Given the substantial evidence and growing concern for the potential carcinogenic effects of children’s exposure to ionizing radiation during computed tomography (CT) examinations, appropriate use of acquisition parameters is essential to attain diagnostic image quality at the lowest possible radiation dose. The objective of this article is to provide a systematic review to the pediatric imaging team members on how to manage pediatric CT doses and control the essential scanning parameters. The article also highlights other key factors that can be easily used to ensure safe imaging. Some practical tips and technical considerations are provided to be simply incorporated into clinical practice. Optimization of CT imaging is a dynamic process and needs understanding and engagement of all pediatric imaging team members, as keeping our children safe should be the ultimate goal in CT imaging.

Objectives The prognosis of hepatocellular carcinoma (HCC) is extremely worse, and chronic hepatitis C virus infection is one of the most important causes of HCC. The use of diagnostic serological markers in following up the high-risk individuals for developing HCC may help in its early detection and therapy. This study aimed to assess the effectiveness of serum Golgi protein 73 (GP73) and glypican-3 (GPC3) as new tumor biomarkers for early detection of HCC. Patients and methods A case–control study included 125 patients infected with hepatitis C virus, comprising 60 with cirrhosis and 65 with HCC, in addition to 60 healthy individuals considered as the normal control group. Serum levels of GP73, GPC3, and alpha-fetoprotein (AFP) were assessed by enzyme-linked immunosorbent assay technique. Result Serum GP73 and AFP levels were significantly higher in patients with HCC as compared with cirrhosis and control groups; however, their levels were significantly increased in patients with cirrhosis as compared with the healthy group (both P<0.001). However, GP73 was more sensitive than AFP in the diagnosis of HCC as the area under the receiver operating characteristic curve (area under the curve) with 95% confidence interval was 0.98 (0.95–1.0) for GP73 and 0.82 (0.74–0.90) for AFP. However, the area under the curve with 95% confidence interval for GPC3 was 0.44 (0.36–0.53). There was a significant association between AFP level and Barcelona clinic liver cancer staging of HCC (P=0.02). In addition, the serum level of GPC3 was higher in cirrhotic patients than other groups (P=0.007). Conclusion Serum GP73 and not GPC3 can be used as early potential tumor biomarker for HCC diagnosis and also to differentiate HCC from cirrhosis.

Aim To calculate the workload and infection rates following the strategies implemented for COVID-19 pandemic. Background Since its outbreak in Wuhan China, the ongoing pandemic of coronavirus disease 2019 has become devastating, and despite implementation of extensive control measures, it has rapidly spread all over the world. Till now pregnant women do not appear any more likely to acquire Covid-19 infection than the general population. However, standard care is not enough, and additional measures and strategies should be implemented to prevent disease spread to the healthcare providers or other patients especially in the emergency setting. Methods We have conducted a retrospective search for the different strategies implemented by Kasr Al-Ainy Ob/Gyn Department followed by calculation of the workload and infection rates following implementation of such plans of action. We traced and collected the protective strategies implemented to ensure control of disease spread. Results There was a 11.7 and 24.6% decrease in the number of attending cases and admitted cases, respectively, during the pandemic as compared with the earlier prepandemic period. We also found a change in the number of service providers as well as a change in the facility settings in the emergency department. Adequate spacing between patients’ beds was measured to be at least 3 m and suspected cases were kept in isolation rooms. Conclusions The drop in the number of presenting and admitted case was due to lockdown procedures which encouraged the patients to seek nearby health care facilities and avoid going to crowded tertiary centres as ours.

Background Fatigue and cognitive dysfunctions in multiple sclerosis (MS) are well-established complications that considerably impact patients’ independence, yet lack proper medical management. Purpose To test the efficacy of low-level laser therapy (LLLT) and broadband ultraviolet B-radiation (BB-UVBR) combination on modulating fatigue and cognitive functions for patients with MS. Patients and methods Pretest–post-test nonrandomized clinical trial study. Forty participants were included, nevertheless, 32 completed the study, age 20–45 years old with definite relapsing–remitting MS on monthly cortisone therapy. Then, they were assigned into two groups, control group (n=14) received pulsed LLLT, and study group (n=18) received the same LLLT program in addition to BB-UVBR for 12 sessions. Primary measures were fatigue, Fatigue Severity Scale (FSS) and cognition, a computerized reactive stress tolerance, and percentile ratio for correct answers (PRC). Besides, Expanded Disability Status Scale (EDSS) as a secondary measure. Results The two groups were comparable at baseline in FSS, PRC, and EDSS (P≥0.05). Patients on LLLT group showed post-test highly significant improvement of PRC, FSS (P<0.001), and EDSS (P=0.023). Similarly, UVBR and LLLT group showed highly significant improvements of PRC, FSS, and EDSS (P<0.001). However, no significant differences (P≥0.05) of PRC, FSS, or EDSS were found between the two groups posttreatment. Conclusion The study suggests that there was no added value of UVBR to LLLT. That LLLT program alone has a potent beneficial short-term effect, on modulating fatigue, cognitive functions, and disability status for patients with relapsing–remitting MS.

Introduction The use of radial-artery access for percutaneous coronary angiography and interventions is recently adopted by many interventional cardiologists as their default access in coronary procedures. In some patients who have a weak radial pulse, or those who have used the radial artery as a bypass graft during coronary-artery bypass surgery, ulnar access may be a safe and convenient alternative to radial access that allows the operator to use forearm access and avoid crossing over to the femoral approach Aim In this study, we compared the safety and efficacy of ulnar access versus radial access for coronary angiography and interventions. Patients and methods This study was conducted on 100 patients who presented with chronic coronary syndromes and were referred for coronary angiography and percutaneous coronary intervention if needed. They were divided into two groups, group A consisted of 50 patients for which coronary angiography was done through transradial access, and group B consisted of 50 patients for which coronary angiography was done through transulnar access. The complication rate, crossover rate, and patient discomfort were compared in both groups. Results We found that hematoma formation and patient discomfort were found more significantly in the ulnar-access group. Access-artery occlusion was found more significantly in the radial-access group. There was no significant difference between both groups regarding access-artery spasm and crossover. Conclusion The transulnar approach proved to be noninferior to the transradial approach for coronary procedures.