Patients with chronic hepatitis have impaired glucose metabolism with hyperinsulinemia and insulin resistance, this hyperinsulinemia has been shown to be due to decreased insulin catabolism rather than increased pancreatic insulin secretion.We aim to evaluate insulin resistance in non diabetic patients with chronic hepatitis C virus infection. our study was a case-control study conducted in Tropical Medicine and Gastroenterology Department AL-Azhar University Hospital. 60 patients and 30 healthy controls were included in the study. The patients were classified into two groups:Group A: 30 patients with chronic hepatitis C infection were selected with positive HCV RNA in serum for at least 6 months; Patients were not receiving anti-viral therapy at the time of sampling They showed no evidence of cirrhosis. Group B: 30 patients with HCV related liver cirrhosis. They were divided according to Child Pugh score; twenty patients with HCV related compensated liver cirrhosis (Child A) Ten patients with HCV related decompensated liver cirrhosis (Child B and C). Group C: The control group: included 30 healthy individuals.  All patients and control were subjected to the following: Liver function tests: Alanine transaminase (ALT), Aspartate transaminase (AST), total and direct bilirubin, total protein, serum albumin. Prothrombin time (PT) & international normalization ratio (INR). Renal function tests: Blood urea nitrogen (BUN), Na, K. Complete blood count. Alpha fetoprotein (αFP).  Overnight fasting and two hours postprandial blood glucose level. Fasting serum insulin of each individual.  Insulin resistance was  determined via the Homeostasis  Model assessment (HOMA-IR) Statistical analysis of data will be done by using SPSS(statistical program for social science version22,produced by IBM SPSS Inc.,Chicago,USA). Results: We found that out of 30 CHC and 30 LC (20 compensated LC, 10 de compensated LC) 8 (26.7%); 8 (40%) patients and 5(50%) respectively had HOMA-IR levels greater than 2.5, which is consistent with IR diagnosis. Decompensated cirrhotic patients showed higher frequency of IR compared  to CHC, and compensated cirrhotic patients. Coclusion: In chronic hepatitis C patients, HOMA-IR, fasting serum insulin and fasting blood glucose were significantly higher than healthy controls.

Background: There is a strong correlation between Helicobacter pylori (HP) infection and coronary artery disease (CAD). There is also a strong correlation between HP infection and the severity of coronary artery atherosclerosis in patients with CAD. Our study determined the association of HP infection and severity of coronary artery atherosclerosis in patients with suspected CAD. Methods: A prospective study of 100 individuals who had coronary angiography for coronary atherosclerosis was conducted. Body mass index (BMI), blood pressure, blood cholesterol, blood glucose, leukocyte count, hemoglobin, and urea breath test were all done on the patients. Coronary angiograms were graded based on vascular and angiographic severity scores. Results: Triglyceride, (TG), Low Density Lipoprotein (LDL), C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), vessel score, and angiographic severity score all showed high correlations with Gensini score. There was a substantial association between vessel score and TG, LDL and angiographic severity score. It was found that angiographic severity score has a substantial positive link to a person's BMI; LDL; CRP; ESR, and vessel score. Conclusion: Although HP infection has been linked to an increased risk of coronary artery disease (CAD), established risk variables outweigh their potential impact.

Background: One of the most critical health concerns of our day is acute deterioration of chronic obstructive lung disease (COPD). Detecting concurrent heart illness in these individuals might be challenging.Objective: Aims of this study were determining the diagnostic value of B-type natriuretic peptide (BNP) levels in the identification of acute COPD exacerbations (AECOPD) that were linked with left ventricular (LV) dysfunction and pulmonary hypertension. Methods: a prospective study of 100 patients with acute COPD exacerbations was done. All research participants were subjected to history taking, clinical examination, laboratory testing, blood gas analysis, echocardiography, and NT-pro BNP plasma level estimation. Results: Receiver operating characteristic (ROC) curve for BNP as a diagnostic for LV systolic dysfunction showed that area under the curve (AUC) was 0.923 at cut off point of 72.1 ng/ml with sensitivity of 93.3% and specificity of 84.6% (P<0.001). Conclusion:Heart failure is confirmed when the average natriuretic (NT)-BNP level in the left ventricle during AECOPD is higher than normal, which should prompt quick treatment for both conditions.

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Objective:The aim of this study was to evaluate the changing of TK1 (where TK is thymidine kinase) activity before and after adjuvant chemotherapy as prognostic factor in patients with breast cancer. Patients and methods: 40 patients with breast cancer lesion were included in the study and 40 healthy volanteers . The patient's age ranged from 28 to 76 years old with the mean age ± 38.24 year. The all patients were referred from the Oncology department to Clinical pathology department AT Al-Azhar Assiut University Hospital during the period from November 2017 to October 2018. Results: In the current study in the breast cancer group, the highest TK activity was observed than in control group & in the breast cancer group, the highest TK activity was observed pretherapy than post therapy group. Conclusion: Based on the results of this study we can conclude the following: This study demonstrates that TK1 is a promising serum marker in breast cancer. High serum TK1 activity, which is associated with aggressive features of primary breast cancer, was found to be associated with a cancer recurrence.