ABSTRACT
Background and Study Aims: Egypt has a high prevalence of hepatitis C virus [HCV] and high morbidity and mortality related to cirrhosis complications. Patients with cirrhosis have an increased risk of bacterial infections. Approximately 25-35% of cirrhotics had infections at admission or during hospitalisation. Data on infection among cirrhotics in Egypt are limited. This study aimed to determine the frequency and microbiological spectrum of infections in cirrhotics and possible risk factors
Patients and Methods: This study was conducted at a tertiary care hospital. The frequency and microbiological spectrum of infections in cirrhotics were determined. The risk factors for infection were evaluated
Results: Of the 100 patients with liver cirrhosis, 61% had infection. Ascitic fluid infection [AFI] was the most common infection [44.3%], followed by urinary tract infection [UTI] [21.3%], respiratory tract infection [RTI] [19.7%], gastroenteritis [6.6%] and skin infection [4.9%]. The only risk factor for infection among cirrhotics was diabetes mellitus [DM] [p = 0.047]. The mean value of mid-arm muscle circumference was significantly lower in the infected group [p = 0.047]. Among all the cirrhotics, 32.0% had mild to moderate malnutrition and 52.0% had severe malnutrition. The frequency of infection was higher in severe malnutrition [71.2%]
Conclusions: The frequency of infections among cirrhotics was 61%. Many types of infections including AFI, RTI, UTI and skin infections were present in patients with liver cirrhosis, but AFI was the most common. DM was the only risk factor for infection, and independent predictors for infection were elevated WBC count and C-reactive proteinlevels. The frequency of infection was related to the degree of malnutrition
ABSTRACT
Objectives: To evaluate values of Cyclin D and Cdk4 in HCC, chronic hepatitis C, HCV related liver cirrhosis and healthy controls, their clinico-radiological correlations and prognosis of HCC
Methods: Group 1: Fifty patients with HCC, Group 2.Fifty patients with chronic hepatitis C with or without cirrhosis and Group 3: Thirty healthy controls were enrolled. All patients were positive for hepatitis C virus [HCV] antibody and confirmed by HCV RNA. Calculation of Barcelona-Clinic Liver Cancer [BCLC] staging system, MELD and Child-Pugh scores. mRNA for cyclin Dl and Cdk4 were analyzed by quantitative RT-PCR
Results: The mean Cyclin Dl and Cdk4 values were higher in HCC group compared with the other two groups [p value= 0.001]. In HCC group, the mean Cdk4 and cyclin Dlvalues were significantly higher among HCC patients with multiple hepatic focal lesion [HFL] [p value= 0. 0001, and003 respectively] compared with those with single lesion. A significant correlation between size of [HFL], alpha-Fetoprotein[AFP] and mean Cdk4 value [p value= 0.028, 0.0001 respectively]
Conclusions: Significant values of cyclin Dl and Cdk4 were found in HCC, compared to normal and chronic hepatitis C and correlated to the number, size of HFL and AFP level. Thus, the assessment of cyclin Dl and Cdk4 may provide a novel strategy for prognostication and targeted therapy of HCC