Objective. Evaluating the efficacy and safety of arginine and glutamine supplementation in decreasing the incidence of NEC among preterm neonates. Methods. Prospective case-control study done on 75 preterm neonates ≤34 weeks, divided equally into L-arginine group receiving enteral L-arginine, glutamine group receiving enteral glutamine, and control group. Serum L-arginine and glutamine levels were measured at time of enrollment (sample 1), after 14 days of enrollment (sample 2), and at time of diagnosis of NEC (sample 3). Results. The incidence of NEC was 9.3%. There was no difference in the frequency of NEC between L-arginine and control groups (P > 0.05). NEC was not detected in glutamine group; L-arginine concentrations were significantly lower in arginine group than control group in both samples while glutamine concentrations were comparable in glutamine and control groups in both samples. No significant difference was found between groups as regards number of septic episodes, duration to reach full oral intake, or duration of hospital stay. Conclusion. Enteral L-arginine supplementation did not seem to reduce the incidence of NEC. Enteral glutamine may have a preventive role against NEC if supplied early to preterm neonates. However, larger studies are needed to confirm these findings. This work is registered in ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT01263041).

Background A burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease. We aimed to evaluate the hemoglobin A1c (HbA1c) levels before and after therapy with direct-acting antivirals (DAAs) in HCV-diabetic patients who achieved sustained virological response (SVR) at Aswan Fever Hospital. This prospective study was conducted at the Viral Hepatitis Treatment Center, Aswan Fever Hospital, Aswan, Egypt, between November 2017 and May 2018. A total of 85 randomly selected diabetic patients (type 2 diabetes mellitus) with chronic HCV infection were received sofosbuvir and daclatasvir as a dual therapy for 3 months, then followed up for week 12 after the end of DAA therapy, Changes in the levels of hemoglobin A1c (HbA1c) were measured at baseline then 12 weeks after the end of treatment with DAAs. Results Thirty-two patients (37.6%) showed a significant glycemic improvement after receiving DAAs therapy; in the form of > 1% reduction in HbA1c level (p value < 0.001). Their baseline mean HbA1c level was 7.98 ± 0.62% which was significantly improved 12 weeks after the end of therapy (SVR) to reach a level of 6.88 ± 0.81%. Meanwhile, 53 patients (62.4%) had a baseline mean HbA1c of 8.24 ± 0.64% and a post-treatment mean HbA1c level of 8.34 ± 0.61% (p value = 0.083). Conclusion DAAs-based eradication of HCV is associated with improved glycemic control in 37.6% of patients with diabetes as evidenced by a significant reduction of mean HbA1c.

Background: High percentage of intensive care unit (ICU) admissions are due to sepsis. Some evidence suggests procalcitonin (PCT) is a useful sepsis prognostic marker. Acute phase protein, which is called pentraxin3 (PTX3) may help in sepsis screening. Objective: To assess the prognostic value of the PTX3 and PCT in neonatal sepsis in comparison with other screening markers. Patients and Methods: A prospective study included 40 neonates with sepsis. The study had been conducted in the neonatal ICUs of Ain Shams University, Children's Hospital during the period from January 2020 to May 2022. All neonates had been subjected to clinical examination, anthropometric measurements and sepsis scoring by neonatal sequential organ failure assessment (nSOFA). Laboratory investigations were performed including complete blood count, blood culture, assay of serum levels of C-reactive protein (CRP), PCT and PTX3. Results: The CRP levels were significantly lower in the deteriorated group compared to the better group, whereas PCT and PTX3 levels were significantly higher with p-value=0.004, 0.016 and 0.019, respectively. After 3 days, CRP, PCT and PTX3 levels increased significantly in deteriorated group than improved group with p-value=0.002, <0.001 and <0.001, respectively. The combination between baseline nSOFA score, CRP and PCT levels had a sensitivity of 84.62%, specificity of 92.59% and AUC 0.906. While combination between baseline nSOFA CRP and PTX3 levels had the highest sensitivity of 100% and AUC of 0.909 in prediction the poor outcome of the studied patients. Conclusion: Serum levels PCT and PTX3 seem to be promising prognostic markers in neonatal sepsis.

Introduction: Breast cancer (BC) is a multifactorial disease, that is attributed to non-familial factors such as environmental or genetic factors that play a vital role in the development of the disease. BRCA1/2 mutations represent a high risk of breast cancer. The current study focused on exploring the relationship between the presence of BRCA1/2 mutations and some clinicopathological characteristics which might impact the pathogenesis of BC disease. Material and Methods: Genomic DNA samples were obtained from 19 fresh tissues using Gene JET Extraction Kit (Thermo Scientific/US, Canada), and 29 FFPE using QIAamp DNA FFPE Tissue Kit (Qiagen, Valencia, USA) obtained from pretreatment BC patients. Library preparation was performed using Devyser BRCA NGS kit (DEVYSER, Stockholm, Sweden), according to the manufacturer's instructions. The reagent kit V2, 500 Cycles PE, on the Illumina MiSeq System (Illumina, San Diego, CA, USA). The BRCA1 and BRCA2 genes reference were: NM_007300 and NM_000059, respectively. Variants were called using freebayes (1.1.0.46) and annotated using ANNOVAR(version2019Oct24). All samples were subjected for detection of Human Mammary Tumor Virus (HMTV) and Human Papillomavirus (HPV) DNAs using qualitative PCR assay. Result: The study identified 40 and 54 different BRCA1 and BRCA2 mutations, mostly in the form of frameshift and stop codon mutations. Regarding, BRCA1, 14 pathogenic mutations were detected, exon10 and exon 9 showed to be the most affected exons representing (c.C1612T (25%) and c.C1471T(22.9%), respectively. For BRCA2, only five pathogenic mutations were identified, exon 11 and exon 14 showed to be the most affected exons (cT4001A(6.25%) and c.7231delA(4.16%), respectively. Regarding relation between BRCA1/2 genes mutations and clinicopathological parameters, BRCA1 and BRCA2 carriers were younger than non-carriers though not significant (p=0.440). Regarding the tumor characteristics, BRCA1/2 carriers had large tumor size (p=0.091), high tumor grade compared to non-carriers but without significance (P=0.098). Micro-classifications positivity (60%) was also more frequently among BRCA1/2 carrier than non-carrier (p= 0.082). Regarding detection of HMTV and HPV, BRCA1/2 mutation carriers has a skew towards negative results (P=&lt;0.001 and 0.004, respectively). Conclusion: Our data suggest that BRCA1/2 mutations might contribute to the pathogenesis among both familial and non-familial Egyptian breast cancer patients, but we need more sample size to confirm the findings. It also identifies the most affected exons in preparation for establishing a diagnostic tool like HRM for genetic counseling, which will help when selecting treatment modalities for BC patients. STDF Acknowledgment: This project was supported financially by the Science and Technology Development Fund (STDF), Egypt, Grant No.22944 Citation Format: Samah A. Loutfy, Nasra F. Abdel Fattah, Ahmed B. Barakat, Omar R. Alfarouk, Tarek M. Hashem, Ahmed M. Osman, Shimaa A. Metwally, Maha A. Abo-Shadi, Amany M. Helal, Shaza A. Habib, Ahmed A. El Sherif, Abdel Wahab El Ghareeb, Mohamed M. Mouneer, Manar M. Moneer, Marwa A. Abdel-Wahed, Mona A. Salem, Asmaa M. M. M. Salama, Fatma S. Hafez, Sara H. Agwa, Hesham Elghazaly, Manal M. El-Mahdy, Mark J. Dunning, Sherif F. El-Khamisy. BRCA1 and BRCA2 mutations and its clinical relevance among egyptian breast cancer women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2512.

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