A great global concern is currently focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities. The goal of this study was to determine the frequency of newly diagnosed diabetes mellitus (DM) and its different types among COVID-19 patients, and to check the glycemic control in diabetic cases for three months. After excluding known cases of DM, 570 patients with confirmed COVID-19 were studied. All participants were classified as non-diabetic or newly discovered diabetic. According to hemoglobin A1c (HbA1c) and fasting insulin, newly discovered diabetic patients were further classified into pre-existing DM, new-onset type 1 DM, and new-onset type 2 DM. Glycemic control was monitored for three months in newly diagnosed diabetic patients. DM was diagnosed in 77 patients (13.5%); 12 (2.1%) with pre-existing DM, 7 (1.2%) with new-onset type 1 DM, and 58 (10.2%) with new-onset type 2 DM. Significantly higher rates of severe infection and mortality (p < 0.001 and p = 0.046) were evident among diabetic patients. Among survived diabetic patients (n = 63), hyperglycemia and the need for anti-diabetic treatment persisted in 73% of them for three months. COVID-19 was associated with a new-onset of DM in 11.4% of all participants and expression of pre-existing DM in 2.1% of all participants, both being associated with severe infection. COVID-19 patients with newly diagnosed diabetes had high risk of mortality. New-onset DM persisted for at least three months in more than two-thirds of cases.

Serum miR-210 and miR-155 levels are independent diagnostic markers for RA, out-performing several routine indices and reflect disease activity. Thus, miR-210 and miR-155 might serve as non-invasive biomarkers for the diagnosis of RA.

BACKGROUND AND OBJECTIVESThe current practice in Zagazig University Hospitals Laboratories (ZUHL) is manual verification of all results for the later release of reports. These processes are time consuming and tedious, with large inter-individual variation that slows the turnaround time (TAT). Autoverification is the process of comparing patient results, generated from interfaced instruments, against laboratory-defined acceptance parameters. This study describes an autoverification engine designed and implemented in ZUHL, Egypt.DESIGN AND SETTINGSA descriptive study conducted at ZUHL, from January 2012–December 2013.MATERIALS AND METHODSA rule-based system was used in designing an autoverification engine. The engine was preliminarily evaluated on a thyroid function panel. A total of 563 rules were written and tested on 563 simulated cases and 1673 archived cases. The engine decisions were compared to that of 4 independent expert reviewers. The impact of engine implementation on TAT was evaluated.RESULTSAgreement was achieved among the 4 reviewers in 55.5% of cases, and with the engine in 51.5% of cases. The autoverification rate for archived cases was 63.8%. Reported lab TAT was reduced by 34.9%, and TAT segment from the completion of analysis to verification was reduced by 61.8%.CONCLUSIONThe developed rule-based autoverification system has a verification rate comparable to that of the commercially available software. However, the in-house development of this system had saved the hospital the cost of commercially available ones. The implementation of the system shortened the TAT and minimized the number of samples that needed staff revision, which enabled laboratory staff to devote more time and effort to handle problematic test results and to improve patient care quality.

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Background: Pulmonary hypertension (PH) is one of the most common complications developed during the course of chronic obstructive pulmonary disease (COPD). Platelet activation plays an important role in its pathophysiology, and mean platelet volume (MPV) is considered a respectable index of platelet activation. The aim of this work is to assess the ability of MPV in predicting PH secondary to COPD as well as its severity. Methods: A cross-sectional study was conducted on 228 stable COPD patients. CBC, echocardiography, and pulmonary function tests were performed. Results: The prevalence of PH in stable COPD patients was high (63%), and the majority of patients had a mild degree (33%). There was no significant association between PH presence with different COPD grade, but, in very severe COPD, severe PH was significantly presented. MPV in COPD patients with PH was significantly higher than those without (9.02±1.14 vs 7.11±0.98, P <0.001). Moreover, a significant statistical rising of MPV with increased severity of PH. Multivariate regression analysis of predictors of PH demonstrated that; MPV is a real predictor of PH in such patients. The likelihood probability of PH increased up to 7-times with increasing one unit of MPV; (OR=6.7). A cut-off value of MPV >7.25 had 96% sensitivity and 76% specificity in predicting PH. Conclusion: MPV was higher in COPD patients with PH and positively correlated with PH severity. If the data are to be confirmed, MPV may be taken into consideration in decision-making and management of COPD patients.

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Background: Hepatocellular carcinoma (HCC) is the fourth most common cancer-related cause of death worldwide and poses a severe threat to public health. In addition to being an underlying risk factor for HCC, obesity is one of the common causes of metabolic-associated fatty liver disease (MAFLD). Objective: Therefore, the current study aimed to investigate the expression levels of both circARF3 (ADP-ribosylation factor 3) and its target gene miR-103 in obese patients with MAFLD and to assess their relations to susceptibility and clinicopathological features of HCC. Patients and methods:The current study was conducted on 100 subjects (50 control groups and 50 obese patients with MAFLD). The case group was subclassified to 39 patients without HCC and 11 patients with HCC. The expression levels of circARF3 and miR-103 were investigated by RT PCR. Resultsː Our results revealed statistically significant higher values of circARF3 in MAFLD (1.89±0.614) compared to control (0.72±0.341). In addition, the level of miR-103 was statistically significantly higher in MAFLD (2.41±0.82) compared to control (0.912±0.335), P ˂0.001. Also, there were statistically significant higher values of circARF3 in HCC (4.67±1.63) compared to non-HCC (1.44± 0.74).In addition, the level of miR-103 was statistically significantly higher in HCC (4.99±1.32) compared to non-HCC (1.512±0.45), P <0.001. Interestingly, circARF3 and miR-103 significantly correlated with obesity indices and metabolic and hepatic dysfunction biomarkers. Cut-off values 0.94, 1.2, 1.8, 2.98 were able to discriminate simple steatosis, steatohepatitis, cirrhosis, and HCC with AUC 0.78, 0.64, 0.77, 0.81 respectively. Conclusionsː The current study results detected upregulation of both studied epigenetic markers; circARF3 and miR-103 in obese MAFLD patients especially patients with HCC. Thus, they could be used as diagnostic biomarkers of MAFLD-associated HCC.

Background: Subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) are two common medical conditions. Thyroid dysfunction, prominently SCH has been described more frequently in MetS patients than general population. SCH affect MetS parameters including high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), plasma glucose and blood pressure. The relation between the two conditions looks like a bi-directional relationship. Objectives: The aim of this study was to investigate the association between SCH and MetS in Egyptian young adults and to study the prevalence of MetS and its components in SCH subjects.Patients and methods: The study was conducted at Zagazig University Hospitals. 602 freshman-year students with no history of medical disease were included in the study. General examination, anthropometric, and routine investigations plus thyroid function tests were done for all. Results: Diastolic hypertension (DBP) and impaired fasting glycaemia (IFG) showed significant differences between SCH and EUT. Among the 602 participants, 23.9 % were diagnosed with MetS and 8.9 % with SCH. MetS was found in 22.4 % in the euthyroidism (EUT) group and in 39 % in the SCH group. SCH was found in 14.6 % in subjects with MetS and in 7.2% in non-MetS subjects. There was a significant association between MetS and SCH (χ2=7.3, p˂0.05). Weight, BMI, and DBP were the significant predictors for SCH in patients with MetS. Conclusions: It could be concluded that there is a significant association between MetS and SCH. DBP and IFG show significant difference between SCH and EUT.