AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; ...AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; positive microbiology, histo-pathology, imaging or response to trial of anti TB drugs） during the period 1999 to 2004 were analyzed. Patient＇s characteristics, laboratory investigations, radiological, endoscopic and surgical findings were evaluated. Abdominal site involved （intestinal, peritoneal, visceral, and nodal） and response to treatment was also noted.RESULTS： There were 209 patients enrolled. One hundred and twenty-three （59%） were females. Symptoms were abdominal pain 294 （93%）, fever 234 （64%）, night sweats 99 （48%）, weight loss 98 （47%）, vomiting 75 （36%）, ascites 74 （35%）, constipation 64 （31%）, and diarrhea 25 （12%）. Sub-acute and acute intestinal obstruction was seen in 28 （13%） and 12 （11%） respectively. Radiological evidence of pulmonary tuberculosis was found in 134 （64%） patients. Basis of diagnosis of abdominal tuberculosis were radiology （Chest and barium X-Rays, Ultrasound and CT scan abdomen） in 111 （53%） and histo-pathology （tissue obtained during surgery, colonoscopy, CT or ultrasound guided biopsy, laparoscopy and upper gastro intestinal endoscopy） in 87 （42%） patients. Mycobacterium culture was positive in 6/87 （7%） patients and response to therapeutic trial of anti tubercular drugs was the basis of diagnosis in 5 （2.3%） patients. Predominant site of involvement by abdominal TB was intestinal in 103 （49%） patients, peritoneal in 87 （42%） patients, solid viscera in 10 （5%） and nodal in 9 （4%） patients. Response to medical treatment was found in 158 （76%） patients and additionally 35 （17%） patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patients died （eight post operative） and no case of relapse was noted.CONCLUSION： Abdominal TB has diverse and nonspecific symptomatology. No single test is adequate for diagnosis of abdominal tuberculosis in all patients. Abdominal TB in non-HIV patients remains an ongoing diagnostic dilemma requiring a high index of clinical suspicion.展开更多
AIM: To determine the predictive factors for early aspiration in liver abscess. METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in ...AIM: To determine the predictive factors for early aspiration in liver abscess. METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess. RESULTS: A total of 966 patients, 738 (76%) male, mean age 43 ± 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age ≥ 55 years, size of abscess ≥ 5 cm, involvement of both lobes of the liver and duration of symptoms ≥ 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group. CONCLUSION: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.展开更多
OBJECTIVE： Helicobacter pylori is a Gram-negative organism. Its outer membrane protein Q（Hop Q） mediates host-pathogen interactions; Hop Q genotypes 1 and 2 are found associating with gastroduodenal pathologies. Th...OBJECTIVE： Helicobacter pylori is a Gram-negative organism. Its outer membrane protein Q（Hop Q） mediates host-pathogen interactions; Hop Q genotypes 1 and 2 are found associating with gastroduodenal pathologies. The authors measured the anti-adhesion effects of the extracts of Abelmoschus esculentus, Zingiber officinale, Trachyspermum ammi, Glycyrrhiza glabra, Curcuma longa and Capsicum annum against Hop Q genotypes and H. pylori cytotoxin-associated gene A（Cag A）.METHODS： DNA was extracted by polymerase chain reaction of the Hop Q genotypes（i.e., type 1, type 2 and Cag A） from 115 H. pylori strains. The effect of the extracts from selected dietary ingredients was determined using a gastric adenocarcinoma cell line and a quantitative DNA fragmentation assay. The anti-adhesive effect of these extracts on H. pylori was tested using an anti-adhesion analysis.RESULTS： C. annum, C. longa and A. esculentus showed prominent anti-adhesion effects with resultant values of 17.3% ± 2.9%, 14.6% ± 3.7%, 13.8% ± 3.6%, respectively, against Hop Q type 1 and 13.1% ± 1.7%, 12.1% ± 2%, 11.1% ± 1.6%, respectively, against Hop Q type 2. C. longa（93%）, C. annum（89%） and A. esculentus（75%） had better anti-adhesive activity against H. pylori with Hop Q type 1 compared to Hop Q type 2 with respective values of 70%, 64% and 51%. Extracts of C. annum（14.7% ± 4.1%）, A. esculentus（12.3% ± 4.1%） and Z. officinale（8.4% ± 2.8%） had an anti-adhesion effect against Cag A-positive H. pylori strains compared to Cag A-negative strains.展开更多
文摘AIM： To assess the clinical features, yield of the diagnostic tests and outcome of abdominal tuberculosis in non-HIV patients.METHODS： Adult patients with discharge diagnosis of abdominal tuberculosis （based upon; positive microbiology, histo-pathology, imaging or response to trial of anti TB drugs） during the period 1999 to 2004 were analyzed. Patient＇s characteristics, laboratory investigations, radiological, endoscopic and surgical findings were evaluated. Abdominal site involved （intestinal, peritoneal, visceral, and nodal） and response to treatment was also noted.RESULTS： There were 209 patients enrolled. One hundred and twenty-three （59%） were females. Symptoms were abdominal pain 294 （93%）, fever 234 （64%）, night sweats 99 （48%）, weight loss 98 （47%）, vomiting 75 （36%）, ascites 74 （35%）, constipation 64 （31%）, and diarrhea 25 （12%）. Sub-acute and acute intestinal obstruction was seen in 28 （13%） and 12 （11%） respectively. Radiological evidence of pulmonary tuberculosis was found in 134 （64%） patients. Basis of diagnosis of abdominal tuberculosis were radiology （Chest and barium X-Rays, Ultrasound and CT scan abdomen） in 111 （53%） and histo-pathology （tissue obtained during surgery, colonoscopy, CT or ultrasound guided biopsy, laparoscopy and upper gastro intestinal endoscopy） in 87 （42%） patients. Mycobacterium culture was positive in 6/87 （7%） patients and response to therapeutic trial of anti tubercular drugs was the basis of diagnosis in 5 （2.3%） patients. Predominant site of involvement by abdominal TB was intestinal in 103 （49%） patients, peritoneal in 87 （42%） patients, solid viscera in 10 （5%） and nodal in 9 （4%） patients. Response to medical treatment was found in 158 （76%） patients and additionally 35 （17%） patients also underwent surgery. In a 425 ± 120 d follow-up period 12 patients died （eight post operative） and no case of relapse was noted.CONCLUSION： Abdominal TB has diverse and nonspecific symptomatology. No single test is adequate for diagnosis of abdominal tuberculosis in all patients. Abdominal TB in non-HIV patients remains an ongoing diagnostic dilemma requiring a high index of clinical suspicion.
文摘AIM: To determine the predictive factors for early aspiration in liver abscess. METHODS: A retrospective analysis of all patients with liver abscess from 1995 to 2004 was performed. Abscess was diagnosed as amebic in 661 (68%) patients, pyogenic in 200 (21%), indeterminate in 73 (8%) and mixed in 32 (3%). Multiple logistic regression analysis was performed to determine predictive factors for aspiration of liver abscess. RESULTS: A total of 966 patients, 738 (76%) male, mean age 43 ± 17 years, were evaluated: 540 patients responded to medical therapy while adjunctive percutaneous aspiration was performed in 426 patients. Predictive factors for aspiration of liver abscess were: age ≥ 55 years, size of abscess ≥ 5 cm, involvement of both lobes of the liver and duration of symptoms ≥ 7 d. Hospital stay in the aspiration group was relatively longer than in the non aspiration group. Twelve patients died in the aspiration group and this mortality was not statistically significant when compared to the non aspiration group. CONCLUSION: Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.
文摘OBJECTIVE： Helicobacter pylori is a Gram-negative organism. Its outer membrane protein Q（Hop Q） mediates host-pathogen interactions; Hop Q genotypes 1 and 2 are found associating with gastroduodenal pathologies. The authors measured the anti-adhesion effects of the extracts of Abelmoschus esculentus, Zingiber officinale, Trachyspermum ammi, Glycyrrhiza glabra, Curcuma longa and Capsicum annum against Hop Q genotypes and H. pylori cytotoxin-associated gene A（Cag A）.METHODS： DNA was extracted by polymerase chain reaction of the Hop Q genotypes（i.e., type 1, type 2 and Cag A） from 115 H. pylori strains. The effect of the extracts from selected dietary ingredients was determined using a gastric adenocarcinoma cell line and a quantitative DNA fragmentation assay. The anti-adhesive effect of these extracts on H. pylori was tested using an anti-adhesion analysis.RESULTS： C. annum, C. longa and A. esculentus showed prominent anti-adhesion effects with resultant values of 17.3% ± 2.9%, 14.6% ± 3.7%, 13.8% ± 3.6%, respectively, against Hop Q type 1 and 13.1% ± 1.7%, 12.1% ± 2%, 11.1% ± 1.6%, respectively, against Hop Q type 2. C. longa（93%）, C. annum（89%） and A. esculentus（75%） had better anti-adhesive activity against H. pylori with Hop Q type 1 compared to Hop Q type 2 with respective values of 70%, 64% and 51%. Extracts of C. annum（14.7% ± 4.1%）, A. esculentus（12.3% ± 4.1%） and Z. officinale（8.4% ± 2.8%） had an anti-adhesion effect against Cag A-positive H. pylori strains compared to Cag A-negative strains.
