Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Nitazoxanide Based Therapeutic Regimens: Will this Solve the Puzzle of Increasing Resistance of Helicobacter pylori to Conventional Treatment?1228814410.21608/aeji.2023.288144ENSherief Abd-ElsalamTropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt0000 0003 4366 2218Journal Article20230301This problem of treatment resistance calls for further research into alternative medications. Due to emerging antibiotic resistance and poor patient compliance with finishing the treatment cycle, which lowers <em>H. pylori</em> elimination rates, <em>H. pylori</em> infection has grown extremely resistant to conventional first-line treatment regimens. As a result, there is a lot of interest in evaluating novel antibiotic combinations and therapy plans for <em>H. pylori</em>.<br /> The antibiotic nitazoxanide (NTZ), which has been stabilised as a treatment, has microbiological properties that are comparable to those of metronidazole. It has a broad spectrum of action against microbial and anaerobic bacteria, anaerobic protozoa, and parasitic worms .<br /> Inhibition of lipid polysaccharide (LS) caused by the production of pro-inflammatory cytokines in macrophages are additional noteworthy immune properties of nitazoxanide .<br /> When NTZ and omeprazole were combined (1 g of NTZ twice daily with 20 milligrammes of omeprazole once daily) for seven days, 91 patients experienced an 83% eradication rate. <br /> All this points to the importance of further research on nitazoxanide based treatment regimens as novel regimens for <em>Helicobacter pylori</em> eradication as this may solve the puzzle of increasing resistance of <em>Helicobacter pylori</em> to conventional treatment.https://aeji.journals.ekb.eg/article_288144_007f910b6964882edfb8413e405b3ee1.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Diagnostic Accuracy of Plasma Osteopontin in Egyptian Hepatocellular Carcinoma Patients31427260410.21608/aeji.2022.155395.1244ENEhab FMostafaDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut
University, Assiut, Egypt.Hend MEltaherHospital of Endemic Diseases (Almotawattena Hospital), Ministry of Health, Assiut,
Egypt.Eman Nasr EldinDepartment of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt.Sahar MHassanyDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut
University, Assiut, Egypt.Journal Article20220906<strong>Background and study aim:</strong> Hepatocellular carcinoma (HCC) is the most common primary liver cancer, coming 4th in most common cancers, and 2nd in cancer-related mortality in Egypt. HCC biomarkers help in case screening, diagnosis, and follow-up. This study aims at evaluating the diagnostic value of plasma osteopontin (OPN) compared to alpha-fetoprotein (AFP) for diagnosing HCC in Egyptian patients.<br /> <strong>Patients and Methods:</strong> 120 subjects in Alrajhi Liver Hospital, Assiut University were included (60 HCC, 30 liver cirrhosis, and 30 healthy individuals). Plasma OPN and AFP levels were evaluated using commercially available ELISA kits. Uncontrolled diabetic and hypertensive patients, patients with other tumors than HCC or those receiving HCC treatments were excluded..<br /> <strong>Results: </strong>OPN plasma levels were higher in HCC group compared to cirrhotic <em></em>and control groups respectively (200 vs. 77.5 vs. 25.5 ng/ml, p < 0.05). <em></em>Tumors >5cm in diameter resulted in significantly higher plasma OPN <em></em>compared to tumors or lymph nodes didn’t significantly affect OPN levels in HCC group <em></em>(p>0.05). Diagnostic sensitivity, specificity, and overall accuracy of <em></em>OPN for HCC vs Cirrhotic group were superior to AFP (97%, 70%, <em></em>and 84% at cut-off value 90 ng/mL for OPN vs 90%, 63% and 77% at <em></em>cut-off value 5.5 ng/ml for AFP). The area under the ROC curve (AUC) <em></em>value for OPN was higher than AUC value for AFP (0.923 vs. 0.902)<em></em>.<br /> <strong>Conclusion: </strong>Serum OPN had better diagnostic ability for detecting HCC compared to AFP, suggesting OPN as a promising diagnostic marker for HCC at normal AFP levels.https://aeji.journals.ekb.eg/article_272604_135a968736d405a08db2fdd7ff981465.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Carvedilol versus Band Ligation for Primary Prophylaxis of Variceal Bleeding in Cirrhosis with Systemic Hypertension: A Randomized Controlled Trial152627457110.21608/aeji.2022.166360.1259ENSamah SolimanDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta
University, El-Giash Street 31527, Tanta, Egypt .Lobna Abo AliDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta
University, El-Giash Street 31527, Tanta, Egypt .Mohamed RabeaDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta
University, El-Giash Street 31527, Tanta, Egypt .Nabila ElgazzarDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta
University, El-Giash Street 31527, Tanta, Egypt .Asem ElfertDepartment of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta
University, El-Giash Street 31527, Tanta, Egypt .Journal Article20221014<strong>Background and study aims:</strong> Up to our knowledge, no study was performed on primary prophylaxis of variceal bleeding in cirrhosis with systemic arterial hypertension. So, we will evaluate the safety and efficacy of carvedilol versus endoscopic band ligation (EBL) for the primary prophylaxis of variceal bleeding in hypertensive cirrhotic patients.<br /> <strong>Patients and Methods:</strong> In this randomized controlled trial, 306 cirrhotic hypertensive patients with large and/or risky esophageal varices were randomized into EBL and carvedilol groups. Carvedilol was given orally at an initial dose of 6.25 mg twice daily, and titrated up to achieve a normotensive response. When maximum of 25mg twice daily was given without satisfactory control of blood pressure, diuretic and enalapril was added.<br /> <strong>Results: </strong>Variceal bleeding within a follow up period of one year was found to be 1.3% in EBL <em></em>group versus 2.6% in carvedilol group without statistically significant difference <em></em>(P=0.680). In carvedilol group, systolic blood pressure, diastolic blood pressure and <em></em>mean arterial pressure were significantly decreased at 3 months of follow up till the end <em></em>of the study, while heart rate was significantly decreased at 9 months of follow up till <em></em>the end of the study when compared with the baseline (P <0.001). Adverse events were <em></em>significantly higher in the EBL group (25.49%) than carvedilol group (10.46%) (P< <em></em>0.05)<em></em>.<br /> <strong>Conclusion: </strong>Carvedilol was safe and effective in the primary prophylaxis of esophageal variceal bleeding in cirrhotic patients with systemic arterial hypertension .https://aeji.journals.ekb.eg/article_274571_bf84b536c5c023c6cd891f01755353fe.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Association between Proton Pump Inhibitors Use and Spontaneous Bacterial Peritonitis Development in Egyptian Cirrhotic Patients with Ascites273427457510.21608/aeji.2022.172836.1266ENWalaa MElsayedDekernis Fever Hospital, Daqahleya Governorate, EgyptEl Saeed GEl BadrawyDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptAmal HAtaDepartment of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig
University, EgyptSoha AElhawariDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptJournal Article20221105<strong>Background and study aim:</strong> Spontaneous bacterial peritonitis (SBP) is a frequent complication in cirrhotic patients with ascites with significant morbidity and mortality. In patients with liver disease, there are many indications for acid suppressive therapy. Proton pump inhibitors (PPIs) are the most frequently prescribed drugs for acid suppression in patients with cirrhosis. Several studies evaluating the risk of SBP in patients on PPIs use have shown conflicting results. This study aimed at exploring whether PPIs use in Egyptian cirrhotic patients with ascites is associated with spontaneous bacterial peritonitis development.<br /> <strong>Patients and Methods:</strong> The study included 209 patients with liver cirrhosis and ascites. According to ascitic fluid polymorphonuclear leucocyte (PMN) cell count, patients were allocated into: SBP group (PMN <span style="text-decoration: underline;">></span> 250 cell/ mm<sup>3</sup>), and non-SBP group (PMN < 250 cell/ mm<sup>3</sup>). Both groups were compared to each other as regards rate of PPIs use, PPIs types and their indication.<br /> <strong>Results: </strong>Out of 209 cirrhotic patients with ascites, SBP was detected in 34.9% of <em></em>patients whether they were on PPIs or not. SBP patients had a <em></em>significant higher use of PPIs therapy (72.6%) than the non-SBP <em></em>patients (26.5%) (<em>P<</em>0.001). However, there was no statistical significant <em></em>difference regarding type of PPIs or indications of use (<em>P></em>0.05)<em></em>.<br /> <strong>Conclusion: </strong>The rate of PPIs use was higher in SBP patients than in patients without SBP. There were no differences regarding PPIs types or indications of use between both groups. Thus, PPIs therapy should be judiciously used and only when indicated in patients with liver cirrhosis and ascites.https://aeji.journals.ekb.eg/article_274575_16219c08c075545232edda1cc7962440.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Evaluation of Lipid Profile in Patients with Hepatitis C Virus Related Liver Cirrhosis354227990510.21608/aeji.2022.171614.1265ENAmira AAbdelhai SonbolDepartment of Hepatology and Gastroenterology, Alahrar Hospital ,Zagzig,Egypt..Hala IHussienDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig,
Egypt.Hoda AIbraheemDepartment of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig,
Egypt.Ahmed ABadawyDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig,
Egypt.Journal Article20221119<strong>Background:</strong> Liver cirrhosis is characterized by multiple metabolic changes. Hepatitis C virus (HCV) induced cirrhosis is one of the universal causes of morbidity and mortality. The peak prevalence of antibodies to hepatitis C virus (HCV) was reported in Egypt. The aim of this study was to evaluate lipid profile in patients with hepatitis C virus induced liver cirrhosis.<br /> <strong>Study aim:</strong> To evaluate lipid profile in patients with hepatitis C virus induced liver cirrhosis.<br /> <strong>Patients and Methods:</strong> This Case control study was conducted on 63 subjects divided into 21 subjects in each of 3 groups: Chronic hepatitis C group, cirrhotic groups and healthy control group. Full history taking and examination were done for all cases. Fasting serum lipid profile of serum total cholesterol , TG , HDL, LDL, VLDL were measured for all cases<em></em>.<br /> <strong>Results:</strong> There was statistically significant difference between the studied groups regarding total cholesterol and HDL cholesterol, TG and VLDL cholesterol. The best cutoff of HDL cholesterol in diagnosis of presence of liver cirrhosis was ≤37.71 mg/dl with area under curve 0.745, sensitivity 71.4%, specificity 71.4%, positive predictive value 55.6%, negative predictive value 83.3%m accuracy 71.4%. The best cutoff of VLDL cholesterol in diagnosis of presence of liver cirrhosis is ≤21.423 mg/dl with area under curve 0.78, sensitivity 84.5%, specificity 75.0%, positive predictive value 63.3%, negative predictive value 90.2%m accuracy 78.5%. Significant AUC was recorded with cutoff regard Serum cholesterol, Serum triglycerides, LDL and VLDL ≤157.5, ≤152.9, ≤83.2 and ≤30.59 respectively with perfect validity.<br /> <strong>Conclusion: </strong>lipid parameters may be considered as a supporting method in appraising hepatic illness .https://aeji.journals.ekb.eg/article_279905_ce3490e609a052839c2c4705e0281438.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301The Efficacy of Bacterial Meningitis Score in Predicting Bacterial Meningitis at Mansoura Fever Hospital435227992410.21608/aeji.2022.174090.1269ENAbeer HAbdelkaderDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.0000-0003-3588-0389Ahmed IGadSpecialist in Infectious Diseases, Mansoura Fever Hospital, Mansora, Egypt.Emad AMohamedDepartment of Microbiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.Mustafa HElshamyDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt.Journal Article20221116<strong>Background and study aims:</strong> Despite the advances in the diagnosis and treatment of infectious diseases, the meningitis and the encephalitis are still considered to be important causes of mortality and morbidity. Early diagnosis and starting immediate empirical therapy are the key factors of decreasing morbidity and mortality. We aimed to detect the frequency of bacterial meningitis among the suspected cases and to evaluate bacterial meningitis score (BMS) for detection the bacterial meningitis cases.<br /> <strong>Methods:</strong> This study was a cross-sectional included 48 patients admitted to the Mansoura Fever Hospital with clinical pictures suspected of meningitis. Full medical history, clinical examination, laboratory investigations and lumber puncture with CSF examination were provided to the participant patients. They were classified according to the results of CSF culture into two groups. The first group: included 12 patients with confirmed septic meningitis. The second group: included 36 patients with aseptic meningitis. The Application of bacterial meningitis score (BMS) was applied.<br /> <strong>Results: </strong>The incidence of the bacterial meningitis in our study was 25% (12 from 48 patients).<br /> The aspect of CSF was turbid among all the patients of septic meningitis, while was turbid only in in (8.3%) of aseptic meningitis cases. The total leucocytes count, polymorphs, and protein were significantly higher in patients with septic meningitis. The bacterial meningitis score has high sensitivity (91.7%), specificity (97.2%), PPV (91.7%) and NPV (97.2%) in the diagnosis of the septic meningitis cases<em></em>.<br /> <strong>Conclusion: </strong>The BMS is a quick, simple score, and highly accurate, which could be used for the diagnosis of the septic meningitis .https://aeji.journals.ekb.eg/article_279924_a3167e5d978917df847d2d51710856b0.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Optimality of 2-week Versus 4-week Intervals in Secondary Prophylaxis of Bleeding by Endoscopic Esophageal Variceal Ligation536128197710.21608/aeji.2023.181161.1273ENMarwa M AyeshOthmanDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptGhada ASalemDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptSameh MAbdel MonemDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptAmal AJoudaDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, EgyptAhmed LSharafDepartment of Tropical Medicine, Faculty of Medicine, Zagazig University, Egypt0000-0003-0318-0783Journal Article20221215<strong>Background and study aim:</strong> There is a constant debate about the most appropriate intervals between endoscopic variceal ligation (<em>EVL</em>) sessions that can help achieve variceal obliteration with minimal complications. This study aims to compare 2-weekly and 4-weekly EVL schedule as regards achieving variceal obliteration and prevention of recurrent variceal bleeding.<br /> <strong>Methods:</strong> This study included 204 patients with first attack variceal bleeding randomly allocated in two groups; group I: included 102 patients who underwent 2-weekly <em>EVL</em> schedule and group II: included 102 patients who underwent 4-weekly <em>EVL</em> schedule. Both groups were followed up till either obliteration or recurrence of bleeding occurred.<br /> <strong>Results: </strong>Group I had significantly higher rate of variceal obliteration at both week 8 (17.5 % vs 0 % P < 0.001) and in week 12 (40 % vs 6.2 % P < 0.001). The overall rate of rebleeding was higher in group II (9.8 % vs 21.6 % p < 0.001). There were no significant differences between the studied groups as regards any of the post banding symptoms, complication, and rehospitalization<em></em>.<br /> <strong>Conclusion: </strong>The two weekly <em>EVL</em> schedule can help achieve variceal obliteration in shorter duration than 4 weekly schedule and lower overall rate of rebleeding without any significant increase in the post banding symptoms, complication and rehospitalization.https://aeji.journals.ekb.eg/article_281977_19c7a36b58af0d1799371711e1113fd8.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Evaluation of Polymyxin NP Test as a Rapid Method for Detection of Polymyxins Resistance in Enterobacteriaceae 627428582610.21608/aeji.2023.182460.1275ENNoha Alaa EldinFahimDepartment of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt0000-0001-6388-3857Amira SaadEl-BeihDepartment of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, EgyptSherin AhmedElMasryDepartment of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, EgyptJournal Article20221226<strong>Background and study aim:</strong> Polymyxins are considered the last remedy for multidrug-resistant <em>Enterobacteriaceae</em>. However, due to their overuse, Polymyxin resistance rose and posed the urge to find new methods to aid their rapid diagnosis. So, this study aimed to assess the diagnostic efficacy of the rapid polymyxin NP test for diagnosis of colistin and polymyxin-resistant Enterobacteriaceae and detect the frequency of mcr-1 and mcr-2 genes among the MDR-<em>Enterobacteriaceae</em> isolates.<br /> <strong>Patients and Methods:</strong> This study included 42 isolates of MDR-Enterobacteriaceae that were subjected to broth microdilution method to detect the MICs for polymyxin B and colistin, rapid polymyxin NP test using Polymyxin B, and conventional PCR for the identification of Polymyxins resistant genes; mcr-1 and mcr-2<em></em>.<br /> <strong>Results:</strong> Eighteen out of 42 isolates were resistant to colistin (42.9%), while 15/42 were resistant to polymyxin (35.7%). For both colistin and polymyxin MIC, the polymyxin NP test exhibited an overall sensitivity, specificity, PPV, and NPV of (77.8%, 91.7%, 87.5%, 84.6%) and (93.3%, 92.6%, 87.5%, 96.2%) respectively. Seventeen isolates were positive for mcr-1 gene (40.5%) and five isolates were positive for mcr-2 gene (11.9%).<br /> <strong>Conclusion: </strong>The rapid polymyxin NP test is an easy and quick that can reliably detect both polymyxin-resistant and susceptible <em>Enterobacteriaceae</em> isolates. This test can be implemented as a screening tool in the outbreak management and active surveillance for presence of Polymyxins resistance. Therefore, combined with PCR, it can play a substantial role to contain antimicrobial resistance and prevent transfer of resistance genes among patients.https://aeji.journals.ekb.eg/article_285826_07e2dae03167959f521c883d984823f6.pdfZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-761313120230301Chatbots, ChatGPT, and Scholarly Manuscripts - WAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications757928293610.21608/aeji.2023.282936ENChris ZielinskiVice President, WAME; Centre for Global Health, University of Winchester, UKMargaret WinkerTrustee, WAMERakesh AggarwalPresident, WAME, Associate Editor, Journal of Gastroenterology and Hepatology;
Director, Jawaharlal Institute of Postgraduate Medical Education and Research,
Puducherry, IndiaLorraine FerrisTrustee, WAME; Professor, Dalla Lana School of Public Health, University of TorontoMarkus HeinemannTreasurer, WAME; Editor-in-Chief, The Thoracic and Cardiovascular SurgeonJose Florencio LapeñaSecretary, WAME; Editor, Philippine Journal of Otolaryngology Head & Neck
SurgerySanjay PaiDirector, WAME; Working Committee, The National Medical Journal of IndiaEdsel IngDirector, WAME; Section Editor, Canadian Journal of Ophthalmology; Professor,
University of TorontoLeslie CitromeDirector, WAME; Editor-in-Chief, Current Medical Research and Opinion; Topic
Editor for Psychiatry for Clinical TherapeuticsJournal Article20230129Journals have begun to publish papers in which chatbots such as ChatGPT are shown as co-authors. The following WAME recommendations are intended to inform editors and help them develop policies regarding chatbots for their journals, to help authors understand how use of chatbots might be attributed in their work, and address the need for all journal editors to have access manuscript screening tools. In this rapidly evolving field, we expect these recommendations to evolve as well.https://aeji.journals.ekb.eg/article_282936_f87a3953e8f65366a96d919aeee40cd9.pdf