Assessment of the co-incidence between non alcoholic fatty liver disease and carotid atherosclerosis

Non-alcoholic fatty liver disease [NAFLD] is currently the most common cause of abnormal liver biochemistry and cryptogenic cirrhosis. Those with NAFLD have a higher prevalence of atherosclerosis, as shown by increased carotid artery intimal media thickness [CIMT]. The aim of this study is to assess the co-incidence and prevalence between NAFLD and carotid atherosclerosis. In this study seventy-two subjects were categorized into 2 groups. QL 52 patients diagnosed as NAFLD with diabetes mellitus type 2 or obesity or hyperlipedemia. Gil: 20 diseased controls diagnosed as NAFLD without other predisposing factor. CIMT and plaque prevalence were estimated by carotid ultrasonography as a single trained operator who was blind to clinical characteristics of participants. The results showed that CIMT by carotid duplex ultrasonography was significantly higher in group A than group B but CIMT did not reveal any significant difference as regards to the etiology of NAFLD. CIMT was significantly higher in cases with bright liver than those with homogenous liver [by abdominal US] in group I and II. CIMT was significantly higher in those with moderate steatosis than those with mild steatosis [in GI and Gil]

Genotypic and phenotypic patterns of antimicrobial susceptibility of Helicobacter pylori strains among Egyptian patients

Helicobacter pylori [H. pylori] is currently recognized as one of the most common chronic bacterial infections worldwide. Eradication of bacteria is effective in healing peptic ulcers, preventing ulcer relapses, and potentially decreasing the risk of progression to gastric carcinoma. For successful eradication of bacteria, it is imperative that the clinician be aware of the current antimicrobial susceptibility profiles of isolates within the region. Therefore, the aim of this study is to compare the phenotypic and genotypic patterns of antibiotics' susceptibility to H. pylori strains among Egyptian patients. 60 symptomatic cases were enrolled. H. pylori infection was diagnosed by upper endoscopy as well as biopsy. Antimicrobial susceptibility to H. pylori strains was assessed in all subjects by disc diffusion and Ellipsometer testing [E-testing] methods. Further molecular characterization of genes encoding antimicrobial resistance of isolated strains was done by the polymerase chain reaction [PCR]. For metronidazole and ciprofloxacin, we compared the phenotypic and genotypic patterns of resistance as detected by PCR amplification of the resistance genes. Resistance rates by E-test were 100% and 25% for metronidazole and ciprofloxacin respectively from 16 isolated H. pylori strains. Improving the knowledge of resistance mechanisms, the elaboration of rational and efficacious associations for the treatment H. pylori infection are of high importance especially in determining the therapeutic outcome. Further progress should ultimately focus on the establishment of a cheap, feasible and reliable laboratory test to predict the outcome of a therapeutic scheme

Impact of hepatocellular carcinoma on health related quality of life in Egyptian patients: a single centre study

Among patients with chronic liver disease, impairment in HRQOL has been reported. Hepatocellular carcinoma [HCC] is one of the major squeal of chronic liver diseases. So, relationship between subjective HRQOL and HCC must be analysed. This study assessed the effect of HCC on HRQOL, and its loco-regional treatment on HRQOL. Forty patients with HCV related chronic liver disease as a control group was enrolled in the study. Eighty HCC patients on top of chronic HCV liver disease categorized according to the modality of loco-regional treatment [BCLC staging system] into Gl; 40 HCC patients treated with radiofrequency ablation [RFA] and GIl; 40 HCC patients treated with trans-arterial chemoembolization [TACE]. The SF-36 questionnaire was performed before and one month after the intervention. Comparing the parameters of HRQOL in GI before and after RFA, and in Gil before and after TACE; there was a statistically significant improvement in group I. However, the improvement in group II [TACE] was non-significant [P>0.05]

Assessment of rose bengal test in diagnosing Egyptian human brucellosis

A total of 30 patients suffering from brucellosis were suspected based on history taking, clinical manifestations and positive serum tube agglutination test [at titer >/= 1/160]. The followings were done for all cases; complete blood picture [differential leucocytic count] and liver function tests, serodiagnosis of Brucella [serum tube agglutination test [STAT] as well as Rose Bengal test [RBT] and PCR. The study aimed to analyze the diagnostic value of RBT as compared to STAT and PCR for human brucellosis, and to evaluate the sensitivity, specificity, accuracy, the cost and the time consuming of RBT as compared to STAT and PCR. There was a significant difference between diagnosis by RBT and both STAT >/= 1/640, and STAT >/= 1/1280. Also, there was a significant difference between PCR and both STAT>1/640, and STAT >/= 1/1280. No significant difference was detected between RBT in diagnosing acute and chronic infection. STAT >/= 1/320 proved to be better than STAT at other titers and RBT in diagnosis of brucellosis. RBT proved to be suitable as screening test regarding time [faster] and cost. But, STAT >/= 1/320 from a practical and economic point of views proved to be the best one in diagnosing human brucellosis

Assessment of interleukin-6 in diagnosis of hepatocellular carcinoma

Interleukin-6 [IL-6] is a promising tumor marker for hepatocellular carcinoma [HCC]. IL-6 may help to identify a subset of HCC patients with low alpha-fetoprotein [AFP] level and may serve as a complementary tumor marker. To assess the value of serum interleukin-6 levels in patients with chronic liver disease and its level in patients with HCC. To evaluate as well its sensitivity and specificity in comparison to AFP in diagnosis of HCC. Seventy five patients with chronic liver disease [the population of the study] were assessed for serum interleukin-6 levels. The patients were allocated into three groups: Group I: Included 25 patients diagnosed as chronic liver disease with no evidence of HCC. Group II: Included 25 patients diagnosed as HCC on top of post-viral hepatitic chronic liver disease with elevation in AFP [>200ng]. Group III: Included 25 patients diagnosed as HCC on top of post-viral hepatitis chronic liver disease without elevation in AFP [200ng]. Control group: Included 25 age- and sex-matched healthy volunteer controls, with no evidence of liver disease and/or of neoplasm. This study revealed a high statistically significant difference between the three studied groups and controls regarding serum IL-6 levels [P<0.01]. There was a statistical significant positive correlation between mean levels of I L-6 and AFP in HCC patients in group II and III [HCC= 50cases] [P< 0.05]. Regarding the Child-Pugh staging of liver disease, the study revealed that the mean levels of IL-6 in Child C was higher than in Child A and B, but without a statistically significant difference. By using multiple logistic regressions, only loss of weight and AFP had a statistical significant association with the diagnosis of HCC in this study [P< 0.05]. The diagnostic value of IL-6 is significantly increased when it is associated with AFP measurement. Combining the two markers provides a new perspective in the diagnosis of HCC. Our data indicate that IL-6 may be a promising marker for assessment of chronic liver disease [according to Child-Pugh Staging System]. Unfortunately, Interleukin-6 is not a candidate novel tumor marker in detecting HCC patients [with serum AFP level below 200ng/ml]