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   2016| January-June  | Volume 11 | Issue 1  
    Online since July 26, 2016

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Safety and feasibility of laparoscopic cholecystectomy during pregnancy
Mohammad Arafat, Ibrahim A Ghaffar, Ahmad F El-Hussainy, Mansour M Abd Alkhalik, Mahmoud S Ahmad, Taher Mostafa
January-June 2016, 11(1):9-13
Background/aim Symptomatic biliary diseases in pregnant women remain a great challenge to surgeons. The present study aimed to evaluate the safety and feasibility of laparoscopic cholecystectomy (LC) during pregnancy. Patients and methods This prospective, observational study was conducted on 27 pregnant women with a mean age of 27.3 ± 4.1 (range 21–36) years who presented with symptomatic gallbladder diseases (stones or cholecystitis) and underwent LC. Gestational age, operative time, and maternal and fetal outcomes were noted. Results The mean operative time was 58.7 (range 32–78.5) min. Conversion to open cholecystectomy occurred only in one patient with acute cholecystitis due to the presence of severe adhesions (3.7%). No intraoperative or postoperative complications were observed, except for mild wound infection in only one patient (3.7%) and mild uterine contractions in two patients (7.4%). All patients went on to deliver at full term with no abortion or preterm labor. Conclusion Pregnant women with repeated attacks of biliary colic and/or cholecystitis after failure of conservative treatment can undergo LC easily and safely without hazardous effects on either mothers or fetuses, especially in the second trimester.
  3,397 282 -
Effect of Escherichia coli, Salmonella spp., and Staphylococcus aureus isolated from polluted drainage water on rats
Gamal A Osman, Medhat M Menshawy, Abdel Razik H Farrag
January-June 2016, 11(1):1-8
Background/aim Water pollution not only damages the environment but also kills wildlife. The present study aimed to investigate the effect of Escherichia coli, Salmonella typhi, and Staphylococcus aureus, which were isolated from drainage water at El-Rahawey area, Giza, Egypt, on experimental rats. Materials and methods Water samples were collected from the subsurface layer for bacteriological examination, stored in an ice box, and delivered to the laboratory and analyzed to count the total viable bacterial counts/ml using the most probable number technique. The isolated bacteria were given to rats for 21 days at a dose equal to 103/ml and the liver and kidney were dissected for histopathological and histochcemical studies. Results Results showed that the average counts at 22 and 37°C were 105 and 106 CFU/ml, respectively, whereas the average counts by using the most probable number technique/100 ml were 105, 104, 103, 103, and 102 for total coliforms, fecal coliforms, E. coli, Salmonellae group, and total staphylococci, respectively. Isolation of pathogens from water sources were identified by using membrane filter technique on specific media. The histopathological examination of the liver of treated rats with E. coli, S. typhi, and S. aureus revealed swollen hepatocytes with decreased sinusoidal spaces and widely distributed necrotic foci. In the kidney, renal tubules showed extensive epithelial swelling with decreased lumen space and generalized necrotic changes with interstitial hemorrhage in renal cortex. The histochemical study indicated the depletion of staining of protein and polysaccharides. Conclusion E. coli, S. typhi, and S. aureus that are isolated from polluted drainage water cause histological and histochemical changes in the liver and kidney of rats.
  2,988 312 1
Occupational exposure to hepatitis infection among Egyptian healthcare workers and hepatitis B vaccination
Dalal M El-Melligy, Amal Saad-Hussein, Sahar A Khalil
January-June 2016, 11(1):14-21
Background/aim Healthcare workers (HCWs) are at a high risk for blood-borne pathogens due to their contact with patients and contaminated instruments. The present study aimed to determine the risk of exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Egyptian HCWs in relation to the level of infection control education, the number of hepatitis B vaccine doses received, and the resulting immunity. Participants and methods This cross-sectional study was conducted on 228 HCWs. Hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody titer, and hepatitis C virus antibody (HCV-Ab) were tested by using the enzyme-linked immunosorbent assay technique. Real-time PCR for both HBV-DNA and HCV-RNA in serum was done with positive hepatitis B surface antigen and HCV-Ab, respectively. Results During the study period, 78% of the HCWs received full HBV vaccination; 73.6% of them were vaccinated in the last 5 years. Lack of protective hepatitis B surface antibody (HBs-Ab) titer was found in 27.2% of the participants. HCV-Ab was positive in 6.14% HCWs, being significantly higher in individuals 40 years of age or older when compared with those under 40. Half of those with positive HCV-Ab had HCV-RNA below the detection limit. Conclusion Implementation of infection control guidelines played a role in reducing the prevalence of HCV infection among HCWs and in vaccinating HCWs in the last 5 years. Adopting safety-engineered devices is required to help in the reduction of needle stick and sharp medical devices injuries and risk for blood-borne infections.
  2,879 295 1
Ultrastructural and morphometric effect of aluminum phosphate and calcium phosphate nanoparticles as adjuvants in vaccinated mice
Mohamed S Salim, Aliaa M Issa, Abdel Razik H Farrag, Hamdalla H Zidan, Aly F Mohamed
January-June 2016, 11(1):22-28
Background/aim Calcium phosphate (CAP) and aluminum phosphate (alum) compounds have been approved as vaccine adjuvants for humans. The present study aimed to study the ultrastructural and morphometric effect of both aluminum phosphate (alum) and CAP nanoparticle adjuvant. Materials and methods Eighteen Swiss albino mice were used in the experiment. An overall 50% of them were adult and the other 50% were juvenile. Mice were immunized intramuscularly with 0.125 ml of adjuvanted tetanus toxoid vaccine. In the alum adjuvant group, three adult mice and another three juvenile ones were injected with alum adjuvanted vaccine and killed 1 week after immunization. In the CAP adjuvant group, three adult mice and another three juvenile mice were injected with CAP adjuvanted vaccine and killed 1 week after immunization. At the end of the work, samples of the liver, kidney, and brain were subjected to light and electron microscopic examinations. Results In both the alum group and the CAP nanoparticle adjuvant group, the examination revealed wide and severe ultrastructural changes in the liver, kidney, and brain of adult and juvenile mice. These changes included swollen mitochondria with degenerated cristae, severely degenerated ground cytoplasm, and unusual chromatin picture of nucleus. In contrast, morphometric studies of the nucleus/cell ratio and damaged areas showed a significant increase in the liver, kidney, and brain of both adjuvants. Conclusion The results of this study revealed that both aluminum phosphate (alum) and CAP nanoparticle adjuvant caused ultrastructural and morphometric changes in tissues of the liver, kidney, and brain.
  1,780 172 1
Differential effects of t helper-17 cytokines on the functions of granulocytes isolated from schistosoma mansoni-infected patients and healthy individuals
Ayatollah El-Shorbagy, MT Shata, Mohammad A Mohey, Soad Nady
January-June 2016, 11(1):29-36
Background and aim The role of T helper-17 lymphocytes in the regulation of the immune response against Schistosoma soluble egg antigens is still controversial. In this study, the in-vitro effects of T helper-17 cytokines [interleukin (IL)-17 and IL-22] on granulocyte functions isolated from Schistosoma-infected patients or healthy individuals were examined. Patients and methods Twenty-seven Schistosoma mansoni-infected patients and 13 healthy individuals from Kasr Al-Aini Viral Hepatitis Center were enrolled in the present study. Granulocytes were isolated from whole blood of patients and controls by Ficoll–Paque density gradient for removal of the mononuclear layer and then lysis of red blood cells. Granulocytes were stimulated in vitro with soluble egg antigen in the presence of IL-17, IL-22, or both. After 24 h, the supernatants were collected for the measurement of tumor necrosis factor (TNF)-α, hydrogen peroxide (H2O2), myeloperoxidase (MPO), and nitric oxide (NO) using enzyme-linked immunosorbent assay as surrogate markers for granulocyte functions. Results The results indicated that the presence of IL-17 significantly decreased (P<0.05) TNF-α, H2O2, MPO, and NO production by granulocytes isolated from Schistosoma-infected patients. In contrast, in the presence of IL-22 or both IL-17 and IL-22, there were significant increases in the production of H2O2 and TNF-α by granulocytes isolated from Schistosoma-infected patients. Moreover, in the presence of both IL-17 and IL-22, nonsignificant changes were observed in MPO or NO levels compared with those in the control participants. Conclusion IL-17, in contrast to IL-22, inhibited the functional activity of granulocytes isolated from S. mansoni-infected patients. Therefore, neutralization of IL-17 may work as a therapeutic strategy for these patients.
  1,769 181 1