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Papers by Dina Sweed

Egyptian Liver Journal

Background Early detection of biliary atresia (BA) is a great challenge providing the main useful... more Background Early detection of biliary atresia (BA) is a great challenge providing the main useful way to improve its clinical consequence. Promising metabolomics provides an effective method for determining innovative biomarkers and biochemical ways for improving early diagnosis. This study aimed to determine the benefit of serum and urinary potential bile acid metabolites in the differentiation of BA from non-biliary atresia (non-BA) cases using tandem mass spectrometry (MS/MS). Fourteen bile acids metabolites were measured quantitively by MS/MS in serum and urine samples from 102 cholestatic infants and 102 control infants, in addition to the assay of the total serum bile acid enzymatically. Results After the diagnostic clinical and laboratory workflow, cholestatic infants were divided into BA (37 infants) and non-BA (65 infants) subgroups. Remarkably on analysis of serum individual bile acid concentrations, there were significant differences between cholestatic BA and non-BA rega...

Biomolecules

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Interestingly, lncRNA... more Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Interestingly, lncRNA-H19 acts independently in HCC and influences miR-675 expressions. We aimed to assess the potential utility of tissue lncRNA-H19 versus miR-675 expressions as a non-invasive biomarker for HCC diagnosis and prognosis in Egyptian patients. Ninety-one HCC patients and 91 controls included in this study were investigated for expression of lncRNA-H19 and miR675 using RT-qPCR. Our results showed that the expression of lncRNA-H19 and microRNA-675 were higher in patients than in controls (p < 0.001 for both). Additionally, lncRNA-H19 expression was higher in tumorous than in non-tumorous tissue (p < 0.001). Linear regression revealed that miR-675 expression was a significantly higher positive predictor than lncRNA-H19 for tumor size, pathologic grade, and AFP level; similarly, for cyclin D1 and VEGF protein expression. By using the ROC curve, the sensitivity of miR-675 was higher than lncR...

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: The emerging role of sodium-glucose transporter 2 (SGLT2) inhibitors drugs as potenti... more BACKGROUND: The emerging role of sodium-glucose transporter 2 (SGLT2) inhibitors drugs as potential therapeutic agents in myocardial ischemic (MI) injury treatment has raised the concern for possible mechanisms of action. AIM: The current experimental study aimed to investigate the possible protective effects of dapagliflozin (DAPA) a SGLT2i, on isoproterenol (ISO)-induced MI in rats. MATERIALS AND METHODS: Thirty Wistar rats were divided randomly and equally into three groups. Group 1 (control group): Received 1.0 mL of normal saline through an orogastric tube for 14 days. Group 2 (ISO group): Received 1.0 mL of normal saline orally through an orogastric tube for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was freshly dissolved in normal saline and injected subcutaneously once daily. Group 3 (ISO + DAPA-treated group): Received DAPA 1.0 mg/kg/day orally for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was introduced like that described in Group 2....

Open Access Macedonian Journal of Medical Sciences

Background: Ulcerative colitis (UC) is an autoimmune inflammatory bowel disease, characterized by... more Background: Ulcerative colitis (UC) is an autoimmune inflammatory bowel disease, characterized by chronic and relapsing inflammation of the intestinal mucosa. Clinical treatments fail to reduce inflammation and induce side effects in nearly 30% of patients. Mesenchymal stem cells (MSCs) are immunomodulatory agents that can encourage tissue repair and regeneration. Aim: To investigate the ability of MSCs to differentiate into enterocytes under the mediation of activin a, fibroblastic growth factor 2, and epidermal growth factors and to study the effect of administering MSCs to rats with acetic acid (AA)-induced UC. Methods: MSCs isolated from the umbilical cord were induced to differentiate into enterocytes. The induced cells were morphologically evaluated by flow cytometry and immunocytochemistry. Forty rats were divided into four groups: control, AA-induced UC, differentiated, and undifferentiated MSC treated groups. The acute UC in rats was induced by 3% AA transrectal administrat...

World Journal of Surgical Oncology

Background Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of... more Background Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of several preventive and therapeutic modalities. HCC has heterogeneous and wide morpho-molecular patterns, resulting in unique clinical and prognostic criteria. Therefore, we aimed to study the clinical and pathological criteria of HCC to update the morpho-molecular classifications and provide a guide to the diagnosis of this disease. Methods Five hundred thirty pathologically analyzed HCC cases were included in this study. The clinical and survival data of these cases were collected. Results Hepatitis C virus is still the dominant cause of HCC in Egypt. Post-direct-acting antiviral agent HCC showed an aggressive course compared to interferon-related HCC. Old age, male gender, elevated alpha-fetoprotein level, tumor size, and background liver were important prognostic parameters. Special HCC variants have characteristic clinical, laboratory, radiological, prognostic, and survival data. Tu...

Polish Journal of Pathology

The pathogenesis of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) differs accord... more The pathogenesis of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) differs according to whether prior treatment with interferon (IFN) vs. direct-acting antiviral agents (DAAs) was administered. Cyclooxygenase-2 (COX-2), yes-associated protein 1 (YAP), and transcriptional co-activator with PDZ-binding motif (TAZ) play a crucial role in hepatocarcinogenesis. However, their roles in untreated or treated HCV-related HCC development have not been clarified. Therefore, we performed an immunohistochemical study and stained tissue from 83 HCV-related HCC cases using antibodies against COX-2, YAP, and TAZ and correlated their expression with the clinicopathological characteri stics and survival data. The cases were subdivided into 3 groups based on prior HCV treatment. In the 3 groups, COX-2 was significantly higher in HCC tissue compared with adjacent non-tumour liver tissue. However, the expression of YAP/TAZ was not significantly different between HCC and adjacent non-tumour tissue. We further grouped HCC cases into YAP + /TAZ + and YAP-/TAZcases. In the YAP + /TAZ + cases, COX-2 was significantly associated with tumour size, tumour multifocality, and late pathologic stage. No significant difference was observed in COX-2 and TAZ expression as a result of IFN or DAA treatment; however, YAP was significantly higher in IFN-treated HCC. Cyclo-oxygenase-2 overexpression may play a role in late HCC development, while YAP/TAZ could play an early role in HCC progression. Sustained expression of combined YAP/TAZ could mediate the poor prognostic role of COX-2.

The Egyptian Journal of Hospital Medicine

Background: Although a juvenile polyp is the commonest pediatric polyp, little is known regarding... more Background: Although a juvenile polyp is the commonest pediatric polyp, little is known regarding its pathogenesis. Objective: We aimed to study the role of eosinophils and platelet-derived growth factor receptor A (PDGFRA) expression in juvenile polyps. This could help in understanding the possible mechanism of polyp formation. Material and methods: This was a retrospective study that included 63 cases of juvenile polyps that were divided into three groups according to the number of polyps. Peripheral and tissue eosinophilia was evaluated. An immunohistochemical study of mothers against decapentaplegic homolog 4 (SMAD4) and PDGFRA was conducted. Results: The majority (82.5%) of the juvenile polyps were solitary, 11.1% were multiple, and 6.4% of them were cases of juvenile polyposis syndrome. There was an increased number of blood eosinophils (a median value of 2 × 10 3 cells/µL) and tissue eosinophils (a median value of 30/HPF). In addition, PDGFRA was overexpressed in 66.7% of cases. The expression of PDGFRA was significantly associated with tissue eosinophilia (p = 0.008). Tissue eosinophilia and PDGRA overexpression were significantly observed in patients with maintained SMAD4 expression. Conclusions: Tissue eosinophilia and PDGFRA overexpression were observed in majority of juvenile polyp cases. Juvenile polyps could share histopathological and molecular similarity to inflammatory fibroid polyp. The pathogenesis of juvenile polyp could be influenced by allergic or neoplastic factors.

Clinical and Experimental Medicine, Mar 9, 2022

Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, ... more Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, a lot of queries had emerged about its role following the end of the interferon era. The aim of this study was to re-evaluate the current role of LB in the diagnosis of liver diseases. All patients who had underwent LB at the Department of Hepatology, National Liver Institute, from January 2015 through December 2018 were recruited. Indications for LB, pathology reports and medical records of all cases were retrieved, reviewed and statistically analyzed. A total of 275 liver biopsies were collected, 191 males and 84 females with mean age 41.22 ± 13.36 years. Etiological diagnosis made by histopathological evaluation was 48 drug-induced liver injury (DILI), 42 nonalcoholic fatty liver disease (NAFLD), 34 chronic hepatitis B, or C with cholestasis, 29 autoimmune hepatitis, 34 primary sclerosing cholangitis, 13 primary biliary cholangitis, 7 autoimmune overlap syndrome, 13 active bilharziasis and 10 Wilson's disease. Minor number of cases was diagnosed by different other etiologies. Initial diagnosis was made by liver biopsy and confirmed by clinical response and laboratory findings. Liver biopsy is still considered as the gold standard diagnostic measure of different liver diseases representing an integral component of management decisions in hepatology.

Objectives To study the epidemiological and pathological properties of hepatocellular carcinoma (... more Objectives To study the epidemiological and pathological properties of hepatocellular carcinoma (HCC) cases eligible for surgical resection. Background HCC is the sixth most common cancer worldwide and the third most common cause of cancer death. In Egypt, liver cancer forms 1.68% of the total malignancies. HCC constitutes 70.48% of all liver tumors among Egyptians. HCC represents the main complication of cirrhosis. Materials and methods This longitudinal study included 92 HCC patients who had undergone surgical intervention. Clinical and demographic data were collected from medical records, and paraffin blocks were retrieved from the Archives of the Pathology Department, National Liver Institute, Menoufia University, during the period between March 2007 and October 2014. Results revealed that 51.1% of the studied HCC patients were at least 58 years old, 81.5% male and 18.5% female, 51.2% of the patients had an a-fetoprotein level of at least 200 ng/ml and 95.7% were positive for he...

Asian Pacific Journal of Cancer Prevention

Egypt, pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC) constitute 15.9% and ... more Egypt, pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC) constitute 15.9% and 1.8%, respectively, of all hepatobiliary and gastrointestinal malignancies (Mokhtar et al., 2016). Risk factors for PDAC include smoking, diabetes mellitus, alcohol intake, chronic and hereditary pancreatitis, and familial cancer syndromes. Duodenal carcinoma and AC may arise from preexisting adenomas, and bile duct cancers are associated with primary sclerosing cholangitis and congenital anomalies (Hutchins and Williamson, 2003). Radical pancreaticoduodenectomy (PD) is the treatment of choice for all resectable PAAC subtypes.

Egyptian Liver Journal

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects ... more Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions AIHA patients co-infected with SARS-CoV-2 may be at risk...

International Journal of Cancer and Biomedical Research

Egyptian Liver Journal

Background The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavir... more Background The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described in China as an unexplained pneumonia transmitted by respiratory droplets. Gastrointestinal (GI) and liver injury associated with SARS-CoV-2 infection were reported as an early or sole disease manifestation, mainly outside China. The exact mechanism and incidence of GI and liver involvement are not well elucidated. Main body We conducted a PubMed search for all articles written in the English language about SARS-CoV-2 affecting the GI and liver. Following data extraction, 590 articles were selected. In addition to respiratory droplets, SARS-CoV-2 may reach the GI system through the fecal-oral route, saliva, and swallowing of nasopharyngeal fluids, while breastmilk and blood transmission were not implicated. Moreover, GI infection may act as a septic focus for viral persistence and transmission to the liver, appendix, and brain. In addition to the dire...

The Medical Journal of Cairo University

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects... more Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation: A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions: AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.

Egyptian Liver Journal

Background The rapidly developing era of direct-acting antiviral regimens (DAAs) for more than on... more Background The rapidly developing era of direct-acting antiviral regimens (DAAs) for more than one hepatitis C virus (HCV) genotype had certainly alleviated HCV burden all over the world. Liver fibrosis is the major dramatic complication of HCV infection, and its progression leads to cirrhosis, liver failure, and hepatocellular carcinoma. The impact of DAAs on liver fibrosis had been debatably evaluated with undetermined resolution. Main body The aim of this review is to accurately revise the effects of DAA regimens on liver fibrosis which can either be regression, progression, or non-significant association. Liver fibrosis regression is a genuine fact assured by many retrospective and prospective clinical studies. Evaluation could be concluded early post-therapy reflecting the dynamic nature of the process. Conclusions The ideal application of DAA regimens in treating HCV has to be accomplished with efficient non-invasive markers in differentiating proper fibrosis evaluation from n...

Background: Non-alcoholic fatty liver disease (NAFLD) is the emerging cause of chronic liver dise... more Background: Non-alcoholic fatty liver disease (NAFLD) is the emerging cause of chronic liver disease. In addition, steatosis may lead to failure of obtaining sustained virological response after hepatitis C virus eradication. Therefore, there is a trend to identify effective strategies for managing hepatic steatosis. Farnesoid X receptor (FXR) agonists are reported to play a role in NAFLD treatment. Objective: This study aimed to explore the immunohistochemical expression of FXR in NAFLD spectrum in association with the clinicopathological data. Material and method: This was a retrospective study including 50 cases of NAFLD and 23 cases of normal liver. The NAFLD group was subdivided into 11 cases of NAFL (simple steatosis) and 39 cases of non-alcoholic steatohepatitis (NASH). Results: Hepatocyte FXR nuclear expression was significantly decreased in NASH group (P=0.001) with no significant decrease in NAFL group compared to normal liver (P=0.149). Bile duct FXR expression was signif...

Journal of Gastrointestinal Cancer

Egyptian Liver Journal

Background Early detection of biliary atresia (BA) is a great challenge providing the main useful... more Background Early detection of biliary atresia (BA) is a great challenge providing the main useful way to improve its clinical consequence. Promising metabolomics provides an effective method for determining innovative biomarkers and biochemical ways for improving early diagnosis. This study aimed to determine the benefit of serum and urinary potential bile acid metabolites in the differentiation of BA from non-biliary atresia (non-BA) cases using tandem mass spectrometry (MS/MS). Fourteen bile acids metabolites were measured quantitively by MS/MS in serum and urine samples from 102 cholestatic infants and 102 control infants, in addition to the assay of the total serum bile acid enzymatically. Results After the diagnostic clinical and laboratory workflow, cholestatic infants were divided into BA (37 infants) and non-BA (65 infants) subgroups. Remarkably on analysis of serum individual bile acid concentrations, there were significant differences between cholestatic BA and non-BA rega...

Biomolecules

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Interestingly, lncRNA... more Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Interestingly, lncRNA-H19 acts independently in HCC and influences miR-675 expressions. We aimed to assess the potential utility of tissue lncRNA-H19 versus miR-675 expressions as a non-invasive biomarker for HCC diagnosis and prognosis in Egyptian patients. Ninety-one HCC patients and 91 controls included in this study were investigated for expression of lncRNA-H19 and miR675 using RT-qPCR. Our results showed that the expression of lncRNA-H19 and microRNA-675 were higher in patients than in controls (p < 0.001 for both). Additionally, lncRNA-H19 expression was higher in tumorous than in non-tumorous tissue (p < 0.001). Linear regression revealed that miR-675 expression was a significantly higher positive predictor than lncRNA-H19 for tumor size, pathologic grade, and AFP level; similarly, for cyclin D1 and VEGF protein expression. By using the ROC curve, the sensitivity of miR-675 was higher than lncR...

Open Access Macedonian Journal of Medical Sciences

BACKGROUND: The emerging role of sodium-glucose transporter 2 (SGLT2) inhibitors drugs as potenti... more BACKGROUND: The emerging role of sodium-glucose transporter 2 (SGLT2) inhibitors drugs as potential therapeutic agents in myocardial ischemic (MI) injury treatment has raised the concern for possible mechanisms of action. AIM: The current experimental study aimed to investigate the possible protective effects of dapagliflozin (DAPA) a SGLT2i, on isoproterenol (ISO)-induced MI in rats. MATERIALS AND METHODS: Thirty Wistar rats were divided randomly and equally into three groups. Group 1 (control group): Received 1.0 mL of normal saline through an orogastric tube for 14 days. Group 2 (ISO group): Received 1.0 mL of normal saline orally through an orogastric tube for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was freshly dissolved in normal saline and injected subcutaneously once daily. Group 3 (ISO + DAPA-treated group): Received DAPA 1.0 mg/kg/day orally for 14 days. In the last 2 days (days 13 and 14), ISO (100 mg/kg) was introduced like that described in Group 2....

Open Access Macedonian Journal of Medical Sciences

Background: Ulcerative colitis (UC) is an autoimmune inflammatory bowel disease, characterized by... more Background: Ulcerative colitis (UC) is an autoimmune inflammatory bowel disease, characterized by chronic and relapsing inflammation of the intestinal mucosa. Clinical treatments fail to reduce inflammation and induce side effects in nearly 30% of patients. Mesenchymal stem cells (MSCs) are immunomodulatory agents that can encourage tissue repair and regeneration. Aim: To investigate the ability of MSCs to differentiate into enterocytes under the mediation of activin a, fibroblastic growth factor 2, and epidermal growth factors and to study the effect of administering MSCs to rats with acetic acid (AA)-induced UC. Methods: MSCs isolated from the umbilical cord were induced to differentiate into enterocytes. The induced cells were morphologically evaluated by flow cytometry and immunocytochemistry. Forty rats were divided into four groups: control, AA-induced UC, differentiated, and undifferentiated MSC treated groups. The acute UC in rats was induced by 3% AA transrectal administrat...

World Journal of Surgical Oncology

Background Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of... more Background Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of several preventive and therapeutic modalities. HCC has heterogeneous and wide morpho-molecular patterns, resulting in unique clinical and prognostic criteria. Therefore, we aimed to study the clinical and pathological criteria of HCC to update the morpho-molecular classifications and provide a guide to the diagnosis of this disease. Methods Five hundred thirty pathologically analyzed HCC cases were included in this study. The clinical and survival data of these cases were collected. Results Hepatitis C virus is still the dominant cause of HCC in Egypt. Post-direct-acting antiviral agent HCC showed an aggressive course compared to interferon-related HCC. Old age, male gender, elevated alpha-fetoprotein level, tumor size, and background liver were important prognostic parameters. Special HCC variants have characteristic clinical, laboratory, radiological, prognostic, and survival data. Tu...

Polish Journal of Pathology

The pathogenesis of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) differs accord... more The pathogenesis of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) differs according to whether prior treatment with interferon (IFN) vs. direct-acting antiviral agents (DAAs) was administered. Cyclooxygenase-2 (COX-2), yes-associated protein 1 (YAP), and transcriptional co-activator with PDZ-binding motif (TAZ) play a crucial role in hepatocarcinogenesis. However, their roles in untreated or treated HCV-related HCC development have not been clarified. Therefore, we performed an immunohistochemical study and stained tissue from 83 HCV-related HCC cases using antibodies against COX-2, YAP, and TAZ and correlated their expression with the clinicopathological characteri stics and survival data. The cases were subdivided into 3 groups based on prior HCV treatment. In the 3 groups, COX-2 was significantly higher in HCC tissue compared with adjacent non-tumour liver tissue. However, the expression of YAP/TAZ was not significantly different between HCC and adjacent non-tumour tissue. We further grouped HCC cases into YAP + /TAZ + and YAP-/TAZcases. In the YAP + /TAZ + cases, COX-2 was significantly associated with tumour size, tumour multifocality, and late pathologic stage. No significant difference was observed in COX-2 and TAZ expression as a result of IFN or DAA treatment; however, YAP was significantly higher in IFN-treated HCC. Cyclo-oxygenase-2 overexpression may play a role in late HCC development, while YAP/TAZ could play an early role in HCC progression. Sustained expression of combined YAP/TAZ could mediate the poor prognostic role of COX-2.

The Egyptian Journal of Hospital Medicine

Background: Although a juvenile polyp is the commonest pediatric polyp, little is known regarding... more Background: Although a juvenile polyp is the commonest pediatric polyp, little is known regarding its pathogenesis. Objective: We aimed to study the role of eosinophils and platelet-derived growth factor receptor A (PDGFRA) expression in juvenile polyps. This could help in understanding the possible mechanism of polyp formation. Material and methods: This was a retrospective study that included 63 cases of juvenile polyps that were divided into three groups according to the number of polyps. Peripheral and tissue eosinophilia was evaluated. An immunohistochemical study of mothers against decapentaplegic homolog 4 (SMAD4) and PDGFRA was conducted. Results: The majority (82.5%) of the juvenile polyps were solitary, 11.1% were multiple, and 6.4% of them were cases of juvenile polyposis syndrome. There was an increased number of blood eosinophils (a median value of 2 × 10 3 cells/µL) and tissue eosinophils (a median value of 30/HPF). In addition, PDGFRA was overexpressed in 66.7% of cases. The expression of PDGFRA was significantly associated with tissue eosinophilia (p = 0.008). Tissue eosinophilia and PDGRA overexpression were significantly observed in patients with maintained SMAD4 expression. Conclusions: Tissue eosinophilia and PDGFRA overexpression were observed in majority of juvenile polyp cases. Juvenile polyps could share histopathological and molecular similarity to inflammatory fibroid polyp. The pathogenesis of juvenile polyp could be influenced by allergic or neoplastic factors.

Clinical and Experimental Medicine, Mar 9, 2022

Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, ... more Liver biopsy (LB) is the cornerstone in the management of patients with liver diseases. However, a lot of queries had emerged about its role following the end of the interferon era. The aim of this study was to re-evaluate the current role of LB in the diagnosis of liver diseases. All patients who had underwent LB at the Department of Hepatology, National Liver Institute, from January 2015 through December 2018 were recruited. Indications for LB, pathology reports and medical records of all cases were retrieved, reviewed and statistically analyzed. A total of 275 liver biopsies were collected, 191 males and 84 females with mean age 41.22 ± 13.36 years. Etiological diagnosis made by histopathological evaluation was 48 drug-induced liver injury (DILI), 42 nonalcoholic fatty liver disease (NAFLD), 34 chronic hepatitis B, or C with cholestasis, 29 autoimmune hepatitis, 34 primary sclerosing cholangitis, 13 primary biliary cholangitis, 7 autoimmune overlap syndrome, 13 active bilharziasis and 10 Wilson's disease. Minor number of cases was diagnosed by different other etiologies. Initial diagnosis was made by liver biopsy and confirmed by clinical response and laboratory findings. Liver biopsy is still considered as the gold standard diagnostic measure of different liver diseases representing an integral component of management decisions in hepatology.

Objectives To study the epidemiological and pathological properties of hepatocellular carcinoma (... more Objectives To study the epidemiological and pathological properties of hepatocellular carcinoma (HCC) cases eligible for surgical resection. Background HCC is the sixth most common cancer worldwide and the third most common cause of cancer death. In Egypt, liver cancer forms 1.68% of the total malignancies. HCC constitutes 70.48% of all liver tumors among Egyptians. HCC represents the main complication of cirrhosis. Materials and methods This longitudinal study included 92 HCC patients who had undergone surgical intervention. Clinical and demographic data were collected from medical records, and paraffin blocks were retrieved from the Archives of the Pathology Department, National Liver Institute, Menoufia University, during the period between March 2007 and October 2014. Results revealed that 51.1% of the studied HCC patients were at least 58 years old, 81.5% male and 18.5% female, 51.2% of the patients had an a-fetoprotein level of at least 200 ng/ml and 95.7% were positive for he...

Asian Pacific Journal of Cancer Prevention

Egypt, pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC) constitute 15.9% and ... more Egypt, pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC) constitute 15.9% and 1.8%, respectively, of all hepatobiliary and gastrointestinal malignancies (Mokhtar et al., 2016). Risk factors for PDAC include smoking, diabetes mellitus, alcohol intake, chronic and hereditary pancreatitis, and familial cancer syndromes. Duodenal carcinoma and AC may arise from preexisting adenomas, and bile duct cancers are associated with primary sclerosing cholangitis and congenital anomalies (Hutchins and Williamson, 2003). Radical pancreaticoduodenectomy (PD) is the treatment of choice for all resectable PAAC subtypes.

Egyptian Liver Journal

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects ... more Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions AIHA patients co-infected with SARS-CoV-2 may be at risk...

International Journal of Cancer and Biomedical Research

Egyptian Liver Journal

Background The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavir... more Background The pandemic of COVID19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first described in China as an unexplained pneumonia transmitted by respiratory droplets. Gastrointestinal (GI) and liver injury associated with SARS-CoV-2 infection were reported as an early or sole disease manifestation, mainly outside China. The exact mechanism and incidence of GI and liver involvement are not well elucidated. Main body We conducted a PubMed search for all articles written in the English language about SARS-CoV-2 affecting the GI and liver. Following data extraction, 590 articles were selected. In addition to respiratory droplets, SARS-CoV-2 may reach the GI system through the fecal-oral route, saliva, and swallowing of nasopharyngeal fluids, while breastmilk and blood transmission were not implicated. Moreover, GI infection may act as a septic focus for viral persistence and transmission to the liver, appendix, and brain. In addition to the dire...

The Medical Journal of Cairo University

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects... more Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation: A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions: AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.

Egyptian Liver Journal

Background The rapidly developing era of direct-acting antiviral regimens (DAAs) for more than on... more Background The rapidly developing era of direct-acting antiviral regimens (DAAs) for more than one hepatitis C virus (HCV) genotype had certainly alleviated HCV burden all over the world. Liver fibrosis is the major dramatic complication of HCV infection, and its progression leads to cirrhosis, liver failure, and hepatocellular carcinoma. The impact of DAAs on liver fibrosis had been debatably evaluated with undetermined resolution. Main body The aim of this review is to accurately revise the effects of DAA regimens on liver fibrosis which can either be regression, progression, or non-significant association. Liver fibrosis regression is a genuine fact assured by many retrospective and prospective clinical studies. Evaluation could be concluded early post-therapy reflecting the dynamic nature of the process. Conclusions The ideal application of DAA regimens in treating HCV has to be accomplished with efficient non-invasive markers in differentiating proper fibrosis evaluation from n...

Background: Non-alcoholic fatty liver disease (NAFLD) is the emerging cause of chronic liver dise... more Background: Non-alcoholic fatty liver disease (NAFLD) is the emerging cause of chronic liver disease. In addition, steatosis may lead to failure of obtaining sustained virological response after hepatitis C virus eradication. Therefore, there is a trend to identify effective strategies for managing hepatic steatosis. Farnesoid X receptor (FXR) agonists are reported to play a role in NAFLD treatment. Objective: This study aimed to explore the immunohistochemical expression of FXR in NAFLD spectrum in association with the clinicopathological data. Material and method: This was a retrospective study including 50 cases of NAFLD and 23 cases of normal liver. The NAFLD group was subdivided into 11 cases of NAFL (simple steatosis) and 39 cases of non-alcoholic steatohepatitis (NASH). Results: Hepatocyte FXR nuclear expression was significantly decreased in NASH group (P=0.001) with no significant decrease in NAFL group compared to normal liver (P=0.149). Bile duct FXR expression was signif...

Journal of Gastrointestinal Cancer