الفهرس 
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Abstract
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SUMMAR!&: OO!fCWSIOll , ,- . - ’. i ’,-
The··present study was ma~ly aimed at defining the
hi~tQpathologi~al changes occurring in the livor of pat-
1ents y.t1t:b ’\l’1~:r.~e~t:tUs .a.nd-to :B1i’llttb~ij.h/jnyo(l~~l-
&t:iolil p&tween these .changea and any :past hist.ory of’bilharz.
tillaf1:’ec:1;i.-•o(nHmo’Qn’eltt1;yw±ttr~he-”previously mentionedpr.!
nc1pal.lIim, invest:l.gat1on of {jp:yrdatfonsh:l.p
between the jJlcidep,ce of v:l.raJ.hepatitis a.!:ldenviromnental1’
a9tors such as occuPatiQn ha4, been tried.
The study has involved the h:l.st~patholo~ical investigat1op’
Qf liver biops1ea-tElk~ f:;r-om 50 patients with
chronic viraln~patitis during the p~r1od of stay in a
major mll:l.taryhospital shtioned in C!t1ro.Biopsy samples
were optained by .!:leedletechnique in 40 cases and through
surgic!’!lprocedure in the remain~ 10 Ca/il8a.
T~8 study has revealed the following results :
I- Clinical findings in cases of viral hepatitis:
The c~inical signs and symptoms recorded ’in viral
hepatitis patients examined~1n this study were :principally
jaundice, ltver enlargement, tenderness, i1v~shrunkage,
and splenic enlargement.
ThEt +ne:1dence of each ona of these signsand.symptoms
was dif~er~nt according to whether previous affection with
bUha~z1-a$b ·was present (l.!!!gz-oup) Of absent (2~roup).
Information regarding these findings was discussed in
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table (Iv). Jaundipe was deteoted in 53.8 $b of cases of
lst~oqp, shr~e~ +~ver i~ l~,4 %w ~n&~~+ar~~d spleen
inc 7~..9•%; C’OJ!’l:’:e.Sllto’nidgiu:rle:alg:In: t, he 2.n.d--group were
33’.)%. 8.3 % and 41.1 % J::eslle.ct1Ycdy:~
II- Histopathological changes in oases of viral hepatitis:
,A) The study revealed -that 60 % of patientS witlj.
<lhr01l1ovi;r.-alhepatitisshowad s~e;ns o:fC}.If,32 %.presentedwi1t;
’CW,. whereas the remaining 8 % were diagnosed
as :resplv1f1SNlpfilti USc.
B}.The hiJ3tqpai;hologi¢al lesions recorded Yfere mllinly
8ffeoUng i1V’er·archihctu.reJ.pax.e~clly:ml;hle,patocytes and
portal a~fils. Results concerning these leElionEi and itEi
inoidence were described in details inTa~les I a~d II.
The main f~gUres were; out ~f 30 CAH oas~s examined,B3.J%
showed complete loss of architeoture, and ~6.7 % had partial
!qss. Corresponding figures for the 16 CPH caseS exami.
ned we’fe :\.8.8% and 68.7 % respectively. As regards the
paren1:thymaLcltanges 66.7 % of tijose CAR case” showed sevElre
collapse and 33.3 % showed partialcollepse. Corresponding
f~g~~~ for CPH cas eElwere 56.3 % and 43.7 % respectively.
AEI regllrds the changes in the hflpatocytes, focal necroElis
was .pr,aent ~nB3.3 % of (JAH oases, 9J~7 % of em and 75:%
of resolving hepBtUisjfatty,*ang-.s ”’ere prevent in 63.3%
of CA ij:cases, 31.3 % of CPR and 25 % of resolving hepatitis,
whereas corresponding;11.iEures fo’!:8cidop~il~chal:1ges were
33.3 %, 56.3 % ana 0.0 % respectively.
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_ Challges in the portal areal’!showEld:fibrosis and cellular
inf11tr~tiqu were found in 100 % of CAR pases. Cellular
1nfiltratio~ tn 100% of CPR casea. wherea~ fibrosis-was
I?resen-~on1r j;n25 % of cm oases.
_ Bilhar~al granulomata were detected in la% of CAR cases
4nd18.7 % of CPH cases.
_ No cha~~1J in the pprtal areall of re$olvine; hepEjtitis
cases were detected.
Perc~ntag~a pf these histopathological di~gnosis differ
¢qnsider~~ly in first group of patients with previous infection
with bilharziasis from those in second group of ps’U-ents
w~thout p~st history of such affection.
TM .tncidenoe of CAH and CPHin the l~, groq.pWail higher
than tha~ in the 2nd group {Table III}.
Histopat~ologica~ly t~e 1!1group r~Ve~l~t38.5% C~H with-
,.
O\l.tcirrhouis, 26.9 ~ CAR wtip. cirrhosis-and J4.6%CPH.
Correspond~ fi~urel’!in the ~grQup werEl29.2 %, 25% and
29.2 % l:es~ct:j..vely~whil~ resolving hepeUt;l.f’ shewed allopposite
~tateof aftairs.The~~ ?8sults show that bilharsiasis
pre-dtepC/aas1;o-mor:ea-ggressi-v~le-a~s.
Il~_-.rnulaenca of viral-hepatitis in relation to occupation:
study of th~ PElrsonal data of patient13 exariiinedhas pre-
11lllinaryrevea+ed that incidenoe of viral hepatitis was more
~ fa:m~r’s and studll1U;sthan in 1ndiv1dImls holdine; oth.er
occupation, 32 %, 56 % and 12 % respsctivrely.
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aQweve~.the number of samplea cansituted the material
of the lltUc}ywall’J,imited-. ao that sccurs’!;e and decis-
1va --Ct<iX!rc:;1inu$itohnis, part-icuta~BP’ecte~uldn l :the
tll.sde,.- .Ftp;-the;t’ 1nvestil?;atio~s ill. this field is a neoeas1ty-
,In eonclU?1on. h±utopathologfcal chang~~ occurring
in ~e liver of vira~ hepatitis patient~’ma1nly include
:U.ver a;rciUtec~l¢e. parenchyma.iI81tStocytes and portal ar.as.
SUchcchangeava;ry acco;odingto thes-ta~.e. andtYPe’ of h~patit1s.
Thep,rcent~geaof~~topat~ologic8lohange~carried
out !}npatielftll lllide;rsurvey’ di~fer cotls1q.erably in th(lse
indivi~u~ls with.~~ev10us b1lharzia1affect~on than those
~thout SU9hsffect1on.Incidence’pf each sf CAHandCPHwas
higher itl individuals of first group’ than that in the second.