Background: Helicobacter pylori infection is one of the most prevalent chronic bacterial human infections worldwide. Helicobacter pylori colonizes the gastric mucosa and causes persistent gastritis that may progress to gastric cancer. Increased resistance of H. pylori presents a major problem in most countries. Statins, including simvastatin, which are currently used to treat hypercholesterolemia, appear to have potential synergistic role to antibiotics. This study aimed to assess the value of adding simvastatin as adjuvant to standard triple therapy in patients infected with H. pylori . Methods: This study was conducted on 100 patients diagnosed with H. pylori by the presence of antigen in stools. All patients were randomly subjected either to the standard triple regimen (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid) (group 1, N=50) or to the standard triple regimen plus simvastatin (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid + simvastatin 20 mg bid) (group 2, N=50). Both groups were treated for 14 days and eradication of H. pylori was assessed by a stool antigen test 4 weeks after therapy. Results: Eradication of H. pylori infection was significantly higher in patients treated with the standard triple therapy plus simvastatin (n=41, 82%) than in patients treated with the standard triple therapy (n=31, 62%) ( P <0.022). Conclusion: Simvastatin significantly improves the H. pylori eradication rate.

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Background and aimCardiac dysfunction is a prevalent finding in patients with liver cirrhosis. We aimed to evaluate left ventricular function by tissue Doppler imaging in patients with liver cirrhosis.Patients and methods This is a cross-sectional case-control study that involved 90 patients with liver cirrhosis: 30 patients with Child A, 30 patients with Child B, and 30 patients with Child C cirrhosis. Moreover, 45 healthy volunteers were included in the study as a control group. All patients and controls were examined by conventional Doppler and tissue Doppler echocardiography. ResultsPatients with liver cirrhosis showed significantly lower ejection fraction (EF) levels than control group (P=0.001), but only nine patients showed EF levels less than 55. Moreover, there is significantly decrease in EF in patients with decompensated cirrhosis than those with compensated cirrhosis (P=0.005). A total of 60 patients showed diastolic dysfunction: 10 patients with Child A, 20 patients with Child B, and 30 patients with Child C cirrhosis. There were significantly differences between patients with liver cirrhosis and control group in the other parameters of systolic (S wave and myocardia performance index) and diastolic (early and late velocity and deceleration and isovolumetric relaxation time) functions. ConclusionPatients with liver cirrhosis showed significantly decreased left ventricular systolic and diastolic functions than control group, which is more pronounced in decompensated than compensated patients.

BACKGROUND/AIM: An association between non-alcoholic fatty liver disease (NAFLD) and serum vitamin D levels is thought to exist. However, the definite role and mechanisms are unknown. Aim: we aimed to investigate serum vitamin D levels in patients with NAFLD. METHODS: Fifty patients with NAFLD and another 50 healthy volunteers without NAFLD or any clinically apparent liver diseases were enrolled in this study. Diagnosis of NAFLD is based on ultrasound (U.S) findings after exclusion of other possible causes of NAFLD and chronic liver diseases. Serum 25(OH) vitamin D levels were measured using ELISA based test. RESULTS: There are statistically significant decrease of serum 25(OH) vitamin D levels in patients with NAFLD than those without NAFLD. Serum 25(OH) vitamin D level is inversely correlated with body mass index (BMI), total cholesterol, triglycerides, low density lipoprotein (LDL) and age. CONCLUSION: Serum 25(OH) vitamin D level is inversely associated with NAFLD.

Purpose Periportal hyperechogenicity has been recorded in many inflammatory and infectious diseases, including viral hepatitis, inflammatory bowel diseases, toxic shock syndrome of staphylococcus infection, typhoid fever, and schistosomiasis. We aimed to evaluate the echogenicity of the portal tracts of the liver by abdominal ultrasound imaging in patients with fever irrespective of the cause. Methods Abdominal ultrasound examination was performed in 277 consecutive patients presented with fever at their first visit and repeated 2 weeks later after their recovery. Results Transient periportal hyperechogenicity was present in 39% (108 patients) of the feverish patients studied irrespective of the cause of the fever. Conclusion Transient periportal hyperechogenicity is a frequent ultrasonographic finding in feverish patients irrespective of the cause of fever, and hence should not be misdiagnosed as liver disease or chronic periportal fibrosis unless the hyperechogenicity persists after recovery from the febrile or inflammatory condition.