Role of interferon gamma in SARS-CoV-2-positive patients with parasitic infections.

BACKGROUND: By 27 June 2020, almost half a million people had died due to COVID-19 infections. The susceptibility and severity of infection vary significantly across nations. The contribution of chronic viral and parasitic infections to immune homeostasis remains a concern. By investigating the role of interferon (IFN)-γ, we conducted this study to understand the connection between the decrease in numbers and severity of COVID-19 cases within parasitic endemic regions. Our research included 375 patients referred to hospitals for diagnosis of COVID-19 infection. Patients were subjected to full investigations, in particular severe acute respiratory syndrome coronavirus-2 nucleic acid and Toxoplasma IgM and IgG antibody detection, stool examination, and quantitative IFN-γ measurement. RESULTS: The majority of the studied cases had chest manifestation either alone (54.7%) or in association with gastrointestinal (GIT) manifestations (19.7%), whereas 25.6% had GIT symptoms. We reported parasitic infections in 72.8% of mild COVID-19 cases and 20.7% of severe cases. Toxoplasma gondii, Cryptosporidium, Blastocyst, and Giardia were the most common parasitic infections among the COVID-19 cases studied. CONCLUSION: The remarkable adaptation of human immune response to COVID-19 infection by parasitic infections with high levels of IFN-γ was observed in moderate cases compared with low levels in extreme cases. The potential therapeutic efforts aimed at the role of parasitic infection in immune system modulation are needed if this hypothesis is confirmed.

Endoscopic injection of autologous blood versus diluted epinephrine for control of actively bleeding gastroduodenal ulcers: a randomized-controlled study.

INTRODUCTION: A preliminary report showed that autologous blood is an effective and easily applicable technique that can control actively bleeding gastroduodenal ulcers. The aim of this study was to test whether an endoscopic injection of autologous blood is comparable to an endoscopic injection of diluted epinephrine in controlling bleeding from gastroduodenal ulcers. PATIENTS AND METHODS: A total of 100 patients with actively bleeding gastroduodenal ulcers were assigned randomly to either an autologous blood injection (group A, n=50) or a diluted epinephrine injection (group B, n=50) along the edges of the ulcers. Groups were compared for rates of initial hemostasis, rebleeding, and complications. RESULTS: All patients initially achieved hemostasis (100%). Rebleeding occurred in four patients from group A (8%) and five patients from group B (10%). Two patients in group B developed cardiovascular complications (arrhythmia and ischemic heart attack), whereas none in group A developed complications. CONCLUSION: Autologous blood is effective, comparable to diluted epinephrine in achieving initial hemostasis from actively bleeding gastroduodenal ulcers, associated with an 8% rebleeding rate, and led to no complications.

Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience.

BACKGROUND: Foreign bodies (FBs) in the upper gastrointestinal tract are produced chiefly by accidental swallowing but rarely produce symptoms. Removal of FBs is not an infrequent challenge for upper gastrointestinal endoscopy. The aim of this study is to elicit our experience in a 5-year period in dealing with FBs in the upper gastrointestinal tract using upper endoscopy. METHODS: This retrospective study was conducted at Zagazig University Hospitals, Egypt, over a 5-year period. We reviewed all patients' files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. RESULTS: A total of 45 patients were identified. Their ages ranged from 6 months to 102 years. Slight male predominance was noticed (53.3%). The most frequent presentation was a history of FB ingestion without any associated manifestations (44.4%). Coins were the most commonly encountered FBs (14/45). Esophagus was the most common site of trapping (27/45). The overall success rate was 95.6% (43/45). Upper endoscopy successfully resolved the problem by either FB removal (41/43) or dislodgment of the impacted fleshy meat to the stomach (2/43). Two cases were referred for surgical removal. The rate of complications was 6.7%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. CONCLUSION: Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units, and under conscious sedation in most cases, with high success rates and minor complications.