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Articles by Ashraf Elsherbiny
Total Records ( 3 ) for Ashraf Elsherbiny
  Ashraf Elsherbiny , Heba Sayed Assal , Mohamed Abd Elmabood and Emad A. A. Hussein
  The aim of present study was to compare three different endoscopic methods in the management of Type I and II gastric varices (GV): (I) gastric variceal obturation using cyanoacrylate, (II) gastric variceal sclerotherapy using absolute alcohol and (III) gastric variceal ligation by rubber (O) bands. The comparison regards the technical ease, efficacy, complications and number of sessions needed to eradicate varices. To fulfill this aim we studied 115 patients with chronic liver disease and gastric varices presented to the central endoscopy unit Ain Shams University Hospital. The patients were categorized into (3) groups: Group I included 45 patients who underwent GV obturation using cyanoacrylate, Group II included 30 patients who underwent GV sclerotherapy using alcohol injection and Group III included 40 patients who underwent GV band ligation. All patients were age and sex matched. We excluded patients with Type III GV, hepatic encephalopathy, hepatocellular carcinoma and prior history of sclerotherapy, band ligation or shunt operation. Present results showed that cyanoacrylate obturation of gastric varices was more effective in controlling gastric variceal bleeding (95.6%) than other methods with low number of sessions and low rebleeding rate than GV Ligation (35%) or alcohol injection (46.7%). So We conclude that gastric variceal obturation by cyanoacrylate proved more effective and safer than gastric variceal ligation or injection sclerotherapy using absolute alcohol in the management of Type I and II gastric varices.
  Heba Sayed Assal , Mohamed Fath-Allah and Ashraf Elsherbiny
  Adiponectin is an adipocyte-secreted protein that circulates in high concentrations in the serum and acts to increase insulin sensitivity. Leptin is an adipocyte-derived hormone that acts to reduce food intake and increase energy expenditure by binding and activating its specific receptor in the hypothalamus. Clinical aspects of diabetes and obesity are somewhat different, even at similar levels of insulin resistance. The purpose of this study was carried out to determine serum leptin, serum adeponectin and to compare leptin to adeponectin ratio in diabetic and non-diabetic obese participants. One hundred patients were enrolled in the study, 40 type 2 diabetic obese, 40 obese persons and 20 non-obese volunteers as a control group. Body mass index and waist-to-hip ratio was calculated. Laboratory investigations were: alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, Creatinine, fasting and post-prandial glucose levels, glycated haemoglobin (HbA1c), cholesterol, triglycerides (TGs), HDL-cholesterol, LDL-cholesterol, leptin and adiponectin. Subjects were categorized into 3 groups, Group I: included 40 obese (mean BMI was 33.6±2.0 kg m-2) patients with type II diabetes. The mean of HbA1c was 6.9±1.5%; serum TGs was 141.6±93 mg %; serum creatinine was 0.86±0.15 mg %; serum leptin was 12.9±0.35 ng mL-1; serum adiponectin was 6.44±0.16 μg mL-1. Group II: included a total number of 40 obese (mean BMI was 34.8±1.2 kg m-2) participants The mean of HbA1c was 5.6±2.7%; serum TGs was 115±54 mg %; serum creatinine was 0.95±0.2 mg %; serum leptin was 8.7±0.5 ng mL-1; serum adiponectin was 7.84±0.25 μg mL-1. Group III: included a total number of 20 non-obese volunteers (age ranged from 28 to 58 with a mean of 44.9±14.5 years; 13 males and 7 females). The mean of HbA1c was 5.2±0.5%; serum TGs was 104±22 mg %; serum creatinine was 0.84±0.5 mg %; serum leptin was 5.2±0.2 ng mL-1; serum adiponectin was 9.2±0.3 μg mL-1. Present results showed that obesity, WHR and DM are inversely associated with adiponectin, directly associated with leptin and leptin/adiponectin ratio.
  Wafaa M. Ezzat , Hala M. Raslan , Ashraf Elsherbiny , Mohamed Mokhles , Mohamed Mahmoud Ahmed , Nagwa Abd El-Ghaffar and Enas Abdel Rasheed
  Aim of this study to detect the effect of chronic liver diseases on bone mineral density and bone turnover markers. Sixty two patients with chronic hepatitis C viral (HCV) infection were included in the study. They were 37 males and 25 females, their ages ranged from 27 to 68 years. They were divided into two groups. The first group consisted of 37 patients with chronic hepatitis (22 males and 15 females, age range: 27-59 years) and the second group consisted of 25 patients with liver cirrhosis (16 males and 9 females, age range: 34-68 years). Thirty three healthy subjects age and sex matched with the patients were taken as control group. For all patients and controls Bone Mineral Density (BMD) g cm¯2 of the lumbar spines and the left proximal femur were measured by dual energy X-ray absorptiometry (DEXA) and serum levels of osteocalcin, C- terminal propeptide of type I collagen (CICP), osteoprotegrin (OPG) and soluble receptor activator of nuclear factor (sRANKL) NF-KB ligand and urinary deoxypyridinoline (DPD) were assessed. The results showed that BMD at the proximal femur was normal among 35.1% of patients with chronic hepatitis, 36% of patients with liver cirhosis and 51.5% of controls with insignificant difference. Osteopenia was present among 43.2% of patients with chronic hepatitis, 32% of patients with liver cirrhosis and 39.4% of controls with insignificant difference. Osteoporosis was significantly more prevalent among patients with liver cirrhosis (323%) compared to controls (9.1%) p = 0.04. BMD of the lumbar spine was normal among 45.9% of patients with chronic hepatitis, 48% of patients with liver cirrhosis and 72.7% of normal control with insignificant difference. Osteopenia was present among 45.9% of patients with chronic hepatitis, 36% of patients with liver cirrhosis and 24.2% of controls with significant difference between chronic hepatitis and controls (p = 0.02). Osteoporosis was present among 8.1% of patients with chronic hepatitis, 16% of patients with liver cirrhosis and 3% of controls with insignificant difference. There was no significant difference as regard mean values of osteocalcin and CICP between chronic hepatitis (7.6±13.1 and 171.9±136.3, respectively), cirrhosis (7.3±3.7 and 246.5±160.2, respectively) and controls (3.4±3 and 224.2±122.1, respectively). Mean values of OPG were significantly higher in cirrhosis (8.9±9.1) compared to controls (4.9±3.9) (p = 0.03). As regard markers of bone resorption, there was no significant difference between the three groups. Mean urinary DPD levels among chronic hepatitis, cirrhosis and controls were: 40.3±29.8, 42.2±26.7 and 65.7±49.6, respectively. Serum levels of sRANKL among chronic hepatitis, cirrhosis and controls were: 0.5±0.5, 0.6±0.7 and 0.4±0.3, respectively. When we classify all patients and controls according to BMD of proximal femur and lumbar spine, into three groups: normal, osteopenia and osteoporosis, we did not found any significant difference as regard bone turnover markers between the three groups. When we do the same classsification for the patients with chronic hepatitis and cirrhosis each separately, we found that in patients with cirrhosis, mean CICP levels were significantly lower among patients with osteopenia of proximal femur (172±108.1) compared to patients with normal BMD (351.6±131.8) (p = 0.05). BMD is decreased in chronic liver disease, with the proximal femur most commonly affected and patients with liver cirrhosis are at higher risk than patients with chronic hepatitis.
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