Correlation of ultrasonographic findings with histopathological diagnosis in HCV related chronic liver diseases

Hepatitis C virus is a major cause of chronic liver disease worldwide, it is estimated that 1% of the world's population may be infected with hepatitis C. Egypt has the highest countrywide prevalence of hepatitis C virus in the world, with an estimated 8-10 million have been exposed to the virus and 5-7 million have active infection. Over 80% of acutely infected patients go on to develop chronicity but only 20% to 25% will develop end stage liver disease and complications. Liver biopsy has been recommended to exclude other liver diseases and to establish a histological stage and grade of liver disease. This provides an important clue for management and potentially for prognosis of chronic hepatitis C. conventional transabdominal ultrasonography is accurate in predicting the final diagnosis in patients with compensated chronic liver disease and may identify cirrhosis in different cases. This study was designed to confirm the diagnostic accuracy of ultrasonography to detect early changes of liver cirrhosis in chronic hepatitis C patients. The study included 80 patients with HCV related compensated chronic liver disease; All patients were subjected to full clinical assessment, laboratory tests, HB markers, HCV Abs, PCR for HCV, conventional transabdominal ultrasonongraphy, with duplex Doppler examination and histopathological examination of liver biopsy specimens using modified [Knodell] Histologic Activity index [HAI] score. The study included 80 patients with chronic liver disease, with a male to female ratio of 4:1. Dental manipulation, previous surgery, and parentral antischistosomal therapy were the most common risk factors. A significant positive correlation was present between the right lobe in mid clavicular line and hisologic activity index [HAI], and a negative correlation between hepatic artery resistive index [HARI] and HAI. A highly positive correlation between the liver surface and fibrosis stage and a negative correlation between portal vein peak velocity and the fibrosis stage. A significant positive correlation between bright liver, the size of the left lobe in midline, quadrate lobe transverse diameter, splenic sizes and hepatoduodenal lymph nodes on ultrasonography and steatosis grade. In conclusion abdominal ultrasonography together with duplex Doppler examination is an accurate method in detecting early changes of liver cirrhosis in chronic liver disease

[Irrational thoughts and their relation to anger]

The study leads to the reveal of the irrational thoughts and the anger experts and recognizing the rates of it s spread and the correlation between irrational thoughts and anger experts. The sample is 368 measure of irrational, and 160 measure of anger, the study came to the conclusion which is the spread of irrational thoughts among the study sample which reached 95.5%, high rates of anger which reached 56.3%. There is no correlation indicates statically between irrational thoughts and anger for the study sample the irrational thoughts was a must, having perfection, feeling, expecting problems, neglecting, love problems, fear from feeling incapable, attempt to reformation, annoyed for people problems, ask for backing up, perfection, the man is the only source of happiness for the woman, the experiences that leads to anger was the physical answer, property loss, frustration, stop work, stop daily exercise, missing respect

Profile of glucose abnormalities in patients with chronic hepatitis C and its relevance to hepatogenic diabetes

Background and aim of the work: HCV infection causes serious liver diseases including liver cirrhosis and liver cancer. It can also cause some extrahepatic diseases like diabetes mellitus. We aimed in this study to detect glucose abnormalities in patients with chronic hepatitis C and liver cirrhosis

Subjects and methods: the study was conducted on 70 subjects, 60 of them were HCV +ve and 10 apparently healthy volunteers as control. Patients were grouped into four groups. Group l: included 15 chronic hepatitis C patients[12 males, 3 females; mean age 46 +/- 8.0 years. Group 2: included 15 patients with Child A class, 9 males and 6 females with mean age 49 +/- 5.2 years. Group 3: included 15 patients with Child class B [7 males and 8 females with mean age 52.5 +/- 7.6 years. Group 4: included 15 patients with Child C class [9 males and 6 females with mean age 48.4 +/- 7.1 years]. Complete history and clinical examination, abdominal ultrasound were done. Liver function tests, fasting and postprandial blood glucose, renal function tests. HCV Ab, HBsAg, HCV RNA were done. Serum Insulin levels and C-peptide were measured by ELISA method

Results: body weight, body mass index [BMI], waist to hip ratio [WHR] in patients with chronic hepatitis C and cirrhotics were not different from the control group. 31.6% of patients were diabetics, 45% of patients had impaired glucose tolerance and 23.4% of patients had normal blood glucose. There was highly significant increase in both c-peptide and blood insulin levels in diabetic patients when compared to patients with impaired glucose tolerance and patients with normal blood glucose with p value < 0.0001

Conclusions: hyperinsulinemia and increased levels of serum C-peptide were found to be significantly more prevalent in chronic HCV patients. HCV-related liver diseases have great liability to develop disordered glucose homeostasis. Hyperinsulinemia and peripheral insulin resistance is one of the most important factors that underlie pathogenesis of hepatogenic diabetes