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Pancreatobiliary Diseases Management by Endoscopic Ultrasonography/Endoscopic Retrograde Cholangiopancreatography Interface in Kurdistan Centre for Gastroenterology & Hepatology
Taha Ahmed Mohmmad Al-karboly
Issue:
Volume 3, Issue 6, November 2015
Pages:
217-223
Received:
4 September 2015
Accepted:
19 September 2015
Published:
15 October 2015
Abstract: Background: Pancreatobiliarydiseases (PBD) comprises diseases of both biliary system and pancreas and their diagnosis depends on appropriate clinical evaluation and investigations including imaging modalities like transabdominal ultrasound (TAUS), Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT); Endoscopic ultrasound(EUS) have been found to be more sensitive than other imaging modality for detecting PBD, and less invasive than endoscopic retrograde cholangiopancreatography (ERCP). Aim of study: To compare the sensitivity and specificity of EUS with other imaging studies like ERCP, TAUS, CT scan, and MRCP/MRI for diagnosing PBD. Patients & Methods: This study conducted in Kurdistan Centre for Gastroenterology and Hepatology (KCGH) from December 2013 through December 2014, after approval of institutional board ethical committee and taking written informed consents from all patients. A total number of 100 patients were enrolled in the study. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EUS, MRCP, and TAUS for PBD (benign & malignant). ERCP was used as a reference standard for comparison. Results: 60% were females and 40% were males; the main presenting symptoms were combined abdominal pain and obstructive jaundice. The sensitivity, specificity, PPV, NPV, and accuracy of EUS for detecting benign biliary diseases like (bile duct stone and its complications) were 96.1%, 65.2%, 86%, 83.3%, and 89%, respectively; and for detecting pancreatobiliary tumors (PBT) were 84.6%, 97.7%, 84.6%, 97.7%, and 96%, respectively. The sensitivity of TAUS, MRCP for diagnosing biliary diseases were 58%, and 60%, respectively; and their sensitivity for detecting PBT were 37.5%, and 50%, respectively. The comparison between CT scan and ERCP was not feasible statistically. Conclusion: EUS has a higher sensitivity in comparison to other imaging modalities in detecting PBD; we can depend on it in selecting patients for therapeutic ERCP, in order to avoid unnecessary ERCP and its complications. The sensitivity and specificity of EUS in KCGH is comparable to other studies elsewhere.
Abstract: Background: Pancreatobiliarydiseases (PBD) comprises diseases of both biliary system and pancreas and their diagnosis depends on appropriate clinical evaluation and investigations including imaging modalities like transabdominal ultrasound (TAUS), Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT); Endoscopic ultrasound...
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Endoscopic Findings in Egyptian Patients with Oesophageal Dysphagia at Different Age Groups
Marwa Ahmed Saad Gouda,
Ahmed Ismail Al-lakani,
Magdy Mohammed Bedewy
Issue:
Volume 3, Issue 6, November 2015
Pages:
224-230
Received:
12 October 2015
Accepted:
21 October 2015
Published:
31 October 2015
Abstract: Dysphagia is the medical term for the symptom of difficulty in swallowing. Dysphagia can occur in all age groups, and its prevalence increases with aging. Diagnosis of dysphagia is important due to associated morbidity and mortality, so it warrants early evaluation. The current study aimed to determine the frequency of common endoscopic findings in Egyptian patients presenting with esophageal dysphagia. This cross-sectional, descriptive study was carried out in the department of Gastroenterology, faculty of medicine, Alexandria University in the period from January 2012 -December 2014. 127 patients with dysphagia were included in the study and were subjected to endoscopy. A total of 127 patients; 73 females (57.5%), and 54 males (42.5%) presenting with dysphagia were studied, the mean age was 49.56±16.41 years. gastro-esophageal reflux (GERD)/reflux esophagitis was the most common findings noted in 25(19.7%) patients, followed by esophageal stricture noted in 22 patients (17.3%), esophageal mass in 21 patients (16.5%), normal endoscopic findings in 20 patients (15.7%), achalasia of the esophagus in 12 patients (9.4%), eosinophilic esophagitis in 6 (4.7%) patients, esophageal web/rings in 5 (3.9%)patients, diffuse esophageal spasm in 4 patients ( 3.1%), foreign body impaction in 2 patients (1.6%), and hiatal hernia in 2 patients (1.6). 8 (6.3%) patients had findings other than the ones mentioned above. We concluded that GERD/reflux esophagitis, and esophageal strictures are the commonest causes of dysphagia in our population. Also malignant esophageal mass is the main cause of dysphagia in elderly population, both warrants early diagnosis and management.
Abstract: Dysphagia is the medical term for the symptom of difficulty in swallowing. Dysphagia can occur in all age groups, and its prevalence increases with aging. Diagnosis of dysphagia is important due to associated morbidity and mortality, so it warrants early evaluation. The current study aimed to determine the frequency of common endoscopic findings in...
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Improved Susceptibility Pattern of Antimicrobials Using Vital Energy Treatment on Shigella sonnei
Mahendra Kumar Trivedi,
Alice Branton,
Dahryn Trivedi,
Gopal Nayak,
Mayank Gangwar,
Snehasis Jana
Issue:
Volume 3, Issue 6, November 2015
Pages:
231-237
Received:
6 October 2015
Accepted:
15 October 2015
Published:
16 November 2015
Abstract: Complementary and alternative medicine (CAM) has become increasingly popular and reported for countless benefits in biomedical health care systems. The study assessed the potential impact of The Trivedi Effect® (biofield energy) on Shigella sonnei for changes in antimicrobial sensitivity, biochemical study, and biotype number using MicroScan Walk-Away® system. The cells were obtained from MicroBioLogics Inc., USA bearing the American Type Culture Collection (ATCC 9290) number, and divided into two groups, Group (Gr.) I: control and Gr. II: treated. Gr. II was subjected to Mr. Trivedi’s biofield energy treatment and further subdivided into two sub-groups, Gr. IIA and Gr. IIB. Gr. IIA was analyzed on day 10, while Gr. IIB was stored and analyzed on day 160 (Study I). The Gr. IIB sample was retreated on day 160 (Study II), and was divided into three separate tubes as first, second and third tube, which were analyzed on day 5, 10 and 15, respectively. Results showed that 35% (7 out of 20) antimicrobials were reported with improved sensitivity profile. Moreover, the minimum inhibitory concentration study showed that 56.25% (18 out of 32) tested antimicrobials were reported with decreased concentration by two to four-fold as compared with the control after biofield treatment. The effect was further analyzed and sustained in the biochemical study, where 57.57% (19 out of 33) tested biochemicals showed altered reaction pattern as compared with the control. The biotype study showed an alteration in the biotype number in all the experimental treated groups as compared to the control. Encouraging results suggests that bioenergy healing treatment as an integrative medicine against S. sonnei would be a better and safe treatment approach in near future.
Abstract: Complementary and alternative medicine (CAM) has become increasingly popular and reported for countless benefits in biomedical health care systems. The study assessed the potential impact of The Trivedi Effect® (biofield energy) on Shigella sonnei for changes in antimicrobial sensitivity, biochemical study, and biotype number using MicroScan Walk-A...
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Study the Efficacy of Budesonide Enema in Treating Collagenous Microscopic Colitis: An Egyptian Trial
Marwa Ahmed Saad Gouda,
Ahmed Ismail Al-lakani,
Magdy Mohammed Bedewy
Issue:
Volume 3, Issue 6, November 2015
Pages:
238-244
Received:
27 October 2015
Accepted:
4 November 2015
Published:
17 November 2015
Abstract: Chronic diarrhea can have a substantial impact on the patient’s quality of life and overall health. Microscopic colitis (MC) is an inflammatory bowel disease, which is characterized by chronic watery diarrhea. Many drugs, including steroids, had emerged to treat MC. Our aim was testing the efficacy of Budesonide enema in improvement of patients with collagenous microscopic colitis both clinically and histo-pathologiclly. 22 patients with active microscopic colitis were enrolled in the present study, 15 women, and 7 men, with mean age of 60.9±8.5 years. Mean duration of symptoms was 2.6±0.8 years. Patients were given Budesonide enema 2mg/100ml twice daily for 2 weeks then, once daily for 4 weeks. They were evaluated both clinically and histopathologically after 6 weeks.18 patients (81.8%) showed high statistically significant decrease in the thickness of collage layer, and degree of inflammation. The patients’ frequency of stool decreased from 7.6±1.0 to 2.7±1.6 motions/day (p<0.001), and also consistency of stool improved (p<0.001).We concluded that Budesonide enema in a dose of 2 mg/100ml was well tolerated and effective in induction of remission in active collagenous colitis. Effects on both clinical symptoms and inflammatory infiltrate were seen. Recurrence rate after stopping treatment is moderate. Non-responders may need prolonged duration of treatment or omitting the drugs that may be responsible for colonic inflammation.
Abstract: Chronic diarrhea can have a substantial impact on the patient’s quality of life and overall health. Microscopic colitis (MC) is an inflammatory bowel disease, which is characterized by chronic watery diarrhea. Many drugs, including steroids, had emerged to treat MC. Our aim was testing the efficacy of Budesonide enema in improvement of patients wit...
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Post Stroke Seizure in Group of Hospitalized Patient in Baghdad Teaching Hospital
Samer Mohammed Saeed Ridha,
Bahaa Hassan,
Saadoun Al Ameer,
Zaki Noah Hasan
Issue:
Volume 3, Issue 6, November 2015
Pages:
245-249
Received:
27 September 2015
Accepted:
7 October 2015
Published:
22 December 2015
Abstract: Background: Stroke is the most common causes of seizures in adulthood. The incidence of seizures after stroke varies widely between 3.7% to 42.8%. Objectives: To assess the incidence of post – stroke seizures, the time of onset of seizures and, the type of seizures, also to evaluate the relationship between the development of seizures with subtypes of stroke, stroke size, and stroke site. Patients and methods: Data of 380stroke patients were collected consecutively in Baghdad Teaching Hospital from Oct. 2013 to Nov. 2014; age, sex, date of stroke, symptoms and signs of stroke, time of seizures onset, patterns of seizures, neuroimaging findings, and the findings of both carotid Doppler and echocardiography were studied in both ischemic and hemorrhagic stroke. . Statistical analyses were performed using the SPSS software package for Windows 6.0. Results: Post – stroke seizures were developed in (9.73%) of our patients, furthermore, (8.5%) of patients with ischemic stroke and (18%) of patients with hemorrhagic stroke developed seizures. early onset seizures occurred in (56.76%) of patients with post – stroke seizures, while (71.43%) developed seizures within the first 24 hours. status epilepticus was seen in (10.8%). partial seizures developed in (61.9%) of patients with early onset seizures, while, (75%) of patients with late onset seizures had Secondarily generalized seizures. post – stroke seizures were occurred in (81.1%) of patients with cortical lesions, (P< 0.00005). Also (20%) of patients with large size lesion developed seizures, while (5.3%) of patients with small lesion developed seizures, (P < 0.0002). Post – stroke seizures developed in; (17.53%), (6.06%), (1.47%), of patients with embolic, thrombotic, and lacunar subtype of stroke, (P = 0.0004). Conclusions: The post – hemorrhagic stroke seizures more frequently within the first 24hr after the onset of stroke, while the post – ischemic stroke seizures occur equally at early onset and at late onset seizures, early onset seizures are more likely to be simple partial seizures, while late onset seizures are more likely to be secondarily generalized, further more status epilepticus occur more frequently within the first week after the onset of stroke. The hemorrhagic stroke, the embolic stroke, the cortical lesion and the large size lesion are associated with a higher risk for the development of the post – stroke seizures.
Abstract: Background: Stroke is the most common causes of seizures in adulthood. The incidence of seizures after stroke varies widely between 3.7% to 42.8%. Objectives: To assess the incidence of post – stroke seizures, the time of onset of seizures and, the type of seizures, also to evaluate the relationship between the development of seizures with subtypes...
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Relationship Between Neutrophil-Lymphocyte Ratio and Microvascular Complications in Egyptian Patients with Type 2 Diabetes
Eman Youssef Moursy,
Magdy Helmy Megallaa,
Reham Fadl Mouftah,
Soha Magdy Ahmed
Issue:
Volume 3, Issue 6, November 2015
Pages:
250-255
Received:
29 October 2015
Accepted:
18 November 2015
Published:
22 December 2015
Abstract: Several epidemiological studies have shown that chronic inflammation plays a central role in the pathogenesis of diabetes and its various complications. Neutrophil-lymphocyte ratio (NLR) is a novel potential marker in determining inflammation. The aim of this study was to evaluate the relationship between diabetic microvascular complications, namely diabetic retinopathy, nephropathy, neuropathy, and neutrophil-lymphocyte ratio in type 2 diabetic patients. The study took place in the Unit of Diabetes & Metabolism at the Faculty of Medicine, Alexandria University, Alexandria, Egypt, and included a total of 280 subjects, 200 male patients with type 2 diabetes, 108 of them having one or more microvascular complication, and a control group including 80 healthy age and sex-matched subjects. Results of our study showed that neutrophil-lymphocyte ratio (NLR) values were significantly higher in diabetic patients with retinopathy (p<0.001), neuropathy (p=0.025) and nephropathy (p<0.001) than those of diabetic patients without any microvascular complications and healthy control subjects. NLR levels correlated positively with body mass index (BMI) (r=0.436, p<0.001), glycosylated hemoglobin (HbA1c) (r=0.526, p=0.001) and erythrocyte sedimentation rate (ESR) (r=0.396, p=0.017). Based on the results of this study, we can conclude that neutrophil-lymphocyte ratio (NLR), which is an efficient, simple and stable marker of inflammation, can serve as an important predictor for the presence of microvascular complications in Egyptian patients with type 2 diabetes.
Abstract: Several epidemiological studies have shown that chronic inflammation plays a central role in the pathogenesis of diabetes and its various complications. Neutrophil-lymphocyte ratio (NLR) is a novel potential marker in determining inflammation. The aim of this study was to evaluate the relationship between diabetic microvascular complications, namel...
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Clinical and Social Concerns in Treated Patients with Primary Hypothyroidism in Basrah: A Cross Sectional Study
Haider Ayad Alidrisi,
Alaa Khattar Musa,
Abbas Ali Mansour
Issue:
Volume 3, Issue 6, November 2015
Pages:
256-263
Received:
21 October 2015
Accepted:
2 November 2015
Published:
30 December 2015
Abstract: Background: Despite available treatment for hypothyroidism, L-thyroxine replacement therapy in a biochemically appropriate dose does not necessarily relieve patients' symptoms and complaints. The aim of the study was to evaluate the concerns of patients treated with hypothyroidism and to correlate these concerns with different patient characteristics and thyroid biochemical control. Subjects and Methods: one hundred eighteen treated primary hypothyroid patients attending Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC) in Al-Basrah were entering a questionnaire designed to capture personal, anthropometric, biochemical and clinical data. Twenty-four concerns were questioned to the patients who score these concerns on a 4 point Likert scale. Results: The most scored patients' concerns were fatigue, neuropathic pain, lack of weight loss, cold intolerance, breathing problems, and swallowing problems. No statistically significant relations were existed between these concerns and thyroid stimulating hormone (TSH) control, except for a high TSH group which were highly likely to have concerns of feeling sick (OR: 0.27, 95%CI 0.54 to 2.0, p=0.001), neuropathic pain (OR: 0.4, 95%CI 0.17 to 1.6, p=0. 01), cold intolerance (OR: 0.35, 95%CI 0. 0.3 to 1.7, p=0.005), and hair problems (OR: 0.26, 95%CI 0.6 to 2.1, P<0.0001). A significant correlation existed between duration of the hypothyroidism and patients' concerns of swelling of the hands and feet (R=0.7 P<0.0001), memory problems (R=0.4 P<0.0001), hearing disturbance (R=0. 38 P<0.0001), and hair problems (R=0. 3 P=0.001). Age significantly affects patients' concerns of memory problems (R=0. 6 P<0.0001), swelling of the hands and feet (R=0.4 P<0.0001), and hearing disturbance (R=0.37 P<0.0001). Positive correlation was present between low density lipoprotein cholesterol level and patients' concerns of cold intolerance (R=0.3 P=0.001), hair problems (R=0. 28 P=0.003), feeling sick (R=0. 2 P=0. 02), and neuropathic pain (R=0.18 P=0.04). The total cholesterol level also showed a positive correlation with patients' concerns of cold intolerance (R=0.3 P=0.001), hair problems (R=0. 25 P=0.01), neuropathic pain (R=0. 22 P=0. 01), and fatigue (R=0. 2 P=0.04). Conclusion: We cannot rely on the TSH level alone as a marker of optimal treatment outcome in patients with primary hypothyroidism because it does not reflect the concern status of the patients.
Abstract: Background: Despite available treatment for hypothyroidism, L-thyroxine replacement therapy in a biochemically appropriate dose does not necessarily relieve patients' symptoms and complaints. The aim of the study was to evaluate the concerns of patients treated with hypothyroidism and to correlate these concerns with different patient characteristi...
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Survey of Public Attitude, Awareness and Beliefs of Organ Donation in Western Region of Saudi Arabia
Abdulrahman Soubhanneyaz,
Ahmed Kaki,
Muatasim Noorelahi
Issue:
Volume 3, Issue 6, November 2015
Pages:
264-271
Received:
21 December 2015
Accepted:
29 December 2015
Published:
8 January 2016
Abstract: Although organ transplantation is often the only preferable treatment for end-stage organ disease, there are not many organ donors in Saudi Arabia. This cross-sectional study analyzed data from 461 subjects recruited from the western region of Saudi Arabia to explore the current public awareness, attitudes and beliefs towards organ donation. The data were collected through a self-administered validated structured questionnaire. The collected data were analyzed and compared by subjects' age and sex using appropriate statistical tests with the level of statistical significance was defined as P ≤ 0.05. The mean age of the studied 461subjects was 28.3 ± 10.9 years, of them 74.0% were females and 26.0% were males. The study findings revealed that 73.5% of the studied subjects were willing to donate their organs with no significant differences between the studied males and females, although only 4.6% of them reported to have a donation card. Religion, money, and age of the recipient appeared to have no role in their willing of organ donation. The majority of the participants knew well the organ which can be donated; although 64.5% of them have no knowledge about the regulations and legislation of organ donation. The participants have also believed that governmental incentives in the form of monetary and health treatment for donor family and awards would be effective in promoting organ donation in the country. A considerable proportion of respondents in this study were willing to donate their organs, in which religion and financial reasons were not factors. The observed low level of knowledge about regulations and legislations necessitates more efforts to spread awareness about such important issues. Future representative national studies are needed before any generalization can be assumed.
Abstract: Although organ transplantation is often the only preferable treatment for end-stage organ disease, there are not many organ donors in Saudi Arabia. This cross-sectional study analyzed data from 461 subjects recruited from the western region of Saudi Arabia to explore the current public awareness, attitudes and beliefs towards organ donation. The da...
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