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OBJECTIVE Molecular profiles, such as isocitrate dehydrogenase (IDH) mutation and O6-methylguanine-DNA methyltransferase (MGMT) methylation status, have important prognostic roles for glioblastoma patients. The authors studied the efficacy and safety of stereotactic radiosurgery (SRS) for glioblastoma patients with consideration of molecular tumor profiles. METHODS For this retrospective observational multiinstitutional study, the authors pooled consecutive patients who were treated using SRS for glioblastoma at eight institutions participating in the International Radiosurgery Research Foundation. They evaluated predictors of overall and progression-free survival with consideration of IDH mutation and MGMT methylation status. RESULTS Ninety-six patients (median age 56 years) underwent SRS (median dose 15 Gy and median treatment volume 5.53 cm3) at 147 tumor sites (range 1 to 7). The majority of patients underwent prior fractionated radiation therapy (92%) and temozolomide chemotherapy (98%). Most patients were treated at recurrence (85%), and boost SRS was used for 12% of patients. The majority of patients harbored IDH wild-type (82%) and MGMT-methylated (62%) tumors. Molecular data were unavailable for 33 patients. Median survival durations after SRS were similar between patients harboring IDH wild-type tumors and those with IDH mutant tumors (9.0 months vs 11 months, respectively), as well as between those with MGMT-methylated tumors and those with MGMT-unmethylated tumors (9.8 vs. 9.0 months, respectively). Prescription dose > 15 Gy (OR 0.367, 95% CI 0.190–0.709, p = 0.003) and treatment volume > 5 cm3 (OR 1.036, 95% CI 1.007–1.065, p = 0.014) predicted overall survival after controlling for age and IDH status. Treatment volume > 5 cm3 (OR 2.215, 95% CI 1.159–4.234, p = 0.02) and absence of gross-total resection (OR 0.403, 95% CI 0.208–0.781, p = 0.007) were associated with inferior local control of SRS-treated lesions in multivariate models. Nine patients experienced adverse radiation events after SRS, and 7 patients developed radiation necrosis at 59 to 395 days after SRS. CONCLUSIONS Post-SRS survival was similar as a function of IDH mutation and MGMT promoter methylation status, suggesting that molecular profiles of glioblastoma should be considered when selecting candidates for SRS. SRS prescription dose > 15 Gy and treatment volume ≤ 5 cm3 were associated with longer survival, independent of age and IDH status. Prior gross-total resection and smaller treatment volume were associated with superior local control.

Objective Isocitrate dehydrogenase (IDH) mutation status is recommended used for diagnosis and prognostication of glioblastoma patients. We studied efficacy and safety of stereotactic radiosurgery (SRS) for patients with recurrent IDH-wt glioblastoma. Methods Consecutive patients treated with SRS for IDH-wt glioblastoma were pooled for this retrospective observational international multi-institutional study from institutions participating in the International Radiosurgery Research Foundation. Results Sixty patients (median age 61 years) underwent SRS (median dose 15 Gy and median treatment volume: 7.01 cm3) for IDH-wt glioblastoma. All patients had histories of surgery and chemotherapy with temozolomide, and 98% underwent fractionated radiation therapy. MGMT status was available for 42 patients, of which half of patients had MGMT mutant glioblastomas. During median post-SRS imaging follow-up of 6 months, 52% of patients experienced tumor progression. Median post-SRS progression free survival was 4 months. SRS prescription dose of > 14 Gy predicted longer progression free survival [HR 0.357 95% (0.164-0.777) p = 0.009]. Fifty-percent of patients died during post-SRS clinical follow-up that ranged from 1 to 33 months. SRS treatment volume of > 5 cc emerged as an independent predictor of shorter post-SRS overall survival [HR 2.802 95% CI (1.219-6.444) p = 0.02]. Adverse radiation events (ARE) suggestive of radiation necrosis were diagnosed in 6/55 (10%) patients and were managed conservatively in the majority of patients. Conclusions SRS prescription dose of > 14 Gy is associated with longer progression free survival while tumor volume of > 5 cc is associated with shorter overall survival after SRS for IDH-wt glioblastomas. AREs are rare and are typically managed conservatively.

In the family of amorphous semiconductors, non-oxide chalcogenide glasses (ChGs) are in the spotlight because of their widespread applications in various scientific and industrial fields. In this p...

Background Granulocyte-macrophage colony-stimulating factor (GM-CSF) is believed to play an important role in the development of acne vulgaris. Aim of the work To investigate the presence of GM-CSF 3928C/T and GM-CSF 3606 T/C promoter gene polymorphisms in Egyptian acne patients. Methods To examine whether GM-CSF single nucleotide polymorphisms (SNPs) are associated with susceptibility to acne vulgaris (AV), we investigated the genotype and allele frequencies of the SNP 3928C/T and 3606T⁄C of the GM-CSF gene in 100 Egyptian acne patients (29 with mild acne, 38 with moderate acne, and 33 with severe acne) and 100 controls, using a PCR restriction fragment length polymorphism (RFLP) method. Results There was a highly significant difference in genotype and allele frequencies of the 3928C/T group between patients with acne vulgaris and controls for the SNP site. Regarding the 3606 T/C subgroup only a marginal significant difference was found between cases and controls in TC pattern (p = 0.039); with the TC genotype appearing more in cases (53% of patients) than controls (35% of healthy controls). Conclusion We report a novel GM-CSF 3928C/T promoter gene polymorphism contributing to the pathogenesis of acne in Egyptian population.

Background: Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Risk factors for HCC include chronic hepatitis B and hepatitis C, alcohol addiction, metabolic liver disease and exposure to dietary toxins such as aflatoxins and aristolochic acid. Objective: To determine the value of serum Medkine level as a potential biomarker for patients with hepatocellular carcinoma. Patients and methods: This study was conducted at the Gastroenterology and Hepatology Unit, Department of Internal Medicine Al-Azhar and Misr University for Science and Technology. 90 Egyptian patients were recruited and were divided into 3 Group I included 30 patients with liver cirrhosis, HCC was excluded in these patients at time of recruitment in the study, exclusion of HCC was based on the absence of any hepatic focal lesion in abdominal ultrasonography scanning. Group II included 40 patients with HCC. Diagnosis of HCC was based on the appearance of typical vascular pattern of enhancement in triphasic spiral CT scan of the abdomen. Control Group included 20 age and sex-matched apparently healthy subjects. Results: Different liver function tests showed no statistically difference between two groups except for ALK. Ph and gamma glutamyltransferase (GGT) which were significant higher in group II than group I. There was a highly statistically significance difference regarding alpha-fetoprotein (AFP) which was higher in group II than group I and control group. Serum AFP levels were found to be significantly correlated with larger tumor size in this study. In addition, patients with advanced-stage hepatocellular carcinomas had significantly higher median AFP serum levels (BCLC B/C) than that of early-stage tumors (BCLC 0/A) (237ng/mL versus 23ng/mL). However, no significant correlation was found between serum midkine (MDK) levels with tumor size, number or serum levels of AFP, and no significant association was found between serum MDK levels and BCLC stages. The best cutoff values for MDK and AFP to discriminate HCC cases from those with liver cirrhosis were 0.39 and 10ng/mL, respectively, with sensitivities (90% versus 77.5%), specificities (60% versus 80%). The overall diagnostic performance of MDK for HCC diagnosis was much better than that of AFP. On comparing the sensitivities and specificities of MDK at the cutoff 0.39ng/mL to those of AFP at different cutoff values (10 and 400), the overall diagnostic performance of MDK for HCC diagnosis was much better than that of AFP. Conclusion: Alpha-fetoprotein and midkine may have a complementary role in hepatocellular carcinoma surveillance and screening. Midkine increased the diagnostic yield in alpha-fetoprotein -negative hepatocellular carcinoma and the presence of either elevated alpha-fetoprotein or midkine increased the sensitivity of hepatocellular carcinoma detection. Midkine was also superior to alpha-fetoprotein in the diagnosis of NASH-related hepatocellular carcinoma and this finding postulated an exciting novel role for midkine in NASH-related carcinogenesis.

Background: Ischemic heart diseases are major sources of morbidity and mortality worldwide. Several biomarkers have been suggested to aid in the diagnosis of myocardial infarction and unstable angina. Multiple micro-RNAs, a class of regulatory ribonucleic acids, have been studied in ischemic heart disease patients for a potential role in diagnosis. Objective: To study the role of micro RNA-21(miRNA21 or miR21) in Egyptian patients with ischemic heart diseases(IHD), myocardial infarction (MI) and unstable angina (UA) to evaluate its diagnostic value in IHDs. Patients and Methods: This prospective case-control study included 50 subjects, divided into two groups: Patient group including 30 subjects, and control group including 20 subjects. Subjects were subjected to full history taking and clinical assessment, routine lab investigations, cardiac markers assay, and determination of serum expression of Micro RNA-21 using real-time polymerase chain reaction (PCR). This study was conducted on patients attending at cardiology department, Al-Hussein University Hospital. Study started in March 2018, and ended in October 2018. Results: Micro-RNA expression profile showed that miR-21 was up-regulated in MI and UA patients in general, with a statistically extremely highly significant difference (p=

Purpose Although surgery remains a treatment option for symptomatic brain metastases, the need for adjuvant radiation after surgery is widely accepted as standard. Despite a multitude of randomized trials aimed at identifying the ideal radiation treatment plan for surgically resected metastases, the development of new delivery regiments necessitates a periodic re-evaluation of dosimetric performance/outcome. Here, we compare the homogeneity index (HI) across three platforms: single-session stereotactic radiosurgery (SRS), multisession stereotactic radiotherapy, and intraoperative radiotherapy (IORT). Methods and Materials Patients treated with IORT after surgical resection of brain metastases were identified and dosimetric parameters collected from the dose-volume histograms based on the development of conformal plans for adjuvant radiation using Gamma Knife-SRS (GK-SRS), linear accelerator based intensity-modulated radiation therapy, and IORT. HIs were calculated using four established methods and compared across platforms within the patient cohort. Statistical analyses were performed using analysis of variance. Results The mean maximal doses for the GK-SRS and IMRT plans were 30 Gy and 29 Gy with margin prescription doses of 16 Gy and 24 Gy, respectively. The IORT dose was 30 Gy to the applicator surface. HIs varied based on calculation methods, but maintained consistency when comparing across platforms with IORT having the lower mean HI value (0.56; 95% confidence interval (CI) 0.55–0.60) in single-fraction treatment, compared with GK-SRS (0.77; 95% CI 0.76–0.80). The mean multisession IMRT HI was lower than both single-fraction treatment modalities at 0.41 (95% CI 0.40–0.42). Conclusions When using the HI as the primary dosimetric parameter for adjuvant radiation plans after surgical resection of brain metastases IORT offers improved dose homogeneity compared with GK-SRS in single-fraction treatment, whereas fractionated LINAC-based IMRT was superior with respect to the HI in comparison among all three methods.

In the present study, quercetin was examined against lung human cancer cells using A549 and H69 cancer cell lines in addition to normal non cancer cells (W138). Two genes Bax and Bcl-2 that play an important role in apoptosis pathways were investigated. Also Immunohistochemical study for caspase-3 which is considered as indicator for apoptosis was performed. Quercetin showed good anti proliferative activity against tested lung cancer cell lines, IC50 values on A549 are 8.65, 7.96 and 5.14 µg/ml at 24, 48 and 72h respectively. Also significant effects of quercetin on Bax, Bcl-2 and caspase-3 were observed, that can prove its ability to induce apoptosis. On the other hand quercetin showed good therapeutic effects against cyclophosphamide induced lung toxicity that were observed in the histopathology study. In vitro studies were also performed such as cell cycle analysis through flowcytometry. The obtained results from all these performed analysis proved that quercetin can induce apoptosis in human lung cancer cells, additionally quercetin showed ability to reduce MDA and increase SOD and GSHP levels which indicates its ability in suppressing oxidative stress, Quercetin has played a therapeutic role in cyclophosphamide induced lung toxicity as it has improved restoring of the damaged lung tissue as discussed in this research work.

Background: The detection of early gastric cancer may improve survival and avoid major gastric surgeries. Gastric Intestinal Metaplasia (GIM) is a precancerous lesion of the stomach. Screening for GIM may therefore lead to early detection of gastric neoplastic lesions. Objective: This study was designed to determine the effect of conventional Narrow Band Image (NBI) in combination with acetic acid (AA-NBI) on the diagnosis of antral GIM. Patients and Methods: The present study was performed in 100 consecutive adults who required endoscopic examination at AL Hussein University Hospital, Department of Internal Medicine, Endoscopy Unit, Conventional white-light endoscopy (WLE), NBI and AA-NBI was performed in all patients by the same endoscopist during a single procedure with a GIF Q290 endoscope (Olympus Medical Systems, Tokyo, Japan), All suspicious antral gastric lesions was photographed. Any abnormal mucosal change, such as localized discoloration and rough areas, was considered indicative of GIM lesions. Results: Fifty-six (56.0%) out of the 100 individuals examined were found to have GIM (by biopsy), of which 34 (60.7%) were diagnosed correctly by NBI (sensitivity 66.7% and specificity 68.2%) and 42 (75%) were correctly identified by AA–NBI (sensitivity 75% and specificity 73.91%), as compared to only 24 (42.86%) by WLE (sensitivity 42.86% and specificity 37.5%). Therefore, the sensitivity of AA–NBI in the diagnosis of GIM was significantly higher than NBI (p < 0.05) and WLE (p < 0.001). Our study indicates that AA-NBI can improve the accuracy of endoscopy-targeted biopsies for GIM. Conclusion: Acetic acid staining combined with NBI was of a higher sensitivity and specificity in the diagnosis of intestinal metaplasia in gastric mucosa, which was in good consistency with the pathological diagnosis. Compared with the normal NBI, it was more capable to detect lesions of intestinal metaplasia in gastric mucosa, improved the accuracy of targeted biopsy to intestinal metaplasia, and has an important significance in the early detection and treatment of tumors.

Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2), is an ongoing pandemic that has already affected millions of patients worldwide, and is associated with significant morbidity and mortality burden. Objective: To characterize the clinical manifestations and outcomes of COVID-19 in Egyptian patients. Patients and Methods: This was a retrospective cohort study conducted on 333 subjects with COVID-19 who were admitted to Al-Azhar University Specialized Hospital, Quarantine Hospital, and some patients during follow up after discharge from other quarantine hospitals, during the period from 15th of April, 2020 to 31st of August, 2020. Presenting clinical manifestations, laboratory findings, imaging findings and mortality rate were recorded from electronic medical records and sometimes from patients. Results: The vast majority had cough (82.6%) and fever (51.7%), while 23.4% had dyspnea among COVID-19 patients. There was a significant older age among died cases (66.4 ± 17.4 years old) than recovered cases (40.3 ± 14.9 years old) (p- value

Cystic echinococcosis (CE) is a severe neglected zoonotic parasitic disease caused by the larval stage of the dog tapeworm, Echinococcus granulosus. The objectives of this study were to determine the prevalence of hydatid cysts in dromedary camels (Camelus dromedarius) at Sharkia province, Egypt and investigate the occurrence of bacteria in hydatid fluid. A total of 6416 dromedary camels slaughtered in five abattoirs in Sharkia province, Egypt during the period from January and December 2018 were investigated for the presence of hydatid cysts. Furthermore, the bacterial species in 10 hydatid fluid isolated from lungs and livers was identified. The current findings revealed that the prevalence of hydatid cysts was 3.7%. Among those, the infection rate in lungs was 78.2%, which was significantly higher than hepatic infections (21.8%). The prevalence of hydatid cysts was the highest in winter (7.4%) and the lowest in spring (1.5%). The most common bacterial species found inside hydatid fluid collected from lungs were Salmonella spp., Staphylococcus spp., Enterococci and Pseudomonas spp. Meanwhile, Staphylococcus spp. were isolated from hepatic hydatid fluid. In conclusion, hydatid cysts infection is prevalent in dromedary camels in Sharkia province, Egypt as well as various aerobic and anaerobic bacterial species were isolated from hydatid fluid from camel lungs and livers.

Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. Results: The majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) ( p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) ( p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) ( p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) ( p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. Conclusion Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.

Background: Acne is one of the commonest chronic inflammatory dermatological diseases among adolescents. Aim of the work: The aim of the study was to detect the prevalence of acne among pre adolescents in primary and preparatory schools in Damietta governorate Egypt. Subjects and methods: This was a cross sectional study, that was conducted on 1624 pre adolescents in primary and preparatory schools in Damietta governorate. Results: 569 (35.0%) of cases were under 10 years. Age ranged from 8-13 years with mean value 11.44±1.680 years. Male cases were 781 (48.1%) while female cases were 843 (51.9%) and 251(65.8%) had mild acne grade, 122(31.9%) had moderate acne grade and 9(2.4%) had severe acne grade. Conclusion: Acne is one amongst the most common skin disease and includes a great effect on quality of life among pre adolescents attending primary and preparatory schools in Damietta governorate, the prevalence of acne vulgaris among pre adolescents in primary and preparatory schools in Damietta governorate Egypt was 23.5%.

Background Postcircumcision penile gangrene is a devastating complication that may lead to total or subtotal penile loss requiring penile reconstruction. Pediatric penile reconstruction poses diverse challenges for most plastic surgeon.Patients and Methods Retrospective cohort study of 12 children ranged from 6 to 36 months old suffered from total or partial penile loss secondary to electrocautery burn during circumcisions. Reconstruction was done by island groin flap for phallus in first stage and urethral reconstruction by tubularized scrotal flap 6 months later. The outcome was evaluated by assessment of flap survival, the esthetic appearance, urethral competence and rate of complication.Results Follow-up was ranged from 6 to 24 months. A new phallus of satisfactory dimensions was achieved in all cases. Complications included partial necrosis of the flap in two cases, fistulas in two cases, and stenosis of the urethral anastomosis in one case. These complications were successfully resolved by corrective surgery. Good satisfactory result regarded as shape and urination stream.Conclusion Penile reconstruction can be performed in children with good results and low complication rate. The use of island groin flap for phallus reconstruction followed by urethral reconstruction by tubularized scrotal flap 6 months later was found effective, time saving, and with minor complication.

Background and purpose To perform a systematic review/meta-analysis of outcomes for patients with spinal metastases treated with stereotactic radiosurgery (SRS) (either single-fraction (SF-SRS) or multiple-fraction (MF-SRS)) or conventional radiotherapy (RT). Materials and methods Thirty-seven studies were identified. Primary outcomes were 1-year local control (LC) and acute/late grade 3–5 toxicities (including vertebral compression fractures (VCF)). Weighted random effects meta-analyses using the DerSimonian and Laird methods and meta-regressions were conducted to characterize and compare effect sizes. Mixed effects regression models were used in dose analyses. Results A total of 3237 patients with 4911 lesions were included; 43.8%, 19.7%, and 36.5% of lesions received SF-SRS, MF-SRS, or RT, respectively. SF-SRS resulted in improved 1-year LC (92.9% (95% CI: 86.4–97.4%); p = 0.007) compared to RT (81.0% (95% CI: 69.2–90.5%)) with no difference between MF-SRS (82.1%; p = 0.86) and RT. On subgroup analysis of de novo metastases, superior 1-year LC following SF-SRS (95.5% (95% CI: 87.4–99.6%)) was maintained compared to RT (83.6% (95% CI: 70.4–93.5%); p = 0.007). A 4.7% increase in LC was noted for each 10 Gy10 increase in biologically effective dose (BED10, assuming an alpha/beta = 10) with SRS (p Conclusion SF-SRS resulted in superior LC with a roughly 5% LC benefit for every 10 Gy10 increase in BED10 with higher VCF rates compared to MF-SRS. If LC is the goal of treatment, then SRS may be a preferred treatment modality. However, these results are hypothesis-generating, and prospective randomized clinical trials are indicated to definitively address the question of whether SRS results in improved LC compared to RT.

Purpose We present a case of misdiagnosed fungal keratitis due to a bilateral nummular presentation. Observations A 41-year-old female patient, contact lens wearer, presented initially at an optometrist with acute bilateral blurred vision and photophobia. She was found on exam to have multiple round stromal infiltrates bilaterally. She did not have significant ocular surface issues prior and had no history of topical steroid use. Adenovirus testing was negative, and she was started on a topical antibiotic-steroid combination. She did not improve and was referred for further evaluation. We initially suspected a herpetic infection and began treatment with oral antivirals. Cultures came back positive for Candida albicans in the right eye. She was very photophobic and cultures were unable to adequately be obtained from the left eye. She was switched to topical voriconazole drop in both eyes and gradually improved with excellent visual outcome. Urogenital cultures were negative. Contact lens use was discontinued through the course of treatment. Conclusions Bilateral Candida keratitis is rare and has not been reported in a nummular pattern and in a patient without significant ocular surface issues or chronic use of steroid drops. Differential diagnosis of nummular keratitis mostly includes viral and inflammatory conditions. This case highlights the need to stay alert to a possible fungal etiology and a potential risk of using topical steroids at initial presentation of nummular keratitis.

Objective: This study aimed to assess the knowledge, attitude, and training of health-care workers (HCW), and their perception of the preparedness of hospitals for communicable disease (CD) threats during mass gathering (MG) events. Methods: This was a cross-sectional study conducted from June 1 to July 31, 2019, of doctors and registered nurses working in the emergency departments (EDs) of 5 main hospitals in Qatar. A self-administered online survey was used for data collection. Results: The overall mean knowledge score about CD threat among study participants was 75.0% (SD ± 18.1). The majority of the participants had a favorable attitude toward CD preparedness during MG events. The participants achieved high scores in attending workshops on triaging, first aid, and infection control. Study participants as well had favorable perceptions about the current preparedness of their respective hospitals to respond to CD outbreaks in MG events. Conclusions: The participants were knowledgeable about the risk of CD outbreaks during MG events (eg, Federation of International Football Association (FIFA) World Cup games 2022) and had a favorable attitude and necessary training to respond to such outbreaks. Regular practice drills are necessary to ensure that all members of the workforce are knowledgeable of the necessary actions to take in emergent high-risk situations.

Introduction Due to high levels of intravenous drug use (IVDU) in West Virginia (WV), there are increasing numbers of hospitalizations for infective endocarditis (IE). More specifically, pregnant patients with IE are a uniquely challenging population, with complex management and a clinical course that further affects the health of the fetus, with high morbidity and mortality. Timely recognition and awareness of the most common bacterial causes will provide hospitals and clinicians with valuable information to manage future patients. Methods This retrospective study analyzed the clinical course of pregnant patients admitted with IE and IVDU history presenting at Cabell Huntington Hospital from 2013 to 2018. Inclusion criteria were women between 16 and 45 years of age confirmed to be pregnant by urine pregnancy test and ultrasonography with at least eight weeks gestation, with a first-time diagnosis of endocarditis and an identified history of IVDU. We excluded charts with pre-existing risk factors including a history of valvular disease, rheumatic heart disease, surgical valve repair or mechanical valve replacement, or a diagnosis of coagulopathies. The resulting charts were evaluated for isolated organisms, reported clinical course, and complications of the pregnancy. Results A total of 10 patients were identified, with methicillin-susceptible and methicillin-resistant Staphylococcus aureus, Serratia marcescens, Haemophilus parainfluenza, and Enterococcus faecalis species. Complications included loss of fetus (30%), septic embolization (40%), hemorrhagic stroke (10%), and transfer to outside facilities for cardiothoracic surgical intervention (40%). Discussion IE in pregnancy, while rare, has serious complications. In the context of the IVDU epidemic, it has an increasing impact on WV hospitals. A better understanding of the clinical course may allow for early diagnosis and guide the development of rational empiric therapies. More effective management of IE in pregnant patients can reduce complications and potentially improve maternal and fetal morbidity or mortality.

Objectives. Motor vehicle repair workers are a vulnerable group for developing occupational dermatoses. They are exposed to a wide range of chemical, physical and mechanical hazards. This study aim...

Purpose this study was conducted between 2011 and 2017 at the faculty of Veterinary Medicine Cairo University and aimed to histologically and radiologically compare the efficiency of freshly isolated bone marrow mesenchymal stem cells (F-BMMSC) versus culture expanded bone marrow mesenchymal stem cells (E-BMMSC) when added to the mixture of autologous platelet rich fibrin (PRF), collagen with nano-hydroxyapatite in healing of critical bony mandibular defects in mandibular site in dogs. Material and methods 12 healthy adult Mongrel dogs were used in this study and bilateral rectangular full thickness mandibular inferior border critical bone defects (15X10 mm) just before the angle area were resected. Group A (The left side) contained: E-BMMSCs The expanded BMSC seeded on collagen sponge with Nano-Hydroxyapatite and PRF membrane. Group B (The right side) contained: F-BMMSCs The Gradient immediately separated BMSC seeded on collagen sponge with Nano-Hydroxyapatite and PRF membrane. Radiographic follow up was done immediate, 4, 8, 12 weeks Scarification was done 4, 8, 12 weeks postoperative. local bone mineral densities (BMD) were measured on a DXA system. Histological evaluation was done using H&E. Results the results showed that group B right defects had better healing results than group A right defects all over the follow-up period, but the differences were not statically significant. Conclusion the study findings indicate that The F-BMMSCs that seeded in nano-hydroxyapatite collagen type I n-HA-COL scaffolds combined with platelet rich fibrin PRF successfully repaired mandibular critical size defects, the same as the E-BMMSCs seeded in the same scaffold. .

Background: Type 2 diabetes mellitus is the most common form of diabetes. Millions of patients worldwide have been diagnosed as type 2 diabetes and many more are unaware they are at high risk. It represents a major public health threat and constitutes an important contributor to the predicted decline in life expectancy. Objective: The aim of the present work was to evaluate serum chemerin level and its association with kidney functions in patients with type 2 diabetes mellitus. Patients and methods: This case control study was conducted at Clinical Pathology Departments of Al-Azhar University Hospitals. It was carried out on 80 subjects of matched age and sex divided as 60 type 2 diabetic patients and 20 apparently healthy volunteers (hospital staff) serving as control group. Results: In a correlation study between serum chemerin and other studied parameter in diabetic patients, a significant positive correlation was found between serum levels of chemerin, FBS, ACR, serum creatinine, serum urea, fasting insulin, HOMA-IR index and BMI. On the other hand, a highly significant negative correlation between serum chemerin and eGFR was observed in patients' group. Furthermore, we evaluated the diagnostic performance of chemerin for discriminating patients with macroalbuminuria from those without. The best diagnostic cutoff for chemerin was 100.1 ng/mL. This had a diagnostic sensitivity of 85%, specificity 75%, negative predictive value 63%, positive predictive value 90.9%. The area under the curve (AUC) was 78.3%. Conclusion: These findings suggested that serum chemerin can be used as a predictive marker for diabetic nephropathy.

Background: Medical treatment of decompensated cirrhosis due to hepatitis C virus (HCV) remains a clinical challenge even in the era of direct-acting antiviral drugs (DAAs). We evaluated the efficacy and safety of DAAs in the management of HCV-related decompensated cirrhosis. Objective: The current study aimed to evaluate the efficacy and safety of DAAs in managing HCV patients with decompensated cirrhosis and the impact of achieving sustained virological response on improving the quality of life, short term survival and if viral eradication would step down CTP score. Patients and Methods: The study included a treatment group I (n = 25) composed of HCV patients with decompensated cirrhosis Child B and group II (n = 22) with decompensated cirrhosis Child C. both groups received DAAs (sofosbuvir 400 mg, daclatasvir 60 mg) plus ribavirin as tolerated for 3 months and follow-up was done for 6 months. Results: In both treated groups, there were improvements in platelet count, albumin, Child-Torcout-Pugh (CTP) (p = 0.001) and a significant reduction in the frequency of hepatic encephalopathy (HE). Also, there was improvement in quality of life of both treated groups. Conclusion: Treatment of HCV with decompensated cirrhosis with DAAS had improved CTP score, quality of life and survival.

Background: Weighing in at around 3 pounds, the liver is the body’s second largest organ; only the skin is larger and heavier. The liver performs many essential functions related to digestion, metabolism, immunity, and the storage of nutrients within the body. These functions make the liver a vital organ without which the tissues of the body would quickly die from lack of energy and nutrients. Fortunately, the liver has an incredible capacity for regeneration of dead or damaged tissues; it can grow as quickly as a cancerous tumor to restore its normal size and function. Objective: to evaluate the levels of fibrosis regression by ARFI in the patients with successful eradication of chronic hepatitis C virus after 12 weeks and 24 weeks after completion of treatment with direct acting antiviral drugs (sustained virological response, SVR 12 and SVR 24). Patients and Methods: This prospective and observational cohort study was conducted during the period between June 2016 and February 2019 in total of 60 individuals at Al-Azhar (Al-Hussein) Hospital and National Search Institute in Cairo divided into three groups. Results: Results show that the median fibrosis degree measured by ARFI in all patients was significantly decreased after HCV eradication with 100 % success in cure rate and 16.5% of patients failed to regress fibrosis. Conclusion: A disappointing percentage (16.5%) failure in fibrosis regression although reaching a sustained virological response.

Background: Beta-thalassemias (b-thalassemias) are a group of inherited blood disorders caused by reduced or absent synthesis of the beta chains of hemoglobin resulting in variable phenotypes ranging from severe anemia to clinically asymp-tomatic individuals. Thalassemia is the commonest hereditary hemolytic anemia in Egypt. Iron overload is a major compli-cation of repeated blood transfusion in patients with thalassem-ia. Soluble Transferrin Receptor (sTfR), one of the main regulators of cellular iron homeostasis, is the truncated form of the tissue receptor.Aim of Study: This work was conducted to study the pathophysiology of iron overload in children with b-thalassemia intermedia and thalassemia major and explore the possible utility of Soluble Transferrin Receptor (sTfR) for the evaluation of iron overload and ineffective erythropoi-esis in pediatric Egyptian patients with s thalassemia major, b-thalassemia intermedia and comparing this with the controls.Patients and Methods: This study was conducted on sixty b-thalassemia patients (30 b-thalassemia major and 30 b-thalassemia intermedia) together with 30 age and sex matched controls. Patients were selected from the outpatient clinics of the Pediatric Hematology Unit and the Inpatients of Pediatric Department; Faculty of Medicine, Beni Suef University Hospital during the year 2017. Patients and control were subjected to clinical evaluation and complete blood count along with serum ferritin and sTfR levels by Enzyme-Linked Immunosorbent Assay (ELIZA) technique.Results: Both serum ferritin and sTfR levels were signif-icantly higher in patients compared with controls and in patients with thalassemia major compared with those with thalassemia intermedia. Serum ferritin and sTfR levels were significantly positively correlated with patients' age and with each other. Each of them was negatively correlated with age of disease onset, frequency of blood transfusions and with hemoglobin level.Conclusion: Serum levels of ferritin and soluble transferrin receptor were significantly higher in both thalassemic groups in comparison to control group.

Avian pathogenic Escherichia coli (APEC) is one of the extra intestinal pathogenic E. coli (ExPEC). Previous studies showed that O1, O2 and O78 serotypes are mostly associated with Colibacillosis outbreaks, but recently there are emergent new pathogenic serotypes that have spread worldwide. Wide antigenic diversity exists among APEC strains in Egypt; however, the involvement of a particular O serotype in the infection process appears to vary with the geographical region. Different virulence genes have been identified in APEC. Recently; the presence of these virulence genes is being employed as an indication of pathogenicity, rather than the tedious E. coli serotyping methods. In Egypt; several virulence genes were studied, and were found to be different based on the geographical area. However; all studies were limited to a small number of screened virulence genes, in addition to the inconsistency of these screened genes. To control APEC, antibiotics have been used for decades; however the emergence of multi-drug resistant E. coli, and the difficulty of discovering new antimicrobial therapies made vaccine the best choice to control E. coli infections in poultry farms. In this review, the various aspects of APEC infection in poultry with special focus on the epidemiology of APEC in Egypt in relation to virulence traits were discussed. In addition, the most recent vaccination trials against the APEC diseases in poultry were discussed. We concluded that the virulence gene patterns of APEC can be considered as molecular markers of pathogenicity. Although of their current limitations, some vaccine trials showed promising results as good alternative to control colibacillosis in poultry.

Commercial broiler chickens are frequently infected with Ecoli serotypes in form of collibacillosis which characterized as an initial respiratory infection (air sacculitis) followed by generalized septicemia, perihepatitis and pericarditis. The present work aimed to study the ability of E.coli O125 previuosly isolated and identified from diseased broilers suffered from pericarditis , airsacculitis and perihapatitis to induce a disease and The current study aimed to determine the pathogenicity of E. coli serogroup O125 in broiler chicks, a trial of prevention and treatment using probiotic ( Guardyazin-m) or antibiotic (Cipronate20%). The chicks were divided into seven groups including control negative, orally infected , subcutenously infected , probiotic treated group, and finally antibiotic treated group. The clinical signs, mortality, performance parameters and postmortem examination as well as the pathological changes in liver and intestine were recorded. The probiotic group gave the best results in controlling infection by E. coli O125 followed by antibiotic. In conclusion, the E. coli O125 serogroup was pathogenic to chicks when experimentally inoculated, so particular attention must be directed toward E. coli O125 as a pathogen infecting bird. Also probiotics was of great value in protection against the E. coli infection and improve the performance parameters of chicks . Its effect on feed consumption , weekly body weight gain and feed conversion rate (FCR) was determined.

Background The present study aimed to illustrate comparative morphological, histological, and functional variations of the hyoid apparatus of Acanthodactylus boskianus and Ptyodactylus guttatus. Result The hyoid apparatuses and musculature of the two investigated species are well-developed. The hyoid apparatuses exhibit high mobility with different articulation sites between their skeletal elements. The degree of ossification of the hyoid apparatus of gecko is more developed than that of the lacertid lizard. In P. guttatus, a well-developed synchondrosis articulation appears between the basihyoid and ceratobranchialis of the hyoid apparatus. Meanwhile, in A. boskianus, the articular ligament which appears between basihyoid and ceratobranchialis is less developed and also appears as a ligament connection between the two parts of hyoid cornua in which ligaments provide more mobility to the hyoid of lacertid lizard. Conclusion The results reflect a phylogenetically informative character about these clad and explain the different functional demands imposed on the hyoid apparatus as well as confirm the important role of hyoid apparatus in the movement of the tongue during the prey transport.

E coli infection in poultry is one of the principle causes of mortality and morbidity in chickens and turkeys resulting in retardationof growth and decreased feed conversion rate . The most common form of collibacillosis is characterized as an initial respiratoryinfection (air sacculitis) followed by generalized septicemia, perihepatitis and pericarditis. The present study aimed to identify thebacteria associated with pericarditis , airsacculitis and perihapatitis in Egyptian broiler chickens. A total 300 samples of diseasedand dead broilers from 3-6 weeks age were collected. The isolated bacteria included E. coli, Klebsiella spp., Shigella spp. AndEnterobacter spp. Sero-grouping of the isolated E. coli strains revealed O125, O158, O55,O129, O20 , O6 , O8 , O27, O115,O142 and un-typed strains with prevalence of 16%, 12%, 8%, 8%, 8% , 8% , 8% , 8% ,4%,4% and 16% respectively. Themajority of E coli isolates were sensitive to colistin sulphate (38%) and Norofloxacin (38%) followed by ciprofloxacin (19%),cefotaxim (19%) and Ofloxacin (19%). On the other hand, E coli were resistant (100%)to amoxicillin, clindamycin ,Erythromycin and streptomycin. PCR analysis for antibiotic resistance genes of E coli detected that 12 serogroups isolates werepositive using the specific primers for Aada2 , BlaCTX and TetA(A) genes. The current study demonstrated the high prevalenceof E. coli indeed broilers suffered from pericarditis , perihepatitis and airsacculitis . Measures are needed to control E. colicontamination in poultry farms to reduce economic losses caused by infection of E.coli.

The introduction of sildenafil (SDF) to treat erectile dysfunction has solved a widespread condition with negative on the quality of life. Recently, the co-administration of tramadol (TMD) with SDF to manage premature ejaculation has illegally increased and thus drug-drug interaction studies of these drugs became of great importance. Although certain biological functions have been altered upon co-administration of the two drugs, methods for their determination in vivo to understand their interactions have yet to be published. Herein, therefore, an HPLC method with photometric detection was developed for the determination of a binary mixture of TMD and SDF in rabbit plasma after oral administration. In this study, a reversed-phase chromatography was performed at room temperature on a C18 column with a mobile phase composed of 10 mM Na2HPO4 solution (pH 7.5): acetonitrile (45:55, v/v) at a flow rate of 0.8 mL min−1 using caffeine (CAF) as an internal standard. The detector was set at 220 nm. The total analysis time was 6 min. Calibration graphs were linear in the concentration ranges of 0.1–10 and 0.05–10 μg mL−1 with a detection limit of 0.05 and 0.02 μg mL−1 for TMD and SDF, respectively. The method was validated in terms of accuracy, precision, limit of detection and quantitation, recovery, and stability as per US FDA bioanalytical guidelines. In addition, the metabolites N-desmethylsildenafil (UK-103,320) and O-desmethyltramadol were quantified in rabbit plasma after 2 h of oral administration using LC–MS/MS. The simultaneous administration of TMD with SDF has affected peak plasma concentration (Cmax), Tmax, area under the concentration-time curve (AUC), and the elimination rate constant (Kel) of SDF. The present study is the first to give valuable insights into the drug-drug interaction and the pharmacokinetic implications associated with the co-administration of SDF and TMD.

Background: Barrett’s esophagus (BE) is an important risk factor for the occurrence esophageal adenocarcinoma. Endoscopic surveillance for Barrett’s dysplasia is indicated in all patients with BE. Recent data found that with the use of advanced endoscopic techniques there is an increased diagnostic yield for dysplasia. Aim: The aim of this study is to assess the accuracy of acetic acid assisted narrow band imaging (AA-NBI) endoscopy in detection of Barrett’s dysplasia. Patients and Methods: Forty patients with BE surveyed for Barrett’s dysplasia by AANBI endoscopy. Patients with difficult sampling (n=1) or not proved to have Barrett’s mucosa by histopathology (n=5) were excluded. Patients with positive and negative dysplasia underwent targeted and random endoscopic biopsy, respectively. The diagnosis of BE based on Prague endoscopic classification. The pathological assessment of Barrett’s dysplasia based on Vienna classification. Results: A total of 34 patients were included; their mean age was 39.03±14.23 years; they were 19 (55.88%) males and 15 (44.11%) females. Of them 28 (82.35%) had cardiac type BE, 3 (8.82%) had fundic type BE and 3 (8.82%) had intestinal type BE. Five patients were depicted as Barrett’s dysplasia by AA-NBI. Low grade dysplasia was proved in 3 of them by histopathology. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of AA-NBI in diagnosis of Barrett’s dysplasia were 100%, 93.5%, 60%, 100%, and 94.1% respectively. Conclusion: Nine percent of patients with BE are positive for dysplasia. AA-NBI has promising sensitivity, specificity and accuracy in prediction of Barrett’s dysplasia.

Background: in developing countries, sepsis represents the 3rd cause of neonatal mortality. Procalcitonin and MPV have been studied widely as markers for neonatal sepsis. Objective: evaluation of the value of platelet volume parameters compared to procalcitonin as early biomarkers of neonatal sepsis. Patients and Methodology: a prospective case-control study on 80 newborn infants admitted to the university neonatal intensive care unit, Sayed Galal University Hospital, between September and December 2020. Studied neonates have been divided equally into; sepsis, and control groups. Cases were suspected based on clinical presentation, risk factors, and hematological scoring system (≥3); and further subdivided into group A: with proven sepsis, and group B: with clinical sepsis. Serum procalcitonin, CRP, blood cultures, and CBC were performed within the 1st 36 hours of life. Results: MPV was higher in both sepsis (p < 0.0001), and culture-proven sepsis groups (p=0.00057). Other platelet parameters showed no significant difference among sepsis and control groups. Procalcitonin level was higher in both sepsis (p < 0.00001), and culture-proven sepsis groups (p < 0.00001). MPV of ≥ 9.54 fL, and PCT of ≥ 0.157 ng/mL cutoff points showed sensitivity, specificity, PPV, and NPV of (92.5%, 87.5%, 88.1%, 92.1%) respectively for MPV, and (95%, 65%, 73.1%, 92.9%) respectively for PCT. MPV showed also positive correlation in sepsis group (p= 0.02089, 0.03134) with PCT and CRP respectively. Conclusion: MPV and PCT showed close sensitivities, while MPV septicity was even higher. MPV may be considered as a sensitive, affordable, and reliable marker for neonatal sepsis.

Primary cutaneous cryptococcosis is an uncommon condition. Patients with immunosuppression and those of older age are more susceptible to infection, warranting investigations into underlying systemic disease. We report the case of a 49-year-old male with multiple sclerosis in remission on fingolimod who presented with a non-healing skin lesion on his upper thigh for a duration of two years. Skin biopsy showed dermal parasitized histiocytes, and serum antigens for histoplasmosis and Cryptococcus were negative. Further investigation with polymerase chain reaction (PCR) demonstrated cutaneous cryptococcal infection, with no associated systemic signs or symptoms. This case report highlights an uncommon presentation of cutaneous cryptococcosis on an unexposed skin surface with successful and rapid improvement following fluconazole therapy without fingolimod discontinuation.

Several retrospective series have reported that patients with collagen vascular disease (CVD) are at increased risk of radiation (RT) toxicity. However, the evidence is mixed, and many series lack control groups. We performed a meta-analysis including only case-cohort or randomized studies that examined the risk of RT toxicity for patients with CVD compared with controls.Meta-analysis of Observational Studies in Epidemiology guidelines were used to perform a comprehensive search identifying case-control or randomized studies reporting RT toxicity outcomes for patients with CVD versus controls. Data were synthesized from studies reporting grade 2 to 3 or more (G2/3 +) acute and late RT toxicities. Results were analyzed with fixed effects meta-analysis on the random-effects model for between-study heterogeneity; otherwise, the fixed-effects model was used. Hazard ratio or odds ratio (OR) were the effect-size estimators, as appropriate.Ten studies were included, with 4028 patients (CVD: 406, control: 3622). Patients with CVD had higher rates of acute G2/3 + toxicity (26.2% vs 16.5%, OR [odds ratio] 2.01; P.001) and late G2/3 + toxicity (18.4% vs 10.1%, OR 2.37; P.001). Higher rates of late G2/3 + toxicity were observed for CVD patients with systemic lupus erythematous (21% vs 9.7%; OR 2.55, P = .03), systemic scleroderma (31.8% vs 9.7%, OR 3.85; P = .03), rheumatoid arthritis (11.7% vs 8.4%, OR = 2.56; P = .008), and those irradiated to the pelvis/abdomen (32.2% vs 11.9%, OR 3.29; P = .001), breast (14.7% vs 4.4%, OR 3.51; P = .003), thorax (12.5% vs 8.7%, OR 3.46; P.001), and skin (14.6% vs 5.2%, OR 2.59; P = .02). Late grade 5 toxicities were significantly higher for patients with CVD, although absolute rates were low (3.9% vs 0.6%, OR = 7.81; P = .01).Moderate and severe toxicities are more likely in patients with CVD, with variable risk depending on toxicity grade, CVD subtype, treatment site, and dose. Severe toxicities are uncommon. These factors should be considered when informing patients of treatment-related risks and monitoring for morbid treatment sequelae.

Background: Although the internet can be a source of reassurance and clarification for expectant women, it ‎could cause concerns or feelings of worry when reading about pregnancy-related ‎information. The current research sought to assess the feelings of worry and perceived reliability towards online pregnancy-related information and the associated factors among expectant women attending antenatal clinics at primary healthcare centers in Qatar.Methods: A cross-sectional study design was employed. The participants were recruited through a systematic random sampling technique. ‎A self-administered questionnaire was used to collect data from the participants. Descriptive and analytic statistics were used when appropriate‎.Results: A total of 327 expecting women completed the questionnaire. Most participants were aged between 26-34 years (74.1%), held a college/university degree (76.4%), and multigravidas (73.1%). About one-third of the women ‎(31.2‎%) reported feeling worried due to something they read online. The participants coped with these feelings by consulting their antenatal care provider at the next appointment (51.0%) or by talking with relatives and friends (47.0%). Furthermore, most women (79.2%) considered online pregnancy-related information to be reliable or highly reliable. Holding a college/university degree, primigravidae, and having no children were factors significantly associated with a high perception of reliability of online health information.Conclusion: Although online pregnancy information caused feelings of worry for some pregnant ‎women, most women perceived such information to be reliable. Thus, antenatal care providers should be equipped to guide pregnant women on how to access high-quality web-based information.

Background Internet usage has been steadily increasing and the available online information for pregnant women today is immense. Objective This study aimed to investigate the prevalence of women who search for information relating to pregnancy on the internet and to identify predictors of this behavior among expecting women visiting primary health care (PHC) centers in Qatar. Methods A cross-sectional study was conducted at the antenatal clinics of six PHC centers in Qatar from June 1 to December 31, 2019. Pregnant women were recruited through a systematic random sampling technique. Participants were interviewed using a structured questionnaire. Descriptive and analytic statistics were used when appropriate. A multivariable logistic regression analysis was constructed to identify the predictors of internet use for pregnancy-related information. Results The study included 403 pregnant women (response rate: 87.9%). Most of them were in the 26–35 years age category (71.5%), in the second trimester (55.5%), and had 1–2 children at home (51.5%). The internet was the most common source (81.1%) of pregnancy-related information. The access to online information was mainly through websites (67.3%), mobile applications (48.3%), and social media platforms (39.7%). The most frequently searched topics online were fetal development (74.3%), diet during pregnancy (53.6%), and management of health problems (39.6%). The multivariable regression model identified the age group 26–35 years (AOR: 4.93; 95% CI: 2.14, 11.38), Arabs (AOR: 4.12; 95% CI: 2.03, 8.36), tertiary education (AOR: 5.22; 95% CI: 1.78, 15.33), being a housewife (AOR: 6.37; 95% CI: 1.44, 28.19), or employed (AOR: 5.56 95% CI: 1.31, 23.63), and having up to 2 children as independent predictors of internet use for pregnancy-related information. Conclusion The internet was a commonly used source of health information among pregnant women in Qatar. Internet use was significantly associated with the age group of 26–35 years, Arabs, higher level of education, being employed or a housewife, and having up to two children.

Objectives Headache is considered one of the most frequent neurological manifestations of coronavirus disease 2019 (COVID-19). This work aimed to identify the relative frequency of COVID-19-related headache and to clarify the impact of clinical, laboratory findings of COVID-19 infection on headache occurrence and its response to analgesics. Design Cross-sectional study. Setting Recovered COVID-19 patients. Subjects In total, 782 patients with a confirmed diagnosis of COVID-19 infection. Methods Clinical, laboratory, and imaging data were obtained from the hospital medical records. Regarding patients who developed COVID-19 related headache, a trained neurologist performed an analysis of headache and its response to analgesics. Results The relative frequency of COVID-19 related headache among our sample was 55.1% with 95% confidence interval (CI) (.516–.586) for the estimated population prevalence. Female gender, malignancy, primary headache, fever, dehydration, lower levels of hemoglobin and platelets and higher levels of neutrophil/lymphocyte ratio (NLR) and CRP were significantly associated with COVID-19 related headache. Multivariate analysis revealed that female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count were independent predictors of headache occurrence. By evaluating headache response to analgesics, old age, diabetes, hypertension, primary headache, severe COVID-19, steroid intake, higher CRP and ferritin and lower hemoglobin levels were associated with poor response to analgesics. Multivariate analysis revealed that primary headache, steroids intake, moderate and severe COVID-19 were independent predictors of non-response to analgesics. Discussion Headache occurs in 55.1% of patients with COVID-19. Female gender, fever, dehydration, primary headache, high NLR, and decreased platelet count are considered independent predictors of COVID-19 related headache.

The current observations focused on the ultrastructure comparison between the tongue of two reptile species endemic the Egyptian fauna; Bosc's fringe-toed lizard Acanthodactylus boskianus and Sinai fan-fingered gecko Ptyodactylus guttatus to exhibit the relationship between the lingual epithelium and its function according to their specific feeding strategy. A. boskianus possessed triangular elongated tongue with bifurcated tapering apex and wide base while; the P. guttatus had a triangular flattened tongue with conical shallow bifurcated apex and broad base. The ventral surface of the lingual apex of A. boskianus had transverse while in P. guttatus had two oval pads and median ventral groove. Both surfaces of the tongue of both examined species are covered by stratified squamous epithelium with great variability of degree of keratinization. The dorsal epithelium formed flattened and conical filiform papillae in A. boskianus, while in P. guttatus formed cylindrical papillae, conical, and tall filiform ones. Few taste buds are observed on the fore-tongue but increase on the mid-tongue of A. boskianus, while in P. guttatus, numerous taste buds are distributed on the fore-tongue and mid-tongue. Both surfaces of the laryngeal mound of both examined species provided with numerous of cilia and orifices of laryngeal gland. The present results confirmed that the tongue of A. boskianus acts as a chemoreceptor organ to follow pheromone trails of prey and mates. While in P. guttatus the tongue may play an important role in the feeding mechanism and act as a chemoreceptor organ.