Ahmed Fouad

Evaluation of the diagnostic value of serum and tissue apoptotic cytokeratin-18 in patients with chronic hepatitis C

BACKGROUND AND STUDY AIMS Hepatitis C virus (HCV) is considered the most common aetiology of chronic liver disease (CLD) in Egypt. The disease severity ranges from mild illness to cirrhosis and hepatocellular carcinoma. A role for apoptosis in liver damage caused by HCV chronic infection has been suggested. Cytokeratin 18 (CK-18) is the major intermediate filament protein in the liver and is a known caspase substrate in hepatocyte apoptosis. Therefore, we analysed the serum and tissue levels of CK-18 in patients with chronic HCV infection to evaluate its role in hepatocyte apoptosis. We also correlated CK-18 expression with the severity of hepatic pathology. PATIENTS AND METHODS This study examined 80 Egyptian patients with liver disease. There were 69 patients with chronic hepatitis C and 11 patients with hepatitis C-induced cirrhotic changes. Fifteen healthy controls were also included in the study. The levels of CK-18 fragment were quantified in paired serum and liver biopsy samples. RESULTS The serum and tissue CK-18 levels were reduced in chronic HCV patients compared to early cirrhosis patients. This result indicates that serum levels of CK-18 and the hepatic expression of CK-18 might play an important role in disease progression. The serum and tissue levels of CK-18 were significantly increased and directly correlated with inflammation severity, stage of fibrosis, and ALT levels in the chronic HCV group and the cirrhotic liver group. There was no significant difference in viral load between patient cohorts. CONCLUSION The serum level and the hepatic expression of CK-18 are related to disease activity and are directly correlated with METAVIR scoring. This result suggests that serum CK-18 levels may be useful for monitoring disease activity in chronic HCV and liver cirrhosis patients.

Fibroscan of chronic HCV patients coinfected with schistosomiasis.

BACKGROUND AND STUDY AIMS Both hepatitis C virus (HCV) and schistosomiasis are highly endemic in Egypt and coinfection is frequently encountered. Such coinfection is responsible for leading to a more severe liver disease. Hence, the aim of the study was to assess the fibroscan in chronic HCV patients coinfected with Schistosoma. PATIENTS AND METHODS This study included 231 chronic HCV patients. Routine pre-treatment work-up was done including anti-schistosomal antibodies. Liver stiffness measurements using fibroscan and reference needle-liver biopsy were done. Patients were categorised into two groups: HCV patients with positive schistosomal serology and HCV patients with negative schistosomal serology. RESULTS Anti-schistosomal antibody was positive in 29% of the studied population. Positive schistosomal serology status was significantly associated with the disagreement between the results of liver biopsy (Metavir) and the fibroscan results (p value=0.02), which was more obvious in F2 and F3 fibrosis stages. The sensitivity of fibroscan for the detection of the F2 stage decreased from 64% among negative schistosomal serology patients to 30.8% among positive schistosomal serology patients, and for the F3 stage it decreased from 43.8% to 21.4%, respectively. Multivariate logistic regression showed that fibrosis stages (F0-F1 and F4) were the most independent factors that were associated with the agreement between fibroscan and liver biopsy (odds ratio (OR) 3.4, 7.12 and p value <0.001, <0.001, respectively). CONCLUSION Although the sensitivity of fibroscan for the detection of fibrosis stages (F2 and F3) was impaired in patients with positive schistosomal serology, fibrosis stages (F0-F1 and F4) were the most independent factors associated with the agreement between fibroscan and liver biopsy.

Effects of rice bran on performance, egg quality, oxidative status, yolk fatty acid composition, and fatty acid metabolism-related gene expression in laying ducks

The study was designed to evaluate the effects of different dietary levels of rice bran (RB) in laying duck diets on performance, egg quality, oxidation status, egg yolk fatty acid composition, and hepatic expression of fatty acid metabolism-related genes. Longyan females (1080) with similar BW at 19 wk of age were randomly assigned to 6 dietary treatments, each consisting of 6 replicates of 30 birds. The basal diet (I) was a typical corn-soybean ration while the experimental diets (II to VI) substituted RB for corn and wheat bran and a small reduction of soybean meal. The level of substitution in diets (II to VI) was 6%, 12%, 18%, 24%, and 30%, respectively. The experiment lasted for 12 wks. Average egg weight and daily egg mass decreased linearly as the level of RB inclusion increased (P<0.001) and feed conversion ratio linearly increased (P<0.001). The proportions of C14:0 and C18:0 and total saturated fatty acids (SFA) in egg yolk linearly decreased with increasing RB, and many of the key polyunsaturated fatty acids (PUFA), like C18:2 n-6 and C18:3 n-3, linearly increased (P<0.001), but not those of C20:5 n-3 and C22:6 n-3. There were linear decreases (P<0.001) in hepatic abundance of FAS and SREBP1 transcripts, with a substantial reduction to about 30% those of ducks fed the control diet; there were no treatment effects on productive performance, eggshell thickness, strength, Haugh unit, antioxidation status, and egg yolk cholesterol or triglyceride content (P>0.05). In conclusion, the current study suggests that ducks from 19 to 31 wk could be fed diets with up to about 18% RB without effect on the number of eggs produced, egg quality, and oxidative status. Increasing amounts of RB linearly increased egg yolk concentrations of key fatty acids like C18:2 n-6 and C18:3 n-3 and decreased the hepatic abundance of FAS and SREBP-1 transcripts.

Relation of ALT and AST levels to the histopathological changes in liver biopsies of patients with chronic hepatitis C genotype 4.

BACKGROUND AND STUDY AIMS Worldwide, Egypt has a high prevalence of adult hepatitis C virus (HCV) infection. Serum alanine aminotransferase (ALT) activity is most commonly measured to assess hepatic disease. The revision of the definition of the normal limits for the ALT level is advisable. The aim of this work was to compare the histopathological changes in the liver tissue biopsies of HCV-infected patients, clinically presenting with ALT levels below normal, based on the conventional, previously used upper limit of normal (ULN) of ALT (40U/L for men and 30U/L for women) with the proposed new ULN (30U/L for men, and 19U/L for women). PATIENTS AND METHODS This is a retrospective cross-sectional study. A total of 668 cases of chronic hepatitis C genotype 4 were included. Patients were classified according to grades of histological activity and fibrosis stages (by the Metavir scoring system). They were also classified into normal and high groups according to the old and new cutoffs of both aspartate transaminase (AST) and ALT levels. RESULTS The results of our study showed that the serum AST level in our study showed a better correlation with the histopathological changes in liver biopsy rather than ALT, especially when using the old cutoff of the ULN for AST. The serum ALT level in our study (both the old and the new cutoffs) did not show a significant correlation with the histopathological status in the liver biopsies of our patients. CONCLUSION This study concluded that the old cutoff of the ULN AST is a better predictor of fibrosis.

Role of transforming growth factor-β1 in serum and - 509 C>T promoter gene polymorphism in development of liver cirrhosis in Egyptian patients.

Objectives Liver cirrhosis is a condition in which the liver slowly deteriorates and malfunctions due to chronic injury. HCV is one of the major causes of liver fibrosis and ultimate progression to cirrhosis. Transforming growth factor-beta1 (TGF-β1), one of the three isoforms of TGF-β, is a pleiotrophic cytokine that regulates the proliferation and differentiation of cells, embryonic development, wound healing and angiogenesis. This study aimed to evaluate the role of serum TGF-β1 and − 509 C>T promoter gene polymorphism in the development of liver cirrhosis. Design and methods Besides routine liver profiles, serum TGF-β1 was measured in 40 liver cirrhosis patients and 40 controls using ELISA technique. TGF-β1 − 509 C>T promoter gene polymorphism was detected using PCR-RFLP technique. Results TGF-β1 − 509 CT and TT genotype frequencies were significantly higher in the cirrhotic group (52.5%, 25%; respectively) than control group (10%, 7.5%; respectively); OR = 16.238 (95% CI 5.391–48.914, p < 0.05). The − 509 T allele carriers are more prone to develop liver cirrhosis than − 509 C allele carriers; OR = 7.359 (95% CI 3.325–16.288, p < 0.05). Serum TGF-β1 was significantly higher in cirrhotic group (11.79 ± 1.45 ng/ml) than control group (8.67 ± 1.23 ng/ml); p < 0.05. Also serum TGF-β1 was significantly higher in TT genotype than CT and CC genotypes (p < 0.05). A significant positive correlation was observed between serum TGF-β1 and alkaline phosphatase (r = 0.559, p < 0.05); AST (r = 0.573, p < 0.05). A significant negative correlation was observed between serum TGF-β1 and albumin (r = − 0.331, p < 0.05). Conclusion There is an association between serum TGF-β1, − 509 CT and TT genotypes of TGF-β1 gene and the higher risk for liver cirrhosis development of liver cirrhosis.

Effects of dietary methionine on performance, egg quality and glutathione redox system in egg-laying ducks

Abstract In this study, 6 dietary DL-methionine (Met) levels (2.5, 3.0, 3.5, 4.0, 4.5 and 5.0 g/kg) were tested to estimate the dietary Met requirements of Longyan ducks from 19 to 46 weeks of age, and to investigate its effect on the glutathione redox system. In total, 1080 Longyan ducks aged 19 weeks were allocated randomly to the 6 dietary treatments, where each treatment comprised 6 replicate pens with 30 ducks per pen. Met had no effects on egg production, yolk weight, yolk colour or the glutathione redox system, but the egg weight, egg mass and feed conversion ratio (FCR) were improved significantly by dietary Met supplementation. As the dietary Met concentration increased, the eggshell thickness and breaking strength decreased significantly, whereas the albumen weight increased significantly. According to broken-line regression analysis, the optimum Met requirements for egg weight, egg mass, FCR and albumen weight are 686, 661, 658 and 731 mg/bird/d, respectively, with a dietary crude protein level of 170 g/kg.

Effects of dietary lysine supplementation on performance, egg quality, and development of reproductive system in egg-laying ducks

ABSTRACT This study was conducted to examine five lysine (Lys) levels (0.75, 0.80, 0.85, 0.90, and 0.95%) to estimate the optimal level of Lys for Longyan laying ducks from 22 to 38 wk of age. Nine hundred Longyan ducks aged 22 wk were assigned randomly to the 5 dietary treatments, where each treatment comprised 6 replicate pens with 30 ducks per pen. Lys had no effects on egg production, egg mass, feed conversion ratio, shape index, Haugh unit, yolk colour, yolk weight, or albumen weight, but the egg weight was improved significantly (P < 0.05) by dietary Lys supplementation, whereas the eggshell thickness, eggshell weight, and eggshell proportion decreased significantly as the Lys levels increased. Dietary supplementation of Lys did not affect the reproductive organ indices or the plasma levels of estradiol, luteinizing hormone, or follicle-stimulating hormone, whereas the plasma level of progesterone declined significantly (P < 0.01) as elevation the concentrations of Lys in the diets. In conclusion, the results indicate that the optimal Lys level in Longyan laying ducks diets is 0.80% to produce eggs with normal egg weight without adverse effects on the eggshell weight, eggshell proportion, or eggshell thickness.

A Novel Quota Sampling Algorithm for Generating Representative Random Samples given Small Sample Size

In this paper, a novel algorithm is proposed for sampling from discrete probability distributions using the probability proportional to size sampling method, which is a special case of Quota sampling method. The motivation for this study is to devise an efficient sampling algorithm that can be used in stochastic optimization problems --when there is a need to minimize the sample size. Several experiments have been conducted to compare the proposed algorithm with two widely used sample generation methods, the Monte Carlo using inverse transform, and quasi-Monte Carlo algorithms. The proposed algorithm gave better accuracy than these methods, and in terms of time complexity it is nearly of the same order.

A new unconstraining method for demand forecasting

In this paper we propose a new unconstraining method for demand forecasting. Since true demand forecasting is a key aspect of hotel room revenue management systems, inaccurate forecasts will significantly impact the performance of these systems. We propose a method based on a Monte Carlo simulation forecasting model and an Expectation-Maximization (EM) algorithm that, unlike traditional statistical unconstraining methods, takes into account the time-series aspect of the observed demand (trend and seasonality) and handles the complex distribution of the demand and its relationship with other system variables/parameters. Our approach is presented in an efficient and simple algorithm. We considered as a case study the data for Plaza Hotel, Alexandria, Egypt. The primary results of our approach demonstrate that it can produce efficient solutions for estimating the unconstrained demand which provide revenue improvements in the industry.

Nutritional requirements of meat-type and egg-type ducks: what do we know?

The demand for duck meat, duck eggs, and associated products is increasing each year. Classic and modern selection programs have been applied to enhance the economic traits of ducks to satisfy the requirements of consumers and enhance the incomes of producers. The nutritional requirements of unselected ducks may not be adequate, however, to fulfill the potential productivity performance of modern birds, including both meat-type and egg-type ducks. In particular, an imbalanced diet is associated with low productive performance and signs of nutritional deficiency (if insufficient nutrients are supplied), as well as with high feed costs and manure problems that reflect flock health and welfare (if excessive nutrients are supplied). Thus, the main aim of this review is to summarize the results of previous studies that estimated the nutrient requirements of meat-type and egg-type ducks in order to evaluate current knowledge and to identify further issues that need to be addressed. In addition, the results obtained in previous studies are compared in order to understand how to lower commercial feed costs, fulfill the genetic potential of selected ducks, protect the environment from pollution, and satisfy the welfare and health needs of ducks.