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Hepatobiliary manifestations in children with inflammatory bowel disease:A single-center experience in a low/middle income country

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2020年第3期11卷 48-58页

作者： Mortada HF El-Shabrawi Sara Tarek Maha Abou-Zekri Safa Meshaal Afaf Enayet engy adel mogahed Department of Paediatrics Kasr Alainy School of MedicineCairo UniversityCairo 11562Egypt Department of Clinical Pathology Kasr Alainy School of MedicineCairo UniversityCairo 11562Egypt

BACKGROUNDThere has been a worldwide increase in the reported incidence of inflammatorybowel disease (IBD) in children over the past 2-3 decades. The hepatobiliary (HB)manifestations of IBD have been well-studied in children in industrialized anddeveloped countries but are infrequently reported in low- and middle-incomecountries (LMIC) such as *** determine the prevalence of the HB manifestations in a cohort of Egyptianchildren with *** cross-sectional observational study was carried out over a period of 6 mo(between June 2013 to December 2013, at the Paediatric Hepatology andGastroenterology Units of Cairo University Children's Hospital, which is thelargest paediatric tertiary care centre in the *** study included 48 patients with confirmed IBD based upon clinical,laboratory, endoscopic and histopathological features, 29 (60.4%) were ***-four patients (50%) had ulcerative colitis (UC), 11 (22.9%) had Crohn'sdisease (CD) and 13 (27.1%) had unclassified-IBD (IBD-U), which was formerlyknown as indeterminate colitis. The mean age of the patients at the time ofpresentation was 8.14 (± SD 4.02) years and the mean age at the time of studyenrolment was 10.16 (± SD 4.19) years. All patients were screened for HBmanifestations by physical examination, liver function tests, imaging and liver biopsy when indicated. HB disorders were confirmed in 13 patients (27.1%).Transaminases were elevated in 3 patients (6.3%). Two patients (4.2%) hadelevated biliary enzymes (one was diagnosed as primary sclerosing cholangitis(PSC) and the other was diagnosed with PSC/autoimmune hepatitis overlapsyndrome and the third patient had hepatitis C virus infection. Ten patients(20.8%) had bright echogenic liver on ultrasound suggesting fatty infiltration as asequel of malnutrition or medication *** commonest HB disorders in Egyptian children with IBD were abnormal liverfunction tests, fatty infiltration and PSC. These HB manifestations i

关键词： Children Crohn's disease Egypt Elevated liver enzymes Hepatobiliary Inflammatory bowel disease Ulcerative colitis

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Clinical and Biochemical Changes in Polycystic Ovarian Syndrome Patients in Response to 3 Different Oral Hypoglycemic Drugs: A Double Blind Randomized Controlled Study

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Open Journal of Obstetrics and Gynecology 2017年第1期7卷 117-128页

作者： Ahmed S. El-Halwagy adel A. Al-Gergawy engy S. Eleslam Enaam S. Abd Elbar Faculty of Medicine Tanta University Tanta Egypt

Introduction: This study was done to evaluate other oral hypoglycemic medications;especially the new ones in the management of PCOS patients as alternatives to the standard medication used for this purpose Metformin. Patients and Methods: 105 patients were enrolled and randomly distributed into 3 groups according to sequence of computer-generated block-random numbers. Each group included 35 patients. This randomized double blind case controlled study was conducted at Tanta University Hospital from December 1, 2015 to October, 1, 2016. In group A (study group 1) the patients received Pioglitazobe 30 mg once a day for 6 months while in group B (study group 2) the patients received Vildagliptin 50 mg once daily. In Group C (control group) the patients received Metformin 500 mg tds. for 6 months. The clinical outcome measures of the study were the improvement in the regularity of the menstrual cycle, the BMI and the improvement in the modified Ferriman-Gallwey (F-G) score for hirsutism. The biochemical outcome measures will be the change in the Serum Free testosterone, dehydroepiandrosterone (DHEA), fasting insulin level, Glcosylated hemoglobin (Hb A1c) and fasting Low Density Lipoproteins (LDL) levels. Results: Pioglitazobe in the study group 1 patients showed a significant reduction of BMI (p = 0.016), Ferriman-Gallwey score (p = 0.003), free testosterone level (p = 0.003), DHEA level (p = 0.001), fasting insulin level (p = 0.036) and Hb a1c level (p = 0.000), and also significant reduction of menstrual irregularities (p = 0.035). When compared to Metformin in the control group 3, there were significant reduction of BMI (p = 0.010), Ferriman-Gallwey score (p = 0.002), free testosterone level (p = 0.034), Hb a1c (p = 0.000) level and significant reduction of menstrual irregularities (p = 0.004) only. This means that the clinical and metabolic effect of Pioglitazobe is better than Metformin in PCOS patients. On the contrary there were disappointing results of the new dr

关键词： PCOS Pioglitazobe Vildagliptin Metformin

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