Editor-in-Chief, Deputy Editor 2017-2019





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Original articles

A comparative study between three noninvasive predictors of oesophageal varices in post hepatitis C virus liver cirrhosis in Egypt

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Background and aim : The prevention of variceal bleeding is very important. The current guide lines recommend screening of all cirrhotic patients by endoscopy, to identify patients at risk of bleeding in whom prophylactic treatment should be started. Repeated endoscopic examinations are unpleasant for patients, and carry a high cost impact and burden on endoscopic units, while only 50% of cirrhotic patients have esophageal varices, 30% of whom have large varices. The aim of this study is to evaluate prospectively the spleen size, platelet count and platelet count/spleen diameter ratio as noninvasive predictors of oesophageal varices in post hepatitis C virus liver cirrhosis in Egypt. Patients and methods : One hundred patients with post hepatitis C virus liver cirrhosis were included in the study. All studied subjects underwent a detailed history taking, clinical examination, biochemical workup, upper gastrointestinal endoscopy and abdominal ultrasound. The platelet count to spleen diameter ratio was calculated. Results : All the 3 predictors showed high statistically significant correlation with the presence, size and the grade of oesophageal varices. Among the 3 noninvasive predictors the platelet count/spleen diameter ratio gave the highest accuracy (94%) at a cut-off value of 1326.58 followed by the spleen size (89%) at a cut-off value of 131.5 mm and lastly the platelet count (84%) at a cut-of value of 131000/mm3. Conclusion : The use of the three studied predictors in this study can help the physicians to restrict endoscopy to those who are highly suspected to have oesophageal varices. (Acta gastro enterol. belg., 2011, 74, 497-502). [Product Details...]

Ampulla of Vater tumors : Impact of intraductal ultrasound and transpapillary endoscopic biopsies on diagnostic accuracy and therapy

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Background and study aims : To evaluate the diagnostic impact of intraductal ultrasound (IDUS) and endoscopic transpapillary forceps biopsies (ETP) in ampullary tumors. Patients and Methods : Seventy-two patients with suspected ampullary tumor were examined by ERCP, including IDUS and ETP. Histopathological correlation or long-term follow-up was available for all patients undergoing these procedures. Final diagnosis revealed ampullary adenoma in 40 patients and ampullary carcinoma in 32 cases. Sensitivity, specificity, accuracy rates as well as positive and negative predictive values (PPV, NPV) for each of the diagnostic measures were calculated including T and N stage accuracy. Results : Four carcinomas were misclassified by IDUS giving sensitivity, specificity and accuracy rates of 87.5%, 92.5% and 90.2%, respectively. Using ETP a correct pre-interventional diagnosis of ampullary carcinoma was achieved in 22 out of 32 patients resulting in a sensitivity, specificity and accuracy data of 68.7%, 100% and 86%, respectively. Improvement of sensitivity and accuracy to 97% and 94.5%, respectively, could be achieved by IDUS in combination with ETP. IDUS accuracy for T1, T2 and T3 stages was 86%, 71% and 86%, respectively. For N0 and N1 stages accuracy of 75% each was calculated. Conclusions : IDUS+ETP substantiate the diagnosis and further management of ampullary tumors. ETP alone is not useful in detecting malignancy (false-negative rate of 31.3%). IDUS accurately predicts T and N stages in patients and is able to accurately predict cases which potentially are treatable endoscopically. (Acta gastro enterol. belg., 2011, 74, 509-515). [Product Details...]

Risk Factors for Non-alcoholic Fatty Liver Disease in a Chinese Population

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Background : Non-alcoholic fatty liver disease (NAFLD) is a serious health concern in China. The goal of this cross-sectional study was to determine the prevalence of NAFLD and identify the risk factors associated with this disease in Northern China. Methods : In 2007, a total of 6063 adults from Dehui, a city in Northern China, were surveyed and demographic and social-economic characteristics, life behaviors, and medical history were recorded. Among them, 3850 subjects were randomly selected for physical examination, fasting plasma glucose (FPG) test, fasting lipid and liver function profiles, hepatitis B and C infection screening, and ultrasound examination. The frequency of NAFLD in this population was analyzed by the Chi-square test and the association of potential risk factors was analyzed by logistic regression. Results : The prevalence of NAFLD was 15.9% in this population and the prevalence in females was significantly higher than that in males, particularly for the elderly subgroup. Obesity, hypertension, FPG, diabetes, and metabolic syndrome (MS)-related hyperlipidemia were significantly associated with NAFLD. The data indicate that MS-related multiple risk factors synergistically increase the risk for NAFLD. Conclusion : The prevalence of NAFLD is high in Northern China, which may be associated with the high incidence of diabetes,hypertension, and MS in this area. (Acta gastro enterol. belg.,2011, 74, 503-508). [Product Details...]

The effects of Teucrium polium on ionizing radiation-induced intestinal damage in rats

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Background and study aims : Oxidative stress plays an important role in development of intestinal injury after abdomino-pelvic radiation therapy. Teucrium polium (TP) is a medicinal plant which has antioxidant and anti-inflammatory properties. The aim of this study was to investigate the effect of TP on radiation-induced intestinal oxidative damage in rats. Materials and methods : Group 1 (n = 8), the control group ; Group 2 (n = 8), the RAD (radiation) group in which each rat received a single whole-body 800 cGy radiation performed with a LINAC ; Group 3 (n = 8), the RAD + TP group in which rats were exposed to radiation as in Group 2, followed by intragastric administration of 0.5 g/kg/daily TP extract for 7 consecutive days ; and Group 4 (n = 8), the TP group, rats received only intragastric TP for 7 days. Results : Radiation led to intestinal damage, which was accompanied by an increase in intestinal thiobarbituric-acid-reactive substances (TBARS) and myeloperoxidase (MPO) levels, and a decrease in reduced glutathione (GSH) levels. Although TP significantly decreased intestinal MPO levels and inflammation scores, it neither reverted intestinal TBARS and GSH levels nor ameliorated other histological parameters of the disease. Conclusions : Our results suggest that TP reduces inflammation but does not ameliorate the increased oxidative stress conditions in radiation-induced intestinal damage in rats. (Acta gastro enterol. belg., 2011, 74, 491-496). [Product Details...]

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