Salem Youssef Mohamed

Background: The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic has highlighted the potential exacerbation of gastrointestinal symptoms in patients with disorders of gut‐brain interaction (DGBIs). However, the distinct symptom trajectories and psychological burden in patients with post‐COVID‐19 DGBIs compared with patients with pre‐existing irritable bowel syndrome (IBS)/functional dyspepsia (FD) and non‐DGBI controls remain poorly understood. Objectives: To examine the long‐term gastrointestinal symptom progression and psychological comorbidities in patients with post‐COVID‐19 DGBI, patients with pre‐existing IBS/FD and non‐DGBI controls. Methods: This post hoc analysis of a prospective multicenter cohort study reviewed patient charts for demographic data and medical history. Participants completed the Gastrointestinal Symptom Rating Scale at four time points: baseline, 1, 6, and 12 months, and the Hospital Anxiety and Depression Scale at 6 and 12 months. The cohort was divided into three groups: (1) post‐COVID‐19 DGBIs (2) non‐DGBI, and (3) pre‐existing IBS/FD, with the post‐COVID‐19 DGBIs group compared to the latter two control groups. Results: Among 599 eligible patients, 27 (4.5%) were identified as post‐COVID‐19 DGBI. This group experienced worsening abdominal pain, hunger pain, heartburn, and acid regurgitation, unlike symptom improvement or stability in non‐DGBI controls ( p < 0.001 for all symptoms, except hunger pain, p = 0.001). While patients with pre‐existing IBS/FD improved in most gastrointestinal symptoms but worsened in constipation and incomplete evacuation, patients with post‐COVID‐19 DGBI exhibited consistent symptom deterioration across multiple gastrointestinal domains. Anxiety and depression remained unchanged in patients with post‐COVID‐19 DGBI, contrasting with significant reductions in controls (non‐DGBI: p = 0.003 and p = 0.057; pre‐existing IBS/FD: p = 0.019 and p = 0.007, respectively). Conclusions: COVID‐19 infection is associated with the development of newly diagnosed DGBIs and distinct symptom trajectories when compared with patients with pre‐existing IBS/FD. Patients with post‐COVID‐19 DGBI experience progressive gastrointestinal symptom deterioration and persistent psychological distress, underscoring the need for tailored management strategies for this unique subgroup.

Background: Hyperglycemia is one of the most important independent risk factors that affect the prognosis and outcome of COVID-19 patients. Coronavirus disease 2019 infection is associated with poor glycemic control. This study's objectives were to determine the effect of hyperglycemia on the prognosis and outcome of COVID-19 patients and to detect whether COVID-19 infection can induce new-onset diabetes. Patients and Methods: This cohort study was carried out on 240 hospitalized Egyptian COVID-19 patients, at Zagazig University Hospital isolation intensive care unit, between March 2020 and March 2021. They compared patients with diabetes and uncontrolled hyperglycemia against each other and COVID-19 patients without diabetes or uncontrolled hyperglycemia. Baseline demographic data, clinical features, and laboratory analysis were collected. Clinical outcome was evaluated via hospital stay and survival rate. Patients with uncontrolled hyperglycemia and nondiabetic patients were followed up 1 year after the hospital discharge to detect the development of new-onset diabetes. Result: The diabetic group had the highest creatinine level, and the nondiabetic group had a minor C-reactive protein and D-dimer. The difference is significant between diabetic and nondiabetic groups concerning hospital stay. The nondiabetic group had the shortest hospital stay. There is a statistically substantial relationship between mortality and the glycosylated hemoglobin, serum creatinine, C-reactive protein, D-dimer, and serum ferritin. A total of 46.6% of survivors in the uncontrolled hyperglycemic group and 3.4% in the nondiabetic group developed diabetes mellitus during follow-up. There is a statistically significant relationship between new-onset diabetes mellitus and D-dimer. Conclusions: Coronavirus disease 2019 can induce diabetes mellitus in vulnerable patients (presented with uncontrolled hyperglycemia at admission). In addition, COVID-19 patients with diabetes or uncontrolled hyperglycemia have worse outcomes and poor prognoses.

African countries are experiencing a surge in national and international collaborations, and key steps are needed to guide such partnerships for the benefit of all. Proposed solutions aim to scale meaningful collaboration with African researchers.

Endoscopy is a competitive field in clinical practice, in which skilled endoscopists are in high demand. The learning process for Junior Gastrointestinal Endoscopists (JGEs) is difficult, quite long, and technically demanding. This directs JGEs to seek additive learning sources, including online sources. The purpose of this study was to determine the frequency, context, attitudes, perceived benefits, drawbacks, and recommendations for using YouTube videos as an educational platform among JGEs from the uses'prespective. We disseminated a cross-sectional online questionnaire from January 15th to March 17th, 2022, and recruited 166 JGE from 39 different countries. The majority of surveyed JGEs (138, 85.2%) were already using YouTube as a learning tool. The majority of JGEs (97, 59.8%) reported gaining knowledge and applying it in their clinical practice, but 56 (34.6 %) reported gaining knowledge without application in real practice. Most participants (124, 76.5 %) reported missing procedure details in YouTube endoscopy videos. The majority of JGEs (110, 80.9%) reported that YouTube videos are provided by endoscopy specialists. Only one participant, 0.6% out of the 166 JGEs surveyed, disliked video records, including YouTube as a source of learning. Based on their experience, 106 (65.4%) of participants recommended YouTube as an educational tool for the coming generation of JGEs. We consider that YouTube represents a potentially useful tool for JGEs, supplying them with both knowledge and clinical practice tricks. However, many drawbacks could make the experience misleading and time-consuming. Consequently, we encourage educa platforms to upload well-constructed, peer- reviewed, interactive educational endoscopy videos.

Background: Colorectal cancer is the third most common cancer in the world. Randomized trials have demonstrated the efficacy of screening. In this review, we discussed the benefits of colonoscopy &other screening tests and their role in decreasing the mortality rate from CRC. Aim of work: this minireview discusses the different CRC screening modalities and the adherence of populations to these procedures.

Background: hepatitis C is an inflammatory liver disease caused by the hepatitis C infection (HCV), and without treatment, almost 50% will progress to liver cirrhosis. Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer and the fourth leading cause of cancer-related mortality. Aim of the study: the objective of this study was to evaluate the serum level of vitronectin (VTN) compared to AFP and determine their role as diagnostic and prognostic markers of HCV-related liver diseases. Subject and Methods: this study involved 52 HCV patients from which 26 patients were cirrhotic, and 26 patients had HCC (on top of hepatitis C virus-related cirrhosis) plus 10 healthy people as a control group. It was carried out in Gastroenterology and Hepatology Unit, Internal Medicine Department, Zagazig University Hospitals, Egypt. All individuals in this study were subjected to physical examination, full history taking, liver function tests, assessment of serum levels of Vitronectin (VTN) and alpha-fetoprotein (AFP) before and after the intervention within three months. Results: serum level of vitronectin increased significantly in cirrhosis patients and HCC patients than controls (p = 0.0041), (p < 0.001), respectively, and in HCC than cirrhosis patients (p < 0.001). Significant positive correlations were observed between levels of serum VTN and AFP in all HCV patients as well as cirrhotic patients (p < 0.001, p = 0.011, respectively). On the contrary, VTN and AFP didn’t show a significant correlation in HCC patients’ group. Moreover, the median serum level of VTN decreased significantly after treatment in patients with HCC (p < 0.001). At cut-off 38.5 ng/mL for AFP it shows sensitivity 80.8%, specificity 76.9% to differentiate HCC from cirrhosis cases. While VTN shows 84.6% sensitivity, 96.2% specificity at cut-off 26.5 μg/mL. Regarding clinicopathological characteristics and VTN levels, half of patients were stage B, 63.9% had tumor size >3 cm, 84.6% had more than one focal lesion. Conclusions: these results may allow one to speculate a potential role of Vitronectin in diagnosis and prognosis of HCC on top of cirrhosis related to HCV infection in addition to AFP and US and CT.

INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID−) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection.

Hepatocellular carcinoma (HCC) is a heterogeneous disease that develops most of the time on diseases liver. Early diagnosis and management are the best options for the patients, so screening programs are mandatory for those who are at risk of the development of HCC. Despite the challenge of management of HCC, there is hopeful management for HCC as the field of primary liver cancer has moved quickly

Hepatocellular carcinoma (HCC) is a heterogeneous disease that develops most of the time in the diseased liver. Early diagnosis and management are the best options for patients, so screening programs are mandatory for those at risk of developing HCC. Despite the challenges of management of HCC, there is hopeful management for HCC as the field of primary liver cancer has moved quickly.