AIM:The aim of this study was to compare efficiency of three types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with healthy diet among obese females. SUBJECTS AND METHODS:Randomized longitudinal prospective study, carried out on 76 adult females. Blood pressure, anthropometric, ultrasonographic and biochemical assessments were done. RESULTS:Females undergo nutritional intervention showed highly significant improvement in the anthropometric measurements, visceral fat at umbilicus by US and diastolic blood pressure (decreased), and insignificant differences in fasting blood sugar and lipid profile. Female undergo acupuncture intervention showed highly significant improvement in visceral fat by US, lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL), and decreased fasting blood sugar, and insignificant differences in the anthropometric measurements. Those undergo laser intervention showed highly significant improvement in all anthropometric measurements under study, visceral fat at umbilicus by US, blood pressure and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS:Nutritional intervention alone could be used to reduce weight if the lipid profile within normal range, but if it is impaired, acupuncture should be used beside. To strength the reduction in body anthropometry, laser intervention was recommended beside the nutritional intervention.

To assess impact of PTPN22 1858C→T polymorphism, HLA shared epitope and autoantibodies on susceptibility and severity of rheumatoid arthritis (RA). A total of 150 RA patients and 150 controls were included in the study. Anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor isotypes (IgG, IgM and IgA) were assayed by ELISA. PTPN22 1858C→T polymorphism was performed by RFLP analysis and HLA-DRB1 genotyping by PCR-SSP analysis. Single-view, anteroposterior radiographs of the hands and feet were obtained on all RA patients. The results showed association of PTPN22 1858 T allele with RA (OR = 2.3, 95 % CI 1.5-3.5) and bone erosion (OR = 2.9, 95 % CI 1.1-7.6). The associations increased with the combination of positive autoantibodies, HLA-DRB1 SE with PTPN22 1858 T allele carriage. The highest association was with the combination with anti-CCP antibodies (OR = 47.3, 95 % CI 10.9-204.4 for RA and OR = 69.4, 95 % CI 15.8-305.5 for erosion p < 0.001). Combination of PTPN22 1858 T allele carriage with negative RF isotypes or with absence HLA-DRB1 SE showed no significant association with RA. The presence of PTPN22 1858C→T polymorphism with HLA SE and autoantibodies increases risk of RA development and erosive disease.

Objective: To determine appropriate visceral fat cut-off values using ultrasound (USVF); for obesity according to existing waist circumference (WC), waist/hip ratio (WHR) and BMI cut-off levels.Methods: 998 Egyptian adults, aged 25-55 years, were studied in a cross-sectional survey for evaluation of "Visceral and Central Obesity as an Early Estimator for Obesity Health Risk". Results:Using WC as standard for classification of central obesity, cut-off points of USVF were found to be 6.5 cm for men and 5 cm for women; using ROC analysis; with 76 % sensitivity, 83% specificity, 1.06 PPV/NPV, and 81% accuracy for men, and with 77 % sensitivity, 76% specificity, 0.99 PPV/NPV, and 76% accuracy for women. Same cut-off points of USVF were detected using BMI as standard; with 71 % sensitivity, 77% specificity, 1.04 PPV/NPV, and 75% accuracy for men, and 74% sensitivity, 79% specificity, 1.03 PPV/NPV, and 77% accuracy for women. Even by using WHR as standard, these cut-offs increased 0.5 cm only for both men and women (7 and 5.5 cm respectively). Conclusion:The best cut-off points of visceral fat; using US in Egyptian adults; is 6.5 cm for men and 5 cm for women.

Objective: To determine appropriate visceral fat cut-off values using ultrasound (USVF); for obesity according to existing waist circumference (WC), waist/hip ratio (WHR) and BMI cut-off levels.Methods: 998 Egyptian adults, aged 25-55 years, were studied in a cross-sectional survey for evaluation of "Visceral and Central Obesity as an Early Estimator for Obesity Health Risk". Results:Using WC as standard for classification of central obesity, cut-off points of USVF were found to be 6.5 cm for men and 5 cm for women; using ROC analysis; with 76 % sensitivity, 83% specificity, 1.06 PPV/NPV, and 81% accuracy for men, and with 77 % sensitivity, 76% specificity, 0.99 PPV/NPV, and 76% accuracy for women. Same cut-off points of USVF were detected using BMI as standard; with 71 % sensitivity, 77% specificity, 1.04 PPV/NPV, and 75% accuracy for men, and 74% sensitivity, 79% specificity, 1.03 PPV/NPV, and 77% accuracy for women. Even by using WHR as standard, these cut-offs increased 0.5 cm only for both men and women (7 and 5.5 cm respectively). Conclusion:The best cut-off points of visceral fat; using US in Egyptian adults; is 6.5 cm for men and 5 cm for women.

Background: COVID-19 is a highly infectious disease that necessitates simple and rapid methods for recognising severe patients. Aims: To correlate between chest lesions in CT, neutrophil-lymphocyte ratio (NLR), and platelets-lymphocytes ratio in patients with COVID-19, and to detect their cut-off values as an early warning of severe COVID-19 in Egyptian patients. Subjects and Methods: A cross-sectional study included 100 adult patients with COVID-19 attending Ahmed Maher Teaching Hospital, Cairo, Egypt. Clinical, laboratory, and radiological assessments were done. They were classified according to their CT grades into three groups: seven patients with a normal chest CT, 45 non-severe cases, and 48 severe cases. Results: Dyspnoea was the most common symptom among the severe cases (79.2%) and fever among non-severe cases (71.1%), while cough (85.7%) was the most common among cases with a normal CT. The age, NLR, C-reactive protein (CRP), and D-dimer of severe cases were significantly the highest, while the absolute lymphocytes were significantly the lowest. Highly significant positive correlations were found between CT grades with D-dimer, NLR, and CRP; significant positive correlation was found with age; and significant negative correlation with CT. Using receiver operating characteristic analysis, areas under the curve of D-dimer, NLR, age, CRP, ferritin, and platelet-lymphocyte ratio were 0.760, 0.698, 0.640, 0.627, 0.614, and 0.595, respectively. The optimal cut-off value of NLR was 2.50 with 0.74 specificity, 0.61 sensitivity, and 67.5 accuracy. Conclusion: NLR is a reliable and easy-to-use predictor of COVID-19 severity. NLR (>2.5) should prompt prescription of a chest CT as it could reveal essential lesions that influence further management.