bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Serum Chemerin Level in Chronic Hepatitis C Virus Patients with and without Nonalcoholic Fatty Liver Disease
Authors: Makhlouf Mohamed Ali Marie , Fathallah Ahmed Magdy , Alashram Mohamed Badawy , Farid Algazzar Mohammed
Published: August 2023

Background

Chronic hepatitis C (CHC) has a number of features that suggest that it should be recognized not only as a viral disease but also as a metabolic liver disease that encompasses insulin resistance (IR), liver steatosis, impaired glucose tolerance or type 2 diabetes mellitus (T2DM) and disturbances in lipid metabolism.

Objective

To evaluate the role of serum Chemerin as a biomarker in patients with chronic hepatitis C virus with and without Non Alcoholic Fatty Liver Disease and its correlation to disease progress and activity and to evaluate its relationship with various laboratory parameters of the disease.

Patients and Methods

Type of study: A case control study. Study setting: outpatient clinics and inpatient wards at King Fahd hospital, Medina, Saudi Arabia & outpatient clinics at Ain Shams university hospitals, Egypt. Study Period: 6 months. Study Population: The study was conducted on normal populations, chronic HCV patients with NAFLD, and chronic HCV patients without NAFLD.

Results

In the present study the mean chemerin level was found to be statistically higher in chronic hepatitis C virus patients with NAFLD group compared to chronic hepatitis C virus patients without NAFLD group and was found to be statistically higher in both previous groups than in control group (p value <0.05). There was significant positive correlation between serum chemerin with ALT (p value <0.01), AST (p value<0.01), BMI (P value<0.01), INR (p value<0.01), triglyceride (p value<0.01), FIB4 index (p value <0.01) and NAFLD fibrosis score (p value <0.01). There was significant negative correlation between serum chemerin with serum ALBUMIN (p value <0.01).

Conclusion

The results obtained in the current study demonstrate that the serum chemerin level increased in parallel with the worsening liver functional reserves in CHC patients and serum chemerin level incrased in patients with CHC associated with NAFLD. It could be concluded that chemerin may be considered as additional tools for assessment of prognosis of CHC and monitoring the virally derived metabolic abnormality.
Clinical, Laboratory, Endoscopic and Histological Correlation to Assess Actual Remission in Patients with Ulcerative Colitis
Authors: Farag Sherif Monier Mohamed , Kortam Nermine Mohamed Abd Raboh , Faheem Heba Ahmed , Elmokemy Mohammed Sobhy Ibrahim
Published: August 2023

Background

Ulcerative colitis (UC) is an idiopathic inflammatory disease of the colon which results in diffuse friability and superficial erosions on the colonic wall associated with bleeding. It is the most common form of inflammatory bowel disease (IBD) worldwide.

Objective

Evaluate the correlation between clinical remission, laboratory and inflammatory markers, endoscopic and histological remission in patients with ulcerative colitis. Assess to what extent clinical remission affects “treat to target” policy.

Patients and Methods

The present study was conducted at Internal medicine and Gastroenterology department, Ain Shams University Hospitals on 30 patients who was diagnosed with ulcerative colitis and were on clinical remission for 6 months. Patients were evaluated for laboratory, endoscopic and histological remission.

Results

There is significant correlation between mayo score and TLC after remission where Pvalue =0.042*, but no correlation was found with ESR, PLT or HB%.

Conclusion

There was significant improvement in colonoscopic picture of the study group as regard Mayo score after remission. There was significant improvement in laboratory data of the study group as regard Mayo score after remission. There was no correlation between endoscopic and histologic activity after remission. Fecal calprotectin was significantly correlated with both endoscopic and histologic activity.
Relationship between Clinical, Serological and Ultrasound Assessment of Rheumatoid Arthritis Activity
Authors: Gabal Mervat Mamdouh Abo , Elaziz Amina Badr Eldin Abd , Hassan Sameh Abdel Moteleb , Mohammed Elham Shaaban , Mohammed Mostafa Adel Mohammed
Published: August 2023

Background

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of synovial tissue that leads to damage of cartilage and bone, resulting in irreversible joint destruction.

Aim of the Work

Our study’s aim was to assess the relationship between systematic ultrasound (US) evaluation using 7-joint and 12-joint scores and both clinical and serological evaluations in the determination of disease activity in rheumatoid arthritis patients. Also, we assessed the difference between both scores to know which is more accurate in assessing disease activity.

Patients and Methods

It was a cross sectional study that was carried out on fifty-five Egyptian RA patients diagnosed according to the 2010 American College of Rheumatology (ACR)/EULAR criteria. Patients were recruited from the rheumatology outpatient clinic at Ain Shams university hospital.

Results

Regarding 7-joint score parameters, mean and standard deviation for GS synovitis was 5.72 ± 4.44, PD synovitis was 3.74 ± 5.24, GS tenosynovitis was 1.15 ± 1.68, PD tenosynovitis was 1.76 ± 3.44 and erosions 1.07 ± 1.37. Regarding the examined areas for 7-joint score, wrist dorsal synovitis was the most common synovitis (98%), 2nd metacarpo-phalangeal joint (56%) then 2nd metatarso-phalangeal joint (49%). Wrist dorsal tenosynovitis (36%) was the most frequent tenosynovitis. Radial (33%), dorsal erosions (18%) of 2nd metacarpo-phalangeal joint and radial erosions (13%) of 5th metatarso-phalangeal joint were the most common erosions found. Our study detected significant positive correlation (P value <0.05 and positive correlation coefficient) between majority of 7-joint and 12-joint score parameters (both GS and PD) and clinical disease activity variables, ESR, CRP and platelet count. Our study showed highly significant positive correlation (P value <0.01 and positive correlation coefficient) between all parameters of 7-joint and 12-joint scores. We found that 12 joint score is slightly better than 7 joint score in accuracy and sensitivity in assessing rheumatoid arthritis disease activity despite being more time-consuming.

Conclusion

The 7-joint and 12-joint ultrasound scores were simple and practical sum scoring systems for use in the detection of synovitis in patients with RA and in assessment of disease activity in synovium. The correlations between the clinical disease activity indices, ESR, CRP, platelet count and components of the 7-joint and 12-joint scores may indicate their value in assessment of disease activity and severity up to date. The composite score (Combined synovitis score) for 12-joint score was significantly differentiating between moderate-severe patient groups (classified according to DAS28) with P value 0.029, so 12-joint score was better in identifying minimal difference in disease activity despite being time-consuming.
Association of Serum Zinc Level and Clinical Outcome in Patients with COVID19 Virus
Authors: Alnaqeeb Noha Abdelrazeq , ElGhandour Ahmed Mohamed , Fathallah Ahmed Magdy , Kamal Norhan Khaled Mohamed
Published: August 2023

Background

Zinc, one of the anti-inflammatory and antioxidant micronutrient found in food with well-established role in immunity, is currently being used in some clinical trials against COVID-19.

Objective

The aim of our study was to assess the association between mean levels of Zinc in the patients and mortality caused by COVID-19.

Patients and Methods

This was a comparative cross-sectional study that was performed on 60 Egyptian patients at Ain Shams University Quarantine field hospital, Ain Shams University Quarantine hospital In Al OboUr, and outpatient clinics at Ain shams university hospitals for 6 months period This study patients were divided according to clinical outcome into: Group I that included patients admitted to ICU and Group II that included patients admitted to ward.

Results

There was no statistically significant difference found between two groups regarding Sex, Age and Special habits, and there was no statistically significant difference found between two groups regarding CO-RADS classification, and there was statistically highly significant difference found found between two groups regarding Medical history. There was statistically significant difference found between two groups regarding Zinc level. There was statistically no significant difference found between two groups regarding Lymphocytes, Hemoglobin, Platelets, BUN, S. Creatinine, Total Bilirubin and S. Albumin, and there was statistically significant difference found between two groups regarding Neutrophil- Lymphocyte ratio, CRP, ESR, AST, ALT, FERRITIN and LDH, and there was statistically highly significant difference found between two groups regarding TLC, Neutrophils, D-DIMER and VIT D.

Conclusion

This study concluded a correlation between low SZC and COVID-19 severity and mortality. The cause is likely to be a combination of immune system imbalance and a direct benefit of viral replication. Thus, we propose SZC as a novel and additional parameter to predict COVID19 outcome.
Effect of Vitamin D on Irritable Bowel Syndrome on Ain Shams University Medical Students
Authors: Ibrahim Wesam A , Eid Yara M , Zaky Doaa Z , El Nabawy Omnia M , Elsheikh Noseila M
Published: August 2023

Objective

Irritable Bowel Syndrome (IBS) can be divided into three subtypes according to bowel habits –IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), and IBS with mixed bowel habits (IBS-M). Incidence of IBS has been increasing over last two decades. Recent studies have suggested a relationship between vitamin D and IBS. Vitamin D has a potential role as immune modulator, antiinflammatory, and anti-microbial agent that can explain its role in IBS.

Method

This study is part of The Nutritional Assessment of Medical Students of Ain Shams University (NAMS/ASU), the project was designed to evaluate the nutritional status of the undergraduate medical students. All participants were subjected to: Interview questionnaires including data: name, age, sex, study grade, past medical history and family history. Dietary recall: 24 hrs food recall, food frequency related iron intake. All data was analyzed using food composition table National Nutritional Institute (NNI). General clinical examination laying stress on: Systolic blood pressure & Diastolic blood pressure. This study was applied on 40 students who were diagnosed as IBS by ROME 4 criteria and vitamin D deficiency (<20 IU). They were advised to eat rich vitamin D food and vitamin D supplementation by vitamin D oral drops cholecalciferol 42000 IU per week for 12 weeks then vitamin D level was reevaluated again and check ROME IV criteria for IBS.

Results

Demographic data of Irritable Bowel Syndrome among Ain Shams University Medical Students according to their demographic data regarding age, sex and BMI shows that the ranged age 20-24 with mean 22.33±1.37, while female (65%) and male (35%), as well as ranged BMI 1930 with mean 23.75±3.02 and the ranged systolic blood pressure 95-130 with mean 113.13±10.23, also ranged diastolic 60-85 with mean 73.88±7.02 of blood pressure of demographic data. After three months of vitmin D intervention participants were divided into 2 groups according to IBS symptoms relief group 1 was with no symptoms (ROME IV criteria are not fulfilled), while group 2 are the candidates whom ROME IV criteria are fulfilled but with a less degree and improvement of Rome IV criteria.%.

Conclusion

Female sex is more liable for IBS, being a student in a medical college and lack of exercise. Our study indicated that Vitamin D supplementation could play a therapeutic role in the control of IBS in medical students.
Effects of Ramadan Fasting on Diabetic Nephropathy in Type 2 Diabetic Patients
Authors: Mohammad Magda Shukry , Mahdy Maram Mohamed Maher , Ibrahim Nesma Ali , Jalil NourAlhoda Ahmed Abdul
Published: August 2023

Background

Type 2 diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients, as well as on the health care system. Diabetic nephropathy is one of the major complications of diabetes, characterized by proteinuria and renal insufficiency. The development of microalbuminuria is an early marker for diabetic nephropathy, which is potentially modifiable through lifestyle changes and pharmacological interventions targeting blood glucose and blood pressure, specifically through the renin angiotensin system.

Aim of the Work

The aim of this work is to study the effect of Ramadan fasting on diabetic nephropathy in type 2 diabetic patients.

Patients and Methods

Our study conducted on 90 type 2 diabetic patients, their age between 40-60 years; all of them are welling to fast the whole month of Ramadan, selected from the outpatient clinic of endocrinology, Ain Shams University Hospitals.

Results

There was a highly statistically significant increase in Creatinine (p < 0.001) as well as a highly statistically significant increase in urea after Ramdan in all studied group (P < 0.001). The Percentage change in GFR was significantly higher in macroalbuminuria. The Percentage change in A/C ratio in micro and macroalbuminuria were significantly lower when compared to normoalbuminuria, as well as in macroalbuminuria when compared to microalbuminuria groups. (P = 0.001). There were no significant differences found regarding, body mass index;, systolic blood pressure, diastolic blood pressure fasting blood glucose, postprandial blood glucose, HbA1c before and after Ramadan.

Conclusion

Ramadan fasting has no harmful impact on albuminuria among patients with T2DM. However, fasting leads to a significant decline in renal function parameters among diabetic patients with albuminuria. This decline is more prominent in patients with macroalbuminuria than patients with microalbuminuria. Thus, fasting should be avoided in patients with a severe decline in renal functions. Patients should be advised regarding adequate hydration and dietary modification during Pre-Ramadan health care education. On the other hand, Ramadan fasting has no negative impacts on glycemic control and other metabolic parameters. Nevertheless, further trials that assess the role of fasting in at-risk patients are still needed.
The Benefit of an Intensive Training Course on ERCP Artificial Simulator on Decreasing the Cannulation Time Achieved by the Trainees
Authors: Mounis Ahmed Ali , Al Baz Hossam Samir , Mostafa Mostafa Ibrahim , Badawy Al Ashram Mohamed Nabil , Gawad Nouran Roshdy Abd Ellah Abd El
Published: August 2023

Background

Trainees learn to perform ERCP with hands-on training in a clinical setting on real patients under the supervision of a trained endoscopist: the so-called master apprentice model. This setting offers immediate feedback from an experienced endoscopist, but it also has certain drawbacks. Trainees learn by “trial and error,” which potentially increases patient discomfort and risk of complications and prolongs procedure time, which has additional economic consequences. Simulators offer the potential to train in a dedicated „learning environment, offering a less stressful situation with less potential risks and the opportunity to endlessly repeat specific tasks.

Aim of the Work

The aim of this study is to test the benefit of a two weeks intensive training course on ERCP artificial simulator on decreasing the cannulation time achieved by the trainees.

Patients and Methods

This is a prospective study including 20 trainees classified into 2 equal groups; group (1) included 10 trainees were enrolled in a clinical training program only, and group (2) included 10 trainees were enrolled in an intensive two weeks hands on training on BoskoskiCostamagna ERCP trainer followed by clinical training. Another group (3) included 10 expert endoscopist represent the control group.

Results

All steps for ERCP shows successful ERCP steps of the three studied groups, however group (2) showed better improvement than group (1) as compared to group (3). None had failed for the overall technique. All steps for ERCP in the current study shows statistically highly significant difference (p < 0.001) in comparison between the three studied groups. Group (2) with intensive training program had a highly significant difference than group (1) and group (3) had a highly significant difference than both groups (1) & (2). The total biliary and pancreatic cannulation times were statistically highly significant difference in comparison between the three studied groups.

Conclusion

ERCP is a skill demanding procedure, therefore trainees who will train in ERCP should be selected between those who are likely to achieve competence and will make good use of the valuable skills. Structured ERCP training programs are still not widely available, especially in developing countries. Scientific societies should promote training in endoscopy on all levels especially through scholarships for doctors from developing countries.
Study of the Relation between Atherosclerosis and Serum Level of 25(OH) Vitamin D among Maintenance Hemodialysis Patients
Authors: Wahab Saeed Abdel , Bichari Walid Ahmed , Abdelmobdy Ashraf Hassan , Othman Omaira Ahmed
Published: August 2023

Background

Cardiovascular (CV) disease is considered the main cause of exceedingly high overall mortality observed in hemodialysis patients. A number of studies have shown variable results on the relationship between 25 (OH) D deficiency and subclinical atherosclerosis.

Aim and objectives

To measure the relationship of serum 25(OH) D with Carotid intima-media thickness (cIMT) as a surrogate marker for the presence of atherosclerosis in hemodialysis patients,

Subjects and methods

This was a cross sectional study, was conducted on 90 patients (ESRD) undergoing hemodialysis in The National Institute of Nephrology and Urology divided into two groups: (Group A); included 45 ESRD patients on maintenance hemodialysis with normal carotid intima media thickness, (Group B): included 45 ESRD patients on maintenance hemodialysis with increased carotid intima media thickness during a period of 6 months.

Result

There were highly significant difference between both groups as regard 1, 25(OH) 2D, ng/ml.

Conclusion

Our findings suggested that vitamin D deficiency is not an independent predictor of subclinical atherosclerosis in elderly patients after adjusting confounding factors. Future studies to address the association between serum 25(OH) D and the cIMT need to be explored carefully. Finally we came to the conclusion that in patients on HD, the deficiency of vitamin D is related to rising of ESR asan inflammatory marke,
Study of the Relation between 8_Hydroxy-2′-deoxyguanosin (8_OHDG) and Suspicious Thyroid Nodule in a Patients with Multinodular Goiter
Authors: Sheriba Nermin Ahmed , Mahdy Maram Mohamed Maher , Marawan Dina Ahmed , Eljazwi Ruwida Fouli Farag Mohamed
Published: August 2023

Background

Nodular disease of the thyroid gland is prevalent. The lifetime risk for developing a palpable thyroid nodule is estimated to be 5-10%, however, high resolution ultrasound has revealed thyroid nodules in 19-68% of randomly selected individuals. The condition affects more women than men.

Aim of the Work

In this study we aimed to study the relation between 8_Hydroxy-2'deoxyguanosin (8_OHDG) and Suspicious Thyroid nodule in a Patients with Multinodular Goiter.

Patients and Methods

The present study was a case-control study that was conducted on 60 subjects patients presented with MNG at Ain Shams University hospital during the period from January to December 2019.

Results

The results of our study demonstrated that plasma 8_OHDG levels were higher in patients with Multinodular goiter than in control group, and were higher in MNG patients with cancer than MNG without cancer. Which confirms the presence of oxidative stress in patients with non-toxic multinodular goiter and 8-OHDG levels may be markers of the carcinogenic potential of Multinodular goiter.

Conclusion

Our study confirms the presence of oxidative stress in patients with non-toxic multinodular goitre. The plasma 8-OHDG levels may be markers of the carcinogenic potential of multinodular goiter and could be used for early detection of different cancer types, including thyroid cancer. This warrants nutritional support with antioxidant agents in patients with non-toxic multinodular goiter. Further studies are warranted for better understanding of underlying pathogenic mechanism of oxidative stress in non-toxic Multinodulargoitre.
Role of Activin A as a Novel Marker for Diagnosis and Evaluation of Nonalchoholic Fatty Liver Disease
Authors: Bakir Amal Shawky Mohamed , Abohalima Ahmed Samir , Ghait Ramy Samir , Atalla Samir Yousry Barsoum
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is a disease gaining increasing interest worldwide. It ranges from simple nonalcoholic steatosis to nonalcoholic steatohepatitis (NASH), is characterized by steatosis, inflammation and fibrosis, and may lead to liver cirrhosis and hepatocellular carcinoma. Nonalcoholic fatty liver disease shares common pathogenetic mechanisms with other components of the insulin resistance or metabolic syndrome, with adipokines playing a crucial role.

Aim of the Work

Recent studies suggest that activin A, a member of the transforming growth factor (TGF) superfamily, is involved in the pathogenesis of liver disorders. We sought to explore its possible role in non-alcoholic fatty liver disease (NAFLD).

Patients and Methods

This study is a comparative case control study. This study was carried out at outpatient’s clinics of internal medicine department of Ain Shams University.

Target population

Group 1: Including 35 patients with NAS (steatosis) with exclusion criteria of intake of hepatotoxic drugs. Group 2: Including 35 patients with fatty liver and elevated liver enzymes (NASH). Group 3: Including 20 patients as a control group.

Results

There was high statistically significant difference between the studied groups as regard weight and BMI. In the Steatosis group the mean Liver size was 13.97 (±1.29 SD) with range (1216) cm, all the patients (100%) had enlarged- echogenic liver. In the NASH group the mean Liver size was 13.71 (±1.36 SD) with range (12-16) cm, all the patients (100%) had enlarged-echogenic liver. In the control group the mean Liver size was 9.85 (±1.5 SD) with range (8-12) cm, all the patients (100%) had Normal liver. There was high statistically significant difference between the studied groups as regard liver size. There was high statistically significant difference between the studied groups as regard ALT, AST, total and direct bilirubin, plts count and activin A, significant difference between the studied groups as regard Albumin. There was high statistically significant difference between the studied groups as regard APRI score, FIB-4. There was high correlation between Activin A and BMI, APRI score, FIB-4 and liver size with high significance (p < 0.001). Using Activin A. it was shown that above 858.5, it can discriminate between NAFLD and nonNAFLD with level of sensitivity 100% and specificity 100%.

Conclusion

Serum activin A showed a trend towards progressive increase from controls, to SS and NASH patients, but the significance was lost after adjustment for measures of adiposity. Activin A was not independently associated with NASH or any specific hepatic lesion within NAFLD patients. Prospective studies are needed to confirm the hypothesis raised herein, before mechanistic studies attempt to elucidate mechanism and prove causality.
Impact of Dialysis Fluid Delivery System on Anemia in Hemodialysis Patients
Authors: Hebah Hayam Ahmed , Hassan Mohamed Saeed , Mohsen EL-sharabasy Reem , Mourad Tarek Ali Hasan Ali
Published: August 2023

Background

Patients on standard dialysis, in particular those on high-flux and high-efficiency dialysis, are exposed to hundreds of liters of dialysis-water per week. The quality of dialysis-water is a factor responsible for inflammation which is a potent trigger of atherosclerosis and a pathogenic factor in anemia, increasing mortality and morbidity in these patients. Current systems for water treatment do not completely eliminate bacteria and endotoxins. Our study tests if improved dialysiswater purity by using Central dialysis Fluid Delivery System (CDDS) can reduce inflammation and ameliorate hemoglobin levels.

Aim of the Work

The aim of this work is to compare between the effect of using Central Dialysis Fluid Delivery System (CDDS) and Single Dialysis Fluid Delivery System (SDDS) on Anemia in prevalent Hemodialysis Patients

Patients and Methods

This prospective observational cohort study was conducted between May 2019 and July 2019 and was conducted on 100 prevalent Hemodialysis Patient divided into 2 groups, each group included 50 patients, one group receiving Hemodialysis treatment using the central dialysis fluid delivery system (CDDS), while the other group receiving Hemodialysis treatment using the single-patient dialysis fluid delivery system (SPPDS).

Results

Endotoxin level in the dialysate fluid was found to be markedly lower in the CDDS group (0.05 EU/ml) compared to the SPDDS group (0.11 EU/ml). Baseline CRP level didn’t differ significantly between both groups (P-value: 0.88), however throughout the follow up period patients who were on dialysis using the CDDS showed a sustained significant decrease in CRP level compared to those using the SPDDS (P-value: <0.001 for the 3m follow up period), denoting improvement of their chronic inflammatory status. Baseline hemoglobin level didn’t differ significantly between both groups (P-value: 0.52), however throughout the follow up period patients who received dialysis using CDDS showed a sustained significant increase in their hemoglobin level, while those receiving dialysis using SPDDS showed no significant change in their hemoglobin level, also hemoglobin level in the CDDS Group was higher than in the SPDDS group at 1st, 2nd and 3rd months. (P-value: 0.008, <0.001 and <0.001 for the follow up month 1, 2 and 3 respectively). Using URR as an indicator for efficiency of the HD session, there was no statistically significant difference between both groups among three months of follow-up.

Conclusion

Ultrapure dialysis fluid (UPD) produced by the Central dialysis
Pattern of Liver Injury in COVID-19 Patients
Authors: Mahmoud Hossam Abedelaziz , Kamal Maha Mohsen Mohamed , Ashram Mohamed Nabil Badawy Al , Fahmey Wael Wadea
Published: August 2023

Background

The new coronavirus SARS-CoV-2 (COVID-19) is the cause of severe acute respiratory syndrome (SARS), a severe form of viral pneumonia. The virus spread rapidly from China to the rest of the world in a very short time and with considerable intensity and severity creating a ―global emergency.‖ The global pandemic COVID-19 caused by the new coronavirus SARS-CoV-2 has already caused about 1.4 million deaths.

Aim of the Work

To evaluate the incidence of concurrent elevation of liver function tests (AST, ALT, BILIRUBIN), examine dynamic changes of it and its relationship with disease throughout the course of COVID-19 patients

Patients and Methods

This was a retrospective cohort study was carried out in Ain Shams University isolation Hospitals including 105 adult patients of both genders with confirmed COVID19 from 15 March 2020 to 15 June 2020.

Results

The mean age of mild severity group was 56.77 (±13.09 SD) with range (24-80) and among them there were 19 (30.6%) males. The mean age of severe group was 60.52 (±14.68 SD) with range (25-82) and among them there were 26 (54.7%) males. There was statistically significant difference between the studied groups as regard Sex. There was high statistically significant difference between the studied groups as regard Hospital stay. Hospital stays ranged from 2-20 days. Disease duration ranged from 8-27 days. There was no statistically significant difference between the studied groups as regard co-morbidity. The commonest morbidities among the studied group were hypertension and diabetes mellitus. There was statistically significant difference between the studied groups as regard AST and bilirubin. As regard comparison between the studied groups as regard Lab finding During stay; there was statistically significant difference between the studied groups as regard AST and bilirubin. As regard comparison between the studied groups as regard Lab finding at discharge; there was statistically significant difference between the studied groups as regard bilirubin. Based on our findings, we see that evaluations of the mechanism of hepatic injuries in COVID-19 infection are needed.

Conclusion

The hepatic consequences of SARS-CoV-2 infection are now recognized as an important component of COVID-19. Elevated liver function is very common in patients with COVID-19 infection.
Effect of Direct Acting Anti-Viral Drugs on Myostatin Level among CRF Egyptian Patients with Chronic HCV Infection and Its Correlation with Sarcopenia
Authors: Makhlouf Mohamed Ali Marie , Ashram Mohamed Nabil Badawy Al , Fathalla Ahmed Magdy , Abd el Elah Elgezery Wessam
Published: August 2023

Background

Chronic kidney disease (CKD) is a progressive condition that might negatively affect musculoskeletal health. Secondary sarcopenia due to chronic kidney disease may be accompanied with elevated fall risk and mobility limitations. The loss of muscle mass, in addition to the impact of poor body composition on muscle strength and mobility status are necessary for classification and staging of sarcopenia.

Aim of the Work

The main aim of this study was to assess the effect of direct anti-viral drugs on myostatin level and its correlation with sarcopenia in CRF patient with chronic HCV.

Patients and Methods

This was a case control study was conducted at gastroenterology outpatients’ clinics and internal medicine and nephrology department Ain Shams university hospital and om elmasryeen general hospital including 50 chronic renal failure patients with chronic HCV infection and normal persons; they were divided into: Group A: 20 chronic HCV patient received direct acting anti-viral drugs. Group B: 20 chronic HCV patients didn’t receive direct acting antiviral drugs. Group C: 10 normal persons without chronic renal failure or hepatitis C virus. The duration of the study ranged from 6-12 months.

Results

There was no statistically significant difference between the studied groups as regard demographic data, there was high statistically significant difference between the studied groups as regard weight, lean body mass and BMI, there was high statistically significant difference between the studied groups as regard Hb, there was high statistically significant difference between the studied groups as regard history of ALT and AST and significant difference between the two studied groups as regards Alpha fetoprotein, there was high statistically significant difference between the studied groups as regard history of BUN and significant difference between the two studied groups as regards Creatinine, there was statistically significant difference between the studied groups as regard Serum myostatin.

Conclusion

The serum myostatin level was significantly lower in chronic HCV patients didn’t receive direct acting anti-viral drugs than those who received direct acting anti-viral drugs and control groups.
Impact of Initiation of Insulin Therapy on Serum Prolactin and Cortisol Levels in Type 2 Diabetic Male Patients
Authors: Hamed Mohamed Saad , El Sherbeny Alyaa Ahmed , Khairy Mansour Hany , Al Gammal Yasmine Hamdy Moustafa Moussa
Published: August 2023

Background

Type 2 Diabetes Mellitus is a common metabolic disease characterized by a decline in insulin sensitivity and relative insulin insufficiency-induced hyperglycemia. In type 2 diabetic patients who have failed to achieve target glycemic control goals on oral anti-diabetic drug therapy, Initiating insulin therapy significantly improved overall glycemic control.

Objective

To assess Impact of Initiation of Insulin Therapy on Serum Prolactin and Cortisol levels In Type 2 Diabetic Male Patients.

Subjects and Methods

It was conducted on thirty (30) male patients who were diagnosed to have type 2 diabetes attending diabetes clinic at Ain- Shams University Hospital from 1 Jan. to 1 July 2018. Their ages range from 40 to 60 years old.

Results

On studying the Correlation between cortisol and prolactin with other laboratory findings showed that: There were no significant correlations between cortisol a.m. and prolactin with FBS, 2HPPBG and HbA1C (P > 0.05) in the first and third visits in group I. And no significant correlations between cortisol a.m. and prolactin with FBS and 2HPPBG (P > 0.05) in the second visit in group I. But there was a significant positive correlation between cortisol with FBS (P = 0.028) and HbA1C (P = 0.033) in group II. And a significant positive correlation between cortisol with FBS (P = 0.034) and 2HPPBG (P = 0.041) in group III. There was a highly significant positive correlation between cortisol and FBS (P = 0.001) in group III. And there was a highly significant positive correlation between prolactin with 2HPPBG (P = 0.008) in group II.

Conclusion

We conclude from this study that initiation of insulin therapy in poorly controlled diabetic patients achieves a highly significant reduction in blood glucose level. Also, insulin therapy in diabetic patients has impact on other hormones regulating blood glucose level as it reduces serum prolactin and cortisol levels. Also we conclude that prolactin is a diabetogenic hormone.
Role of Circulating Vascular Cell Adhesion Protein – 1 as a Biomarker in Non-alcoholic Fatty Liver Disease
Authors: EL Moghny Mostafa Mohamed Abd , Ali El Ray Ahmed , Abd El Sadek Ahmed Samir , EL Hamid Rafat Khaled Abdl , Alsaid Yasser Mohamed Ali Abdelhady
Published: August 2023

Background

As a result of the obesity pandemic, non-alcoholic fatty liver disease (NAFLD) has become the most common cause of chronic liver disease worldwide. NAFLD is the hepatic manifestation of obesity and a precursor of and independent risk factor for type 2 diabetes

Aim of the Work

To assess the level of vascular cell adhesion molecule 1 (VCAM-1) as noninvasive diagnostic tools for diagnosis of NAFLD degree of fibrosis.

Patients and Methods

A Case-Control clinical study in the Internal medicine and hepatology outpatient clinic at Ain Shams University Hospital for 6-month on 60 persons that were included in this study divided into 2 groups: Group A: 30 patient with NAFLD as a study group. Group B: 30 healthy subjects as a control group.

Results

In the present study, the mean VCAM-1 was 2.392 ± 0.3 in NAFLD group, 9.893 ± 2.3 in NASH group and 1.983 ± 0.3 in control group with high statistical significant increase in NASH followed by NAFLD than in control group. Regarding to ROC curve, VCAM-1 had excellent Diagnostic performance with an AUC of 0.994. A best cut-off criterion of VCAM-1 > 7.7 ng/mL could discriminate between patients with NASH from control group with a sensitivity of 95% and specificity of 100% In our study, there was no significant correlation in between VCAM-1 and age, AST, ALT In the present study, the significant predictors of bad outcome in patients with NAFLD and NASH were higher VCAM-1 level, GGT and higher AST levels

Conclusion

The significant predictors of bad outcome in patients with NAFLD and NASH were higher VCAM-1 level, GGT and higher AST levels.
Sexual Dysfunction in a Sample of Women Having Infertility and Its Impact on Quality of Life
Authors: Abdelrazek Yasser M , Tantawy Walid H , Awad Mona I , Naguib Rehab M , Eltoukhi Diana A
Published: August 2023

Conflict of interest

None of the above authors have any conflict of interest to disclose.

Background

Female sexual disorders are prevalent disorder which is underdiagnosed due to cultural barriers in seeking help in management, having huge impact on mental health quality of life. The studies investigating the impact of infertility on female sexual dysfunction are scarce, but they have consistently demonstrated that sexual complaints are very common among infertile women.

Sometimes appropriate treatment of female sexual dysfunction can preclude the use of expensive and unnecessary treatment for infertility. This study will compare sexual dysfunction and quality of life among infertile women and fertile women.

Aim of the Work

To assess the female sexual function among infertile women and comorbid psychiatric disorders among infertile women.

Subjects and method: This is cross sectional study, which was conducted on random sample of 168 infertile females and 167 fertile females, attending outpatient infertile clinic, and the gynaecology outpatient clinic, Ain Shams University hospital, the study started September 2017 until February 2019, all females who fulfil inclusion criteria were subjected to SCID-I, The Arabic version of (FSFI), The Arabic version of PCASEE.

Results

there was a statistically significant relationship between female sexual dysfunction among infertile group and fertile group, in the infertile group, 123 females (73.2%) of the infertile females did not have mental disorder and 45 females (26.7%) had mental disorder, 19 females (11.3%) of them had anxiety disorder (generalized anxiety disorder, social phobia, and panic disorder) and 26 females (15.5%) of them had major depression disorder.

Conclusion

There is high prevalence of female sexual dysfunction among the infertile female group, and there was strong association between infertility, sexual dysfunction and developing comorbid psychiatric disorder. Further assessments should be considered in the infertility clinic, proper documentation as well. Management should include psychotherapy, lubricants, targeted sexual-therapy and pharmacological treatment.

Abbreviation

SCID-I: Structured Clinical Interview for the DSM-IV Axis I Disorder; FSFI: Female sexual dysfunction index; PCASEE: Physical, cognitive, Affect, Social, economic, ego, quality of life
Stress and Sleep Difficulties in a Sample of Medical Students, Ain-Shams University
Authors: Khalil Afaf H , Saad Ahmed , ElSerafiy Doha , Shorub Eman , Hamdy Rabab
Published: August 2023

Introduction: Background

Becoming a medical doctor is a highly complex process. High incidence of stress disorders among medical students was reported. Psychological stress is a triggering factor for insomnia and has a bidirectional association with poor sleep quality. the relationship between stress and sleep difficulties among medical students should be assessed and evaluated as it may affect Academic achievement, and cause difficulty in concentration, tiredness, headache, bad appetite, disturbed bowel habits and tiredness and weakness during daytime, To raise the awareness about the importance of good sleep quality for health and academic achievement

Objective

To measure stress among medical students, determine pattern of sleep difficulties and to find relationship between stress and sleep quality among medical students.

Subjects and Methods: A cross sectional study, Questionnaire based, convenience sample. The sample consisted of 300 undergraduate medical students at Faculty of Medicine, Ain-Shams University, Egypt from January 2019 to March 2020. All students fulfilling the inclusion criteria were offered to participate in the study by using GHQ, PSQI, MSSQ & SCID I

Results

300 medical students were recruited in this study; their mean age were 21.4 ± 2.3 year ranging from 17-30 years. 40 % (n = 120) of them were males & 60% (n = 180) were females. 98% (n = 294) of the study sample were single and 4.7% of students (n = 14) were smoker. 50.7% (n = 152) had one or more hobbies. Females reported higher Mean ± SD than males in all MSSQ domains except Drive & desire related stressors. There was statistically significant difference regarding female gender was reported.

Conclusion

There is high prevalence of stress and poor sleep quality in medical school students. Strong association between sleep quality and stress was found. Medical students need to be educated about sleep hygiene and stress management programs to emphasize on study skills, time management, healthy lifestyles, and effective coping strategies.

Conflicts of Interest

None of the authors have any conflicts of interest to disclose.

Abbreviations

PSQI: Pittsburgh Sleep Quality Index; GHQ: General health Questionnaire; MSSQ: medical students stress scale
Comparative Study between Anterior and Posterior Approaches in Management of Cervical Spondylotic Myelopathy
Authors: Assar Ahmed Mohamed , Sabry Esmail Hassan , Abdelraheem Hisham Anwer , Hamza Emad Mamoun , Mohaaed hefni Sameh
Published: August 2023

Background

The best surgical approach for management of degenerative cervical myelopathy remains area of debate between spinal surgeons. The purpose of this study compare between anterior approach (anterior cervical discectomy with fusion) and posterior approach (laminectomy with and without fusion) for treatment of multilevel spondylotic myelopathy according to clinical, radiological outcomes, recovery rates and complications.

Material and Methods

A total of 20 patients were operated by anterior cervical discectomy and fusion (ACDF) and 20 patients were operated by cervical laminectomy with and without fusion in this study. Preoperative and postoperative clinical assessment were done using modified Japanese Orthopedic Association (mJOA) score and Myelopathy scale (MS). Postoperative complications, recovery rate and intraoperative blood loss are recorded. Preoperative and postoperative radiological analysis were done using Cobb angle measurement (C2-7 angle) and canal diameter assessment by measuring the canal through the center of each vertebra and intervertebral discs (C2–C7) on 10 transverse planes on mid-sagittal T2WI image.

Results

There was significant decrease in pre-operative mJOA scale in posterior approach group; compared to anterior group (P = 0.41). There was highly significant decrease in duration of symptoms in anterior approach group; compared to anterior group (P < 0.01) and significant decrease in pre-operative MS scale in anterior approach group; compared to anterior group (P < 0.05). There is non-significant difference as regards post-operative mJOA scale and MS scale between anterior and posterior group (p > 0.05). Although recovery rate was higher in anterior group than posterior group (49.5 ± 27.2 vs 39.51 ± 11.30), but finally There was no significant difference as regards postoperative recovery, improvement and complications rates (p > 0.05). postoperative canal diameter change was greater in posterior surgery than anterior group (11.1 ± 1.98 vs 9.5 ± 0.76). Reoperation rate was higher in anterior group. Postoperative C5 palsy and axial neck pain were higher in posterior group.

Conclusions

Both anterior and posterior approaches were successful to treat multilevel CSM, but no definitive surgical approach was proved for management of CSM and each case should be evaluated carefully for determination of best surgical approach according to preoperative Cobb angle and canal diameter.
Different Surgical Modalities in the Management of Trigeminal Schwannomas
Authors: El-Bahy Khaled , Desouky Ahmad E , Abouelmaaty Emad M , Darwish Assem M
Published: August 2023

Background

Schwannomas are well capsulated, slowly growing benign tumors. These tumors arise from schwann cells that wrap the peripheral or cranial nerves; hence, these tumors are basically peripheral nerve sheath tumors.

Aim of the Work

to evaluate the result of different approaches for trigeminal schwannoma.

Patients and Methods

This retrospective study was conducted on 15 patients with trigeminal schwannoma who underwent different surgical modalities in the management at Ain Shams University Hospitals and Nasser Institute Hospital during the period from 2015 to 2019.

Results

Mean Preoperative GCS in this study was 15 preoperative, as GOS was 5 in 10 patients, 4 in 3 patients and 2 in 2 patients immediately postoperative while 3 months follow up shows that 14 patients GOS were 5 as one case was 1 (died). Headache was reported in 53.3% of our patients, SNHL and tinnitus were present in 80% of our patients, and facial pain and numbness were present in 33.3%, while vomiting & ocular movement were not presented among our patients. The tumor was right sided in 60% of our patients & the rest of patients 40% had left sided tumor. 26.7% of patients had tumor class A, 20% had tumor class B & 53.3% of them had class C tumor. Retrosigmoid approach was used in 6.7% of patients, Fronto-temporo-orbito-zygomatic (FTOZ) Dolanc approach was used in 26.7%, FTOZ approach was used in 6.7%, transzygomatic extradural subtemporal approach was used in 6.7%, Dolanc extradural subtemporal approach was used in 26.7%, extradural subtemporal approach was used in 6.7% & anterior petrosectomy (Kwase) approach was used in 20.0% of our study population. Partial resection was done for 26.7% of patients, Subtotal resection was done for 33.3% of patients, and complete resection was done for 40.0% of patients. Cavernous extension was present in 53.3% of our patients, Gamma Knife (GK) postoperative was needed in 53.3% of our patients & Pathology finding was Trigeminal Schwannoma (TS) in 100% of our patients. There was statistically significant difference between different approaches regarding Cavernous extension. As Cavernous extension was needed for all patients who underwent FTOZ Dolanc & Extradural subtemporal Dolanc only (p = 0.002). There was no statistically significant difference found between different approaches regarding the Extent of resection. Intra operative complications, Gk postoperative & pathology.

Conclusion

total removal via the proper approach can be the best treatment for trigeminal schwannoma with a low complication rate.