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Hepatitis-B surface antigen (HBsAg) and its corresponding antibody (anti-HBs) have been detected by radio-immunoassay in children and adults and in adult expatriates in Zaria, Northern Nigeria. The exposure rate to hepatitis-B virus (frequency of HBsAg and anti-Hbs) was found to vary from 59% in children under five years to 72.5% in adults over 30 years of age, while the frequency of HBsAg alone was 40% and 10% respectively. The anti-HBs prevalence rates rose progressively with age and reached a peak at 62.5% in adults. Five of 32 adult expatriates (15.6%) were positive for anti-HBs. The factors contributing to the high exposure rate in the indigenous population in this region require further study to enable judicious use to be made of preventive measures.

Fiberoptic esophagogastroduodenoscopic examination of 747 Saudi patients who presented with acute upper gastrointestinal (UGI) bleeding between January 1984G to December 1986G showed that ruptured esophageal varices, erosive gastritis, duodenitis and peptic ulcer disease were the most common findings. There were 515 males and 232 females (M:F2.2:1). Multiple lesions were detected in 83% of patients, emphasizing the need to anticipate more than one lesion at endoscopy in a patient with UGI bleeding. Sixty-seven patients (8.9%) gave a history of drug ingestion prior to the episode of bleeding; gastric and duodenal erosions were the most common lesions in these patients. No source of bleeding was apparent in 26 (3.5%) patients at the time of endoscopy. Endoscopy rather than barium studies has become established as the standard investigation in our patients with upper gastrointestinal bleeding. Upper gastrointestinal (UGI) bleeding remains a common emergency worldwide. Its frequency is estimated at one in every 2,000 people per year in the UK [1]. Definitive diagnosis of the cause of bleeding relies largely on endoscopy, which is superior to barium studies in identifying the source of bleeding. Dronfield et al [2] and Stevenson et al [3] found double-contrast barium radiology is of equal diagnostic value in the identification of chronic ulcers. Endoscopy, however, has the added advantage of being performed with thepatients supine, thus avoiding the problems of postural hypotension. In addition, assessment of the site, rate of bleeding, and the causative pathology with histological confirmation as well as the option of intervention is unique to endoscopy. The etiology of UGI bleeding varies with the geographical area. In the US, esophageal varices and gastric erosions occur more frequently than in the UK where peptic ulcer accounts for the bleeding [3,4], InTurkey, duodenal ulcerwas the most common cause of bleeding in a series of 184 patients (32%), with UGI bleeding among 5,000 endoscopies spanning a period of five years [5]. Al-Moegel et al [6] reported that history of hematemesis was a common reason for the procedure in a series of 2,742 upper gastrointestinal endoscopies in Riyadh Central Hospital (RCH),Riyadh. Bleeding from rare causes such as fundal and duodenal varices has subsequently been reported by Al-Mofarreh (1986, 1987 from the same center [7][8][9]. More recently, Laajam et al [10] reported their findings in 6,386 upper GI endoscopies over a 5 year period from two teaching hospitals also in the city of Riyadh: 424 (6.7%) had UGI bleeding. Esophageal varices 39%, duodenal ulcer 33.9%, and gastric erosions 3.7% accounted for 77% of cases with history of bleeding, while gastric cancer and carcinoma of the esophagus accounted for the remainder. Since the initial report by , over 20,000 upper GI endoscopies have been performed in the gastrointestinal unit of RCH for a multiplicity of indications, prominent among which is UGI bleeding. In this report, we focus on the etiology and prevalence of UGI bleeding ...

Prevalence of antibodies to hepatitis C virus (anti-HCV) was determined in 190 adults (mean age 40.4 years; range 15 to 75) with end-stage renal disease (ESRD) who are on regular hemodialysis in the Nephrology Unit, Riyadh Central Hospital. The overall prevalence rate was 53.7% (48.7% and 61.0% in Saudi's and expatriates, respectively). These figures are considerably higher than the figures of 34.8% reported from hemodialysis units in Riyadh, 20% in Spain, 5.5% in Germany, and 1% in the United Kingdom. The possible reasons for the high prevalence of this marker of HCV in our hemodialysis unit are considered and suggestions made for its control.