Management options in hepatic hydatid disease

Objective: The aim of this retrospective study is to analyse the outcome of 4 different methods in management of hepatic hydatid disease. Patients and Methods: The study was carried out in the Military Hospital, Riyadh: 110 patients were included; 37 were treated medically; 26 patients were subjected to percutaneous drainage via ultrasound guidance. Fifty patients required surgical treatment, while the remaining 10 patients were managed endoscopically. Results: The study showed different responses of the 4 methods applied. Conclusion: This retrospective analysis revealed that percutaneous draiange of the hydrated cysts achieved the best yield among all other methods

ALLGROVE'S SYNDROME: CASE REPORT AND LITERATURE REVIEW

This report concerns two brothers aged 10 and 18 years with long-standing dysphagia that started at age three and six years respectively. They had been diagnosed as achalasia and treated accordingly. The appearance of additional symptoms and clinical signs required further investigations including abdominal sonography, esophago-gastroduodenoscopy, barium swallow, esophageal manometry, computerized tomography (CT) of abdomen and brain, biochemical profiles, and neurologic and ophthalmic evaluations. The results of these extensive investigations along with the clinical evaluations were consistent with Allgrove's syndrome

The impact of functional dyspepsia on health-related quality of life in Saudi patients

<b>Objective: </b> The purpose of this study was to evaluate the impact of non-ulcer dyspepsia (NUD) on health-related quality of life (HRQOL), which was assessed using the Nepean Dyspepsia Index, the Short Form-12 quality of life (QOL) scale, the general health questionnaire (GHQ-30) and the self-reporting questionnaire (SRQ-20). <b> Materials and Methods:</b> Validated Arabic versions of the four scales were administered to 158 subjects (54 with NUD, 50 with gastroesophageal reflux disease [GERD] and 54 with no history of gastrointestinal [GI] disease), with a mean age of 46.6 years and SD 10.7. <b> Results:</b> Subjects with NUD showed the poorest scores in all indices of general QOL and HRQOL. The differences between the NUD patients and the health control in all HRQOL indices were statistically significant (<i> P</i> &lt; 0.05 to <i> P</i> &lt; 0.001). Comparison between NUD and GERD patients showed significant differences only in the indices of psychological health related QOL (<i> P</i> &lt; 0.05) but not in the indices of other components of QOL, including physical health components. The study also showed that the women scored lower than men in HRQOL indices, particularly those of psychological and mental health components (<i> P</i> &lt; 0.05 to <i> P</i> &lt; 0.001). Finally, it was found that severity of symptoms is associated with the degree of impairments in HRQOL - (r = 0.69) was significant at (<i> P</i> &lt; 0.001). <b> Conclusion:</b> Results of our study showed that HRQOL was significantly impaired in the NUD group. Psychological and mental health related quality of life was particularly impaired in this group compared to both normal patients and patients with similar GI disease. This magnitude of effects on HRQOL was also found to be associated with the severity of symptoms. The implications of these findings for the management of NUD are discussed

Adult hereditary fructose intolerance

Hereditary fructose intolerance (HFI) is an under-recognized, preventable life-threatening condition. It is an autosomal recessive disorder with subnormal activity of aldolase B in the liver, kidney and small bowel. Symptoms are present only after the ingestion of fructose, which leads to brisk hypoglycemia, and an individual with continued ingestion will exhibit vomiting, abdominal pain, failure to thrive, and renal and liver failure. A diagnosis of HFI was made in a 50-year-old woman on the basis of medical history, response to IV fructose intolerance test, demonstration of aldolase B activity reduction in duodenal biopsy, and molecular analysis of leukocyte DNA by PCR showed homozygosity for two doses of mutant gene. HFI may remain undiagnosed until adult life and may lead to disastrous complications following inadvertent fructose or sorbitol infusion. Several lethal episodes of HFI following sorbitol and fructose infusion have been reported. The diagnosis can only be suspected by taking a careful dietary history, and this can present serious complications

Comparative study of <i>Nigella</i> <i>Sativa</i> and triple therapy in eradication of <i>Helicobacter Pylori</i> in patients with non-ulcer dyspepsia

Background/Aim: A large number of diseases are ascribed to Helicobacter pylori (H. pylori), particularly chronic active gastritis, peptic ulcer disease and gastric cancer. Successful treatment of H. pylori infection with antimicrobial agents can lead to regression of H. pylori-associated disorders. Antibiotic resistance against H. pylori is increasing, and it is necessary to find new effective agents. Nigella sativa seed (NS), a commonly used herb, possesses in vitro anti-helicobacter activity. The present study was undertaken to evaluate the efficacy of NS in eradication of H. pylori infection in non-ulcer dyspeptic patients. Materials and Methods: The study was conducted on 88 adult patients attending King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, from 2007 to 2008, with dyspeptic symptoms and found positive for H. pylori infection by histopathology and urease test. Patients were randomly assigned to four groups, receiving i) triple therapy (TT) comprising of clarithromycin, amoxicillin, omeprazole [n= 23], ii) 1 g NS &#x002B; 40 mg omeprazole (OM) [n= 21], iii) 2 g NS &#x002B; OM [n= 21] or iv) 3 g NS &#x002B; OM [n= 23]. Negative H. pylori stool antigen test four weeks after end of treatment was considered as eradication. Results: H. pylori eradication was 82.6, 47.6, 66.7 and 47.8&#x0025; with TT, 1 g NS, 2 g NS and 3 g NS, respectively. Eradication rates with 2 g NS and TT were statistically not different from each other, whereas H. pylori eradication with other doses was significantly less than that with TT (P &lt; 0.05). Dyspepsia symptoms improved in all groups to a similar extent. Conclusions: N. sativa seeds possess clinically useful anti-H. pylori activity, comparable to triple therapy. Further clinical studies combining N. sativa with antibiotics are suggested