AIMTo evaluate the reversibility of minimal hepatic encephalopathy (MHE) following liver transplantation (LT) in Egyptian cirrhotic patients.METHODSThis prospective study included twenty patients with biopsy-proven liver cirrhosis listed for LT and twenty age- and sex-matched healthy control subjects. All underwent neuro-psychiatric examination, laboratory investigations, radiological studies and psychometric tests including trail making test A (TMT A), TMT B, digit symbol test and serial dotting test. The psychometric hepatic encephalopathy score (PHES) was calculated for patients to diagnose MHE. Psychometric tests were repeated six months following LT in the cirrhotic patient group.RESULTSBefore LT, psychometric tests showed highly significant deficits in cirrhotic patients in comparison to controls (P < 0.001). There was a statistically significant improvement in test values in the patient group after LT; however, their values were still significantly worse than those of the controls (P < 0.001). The PHES detected MHE in 16 patients (80%) before LT with a median value of -7 ± 3.5. The median PHES value was significantly improved following LT, reaching -4.5 ± 5 (P < 0.001), and the number of patients with MHE decreased to 11 (55%). The pre-transplant model for end-stage liver disease (MELD) score ≥ 15 was significantly related to the presence of post-transplant MHE (P = 0.005). More patients in whom reversal of MHE was observed had a pre-transplant MELD score < 15.CONCLUSIONReversal of MHE in cirrhotic patients could be achieved by LT, especially in those with a MELD score < 15.

Background/Aim:Among the various methods for evaluating gastric emptying, the real-time ultrasound is safe, does not require intubation, or rely on either radiologic or radionuclide technique. The aim of our work was to measure the gastric emptying in pediatric patients with portal hypertension by using the real-time ultrasound.Patients and Methods:Forty patients with portal hypertension with mean age 7 ± 2.8 years and 20 healthy children as a control group underwent gastric emptying study by using real-time ultrasound. The cross-sectional area of the gastric antrum was measured in the fasting state and then each subject was allowed to drink tap water then calculated by using formula area (π longitudinal × anteroposterior diameter/4). The intragastric volume was assumed to be directly proportional to the cross-sectional area of the antrum.Results:The mean gastric emptying half-time volume was significantly delayed in portal hypertension patients (40 ± 6.8 min) compared with the control subjects (27.1 ± 3.6) min (P<0.05). Patients with extrahepatic portal vein obstruction had significant delayed gastric emptying in comparison to patients with portal hypertension due to other etiologies (36.14 ± 4.9 vs 44.41 ± 6.04 min; P<0.01).Conclusion:Ultrasound is a noninvasive and a reliable method for measuring gastric emptying in pediatric patients. Gastric emptying was significantly delayed in patients with portal hypertension. Etiology of portal hypertension may influence gastric emptying time in patients with chronic liver disease.

The past decade has witnessed substantial progress towards the application of low-rate speech coders to civilian and military communications as well as computer-related voice applications. Central to this progress has been the development of new speech coders capable of producing highquality speech at low data rates. Most of these coders incorporate mechanisms to represent the spectral properties of speech, provide for speech waveform matching, and optimize the coder's performance for the human ear. A number of these coders have already been adopted in national and international cellular telephony standards.In mobile communication systems, service providers are continuously met with the challenge of accommodating more users within a limited allocated bandwidth. For this reason, manufactures and service providers are continuously in search of low bit-rate speech coders that deliver toll-quality speech.In this paper the simulated low bit rate vocoder (LPC) using MATLAB was implemented. The result obtained from LPC was compared with other implemented voice compression using wavelet transform. From the results we see that the performance of wavelet transform was better than LPC. Keywords-LPC.DWT.RELP.CELPV7-92 978-1-4244-6349-7/10/$26.00 c 2010 IEEE

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Background HCC is one of the most common malignancies worldwide and is a major cause of death, because of its high frequency and poor prognosis. It is especially common in Egypt, where it develops on top of cirrhosis secondary to viral hepatitis C and B. Since HCV infection is highly prevalent in Egypt, it accounts to most of the cases of HCC in Egypt. HCV infection is found in a variable proportion in HCC cases in different populations, accounting for 75-90% of cases in Japan, 31-47% in the U.S, 44-76% in Italy, and 60%-75% of HCC cases in Spain. Objective To compare between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection. Patients and Methods Our study was a comparative study including 60 patients divided into 2 groups as follow patients successfully treated with Ledipasvir based regimen (Group A) and patients successfully treated with Daclatasvir based regimen (Group B) from January 2016 to June 2017. Results There were no statistically significant difference between the two groups as regard demographic and laboratory data. In comparison between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection in the first group there were 3/30 cases of percentage of 10% has developed HCC and in the second group there were 2/30 cases of percentage 6.6% has developed HCC after successful therapy for each group, there were no statistically significant difference between the two groups as regard the incidence of HCC after successful treatment, but generally DAA as Ledipasvir based regimen and daclatasvir based regimen both have low incidence of HCC after successful therapy of HCV infection. Conclusion There were several researches to study relation between DAA as treatment for HCV infection and HCC incidence after successful therapy. Our study was done to compare between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection.