AimThe aim was to describe the incidence of access-site complications (ASCs) and determine the risk factors leading to them in patients undergoing endovascular interventions for treatment of peripheral arterial disease.Materials and methodsA prospective study was conducted on all patients who underwent endovascular procedures for the treatment of peripheral arterial disease at the Department Vascular Surgery, Assiut University Hospital, between May 2017 and May 2018. Access choice depended on the vessel condition, Duplex ultrasound examination, and surgeon's preference. ASCs were detected using clinical and duplex ultrasound examination. Follow-up of patients was done at 3 and 6 months postoperatively. Univariate and multivariate analyses were used to determine risk factors predicting occurrence of ASCs.ResultsOf the 210 patients, ASCs were encountered in 23 (11%) cases. Nine (4.3%) patients presented with thrombosis of the access artery, eight (3.8%) had access-site hematoma, four (1.9%) complained of external bleeding, and two patients (0.95%) presented with femoral artery pseudoaneurysm. Significant risk factors for ASCs were advanced age (=0.027), hypertension (=0.011), increased BMI (=0.015), small vessel diameter (=0.031), and prolonged procedure time 

SARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery

Summary Peri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5)

Background:Hepatocellular carcinoma (HCC) is the most prevalent liver cancer with a high incidence and mortality, mainly when discovered in its advanced stages. Periodic screening is necessary for high risk populations for the detection of the disease in the early curable stage. The most commonly used tumor marker for screening and diagnosis of HCC is AFP. Various studies have investigated the function of miRNAs as diagnostic or prognostic biomarkers in human cancers, including HCC, where they serve both as oncogenes and tumor suppressor genes, depending on the cellular affection of their targets. This study aims to evaluate the expression of miRNA-130b in the plasma of patients with HCC, HCV, and LC and its relation to BCLC staging. Evaluate the diagnostic performance of miRNA-130b, AFP and their combination for the diagnosis of HCC, especially in early stages and high-risk cirrhotic patients.

Methods:The study included four groups: 39 patients with HCC, 15 patients with HCV without any other pathology, 15 patients with LC on top of HCV and 10 healthy control individuals. AFP was measured by chemiluminescence using ADVIA Centaur Auto-Analyzer. The expression level of miRNA-130b was assessed by a real-time polymerase chain reaction.

Results: Patients with HCC had significantly higher level of micro-RNA-130b and AFP in comparison to other groups. LC patients had significantly higher levels of AFP in comparison to those with HCV. Levels of miRNA-130b and AFP were higher in late stages of HCC and large size of HFL. By ROC curve analysis miRN-130b had better diagnostic performance in detection of high risk cirrhotic patients than AFP or on combination of both markers. For diagnosis of early HCC and differentiation between HCC and LC it was found that combination of both markers had higher AUC than each marker alone.

Conclusion:Plasma miRNA-130b level can be used as a good marker for distinguishing HCC patients from non-malignant groups (HCV, LC, and normal healthy controls) with better diagnostic performance than AFP. It showed higher levels in late stages of HCC. Combination of both markers was better in diagnosis of early stages of HCC and distinguishing LC from HCC.

Aim

This study aims to assess the prevalence of anemia among pneumonic children aged 2 months up to 2 years and identify the associated factors in those children.

Pregnancy of unknown location (PUL) is a term used to describe failure of visualization of intrauterine or extrauterine gestational sac in a woman with a positive pregnancy test.

Body of the abstract

Ectopic pregnancy (EP) accounts for 1–2 % of all pregnancies. EP contributes to maternal mortality of a known cause by 4% in developed countries. However, case fatality rate may be 10 times higher in low-resource countries. This may be attributed to delayed diagnosis and lack of resources. PUL is a temporary term that may eventually lead to diagnosis of viable intrauterine pregnancy, pregnancy loss, or more seriously, EP.

Abstract
Background/Aims: Hepatocellular carcinoma (HCC) is the fifth most common malignancy and
most frequently develops in patients with cirrhosis. Surveillance strategies are recommended
in high-risk groups because early detection of small lesions improves the likelihood of
curative treatment. This study investigated the prospective clinical significance of serum levels
of anti-Ku86 and plasma levels of lamin B1and vimentin as early markers of HCC. Methods:
We recruited 74 patients at Assiut University Hospital—37 with HCC and 37 with chronic
liver disease (liver cirrhosis patients)—and 36 age- and sex-matched healthy controls. Lamin
B1 and vimentin mRNA expression levels were evaluated by reverse transcription-PCR and
serum levels of anti-Ku86 were measured by enzyme-linked immunosorbent assay. Results:
Compared with liver disease patients and controls, HCC patients showed higher levels of lamin
B1 mRNA (sensitivity, 96%; specificity, 65%), vimentin mRNA (sensitivity, 94%; specificity, 92%),
and anti-Ku86 (sensitivity, 94%; specificity, 80%). LaminB1 levels were significantly higher in
patients with a tumor size < 2 cm than in patients with tumors 2–5 cm and >5cm in size. Lamin
B1 had significant positive correlations with alpha-fetoprotein (AFP) (P=0.034) and anti-Ku86
(P=0.002). Receiver operating characteristic curves for differentiating HCCfrom liver cirrhosis
revealed a higher area under the curve(AUC).for vimentin than for AFP, lamin B1, and anti-Ku86
for the diagnosis of HCC (P<0.001). Conclusion: Circulating levels of anti-Ku86, lamin B1,and
vimentin might be potential surrogate markers of HCC, either alone or in combination with
AFP. However, independent and discriminative serological biomarkers with higher sensitivity
and specificity are still needed for the early detection of HCC.

Purpose: To highlight the anterior chamber parameters changes after pars plana vitrectomy with silicone oil tamponade by Scheimpflug imaging. Methods: A prospective observational study was conducted on 20 patients (20 eyes) who had PPV for various indications. Using Scheimpflug imaging, all participants were assessed before PPV with Silicone oil tamponade and 1 week after the surgery to demonstrate the changes in AC parameters. The primary outcome measure was the change in central AC depth, while the secondary outcome measures were the changes in peripheral AC depth, AC volume, and anterior chamber angle. Results: There was a statistically significant reduction in CACD and Average PACD compared with the preoperative values (P=0.013 and <0.001, respectively). Moreover, there was a significant moderate positive correlation between AvPACD difference and preoperative AvPACD (r=0.512, P-value<0.001). There was a significant reduction in mean ACV compared with the preoperative value (P=0.010). There was a significant, strong positive correlation between ACV difference and preoperative ACV (r=0.742, p value <0.001). The mean ACA was 36.96°±12.89° preoperatively and decreased to 33.90°±8.44° one week postoperatively. However, this change was not statistically significant (P=0.293). There was a statistically significant strong positive correlation between ACA difference and preo perative ACA (r=0.781, p-value<0.001). Conclusion: Silicone oil tamponade with PPV induces significant short-term alterations in anterior chamber parameters, particularly a reduction in anterior chamber depth and volume. A comprehensive understanding of these parameter variations is essential for effective postoperative management.

Assessment and quantification of ipsilateral and contralateral ankle joint alignment changes after unilateral total knee arthroplasty for knee osteoarthritis with varus