Diagnostic Value of Upper and Lower Endoscopy in Assessment of Patients with Microcytic Hypochromic Anaemia without Site-specific Gastrointestinal Manifestations

Background: Iron deficiency anemia (IDA), is often caused by digestive disorder and should always be assessed, as its causes could be severe illness such as cancer. Objectives: To study the diagnostic value of both upper and lower endoscopic examinations among patients with microcytic hypochromic anaemia without site -specific gastrointestinal (GIT) manifestations. Patients and methods: A total of 50 Egyptian patients with IDA were included. Patients were clinically evaluated and investigated for: Complete blood picture, serum ferritin, serum iron and total iron binding capacity (TIBC). Patients were screened with Esophagogastroduodenoscopy (EGD) and colonoscopy. Results: The mean ±SD age of the patients was 36.4 ± 16.7, 19 males (38%) and 31 females (62%). The most common finding of EGD was Gastritis, it was present in 20 patients (40%) followed by Peptic ulcer in 9 patients (18%). There were 2 patients (4%) with celiac disease, 1 patient (2%) with crohn’s disease, 2 patients (4%) with Gastric cancer, and 1 patient (2%) with angiodysplasia while there were 14 patients (28%) with normal EGD. Both procedures showed negative findings in 10 patients (20%), both procedures showed positive findings in 8 patients (16%) while 1 procedure only showed positive finding in 32 patients (64%). Conclusion: Bidirectional endoscopies are valuable to detect the cause of IDA in patients without site –specific (GIT) manifestations. The most common GIT lesions were gastritis followed by peptic ulcer

Outcome of Acute Kidney Injury (AKI) in Coronavirus Disease 2019 (COVID-19) patients

Background: Coronavirus Disease 2019 (COVID-19) is a globally emerging illness, resulting in potential effects on public health and global economies. Objectives: To assess the incidence of Acute Kidney Injury among patients who are infected with COVID-19, and to evaluate risk factors. Patients and methods: This study enrolled100 adult patients infected with COVID-19 and recently diagnosed with polymerase chain reaction (PCR). The patients were submitted to clinical examination and laboratory testing for ESR, CRP, CBC, Serum creatinine, and D-dimer. Patients were also assessed radiologically by CT Chest. Highresolution computed tomography Parenchymal abnormalities on HRCT were assessed. AKI patients were classified based on Acute Kidney Injury Network staging. Results: The mean age of all studied patients was 48.1 ± 10.8 years and mean BMI of all studied patients was 31.3 ± 4.6 kg/m2, 51 patients were males (51%) and 49 females (49%). There were 35 patients (35%) with a mild infection, 23 patients (23%) with moderate, and 42 patients (42%) with severe in the studied patients. The overall AKI prevalence among COVID-19 patients was 18 %. All of them were grade III AKI. Our study revealed that old age, severity of infection, dyspnea, elevated CRP, ALT, AST, PT, INR, Urea, and Creatinine were considerable distinct predictors for AKI. Conclusion: The Prevalence of AKI among COVID-19 patients was 18 %. Old age, the severity of infection, dyspnea, elevated CRP, increased serum urea, Creatinine were significant independent predictors for AKI