Background: Hepatitis C virus (HCV) is one of the most potential pathogens all over the world. Egypt has the highest HCV prevalence in the world. The hepatocellular carcinoma (HCC) is among cancers with the poorest outlook. The detection of HCC improves the outcome. The poor sensitivity of AFP underlines the need for a biomarker that can detect HCC. It was found that the CD25 is increased in patients with HCC. Aim: To assess the performance of serum soluble CD25 (sCD25) in the prediction of early HCC and compare it to α-fetoprotein (AFP); the classical biomarker of HCC. Patients and Methods: This study was a descriptive study. Patients were recruited from the Hepatology and Gastro-enterology department at Suez Canal University hospital. The study included 60 subjects, normal healthy individuals (n=20), cirrhotic patients (n=20) and HCC patients (n=20). 2 blood samples were collected from each patient one for liver profile and second stored for sCD25. Liver function tests, AFP and sCD25 were done to all the participants. Results: Our results show a highly significant increased levels of sCD25 in patients with cirrhotic liver and HCC compared to normal controls, (p=0.001). No difference was found in sCD25 levels in HCC patients compared to liver cirrhosis patients (p=0.862). Conclusion: sCD25 can differentiate HCC patients from normal healthy persons but not from cirrhotic patients. Thus, sCD25 cannot be used as an accurate diagnostic marker for HCC.
Background:The risk for diabetic nephropathy in type 2 diabetes is about 30-40%, and it is considered the leading cause of end-stage renal disease. Small dense low-density lipoprotein (sdLDL) particles are believed to be atherogenic, and its predominance has been accepted as an emerging cardiovascular risk factor. This study aimed to assess small dense LDL as a potential risk factor and a possible predictor for diabetic nephropathy in type 2 diabetic patients.Patients and Methods:According to microalbuminuria test, 40 diabetic patients were categorized into two groups: Diabetic patients without nephropathy (microalbuminuria negative group) and diabetic patients with nephropathy (microalbuminuria positive group), each group consists of 20 patients and all were non-obese and normotensive. The patients were re-classified into three sub-groups depending on the glomerular filtration rate (GFR).Results:The mean of small dense LDL level in the microalbuminuria positive group was higher than that in the microalbuminuria negative group, but without statistical significance. It was significantly higher in patients with either mild or moderate decrease in estimated GFR than in patients with normal estimated GFR. There was statistically significant correlation between small dense LDL and albuminuria and significant inverse correlation between small dense LDL and estimated GFR in all patients in the study. Based on microalbuminuria, the sensitivity and specificity of small dense LDL in the diagnosis of diabetic nephropathy was 40% and 80%, respectively, with cutoff values of small dense LDL >55.14 mg/dl. On the other hand, based on GFR, the sensitivity and specificity were 88.24% and 73.91% respectively, with cutoff values of small dense LDL >41.89 mg/dl.Conclusion:Small dense LDL is correlated with the incidence and severity of diabetic nephropathy in type 2 diabetic patients. It should be considered as a potential risk factor and as a diagnostic biomarker to be used in conjunction with other biochemical markers for early diagnosis, assessment, and follow-up of diabetic nephropathy.
The World Health Organization (WHO) describes diabetes mellitus (DM) as the most common endocrine disease in the world. In the year 2000, diabetes affects more than 230 million people worldwide, and according to the most recent projections, it is expected to affect 370 million people by the year 2030. [1] For Egypt, the total projected number of people with diabetes is about 6.7 million (9%). [2] Diabetic neuropathy (DN) is a debilitating disorder that occurs in nearly 50% of patients with diabetes. It is a late fi nding in type 1 diabetes, but can be an early fi nding in type 2 diabetes. Neuropathy is estimated to be present in 7.5% of patients at the time of diabetes diagnosis. [3-7] DN can affect any part of the nervous system. This nerve disorder should be suspected in all the patients with type 2 diabetes and in patients who have had type 1 diabetes for more than 5 years. In Background: Diabetic neuropathy (DN) can affect any part of the nervous system and should be suspected in all patients who have had diabetes for more than 5 years. Family physicians (FPs) can play an important role with the care and education of people with diabetes. They can augment the knowledge and motivate the diabetics to acquire a healthy life style, which would further lead to a good glycemic control providing protection from the chronic complications. Lack of compliance with the guidelines on the part of the diabetic subjects, indicates defi ciencies in the FPs' knowledge, implementation techniques, and attitude problems. Therefore, the present study was conducted to assess FPs' knowledge, attitude, and practice regarding DN for further educational interventions that will improve their quality of care for diabetic patients in family practice centers. Materials and Methods: The study population was 60 FPs working in family practice centers affi liated to Suez Canal University Hospitals. The questionnaire composed of three groups of questions to collect data for evaluation of knowledge, attitude, and practice; two written patient problems to assess their practice and two questions to assess barriers and recommendations of physicians. To pass the evaluation; 50, 80, and 60% were the cut off points to pass the evaluation for knowledge, attitude, and practice, respectively. Results: 48.3, 66.7, and 43.3% of the evaluated FPs passed the knowledge, attitude, and practice assessment, respectively. Eighty-fi ve percent of physicians felt that they need more knowledge and training in DN management. Physicians' qualifi cation (P = 0.037) was a signifi cant variable in passing the knowledge test, but qualifi cation and experience years (P = 0.007 and 0.035, respectively) were signifi cant variables in passing the practice test. There was a positive signifi cant (P = 0.021) correlation between practice and knowledge score. Postgraduate knowledge accounts the majority (78.3%) as a source of information about DN. Providing physicians with standardized guidelines (81.7%), continuous medical education seminars (76.7%) and training courses (76.7%)...
Background and aim of the work Hepatocellular cancer (HCC) is one of the common liver cancers and considered to be the sixth most commonly occurring cancer in the world and the second leading cause of death among cancer patients. More recent studies on HCC showed that the elevated serum endocan level was a predictive factor of recurrence after radiofrequency ablation. The aim of this study is to evaluate the serum endocan level as a prognostic biomarker for recurrence of HCC after percutaneous radiofrequency ablation. Patients and methods Analytic-prospective study was carried out in Suez Canal University Hospitals. The study was carried out on 80 patients classified into three groups: group 1 (control group) consisted of 20 apparently healthy persons; group 2 consisted of 20 patients with liver cirrhosis; and group 3 consisted of 40 treatment-naive HCC patients who were prepared for radiofrequency ablation. All HCC patients (who were confirmed to have complete ablation after RF) were followed up by using triphasic abdominal CT, serum AFP and serum endocan assessment at 3 and 6 months after radiofrequency ablation. Results Our study revealed a high level of serum endocan in the HCC group with a statistically significant difference (<0.001) between the three groups. HCC patients had a higher level of serum endocan (6.2 ± 2.25) followed by an liver cirrhosis group (2.0 ± 1.29) and then the control group (1.0 ± 0.3). The serum endocan level had a positive correlation with recurrence of HCC (P < 0.0001). There was a positive correlation between serum endocan and serum alanine transferase (P = 0.02), and a positive correlation between serum endocan and the number of tumors (P = 0.01). Conclusion Serum endocan is considered as a prognostic biomarker for tumor recurrence in HCC patients after radiofrequency ablation.
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