Impact of Hepatitis C Virus Eradication Following Direct Acting Antivirals on Liver Stiffness Measurement

Background Hepatitis C infection is a disease with significant global impact, about 130150 million people chronically infected with the hepatitis C virus (HCV), representing about 2-2.5% of the world’s population. In Egypt, the prevalence is 10% and according to the last DHS in 2015 it was 7%. Aim of the Work to evaluate the effect of SVR using DAAs on the stage of the liver fibrosis in HCV patients by measuring of liver stiffness, using transient elastography before and after receiving treatment. Patients and Methods This study was conducted in co-operation between Gastroenterology and Hepatology Department, AinShams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute between January 2019 to September 2019. It included 103 adult Egyptian patients who received SOF/DAC for three months and were assessed before and after achieving SVR-24. The patients were recruited from the outpatient clinic of Theodor Bilharz Research Institute Hospital (after consents were obtained). Results study showed that achieving SVR-24 was associated with improvement of LSM assessed by Transient Elastography and application of FIB-4 score and overall improvement of liver biochemistry as shown by reduction of AST, ALT and serum bilirubin and increase of serum albumin, INR and platelets. This was accompanied by increase of hemoglobin, Creatinine and BMI. The study also showed despite the fact that results were accompanied by significant improvement in LSM, Fib-4 and liver biochemistry, achieving SVR did not guarantee improvement of cirrhosis; only 29% of cirrhotics regressed to sub-cirrhotic range (LSM <12.5 kPa). Conclusion Sofosbuvir / Daclatasvir combination is effective and well tolerated for treatment of genotype 4 chronic hepatitis C patients. Achieving SVR-24 was associated with significant improvement of LSM using transient elastography to assess liver fibrosis. Achieving SVR-24 was associated with overall improvement of liver biochemistry. Improvement of LSM was more in cirrhotic patients than non-cirrhotic patients.

Programmed Death-Ligand 1 (PD-L1) Gene Polymorphisms as Predictive Markers for Development of Hepatocellular Carcinoma in Chronic Hepatitis C Virus Patients

Background Hepatocellular carcinoma is the sixth most common cause of cancer, and ranks fourth among the causes of cancer-related death. Major risk factors for HCC include chronic alcohol consumption, hepatitis B, hepatitis C and non-alcoholic fatty liver disease. Other, less common causes are Wilson’s disease, hereditary hemochromatosis, alpha1-antitrypsin deficiency, primary biliary cirrhosis and autoimmune hepatitis. Objective To investigate the associations of the genetic variants of PD-L1 (rs4143815 and rs2297136) with the risk of HCC in the Egyptian population. Patients and Methods This study was conducted in co-operation between Gastroenterology and Hepatology Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute “between” March 2020 to July 2020. It included total participants of 138 Divided to Group (A): 35 normal people as control. Group (B): 51 patients with HCV infection and cirrhosis Group (c): 52 patients with HCV infection and cirrhosis with HCC. The patients were recruited from the outpatient clinic of Theodor Bilharz Research Institute Hospital (after consents were obtained). Results Also, the present study demonstrated that the functional polymorphisms (rs4143815) (CG) of the PD-L1 gene were associated with HCC risk as it is expressed in (53.3%) in HCC, (25.6%) in cirrhosis and (23.1%) in control group. And, rs4143815 (CG) show significant increase in Child C patients as (75%) Child C vs. (10%) Child A and (45%) was MELD/NA (20-29) vs. (10%) <9 with (61%) of patients were stage D in BCLC. There is significant increase in rs4143815 (CG) with age as 95% of gene positive patients more than 50years.With no significant in gender as 70% males and 30% females and there is no significant in smoking and DM. So, PDL-1 gene polymorphism rs4143815 (CG) could be used as a predictive marker for HCC after validation by larger studies or met analysis. Conclusion The present study demonstrated that the functional polymorphisms (rs4143815) (CG) of the PD-L1 gene were associated with HCC risk as it is expressed in (53.3%) of HCC, (25.6%) of cirrhosis and (23.1) % of control group. There is significant increase in rs4143815 (CG) with age as 95% of gene positive patients more than 50 years with no significance in gender smoking and DM. rs4143815 (CG) show significant increase in Child C patients as (75%) Child C vs. (10%) Child A and (45%) of patients was MELD/NA (20-29) vs. (10%) <9 and (70%) of patients were stage D in BCLC.

Assessment of Mupirocin Resistance among Clinical Isolates of Methicillin Resistant Staphylococcus aureus

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is considered a major risk factor for nosocomial infections and its decolonization has reduced these infections. Mupirocin (MUP) is the topical antibiotic of choice for decolonization. MUP decolonization failure is attributed to MUP resistance. Objective: The aim of the current study is to assess MUP resistance among MRSA isolates phenotypically and genotypically. Methodology: Fifty MRSA isolates were identified in Microbiology Department in the Medical Research Institute hospital, Alexandria University. Antibiotic susceptibility to different classes of antibiotics by disk diffusion method was done. MUP minimum inhibitory concentration (MIC) was determined phenotypically by MUP Ezy MIC™ Strips. MUP resistance was determined genetically by multiplex PCR detection of mupA and mupB. Results: Of all MRSA isolates, 6% exhibited high level and none showed low level MUP resistance. Only mupA was detected in all resistant isolates. Conclusion: Despite low prevalence of MUP resistance, it is appropriate to test MUP resistance prior nasal decolonization

A comparison of Tzanakis and Alvarado scoring system in the diagnosis of acute appendicitis

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV– 100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.

Featuring: Antonio Bayés de Luna

In the Cardiology Masters section of European Cardiology Review, we bring you an insight into the career of a key contributor to the field of cardiology. In this issue, we feature Professor Antonio Bayés de Luna, Senior Researcher at the Cardiovascular Research Foundation, Cardiovascular ICCC-Program, Research Institute, Hospital de Sant Pau, IIB Sant Pau, Barcelona, Spain.

Assessment of professional nursing governance and hospital magnet components at Alexandria Medical Research Institute, Egypt

Background and objective: In the context of a rapidly evolving health care system, health care institutions strive to set a path towards an excellent professional practice environment. Since improving clinical nurse work environments is a major issue faced by nurse executives and administrators, they become challenged to establish nursing governance models, and leadership practices so that clinical nurses can engage in the work processes and relationships that are empirically linked to quality patient outcomes. The main aim of this study was to assess the current status of professional nursing governance and hospital magnet components at Alexandria Medical Research Institute, Egypt.Methods: A descriptive research design was conducted at Alexandria Medical Research Institute hospital, using a convenience sample (N = 220) that composed of two groups including; all hospital medical administrators (n = 10) and hospital nursing workforce (n = 210). Index of Professional Nursing Governance Questionnaire (IPNGQ) and Magnet Hospital Forces Interview were proved valid and reliable to measure study variables.Results: The overall mean score of professional nursing governance was (187.59 ± 63.74) reflected that staff nurses practice the first level of nursing shared governance (primarily nursing management who take the decision with some staff input). In addition, both medical administrators and nursing staff identified the hospital has a good structure, nursing leadership practices that support shared governance and magnet recognition. Structural equation model and correlation analysis revealed a positive association between overall professional nursing governance and hospital magnet components (p < .05).Conclusions and recommendations: The study emphasized the hospital administrators’ important role for providing supportive organizational structures and leadership practices for increasing participation of nursing staff in work design, problem-solving, conflict resolution, committees and organizational decision-making as “key ingredients to a successful organization” in turn, lead to a healthy and magnet-like work environment. Training programs for nurses’ professional development are recommended which enhance and increases their autonomy and empowerment.

Your colour memory y La pell de la pell: Del artista al científico

Este artículo aborda dos experiencias de visualización, resultado del encuentro y colaboración entre artistas y científicos con el objetivo de dar respuesta a cuestiones planteadas en el proyecto I+D+i “Metamétodo: Metodologías compartidas y procesos artísticos en la sociedad del conocimiento HAR2010-18453 (subprograma ARTE)”, dirigido por Alicia Vela y desarrolladas por miembros del equipo IMARTE de la Facultad de Bellas Artes de la UB. La primera propuesta titulada Your colour memory se realiza en colaboración con la Unidad y Laboratorio de Enfermedades Neuromusculares del Instituto de Investigación Hospital de Sant Pau (UAB). En ella se analiza la capacidad del razonamiento científico como verdad certera indiscutible y el laboratorio como escenario donde germina dicha argumentación. El segundo estudio, titulado La pell de la pell, mediante la visualización de cromatografías y de planchas de fotopolímero sensible, establece una analogía con las “fachadas vivas”, construidas de hormigón biológico dónde los líquenes son los protagonistas. El estudio surge a partir del contacto y distintas visitas al Departamento de Botánica de la Facultad de Biología de la UB.Palabras-clave: Metamétodo; arte-ciencia; luz; color, sostenibilidad Your colour memory and the skin of the skin: From the artist to the scientistAbstractThis article explain two experiences of visualization framed within the Research and Development (I+D) project "Metamethod. Shared methodologies in artistic processes HAR 2010-18453 (subprogram ARTE)" developed by the artists and researchers of IMARTE Group, University of Barcelona. The first experience titled Your colour memory was made with Neuromuscular Diseases Unit and Laboratory of the Research Institute Hospital de Sant Pau (UAB). Examines the power of scientific reasoning as an unquestionable truth and the laboratory as the stage where that argument germinates. The second study, entitled The skin of the skin, starts after contact by Department of Botany, Faculty of Biology (UB). The idea of how to build living façades through biological concrete suggests an analogy from a particular visualization of the chromatographies and photopolymer plates.Keywords: Metamethod; art-science; light; color; SUSTAINABILITY