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   Table of Contents - Current issue
Coverpage
January-March 2017
Volume 42 | Issue 1
Page Nos. 1-44

Online since Thursday, May 18, 2017

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ORIGINAL ARTICLES  

Association between immunophenotypic markers and cytogenetic aberrations in Egyptian patients with plasma cell myeloma p. 1
Noha H Boshnak, Azza E Hashem
DOI:10.4103/1110-1067.206433  
Background Plasma cell myeloma is a devastating disease of clonal plasma cells that show considerable diversity both in their immunophenotypic and in their cytogenetic features. Immunophenotyping has been used widely for diagnostic and prognostic evaluation of malignant plasma cells. Aim The aim of this study was to evaluate the relationship between the immunophenotypic profile and standard prognostic factors, and also to determine the correlation between different antigenic expression and the cytogenetic aberrations as well as clinical stage in patients with plasma cell myeloma. Patients and methods A total of 31 newly diagnosed Egyptian patients with plasma cell myeloma were evaluated by multiparameter flow cytometry. Interphase fluorescence in situ hybridization was performed for detection of the expression of the 14q32 immunoglobulin H rearrangement, t(11;14), t(4;14), 13q del, and 17p del on bone marrow samples collected from the patients at diagnosis. Results Positive expression of CD19, CD20, CD13, and CD33 was detected in 38.7, 51.6, 19.4, and 12.9% of patients, whereas CD56, CD45, CD65, and CD117 were expressed in 41.9, 77.4, 9.7, and 25.8% of patients, respectively. A statistically significant correlation was found between CD13 positivity, CD56 positivity, or CD45 negativity and advanced International Staging System (P=0.011, 0.036, and 0.004, respectively). CD33-negative cases were significantly associated with absence of the 14q32 immunoglobulin H rearrangement (P=0.050) and absence of t(4;14) (P=0.018). CD45 positivity and CD13 negativity were correlated with absence of 13q del (P=0.031 and 0.011, respectively). Conclusion Immunophenotypic antigenic expression profile is associated with advanced clinical stage and absence of some cytogenetic aberrations in plasma cell myeloma.
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Alloimmunization in Egyptian children with transfusion-dependent B-thalassaemia: a major challenge p. 9
Nahla F Osman, Seham A Ragab, Mohamed A Soliman
DOI:10.4103/1110-1067.206432  
Purpose B-thalassaemia is a common health issue in Egypt. However, few national studies were carried out to address the problem of alloimmunization and common alloantibodies in multitransfused thalassaemia patients. This study was designed to address those issues with the aim of optimizing the management in those patients. Patients and methods The study included 281 multitransfused B-thalassaemia Egyptian children from Delta region. Antibody screening and identification were carried out using column agglutination technology. Results Sixty-seven (23.8%) patients were found to have alloantibodies. Anti-Kell and anti-E antibodies were the most commonly encountered antibodies seen in 37.3 and 34.3% of patients, respectively. There was no significant difference in alloimmunization rate between boys and girls or between patients with thalassaemia major and intermediate. Conclusion Alloimmunization is seen in nearly a quarter of multitransfused B-thalassaemia patients. Development of red blood cell antibodies is multifactorial; however, a significant proportion of those can be prevented if pretransfusion testing involved cross-matching for the most immunogenic minor red blood cell antigens. Although this would increase the upfront cost, the long-term cost is likely to fall and is likely to improve patients’ management.
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Hemoglobin level and iron profile as risk factors for lower respiratory tract infections among children p. 14
Osama N.E. Saleh, Manal M Ismail, Marwa H Abdel Hamed, Mai E.M.A. Bassiony
DOI:10.4103/1110-1067.206434  
Context Acute lower respiratory tract infection is a major cause of death under 5 years of age, and anemia is the commonest cofactor in pediatric patients seeking medical advice, especially in developing countries. Aim The aim of this study was to evaluate the role of anemia as a risk factor for lower respiratory tract infections in infants and children. Setting and design A case–control study was conducted in Children’s Hospital, Ain Shams University. Patients and methods This study was conducted on a total of 80 infants and children aged 6 months to 6 years − 40 cases hospitalized for lower respiratory tract infections, with a mean age of 13.2±9.3 months, and 40 age and sex-matched healthy controls without any respiratory problems, with a mean age of 14.8±10.09 months. Results There was a statistically higher percentage of iron deficiency anemia among cases (55%) than among controls (27.5%), with a significantly lower mean hemoglobin level among anemic cases than among anemic controls. There was a significantly lower mean serum iron in anemic cases than in anemic controls. Recurrent chest infection was statistically significantly more common in anemic cases (93%) than in nonanemic cases (8%). Conclusion The present work concluded that anemia, especially iron deficiency anemia, may play a role in the development of acute lower respiratory tract infections among Egyptian children.
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Multicentre study of hepatitis C virus status in Egyptian patients with B-cell non-Hodgkin’s lymphoma with assessment of patients’ immunological state p. 19
Mohamed O Azzazi, Mohamed A.M. Mohamed, Mohamed M Mousa, Rasha M Mohammed, Salma S Eldin Youssef
DOI:10.4103/1110-1067.206435  
Background Hepatitis C virus (HCV) is both hepatotropic and lymphotropic and is estimated to affect over 180 million individuals worldwide. Chronic HCV infection has been associated with B-cell indolent lymphomas, especially marginal zone lymphoma. Objectives Our study aimed to study the relation between HCV infection in B-cell non-Hodgkin’s lymphoma (NHL) patients and the patients’ immunological state, and to study the characteristics of different histological forms of NHL in HCV-positive patients in relation to HCV genotypes and to viral load. Patients and methods This study was carried out on 100 B-cell non-Hodgkin’s lymphoma (B-NHL) patients and three control groups including 50 patients with various solid malignancies, 50 patients with non-HCV hepatic affection, and 50 control healthy participants, respectively. All patients were subjected to laboratory investigations including complete blood count, erythrocyte sedimentation rate, C-reactive protein, liver profile, renal profile, serum lactate dehydrogenase (LDH), serum β2 microglobulin, serum cryoglobulins, serum immunoglobulins, HCV antibody detection by enzyme immunoassay, quantification of HCV RNA by RT-PCR, and identification of HCV genotype by LiPA. Results Our results showed that the most prevalent histopathologic subtype of B-NHL among HCV-positive patients was mucosa associated lymphoid tissue lymphoma (±SD 71.4%). The prevalence of HCV infection among B-NHL patients was found to be 43% and all HCV-positive patients had genotype 4. Viral load was positively correlated with serum LDH, serum β2 microglobulin, and serum IgM levels, and inversely correlated with platelet count and prothrombin concentration in HCV-positive patients of B-NHL and solid malignancies groups. Serum cryoglobulinemia was identified in HCV-positive patients of both B-NHL (74.4%) and control solid malignancies groups (66.6%). Conclusion From these results, we can conclude that the prevalence of HCV infection among B-NHL Egyptian patients is ∼43%, with detection of serum cryoglobulins and elevation of serum levels of immunoglobulins IgG, IgM, LDH, and β2 microglobulin in HCV-positive patients.
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Assessment of autologous platelet gel injection in nonunited long bones p. 31
Ayman Tawfik, Noha Kamel
DOI:10.4103/1110-1067.206430  
Aim Growing interest in nontransfusional hemoconcentrate use is evident. The aim of this study was to assess the effectiveness of autologous platelet gel injection in nonunited long bones. Settings and design This single-center prospective study was conducted on 20 patients with long-bone nonunions. Patients and methods Patients with clinical and radiological signs of long-bone nonunions and eligible for autologous donation were included. Autologous platelets were prepared in blood bank and activated with calcium gluconate and autologous thrombin shortly before injection. Fracture healing was evaluated clinically and with radiographic views in two planes at serial follow-ups of 6 weeks after injection and then every 4 weeks until healing was confirmed. Results The median time between injury and platelet gel injection was 8 months. Evidence of callus formation was seen in 17 (85%) patients by the end of 17th week; the remaining three patients failed to achieve union at 24 weeks’ follow-up. Conclusion Platelet gel injection is a safe nonoperative modality for nonunited long bones.
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Phytochemical analysis, toxicity profile, and hemomodulatory properties of Annona muricata (Soursop) p. 36
Kingsley C Agu, Ngozi P Okolie, Ikechi Eze, John C Anionye, Abiodun Falodun
DOI:10.4103/1110-1067.206431  
Background A wide array of ethnomedicinal values have been attributed to the different parts of Annona muricata, and indigenous communities in Nigeria, Africa, and South America extensively use this plant to augment conventional drugs. Aim The beneficial effects of A. muricata on the hematological profile have also been widely reported and this research sought to validate these claims. Design Adult albino Wistar rats were used in this study. Methanolic extracts of the various parts of the plant were used, with which we determined the 50% lethal dose (LD50) and acute toxicity status of the plant before hematological studies for a duration of 28 days (subchronic studies). Materials and methods During the subchronic studies, 100, 200, 400, 600, and 800 mg/kg of the fruit, leaf, stem-bark, and root-bark methanolic extracts were administered to groups 2–6, respectively, whereas group received 2 ml of distilled water and served as control. At the end of the administration period, the rats were killed and blood samples collected for onward hematological studies. Phytochemicals were quantified using standard procedures. Results The obtained results showed that both the leaf and fruit extracts had LD50 of 1918.33 mg/kg, whereas the stem-bark and root-bark both had LD50 above 5000 mg/kg. Subchronic observations were also made, including increased heart rates and diarrhea. The fruit and stem-bark extracts recorded a dose-dependent increase in CD4+ cells, especially from the 200 mg/kg dose. Also, the fruit, leaf, and root-bark extracts showed a dose-dependent increase in white blood cells and lymphocytes. The extracts of the various parts of the plant apart from the stem-bark recorded marked increase in platelet levels. The various extracts of the plant parts recorded striking increase in red blood cells, hemoglobin concentration, and packed cell volume. These observations could be linked to the remarkable quantity of alkaloids, flavonoids, and phenols present in the leaf and fruit fractions. Conclusion Thus, the obtained data suggest and validate the reported hemomodulatory and wound-healing properties of A. muricata, especially the fruit and leaf.
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