Abstract
Background and aim: Cirrhotic patients have increased mortality and longer hospital stay due to increased susceptibility to develop bacterial infection. Herein, we aimed to evaluate the role of neutrophil to lymphocytes ratio(NLR) and high sensitivity C-reactive protein(Hs-CRP) in diagnosis of infection and prediction of short term mortality in hospitalized cirrhotic patients. Patients and methods: The study included 50 cirrhotic patients hospitalized in ICU of a central Liver hospital. The presence of overt infection was evaluated. The NLR was calculated as the ratio of the neutrophils to lymphocytes in the peripheral blood. Hs-CRP concentration was measured by Immunoturbidimetric assay. Model for End-Stage Liver Disease(MELD) score, Child-Pugh score and the presence of systemic inflammatory response syndrome(SIRS) were assessed.
Results: The main cause of admission was refractory ascites(50%), followed by hematemesis(24%), spontaneous bacterial peritonitis(18%) and hepatic encephalopathy(8%). Development of SIRS occurred in 24(48%) patients and death occurred in 15(30%) patients. NLR and Hs-CRP were significantly higher in patients who developed SIRS(0.03and P= 0.01) respectively. For predicting short-term survival, MELD score, NLR and Hs-CRP were significant factors(P = 0.03, 0.01 and 0.01 respectively).
Conclusion: NLR and Hs-CRP are helpful diagnostic markers of infection and development of SIRS in hospitalized cirrhotic patients. In addition to the classical MELD score, NLR may be a useful predictor of the short-term mortality in hospitalized cirrhotic patients particularly in Child–Pugh class C.
Keywords: high sensitivity C-reactive protein, Neutrophil-to-lymphocyte ratio, Liver cirrhosis, SIRS, short-term Survival

The effect of nonalcoholic fatty liver disease (NAFLD) on outcome of patients with ST‑segment
elevation myocardial infarction is controversial. The purpose of the study aimed to assess the
effect of NAFLD on myocardial and epicardial reperfusion after primary percutaneous coronary
intervention (PPCI) among nondiabetic patients.
Patients and methods
A total of 240 nondiabetic patients with ST‑segment elevation myocardial infarction were
recruited and underwent PPCI. After revascularization, epicardial reperfusion had been
assessed by thrombolysis in myocardial infarction (TIMI) flow grades and TIMI frame
count, and myocardial reperfusion had been assessed by TIMI myocardial perfusion grade
and ST‑segment resolution. NAFLD had been assessed and graded based on abdominal
ultrasonography and then the patients were subdivided into NAFLD group (111 patients) and
non‑NAFLD group (129 patients).
Results
The overall prevalence of NAFLD in the current study was 46.5%. Clinically, KILLIP class more
than I was significant in NAFLD group [24 (P < 0.001)]. Multivessel coronary artery disease was
significant in NAFLD group [63 (56.8%) vs. 23 (17.8%); P < 0.001]. Eleven patients of NAFLD
group died, whereas no deaths occurred in the other group. Postprocedural myocardial blush
grades 0 and 1 were significant in patients with NAFLD group (P < 0.001). Moreover, absent
ST‑segment resolution and TIMI frame count were significant (P < 0.001) in NAFLD group.
Finally, NAFLD was an independent predictor for in‑hospital and follow‑up cardiac events.
Conclusions
NAFLD is considered an independent risk factor for the occurrence of in‑hospital and follow‑up
adverse cardiac events after PPCI in nondiabetic patients.

Background

Coronavirus disease 2019 (COVID-19) has a significant impact on children, adolescents, and their families. So, the purpose of this study is to investigate the prevalence of children’s psychological problems during the COVID-19 pandemic and their association of COVID-19 infection in children and their risk factors. A cross-sectional study was conducted on 148 children aged 6–12 years old categorized into 2 groups based on COVID-19 infection history. Participants were assessed by the Socioeconomic Scale and the Checklist for Children’s Behavior (CBCL).

Results

Children who had COVID-19 had a high percentage of problems regarding family, school, social, financial, and parent problems due to the COVID-19 pandemic. Regarding CBCL, children who had COVID-19 infection had a higher percentage of clinical rating than the other …