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Aim of the study: Metabolic associated steatotic liver disease (MASLD) is one of the most frequent chronic liver diseases in the world; macrophage activation is reflected by increased expression of CD163, which sheds as serum soluble CD163 that is linked to hepatic steatosis, inflammation, and fibrosis. Aim of the study was assessment of liver macrophage activation and hepatic histopathological changes in patients with MASLD. Material and methods: A total of 30 patients with MASLD and equal numbers of age- and sex-matched healthy controls were enrolled in the study. Quantitative serum levels of soluble CD163 (sCD163) were determined using a commercially available standard sandwich ELISA kit. Core liver biopsies were obtained from patients with MASLD and evaluation of CD163 using anti-CD163 Ab-1 (Clone 10D6) - mouse monoclonal antibody. Results: The median sCD163 level was significantly higher in patients with MASLD compared with healthy controls. It can discriminate patients with MASLD from healthy controls at a cut-off value of 814 pg/ml. sCD163 level and intrahepatic total CD163-positive cell count were positively correlated, and both showed positive correlations with nonalcoholic fatty liver disease activity score. Conclusions: Soluble CD163 can discriminate MASLD patients from healthy controls after the exclusion of other causes of inflammation. [ABSTRACT FROM AUTHOR]

Aim of the study: The study aimed to investigate serum and ascitic fluid D-dimer level in patients with liver cirrhosis with and without ascites and to evaluate the impact of spontaneous bacterial peritonitis (SBP) on circulating serum and ascitic fluid D-dimer levels. Material and methods: This study was conducted on 60 subjects who were further subdivided into group I comprising 15 patients with liver cirrhosis and no ascites, group II comprising 15 cirrhotic patients with ascites, group III comprising 15 cirrhotic patients with ascites and SBP, and group IV comprising 15 healthy controls. All patients were subjected to full history taking, physical examination, laboratory investigations, and measurement of serum D-dimer in all groups and ascitic fluid D-dimer in groups II and III. The diagnostic performance of serum D-dimer was tested to detect SBP. Results: Serum D-dimer differed significantly between groups III and IV, whilst no significant differences were detected between the other groups and group IV. Moreover, group III showed a significantly higher level of serum D-dimer. Ascitic fluid D-dimer mean levels showed no statistically significant differences. A statistically significant positive correlation was found between serum D-dimer level and ascitic fluid D-dimer in group III, r = 0.682. Using a sensitivity and specificity level of 80%, a cut-off value (COV) of > 323.2 ng/ml could differentiate between patients with SBP and patients with ascites only. Conclusions: Serum D-dimer significantly correlated with ascitic fluid D-dimer in patients with SBP, whereas no significant correlation was found in patients with cirrhotic ascites without bacterial infection. D-dimer showed good diagnostic performance for SBP among patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C Virus (HCV) is widely prevalent in Egypt. There is an evidence of neurocognitive dysfunction even in the absence of advanced liver disease in patients with chronic HCV infection. The patients are more likely to manifest impairments in the quality of life, fatigue, and depression than patients with liver disease of other etiology. Objective: The work aimed to study the impact of HCV infection on cerebral functions using cerebral Magnetic-Resonance Spectroscopy (MRS). Patients and Methods: The study included two groups; A patients' group composed of 20 chronic, drug-naïve HCV patients and a control group composed of 20 healthy subjects. MRS and Psychometric assessment were done including Mini-Mental State Examination (MMSE), Fatigue Severity Scale (FSS) and 17-Item Hamilton Depression Rating Scale (HDRS). Results: Chronic HCV patients scored worse on both FSS and 17- Item HDRS than Controls, and showed an altered spectroscopic metabolic ratio along white matter at the level of the centrum semiovale bilaterally. The choline/creatine, ratios and N-acetyl aspartate/creatine ratios were significantly higher in the white matter of the patients compared to healthy volunteers. There was a positive correlation between abnormal spectroscopic findings and the severity of fatigue and depression. Conclusion: The altered cerebral metabolism in patients with chronic hepatitis C infection (with preserved liver functions) suggested that HCV may exert a direct effect on brain function. [ABSTRACT FROM AUTHOR]