Résumé
Background: Patients with liver cirrhosis seem to be at increased risk of complications during fasting. This study aimed to assess the effect of Ramadan fasting on liver functions and portal hemodynamics among patients with liver cirrhosis in comparison with healthy subjects
Materials and Methods: Participants were divided into three groups. Group I: patients with liver cirrhosis who fasted during Ramadan [n = 34], group II: patients with cirrhosis who did not fast [n = 8], and group III: healthy volunteers who fasted [n = 30]. This study was done from May 2017 to July 2017 and the month of Ramadan began on May 27th to June 26th, 2017. Portal hemodynamics were evaluated by portal vein diameter, congestion index [CI], and portal flow velocity. Laboratory investigations were determined before, during, and after Ramadan as an indicator of the changes in the liver functions
Results: There were no dropouts during the study. Among the three groups, portal vein parameters showed statistically non-significant differences. Model for End-Stage Liver Disease [MELD] score and serum albumin levels showed a significant difference when the group I and II compared separately to group III [P = 0.000], while there were no differences between group I and group II [P = 0.6 and 0.57, respectively]. For portal vein CI, there was a significant difference between the patients with cirrhosis [fasting; group I and non-fasting; group II] and healthy subjects [group III] [p = 0.000], while the CI did not change significantly between the groups I and II [p = 0.54]
Conclusions: Patients with cirrhosis showed changes in their liver functions and portal hemodynamics irrespective of their fasting status and these differences were more pronounced in portal vein CI, MELD score, and serum albumin when compared with healthy subjects
Résumé
Objective: to investigate the frequency of white matter abnormalities [WMAs] in patients with migraine and their relationship to type, duration, and frequency of migraine attacks
Methods: eighty four patients with migraine whose ages ranged between 16 and 50 years were evaluated. Twenty four patients had migraine with aura and 60 had migraine without aura, according to the diagnostic criteria of the International Headache Society. Patients with known vascular risk factors were excluded. Twenty age and sex matched healthy subjects were used as a control group. MRI brain was done in all patients and control group and evaluated for the presence of white matter lesions
Results: in 15 [17.9%] of 84 patients, white matter abnormalities were present on magnetic resonance imaging. Ten of these patients [66.7%] had migraine with aura, and 5 patients [33.3%] had migraine without aura. The presence of white matter foci was significantly higher in patients with aura than in those without aura [p<0.001]. Patients with WMAs were significantly older than those without [p<0.05]. Frequency of WMAs was significantly higher in those with history of more than two attacks per month [P<0.05]. The presence of WMAs was not significantly related to sex, disease duration or ergotamine consumption
We conclude that patients with migraine may have non-specific WMAs. Detection of white matter foci should be interpreted with particular caution before diagnosing other conditions since these lesions could be ischemic in origin and related to age, migraine with aura and attack frequency