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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]