Sexual dysfunction in women with type 2 diabetes mellitus: A single-centre cross-sectional study from Bangladesh

ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.

Can Costus afer be used for co-treatment of COVID-19, its symptoms and comorbidities? A novel approach for combating the pandemic and implications for sub-Saharan Africa

@#Despite the huge loss of lives and massive disruption of the world economy by the COVID-19 pandemic caused by SARS-CoV-2, scientists are yet to come out with an effective therapeutic against this viral disease. Several vaccines have obtained ‘emergency approval’, but difficulties are being faced in the even distribution of vaccines amongst high- and lowincome countries. On top of it, comorbidities associated with COVID-19 like diabetes, hypertension and malaria can seriously impede the treatment of the main disease, thus increasing the fatality rate. This is more so in the context of sub-Saharan African and south Asian countries. Our objective was to demonstrate that a single plant containing different phytoconstituents may be used for treatment of COVID-19 and comorbidities. Towards initial selection of a plant, existing scientific literature was scanned for reported relevant traditional uses, phytochemicals and pharmacological activities of a number of plants and their phytoconstituents pertaining to treatment of COVID-19 symptoms and comorbidities. Molecular docking studies were then performed with phytochemicals of the selected plant and SARS-CoV-2 components – Mpro, and spike protein receptor binding domain and hACE2 interface using AutoDock Vina. We showed that crude extracts of an indigenous African plant, Costus afer having traditional antidiabetic and antimalarial uses, has phytochemicals with high binding affinities for Mpro, and/or spike protein receptor binding domain and hACE2 interface; the various phytochemicals with predicted high binding energies include aferoside C, dibutyl phthalate, nerolidol, suginal, and ±-terpinene, making them potential therapeutics for COVID-19. The results suggest that crude extracts and phytochemicals of C. afer can function as a treatment modality for COVID-19 and comorbidities like especially diabetes and malaria.

Potential role of flavonoids against SARS-CoV-2 induced diarrhea

@#COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea.

In silico screening of Allium cepa phytochemicals for their binding abilities to SARS and SARS-CoV-2 3C-like protease and COVID-19 human receptor ACE-2

@# Corona virus SARS-CoV-2-induced viral disease (COVID-19) is a zoonotic disease that was initially transmitted from animals to humans. The virus surfaced towards the end of December 2019 in Wuhan, China where earlier SARS (Severe Acute Respiratory Syndrome) had also surfaced in 2003. Unlike SARS, SARS-CoV-2 (a close relative of the SARS virus) created a pandemic, and as of February 24 2021, caused 112,778,672 infections and 2,499,252 deaths world-wide. Despite the best efforts of scientists, no drugs against COVID-19 are yet in sight; five vaccines have received emergency approval in various countries, but it would be a difficult task to vaccinate twice the world population of 8 billion. The objective of the present study was to evaluate through in silico screening a number of phytochemicals in Allium cepa (onion) regarding their ability to bind to the main protease of COVID-19 known as the 3C-like protease or 3CLpro, (PDB ID: 6LU7), 3CLpro of SARS (PDB ID: 3M3V), and human angiotensin converting enzyme-2 (ACE-2), [PDB ID: 1R42], which functions as a receptor for entry of the virus into humans. Molecular docking (blind docking, that is docking not only against any target pocket) were done with the help of AutoDockVina. It was observed that of the twenty-two phytochemicals screened, twelve showed good binding affinities to the main protease of SARS-CoV-2. Surprisingly, the compounds also demonstrated good binding affinities to ACE-2. It is therefore very likely that the binding affinities shown by these compounds against both 3CLpro and ACE-2 merit further study for their potential use as therapeutic agents.

Formulation Development, Characterization and In-vitro Evaluation of Tamoxifen Loaded Liposomes

Background: The study was aimed to prepare and evaluate tamoxifen loaded controlled release liposomes to reduce the side effects of tamoxifen during cancer treatment. Methods: Different tamoxifen loaded liposomes were prepared by modified ether injection (MEIM) and thin film hydration method (TFHM) under prescribed conditions. The prepared liposomes were characterized by using optical microscopy, evaluating encapsulation efficiency, in-vitro and ex-vivo diffusion studies by using dialysis membrane and chicken intestinal sac respectively.Results: The data revealed that all of the liposomes were spherical in shape and stable under three physical conditions i.e. 4, 25 and 37 ± 2°C temperatures and 60 ±5% relative humidity. Additionally most of the liposomes followed zero order and class II release kinetics. It was also observed that with the increase of phospholipids and cholesterol, entrapment efficiency of liposome vesicles increased thus giving a controlled release drug delivery system but further increase reduced this efficiency at a certain level.Conclusion: The formulated control release liposomes might be a good drug delivery system for target oriented drug delivery with minimum side effects of tamoxifen during cancer treatment

Seroprevalence of Hepatitis B and Hepatitis C in end-stage renal disease patients on maintenance hemodialysis: a single-center study from Bangladesh

Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are important causes of morbidity and mortality in hemodialysis (HD) patients. The aim of this study was to estimate the seroprevalence of HBV and HCV among end-stage renal disease (ESRD) patients on maintenance HD.Methods: This cross-sectional study was conducted in the hemodialysis unit of a military hospital of Bangladesh from October 2013 to March 2014 and included 141 maintenance HD patients. All patients were assessed by HBsAg and anti-HCV antibodies in addition to routine liver function tests.Results: The age range of the study subjects were 18-70 years, and the majority (85.11%) were male. Among them 22 (15.60%) were positive for anti HCV, 5(3.5%) were positive for HBsAg, and 3 patients (2.13%) were positive for both HBsAg and anti-HCV. The duration of hemodialysis was higher in anti-HCV positive patients (49±24 vs. 25±10 months, p <0.05) than anti-HCV negative ones. Anti-HCV positive patients in this study received a higher number of blood transfusion (units) than anti-HCV negative patients (7.5±4.3 vs. 2.8±1.7 units, p <0.05). HBsAg positive patients also received a higher number of blood transfusion (units) than HBsAg negative patients (8.2±3.1 vs. 3.2±1.2 units, p <0.05).Conclusions: Hepatitis C virus was the major form of hepatitis in HD patients in this study. The duration of HD was higher in anti-HCV positive patients; the numbers of blood transfusion units were higher in patients positive for HCV and HBV than the negative ones.

Circadian variation in stroke: a hospital-based study

Background: Proof of a circadian rhythm in the occurrence of cerebral infarction and other types of stroke might provide clues to factors which immediately precipitate these events, which in turn might lead to more rational treatments. The aims of the current study were to find out the circadian variation of stroke onset and to determine the risk factors related to circadian variation.Methods: This cross-sectional study was conducted in a tertiary hospital of Bangladesh from July to December 2014 among 67 diagnosed cases of ischemic and hemorrhagic stroke of first attack. Times of onset of stroke and wake-sleep state were recorded.Results: The mean age of the study subjects was 62.1 years, 64.2% were male. Among them, 59.7% had an ischemic stroke and 40.3% had a hemorrhagic stroke. The occurrence of stroke was most common during 6 am to 12 pm (47.8%), followed by 12 am to 6 am (25.4%), 12 pm to 6 pm (17.9%), and 6 pm to 12 am (9.0%). Circadian variation of stroke was homogenous and statistically insignificant in association with age group when categorized as below 65 years and 65 years or above years, sex, smoking habit, and presence or absence of diabetes mellitus, atrial fibrillation, and dyslipidemia. But hypertension and ischemic heart disease (IHD) were significantly associated with circadian variation of stroke. The occurrence of ischemic stroke and hemorrhagic stroke was most common from 6 am to 12 pm (47.5% and 48.1%) respectively. When considered separately, significant circadian variation noted for ischemic stroke and hemorrhagic strokes were also noted.Conclusions: The study contributes further evidence for the circadian variation in the occurrence of ischemic stroke and hemorrhagic stroke. Attempts to prevent their occurrence must take into account this circadian variation.

In vitro Synergistic Action of Honey and Essential Oils against Two Species of Aspergillus: A Preliminary Study.

In order to evaluate the synergistic action of essential oils (EO) on the antifungal activity of honey, a comparative method of adding honey with and without EO to culture media was used. One variety of honey and five EO types were used to determine the minimum inhibitory concentration (MIC) against two clinical isolates of microfungi; namely Aspergillus niger and Aspergillus flavus. In a second step, lower concentrations of honey than the MIC were mixed with a set of sub-MIC of EO and then added to media to determine the minimum synergistic inhibitory concentration (MSIC). The MIC of honey without EO was 47% (v ⁄ v) against A. niger and 50% (v ⁄ v) against A. flavus. The MIC of EO varied strongly from one variety to another one with that of Eugenia caryophylata being the most effective against the tested Aspergillus species. When the EO was mixed with honey, a MIC drop was observed with each variety of EO. Isobolographic representation shows a synergistic action between honey and all EO types against the tested fungi. Further research studies are needed to elucidate and optimize the effective combination of these natural products in clinical practice.

Virulence factors in mycoplasma of human origin

Although mycoplasmas posses a very limited genome, little is known about their virulence mechanisms and methods of persistence in the host. The significant genome compaction that occurred in mycoplasma was made possible by adopting a parasitic mode of life. Demonstration of the correlation between urogenital infection and some Mycoplasma species. Also detection of some virulence genes of mycoplasma and ureaplasma isolates by PCR. Collection of urine, semen, vaginal swabs and synovial fluid from patients of urogenital manifestation with or without arthritis. Isolation of mycoplasma on the suitable media, identification of the isolates by using different biochemical tests, serological typing of the isolates by specific antisera and detection of some virulence genes by PCR. out of 524 examined samples 84 [16.03%] proved to be positive for mycoplasma by culture. The results revealed that most prevalent Mycoplasma species were M. genitalium [24.74%], M. hominis [23.71%], M. fermentans [38.13%] and U. urealyticum [13.40%] by using specific antisera. PCR technique were used for detection of some virulence gene [16SrRNA, P[1], and P[a] cytoadhesine and gyrA genes] of the isolated mycoplasma and ureaplasma. The results of this study is explained the role of mycoplasma in causing some urogenital infection due to some genes detected, these may responsible for different virulence potentials

Effect of methomyl on fertility, embryotoxicity and physiological parameters in female rats.

The widespread use of pesticide leads to severe environmental pollution and health hazards. In the present study sexually mature female rats were administered methomyl at three different doses (2 mg/kg b.wt, 1 mg/kg b.wt and 0.67 mg/kg b.wt corresponding to 1/10 and 1/20 and 1/30 LD50 methomyl, respectively) daily by oral gavage for 28 consecutive days. Some biochemical parameters (lipid profiles, total proteins), levels of sex hormones in addition to fertility index and reproductive outcomes were determined. The levels of MDA and the activities of ovarian antioxidant enzymes (CAT, SOD, Gpx) were also estimated. Methomyl exposure increased maternal levels of cholesterol, triglyceride, total lipids, and levels of estradiol; and reduced the levels of progesterone in the 1/10 and 1/20 LD50 groups whereas no changes in total proteins were observed. In addition, methomyl treatment significantly reduced the number of implantation sites, the number of live fetuses and increased the incidence of dead embryos and resorption sites at the same dose levels. The antioxidative status in the ovary at the higher dose of methomyl was markedly depleted. Histopathological examination of the intoxicated ovaries revealed variable degrees of degenerative changes in the 1/10 and 1/20 LD50 groups. In conclusion, exposure of female rats to methomyl induced maternal and developmental toxicity at 1/10 and 1/20 LD50 groups. However, 1/30 LD50 methomyl dose produced no evidence of maternal toxicity. Therefore, its application should be limited to a designed program with special care in handling to minimize its hazards.

Synergistic Effect of Monofloral Honeys and Essential Oils against Pseudomonas aeruginosa.

Aims: The emergence of pathogenic bacterial strains with resistance to commonly used antibiotics has necessitated a search for novel types of antibacterial agents. The main objective of this study was to evaluate the synergistic action between honeys and the essential oils (EOs) against Pseudomonas aeruginosa (ATCC 27853). Study Design and Methodology: In the first step, the minimum inhibitory concentration (MIC) of each honeys and Eos were determined. In the second step, lower concentrations of honey than the MIC were mixed with a set of sub-MIC of EOs and then added to media to determine the minimum synergistic inhibitory concentration (MSIC). Place of Study: Laboratory Research onof Local Animal Products, Ibn-Khaldoun University, Tiaret, Algeria. Results: The results indicated that the essential oils and all varieties of honey were effective against P. aeruginosa. The effectiveness was correlated to the botanical origin of honey and EOs. Wild carrot honey and Origanum vulgaris EOs were the most effective against the tested bacteria with a MIC of 8% and 2% respectively. Adding EOs to honey decreases the MIC values and the isobolographic representation shows a synergistic action between the EOs and all varieties of honey. Conclusion: The current prevalence of antibacterial resistant species has led to a re-evaluation of the therapeutic use of ancient remedies, including honey and EOs, which may receive renewed recognition as wound and burn healers

Early Outcome of Laparoscopic Abdominoperineal Resection, Our Experience in Bangabandhu Sheikh Mujib Medical University.

Anorectal malignancies that require abdominoperineal resection (APR) is very common. Laparoscopic APR can be a better option. Laparoscopic APR has been seldom studied. This study aims to evaluate perioperative and early postoperative outcomes of laparoscopic APRs performed for the treatment of ano-rectal carcinomas. Patients operated for ano-rectal carcinoma between June 2011 to June 2013 in Bangabandhu Sheikh Mujib Medical University (BSMMU) were observed. Demographics, tumor and procedure-related parameters, perioperative results, early postoperative outcomes and survival were observed. Total 22 patients were under went laparoscopic APR. Male: Female ratio was 15:7 (68.18%: 31.82%). Age range was from 30-65 years with a mean age of 36.55 years. Mean operation time was 165 minutes and mean post-operative hospital stay was 6.8 days. Overall complication rate was 45.45%. Laparoscopic APR is a safe, effective and technically feasible procedure. It can be a better operative procedure than open APR.

Effect of intravenous dexmedetomidine infusion on some proinflammatory cytokines, stress hormones and recovery profile in major abdominal surgery

This study was designed to evaluate the effect of intravenous dexmedetomidine infusion in patients undergoing major abdominal surgery on stress response markers as plasma interleukin-6, cortisol and blood glucose level. It also assessed its effect on recovery profile and postoperative pain. Thirty adult ASA I-III patients admitted to the surgery department of the Alexandria Main University Hospital scheduled for elective major abdominal surgery under general anaesthesia were included. They were randomly classified into two equal groups of 15 patients each, dexmedetomidine group [Group D] received intravenous dexmedetomidine infusion and placebo group [Group P] received intravenous infusion of normal saline. Haemodynamic parameters were recorded intra- and postoperatively. Interleukin-6, cortisol and blood glucose levels were measured. Recovery profile, postoperative pain score and analgesic requirement postoperatively were assessed. Heart rate and mean arterial pressure were significantly lower in group D relative to group P during most of the intra- and postoperative periods. Postoperatively, the levels of interleukin-6, cortisol and blood glucose were significantly lower in group D relative to group P. Recovery time was longer in group D than group P but with no significant difference. Postoperative pain score was significantly less in group D relative to group P during the early postoperative period with smaller amount of analgesic requirements in group D. Dexmedetomidine is safe and effective in blunting the postoperative rise of the proinflammatory cytokine interleukin-6 and resulted in lower levels of markers of stress response to surgery as cortisol and blood glucose. Dexmedetomidine also reduces the postoperative pain score without delaying recovery from anaesthesia

Echoguided pair technique in diagnosis and treatment of abdominal hydatid cystic disease in Egyptian patients: clnical and ultrasonographic follow up

The introduction of the percutaneous puncture, aspiration, injection of scolecidal agent and reaspiration [PAIR] technique is gaining an increasing acceptance in diagnosis and treatment of abdominal cystic hydatid disease [CHD]. Thirty-three patients [12 male and 21 female with age between 15 and 70 years] had 46 cysts in liver, spleen and kidneys [75.7%, 18.2% and 6.1% respectively]. Puncture, aspiration, injection of 95% sterile alcohol for 20 minutes and reaspitation [PAIR] was used for treatment of hydatid cysts of different types and sizes. Follow up both clinically and ultrasonographically was done over a period of 2 years. The commonest ultrasound picture was type la [overall echofree] in 80.4%, commonly in the liver [75.7%] mainly in the right lobe [88%]. Improvement of symptoms had occurred its 85% within 3 weeks. As regards ultrasound follow up of 41 non-complicated cysts within the 1[st] six months, was disappearance of 5 cysts, 34 reduced in size and 36 showed different grades of solidification. After 1.5 year 10 more cysts disappeared while the pseudotumour appearance was shown in remaining 26 cysts. Ultrasound follow up of the 5 infected cysts revealed complete cure within a period of 8-16 weeks in 4 of them. The last patient discontinued drainage therapy and was referred to surgery. This makes ultrasound cure reaching 97%. Minor complications were skin reaction only in 2 patients [6%]. No fatal anaphylaxis cyst recurrence or rupture into the peritoneal cavity or bleeding from renal or splenic puncturing. PAIR technique under ultrasonographic guidance is the first choice method for treatment of abdominal CHD especially in the developing countries and inoperable hydatid cysts

Management of obesity and outcomes of hepatitis C treatment

Obesity is a modifiable risk factor for nonresponse to chronic hepatitis C [CHC] treatment. We examined whether weight loss during pegylated interferon [IFN] plus Ribavirin therapy is associated with improved response. Rapid virological response, early virological response, end of treatment response, and sustained virological response [SVR] were compared among patients with or without weight loss [>/= 0.5 body mass index [BMI]] during therapy for hepatitis C virus. Among 324, who provided consent, 280 were treatment-naive patients and 200 started pegylated-IFN/Ribavirin therapy and were included in the study. Median pretreatment BMI was 28.8 +/- 5.7 [19.9-48.9] with 42.6% overweight and 31.6% obese [BMI 25-30 and >/= 30, respectively]. Hepatitis C virus genotype 1 was the prevalent genotype among the candidates of this study, affecting 99 cases of 136 [72.7%], whereas genotypes 2/3 affected 37 cases [27.3%]. For genotype 1, weight loss at 1 and 3 months was associated with higher SVR rates [59.5 vs. 36.8% at 1 month and 55.2 vs. 34.1% at 3 months, respectively, P values=0.02 and 0.03, respectively]. Hepatic fibrosis, elevation of high-density lipoprotein, and decline of homeostasis model of assessment-insulin resistance at 6-months follow-up were proven to be independent predictors for SVR. Weight loss during the first 6 months of IFN therapy was associated with improved SVR in patients with CHC genotype 1 rather than genotypes 2/3. Molecular changes associated with weight loss during CHC and its relation with treatment response need to be prospectively examined

The use of E-test for the drug susceptibility testing of Mycobacterium tuberculosis - A solution or an illusion.

Aim: To evaluate E-test as a tool for rapid determination of drug susceptibility against the conventional LJ method focusing on reliability, expense, ease of standardization and performance of the technique in low resource settings. Materials and Methods: A total of 74 clinical isolates (2004-2005) of Mycobacterium tuberculosis were tested using E-test for susceptibility to streptomycin (STM), isoniazid (INH), rifampicin (RIF) and ethambutol (EMB) by E-strip and LJ (LJPM) proportion methods. Results: The LJPM method, the gold standard, detected resistance against STM in 16.2%, INH in 40.5%, RIF in 18.9% and EMB in 27% cases. In comparison, the resistance values showed by E-test was 66.67% for STM, 57.14% for INH 71.43% for RIF and 80% for EMB. The susceptible correlation was 90.32% for STM, 73.91% for INH, 93.33% for RIF and 59.26% for EMB. E-test correctly identified only eight of the 12 (66.6%) MDR isolates and wrongly identified four isolates which were not MDR. The overall agreement between the two methods was only 48.6%. Resistant isolates showed false positive resistance observed while using E-strip towards all the drugs. Conclusion: E-strips are not quite feasible as a replacement for LJ-proportion method on a large scale due to high risk of cross contamination, laboratory infection, expense associated with it and high false positive resistance observed to all first line drugs. However, the good correlation observed for RIF between the two methods indicates that E-test could contribute to the role in rapid screening of MDR TB isolates as rifampicin mutations are invariably observed in MDR TB isolates.

Engasgamento em bebês após busca às cegas com os dedos / Infants choking following blind finger sweep

OBJETIVO: Em situações estressantes, as pessoas geralmente usam os dedos para retirar corpos estranhos de faringe da boca. Este artigo relata três casos de óbito de bebês após o uso dessa técnica. MÉTODOS: Um total de 26 casos de engasgamento causado por aspiração de corpos estranhos nas vias respiratórias superiores e inferiores envolvendo crianças menores de 11 anos submetidas a autopsia no Departamento de Medicina Forense da Universidade da Jordânia entre 1996 e 2006 foram revisados. RESULTADOS: O uso de busca às cegas com os dedos para retirar corpos estranhos de faringe foi relatado em três bebês durante o choro. Todas as crianças eram menores de 1 ano e haviam se engasgado com grãos-de-bico, uma bola de gude e um lápis curto. A diversidade, o tamanho, a forma, e a maciez da superfície são as principais características que fazem com que esses corpos estranhos sejam mais difíceis de ser removidos com os dedos e facilitam sua entrada via respiratória. CONCLUSÃO: Esses casos mostraram que a busca às cegas com os dedos na boca de bebês durante o choro não é somente uma manobra perigosa, mas também pode ser fatal.

OBJECTIVE: In stressful situations, people usually use finger sweep to remove pharyngeal foreign bodies from the mouth. This article reports on three cases of death of infants following the use of this technique. METHODS: A total of 26 cases of choking caused by foreign bodies aspiration in the upper and lower respiratory passages involving children younger than 11 years of age autopsied at the Forensic Department of University of Jordânia between 1996 and 2006 were reviewed. RESULTS: Blind finger sweep to remove pharyngeal foreign bodies were reported in three crying infants. All of these cases were younger than 1 year of age and choked on a chickpea, a marble and a short pencil. Diversity, size, shape and smoothness of the surface are the main characteristics that render the foreign bodies less easily caught by fingers and make them easily enter the respiratory passage. CONCLUSION: These cases showed that blind finger sweep in crying infants is not only dangerous but can be a fatal maneuver.

Improvement of steatosis after interferon therapy in HCV genotype 4 is related to weight loss.

Introduction Hepatic steatosis is common in patients with chronic hepatitis C virus (HCV) infection, and its occurrence may be related to both host and viral factors. Relationship between improvement in steatosis and response to anti-viral treatment remains unclear. This study assessed the factors associated with steatosis in patients infected with genotype 4 HCV, and to correlate degree of changes in steatosis with host factors and response to treatment. Methods Records of 175 patients with chronic genotype 4 HCV infection, who had received interferon and ribavirin combination therapy, were reviewed retrospectively to extract data on body mass index (BMI), presence of diabetes mellitus, and liver histology findings. Paired BMI data and liver biopsies (pre- and 24-weeks post-treatment) were available in 86 patients. Baseline steatosis and its changes (before and after treatment) were the dependent variables in a univariate and multivariate analyses. Results Steatosis was found in 88/175 (50.3%) of baseline biopsies. Its presence was related to baseline BMI (r=0.33, P<0.01), but not with viral load, or grade of liver inflammation or fibrosis. On follow up, improvement in steatosis was significantly associated with degree of weight loss but not with response to anti-viral treatment. Conclusion Steatosis is common in genotype 4 HCV infection, and its presence appears to be related to high BMI, but not to viral load or degree of liver injury.