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Background: Psoriasis is a chronic inflammatory, immune-mediated systemic disease with skin manifestations that typically follow a relapsing and remitting course. The most common form, plaque psoriasis, occurs in ∼80–90% of psoriatic patients. Objective: The aim of the current work was to evaluate level of serum testosterone in psoriasis male patients and its relation to severity of the disease. Patients and methods: This cohort study included a total of 35 psoriatic patients, attending At Outpatient Clinic, Dermatology and Venereology Department, Zagazig University Hospital, Egypt. This study was conducted between January 2020 to October 2020. Serum free and total testosterone and total cholesterol were measured. Result: About two thirds of the studied group (71.4 %) had normal testosterone level and (28.6 %) had low testosterone level. Conclusion: Low serum total and free testosterone levels in male psoriasis patients are present and they correlate with disease severity.

Objective This study aims to identify the risk factors for cardiovascular mortality in melanoma patients. Methods Data of melanoma patients were obtained from the Surveillance, Epidemiology, and End Results database. We used Person's chi-square test to assess the relationships between categorical variables. We used Kaplan-Meier test in the univariate analysis and Cox regression test for the multivariate analysis. Analyses were conducted using the SPSS software. Results We analyzed data of 194 503 melanoma patients. Among them, 28 818 (14.8 %) died due to cardiovascular diseases. Cardiovascular-specific survival was higher in younger patients, women, married, localized disease, superficial spreading melanoma and in patients who had surgery. It was lower in patients who received chemotherapy or radiotherapy. The multivariate analysis revealed a higher risk of cardiovascular mortality in patients aged 50-64 years [hazard ratio (HR), 7.297; 95% confidence interval (CI), 6.68-7.97], patients aged ≥65 years (HR, 43.309; 95% CI, 39.706-47.240), men (HR, 1.535; 95% CI, 1.475-1.597), Blacks (HR, 1.29; 95% CI, 1.044-1.594), separated (HR, 1.286; 95% CI, 1.058-1.562), widowed (HR, 1.829; 95% CI, 1.706-1.961), patients with no or unknown history of chemotherapy (HR, 1.302; 95% CI, 1.071-1.583) or radiotherapy (HR, 1.477; 95% CI, 1.217-1.793) and patients with no surgery (HR, 1.468; 95% CI, 1.264-1.706). Conclusions In patients with melanoma, the risk of cardiovascular death is higher in older patients, men, Blacks, separated, widowed and patients with nodular or lentigo maligna melanoma. The risk is lower in married, patients with superficial spreading or acral lentiginous melanoma, and patients who had chemotherapy, radiotherapy or surgery.

Background The main purpose is to investigate the effect of LiCO3 as an add-on therapy with radioactive iodine in increasing the cure and decreasing the T4 level compared to radioactive iodine alone. The primary outcome is the cure rate as defined by the number of hyperthyroid patients who became euthyroid or hypothyroid. The secondary outcome is the T4 level. Methods Four databases were searched (PubMed, Scopus, Web of Science, and Cochrane central library). The inclusion criteria were randomized and non-randomized clinical trials of hyperthyroidism patients receiving LiCO3 with radioiodine compared with hyperthyroidism patients receiving radioactive iodine alone. Included studies were appraised with the risk of bias version 2 tool, according to the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Results Nine studies were eligible for inclusion in the study, six randomized control trials and three non-randomized control trials. There were 477 patients in the intervention group and 451 patients in the control group. The cure rate was not significantly different between the two groups, while it was significantly increased with 5000 to 6500 mg optimized cumulative dose of LiCO3 compared with the control group, P = 0.0001. The T4 level showed no significant difference between the two groups, P = 0.13. Conclusions LiCO3 adjunct to radioactive iodine did not show significant differences compared with radioactive iodine alone in terms of cure rate or decreasing T4 level. However, the dose of 5000 to 6000 mg of LiCO3 may increase the cure rate.

Purpose We aimed to assess the efficacy and safety of flow-diverter stents (FDs) in the management of posterior circulation cerebral aneurysms and compare FD efficacy between anterior and posterior circulation aneurysms. Methods We searched the PubMed, Scopus, Cochrane, and Web of Science databases for relevant studies through March 2020. Studies assessing FDs for posterior circulation aneurysms that included ≥20 treated aneurysms were included. Moreover, the studies compared FD efficacy between anterior and posterior circulation aneurysms were included. Data regarding angiographic aneurysmal occlusion, procedural complications, mortality, and morbidity were extracted and pooled in a random-effects meta-analysis model. Results Fourteen studies with a total of 659 patients and 676 posterior circulation aneurysms were included. The pooled rate of aneurysmal occlusion at long-term angiographic follow-up was 78% [95% confidence interval (CI), 71–85]. The pooled rates of intraparenchymal hemorrhage, ischemia, and procedure-related mortality and neurological morbidity were 2%, 8%, 7%, and 6%, respectively. Complete occlusion occurred in 82.4% of the posterior circulation aneurysm subgroup and 77.5% of the anterior circulation aneurysm subgroup. The difference was not significant (relative risk 1.01; 95% CI, 0.86–1.19; p = 0.91). Regression analysis showed that elderly patients and females had higher morbidity. Conclusion Posterior circulation aneurysms can be effectively treated with FDs with comparable occlusion rates to those in anterior circulation aneurysms. However, periprocedural complications are not negligible.

Objective: To describe the mortality difference between acute ischemic stroke (AIS) and non-AIS groups within COVID-19 patients. Materials & methods: We included observational studies through September 2020 that categorized COVID-19 patients into two groups (with and without AIS). Results: Eight studies with a total sample size of 19,399 COVID-19 patients were included. The pooled risk difference showed that patients with COVID-19 who developed AIS had significantly higher mortality than those without AIS by a risk difference of 24% (95% CI: 0.10–0.39; p = 0.001). In two studies, the COVID-19+AIS group had significantly higher lymphocytes, procalcitonin and creatinine levels. Conclusion: Developing AIS significantly adds to the mortality of COVID-19. Timely interventions to manage those patients are strongly recommended., Lay abstract We systematically searched for COVID-19 studies that categorized patients into two groups: with and without acute ischemic stroke (AIS). Of 5100 unique records, eight studies with a total of 19,399 COVID-19 patients were included. The overall mortality rate of COVID-19 patients who developed AIS was 29.6% compared with 2.6% in those without AIS. We therefore conclude that development of AIS increases the mortality rate of COVID-19, and recommend timely intervention for such patients.

Khellin was successfully extracted from Ammi visnaga fruits with a recovery percent of 96.15%. Next radio-iodination of Khellin was successfully achieved with a high yield. The biodistribution study of [131I]iodo-khellin in tumour bearing mice revealed that khellin preferentially localization at tumour tissue. Target prediction study for [131I]iodo-khellin revealed that PI3K and VEGFR are potential targets for iodo-khellin with good affinity. The results of this study potentiate [131I]iodo-khellin as a good theranostic agent for tumour imaging and therapy.

Background: Dexamethasone has analgesic and antiemetic actions that have been documented in the literature. Therefore, we performed a systematic review and meta-analysis to investigate its overall effectiveness in reducing a variety of negative outcomes after cesarean section. Objectives: To investigate the efficacy and safety of dexamethasone for reducing pain associated with cesarean section, nausea, vomiting, pruritus, postoperative need for analgesia, postoperative antiemetic requests and headache. Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science for relevant clinical trials. We then performed a systematic review and meta-analysis, including only randomized, placebo-controlled clinical trials. Our main population target was women undergoing elective cesarean delivery. The intervention under consideration was dexamethasone administered both by intravenous (IV) or subcutaneous (SC) over a variety of doses. The comparator was a placebo. Our main outcomes included: (1) perceptions as indicated by pain scores, (2) occurrence of nausea and (3) occurrence of vomiting. Secondary outcomes included: (4) occurrence of pruritus, (5) need for postoperative analgesia, (6) need for postoperative antiemetic drugs and (7) occurrence of headache. We assessed the quality of included studies using the risk of bias tool described in Cochrane's handbook for systematic reviews of interventions. Results: We found that dexamethasone seemed to significantly reduce scores for pain at rest (p

Background: Epilepsy and headache are the two most common neurologic disorders affecting individuals of all ages worldwide. The relation between headache and epilepsy is complicated, and the comorbidity of headache and epilepsy is still poorly understood. Aim of the work: Study of headache characteristics in controlled and uncontrolled epileptic patients. Methods: We evaluated headaches in 100 consecutive patients with epilepsy attending the outpatient clinic and epilepsy clinic at Sohag university hospital and performed interictal EEG to all patients. Results: In our study we found that the occurrence of headaches being linked to longer duration of epilepsy, high frequency of seizures and use of polytherapy of antiepileptics. Conclusion: Control of seizures in epileptic patients help in controlling headaches and decrease its frequency.

BACKGROUND Abdominal binder is a non-pharmacological method of relieving pain after surgical procedures. OBJECTIVES To evaluate the effectiveness of the abdominal binder in relieving pain and distress scores after cesarean delivery (CD). SEARCH STRATEGY The following terms were searched: cesarean section, cesarean, caesarean, abdominal deliveries, C-section, abdominal delivery, abdominal binding, binder, and abdominal binder. SELECTION CRITERIA Randomized controlled trials (RCTs) with patients undergoing CD receiving an abdominal binder compared with non-users of the abdominal binder. DATA COLLECTION AND ANALYSIS Five electronic databases were searched until November 2019. Records were screened for eligibility. Data were extracted independently and analyzed. The main outcomes were pain and distress scores. RESULTS The final analysis included six RCTs. Overall effect estimate favored the abdominal binder group over the control group in the following outcomes: VAS pain scores after 24 h (mean difference [MD] -1.76; 95% confidence interval [CI] -3.14 to -0.39; P = 0.01), VAS scores after 48 h (MD -1.21; 95% CI -1.51 to -0.90; P

Background: Urinary tract infections UTIs occur repeatedly after stroke and are related to bad outcomes with increased rates of deterioration in neurological state during hospitalization, death or long term disability as well as increased length of hospitalization. Factors found to predict UTI include stroke severity, depressed consciousness level, increased post-void residual urine volume, and diabetes mellitus. Stroke severity appears to be the most important predictor of infection risk. We aimed to determine the risk factors associated with UTI after acute stroke, and its association with outcome. Subjects and Methods: This is prospective cohort study. We analysed clinical data of 100 patients with first ever ischemic stroke. We assessed risk factors for UTI, as well as clinical outcome. Results: Urinary tract infection was found in 72% of our subjects. On univariate analysis, patients with UTI were more likely to have had a more severe stroke, more likely to be catheterized and more likely to have a higher serum creatinine level. The multivariate analysis revealed that greater stroke severity was independently associated with increased risk of developing UTI. Greater stroke severity measured by CSS was independently associated with unfavorable outcome on discharge. Conclusion: UTI is common after acute stroke. It is associated with more severe stroke.

Brucellosis is considered as endemic disease of animals and humans since thousands of years in Egypt. However, brucellosis in pigs has never been reported in Egypt. Thus, serological and molecular assays were applied to detect anti-Brucella antibodies and DNA in serum samples collected from pigs. In total 331 blood samples collected from male and female pigs at slaughterhouses of Cairo and Giza governorates were investigated using Brucella c- and i-ELISA and Brucella real-time PCR. Anti-Brucella antibodies were detected in 16 (4.83%) and 36 (10.8%) sera by i-ELISA and c-ELISA, respectively. Brucella DNA was detected in 10 (3.02%) seropositive samples and identified as Brucella melitensis (7/10) and Brucella suis (3/10). A higher prevelance was found in boars. This is the first study investigating pig brucellosis in Egypt. The results of this study will raise awareness for brucellosis in these farm animals and will help to develop effective control strategies.

Objectives Pregnancy after kidney transplant has a high risk for maternal and fetal complications; however, it can be successful if patients are properly selected. Here, we studied outcomes and complications of pregnancies in kidney transplant recipients who received calcineurin inhibitor-based immunosuppression. Materials and methods In this case control study, we reviewed patients who became pregnant between 2004 and 2017. For this analysis, each pregnancy was considered an event. We divided pregnancies into 2 groups according to calcineurin inhibitor-based maintenance immunosuppression: group 1 (49 pregnancies) received cyclosporine, and group 2 (33 pregnancies) received tacrolimus. Patients also received steroids and azathioprine. Patients had regular antenatal follow-up at the Hamed Alessa Organ Transplant Center (Kuwait) and in the maternity hospital (monthly until month 7 and then weekly until delivery). Results Of 750 female kidney transplant recipients within childbearing potential, there were 82 pregnancies (10.9%) in 49 recipients (6.5%). Seventy-eight pregnancies were planned, and 4 pregnancies occurred while women were using contraception. There was 1 triple pregnancy, 5 double, and 76 single pregnancies. Two women had preeclampsia as maternal complication, 2 had uncontrolled hypertension, and 7 developed graft dysfunction. Forty-seven women (57.3%) had caesarean section, and the remaining had vaginal deliveries. Of 89 babies, 86 were viable (1 intrauterine fetal death and 2 abortions). Eight babies were delivered prematurely with low birth weight, and 2 needed incubators. Mean serum creatinine levels were 97.9 ± 24, 109 ± 38, 100 ± 39, 120 ± 46, and 115 ± 57 μmol/L at baseline, first, second, and third trimesters, and postpartum, respectively. Twelve patients showed high panel reactive antibodies but without donor-specific antibodies. Conclusions Posttransplant pregnancy can be successful in most renal allograft recipients, but the increased risk of fetal and maternal complications, including low birth weight, spontaneous abortus, and preeclampsia, should be considered.

Introduction HCV is a health problem that confronts many countries in the world. Those patients will develop complications like cirrhosis and HCC, which is one of the most common cancers in the world, especially in Egypt, and considered the third leading cause of death worldwide. The prognosis of HCC is still dismal due to the late diagnosis. miRNAs are small, short noncoding RNAs, which have roles in the diagnosis of HCC. In our study, we focus on biological aspects of miRNAs. We report that miR-501 is strongly expressed and observed in the process of HCC development. miR-501 regulation is important as an oncofetal relevant to the diagnosis of HCC. Method This study was conducted on 100 adult patients; 25 patients were positive for anti-HCV and 25 patients were negative for HCV and enrolled as a control group. Patients were categorized into three groups: fibrosis (n = 25), CHC (n = 25), and HCC (n = 25) related to HCV evident by CT abdomen. All patients and controls were subjected to full clinical assessment and laboratory investigation. Blood (8 mL) was withdrawn from subjects, and 3 mL was collected in EDTA tubes for processing total RNA extraction and miRNA. The remaining 5 mL was left for determination of biochemical parameters. miRN-501 expression levels were determined by RT-PCR. Results The data revealed a significant increase in levels of AST, ALT, ALP, and CBC in both HCC and CHC groups compared to controls. The results of miRNA expression showed that miR-501 was higher in the HCC group than non-HCC group at P1.1. Conclusion miR-501 can be used as a noninvasive biomarker for early diagnosis of HCC among patients with HCV on account of its affectability for HCC.

Introduction Hematological complications such as neutropenia, thrombocytopenia, and anemia of DAAs/ribavirin in HCV can result in suboptimal outcomes. This study was aimed to investigate the frequency of hematological variations and their impact on the response to DAA therapy. Patients were defined as having hematological abnormalities if they had the presence of either/or a combination of the following hematological parameters at least once during the first month of treatment: drop in (Hb) level, TLC, and PLT count. Pretreatment, Hb, WBC count, and PLT count were not statistically related to the treatment response. However, lower count of all parameters was associated with moderate or advanced hepatic fibrosis stages according to the METAVIR scoring (P < .001). Static analysis showed that drop in Hb, TLC, and PLT count was significantly associated with response to treatment; P < .001, .21, and .41, respectively. Methods Fifty-eight patients for treatment of chronic hepatitis were studied. Their hematological parameters including TLC, Hb, and platelet counts were recorded before starting antiviral therapy and then at 3 monthly intervals. All the patients were given DAAS/ribavirin as antiviral therapy. Data were collected over a period of 3 months. Results Fifty-eight patients with mean (SD) age of 54.38 (12.67) years were studied. There was a mean hemoglobin (Hb) fall of 1.5 g/dL at the first 4 weeks of antiviral therapy. Mean TLC fell to 1.03 × 10⁹/L in the first month. A similar downward trend was noted in platelet values with a mean fall of 12.3 × 10⁹/mm in the first month of the antiviral therapy. Of the cases, 41.4% developed clinically significant anemia as evidenced by hemoglobin 11 g/dL after 4 weeks of antiviral therapy; this fall was noted only in first 4 weeks of treatment. Conclusion Significant hematological abnormalities occurred within the first 4 weeks of antiretroviral therapy. There was significant decrease in hemoglobin level.

ABO blood group was first discovered by Landsteiner in 1901. Currently, there are more than 30 blood group systems, but ABO system remains the most clinically important of all blood groups in transfusion practice. The ABO blood group system antibodies are naturally occurring without any exposure to RBCs through transfusion or pregnancy, unlike the other blood group systems. Method The study was performed on a total of 40,591 healthy blood donors in Egypt. ABO and Rh (D) groupings were performed on all donors’ samples. Data on the frequency of ABO and Rh(D) blood groups were reported in numbers and percentages. Results The study showed that type A is the most common blood group (35.12%) in Egypt followed by O at 31.94%, followed by B at 23.12%, while AB had the least prevalence at 9.74%; A > O > B > AB. Our study showed that 91.78% of the donor population were Rh positive and 8.22% were Rh negative. The frequencies of the IA, IB, and IO alleles were calculated using the Hardy-Weinberg law of equilibrium. The calculated gene frequencies are 0.2537 for IA (p), 0.1812 for IB (q), and 0.5651 for IO (r). In the Egyptian population, O (r) records the highest value, followed by B (q) and A (p); O > B > A. The homozygous types were as follows: OO, 31.94%; AA, 6.43%; and BB, 3.28%. The heterozygous types were AO, 28.67%; BO, 20.47%; and AB, 9.78%. Conclusions The study provides the first accurate ABO gene frequency data as well as information on the distribution of ABO blood group Rh groups of various alleles in the Egyptian population. This information is very helpful in the effective management of the blood bank inventory. It will help transfusion services planning for future health challenge and improve blood transfusion practice.

MATERIALS AND METHODS Laparoscopic nephropexy was performed in 8 consecutive cases with symptomatic nephroptosis through suturing and fixation of a polyprolene mesh between the posterior surface of the kidney and quadratus lumborum muscle. All patients had symptomatic nephroptosis. Preoperatively, intravenous urography and a split renal scan in supine and upright positions were done for all patients. RESULTS The operation was successfully completed laparoscopically in all cases with a mean operative time of 135 minutes without major perioperative complications. The median blood loss was 60 mL. Hospital stay was 3.2 days (range, 2 to 6 d). Seven cases improved significantly after operation in a mean follow-up of 1.5 years. The success rate of this study is 87.5%. CONCLUSIONS Laparoscopic nephropexy using polyprolene mesh is a minimally invasive, suitable, and clinically established procedure for the treatment of symptomatic nephroptosis with good results in comparison with open surgery.