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Rheumatoid arthritis (RA) is characterized by ongoing joint destruction. MicroRNAs (miRs) are blood-based biomarkers linked to RA pathogenesis. The musculoskeletal ultrasonography seven-joint score (US7) is an objective tool to assess RA activity. We aimed to evaluate miR-223 and miR-16 roles in monitoring RA activity and to investigate if there is a link between their plasma levels and US7 score. This study enrolled 76 RA patients classified according to Disease Activity Score 28-joint count with erythrocyte sediment rate (DAS28-ESR) to inactive cases (n = 38) and active cases (n = 38). Each patient's joint was scored for synovial proliferation (gray-scale ultrasound 'GSUS7') and vascularization (power Doppler ultrasound 'PDUS7'). Real-time quantitative PCR was used to measure the expression levels of miR-16 and miR-223 in plasma. When compared to inactive group, the active group revealed significant upregulation of miR-16 and miR-223, (P = 0.001 and P = 0.02, respectively). miR-16 and miR-223 levels were correlated with synovitis PDUS7 (r = 0.34, p0.01 and r= 0.25, P = 0.03, respectively). miR-16 was also positively correlated with synovitis GSUS7 (r= 0.42, p0.001). miR-223 upregulation discriminated active from inactive RA patients at AUC = 0.64, with 76% sensitivity and 50% specificity at cutoff 2.8-fold change), whereas miR-16 distinguished the two groups at AUC = 0.78 with 87% sensitivity and 53% specificity at cutoff38.27-fold change. In conclusion, upregulated miR-16 may have more potential to serve as activity biomarkers than miR-223 in RA. The miR-16 level was linked to synovitis GSUS7 and synovitis PDUS7 changes but miR-223 only linked to synovitis PDUS.

IntroductionSleep disordered breathing (SDB) represents common comorbidities of childhood obesity leading to interrupted sleep and sleep deprivation. Sleep deprivation alters secretion of brain-derived neurotrophic factor (BDNF), which is an appetite regulator. However, little is known about the relation between BDNF and central obesity in children with SDB. The aim of the study was to evaluate BDNF level and anthropometric indices in relation to SDB in children with obesityMaterial and methodsA prospective case-control study was conducted on 30 children with obesity (BMI > 95th percentile) and 30 healthy lean children (BMI 5th-85th percentile). Polysomnographic, anthropometric data and BDNF serum level were obtained from all included children. Serum level of BDNF and anthropometric indices of obesity were assessed in relation to SDB in children with obesity. Regression analysis was done to determine predictors for SDB in children with obesity.ResultsIn comparison to healthy controls, anthropometric indices of central obesity were significantly higher while BDNF was significantly lower in obese children, especially those with SDB. Respiratory disturbance index has a significant positive correlation with anthropometric indices of central obesity and a significant negative correlation with BDNF level. Central obesity and decreased BDNF were associated with 2-fold increased risk for SDB. Waist circumference/height ratio and neck circumference/height ratio have 89.5%, 75% sensitivity and 81.23%, 84.62% specificity at a cutoff point > 0.62, > 0.24 respectively for prediction of SDB in children with obesity.ConclusionsCentral obesity and decreased BDNF represent independent predictors for SDB in children with obesity. Anthropometric indices adjusted to height are a simple screening tool for SDB in obese children.

Nehal Farouk,1 Walaa Mohamed Omar Ashry,2 Hanan A EL-Hagrasy,3 Eman F Mohamed,4 Heba H Eltrawy,5 Asmaa M El-Nasser,6 Walaa Shipl,7 Shahinaz El Attar,7 Lobna Kh Sakr,8 Maisa A Abdel Wahab,1 Eman M Abdelsalam,4 Fawzia A Sharaf,3 Inass Hassan Ahmad9 1Vascular Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Microbiology and Immunology Department, Damietta Faculty of Medicine (Girls), Al-Azhar University, Damietta, Egypt; 3Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 4Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5Chest Diseases Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 6Medical Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 7Medical Biochemistry and Molecular Biology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 8Radio-Diagnosis Department, faculty of medicine for girls, Al-Azhar University, Cairo, Egypt; 9Endocrinology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EgyptCorrespondence: Heba H Eltrawy, Chest Diseases Department, Faculty of medicine for girls, Al-Azhar University, Cairo, Egypt, Tel +20 1006381297, Email hebahamed182@gmail.comBackground and Aim: Deep venous thrombosis (DVT) of the lower extremities is common in Covid-19 patients. Interleukin (IL)-6 and P-selectin were found to be elevated in Covid-19 patients. The current study aimed to evaluate P-selectin and IL6 in Covid-19 patients with DVT and to explore its relation to clinical and laboratory parameters in those patients.Patients and methods: The present retrospective study included 150 hospitalized COVID-19 patients diagnosed on the basis of a positive result of reverse-transcriptase polymerase chain reaction (RT-PCR) test. Laboratory assessments were included for IL-6 and P selectin assessments via enzyme-linked immunosorbent assay. The primary outcome of the present study was the development of DVT detected by Doppler ultrasound (DU) evaluation of the lower extremities during the admission.Results: The present study included 150 hospitalized Covid-19 patients. DVT was developed in 59 patients (39.3%). DVP patients had significantly higher levels of P selectin [76.0 (63.0– 87.0) versus 63.0 (54.3– 75.0), p < 0.001] and IL-6 [37.0 (27.0– 49.0) versus 18.5 (13.5– 31.5), p < 0.001]. ROC curve analysis revealed good performance of P selectin [AUC (95% CI): 0.72 (0.64– 0.81)] and IL-6 [AUC (95% CI): 0.79 (0.71– 0.86)] in identification of DVT. Logistic regression analysis identified the presence of severe disease [OR (95% CI): 9.016 (3.61– 22.49), p < 0.001], elevated P selectin [OR (95% CI): 1.032 (1.005– 1.059), p = 0.018] and elevated IL-6 [OR (95% CI): 1.062 (1.033– 1.091), p < 0.001] as significant predictors of DVT development in multivariate analysis.Conclusion: The present study identified a probable role of elevated P-selectin and IL-6 levels in the DVT development in hospitalized Covid-19 patients.Keywords: Covid-19, deep venous thrombosis, interleukin 6

Metabolic syndrome (MetS) in men is a common problem. Several studies highlight that testosterone deficiency is associated with metabolic disorders that may be explained by "myokines". Irisin is an adipo-myokine that has beneficial metabolic effects.To evaluate serum testosterone in a sample of Egyptian men with MetS diagnosed by NCEP ATP III, and correlate it with serum irisin level.A total of 90 men (60 with MetS and 30 healthy age-matched controls) participated in the study. Testosterone level is estimated by an automated system, Irisin level was measured by ELISA.Circulating irisin was positively correlated with serum testosterone and was significantly lower in patients with MetS.This study highlights the effect of serum testosterone on irisin formation from skeletal muscle. Recommendations

Background Vitamin D has a wide range of biological functions. The presence of vitamin D receptors (VDRs) in many tissues explains its diverse actions. The VDR gene is highly polymorphic, with many single nucleotide polymorphisms. The FokI polymorphism in the VDR gene is the only polymorphism that influences the size of the translated protein. Type 2 diabetes mellitus (T2DM) is a growing problem worldwide, it results from a complex of inheritance and environment interactions. Vitamin D deficiency and VDR gene polymorphism FokI have been linked to T2DM and diabetic microvascular and macrovascular complications. Aim The aim of this study is to determine the association of VDR gene polymorphism FokI with T2DM and diabetic microvascular and macrovascular complications in postmenopausal women. Participants and methods This study was carried out on 200 postmenopausal Egyptian women (50 healthy controls, 50 patients with T2DM without microvascular or macrovascular complications, 50 T2DM patients with microvascular complications, and 50 T2DM patients with macrovascular complications). VDR FokI genotypes were determined by PCR-restriction fragment length polymorphism analysis and hydroxy vitamin D (25OHD) levels were measured by enzyme linked immunosorbent assay. Results The prevalence of the polymorphic genotypes ff and the f allele was statistically significantly increased in diabetic patients than in controls (P