Aim: To explore the potential usefulness of serum microRNA (miR-122) as non-invasive diagnostic marker for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). Methods: The study has been conducted on 100 participants and were divided into 4 equal groups: Group I; Twenty five normal, healthy individuals' age and gender-matched healthy volunteers (control group). Group II; Twenty five chronic HCV patients without cirrhosis. Group III; Twenty five HCV related cirrhosis without HCC. Group IV; Twenty five HCV-related HCC (proved radiologically by abdominal ultrasonography (US) & Triphasic abdominal computed tomography (CT). All participants underwent full clinical assessment and laboratory investigations in addition to the evaluation of the level of serum miR-122 by RT-PCR. Results: microRNA-122 displayed significant fold increase in expression level in chronic hepatitis group (9.85), and less significant fold increase in cirrhosis group (3.73) and significant fold increase in expression level in HCC group (7.46). Comparing serum miR-122 expression level between different studied groups displayed that, No significant fold change in miR-122 expression was found between different groups and that miRNA122 had no significant up-regulation in HCC patients in comparison to non-HCC patients (Hepatitis and Cirrhosis); (P value = 0.682). Specificity & sensitivity was 94% & 16% respectively, with AUROC (0.529). Conclusion: miR-122 could not be used as a biomarker for early detection of HCC in HCV related cirrhosis.

Background Myocardial injury in conditions other than coronary artery disease (CAD), known as type 2 myocardial infarction, is mostly related to mismatch between myocardial oxygen supply and demand. Cirrhotic patients with acute upper gastrointestinal bleeding (UGIB) are usually hemodynamically unstable. Hypovolemia, hypotension, and decreased oxygen-carrying capacity as consequences of UGIB may precipitate subclinical heart failure and myocardial injury. Aim of work Assessment of the prevalence and potential risk factors of myocardial injury in patients with liver cirrhosis with acute UGIB. Patients and methods The study was conducted on 132 patients diagnosed with liver cirrhosis presenting by UGIT bleeding at Mansoura University Hospitals during one year. Patients were divided into 2 groups: group 1 (76 patients) with myocardial injury or ischemic heart disease and group 2 (60 patients) without. Results The incidence of myocardial injury in this study (elevated troponin levels above cutoff value and/or ECG changes) was 55% of patients. Troponin I was positive in 25% of patients. ECG ischemic changes were found in 36.3% of patients in the form of ST-segment deviation or T-wave inversion. On univariate analysis, predictors of myocardial injury in patients with UGIB included MELD score and variceal source of GI bleeding. On multivariate analysis variceal source of GI bleeding is an independent predictor of myocardial injury. Variceal bleeding was found in 95 % of the ischemic group versus 63% in the other group. Conclusion More than half of the study patients presented with UGIB have suffered from unnoticed subclinical myocardial injury. Variceal source of GI bleeding was found to be an independent predictor of myocardial injury.

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This work discussed the best diagnostic modility for early detection of pancreatic cancer compared to final diagnosis reached by histopathological examination. The present study was constructed by doing imaging modalities computed tomography (CT) and endoscopic ultrasonography (EUS) on 24 patients admitted to surgery department in the faculty of medicine with suspected pancreatic malignancy. As regard masses diameters detected by each modality, EUS was found to be superior to CT in detection of masses less than 20mm in diameter. According to the mass nature, those found in the head region tended to be malignant more frequently than the body and tail, Moreover, solid heterogeneous masses also were more likely to be malignant than the cystic ones as detected by the imaging modalities, with higher accuracy of EUS than with CT. EUS showed more accurate information as regards lymph node involvement and vascular invasion than CT. All of which affected the assessment of resectability of pancreatic masses. On head-to-head comparison, EUS appeared to perform better than CT scan in respect to nodal staging. Based on these results, we conclude that EUS staging should be the standard of care along with state of the art CT scan for the preoperative evaluation of patients with pancreatic cancer. However, large, prospective, multicenter studies directly comparing the accuracy of linear EUS vs. new generation CT scanners are still needed.