eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
1
6
10.21608/aeji.2012.14594
14594
Original Article
Goitre by Using Scintigraphy and Biopsy in Sudan
Amin Elzaki
aminzaki2000@yahoo.com
1
Hamid Osman
2
Alzaiem Alazhari University, College of Radiological Sciences and Medical Imaging, Sudan
Taif University, College of Applied Medical Science, Radiological Science Department, KSA
Background and study aim: Goitre has been recognized in Sudan as a public health problem since the 1950's. Nationwide surveys on goitre were launched and various approaches in the quest for a solution to the problem were applied. Still, the number of goitrous individuals continues to grow each year. This article sheds lights and reiterates the frequency of goitre in Sudanese in the basis of scintigraphy and biopsy. The statistical findings should be especially useful to professionals in endemic medicine and endocrinology. Patients and methods:The study was conducted at the Radiation and Isotope Center (RICK), Khartoum . A total of 400 patients received 2 mCi of Tc 99m Pertechnetate intravenously. Imaging was performed using a Nucline gamma camera computer system with general purpose parallel hole collimator. Biopsy was carried out by Fine Needle Aspiration Biopsy (FNAB) with the guidance of ultrasonography. Results : Goitre was more among females (88.8 %) as compared to males (11.2%) with a female: male ratio of 8:1. Goitre increased in the age group 20-40 with an average age of 35 years. Scintigraphy revealed diffuse goitre in 57.5%, multi nodular goitre in 37.5% and a single (solitary) thyroid nodule in 5% of the sample studied. Toxic goitre was reported in 4% of the patients while the rest were diagnosed as non-toxic goitre . The biopsy results showed that 8% of nodular goitres were malignant and the rest had cystic or degenerative changes only. Conclusion : The study suggests that goitre in its major kinds, diffuse or nodular have the same frequency scintigraphically. Thyroid malignancy within nodular goitre remains in the minimum level. The goitre sill remains a major public health issue in Sudan and implementing iodine prophylaxis programs must be more activated
https://aeji.journals.ekb.eg/article_14594_cbec2bebac65bb5a13882536bba2a8c0.pdf
Endemic Goitre
Scintigraphy
Biopsy
Nodular goitre
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
7
15
10.21608/aeji.2012.14600
14600
Original Article
Assessment of Tumor Markers in Bile in Patients with Pancreaticobiliary Malignancy: ERCP- Based Study
Mahmoud El-Bendary
1
Hassan El-Garem
2
Mahmoud Abdel-Aziz
3
Shereen Shawki
4
Ahmed Abdel-Razik
5
Tropical Medicine Department, Faculty of Medicine , Mansoura University, Egypt
Tropical Medicine Department, Faculty of Medicine , Cairo University, Egypt.
Tropical Medicine Department, Faculty of Medicine , Mansoura University, Egypt
Clinical Pathology Department, Faculty of Medicine , Cairo University, Egypt.
Tropical Medicine Department, Faculty of Medicine , Mansoura University, Egypt
Background and study aim: The value of serum tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in the differential diagnosis of obstructive biliary disease is a matter of debate. We aimed to define their role prospectively. Patients and methods: Thirty five cholestatic patients , 14 malignant group, their age ranged from 47-72 years (mean: 58.43 ± 9.08 years), 14 benign group, their age ranged from 46-72 years (mean: 60.21 ± 10.45 years) and 7 calcular, their age ranged from 48-71 years (mean: 60.14 ± 7.78 years) who were referred for endoscopic retrograde cholangiopancreatography examination for obstructive jaundice were included. Bile was obtained through cannulation of ERCP. Serum samples were taken from all patients at the time of acquisition of bile. Serum and bile samples were stored at -80 °C until they were tested. CEA and CA19-9 levels were measured with enzyme immunoassay methods in serum and bile samples by using Immunospec CA 19-9 and Immunospec CEA kits, respectively (Canoga Park,CA, 91303). Results : In 14 patients with malignant disease, serum CEA levels were 36.77 (23.33-124.92) ng/ml and CA19-9 were 418.07 (1.23-483.47) U/ml, while in 14 patients with benign disease the serum CEA levels were 15.43 (0.38-30.80) ng/ml and CA19-9 were 144.6 (3.99-471.15) U/ml. The difference for both values was significant (p<0.05). In malignant disease bile CEA and CA19-9 levels were 5.05 (0-124.84) ng/ml, 455.61 (0.07-483.80) U/ml respectively, while in benign disease the corresponding levels were 3.22 (0-121.81) ng/ml for CEA and 421.45 (0-485.06) U/ml for CA19-9. The differences were not significant in this case (p>0.05). Conclusion :It was concluded that serum CEA and CA19-9 levels are increased both in malignant and benign obstructive biliary diseases. However, levels of serum CEA are markedly increased and mostly restricted to malignant diseases. Measurement of these markers in bile was of no clinical significance.
https://aeji.journals.ekb.eg/article_14600_fe6fc36c7dfd1f8fb9ac9bc68d5ea039.pdf
Carcinoembryonic antigen
carbohydrate antigen
CA19-9
hepatopancreatobiliary disease
Bile
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
16
24
10.21608/aeji.2012.14602
14602
Original Article
Corroboration of Serum Apolipoprotein J (Clusterin) as a Biomarker for Evaluating Hepatocellular Carcinoma
Abeer Nafee
abeern2009@hotmail.com
1
Heba Pasha
hebapasha@yahoo.com
2
Salah Abd El Aal
3
Naglaa Mostafa
4
Tropical Medicine Department , Faculty of Medicine , Zagazig University,Egypt
Medical Biochemistry Department , Faculty of Medicine , Zagazig University,Egypt
General Surgery Department , Faculty of Medicine , Zagazig University,Egypt
Pathology Department , Faculty of Medicine , Zagazig University,Egypt
Background and study aim: Hepatocellualr carcinoma (HCC) is an increasing problem in Egypt. Clusterin has been reported to play a significant role in tumorigenesis. The aim of this study is to evaluate clusterin as a marker for evaluating diagnosis and metastasis potential of HCC. Patients and Methods: Eighty patients with HCC, 30 patients with liver cirrhosis, 30 patients with chronic hepatitis and 30 healthy controls were enrolled in study. The diagnosis of HCC patients was based on computed tomography. Estimation of serum clusterin was done by enzyme linked immunosorbent assay. Results: Serum clusterin levels were significantly increased in patients with HCC (P<0.001). Serum clusterin reached the lowest significant levels in cirrhotic patients. Serum clusterin was highly increased in patients with poorly differentiated tumor and in those with capsular infiltration; also it was significantly related with portal vein invasion and lymph node infiltration. In addition, serum clusterin levels were significantly increased according to the progression of Barcelona Clinic Liver Cancer and Tumor-Nodes-Metastasis staging systems. However, these findings were not observed with alpha fetoprotein (AFP). Receiver operator characteristic curve showed that clusterin had a greater area under curve value (0.95) than that of AFP (0.85). At cutoff value 128 ug/ml, serum clusterin yielded 90% sensitivity and 87% specificity for predicting HCC. While at cutoff value 100 ng/ml, serum AFP had 75% sensitivity and 80% specificity. Conclusion: We concluded that serum clusterin is a promising useful marker for diagnosis of HCC. Higher level of clusterin was closely related to capsular infiltration, venous invasion, lymph node metastasis and poorly differentiated tumor suggesting that clusterin might be deemed as a useful marker for predicting the progression and metastasis potential of HCC.
https://aeji.journals.ekb.eg/article_14602_818514730dd46449e3edce06822cd35f.pdf
Chronic hepatitis
Clusterin
hepatocellualr carcinoma
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
2012-03-01
2
1
25
35
10.21608/aeji.2012.15415
15415
Original Article
Predictors of HCV Response to Treatment with Pegylated Interferon and Ribavirin in Sharkia Governorate
Mohamed Abdel-Aal
alnimrsahar@yahoo.co
1
Monkez Yousif
2
Hoda El-Hady
3
Hala Hussein
4
Sahar El-Nemr
alnimrsahar@yahoo.com
5
Internal medicine Department ,Faculty of Medicine, Zagazig University, Egypt.
Internal medicine Department ,Faculty of Medicine, Zagazig University, Egypt.
Internal medicine Department ,Faculty of Medicine, Zagazig University, Egypt.
Tropical medicine Department ,Faulty of Medicine, Zagazig University, Egypt.
Tropical medicine Department ,Faulty of Medicine, Zagazig University, Egypt.
Background and study aim: The current standard of care (SOC) for chronic hepatitis C (CHC) in Egypt is pegylated interferon and ribavirin (PEG-INF/RBV) for 48 weeks, which is expensive, can be difficult to tolerate and with high failure rate. Additional information about predicting sustained virologic response (SVR) may be helpful in making proper decisions of treatment. This is a retrospective observational cohort study which was designed to identify predictors of SVR to PEG-INF/RBV among a cohort of Sharkian patients in Egypt Patients and methods: 2991 patients with CHC fulfilling all inclusion and exclusion criteria for treatment were enrolled in this study. Patients were allocated randomly to treatment with either PEG-INF α2a/RBV (67.8%) or PEG-INF α2b/RBV (32.2%). Virologic monitoring was planned to be tested basically and at weeks 12, 24, 48 and 72 weeks after initiation of treatment. Results: Analysis of data could be applied to 795 (26.6%) patients of the cohort because of their adherence to protocol and availability of treatment and follow up data. The remaining participants of the study (73.4%) were excluded because of lack of essential data and drop out for various reasons. Overall SVR was encountered in 404 (50.8%) patients and in 54.9% and 44.2% for patients treated with PEG-INF α2a and PEG-INF α2b respectively ( p< 0.0001 ). Responders had statistically significant lower levels of fasting blood sugar, ALT, AST, indirect bilirubin, α fetoprotein, hemoglobin, stage of liver fibrosis and HCV RNA and higher values of alkaline phosphatase,serum albumin, prothrombin time , absolute neutrophil and platelet counts. In multivariate linear regression analysis, early virologic response (EVR) and receiving PEG-INF α2a (rather than PEG-INF α2b) were predictors of SVR. Conclusion: Overall SVR among Sharkian patients with CHC, treated with SOC therapy is 50.8%. EVR is the best independent predictor of SVR. The form of PEG-INF may also predict the treatment response. None of the initial pretreatment variables could predict the SVR to treatment with the current SOC for CHC.
https://aeji.journals.ekb.eg/article_15415_42bdc9b8194658d83a9006087abfc96b.pdf
HCV
Pegylated interferon-α
PEGINF
response predictors
Ribavirin
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
36
53
10.21608/aeji.2012.15811
15811
Extrahepatic Manifestations of Hepatitis C Virus: An Extending List
Amira Soliman
1
Soha El hawari
2
Mohamed Refaey
rifae2007@yahoo.com
3
Nabila Ahmed
nabila.hassan25@yahoo.com
4
Mohamed Emara
emara_20007@yahoo.com
5
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Hepatitis C virus is a hepato-lymphotropic virus that was also detected in various organs of the body. Furthermore, this form of infection may be presented for the first time by an extrahepatic manifestation. Different extrahepatic manifestations for hepatitis C was described; these extend from strong associations as in mixed cryoglobulinemia to others were anecdotal finding as vitiligo was reported. The list of extrahepatic manifestations of hepatitis C is extending. In this review we tried to shade the light on this expanding list.
https://aeji.journals.ekb.eg/article_15811_25763bdfa86cd084c6a8ce373f191295.pdf
HepatitisC
mixed cryoglobulinemia
lymphoproliferative disorders
Porphyria cutanea tarda
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
54
54
10.21608/aeji.2012.15601
15601
Video Case :Stenting of Periampullary Carcinoma
Tarik Zaher
tareqzaher@zu.edu.eg
1
Endemic and Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt.
A 45 years old female Egyptian patient from Fakus , Sharkia , Egypt was presented by upper abdominal pain and jaundice .Abdominal ultrasonography revealed dilated common bile duct (CBD). ERCP showed apparently healthy major duodenal papilla with mild swelling , X ray showed dilated CBD . Sphincterotomy was done with introduction of both basket and balloon in many attempts without extraction of stones. The patient pain and jaundice were relieved .2 months later the patient complained of pain and jaundice again. Another ERCP was performed and showed infiltration of the major papilla. 6.5 cm , 10 F plastic stent was introduced in the CBD with good drainage of bile ( video) . Microscopic examination of the biopsies revealed malignant cells. The patient was operated radically later on.
https://aeji.journals.ekb.eg/article_15601_3398bffff79d877ca80d8b9a5dd889c6.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
55
55
10.21608/aeji.2012.15605
15605
Image Case: Ascaris Worm Extraction During Upper Gastrointestinal Endoscopy
Mohamed Emara
emara_20007@yahoo.com
1
Ibrahim Ibrahim
2
Tropical Medicine Department , Faculty of Medicine , Zagazig University,Egypt
Tropical Medicine Department , Faculty of Medicine , Zagazig University,Egypt
Nematode infection including Ascariais is a worldwide infection [1,2]. Nematode infection in particular ancylostomiasis and ascariasis have long been prevalent in Egypt and trials to trace this infection goes back to Lord Kitehenere in 1913 [3]. Although the decline in the incidence of this form of infection in Egypt, due to application of good hygienic techniques, mass and effective treatment ……etc, we reported a 55 years old male patient with chronic hepatitis C virus infection, nonresponder to pegylated interferon therapy complained from persistent epigastric pain and was non-responder to multiple courses of proton pump inhibitors. We decided to examine this patient by upper gastrointestinal endoscopy, where this long white worm was seen in the duodenum ; extraction by biopsy forceps was done.
https://aeji.journals.ekb.eg/article_15605_2cfdcf4e06117d263633e4f0a3f4ac38.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
56
58
10.21608/aeji.2012.15608
15608
Image Case : Pyloric Stenosis in Female Infant
Amin Elzaki
aminzaki2000@yahoo.com
1
Hamid Osman
2
Nglaa Fathy
3
Alzaiem Alazhari University, College of Radiological Sciences and Medical Imaging, Sudan
Taif University, Faculty of Medical Applied Science, Radiological Science Department, KSA
University of Medical Science and Technology UMST, Faculty of Radiological Science, Sudan
Pyloric stenosis also known as Infantile Hypertrophic Pyloric Stenosis (IHPS), is the most common cause of intestinal obstruction in infancy. IHPS occurs secondary to hypertrophy and hyperplasia of the muscular layers of the pylorus, causing a functional gastric outlet obstruction. IHPS can be diagnosed by radiography and/or ultrasonography. An Endoscopy-Guided Balloon Dilatation (EGBD) is a new non-operative technique which can be used as a choice in treating IHPS.
https://aeji.journals.ekb.eg/article_15608_b1f254ed678779748597d15f3367e103.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-03-01
2
1
59
60
10.21608/aeji.2012.15611
15611
Case 1,2012: A 65 Years Old Man with Tetanus
Tarik Zaher
tareqzaher@zu.edu.eg
1
Khaled Helmy
2
Tropical Medicine Depatrment, Faculty of Medicine, Zagazig University, Egypt
Anesthesia Department and Intensive Care Unit , Faculty of Medicine , Zagazig University ,Egypt
A 65 years old man from Dyrab Nejm, Sharkia Governorate, Egypt with wound in the foot due to penetration by a nail was presented 2 weeks later by dysphagia, trismus (lock jaw), rigidity of the neck, limbs and abdominal muscles. There was no history of bite. Attacks of spasms (convulsions) with occasional cyanosis were noticed. The patients was admitted initially to Zagazig Fever Hospital, then the patient was referred to Intensive Care Unit , Surgical Building , Zagazig University Hospitals, CSF examination was normal, tracheostomy was performed with aspiration of chest secretions and oxygen supply through it. Nasogastric tube (Ryle) was also difficulty introduced. The feeding was enteral .100,000 U equine antitetanic serum was administered intramuscularly in the first days of hospitalization after test for hypersensitivity . The patient was conscious with inability to talk. He wrote what he wanted. The patient was put in dark silent room. Diazepam in a dose of 20 mg/8 hrs infusion was administered for 3 weeks then tapered gradually. Intravenous muscle relaxants was administered for 4 weeks also chlorpromazin in a dose of 50 mg/8 hrs through the Ryle was administered in the first 2 weeks. Metronidazol 500 I.V. every 8 hrs for 10 days was administered as well as prophylactic macrolid antibiotic. By the end of 4 th week of illness the spasms ceased and the patient could talk but neck , abdominal and limbs rigidity were still present .
https://aeji.journals.ekb.eg/article_15611_b2059e301d2d317de388fd592b3b7dbd.pdf