Background: The presence of an elevated absolute polymorphonuclear leukocyte count in the ascitic fluid (>250 cells/mm3) in combination with a positive ascitic fluid bacterial culture is diagnostic of spontaneous bacterial peritonitis. Among the families of calcium-binding proteins known as S100, calprotectin belongs to the subfamily known as calgranulins. Objective: The aim of the current work was to examine the value of ascitic fluid calprotectin for the diagnosis and prognosis of spontaneous bacterial peritonitis in people with liver cirrhosis. Patients and Methods: Between April 2018 and May 2019, 50 Egyptians with liver cirrhosis and ascites were recruited. Forty individuals with spontaneous bacterial peritonitis (SBP) and 10 patients with ascites without SBP were studied. Biochemical, bacterial, and ascitic calprotectin level, as well as diagnostic paracentesis, were performed to all patients. Results: When comparing individuals with cirrhosis and SBP to those without SBP, the level of calprotectin in the ascitic fluid was significantly higher in SBP patients (P= 0.000). Its mean values were statistically significantly reduced after treatment of SBP in comparison to its level before treatment [reduced from 626.75 ± 188.05 to 251.25 ± 223.13 ug/l] with p value 0.000. At a cutoff value of >320 ug/l, ascitic calprotectin may be a possible marker of development of SBP among cirrhotic patients with ascites with 95% sensitivity and 90% specificity. Conclusion: It could be concluded that ascitic fluid calprotectin may be useful in the diagnosis and prognosis of patients with liver cirrhosis and spontaneous bacterial peritonitis.

Barrett's esophagus (BE) is the most important risk factor for esophageal adenocarcinoma. High resolution magnification endoscopy with Narrow band imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of Barrett's esophagus. The aim of this work was to study the diagnostic value of chromo endoscopy versus NBI in detection of Barrett's esophagus. Patients and methods: Forty patients their conventional white light endoscopy revealed the diagnosis of GERD and showed findings suggestive of Barrett's esophagus, they were divided into 20 patients underwent chromo endoscopy and 20 patients underwent Narrow band imaging (NBI), The endoscopic results of both groups were compared with the final histo pathological diagnosis. Results: NBI showed higher accuracy than chromo endoscopy 75 % which vs. 70 % P< 0.05 in detection of BE. NBI had an accuracy of 70 and 75 % in type A pattern (round pits with regular microvasculature) to predict columnar mucosa without intestinal metaplasia and type B pattern (villous pits with regular microvasculature) to predict specialized intestinal metaplasia respectively. Conclusion: NBI is not only helpful in detecting metaplasia but also in differentiating cardiac from intestinal metaplasia, as it allows clear visualization of micro structural and micro vascular patterns.

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Hemodialysis (HD), despite being the most common treatment modality for endstage renal disease (ESRD), still carries a mortality rate higher than 20-50%/year resulting from various comorbidities. The aim of this study was to measure the plasma level of pentraxin-3 (PTX-3) in patients on maintenance HD and to assess its relationships to comorbidities such as malnutrition and associated comorbid diseases. This case-control study included 50 HD patients, 30 ESRD patients, and 30 healthy controls. HD patients were classified into different subgroups according to the Davies comorbidity index and malnutrition score. Plasma PTX-3 was analyzed by a sandwich ELISA technique. Plasma level of PTX-3 reached its highest levels in HD patients followed by ESRD patients as compared to healthy controls. Moreover, within the different subgroups, the highest levels and the highest odd ratio of PTX-3 were detected in the subgroups having the highest Davies comorbidity index or the highest malnutrition score as compared to the other subgroups. At a cutoff of 0.6 ng/mL, PTX-3 was able to discriminate HD patients with low Davies comorbidity index from those with both medium and high Davies comorbidity index with a diagnostic sensitivity of 92.5% and a diagnostic specificity of 70.0%. Meanwhile, the best cutoff of plasma PTX-3 for discriminating patients with mild malnutrition from severe and moderate malnutrition was 0.6 ng/mL with a diagnostic sensitivity of 90.9% and a diagnostic specificity of 41.2%. In conclusion, PTX-3 appears to be a clinically useful marker for the early identification of patients with renal failure on maintenance HD who are at substantially increased risk of morbidity. These patients may require care and aggressive follow-up in more specialized units and an early referral to a renal transplant center.