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H. pylori infection causes peptic ulcer, chronic gastritis, mucosa-associated lymphoid tissue lymphoma, and gastric carcinoma. It has several virulence factors such as cytotoxin-associated gene A(cagA) and the induced by contact with epithelium antigen (iceA). We aimed to explore the relationship between cagA and iceA of H. pylori and gastrointestinal diseases. One hundred and eighteen patients who attended Gastrointestinal Endoscopy Unit at Zagazig University Hospitals, Egypt, were included in this study. Two gastric biopsies were collected and evaluated by rapid urease test (RUT) and PCR. cagA and iceA genes were amplified by PCR. We found that 54 patients (45.76%) were positive by both RUT and PCR. cagA and iceA genes were present in 57.4% and 46.29% of the studied patients, respectively. cagA was the most prevalent gene in gastritis (33.3%) and peptic ulcer (68.7%). iceA1/iceA2 positive genes were the most prevalent in gastric cancer (75%). iceA1 gene was present in 38.7% of cagA positive cases, but iceA2 gene was present in 45.2% of cagA positive cases. iceA1/iceA2 positive genes were present in 29% of cagA positive cases. In conclusion, cagA and iceA genes could be used as markers for severe gastrointestinal diseases. iceA gene was strongly related to cagA gene.
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Background and study aim: Liver Cirrhosis is a strong and a common known risk factor for Cholelithiasis. Cholelithiasis is a multifactorial disease, based on a complex interaction of environmental and genetic factors. The primary aim of this study is to determine the frequency of cholelithiasis in chronic liver disease (CLD) patients admitted to Zagazig university hospitals. The secondary aim is to determine the risk factors and their association with the underlying etiology and severity of liver disease.Patients and Methods: We conducted a hospital based study including 131 patients with chronic liver disease based on clinical, laboratory and Ultrasonographic findings. Demographic, clinical and etiological data were recorded, using a pre-coded questionnaire. A number of laboratory tests as fasting plasma glucose, total cholesterol, triglyceride, aspartate aminotransferase (AST), alanine amino-transferase (ALT), alkaline phosphatase (ALP), hepatitis B surface antigen (HBsAg), and antibody to hepatitis C virus (HCV-Ab) were analyzed.Results: The number of registered cases was 131 with age (52.9±11.7).There were 55 (42%) males and 76 (58%) females. Hepatitis C (HCV) was present in 101 (77%) cases. The prevalence of cholelithiasis was 50.4%% (66 of 131 patients). Most of cholelithiasis patients presented with child C stage (68.2%), followed by child B (21.2%) and the least one was Child A. Hepatitis C (10.6%) was found to be associated with cholelithiasis (75.8%), followed by hepatitis B (13.6%). Auto-immune disease, diabetes mellitus, contraceptive pills and obesity are considered risk factors for cholelithiasis. Conclusion: Cholelithiasis tends to occur more frequently in patients with decompensated CLD. The higher incidence of cholelithiasis in CLD appears to be associated with HCV infection. This is an important parameter to be considered in a country with high prevalence of HCV as Egypt
Assuntos
Egito , Hepacivirus , Fatores de RiscoRESUMO
BACKGROUND AND STUDY AIMS: Spontaneous bacterial peritonitis (SBP) is a significant cause of mortality in cirrhosis. Reducing toxic burden of infected ascitic fluid through paracentesis needs further studies as adjunctive therapy of SBP. We aimed to evaluate different therapies for SBP. PATIENTS AND METHODS: Thirty-six cirrhotic ascitic patients with SBP were examined and classified according to treatment modality (5-7 days) into: Group A received cefotaxime, group B received cefotaxime and albumin 1.5 g/kg body weight within 6h of SBP being diagnosed and 1g/kg body weight on day 3, group C received cefotaxime and paracentesis with volume dependent albumin infusion. Control group of 12 cirrhotic ascitic patients free from SBP were included. Routine laboratory tests, ascitic fluid analysis for leucocytes and culture were done, inflammatory mediators such as nitric oxide and tumour necrosis factor alpha were measured in serum and ascitic fluid. Duplex-Doppler assessment of portal flow volume and renal resistive index, Echocardiography to measure end diastolic and end systolic volumes, stroke volume and cardiac output were done. Tests were carried out before and after therapy. RESULTS: Treatment response was assessed by, cardiac haemodynamics, portal and renal flow and NO and TNF. All studied parameters; laboratory, cardiac, Doppler exhibited a significant improvement in group B in contrast to the other groups as demonstrated by post therapy reduction of (blood and ascitic fluid WBCs & PNLS, serum and ascitic NO & TNF and renal resistive index), elevation of (serum albumin and portal flow volume) and improvement of cardiac haemodynamic. CONCLUSION: Treatment of spontaneous bacterial peritonitis by cefotaxime and body weight based albumin infusion gave most favourable results compared to other regimens. Postulation of removing toxic burden through paracentesis has not been confirmed.
