Background: Helicobacter pylori infection is one of the most prevalent chronic bacterial human infections worldwide. Helicobacter pylori colonizes the gastric mucosa and causes persistent gastritis that may progress to gastric cancer. Increased resistance of H. pylori presents a major problem in most countries. Statins, including simvastatin, which are currently used to treat hypercholesterolemia, appear to have potential synergistic role to antibiotics. This study aimed to assess the value of adding simvastatin as adjuvant to standard triple therapy in patients infected with H. pylori . Methods: This study was conducted on 100 patients diagnosed with H. pylori by the presence of antigen in stools. All patients were randomly subjected either to the standard triple regimen (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid) (group 1, N=50) or to the standard triple regimen plus simvastatin (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid + simvastatin 20 mg bid) (group 2, N=50). Both groups were treated for 14 days and eradication of H. pylori was assessed by a stool antigen test 4 weeks after therapy. Results: Eradication of H. pylori infection was significantly higher in patients treated with the standard triple therapy plus simvastatin (n=41, 82%) than in patients treated with the standard triple therapy (n=31, 62%) ( P <0.022). Conclusion: Simvastatin significantly improves the H. pylori eradication rate.

Background: Coronavirus disease-2019 (COVID-19) is a global pandemic health problem which causes a wide spectrum of clinical manifestations and considerable mortality rates. Unfortunately, recovered patients who survive COVID-19 may continue to report wide varieties of clinical manifestations of multisystem affection such as fatigue, dyspnea, myalgia, anxiety, depression, acute myocardial infarction, peripheral and pulmonary embolisms. Objective: We aimed to assess the prevalence of post-COVID-19 manifestations. Methods: We conducted a systematic review on post COVID-19 manifestations by searching Pubmed, Scopus, Web of Science (WOS), EBSCO, Wily, and World health organization (WHO) databases. Screening, selection, data extraction, data synthesis and quality assessment were done by two independent reviewers. Results: Of 1,371 references, 817 references remained after duplicates, reviews; case reports, commentaries, and any article containing non-original information were removed. According to eligibility criteria for this systematic review, 12 studies were included for qualitative synthesis. The overall prevalence of post-COVID-19 manifestations ranged from 35% to 90.5%. Fatigue, dyspnea, neuropsychological disorders, and pain were the most frequent post COVID-19 symptoms. Conclusion: This systematic review showed that 35% to 90.5% of recovered patients who survive COVID-19 continue to have wide varieties of clinical manifestations and fatigue, dyspnea, neuropsychological disorders, and pain were the most frequent post COVID-19 symptoms.

Background The function of different populations of the immune system in bladder cancer (BCa) is well established. However, the cohesive role of the immune cell profile of schistosomal BCa at systemic and tissue levels is still lacking, especially in endemic countries. The balance hypothesized between protumorigenic and antitumor molecules determines the prognosis of tumor progression. This study aimed to investigate the frequency of T cell subsets at both blood and tumor tissue, regulatory T(Treg), regulatory B cells (Breg) and proinflammatory cytokines in S. haematobium-related BCa patients in Egypt. Methodology/Principal findings The frequency of T cell subsets at both blood and tumor tissue, regulatory T(Treg), regulatory B cells (Breg) were studied by flow cytometry and proinflammatory cytokines by ELISA in S. haematobium-related BCa patients in Egypt. The results indicated a significant increase in the activity of T-cell populations, particularly CD3+, CD4+, and regulatory T cells (Tregs), and a decrease in cytotoxic CD8+ T cells in the patient group. An increased proportion of CD19+CD24+CD38+ Bregs and proinflammatory cytokines (IL-1β, IL-6, and TNF-α) was also observed. However, T-cell subpopulations in the tumor microenvironment showed a significant reduction in cancer patients compared to controls. Moreover, positive correlations were observed between the frequencies of Bregs and Tregs, suggesting the promotion of cancer progression besides their relation to the intensity of schistosomal infection. Conclusions/Significance Trapped Schistosoma haematobium eggs in bladder tissue might lead to persistent inflammation that contributes to immunomodulation and promotes tumor progression, as evidenced by the increase in peripheral T helper, Tregs, Bregs and serum tumor-promoting cytokines. Considering the role and integrated functions of specific immune responses in BCa could help future diagnostic and therapeutic implications.

BACKGROUND/AIM: An association between non-alcoholic fatty liver disease (NAFLD) and serum vitamin D levels is thought to exist. However, the definite role and mechanisms are unknown. Aim: we aimed to investigate serum vitamin D levels in patients with NAFLD. METHODS: Fifty patients with NAFLD and another 50 healthy volunteers without NAFLD or any clinically apparent liver diseases were enrolled in this study. Diagnosis of NAFLD is based on ultrasound (U.S) findings after exclusion of other possible causes of NAFLD and chronic liver diseases. Serum 25(OH) vitamin D levels were measured using ELISA based test. RESULTS: There are statistically significant decrease of serum 25(OH) vitamin D levels in patients with NAFLD than those without NAFLD. Serum 25(OH) vitamin D level is inversely correlated with body mass index (BMI), total cholesterol, triglycerides, low density lipoprotein (LDL) and age. CONCLUSION: Serum 25(OH) vitamin D level is inversely associated with NAFLD.

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