Within the past decade, there have been numerous reports on the use of cyclosporine in idiopathic nephrosis. In this review, the results of both uncontrolled and controlled studies of the therapeutic effects of cyclosporine in steroid-sensitive/dependent idiopathic nephrosis and in steroid-resistant idiopathic nephrosis are analyzed. Cyclosporine is efficient in up to 80% of patients with steroid-sensitive/dependent idiopathic nephrosis. Most patients, however, relapse when the drug is withdrawn, thus necessitating prolonged treatments. Although cyclosporine is less efficient in patients with steroid-resistant idiopathic nephrosis, a few studies seem to indicate that this drug may be successful in some patients, especially if combined with corticosteroids. There is no evidence that cyclosporine can prevent the recurrence of nephrotic syndrome on the graft after renal transplantation. However, in patients in whom disease has recurred, high doses of cyclosporine may be effective alone or in combination with plasma exchanges. The main worrisome side effect of cyclosporine is chronic nephrotoxicity, which should be differentiated from acute or "functional" toxicity. Follow-up studies including pretreatment and posttreatment renal biopsies show a lack of correlation between structural damage and renal function, suggesting that a histologic examination of the renal parenchyma is the only reliable way of evaluating chronic cyclosporine nephrotoxicity.

Background The ongoing global pandemic of coronavirus disease 2019 (COVID-19) may cause, in addition to lung disease, a wide spectrum of non-respiratory complications. Among these are thromboembolic complications. The theories that explain the mechanism of thromboembolic complications of COVID-19 are accumulating rapidly, and in addition to the role of imaging for assessment of COVID-19 pneumonia, CT may be useful for identification of these complications, such as pulmonary embolism, ischaemic stroke, mesenteric ischaemia, and acro-ischaemia. Results Thromboembolic manifestations were diagnosed in 10% of our patients (124 patients out of the total 1245 COVID-19 patients); 56 patients (45.2%) presented with pulmonary embolism, 32 patients (25.8%) presented with cerebrovascular manifestations, 17 patients (13.7%) presented with limb affection, and 19 patients (15.3%) presented with gastrointestinal thromboembolic complications. Most of our patients had significant comorbidities; diabetes was found in 72 patients (58%), dyslipidemia in 72 patients (58%), smoking in 71 patients (57.3%), hypertension in 63 patients (50.8%), and morbid obesity in 40 patients (32.2%). Thromboembolic events were diagnosed on admission in 41 patients (33.1%), during the first week in 61 patients (49.2%), and after the first week in 22 patients (17.7%). Conclusions The incidence of thromboembolic complications in COVID-19 patients is relatively high resulting in a multisystem thrombotic disease. In addition to the crucial role of imaging for assessment of COVID-19 pneumonia, CT is important for assessment of the thromboembolic complications, such as pulmonary embolism, ischaemic stroke, mesenteric ischaemia, and peripheral ischaemia, especially in patients with elevated d-dimer levels and those with sudden clinical deterioration.

Background: Tuberculous pleural effusion (TPE) is the second most common form of extrapulmonary tuberculosis (EPTB). Up to 50% after treatment complicated with pleural thickening. Pleural biopsy has been considered the gold standard in diagnosis of TPE but it is invasive, so that pleural fluid markers of TPE have been extensively evaluated as an alternative to pleural biopsy. Thoracentesis for measuring these fluid markers is important.Aim: Assessing the value of diagnostic thoracentesis (by measuring pleural adenosine deaminase levels) and role of therapeutic thoracentesis in preventing pleural thickening.Subjects and methods: 10 cases with transudative pleural effusion and 45 cases with already diagnosed exudative effusion (30 cases of TPE, and 15 cases of Malignant PE) were included. 50 ml pleural fluid samples were aspirated and sent for measuring ADA levels. The 30 cases of TPE were classified into 2 equal groups the 1st group started 6 months anti tuberculous therapy plus repeated thoracentesis while the 2nd started anti tuberculous therapy only. Chest CT scan was done after 2 and 6 months for assessment of pleural effusion and pleural thickening.Results: Patients with tuberculous pleural effusion had higher pleural effusion ADA levels (mean ± SD 68.51 ± 24.06) than those with malignant pleural effusion (mean ± SD 25.47 ± 12.09) or transudative pleural effusion (mean ± SD 16.58 ± 2.93) and these levels had highly a significant difference (P-value <0.001). Also, there was a significant difference (P-value <0.05) between levels of ADA in malignant and transudative pleural effusion. Using a cut-off point of the pleural fluid ADA (30.49 IU/L) with AUC of 96.7 (sensitivity 96.7%, specificity 84%, NPV 88%, PPV 95% and accuracy 91%) discrimination between tuberculous and other causes of pleural effusion occurred. Regarding the pleural thickening, after 2 months of ttt, in group I, 3 cases developed pleural thickening, while in group II, 9 cases developed thickening. After 6 months, there was one case of pleural thickening in group I, while in group II, 5 cases developed pleural thickening. And there was a significant difference (P value <0.05) between both groups, after 2 and 6 months of treatment.

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Background: Several causes may destroy the skeletal remnants. Environmental causes, blasts, decomposition, and traumatic destruction may impede identification of bones. Furthermore, some forensic science researches showed inconsistency in using skull and pelvis bones in gender identification. In progressive skeletal destruction, the integrity of sternum may be conserved. In the postmortem duration, morphometric investigations of the sternum can be done by using radiological means. Aim of the work: This study was done to assess the sensitivity of sternal and 4th rib measurement analysis for sex determination in Egyptian population. Subjects and methods: Cross-Sectional study of thoracic Computed Tomography (CT) images of 261 adult Egyptians arrived at Menoufia university hospital. Meso-sternum length (SL), Manubrium length (ML), Sternebra 1 width (MS1), Sternebra 3 width (MS3), 4 TH Rib (its width at the level of costochondral junction) were measured. Differences between genders were detected by student t-test. Results: All sternal and forth rib measurements are significantly higher in males. The highest sensitivity and specificity values for sex discrimination were identified in SL as the sensitivity was 90.6% and specificity was 70.6%. Sex equation =-13.134+ (SL*0.06) + (ML*0.111) + (MS1*0.045) + (MS3*0.024) + (4 th rib*0.092). Conclusion: The sternum represented a reliable bone for sex determination in Egyptian population, based on a CT scan. The data generated from morphometric sternum studies are population specific data. Researchers can use a rapid and easy CT scanning for sternum and fourth rib as an effective method for sex identification. Recommendation:-we need to increase the number of conducted studies using radiological methods with proper analyses, as we can add other bones for forensic anthropologic evaluation.-As there are ethnic differences within national populations appeared in previous studies outside Egypt, we recommend other studies on the same bone in other Egyptian areas.-Use the equation of the sternal bone and the fourth rib measurement in determining sex.