ABSTRACT
Introduction: Spontaneous bacterial peritonitis [SBP] is a frequent and life threatening complication ofcirrhosis. Several large studies have identified additional risk factors for the development ofSBP. Zinc deficiency has been found to be frequent in cirrhotic patients
Aim of the work: The aim of the present study was to evaluate the frequency, possible risk factors and the roleof zinc in the development of first time and recurrent SBP
Methodology:A total of 176 cirrhotic ascetic patients admitted to the Hepatology Department in Sohag University Hospital were enroled in the study. SBP peritonitis was diagnosed throughhistory?taking and through examination and laboratory investigations, including ascetic fluidstudy and the detection of serum zinc level
Results: Of the 176 cirrhotic patients, SBP was diagnosed in 54 [31%]; in total, 40 patients [23%] had single and 14 [8%] had recurrent episodes of SBP. Out of the 23 studied clinical and laboratory variables, we found that the prolonged use of proton pump inhibitor [PPI][P = 0.001],lower prothrombin concentration [P = 0.03], ascetic protein level less than or equal to1 g/dl [P < 0.0001] and zinc deficiency [P = 0.001] were independent risk factors for the development of SBP in cirrhotic patients; using multivariate analysis, only low protein in ascites less than or equal to 1 and low zinc status were predictors of SBP
Conclusion: In our study, the frequency of SBP was 31%; overall, 23% of the patients had first?episodeand 8% had recurrent SBP. The use of PPI, low platelet count, ascetic protein content andzinc deficiency were the predictors for the development of SBP; only low protein in ascites less than or equal to 1 and low zinc status were independent predictors of SBP
ABSTRACT
The role of MSCT coronary angiography in assistance and guidance of PCI of CTO has been studied in multiple small registries and prospective studies but up till now there is no randomized trial testing this issue. We performed this randomized trial to study the effect of MSCT coronary angiography on the success rate of PCI of CTO and whether it decreases or increases the exposure to radiation and contrast media during PCI. Forty patients were randomized to direct PCI group and MSCT assisted PCI group [20 patients each]. Although MSCT gave a better understanding of the morphologic CTO characteristics and could predict accurately procedural failure, this was not reflected on the success rate and there was no difference between both groups regarding success rate, radiation exposure nor the used contrast media volume during PCI Moreover the patients in the MSCT group were exposed to an extra-dose of radiation and contrast media during MSCT examination. preprocedural MSCT coronary angiography before PCI of CTO did not affect the success rate of the CTO recanalization. MSCT is an excellent predictor of procedural failure of CTO recanalization but at the expense of high dose of radiation exposure and increased usage of contrast media volume