Background In Egypt, the prevalence of chronic hepatitis C (CHC) infection is 13.8% of whole population and about 80% of the patients with hepatocellular carcinoma have underling hepatitis C. Aim This study was designed to assess the diagnostic value of plasma miR-122 and miR-21 in patients with CHC, genotype-4, to detect fibrosis progression versus noninvasive indices and their diagnostic value in detection of early stages of hepatocellular carcinoma (HCC). Methodology A prospective study that included 180 patients, divided into 3 groups: healthy controls (group I), CHC patients (group II), and hepatitis C patients with HCC (group III); all cases were subjected to thorough clinical, radiological, and laboratory investigations. Selected biomarkers were evaluated and correlated with degree of liver damage. Results revealed that miR-122 followed by miR-21 had the highest efficiency in prediction of liver cell damage. Also, miR-21 was strongly correlated with vascular endothelial growth factor (VEGF) and alpha fetoprotein (α-FP) in HCC patients. Conclusions Plasma miR-122 and miR-21 had strong correlation with degree fibrosis in HCV genotype-4 patients; consequently they can be considered as potential biomarker for early detection of hepatic fibrosis. Moreover, miR-21 can be used as a potential biomarker, for early detection of HCC combined with VEGF and α-FP.

Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as bariatric surgery, a small percentage of subjects regain weight after surgery. This study was designed to evaluate body weight changes over a period of two years after LSG and investigate the role of serotonin in regulating energy balance. This is a prospective cohort study. A total of 92 patients with morbid obesity (64 women and 28 men) underwent LSG. All the participants were subjected to physical examination and detailed medical history. Anthropometric measurements were accomplished pre-operative and post-operatively at a frequency of four times per year for two years follow-up. Laboratory investigations were performed pre-operatively, and one and two years post-operatively. Blood samples were collected in the fasting state; for glucose, lipid profile and hormonal assays. Hormones measured were plasma insulin, leptin, serotonin and ghrelin. Results revealed that 35.7% weight loss occurred after one year. However, there was variability in the individual weight loss curve during the period between the first and second post-operative years. Thus, patients were divided into two groups: group I included 78 patients (84%) who maintained the lost weight, and group II included 14 patients (16.0%) who regained weight within 24 months post-operatively. Correlation with BMI revealed positive correlation with leptin and serotonin, whilst negative correlation with ghrelin in group II patients. Mechanisms of weight loss after LSG are not only attributable to gastric restriction but also to the neurohormonal changes. In addition, serotonin may possibly contribute to the interplay of regulatory systems of energy homeostasis.

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Obesity has been identified as a medical problem. Obesity may be associated with abnormal metabolism and micronutrient deficiencies. Thus, obesity and malnutrition at the same time is a reality. However, in the past it was unusual to say that people who eat much were liable to be malnourished. Now-a-days, eating too much does not mean meeting nutritional requirements. This is due to the fact that several factors affect those requirements; as nature of diet, dietary habits, food preparation and host-related factors as intestinal absorption.Trace elements are of great value in regulation of normal body metabolism, as they interact with many enzymes and hormones; some of which will be discussed. MAGNESIUMIt is the second most abundant intracellular cation, approximately 50% of total body magnesium is found in bones. The other 50% is found inside cells of body tissues and only 1% is found in blood. Magnesium is essential for absorption and utilization of nutrients; carbohydrates, fats and proteins. It is a critical cofactor for hundreds of enzymes especially those involved in glucose metabolism and a direct antagonist of intracellular calcium. Moreover, it is associated with insulin sensitivity. As hypomagnesaemia results in reduced insulin sensitivity of peripheral tissue through reduced auto-phosphorylation of tyrosine kinase, a component of the β-subunit of the insulin receptor for which magnesium is a co-factor. Also, hypomagnesaemia may be associated with reduced β-cells proliferation and thus affecting insulin production. Therefore, serum magnesium levels are negatively correlated with Insulin Resistance (HOMA-IR).The exact mechanism of hypomagnesaemia in obese patients is unclear but may be related to eating habits; as increased intake of carbonated soft drinks, which are rich in phosphorous and thereby interfere with magnesium absorption, or increased intake of caffeine resulting in increased magnesium excretion. Another mechanism may be increased intake of dairy products with high Ca+ content and or fat content thus interfere with its absorption.

BackgroundPre-eclampsia is a potentially serious condition that still accounts for significant morbidity and mortality for the affected mother and neonate. Although the pathogenesis is not fully understood, it is now widely accepted that vascular endothelial dysfunction is the most important and principal event in the pathophysiology of the disease. The aims of our study were to compare serum soluble endoglin levels at week 13 in normotensive pregnant women and in high-risk women, to determine whether the maternal plasma soluble endoglin concentration at 26 weeks is increased in pregnancies that subsequently develop pre-eclampsia, and to identify if soluble endoglin measurement improves the results of screening for pre-eclampsia.MethodsThis work was conducted in 60 healthy pregnant controls and 110 pregnant women at high risk for pre-eclampsia. Gestational age was confirmed by date of last menstrual period and first trimester ultrasound. The time of onset of pre-eclampsia was defined as the time of first elevated blood pressure or urinary protein measurement leading to the diagnosis. Blood samples were collected for measurement of soluble endoglin and other routine laboratory tests, including measurement of urinary proteins. Serum soluble endoglin was estimated by sandwich enzyme-linked immunosorbent assay.ResultsThere was a highly significant increase in serum soluble endoglin in high-risk women compared with controls at week 13 (P < 0.001). Further determination of soluble endoglin revealed a more significant increase in women who developed early-onset pre-eclampsia compared with those who developed late-onset pre-eclampsia. Moreover, a significant positive correlation was found between soluble endoglin and both diastolic blood pressure and total urinary protein, ie, severity of pre-eclampsia.ConclusionEstimation of serum soluble endoglin at gestational week 13 could be used as a sensitive screening test for women at high risk of developing pre-eclampsia prior to onset of its clinical manifestations, which could potentially improve the outcome of pregnancy.

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Background Direct-acting antiviral (DAAs) represent advancement in the management of hepatitis C virus (HCV)-related hepatic cirrhosis. A high proportion of patients achieve a sustained virologic response; eradication of HCV is coupled with a decreased risk of hepatocellular carcinoma. Recent evidence suggests that shortening of the DNA telomere may be linked to cellular senescence as well as predisposition to malignant transformation. Objective This study aimed to assess pretreatment leukocytic DNA telomere length in HCV-related cirrhosis and post viral eradication using DAAs. Patients and methods This study included 24 patients with HCV-related cirrhosis, Child–Pugh A. Whole-blood samples were obtained from patients before treatment and 12 weeks after the end of treatment, as well as from 24 healthy controls. Terminal restriction fragment, corresponding to telomere length, was measured using a nonradioactive Southern blot technique, detected by chemiluminescence. Results DNA telomere length was significantly shorter before treatment compared with 12 weeks after end of treatment in HCV-related cirrhotic patients. Also, it was significantly shorter in patients before treatment compared with healthy individuals. Conclusion Telomere elongation in blood leukocytes can be considered a marker of recovery of inflammation after DAAs-induced HCV eradication. Still, the possibility of activation by cancer initiation cannot be excluded.