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Background Portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE) are two different pathologies that cause bleeding in cirrhotic patients. These two pathologies are still difficult to be distinguished by white light endoscopy (conventional), as they both appear as red spots in the gastric antral mucosa in the case of severe PHG. The aim of our study was to assess the efficacy of Versatile Intelligent Staining Technology (VIST) in comparison to histopathology in the diagnosis and classification of GAVE. Methods A cross-sectional study included 50 patients with liver cirrhosis recruited from Alexandria Main University Hospital. Patients with connective tissue diseases and chronic kidney disease were excluded. All patients were examined by both conventional white light endoscopy (WLE) and image enhancement technology (VIST) using Sonoscape HD500 endoscope. GAVE was diagnosed as tortuous columns of ectatic vessels in the gastric antrum. Histopathological examination was used as the standard tool for the diagnosis of GAVE. Results A total of 50 patients were included, 28 patients (56 %) were diagnosed as GAVE by pathology vs 22 (44 %) as non-GAVE. Twenty-three of 28 (78.6 %) cases of GAVE were detected by VIST. VIST had superior sensitivity than WLE in the detection of GAVE, 82.1 % vs 7.1 %, while WLE had higher specificity 95.5 % vs 59.1 % by VIST. There was statistical significance between VIST and pathology in the diagnosis of GAVE, p<0.035, but no statistical significance between WLE and pathology. VIST has identified two types of GAVE: focal in 12/28 cases and diffuse in 11/28, and five were not diagnosed by VIST. Conclusions Versatile Intelligent Staining Technology could be used as an alternative tool to histopathological diagnosis of GAVE. GAVE can present as a focal group of ectatic vessels which adds a new class to GAVE classification that was previously misdiagnosed.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Intervening early in the disease course by antivirals can delay progression and improve clinical outcomes. Since Direct-acting antivirals (DAAs) changed the entire landscape of hepatitis C (HCV) treatment, there has been considerable interest with these DAAs, such as sofosbuvir and daclatasvir, as new repurposed options in COVID-19 therapeutics . OBJECTIVE This study is carried out to determine whether sofosbuvir/daclatasvir-based regimens improve clinical outcomes of patients with moderate or severe COVID-19. METHODS This was a prospective study including patients with PCR- confirmed COVID-19, that were treated with sofosbuvir and Daklatasvir- based regimen for 14 days. Results: Demographic data of the included 54 patients: Male (57%), female (43%), age <50 years (48%), > 50 years (52%), smoking (9%), diabetes mellitus (9%) and hypertension in 28% of patients. Clinical presentation of COVID-19: Fever (87%), cough (97%), dyspnea (70%), chest pain (61%), sore throat (53%), diarrhea (50%), mood changes (43%), muscle pain (87%), oxygen saturation median (93.5 +/- 5.5 %), and CT chest changes indicating COVID-19 was received in (55%) of patients. Laboratory data: PCR for Covid-19 was positive in (100%) , CRP was positive in (87%). RESULTS Complete recovery was observed in 100%, and none of the patients progressed to severe stage. CONCLUSIONS Conclusions: Sofosbuvir/ daclatasvir- based regimen is highly effective and safe in curing patients with Covid-19, preventing progression to severe stage as well as in decreasing mortality. CLINICALTRIAL The study has been approved by Faculty of Medicine- Alexandria University Ethics Committee (IRB No: 00012098) according to Ethical standards of scientific research.