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Background: Crohn's disease (CD) and ulcerative colitis (UC) are examples of inflammatory bowel diseases (IBDs), which are chronic gastrointestinal tract illnesses with no known cause. In UC, there is a correlation between leucine-rich alpha-2 glycoprotein (LRG) and clinical disease activity. The purpose of this study was to evaluate the relationship between UC patients' LRG serum levels and their illness activity and severity. Method: We performed this prospective cohort study on 36 Ulcerative colitis patients. C-Reactive Protein (CRP), serum urea, creatinine, total bilirubinand fecal calprotectin were assessed. Serum LRG levels were measured by using double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Results: The best cutoff of baseline LRG for diagnosing severe UC in comparison to mild and moderate cases was =67.4µg/ml with area under curve 0.913 with sensitivity 91.7%, specificity 87.5%, positive predictive value 78.6%, negative predictive value 95.5% and overall accuracy 91.7% (p=0.002). A statistically significant positive correlation was revealed between baseline LRG and Mayo score (p<0.001). A significant difference was found between mild, moderate &severe disease groups with baseline LRG (p<0.001). On comparing each two groups with one way ANOVAand Mann Whitney test, the difference was significant between mild and both moderate and severe disease (significantly lower in mild group with p values of 0.013, and <0.001 respectively). Conclusions: Leucine-rich glycoprotein could be a reliable serum biomarker for the assessment of clinical disease activity in patients with IBD. It can be an alternative to CRP and fecal calprotectin for the assessment of ulcerative colitis disease. [ABSTRACT FROM AUTHOR]

The article provides ten rules for successful and sustainable research collaborations in Africa. It emphasizes the importance of understanding the cultural, social, and political landscapes of Africa and adapting research methodologies accordingly. Regular and open communication strategies are highlighted as crucial for collaboration and mutual understanding. The article also emphasizes the need for responsible exchange of research materials and resources, promoting equity and inclusion, and addressing disparities in resources. The Cape Town Statement provides recommendations for ethical research, aiming to address the imbalance in research benefits between high-income and low- and middle-income countries. Challenges to achieving equitable research collaborations include resource distribution, cultural and linguistic diversity, and power dynamics. Overcoming these obstacles requires fostering inclusivity, addressing cultural differences, and incorporating capacity-building components. Open science practices, adherence to local ethical approval policies, and clear publication guidelines are also essential. Collaborative research in Africa has the potential to contribute to global health systems, socioeconomic development, and the understanding of complex diseases. Following these guidelines can lead to a more equitable and impactful scientific enterprise. [Extracted from the article]

Background: Crohn's disease and ulcerative colitis are both examples of inflammatory bowel diseases (IBDs) that are chronic GIT diseases of unknown etiology. Aim: This research aimed to ascertain the interleukin-23 serum level in Crohn's disease and ulcerative colitis disease patients. Patients and Methods: The research was a case-control investigation involving 72 participants, subdivided into 48 patients who were either hospitalized in ICU or inpatient wards or outpatient clinics (IBD OPD) in Internal Medicine Department, (Zagazig University Hospitals). In addition, 24 healthy individuals who were age- and sexmatched were selected as a control. Results: There were discernible contrasts between the groups with regard to the levels of IL-23. When the two groups are compared, it is clear that there was a considerable distinction between Crohn's disease (CD) in remission and moderate and severe ulcerative colitis. In addition, there was a significant difference between Crohn's disease, which is moderately severe, and ulcerative colitis, which is very severe. There is a large gap between having moderate Crohn's disease and having moderate ulcerative colitis. Conclusion: The findings of this study lend support to the hypothesis that determining an individual's IL-23 levels may be helpful in determining the degree to which Crohn's disease or UC is present. It is possible to postulate that IL-23 is a reliable indicator of the eventual results of the patients. Therefore, it is possible for it to be evaluated with a lower amount of effort and cost compared to other markers and procedures. [ABSTRACT FROM AUTHOR]

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Background: Colorectal cancer (CRC) is known to be the third most frequently diagnosed cancer and the fourth leading cause of cancer death worldwide. In Egypt, colorectal carcinoma is considered the 7th prevalent cancer, accounting for 3.47% of male cancers and 3% of female malignancies. A localized CRC can be entirely cured via surgical resection. Metastasis remains the leading cause of cancer mortality. IMP3 is an independent prognostic biomarker that expects metastasis and poor prognosis in CRC. The upregulation of nuclear cyclin D1 plays an essential role in pathogenesis and metastases of CRC. We aimed to investigate the expression of IMP3 and cyclin D1 in colorectal carcinoma and their correlation with other clinicopathological features. Method: In this retrospective cohort study, 80 formalin-fixed and paraffin-embedded blocks of CRC were obtained from the subjects. The immunohistochemical expression of IMP3 and cyclin D1 were examined and found to be correlated with clinical- pathological parameters and the outcome of the patients. Results: Overexpression of IMP3 and cyclin D1 was noted in 68.75% and 56.25%, respectively. IMP3 expression was significantly correlated with tumor grade (P < 0.001), tumor, node, and metastases (TNM) stage (P = 0.040), and lymphovascular invasion (P = 0.005); cyclin D1 was significantly associated with TNM stage (P < 0.001), lymph node (LN) metastasis (P < 0.001), and distant metastasis (DM) (P = 0.004); cyclin D1 was significantly correlated with TNM stage (P < 0.001), LN metastasis (P < 0.001), and DM (P = 0.004). Conclusion: IMP3 and cyclin d1 were associated with poor prognosis in CRC, which makes them attractive targets for anticancer drug development. [ABSTRACT FROM AUTHOR]

Background: Patients with liver cirrhosis seem to be at increased risk of complications during fasting. This study aimed to assess the effect of Ramadan fasting on liver functions and portal hemodynamics among patients with liver cirrhosis in comparison with healthy subjects. Materials and Methods: Participants were divided into three groups. Group I: patients with liver cirrhosis who fasted during Ramadan (n = 34), group II: patients with cirrhosis who did not fast (n = 8), and group III: healthy volunteers who fasted (n = 30). This study was done from May 2017 to July 2017 and the month of Ramadan began on May 27th to June 26th, 2017. Portal hemodynamics were evaluated by portal vein diameter, congestion index (CI), and portal flow velocity. Laboratory investigations were determined before, during, and after Ramadan as an indicator of the changes in the liver functions. Results: There were no dropouts during the study. Among the three groups, portal vein parameters showed statistically non-significant differences. Model for End stage Liver Disease (MELD) score and serum albumin levels showed a significant difference when the group I and II compared separately to group III (p = 0.000), while there were no differences between group I and group II (p = 0.6 and 0.57, respectively). For portal vein CI, there was a significant difference between the patients with cirrhosis (fasting; group I and non-fasting; group II) and healthy subjects (group III) (p = 0.000), while the CI did not change significantly between the groups I and II (p = 0.54). Conclusion: Patients with cirrhosis showed changes in their liver functions and portal hemodynamics irrespective of their fasting status and these differences were more pronounced in portal vein CI, MELD score, and serum albumin when compared with healthy subjects. [ABSTRACT FROM AUTHOR]

Aim: The objective of this work is to find out whether there is a relation between the expression of TLR4 and fibrosis progression in chronic HCV patients. Background: Toll-like Receptor 4 (TLR4) is a pattern recognition receptor whose activation results in the production of several proinflammatory cytokines. Methods: Fifty patients with chronic HCV were included. They were divided into group A: 40 patients (F1-F4) and group B (control group) which included ten patients (F0) based on fibroscan value. All patients were exposed to clinical and laboratory evaluations preliminary to antiviral therapy, assessment of TLR4 mRNA by Real Time- PCR. Results: Twenty-eight males and 22 females with a mean age 28.9±6.1 years. The mean TLR4 expression is 11.2±7.4 folds, TLR4 expression in F0 group is 2.8±1.9, in F1 group 4.8±1.5, F2 group 10.2±2.5, F3 group 16.8±1.5 and in F4 21.3±3.6 folds (p<0.001). TLR4 showed a positive correlation with age, fibrosis stage, HCV RNA, serum transaminases, total bilirubin and prothrombin time, a negative correlation with platelet count and serum albumin. Fibrosis progression was independently associated with TLR4 expression (β=0. 648, P<0.0001), RNA (β= 0.160, P =0.001) and platelet count (β= -0.248, P = 0.004). Conclusion: The expression of TLR4 is highly correlated with the fibrosis progression; TLR4 may be a potential target for drugs to limit the progression of fibrosis. [ABSTRACT FROM AUTHOR]

Introduction: Toxoplasma gondii is an intracellular protozoan that may disrupt the traditional cell barriers against cancer, allowing the accumulation of oncogenic mutations over time. Our research aimed to explore the relationship between T. gondii infection and tumor development. Methodology: The anti-T. gondii IgG and IgM antibodies were tested for156 patients with tumors (51 with breast cancer, 20 with hepatoma, 20 with larynx carcinoma, 20 with squamous cell carcinoma of bone, 16 with lymphoma, 13 with brain tumor, 4 with bladder cancer and 12 with benign uterine tumor) and 90 healthy controls by using electrochemiluminescence immunoassay. Tissue specimens were collected from T. gondii seropositive cases for histological and immunohistochemistry (IHC) examinations. Results: The seroprevalence of human toxoplasmosis in the Sharkia Governorate, Egypt is significantly correlated with various types of tumors: breast cancer in 49 subjects (96.1%), and squamous cell carcinoma of bone in 16 subjects (80%). It was also present in nine cases of brain tumors. Anti-Toxoplasma IgG was detected in seven cases of liver tumors and one-quarter of bladder cancer. The anti- Toxoplasma IgM was present in three patients with benign uterine tumors, one patient with a bone tumor and two patients with breast cancer. Toxoplasma cysts were detected in immunostained brain sections. Conclusion: The correlation between T. gondii infection and tumors was established by this study indicating a significant emerging role of human toxoplasmosis in the etiology or existence of particular types of tumors. [ABSTRACT FROM AUTHOR]

Objectives: The long-term consequences of COVID-19 infection on the gastrointestinal tract remain unclear. Here, we aimed to evaluate the prevalence of gastrointestinal symptoms and post-COVID-19 disorders of gut-brain interaction after hospitalisation for SARS-CoV-2 infection., Design: GI-COVID-19 is a prospective, multicentre, controlled study. Patients with and without COVID-19 diagnosis were evaluated on hospital admission and after 1, 6 and 12 months post hospitalisation. Gastrointestinal symptoms, anxiety and depression were assessed using validated questionnaires., Results: The study included 2183 hospitalised patients. The primary analysis included a total of 883 patients (614 patients with COVID-19 and 269 controls) due to the exclusion of patients with pre-existing gastrointestinal symptoms and/or surgery. At enrolment, gastrointestinal symptoms were more frequent among patients with COVID-19 than in the control group (59.3% vs 39.7%, p<0.001). At the 12-month follow-up, constipation and hard stools were significantly more prevalent in controls than in patients with COVID-19 (16% vs 9.6%, p=0.019 and 17.7% vs 10.9%, p=0.011, respectively). Compared with controls, patients with COVID-19 reported higher rates of irritable bowel syndrome (IBS) according to Rome IV criteria: 0.5% versus 3.2%, p=0.045. Factors significantly associated with IBS diagnosis included history of allergies, chronic intake of proton pump inhibitors and presence of dyspnoea. At the 6-month follow-up, the rate of patients with COVID-19 fulfilling the criteria for depression was higher than among controls., Conclusion: Compared with controls, hospitalised patients with COVID-19 had fewer problems of constipation and hard stools at 12 months after acute infection. Patients with COVID-19 had significantly higher rates of IBS than controls., Trial Registration Number: NCT04691895., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Management of superficial bowel neoplasia (SBN) in early stages is associated with better outcomes. The last few decades experienced a paradigm shift in the management of SBN with the introduction of advanced endoscopic resection techniques (ERTs). However, there are no clear data about the aspects of ERTs in Egypt despite the growing gastroenterology practice., Aim: To investigate the knowledge, attitude, and practice of ERTs toward management of SBN among Egyptian practitioners and the suitability of the endoscopy units' infrastructures toward these techniques., Methods: An online 2-pages questionnaire was used. The first page comprised demographic data, and questions for all physicians, about the knowledge (11 questions) of and attitude (5 questions) toward ERTs as a therapeutic option for SBN. The second page investigated the practice of ERTs by endoscopists (6 questions) and the infrastructures of their endoscopy units (14 questions). The survey was disseminated through July 2021 and the data were collected in an excel sheet and later analyzed anonymously., Results: The complete responses were 833/2300 (36.2%). The majority of the participants were males ( n = 560, 67.2%), middle-aged ( n = 366, 43.9%), consultants ( n = 464, 55.7%), gastroenterologists ( n = 678, 81.4%), spending ≥ 15 years in practice ( n = 368, 44.2%), and were working in university hospitals ( n = 569, 68.3%). The majority correctly identified the definition of SBN (88.4%) and the terms polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD) (92.1%, 90.2%, and 89.1% respectively). However, 26.9%, 43.2% and 49.5% did not recognize the clear indication of polypectomy, EMR, and ESD respectively. Although 68.1% of physicians are convinced about the ERTs for management of SBN; only 8.9% referred all candidate cases for ERTs. About 76.5% of endoscopists had formal training in the basic polypectomy techniques while formal training for EMR and ESD was encountered only in 31.9% and 7.2% respectively. About 71.6% and 88.4% of endoscopists did not perform EMR or ESD in the last one year. Consequently, the complication rate reported by endoscopists was limited to 18.1% ( n = 103) of endoscopists. Only 25.8% of endoscopists feel confident in the management of ERTs-related complications and a half (49.9%) were not sure about their competency. Regarding the endoscopy units' infrastructures, only 4.2% of the centers had their endoscopes 100% armed with optical enhancements and 54.4% considered their institutions ready for managing ERTs-related complications. Only 18.3% ( n = 104) of endoscopists treated their complicated cases surgically because the most frequent ERTs-related complications were procedural bleeding (26.7%), and perforations (17%)., Conclusion: A significant deficiency was reported in the knowledge and attitude of Egyptian practitioners caring for patients with SBN toward ERTs. The lack of trained endoscopists in both EMR and ESD in part is due to unsuitable infrastructures of many endoscopy units., Competing Interests: Conflict-of-interest statement: All authors declare that they did not have any conflict of interest., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The current coronavirus disease 2019 (COVID-19) pandemic has affected routine endoscopy service across the gastroenterology community. This led to the suspension of service provision for elective cases., Aim: To assess the potential barriers for resuming the endoscopy service in Egypt., Methods: A national online survey, four domains, was disseminated over a period of 4 wk in August 2020. The primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s)., Results: A hundred and thirteen Egyptian endoscopy centers participated in the survey. The waiting list was increased by ≥ 50% in 44.9% of areas with clusters of COVID-19 cases ( n = 49) and in 35.5% of areas with sporadic cases ( n = 62). Thirty nine (34.8%) centers suffered from staff shortage, which was considered a barrier against service resumption by 86.4% of centers in per-protocol analysis. In multivariate analysis, the burden of cases in the unit locality, staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice ( P = 0.029, < 0.001 and 0.02, respectively) and Odd's ratio (0.15, 1.8 and 0.16, respectively)., Conclusion: The COVID-19 pandemic has led to restrictions in endoscopic volumes. The staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against recovery. Increasing working hours and dividing endoscopy staff into teams may help to overcome the current situation., Competing Interests: Conflict-of-interest statement: Nothing to disclose., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)