Serum Squamous Cell Carcinoma Antigen Level in Cirrhotic Chronic Hepatitis C Patients With and Without Hepatocellular Carcinoma

This study will be carried out on 500 personnel divided into five groups : Group A: 100 cases of hepatocellular carcinoma without interventions. Group B: same 100 cases of group A before and 3 months after successful interventions.Group C: 100 cases of established cirrhosis. Group D: 100 cases with chronic hepatitis C virus infection without established cirrhosis. Group E: 100 healthy individuals as controls.Methods: Sera from selected patients and controls have been used for estimation of SCC-Ag using CanAg SCC EIA. Results: high significant increase in serum SCCA level in patients with HCC (groupA and groupB) when compared to cirrhotic, chronic HCV and control groups (P < 0.001). Positive significant correlation was found between AFP and serum SCCA level .The best cut-off value to differentiate HCC patients from cirrhotic patients was 3.2 ng/ml for SCCA yielded with 80% sensitivity and 90% specificity. When combined sensitivity of both markers was calculated in our study at the best-chosen cutoff values (SCCA 3.2 ng/ml and AFP 200 ng/ml) sensitivity improved to 93%.Conclusion: Combined SCCA and AFP can be used as in diagnosis of HCC and follow up 3 months after therapeutic intervention

Plasma soluble CD 163 level as a marker of oesophageal varices in cirrhotic patients

Background: Variceal bleeding (VB), the most common lethal complication of cirrhosis, associated with high mortality. Timely prediction of esophageal varices (EV) represents a real challenge for the medical team. This study evaluated the level of plasma soluble CD 163 as a marker of the presence of EVs and to compare it with other noninvasive clinical, laboratory and ultrasonographic parameters as well as endoscopy.Methods: This prospective controlled study was conducted on 80 adults. Gp I had no oesophageal varices, gp II had small varices, gp IIIa had large varices, gp IIIb are the same patients of gp IIIa but after eradication of varices and gp IV as healthy controls. Serum samples were assayed for soluble CD 163.Results: soluble CD163 was statistically significant different between controls and all liver cirrhosis. it showed a statistically significant difference between group I and II (p = 0.009) and between group I and IIIa (p &lt; 0.001) and between group II and IIIa (p &lt; 0.001) but, no difference between group IIIa and IIIb (p = 0.179).Conclusion: Serum soluble CD163 is a good noninvasive predictor for the presence of EVs and it may be used for grading of EVs. Its level does not change after esophageal varices eradication.Trial registration: IRB No: 00007589 FWA No: 00015712 The Ethics Committee of the faculty of medicine Alexandria University.Keywords: Hepatic, Cirrhosis, Varices, CD163, Endoscopy, Ultrasonograph

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Investigating the Structure-Activity Relationship of Laulimalides Marine Macrolides as Promising Inhibitors for SARS-CoV-2 Main Protease (Mpro)

SARS-CoV-2, the new coronavirus variant is a world-wide health crisis. Over spans of human history, preparations derived from natural products have always been recognized as a preliminary source of medications. Taking into account the SARS-CoV-2 main protease (Mpro) as the essential element of the viral cycle and as a main target, herein we highlight a computer-aided comprehensive virtual screening for a focused chemical list of 14 laulimalides marine macrolides against SARS-CoV-2 main protease (Mpro) using a set of integrated modern computational techniques including molecular docking (MDock), molecule dynamic simulations (MDS) and structure-activity relationships (SARs) as well. Indeed, computational studies had disclosed two promising macrolides [laulimalides LA4 (6) and LA18 (13)] based on their remarkable ligand-protein energy scores and relevant binding affinities with the SARS-CoV-2 (Mpro) pocket residues. Consequentially, the two compounds were further investigated thermodynamically though deciphering their MD simulations at 100 ns, where they showed noticeable stability within the accommodated (Mpro) pockets. Moreover, in-deep SARs studies suggested the crucial roles of the C-23 subistituted side chain and the C-20 methoxy as essential pharmacophoric structural features for activity. Such interesting outcomes are highly recommending further in vitro/vivo examinations regarding those marine macrolides and open a gate towards developing more effective antivirals drug leads