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  • 1
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    Real‐world safety and effectiveness of retreatment of Egyptian chronic hepatitis C patients not responding to NS5A inhibitor‐based therapies
    Wiley ; 2020
    In:  Journal of Viral Hepatitis Vol. 27, No. 11 ( 2020-11), p. 1190-1201
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 27, No. 11 ( 2020-11), p. 1190-1201
    Abstract: The aim of this study was to assess the efficacy and safety of two protocols for retreatment of a cohort of Egyptian patients with chronic hepatitis C (CHC) who relapsed after NS5A inhibitor‐based therapy. We conducted a prospective cohort study to assess the safety and efficacy of 12 weeks’ retreatment with either combination of sofosbuvir/daclatasvir/simeprevir plus ribavirin (SOF/DCV/SMV/RBV, n = 45) or sofosbuvir/ombitasvir/paritaprevir/ritonavir plus ribavirin (SOF/OBV/PTV/r/RBV, n = 163) in patients who had previously failed NS5A inhibitors‐based regimens. The primary end point was SVR 12 weeks after the end of treatment (SVR12). Safety follow‐up data were recorded for 60 weeks after the end of treatment. Two hundred‐eight patients were included in the study. Of them, 53.4% of patients were females and 40.4% had liver cirrhosis. The most common prior drug combinations were sofosbuvir/daclatasvir (n = 94) and sofosbuvir/daclatasvir plus ribavirin (n = 109). The overall SVR12 rates were 98.1%. In SOF/DCV/SMV/RBV group, 95.6% achieved SVR12, while in SOF/OBV/PTV/r/RBV group, the SVR12 rates were 98.8%. SVR12 was higher in cirrhotic patients (84/84) than noncirrhotic (120/124), P value = .0149. Regarding the safety outcomes, anaemia and fatigue were significantly higher in SOF/OBV/PTV/r/RBV group. Hepatocellular carcinoma (HCC) was reported in eight (3.8%) patients (four in each group). Of them, death was confirmed in four patients. Retreatment of Egyptian CHC relapsed patients with either sofosbuvir/daclatasvir/simeprevir plus ribavirin or sofosbuvir/ombitasvir/paritaprevir/ritonavir plus ribavirin is highly effective and well‐tolerated for both noncirrhotic and compensated cirrhotic patients. Incidental de novo HCC and hepatic decompensation are comparable in the two groups.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v27.11
    DOI: 10.1111/jvh.13349
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2007924-2
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  • 2
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    Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett’s Esophagus and Related Superficial Lesions
    Hindawi Limited ; 2015
    In:  International Scholarly Research Notices Vol. 2015 ( 2015-01-29), p. 1-6
    Details
    In: International Scholarly Research Notices, Hindawi Limited, Vol. 2015 ( 2015-01-29), p. 1-6
    Abstract: Background . Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective . The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods . A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75 ± 13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results . Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa = 0.43 , 95% CI: 0.170–0.69). Conclusions . Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients.
    Type of Medium: Online Resource
    ISSN: 2356-7872
    URL: Article
    DOI: 10.1155/2015/735807
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2015
    detail.hit.zdb_id: 2778458-7
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  • 3
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    Outcome predictors of intravenous thrombolytic therapy in acute ischemic stroke patients: an Egyptian center experiences
    Springer Science and Business Media LLC ; 2020
    In:  The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Vol. 56, No. 1 ( 2020-12)
    Details
    In: The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Springer Science and Business Media LLC, Vol. 56, No. 1 ( 2020-12)
    Abstract: Intravenous thrombolytic therapy remains the guideline-recommended treatment to improve outcomes after acute ischemic stroke. However, the functional outcome among patients with acute ischemic stroke after receiving intravenous thrombolytic therapy is influenced by huge variety of factors, and this was the aim of our study to evaluate the outcome predictors of intravenous thrombolytic therapy in a sample of Egyptian patients with acute ischemic stroke. Methods We enrolled 183 acute ischemic stroke patients who were treated with intravenous recombinant tissue plasminogen activator (IV rtPA) according to the last updated guidelines of American Heart Association and American Stroke Association (AHA/ASA) from February 2018 to February 2020; however, only 150 patients of them completed our study plan till the end. Data of study variables were collected, analyzed statistically and correlated with the functional outcome 3 months after receiving IV rtPA using the modified Rankin Scale (mRS). Results Good functional outcome was seen in 98 (65.3%) patients and poor functional outcome was seen in 52 (34.7%) patients. Multivariate analysis of the study variables was done to detect the significant independent predictors of the functional outcome. Atrial fibrillation (AF) ( P value 〈 0.001 * OR 6.28 * (95% C.I)), hypertension ( P value 0.001 * OR 3.65 * (95% C.I)), diabetes mellitus (DM) ( P value 0.009 * OR 2.805 * (95% C.I)), increased National Institute of Health Stroke Scale (NIHSS) score 24 h after receiving IV rtPA ( P value 0.003 * OR 8.039 * (95% C.I)), increased pulsatility index (PI) value in cerebral vessels at the same side of stroke lesion ( P value 0.038 * OR 42.48 * (95% C.I)) were the significant independent predictors of poor functional outcome. On the other hand decreased NIHSS score 24 h after receiving IV rtPA ( P value 0.003 * OR 0.124 * (95% C.I)), Normal value of PI in cerebral vessels at the same side of stroke lesion ( P value 0.038 * OR 42.48 * (95% C.I)) were the significant independent predictors of good functional outcome. Conclusion Intravenous thrombolytic therapy improves the functional outcome of acute ischemic stroke patients. Also, AF, hypertension, DM, NIHSS 24 h after receiving IV rtPA and PI could be used as independent predictors of the functional outcome.
    Type of Medium: Online Resource
    ISSN: 1687-8329
    URL: Article
    DOI: 10.1186/s41983-020-00229-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2686351-0
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  • 4
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    Do obesity and diabetes increase the frequency and risk of bile reflux gastritis post-cholecystectomy?
    Index Copernicus ; 2022
    In:  Polish Journal of Surgery Vol. 94, No. 5 ( 2022-1-14), p. 1-8
    Details
    In: Polish Journal of Surgery, Index Copernicus, Vol. 94, No. 5 ( 2022-1-14), p. 1-8
    Abstract: 〈 br 〉 〈 b 〉 Introduction: 〈 /b 〉 Biliary gastropathy is a disease characterized by upper abdominal pain, frequent heartburn, nausea, and vomiting of bile. It is caused by the backward flow of duodenal fluid into the stomach and esophagus. 〈 /br 〉 〈 br 〉 〈 b 〉 Aim: 〈 /b 〉 A retrospective cohort study was performed to estimate the prevalence and risk factors of bile reflux gastritis secondary to cholecystectomy and to evaluate the endoscopic and histopathologic changes in gastric mucosa caused by bile reflux gastritis. 〈 /br 〉 〈 br 〉 〈 b 〉 Materials and methods: 〈 /b 〉 The study involved 64 patients with epigastric pain and/or dyspeptic symptoms during the period from January 2018 to December 2020 who presented to Zagazig University Hospitals. The subjects were divided into two groups: the control group (CG), with 30 subjects who had never undergone any biliary interventions, and the post-cholecystectomy group (PCG), consisting of 34 patients who had undergone cholecystectomy. 〈 /br 〉 〈 br 〉 〈 b 〉 Results: 〈 /b 〉 The prevalence of bile reflux gastritis was 16.7% in the CG and 61.8% in the PCG. In both groups, diabetes, obesity, increased gastric bilirubin, and increased gastric pH were risk factors for bile reflux gastritis (r = 0.28, 0.48, 0.78, and 0.57, respectively). However, there were no correlations between age, sex, epigastric pain, heartburn, vomiting, and the presence of bile reflux gastritis. 〈 /br 〉 〈 br 〉 〈 b 〉 Discussion: 〈 /b 〉 Bile reflux gastritis is a common complication following cholecystectomy and is more common among obese and diabetic patients. 〈 /br 〉
    Type of Medium: Online Resource
    ISSN: 0032-373X , 2299-2847
    URL: Journal
    URL: Article
    DOI: 10.5604/0032373X
    DOI: 10.5604/01.3001.0015.6980
    Language: English
    Publisher: Index Copernicus
    Publication Date: 2022
    detail.hit.zdb_id: 2406095-1
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  • 5
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    Morbidity and mortality during hepatitis C treatment using sofosbuvir and daclatasvir with or without ribavirin, in a cohort of Egyptian patients
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  European Journal of Gastroenterology & Hepatology Vol. 32, No. 8 ( 2020-8), p. 1046-1053
    Details
    In: European Journal of Gastroenterology & Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 8 ( 2020-8), p. 1046-1053
    Abstract: Though direct-acting antiviral agents (DAAs) therapy is associated with a high cure rate of hepatitis C virus infection, a potential risk of serious adverse events (SAEs) exists. The aim of this study was to determine the incidence and predictors of morbidity and mortality related to DAAs therapy. Methods This prospective study was conducted on a real word cohort of 1562 treatment naïve chronic hepatitis C (CHC) Egyptian patients, who received 12-weeks therapy with sofosbuvir (SOF) plus daclatasvir (DCV) ± ribavirin (RBV). The incidence and predictors of SAEs and mortality during treatment course and over the following 12 weeks were recorded. Results The mean age of study participants was 51.38 ± 9.70 years (55.22%, males). Liver cirrhosis was defined in 72.4% of participants. SAEs were recorded in 120 participants (7.68%), including hepatic decompensation, gastrointestinal bleeding, anemia and hepatocellular carcinoma. Nine patients (0.58%) died and 69 patients (4.42%) discontinued therapy due to SAEs. Severity of cirrhosis was the significant predictor of morbidities and mortality. Hepatic decompensation was predicted by baseline serum albumin [cutoff value: 3.00 g/dL, area under the receiver operating characteristic curve (AUROC): 0.953] and serum bilirubin (cutoff value: 1.75 mg/dL, AUROC: 0.940). Conclusion The risk of morbidity and mortality related to SOF/DCV ± RBV therapy in CHC patients is small and is significantly linked to advanced cirrhosis.
    Type of Medium: Online Resource
    ISSN: 0954-691X
    URL: Article
    DOI: 10.1097/MEG.0000000000001695
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2030291-5
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  • 6
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    Value of Serum Growth Differentiation Factor 15 in diagnosis of Colorectal Cancer
    Egypts Presidential Specialized Council for Education and Scientific Research ; 2021
    In:  The Egyptian Journal of Hospital Medicine Vol. 85, No. 2 ( 2021-10-01), p. 3639-3644
    Details
    In: The Egyptian Journal of Hospital Medicine, Egypts Presidential Specialized Council for Education and Scientific Research, Vol. 85, No. 2 ( 2021-10-01), p. 3639-3644
    Type of Medium: Online Resource
    ISSN: 2090-7125
    URL: Article
    DOI: 10.21608/ejhm.2021.201980
    Language: English
    Publisher: Egypts Presidential Specialized Council for Education and Scientific Research
    Publication Date: 2021
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  • 7
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    Post-cholecystectomy bile reflux gastritis: Prevalence, risk factors, and clinical characteristics
    SAGE Publications ; 2023
    In:  Chronic Illness Vol. 19, No. 3 ( 2023-09), p. 529-538
    Details
    In: Chronic Illness, SAGE Publications, Vol. 19, No. 3 ( 2023-09), p. 529-538
    Abstract: Bile reflux gastritis is caused by the backward flow of duodenal fluid into the stomach. A retrospective cohort study was performed to estimate the prevalence and risk factors of bile reflux gastritis postcholecystectomy, and to evaluate the endoscopic and histopathologic changes in gastric mucosa. Methods Patients with refractory upper abdominal pain right below the ribs with symptoms of bloating, burping, nausea, vomiting, and bile regurgitation during the period from January 2018 to December 2020, submitted to Zagazig University Hospitals were enrolled in this study. The studied 64 patients were divided into two groups; the control group (CG): 30 subjects who had never undergone any biliary interventions, and the post-cholecystectomy group (PCG): 34 patients who had undergone cholecystectomy. Results The prevalence of bile reflux gastritis was (16.7%) and (61.8%) in CG and PCG, respectively. Diabetes, obesity, elevated gastric bilirubin, and elevated stomach pH were all risk factors for bile reflux gastritis in both groups ( r  =  .28,.48,.78,.57 respectively) . Age, sex, epigastric pain, heartburn, vomiting, and the existence of bile reflux gastritis, on the other hand, had no correlation. Discussion After a cholecystectomy, bile reflux gastritis is prevalent, especially among obese and diabetic patients.
    Type of Medium: Online Resource
    ISSN: 1742-3953 , 1745-9206
    URL: Article
    DOI: 10.1177/17423953221097440
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2183572-X
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  • 8
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    A novel serum index for accurate diagnosis of spontaneous bacterial peritonitis in cirrhotic patients without other infections
    Springer Science and Business Media LLC ; 2020
    In:  Egyptian Liver Journal Vol. 10, No. 1 ( 2020-12)
    Details
    In: Egyptian Liver Journal, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-12)
    Abstract: The accurate non-invasive diagnosis of spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis has not been achieved yet. The aim of the study was to obtain an unmistakable diagnosis of SBP using a new simple serum bioscore, made by combined measurement of procalcitonin (PCT), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), which we called the PEC index. This cross-sectional analytic study comprised 178 cirrhotic patients with ascites (60 patients with SBP and 118 patients with sterile ascites), after excluding non-SBP infection, during the period from March 2019 until September 2019. In all participants, serum levels of PCT, ESR, and CRP were measured, and PEC index was calculated [PEC index = PCT × (ESR + CRP)]. Results Patients with SBP ( n = 60) had significantly higher serum PEC index than those with sterile ascites ( n = 118) (41.0/31.2–93.0 vs. 9.9/5.9–15.0, P 〈 0.001). PEC index distinguished culture positive cases significantly ( P 〈 0.001). Using receiver operating characteristic (ROC) statistics, the sensitivity and specificity of PCT, at a cutoff value of 0.590 ng/mL, for SBP diagnosis, were 81.67% and 93.33%, respectively (area under the curve [AUC] = 0.879; 95% confidence interval [CI] 0.809–0.948). The sensitivity and specificity of ESR, at a cutoff value of 27.0 mm/hour, were 73.33% and 61.67%, respectively (AUC = 0.679; 95% CI 0.581–0.776). The sensitivity and specificity of CRP, at a cutoff value of 21.0 mg/L, were 93.33% and 51.67%, respectively (AUC = 0.736; 95% CI 0.639–0.833). While, the sensitivity and specificity of PEC index, at a cutoff value of 20, were highest (98.33% and 96.67%, respectively, AUC = 0.977; 95% CI 0.940–0.996). Conclusion Serum PEC index makes an accurate noninvasive diagnosis of SBP, after excluding other infections.
    Type of Medium: Online Resource
    ISSN: 2090-6226
    URL: Article
    DOI: 10.1186/s43066-020-0021-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
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  • 9
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    Bile reflux gastropathy: Prevalence and risk factors after therapeutic biliary interventions: A retrospective cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Annals of Medicine and Surgery Vol. 72 ( 2021-12), p. 103168-
    Details
    In: Annals of Medicine and Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 72 ( 2021-12), p. 103168-
    Type of Medium: Online Resource
    ISSN: 2049-0801
    URL: Article
    DOI: 10.1016/j.amsu.2021.103168
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2745440-X
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  • 10
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    High-Dose Dual Therapy versus Triple Therapy for Treatment of H. Pylori Infection: A Parallel Randomized Study
    GP Innovations Pvt. Ltd. ; 2020
    In:  International Journal of Research in Pharmaceutical Sciences Vol. 11, No. SPL4 ( 2020-12-21), p. 2158-2164
    Details
    In: International Journal of Research in Pharmaceutical Sciences, GP Innovations Pvt. Ltd., Vol. 11, No. SPL4 ( 2020-12-21), p. 2158-2164
    Abstract: The prevalence of antibiotic resistance has considerably increased and as a result, the elimination pace of Helicobacter pylori (H.pylori) infection have decreased significantly to an unacceptable level. High dose dual therapy (HDDT) has been suggested as an alternative to standard triple therapy (TT) for the first-line treatment of H. pylori infection. The aim of the present work was to compare the effectiveness and tolerability of HDDT with standard TT, for treatment of H. pylori infection. This randomized parallel interventional study was carried out on 130 treatment naïve H. pylori infected patients, selected from outpatient clinic of Hepatology and Gastroenterology department of Zagazig University Hospitals, in the duration between November 2017 and December 2018. All patients were H. pylori positive as was evidenced by stool antigen test. Patients were divided into two groups; group A (n=65) received a 14-day HDDT (esomeprazole 40 mg twice daily and amoxicillin 1 g three times daily) whereas group B (n=65) received a 14-day TT (esomeprazole 20 mg, amoxicillin 1 g and clarithromycin 500 mg, each administered twice daily). Eradication rates, side effects and drug compliance were compared among both groups. The eradication rate between the two regimens was not significantly different. The eradication rates were 80% for TT and 72.3% for HDDT (P= 0.3). No significant differences were observed between both groups regarding the side effects or patient adherence. HDDT is as effective and safe as TT as empiric first-line therapy for H pylori infection.
    Type of Medium: Online Resource
    ISSN: 0975-7538
    URL: Issue
    URL: Article
    DOI: 10.26452/ijrps.v11iSPL4
    DOI: 10.26452/ijrps.v11iSPL4.4437
    Language: Unknown
    Publisher: GP Innovations Pvt. Ltd.
    Publication Date: 2020
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