Rheumatoid arthritis (RA) is one of the common autoimmune diseases, which affected by genetic and environmental factors. IL-12 is important cytokine that play an effective role in the inflammatory reaction of RA. It regulates the balance between Th1 and Th2 cells. Gene polymorphism of cytokines may predispose to susceptibility and severity of RA. To assess the association between single nucleotide polymorphism (SNP) in IL-12B gene (rs3212227 A/C) and serum level of IL-12 with the development and or activity of RA disease in Egyptian population. Sixty RA patients and thirty healthy individuals were studied for IL-12B gene (rs3212227 A/C) polymorphism using PCR-RFLP. Serum level of IL-12 was measured by ELISA. The frequency of genotype AC, CC, AC+CC and C allele were significantly higher in patients compared to control group (P<0.02, 0.007, 0.02) respectively. Serum level of IL-12 was significantly higher in patients compared to control (P<0.000). Patients who carry AC+CC genotypes had significantly higher DAS28, RF, ACCP and IL-12 compared to AA genotype patients (P<0.05, 0.000, 0.000, 0.000) respectively. RA patients who carry AC, CC genotypes had more positive inflammatory markers (RF, ACCP) with P<0.000, 0.05 respectively. Significant positive correlation was found between serum IL-12 and number of swollen joints, RF and ACCP. Present findings suggest that IL-12B gene (rs3212227 A/C) may be associated with development and activity of RA and that serum IL-12 can be used as predictor of activity of the disease

Type 1 diabetes mellitus (T1DM) remains the most common form of diabetes in childhood. The incidence of type 1 diabetes is continuously increased. Zinc transporter protein 8 antibodies (ZnT8A) measurement can be helpful in detection of suspected new cases of type 1diabetes when other islet auto antibodies are negative. We evaluated the role of ZnT8A in diagnosis of new cases of T1DM in comparison to islet cell antibody (ICA), and assessed its prediction value among siblings. 31 of newly diagnosed T1DM patients and 55 age and sex matched healthy siblings were included. Measurements of ZnT8A and ICA was carried out by ELISA. ZnT8A had 45% sensitivity and 69% specificity while ICA had 64.5% sensitivity and 83.64% specificity. 22.6% of diabetic patients had high level of ZnT8A as compared to 20% of siblings (P< 0.001 and P < 0.001, respectively). 28.6% of diabetic patients with high titer ZnT8A had positive ICA (P <0.04) as compared to 63.6% in sibling group (P<0.001). It is concluded that ZnT8A and ICA play an important role in diagnosis and prediction of T1DM cases.

Introduction
Microalbuminuria is considered an early marker of glomerular injury in patients with
diabetes, but tubular injury can precede glomerular injury and cannot be detected
by microalbumin. We need a new and early marker of kidney injury in
normoalbuminuric diabetic patients. Urinary heme oxygenase-1 (uHO-1) is an
enzyme that is produced in tubules in response to oxidative stress and can be a
marker of tubular injury.
Aim
To investigate the clinical implication of uHO-1 as an early diagnostic marker in
diabetic nephropathy (DN).
Patients and methods
A total of 65 diabetic patients, comprising 20 microalbuminuric patients and 45
normoalbuminuric patients, and 20 healthy participants as a control group were
included in this study. Level of uHO-1 was detected by enzyme-linked
immunosorbent assay.
Results
uHO-1 was highly significantly elevated (P<0.000) in microalbuminuric group
compared with normoalbuminuric group and control group, respectively.
Normoalbuminuric group was highly significantly elevated (P<0.000) in uHO-1
compared with the control group. uHO-1 was positively correlated with
albumin–creatinine ratio but was not correlated with estimated glomerular
filtration rate. Receiver operating characteristic curve analysis of uHO-1 levels
for early diagnosis of DN revealed that the cutoff value of uHO-1 was 5.8 ng/ml
(sensitivity 80% and specificity 71%) for early diagnosis of DN.
Conclusion
The findings of this study indicate that elevated levels of uHO-1 can be detected in
normoalbuminuric diabetic patients and revealed renal tubular damage. uHO-1
may be used as an early biomarker for DN.

Context: Febrile convulsion is one of the most important types of convulsions
in children. Iron and zinc are important trace elements that affect some enzymes
in central nervous system, and their deficiencies could disturb the inhibitory
mechanisms in the brain, thus producing convulsions. Aim: To evaluate the
relation between iron deficiency, zinc deficiency, and febrile convulsions. Settings
and Design: A cross-sectional study was carried out. Subjects and Methods: The
study included 100 children of the pediatric hospital in Assiut University, Assiut,
Egypt; 50 children with febrile convulsions as the study group and 50 febrile
children without convulsions as the control group. Statistical Analysis: The
Statistical Package for the Social Sciences (SPSS) software, version 20, was used
for statistical analysis. Results: The mean value of hemoglobin, mean corpuscular
volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin
concentration iron, and ferritin were significantly lower in cases than that in the
control group. Significantly, zinc level was lower in 68% of cases and 36% of
control children. Moreover, the mean value of zinc was significantly lower in
cases than that in the control group. Conclusion: Lower levels of iron and zinc
seem to be predisposing factors for developing febrile convulsions

Background
Hepatocellular carcinoma (HCC) is a common worldwide cancer. α‑Fetoprotein (AFP) is a
routinely used biomarker for HCC diagnosis, but with reduced clinical applicability due to low
sensitivity and specificity. Dickkopf‑1 (DKK‑1) is vital in the differentiation, survival, apoptosis,
and cell death. DKK‑1 has a potential oncogenic role in carcinogenesis.
Aim
In this study, we evaluated the diagnostic and prognostic performance of serum DKK‑1, AFP,
and their combination in HCC.
Patient and methods
This study was done on 40 HCC patients, 24 liver cirrhosis patients, and 16 age‑matched
and sex‑matched healthy controls. The patients were selected from the Tropical Medicine and
Gastroenterology Department, Al‑Rajhi Liver Hospital.
Results
The optimum cutoff for DKK‑1 in HCC patients versus liver cirrhosis and control groups was
more than 331 pg/ml with a sensitivity of 80.0% and specificity of 87.5%. The optimum cutoff
for AFP was more than 8 IU/ml (sensitivity 77.5%, specificity 85.0%).The combination of the
two markers had the best sensitivity (92.5%) in the diagnosis of HCC patients.
Conclusion
DKK‑1 levels was significantly higher in newly diagnosed HCC patients than in the nonmalignant
control group. The combination of the two markers (DKK‑1 and AFP) enhanced the sensitivity

Background
Acute kidney injury (AKI) after a percutaneous coronary intervention (PCI) is a major complexity.
Early AKI diagnosis can help in treating this complication. Neutrophil gelatinase‑associated
lipocalin (NGAL) is a recent marker for the diagnosis of contrast‑induced acute kidney
injury (CI‑AKI). This research targeted to evaluate the early diagnosis of CI‑AKI and predictive
value of NGAL and study the correlation between renal role tests and serum NGAL in cases
with coronary artery disorder.
This research was conducted on 45 cases with coronary artery disorder. Serum NGAL, urea,
and creatinine (SCr) were evaluated. The estimated glomerular‑filtration rate (eGFR) was
measured 2 and 48 h after PCI.
Results
In total, 11 (24.4%) patients had AKI, while 34 (75.6%) patients had no AKI. Serum urea NGAL
was significantly greater in AKI cases either 2 or 48 h after PCI, while SCr was significantly
greater in AKI cases 48 h after PCI. eGFR 48 h after PCI was significantly decreased in AKI
patients. Albumin/creatinine (A/C) ratio was significantly greater in AKI cases. Serum NGAL
2 h after PCI positively correlated with A/C ratio and SCr 48 h after PCI, but is negatively
correlated with eGFR 48 h after PCI. After 2 h, serum levels of NGAL had 90% sensitivity and
55% specificity; after 48 h, they had 81% sensitivity and 61% specificity. SCr after 2 h had
63% sensitivity and 82% specificity, and after 48 h, had 90% sensitivity and 88% specificity.
Conclusion
Serum NGAL can represent a sensitive early predictor biomarker for kidney damage after PCI.

Background: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health problem. Inherited
thrombophilias have been one of the causes. Mutation in genes encoding coagulation proteins, including prothrombin
(PT G20210A) and methylenetetrahydrofolate reductase (MTHFR) genes, increase tendency for venous thromboembolism.
This study aimed to evaluate association between polymorphisms in prothrombine and MTHFR genes with
RM. We also evaluated association between protein C (PC), protein S (PS), antithrombin III (ATIII), and homocystiene
with RM.
Materials and Methods: We conducted a case-control study on women with history of miscarriages and healthy
controls. Genetic analysis was done using (TaqMan) polymerase chain reaction (PCR) technique and the other
tests were performed to check general health indications and thrombophilia markers.
Results: In this study, 195 RM group (group I) participants and 90 healthy controls (group II), PC, PS, ATIII deficiency
and Hyperhomocysteinemia were in 7.2, 65.6, 9.2, 10.8% of group I respectively, but was 1.1, 7.8, 2.2, 2.2% of group
II. PT G20210A showed two in group I were A/G, no A/G in group II, and no AA carrier in the either group. G allele
was observed in 99.5% of the group I and 100% of the group II, while A allele was detected in 0.5% of group I. MTHFR
C677T gene showed C/T mutation in 33.3% of group I and 32.2% of group II, while T/T mutation was detected in 12.8%
of group I and 8.9% of the group II. C allele was found in 70.5% of group I and 75% of group II, while T allele was found
in 29.5% of group I and 25% of group II (P=0.269).
Conclusion: PT G20210A and MTHFR C677T gene mutations are not correlated with RM in the Egyptian population.
However, Egyptian women with RM are strongly associated with hyperhomocysteinemia, PC, PS, and ATIII deficiencies
(registration number: NCT03209063)

Diagnosis of breast cancer by using sensitive and specific biomarkers is necessary. Cell- free DNA (cf-DNA) is a candidate biomarker in various cancers. Contrasting, shorted uniformed DNA released from apoptotic non-diseased cells, DNA released from malignant cells varies in size. DNA integrity is a ratio between 247 and 115 bp. This study aimed to evaluate the diagnostic values of cf-DNA using ALU -247 and ALU- 115 and DNA integrity in peripheral blood of breast cancer patients as a noninvasive marker. Also, to determine correlations between ALU-247 and ALU-115, DNA integrity, cancer antigen (CA )15-3 and carcinoembryonic antigen (CEA) with each other in breast cancer patients and in different stages of breast cancer. This study included 100 females, divided into 3 groups. The first group consisted of 20 apparently healthy females as the control group. The second group included 20 patients with benign breast lesions. The third group included 60 patients with breast cancer. Serum levels of both ALU-247 and ALU-115 as well as cf-DNA integrity were statistically significant higher in breast cancer patients as compared to the control group (p=0.018, p<0.001 and p=0.009 respectively). Compared to the control group, ALU-247 had the best diagnostic sensitivity for diagnosis of breast cancer (86.78%) with 75% specificity with area under the curve of 0.848. We concluded that measuring ALU-247, ALU-115 and DNA integrity in peripheral blood would be a promising novel approach for diagnosis and early detection of breast cancer.

Background. COVID-19 is an illness caused by a novel coronavirus known as severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2). Laboratory healthcare workers (LHCWs) are at highest risk for COVID-19 infection due to direct exposure to
COVID-19 patients and/or infected samples. Objectives. Our primary objective in this study was to evaluate SARS-CoV-2 Ab
testing as a screening tool for detecting COVID-19 infection among asymptomatic LHCWs. Our secondary aims were to establish
the relationship between exposure to COVID-19 infection and subsequent asymptomatic disease and working in di”erent areas of
the laboratory. Method. e detection of SARS-CoV-2 antibodies was done by di”erent methods (rapid testing, electrochemiluminescence,
and chemiluminescent microparticle immunoassay). e study included 199 asymptomatic LHCWs at
Assiut University Hospital, Egypt, from di”erent laboratory areas including molecular biology, microbiology, parasitology, and
outpatient clinic laboratories in addition to LHCWs involved in automation, phlebotomy, rotating physicians, and those working
in the sample receiving area. Results. e incidence of SARS-CoV-2 antibodies by rapid testing and immunoassay among
asymptomatic LHCWs was 29.6% and 24.4%. Laboratory phlebotomists (55.6%) were most likely to be exposed to positive
patients and samples, followed by those working in the sample receiving area (32%), LHCWs in the automation area (29.6%),
rotating doctors (28.6%), and LHCWs in the diagnostic molecular biology laboratory (15.4%). e sensitivities of the rapid test
and SARS-CoV-2 total antibody were 94.1% and 92%, whereas the speciœcities were 92.6% and 91%. Conclusion. Rapid serological
testing is an e”ective screening method for the detection of SARS-CoV-2 infection among asymptomatic LHCWs and the
identiœcation of the groups of workers who have a signiœcantly higher seroprevalence than the rest of the laboratory population.