Jornal de doenças infecciosas e medicina

Background: Hepatitis A and C viruses are common causing hepatitis (inflammation of liver). Acute and chronic liver infections are characterized by the expression of pro anti-inflammatory cytokines. Human interleukin 6 (IL-6) alliance is interferon beta 2 (designation used in this study) a multifunctional cytokine that interfere in the regulation, maturation and differentiation of immune response. Objective: The aim of this study is to demonstrate the level of IFN-β2 and correlates with AST level in patient’s serum with hepatitis A and C infections. Methods: We evaluate 46 patients presumably with acute HAV and chronic HCV whom have positive HAV IgM, HCV Ab respectively. AST chemical serum levels were detected using kit of an automated chemical Analyzer. IFN-β2 serum level was demonstrated using ELISA technique. Correlation between parameters was evaluated using SPSS and Tableau statistical software. Results: IFN-β2 serum level is raised with CHC more than AHA compared with control samples. AST level was elevated with CHC infections more than AHA infections. The correlation coefficient between IFN-β2 level and AST is significant value with CHC patients but is not value with AHA patients. There is a significant correlation between IFN-β2 and AST levels. Negative correlation coefficient emerged between age parameter and groups of hepatitis. Conclusion: IFN-β2 levels elevated with the increase of AST levels in patients with chronic hepatitis C. The serum levels of IFN-β2, AST varied in different courses of acute hepatitis A and chronic hepatitis C infection. We speculated that measuring levels of IFN-β2 and AST could be used as an indicator to judge the patient's condition with CHC, but not with AHA patients.

Background: We report the first case in the literature of a spontaneous pneumoperitoneum and retropneumoperitoneum.

Case presentation: A 16 year old female, with no previous history of illness, presented in Emmergency Department with brutal acute abdominal pain with septic shock signs. The abdomen computed tomography showed pneumoperitoneum and retro-pneumoperitoneum. The patient was operated by laparoscopy which revealed a moderate purulent ascites but didn’t find any cause of the peritonitis. Post operative care was uneventful and patient was discharged at the 6th post operative day. The ascitic fluid culture was negative.

Conclusion: The laparoscopic approach for acute peritonitis management is very important because it is an efficient tool to diagnose and treat unusual causes of acute spontaneous or primary peritonitis, and permits also to avoid useless laparotomy.

Introduction: Hepatitis B virus (HBV) infection remains a worldwide public health problem. The last major review of the epidemiology and management of HBV in the Middle East was published in 2011. This paper aims to assess the current situation of the HBV care pathway in Kuwait, identify gaps and barriers therein and recommend initiatives to improve patient management.
Materials and Methods: A literature search was conducted in PubMed as well as free internet searches. To provide context to the results and to collect information on areas for which limited evidence was found, interviews and group discussions were held with HBV experts.
Results: There is limited evidence on the national prevalence of HBV; however, prevalence is expected to be higher in those >30 years of age born before the introduction of the HBV vaccination program. There is also limited data on the burden of HBV-related hepatocellular carcinoma in the country. Public and health-care provider awareness of various aspects of the disease is perceived to be low. There are several mandated national screening structures; however, there are no country-specific HBV guidelines regarding diagnosis, linkage-to-care, treatment
and follow-up.
Conclusion: Although significant improvements have been made in the past 30 years in Kuwait in terms of a decline in prevalence, both the burden due to HBV complications and the coverage of screening and treatment remain unclear. Efforts must be made in all areas of the HBV care pathway to improve morbidity and reduce mortality in Kuwait, and the interventions should be supported by research evidence.

Introduction and Objective: The objective of this study is to retrospectively evaluate the sociodemographic characteristics, and clinical and laboratory findings of patients diagnosed with Henoch-Schönlein purpura (HSP) and followed by our clinic, and to review the treatment approaches for these patients. Materials and Methods: The sociodemographic data, clinical and laboratory findings, and treatment information of patients diagnosed with Henoch-Schönlein purpura and admitted to the Pediatric Clinic of the Ministry of Health Okmeydanı Training and Research Hospital between 1 January 2008 - 31 August 2013 were obtained from the file records in the hospital’s data processing system and evaluated in this retrospective, cross-sectional study. Results: The study included 85 patients (49 M, 36 F) between the ages of 2-16 years. 49 patients (57.6%) were male and 36 patients (42.4%) were female, wherein the male: female ratio was 1.36:1. The mean age was 9.9 ± 3.3 years, wherein 53 patients (62.4%) were under 10 years of age and 32 patients (37.6%) were over 10. The most common etiological factor was upper respiratory tract infections (URTI). Purpura was the only symptom observed in all patients and joint involvement was the second most common symptom (60%). Gastrointestinal system (GIS) involvement was observed in 46 patients (58.8%) and invagination was observed in one patient. Nine patients (10.6%) had renal involvement with mild nephropathy. The most frequently observed laboratory findings were increased CRP (47%) and leukocytosis (31%). It was observed that 29 patients (34.1%) were administered nonsteroidal anti-inflammatory drugs and 38 patients (44.7%) were administered corticosteroids in their treatment. Conclusion: HSP, which is commonly seen in children and leads to life-threatening complications in a minority of patients, still remains significant. All patients with GIS symptoms should be examined using imaging methods and monitored in order to assess the severity of the disease, and any GIS complications should be observed and followed-up on.

Globally, Hepatitis-A Virus (HAV) is a major etiology of acute hepatitis. Though, enterically transmitted, there is evidence HAV being transmitted through of blood transfusion. The presence of HAV antibodies may indicate infectious threat to blood transfusion safety. In view of these, the present study was aimed to determine the seroprevalence and associated risk factors of HAV among blood donors in three tertiary Hospitals in Sokoto State, Nigeria. Blood samples were collected from one hundred and sixty eight (168) blood donors >20 years. Sera from these samples were investigated for anti- HAV specific IgG and IgM antibodies using a commercial enzyme immunosorbent assay (ELISA) Kits. Structured questionnaires were used to access sociodemographic variables of subjects Seroprevalence of HAV- specific IgG and IgM were 86.3.1% and 0.0%, respectively. Of 168 blood donors, 145 had previous exposure to HAV [IgG (+) IgM (-), and none had recent infection [IgG (-) IgM (+)], 23 were susceptible to HAV [IgG (-) IgM (-). There was no significant association between seroprevalence and any of the risk factors and sociodemographic variables studied (p>0.05). Findings from this study revealed that larger proportion of blood donors are already immune to HAV infection, while none of them had active HAV infection. The high prevalence of Hepatitis A antibodies among the studied subject reflects a high HAV transmission rate in this area. Hence, determination of HAV should be taken into consideration before blood transfusion.