Adult onset diabetes mellitus in hepatitis C virus infection

There is growing evidence to suggest an association between hepatitis C virus [HCV] infection and diabetes, two common disorders that cause devastating long-term complications in a signficant number of patients. Several reports have found a high prevelance of HCV infection among diabetic patients. Additionally, a high prevelance of diabetes has also been reported in HCV- infected patients in comparison with other liver diseases. On the other hand some authors have not observed an association between HCV infection and diabetes, while others found that diabetes mellitus type 2 occurred with increasing frequency among patients with hepatitis C and this was associated with family history of diabetes mellitus. HCV seropositivity among patients with type 2 diabetes mellitus is higher than in the general population. Aim of work: Is to study the association between HCV infection and diabetes mellitus. This study included 410 consecutive patients with chronic liver diseases. They were attending the outpatient clinic of the National Hepatol-ogy and Tropical Medicine Research Institute and Aswan Teaching Hospital in the period from May 2004 to July 2005. Their ages ranged from 20-60 years. They were 304 males and 106 females. Patients were classified into 3 groups. Group A consisted of 220 non cirrhotic patients with HCV +ve. Group B consisted of 110 cirrhotic patients with HCV +ve. Group C consisted of 80 patients all are -ve for HCV Ab. Type2 diabetes was diagnosed as a fasting plasma glucose level [7.0mmol/L [126 mg/L] or on treatment with oral hypoglycaemic agents. It was found that distribution of diabetes mellitus between group A and B [HCV +ve] and group C [HCV Ab -ve] were 21.21%, 27.27%, 12.5% in respect order. There were no significant difference between AST levels, ALT level, BMI and diabetes mellitus. we have found an association between diabetes mellitus and HCV infection. It remains to be determined whether an HCV infection leads to diabetes mellitus or vice versa

Gastrointestinal complication of NSAIDs therapy: the safest choice, risk factors, and avoidance

As, combination of misoprostol or PPIs plus NSAIDs or use of safer NSAIDs, including COX-2 inhibitors, may reduce the gastrointestinal complication associated with NSAIDs therapy. We aimed to demonstrate: the safest drug, risk factors, and plan of avoidance Fifty patients with rheumatological and cardiovascular indications for NSAIDs classified into: twenty patients treated by NSAIDs alone, fifteen patients treated by NSAIDs and proton pump inhibitors [used for a week every month of treatment course], and fifteen patients treated by anti COX2. Involved in this study, subjected to careful clinical examinations, upper endoscopies, with stress on the possible risk factors exaggerate gastrointestinal complication of NSAIDs. In hypertension, bronchospasm, and allergies there were no significant difference between patients treated by NSAIDs, NSAIDs plus PPIs, or Anti COX2. Heartburn was; 50%, 26.6%, and 33.3% in group 1, 2, and 3 respectively, GIT hemorrhage; 25%, 13%, and 6.6 for group 1, 2, and 3 respectively. With observation of higher percentage of heartburn, and GIT hemorrhage among patients treated by NSAIDs alone which was double this percentages observed among group treated by NSAIDs plus PPIs [addition of PPIs reduce GIT complications to the half]. However patients treated by Anti COX2 shown reduction in GIT manifestation by three folds. Only one case of death among group 1. In endoscopic examination there were noticed higher percentages of oesophagitis, gastritis, and peptic ulcer among patients treated by NSAIDs alone which were double this percentages noticed among group treated by NSAIDs plus PPIs [addition of PPIs reduce HCL related complications to the half]. However, deudenitis, cardiac incompetent, congestive gastropathy, and abnormal pylorus shown no significant difference between group 1, and 2. Patients treated by Anti COX2 shown reduction in GIT manifestation by three folds. Addition of PPIs with NSAIDs reduces GIT complications to the half as PPIs reduce HCL related complications. However, Patients treated by Anti COX2 shown reduction in GIT manifestation and HCL related complications by three folds. By further economical study for cost benefit from combined therapy versus Anti COX2