Debates are inevitable in science and could be a powerful tool for addressing controversial topics as it promotes critical thinking and inspires individuals to consider alternate viewpoints. However, debates can help only to identify the issues that need to be clarified to address this question, but it can never help resolve the controversy itself. In the era of evidence‐based medicine, the need for an evidence‐based debate is mandatory. Polarising opinions and major debate have recently arisen in hepatology on the nomenclature and diagnostic criteria for fatty liver disease associated with metabolic dysfunction (non alcoholic fatty liver disease [NAFLD]‐metabolic (dysfunction) associated fatty liver disease [MAFLD] debate). The aim of this viewpoint is to suggest a way to settle the debate through evidence. Descriptive review using PubMed to identify literature on the evidence and eminence‐based medicine and studies comparing MAFLD and NAFLD criteria. The emerging studies comparing the performance of diagnostic criteria of NAFLD and MAFLD represent the dawn of a new era for reframing the ongoing debate by acquisition of the mandatory evidence that will both resolve the debate and lead to novel avenues of research. In conclusion, the time has come to hold debate and focus on gathering and building the evidence to settle it. It does not matter who wins the debate and once there is robust evidence, we should all follow it wherever it leads.
Climate change is already a reality in Africa. Many countries across Africa are classified as Least-Developed Countries (LDCs) with poor socio-economic conditions and by implication are faced with particular challenges in responding to the impacts of climate change. African countries have the least efficient public health systems in the world. Infectious disease burdens, which are sensitive to climate impacts, are highest in the sub-Saharan African region. Changes in climate will affect the spread of infectious agents as well as alter people’s disposition to these infections Climate change has the capability to drive parasitic disease incidence and prevalence worldwide. There are both direct and indirect implications of climate change on the scope and distribution of parasitic organisms and their associated vectors and host species. Currently there is lack of reviews in the literature addressing comprehensively the impact of climate change on the prevalence of parasitic liver disease in Africa. The aim of the current review is to discuss the impact of climate change on parasitic liver disease in Africa, and to detect the gaps in the research done in this field. This review is discussing the impact of climate change on some common parasitic liver diseases in Africa regarding the spread of infectious agents and the liver diseases caused by them. Conclusion: Evidences showed that climate change; including rise in ambient temperature, disturbance of rainfall, water safety, and ecological changes, leads to change in the expansion of vectors or reservoirs of infection and the burden of parasitic infections in endemic areas in Africa. In addition to the effect of man-made construction of irrigation schemes are also responsible for continued transmission of some parasitic diseases in African countries.
Background: Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. This study aimed to evaluate the impact of DAAs on achievement of improvement in liver fibrosis, and to evaluate risk factors associated with progression of liver fibrosis in patients achieved sustained virological response (SVR). Method: the study included 300 patients diagnosed with chronic HCV infection started their treatment protocol form 2016 who were divided into two groups; Group I (150 patients) included patients who received Sofosbuvir + Simeprevir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment, and Group II (150 patients) included patients who received Sofosbuvir + Daclatasvir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment. All cases were subjected to complete history taking, thorough physical examination, routine laboratory investigations, pelviabdominal US together with transient elastography were ordered for all cases. Results: both HCV treatment regimens showed improvement in liver fibrosis, fibro scan parameters showed a significant decrease in both groups compared to the baseline as pretreatment examination revealed mean values of 9.81 and 9.75 in both groups respectively. After treatment, both groups had mean values of 8.11 and 8.05. Both groups showed a significant change compared to its pre-treatment value (p < 0.001). There was a significant negative correlation between fibro scan parameter decrease with age, BMI, and HbA1C levels. There was no difference in degree of improvement of liver fibrosis between both regimens. Conclusion: fibrosis regressed significantly after DAAs
H. pylori eradication was not associated with impaired ulcer healing in a Middle Eastern population with symptomatic NSAID induced gastro/duodenal lesions, when a high healing dose of omeprazole (40 mg) was used. After eradication, omeprazole 10 or 20 mg per day were highly and equally effective for maintenance of gastroduodenal mucosal integrity during continued NSAID use. H. pylori should be eradicated from symptomatic Middle Eastern NSAID users with peptic ulcer disease.
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