Abbreviations: SGA, Subjective global assessment; MNA, Mini-nutritional assessment; CONUT, Contro... more Abbreviations: SGA, Subjective global assessment; MNA, Mini-nutritional assessment; CONUT, Controlling nutritional status; HGS, Hand grip strength. body mass index (BMI), spontaneous bacterial peritonitis (SBP), hepato-renal syndrome (HRS, European Society of Enteral and Parenteral Nutrition (ESPEN), complete blood count (CBC), International Normalized Ratio (INR), negative predictive value (NPV) Statistical Package for Social Studies (SPSS), reservoir operator characteristic (ROC)
Hepatitis C virus (HCV) infection is associated with a particularly poor outcome after liver tran... more Hepatitis C virus (HCV) infection is associated with a particularly poor outcome after liver transplantation. In December 2014, sofosbuvir/ledipasvir (SOF/LDV) fixed‐dose combination (FDC) was approved for HCV genotype 1 and 4 in Europe. In orthotopic liver transplantation (OLT) recipients, the interferon‐free treatment of HCV re‐infection with novel direct‐acting antivirals has been demonstrated to be safe and effective in clinical trials, but real‐world data are missing. The aim of this study was to investigate the safety and efficacy of SOF/LDV FDC in OLT recipients in the real‐life setting.
Background and Aims: The decision to treat chronic hepatitis B Virus infection (CHB) may necessit... more Background and Aims: The decision to treat chronic hepatitis B Virus infection (CHB) may necessitate an assessment of the degree of liver fibrosis. Guidelines recommend Fibroscan examination in such cases. However, it is costly and not widely available. Red cell distribution width (RDW) and platelet count are simple parameters obtained from the blood pictures; and their ratio RDW to platelet ratio (RPR) was claimed to correlate with liver fibrosis. We aimed to assess the ability of RPR to replace the costly fibroscan in the detection of significant fibrosis in chronic hepatitis B patients. Patients and Methods: This cross-sectional study was conducted in the Tropical medicine department, Tanta University, Egypt, between December 2018 and September 2019. One hundred and twenty-five patients with CHB were included and divided according to the fibroscan examination into: Group I: patients with no significant fibrosis (n=66), Group II: patients with significant (≥ F2) fibrosis (n=59). R...
African Journal of Gastroenterology and Hepatology
Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that include... more Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that includes simple steatosis, which can proceed to non-alcoholic steatohepatitis, cirrhosis, and, finally, hepatocellular carcinoma. Owing to the invasive nature of liver biopsy, the need for non-invasive tools were required for diagnosis. Objective: To compare the performance of simple biochemical scores (fibroblast) FIB-5 and (fibrosis-4) FIB-4 with fibroscan to differentiate mild to moderate fibrosis (MF; F0 to F2) from advanced fibrosis (AF; F3 to F4) in patients with NAFLD.
Background: The gut–liver axis has many implications in non-alcoholic fatty liver disease onset a... more Background: The gut–liver axis has many implications in non-alcoholic fatty liver disease onset as the major contributor of intestinal dysbiosis. Gut microbiota have an important role in intestinal barrier function and reversal of leaky gut. Probiotics may restore intestinal barrier integrity and contribute to hepatic functions recovery and alleviating inflammatory and fibrogenic processes. We aimed to evaluate the impact of probiotics on gut microbiota and non-alcoholic fatty liver disease progression. Results: Sixty non-alcoholic fatty liver disease patients (30 non-alcoholic fatty liver and 30 non-alcoholic steatohepatitis patients) were included in this open label randomized controlled study. Half of the patients of each group were randomized to receive probiotics in addition to classic management. The patients were followed-up for 6 months. The non-alcoholic fatty liver disease patients in the probiotic group experienced significant improvement in their Alanine aminotransferase...
Background: Screening of Esophageal Varices (EV) in liver cirrhosis is highly recommended in all ... more Background: Screening of Esophageal Varices (EV) in liver cirrhosis is highly recommended in all consensus reports. The standard screening procedure is endoscopy. Insulin resistance (IR) and the quantitative insulin sensitivity check index (QUICKI) are reliable predictors of portal hypertension. Objective: The study aimed to assess and compare the validity of insulin sensitivity/insulin resistance markers and other non-invasive markers for the detection of EVs in post chronic hepatitis C virus cirrhotic patients. Patients and Methods: In this cross-sectional study, 76 patients were screened by esophagogastroduodenoscopy and abdominal ultrasonography. Estimation of fasting serum insulin by ELISA technique was carried out. Homeostasis model assessment of insulin resistance (HOMA-IR) and QUICKI was performed. Results: The patients with an advanced grade of EV had higher insulin resistance and lower QUICKI. A cut-off value of HOMA-IR ≥ 3.4 could significantly predict EVs with 72% sensit...
plasma photocoagulation, Endoscopic band Ligation, Rebleeding. Background: Endoscopic band ligati... more plasma photocoagulation, Endoscopic band Ligation, Rebleeding. Background: Endoscopic band ligation (EBL) is an established maneuver for secondary prevention of variceal bleeding. However, recurrence of varices and postbanding ulcers are frequent problems. This is the first retrospective study that determined the the long-term re-bleeding rate in patients with esophageal varices who had done endoscopic Argon plasma photocoagulation (APC) after endoscopic band ligation. Aim: To determine the long-term re-bleeding rate of APC after endoscopic band ligation versus endoscopic band ligation alone for eradication of esophageal varices. Methods: Two hundred patients with cirrhosis, and had performed endoscopic band ligation for eradication of varices were randomized to either argon plasma coagulation after band ligation or observation. Endoscopy was performed every 3 months to check for recurrence of varices in both groups. If varices were
<strong>Background</strong>: Endoscopic band ligation (EBL) is an established maneuve... more <strong>Background</strong>: Endoscopic band ligation (EBL) is an established maneuver for secondary prevention of variceal bleeding. However, recurrence of varices and postbanding ulcers are frequent problems. This is the first retrospective study that determined the the long-term re-bleeding rate in patients with esophageal varices who had done endoscopic Argon plasma photocoagulation (APC) after endoscopic band ligation. <strong>Aim</strong>: To determine the long-term re-bleeding rate of APC after endoscopic band ligation versus endoscopic band ligation alone for eradication of esophageal varices. <strong>Methods</strong>: Two hundred patients with cirrhosis, and had performed endoscopic band ligation for eradication of varices were randomized to either argon plasma coagulation after band ligation or observation. Endoscopy was performed every 3 months to check for recurrence of varices in both groups. If varices were unremarkable twice, patients were moved to every six months throughout the whole period of the study. <strong>Results</strong>: The 1-year, 2-year and 3-years rebleeding rates in the group of APC were 1%, 3% and 3%, respectively. While, rebleeding rates in the control group were 26%, 29% and 29% at 1-year, 2-years and 3-years respectively. <strong>Conclusions</strong>: The present study confirms the effectiveness of APC in significantly reducing the rate of rebleeding after endoscopic band ligation.
Background and study aim: Liver biopsy is the gold standard method to assess hepatic inflammation... more Background and study aim: Liver biopsy is the gold standard method to assess hepatic inflammation and fibrosis in chronic hepatitis C infection (HCV). The non-invasive assessment of liver fibrosis is the key target that has inspired many new methods because of the limitations of liver biopsy. The aim of the work was to improve the efficiency of non-invasive liver fibrosis assessment in Egyptian patients with chronic hepatitis C by comparing Doppler ultrasound (US) of hepatic blood flow and fibroscan with liver biopsy. Patients and Method: In this retrospective analysis, 78 patients with HCV had already undergone liver biopsies as part of work panel prior to HCV treatment. Fibroscan examination, abdominal ultrasonography and Doppler ultrasound were done to the patients by experienced operators. Results: There was a strong positive correlation between the degree of liver fibrosis by fibroscan and the degree of inflammation in the histopathological analysis. Receiver Operator Characteristic (ROC) curve analysis revealed that fibroscan failed to detect FII fibrosis. However, fibroscan was more accurate in detecting FIII fibrosis.The Doppler ultrasound parameter ROC curve analysis, the portal vein blood flow volume (PVBFV) was shown to be more accurate in detecting lower grades of fibrosis than higher. Conclusion: For detection higher degrees of fibrosis, Fibroscan has a strong match with liver biopsy; however, Doppler US is more sensitive in detecting lower grades of fibrosis in patients infected with HCV .
Background Liver cirrhosis is a diffuse process in which the anatomical structure and function of... more Background Liver cirrhosis is a diffuse process in which the anatomical structure and function of the liver are disturbed. Lipid metabolism occurs mainly in the hepatocytes. In liver cirrhosis, it is expected to detect abnormal lipid profile and abnormal neutrophil to lymphocyte ratio due to necro-inflammation and hepatocyte dysfunction. This study aimed to estimate the lipid profile in patients with liver cirrhosis and to assess its relation to the severity of the liver disease based on Child-Pugh Turcotte score and Neutrophil to Lymphocyte Ratio (NLR). Methods: This study included 500 cirrhotic patients. All patients are subjected to history taking, clinical examination, liver and renal function tests, lipid profile, and also abdomino-pelvic ultrasound. Child -Pugh score, fibrosis-4 score (FIB4), and neutrophil and platelet lymphocyte ratio were calculated. Results: A total of 500 patients were enrolled in this study; 12 patients were excluded (two patients were on the immunosuppr...
No specific antiviral drugs have been approved for the treatment of COVID-19. This study aimed to... more No specific antiviral drugs have been approved for the treatment of COVID-19. This study aimed to evaluate the efficacy of favipiravir in treatment of COVID-19. This was a multicenter randomized controlled study including 96 patients with COVID-19 who were randomly assigned into a chloroquine (CQ) group and a favipiravir group. None of the patients in the favipiravir group needed mechanical ventilation (p = 0.129). One patient (2.3%) in the favipiravir group and two patients (4.2%) in the CQ group died (p = 1.00). Favipiravir is a promising drug for COVID-19 that decreases the hospital stay and the need for mechanical ventilation. ClinicalTrials.gov Identifier NCT04351295.
Researchers around the world are working at record speed to find the best ways to treat and preve... more Researchers around the world are working at record speed to find the best ways to treat and prevent coronavirus disease 2019 (COVID-19). This study aimed to evaluate the efficacy of ivermectin for the treatment of hospitalized mild to moderate COVID-19 infected patients. This was a randomized open-label controlled study that included 164 patients with COVID-19. Patients were randomized into two groups where Group 1 (Ivermectin group) included patients who received
Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glu... more Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan. Materials And Methods: After ethical approval of the protocol, a total of 170 chronic HBV patients were recruited from tropical medicine department, Tanta University. They underwent fibroscan examination for fibrosis and steatosis measurement with concomitant testing of liver functions and complete blood picture. Proposed serum markers were calculated. The relation between these ratios with the fibrosis and steatosis measured by fibroscan were tested using Pearson rank correlation. Results: There was a highly significant positive correlation be...
Endocrine, Metabolic & Immune Disorders - Drug Targets, 2021
Background and Aims: Eradication of hepatitis C virus (HCV) by direct-acting-antiviral- agents (D... more Background and Aims: Eradication of hepatitis C virus (HCV) by direct-acting-antiviral- agents (DAAs) was followed by fibrosis regression, but little is available about hepatic steatosis changes after DAAs. The aim of this work was to assess the prevalence of hepatic steatosis among HCV Egyptian patients and the long term changes occuring after viral eradication. Methods: This prospective cohort study included 150 HCV patients with significant fibrosis. They were examined by Transient elastography to evaluate liver stiffness measurement (LSM) and hepatic steatosis before treatment, at SVR12 and 1 year after the end of therapy. Results: LSM showed a significant positive correlation to pretreatment of hepatic steatosis. LSM significantly decreased and hepatic steatosis significantly increased both at SVR12 and one year after DAAs. Patients with steatosis showed significantly higher median LSM and controlled attenuation parameter (CAP) values at: baseline, SVR12, and one year after the...
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry, 2021
Background & Aims: Pruritus associated with liver diseases confines daily activities and causes s... more Background & Aims: Pruritus associated with liver diseases confines daily activities and causes sleep deprivation in patients with chronic liver diseases. Autotoxin enzyme (ATX) was found to be higher in sera of patients with intrahepatic cholestasis and it was found to be associated with the intensity of itching. The aim of this study was to assess the correlation between the autotaxin enzyme and pruritus in Egyptian patients suffering from chronic liver disease (CLD). Methods: This cross-sectional study was carried on a total number of 80 patients with chronic liver disease divided into four groups: Group A and B included cirrhotic patients suffering from pruritis with and without cholestasis, while group C and D included patients without pruritis with or without cholestasis and group E included 17 healthy controls. They were subjected to measurement of serum autotoxin concentration by ELISA in addition to routine investigations including liver function tests: Total and direct bil...
European Journal of Gastroenterology & Hepatology, 2021
BACKGROUND AND OBJECTIVES A scarce number of researches discussed the impact of cholecystectomies... more BACKGROUND AND OBJECTIVES A scarce number of researches discussed the impact of cholecystectomies on the anatomy of common bile duct (CBD) and intern if this will affect the difficulty of endoscopic retrograde cholangiopancreatography (ERCP). The objective of present study was to assess the impact of complicated cholecystectomy on the complexity and safety of the ERCP procedure. STUDY DESIGN A total of 100 patients were enrolled after meeting the following inclusion criteria - study group (group A): 50 patients with previous history of complicated laparoscopic cholecystectomy and control group (group B): 50 patients with previous noncomplicated laparoscopic cholecystectomy. ERCP was performed and complexity was judged by a number of cannulation attempts, ERCP time, pancreatic cannulation and post-ERCP pancreatitis. RESULTS The study revealed prolonged ERCP procedure duration in noncomplicated cholecystectomy (24.2 ± 8.5 min) and it was significantly more prolonged in complicated cholecystectomy (39.6 ± 10.7 min; P = 0.03). The trials of cannulation attempts were significantly higher in the study group with complicated cholecystectomy (P = 0.009). Pancreatic duct cannulation was frequently higher in the complicated cholecystectomy group (P = 0.03). Difficult or failed stone extraction was significantly prevalent in the complicated cholecystectomy group and the occurrence of post-ERCP pancreatitis (PEP) was significantly higher than the control group. CONCLUSION ERCP after complicated laparoscopic cholecystectomy is more complex with increased duration liability of complications.
Background & Aims: With the introduction of sofosbuvir-based regimens, high cure rates and decrea... more Background & Aims: With the introduction of sofosbuvir-based regimens, high cure rates and decreased duration has been achieved. Several studies showed variances in SVR rates between different genotypes, with lower rates of SVR among cirrhotic patients. The aim of our study was to assess the safety and effectiveness of sofosbuvir-based antiviral regimens for the treatment of HCVinfected Egyptian cirrhotic patients. Methods: This was a retrospective, observational, and comparative study. A total of nine hundred and forty-six cirrhotic patients with chronic HCV genotype 4 infection, who were eligible for direct acting drugs (DAAs) therapy, were enrolled. The primary outcome measures were the number of patients with successful eradication of the virus evidenced by SVR at 12 weeks after discontinuation of therapy (SVR12), and the secondary outcome measures were the incidence of adverse effects associated with the tested HCV therapy. Results: Among the 946 patients enrolled in the study,...
Abbreviations: SGA, Subjective global assessment; MNA, Mini-nutritional assessment; CONUT, Contro... more Abbreviations: SGA, Subjective global assessment; MNA, Mini-nutritional assessment; CONUT, Controlling nutritional status; HGS, Hand grip strength. body mass index (BMI), spontaneous bacterial peritonitis (SBP), hepato-renal syndrome (HRS, European Society of Enteral and Parenteral Nutrition (ESPEN), complete blood count (CBC), International Normalized Ratio (INR), negative predictive value (NPV) Statistical Package for Social Studies (SPSS), reservoir operator characteristic (ROC)
Hepatitis C virus (HCV) infection is associated with a particularly poor outcome after liver tran... more Hepatitis C virus (HCV) infection is associated with a particularly poor outcome after liver transplantation. In December 2014, sofosbuvir/ledipasvir (SOF/LDV) fixed‐dose combination (FDC) was approved for HCV genotype 1 and 4 in Europe. In orthotopic liver transplantation (OLT) recipients, the interferon‐free treatment of HCV re‐infection with novel direct‐acting antivirals has been demonstrated to be safe and effective in clinical trials, but real‐world data are missing. The aim of this study was to investigate the safety and efficacy of SOF/LDV FDC in OLT recipients in the real‐life setting.
Background and Aims: The decision to treat chronic hepatitis B Virus infection (CHB) may necessit... more Background and Aims: The decision to treat chronic hepatitis B Virus infection (CHB) may necessitate an assessment of the degree of liver fibrosis. Guidelines recommend Fibroscan examination in such cases. However, it is costly and not widely available. Red cell distribution width (RDW) and platelet count are simple parameters obtained from the blood pictures; and their ratio RDW to platelet ratio (RPR) was claimed to correlate with liver fibrosis. We aimed to assess the ability of RPR to replace the costly fibroscan in the detection of significant fibrosis in chronic hepatitis B patients. Patients and Methods: This cross-sectional study was conducted in the Tropical medicine department, Tanta University, Egypt, between December 2018 and September 2019. One hundred and twenty-five patients with CHB were included and divided according to the fibroscan examination into: Group I: patients with no significant fibrosis (n=66), Group II: patients with significant (≥ F2) fibrosis (n=59). R...
African Journal of Gastroenterology and Hepatology
Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that include... more Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that includes simple steatosis, which can proceed to non-alcoholic steatohepatitis, cirrhosis, and, finally, hepatocellular carcinoma. Owing to the invasive nature of liver biopsy, the need for non-invasive tools were required for diagnosis. Objective: To compare the performance of simple biochemical scores (fibroblast) FIB-5 and (fibrosis-4) FIB-4 with fibroscan to differentiate mild to moderate fibrosis (MF; F0 to F2) from advanced fibrosis (AF; F3 to F4) in patients with NAFLD.
Background: The gut–liver axis has many implications in non-alcoholic fatty liver disease onset a... more Background: The gut–liver axis has many implications in non-alcoholic fatty liver disease onset as the major contributor of intestinal dysbiosis. Gut microbiota have an important role in intestinal barrier function and reversal of leaky gut. Probiotics may restore intestinal barrier integrity and contribute to hepatic functions recovery and alleviating inflammatory and fibrogenic processes. We aimed to evaluate the impact of probiotics on gut microbiota and non-alcoholic fatty liver disease progression. Results: Sixty non-alcoholic fatty liver disease patients (30 non-alcoholic fatty liver and 30 non-alcoholic steatohepatitis patients) were included in this open label randomized controlled study. Half of the patients of each group were randomized to receive probiotics in addition to classic management. The patients were followed-up for 6 months. The non-alcoholic fatty liver disease patients in the probiotic group experienced significant improvement in their Alanine aminotransferase...
Background: Screening of Esophageal Varices (EV) in liver cirrhosis is highly recommended in all ... more Background: Screening of Esophageal Varices (EV) in liver cirrhosis is highly recommended in all consensus reports. The standard screening procedure is endoscopy. Insulin resistance (IR) and the quantitative insulin sensitivity check index (QUICKI) are reliable predictors of portal hypertension. Objective: The study aimed to assess and compare the validity of insulin sensitivity/insulin resistance markers and other non-invasive markers for the detection of EVs in post chronic hepatitis C virus cirrhotic patients. Patients and Methods: In this cross-sectional study, 76 patients were screened by esophagogastroduodenoscopy and abdominal ultrasonography. Estimation of fasting serum insulin by ELISA technique was carried out. Homeostasis model assessment of insulin resistance (HOMA-IR) and QUICKI was performed. Results: The patients with an advanced grade of EV had higher insulin resistance and lower QUICKI. A cut-off value of HOMA-IR ≥ 3.4 could significantly predict EVs with 72% sensit...
plasma photocoagulation, Endoscopic band Ligation, Rebleeding. Background: Endoscopic band ligati... more plasma photocoagulation, Endoscopic band Ligation, Rebleeding. Background: Endoscopic band ligation (EBL) is an established maneuver for secondary prevention of variceal bleeding. However, recurrence of varices and postbanding ulcers are frequent problems. This is the first retrospective study that determined the the long-term re-bleeding rate in patients with esophageal varices who had done endoscopic Argon plasma photocoagulation (APC) after endoscopic band ligation. Aim: To determine the long-term re-bleeding rate of APC after endoscopic band ligation versus endoscopic band ligation alone for eradication of esophageal varices. Methods: Two hundred patients with cirrhosis, and had performed endoscopic band ligation for eradication of varices were randomized to either argon plasma coagulation after band ligation or observation. Endoscopy was performed every 3 months to check for recurrence of varices in both groups. If varices were
<strong>Background</strong>: Endoscopic band ligation (EBL) is an established maneuve... more <strong>Background</strong>: Endoscopic band ligation (EBL) is an established maneuver for secondary prevention of variceal bleeding. However, recurrence of varices and postbanding ulcers are frequent problems. This is the first retrospective study that determined the the long-term re-bleeding rate in patients with esophageal varices who had done endoscopic Argon plasma photocoagulation (APC) after endoscopic band ligation. <strong>Aim</strong>: To determine the long-term re-bleeding rate of APC after endoscopic band ligation versus endoscopic band ligation alone for eradication of esophageal varices. <strong>Methods</strong>: Two hundred patients with cirrhosis, and had performed endoscopic band ligation for eradication of varices were randomized to either argon plasma coagulation after band ligation or observation. Endoscopy was performed every 3 months to check for recurrence of varices in both groups. If varices were unremarkable twice, patients were moved to every six months throughout the whole period of the study. <strong>Results</strong>: The 1-year, 2-year and 3-years rebleeding rates in the group of APC were 1%, 3% and 3%, respectively. While, rebleeding rates in the control group were 26%, 29% and 29% at 1-year, 2-years and 3-years respectively. <strong>Conclusions</strong>: The present study confirms the effectiveness of APC in significantly reducing the rate of rebleeding after endoscopic band ligation.
Background and study aim: Liver biopsy is the gold standard method to assess hepatic inflammation... more Background and study aim: Liver biopsy is the gold standard method to assess hepatic inflammation and fibrosis in chronic hepatitis C infection (HCV). The non-invasive assessment of liver fibrosis is the key target that has inspired many new methods because of the limitations of liver biopsy. The aim of the work was to improve the efficiency of non-invasive liver fibrosis assessment in Egyptian patients with chronic hepatitis C by comparing Doppler ultrasound (US) of hepatic blood flow and fibroscan with liver biopsy. Patients and Method: In this retrospective analysis, 78 patients with HCV had already undergone liver biopsies as part of work panel prior to HCV treatment. Fibroscan examination, abdominal ultrasonography and Doppler ultrasound were done to the patients by experienced operators. Results: There was a strong positive correlation between the degree of liver fibrosis by fibroscan and the degree of inflammation in the histopathological analysis. Receiver Operator Characteristic (ROC) curve analysis revealed that fibroscan failed to detect FII fibrosis. However, fibroscan was more accurate in detecting FIII fibrosis.The Doppler ultrasound parameter ROC curve analysis, the portal vein blood flow volume (PVBFV) was shown to be more accurate in detecting lower grades of fibrosis than higher. Conclusion: For detection higher degrees of fibrosis, Fibroscan has a strong match with liver biopsy; however, Doppler US is more sensitive in detecting lower grades of fibrosis in patients infected with HCV .
Background Liver cirrhosis is a diffuse process in which the anatomical structure and function of... more Background Liver cirrhosis is a diffuse process in which the anatomical structure and function of the liver are disturbed. Lipid metabolism occurs mainly in the hepatocytes. In liver cirrhosis, it is expected to detect abnormal lipid profile and abnormal neutrophil to lymphocyte ratio due to necro-inflammation and hepatocyte dysfunction. This study aimed to estimate the lipid profile in patients with liver cirrhosis and to assess its relation to the severity of the liver disease based on Child-Pugh Turcotte score and Neutrophil to Lymphocyte Ratio (NLR). Methods: This study included 500 cirrhotic patients. All patients are subjected to history taking, clinical examination, liver and renal function tests, lipid profile, and also abdomino-pelvic ultrasound. Child -Pugh score, fibrosis-4 score (FIB4), and neutrophil and platelet lymphocyte ratio were calculated. Results: A total of 500 patients were enrolled in this study; 12 patients were excluded (two patients were on the immunosuppr...
No specific antiviral drugs have been approved for the treatment of COVID-19. This study aimed to... more No specific antiviral drugs have been approved for the treatment of COVID-19. This study aimed to evaluate the efficacy of favipiravir in treatment of COVID-19. This was a multicenter randomized controlled study including 96 patients with COVID-19 who were randomly assigned into a chloroquine (CQ) group and a favipiravir group. None of the patients in the favipiravir group needed mechanical ventilation (p = 0.129). One patient (2.3%) in the favipiravir group and two patients (4.2%) in the CQ group died (p = 1.00). Favipiravir is a promising drug for COVID-19 that decreases the hospital stay and the need for mechanical ventilation. ClinicalTrials.gov Identifier NCT04351295.
Researchers around the world are working at record speed to find the best ways to treat and preve... more Researchers around the world are working at record speed to find the best ways to treat and prevent coronavirus disease 2019 (COVID-19). This study aimed to evaluate the efficacy of ivermectin for the treatment of hospitalized mild to moderate COVID-19 infected patients. This was a randomized open-label controlled study that included 164 patients with COVID-19. Patients were randomized into two groups where Group 1 (Ivermectin group) included patients who received
Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glu... more Background & Aims: The gamma-glutamyl transpeptidase (GGT) to platelet ratio (GPR), the gamma-glutamyl transpeptidase to albumin (GAR) and S-index are novel biomarkers suggested to assess liver fibrosis. The aim of the work was to assess the correlation between GGT and other related markers as GAR and GPR among other previous documented markers and the degree of fibrosis and steatosis in chronic HBV Egyptian patients as measured by fibroscan. Materials And Methods: After ethical approval of the protocol, a total of 170 chronic HBV patients were recruited from tropical medicine department, Tanta University. They underwent fibroscan examination for fibrosis and steatosis measurement with concomitant testing of liver functions and complete blood picture. Proposed serum markers were calculated. The relation between these ratios with the fibrosis and steatosis measured by fibroscan were tested using Pearson rank correlation. Results: There was a highly significant positive correlation be...
Endocrine, Metabolic & Immune Disorders - Drug Targets, 2021
Background and Aims: Eradication of hepatitis C virus (HCV) by direct-acting-antiviral- agents (D... more Background and Aims: Eradication of hepatitis C virus (HCV) by direct-acting-antiviral- agents (DAAs) was followed by fibrosis regression, but little is available about hepatic steatosis changes after DAAs. The aim of this work was to assess the prevalence of hepatic steatosis among HCV Egyptian patients and the long term changes occuring after viral eradication. Methods: This prospective cohort study included 150 HCV patients with significant fibrosis. They were examined by Transient elastography to evaluate liver stiffness measurement (LSM) and hepatic steatosis before treatment, at SVR12 and 1 year after the end of therapy. Results: LSM showed a significant positive correlation to pretreatment of hepatic steatosis. LSM significantly decreased and hepatic steatosis significantly increased both at SVR12 and one year after DAAs. Patients with steatosis showed significantly higher median LSM and controlled attenuation parameter (CAP) values at: baseline, SVR12, and one year after the...
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry, 2021
Background & Aims: Pruritus associated with liver diseases confines daily activities and causes s... more Background & Aims: Pruritus associated with liver diseases confines daily activities and causes sleep deprivation in patients with chronic liver diseases. Autotoxin enzyme (ATX) was found to be higher in sera of patients with intrahepatic cholestasis and it was found to be associated with the intensity of itching. The aim of this study was to assess the correlation between the autotaxin enzyme and pruritus in Egyptian patients suffering from chronic liver disease (CLD). Methods: This cross-sectional study was carried on a total number of 80 patients with chronic liver disease divided into four groups: Group A and B included cirrhotic patients suffering from pruritis with and without cholestasis, while group C and D included patients without pruritis with or without cholestasis and group E included 17 healthy controls. They were subjected to measurement of serum autotoxin concentration by ELISA in addition to routine investigations including liver function tests: Total and direct bil...
European Journal of Gastroenterology & Hepatology, 2021
BACKGROUND AND OBJECTIVES A scarce number of researches discussed the impact of cholecystectomies... more BACKGROUND AND OBJECTIVES A scarce number of researches discussed the impact of cholecystectomies on the anatomy of common bile duct (CBD) and intern if this will affect the difficulty of endoscopic retrograde cholangiopancreatography (ERCP). The objective of present study was to assess the impact of complicated cholecystectomy on the complexity and safety of the ERCP procedure. STUDY DESIGN A total of 100 patients were enrolled after meeting the following inclusion criteria - study group (group A): 50 patients with previous history of complicated laparoscopic cholecystectomy and control group (group B): 50 patients with previous noncomplicated laparoscopic cholecystectomy. ERCP was performed and complexity was judged by a number of cannulation attempts, ERCP time, pancreatic cannulation and post-ERCP pancreatitis. RESULTS The study revealed prolonged ERCP procedure duration in noncomplicated cholecystectomy (24.2 ± 8.5 min) and it was significantly more prolonged in complicated cholecystectomy (39.6 ± 10.7 min; P = 0.03). The trials of cannulation attempts were significantly higher in the study group with complicated cholecystectomy (P = 0.009). Pancreatic duct cannulation was frequently higher in the complicated cholecystectomy group (P = 0.03). Difficult or failed stone extraction was significantly prevalent in the complicated cholecystectomy group and the occurrence of post-ERCP pancreatitis (PEP) was significantly higher than the control group. CONCLUSION ERCP after complicated laparoscopic cholecystectomy is more complex with increased duration liability of complications.
Background & Aims: With the introduction of sofosbuvir-based regimens, high cure rates and decrea... more Background & Aims: With the introduction of sofosbuvir-based regimens, high cure rates and decreased duration has been achieved. Several studies showed variances in SVR rates between different genotypes, with lower rates of SVR among cirrhotic patients. The aim of our study was to assess the safety and effectiveness of sofosbuvir-based antiviral regimens for the treatment of HCVinfected Egyptian cirrhotic patients. Methods: This was a retrospective, observational, and comparative study. A total of nine hundred and forty-six cirrhotic patients with chronic HCV genotype 4 infection, who were eligible for direct acting drugs (DAAs) therapy, were enrolled. The primary outcome measures were the number of patients with successful eradication of the virus evidenced by SVR at 12 weeks after discontinuation of therapy (SVR12), and the secondary outcome measures were the incidence of adverse effects associated with the tested HCV therapy. Results: Among the 946 patients enrolled in the study,...
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