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Background :Acute kidney injury(AKI) is common in cirrhosis but differential diagnosis remains a challenge. Serum creatinine (SCr) less sensitive in reflecting renal dysfunction in cirrhotic patients. Aim of the Work: to study the usefulness of NGAL as an early biomarker of AKI in cirrhotic patients. Subjects and Methods: 80 subjects included, classified into 3 groups: GroupΙ: 10 control subjects. Group Π (GpΠ): 40 compensated hepatic patients without AKI, further subdivided into four subcategories: (GpΠa1): 10 patients with HCV under interferon plus ribavirin therapy. (GpΠa2): 10 patients with HCV not under interferon or ribavirin therapy. (GpΠb): 10 patients with Bilharzial liver fibrosis. (GpΠc): 10 patients with combined HCV and Bilharzial liver fibrosis. Group Ш (GpШ): 30 decompensated hepatic patients with AKI, further subdivided into three subcategories: (Gp Шa): 10 patients with Acute tubular necrosis. (Gp Шb): 10 patients with hepatorenal syndrome. (Gp Шc): 10 patients with Pre-renal azotemia. All participants were subjected to the routine lab investigations in addition to specific lab test plasma NGAL (pNGAL).Results: No significant difference was found in kidney function parameters (SCr, urea, GFR) between patients with AKI and patients without AKI. However, patients with AKI had higher pNGAL compared to patients without AKI. There were significant difference among group III subcategories, patients with ATN had pNGAL levels markedly higher (mean 295 ng/ml) compared to those of patients with PRA (mean 86.5 ng/ml), Patients with HRS had intermediate values {mean 142 ng/ml}. In patients with ATN, pNGAL markedly rise within 3 hrs of kidney injury compared to SCr which rises after 24 hrs. Among GpΠ subcategories, no significant difference was found in either pNGAL or kidney function parameters. Conclusions: pNGAL is an early biomarker of AKI and it can also discriminate type of AKI in cirrhosis

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Purpose This study aimed to assess PIM-2 gene expression level as a prognostic marker in AML patients and to correlate the results with their clinical outcome. Patients and Methods This study was conducted on 50 de novo younger AML patients (median age 44). Quantitative real-time polymerase chain reaction (QRT-PCR) was used to assess the expression level of the PIM-2 gene. The transcription level of the target gene ( PIM-2 ) was normalized to that of the reference gene (GAPDH). Twenty control samples were withdrawn from 20 age- and sex-matched individuals for the analysis of the results using the 2 −ΔΔCT method. On day 28 following induction chemotherapy, patients’ bone marrow (BM) was examined for evaluation of their remission status. Results PIM-2 gene expression was higher among AML patients who did not achieve complete remission (CR); also, it was higher in patients in the intermediate and poor cytogenetic risk groups. A significant positive correlation was found between PIM-2 level and BM blasts on day 28. In AML patients, PIM-2 has been discovered to be an independent predictive factor for achieving CR following standard induction treatment. Receiver operating characteristic curve (ROC) and area under the curve (AUC) were performed for PIM-2 level at diagnosis to evaluate its role in achieving remission after induction. It was found that PIM-2 at cutoff ≤1.6 had an AUC (0.903) with a sensitivity (90.48%) and specificity (86.21%), P <0.001. Conclusion Overexpression of the PIM-2 gene is associated with induction failure and low CR.