AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PD...AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.展开更多
AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepato-cellular carcinoma(FL-HCC)over a 15-year period. METHODS This is a retrospective study including 22 pati...AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepato-cellular carcinoma(FL-HCC)over a 15-year period. METHODS This is a retrospective study including 22 patients with a pathologic diagnosis of FL-HCC who underwent hepatectomy over a 15-year period. Tumor characteristics,survival and recurrence were evaluated. RESULTS There were 11 male and 11 female with a median age of 29 years(range from 21 to 58 years). Two(9%)patients had hepatitis C viral infection and only 2(9%)patients had alpha-fetoprotein level > 200 ng/m L. The median size of the tumors was 12 cm(range from 5-20 cm). Vascular invasion was detected in 5(23%)patients. Four(18%)patients had lymph node metastases. The median follow up period was 42 mo and the 5-year survival was 65%. Five(23%)patients had a recurrent disease,4 of them had a second surgery with 36 mo median time interval. Vascular invasion is the only significant negative prognostic factor CONCLUSION FL-HCC has a favorable prognosis than common HCC and should be suspected in young patients with non cirrhotic liver. Aggressive surgical resection should be done for all patients. Repeated hepatectomy should be considered for these patients as it has a relatively indolent course.展开更多
A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid pr...A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid profile of freshwater prawn, Macrobrachium rosenbergii post-larvae （PL）. The experiment was conducted in cubic indoor fiberglass tanks, each holding 700 L in triplicate. Post-larvae with an average weight of 20.8 ± 0.20 mg were stocked at 80 PL m2. Five experimental isocaloric （15.06 MJ kgl digestible energy）, and isonitrogenous （30.45% digestible protein） diets were formulated by blending of soybean oil and linseed oil to containing five dietary LA/LNA ratios （7.80, 2.75, 1.28, 0.65 and 0.30）. The highest survival values were recorded for prawn PL fed diet containing 0.65 LA/LAN ratios. Growth indices of PL significantly increased （P 〈 0.05） with decreased dietary LA/LAN ratios to 0.65. The same trend was observed for the highest （P ≤ 0.05） protein efficiency ratio, protein productive value, fat retention, energy retention and best feed conversion ratio. The total whole tissue polyunsaturated fatty acid composition of M. rosenbergii PL was dominated by LA followed by LAN. Post larvae fed the diets containing higher LA/LNA ratios showed a higher tissue LA/LNA ratio. The obtained findings revealed that fatty acid patterns ofM. rosenbergii PL were influenced by fatty acid profiles of diets. The diet containing 0.65 LA/LNA ratio is recommended to obtaining optimum growth performance and feed utilization for M. rosenbergii PL.展开更多
AIMTo detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODSThis is a prospective cohort study of all patients who...AIMTo detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODSThis is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTSThe study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients. Overall, PEP occurred in 102 (10.2%) patients of the study population; eighty (78.4%) cases were of mild to moderate degree, while severe pancreatitis occurred in 22 (21.6%) patients. No hospital mortality was reported for any of PEP patients during the study duration. Age less than 35 years (P = 0.001, OR = 0.035), narrower common bile duct (CBD) diameter (P = 0.0001) and increased number of pancreatic cannulations (P = 0.0001) were independent risk factors for the occurrence of PEP. CONCLUSIONPEP is the most frequent and devastating complication after ERCP. Age less than 35 years, narrower median CBD diameter and increased number of pancreatic cannulations are independent risk factors for the occurrence of PEP. Patients with these risk factors are candidates for prophylactic and preventive measures against PEP.展开更多
AIM:To determine predictors of long term survival after resection of hilar cholangiocarcinoma(HC) by comparing patients surviving > 5 years with those who survived < 5 years.METHODS:This is a retrospective study...AIM:To determine predictors of long term survival after resection of hilar cholangiocarcinoma(HC) by comparing patients surviving > 5 years with those who survived < 5 years.METHODS:This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center,Mansoura University,Egypt between January 2002 and April 2013.All data of the patients were collected from the medical records.patients were divided into two groups according to their survival:patients surviving less than 5 years and those who survived > 5 years.RESULTS:There were 34(14%) long term survivors(5 year survivors) among the 243 patients.Fiveyear survivors were younger at diagnosis than those surviving less than 5 years(mean age,50.47 ± 4.45 vs 54.59 ± 4.98,p = 0.001).Gender,clinical presentation,preoperative drainage,preoperative serum bilirubin,albumin and serum glutamic-pyruvic transaminase were similar between the two groups.The level of CA 19-9 was significantly higher in patients surviving < 5 years(395.71 ± 31.43 vs 254.06 ± 42.19,p = 0.0001).Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year,includingyoung age(p = 0.001),serum CA19-9(p = 0.0001),non-cirrhotic liver(p = 0.02),major hepatic resection(p = 0.001),caudate lobe resection(p = 0.006),well differentiated tumour(p = 0.03),lymph node status(0.008),R0 resection margin(p = 0.0001) and early postoperative liver cell failure(p = 0.02).CONCLUSION:Liver status,resection of caudate lobe,lymph node status,R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival.展开更多
Background: Pancreaticoduodenectomy(PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival( ≥ 5 years) after PD. Methods...Background: Pancreaticoduodenectomy(PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival( ≥ 5 years) after PD. Methods: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group(I) patients who survived less than 5 years and group(II) patients who survived ≥ 5 years. Results: There were 47(20.6%) long-term survivors( ≥ 5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31(66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include age < 60 years old, serum CEA < 5 ng/mL, serum CA 19-9 < 37 U/mL, non-cirrhotic liver, tumor size < 2 cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9 < 37 U/mL [OR(95% CI) = 1.712(1.24 8–2.34 8), P = 0.001], smaller tumor size [OR(95% CI) = 1.335(1.032–1.726), P = 0.028] and R0 resection [OR(95% CI) = 3.098(2.095–4.582), P < 0.001] were independent factors for survival ≥ 5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%. Conclusions: The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9 < 37 U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survival ≥ 5 years.展开更多
AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft...AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.展开更多
AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones...AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones(CBDS).METHODS: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram(TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven CBDS.RESULTS: Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases(84.2%) where removal of stones were successful; passed stones in 6 cases(7.9%); short lower end stricture with small stones present in two cases(2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case(1.3%) which was treated by open hepaticojejunostomy; and one case(1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled. CONCLUSION: The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options.展开更多
Alzheimer’s disease(AD)is the most common neurodegenerative disorder characterized by slow and progressive decline of cognitive and memory functions.In only approximately 5%of the cases,AD is familial,as often predis...Alzheimer’s disease(AD)is the most common neurodegenerative disorder characterized by slow and progressive decline of cognitive and memory functions.In only approximately 5%of the cases,AD is familial,as often predisposed by genetic mutations(Hoogmartens et al.,2021),while sporadic AD accounts for approximately 95%of the cases.The amyloid cascade hypothesis is one of the fundamental hypotheses put out to explain AD pathogenesis as dysregulated homeostasis of amyloid-β(Aβ)peptides that leads to the accumulation of Aβplaques in the parenchyma,an anatomical hallmark of AD.展开更多
The global incidence of coronavirus disease 2019(COVID-19)continues to increase despite health care efforts.The disease is caused by coronavirus 2 with high transmission and mortality rates.Little is known about the m...The global incidence of coronavirus disease 2019(COVID-19)continues to increase despite health care efforts.The disease is caused by coronavirus 2 with high transmission and mortality rates.Little is known about the management of COVID-19 in advanced liver disease.The aim of work was to propose a plan for management of this drastic disease in case of this specific population with review of medications that could be suitable for advanced liver disease.All the guidelines and medications available for treatment of COVID-19 were reviewed with selection of the less toxic medications that could be used in advanced liver disease.Drugs suitable to manage COVID-19 in patients with liver disease might include remdesivir intravenously,nitazoxanide+sofosbuvir,ivermectin,tocilizumab,convalescent plasma,and low molecular weight heparin in certain situations.Advanced liver disease is associated with portal hypertension and splenomegaly with reduction of blood elements and immune dysfunction and impaired T cell function.Thus,when confronted by cytokine storm as an immune response to COVID-19,there may be an increase in the mortality rate of these patients.Through this review,a plan to treat COVID-19 in this special group of patients with advanced cirrhosis is proposed.展开更多
The aim of the present study was to design and evaluate single pulse and floating double pulse valsartan core-in-cup tablets.Core tablets were prepared by direct compression of a homogenous mixture of valsartan,Avice...The aim of the present study was to design and evaluate single pulse and floating double pulse valsartan core-in-cup tablets.Core tablets were prepared by direct compression of a homogenous mixture of valsartan,Avicel PH-101,Croscarmellose sodium(CCNa),magnesium stearate&Aerosil.Weight variation,Hardness and Disintegration time were measured for the core tablets.Core-in-cup tablets were formulated using different polymers as a plug layer,including sodium alginate(SA),sodium carboxymethylcellulose(NaCMC)and hydroxypropyl methyl cellulose(HPMC).The floating behavior,water uptake and drug release from the prepared formulations were evaluated.Differential Scanning Calorimetry(DSC)was also performed to detect the possible drug excipient interaction.Stability study of the selected formula was performed at 25C&60%RH and at 40C&75%RH for 3 months.Finally,the existence of the selected formula in the stomach after oral administration to human volunteers was verified via x-ray radiography.The results showed that the release lag time of the tablets increased when the quantity of the plug layer increased thus decreasing the drug release.Plug layer polymers showed a lag time with rank order:SA<NaCMC<HPMC.Selected formulations are F5&F6.F5(having SA as the plug polymer)released valsartan after a lag time of 2 h while F6 released the drug in two successive pulses with a reasonable lag time in between due to its floating behavior.Formulations were stable for at least 3 months under standard long-term and accelerated storage conditions.In conclusion,pulsatile single pulse and floating double pulse stable valsartan core-incup tablets were successfully formulated which provided a desirable lag time followed by a rapid drug release.展开更多
BACKGROUND： Although the mortality and morbidity of pancreaticoduodenectomy（PD） have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the f...BACKGROUND： Although the mortality and morbidity of pancreaticoduodenectomy（PD） have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly patients.METHODS： We studied all patients who had undergone PD in our center between January 1995 and February 2015. The patients were divided into three groups based on age： group I（patients aged 〈60 years）, group II（those aged 60 to 69 years） and group III（those aged ≥70 years）. The primary outcome was the rate of total postoperative complications. Secondary endpoint included total operative time, hospital mortality, length of postoperative hospital stay, delayed gastric emptying, re-exploration, and survival rate.RESULTS： A total of 828 patients who had undergone PD for resection of periampullary tumor were included in this study. There were 579（69.9%） patients in group I, 201（24.3%） in group II, and 48（5.8%） in group III. The overall incidence of complications was higher in elderly patients（25.9% in group I, 36.8% in group II, and 37.5% in group III; P=0.006）. There were more patients complicated with delayed gastric emptying in group II compared with the other two groups. There was no significant difference in the incidence of postoperative pancreatic fistula, biliary leakage, pancreatitis, pulmonary complications and hospital mortality.CONCLUSIONS： PD can be performed safely in selected elderly patients. Advanced age alone should not be a contraindication for PD. The outcome of elderly patients who have undergone PD is similar to that of younger patients, and the increased rate of complications is due to the presence of associated comorbidities.展开更多
<b><span style="font-family:""><span style="font-family:Verdana;">Back</span><span style="font-family:Verdana;">ground:</span></span></b&...<b><span style="font-family:""><span style="font-family:Verdana;">Back</span><span style="font-family:Verdana;">ground:</span></span></b><span style="font-family:""> <i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassaemia (</span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-Thal) is an inherited chronic haemoly</span></span><span style="font-family:""><span style="font-family:Verdana;">tic anaemia resulting from absent or low level of synthesis of </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-globin chains of haemoglobin A in erythropoietic cells. The complement system is an important part of innate immune response that may be implicated in red blood cell (RBC) lysis. Mammalian cells are provided with surface bound complement regulatory proteins (MCRPs) that regulate the activation of complement cascade, thus protecting them from uncontrolled complement-mediated lysis. Objective is to evaluate the role of complement regulatory proteins (CD55, CD59, and CD35) on red blood cells, and to explain the pathogenesis of anaemia in </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassemia major. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This case-control study enrolled 74 </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;"> thalassemia major patients who were compared with 40 age and sex matched controls. We performed expression of CD55, CD59, and CD35 on RBCs using flow cytometry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> CD55 levels of </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassemia major patients (79.78% ± 18.54%) were significantly decreased compared to healthy controls (99.45% ± 0.59%) (P < 0.001). CD59 levels of </span><i><s展开更多
Transient current (I-t), current-voltage (I-V) characteristics, and dc conductivity ln(σ) for bisphenol A corn-cobs (BPACC) sample were investigated. At higher temperatures, I-V characteristics reveal that the dc cur...Transient current (I-t), current-voltage (I-V) characteristics, and dc conductivity ln(σ) for bisphenol A corn-cobs (BPACC) sample were investigated. At higher temperatures, I-V characteristics reveal that the dc cur-rent for the sample undergoes two regions one due to ohmic conduction and the other has been attributed to Space charge limited current (SCLC). The activation energy (Ea), the electron mobility μo), effective electron mobility ?μe), the concentration of the charge’s concentrations in conduction band, trapping factor (θ) and the trap concentration (Nt) were calculated. At lower temperatures, the dc current exhibits a peculiar behavior for I-t regime and I-V characteristics. Transient current of BPACC sample exhibits approximately constant value at constant electric field and it has saturation value for I-V characteristics. The attained results suggest strongly the applicability of this material in the electrical applications.展开更多
No standardized description or definition of post-hepatectomy liver failure has been introduced.Definitions based on the degree of rise in serum total bilirubin or prolongation of prothrombin time postoperatively were...No standardized description or definition of post-hepatectomy liver failure has been introduced.Definitions based on the degree of rise in serum total bilirubin or prolongation of prothrombin time postoperatively were predictive of shortterm mortality.Due to lack of universal definition,however,its prevalence is variable but may reach up to 12%posthepatectomy,according to the definition by International Study Group of Liver Surgery,and or 34%,as in some reports.展开更多
The entropy per rapidity dS/dy produced in central Pb-Pb ultra-relativistic nuclear collisions at LHC energies is calculated using experimentally identified particle spectra and source radii estimated from Hanbury Bro...The entropy per rapidity dS/dy produced in central Pb-Pb ultra-relativistic nuclear collisions at LHC energies is calculated using experimentally identified particle spectra and source radii estimated from Hanbury Brown-Twiss (HBT) correlations for particles π, k, p, Λ, Ω, and ∑ and π, k, p, Λ, and K^(0)_(s) at √s =2.76 and 5.02 TeV, respectively. An artificial neural network (ANN) simulation model is used to estimate the entropy per rapidity dS/dy at the considered energies. The simulation results are compared with equivalent experimental data, and a good agreement is achieved. A mathematical equation describing the experimental data is obtained. Extrapolation of the transverse momentum spectra at pT =0 is required to calculate dS/dy;thus, we use two different fitting functions, the Tsallis distribution and hadron resonance gas (HRG) model. The success of the ANN model in describing the experimental measurements leads to the prediction of several spectra values for the mentioned particles, which may lead to further predictions in the absence of experiments.展开更多
This paper presents the modification occurred to the dielectric strength feature of low density polyethylene compounded with nano magnesia(LDPE/MgO).MgO nanoparticles were prepared using sol-gel technique,MgO filler s...This paper presents the modification occurred to the dielectric strength feature of low density polyethylene compounded with nano magnesia(LDPE/MgO).MgO nanoparticles were prepared using sol-gel technique,MgO filler surface was functionalized to improve the interfacial bonding.Specimen’s groups of composites with different filler concentrations were fabricated by mix blend method.Samples exposed to various salinity media by immersion,dielectric strength test was applied on each set according to relevant ASTM standard with identical testing technique.The results were statistically processed then compared to the pristine material.Tests results utilized to learn Artificial Neural Network in order to acquire the value of dielectric strength of compounds having similar composition but containing different doping amounts or influenced with various salinity level media.The dielectric strength is enhanced by the addition of MgO nanofiller.From the investigation of the obtained results,it is concluded that additives of 1.4%filler concentration by weight is the optimum MgO content for LDPE/MgO nanofiller material.We think that this paper may promote a good researching methodology that gather both empirical work and numerical tools in this field.展开更多
The present study was conducted to evaluate the effect of either individual or combined wheat bran(WB) replacement with Azolla pinnata supplemented with Digestin^(TM) in the diet of freshwater prawn, Macrobrachium ros...The present study was conducted to evaluate the effect of either individual or combined wheat bran(WB) replacement with Azolla pinnata supplemented with Digestin^(TM) in the diet of freshwater prawn, Macrobrachium rosenbergii Postlarvae(PL) on growth performance, nutrient utilization, chemical body composition and survival(%). Experimental diets were a wheat bran-soybean based diet with no Azolla and Digestin^(TM)(control, T_1), and diets containing 17% Azolla supplemented with Digestin^(TM) 0%(T_2), 1%(T_3), 2%(T_4) and 3%(T 5). Each experimental diet was allocated into three tanks(6 m^3/tank) fed for 12 wks. Each tank was subdivided into three equal pens by nets(2 m^3) and stoked with 84 PL/m^2. The experimental diets were readily consumed by prawns PLs where both high growth and good feed efficiency were achieved for all diets. The results showed that the diets containing A. pinnata supplemented with Digestin? at the level up to 3% have the higher growth and better nutrient utilization than the control diet. No differences were observed for moisture and protein content among the experimental diets. However, the highest protein content was observed on prawns fed on diets T_1 and T 5 respectively, while the lowest value was recorded for T_4 diet. The results also show that prawn PLs fed the diets contain A. pinnata and supplemented with Digestin^(TM) recorded the highest values of body lipid content compared to the control diet. Feed efficiency and economic conversion rate(ECR) values show that economic performance and the cost-effectiveness of the A. pinnata supplemented with up to 3% Digestin^(TM) recorded the highest net return, and therefore it is recommended for prawn, M. rosenbergii PL's. These results are clearly indicating that A. pinnata have a good potential for use in prawn diets at reasonable levels than other conventional diets.展开更多
Background: Early promotion of hepatitis B (HB) vaccination among health care workers is an important component of the HBV infection control. No available data assess immune response of HB vaccination among Egyptian m...Background: Early promotion of hepatitis B (HB) vaccination among health care workers is an important component of the HBV infection control. No available data assess immune response of HB vaccination among Egyptian medical students. Objective: we conducted this study to evaluate the immune response among medical students after completion of their vaccination schedule. Methods: A total of 150 Egyptian medical students were included. Three doses of recombinant HB vaccine had been administered to all participating students at 0, 1 and 6 months. Antibody to hepatitis B surface antigen (Anti-HBs) titers, hepatitis B surface antigen (HBsAg), and total antibody to hepatitis B core antigen (anti-HBc) were measured by enzyme immunoassay, 1 to 2 months after completion of vaccination course. Results: Among 150 students included, the mean age was 22.4 ± 1.7 years (range 18 - 28 years). Fifty nine (39.4%) were males and 91 (60.6%) were females. All students have anti-HBs levels more than 100 IU/L. The mean anti-HBs of included students was 8994.2 ± 6373.1 IU/L. There was no significant difference of anti-HBs levels regarding age, sex, residence or body mass index distribution. Conclusion: Early HB vaccination of health care workers is associated with good immune response and should be encouraged.展开更多
文摘AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.
文摘AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepato-cellular carcinoma(FL-HCC)over a 15-year period. METHODS This is a retrospective study including 22 patients with a pathologic diagnosis of FL-HCC who underwent hepatectomy over a 15-year period. Tumor characteristics,survival and recurrence were evaluated. RESULTS There were 11 male and 11 female with a median age of 29 years(range from 21 to 58 years). Two(9%)patients had hepatitis C viral infection and only 2(9%)patients had alpha-fetoprotein level > 200 ng/m L. The median size of the tumors was 12 cm(range from 5-20 cm). Vascular invasion was detected in 5(23%)patients. Four(18%)patients had lymph node metastases. The median follow up period was 42 mo and the 5-year survival was 65%. Five(23%)patients had a recurrent disease,4 of them had a second surgery with 36 mo median time interval. Vascular invasion is the only significant negative prognostic factor CONCLUSION FL-HCC has a favorable prognosis than common HCC and should be suspected in young patients with non cirrhotic liver. Aggressive surgical resection should be done for all patients. Repeated hepatectomy should be considered for these patients as it has a relatively indolent course.
文摘A 90-day experiment was conducted to investigate the effects of different dietary linoleic acid （LA; 18：2n-6） and linolenic acid ratios （LNA; 18：3n-3） on growth induces, feed utilization and tissue fatty acid profile of freshwater prawn, Macrobrachium rosenbergii post-larvae （PL）. The experiment was conducted in cubic indoor fiberglass tanks, each holding 700 L in triplicate. Post-larvae with an average weight of 20.8 ± 0.20 mg were stocked at 80 PL m2. Five experimental isocaloric （15.06 MJ kgl digestible energy）, and isonitrogenous （30.45% digestible protein） diets were formulated by blending of soybean oil and linseed oil to containing five dietary LA/LNA ratios （7.80, 2.75, 1.28, 0.65 and 0.30）. The highest survival values were recorded for prawn PL fed diet containing 0.65 LA/LAN ratios. Growth indices of PL significantly increased （P 〈 0.05） with decreased dietary LA/LAN ratios to 0.65. The same trend was observed for the highest （P ≤ 0.05） protein efficiency ratio, protein productive value, fat retention, energy retention and best feed conversion ratio. The total whole tissue polyunsaturated fatty acid composition of M. rosenbergii PL was dominated by LA followed by LAN. Post larvae fed the diets containing higher LA/LNA ratios showed a higher tissue LA/LNA ratio. The obtained findings revealed that fatty acid patterns ofM. rosenbergii PL were influenced by fatty acid profiles of diets. The diet containing 0.65 LA/LNA ratio is recommended to obtaining optimum growth performance and feed utilization for M. rosenbergii PL.
文摘AIMTo detect risk factors for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) and investigate the predictors of its severity. METHODSThis is a prospective cohort study of all patients who underwent ERCP. Pre-ERCP data, intraoperative data, and post-ERCP data were collected. RESULTSThe study population consisted of 996 patients. Their mean age at presentation was 58.42 (± 14.72) years, and there were 454 male and 442 female patients. Overall, PEP occurred in 102 (10.2%) patients of the study population; eighty (78.4%) cases were of mild to moderate degree, while severe pancreatitis occurred in 22 (21.6%) patients. No hospital mortality was reported for any of PEP patients during the study duration. Age less than 35 years (P = 0.001, OR = 0.035), narrower common bile duct (CBD) diameter (P = 0.0001) and increased number of pancreatic cannulations (P = 0.0001) were independent risk factors for the occurrence of PEP. CONCLUSIONPEP is the most frequent and devastating complication after ERCP. Age less than 35 years, narrower median CBD diameter and increased number of pancreatic cannulations are independent risk factors for the occurrence of PEP. Patients with these risk factors are candidates for prophylactic and preventive measures against PEP.
文摘AIM:To determine predictors of long term survival after resection of hilar cholangiocarcinoma(HC) by comparing patients surviving > 5 years with those who survived < 5 years.METHODS:This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center,Mansoura University,Egypt between January 2002 and April 2013.All data of the patients were collected from the medical records.patients were divided into two groups according to their survival:patients surviving less than 5 years and those who survived > 5 years.RESULTS:There were 34(14%) long term survivors(5 year survivors) among the 243 patients.Fiveyear survivors were younger at diagnosis than those surviving less than 5 years(mean age,50.47 ± 4.45 vs 54.59 ± 4.98,p = 0.001).Gender,clinical presentation,preoperative drainage,preoperative serum bilirubin,albumin and serum glutamic-pyruvic transaminase were similar between the two groups.The level of CA 19-9 was significantly higher in patients surviving < 5 years(395.71 ± 31.43 vs 254.06 ± 42.19,p = 0.0001).Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year,includingyoung age(p = 0.001),serum CA19-9(p = 0.0001),non-cirrhotic liver(p = 0.02),major hepatic resection(p = 0.001),caudate lobe resection(p = 0.006),well differentiated tumour(p = 0.03),lymph node status(0.008),R0 resection margin(p = 0.0001) and early postoperative liver cell failure(p = 0.02).CONCLUSION:Liver status,resection of caudate lobe,lymph node status,R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival.
文摘Background: Pancreaticoduodenectomy(PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival( ≥ 5 years) after PD. Methods: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group(I) patients who survived less than 5 years and group(II) patients who survived ≥ 5 years. Results: There were 47(20.6%) long-term survivors( ≥ 5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31(66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include age < 60 years old, serum CEA < 5 ng/mL, serum CA 19-9 < 37 U/mL, non-cirrhotic liver, tumor size < 2 cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9 < 37 U/mL [OR(95% CI) = 1.712(1.24 8–2.34 8), P = 0.001], smaller tumor size [OR(95% CI) = 1.335(1.032–1.726), P = 0.028] and R0 resection [OR(95% CI) = 3.098(2.095–4.582), P < 0.001] were independent factors for survival ≥ 5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%. Conclusions: The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9 < 37 U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survival ≥ 5 years.
文摘AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.
文摘AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones(CBDS).METHODS: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram(TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven CBDS.RESULTS: Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases(84.2%) where removal of stones were successful; passed stones in 6 cases(7.9%); short lower end stricture with small stones present in two cases(2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case(1.3%) which was treated by open hepaticojejunostomy; and one case(1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled. CONCLUSION: The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options.
基金funded by the Deutsche Forschungsgemeinschaft(DFG),the BONFOR program of the Medical Faculty of the University of Bonn,and the Alexander-von-Humboldt Foundation.
文摘Alzheimer’s disease(AD)is the most common neurodegenerative disorder characterized by slow and progressive decline of cognitive and memory functions.In only approximately 5%of the cases,AD is familial,as often predisposed by genetic mutations(Hoogmartens et al.,2021),while sporadic AD accounts for approximately 95%of the cases.The amyloid cascade hypothesis is one of the fundamental hypotheses put out to explain AD pathogenesis as dysregulated homeostasis of amyloid-β(Aβ)peptides that leads to the accumulation of Aβplaques in the parenchyma,an anatomical hallmark of AD.
文摘The global incidence of coronavirus disease 2019(COVID-19)continues to increase despite health care efforts.The disease is caused by coronavirus 2 with high transmission and mortality rates.Little is known about the management of COVID-19 in advanced liver disease.The aim of work was to propose a plan for management of this drastic disease in case of this specific population with review of medications that could be suitable for advanced liver disease.All the guidelines and medications available for treatment of COVID-19 were reviewed with selection of the less toxic medications that could be used in advanced liver disease.Drugs suitable to manage COVID-19 in patients with liver disease might include remdesivir intravenously,nitazoxanide+sofosbuvir,ivermectin,tocilizumab,convalescent plasma,and low molecular weight heparin in certain situations.Advanced liver disease is associated with portal hypertension and splenomegaly with reduction of blood elements and immune dysfunction and impaired T cell function.Thus,when confronted by cytokine storm as an immune response to COVID-19,there may be an increase in the mortality rate of these patients.Through this review,a plan to treat COVID-19 in this special group of patients with advanced cirrhosis is proposed.
基金Grateful thanks to Prof.Dr.Mohamed H.Zahran,Emeritus Professor of Radiology,Radiology Department,Faculty of Medicine,Alexandria University,for supervision of the X-ray study and his precious support.
文摘The aim of the present study was to design and evaluate single pulse and floating double pulse valsartan core-in-cup tablets.Core tablets were prepared by direct compression of a homogenous mixture of valsartan,Avicel PH-101,Croscarmellose sodium(CCNa),magnesium stearate&Aerosil.Weight variation,Hardness and Disintegration time were measured for the core tablets.Core-in-cup tablets were formulated using different polymers as a plug layer,including sodium alginate(SA),sodium carboxymethylcellulose(NaCMC)and hydroxypropyl methyl cellulose(HPMC).The floating behavior,water uptake and drug release from the prepared formulations were evaluated.Differential Scanning Calorimetry(DSC)was also performed to detect the possible drug excipient interaction.Stability study of the selected formula was performed at 25C&60%RH and at 40C&75%RH for 3 months.Finally,the existence of the selected formula in the stomach after oral administration to human volunteers was verified via x-ray radiography.The results showed that the release lag time of the tablets increased when the quantity of the plug layer increased thus decreasing the drug release.Plug layer polymers showed a lag time with rank order:SA<NaCMC<HPMC.Selected formulations are F5&F6.F5(having SA as the plug polymer)released valsartan after a lag time of 2 h while F6 released the drug in two successive pulses with a reasonable lag time in between due to its floating behavior.Formulations were stable for at least 3 months under standard long-term and accelerated storage conditions.In conclusion,pulsatile single pulse and floating double pulse stable valsartan core-incup tablets were successfully formulated which provided a desirable lag time followed by a rapid drug release.
文摘BACKGROUND： Although the mortality and morbidity of pancreaticoduodenectomy（PD） have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly patients.METHODS： We studied all patients who had undergone PD in our center between January 1995 and February 2015. The patients were divided into three groups based on age： group I（patients aged 〈60 years）, group II（those aged 60 to 69 years） and group III（those aged ≥70 years）. The primary outcome was the rate of total postoperative complications. Secondary endpoint included total operative time, hospital mortality, length of postoperative hospital stay, delayed gastric emptying, re-exploration, and survival rate.RESULTS： A total of 828 patients who had undergone PD for resection of periampullary tumor were included in this study. There were 579（69.9%） patients in group I, 201（24.3%） in group II, and 48（5.8%） in group III. The overall incidence of complications was higher in elderly patients（25.9% in group I, 36.8% in group II, and 37.5% in group III; P=0.006）. There were more patients complicated with delayed gastric emptying in group II compared with the other two groups. There was no significant difference in the incidence of postoperative pancreatic fistula, biliary leakage, pancreatitis, pulmonary complications and hospital mortality.CONCLUSIONS： PD can be performed safely in selected elderly patients. Advanced age alone should not be a contraindication for PD. The outcome of elderly patients who have undergone PD is similar to that of younger patients, and the increased rate of complications is due to the presence of associated comorbidities.
文摘<b><span style="font-family:""><span style="font-family:Verdana;">Back</span><span style="font-family:Verdana;">ground:</span></span></b><span style="font-family:""> <i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassaemia (</span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-Thal) is an inherited chronic haemoly</span></span><span style="font-family:""><span style="font-family:Verdana;">tic anaemia resulting from absent or low level of synthesis of </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-globin chains of haemoglobin A in erythropoietic cells. The complement system is an important part of innate immune response that may be implicated in red blood cell (RBC) lysis. Mammalian cells are provided with surface bound complement regulatory proteins (MCRPs) that regulate the activation of complement cascade, thus protecting them from uncontrolled complement-mediated lysis. Objective is to evaluate the role of complement regulatory proteins (CD55, CD59, and CD35) on red blood cells, and to explain the pathogenesis of anaemia in </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassemia major. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This case-control study enrolled 74 </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;"> thalassemia major patients who were compared with 40 age and sex matched controls. We performed expression of CD55, CD59, and CD35 on RBCs using flow cytometry. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> CD55 levels of </span><i><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">-thalassemia major patients (79.78% ± 18.54%) were significantly decreased compared to healthy controls (99.45% ± 0.59%) (P < 0.001). CD59 levels of </span><i><s
文摘Transient current (I-t), current-voltage (I-V) characteristics, and dc conductivity ln(σ) for bisphenol A corn-cobs (BPACC) sample were investigated. At higher temperatures, I-V characteristics reveal that the dc cur-rent for the sample undergoes two regions one due to ohmic conduction and the other has been attributed to Space charge limited current (SCLC). The activation energy (Ea), the electron mobility μo), effective electron mobility ?μe), the concentration of the charge’s concentrations in conduction band, trapping factor (θ) and the trap concentration (Nt) were calculated. At lower temperatures, the dc current exhibits a peculiar behavior for I-t regime and I-V characteristics. Transient current of BPACC sample exhibits approximately constant value at constant electric field and it has saturation value for I-V characteristics. The attained results suggest strongly the applicability of this material in the electrical applications.
文摘No standardized description or definition of post-hepatectomy liver failure has been introduced.Definitions based on the degree of rise in serum total bilirubin or prolongation of prothrombin time postoperatively were predictive of shortterm mortality.Due to lack of universal definition,however,its prevalence is variable but may reach up to 12%posthepatectomy,according to the definition by International Study Group of Liver Surgery,and or 34%,as in some reports.
文摘The entropy per rapidity dS/dy produced in central Pb-Pb ultra-relativistic nuclear collisions at LHC energies is calculated using experimentally identified particle spectra and source radii estimated from Hanbury Brown-Twiss (HBT) correlations for particles π, k, p, Λ, Ω, and ∑ and π, k, p, Λ, and K^(0)_(s) at √s =2.76 and 5.02 TeV, respectively. An artificial neural network (ANN) simulation model is used to estimate the entropy per rapidity dS/dy at the considered energies. The simulation results are compared with equivalent experimental data, and a good agreement is achieved. A mathematical equation describing the experimental data is obtained. Extrapolation of the transverse momentum spectra at pT =0 is required to calculate dS/dy;thus, we use two different fitting functions, the Tsallis distribution and hadron resonance gas (HRG) model. The success of the ANN model in describing the experimental measurements leads to the prediction of several spectra values for the mentioned particles, which may lead to further predictions in the absence of experiments.
基金The authors gratefully acknowledge Faculty of Science,Ain Shams university,Faculty of Engineering,Aswan University,and Egyplast Factory R&D section(El Sewedy Group)for their cooperation and contribution to this work。
文摘This paper presents the modification occurred to the dielectric strength feature of low density polyethylene compounded with nano magnesia(LDPE/MgO).MgO nanoparticles were prepared using sol-gel technique,MgO filler surface was functionalized to improve the interfacial bonding.Specimen’s groups of composites with different filler concentrations were fabricated by mix blend method.Samples exposed to various salinity media by immersion,dielectric strength test was applied on each set according to relevant ASTM standard with identical testing technique.The results were statistically processed then compared to the pristine material.Tests results utilized to learn Artificial Neural Network in order to acquire the value of dielectric strength of compounds having similar composition but containing different doping amounts or influenced with various salinity level media.The dielectric strength is enhanced by the addition of MgO nanofiller.From the investigation of the obtained results,it is concluded that additives of 1.4%filler concentration by weight is the optimum MgO content for LDPE/MgO nanofiller material.We think that this paper may promote a good researching methodology that gather both empirical work and numerical tools in this field.
文摘The present study was conducted to evaluate the effect of either individual or combined wheat bran(WB) replacement with Azolla pinnata supplemented with Digestin^(TM) in the diet of freshwater prawn, Macrobrachium rosenbergii Postlarvae(PL) on growth performance, nutrient utilization, chemical body composition and survival(%). Experimental diets were a wheat bran-soybean based diet with no Azolla and Digestin^(TM)(control, T_1), and diets containing 17% Azolla supplemented with Digestin^(TM) 0%(T_2), 1%(T_3), 2%(T_4) and 3%(T 5). Each experimental diet was allocated into three tanks(6 m^3/tank) fed for 12 wks. Each tank was subdivided into three equal pens by nets(2 m^3) and stoked with 84 PL/m^2. The experimental diets were readily consumed by prawns PLs where both high growth and good feed efficiency were achieved for all diets. The results showed that the diets containing A. pinnata supplemented with Digestin? at the level up to 3% have the higher growth and better nutrient utilization than the control diet. No differences were observed for moisture and protein content among the experimental diets. However, the highest protein content was observed on prawns fed on diets T_1 and T 5 respectively, while the lowest value was recorded for T_4 diet. The results also show that prawn PLs fed the diets contain A. pinnata and supplemented with Digestin^(TM) recorded the highest values of body lipid content compared to the control diet. Feed efficiency and economic conversion rate(ECR) values show that economic performance and the cost-effectiveness of the A. pinnata supplemented with up to 3% Digestin^(TM) recorded the highest net return, and therefore it is recommended for prawn, M. rosenbergii PL's. These results are clearly indicating that A. pinnata have a good potential for use in prawn diets at reasonable levels than other conventional diets.
文摘Background: Early promotion of hepatitis B (HB) vaccination among health care workers is an important component of the HBV infection control. No available data assess immune response of HB vaccination among Egyptian medical students. Objective: we conducted this study to evaluate the immune response among medical students after completion of their vaccination schedule. Methods: A total of 150 Egyptian medical students were included. Three doses of recombinant HB vaccine had been administered to all participating students at 0, 1 and 6 months. Antibody to hepatitis B surface antigen (Anti-HBs) titers, hepatitis B surface antigen (HBsAg), and total antibody to hepatitis B core antigen (anti-HBc) were measured by enzyme immunoassay, 1 to 2 months after completion of vaccination course. Results: Among 150 students included, the mean age was 22.4 ± 1.7 years (range 18 - 28 years). Fifty nine (39.4%) were males and 91 (60.6%) were females. All students have anti-HBs levels more than 100 IU/L. The mean anti-HBs of included students was 8994.2 ± 6373.1 IU/L. There was no significant difference of anti-HBs levels regarding age, sex, residence or body mass index distribution. Conclusion: Early HB vaccination of health care workers is associated with good immune response and should be encouraged.
