The egyptian clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease.

The landscape of chronic liver disease in Egypt has drastically changed over the past few decades. The prevalence of metabolic-associated fatty liver disease (MAFLD) has risen to alarming levels. Despite the magnitude of the problem, no regional guidelines have been developed to tackle this disease. This document provides the clinical practice guidelines of the key Egyptian opinion leaders on MAFLD screening, diagnosis, and management, and covers various aspects in the management of MAFLD. The document considers our local situations and the burden of clinical management for the healthcare sector and is proposed for daily clinical practical use. Particular reference to special groups was done whenever necessary.

Correlation of plasma levels of tumor necrosis factor, interleukin-6 and nitric oxide with the severity of human malaria.

Thirty two patients of malaria (15, 11 & 6) having P. vivax, uncomplicated and complicated P. falciparum malaria respectively, and 10 healthy controls were subjected to full clinical and laboratory examinations as well as estimation of plasma levels of tumor necrosis factor (TNF), interleukin-6 (IL-6) and nitric oxide (NO). The main clinical presentations were fever, pallor, jaundice, splenomegaly and anaemia which were more pronounced in patients with complicated falciparum malaria. Light coma (50%), convulsions (33.3%), severe anaemia (66.6%). severe hypoglycemia (66.6%) and increased blood lactate levels (50%) were detected in patients with complicated falciparum malaria. The results showed significant elevation of plasma levels of TNF, IL-6 and NO in all malaria patients as compared to the controls. The levels were significantly higher in patients with complicated falciparum malaria than in the other patient groups. The TNF, IL-6 and NO had an effective role in pathogenesis of malaria and their levels in can be a useful diagnostic markers for malaria and severity.