This study shows that prophylactic use of pure natural honey was effective in reducing mucositis resulting from radiochemotherapy in patients with head and neck cancer.

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BackgroundHypoxic ischemic encephalopathy (HIE) occurs in one to three per 1000 live full-term births. Fifteen to twenty percent will die in the postnatal period, and an additional 25 % will develop severe and permanent neuropsychological sequalae. The control of growth and nutritional status in the fetus and neonate is a complex mechanism, in which also hormones produced by adipose tissue, such as adiponectin and leptin are involved. The aim of this study was to measure the levels of adiponectin, leptin and insulin in neonates with HIE at birth and in early postnatal life and comparing them with normal healthy AGA and SGA neonatesMethodsThis study carried out on 80 full-term neonates born in Minia university hospital during the period from May 2013 to December 2014. They were divided into group I included 25 neonates with HIE and group II included 55 normal healthy neonates (30 appropriate for gestational age (AGA) and 25 small for gestational age (SGA)). Weight, length, head circumference, body mass index (BMI), glucose, adiponectin, leptin and insulin levels were measured for all neonates. Adiponectin, leptin and insulin levels were compared between neonates with HIE and normal healthy neonates as well as between AGA and SGA neonates at birth, 2nd and 6th days of life.ResultsAdiponectin and leptin levels were significantly higher at birth then began to decrease during the first postnatal week in all neonates while insulin level increased during the same period. Serum adiponectin levels were significantly lower while serum leptin and insulin levels were significantly higher in neonates with HIE than healthy neonates. In all neonates, the serum adiponectin level was positively correlated at birth with weight, length, BMI and leptin levels but not with insulin level. In neonates with HIE, serum adiponectin level was not correlated with weight, BMI, leptin level or insulin level. In all neonates, the serum leptin level was positively correlated at birth with body weight, height and BMI. In neonates with HIE serum leptin levels were not correlated with weight, BMI or insulin level after birth. There were no correlations between either leptin or adiponectin serum levels or any of the studied parameters in neonates with HIEConclusionsNeonates who are suffering from HIE had lower serum levels of adiponectin and higher serum levels of leptin and insulin than normal healthy neonates at birth and during the early postnatal period. The decline of leptin and increased the insulin levels after birth in all neonates may be important for the stimulation of feeding behavior and the acquisition of energy homeostasis during the early postnatal life. Positive significant correlations between adiponectin, leptin, body weight and body mass indices were present in normal healthy neonates but not in neonates with HIE reflecting the effect of hypoxia on the regulatory mechanisms controlling the adipose tissue functions.

Background and objectives: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and the third leading cause of cancer related mortality worldwide. The identification of new high-sensitivity and high-specificity markers for HCCis essential. Annexin A2 (ANXA2) plays an important role in the pathogenesis of multiple malignancies particularly HCCs and its expression strongly also affects the outcomes of HCC patients. This study aimed to investigate the clinical utility of hepatic and circulating Annexin A2 expression levels as a novel diagnostic marker of HCC and to correlate its level with alpha fetoprotein (AFP), the current marker ofHCC. Patients and methods: A total number of 40 patients(6 patients with chronic hepatitis, 8 patients with liver fiberosis, 6 patients with liver cirrhosis, 8 patients with early HCC and 12 patients with late HCC). The same number of age and sex matched healthy people was enrolled as a control group. All patients and controls were subjected to full medical history, complete medical examination abdominal sonography, laboratory investigations including liver function tests, AFP, platelet count, Prothrombin time and concentration, HBsAg, anti-HCV and serum HCV RNA quantitation by real time PCR. Liver biopsies were done for all patients. Evaluation of serum ANXA2 level for all patient and controlgroups was detected by using a human ANXA2 ELISA kit. Analyzing the ANXA2 expression at mRNA and protein levels was detected for patient groups by using RT-PCR by immunohistochemistry staining, respectively. Results: Serum ANXA2was significantly increased in all patient groups (except for chronic hepatitis group) compared to the control group (P<0.01). The serological evaluation and expression of ANXA2 levels were significantly increased in early HCC compared to serum AFP. ANXA2 expression was localized in both cell membrane and cytoplasm in HCC tissue, not detected in normal tissues and limited to some hepatocytes in chronic hepatitis patients. Over expression of ANXA2 mRNA levelwas present in HCC tissues compared to other patient groups (P<0.001). There was a significant relation with HCV infection, (P<0.001) when comparing ANXA2 values among positive and negative HCV RNA in HCC patients. No correlations were found between serum ANXA2 levels with serum AST,ALT, platelet count, INR and HBsAgin comparison to controls. Conclusion: Our results demonstrated increased levels of ANXA2 in both of tissues and sera of HCC patients and also in both AFP-positive and-negative cases. Results of serumANXA2 was concomitant with hepatic ANXA2 expression by RT-PCR and immunocytochemistry staining. Remarkably, Combination of conventional serum marker AFP with serumANXA2 may complement and benefit for early HCC detection.

Introduction The differentiation between systemic inflammatory response syndrome and sepsis is very important as it determines essential treatment decisions, such as selection, initiation, and duration of antibiotic therapy. Objectives We aimed to investigate the diagnostic value of Procalcitonin, Monocyte Chemoattractant Protein-1, soluble Mannose Receptor, Presepsin as early biomarkers of pediatric sepsis in comparison to systemic inflammatory response syndrome in severely ill children. Patients and methods This study included 58 children diagnosed as sepsis (group 1), 24 children with systemic inflammatory response syndrome without infection (group 2), and 50 healthy children as controls (group 3). All the plasma levels of the studied biomarkers were measured and ROC curves were created for all the tested parameters to discriminate between sepsis and SIRS. Results The area under the curve for Monocyte Chemoattractant Protein-1 was 0.926 (0.846-0.927) with sensitivity 100% and specificity 62.5%. The soluble Mannose Receptor had the highest sensitivity (100%), with AUC equals 1(.0.956-1.0) and specificity of 100%. The cut-off values for Procalcitonin, Presepsin, soluble Mannose Receptor, and Monocyte Chemoattractant Protein-1 and were: 0.62 ng/ml, 100 pg/ml, 13 ng/ml and 90 pg/ml, respectively. In septic cases, both soluble Mannose Receptor and Procalcitonin have positive correlations with the severity of sepsis, low Glasgow Coma Scale, ventilatory support, use of inotropic drugs and mortality rate (r = 0.950, 0.812, 0.795, 0.732 and 0.861respectively) for soluble Mannose Receptor and (0.536, 0.473, 0.422, 0.305 and 0.474 respectively) for Procalcitonin. Conclusion Soluble Mannose Receptor, Presepsin, and Monocyte Chemoattractant Protein-1 can be used to differentiate between sepsis and SIRS in critically ill children.

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To assess the role, risk factors and outcome of different comorbidities in acquiring pulmonary fungal infection among COPD patients. METHODS: In this prospective cross-sectional analytic study, different samples (sputum, bronchoalveolar lavage (BAL), and blood) from 177 COPD admitted to tertiary university hospital, were examined for fungal infection using direct microscopy and culture. BAL and serum samples were examined by Human (1-3)-b-D-glucan (1,3BDG) and Galactomannan (GM) ELISA tests. RESULTS: Pulmonary fungal infection was confirmed in (77.8%) out of COPD patients with comorbidities versus (53.1%) in COPD patients without comorbidities (53.1%) (P< 0.001) with predominance of candida and aspergillus spp., in both groups. Serum GM was positive in 16 (19.7%) COPD patients with comorbidities versus 7 (7 .3%) in COPD patients without comorbidities (P¼0.02). BAL GM had a higher diagnostic yield in comparison to serum GM and 1,3BDG. There was no significant association between culture-positivity and radiological findings. Mechanical ventilation, corticosteroid therapy, ICU admission and age were the major risk factors for pulmonary fungal infection in COPD patients with comorbiditi es (P ¼ 0.012; ODR¼2.23, P ¼ 0.028; ODR¼1.99, P ¼ 0.025; ODR¼1.94, P ¼ 0.034; respectively).COPD patients with comorbidities had significantly higher mortality rate (12.3%) than COPD patients without comorbidities (3.1%) (P¼0.01). CONCLUSIONS: COPD patients with comorbidities had higher prevalence of pulmonary fungal infection and higher mortality rate than COPD patients without comorbidities. Age, mechanical ventilation, corticosteroids therapy and ICU admission were independently risk factors for pulmonary fungal infection in COPD patients with comorbidities. CLINICAL IMPLICATIONS: Comorbities are risk factors for acquiring pulmonary fungal infection in COPD patients and is associated with higher mortality rate.

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