Background: Although obstructive sleep apnea syndrome (OSAS) has been associated with chronic kidney disease CKD, there are little data about early screening of renal affection in OSAS patients. Aim of the work: To evaluate renal function in OSAS patients with or without diabetes mellitus (DM) using blood indices [mean platelet volume (MPV) and red cell distribution width (RDW)] and serum neutrophil gelatinase associated lipocalin (NGAL) as early markers of kidney injury. Patients and methods: This case control analytic study was designed to enroll 20 OSAS patients with DM, 20 OSAS patients without DM, and 20 non OSAS diabetic patients as control group. All patients underwent full over-night attended diagnostic polysomnography. Those with AHI
5 were considered to have OSAS. Laboratory parameters including complete blood count with MPV and RDW, serum glucose, urea, creatinine, Hemoglobin A1c, urine albumin creatinine ratio UACR and serum NGAL were done to all enrolled participants. Results: Urine albumin creatinine ratio UACR
3 mg/mmol was found in 11 (55%) of OSAS diabetic group, 6 (30%) of non diabetic OSAS group and in 11 (55%) of D.M group. Both diabetic and non diabetic OSAS patients had significantly higher RDW and NGAL compared to non OSAS diabetic. The diabetic OSAS group had also significantly higher serum urea and creatinine compared to DM group. In OSAS patients, RDW had significant positive correlation with UACR. Meanwhile both RDW and NGAL were determined to have significant positive correlation with desaturation index during sleep, but not correlated to AHI. Conclusion: Renal impairment is common in OSAS patients but more frequent if associated with diabetes mellitus. RDW% can be used as simple screening test for early detection of renal injury in OSAS patients with or without diabetes mellitus.

Background: Although obstructive sleep apnea syndrome (OSAS) has been associated with chronic kidney disease CKD, there are little data about early screening of renal affection in OSAS patients. Aim of the work: To evaluate renal function in OSAS patients with or without diabetes mellitus (DM) using blood indices [mean platelet volume (MPV) and red cell distribution width (RDW)] and serum neutrophil gelatinase associated lipocalin (NGAL) as early markers of kidney injury. Patients and methods: This case control analytic study was designed to enroll 20 OSAS patients with DM, 20 OSAS patients without DM, and 20 non OSAS diabetic patients as control group. All patients underwent full over-night attended diagnostic polysomnography. Those with AHI
5 were considered to have OSAS. Laboratory parameters including complete blood count with MPV and RDW, serum glucose, urea, creatinine, Hemoglobin A1c, urine albumin creatinine ratio UACR and serum NGAL were done to all enrolled participants. Results: Urine albumin creatinine ratio UACR
3 mg/mmol was found in 11 (55%) of OSAS diabetic group, 6 (30%) of non diabetic OSAS group and in 11 (55%) of D.M group. Both diabetic and non diabetic OSAS patients had significantly higher RDW and NGAL compared to non OSAS diabetic. The diabetic OSAS group had also significantly higher serum urea and creatinine compared to DM group. In OSAS patients, RDW had significant positive correlation with UACR. Meanwhile both RDW and NGAL were determined to have significant positive correlation with desaturation index during sleep, but not correlated to AHI. Conclusion: Renal impairment is common in OSAS patients but more frequent if associated with diabetes mellitus. RDW% can be used as simple screening test for early detection of renal injury in OSAS patients with or without diabetes mellitus.

Background: Haemophilia is a group of rare congenital disorders of blood where there’s a defect in mechanism of clotting due to deficiency in factor VIII (Haemophilia A) or factor IX (Haemophilia B). It’s inherited as xlinked recessive disorder but 30% of patients have no family history of the disease and they usually have spontaneous new mutation. Aim: to describe the epidemiological situation of haemophilia in Assiut, assist the various complications and the type of treatment. Patients and Methods: retrospective study was conducted on 75 hemophilic patients who were attending to Clinical Hematology Unit, Internal Medicine Department; Assiut University Hospital, Clinical Hematology Unit of Assiut Pediatric Hospital and Hematological Clinics in Assiut Health Insurance Clinics from the period between 2014-2016. Results: haemophilia A represent 85.3% of the studied patients and 14.7% had haemophilia B. As regard residency 64% of haemophilia A patients and 13.3% of haemophilia B patients live in rural areas. We found positive consanguinity in 77.3% of hemophilic patients. Patients were classified according to the severity of bleeding manifestations into mild haemophilia in 84.4%, moderate haemophilia in 15.6%. As regards complications of hemophilic patients 76% had complication. The most common complications were hemarthrosis in 26.7% patients, muscle hematoma in16% and post transfusion infections as we found Positive HCV in 5.3%. As regard Treatment 54(72%) of all hemophilic patients were on demand treatment and 18(24%) with prophylaxis treatment while 3(4%) with no treatment. There was statistically significant (P 0.001) increased complications in patients received on demand treatment compared to those received prophylaxis treatment. Conclusions: The most common inherited bleeding disorder in our locality was haemophilia A followed by haemophilia B. Haemophilia was more common in rural area. Increase cases with consanguineous marriages. Hemarthrosis, hematoma and hepatitis C infection represented the main complications. Awareness, education and genetic counseling will be needed to decrease the spread of haemophilia in our community. Factor support (prophylaxis treatment) should be initiated for all patients as early as possible just diagnosis is confirmed to reduce the frequency of complications. Screening of blood and blood products to reduce the risk of viral hepatitis.

Background: Haemophilia is a group of rare congenital disorders of blood where there’s a defect in mechanism of clotting due to deficiency in factor VIII (Haemophilia A) or factor IX (Haemophilia B). It’s inherited as xlinked recessive disorder but 30% of patients have no family history of the disease and they usually have spontaneous new mutation. Aim: to describe the epidemiological situation of haemophilia in Assiut, assist the various complications and the type of treatment. Patients and Methods: retrospective study was conducted on 75 hemophilic patients who were attending to Clinical Hematology Unit, Internal Medicine Department; Assiut University Hospital, Clinical Hematology Unit of Assiut Pediatric Hospital and Hematological Clinics in Assiut Health Insurance Clinics from the period between 2014-2016. Results: haemophilia A represent 85.3% of the studied patients and 14.7% had haemophilia B. As regard residency 64% of haemophilia A patients and 13.3% of haemophilia B patients live in rural areas. We found positive consanguinity in 77.3% of hemophilic patients. Patients were classified according to the severity of bleeding manifestations into mild haemophilia in 84.4%, moderate haemophilia in 15.6%. As regards complications of hemophilic patients 76% had complication. The most common complications were hemarthrosis in 26.7% patients, muscle hematoma in16% and post transfusion infections as we found Positive HCV in 5.3%. As regard Treatment 54(72%) of all hemophilic patients were on demand treatment and 18(24%) with prophylaxis treatment while 3(4%) with no treatment. There was statistically significant (P 0.001) increased complications in patients received on demand treatment compared to those received prophylaxis treatment. Conclusions: The most common inherited bleeding disorder in our locality was haemophilia A followed by haemophilia B. Haemophilia was more common in rural area. Increase cases with consanguineous marriages. Hemarthrosis, hematoma and hepatitis C infection represented the main complications. Awareness, education and genetic counseling will be needed to decrease the spread of haemophilia in our community. Factor support (prophylaxis treatment) should be initiated for all patients as early as possible just diagnosis is confirmed to reduce the frequency of complications. Screening of blood and blood products to reduce the risk of viral hepatitis.

Background: Haemophilia is a group of rare congenital disorders of blood where there’s a defect in mechanism of clotting due to deficiency in factor VIII (Haemophilia A) or factor IX (Haemophilia B). It’s inherited as xlinked recessive disorder but 30% of patients have no family history of the disease and they usually have spontaneous new mutation. Aim: to describe the epidemiological situation of haemophilia in Assiut, assist the various complications and the type of treatment. Patients and Methods: retrospective study was conducted on 75 hemophilic patients who were attending to Clinical Hematology Unit, Internal Medicine Department; Assiut University Hospital, Clinical Hematology Unit of Assiut Pediatric Hospital and Hematological Clinics in Assiut Health Insurance Clinics from the period between 2014-2016. Results: haemophilia A represent 85.3% of the studied patients and 14.7% had haemophilia B. As regard residency 64% of haemophilia A patients and 13.3% of haemophilia B patients live in rural areas. We found positive consanguinity in 77.3% of hemophilic patients. Patients were classified according to the severity of bleeding manifestations into mild haemophilia in 84.4%, moderate haemophilia in 15.6%. As regards complications of hemophilic patients 76% had complication. The most common complications were hemarthrosis in 26.7% patients, muscle hematoma in16% and post transfusion infections as we found Positive HCV in 5.3%. As regard Treatment 54(72%) of all hemophilic patients were on demand treatment and 18(24%) with prophylaxis treatment while 3(4%) with no treatment. There was statistically significant (P 0.001) increased complications in patients received on demand treatment compared to those received prophylaxis treatment. Conclusions: The most common inherited bleeding disorder in our locality was haemophilia A followed by haemophilia B. Haemophilia was more common in rural area. Increase cases with consanguineous marriages. Hemarthrosis, hematoma and hepatitis C infection represented the main complications. Awareness, education and genetic counseling will be needed to decrease the spread of haemophilia in our community. Factor support (prophylaxis treatment) should be initiated for all patients as early as possible just diagnosis is confirmed to reduce the frequency of complications. Screening of blood and blood products to reduce the risk of viral hepatitis.

Background: Haemophilia is a group of rare congenital disorders of blood where there’s a defect in mechanism of clotting due to deficiency in factor VIII (Haemophilia A) or factor IX (Haemophilia B). It’s inherited as xlinked recessive disorder but 30% of patients have no family history of the disease and they usually have spontaneous new mutation. Aim: to describe the epidemiological situation of haemophilia in Assiut, assist the various complications and the type of treatment. Patients and Methods: retrospective study was conducted on 75 hemophilic patients who were attending to Clinical Hematology Unit, Internal Medicine Department; Assiut University Hospital, Clinical Hematology Unit of Assiut Pediatric Hospital and Hematological Clinics in Assiut Health Insurance Clinics from the period between 2014-2016. Results: haemophilia A represent 85.3% of the studied patients and 14.7% had haemophilia B. As regard residency 64% of haemophilia A patients and 13.3% of haemophilia B patients live in rural areas. We found positive consanguinity in 77.3% of hemophilic patients. Patients were classified according to the severity of bleeding manifestations into mild haemophilia in 84.4%, moderate haemophilia in 15.6%. As regards complications of hemophilic patients 76% had complication. The most common complications were hemarthrosis in 26.7% patients, muscle hematoma in16% and post transfusion infections as we found Positive HCV in 5.3%. As regard Treatment 54(72%) of all hemophilic patients were on demand treatment and 18(24%) with prophylaxis treatment while 3(4%) with no treatment. There was statistically significant (P 0.001) increased complications in patients received on demand treatment compared to those received prophylaxis treatment. Conclusions: The most common inherited bleeding disorder in our locality was haemophilia A followed by haemophilia B. Haemophilia was more common in rural area. Increase cases with consanguineous marriages. Hemarthrosis, hematoma and hepatitis C infection represented the main complications. Awareness, education and genetic counseling will be needed to decrease the spread of haemophilia in our community. Factor support (prophylaxis treatment) should be initiated for all patients as early as possible just diagnosis is confirmed to reduce the frequency of complications. Screening of blood and blood products to reduce the risk of viral hepatitis.

Background: Haemophilia is a group of rare congenital disorders of blood where there’s a defect in mechanism of clotting due to deficiency in factor VIII (Haemophilia A) or factor IX (Haemophilia B). It’s inherited as xlinked recessive disorder but 30% of patients have no family history of the disease and they usually have spontaneous new mutation. Aim: to describe the epidemiological situation of haemophilia in Assiut, assist the various complications and the type of treatment. Patients and Methods: retrospective study was conducted on 75 hemophilic patients who were attending to Clinical Hematology Unit, Internal Medicine Department; Assiut University Hospital, Clinical Hematology Unit of Assiut Pediatric Hospital and Hematological Clinics in Assiut Health Insurance Clinics from the period between 2014-2016. Results: haemophilia A represent 85.3% of the studied patients and 14.7% had haemophilia B. As regard residency 64% of haemophilia A patients and 13.3% of haemophilia B patients live in rural areas. We found positive consanguinity in 77.3% of hemophilic patients. Patients were classified according to the severity of bleeding manifestations into mild haemophilia in 84.4%, moderate haemophilia in 15.6%. As regards complications of hemophilic patients 76% had complication. The most common complications were hemarthrosis in 26.7% patients, muscle hematoma in16% and post transfusion infections as we found Positive HCV in 5.3%. As regard Treatment 54(72%) of all hemophilic patients were on demand treatment and 18(24%) with prophylaxis treatment while 3(4%) with no treatment. There was statistically significant (P 0.001) increased complications in patients received on demand treatment compared to those received prophylaxis treatment. Conclusions: The most common inherited bleeding disorder in our locality was haemophilia A followed by haemophilia B. Haemophilia was more common in rural area. Increase cases with consanguineous marriages. Hemarthrosis, hematoma and hepatitis C infection represented the main complications. Awareness, education and genetic counseling will be needed to decrease the spread of haemophilia in our community. Factor support (prophylaxis treatment) should be initiated for all patients as early as possible just diagnosis is confirmed to reduce the frequency of complications. Screening of blood and blood products to reduce the risk of viral hepatitis.

Background: Transfusion support after allogeneic transplantation is closely associated with morbidity, cost and may also affect long-term outcome. To better predict the determinants of hematopoietic recovery of allogeneic hematopoietic stem cell transplantation (HSCT) recipients, we analyzed 214 consecutive patients at our institution from January 2012 to December 2013.

Objective/Background Chronic lymphocytic leukemia is one of the commonest leukemias affecting adults. CD39 inhibits T-cell and Natural killer (NK) cell responses by hydrolyzing adenosine triphosphate and adenosine diphosphate, suppressing the immune system. We investigated expression of CD39 on CD4+ T Lymphocytes in chronic lymphocytic leukemia (CLL) patients and its relationship with deletion 6q, its association with disease stage and survival. Methods Thirty CLL patients and 20 matched controls were included in the study. Bone marrow studies with immunophenotyping, CD39, CD38, and ZAP-70, and detection of del 6q by FISH were performed. Results CD39+ CD4+ T helper cells in CLL patients were significantly expressed compared with the controls (p  .001). Levels of CD39+ CD4+ T cells were significantly expressed in high risk CLL patients. Del 6q was detected in 63.3% of patients and it correlated with CD39, CD38, and ZAP-70, and advanced stage disease. There was a significant relation between response to treatment and CD39 expression and del 6q, also there was a significant difference in overall survival (OS) between patients with and without Del 6q. Conclusion CD39 expression on CD4+ Tcells and del 6q act as prognostic markers in CLL. Blocking or inhibition of CD39 may be a target for new immune therapy for CLL.

Objective/Background Chronic lymphocytic leukemia is one of the commonest leukemias affecting adults. CD39 inhibits T-cell and Natural killer (NK) cell responses by hydrolyzing adenosine triphosphate and adenosine diphosphate, suppressing the immune system. We investigated expression of CD39 on CD4+ T Lymphocytes in chronic lymphocytic leukemia (CLL) patients and its relationship with deletion 6q, its association with disease stage and survival. Methods Thirty CLL patients and 20 matched controls were included in the study. Bone marrow studies with immunophenotyping, CD39, CD38, and ZAP-70, and detection of del 6q by FISH were performed. Results CD39+ CD4+ T helper cells in CLL patients were significantly expressed compared with the controls (p  .001). Levels of CD39+ CD4+ T cells were significantly expressed in high risk CLL patients. Del 6q was detected in 63.3% of patients and it correlated with CD39, CD38, and ZAP-70, and advanced stage disease. There was a significant relation between response to treatment and CD39 expression and del 6q, also there was a significant difference in overall survival (OS) between patients with and without Del 6q. Conclusion CD39 expression on CD4+ Tcells and del 6q act as prognostic markers in CLL. Blocking or inhibition of CD39 may be a target for new immune therapy for CLL.