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Background: Uterine fibroids (UFs) are the most common benign tumors affecting women of reproductive age]. patients with uterine fibriod suffer from pelvic pain, menorrhagia, dysmenorrhea/dyspareunia, pressure-related symptoms, miscarriage, and subfertility. The aim of this study was to assess the relationship between occurrence, size, and clinical symptoms of uterine fibroid and the serum level of Vitamin D. Methods: The study was designed as an observational case control study. This study was conducted at Tanta University Maternity Hospital at the department of obstetric and Gynecology from March 2020 to September 2020.This study was conducted on 75 women in their reproductive age (20-45 yrs) recruited at Tanta obstetric and gynecology department (inpatient wards), they were subdivided into two groups:Group A: case group: 50 Women with uterine fibroid. Group B: control group: 25 Women with normal uterine examination and transvaginal ultrasound. Measuring the level of serum vitamin D3 in both control and women with uterine fibroid. Results: The age, in case group, ranged from 20-45 yrs with mean level 30.50± 4.56 yrs and in control group ranged from 20-45 with mean value 31.01+ 5.11 yrs. the diagnostic performance of vitamin D test in diagnosing uterine fibroid through illustrating sensitivity and specificity of vitamin D level to predict uterine fibroid. Area under the curve was 0.881with cut off value 14.3 ng/ml, the sensitivity of vitamin D to predict the fibroid was 79.3%, the specificity was 66.7 and test accuracy was 74.4%. Conclusions: The current study showed a significant association between vitamin D3 deficiency in reproductive age women and the occurrence of uterine fibroid, the mean vitamin D3 level in the case group was 13.8±7.93 ng/ml and in the control group was 20.79+8.95 ng/ml. There is correlation between vitamin D3 level and the size of uterine fibroid. Vitamin D3 deficiency is widely spread among the study population with 80 % prevalence while vitamin D3 insufficiency is prevalent in 14% among study participants

Background: As a result of prematurity, Acute kidney injury (AKI) occurs commonly in preterm neonates and is associated with increased morbidity and mortality. (AKI) is defined as a rapid, potentially reversible deterioration in renal functions sufficient to result in accumulation of nitrogenous wastes in the body. Aim of the Study: the aim of this study was to determine whether preterm neonates who took caffeine citrate from the first day after birth were less likely to AKI within the first 7 days. Patients and Methods: This case control study was conducted on 100 preterm neonates at Neonatal Intensive Care Units (NICUS), Pediatric Department, Tanta University with gestational age less than (30 weeks) were grouped into group A and B. Group A 50 preterm neonates who received caffeine citrate from the first day after birth with dose (20 mg/kg) loading dose, and (5 mg/kg/dose) every 24hrs of maintenance dose, given as slow intravenous infusion over twenty to thirty minutes for a week. Group B 50 preterm neonates who did not receive caffeine citrate. Inclusion Criteria: all preterms

Background: The severe form of nausea and vomiting of pregnancy called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Helicobacter pylori (H. pylori) is a prevalent gram-negative flagellated spiral bacterium that colonizes the stomach of half of the world’s population. Researchers have hypothesized that maternal hormonal and immunological changes during pregnancy that prevent allogenic rejection of fetus reactivates the bacterium. Aim of the work is to compare between patients with hyperemesis gravidarum and normal pregnancy regarding presence of Helicobacter pylori antibodies for proper management. Materials and Methods: A case-control study was carried out on ninety pregnant women at 5-15 weeks of gestation, thirty pregnant females with single living fetus complaining of HG (Group A), Thirty pregnant females who were multiple pregnancy and/or trophoblastic disorders complaining of HG (Group B) and Thirty pregnant females with normal pregnancy (Group C). Serum test for H. pylori IgG antibody titer was done for all patients and controls using enzyme immunoassay-based kit. Results: H. pylori were noted in 32 hyperemetic cases and 6 control subjects. The presence of H. pylori increased the risk of HG more than two fold (OR = 2.923, 95% CI: 1.326-6.446, P < 0.05). Conclusion: There is powerful correlation between H. pylori and hyperemesis gravidarum which proved in single, multiple pregnancy and/or trophoblastic disorders.

Background: Colorectal cancer (CRC) determination is focused on clinical, serological and endoscopic observations These methods are considered as non-invasive, cost-effective and convenient clinical examination methods. A direct association between M2 Pyruvate Kinase (M2-PK) and separate oncoprotein is the product of dissociation of tetrameric form from dimeric structure in tumor cells. The aim of this analysis is to assess the sensitivity in high risk or symptomatic populations of fecal tumor M2-PK. Methods: This study is a cross sectional study carried out on 50 patients who were categorized into two groups: 25 patients with colorectal neoplasms (group 1). 25 patients symptomatizing of: diarrhea, persistent abdominal discomfort or bleeding per rectum, without colorectal neoplasms (group 2). Results: The median value of stool M2-PK showed statistically significance. At cut-off ≥ 70 of stool M2-PK to predict activity, sensitivity was 88%, specificity was 84%, PPV was 84.6% and NPV was 87.5%. AUC was 0.907 and P value was

Protozoal water contamination is an alarming cause of countless waterborne outbreaks. The mosteminent causal protozoa are Cryptosporidium and Giardia species (spp.) as they can endure aquaticenvironment even with chlorine disinfectants. The currently used traditional techniques cannot permitan easy detection of the waterborne protozoa concerning their count, viability, and pathogenicity. Thepresent work detected protozoal contamination of the drinking water in Egypt with the determinationof their load, viability and potential pathogenicity. Four techniques were compared including conventionalstaining techniques, immunofluorescence (IF) staining, flow cytometry (FC) and molecularstudy. Also, viability was assessed by conventional trypan blue stain and nucleic acid stain. Along ayear, 64 water samples were collected and concentrated from water tanks and tap water of differentdistricts, significant differences (P < 0.001) was between the different techniques in each season regardingthe detection of Giardia cysts and Cryptosporidium oocysts. Number of total positive sampleswas significantly higher in tank water than tap water (P < 0.001) especially at summer. Flow cytometryand nested polymerase chain reaction (nPCR) proved to be much more sensitive than IF assay, andconventional staining techniques. Regarding viability, nucleic acid stain was more sensitive than trypanblue stain (P < 0.001). Also, C. parvum predominate other Cryptosporidium genotypes.

Background: Gestational diabetes mellitus (GDM) defined as glucose intolerance, which is first detected during pregnancy. Adiponectin is a protein that secreted from both adipose tissue & placenta in pregnancy. 1,5 anhydroglucitol in a steady-state normally and almost completely reabsorbed in renal tubules. Serum levels decreased in periods of hyperglycemia due to increased urinary excretion. The objective of this study is to predict gestational diabetes by measuring serum adiponectin, and 1, 5 anhydroglucitol during the first trimester. Materials and Methods: This case-control study was conducted on 50 patients who attended inpatient and outpatient clinics Obstetrics & Gynecology Department. The study population grouped in two groups, Group A and B. Each group was comprised of 25 cases. Group I (25 cases): with high risk for gestational diabetes. Group II (25 cases): with no risk locates for developing gestational diabetes. Serum glucose level and adiponectin 1,5 anhydroglucitol was measured by ELISA method in the first trimester. Results: The mean levels of the Adiponectin (μg/ml) and the 1,5 AG were significantly lower in GDM women (5.2 ± 2.1μg/mL,) and (6.8 ± 5.7μg/mL,) respectively compared to women without GDM (7.8 ± 2.4μg/mL) and (9.8 ± 4.2μg/mL) respectively (p = 0.001). The correlation between Adiponectin and BMI >30KG/M2, Fasting plasma glucose in the study group I with a significant correlation between in the first trimester. ROC curve of 1,5 AG was conducted for developing gestational diabetes. Excellent AUC was found (AUC = 0.907, p

Background: Hospital-acquired pneumonia is a major medical problem even in developed countries. It is the most common nosocomial infection reaching 25% of all infections in the intensive care unit (ICU). Aim: Aim is to study the radiographic findings of hospital acquired pneumonia in collaboration with laboratory and clinical findings in pediatric intensive care unit. Patients and Methods: A prospective study on 60 pediatric patients admitted to PICU. Cases were divided into two groups. Group A: 30 cases with clear chest x-ray on admission and developed Hospital Acquired Pneumonia (HAP) after 48 hours. Group B: 30 cases with Community Acquired Pneumonia (CAP) on admission. Both groups were subdivided into mechanically ventilated and non-Mechanically Ventilated (MV and non-MV). Results: Regarding X-ray in 1st day there was significant increase in CAP compared with HAP in the form of Bronchopneumonia and lobar pneumonia with effusion. X-ray in HAP had significant worsening in 3rd day compared with 1st day in both MV and non-MV groups. Otherwise no difference was found between groups. Regarding CT Chest, there was statistically significant increase in Bronchopneumonia in non-MV CAP compared with other groups. Also, there was statistically significant increase in Rt. Upper lobar pneumonia in MV HAP compared with other groups. Similarly, there was statistically significant increase in Lt. pleural effusion with underling consolidation collapse of lower lobe in MV HAP compared with other groups. There was statistically significant increase in Rt. pleural effusion with underling consolidation collapse of rt. Lung in non-MV CAP compared with other groups. There was statistically significant increase in Bronchopneumonia with Rt. minimal pneumothorax in MV CAP compared with other groups. Otherwise, there was no significant difference between the studied groups. Conclusion: Hospital acquired pneumonia was worse radiologically and bacteriologically. Hence, need more time to heal and more aggressive therapy was needed. Clinical pulmonary infection score was predictor for mortality. Predictors for length of stay (LOS) were found total leukocystic count (TLC), Absolute Neutrophilic Count (ANC), ESR and Culture & Sensitivity of bronchial secretions.

Background: Endoglin (CD105), a cell membrane glyco-protein of approximately 180kDa, has been described as a proliferation-associated antigen of leukemia and endothelial cells, and it represents a powerful marker to quantify tumor angiogenesis. CD105 expression is higher on leukemic cells with immature morphological and phenotypic characteristics compared to normal hematopoietic progenitors. Higher amounts of sCD105 were measured in AML and Chronic Myeloproliferative Disorders (CMD) patients than in healthy subjects. CD105 is involved in the control of vascular en-dothelial cell proliferation, adhesion and migration. CD105 might have a direct involvement in cancer by increase of tumor mass. CD105 levels may be useful as an indicator for disease progression and to identify patients at risk of recurrence and metastasis.Aim of Study: Our aim is to evaluate the role of endoglin (CD 105) expression in patients with AML to clarify its role as a prognostic marker.Material and Methods: This study was carried out on 50 patients with newly diagnosed acute myeloid leukemia who attended the Hematology/Oncology Unit of Tanta University Hospitals. The patients were selected for the study on the basis of standard clinical, hematological and immune pheno-typic criteria for diagnosis of AML. CD105 expression was measured in bone marrow aspirate of AML patients using RD SYSTEMS kits and BD FACS calibur.Subjects included in this study were divided into two groups according to CD 105 exppression; positive and negative groups and classified according to FAB subtypes and immu-nophenotypic features.Results: There was a significant difference in distribution of CD105 expression in different FAB subtypes. There was a significant positive correlation between CD 105 expression and Hb concentration, WBCs count and blast count in periph-eral blood and BM. There was no significant correlation between CD105 expression and platelets count and serum LDH level. Kaplan-Meier survival curve show significant higher overall survival and disease free survival in negative CD105 expression group than in positive CD105 expression group.Conclusions: Positive CD105 expression levels are asso-ciated with a bad outcome in AML patients and its expression can be easy determined in routine flow cytometric analysis. Therefore, it should be regularly investigated as a bad prog-nostic factor for assessment of AML patients.

Background: Gestational anemia increases the incidence of maternal and fetal complications. Adjuvant recombinant human erythropoietin (rHuEPO) has been used in patients who refuse blood transfusions, have a low response to treatment with iron iron sucrose, have limited time before birth, or have other illnesses that complicate the anemia. We demonstrated that the use of adjuvant rHuEPO with iron sucrose reduces the anemia time period and is innocuous to the fetus.Aim of the Study: To evaluate the efficacy of Recombinant Human Erythropoietin in the pregnant Patients with Iron Deficiency Anemia.Patients and Methods: This is a prospective study includ-ing 70 pregnant women with iron deficiency anemia attending to the out-patient clinic of the department of Obstetric and Gynecology of Tanta University Hospital from June 2016 till June 2017. Divided into two groups, Group (A) Include (35) patients; received 200mg (10ml) iron sucrose intravenously twice weekly. Group (B) Include (35) patients; received 200 mg iron sucrose intravenously twice weekly and reco mbinant human erythropoietin (rhEPo) subcutaneous twice weekly.Results: We found that group B shows higher level of serum iron than group A in second sample but differences still insignificant p-value 0.077. But group B shows lower level of serum ferritin than group A in the same sample and the difference is significant p-value 0.042 but it had higher level Hb level & Hematocrite & MCH and Reticulocytic count. The mean Hb level was 11g/dl ranging from (10.5 to 11.5) and 11.7g/dl ranging from (10.8 to 12.6) in group A&B respectively.Hemoglobin levels are raisied by up to 2.7g/dL and 3.2g/dL in group A&B respectively.Conclusion: The use of adjuvant recombinant human erythropoietin can safely enhance the efficacy of iron sucrose in the treatment of gestational iron-deficiency anemia that did not respond to oral supplementation.

Pleural effusion is relatively common clinical condition that requires differential diagnosis. It is defined as collection of fluid in pleural space. Pleural effusion is often diagnostic dilemma for the physician. The aim of the study was to assess the procalcitonin (PCT) and C-reactive protein (CRP) levels in serum and pleural fluid to evaluate their usefulness in the differentiation among benign and malignant pleural effusions. This study was conducted in Chest Department, Tanta University Hospital, it included 54 adult patients with pleural effusions of different etiologies, 8 transudative effusion, 14 para-pneumonic effusion, 14 tuberculous effusion and 18 malignant effusion. We measured serum and pleural procalcitonin and C-reactive protein by ELISA. The mean serum and pleural fluid procalcitonin (PCT) levels in parapneumonic effusions were significantly higher compared with transudative, tuberculous and malignant pleural effusions p < 0.05. A significant positive correlation between serum and pleural fluid PCT levels was observed in the studied groups. The mean serum and pleural fluid CRP concentration were significantly lower in malignant and transudative pleural effusion than tuberculous and para-pneumonic effusion p < 0.05. Significant positive correlation between serum and pleural fluid CRP levels was observed in the studied groups. Procalcitonin levels in serum and pleural effusion were significantly lower in malignant effusion compared to para-pneumonic pleural effusion and CRP levels were significantly lower compared to other types of exudative pleural effusion.

Background Tissue hypoxia due to repeated sleep apneas leads to evolution of reactive oxygen stress and serum levels of uric acid (UA) and lactate in patients with obstructive sleep apnea syndrome (OSAS). Objective The objective of this study was to determine whether there is an association between OSAS and both serum UA and lactate levels as potential markers of tissue hypoxia and their relation with OSAS severity. Participants and methods Thirty participants were classified into two groups. Group I included 10 control persons matched to obstructive sleep apnea (OSA) patients by sex, age, and BMI. Group II included 20 patients with OSA as diagnosed by polysomnography [apnea–hypopnea index (AHI)≥5]. The following were conducted: full history, clinical examination, complete overnight polysomnography to detect AHI, oxygen saturation parameters, and snoring index. Finally serum lactate and UA levels were assessed through two samples of peripheral arterial blood: one before sleep and the second at the end of polysomnography. Results In OSA patients, the mean levels of serum UA and lactate both before and after sleep were significantly higher compared with controls with significant overnight increase after sleep and high percent of change of serum UA and lactate levels. These higher levels were independent of age, sex, and BMI. Moreover, UA and lactate levels after sleep in OSA patients were significantly correlated with OSA severity (AHI) and degree of nocturnal hypoxia through positive correlation with (%TST Conclusion Both serum UA and lactate may be considered as potential markers of tissue hypoxia and related to OSAS severity. Their levels were significantly elevated after sleep with significant overnight rise and significant positive correlation with AHI, %TST

We investigated the feasibility of profiling and measuring the concentration of clusterin in urine and serum for individuals with transitional cell carcinoma (TCC) of the bladder and comparing it with nontumor controls. In addition, we analyzed the correlation of expression of clusterin in specimens of TCC to various clinicopathologic parameters and prognosis of bladder cancer. Blood and urine samples were used from 68 patients with TCC of the bladder and from 61 patients with benign urological diseases. Enzyme-linked immunosorbent assays (ELISA) were performed for clusterin from serum and urine. Quantitation of clusterin mRNA was carried out in 68 bladder tumor specimens from radical cystectomy or transurethral resection and 26 normal bladder specimens from BPH patients by using RT-PCR method. Correlation for the expression of clusterin mRNA with clinicopathologic parameters was analyzed. Serum and urine clusterin was significantly higher in individuals with bladder cancer than control (p = 0.001). Sensitivity and specificity of serum and urine clusterin as a tumor marker for TCC of the bladder was found to be 80%, 91%, 87.1% and 96.7% respectively. Clusterin expression was significantly higher in TCC specimens than normal tissue specimens (P < 0.001). Expression of clusterin was significantly higher in patients with invasive TCC of the bladder than that in patients with superficial TCC and control (P < 0.001). Overexpression of clusterin mRNA was significantly associated with tumor recurrence and overall survival (p < 0.001). The recurrence-free survival time of patients with overexpression of clusterin was significantly shorter than that of patients with weak expression of clusterin (9.8 months vs. 35.2 months). Clusterin may be considered as a potential diagnostic and prognostic biomarker for bladder cancer using urine, serum and/or molecular biology techniques.

Background Nitric oxide (NO) has an important effect on blood pressure, arterial wall, and the basal release of endothelial NO in hypertension (HPN) may be reduced. Until now, there is no solid data revealing the potential role of the polymorphism of the nitric oxide synthase gene (NOS) in patients with HPN and microvascular angina. Aim The aim of the present study is to investigate the gene of endothelial nitric oxide synthase (eNOS), as the polymorphism of this gene may be a putative candidate for HPN and initiate the process of atherosclerosis. Methods Sixty participants were recruited for this study; 50 were hypertensive patients complaining of chest pain [30 of them have electrocardiogram (EKG) changes of ischemia], 20 had isolated HPN, and 10 healthy volunteers served as control. All patients underwent stress myocardial perfusion imaging (MPI) and coronary angiography. Genotyping of eNOS for all patients and controls was performed. The linkages between HPN, microvascular angina and eNOS gene polymorphism were investigated. Results MPI and coronary angiography revealed that 15 patients had chest pain with true ischemia and reversible myocardial perfusion defects (multiple and mild) but normal epicardial coronary arteries (microvascular angina), while 15 patients had significant coronary artery disease (CAD), and 20 hypertensive patients showed normal perfusion scan and coronary angiography. The prevalence of the NOS G298 allele was higher in the hypertensive group with microvascular angina (documented by MPI) than it was among the control participants (P Conclusion eNOS gene polymorphism is proved to be an important etiology in microvascular angina (x-syndrome) among hypertensive patients. In addition, the eNOS mutant gene showed a significant increase in isolated HPN and in patients with CAD.

Background: Acute mesenteric ischemia (AMI) is a life-threatening problem, and the early clinical manifestations of it are non-specific. Despite the advances in laboratory & radiological diagnostic procedures, the mortality rate of AMI is still high. Aim: The purpose of the study to evaluate the ability of α-glutathione S-transferase (α- GST) to predict AMI in patients with abdominal pain. Methods: This prospective study was conducted in Tanta University Hospitals between November 2014 and December 2017. Nighty patients were included after clinical suspicious of AMI. Serum levels of α- GST were measured in the collected stored samples, and other biochemical markers were performed (e.g. LDH, PH, and WBC). AMI was confirmed by CT angiography or laparotomy. Patients without ischemic bowel were considered to be controls. Results: A total of 90 patients in the study, the ischemic group included 52 patients, and the non-ischemic group included 38 patients. Patients with intestinal ischemia had significant higher serum values of D-dimer, LDH and α –GST. Where α –GST diagnosed AMI by accuracy of 84.4%. Conclusion: Measurement of plasma α -GST is a simple, early, easy, and effective procedure making it a useful serum biomarker for early diagnosis of AMI.