Clinical and epidemiological characteristics of norovirus gastroenteritis among hospitalized children in Lebanon

AIM To assess the burden of norovirus(No V) and to determine the diversity of circulating strains among hospitalized children in Lebanon. METHODS Stool samples were collected from children presenting with acute gastroenteritis to six major hospitals in Lebanon. A total of 739 eligible stool samples, testing negative for diarrhea caused by rotavirus as a possible viral pathogen, were collected between January 2011 and June 2013. A standardized questionnaire including demographic, epidemiological and clinical observations was used at the time of hospitalization of children presenting with diarrhea. Viral RNA was extracted from stool samples followed by reverse transcription polymerase chain reaction and nucleotide sequencing of a fragment of the viral protein 1 capsid gene. Multiple sequence alignments were carried out and phylogenetic trees were constructed using the MEGA 6 software.RESULTS Overall, 11.2% of stool samples collected from children aged < 5 years tested positive for No V genogroups Ⅰ(GⅠ) and Ⅱ(GⅡ). GⅡ accounted for 10.6% of the gastroenteritis cases with only five samples being positive for GⅠ(0.7%). The majority of hospitalized children showed symptoms of diarrhea, dehydration, vomiting and fever. Upon sequencing of positive samples and based on their clustering in the phylogenetic tree, 4/5 of GⅠ gastroenteritis cases were designated GⅠ.3 and one case as GⅠ.4. GⅡ.4 was predominantly detected in stool of our study participants(68%). We report a JB-15/KOR/2008 GⅡ.4 Apeldoorn 2008-like variant strain circulating in 2011; this strain was replaced between 2012 and 2013 by a variant sharing homology with the Sydney/NSW0514/2012/AUS GⅡ.4 Sydney 2012 and Sydney 2012/FRA GⅡ.4 strains. We also report the co-circulation of non-GⅡ.4 genotypes among hospitalized children. Our data show that No V gastroenteritis can occur throughout the year with the highest number of cases detected during the hot months.CONCLUSION The majority of No V-associated viral gastroenteritis cases among our participants are attributable to GⅡ.4, which is compatible with results reported worldwide.

Potential role of killer immunoglobulin receptor genes among individuals vaccinated against hepatitis B virus in Lebanon

AIMTo explore the role of killer immunoglobulin receptor (KIR) genes in responsiveness or non-responsiveness to vaccination against hepatitis B virus. METHODSWe recruited 101 voluntary participants between March 2010 and December 2011. Sera samples from vaccinated and non-vaccinated participants were tested for the presence of anti-HBs antibodies as a measure of protection against hepatitis B, hepatitis B surface antigen and hepatitis B core antibody as indicators of infection by enzyme-linked immunosorbent assay. KIR gene frequencies were determined by polymerase chain reaction. RESULTSSera samples from 99 participants were tested for the levels of anti-HBs as an indicator of protection (&ge; 10 mIU/mL) following vaccination as defined by the World Health Organization international reference standard. Among the vaccinated participants, 47% (35/74) had anti-HBs titers above 100 mIU/mL, 22% (16/74) had anti-HBs ranging between 10-100 mIU/mL, and 20% (15/74) had values of less than 10 mIU/mL. We report the lack of significant association between the number of vaccine dosages and the titer of antibodies among our vaccinated participants. The inhibitory KIR2DL1, KIR2DL4, KIR3DL1, KIR3DL2, and KIR3DL were detected in more than 95%, whereas KIR2DL2, KIR2DL3, KIR2DL5 (KR2DL5A and KIR2DL5B) were expressed in 56%, 84% and 42% (25% and 29%) of participants, respectively. The observed frequency of the activating KIR genes ranged between 35% and 55% except for KIR2DS4, detected in 95% of the study participants (40.6% 2DS4*001/002; 82.2% 2DS4*003/007). KIR2DP1 pseudogene was detected in 99% of our participants, whereas KIR3DP*001/02/04 and KIR3DP1*003 had frequencies of 17% and 100%, respectively. No association between the frequency of KIR genes and anti-HBs antibodies was detected. When we compared the frequency of KIR genes between vaccinated individuals with protective antibodies titers and those who lost their protective antibody levels, we did not detect a significant difference. KIR2DL5B was significantly different among different groups of vaccinated participants (group I > 100 mIU/mL, group II 10-100 mIU/mL, group III CONCLUSIONTo our knowledge, this is the first study screening for the possible role of KIR genes among individuals vaccinated against hepatitis B virus (HBV). Our results can be used to design larger studies to better understand the role of KIR genes in protection against or susceptibility to HBV post vaccination.

Fibrinogen Levels in Hypertensive and Normotensive: A Cross-Sectional Study from El-Obied City, Sudan

Hypertension (HTN) has been defined as a blood pressure level at which an otherwise healthy person would have an increased risk of cardiovascular disease that could be mitigated through blood pressure-lowering treatment. Worldwide, hypertension is one of the most common causes of death. The prevalence of hypertension and cardiovascular disease increases with age, and has been found to be higher in those of South Asian and African ancestry, and in Aboriginal populations. Hypertension is not only one of the most important risk factors for cardiovascular disease, but also the number one modifiable risk factor for stroke. Alterations in blood coagulation system have been reported in patients of hypertension. Fibrinogen has been identified as a major independent risk factor for cardiovascular diseases. This was a descriptive cross-sectional study, conducted in Elobied teaching hospital during period from March to June 2014. The aim of this study is to determine the level of fibrinogen among hypertensive patients. Seventy percent of the patients (about 35 patients) had high fibrinogen level above 400 mg/dl compared with the control and about 30% (15 patients) were within the normal range of 200 mg - 400 mg/dl. This study has concluded that there was a significant increase in fibrinogen level in hypertensive patients compared to control, while the gender has no effect on the level of fibrinogen.

The Expression of miRNAs in Sudanese Patients with Systemic Lupus Erythematosus in Khartoum State

Background: MicroRNAs (miRs) are noncoding gene regulators that may have a role as diagnostic or prognostic biomarkers in systemic lupus erythematosus (SLE). Aim: To measure the blood levels of miR-146a, miR-126 and miR-30a in Sudanese SLE patients and to investigate their potential role in disease pathogenesis and utility as biomarkers for SLE. Material and Methods: A total of 48 SLE patients and 20 matched healthy individuals were enrolled in this study. SLE disease activity index (SLEDAI) was assessed. The blood levels of miR-146a, miR-126 and miR-30a were determined by Real-time polymerase chain reaction (PCR) in all participants. Γ-INF and IL-2 were analyzed by ELISA, and CD markers were used in flow cytometry. Results: The mean age of the patients was 31.5 ± 8.5 years with disease duration > 5 years. In SLE patients, the mean blood level fold changes of miR-146a (0.33 ± 0.277;P < 0.001), miR-126 (2.44 ± 1.771;P = 0.007) and miR-30a (1.56 ± 1.40;P > 0.305) compared to controls. Down regulation of miR-146a increase expression of γ-INF (P < 0.002), whereas the up regulation of miR-126 increase expression of CD markers (P MiR-126 at a cut-off value 1.209 and miR-146a at cut-off value of 0.9233 which can discriminate between SLE patients significantly associated with SLE disease. Conversely, miR-30a was insignificantly associated with SLE disease (P value > 0.05) as no differences between the SLE patients and healthy control. Conclusion: Circulating miR-146a and miR-126 could be a potential noninvasive biomarker in SLE. This study provides an overview of the current state of research on the role of miRNAs in the immune pathogenesis and regulation of SLE. Further studies are needed in miRNAs profiling expressions of SLE diseases.