Abstract: Background: Hormones of the thyroid gland play an important role in the regulation of various metabolic processes. Disturbances in thyroid hormone concentrations may lead to hyperlipidemia and obesity, thus contributing to NAFLD. Aim: To evaluate thyroid dysfunction and determine its possible relationship to nonalcoholic fatty liver disease (NAFLD) in obese adults. Methods: our cross-sectional study recruited 100 obese patients, patients were subjected to a full medical history, physical examination, abdominal ultrasonography as well as routine laboratory tests in addition to liver function and thyroid function testing. NAFLD was recognized on the basis of ultrasonographic findings, and in the absence of other causes of liver disease. Results: Patients was divided in two groups, Group 1 (65 patients) with NAFLD and Group 2 (35 patients) without NAFLD. Out of 100 patients recruited in the study; the most common thyroid dysfunction was overt hypothyroidism (22%) followed by (9%) had subclinical hypothyroidism. 26 patients with NAFLD (40%) were found to have thyroid dysfunction, of them 8 NAFLD patients (12.3%) had subclinical hypothyroidism and 18 NAFLD patients (27.7%) had overt hypothyroidism. Although Prevalence of thyroid dysfunction (whether overt hypothyroidism or subclinical hypothyroidism) was 22 % and 9 % respectively among patients with obesity, there was non-significant positive correlation between BMI and TSH (r= 0.051 and P=0.612). Multivariate regression analysis revealed that; fatty liver , obesity index and dyslipedemia were predictors of thyroid dysfunction in obese patients. Conclusion:Thyroid hypofunction is common in obese patients with NAFLD, which has implications for screening for hypothyroidism in patients with NAFLD and for the administration of appropriate therapy for hypothyroidism.
Keywords: Non-alcoholic fatty liver disease, Hypothyroidism, Obesity.

Key Words
Chronic hepatitis C • Hepatocellular carcinoma • Vimentin • LaminB1 • Antiku 86
Abstract
Background/Aims: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and
most frequently develops in patients with cirrhosis. Surveillance strategies are recommended
in high-risk groups because early detection of small lesions improves the likelihood of
curative treatment. This study investigated the prospective clinical significance of serum levels
of anti-Ku86 and plasma levels of lamin B1and vimentin as early markers of HCC. Methods:
We recruited 74 patients at Assiut University Hospital—37 with HCC and 37 with chronic
liver disease (liver cirrhosis patients)—and 36 age- and sex-matched healthy controls. Lamin
B1 and vimentin mRNA expression levels were evaluated by reverse transcription-PCR and
serum levels of anti-Ku86 were measured by enzyme-linked immunosorbent assay. Results:
Compared with liver disease patients and controls, HCC patients showed higher levels of lamin
B1 mRNA (sensitivity, 96%; specificity, 65%), vimentin mRNA (sensitivity, 94%; specificity, 92%),
and anti-Ku86 (sensitivity, 94%; specificity, 80%). LaminB1 levels were significantly higher in
patients with a tumor size < 2 cm than in patients with tumors 2–5 cm and >5cm in size. Lamin
B1 had significant positive correlations with alpha-fetoprotein (AFP) (P=0.034) and anti-Ku86
(P=0.002). Receiver operating characteristic curves for differentiating HCCfrom liver cirrhosis
revealed a higher area under the curve(AUC).for vimentin than for AFP, lamin B1, and anti-Ku86
for the diagnosis of HCC (P<0.001). Conclusion: Circulating levels of anti-Ku86, lamin B1,and
vimentin might be potential surrogate markers of HCC, either alone or in combination with
AFP. However, independent and discriminative serological biomarkers with higher sensitivity
and specificity are still needed for the early detection of HCC.

Abstract
Background: The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated
by the presence of hypertension. Therefore, proper control of BP in diabetic hypertensive patients is essential. Few
studies have specifically investigated the prognostic significance of central BP in Egyptian populations with diabetes
and hypertension and its relation with cardiovascular outcome. This study aims to evaluate relation between central
BP and diabetic composite cardiovascular complications.
Results: Diabetic patients with CVD were significantly older (p value < 0.01), obese (p value < 0.01) with long duration
of diabetes (p value < 0.001) and had significantly higher peripheral and central systolic and diastolic BP and higher
AIx@75(p values < 0.01) than those without CVD. Regarding the metabolic parameters, they had significantly higher
fasting blood glucose, HbA1c, and higher blood cholesterol levels (p values < 0.001), higher LDL (p value < 0.01), triglycerides
levels (p value = 0.014), and microalbuminuria (p value = 0.028). Logistic regression analysis found increased
BMI, central systolic BP, and AIx@75 were independent predictors of composite CVD (p values < 0.05).
Conclusions: There is a pattern of favorability towards central rather than peripheral BP indices to predict the occurrence
of CVD in diabetic patients.
Keywords: Type 2 diabetes, Central blood pressure, Composite cardiovascular diseases, Assiut University Hospitals

Abstract. The abstract provides a concise summary of the study on the dietary beliefs and habits of patients with Inflammatory Bowel Disease (IBD) in Egypt. It encompasses key findings, patient perceptions, dietary practices, and comparisons with international studies. The abstract emphasizes the significance of cultural factors, the preference for personalized diets, and the use of dietary tools in managing IBD symptoms. The study's limitations and implications for patient education are also acknowledged. Overall, the abstract serves as a comprehensive overview, inviting further exploration into the intricate relationship between dietary behaviors and IBD in the Egyptian context.
Keywords: DiaInflammatory Bowel Disease (IBD), Personalized Diets, Microbiota, Patient Perceptions, Oriental Foods
 

Abstract. Background and purpose: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disorder with hepatic fat deposits. Emerging data have highlighted the co-existence of NAFLD and inflammatory bowel diseases (IBDs); both of which are increasingly prevalent disorders with significant complications. This study was designed to evaluate the frequency of NAFLD among patients with IBDs. Methods: Cross sectional study was conducted on a total of 178 patients with IBDs. All participants were subjected to history taking and clinical evaluation including abdominal ultrasound to assess frequency of non-alcoholic fatty liver disease in those patients. Results: Out of those patients, 49 (27.5%) were found to have NAFLD while the other 129 (72.5%) patients didn’t have NAFLD based on ultrasound evaluation. Grade of NAFLD among those patients was; grade 1, grade 2 and grade 3 in 37/49 (75.5%), 6/49 (12.2%) and 6/49 (12.2%) patients, respectively. Both groups of patients with and without NAFLD had insignificant differences as regard baseline data with exception of significantly higher frequency of hypertension among patients with NAFLD. Also, those patients had longer duration of the disease and higher frequency of steroid use. Based on the current study, predictors for NAFLD among patients with IBDs were hypertension, disease duration > 5 years, previous flare and steroid therapy. Conclusion: Patients with IBDs are at risk to develop NAFLD that may progress to serious outcomes. So, patients with IBDs should be regularly screened for NAFLD by simple non-invasive methods as abdominal ultrasound.
Keywords: non-alcoholic fatty liver, inflammatory bowel disease, hepatic steatosis, steatohepatitis, liver echogenicity.

Abstract
Background and aim: Cirrhotic patients have increased mortality and longer hospital stay due to increased susceptibility to develop bacterial infection. Herein, we aimed to evaluate the role of neutrophil to lymphocytes ratio(NLR) and high sensitivity C-reactive protein(Hs-CRP) in diagnosis of infection and prediction of short term mortality in hospitalized cirrhotic patients. Patients and methods: The study included 50 cirrhotic patients hospitalized in ICU of a central Liver hospital. The presence of overt infection was evaluated. The NLR was calculated as the ratio of the neutrophils to lymphocytes in the peripheral blood. Hs-CRP concentration was measured by Immunoturbidimetric assay. Model for End-Stage Liver Disease(MELD) score, Child-Pugh score and the presence of systemic inflammatory response syndrome(SIRS) were assessed.
Results: The main cause of admission was refractory ascites(50%), followed by hematemesis(24%), spontaneous bacterial peritonitis(18%) and hepatic encephalopathy(8%). Development of SIRS occurred in 24(48%) patients and death occurred in 15(30%) patients. NLR and Hs-CRP were significantly higher in patients who developed SIRS(0.03and P= 0.01) respectively. For predicting short-term survival, MELD score, NLR and Hs-CRP were significant factors(P = 0.03, 0.01 and 0.01 respectively).
Conclusion: NLR and Hs-CRP are helpful diagnostic markers of infection and development of SIRS in hospitalized cirrhotic patients. In addition to the classical MELD score, NLR may be a useful predictor of the short-term mortality in hospitalized cirrhotic patients particularly in Child–Pugh class C.
Keywords: high sensitivity C-reactive protein, Neutrophil-to-lymphocyte ratio, Liver cirrhosis, SIRS, short-term Survival

The effect of nonalcoholic fatty liver disease (NAFLD) on outcome of patients with ST‑segment
elevation myocardial infarction is controversial. The purpose of the study aimed to assess the
effect of NAFLD on myocardial and epicardial reperfusion after primary percutaneous coronary
intervention (PPCI) among nondiabetic patients.
Patients and methods
A total of 240 nondiabetic patients with ST‑segment elevation myocardial infarction were
recruited and underwent PPCI. After revascularization, epicardial reperfusion had been
assessed by thrombolysis in myocardial infarction (TIMI) flow grades and TIMI frame
count, and myocardial reperfusion had been assessed by TIMI myocardial perfusion grade
and ST‑segment resolution. NAFLD had been assessed and graded based on abdominal
ultrasonography and then the patients were subdivided into NAFLD group (111 patients) and
non‑NAFLD group (129 patients).
Results
The overall prevalence of NAFLD in the current study was 46.5%. Clinically, KILLIP class more
than I was significant in NAFLD group [24 (P < 0.001)]. Multivessel coronary artery disease was
significant in NAFLD group [63 (56.8%) vs. 23 (17.8%); P < 0.001]. Eleven patients of NAFLD
group died, whereas no deaths occurred in the other group. Postprocedural myocardial blush
grades 0 and 1 were significant in patients with NAFLD group (P < 0.001). Moreover, absent
ST‑segment resolution and TIMI frame count were significant (P < 0.001) in NAFLD group.
Finally, NAFLD was an independent predictor for in‑hospital and follow‑up cardiac events.
Conclusions
NAFLD is considered an independent risk factor for the occurrence of in‑hospital and follow‑up
adverse cardiac events after PPCI in nondiabetic patients.