eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
95
103
10.21608/aeji.2012.16069
16069
Original Article
Different Treatment Modalities for Improving HCV Response
Ghada Salem
1
Nahla El-Gamal
2
Maged Abd El-Aziz
3
Rashed Hassan
4
Tropical medicine Department , Faculty of Medicine, Zagazig University,Egypt
Tropical medicine Department , Faculty of Medicine, Zagazig University,Egypt
Tropical medicine Department , Faculty of Medicine, Zagazig University,Egypt
Tropical medicine Department , Faculty of Medicine, Zagazig University,Egypt
Background and study aim: Hepatitis C virus is a major health problem throughout the world .Interferon (INF) was the only therapeutic opinion until the mid 1990s.Ribavirin(RBV) when added improve the SVR rate (8 to 42%) in patients with genotype 4 infection. Nitazoxanide induces a naturally occurring antiviral intracellular protein and a key mediator of host cell defense against viral infection, it is also believed that it inhibits viral glycoproteins at the post translational level. We aimed to study the impact of NTZ in addition to PEG-INFα 2a and RBV on virological response in patients with chronic hepatitis C. Patients and Methods: In this work, we studied 100 HCV patients who met the inclusion criteria of age, BMI, normal laboratory findings of liver and kidney functions, CBC, blood glucose level, thyroid functions and with absence of immunological disease. Quantitative PCR for HCV RNA and liver biopsy were done for each patient. Any patient showed more than F3 or A3 in this biopsy was excluded. All patients are followed clinically and by laboratory throughout the period of the study. All patients were divided into three groups: Group (A) received the SOC: PEG-IFN α2a 180µg and RBV (1000, 1200mg), group (B): received SOC and Nitazoxanide and group (C): received NTZ alone. Results: EVR in group (A) patients was 83.3% compared to 86.6% in group B patients . 24 week PCR negativity was 76.6% for group A and 80% for group B . As regard NTZ as a monotherapy ; four patients (10%) showed pEVR (>2log drop in HCV RNA) but they failed to achieve – ve HCV RNA at the end of treatment, nineteen patients showed <2log drop in HCV RNA at week 12. Out of these nineteen patients, 15 patients showed further decrease in HCV viral load at weeks 24. Abdominal pain 7%, nausea 5% vomiting 2.5%, urine discoloration 2.5% were the most side effects of NTZ. Conclusion: We can conclude that treatment modalities with PEG- INF, RBV and NTZ is associated with increase in virological response rates and monotherapy of CHC patients with NTZ decreases HCV RNA viral load in some patients, there was mild side effects attributable to NTZ.
https://aeji.journals.ekb.eg/article_16069_e08d461c5a505736d1d3d5323d258d44.pdf
Treatment
HCV
Response
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
104
110
10.21608/aeji.2012.16009
16009
Original Article
Serum Level of pro Brain Type Natriuretic Peptide in Diuretic Resistance and Diuretic Respondent Ascites in Cirrhotic Patients
Ehab Mostafa
erhhnoh@yahoo.com
1
Emad Hamed
2
Marawan Atiyah
3
Hoda Hagrass
4
Internal Medicine Depatrment,Faculty of Medicine, Zagazig University, Egypt
Internal Medicine Depatrment,Faculty of Medicine, Zagazig University, Egypt
Internal Medicine Depatrment,Faculty of Medicine, Zagazig University, Egypt
Clinical Pathology Department,Faculty of Medicne, Zagazig University, Egypt
Background and Study aim: Diuretic resistance in patients with cirrhosis is clinically manifested by the failure to lose weight or ascetic volume despite high dosages of loop diuretics and sodium restriction. Natriuretic peptides(NP) promote natriuresis and diuresis. Atrial natriuretic peptide (ANP) is known to act as a rapid response hormone and Brain natriuretic peptide( BNP) more as a “back up hormone” activated only after prolonged ventricular overload .Pro BNP are more stable and have been suggested to have a longer biological half life than other natriuretic peptides . The aim of this work is to study the effect of vascular volume on serum level of Pro BNP and to find out the difference of serum level of pro BNP in both diuretic resistant and diuretic responder ascites. Patients and Methods: The study was conducted on 89 patients. Patients subdivided into 2 groups :group 1(41 patients) described as diuretic resistance ascites and group 2 (48 patients) as diuretic respondent.In which both groups underwent laboratory and echocardiography study . NT-proBNP were measured by electrochemiluminescence immunoassay “ECLIA ” , Doppler echocardiography by using a System FiVe digital ultrasound machine. Results: There was no significant difference between the groups as regards age, serum potassium, liver enzymes, serum bilirubin, total proteins, international normalized ratio or partial thromboplastin time. The following parameters were significantly lower in the diuretic-resistant group: serum albumin and platelet count. However, the diureticresistant patients had higher blood urea nitrogen (BUN), serum creatinine and higher Child score. There were significant differences between both groups regarding serum level of pro BNP, serum and urinary NA, left atrial dimension (LAD) and left ventricular end diastolic dimension (LVEDD) in which all parameter were higher in diuretic respondent versus resistant group. Also significant positive correlation was noted between Pro BNP and serum and Urinary NA, LAD and LVEDD. Conclusion: Pro BNP is higher in diuretic responder than in diuretic resistance group, and although the latter group has a higher level of Pro BNP than the cut off point but it is not enough to induce diuresis. Also we found that decrease intravascular compartment may decrease cardiac chamber expansion with subsequent decrease in the level of natriuretic peptide leading to decrease the response of diuretic.
https://aeji.journals.ekb.eg/article_16009_81ebba62bc21782756beb8a0de1ecd84.pdf
Diuretic resistance ascitis
diuretic respondent
Natriuretic peptide
Pro BNP
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
111
120
10.21608/aeji.2012.16010
16010
Original Article
Tuberculosis Effects in Urinary Tract by using Ultrasound in Sudan
Mustafa Mahmoud
zuhairmustafa4@hotmail.com
1
Yousif Hamdeen
2
Sudan University of Science and Technology, College of Medical Radiological Science, Fundamental Medical Radiologic Sciences Department, P.O. Box: 1908, Khartoum- Sudan.
Al-Nihood Teaching Hospital, Radiology and Medical Imaging Department, Khartoum- Sudan.
Background and study aim: Tuberculosis (TB) is a huge public concern in Sudan. According to the world health organization (WHO), Sudan alone carries 15% of the TB burden in the Eastern Mediterranean Region. This study was designed with the aim to evaluate the clinical value of sonography in the diagnosis and determine the effects of TB in the urinary tract (kidneys, ureters and urinary bladder) of infected and untreated Sudanese subjects. Patients and Methods: This prospective study was conducted at Al-Nihood Teaching Hospital in West Kurdufan State- Sudan. It spanned a period of 4 years from January 2008 to January 2012, involving 200 untreated Sudanese patients (118; 59% males and 82; 41% females) and aged 1 to 85 years; mean age of 37 ± 2.9 years. Samples proved to have TB either by one urine culture positive for Mycobacterium TB, or a histopathological confirmation of caseating necrotic lesions in a biopsy or surgery specimen. Sonography was performed using Toshiba Just Vision 200 and Tokimec CS-2020 fitted with 3.5 MHz convex transducers. Results: In TB patients, ultrasound findings in kidneys were varied and included wide spectrum of abnormalities like renal stones (24%), hydronephrosis (17%), renal cavitations (8%), renal cyst (16%), Pyelonephritis (12%), parenchymal renal disease (9%), renal abscess (3%), atrophied kidneys (5%), renal solid mass, end stage kidney disease and non visualized kidneys (2%). Findings in ureters include hydroureter (8%) and in urinary bladder (UB) ultrasound detected UB wall thickening (12.5%), vesicle stone (1%) and UB mass (0.5%). Conclusion: Urinary tract sonography is a quick and non invasive method of evaluating the urinary tract in miliary TB conditions. Therefore, after proven TB infection either by urine culture or histological confirmation, ultrasound can used widely to determine its effects in urinary tract and to monitor the therapeutic efficacy in a clinical situation.
https://aeji.journals.ekb.eg/article_16010_5625ee841816ec5695be34e1e1577450.pdf
tuberculosis
urinary tract
Ultrasound
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
121
124
10.21608/aeji.2012.16062
16062
Acute Diarrheal Illness – The Most Common Medical Problem Worldwide
Angela Revelas
donnoiko@gmail.com
1
St.Nicolaos General Hospital ,Crete, Greece
Diarrhea can result in significant morbidity and mortality, depending on the degree of severity. The history and clinical presentation should dictate initial treatment and management.
https://aeji.journals.ekb.eg/article_16062_17a6a0d06f3c31dd8e96e01a19e3da9a.pdf
diarrhea
viral
Bacterial
protozoal
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
125
130
10.21608/aeji.2012.16065
16065
Gastrointestinal Stromal Tumors with Unusual Presentations: Case Series
Mohamed Refaey
rifae2007@yahoo.com
1
Mohamed Emara
emara_20007@yahoo.com
2
Tarik Zaher
tareqzaher@zu.edu.eg
3
Tarik Ezzat
4
Magdy El-Moghazy
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.
General Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
General Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Background: Gastrointestinal stromal tumors are rare mesenchymal tumors; and it may be presented by a variety of manifestations.. Case Presentation: A 56-year-old Egyptian male patient presented with a massive gastrointestinal bleeding with hemodynamic instability, with history of previous two mild attacks. After initial resuscitation, endoscopic, pathological and immunohistochemical examination; diagnosis of gastrointestinal stromal tumor was confirmed. The patient's tumor is of low risk and complete surgical excision with safety margins was performed. Another 60-year-old Egyptian female diabetic patient presented for preoperative assessment for cataract operation. On examination large abdominal mass was discovered. After initial diagnostic work up surgical resection was done. Pathological and immunohistochemical examination confirmed the diagnosis of gastrointestinal stromal tumor. Conclusion: Gastrointestinal stromal tumors, should not be overlooked while investigating cases of massive upper gastrointestinal bleeding and cases of large abdominal masses especially in elderly patients
https://aeji.journals.ekb.eg/article_16065_5da8aed251cbad084e412a0ab227ffc9.pdf
Gastrointestinal stromal tumors
hematemesis
melena
abdominal mass
immuonohistochemisrty
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
131
131
10.21608/aeji.2012.16066
16066
Video case: Diagnosis of Achalsia by Abdominal Ultrasonography
Mohamed Emara
emara_20007@yahoo.com
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt
A-55-year old female presented by progressive dysphagia over a long period, she refused endoscope examination for a long period. On abdominal ultrasonic examination the esophageus appeared dilated and tapers in a funnel shaped manner. Upper endoscopic examination and barium swallow confirmed the diagnosis.
https://aeji.journals.ekb.eg/article_16066_abfceed09ee954699ad1ae1df2fdef36.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2012-09-01
2
3
132
132
10.21608/aeji.2012.16067
16067
Image Case:Extraction of an Impacted Coin in Upper Esophagus in 3 Years Old Female
Mohamed Radwan
mradwan@zu.edu.eg
1
Mohamed Emara
emara_20007@yahoo.com
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
A 3-year-old female swallowed a large metallic coin (one Egyptian pound; the largest coin in Egypt). Laryngeal examination failed to demonstrate the coin and serial X ray films showed the coin impacted in the upper esophagus. Extraction under general anesthesia was done 5 days after swallowing. Areas of pressure necrosis at the site of impaction, as well as changes in the coin were noticed.
https://aeji.journals.ekb.eg/article_16067_18ff58b241f5baa570bba5358e180391.pdf