clinical outcome of the extract of ginkgo biloba in Egyptian chronic hepatitis C patients

This study was designed to evaluate the clinical efficacy and safety of Ginkgo biloba [EGb] extract, ursodeoxycholic acid [UDCA] and their combination in patients with chronic hepatitis C. This is a prospective 3-arm randomized controlled pilot study performed on 67 patients diagnosed with chronic HCV, who were randomly assigned to receive either EGb, UDCA or EGb+UDCA for a period of 4 weeks. Patients were monitored for liver transaminases, albumin, total bilirubin, International normalized ratio [INR], serum total antioxidant capacity [TAC], serum transforming growth factor beta-1 [TGF-beta1] and serum hyaluronic acid [HA] at baseline and after 4 weeks. Assessment of quality of life was performed using the RAND SF-36 questionnaire. Safety was evaluated by adverse effect reporting and monitoring the complete blood count. After treatment, no change in liver transaminases was observed in the EGb-group, while the UDCA-group and the EGb+UDCA-group showed significant decrease in the transaminases level [p<0.05]. No significant changes in the levels of total bilirubin, albumin nor INR were observed. The serum TAC level was significantly increased, while the serum levels of TGFbeta1 and HA were significantly declined in all the three groups [p<0.001]. Regarding quality of life, EGb-group showed no change in the component summary scores of the RAND SF-36 questionnaire. On the other hand, the UDCA-group showed a significant increase in both the physical and mental component summary scores, while the EGb+UDCA group showed a significant increase in only the mental component summary score. All treatment regimens were well tolerated by all patients. In conclusion, the usage of Ginkgo biloba extract in the studied HCV-cohorts proved to exhibit antioxidant efficacy and potential to lower fibrosis markers and profibrotic growth factors; yet, this hepatoprotective action failed to ameliorate the liver transaminases. The combined administration of EGb and UDCA showed no additional clinical benefit

Towards an Egyptian guideline from screening to treatment of hepatocellular carcinoma [part I]

These recommendations provide a data-supported and based-evidenced approach to the screening, diagnosis, staging and treatment of Egyptian patients with hepatocellular carcinoma [HCC] in which we tried to construct an Egyptian algorithm for our Egyptian HCC patients in terms of type and timing of surveillance, readily available diagnostic tools that suit our means and the proper and efficient timely treatment that suits our resources. They are based on the experience of the authors in the specified topic and the AASLD Policy on the Development and Use of Practice Guidelines. These recommendations suggest preferred approaches to screening [for early detection of cases with hepatic nodule and/or elevated AFP], diagnosis [for accurate diagnosis of HCC cases], staging [for detection of specific category of treatment according the patient's general condition] and treatment [selection of the most suitable treatment option for the patient after his proper evaluation]. In an attempt to characterize the quality of evidence supported recommendations, the Egyptian Guidelines requires a category to be assigned and reported with each recommendation [Table I]

Towards an Egyptian guideline from screening to treatment of hepatocelhilar carcinoma [part II]

These recommendations provide a data-supported and evidence based approach to the screening, diagnosis, staging and treatment of Egyptian patients with hepatocellular carcinoma [HCC] in which we tried to construct an Egyptian algorithm for our Egyptian HCC patients in terms of type and timing of surveillance, readily available diagnostic tools that suits our means and the proper and efficient timely treatment that suits our resources. They are based on the experience of the authors in the specified topic and the AASLD Policy on the Development and Use of Practice Guidelines. These recommendations suggest preferred approaches to screening [for early detection of cases with hepatic nodule and/or elevated AFP], diagnosis [for accurate diagnosis of HCC cases], staging [for detection of specific category of treatment according the patient's general condition] and treatment [selection of the most suitable treatment option for the patient after his proper evaluation]. In an attempt to characterize the quality of evidence supported recommendations, the Egyptian Guidelines requires a category to be assigned and reported with each recommendation [Table 1]