Noninvasive prediction of esophageal varices this ratio remained valuable in the prediction of the presence of EVs in patients with no signs of decompensa- tion, with 100% sensitivity and NPV. This property might be particularly useful; its clinical importance has recent- ly been emphasized (3, 10, 46, 47). Although our results were based on a subset analysis and in smaller sample sizes, routine periodic endoscopy, as recommended by the Ministry of National Health in Egypt, should be considered in the follow-up of cirrhotic patients; based on limitations in financial resources, this sample ratio; platelet count:spleen diameter ratio should be applied. In conclusion, the platelet count:spleen diameter ratio is an accurate noninvasive method of assessing EVs in Egyptian patients with compensated or decompensated liver cirrhosis. It is easy to calculate and can reduce the financial and sanitary burdens of endoscopy units, par- ticularly in developing countries. Additional large multi- center studies on this ratio should be performed. Financial support This study was supported by the Department of Inter- nal Medicine, Department of Clinical Pathology, Uni- versity of Minia, Minia City, Egypt, and Minia University Hospital Research Foundation. The University of Minia, Minia University Hospital Research Foundation had no role in the design or conduct of the study; the collection, analysis, or interpretation of the data; or the preparation or review of the manuscript. Authors contribution Specific author contributions: Dr. Mona Abu El Maka- rem had full access to all of the data in the study and ac- curacy of the data analysis, study concept, and design. Yehia Shaker, Mohammed Shatat, Maysa Abd-elmoty, Atef Elakad : acquisition of data. Mona Abu El Makarem, Mo- hammed Shatat, Amal M.Kamal: drafting of the manu- script. Mohammed Shatat, Ali M. El Sherif: statistical analysis, Ali. 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