The purpose of the research is identifying patients with helicobacteriosis and opisthorchosis, and determining regular features of the course of combined diseases.Materials and methods. The study involved 50 patients in the Gastroenterology Department with helicobacteriosis diagnosed. Helicobacter pylori was confirmed by the HP test during fibrogastroduodenoscopy. Opisthorchis felineus was detected in patients using the study of feces by the Kato technique and enrichment method. The patients were divided into 2 groups of 25 people each. The first group only consisted of patients with H. pylori. The second group consisted of patients in whom H. pуlori and O. felineus were identified. Initially, the levels of aminotransferases and bilirubin were assessed using a biochemical blood test on a MIURA 200 apparatus. The manifestation of such clinical symptoms as abdominal pain was assessed using a visual analogue scale (VAS). Further, the eradication of H. pylori during therapy was assessed based on the Maastricht V recommendations for 14 days, including the use of three drugs: omeprazole at a dose of 20 mg 2 times a day, clarithromycin – 500 mg 2 times a day, amoxicillin – 1000 mg 2 times a day, and the effectivity of treatment of patients of the second group with opisthorchosis with the use of praziquantel at a dose of 60 mg/kg of body weight during the day three times every 4 hours.Results and discussion. In the second group of patients with combined pathology, pain intensity was estimated at 4–5 scores in 20 people (80%), and at 2–3 scores in 25 people (100%) in the first group. The severity of nausea was also higher in 100% of patients in the second group. Values for AST and ALT in blood were higher in patients of the second group – by an average of 50–100% in 18 people (72%); increase in the level of bilirubin by 15% in 23 people (92%). Combined pathology (opisthorchosis and helicobacteriosis) is accompanied by more pronounced clinical symptoms (abdominal pain and nausea). In patients with opisthorchosis and H. pуlori, aminotransferases increased up to three reference values and bilirubin increased by 15% were noted. For helicobacteriosis and opisthorchosis, longer treatment was required. The presence of H. pylori at the same time with opisthorchosis did not affect the efficacy of antiparasitic therapy.
The purpose of the research is identifying and determining clinical and laboratory features of coinfection caused by Opisthorchis felineus and Lamblia intestinalis.Materials and methods. We described a clinical picture and laboratory abnormalities in 50 patients with O. felineus infection. Of these cases, 25 people were diagnosed with lambliosis. The therapy included three consecutive stages: preparatory stage, antiprotozoal and anthelmintic treatments, and rehabilitation stage. The preparatory stage was aimed to improve the biliary tract function, to reduce intoxication symptoms, and to stop acute allergic reactions. The patients received choleretics, antispasmodics, antibacterial drugs, antihistamines, enzymes, and adsorbents for 2–4 weeks. At the end of the preparatory stage, the patients from the second group were prescribed albendazole of 800 mg per day in two doses of 400 mg per os during meals for 5 days. In the second treatment stage, the patients with opisthorchosis received praziquantel at a dose of 75 mg/kg of body weight per os for one day in three doses. The rehabilitation phase lasted for four months. The next step was to assess lamblia eradication results by the control coproprotozooscopy and/or biliprotozooscopy for cysts and/or vegetative forms of L. intestinalis at 7 days, 1 month and 6 months after treatment with albendazole. The control coproovoscopy for O. felineus eggs was performed at 6 months after praziquantel treatment.Results and discussion. We studied the influence of L. intestinalis on the nature and severity of clinical and laboratory symptoms of opisthorchosis. It was revealed that clinical symptoms (abdominal pain, nausea, low-grade fever or dermatosis) and laboratory syndromes (cytolysis and cholestasis) were more pronounced in case of concomitant helminth and protozoan infections. Lambliosis is more difcult to treat when combined with opisthorchosis.
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