Background and study aim. The introduction of directacting antiviral agents (DAAs) has increased sustained virologic response (SVR) rates in patients with chronic hepatitis C infection (CHC). The aim of this study is to evaluate the efficacy of DAAs in treatment of Egyptian patients with CHC, and to determine the parameters associated with non-response
Hepatocellular carcinoma (HCC) has many options for management; some of them are complicated by development of portal hypertension (PHT). Doppler ultrasound is an effective method to diagnose and monitor PHT changes after HCC ablation procedures. The aim of this study is to investigate changes in portal pressure hemodynamics of HCC patients following treatment with different interventional strategies: radiofrequency ablation (RFA), microwave ablation (MWA), and transarterial chemoembolization (TACE). A total of 60 patients with HCC were divided into three main groups, and each group received a different type of therapy (RFA, MWA, and TACE). Full medical record and basic investigations were performed including Doppler ultrasound and upper GIT endoscopy for evaluation of PHT parameters, and then repeated after three months of ablation. RFA is associated with the increased splenic artery resistive index, while MWA has no significant impact on PHT indices. TACE has led to a marked increase in liver vascular index with significant decrease in hepatic artery resistive index and PHI after treatment. No significant changes in esophageal varices were observed by upper GIT endoscopy following all ablation methods. RFA is quite safe but associated with degree of PHT. On the contrary, TACE is associated with improved PHT parameters. MWA has no significant association to development of PHT following the technique. Doppler ultrasound could be used as a reliable and effective method of evaluation of PHT post ablation for HCC.
Background: COVID-19 pandemic has resulted in exceptional human, public, and economic impacts worldwide. We aimed to evaluate the impact of COVID-19 on hospital admission for endoscopy unit during the COVID-19 pandemic, 2020 in comparison to similar periods in non COVID-19, 2019. Methods: Data from endoscopy unit (between 1 st April to the end of June 2020 were collected and compared to a similar pre-COVID-19period in 2019 as regards, hospitalization rate and endoscopy indication. Result: Compared with non COVID-19 period in 2019, there was a significant reduction during the similar period of COVID-19 pandemic in 2020 as regards; total number of patients who were admitted to endoscopy unit (p< 0.0001), admittion for diagnostic endoscopy due to persistent abdominal pain (14.76% versus 17.81%, p< 0.0001) and follow up band ligation of esophageal varices (48.70% Vs 50.52, p< 0.0001). No significant change between both studied times as regards hospital admission due to gastrointestinal bleeding (25.38% Vs 23.89, p= 0.51) and foreign body swallows. Admitted patients had a similar gender distribution in both studied periods (p= 0.61). In comparison to non COVID-19 times, the majority of admitted patients during pandemic time of COVID 19 were younger than 60 years (65.68% Vs 39.20%, p< 0.0001). Conclusion: Our result demonstrated a significantly lower admission rate for endoscopy during pandemic time of COVID-19 in comparison to similar non pandemic time in 2019, however, hospitalization for urgent endoscopy dose not affected by pandemic time especially for upper gastrointestinal bleeding, suspected malignancy and foreign body swallows.
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