Background: Helicobacter pylori is endemic in Egypt and present a main cause of gastrointestinal bleeding.

Aim: this study is to evaluate the prevalence of H.pylori infection in hemophilic patients, and to assess its impact on gastrointestinal bleeding associated with this infection in such patients.

Methods: we prospectively investigated the prevalence of H.pylori infection in 40 Egyptian patients with Hemophilia -A, -B and VonWillebrand syndrome and 20 normal male subjects was included. Every patient and control subject in the study was tested one time for H.pylori stool antigen by ELISA. All patients and control subjects were tested for occult blood using Guaiac-based fecal occult blood test. Results: Twenty eight out of 40 patients (70%) are H. pylori positive; and 12 out of 20 controls (60%) are H. pylori positive. The odds ratio is ‎1.55, 95% CI (0.6162 to 3.9269), ‎Significance level P=0.3497. Among 28 H.pylori positive patients, 5 patients (17.9 %) tested positive for occult blood. Among the 12 H.pylori positive subjects ‎ in the‎ control group, only one tested positive for occult blood (8.3%). Odds ratio for Occult bleeding in H pylori positive patients and control was 2.39: P=0.4504. None of the H.pylori negative patients or control subjects had a positive occult blood disease. Conclusion: patients with hemophilia, H. pylori should not be considered as an important cause of GI bleeding. The recurrence of the infection and GI bleeding could be prevented with eradication of H.pylori. Screening tests for H. pylori would not be needed in patients with hemophilia in endemic areas.

Background: Many parameters are included to determine the risk stratification of Acute Lymphoblastic Leukemia (ALL), Philadelphia Chromosome (Ph)/BCR-ABL–positive (ALL) is the largest genetically defined subtype in adult ALL with poor outcome. Here, we detected IL-2Rα (CD25) in patients with ALL and explored its diagnostic and prognostic value.

Patients and methods : Thirty ALL patients were recruited in Egypt , newly diagnosed with ages above 18 years old, after informed consent they invited to perform CD25 marker using Coulter EPICSXL, PCR for BCR – ABL fusion gene and Fluorescence in Situ Hybridization (FISH) were also performed along with CBC, LDH, Uric acid, CT scan allover and testicular ultrasonography.

Results: (70%) of patients were males while (30%) were females with no statistically significant difference as correlated with CD25, 13 (43. 33%) patients had positive CD25 , recurrent infections had occurred in 8 patients (26. 67%) with no significant correlation with CD25 (P = 0. 361), 16(53. 33%) patients suffered from fever, while 5 (16. 67%) experienced bleeding with no significant correlation among them with CD 25 (P> 0.05 in both). FISH cytology and PCR were positive in 11 (36.67%) patients. There was highly statistically significant correlation among CD25 and FISH and PCR for BCR-ABL, LDH, total leucocytic count with (P value <0.001). We showed that CD25 measurements compare favorably with other ALL prognostic criteria.

Conclusion: (CD25) expression was corresponding to Philadelphia chromosome. IL-2R α (CD25) is proved to be a valuable marker for monitoring ALL patients, an important parameter for prognosis and follow-up of ALL patients

Hemophagocytic Lymphohistiocytosis (HLH) is a rare and life threatening syndrome caused by excessive and dis-regulated immune activation. It can present as a primary sporadic disorder or be secondary to a trigger disrupting the immune homeostasis, such as auto-immune disorders, malignancies and mainly infections. It is usually of low suspicion index, and has variable presentations lacking specific pathognomonic clinical or laboratory signs. HLH is a medical emergency, and is associated with poor prognosis in most of the cases. An early diagnosis and initiation of appropriate treatment may change the outcome. Here I present a review of the literature concerning HLH, and one related pathologically similar disorder, the Macrophage Activation Syndrome (MAS), emphasizing on the clinical presentation, associated etiologies, diagnosis, treatment and prognosis, thus making the clinicians more aware of this fatal syndrome in order to decrease the related mortality.

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