Background and Aim: Hepatocellular carcinoma deemed for the plurality of primary liver cancers. Malignancy of the liver is the fourth most popular etiology of cancer mortality worldwide. The high mortality of HCC cases is linked to the delay in diagnosis. Aberrant expression of Axl frequently occurs in many malignancies and is critical for promoting cell proliferation, migration, angiogenesis and metastasis. Axl deregulated activation or expression is linked to resistance to targeted cancer therapies. we aimed to to clear up the diagnostic role of sAXL in HCC patients.Methods: Study included 90 participants; 40 HCC patients on top of liver cirrhosis, 30 patients with liver cirrhosis and twenty healthy subjects (controls). CBC, liver and kidney function tests, alphafetoprotein, abdominal ultrasound and triphasic CT were performed. sAxl was assessed by ELISA.Results: sAxl was considerably higher in HCC patients than in cirrhotic and control participants (p<0.001), with higher levels in cirrhotic patients than controls (p<0.001). sAxl can differentiate early HCC cases from patients with cirrhosis (p<0.001). ROC curve analysis showed that sAxl has sensitivity 92.5%, specificity 93.3% and AUC 0.949 at cut off value >63.5, AFP at cut off >40.34 has sensitivity, specificity and AUC 57.5%, 60% and 0.675 respectively. The combination of AFP and sAxl at related cut off points has higher sensitivity (97.5%) and AUC 0.972 in predicting HCC in cirrhotic patients. sAxl was positively correlated with tumor size. Conclusion:sAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination of sAxl with AFP improved the sensitivity for early HCC diagnosis.
Background and study aim: Malaria morbidity and mortality can be prevented or minimized by rapid diagnosis and treatment. Blood based rapid diagnostic tests (bRDT) for malaria are currently in use but other body fluids specific diagnostic test kits are being developed. One of these tests is Urine Malaria Test (UMT) dipstick, it is a one-step test used to detect Histidine Rich Protein 2 (HRP2), a polyhistidine antigen of plasmodium falciparum (Pf) in urine of affected patients. The aim of the present study was to evaluate the role of UMT in diagnosis of Pf malaria and its ability to detect the limits of Pf parasitemia in febrile patients admitted to Abbasia Fever Hospital, Egypt. Patients and Methods: This study was conducted on 52 Pf malarial patients who were admitted to Abbassia Fever Hospital. Patients were subjected to meticulous history taking, clinical examination, routine laboratory investigations, abdominal ultrasound, blood film microscopy for malaria, rapid blood test (RBT) and UMT. Confirmed Pf malaria in the studied patients was based on the presence of positive parasite-based tests (+ve blood film microscopy with/without RBT for Pf malaria). Results: The UMT was positive in 50% of cases with 50% false negative results in parasitologically confirmed Pf malarial patients. Sixteen patients presented with parasitemia ≤0.5% (ranged between 0.1% to ≤0.5%) in thick blood film and there was non-significant difference between positive and negative UMT in these patients [43.75% of cases were +ve versus 56.25%-ve test (p=0.280) with sensitivity (55.56%), specificity (71.43%) and accuracy (62.5%)]. The +ve UMT results were significantly related to higher parasitemia, lower Glasgow coma scale, lower platelet count and severe disease. Conclusion: The UMT is simple, easy, self-performed and promising test in diagnosis of Pf malaria, however the sensitivity and specificity were apparently low.
Background and aim: Due to the increased mortality and danger of bleeding, the presence of esophageal varices (EV) caused by portal hypertension is a serious concern in cirrhotic patients. 60-80% of newly diagnosed cirrhotic patients have EV, and 5-15% of big EV cases experience their first variceal bleeding within the first year. Our goal was to investigate the relationship between cardiac dysfunction and endoscopic indicators of portal hypertension in cirrhotic patients.Methods: 60 participants were included; 40 cirrhotic patients with oesophageal varices and 20 non-cirrhotic individuals with no evidence of portal hypertension in endoscopy (control group). Complete blood count, liver and kidney functions, Esophagogastroduodenoscopy, Electrocardiographic evaluation, and echocardiography were performed. Results:The QTc interval, the LA volume, LV mass index, E-wave deceleration time, atrial flow velocities, E/E′ ratio, and E/A ratio were significantly increased among cirrhotic patients compared to controls. However, only the LA volume was substantially higher and E/E′ ratio was considerably lower for patients with high-grade EV than those with low grades. ROC curve to discriminate between cirrhotic and noncirrhotic groups, the QTc interval, E-wave deceleration time, and E/A ratio had the highest accuracy 93.7%, 96.1%, and 84.2% respectively.Likewise, discriminating patients with high-grade EV from those with low ones, LA volume, E/È ratio, and QTc interval showed the highest accuracy at 75.6%, 70.9%, and 66.7% respectively with the sensitivity of 92.31, 100.0, and 76.92 respectively. Conclusion: Electrocardiographic and echocardiographicexaminations are valuable non-invasive procedures that could evaluate cardiac dysfunction in cirrhotic patients and could help predict EV .
Conclusion:HCVcAg is a sensitive, specific test, less expensive (cost 0.46 that of PCR per single sample) but false negative results of HCVcAg existed with low viremia (< 2000 IU/ml).
Background: SARS-COV2 pandemic had a great impact on our life. Changes had been done to accommodate the current situation. Infection control measures in the endoscopy units had entirely changed. Also, prioritizations of different procedures had changed especially in the lockdown time. Peroral Endoscopic Myotomy (POEM) is considered a low priority endoscopic procedure. Case presentation: We report a 12-year-old child complaining of dysphagia and weight loss who was diagnosed as Type II achalasia. She underwent POEM. According to our Egyptian protocol; COVID-19 was excluded pre-procedural. After POEM, immediately post-procedural chest X-ray was done as usual, and it showed a shadow in the right lung base. Accordingly, HRCT of the chest was done and it showed bilateral asymmetrical patchy areas of ground-glass opacities in the posterior segments of both lower lung lobes (CO-RADS 4). PCR for COVID-19 was positive. Conclusion: We report a very unique COVID-19 case that raises many challengeable issues and shows a useful message about the risk of silent COVID-19 infection in children during the endoscopy. Keywords: achalasia; Poem; 3rd Space endoscopy; COVID-19.
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