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Introduction: Regulatory T cells (Treg) deficits, both quantitative and qualitative, are known to be possible triggers for the development of autoimmune disorders by causing T and B cells dysfunction. The contribution of Treg deficiency in the etiology of systemic lupus erythematosus (SLE) is still being debated. The aim of the present study is to evaluate the percentage of circulating CD4+CD25+Foxp3+ Treg cells in a cohort of Egyptian SLE patients and to correlate this value with the activity and damage index of these patients. Methods: 50 female patients with SLE together with an equal number of age- and sex-matched healthy controls were enrolled in the study. Flow cytometric determination of peripheral Treg cells was carried out for all participants by detecting the percentage of CD4+CD25+Foxp3+ cells to compare cases with the control group. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), while disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI). Both indices were correlated with the percentage of CD4+CD25+Foxp3 T regulatory cells. Results: CD4+CD25+Foxp3+ Treg cells percentage was significantly decreased in patients with SLE as compared to healthy controls. On correlating CD4+CD25+Foxp3+ Treg percentage with SLEDAI-2K, a significantly negative correlation was found. Also, there was a negative significant correlation between CD4+CD25+Foxp3+ Treg cells percentage and SLICC/ACR DI. On correlating SLEDAI-2K with damage index (SLICC/ACR DI), we found highly significant positive correlation. Conclusion: Our study showed impaired production of CD4+CD25+Foxp3+ Tregs in SLE patients, which can play a reciprocal role with some cytokines to affect the activity of the disease and organ damage. CD4+CD25+Foxp3+ Tregs cells should be the target to determine the clinical effectiveness of new therapy to modulate Tregs besides the traditional treatments. [ABSTRACT FROM AUTHOR]

Lumbar spinal fusion is widely used in treating degenerative and traumatic conditions of the lumbar spine. The impact of chronic hyperlipidemia on perioperative complications has not been yet investigated. This study compared the perioperative complications of single- and multi-level lumbar fusions in patients with and without chronic hyperlipidemia. Retrospective database study. Patients with or without chronic hyperlipidemia who underwent single- or multilevel lumbar fusions between 2010 and 2019. Perioperative surgical and medical complications. A nationwide claims database, PearlDiver, was utilized for this study. International Classification of Diseases (ICD-9 and ICD-10) codes were used to identify patients with chronic hyperlipidemia. Current Procedural Terminology (CPT) codes were used to identify lumbar spinal fusion surgeries. Utilizing the appropriate ICD-9, ICD-10 and CPT codes, we retrieved the perioperative surgical and medical complications. Propensity score matching was implemented to control for the confounding factors, including age, gender and Elixhauser Comorbidity Index (ECI). Chi-square test was used to compare the incidence of complications among groups. Single-level lumbar fusions included a total of 65,674 patients: with hyperlipidemia (n=18,395) and without hyperlipidemia (n=47,279). Propensity score matching resulted in 16,930 patients in each group. Patients with hyperlipidemia had a higher incidence of wound complications (481 [2.8%] vs 357 [2.1%], P < 0.001), surgical site infection (370 [2.2%] vs 231 [1.4%], P < 0.001), failed back syndrome (1914 [11.3%] vs 1605 [9.5%], P < 0.001), hardware removal (1,006 [5.9%] vs 761 [4.5%], P < 0.001), deep venous thrombosis/pulmonary embolism (264 [1.6%] vs 216 [1.3%], P=0.031), myocardial infarction (81 [0.5%] vs 23 [0.1%], P < 0.001), cerebrovascular accident (86 [0.5%] vs 39 [0.2%], P < 0.001), renal failure (305 [1.8%] vs 197 [1.2%], P < 0.001), sepsis (103 [0.6%] vs 51 [0.3%], P < 0.001), urinary tract infection/incontinence (697 [4.1%] vs 436 [2.6%], P < 0.001). Multilevel lumbar fusions included a total of 48,928 patients: with hyperlipidemia (n=15,527) and without hyperlipidemia (n=33,401). Propensity score matching resulted in 14,218 patients in each group. Patients with hyperlipidemia had a higher incidence of nerve root injury (33 [0.2%] vs 17 [0.1%], P=0.034), wound complications (624 [4.4%] vs 508 [3.6%], p < 0.001), surgical site infection (438 [3.1%] vs 307 [2.2%], p < 0.001), failed back syndrome (2,024 [14.2%] vs 1,642 [11.5%], p < 0.001), hardware removal (1,146 [8.1%] vs 885 [6.2%], p < 0.001), revision (922 [6.5%] vs 1,055 [7.4%], P=0.002), myocardial infarction (120 [0.8%] vs 41 [0.3%], p < 0.001), renal failure (472 [3.3%] vs 313 [2.2%], p < 0.001), urinary tract infection (810 [5.7%] vs 618 [4.3%], p < 0.001). Following single- or multilevel lumbar fusions, patients with chronic hyperlipidemia have an increased risk of perioperative complications, including wound complications, surgical site infection, failed back syndrome, hardware removal, myocardial infarction, renal failure and urinary tract infection. In multilevel lumbar fusions, chronic hyperlipidemia is associated with a higher incidence of nerve root injury and revision rates. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is becoming a public health problem with increasing incidence and it has been shown to be associated with diabetes, dyslipidemia, obesity and metabolic syndrome and ultimately puts more than half the world's population at risk of developing NAFLD/NASH/cirrhosis in the coming decades. The importance of detection of patients with NAFLD is to intervene the associated factors and avoid transformation to more severe forms of the disease. Methods: An observational case control study was carried out at Medicine Department, Dhaka Medical College Hospital (DMCH), Dhaka, during the period of August, 2011 to June, 2012. A total number of 100 consecutive patients and 100 healthy controls was approaches DMCH were enrolled in this study. Out of 100 NAFLD patients only 20 patients gave consent for liver biopsy to see the extent of liver damage. Result: Less physical activity, Obesity, mean blood pressure, Diabetes, TG, TC were significantly (P<0.05) higher in NAFLD. Metabolic syndrome was 64% in NAFLD. According to NASH Activity Scoring system definite NASH (score >5) was found in 9(45%) of the NAFLD group. Conclusion: Significant proportion of NAFLD patient suffers from NASH which is alarming and they have potential for the development of advanced liver disease. So recognition of these risk factors inpatients of NAFLD can help in early implementation of strategies that halt the progression of this disease. [ABSTRACT FROM AUTHOR]

Objective. This paper examines the prevalence and socioeconomic correlates of unintended pregnancy among rural women in Bangladesh. Material and Methods. The study used data from the 2007 Bangladesh Demographic and Health Survey. Chi-square tests and binary logistic regression were performed using the data set. Results. Overall, 30.0% of the most recent births were unplanned. Both bivariate and multivariate analyses confirm that age, ever use of contraceptive method, religion and wealth index were important determinants of unintended pregnancy. Pregnancy order appeared as the most single determinant of unplanned pregnancy. Women with fourth or higher order pregnancies were at higher risk (OR=4.31, 95%CI; 4.31-6.56) of unintended pregnancy than those who experienced pregnancy for the first time. Conclusion. Unintended pregnancy is common in rural Bangladesh. Intervention programs regarding reproductive health and services should be undertaken. Awareness should be created to continue the use of modern contraceptive methods to avoid unintended pregnancy. [ABSTRACT FROM AUTHOR]

The insertion of Al(III) cation into a poly(8-Hydroxyquinoline) (PHQ) instead of some metal ions such as Co(II), Ni(II), Zn(II) or Fe(III) ions via cation-exchange mechanism has been studied by several techniques. The presence of Al(III) and the absence of Co(II) cations has been proved by elemental analysis of the polymer chelates product. Molecular mechanics (MM+) calculations showed that the potential energy (PE, kJ mol−1) of the optimum molecular geometric structure (OMG) of the PHQ–Al(III) matrix is about seventy-six (76.185) greater than the PE of the PHQ–Co(II) complex. The TGA thermograms show that the PHQ–Al(III) matrix is thermally unstable than the PHQ–Co(II) complex under the same conditions. These observations indicate that the PHQ–Al(III) is expanded coil-like form. So, the thermal decomposition of PHQ–Al(III) complex is easy than the compacted coil-likes form of PHQ–Co(II) complex. The incorporation of Al(III) ion via cation-exchange properties have been investigated by spectrophotometric technique. The decrease of the absorbance at about ~370 nm of PHQ–Co(II) complex associated with increasing concentration of Al(III) revealed the replacement of that metal ion by Al(III) into PHQ chain. The cation-exchange constant ( K ex) of the divalent ions [Ni(II), Co(II), Cr(II), Zn(II), Mn(II), Mg(II) and Cu(II)] from PHQ–M(II) by the additions of Al(III) according to the following series: Ni(II) > Co(II) > Cr(II) > Cu(II) > Zn(II) > Mn(II) > Mg(II). [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Pharmaceutical care programmes delivered by pharmacists are known to improve quality of care for both ambulatory and hospitalized patients with a variety of chronic and acute conditions. • Reduction of HbA1c and normalization of blood pressure are key targets for diabetes care programmes, since they are key to reducing diabetes complications. • Good knowledge about disease, medications, diet and exercise requirements can improve the effectiveness of self-management of diabetes. WHAT THIS STUDY ADDS • In a randomized, controlled clinical trial, a comprehensive pharmaceutical care programme (consisting of patient education and advice on medication adherence, metabolic control and life style) delivered by a clinical pharmacist over a 12-month period, significantly improved glycaemic control and health-related quality of life in Type 2 diabetes patients attending a military hospital outpatient clinic in the United Arab Emirates (UAE). • A significant reduction in HbA1c was important in the reduction of the 10-year coronary heart disease risk scores (by British National Formulary and Framingham methods) seen in patients who received the present care programme. • The outcomes of this study advocate an increased role for clinical pharmacists in the healthcare system in the UAE. AIMS To examine the influence of a pharmaceutical care programme on disease control and health-related quality of life in Type 2 diabetes patients in the United Arab Emirates. METHODS A total of 240 Type 2 diabetes patients were recruited into a randomized, controlled, prospective clinical trial with a 12-month follow-up. A range of clinical measures, medication adherence and health-related quality of life (Short Form 36) were evaluated at baseline and up to 12 months. Intervention group patients received pharmaceutical care from a clinical pharmacist, whereas control group patients received their usual care from medical and nursing staff. The primary outcome measure was change in HbA1c. British National Formulary and Framingham scoring methods were used to estimate changes in 10-year coronary heart disease risk scores in all patients. RESULTS A total of 234 patients completed the study. Significant reductions ( P < 0.001) in mean values (baseline vs. 12 months; 95% confidence interval) of HbA1c[8.5% (8.3, 8.7) vs. 6.9% (6.7, 7.1)], systolic [131.4 mmHg (128.1, 134.7) vs. 127.2 mmHg (124.4, 130.1)] and diastolic blood pressure [85.2 mmHg (83.5, 86.8) vs. 76.3 mmHg (74.9, 77.7)] were observed in the intervention group; no significant changes were noted in the control group. The mean Framingham risk prediction score in the intervention group was 10.56% (9.7, 11.4) at baseline; this decreased to 7.7% (6.9, 8.5) ( P < 0.001) at 12 months but remained unchanged in the control group. CONCLUSIONS The pharmaceutical care programme resulted in better glycaemic control and reduced cardiovascular risk scores in Type 2 diabetes patients over a 12-month period. [ABSTRACT FROM AUTHOR]

Background: Pedicle screw fixation the gold standard for lumbar spine stabilization. Pedicle screw has fixation offers multiple advantages, allowing superior correction of spinal deformities, and reduced rates of loss of non-union. Cortical Bone Trajectory (CBT) is a new technique in which screws follow a caudal-tocephalad path in the sagittal plane and a medial-to-lateral directed path in the transverse plane. CBT is reducing operative and post-operative complications and has high fixation strength. Purpose: To Compare the clinical outcomes between CBT and traditional trajectory (TT) in surgical management of degenerative spondylolisthesis. Materials and Methods: A comprehensive electronic search in Pubmed, MEDLINE and Chocrane library databases, Google scholar and Research gate for articles that published between 2009 to 2020 using these keywords: Cortical bone trajectory, Cortical bone trajectory-pedicle screw, Pedicle screw. Results: The majority of literature suggests that the CBT technique results in similar or decreased postoperative back and leg pain compared to TT. Regarding the disability ODI and the operative time showed no significant differences between the CBT and TT. Radiographic outcomes between both studies show no statistical difference in fusion rates and vertebral slippage. Intraoperative blood loss was significantly less with CBT compared to TT. Conclusion: there is no widely accepted consensus regarding comparison of clinical outcomes and complications between the CBT and TT procedures. Generally, indications for CBT and TT are similar between most studies, especially for common pathologies resulting in spondylolisthesis. [ABSTRACT FROM AUTHOR]

Background: Antipsychotics, including risperidone (RIS), are frequently indicated for various autism spectrum disorder (ASD) manifestations; however, "actionable" PGx testing in psychiatry regarding antipsychotic dosing and selection has limited applications in routine clinical practice because of the lack of standard guidelines, mostly due to the inconsistency and scarcity of genetic variant data. The current study is aimed at examining the association of RIS effectiveness, according to ABC-CV and CGI indexes, with relevant pharmacokinetics (PK) and pharmacodynamics (PD) genes. Methods: Eighty-nine ASD children who received a consistent RIS-based regimen for at least 8 weeks were included. The Axiom PharmacoFocus Array technique was employed to generate accurate star allele-predicted phenotypes of 3 PK genes (CYP3A4, CYP3A5, and CYP2D6). Genotype calls for 5 candidate PD receptor genes (DRD1, DRD2, DRD3, HTR2C, and HTR2A) were obtained and reported as wild type, heterozygous, or homozygous for 11 variants. Results: Based on the ABC total score, 42 (47.2%) children were classified as responders, while 47 (52.8%) were classified as nonresponders. Multivariate logistic regression analyses, adjusted for nongenetic factors, suggested nonsignificant impacts of the star allele-predicted phenotypes of all 3 PK genes on improvement in ASD symptoms or CGI scores. However, significant positive or negative associations of certain PD variants involved in dopaminergic and serotonergic pathways were observed with specific ASD core and noncore symptom subdomains. Our significant polymorphism findings, mainly those in DRD2 (rs1800497, rs1799978, and rs2734841), HTR2C (rs3813929), and HTR2A (rs6311), were largely consistent with earlier findings (predictors of RIS effectiveness in adult schizophrenia patients), confirming their validity for identifying ASD children with a greater likelihood of core symptom improvement compared to noncarriers/wild types. Other novel findings of this study, such as significant improvements in DRD3 rs167771 carriers, particularly in ABC total and lethargy/social withdrawal scores, and DRD1 rs1875964 homozygotes and DRD2 rs1079598 wild types in stereotypic behavior, warrant further verification in biochemical and clinical studies to confirm their feasibility for inclusion in a PGx panel. Conclusion: In conclusion, we provide evidence of potential genetic markers involved in clinical response variability to RIS therapy in ASD children. However, replication in prospective samples with greater ethnic diversity and sample sizes is necessary. [ABSTRACT FROM AUTHOR]

Interfacial tension (IFT) is a key physical property that affects various processes in the oil and gas industry, such as enhanced oil recovery, multiphase flow, and emulsion stability. Accurate prediction of IFT is essential for optimizing these processes and increasing their efficiency. This article compares the performance of six machine learning models, namely Support Vector Regression (SVR), Random Forests (RF), Decision Tree (DT), Gradient Boosting (GB), Catboosting (CB), and XGBoosting (XGB), in predicting IFT between oil/gas and oil/water systems. The models are trained and tested on a dataset that contains various input parameters that influence IFT, such as gas-oil ratio, gas formation volume factor, oil density, etc. The results show that SVR and Catboost models achieve the highest accuracy for oil/gas IFT prediction, with an R-squared value of 0.99, while SVR outperforms Catboost for Oil/Water IFT prediction, with an R-squared value of 0.99. The study demonstrates the potential of machine learning models as a reliable and resilient tool for predicting IFT in the oil and gas industry. The findings of this study can help improve the understanding and optimization of IFT forecasting and facilitate the development of more efficient reservoir management strategies. [ABSTRACT FROM AUTHOR]

Interfacial tension (IFT) is a key physical property that affects various processes in the oil and gas industry, such as enhanced oil recovery, multiphase flow, and emulsion stability. Accurate prediction of IFT is essential for optimizing these processes and increasing their efficiency. This article compares the performance of six machine learning models, namely Support Vector Regression (SVR), Random Forests (RF), Decision Tree (DT), Gradient Boosting (GB), Catboosting (CB), and XGBoosting (XGB), in predicting IFT between oil/gas and oil/water systems. The models are trained and tested on a dataset that contains various input parameters that influence IFT, such as gas-oil ratio, gas formation volume factor, oil density, etc. The results show that SVR and Catboost models achieve the highest accuracy for oil/gas IFT prediction, with an R-squared value of 0.99, while SVR outperforms Catboost for Oil/Water IFT prediction, with an R-squared value of 0.99. The study demonstrates the potential of machine learning models as a reliable and resilient tool for predicting IFT in the oil and gas industry. The findings of this study can help improve the understanding and optimization of IFT forecasting and facilitate the development of more efficient reservoir management strategies. [ABSTRACT FROM AUTHOR]

A rapid, cost-effective, and simple nucleic acid isolation technique coupled with a point-of-need DNA amplification assay is a desirable goal for programmatic use. For diagnosis of Visceral Leishmaniasis (VL), Recombinase Polymerase Amplification (RPA) rapid tests for the detection of Leishmania DNA are versatile and have operational advantages over qPCR. To facilitate the delivery of the RPA test at point-of-need for VL diagnosis, we compared two rapid DNA extraction methods, SwiftDx (SX) and an in-house Boil and Spin (BS) method, coupled with RPA amplification, versus more widely used methods for DNA extraction and amplification, namely Qiagen (Q) kits and qPCR, respectively. A total of 50 confirmed VL patients and 50 controls, matched for age and gender, were recruited from Mymensingh, Bangladesh, a region highly endemic for VL. Blood samples were collected from each participant and DNA was extracted using Q, SX and BS methods. Following DNA extraction, qPCR and RPA assays were performed to detect L. donovani in downstream analysis. No significant differences in sensitivity of the RPA assay were observed between DNA extraction methods, 94.00% (95% CI: 83.45–98.75%), 90% (95% CI: 78.19–96.67%), and 88% (95% CI: 75.69–95.47%) when using Q, SX, and BS, respectively. Similarly, using qPCR, no significant differences in sensitivity were obtained when using Q or SX for DNA extraction, 94.00% (95% CI: 83.45–98.75%) and 92.00% (80.77–97.78%), respectively. It is encouraging that RPA and qPCR showed excellent agreement (k: 0.919–0.980) when different extraction methods were used and that the DNA impurities using BS had no inhibitory effect on the RPA assay. Furthermore, significantly higher DNA yields were obtained using SX and BS versus Q; however, a significantly higher parasite load was detected using qPCR when DNA was extracted using Q versus SX. Considering the cost, execution time, feasibility, and performance of RPA assay, rapid extraction methods such as the Boil and Spin technique appear to have the potential for implementation in resource-limited endemic settings. Further clinical research is warranted prior to broader application. [ABSTRACT FROM AUTHOR]

Background: Malnutrition including undernutrition, overnutrition, and micronutrient deficiencies are considerable problems worldwide, with variable burdens among different communities. Its complications include physical and cognitive impairment, with the probability of irreversible lifelong consequences. We aimed to assess the prevalence of undernutrition, overweight, obesity, and anemia in preschoolers, being a risk group for developmental adverse events. Methods: We recruited 505 healthy preschool children, with a male: female ratio of 1.05:1. Children with chronic diseases were excluded. We used anthropometry and complete blood count to screen for malnutrition and anemia. Results: The mean age of the study group was 3.8 ± 1.4 years (1.02–7). The screening results were average in 228 (45.1%) children, while 277 (54.9%) children had either abnormal anthropometry, anemia, or both. We observed undernutrition in 48 (9.5%) children; among them, 33 (6.6%) were underweight, 33 (6.6%) wasted, and 15 (3%) were stunted, with no significant difference between children aged below or above five. We identified overnutrition in 125 (24.8%); 43 (8.5%) were overweight, 12 (2.4%) were obese, and 70 (13.9%) had a high body mass index Z score, not qualifying the definition of overweight. Anemia was diagnosed in 141 (27.9%) children and was significantly more frequent among older children without gender discrimination. About 10% (50 children) had both anemia and abnormal anthropometry. The frequency of abnormal anthropometry was comparable between children with anemia and those with normal hemoglobin. Conclusion: Malnutrition and anemia in preschoolers are still a heavy burden affecting about half of our study group, with an upward trend towards the overnutrition side. Anemia is still a moderate public health problem in preschoolers. [ABSTRACT FROM AUTHOR]

Severe respiratory involvement that follows a process of immune dysregulation and intense cytokine production remains to be the most dreaded complication of Coronavirus Disease-2019 (COVID-19) infection. The aim of this study was to analyze T lymphocyte subsets and natural killer (NK) lymphocytes in moderate and severe cases of COVID-19 infection and assess their significance in disease severity and prognosis. Twenty moderate cases and 20 severe cases of COVID-19 were studied and compared regarding blood picture, biochemical markers, T lymphocyte population subsets, and NK lymphocytes, which were determined by flow cytometric analysis. On analyzing the flow cytometric data of T lymphocyte cells and their subsets and NK cells in two groups of COVID-19 infection (one group moderate and the other severe cases), some immature NK lymphocyte relative and absolute counts were higher in the severe patients with worse outcome and death, while some mature NK lymphocyte relative and absolute counts were depressed in both groups. Also, interleukin (IL)-6 was significantly higher in severe cases when compared to moderate cases, and there was a positive significant correlation between immature NK lymphocyte relative and absolute counts and IL-6. There was no statistically significant difference between T lymphocyte subsets (T helper and T cytotoxic) with disease severity or outcome. Some immature NK lymphocyte subsets contribute to the widespread inflammatory response that complicates severe cases of COVID-19; therapeutic approaches directed to enhancing NK maturation or drugs that block NK cell inhibitory receptors have a potential role in controlling COVID-19 induced cytokine storm. [ABSTRACT FROM AUTHOR]

Background: Low‐ and middle‐income countries (LMICs) have a disproportionately high burden of chronic diseases, with inequalities in health care access and quality services. This study aimed to assess patients' preferences for healthcare services for chronic disease management among adult patients in Bangladesh. Methods: The present analysis was conducted among 10,385 patients suffering from chronic diseases, drawn from the latest Household Income and Expenditure Survey 2016–2017. We used the multinomial logistic regression to investigate the association of chronic comorbid conditions and healthcare service‐related factors with patients' preferences for healthcare services. Results: The top four dimensions of patient preference for healthcare services in order of magnitude were quality of treatment (30.3%), short distance to health facility (27.6%), affordability of health care (21.7%) and availability of doctors (11.0%). Patients with heart disease had a 29% significantly lower preference for healthcare affordability than the quality of healthcare services (relative risk ratio [RRR] = 0.71; 0.56–0.90). Patients who received healthcare services from pharmacies or dispensaries were more likely to prefer a short distance to a health facility (RRR = 6.99; 4.80–9.86) or affordability of healthcare services (RRR = 3.13; 2.25–4.36). Patients with comorbid conditions were more likely to prefer healthcare affordability (RRR = 1.39; 1.15–1.68). In addition, patients who received health care from a public facility had 2.93 times higher preference for the availability of medical doctors (RRR = 2.93; 1.70–5.04) than the quality of treatment in the health facility, when compared with private service providers. Conclusions: Patient preferences for healthcare services in chronic disease management were significantly associated with the type of disease and its magnitude and characteristics of healthcare providers. Therefore, to enhance service provision and equitable distribution and uptake of health services, policymakers and public health practitioners should consider patient preferences in designing national strategic frameworks for chronic disease management. Patient or Public Contribution: Our research team includes four researchers (co‐authors) with chronic diseases who have experience of living or working with people suffering from chronic conditions or diseases. [ABSTRACT FROM AUTHOR]

Background and Objective: Obstetric venous thromboembolism (VTE) poses a life-threating burden and it is one of the major causes of maternal morbidity and mortality with an increased incidence throughout the last decades. The objectives of this study were to assess the incidence of VTE, types of prophylaxis received, and factors determining prophylaxis in women at VTE risk during pregnancy and puerperium at a tertiary hospital for 1 year.Methods: This is a prospective study that was carried out at Minia maternity university hospital, Egypt during the period from June 2018 to June 2019. The study included women attended the hospital at risk of VTE as per the RCOG guidelines. Full history, patient characteristics, and VTE risk factors were assessed.Results: During the study period, a total of 901 women attended the hospital and perceived at risk of VTE (298 cases during pregnancy and 603 cases during puerperium), about half of them were mild in intensity. They comprise 8.22% of the total deliveries during the study period (n = 10,956). About two-thirds of them (71.5%) had a cesarean delivery. Varicose veins were found in 209 cases (23.2%), previous VTE in 189 cases (21.0%), previous superficial vein thrombosis was recorded in 240 cases (26.6%) and previous arterial ischemic events in 83 cases (9.2%). The vast majority of patients (99.6%) received the pharmacological type of prophylaxis (55.6% of them received unfractionated heparin and the rest of them 43.9% received Aspirin). Only six cases developed VTE from the total included cases with an incidence of 0.55/1000 maternities (0.055%). Obesity (BMI >30 kg/m2) and cesarean delivery were significant factors that determine VTE prophylaxis with an odds ratio of 1.68 (95% CI, 1.20-2.35, p < .01) and 2.05 (95% CI, 1.49-2.80, p < .01), respectively.Conclusion: The incidence of women perceived at VTE risk was 8.22%, about half of them were mild in intensity. The risk of VTE was higher during the postpartum period than that during pregnancy. The incidence of VTE was 0.55/1000 overall maternities (0.055%). The pharmacological type of prophylaxis was the predominant used type. Obesity and cesarean delivery were significant factors determining VTE prophylaxis. [ABSTRACT FROM AUTHOR]

Oral Direct‐acting antivirals (DAAs) are safe, highly effective altering disease burden and prognosis in hepatitis C patients. Sustained virologic response (SVR) is achieved nowadays in more than 90% of the treated patients and related to the improvements in functions of the liver, fibrosis plus survival. Furthermore, portal hypertension is thought to be improved with achievement of virological response, parallel to the improvements in hepatic inflammation and fibrosis. We aimed to assess the recurrence rate of oesophageal varices by long‐term follow‐up in patients treated with different DAAs regimens who had achieved SVR. We studied 176 Child A cirrhotic HCV patients who achieved SVR after DAAs treatment and had a history of endoscopic oesophageal varices obliteration and were on maximum tolerated propranolol dose. They were subjected to follow‐up upper gastrointestinal endoscopy repeated every 6 months for 4 years. Fifty‐two patients (29.5%) had recurrence of oesophageal varices observed during the 4‐years follow‐up upper GIT endoscopy. On multivariate analysis, platelet count was the only significant variable, P‐value =.007*. HbA1C, HOMA IR, BMI 1 and BMI 2 showed non‐significant differences between the studied groups. By ROC analysis, we identified baseline platelet count of 96 000/µL with 100% sensitivity (95% confidence interval [CI] [91%‐100%]) and 74% specificity (95% CI [65%‐81%]). Spearman correlation showed a positive correlation between AFP, age, AST, Bilirubin, creatinine, INR. Patients who achieved SVR post DAAs showed a significant decrease in oesophageal varices recurrence post endoscopic obliteration. Baseline platelet count was found to be a strong independent predictor for oesophageal varices recurrence. [ABSTRACT FROM AUTHOR]

Highlights: [•] Agonist form of CXCL10 is undetectable in chronic HCVg4 patients. [•] Increased sDPPIV concentration and DPP activity in HCVg4 patients. [•] CXCL10 expression does not correlate with localization of CXCR3+ cells in liver. [•] Chemokine antagonism as a general mechanism of immune modulation in chronic HCV. [•] Highlights role for DPPIV as a drug target for treatment of HCVg4 patients. [ABSTRACT FROM AUTHOR]