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The coronavirus disease 2019 (COVID-19) is still striking the global population affecting all age groups. So far, many clinical features associated with COVID-19 illness remain under-identified, especially atypical manifestations. It is essential to characterize associated rare symptoms to better recognize complications. As severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes Multisystem Inflammatory Syndrome in children (MIS-C) in severe infection manifesting as a generalized inflammatory reaction and immune response in many body systems, potential involvement of the male urogenital tract by SARS-CoV-2 should be considered. Herein, we report a case of a pediatric patient with orchiepididymitis associated with COVID-19 infection, emphasizing the importance of considering other manifestations such as genital involvement of MIS-C in children with COVID-19 and highlighting the need to monitor the genitourinary function after infection. Therefore, andrological consultation is necessary to evaluate fertility as a long-term follow-up, especially as the effects of SARS-CoV-2 on male reproductive function are still to be thoroughly researched.

Background Acute hyperglycemia is a common finding in both diabetic and non-diabetic patients with acute coronary syndrome (ACS) who present to the emergency department (ED). The prognostic role of hyperglycemia in diabetic patients with ACS remains controversial at least on the short-term basis. The aim of the present study was to find the relation between the glycemic gap and clinical outcome in diabetic patients with ACS. Methods The study included 100 diabetic patients with ACS to who were prospectively followed during their hospital stay. Admission blood glucose was measured and glycemic gap was calculated. Results In diabetic patients suffering ACS, there was a significant relation between the glycemic gap value, occurrence of major adverse cardiovascular events (MACE) and length of hospital stay. Conclusion Glycemic gap is a better marker than admission blood glucose alone in diabetic patients presenting with ACS. This study added the optimal cut-off value for this important biomarker.

Background. The incidence of type 2 diabetes mellitus (T2DM) has increased over the past years and early identification and management of its complications especially diabetic kidney disease (DKD) is of great importance. T2DM and DKD are of multifactorial etio logy with contribution of genetic and environmental factors. We aimed to study the expression of ABCC8 and Notch 2 genes in patients with T2DM and to find their association with DKD. Methods. The present work was carried on 80 patients with T2DM (40 with DKD and 40 without DKD) and 40 healthy subjects as a control group. Real time polymerase chain reaction was used to assess gene expression. Results. Altered expression of ABCC8 and Notch 2 genes were found in patients with T2DM compared to control group. ABCC8 expression had significant positive correlation with HbA 1c while Notch 2 expres sion had significant positive correlation with fasting plasma glucose and HbA 1c. Notch 2 expression was significantly higher in patients with DKD compared to those without DKD. Multivariate regression analysis showed that Notch 2 expression had independent relation with increased urinary albumin excretion and reduced estimated glomerular filtration rate. ABCC8 gene expression did not show significant difference between diabetic patients with DKD compared to those without DKD. Conclusion. Increased expression of ABCC8 and Notch 2 genes may play a role in pathogenesis of T2DM. Overexpression of Notch 2 gene may have a role in the development of albuminuria and DKD in patients with T2DM which may represent a possible diagnostic tool and a possible therapeutic target.

The DISCOVER study is a three-year, non-interventional prospective study conducted in 37 countries, including Egypt, to assess the treatment patterns and outcomes in patients with type 2 diabetes mellitus initiating a second-line antidiabetic therapy (add-on or switch). In this report of the Egyptian cohort of DISCOVER, baseline data were collected according to routine clinical practice at 38 study sites, using a standardized electronic case report form, in the period from December-2014 to November-2019. We enrolled 583 patients (mean age: 52.9 ± 9.8 years and median duration since diagnosis: median 36.5, IQR 18.1, 70.4 months). The mean HbA1c value at baseline was 8.6 ± 1.4%, indicating poor glycemic control. The most commonly prescribed first-line medications were metformin or sulfonylurea monotherapy. For second linetherapy, the majority of patients switched to dual therapy with metformin plus sulfonylureas or DPP-4 inhibitors. Fewer patients switched to triple therapy, treatment by four or more medications, or insulin treatment (15, 12, and 35 patients, respectively). The most commonly cited reasons for switching to second-line therapy were lack of efficacy, weight gain, hypoglycemic events, and side effects (549, 54, 25, and 21 patients, respectively). The set treatment target of enrolled patients at the initiation of second-line therapy was an HbA1c level of 6.9%. Follow-up data will assess the outcomes of such changes in the Egyptian population.