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Background Many significant evidences implicate interleukin-17 (IL-17) in inflammation, autoimmunity, and defense against some bacteria. One of the chronic autoimmune diseases in which IL-17 might be involved in is systemic lupus erythematosus (SLE). Evidences have identified IL-17 as a key player in the pathogenesis of SLE. Aim of the study The aim of this study was to verify how IL-17 was involved in the immune response in patients with SLE. Patients and methods Forty diagnosed cases of SLE and 20 apparently healthy individuals serving as a control group were recruited for this case–control study from Benha University Hospital and Benha Teaching Hospital. Sterile peripheral blood samples were collected from the study group and the percentage of IL-17 expressing T-cell subpopulation was determined by using flow cytometry. Results After suitable statistical analysis, our results showed a high percentage of intracellular IL-17 in SLE patients and a high statistical increase in the intensity of IL-17 in CD3⁺, CD4⁺, and CD8⁺ T cells in SLE cases when compared with the control group. Conclusion High percentage and intensity of IL-17 in T-cell subpopulation reflect its close involvement in the inflammatory immune response, which provides an evidence of its role in the pathogenesis of SLE.

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Undifferentiated pleomorphic sarcoma (UPS)/malignant fibrous histiocytoma (MFH) is quite rare in the larynx, with few cases reported. In the present study, we report an UPS/MFH of the larynx arising as a second primary neoplasm. It showed giant cells, spindle areas with vague storiform appearance, and myxoid areas. CD68 was positive in the giant cells and focally in the tumor cells. S100 showed scattered positivity in stellate cells. Desmin and specific muscle actin were negative, whereas h-caldesmon was positive in tumor cells and medium-sized blood vessels, denoting a possible myogenic differentiation. To the best of our knowledge this is one of the rare case reports of UPS/MFH with giant cells in the larynx arising as a second primary neoplasm.

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Aim Diabetes mellitus (DM), especially type 2, is a major health problem, and diabetic nephropathy is the main cause of end-stage renal disease. Renal ischemia–reperfusion (I/R) injury is common in diabetic patients. Recent studies reported increased vulnerability of kidneys to I/R injury in diabetic rats. In view of the reported efficacy of glucagon-like peptide-1 (GLP-1) on I/R injury, this study was designed to assess the effect of exenatide (GLP-1) on renal I/R in type 2 DM. Materials and methods Type 2 DM in rats was induced by administration of nicotinamide (110 mg/kg, intraperitoneal), 15 min before a single dose of streptozotocin (45 mg/kg, intraperitoneal). Renal I/R was performed in both diabetic and normal rats. The protocol comprised ischemia for 30 min followed by reperfusion for 24 h aynd a treatment period with exenatide 2 weeks before induction of ischemia. Results Renal I/R in diabetic rats induced marked renal dysfunction associated with a significant increase in malondialdehyde, nitric oxide, and tumor necrosis factor α levels. Antioxidant enzymes such as reduced glutathione and superoxide dismutase were significantly reduced. Exenatide treatment significantly normalized these biochemical parameters compared with diabetic I/R rats. Conclusion In conclusion, exenatide protects renal I/R injury in type 2 DM. These findings have major implication in the treatment of ischemic injury that is prone to develop in DM.

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Background Ghrelin is a 28-amino acid acylated peptide that was recently identified as endogenous ligand for growth hormone secretagogue receptor. It is a potent orexigenic peptide that stimulates food intake, adipogenesis, and body weight gain. However, its physiological role in the regulation of energy homeostasis is still controversial. Aim The study was performed to show the physiological role of ghrelin in energy balance and body weight homeostasis through assessing the effect of obesity and undernutrition on the plasma ghrelin level. Materials and methods Twenty-four adult male albino rats weighing 140–190 g were divided into three groups: group I (control group): rats of this group were given free access to food and water, group II (induction of obesity): rats of this group were fed a high-caloric diet for induction of obesity, and group III (chronic food restriction): rats of this group were fed by 30% of the diet consumed by the control group. Results The body weight is significantly increased in rats, which fed a high-caloric diet for induction of obesity, whereas plasma ghrelin level was significantly decreased. Food-restricted rats showed significantly decreased body weight and significantly elevated plasma ghrelin level. Conclusion These findings suggest that ghrelin has a pivotal role in mediating the physiological responses to undernutrition and overnutrition. Changes in the circulating level of ghrelin can represent an adaptative response to prevent long-lasting alterations in the energy balance and body weight.

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Background Despite extensive investigation, no single test meets the criteria that could make it an ideal marker for early diagnosis of sepsis in the newborn. Generally, screening includes a complete blood count with differential white blood cell count and may be accompanied by other adjuvant tests such as evaluation of C-reactive protein. Objective The aim of the study was to evaluate the role of cord blood interleukin-6 (IL-6) as an early predictor of early-onset neonatal sepsis in preterm babies. Patients and methods We studied 75 preterm babies with risk factors of early-onset sepsis in Benha University Hospitals and measured IL-6 in cord blood samples to correlate them with C-reactive protein, hemoglobin percentage, white blood cells count with immature/total (I/T) ratio, and platelet count. Patients were classified into three groups according to gestational age and subdivided according to sepsis state into proven sepsis group (12 cases), probable sepsis group (48 cases) and noninfected group (15 cases). Samples were taken from the patients early just after birth in the resuscitation room. Statistical analysis The collected data were coded, tabulated and statistically analysed using SPSS (Statistical Package for Social Sciences), version 18.0. Results were considered significant if P value is less than 0.05 and highly significant if P value is less than 0.01. Results In our study, cord blood IL-6 was significantly higher in the septic group (probable and proven) with median 371.92 and 124.85 pg/ml, respectively, than in the noninfected group, with median 8.53 pg/ml (P < 0.0001). The best cutoff level for IL-6 to diagnose neonatal sepsis is 47.5 pg/ml, with sensitivity 98.3% and specificity 93.3%. Conclusion Cord blood IL-6 can be used as a predictor of early-onset neonatal sepsis in preterm babies.

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Introduction Regulatory T-cells (Tregs) are essential to balance between proinflammatory and anti-inflammatory responses by protecting against autoimmune reactions. They have different roles in skin tumors, including cutaneous T-cell lymphomas. Foxp3 (forkhead box P3) is thought to be a reliable marker for Tregs. Contradictory results were reported in the literature when the density of Tregs in the skin of mycosis fungoides (MF, a type of cutaneous T-cell lymphoma) was compared with some pathologically mimicking inflammatory dermatoses. Patients and methods This is a comparative cross-sectional study of lesional skin biopsies from 36 cases of MF versus those from 36 cases of histopathological mimickers, including 10 cases of psoriasis, 10 cases of spongiotic dermatitis, and 16 cases of lichenoid dermatoses (10 with pityriasis lichenoides chronica and six with discoid lupus erythematosus). We compared the densities of Foxp3+ Tregs in relation to CD4+ cells in the epidermis and dermis of these groups using Foxp3 and CD4 monoclonal antibodies. Results The MF group showed a lower statistically significant difference as regards epidermal and dermal Foxp3/CD4+ ratios compared with the histologic mimicker group. Conclusion MF lesions showed a significantly lower density of CD4+ Foxp3+ Tregs compared with its histological mimickers, which might be attributed to their limited proliferation at the expense of malignant T-lymphocytes.

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Introduction Ankle injury is a common condition secondary to trauma; ultrasonography plays a big role in the assessment of a variety of musculoskeletal disorders. These improvements along with economic factors and availability have resulted in renewed interest in using ultrasound (US) as a diagnostic tool. As such, the efficacy of US has been compared with other modalities, in particular MRI, as a cost effective imaging alternative. Context US is a rapid, accurate, and cheap diagnosing tool. Aims The aim of this study was to show the efficacy of US as a cost effective diagnostic imaging alternative. Settings and design Selected individuals of ankle or foot injuries by clinical examination, with no exclusion criteria. Performing real time ankle US bilaterally for each patient. Participants and methods They will be divided into two groups: first control group which demonstrates 25 asymptomatic ankle ligaments and tendons. Second group includes 25 patients suffering from unilateral or bilateral ankle as sequelae of trauma. All patients will be subjected to history taking and real-time high-resolution ultrasonography. The procedures followed were in accordance with the ethical standards and approval by Benha University. Statistical analysis used Parametric analysis of our results using Excel program. Results Forty pathological entities were diagnosed by both utilized imaging modalities in 25 cases. The study included 11 cases with tendon pathology that were interpreted into 13 pathological entities by all imaging modalities. However, US missed two cases: (a) a case of partial tear of Achilles tendon; (b) a case of flexor hallucis longus tenosynovitis. US could detect all of the ligamentous lesions identified in three cases, which were interpreted as tear by MRI, likely due to US anisotropy effect. Conclusion Ankle US is a rapid, accurate, and cost effective imaging modality.

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Background This study was conducted to highlight the role of ultrasonography as an initial imaging modality for evaluation of symptomatic Achilles tendon disorders. Patient and Methods 60 patients (33 men and 27 women) had symptomatic Achilles tendons disorders and confirmed clinically as all patients were referred from orthopedic surgery department. 20 patients had history of blunt trauma followed by pain which may be associated with lost plantar flexion. 40 patients had chronic pain either associated or not associated with swelling at the site of Achilles tendon. US examination (13 MHz probe, GE logic P5 machine) using real time with color and power Doppler examination was performed while the patient in prone position. Results US depicted full-thickness tears in 11 (18.5%) tendons where tendon gaps were not significant (less than 5 mm) in 6 tendons and significant (more than 5 mm) in 5 tendons. De novo partial tears were detected in 15 (25%) tendons. Tendinopathy were seen in 18 (30%) tendons. US depicted paratenonopathy in 3 tendons (5%). 13 (21.7%) tendons appeared normal by ultrasonography. Conclusion Ultrasonography is an initial imaging of choice for evaluation of symptomatic Achilles tendon disorders. Diagnostic accuracy reaches 85%. However, Tendons that appeared normal by US should be followed by MRI for more diagnostic accuracy, detailed regional evaluation and subsequently can exclude other etiologies giving similar clinical manifestations.

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Background/aim The progress of any nation depends on the academic achievement and professional development of its young, and for this reason every nation emphasizes on the achievements and development of its students. Thus, the aim of the present study was to assess the quality of life of some Mansoura University students in the Faculty of Education and the Faculty of Medicine. Methods This cross-sectional study was carried out at Mansoura University on 150 students by using a questionnaire designed during lectures. Results We found a significant difference in the quality of life between Malaysian and Egyptian students, as the mean score for Malaysian students was 160.42 (high) and for Egyptians it was 131.94 (good). There was no significant difference in the quality of life between male and female students, as the mean score for males was 134.22 (good) and for females 144.43 (good). There was no significant difference as regards the reaction between nationality and sex on the quality of life between the four groups (Egyptian males, Egyptian females, Malaysian males, and Malaysian females) and their mean scores were 129.32, 133.47, 158, and 160.88 (good, good, high, and high), respectively. There was no significant difference between the students of the Faculty of Education (132.36) and Egyptian students of the Faculty of Medicine (131.52). Conclusion The quality of life of Malaysian students living in Egypt was better than that of Egyptian students; it did not differ much between male and female students. Moreover, the quality of life was not affected by nationality if sex was taken into consideration. Comparing Egyptian students in both faculties (Medicine and Education) showed no significant difference as regards the quality of life.

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Headache and facial pain disorders are prevalent, disabling, and largely treatable, but are under-recognized, underdiagnosed, and undertreated, and a burden, both to the individual and to the society. Headache and facial pain cuts across a diverse group of physicians, including neurologists, neurosurgeons, headache specialists, otolaryngologists, dental specialists, anesthesiologists, and pain specialists. This review discusses the relevant neuroanatomy, the updates in pathophysiology, and classification of headache and facial pain disorders. We will also introduce the art of history-taking in headache patients, as well as physical examination, investigation, and treatment of the most common disorders.

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Diffusion-weighted imaging is a potentially useful adjunct to conventional MRI in the evaluation of gynecologic tumors, thus improving the overall diagnostic accuracy, tumor staging, prediction of response to therapy, and treatment follow-up.

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