Valproic acid (VPA) is one of the most used anti-epileptic drugs inspite of its many adverse effects as anemia, leucopenia, thrombocytopenia, and liver toxicity. The hepatoprotective effect of alpha-lipoic acid (ALA) was confirmed. Aim of the study: The aim of this study was to detect the protective effect of ALA against the adverse effects of VPA. Materials& Methods: Thirty white albino Wistar male rats were divided into 4 groups. Group (1) was the control group; Group (2) included rats that received ALA (100mg/kg/day) orally for 14 days; Group (3) and Group (4) included rats that received VPA (500 mg/kg/day) for 15 days intraperitoneal, but group 4 rats received ALA (100mg/kg/day) orally for 14 days prior to VPA. Blood samples were collected and livers were excised from rats for colorimetric analysis and rt-PCR. Results: Rats that received VPA showed leucopenia, thrombocytopenia, a significant decrease of SOD, glutathione, Nrf2, and Sirt1, besides a significant increase of MDA and TNF alpha. Prior treatment with ALA prevented all these results. Conclusion: ALA protected against VPA-induced liver damage and hematological disturbance via anti-oxidant and anti-inflammatory properties.

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Background In beta-thalassemia major (TM) patients, levels of liver iron overload and the presence of chronic hepatitis C are directly correlated with the onset and severity of liver fibrosis. A noninvasive approach that can evaluate cirrhosis and liver fibrosis in these patients is transient elastography (TE). We aimed to find out the role of noninvasive elastography in the assessment of liver fibrosis in young beta-thalassemia major patients receiving frequent blood transfusions. Identifying the patients' risk factors for liver fibrosis is another goal. The study comprised 53 patients, all of whom had a thorough history-taking procedure, clinical examination, and investigations such as CBC, serum ferritin, HCV and HBV serology, and liver function testing. It was carried out transient elastography to find liver fibrosis. Results According to transient elastography, 52.8% of the patients had severe fibrosis (F2 and higher). 9.4% of people had positive HCV serology results. Significant liver fibrosis was correlated with all serum ferritin levels (708.2 ± 182.1, 3213.5 ± 1272.9, nonsignificant vs. significant fibrosis), HCV infection, age, blood transfusion frequency, and irregular chelation therapy. But no significant correlation regarding sex and BMI was detected. Conclusion Transient elastography is an alternate noninvasive approach that assesses liver fibrosis in beta-thalassemia major patients. The risk of liver fibrosis is related to iron overload, HCV seropositivity, advanced age, frequent blood transfusion, and irregular chelation therapy.

Background The incidence of typhoid fever is increasing in Egypt. The Widal test is the evaluation most widely used in Egypt for diagnosis, but it has many drawbacks; therefore, new diagnostic tools are needed. Our aim was to evaluate the diagnostic accuracy of the onsite typhoid IgG/IgM combo rapid test in diagnosing typhoid fever. Method Blood specimens were collected from 90 patients (of all ages) who presented with fever of more than 4 days’ duration. The OnSite Combo test and the Widal test were performed for all patients. Results The OnSite Combo test results were positive in approximately 24% of all patients; the Widal test results were positive in 18.9%; and typhoid was diagnosed through blood culture in 32.2%. The OnSite Combo test had 72.4% sensitivity, 98.4% specificity, a positive predictive value of 95.5%, and a negative predictive value of 88.2%. In contrast, the Widal test had 51.7% sensitivity, 69.7% specificity, a positive predictive value of 88.2%, and a negative predictive value of 80.8%. Conclusions The onsite combo test was more efficacious than the Widal test in diagnosing typhoid fever.