13^th Euro-Global Gastroenterology Conference August 20-21, 2018 Rome, Italy

Dustov Abdusamad is of the age 64 years from Bangladesh. He is working as Head of the Department of Virology in the Institute of Gastroenterology of Republic of Tajikistan. He is greatly interested in research works on Viruses. He participated in many international conferences. He has more than 20 publications.

Chronic HBV and/or HCV infection can progress to liver cirrhosis and hepatocellular carcinoma (HCC) [1-4]. Among 124 hepatitis patients, 84 (67.7%) were assigned into chronic hepatitis (group 1) and 40 (32.2%) into liver cirrhosis/HCC(group 2). There was no significant difference in age between both groups. The HCV was positive in only 4 of the 15 cases, suggesting that HCV RNA was degraded in these samples, while remaining 11 cases had resolved acute HCV infection. HCV infection was found to be high in both groups (group 1 = 47.6% and group 2 = 42.5%). HCV RNA was detected in 91% of cases (100% in group 1 and 70.5% in group 2). Anti-HBc was found to be high in both groups (94% and 87.5%, respectively). Although Seroprevalence of anti-HBs was very low (12.1%) in the studied population but significantly high in group 1 (16.6%) than group 2 (P = 0.0356).. The Seroprevalence of HBsAg was equally high in both groups, that is, group 1 = 40.4% and group 2 = 42.5%, whereas DNA positivity was 70.5% and 76.4%, respectively. Overall anti-HDV Seroprevalence was 23.5%, 12 out of 51 HBsAg positive cases, relatively higher in group 2 (35.2%) compared to group 1 (17.6%) P = 0.1990. HDV viremia was detected in 83.3% of cases (100% in group 1 and 66.6% in group 2). HCV genotyping was determined as HCV genotype 2c (HCV/2c) in E1 region. A total of 7.6% of cases were un-typeable by one of either method. Overall, HCV/1b was a predominant genotype (84.6%) in Tajikistan, followed by HCV/3a (7.6%), 2a (5.7%), and 2c (1.9%). HBV genotype D (HBV/D) was the predominant genotype (94.1%) in both groups, that is, group 1 = 97% and group 2 = 88.2%, followed by genotype A (2.9% and 11.7%, respectively). HBV genotypes were determined in 45 (88%) of 51 HBsAg-positive. The full genome analysis revealed that of the four HBV/D strains, two belonged to sub genotype D1, and the remaining two to sub genotype D2. All three HBV/A strains in this study were belonged to sub genotype Ae. The results of the phylogenetic genotyping were all concordant with EIA-genotyping results

Rami George Maalouf is graduated from Holy Spirit University of Kaslik in 2018. Now he is in PGY 1 Gastroenterology. He is very much interested on IBD research works and has publications on IBD researches. Currently he is working on IBD.

Background: Gastric acid inhibitors may decrease vitamin B12 absorption and thus lead to vitamin B12 deficiency. PPIs(Proton pump inhibitors) are often overused in the Lebanese population. Objectives: The objective of this study is to evaluate the relationship between the use of proton pump inhibitors and vitamin B12 deficiency in a Lebanese population. Methods: A retrospective case-control study based on a sample of 210 outpatients from the Lebanese community was performed. We compared 70 patients who were originally diagnosed with vitamin B12 deficiency between May 2016 and May 2017 with 140 patients without vitamin B12 deficiency. Results: After comparing the two groups, cases and controls, that were matched by age and gender, we found that there was a significant P value of 0.0001, indicating that the number of long-term PPI users (equal or more than 2 years) have a higher proportion among the cases (vitamin B12 deficiency) than among the controls (no vitamin B12 deficiency). In addition, we found that the P value is more significant in the “only women” group (P=0.004), but P values concerning age groups are not coherent. Conclusions: We conclude that a significant association between long-term proton pump inhibitors use and vitamin B12 deficiency in a Lebanese population exists, which is stronger among women but unclear concerning the age groups.

Ramazanova Zamira is of age 63 years from Institute of Gastroenterology of the Republic of Tajikistan. She works at the Department of virology, Institute of Gastroenterology of the Republic of Tajikistan. She has published more than 30 papers in reputed journals.

Hepatitis delta virus (HDV) infection results in more severe and even fulminant form of hepatitis B in co-infected cases. This study was designed to estimate the prevalence of anti-HDV positivity and the associated risk factors in patients with chronic hepatitis B virus infection in Tajikistan. In this cross-sectional study a total of 440 consecutive patients with chronic hepatitis B virus (HBV) infection attending the Institute Gastroenterology of the Ministry of Health, Republic of Tajikistan clinic from 2014 to 2017 were included. We performed test for HDV serum marker, using commercially available enzymelinked immunosorbent assay kit. Patients were split into two groups according to their HDV antibody status as HDV positive or negative. The collected data were coded, and the statistical analyses were conducted. 440 patients with various forms of chronic HBV-related liver diseases enrolled in the study. 200 (45.5%) patients were carrier for HBV. 196 (44.5%) patients had chronic active hepatitis and 44 (10%) patients suffered from cirrhosis. Anti-HDV was demonstrated in 75 patients (17%). The prevalence of HDV was 7%, 16.3% and 65.9% in carriers, patients with chronic active hepatitis and cirrhosis, respectively. HDV infection is still an important public health problem in Tajikistan and appears a major cause of progression of liver disease induced by HBV.

Mykhailo Bilousov is currently a 4th year student of Danylo Halytsky Lviv National Medical University. He has given a retrospective analysis of the case of successful surgical repair of congenital diaphragmatic hernia. The abstract is aimed to attract attention of the scientists all over the world to the CDH problem in order to find new ways of its treatment. It showed the great interest of the author in improving the health and well-being of the population. He has focused on achieving positive results in medicine and gaining improvement in the methods of treatment of severe and rare pathologies.

Statement of the Problem: A 22‐year‐old nulliparous woman was announced at 22 weeks' gestation that her foetal had a leftsided congenital diaphragmatic hernia (CDH): stomach, loops of bowel and a major portion of the liver herniated into the chest, squashing the lung (lung hypoplasia) and pushing the heart over to right side of the chest. Purpose: The purpose of this study is to describe in retrospection the case of successful surgical repair carried out at The Children’s Memorial Health Institute (Warsaw, Poland). Methodology & Theoretical Orientation: The probability of cardiovascular, digestive, neurologic or skeletal congenital malformation, and persistent pulmonary hypertension as serious consequences was not excluded. There was a possibility to have gastroesophageal reflux (GERD), one of the major sequelae in infants who survive CDH repair. CDH might be a source of feeding problems, failure to thrive, esophagitis and respiratory problems. Foetal karyotype was normal. The mother decided to give birth to her son despite doctors advising her to terminate the pregnancy (there was no chance to survive in Ukraine). Mother made every effort to find a clinic abroad that would agree to do Caesarean and a successful newborn operation. Findings: The main conditions for A Dubravsky’s survival were: a great mother’s love, prenatal diagnosis of CDH, formulation of management strategy based on the prognostic elements, skilful Caesarean section, postnatal care of the newborn, stabilization, prompt transportation, emergent surgery performed by great Polish specialists and compensatory growth of the lungs. Conclusions & Significance: The outcome was favourable with a 14‐year follow‐up. Epigastric pain, chronic cough and recurrent bronchitis are reported. Thoracic deformities are observed. At the time of writing the child was growing satisfactory and there were no apparent digestive disorders. The chance of the next baby having CDH was very small, so his sister was born in 2012 without CDH.

Leonid Pavlovskyi, Doctor graduated from National Medical University. She is currently working in Gastroenterology Department in one of the central hospital. She also works as an Assistant of Internal Medicine Department of National Medical University.

Introduction: Sphingolipids are biological active components of all cell membrane. They play a great role in cell interconnections and take part in such process as a proliferation, maturation and cell apoptosis. Ceramide deserve special an attention, because they could be precursors of apoptosis and lead to development of diabetes mellitus type 2 (DM type 2) and nonalcoholic fatty liver disease (NAFLD). Objectives: The objective of this study is to investigate dependence between ceramide levels in plasma, level of insulin and HOMA (homeostatic model assessment) indices in patients with DM type 2 and activity of AST(aspartate transaminase), ALT (alanine transaminase) in patients with NAFLD. Materials & Methods: We performed researches in three groups. The total number of patients was 60 (n=60). Two of them consisted of patients with DM type 2 and NAFLD (n=20, n=20 respectively) and the third one was healthy persons. The level of insulin, HOMA indices and activity of AST and ALT were assessed by using common biochemical blood analyses. Plasma ceramides (C14:0, C16:0, C18:0, C18:1, C20:0, C24:0 and C24:1) were quantified using electrospray ionization tandem mass spectrometry after separation with HPLC. Results: As result of researches, we got data that show high levels of ceramide in the first and second group comparing with healthy persons. This result is tightly correlated with the high level of insulin, HOMA indices and activity of AST and ALT in patients with DM type 2 and NAFLD respectively. Conclusions: During our researches, we found out dependence between high ceramide levels with severity of DM type 2 and activity rate of NAFLD. So, further investigation of ceramide is needed for taking them as parameters for prognosis DM type 2 severity or as development NAFLD complications such as nonalcoholic steatohepatitis.

Lem Edith Abongwa, a Medical Microbiologist is pursuing PhD from Kenyatta University, Kenya. She is also an Assistant Lecturer at the University of Bamenda, Cameroon. Her research interest is on HIV and Hepatitis B virus. She is interested in the identification and assessment of risk factors that expose communities to these infections and possible solutions to prevent and control them as well as parasite strain diversity and severity to infectious infection. Prior to medical research she was the Head of a public health non-governmental organization assessing the implementation of option B+ in two regions of Cameroon sponsored by a PEPFAR HIV/AIDS project in Cameroon.

Aims/Purpose: Hepatotoxicity due to highly active antiretroviral therapy (HAART) has gained prominent attention since it can be affected by many factors. The aim of this study was to determine the prevalence of hepatotoxicity and related risk factors of severe hepatotoxicity following HAART initiation. Methods: One hundred naive HIV-1 patients were recruited and followed up for 24 weeks. They were placed on either Tenofovir (TDF)+Lamivudine (3TC)+Efavirenz(EFV) or Zidovudine (AZT)+Lamivudine+Nevirapine (NVP) or Zidovudine+Lamivudine+Efavirenz regimen. Venous blood samples were collected to measure trans aminotransferases (ALT and AST) and alkaline phosphatase (ALP), using colometric enzymatic reaction which were used to classified hepatotoxicity based on age and sex. Results: A total of 38 (38%) and 55 (55%) patients presented with hepatotoxicity while 15% and 28% of patients of them had severe hepatotoxicity at 4 and 24 weeks respectively. Serum levels of all enzymes increased significantly (p<0.05) with increased treatment duration. Univariate analysis revealed that the risk factor of developing severe hepatotoxicity was significantly (p<0.05) greater in patients <30years, males, low BMI, low monthly income earners and patient on AZT+3TC+ NVP regimen. While multivariate analysis showed that age <30 years, Low BMI, low monthly income and the use of AZT+3TC+NVP was an independent risk factors. Conclusions: Low BMI, <30years, low monthly income and the use of AZT+3TC+NVP regimen were identifiable risk factors for the development of severe hepatotoxicity. As such these factors should be considered as an important strategy by clinicians in preventing the hepatotoxicity.