ORIGINAL_ARTICLE
Detection of Parasites During Upper Gastrointestinal Endoscopic Procedures
Background and study aim: : Helminthic and protozoal infestation of the alimentary tract is endemic in tropical and subtropical areas and also occur in temperate zones. The aim of this study was to evaluate the frequency and characterization of parasites detected during upper digestive endoscopic procedures. Patients and methods:: Retrospective analysis of the records of patients exposed to upper endoscopic procedures in the endoscopy units, Tropical Medicine Department, Zagazig University Hospitals, Egypt in a 5 year period extending from January 2007 to January 2012. A total of 4925 cases were included; 4708 cases for gastrodudenoscopy (EGDS) and 217 cases for endoscopic-retrograde-cholangio-pancreatography (ERCP). All cases were reviewed as regard age, sex, residence, indications for endoscopy and endoscopic features. Cases with parasitic infestations were characterized regarding the mentioned variables. Results : :A total of 8 cases with parasitic infestations were described. Six cases detected by EGDS and 2 cases by ERCP. Five cases were Ancylostoma duodenale , one case Ascaris lumbricoides, one case Strongyloides stercoralis and one case Fasciola hepatica. Most cases were presented with anemia and persistent epigastric pain. Seven cases were associated with duodenitis on endoscopic examination. Conclusion : :Parasites are not common findings during upper digestive endoscopic procedures, and should be suspected in patients with anemia and persistent epigastric pain.
https://aeji.journals.ekb.eg/article_15404_55d376584a2e70283243b173947c83d2.pdf
2012-06-01
61
68
10.21608/aeji.2012.15404
Parasites
Ancylostoma
Ascaris
Strongyloides
Fasciola
Endoscopy
Tarik
Zaher
tareqzaher@zu.edu.eg
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohamed
Emara
emara_20007@yahoo.com
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
Ehab
Darweish
3
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohieddin
Abdul-Fattah
4
Parasitology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmed
Bihery
ahmedbihery@yahoo.com
5
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohamed
Refaey
rifae2007@yahoo.com
6
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohamed
Radwan
7
Parasitology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Helicobacter Pylori Infection / Hepatic Encephalopathy InterRelationship before and after its Eradication
Background and study aim: Helicobacter pylori (H. pylori) bacteria convert urea to ammonia, which has been implicated in causation of hepatic encephalopathy(HE) in patients with liver cirrhosis.The aim of this work was to assess the effect of helicobacter pylori infection and its eradication on hepatic encephalopathy. Patients and methods: From March 2010 to November 2011, in Tropical Medicine Department, Zagazig university Hospitals, 90 patients with grade 0-II hepatic encephalopathy were enrolled in the study. The patients diagnosed for hepatic encephalopathy using psychometric tests [number connection test (NCT), and circle connection test( CCT)] and Grading of the symptoms of hepatic encephalopathy was performed, they were evaluated for H. pylori infection (through detection of H. pylori stool Ag) , liver impairment, and blood ammonia concentration. A group of the H. pylori +ve patients were given eradication therapy (triple therapy: 1 wk therapy with omeprazole plus clarithromycin and tinidazole), then patients were revaluated after 2 months using psychometric tests and blood ammonia concentration and compared with untreated group. Results: In our study, the mean level of blood ammonia concentration was significantly higher in H. pylori-positive patients (group II and III: 78.1±9.36 and 82.73±12.22 mmol/L) in comparison to H. pylori-negative patients (group I: 65±17.47 mmol/L ) where P<0.001. Also the time needed to perform NCT and CCT show the lowest mean in H. pylori - negative patients (64.73±13.08 and 35.67±6.66 sec. respectively) in comparison to H. pylori- positive patients with statistically significant difference (P<0.001 for both tests). CCT was significantly reduced in treated and eradicated patients after therapy (30.46±4.9 sec) and shows statistically significant difference (P<0.001) in comparison to untreated or failed to eradicate groups. The blood ammonia concentration in patients with H pylori was significantly reduced after bacterium eradication compared with the concentration after conventional treatment to HE in H. pylori infected controls (49.04± 13.67 vs 61.17±9.81). However, blood ammonia level was reduced in those who received treatment and failed to eradicate in a significant difference from those who didn’t receive eradication therapy (infected controls) (61.17±9.81 vs 75±14.9). Also there was statistically significant difference as regard to hepatic encephalopathy grade pre- and post treatment in infected treated and eradicated group (P=0.04) while there was no statistically significant difference in infected controls or failed to eradicate groups. Conclusion: H pylori infection is an important factor for inducing high blood ammonia concentration in HE patients. Anti-H. pylori therapy results in reduction in blood ammonia levels and may be helpful for treatment and prevention of HE.
https://aeji.journals.ekb.eg/article_16068_317cc2a4282720e24c8eae45c0793933.pdf
2012-06-01
69
76
10.21608/aeji.2012.16068
Helicobacter pylori
hepatic encephalopathy
hyperammonemia
Salama
El Ghonaimy
1
Tropical medicine Department,Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Sami
Abd El-Wahab
2
Tropical medicine Department,Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Yosri
Abo El Magd
3
Biochemistry Department,Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
Sherweet
Ibrahim
sherisahlol@yahoo.com
4
Tropical medicine Department,Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Improving Community Knowledge and Attitude towards PulmonaryTuberculosis in Zagazig District- Sharkia Governorate through Application of Interventional Health Education Program
Background and study aim: Egypt has achieved treatment success rates higher than the WHO-recommended target of 85 percent. However the case detection rate of about 50 percent remains below the 70 percent target. This is due to low awareness of population about tuberculosis, delay of patients medical advice about chest symptoms, and lack of coordination between different health sectors.The aim of this study is to clarify knowledge and attitudes regarding pulmonary TB among population of Zagazig district in Sharkia governorate, and to assess the effect of a community intervention health education in improving their knowledge and attitudes about pulmonary TB. Patients and methods: Survey was conducted on 254 individuals from both sexes ≥ 18years old in Zagazig district, Sharkia governorate. A questionnaire for Knowledge and attitude about pulmonary tuberculosis was adapted from ( Advocacy, Communication and Social Mobilization for TB control /A guide to developing knowledge, attitude and practice surveys). Then an intervention health education program was implemented and evaluated after three months. Results: The study revealed that 61.4% of adults of both sexes had unsatisfactory knowledge about tuberculosis. Only (16.5%) were aware that diagnosis and treatment of tuberculosis were free of charge. The correct duration of standard treatment was reported by (21.7%) of studied group. Only 54.3% of study group seeking treatment at a health facility, when feel symptom. About 62.3% were more likely to feel fear and embarrassed if being a TB patient. However, about 60.2% of study population seem to be supportive to tuberculosis patients. The main source of acquired information about tuberculosis were television (54.7%). Regarding the effect of the health education intervention on knowledge of the studied group; there were statistical significant improvement in knowing the mode of transmission of pulmonary TB, place of treatment, and its duration after health education program (p<0.05). The studied group who had satisfactory knowledge about pulmonary tuberculosis was doubled after health education program. Conclusion: The survey results showed that the overall knowledge regarding TB was unsatisfactory in the studied population. After health education program there is improvement of knowledge regarding TB among studied group.
https://aeji.journals.ekb.eg/article_15954_8eaec1839100e4e959ad6ccc7b14e0b2.pdf
2012-06-01
77
86
10.21608/aeji.2012.15954
improving
pulmonary tuberculosis
Knowledge
Attitude
health education
Sohair
Hagag
dr.sohierhagag@yahoo.com
1
Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
LEAD_AUTHOR
Mona
Abosrea
2
Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
Shereen
Eassa
3
Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
AUTHOR
ORIGINAL_ARTICLE
Evaluation of Carvedilol in Prevention of First Attack of Variceal Hemorrhage in Patients with Liver Cirrhosis
Background and study aim: Carvedilol has beneficial effects on splanchnic haemodynamics following acute and chronic administration in cirrhosis. The aim of this study is to evaluate the role of carvedilol in prevention of first variceal bleeding in patients with liver cirrhosis and to compare its effect with that of variceal band ligation (VBL) and propranolol. Patients and methods: Seventy five patients with liver cirrhosis and endoscopically proven esophageal varices (grade II or larger in size with or without variceal red color signs), that have not bled yet were randomized to either VBL performed every 2 weeks until varices were eradicated (25 patients), carvedilol 12.5mg once daily (25 patients) or propranolol titrated to reduce resting pulse by >25% (25 patients) and followed up on the same schedule at 6 and 12 months. Results: Carvedilol had lowest rate of the first variceal bleeding when compared with VBL and propranolol (10%, 12% and 20% respectively). Carvedilol had significantly decreased the percentage of patients with varices grade III or IV over the follow up period (from 40% to 24%). Both carvedilol and propranolol significantly decreased severity of portal hypertensive gastropathy over follow up period. On the other hand, VBL significantly increased severity of portal hypertensive gastropathy. Conclusion: Carvedilol is effective in preventing the first variceal bleeding. Carvedilol is an option for primary prophylaxis in cirrhosis and esophageal varices grade ≥ II in single daily dose of 12.5 mg.
https://aeji.journals.ekb.eg/article_15955_10ead7c996923d767165c631b4e983a2.pdf
2012-06-01
87
91
10.21608/aeji.2012.15955
Carvedilol
Propranolol
variceal band ligation
Ahmad
Mahmod
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Samy
Essa
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Eman
Abdel Aal
3
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Hosam
Dawod
engfikry@yahoo.com
4
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
LEAD_AUTHOR
ORIGINAL_ARTICLE
Video Case: Lower Esophageal Crack and Gastric Leiomyoma: Uncommon Causes of Upper Gastrointestinal Bleeding in Egypt
A 62 years old male patient presented by an acute attack of upper gastrointestinal bleeding. The patient gave no history of any chronic medical disease. He then was admitted to the emergency unit of Al-Reyah Hospital (a charity hospital, Biala, Kafr El-Sheikh, Egypt) and after resuscitation measures an emergency upper GIT endoscopy was done, the source of bleeding was identified as a lower esophageal linear crack while a large gastric smooth mass not yielding on pressure was seen and it seems to be most probably a gastric leiomyoma.
https://aeji.journals.ekb.eg/article_15956_071ff7cd079741076329cb3add58ec77.pdf
2012-06-01
92
92
10.21608/aeji.2012.15956
Mohamed
Emara
emara_20007@yahoo.com
1
Tropical Medicine Department ,Faculty of Medicine ,Zagazig University ,Zagazig ,Egypt
LEAD_AUTHOR
Ahmed
El-Madawy
2
Kafr El Sheikh liver centre, Kafr El Sheikh , Egypt
AUTHOR
ORIGINAL_ARTICLE
Image case: Extraction of Large Stone from the Common Bile Duct
A 60 years old women presented by abdominal pain and recurrent bouts of fever 4 years after cholecystectomy. Abdominal ultrasonography revealed dilated common bile duct and stone inside. Serum bilirubin was mildly elevated.
Endoscopic retrograde cholangiopancreatography (ERCP) revealed dilated common bile duct with large stone inside. Sphincterotomy was done and large stone was extracted by basket forceps.
https://aeji.journals.ekb.eg/article_15957_bc7aab2f35bb4fb1b92cb89419276bb1.pdf
2012-06-01
93
94
10.21608/aeji.2012.15957
Tarik
Zaher
tareqzaher@zu.edu.eg
1
Tropical Medicine Department , Faculty of Medicine , Zagazig University, Egypt.
LEAD_AUTHOR