Hepatocellular carcinoma (HC) ranks as the 5 th most common malignant cancer and the 3 rd most frequent cause of death worldwide. The majority of HCC patients are not amenable to curative therapy as they are detected at late stages. Therefore, our aim was to evaluate the clinical implications of TNF-α level and its correlation with the activities of GGT and LDH in monitoring the progression of HCV-chronic liver disease. Materials and methods: This study comprised forty eight patients suffering from HCV-chronic liver disease; 24(50%) cases with HCC, 14(29.2%) cases with LC and 10(20.8%) cases with CH. Twenty five healthy individuals (HI) served as control group. Sera of all individuals were examined for the activities of TNF-α, LDH, GGT, AFP and its correlation with other laboratory investigations. Results: Serum levels of TNF-α, LDH, AFP were elevated significantly in HCC patients compared to LC and CH but the difference between LC and CH was elevated significantly only (p<0.0001) in TNF-α. Significant association was recorded between LDH and TNF-α, GGT, AFP, ALT and AST levels. Linear regression for TNF-α, LDH and AFP showed significant prediction for progression of HCV-chronic liver disease. Conclusion: Serum level of LDH and TNF-α could be used simultaneously with AFP for the evaluation of chronic inflammation leading to cancer development.

In the past, the surgical management of displaced intraarticular calcaneal fractures has been a contentious issue. Soft tissue problems and concurrent disease must be taken into account in individuals with this syndrome. Stability, anatomic reduction of the fracture, and preservation of soft tissue may all be achieved with the minimally invasive sinus tarsi technique. The purpose of this thesis was to evaluate the result of fixation of displaced intra-articular calcaneus fractures using sinus tarsi approach. Methods: This prospective clinical study included twenty adult patients suffering from recent displaced intra-articular calcaneal fractures from September 2020 and august 2021 that were treated by open reduction and internal fixation through minimal invasive sinus tarsai approach in Orthopedic department of Benha faculty of medicine and Meniet-Elnasr general hospital. After 6 months follow up, mean of AOFAS score was 90.25 ranged from 74 to 99. Mean of Bohler angle was 27.25° and mean of Gissane angle was 122.65°. Regarding patient's outcome according to AOFAS scale, 14 (70%) of patients showed excellent results while 4 (20%) of patients showed good results and 2 patients (10%) showed fair results. There was a statistically significant correlation between AOFAS score and (postoperative Bohler angle) while no significant correlation was founded between AOFAS score and (Age, Sex, preoperative and postoperative Gissane angle). There was a statistically significant correlation between Sanders type and (Age, preoperative Bohler angle) while no significant correlation was founded between Sanders type and (Sex, preoperative and postoperative Gissane angle). Conclusion: Sinus tarsi approach is a less invasive method for treatment of calcaneal fractures. It permits good visualization of the fracture, and allows anatomic reduction of articular surfaces with a decrease of wound complications and shorter waiting time before surgery. It is a valid option of treatment for displaced intra-articular calcaneal fractures with more advantage to Sanders type II.

Cancer is a disease in which the cell's natural division mechanisms, which are regulated by its genetic material (DNA), are disrupted.Viruses, chemical carcinogens, chromosomal rearrangement, tumour suppressor genes, and spontaneous transformation have all been linked to cancer (Anwar et al., 2020). Cancer claimed the lives of 8.9 million people worldwide in 2017, according to the World Health Organization.This figure is projected to increase to 12.0 million by 2030. One of three factors can lead to cancer:a poor diet, a genetic predisposition, or environmental exposure. In the case of lung cancer, a bad diet is responsible for at least 35% of all cancers worldwide, with the addition of alcohol and cigarettes increasing the figure to 60%. A hereditary predisposition to cancer accounts for around 20% of cancer cases, leaving the majority of cancers to be caused by a number of environmental carcinogens (Rehm et al., 2020).