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BACKGROUND: Metabolic diseases are known to be risk factors of kidney injury. The glycoprotein Uromodulin Tamm-Horsfall protein is a biochemical marker specifically synthesized and secreted by kidney tubular epithelial cells. AIM: The study aimed to use novel biochemical parameters to predict early changes in renal functions and to use natural food supplements to help in the prevention and management of such conditions. METHODS: Crossover studies comparing two interventions trials. Subjects: Seventy obese females were included in this study. They were divided in two groups, first group (34 women) with mean age 45.82 ± 1.51 and mean body mass index (BMI) 35.65 ± 0.68 kg/m2, and second group (36 women) with mean age 49.80 ± 2.27, and mean BMI 37.67 ± 1.59. Intervention: All participants have followed a low caloric balanced regimen (1000–1200 Kcal/day) of the each groups consumed a different specific nutritional supplement composed mainly of whole grains and herbs. All patients were monitored clinically, anthropometrically, dietary 24 h recall and biochemically. RESULTS: After intervention all the recorded anthropometric parameters showed significant decreases at p ≤ 0.05–0.01. The serum uromodulin (sUMOD) increased significantly after intervention in both groups the increments were 15.56 and 9.37%. Numerically creatinine and urea decreased, while creatinine clearance increased. CONCLUSION: Data revealed the importance of using dietary therapy composed of hypocaloric diet with supplements made from whole grains and special herbs in management of obesity and its metabolic disorders. sUMOD proved to be an accurate biochemical marker that showed the kidneys’ response to the management in comparison to using usual diagnostic markers.

Background Tumor-associated macrophages (TAMs), inflammatory cells in tumor microenvironment, are crucial for the tumor occurrence and progression which in turn increase the expression of soluble CD163 (sCD163). Nevertheless, not much has been established regarding sCD163 and its connection to HCC diagnosis and prognosis. This study was conducted to evaluate the diagnostic and prognostic role of sCD163 in patients with HCC on top of HCV-related liver cirrhosis. Forty adult patients with HCV-related liver cirrhosis and HCC (HCC group) were randomly selected and subjected to locoregional therapies, either transarterial chemoembolization (TACE) or radiofrequency ablation (RFA). Four patients were excluded because of portal vein invasion. Another group of 20 patients with liver cirrhosis only served as controls (LC group). Routine laboratory studies and abdominal ultrasound were done for all. Alpha-fetoprotein (AFP) and sCD163 were measured twice, at baseline and 1-month post-intervention, using a commercially available enzyme-linked immunosorbent assay kit. Results At baseline, sCD163 showed an insignificant higher value in HCC group (p > 0.05). The best cutoff value for sCD163 and AFP was 6.2 mg/L and 195 ng/mL, respectively. AFP had a larger area under the curve (0.88 vs. 0.767). An overall significant decline was seen in sCD163 after treatment (6.5±1.5 to 3.1±2.5 mg/L; p < 0.001), while AFP showed an insignificant decrease (p > 0.05). Also, sCD163 decreased significantly in the eradicated cases (6.1±1.4 mg/L before intervention vs. 2.3±1.4 mg/L after intervention, p < 0.01), while there was a significant increase in the recurrent cases (8.4±0.4 mg/L before intervention vs. 10.3±1.6 after intervention; p < 0.05). Moreover, sCD163 showed a significant difference in its pre-intervention and post-intervention values between recurrent and eradicated HCC cases (p < 0.01). Conclusions It is concluded that sCD163 has a minor role as a diagnostic marker for HCC, yet it could be used as a good prognostic marker in predicting the tumor response to locoregional therapies.

BACKGROUND: Anxiety and depression are reported as two major frequent and chief complaints among peri-menopausal women in several societies. AIM: The objective of the study was to study the effect of using two dietary supplements to beat depression and anxiety associated with menopause. SUBJECTS AND METHODS: Sixty-six volunteers’ menopausal women participated on the study for 8 weeks, 35 subjects consumed daily cookies prepared mainly from soya flour and flaxseed, and 31 females consumed daily a blend composed mainly of raw unroasted peanut and raw sesame. Follow-up was performed with menopause rating scale, anxiety score, depression score, and biochemical parameters. RESULTS: Soya cookies were rich in plant-based protein and total phenols while blend was a good source of unsaturated fatty acid. Blend consumers showed significant percentage reduction in beck anxiety score and beck depression score after intervention, more than cookies consumers group. The anthropometrics parameters were statistical significant changed on both groups, more on the group who consumed the soya cookies. Soya cookies demonstrated an anti-inflammatory effect, while blend had an antioxidant and anti-inflammatory effects as was shown on the serum assay of interleukin-6 and malondialdehyde as an inflammatory marker and an antioxidant marker, respectively. CONCLUSION: From the results, it can be concluded that the supplementation of products enriched with unsaturated fatty acid was more beneficial to slow down the psychological menopause symptoms than natural estrogen rich product consumption.

Background: adjunctive local periodontal therapy is one of the best options to improve the health of the pocket tissue. The comparison of local effects of simvastatin and metformin as aid in enhance the healing of periodontal tissue is the point of importance. Methods: a total of 45 systemically healthy patients with mild to moderate chronic periodontitis; which having a generalized pocket depth varied from 3mm to 5mm. All patients handled by scaling and root planning and divided haphazardly into: group I, as a control group (n= 15), in which the patients treated by application of placebo gel; group II, (n= 15) treated with application 1.2% simvastatin gel; group III, (n= 15), treated with application of 1% metformin gel. Clinical and biochemical criteria were collected at threshold 3, 6 and 9 months. Results: an advancement in both plaque and gingival indexes was noticed in total 3 groups at 6 and 9 months. Plaque index and gingival index showed decrement in group II and III than group I. The cutback in probing depth and clinical attachment loss was higher in the group III than other groups. Significant minimization in both IL-6 and TNF-α levels occurred from baseline to the end of measurement duration in all groups. Clear interaction was established amid IL-6 and TNF-α heights. Conclusion: metformin was comparatively better than simvastatin in respect of clinical and biochemical markers.

Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

Objectives To investigate whether etamsylate may be an alternative to tranexamic acid in reduction of blood loss during elective cesarean section. Methods Prospective double-blinded multi-center randomized controlled trial involving 180 qualified women equally divided into three groups each containing 60 women received either tranexamic acid, etamsylate or placebo 20 min before elective cesarean section and blood loss was estimated. Results Mean blood loss, cases needing blood transfusion and cases needing further interventions were significantly lower in tranexamic acid and etamsylate group than placebo group, while mean postoperative hemoglobin and hematocrite were significantly higher in both tranexamic acid and etamsylate as compared to placebo. Conclusions Etamsylate is an effective second-line therapy (after tranexamic acid) in reducing blood loss during elective cesarean section with low risk of side effects, therefore, it can be an effective alternative to tranexamic acid in cases with contraindications or anticipated to be at high-risk of developing side effects from tranexamic acid.

BackgroundWomen experience various menopausal symptoms during the menopause; these symptoms can affect their quality of life and health. The aim of this study was to help females around this time to relief their symptoms by natural safe product.Subjects and methodsForty-two women participated as volunteers, who are suffering from different symptoms of menopause with mean age 45.36 ± 0.98 years. Full clinical examination, anthropometric parameters, dietary recalls, and Menopause Rating Scale evaluation were recorded. Blood sampling and biochemical analysis was done including important sex hormones. Participants daily consumed 45 g of supplement made from raw unsalted crashed peanut, raw sesame, dry coriander, and dry thyme that were made in the form of blend. Study period lasted for 8 weeks. Chemical composition of the blend was assessed.ResultsAll participants showed marked improvement in psychological, urogenital, and somatic symptoms after intervention.ConclusionData of this study showed that the blend had a beneficial impact on the physical, psychological, and mental health in perimenopausal women. So, functional foods must be considered in controlling different menopausal annoying symptoms; perimenopausal women can use this blend as a safe and effective food supplement.

Background Nonalcoholic fatty liver disease (NAFLD) is a possible risk factor for chronic kidney disease (CKD). Renal resistive index (RRI) which is a ratio of peak systolic and end diastolic velocity can test arterial stiffness and endothelial renal dysfunction. The aim of the work is to detect the relation between NAFLD and RRI as an indicator of early renal affection and its relation to the disease severity. This study included 150 subjects divided into 3 groups: patients with NASH, simple steatosis, and control group (50 patients each). All patients were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound examination, and RRI measurement. Results 6.0% of NASH patients had significant fibrosis by NAFLD fibrosis score. RRI was significantly higher in NASH patients with fibrosis (mean = 0.74) than NASH patients without fibrosis (mean = 0.65) and patients with simple steatosis (mean = 0.63). It was the lowest in normal controls (mean = 0.61). There were significant correlations between RRI and age, BMI, serum lipids, liver enzymes, and NAFLD fibrosis score. Multiple linear regression analysis found that age and serum cholesterol were significant independent factors of increased RRI (p Conclusion RRI was significantly higher in NASH patients with and without hepatic fibrosis. RRI correlates significantly with NAFLD fibrosis score. RRI can be used as an indicator of early renal affection in patients with NAFLD.

Background This study aimed to compare the effect of using versus not using the Rapid-Shallow Breathing Index (RSBI) as a readiness criterion for Spontaneous Breathing Trials (SBT) on SBT success. Materials and Methods Daily readiness screens were performed within a respiratory therapist-driven weaning protocol. Patients who passed these screens underwent a one-time measurement of the RSBI and then a SBT regardless of RSBI result. The proportion of passed readiness screens reaching SBT success was compared to the proportion that would have been obtained if RSBI ≤ 105 br/min/L had been used as an additional screen criterion. Results Two hundred and fifty SBTs performed on 157 patients were analyzed. The sensitivity of RSBI ≤ 105 br/min/L to predict SBT success was 94.8% (95% CI 90.6-97.5). Relative to potentially using RSBI, 14.4% additional SBTs were performed. A third of these were successful, and no complications were detected in the rest that failed. The proportion of passed readiness screens reaching SBT success would have been 4% (95% CI 1.2-6.8) (P = 0.002) lower if RSBI had been used. Conclusions The inclusion of the RSBI in a readiness screen may not be useful in a weaning protocol.

The current study aims to compare between a transvaginal sonographic measurement of cervical length and Bishop score in the induction of labor (IOL) at term for prediction of cesarean delivery (CD).A prospective cohort study included 320 full-term pregnant women attending Ain Shams Maternity Hospital in the period from August 2017 to February 2018 were enrolled. Seventy-three women were delivered by CD (positive group), and 247 women were delivered vaginally (negative group). All patients had a vaginal examination for assessing the Bishop Score before IOL then a transvaginal ultrasound for assessment of cervical length. IOL was initiated by using PGE1 analog. The primary outcome measure was the accuracy of the cervical length or the bishop score for prediction of the CD.In our current study, CD was achieved in 22.8% of all participants while vaginal delivery was achieved in 77.8% after IOL by misoprostol 25 micrograms within 24 h from the beginning of induction. Both the cervical length and Bishop Score had poor predictive value for CD (AUC = 0.694 and 0.623, respectively).Both transvaginal sonography for cervical length and Bishop score are useful predictors of the need for CD following labor induction.

There is growing evidence that lipids play a fundamental role in neuronal plasticity and learning and memory. Effects of nutrition on brain lipid composition and neuronal functioning are known, but the feeding interventions are often severe and may not reflect nutritional effects below clinical relevance. Therefore, we tested two commercially available rat feeding diets with only moderate differences in the food compositions, a standard diet (gross energy metabolizable 12.8 MJ/kg) and a energy reduced diet (gross energy metabolizable 8.9 MJ/kg) on possible effects upon dentate gyrus lipid composition, spatial learning and memory in a water maze and corticosterone release (blood serum concentrations) in adult male rats. Rats were fed with the standard diet up to an age of 8 weeks. One group was further fed with the standard and another with the energy reduced diet until an age of 5 months. We did not found differences in serum corticosterone levels. We found group differences in a variety of lipids in the hippocampal dentate gyrus.. Most of the lipid levels were lower in energy reduced diets, namely glycerophosphoethanolamines, sphingomyelins and hexosyceramides, whereas some ceramides (Cer18:0 and Cer24:1) and glycerophosphocholines (PC34:3 and PC36:2) were upregulated compared to the standard diet group. The performance in a common reference memory water maze task was not different between groups, however during reversal learning (platform in a different position) after the initial training, the standard diet fed rats learned better and spatial memory was improved compared to the energy reduced diet group. Thus, moderate differences in feeding diets have effects specifically upon spatial cognitive flexibility. Possible relations between differences in lipid composition and cognitive flexibility are discussed.

Introduction: Cancer is a serious public health problem in many parts of the world; oral squamous cell carcinoma was the 11th most common malignant neoplasm in human papulation. The hamster cheek pouch carcinogenesis model is a well-known animal system that closely mimics the development of premalignant and malignant lesions in human oral cancer. The expressions of cancerization process in this model using DNA ploidy and S-phase fraction is the point of interest. Aim of the study: This research was carried out to study the analysis of DNA ploidy and S-phase fraction in relation to development of oral squamous cell carcinoma during hamster cheek pouches carcinogenesis process induced by DMBA. Material and methods: A total of 50 young gold Syrian hamsters distributed into groups as follows: 2 normal animals examined for the normal histology of the cheek pouch mucosa and 48 animals divided into; group I, as a control group (n= 12), in which pouches were painted with a heavy mineral oil only; group II, were painted with DMBA mixed in a heavy mineral oil (n=36). The examined animal tissue utilized for flow cytometry analysis to obtain DNA ploidy and S-phase fraction development during carcinogenesis process. Results: The flow cytometric analysis of DNA content demonstrated a significant role in carcinogenesis process in oral squamous cell carcinoma. Moreover, they provided a significant analysis in the proliferation and activity of the cancer cells as measured by the S-phase fraction activity.Conclusions: The combinatorial DNA content analysis involving general ploidy and S-phase fraction have potential for support in the early diagnosis; during the development of oral squamous cell carcinoma.

Background Nutrition and good health are two dependent parallel axes; female’s health at different ages in general and at the time of menopause in particular has received a lot of attention last several years. The objective of this experimental study was to evaluate the effect of consuming food supplement versus lifestyle modification in the dietary habit on menopausal symptoms in perimenopausal Egyptians females. Results Forty seven females in the perimenopausal stage of life with mean age 46.04 ± 5.88 years participated on the food supplement consumption group, they consumed 75 g per day of a rusk (prepared from corn flour, wheat flour 72%, full cream milk powder, flaxseed oil, wheat germ, clove and cinnamon powder) for 2 months. They were compared with the control group (forty nine females with mean age 46.91 ± 5.39 years) who changed their foods habits to a healthy life style. Menopause rating scale and the biochemical analysis were comparable on day 1 and on day 60. The total menopause rating scale and its three subscales (psychological, urogenital and somatic), waist circumference, serum follicle stimulating hormone and estradiol in the corn rusk supplement group showed a statistically significant improvement. No significant difference was noted in the control group apart of the psychological subscale and waist circumference. Conclusions Corn Rusk enriched with clove and cinnamon as a food supplement snake is promising to relief menopausal symptoms and should be considered on the diet of menopausal females.

Background The diagnostic approach for patients with laryngeal lesions differs among otolaryngologists. Indirect laryngoscopy, flexible fibrooptic laryngoscopy, CT, and MRI are all modalities used for diagnosis. Ultrasonography is noninvasive, non-irradiating, and safe. The availability, affordability, and usability of portable ultrasound units have undergone dramatic improvements. It is well tolerated by patients, dynamic technique that can be performed easily in phonation, quickly performed, and allows for photo-documentation. Our objective is to evaluate the laryngeal ultrasound as a diagnostic tool to evaluate different laryngeal structure as regard laryngeal dynamics (range and abnormality), and anatomic structures. This prospective study was carried out on individuals in “blinded for peer review” hospitals. They were divided into group I (healthy volunteers), group II (unilateral vocal fold paralysis), and group III (patients underwent vertical hemilaryngectomies). All patients were subjected to full history taking, detailed head and neck examination, and fibrooptic nasopharyngolaryngoscopy then all patients underwent laryngeal sonographic examination. The photos were analyzed to identify various laryngeal structures and to measure glottic areas and inter-arytenoid distances. Results After recognition of laryngeal anatomic details and different measurements, we found that the percent of change in length and area were much less in group III than group I or II. Another important finding is that glottic area during respiration is related significantly to interarytenoid length during respiration with a statistically significant regression coefficient. Conclusion Laryngeal ultrasound is a valid diagnostic tool for imaging laryngeal structures and measuring various distances and areas inside the larynx. It is recommended to consider ultrasonography as a reliable imaging modality, and at least a useful adjunct to endoscopy when identification of airway patency, vocal fold mobility, or structural alterations is suspected. To our best knowledge, this study may contain a hitherto undescribed correlation between inter-arytenoid length and glottic area.

Lipids play a major role for several brain functions, including cognition and memory. There is a series of work on individual lipids showing involvement in memory mechanisms, a concise lipidome was not reported so far. Moreover, there is no evidence for age-related memory decline and there is only work on brain of young vs. aging animals. Aging animals, however, are not a homogeneous group with respect to memory impairments, thus animals with impaired and unimpaired memory can be discriminated. Following recent studies of hippocampal lipid profiles and hypothalamus controlled hormone profiles, the aim of this study was to compare hypothalamic, lipidomic changes in male Sprague-Dawley rats between young (YM), old impaired (OMI) and old unimpaired (OMU) males. Grouping criterions for aged rats were evaluated by testing them in a spatial memory task, the hole-board. YMs were also tested. Subsequently brains were removed, dissected and hypothalami were kept at -80°C until sample preparation and analysis on liquid chromatography / mass spectrometry (LC-MS). Significant differences in the amounts of a series of lipids from several classes could be detected between young and aged and between OMI and OMU. A large number of lipids were increased in OMI and a smaller number in OMU as compared to young rats. Differences of lipid ratios (log2 of ratio) between OMI and OMU consisted of glycerophosphocholines (aPC 36:2 and 36:3; PC 34:0, 36:1, 36:3 and 40:2); Glycerophosphoethanolamines (aPE 34:2, 38:5 and 40:5; LPE 18:1, 20:1, 20:4, 22:4 and 22:6; PE36:1 and 38:4); glycerophosphoserines (PS 36:1, 40:4, and 40:6); triacylglycerol TG 52:4; ceramide Cer 17:2 and sphingomyelin SM 20:0. Thus, hypothalamic lipid profiles across different lipid classes discriminate aged male animals into OMU and OMI. The underlying mechanisms may be related to different functional networks of lipids in memory mechanisms and differences in metabolic processes. The study underlines the importance of lipidomics in the pathophysiology of age-related cognitive decline. The necessity of evaluating the cognitive status of aged subjects by behavioral tests results in more specific detection of critical lipids in memory decline, on which now can be focused in subsequent memory studies in animals and humans.

Background Chronic hepatitis C virus (HCV) infection represents a global public health challenge, and new drugs have been authorized for its treatment. The current study aimed to detect the change in blood levels of tryptophan and phenylalanine with the recent therapy direct-acting antiviral (sofosbuvir). Methods This case-controlled study was conducted on HCV patients including 40 treated with direct-acting antiviral (sofosbuvir), 40 untreated underestimations of full medical history, and laboratory tests involved ELISA assay and real-time (RT) PCR technique as well as measuring tryptophan and phenylalanine by HPLC-UV, in addition to 20 apparently healthy subjects served as a control group. Results There is a high statistical significant decrease in tryptophan and increase in phenylalanine in treated cases than untreated cases and control groups. This study showed that phenylalanine at the cutoff of 2.13 μg/ml had 96.9% sensitivity and 62.5% specificity among treated cases; also, tryptophan at the cutoff of 8.53 ng/ml had 81.2% sensitivity and 75% specificity to predict severe depression. There is a statistically significant increase in tryptophan and decrease in phenylalanine in mild/moderate than very severe depression. Conclusion Direct-acting antiviral (sofosbuvir) causes a decrease in tryptophan levels and increase in phenylalanine levels that as a result leading to depressive symptoms as adverse effects, so advising by dietary supplements of tryptophan for patients treated from chronic HCV by direct-acting antiviral (sofosbuvir).

Aim of the work: this study aimed to assess if the Magnetic Resonance Cholangiopancreatography (MRCP) in patients undergoing cholecystectomy, changed the treatment plan or changed the operation method. Patients and method: this study was carried out in the Radiology Departments of Ain Shams University Hospitals. A total of 30 patients undergoing cholecystectomy were referred for preoperative MRCP. They were 20 (66.7%) females and 10 (33.3%) males. Their age was ranged from 20-60 years old. Results: Among the 30 cases, 21 cases had dilated common bile duct (CBD), 11 patients had CBD stones, 2 of which were silent, one case had silent CHD stone, one case had Mirizzi type I syndrome, 3 cases had trifurcation of the CHD, 4 cases had cystic duct anatomic variants and one case had duplicated GB. Conclusion: In candidate patients for cholecystectomy, routine preoperative MRCP is mandatory for confirmation of the already known pathologies, detection of other missed pathologies by US as well as detection of anatomical variants of biliary tract, these will help the surgeon for replanning and adjusting the surgical approach to preventing or at least decreasing the probability of post operative complications.

Background: nowadays, magnetic resonance plays a key role in management of liver lesions, using a radiation-free technique and a safe contrast agent profile. The heightened soft-tissue resolution and sensitivity to intravenous contrast agents provided by magnetic resonance imaging (MRI) makes it an invaluable problem-solving tool for fully characterizing focal liver lesions (FLL). Diffusion-weighted imaging (DWI) sequences have been shown to be an emerging contributor for liver MRI and are being incorporated in most abdominal MR protocols. Aims: To determine the role of MRI in characterization of benign hepatic focal lesions. Patients and methods: This study included 30 patients (11 M, 19 F with mean age of 47.7 years) with benign hepatic focal lesions. They were simple cyst (n =6), hemangioma (n = 11), abscess (n = 4), adenoma (n = 2), focal nodular hyperplasia (n = 3), Hydatid cyst (n=1) and regenerative nodules (n = 3). They underwent routine MR imaging and diffusion MR weighted imaging using 1.5 tesla MR unit (Philips Achieva). Diffusion MR imaging was done using spin echo type of single shot echo planar imaging (EPI) with b value of 0, &800 mm2/sec. The apparent diffusion coefficient (ADC) map was reconstructed and ADC value was measured. The mean ADC values correlated with histopathological results as well as followup imaging results. Results: The mean ADC values were significantly different within benign hepatic focal lesions (P < 0.001). There was highly statically significant relation between cyst and hemangioma (p-value < 0.001), cyst and abscess (p-value

Background and Aim Many studies have found a relationship between hepatic iron, serum ferritin, and non-alcoholic fatty liver disease (NAFLD) or its progress. The aim of this study is to assess the value of serum ferritin as a non-invasive marker in the prediction of hepatic fibrosis in NAFLD. Methods This study included 113 subjects who were classified into three groups. Group I included 30 healthy subjects as control with no clinical, radiological, and histological features of NAFLD. Group II included 31 NAFLD patients without hepatic fibrosis. Group III included 52 patients with hepatic fibrosis on top of NAFLD. Results Serum ferritin was determined using ferritin ELISA kit. Fibrosis 4 score was calculated. Liver biopsy was conducted for included patients. Significantly higher levels of serum ferritin were found in patients with hepatic fibrosis on top of NAFLD than controls. Receiver operating characteristic curve analysis revealed that an optimum cutoff level of 51.95 ng/mL was the best to predict fibrosis on top of NAFLD with diagnostic sensitivity and specificity of 65% and 60%, respectively, and area under the curve = 0.658. Conclusion Higher serum ferritin was found in patients with hepatic fibrosis on top of NAFLD. Serum ferritin was found to be a predictor of fibrosis on top of NAFLD with moderate sensitivity and specificity.

To study the association between maternal serum amyloid A (mSAA) levels and preterm birth (PTB).This prospective observational nested case control study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt, between May 2017 and December 2017. The study recruited pregnant women at 26-34 weeks presented with threatened preterm labor (PTL). Women with PTB were included in cases group while control group included women who continued pregnancy and delivered at term. Serum samples were collected to measure mSAA levels. The main outcome of the study was the association between mSAA levels and PTB. Secondary outcomes included neonatal intensive care unit admissions and neonatal mortality.Fifty-eight women were included in the final analysis (29 in each group). Women with PTB had a statistically significant higher mSAA levels [5.1 (4.5-7.7) vs. 1.2 (0.0-2.5) mg/l, for cases and controls respectively,mSAA level was found to be elevated among women with threatened PTL who end with PTB; mSAA is a potentially useful predictive marker of PTB that warrant further study. CLINICALTRIALS.GOV: NCT01639027.

Nutrition can have significant effects on behavior and cognitive processes. Most of the studies related to this use extremely modified diets, such as high fat contents or the exclusion of distinct components needed for normal development and bodily homeostasis. Here we report significant effects of diets with moderate differences in compositions on food rewarded spatial learning in young (3-4 months), adult (6-7 months), and aged (17-18 months) rats. Young rats fed with a lower energy diet showed better performance only during aquisition of the spatial task when compared to rats fed with a standard diet. Adult rats (6-7 months) fed with a standard diet performed less well in the spatial learning task, than rats fed with lower energy diet. Aged rats fed with a lower energy diet (from 13 to 18 months of age) performed better during all training phases, as in a previous test when they were adult and fed with a standard diet. This difference could only be partly explained by lower motivation to search for food in the first test. Correspondingly, the variability of individual performance was significantly higher and increased over trials in adult rats fed with the standard diet as compared to adult rats fed with lower energy diet. Thus, moderate changes in feeding diets have large effects on motivation and cognition in elderly and less in young rats in a food rewarded spatial learning task. Therefore, nutrition effects upon food rewarded spatial learning and memory should be considered especially in aging studies.

Working memory is short-term memory, so temporal improvement does not reflect the consolidation of a memory trace, rather the functionality of the underlying neuronal circuits and molecular signaling cascades. The administration of drugs–either one-time or through daily injection–can elucidate the underlying mechanisms. The T-maze is especially suitable for studying dopamine-dependent working memory, since it is less stressful than other tests, for example, water maze-based paradigms ( Bezu et al., 2016 and 2017). Here, we present a training protocol for evaluating the underlying mechanisms that lead to the development of spatial working memory in rats. Our approach uses a T-maze, and it can be used to get high temporal resolution.

Joint hypermobility is a common, primarily benign finding in the general population. However, in a subset of individuals joint hypermobility causes a range of clinical problems mainly affecting the musculoskeletal system and, to a lesser extent, extra-articular disorders. Joint hypermobility often appears as a familial trait and is shared by several inherited connective tissue disorders, including the hypermobility subtype of Ehlers-Danlos syndrome (hEDS) and benign joint hypermobility syndrome (BJHS/JHS). Although joint hypermobility has primarily been thought of as a rheumatological disorder, increasing evidence shows significant associations between both hEDS and BJHS with specific extra-articular disorders. To date, the strongest associations of these 2 conditions are with anxiety disorders, orthostatic tachycardia, various functional gastrointestinal (GI) disorders and pelvic and bladder dysfunction. This review article focuses on GI disorders associated with both hEDS and BJHS. The aim of this review is to evaluate existing research and literature regarding associations between JHS (hEDS/BJHS) and GI disorders. Our goal is to raise awareness of BJHS/JHS and hEDS as an explanation for chronic unexplained symptoms and functional GI disorders as well as to review the current standard tests available for proper evaluation of GI symptoms in these patients.

A series of compounds have been shown to enhance cognitive function via the dopaminergic system and indeed the search for more active and less toxic compounds is continuing. It was therefore the aim of the study to synthetise and test a novel heterocyclic compound for cognitive enhancement in a paradigm for working memory. Specific and effective dopamine re-uptake inhibition DAT (IC50 = 4,1 ± 0,8 μM) made us test this compound in a radial arm maze (RAM) in the rat. CE-125 (4-((benzhydrylsulfinyl)methyl)-2-cyclopropylthiazole), was tested for dopamine (DAT), serotonin and norepinephrine re-uptake inhibition by a well-established system. The working memory index (WMI) was evaluated in male Sprague Dawley rats that were intraperitoneally injected with CE-125 (1 or 10 mg/kg body weight). In order to evaluate basic neurotoxicity, the open field, elevated plus maze, rota rod studies and the forced swim test were carried out. Frontal cortex was taken at the last day of the RAM test and dopamine receptors D1R and D2R, DAT and phosphorylated DAT protein levels were determined. On the 10th day both doses were increasing the WMI as compared to the vehicle-treated group. In both, trained and treated groups, D1R levels were significantly reduced while D2R levels were unchanged. DAT levels were comparable between all groups while phosphorylated DAT levels were increased in the trained group treated with 1 mg/kg body weight. CE-125 as a probably non-neurotoxic compound and specific reuptake inhibitor was shown to increase performance (WMI) and modulation of the dopaminergic system is proposed as a possible mechanism of action.

Aim of the work The purpose of this study was to evaluate the frequency of anatomical variations and congenital anomalies of intra and extra-hepatic biliary system in our geographical zone in Egypt encountered during open and laparoscopic cholecystectomies through performing routine intraoperative cholangiogram (IOC) during the operation. Patients and methods Intraoperative cholangiogram (IOC) was performed for 248 patients undergoing cholecystectomy (open or laparoscopic) at Ain-Shams university specialized hospital (ASUSH), Cairo, Egypt, from May-2011 to April 2015. All IOC’s were performed by the hepato-biliary surgeon and reviewed by the radiologist and then compared with the known internationally published anatomical variations. These results were then confirmed by total agreement between: radiologists. Results In our study, typical biliary anatomy (type A) was observed in 60% of the cases ( n = 150 patients) vs 57% published in most references, type B (11.3% n = 28 vs 12%), type C1 (11.3% n = 28 vs 16%), type C2 (6.5% n = 16 vs 4%), type D1 (3.6% n = 9 vs 5%), type D2 (2.8% n = 7 vs 1%), type E1 (2% n = 5 vs 2%), type E2 (0.8% n = 2 vs 1%) and type F (1.2% n = 3 vs 1%). With regard to the cystic duct variations we found type A, ( n = 190) the normal direct cystic duct in 76.6% which is nearly similar to the 75% published in most references. However, type B ( n = 30) was found in 12.1% vs 20% and type C ( n = 28) in 11.3% vs 5%. Conclusion In our small scale study ( n = 248); the more common typical biliary anatomy is observed here in Egypt at percentages nearly similar to that reported in the international literature. On the other hand, the less common variation types, show prevalence here in Egypt that are different from those reported in the international literature; a finding that could cause a higher number of bile duct injuries in laparoscopic cholecystectomies if not recognized.

Objective To assess the diagnostic performance of 18F-FDG PET/CT scan in the detection of recurrent disease in CRC patients who have suspected local and/or distant recurrent disease compared to contrast enhanced CT scan (CECT). Material and method 96 CRC treated patients with suspected recurrence were examined by CECT and 18F-FDG PET/CT. Pathological results, clinical or imaging follow-up, or the responsiveness of the lesion to the treatment with chemotherapy or radiation therapy were reviewed for gold standard. Results Recurrent or metastatic disease was found in 74 (77.1%) of 96 patients. Calculated sensitivity, specificity, and accuracy of 18F-FDG PET/CT were 92%, 72.7%, and 88.5%. The specificity of 18F-FDG PET/CT was statistically significantly better than that of CECT as it can reduce the false positive results of CECT in 13 patients, however regarding the sensitivity. 18F-FDG PET/CT showed better value but without statistical significance. Conclusion 18F-FDG PET/CT is a better method to evaluate postoperative CRC patients with suspected tumor recurrence or distant metastasis than CT with significantly higher specificity.