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Table (1) Factors that contribute to malnutrition in chronic liver disease 20,21 .

This study aimed to assess the role of micro-ribonucleic acid-24 (microRNA-24) expression in patients with cirrhosis and hepatocellular carcinoma (HCC) who have experienced high levels of aflatoxin B1 (AFB1) exposure. Fifty HCC and 24 hepatic cirrhosis patients, in addition to 20 healthy control subjects were included in this study. Aflatoxin B1 was measured by enzyme-linked immunosorbent assay (ELISA) and microRNA-24 was detected using real-time polymerase chain reaction (real-time PCR). Both aflatoxin B1 levels and microRNA-24 expression were found to be significantly increased in all patient groups in comparison to controls, more so in the HCC than cirrhotic group (p<0.0001). A highly significant correlation was detected between levels of AFB1 and amount of microRNA-24 expressed in both patient groups relative to their control counterparts (p<0.0001). Receiver Operating Characteristic (ROC) curve performed to evaluate the ability of microRNA-24 to differentiate between HCC and cirrhosis showed that it had sensitivity of 80% and specificity of 63% at cutoff 1.3, which was highly significant (p<0.0001). Increased aflatoxin B1 levels detected in patients with cirrhosis and HCC further support previous studies evaluating the level of exposure of the Egyptian population to this carcinogen and support the critical role of aflatoxin B1 in the appearance of HCC. In addition, microRNA-24 expression levels demonstrated in both cirrhosis and HCC might be valuable for use as a noninvasive diagnostic tool for diagnosis of HCC.

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Background: Vitamin D deficiency has been proposed as a risk factor for diabetes mellitus type 2(DM type 2). Insulin receptor gene expression and insulin secretion are modulated by vitamin D, indicating their role in the pathogenesis and development of DM type 2. Furthermore, elevated PTH levels may play a role in the etiology of metabolic syndrome (MS), through an association with its individual components or via insulin resistance. Aim:This study aimed to investigate the role of vitamin D and parathyroid hormone in glycemic control of DM type 2. Materials and Methods: The study included 90 participants: 6o patients diagnosed as DM type 2 and 30 healthy age and sex-matched subjects as control. All studied subjects underwent full history taking and complete physical examination. Laboratory tests included fasting blood sugar (FBS), HbA1c, lipid profile, vitamin D and parathyroid hormone serum levels. Results: As regard 25(OH) vitamin D levels, 78.33% of patients were deficient or insufficient, compared to 20% of control subjects that were deficient or insufficient. 25(OH) vitamin D levels showed a significant negative correlation with age (p= 0.002), weight (p=0.0001), BMI (p=0.0001) , FBG (p=0.0001), HbA1C (p=0.0001) and TG (p=0.002). Along with a significant positive correlation with HDL-C (p= 0.0001). PTH levels showed a significant negative correlation with HDL-c (P= 0.0001), 25(OH) vitamin D (P=0.001), in addition to a significant positive correlation with weight (P=0.0001), BMI (P=0.0001), FBG (P=0.005) and HbA1c (P=0.0001). Conclusion: Not only vitamin D but also parathyroid hormone may play a role in glycemic control in patients with DM Type 2

Background: Polymorphisms in the cytokine gene involving IFN gamma (IFN-γ) have been implicated in many infections including HCV. The aim of this study is to evaluate the association between IFN-γ polymorphism in three regions, (+2109A/G, +874A/T, -183G/T) and either chronicity or spontaneous viral clearance (SCV) in HCV infected patients. Materials and Methods: The study included 200 HCV-infected patients divided into Group I of 100 patients with spontaneous virus clearance (SVC) and Group II of 100 patients with persistent chronic hepatitis C infection (PI) who did not receive any therapy. These patients were subjected to history taking, full clinical examination and laboratory investigations included analysis of IFN-γ gene polymorphisms. Results: At locus +2109 of the IFN-γ gene, patients with A/A genotype had a significantly higher rate of spontaneous hepatitis C clearance while the G/G genotype was more prone to persistent infection. No statistically significant difference was found between both groups regarding loci +874 and -183 of the IFN-γ gene, but column proportion comparison using Bonferroni method at locus +874 revealed a higher proportion for T/A genotype in SVC group. Both haplotypes AAT and TGT were more susceptible to chronic HCV infection, as were heterozygote T/A at locus +874 and G/G genotype at locus +2109s. A/G and A/A genotypes at locus +2109, TLC at cut off value ≤7.15, and AST at cut off value ≤27.5 were considered independent predictors for development of SVC. Conclusions: Polymorphisms in the IFN-γ gene may play role in sequelae following HCV infection, possibly determining whether the virus will be cleared spontaneously or not.Polymorphisms in cytokine genes, including interferon gamma (IFN-γ), have been implicated in numerous infections 17,18 , autoimmune diseases, and chronic inflammatory conditions 18,19 . Some polymorphisms reported in the regulatory and coding regions of IFN-γ gene include -183G/T,

Background: Recent data have emerged that a targeted biopsy technique using Narrow-Band Imaging (NBI) could be considered in patients undergoing surveillance for Barrett's esophagus (BE). Aim of the study:to determine the role of NBI compared to conventional-white light endoscopy (WLE) in diagnosis of Barrett's esophagus in patients with chronic gastroesophageal reflux disease. Patients and methods: the study included 274 patients with chronic reflux symptoms, conventionalwhite light endoscopy (WLE) was done in all cases for diagnosis of BE.Ninety patients showed Barrett's mucosa pattern by white-light endoscopy so 4-random biopsies were taken and examined by histopathology for detection of columnar-lined intestinal metaplasia, then patients who showed negative histopathology for intestinal metaplasia were re-endoscopied and NBI targeted biopsies were taken for histopathological confirmation of presence of intestinal metaplasia.Based on histopathology results, patients were divided into 2 groups, group 1 (B E positive, 80 patients) and group 2 (BE negative, 10 patients). Group showed increased detection rates in age > 30 years. Results: 90 patients had columnar-lined epithelium (CLE) by WLE (32.8%); Seventy-three patients with 4 quadrant biopsy technique confirmed to have intestinal metaplasia (81.1% of cases with endoscopic BE, and 26.6% of all screened patients), 17 patients with negative histopathology for BE were re-examined endoscopically and NBI -targeted biopsies were taken, 7 patients of them showed intestinal metaplasia, so total patients confirmed to have BE has risen to 80 patients (88.9%). Conclusion: NBI-targeted biopsies could diagnose BE in patients tested negative by WLE taken biopsies

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