Background: Chronic inflammation in adipose tissue may play a substantial role in the pathogenesis of obesity-related metabolic disorders. The present study aims to evaluate the changes in adipocytokines, bile acids, fibroblast growth factor 19 (FGF-19) and proinflammatory cytokines 6 months after laparoscopic sleeve gastrectomy (LSG). Methods: This prospective study included 75 obese patients with body mass index >35 kg/m 2 who underwent LSG. All patients were recruited preoperatively and followed up post-operatively at 6 months, with laboratory assessment of their cytokines including adiponectin, leptin, resistin, bile acid, interleukin (IL)-6, IL-8, tumour necrosis factor-α, monocyte chemotactic protein-1, high-sensitivity C-reactive protein, plasminogen activator inhibitor-1, serum amyloid-A and FGF-19. Results: There were statistically highly significant changes regarding anthropometric parameters (weight, body mass index and waist-to-hip ratio), blood glucose and lipid profile as well as liver enzymes at 6 months post-sleeve gastrectomy. The present study showed that the levels of serum adiponectin and FGF-19 significantly increased at 6 months of follow-up after surgery (P < 0.001), while the levels of serum leptin, resistin, highsensitivity C-reactive protein, plasminogen activator inhibitor-1 and serum amyloid-A significantly decreased at 6 months of follow-up after surgery (P < 0.001). There were no significant differences regarding serum bile acid, IL-6, IL-8, tumour necrosis factor-α and monocyte chemotactic protein-1. Conclusion: Weight loss after LSG is associated with significant improvement of the adipokine levels towards anti-diabetic and anti-inflammatory profiles. Future studies should use a larger sample size and longer follow-up periods.

Purpose One anastomosis gastric bypass (OAGB) is a promising bariatric procedure. We performed this study to evaluate the changes in a group of inflammatory cytokines 12 months after OAGB. Methods A single-arm prospective study was conducted on obese patients who underwent OAGB. The serum levels of the following adipocytokines were monitored pre-and 12 months postoperatively: adiponectin, leptin, interleukin 6 (IL-6), interleukin 8 (IL-8) levels, tumor necrosis factor-alpha (TNF-α), serum amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), and monocyte chemotactic protein 1 (MCP-1). Results A total of 62 patients were included with a mean age of 43.9 ± 6.8 years old. The serum adiponectin increased significantly from 7.64 ± 0.29 to 8.76 ± 0.42 μg/mL 12 months after the operation (p < 0.001). hs-CRP and IL-6 decreased significantly 12 months after the OAGB from 3323.35 ± 643.4 ng/mL and 3.72 ± 7.7 pg/mL to 1376.81 ± 609.4 ng/mL and 3.64 ± 6.9 pg/mL, respectively (p < 0.001). The MCP-1 showed significant increase in its level after OAGB as well (p = 0.014). In contrary, there were no significant changes in serum levels of IL-8 (p = 0.12) and TNF-α (p = 0.84) 12 months after the operation. The correlation analysis showed significant correlations between initial body mass index (BMI) with serum adiponectin, IL-8, and serum SAA. Conclusion OAGB can significantly impact the inflammatory cytokine profile in obese patients with possible subsequent protection from obesity-related comorbidities such as insulin resistance, cardiovascular diseases, and certain cancers.

Infertility among couples in Egypt is causing increasing concern. Investigations showed a relationship between ovulatory disorders and the incidence of female factor-mediated fertility difficulties in couples. However, the factors responsible for the sudden increase in ovulatory disorders are not fully understood. The aim of this study was to assess the presence of aflatoxin in sera of infertile women and to correlate this with ovarian functions and hormonal parameters. Blood samples were collected from 70 adult Egyptian females comprising 50 infertile and 20 fertile control individuals, and screened for the presence of aflatoxin B 1 (AFB 1 ). Ovarian function was examined by measuring mean ovarian volume, and the umber and size of ovarian follicles. Blood hormonal levels were determined. All blood samples (patients and controls) showed negative results as regards AFB 1 analysis. However, there was a significant enlargement in the mean ovarian volume but a significant decrease in follicular size. In addition, there were significant higher levels of lutinizing hormone (LH) and significant lower levels of mid-luteal progesterone in infertile females. Although blood samples were negative with respect to AFB 1 , the role of aflatoxin cannot be excluded as a contributing factor to female infertility, since the toxin was found to produce deleterious effects on the reproductive system in animals. More studies including aflatoxin analysis in ovarian biopsies are recommended to ascertain involvement of this toxin.

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Background. Although hyperfunctioning thyroid disorders were thought to be protective against malignancy, some recent studies reported a high incidence of incidentally discovered cancer in patients with hyperfunctioning benign thyroid disorders. We performed this study to estimate the incidence and predictors of malignant thyroid disease in patients with toxic nodular goiter (TNG). Patients and Methods. The data of 98 patients diagnosed with TNG were reviewed (including toxic multinodular goiter SMNG and single toxic nodule STN). The collected data included patients age, gender, systemic comorbidities, family history of thyroid malignancy, previous neck radiation, type of disease (multinodular or single), size of the dominant nodule by the US, operative time, and detection of significant lymph nodes during operation. Based on the histopathological analysis, the cases were allocated into benign and malignant groups. Results. Malignancy was detected in 21 patients (21.43%). Although age distribution was comparable between the two groups, males showed a significant increase in association with malignancy. Medical comorbidities and family history of cancer did not differ between the two groups. However, TMNG showed a statistically higher prevalence in the malignant group. Operative data, including operative time and lymph node detection, were comparable between the two groups. On regression analysis, both male gender and TMNG were significant predictors of malignancy. Conclusion. The presence of thyroid hyperfunction is not a protective factor against malignancy, as malignancy was detected in about 1/5 of cases. Male gender and TMNG were significant risk factors of malignancy in such patients.