Consultant gastroenterology and hepatology in King Fahd Hospital Madinah KSA responsible for the treatment of the admitted cases ,upper ,lower endoscopy either diagnostic or therapeutic also ERCP either diagnostic or therapeutic .Outpatient clinic for hepatology and gastroenterology( from august 2007 till march 2015).\r\n-Assistant professor of internal medicine (from march 2015 till now) Faculty of Medicine, Mansoura University ,Mansoura Specialized Medical Hospital, (Gastroenterology and Hepatology unit) , and Haematemsis unit in Emergency Hospital.\r\n\r\n\r\n
Abstract: Objectives: Quantitative estimation of serum levels of hepatitis B surface antigen (HBsAg) and HB viral DNA load (HB VDL) in chronic hepatitis B (CHB) patients and their applicability for differentiating between disease phases and to predict the outcome of liver biopsy. Patients & Methods: The study included 113 patients; 67 males and 46 females; with mean age of 42.6±10.8 years and mean disease duration of 5.6±1.1 years. All patients underwent clinical examination, and blind liver biopsy was taken for necrosis and fibrosis histopathological scoring. Fasting venous blood samples were collected for estimation of serum AST and ALT, estimation of hepatitis B serological markers by ELISA and quantitative estimation of serum HBsAg by Roche Cobas e 411 analyzer and estimation of HB VDL by real time PCR. Results: Fifty-three patients were HB e antigen (HBeAg)-positive, while\r\n60 patients were HBeAg-negative. Mean total serum HB VDL was 2907.2±1060 IU/ml; 32 patients had low and 81 patients had high HB VDL. Mean total serum HBsAg level was 24.7±5.9x103 IU/ml. The ratio of the median log10 of serum HB VDL/ serum HBsAg level was 0.42 in low VDL patients and 0.4 in high VDL patients. Regression analysis defined high log10 of serum HBsAg level as the persistently significant determinant of cases with immune tolerance (IT) and/or immune reactive (IR), liver necrosis score, high log10 of serum VDL, the ratio of log10 values of serum VDL to serum HBsAg and male gender. ROC curve analysis defined high log10 of serum HBsAg level as a significant specific and the ratio of log10 of serum HB VDL to serum HBsAg as a significant sensitive predictor for IT cases and high log10 of serum HB VDL and positive HBeAg as significant predictors for presence of fibrosis. Conclusion: Quantitative estimation of serum level of HBsAg and viral load could differentiate between phases of CHB disease and predict histopathological status of the liver, so could spare liver biopsy with its inherent complications.\r\n
Alesia Karpovich has completed the Faculty of Medicine at the age of 25 years from Grodno State Medical University and clinical internship from Grodno State Medical University. She is the assistant of the Department of Internal Medicine. She is the author of more than 40 publications. She is working on his PhD thesis on the study of the characteristics of melatonin secretion in patients with gastroesophageal reflux disease associated with obstructive sleep apnea syndrome.
Gastroesophageal reflux disease (GERD) and obstructive sleep apnea syndrome (OSAS) are widespread medical conditions and often occur as associated disorders. There is some evidence of probable association of Barrett\\\'s esophagus development and OSAS. However, it has been proved that timely OSAS treatment results in the reduction of GERD symptoms. The issues of OSAS prediction in GERD patients have not been properly described, therefore the investigations in this area are rather topical. The investigations were carried out in 58 persons, aged 30-60 years: patients with GERD (group I, n=29) and with GERD/OSAS (group II, n=29). Daily melatonin production was assessed by concentration of 6-sulfatoxymelatonin (6SMT) in 24-hour urine (as well as separately for day and night). The average 6-SMT concentration in group I was 30.53 (7.1; 71.78) ng/ml in 24-hours urine and 31.53 (8.1; 73.34) ng/ml in a daytime portion of urine. In group II 6-SMT concentration was significantly higher than in group I: 101.89 (72.12;149.67) ng/ml in the 24-hour urine and 131.0 (89.28; 180.44) ng/ml in a daytime portion of urine (p < 0.0001, p < 0.0001). The positive correlation was revealed between the severity of OSAS and the level of 6-SMT in daytime urine (r = 0.50, p = 0.00002). The predictive value of concentration of 6-SMT in a daytime portion of urine was analyzed using a receiver operator characteristic (ROC) curve (AUROC = 0.91; р < 0,0001). The threshold value of 6-SMT level in a daily portion of urine is 73.08 ng/ml (sensitivity 92.3%, specificity 72.4%).