Background and study aim: Hepatocellular carcinoma (HCC) accounts for 70-80% of all liver cancers and the 5-year survival is only 3-5%. This bad prognosis is due to the lack of an effective method for early diagnosis. So, only 30-40% of patients with HCC are suitable for curative treatments at the time of diagnosis. Thus, there is a great need for tools to diagnose HCC early especially in cirrhotic patients. The aim of this work is to assess the validity of serum DKK1 as a diagnostic marker for HCC and to assess prognostic value of serum DKK1 in predicting treatment response, complication and survival in HCC patients. Patients and Methods: This study included 60 Patients divided into two groups. Group A: consisted of 30 patients with post hepatitic C and/or B liver cirrhosis. Group B: consisted of 30 patients with HCC on top of post hepatitic C and/or B liver cirrhosis. Group B patients underwent either radiofrequency ablation or ethanol injection. Clinical assessment, routine laboratory evaluation, CT studies and measurement of serum alpha-fetoprotein (AFP) and DKK1 were performed to all patients and repeated to group B patients 1 and 3 months after treatment. Results: The optimum cut off value of DKK1 for diagnosis of HCC was 4.3 ng/mL (AUC 0.89, sensitivity 66.7% and specificity 96.6%) (P<0.001). While, the optimum cut off value for AFP was > 101 ng/mL with 90% sensitivity and 75.9% specificity (p<0.001). Testing of both DKK1 and AFP increased the diagnostic accuracy for HCC (AUC 0.901, sensitivity 93.3%, and specificity 75.9) (P<0.001). Serum DKK1 level significantly decreases after HCC treatment with either radiofrequency ablation or ethanol injection (P<0.001). Conclusion: Testing of both DKK1 and AFP significantly increased the diagnostic accuracy for HCC. Meanwhile, DKK1 can be used alone for HCC diagnosis even in HCC with inconclusive AFP. DKK1 has a promising prognostic value and can be used for follow up of HCC patients who underwent loco-regional treatment.

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Backgroundand study aim: Hepatocellular carcinoma (HCC) is the 4 th most common cancer in Egypt and is the 2 nd leading cause of cancer-related death in both men and women. The aim of this study is to determine the frequency of HCC in cirrhotic patients admitted in Al-Ahrar Teaching hospital especially after hepatitis C virus (HCV) treatment with new direct-acting antivirals (DAAs). Patients and Methods:This study included 107 patients with liver cirrhosis admitted to Al-Ahrar Teaching hospital. All patients undergo complete blood count, liver functions, kidney functions, coagulation profiles, serology for viral hepatitis, serum alpha-fetoprotein, abdominal ultrasound, and tri-phasic computed tomography.Results: HCC was diagnosed in about 9 % of cirrhotic patients in this study. The etiology of cirrhosis was HCV (66.4 %), non-viral causes (23.3 %), and HBV (9.3 %). There was no statistically significant difference between HCC and non-HCC patients as regard viral markers and HCV treatment. According to Barcelona-Clinic Liver Cancer staging, 80 % of patients among HCC group was stage D while 20 % of patients were Stage A -C. Conclusion:HCC is prevalent in cirrhotic patient admitted in Al-Ahrar Teaching Hospital. HCV treatment with DAAs does not raise the risk of HCC occurrence in cirrhotic HCV patients.

Conclusion: Hyponatremic patients had statistically significant portal hemodynamic changes with increased morbidity and mortality in them. Awwaad et al., Afro-Egypt J Infect Endem Dis 2019; 9(4):260-269 https://aeji.journals.ekb.eg/

Background and study aim: Treatment of HCV with interferon takes a long duration and has many side effects. The use of antioxidants with interferon/ribavirin therapy is believed to minimize the side effects and improves adherence and hence improves response to therapy. Reactive oxygen species are part of the human defense mechanisms towards infection and they increase due to hepatitis C virus infection. In this study we aim to study the impact of the concomitant use of antioxidants with interferon/ribavirin combination therapy for HCV on response as regards enzymes level, rate of viral clearance as well as liver histopathology.. Patients and methods: 240 patients on interferon/ribavirin therapy for chronic hepatitis C divided in two groups. The test group received concomitant antioxidant combination while the control group received only interferon/ribavirin. Follow up of liver function tests, complete blood count, viral load by PCR and post treatment histopathology by liver biopsy were performed. Results: Liver enzymes level in test group achieved a larger and faster decline than in control group. Hematological parameters were significantly higher in the test group all through period of follow up. Viral load and histopathology showed no significant difference between the two groups. Conclusion: concomitant use of antioxidants with interferon/ ribavirin therapy minimizes complications of therapy and rapidly normalizes the liver enzymes level without affecting the rate of response to therapy or histopathology of the liver.