JOURNAL OF MEDICAL RESEARCH INSTITUTE <p>The "<strong>Journal of Medical Research Institute (JMRI)</strong>" is the official journal of Medical Research Institute, Alexandria University, Egypt. It is multidisciplinary, peer – reviewed and published bi-annually.</p> medical research institute, Alexandria university en-US JOURNAL OF MEDICAL RESEARCH INSTITUTE 1110-0133 ROLE OF GATED SPECT USING TC 99 SESTAMIBI IN EARLY DETECTION OF SUBCLINICAL HCV RELATED CIRRHOTIC CARDIOMYOPATHY� <p>Background: HCV is one of the health priority in Egypt due to its high <br>prevalence. Cirrhotic cardiomyopathy in manifest stage can affect the <br>patient’s prognosis. This study aimed to evaluate the ability of gated <br>SPECT in detection of early HCV related cirrhotic cardiomyopathy<br>Methods: We studied forty Child A HCV cirrhotic patients with no other <br>cardiac risk factors by conventional echocardiography and Tc99 sestamibi <br>gated SPECT and twenty normal persons as controls.<br>Results: the studied group showed blunted response to stress no ischemic <br>changes and normal right ventricular measures.<br>Conclusions: HCV had an early effect on the heart in the form of <br>chronotropic impairment with stress.</p> Marwa Gaber Gamal Amin Moataz Zaki Ahmed Abdelaty Gehan Magdy Copyright (c) 2019-12-01 2019-12-01 40 2 36 43 ASCITIC INTERLEUKIN 6 AND SERUM PROCALCITONIN FOR EARLY DETECTION OF SPONTANEOUS BACTERIAL PERITONITIS IN ADVANCED LIVER CIRRHOSIS� <p>Background: Liver cirrhosis is associated with frequent bacterial <br>infections that increase mortality. Spontaneous bacterial peritonitis (SBP) <br>is an important cause of mortality and morbidity in such patients with <br>ascites. A polymorphonuclear (PMN) cell count &gt;250/μl in the ascitic <br>fluid is the current gold standard for diagnosing SBP which is considered <br>a subjective test. Early diagnosis of SBP although vital is difficult in these <br>patients. Interleukin 6 is pro-inflammatory marker that increases earlier in <br>bacterial infection than other inflammatory markers. This is crucial in <br>cirrhotic patients to initiate treatment accordingly.<br>Objective: Evaluate the role of IL 6 together with other inflammatory <br>markers in early diagnosis of SBP and as prognostic markers as well.<br>Patients and methods: The study was conducted on 60 cirrhotic patients <br>with ascites divided into 2 groups. Group I included 30 cirrhotic patients <br>with sterile ascites and group II, 30 patients with SBP. Liver profile, <br>serum creatinine, serum sodium, ascitic IL6 , C-reactive protein, serum <br>pro-calcitonin , and ascitic fluid analysis were done for all patients in both <br>groups. Exclusion criteria included; acute infection, diabetes mellitus, <br>coronary vascular disease, collagen vascular disease and any form of <br>sepsis.<br>Results: Ascitic IL6 mean value was 2171.5(62.2 – 5000) and 342.5(146 <br>– 2567) pg/ml in groups I and II respectively which was significantly <br>higher in group I than among group II patients (P&lt;0.001). Furthermore, <br>the mean s. procalcitonin was 0.8(0.4-1.1) and 0.4(0.04-0.7) ng/ml among <br>groups In and II respectively and it was significantly higher among the <br>patients with SBP (P&lt;0.001). Diagnosis of SBP among patients with liver <br>cirrhosis could be suggested when ascitic IL6 and serum procalcitonin are <br>assessed at a cut-off values of &gt;780 pg/ml and &gt;0.4ng/ml respectively.<br>Conclusion: Ascitic IL6 and serum procalcitonin can be used as a <br>valuable surrogate serum marker for early diagnosis of SBP in cirrhotic <br>patients.</p> Marwa Ibrahim Metawea Doaa Ahmed Elwazzan Reham Abdel Haleem Abo Elwafa Sara Lotfy Asser Copyright (c) 2019-12-01 2019-12-01 40 2 44 51