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Mousa N, Abdel-Razik A, Sheta T, G Deiab A, Habib A, Diasty M, Eldesoky A, Taha A, Mousa E, Yassen A, Fathy A, Elgamal A. Endoscopic management of acute oesophageal variceal bleeding within 12 hours of admission is superior to 12-24 hours. Br J Biomed Sci 2021; 78:130-134. [PMID: 33305686 DOI: 10.1080/09674845.2020.1857049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Acute oesophageal variceal haemorrhage (AOVH) is a medical emergency. The American Association for the Study of Liver Diseases recommends endoscopy management as soon as possible and not more than 12 hours after presentation. The United Kingdom guidelines recommended endoscopy for unstable patients with severe acute upper gastrointestinal bleeding immediately after resuscitation and within 24 hours of admission. We aimed to evaluate the outcome of endoscopic management of AOVH in less than 12 hours compared to 12-24 hours post admission.Methods: 297 patients with AOVH were divided into groups depending on the timing of the endoscopic management: 180 within 12 h of admission and 117 patients at 12-24 hours of admission. Routine clinical and laboratory data were collected.Results: Compared to patients with endoscopic management at 12-24 hours (mean 16 hours), patients with endoscopic management within 12 hours (mean 8.3 hours) of admission had fewer hospital stay days (P = 0.001), significant reduction of ammonia levels (P < 0.0001) and significant improvement in associated hepatic encephalopathy grade 25 (p = 0.048). There were no major clinical events in the 12-hour group, but 8 events in the 12-24 hour group (p < 0.01).Conclusion: Endoscopic management of acute variceal bleeding within 12 hours of admission is superior to endoscopic management at 12-24 hours of admission regarding reduction of hospital stay, ammonia levels, correction of hepatic encephalopathy, re-bleeding and mortality rate, hence, reducing the cost of treatment benefiting patient satisfaction and improving hospital bed availability.
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Affiliation(s)
- N Mousa
- Tropical Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A Abdel-Razik
- Tropical Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - T Sheta
- Internal Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A G Deiab
- Internal Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A Habib
- Internal Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - M Diasty
- Tropical Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A Eldesoky
- Internal Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A Taha
- Faculty of Medicine, October 6 University, Giza, Egypt
| | - E Mousa
- Faculty of Dentistry, Mansoura University, Al Mansurah, Egypt
| | - A Yassen
- Tropical Medicine Department, Mansoura University, Al Mansurah, Egypt
| | - A Fathy
- Public Health and Community Medicine, Mansoura University, Al Mansurah, Egypt
| | - A Elgamal
- Department of Tropical Medicine, Menoufia University, Menoufia, Egypt
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Al-Sabagh A, Abdou M, Migahed M, Fadl A, Farag AA, Mohammedy M, Abd-Elwanees S, Deiab A. Influence of ilmenite ore particles as pigment on the anticorrosion and mechanical performance properties of polyamine cured epoxy for internal coating of gas transmission pipelines. Egyptian Journal of Petroleum 2018; 27:427-436. [DOI: 10.1016/j.ejpe.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Mousa N, Abdel-Razik A, Sheta T, Shabana W, Zakaria S, Awad M, Abd Elsalam M, El-Wakeel N, Elkashef W, Effat N, Elgamal A, Deiab AG, Eldars W. Serum leptin and homeostasis model assessment-IR as novel predictors of early liver fibrosis in chronic hepatitis B virus infection. Br J Biomed Sci 2018; 75:192-196. [PMID: 30079841 DOI: 10.1080/09674845.2018.1505187] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The relationship between hepatitis B virus (HBV) infection, leptin and insulin resistance remains unclear. We hypothesised links between serum leptin and insulin resistance in non-diabetic patients with chronic viral hepatitis B infection and their relation to liver fibrosis. METHODS We recruited 190 untreated patients with chronic HBV infection and 72 healthy controls. Serum leptin, fasting glucose, insulin, liver function tests (LFTs), C-peptide and Homeostasis model assessment-IR (HOMA-IR) were measured/calculated by ELISA and standard techniques. RESULTS Serum leptin, C-peptide (both P < 0.001), HOMA-IR (P = 0.021) and several LFTs were increased in patients with chronic HBV-infection. In multivariate regression analysis, both HOMA-IR (P = 0.003) and leptin (P = 0.002) were significant independent predictors of HBV infection. There were significant positive correlations (P < 0.01) between leptin and HOMA-IR (r = 0.81), between serum leptin and METAVIR activity (r = 0.95), and between HOMA-IR and BMI (r = 0.75), fasting glucose (r = 0.005), and fasting insulin (r = 0.81). Several LFTs, glucose and insulin correlated modestly (r = 0.61-0.69, P < 0.05) with leptin. CONCLUSION Serum leptin may be related to the rate of fibrosis progression in nondiabetic patients with chronic HBV infection. Follow-up by serial measurement of serum leptin and HOMA-IR in non diabetic HBV-infected patients may be used as a non-invasive marker of early liver fibrosis.
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Affiliation(s)
- N Mousa
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - A Abdel-Razik
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - T Sheta
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - W Shabana
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - S Zakaria
- a Department of Tropical Medicine , Mansoura University , Mansoura , Egypt
| | - M Awad
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - M Abd Elsalam
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - N El-Wakeel
- c Department of Medical Microbiology and Immunology , Mansoura University , Mansoura , Egypt
| | - W Elkashef
- d Department of Pathology , Mansoura University , Mansoura , Egypt
| | - N Effat
- e Clinical Pathology Department , Mansoura University , Mansoura , Egypt
| | - A Elgamal
- f Department of Tropical Medicine , Menoufia University , Mansoura , Egypt
| | - A G Deiab
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - W Eldars
- c Department of Medical Microbiology and Immunology , Mansoura University , Mansoura , Egypt
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Al-Sabagh A, Abdou M, Migahed M, Abd-Elwanees S, Fadl A, Deiab A. Investigations using potentiodynamic polarization measurements, cure durability, ultra violet immovability and abrasion resistance of polyamine cured ilmenite epoxy coating for oil and gas storage steel tanks in petroleum sector. Egyptian Journal of Petroleum 2018; 27:415-425. [DOI: 10.1016/j.ejpe.2017.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Mousa N, Abdel-Razik A, Shams M, Sheta T, Zakaria S, Shabana W, Effat N, El-Diasty M, Abed S, Abd Elsalam M, Awad M, Salah M, El-Wakeel N, Deiab AG, Eldars W. Impact of non-alcoholic fatty liver disease on pregnancy. Br J Biomed Sci 2018; 75:197-199. [PMID: 29943682 DOI: 10.1080/09674845.2018.1492205] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- N Mousa
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - A Abdel-Razik
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - M Shams
- Gynecology and Obstetrics Department, Mansoura University, Mansoura, Egypt
| | - T Sheta
- Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - S Zakaria
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - W Shabana
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - N Effat
- Clinical Pathology Department, Mansoura University, Mansoura, Egypt
| | - M El-Diasty
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - S Abed
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - M Abd Elsalam
- Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - M Awad
- Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - M Salah
- Tropical Medicine Department, Mansoura University, Mansoura, Egypt
| | - N El-Wakeel
- Medical Microbiology and Immunology Department, Mansoura University, Mansoura, Egypt
| | - AG Deiab
- Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - W Eldars
- Medical Microbiology and Immunology Department, Mansoura University, Mansoura, Egypt
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Mousa N, Besheer T, Abdel-Razik A, Hamed M, Deiab AG, Sheta T, Eldars W. Can combined blood neutrophil to lymphocyte ratio and C-reactive protein be used for diagnosis of spontaneous bacterial peritonitis? Br J Biomed Sci 2018; 75:71-75. [PMID: 29452544 DOI: 10.1080/09674845.2017.1396706] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Spontaneous bacterial peritonitis (SBP) is diagnosed by the presence of ≥250 polymorphonuclear neutrophils (PMN)/mm3 in the ascites and the absence of surgically treatable cause of intra-abdominal infection. Blood neutrophil lymphocytic ratio (NLR) is an inexpensive and simple test for inflammation. C-reactive protein (CRP) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of combined blood NLR and CRP as a non-invasive test for SBP diagnosis. METHODS Blood NLR was calculated, and CRP value determined in 180 cirrhotic patients with ascites (126 with and 54 without SBP). Sensitivity and specificity of combined blood NLR and CRP values for SBP diagnosis were estimated by receiver operator characteristic curve. RESULTS Both blood NLR and CRP values were significantly higher in SBP (p < 0.001). For SBP diagnosis, a blood NLR of >2.89 had a sensitivity 80.3% and specificity 88.9%. CRP >11.3 mg/dL had a sensitivity 88.9% and specificity 92.6%. In logistic regression analysis, combined blood NLR and CRP had a sensitivity 95.1% and specificity 96.3% at the same cut off values. CONCLUSIONS Combined NLR and CRP could be used as a novel, simple, low-cost, non-invasive test for SBP diagnosis.
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Affiliation(s)
- N Mousa
- a Tropical Medicine Department , Mansoura University , Mansoura , Egypt
| | - T Besheer
- a Tropical Medicine Department , Mansoura University , Mansoura , Egypt
| | - A Abdel-Razik
- a Tropical Medicine Department , Mansoura University , Mansoura , Egypt
| | - M Hamed
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - A G Deiab
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - T Sheta
- b Internal Medicine Department , Mansoura University , Mansoura , Egypt
| | - W Eldars
- c Faculty of Medicine, Medical Microbiology and Immunology Department , Mansoura University , Mansoura , Egypt
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