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Background and study aims: globally, More than 350 million individuals are chronically infected with hepatitis B virus [HBV], and >20 million of them are co-infected with hepatitis D virus [HDV]. The aim of this study was to determine the pattern of HDV infection in patients with chronic hepatitis B in three main tertiary hospitals in Tripoli and Benghazi, Libya
Patients and methods: this cross sectional and descriptive study was conducted on 162 patients with chronic hepatitis B positive for more than six months] who were followed up at hepatitis clinics of the three main tertiary hospitals in Tripoli city [88 patients from Tripoli Medical Centre and Tripoli Central Hospital] and Benghazi city [74 patients from Aljomhoria Hospital] during the period from January 2010 to June 2012. HBV and HDV markers were detected by enzyme linked fluorescent assay [ELFA] or enzyme-linked immunosorbent assay and HBV-DNA was quantified by real-time PCR techniques
Results: the mean age of patients was 36, 92 +/- 15,35. One hundred and three [63.6%] of them were males and 59 [36, 4%] were females. Four patients [2, 5%] were tested positive for anti-HD antibodies; all of them have had clinical and/or histological diagnosis of cirrhosis. In multivariable regression analysis, age [p = .04], elevation of serum ALT [p = .03], elevation of serum AST [p = .04], and presence of cirrhosis [p = .003] were significantly related to HDV seropositivity
Conclusion: although the study demonstrated that Libya has low to moderate prevalence of HDV [2,5%], it is important for policy makers and health care providers to continue the preventive measures for HDV spread, and HBV prevention program including utilization of HBV vaccine. Furthermore, it is imperative to screen chronic HBV patients for HDV for close observation for early diagnosis of subsequent development of liver cirrhosis. Moreover, further epidemiologic and genetic studies are needed to explore the trend for HDV infection in Libya
ABSTRACT
Background and study aims: Prognosis for patients with cirrhosis admitted to a medical intensive care unit [MICU] is poor and no previous studies have been published from Qatar or other countries in the region to investigate this issue. The objective of this study was to assess the predictors for in-hospital mortality and admission of cirrhotic patients to MICU in a single tertiary hospital in Qatar
Patients and methods: All adult cirrhotic MICU patients hospitalized from 2007 through 2012 to Hamad General Hospital-Qatar were included. We compared them to cirrhotic patients admitted to medical wards during same period of time. All data were recorded and analyzed with respect to demographic parameters, clinical features and laboratory as well as radiology characteristics on day one of admission to MICU. Cirrhosis diagnosis was established either with a liver biopsy or the combination of physical, laboratory and radiologic findings. Predictors of mortality were defined by logistic regression analysis
Results: The cohort comprised 109 cirrhotic MICU patients [86.2% males], and their mean age +/- SD was 51.6 +/- 11.5. MICU-cirrhotic patients had longer hospital stays than medical wards-cirrhotic patients [p = 0.01]. Admission with severe hepatic encephalopathy, upper gastrointestinal bleeding and SOFA [Sepsis Related Organ Failure Assessment] score were the independent predicting factors for MICU admission. Mortality was higher for the MICU-cirrhotic group than medical wards group [27 [24.8%] deaths vs. 12 [5.3%] deaths, respectively, p = 0.001]. In multivariate logistic regression analyses, older age > 60 years [p = 0.04], APACH-II score [p = 0.001] and MELD score [p = 0.02] were independent predicting factors for overall mortality
Conclusion: Severe hepatic encephalopathy, upper gastrointestinal bleeding and SOFA score predict MICU admission of cirrhotic patients. Among MICU cirrhotic patients, older age, APACH-II score and MELD score predict mortality
ABSTRACT
Endogenous endophthalmitis is a rare but devastating disease that may frequently result in visual loss despite appropriate and early antibiotic treatment. Recent reports have suggested an increased incidence of endogenous endophthalmitis in East Asia, particularly in Taiwan, where the major source of infection has been liver abscess secondary to Klebsiella pneumoniae. Here we report three cases who presented in Qatar with severe endogenous endophthalmitis associated with Klebsiella pneumonia septicemia secondary to pyogenic liver abscess in a diabetes mellitus underlying.
ABSTRACT
OBJECTIVES@#To describe the epidemiological and clinical profile, treatment and outcome for hydatid diseases among the patients admitted to Hamad General Hospital.@*METHODS@#This retrospective study was carried out on patients admitted to Hamad General Hospital between 1st January 2000 and 31st December 2013. Descriptive statistics including range and percentage were used in analyzing the patient characteristics and laboratory parameters.@*RESULTS@#Hydatid disease was confirmed in 32 patients. The mean age of them was (35.59±13.00) years (range: 11-67 years) and 90.6% (29/32) of them were non-Qataris with male predominance. The main presenting symptom was abdominal pain 71.9% (23/32) followed by fever 45.9% (15/32). The main presenting sign was hepatomegaly 62.5% (20/32). Single organ involvement was found in 87.5% (28/32) and the common site involved was the liver 81.3% (26/32) followed by the lung 15.6% (5/32). The diagnosis was established by abdominal ultrasound and/or abdominal CT and confirmed by serology in all patients. The diagnosis was confirmed by histology in 90.6% (29/32) patients. All patients received albendazole, and 90.6% (29/32) patients had surgical intervention. Duration of albendazole therapy was (53.9±51.5) d. All patients were cured.@*CONCLUSIONS@#Hydatid disease is uncommon in Qatar. It occurs mainly among non-Qataris from endemic areas and affects the liver mostly. Surgical intervention and albendazole administration are highly effective.
ABSTRACT
Objectives: To describe the epidemiological and clinical profile, treatment and outcome for hydatid diseases among the patients admitted to Hamad General Hospital. Methods: This retrospective study was carried out on patients admitted to Hamad General Hospital between 1st January 2000 and 31st December 2013. Descriptive statistics including range and percentage were used in analyzing the patient characteristics and laboratory parameters. Results: Hydatid disease was confirmed in 32 patients. The mean age of them was (35.59±13.00) years (range: 11-67 years) and 90.6% (29/32) of them were non-Qataris with male predominance. The main presenting symptom was abdominal pain 71.9% (23/32) followed by fever 45.9% (15/32). The main presenting sign was hepatomegaly 62.5% (20/32). Single organ involvement was found in 87.5% (28/32) and the common site involved was the liver 81.3% (26/32) followed by the lung 15.6% (5/32). The diagnosis was established by abdominal ultrasound and/or abdominal CT and confirmed by serology in all patients. The diagnosis was confirmed by histology in 90.6% (29/32) patients. All patients received albendazole, and 90.6% (29/32) patients had surgical intervention. Duration of albendazole therapy was (53.9±51.5) d. All patients were cured. Conclusions: Hydatid disease is uncommon in Qatar. It occurs mainly among non-Qataris from endemic areas and affects the liver mostly. Surgical intervention and albendazole administration are highly effective.
ABSTRACT
To describe the etiology, clinical presentation, management and outcome of liver abscess in adult patients admitted at Hamad general hospital, Qatar. A cross sectional study was conducted to involve all adult patients who sequentially encountered episodes of liver abscess during the period from January 1, 2009, to December 31, 2010. Blood cultures were drawn from all patients in the first 24 hours after admission. In addition, all patients had stool examinations and indirect Hemagglutination test for Entameba histolytica. Aspiration of abscess was done under CT guidance and aspirated pus was sent for gram stain and culture. In total, 67 patients were admitted with liver abscess; 56 patients with pyogenic liver abscess and 11 with amebic liver abscess. There were 61 [91%] males and six [9%] females and their mean age was 47.4 +/- 18.5 years. Fever, abdominal pain and vomiting were the commonest presenting features. Of the 56 pyogenic liver abscess patients, four discharged against medical advice and seven refused all invasive procedures and were treated with antibiotics for six weeks. The remaining 44 [79%] patients were treated with antibiotics and one or more invasive procedures, while one patient was treated surgically. The commonest organism isolated was Klebseilla pneumonia found in 21 patients [38%]. The mean duration of hospitalization was 13.6 +/- 8.1 days; the mean duration of antibiotic therapy was 34.7 +/- 40.6 days, and one patient died. In contrast, all amebic liver abscess patients underwent ultrasound guided aspiration and showed good response to metronidazole treatment. Their mean duration of hospitalization was 7.7 +/- 4.1 days, mean duration of therapy was 11.8 +/- 2.1 days, and all patients were cured. Pyogenic liver abscess was more common than amebic liver abscess with Klebseilla pneumonia being the commonest organism. With good medical measures and early drainage of liver abscess, surgical intervention was unnecessary in almost all the case