eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-28
5
3
134
142
10.21608/aeji.2015.17822
17822
Original Article
Significance of Serum Hepatocyte Growth Factor Level in Diagnosis of Hepatocellular Carcinoma
Maha Omar
mahazeinelabedin@yahoo.com
1
Eman Behiry
2
Department of Hepatology ,Gastroenterology and Infectious Diseases, faculty of Medicine, Benha University , Egypt
Clinical and Chemical Pathology Department, Faculty of Medicine, Benha University,Egypt.
Background and study aim : Hepato-cellular carcinoma (HCC) is the most common primary hepatic tumor and one of the most common cancers worldwide. New serum tumor markers are required for diagnosis of HCC as alpha-fetoprotein (AFP), which is the most widely used marker, has poor diagnostic accuracy. Hepatocyte growth factor (HGF) initially identified and molecularly cloned as a potent mitogen of primary cultured hepatocytes, has multiple activities in a variety of tissues during the course of development and also in various disease states. This study was conducted to assess the diagnostic value of serum HGF as a biomarker for diagnosis HCC. .
Patients and Methods: This study was conducted on 30 patients with documented HCC and 30 cirrhotic patients with no evidence of HCC; as well as 25 healthy subjects who served as control group. The levels of AFP and HGF were measured for all cases together with full clinical assessment, liver biochemical profile, viral markers, ultrasound, and abdominal triphasic computerized tomography (CT) scan.
Results: The mean value of serum HGF was highly significantly elevated in HCC group compared to the control group (P<0.001), and its level was higher in HCC than cirrhotic group (795.8 ± 312.04 Vs 322.7 ± 45.2 pg/ml respectively) with significant difference (P<0.001). There was significant correlation between serum HGF level and both ALT, MELD score in HCC group (P = 0.005, 0.02 respectively). At cut off level equal or more than 426.1 pg/ml, HGF could diagnose HCC with 96.7% sensitivity and 98.2% specificity and AUROC was 0.99.
Conclusion: Serum level of HGF could be considered useful marker for diagnosis of HCV related HCC.
https://aeji.journals.ekb.eg/article_17822_f76662003d899e1bbd412381a2e2d3f2.pdf
Diagnosis
HCC
Hepatocyte growth factor
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-30
5
3
143
151
10.21608/aeji.2015.17823
17823
Original Article
Efficacy of Using Neutrophil to Lymphocyte Ratio and Interleukin 6 as Outcome Predictors of Interventional Treatment of Hepatocellular Carcioma
Salama El-Ghoneimy
1
Amira Soliman
2
Mervat Azab
3
Ahmed El-Gebaly
icegebo2011@yahoo.com
4
Sameh Abdel Monem
drsameh154@yahoo.com
5
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
Clinical Pathology 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
https://aeji.journals.ekb.eg/article_17823_3d513336c2caf47b8b8dfcd4dbfe12e4.pdf
Background and study aim: Hepatocellular carcinoma (HCC) is currently the fifth most common solid tumor worldwide and the third leading cause of cancer-related death. Percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA) techniques b
the first group included 72 patients whom had NLR less than 5 and the second group included 64 patients whom had NLR equal or more than 5. Patients underwent PEI or RFA. Clinical assessment
laboratory evaluation and triphasic CT studies were performed to all patients pre-treatment and at 1
6 and 12 months post treatment. NLR and IL-6 level were performed to all patients pre treatment and at 6 months post treatment. Results: The percentage of complete ablation is highly significantly higher in group I after 1 month but
there is no significant difference between outcome of treatment after 1 year in both groups one year after treatment. Post-procedural IL-6 showed highly significantly lower levels in patients whose focal lesions remain ablated till 1 year than in tho
while NLR did not show significant difference among these groups. Post-prcedural IL-6 levels were highly significantly lower in survived than died cases
while NLR did not show significant differences between both groups at 1 year follow up. There was no significant difference in the post-procedural level of NLR or IL-6 between the group who was treated with ethanol injection and who was treated with
liver profile
hematological profile and diameter of focal HCC and also is a good predictor for short term outcome (1-6 months) and neither pre-procedural or post-procedural NLR are predictors of long term outcome or survival (1 year). Post-procedural IL-6 could be
but also for efficacy of treatment
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-29
5
3
152
159
10.21608/aeji.2015.17824
17824
Original Article
Insulin Resistance as Predictor for Esophageal Varices in Hepatitis C Virus Cirrhosis
Fatma Abd El-Salam
1
Hatem Abd El-Raouf
2
Salama El Shinawy
3
Mohamed Mostafa
dr.shawky2008@gmail.com
4
Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Benha University,Benha,Egypt.
Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Benha University,Benha,Egypt.
Clinical pathology Department, Shebein EL-Kom Teaching hospital, Shebein EL-Kom, Egypt.
Hepatology, Gastroenterology and Infectious Diseases Department , Shebein El-Kom Teaching Hospital, Shebein El-Kom,Egypt
Background and study aim :Portal hypertension is one of the most important complications of liver cirrhosis. Endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary additional burden to endoscopic units. This study is designed to assess insulin resistance in cirrhotic patients due to hepatitis C infection as non invasive parameter for esophageal varices. .
Patients and Methods: This study was conducted on 50 cirrhotic patients (Child A) post hepatitis C who attended the Hepatology Department and outpatient clinic at Shebein El Kom Teaching Hospital. All the patients were evaluated by thorough history ,clinical examination, biochemical parameters ,metabolic features, including insulin resistance by the homeostasis model assessment (HOMA), ultrasonongraphy , liver biopsy and upper gastrointestinal endoscopy to search for esophageal varices.
Results: EVs (esophageal varices) were detected in 18 of 50 patients. By multivariate analysis ,the presence of EVs was independently associated with a low platelet count/spleen diameter ratio (562.75 + 99.16) , a high HOMA-IR score (5.49 + 0.754), high body mass index , low hemoglobin, low albumin, high alanine aminotransferase and high aspartate aminotransferase.
Conclusion: Insulin resistance in patients with Hepatitis C virus cirrhosis (Child A ) measured by HOMA-IR score significantly predicts the presence esophageal varices in this patients and can be used as non-invasive parameter for predicting esophageal varices.
https://aeji.journals.ekb.eg/article_17824_dd7c04732327c620495e940ab22a6ccb.pdf
Oesophageal varices
Insulin Resistance
upper gastrointestinal endoscopy
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-28
5
3
160
170
10.21608/aeji.2015.17825
17825
Original Article
Study of Serum Golgi Protein 73 Level as a Marker for Diagnosis of Hepatocellular Carcinoma
Hany Sabry
1
Hossam Mohamed
2
Wafaa Radwan
3
Naglaa El Abd
naglaa_elabd@yahoo.com
4
Tropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Tropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Clinical Pathology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Tropical Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
Background and study aim :Hepatocellular carcinoma (HCC) is the fifth most common neoplasm in the world, and the third most common cause of cancer-related death. Golgi protein 73 is normally expressed in epithelial cells of many human tissues. GP73 expression is upregulated in hepatocytes, and in serum from patients with hepatitis and liver cirrhosis regardless the etiology. This work aimed to study the diagnostic role of serum Golgi protein 73level as a marker for HCC.
Patients and Methods: This study was conducted on 48 patients with HCC on top of liver cirrhosis (GI), 20 patients with liver cirrhosis (GII), and 20 healthy controls (GIII). Patient and controls were subjected to careful medical history, full clinical examination and laboratory investigations including CBC, ESR, liver function tests, renal function tests, viral markers, serum AFP and Serum Golgi protein 73 by ELISA.
Results: Serum GP73 showed highly significant increase (with P value <0.001) in HCC group X±SD (1765.92±747.99) in comparison with cirrhoticX±SD (772.45±73.84) and control X±SD (458.30±103.03) groups, also significantly increased in cirrhotic group in comparison with control group. There was significant increase in mean values of serum GP73 in patients with HCC associated with portal vein thrombosis or lymph node enlargement also there was significant positive correlationbetween GP73 and tumor size. In diagnosis of HCC, at cut off point 55 ng/ml, AFP had sensitivity 81.3% and specificity 70.0%, and Gp73 at cut off point 847.5 ng/l, the sensitivity was 93.8% and specificity 90.0%. With combined use of AFP and Gp73: the sensitivity of diagnosis of HCC increased to 95.8%.
Conclusion: Significant increase in sensitivity, accuracy and negative predictive value with combined use of AFP and Gp73 than AFP alone in diagnosis of HCC.
https://aeji.journals.ekb.eg/article_17825_66c77409c6f4296062c38280add83a8e.pdf
Golgi protein 73
Hepatocellular carcinoma
Alphafetoprotein
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-29
5
3
171
176
10.21608/aeji.2015.17826
17826
Original Article
Radiofrequency Thermal Ablation versus Microwave Ablation for Small Hepatocellular Carcinoma
Mohamed Mohamed
1
Hatem Abd El-Raouf
2
Waleed El Agawy
3
Mohamed Elshewi
4
Esam Hamed
esam.hamed84@gmail.com
5
Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Benha University,Benha,Egypt
Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Benha University,Benha,Egypt
Hepatology, Gastroenterology and Infectious Diseases Department, Mahalla Hepatology Teaching Hospital, Egypt
Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Benha University,Benha,Egypt
Hepatology, Gastroenterology and Infectious Diseases Department, Mahalla Hepatology Teaching Hospital, Egypt
Background and Study Aim : Hepato-cellular carcinoma (HCC) is the fifth most common form of cancer worldwide and the third most common cause of cancer-related deaths. This study was designed to investigate the therapeutic efficacy ofpercutaneous Radiofrequency ablation versus Microwave ablation for small HCC measuring ≤3 cm in diameter.
Patients and methods : This study was carried out in Al-Mahalla Hepatology Teaching Hospital on 30 patients with cirrhosis and small HCC. All the patients were evaluated by thorough history, clinical examination, laboratory investigations, abdominal ultrasound and spiral triphasic CT.
Results: The mean age was 56.2±5.8, 70% (21) were males and 30% (9) were females. There was highly statistical significant increase in liver function in MW ablation as regard AST, ALT and bilirubin, and decrease in a FP level of both groups after treatment. There was no significant difference between two groups in the response to treatment as regarding Triphasic CT and complications.
Conclusion: Microwave (MW) and Radiofrequency (RF) ablation are similar in pathologic appearance and imaging characteristics, but RFA has many limitations and many complications. MW ablation offers many of the advantages of RF ablation while overcoming some of its limitations and the heat-sink effect.
https://aeji.journals.ekb.eg/article_17826_31016790c582bf1f85d6ff53394733d7.pdf
Hepatocellular carcinoma
Radiofrequency ablation
Microwave ablation
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-10-01
5
3
177
182
10.21608/aeji.2015.17827
17827
Original Article
Study of the Impact of Liver Cirrhosis on Health-Related Quality of Life in Chronic Hepatic Patients, Menoufia Governorate
Mohamed Nouh
1
Amira Badawy
2
Hala Mohamed
3
Sherien El-Kashash
dr.shosho3@yahoo.com
4
Tropical Medicine Department, Faculty of Medicine, Menoufiya University,Egypt.
Tropical Medicine Department, Faculty of Medicine, Menoufiya University,Egypt.
Public Health Department, Faculty of Medicine, Menoufiya University,Egypt.
Tropical Medicine Department, Faculty of Medicine, Menoufiya University,Egypt.
Background and study aim: cirrhosis is associated with morbidity and mortality and complications of cirrhosis. Health-related quality of life should be considered an important outcome measure in the treatment of cirrhotic patients. This study is designed to assess the impact of liver cirrhosis on a weighted score of health – related quality of life in those patients.
Patients and Methods: This study was conducted on four groups of patients and control subjects. Group I included 50 Child A liver cirrhosis. Group II included 50 Child B cirrhosis. Group III included 50 Child C liver cirrhosis. Group IV as healthy control subjects. All patients and control subjects completed a Medical Outcomes Study Short Form 36 (SF-36) questionnaires used for measuring the health related quality of life.
Results: There was a highly significant decrease in the short form-36 questionnaire score of health related quality of life with the Child score progression in comparison to other healthy persons, There was statistical significant positive correlation between The SF-36 scores (vitality (energy/fatigue) scale and physical functioning scale) and occupation and education level.
Conclusions: cirrhosis reduced the quality of life of the patients; advanced Child score and development of complications have a negative effect in their quality of life.
https://aeji.journals.ekb.eg/article_17827_7cd8b42930b3b2f87e6e9741261bbed8.pdf
Cirrhosis-Quality of life-SF-36-Child score
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-28
5
3
183
188
10.21608/aeji.2015.17828
17828
Original Article
Study of the Role of Serum Procalcitonin Level in Differentiation between Bacterial and Viral meningitis
Mohamed Nouh
1
Gamal Eldeeb
2
Mohamed Rizk
3
Mohamed Abdelhakam
mohammed.salama.abdel.hakam@gmail.com
4
Tropical Medicine Department , Faculty of Medicine, Menoufia University, Egypt
Tropical Medicine Department , Faculty of Medicine, Menoufia University, Egypt
Biochemistry Department ,Faculty of Medicine - Menoufia University, Egypt
Menouf Fever Hospital, Egypt
Background and Study aim: Serum procalcitonin (PCT) is specific for the diagnosis of bacterial infection. The aim of this study is to evaluate the role of serum PCT in diagnosis of septic meningitis in adults and its efficacy in differential diagnosis.
Patients and Methods: The study included 30 adults of septic meningitis and 30 adults with aseptic meningitis admitted in Menouf Fever Hospital and Tropical Medicine Department with fever, headache, vomiting and seizure. The diagnosis of septic meningitis was based on clinical features; physical examination, blood and cerebrospinal fluid (CSF) cytochemical findings, Gram stain and bacterial culture. Thirty cases of aseptic meningitis admitted during same period were also included in the study, and 20 subjects of matched age and sex, free from any CNS diseases undergoing spinal anaesthesia for non CNS surgical causes as control. Serum PCT was measured by Gloryscience ELISA Kit.
Results: Serum PCT level was significantly higher in patients with septic meningitis than those with aseptic meningitis (P<0.001). In culture and Gram stain positive 23 and 20 cases respectively, serum PCT was significantly elevated (23.123 ± 9.894 pg) than aseptic meningitis (8.652± 1.777pg) (P<0.001). At optimum cut off value of ≥10.36 pg/mL, based on area under receiver operating characteristic (ROC) curve, PCT showed sensitivity, specificity of 100 % and 86.6% respectively for the differentiation of septic from aseptic meningitis.
Conclusions: Serum PCT may be used as diagnostic marker for septic meningitis and its differentiation from aseptic meningitis.
https://aeji.journals.ekb.eg/article_17828_4c3a0a5325206f12807e253426b52a49.pdf
Serum PCT. Septic meningitis .Aseptic meningitis
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-20
5
3
189
200
10.21608/aeji.2015.17830
17830
Dengue and Dengue Hemorrhagic Fever
Maysaa Saeed
dr.maysaaabdallah@windowslive.com
1
Tarek Attia
tareqhamed@liv.com
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt..
Pediatric Department, Faculty of Medicine, Zagazig University, Egypt
Dengue is endemic in at least 100 countries in Asia, the Pacific, the Americas, Africa, and the Caribbean. The World Health Organization (WHO) estimates that 50 to 100 million infections occur yearly, including 500,000 dengue hemorrhagic fever (DHF) cases and 22,000 deaths, mostly among children. Both epidemic and endemic transmission of dengue viruses are maintained through a human-mosquito-human cycle involving mosquitoes of the genus Aedes (Stegomyia). Typical clinical manifestations of dengue range from self-limited dengue fever (DF) to dengue hemorrhagic fever with shock syndrome. Most dengue virus infections in adults are symptomatic. In contrast, most infections among children under age 15 years are asymptomatic or minimally symptomatic. Classic dengue fever is an acute febrile illness accompanied by malaise, headache, retro orbital pain, and marked muscle and joint pains, which evoked the term "break-bone fever". DHF is the most serious manifestation of dengue virus infection and can be associated with circulatory failure and shock. Plasma leakage is the most specific and life-threatening feature of DHF.
https://aeji.journals.ekb.eg/article_17830_cd20786b2dec02ca1594222ba38f9982.pdf
flaviviruses
Dengue virus
hemorrhagic fever
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-29
5
3
201
204
10.21608/aeji.2015.17831
17831
Rhinocerebral Mucormycosis Presented with Cranial Nerves Deficit
Maysaa Saeed
dr.maysaaabdallah@windowslive.com
1
Tarek Attia
2
Abdullah Al Ghamdi
3
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt.
Pediatric Department, Faculty of Medicine, Zagazig University, Egypt.
Internal Medicine Department, King Saud Medical City, Kingdom of Saudi Arabia.
Mucormycosis is a rare opportunistic fungal infection, associated with high mortality, characterized by infarction and necrosis of host tissue. Rhinocerebral mucormycosis (RCM) is the most common clinical variant often associated with poorly controlled diabetes mellitus. The treatment is complex and involves both antifungal and surgery. There is no formal guideline regarding the duration of antifungal, timing and extent of surgical management. We present a case of RCM in a diabetic girl who presented with a 2 weeks history of left facial and periorbital swelling associated with left facial numbness and deficit of the fifth and seventh cranial nerves. Diagnosis of RCM was confirmed by histopathological examination of tissue biopsy. She was successfully treated with liposomal amphotericin B and posaconazole, as step-down therapy, along with minimal surgical debridement. We present this case because of the rarity of RCM, calling for prompt initiation of treatment in a suspected case and to present data about therapeutic modality.
https://aeji.journals.ekb.eg/article_17831_cc5a7500dc0db461275b55e6b821464e.pdf
Diabetes mellitus
mucormycosis
zygomycosis
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-25
5
3
205
205
10.21608/aeji.2015.17833
17833
Video case: Multiple Colonic Polyposis in 28 Years Old Man with Family History of Cancer Colon
Tarek Zaher
tareqzaher@gmail.com
1
General Medicine
28 years old man with family history of cancer colon presented for screening colonoscopy , which revealed 3 sessile ascending colon polyps which were difficult for excision due to looping and jumping of the scope to be followed and excised later on (after 3 monthes). Another pedunculated ascending colon polyp was excised .Also single sigmoid colon and 3 different sizes rectal polyps were excised.
https://aeji.journals.ekb.eg/article_17833_615fb8cd39d180a108899e7196614f8b.pdf
eng
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2015-09-28
5
3
206
206
10.21608/aeji.2015.17835
17835
Image Case:Endoscopic Banding of Dieulafoy's Lesion in 9 Years Old Girl
Mohamed Refaey
rifae2007@yahoo.com
1
Tarek Zaher
tareqzaher@gmail.com
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt.
General Medicine
A 9 years old girl presented with first attack of hematemesis and melena .Upper gastrointestinal endoscopy revealed active blood spurting from Dieulafoy’s lesion ~ 5 cm away from the cardia .Endoscopic banding was performed ,followed by mucosal tattooing using methylene blue,with excellent hemostasis.
https://aeji.journals.ekb.eg/article_17835_598cd582ffdc02ebd2e5ef3ae2686c2a.pdf