AIM:To identify blood donors with occult hepatitis B virus (HBV) infection (OBI) to promote safe blood donation. METHODS:Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV Ab) and human immunodeficiency virus Ab. They were subjected to the detection of alanine aminotransferase (ALT) and aspartate transaminase (AST) and screening for anti-HBV core antibodies (total) by two different techniques; [Monoliza antibodies to hepatitis B core (Anti-HBc) Plus-Bio-Rad] and (ARC-HBc total-ABBOT). Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface (anti-HBs) (ETI-AB-AUK-3, Dia Sorin-Italy). Serum anti-HBs titers > 10 IU/L was considered positive. Quantitative HBV DNA by real time polymerase chain reaction (PCR) (QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/L. Also, 265 recipients were included, 34 of whom were followed up for 3-6 mo. Recipients were investigated for ALT and AST, HBV serological markers: HBsAg (ETI-MAK-4, Dia Sorin-Italy), anti-HBc, quantitative detection of anti-HBs and HBV-DNA. RESULTS: 525/3167 (16.6%) of blood units were positive for total anti-HBc, 64% of those were antiHBs positive. Confirmation by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples, where 451 (90.6%) confirmed positive. Reactivity for anti-HBc was considered confirmed only if two positive results were obtained for each sample, giving an overall prevalence of 451/3167 (14.2%) for total anti-HBc. HBV DNA was quantified by real time PCR in 52/303 (17.2%) of anti-HBc positive blood donors (viral load range: 5 to 3.5 x 10 5

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Background: Assessment of the students' opinion throughout their teaching course is a crucial part to achieve the intended learning outcome. Objectives: Were to assess and compare the students' attitude and perception towards basic medical sciences during the preclinical and clinical academic years, to recognize their opinion to early integration of both basic and clinical sciences, their preferred basic subjects and related causes. Subjects and Methods: A cross sectional study was conducted on 344 female medical students. They were randomly selected through the academic year 2015-2016, at the Faculty of Medicine for Girls, Al-Azhar University in Cairo. Data were collected using a valid and reliable (nine items) questionnaire. The first five items measured the perceived importance and relevance of basic medical sciences to clinical medicine, and the last four items measured students' attitudes towards, and perceived effectiveness of their education in basic medical sciences. Necessity of integration from the first year and the preferred basic medical subjects were also asked about. All opinions were rated using a three points Likert scale. Results: A significant difference between the two groups was obtained as regards that "physician can effectively treat most medical patients without knowing the details of the biological processes (72.4% versus 75.9%). While, disagreement perception was significantly higher among clinical group students (62.8%) compared to preclinical students (47.8%) as regards less value of basic medical sciences in clinical practice. Modest agreement attitude was the dominant towards the further statements with no significant difference (p>0.005). How best to integrate both clinical and basic medical sciences was not significant and represented 67.5% and 71.0% among preclinical and clinical students respectively. The top preferred basic medical sciences were; anatomy, physiology and pathology. Understandable curriculum, good professor and clear method of teaching were the main causes for preference. Conclusion and Recommendation: Overall positive attitude and perception towards basic medical sciences are found, mainly among students in clinical years. Refocusing the basic/clinical medical sciences is essential to cross the gap between knowledge and medical practice. Opinion of the students is necessary to be considered to provide the educational planners with valuable guidelines in order to maximize the benefits of medical curricula and prepare medical students efficiently for clinical work. Further studies prior to the application of the integrated program are required.

Aim of the Study: The national Egyptian hepatitis B virus (HBV) vaccination program coverage of all infants started in 1992. The study aimed to assess immunity against HBV and occurrence of HBV breakthrough infections in vaccinated polytransfused children with malignancies. Patients and Methods: Eighty-nine polytransfused children with malignancies were recruited; 37 were on chemotherapy (male:female 20:17; mean age 7.7±4.0 y), and there were 52 naive patients (male:female 31:21; mean age 7.6±3.2 y). In addition, 162 age-matched and sex-matched healthy controls were recruited. Patients’ sera were tested for quantitative anti-hepatitis B surface (HBs) (enzyme-linked immunoassays technique), hepatitis B surface antigen (HBsAg), total anti-hepatitis B core, and HBV-DNA (nested polymerase chain reaction for surface, core, and x-regions). Results: There was a significant lower percentage of having protective anti-HBs (10 to 100 IU/L) level among those receiving chemotherapy (13.5%) than those without (44.2%) and controls (32.1%). Twenty-one (67.7%) of those on chemotherapy were HBsAg positive compared with 10 (32.2%) of those without. Overall, 46 patients were HBV-DNA positive; 38 were c-region positive, 5 were s-region positive, 2 positive for the c-region and the s-region, and 1 tested positive for the c-region and the x-region. Of 46 patients, 20 were also positive for HBsAg (overt infection), while 26 had occult HBV infection (HBsAg-negative). Anti-HBs ≥10 IU/L co-existed among 45% of patients with overt infection and in 50% of those with occult infection. There was nonsignificant impact of receiving chemotherapy on the level of HBV-DNA. Conclusions: Vaccinated children with malignancies, especially those under chemotherapy, are at a significant risk of HBV infection. The co-existence of anti-HBs with HBsAg and/or HBV-DNA may represent a possible residual transfusion-transmission risk with mutant HBV strains.