Background: Chronic liver disease (CLD) is accompanied by immune dysfunction that increase susceptibility to opportunistic infections, including Toxoplasma gondii. This work aimed to evaluate the seroprevalence of toxoplasmosis among cases with CLD in Sharkia and to evaluate its correlation with disease severity and clinical characteristics. Methods: This case-control study was conducted involving 96 participants, including 48 cases with CLD and 48 sex- and age-matched healthy controls. data were collected. The enzyme-linked immunosorbent test (ELISA) was used to detect serum anti-T. gondii IgG and IgM antibodies. To find independent determinants of T. gondii IgG seropositivity, univariate and multivariable logistic regression analyzes were carried out. Results: Compared to healthy controls, cases with CLD had higher levels of anti-T. gondii IgG seropositivity. (58.3% vs. 27.1%, P = 0.002), whereas IgM seropositivity was uncommon in both groups without significant difference. Among patients, IgG-positive individuals had significantly more advanced liver disease, with a greater incidence of Child-Pugh class C (P = 0.019). Univariate analysis demonstrated significant associations between IgG seropositivity and splenomegaly, elevated liver enzymes, bilirubin, prolonged INR, hypoalbuminemia, and Child–Pugh class C. Following multivariable adjustment, ALT was the only independent predictor of IgG seropositivity, whereas the association with Child–Pugh class became borderline. Conclusion: Cases with CLD exhibited greater prevalence of latent T. gondii infection than healthy controls. T. gondii seropositivity was related to indicators of advanced liver dysfunction, although alanine aminotransferase was the only independent predictor after adjustment for potential confounders. results propose probable relationship between latent toxoplasmosis and CLD severity .
Background: Striae distensae are common dermal scars with limited consistently effective treatment options. Microneedling promotes dermal remodeling and may also enhance penetration of topical agents. This research aimed to compare the efficacy and safety of microneedling combined with platelet rich plasma (PRP) versus microneedling combined with topical insulin in the treatment of striae distensae. Methods: This comparative split body study included 35 patients with striae rubra or striae alba. The right side was treated with microneedling followed by topical platelet rich plasma, while the left side received microneedling followed by topical insulin. Six sessions were performed at 2 week intervals. Striae severity was assessed using the Striae Distensae Severity Score, including color, distribution, depth, elasticity and roughness. Results: Both treatment modalities significantly improved striae distensae severity. However, microneedling plus insulin produced greater overall improvement than microneedling PRP (48.2±19.5% vs 28.5±11.6%, P<0.001) and a lower post treatment total score (5.89±2.43 vs 8.08±1.30, P<0.001). Post treatment roughness, distribution, color, elasticity and depth were all significantly better on the insulin treated side. Good clinical response occurred in 42.9% with insulin compared with 2.9% with platelet rich plasma (P<0.001). Conclusion: Microneedling combined with topical insulin was more effective than microneedling combined with platelet rich plasma for striae distensae, particularly in striae rubra and lesions of shorter duration. Both modalities were well tolerated, while topical insulin showed a stronger clinical response without detectable glycemic adverse effects.
Background: Early recognition of acute kidney injury (AKI) remains difficult in critical care because serum creatinine may rise only after renal function has already declined. Magnesium disturbances are frequent in the intensive care unit (ICU), but their possible relation to subsequent AKI is still not fully clarified. This study investigated whether admission serum magnesium was associated with later development of AKI in critically ill adults. Methods: A prospective cohort of 52 adult ICU patients who stayed for more than 48 hours was followed during admission. Serum magnesium was assessed at enrollment, with values below 1.8 mg/dL considered hypomagnesemia. AKI was identified from serial serum creatinine changes using Kidney Disease: Improving Global Outcomes criteria. Results: Low serum magnesium was found in 36 of 52 patients (69.2%), while 30 patients (57.7%) developed AKI. AKI was observed in 69.4% of patients with hypomagnesemia versus 33.3% of those with normal magnesium concentrations, giving a relative risk of 2.08 (95% CI, 1.12–3.86; P = 0.032). Mortality rose with increasing AKI stage, from 27.3% in patients without AKI to 66.7% in stage 3 disease (P for trend = 0.040). Hypomagnesemia was associated with AKI on univariate analysis (OR 4.55, 95% CI, 1.27–16.32; P = 0.020) and remained significant after adjustment (adjusted OR 4.12, 95% CI, 1.04–16.28; P = 0.043). Conclusion: Admission hypomagnesemia was independently associated with subsequent AKI in critically ill patients. These findings suggest a potential role for serum magnesium in AKI risk assessment, although a causal relationship cannot be established.
Background: Lateral pelvic lymph node (LPLN) disease can influence pelvic control and prognosis in rectal cancer. This study evaluated functional and oncological outcomes after total mesorectal excision (TME) with lateral pelvic lymph node dissection (LPLND) for middle and lower rectal adenocarcinoma. Methods: This prospective cohort included 43 patients undergoing elective upfront TME and bilateral LPLND following multidisciplinary assessment. Bowel function was assessed using the Low Anterior Resection Syndrome (LARS) score after sphincter-preserving surgery. Urinary and sexual outcomes were assessed postoperatively. Exploratory univariable analyses examined associations between preoperative clinicoradiological findings and pathological LPLN metastasis. Results: Mean age was 51.8 years; 24 patients (55.8%) were women. Pathological LPLN metastasis occurred in 8 patients (18.6%). Among 26 patients undergoing sphincter-preserving surgery, 16 (61.5%) had LARS: 12 (46.2%) had minor and 4 (15.4%) major LARS. Grade 5 erectile function was reported by 13 of 19 men (68.4%), and Grade 4 ejaculatory function by 15 (78.9%). Female Sexual Function Index scores ≤26.55 indicated sexual dysfunction in 6 of 11 sexually active women (54.5%). Voiding recovery, defined as post-void residual volume <50 mL within seven days, occurred in 35 patients (81.4%). Enlarged LPLNs on preoperative MRI and suspicious mesorectal nodes on MRI/CT were associated with pathological LPLN metastasis.
Background: Cesarean delivery alters normal maternal-infant microbial transmission and may affect early gut microbiota colonization. This study evaluated whether maternal probiotic or synbiotic supplementation during pregnancy and lactation was associated with differences in infant Bifidobacterium colonization, stool metabolic markers, and gastrointestinal outcomes after cesarean delivery. Methods: This prospective randomized controlled clinical trial included 105 mother-infant pairs allocated equally to Control, Probiotic, and Synbiotic groups. Maternal supplementation began approximately four weeks before the anticipated delivery date and continued during lactation according to the study protocol. Infant outcomes were assessed at day 14, week 6, and month 3. Results: Bifidobacterium relative abundance and qPCR measurements were higher in the Probiotic and Synbiotic groups than in controls at all assessed time points, with the highest values in the Synbiotic group (P < 0.001 for the principal comparisons). At month 3, mean Bifidobacterium relative abundance was 49.73% in the Synbiotic group, 34.84% in the Probiotic group, and 19.98% in controls. The Synbiotic group also had lower stool pH, higher acetate measurements, and lower colic symptom scores. At month 3, the mean colic score was 2.44 versus 6.15 in controls (absolute mean difference 3.71 points; approximate 95% CI, 3.24-4.18). Vomiting and antibiotic use did not differ significantly among groups, while the overall distribution of adverse events differed at week 6. Conclusions: Maternal probiotic and synbiotic supplementation was associated with higher infant Bifidobacterium colonization and lower colic symptom scores after cesarean delivery, with the largest between-group differences observed in the Synbiotic group.
