Background and ObjectivesThe aim of this study was to estimate the proportion of spontaneous viral clearance (SVC) after symptomatic acute hepatitis C and to evaluate the efficacy of 12 weeks of pegylated interferon alfa-2a in patients who did not clear the virus spontaneously.MethodsPatients with symptomatic acute hepatitis C were recruited from two “fever hospitals” in Cairo, Egypt. Patients still viremic three months after the onset of symptoms were considered for treatment with 12 weeks of pegylated interferon alfa-2a (180 µg/week).ResultsBetween May 2002 and February 2006, 2243 adult patients with acute hepatitis were enrolled in the study. The SVC rate among 117 patients with acute hepatitis C was 33.8% (95%CI [25.9%–43.2%]) at three months and 41.5% (95%CI [33.0%–51.2%]) at six months. The sustained virological response (SVR) rate among the 17 patients who started treatment 4–6 months after onset of symptoms was 15/17 = 88.2% (95%CI [63.6%–98.5%]).ConclusionSpontaneous viral clearance was high (41.5% six months after the onset of symptoms) in this population with symptomatic acute hepatitis C. Allowing time for spontaneous clearance should be considered before treatment is initiated for symptomatic acute hepatitis C.

Background and PurposeThe neuroregenerative drug Cerebrolysin has demonstrated efficacy in improving cognition in adults with stroke and Alzheimer's disease. The aim of this study was to determine the efficacy and safety of Cerebrolysin in the treatment of communication defects in infants with severe perinatal brain insult.MethodsA randomized placebo-controlled clinical trial was conducted in which 158 infants (age 6-21 months) with communication defects due to severe perinatal brain insult were enrolled; 120 infants completed the study. The Cerebrolysin group (n=60) received twice-weekly Cerebrolysin injections of 0.1 mL/kg body weight for 5 weeks (total of ten injections). The placebo group (n=60) received the same amount and number of normal saline injections.ResultsThe baseline Communication and Symbolic-Behavior-Scale-Developmental Profile scores were comparable between the two groups. After 3 months, the placebo group exhibited improvements in the social (p<0.01) and speech composite (p=0.02) scores, with 10% and 1.5% increases from baseline, respectively. The scores of the Cerebrolysin group changed from concern to no concern, with increases of 65.44%, 45.54%, 358.06%, and 96.00% from baseline in the social (p<0.001), speech (p<0.001), symbolic (p<0.001), and total (p<0.001) scores.ConclusionsCerebrolysin dramatically improved infants' communication especially symbolic behavior which positively affected social interaction. These findings suggest that cerebrolysin may be an effective and feasible way equivalent to stem cell therapy.

Introduction: Malignant pleural mesothelioma (MPM) remains a serious health problem due to the poor outcome of different therapies. In Egypt, it is mainly attributed to an environmental origin with a high incidence in women and young adults. Aim of work: To identify risk factors of malignant pleural mesothelioma and to carry out survival analysis for malignant pleural mesothelioma patients attending outpatient clinic of Clinical Oncology department at Ain Shams University hospital. Materials and methods: Ninety cases with pathologically confirmed MPM attending the outpatient clinic of clinical oncology department at Ain Shams University hospital were interviewed. Patients in critical conditions who needed hospitalization or palliative treatment were excluded. Included patients were then followed up for two years starting from the date of diagnosis. Results: Logistic regression analysis revealed that living in industrial areas, household exposure to asbestos and history of smoking were significant risk factors of MPM. The mean survival duration of all cases was 24.49 months. Cox regression analysis revealed that factors predicting survival were age and gender. The difference in survival between patients treated with different treatment modalities was not statistically significant. Conclusion: Environmental and household exposure to asbestos as well as smoking play an important role in occurrence of MPM. Age and gender were significant predictors of survival of patients. Strict measures to reduce pollution and thus rates of MPM should be adopted in addition to community awareness of the possible risk factors and preventive measures. Moreover, development of a national record system is required to determine the true size and scope of this environmental problem in Egypt.

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