Introduction: Gastric variceal bleeding is a serious cause of morbidity and mortality among portal hypertension (PH) patients. The exact frequency of gastric varices (GV) and risk factors for bleeding among Upper Egypt patients are not fully estimated. Aim of the work: to estimate the frequency and the possible risk factors for bleeding from gastric varices in Upper Egypt patients. Patients and Methods: We analyzed case records of 1520 patients with portal hypertension (PH), who admitted to Gastroenterology Department at Assuit University Hospital and underwent upper endoscopy during the last two years. Results: GV were seen in 28.5% of patients with PH (433/1520) and were the source of bleeding in 17.6% of patients. The frequencies of gastroesophageal varices type 1 (GOV1), gastroesophageal varices type 2 (GOV2) and isolated gastric varices type 1 (IGV1) were 17.9%, 6.5% and 4.1% of patients; respectively. GOV1, GOV2 and IGV1 were the source of bleeding in 9%, 4.6% and 4% of patients; respectively. In univariate analysis, red color signs (RCS), large gastric varices (F3) and severe liver dysfunction (Child-Pugh class B and C) were significant risk factors for IGV1bleeding (P-value: 0.0001, 0.001, 0.01; respectively). By multivariate logistic regression; RCS and severe liver dysfunction (Child-Pugh class B and C) were independent risk factors for bleeding from GV (Odd's ratio 99 and 17; respectively and P-value 0.0001 and 0.002; respectively). Conclusion: Bleeding from GV is more frequent with the presence of RCS, large GV and severe liver dysfunction. The presence of RCS and severe liver dysfunction are independent risk factors for bleeding from GV.

Infertility has become nowadays not only a medical, but a social problem as well. Infertility in female is caused by various factors. Tubal disease is responsible for 25-35% of female infertility. Pelvic inflammatory disease (PID) is the most common cause of tubal disease. Aim of the study: Determine the frequency of tuberculosis and C. trachomatis in patients with tubal factor infertility to develop a laboratory strategy for identification of the most common causes of tubal factor infertility (M.tuberculosis and C. trachomatis ) in our locality with respect to laparoscopic finding. Patients and Methods: This study was performed on ninety women with primary infertility and abnormal hysterosalpingography as studied group and 30 infertile women (with polycystic ovary as the only cause of infertility ) and normal hysterosalpingography as a control group. Mycobacterium tuberculosis IgG and of C. trachomatis IgG antibodies were performed by enzyme linked immunoassay (ELISA). Polymerase chain reaction (PCR) was performed for detection mpt64 gene of M. tuberculosis and C. trachomatis plasmid DNA Results: In patient group, M.tuberculosis and C. trachomatis IgG antibodies showed positive results in 72 (80%) and 43 patients (81.1%) respectively. In control group they were detected in 23 (76.7%) and 5 (16.6%) respectively. PCR for mpt64 gene of M. tuberculosis was detected in peritoneal fluid of 17 patients (18.89%) and and C. trachomatis plasmid DNA were detected 5 patients (5.56%) respectively. Conclusions: Tuberculosis is one of the major etiological factors for female infertility in Egypt and the use PCR for mpt64 gene o f M. tuberculosis plays an important role in diagnosis of genital tuberculosis with results comparable with laparoscopy and histopathology. Detection of C. trachomatis IgG antibodies by ELISA can play a significant role in detection of C. trachomatis in infertile women.

Chlamydia trachomatis infection is considered to be one of the most common sexually transmitted diseases. It is currently unclear whether chlamydial infection causes pathological conditions of the male accessory glands has consequences for male infertility. This study was aimed to determine the frequency of C. trachomatis infection among infertile men with leukocytospermia using polymerase chain reaction (PCR) and direct detection by flowcytometric analysis in seminal fluid and to assess the relationship between C. trachomatis infection and semen quality hence male infertility. One hundred infertile male patients with leukocytospermia and 30 apparently healthy age matched fertile men were included as controls. Routine semen analysis and LeucoScreen test were done for each patient and control. Detection of C. trachomatis plasmid DNA by PCR and by flowcytometric analysis in semen samples were performed. Primary and secondary infertility were detected in 72(72 %) and 28 (28%) of patients, respectively. Sperm concentration and sperm motility (A+B) were statistically significant lower in patients with leucocytospermia than control group (P0.0001). Sperm concentration in patients with pus cells more than 3 x 106/ml was statistically significant lower than those with pus cells less than 2x106 /ml. Flowcytometric analysis of semen sample for C. trachomatis was positive in 45(45%) patients and C. trachomatis plasmid DNA detection by PCR was positive in 33 (33%) patients. In conclusions, higher detection rate of C. trachomatis by flowcytometry in comparison to was observed. Concerning the effect of C. trachomatis on routine semen characteristics, no significant obvious changes could be detected. Further studies for the assessment of sperm viability and DNA integrity are recommended.

Background & Aim: Psychiatric disorders are common comorbidities in patients with liver cirrhosis that may impair patients' quality of life. The purpose of this study was to evaluate the common psychiatric disorders in cirrhotic patients in our locality. Patients and methods: Psychiatric disorders were prospectively assessed by administration of Symptom Checklist-90 revised (SCL-90-R), Hamilton anxiety rating scale, and Hamilton Checklist of Symptoms of depressive illness to 200 patients with liver cirrhosis and 200 control volunteers of matched age. In addition, clinical data, abdominal ultrasonography and laboratory data (liver function tests for patients) were collected. Results: Compared with controls, cirrhotic patients were significantly more likely to have depression (43.5% versus 14%, P0.001), anxiety (16.5% versus 5.5% P0.001) and increased mean scores of SCL-90-R subscales (e.g. somatization, depression and hostility). Increasing severity of liver cirrhosis (based on the Child-Pugh score) was associated with increased frequency of Psychiatric disorders. Conclusion: Compared with the control group, patients with liver cirrhosis showed significantly higher frequency of comorbid psychiatric disorders which was increased by worsening disease severity.

Warts are common problems affecting adults and children. Multiple treatment options are available, but no single therapy stands out as uniformly effective. Propolis and Echinacea are relatively safe immunomodulators with antiviral properties. The purpose of this study was to assess the efficacy of Propolis and Echinacea in treating different types of warts. In a single-blind, randomized, 3-months trial, 135 patients with different types of warts received oral Propolis, Echinacea, or placebo. In patients with plane and common warts treated with Propolis, cure was achieved in 75% and 73% of patients, respectively. These results were significantly better than those associated with Echinacea treatment or placebo. We conclude that Propolis is an effective and safe immunomodulating therapy for plane and common warts.

Warts are common problems affecting adults and children. Multiple treatment options are available, but no single therapy stands out as uniformly effective. Propolis and Echinacea are relatively safe immunomodulators with antiviral properties. The purpose of this study was to assess the efficacy of Propolis and Echinacea in treating different types of warts. In a single-blind, randomized, 3-months trial, 135 patients with different types of warts received oral Propolis, Echinacea, or placebo. In patients with plane and common warts treated with Propolis, cure was achieved in 75% and 73% of patients, respectively. These results were significantly better than those associated with Echinacea treatment or placebo. We conclude that Propolis is an effective and safe immunomodulating therapy for plane and common warts.

Warts are common problems affecting adults and children. Multiple treatment options are available, but no single therapy stands out as uniformly effective. Propolis and Echinacea are relatively safe immunomodulators with antiviral properties. The purpose of this study was to assess the efficacy of Propolis and Echinacea in treating different types of warts. In a single-blind, randomized, 3-months trial, 135 patients with different types of warts received oral Propolis, Echinacea, or placebo. In patients with plane and common warts treated with Propolis, cure was achieved in 75% and 73% of patients, respectively. These results were significantly better than those associated with Echinacea treatment or placebo. We conclude that Propolis is an effective and safe immunomodulating therapy for plane and common warts.

Background The association of the novel adipokines visfatin and omentin-1 with psoriasis is still obscure. Data concerning other inflammatory diseases suggest a possible role of these adipokines in the pathophysiology of psoriasis. Objectives To investigate serum levels of visfatin and omentin-1 in patients with psoriasis compared with healthy controls, and to consider their relation to disease duration, disease severity and obesity markers. Methods Visfatin and omentin-1 concentrations were measured in 46 patients with plaque-type psoriasis and 42 healthy controls by using specific enzyme-linked immunosorbent assays. Results Patients with psoriasis showed considerably higher serum levels of visfatin than healthy controls with significant positive correlation with disease severity and duration. They also showed lower levels of ominten-1 compared with healthy controls with significant inverse correlation with body mass index and waist circumference. Conclusions Coordinated roles for visfatin and omentin-1 are suggested in the modulation of the inflammatory environment in patients with psoriasis. Given the significant relations of omentin-1 with obesity markers, the health consequences of excessive weight should be better communicated to patients with psoriasis.

Background Although several lasers meet the wavelength criteria for selective follicular destruction, the treatment of darker skin phototypes is particularly challenging because absorption of laser energy by the targeted hairs is compromised by an increased concentration of epidermal melanin. Objectives To compare satisfaction level, safety and effectiveness of a long-pulsed Nd:YAG laser and intense pulsed light (IPL) in axillary hair reduction in subjects with dark skin. Methods The study design was a within-patient, right-left, assessor-blinded, comparison of long-pulsed Nd:YAG laser and IPL. Fifty women (skin phototypes IV–VI) volunteered for removal of axillary hair. Five sessions at 4- to 6-week intervals were performed. Hair counts at both sides were compared at baseline and 6 months after the last session. Final overall evaluations were performed by subjects and clinician at the end of the study. Satisfaction was scored for both devices. Results Thirty-nine women completed the study. At 6 months, the decrease in hair counts on the laser side (79Æ4%, P 0Æ001 vs. pretreatment) was significantly (P 0Æ01) greater than that on the IPL side (54Æ4%, P 0Æ01 vs. pretreatment). Only temporary adverse effects were reported at both sides. Higher pain scores and more inflammation were reported with Nd:YAG laser; however, it was preferred by 29 volunteers (74%). Volunteers reported higher satisfaction score with Nd:YAG laser (P 0Æ01). Conclusions Dark skin can be treated by both systems safely and effectively; however, long-pulsed (1064 nm) Nd:YAG laser is more effective as reported by both subjects and clinician.