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Non-alcoholic fatty liver disease (NAFLD) is related to metabolic syndrome via insulin resistance, where preventing disease progression is crucial in the management process. The study included 240 NAFLD patients with type 2 diabetes who were randomly allocated into empagliflozin 25 mg (EMPA group), ursodeoxycholic acid 250 mg (UDCA group), or the control group (placebo). The study outcomes included: changes in liver fat content (LFC; %) (utilizing the Dixon-based MRI-PDFF approach), liver enzymes, lipid and glycemic profiles, FIB-4 index, and non-alcoholic fatty liver score (NFS). All endpoints were assessed at baseline and after 6 months. EMPA outperformed UDCA and placebo in decreasing LFC (−8.73% vs. −5.71% vs. −1.99%; p < 0.0001). In post-treatment ultrasound images and MRI-PDFF calculations, more patients had normal fatty liver grade (no steatosis or LFC < 6.5%) with EMPA compared to UDCA. EMPA and UDCA showed significant regression in the FIB-4 index (−0.34 vs. −0.55; p = 0.011) and NFS scores (−1.00 vs. −1.11; p = 0.392), respectively. UDCA achieved higher reductions in insulin resistance than EMPA (p = 0.03); however, only EMPA significantly increased beta-cell function (54.20; p = 0.03). When exploring the differences between the two drugs, EMPA was better in decreasing LFC (%), while UDCA achieved higher reductions in liver fibrosis scores. Both showed a similar safety profile in managing liver steatosis.

Background The prevalence of chronic kidney disease (CKD) and end-stage kidney disease (ESKD) is increasing continuously as a result of the dramatic growth in the prevalence of two main causes of ESKD which are diabetes mellitus (DM) and hypertension, hence, ESKD represents a global concern. Based on the sixth annual report of the Egyptian society of nephrology, the prevalence of ESKD in Egypt is estimated to be 375 per 1000,000. Meanwhile, other studies estimated the prevalence in El-Minia governorate to be around 308 per 1000,000. Hemodialysis (HD) represents the main modality of Kidney replacement therapy (KRT) for sufferers of ESKD in El-Minia governorate. Patients treated with in-center HD attend dialysis care usually three times per week for several hours each time, hence, their experiences during dialysis care will likely have a major impact on living with chronic illness. Hence, measuring patient satisfaction is very important as it is not only an outcome but also a contributor to other outcomes and objectives, it can provide valuable information about problem areas that can be modified to improve patient experience and outcomes. Methods A single-center cross-sectional prospective study was conducted in the HD unit, Minia nephrology and urology university hospital. Demographic data were obtained through face-to-face interviews, Patients received a questionnaire to assess satisfaction with medical staff interactions, as well as care before, during, and after dialysis. An observational checklist of healthcare staff and equipment in the dialysis unit was also given to the patients. Results One hundred nineteen patients participated in the study; patients were generally satisfied with the care provided in the dialysis unit (mean = 2.64), patients were most satisfied with aspects of care related to nurses, while they were neutral about aspects related to physicians, and were dissatisfied with nutritional care. Conclusion There are multiple problem areas in the HD unit affecting patients’ experience, and further improvement in the care provided in the dialysis unit is required.

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Background: Chronic infection with Hepatitis C virus (HCV) is considered as a major cause for developing liver cirrhosis and hepatocellular carcinoma. A new era in HCV treatment is ongoing using Direct Acting Antiviral activity (DAA). The first approved DAA drug was Sofosbuvir which has a high tolerability and preferable pharmacokinetic profile. Another recently developed drug is Daclatasvir a first-in-class HCV NS5A replication complex inhibitor. Both drugs are administered orally once daily and have potent antiviral activity with wide genotypic coverage. Methods: In the outpatient clinic, one hundred and fifty naïve difficult to treat chronic HCV patients were recruited from Tropical Medicine Department at Fayoum public hospital. A combination of Daclatasvir (60 mg) and Sofosbuvir (400 mg) (DCV/SOF) has been administered for those patients once daily with Ribavirin (1200 mg or 1000 mg based on patients’ weight on two divided doses) over a period of 12 weeks. All patients have been followed up for clinical, laboratory assessment and HCV PCR to detect the efficacy and safety of the therapy. Results: Sustained Virologic Response rate (SVR12) was achieved in the vast majority of patients (90.67%). Cirrhotic patients showed lower SVR compared to non-cirrhotic patients (88.89% vs 90.91%, respectively). Around half of the patients (49.33%) developed adverse events (AEs) during treatment. The most common AEs were headache, fatigue and abdominal pain Conclusion: The available evidence seems to suggest that combination therapy of (DCV/SOF with RBV) in the treatment of chronic HCV genotype IV naïve difficult to treat patients either cirrhotic or non-cirrhotic is safe and effective. Monitoring for clinical and laboratory hepatic parameters was the basis for these findings.