ORIGINAL_ARTICLE
The Effect Of Antioxidants On The Side Effects Of Pegylated Interferon/Ribavirin Combination Therapy In Patients With Chronic Hepatitis C
Background and study aim:: Combined anti-hepatitis C therapy with pegylated interferon and ribavirin is associated with numerous side effects that affect both patients’ compliance and response rates. These side effects are believed to be, in part, due to oxidative stress induced by ribavirin. In the present work, we tried to evaluate if antioxidants can ameliorate the side effects of this therapy in patients with chronic hepatitis C (CHC).
Patients and methods: Two hundred selected patients with CHC were randomized to receive either the standard antiviral combination therapy (Peginterferon and Ribavirin) plus antioxidant mixture (slow release vitamin C 500 mg daily, vitamin E 400 mg daily, silymarin 420 mg daily and N-acetylcystein 600 mg daily) for 48 weeks (study group, group I) or to receive the standard combination therapy only for 48 weeks (control group, group II). Patients were followed up during the whole treatment course to assess the occurrence of subjective and laboratory side effects of the combined antiviral therapy.
Results :The results of our study revealed statistically significant difference between both groups regarding changes in hemoglobin concentration along therapy from week one onwards as reduction in hemoglobin concentration along therapy was significantly lower in group I; p = 0.001. The frequency of significant anemia (Hb < 10 gm/dl) in group I was significantly lower than Group II from week twelve onwards; p value ranged from 0.013 to 0.001. Moreover, the frequency of fatigue was significantly lower in group I from week two onwards till the end of therapy; p value ranged from 0.027 to < 0.001. On the other hand, all other checked side effects either subjective or laboratory revealed a non significant statistical difference between both groups.
Conclusion : The use of an antioxidant mixture with antiviral combination therapy in patients with CHC can improve treatment associated anemia and fatigue but has no effect on other treatment associated side effects.
https://aeji.journals.ekb.eg/article_17059_3407971c2e2fe7834001185e9f4f0eec.pdf
2013-03-12
1
8
10.21608/aeji.2013.17059
Chronic hepatitis C
antioxidants
peginterferon
Ribavirin
Ahmed
Farouq
farouqmail2000@yahoo.com
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Amr
Mourad
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmad
Mahmoud
3
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Maged
Abd El-Aziz
4
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Soha
Elhawari
sohaelhawary@yahoo.com
5
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmad
Behiry
6
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Clinical and Epidemiologic Study of Hepatitis C Virus Genotype 4 Infection among Patients with B cell non Hodgkin's Lymphoma
Background and study aim:: Many recent studies showed that chronic infection with hepatitis C virus (HCV) is associated with increased risk for B-cell non-Hodgkin's lymphoma (NHL). The aim of this study is to evaluate the frequency of HCV infection in a series of de novo B cell non Hodgkin's lymphoma (NHL) patients and to correlate virological findings with clinico-histological features.
Patients and methods: 50 patients with B cell NHL diagnosed by histopathology and immunophenotyping were recruited from Tropical medicine department and Oncology unit affiliated to Internal medicine department, Zagazig University hospitals. Gender and age matched controls (N = 50) were volunteers selected from relatives of patients. Study participants were subjected to history taking, clinical examination, routine and specific laboratory tests. Anti-HCV antibody was determined by ELISA for all study participants. HCV RNA PCR was done for all cases and HCV antibody positive controls. Appropriate radiologic examinations were performed.
Results :Frequency of HCV infections were statistically significantly higher in B cell NHL patients than in controls (p = 0.004). ALT levels were statistically significantly higher in HCV positive patients than in HCV positive controls (p < 0.001) and HCV negative patients but without statistically significant difference (p = 0.067). There was no statistically significant difference in histologic types, grades and stages of NHL between HCV positive patients and HCV negative patients. Cryoglobulinemia showed no significant difference between studied groups.
Conclusion : HCV has a strong association with de novo B cell NHL, not complicating essential mixed cryoglobulinemia (EMC).
https://aeji.journals.ekb.eg/article_17091_2f5a4cb657aab44736208bc413e5a272.pdf
2013-03-20
9
16
10.21608/aeji.2013.17091
hepatitis C
Lymphoma
non- Hodgkin
case-control study
Mohammad
Al-Khashab
n.n1438@yahoo.com
1
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Mohammad
Emam
2
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Walid
Abd El Dayem
3
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmad
Sherbini
4
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Nagla
Abd El Wahab
5
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Noha
Shaheen
6
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ibrahim
Ibrahim
7
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Samar
Abd-AlRaouf
8
Pathology Departments, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Efficacy of Ribavirin to Prevent Hepatitis Reactivation in Hepatitis C Virus-infected Patients Treated for Non-Hodgkin Lymphoma
Background and study aim:: Reports have found an association between B cell non-Hodgkin lymphomas (NHL) and Hepatitis C virus (HCV) infection. However, data on acute exacerbation and reactivation of chronic HCV infection following chemotherapy are very limited. We studied the efficacy of ribavirin to prevent hepatitis reactivation in HCV-infected patients treated for NHL.
Patients and methods: This study was carried out at Medical Oncology & Hematology Department , Zagazig University Hospitals. It included 57 patients with B-cell NHL who were naïve to chemotherapy, among them 24 patients were positive for HCV and 33 patients were negative for HCV (group C). The HCV positive group were subdivided into 11 patients who received ribavirin (group A) and 13 patients did not receive ribavirin (group B). Routine investigations for NHL were done, HCV RNA was measured for HCV positive patients before and after the end of chemotherapy.
Results :HCV infection occurred in 42% of patients with B cell NHL. Acute hepatic enzyme exacerbation occurred in 8 (14%) of all patients with the highest percentage was 29.2 % among HCV infected patients (7/24), while only one patient (3%) in the HCV negative group (p= 0.007). Among the 24 NHL patients with HCV positivity, we compared group A versus group B during chemotherapy as regards to hepatic enzyme flare, it was ( 27% & 30%, respectively, p= 0.6). Five (20.8%) of 24 NHL patients with HCV positivity developed HCV PCR reactivation; 2 patients of group A and 3 patients of group B (18.2% & 23.1%, respectively, p= 0.58). The outcome was comparable between the three groups.
Conclusion : The frequency of HCV infection in patients with B cell NHL is higher than in the general population. Acute exacerbation and reactivation of chronic HCV infection occur in a sizeable subset of patients with NHL during chemotherapy. The use of ribavirin did not decrease hepatic enzyme flare or HCV PCR reactivation during chemotherapy.
https://aeji.journals.ekb.eg/article_17092_fc61c943931b78d3796b097f50839028.pdf
2013-03-24
17
26
10.21608/aeji.2013.17092
Hepatitis C virus
Ribavirin
Non-Hodgkin lymphoma
Reactivation
Fouad
Abo-Taleb
abotasnem1@gmail.com
1
Medical Oncology and Hematology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ashraf
El-Hefeni
2
Medical Oncology and Hematology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Ahmed
Kotb
3
Medical Oncology and Hematology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
Tarek
El-Gohary
4
Medical Oncology and Hematology Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Fungal Infections in the Elderly
Fungi are increasingly recognised as major pathogens in critically ill patients. Several reasons have been proposed for the increase in invasive fungal infections, including the use of antineoplastic and immunosuppressive agents, broad-spectrum antibiotics, and prosthetic devices and grafts, and more aggressive surgery. Patients with burns, neutropenia, HIV infection and pancreatitis are also predisposed to fungal infection Candidiasis is caused by infection with species of the genus Candida, predominantly with Candida albicans. Candida species are ubiquitous fungi that represent the most common fungal pathogens that affect humans. The growing problem of mucosal and systemic candidiasis reflects the enormous increase in the number of patients at risk and the increased opportunity that exists for Candida species to invade tissues normally resistant to invasion.
https://aeji.journals.ekb.eg/article_17093_f4df3402e94c43d3ad672f5a3abc1b5a.pdf
2013-03-27
27
30
10.21608/aeji.2013.17093
Elderly
Infections
candidiasis
skin
illness
drugs
Angela
Revelas
donnoiko@gmail.com
1
St.Nicolaos General Hospital ,Crete, Greece
AUTHOR
Emmanuel
Liannos
2
Urological Department of St.Nicolaos Hospital -Crete , Greece.
AUTHOR
Dimitrios
Arvanitakis
3
Neurosurgery Clinic of Venizeleio General Hospital-Crete , Greece.
AUTHOR
ORIGINAL_ARTICLE
Video Case :Extraction of a Pin from the Stomach of a 13 Years Girl
A pin was accidentally ingested by a 13 years Girl . Repeated X rays over one month revealed impacted pin in the upper abdomen. Upper gastrointestinal endoscopy using Olympus GIF Q160 endoscope was performed. 5 mg midazolam was administered intravenously . Endoscopy revealed penetrated pin in the antrum of the stomach. Extraction using shark tooth forceps was doned. .
https://aeji.journals.ekb.eg/article_17095_c4aa8bda47c0ddc7e0f2dfc7833f9879.pdf
2013-03-25
31
31
10.21608/aeji.2013.17095
Tarik
Zaher
tareqzaher@zu.edu.eg
1
Endemic and Tropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Image Case:Sub-capsular Pyogenic Splenic Abscess: Feasibility of Ultrasound Guided Drainage
We reported a 58-year old female with chronic liver disease, type 2 diabetes, ischemic heart disease and hypertension presented by left hypochondrial dull aching pain. She denies fever, malaise, nausea, vomiting, bowel habit disturbance and dysuria. On examination she looked mildly toxic, blood pressure 140/80, pulse 68 regular, temperature 37 C. Ultrasonographic examination revealed subcapsular collection in the spleen that was further confirmed in abdominal CT scan (figure 1). Ultrasonographic guided aspiration (figure 2) and broad spectrum antibiotics including cefoperazone and ciprofloxacin to the isolated gram negative bacilli depending on the culture and sensitivity testing achieved complete response .
https://aeji.journals.ekb.eg/article_17096_f8a963fc9e5488ba9d21485d6056a4c0.pdf
2013-03-25
32
32
10.21608/aeji.2013.17096
Mohamed
Emara
emara_20007@yahoo.com
1
Tropical Medicine Department ,Faculty of Medicine ,Zagazig University ,Zagazig ,Egypt
AUTHOR
Mohamed
Abd-Elwahab
2
Alreayah, Charity Hospital, Biala, Kafr El-Shiekh, Egypt
AUTHOR
Sameh
Abo-Sheash
3
Biala Fever Hospital, Biala, Kafr El-Shiekh, Egypt
AUTHOR
ORIGINAL_ARTICLE
Image Case:Loculated Abdominal Collection following Leaking Hepatocellular Carcinoma
A 60 years old women presented by progressive abdominal distension and abdominal pain. When presented ultrasound guided abdominocentesis confirmed intraperitoneal hemorrhage further assessment by abdominal-pelvic CT scans showed leaking sub capsular hepatic focal lesion consistent with hepatocellular carcinoma. The patient was treated conservatively and 2 months later she experienced recurrent abdominal pain and sub acute intestinal obstruction. Ultrasonographic examination showed intrabdominal loculations(figure 1). The differential diagnosis of this condition includes intraperitoneal hemorrhage due to other causes, abdominal TB and recurrent spontaneous bacterial peritonitis in ascetic patients.
https://aeji.journals.ekb.eg/article_17097_7af78904091a3ce07437055e867959a1.pdf
2013-03-26
33
33
10.21608/aeji.2013.17097
Ahmed
Bihery
ahmedbihery@yahoo.com
1
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt
AUTHOR
Emad
Emara
2
Radiodiagnosis Department, Faculty of Medicine, Zagazig University, Egypt
AUTHOR