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Background: Infection with Hepatitis C virus (HCV) is of significant public-health encumbrance in Egyptian population that afford the considerable predominance rate worldwide. This study was aimed to evaluate the correlation between the different treatment regimens on cardiac cardiovascular complication. Methods and Results: In this study, 390 patients diagnosed as HCV infection in Mansoura, Egypt were sectioned into four groups. Group A treated with ledipasvir and sofosbuvir (LED +SOF), group B received simepriver and sofosbuvir (SIM+SOF), group C treated sofosbuvir and daclatasvir (Sof+DCV) and group D received with triple combination therapy of sofosbuvir, daclatasvir and ribavirin (SOF+DCV+ RBV). The full hepatological assessment, blood analysis and clinical investigation were performed. All participants went through a cardiac assessment for detection of development of cardiovascular changes. There was significant elevation in levels of AST, ALT, serum albumin, platelet count, heamoglobin concentration and the Child classification between the studied groups. There was significant difference in the CMR results during the study especially in fourth group (SOF+DCV+RBV) group. No statistical difference regarding pericardial effusion. There was significant elevation of cardiac enzymes (Troponin, CK MB, BNP ) mostly in all groups especially in the fourth group (SOF+DCV+ RBV) with one outlier in SOF+DCV group and 3 outliers presented mainly with BNP (P value <0.001). Conclusions: DAAs are proved its efficacy in management of chronic HCV in Egyptian patients as standard of care for hepatitis C treatment. Also tested its safety on the heart with most of its applied regimens.

Background: Peutz-Jeghers syndrome (PJS) is a rare autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps of the entire gastrointestinal tract. A Peutz-Jeghers polyp (PJP) in a patient without pigmentation or a family history of the disease is called an isolated or solitary PJP. Individuals with PJS carry a very high risk of developing gastrointestinal (GI) as well as extra-GI malignancies. This case report documents lesion multiplicity and their malignant potential in a young patient with PJS presenting in a serious condition for the first time. Case report: An 18-year-old female Egyptian patient was admitted with hematochezia and remarkable anemia. After appropriate resuscitation and consent, colonoscopic evaluation revealed seven pedunculated colonic polyps at the ascending and the transverse colon, and numerous variable-sized sessile polyps were scattered all over the colon. To establish hemostasis, endoscopic polypectomy for pedunculated polyps and argon plasma photocoagulation for the bleeding sessile polyps were performed. Histopathological examination revealed cecal adenocarcinoma in one specimen and two simultaneous in situ carcinoma at the transverse and the sigmoid colon in the mucosae of the excised histologically proven hamartomatous polyps. Additionally, one focal in situ carcinoma in the resected colon was detected. Conclusions: When considering the family history, serious GI neoplastic lesions may be unmasked in young patients with PJS who present with hematochezia, even in the absence of its characteristic mucocutaneous pigmented lesions. GI endoscopic surveillance programs should be adopted for diagnosed cases of PJS and their families. Genetic prenatal screening for early detection is the best option for primary prevention.

Background and Aim: Direct acting antiviral agents (DAAs) are highly effective and safe treatment in patients with chronic hepatitis C infection (CHC). The aim of this study is to evaluate outcomes of direct acting antiviral drugs for treatment of HCV infection in patients with decompensated liver cirrhosis. Materials and methods: This study included 115 HCV decompensated cirrhotic patients who were treated according to the Egyptian National Treatment Program for Hepatitis C Virus. The patients were divided into 3 groups; Group I, included 70 patients received sofosbuvir and daclatasvir for 24 weeks, Group II, included 18 patients received sofosbuvir, daclatasvir and ribavirin for 12 weeks and control group, included 27 patients refused antiviral therapy. Results: The sustained virologic response (SVR) in the present study was 91% (89.3% in group I and 92.3% in group II) with non-significant difference between both groups. Compared to untreated control group and to baseline parameters, both treated groups showed significant improvement as regarding, liver function, INR, creatinine, Child-Turcott-Pugh score and MELD score12 weeks post-treatment. There was a statistically significant decrease in variceal bleeding, ascites and hepatic encephalopathy in treated group compared to control group with no statistically significant difference recorded between the three studied groups regarding hepatocellular carcinoma, hepatorenal syndrome, spontaneous bacterial peritonitis and pleural effusion. Conclusions: Treatment of decompensated HCV cirrhotic patients with DAAs had SVR about 91%. SVR is associated with improvement in liver function and a significant reduction cirrhotic related complications. Materials and methodsThis prospective study included 115 HCV decompensated cirrhotic patients accepted treatment by direct acting antiviral drugs (DAAs) according to the National committee for control of Viral Hepatitis (NCCVH) protocol in Internal Medicine Department, Mansoura university Hospital under the supervision of Ministry of Health from July 2017 to September 2019. The study was ethically approved by the Medical Research Ethics Committee, Faculty of Medicine, Mansoura University. A written informed consent was obtained from all patients after revealing the objective of the research, its advantages and hazards and duration of the research. The patients were divided into 3 groups; Group I; included 70 patients received sofosbuvir (SOF) and daclatasvir (DAC) for 24 weeks, Group II; included 18 patients received sofosbuvir, daclatasvir and ribavirin for 12 weeks and