An Extremely Uncommon Case of Parasitic Infection Presenting as Eosinophilic Ascites in a Young Patient

We report the case of a 24-year-old male patient admitted for recent ascites and splenomegaly of unknown origin. The patient was referred to our institution with complaints of diarrhea, epigastric pain, abdominal cramping and weight loss over the past three weeks. The acute onset presented with colicky abdominal pain and peritoneal effusion. History revealed reduced appetite and weight gain of 7 kg over the last one month. His past medical history and family history was negative. He had no history of alcohol abuse or viral hepatitis infection. Laboratory data revealed normal transaminases and bilirubin levels, and alkaline phosphatase and gammaglutamyltransferase were within normal range. A diagnostic laparoscopy was performed which showed free peritoneal fluid and normal abdominal viscera. Upper gastrointestinal system endoscopy performed a few days later revealed diffuse severe erythematous pangastritis and gastroduodenal gastric reflux. Duodenal biopsies showed chronic nonspecific duodenitis. Antrum and corpus biopsies showed chronic gastritis. The ascitic fluid was straw-colored and sterile with 80% eosinophils. Stool exam was negative for parasitic infection. Treatment with albendazole 400 mg twice daily for 5 days led to the disappearance of ascites and other signs and symptoms. Three months after albendazole treatment the eosinophilic cell count was normal. The final diagnosis was consistent with parasitic infection while the clinical, sonographic and histological findings suggested an eosinophilic ascites. We emphasize the importance of excluding parasitic infection in all patients with eosinophilic ascites. We chose an alternative way (albendazole treatment) to resolve this clinical picture. With our alternative way for excluding this parasitic infection, we treated the patient and then found the cause

Spiramycin-associated Acute Pancreatitis: Cause or Coincidence?

So far, spiramycin-associated acute pancreatitis has not been reported in literature. In this letter, it was presented that A 63-year-old female subject was experienced acute pancreatitis 4 days after taking spiramycin for therapy of dental infection, as an unusual approach. She was prescribed spiramycin tablet for dental infection, and in 4th day, she admitted to emergency service with severe epigastric pain with radiation to the flank and back. Her magnetic resonance (MR) cholangiography and upper abdominal MR imaging revealed acute edematous pancreatitis without any gallstone. As a macrolide antibiotic, clinicians should be aware of potential side effects of spiramycin including acute pancreatitis. [Med-Science 2015; 4(2.000): 2352-5

May Ursodeoxycholic Acid Significantly Improve Liver Function Tests among Patients with Hepatitis C?

In their relevant study, the authors demonstrated that ursodeoxycholic acid therapy significantly improvedliver function tests either when given alone or combined with silymarin. But, silymarin itself failed to improve liver function tests. We thank to the authors for their valuable contribution. However, there are some concerns that need to be explained in a detailed manner for a better understanding of the results presented in the manuscript. [Med-Science 2015; 4(4.000): 2986-8

Circulating mir-200c and mir-33a may be used as biomarkers for predicting high fructose corn syrup-induced fatty liver and vitamin D supplementation-related liver changes

Background/aim: Nonalcoholic fatty liver is one of the most common forms of liver disease and role of microRNAs (miRNAs) on this illness is currently unclear. It was aimed to evaluate the predictive role of circulating miR-33a and mir-200c on high fructose corn syrup (HFCS)-induced fatty liver and vitamin D-3 supplementation-related hepatic changes. Materials and methods: Twenty-four rats were randomized into three groups: sham (n = 8), experimental fatty liver group (n = 8), and fatty liver + vitamin D-3 supplementation group (n = 8). In the treatment group, 10 mu g/kg/week of vitamin D-3 was given by orogastric tube weekly for 4 weeks in addition to a high fructose diet. Serum AST, ALT, TNF-alpha, and MDA levels were tested. Liver tissue samples were examined using hematoxylin/eosin, periodic acid-Schif (PAS) and Masson's Trichrome staining. Circulating miR-33a and mir-200c were quantified by qRT-PCR method. Moreover, in silico analyses were accomplished. Results: In the vitamin D-3 group, results of biochemical parameters were significantly different than those of the fatty liver group (p < 0.001). Moreover, significant differences in serum levels of circulating miR-33a and mir-200c were identified among all groups (p < 0.05). Finally, more favorable histopathological changes were noticed in the vitamin D-3 supplementation group. The expressions of Ki-67 were also considerably reduced in the vitamin D-3 group. According to KEGG pathway analysis, mir-33a and mir-200c were found to play a common role in the Hippo signaling pathway, lysine degradation, and protein processing. Conclusion: Our current experimental fatty liver study showed that, in a specified dose, vitamin D-3 supplementation could alleviate adverse undesirable hepatic effects of HFCS via miR-33a and mir-200c.Scientific Research Project Fund of University of Health Sciences [2018/024]This work is supported by the Scientific Research Project Fund of University of Health Sciences under the project number 2018/024

Successful Management of an Esophageal Foreign Body with a Rigid Bronchoscopy

Ingestion of a sharp foreign object can lead to esophageal hemorrhage and perforation, which is related to high morbidity and mortality. To avoid such complications, early and adequate therapeutic management of these cases is crucial. Herein, we would like to present two cases of esophageal foreign bodies that were successfully managed with rigid bronchoscopy after failed attempts with upper gastrointestinal endoscopic intervention. [Med-Science 2015; 4(2.000): 2340-3