<b><i>Introduction:</i></b> The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. <b><i>Objective:</i></b> In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. <b><i>Methods:</i></b> A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. <b><i>Results:</i></b> The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment (<i>p</i> ≤ 0.05); mean AFP level (5,085.2 ± 11,883.2 ng/mL) was also significantly higher. HCC patients after DAA treatment had significantly advanced stages and limited treatment options (<i>p</i> ≤ 0.05). <b><i>Conclusion:</i></b> The changing HCC pattern after DAA treatment may suggest the need for new HCC staging and treatment protocols.
Total phenolic content (TPC), total flavonoids content (TFC), phenolic compounds and antioxidant properties of extracts olive leaves were determined. Total phenolic compound for the extracted olive leaves were evaluated using the Folin-Ciocalteu method, while the total flavonoid contents were determined with an aluminum chloride colorimetric assay. The 2,2-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging effect of the herbs was measured by spectrophotometry. The antimicrobial activity and hemolytic activity of extracts were performed. The components of the extracted olive leaves were determined by EDX analysis and HPLC. The main components determined in the extracted olive leaves were Gallic acid, Vanillin, Rutin, Kaempferol, Naringenin, Ferulic acid, Coumaric acid, Catechin, Cinnamic acid, Syringic acid, Coffeic acid and Methyl gallate in El-Farafra leaves extract, and Gallic acid, Kaempferol, Ellagic acid, Querectin, Rutin, Catechin, Syringic acid, Ferulic and Naringenin in Borg El-Arab leaves extract. Results showed that the values of total phenols are higher than that within the total flavonoids. From the biological studies it was observed that Borg El-Arab extract has antimicrobial effect for gram-positive bacteria and Yeast higher that El-Frafra extract, while they have the same effect on the gram-negative bacteria.
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