scholarly journals Fibrin Monomer in Chronic HCV ‎Cirrhotic Patients

2021 ◽  
pp. 260-269
Author(s):  
B. B. CH. Eman Ram ◽  
M. A. M. D. Sherief ◽  
S. M‎. Wesam ◽  
K. Z. Mohammed
Keyword(s):  
Portal Hypertension ◽  
Early Detection ◽  
Thrombus Formation ◽  
Clinical Pathology ◽  
Control Group ◽  
University Hospitals ◽  
Early Management ◽  
Fibrin Monomer ◽  
Cirrhotic Patients ◽  
Chronic Hcv

Background: Cirrhosis is a diffuse pathophysiological state of the liver that is thought to be the final stage of various liver injuries. It is characterized by chronic necroinflammatory and fibrogenetic processes, which result in the conversion of normal liver architecture into structurally abnormal nodules, dense fibrotic septa, concomitant parenchymal exaustment, and liver tissue collapse. Aim of this Work is to study fibrin monomer in chronic HCV patients with and without portal hypertension aiming to investigate its value in these patients and if it aides in early detection of thrombus formation.‎ Patients and Methods: They were fifty chronic HCV cirrhotic patients with and ‎without portal hypertension. Patients of these study were selected from Tropical and internal medicine departments and investigated at Clinical Pathology department in Tanta University hospitals, Faculty of Medicine, Tanta University during the period from July 2018 to January 2020. Results: The individuals included in this study were comprised as: Group 1: Twenty-five healthy volunteers (matched for age and gender) were investigated as a control group. Group 2: Twenty-five diagnosed cirrhotic patients without portal hypertension. Group 3: Twenty-five diagnosed cirrhotic patients with portal hypertension. The result of the present study was statistically analyzed, summarized and presented in tables. Conclusion: It may be concluded that soluble fibrin monomer complex could represent a useful marker ‎for early detection of thrombus generation in chronic HCV cirrhotic patients. It may enable ‎us to pick up vulnerable patients in early stages to start early management.

scholarly journals Elevated mean platelet volume is a marker of acute coronary syndrome

2014 ◽  
Vol 42 (2) ◽  
pp. 45-50 ◽  
Author(s):  
S Pervin ◽  
S Ferdoushi ◽  
M Hossain ◽  
AI Joarder ◽  
T Sultana
Keyword(s):  
Acute Coronary Syndrome ◽  
Early Detection ◽  
Troponin I ◽  
Thrombus Formation ◽  
Clinical Pathology ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Cardiac Biomarkers ◽  
Coronary Syndrome ◽  
Anti Platelet Therapy

Acute coronary syndrome (ACS) is a set of signs and symptoms due to rupture of a plaque and are a consequence of platelet rich coronary thrombus formation. Platelet parameters especially MPV could be an important and reliable markers in early detection of ACS when other markers are not available. This quasi- experimental study was conducted from September 2011 to August 2012 in the Department of Clinical Pathology, BSMMU, in collaboration with Department of Cardiology, BSMMU and BIRDEM on 79 patients with ACS diagnosed on the basis of clinical history, Electrocardiographic changes and increased cardiac markers especially troponin I with 63 subjects enrolled as control. For determination of platelet parameters, the blood sample was obtained from all patients of ACS before anti-platelet therapy when patient attended in the Cardiac emergency department and on 5th day of ongoing anti-platelet therapy in coronary care unit. The sensitivity, specificity, accuracy, positive and negative predictive value of platelet counts and MPV were 83%, 28.1%, 42.3%, 37.6%, 64% and 90.6%, 49.4%, 64.8%, 51.6%, 89.8% respectively. In our study, we found that MPV had higher sensitivity and specificity in contrast to platelet count. MPV may used as predictor for early detection of ACS and risk stratification when other cardiac biomarkers are negative. DOI: http://dx.doi.org/10.3329/bmj.v42i2.18985 Bangladesh Med J. 2013 May; 42 (2): 45-50

scholarly journals Effect of Using Direct Acting Anti-Virals In Treatment of HCV Naive Patient with and without Portal Hypertension

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K Z Alkarmouty ◽  
E S Mohamed ◽  
H A Fahim ◽  
A R E A Elsabagh
Keyword(s):  
Portal Hypertension ◽  
Hcv Infection ◽  
Control Group ◽  
P Value ◽  
Direct Acting Antivirals ◽  
Naive Patient ◽  
Genotype 4 ◽  
Group I ◽  
Cirrhotic Patients ◽  
Direct Acting

Abstract Background Hepatitis C Virus (HCV) infection is a major global health challenge; it is estimated that more than 80 million people are chronically infected worldwide. Egypt has the highest prevalence of HCV in the world (predominantly genotype 4) secondary to the previous schistosomiasis eradication campaigns with very high incidence rates among elderly, rural areas and in lower social classes. However, several oral anti-HCV drugs (direct acting antivirals; DAAs) have been developed over the last several years. Now, HCV can be eliminated from the infected host within 12 wk of DAA combination therapy without noticeable side effects Aims: to evaluate the Effect of presence of portal hypertension on the results of treatment of chronic HCV infected naive patient with direct acting antivirals Patients and Methods 200 subjects were divided into 2 groups: group I: including 100 cirrhotic patients with HCV infection and portal hypertension, group II: including 100 cirrhotic patients with HCV infection without portal hypertension. Diagnosis of portal hypertension was confirmed by presence of esophageal varices in endoscopy. Both group received combination of IFN-free DAAs. Results CK-18 was significantly elevated in patients of group I in comparison to group 11, with mean ± SD: 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value: 0.001. with mean ±SD: 59.6± 28, when compared with control group (with 23±8) P value < 0.001. ROC curve between Cases and Control as regards CK18 with Area Under the Curve (AUC): 0.925. Cutoff > 30 ug/l With Sensitivity: 86.67% & Specificity: 83.33%. Ck-18 was found to be correlated with steatosis and fibrosis assessed by fibroscan with P value< 0.001. Conclusion treatment of 200 patients with HCV and compensated cirrhosis, HCV eradication reduced risk for liver decompensation, regardless of whether the patients had EVs.

scholarly journals In Egyptian Patients with Hepatocellular Carcinoma the role of MicroRNA-215

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S136-S137
Author(s):  
H A Ali
Keyword(s):  
Real Time ◽  
Hcv Infection ◽  
Control Group ◽  
Hcv Rna ◽  
Group I ◽  
Significant Difference ◽  
Hcv Antibody ◽  
Cirrhotic Patients ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

Abstract Introduction/Objective MicroRNAs (miRNAs) are a class of evolutionarily conserved small non-coding RNAs which are make a contribution in the regulation of gene expression and protein translation, and they play vital roles in differentiation, cell growth, and the development of diverse types of cancers. Methods/Case Report Our research was done in hepatology and gastroenterology department at the National Liver Institute, Menoufia University. It included 135 patients and 60 healthy subjects serving as control group. We have 3 groups: Group I (Control) This group included 60 apparently healthy individuals. They were 32 males and 28 females, whose ages ranged from 39 to 67 years old (mean ±SD= 51.67 ± 6.40 years). Group II (Cirrhosis) This group included 75 patients with liver cirrhosis due to chronic HCV infection. They were 41 males and 34 females whose ages ranged from 41 to 68 years old (mean ±SD= 54±6.73 years). Group III (HCC) Sixty patients with HCC were included. They were 35 males and 25 females, whose ages ranged from 41 to 70 years old (mean ±SD= 53.97±6.15 years). Laboratory Investigations Complete blood count (CBC), Liver tests: aspartate transaminase (AST) and alanine transaminase (ALT), serum albumin, total and direct bilirubin, alkaline phosphatase and INR were measured. Serum creatinine was also measured. The analysis of serum alpha fetoprotein (AFP) (ng/ml) was done. Chronic HCV infection was diagnosed by detection of HCV antibody and HCV RNA by real time PCR. Anti-HCV antibody was detected by means of a third generation enzyme immunoassay. Quantification of HCV RNA level was performed by means of COBAS Taqman 84 (Roche) real time HCV RNA Assay with lower detection limit 15 IU/ml. Results (if a Case Study enter NA) In control group, miRNA-215 ranged from 1.60 to 21.30 with a median value of 6.89. In cirrhotic patients group, it ranged from 0.70 to 14.65 with a median value of 2.85. In patients with HCC group, it ranged from 0.03 to 10.95 with a median value of 0.52 (pg/ml). MiRNA-215 and AFA mean levels showed a statistically significant difference (p <0.001) between the three studied groups. Conclusion In conclusion, MicroRNA-215 was proved to be significantly lower in HCC patients compared to cirrhotic patients and control group. This marker might be used as a potential serologic marker for HCC and a complementary diagnostic tool in monitoring cirrhotic patients for detection of HCC.

scholarly journals Urinary Biomarkers of Acute Kidney Injury in Patients with Liver Cirrhosis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Anass Ahmed Qasem ◽  
Salama Elsayed Farag ◽  
Emad Hamed ◽  
Mohamed Emara ◽  
Ahmed Bihery ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Impairment ◽  
Kidney Injury ◽  
Urinary Ngal ◽  
University Hospitals ◽  
Early Management ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Tubular Necrosis ◽  
Improve Risk Stratification ◽  
Cirrhotic Patients

Acute kidney injury (AKI) is a common complication in cirrhotic patients. Serum creatinine is a poor biomarker for detection of renal impairment in cirrhotic patients. This study aimed to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary interleukin-18 (IL-18) as early biomarkers of acute kidney injury in cirrhotic patients. 160 patients with cirrhosis admitted to the Liver Units at Zagazig University Hospitals were classified into three groups: (I) nonascitic patients, (II) ascitic patients without renal impairment, and (III) ascitic patients with renal impairment. Patients with renal impairment were further divided into four subgroups: [A] prerenal azotemia, [B] chronic kidney disease (CKD), [C] hepatorenal syndrome (HRS), and [D] acute tubular necrosis (ATN). Significant elevation of both urinary NGAL and urinary IL-18 in cirrhotic patients with renal impairment especially in patients with ATN was observed. Urinary NGAL and urinary IL-18 have the ability to differentiate between AKI types in patients with cirrhosis. This could improve risk stratification for patients admitted to the hospital with cirrhosis, perhaps leading to early ICU admission, transplant evaluation, and prompt initiation of HRS therapy and early management of AKI.

scholarly journals The role of ultrasonography in the evaluation of portal hemodynamics in healthy adults and pathologic conditions

2016 ◽  
Vol 22 (2) ◽  
pp. 128-134 ◽  
Author(s):  
C. Anda Achim ◽  
P. Bordei ◽  
E. Dumitru
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Esophageal Varices ◽  
Healthy Subjects ◽  
Portal Blood Flow ◽  
Control Group ◽  
Portal Hemodynamics ◽  
Cirrhotic Patients

AbstractIntroduction: Portal hypertension results from increased resistance to the portal blood flow. The ultrasound represents a noninvasive tool for assessing the structural and hemodynamic abnormalities in this condition.Objectives: The assessment of the hemodynamic blood flow of the liver and spleen by using Doppler ultrasound in patients with portal hypertension compared with healthy subjects and to identify correlations with the severity of liver cirrhosis and esophageal varices.Materials and Method: This study included 50 patients with liver cirrhosis and 20 healthy subjects as controls. Different correlations were carried out between hemodynamic variables obtained from the Doppler examination and the severity of cirrhosis as assessed by the Child score and the degree of esophageal varices at endoscopy.Results: The portal vein diameter was larger in cirrhotic patients compared with the control group. The mean portal vein velocity and the blood flow were significantly lower in advanced forms of liver cirrhosis. The portal vein congestion index, the pulsatility and resistivity indexes of the hepatic artery were significantly increased in patients with CHILD B and C cirrhosis compared with the control group and patients in CHILD class A. There were no statistically significant differences between the pulsatility and resistivity indexes of the splenic artery in patients with cirrhosis. The liver vascular index was significantly lower in patients with advanced cirrhosis.Conclusions: The ultrasound is a valuable noninvasive tool for cirrhotic patients with portal hypertension. However, it is not sufficiently accurate in differentiating between different classes of cirrhosis or degrees of esophageal varices.

scholarly journals Correlation Of Portal Vein Pulsatility Pattern And Severity Of Liver Disease In Patients With Cirrhosis And Portal Hypertension

2013 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Anish Subedee ◽  
Benu Lohani ◽  
Shashi Sharma
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Portal Vein ◽  
Pulsatility Index ◽  
Study Groups ◽  
Control Group ◽  
Pulsatility Pattern ◽  
Cirrhotic Patients ◽  
The Difference ◽  
Cirrhotic Group

Objective: To correlate the portal vein pulsatility pattern with severity of liver disease in patients with cirrhosis of liver and portal hypertension. Subjects and methods: Doppler signals from the main portal vein of 36 healthy adults and 52 cirrhotic patients with portal hypertension were studied. Severity of liver disease was graded using modified Child-Pugh classification. Pulsatility of portal flow was quantified using portal venous pulsatility index and complete spectral widening was defined as absence of window below the wave base. The Doppler findings were correlated between the study groups. Results: The mean pulsatility index value in control group was 0.37+0.10 and in cirrhotic patients was 0.17+0.03 (Child A- 0.21+0.02, Child B- 0.18+0.02, Child C- 0.14+0.03). The difference between control and cirrhosis group, as well as the difference within different Child classes were statistically significant (P<0.05). None of the patients in control group had complete spectral widening while 76.92% of cirrhotic patients had complete spectral widening (28.5% of Child A, 66.6% of Child B and 100% of Child C). The difference in distribution of complete spectral widening between control and cirrhotic group as well as within the cirrhotic group was statistically significant (P<0.05). Conclusion: Portal vein pulsatility index and spectral widening can reflect the early hemodynamic changes in cirrhotic patients. These changes become more pronounced with increasing severity of liver disease. Journal of Nobel Medical College Vol. 2, No.1 Issue 3 Nov.-April 2013 Page 1-8 DOI: http://dx.doi.org/10.3126/jonmc.v2i1.7664

On the Early Detection of Intravascular Coagulation

1972 ◽  
Vol 27 (03) ◽  
pp. 365-376 ◽  
Author(s):  
G Fedder ◽  
Elisabeth M. Prakke ◽  
J Vreeken
Keyword(s):  
Early Detection ◽  
Clinical Medicine ◽  
Blood Platelets ◽  
Factor V ◽  
Intravascular Coagulation ◽  
Fibrin Monomer ◽  
Gelation Test

SummarySince the conception of intravascular coagulation has been introduced in clinical medicine, the interest of clinicians in the early detection of this syndrome is continuously increasing. Therefore small amounts of thrombin and thromboplastin were infused into rabbits and special parameters, such as presence of an activated form of factor V and occurrence of a positive fibrin monomer test, were checked. As it turned out, activation of factor V (proaccelerin, accelerator globulin or AcG) was an earlier sign of intravascular coagulation than the appearance of a positive gelation test, which may occur without changes in fibrinogen or the number of blood platelets. These experiments could be of value for the early detection of intravascular coagulation in man.

The Modification of Experimental Occlusive Arterial Thrombosis in the Rat by Malayan Pit Viper Venom

1968 ◽  
Vol 19 (01/02) ◽  
pp. 242-247 ◽  
Author(s):  
K. E Chan
Keyword(s):  
Arterial Thrombosis ◽  
Thrombus Formation ◽  
Arterial Occlusion ◽  
Control Group ◽  
Antithrombotic Effect ◽  
Daily Dose

SummaryThe effect of Malayan pit viper (Ancistrodon rhodostoma) venom on the fate of experimental arterial thrombosis was studied in rats. A suitable daily dose of venom (500 μg) was used to induce hypofibrinogenaemia in the treated rats for the greater part of each of three consecutive post-operative days.The treated animals showed a statistically significant overall reduction in the incidence of both red thrombus formation and thrombotic arterial occlusion when compared to a control group. This antithrombotic effect of the venom could be observed in the 7-day period following the cessation of the treatment.

Systematic review of cervical cancer prevalence and determinants of early detection in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 32-36
Author(s):  
Eleazar Ndabarora ◽  
Dariya Mukamusoni ◽  
Clarte Ndikumasabo ◽  
Védaste Ngirinshuti
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Early Detection ◽  
Cervical Cancer Screening ◽  
Sub Saharan Africa ◽  
Extensive Literature ◽  
Early Management ◽  
Screening Programs ◽  
Mesh Terms ◽  
Sub Saharan

Cervical cancer is one of the leading causes of morbidity and mortality globally and in Sub-Saharan Africa in particular. There is evidence that early detection and early management of cases are the best strategies to prevent and control this health threat, since treatment of the later stages of the diseases are very expensive. The objectives of the review were: (1) to identify and review studies on the prevalence of cervical cancer and determinants of early detection in Sub-Saharan Africa, and (2) to recommend further studies and interventions based on the findings of this review. Extensive literature search was conducted using the MeSH terms. Articles on cervical cancer and/or determinants of early detection which fulfilled inclusion criteria were reviewed independently by three reviewers. The prevalence of cervical cancer in Sub-Saharan Africa is increasing. Although there are evidences that cervical cancer screening programs are practical and feasible even in resource-limited settings in Sub-Saharan Africa, there is a very low uptake of cervical cancer screening and there are key factors that need to be addressed in order to make these programs established and effective.

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