Sohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Relationship between Demodex spp. infestation and acne disease1615707910.21608/smj.2021.61513.1224ENEsraa OmarAliparasitology faculty of medicine sohag universityNoha SammerAhmedprasitology faculty of medicine sohag universityJournal Article20210224Abstract:<br />Background: Demodex mites present on the skin of healthy individuals. Demodex mites in high densities may play a pathogenic role. <br />Aims: To evaluate the correlation between Demodex infestation and acne vulgaris. <br />Setting: Outpatient Clinic of Dermatology Department, Faculty of Medicine, Sohag University. <br />Patients and methods: One hundred patients diagnosed with acne and an equal number of healthy volunteers (with age and sex matching) as control groups were enrolled in this study. Skin scrapping was taken in the patient and the control groups. Samples were <br />examined by the light microscope, and Demodex were counted.<br />Results: regarding gender and age, no significant difference was present between the patients and controls (p > 0.05). Demodex infestation were higher in patients than in controls (p = 0.001). no statistically significant relationship between age, sex, family history, presence of animal at home, or severity of acne and the positivity of Demodex mites (p-value for all > 0.05).<br />Conclusion: Acne vulgaris is significantly correlated with Demodex infestation.https://smj.journals.ekb.eg/article_157079_d7a4c64a8b8cebafb352b1f39dd040ca.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Levamisole in steroid dependent and frequently relapsing nephrotic syndrome71315707710.21608/smj.2021.61433.1223ENGhada AshryBorhamPediatric department
Sohag Faculty of medicine
Sohag University0000-0003-1969-7939Magda MohamedAliPublic health and Community medicine,Sohag University,EgyptJournal Article20210214Abstract<br />Background and aim of work: Levamisole is an antihelminthic agent with immunomodulatory properties. It resulted in a significant reduction in relapse rate and prednisone dosage in frequently relapsing and/or steroid-dependent nephrotic children with few side effects. This work aimed to study the effectiveness and side effects of levamisole as second-line therapy in patients with steroid-dependent and/or frequently relapsing nephrotic syndrome in our locality in Sohag, Egypt.<br />Patients and Methods: A retrospective study included records of patients with idiopathic steroid dependent and frequently relapsing nephrotic syndrome who followed in our Sohag pediatric nephrology clinic in the period from 2010 to 2020 and used levamisole. Relapse frequency/yr and steroid dependent dose before, during, and after levamisole use were calculated. Levamisole complications were recorded.<br />Results: It included 38 children (26 boys and 12 girls). Mean age at disease onset (3.9±1.8 yr). Levamisole course was 3-12 months according to the response. During levamisole course; relapses stopped in 12 (32%) patients, reduced in 5 (13%), and were the same in 21 (55%). After levamisole stoppage; no relapses were in 3 (8%) patients, infrequent relapses in 11 (29%), and frequent relapses in 24 (63%). Frequency of relapses/yr and mean steroid-dependent dose before levamisole use were significantly higher in the failed group than in the successful group (P-value 0.001 for both). No levamisole complications were recorded. <br />Conclusion: Levamisole is a cheap, safe, and effective drug in steroid-dependent and frequently relapsing nephrotic syndrome.https://smj.journals.ekb.eg/article_157077_8277eef289e1f98fe4d237e756b56c5f.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Can Mosquitoes’ bites block the hypothesized species jump which leads to the emergence of new viruses? A hypothesis, after reviewing history and geography.142216128010.21608/smj.2021.52799.1214ENHassan MohammedElnadyDepartment of Neurology and Psychological medicine, Faculty of medicine, Sohage University, Sohag, Egypt0000-0002-1904-9248Ali AbdelrahmanGhweilTropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt.Tamer Mohamed MahmoudAbdellahMedical Microbiology and Immunity department, Faculty of Medicine, Sohag University, Sohag, Egypt.AshrafKhodearyClinical Pathology Department, Faculty of Medicine, Sohag University, Sohâg, Egypt.SafaaKhalafTropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Sohag, Egypt0000-0001-7974-8086MahmoudSaif-Al-IslamTropical Medicine and Gastroenterology Department, Faculty of Medicine, Sohag University, Sohag. Egypt0000-0003-3311-3354Journal Article20201228Abstract<br />Some people have no choice but to get in contact with animals, but this contact is accused of being the main cause of the emergence of new viruses. Novel and creative ways of thinking are needed to reveal the mystery of the reasons that led to the emergence of the viral epidemics and try to treat them.<br />In our opinion, humankind has been exposed to viral pandemics or at least viral outbreaks in places where, and times when, humans have come close to achieving success in eliminating mosquitoes. And we think that the temporal and local linking between the most important mosquito elimination procedure (which is fighting malaria) and the occurrence of viral pandemics will help in answering many of the questions that have been asked about these pandemics.<br />For viruses, “Species jumps”, a jump between one host species and humans is one of the main steps in the emergence process. Not all mosquito bites are similar; there are three possibilities that can occur to a human or animal after a mosquito bite depending on the mosquito's health status. We hypothesize that, a one category of mosquito bites stands as a front block against the “Species jumps”. This blocking wall will fall if mosquitoes are eliminated which will open the way for new viruses to emerge.<br />Our hypothesis assumes that, mosquitoes are "natural vaccinators", as long as humans are able to get rid of insect-borne diseases in ways other than vector eradication.https://smj.journals.ekb.eg/article_161280_7476d2138b74b60761fbd67fd9ac3b14.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401The tumor site of origin and its effect on survival in gastrointestinal stromal tumors(GIST)233016485010.21608/smj.2021.53164.1216ENAmal AliOmaroncology department faculty of medicine Sohag university000000024857703AliAliDepartment of Clincal Oncology and Nuclear Medicine, Faculty of Medicine, Sohag University.Asmaa AbdelghanyAbdelatifDepartment of Clinical oncology, Faculty of Medicine, Sohag University, Sohag, Egypt.Journal Article20201220Abstract<br />Background: GIST is a common mesenchymal tumor of the Gastrointestinal Tract. The stomach is the most frequently affected site. In this study, we focus on the relation between tumor site and survival.<br />Materials and methods: our retrospective study included 47 patients diagnosed with GIST at Sohag University Hospital, Sohag Cancer Center, and Sohag Health Insurance Hospitals during the period between 2012 -2017. The collected data were extracted from patient's files. Missed data in the files were obtained via phone communication with the patients or their relatives. <br />Results: 47 cases with gastrointestinal tumors were selected. All tumors were stained positive for c-kit. 48.9% (23/47) of the tumors were located in the stomach, 40.4% (19/47) in the small intestine, and 10.6% (5/47) in the large intestine. The mean progression-free survival (PFS) was 20.75 months ranging between 7months and 39 months. On analyzing the impact of tumor site on PFS we found that There was a significant relationship between the gastric site of the tumor and improved PFS (log-rank P = 0.010). The mean overall survival (OS) was 35.26 months ranging between 1 month and 108 months, on analyzing the impact of tumor site on OS we found no relation. <br />Conclusion: Gastric origin of GIST is associated with more benign behavior and improved PFS in comparison with the intestinal origin.<br />Keywords: GIST, gastric GIST, survival.https://smj.journals.ekb.eg/article_164850_2530e894c44b03151d37e476f476ceff.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Updates In The Pathogenesis Of Alopecia Areata314116485310.21608/smj.2021.67540.1236ENZeinab Abu BahaGoudadepartment of dermatology, faculty of medicine, Sohag university, SohagEssamNadadepartment Dermatology, Venereology and Andrology , Faculty of Medicine, Sohag University, SohagHanan AbdlRadiAssafDepartment of dermatology, Venereology and Andrology, Faculty of Medicine, sohag university, SohagSoha HishmatAboeldahabdepartment of Dermatology, Venerology and Andrology, Faculty of Medicine, Sohag University,SohagJournal Article20210314Abstract:<br />Alopecia areata is the most prevalent autoimmune disorder which causes non-scarring hair loss. It may increase the anxiety of patients and increase their chances of developing psychological and psychiatric disorders. There are two proposed theories for the pathogenesis of alopecia areata.<br />The most evidence-based hypothesis is an autoimmune reaction caused by collapse of hair follicle immune privilege, Immune privilege collapse is assumed to be either a primary event that triggers antigen presentation in a disturbed hair follicle environment, or an event that occurs as a result of dysregulation of central immune system that involves the follicles.<br />Several gene loci have been identified with alopecia areata. The key immune effectors in the pathogenesis include autoreactive effector T cells, natural-killer group 2, member (NKG2D) + CD8+cytotoxic T cells, natural killer (NK) cells, Janus kinase, signal transducers and activators of transcription (JAK/STAT) pathway, MHC-I chain-related gene A (MICA), interferon‐γ (IFN‐γ) and interleukin-15 (IL-15). <br />Alopecia areata has no accepted cure and has an unpredictable response to treatment. The recognition of the exact pathogenic mechanisms of alopecia areata is necessary to identify the potential therapeutic targets. <br />Key words: alopecia areata, pathogenesis, immune privilege.https://smj.journals.ekb.eg/article_164853_89d17f6ba9d95745ae056ee083e2c366.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Superficial Cryotherapy, Does It Work In Alopecia Areata?424616486210.21608/smj.2021.66567.1231ENZeinab Abu BahaGoudadepartment of dermatology, faculty of medicine, Sohag university, SohagEssamNadaDepartment of Dermatology, Venereology and Andrology , Faculty of Medicine, Sohag University, SohagHanan AbdlRadiAssafDepartment of dermatology, Venereology and Andrology, Faculty of Medicine, sohag university, SohagSoha HishmatAboeldahabDepartment of dermatology, Venereology and Andrology, Faculty of Medicine, sohag university.Journal Article20210306Abstract:<br />Alopecia areata is a common cause of nonscarring alopecia, with patchy, confluent or diffuse patterns, involving mainly the scalp and other hairy areas of the body. It's considered a therapeutic challenge due to prognosis, unpredictable course and variable efficacy of available therapies. Several studies have evaluated the efficacy of cryotherapy in the treatment of alopecia areata with varying success rates.<br />Superficial cryotherapy using liquid nitrogen mainly was used in several studies for treating alopecia areata with various subtypes including mild, moderate and recalcitrant alopecia areata, and alopecia totalis with variable rates of therapeutically accepted terminal hair regrowth. Its main mechanisms of efficacy in alopecia areata are vascular changes and immunomodulation. <br />Superficial cryotherapy was effective and safe in treating alopecia areata of the eyebrows. It was nearly as effective as topical steroids and topical PUVA therapy, and was combined with topical immunotherapy and topical steroid with increased efficacy. It's well-tolerated, convenient and simple office-based procedure, especially in children who are susceptible to side effects of other conventional therapeutic options.<br />The reported side effects of superficial cryotherapy included vesiculation, erosion, crust formation, transient pigmentary alteration and partial leukotrichia, however they were transient. <br />Key words: alopecia, cryotherapy, liquid nitrogenhttps://smj.journals.ekb.eg/article_164862_80dddcfd8490e0b65031c21982f7591e.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Management of Hospitalized cases with Recurrent Epistaxis at sohag UniversityHospital475316486610.21608/smj.2021.61594.1225ENKamarElsayedENT.Medicine.sohag.egyptAbdelmatinMousaENT department, Faculty of medicine, Sohag universityIbrahimRezkENT department, faculty of medicine, sohag universityWaleadMohamedENT.faculty of medicine.sohag universityJournal Article20210218Abstract<br />Introduction: Epistaxis is a common problem that ranges from a minor nuisance to a life-threatening emergency. Multiple modalities exist to treat anterior and posterior bleeding and sometimes more than one treatment must be used. Otolaryngologists must be prepared to deal with severe or refractory bleeding through the use of medications, packing materials, and radiologic or surgical interventions.<br />Methods: This study is a descriptive prospective study that started with 137 patients presented with recurrent epistaxis selected to analyszes etiology and different methods of interventions in management, during the period from January 2016 to June 2017 at Sohag University Hospital.<br />Results: The mean age of patients in our study was 42.1 years, with a little male predominance (53%) and 62% of cases had unilateral bleeding. Regarding the cause of epistaxis, 35,77% of cases of had general causes; 27,01% had local causes; 5,11% had amedication-related bleeding and 32,12% were idiopathic.<br />Regarding management, 48.88% of cases showed a response to anterior nasal pack, 30.66%to conservative treatment and 6.75% to sphenopalatine artery ligation.<br />Conclusion: Recurrent epistaxis in hospitalized patient is a common emergency condition in Otorhino-laryngology; affecting people of any age. Conservative methods; especially nasal packing are effective to arrest epistaxis in most of the patients; especially if the source is anterior bleeding. Surgical intervention is needed in resistant cases.https://smj.journals.ekb.eg/article_164866_5f6ae3c9a8549e0ee69175ce5ef169b6.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401FEASIBILITY AND EFFECTIVENESS OF RETROSIGMOID APPROACH IN VESTIBULAR SCHWANNOMA SURGERY546118076510.21608/smj.2021.73986.1247ENMohamedTawfikNeurosurgery Department, Faculty of Medicine, Sohag UniversityWalid KhalafAbouzeidDepartment of Neurosurgery, Faculty of Medicine, Sohag University, Sohag City, Sohag Governorate, EgyptMohamed AhmedAbdelaalDepartment of Neurosurgery, Faculty of Medicine, Sohag University, Sohag City, Sohag Governorate, EgyptMagda MohamedAliPublic health and Community medicine,Sohag University,EgyptJournal Article20210427FEASIBILITY AND EFFECTIVENESS OF RETROSIGMOID APPROACH IN VESTIBULAR SCHWANNOMA SURGERY<br /><br />Purpose: To assess the feasibility and effectiveness of the lateral suboccipital retrosigmoid approach in the surgical management of vestibular schwannoma.<br /><br />Materials and Methods: We conducted a prospective hospital-based case series conducted on 356 patients during the period from May 2018 to May 2020 in collaboration with the neurosurgery department, "Sohag University hospital", and "Tokyo Medical University Hospital". Patients included who were undergoing surgical intervention for vestibular schwannoma (VS) through retrosigmoid approach. All patients in our study were followed up for a minimum of four months. For each patient intraoperative tumor resection volume was recorded, postoperative complications, facial and cochlear nerve functions were assessed.<br /><br />Results: Enrolled in this study 356 cases, the majority (54.8%) of patients were females; while (45.2%) were males were included with a mean age (42.57 ± 12.3) years. We achieved a mean follow-up of 6.2 months; ranging (4-9 months). Postoperative scoring of facial nerve function was a good outcome in 79.4%, fair outcome in 17.5%, and poor outcome in 3.1%.<br /><br />Conclusion: We assessed the results of surgery using a retrosigmoid approach in 356 patients with VS. Surgical management of VS using retrosigmoid approach is safe and effective but after the advancement of microsurgical techniques like drilling and neurophysiological monitoring especially for seventh and eighth cranial nerves, the possibility of preserving the facial and cochlear functions became more feasible with excellent results.https://smj.journals.ekb.eg/article_180765_639bcc2c76e3a48b9f4f71991cdb9226.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Association of common variants in the IGF2BP2 gene with type 2 diabetes626918077310.21608/smj.2021.67655.1237ENWaelAliClinical Pathology, faculty of medicine, sohag university, sohag, EgyptJournal Article20210428Background: Common Variants in insulin-like binding protein 2 (IGF2BP2) gene to be associated with type 2 diabetes (T2DM) by several genome-wide association studies and replication analyses. This study aimed to determine the association of IGF2BP2 variants rs4402960 and rs1470579 with T2DM in Egyptian people.<br />Methods: This study involved 50 T2DM patients and 50 control subjects. Genotyping of SNPs in (IGF2BP2) gene (rs1470579) and (rs4402960) variants using Real-time PCR.<br />Results: In this study, using logistic regression of this additive model of SNP rs4402960, the presence of homozygous variant allele (TT) genotype carries a 3 fold risk of DM with an odds ratio (OR) of 3.28 (p = 0.095), and homozygous variant allele (CC) genotype of SNP rs1470579 carries a 5 fold risk of DM with OR of 5.44 (p = 0.011). Using the dominant model, the two IGF2BP2 variants carry a high risk of DM. Meanwhile, using the recessive model only SNP rs1470579 carries a risk near 3 fold risk of DM.<br />Conclusions: This study shows that IGF2BP2 susceptibility variants rs4402960 and rs1470579 are associated with T2DM in Egypt.https://smj.journals.ekb.eg/article_180773_b6e03344d286dcc50b03897805247b0b.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Evaluation of clients and care providers Satisfaction from provided services of Movable clinics, Rural Sohag; Sohag governorate-Upper Egypt.708318077810.21608/smj.2021.75669.1251ENMagda MohamedAliPublic health and Community medicine,Sohag University,EgyptJournal Article20210509Background: In Egypt, the "Mobile Clinics" project has started in 1997 to provide many services including non-fee family planning/reproductive health services. Higher patient satisfaction is central to the success of any healthcare system. Objective: To assess client satisfaction with mobile clinics at Elbelina district - Upper Egypt aiming to improve the services introduced by it. Methods: This descriptive cross-sectional study was conducted on 428 clients who attended the mobile clinics in El-Baliana district (Sohag) during the period January–June 2020 and fulfilled inclusion and exclusion criteria. A questionnaire was designed to assess the satisfaction of clients with the services provided by mobile clinics and the enrolled participants were interviewed by well-trained interviewers in the mobile clinics during the scheduled break times. Results: 74.8% of the enrolled clients were females and 83.2% of them were married. 79.4% of the visits were repeated, 75.9% of them were non-scheduled and 53% of clients attended the mobile clinics for family planning services. A statistically significant association was found between sex and satisfaction level of registration services as well as health insurance office. Changes in residency were associated with statistically significant changes in the satisfaction levels of reception services, the satisfaction of the levels of attention and professionalism of the nursing staff, and satisfaction of the attention and professionalism of the physician. Conclusion: This indicates that the mobile clinic service represents an important model for the delivery of healthcare to communities in geographically and topographically inaccessible areas. Keywords: Mobile clinics; Client satisfaction.https://smj.journals.ekb.eg/article_180778_2e31b3299d344f3dd89dc737db7c7409.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401A New Synthetic Cannabinoid Substance, AB-CHMINACA: Review Article849219260610.21608/smj.2021.74742.1249ENRasha Elhaddad AliMousaDepartment of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Sohag University, Sohag, Egypt.0000-0003-3583-0293Sahar MohamedGebrilDepartment of Histology, Faculty of Medicine, Sohag University, Sohag, EgyptKhaled Masoud MohamedMasoudDepartment of Forensic Chemistry, Naif Arab University for Security Sciences, Riyadh, Saudi ArabiRania AhmadRadwanDepartment of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Sohag University, Sohag, EgyptSoheir AliMohammadDepartment of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, sohag University, Sohag, EgyptJournal Article20210503The synthetically new illicit drugs which are called New psychoactive substances (NPS) are the calamity of the modern era. Their danger is much more than the natural drugs of abuse and at the same time, they cannot be detected on regular drug screens making diagnosis very difficult. The number of NPS is growing very fast making their detection more complicated. Another challenge is that their health effects are not well studied and cannot be predicted. Synthetic cannabinoids (SCs) are the most prevalent group in all available NPS. One recent member of the SCs group is AB-CHMINACA. This review article summarizes the available data about AB-CHMINACA. The obtained data were summarized under the following subtitles; historical background, chemical structure, classification, physical characters, pharmacokinetics and pharmacodynamics, toxicity, methods of detection, the magnitude of the problem, and the situation in Egypt. The reviewed studies reveal that AB-CHMINACA like other SC substances are considered toxic with high liability for dependence. Most of the available studies are case reports. The available literature is lacking in specific organ pathology and well-structured toxicity studies.https://smj.journals.ekb.eg/article_192606_e15d5f633a36581e070e167f8be6057b.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401Comparative study between the effect of aspartame and stevia on the Purkinje cells of the cerebellar cortex of albino rats. (electron microscopic study)939919253010.21608/smj.2021.72094.1244ENAsmaa SabryBassitanatomy department ,faculty of medicine sohage university,sohageAsmaa MohammedKhalafforensic medicine and clinical toxicology, faculty of medicine, sohag universityAlshimaa HafezAbdelallbiochemistry department ,faculty of medicine sohage university,sohageHasnaa AhmedAlidepartment of a forensic medicine and clinical toxicology, faculty of medicine , sohag universityZahra MohamedIsmaelAnatomy department faculty of medicin sohag university sohag egyptJournal Article20210430Abstract:<br />Introduction: use of sweetener natural or artificial is widely used and appeared to harm the structure of the cerebellar cortex <br />Aim of the work: comparison between the effect of aspartame and stevia on the Purkinje cells of the cerebellar cortex of albino rats.<br />Material and methods: A total of 30 adult male albino rats were used The animals were divided into Group I (Control): received distilled water, Group II (ASP treated): which received aspartame (ASP), which is given at a daily dose 250 mg/kg dissolved in distilled water for 4 weeks. <br />Group III (stevia treated): This received Stevia at a daily dose of 250mg/kg given orally by intragastric tube for 4 weeks. The rats' offspring from each of the groups were randomly selected, sacrificed then their skulls were <br />opened and their cerebellar tissues were taken for transmission electron microscope study.<br />Result: aspartame affected the Purkinje cells where it becomes a shrunken loss of its piriform appearance also in the stevia-treated group, the Purkinje cells lost their piriform shape with ill define cytoplasm and nuclei while Some Purkinje cells appeared normal.Conclousion: Stevioside and aspartame appeared to have a harmful effect on the structure of the purkinji cells of cerebellar cortex.https://smj.journals.ekb.eg/article_192530_ebdd7e78115ced44196841bfa9c5625d.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401The relation of systemic lupus erythematosus activity and histopathology of renal biopsy10010519361510.21608/smj.2021.74553.1248ENRanaSaad-eldinDepartment of rheumatology and rehabilitation, Sohag faculty of medicine, Sohag universityNehalFathyRheumatology &amp; rehabilitation department , assiut faculty of medicine , assiut universityAfaf TahaEl-NasharDepartment of Pathology, Faculty of Medicine, Sohag/0000-0003-1079-2112Esam MohammedAbo Al-FadlDepartment of Internal Medicine and Department of Rheumatology, Rehabilitation and Physical medicine,Faculty of Medicine- Sohag University.Journal Article20210506Background: About 50% of patients with systemic lupus erythematosus (SLE) develop lupus nephritis during the course of their disease. Up to 10% of these patients reach the end-stage renal disease.<br />Purpose: Detection of the relationship between the activity of systemic lupus erythematosus (SLE) and histopathology of renal biopsy.<br />Patients and methods: This study is cross- sectional and observational. It included one hundred Egyptian patients with SLE according to the 2015 ACR/SLICC Revised criteria. SLE Disease Activity Index (SLEDAI) and renal biopsy were done to all patients in addition to the routine investigations.<br />Results: Of the one hundred patients; 9 were males and 91 were females with a mean age ± standard deviation of 32.28 ± 9.59 years and a median of 31.5 years. The mean value SLEDAI was 11.92 ± 3.92. Lupus nephritis (LN) was found in 85 patients (85%) with 5 patients (5%) having class 1, 73 patients (73%) having class 2 and 7 patients (7%) having class3 LN. <br />Conclusion: Ther relationship between the SLEDAI score and the histopathological study of renal biopsy in patients with SLE is strong and significant with a mean value of SLEDAI directly proportional to the class of LN.https://smj.journals.ekb.eg/article_193615_a1c9dcd59b59067288dc6330502c7192.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401New concepts in pathogenesis of primary immune thrombocytopenia10611119361910.21608/smj.2021.78054.1255ENHesham M.Hefneychemical and clinical pathology , faculty of medicine , Sohag university , Sohag , SohagDoaa S.M.Bardisclinical and chemical pathology department faculty of medicine sohag universityHasnaa A.Aboalwafaclinical and chemical pathology department, medical faculty, sohag university , sohagHeba A.Ahmedclinical and chemical pathology faculty of medicine sohag universityJournal Article20210605Primary immune thrombocytopenia (ITP) is a common condition characterized by a low peripheral platelet count (100000/L) caused by cell-mediated and humoral-mediated destruction of the platelet. Immunological tolerance to platelet antigens is lost in these patients. The main step in the pathogenesis includes the overactivation of T-cells, particularly T-helper cells, the release of various cytokines, and the interaction of autoantibodies with platelet surface antigens, which results in platelet destruction by the immune system in the spleen. The most common PLT antigens against which autoantibodies are directed are CD41 and CD61. These antigens are occupied by autoantibodies so there is decreased detection of these antigens on the surface of platelets. PD1 is an important negative stimulatory molecule of the immune system a member of CD28/B7 family. ITP patients have considerably increased levels of PD-1 on CD4+T- cells in their peripheral blood than healthy people., indicating that the PD1 molecule plays an important role in illness etiology.<br />Abbreviations: ITP: Primary immune thrombocytopenia, PD1: programmed death 1.https://smj.journals.ekb.eg/article_193619_fc5e2ef23102631f1ca4160bd526c020.pdfSohag University; Faculty of MedicineSohag Medical Journal1687-835325220210401The Impact of Programmed Death-1 on Immune Thrombocytopenia11212019362510.21608/smj.2021.78198.1256ENHasnaa A.Aboalwafaclinical and chemical pathology department, medical faculty, sohag university , sohagDoaa S.M.Bardisclinical and chemical pathology department faculty of medicine sohag universityHeba A.Ahmedclinical and chemical pathology faculty of medicine sohag universityHesham M.Hefneychemical and clinical pathology , faculty of medicine , Sohag university , Sohag , SohagAhmed A.Allamclinical and chemical pathology faculty of medicine sohag universityJournal Article20210605Abstract: <br />Background programmed death (PD-1) has an important role in inhibiting the immune system in immune thrombocytopenic purpura (ITP) by switching off auto-reactive T-cells. This work aims to assess the expression of (PD)-1 negative co-stimulatory molecule in patients with ITP and to detect its relation with platelet count. Patient and methods, forty patients were newly diagnosed as ITP 13 males and 27 females were included, their age ranged from 1 to 43 years and twenty-six healthy subjects 8 males and 18 females as control group their age ranged from 5 to 62 year. Expression of PD-1+ CD4+ T-cells by B.D FACS Calibur flow cytometry was performed in ITP patients and healthy subjects on peripheral blood samples, Mo Abs supplied by BD Bioscience, United States. PD-1 FITC Lot: GR 145543-6 and CD4 PE Cat: 555347, San Jose, California. Negative mouse isotypic control (PE Lot: 0279236, FITC Lot: 0273533). Results, percentages of PD-1 on CD4+T cells in peripheral blood from patients with ITP were considerably higher than that from healthy subjects (p < 0.001), it has no predictive risk for thrombocytopenia Odd's ratio ( 3.773 ) p ( 0.187), CI ( 0. 525 – 27.09). Conclusion: Increased expression of PD-1 molecule on CD-4 T-cells as inhibitory signals to the activated immune system against self-antigens an important part of ITP pathogenesis. Has no predictive role in the degree of thrombocytopenia.https://smj.journals.ekb.eg/article_193625_77b9fef840f9175ccc27cd2461b9298c.pdf