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Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver disease globally, closely associated with metabolic syndrome. This study aimed to identify significant predictors of metabolic syndrome in patients with MASLD. A retrospective cross-sectional study was conducted on adult type 2 diabetes mellitus (T2DM) patients between January 2018 and April 2022. Of 314 initially collected patients, those without MASLD or with other liver diseases were excluded, leaving 240 MASLD patients for analysis. Metabolic syndrome was assessed using the NCEP ATP III criteria, and data analysis was performed using Stata17. Higher systolic blood pressure (adjusted OR = 1.000427, p < 0.0001) and larger waist circumference (adjusted OR = 1.001517, p < 0.0001) were independently associated with increased odds of metabolic syndrome. Additionally, higher triglyceride levels (adjusted OR = 1.064834, p < 0.0001) and lower HDL cholesterol levels (adjusted OR = 0.998595, p = 0.003) were significant predictors. Other variables, including age, HbA1c, BMI, LDL, and hepatic steatosis index, were not significantly associated with metabolic syndrome after adjusting for confounders. Higher systolic blood pressure, larger waist circumference, elevated triglyceride levels, and lower HDL cholesterol levels are significant predictors of metabolic syndrome in MASLD patients.

Antibiotic resistance among bacteria is recognized as the primary factor contributing to the failure of treatment. In this research, our objective was to examine the prevalence of antibiotic resistance in H. pylori bacteria in Palestine. We enlisted 91 individuals suffering from dyspepsia, comprising 49 females and 42 males. These participants underwent esophagogastroduodenoscopy procedures with gastric biopsies. These biopsies were subsequently subjected to microbiological assessments and tested for their susceptibility to various antimicrobial drugs. Among the 91 patients, 38 (41.7%) exhibited the presence of H. pylori. Notably, Ciprofloxacin displayed the highest efficacy against H. pylori, followed by Levofloxacin, Moxifloxacin, and Amoxicillin, with resistance rates of 0%, 0%, 2.6%, and 18.4%, respectively. On the contrary, Metronidazole and Clarithromycin demonstrated the lowest effectiveness, with resistance percentages of 100% and 47.4%, respectively. The outcomes of this investigation emphasize that H. pylori strains within the Palestinian patient group exhibit substantial resistance to conventional first-line antibiotics like clarithromycin and metronidazole. However, alternative agents such as fluoroquinolones and amoxicillin remain efficacious choices. Consequently, we recommend favoring quinolone-based treatment regimens for H. pylori infections and adopting a more judicious approach to antibiotic usage among the Palestinian population.

Chronic mesenteric ischemia (CMI) is a rare cause of abdominal pain with risk factors as Diabetes, Hypertension, smoking and age above 65-year-old age. A 55 -year-old man, a heavy smoker, with no other risk factor for chronic mesenteric ischemia, presented with a recurrent episodes of abdominal pain. Many differential diagnoses were excluded, CT angiography was showed Inferior Mesenteric artery (IMA) and superior Mesenteric artery (SMA) stenosis, then the Intervention was done successful. Gastric ulcers that are resistant to treatment, H. pylori negative and with no history of non-steroidal anti-inflammatory drugs (NSAID) use should be investigated for a possible ischemic.

Background: Limited data are available for evaluating the effect of blood glucose on transcatheter aortic valve replacement (TAVR) outcomes in patients with diabetes. We aimed to assess the impact of glucose levels on short-term and long-term adverse outcomes in patients undergoing TAVR. Methods and Results: Data from severe aortic stenosis (AS) patients who underwent TAVR from 2010 to 2022 were collected retrospectively. In total, 615 patients were enrolled in the study: Among the total patient population, 43% had diabetes mellitus (DM), with a mean hemoglobin A1c (HbA1c) level of 7.4 ± 2.5. Within this cohort, 33% were classified as having uncontrolled diabetes, while 17% were considered well-controlled. Diabetic patients were younger (80.7 ± 6.8 vs. 82.0 ± 6.8 years, p = 0.001) and had more cardiovascular risk factors. No significant differences were found in outcomes between the two groups during the twelve-year follow-up. A multivariable logistic regression analysis was conducted on 270 DM patients to examine the impact of blood glucose levels and HbA1c on outcomes such as arrhythmia, stroke, and acute kidney injury (AKI). For arrhythmia, the odds ratio for HbA1c and blood glucose were 1.1039 (p = 0.23), and 0.998 (p = 0.76), indicating no significant associations. In stroke cases, HbA1c had an odds ratio of 1.194 (p = 0.36), while an odds ratio of 1.020 (p = 0.013) for blood glucose indicated a significant association. Notably, for AKI, the odds ratio for HbA1c was 2.304 (p = 0.02), indicating a significant link between higher HbA1c levels and increased AKI risk, with blood glucose levels trending toward significance (odds ratio = 1.0137, p = 0.061). Conclusions: Diabetic status is a predictor of short-term outcomes following TAVR. Thus, these screening parameters should be included in risk assessment tools for TAVR candidates.

Despite transforming care for severe aortic stenosis, TAVR is still followed by early and late mortality. The triglyceride–glucose (TyG) index, an insulin-resistance marker from routine triglyceride and glucose levels, may flag high-risk patients in Ashkenazi-Jewish and Mediterranean individuals. We examined whether baseline TyG predicts all-cause mortality at 30 days, 1 year, and 3 years post-TAVR. We retrospectively studied patients with severe symptomatic aortic stenosis who underwent TAVR at a single tertiary center between 2010 and 2024. The TyG index was calculated from baseline triglyceride and glucose values. The primary endpoint was all-cause mortality at 1 year, with secondary endpoints of all-cause mortality at 30 days and 3 years. Cox proportional hazards models evaluated the association between TyG (per 1-unit increase) and mortality, adjusting for major clinical risk factors. Additionally, ROC curves were used to derive cohort-specific TyG thresholds for short-term and long-term mortality. Results: A total of 821 TAVR patients were included. All-cause mortality was 3.4 % at 30 days, 10.9 % at 1 year, and 19.7 % at 3 years. Higher baseline TyG was associated with significantly increased mortality risk at all time points. After multivariable adjustment, each 1-unit increase in TyG index conferred a higher hazard of 1-year death (adjusted HR 1.62, 95 % CI 1.21–2.16) and remained predictive of mortality at 30 days (HR 1.92, 95 % CI 1.08–3.42) and 3 years (HR 1.42, 95 % CI 1.14–1.77). ROC analysis identified distinct TyG thresholds for short-term and long-term outcomes, with an optimal cut-point of 9.012 for 30-day mortality, 9.15 for 1-year mortality, and 8.700 for 3-year mortality. Baseline TyG index is an independent predictor of early, short-term, and long-term mortality after TAVR. The identification of cohort-specific TyG cut-points highlights population-specific metabolic risk calibration and supports the use of TyG as a simple and informative biomarker for refining risk stratification and follow-up intensity in TAVR recipients.