prospective study: prediction of the first variceal haemorrhage in schistosomal and non schistosomal liver disease

A prospective study was conducted on liver disease patients without previous history of bleeding [haematemesis and/or melena] to identify those at highest risk of bleeding. A hundred and twenty non-alcoholic patients [96 males and 24 females], ages ranging from 30 to 60 years were studied. Patients were followed for up to two years or to time of bleeding [mean 18 +/- 7.3 months], during which 34 [28.3%] patients bled. Schistosomal patients showed less incidence of bleeding [12.1%, p < 0.05] than those with mixed aetiology [Schistosoma and cirrhosis 23.5%, and chronic active hepatitis and schistosoma 44.4%]. The presence of positive viral markers [either HCV antibodies or HBsAg] was associated with a higher percent of bleeding during the follow-up period [43.2% and 45.4%, respectively], than those negative for these markers [21.7%, 24.4%, respectively]. Univariate analysis showed the following significant risk factors associated with bleeding: modified child classification, reduced platelet count, endoscopic findings of cherry red spots, gastric varices and increased grade of oesophageal varices. Multivariate analysis revealed that the risk of bleeding was significantly related to the presence of cherry red spots, the presence of gastric varices, grade of oesophageal varices and the patient's prothrombin time. In conclusion, bleeding from oesophageal varices is a frequent and serious event in patients with chronic liver disease. The risk of variceal bleeding from liver disease with mixed aetiology [schistosomiasis associated with viral hepatitis HBV or HCV] was found to be significantly higher than that with schistosomal aetiology alone. The endoscopic findings of cherry red spots, gastric varices, increased grade of oesophageal varices and to a lesser extent the prothrombin time were found to be high risk factors. Patients having those risk factors should be considered for prophylactic measures

Study of the levels of some trace elements in intestinal bilhariasis

This work deals mainly with the study of some trace elements in the tissue in active instestinal bilharziasis. Twenty five patients aged from 13-52 years suffering from active intestinal bilharziasis were divided into two groups. Group 1: Consists of 15 patients suffering from active intestinal bilharziasis without ascites. Group 11: Consists of 10 patients suffering from active intestinal bilharziasis with ascites. Zinc copper, magnesium, manganese and vanadium in plasma and liver tissue were estimated by Atomic Absorption technique our results indicate that plasma copper is increased in both groups than normal value, with a lower level in non ascetic patients than in ascetic patients and the difference is statistically significant, while that of zinc and magnesium are decreased. Zinc is lower in ascetic patients than in non ascetic patients, while magnesium is lower in non asctiic patients than in ascetic patients. Plasma manganese and vanadium, in both groups do not significantly differ from normal value. The hepatic content of copper in both groups is increased than in normal, with a lower level in non ascetic patients, the difference is statistically significant, while that of manganese zinc and magnesium are decreased. The manganese in liver tissue is decreased more in non ascetic patients than in the ascetic patients while magnesium is lower in ascetic patients than non ascetic patients. Vanadium do not significantly differ from the normal value

Preliminary studies on hepatitis B surface antigen in the liver of patients with schistosomiasis

The detection of HBsAg in the liver tissue of 31 patients with active intestinal schistosomiasis with chronic liver disease was carried out by using the Orcein stain. The result of liver biopsy was as follows, the pure hepatic schistosomiasis was [29 percent] none of them was Orcein positive, the incidence CPH was [29 percent] and [44, 5 percent] were Orcein positive, the CAH was [25.5 percent] and [75 percent] were Orcein positive and the patients in mixed group were [16.1 percent] those who were Orcein positive constituted [40 percent]