Insulin resistance, steatosis, and fibrosis in Egyptian patients with chronic hepatitis C virus infection

Both nonalcoholic fatty liver disease [NAFLD] and chronic hepatitis C virus [HCV] infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C [CHC] [necroinflammation and fibrosis] and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. Our study included 92 male patients. Their mean +/- SD age and aspartate aminotransferase [AST] level were 42 +/- 7.7 years [range 20-56] and 68 +/- 41.7 U/L [range 16-214], respectively. The mean insulin level and insulin resistance index were 15.6 +/- 18.3 mlU/mL [range 5.1-137.4] and 5.9 +/- 15.2 [range 0.9-136.2], respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age >40 years, and steatosis. Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age

Epidemiology of gastro-oesphageal reflux disease [symptom-based criteria] in a rural area in Assiut governorate

GERD is one of the commonest upper gastrointestinal disorders. When defined as at least weekly heartburn and / or acid regurgitation, the prevalence in the western world generally ranges between 10% and 20% whereas in Asia the prevalence is reported to be less than 5%. There is a trend for the prevalence in North America to be higher than that in Europe, and a trend is also suggested for a higher prevalence in Northern over Southern Europe. The situation in Africa is unclear, so we designed this epidemiological study in a rural area of Assiut governorate, Egypt. The aim of this study is to estimate the prevalence of GERD symptoms and related risk factors. A cross-sectional community-based study was carried out in Ezbet Fath El-Bab, Mankabad village. A total of at least 300 houses were visited A well designed questionnaire was used for data collections, 393 persons [197 males and 196 females] were included in the study. The prevalence of at least weekly heartburn was 7.12% and the prevalence of weekly acid regurgitation was 2.03%. 58.8% of subjects with heartburn were males, while 44.7% of subjects with acid regurgitation were males. Logistic regression analysis for risk factors related to heartburn revealed that only smoking [P< 0.001] and psychosomatic condition [P< 0.001] were significantly related Logistic regression analysis for risk factors related to regurgitation revealed that only psychosomatic condition was significantly related From this study, we concluded that the prevalence of GERD symptoms in Egypt is less than that reported in western world and is in accordance to that reported in China and Asia. Smoking and the psychosomatic condition were significantly related to heartburn while psychosomatic condition only was significantly related to acid regurgitation