TACE is a potentially curative, palliative, neoadjuvant, bridging and symptomatic therapy option for local and diffuse HCC.

Background and study aim: Viral infections is the cause of liver inflammation, cirrhosis and even liver hepatocellular carcinoma (HCC). Despite the availability of HBV vaccine and antiviral treatment for HBV and HCV both remain a major health problem. The aim of this study To determine the seroprevalence of HBV and HCV infection among pregnant women in Sharkia governorate, Egypt.Subject and Methods: : is a crosssectional study, It involved 563pregnant women attending the antenatal care clinic, all women are subjected to full history taking, clinical examination, laboratory investigations, detection of HBsAb, HCV antibodies by rapid one-step test then by ELISA if positive, PCR was done.Results: In this study, 10 cases had anti-HCV positive with ELISA, 8 cases were positive by PCR while one case was positive for HBs Ag by ELISA, no coinfected pregnant women were detected. the prevalence rate of HBV&HCV was 0.17%, 1.7 % respectively. Conclusion:All pregnant women should be routinely screened during an early antenatal visit for HCV Antibodies and HBsAg. Cases with HCV antibodies positivity should be subjected to PCR for HCV RNA.

Background and study aim: Proper assessment of liver fibrosis and cirrhosis by non-invasive procedures are needed before appropriate management. This study aimed at detecting the role of IL-1α and TGF-β1as non-invasive liver fibrosis markers in chronic liver diseases. Patients and methods:The subjects included in this study were divided into 4 groups. Group1: 15 chronic HCV patients, group 2: 15 HCC patients, group 3: 15 patients with NAFLD, group 4: 15 healthy control subjects. Serum IL-1α and TGF-β1 measured by ELISA to patients and control groups with calculation of FIB-4 and APRI score.Results: IL-1α and TGF-β1 were significantly high in all hepatic patients compared to control group. The highest level of serum TGF-β1 was in HCC patients. There was a positive correlation between serum IL-1α and ALT, AST, ALP and HCV RNA by PCR. There was a negative correlation between IL-1α and TGF-β1. There was a highly significant positive correlation between TGF-β1 and FIB4, APRI score, ALP and AFP. Conclusion:Chronic liver diseases including HCV, HCC and NAFLD were associated with higher levels of IL-1α and TGF-β1 than healthy subjects.

Background and study aim: Hepatitis C is the most pressing public health challenge in Egypt with variable prevalence rates among different age groups. This study aimed to detect the efficacy and adverse effects of sofosbuvir plus daclatasvir therapy in treatment of chronic HCV patients in Sharkia governorate. Patients and Methods: One hundred and ten patients were included in this study, divided into 4 groups; group I: 55 treatment naïve patients receiving (sofosbuvir + daclatasvir) for 12 weeks, group II: 36 treatment naïve patients receiving (sofosbuvir + daclatasvir +ribavirin) for 12 weeks, Group III: 9 treatment experienced patients receiving (sofosbuvir + daclatasvir + ribavirin) for 24 weeks and Group IV: 10 chronic HCV patients not receiving anti-viral therapy. Patients were followed by clinical and laboratory evaluation monthly during treatment and for 3 months after end of treatment. In addition, the virological response and adverse effects were reported. Results: The rate of SVR response was equal in the three treated groups. There was statistically significant increase in nausea and headache in groups I and II while arthralgia, myalgia and fatigue were more frequent in group I. There was also statistically significant improvement in Child score among treated cirrhotic patients after treatment. Conclusion: Daclatasvir plus sofosbuvir with or without ribavirin for 12 or 24 weeks is highly effective in treatment of naïve or experienced Egyptian HCV patients in Sharkia governorate. This combination is well tolerated in both cirrhotic and noncirrhotic patients with mild adverse effects.

Background and study aim: Spontaneous bacterial peritonitis is a serious condition that needs rapid diagnosis and rapid management due to its serious sequelae. SBP is diagnosed when the polymorphonuclear cells count in the ascetic fluid exceeds 250 cell/µL. Mean platelet volume (MPV) was found to be significantly larger in the cirrhotic patients with ascetic fluid infection than cirrhotic patients without ascetic fluid infection. In our study we aimed to assess the role and clinical performance of MPV as a diagnostic marker of SBP. Patients and Methods: This cross sectional study was performed on 124 cirrhotic patients with ascites. They were classified into two groups according to ascetic fluid PMN count into two groups. Group I: 38 patients with ascetic fluid infection, PMN >250 cell/µL and group II: 86 patients without ascetic fluid infection, PMN count <250 cells/µL. Results: The MPV was significantly higher among patients with ascetic fluid infection (11.1±1.2 vs 9.4±1.1 p<0.001). Blotting the ROC curve, MPV was proved to diagnose SBP at a cut off value of 10.45 fL with sensitivity and specificity of 74.4% and 78.9% respectively. Conclusion: MPV is a useful diagnostic marker that can predict the presence of SBP in cirrhotic patients with ascites.