controlled study of nitazoxanide [NTZ] 3 years after treatment of hepatitis C genotype

This study is an extension of an earlier, randomized; placebo-controlled that showed the efficacy of nitazoxanide [NTZ] 500 mg tablets twice daily for 6 months in treating HCV genotype 4. Access was available to 13/32 patients of the original study with chronic HCV during more than 3 years after the study was finished. One patient [with portal hypertension and oesophageal varices [O.V]] was among 3 with SVR out of 9 of the NTZ treated patients suggesting that NTZ could successfully be used even in patients with O.V. SVR remain so up to the end of the follow-up period compared to none of the other 4 patients who received placebo. A fourth patient of NTZ group achieved virological response at the end of follow-up although she firstly showed RVR and then viral breakthrough. Most of the remaining patients of the NTZ group who did not achieve SVR showed variable partial response. No serious adverse events were reported in both groups during treatment and thereafter

Pattern of meningitis in kalyobia. Governorate Egypt in the last therteen years [1984 to 1996]

Total of 3822 cases of meningitis were reported to the central laboratories of Kalyobia Governorate [Egypt] from the first of January 1984 to the end of December 1996. The main trend of the disease showed peak incidence in the period from 1989 to 1991 [Epidemic wave]. Haemophilus influenzae [35.04%] and Nesseria meningitidis [24.23%] were the most common bacterial agents diagnosed. Meningococcal meningitis was mostly caused by group A [30.24%] and group B [13.17%] allover the period of the study, while other new groups were diagnosed during the epidemic period [CD, W 135, Y and Z], the later showed high frequency [28.94%]. 11.30% of the cases had purulent meningitis but without detectable aetiology owing to the early use of antibiotics. A govemomental fever hospital taken as a sample model, high frequency of cases was below 15 years with 1.22 male to female ratio, but epidemic period showed increase in the female frequency. Meningococci were the responsible agent during the epidemic and responsible for 23.07% of all the hospital mortalities. The highest case fatality rate was in the preepidemic period [15.7%]. From this study it is recommended to establish a preventive program aiming at reducing the disease incidence, morbidity and mortality through: increasing the immunization coverage, improve the vaccine quality, disease surveillance and proper management of the diagnosed cases

study of the humural immunity and [HLA] tissue typing in different clinical forms of amoebiasis

Humoral immunity and HLA tissue typing were studied in 50 patients with different clinical forms of amoebiasis selected from hundreds of subjects examianed for the infection. Both IgG and IgA levels were significantly increased in amoebic liver abscess, hepatic amoebiasis and hepatomegalic groups of patients. But, only IgA level was significantly increased in amoebic colitis. It has been also found that HLA10 was significantly increased in patients with amoebic liver abscess and HLA-B13 was increased in patients with amoebic liver abscess, amoebic colitis and cyst passers. These results showed that the different clinical forms of amoebiasis are significantly associated with the humoral immunity and their HLA tissue typing. This may be an important explianation for the susceptibility of amoebic infection to develop one clinical form than the other

Study of HBV markers and HLA typing in chronic liver diseases [CLD]

Ninety patients with chronic liver disease [CLD] were classified into 5 groups according to histopathological picture of their liver biopsies. The results showed pure bilharzial periportal fibrosis [BPPF] in 18.5% of cases, post-necrotic cirrhosis [PNC] in 38%, mixed [schistosomiasis plus histological features of postviral CLD] in 29%, non-specific hepatitis [NSH] in 7.2% and hepatocellular carcinoma [HCC] in 6.18%. The incidence of HBsAg and HBcAb were significantly increased in the mixed and PNC groups and HBsAg only in HCC group. Meanwhile, 18.1% of cases showed tissue positivity for HBsAg with negative serum samples. HLA-A2, B5 and B14 were present in BPPF at a high significant level. A positive correlation was also found between HLA-A9, A10 and both PNC and mixed cases and between HLA B27, B35 and long term carriage of HBsAg. It appears, therefore, that chronic hepatitis B infection is responsible for more severe and serious liver disease than schistosomiasis per se. The HLA findings may also suggest that the complications of schistosomiasis and the predisposition to the chronic HBV infection and/or carrier state may be genetically determined

Assessment of gastrointestinal haemorrhage in chronic liver disease

Forty-five patients with chronic liver disease [CLD] with and without history of haematemesis and/or melena were studied together with 15 healthy adults [control group]. Upper gastrointestinal [GIT] endoscopy, liver function tests, complete coagulation screen with routine urine and stool examination and occult blood in stool were done. A significant rise of serum bilirubin, transaminases [SGOT and SGPT] and alkaline phosphatase, prolongation of prothrombin time [PT] and activated partial thromboplastin time [PTTK] and reduction of platelet count occurred in all patients when compared to the control group. More significant elevation of transaminases and prolongation of PT, PTTK and BT were detected in patients with a history of bleeding varices than in those without. The reduction in platelet count was more significant in patients with history of manifested bleeding than in those without varices. Occult blood in stools of bleeders was more statistically significant when compared to those without. It was recommended, therefore, to investigate bleeding from GIT in patients with CLD, even without manifested blood loss. Early correction of coagulation disorders, proper management of associated pathological conditions, regular laboratory follow-up and prophylactic sclerotherapy of high risk oesophageal varices may help for better prognosis of such patients

Atypical virus B hepatitis in Egypt

This cases-control study comprise 70patients with chronic liver disease [CLD] compared to 30 matched controls. When the patients hepatitis B virus [HBV] serological markers and serum aminotransferases results computed with their histhopathological findings, a new presentation was emerged. This included forms where HBV runs its typical course [13.61%] and another more prevalent one where HBV turn into atypical form [40.9%]. Explanation of such observation includes a role of undetectable variant in HBV-HBeAg negative patients due to mutation of HBV in response to immunological stress by schistosomiasis and probably other causes in this Mediterranaen area

Peptic ulcer in chronic liver disease patients: a novel approach

The study here reported comprised 30 patients with peptic ulcer, 20 of them were also suffering from chronic liver disease [CLD] with portal hypertension. All patients were attending Benha and Ain Shams Universities' Hospitals seeking medical intervension for their illness. Portal haemodynamic study using the Duplex Dppler sonography [DDS] with colour flow mapping revealed that the basal portal flow velocity and volume, rather than the portal vein calibre alone, are the fundamental predictors of portal hypertension. Moreover, after a standard meal, a significant increase in the basal portal blood flow volume was observed in patients with peptic ulcer alone. Such increase was not significant in patients with chronic hepatitis and almost neglligible in patients with hepatic cirrhosis. It was, therefore, assumed that stasis of blood in the portal circulation would lead to a state of chronic venous congestion refered to as "congestive poartal ischemia" particularly augmented after meals. This pioneering observation is important among other factors contributing to increased frequency and delayed healing of peptic ulcer in patients with chronic liver disease and portal hypertension

Duodeno-jejunal lesions in clinical giardiasis

In patients with clinical giardiasis, the duodeno-jejunal mucosa appeared by endoscopy to be pale and oedematous. This abnormality was confirmed when biopsies taken from this area were found, by immunofluorescent study, to be damaged by complement containing immunocomplex including IgM. Further confirmation was obtained by measurement of IgM and C3 levels in the patients' sera. Both components were active as the former was increased and the latter was consumed

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]