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MINI-REVIEW
Jong-Hon Kang, Takeshi Matsui

Changing Etiology in Liver Cirrhosis in Sapporo, Japan

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:77-80][No of Hits : 699]


ABSTRACT

In Japan, preventive measures and antiviral therapy against acute or chronic viral infection had achieved remarkable progress in the 1980s or later. On the contrary, metabolic syndrome complicated with fatty liver has emerged as a public health concern to date.
In the current study, we attempted to clarify etiological changes in liver cirrhosis treated in a single tertiary institute in Sapporo, Japan, from 1998 to 2016.
Medical records of 1,166 patients (787 males, with mean of 64.9 ± 11.7 years), diagnosed as having liver cirrhosis for 19 years, were retrospectively reviewed to analyze etiology and clinical features.
During the past 10 years, annual numbers of cirrhotic patients with chronic infection of hepatitis B virus (HBV) or hepatitis C virus (HCV) decreased from 50 or more to 20 or less, and alcoholic liver disease or cryptogenic liver injury emerged as major cause of liver cirrhosis. Among 100 cirrhotic patients of unknown cause, nonalcoholic fatty liver disease (NAFLD) occupied almost 50% in 19 observational years.
In order to control the rising trend in NAFLD related with metabolic syndrome, preventive measures including education in society would be required in Japan.

Keywords: Etiology, Japan, Liver cirrhosis.

How to cite this article: Kang J-H, Matsui T. Changing Etiology in Liver Cirrhosis in Sapporo, Japan. Euroasian J Hepato-Gastroenterol 2018;8(1):77-80.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Tadashi Ohara, Tatsuo Suzutani

Intake of Bifidobacterium longum and Fructooligosaccharides prevents Colorectal Carcinogenesis

[Year:2018] [Month:January-June] [Volumn:8 ] [Number:1] [Pages:100] [Pages No:11-17][No of Hits : 504]


ABSTRACT

Introduction: We aimed to investigate the effects of intake of yogurt containing Bifidobacterium longum (BB536-y) and fructo-oligosaccharides (FOS) in preventing colorectal carcinogenesis in healthy subjects, and the preventive effects of short-chain fatty acids (SCFA), whose production was enhanced by the intake of BB536-y and FOS, in human colon cancer cell lines.

Materials and methods: The subjects were 27 healthy persons who were divided into a group taking yogurt containing BB536 (BB536-y group; n = 14) and a group taking yogurt containing BB536 and FOS (BB536-y with FOS group; n = 13) once a day for 5 weeks. The feces were sampled before and after the intake to analyze the amount of SCFA in the feces and the profile of intestinal flora, such as putrefactive bacteria and Bacteroides fragilis enterotoxin (ETBF). Subsequently, human colon cancer cell lines (DLD-1 cells, WirDr cells) were cultured in the presence of SCFA (butyric acid, isobutyric acid, acetic acid) in order to evaluate the cell growth-inhibitory activity of SCFA (WST-8 assay) by calculating the IC50 value from the dose-response curve.

Results: Intake of BB536-y increased the total amount of SCFA in the feces and significantly suppressed the detection rate of ETBF and growth of putrefactive bacteria. Intake of BB536-y with FOS was associated with a higher Bifidobacterium detection rate than that of BB536-y alone. The contents of butyric acid, isobutyric acid, and acetic acid, namely, of SCFA, were also decreased. Analysis of the results of culture of DLD-1 cells and WirDr cells in the presence of butyric acid, isobutyric acid, and acetic acid revealed that each of the substances showed significant cell growth-inhibitory activity, with the activity being the highest for butyric acid, followed by that for isobutyric acid and acetic acid.

Conclusion: These findings suggest that intake of both BB536-y and BB536-y with FOS prevents colorectal carcinogenesis.

Keywords: Colorectal carcinoma, Gastroenterology, Intestinal microbiome, Prebiotics, Probiotics, Short-chain fatty acids.

How to cite this article: Ohara T, Suzutani T. Intake of Bifidobacterium longum and Fructooligosaccharides prevents Colorectal Carcinogenesis. Euroasian J Hepato-Gastroenterol 2018;8(1):11-17.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Gokben Ozbey, Alfizah Hanafiah

Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:34-39][No of Hits : 1482]


ABSTRACT

H. pylori infection is a global public health problem associated with some gastrointestinal diseases in children, especially in developing countries, since prevalence of H. pylori is low in the developed world. Both noninvasive (stool antigen test, urea breath test, and blood test) and invasive (histology, rapid urease test, and microbiological culture) tests have been utilized to detect H. pylori infection. However, a single test is not reliable enough and does not provide accurate enough data to determine H. pylori infection among children. Risk factors of H. pylori infection in children were related to ethnicities, household properties, geographic location, living conditions, water sources, type of housing, presence/absence of sewage systems, and garbage collection within the living environment. These risk factors were usually associated with the socioeconomic status of the family. This review article aims to determine the gaps in the knowledge of the epidemiology, risk factors, and diagnostic tests of H. pylori infection among children.

Keywords: Children, Diagnostic tests, Epidemiology, Helicobacter pylori.

How to cite this article: Ozbey G, Hanafiah A. Epidemiology, Diagnosis, and Risk Factors of Helicobacter pylori Infection in Children. Euroasian J Hepato-Gastroenterol 2017;7(1):34-39.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Dina Zerem, Omar Zerem, Enver Zerem

Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:1-5][No of Hits : 1193]


ABSTRACT

Aim: The assessment of the severity of acute pancreatitis (AP) is important for proper management of the disease and for its prognosis. The aim was to correlate clinical, biochemical, and imaging diagnostic parameters and evaluate their prognostic values in the early assessment of severity of AP.

Materials and methods: We prospectively studied 128 consecutive patients with AP. The predictors were clinical, biochemical, and imaging diagnostic parameters. The outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced computer tomography, and pancreatitisspecific clinical and laboratory findings were done.

Results: According to the Atlanta classification, 84 patients (65.6%) had mild and 44 (34.4%) had severe AP. The severity markers were significantly different between the mild and the severe groups (p < 0.001). Leukocyte count, serum albumin level, C-reactive protein (CRP), Ranson, acute physiology and chronic health evaluation II (APACHE II), and Glasgow score were the factors associated with radiological severity grade. Leukocyte count, CRP, Ranson score, APACHE II, and Glasgow score were the factors associated with the number and appearance of acute fluid collections (AFCs). A significant association was found between the number of AFCs and the occurrence of complications [odds ratio 4.4; 95% confidence interval 2.5-7.6]. Hospital stay was significantly longer in the group with severe disease as compared with the group with mild disease (p < 0.001).

Conclusion: Clinical, biochemical, and imaging diagnostic parameters are related to the clinical course of AP and they can predict its severity. This allows us to determine the severity of the disease and to target the patients with high scores for close monitoring and more aggressive intervention.

Keywords: Acute pancreatitis, Clinical outcome, Complications, Computed tomography, Conventional transabdominal ultrasound, C-reactive protein.

How to cite this article: Zerem D, Zerem O, Zerem E. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis. Euroasian J Hepato-Gastroenterol 2017;7(1):1-5.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Hasitha S Wijewantha

Liver Disease in Sri Lanka

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:78-81][No of Hits : 1155]


ABSTRACT

Liver disease in Sri Lanka is mainly due to alcoholic liver disease and nonalcoholic fatty liver disease. In contrast to other South Asian countries, the prevalence of hepatitis B and C is low in Sri Lanka and prevalence of hepatitis A is intermediate. The few reported cases of hepatitis E in Sri Lanka are mainly in people who have traveled to neighboring South Asian countries. Wilson’s disease, autoimmune hepatitis, hemochromatosis, drug-induced liver disease, and primary biliary cirrhosis are recognized causes of liver disease in Sri Lanka. Pyogenic and amebic liver abscesses and dengue infection are the other causes of liver disease. Some of the commonly used plants as traditional herbal medicine in Sri Lanka have been shown to have deleterious effects on the liver in animal studies. Considering the high popularity of traditional herbal medicine in the country, it is likely that herbal medicine is an etiological factor for liver disease in Sri Lanka, but no published data are available.

Keywords: Causes of cirrhosis, Liver disease, Nonalcoholic fatty liver disease, Viral hepatitis.

Address reprint requests to: Wijewantha HS. Liver Disease in Sri Lanka. Euroasian J Hepato- Gastroenterol 2017;7(1):78-81.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Ananta Shrestha, Birendra P Gupta, Thupten K Lama

Current Treatment of Acute and Chronic Hepatitis E Virus Infection: Role of Antivirals

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:73-77][No of Hits : 1113]


ABSTRACT

Hepatitis E virus (HEV) infection results in nearly 20 million new infections, resulting in 70,000 deaths globally each year. Previously thought as a disease limited to developing nations with poor sanitation and hygiene, it is increasingly recognized that even the most developed nations are not spared. A clear dichotomy in epidemiology of HEV is noted between developing and industrialized nations. The HEV genotypes 1 and 2 are common in Asia and Africa and are transmitted mainly by contaminated drinking water. Sporadic as well as large-scale epidemics of acute hepatitis have been noted with HEV genotype 1 infection in developing countries of Asia and Africa. On the contrary, HEV genotypes 3 and 4 are common in industrialized nations and unlike genotypes 1 and 2, they are transmitted by consumption of raw meat products, fruits, and blood transfusion. Large epidemics have not been reported with HEV genotypes 3 and 4 and manifestation is usually indolent, though severe acute hepatitis has been reported.

Keywords: Antiviral drugs, Epidemiology, Hepatitis E, Therapy.

How to cite this article: Shrestha A, Gupta BP, Lama TK. Current Treatment of Acute and Chronic Hepatitis E Virus Infection: Role of Antivirals. Euroasian J Hepato-Gastroenterol 2017;7(1):73-77.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Mukta Waghmare, Hemanshi Shah, Charu Tiwari, Kiran Khedkar, Suraj Gandhi

Management of Liver Abscess in Children: Our Experience

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:23-26][No of Hits : 1024]


ABSTRACT

Introduction: Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Liver abscesses are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient.

Materials and methods: A total of 34 patients less than 12 years were assessed in a retrospective study from January 2012 to 2016. Patients were assessed in terms of age of presentation, etiology, bacteriology, diagnosis, and modality of treatment.

Results: The mean age of presentation was 6.3 years. Average volume of abscess was 164 cc. Nine patients (26.4%) underwent percutaneous needle aspiration under ultrasound guidance with wide bore needle (18 G disposable needle). Three patients required more than two sittings of aspiration. Patients with volume more than 80 cc were treated with catheter drainage. Twenty patients (58.8%) underwent ultrasound-guided percutaneous catheter drainage. Two patients required catheter drainage for large abscess and needle aspiration for the smaller abscess.

Conclusion: Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases.

Keywords: Catheter drainage, Liver abscess, Percutaneous aspiration, Predisposing factors.

How to cite this article: Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepato-Gastroenterol 2017;7(1):23-26.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Mustafa Guclu, A Faruq Agan

Association of Severity of Helicobacter pylori Infection with Peripheral Blood Neutrophil to Lymphocyte Ratio and Mean Platelet Volume

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:11-16][No of Hits : 894]


ABSTRACT

Aim: To determine the correlation of Helicobacter pylori infection with peripheral blood neutrophil/ lymphocyte ratio (NLR) and mean platelet volume (MPV).

Materials and methods: The NLR, MPV, platelets, leukocytes, neutrophils, and lymphocytes were calculated and the differences between groups were investigated.

Results: A total of 199 patients were included in the study. Neutrophil/lymphocyte ratio was statistically lower in H. pylori-positive patients than in H. pylori-negative patients (1.94 ± 0.79 vs 2.67 ± 2.35 respectively, p = 0.04). There was no significant difference between H. pylori-negative patients and H. pylori-positive patients of severe intensity in terms of MPV. However, peripheral blood lymphocytes and platelets were statistically significantly higher in H. pylori-positive patients of severe intensity (lymphocytes 2150 ± 826 vs 2954 ± 2436 respectively, p = 0.000 and platelets 258247 ± 69494 vs 265611 ± 113397 respectively, p = 0.02) compared with H. pylori-negative patients.

Conclusion: A moderate increase in the intensity of H. pylori does not lead to a significant change in MPV as measured by hemogram; however, it gives rise to a statistically significant fall in NLR. Presence of severe H. pylori-positive intensity leads to a statistically significant increase in peripheral blood lymphocytes and platelets compared with H. pylori-negative patients.

Keywords: Helicobacter pylori, Mean platelet volume, Neutrophil to lymphocyte ratio.

How to cite this article: Guclu M, Agan AF. Association of Severity of Helicobacter pylori Infection with Peripheral Blood Neutrophil to Lymphocyte Ratio and Mean Platelet Volume. Euroasian J Hepato- Gastroenterol 2017;7(1):11-16.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Hasan Ozkan

HBV Treatment in Turkey: The Value of Hepatitis B Surface Antigen Quantification of Chronic Hepatitis B Patients in the Long-term Follow-up―A Single-center Study

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:82-83][No of Hits : 884]


ABSTRACT

Hepatitis B surface antigen (HBsAg) seems to have significant clinical implications to assess the prognosis of chronic hepatitis B (CHB). We assessed HBsAg levels serially in patients with CHB in a single center in Turkey.

Keywords: Chronic hepatitis B, Follow-up, Hepatitis B surface antigen.

How to cite this article: Ozkan H. HBV Treatment in Turkey: The Value of Hepatitis B Surface Antigen Quantification of Chronic Hepatitis B Patients in the Long-term Follow-up―A Single-center Study. Euroasian J Hepato-Gastroenterol 2017;7(1):82-83.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
David H Muljono

Epidemiology of Hepatitis B and C in Republic of Indonesia

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:55-59][No of Hits : 859]


ABSTRACT

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections pose serious problems in terms of public health and clinical intervention in a country with approximately 250 million people, who live in more than 17,000 islands. Efforts to combat HBV and HCV have been made through the implementation of universal infant hepatitis B immunization, blood screening, and other health promotion actions, and building epidemiological data to develop intervention strategies. A nationwide study in 2013 revealed hepatitis B surface antigen (HBsAg) prevalence of 7.1%, which indicates that Indonesia has moved from high to moderate endemicity of hepatitis B, leaving the prevalence of 9.4% in 2007. The occurrences of new hepatitis B cases still continue in early childhood period, which may root from low coverage of birth-dose hepatitis B immunization in remote islands, and the potential mother-to-child transmission of HBV from HBsAg-positive pregnant mothers. Other problems still exist including the high HBV infection rates among young adults in remote islands, the presence of occult hepatitis B, as well as the substantial prevalence of HCV infection in general population, who do not have access to diagnosis and treatment. Effective preventive and control strategies are being developed tailored to the local capacity, infrastructures, socioeconomics, and culture, as well as geographical aspects of the country.

Keywords: Epidemiology, Hepatitis B virus, Hepatitis C virus, Indonesia.

How to cite this article: Muljono DH. Epidemiology of Hepatitis B and C in Republic of Indonesia. Euroasian J Hepato-Gastroenterol 2017;7(1):55-59.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Tarana Gupta, Sahaj Rathi, Radha K Dhiman

Managing Encephalopathy in the Outpatient Setting

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:48-54][No of Hits : 849]


ABSTRACT

In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination. Presence of poor work productivity, increased accidental injuries on complex machinery and driving, etc., raise the suspicion of cognitive dysfunction. Specialized neurocognitive testing like psychometric HE, computerized tests like critical flicker frequency tests, inhibitory control tests, Stroop encephalopathy tests, and electroencephalography are needed to diagnose overt HE. Various studies have shown lactulose and rifaximin to be useful in overt HE. However, presence of persistent and recurrent HE in cirrhosis is an indication for liver transplant. Lactulose is effective both in improving reversal of minimal HE and in reducing the risk of development of overt HE.

Keywords: Cirrhosis, Hepatic encephalopathy, Minimal hepatic encephalopathy, Neurocognitive testing.

How to cite this article: Gupta T, Rathi S, Dhiman RK. Managing Encephalopathy in the Outpatient Setting. Euroasian J Hepato-Gastroenterol 2017;7(1):48-54.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Oidov Baatarkhuu, G Uugantsetseg, D Munkh-Orshikh, N Naranzul, S Badamjav, D Tserendagva, J Amarsanaa, Kim Do Young

Viral Hepatitis and Liver Diseases in Mongolia

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:68-72][No of Hits : 712]


ABSTRACT

Mongolia is known for its high endemicity for viral hepatitis. Previous studies report that the seroprevalence of hepatitis B virus (HBV) is 11.8% (178/1,512) among the unvaccinated population in 13 provinces and Ulaanbaatar city. The serosurvey of adults (≥20 years of age) conducted during 2013 among persons in four provinces and in Ulaanbaatar showed that the overall prevalence of hepatitis B surface antigen (HBsAg) positivity was 10.6%. The overall prevalence of anti-hepatitis C virus (HCV) and HCV ribonucleic acid among 1,512 apparently healthy subjects was 15.6% (236/1,512) and 11.0% (167/1,512) respectively.
In a previous study, we reported on the prevalence of HBV, HDV, and HCV infections in 110 consecutive patients presenting with acute hepatitis at eight city hospitals in Ulaanbaatar. In that study, 16.4, 32.7, 6.4, 1.8, and 27.3% of the patients were diagnosed as having acute hepatitis due to hepatitis A, B, C, HBV/HDV coinfection, and superinfection respectively. In the current study (2012.2014), results show that acute hepatitis A, B, C, and D was diagnosed in 47.9, 40.7, 5.3, and 9% respectively.
Chronic HBV and HCV infections, which are associated with cancer and cirrhosis respectively, are responsible for 95% of liver cancers in Mongolia. The most common etiology for hepatocellular carcinoma was HCV infection (n = 89, 45.6%), followed by HBV infection (n = 67, 34.4%).

Keywords: Hepatitis A virus, Hepatitis B virus, Hepatitis C virus, Hepatitis D virus, Hepatocellular carcinoma.

How to cite this article: Baatarkhuu O, Uugantsetseg G, Munkh-Orshikh D, Naranzul N, Badamjav S, Tserendagva D, Amarsanaa J, Young KD. Viral Hepatitis and Liver Diseases in Mongolia. Euroasian J Hepato-Gastroenterol 2017;7(1):68-72.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Ruksana Raihan, Rosmawati Mohammed, Muhammad Radzi Abu Hassan, Rosaida Md Said

Chronic Viral Hepatitis in Malaysia: “Where are we now?”

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:65-67][No of Hits : 706]


ABSTRACT

Malaysia is a country where an estimated 1 million people are chronically infected with hepatitis B virus (HBV) and an estimated 2.5% of the adult population are positive for antibody to hepatitis C virus (HCV). Effective nationwide vaccine coverage seems to be a highly effective measure to prevent new HBV infection. Treatment of HCV infection is also a regular practice in Malaysia. These measures highlight the possibility to reach the World Health Organization elimination target by 2030. To achieve this target, the Health Ministry and other nongovernmental organizations, such as My Commitment to Cure (MyC2C) are working together to develop a strategic road map to reach the global elimination target in Malaysia by 2030.

Keywords: Global target, Hepatitis B virus, Hepatitis C virus.

How to cite this article: Raihan R, Mohamed R, Hasan MRA, Rosaida MS. Chronic Viral Hepatitis in Malaysia: “Where are we now?” Euroasian J Hepato-Gastroenterol 2017;7(1):65-67.

Source of support: Nil

Conflict of interest: None


 
BRIEF REPORT
Sameh M Abdel Monem

Probiotic Therapy in Patients with Nonalcoholic Steatohepatitis in Zagazig University Hospitals

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:101-106][No of Hits : 688]


ABSTRACT

Aim: Nonalcoholic fatty liver disease (NAFLD) is probably the most common liver disorder in the world. A subgroup of NAFLD patients is characterized by injury to the hepatocytes and inflammation in addition to excessive fat (steatohepatitis), the latter condition is nominated nonalcoholic steatohepatitis (NASH). This work aimed to evaluate the role of probiotics on the outcome of NASH in patients admitted to the Tropical Medicine Department, Faculty of Medicine, Zagazig University (inpatients and outpatients).

Materials and methods: This study was performed on 30 patients (17 males and 13 females), with body mass index from 30 to 35 and average age of 44 years with bright fatty liver in ultrasonography and raised alanine transaminase (ALT) and aspartate transaminase (AST) and positive liver biopsy findings. The patients were divided into group I (case group) that included 15 patients who received probiotics and group II of 15 patients as control group who did not receive probiotics; the study was conducted between November 2014 and April 2016. Clinical assessment, laboratory evaluation, pelvic-abdominal ultrasound, and liver biopsy of all cases were carried out.

Results: In this study, there was significant decrease in liver enzymes (ALT and AST) and no statistically significant other laboratory findings. Also there was relief for dyspepsia in some patients.

Conclusion: Probiotics treatment is effective, safe, well-tolerated, inexpensive, appropriate for longterm use, and optimally, works at multiple levels to downregulate inflammatory mediators, and therefore, probiotics could be an option in the treatment of NASH.

Keywords: Nonalcoholic fatty liver disease, Probiotics, Steatohepatitis.

How to cite this article: Monem SMA. Probiotic Therapy in Patients with Nonalcoholic Steatohepatitis in Zagazig University Hospitals. Euroasian J Hepato-Gastroenterol 2017;7(1):101-106.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Anurag S Lavekar, Dhananjay V Raje, Tanuja Manohar, Amarja A Lavekar

Role of Probiotics in the Treatment of Nonalcoholic FattyLiver Disease: A Meta-analysis

[Year:2017] [Month:July-December] [Volumn:7 ] [Number:2] [Pages:75] [Pages No:130-137][No of Hits : 654]


ABSTRACT

Aim: Despite extensive ongoing research, there is scarcity of widely accepted therapeutic options for the treatment of nonalcoholic fatty liver disease (NAFLD). Probiotics are a promising treatment option for treating NAFLD; however, their effectiveness needs to be established. Since any single randomized controlled trial (RCT) cannot establish the role of probiotics in the treatment of NAFLD, this study aims at meta-analysis of different RCTs.

Materials and methods: Extensive search was done by two independent observers for RCTs studying the role of probiotics in the treatment of NAFLD. The parameters under consideration were body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), homeostatic model assessment of insulin resistance (HOMA-IR), serum triglycerides (TGs), and ultrasonographic grades of fatty liver. Jadad scale was used to select the articles for meta-analysis. Heterogeneity in the results was evaluated using chi-square test and I2. Significant heterogeneity in the results was decided based on p-value < 0.05 and the corresponding I2 close to 0%.

Results: Seven studies qualified for meta-analysis. Use of probiotics significantly caused reduction in BMI (p < 0.0001), ALT (p < 0.0001), AST (< 0.0001), HOMA-IR (p = 0.006), and ultrasonographic grade of fatty liver (p = 0.0051). Heterogeneity in other parameters was contributed mainly by couple of previous studies.

Conclusion: Meta-analysis shows that variety of parameters has significant improvement after probiotic treatment in different RCTs. However, the magnitude of improvement is not uniform across studies due to varying strains, dose patterns, and treatment duration. In future, probiotics remain a promising option for treating NAFLD.

Keywords: Heterogeneity, Meta-analysis, Probiotics, Ultrasonographic grade.

How to cite this article: Lavekar AS, Raje DV, Manohar T, Lavekar AA. Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis. Euroasian J Hepato-Gastroenterol 2017;7(2):130-137.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Sudhir J Gupta, Nitin R Gaikwad, Amol R Samarth, Sonal R Gattewar

Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up

[Year:2017] [Month:July-December] [Volumn:7 ] [Number:2] [Pages:75] [Pages No:138-141][No of Hits : 654]


ABSTRACT

Background: Achalasia is a chronic disease that can be managed with effective endoscopic modalities.

Aim: To evaluate the effectiveness of single setting of pneumatic balloon dilatation for achalasia and assess the long-term success and outcomes.

Materials and methods: This is a retrospective study of all achalasia patients who underwent pneumatic balloon dilatation at our institute. Patients who could be contacted were inquired regarding their symptoms and dysphagia-free interval after dilatation.

Results: A total of 72 patients were enrolled. Out of this, 14 patients lost to follow-up. Mean age of 58 patients was 45.02 ± 16.51 years. Male:female ratio was 13:16. Mean predilatation Eckardt score was 7.16 ± 0.834. Type I achalasia was present in 10 (17.2%), type II in 44 (75.9%), type III in 4 (6.9%). Predilatation basal integrated relaxation pressure (IRP) was 28.14 ± 14.76 mm Hg. Postdilatation Eckardt score was 2.40 ± 1.67. Postdilatation dysphagia-free interval was 17.28 ± 6.70 months. A total of 9 patients (15.51%) failed to respond to first dilatation and 49 (84.48%) patients benefited from single setting of pneumatic dilatation. Esophageal perforation occurred in 2/58 (3.44%). We did not find any significant difference in gender distribution, age of presentation, duration of symptom, pre- and postdilatation Eckardt score, type of achalasia, and basal IRP on manometry between type of achalasia. Postdilatation dysphagia-free interval in type II achalasia (18.09 ± 5.976 months) was more than types I and III achalasia cardia (p = 0.066), which showed trend toward significance.

Conclusion: Pneumatic balloon dilatation of achalasia cardia is a highly effective endoscopic procedure with minimal complications and mortality. Even the single setting of dilatation can have long-lasting dysphagia-free interval.

Keywords: Achalasia, Eckardt score, Pneumatic balloon dilatation.

How to cite this article: Gupta SJ, Gaikwad NR, Samarth AR, Gattewar SR. Pneumatic Balloon Dilatation for Achalasia Cardia: Outcome, Complications, Success, and Long-term Follow-up. Euroasian J Hepato-Gastroenterol 2017;7(2):138-141.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Banu N Şirvan, Merve K Usta, Nuray U Kızılkan, Nafiye Urgancı

Are Synbiotics added to the Standard Therapy to eradicate Helicobacter pylori in Children Beneficial? A Randomized Controlled Study

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:17-22][No of Hits : 629]


ABSTRACT

Aim: We aimed to evaluate the role of the addition of Bifidobacterium lactis-containing synbiotic to the triple therapy in the case of Helicobacter pylori eradication, the dyspeptic symptoms, and reducing the side effects of antibiotics.

Materials and methods: A total of 104 children aged between 5 and 17 years, who were histopathologically diagnosed with H. pylori were enrolled in this study, of whom 100 were included in the analysis. Patients were randomly classified into two groups. In the first group, 50 patients were administered amoxicillin + clarithromycin + lansoprazole for 14 days and B. lactis-containing synbiotic. In the second group, 50 patients were treated with the standard triple therapy. All patients were given information after completion of therapy.

Results: H. pylori eradication was achieved in 88% in group I who received standard therapy with additional synbiotic and 72% in group II (p = 0.046). The number of patients in the second group who suffered from abdominal pain between the 3rd and 14th day of the treatment was higher (p < 0.05). The addition of probiotics to the triple therapy significantly reduced the frequency of diarrhea, but no significant difference was detected in the frequency of metallic taste (p = 0.04, p = 0.418 respectively).

Conclusion: The addition of synbiotic to the triple therapy is effective for eradicating H. pylori infection in children and is usually helpful to reduce or eliminate dyspeptic symptoms like abdominal pain, diarrhea, and vomiting. This study suggest that improved tolerance to the eradication treatment also reduces the treatment failure by adding probiotics and encourages the future study using probiotic supplementation in H. pylori treatment.

Keywords: Bifidobacterium lactis, Helicobacter pylori, Synbiotic.

How to cite this article: Şirvan BN, Usta MK, Kızılkan NU, Urgancı N. Are Synbiotics added to the Standard Therapy to eradicate Helicobacter Pylori in Children Beneficial? A Randomized Controlled Study. Euroasian J Hepato-Gastroenterol 2017;7(1):17-22.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Mehmet A Erdogan, Ali R Benli, Serap B Acmali, Mustafa Koroglu, Yahya Atayan, Ahmet Danalioglu, Burcak Kayhan

Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:6-10][No of Hits : 628]


ABSTRACT

Aim: To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension.

Materials and methods: This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding. Data derived from medical history, physical examination, ultrasonography, gastrointestinal system endoscopy, complete blood count, hepatic, and renal function tests were recorded and compared between two groups. On physical examination, encephalopathy and ascites were evaluated and graded with respect to Child-Pugh-Turcotte classification.

Results: There was no significant difference between the two groups in terms of age, duration of the disease, and gender of the patient. The only remarkable difference was that hemoglobin (p = 0.02) and hematocrit (p = 0.02) values were lower in group II. Neither the etiology of bleeding was different between groups nor did MPV seem to have a noteworthy impact on bleeding. Interestingly, risk of variceal bleeding increased in parallel to the higher grade of varices.

Conclusion: Our results imply that there is a correlation between the grade of varices and esophageal variceal bleeding in cirrhotic patients. However, association between MPV and variceal bleeding could not be demonstrated. Utilization of noninvasive tests as predictors in these patients necessitates further controlled trials on larger series.

Keywords: Cirrhosis, Mean platelet volume, Portal hypertension, Variceal bleeding.

How to cite this article: Erdogan MA, Benli AR, Acmali SB, Koroglu M, Atayan Y, Danalioglu A , Kayhan B. Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension. Euroasian J Hepato-Gastroenterol 2017;7(1):6-10.

Source of support: Nil

Conflict of interest: None


 
LETTERS-TO-EDITOR
Birnur Yilmaz, Safak Kiziltas, Semsi Yildiz, Burçak Gümüs, Halime Çevik

Simultaneous Immunoglobulin G4-associated Autoimmune Hepatitis and Autoimmune Pancreatitis

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:95-96][No of Hits : 617]


ABSTRACT

The case of a patient with immunoglobulin G4 (IgG4)- associated autoimmune hepatitis (AIH) and autoimmune pancreatitis (AIP) is presented. With increased levels of serum IgG4 and abundant IgG4 positive plasma cell infiltration, AIH was reported and proposed to be called “IgG4-associated AIH.”

Keywords: Autoimmune hepatitis, Autoimmune pancreatitis, Immunoglobulin G4.

How to cite this article: Yilmaz B, Kiziltas S, Yildiz S, Gümüs B, Çevik H. Simultaneous Immunoglobulin G4-associated Autoimmune Hepatitis and Autoimmune Pancreatitis. Euroasian J Hepato-Gastroenterol 2017;7(1):95-96.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Hasan Özkan, Fatih Karakaya, Zihni Karaeren, Sibel Perçinel

Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:92-94][No of Hits : 603]


ABSTRACT

Introduction: CA 19-9 is used as a tumor marker in colon, pancreas, biliary, and gastric cancers. Laryngeal cancer is the most common malignant epithelial tumor among head and neck cancers and has no specific tumor marker.

Case report: A 66-year-old male patient had severe reflux symptoms during 5 years and had an isolated CA 19-9 elevation. Follow-up analysis revealed that he had larynx cancer and after laryngectomy, CA 19-9 levels decreased to normal range.

Discussion: Currently, CA 19-9 is not a marker for malignancy. Laryngeal carcinoma has no specific tumor marker, but laryngeal squamous cell carcinoma may be manifested by elevated CA 19-9 levels.

Keywords: CA 19-9, Laryngeal cancer, Severe reflux disease, Squamous cell carcinoma.

How to cite this article: Özkan H, Karakaya F, Karaeren Z, Perçinel S. Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(1):92-94.

Source of support: Nil

Conflict of interest: None


 
MINI REVIEW
Tatsuya Kanto, Sachiyo Yoshio

Hepatitis Action Plan and Changing Trend of Liver Disease in Japan: Viral Hepatitis and Nonalcoholic Fatty Liver Disease

[Year:2017] [Month:January-June] [Volumn:7 ] [Number:1] [Pages:115] [Pages No:60-64][No of Hits : 580]


ABSTRACT

In Japan, the estimated number of chronic hepatitis B virus infections was 1.1 to 1.4 million, and that of chronic hepatitis C virus was 1.9 to 2.3 million in 2000. The mortality of hepatocellular carcinoma had been increasing and hit the peak at around 2002, which subsequently started to decrease. Japan has a national action plan for addressing viral hepatitis called Basic Act on Hepatitis Measures, established in 2009. In 2011, basic guidelines for promotion of control measures for hepatitis were issued, comprising nine principles in order to promote measures to prevent hepatitis B and C. According to these guidelines, national and local governments share screening costs for testing hepatitis B and C in residents who are over 40 years old. Thus, out-of-pocket expenses from examinees are nil or reduced to the minimum. In addition, for patients with chronic hepatitis B or C and on treatment, drug prices of nucleotide analogs, interferon (IFN) treatment, or IFN-free direct antiviral agents along with examination expenses should be covered by special programs for viral hepatitis. The national and local governments cover the amount in excess of 100 to 200 USD of the cost of treatment. The proportion of liver cancer with nonviral etiology has been increasing in Japan. For the screening and follow-up of patients with nonalcoholic fatty liver disease, we demonstrated that interleukin 34 is a feasible fibrosis marker. Several advantages have prevailed in the Japanese health care systems for patients with viral liver disease compared with those in countries in the Western Pacific region. Therefore, Japan should take a lead in helping the implementation of practical hepatitis action plans in every country when in need.

Keywords: Basic act on hepatitis measures, Basic guidelines for promotion of control measures for hepatitis, Interleukin 34, Nonalcoholic fatty liver disease.

How to cite this article: Kanto T, Yoshio S. Hepatitis Action Plan and Changing Trend of Liver Disease in Japan: Viral Hepatitis and Nonalcoholic Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2017;7(1):60-64.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Alan I Valderrama-Treviño, Baltazar Barrera-Mera, Jesús C Ceballos-Villalva, Eduardo E Montalvo-Javé

Hepatic Metastasis from Colorectal Cancer.

[Year:2017] [Month:July-December] [Volumn:7 ] [Number:2] [Pages:75] [Pages No:166-175][No of Hits : 568]


ABSTRACT

The liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used.
In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors.
Median survival without treatment is <8 months from the moment of its presentation, and a survival rate at 5 years of 11% is the best prognosis for those who present with local metastasis. Even in patients with limited metastatic disease, 5-year survival is exceptional. Patients with hepatic metastasis of colorectal cancer have a median survival of 5 to 20 months with no treatment. Approximately 20 to 30% of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Modern surgical strategies at the main hepatobiliary centers have proved that hepatectomy of 70% of the liver can be performed, with a mortality rate of <5%.
It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital.

Keywords: Colorectal cancer, Hepatic metastasis, Treatment of metastasis.

How to cite this article: Valderrama-Treviño AI, Barrera-Mera B, Ceballos-Villalva JC, Montalvo-Javé EE. Hepatic Metastasis from Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(2):166-175.

Source of support: Alan Isaac Valderrama-Treviño is a doctoral student from Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM) and received fellowship 694871 from CONACYT.

Conflict of interest: None


 
ORIGINAL ARTICLE
Filiz F Bolukbas, Cengiz Bolukbas, Hatice Y Balaban, Cem Aygun, Seyda Ignak, Emine Ergul, Mehtap Yazicioglu, Suat S Ersahin

Intrahepatic Cholestasis of Pregnancy: Spontaneous vs in vitro Fertilization

[Year:2017] [Month:July-December] [Volumn:7 ] [Number:2] [Pages:75] [Pages No:126-129][No of Hits : 565]