Background: Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. This study aimed to evaluate the impact of DAAs on achievement of improvement in liver fibrosis, and to evaluate risk factors associated with progression of liver fibrosis in patients achieved sustained virological response (SVR). Method: the study included 300 patients diagnosed with chronic HCV infection started their treatment protocol form 2016 who were divided into two groups; Group I (150 patients) included patients who received Sofosbuvir + Simeprevir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment, and Group II (150 patients) included patients who received Sofosbuvir + Daclatasvir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment. All cases were subjected to complete history taking, thorough physical examination, routine laboratory investigations, pelviabdominal US together with transient elastography were ordered for all cases. Results: both HCV treatment regimens showed improvement in liver fibrosis, fibro scan parameters showed a significant decrease in both groups compared to the baseline as pretreatment examination revealed mean values of 9.81 and 9.75 in both groups respectively. After treatment, both groups had mean values of 8.11 and 8.05. Both groups showed a significant change compared to its pre-treatment value (p < 0.001). There was a significant negative correlation between fibro scan parameter decrease with age, BMI, and HbA1C levels. There was no difference in degree of improvement of liver fibrosis between both regimens. Conclusion: fibrosis regressed significantly after DAAs

Aim: this study aimed to clarify the possible effect of direct acting antivirals (DAAs) treatment on development of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) cirrhotic patients. , Methods: this study was conducted on 400 chronic hepatitis C cirrhotic patients, divided into two groups according to treatment with DAAs, group I including (200 Patients with chronic HCV cirrhosis treated with DAAs), and group II including (200 patients with chronic HCV cirrhosis without DAAs treatment), all patients were recruited from the Gastroenterology and Hepatology department Kobry Elkobba Military Hospital, all patients were males with no previous history of HCC, human immunodeficiency virus (HIV) or hepatitis B virus (HBV) infection or history of liver transplantation. After one year of follow up all patients were divided into further two subgroups according HCC development, group III ( 11 HCV cirrhotic patients treated with DAAs (sofosbuvir and daclatasvir) and developed HCC) and group IV (22 HCV cirrhotic patients not treated and developed HCC).Results: HCC developed more in not treated group with a significant difference as 11% of not treated group developed HCC compared to 5.5% only of treated group (P=0.046). using univariate cox regression, it was shown that no treatment was an independent risk factor of getting hepatocellular carcinoma (HCC), as cases not receiving the study treatment are at higher risk for developing HCC (HR=3.4, P=0.002). conclusion: DAA treatment is not associated with a higher risk of HCC in cirrhotic patients with chronic HCV infection in the short-term. The occurrence of HCC is significantly decreased in patients treated with DAAs.

Results: Higher mean levels of FBS, 2 hr (2HPP) and fasting plasma insulin (FSI) were detected in group II (HCV+DM) compared to other groups with statistically significant differences between all the studied groups (P value <0.001), consequently HCV diabetic patients were found to have significant higher IR than HCV patients without DM, diabetic patients alone and control group (P value <0.001). Furthermore, there was highly statistically significant differences between all studied groups as regard level of TNF-α (P value <0.001) with higher mean level in group I (HCV group). Insignificant difference in level of TNF-α in HCV patients with or without IR (P value =0.072). Insignificant positive correlation between HOMA-IR and TNFα (P value = 0.63). Conclusion: Chronic HCV patients have significantly elevated fasting plasma insulin level, TNF-α and significant IR and there was insignificant correlation between HOMA-IR and TNF-α.

Objective:The aim of the present study was to adjunct the healing of intra bony periodontal deep pockets using minimal invasive technique and materials (injectable platelet rich fibrin-I PRF-). Subjects & Method: A total of 70 medically healthy adult subjects with chronic periodontitis in a randomized controlled clinical trial were divided into 3 groups; PRP group, iPRF group & control group. PRP preparation: Two Acid citric dextrose (ACD) 8.5 ml tubes of whole blood were centrifuged at 2000 rpm for 7 min at room temperature using Heraeus Megafuge 16R centrifuge. IPRF preparation: Two tubes (without anticoagulant) of 10 ml of whole blood were centrifuged at 700 rpm for 3 min at room temperature using Heraeus Megafuge 16R centrifuge. Results: Postoperative evaluation: I-PRF group showed the highest reduction of probing depth from baseline, while PRP group came second followed by the control group which had the lowest reduction in probing depth. Conclusion: the repeated injection of i-PRF showing a stronger and more durable effect, since it has number of growth factors which are responsible for tissue regeneration capable of inducing fibroblast behavior.

Background and study aim: Egypt has the highest prevalence of hepatitis C virus (HCV) infection in the world and is facing an epidemic of type 2 diabetes mellitus. The objective of this study was to assess the frequency of prediabetes in patients with chronic HCV infection. Subjects and Methods: A crosssectional study was performed on 60 HCV patients. Twenty healthy persons were taken as controls. Full history taking, clinical examination, routine laboratory and radiological investigations were done Body mass index (BMI), Waist Hip ratio, serum fasting glucose and fasting insulin were determined. IR was calculated by the Homeostasis Model for Assessment of Insulin Resistance (HOMA-IR), where values less than 2 has been considered completely normal and higher than 2 as a prediabetic state. Results: Serum fasting glucose, fasting insulin and HOMA-IR levels were significantly higher among HCV group compared with control group. The frequency of prediabetic (HOMA-IR values >2) among non-diabetic chronic HCV patients is 63.33%. Conclusion: Chronic HCV patients should be screened regularly for insulin resistance to avoid the double burden of diabetes mellitus and HCV.