Infectious diseases presenting by fever and hepatomegaly

The present study included 51 patients presenting by infectious fever and hepatomegaly. They were admitted to Abbassia and Embaba Fever Hospitals. Patients were subjected to careful history, thorough clinical examination, complete blood picture, urine and stool examination, repeated blood, urine and stool cultures during fever spikes. Slide and tube agglutination test for typhoid and brucella fevers. Mononucleosis diseases were diagnosed by Monospot test, Epstein Barr IgM and G, Cytomegalovirus IgM and G and Toxoplasmosis by indirect fluorescent test. Abdominal U.S., C.T scan and bone marrow examination whenever needed. Fifty one cases included 31[61%] bacterial cases, 12 [23%] mononucleosis cases and 8 [16%] parasitic cases. Thirty one bacterial group included 11[35%] brucella cases, 7 [23%] extrapulmonary tuberculosis, 5 [16%] urinary tract infection, 4 [13%] gram negative septicaemia and 4 [13%] deep seated abscesses. Twelve cases of mononucleosis cases included 6 [50%] infectious mononucleosis, 4 [33%] cytomegalovirus and 2 [17%] toxoplasmosis cases. Eight cases of parasitological group included 4 [50%] malaria cases, 2 [25%] fasciola cases, 1 [12.5%] amoebic liver abscess and 1 [12.5%] due to kala azar. Two [4%] cases died in our series; 1 due to gram negative septicaemia and the other due to kala azar. Cases are discussed and interpreted

Clinical, Biochemical, Histological and Virological Effect of·Dimthylene Dioxy Biphenyle Dicarboxylate [DOB] in Patients with Compensated Chronic Hepatitis C

Background: chronic liver disease is a major cause of mortality and morbidity in Egypt. D.D.B. was found to improve the abnormal liver function tests in those patients. Since then it has been used in the management of chronic liver disease, yet clinical improvement and changes in the biochemical and pathological examination are still considered study questions

Objectives: to evaluate the efficacy and side effects of D.D.B. compared to Silymarine in wells compensated patients with chronic HCV infection

Method: the study population included 50 patients with compensated chronic HCV infection subdivided into two groups 25 patients each. One group received D.D.B. for 48 weeks and the other received Sily-marine for the same period of time. Each patient was subjected to assessment of the liver function tests, virological studies, abdominal ultrasound, isotope liver scan, liver biopsy and rectal snip before starting the treatment. Further evaluation was performed by repeating the liver function tests every 3 months, the abdominal ultrasound every 6 months, the rest of the tests and the liver biopsy were repeated after one year i.e. at the end of treatment

Results: sustained normalization of ALT level and transient normalization of the AST level was found in the DDB group. No significant effect on the. HCV RNA, level was detected after one year of D.D.B. therapy; in none of the patients did the HCV RNA become undetectable. The liver-splenic ratio in the iso-topic studies showed significant decrease after one-year therapy with D.D.B. The grade of inflammation was unchanged in 10 cases, worse in 11 cases and better in 3 cases while fibrosis was unchanged in 22 cases and worse in 2 cases. No major side effects were observed in either group of patients

Conclusion: DDB has no antiviral effect in patients with chronic HCV infection. It does not show a histological benefit [neither in terms of degree of necroinflammation nor stage of fibrosis] after 1 year of treatment and when compared to Silymarin. On the other hand it improves some biochemical parameters [ALT] as well as the general well being of the patients. It has no major side effects

Age - related alteration in the pituitary thyroid axis

This study includes 80 persons: 70 elderly subjects above 65 years and 10 healthy middle aged control group [20-40 years of age], both elderly subjects and control group were subjected to the following: Complete history taking, thorough clinical examination with local examination of thyroid gland. The blood samples were taken for estimation of T3, T4 and TSH hormones. There were four elderly subjects proved to be hyperthyroid according to Wayne score class in whom T4 was found raised and within normal TSH and T3. There was three elderly subjects with subclinical hypothyroidism in whom TSH was found high and within normal T3 and T4. There was inverse correlation of TSH with age, but no correlation between T3,T4 with age