The purpose of this study is to determine the ocular manifestations of systemic lupus erythematosus and its correlation with the disease activity. Fifty-two lupus patients and 20 healthy controls were included in this study. All patients have undergone complete rheumatological, neurological, and ophthalmic examination including visual acuity, slit-lamp examination of the anterior segment, and dry eye evaluation using Rose Bengal stain and Schirmer test. Fundus examination and fundus photography were done to the suspected cases. Eighteen patients (34.6%) had ocular lesion, from which only 13 (25%) patients were symptomatic. Keratoconjunctivitis was the most common ocular lesion. There was a highly statistically significant difference between patients and controls as regarding all ocular lesions (P > 0.0001). There was good correlation between disease activity index and presence of ocular lesion. Ocular manifestations are common in SLE patients. Lupus retinopathy may reflect systemic, particularly CNS, vascular damage.

Chronic hepatitis C virus (HCV) infection is associated with altered metabolism, including dyslipidemia and insulin resistance. These contribute to disease progression and influences the response to therapy. To investigate the relationships of new direct-acting antiviral drugs, simeprevir/sofosbuvir, with lipid profile and insulin resistance (IR). Eighty chronic hepatitis C genotype 4 patients were included; they were divided into four groups according to the severity of fibrosis as detected by fibroscan. Forty healthy persons volunteered as a control group. Lipid profile changes and IR were analyzed at baseline and after the end of treatment, and any effect of these changes on the response to treatment was studied. Before treatment, the levels of serum triglycerides were significantly higher in patients than in the control, and the levels of fasting insulin showed a progressive increase with advancing stage of fibrosis. At the end of treatment, there were a significant reduction in serum triglycerides, FBS, fasting insulin, and homeostasis model for the assessment of IR (P < 0.001), and a significant elevation of serum cholesterol and low-density lipoprotein (LDL)-c, high-density lipoprotein (HDL)-c, and LDL/HDL ratio (P = 0.001). An end-of-treatment response (week 12) was achieved in (99%) of the treated cases with 99% sustained viral response for 12 weeks post-treatment (week 24). Significant lipid profile changes were detected at the end of treatment. Serum lipid levels and IR are no longer predictors of response to DAAs. Follow-up of the lipid profile is warranted to avoid any possible remote effect of atherosclerotic heart disease.

Carbon monoxide poisoning (CO) is a major public health problem. Brain is the most sensitive organ to hypoxia induced by CO poisoning. Delayed Neurological Sequelae (DNS) is considered to be a delayed onset of neuropsychiatric symptoms after apparent recovery from acute CO poisoning. Therefore, this study was aimed to make a prospective comparative study between three markers (serum glutathione reductase, S100b protein and serum neurone-specific enolase) to predict the occurrence of DNS. This study was performed on 57 adult patients with acute CO poisoning. The markers were measured after arrival and the patients were divided into two groups: the DNS group (8 patients) & the non-DNS group (49 patients). There was a statistical difference between the two groups in terms of significant increase in loss of consciousness, syncope, dizziness, ECG changes, pneumonia, carboxyhemoglobin level, creatine phosphokinase, creatine phosphokinase-MB, troponin I, S100b protein, neurone-specific enolase in DNS grouped patiens and significant decrease in glasgow coma scale and glutathione reductase in DNS group. The cut off value of glutathione reductase was ≤ 30 U/L with a percentage of accuracy 94. 74. The cut off value of S100b protein was > 18.94 Pg/ L with 98.25 % percentage of accuracy, while, the cut off value of neurone-specific enolase was > 30.49 ng/ml and its accuracy was 96.49 %. All these cut off values predicted the occurrence of DNS. SO, it is concluded that serum S100b protein may represent the most reliable chemical marker for the prediction of DNS after acute CO poisoning by logistic regression analysis.

Aim. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. Patients and Methods. Our study includes 112 RA patients (group 1) and 40 healthy controls (group 11). All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT) and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. Results. There is atherosclerosis in 31.3% of asymptomatic RA patients compared with only 5% in controls (P = 0.003**). A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease (P = 0.0001***) and patient's age (P = 0.01*). There is highly statistical significant correlation between atherosclerosis and disease activity index. Conclusion. The frequency of subclinical atherosclerosis was high in long-term active RA patients.

Elkhateeb et al., 27 Screening of Cases of Chronic hepatitis C viral infection among municipal solid waste