Open Journal of Gastroenterology and Hepatology


FIB-5 versus FIB-4 index for assessment of hepatic fibrosis in chronic hepatitis B affected patients

Research Article of Open Journal of Gastroenterology and Hepatology FIB-5 versus FIB-4 index for assessment of hepatic fibrosis in chronic hepatitis B affected patients Khaled Metwally1, Maha Elsabaawy1, Mohamed Abdel-Samiee1, Wessam morad2, Nermine Ehsan3 and, Eman Abdelsameea1 1Hepatology and gastroenterology department, National Liver Institute, Menoufia University, Egypt.2Community and Preventive Medicine Department, National Liver Institute, Menoufia University, Egypt.3Pathology Department, National Liver Institute, Background: Hepatic fibrosis is one of the major complications of chronic HBV infection. One of the most used non-invasive tests for the assessment of hepatic fibrosis is FIB 4 index, this could be used to avoid liver biopsy. Another noninvasive test fibrofast( FIB-5) also used to detect significant hepatic fibrosis. Aim: The aim of this study was to compare the use of FIB-5 and FIB-4 as non invasive markers to assess chronic HBV related nonsignificant and significant fibrosis. Methods: This study was done on 176 chronic HBV patients.  Liver biopsy, FIB-5 and FIB-4 scores both calculated. Results: for the differentiation between nonsignificant fibrosis and significant fibrosis were: At a cutoff level 1.28 PPV 41.4% and specificity 48% for FIB-4 while at a cutoff level 7.08 PPV 98.8% and specificity 98 % for FIB-5 respectively. Conclusion: As regards both scores,  FIB-5 score was more specific than  FIB-4  for the diagnosing significant from non significant hepatic fibrosis in patients with chronic HBV. Abbreviations:  CHB= Chronic hepatitis B. HBV = Hepatitis B virus, ALP= Alkaline phosphatase, ALT= Alanine aminotransferase, AST= Aspartate aminotransferase, PC= prothrombin concentration, NPV= Negative predictive value, PPV= Positive predictive value, SD= Standard deviation, Sn= Sensitivity and SP= Specificity Keywords: FIB-5, Fib-4, fibrosis,  biopsy, chronic HBV ...

Gastric Outlet Obstruction: Transform in Etiogenesis

Research Article of Open Journal of Gastroenterology and Hepatology GASTRIC OUTLET OBSTRUCTION: TRANSFORM IN ETIOGENESIS: STUDY FROM NORTHERN RAJASTHAN ZUBIN PRADEEP SHARMA, RAVINDRA SHARMA, DIVYA SHARMA, SANTOSH YADAV Department of Gastroenterology, Aditya Hospital And Gastroenterology Centre, Rajasthan, India Objective: To determine the frequency of various etiologies of Gastric Outlet Obstruction in Northern part of Rajasthan, India. Design & Duration: Prospective study carried out from March 2018 to March 2019. Methodology: The data of all the patients who presented with the features of Gastric Outlet Obstruction during the above mentioned period was collected. This data was analyzed with specific reference to recent trends in its etiology. This change in trend was compared with other local and international studies. Results: Fifty patients were included in the study. All patients underwent upper GI endoscopy and biopsy; 40 cases were diagnosed by this method and the remaining by CT scan. Gastric carcinoma was the most common cause of Gastric Outlet Obstruction seen in 36% of the cases. The next common etiology was peptic ulcer disease which was responsible for 32% of the patients. Conclusion: The ratio between benign and malignant etiologies of Gastric Outlet Obstruction is showing a gradual change in favour of malignant lesions. This change is similar to the trends reported in the western literature. Keywords: Gastric Outlet Obstruction, etiology, Gastric Carcinoma, Peptic Ulcer disease ...

Clinical Picture of Celiac disease: Experience from a health care provider in Arabia

Research Article of Open Journal of Gastroenterology and Hepatology Clinical Picture of Celiac disease: Experience from a health care provider in Arabia Diamond Joy, MD, MSc, FRCP (UK)1,  Fuad Y Maufa, MD1,  Nassir Al Hayaf, MD1,  Martin Diamond2,3,  Sayed Z Haji, MD2,  Carole A Merriwether4 1Gastroenterology department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. 2Internal Medicine department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. 3Medical Student, Cardiff Medical School, United Kingdom.4Population health department. Gastroenterology department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Background:  Most studies describing clinical features and associations of celiac disease come from the studies conducted in the western world. Our aim was to determine the clinical features and associations of Celiac disease from our centre serving a Middle East population in Saudi Arabia. Methods: This retrospective study was conducted in a health care provider serving the Eastern Province of Saudi Arabia. All patients with biopsy-confirmed celiac disease receiving health care at our centre between April 2002 and December 2018 were identified. Individual case records were reviewed. In addition, the Slicer Dicer function was also used from the Electronic medical health record [EPIC] for analysing the clinical features and associations. Results: We analyzed the clinical features of 149 patients with Celiac disease. 66% of these were females. There was progressively increased yield of confirmed Celiac disease over the study period. This was paralleled by an increase in TTG antibody tests performed year by year. 77 (51.6%) patients had gastrointestinal symptoms. 26% of patients had iron deficiency anemia. 24 patients (16%) had diabetes, of which 46% were type 2. 18 (12%) patients had osteoporosis or osteopenia, and 28 (19%) had various skin diseases. Conclusion: In Saudi Arabia, celiac disease is being increasingly recognized, largely because of increased awareness and increasing TTG antibody testing. Many patients present with non-gastrointestinal symptoms ...

Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance

Case Report of Open Journal of Gastroenterology and Hepatology Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance David Gay, MD1, Darcy Broughel-Baer, DO2, Rachel Hudacko, MD3 1Department of Pathology, Immunology, and Laboratory Medicine, Rutgers New Jersey Medical School, Medical Science Building C-579, 185 South Orange Avenue, Newark, New Jersey 07103 2Department of Pathology, Orange Regional Medical Center, 707 East Main Street, Middletown, New York 10940 3Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, MEB 212, 125 Paterson Street, New Brunswick, New Jersey 08901 Collagenous colitis is a type of microscopic colitis which was originally named based on specific histologic features and the lack of macroscopic abnormalities in the colon. However, there are reports in the literature that describe various macroscopic findings on colonoscopy in patients with histologically confirmed microscopic colitis. We report a case of collagenous colitis that was characterized by a diffusely polypoid colonic mucosa on gross examination of a right hemicolectomy specimen that was performed for a benign neoplasm in a 72 year old man. It is important for endoscopists to be aware of the various macroscopic abnormalities that may be present in this “microscopic” disease. Keywords: Collagenous colitis (CC), microscopic colitis (MC), colon polyps, endoscopy ...

Dr. Mohammed Naeem
Chair, Patient Safety Reporting/Consultant Pediatric Intensivist/ Head PICU (A)/ Assistant Professor, Dept. of Pediatrics. Ministry National Guard Health Affairs Riyadh, Saudi Arabia

Dr Toru Ishikawa
Gastroenterology, Saiseikai Niigata Daini Hospital

Dr. George Paraskevas
Associate Professor of Anatomy Orthopedic Surgeon, Department of AnatomyMedical School, Aristotle University of Thessaloniki, Post Box: 300, Post Code: 54124, Thessaloniki, Greece

Dr. Mahaboob Vali Shaik
Assistant Professor/Senior Scientist, Department of Genetics & stem cell Research, Narayana Medical College & Hospitals

Dr. Ifeadike Chigozie Ozoemena
Associate Professor, Department of Community Medicine, Faculty of Medicine, Nnamdi Azikiwe University

Dr. Eduardo de Moura GH
Professor, niversity of São Paulo School of Medicine, São Paulo, Brazil

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