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Background: Natural-killer group 2 (NKG2), a characteristic receptor of natural killer (NK) cell family, assumes a vital role in modulating NK cytotoxic function. We aimed to detect mRNA expression of both NKG2A and NKG2D in serum NK cells obtained from colorectal cancer (CRC) patients. Methods: We enrolled 36 patients with newly diagnosed CRC, as well as 15 group matched healthy individuals. The patients were further classified into: 23 non-metastatic CRC (group 1) and 13 metastatic CRC (group 2). We detected the expression of NKG2A and NKG2D serum levels for all participants utilizing real-time polymerase chain reaction (RT-PCR). Results: NKG2D and NKG2A mRNA levels in peripheral blood mononuclear cells (PBMCs) were significantly elevated in patients with CRC compared to controls (P<0.01). NKG2D or NKG2A showed sensitivity (77.8, 83.33%) and specificity (73.33, 100%) respectively using receiver-operating characteristic (ROC) curve analysis for discrimination between patients and controls, whereas group 1 and group 2 showed no statistical significant difference in NKG2D and NKG2A levels (P>0.05). Conclusions: Our work is one of the first research that could detect an increase in NKG2D in CRC. In spite of their defensive role in tumor immune surveillance, NKG2D and NKG2A and their ligands could have misused as tumor survival tool, empowering immune avoidance and suppression.

Background: The apolipoprotein A1 level is recognized as a better indicator of cardiovascular disease than other cholesterol measures. Objectives: To assess the serum level of ApoA1 in acute stroke patients and correlate it with the degree of vessel stenosis, stroke severity, prognosis, and functional outcome. Patients and methods: We prospectively included 60 patients with first-ever cerebrovascular ischemic stroke, and they were matched with 30 healthy individuals matched in age and sex. Patients' neurological status was assessed via National Institute of Health and Stroke Scale (NIHSS). A venous blood sample was taken within the first 24 h of stroke onset and assayed for ApoA1 level by Human ApoA1 ELISA kit. Results: ApoA1 level could be used to discriminate between cases and controls at a level of 6.2 μg/ml, with 94.9% sensitivity and 86.6% specificity. Furthermore, there is an inverse relationship between the level of ApoA1 and the clinical outcome expressed by NIHSS score and their prognosis after 3 months. Finally, there is an inverse relationship between ApoA1 level and the degree of stenosis whether intracranial or extracranial. Conclusion: ApoA1 level can be used as a predictor of ischemic stroke and as a prognostic tool for those patients with ischemic stroke.

Purpose Since the declaration of COVID-19 as a pandemic, a wide between-country variation was observed regarding in-hospital mortality and its predictors. Given the scarcity of local research and the need to prioritize the provision of care, this study was conducted aiming to measure the incidence of in-hospital COVID-19 mortality and to develop a simple and clinically applicable model for its prediction. Methods COVID-19-confirmed patients admitted to the designated isolation areas of Ain-Shams University Hospitals (April 2020–February 2021) were included in this retrospective cohort study (n = 3663). Data were retrieved from patients’ records. Kaplan–Meier survival and Cox proportional hazard regression were used. Binary logistic regression was used for creating mortality prediction models. Results Patients were 53.6% males, 4.6% current smokers, and their median age was 58 (IQR 41–68) years. Admission to intensive care units was 41.1% and mortality was 26.5% (972/3663, 95% CI 25.1–28.0%). Independent mortality predictors—with rapid mortality onset—were age ≥ 75 years, patients’ admission in critical condition, and being symptomatic. Current smoking and presence of comorbidities particularly, obesity, malignancy, and chronic haematological disorders predicted mortality too. Some biomarkers were also recognized. Two prediction models exhibited the best performance: a basic model including age, presence/absence of comorbidities, and the severity level of the condition on admission (Area Under Receiver Operating Characteristic Curve (AUC) = 0.832, 95% CI 0.816–0.847) and another model with added International Normalized Ratio (INR) value (AUC = 0.842, 95% CI 0.812–0.873). Conclusion Patients with the identified mortality risk factors are to be prioritized for preventive and rapid treatment measures. With the provided prediction models, clinicians can calculate mortality probability for their patients. Presenting multiple and very generic models can enable clinicians to choose the one containing the parameters available in their specific clinical setting, and also to test the applicability of such models in a non-COVID-19 respiratory infection.

Background Celiac disease is an autoimmune disease which is underestimated over the world. Iron deficiency anemia can be the only presentable symptom for patients with celiac disease. Screening of patients with iron deficiency anemia of obscure origin by anti-tissue transglutaminase serum igA to diagnose celiac disease followed by upper GIT endoscopy is an important step. Objective to evaluate the prevalence of celiac disease in adult patients with iron-deficiency anemia of obscure origin. Methods The present study was a cross-sectional study which included 100 patients with a diagnosis of iron deficiency anemia recruited from Ain Shams University hospitals. All the patients were subjected to: Full history of gastrointestinal symptoms of celiac disease(CD), Age of onset of iron deficiency anemia, Complete blood picture, Serum iron, serum ferritin, transferrin saturation, Anti-tissue transglutaminase antibody immunoglobuline A, Upper gastrointestinal endoscopy and duodenal biopsy to patients who had positive serology. Results The present study showed that 8% of cases with iron deficiency anemia of obscure origin were ultimately diagnosed as cases of celiac diseases while 47% were diagnosed according to duodenal biopsy as potential celiac disease (where there was positive serology and intact villous architecture according to marsh classification) and 45%of cases were non-celiac disease. Conclusion Screening for celiac disease should be considered in patients with iron deficiency anemia of obscure origin

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Background As a chronic medical condition characterized by elevated blood pressure, hypertension is recognized as a major risk factor for a variety of life threatening diseases including stroke, myocardial infarction, heart failure and aortic aneurysm. And most of these severe complications occur in the hypertensive patients with a sudden increase of blood pressure. Aim of the Work The aim of this study is To evaluate the role of IL23 in the immune pathogenesis of hypertension. Subjects and Methods This was a prospective Case-Control study was carried out in the Internal Medicine Department, faculty of medicine, Ain Shams university hospital during the period from November 2016 to December 2017.In this study we performed full history taking and examination, we also performed complete blood count, liver function tests, kidney function tests, estimation of IL23 level in plasma by ELISA in peripheral blood by Flowcytometry. Forty five adult individual were recruited in the study and were further divided into three groups according to the symptoms of blood pressure as follow:group A patients with acute increase of blood pressure, group B patients without acute increase of blood pressure.and group C healthy volunteers with normal blood pressure as control Results we found that mean of IL23/CD4% was higher in group A, followed by group B then group C, all these differences was high significant Conclusion We demonstrated that IL-23 may be involved in the pathogenesis of acute blood pressure increase in the patients with hypertension. Understanding its inflammatory characterization might be of fundamental importance for the prevention and treatment of acute blood pressure increase in hypertensive patients.

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