Background: Tumor necrosis factor-ɑ (TNF-ɑ) is one of the most important cytokines that manage the host defense mechanism, which may play a role in the pathogenesis of COVID-19 patients. The work aims to study the association of TNF-ɑ G-308 A gene polymorphism with the course and outcome of COVID-19 patients in Mansoura University Hospital. Methods: 900 patients with COVID-19 infection and 184 controls were tested for TNF-ɑ G-308 A promoter polymorphism. Different genotypes of TNF-ɑ G-308 A were compared as regards the severity and prognosis of the disease. Results: No statistically significant difference was found between patients and controls as regards the demographic data. The AA genotype of TNF-ɑ showed a higher incidence of the disease in comparison to the other genotypes. As regards the demographic and laboratory characters, no statistically significant difference was found between the different genotypes except for age, lymphopenia, CRP, and serum ferritin levels. In 336(80.0%) cases of the AA genotype, the disease was severe in comparison to 90(41.7%) cases in the GA genotype and no cases in the GG genotype with P = .001. Conclusion: People who carry the A allele of TNF-ɑ polymorphism are more prone to COVID-19 infection. The AA genotype of TNF-ɑ is associated with a more aggressive pattern of the disease. In those patients, the use of anti-TNF therapy may be promising.

Haemorrhoidal disease develops slowly. In comparison to electrocautery, surgical intervention with the Harmonic Scalpel® shear is a revolutionary approach for ablation of symptomatic fourth and third degree haemorrhoids. In contrast to electrocautery, Harmonic Scalpel® causes less discomfort because of its restricted lateral thermal injury during tissue dissection. The purpose of this study was to observe how effective Harmonic Scalpel® is at reducing postoperative problems after a haemorrhoidectomy. A harmonic US scalpel device was utilized to do the hemorrhoidectomy in group A, while a monopolar electrocautery device was employed in group B, which included 82 individuals. In this study, postoperative pain was more statistically significant in the Harmonic haemorridectomy group A than in group B haemorridectomy, in keeping with a pain numerical analogue scale of 1 to 10. The postoperative pain in group A was statistically significant on the 1st, 2nd, 4th, 7th, 14th, and 28th days of follow up, p<0.001. Time off work and patient satisfaction were statistically significant in the harmonic group, 2.50±0.066 compared to the surgery group, 3.56±0.070 (p<0.05). Healing of postoperative ulcers was statistically significant in the harmonic group (2.640.062 vs. 4.120.062 in surgery) (p<0.037).

The current study aimed to compare the utilization efficiency of iron (Fe) feed additives from either bulk or nano sources in Nile tilapia, Oreochromis niloticus diets on growth, haematological, immunity, anti-oxidative, and intestinal topography capacities. Five isonitrogenous and isoenergetic diets were performed; the basal diet served as a control with no Fe added, whereas the experimental diets were shaped by adding bulk-Fe2O3 and nano-Fe2O3 to the basal diet to preserve Fe levels at 0.2 and 0.4 mg kg−1, respectively. Results indicated that superior growth performance was recorded in fish-fed diets supplemented with 0.4 nano-Fe2O3 mg kg−1 diet. In addition, the highest (P ≤ 0.05) survival rate, absorption area of villous (AAV), mucosal to serosal amplification ratio (MSR), and villi parameters (height and width) were noticed in fish fed diet enrichment with either bulk or nano-Fe2O3 source. However, the superiority observed in nano-Fe2O3 fish groups. Also, the highest values of plasma albumin, total protein, high-density lipoprotein cholesterol (HDL-C), white blood cells (WBCs), and lymphocyte absolute count (LYM) (P ≤ 0.05) recorded in fish fed a diet supplemented with nano-Fe2O3 versus the basal diet. Moreover, the highest values of catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD), and plasma lysozyme activity (P ≤ 0.05) were observed in fish fed 0.4 mg/kg−1 nano-Fe2O3, while the lowest value was recorded in fish fed the control diet. The best value of malondialdehyde activity (P ≤ 0.05) recorded in a fish-fed diet supplemented with 0.4 mg/kg−1 nano-Fe2O3. The current findings emphasize the importance of including Fe to improve fish growth, immunity, antioxidant capabilities, and intestinal structure, primarily with a nano-Fe source, which demonstrated a more effective function in satisfying Nile tilapia dietary Fe requirements and improving the aforementioned parameters.

Background: In Biliary enteric anastomosis procedures, hepatico-jejunostomies are a crucial step. Depending on the situation, the hepatico-jejunostomy operation procedure varies depending on the surgical school, and can be continuous or interrupted. Patients and Methods: A prospective comparative randomized study included 100 Patients  complaining of malignant pancreatic tumour (65%), iatrogenic bile duct injury (20%), multiple common bile duct stones (10%) and liver transplantation of cirrhotic patients (5%) underwent hepatico-jejunostomy anastomosis to review a multi-center experience of hepatico-jejunostomy anastomosis in Theodor Bilharz Research Institute and Faculty of Medicine of Cairo University with regard to the types of anastomosis performed, early and late complications, and long-term patency and outcomes. Results: According to the type of suturing technique, hepatico-jejunostomy anastomosis patients are sub grouped into posterior interrupted sutures group A and posterior parachuting sutures group B. A significant direct correlation of leakage in group A  with obstructive jaundice (r = 0.327 and p value = 0.02), CBD diameter (r = 0.408 and p value = 0.001), and Duct wall thickness (r = 0.408 and p value = 0.001) While there were inverse correlations with pre-operative stent (r = -0.375 and p value = 0.01).