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Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

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Open Journal of Gastroenterology 2024年第6期14卷 203-212页

作者： Hajar Cherkaoui Maryam Elkhayari Maria Lahlali Asmae Lamine Nada Lahmidani Amine Mekkaoui Mounia Elyousfi Dafr Allah Benajah Mohammed El Abkari adil ibrahimi Hakima Abid Department of Hepato-Gastroenterology Hassan II University Hospital Fez Morocco Faculty of Medicine and Pharmacy of Fez USMBA Fez Morocco

The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).

关键词： Post-Viral Cirrhosis C Pegylated Interferon Direct Acting Antivirals Sustained Viral Response Child Score Fibrosis

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Dunbar Syndrome and Hypoxic Hepatitis: An Unusual Presentation

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Open Journal of Gastroenterology 2024年第6期14卷 226-232页

作者： Hajar Cherkaoui Ismail Chaouech Yousra El Abidi Haroun Robleh Asmae Lamine Maria Lahlali Nada Lahmidani Amine Mekkaoui Mounia Elyousfi Dafr Allah Benajah adil ibrahimi Mohammed El Abkari Nizar Bouardi Mohammed Maaroufi Hakima Abid Department of Gastroenterology University Hospital Hassan II Fez Morocco Faculty of Medicine and Pharmacy Fez Morocco Department of Radiology University Hospital Hassan II Fez Morocco

Hypoxic hepatitis, also known as ischemic hepatitis, is characterized by acute hepatocellular injury due to inadequate oxygen delivery to the liver. Celiac trunk stenosis can lead to hepatic ischemia and subsequent liver damage. We present the case of an 81-year-old patient with a history of hypertension, ischemic heart disease, hypothyroidism, and biliary lithiasis, who developed hypoxic hepatitis secondary to Dunbar syndrome and a stenosis of the superior mesenteric artery. The patient improved symptoms and liver function tests with conservative management, including intravenous fluids and supportive care. Long-term management involved continued antiplatelet therapy and statins, with consideration of further interventions for celiac trunk stenosis. This case underscores the importance of recognizing Dunbar syndrome as well as superior mesentery trunk stenosis as a potential cause of hypoxic hepatitis. It highlights the need for multidisciplinary management in such cases.

关键词： Dunbar Syndrome Hypoxic Hepatitis Stenosis of Mesentery Artery

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Acute hepatitis secondary to parenteral amiodarone does not preclude subsequent oral therapy

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World Journal of Hepatology 2012年第6期4卷 196-198页

作者： Mounia Lahbabi Nouredine Aqodad adil ibrahimi Mryem Lahlou Hafid Aqodad Department of Hepato-Gastroenterology Hassan II University Hospital Fes 30000 Morocco Department of Cardiology Hassan II University Hospital Fes 30000 Morocco

Amiodarone chlorhydrate is a diiodated benzofuran derivative used to treat cardiac rhythm abnormalities. Hepatotoxicity is a relatively uncommon side effect of amiodarone and symptomatic hepatic dysfunction occurs in less than 1% to 3% of patients taking amiodarone. We report here on an unusual case of amiodarone-induced hepatotoxicity. A 29 year old woman with normal liver function was given amiodarone intravenously to treat her atrial fibrillation. She developed acute toxic hepatitis after 24 h. The intravenous form of amiodarone was immediately avoided and replaced by the oral form, using conventional loading doses as soon as the deranged liver function tests had normalized, without recurrence of the hepatitis. These observations show that the occurrence of acute hepatic impairment with intravenous amiodarone does not necessarily preclude the use of this drug by mouth and the necessity of monitoring the hepatic function of patients treated with amiodarone.

关键词： Amiodarone Hepatitis Toxic hepatitis Polyoxenethylated sorbitan ester

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Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis:A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

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Open Journal of Gastroenterology（肠胃病学期刊） 2024年第6期 203页

作者： Hajar Cherkaoui Maryam Elkhayari Maria Lahlali Asmae Lamine Nada Lahmidani Amine Mekkaoui Mounia Elyousfi Dafr Allah Benajah Mohammed El Abkari adil ibrahimi Hakima Abid

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Dunbar Syndrome and Hypoxic Hepatitis: An Unusual Presentation

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Open Journal of Gastroenterology（肠胃病学期刊） 2024年第6期 226页

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Hbs antigen, what prevalence among pregnant women in Morocco? Preliminary results of a prospective study conducted in Hospital University Hassan II, Fez

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Open Journal of Gastroenterology 2013年第7期3卷 311-313页

作者： Laila Sedreddine Meryem Sekkat Sidi adil ibrahimi Noureddine Aqodad Department of Hepatology and Gastroenterology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morroc Department of Hepatology and Gastroenterology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morroco

The chronic viral hepatitis B is a public health problem and remains a global challenge with 350 million carriers of HBs antigen (HBsAg). The prevalence of HBsAg varies from one country or continent to another. In France, it is estimated to be 0.5%. In Morocco, the data are rare but some studies have estimated the prevalence to be 2.5%. Our aim is to estimate the prevalence of HBsAg among women who have recently given birth at the maternity CHU Hassan II of Morocco Fez, and to describe the epidemiological profile and risk factors for infection. In pregnancy, infection with hepatitis B virus (HBV) is dominated by the risk of mother to child transmission (vertical transmission), which can be avoided by serovaccination of the newborn. The search for HBsAg should be performed in all pregnant women.

关键词： HBs Antigen Prevalence Pregnancy

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The endoscopic pneumatic balloon dilation in treating achalasia in a Moroccan center

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Open Journal of Gastroenterology 2012年第4期2卷 172-176页

作者： Mounia El Yousfi Nada Lahmidani adil ibrahimi Dafr-Allah Benajah Department of Hépato-Gastroenterology University Sidi Mohammed Ben Abdillah Fez Morocco

Aim of the work: Achalasia is a rare pathology whose physiopathogenesis is mysterious. The treatment is based on endoscopic pneumatic dilation (PD) and surgery. The aim of our work is to show our experiment about endoscopic pneumatic dilation as the principal treatment suggested for patients presenting achalasia. Material and method: It is a retrospective study relating 21 cases of achalasia indexed between 2002 and 2007. The remission was judged on Eckardt’s clinical criteria. If the symptoms persist after three episodes of PD, there’s a therapy failure and the patients were then proposed to surgery or recurrent DP. The results: The Middle Age at the time of diagnosis was of 44 ± 10, 66 years (20 to 76). The sex ratio was 1, 3 (12M?9F) (p = 0.5). The diagnosis of achalasia is based on imaging, endoscopy and manometric arguments. The PD of the cardia was proposed in first intention, except two patients who were treated 6 and 15 years before by surgery. 38 dilations were performed for 21 patients with an average of 1.8 PD per patient [1-6]. The rate of good answers after the third episode of PD was about 90.47% (19 patients). There was no complication of the PD. In plain-varied analysis, no predictive factor of good answers to PD was retained. Conclusion: PD is an effective cure with a negligible morbidity and no mortality. The surgery is reserved for the failures of pneumatic dilation.

关键词： Achalasia Esophagus Treatment Pneumatic Dilation

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Young patient with juvenile polyposis syndrome: A case report

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Open Journal of Gastroenterology 2012年第3期2卷 105-108页

作者： Mounia El Yousfi Bahija Benyachou adil ibrahimi Laila Chbani Afaf Amarti Gastroenterology Department Fez University Hospital Fez Morocco Pathology Department Fez University Hospital Fez Morocco

A case is reported here of juvenile polyposis in a 15- year-old girl. She was diagnosed upon the assessment of the dysenteric syndrome. Coloscopy and gastro- scopy had shown polyps of variable size whose histological study confirmed the hamartomatous character typical of the youthful non adenomatous polyps free of dysplasia. There was no localization in the small bowel. Coloprotectomy with ileoanal anastomosis was carried out in view of the importance of diarrhoea and the impacts on the general state of health.

关键词： Hamartomatous Polyp Polyposis Juvenile Polyp Juvenile Polyposis

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Endoscopic Hemostatic Treatment of Gastric Varices during Pregnancy by Injection of Histoacryl

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Open Journal of Gastroenterology 2014年第4期4卷 149-151页

作者： Nora Bousfiha Najoua Bousfiha Chahrazad Bouchikhi Abdelaziz Banani adil ibrahimi Nourdin Aqodad Service d’hépato-gastro-entérologie CHU Hassan II Fès Maroc Service de gynécologie-obstétrique 1 CHU Hassan II Fès Maroc

The occurrence of pregnancy is relatively rare in patients with portal hypertension, and has been reported as clinical cases. However, few studies have evaluated the effectiveness of injecting histoacryl during pregnancy. The choice of treatment for varicose bleeding during pregnancy has been described in the literature based on the elastic ligature. We report the second case, to our knowledge, of treatment of bleeding gastric varices by injection of histoacryl with good maternal and fetal development.

关键词： Gastric Varices Pregnancy Hystoacryl

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Acute pancreatitis revealing ulcerative colitis—A case report

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Open Journal of Gastroenterology 2014年第1期4卷 16-18页

作者： Nora Bousfiha Iliass Iliass Charif Mohamed el Abkari adil ibrahimi Ihsane Mellouki School of Medicine and Pharmacy of Fez Sidi Mohammed Ben Abdellah University Fez Morocco

The association of acute pancreatitis with ulcerative colitis [UC] has been described in the literature. It is usually induced by drugs, but sometimes it may be idiopathic. This association remains rare. We report the case of a patient who was treated in our department. Medical observation: Mr. KA, a 60-year-old man, was admitted in our unit for management of acute epigastric. The clinical examination at the admission was normal. After eliminating a cardiac or surgical cause, the diagnosis of acute pancreatitis was made on the basis of the presence of a serum lipase up to 5 times the normal level and pain intensity. An abdominal scanner tomography was performed for the assessment of the pancreatitis. It has shown a pancreatitis stage C associated with a thick rectosigmoidien that was discovered incidentally. Symptomatology was enriched 10 days after by the occurrence of rectal bleeding. A lower endoscopy was performed after the improvement of the pancreatitis and had shown an ulcerative colitis on pancolitis which was confirmed by biopsy. In order to search other causes of this pancreatitis, other tests were made [a biliary IRM, endoscopic ultrasonography, autoimmune tests] and the results were negative. We concluded an idiopathic pancreatitis. The ulcerative colitis was classified as moderate and the patient was put on oral corticosteroids with degression. The evolution was marked by a clinical and biological improvement of pancreatitis and colitis. Conclusion: The association of idiopathic pancreatitis with ulcerative colitis is rare. The case of our patient is the first case reported in our series with 400 cases of ulcerative colitis diagnosed in our service.

关键词： Acute Pancreatitis Ulcerative Colitis

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