The landscape of chronic liver disease in Egypt has drastically changed over the past few decades. The prevalence of metabolic-associated fatty liver disease (MAFLD) has risen to alarming levels. Despite the magnitude of the problem, no regional guidelines have been developed to tackle this disease. This document provides the clinical practice guidelines of the key Egyptian opinion leaders on MAFLD screening, diagnosis, and management, and covers various aspects in the management of MAFLD. The document considers our local situations and the burden of clinical management for the healthcare sector and is proposed for daily clinical practical use. Particular reference to special groups was done whenever necessary.

Chronic hepatitis C virus infection and NSAID-associated splenomegaly because of portal hypertension are significant predictors of mortality in nonalcoholic patients presenting with upper GI bleeding.

In countries endemic for liver and GIT diseases, frequent emergency department (ED) patients contribute to a disproportionate number of visits consuming substantial amount of medical resources. One of the most frequent ED visits is patients who present with hypovolemic shock, abdominal pain, or confusion with or without signs of upper gastrointestinal bleeding (UGIB). The use of conventional two-dimensional ultrasound (2D-U/S) may provide immediate and useful information on the presence of esophageal varices, gastrointestinal tumors, and other GIT abnormalities.The current study investigated the feasibility of using (2D-U/S) to predict the source of UGIB in ED and to determine patients’ priority for UGE.Between February 2003 and March 2013, we retrospectively reviewed the profiles of 38,551 Egyptian patients, aged 2 to 75 years old, who presented with a history of GI/liver diseases and no alcohol consumption. We assessed the value of 2D-U/S technology in predicting the source of UGIB.Of 38,551 patients presenting to ED, 900 patients (2.3%), 534 male (59.3%) and 366 female (40.7%) developed UGIB. Analyzing results obtained from U/S examinations by data mining for emergent UGE were patients with liver cirrhosis (LC), splenomegaly, and ascites (42.6% incidence of UGIB), followed by LC and splenomegaly (14.6%), LC only (9.4%), and was only 0.5% who had no morbidity finding by 2D-U/S.Ultrasonographic instrumentation increases the feasibility of predictive emergency medicine. The area has recently not only gained a fresh impulse, but also a new set of complex problems that needs to be addressed in the emergency medicine setting according to each priority.

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Backgrounds: Although Colorectal cancer accounts for over 10% of all cancer incidence, it is highly preventable and can be detected at a stage when there are often no symptoms. The American Society for Gastrointestinal Endoscopy encourages everyone over 50 to be screened for colorectal cancer, but many should start much earlier due to health and family history. Minimally invasive tests will be superior overtime taking into consideration availability, costs, convenience, and patient–clinicians preferences. Methods: 50 patients with known colorectal cancer (CRC) were enrolled based on colonoscopic and histopathological findings and 25 healthy subjects were enrolled as control group. Level of microRNA-21 gene expression was measured in both groups. Results: Level of microRNA-21 gene expression was significantly higher among CRC group in comparison to control group (2.76 ± 0.56 vs. 0.71 ± 0.16 (u/l); P< 0.001). A cut off point > 1.09 u/l, microRNA-21 gene expression had 96% sensitivity and 95% specificity with area under curve was 0.95 for detection of colo-rectal cancer. Level of microRNA-21 gene expression was significantly higher among CRC group in comparison to control group and its level was increasing with those with metastasis.Conclusion: Level of microRNA-21 gene expression is useful biomarker for discriminating CRC patients from healthy people.