الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Hepatosplenic affection represents a frequent clinical phenomenon in the tropics. In Eygpt, there is an increasing prevalence of hepatosplenic affection but still the exact aetiology of endemic hepatosplenomegaly is diverse. Although schistosomiasis is incriminated as the major disease which affects mainly the liver and the spleen, it seems that this pattern is changing from schistosomal to non schistosoma\. Other causes were discovered as causative agents such as viral hepatitis, Fasciola, Ebstein.Barr Virus, hepatoblastoma, amyloidosis, aflatoxins and others. Ultrasonography is a reliable, accurate and non-invasive tool to measure both liver and spleen sizes. Moreover, the sonographic pattern of the hepatic peri-portal fibrosis characteristic for Schistosoma infection is not mimicked by other hepatic lesions. d The aim of this work is to estimate the prevalence of hepatomegaly and/or splenomegaly using ultrasonography, .and to identify Schistosoma, Fasciola, Hepatitis B Virus and Leishmania donovani as causative agents for hepatosplenic affection. (Nile Delta). 720 individuals who aged more than 15 years were sonographed. ! Hepatomegaly andlor splenomegaly were diagnosed sonographically according to standard tables and measurements. Stool and urine samples were collected , , This work was carried out in EI-Saada village, Kafr El-Sheikh Govemorateand prepared using Kato-Katz and nuclepore filteration techniques for stool and , urine respectively. individuals out of those with hepatosplenic affection and 41 individuals out of those without hepatosplenic affection were chosen from the even numbered houses as matched by age and sex to be enrolled in a casecontrol study. Each member of the cases and the controls gave blood sample. Each serum was tested for the prsence of antibodies against: 1. Schistosoma mansoni using soluble egg antigen (SEA) and ELlSA.technique. 2. Fasciola using excretory-secretory antigen (ES) with adoption of ELlSA. 3. Leishmania donovani using the indirect haemagglutination test. . 4. E ~oh serum was tested for the presence of hepatitis B surface antigent, (HBs Ag) and antibodies against hepatitis B core antigen (HBc Ab) using the ~ enzyme immuno-assay (EIA) technique. .. 1 Hepatosplenic affection in the village amounted to 77.1 (67.1 hepatomegaly I 2.1 hepatosplenomegaly). splenomegaly and 7.9 Hepatomegaly alone was more common among females especially house-wives and students (76.9 & 66.1 ).