bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Fibrinogen as a Biomarker for Mortality and Hospitalized Exacerbations in People with COPD
Authors: Abd El Hameed Karim Hala Asef , Elassal Gehan Mohamed , Abo Bakr Yosra Tayseer
Published: November 2024

Background

Chronic obstructive pulmonary disease (COPD), predominantly prevalent in smokers, is a chronic inflammatory disorder of the airway and lungs. COPD is one of the most prevalent diseases and the third leading cause of death globally. COPD is a common, preventable, treatable disease that characterize by persistent chest symptoms and airflow limitation due to air way or, and alveolar abnormalities. Fibrinogen is a soluble protein that is produced in the liver and released into the bloodstream, with normal ranges of 200-400 mg/dL or 2-4 g/L. COPD and fibrinogen are associated with frequency of hospitalizatied exacerbations of COPD, and related to the severity of the disease and mortality.

Objective

To explore whether the fibrinogen level affects the mortality and hospitalized excerbations in COPD patients.

Methods

The present study was conducted upon 50 subjects during the period from August 2022 to January 2023 who were admitted to our chest department at Ain Sham University Hospitals.

Results

We made our study on 50 smoker patients, spirometric assessment for all patients was done to confirm COPD diagnosis. The mean age was 59.0± 8.83 years. There were 47 (94%) males and 3 (6%) females with male to female ratio was 16.7:1. Fibrinogen test was done during exacerbation with mean fibrinogen level was 3.64± 1.01 g/L. According to cutoff of fibrinogen level, most of excerbated patients had high fibrinogen level (>3.2). The mean FEV1 was 41.06± 18.75 there was a significant negative correlation between fibrinogen level and FEV1 shows that high fibrinogen level was significantly higher in cases with severe and very severe conditions. Most cases (94%) were discharged while three cases (6%) died shows that there was no significant relation between fibrinogen level and mortality.

Conclusion

Aecopd associated with high fibrinogen level and that the plasma fibrinogen level was increased with decreasing value of FEV1 showing significant negative correlation between plasma fibrinogen level and FEV1% predicated value. this suggests that high plasma fibrinogen level could be a diagnosis of severity of copd and a poor prognostic factor. but no significant relation between fibrinogen level and mortality. the results of the present study, combined with the fact that plasma fibrinogen is a widely and rapidly available, easy to interpret, low-cost biomarker, suggest a possible role for plasma fibrinogen in the identification of copd patients at an increased risk of adverse outcomes.
Use of Venous to Arterial Carbon Dioxide Tension Difference to Guide Resuscitation Therapy in Septic Shock
Authors: Sharkawy Samar Hassan , Mahmoud Mahmoud M , Maguid Abdel latif Mona Mohamed Abdel
Published: November 2024

Background

Early recognition and correction of tissue hypoperfusion is a cornerstone in the management of septic shock patients. The venous to arterial carbon dioxide tension difference, which is a marker of the adequacy of cardiac output to global metabolic demand, is a helpful additional means to detect patients who stay under resuscitation after optimization of o2 derived parameters. In this regard, its monitoring should help the clinicians for the decision of giving therapy targeting at increasing cardiac output.

Aim of the Work

Venous To arterial carbon dioxide tension difference to guide resuscitation therapy in septic shock.

Patients and Methods

This study was a prospective, cross sectional study done on patients recruited from Respiratory ICU at Ain Shams University

Results

The P(v-a)CO2/C(a-v)O2 ratio might provide additional information for assessments of oxygen debt, it may become a specific end point for resuscitation. However, the P(v-a)CO2/C(a-v)O2 ratio depends on complex interactions between the central venous oxygen saturation (Scvo2), P(v-a)CO2, hemoglobin concentration (Hb), arterial oxygen saturation (Sao2), and arterial oxygen tension (Pao2). Thus, many factors can influence the calculation of the P(v-a)CO2/C(a-v)O2 ratio in real clinical practice. The value of the P(v-a)CO2/C(a-v)O2 ratio remains controversial.

Conclusion

In the presence of a normal/high ScvO2 (≥ 70%), an elevated ΔPCO2 still suggests that rising cardiac output can be indicated with the purpose of reducing global tissue hypoxia. However, if both ScvO2 and ΔPCO2 are normal in a state of global anaerobic metabolism, manipulating the microcirculation will probably be ineffective to reduce oxygen deficit.
The Use of Biochemical Markers in Covid-19 Infection for Detecting Disease Severity and Patient Outcome
Authors: Mohammed Ezzat Nada Ahmed Hany , Abdel Wahab Korraa Emad El Din , Mohammed Hilal Amr Mohammed , Sayed Daif Marwa
Published: November 2024

Background

Corona viridea is a family of viruses that cause illness such as respiratory diseases or gastrointestinal diseases. Respiratory diseases can range from common cold to more severe diseases such as, Middle East Respiratory Syndrome (MERS-CoV) and severe Acute Respiratory Syndrome (SARS-CoV). In December 2019, the city of Wuhan in China became the epicentre of unexplainable cases of pneumonia, which in January 2020 were identified as a new coronavirus, turning rapidly into a major problem of public health worldwide. This pathogen, corresponding to a beta coronavirus, is made up of single chains of positive RNA belonging to the large Coronaviridae subfamily and has the ability to infect mammals and other animals.

Aim of the Work

to use different biomarkers to evaluate if they are able to predict clinical outcomes and correlate with the severity of COVID-19 disease.

Patients and Methods

This retrospective study was conducted on COVID-19 infection patients who were admitted in Ain Shams University Isolation for 6 months from 1st of April 2021 to 31st of October 2021. It included hospitalized isolated patients in “Ain Shams University Isolation Hospital” with COVID-19 infection confirmed by “Polymerase chain reaction (PCR) positive for SARS-CoV2”.

Results

Results in the current study show that LDH was significantly increased in patients who died compared to patients who recovered (p = 0.023) indicating a good prognostic value. Procalcitonin also showed good prognostic value being higher in patients who died than in patients who recovered. This study showed no significant relation between severity or outcome of disease and liver function tests including AST and ALT (p > 0.05), nor severity or outcome of disease and kidney function tests including BUN and serum creatinine. There was also no significant relation between serum ferritin and D-dimer levels and the severity or outcome of disease.

Conclusion

This work suggests that there is clear evidence of how the levels of some biomarkers may alternate according to severity of COVID-19 infection. Biomarkers of prognostic significance such as LDH and PCT have shown remarkable clinical implications for ineffective management, monitoring, and assessment of the severity of disease in COVID- 19 patients. This can be used as an adjunct in clinical practice to guide treatment and admission to ICU. Doing so may improve prognosis and minimise the mortality rates.
Pulmonary Complications in Egyptian Bone Marrow Transplantation Recipients and their Effect on the Outcome of Transplant: A Single Center Experience
Authors: Al-Abbassy Yasmin Fahd , Ahmed Mona Mansour , Samra Mohamed Abdelmooti Mohamed , Ali Abd El-Haleem Tamer Mohamed , El-Kader Maryam Ali Abd
Published: November 2024

Background

Pulmonary complications, both infectious and non- infectious, are found in 40%–60% of all Bone Marrow Transplantation recipients, which lead to a significant morbidity and mortality. In some studies, pulmonary complications are the main cause of 50% of all deaths in this population, and patients with these complications have a higher mortality rate than those without such complications

Aim

This study is to evaluate the pulmonary complications in BMT Recipients and their effect on the outcome in these Patients

Patients and Methods

Our study was a retrospective-prospective Cohort clinical study on 150 patients who underwent Bone Marrow Transplantation (allogeneic and autologous) in Wadi El-Neel Hospital. It was for 2 years in patients who underwent the procedure in 2017 (one year retrospective from 2017 to 2018 and one year prospective from 2018 to 2019)and for one year in those who underwent it in 2018 (prospective from 2018 to 2019) and we continued the follow up of all cases till the end of 2019. Patients were subjected to blood and sputum examination with sputum culture for fungi if suspected fungal infection, High resolution CT chest along with spirometry if indicated.

Results

150 patients were studied for Pulmonary complications either infectious or noninfectious after HSCT where pulmonary complications were found in 48% of patients, the most common pulmonary complication was Bacterial pneumonia in 14.7%, 50 patients (33.3% of patients) died; The cause was predominantly pulmonary in 28 patients (56%) of the deaths, 88% died in the first 100 days with 66% of them in the first 30 days. The pulmonary complications related mortality in those 28 patients;54.8% of death were due to infectious causes and 5.8% were due to non-infectious causes with 22 patients of infectious causes (95.7%) died within 100 days, also, presence of CT chest abnormalities has an independent effect on survival time for those patients

Conclusion

Pulmonary complications are a major complication after BMT affecting the patients' prognosis, They represent significant cause of mortality and bacterial pneumonia is a highly significant factor for death in those population, The first 100 days after BMT are the most critical period
Next-Generation Sequencing-based Genetic Landscape and its Clinical Implications for Egyptian Patients with Acute Myeloid Leukemia and Myelodysplastic Syndrome
Authors: Abdel Rahman Nada Ahmed Hamed , Mekawy Mohamed Amin , Hamza Mohamed Tarif Mohamed , Moustafa Gehan Moustafa Hamed , Agamy Heba Samy
Published: November 2024

Background

Myeloid malignancies are a heterogeneous group of clonal disorders characterized by disturbed hematopoietic stem cells self-renewal, proliferation, and differentiation capacity as a result of genetic and epigenetic changes. The molecular landscape of these diseases is complex involving many molecular alterations. Several techniques have been used to identify these genetic alterations including; FISH, RT-PCR (real time-PCR) and recently next generation sequencing (NGS) that is capable of detecting copy number variations (CNV) or translocations by a fast less expensive technique making it more practical in clinical practice.

Objectives

Designing a genetic map for Egyptian population with myeloid and detecting the prognostic impact of these genetic alterations.

Patients and Methods

Myeloid NGS Oncomine 79-gene panel was applied on 42 patients diagnosed with myeloid neoplasms (Mainly AML & MDS) recruited from the hematology unit, and their follow up till 12 months.

Results

Among the different studied groups, the highest NGS variants were found in AML compared to other myeloid neoplasms, while the percentage of patients with no NGS variants is higher in MDS (77.8%). The most frequently mutated genes detected in myeloid neoplasms were NPM1 mutation in 8 patients (19%), followed by NRAS mutation in 7 patients (16.7%). BCR-ABL1 and CALR mutations were significantly more common in the MPN group (P- value =0.000). TET2 was significantly more common in MDS/MPN patients (P-value =0.027). TP53 mutation was detected in all myeloid neoplasms (Mainly in MDS) except AML (P-value =0.027). NPM1 was significantly more frequent in AML group (P-value =0.042). There was a significant correlation between the presence of NGS variants and the clinical outcome, as the presence of one or more NGS variants is associated with poor clinical outcome & lower survival rate (p value =0.038).

Conclusion

Assessment of clinically important genetic alterations by NGS is essential for the diagnosis, prognosis, monitor measurable residual disease and detect predictive mutational markers/therapeutic targets in myeloid neoplasms. However, it cannot identify structural abnormalities, so simultaneous cytogenetic analysis to have a complete picture of the genomic profile is essential.
Significance of miRNA-192 as a Prognostic Marker in Chronic Lymphocytic Leukemia
Authors: Ali Soliman Samah Hussein , Shalaby Nahela Ahmed , Gamal Eissa Doaa Ahmed , El Dine Salem Dalia Diaa
Published: November 2024

Background

Chronic lymphocytic leukemia (CLL) is the most common human leukemia in western world. This disease can arise in two forms, aggressive and indolent, both characterized by the accumulation of incompetent CD5+ B lymphocytes. MicroRNAs (miRNAs): represent a class of small non-coding RNAs (ncRNAs) of 19–25 nucleotide (nt) length, which post-transcriptionally regulate protein expression, impacting on key cellular functions. miRNAs control numerous cellular/molecular processes such as apoptosis, cell proliferation and differentiation. Deregulated expression of miRNAs contributes to the initiation or development of numerous diseases such as cancer. One of these microRNA is miR-192 which has been suggested to be a positive regulator of p53 (a tumor suppressor gene) and its expression is deregulated in biological samples of cancer patients.

Objective

To evaluate miRNA-192 as a prognostic biomarker in CLL patients, correlate miRNA-192 expression levels to p53 gene in CLL and find out the association between miRNA- 192 and p53 genes expressions and prognostic criteria of CLL.

Methods

The present study was conducted on 40 newly diagnosed CLL patients who attended the Hematology outpatient clinic-Ain Shams University hospital during the years from 2018 to 2019 and were included in the study in addition to ten healthy subjects. Quantitation of plasma miR-192 and P53 expression levels were done by real-time quantitative polymerase chain reaction.

Results

A significant statistical association between poor patients’ outcome and advanced clinical Rai staging together with unfavorable cytogenetic profile was found. Moreover, significant statistical association was also observed in patients with poor outcome expressing low levels of miRNA-192 with p value (P = 0.00) and increased levels of P53. miRNA-192 expression levels in our work were significantly lower in patients with lymphadenopathy and in patients with unfavorable cytogenetic profile. However, it was significantly higher among patients with good prognosis in comparison to patients with worse one.

Conclusion

miRNA-192 expression levels was significantly correlated with some standard prognostic factors as TLC, Hb &insignificantly with platelets, P53 expression level and favorable cytogenetic profile indicated that circulating miR-192 can serve as non-invasive biomarker that can be used for predicting prognosis and monitoring of therapy in CLL patients.
Expansion of Identification Panel of Enterococci by Conventional Methods
Authors: Fahmi Zainab Fawzy , Saber Sally , Sherif Basma
Published: November 2024

Background

Enterococcus species (spp) represent part of the normal flora of the human gastrointestinal tract. However, recently they have gained greater interest due to their ability to emerge as one of the most important nosocomial pathogens worldwide. The conventional method for Enterococcal identification can be made reliable via involvement of multiple biochemical reactions to reach definitive diagnosis in case of resource constraint labs where automated methods may not be affordable. This study aimed to expand the conventional biochemical panel involved in identification of Enterococcus spp which made it on equal footing with the automated identification.

Methods

This study included 308 samples sent for routine culture and sensitivity at microbiology lab. Samples were collected from different departments at Ain Shams University Hospitals. 50 isolates were selected randomly to perform automated identification through Vitek 2 Compact system as well as perform further conventional biochemical testing as PYR test and Modified salt broth test.

Results

Our study showed frequency of isolation of E.faecalis, E.faecium and E.gallinarum are 70%, 26% and 4% respectively among the studied isolates. Pyrrolidonyl arylamidase (PYR) test was rapid and easy for interpretation. Modified salt broth together with PYR showed high accuracy. As regard antimicrobial susceptibility test, Penicillin showed the highest resistance among enterococcal species.

Conclusion

the conventional biochemical panel: PYR and modified salt broth involved in identification of Enterococcus spp can be on equal footing with the automated identification.
Intradermal Botulinum Toxin A versus Intradermal Minoxidil in the Management of Androgenetic Alopecia: A Comparative Study
Authors: Saleh Hanan Mohamed , Ibrahim Samah , Maher Dana Ashraf
Published: November 2024

Androgenetic alopecia (AGA) is one of the most frequent clinical complaints encountered by dermatologists. The two most common treatments for AGA are topical minoxidil and finasteride. Several new therapies are emerging or being studied as treatment options for AGA, including PRP injections, intralesional injection of latanoprost. The aim of our study was to assess the efficacy of intradermal minoxidil versus botulinum toxin A in the treatment of AGA. The study was conducted on thirty patients attending the dermatology clinic complaining of AGA. Participants were divided into two groups (15 per group), group A receiving intradermal BTA injections and group B receiving intradermal minoxidil. The participants received one session every 4 weeks for a total of 3 sessions. Follow-up for the patients was done at every session and 12 weeks after last session. Comparison between BTA and minoxidil groups regarding assessment of total, terminal, vellus hair count and terminal/vellus ratio at baseline and 20 weeks of follow up showed no statistically significant difference. Comparison among BTA, the terminal hair count medians were 103, 116, 117, and 157 with a P value 0.003 showing highly statistically significant increase at each follow up visit. Comparison among Minoxidil group at different times of assessment revealed highly significant difference regarding the count of total, terminal, vellus hair and terminal/vellus hair ratio. Regarding the total hair count, the median count was 164, 135, 155, and 176 respectively, with a P value less than 0.001. In the BTA group, 53.3% and in the minoxidil group, 66.7% had an improvement in the total hair count from baseline to 20 weeks. There was significant negative correlation between the terminal hair percent of change (between baseline and 20 weeks) and age in both groups, in BTA group (p = 0.004) and in minoxidil group (P = 0.049). In BTA group, there was significant negative correlation between duration of AGA and % of change from baseline to 20 weeks regarding total count (p = 0.048). Digital and dermoscopic images were taken for AGA patients included in the study, to demonstrate their progress at different treatment times.

Conclusion

Both intradermal botulinum toxin A and intradermal minoxidil are equally effective treatment modalities of AGA. They are advantageous due to minimal invasiveness and absence of major side effects. Minoxidil is of an affordable cost compared to BTA, therefore, can be considered to be more cost-effective.
Efficacy and Safety of Biologic Therapies for Treatment of Psoriasis: A Systematic Review and Observational Meta-Analysis
Authors: Naeem Sallam Mohamed Abd El , Hafeez Elsayed Zeinab Abd El , Elhusseiny Rania Mahmoud , Mohamed Tamer Mohsen , El Fatah Abouzeid May Mohsen Abd
Published: November 2024

Background

Psoriasis is a chronic, systemic, immune-mediated inflammatory skin disease of unknown etiology, however, several cytokines were reported to share in the pathogenesis of psoriasis as IL-12, IL- 23 and TNF-α. Biologics targeting these cytokines showed effective results in treatment of psoriasis patients. However, long term efficacy and tolerability of these agents is still questionable.

Objective

To compare the efficacy and safety of anti-TNF alpha, anti IL12/23, anti IL17, anti IL23 in moderate to severe psoriasis over long periods of treatment in order to complete the efficacy and safety profile of biologic therapies.

Patients and Methods

We searched ClinicalTrials.gov register (www.clinicaltrials.gov) up to July 2022 with the following search terms: psoriasis AND one by one each biologic therapy name listed in types of interventions.

Results

Regarding rate of PASI 75 at year 1, IL-12/23 inhibitors have a greater probability of achieving a PASI 75 response than anti-TNF alpha, with the pooled PASI 75 estimate at 84% and 76.18%, respectively. While, regarding rate of PASI 75 at year 2, 3, 4 and 5, there are no studies that assess the PASI 75 at year 2 or more for anti-TNF. The PASI 75 at years 2, 3, and 5 for IL- 12/23 inhibitors appeared to be stable at about 80 %, while it reached 91% at year 4. Rate of serious infections was 2.9% and 2.4% with anti-TNF alpha and IL-12/23 inhibitors respectively. There was showing no significant difference in the risk of serious infection between the two classes. In the current study, the rate of malignancy showed no-significant difference in psoriatic patients as patients receiving anti-TNF-alpha had 3.7% rate while in patients receiving IL 12/23 inhibitors the rate was 3.9%.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023.

Conclusion

In the current meta-analysis we compare the efficacy and safety of anti-TNF alpha and anti IL12/23 in moderate to severe psoriasis over long periods of treatment in order to complete the efficacy and safety profile of biologic therapies. IL-12/23 inhibitors have a greater probability of achieving a PASI 75 response than anti-TNF alpha. There was no significant difference in the risk of serious infection or rate of malignancy between the two classes. Moreover, there was insignificant risk of MACEs with IL12/23 inhibitors and a slight increased risk with anti-TNF alpha. There was significant rate of common adverse events in patients receiving anti-TNF-alpha compared to patients receiving IL 12/23 inhibitors.
Efficacy of Non-cross Linked Hyaluronic Acid Injection versus Platelet Rich Plasma Injection in Treatment of Sexual Dysfunction Caused by Vulvo-vaginal Atrophy in Post-menopausal Females and Their Impact on Sexual Satisfaction
Authors: Shawki Mikhail Sylvia Ragy , Kahky Hanan El , Elfakkar Nehal Mohammed Zu , Elhusseiny Rania Mahmoud , Mohamed Nassar Salma Ashraf
Published: November 2024

Background

Sexuality in women is a relatively new field of bio-medical research. The prevalence of female sexual dysfunction among postmenopausal women approaches 50% with vulvovaginal atrophy being a cardinal sign in most post females among this age group. For decades hormone replacement therapy was the only solution to get rid of symptoms associated with this atrophy. However, hormone replacement therapy was limited by its serious side effects, raising the need for new treatment strategies with less side effects.

Objectives

The aim of this study is to compare between the efficacy and safety of non-cross linked hyaluronic acid injection (HA) versus autologous platelet rich plasma (PRP) injection into the vagina and labia majora of post- menopausal females presented with vulvo-vaginal atrophy to improve female sexual dysfunction.

Methods

Twenty post menopausal female patients presenting with vulvovaginal atrophy were enrolled in this study. Patients were randomly divided into two groups, 10 patients in each group. The first group received non cross linked hyaluronic acid injection into the labia majora and the vagina, however the second group received platelets rich plasma injections in the same sites as the first group. Subjective assessment was carried out in the form of female sexual function index questionnaire, female sexual distress scale revised questionnaire, index of sexual satisfaction for the female and male partner and global aesthetic improvement scale. Objective assessment was carried out by measuring the labia majora length and reviewing the histopathological changes occurring in the vulva through skin biopsies taken before and after treatment. Estimating the change in vaginal was thickness was done through performing transvaginal ultrasound.

Results

Non cross linked hyaluronic acid as well as PRP were found to be effective and safe in the treatment of post menopausal vulvovaginal atrophy. However, HA showed more significant improvement in female sexual function index (P < 0.01) and significantly higher couple satisfaction as assessed by index of sexual satisfaction (P < 0.05). There was also higher values in vaginal wall thickness as measured by transvaginal ultrasound in favor of HA injected group. Histopathological assessment showed more changes in papillary dermis in HA treated group. No complications were reported in both groups

Conclusion

There was a great need for non hormonal therapies for post menopausal females. Both non cross linked hyaluronic acid and PRP were effective in relieving symptoms of vulvovaginal atrophy. However, non cross linked hyaluronic acid showed more patient and over all couple satisfaction. It also showed more improvement in histopathology and ultrasound assessments.
Hypericin Mediated Photodynamic Therapy (HY-PDT) versus Methylene Blue Mediated Photodynamic Therapy (MB-PDT) in Treatment of Common Warts: A Comparative Study
Authors: Omar Zulfa Mohammad Ahmad , Fathy Ghada , El-Samahy Mai
Published: November 2024

Background

Many therapeutic modalities are available for the treatment of warts, but no single therapy is universally effective. Warts can resolve, recur, shrink, or grow despite therapy.

Aim of the Study

to compare between the efficacy and safety of topical hypericin (HY)-mediated photodynamic therapy (PDT) and methylene blue (MB)-mediated PDT in the treatment of common warts.

Patients and Methods

The study included 40 patients subdivided into two groups (20 patients each). Group one (MB group) patients were treated with topical MB/IPL PDT. Group two (Hypericin group) patients were treated with topical HY/IPL PDT. Patients were assessed using digital photography and dermoscopic examinations.

Results

MB-mediated PDT group showed that there was significant difference regarding the decrease of size of warts before versus after MB-mediated PDT. HY- mediated PDT group showed that there was a significant difference regarding the decrease of size and number of warts before versus after HY-mediated PDT. There was better response with HY-mediated PDT compared to MB-mediated PDT without statistical significance.

Conclusion

Both HY and MB-mediated PDT are effective in clearing common warts. Hypericin is a promising photosensitizer alternative that has a potential efficacy for clearing wart by PDT.
Efficacy of Autologous Cartilage Augmentation of Posterior Pharyngeal Wall in Management of Velopharyngeal Insufficiency A Meta-Analysis study
Authors: Samny Talat Ali Hassan El , Askoura Anas Mohamed Ali Nasr , Kamel Abdel Aty Ahmed Mohamed , Hosney Akram Hany Mohammed
Published: November 2024

Background

Velopharyngeal dysfunction is a disorder of the velopharyngeal sphincter or valve, which functions to separate the nasal and oral cavities during speech, swallowing, vomiting, blowing, and sucking. When the soft palate and pharyngeal walls are unable to form an effective seal, an abnormal connection between the nasal and oral cavities leads to hypernasal speech, increased nasal resonance, nasal regurgitation, nasal emission, and decreased intraoral pressure during speech. The overall result is decreased speech intelligibility and significant functional and social impairment.

Objective

To assess the efficacy of autologous cartilage augmentation of posterior pharyngeal wall in the treatment of velopharyngeal insufficiency.

Patients and Methods

An electronic database search (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted with the goal of identifying all available studies related to use of cartilage graft in posterior pharyngeal wall augmentation in Velopharyngeal insufficiency to 2022.

Results

Rate of improvement in nasal hyper resonance was 82%. Rate of improvement in speech intelligibility was 85%. Rate of improvement in velopharyngeal closure was 76%. Rate of improvement in nasal emission was 61%.

Conclusion

We conclude that cartilage augmentation of posterior pharyngeal wall is appropriate for patients with minimal velopharyngeal gap and is effective for improvement of velopharyngeal closure and speech.
Development of a Screening Tool for the Impact of Children’s Feeding/Swallowing Problems on Their Caregivers
Authors: El Fattah Elattar Marwa Mahmoud Abd , Nassar Jilan Fouad , Khattab Ahmed Nabil , ElFiky Yomna Hassan
Published: November 2024

Background

Health-Related Quality of Life (HRQOL) has been established as an important gauge of patient-based health outcomes. It has emerged as an important health outcome in clinical trials and healthcare research, for which HRQOL assessment instruments have played an important role.

Aim of the Work

the aim of this study is to develop a screening tool to measure the impact of children’s feeding/swallowing difficulties on their caregivers, as understanding the specific concerns of these caregivers may provide health care providers and funding sources with information about management recommendations and this ultimately improves the care provided.

Patients and Methods

This study is a cross-sectional study, the 26-item Arabic Egyptian Feeding/Swallowing Disorder Impact Questionnaire (AEFSDIQ) was administered to 150 caregivers whose children complaining of feeding/swallowing disorders and coming to our Phoniatrics unit for first evaluation or follow up.

Results

Validation of the Caregiver Impact Questionnaire was done. Internal consistency reliability of the full scale was demonstrated by Kuder-richardson KR20 Reliability coefficient and it was equal 0.744 which indicated that the constructed questionnaire homogenous and is likely to produce consistent responses, which proved good reliability of the questionnaire.

Conclusions

This study presents a comprehensive, valid and reliable tool that can assess the impact of feeding/swallowing disorders on their caregivers. Caring for these children adversely impacts the QOL of caregivers. Clinicians can deliver better services by identifying and paying appropriate attention to factors that influence the QOL of caregivers of children with feeding/ swallowing problems.

Recommendations

From the course of the present study, we recommend that further multicenter studies with larger sample size could be of value for assignment of this questionnaire.
Efficacy of Nasal Steroid Irrigation in Chronic Rhinosinusitis after Sinus Surgery: A Meta-Analysis Study
Authors: El-Gabry Merna Mostafa Mohamed , Sabry Sabry Magdy , Fawzy El-Beltagy Yasser Mohamed , Teaima Ahmed Abdelmoneim
Published: November 2024

Background

Chronic rhinosinusitis (CRS) is a frequent multifactorial inflammatory disorder that ranges from single sinus disease to extensive sinonasal airway inflammation that reduces the patient's quality of life. The goal of CRS treatment is to decrease infectious exacerbations while controlling inflammation.

Methods

We conducted a meta-analysis study to assess the efficacy of nasal steroid irrigation in CRS after sinus surgery. This study included published medical articles from 1990 till 2023 concerning the efficacy of nasal steroid irrigation in CRS after sinus surgery through the Medline data base (PubMed), Web of science, Springer, Cochrane library, EMBASE.

Results

Sixteen studies (n = 678) met the inclusion criteria and were reviewed and analyzed. Nasal steroid irrigation resulted in statistically highly significant improvement (p < 0.01) in both SNOT and LKES at 6 and 12 weeks, and 12 months evaluation after surgery, in SNOT only at 6 months evaluation and in LKES only in 2 weeks evaluation. The improvement in SNOT was statistically significant (p = 0.04) at 2 weeks evaluation, however, there was no statistically significant improvement (p = 0.18) in LKES at 6 months evaluation after surgery. When compared to saline alone irrigation, steroid irrigation resulted in highly statistical improvement in (p < 0.01) in SNOT at 6 weeks and in LKES at 2 weeks and 12 weeks evaluation. It also resulted in statistically significant improvement in SNOT at 2 weeks (p = 0.01) and 12 weeks (p = 0.02) and in LKES at 6 weeks (p = 0.01) and 12 months (p = 0.02), However the improvement wasn’t statistically significant at 6 months (p = 0.35) and at 12 months (p = 0.95) in SNOT and at 6 months (p = 0.10) in LKES.

Conclusion

The addition of steroid to normal saline for nasal irrigation in CRS patients who underwent functional endoscopic sinus surgery is more effective than saline alone irrigation both subjectively and objectively over short-term follow-up visits.
Role of Transoral Robotic Surgery in Treatment of Oropharyngeal Carcinoma
Authors: Al Kahky Ayman Mohamed Othman , Hassan Mohamed Amir , Maarouf Ahmed Mahmoud , Aziz Shafei Hamza Rania Mohamed Abdel
Published: November 2024

Background

Transoral surgery in the oropharynx is a surgical strategy for directly accessing and resecting oropharyngeal tumors through the mouth. Direct access to the tumor, as opposed to transcervical approaches, helps avoid the morbidity of open approaches and thus allows for faster recovery of the functions, the most important of which is swallowing.

Aim of the Work

The aim of this work is to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS) and long term oncologic and the functional outcomes of TORS in treatment of oropharyngeal carcinoma by doing a meta-analytical study.

Materials and Methods

This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. This meta-analysis was conducted to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS), and long-term oncologic and functional outcomes of TORS in the treatment of oropharyngeal carcinoma. We enrolled 12 studies that studied the outcome of TORS surgeries of oropharyngeal carcinoma patients. These studies contained 4460 patients with 3688 male patients and 772 female patients with a male-to-female ratio of 5.1/1.

Results

Our meta-analysis showed that the pooled (disease free survival rate) in random effect model was 86.2% and in random effect model pooled (overall survival rate) was 90.3%. Our meta-analysis showed that in oropharyngeal carcinoma patients in random-effects models the pooled (local recurrence rate) was 2.6%, for regional recurrence rate was 3.5% and for distant recurrence rate was 3.2%.

Conclusion

These findings showed that TORS had a better locoregional control rate than different treatment modalities. this difference was due to differences in tumor stage and site in different studies and used techniques. Regarding the prolonged gastrostomy tube dependence rate, this meta-analysis showed that the rate was 6.1% in the random-effects model.
Factors Affecting Adherence to Medications among Type2 Diabetic Patients Attending Primary Health Care Center in Cairo
Authors: Salama Hemat Abd El-Salam Ahmed , Shaltoot Heba Mohamed Hamed , Abdul-Rahman Samia Ahmed , Abd El-Hamid Diaa Marzouk
Published: November 2024

Background

Poor adherence to medications is a major public health problem. Non-adherence results in disease progression, reduced functional abilities, a lower quality of life, waste of medication and increase use of medical resources such as nursing homes, hospital visits and hospital admissions.

Objective

To measure the prevalence and factors affecting adherence to medications among T2DM patients attending primary health care center of Saraya El Quobba. To measure the agreement between MTA (Measure Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires as a tool of measurement treatment adherence.

Methods

A Cross sectional study was carried out in family medicine center of Saraya El Qubba in Cairo on 130 participants who had been diagnosed T2DM at least3 months before. Patients with T1DM, Patients with known history of psychiatric illness or cognitive impairment, Patients with communication problems such as aphasia, severe hearing or visual impairment were excluded. Selection of participants was done through Systematic Random Sampling. Data about adherence was collected using structured questionnaires MTA (Measurement Treatment Adherence) and ARMS (Adherence to Refills and Medications Scale) questionnaires.

Results

62.6% of our sample were females, 38.9% belonged to age group of 60-70 years, 71.8% were married, 29% had intermediate education, 61.8% were unemployed. The level of adherence among patients attending primary health centre of Saraya El Quobba was 65.6%. Many factors were found to affect medication adherence as regular monitoring of blood glucose level (76.7%), regular follow up visit (75.9%), presence of family support (20.6), monthly income (84.2%) and educational level. There was a statistically significant strong negative correlation between the 2 measurements scores (r=-0.8644, p < 0.001).

Conclusion

The level of adherence was high among the participants in the current study. Many factors were found to affect medication adherence as regular monitoring of blood glucose level, regular follow up visit, presence of family support, monthly income, both high and low educational level. Agreement between to questionnaires was found.
The Effect of Probiotic Lactobacillus acidophilus on the Management of Symptoms, Duration, and Disease Progression in Mild and Moderate COVID-19 Cases: A Randomized Controlled Clinical Trial
Authors: Hassan Samar Osama Ahmed , El-Din Hassan Ahmed Nour , Mohamed Manal Sabry , Al Ashram Mohamed Nabil Badawy , Nesim Mina Michael , Allam Mohamed Farouk
Published: November 2024

Background

COVID-19, a recently identified human disease resulting from a novel coronavirus, has led to a worldwide pandemic crisis. Considering their antiviral, anti- inflammatory, and immunomodulatory effects, probiotics emerge as potential treatment options.

Objective

To evaluate the efficacy of probiotic supplements, specifically Lactobacillus acidophilus, in managing symptoms, duration, and the progression of mild and moderate COVID-19 infections.

Methods

A randomized controlled clinical trial was conducted at the triage clinic of the Family Medicine Department at Ain Shams University Hospitals, involving 100 participants diagnosed with mild and moderate COVID-19 severity. Excluded from the study were individuals below 18 or above 65 years old, those with any co-morbidity, pregnant or lactating females, and confirmed cases of severe COVID-19. The randomization process involved sealed envelopes containing codes for either the intervention or control group. Patients are monitored for the alleviation of their symptoms, with attention to the absence of new symptoms emerging throughout a two-week period.

Results

The study included 100 patients with mild and moderate COVID-19 severity, evenly distributed with 50 patients in each group. Approximately one-third of participants were aged between 29 and 39 years, one-quarter were between 18 and 28 years, and 40.6% were aged 40 years and above. The average duration for symptom improvement was 11 days in the probiotic group and 12 days in the control group. Both groups exhibited improvement in inflammatory markers over time, with no statistically significant difference between them.

Conclusion

Probiotic Lactobacillus acidophilus demonstrates no substantial impact on the symptoms, duration, and progression of mild and moderate cases of COVID-19.
Sex Determination by Analyzing Morphometrics of Sella Turcica, Foramen Magnum and Mastoid Process Using Head and Neck Multislice Computed Tomography in Egyptian Population
Authors: Kamaleldin Omar N , Abdelaal Seham F , Abdelrahman Hazem I , Elsayed Emad A
Published: November 2024

Background

Identification of unknown individuals is fundamental in forensic studies, and is based upon the determination of sex, age, ethnicity and stature of individuals. Sella turcica, Foramen magnum and Mastoid processes can be used in forensic medicine to aid sex identification of living humans and their remains in severe conditions as mass disasters due to their position in the basicranium, which has a resistant nature and is a commonly preserved part of the human skeleton.

Aim

This study aimed to analyze and compare the parameters of the Sella Turcica, Foramen magnum and Mastoid processes for sex determination in adult and child Egyptian samples.

Methods

This is a Comparative cross-sectional study involving 120 Egyptian patients divided into 60 Adult cases and 60 Children cases, conducted in Radiology department - Ain Shams University Hospitals in Cairo, Egypt during the period from the beginning of August 2021 to the end of July 2022. Each group is subdivided into 30 males and 30 females. The Sella turcica, Foramen magnum and Mastoid processes parameters in multislice Computed Tomography (MSCT) scans were measured in all the cases, and findings were tabulated.

Results

The current study showed a significant statistical difference between males and females in adult cases as regards the anterior-posterior (A-P) diameter of sella turcica, the maximum width of the foramen magnum (FMW), the foramen magnum area (FMA), the maximum length of the right occipital condyle (LROC), the maximum length of the left occipital condyle (LLOC) and the mastoid area (P value<0.05). In children cases there was a significant statistical difference between males and females as regards the Sella turcica length, the Sella turcica depth, (A-P) diameter of Sella turcica, the maximum foramen magnum length (FML), FMA and LLOC (P value<0.05). the present study showed that the best single parameter in determining the sex of adult cases is mastoid area, and in children cases is FML.

Conclusion

A-P diameter of sella turcica, FMW, FMA, LROC, LLOC and mastoid area are more efficient than other parameters in determining the sex of adult cases, while the Sella turcica length, depth and A-P diameter, FML, FMA and LLOC are more efficient than other parameters in determining the sex of children cases.

Recommendation

Further studies are needed to assess the correlation of the Sella turcica, Foramen magnum and Mastoid process parameters with age and other ethnic groups with a larger sample size.
Evaluation and Comparison of the Accuracy of Nolla and Demirjian Methods for Age Estimation in a sample of Egyptian Children Using Panoramic Radiographs (A Retrospective Study)
Authors: El-Gaidy Sara A , Ramadan Magda M , Salem Hanan E , El-Oefy Omnia S , Bayoumy Raghdaa A
Published: November 2024

Background

Age estimation is an important procedure in forensic field. It is very crucial for the identification of both living and dead persons. For living it is performed in circumstances where the birth certificate is not available or the records are suspicious. This could be of value in civil conflicts e.g. marriage, employment, military recruitment, inheritance and adoption. Also it is important in criminal cases involving rape, kidnapping and illegal immigration, as well as for medical cases as pediatric endocrinopathy and orthodontic malocclusion. Age estimation of cadavers is performed in criminal cases, as well as for identification of mutilated victims of mass disasters, such as fires, crashes, accidents, feticides, homicides and infanticides.

Aim

Estimation the age of a sample of Egyptian children through using both Nolla and Demirjain methods, Comparison of these ages with their chronological ages and then assessing the accuracy of these methods in age estimation.

Methods

A retrospective study was performed on panoramic radiographs of 180 subjects aged less than 6–16 years. The mean dental age (DA) according to the Demirjian and Nolla methods were compared to the mean chronological age (CA).

Results

The mean CA of the study sample was 9.90±2.71 and 9.40±3.23 years for females and males, respectively. Using the Demirjian method, the mean estimated DA was 9.38±2.09 years for females and 9.77±3.01 years for males. For Nolla method, the mean estimated DA was 8.48±1.79 and 9.07±2.77 years for females and males, respectively. The mean differences between the CA and DA according to the Demirjian were -0.52 and 0.37 years for females and males, respectively. For Nolla method the mean differences were -1.42 and -0.33.

Conclusions

Nolla method was found to be a more accurate method for estimating DA in Egyptian population. The predictive ability of Nolla method by linear regression analysis was 98%.
Physicians' Knowledge, Attitude and Practice Regarding Medical Errors: Cross Sectional Study in Governmental Hospitals in Cairo
Authors: Hamed Hanan , Azab Sonya M S , Talaat Walaa , Hassan Shaimaa
Published: November 2024

Background

Medical errors are inevitable events in almost all healthcare settings and represent a major source of morbidity and mortality throughout the world. In Egypt, medical error is one of the most distressing issues facing the physicians due to absence of settled laws regarding medical malpractice litigations and unjustified social media which flare up any medical error without scientific criticism of the case. This study aimed to assess physicians’ knowledge and attitude toward medical errors and their reported incidence of medical errors and their leading factors.

Methods

This cross-sectional study was conducted on physicians working in governmental hospitals in Cairo, with duration of work experience equal or more than two years. An online self-administered structured questionnaire was used for data collection.

Results

The study included 580 physicians, with different specialties. There was no significant difference either in knowledge or practice score between the respondent physicians according to their personal characteristics. Diagnostic errors were the most common errors reported by the participants (either missed diagnosis 73.4%, delayed diagnosis 71.3% or wrong diagnosis 58.4%); followed by failure of communication (between medical staff 53.4% and with the patient 47.5%). Incidence of infection or contamination was the most reported surgical error (32.5%) and inadequate preoperative assessment and/or preparation of patient was the most common anesthetic error (27.7%). Regarding the resulting damage from the errors, 7.8% of the participants reported incidence of patient’s death, 4.7% of them reported incidence of severe physical damage, 26.6% reported by mild-to - moderate physical damage and 31.7% of them reported financial damage. Most of them reported defensive medicine practices.

Conclusions

Participants’ knowledge about medical responsibility was insufficient. Although most of them reported incidence of medical errors, they recommended establishment of guiding system helping them to disclose incidence of errors and taking actions to prevent them in the future.