Sonographic study of gall bladder function in patients with chronic liver disease and its relation to gall stone formation

Gall stones occur in about 30% of patients with cirrhosis, gall stones are often asymptomatic in liver cirrhosis, and the hypothesis of diminished gall bladder contractility in chronic liver disease may explain the high frequency of asymptomatic gall bladder stones. The present study was designed to evaluate ultrasonographically the alteration of gall bladder contractility and whether there is a relation between this alteration and cholelithiasis in chronic liver disease. Twenty selected male patients with hepatosplenic involvement in addition to 20 healthy male control of age matched they were divided into 3 groups: Group 1: Chronic liver disease [CLD] with gall stones [10 patients]. Group 2: CLD without gall stones [10 patients]. Group 3: Healthy controls [20]. Ultrasonographic examination was performed, fasting and one hour after a standard fatty meal, G.B. volume was calculated as follow: Vol. = Lx Wx Hx TI/6 The results showed Significant increase in the fasting volume of the gall bladder when comparing group 1 and control P<0.01 Significant increase in post prandial volume comparing G1 and G2 P<0.05. Highly significant increase in postprandial volume comparing G1 and control P<0.01. Significant increase in post prandial volume comparing G2 and control P<0.05. It is concluded from this study that delayed emptying of the gall bladder is a risk factor for gall bladder stone formation in cirrhotic patients, together with other risk factors as increased age, severity of cirrhosis and increased levels of serum triglycerides, and that ultrasound is an easy, non-invasive tool for the evaluation of the gall bladder motor function

Neuropsychiatric changes associated with variceal sclerotherapy

Twenty patients with bleeding eosophageal varices undergoing variceal sclerotherapy were studied. Clinical, laboratory, psychological and E.E.G assessment were performed before and after sclerotherapy. Symptoms and signs of hepatic encephalopathy were found in half of the cases. Psychological tests detected mild confusion, diminished attention, impaired memory and psychomotor retardation in 100% of the patients in contradistinction to clinical assessment which detected only 50% of the cases. E.E.G. findings revealed mild to moderate changes in 60% of the patients while the typical triphasic waves were found in only 25% of the cases. There was no statistically significant difference in the results of psychometric tests and E.E.G after variceal sclerotherapy when compared to values before sclerotherapy

Brucella agglutination titre in febrile versus healthy cases

Brucella tube agglutination test was performed to measure brucella antibody titre in 55 clinically healthy individuals [controls], and 45 febrile patients due to variable clinical diagnosis. The former group had the custom to drink unpasteurised milk. Brucella antibodies were detected in 20 [36.3%] healthy subjects with titre ranging from 1:15 to 1:60, while the rest 35 [63.7%] had negative titre. From the febrile group, 36 [80%] patients had positive titre. The highest antibody titre [1:960] was observed in two cases who had clinical manifestations suggestive of brucellosis, and their repeated blood cultures were positive for brucella organisms. Out of 7 typhoid fever cases, 5 cases [70.4%] had titres ranging from 1:60 to 1:240, but with no rising titres in subsequent estimations. Fever of other aetiologies were either negative or positive at low levels for brucella agglutination titres, the significance of these results had been discussed