen (NPX). Brufen (ibuprofen) has
(NSAIDs) are the most frequently asked groups
effectual anti-inflammatory, analgesic and
of pharmaceutical dealership all over the world.
antipyretic properties. It has effective action on
NSAIDs are pharmaceutical agents with various
muscle pain and several other inflammatory
analgesic, anti-inflammatory and antipyretic
diseases [1].Brufen acts by inhibiting the
characteristics. Chemically, NSAIDs are a
cyclooxygenase enzyme system, particularly
different group and are not closely linked in
COX-1 (constitutive) and COX-2 (induced at the
terms of infrastructure; but, they have in
site of inflammation). The cyclooxygenase are
common several therapeutic application and side
responsible for converting arachidonic acid to
effects. The most widely used drugs within
prostaglandins and thromboxanes, which are
NSAID are ibuprofen (IBP), diclofenac (DCF),
mediators, participated in various homeostatic
Received:8/1/2015 DOI : 10.12816/0013792

Full Paper (vol.60 paper# 8)

c:\work\Jor\vol60_9 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 347-353

Age Structure of a Red Fox (Vulpes vulpes) Sample from Egypt
Mahmoud I. Younes1 and Ali E. Basuony1
1Department of Zoology, Faculty of Science, Al Azhar University, Nasr City, Cairo, Egypt
Corresponding author:

the Red Fox Vulpes vulpes is the most common and wide spread wild carnivore in
Egypt. Materials and methods:we examine a museum sample of 179 specimens from different
parts of Egypt to determine age structure using dentine layers counting method. Specimens were
grouped into three population groups according to their geographical region of origin.
Results:the average age of foxes in the sample was 1.46 years and ranging from 1 to 7 years of age.
Differences in age structure of populations from the three geographical regions and differences
between sexes are presented and discussed.
Key words: Red Fox, Age structure, Dentine layers, Age classes


and the different population it represents can
The Red Fox Vulpes vulpes is one of the most
provide basis for efforts to control rabies or to
common wild carnivores in Egypt1. This

highly adapted carnivore occurs in a great
regulate the quickly expanding trapping and
variety of habitats throughout the country2
totally unregulated fur trade.
and its distribution is somewhat linked to
Several methods, based on morphological
human distribution. Although some aspects of
indicators have been used for age
the distribution and genetics have been
determination in Vulpes vulpes. These
recently worked out3 many aspects of its
indicators include body weight, body length,
biology in Egypt are little known.1, 4
cranial dimensions, dry weight of eye lens,
As the most common and widespread
extent of fusion of cranial sutures or
carnivore in Egypt, the Red fox holds a
development of the sagittal crest, tooth wear,
special position in zoonotic Medicine. World
occlusion of the dental pulp, or increments in
Health Organization (WHO) reports point out
dentine layers.8,9,10,11, 12 Among many methods
that rabies in red foxes is a public health
problem in the Middle East, including Egypt.5,
6, 7
cementum analysis method is a widely
On the other hand, thousands of individuals of
accepted method for age determination of
this fox are trapped every winter by
many mammals13; 14; 15 and is often considered
professional trappers for the fur trade.
Trapping of foxes and exportation pelts are
method.8,11,12,16 Roulichova and Andera16
not in any way regulated by the government.
described a simplified method based on
The impact of current trapping on the
counting dentine layers in unstained, sanded
population in different areas and in Egypt in
canine roots. The method allows the simple,
general remain unknown.
yet reliable age estimation from one year
One of the key aspects in the biology of this
onwards. In this study we use the dentine
fox in Egypt is its population characters.
layer counting method as described by
Population size, structure and trends are
Roulichova and Andera16 to investigate the
among the more important parameters that are
age structure of large museum sample of the
instrumental for any effort to manage any
red fox Vulpes vulpes representing different
parts of Egypt.
comprehensive sample of the Red Fox is
available at the Al-Azhar University
We used a series of 179 red fox skulls
Zoological Collection (AUZC) in Cairo.
deposited in the Al Azhar University
Investigating the age structure of this sample
Zoological Collections (AUZC), Department
of Zoology, Faculty of Science, Al Azhar
DOI: 10.12816/0013793


Full Paper (vol.60 paper# 9)

c:\work\Jor\vol60_10 The Egyptian Journal of Hospital Medicine (Jul. 2015) Vol. 60, Page 354-362

Is Lasik an Effective Treatment Modality for Hyperopia or Hyperopic
Hesham M. Hosny, Adel M. Abdul Wahab, Mona El Sayed Ali H
Jihan Abdallah , Doaa Ali Mahmoud.
Department of Ophthalmology , Faculty of Medicine , AlAzhar University.

To assess the efficacy, safety and stability of LASIK surgery for treatment of low to moderate
degree hyperopia and hyperopic astigmatism.
Patients and methods: The study included 34 eyes in 17 patients (7 males, and 10 females) with
bilateral low to moderate degree hyperopia or hyperopic astigmatism. Their mean age + SD was 26.7 +
4.1 years. Range of hyperopia was between +1.75 to +5.50 D, astigmatic errors range was 0.00 to -1.50
D while the spherical equivalent refraction ranged from +1.4 to + 4.8 D. Patients included in this study
had a stable refraction for at least one year. All patients underwent bilateral LASIK surgery in the same
session in Dr Soliman Faqeeh Hospital (DSFH) and the Eye Subspecialty Center (ESC) using the
ALLEGRETTO EYE - Q Excimer Laser machine.
UCVA after one year was 20/20 or better in 30 eyes (88.2%), 20/30 or better in 32 eyes
(94.1%) and 20/40 or better in 34 eyes (100%), while BCVA was 20/20 or better in 33 eyes (97.1%) and
20/40 or better in 34 eyes (100%). There was no decrease in UCVA after LASIK surgery. One eye
(2.9%) showed 2 lines drop in BCVA after LASIK surgery due to broad wrinkles of the flap. The flap
was lifted after one day; trial to flatten the wrinkles showed incomplete resolution. One eye (2.9%)
showed diffuse lamellar keratitis (DLK) at one week after LASIK surgery. There was regression in the
manifest spherical equivalent refraction one year after LASIK surgery as compared with that at one
month, but the difference was statistically insignificant (P=O.46). The mean score of patient satisfaction
was 9.4 at one year postoperatively.
Conclusion: LASIK surgery is a safe, predictable, stable and effective for treatment of mild to moderate
degree hyperopia and hyperopic astigmatism. No significant regression in UCVA, BCVA or manifest
refraction was reported up to 12 months follow up.
Key words: LASIK, Ablation, Hyperopia, Astigmatism, Pentacam.

upper limit for hyperopic LASIK correction is
Laser in situ keratomileusis (LASIK) is a
+5.0D(5), while Waring et al.reported that the
surgical procedure for the treatment of
upper limit for hyperopic LASIK correction is
myopia, myopic and hyperopic astigmatism,
and low to moderate hyperopia.(1)
LASIK is approved by the FDA (US Food
Correction of hyperopia is significantly more
and Drug Administration) for the treatment of
difficult to be predicted than myopia.
Hyperopic correction is significantly more
Hyperopic LASIK consists of an annular zone
likely to regress at a greater percentage than
of ablation to cause a relative flattening of the
myopic correction(2-3).
corneal periphery and a concomitant relative
Photorefractive keratectomy (PRK) has been
steepening of the center (optical zone) to
used successfully for treatment of hyperopia
achieve the desired refractive effect. (8)
but has problems of regression, induced
astigmatism, and corneal haze. LASIK
The aim of this study is to assess the efficacy,
overcomes some disadvantages of PRK and
safety and stability of LASIK surgery for
has become the procedure of choice for
treatment of low to moderate degree
treating hyperopia.(4) Sheri reported that the
hyperopia and hyperopic astigmatism.

Received:8/1/2015 DOI: 10.12816/0013794

Full Paper (vol.60 paper# 10)