Serum Squamous Cell Carcinoma Antigen Level in Cirrhotic Chronic Hepatitis C Patients With and Without Hepatocellular Carcinoma

This study will be carried out on 500 personnel divided into five groups : Group A: 100 cases of hepatocellular carcinoma without interventions. Group B: same 100 cases of group A before and 3 months after successful interventions.Group C: 100 cases of established cirrhosis. Group D: 100 cases with chronic hepatitis C virus infection without established cirrhosis. Group E: 100 healthy individuals as controls.Methods: Sera from selected patients and controls have been used for estimation of SCC-Ag using CanAg SCC EIA. Results: high significant increase in serum SCCA level in patients with HCC (groupA and groupB) when compared to cirrhotic, chronic HCV and control groups (P < 0.001). Positive significant correlation was found between AFP and serum SCCA level .The best cut-off value to differentiate HCC patients from cirrhotic patients was 3.2 ng/ml for SCCA yielded with 80% sensitivity and 90% specificity. When combined sensitivity of both markers was calculated in our study at the best-chosen cutoff values (SCCA 3.2 ng/ml and AFP 200 ng/ml) sensitivity improved to 93%.Conclusion: Combined SCCA and AFP can be used as in diagnosis of HCC and follow up 3 months after therapeutic intervention

Helicobacter pylori eradication rates using clarithromycin and levofloxacin-based regimens in patients with previous COVID-19 treatment: a randomized clinical trial

Abstract Background Helicobacter pylori (H. pylori) is affecting half of the globe. It is considered a main causative organism of chronic gastritis, peptic ulcer disease, and different gastric maliganacies. It has been also correlated to extraintestinal diseases, including refractory iron deficiency anaemia, vitamin B12 deficiency, and immune thrombocytopenic purpura. The misuse of antibiotics during the coronavirus diseases 2019 (COVID-19) pandemic time can affect H. pylori eradication rates. Our aim was to compare the efficacy of clarithromycin versus levofloxacin-based regimens for H. pylori treatment in naïve patients after the COVID-19 pandemic misuse of antibiotics. Methods A total of 270 naïve H. pylori infected patients with previous treatment for COVID-19 more than 3 months before enrolment were recruited. Patients were randomized to receive either clarithromycin, esomeprazole, and amoxicillin, or levofloxacin, esomeprazole, and amoxicillin. Results A total of 270 naïve H. pylori infected patients with previous treatment for COVID-19 more than 3 months before enrolment were included, 135 in each arm. In total, 19 patients in the clarithromycin group and 18 patients in the levofloxacin group stopped treatment after 2–4 days because of side effects or were lost for follow-up. Finally, 116 subjects in the clarithromycin group and 117 in the levofloxacin group were assessed. The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: group I, 55.56% and 64.66%; and Group II, 64.44% and 74.36% respectively (p = 0.11). Conclusion As COVID-19 pandemic has moved forward fast, high resistance rates of H. pylori to both clarithromycin and levofloxacin were developed after less than two years from the start of the pandemic. Molecular & genetic testing is highly recommended to identify antimicrobial resistance patterns. Strategies to prevent antibiotic misuse in the treatment of COVID-19 are needed to prevent more antibiotic resistance. Trial Registration: The trial was registered on Clinicaltrials.gov NCT05035186. Date of registration is 2-09-2021

Prognostic and diagnostic anthropometric biomarkers of sarcopenia in a cohort of Egyptian patients with hepatitis C-induced liver cirrhosis

Abstract Background Chronic hepatitis C (HCV) infection is a leading cause of liver cirrhosis (LC) worldwide with decompensation-related clinical sequelae. Sarcopenia is currently recognized as a fundamental complication of LC owing to various mechanisms. This study aimed to assess the role of anthropometric measures of sarcopenia in predicting the outcome of LC as assessed by the Child-Turcotte-Pugh (CTP) grade. Results A cross-sectional study was carried out on 80 patients with HCV-related LC with different CTP grades. The diagnosis of sarcopenia was based on the 2018 definition of sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP). Muscle strength was assessed by hand grip strength (HGS) and lower leg extension strength (LES). Assessment of muscle mass was performed by measuring mid-calf circumference (MCC) and mid-arm muscle circumference (MAMC). HGS varied significantly between the different CTP grades, being highest in CTP grade C. Additionally, the number of patients diagnosed with “definitive sarcopenia” using either HGS/MCC or LES/MCC varied significantly between CTP grades, being highest in CTP grade C. Conclusions HGS is a better predictor of worse outcomes of liver cirrhosis than LES. The combination of MCC and HGS or LES is a potentially promising noninvasive prognostic biomarker of liver disease

Tissue inhibitor of matrix metalloprotinase-1 and collagen type IV in HCV-associated cirrhosis and grading of esophageal varices

Abstract Background Esophageal varices are abnormally dilated submucosal veins of the esophagus which develop as a result of portal hypertension due to cirrhosis. Collagen type IV is upregulated with a 14-fold increase in cirrhosis. Tissue inhibitor of metalloproteinases-1 (TIMP-1) is also upregulated during hepatic fibrogenesis and considered to promote fibrosis in the injured liver. The objective of this research was to study the serum levels of tissue inhibitor of matrix metalloprotinase-1 and serum collagen type IV in patients with post hepatitis C cirrhosis and their relation to the different grades of esophageal varices. Patients and methods This study was carried out on one hundred and twenty individuals classified into three groups: Group I included thirty patients with liver cirrhosis without esophageal varices. Group II included sixty patients with liver cirrhosis with esophageal varices. Group III included thirty healthy volunteers as controls. Results A significant positive correlation was found between collagen type IV and the presence of esophageal varices in esophageal varices group (p = 0001*). Also, a significant positive correlation was found between TIMP-1 and the presence of esophageal varices in esophageal varices group (p = 0.033*). After conducting multivariate logistic regression analysis, collagen type IV and INR were found to be independent risk factors for esophageal varices in patients with cirrhosis. Conclusion The serum collagen type IV and TIMP-1 levels are useful markers for predicting of presence of esophageal varices