Use of fibroscan in assessment of hepatic fibrosis in patients with chronic hepatitis B infection

Introduction: Assessment of the stage of liver fibrosis plays a prominent role in the decision process of treatment in chronic viral hepatitis.Objective: To determine the stage of fibrosis in patients with chronic HBV infection using fibroscan.Method: This is a cross sectional descriptive study involving patients with CHB with a valid transient elastography (TE) measurement. Liver function test and platelet count was determined. APRI and FIB-4 were calculated and Spermans rank coefficient was applied for correlation of transient elastography (TE) with either serum biomarkers.Results: 190 patients were enrolled, mean age 36.3years, 64.2% males and 89.9% were asymptomatic. TE correlated significantly with APRI and FIB-4 (r = 0.58; P < 0.001 and r = 0.42; P < 0.001, respectively). Most of the patients 131(68.9%) had no significant fibrosis (F0,F1) while those with significant fibrosis and cirrhosis were 59 (31.1%) and 23(12.1%) respectively.Conclusion: The prevalence of significant fibrosis and cirrhosis is high in this population.Keywords: Fibroscan, Hepatic fibrosis, APRI, FIB-

Ascending aortic dissection in the developing world; case report

Aortic dissection is frequently a life threatening condition and is the most common emergency of the acute aortic syndromes. Left untreated or poorly treated; the mortality rate has been reported to increase by 1-3% per hour after presentation and is approximately 36-72% within an hour of diagnosis and 62-91% within one week. Various contributory factors related to human resources, technical resources, socio-economic constraints and other utilities in poor income countries with poor health indices also worsen the prognosis of acute aortic dissection. We have made an attempt to remind ourselves of the continued existence and challenges in managing this disease.Keywords: Aortic Dissection, Mortality, Outcome, Underdevelope

A spot check on the prevalence of viral hepatitis B on the plateau

Hepatitis B is a disease which is present globally and over 2 billion people have been infected with hepatitis b according to the World Health Organization. In Nigeria hepatitis B, chronic infection: which is defined as persistence of infection in a human being greater than six months is present in an endemic proportion. In fact Nigeria is described as an area of hyper-endemicity, having a National Prevalence that is greater than 8% of the population.Methodology: The study was carried as part of awareness campaign in a university community. Samples were taken from the participants via finger prick. Two drops of blood were placed on the strip and a buffer was added and read after five minutes.Results: There were a total of 684 participants. Out of which 404 (59.06%) were males and 280(40.94%) were females. The mean age for the study participants was 26.169±.9. Those who were positive for hepatitis b surface antigen were 75(10.96%) while those who are negative were 609(89.04%).Those with history of previous immunization for hepatitis B were 152(22.22%).Conclusion: There is still a very high prevalence of hepatitis with very low uptake of vaccination, these calls for an urgent public health intervention.Keywords: Prevalence, Hepatitis B, Spot check, viru

The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (<45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening