A Simple Scoring Model Predicting the Outcome of COVID-19 Patients: Tanta COVID Score.

Background: COVID-19 is a worldwide pandemic with high rates of morbidity and mortality, and an uncertain prognosis leading to an increased risk of infection in health providers and limited hospital care capacities. In this study, we have proposed a predictive, interpretable prognosis scoring system with the use of readily obtained clinical, radiological and laboratory characteristics to accurately predict worsening of the condition and overall survival of patients with COVID-19.

Methods: This is a single-center, observational, prospective, cohort study.

Tanta Protocol for Management of COVID-19: Perspectives from a Developing Country.

In late 2019, SARS-COV-2 disease was firstly discovered in Wuhan, China and then it infected millions of people worldwide. Later, the World Health Organization (WHO) described COVID-19 as the first pandemic invading the world in the 21st century. The WHO has declared that the emerging infection will last long enough to force adjustments not only in people's lifestyles but also in the health care system.

HCV and HEV: two players in an Egyptian village, a study of prevalence, incidence, and co-infection.

The highest recorded hepatitis C virus (HCV) prevalence worldwide is in Egypt. A high prevalence of hepatitis E virus (HEV) in chronic liver disease has been reported. The aim of this study was to study prevalence, incidence, and outcome of HCV infection in an Egyptian Nile Delta village and the relation between HEV infection and HCV-related chronic hepatic affection.

Efficacy of a non-invasive model in predicting the cardiovascular morbidity and histological severity in non-alcoholic fatty liver disease.

Background: Insulin resistance (IR) in cases of non-alcoholic fatty liver disease (NAFLD) is connected to remarkable liver cell inflammation and cardiovascular complications. Given the prevalence of NAFLD and its association with potential sequels, there is a strong need for an accurate non-invasive tool to monitor the progression of NAFLD.

Methods: 272 patients with NAFLD and cardio-metabolic risk factors were tested for HOMA-IR, mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR), uric acid, ferritin, lipid profile, liver stiffness measurement (LSM), controlled attenuation parameter (CAP) by fibroscan and carotid intima media thickness (CIMT).

Evaluation of the blood ammonia level as a non-invasive predictor for the presence of esophageal varices and the risk of bleeding.

Background/aims: The development of esophageal varices (EV) and resultant bleeding are the most critical complications of portal hypertension. Upper gastrointestinal endoscopy is the gold standard for diagnosis of EV. To find a non-invasive method for diagnosis of EV and to predict the bleeding risk is appealing and would decrease the cost and discomfort of upper endoscopy.

may be an initiating factor in newly diagnosed ulcerative colitis patients: A pilot study.

Aim: To directly visualize () by the highly sensitive and specific technique of immunohistochemical staining in colonic tissue from patients newly diagnosed with ulcerative colitis (UC).

Methods: Colonoscopic biopsies from thirty patients with newly diagnosed UC and thirty controls were stained with Giemsa stain and immunohistochemical stain for detection of in the colonic tissue. Results were confirmed by testing Ag in the stool then infected patients were randomized to receive either anti treatment or placebo.

Blood Ammonia Level Correlates with Severity of Cirrhotic Portal Hypertensive Gastropathy.

Background: Portal hypertensive gastropathy (PHG) is a common anomaly with potential for bleeding found in portal hypertension. Blood ammonia levels correlate well with liver disease severity and existence of portosystemic shunts. Increased ammonia results in vasodilation and hepatic stellate cell activation causing and exacerbating portal hypertension.

Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis.

Background And Aims: Muscle cramps markedly affect the quality of life in cirrhotic patients with no available highly effective treatment. The aim of this study was to assess the safety and efficacy of orphenadrine in the treatment of muscle cramps in cirrhotic patients.

Methods: The study enrolled 30 liver cirrhosis patients complaining of frequent muscle cramps (≥3 per week), who were randomized to receive either orphenadrine 100 mg or calcium carbonate 500 mg twice daily as a control for one month.

A Randomized Controlled Trial Comparing Nitazoxanide Plus Lactulose With Lactulose Alone in Treatment of Overt Hepatic Encephalopathy.

Background And Aims: Hepatic encephalopathy (HE) is a reversible spectrum of neuropsychiatric abnormalities associated with liver dysfunction. Lactulose is a nonabsorbable disaccharide presently used to treat HE. Nitazoxanide (NTZ) has a broad-spectrum activity against urease-producing bacteria, so it decreases ammonia production and is therefore expected to reverse the symptoms of HE.

Randomized trial of preoperative administration of oral pregabalin for postoperative analgesia in patients scheduled for radiofrequency ablation of focal lesions in the liver.

Purpose: The aim of this study was to evaluate the effect of preoperative pregabalin on postoperative analgesia in patients undergoing radiofrequency ablation (RFA) of hepatic focal lesions (HFLs).

Methods: This randomised controlled study was carried out on 70 adult patients for whom RFA was indicated to treat hepatocellular carcinoma. They were randomised into two groups: Group I: 35 patients who were given a placebo before the procedure and Group II: 35 patients who were given 150 mg of oral pregabalin one hour before the procedure.

High numbers of myeloid derived suppressor cells in peripheral blood and ascitic fluid of cirrhotic and HCC patients.

Background: Hepatocellular carcinoma (HCC) is the 3rd most common cause of cancer-related death worldwide. It has evolved different immune escape mechanisms, which might include emergence of lymphoid and myeloid regulatory cells. Aim of this work: To determine the numbers of Myeloid-derived suppressor cells (MDSCs) in peripheral blood and ascitic fluid in cirrhosis and HCC and their relation to IFN-γ and α-fetoprotein (α-FP).

Anti-Nuclear Cytoplasmic Antibody-Associated Vasculitis: A Probable Adverse Effect of Sofosbuvir Treatment in Chronic Hepatitis C Patients.

Egypt has the largest hepatitis C virus (HCV) epidemic worldwide. Sofosbuvir is an antiviral drug acting by inhibition of the HCV NS5B polymerase. It has shown high efficacy in combination with several other drugs and has a low reported rate of side effects.

Randomized controlled trial of scleroligation versus band ligation alone for eradication of gastroesophageal varices.

Background And Aims: Gastric varices develop in 5% to 33% of patients with portal hypertension. Their most common form is concomitant gastroesophageal varices. Scleroligation (combined sclerotherapy and band ligation) has been used successfully in management of esophageal varices but has not been evaluated previously in the management of gastroesophageal varices.

Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study.

Background: Globally, hepatocellular carcinoma (HCC) is the third most frequent cause of cancer-related mortality. In recent years, transarterial chemoembolization, radiofrequency ablation, and microwave ablation (MWA) have been accepted as treatment modalities for patients with surgically unresectable HCC.

Aim Of This Work: This study aimed to compare combination treatment with radiofrequency or MWA, followed by transarterial chemoembolization, and performed in a single session.

Pigtail Catheter: A Less Invasive Option for Pleural Drainage in Egyptian Patients with Recurrent Hepatic Hydrothorax.

Background and Aims. Treatment of hepatic hydrothorax is a clinical challenge. Chest tube insertion for hepatic hydrothorax is associated with high complication rates.

A 2-week Nitazoxanide-based quadruple treatment as a rescue therapy for Helicobacter pylori eradication: A single center experience.

As there are increasing reports of fluoroquinolone resistance on use as a first- or second-line treatment for Helicobacter pylori (H pylori), we aimed at evaluation of the efficacy and safety of nitazoxanide-based regimen as a rescue regimen in Egyptian patients whose previous traditional treatment for H pylori infection failed.In total, 100 patients from the outpatient clinic of the Tropical medicine department, Tanta University hospital in whom the standard triple therapy (clarithromycin-based triple therapy) failed were enrolled in the study. Nitazoxanide (500 mg bid), levofloxacin (500 mg once daily), omeprazole (40 mg bid), and doxycyclin (100 mg twice daily) were prescribed for 14 days.

Correlation of platelets count with endoscopic findings in a cohort of Egyptian patients with liver cirrhosis.

Screening endoscopy is recommended for early detection of esophageal varices (EVs) in cirrhotic patients with portal hypertension. However, this approach is limited by its invasiveness and cost. The aim of the study was to determine if platelet count can predict the presence of EVs, especially large (grade III, IV) EVs in need of prophylactic therapy, in a cohort of Egyptian patients with liver cirrhosis.

Endoscopic Ultrasound Staging of Upper Gastrointestinal Malignancies.

Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past.

Higher Grades and Repeated Recurrence of Hepatic Encephalopathy May Be Related to High Serum Manganese Levels.

Hepatic encephalopathy is a serious complication of liver failure. Until now, the precise pathophysiologic mechanisms are not fully determined. It has been demonstrated that manganese plays an important role in the pathogenesis of hepatic encephalopathy.

Gastroenterologists and interventional radiologists: friends or foes? A multidisciplinary approach for solving gastrointestinal problems.

While endoscopy used to have more therapeutic abilities than radiology, interventional radiology is now racing to lead the minimally invasive diagnostic and therapeutic techniques in medicine as well as surgery. Expecting the new epidemic of hepatocellular carcinoma, radiologists and gastroenterologists are on the run competing in many procedures that are needed. While some radiologists worry about non-radiologists who "intervene" in radiology, many gastroenterologists defend their specialty.

Indications and outcome of colonoscopy in the middle of Nile delta of Egypt.

Background: In Egypt, few data are available on the outcome of colonoscopy. Epidemiologic studies have shown that inflammatory bowel disease (IBD) tends to increase. Endoscopists have reported an increasing incidence of IBD and colorectal cancer (CRC).

GB virus C/hepatitis G virus in serum and liver of patients with chronic C and non B non C hepatitis: molecular and immunological aspects.

GB virus C/hepatitis G Virus (HGV) is a single-stranded RNA virus that is transmitted parenteraly. This study investigates GB virus C in 62 patients with chronic hepatitis C (CHC) and non B non C hepatitis (CNBNC). The viral E2 protein was examined in the sera of the patients (using western blott assay) while viral replication in the liver was examined by detecting the negative strand of HGV-RNA and its E2 protein in liver tissue using in situ hybridization and immunohistochemical staining respectively.