Prognosis of hepatocellular carcinoma using the albumin to alkaline phosphatase ratio, literature review, and meta-analysis.

Background: Data about the impact of albumin-to-alkaline phosphatase ratio (AAPR) on prognosis in hepatocellular cancer (HCC) patients are inconclusive and conflicting. Methods: The authors systematically searched literatures from seven databases (PubMed, Medline, Web of Science, Cochrane Library, Embase, Google Scholar, and CINAHL), updated to September 2023. Hazard ratios (HRs) and 95% CIs were pooled and synthesized using Comprehensive Meta-Analysis version 3 in order to assess the overall impact of AAPR on patient's prognosis. Results: In total, 8 studies involving 13 cohorts with 3774 cases were included. Pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for overall survival (HR=0.429, 95% CI: 0.361-0.509, P=0.001; HR=0.476, 95% CI: 0.421-0.538, P=0.001; respectively). Similarly, pooled multivariate results showed that higher AAPR was associated with better disease-free survival (HR=0.558, 95% CI: 0.452-0.688, P=0.001). Moreover, pooled results from both univariate and multivariate analyses revealed that higher AAPR was an independent prognostic factor for recurrence-free survival (HR=0.540, 95% CI: 0.420-0.694, P=0.001; HR=0.647, 95% CI: 0.494-0.848, P=0.002; respectively). Subgroups analysis showed that elevated AAPR still significantly correlated with better overall survival across the confounding factors. Moreover, sensitivity analysis suggested the robustness of these findings and no publication bias was detected. Conclusions: In summary, higher AAPR could be considered as a reliable prognostic factor in patients with HCC, which could be used as a routine inspection of HCC patients to individualized prognosis prediction and clinical decision making.

A Case of Eosinophilic Gastroenteritis Associated with Eosinophilic Ascites Diagnosed by Full-Thickness Biopsy of the Small Intestine.

BACKGROUND Eosinophilic gastroenteritis is a rare disease, characterized by infiltrates of eosinophils in the intestinal mucosa, muscularis propria, and serosa. Eosinophilic gastroenteritis is due to Type 1 hypersensitivity and can be associated with other atopic diseases. The clinical course of eosinophilic gastroenteritis varies depending on the location, extent, and depth of eosinophilic infiltration of the gastrointestinal tract, which can make the diagnosis challenging. A case of eosinophilic gastroenteritis associated with eosinophilic ascites is presented that emphasizes the importance of full-thickness intestinal biopsy, which includes the muscularis propria, to allow the definitive diagnosis to be made. CASE REPORT A 28-year-old man presented with vague abdominal pain, nonspecific gastrointestinal symptoms, unintentional weight loss, and progressive ascites during the previous several months. A diagnosis of eosinophilic gastroenteritis was made after the exclusion of other possible causes, which was confirmed by histopathology of a full-thickness intestinal biopsy. The patient was treated with steroids. At one-month follow-up, the patient reported reduced abdominal pain. CONCLUSIONS A case of eosinophilic gastroenteritis associated with eosinophilic ascites is presented that emphasizes the importance of full-thickness intestinal biopsy, which includes the muscularis propria, to allow the definitive diagnosis to be made.

Epilepsy as a health problem among school children in Turaif, Northern Saudi Arabia, 2017.

BACKGROUND: Epilepsy is the most common serious neurological disorder and is one of the world's most prevalent non-communicable diseases. There are no recently published data on the prevalence of epilepsy in school children in Northern Saudi Arabia. OBJECTIVE: This study was conducted to determine the prevalence of epilepsy and to show some of its risk factors in school children and adolescents (6-18 years) in Turaif city, Northern Saudi Arabia. METHODS: This, population-based, cross-sectional study was conducted in Turaif city, over a 6-month period, from July 2016 to January 2017. It included pupils aged 6 to18 years in all primary, preparatory and secondary schools in Turaif city. Multi-stage sampling was employed. A designated structured questionnaire was completed for each patient and included the patient's history, clinical examination, investigations and medications. Data were analyzed by SPSS version 16, using Chi-Squared test and descriptive statistics. RESULTS: Out of 1,230 children, 66 (5.5%) had epilepsy; 68.2% of them were males and 31.8% females (p=0.000). Consanguinity between parents plays a significant role where 59.1% of cases had parents who were cousins (p=0.000). Family history also had a significant effect as 68.2% of cases had epilepsy cases in their families (p=0.000). CONCLUSION: Epilepsy prevalence among school children (6-18 years) in Turaif city is higher in males than females. Consanguinity and positive family history are important factors. Decision makers must take effective steps to limit the causes and risk factors of the problem.