Screening for H. pylori should be added to the investigations of hyperemesis gravidarum cases. Non teratogenic treatment can be considered in intractable cases.

Response to iron therapy in cases of iron deficiency anemia in patients without H. pylori infection was better than those infected with H. pylori. H. pylori eradication in the infected cases increased their response to iron therapy.

Our patient had 2 vaginal deliveries. Over elective cesarean delivery, we prefer early epidural anesthesia, combined with regular inhalation analgesia as needed, for women with myotonia congenita. If a cesarean delivery is necessary, the epidural solution can be strengthened or the epidural anesthesia can be replaced by spinal anesthesia [5].

Background ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease that causes inflammation and ulcers in the innermost layers of the large intestine (colon) and rectum. Assessment of intestinal inflammation in UC is crucial and still remains a difficult challenge for the clinician. Although endoscopic modalities with biopsy sampling seem to be the most reliable method for estimating disease severity, they are invasive and costly. Apart from endoscopic interventions, disease severity can be assessed using both laboratory studies and non-invasive imaging tests. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), acid glycoprotein, platelet count and albumin are in common use but have only modest accuracy in reflecting UC disease activity. Therefore, adjunctive use of additional serum markers that will be more sensitive and specific for determination of disease activity and achieving diagnostic accuracy is strongly needed in daily clinical practice. Aim of the Work to investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of ulcerative colitis disease. Patients and Methods a case control study that was conducted at the Gastroenterology Clinic, Internal Medicine Department, Ain Shams University during the period of January to July 2018. 60 patients were recruited for the study. They were divided as follows; Group “A”: 40 patients newly diagnosed as ulcerative colitis based on colonoscopy and biopsy, subdivided as follows; 20 patients with active ulcerative colitis and 20 patients with inactive ulcerative colitis. Group “B”: 20 healthy individuals free from any systemic diseases serving as a control group. Results in this study, the serum levels of serum B2-microglobulins were highest in patients with active ulcerative colitis compared to those with inactive ulcerative colitis and the control groups. Also B2-microglobulins values become higher with higher number of presenting symptoms and endoscopic activity, which becomes higher in severe disease. Conclusion our results revealed that serum B2-microglobulin was simple and non-invasive marker that could be helpful for differentiating active UC from inactive disease. Moreover, it was more helpful when used together with serum laboratory inflammatory indices (ESR and CRP).

BACKGROUND Despite significant advancements in liver transplantation (LT) surgical procedures and perioperative care, post-LT biliary complications (BCs) remain a significant source of morbidity, mortality, and graft failure. In addition, data are conflicting regarding the health-related quality of life (HRQoL) of LT recipients. Thus, the success of LT should be considered in terms of both the survival and recovery of HRQoL. AIM To assess the impact of BCs on the HRQoL of live-donor LT recipients (LDLT-Rs). METHODS We retrospectively analysed data for 25 LDLT-Rs who developed BCs post-LT between January 2011 and December 2016 at our institution. The Short Form 12 version 2 (SF 12v2) health survey was used to assess their HRQoL. We also included 25 LDLT-Rs without any post-LT complications as a control group. RESULTS The scores for HRQoL of LDLT-Rs who developed BCs were significantly higher than the norm-based scores in the domains of physical functioning ( P = 0.003), role-physical ( P < 0.001), bodily pain ( P = 0.003), general health ( P = 0.004), social functioning ( P = 0.005), role-emotional ( P < 0.001), and mental health ( P < 0.001). No significant difference between the two groups regarding vitality was detected ( P = 1.000). The LDLT-Rs with BCs had significantly lower scores than LDLT-Rs without BCs in all HRQoL domains ( P < 0.001) and the mental ( P < 0.001) and physical ( P = 0.0002) component summary scores. CONCLUSION The development of BCs in LDLT-Rs causes a lower range of improvement in HRQoL.