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Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

World Journal of Gastroenterology 2015年第46期21卷 13132-13139页

作者： Moutaz Derbala Mohammed Elshiekh Elbadri Aliaa Mohamed Amer Saad Al Kaabi Khaleel hassan Sultan Yasser Medhat Kamel eman hassan satti elsayed Tony Yervant Avades Prem Chandra Fatma M Shebl Gastroenterology and Hepatology Hamad Medical CorporationHamad General Hospital Gastroenterology and Hepatology Theodor Bilharz Research Institute Medical Department Weill Cornell Medical College Laboratory Medicine and pathology Hematology SectionHamad Medical CorporationHamad General Hospital General Medicine Medical EducationHamad Medical CorporationHamad General Hospital Department of Laboratory Medicine and Pathology Hamad Medical CorporationHamad General Hospital Medical Research Center Hamad Medical CorporationHamad General Hospital Chronic Disease Epidemiology DepartmentYale School of Public Health

AIM: To assess the diagnostic accuracy,of aminotransferase-to-platelet ratio index(APRI) alone and with antischistosomal antibody(Ab) in patients with hepatitis C virus(HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptianmen patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease,including; history of previous antiviral or interferon therapy,immunosuppressive,therapy,chronic hepatitis B infection,human immunodeficiency virus co-infection,autoimmune hepatitis,decompensated liver disease,hepatocellular carcinoma,prior liver transplantation,and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis,whereas 30.4%,37.5%,20.4%,and 4.6% had fibrosis of stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ respectively. In bivariate analysis,APRI score,levels of AST,platelet count and age of patient showed statistically significant association with liver fibrosis(P < 0.0001); whereas antischistosomal antibody titer(P = 0.52) and HCV RNA titer(P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis,significant fibrosis,severe fibrosis and cirrhosis of APRI score were 63%,73.2%,81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patient

关键词： Hepatitis C Schistosomiasis Aspartate transaminase

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Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital

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Open Journal of Obstetrics and Gynecology 2017年第7期7卷 725-733页

作者： eman Ali AbdElfatah elsayed Elbadwy Mohamed Awad Tamer Mamdouh Abd-Eldaym Zynab hassan Ali Department of Obstetrics and Gynecology Faculty of Medicine Alexandria University Alexandria Egypt

Objective: The aim of this study was to determine the incidence, risk factors, and outcomes of management of patients with placenta accreta. Background Placenta accreta occurs when the placental implantation is abnormal. The marked increase in incidence has been attributed to the increasing prevalence of cesarean delivery in recent years. The most common theory is defective decidualization. The most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. The first clinical manifestation of placenta accreta is usually profuse, life-threatening hemorrhage. The recommended management of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ. Patients and methods: It’s a study of all cases of placenta accreta at El-Shatby Maternity University Hospital starting from 1/4/2016 till 1/10/2016. Selection of the cases will only be dependent upon their pregnancy gestational age above 28 weeks of gestation. Results: The incidence of placenta accreta was 1/75 cesarean deliveries. The ultrasonography and doppler had a false negative rate of 54.6% and a sensitivity of 45.2% in diagnosis of placenta accreta. The rate of blood transfusion was 79.6%. Uterine preserving procedures performed in 66%. Cesarean hysterectomy performed in 34%. Intensive care unit admission occurred in 27.3%. The mean gestational age at delivery was 33.8 ± 4.6 weeks’ gestation. 31.8% admitted to the neonatal intensive care unit. Conclusion: The incidence of placenta accreta increased due to the increasing rate of cesarean deliveries, prenatal diagnosis of placenta accreta is paramount, as most women are asymptomatic. Prenatal diagnosis allows time for a multidisciplinary team to make delivery plans, which will help decrease surgical complications.

关键词： Pregnancy Cesarean Deliveries Placenta Accreta Postpartum Haemorrhage Blood Transfusion Hysterectomy

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Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study

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World Journal of Gastroenterology 2021年第40期27卷 6951-6966页

作者： Hend Ibrahim Shousha Shimaa Afify Rabab Maher Noha Asem eman Fouad Ehab F Mostafa Mohammed A Medhat Amr Abdalazeem Hazem Elmorsy Miriam M Aziz Rateba S Mohammed Mohamed Ibrahem hassan Elgarem Dalia Omran Mohamed hassany Bassem elsayed Ahmed Y Abdelaziz Mohamed El Kassas Endemic Medicine Faculty of MedicineCairo UniversityCairo 11562Egypt Gastroenterology Department National Hepatology&Tropical Medicine Research InstituteCairo 11563Egypt Hepatology Department Students HospitalCairo UniversityGiza 12566Egypt The Public Health Department Faculty of MedicineCairo UniversityCairo 11562Egypt Egyptian Ministry of Health and PopulationCairo 11567Egypt Department of Tropical Medicine and Gastroenterology Faculty of MedicineAssiut UniversityAssiut 15655Egypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairo 13544Egypt Internal Medicine 15 Mayo Smart HospitalMinistry of Health and PopulationCairo 13488Egypt Pediatrics Department Faculty of MedicineCairo UniversityCairo 11562Egypt Occupational and Environmental Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Clinical Biochemistry Department Faculty of medicineCairo UniversityCairo 11562Egypt Endemic Medicine Department Faculty of MedicineCairo UniversityCairo 11562Egypt Urology Department Cairo UniversityCairo 11562Egypt

BACKGROUND Various liver and gastrointestinal involvements occur in patients with coronavirus disease 2019(COVID-19)at variable *** studies report mild liver function disturbances correlated with COVID-19 severity,though liver failure is *** To study liver and gastrointestinal dysfunctions in Egyptian patients with COVID-19 and their relation to disease outcomes METHODS This multicentre cohort study was conducted on 547 Egyptian patients from April 15,2020 to July 29,*** polymerase chain reaction-confirmed COVID-19 cases were included from four quarantine hospitals affiliated to the Egyptian ministry of *** information,laboratory characteristics,treatments,fibrosis-4(FIB-4)index,COVID-19 severity,and outcomes were recorded and compared according to the degree of liver enzyme elevation and the presence of gastrointestinal ***-ups were conducted until discharge or *** analyses were performed to determine the independent factors affecting *** This study included 547 patients,of whom 53(9.68%)died during hospitalization and 1 was discharged upon his ***’mean age was 45.04±17.61 years,and 21.98%had severe or critical *** aminotransferase(ALT)and aspartate aminotransferase(AST)were available for 430 and 428 patients,*** total,26%and 32%of patients had elevated ALT and AST,*** liver injury with ALT or AST elevation exceeding 3-fold was recorded in 21(4.91%)and 16(3.73%)patients,*** gender,smoking,hypertension,chronic hepatitis C,and lung involvement were associated with elevated AST or *** was elevated in 50%of patients over ***-4 was significantly higher in patients admitted to the intensive care unit(ICU),those with more severe COVID-19,and *** independent variables affecting outcome were supplementary vitamin C intake(1 g daily capsules)[odds ratio(OR):0.05,95%confidence interval(CI

关键词： COVID-19 Egypt Liver injury Gastrointestinal symptoms Fibrosis-4 Liver enzymes

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