ABSTRACT
Background: Development of oesophageal varices is a major complication that may occur in up to 90% of cirrhotic patients. The endoscopic screening is an invasive procedure. This is why the selection of patients with large oesophageal varices at high risk for bleeding has become an issue of growing importance. In this respect, several clinical, biochemical, ultrasonographic and elastrogarphic [transient elastography-TE] methods have been proposed [and some of them validated] as noninvasive alternatives to endoscopy
Objectives: It was to evaluate transient elastography by fibroscan in the prediction and determination of the grade of esophageal varices in cirrhotic patients due to chronic hepatitis c virus [HCV] infection with or without bilharziasis
Patients and Methods: Sixty Egyptian patients with body mass index [BMI] <35, no history of: upper gastro-intestinal tract [GIT] bleeding, hepatocellular carcinoma, moderate and tense ascites or any other cause of liver cirrhosis. The patients were divided into two groups: Group I included thirty patients with liver cirrhosis due to HCV infection only. Group II included thirty patients with liver cirrhosis due to HCV infection associated with bilharziasis. The patients were subjected to: 1] Thorough history taking. 2] Detailed clinical examination. 3] Laboratory tests. 4] Abdominal ultrasound. 5] Rectal snip for diagnosis of bilharziasis. 6] Upper gastrointestinal endoscopy. 7] fibroscan
Results: Regarding fibroscan in both groups, the mean values of fibroscan were lower in patients without esophageal varices than patients with esophageal varices or with large esophageal varices with statistically high significant differences [p<0.01]. Regarding fibroscan in group I, the mean values of fibroscan were lower in patients without esophageal varices than patients with small esophageal varices with statistically high significant differences [p<0.01]. But in group II, the mean values of fibroscan were lower in patients without esophageal varices than patients with small esophageal varices with statistically non significant differences [p > 0.05]. In both groups, the mean values of fibroscan were lower in patients with small esophageal varices than patients with large esophageal varices with statistically non significant differences [p > 0.05]
Conclusion: fibroscan is valuable in predicting the presence of esophageal varices and large esophageal varices in patients with post HCV liver cirrhosis with or without bilharziasis but couldnot predict the grade of esophageal varices
ABSTRACT
Schistosomiasis is the second most prevalent tropical disease in the world after malaria and is caused by the Schistosoma, genus of fluke. The pathophysiology of schistosomiasis is due to the immune response against the schistosome eggs. The clinical manifestations depend on the species of parasite, intensity of worm burden, and immunity of the person to the parasite. Many trials were done for production of vaccine against infection of shistosomiasis and many efforts were spent to prevent infection, but the rate of new cases is still high. On the other hand, we need a methed to prevent or at least decrease the inflammatory reaction caused by schistosomiasis. This study aimed to the evaluation of possible protective effect of anti-oxidant beta-carotene on S.mansoni infected mice or decrease the inflammatory reaction caused by schistosomiasis. Sixty mice were included in this study and they were divided into 4 groups, every group is 15 mice: Group [1]: [treated infected group]; Group [2]: [treated noninfected group]; Group [3]: [infected group] and Group [4]: [normal control]. The results: b-carotene reduced worm burden to about 20%. Beta-carotene significantly reduced hepatic and intestinal tissue egg load with a reduction percentage of 26% and 18% respectively. Beta-carotene normalized the serum enzyme AST that were elevated by schistosomal infection. Beta-carotene did not significantly change serum proteins both in infected and non infected animals. Beta-carotene exerted immunomodulatory effects on inflammatory reaction of hepatic schistosoma reflected as significant reduction in mean cellular infiltration diameter, more circumscription and less inflammatory cellular content, as well as more inflammatory reaction changes in schistosomal ova. We recommended further studies to judge the protective efficacy of beta-carotene through histological study of animal skin and to judge its therapeutic efficacy if administered adjuvant with antibilharzial therapy
ABSTRACT
Eleven breast cancer patients [stage II] aged 43-52 years were pre- and postoperatively followed up with serial determinations of serum carcinoembryonic antigen [CEA], cancer antigen 15.3 [CA15- 3], mammary carcinoma antigen [MCA], progesterone and estradiol to assess the clinical value of these parameters in the diagnosis of breast cancer. The mean preoperative values of the abovementioned parameters in patients with breast cancer were statistically significantly higher than controls. In addition, the concentrations of CEA, CA15- 3, progesterone and estradiol in the serum postoperatively showed a significant change compared with their levels before surgery. The results indicated the existence of a good correlation between serum CEA with CA15-3 and CAl5-3 with progesterone pre- and postoperatively in breast cancer patients