Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The dur...Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.展开更多
Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected...Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied.Results:Anti-T.gondii IgG antibodies were found in 32.8%of patients and in 22.2%of controls(P=0.02).Toxoplasma seropositivity was significantly associated with lymphadenopathy,history of blood transfusion and reflex impairment in patients.Chronic hepatitis C virus(HCV)and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T.gondii seropositivity(odds ratio(OR) =4;95%confidence interval(CI):1.3-12.6;P=0.013,OR=4.8;95%CI:1.5-14.9;P=0.006,respectively).Within the chronic HCV group,T.gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation(OR=19.4;95%CI:2.3-165.2;P=0.0008,OR=0.29;95%CI:0.1-0.8;P=0.01,respectively).Albumin,international normalized ratio(INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positrvc chronic HCV patients(P=0.00 l,0.03,0.04,respectively).Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group(OR= 0.08;95%67:0.01-0.5;P=0.003).Conclusions:Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution,suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis.展开更多
文摘Intermittent fasting(IF)is an intervention that involves not only dietary modific-ations but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding.The duration of fasting differs from one regimen to another.Ramadan fasting(RF)is a religious fasting for Muslims,it lasts for only one month every one lunar year.In this model of fasting,observers abstain from food and water for a period that extends from dawn to sunset.The period of daily fasting is variable(12-18 hours)as Ramadan rotates in all seasons of the year.Consequently,longer duration of daily fasting is observed during the summer.In fact,RF is a peculiar type of IF.It is a dry IF as no water is allowed during the fasting hours,also there are no calorie restrictions during feeding hours,and the mealtime is exclusively nighttime.These three variables of the RF model are believed to have a variable impact on different liver diseases.RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improve-ments in anthropometric measures,metabolic profile,and liver biochemistry regardless of the calorie restriction among lean and obese patients.The situation is rather different for patients with liver cirrhosis.RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis.Cirrhotic patients developed new ascites,ascites were increased,had higher serum bilirubin levels after Ramadan,and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding.These complications were higher among patients with Child class B and C cirrhosis,and some fatalities occurred due to fasting.Liver transplant recipients as a special group of patients,are vulnerable to dehydration,fluctuation in blood immunosuppressive levels,likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them.Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.
文摘Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied.Results:Anti-T.gondii IgG antibodies were found in 32.8%of patients and in 22.2%of controls(P=0.02).Toxoplasma seropositivity was significantly associated with lymphadenopathy,history of blood transfusion and reflex impairment in patients.Chronic hepatitis C virus(HCV)and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T.gondii seropositivity(odds ratio(OR) =4;95%confidence interval(CI):1.3-12.6;P=0.013,OR=4.8;95%CI:1.5-14.9;P=0.006,respectively).Within the chronic HCV group,T.gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation(OR=19.4;95%CI:2.3-165.2;P=0.0008,OR=0.29;95%CI:0.1-0.8;P=0.01,respectively).Albumin,international normalized ratio(INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positrvc chronic HCV patients(P=0.00 l,0.03,0.04,respectively).Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group(OR= 0.08;95%67:0.01-0.5;P=0.003).Conclusions:Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution,suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis.
