Current Issue : April - June Volume : 2021 Issue Number : 2 Articles : 5 Articles
Gender difference in chronic hepatitis C (CHC) infection is not previously well studied. We aimed to analyze the effect of gender difference on the risk factors of CHC, disease progression, and outcome after oral direct acting antiviral (DAA) therapy. The study was conducted at Tropical Medicine and Gastroenterology Department, Sohag University, Egypt, in the period between 2018 and 2020. 775 patients were evaluated for hepatitis C virus (HCV) risk factors. Laboratory investigations, abdominal ultrasound and liver Shear wave elastography (SWE) were done. The patients were given antiviral therapy and followed up to assess the response and side effects of DAA therapy. 434 (56%) of study patients were males and 341 (44%) were females. Catching infection from blood transfusion and intravenous (IV) injection of tarter emetic was significantly higher in males, while catching infection from surgical operation was significantly higher in females. Hepatic fibrosis was significantly more extensive in males. Side effects were reported more in females. Sustained virological response (SVR) 12 was reported in 98.6%. Females had a slightly better SVR12 than males (99.4% versus 97.9%). In conclusion males were different from females in exposure to HCV risk factors. After introduction of blood screening and stoppage of parenteral anti-bilharzial therapy the risk of HCV infection could be greatly prevented in males, while the exposure of females to obstetric procedure is increasing nowadays which hides a risk of ongoing infection in females. So, HCV surveillance programs in females retain their importance in early detection and management of CHC. Although hepatic fibrosis progression was more in males, females were more liable to adverse events of DAA therapy. So, researchers should consider the gender of their patients in drug design and administration....
Introduction: Upper gastrointestinal (GI) endoscopy is an examination that involves exploring the upper part of the digestive tract using an endoscope. Our study was aimed to evaluate the practice of Upper GI endoscopy at the mother-child hospital in Mali. Patients and Methods: This was a descriptive retrospective study on reports of Upper GI endoscopy results in the digestive endoscopy unit at the mother-child hospital in Bamako from January to December 2018. Results: Endoscopy was performed in 465 patients including 231 males and 234 females. The sex ratio was 0.98. Patients were aged 46.69 years old on average with the extremes of 8 and 90 years old. Epigastralgia was the main referral in 50.5%. Endoscopy was normal in 24.7%. The main diagnostics were duodenogastric reflux in 32.5% and gastritis in 14.4%. Conclusion: The practice of Upper GI endoscopy at the mother-child hospital in Mali has allowed the exploration of the upper digestive tract to contribute to the diagnosis of esogastroduodenal lesions....
Background: Gastrointestinal hemorrhage from ruptured esophageal varices is of concern in Africa where gastrointestinal fibroscopy for diagnosis is lacking. Purpose: To determine the performance of the length of the spleen, of the platelet count in the diagnosis of esophageal varices (OVs) by specifying the diagnostic thresholds in order to facilitate the prophylaxis of varicose hemorrhages in black African cirrhotic patients. Material and Method: This was a prospective study with a descriptive and analytical aim on cirrhotic patients hospitalized at the university hospital of Bouake (Ivory Coast) from 2017 to 2019. The patients included in the study were the cirrhotic of black race hospitalized having carried out an abdominal ultrasound with measurement of the spleen diameter (SD), an eso-gastro-duodenal endoscopy, and a blood count with platelet count (PC). The first primary endpoint was the diagnosis of esophageal varices in cirrhosis. Cirrhosis was retained by the combination of clinical, biological, ultrasound and endoscopic arguments. The OVs were distributed according to size and the presence of red signs. The platelet count, and the measurement of the spleen to calculate the PC/SD ratio were the second endpoint. The secondary endpoints studied were, the viral and ethyl etiologies of the cirrhosis, the Chlid-Pugh prognostic score. Performance was assessed using the ROC curve. The difference was significant for p less than 0.05. Results: The study included 101 patients; they were 79 men (78.2%) and 22 women (21.8%). The mean age of the cirrhotic patients was 48 ± 14. Esophageal varices were present in (n = 93; 92%) of cases. The different etiologies were hepatitis B virus (HBV) (n = 65; 78.3%), hepatitis C virus (HCV) (n = 21; 25, 3%), and alcohol (n = 6; 7.2%). Platelet count (PC) < 100,000/mm3 was statistically related to the presence of OV with red signs. Splenomegaly (SD > 130 mm) and PC/SD ratio < 1000 were significantly related to the presence of OVs and large OVs. SD with a cutoff of > 102 mm predicted 75% of OVs (AUROC = 0.797). CP with a cutoff < 131,000/mm3, predicted 100% of OVs (AUROC = 0.756). The PC/SD ratio < 1205 diagnosed 100% of OV (AUROC = 0.801). The PC/SD ratio < 818 and SD > 129 mm predicted large OVs. Conclusion: Platelet count, spleen diamater, and PC/SD ratio were all performant for the diagnosis of OVs in our setting with better diagnostic performance for PC/SD. This report could help initiate prophylactic treatment for OVs rupture in cirrhotic patients in health centers where gastrointestinal endoscopy is lacking....
Biomarkers for cancer diagnosis, prognosis and prediction are important tools and an urgent need in precision medicine for pancreatic cancer. In recent years, many experimental and clinical studies aimed at identifying new biomarkers for pancreatic ductal adenocarcinoma. In the review, we summarized current investigations on using novel protein markers, cell-free DNA, metabolome compounds, immune and stroma signatures and microbiome compositions as biomarkers for pancreatic cancer. Our comprehensive overview shows that although there are new promising biomarkers, CA 19-9 remains currently the only regularly used and validated biomarker for pancreatic cancer in clinical routine....
Background. Hepatic encephalopathy (HE) is one of the most debilitating complications of cirrhosis leading to death. Decrease in HE mortality and recurrence has been linked with timely identification and early treatment. There is a need to document the burden, predictors, and treatment outcomes of HE in an adult population with liver cirrhosis in our setting as only reports from resource-endowed countries abound in the literature. This study aimed therefore to determine the prevalence, predictors, and treatment outcomes of patients with liver cirrhosis admitted at St. Dominic Hospital (SDH) in Akwatia, Ghana. Materials and Methods. A prospective study was conducted involving one hundred and sixty-seven (167) patients admitted at the medical wards in SDH with liver cirrhosis from January 1st, 2018, to March 24th, 2020.The demographic and clinical features of the patients were collected using a standardized questionnaire. Biochemical, haematological, and abdominal ultrasound scans were done for all patients. Patients were then followed up until discharge or death. Results. There were 109 (65.3%) males out of the 167 patients with a mean age of 45.8 and 47.5 years for those with and without HE, respectively. The prevalence of HE was 31.7% (53/167). Out of 53 participants with HE, 75.5% (40/53) died. There was a strong association between HE and death (p < 0.001). The major precipitating factor of HE was infection (64.2%). Severe ascites (OR 0.009) were clinical feature independently associated with HE, whereas high creatinine (OR 0.987), blood urea nitrogen (BUN) (OR 1.199), Child–Pugh score (CPS) (OR 5.899), and low platelets (OR 0.992) were the laboratory parameters and scores independently predictive of HE. Conclusion. HE was common among patients with liver cirrhosis admitted at SDH with high in-patient mortality. The commonest precipitating factor for HE was infection(s). Severe ascites, low platelet count, high creatinine, BUN, and CPS were independent predictors of HE....
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