bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of using stromal vascular fraction and platelet rich plasma in the treatment of androgenetic alopecia
Authors: Osama A B , Ahdallah Elfeky K , Ali E K M , Mamdouh N A
Published: May 2020

Background

Platelet Rich Plasma (PRP) is based on the release of growth factors stimulating the initiation/extension of anagen phase as well as promoting vascularization, Adipose Derived Stem Cell (AT-ADSCs) treatment through injection of stromal vascular fraction were recently introduced as an alternative potential therapeutic application for hair growth.

Purpose

This study aims to compare the efficacy, safety and adverse effects of using lipo-aspirate stromal vascular fraction versus Platelet Rich Plasma injection in the treatment of Androgenetic Alopecia (AGA).

Patients And Methods

Forty randomized patients were treated by PRP, and SVF. Each patient was evaluated. And each lesion was treated by those modalities, patients received three sessions with one month interval for 3 months, follow up after 3 months.

Results

A highly significant improvement <0.001 in terminal hair count of SVF group evaluated by videodermoscopy assessment of AGA. That were confirmed by highly significant improvement in inter-mediate hair count and mean caliber (<0.001) associated with high incidence of side effects especially headache and erythema.

In contrast. PRP group showed significant improvement 0.048 in terminal hair count and non-significant improvement in inter-mediate hair count and of mean caliber with minimum side effects.

SVF group showed a significant improvement in terminal hair count than PRP and a highly significant improvement in Inter-mediate hair count.

Regard the clinical improvement and photographic assessment, SVF evoked upper hand of clinical improvement than PRP without statistically difference.

Also, side effects of SVF showed highly significant pain, headache and erythema but no serious adverse events.

Our study suggests that was significant improvement in AGA after PRP and highly significant after SVF therapy, with significant difference of SVF in terminal hair count and highly significant in vellus hair. Both modalities could effectively and safely he used to treat AGA.

Conclusion

our study suggested that there was significant improvement in AGA after both PRP and highly significant after SVF therapy. The results indicated a significant difference between PRP and SVF regarding terminal hair count and highly significant for vellus hair count, but non-significant difference in hair diameter. Both modalities could effectively and safely be used to treat AGA and there was statistically improvement in AGA after both PRP and SVF therapies.
Predictive Factors of Difficulty of Laparoscopic Management of Cancer Rectum
Authors: Hanna H H , Ibrahim M , Gerges M W W F
Published: May 2020

Background

rectal cancers compromise approximately 25% of all primary colorectal cancers and follow a different natural disease course compared to colonic tumours, also it is well established that surgical approach, local recurrence rates and associated complications of rectal tumours are distinct from colonic ones.

Purpose

to use the previously mentioned factors that can influence the difficulty of performing laparoscopic anterior resection. And by using standardized operative time as an end point build reliable study models thys predicting operative difficulty for clinical use.

Patients and Methods

this is a prospective case series descriptive study analyzing the predictive factors of laparoscopic approach in surgical management of rectal carcinoma. Clinical records of listed patients that underwent laparoscopic anterior resection at Ain Shams University Hospitals were reviewed. Clinical records of listed patients that underwent laparoscopic anterior resection at Ain Shams University Hospitals from March 2018 to September 2018 were reviewed.

Results

some factors collected from the patients data as high BMI, old age, intraoperative blood loss and tumor staging may predict the difficulty of laparoscopic intervention for cancer rectum.

Conclusion

laparoscopic resection for low rectal cancers is a feasible technique and with proper training it can be performed safely with acceptable rates of overall morbidity and by taking into consideration the above mentioned factors that may predict the difficulty of Laparoscopic intervention in order to have the best outcome from the decision of Laparoscopic anterior resection for patients with cancer rectum.
Identification of Preoperative Risk Factors Associated with the Conversion of Laparoscopic to Open Appendectomies: Prospective Randomized Study
Authors: Ebied E F , Darwish A A , Khalil A A , Elhefnawy H R M
Published: May 2020

Bachground

the principal advantages of this approach are a more precise diagnosis of appendicitis, reduction in post-operative pain, fewer superficial-surgical-site infection, earlier return to normal activity and reduction of the duration of hospital stay.

Purpose

to assess the preoperative patient and surgery risk factors that increase the likelihood of conversion of a laparoscopic appendectomy to an open Appendectomy in Egyptian patients.

Patients and Methods

this study was conducted in El Demerdash Hospital; Ain shams University, from December 2017 to June 2018. The study was conducted on 30 patients with suspected appendicitis.

Results

there were 30 patients identified who underwent an initial laparoscopic approach for acute appendicitis. The age range was from 18 to 52 years. The Female to Male ratio was 19:11. Of the 30 initial LA, 9 cases were converted to OA (30%).

Conclusion

surgeon can initiate open appendectomy or aim to have a low threshold of conversion if any of the above mention risk factors present in combination.
Conventional Laparoscopic Nissen Fundoplication versus Rossetti’s Modification in Management of GERD; A Comparative Study
Authors: Elfiky K A , Elsaeed K , Hassan M I , Ain-shoka A A , Elsayed M A , Hanafy D M
Published: May 2020

Background

gastroesophageal reflux disease (GERD) is increasingly prevalent and costly, and it may affect as much as 20% of the western population. The pathophysiology of GERD is not due to acid overproduction but rather mechanical dysfunction centered around the lower esophageal sphincter (LES). Furthermore, the mainstay of GERD treatment, proton pump inhibitors (PPIs), have come under scrutiny because of worrisome side effects.

Aim of the Work

to prospectively compare between laparoscopic Nissen fundoplication and its Rossetti’s modification as anti-reflux procedures along with their operative and post-operative outcomes.

Patients and Methods

this is a prospective randomized study that was conducted on twenty (20) patients presenting to Ain-Shams University Hospitals in whom fundoplication was indicated for management of chronic GERD and was operated upon starting October 2016 to October 2018 with minimal follow up duration of one year.

Results

both procedures were nearly efficient and equal as regards the symptomatic control for the patients, the improvement in their quality of life, healing of esophagitis restoration of the high pressure zone, and post-operative hospital stay, while the Nissen’s procedure was nearly similar to the Rossetti’s modification in the aspect of post-operative dysphagia and gas-bloat syndrome, the modified Rossetti procedure showed significant superiority regarding the operative time, the incidence of intra-operative bleeding and splenic injury.

Conclusion

the Rossetti procedure carried better results in the operative time, operative bleeding and splenic injury though it showed nearly no difference in incidence of post-operative dysphagia.
Graft and patient survival in portal vein thrombosis in living donor liver transplantation
Authors: Ramadan A M , Hytham N M , Mamdouh K K , Fathy A M
Published: May 2020

Background and Rational

To date, only few studies have evaluated the benefits of anticoagulation in individuals with cirrhosis. An obvious goal of anticoagulation is PV recanalization: when cirrhotic individuals with PVT are treated with anticoagulation, complete recanalization has been described in 33–45% while partial PV recanalization is observed in 15–35% of cases. LDLT has emerged as the alternative life-saving treatment to DDLT. Over the past 2 decades, the number of LDLTs has steadily increased in many transplant centers, especially in Asia. The separation between occlusive and non-occlusive thrombosis is very important; in patients with partial PVT, post-transplant mortality outcomes are no different from non-PVT patients but it is significantly increased in patients with complete PVT.

Patients and Methods

This randomized prospective study will include 79 patients who will undergo LDLT in Ain Shams Specialized and Egypt Air hospitals, there are two groups of patients according to presence of portal vein thrombosis or not group A 39 patients of non PVT and group B 40 patient of PVT including different grades of PVT according Yerdel classification.

Results

In this study, there is no significant difference between groups regard age but Males were significantly associated with group B. In this study, there is no significant difference between groups regard CHILD and MELD scores and this findings. In our study there is no significantly difference between groups A and B regarding ICU stay, hospital stay and cell saver. In this study, comparisons of the PVT patients and controls showed no statistical significant differences regard HA thrombosis, post operative pulmonary embolism and biliary leak but PV rethrombosis is significantly associated with PVT patients, mortality sig associated with PVT patients.

Conclusion

The outcomes of patients with PVT who underwent LDLT are inferior to those without PVT. Patients with PVT has lower survival rate, higher postoperative PV rethrombosis.
Comparative study between Single Anastomosis Duodeno–Ileal Bypass with Sleeve Gastrectomy and Mini-Gastric Bypass Surgery for the Treatment of Morbid Obesity
Authors: Abdelhamid A , Albalkiny S , Abdel-Samee K , Mustafa A
Published: May 2020

Background

Metabolic and bariatric surgery is a proven therapy for the treatment of obesity and its related comorbidities. Malabsorptive operations usually offer a higher rate of metabolic improvement, despite higher rate of complications and secondary effects.

Objectives

To compare Single Anastomosis Duodeno–Ileal bypass with Sleeve gastrectomy (SADIS) and Mini-Gastric Bypass operation as two types of bariatric surgeries with regard to weight loss, metabolic outcome and nutritional deficiencies within one year of post-operative follow up.

Methods

We performed a prospective comparison of 40 morbidly obese patients submitted to SADIS (n. = 20) and MGB (n. = 20) between July 2016 to July 2017 with one year of postoperative follow up.

Results

The groups were nearly similar in terms of age and sex. The SADI-S group had BMI of (47.4 vs 46.1) with 100% prevalence of DM in both groups, hypertension in SADIS 70% vs 65% in MGB and almost equal incidence of dyslipidemia. The SADI-S group presented markedly higher percentage of EWL of 91.4% vs 71.6% after one year. Control of DM, with HbA1c below 6%, was obtained in 85% in both groups with more decrease in mean HbA1c of SADIS being 5.44 vs 5.815 in MGB after one year. Most patients abandoned antidiabetic therapy or at least were controlled by less medications and lower doses. The SADI-S group presented remission of hypertension by 90% of patients as those of MGB but with far less medications. Lipid profile improvement was noticed in both groups with slightly higher resolution in SADIS group by 95% vs 90% for total cholesterol, 85% in both groups for T.G, 80% vs 85% for LDL, 65% vs 70% for HDL in SADIS and MGB patients respectively. Although the nutritional deficiency is still a considerable concern after SADIS, ours study didn’t show intense difference from MGB provided that proper vitamin supplementation and patient compliance are maintained postoperatively.

Conclusion

When compared to gastric bypass, SADI-S appears to be an effective and safe therapeutic technique with excellent short-term results for treating morbid obesity and its associated comorbidities with a low rate of nutritional complications. Proving its safety and efficacy by further studies will grant it more popularity in the future.
The study of prognostic factors in resistant spontaneous bacterial peritonitis in cirrhotic patients
Authors: Abdelwahab K M , Yousry W A , Mansour K A , Mohammed S G
Published: May 2020

Background

Spontaneous Bacterial Peritonitis is the most common form of infection seen in-patient with cirrhosis and is responsible of hospital mortality rate of approximately 32%, the increasing trend of resistance associated with low treatment efficacy of traditional therapy in nosocomial infection. It has been considered a life-threatening infection that requires a prompt diagnosis and treatment.

Aim

To evaluate the effect of certain prognostic factors namely Child -Pugh score, MELD Score and isolated organisms by bacterial cultures & Identifying organisms responsible for resistant SBP will guide in modification of antimicrobial treatment regimen.

Methods

A prospective cohort Study was conducted on 100 Egyptian cirrhotic and Ascetic patients for whom suspected for Spontaneous bacterial peritonitis (SBP) with no prior antimicrobial treatment. SBP and RSBP(Resistant spontaneous bacterial peritonitis) was diagnosed through history-taking through examination, clinical assessment and laboratory investigations, including ascetic fluid study analysis and the detection of culture sensitivity, recruited from the Gastrointestinal and Hepatology Unit of Nasser Institute Hospital, over a period from December 2016 to April 2017.

Results

Our study showed that out of 100 cirrhotic and Ascetic, out of 100; 60 were diagnosed SBP, out of those 60 resistant SBP were diagnosed in 30 patients with culture positive that responded on 2nd line treatment; Meropenem; 1g IV (with dose modification according creatinine clearance level) every 8 h for 5 days are the cases group and remained 30 that respond on the usual 1st line treatment; 2g of intravenous (IV) Cefotaxime (CTX) every 8h for 5days; are the control group. We found that there was no statistical significant difference between the studied groups as regards age and sex, Fever and abdominal pain were the most frequent manifestations in both group.

There was statistically significant difference between both groups according to the grade of Ascites, Hepatic encephalopathy and at the peritoneal fluid analysis after 48 h of 2 gram of CTX for TLC and Neutrophil & also Cl, Glucose and LDH (P value<0.05).

The RSBP prediction by Child score at cut off value ≥9.5 and the most frequent organism is Klebsiella in cultures results among RSBP which is being responded on Meropenem treatment.

Conclusion

RSBP associated with child c patients at cut off value≥9.5 so Child score is more useful as prognostic tool than MELD score although MELD score has higher accuracy prediction than Child score because it is vulnerable in Laboratory measurement.
Study of IL28B gene variation as a predictor of response to directly acting antiviral therapy in hepatic transplantation hepatitis C Egyptian patients
Authors: Badawy H M , Taha S S , Abdelrahman Y O , Gadallah S H , Samir R , Ghait S S
Published: May 2020

Background

IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients in the non-transplant setting.

Objective

To determine the prevalence and impact on clinical outcomes of donor and recipient IL28B genotypes among liver transplant recipients receiving directly acting antiviral therapy compared to those of HCV non-transplant patients.

Patient and Methods

This study included 60 patients divided into 2 groups: group 1 included 30 patients subjected to living donor liver transplantation and group 2 included 30 patients of HCV infection. Each group was subdivided into group A and group B according to the regimen of directly acting antiviral therapy (sofosbuvir-ledibasvir, sofosbuvir-daclatasvir). Liver transplantation was done between January 2016 and April 2018. Genotyping of the polymorphism was performed on DNA collected from all donors and recipients in group 1 before and after liver transplantation and also collected from all patients of group 2. Sustained virological response was found in 28 patients in group 1 (transplanted group) and 29 patients in group 2 (non-transplanted group) with no significant difference.

Results

No significant difference also was found in both groups according to the type of regimen. Also the type of genotype CC, CT and TT of IL28B in donors and recipients were not significantly associated or affecting the results of SVR in both groups of patients.

Conclusion

Our results support no role of recipient IL28B genotype in the response to directly acting antiviral drugs for hepatitis C recurrence. Interestingly, donor genotype seems not to influence the response pattern in recipients who have different IL28B genotype.
Effect of using Direct Acting Antivirals on the Synthetic Liver Functions in Treatment-Naïve Patients with Chronic Hepatitis C Virus Infection Genotype 4
Authors: Hamdy K , Ibrahim N , Safwat E , Elrefaei A
Published: May 2020

Background and aim of the study

Interferon-free direct-acting antivirals (DAAs) combination therapies, including sofosbuvir (SOF), daclatasvir (DCV) and paritaprevir -r/ombitasvir therapy with or without ribavirin, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvement of synthetic liver function is unclear. The aim of this study was to evaluate the effect of DAAs on the synthetic functions of the liver in treatment- naïve chronic HCV genotype 4 patients who treated by different regimens of DAAs for 12 weeks and achieved a sustained virological response at 12 weeks after treatment completion (SVR 12).

Patients and Methods

From September 2017 to March 2018, 150 treatment- naïve chronic HCV genotype 4 Egyptian patients received different DAAs regimens for 12 weeks were enrolled for this prospective cohort study, to evaluate the effect of DAAs on serum albumin, total bilirubin, INR, prothrombin concentration and platelets count at the end of treatment (WK12) and at week 12 post treatment in comparison to baseline. Patients were categorized to three groups; Group 1 (easy to treat) included 60 patients treated by SOF/DAC regimen, Group 2 (Difficult to treat) included 60 patients treated by SOF/DAC + ribavirin regimen and Group 3 included 30 chronic HCV patients with chronic kidney disease (eGFR ≤ 30 ml/min and Haemoglobin level >10g/dl) treated by Qurevo (paritaprevir-r/ombitasvir) + ribavirin and all included patients were treated for 12 weeks and achieved a sustained virological response at week 12 post treatment (SVR 12).

Results

There was a statistically highly significant improvement of serum albumin, total bilirubin, PC and INR (P = 0.001) among groups 1 and 2 patients at both time points _the end of treatment and WK12 post treatment_ (except for s. total bilirubin; P value was 0.11 at the end of treatment as compared to baseline). Platelets count showed a statistically highly significant improvement (P = 0.001) at both time points among group 1 patients, however among groups 2 and 3, it showed a statistically highly significant decline at the end of treatment (P = 0.001) as compared to baseline then showed a statistically highly significant improvement at WK12 post treatment (P = 0.001) among group 2 patients and (P = 0.027) among group 3 patients as compared to baseline value. Among group 3 cases there was a statistically significant improvement of serum albumin (P = 0.001) and PC (P = 0.025) at WK12 post treatment as compared to baseline.

Conclusion

In conclusion, based on analysis of all laboratory parameters in this study, we can conclude that direct acting antiviral therapy (DAAs) is effective in improvement of synthetic liver functions in chronic hepatitis C genotype 4 patients who achieved a sustained virological response.
Study of the role of soluble transferrin receptor/ferritin index in the assessment of anemia in inflammatory bowel disease patients
Authors: Awad E A , Soliman M L , George T M A , Elshabasy S G F
Published: May 2020

Background

Idiopathic inflammatory bowel disease (IBD) includes those conditions characterized by a tendency for chronic or relapsing immune activation and inflammation within the gastrointestinal tract, Crohn’s disease (CD) and ulcerative colitis (UC) are the two major forms of idiopathic IBD.

Aim of the Work

The aim of this study is to evaluate the clinical usefulness of the soluble transferrin receptor-Ferritin index in the evaluation of anemia in patients with IBD and especially for differentiation between iron deficiency anemia and anemia of chronic disease.

Patients and Methods

This study included fifty patients with established diagnosis of IBD either Ulcerative Colitis or Crohn’s disease. They were collected at Internal Medicine and Gastroenterology outpatient clinics and inpatient wards at Ain Shams University hospitals as well at New Cairo hospital in the period from March 2017 to September 2017. They were classified into 2 groups:

group I

25 patients with Crohn’s disease and anemia with active or inactive disease,

group II

25 patients with ulcerative colitis and anemia with active or inactive disease,

group III

25 healthy controls with no significant medical or family history of IBD.

Results

In the current study there was no significant difference between the different study groups regarding the demographic data except for the disease localization as there was significant difference between ulcerative and crohn’s disease.

Conclusion

The results of the current study stated that the sTfR and sTfR-F index seems to be very efficient in the detection and diagnosis of IDA, among patients with IBD. Its detection rate is higher using sTfR/F index than sTfR alone and of course higher than the other existing markers. It is essential to mention that the clinical use of this sTfR/F index rather adds to the value of other established markers, such as ferritin, transferrin and Tsat, than replaces them in the diagnosis of IDA. Therefore, sTfR-F index could be proposed as an additional parameter, which can improve the diagnosis of iron deficiency anemia in patients with IBD. This remains to be confirmed with other larger studies.
Chronic Spontaneous Urticaria and Gut Flora (Lactobacilli)
Authors: Refaat M M , Kamal S T , Elgendy A M M , Ismail D H
Published: May 2020

Background and Aims

Chronic Urticaria is a common disorder which is defined by recurrent occurrence of wheals and sometimes angioedema. It has a notable influence on the patient’s quality of life. Regulation of the immune system is one of the important roles of the gut microbiota.

Objective

Comparing the frequency and bacterial load of Lactobacillus between patients with chronic urticaria and healthy controls.

Methods

Forty patients with chronic urticaria were recruited from the outpatient clinic of Allergy and Clinical Immunology at Ain Shams University Hospitals and 40 age and sex matched healthy individuals were included in the present study. Stool samples were analyzed for determining the frequency and bacterial load of Lactobacillus.

Results

There was a difference among the frequency of detectable Lactobacillus in stool samples of patients with chronic urticaria and healthy controls. The relative amounts of Lactobacillus were significantly higher in fecal samples from controls compared to patients with chronic urticaria (P < 0.001).

Conclusion

Our study showed that some types of gut microbiota are found in normal individuals in a higher amounts than patients with chronic spontaneous urticaria.
Incidence & outcome of invasive fungal infections in patients with febrile neutropenia
Authors: Hennawy F S K , Elzimaity M M T , Moustafa N N , Kamal G M , Abdelhady E A , Said R M M
Published: May 2020

Background

Invasive fungal infection (IFI) is a major cause morbidity and mortality among patients with hematological malignancies who receive chemotherapy or hematopoietic stem cell transplantation (HSCT). Thus, early diagnosis and treatment of these infections are of crucial importance. Certain factors have been identified as risk factors for IFI.

Objectives

Assessment of incidence and outcome of IFI in Egyptian patients with febrile neutropenia.

Patients and Methods

50 febrile neutropenia episodes were studied. Patients were all subjected to history taking, clinical examination and further investigations including imaging studies, Galactomannan and Mannan antigen assays, and patients were followed up for observing the outcome.

Results

Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value < 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP.

Conclusion

IFI incidence is affected by age, gender, primary diagnosis and severity of neutropenia, and IFI has a worse outcome compared to other causes of febrile neutropenia.
Prognostic significance of serum Growth differentiating factor15(GDF) in adult acute myeloid leukemia patients
Authors: Hegab H M A , Elghammaz A M S , Elrazzaz M K H , Helal R A A
Published: May 2020

Background

Growth differentiation factor 15 (GDF-15)3 is a stress responsive member of the transforming growth Factor-B(TGF-B) cytokine superfamily. In health GDF-15 is weakly expressed in human tissues. Under pathological conditions, GDF-15 can be produced by many malignant and non-malignant conditions.

The aim of the present study is to assess expression of Growth differentiation factor 15 (GDF15) in the serum of adult patients with acute myeloid leukemia and its influence on remission and survival statuses of AML patients.

Material and methods

The serum level of GDF15 was measured in 30 AML patients in comparison to 15 healthy adult controls.

Results and conclusion

Higher GDF15 levels were observed in AML patients than in controls with a sensitivity of 93% and a specificity of 93.3% at cut off level of 1530 pg/ml assessed by ROC curve. Comparing the outcome (alive and dead) between patients above and below the mean level of GDF15(5674pg/ml) it was statistically significant (P = 0.028), but there is no statistical difference between the resistant patients and patients in remission (P-value= 0.593) Comparison between the overall survival (OS) in AML patients with GDF15> 5674pg/ml and those with GDF15<5674pg/ml,It was statistically significant.(P-value <0.001).A statistically significant positive correlation is detected between age and the GDF15 level in the patients group (P-value= 0.011).
CD 44 as a Marker of Rejection in Patients with Post Liver Transplantation
Authors: Bayomy E M , Yousef T M , Ahmed M B , Zaki K A , Elghandour A M , Elfors M A A , Agwa S H
Published: May 2020

Background

The first human orthotopic liver transplantation (LT) in Europe was performed by Sir Roy Calne in Cambridge in 1968, only one year after the first successful human liver transplantation reported by Thomas Starzl in the United States. Since then LT has evolved rapidly, becoming the standard therapy for acute and chronic liver failure of all aetiologies, with more than 80,000 procedures performed to date. Survival rates have improved significantly in the last 25 years, achieving rates of 96% and 71% at 1 and 10 years after LT respectively.

Objective

To assessment of value of serum level of CD44 as a marker of rejection in patients with post liver transplantation.

Patients and Methods

The study was conducted on patient all were recruited from ASCOT from May 2017 till December 2018. It included 20 adult patients with Post LDLT with elevated liver function tests and they were reviewed to determine if the serum level of CD44 had a value in diagnosis of acute rejection depending on proving the rejection by liver biopsy. They were distributed as 14 males and 6 females with age ranging 16 - 59 years. After obtaining the results of liver biopsy we had 14 patients with rejection, 4 patients with cholangitis with biliary obstruction and 2 patient with rejection with vascular insult.

Results

The control group was with irrelevant past medical history and normal liver functions, normal liver biopsy and underwent measurement of CD44 serum level. They were distributed as 14 males and 6 females with age ranging 26 – 41 years.

Conclusion

There was correlation between different pathological findings in liver biopsy and Serum level of CD44 that the low levels being with rejection and higher levels being with control group, that the CD44 may be used as a marker for rejection.
Quantification of Core Antigen Monitors Efficacy of Combination Therapy of Sofosbuvir, Daclatasvir and Ribavirin in Egyptian Cirrhotic Patients with HCV Infection as an Alternative to PCR
Authors: Nashaat E H , Abdel-azziz H , Mohammed A I , Hassan A H
Published: May 2020

Background

Hepatitis C virus (HCV) is a major public health problem throughout the world. Acute HCV infection is asymptomatic in most cases, and only 15% of cases are symptomatic,but Chronic hepatitis C (CHC) shows a variable clinical course, ranging from mild histopathological changes to active hepatitis and the development of hepatic fibrosis, cirrhosis and HCC. The aim of this work is to detect accuracy of core antigen in Egyptian cirrhotic patients with HCV Infection treated with combination therapy of Sofosbuvir, Daclatasvir and Ribavirin as an alternative to PCR. Patients and methods: The study included20 Egyptian treatment-naïve chronic hepatitis C patients with cirrhosis (Cirrhosis was diagnosed on ultrasound basis) on Sofosbuvir, Daclatasvir and Ribavirin. Results Treatment with sofosbuvir plus Daclatasvir and Ribavirin for 12 weeks resulted in undetectable HCV RNA by PCR in 95% (19/20) of the patients at the end of treatment and only 5% (1/20) of the patients achieved SVR after 6 months not 3(both HCV RNA AND HCV Core Antigen tests were negative for all patients). Conclusion: In our study there was a correlation between HCV RNA and HCV core antigen results, so HCV core antigen can be used as an alternative marker to HCV RNA in treatment of HCV infected cirrhotic patients receiving Sofosbuvir, Daclatasvir and Ribavirin.during treatment and for monitoring its efficacy.
Study of Urinary Calprotectin Levels in Type 2 Diabetics with Peripheral Arterial Disease
Authors: Halawa M R , Abushady M M , Abdelsalam M M , Mohamed N R , Basabbea A S S , Ismail S A , Shehata S M
Published: May 2020

Objective

The aim of the present study is to investigate the association of urinary calprotectin levels with lower extremities peripheral arterial disease (LEPAD) in patients with type 2 diabetes mellitus (T2DM).

Background

calprotectin is formed by two different calcium- binding proteins; it constitutes about 40% of neutrophils all cytosolic proteins. Calprotectin or its components (S100A8/S100A9) consider as a potential therapeutic target in inflammatory conditions including diabetes mellitus. The ankle-brachial index of less than 0.9 was applied for LEPAD diagnosis.

Method

we recruited 60 patients with T2DM; half of them had LEPAD and a healthy control group consists of 30 participants. Urinary Calprotectin and high sensitivity CRP (hsCRP) were measured by enzyme-linked immunoassay kit.

Results

Urinary calprotectin level was statistically significant higher among the three participating groups (p value <0.001), however, in post-hoc analysis there was no difference between patients with type 2 diabetes mellitus with or without LEPAD (p value =0.993). However, urinary calprotectin was weakly associated with LEPAD severity (p value = 0.175, p value = 0.06 respectively).There was a statistically significant positive correlation between urinary calprotectin level and hsCRP (r = 0.65, p value 0.001).

Conclusion

Urinary calprotectin cannot be used as a biomarker for LEPAD in T2DM.
Health Related Quality of Life in Chronic Hepatitis C Patients before and after treatment
Authors: Abdelaziz H , Seifeldin S , Elhosseiny M , Abolfotouh A
Published: May 2020

Back ground

Chronic hepatitis C (CHC) virus infection is a major cause of chronic liver disease and death throughout the world; several studies have shown an impaired health-related quality of life (HRQoL)in patients with CHC compared to general population whereas treatment of this disease often produce varying degrees of adverse effects which may negatively affect a patient’s HRQoL.

Aim

To measure the change in the HRQoL of the patients after the treatment and compare this change with response to treatment.

Methodology

427 chronic HCV newly recruited patients to receive pegylated interferon and ribavirin for 48 weeks in the National Hepatology & Tropical medicine Research Institute were selected and completed the SF-36 quality of life questionnaire before treatment and at the end of treatment then followed up for another six months to determine sustained virological response (SVR).

Results Patients’ HRQoL showed deterioration in all domains at the end of treatment compared to baseline measures with high statistical significant differences (p < 0.001). Non-responders showed more deterioration than patients with SVR especially in the perception of “mental health, social wellbeing, bodily pain, and general health”.

Conclusion Sustained virological response rate between chronic hepatitis C patients receiving combined anti-viral therapy (interferon and ribavirin) was 63.5%. HRQoL of patients receiving combined anti-viral therapy (interferon and ribavirin) deteriorated during the course of treatment till the end of treatment. Patients with SVR were less deteriorated than non-responders.
Study of Serum Chemerin in Patients of Polycystic Ovarian Syndrome and its Relation to Insulin Resistance
Authors: Halawa M R , Abdelbaky R S , Eid Y M , Nasr M S , Hendawy L M , Mohamed B M
Published: May 2020

Background

study of chemerin level in polycystic ovarian syndrome (PCO) patients and its relation to insulin resistance (IR). Upon chemerin on adipose tissue and glucose metabolism, serum chemerin has been recently studied in (PCO) women

Aim

We aimed to study the level of serum chemerin in PCO patients and its relation to insulin resistance.

Methods

The current study included 45 subjects with PCO syndrome and 45 healthy subjects as a control group. PCO subjects were divided into 27 obese PCO and 18 lean PCO. Control women were divided into 25 obese women and 20 lean women. Measurement of serum chemerin levels, fasting blood glucose (FBG),fasting insulin (FIN), total testosterone and pelvic ultrasonography

Results

Serum chemerin was significantly higher in the obese PCOS group (99.65 ± 13.72 ng/mL) compared with lean PCOS (87.99 ± 5,64 ng/mL) and the obese (76.82 ± 2.39 ng/mL) and non-obese (69.19 ± 8.40 ng/mL) control groups. In PCOS women, serum chemerin levels were positively correlated with Body mass index (BMI) (r = 0.835, P < 0.001), Fasting blood glucose (FBG) (r = 0.493, P < 0.005), Fasting insulin (FIN) (r = 0.913, P < 0.001), Homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.9181, P < 0.001).

Conclusion

There is an increase in serum chemerin level in PCOS patients with even more significant increase in patients with obese PCOS.
Panton Valentine Gene in both Community-acquired and Healthcare-acquired Methicillin Resistant Staphylococcus aureus Isolates from Ain Shams University Hospitals
Authors: Mohamed R A , Fathi L F , Salaheldeen N N
Published: May 2020

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen that is associated with both hospital and community infections. Panton Valentine leukocidin (PVL) is an important virulence factor of S. aureus that is considered by many authors a marker of community acquired MRSA (CA-MRSA).

Aim of the Work

This study aimed to determine the prevalence of PVL genes among healthcare acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) and CA-MRSA isolates, and to test the hypothesis that PVL is a reliable marker of CA-MRSA isolates.

Material and Methods

This comparative cross-sectional study was done on fifteen community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) and fifteen hospital acquired methicillin resistant Staphylococcus aureus (HA-MRSA), obtained from patients attending outpatient clinics, presenting with community-acquired pyogenic infections and patients with healthcare acquired pyogenic infections in Intensive Care Units (ICUs), during the period from May 2017 till February 2018. Clinical specimens included pus and different body fluids.

Staphylococcus aureus was isolated and identified using conventional microbiological methods3. Isolates were then tested for methicillin resistance by culture on mannitol salt agar (MSA) with cefoxitin4. The presence of mecA and pvl genes in all MRSA isolates was subsequently detected by PCR5,6.

Results

Among 15 HA-MRSA isolates, mecA gene was positive in 40% (6/15) of isolates, while pvl gene was positive in 53.3% (8/15) of isolates. Among 15 CA-MRSA isolates, mecA gene was positive in 46.7% (7/15) of isolates, while pvl gene was positive in 26.7% (4/15) of isolates.

Conclusion

We conclude that pvl gene is not a sole genetic marker for diagnosis CA-MRSA, as there was no significant correlation between mecA that encodes for methicillin resistance and pvl genes among fifteen CA-MRSA isolates (P value =1).
Neuro-endocrinal effects of antipsychotics
Authors: Elmahallawy N M N , Elsheikh M M , Mahmoud D A , Ibrahim M A
Published: May 2020

Background

Over the past few years, prescriptions of antipsychotic medications have risen significantly. In particular, there is increasing use of second- and third-generation antipsychotic agents. However, numerous studies have shown clinically relevant adverse effects (such as weight gain, metabolic disorders, prolactin changes, and extrapyramidal symptoms [EPS]) with these therapeutic agents.

The objective of this article is to provide a comparative review of the safety data available for antipsychotic drug use.

Methods

review the available literatures and case studies done on the neuro-endocrinal effects of the antipsychotics for the past 20 years from the following database: libraries of faculties of medicine of various Egyptian universities and database of various journals of psychiatry and through Pubmed and Scopus search engines.

Limitations

Absence of Arabic studies. Shortage of modern references.

Conclusions

Atypical antipsychotics are thought to be safer than typical antipsychotics, so they are the first-line of treatment at first-episode of psychosis, at least in the short-term. But, atypical antipsychotics still have severe neuro-endocrinal side effects. Each drug should be considered according to their suited to the patient. To avoid the side effects, choose the suitable antipsychotic drug, use the lowest efficatious dose; the minimum dose and duration of treatment, have good communication with the patients about the side effects to treat them immediately when they appear and to stop the medication.
The relationship between disturbed Eating behavior and Substance abuse in an Egyptian sample
Authors: Essawy H I , Elghonemy S H , Mahmoud D A , Arafa A M
Published: May 2020

Background

Substance use disorder (SUD) is a significant public health concern and the comorbidity between eating disorders also, substance use disorders (SUDs) in general have been sought in causal or common etiology. Personality traits have been suggested as shared influences on both of them .Early screening for risk factors for the development of co-occurring eating disorders and substance use disorder as well as sociocultural factors can improve the prognosis of patients

Aim of the work

to estimate the occurrence of disturbed eating behavior in patients with substance use disorder.

Subjects and Methods

The present study is a cross sectional observational study aimed to investigate the relation between disturbed eating behavior and the severity of substance abuse in patients with substance use disorder. Illustrate the Association between disturbed eating behavior and the severity of substance.

Results

The results are divided in to 2 parts: Descriptive part of the socio demographic data, disturbed eating behaviors and analytical part consists of relation between disturbed eating behavior and socio demographic data, as well as relation between addiction severity and sociodemographic data, and finally between disturbed eating behaviors and addiction severity index.

Conclusion

As the duration of SUD increases the interparental conflicts and interparental violence increases which increases the risk of internalizing, externalizing and total behavioral problems among their children.
Epidemiology of Stroke in Sohag; Hospital Based Study
Authors: Aref H , Ahmed S , Shalash A , Abdelrahem M I A
Published: May 2020

Background

Stroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This hospital based study aimed to estimate the epidemiology of stroke of referral hospitals in Sohag Governorate in Upper Egypt. the study investigated stroke risk factors, types, mortality and disability in this city.

Material and Methods

A hospital based study was done in three Sohag hospitals during 2016 and 2017. Patients with acute cerebrovascular stroke admitted at Sohag hospitals and were underwent full clinical assessment, National Institute of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) scoring, lab investigations, and neuroimaging. stroke risk factors, types, mortality and disability were determined.

Results

480 patients were recruited; the median age was 60 years old, males were 49% and females were 51%. Ischemic arterial infarction was 69.4%, hemorrhagic stroke was 26.9% and SAH was 3.75%.

Conclusion

Cerebrovascular stroke is more frequent in Sohag populations; ischemic stroke is more common than hemorrhagic stroke. Hypertension and diabetes mellitus are the main risk factors. Mortality during admission is more than the fifth of all cases.
Clinico - aetiological profile of new onset seizures among adult Egyptians
Authors: Mohamed A K , Mahmoud M H , Awad E M , Shafik M A
Published: May 2020

Objectives

We aimed to evaluate the clinical and etiological profile of new onset seizures in adults with the help of laboratory and neuroimaging studies in a tertiary care hospital in Cairo.

Methods

An observational hospital based cross sectional analytical study of 120 cases with new onset seizures were included in the study, who had their first seizure above the age of 18, and admitted to Neurology OPCs and ER of Ain Shams University and Nasr city Health Insurance Hospitals between March 2018 to September 2018. We determined the type of seizure and etiological factors.

Results

In the 120 patients, whose specific incidence of acute new onset seizures was found to be highest in males in the age group > 55 years 48 (66.67 %), we found the most common seizure type was generalized seizure 56 (46.67%) and the most common etiologic factor was cerebrovascular diseases 58 (48.33 %). Patients presented with cluster seizures was 31 (25.83 %) and status epileptics was 14 (11.67 %). The most common metabolic insult was hypocalcemia 12 (10%) and hyponatremia 8 (6.76%).

Conclusion

Cerebrovascular disease was the most common etiology after 55 years of age whereas Idiopathic epilepsy syndrome and Metabolic insults were common in younger individuals (18-35) years of age. Patients presented with cluster seizures were mostly found to have SOL.
Gender differences in clinical and sociodemographic pattern of substance Use disorder
Authors: Elhabiby M M , Elrassas H H , Morsi M H , Ezzat F M N
Published: May 2020

Background

Substance use disorder (SUD) is a significant public health concern and is one among the most common psychiatric disorders beginning in young adulthood. The history of substance abuse is as old as mankind itself; recently it has become a global problem that is influenced by social, economic, political, and psychosocial factors, scientist have long noted an association between social relationships and health.

Aim of the work

to analyze and discuss similarities and difference between the genders in substance use disorder, highlighting severity of substance use disorder in both male and female focusing on comorbidity of substance use disorder in both male and female.

Subjects and Methods

This cross sectional descriptive study was conducted on a sample of 117 addict patient (39 f and 78 m) who seek a treatment in Egyptian psychiatric hospitals. The Sample was collected from inpatient and outpatient department of Ain Shams Psychiatric hospital, Heliopolis (Almatar) Psychiatric Hospital and Alabasseya Psychiatric hospital.

Results

the study revealed a statistically significant difference in various parameters as the mean age of abuse was higher among men than women with longer duration of life time and last 30 days intake compared to females. As regard marital status, married men percentage was lower in comparison to females who had a higher percentage of divorces. Regarding educational level, more females completed primary level but more males completed to tertiary diploma and higher percentage compared with females. Males abuse was more physically and emotionally but females exposed to more sexual abuse. Legal problems were higher in males as violation and drug charge compared to the females. On the other hand, job and dealing drugs as a source of money for drugs were mainly in males but females gained money mainly from the family or prostitution. Men showed higher rates of HCV infection than female.

Conclusion

there is a clear difference between men and women in many of the points covered in this study, which confirms that there must be different programs developed specifically for women and not as sometimes happens by the application of treatment programs addiction to men, which leads to the consequences of unsatisfactory For female patients as well as those involved in the treatment of addiction.