bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the Acute Hemodynamic Effects of Inhaled Milrinone versus Inhaled Nitroglycerin on Mechanically Ventilated Patients with Pulmonary Hypertension after Mitral Valve Replacement Surgeries
Authors: Sultan Sherif Sayed Ali , Mostafa Wafaa El-Sayed Ismael , El-Komos Samaan Paula Micheal , Hassan Ahmed Kamel Abdel Ghany , Saeed Ahmed Sarhan Farag
Published: August 2023

Background

Pulmonary hypertension is a usual complication of long-standing mitral valve disease. Perioperative pulmonary hypertension is a risk factor for right ventricular failure and is an important cause of morbidity and mortality in patients with pulmonary hypertension undergoing mitral valve surgery.

Aim of the Work

To compare inhaled milrinone and inhaled nitroglycerin hemodynamic effects on mechanically ventilated patients with pulmonary hypertension after mitral valve replacement surgery by measuring invasive blood pressure, heart rate, central venous pressure and bedside transthoracic echocardiography to assess pulmonary artery pressure.

Patients and Methods

The study was conducted in National Heart Institute, Giza, Egypt during the six months between October, 2020 and March, 2021. This study was conducted on 40 patients. Patients were randomized on the basis of computer-generated random numbers into two equal groups (20 patients each) Using PASS11 program for sample size calculation. In group A, patients received inhaled nitroglycerin (50 µ/kg) and in group B, patients received inhaled milrinone (50 µ/kg) through jet nebulizer.

Results

Both inhaled milrinone and inhaled nitroglycerin proved to be selective pulmonary vasodilators, since they induced significant reductions in mPAP, SPAP, and DPAP. The favorable effects of both agents on the pulmonary vasculature was confirmed by both hemodynamic and echocardiographic measurements. At the same time, both agents were devoid of systemic side effects, since mean arterial pressure, systolic arterial pressure and diastolic arterial pressure were not affected.

Conclusion

There was no significance between two groups, so inhaled nitroglycerin appears to be an effective, easy to administer, inexpensive, available and save alternative for treatment of PH in mechanically ventilated patients after mitral valve replacement surgeries as there was no significance between two groups.
Ketofol Infusion versus Isoflurane as Maintenance of Anesthesia on Hemodynamics in Radical Cystectomy Operation
Authors: Amir Mina Noshy , Nasr Nermin Sadek , Anis Sherif George , Emam Dalia Fahmy
Published: August 2023

Background

radical cystectomy is a major operation where bleeding from sacral plexus during dissection of the bladder may occurs leading to hemodynamic instability and organ ischemia due to hypo perfusion. So using anesthetic drugs that provide hemodynamic stability will decrease intraoperative and post-operative morbidity and ICU and hospital stay.

Objectives

The Aim of this study is to compare the effect of anesthetic agent ketofol infusion versus isoflurane inhalation on hemodynamics in maintenance of anesthesia in radical cystectomy operation as a primary outcome and recovery time as a secondary outcome.

Methods and material

This prospective randomized clinical trial study was conducted in Ain Shams University hospital after approval of the anesthesia department and the local ethics and research committee over 6 months and after obtaining a written informed consent. Sixty patients underwent radical cystectomy were included in the study their ages range between 50 and 70 years old and classified as ASA I and II, III. The patients were randomly divided using computer generated randomization into two groups 30 patients in each (n = 30), Group I received isoflurane inhalation while group K received Ketofol infusion.

Results

this study demonstrated that maintenance of anesthesia by ketofol infusion provides more hemodynamic stability with maintaining of blood pressure and heart rate rather than isoflurane inhalation.

Conclusions

We conclude that maintenance of anesthesia with ketofol infusion provides more hemodynamic stability and least intraoperative and postoperative morbidity than isoflurane inhalation in patients undergoing radical cystectomy.
Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Open Appendectomy
Authors: Abo-EL Ela Sahar Kamal , Nofal Walid Hamed , Haggag Adham Magdy , Samee Mohamed Ayoub Abdel
Published: August 2023

Background

The transversus abdominis plane (TAP) block has been used for post-operative pain relief in various abdominal surgeries as part of the multimodal analgesic approach. It creates satisfactory somatic analgesia with insignificant or no visceral blockade.

Aim of the Work

The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with TAP block during appendectomy surgery and in the early postoperative period regarding pain relief, provision of comfort, and improved respiratory functions.

Patients and Methods

After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, patients were included in the study, and were divided into two groups (n = 25; each); group QLB and group TAP. Group QLB: Patients (n = 25) of this group received right side ultrasound-guided QLB after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.25%. Group TAP: Patients (n = 25) of this group received right side ultrasoundguided TAP block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.25%.

Results

The study's results show the differences in the analgesic efficacy between US guided QL block & TAP block which are as follow: The patient group that had TAP block as analgesia for appendectomy require higher level of analgesia post op, this can be explained by the fact that the average MBP of this group is predominently higher than in QL group, as well as SBP & DBP differences are evident & higher in TAP block group. The patients HR as a response to pain is significantly high in TAP block group. This was clearly reflected on the time for the first time analgesia needed postoperative, the TAB block group needs analgesia faster & needs more doses of Pethidine. The VAS score is also higher in QL group.

Conclusion

Quadratus lumborum block was more effective technique in providing analgesia after appendectomy in comparison to transversus abdominis plane block and even more time covering to rescue opioid.
Off Pump CABG Improves Postoperative Incidence of Coagulopathy Compared with CABG on Pump
Authors: Hammad Mohamed Ibrahim Moustafa , Foad El-Bokl Fekry , Eltaher Walid Mohamed Abd -Elmigeed , Shorbagy Mohamed Sied
Published: August 2023

Background

Coronary artery bypass grafting remains the standard treatment for patients with extensive coronary artery disease. Coronary surgery without use of cardiopulmonary bypass avoids the deleterious systemic inflammatory effects of the extracorporeal circuit. However there is an ongoing debate surrounding the clinical outcomes after on-pump versus off-pump coronary artery bypass (ONCAB versus OPCAB) grafting surgery.

Aim of the Work

To compare the incidence of postoperative coagulopathy transfusion of blood product therapy, (Packed RBCs, FFP and platelet concentrate) bleeding (amount of blood in chest tube drains) and reexploration, that occur in adults off pump CABG surgery in comparison to on pump CABG.

Patients and Methods

We enrolled sixty consecutive adult patients scheduled for isolated CABG surgery (with a median sternotomy) with or without cardiopulmonary bypass pump. The patients are allocated in two groups where thirty patients in each group (group A – On pump – ONCAB- conventional surgery) and (group B – Off pump – OPCAB – beating heart) after obtaining their written informed consent.

Results

The clinical outcome measure was the incidence of bleeding in group B less than group A. In our study there was highly significant increase in the amount of blood in drains, transfusion requirements and need for re-exploration within twenty four hours after surgery in group A than group B.

Conclusion

We concluded that off pump cardiac surgery is better than on pump procedure in decreasing risk of bleeding, post-operative transfusion requirements and risk of re-exploration.
A Comparative Study of Transversus Abdominis Plane Block versus Quadratus Lumborum Block for Postoperative Analgesia following Lower Abdominal Surgeries
Authors: Ali Naglaa Mohamed , Ahmed Ibrahim Mohamed Elsayd , Helal Nada Mousa Osman
Published: August 2023

Background

Operations rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization.

Aim of the Work

This work aims to compare the efficacy of Transversus Abdominis Plane (TAP) Block versus Quadratus Lumborum 2 (QL 2) Block on postoperative period regarding pain control, total opioid given in the first 24-hour post-operative, VAS score and first time to ask for analgesia in patients undergoing lower abdominal surgeries.

Patients and Methods

After approval of the anesthesiology department and scientific and ethical committees, this Randomized controlled trial study was conducted in Ain Shams University Hospitals. Forty patients scheduled for elective lower abdominal surgeries were included in this study. The patients' age was ranged from 21 to 65 years and with the American Society of Anesthesiologists (ASA) Class-I and II. At the end of the surgery, patients were randomized using a random number table and the use of a closed envelopes technique to receive either quadratus lumborum block (Group QLB), or TAP (transversus abdominis plane) block (Group TAP), each group constitutes of 20 patients.

Results

In this study, the effect of quadratus lumborum block and transversus abdominis plane block result of decreased incidence and severity of postoperative pain (VAS) resulting in decrease in incidence and degree of sedation and opioid total requirement. The present study showed that the quadratus lumborum block was more efficient than the tansversus abdominis plane block. The first rescue for analgesia (pethidine), total pethidine consumption and pain scores (visual analog scale) indicated that the superiority of the QL block technique affected the TAP block technique. The patients of group TAB had higher pain scores and were the first to ask for rescue analgesia; therefore, they had highest total pethidine consumption in the first 24 hours postoperatively in comparison to patients of group QLB. This is mainly due to the extension of the local anesthetic agent beyond the transverse abdominal plane to the thoracic paravertebral space, which then results in more analgesia, even somatic and visceral pain control.

Conclusion

Quadratus lumborum block was the most effective technique in providing analgesia after lower abdominal surgeries in comparison to transversus abdominis plane block and even more time covering to rescue opioid.
Impact of High Glucose on Sorafenib Resistance in HepG2 Cell Lines
Authors: Esawie Mohammed Sayed , Ali Hebatalla Said , Louka Manal Louis , Hasanin Amany Helmy Mohamed
Published: August 2023

Background

Sorafenib is an FDA approved chemotherapeutic against Hepatocellular Carcinoma (HCC), yet associated with various resistance mechanisms. The role of high glucose status on sorafenib action is still to be elucidated. This study clarifies such interaction; taking HepG2 cell lines as HCC models, MALAT1 and H19 as molecular players. Methodology: HepG2 cell lines were purchased and classified into 8 groups. High glucose status was set by using D-glucose (33 mM) with insulin (1 µM). Mannitol (27.5 mM) was used as a negative osmotic control. Two concentrations of sorafenib were prepared; 15 µM and 20 µM. All experiments were carried out in triplicates. Cellular viability was assessed with MTT viability assay. Then, with trypan blue viability assay, the results were double checked and HepG2 morphology was examined by optical microscopy. MALAT1 and H19 RQs were assessed by real time PCR (RT-PCR). Statistical analysis was performed by SPSS software.

Results

In comparison with sorafenib impact on HepG2, high glucose status drops cellular viability to 72.89% (p < 0.01). Similar outcomes occur with hyperosmolar mannitol, it decreases cellular viability to 83.13% (p < 0.001). Regarding the molecular impact, hyperosmolar mannitol with sorafenib elevates both MALAT1 and H19. Yet, high glucose status elevates MALAT1 and declines H19 (p < 0.05 and p < 0.001 for MALAT1 and H19 comparisons respectively).

Conclusion

High glucose settings sensitize HepG2 to the cytotoxic impact of sorafenib and so does mannitol. This could attribute the impact of high glucose status to the hyperosmolar stress it induces on HepG2. Mannitol is recommended for further confirmatory studies either as a separate therapeutic or as an adjuvant to sorafenib.
The Efficacy of Corticosteroids in the Management of Tietze Syndrome: A Randomized Controlled Trial
Authors: El-sayed Hany Hassan , Ismail Ihab Abdel-Razik , Ibrahim Mohamad Abdel-Gayed , Warda Ali Mohamad Ali
Published: August 2023

Background

So far there are no clinical trials in the literature discussing the methods of treatment of Tietze‟s syndrome. Particularly, conservative methods of treatment are used, which include pain management using analgesics and nonsteroidal anti-inflammatory drugs. Oral corticosteroids offer a safe and effective treatment modality that is proven to be useful in a significant number of chest wall syndromes such as Sternoclavicular arthritis, Painful xiphoid syndrome, Costovertebral arthritis, and Slipping rib syndrome as well as conditions arising from ligament and tendon diathesis.

Objective

To use oral Corticosteroids in management of patients with Tietze syndrome at Ain shams university hospitals‟ cardiothoracic department and measuring the outcome randomly compared with the conventional NSAIDs to achieve the best outcome and quality of life.

Methods

This study included 40 patients who were diagnosed clinically as Tietze Syndrome at Ain Shams University Hospitals-cardiothoracic department in the duration between August 2020 till March 2022 with age ranging from 14 to 45 years and were sorted randomly. Two groups of patients were chosen and matched randomly as „Control arm‟ and „Interventional arm‟. The control group received the conventional NSAIDs (in the form of 50 mg of diclofenac potassium as „cataflam‟ twice daily) and the Interventional group received oral corticosteroids (in the form of 20 mg of prednisolone as „solupred‟ twice daily).

Results

Our study suggested that in patients with moderate to severe chondritis diagnosed clinically as Tietze syndrome, a 3 week course of oral 40 mg prednisolone is superior to the conventional oral NSAIDs in alleviating pain and improving the quality of life which is evidenced by the decline in EQ-5D total score of patients receiving oral steroids at the end of the treatment course as well as during each week throughout the trial timeframe. A highly significant reduction in pain score demonstrated via NRS was evident in the steroid-treated group compared to the NSAIDs-treated group at the same time point.

Conclusion

Oral corticosteroids are effective and safe in non-responding, obstinate Tietze syndrome. The results were unexpectedly good, obtaining significant relief and an outstanding refinement in quality of life reported by patients receiving oral steoids. There is no widely accepted protocol for oral steroid usage in Tietze syndrome and similar chest wall pain syndromes. Some other studies propose surgery in such patients. We think that surgery is a troublesome intervention for the patient and his doctor as well.
Impact of Regional Network on the Management of STEMI Patients in North Cairo
Authors: Saleh Atef K , Guindy Ramez R , Shahin Sameh M , Okasha Nireen K , Abdalhamid Mohammed A , Fakhry Hany M
Published: August 2023

Background

Worldwide, coronary artery disease (CAD) is the single most frequent cause of death.

Over seven million people every year die from CAD. The management of patients with STElevation myocardial infarction (STEMI) is influenced by health care service organizations. Regional STEMI networks for acute myocardial infarction facilitate primary percutaneous coronary intervention (PPCI) and its efficacy in reducing mortality and improving its outcomes.

Aim of the Work

The aim of the present study was to examine the impact of regional STEMI network on patients' management and on hospital outcomes in north Cairo governorate, Egypt.

Methods

The present study is a Prospective observational multicenter study that was conducted on 352 patients with STEMI and symptom onset within 48 hours who presented to north Cairo hospitals. The patients were divided into 2 groups, group I in the first six months before establishment of a network between the north Cairo hospitals and group II in the second six months when the network between those hospitals was activated. Comparison was done between the two groups as regards patients' demographics, logistics of presentation and in hospital outcomes.

Results

The number of patients upon implementation of STEMI network increased from 140 to 212 (51.4%) to the same hospitals with the same facilities and in equal periods of time (6 months). It was found that the mean time of chest pain to first medical contact (FMC) between the two groups before and after establishment of STEMI network did not change, it was 4 hours in both groups (P = 0.36) while the mean door to balloon time improved from 54.3 to 44.1 minutes (P = 0.01). In our study thrombolytic therapy use declined from 36.4% before STEMI network set up to only 7.5% (P > 0.001), Ejection fraction (EF) improved from 51.3% to 55.4% (P > 0.001), mitral regurge (MR) also improved upon establishment of STEMI network from 53.6% to 78.8 with (P > 0.001), the mean CCU stay in group II was 2 days versus 3 days before implementation of STEMI network (P > 0.001), the mean door in door out from the spokes was 40 minutes. In-hospital mortality improved upon establishment of STEMI network from 6.4% to 2.8% (P = 0.10).

Conclusion

The establishment of the STEMI network in Egypt is feasible and can lead to improvement of patients' outcomes. Thrombolytic therapy was no longer the main reperfusion therapy and primary PCI was offered to most patients after establishment of STEMI network.
Effect of Radiofrequency Current Application during Catheter Ablation on Heart Rate Variability in Patients with Supraventricular Tachycardia
Authors: Lotfy Nashaat , Effat Emad , Samir Rania , Eldamnhoury Hayam
Published: August 2023

Background

The autonomic nervous system has a significant regulatory effect on heart function; in addition to heart rate, cardiac conduction properties, hemodynamics, the cellular properties of cardiac myocytes, and cardiac arrhythmogenesis are also affected by the autonomic nervous system.

Objectives

In this study, we aimed to assess the Relationship between RF current application during Catheter ablation and it's effect on Heart Rate variability in patients undergoing RF catheter ablation for supraventricular Tachycardia.

Patients and Methods

This study is a cohort study, randomized clinical study, recruiting 20 patients from Ain Shams University hospitals, Cairo, Egypt. All patients were symptomatic with drug refractory documented supraventricular tachycardias. who underwent RF ablation March 2020 till February 2021 and were followed up for 1 month after the procedure.

Results

Compared with preablation data, HRV were shorter in all the RFA at the follow-up assessment. The 24-h Holter monitoring showed that mean and maximal HR were increased, whereas the HRV parameters, including time domain indices (SDNN, rMSSD) and frequency domain index, which reflect the attenuation of parasympathetic tone, were decreased in the RFA during the postablation period. In this study, there was significant increasing in mean heart rate regarding basal and the subsequent follow up after 1 week and 1 month. Post ablation high sinus rate (PA-HSR) was defined as an increase in resting sinus rate > or = 20 bpm or a resting sinus rate > or = 92 bpm without physiological or hemodynamic causes. In this study PAHSR was found in 10 patients (50%) by month-1 follow up. There is relation between the target site of RF ablation and the difference of HRV parameters.

Conclusion

Cardiac autonomic dysfunction assessed by changes in time domain and frequency domain heart rate variability parameters persisted for 1 month after radiofrequency ablation. Parasympathetic denervation may be one mechanism of Post ablation high sinus rate.
Outcomes of COPD Patients in RICU Ain Shams University Hospital and ICU Mansura
Authors: EL Monem Aya Kamal Abd , EL Sabour Faramawy Mohammad Abd , Ali Tamer Mohamed
Published: August 2023

Background

Chronic obstructive pulmonary disease (COPD) is a disease characterized by progressive, persistent, expiratory airflow limitation that is not fully reversible. In the United States, COPD annually accounts for $29.5 billion in direct health care costs, 750,000 hospitalizations, and 1.5 million emergency visits. Globally it is now ranked as the fifth leading cause of death. An exacerbation of COPD is characterized by an acute worsening of a patient's respiratory symptoms that result in change in treatment and increased utilization of health care resources.

Objective

the aim of this work was to evaluate the characteristics and clinical outcomes of COPD patients admitted to RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital.

Patients and Methods

This was an observational study conducted on a total of 100 patients admitted to ICU with acute exacerbation of Chronic Obstructive Pulmonary Disease at RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital within the period from November 2019 to April 2020. We excluded patients with obstructive lung disease other than COPD, Restrective lung disease, Malignancy and TB. The all cases were subjected to Full detailed medical history and full thorough clinical examination. We assessed the outcomes in regard to Length of stay (LOS) and MV duration. Assessment of the outcome which was be either death or discharge to chest ward, home or referral to any other department to complete the treatment.

Results

The study demonstrated that, the prevalence was 78% survival versus 22% mortality. there was a statistically significant difference among survivors and dead in terms of the cause of admission, there was statistically significant increase among dead cases compared to the survivors regarding APACHE II score, there was there was highly statistically significant decrease in terms of all PH measurements and all PCO2 measurements but there were no statistically significant differences among dead cases and survivors regarding all PO2 measurements, all HCO3 measurements and all SaO2 measurements.

Conclusion

Mortality was demonstrated to be correlated with several factors such as presence of co-morbidity, original cause of admission, APACHE II score, ABG parameters, WBCs, neutrophils, creatinine, urea, Reintubation, and complications of invasive ventilation.
Study of the Effect of CYP3A5 Single Nucleotide Polymorphism on Tacrolimus Metabolism in Liver Transplant Patients
Authors: Saleh ElHadidi Eman , Hussein Maha Mohsen , Kamal El-Din Manal Mohsen Mohamed , Ghani Amani Mohamed Abdel , Habib Dina Ayed Abdel Moez
Published: August 2023

Background

Liver transplantation (LT) is currently recognized as the most effective treatment for all types of end stage liver diseases. Major advances have been made in the field of liver transplantation due to improvements in surgical techniques and organ conservation as well as optimization of intensive care and immunosuppressive management.

Aim of the Work

To assess the influence of CYP3A5 rs776746 gene polymorphism on tacrolimus dose and its role in individualizing tacrolimus dose in Egyptian liver transplant recipient.

Patients and Methods

The study included 25 liver transplant recipients and their corresponding donors. CYP3A5 gene polymorphism was done to all participants by RTPCR. For recipients, tacrolimus trough level was measured and tacrolimus weight adjusted dose was recorded. Drug concentration over dose ratio was calculated (C/D ratio).

Results

The present study showed that recipients carrying 3*1 and 1*1 genotypes required higher dose of tacrolimus than recipients with 3*3 genotype but was not statistical significance. Donors carrying 3*1 and 1*1 genotypes, their corresponding recepients needed higher doses of tacrolimus to achieve the desired trough levels and thus lower C/D ratio compared to recipients with donors carrying 3*3 genotype with statistically significant difference in the first month post transpalnt.

Conclusion

The present study revealed that recipients and grafts carrying 3*1 and 1*1 genotypes require higher dose of tacrolimus than those with 3*3 genotype. Effect of graft’s CYP3A5 genotype has higher significance than recipient’s genotype on tacrolimus dose and C/D ratio.
The Clinical Utility of Transcription Factor 7-Like-2 (TCF7L2) Gene Polymorphism rs12255372 in Type 2 Diabetes Mellitus
Authors: Mahmoud Nermine Helmy , Hassan Somia Abd El-Hamid , Abdel-Wahed Marwa Ali , Farouk Manar Hassan
Published: August 2023

Background

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from defect of insulin secretion and/or increased cellular resistance to insulin.

Aim of the Work

Our study aimed to evaluate the association of TCF7L2 rs12255372 gene polymorphism with T2D.

Patients and Methods

The study was conducted on forty seven (47) diabetic patients who were recruited from the out-patient clinic and in-patient Department of Endocrinology at Ain Shams University Hospitals; in addition, twenty three (23) age- and sex-matched healthy subjects taken as healthy control group. Assay of TCF7L2 rs12255372 gene polymorphism was performed by real-time PCR analysis.

Results

The study had demonstrated that there was no significant association between TCF7L2 rs12255372 G>T gene polymorphism and T2D. However, there was significant association between the concordance of risk T allele and the occurrence of dyslipidemia.

Conclusion

Our study did not confirm the presence of significant association between the TCF7L2 rs12255372 (G/T) polymorphism and T2D inspite of higher frequency of T allele in diabetic patients than healthy controls, however, it pointed to the association between the concordance of T allele in T2D patients with poor glycemic control with sulphonylurea.
Diagnostic Evaluation of Modified Hematological Sepsis Score and Presepsin in Neonatal Sepsis
Authors: Ibrahim Marina Mamdouh Malky , El-Sewefy Dalia Ahmed , Ibrahim Mariam John Amin , Pessar Shaimaa Abdelmalik
Published: August 2023

Background

Early diagnosis of neonatal sepsis and assessment of the severity of the disease is not yet effectively achieved. Some hematological parameters are used to formulate a hematological scoring system (HSS) and a modified hematological scoring system(MHSS), for diagnosis of neonatal sepsis. A promising biomarker is Presepsin, or Soluble Cluster of Differentiation 14 SubType (sCD14-ST), which is a proteolysis product of CD14, that is produced after immune activation during infections.

Aim of the Work

To evaluate the performance of both HSS, MHSS and serum presepsin level, in neonatal sepsis, and compare them to C-reactive protein (CRP) as diagnostic tools and predictors of mortality.

Methods

The study was divided into two groups, one group comprised 51 neonates who further subgrouped into suspected & proved sepsis, along with 30 neonates who were admitted for non-infectious causes who served as control group. Both groups were subjected to calculation of HSS, MHSS, serum presepsin levels, CRP measurement, blood culture and, assessed for clinical severity and mortality.

Results

Hematological sepsis scores and presepsin levels were significantly higher in sepsis group. Presepsin showed the best diagnostic performance at > 0.5 ng/ml (AUC 0.979; sensitivity of 94.1% and specificity of 100%). While HSS and MHSS at a cutoff value > 1 achieved comparable specificity but lower sensitivity, 72.6% for the former and 76.5% for the later. Presepsin also was significantly higher in died group with the best predictive performance over CRP at cut-off value >1.9 ng/ml (AUC 0.83; sensitivity of 85.7% and specificity of 79.6%)

Conclusions

Hematological sepsis scores and presepsin were found to be useful diagnostic tools in neonatal sepsis with presepsin as a good predictor of mortality comparable to CRP.

Disclosure: The authors declare that they have no conflict of interest.
Study of Clinical Utility of miRNA-31 in Diagnosis of Bladder Cancer in Egyptian Patients
Authors: Sabbour Ghada Sadek , Hassan Mona Mohamed , Aly Heba Hassan , Ismaiil Shimaa Mostafa , El-Leithy Tarek Ramzy , Mahgoub Eman Seyam , El-Sisy Mostafa Mostafa Mohamed
Published: August 2023

Background

Bladder cancer ranks as one of the most prevalent cancers worldwide, with a rising incidence and prevalence; also it is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type.

Objective

To evaluate the clinical utility of miRNA-31 in plasma as an early novel diagnostic marker for patients with bladder cancer, in comparison to cystoscopy with histopathology as a conventionally used technique for cancer detection.

Patients and Methods

This study was performed on a total of 45 subjects selected from Urosurgery department at Theodor Bilharz Research Institute (TBRI) and Ain shams university hospitals in the period from January to October 2020. They were divided into the following groups: Group 1: 30 Bladder cancer (BCA) patients diagnosed by clinical examination, laboratory investigations (Urine cytology, urine analysis, complete blood count, liver & kidney functions) & cystoscopy with histopathology. Group 2: 15 apparently healthy volunteers matched in age and sex with the patients taken as the control group.

Results

It is found that miRNA 31 is abnormally expressed in cancer cells and play an important role in cancer development. It functions as an oncogene or a tumor suppressor in different cancer types which made it a candidate for our study. The present study revealed a statistical significance of miRNA-31 upregulation in plasma of late BC patients in comparison with early BC patients and control group, but there was no significance between its upregulation in the plasma of early BC patients in comparison with the control group. This shows that circulating miRNA-31 in plasma can be used as a prognostic biomarker for BC.

Conclusion

The present study revealed that the circulating miRNA-31 in plasma has no role as a diagnostic biomarker for BC.
Efficacy of Ablative Fractional Carbon Dioxide Laser Alone and Combined with Platelet-Rich Plasma in the Treatment of Androgenetic Alopecia
Authors: Galal Amira Nagy Mohamed , Afify Ahmed Abd Elfattah , Nabil Tarek , Samahy Mai Hussein El
Published: August 2023

Androgenetic alopecia (AGA) is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Fractional CO2 laser treatment has effectively induced hair regrowth through the wound-healing process. Platelet-rich plasma (PRP) ensures local delivery of growth factors, modification of the inflammatory response, and stimulation of cell proliferation and differentiation within the target tissue. PRP therefore showed a beneficial effect in treatment of AGA.

Aim of the Study

The aim of this study is to evaluate and compare the efficacy and safety of ablative carbon dioxide (CO2) fractional laser alone or combined with platelets rich plasma therapy in the treatment of Male Androgenetic Alopecia.

Patients and Methods

The study included 35 patients suffering from AGA. All patients will receive bilateral ablative fractional CO2 laser treatment on the alopecic scalp and the right or left side of the scalp will be randomly selected to be covered with platelet-rich plasma and the other half of the scalp will be covered with saline after the laser at the same session.

Results

Combined ablative fractional CO2 laser treatment and platelet-rich plasma showed statistically significant improvement compared to ablative fractional CO2 laser alone.
Assessment of the Role of Dermoscope for Monitoring Patients with Chronic Plaque Psoriasis before and after Narrowband Ultraviolet B Phototherapy
Authors: Sayed Mahira H El , Lotfi Ranya A , Ragheb Pola O
Published: August 2023

Background

Phototherapy is a traditional treatment for psoriasis, but its prolonged use is associated with cumulative toxicity, so physicians are in continuous need of tools to predict and monitor the progress of the disease.

Objectives

To detect if there is any role for dermoscopy in monitoring patients with chronic plaque psoriasis on narrowband ultraviolet B phototherapy.

Patients and Methods

A total of 30 patients with Chronic Plaque psoriasis were treated by narrow-band ultraviolet B phototherapy for three months according to their local and general conditions. Psoriasis Area and Severity Index score calculation and dermoscopic examination were done at baseline, after 6 weeks, and after 12 weeks of starting treatment.

Results

A significant association was noted between changes in the vessel distribution in psoriatic lesions and the response to treatment according to Psoriasis Area and Severity Index score assessment along with treatment visits, whereas the presence of globular blood vessels was significantly associated with poor clinical response.

Conclusion

Dermoscope is a rapid simple tool to predict the response of psoriatic patients to phototherapy using vascular pattern assessment.
Evaluation of Serum Lipocalin-2 Level and Its Relation to Insulin Resistance in Patients with Inflammatory Acne Vulgaris
Authors: Al Hashimi Sara Hameed Samin , Zaki Marwa SalahEldin , Soltan Marwa Yassin
Published: August 2023

Introduction

Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit. It is characterized by the formation of non-inflammatory comedones and inflammatory papules, pustules, nodules and cysts. Lipocalin-2 (LCN2) is an attractive biomarker of inflammation, ischemia, infection, and kidney damage.

Aim of the Study

The current study aimed to evaluate serum Lipocalin-2 levels in inflammatory acne vulgaris patients and to reveal the possible relation between its serum levels and the insulin resistance status in acne patients.

Patients and Methods

The study included 60 patients suffering from inflammatory acne vulgaris and 60 healthy control subjects. Full general and dermatological examination were performed, recording of BMI, GAGS score was done. Then, measurement of fasting insulin and fasting glucose was performed to calculate HOMA-IR.

Results

Serum lipocalin-2, fasting insulin and HOMA-IR levels were significantly higher in acne patients compared to control subjects.

Conclusion

Inflammatory acne vulgaris patients have higher levels of serum lipocalin-2 which might be related to acne pathogenesis.
Reliability of Fine Needle Aspiration Cytology for Salivary Gland Tumours Meta-Analytical Study
Authors: Fawzy Yasser Mohamed , Abdelkader Hesham Abdelaaty , Shafik Michael Rezk , Fayek Hany Shoukry
Published: August 2023

Background

Fine needle aspiration (FNA) cytology is a safe, reliable, minimally invasive and cost- effective technique for the diagnosis of salivary gland lesions.

Aim and objectives

to assess the accuracy, sensitivity and specificity of FNAC for diagnosis of salivary gland tumors in comparison with biopsy as definite diagnostic tool for these tumors.

Subjects and methods

This is a Retrospective and prospective studies, was carried out on Patients diagnosed with salivary gland tumors, treated with surgical management.

Result

FNA was associated with statistically significant fewer nondiagnostic results, Pooled analysis of all studies (n = 3605) revealed that rate of nondiagnostic results is 2.992% with 95% CI of rate 91.10–95.09 with absence of publication bias.

Conclusion

Fine needle aspiration biopsy is an important diagnostic tool for evaluating parotid gland tumors. It is more accurate in detecting benign tumors. In tumors greater than 2 cm and extending to the deep lobe, the sensitivity of fine needle aspiration biopsy is high. The use of fine needle aspiration biopsy in conjunction with clinical and radiological evaluation may help to reduce false positive and false negative results

Funding Sources

This research received no grant from any funding agency in the public, commercial or not-for-profit sectors.
Frequency and Pattern of Antibiotic Prescription for Common Infections Presented in Five Primary Healthcare Centers, Cairo, Egypt
Authors: Albahi Abeer Subhi Mohamed , Wahdan Maha M , Amen Ghada Essam Elden , Hassan Ahmed Nour Eldin
Published: August 2023

Background

rationale antibiotic prescription is a key strategy to control antibacterial resistance.

Objectives

to measure the antibiotic prescription rate, and to identify the most commonly prescribed antibiotic, and to explore the reasons for irrational antibiotic prescription in five primary healthcare (PHC) settings in Egypt.

Method

A Cross-sectional study was conducted on 535 prescriptions collected from five primary healthcare centres; and checklists about symptoms and signs of common health problems of respiratory tract, gastrointestinal tract and urinary tract for antibiotic prescription was fulfilled.

Results

Antibiotic prescription rate was (33.8%) and the most commonly prescribed antibiotic was Amoxil (Penicillin) (31.5%). Only (26.4%) of antibiotic prescriptions were adherence to the guidelines of Ministry of health of Egypt. Only (31.3%) of patients had upper respiratory tract infection were treated according to the guidelines where Tonsillitis was the most common URT diagnosis (43%), where only (34.3%) of them took Amoxil, followed by bronchitis (67.2%), where (46.3%) of them took Amoxil (adherent to guidelines). Only (31.2%) of patients had lower respiratory tract infection were treated according to the guidelines. Most of urinary tract infections were found among females (86.8%) and cipro was the most commonly prescribed antibiotic (39.5%).

Conclusion

Antibiotics are frequently prescribed in primary health care centers in Egypt, and most of these prescriptions are inappropriate. Training sessions for physicians is mandatory to improve their awareness, attitude and practice towards antibiotics prescription.
Quality of Antenatal Care Services in Four Accredited Primary Health Care Centers in Cairo, Egypt
Authors: Salem Yosra Abd El-Rahman Abd Allah , Shehata Isis Magdy Mossad , Sokkary Mohamed El , El-Awady Mohamed
Published: August 2023

Background

Antenatal care (ANC) is a careful, systematic assessment and follow-up of pregnant women, that includes education, counseling, screening, and treatment to assure the best possible health of the mother and her fetus. In order to assure each women gets the best quality of care, quality assessment of all items of antenatal care should be arranged regularly. This study aims to measure the perceived quality of antenatal care services, the adherence of the primary care physician to the Egyptian ministry of health guidelines as well as the overall satisfaction of pregnant women about their antenatal care services.

Methods

A cross sectional study was conducted from January till April 2021 among women aged 1849 years old who attend antenatal care clinics at four primary health centres in Cairo, Egypt. All health centres included in the study are government run facilities.

Results

Despite the high overall satisfaction (98%) reported for the antenatal care services, the total quality score was low (<60%), the highest satisfaction was reported from most of accessibility point and cleanliness of the primary care centers, answering inquiries, number of the doctors, discussion of the delivery plan, health education about importance of folic acid and iron supplements, family planning and cost of the service. Lowest satisfaction reported from the PHC was for working hours of the center, history taking, examination time, health education about diet, breastfeeding, and the harmful effects of passive smoking. Although most women reported that they had the majority of the Egyptian antenatal guidelines covered by their physician, items like past medical history, personal hygiene and oral glucose challenge test were missed.

Conclusion

The findings showed the need for new approaches to upgrade the quality of antenatal care and improve the health education skills for the primary care physicians, despite the high overall satisfaction.
Safety of Concomitant Laparoscopic Cholecystectomy and Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients: A Meta-Analysis
Authors: Shafik Youhanna Shohdy , Elsayed Mohamed Gamal , Hosny Ahmed Hany Mohamed
Published: August 2023

Background

Laparoscopic sleeve gastrectomy is one of the most common bariatric procedure performed. The prevalence of cholelithiasis in morbidly obese individuals is 19–30 % and Gall stones are more symptomatic in obese patients than in non-obese patients. This study evaluates the safety of performing laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy in the same session.

Objective

To evaluate the safety profile of performing laparoscopic cholecystectomy and sleeve gastrectomyin the same session in terms of : The incidence of biliary leakage. The incidence of gastric leakage. The incidence of intra operative bleeding from the sleeve gastrectomy and the cholecystectomy. The incidence of post-operative bleeding. The incidence of post-operative surgical site infection. Operation time. Length of hospital stay.

Method

Selected papers for the present meta-analysis included those that provided data from January 2010 to December 2020 on factors related to the patients who undergone laparoscopic sleeve gastrectomy with and without laparoscopic cholecystectomy. When institutions have published duplicate trials, only the most updated reports were included for qualitative appraisal. All publications were limited to human subjects and English language. Abstracts, case reports, conference presentations, editorials and expert opinions were excluded.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction

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

Conclusion

Overall concomitant laparoscopic sleeve gastrectomy and laparoscopic cholecystectomy appears to be a safe procedure. The increase in surgical site infection and pneumonia may warrant prophylaxis against such infections with antibiotics. Another study is needed to determine the need and efficacy of such prophylaxis
Evaluation of Post-Operative Wound Complications of Securing Mesh with Polypropylene Suture versus Staples in Lichtenstein Inguinal Hernioplasty; A Comparative Prospective Study
Authors: Mostafa Ashraf Abdel-Moghney , moaty Karim Fahmy Abdel , Hamed Mohammed Korayem Fattouh , Hammad Ahmed Mohammed Abdel-bar
Published: August 2023

Background

Hernia is defined as a Protrusion of a viscus or a part of viscus through an abnormal opening in the wall of its containing cavity. It is estimated that the most common type of hernia is inguinal hernia with approximately 27% to 43% rate of occurrence in males and it is 3-6% in females. Inguinal hernia repair is one of the most common surgical procedure carried out world-wide, more than 20 million people undergo inguinal hernia repair annually.

Objective

To compare polypropylene suture and staples for securing mesh in Lichtenstein inguinal hernioplasty in terms of mean operating time and postoperative complications, mainly (Pain, Wound ecchymosis, Wound infection, Wound Hematoma, Wound Seroma, Wound Abscess, Scrotal edema, Scrotal Hematoma, Scrotal Abscess).

Patients and Methods

In a randomized prospective clinical trial we elected 50 patients equally subdivided in 2 groups, 25 patients in each group. In-group A we fixed the mesh with polypropylene sutures and in group B we used staplers for fixation.

Results

There's significant decrease in mean operative time in staples group compared to polypropylene group with comparable results between both groups as regard pain and postoperative complications.

Conclusion

Using staples for securing mesh in Lichtenstein inguinal hernioplasty significantly reduced operation time with comparable results as regard postoperative pain and complications.
Comparative Study between Onlay and Sublay Placement of Polyproline Mesh in Ventral Hernia Repair
Authors: Farouk Abadeer Ashraf , AbdAllah Bishoy Samir , Boshra Gerges Wadie
Published: August 2023

Background

Ventral hernia repair is one of the most common surgical operations performed all over the world. Onlay and sublay mesh repairs are the commonly performed techniques for the same. However, the debate still continues about the superiority of both techniques over each other. The aim of this study was to compare the outcome of the onlay versus sublay mesh repair for ventral hernia.

Aim of the Work

The purpose of this study is to compare between two techniques of mesh placement in uncomplicated ventral hernias, onlay (mesh on external oblique) versus sublay (mesh in the retromuscular space) regarding complications (superficial skin infection, seroma collection, operative time, hospital stay and 18 months recurrence rate.

Patients and Methods

The study frame is two years starting from August 2019 to August 2021 in general surgery department at Ain shams university hospital a. Total 60 adult patients who are scheduled to undergo hernioplasty for ventral abdominal wall hernias, 30 are included group A (onlay) and 30 in group B (sublay).

Results

Maior wound infection was 10% in the onlay group in coparison by the 3.3% of sublay group. Seroma is 33.3% in onlay group while 26.7% in sublay group. Recurrence rate is 6.7% in onlay while 3.3%in sublay group.

Conclusion

Our study revealed that ventral hernias are common in females more than males mainly in the fifth decade of life. Although there are many methods in repair such herniorraphy which associated with a high rate of recurrence so mesh repair is the best in such cases. We have found that sublay hernioplasty is better than onlay hernioplasty according to the post-operative complications such as recurrence, seroma formation and wound infection. However sublay hernioplsaty takes longer operative time than the onlay technique due to the disscection to get the retromuscular space, no significant statistical difference in the operative time., no significant blood loss and hospital stay between the two techniques.