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BACKGROUNDThe prevalence of hepatitis C virus (HCV) in Egypt is quite high, and the combined oral direct-acting antiviral agents (DAAs) may have impressive results.OBJECTIVETo assess the cardiovascular effects of DAAs in patients with HCV.METHODSA total of 170 patients with HCV were divided into 2 groups: first group (100 patients) received triple combination therapy (pegylated interferon alfa, sofosbuvir, and ribavirin, whereas the second group (70 patients) received dual combination therapy (sofosbuvir and simeprevir). Group 1 patients were followed up for 1 year more than 3 visits, whereas group 2 patients were followed up for 6 months more than 2 visits; and the end point of the study was the development of a major cardiovascular event (eg, congestive heart failure, echocardiographic evidence of left ventricular dysfunction, occurrence of significant arrhythmias, or acute coronary syndrome). The following parameters were accomplished: medical history and clinical examination, electrocardiogram, echo-Doppler study, and laboratory investigations.RESULTSNo significant differences were found between the 2 study groups regarding demographic criteria. None of the both group patients had developed any major cardiac event. No significant changes were observed regarding ST-T wave abnormalities, arrhythmias, or QT interval. None of the both group patients developed echocardiographic regional wall motion abnormalities at baseline or at study end. Systolic function parameters showed minute nonsignificant changes over study visits. Diastolic function parameters showed nonsignificant changes between baseline and 6-month and 12-month visits.CONCLUSIONSThe DAAs used in combination regimen with interferon or used orally in combination do not significantly affect the cardio-vascular system.

The therapeutic outcomes of EPLBD for removal of large bile duct stones are better than those of ES with comparable complication rate. EPLBD is also recommended for removal of large CBD stone in patients with an underlying coagulopathy or need for anticoagulation following endoscopic retrograde cholangiopancreaticography.

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Currently, a new coronavirus(COVID-19) has affected millions of people worldwide. For this reason, it's not sufficient that radiologists can slow down the virus spreading manually. Convolutional Neural Networks (CNNs) can be utilized as a tool to aid radiologists in diagnosing COVID-19 images, which consequently can save efforts and time. In this work, a dataset of CT images of confirmed and negative COVID-19 was used for the screening of COVID-19. Some preprocessing operations were applied to enhance the COVID-19 CT images which aim at including only the Area of Interest (AOI). This was accomplished in three stages. First, a conversion of the CT images to the binary scale was performed by applying a global threshold algorithm. Then, the median filter algorithm was applied to remove random noise. Then, we include only the ROI (the lung) and exclude other parts of the images. Finally, we applied VGGNet 19 to extract features from the preprocessed CT images, which is a popular CNN architecture, trained previously on ImageNet. The proposed pipeline showed high performance by achieving 98.31%, 100%, 98.19% and 98.64% of accuracy, recall, precision and f1-score, respectively. To the best of our knowledge, these results are the best published on this dataset when compared to a set of recently published works. Also, the proposed model overcomes several popular CNNs architectures.

Breast cancer is the most common neoplasm in women, accounting for 26 % of all cancers diagnosed annually, it is overall the second leading cause of cancer death (following lung cancer). In Egypt breast cancer constitutes 33 % of all female cancer and the median age is 46 years old, one decade younger than corresponding western countries. The incidence of breast cancer is highest among women of higher socioeconomic background. Also the incidence is higher among whites less common in black women. Most cancer patients are diagnosed sporadic and not associated with any clear familial predisposition 1. Breast cancer is not a single entity but instead comprises several biologically distinct subtypes. Based on molecular profiles, breast cancers have been classified into four main subtypes: luminal subtype A, luminal subtype B, ERbB2 positive receptors (HER2 positive/ER negative) and TNBC 2,3,4. Triple-negative breast cancer (TNBC) is defined as a clinical entity referring to tumors that do not express estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER2) accounting for approximately 15%-20% 5,6 of breast cancers. TNBC has important clinical implications, because it is typically high grade, and exhibits a high rate of proliferation 7,8. In general, compared with other subtypes of breast cancer, TNBC has a less favorable clinical outcome in terms of the nature and likelihood of

Introduction: Laparoscopic appendicectomy has gained popularity due to the advantages of minimal-access surgery. Inadequate closure of the appendix stump leads to intra-abdominal surgical site infection or even fecal fistula. The base of the appendix can be secured with endostapler, endoloops, metallic clips or intracorporeal ligature. Aim: To evaluate the handmade extra-corporeal loop versus endoclip in securing the base of the appendix in non-complicated acute appendicitis. Methods: During the period from

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