Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
AIDS Effects in Liver and Biliary Tract by using Ultrasound in Sudan
133
139
EN
Mustafa
Z
Mahmoud
Sudan University of Science and Technology, College of Medical Radiological Science,
Fundamental Medical Radiologic Sciences Department, Khartoum, Sudan.
zuhairmustafa4@hotmail.com
Alsafi
A
Abdulla
Sudan University of Science and Technology, College of Medical Radiological Science,
Radiotherapy Department, Khartoum, Sudan.
Ala
M
Abd Elgyoum
Alzaeim Alazhari University, Faculty of Radiological Sciences and Medical Imaging,
Khartoum North, Sudan.
10.21608/aeji.2012.15962
Background and study aim: The human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system, destroying or impairing their function. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to infections. The United Nations (UN) estimates that Sudan has the highest rate of HIV infection in North Africa and the Middle East. The aim of this study was to describe the effects of AIDS in liver and biliary tract and evaluate the clinical utility of hepatic and biliary tract sonography in AIDS patients in Khartoum state, Sudan. Patient and Methods: This prospective study was conducted at Omdurman, Elshaab and Bashayer Teaching Hospitals, in Khartoum State, Sudan. It spanned a period of 3 years from January 2009 to January 2012, involving 300 HIV positive Sudanese patients (198; 66% males and 102; 34% females) and aged 6 to 60 years; mean age of 46 ± 6.4 years. Samples proved to have AIDS by enzyme immuno assay test (EIA) and also confirmed by Western blot (protein immunoblot) blood test. Sonography was performed using Toshiba Just Vision 200, Aloka SSD 500 and Siemens Antares fitted with 3.5 MHz convex transducers. Results: In AIDS patients, ultrasound findings in liver included wide spectrum of abnormalities like hepatomegally (88; 29.3%), portal hypertension (49; 16.3%), periportal fibrosis (20; 6.7%), fatty fibrotic changes (42; 14%), jaundice (18; 6%), extra hepatic ducts dilatation (24; 8%), cholecystitis (33; 11%), cholelithiasis (24; 8%) and Kaposi sarcoma (18; 6%). Conclusion: Abdominal ultrasound is a simple and cost effective tool and can be used as a baseline imaging modality in AIDS infected patients. Liver enlargement and gall bladder wall thickening are common effects develop due to AIDS infection in population at Khartoum state, Sudan.
AIDS,cholecystitis,Hepatomegally,Kaposi sarcoma,Ultrasound
https://aeji.journals.ekb.eg/article_15962.html
https://aeji.journals.ekb.eg/article_15962_1d82b0850d38da69e57ec4cdd7520a47.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Study of Brain Changes in Chronic Hepatic Encephalopathy by Using MR Imaging
140
147
EN
Mohamed
N
El-Khashab
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt
Salama
M
ElGhonamy
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt
Sherif
M
Galal
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt
dsherifgalal@yahoo.com
Rasha
I
Salama
Tropical Medicine Department, Faculty of Medicine, Zagazig University,Egypt
salamarasha@yahoo.com
Adel
AL
Sanour
Radiology Department, Faculty of Medicine, Zagazig University,Egypt
10.21608/aeji.2012.16087
Background and study aim: Hepatic encephalopathy (HE) reflects a spectrum of neuro-psychiatric abnormalities. The aim of this study was to evaluate MR imaging of the brain in different grades of chronic HE and its correlation with clinical neurological abnormalities. Patients and Methods: Sixty patients were included, 40 patients with chronic HE were divided into group I (GI) chronic persistent HE (n=20), group II (GII) chronic relapsing HE (n=20), another 20 patients with early compensated cirrhosis were chosen as control group (GIII), all patients were subjected to full clinical and laboratory investigations, estimation of serum ammonia and Manganese level in the blood, psychometric tests ,conventional MRI and MRS. Results: A statistically significant increase in serum level of ammonia and manganese in GI (162.155.8 mol/L, 3.350.34 ug/dl, respectively) when compared to other groups. By conventional MRI there was statistically significant increased signal intensity of T1 and T2 in group I compared with other groups. By MRS, there was statistical significant increase of glutamine in GI (3.90.17 pp,) when compared to GII (3.70.13 ppm) & GIII (2.480.3 ppm) and significant reduction of both choline and myinstol among GI 1.980.17 ppm, 2.190.20 ppm, when compared to GII 2.290.17 ppm, 2.740.17 ppm and GIII 2.590.019 ppm, 3.150.11 ppm. Moreover there was significant elevation in signal intensity of T1 corresponding to elevation of serum manganese (2.910.6 ug/dl) and significant elevation of signal intensity in T2 corresponding to elevation of serum ammonia (116.949 mol/L), as well as highly significant positive correlation between serum ammonia and glutamine (r = 0.86) and highly significant negative correlation between serum ammonia and choline (r = -0.42) and myinstol (r = -0.47). Conclusion: Changes in brain metabolites as detected by MRS may be sensitive markers for clinical monitoring of brain dysfunction and cognitive impairment in patient with chronic HE.
Brain Changes,hepatic encephalopathy,Magnetic Resonance Imaging,Manganese,ammonia,Myoinsitol
https://aeji.journals.ekb.eg/article_16087.html
https://aeji.journals.ekb.eg/article_16087_3fe6aff536b3958612c9c6f48aba64e9.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Effect of Intrapulmonary Inhalation of Honey, Nigella Sativa and Curcumin on Liver Function in Patients with Chronic Liver Disease
148
154
EN
Ehab
F
Mostafa
Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt.
hobanoh@yahoo.com
Amany
M
Ibrahim
Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt.
Emad
F
Hamed
Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,Egypt.
10.21608/aeji.2012.16105
Background and study aim: Evidence indicates, that honey, nigella sativa and Curcumin can exert several healthbeneficial effects. The aim of this study was to examine the efficacy and safety of honey, curcumin and nigella sativa inhalation on liver function in patients with chronic liver disease. Patients Methods:The study was conducted in 58 Patients (group1) with chronic liver disease due to hepatitis C and or B infection, with abnormal liver function test regarding liver enzymes, serum albumin, serum total bilirubin and international normalized ratio (INR). Another 43 patients(group2) with chronic liver disease with abnormal liver functions test as a control diseased subjects. Patients were subjected to inhalation of honey solution diluted with water with total 5 ml solution with 1 ml of curcumin solution, then adding of 2 drops of nigella sativa oil , the patients subjected to 2 times inhalation per day for 3 months. The other 43 control subjects received inhalation of 10% dextrose for the same duration. Results: there was significant difference in patients group before and after mixed solution inhalation for 3 months with decrease in serum level of ALT and less significant decrease in AST, also there was significant decrease in serum total bilirubin and INR level, already with significant increase in serum albumin. Correlation between duration of exposure to the mixed solution inhalation and change of liver functions after one and 3 months duration, showed significant negative correlation between duration and decrease in ALT, AST, INR and serum bilirubin with positive correlation with serum albumin. No significant changes was detected in liver functions in control subjects after inhalation of 10% dextrose for the same duration. Conclusion: Natural medications like honey, curcumin and nigella sativa administered by new methods like inhalation my contribute in improving liver functions with high safety profile.
Honey,Nigella Sativa,Curcumin,inhalation,liver function,Chronic liver disease
https://aeji.journals.ekb.eg/article_16105.html
https://aeji.journals.ekb.eg/article_16105_cdfc0310c8cf292494abb79a5f77b137.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Role of Toxoplasmosis in Acute Flaccid Paralysis among Children
155
161
EN
Zeinab
I
Al-Darawany
Paediatrics Department, Faculty of Medicine , Zagazig University, Egypt
Taghrid
M
Abdallah
Tropical Medicine Department, Faculty of Medicine , Zagazig University, Egypt
Talaat
Fathy
Tropical Medicine Department, Faculty of Medicine , Zagazig University, Egypt
Sara
Abdel-Rahman
Parasitology Department, Faculty of Medicine , Zagazig University, Egypt
sarameram@yahoo.com
Ashraf
Salah
Parasitology Department, Faculty of Medicine , Zagazig University, Egypt
Rashad
M
Lasheen
Sharkiya Directorate of Health and population, Egypt
10.21608/aeji.2012.16106
Background and study aim: With the eradication of poliomyelitis, GuillainBarré syndrome (GBS) is the most common cause of Acute Flaccid Paralysis (AFP) in children. The present study aimed at assessment of how far Toxoplasmosis contributes to the cases of Acute Flaccid Paralysis (AFP) among children in Sharqiya governorate, Egypt. Patient and Methods: Over years from April 2010 to September 2012, one hundred children with non-polio acute flaccid paralysis were selected, after their parent written consent, out of children monitored in Sharqiya Governorate by the Project of Acute Flaccid Paralysis (AFP) Surveillance, the Ministry of Health and Population, Egypt. As they underwent treatment by appropriate therapy for AFP, anti-Toxoplasma IgM and IgG antibodies, anti-Campylobacter jejuni IgM and IgG antibodies and tumor necrosis factor alpha (TNF-α) were sought quantitatively in their sera by ElISA. Results:Anti-Toxoplasma IgM and IgG were respectively detected among 3 (3%) and 42 (42%) of them. Anticampylobacter IgM and IgG were respectively detected among 25 (25%) and 54 (54%) of them. TNF-α absorbance values were 0.95±0.35 among 3 patients with symptomatic acute toxoplasmosis (positive IgM and IgG), 0.22 ±0.11 among 39 patients with chronic toxoplasmosis (with positive anti Toxoplasma IgG only), and 0.21±0.12 among patients without toxoplasmosis. The 3 cases of acute flaccid paralysis due to acute toxoplasmosis did not respond to the ordinary treatment of AFP treatment; but dramatically responded to Sulfadiazine and Pyrimethamine. Conclusion: These results may make the study hypothesize that Toxoplasma may exert its pathogenic effect on nerve myelin directly via TNF-α. Thus approaching Acute Flaccid Paralysis, higher index of suspicion is needed so as to do not miss cases with toxoplasmic etiology.
Barré syndrome,Acute Flaccid Paralysis,Toxoplasma
https://aeji.journals.ekb.eg/article_16106.html
https://aeji.journals.ekb.eg/article_16106_d35cc335b5b07e8f2ef4b6bcd0683337.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Faecal Calprotectin as Reliable Non-invasive Marker to Assess the Severity of Mucosal Inflammation in Patients with Ulcerative Colitis
162
167
EN
Mohamed
Elkhashab
Tropical Medicine Department, Faculty of Medicine, Zagazig Universiy, Egypt
elkhashab2005@hotmail.com
Salama
Al goniemy
Tropical Medicine Department, Faculty of Medicine, Zagazig Universiy, Egypt
Ghada
A
Salem
Tropical Medicine Department, Faculty of Medicine, Zagazig Universiy, Egypt
Hisham
I
Mostafa
Student Hospital,Zagazig University,Egypt
10.21608/aeji.2012.16170
Background and study aim: We aimed to evaluate the validity and accuracy of the faecal calprotectin in differentiating patients with IBD from those with IBS and in the assessment of the severity of intestinal mucosal inflammation in patients with ulcerative colitis (UC) which may facilitate in the prognosis and follow. Patients and Methods: We studied 60 Patients who came to endoscopy unit with lower gastroenterological symptoms. Patients with history of infections, malignancy, gastrointestinal surgery, pregnancy, alcohol abuse or taking nonsteroidal anti-inflammatory drugs were excluded from study. All patients subjected to thorough medical history, simple clinical colitis activity index was determined with a score ˃ 4 indicate active UC, complete blood picture, liver, kidney function tests, ESR, CRP, ANCA were done, a stool sample for FC levels determined by a highly sensitive enzymelinked immunosorbent assay and total colonoscopy with histological examination of intestinal mucosa biopsy were done. The patients divided into 2 groups. Group A: patients with UC, group B: patients with manifestation of irritable bowel syndrome as a control group. Results: There was a high significant difference between individuals with no pathological activity and other degree of mucosal inflammation as regard simple clinical colitis activity index, endoscopic appearance and faecal calprotectin (p = 0.000). The sensitivity, specificity, positive predictive value and negative predictive value of faecal calprotectin in diagnosis of UC were 93.5%, 89.7%, 90.6%, and 92.9% respectively. The positive predictive value and negative predictive value of simple clinical colitis activity index for diagnosis of UC were 76.5% and 80.8% respectively. The positive predictive value and negative predictive value of endoscopic appearance for diagnosis of UC were 100%, and 85.3% respectively. There was a high significant difference and positive correlation between faecal calprotectin, score of colonic pathological activity, endoscopic appearance and simple clinical colitis activity index. Conclusion: Faecal calprotectin is highly useful for the diagnosis and disease monitoring of patients with UC as it is easy, non invasive, reliable tool
Calprotectin,ulcerative colitis,
https://aeji.journals.ekb.eg/article_16170.html
https://aeji.journals.ekb.eg/article_16170_539a7071a18559048b41e33a39131767.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
A Study of the Effect of the Use of Antioxidants in Patients with Hepatitis C Receiving Interferon/Ribavirin Therapy on the Response to Therapy
168
177
EN
Ibrahim
M
Hegazy
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Elsaid
G
Elbadrawy
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Soha
Khorshid
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Sahar
Elnemr
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Talaat
Fathy
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Ashraf
Metwally
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
Magdy
Ismael
Pathology Department, Faculty of Medicine,Zagazig University, Egypt
Amal
A
Gouda
Tropical Medicine Department, Faculty of Medicine,Zagazig University, Egypt.
dr.amaljouda@yahoo.com
10.21608/aeji.2012.16185
Background and study aim: Treatment of HCV with interferon takes a long duration and has many side effects. The use of antioxidants with interferon/ribavirin therapy is believed to minimize the side effects and improves adherence and hence improves response to therapy. Reactive oxygen species are part of the human defense mechanisms towards infection and they increase due to hepatitis C virus infection. In this study we aim to study the impact of the concomitant use of antioxidants with interferon/ribavirin combination therapy for HCV on response as regards enzymes level, rate of viral clearance as well as liver histopathology.. Patients and methods: 240 patients on interferon/ribavirin therapy for chronic hepatitis C divided in two groups. The test group received concomitant antioxidant combination while the control group received only interferon/ribavirin. Follow up of liver function tests, complete blood count, viral load by PCR and post treatment histopathology by liver biopsy were performed. Results: Liver enzymes level in test group achieved a larger and faster decline than in control group. Hematological parameters were significantly higher in the test group all through period of follow up. Viral load and histopathology showed no significant difference between the two groups. Conclusion: concomitant use of antioxidants with interferon/ ribavirin therapy minimizes complications of therapy and rapidly normalizes the liver enzymes level without affecting the rate of response to therapy or histopathology of the liver.
antioxidants,hepatitis C
https://aeji.journals.ekb.eg/article_16185.html
https://aeji.journals.ekb.eg/article_16185_94345bfad5508a159d0340331da97292.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Video Case: Endoscopic Extraction of a Large Piece of Fleshy Meat from the Esophagus by the Polypectomy Snare
178
178
EN
Mohamed
H
Emara
0000-0002-1504-7851
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,
Egypt
emara_20007@yahoo.com
10.21608/aeji.2012.16253
A fifty five years old female presented with acute dysphasia of 5 hours duration following ingestion of a large piece of fleshy meat. The patient feel a sense of impacted lump at the lower end of the sternum associated with repeated attack of retching. When examined by flexible upper endoscopy under light sedation using intravenous diazepam 10 mg, a large white fleshy piece of meat was seen impacted at the lower end of the esophagus about 35 cm from incisors. Several trials to push the fleshy meat to inside the stomach failed. Then several trials for fragmentation using the biopsy forceps and Dormia basket failed to extract the meat, till finally it was grasped firmly with a polypectomy snare and extracted to outside without any further hazard to the patient
https://aeji.journals.ekb.eg/article_16253.html
https://aeji.journals.ekb.eg/article_16253_d702c347706ff741b806510e0c20bd22.pdf
Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine Department
Afro-Egyptian Journal of Infectious and Endemic Diseases
2090-7613
2090-7184
2
4
2012
12
01
Image Case: Sausage Shaped Stone Extraction from the Common Bile Duct
179
179
EN
Mohamed
Radwan
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,
Egyp
drmmagdy@yahoo.com
Mohamed
H
Emara
0000-0002-1504-7851
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,
Egyp
emara_20007@yahoo.com
Ibrahim
M
Ibrahim
Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig,
Egyp
10.21608/aeji.2012.16254
A 60-year old male patient presented with recurrent obstructive jaundice. He gave history of chronic hepatitis C and cholecystectmy. When presented for the current episode of obstructive jaundice his lab was bilirubin total 5.1 mg/dl, bilirubin direct 4.1 mg/dl, prothrombin concentration 77%, Haemoglobin 11 gm%. ERCP showed oblong filling defect involving the lower one third of common bile duct. Extrcation balloon extracted this large stone that appears sausage shaped emerging from the duodenal papilla after precut sphincterotomy.
https://aeji.journals.ekb.eg/article_16254.html
https://aeji.journals.ekb.eg/article_16254_f98311cf72c399676c42c03383ad8873.pdf