epatitis C virus (HCV) is a major health problem all over the world with the highest prevalence reported in Egypt. Various treatment regimens have been developed over the last years. Interferon (IFN) based regimen was the standard of care regimen and then the IFN-free therapies were emerged. Host innate immunity through the activity of natural killer (NK) cell is one of the major players in competing infections and tumors, by producing perforin and granzymes that cause cytolysis of target cells, or by the production of various cytokines such as natural interferon gamma. Natural cytotoxicity receptors (NCRs), including Nkp30, Nkp44 and Nkp46, are a group of activating receptors that almost have restricted expression on the surface of NK cells and their density correlates with NK cytotoxicity. The role of these cells is not fully elucidated in patients with chronic HCV infection either treatment-naive or treatment experienced. Therefore, this study aimed to investigate the change that occurs in NK cell activity and cytotoxicity in response to successful elimination of HCV from blood after triple therapy with PEG-IFN-α, ribavirin and sofosbuvir. A total of 56 (50 male: 6 female) HCV patients with mean age of 41.6±12.1 years were included in this study. They were divided into two groups: treatment naive group (20 patients) and the sustained virologic response (SVR) group (36 patients). All patients were investigated for their NK cell profile, NCRs, perforin and granzyme B expression by flow cytometry. Data was expressed as mean fluorescence intensity (MFI). Results revealed significant increase in MFI of granzyme B (P= 0.001) and decrease in MFI of 

There is a significant rise in the prevalence of allergic diseases, including asthma and food allergies.
Studies indicated that the exposure to indoor allergens (mold, dust mites) may be more relevant to the
development of asthma and atopy.IgE is best known as a mediator of allergic reactions ranging from
allergic rhinitis and asthma to life threatening anaphylactic shock. The aim of this study was to detect
the prevalence of food allergens (milk and egg) and indoor allergens (house dust mites and
Alternaria), and their possible relation to the severity of disease in children with asthma attending
Assiut University Children Hospital. The study included 50 cases with asthma attending Assiut
University Children Hospital, during the period from September 2009 to August 2010. Their ages
ranged from 4-14 years. They consisted of 30 males and 20 females. They were selected and classified
according the GINA classification of asthma 2008. They consisted of 10 cases with mild intermittent
asthma, 10 cases with mild persistent asthma, 15 cases with moderate persistent asthma, 15 cases with
severe persistent asthma, as well as 25 apparently healthy children with matchable age and sex as a
control group. All cases and controls were subjected to full history and thorough clinical examination.
Complete blood count, chest x-ray, pulse oxymetry, tuberculin test, urine & stool analysis and
pulmonary function tests were done for all patients and controls. Specific IgE was performed by
human allergen specific assay semi quantitative kit. The percentage frequency of asthma cases with
significantly high IgE level for the studied antigens were significantly higher than those in the control
group. Cases with significant increase in house dust mite specific IgE level were the commonest (84%)
among our patients with asthma followed by those with significant increase in milk specific IgE level
(78%), followed by those with significant increase in Alternaria specific IgE level (68%) and lastly by
those with significant increase in egg specific IgE level (64%) .The percentage frequency of patients
with significant increase in IgE level for the four studied antigens was significantly higher than those
with significant increase in IgE level for three, two or one of the studied antigens. The distribution of
these patients with significant increase in IgE level for the four studied antigens was significantly
higher in the group of cases classified as having severe persistent and moderate persistent asthma.
Cases with moderate and severe increase in serum IgE level were more common in the moderate and
severe persistent asthma patient groups. It could be concluded that house dust mites allergens
followed by food (milk and Alternaria) allergens, then by egg allergens are common among our
studied patients with asthma and correlate with the severity of asthma. Sensitization to more than one
allergen was more common in our studied patients with asthma. This may suggest the role of patient
susceptibility to immune reaction against various allergens. Laboratory studies of patients with
asthma particularly those with moderate and severe persistent asthma for these allergens is
recommended. Studies on the value of desensitization of these patients for such antigens for possible
better management of their illness is highly recommended.

Introduction: Clinical and laboratory markers have limited specificity and sensitivity for predicting renal disease in Systemic Lupus Erythematosus (SLE) patients.
Aim of the Work: In this study we investigated whether urinary neutrophil gelatinase associated lipocalin (uNGAL) predicts active nephritis with or without history of biopsy-proven lupus nephritis (LN), also to find the correlation between uNGAL with serum creatinine level, creatinine clearance, anti-double-stranded (dsDNA) anti body and disease activity score in SLE patients.
Methods: Sixty-three SLE patients based on the American College of Rheumatology (ACR) criteria in this cross sectional study were divided into two groups: patients with and without nephritis. For each group disease activity was measured by SLEDAI [1,2] and then divided to low (SLEDAI<8) and high activity (SLEDAI ³8) according to Annett et al., 2003 [3]. 24 hours uNGALvalues were measured to each group. uNGAL sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating character-istic (ROC) curve was constructed.
Results: The mean±SD of 24-hours uNGAL in patients with LN was significant higher (24.61±3.44mg/24hours) compared to patients without nephritis (16.80±3.54mg/24 hours) with p-value of (p=0.000). A significant positive corre-lation was found between serum creatinine and uNGAL (r=0.324; p=0.030), while there was significant negative correlation between Creatinine clearance and uNGAL (r=–0.310; p=0.013). uNGAL had high sensitivity (82%) and moderate specificity (67%) in patients with biopsy proven LN in comparison to that of anti-dsDNA which had low sensitivity (50%) and specificity (37%) in detection of renal flare in LN patients.
Conclusions: uNGAL predicts renal flare in LN patients with high sensitivity and specificity. Furthermore, uNGAL is a more sensitive and specific for renal flare in patients with a history of LN than anti-dsDNA antibody. So uNGAL may help in earlier diagnosis and treatment of LN with good outcomes in these patients.

Background : Coronary artery diseases are the predominant cause of morbidity and mortality in developed and developing countries. Thus, extraordinary efforts have been directed to determine the molecular and pathological characteristics of the diseased heart ,in order to develop novel diagnostic and therapeutic strategies .miRNAs are class of abundant, non-coding RNAs that attracted scientists′ attention for their promising role as diagnostic and prognostic biomarkers in cardiovascular diseases. Aim of the work: To identify whether miRNA-1 is a dependable biomarker for diagnosis of acute myocardial infarction or not. Subjects and methods: 69 patients with coronary artery disease were included in this study; 36 patients with AMI and 33 patients with unstable angina. Those patients were admitted to coronary care unit, Assuit University Hospital during the period of March to October 2014. In addition to, 22 apparently healthy subjects were included as a control group. Cardiac troponin I & miRNA-1was done for all subjects. Results: In patients with AMI the results of miRNA-1 ranged from 28.3 – 6763.9 fold changes above the control level. In those with UA, miRNA-1 result ranged from 1.74 – 144.37 fold changes above the control level (when the control group is one fold). Comparison between different groups regarding results of miRNA-1 revealed that there was a highly significant difference (P<0.001) between different groups. There was a highly significant increase in patients with AMI when compared with the control group, also a statistically significant increase (P<0.001) in patients with UA when compared with the control group and a statistically significant increase (P<0.001) in patients with AMI when compared with those of UA. Conclusion: miRNA-1 is a novel dependable biomarker in patients with acute coronary syndrome. It shows significant upregulation in patients with AMI, but this upregulation is far from that of UA.

Background
The study aims to determine the accuracy of computed tomography angiography (CTA) in the diagnosis of cases of acute mesenteric ischemia (AMI).
Patients and methods
Fifty patients clinically suspected to have AMI were included and evaluated by multislice computed tomography (MSCT) abdominal angiography to detect the sensitivity, specificity, and diagnostic accuracy of the procedure.
Results
The final diagnosis confirmed mesenteric vascular occlusion (MVO) in 29 (58%) patients; of the 29 patients with MVO, 10 (34.5%) patients had arterial occlusion and 19 (65.5%) had venous occlusion. MSCT showed MVO in 28 (56%) patients; of the 28 patients with MVO, 10 (35.7%) patients had arterial occlusion and 18 (64.3%) patients had venous occlusion. As regards the 28 patients diagnosed by MSCT as MVO, the final diagnosis approved MVO in 27 of them while one patient was negative. CTA showed a sensitivity of 93.1%, specificity of 95.24%, and an overall accuracy of 94%.
Conclusion
CTA is an accurate tool that helps in the diagnosis of bowel ischemia with high accuracy in diagnosis. This supports the role of CTA as the ideal first-step imaging procedure in cases suspected to have AMI.

Keywords: abdominal angina, mesenteric ischemia, multislice computed tomography angiography

Type 1 diabetes (T1D) is an autoimmune disease associated with multiple genetics and environmental factors. The aim of the study is to determine the frequency of HLA-B*08 and HLA-B*39 and its linkage disequilibrium with common risk haplotypes DR3-DQA1-05-DQB1*02, and DR4-DQA1-03-DQB1*0302 among T1D Egyptian infants. And assess different environmental factors as early exposure to cow's milk, exclusive breast feeding, mode of delivery and low birth weight. Sixty eight diabetic infants and 120 healthy controls were studied. HLA-DQB1, and DQA1 alleles were identified using homogeneous PCR and oligonucleotide hybridization assays. HLA-B*08 and HLA-B*39 genes were identified using multiplex PCR. The results showed that early exposure to cow's milk before 6 months carry a significant risk for T1D (16% in patients versus 6.6%in control group, P value=0.03). HLA-B*08 frequency was significantly higher among T1D infants than in control group(14.5% in diabetic infants versus 5%in control group, P value=0.024). DR3-DQA1-05-DQB1*02, and DR4-DQA1-03-DQB1*0302 were significantly higher in diabetic infants than controls (P value <0.001 and 0.004 respectively ). HLA-B*08 gene was found in (15.5%) of DR3-DQA1-05-DQB1*02 positive cases while in control group it was found in (13.5%) (P value=0.8). In conclusion, HLA-B*08 gene carry a risk for T1D in Egyptian infants, while DR3-DQA1-05-DQB1*02 haplotype lacks linkage disequilibrium with HLA-B*08 among T1D infants. Further studies are needed to determine which HLA-B gene is strongly linked to DR3-DQA1-05-DQB1*02 haplotype in T1D infantsother than HLA-B*08 and HLA-B*18.

Hepatitis C virus (HCV) is a major health problem all over the world with the highest prevalence reported in Egypt. Various treatment regimens have been developed over the last years. Interferon (IFN) based regimen was the standard of care regimen and then the IFN-free therapies were emerged. Host innate immunity through the activity of natural killer (NK) cell is one of the major players in competing infections and tumors, by producing perforin and granzymes that cause cytolysis of target cells, or by the production of various cytokines such as natural interferon gamma. Natural cytotoxicity receptors (NCRs), including Nkp30, Nkp44 and Nkp46, are a group of activating receptors that almost have restricted expression on the surface of NK cells and their density correlates with NK cytotoxicity. The role of these cells is not fully elucidated in patients with chronic HCV infection either treatment-naive or treatment experienced. Therefore, this study aimed to investigate the change that occurs in NK cell activity and cytotoxicity in response to successful elimination of HCV from blood after triple therapy with PEG-IFN-α, ribavirin and sofosbuvir. A total of 56 (50 male: 6 female) HCV patients with mean age of 41.6± 12.1 years were included in this study. They were divided into two groups: treatment naive group (20 patients) and the sustained virologic response (SVR) group (36 patients). All patients were investigated for their NK cell profile, NCRs, perforin and granzyme B expression by flow cytometry. Data was expressed as mean fluorescence intensity (MFI). Results revealed significant increase in MFI of granzyme B (P=0.001) and decrease in MFI of NKp30 (P=0.042) in the SVR group as compared to treatment naïve group. These findings indicated that triple therapy of HCV (IFN, Ribavirin and Sofosbuvir) effected NK activation and cytotoxicity.

Background: Recurrent wheezy chest is a common complaint in pediatric
practice. Vitamin D is a potent immunomodulator in allergic diseases as wheezy
chest and asthma. The prevalence of vitamin D deficiency has been increasing
in Egypt leading to significant morbidities. Objectives: This study aimed to
assess serum 25 hydroxy (OH) Vitamin D level in preschool children with
recurrent wheezy chest, and to assess its relation to the recurrence, severity,
and level of control of the wheezing episodes. Methods: The study included 100
preschool children (aged 2 to 5 years), of both sexes, recruited from the
Emergency department, Allergy and Pulmonology units at Assiut University
Children Hospital, Egypt. They should have at least 3 documented episodes of
wheeze, cough, and difficulty breathing in the last year with clinical
improvement on inhaled short-acting beta 2 agonists. Patients were subjected to
questionnaire-based history, clinical examination, and laboratory investigations
(complete blood count (CBC) with the absolute eosinophil count, serum total
IgE level, and serum 25 hydroxy (OH) Vitamin D level). Pediatric Respiratory
Assessment Measure (PRAM score) for assessment of the severity of the
wheezing episodes and Global Initiative for Asthma (GINA) based level of
asthma control for children 5 years and younger were applied. The patients
were grouped according to PRAM score to mild, moderate and severe episodes
and according to vitamin D level as sufficient and below-sufficient groups
(including deficient and insufficient patients). Results: 25(OH) Vitamin D level
was below-sufficient in 53% of the studied patients (deficient in 32% and
insufficient in 21%). PRAM score was significantly lower in patients with
sufficient 25(OH) Vitamin D level versus those with below-sufficient level (p <
0.025). There was a significant negative correlation between PRAM score and
25 (OH) Vitamin D level (r = -0.334, p = 0.001). Conclusion: There is an
inverse relationship between 25(OH)vitamin D level and parameters of asthma
severity, as well as with the level of asthma control in preschool children with
recurrent wheezy chest.