bluuebunny/crossref_metadata_2025 huggingface dataset:
Subcostal TAP Block Versus Lateral TAP Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy
Authors: Saba Tomas Michael Naser , Taha Abdallah El-Safty Omar Mohamed , Shoukry Mohamed Randa Ali , Mahmoud Khamis Ahmad Mohamed , Attia Samy Engy Samy
Published: November 2024

Background

Total abdominal hysterectomy surgeries are associated with severe postoperative pain. Effective pain management reduces the incidence of postoperative cardiac and pulmonary complications, decreases risk of postoperative deep venous thrombosis through early mobilization, provides patient satisfaction and reduces cost of hospital stay. A number of analgesic strategies have been adopted to minimize postoperative pain after abdominal surgeries. Studies suggest that abdominal wall blocks provide effective pain relief and faster postoperative rehabilitation than systemic analgesia.

Objective

To compare the effectiveness of subcostal versus lateral TAP blocks for post- operative pain management in patients undergoing total abdominal hysterectomy.

Patients and Methods

This study was a prospective randomised clinical study conducted in Ain Shams University Hospitals from October 2021 till October 2022 with a sample size of 100 patients undergoing total abdominal hysterectomy under general anaesthesia, divided into 2 groups, 50 patients each: Group A: Subcostal TAP Block group, Group B: lateral TAP Block group.

Results

These results demonstrated that performing postoperative bilateral subcostal TAP block in group (A) was associated with significant increase in heart rate, mean arterial blood pressure, pain scores and pethidine requirements postoperatively in comparison to bilateral lateral TAP block in group (B) which provided more effective analgesia than subcostal approach.

Conclusion

The quality of postoperative analgesia was more effective in patients received lateral TAP block than those received subcostal TAP block regarding hemodynamic changes, pain scores, doses of pethidine required for pain relief and postoperative mobilization.
Ultrasound Guided Suprascapular Nerve Block Combined with Intra-Articular Injection of Bupivacaine versus Ultrasound-Guided Interscalene Nerve Block in Shoulder Arthroscopy
Authors: Elsayed Abdullatif Ayman Ahmed , Hussein Mostafa Mansour , Mohamed Mohamed Abdelwareth , Mohamed Ezzat Shahrour Mohamed Tarek
Published: November 2024

Background

Severe intraoperative and postoperative pain associated with arthroscopic shoulder surgery has a high incidence reaching up to 45%; it is often significant enough to interfere with initial recovery and rehabilitation. This pain is difficult to manage without large doses of opioids.

Objective

To compare Interscalene nerve block ISNB with the suprascapular nerve and Intra- articular injection (SSNB+IAI) for postoperative analgesia after shoulder arthroscopic surgery guided with ultrasound.

Patients and Methods

This is a prospective, randomized, double-blinded study, that was carried out in Ain Shams University Educational Hospitals, through a period of six months.

Results

The ISNB and SSNB+IAI have the same efficacy for postoperative analgesia after shoulder arthroscopy done for different purposes. A non-significant difference in patient satisfaction assessed 24-hour post-operative, with p-value 0.054. There is a significant difference between the two groups regarding the reported complications, with a p-value of 0.017. Highly significant difference between the two groups regarding phrenic nerve paresis which is assessed using diaphragmatic ultrasound, with a p-value of 0.000. Based on our results we recommend further studies on larger patients and longer periods of follow-up to emphasize our conclusion.

Conclusion

ISNB and SSNB+IAI provided similar postoperative analgesia and patient satisfaction, but the higher rate of complications in ISNB made the SSNB+IAI superior for use in arthroscopic shoulder surgery.
The Effect of Erector Spinae Plane Block on Postoperative Quality of Recovery after Laparoscopic Cholecystectomy
Authors: Abdelfattah Amr Mohamed , Said Alfred Maurice , Elsayed Ahmed El Sherif Ibrahim Mohamed , Abd el halim Yara Emad Saber
Published: November 2024

Background

The postoperative pain following laparoscopic cholecystectomy consists of both somatic and visceral components with pain originating from port entry wounds, gallbladder resection and abdominal insufflation that leads to peritoneal distention and peritoneal damage.

Objective

To determine whether erector spinae plane block improves post operative pain, opioid consumption, nausea, vomiting and early mobilization in patients undergoing (LC).

Patients and Methods

This prospective randomized controlled interventional study was conducted at operative theatres, Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University Hospitals for 6 months.

Results

These results suggest that ESPB can be effective option for postoperative pain management in laparoscopic cholecystectomy, allowing healthcare providers and patients to choose the most suitable technique based on individual preferences and clinical considerations. However, further research with larger sample sizes and multicentric studies would be valuable to confirm these findings and explore potential variations in different patient populations or surgical settings.

Conclusion

The incorporation of specific numerical findings from multiple studies accentuates the robust evidence suggesting that erector spinae plane block is associated with superior pain control, faster recovery, and reduced reliance on rescue analgesia in laparoscopic cholecystectomy. These quantitative outcomes underscore the potential of ESP block as a transformative analgesic technique in the realm of perioperative care.
Outcomes of Extra-Anatomic Surgical Bypass in Treatment of Central Venous Occlusive Disease in Pediatric Chronic Hemodialysis Patients: One-Year Follow-Up
Authors: Elkenawy Moustafa Mahmoud , AbdelAzim Tarek Ahmed Adel , Fakhr Mohamed Emam
Published: November 2024

Background

Maintenance of hemodialysis vascular access patency in pediatric patients remains a key issue. Venous hypertension due to proximal central venous outflow obstruction is a major impediment to long-term arteriovenous access. Prior ipsilateral insertion of central venous catheters is a common risk factor. Management of Central venous occlusive disease (CVOD) in an attempt to avert sacrificing the fistula and improving symptoms of venous hypertension. Surgical bypass has the advantage of being a bale out technique for management of CVOD with maintaining the existing dialysis access and providing prolonged patency and satisfactory outcome specially with the scarce data about the role of endovascular intervention in management of CVOD in pediatric population.

Objectives

The aim of our prospective, observational study is to evaluate the efficacy and outcome of the surgical management of hemodialysis-related central venous occlusive disease in pediatric patients.

Patients and Methods

This study was conducted on (15) Pediatric patients with end stage renal disease on regular hemodialysis via upper extremity access who underwent extra-anatomic surgical bypass to treat symptomatic venous hypertension due to central venous occlusive disease. Bypass take-off was from subclavian vein, cephalic vein, or axillary vein of the affected side according to site of obstruction and outflow including contralateral subclavian vein, internal jugular vein or ipsilateral femoral vein. The study period started from June 2021 until May 2022. Patients included in the study were essentially attending the Vascular Outpatient Clinic at Ain Shams University Hospitals and Nasser Institute for Search & Treatment at Cairo.

Results

Regarding the type of bypass used in the studied patients, the most frequent type used is Lt Axillary to Rt Subclavian bypass and Lt Subclavian to Rt Subclavian bypass 3 (20%) followed by Rt Axillary to Lt Subclavian bypass, Rt Cephalic to Lt Subclavian bypass and Rt Axillary to Rt femoral bypass 2 (13.33%). Technical success was achieved in the 15 (100%) cases while functional success occurred in 13 (86.6%) cases; patients had performed their 4 hours hemodialysis sessions via their preexisting access within 24 h post-procedurally. No in-hospital morbidity or death was recorded. Primary patency rates at 1, 3, 6, and 12 months were 93.3, 86.6, 73.3, and 66.6%, respectively. Secondary patency rates at 1, 3, 6, and 12 months were 100, 93.3, 80, and 73.3%, respectively.

Conclusion

Extra-anatomic surgical bypass is safe and effective method for management of Central venous occlusive disease and has the advantage of being a bail out technique for maintaining the existing dialysis access and also providing symptomatic relief of venous hypertension, prolonged patency and satisfactory outcome.
Predictors of Isolated Coronary Artery Ectasia (CAE) in Egyptian Population
Authors: Tamara Ahmed Fathy , Tantawy Mahmoud Ahmed , Elbarbary Ahmed , Abdelmoamen Amr Hossam
Published: November 2024

Background

Coronary artery ectasia (CAE) is defined as a dilation of ≥ 1.5-fold compared to the diameter of adjacent normal segments of the same or other arteries. The term 'ectasia' refers to the diffuse dilation of a coronary artery, while focal coronary dilation is referred to as 'coronary aneurysm'. The exact pathophysiology of CAE remains unknown.

Objective

To evaluate risk factors and clinical criteria as predictors of isolated coronary artery ectasia in the Egyptian population referred to our Cath laboratory for coronary angiography.

Patients and Methods

This Retrospective Study was carried out at our Cath lab at Misr University for Science and Technology (MUST) hospital. Among patients attending Souad Kaafi University Hospital, undergoing coronary angiography from November 2018 to October 2022 that 2100 patients, we found 40 patients with isolated coronary artery ectasia who enrolled in this study, and 252 patients with normal coronary angiography as a control group.

Results

The multivariate logistic regression analysis to assess predictors of the incidence of CAE among the studied patients shows that the most important associated factor that affected the incidence of CAE was smoking with an odd ratio of 7.769 and 95% CI (3.311- 18.229). Among patients with isolated coronary artery ectasia, on the number of affected vessels, Smoking status was significantly associated with the extent of coronary artery involvement, with a significant decrease in the proportion of smokers from the three-vessel group (84%) to the two-vessel group (42.9%) and the single-vessel group (0%) (p = 0.000). Among patients, there was statistical significance between isolated coronary artery ectasia and multiple vessel affection.

Conclusion

This study revealed that smoking is significantly associated with the presence of coronary artery ectasia (CAE), while diabetes mellitus (DM) and smoking showed a potential link to more extensive coronary artery involvement. Although other cardiovascular risk factors did not show significant associations, most patients with isolated CAE demonstrated involvement of multiple coronary vessels.
Outcomes of Tocilizumab and Sarilumab for Hospitalized Patients with COVID-19: Retrospective Study
Authors: Madkour Ashraf Mokhtar , El Maraghy Ashraf Abbas , Ghaly Ragy Mamdouh , Fadly Boles Raafat
Published: November 2024

Background

Coronavirus disease 2019 (Covid-19) is associated with immune dysregulation and hyperinflammation, including elevated interleukin-6 levels. The use of tocilizumab, a monoclonal antibody against the interleukin-6 receptor, has resulted in better outcomes in patients with severe Covid-19 pneumonia in previous studies. However, more data are needed to emphasize these studies;

Objectives

The aim of this work was to study the outcomes of TZ and SL for hospitalized patients with COVID-19;

Patients and Methods

This retrospective study was carried out at Specialized Ain Shams University Obour Hospital on 100 severe or critically ill hospitalized COVID-19 patients;

Results

In critically ill patients with Covid-19, the interleukin-6 receptor antagonists tocilizumab and sarilumab were both effective as compared with the current standard of care, which included glucocorticoids in the majority of patients (>80%). The benefit was consistent across primary and secondary outcomes and across subgroups and secondary analyses;

Conclusion

In this randomized trial involving hospitalized patients with severe Covid-19 pneumonia, the use of tocilizumab did not result in significantly better clinical status or lower mortality than sarilumab at 28 days. In which administration of either tocilizumab or sarilumab was associated with improve clinical and laboratory outcome compared. The association is not dependent on the choice of interleukin-6 receptor antagonist.
The Value of Non-Cultured Adipose Derived Stem Cells (ADSCs) in Mechanically Micro Emulsified Adipose Tissue (Nanofat) together with Platelet-Rich Plasma (PRP) in Female Pattern Hair Loss (FPHL)
Authors: Abdallah Marwa Abdel-Rahim , El-Sayed Abou-Noor Mahy El-Bassiouny , Tamim Mohamed Marwa Abdelfatah
Published: November 2024

Background

Female pattern hair loss (FPHL) is the most common cause of non- scaring alopecia in females and it significantly affects individuals' overall quality of life. Managing this condition poses a regular challenge in dermatological practice due to the limited supporting evidence for many therapeutic options, frequently resulting in unmet patient expectations. Nanofat grafts, generated by emulsification and filtering of microfat, contain growth factors and Adipose Derived Stem Cells (ADSCs) that can induce tissue regeneration and improve tissue quality

Objective

To assess the efficacy of Platelets Rich Plasma (PRP) added to Nanofat in Female Pattern Hair Loss (FPHL)

Methods

This is an Interventional study, which included 20 female patients with female pattern hair loss (FPHL) after exclusion of other causes of alopecia. Patients were selected from the outpatient clinic of Dermatology of Ain Shams University Hospitals from December 2022 till May 2023.

Results

In our study, 20 FPHL patients aging from 18 to 50 years. They were treated by Nanofat with PRP. They were followed up at12 and 24 weeks clinically by photography and trichoscopically by counting terminal and vellus hair and assessing the change in terminal and vellus hair thickness which were analyzed using image J data analysis software. Mean terminal hair count was increased highly significantly in number, as it increased from 73.90 hair/cm2 before treatment to 120.05 hair/cm2. There were high statistically significant decrease in vellus hair count, decreased from 46.60 to 25.20 (p < 0.001). There was high statistically significant increase in terminal hair thickness after treatment from 0.044 to 0.062 after 6months, (p < 0.001). There was high statistically significant increase in vellus hair thickness after treatment from 0.020 to 0.026 after 6 months from 0.020 to 0.023, p < 0.001

Conclusion

The procedure seems safe, effective, well-tolerated by all the patients with encouraging response from these patients. We observed no adverse side effects in any. patient
The Impact of Probiotic Supplementation on Liver Enzymes in Patients with Non-Alcoholic Fatty Liver Disease Attending the Family Medicine Clinic at Ain Shams University Hospitals
Authors: Abd El Hamid Alaa Ahmed , Mohamed Azza Emam , sabry Manal , Amin Ghada Essam El-Din , Elessawy Hagar , Allam Mohamed Farouk
Published: November 2024

Background

Non-alcoholic fatty liver disease (NAFLD) is a condition marked by the accumulation of fat (more than 5% of liver tissue) without the presence of alcohol abuse or other chronic liver ailments. NAFLD can lead to liver inflammation and advance to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and, in severe cases, may contribute to the development of hepatocellular carcinoma (HCC)

Objective

To assess the impact of probiotic supplementation, specifically lactobacillus, on liver enzymes (ALT & AST).

Patients and Methods

This study involved 50 participants (15 males and 35 females) with a body mass index equal to or greater than 25 and an age range of 18-60 years, all exhibiting evidence of bright fatty liver in ultrasonography. Exclusion criteria comprised any signs of other chronic liver diseases, including viral hepatitis (B and C), autoimmune hepatitis, a history of alcohol consumption, diabetes mellitus (DM), statin therapy for cardiovascular disease (CVD), recent surgery, gastroenteritis, or diarrhea in the last 2 weeks. The participants were divided into two groups: a probiotic group consisting of 25 patients who received daily probiotics for 12 weeks along with diet and lifestyle modifications, and a standard treatment group of 25 patients who underwent diet and lifestyle modifications only. The study involved clinical assessments, laboratory evaluations, and abdominal ultrasound for all participants.

Results

The average age of the entire study sample was 46.48. No statistically significant differences were observed between the standard treatment group and the probiotic- treated group with respect to smoking, weight, and BMI. The probiotic-treated group exhibited a significant reduction in ALT and AST (P values 0.014 and 0.004, respectively), while the standard treatment group showed a smaller decrease in AST only (P value 0.025).

Conclusion

The findings of the present study indicate that short-term treatment with the probiotic resulted in improvements in ALT and AST levels in the probiotic group
Study of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) and C Reactive Protein (CRP) as Systemic Biomarkers of Inflammation among Apparently Healthy Egyptian Obese Subjects
Authors: Elsayed Nagy Menna-t-Allah , Rahman El Shayeb Mohamed Abdel , Farres Mohamed Nazmy , Ahmed Eman Elsayed , Mohamed Abdel Rahman Salwa Mostafa , Mahmoud Mayada Moneer
Published: November 2024

Background

Obesity is presumed to be a chronic state of subclinical inflammation which is a major risk factor for many disorders.

Objective

is to evaluate Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and C reactive protein (CRP) as biomarkers for the inflammatory state associated with obesity among apparently healthy Egyptian subjects.

Patients and Methods

The present study was conducted on 60 apparently healthy individuals, including 30 obese subjects and 30 non-obese subjects. They were recruited from the outpatient departments of Ain Shams University Hospitals. Inflammatory biomarkers NLR, PLR and CRP were compared between both groups.

Results

There was a statistically significant increase in the PLR and CRP level in the obese group compared to the non obese group while there was no statistically significant increase in the NLR between both groups.

Conclusion

Both CRP and PLR (but not NLR) can be used as markers for estimation of ongoing subclinical inflammation in apparently healthy obese subjects.
Assessment of Pre-Operative Predictive Factors Favoring Conversion from Laparoscopic to Open Cholecystectomy in Acute Cholecystitis
Authors: Abbas Ahmed Adel , Mohamed Amr Arafa , Abdelazim Mohamed Samy
Published: November 2024

Background

Acute cholecystitis refers to inflammation of the gallbladder. The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct. Accurate diagnosis of cholecystitis requires a multifactorial, systematic approach that involves a detailed history, physical exam, serologic tests, and imaging. The (Tokyo guidelines 2018) diagnostic criteria for acute cholecystitis is widely used now days and well accepted.

Objective

To asses pre-operative predictive factors favoring conversion of laparoscopic cholecystectomy into open cholecystectomy in acute cholecystitis such as: (TLC- history of DM and previous abdominal surgery -gall bladder wall thickness _ pericholecystic fluid collection and loss of gallbladder wall enhancement on CT).

Patients and Methods

This study included 100 patients admitted to Ain Shams university hospitals diagnosed with acute cholecystitis, underwent laparoscopic cholecystectomy, half of them converted to open cholecystectomy, the two groups are compared to each other to figure out preoperative factors favoring conversion cholecystectomy

Results

Obesity (BMI≥30 kg/m2) in this study has shown to be associated with risk of conversion in this study. In converted group there is 25 (50%) patients who are obese compared to 14 (28%) patients in laparoscopic group with P-value of 0.04. In our study we haven’t assessed the role of intraoperative findings on conversion rate. We chose not to include this factor in our analysis to make primary concern regarding pre-operative factors.

Conclusion

Obesity, DM, previous abdominal surgery, loss of gallbladder wall enhancement in CT study and prolonged prothrombin time are risk factors of conversion cholecystectomy in acute cholecystitis. Appropriate management of risk-related preoperative factors may improve patients’ outcomes making in mind the concept of conversion to open cholecystectomy should not be viewed as a complication or a failure but just the opposite. It is showing good judgment to complete the operation in the safest manner possible.
Specimen Rejection in the Laboratory of a Secondary Medical Center in Egypt
Authors: Eltelbany Manal A Shams Eldin , Hussein Wafaa M , Aziz Lilian W
Published: November 2024

Background

Errors in Laboratory testing have a direct impact on patient safety, as it directly affects diagnosis and management. Most errors occur in the pre-analytical phase, which occurs outside the laboratory. This study aimed to investigate the laboratory specimen rejection rate and causes in the pre-analytical phase in the laboratory of petroleum medical center.

Methods

The present study was conducted at Petroleum medical center in Egypt from August 2022 to June 2023. The study included 1701 specimens, Checklist was used to collect data about specimens received at laboratory, it includes information about source of specimen, type of specimen, date and time specimen was collected and received at the laboratory, phlebotomist, specimen transports and storage conditions, whether a specimen was rejected, and the rejection reason.

Results

Out of 1701 specimens, 98 (5.76%) were rejected. Clotting of anticoagulated specimens caused 49 (50%) of the rejections, followed by insufficient volume and hemolysis accounting for 8 (8.1%) each. Most of the rejected specimens came from the Emergency department 16 (16.33%), intensive care unit 24 (24.94%) and medical ward “6” 27 (27.55%). About 12/69(17.39%) of the specimens collected by physicians were rejected compared to 65/1013 (6.42%) for nurses and 21/619 (3.39%) for laboratory technicians.

Conclusions

The specimen rejection rate in this study was around 98/1701(5.76%). Clotting of anticoagulated specimens was the most important cause for rejection.
Spectrum of Renal Diseases Diagnosed by Renal Biopsy and its Clinical Correlation in Ain Shams University Hospitals
Authors: El-Sayed Hesham , Said Heba El , M.I Salman , Behairy Maha , Gharib Mohamed Sary , Ahmed Al Shaimaa Ebrahem
Published: November 2024

Background

The spectrum of biopsy-proven renal diseases differs between locations and changes over time. It is therefore essential to describe the local epidemiological trends and the prevalence of renal biopsy in various regions to highlight new pathology of various renal diseases and provide a basis for further hypothesis-driven research.

Objective

To evaluate the Spectrum of renal diseases diagnosed by renal biopsy in Ain Shams University Hospitals and study the clinical correlation of renal biopsies.

Patients and Methods

This retrospective study reviewed 1851 renal biopsies from Ain Shams University Specialized Hospital Histopathology lab and Electron Microscopy (EM) lab, during the period from January 1, 2019, to December 31, 2022. Clinical data was collected regarding the patient`s age, clinical presentations at the time of biopsy, diagnostic tests at the time of biopsy, and systemic diseases. The specimen’s reports were verified by at least two histopathologists. Histopathological findings were organized according to the recent classification system.

Results

We have analyzed the data of 1851 renal biopsies, with a mean age of 38.43 ± 14.83. 52.4% of the study population are males, and 47.6% are females. Hypertension was present in 71.9% of the patients. Primary glomerulonephritis was the most common renal pathology diagnosis, accounting for 47.1% of the cases, followed by secondary glomerulonephritis (27.5%) and vascular diseases (21.5%). Hypertensive nephrosclerosis was diagnosed in 18.7% of the patients. There were significant differences in the diagnosis of renal pathology among different age groups. Lupus nephritis was the most common diagnosis in the age group of 18-39 (24.6%), while hypertensive nephrosclerosis was the most common in the age groups of 40-59 (27%) and ≥60 (25.6%).

Conclusion

Renal biopsy most commonly presents with nephrotic syndrome. Primary glomerulonephritis is the most common diagnosis, with membranous GN being the most prevalent. Lupus nephritis is the most common secondary glomerulonephritis.
Assessment of Interleukin-35 Expression in Adult Egyptian Immune Thrombocytopenic Purpura Patients
Authors: El-Razzaz Mostafa K , Abdou Dina M , Moussa Mohamed M , Mostafa Nevine N , Nabeeh Nermeen A , Saber Heba M
Published: November 2024

Background

Immune Thrombocytopenic Purpura (ITP) is one of the common autoimmune diseases in Egypt, this disease causes a considerable drop in platelet counts rendering the patients at very high risk of bleeding. For this, ongoing research to determine an accurate diagnostic tool that would help in rapid diagnosis and also the remote prognosis of the disease are continuous. IL-35 is one of the interleukin family that now has been highlighted as a useful prognostic marker in many autoimmune diseases e.g.: SLE. In the light of its significance that was detected in other autoimmune disease, this study was to specify this interleukin in the context of the diagnosis of ITP.

Method

This pilot observational study was carried out on 60 patients and 20 normal controls. The patient group was categorized into newly diagnosed, relapsed and resistant groups. IL-35 was measured in serum by ELISA.

Results

This study demonstrated that plasma IL-35 levels were significantly lower in ITP patients than those in healthy controls and that IL-35 expression levels positively correlated with circulating platelet counts. Moreover, it was noted that a decrease in IL-35 contributes to the pathogenesis of ITP, and a statistically significant association between IL-35 levels and disease outcomes in ITP patients (P = 0.033). Specifically, patients with elevated IL-35 levels exhibited higher remission rates (28.8%) than patients experiencing only partial remission or resistance to treatment.

Conclusion

This finding suggested that IL-35 may play a role in predicting or potentially influencing disease prognosis.
Burden of HCV among Prevalent Hemodialysis Patients after National Egyptian HCV Eradication Program in El-Dakhlia Government
Authors: Sarhan Iman Ibraheim , ELSharkawy Magdy Mohamed , El Gaafary Maha Mohamed , Taher Hendam Doaa Mohammed , Abdelwahab Sanad Khaled Gouda
Published: November 2024

Background

Egypt has aimed to treat 250000 people annually up to 2020 in the first phase of their treatment program aiming at reducing the number of viremic patients, thus limiting the ongoing HCV transmission. Egypt is struggling to eliminate HCV and HCV-related morbidity by 2030.

Aim and Objectives

to measure the frequency rate of HCV infection among ESRD patients and identify the reasons of un-treatment among those who were offered the treatment free of charge.

Subjects and Methods

This multi-center cross sectional study included 500 patients receiving hemodialysis sessions on regular basis for more than 3 months in Dakahlia Governorate, patient recruitment from November 2022 to April 2023.

Result

According to patients` medical history we found that, 23.4% of patients had previous HCV infection from them 12.6% received treatment and 10.8% didn`t receive treatment due to several causes as one patient didn`t know about the drug availability, five patients (1%) fear from occurrence of side effects, 43 patients (8.6%) didn`t need treatment and five patients (1%) had other causes as had contraindication of drugs, non-compliance and deterioration of health status. Also, 20.4% of patients had been informed that they completely recovered and 0.8% had recurrence. After investigations, 1% of patients had positive HbsAg, 23.4% had positive HCV Ab, 4.2% positive HCV PCR.

Conclusion

The low prevalence of HCV among hemodialysis patients of HCV in HD patients confirm that HCV infection doesn’t become a major health problem among patients on maintenance HD.
Testosterone Levels in Egyptian Men Type 1 Diabetic Patients and Their Association with Diabetic Nephropathy
Authors: Maher Mahdy Maram Mohamed , Ali Hendawy Laila Mahmoud , Neseem Mina Mechaiel , Saleh Amr Mahmoud Mohamed , Abd Eltawab Mohamed Hadeer Osama
Published: November 2024

Background

Type 1 diabetes is a chronic illness characterized by the body's inability to produce insulin due to the autoimmune destruction of beta cells in the pancreas. It can develop in adults and is often onset in childhood.

Aims and Objectives

To identify testosterone levels in Egyptian men with type 1 diabetes with and without nephropathy and identify its correlation with micrcoalbuminuria.

Subjects and Methods

This study was case control study conducted at Diabetes outpatient clinic at Ain Shams University Hospital. The study was performed on diabetic subjects aging above 20 years old. The study was included 120 patients with diabetes divided into 3 groups: 40 cases with type 1 diabetes and diabetic nephropathy, 40cases with type 1 diabetes without diabetic nephropathy, 40 Healthy males as a control group.

Result

Testosterone levels were higher in patients with T1D than in healthy controls. Total testosterone levels were significantly higher in T1DM patients with diabetic nephropathy compared to those without diabetic nephropathy. Sex hormone-binding globulin showed no association with T1DM or diabetic nephropathy.

Conclusion

The current study showed that testosterone levels were higher in patients with T1D than in healthy controls. Total testosterone levels were significantly higher in T1DM patients with diabetic nephropathy compared to those without diabetic nephropathy.
Effect of Intra-Dialytic Exercise Onhemodialysis Session Adequacy and Solutes Clearance and Rebound in Prevalent Hemodialysis Patients
Authors: Elshinnawy Howaida Abdelhamid , Elsayed Hisham Mohamed , Hebah Hayam Ahmed , Abdelmohsen Waleed Anwar , Farrag Dina Abou-bakr , Abdelgawad Mostafa Abdelnasier
Published: November 2024

Background

Hemodialysis is an indispensable therapeutic intervention for patients with end-stage renal disease (ESRD). However, it has certain limitations in managing the reduction in physical functionality and cardiovascular fitness. On the other hand, intradialytic exercise has demonstrated potential in enhancing health-related quality of life (HRQOL) and cardiopulmonary fitness in patients with chronic kidney disease who are undergoing maintenance hemodialysis.

Aim of the Work

This study aimed to investigate the impact of intra-dialytic exercise on the efficiency of hemodialysis sessions, the clearance of various solutes, and solute rebound in patients with ESRD receiving regular hemodialysis.

Patients and Methods

The study included forty adult ESRD patients undergoing regular hemodialysis, divided into two groups: Group 1 (intra-dialytic exercise program) and Group 2 (no intra-dialytic exercise program). Clinical characteristics were matched between the groups to ensure unbiased findings.

Results

The intra-dialytic exercise group showed significantly lower blood urea nitrogen levels and higher urea reduction ratio (URR%) compared to the control group. Equilibrated Kt/V (eKt/V) values were also higher in the exercise group, suggesting more efficient dialysis treatment. In terms of minerals, the exercise group had reduced phosphorus levels and higher phosphorus reduction rate (Po4 RR%) compared to the control group. However, no significant difference was found in potassium levels between the groups.

Conclusion

The findings support previous research on the positive effects of intra-dialytic exercise on dialysis efficacy and electrolyte management. Intra-dialytic exercise may enhance waste product clearance and improve overall health outcomes in ESRD patients.
Association of Hand-Grip Strength and Non-Alcoholic Fatty Liver Disease Index in Older Adults
Authors: Baiomy Essam , Abdo Ahmed Abbas , Radwan Shrouk Hamed Abdelwahab
Published: November 2024

Background

The association between grip strength (GS) and non-alcoholic fatty liver disease (NAFLD) has been reported by recent epidemiological studies, however, the results of these studies are inconsistent.

Aim of the Work

Verification of the association between hand-grip strength and indicators of non- alcoholic hepatic steatosis and fibrosis in older adults.

Patients and Methods

A total of 110 older adults who had their diagnosis of NAFLD (hepatic steatosis and fibrosis) that confirmed by non-invasive method and attended or admitted to the Hepatology Unit were enrolled. Calculation of fatty liver index and NAFLD score for all patients was performed.

Results

There was statistically significant association between significant hepatic fibrosis and FLI and hand-grip strength; FLI was elevated (positive correlation) and hand-grip strength was decreased (negative correlation). Presence of significant hepatic fibrosis was statistically significant associated with decreased ALT and platelet levels (negative correlation) and increased AST/ALT ratio and GGT levels (positive correlation).

Conclusion

There is significant clinical evidence that the HGS is inversely associated with the incidence of NAFLD. NAFLD can be associated with muscular impairment in older adults, as demonstrated by lower muscle strength.
Relation between Vitamin D and Idiopathic Generalized Epilepsy in Children
Authors: Ahmed Nahed Salah eldin , Elsayed Lobna Mohamed Elnabil , Nada Maha A , shehab Abeer Alsayed Ali , Aboshady Eman Mones Mahmoud Ibrahim , ELKordy Aya M
Published: November 2024

Objectives

This study aimed to explore vitamin D status among children with generalized idiopathic epilepsy and comparing it with healthy control and follow up after 3months for cases with deficient and insufficient vitamin D serum level.

Subjects and Methods

The study was carried on forty epileptic children (2-16 years old) and forty age and sex matched healthy control subjects. Serum vitamin D level as well as parathormone level was performed for all patients and control subjects and follow up after 3months for cases with deficient and insufficient vitamin D serum level.

Results

There was a statistically significant difference between patients and control regarding family history(0.04) and febrile convulsions(P value<0.001). there was also a statistically significant difference between patients and control regarding ionized calcium (P value<0.001) and vitamin D status (p value = 0.043). There was also a statistically highly significant difference regarding serum vitamin D level in deficient and insufficient cases before and after 3months (P value<0.001) moreover, there was a statistically significant difference regarding frequency of seizure in deficient and insufficient cases before and after 3months (p value = 0.02). Patients with insufficient serum vitamin D levels had a significant lower age at onset of epilepsy than patients with deficient or normal levels (p value=0.046). Both vitamin D level and family history were found to be a significant predictor for developing IGEs in children (P value <0.001) for both.

Conclusion

Vitamin D deficiency is prevalent in treatment children with idiopathic generalized epilepsy and it is associated with increased frequency of seizures and lower age at onset of epilepsy. We recommend measuring and correction of vitamin D deficiency and follow up insufficient and deficient cases who have IGEs with EEG as it is a relatively cheap and easy method that might improve seizure control hand in hand with administering AEDs.
Impact of Letrozole on Prevention of Early Onset Ovarian Hyperstimulation Syndrome in GnRH Antagonist Protocol: A Randomized Controlled Trial
Authors: Al Saidi Fatma Gamal Mohamed , Kholy Abdellatif Galal El , Gomaa Ihab Adel , Abbas Ahmed Mohamed
Published: November 2024

Background

Ovarian hyperstimulation syndrome (OHSS) is a risk associated with assisted reproductive technology. There is a link between higher incidences of OHSS and higher blood estrogen levels. With its strong, targeted, and reversible inhibition of aromatase and E synthetase, the nonsteroidal aromatase inhibitor letrozole can prevent the conversion of androgens into estrogens.

Methods

Study populations were divided into two equal groups: Group I: Consisted of 85 women who received controlled ovarian stimulation with a conventional antagonist protocol and letrozole. Group II: Consisted of 85 women who received controlled ovarian stimulation with a conventional GnRH antagonist protocol and a placebo.

Results

There were statistically significant differences among the groups in terms of Estradiol level on Trigger Day (p = 0.037), Number of oocytes retrieved (p = 0.018). The total days of stimulation and cumulative Gonadotropin dose were significantly lower in the Letrozole group (p = 0.045). There were no significant differences between the groups as regard endometrial thickness at trigger day, number of fertilized oocytes, fertilization rate, embryos transferred per cycle, and fresh embryos transferred, mild and critical early onset OHSS, Cycle cancels, Biochemical pregnancy, and Clinical pregnancy between the two groups (P > 0.05). There was a significant difference as regard moderate and severe early onset OHSS between the two groups (P < 0.05).

Conclusion

We've concluded that for PCOS patients facing a high risk of OHSS, supplementing the GnRH-ant protocol with LE offers a safer, more effective, cost-efficient, and patient-friendly approach compared to the traditional GnRH-ant protocol. The use of LE alongside conventional protocols might alleviate severe forms of OHSS, even among those at extreme risk, without compromising the potential for implantation, pregnancy, and delivery
Frontal Lobe Growth Impairment in Fetuses with Congenital Heart Disease Using Ultrasound Parameters; A Comparative Cross-Sectional Study
Authors: Sakna Noha A , Mohamed Mourad M A , Nasr El din Mohamed H , Zeinhom Ahmed M
Published: November 2024

Background

There is evidence; in neonates with critical congenital heart disease CHD, that the abnormal hemodynamics do not affect all brain regions similarly, with the frontal lobe growth being more severely impaired, especially in cases with univentricular heart anatomy.

Aim and Objectives

To assess whether fetuses with congenital heart disease (CHD) have smaller frontal brain areas compared with normal controls.

Subjects and Methods

This Cross-sectional study was conducted at Ain Shams University Maternity Hospital (Fetal Medicine unit). The study group included 280 women, 140 women whose fetuses are normal and the other 140 women whose fetuses suffered congenital heart disease using ultrasonography. Measuring the distance from the internal edge of the frontal bone to the posterior edge of the CSP (measured in-to-in), i.e the frontal lobe anteroposterior diameter (FAPD), which was assumed to be representative of the area of the frontal lobes; measuring of the occipitofrontal diameter (OFD), (also measured in-to-in), from the internal edge of the frontal bone to the internal edge of the occipital bone. The ratio of these two measurements, calculated as FAPD/OFD×100 and referred to as ‘FAPD/OFD ratio’, represents the reference index that was used in this investigation to assess the growth of the frontal component of the fetal brain in relation to the growth of the whole brain. Fetal echocardiography was done for both groups to assess the cardiac anomalies.

Result

There was a statistically significant difference between the studied groups regarding History of CHD. the FAPD/OFD ratio was significantly smaller in both the group of left-heart lesion or univentricular heart and the group of all other CHDs, compared with normal fetuses (P < 0.0001), with no statistically significant difference between the two CHD groups. There was no statistically significant difference between the studied groups regarding comparison between surgical history, co-morbidities and Correlation of frontal anteroposterior diameter (FAPD), occiptofrontal diamter (OFD) and FAPD/OFD ratio with the other studied parameters in all cases except in gestational age and CNS anomalies.

Conclusion

Fetuses with CHD have a shorter FAPD and a smaller FAPD/OFD ratio compared to normal fetuses. This impaired growth of the frontal area of the brain seems to occur in all types of CHD, regardless of their impact on the hemodynamics.
A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Endometrial Sampling Tests for Detecting Endometrial Cancer
Authors: Sakna Noha , Elgendi Marwa , Salama Mohamed , Zeinhom Ahmed , Labib Somia , Nabhan Ashraf
Published: November 2024

Objectives

to determine the diagnostic accuracy of different endometrial sampling tests for detecting endometrial carcinoma.

Design

a systematic review and meta-analysis of studies of diagnostic accuracy.

Eligibility Criteria

We included published diagnostic test accuracy studies of women, of all ages, who had an endometrial sampling for preoperatively detecting endometrial cancer with verification using histopathology of hysterectomy specimens as the reference standard. We excluded case control and case series studies.

Information Sources

We searched the Cochrane library, MEDLINE/PubMed, CINAHL, Web of Science, and Scopus from the date of inception of the databases to January 18, 2023. We did not apply any restrictions on language or date of publication. We searched the references of included studies and other systematic reviews.

Risk of Bias

We extracted study data and assessed study quality using the revised quality assessment tool for diagnostic accuracy studies (QUADAS-2).

Synthesis of Results

We used bivariate diagnostic random-effects meta-analysis and presented the results in a summary receiver operating characteristic curve. We assessed the certainty of evidence as recommended by the GRADE approach.

Results

Twelve included studies, published between 1986 and 2022, recruited 1607 participants. Seven studies were low risk of bias in all domains and all studies had low applicability concerns. The most examined index tests were Pipelle and conventional dilation and curettage. For diagnosing endometrial carcinoma, the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio (95% confidence intervals), for Pipelle were 0.774 (0.565, 0.900), 0.985 (0.927, 0.997), 97.000 (14.000, 349.000), and 0.241 (0.101, 0.442) and for conventional dilation and curettage were 0.773 (0.333, 0.959), 0.987 (0.967, 0.995), 62.300 (18.600, 148.000), and 0.268 (0.042, 0.676); respectively.

Conclusion

High certainty evidence indicates that pre-operative endometrial sampling particularly using Pipelle or conventional curettage is accurate in diagnosing endometrial cancer. Studies assessing other endometrial sampling tests were sparse.

Systematic review Registration

Center for Open Science, osf.io/h8e9z
Carbetocin vs Oxytocin in Decreasing Intraoperative Blood Loss in Women Undergoing Caesarean Section
Authors: Abdelmegeed Abdelmegeed Ismail , Hussein Ahmed Mahmoud , Abbas Yomna Ayman Salah , ELDin Mansour Ahmed Mohammed Essam
Published: November 2024

Background

Primary postpartum haemorrhage (PPH) is a major cause of maternal mortality, accounting for 6% of all cases worldwide. PPH is defined as blood loss of 500 mL or more in vaginal delivery, or 1000 mL or more in cesarean delivery; these conditions can occur within the first 24 hours after delivery (primary PPH) or between 24 hours and 6 weeks after delivery (secondary PPH).

Objective

To compare Carbetocin vs Oxytocin in decreasing intraoperative blood loss in women undergoing Caesarean section.

Patients and Methods

This was a randomized controlled clinical trial that was conducted in Ain Shams University Maternity Hospital (ASUMH) on Women undergoing Ceaserean section attending Ain Shams Maternity Hospital.

Results

Need for other uterotonics & Incidence of PPH were higher in intervention (A) who received oxytocin compared to intervention (B) who received carbetocin with P value (<0,001&<0,001). There was no statistically significant difference between the two interventions as regards Hb drop and total estimated blood loss.

Conclusion

The current study showed that the use of Carbetocin and oxytocin were safe and effective in decreasing intra and postoperative blood loss in women undergoing planned cesarean section. The use of Carbetocin resulted in significantly decrease the need for other uterotonics & decrease risk of PPH compared to oxytocin alone.
Meta-Analysis Study for the Best Surgical Techniques for Secondary Intraocular Lens Implantation in Complicated Cataract Surgeries
Authors: Salman Abd El Rahman G , El zankalony Yasser A , Fawzy Samah M , Mostafa Moustafa E , Ahmed Sarah Amr Ashmawy
Published: November 2024

Background

The most appropriate location to implant intraocular lenses (IOL) is the interior of the capsular bag, but in complicated cataract surgeries, procedures of secondary IOL implantation are associated with insufficiency or absence of this anatomic structure. In these cases, the IOL must be fixated at alternative sites of the eye globe, e.g., the iris or the sclera.

Aim of the Work

to compare different surgical IOL implantation techniques for best correction of aphakia, postoperative visual acuity, acquired astigmatism and least complications as corneal decompensation, glaucoma and angle support.

Methodology

This systematic review included a discussion of all available studies meeting the eligible criteria including: well conducted descriptive studies, cohort, articles, accepted manuscripts, clinical trials, analytic studies and the literature of reviews, technical notes. An extensive search of electronic literature located 291 studies; 160 duplicates were removed and 131 of which were eliminated after the title and abstract were reviewed.

Results

This study demonstrated a statistically significant change in the mean BCVA improvement in all techniques when comparing the baseline to one and three month follow up after operation, though with no statistically difference between the three techniques as A final corrected distance visual acuity of 6/12 or better was achieved in (65%) implanted with an AC-IFIOL, in (44.3%) with anRP-IFIOL, and (18.1%) with an SF-PCIOL(two studies only taken in consideration). At six month follow up all groups showed no significant difference in the BCVA compared to the baseline and along the follow up periods. There is no significant loss in mean ECD in all groups. Regarding IOP elevation it was more in scleral fixated and anterior chamber IOL than that in retropupillary IOL, and glaucoma was the second most common complication in secondary IOL implantation after anterior chamber reaction.

Conclusion

AC-IFIOL, RP-IFIOL, and SF-IFIOL were similar in visual efficacy and mean corneal endothelial cell loss. Although IOP elevation was significantly higher in the SF- PCIOL group than in the other groups, other rates of complications were similar between the groups.