Background: Hepatocellular carcinoma [HCC] is one of the leading causes of cancer-related deaths worldwide. A major problem with HCC surveillance is the lack of reliable biomarkers. Serum transthyretin [TTR] may be a sensitive marker for the diagnosis of patients with liver cell damage, liver cirrhosis or hepatocellular carcinoma. Aim of the work:This study aimed to evaluate the potentiality of serum transthyretin [TTR] as a novel biomarker for detection of HCC in cirrhotic patients. Patients and Methods: This Current study was conducted on 70 patients with chronic liver disease. Also, 20 healthy person matched for age and sex were included as a control group. Patients were classified into 2 groups [30 cirrhotic patients with newly diagnosed HCC & 40 cirrhotic patients without HCC]. Serum TTR levels were measured using enzyme linked immunosorbent assay technique. Results: Serum levels of TTR were significantly much lower in HCC patients when compared to cirrhotic patients without HCC or control group [p<0.0001]. Significant decrease of serum TTR in HCC patients, with portal vein invasion or nodal invasion than in HCC without vascular or nodal invasion. The diagnostic accuracy of TTR was higher than that of AFP regarding sensitivity [83.3%] and negative predictive value [81.4%] in diagnosis of HCC. Conclusion: detection of lower level of TTR alone or in combination with other validated markers may be potentially informative biomarker for detection of HCC among cirrhotic patients at early noninvasive stage where curative treatment can be applied.

Introduction: Cardiac failure in children with Thalassemia major (TM) is the major cause of death due to iron overload. Spirulina is a micro alga with proven anti-inflammatory, antioxidant and may have a cardioprotective effect. Aim of the Work: The aim of this study was to evaluate the possible beneficial effect of spirulina supplement in TM children. Subject and Methods: It is an interventional study carried out in 60 children with TM and 30 healthy children matched for age and sex as control. Both groups received spirulina supplement at a dose of 250 mg/kg/d for 3 months. 2D Echo, Tissue Doppler, and speckle tracking imaging (STI) were done for all the studied cohort before and after the 3-month duration of spirulina supplement. Results: There was significant improvement in hemoglobin level at the end of 3-month period (8.27±1.3 vs. 9.023±1.7; P <0.033) with decrease the frequency of blood transfusion in TM patients (66.6% vs. 40% required transfusion at interval less than 2 wk). Left ventricle global longitudinal strain (LVGLS) significantly improved after 3-month period (−21.7±4.64 vs. −24.67±4.478; P <0.002). Conclusions: Spirulina supplement has possible beneficial effect in minimizing the frequency of blood transfusion as well as cardioprotective effect against cardiac damage in TM patients.