Group Of Egyptian Patients Research Articles

Obstructive sleep apnea in type 2 diabetes mellitus patients

Abstract Objective The study aims to identify the prevalence and risk factors for OSA in a group of Egyptian patients with type 2 diabetes. Methods 125 type 2 diabetes mellitus patients visited Mansoura University Hospital (Diabetes Mellitus Outpatient Clinic (OPC) at Specialized Medical Hospital and the Sleep Disordered Breathing Unit of the Chest Department), all of them exposed to history taking, the patients underwent anthropometric measurements (weight, height, body mass index, neck circumference), a test of their tonsillar size, Malampati score, Friedman OSA score, Epworth sleepiness scale (ESS), Berlin questionnaire, STOP BANG questionnaire, full-night polysomnography, fasting, and postprandial blood sugar. Results The study included 125 T2DM Egyptian patients with a mean age of 54.63 ± 9.47 years. Males accounted for 35.2 percent of patients, while females accounted for 64.8%. According to the study of co-morbidity, hypertension constituted 77 (61.1%), ischemic heart disease 28 (22.4%), other cardiac diseases 11 (8.8%), bronchial asthma 6 (4.8%), liver diseases 6 (4.8%), hypothyroidism 3 (2.4%), and renal diseases 3 (2.4%). A total of seven patients (5.6%) had no OSA symptoms, 87 had borderline symptoms, and 31 had positive symptoms. There were 51 (40.8%) normal patients, 12 (9.6%) borderline patients, and 62 (49.6%) sleepy patients on the Epworth scale. According to the Stop-Bang questionnaire, 121 (96.8%) patients answered positively. It was determined that 122 patients (97.6%) were at high risk based on the Berlin questionnaire. There were 17 patients (13.6%) with OSA on polysomnography, of which six were moderate (35.3%) and 11 were severe (64.7%). Among moderate and severe OSA patients, glycosylated hemoglobin levels differed significantly. Multivariate logistic regression analysis for independent predictors of OSA, chronic renal disease patients is the most common associated risk factor (OR = 14.3, CI = 1.2–67) then hypertension (OR = 5.6,CI=1.2–25.5) and heart failure (OR = 4.4). Conclusions OSA affects 13.6% patients with type 2 diabetes patients who are hypertensive are at higher risk of OSA, chronic renal failure is considered another risk factor Furthers studies are needed on a big scale of Egyptian diabetic patients to detect the prevalence of OSA

The Association of LPL Gene Variants with Type 2 Diabetes Mellitus and Obesity Susceptibility among Group of Egyptian Patients

The Association of LPL Gene Variants with Type 2 Diabetes Mellitus and Obesity Susceptibility among Group of Egyptian Patients

Association of PNPLA3 (rs738409) & TM6SF2 (rs58542926) and ATG16L1 (rs2241880) genetic variants with susceptibility to hepatocellular carcinoma in a group of Egyptian patients with HCV-induced liver cirrhosis

Association of PNPLA3 (rs738409) & TM6SF2 (rs58542926) and ATG16L1 (rs2241880) genetic variants with susceptibility to hepatocellular carcinoma in a group of Egyptian patients with HCV-induced liver cirrhosis

Assessment of serum levels of vitamin D and tissue levels of vitamin D receptors in acanthosis nigricans

Background Acanthosis nigricans (AN) is a skin disorder characterized by symmetrical, thickened, dark plaques comprising hyperkeratosis and acanthosis. Vitamin D (VD) plays an important role in the regulation of skin proliferation and differentiation, and mediates its action by binding to specific vitamin D receptors (VDR) in the nuclei of target cells. Objective To measure the serum levels of VD and tissue levels of VDR in a group of Egyptian patients with AN in comparison to healthy controls, in order to shed more light on the possible relation between VD, VDR, and AN. Patients and methods This study included 25 AN patients and 25 age-matched and sex-matched healthy controls. Blood samples and skin biopsies were taken from all participants for the evaluation of serum VD, glucose, insulin, and tissue VDR levels. Results Serum VD and tissue VDR were significantly lower (P<0.001 for both), while serum insulin and homeostatic model for insulin resistance were significantly higher (P<0.001 and P=0.002, respectively) in patients than controls. Patients had a more deficient pattern of VD status than controls (P<0.001). There was a statistically significant positive correlation between serum VD and tissue VDR in patients (r=0.632, P=0.001). Conclusion The present study suggests a possible role for low serum VD and tissue VDR levels in causing AN, in genetically predisposed individuals.

Apolipoprotein E Gene Polymorphism, Serum Lipids, and Risk of Superficial Fungal Infections in Egyptian Patients - A Preliminary Case-Controlled Study.

Apolipoprotein E (APOE) gene isoforms have been found to affect the risk of superficial fungal infections (SFIs). However, the data only cover a few ethnicities. The present work intended to investigate the association of APOE gene polymorphism and serum lipids with the susceptibility of SFIs among a group of Egyptian patients. Standard laboratory methods were used to estimate the serum lipid profile, and polymerase chain reaction-restriction fragment length polymorphism was used to detect APOE gene polymorphism in deoxyribonucleic acid extracted from 150 SFI patients and an equal number of apparently healthy matched controls. Serum total cholesterol, triglycerides, and low-density lipoprotein cholesterol were significantly higher in the studied patients than in controls. The APOE gene ε2, ε4 alleles, and ε3/4 and ε3/2 genotypes were significantly distributed in the patients than in the controls. APOE ε3/3 genotype was predominant in dermatophytosis and tinea versicolour patients, and ε3/4 genotype was predominant in candidiasis. ApoE alleles ε2 and ε4, and genotypes ε2/3 and ε3/4 are linked to SFI and may be risk factors, whereas allele ε3 and genotype ε3/3 may be protective for SFI in the Egyptian population studied. The lipid profile results suggest that hyperlipidemia may provide evidence for SFI pathogenesis. However; further large-scale studies are still needed to validate our results.

Role of Transcription Factor 7 like 2 and Silent Information Regulator 1 Genes in the Development of Cardiovascular Complications in a Group of Egyptian Patients with Chronic Kidney Disease

BACKGROUND: Sirtuins silent information regulator 1 (SIRT) is histone deacetylases that act as antioxidants and involved in the pathogenesis of cardiovascular diseases (CVD) which are the major complications of chronic kidney disease (CKD). Transcription factor 7-like 2 (TCF7L2) genetic polymorphisms could contribute to the risk of CVD as TCF7L2 proteins regulate vascular remodeling. AIM: We tried to demonstrate the role of genetic polymorphisms: rs7069102 and rs10823108 in SIRT1 gene and rs7903146 in TCF7L2 gene in the development of CVD in CKD Egyptian patients. METHODS: This study included 120 CKD patients (60 with CVD and 60 without CVD) and 60 age and sex-matched healthy subjects as a control group. Routine laboratory investigations were performed and genotyping for candidate single nucleotide polymorphisms was done by Taqman-real-time polymerase chain reaction. RESULTS: The frequency of the C allele of rs7069102 was significantly higher in CKD patients with CVD as compared to the normal control group (p &lt; 0.001) and as compared to CKD patients without CVD (p &lt; 0.001). Percentages of AG and GG genotypes of rs10823108 were significantly higher in CKD patients with CVD as compared to the normal control group (p = 0.002, 0.035, respectively). The frequency of the T allele of rs7903146 was significantly higher in CKD patients with CVD as compared to the normal control group (p &lt; 0.001). CONCLUSION: We found that C allele of rs7069102, GG and AG genotypes of rs10823108 in the SIRT1 gene and T allele of rs7903146 in TCF7L2 gene have a potential role in the pathogenesis and the risk of CVD development in CKD Egyptian patients.

Serum interleukin-17 expression in a group of Egyptian patients with juvenile systemic lupus erythematosus

Background: Systemic lupus erythematosus (SLE) is a chronic multi-organ systemic autoimmune disease. Interleukin-17 (IL-17) is a powerful proinflammatory cytokine that is involved in the development of several autoimmune diseases, including SLE. Objective: We aimed to evaluate the serum IL-17 expression in pediatric SLE and correlate this to the disease activity and other biomarkers of disease activity . Methods: Thirty-six patients diagnosed with pediatric SLE were enrolled in the study and were classified according to the SLE disease activity index (SLEDAI) score into two subgroups; mild activity (SLEDAI <5) and moderate to severe activity (SLEDAI ≥ 5). Routine laboratory work-up of SLE was done. IL-17 level was assessed by ELISA in the patients’ group (n=36) as well as in 17 age and sex-matched healthy subjects. Results: Our patients were 32 females (88.9 %) and 4 males (11.1 %). Their mean age at enrollment was 13.7 ± 2.7 years. The median (IQR) serum IL-17 level was significantly higher in patients than controls [138 pg/nl (68.5-200.15) versus 8.6 pg/nl (5.98-11.55) respectively]. There was no significant correlation between serum levels of IL-17 levels and disease activity scores. SLE patients with mild activity were comparable to those with moderate to severe activity in terms of IL-17 expression. Conclusion: SLE in children is associated with a significant increase in serum IL-17, whatever the activity status is, suggesting a potential role in the pathogenesis of the disease. Our conclusion is limited by the sample size.

Association Analysis of Genetic Variants of Sodium Taurocholate Co-Transporting Polypeptide NTCP Gene (SLC10A1) and HBV Infection Status in a Cohort of Egyptian Patients

Background: Single nucleotide polymorphisms (SNPs) in the SLC10A1 gene, coding for a functional receptor of hepatitis B virus (HBV), sodium taurocholate co-transporting polypeptide (NTCP), may influence the susceptibility, outcome, and disease course of HBV infection in some populations. Aim: to determine the prevalence of SNPs of the NTCP gene, rs2296651 and rs943277, and their relationship with chronic HBV infection in a group of Egyptian patients. Methods: One hundred and thirty seven patients with HBV and 65 healthy controls were enrolled, and the patients were divided into two groups; group I chronic HBV infection (68 patients with normal ALT and minimal or no liver necroinflammation or fibrosis) and group II chronic hepatitis B (69 patients with elevated ALT and moderate or severe liver necroinflammation). They were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound, and liver stiffness measurement using both Echosens® Fibroscan and acoustic radiation force impulse (ARFI). A real time PCR TaqMan 5′ allelic discrimination assay was applied to detect the SNPs in the NTCP gene, rs2296651 and rs943277. Results: On studying the rs2296651 variant, all controls and patients had genotype GG without any significant association with HBV infection or disease progression. However, the rs943277 variant in all controls and 98% of patients had genotype GA, except for two chronic HBV infection patients who had genotype AA, but no significant difference between patients and controls was found. The non-invasive methods for liver fibrosis assessment ARFI, AST/platelet’s ratio (APRI), and fibrosis-4 score (FIB-4) could predict the stages of fibrosis in agreement with Fibroscan with AUCOR 0.8, 0.79, and 0.76, respectively. Conclusion: These findings may suggest that there is no relation between these SNPs of the NTCP gene and the susceptibility or chronicity of HBV infection in the Egyptian population. We also suggest that the use of the non-invasive methods for liver fibrosis assessment, ARFI, FIB-4, and APRI, may decrease the need for liver biopsies in the prediction of significant hepatic fibrosis in chronic HBV patients.

Genotypic spectrum of 21-hydroxylase deficiency in an endogamous population.

Congenital adrenal hyperplasia (CAH) due to autosomal recessive 21-hydroxylase deficiency (21-OHD) is caused by defects in the CYP21 (CYP21A2) gene. Several mutations have been identified in the CYP21 (CYP21A2) gene of patients with 21-OHD. We aimed at determining the frequency of these mutations among a group of Egyptian patients and studying the genotype-phenotype correlation. Forty-seven patients with CAH due to 21-OHD from 42 different families diagnosed by clinical and hormonal evaluation and classified accordingly into salt wasting (SW) and simple virilizing (SV) phenotypes were enrolled. Their ages ranged between 1.78 and 18.99years. Molecular analysis of the CYP21 (CYP21A2) gene was performed for the detection of eleven common mutations: P30L, I2 splice (I2 G), Del 8bp E3 (G110del8nt), I172N, cluster E6 (I236N, V237E, M239K), V281L, L307 frameshift (F306 + T), Q318X, R356W, P453S, R483P by polymerase chain reaction (PCR) and reverse hybridization. Disease-causing mutations were identified in 47 patients, 55.31% of them were compound heterozygous. The most frequent mutations were I2 splice (25.43%), followed by cluster E6 (16.66%) and P30L (15.78%). Two point mutations (P453S, R483P) were not identified in any patient. In the SW patients, genotypes were more compatible with their phenotypes. Molecular characterization should be considered along with clinical and biochemical diagnosis of CAH since it could confirm the diagnosis, outline the treatment strategy and morbidity, and ensure proper genetic counseling.

ALL-228: CRLF2 and IKZF1 Expression in Egyptian Acute Lymphoblastic Leukemia Patients

Objective Overexpression of cytokine receptor-like factor 2 (CRLF2) caused by different genetic aberrations has been detected in ALL and is linked to poor outcome. The majority of cases having high CRLF2 expression are clustered in the Philadelphia-like (Ph-like) ALL subgroup. Furthermore, Ph-like ALL is accompanied by alterations of the IKZF1 gene, encoding the transcription factor Ikaros. Thus, it was important to recognize and identify these cases at presentation. Materials and Methods We investigated clinical characteristics and the prognostic significance of mRNA expression levels of CRLF2 and IKZF1 alterations in a group of Egyptian patients with ALL. Peripheral blood samples from 34 newly diagnosed ALL cases, together with 14 healthy controls, were assessed for CRLF2 and IKZF1 expression by qRT-PCR. Results CRLF2 mRNA level showed significant overexpression in ALL patients in comparison to healthy controls (P = 0.038). Overall survival was shorter among B-ALL patients, with high CRLF2 (6.1 months versus 19.4 months, respectively, P = 0.04). Moreover, patients with low IKZF1 exhibited significantly higher total leucocytic counts and lower platelet counts (P 0.038 and 0.044, respectively). Conclusion High CRLF2 expression was linked to poor survival among B-ALL cases. Identification of Ph-like ALL should be recognized as a distinct, high-risk entity, and future research on improving diagnostic and therapeutic approaches is required in our locality.

Association of CYP2J2 Gene Polymorphism with Ischemic Stroke

Abstract Background Stroke is regarded as a severe disorder with high morbidity and high mortality, which is a major healthcare problem and a serious economic burden worldwide. It claims over 6 million deaths each year worldwide. Aim To investigate the association of CYP2J2 gene polymorphism with increased risk of ischemic stroke in a group of Egyptian patients. Subjects and Methods This study was conducted at Clinical Pathology and Stroke Units of Ain Shams University Hospitals, between November 2017 and July 2018. A total number of 30 subjects were included (20 patients and 10 controls). Results Our study concluded that risk of hypertension is higher in heterozygous GT population (100%) compared to the wild type (51.22%), whereas no significant increase in the ischemic stroke risk was observed between wild and heterozygous groups. Conclusion The most frequent genotype among the chosen sample of Egyptian population in the study (acute ischemic stroke patients and controls) was the wild TT genotype although not statistically different than other genotypes.

Evaluation of androgen receptor status in urothelial carcinoma of the urinary bladder in Egyptian patients: an immunohistochemical study

BackgroundThe roles of androgen and androgen receptor (AR) signaling in the oncogenesis of prostate cancer are very well established. What is more poorly understood is the role of AR in other human malignancies including bladder cancer. The incidence of bladder cancer is much higher in males than females, but the exact etiology has not been fully elucidated. This gender disparity has raised the possibility of the AR pathway being involved in the genesis of this disease. Thereby, the aim of this work was to evaluate the expression of AR in a group of Egyptian patients with urothelial bladder carcinoma and to assess whether its expression was correlated with other pathological tumor features. Urothelial bladder carcinoma tissue samples from 50 patients were studied by immunostaining for AR expression in tumor cells.ResultsAR was positively expressed in 29 (58%) patients, while negative expression was observed in 21 (42%) patients. No statistically significant difference in AR expression with respect to tumor grade (P = 0.07) and pT stage (P = 0.09) was observed.ConclusionsThe results obtained in this study indicates a clinical value of the AR expression in Egyptian patients with urothelial bladder carcinoma, providing the basis for further studies to evaluate its role and the possibility of new target-based therapies for urothelial bladder carcinoma.

Prediction of The Functional Outcome in A Group of Egyptian Patients with Posterior Circulation Stroke

Background: Stroke is the third most common cause of disability and second most common cause of death worldwide. Brainstem is involved in almost all the important functions of the central nervous system, and brainstem infarction is relatively dangerous with high mortality. Early prediction of the severity and degree of disability and identification of high-risk patients are critical for the treatment of patients with brain stem infarction and might contribute to reduce death rates and comorbidities after stroke. Objective: To assess the usefulness of Posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) for predicting functional outcome in posterior circulation stroke patients. Subjects and Methods: A cohort study on 61 patients with first-ever acute ischemic stroke who were admitted within 24 h from onset. Results: We observed a statistically significant correlation between poor outcome and high NIHSS score on initial assessment, as well as low pc-ASPECTS score, in contrast to other factors involved in the study such as, age, sex, hypertension, atrial fibrillation, diabetes mellitus, high lipid profile, smoking, time from onset to presentation, ESR, initial blood glucose measurement, HbA1C, leukoaraiosis, silent infarction or type of stroke. Conclusion: both the pc-ASPECTS and NIHSS help clinicians predict functional outcomes. The pc-ASPECTS is more reliable than the NIHSS in minor stroke prediction. Moreover, the combination of the pc-ASPECTS and NIHSS has an additive effect in predicting the functional outcomes of patients with posterior circulation stroke.

Prediction of The Functional Outcome in A Group of Egyptian Patients with Posterior Circulation Stroke

Background: Stroke is the third most common cause of disability and second most common cause of death worldwide. Brainstem is involved in almost all the important functions of the central nervous system, and brainstem infarction is relatively dangerous with high mortality. Early prediction of the severity and degree of disability and identification of high-risk patients are critical for the treatment of patients with brain stem infarction and might contribute to reduce death rates and comorbidities after stroke. Objective: To assess the usefulness of Posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) for predicting functional outcome in posterior circulation stroke patients. Subjects and Methods: A cohort study on 61 patients with first-ever acute ischemic stroke who were admitted within 24 h from onset. Results: We observed a statistically significant correlation between poor outcome and high NIHSS score on initial assessment, as well as low pc-ASPECTS score, in contrast to other factors involved in the study such as, age, sex, hypertension, atrial fibrillation, diabetes mellitus, high lipid profile, smoking, time from onset to presentation, ESR, initial blood glucose measurement, HbA1C, leukoaraiosis, silent infarction or type of stroke. Conclusion: both the pc-ASPECTS and NIHSS help clinicians predict functional outcomes. The pc-ASPECTS is more reliable than the NIHSS in minor stroke prediction. Moreover, the combination of the pc-ASPECTS and NIHSS has an additive effect in predicting the functional outcomes of patients with posterior circulation stroke.

Assessment of Serum Level of 25-Hydroxy Vitamin D in Patients with Acne Vulgaris

Background: acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit, characterized by the formation of non-inflammatory comedones and inflammatory papules, pustules, nodules and cysts. Objective: the aim of this study was to evaluate serum levels of vitamin D in a group of Egyptian patients with acne vulgaris in comparison to controls, in order to shed more light on its possible role in the pathogenesis and detect any relation between vitamin D and acne severity. Patients and Methods: the study recruited 90 subjects, 60 acne vulgaris patients and 30 age and sex matched healthy controls. All patients were subjected to detailed history taking and examination to detect extent and severity of acne vulgaris. Blood samples were taken from all participants to assess serum 25 OH D level. Results: revealed lower serum vitamin D levels in acne patients in comparison to controls, with statistically significant p value (0.009). Serum 25 OH D level showed no significant difference in females than in males in both patients (p = 0.726) and controls in comparison to patients (p = 0.794). There was no significant difference in level of 25 OH D between participants reporting adequate sun exposure and those reporting inadequate sun exposure in patients (p = 0.804) but it was statistically significant p value in controls in comparison to patients (p < 0.001). Conclusion: the present study revealed lower, statistically significant, serum vitamin D levels in acne patients, suggesting a possible role for vitamin D supplementation in acne treatment.

Genetic Association Between Growth Differentiation Factor 5 Single Nucleotide Polymorphism and Primary Knee Osteoarthritis in a Group of Egyptian Patients: A Pilot Study.

Aim:This study aimed to determine the genetic association between Growth Differentiation Factor 5 (GDF5) gene (rs143383 T/C) single nucleotide polymorphism (SNP) and primary knee osteoarthritis (OA) in a group of Egyptian patients.Patients and Methods:The study included 47 patients with primary knee OA and 40 apparently healthy control subjects. The disease was assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and Health Assessment Questionnaire (HAQ). Radiological assessment was done by Kellgren-Laurence (K/L) grading system. The genetic association of the SNP with primary knee OA was assessed by restriction fragment length polymorphism - polymerase chain reaction (RFLP-PCR).Results:The mean total WOMAC index was significantly higher in patients with TT genotype as compared to patients with CC and CT genotypes (P<0.001). Similarly, the HAQ score was significantly higher among patients with TT genotype when compared to patients with CT and CC genotypes (P<0.001). There was a statistically significant association between different GDF5 genotypes and K/L radiological grading of knee OA among the studied patients (P=0.029). No statistically significant association was detected on comparing the frequency distribution of GDF5 alleles and genotypes frequencies of the SNP in patients and healthy controls.Conclusion:There is a possible genetic association between GDF5 (rs143383) SNP and severity of primary knee OA, which might facilitate the detection of patients with high risk for disease progression. The present study did not detect an association between the SNP and development of primary knee OA.

PB1915 CD14 AS A POTENTIAL PROGNOSTIC FACTOR AND BCL‐2 AS A THERAPEUTIC TARGET IN EGYPTIAN B‐CELL CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS

Please indicate where the abstract has been published before: Journal of Applied Hematology.Background:B‐cell chronic lymphocytic leukemia (B‐CLL) is a unique lymphoproliferative disorder that scarcely occurs under the age of 40. B‐CLL represents a neoplastic disorder caused primarily by defective programmed cell death and accompanied by a myriad of cellular and humoral immune defects.Aims:This study aimed to assess Bcl‐2 and CD14 expression in B‐CLL patients and their study as probable prognostic and therapy targeting factors.Methods:In this study, we assessed Bcl‐2 and cluster of differentiation (CD14) expression in a group of Egyptian patients with B‐CLL. Forty B‐CLL patients and 20 apparently healthy individuals served as the control group were included in this study.Results:Aberrant expression of Bcl‐2 protein appeared in all B‐CLL patients (100%). Bcl‐2 expression showed a highly positive correlation with total lymphocyte count and lymphocyte count (P = .000 for both) and a positive correlation with lactate dehydrogenase (P = 0.044). The expression of myelomonocytic antigen “CD14” above the cutoff value 5 × 109/L was reported in 70% (28/40) of B‐CLL patients, 55.6% (10/18) of the intermediate‐risk group, and 81.8% (18/22) of high‐risk group.Summary/Conclusion:There was a significant increase in Bcl‐2 protein and CD14 in B‐CLL patients. Bcl‐2 was highly increased in all patients and CD14 more observed in the high‐risk group than that of the intermediate risk group.

Palatally displaced maxillary lateral incisors maybe a causative factor of mandibular deficiency

Introduction: Several factors play a role in the etiology of skeletal Class II malocclusion. Displaced maxillary incisors might have a hindering effect on mandibular growth potential. Aim of the study: The aim of this cross-sectional study was to evaluate the influence of palatally displaced maxillary incisors on mandibular growth in a group of Egyptian patients. Subjects and Methods: The sample consisted of the digital lateral cephalometric radiographs of untreated 24 patients (12 females and 12 males) with age range of 15-30 years and a mean age of 22.4 years during the permanent dentition stage. The radiographs were selected from the patient database of private practice in Cairo. The sample was divided into 2 groups each consisting of 12 patients. Group A had palatally displaced maxillary lateral incisors without crossbite. Group B had palatally displaced maxillary lateral incisors with crossbite. Linear and angular cephalometric measurements (ANB & Witts appraisal) were used to assess the anteroposterior skeletal malocclusion and the position of the apical bases of the jaws in both groups. Independent samples t-test was performed to compare the results between the two groups. Results: Cephalometric measurements revealed statistically significant differences between groups A and B showing a mild skeletal Class II malocclusion with a retrognathic mandible in Group A (mean ANB = 4.4˚ ± 1.85), (mean Witts= 1.85 mm ± 3.22) while Group B had skeletal Class I pattern with mild skeletal Class III tendency (mean ANB= 0.8˚± 1.88), (mean Witts=-2.5mm ± 2.33). Conclusions: Palatally displaced maxillary lateral incisors without crossbite cause restraining effect on normal mandibular growth which results in mild skeletal Class II with mandibular deficiency. However, palatally displaced maxillary lateral incisors that are in crossbite have no restraining effect on mandibular growth which results in normal to slightly excessive mandibular growth. This can be used as a tool for early prediction of mandibular growth pattern that necessitates immediate intervention.

Seroprevalence of Toxoplasma gondii among a group of Egyptian patients with type I diabetes mellitus

BackgroundToxoplasmosis is probably one of the most common parasitic infections of humans. While infection of healthy adults is usually relatively mild, serious disease can result in utero or when the host is immuno-compromised. Toxoplasmosis in diabetic patients may occur due to recently acquired acute infection or they may suffer from dissemination of reactivated latent infection. In the present study, the antinuclear antibody prevalence was tested to determine the possible relationship with Toxoplasma seroprevalence and clinical findings in type I diabetic patients.MethodsToxoplasma gondii antibodies were tested serologically in 60 patients of type I diabetes mellitus and 60 controls using ELISA technique.ResultsThe seropositivity for anti-Toxoplasma IgG antibodies in the study groups was 45% in type I diabetes mellitus patients (group 1) and 23.3% in the control (group 2) with p value = 0.012 showing a statistically significant difference between groups, while only three patients of diabetes type1 group were positive for anti-Toxoplasma IgM with p value = 0.244 showing no statistically significant differences between the two groups. Results showed that only one patient of diabetes type 1 (group1) had positive ANA and one control (group2) had positive ANA. Thus, no correlation could be detected from such results.ConclusionThe study results showed a statistically significantly higher proportion (45%) of seropositivity anti-Toxoplasma IgG antibodies among type I diabetes mellitus patients compared to 23.3% among the control group, while there was no association could be detected between the studied groups regarding the ANA.

Vertebrobasilar Occlusive Diseases in a Group of Egyptian Patients with Posterior Circulation Ischemiaat Interventional Neurology Unit Al-Hussein University Hospital

Background: stroke is the third leading cause of long-term disability and a major cause of mortality worldwide. Eighty percent of strokes are ischemic. Twenty percent of ischemic events involve tissue supplied by the posterior (Vertebrobasilar) circulation. Aim of the Work:the aim of the study was to assess clinical, risk factors, etiology and vascular lesions of vertebrobasilar occlusive diseases in a sample of Egyptian patients with posterior cerebral circulation ischemia at Al-Hussein Neuro-intervention Unit. Patients and Methods: this study was carried out on patients presented with posterior cerebral circulation ischemia undergoing diagnostic cerebral angiography at the Neuro-interventional Unit in Neurology Department of Al -Hussein University Hospital and Bab-Alshaeria University Hospital. We studied risk factors, vascular lesions, symptoms and signs in patients with vertebrobasilar disease. Results: in the present study, DM was the most frequent risk factor, present in 20 patients (66.67%), followed by hypertension (19 patients [63.33%]), hyperlipidemia (14 patients [46.67%]), smoking (13 patients [43.33%]) and IHD (12 patients [40%]). Conclusion: early detection of stenotic lesions is highly valuable for preventing patients from recurrent TIAs and strokes. Recent improvements in imaging with application the arrival of vertebral artery angioplasty and stenting, however, have opened up new opportunities for intervention in this disease. Digital subtraction angiography is the gold standard method for diagnosis of vertebrobasilardiseasesand the most sensitive for detecting intracranial and extracranial stenotic lesions.