Boceprevir-induced Herpes Zoster.

Herpes zoster is caused by reactivation of the varicella zoster virus (VZV), that attacks peripheral or cranial nerves and result in painful cutaneous inflammation. Boceprevir is a protease inhibitor which used as a new therapeutic agent for chronic hepatitis C infection. Boceprevir associated herpes zoster is extremely rare condition. We present herpes zoster infection assosiated Boceprevir in patint with chronic hepatitis C. How to cite this article: Babali A, Cakal B, Tanoglu A, Karaahmet F, Kekilli M. Boceprevir-induced Herpes Zoster. Euroasian J Hepatogastroenterol, 2018;8(2):161-162.

Inclusion of a spasmolytic in bowel cleansing: a prospective randomized study.

The quality of colon cleansing and the tolerance of patients to the procedure are two major determinants of the quality of a colonoscopy. Many bowel-cleansing regimens are known, but there is no ideal regimen. Alverine citrate (Relaxyl, Spasmonal) is a spasmolytic agent that has been shown to affect responses of mechanoreceptors of the intestine to both mechanical and chemical stimuli. Patients who underwent colonoscopies at four centers were randomly assigned two different bowel-cleansing procedures. The bowel-cleansing methods were oral sodium phosphate (NaP) (Group I) and oral NaP plus alverine citrate (Group II). Patients were randomized into one of these regimens. The quality of colon cleansing was assessed by an endoscopist with an empirical, clinically meaningful 3-point scale. Both groups were similar with respect to age, gender, and pre- and postcolonoscopic diagnosis. In Group I, 76 patients (47 women and 29 men; aged 39.53 ± 7.87 years) and in Group II, 71 patients (41 women and 30 men; aged 39.78 ± 8.27 years) were included in the study. In Groups I and II, 37 (48.7%) and 41 (57.7%) patients had perfect bowel cleansing, respectively. The overall colon cleansing in the group with NaP plus alverine citrate was comparable with that in the NaP group. The tolerability of patients to the colonoscopy in the two groups was also similar. Based on the present data, adding oral alverine citrate to NaP does not increase either the quality of bowel cleansing or the tolerance of patients to the procedure.

Serum α-fetoprotein levels in liver steatosis.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is a common disorder and becoming a leading cause of cirrhosis in the western world. The monitoring of the disease is challenging and the prognostic importance of α-fetoprotein (AFP) level elevation in NAFLD remains uncertain. METHODS: Eighty-four patients were evaluated in the study. Patients with evidence of fatty liver in an abdominal ultrasonography performed for any reason were enrolled in the study. Degree of liver steatosis was graded into three groups. As a control group, patients without fatty liver or other liver diseases were included. All patients and controls were asked about prior hepatic diseases, consumption of alcohol, smoking, drug use, and a physical examination, biochemical analyses including liver function tests, different components of the metabolic syndrome, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) score were also performed. RESULTS: Body mass index, aspartate aminotransferase, alanine aminotransferase, glucose, insulin, and HOMA-IR in patients with NAFLD were higher than in control group. Triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels were higher in NAFLD group than in control group. A statistically significant increase in AFP levels was noted in patients with NAFLD (4.09 ± 1.68) when compared with healthy controls (2.95 ± 0.41) (P < 0.05). A statistically significant increase in AFP levels was noted in patients with grade 3 NAFLD (5.43 ± 1.51) when compared with grade 1 (2.92 ± 1.06) and grade 2 NAFLD groups (3.97 ± 1.45). Also, AFP was significantly higher in grade 2 NAFLD group than in grade 1 NAFLD group. AFP was correlated with NAFLD grade, but neither ALT nor AST showed correlation. According to multivariate analysis, correlation between NAFLD grade and serum AFP levels was independent from the other factors. CONCLUSION: Patients with NAFLD have higher AFP levels than those without fatty liver changes. AFP levels rise as grade of liver steatosis increases. NAFLD should be among the differential diagnosis of elevated serum AFP levels.

Do scattered white spots in the duodenum mark a specific gastrointestinal pathology?

OBJECTIVE: To discover whether scattered white spots (SWS) in the duodenum are related to a specific kind of disease. We also scrutinized other upper endoscopic findings which might be associated with SWS. METHODS: Among the patients who were admitted for upper gastrointestinal system endoscopy, those having the endoscopic appearance of SWS in duodenum were enrolled in this study. In total 107 patients [70 women, 37 men, mean age: 51.6 +/- 16.88 years (range: 17-82 years)] were included. At least three duodenal biopsies were taken from each patient and histopathological examinations were done by experienced pathologists. RESULTS: The histopathological examination revealed that 39 (36.4%) patients had intestinal lymphangiectasia (IL), 15 (14%) patients had giardiasis (G) and 30 (28.1%) patients had chronic non-specific duodenitis (CD). Two patients with IL were also found to have G. Twenty patients had both IL and CD. One had both G and CD. G was the least common etiology for SWS in the duodenum. The most common reasons for SWS in the duodenum in this study group were IL and CD, in order of decreasing frequency. There was no significant relationship with the other upper endoscopic findings in all these patients. CONCLUSION: Histopathological examinations should be provided for each patient with SWS in the duodenum to assess the etiology.

Dyspepsia in Turkish patients on continuous ambulatory peritoneal dialysis.

BACKGROUND AND AIMS: Although dyspepsia is very common in uremic patients, there is not much data on the prevalence of dyspepsia undergoing continuous ambulatory peritoneal dialysis (CAPD). The aims of this study are to assess the prevalence of dyspepsia, Helicobacter pylori, and the association between dyspeptic symptoms and diabetes. METHODS: One hundred and thirty CAPD patients were included in the study. The presence or absence of dyspepsia was assessed by using the Hong Kong Index of Dyspepsia (HKID) Questionnaire. A score of >or=16 indicates the presence of dyspepsia. The patients who were diagnosed with dyspepsia had endoscopic examination and were judged to be infected with H. pylori if the organism was demonstrated in the biopsy. RESULTS: Sixty-four of 130 CAPD patients (49.2%) had a HKID score of 16 or more. H. pylori was identified in 17 of 64 CAPD patients with dyspepsia (26.6%). Thirty-four patients (25.8%) were diabetic, and there was no association between diabetes and dyspepsia (P=0.68). The most frequent finding in patients with dyspepsia was gastritis or gastric ulcer in endoscopic evaluation. The mean serum albumin level was also not statistically significantly different between the two groups. CONCLUSIONS: Dyspepsia is common and the prevalence of H. pylori infection is 26.6% in our CAPD patients with dyspepsia. Dyspepsia is not associated with the presence of H. pylori and diabetes in CAPD patients. Large-scale studies are needed to elucidate dyspepsia related risk factors and physiopathological mechanisms.

Primary anorectal malignant melanoma: two case reports and review of the literature.

Anorectal melanoma is a very rare tumor with poor prognosis because of delay in diagnosis. It is often mistaken for benign conditions such as hemorrhoids or rectal polyps. Surgical treatment ranges from local excision to radical abdominoperinal resection. Herein, we report 2 cases of anorectal malignant melanoma and further review the diagnostic and therapeutic approaches in light of the pertinent literature.