Background: Spontaneous bacterial peritonitis (SBP) is an acute infection of ascites with the absence of surgically treatable cause and the gold standard method in its diagnosis is the presence of 250 polymorphonuclear neutrophils (PMN) /mm3 or more by diagnostic paracentesis. Blood neutrophil/lymphocytic ratio (NLR) is an applicable, inexpensive, and simple test for inflammation. C-reactive protein/albumin ratio (CAR) is an inflammatory marker used for the diagnosis and follow-up of many diseases and morbidities. We aimed to evaluate the clinical utility of both blood NLR and CAR as applicable, simple and non-invasive tests for SBP follow-up. Patients and Methods: This study was done on 80 cirrhotic ascitic patients attending the Tropical Medicine Department of Tanta University Hospital. They were subjected to full history taking, clinical examination, laboratory investigations, and ascitic fluid analysis. The patients were divided into two groups according to the results of diagnostic paracentesis into group I: 40 cirrhotic ascitic patients without spontaneous bacterial peritonitis and group II: 40 cirrhotic ascitic patients with spontaneous bacterial peritonitis, and then SBP group were tested after treatment by third-generation cephalosporin for five days for ascitic sample, NLR and CAR. Results: Both blood NLR and CAR were significantly higher in SBP patients. Also, a significant decrease in both ratios was observed post-treatment with significant positive correlations between both NLR and CAR with ascitic neutrophil count after SBP treatment. Conclusion: NLR and CAR can be used as quick, cheap, and applicable markers of the response of treatment in SBP patients.
Background: Hepatocellular Carcinoma (HCC) is a major health problem worldwide and its diagnosis is still challenging. Thioredoxin (TRX) is a class of small redox proteins known to be present in all organisms. It plays a role in many important biological processes, including redox signaling. Aims: The main aim of this study was to study the serum thioredoxin level for assessment of response after ablation therapy for hepatocellular carcinoma in Egyptian patients. Patients and Methods: This prospective case study was carried out in Department of Tropical Medicine and Infectious Diseases, Tanta University Hospital. The duration of study was from April 2019 till April 2020. Results: Significant differences were found between the four groups regarding TRX as group B and C showed significant elevation in TRX level compared to group A & D. TRX was significantly decreased after 6 months compared to 3 months and preoperative. TRX at cutoff 100 ng/ml can differentiate between early HCC and liver cirrhosis with the sensitivity, specificity, PPV and NPV was 95%, 85%, 86% and 94% respectively. There were positive significant correlations between TRX and focal lesion size. There were also positive significant correlations between TRX and aspartate transaminase (AST), Total bilirubin, direct bilirubin and international normalization ratio (INR). In group C after therapeutic intervention, there was a significant decrease in TRX level among patients showing complete response compared to those with partial response or progressive course. Conclusions: TRX could serve as a potential diagnostic biomarker for HCC. TRX could be used as a predictive marker of therapeutic ablation outcome in hepatocellular carcinoma patients.
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