Prostaglandin E [2] level in patients with liver cirrhosis with and without hepatorenal syndrome

Eighty subjects were selected for this study, 65 of them were patients of liver cirrhosis [43 males and 22 females] and 15 of them were normal individuals as a control group [11 males and 4 females]. All the 80 subjects were subjected to full clinical assessment, biochemical liver profile, kidney profile, abdominal ultrasonography and estimation of plasma prostaglandin E2 [PGE2]. It was found that PGE2 was significantly increased in cirrhotic patients and this increase was more in ascitic than non-ascitic patients and more in Child C patients than in other Child classes, but there is evident marked significant drop in PGE2 level with the development of hepatorenal syndrome [HRS]. It was concluded that the increase of the vasodilator PGE2 in cirrhotic patients is a protective factor against the catastrophic effect of increased vasoconstrictor mediators characteristic of liver cirrhosis and the drop of PGE2 could be a causative factor in pathogenesis of HRS as it drops leaving the kidney under the vigorous effect of vasoconstrictors. The study postulated a new formula which might be more sensitive for the prediction of HRS

Effects of trunkal vagotomy and drainage upon helicobacter gastritis

This study was carried in the Surgical Department of Kasr El-Aini University Hospital over a period extending from November 1995 through December 1998. Twenty patients suffering from chronic duodenal ulccration, 14 males and 6 females, with a mean age of 38.8 years, who presented for surgery, were included in the study. The indications for surgery constituted failure of long term medical treatment [12 cases], complications [4 cases], frequent relapses [2 cases]. Pre-operative endoscopic biopsy from the gastric antrum revealed positive H.pylori infestations in all cases. 3 months following trunkaI vagotomy and gastroentcrostomy, re-endoscopy revealed healing of the ulcers in all cases. Biopsies obtained from within one inch of the gasto-enterostomy revealed however, persistence of H. pylori in 40% [8] of cases

Activated nitriles in heterocyclic synthesis: synthesis of substituted pyrazolopyridine, pyridine, 4H-pyran and naphthodiapyran derivatives

Several new pyrazolopyridines VIa-c were synthesized by reacting 4-nitrosoantipyrine [IIa] with arylidenemalononitriles Ia-c or ethyl arylidenecyanoacetates If-h. Reaction of Ia-c with 4-[azidomethylcarbonyl] antipyrine [IIb] afforded the pyridine derivatives XVI. The 4H-pyrans and naphthodipyran derivatives XVIII- XXI were prepared by reacting I with polyhydric phenols

Bacteraemia following diagnostic and therapeutic ERCP

Thirty patients undergoing endoscopic retrograde cholangiopancreatography [ERCP] were studied. Blood samples were taken just before, 5 minutes after cannulation of the papilla and, 15 minutes after the end of examination. The samples were cultured for both aerobic and anaerobic organisms. Seven cases [23.3%] showed positive cultures. The isolated organisms in 4 of them were considered as normal commensals of the skin. While in 3 cases [10%], the organism, were considered pathogenic. We concluded that ercp is a safe procedure and not accompanied by bacteraemia except in the immunocompromised cases. Thus, the immunocompromised patients should be considered a high risk for the development of bacteraemia following ERCP. The use of prophylactic antibiotics is recommended before and after procedure in all immunodepressed patients and patients with chronic valvular diseases