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Purpose To evaluate the diagnostic efficacy of quantitative liver MR imaging using diffusion-weighted imaging (DWI) and normalized apparent diffusion coefficient (ADC) in diagnosis and staging of liver fibrosis and cirrhosis in egyptian patients with hepatitis C virus (HCV) infection and compare the results with transient elastography (FibroScan). Materials and Methods Twenty-five patients known to have hepatitis C virus were enrolled after fulfilling inclusion and exclusion criteria.. Quantification of liver, spleen and muscle ADC values was done using MRI DWI sequences using 4 different b-values (0, 200, 400, 800). Normalized ADC was calculated as the ratio of liver ADC to spleen ADC.. Post processing was performed using 3D synapse ADC viewer Tool. Results Liver ADC failed to distinguish different stages of fibrosis, except between stages 2 and 3 (p = 0.016). Normalized liver ADC distinguished between individual groups of fibrosis , with significant differences between mild stages (stage 0/1) and sever stages of fibrosis (stages 3) and between stages 0/1 and cirrhosis (stage 4). There were significant differences between stages 0–2 and 3–4 using normalized liver ADC. There was a statistically significant moderate correlation between fibrosis stage and normalized liver ADC (r = −0.403; p = 0.009). ROC analysis revealed higher performance using normalized liver ADC compared with liver ADC, with higher AUC, sensitivity, and specificity for detection of cirrhosis (stage 0 vs 4 and stages 0–3 vs 4), moderate-to-advanced fibrosis (stages 2–4), and advanced fibrosis and cirrhosis (stages 3–4), reaching significance for all comparisons except for diagnosis of stage 4 (cirrhosis). Conclusion Our results suggest that normalizing liver ADC with spleen ADC improves diagnostic accuracy for detection of liver fibrosis and cirrhosis in egyptian population when using breath-hold diffusion-weighted imaging.

The study aims to evaluate the presence of metabolic syndrome (MetS) among Egyptian systemic lupus erythematosus (SLE) patients. Additionally, we intended to determine the association of MetS with disease activity, clinical and laboratory features. This cross-sectional study included adult SLE patients diagnosed and followed in rheumatology outpatient clinics. The demographic data, clinical and laboratory parameters were assessed for all patients. Disease activity was measured using SLE Disease Activity Index (SLEDAI-2k). Patients were diagnosed to have MetS according to The National Cholesterol Education Program Adult Treatment Panel III (NCEP). The characteristics of SLE patients and their disease status were compared between those with and without MetS. A total of 74 SLE patients were included; mean age was 32.1 ± 10.9 years and 87.8% were females. Twenty-five (33.8%) SLE patients had neuropsychiatric lupus (NPSLE), with headache the most common manifestation. MetS was diagnosed in 45.9% of the SLE group. Patients with MetS had significantly older age, delayed age of diagnosis and higher SLEDAI-2k scores (p = 0.015, p = 0.014 and p = 0.019, respectively) compared to those without MetS. NPSLE was significantly correlated with MetS (r = 0.32, p = 0.006) and in particular with higher central obesity (r = 0.43, p

Background Involvement of the wrist joint is very frequent in approximately 70% of rheumatoid arthritis (RA) patients. Magnetic resonance imaging (MRI) benefits of high sensitivity and specificity in the evaluation of RA joints make it a worthy surrogate gold standard in diagnosis. Availability of musculoskeletal ultrasound (MSUS)with low costs and also patient friendly manner, might be a very good diagnostic substitute for screening. Conventional radiography(CR) can provide only indirect information on synovial inflammation, however, the technique is insensitive to early bone damage. Objectives We aimed to examine whether MSUS can provide information on signs of inflammation and destruction in RA wrist joint in early and late disease and compare the findings with MRI and CR. Methods Eighty RA patients with wrist joint involvement were selected from those attending Rheumatology outpatient’s clinics of Assiut and Alazhar university hospitals. Patients were then classified into two groups according to the disease duration as follows:Group A: included patients with early RA (≤ 2 years). Group B: included patients with long standing RA (≤ 2 years). All patients were subjected to complete history taking and clinical examination with assessment of disease activity according to DAS-28 in addition to the comparative CR, MSKUS and MRI. Results MSUS is more sensitive than CR in the detection of erosions both in early and late RA however the sensitivity increased significantly in late disease (0.45 versus 0.63). The ability of the three imaging modalities in detecting erosions was found to be more remarkable in the group of late RA with P value ˂0.001. With MRI as the reference, the sensitivity and specificity of MSUS for all studied cases collectively were 76.4% and 72% respectively. In the group of early RA (Group A), the sensitivity and specificity of MSUS were 45.5% and 70% respectively, while those for CR were 18.2% and 100% respectively. In (Group B), the sensitivity of MSUS was 84% while the specificity was 80%. For CR the sensitivity was 63% while the specificity was 80%. In the detection of soft tissue abnormality, the sensitivity and specificity of MSUS for all studied cases were 85.2% and 89.5% respectively with high agreement between MSUS and MRI (Kappa = 0.66). In the group of early RA, the sensitivity and specificity of MSUS were 88% and 83.3% respectively. Whereas, they were 83.3% and 92.3% in the group of established RA. the detection of soft tissue abnormality was significantly correlated with disease activity in patients of group (B) with p value of 0.01 for MRI and 0.03 for MSUS. Conclusions Musculoskeletal Ultrasonography is a sensitive tool and comparable to MRI in the diagnosis of bone erosions and joint inflammation in early and late rheumatoid wrist. It is more sensitive than conventional radiography in the detection of erosions with increasing sensitivity on long standing disease. It is also more sensitive than clinical examination in the detection of inflamed wrist joint in both early and long standing RA. Musculoskeletal US should become of increasing relevance to rheumatologists, and be widely applied in daily clinical practice. Disclosure of Interest None Declared

Clarias lazera fishes have been examined for helminth parasites. The following parasites were identified Orientocreadium batrachoides (Tunbangui, 1931), Glossidium pedatum (Looss, 1899), Polyonchoborthrium clarias (Woodland, 1925), Procmaollanus leveiconchus (Railliet and Henery, 1915) and Paracamallans cyathopharynx (Baylis, 1932).

This work aims at modeling, simulating and analyzing the dynamic performance of the first egyptian pressurized water reactor nuclear power plant as a power supply in a forecasted national power system. A digital simulator has been developed which incorporates nonlinear mathematical models for: a PWR, pressurizer, steam generator, coolant pumps, steam and hydro-turbines, synchronous machines, loads and other network components, plant controllers and speed governors. The results obtained include: 1. The dynamic response of the nuclear plant following the forced outage of two of the feeding Transmission Lines (T.L's.), i.e. 21 % loss of the area power supply. 2. The overall system frequency behaviour following the disconnection of the PWR plant. 3. A comparison between Dynamic Energy Balance (DEB) frequency calculations of the overall power system (represented by its center of inertia) and the transient stability calculations of the nuclear plant system frequency following the loss of 28 % of the area power supply.

Protein and fat deficiency diet produced significant reduction of Giardia cysts in rats, while vitamin A, D and iron deficiency diet had no effect on cyst count. On the other hand pathological changes due to Giardia infection encountered in small intestine and liver were aggravated by the diet deficiency induced.