eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
237
240
10.21608/aeji.2020.109358
109358
Editorial : Hepatic Cirrhosis Clinical and Pathological Association; What is beyond?
Talaat Fathy
talaat_fathy1972@yahoo.com
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Cirrhosis is characterized by fibrosis and nodule formation of the liver, secondary to a chronic injury, which leads to alteration of the normal lobular organization of the liver. Various insults can injure the liver, including viral infections, toxins, hereditary conditions, or autoimmune processes. With each injury, the liver forms scar tissue (fibrosis), initially without losing its function. After a long-standing injury, most of the liver tissue gets fibrosed, leading to loss of function and the development of cirrhosis. According to an interesting study published in the current issue of the Afro-Egyptian Journal of Infectious and Endemic Diseases; “Cardiac Changes in Cirrhotic Patients”, 70% of the studied patients with liver cirrhosis have cardiac dysfunction in the absence of other risk factors for cardiac diseases. In addition, the degree of cardiac dysfunction is correlated with the severity of liver disease of cirrhotic patients. According to the study of ‘Assessment of Thyroid Dysfunction in Patients with Chronic Hepatitis C Virus Related Liver Diseases’; published in the current issue of the Afro-Egyptian Journal of Infectious and Endemic Diseases; cirrhotic hepatitis C patients have thyroid abnormalities higher than non-cirrhotic patients do. It is intensely related to the severity of liver affection and the advancing of Child score. Serum bilirubin, prothrombin time, duration of disease and degree of liver cirrhosis are dependent risk factor for TSH abnormalities. TSH, FreeT4 and Free T3 can be considered to be useful prognostic indices.
https://aeji.journals.ekb.eg/article_109358_a12b3a76075c31afd02af176b45a17cb.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
241
248
10.21608/aeji.2020.35918.1096
107600
ERCP among Cirrhotics: What are the differences?
Mohamed Emara
emara_20007@yahoo.com
1
Hassan Elbatee
hassanelbatae_68@yahoo.com
2
Mohamed Radwan
drmmagdy@gmail.com
3
Ibrahim Amer
hema.amer30@gmail.com
4
Mariam Zaghloul
mariam_zaghloul@med.kfs.edu.eg
5
Mohamed Ahmed
dr.mm63@yahoo.com
6
Aya Mahrous
yoye_85@hotmail.com
7
Soha Elhawari
sohaelhawary@yahoo.com
8
Eslam Elshenawy
eslam.elshennawy18@gmail.com
9
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
The endoscopic retrograde cholangio-pancreatography (ERCP) is considered a main therapeutic intervention in the management of biliary and pancreatic disorders. In the average risk populations it is associated with adverse events. The most common adverse event is post-ERCP pancreatitis. Patients with liver cirrhosis are increasingly seen in ERCP theaters with different indications for the ERCP. Because cirrhotic patients are prone to complications it is expected that they develop more adverse events when operated with ERCP. Bleeding diathesis is the most serious because of the underlying coagulopathy and thrombocytopenia that are commonly encountered among them in particular with advanced Child class. In this mini review we discussed how different is the ERCP among cirrhotics regarding the expected benefits and the reported risks and we showed our experience in dealing with this subgroup of patients. The art of managing cirrhotic patients with ERCP is a team work and not a one man show.
https://aeji.journals.ekb.eg/article_107600_40164ca87ebc1bb2efb2c491d623b615.pdf
ERCP
Cirrhosis
Bleeding
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
249
256
10.21608/aeji.2020.25908.1057
95584
Original Article
Cardiac Changes in Cirrhotic Patients
Sameh Abdel Monem
drsameh154@yahoo.com
1
Mostafa Moaz
mostafamoaz2010@yahoo.com
2
Hisham Roshdy
drhisham343@gmail.com
3
Kamal Amer
kamalamer82@gmail.com
4
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.
Department of Cardiology, Faculty of Medicine, Zagazig University, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.
Background and study aim: Cardiac dysfunction in cirrhotic patients presented by imperfect cardiac contractility in response to stress and/or change in the diastolic relaxation of the heart with electrophysiological changes in lack of other recognized cardiac disease. The study aimed to assess the cardiac changes in cirrhotic patients. Patients and Methods: our study was conducted on 100 adult cirrhotic patients who were divided according to the Child Pugh score into 3 groups: G1: comprised 30 Child A patients. G2: comprised 30 Child B patients. G3: comprised 40 Child C patients. Full history, clinical examination, laboratory (CBC, liver and kidney function tests, viral markers and FBS), ECG and cardiac echo-doppler were done for all patients. Results: Out of 100 cirrhotic patients, QTC interval was found to be prolonged in 70 cirrhotic patients. Echo-cardiographic abnormalities were found in Child B and C group patients more than in Child A patients. There was significant increase in Echo parameters as (IVRT and PAP) with liver disease deterioration from Child A to Child C. There was no significant difference regarding left and right ventricular end diastolic diameter among the studied groups. Conclusion: 70% of cirrhotic patients had cardiac changes and there is positive correlation between severity of liver cirrhosis and cardiac changes.
https://aeji.journals.ekb.eg/article_95584_b78a0f867e217d3ed8ce517d3a518db7.pdf
Liver cirrhosis
cirrhotic cardiomyopathy
child pugh score
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
257
263
10.21608/aeji.2020.27008.1062
98669
Original Article
Assessment of Thyroid Dysfunction in Patients with Chronic Hepatitis C Virus Related Liver Diseases
Islam Hassan
islammostafa3889@gmail.com
1
Nader Elnemr
nadernemr95@yahoo.com
2
Mohamed Aboelmagd
aboelmagd_tm@yahoo.com
3
Fatma Moussa Mohamed
frageh2002@hotmail.com
4
Endemic and Infectious Diseases Specialist, Ministry of Health,Egypt.
Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Suez, Egypt.
Department of Endemic and Infectious Diseases, Faculty of Medicine, Suez Canal University, Suez, Egypt.
Department of Infectious, Gastrointestinal and Hepatology Diseases, Faculty of Medicine, Suez University, Suez, Egypt.
Background and study aim: Hepatitis C virus is a hepatolymphotropic virus, which is abundant in liver and different body organs. It has a significant role in the metabolism of thyroid hormones, including peripheral conversion of T4 to T3.This research aimed to assess the thyroid dysfunction in patients with chronic hepatitis C (CHC) related liver diseases. Methods: In this cross section study, we included 200 patients aged between 18-60 years. Patients were categorized into two groups: 50 patients with CHC infection without liver cirrhosis, and 150 patients had cirrhosis. The latter group were categorized based on Child-T-Pugh score into three subgroups; Child A, Child B, and Child C. Each group had 50 subjects. Patients were subjected to history taking, laboratory tests to assess liver and thyroid functions, in addition to abdominal ultrasound. Results: The mean of TSH level in non-cirrhotic group was 2.57 while it was 2.81, 5.53, and 10.47 in child A, child B and C, respectively. FT3 mean values in non-cirrhotic group were 2.88 while it was 2.23, 1.42, and 1.01 in child A, B and C, respectively. The mean of FT4 level in non-cirrhotic group was 1.25 while it was 1.08, 0.84, and 0.77 in child A.B and C respectively. Conclusion: Abnormalities in thyroid profile were higher among patient with cirrhosis than in those without cirrhosis. These abnormalities were strongly related to the severity of liver affection and advanced child T-Pugh scoring.
https://aeji.journals.ekb.eg/article_98669_d42b736a15d5eec3e5bfc9a91a1d5997.pdf
Hepatitis C virus
thyroid hormones
Liver cirrhosis
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
264
270
10.21608/aeji.2020.29616.1078
96072
Original Article
Serum Long Intergenic Non-Coding Ribonucleic Acid LINC00152 as a Potential Predictor of Hepatocellular Carcinoma in Egyptian Patients
Ehsan Abdelrahman
prof_ehsan@hotmail.com
1
Ahmed Abd El-Aal
nagdymedbio@yahoo.com
2
Mona Sobhy
monamandour@hotmail.com
3
Ayman Shamsya
dr.ayman1977@gmail.com
4
Yasmin Zanet
yasminzenet@gmail.com
5
Essam El-Din Bedewy
essambedewyclinic@gmail.com
6
Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Egypt.
Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Egypt.
Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Egypt.
Department of Internal Medicine, Faculty of Medicine, Alexandria University, Egypt
Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Egypt
Background and study aim: HCC diagnosis is mostly dependent on imaging studies as well as laboratory tests. The aim of this study is to evaluate possible significance of circulating Linc00152 level as a potential diagnostic marker for HCC diagnosis among Egyptian patients. Patients and Methods: This Cohort (Prospective observational) study was conducted on 60 patients, who were further divided into three groups; 30 patients with cirrhosis and HCC on top (group I), this group was further subdivided into: 15 HCC patients (stage C and D) according to Barcelona-Clinic Liver Cancer (BCLC) staging system (group IA) and 15 HCC patients (stage A and B) according to BCLC staging system (group IB); 15 cirrhotic patients without HCC (group II), lastly 15 healthy subjects with matched age and sex as a control Group (group III). All were subjected to history taking, clinical evaluation, basic liver functions, AFP, ultrasound abdomen followed by Triphasic CT abdomen to document presence of HCC and Linc00152 level assessment Results: Circulating Linc00152 was elevated in-group I compared to two other groups. Serum Linc00152 yielded showed 90% sensitivity and 66.67% specificity in discriminating HCC from cirrhosis, compared to AFP that showed 63.33% sensitivity and 60% specificity, Combination of Linc00152 and AFP might possess a higher ability to discriminate between HCC and cirrhosis rather than without combination. Conclusion: HCC is clearly accompanied by over expression of serum Linc00152. This study suggested that Linc00152 may be promising diagnostic markers for early HCC, also for cirrhosis detection.
https://aeji.journals.ekb.eg/article_96072_5b41e789780323dead67fa792180fae9.pdf
Keywords: Hepatocellular carcinoma
Cirrhosis
alpha-fetoprotein
Linc00152
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
271
278
10.21608/aeji.2020.29513.1077
96497
Original Article
Clostridium Difficile Infection in Inflammatory Bowel Disease; Does it Have an Impact?
Tarek Sabet
tarek_sabet@hotmail.com
1
Amany Elbanna
amany_elbanna@yahoo.com
2
Essam El-Din Bedewy
essambedewyclinic@gmail.com
3
Mohamed Abozamel
medodoctor25@yahoo.com
4
Shwikar Abdel Salam
shwikar121263@yahoo.com
5
Ayman Shamsya
dr.ayman1977@gmail.com
6
Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Egypt.
Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Egypt.
Department of Tropical Medicine & amp; Hygiene, Faculty of Medicine, University Of Alexandria ,Egypt.
Specialist of Internal Medicine, Alexandria University Students' Hospital,Egypt.
Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Alexandria, Egypt.
Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Egypt.
Background and study aim: Limited data exist on outcomes in inflammatory bowel disease (IBD) patients who develop Clostridium Difficile infection (CDI). The aim of the study to investigate prevalence of CDI in IBD with assessment of the disease behavior in affected patients. Patients and Methods: 30 IBD patients and 15 healthy subjects of matched age & sex as control group. Patient were classified into two groups; group I (15 patients with Crohn’s disease), group II (15 patients with ulcerative colitis) & control group (15 Patients not having IBD). Disease activity for group I was determined by Crohn's disease activity index (CDAI) & for group II by Truelove & Witts score. All patients & controls underwent Computed Tomography Enterocolongraphy, ileo-colonoscopy with ileal & colonic biopsies, and Clostridium Difficile detection & quantification plus detection of toxin A & B using SYBR Green Real-time PCR. Results: 3 patients from group I had CDI and these 3 patients had active disease, one with severe activity (CDAI 550) and two with moderate activity (CDAI 380 & 420). Also 3 patients from group II had CDl and these 3 patients had moderate activity. Only one patient from the control group had CDI carriage (non-toxin producing strain).The rest of patients (38 patients) had no CDI (of them, one patient had mildly active Crohn's disease with CDAI of 200 & two patients had mildly active ulcerative colitis & the others were in remission). Conclusion: Prevalence of toxigenic CDI was 20% among IBD patients and significantly associated with disease activity.
https://aeji.journals.ekb.eg/article_96497_af6fa70c57c1f15bd13ea792308610f5.pdf
Keywords: Clostridium Difficile
inflammatory bowel disease
ulcerative colitis
Crohn's Disease
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
279
286
10.21608/aeji.2020.28686.1075
99579
Original Article
Efficacy of Probiotics for Prevention of Small Intestinal Bacterial Overgrowth (SIBO) Recurrence among Patients with Irritable Bowel Syndrome (IBS)
Abdol-Rahim Masjedizadeh
rahim.masjedi@gmail.com
1
Pezhman Alavinejad
pezhmanalavinejad@gmail.com
2
Sam Shahinzadeh
samsurena@yahoo.com
3
Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Iran. Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Iran.
Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Iran. Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Iran.
Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Iran. Department of Internal Medicine, Ahvaz Jundishapur University of Medical Sciences, Iran.
Introduction and study aim: IBS is the most common functional disorder of gastrointestinal (GI) tract. It is shown that intestinal microbiota plays an important role in the pathogenesis of Irritable Bowel Syndrome (IBS). Recent studies have been shown that probiotics could be effective in the improvement of IBS symptoms by changing gut normal microflora. In this study we investigated the probiotics’ efficacy in prevention of small intestinal bacterial overgrowth (SIBO) recurrence among patients with IBS. Patients and Methods: In a double blind clinical trial, patients with IBS and SIBO who were diagnosed based on positive Hydrogen breath test, initially received antibiotics for a period of 10 days and then randomly divided into 2 groups (Mutaflor probiotic and placebo) after confirmation of negative Hydrogen breath test. After 3 months treatment, breath tests were repeated and frequency of SIBO recurrence was compared between 2 groups. Results: Among 172 patients with IBS and SIBO, 159 cases included the study and after antibiotic treatment and negative breath tests, eventually 156 patients were analyzed. Both groups had similar demographic characters such as age, sex, IBS type and PPI consumption. Frequency of SIBO recurrence were significantly lower in the probiotic group than the placebo group (P=0.033). Frequency rate of constipation and mixed type of IBS were almost similar in both groups (P>0.05) and only there was a significant difference in SIBO frequency between 2 groups as diarrhea dominant IBS (P<0.05). Conclusion: Our study showed that Mutaflor probiotic has beneficial effects on reduction of SIBO recurrence among IBS patients and could be successfully used for treatment of these patients.
https://aeji.journals.ekb.eg/article_99579_2de8b45a621574d763360d38ca234de5.pdf
Irritable bowel syndrome
Small Intestinal Bacterial Overgrowth
probiotic
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
287
293
10.21608/aeji.2020.22168.1084
101189
Original Article
Evaluating the Effects of Anti-Viral Therapy on Insulin Resistance and Diabetic Status in Chronic Hepatitis C patients
Gamal Tawfeek
gamaltawfik@gmail.com
1
Abd El-Raoof El-Deib
draeldeib@hotmail.com
2
Fadia Attia
fadiamostafa@gmail.com
3
Nader El-Nemr
nadernemr2002@yahoo.com
4
Asmaa Faisal
asmaafaisal94@yahoo.com
5
Ahmed Faisal
ahmedf65@yahoo.com
6
Department of Internal Medicine, Suez Canal University, Ismaillia, 41522, Egypt
Department of Internal Medicine, Suez Canal University, Ismaillia, 41522, Egypt
Department of Clinical Pathology, Suez Canal University, Ismaillia, 41522, Egypt.
Department of Endemic and Infectious Diseases, Suez Canal University, Ismaillia, 41522, Egypt.
Department of Internal Medicine, Elkantara West Hospital-Ismailia Governorate.
Department of Endemic and Infectious Diseases, Suez Canal University, Ismaillia, 41522, Egypt.
Background and study aim: Chronically Hepatitis C virus (HCV)-infected patient, develops many complications, as liver cirrhosis, diabetes, and hepatocellular carcinoma (HCC). This study aimed at evaluation of direct acting anti-viral therapy effect on insulin resistance (IR) and glycemic status in CHC patients with type 2 diabetes mellitus, 3 months after the end of treatment. Patients and Methods: This prospective work included 72 (better patients) with CHC and type 2 diabetes. All were enrolled for anti-viral therapy at the center for treatment of viral hepatitis in Ismailia Governorate during the period from September 2015 to September 2016. Data from patients’ candidate for anti-viral therapy was collected at pretreatment and after 12 weeks of therapy. The data including, FBS, IR by Homa IR index and quantitative HCV-RNA. Results: There was a significant decrease in the mean fasting blood sugar (FBS) had occurred after treatment with anti-HCV therapy (p < 0.0001). Also, a significant decrease in the mean of HOMA-IR had occurred after treatment with anti-HCV therapy (p < 0.0001). Conclusion: A significant improvement in FBS as well as IR was declared after successful HCV treatment.
https://aeji.journals.ekb.eg/article_101189_cfb1d3fcf030abd1dd3a60b470a71216.pdf
Chronic hepatitis C
direct antiviral drugs
fasting blood sugar
HOMA-IR
Cirrhosis
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
294
300
10.21608/aeji.2020.23205.1049
102044
Original Article
Evaluation of Golgi Protein-73 as a Tumor Marker in Patients with Hepatocellular Carcinoma
Naglaa El-Toukhy
naglaaeltoukhy@yahoo.com
1
Mona Abd-Alrahman
dr.monayousef2020@gmail.com
2
Hesham Eissa
hisham.issa@fmed.bu.edu.eg
3
Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Benha University, Egypt.
Department of Hepatology and Gastroenterology, Benha Teaching Hospital, Egypt.
Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Egypt.
Background and study aim: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumors. In Egypt, it is the second most common cancer in men, and the sixth most frequent cancer in women. Prognosis of HCC depends on tumor stage, with curative therapies effective only in early stage; thus, new and appropriate HCC markers are highly required. The aim was to evaluate serum diagnostic value Golgi Protein 73 in Egyptian HCC patients. Patients and Methods: This study included 30 HCC patients, 30 cirrhotic patients and 20 healthy controls. For all groups clinical data and imaging results were studied; serum alpha-fetoprotein and Golgi Protein 73 were identified. Evaluation of the tumor characteristics including size, number and location. Okuda, CLIP and Tokyo staging methods used in tumor staging. Results: GP73 was significantly higher in HCC patients compared to cirrhotic patients and controls. Its sensitivity and specificity in HCC diagnosis were 95% and 83.3%, respectively, at cut-off 5.8%. There is a positive correlation between GP73 and Okuda score and ClIP score and no correlations with number and size of the tumor, child's classification, MELD, uMELD and Tokyo stages. Conclusion: GP73 could be a useful diagnostic marker for detection and screening of HCC.
https://aeji.journals.ekb.eg/article_102044_7c70fa85d13f869394ec880149838ff5.pdf
Hepatocellular carcinoma
GP73
alpha-fetoprotein
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
301
309
10.21608/aeji.2020.32823.1092
102579
Original Article
Highlighting the Role of Infections in the Etiology of Fever of Unknown Origin Pointing out Toxoplasmosis; in Port Said Governorate
Ahmed Arnous
hoballah405@yahoo.com
1
Nahla Elgammal
nelgammal@zu.edu.eg
2
Nahed Mostafa
nahoodaah58@gmail.com
3
Soha Elhawari
sohaelhawari@yahoo.com
4
Marwa Salama
marwa.salama2003@gmail.com
5
Eman Fawzy
e.magdy_83@hotmail.com
6
Port Said Fever Hospital, Port-Said Governorate, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Sharkia Governorate, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Sharkia Governorate, Egypt.
Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Sharkia Governorate, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Sharkia Governorate, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Sharkia Governorate, Egypt.
Background and study aim: Fever of unknown origin (FUO) is a state of febrile illness for more than three weeks, with a body temperature greater than 38.3 °C on several occasions and uncertain diagnosis. Conditions blamed for FUO were categorized as infectious diseases, non-infectious inflammatory diseases, neoplasms along with miscellaneous causes. This study aims to identify the infectious causes of FUO counting the parasitic causes in Port-Said Fever Hospital/ Egypt. Patients and Methods: 341 patients admitted to Port-Said Fever Hospital/ Egypt during the period from November 2017 till May 2018 complaining of prolonged fever ≥ 3 weeks, without a definite diagnosis, were included in this study. Complete history taking and clinical data including pattern, duration and degree of temperature, in addition to other co-morbidities, radiological examination, laboratory investigations, and clinical evaluation were reported for each patient. Results: The majority of affected cases were adult males, lived in urban areas, and were in contact with animals. Luncheon and beef were the commonest types of consumed food among the studied population. The uppermost detected infection was tuberculosis (17%) followed by typhoid and Brucella infection (11.7% for each), toxoplasmosis and hepatitis were detected in 2.9% and 1.8% respectively. After investigations, 5.9% of the studied group had hepato-splenomegaly and 77.4% of them presented with lymphocytosis. Clinically, 78.9% of patients had lymphadenopathy and 1.8% had jaundice. Additionally, 75.4% of cases presented with an intermittent fever while 24.6% with continuous fever. Approximately 57.2% of them had fever for three weeks and the majority of patients had fever ≥ 39°c. Conclusion: Tuberculosis, typhoid fever, and brucellosis signified the major identified infectious causes for FUO in Port Said governorate/Egypt. Toxoplasmosis can be represented as one of FUO infectious causes. Patients with toxoplasmosis either presented with lymphadenopathy or not, all of them had hepatosplenomegaly, high CRP, leucocytosis, and eosinophilia.
https://aeji.journals.ekb.eg/article_102579_5070644c50bb5969b77358e5a7f4d8db.pdf
FUO
infectious etiology
human toxoplasmosis
Egypt
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
310
322
10.21608/aeji.2020.34944.1094
107766
Original Article
The Impact of Stem Cells on Parenteral Phase of Experimental Trichinosis during Vaccination Trial
Samia Etewa
setewa53@gmail.com
1
Samira Mohammad
samirametwally1971@gmail.com
2
Amira Saleh
3
Eman Abdelbary
4
Eman Mostafa
emanmostafa81@gmail.com
5
Department of Medical Parasitology, Faculty of Medicine, Zagazig University 44519, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University 44519, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University 44519, Egypt.
Department of Medical Pathology, Faculty of Medicine, Zagazig University 44519, Egypt.
Department of Medical Parasitology, Faculty of Medicine, Zagazig University 44519, Egypt.
Background and study aim: Trichinellosis is a severe food-borne parasitic zoonosis. The protective immunity against infection from crude larval antigens (CLA) was performed effectively which suggests that the whole larvae would be possible vaccine candidates. Bone marrow mesenchymal stem cells (BM MSCs) induce immunomodulatory impacts through affection of T-cell proliferation and cytokine production. Methods: Ninety healthy mice were divided into five main groups, 10 mice each, 30 mice were for attaining BM MSCs and 10 mice for CLA preparation. Group 1 & 2 as control, Group 3: immunized with CLA then infected, Group 4: immunized with MSCs then infected. Group 5 immunized with CLA and MSCs then infected. Mice were challenged by orally infective dose with 500 Trichinella spiralis (T. spiralis) larvae. Results: Showed that significant reduction in the number of T. spiralis larvae was in group 5 (received CLA + MSCs) followed by group 3 (received CLA only) then group 4 (received MSCs only) with percentage reductions of 85.4 %, 82 % and 68.9 %, respectively. G2 (infected only) showed absence of CD8+ infiltration. G3 showed moderate density of CD8+ infiltration, G4 and G5 showed high density CD8+ infiltration. However, muscle sections from G2 showed high density of tumor necrosis factor α (TNFα) infiltration; G3 showed moderate density of TNFα infiltration; G4 showed very low density of TNFα infiltration and G5 showed complete absence of TNFα infiltration. Conclusion: We concluded that immunization by CLA combined with BM MSCs as adjuvant generated T-helper type 2 (Th2)-mediated responses with increased CD8+ cell infiltration and decreased TNF-α required for immunity against trichinellosis with a 85.4% reduction in muscle larvae compared with the control group.
https://aeji.journals.ekb.eg/article_107766_e9ce36771719de5f112fe0dea61b2ec5.pdf
Trichinellosis
crude larvae antigen
bone marrow mesnchymal stem cell
CD8+
TNKα
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
323
326
10.21608/aeji.2020.30749.1085
109207
Lobar Pneumonia in a Farmer Responded to Anti-melioidosis Antibiotics
Chee Yik Chang
ccyik28@gmail.com
1
Medical Department, Sarawak General Hospital, Kuching, Malaysia.
A 46-year-old male, farmer, with no prior medical illness presented with a one-month history of intermittent right-sided pleuritic chest pain and productive cough. He complained of fever and breathlessness 3 days before current presentation to the district hospital. He denied any haemoptysis, night sweats, or contact with pulmonary tuberculosis. On examination, the vital signs were normal and lung auscultation revealed bronchial breath sounds and crepitation over the right upper zone. Chest radiograph demonstrated a right upper lobe consolidation with presence of air bronchogram and abdominal ultrasonography was normal. He was admitted for intravenous antibiotic therapy for a presumptive diagnosis of community-acquired pneumonia. He was initially treated with intravenous amoxicillin-clavulanic acid 1.2 g every 8 hours. Differential diagnosis of pulmonary tuberculosis was also considered but later ruled out as the sputum for direct smear microscopy, GenXpert and culture for Mycobacterium tuberculosis were negative. The melioidosis IgM (ELISA), multiple blood and sputum cultures were also negative. A PCR-based confirmatory test for melioidosis was however not available at our setting. In the ward, he continued to have persistent fever and repeated chest radiograph after 1 week of antibiotic showed worsening of right upper lobe consolidation. At this point in time, melioidosis was suspected due to the risk factor of farming. Antibiotic was then changed to intravenous ceftazidime 2 g every 6 hours. The patient responded positively as evidenced by the resolution of fever and respiratory symptoms, and repeated chest radiograph showed improving consolidation at 2 weeks. He was discharged after completing a 2-week course of intravenous ceftazidime, and simultaneously started on oral trimethoprim-sulfamethoxazole as eradication therapy. Upon review in the outpatient clinic 6 weeks later, chest radiograph showed marked improvement with minimal residual right upper lobe consolidation. He was clinically well and did not show any symptoms of relapse. He was planned for eradication therapy of 20 weeks’ duration.
https://aeji.journals.ekb.eg/article_109207_76d2fc10e4d011815c3763662c88cd9d.pdf
Melioidosis
pneumonia
Burkholderia pseudomallei
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2020-09-01
10
3
327
331
10.21608/aeji.2020.30004.1081
96085
Low-Cost Covid-19 Screening Protocol
mohamed Ghanem
mohamed.abdel_latif@yahoo.com
1
Department of Anesthesia and Surgical Intensive care, Faculty of Medicine, Mansoura University, Egypt
Background: COVID19 still not under human medical control, still killing people every were, virus lethality is unpredictable, time needed till having an effective drug or vaccine is still unclear, and humanity economic resources are being exhausted. Low-cost COVID-19 screening program is of great importance all over the world due to early general inventory of COVID-19 +ve patients before the onset of pulmonary symptoms in highly susceptible population (city, village, hospital clinics…etc). Hypothesis: Blood picture changes in COVID-19 +ve patients as lymphocytopenia , increased D-dimer>1000 µg/L(>1µg/ml) and mild elevation of serum Ferritin [early (survivors >400µg/L)and late (non-survivors >1000 µg/L)] occur early prior to pulmonary symptoms, and portable chest X ray hence can be used as reliable indicator for early COVID-19 diagnosis and this may save the use of CT chest as well as swab-PCR. Conclusion: We can screen out COVID 19 endemic zones and run the outpatient clinics in hospitals with the least coast during the period of lack of effective drug or vaccine against COVID 19 epidemic.
https://aeji.journals.ekb.eg/article_96085_fbd7460238f481db4ae4c08ef5ee07c0.pdf
Low-cost
COVID-19
Screening
Protocol