bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Expression of Autophagy Related Gene 5 (ATG5) in Egyptian Patients Newly Diagnosed with Acute Lymphoblastic Leukemia (ALL)
Authors: Soliman AbdelRahman AbdelHamid , Ibrahim Rasha Ibrahim , Saeed Alia Mohamed , Mohamed Haydi Sayed , Nageeb Mary Gamal , Mahmoud Hebatullah Magdy
Published: October 2021

BACKGROUND

Autophagy is the cellular mechanism for homeostasis maintenance and survival under stressful conditions like hypoxia and nutrient deprivation. It has been extensively studied in various types of malignancies. However, the relationship between cancer and autophagy is still controversial. Researchers have been focusing on the exploitation of autophagy in the invention of new cancer therapeutics. Acute lymphoblastic leukemia is one type of malignancies with the highest resistant rates and worst prognosis. Knowing whether autophagy has a role in its initiation or progression would be of a great benefit. It would open the door to adding autophagy modulator drugs to conventional treatments in clinical trials to improve disease outcome.

AIM

To assess the basal level of autophagy in newly diagnosed ALL cases using ATG5 expression level, a key autophagy gene, and detect the relationship between the level of autophagy and prognosis.

PATIENTS AND METHODS

35 newly diagnosed ALL patients and 15 healthy controls were included in the study. ATG5 RNA transcript level was measured by real time RT-PCR in all subjects using peripheral blood samples. Patients were followed up monthly for a year by Bone marrow aspiration and minimal residual disease using multiparameter color flowcytometry to detect resistance and early relapse.

RESULTS

ATG5 expression level was significantly higher in the ALL patients compared to the control group. Cases had approximately twice the mean expression value of the control (2.15±2.2 vs 1.09 ± 0.47). (P value = 0.01). The median value of the ATG 5 expression of the cases was used as a cut point to divide them into two groups of low and high expression. More B-ALL patients were in the high ATG5 group (83% vs 53%, P value=0.05). In addition, the high ATG5 group displayed a significantly lower haemoglobin level, platelet count, LDH level and CD 8 expression than the low ATG5 group (Mean Hb level of 7.7 g/dl vs 9.6 g/dl respectively, P value=0.04, Mean Platelet count of almost 55 x 109/L vs 105 x 109/L respectively, P value = 0.01, Mean LDH level of 455 vs 1260 U/L respectively, P value=0.02, CD8 + patients 0% vs 23% respectively, P value=0.05). Although ATG5 level was also more associated with a higher white blood cell count, the presence of extramedullary disease, a positive Philadelphia chromosome and post induction refractoriness, no statistical significance was found. ATG5 expression neither showed a significant relation with patients overall survival nor their disease free survival.

CONCLUSION

Basal autophagy level is high in ALL disease and associated with more aggressive disease characteristics. More researches are needed to detect its clear relationship with disease prognosis.
Role of Hepcidin as a biomarker for iron status in patients on regular hemodialysis
Authors: Sharkawy Magdy M. El , Hassan Mohamed Saeed , Khedr Lina Essam , Hanna Marco Monir
Published: October 2021

Background

The etiology of anemia in End Stage Renal Disease is multifactorial. Importantly, ESRD patients also have several abnormalities in systemic homeostasis of iron, an essential component in the production of red blood cells.

Aim of the Work

to assess hepcidin level in negative virology End Stage Renal Disease patients & its relation to iron level and erythropoiesis.

Patients and Methods

This study was conducted on 45 patients who are stage V chronic kidney disease on regular haemodialysis. Ten age and sex matched controls were included in the study. The study included 29 (64.4%) males and 16 (35.6%) females; their mean age was 53.40± 11.56 years. The prevalence of diabetes among the studied cases was 17.8%, while that of hypertensive was 42.2%. Mean of serum iron level was 64.23±19.53. Mean of TIBC was 409.96±67.85. Mean of Ferritin level 394.55±139.23 and mean of Hepcidin level was 218.51±127.

Results

Significant negative correlation between Hepcidin level and the Hemoglobin level, and highly significant positive correlation between Hepcidin level and serum Ferritin. Hepcidin up-regulation in the setting of CKD, with subsequent increased serum levels, results in impaired iron absorption from the intestine and decreased iron release from body storage sites. Ultimately, in the setting of such elevated levels, a state of functional iron deficiency may develop and lead to anemia due to iron-restricted erythropoiesis.

Conclusion

Based on current evidence, it seems likely that hepcidin represents a potentially modifiable mediator of anemia of CKD and is thus a potential target for future anemia therapy.
Podocalyxin as an early marker predicting diabetic nephropathy and its correlation with stages of diabetic nephropathy in type two diabetic patients
Authors: Shelbaya Salah El-Din A , Ali Hanan M , Ibrahim Rana H , Sawirs Nourhan Safwat
Published: October 2021

Background

Nephropathy, a major complication of diabetes, is the leading cause of end-stage renal disease. Early identification of nephropathy in diabetes patients is crucial because it creates opportunity for preventing the incidence of DN and/or even slows down the process of end-stage renal disease attributed to diabetes. Human podocytes (Pods) have been demonstrated to be functionally and structurally injured in the natural history of diabetic nephropathy.

Aim of the Work

To evaluate the possible association between the urinary podocalyxin levels and severity and grade of diabetic nephropathy and to use urinary podocalyxin as a non-invasive marker for early stage of diabetic nephropathy in type 2 DM.

Patients and Methods

We collected 60 known clinically and biochemically type 2 diabetic patients.20 diabetic patients with no evidence of diabetic nephropathy, 20 patients diagnosed as diabetic nephropathy in microalbuminuria stages and 20 patients diagnosed as diabetic nephropathy in macroalbuminuria stages from Ain Shams University hospitals between April and December 2018 and 20 apparently healthy volunteers will included as a control group.

Results

Urinary PCX was significantly higher in patients group compared to control group. Urinary PCX was significantly higher in microalbuminuric group than in normoalbuminuric group and higher in macroalbuminuric group than in microalbuminuric group. There was a positive significant correlation between FBS, 2HrPP, HBA1C and urinary PCX. There was a positive significant correlation between s.create and urinary PCX. There was a positive significant correlation between ACR and urinary PCX.

Conclusion

Urinary podocalyxin seems to be beneficial as an early marker for early stages of diabetic nephropathy in type 2 DM patients.
Value of Plasmatic Villin-1 in the prediction of early graft dysfunction in kidney transplant recipients among Egyptian population
Authors: Ezzat M.A , El Tayeb M , Abou Ellail H , Anwar W , Teama N
Published: October 2021

Background

One of the main complications of kidney transplantation is delayed graft function (DGF). There has been enormous growing research interest in the potential for the rapidly expanding fields of medical technology to generate new biomarkers with the aim of early prediction of DGF and modifying its therapy accordingly. Villin-1 has been detected in urine of patients with AKI. Additionally, it is redistributed during AKI from the brush borders of the proximal tubular cells toward the basolateral membrane which positions villin-1 closer to the renal vasculature and suggests that it could be released in the blood as well, so can be as a novel biomarker for DGF.

Methods

Of 70 patients with end-stage renal disease with one or more risk factor for developing delayed graft function attending renal transplantation preparation clinics in ASUSH, IMC and NILE Badrawi hospital in Egypt from May 2016 to July 2019, 41 patients were eligible and assigned into two groups according to the correlation with the serum creatinine levels in the first two days post-transplantation after signed informed consent for participation in our study into group 1 (DGF group) and group 2 (NGF group). We measured the presence of villin-1 by ELISA technique (quantitative) in comparison to serum creatinine levels in plasma at the time of declamping (zero level), 1st, 3rd, 5th, 7th, 12th, 24th, 48th, 72th 96th, 120th hour post declamping, also samples from normal population and chronic kidney disease stage V patients have been collected to establish reference range guide for plasmatic villin-1 in both groups.

Results

Statistically significant differences were noted in the comparison between both groups as regard the plasmatic villin-1 levels at the same measurement points in both groups, also plasmatic villin-1 started to rise above its reference range in the ESRD patients at the 5th hour post declamping while its peak was at the 7th hour in the DGF group’s recipients then started to decrease after that but didn’t settle down between the reference range guide during the regular follow up of its level till the 120th hour post declamping. the reference range guide was from 0.08 and 0.35 ng\ml in males and from 0.055 to 0.35 ng\ml in females in normal population while from 0.38 and 1.4 ng\ml in males and from 0.28 to 1.1 ng\ml in females in the ESRD patients.

Conclusions

Plasmatic villin-1 is a promising novel biomarker for detection of early graft dysfunction in kidney transplant. Due to restrictions of the study design these observations need further confirmation by prospective studies.
Clinical efficacy of Direct Acting Antivirals (DAAs) for Treatment of Recurrent Hepatitis C Virus infection After Liver Transplantation
Authors: Ismail Mohamed Saleh Mohamed Ahmed , El Sayed Osama Aboelfotoh , El-Din Mohamed Mohamed Bahaa , Yousry Wael Ahmed , El-Din Maha Mohsen Kamal , Kumar Prasun Jalal
Published: October 2021

BACKGROUND & AIMS

Recurrent hepatitis C virus (HCV) infection of transplanted liver allografts is universal in patients with detectable HCV viremia at the time of transplantation. Directacting antiviral (DAA) therapy has been adopted as the standard of care for recurrent HCV infection in the post-transplant setting. However, there are insufficient data regarding its efficacy in liver transplant (LT) recipients with a history of hepatocellular carcinoma (HCC), and the risk of HCC recurrence after DAA therapy is unknown. In this study, we aimed to demonstrate predictors of DAA treatment failure and HCC recurrence in LT recipients.

METHODS

A total of 106 LT recipients given DAAs for recurrent HCV infection from 2015 to 2019 were identified (68 with and 38 without HCC). Descriptive statistics and logistic regression models were used to estimate the multivariate odds ratios and respective 95% confidence intervals for predictors of treatment failure and HCC recurrence.

RESULTS

Six patients (6%) experienced DAA therapy failure and 100 (94%) had a sustained virologic response at follow-up week 12 (SVR12). A high alanine transaminase level >35 U/L at treatment week 4 was a significant predictor of treatment failure. DAA failure at follow-up week 12 was significantly associated with post-transplantation HCC recurrence, (odds ratio, 10.6 [95% confidence interval, 1.0-121.6]; P = .05).

CONCLUSIONS

DAAs are effective and safe in the treatment of recurrent HCV infection in LT recipients with history of HCC. Lack of SVR12 is a predictor of post-transplantation HCC recurrence.
Programmed Death-Ligand 1 (PD-L1) Gene Polymorphisms as Predictive Markers for Development of Hepatocellular Carcinoma in Chronic Hepatitis C Virus Patients
Authors: Ali- Eldin Zainab Ahmed , Attar Gamal El , Kaisar Hany Haroun , Samaan Amira Isaac , Hassan Marwa , Attia Mohammed Saad
Published: October 2021

Background

Hepatocellular carcinoma is the sixth most common cause of cancer, and ranks fourth among the causes of cancer-related death. Major risk factors for HCC include chronic alcohol consumption, hepatitis B, hepatitis C and non-alcoholic fatty liver disease. Other, less common causes are Wilson’s disease, hereditary hemochromatosis, alpha1-antitrypsin deficiency, primary biliary cirrhosis and autoimmune hepatitis.

Objective

To investigate the associations of the genetic variants of PD-L1 (rs4143815 and rs2297136) with the risk of HCC in the Egyptian population.

Patients and Methods

This study was conducted in co-operation between Gastroenterology and Hepatology Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute “between” March 2020 to July 2020. It included total participants of 138 Divided to Group (A): 35 normal people as control. Group (B): 51 patients with HCV infection and cirrhosis Group (c): 52 patients with HCV infection and cirrhosis with HCC. The patients were recruited from the outpatient clinic of Theodor Bilharz Research Institute Hospital (after consents were obtained).

Results

Also, the present study demonstrated that the functional polymorphisms (rs4143815) (CG) of the PD-L1 gene were associated with HCC risk as it is expressed in (53.3%) in HCC, (25.6%) in cirrhosis and (23.1%) in control group. And, rs4143815 (CG) show significant increase in Child C patients as (75%) Child C vs. (10%) Child A and (45%) was MELD/NA (20-29) vs. (10%) <9 with (61%) of patients were stage D in BCLC. There is significant increase in rs4143815 (CG) with age as 95% of gene positive patients more than 50years.With no significant in gender as 70% males and 30% females and there is no significant in smoking and DM. So, PDL-1 gene polymorphism rs4143815 (CG) could be used as a predictive marker for HCC after validation by larger studies or met analysis.

Conclusion

The present study demonstrated that the functional polymorphisms (rs4143815) (CG) of the PD-L1 gene were associated with HCC risk as it is expressed in (53.3%) of HCC, (25.6%) of cirrhosis and (23.1) % of control group. There is significant increase in rs4143815 (CG) with age as 95% of gene positive patients more than 50 years with no significance in gender smoking and DM. rs4143815 (CG) show significant increase in Child C patients as (75%) Child C vs. (10%) Child A and (45%) of patients was MELD/NA (20-29) vs. (10%) <9 and (70%) of patients were stage D in BCLC.
Effect of Eradication Helicobacter Pylori on Platelet Counts in Hepatitis C Infected Patients
Authors: El-Sawaby Ahmed Shawky , Awad Emad Ahmed , George Tari Magdy Aziz , Mahmoud Mostafa Adel Saber
Published: October 2021

Background

Hepatitis C virus and H.pylori are the world's leading etiologies of bacterial and viral human diseases. Egypt has the world's largest prevalence of HCV, which was estimated to be 14.7 percent nationally.

Objective

To detect the effect of H. pylori eradication on the platelet counts in hepatitis C virus (HCV)-related CLD patients.

Patients and Methods

This prospective study was conducted at the Gastroenterology clinic, Internal Medicine department at Ain shams university and El-menofya hospital during the period of September 2017 to June 2018. 30 subjects were included in the study. All of them were chronic HCV infected patients (confirmed by HCV Ab and PCR for HCV) associated with thrombocytopenia (less than 100,000/μ) and were found to be H. pylori-positive (Confirmed active H.pylori infection by positive stool antigen test).

Results

Our results showed that there was highly statistically significant difference in platelets count with a pre-treatment range of 48-98 with mean±SD 82.40±14.16 and a post-treatment range of 50-123 with mean±SD 96.17±19.27 (10^3/cmm)

Conclusion

Eradication of Helicobacter Pylori leads to significant improvement of platelet counts in hepatitis C infected patients with thrombocytopenia.
Effect of Trans-Cinnamaldehyde on preformed biofilm and biofilm formation of Escherichia coli isolated from urine specimens
Authors: El-Haddad Eman Adel , El-Hady Soha Abdel Rahman , Hamid Amira Esmail Abdel , Fahim Hisham Abdel Majeed
Published: October 2021

Introduction

Bacteria in most environments exist as communities of sessile cells in a selfproduced polymeric matrix known as biofilms. Biofilms are responsible for more than 80% of infections, including urinary tract infections (UTI). UTI is the most common hospital acquired infection, caused mainly by Escherichia coli (E.coli). E. coli can readily form biofilm in such infections, specially in the presence of indwelling urinary catheter. It’s difficult to eradicate bacteria in biofilms, since they are shielded from the host defense mechanisms as phagocytes and antibodies, as well as antibiotics. Searching for alternative or adjuvant substances for prevention and eradication of biofilm associated infections are therefore urgently needed.

Aim of the work

Studying the efficacy of the trans-cinnamaldehyde (TC) for preventing E. coli biofilm formation.

Materials and methods

Thirty isolates of E.coli were obtained from urine samples. To test the effect of TC on E.coli biofilm formation and preformed biofilms, microtitre plates (MTP) were inoculated with the isolated E.coli and were treated with different concentrations of TC and incubated at 37° C. A colorimetric assay was used to assess biofilm inhibition and inactivation and optical densities (OD) were compared before and after adding different TC concentrations.

Results

The mean OD of the isolated E.coli biofilms was 1.3 and significantly decreased when mixed with TC different concentrations. TC had high activity in inhibition of preformed E.coli biofilms, where no biofilm was detected on MTP treated with 1.25% and 1.5% TC.

Conclusion

TC inhibited the biofilm forming ability of E.coli isolates could fully inactivate formed biofilms, suggesting its possibility to be used as an anti-biofilm agent or adjuvant in preventing and treating UTI caused by biofilm producing E.coli.
Assessment of serum zonulin as a marker of altered intestinal permeability in patients with multiple sclerosis
Authors: Nassef Prof.Dr. Ayman Mohamed , ElNabil Lobna Mohamed , Fouad Mohamed Mahmoud , Moussa Amira Ahmed
Published: October 2021

Background

Here we enrolled patients into 3 groups:

Relapsing remittent MS in relapse (RRMS) [N = 26], progressive MS (progressive)

[N = 19] and relapsing remittent MS in remission (remission) [N = 18]

Control group matching age and sex [N = 20]

P-Value was <0.001, which is significant in RRMS group in relation to progressive, remission and control groups.

P-Value was 0.849, which is insignificant in progressive group in relation to remission group.

P-Value was 0.584, which is insignificant in progressive group in relation to control group.

P-Value was 0.973, which is insignificant in remission group in relation to control group.

Aim of the Work

To investigate the possible association between IP changes and MS through measurement serum zonulin in different population of MS for possible implication on treatment.

Patients and Methods

A. Subjects

Type of the Study

A case control observational cross sectional study

Study Setting

The Neurology department of Ain Shams University hospitals.

Study Period

6 months to 1 year

Study Population

This study will enroll 92 subjects who will be divided into 4 groups; group 1 including 24patients with the diagnosis of relapsing remittent MS (RRMS) who are in relapse phase within one week from the time of sample withdrawal, group 2 including 24 patients with the diagnosis of RRMS who are in remission phase, group 3 including 24 patients with secondary progressive MS (SPMS) and group 4 including 20 age- and sex-matched healthy controls.

Results

In the RRMS group of this study, serum Zonulin varying between (12_ 93) with mean 28.692 and +\-22.894 SD.

In the progressive group of this study, serum Zonulin varying between (2_ 18) with mean

8.021 and +\-3.866 SD.

In the remission group of this study, serum Zonulin varying between (1.5_ 11) with mean

4.522 and +\-3.026 SD.

In the control group of this study, serum Zonulin varying between (1.3_ 6) with mean

2.690 and +\-1.292 SD.

P-Value was <0.001, which is significant in RRMS group in relation to progressive, remission and control groups.

P-Value was 0.849, which is insignificant in progressive group in relation to remission group.

P-Value was 0.584, which is insignificant in progressive group in relation to control group.

P-Value was 0.973, which is insignificant in remission group in relation to control group.

Conclusion

this study included 62 patients diagnosed as multiple sclerosis that are divided into 3 groups and serum Zonulin level was assessed in each group and the results were significant in the relapse group which indicates autoimmune theory of MS and link between gut barrier and CNS also illustrated the role of gut microbiota in the MS. It also supported disintegration of intestinal barrier during the attack of MS for further work up studies regarding oral medication in the acute attack of MS.
Correlation of Serum Albumin Level with Short Term Outcome of Acute Ischemic Stroke Patients
Authors: El-Din Mahmud Mohammed Saad , EL-Khawas Hala Mahmoud , El Din Mahmoud Afify Hossam , Tawfik Mohamed Mohamed
Published: October 2021

Objectives

We aimed to Detect if there is association between serum albumin level in acute ischemic stroke patients and its short term neurological and functional outcome in a tertiary care hospital in Cairo.

Methods

The study was carried out as descriptive (cross-sectional) study conducted on 50 cases first-ever acute ischemic stroke patients were enrolled between June 2018 to December 2018 with follow up after 30 days of discharge from hospital. Inclusion and exclusion criteria were strictly exercised. National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) score was noted. Serum albumin (SA) was estimated from blood Clinical, functional, and radiological evaluation was done for the patients. Statistical SPSS 20.0 software and Microsoft excel were used for statistical analysis (P ≤ 0.05).Relationship between serum albumin and stroke outcome was determined.

Results

A total of 50 stroke cases were thus included in the study comprising 34 males and 16 females. The mean age of patients was 40-65 [59.26±6.25] years, we found the most prevalent risk factors in the present study results were hypertension 36 (72.0%). The mean serum level of albumin were (3.73±0.63) on day o of onset and (3.72±0.63) after 30 days of discharge from hospital. Bivariate analysis shows serum albumin was inversely associated with NIHS score and mRS on day o of onset and after 30 days of discharge from hospital which were NIHSS(r= -0.264, P = 0.044) (r= -0.645, P = <0.001) and mrs (r= -0.321, P = 0.031) (r= -0.587, P = <0.001) respectively.

Conclusion

Hypoalbuminemia had influence to degree of stroke severity, degree of disability and functional outcome. Serum albumin levels had a negatively correlation with NIHSS score and modified Rankin scale. Low serum albumin levels associated with poor prognosis in acute ischemic stroke patients.
The Impact of Psychiatry Round on The Attitude of Medical Students towards Psychiatry as a specialty and a career
Authors: Ahmed S , Ramy H , Abdel Moneim D , Youssef M
Published: October 2021

Background

Psychiatry workplace shortage is a major problem seen in many countries around the world. This could be attributed to negative attitude of medical students towards psychiatry as a career for the past decades despite that medical students are exposed to psychiatry and behavioral science in most courses, starting in the preclinical years and progressing to clinical clerkships in the later years.

Aim of the Work

our study aims to assess the attitude of a sample of medical students towards psychiatry as a specialty and a career before the psychiatry round and the impact of psychiatry round on their attitude.

Patients and Methods

A sample of 50 participants was taken from both 4th and 5th grade of medical students. The socioeconomic status was assessed using socioeconomic status scale (SES), the general health questionnaire (GHQ-28) was used to assess the presence of minor psychiatric illness, the Attitude towards Psychiatry scale (ATP-30) was used to evaluate the attitude of students before psychiatric round and its impact afterwards.

Results

A total of 50 participants were enrolled, consisted of 24 males with 48% of sample and 26 females by 52% of total sample .There was a significant positive change in the attitude of participants toward psychiatry by a P value = 0.041, also it showed increasing in the percentage of the participants that will choose psychiatry as a career after the round than those before receiving the round.

Conclusion

The findings in our study highlight the positive effect of psychiatry round on the undergraduate attitude toward psychiatry as a post-graduation career, and that it could be considered as a strengthening point which can be used to compact stigma towards psychiatry as a career, as well as stigma towards mental illness and the mentally ill.
Depression and psychological burden in a sample of caregivers of children with CKD
Authors: Hassan Y , Saad A , Abdel Moneim D , El hawary Y
Published: October 2021

Background

Studies have suggested that caregivers of patients with chronic illnesses experience higher rates of depression and burden than the general population.

The Aim of this study

To assess the rate of depression and psychological burden in caregivers of children with CKD and compare it with a healthy control group.

Patients and Methods

This is a case control comparative study conducted in El Demerdash pediatric hospital aimed at screening symptoms of depression and psychological burden in a sample of 30 cases of caregivers of children with CKD compared to 30 controls of caregivers, as well as socioeconomic stress as a factor for burden and depression.

Results

The current study confirmed that caregivers of children with chronic kidney disease have significantly more depression and psychological burden compared to their matched controls.

Conclusion

There is a high rate of depression and burden in caregivers of children with CKD which often go unnoticed and neglected.
Metformin with standard neoadjuvant chemotherapy in breast carcinoma
Authors: Azazy Hend Ayman , Gado Nivine Mahmoud , Salem Dina Ahmed , El-Ghamry. Wesam Reda
Published: October 2021

Background

Breast cancer is the most common cancer among women which increases after the age of 35 till it reaches a peak at 55-64 years.

Metformin is a synthetic oral biguanide that has been shown to cause a 30% reduction in the lifetime risk of all cancers in diabetic patients on Metformin. We aimed at evaluating this antineoplastic effect in terms of pathological response, concurrent with standard neoadjuvant chemotherapy in breast cancer.

Methodology

60 non-diabetic breast cancer patients receiving standard neoadjuvant chemotherapy at the breast cancer outpatient clinic, Ain Shams University hospital, were randomized into two arms (30 in each arm);

Arm A

Group receiving Metformin (850 mg bid) with standard line of neoadjuvant chemotherapy (FEC/Taxotere +/- Herceptin).

Arm B

Control group receiving the standard line of neoadjuvant chemotherapy alone.

Results

There’s a significant difference between Metformin and control arm in terms of response (complete and partial) versus no response (p = 0.03). Response to Metformin was significantly more pronounced in Luminal B subtype breast cancer (p = 0.03) and in grade II (p = 0.03). There’s no significant difference in toxicity between both arms; most common toxicities in both arms were vomiting (53.6%), nausea (30.4%) and neutropenia (30.4%)

Conclusion

Metformin has a significant antineoplastic effect which was measured in this study in terms of significant increase in pathological response concurrently with neoadjuvant chemotherapy in breast cancer compared to giving neoadjuvant chemotherapy alone.
Survival outcome and treatment tolerability for postmenopausal females with early stage hormone receptor positive breast cancer treated with different adjuvant hormonal lines (TAM vs. AI vs. switching strategy) for 5 years
Authors: Riyad Atef Youssef , Elkhodary Dalia Abdelghany , Elghamry Wesam Reda Farag , Zaki Islam Abdelrahman Kamel Mohamed
Published: October 2021

Background

The standard adjuvant endocrine treatment for postmenopausal female patients with hormone receptor positive early breast cancer was 5 years of tamoxifen, but recurrence and side effects restrict its usefulness. The aromatase inhibitor (anastrozole or exemestane or letrozole) was compared with tamoxifen for 5 years or started after completing 2-3 years of tamoxifen in postmenopausal female patients diagnosed with early breast cancer at "Ain Shams University Hospitals"

Objective

The aim of the study was to measure survival outcome and treatment tolerability for postmenopausal females with Hormone Receptor Positive early breast cancer who received adjuvant hormonal treatment with tamoxifen [TAM] only for 5 years versus those who received adjuvant hormonal treatment with tamoxifen [TAM] for 2 years switching to aromatase inhibitors [AI] in the sequential 3 years versus those who received adjuvant hormonal treatment with aromatase inhibitors [AI] solely for 5 years.

Patients and methods

This study included 100 postmenopausal women with early breast cancer who presented at the Clinical Oncology Department, Ain Shams University, in the interval from January 2010 until December 2015.

Conclusion

Similar disease free survival and overall survival were observed among the three studied groups. Switching tamoxifen to aromatase inhibitors provides better tolerability in terms of endometrial thickness when compared to 5 years of tamoxifen monotherapy. Patients who administer aromatase inhibitor included in the switching strategy experience less osteoporosis and less generalized bone pain compared to upfront aromatase inhibitor to 5 years. There was a significant improvement of disease free survival (DFS) in human epidermal growth factor receptor 2 (HER 2) negative patients receiving any adjuvant hormonal treatment line for five years in comparison to HER 2 positive patients receiving the same adjuvant hormonal treatment for five years.
Distal Intra Articular Tibial Fracture Treated by Ilizarov with Ligamentotaxis
Authors: Fayd Mahmoud Mohamed , Al-Kersh Mohamed Ahmad , Bishay Elia Saad Fakhry
Published: October 2021

Background

The thin soft tissue and muscles envelope that surrounds the distal tibia makes treatment of these fractures difficult. These fractures are often referred to as ―pilon‖ fractures or ―plafond‖ fractures‖. If the articular surface of the tibia is involved; in such cases an anatomic realignment of the involved articular fracture in conjunction with a stable fixation is crucial.

Objectives

The aim of this paper is to conduct a systematic review of literature about functional and radiological outcomes in patients with distal intra articular tibial fracture treated by external fixator with ligamentotaxis.

Materials and Methods

We performed this systematic review and meta-analysis in accordance to the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. MOOSE is a reporting checklist for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists

Results

Over all, five studies reported the time to union. The overall effect estimates showed that the time to union after Ilizarov external fixator was 12.83 weeks. Three studies reported the rate of union. The overall effect estimates showed that the rate of union after Ilizarov external fixator was 88.4%. Over all, eight studies reported the good-excellent AOFS score. The overall effect estimates showed that the rate of good-excellent AOFS score after Ilizarov external fixator was 69.4%. Nine studies reported the rate of malunion. The overall effect estimates showed that the rate of malunion after Ilizarov external fixator was 10.2%. Over all, seven studies reported the rate of delayed union. The overall effect estimates showed that the rate of delayed union after Ilizarov external fixator was 6.3%. All studies reported the rate of pin infection. The overall effect estimates showed that the rate of pin infection after Ilizarov external fixator was 33.7%. Ten studies reported the rate of major infection. The overall effect estimates showed that the rate of major infection after Ilizarov external fixator was 3.4.

Conclusion

External fixation and ligamentotaxis by either ilizarov or any external fixator is a good and easy method for fixation of distal intraarticulat tibial fracture with few serious complications. due to easy to apply it, less rate of infection, no risk of bleeding since no opening the fracture site, good aligment of the joint, no streaping of the periosteomy that lead to later on good and rapid healing of the fracture.
Recent Trends in the Management of Aneurysmal Bone Cyst
Authors: Sadek Rafeek Ahmed , El Seddawy Ashraf Mohamed , Gomaa Hussein Mohamed Ahmed
Published: October 2021

Background

Aneurysmal bone cysts (ABCs), were first described by Drs. Jaffe and Lichenstein in 1942 when they described pelvic and spine lesions that when exposing the lesion and opening in to its thin wall, the surgeon was immediately confronted by a large hole containing much fluid blood.

Aim of the Work

To describe the efficacy of new line treatment modalities of (Aneurysmal Bone Cysts) compared to conventional lines of management regarding the:

• Long term outcomes and healing rate.

• Recurrence rates.

• Complications after therapy.

Patients and Methods

Criteria for considering studies for this review:

• Types of the studies: published observational analytical studies (case-control_ case-series _ RCT or cohort studies) which studied the efficiency of new lines in the management of aneurysmal bone cyst.

• Types of participants: participants were children and young age (below the age of 50 yrs) with a diagnosis of aneurysmal bone cyst.

• Types of interventions: drugs like (Bisphosphonate or denosumab) were administered for a time determined by the case improvement, or minimally invasive techniques like (cryosurgery or curopsy) was done.

Results

Through the results of our study that compared between these recent modalities according to healing, recurrence, and complications rate; we are able to say that recent strategies have a high rate of healing ranges from 78.57% with bisphosphonate to 100% with doxycycline and cryotherapy.

Conclusion

There are recent evolving trends in the management of ABC other than the classic ways of management, they are less invasive, have less recurrence rate reaches to 0 % like with bisphosphonate, less complications rate as well reaches to 0 % like with doxycycline and bisphosphonate, high healing rate reaches to 100 % like with doxycycline and taking in consideration how to handle cases of ABC that classic way of management can’t handle like spinal ABC.
Oncological Safety of Lipofilling in Patients with Breast Cancer: A Metaanalysis
Authors: Mahmoud Hebatullah Yasser Badr , Setta Hany Saad , El-Shinawi Mohamed
Published: October 2021

Background

Lipofilling is an increasingly popular technique for breast reconstruction following both mastectomy and breast-conserving surgery (BCS). Autologous fat transfer (Lipofilling), is a technique which has been used for many years in the setting of aesthetic breast surgery. Although gaining popularity in this setting, there are still questions regarding its oncological safety when used in patients being treated for breast cancer.

Objective

To systematically evaluate the current literature regarding the oncological safety of lipofilling in patients who underwent surgical treatment for breast cancer by performing a metaanalysis to investigate the recurrence rates and the incidence of complications after lipofilling. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materi als available in the Internet till 2019.

Data Extraction

All the studies which did not fulfill the inclusion criteria were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion

Through this analysis, no evidence that lipofilling significantly increases the risk of locoregional recurrence when used as part of a breast reconstruction procedure after either mastectomy or BCS for breast cancer was found. Therefore, it can be considered an oncologically safe procedure in suitable patients with careful oncological follow-up. In the future, more longterm, adequately powered, multicentre controlled studies are needed. Additionally, more research should be carried out on the incidence of complications following lipofilling so that efforts can be made to prevent them and optimise fat graft survival.
Ultrasound in Detection of Skull Fractures in Children Younger Than Two Years Old with Closed Head Injuries
Authors: Abdallah Randa , Hemeda Tarek Wahby , Elhady Ahmed Mohamad
Published: October 2021

Background

Paediatrics head injuries is a frequent cause of emergency department (ER) visits. The incidence of head traumas in children varies from one country to other with an estimated 47 to 280 per 100,000 children presented to the ER each year due to traumatic brain injury worldwide. Head computed tomography (CT) is the most frequent CT scan performed in paediatrics population, majority of those scans are done to evaluate trauma. Head CT scans increase the risk of developing brain malignancies and leukemia in exposed pediatric patients. Many efforts have been made to limit the use of CT in children with head injuries.

Aim of the Work

Our aim was to evaluate the role of skull ultrasound in detection of skull fractures children younger than two years old with closed head injuries.

Patients and Methods

Type of study was a prospective observational study, sampling method was convenient sampling. The study was conducted according to the stipulations of the Ain Shams University (ASU) ethical and scientific committee. The privacy of participants and confidentiality of data was guaranteed during the various phases of the study. The study was conducted at the radiology unit, Emergency Department, ASU Hospital. The main source of data for this study was patients referred to the Emergency department. Children younger than 2 years presenting with closed head injuries and referred to the radiology department, ASU hospital to perform CT brain, Study Period: 6 months, onset in March 2020.

Results

We found that skull ultrasound examination of pediatric patients with closed head injuries and Glasgow coma scale (GCS) of 14-15 have a high sensitivity and specificity in detecting skull fractures and subsequently prediction of an underlying traumatic brain injury (TBI) in these patients. Ultrasonographic assessment of the whole cranial vault is not always feasible as most of these age group patients are excessively crying and irritable at presentation, applying the ultrasound probe makes them more irritable and are difficult to maintain their head position during the scan. Although head CT is the gold standard diagnostic modality in the setting of head trauma, it exposes patients to significant ionizing radiation, ultrasonography is a safe diagnostic modality and doesn’t expose the patient to ionizing radiation.

Conclusion

Skull ultrasound in the setting of pediatrics mild closed head injuries is feasible, safe, sensitive and specific. It can play a complementary rule in risk stratification of these patients.
The role of Sonoelastography in characterization of solid breast lesions
Authors: Ghanem Alaa Othama Hendawy , Abd Elkhalek Yasser Ibrahim , Abd Elmoteleb Mohamed Gamal Aldin
Published: October 2021

Background

Mammography and Sonography are the important sensitive imaging modalities available in detection of breast cancer.

Sonoelastography is a relatively new imaging technique which acts as a complementary tool to improve the diagnostic ability of ultrasound for evaluating patients with breast masses.

Objective

To evaluate the role of sonoelastography characterization information on solid breast lesions over conventional sonography and mammography either benign or malignant lesions to reduce the number of benign biopsies performed.

Methods

A prospective study was carried at private centers, starting from august 2019 till december 2019.

Results

The study conducted on 40 patients with palpable breast lesions classified to BIRADS 3 and 4a according to conventional ultrasound and mammographic criteria. Their ages ranged from 18 to '75 years with a mean age 47.72 14.91, 22 cases (55%) had no family history of pervious breast disease, and 18 cases (45%) had family history of pervious breast disease.

All patients were subjected to full history taking, clinical examination, conventional gray scale ultrasound, and mammography and ultrasound elastography.

All patients underwent histopathological assessment to reach the final diagnosis.

Among Studied cases , 28 lesions were sampled by fine needle biopsy (70%) and 12 lesions were sampled by true cut needle (30%) .the results revealed 27 breast lesions were benign (67.5%), 9 malignant lesions (22.5%) and 4 lesions shows atypia (10%) according to histopathological assessment.

Among final diagnosis of breast lesions fibro adenoma was the most frequent benign breast lesion detected as 12 lesions from 27 benign breast lesions were fibroadenoma., Also infiltrative ductal carcinoma was the moste frequent among malignant breast lesions as 5 lesions from 9 malignant lesions were infiltrative ductal carcinoma.

Conclusion

Ultrasoundelastography has significant complementray role beside conventional mammogram and ultrasound in characterization of solid breast lesions.
Micro structural abnormalities of the Cingulum in children with focal epilepsy: DTI study
Authors: Abdurrahman Laila Ahmad , Younis Neveen Tawakol , Mohammad Shaimaa Abdelsattar , Aly Nour El Dein Aly Haggag
Published: October 2021

Aim of the work

The aim of this study is to evaluate the microstructural alteration implicating the Cingulum (CG) as one of the major limbic system white matter fiber tracts; in children with focal epilepsy.

Patients and methods

Our study was carried out on twenty-one children with the clinical and EEG diagnosis of focal epilepsy and 22 control subjects who were age and sex matched to patient group in the study. All patients underwent an epilepsy specific MRI protocol. DTI and fiber tractography was performed to all subjects as well. Fractional anisotropy (FA), axial diffusivity, radial diffusivity (RD) and trace were calculated for CG. DTI metrics were compared between both hemispheres as well as between both groups patient group and control group. A p-value less than .05 was considered significant.

Results

Asymmetry in FA, RD, trace and AD values of the CG was demonstrated in patients with focal epilepsy between both hemispheres with significantly lower FA and higher diffusivity values reaching p < 0.001in CG in both hemispheres in patients with focal epilepsy when compared together regardless the seizure focus. Compared with controls, patients with left focal epilepsy demonstrated significant lower FA and higher diffusivity indices in both ipsilateral and contralateral fiber tracts as well p < 0.05. Patients with right focal epilepsy showed no significant asymmetry in different DTI metrics when compared to controls.

Conclusion

Reduction in FA values along with increased diffusivity measures in the CG reflects the microstructural changes taking place in children with focal epilepsy.
Role of FDG-PET CT in differentiating adenocarcinomas from squamous cell carcinomas of the lung
Authors: Salem Amr Muhammad Abdo , Hussein Laila Hosny , Osman Ahmed Mohamed
Published: October 2021

Background

Lung cancer is the leading cause of cancer related deaths worldwide. The combination of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) has a great impact on the diagnosis, staging, and hence on the treatment plan and follow up of lung cancer patients. Maximum standardized uptake value (SUVmax) is a semi-quantitative index which is easily performed and the most widely used quantitative parameter for the analysis of 18F-FDG PET images and for the estimation of metabolic activity.

Objective

to investigate the role of PET/ CT to differentiate between adenocarcinomas (AC) and squamous cell carcinomas (SCC) as the most common lung cancer by comparing their FDG uptake measured in the form of SUVmax.

Methods

A retrospective observational study, conducted at Ain Shams University Hospitals- Radiology Department patients diagnosed with non-small cell lung cancer (NSCLC) and histopathologically proved to be adenocarcinoma or squamous cell carcinoma. All were investigated using PET/CT scans in the period between June 2017 to September 2019. SUVmax of the lesion were measured and statistically analyzed compared with the histopathological type.

Results

A total of 30 patients were evaluated with the age ranging from 31 to 81 years old, the mean was 56.9 years (SD ± 11.53). Among them 25 patients (83.3%) were males and 5 patients (16.7%) were females. Out of the 30 NSCLC patients included in the study, 18 patients (60%) were histopathologically diagnosed as AC and 12 patients (40%) were histopathologically diagnosed as SCC. The mean SUVmax of the 30 NSCLC lesions was 15.02±8.4 (range: 2-32.8).The mean SUVmax of AC lesions was 12.4±7.55 (range: 2-32.8), while the mean SUVmax of SCC lesions was 18.95±8.3 (range: 3.7-30.77). The mean SUVmax of lesions in patients with SCC was significantly higher than that of patients with AC using Wilcoxon-Mann-Whitney test (P = 0.04).

Conclusion

SCC of the lung has higher SUVmax than AC of the lung and it can be used to differentiate between them using PET/CT.
Role of CT and modified Response Evaluation Criteria in Solid Tumors (RECIST criteria) in response evaluation of malignant pleural mesothelioma
Authors: Allam Ass Prof .Dr., Khalid Esmat , Ali Hassan Hend Galal Eldeen Mohamed , Mohamed Basma Abdelbaset
Published: October 2021

Background

Malignant pleural mesothelioma is a rare and aggressive tumor that the growth pattern of it poses unique difficulties in measurement and response assessment . however, robust and reproducible assessment of response is critically important in the conduct, interpretation, and reporting of clinical trials.

Objectives

The aim of this study is to assess the value of CT and modified RECIST criteria in follow up patients of malignant pleural mesothelioma patient during treatment with chemotherapy .

Patients and methods

We evaluated 20 malignant pleural mesothelioma patients undergoing to chemotherapy . Tumor thickness is measures perpendicular to the chest wall or mediastinum in two positions at three separate levels on thoracic CT scans. The sum of the six measurements defined a pleural unidimensional measure. A reduction of at least 30% on two occasions 6 weeks apart defined a partial response; an increase of 20% over the nadir measurement known as progressive disease. Patients who fulfilled the criteria for neither PR nor PD called CD .The validity of the modified criteria was gauged by clinical evaluation .

Results

In our study, CT and modified RECIST criteria were used as the method of choice in response evaluation of malignant pleural mesothelioma .Our study showed as follow up results of each group and comparison between clinical evaluation and modified RECIST criteria show over all accuracy 73.3% with P value = 0.03 and this results confirm accuracy of CT with modified RECIST criteria as good predictor of disease outcome .

Conclusion

These Modified RECIST criteria for tumor response correlate with clinical evaluation and can be used to measure outcome in pleural mesothelioma.