Purpose of the review This study was conducted for diagnosis of secundum ASD in Pediatrics department at Sohag University Hospital to review current different imaging diagnostic modalities for percutaneous device closure of secundum ASD. Index Terms—atrial septal defect, 2DTEE, 3DTEE, ASD IIdevice. Background In children diagnosed with a secundum “atrial septal defect” (ASD II), 3DTEE can reveal anatomic details that improve the efficacy of device closure. Moreover, 3DTEE provides unique en face-view of ASDII. Patients were evaluated also with 2DTEE before and throughout device closure. (7) Conclusion In the vast majority of pediatric patients, transcatheter closure of a secundum atrial septal defect (ASD II) is now preferred to surgical closure. However, multimodality imaging is necessary for accurate patient screening, procedure indication, and the safe and effective delivery of this transcatheter therapeutics. TTE, 2DTEE, and 3DTEE are all options, and there are strong correlation between the maximum diameter of ASD II measured by 3DTEE and those of 2DTEE. ‎

Background: Pulmonary hypertension (PH) is a serious complex pathophysiological disorder that may be related to multiple clinical conditions and associated with high morbidity and mortality rates. It is a major complication of myeloproliferative neoplasms (MPNs) including primary myelofibrosis (PMF) mainly in advanced disease. Development of PH in PMF patients has a bad impact on prognosis of the disease and on the survival in those patients. PH prevalence in PMF and predictors for the disorder are not well established. Objective: The main objective of this thesis is to determine the prevalence of pulmonary hypertension in patients with primary myelofibrosis and to find different parameters that can predict PH in those patients.Results: Our results revealed that 13 patients out of 28 studied PMF patients had PH. There was a significant relationship between old age, long PMF duration since diagnosis at time of evaluation, presence of thrombotic events mainly portal vein thrombosis, anemia, and hyperuricemia and occurrence of PH. The two groups (PH & Non-PH groups) did not differ significantly in terms of gender, comorbidities, WBCs count, platelets count, serum lactate dehydrogenase level, and splenic diameter measured by abdominal ultrasound, presence of JAK 2 & Calreticulin (CALR) gene mutation.Conclusion: PH prevalence in PMF patients in our study was 46.4%. Our findings suggest that old age, long PMF duration since diagnosis, and hyperuricemia appear to be valuable for predicting the development of PH in those patients.

Pulmonary hypertension (PH) is a syndrome characterized by marked remodeling of the pulmonary vasculature and a progressive increase in the pulmonary vascular load, resulting in right ventricular hypertrophy and remodeling. PH is a serious complex disorder which is associated with high morbidity and mortality rates. It is considered one of the major complications of myeloproliferative neoplasms (MPNs) mainly in advanced disease. It is classified according to the World Health Organization (WHO) into five groups. MPNs are involved within group 5 PH which is due to an unclear and/or multifactorial etiology. The occurrence of PH in MPNs patients has a bad impact on the prognosis of the disease and on the survival in those patients. The pathogenesis of PH in MPNs patients is multi-factorial. Three characteristic clinical types of PH are recognized as unique pathologic mechanisms in MPNs patients: chronic thromboembolic pulmonary hypertension (CTEPH), precapillary pulmonary hypertension, and drug-induced pulmonary hypertension.

Antibody-drug Conjugates (ADCs)which are composed of a monoclonal antibody (MoAb), a linker, and a payload; is a type of highly targeted biopharmaceutical drug that conjugate “monoclonal antibodies’ that are specific to antigens present on the surface of particular tumour cells with highly effective anti-cancer agents, all of which are linked to one another via a chemical linker. Recent advances in biotechnology have resulted in significant leaps in therapeutic potential for (ADCs). These improvements have been made possible by ADCs. This review aims to demonstrate the concept of ADC and its based chemotherapies that are used in management of different kinds of cancer in the last few years. This review could be represents an integrated reference for many researchers and those interested in the field of cancer treatments, as it summarizes all antibody-based drugs, their effectiveness, and the types of cancer they treat, making it easier for researchers to view all antibody-based drugs.

Systemic lupus erythematosus (SLE) is an immunopathogenic complex disease which affect many organs of the body. Several pathogenic mechanisms have been identified. Inspite of the new knowledge about understanding the exact mechanisms and triggering parameters for SLE, the exact etiology has not been identified yet. A combination between many factors and complex reactions secondary to different genetic and environmental factors are supposed to be involved. Different genes are implicated to disease activity. Abnormal immune cascade triggered by combination of hormonal and environmental factors or some drugs or chemicals lead to abnormal immune complexes, are important contributors to the development of SLE. Certain environmental factors are supposed to be needed to trigger the disease. Activation of both B cells and T cells and other immune cells leads to activation of immune mechanism. SLE is heterogenous at presentation, that may affect one organ only or had multisystem effect, with a varying clinical presentations ranging from mild cutaneous manifestations to severe multiorgan affection or severe central nervous system affection. This makes the diagnosis and management of SLE very challenging. Management of SLE is determined according the organ involved and the severity of the disease.

Background:- lupus nephritis occurs in up to 60-70 % of patients with SLE and also constitutes one of the major organ manifestations that considerably alters the course and prognosis of SLE. LN is considered a major cause that lead to renal failure, that have a major impact on the short and long term outcome of patients with SLE. Regimens that containing immunosuppressive drugs is the main treatment for active LN and early treatment response can predict long-term prognosis, So we aim to find reliable predictors of early treatment response in patients with SLE. Finding a more comprehensive parameters to develop a better treatment regimen may help decrease longer-term morbidity and mortality.Aim of the study: to examine the predictive factors of renal remission in lupus nephritis patients with lupus nephritis.Results: In our study, after diagnosis by six months, about 61% of patients achieved remission. We found that Chronicity index and Presence of interstitial fibrosis, are reliable factors for predicting the treatment response either responder or not at the end of sixth month of treatment.On multivariate analysis, Chronicity index was considered as independent predictor of disease remission after 6 monthsConclusion: Chronicity index ≤ 3 was considered of significant value for detecting treatment response at the sixth.

Background: Diabetic macular edema (DME) affect vision greatly in diabetic populations. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) are non-invasive technology to have a cross-sectional image of the retina.Purpose: to assess anatomy and ischemia that may occur post. Macular laser treatment for DME using OCT and OCTA and its relation with BCVA.Methods: prospective, observational, cohort study with a total 40 eyes were evaluated with OCT and OCTA before and after macular grid laser used in patients with non- central involving diabetic macular edema.Results: There was highly significant improvement in BCVA (p <0.0001). There was significant reduction of macular thickness (p<0.0001). There is high relation between IS-OS integrity, DRIL and BCVA. There was significant enlargement of foveal avascular zone (FAZ) post. Laser (p =0.001). Vascular density in superficial capillary plexus decreased (statistically significant) when we compare before and after laser and during period 1&3months of follow-up. Vascular density in deep capillary plexus was statistically significant (reduction) (p<0.0001) before and after laser treatment and at 1&3 months of follow-up.Conclusion: macular grid laser is an influential treatment for diabetic macular edema with relative ischemia and mild effect on macular perfusion. Anatomical and functional factors other than central macular thickness are also related to best corrected visual acuity.OCT and OCTA are very helpful during follow -up cases with DME to assess macular thickness, inner and outer retinal integrity, degree of macular ischemia and any complication as ERM that may result from laser.

Introduction: Duane retraction syndrome is a congenital complex strabismus. It was first described in 1887. It presents mainly with limitation of ocular movement, with globe retraction. It may be associated with over shooting of the eye. DRS is one of congenital cranial dysinnervation disorders (CCDD), which are congenital, nonprogressive, sporadic, or familial developmental anomalies of the cranial nerves characterized by abnormal eye, eyelid, and/or facial movements.It has been hypothesized that there is a maldevelopment which may occur due to any insult to the development of the sixth nerve nucleus and/or nerve at 4–8 weeks of pregnancy has been demonstrated to play a causal role in the emergence of this disease process.Aim of the work: to study the prevalence of Duane retraction sundrome (DRS) among cases of strabismus in Sohag university hospitalPatients and Methods: A prospective non-randomized interventional clinical study done in Sohag university hospital. All patients presented with Duane syndrome in strabismus clinic in Sohag university hospital were included.Results: 35 patients had DRS out of 960 strabismus patients, type I was the commonest. DRS is more common in females.

Introduction: Irritable bowel syndrome is a worldwide functional gastrointestinal illness, but its main cause is not definite. The primary cause of gastritis, peptic ulcers, and stomach cancer is Helicobacter pylori. The exact relation between H. pylori infection and IBS incidence is still indefinite. Aim of the work: To assess any potential link between Helicobacter pylori infection and the incidence of irritable bowel syndrome. Patients and method: In our study, we recruited 95 patients. They were divided into Group (1) including those who fulfilled the IBS diagnosis (in compliance with Rome IV criteria) named as a case group and a healthy control group with no IBS diagnosis as Group (2). Every patient enrolled in the study completed a Questionnaire, completed physical examination, H. pylori stool antigen, and stool examination. Results: IBS patients were significantly (P value= 0.001) younger than the control group (32.35± 13.003 vs 41.60± 12.535). Most IBS patients were females (60%) but with no significant difference over males. H. pylori-positive patients were significantly (P value= 0.001) older than the control group (40.47± 12.572 vs 30 ± 13.149). However, there was no discernible gender or stress difference between the two groups. Age (P=0.000) and stress (P=0.000) were discovered through multivariate analysis to be independent predictors of IBS, although H. Pylori infection was not.In conclusion, there was no connection between H. pylori infection and IBS.

Rare autosomal-recessive disorder Chediak-Higashi syndrome (CHS) is characterized by cutaneous hypopigmentation which also affects hair and iris, recurrent bacterial infections, deterioration of intellectual functions and an increased risk of developing hemophagocytic lympho histiocytosis (HLH), which is characterized by pancytopenia, fever, and infiltration of the liver, spleen, and lymph node by lymphocytes and histiocytes with a dismal prognosis, HLH is an accelerated phase of CHS which requires challenging treatment, our case 13 years old female patient was diagnosed with Chediak-Higashi Syndrome, who had advanced HLH aggravated by viral infection HAV(hepatitis A virus), cytomegalovirus (CMV) infection, and autoimmune disease (systemic lupus erythematosus) (SLE), she developed neurological manifestations in the form of peripheral neuropathy large azurophilic granules in granulocytes were identified by Giemsa staining and silvery hair, abnormal hypopigmented dots scattered on her body more in the upper and lower limbs which is very important for the diagnosis of this syndrome. CHS should be differentiated from other causes of partial albinism such as Griscelli syndrome.