In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

In Egypt, bladder cancer is one of the most popular cancer, accounting for 31% of all cancer cases. It ranks first in males about 16.2% of male cancer. The incidence in rural areas among males is near 32 per 100,000. The exact etiology of bladder cancer is still unknown; K-ras gene is known as a critical DNA target for chemical carcinogens as a pesticide. Some occupational hazard exposure is thought to be directly genotoxic, while others might enhance the mutagenicity and carcinogenicity of directly acting genotoxic agents. Analysis of the relationship between pesticide exposure and mutation in the K-ras gene in human bladder cancer. One hundred patients were diagnosed with bladder cancer and one hundred controls attended the outpatient clinic; after taking consent and filling a questionnaire for age, sex, occupation and pesticide exposure, surgically resected specimens were collected and the samples were used to determine the k-ras mutation. Blood samples were taken to analyze the level of acetylcholinesterase enzyme and level of P53. The present study indicated that pesticide exposure may play a great role in malignant transformation of the bladder cells through mutation in the K-ras gene; there was a significant correlation between the acetylcholinesterase enzyme level and k-ras mutation (p 0.001). The results revealed that the level of P53 was significantly high in comparison with the control group (p 0.001). These findings give an alarm to decrease the amount of pesticides used in our area; also, p53 may be used as an indicator to bladder cancer.

This study investigated the urinary tract infection in Assiut university hospitals to evaluate the rate of infection, and the prevalence of extended spectrum β-lactamase producing Klebsiella pneumoniae to define the magnitude of the problem and may help to implement appropriate infection control measures. Methods: This study was conducted from January 2014 to June 2014. Urine samples were collected from urinary tract infected patients to detect the causative organisms. After antimicrobial susceptibility testing, resistant strains to β-lactam antibiotics were selected for detection of ESBLs. In addition PCR was done to determine the most common group of β-lactamase genes responsible for resistance. Results: The study included 340 patients presented to urology department at Assiut University Hospitals. The rate of community and hospital acquired UTI were 41 % (140/340) and 59 % (200/340) respectively. For community patients the commonest isolate was E. coli (54.28%) followed by Klebsiella pneumoniae (29.28%) then Staphylococcus aureus (7.14%), Pseudomonas aeruginosa (1.42%), Coagulase-negative Staphylococcus (3.57%), and Candida species (4.28%).While the pattern of nosocomial isolates was Klebsiella pneumoniae (51%) followed by E. coli (30%) whereas, Staphylococcus aureus (4%), Pseudomonas aeruginosa (11%), Coagulase-negative Staphylococcus (3%), Candida species (1%). Antibiotics sensitivity of K. pneumoniae isolates showed that these organisms were mostly sensitive to meropenem (100%). Phenotypic confirmatory tests (combined disc method, double disc method and ESBL-E-Test) were done to test K. pneumoniae isolates for ESBL production. It was concluded that 60.97% (25/41) of community isolates and 81.37% (83/102) of nosocomial isolates were ESBLs producers. PCR was done to determine the responsible ESBL gene; it revealed that the common ESBL gene was CTX-M followed by TEM then SHV. Further analysis of CTX-M positive isolates showed that CTX-M-group-1 was the predominant type. Conclusion: ESBLs is a neglected healthcare crisis in Egypt that needs strategies to treat, prevent and control the rising rate. In addition, rapid and clinically relevant antibiotic testing service is always required to provide services. Besides, the controlled use of 3rd generation cephalosporin along with implementation of infection control measures are the most effective means of controlling and decreasing the spread of ESBL isolates.

This study investigated the urinary tract infection in Assiut university hospitals to evaluate the rate of infection, and the prevalence of extended spectrum β-lactamase producing Klebsiella pneumoniae to define the magnitude of the problem and may help to implement appropriate infection control measures. Methods: This study was conducted from January 2014 to June 2014. Urine samples were collected from urinary tract infected patients to detect the causative organisms. After antimicrobial susceptibility testing, resistant strains to β-lactam antibiotics were selected for detection of ESBLs. In addition PCR was done to determine the most common group of β-lactamase genes responsible for resistance. Results: The study included 340 patients presented to urology department at Assiut University Hospitals. The rate of community and hospital acquired UTI were 41 % (140/340) and 59 % (200/340) respectively. For community patients the commonest isolate was E. coli (54.28%) followed by Klebsiella pneumoniae (29.28%) then Staphylococcus aureus (7.14%), Pseudomonas aeruginosa (1.42%), Coagulase-negative Staphylococcus (3.57%), and Candida species (4.28%).While the pattern of nosocomial isolates was Klebsiella pneumoniae (51%) followed by E. coli (30%) whereas, Staphylococcus aureus (4%), Pseudomonas aeruginosa (11%), Coagulase-negative Staphylococcus (3%), Candida species (1%). Antibiotics sensitivity of K. pneumoniae isolates showed that these organisms were mostly sensitive to meropenem (100%). Phenotypic confirmatory tests (combined disc method, double disc method and ESBL-E-Test) were done to test K. pneumoniae isolates for ESBL production. It was concluded that 60.97% (25/41) of community isolates and 81.37% (83/102) of nosocomial isolates were ESBLs producers. PCR was done to determine the responsible ESBL gene; it revealed that the common ESBL gene was CTX-M followed by TEM then SHV. Further analysis of CTX-M positive isolates showed that CTX-M-group-1 was the predominant type. Conclusion: ESBLs is a neglected healthcare crisis in Egypt that needs strategies to treat, prevent and control the rising rate. In addition, rapid and clinically relevant antibiotic testing service is always required to provide services. Besides, the controlled use of 3rd generation cephalosporin along with implementation of infection control measures are the most effective means of controlling and decreasing the spread of ESBL isolates.

This study investigated the urinary tract infection in Assiut university hospitals to evaluate the rate of infection, and the prevalence of extended spectrum β-lactamase producing Klebsiella pneumoniae to define the magnitude of the problem and may help to implement appropriate infection control measures. Methods: This study was conducted from January 2014 to June 2014. Urine samples were collected from urinary tract infected patients to detect the causative organisms. After antimicrobial susceptibility testing, resistant strains to β-lactam antibiotics were selected for detection of ESBLs. In addition PCR was done to determine the most common group of β-lactamase genes responsible for resistance. Results: The study included 340 patients presented to urology department at Assiut University Hospitals. The rate of community and hospital acquired UTI were 41 % (140/340) and 59 % (200/340) respectively. For community patients the commonest isolate was E. coli (54.28%) followed by Klebsiella pneumoniae (29.28%) then Staphylococcus aureus (7.14%), Pseudomonas aeruginosa (1.42%), Coagulase-negative Staphylococcus (3.57%), and Candida species (4.28%).While the pattern of nosocomial isolates was Klebsiella pneumoniae (51%) followed by E. coli (30%) whereas, Staphylococcus aureus (4%), Pseudomonas aeruginosa (11%), Coagulase-negative Staphylococcus (3%), Candida species (1%). Antibiotics sensitivity of K. pneumoniae isolates showed that these organisms were mostly sensitive to meropenem (100%). Phenotypic confirmatory tests (combined disc method, double disc method and ESBL-E-Test) were done to test K. pneumoniae isolates for ESBL production. It was concluded that 60.97% (25/41) of community isolates and 81.37% (83/102) of nosocomial isolates were ESBLs producers. PCR was done to determine the responsible ESBL gene; it revealed that the common ESBL gene was CTX-M followed by TEM then SHV. Further analysis of CTX-M positive isolates showed that CTX-M-group-1 was the predominant type. Conclusion: ESBLs is a neglected healthcare crisis in Egypt that needs strategies to treat, prevent and control the rising rate. In addition, rapid and clinically relevant antibiotic testing service is always required to provide services. Besides, the controlled use of 3rd generation cephalosporin along with implementation of infection control measures are the most effective means of controlling and decreasing the spread of ESBL isolates.

Current treatment guidelines recommend the use of entecavir (ETV) as a first-line therapy for chronic HBV infection. Still little is known about its role in restoration of the exhausted HBV immune response. The aim of our study was to assess HBeAg serologic response and serum levels of IFN-γ and IL-5 before and after one year treatment with ETV in chronic hepatitis B patients (CHB) in a trial to find possible predictors for response to ETV treatment in those patients (hepatits B viral clearance and HBeAg seroconversion). The study included 30 chronic hepatitis B patients. All patients received de novo entecavir monotherapy at a daily dose of 0.5 mg for 1 year. Virologic [HBV DNA load, HBV markers (HBsAg, HBeAg, HBeAb)], Biochemical (AST and ALT) and immunological (serum IFN- and IL-5) assessments were done for all patients before and a year after treatment in comparison with healthy controls. Levels of AST and ALT were significantly reduced in all treated patients and normalized in 15. HBeAg seroconversion was achieved in 17 patients, HBV DNA was markedly decreased in all patients and not detectable in 10 of them. IFN-  level increased and IL-5 levels decreased markedly reaching normal levels. Significant relations were detected between HBV DNA, IL-5, HBeAg seroconversion and virologic response (VR) to ETV. ROC curve analysis have shown good prognostic accuracy for both pretreatment HBV DNA and IL5 levels in predicting VR and HBeAg seroconversion after ETV therapy in CHB patients, with pretreatment HBV DNA having somewhat better accuracy and higher propability for the test being correct in predicting loss of HBeAg after treatment. In conclusions, ETV markedly reduced HBV DNA and ALT levels, restored IFN- and IL-5 normal levels and HBeAg seroconversion was achieved in some patients. Both pretreatment levels of HBV DNA and IL5 can be used in predicting VR to ETV but HBV DNA is superior in predicting HBV seroconversion in HBeAg positive patients

Current treatment guidelines recommend the use of entecavir (ETV) as a first-line therapy for chronic HBV infection. Still little is known about its role in restoration of the exhausted HBV immune response. The aim of our study was to assess HBeAg serologic response and serum levels of IFN-γ and IL-5 before and after one year treatment with ETV in chronic hepatitis B patients (CHB) in a trial to find possible predictors for response to ETV treatment in those patients (hepatits B viral clearance and HBeAg seroconversion). The study included 30 chronic hepatitis B patients. All patients received de novo entecavir monotherapy at a daily dose of 0.5 mg for 1 year. Virologic [HBV DNA load, HBV markers (HBsAg, HBeAg, HBeAb)], Biochemical (AST and ALT) and immunological (serum IFN- and IL-5) assessments were done for all patients before and a year after treatment in comparison with healthy controls. Levels of AST and ALT were significantly reduced in all treated patients and normalized in 15. HBeAg seroconversion was achieved in 17 patients, HBV DNA was markedly decreased in all patients and not detectable in 10 of them. IFN-  level increased and IL-5 levels decreased markedly reaching normal levels. Significant relations were detected between HBV DNA, IL-5, HBeAg seroconversion and virologic response (VR) to ETV. ROC curve analysis have shown good prognostic accuracy for both pretreatment HBV DNA and IL5 levels in predicting VR and HBeAg seroconversion after ETV therapy in CHB patients, with pretreatment HBV DNA having somewhat better accuracy and higher propability for the test being correct in predicting loss of HBeAg after treatment. In conclusions, ETV markedly reduced HBV DNA and ALT levels, restored IFN- and IL-5 normal levels and HBeAg seroconversion was achieved in some patients. Both pretreatment levels of HBV DNA and IL5 can be used in predicting VR to ETV but HBV DNA is superior in predicting HBV seroconversion in HBeAg positive patients

Current treatment guidelines recommend the use of entecavir (ETV) as a first-line therapy for chronic HBV infection. Still little is known about its role in restoration of the exhausted HBV immune response. The aim of our study was to assess HBeAg serologic response and serum levels of IFN-γ and IL-5 before and after one year treatment with ETV in chronic hepatitis B patients (CHB) in a trial to find possible predictors for response to ETV treatment in those patients (hepatits B viral clearance and HBeAg seroconversion). The study included 30 chronic hepatitis B patients. All patients received de novo entecavir monotherapy at a daily dose of 0.5 mg for 1 year. Virologic [HBV DNA load, HBV markers (HBsAg, HBeAg, HBeAb)], Biochemical (AST and ALT) and immunological (serum IFN- and IL-5) assessments were done for all patients before and a year after treatment in comparison with healthy controls. Levels of AST and ALT were significantly reduced in all treated patients and normalized in 15. HBeAg seroconversion was achieved in 17 patients, HBV DNA was markedly decreased in all patients and not detectable in 10 of them. IFN-  level increased and IL-5 levels decreased markedly reaching normal levels. Significant relations were detected between HBV DNA, IL-5, HBeAg seroconversion and virologic response (VR) to ETV. ROC curve analysis have shown good prognostic accuracy for both pretreatment HBV DNA and IL5 levels in predicting VR and HBeAg seroconversion after ETV therapy in CHB patients, with pretreatment HBV DNA having somewhat better accuracy and higher propability for the test being correct in predicting loss of HBeAg after treatment. In conclusions, ETV markedly reduced HBV DNA and ALT levels, restored IFN- and IL-5 normal levels and HBeAg seroconversion was achieved in some patients. Both pretreatment levels of HBV DNA and IL5 can be used in predicting VR to ETV but HBV DNA is superior in predicting HBV seroconversion in HBeAg positive patients

Immunological problems have been identified as a potential cause of recurrent pregnancy loss (RPL). The aim of this study was to investigate the effect of Th-1 cell cytokines, leukemia inhibitory factor and hoxA genes in women with RPL. Materials & methods: A prospective, case-control study conducted in Assiut Women Health Hospital, Egypt included 37 women presented with a history of RPL. Samples of uterine flush and endometrial biopsy were taken during the implantation window from those confirmed as not pregnant. Cytokine (LIF and Th1 induced) levels were measured by ELISA, while hoxA10 and hoxA11 gene expression was evaluated by Taq-man Real Time PCR. Results: Higher cytokine mean levels were seen in the RPL group when compared to the control group (TNF-a and LIF cytokines, p
0.001; INF-c and IL2 cytokines, p
0.01). The opposite was true with regards to gene expression, with lower means in both sets found in the RPL group (hoxA11, p
0.000). A statistically significant positive correlation between INF-c and TNF-a, hoxA10 and hoxA11, as well as between LIF and hoxA11 was demonstrated. Conclusion: This study suggests that women with a history of RPL can have abnormal cytokine and gene expression even when not pregnant. Our findings can be a basis for providing of future successful immunological therapy for women with RPL.