Biomarkers in Liver Disease: From Diagnosis to Prognosis
Heba
Pasha
Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig,
Egypt
author
text
article
2020
eng
A study published in Afro-Egypt J Infect Endem Dis under the title of "Serum MiRNA-122 as a Diagnostic Marker in HCV Related Liver Cirrhosis" aimed to evaluate serum miRNA-122 expression as a potential biomarker for diagnosis and monitoring different stages of disease in chronic hepatitis C patients. The study revealed that miRNA-122 expression levels were significantly increased among liver disease patients than healthy controls. Furthermore, miRNA-122 expression levels were significantly higher in the compensated patients compared to the decompensated patients. Also, this study elucidated that serum miRNA-122 levels were decreased with the progression of liver disease (from Child-Pugh class A to C) but without reaching to a significant difference. According to an interesting study published in the current issue of the Afro-Egyptian Journal of Infectious and Endemic Disease " Presepsin and Resistin as Diagnostic Markers for Bacterial Infection in Patients with Decompensated Cirrhosis"Presepsin and resistin were significantly higher among patients with infection and positively correlated with Model for End-stage Liver Disease score (MELD), Child-pough score (CPS), CRP and PCT. At 1205 pg/ml as cutoff, Presepsin could predict infection at sensitivity 83.8%, specificity 93% and accuracy 88.7%. While using 21ng/ml as cutoff, Resistin could predict infection at sensitivity 64.6%, specificity 68.4% and accuracy 66.7%. Adding CRP to PCT or presepsin increased sensitivity to 99%, specificity 73.7%, and accuracy 85.4%. Adding presepsin to PCT or resistin increased sensitivity to 94.9%. Yet combined presepsin and PCT had higher specificity than combined presepsin and resistin. Conclusion: Presepsin has comparable diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis while resistin has poor sensitivity and specificity. Adding presepsin to CRP yields the same diagnostic performance as combined CRP and PCT. So, combining any of them to CRP helps to early diagnose bacterial infection in those patients
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
332
334
https://aeji.journals.ekb.eg/article_123441_c55516f89edc225f621538c819b150cf.pdf
dx.doi.org/10.21608/aeji.2020.123441
Serum MiRNA-122 as a Diagnostic Marker in HCV Related Liver Cirrhosis
Tahia
Ahmed
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
author
Ebtesam
Ahmad
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
author
Salah
Ibrahim
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
author
Maysaa
Saeed
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt
author
text
article
2020
eng
Background and study aim: MicroRNAs were evaluated as biomarkers for liver injury in various liver diseases. This study aimed to evaluate the serum miRNA-122 as a potential biomarker for diagnosis and monitoring different stages of disease in chronic hepatitis C patients. Patients and Methods: A case-control study included 45 subjects, divided into three groups: control group, compensated, and decompensated cirrhotic patients groups. All participants were subjected to full history taking, clinical assessment, routine lab investigations, hepatitis B surface antigen, HCV antibodies, HCV-RNA using PCR, and determination of serum expression of miRNA-122 using real-time PCR. Results: The miRNA-122 expression levels among the two groups with liver disease were significantly higher than the control group. Among cirrhotic patients, the expression levels were significantly higher in the compensated subjects compared to the decompensated group. The miRNA-122 levels decreased with the progression of liver disease (from Child-Pugh class A to C) but without significant difference. Patients with ascites had a significantly lower expression of miR-122 compared to those without ascites. Patients with gastrointestinal bleeding and hepatic encephalopathy had statistically insignificant lower expression of miRNA 122 compared to subjects without these complications. As regards all patients groups there were significant positive correlations between miRNA-122 expression and (AST, ALT, albumin, and viral load) and a significant negative correlation as regard INR. Conclusion: Serum miRNA-122 expression levels decreased with the progression of liver disease and at a cut-off value ≤ 2.74 fold change could predict the occurrence of hepatic decompensation. So Serum miRNA-122 seems to be a useful new diagnostic marker in hepatitis C patients with different stages of the disease.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
335
345
https://aeji.journals.ekb.eg/article_102594_b6c5b5f042482d1fe082cf05d35ed393.pdf
dx.doi.org/10.21608/aeji.2020.30137.1082
HCC Incidence in DAAs-Treated and Untreated Egyptian HCV-Infected Patients
Mohammed
Nouh
Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Egypt.
author
Mahmoud
Moawad Sera
Shebin Elkom Hospital of Infectious Disease and Hepatology, Menoufia Govenorate,
Egypt.
author
Ahmed
El-Gazzarah
Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Egypt.
author
text
article
2020
eng
Background and study aim: It was initially presumed that SVR after DAAs would be associated with a reduction in incidence of new or recurrent HCC. However, suggesting that DAAs may increase the risk of HCC recurrence created uncertainty in the field. This was followed by publication of number of studies in various populations looking at both new and recurrent HCC.The aim of this article is t study the incidence rate of HCC in DAAs-treated patients who have achieved SVR12 and those who haven’t been treated. Patients and Methods: 416 patients were randomly-selected for prospective follow-up screening for the incidence of HCC (by abdominal U/S and AFP) at a 6-months interval for a completed 12 months duration on 1st, 2nd and 3rd screening sessions. They were distributed 132, 112 and 162 patients in groups I (SOF-treated), II (Qurevo-treated) and III (DAAs-ineligible cirrhotic patients). The DAAs-treated patients were selected from those who had achieved SVR12. Patients who didn’t attend the 3 screening sessions were excluded from the prospective analysis. Results: 297 patients completed the 3 screening sessions, distributed 100, 97 and 100 in groups I, II and III respectively. The total incidence of HCC at the 3 screening sessions was significantly-higher among Group III 30% (30/100 patients) versus 19% (19/100 patients) in Group I and 1.03% (1/97 patients) in Group II. Conclusion: The HCC incidence was significantly lower in DAAs-treated patients who achieved SVR12. The incidence of HCC was significantly higher in patients with advanced stages of cirrhosis.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
346
355
https://aeji.journals.ekb.eg/article_105543_3a7ce2babdfea832211774f51bddcb4f.pdf
dx.doi.org/10.21608/aeji.2020.30828.1087
Predictive Value of Red Cell Volume Distribution Width-to-Platelet Ratio in Staging Liver Fibrosis in Chronic HCV-Infected Patients
Ali
Nada
Department of Hepato-Gastroenterology, National Liver Institute, Menoufia
University, Egypt.
author
Nashwa
Shebl
Department of Hepato-Gastroenterology, National Liver Institute, Menoufia
University, Egypt.
author
Ahmed
El-Gazzarah
Department of Tropical Medicine department, Faculty of medicine, Menoufia
University. Egypt.
author
Warda
Othman
Department of Hepato-Gastroenterology, National Liver Institute, Menoufia
University, Egypt.
author
text
article
2020
eng
Background and study aim: The gold standard investigation to stage hepatic cirrhosis is liver biopsy. Being invasive with several major and minor procedure-related complications, liver biopsy is not universally-applied in all the indicated population. In addition to observer-related variations and sampling errors, the need for alternatives to liver biopsy has emerged including several lab-based indices of those; red cell volume distribution width-to-platelet ratio (RPR) have been postulated in some studies. The aim of this article is to study the diagnostic performance of RPR in staging liver cirrhosis in HCV-infected patients. Patients and Methods: 236 patients who had underwent liver biopsy for IFN-based therapy were included in the present study according to pre-defined inclusion and exclusion criteria. They were classified into 4 groups according to the stage of cirrhosis reported by the liver biopsy. Laboratory data, including CBC and biochemical studies, RPR, APRI score and FIB-4 were tabulated for statistical analysis. Results: The AUROCs values for RPR were 0.795, 0.811 and 0.886 for F2, F3 and F4 stage of cirrhosis respectively which were consistently higher than those of APRI (0.680, 0.754 and 0.746 for F2, F3 and F4 stages respectively) and FIB-4 (0.653, 0.765 and 0.810 for F2, F3 and F4 stages respectively). RPR was significantly-correlated with APRI (P<0.002), and FIB-4 (P<0.001) for the prediction of F3 stage of cirrhosis, and F4 stage of cirrhosis (P Conclusion: RPR can be a promising, inexpensive non-invasive tool for the prediction of the stage of hepatic cirrhosis in patients with HCV.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
356
363
https://aeji.journals.ekb.eg/article_105547_6ed603a046433cbfbf245b8796b8f4cd.pdf
dx.doi.org/10.21608/aeji.2020.32493.1090
Prevalence and Predictors of Occult Hepatitis C Infection in High-Risk Egyptian Populations
Mohammad
Sallam
Hepatogastroenterology Unit, Department of Internal Medicine, Faculty of Medicine,
Zagazig University, Egypt.
author
Hanan
Ahmed
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.
author
Hanan
Soliman
Department of Public health, Community, Environment and Occupational Medicine,
Faculty of Medicine, Suez Canal University, Egypt.
author
Sameh
Abdel Monem
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.
author
Essam
Abdel Wahab
Hepatogastroenterology Unit, Department of Internal Medicine, Faculty of Medicine,
Zagazig University, Egypt.
author
text
article
2020
eng
Background and study aim: Direct acting antiviral agents (DAAs) altered hepatitis C virus (HCV) outcomes with a permanent cure in 90% of cases. However, HCV had not wiped out from all cases (1% ~ 15%), which represent occult HCV infection (OCI). The aim of this study is todetect prevalence and predictors of OCI in four high-risk groups. Patients and Methods: 196 participants were enrolled and assigned into four patients groups and one control group; group I (cryptogenic hepatitis), group II (HCV), group III (chronic HBV), group IV (ESRD), and group V (control group). HCV RNA testing in serum and in peripheral blood mononuclear cells, hepatic stiffness estimation and FIB-4 score calculation were done for all participants. Results: Significant differences were found among different study groups regarding frequencies of HTN (p < 0.001) and DM (p < 0.001), history of blood transfusion (p < 0.001), history of previous surgery (p < 0.001), as well as mean values of FIB-4 (p < 0.001) and fibroscan readings (p=0.002). OCI was found in 25 participants (12.7%), with different prevalence rates in different groups; being highest in group I (11/43, 25.3%), followed by group III (6/30, 20%). Among all participants, OCI was significantly associated multiple risk factors that include; history of blood transfusion (p=0.004), previous surgery (p=0.017), positive family history of HCV infection (p < 0.001), advanced fibrosis (p =0.015) and high FIB-4 score (p=0.016). Positive family history of HCV infection and history of blood transfusion were considered as independent predictors for OCI. Conclusion: Testing for OCI in high-risk populations and retesting in SVR cases might be needed to help in complete eradication of chronic HCV infection.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
364
372
https://aeji.journals.ekb.eg/article_107025_3d290b08b80a9207f0c25eaf554a7a0a.pdf
dx.doi.org/10.21608/aeji.2020.32501.1091
Prolonged Fever and Lymphadenopathy in a Series of Egyptian Patients: The Etiology Based on Histopathological Examination
Fatma
Moussa Mohamed
Department of Infectious, Gastrointestinal and Hepatology Diseases, Faculty of Medicine,
Suez university.
author
Walaa
Abd El Gwad
Department of Pathology, Faculty of Medicine, Suez University
author
text
article
2020
eng
Introduction and study aim: prolonged fever and lymphadenopathy (LAP) are two interrelating features that constitute a diagnostic challenge in medical practice. With the great variety in differential diagnoses, a wise clinical impression is needed to reach a provisional diagnosis. This is achieved through knowledge and awareness of the prevalent etiologies among our population. Patients and methods: We included 269 patients with prolonged fever and lymphadenopathy to have an excisional biopsy to reach a definitive diagnosis via histopathological examination. In addition, laboratory tests were performed to assess the role of serology to predict probable diagnoses. Results: Three main etiologies of prolonged fever and lymphadenopathy were detected; malignancy (41.7%), followed by non-specific changes (reactive hyperplasia) (30.5%), then infections (27.8%). The most commonly involved lymph nodes were cervical and axillary, then inguinal. More than half of the patients had only fever and lymphadenopathy, while cachexia and anorexia were the most common associated presentations among others. Most of the patients had high ESR level, whereas high LDH and CRP levels presented in nearly 34% and 22% of them respectively. High CRP, eosinophilia and elevated LDH, characterized malignancy whilst infection was commonly associated with lymphocytosis, monocytosis and high ESR. Old age and high ESR were significant independent predictors of malignancy, and lymphocytosis was a significant predictor of infection. Conclusion: In our region, malignancy is the commonest etiology for fever and lymphadenopathy, in addition to reactive hyperplasia and infections, respectively.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
373
378
https://aeji.journals.ekb.eg/article_107562_9f74206274d38c1ba34718121c5af241.pdf
dx.doi.org/10.21608/aeji.2020.33339.1093
Updated Epidemiological Aspects and outcome of Meningitis Cases at Abbassia Fever Hospital during the Period 2006-2017
Amany
Ibrahim
Department of Tropical Medicine , Faculty of Medicine, Ain Shams University, Egypt.
author
Sara
Abdel Hakam
Department of Tropical Medicine , Faculty of Medicine, Ain Shams University, Egypt.
author
Azza
Hassan Ahmed
Department of Community, Environmental and Occupational Medicine, Faculty of
Medicine , Ain Shams University, Egypt.
author
Amr
Hussein
Abbassia Fever Hospital, Cairo, Egypt.
author
Amira
Al Balakosy
Department of Tropical Medicine , Faculty of Medicine, Ain Shams University, Egypt.
author
text
article
2020
eng
Background and study aim: Meningitis remains a major public health challenge. Epidemiology of meningitis has greatly changed, our aim is to report updates of epidemiologic aspects of meningitis cases including commonest etiologies & outcome. Patients and Methods: This is a retrospective descriptivestudy in which data was retrieved from hospital records of patients older than 18years with an admitting or discharge diagnosis of meningitis presented to Abbassia Fever Hospital in the time period 2006-2017. Results: A total of 959 patients were admitted to Abbassia Fever Hosiptal with final diagnosis of meningitis /meningioencephalitis in the time period 2006-2017. 61% aged (24-64 years), males (64.4%), more cases were reported in spring (38%) than other seasons, specifically in April (15%). Septic meningitis was the commonest etiology of meningitis (66.6%), followed by viral (17%) then tuberculous (15.6%) while cryptococcal was the least (0.6%). Although the etiologic organism was not isolated in 55.3%, streptococcus pneumonia was the commonest organism identified in 20%, followed by Neisseria meningitidis (12.3%) & Haemophilus influenzae (3.3%). 78.7% were completely recovered, 17.6% died & 3.6% had complications on discharge. The highest case fatality rate was in older age (31.7%). Patient outcome was significantly related to age (p < 0.001), smoking (p=0.05) , residence (p < 0.001), etiology of meningitis(p < 0.001) & occurrence of complication (p < 0.001). Conclusion: Septic followed by viral then tuberculous are common causes of community acquired meningitis in patients admitted to Abbassia Fever Hospital. Factors affecting patient outcome are age, residence, etiology
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
379
388
https://aeji.journals.ekb.eg/article_109216_459293f98230a80da3e1a5e84f3b5f75.pdf
dx.doi.org/10.21608/aeji.2020.31957.1088
Presepsin and Resistin as Diagnostic Markers for Bacterial Infection in Patients with Decompensated Cirrhosis
Mahmoud
Sharafeddin
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt.
author
Amany
Abd Allah
Department of Family Medicine, Faculty of Medicine, Zagazig University, Egypt
author
Ahmed
Abdelrahman
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt.
author
text
article
2020
eng
Background and study aim: Bacterial infections mess up prognosis of cirrhotic patients. Presepsin and resistin are favorable infection markers that can help in diagnosis of such condition. This study aimed to assess performance of presepsin and resistin in diagnosis of infection compared with C reactive protein (CRP) and procalcitonin (PCT) among patients with decompensated cirrhosis. Patients and Methods: Two hundred and thirteen patients with decompensated cirrhosis admitted to Internal Medicine hospital, Zagazig University, were included in this study. All patients underwent history taking, thorough clinical examination and laboratory investigations including measuring CRP, PCT, presepsin and resistin. Results: About 47% of patients have infections. Presepsin and resistin were significantly higher among patients with infection and positively correlated with Model for End-stage Liver Disease score (MELD), Child-pough score (CPS), CRP and PCT. Presepsin cutoff≥1205 pg/ml could predict infection at sensitivity 83.8%, specificity 93% and accuracy 88.7%. Resistin cutoff≥21 ng/ml could predict infection at sensitivity 64.6%, specificity 68.4% and accuracy 66.7%. Adding CRP to PCT or presepsin increased sensitivity to 99%, specificity 73.7%, and accuracy 85.4%. Adding presepsin to PCT or resistin increased sensitivity to 94.9%. Yet combined presepsin and PCT had higher specificity than combined presepsin and resistin. Conclusion: Presepsin has comparable diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis while resistin has poor sensitivity and specificity. Adding presepsin to CRP yields the same diagnostic performance as combined CRP and PCT. So, combining any of them to CRP helps to early diagnose bacterial infection in those patients
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
389
396
https://aeji.journals.ekb.eg/article_111642_5fe962583a8c7a43c7c6fe6486e7ba36.pdf
dx.doi.org/10.21608/aeji.2020.36097.1097
Influence of Cytokine Gene Polymorphisms on the Risk of Gastric Disorders in H. pylori Infected Patients
Heba
Pasha
Department of Medical Biochemistry, Faculty of Medicine, Zagazig University,
Zagazig, Egypt.
author
Enas
Tantawy
Department of Microbiology and Immunology, Faculty of Medicine, Zagazig
University, Zagazig, Egypt.
author
Mohamed
Radwan
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig,
Egypt.
author
Hoda
Hagrass
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig,
Egypt;Department of Pathology, College of Medicine, University of Arkansas for Medical
Science, USA.
author
Nagla
Abd Al-Monem
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig,
Egypt.
author
Amira
AL-Karamany
Department of Medical Biochemistry, Faculty of Medicine, Zagazig University,
Zagazig, Egypt.
author
text
article
2020
eng
Background and study aim: Helicobacter pylori (H. pylori) is a common organism in developing countries, it causes gastric disorders and cancer. Pathogenesis of these disorders involve cytokine gene polymorphisms that affect cytokine levels and clinical diseases. The aim of the study is to identify the relationship of IL-1β-511, IL-10-519 and TNF-α-308 polymorphisms to the risk of H. pylori infection and occurrence of gastric disorders. Subjects and methods: IL-1β-511, IL-10-519 and TNF-α-308 polymorphisms were assessed using polymerase chain reaction (PCR) restriction fragment length polymorphism technique (RFLP) in 356 subjects classified according to H. pylori infection and gastric disorders. Results: Carriers of T allele of IL-1β-511 and IL-10-519 had increased risk of H. pylori infection (OR:1.95, 95% CI:1.4-2.7, P Conclusion: This study revealed a significant association of the IL-1β -511C/T and IL-10-819C/T but not TNF-α-308 G/A polymorphisms with risk of Helicobacter pylori infection and different gastric diseases in Egyptian patients.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
397
406
https://aeji.journals.ekb.eg/article_112374_f5eb8269e8e2d5f2462ea68d75c9a533.pdf
dx.doi.org/10.21608/aeji.2020.37775.1099
Microwave Ablation and/or Transcatheter Arterial Chemo-embolization in the Treatment of Hepatocellular Carcinoma
Sara
Abozaid
Department of Tropical Medicine, Faculty of Medicine, Zagazig University,Egypt.
author
Mustafa
Elshamy
Department of Tropical Medicine, Faculty of Medicine, Zagazig University,Egypt.
author
Ahmed
Alazim
Department of Radiology, Faculty of Medicine, Zagazig University,Egypt.
author
Soha
Elhawari
Department of Tropical Medicine, Faculty of Medicine, Zagazig University,Egypt.
author
text
article
2020
eng
Background and study aim: Percutaneous microwave ablation (MWA) and trans-arterial chemo-embolization (TACE) are established therapies for treatment of HCC patients. Lower rates of complete response with mono-therapies have been reported. Therefore, combined treatment strategies, including combined TACE and MWA have been used. The study aimed at comparing the efficacy of MWA mono-therapy; TACE mono-therapy and combined TACE-MWA in the treatment of 3- 5 cm HCC. Patients and methods: The study prospectively included 102 patients with 113 hepatic focal lesions (3-5 cm) diagnosed as HCC by contrast-enhanced triphasic CT or dynamic MRI. Thirty-five HCC in 34 patients were subjected to MWA mono-therapy; 41 HCC in 34 patients were subjected to TACE mono-therapy, while 37 HCC in 34 patients were subjected to combined TACE-MWA therapy. Follow up by contrast-enhanced CT or MRI was done at one month, and every 3 months, up to one year after treatment. Therapeutic tumor response and local tumor progression were evaluated and compared among the groups. Results: After one year follow up, the combined TACE-MWA group showed a higher rate of complete response (CR) (83.3%) when compared to MWA group (76.5%) and TACE group (66.6%) (P>0.05). The local tumor progression (LTP) rate in the combined TACE-MWA group was lower (16.6%) than that in MWA group (23.5%) and TACE group (33.3%) (P=0.2). Conclusion: Combined TACE-MWA therapy appears to be non-significantly superior to MWA mono-therapy and TACE mono-therapy in terms of complete tumor response and local tumor progression in patients with 3-5 cm HCC.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
407
416
https://aeji.journals.ekb.eg/article_113205_8f8ffb0524bdec67f230639fc0592ed0.pdf
dx.doi.org/10.21608/aeji.2020.25284.1054
Gender Competition for Surviving COVID-19
Hamzullah
khan
Associate Professor, Nowshera Medical College, Nowshera, Pakistan
author
Shahtaj
khan
Professor & HOD Hematology Department, Hayatabad medical complex Peshawar, Pakistan
author
text
article
2020
eng
Corona Virus disease termed as COVID-19, is an emerging highly contagious respiratory disease that is caused by novel corona virus. Its main clinical symptoms are fever, dry cough, fatigue, myalgia and dyspnea. In Pakistan, the literature so far covering the prevalence and incidence is deficient. By24thJuly 2020, reported data from government sources declares 270,400 confirmed cases with 5763 deaths. 219783 cases are recovered and 1316 cases are under treatment in high dependency units countrywide. Sindh is the province with highest number of corona cases crossing 115883. Gender and age matters when there is talk about the prognosis and outcome of the disease. A study reported that corona virus is striking and felling more Italian males as compared to females in extreme of age because of their weak immunity status. They further elaborated that Italian model of mortality is a trend mirror of what they observed in China with more causality in male gender and at extreme age. Using the Kaplan Meir test we analyzed the 32 deceased data from our hospital named Qazi Hussain Ahmed Medical Complex Nowshera and district line list for a number of variables including the impact of gender and comparing the survival capabilities of both genders simultaneously infected with COVID-19. We observed that male gender that have contracted COVID-19 in their extreme ages offering less resistance to the virus with poor survival rate as compared to the female’s gender where the surviving capabilities for unknown reasons are stronger than those in male gender (Figure 1). Many factors can contribute including low viral load because of less exposure as compared to the male gender in our religious society. Similarly, there could be some un-discovered immune predominance in female gender that confers more imm
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
417
418
https://aeji.journals.ekb.eg/article_123685_483bf4f93c16169de83a48cbd9ecedd1.pdf
dx.doi.org/10.21608/aeji.2020.43626.1102
Image case: Gastric tuberculosis
Nabila
Hassan Ahmed
Assistant professor of Tropical Medicine ,Zagazig University
author
text
article
2020
eng
35 years old male presented by recurrent hematemesis attacks and recurrent blood transfusion, no history of cough, with history of anti-tuberculosis therapy for pulmonary TB 2 years ago. General examination revealed pallor, emaciated, no lymphadenopathy, local examination showed epigastric tenderness and no organomegaly, and examination of other systems was unremarkable. Haemglobolin was 8 gm% (normocytic normochromic), chest X ray and abdominal ultrasound were free. Upper gastrointestinal endoscopy revealed ulcerated fundal mass. Endoscopic biopsies revealed caseating granulomas by histopathology examination. Discussion Gastrointestinal tuberculosis is a rare disease, presented mainly in the ileoceceal region. Mycobacterium tuberculosis infection in the stomach is similar to gastric carcinoma manifestations. Gastric TB is mainly secondary to pulmonary TB. Antrum and prepyloric area is the most common sites affected. Gastric tuberculosis is mainly existed as ulcerative followed by hypertrophic lesions. GTB diagnosis can be established by detection of acid fast bacilli and/or caseating granuloma in gastric mucosa or submucosa. Chemotherapy is mainly give good results, while surgery may be needed in gastric outlet obstruction cases.
Afro-Egyptian Journal of Infectious and Endemic Diseases
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
2090-7613
10
v.
4
no.
2020
419
420
https://aeji.journals.ekb.eg/article_127389_0ece712c82d17ad7d2d4a5dbdd7c116c.pdf
dx.doi.org/10.21608/aeji.2020.50410.1118