Gender difference in chronic hepatitis C (CHC) infection is not previously well studied. We aimed to analyze the effect of gender difference on the risk factors of CHC, disease progression, and outcome after oral direct acting antiviral (DAA) therapy. The study was conducted at Tropical Medicine and Gastroenterology Department, Sohag University, Egypt, in the period between 2018 and 2020. 775 patients were evaluated for hepatitis C virus (HCV) risk factors. Laboratory investigations, abdominal ultrasound and liver Shear wave elastography (SWE) were done. The patients were given antiviral therapy and followed up to assess the response and side effects of DAA therapy. 434 (56%) of study patients were males and 341 (44%) were females. Catching infection from blood transfusion and intravenous (IV) injection of tarter emetic was significantly higher in males, while catching infection from surgical operation was significantly higher in females. Hepatic fibrosis was significantly more extensive in males. Side effects were reported more in females. Sustained virological response (SVR) 12 was reported in 98.6%. Females had a slightly better SVR12 than males (99.4% versus 97.9%). In conclusion males were different from females in exposure to HCV risk factors. After introduction of blood screening and stoppage of parenteral anti-bilharzial therapy the risk of HCV infection could be greatly prevented in males, while the exposure of females to obstetric procedure is increasing nowadays which hides a risk of ongoing infection in females. So, HCV surveillance programs in females retain their importance in early detection and management of CHC. Although hepatic fibrosis progression was more in males, females were more liable to adverse events of DAA therapy. So, researchers should consider the gender of their patients in drug design and administration.

Coronavirus disease 2019 (COVID-19) is an emerging disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causing an ongoing pandemic and is considered as a national public health emergency. The signs and symptoms of COVID-19 vary from mild symptoms to a fulminating disease with acute respiratory distress syndrome (ARDS) and multi-organ failure, which may culminate into death with no available vaccines or specific antiviral treatments. God provides us with important medicinal plants. Here I shall shed the light on one of these plants that may help in the treatment of COVID-19 or may even cure it. Saussurea costus (S. costus) is a popular plant with medical importance, the roots of which are widely used for healing purposes throughout human history with great safety and effectiveness. Previous studies revealed the presence of many bioactive phytochemical molecules that has antiseptic, antibacterial, antifungal, antiviral, antiinflammatory, antioxidant, anti-lipid peroxidation, immunostimulant, immunomodulating, analgesic, bronchodilor, hepatoprotective and antihepatotoxic properties. S. Costus has immunomodulatory effects on cytokine release and has complementinhibitor substances helpful in the treatment of some diseases related to marked activation of the complement system, like respiratory distress.

Background and Aims. Thrombocytopenia is a common complication in patients with chronic hepatitis C virus (HCV) that increases the risk of bleeding. We aimed to analyze the hematologic effects of the new direct-acting antiviral (DAA) therapy, particularly on the platelet count in chronic HCV-infected patients with thrombocytopenia. Patients and Methods. One hundred thrombocytopenic patients chronically infected with HCV were included in a prospective study. All patients were eligible for receiving anti-HCV treatment with sofosbuvir-based regimens for 12 weeks, according to the protocol of the National Program for treatment of HCV in Egypt sponsored by the Ministry of Health. Results. At the end of treatment (EOT), there was a highly significant increase in platelet count ( p < 0.001 ), a significant increase in white blood cells (WBCs) count ( p ≤ 0.032 ), and a highly significant decrease in hemoglobin level ( p < 0.001 ) as compared to pretreatment levels. Patients with mild to moderate hepatic fibrosis had significantly higher median and interquartile range (IQR) platelet count at baseline and EOT than those with advanced fibrosis and cirrhosis ( p ≤ 0.023 and p < 0.001 , respectively). There was more elevation in platelet count at EOT in patients with mild to moderate fibrosis than those with advanced fibrosis and cirrhosis. Out of the hundred patients, 73% showed improvement of platelet count, while 27% showed no improvement or even decrease in the platelet count. Conclusion. Sofosbuvir-based DAA therapy is a highly effective and safe treatment regimen that results in the improvement of platelet count in thrombocytopenic patients, particularly in mild to moderate stages of hepatic fibrosis.

Some people have no choice but to get in contact with animals, but this contact is accused of being the main cause of the emergence of new viruses. Novel and creative ways of thinking are needed to reveal the mystery of the reasons that led to the emergence of the viral epidemics and try to treat them. In our opinion, humankind has been exposed to viral pandemics or at least viral outbreaks in places where, and times when, humans have come close to achieving success in eliminating mosquitoes. And we think that the temporal and local linking between the most important mosquito elimination procedure (which is fighting malaria) and the occurrence of viral pandemics will help in answering many of the questions that have been asked about these pandemics. For viruses, "Species jumps", a jump between one host species and humans is one of the main steps in the emergence process. Not all mosquito bites are similar; three possibilities can occur to a human or animal after a mosquito bite depending on the mosquito's health status. We hypothesize that one category of mosquito bites stands as a front block against the "Species jumps". This blocking wall will fall if mosquitoes are eliminated which will open the way for new viruses to emerge. Our hypothesis assumes that mosquitoes are "natural vaccinators", as long as humans can get rid of insect-borne diseases in ways other than vector eradication.

Some studies reported a high prevalence of ischemic stroke in hepatitis C virus patients, other several studies have suggested that hepatitis C virus (HCV) may act as a trigger for autoimmune diseases and autoantibodies including Anti-Neutrophil Cytoplasmic Antibody (ANCA) which predispose to vasculitis. Because vasculitis is a risk factor for ischemic stroke, we investigated the association of the hepatitis C virus with ANCA in first-ever ischemic stroke patients. This study included 67 Egyptian patients with first-ever ischemic stroke. These patients were clinically examined and investigated for HCV infection by chemiluminescence & Real Time-PCR, and ANCA antibodies by ELISA. Forty-two patients (62.7%) had HCV infection. Twenty-nine (43.2%) of them were cytoplasmic- Antineutrophil Cytoplasmic Antibodies (c-ANCA) positive, while none was perinuclear- Antineutrophil Cytoplasmic Antibodies (p-ANCA) positive. Comparison between c-ANCA positive and ANCA negative patients showed that 82.8% and 47.4% had anti-HCV antibody, respectively, with P-value 0.003. The c-ANCA level correlated significantly with age, and HCV antibody level. No statistically significant difference was found in both the consciousness and stroke severity between the negative and positive c- ANCA patients. However, patients with positive c-ANCA had smaller and multiple cerebral infarctions with P-value 0.002 and 0.01 respectively. Multiple regression analysis showed that the number and size of cerebral infarctions were independent predictors of c-ANCA positivity with P value 0.02, and 0.03 respectively. In conclusion, c-ANCA level correlates with HCV antibody and may predispose to ischemic stroke by a possible ANCA associated vasculitis.