bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Health Assessment in Patients with Methylmalonic Acidemia
Authors: Emam Mohmed , Sedafy Heba El , Hussain Omar Omar , Hammad Nada , Elnabi Marawa Hasab , Elsayed Solaf M
Published: November 2024

Background

Methylmalonic acidemia (MMA) is a genetically heterogeneous disorder of methylmalonate and cobalamin metabolism. Isolated MMA is a rare inherited disorder of organic acid metabolism associated with elevated methylmalonic acid concentration in the blood and urine without elevation of homocysteine level or malonic acid. Nutritional intervention for MMA patients includes dietary restriction of proteins along with medical food and dietary supplements. Decreased bone mineral density (BMD) is a widely accepted complication of the life-long protein restricted diet in addition to accumulation of acids and toxic metabolites in those patients.

Aim of the Study

To investigate the effect of restricted and modified diet on bone health in a sample of patients with MMA.

Subject and Methods

Clinical, nutritional, selected laboratory parameters of bone health and bone mineral density (BMD) assessment by Dual-energy X-ray absorptiometry (DXA) scan of bones were carried out on Egyptian MMA patients from Genetics Clinic, Medical Genetic Department, Ain Shams University. Bone formation was assessed by measurement of serum osteocalcin level while bone resorption was evaluated by serum carboxy terminal telopeptide of collagen type 1 (S-CTX).

Results

The study included 24 patients from 14 families (13 males and 11 females). Their ages ranged between 5.2 to 26 years with median age of 10 years (IQR: 6.5-14). Consanguineous marriage was present in 91.67 of families. Median age of symptoms was 140 days (IQR: 3.5-332.5) while median age of diagnosis was 12 months (IQR (2.5-40). History of fractures was present in 5 patients (20.83%). Decreased total body BMD was detected in 14 patients (54.5 %) with mean Z score of -1.31 ± 1.38 SD. Decreased spine BMD was present in 21 patients (79.16%) with mean Z score of -1.9 ± 1.1 SD. This decrease was significantly related to non-compliance, chronic acidosis, low serum copper. There was no significant relation between BMD and creatinine, calcium, vitamin D, zinc, selenium, osteocalcin or S-CTX levels.

Conclusion

MMA patients have decreased BMD related to copper deficiency, poor compliance and chronic acidosis. This resulted in defective bone formation and increased bone resorption.
Impact of Androgen deprivation therapy on cognitive function of elderly men with Prostate Cancer
Authors: Bassyouny Nourhan M , Gouda Mohamed M , El Din Mai M Ezz , Sweed Hala S , El Akkad Rania M
Published: November 2024

Background

Prostate cancer affects millions of men worldwide. Androgen deprivation therapy (ADT) is the most prescribed medication for elderly men with prostatic cancer to slow and suppress the disease progression. ADT works on decreasing testosterone level and that can cause multiple side effects including potential cognitive affection, in the form of accelerating cognitive aging, and potentially increasing risk of dementia. Which in our elderly population requires careful consideration.

Aim

evaluation of the effect of androgen-deprivation therapy (ADT) on the cognitive function of elderly men recently diagnosed with prostate cancer (PC).

Methods and Results

The current research is a prospective cohort study conducted on 85 elderly recently diagnosed with prostate cancer and are about to start ADT within 2 weeks of the diagnosis. These patients were recruited from the Oncology and Geriatrics outpatient clinics of Ain Shams University hospitals and are expected to be followed up on ADT for at least 6 months. Cognitive and depression assessments were done using the Montreal cognitive assessment test (MoCA) and MoCA-basic according to their education and Geriatric Depression Scale (GDS) and the Patient Health Questionnaire-9 (PHQ-9). The cases were assessed at the start, after 2 months and after 6 months of ADT use. Cognitively impaired or depressed patients were excluded at the start of the study. This study showed that 57.6% of the studied participants had a lower MoCA score average after 6 months and indicating Mild cognitive impairment. Cognitive domains such as visuospatial, language, recall and attention were affected, 27.0 % were diagnosed with depression after 6 months of the ADT therapy. All of the depressed participants had cognitive impairment.

Conclusion

The use of androgen deprivation therapy caused cognitive decline, regression of some of the cognitive domains and depression in elderly patients with prostate cancer who received androgen deprivation therapy for a period of 6 months. It is recommended that the cognitive function and depression screening is to be assessed regularly to all cancer prostate patients receiving ADT and cognitive training must be advised and prescribed to preserve or improve the patients' cognitive abilities.

Key words

Prostate cancer, Androgen Deprivation Therapy, Cognitive decline, Elderly.
Same Day Elective Surgery Cancellation at El-Demerdash University Hospital: A Cross Sectional Study
Authors: Nasr Eman Mohamed , Al Tehewy Mahi Mahmoud , Ahmed Tarek Youssef , Ibrahim Dalia Ahmed , Mohamed El-Bokl Shaymaa
Published: November 2024

Background

Same day Elective surgery cancellation is a quality issue in the healthcare system that affects the financial aspect of healthcare system due to repeated pre-operative preparations and prolonged hospital stay, leading to increased costs. Aside from its economic impact, it is also associated with considerable psychological and social impact on patients and their families.

Objectives

To measure the prevalence of same day elective surgery cancellation at El-Demerdash University Hospital in Egypt and to identify causes of cancellation in the hospital. Methodology: A cross-sectional study included 993 elective surgical procedures in the operating department at El-Demerdash Hospital which consists of 21 operating rooms (ORs) for elective surgeries.

Results

The prevalence of same day elective surgical cancellation is 12.59%. the vital few causes of cancellation are: Unavailable OR time (24.03%), Unavailable ICU bed (21.71%), Change in patient’s medical condition (14.73%), Prolonged previous operation (10.85%) and Unavailable/failed equipment (7.75%). Vascular surgery department shows the highest cancellation rate (25.40%) followed by Plastic surgery (16%). This study shows that 20.0% of cancellations occur after patient’s arrival to operating department.

Conclusions and Recommendations

Same day elective surgery cancellation at El-Demerdash University Hospital is mainly due to hospital related causes. Managerial strategies and efforts towards vital few causes of cancellation for better utilization of the operating rooms is highly recommended.
The Effect of Aging on the Structure of the Colon of Rat with Reference to Interstitial Cells of Cajal
Authors: EL Morsy Dina Mohamed Rashad EL Saied , Mohamed Soliman Nevine Bahaa El Din , Shaker Safaa Mohammed , Kamel EL Ebiary Faika Hassan
Published: November 2024

Introduction

Aging process is a driving force behind the age associated diseases. The gastrointestinal tract (GIT), including the colon, is affected by the aging process. Constipation, fecal incontinence, and fecal impaction are common complaints of geriatric patients, probably reflecting colonic dysmotility. Interstitial cells of Cajal might be involved in this process, however, there is little known about changes in these cells and gastrointestinal tract with aging.

Aim

The objective of this work was to study the effect of aging on the structure of the colon of male albino rats. Age associated changes of the Interstitial Cells of Cajal (ICC) was also investigated.

Materials and Methods

Thirty male albino rats were equally divided into three groups: Group I (young): included rats aged six weeks. Group II (adult): included rats aged 16 weeks. Group III (senile): included rats aged two years. The specimens from the colon (one cm above the ileo- ceacal valve) of all rats were obtained and processed for light and electron microscopic examinations. Specimens were subjected to hematoxylin and eosin, toluidine blue, Alcian blue-PAS technique, Masson’s trichome, c-kit, and CD 34 immunohistochemical stain as well as transmission electron microscopic examination. Morphometric and statistical studies were also done.

Results

Aging altered the microscopic structure of the different layers of the colon. Focal mucosal corrugation or disruption, epithelial discontinuity, mononuclear cellular infiltration and alteration in the mucous content of goblet cells were found in aged rats. Increased collagen deposition in all colonic layers was also observed. Significant decrease of Nissls’ granules in the neurons of myenteric plexus and the number of goblet cells were also detected. Colonocytes of senile rats showed focal loss of microvilli, vacuolated cytoplasm, swollen mitochondria with irregular cristea and irregular nuclei. Change in nuclear shape and chromatin distribution, mitochondrial swelling and endoplasmic reticulum dilatation were also detected in ICCs in senile rats. Moreover, there was a significant decrease in area percentage of ICCs and telocytes (Tcs).

Conclusions

Aging caused profound alteration in the histological structure of the colon of senile rats. Moreover, ICC showed age related ultrastructural changes. These changes might contribute to age associated gastrointestinal diseases.
Histological Study on the Protective Role of Intranasally Applied Adipose-Derived Mesenchymal Stem Cells on Demyelinated Corpus Callosum in A Mouse Model of Multiple Sclerosis
Authors: Rahman Ahmed Mekawy Mohamed Abd El , Shaker Mohammed Safaa Mohammed , Hamam Ghada Galal , Mohamed Nesma Mohamed
Published: November 2024

Introduction

multiple sclerosis (MS) is the most common demyelinating disease that leads to non-traumatic disability. Intranasal administration of adipose-derived mesenchymal stem cells (ADSCs) is a non-invasive method that has recently received interests for treatment of neurodegenerative diseases.

Aim

to evaluate the possible protective effect of intranasally applied ADSCs on the structure of corpus callosum in adult mice in acute cuprizone-induced demyelination.

Materials and Methods

Thirty adult female mice were equally divided into three groups. Group I (control group); Group II (cuprizone group): in which mice were fed with 0.2% cuprizone daily for six weeks, and Group III (ADSCs treated group) in which mice were fed cuprizone as in group II, then they were given a single intranasally applied dose of ADSCs (1X106) on week four. All mice were sacrificed after six weeks and the corpus callosum was collected. Specimens were processed to hematoxylin and eosin, Luxol fast blue, Immunofluorescent techniques for detection of homing of ADSCs, histo-morphometric studies, and statistical analysis were also done.

Results

intranasally applied ADSCs effectively reached the corpus callosum. Light microscopic examination of the corpus callosum revealed unpacked disorganized fragmented, widely separated demyelinated nerve fibers with wide areas of vacuolation. Administration of ADSCs promoted myelin recovery.

Conclusions

Intranasal route was an effective route for delivery of ADSCs to the corpus callosum. ADSCs were effective in ameliorating structural changes in the corpus callosum in cuprizone model of MS. ADSCs promoted remyelination.
Study of Inorganic Iodine Level in Hemodialysis Patients
Authors: Baschari Ali Walid Ahmed , Abdelwahab Sanad Khaled Gouda , Ibrahim Ahmed Ahmed Ezzat
Published: November 2024

Background

Elevation in serum inorganic iodine levels due to decreased urinary iodine excretion can result in thyroid enlargement, possibly contributing to nodular goiter and hypothyroidism in Chronic Renal Failure (CRF) patients. The mechanisms underlying thyroid dysfunction in Chronic Kidney Disease (CKD) remain unclear. Uremic toxins may interfere with thyroid hormone uptake and receptor binding, suggesting acquired thyroid hormone resistance in uremia

Aim of the Work

The main objective of this study is to determine the serum level of inorganic Iodine in End Stage Renal Disease Patients (ESRD). Also, as a main objective, is to correlate the findings with thyroid function tests.

Patients and Methods

This case-control study was conducted at Ain Shams University Hospitals, encompassing 100 ESRD patients on HD and 50 controls. Hypothyroidism prevalence was examined, with 9% among HD patients and 1% in the control group.

Results

Serum inorganic iodine levels were significantly higher in HD patients than controls (p < 0.001). Free T3 was lower, and TSH was higher in HD patients (p < 0.05). The incidence of thyroid nodules was markedly elevated in HD patients (p < 0.001).

Conclusion

Elevated inorganic iodine levels in most HD patients are associated with abnormal thyroid function tests and an increased frequency of thyroid nodules. Regular monitoring of iodine levels in HD patients, especially in the presence of thyroid gland clinical or chemical abnormalities, is recommended to prevent long-term complications.
Role of Asprosin as a Biomarker of Non-Alcoholic Fatty Liver Disease
Authors: Allam Ehab Hassan Nashaat , Radwan Hesham Hamdy , Alashram Mohamed Nabil Badawy , Alhoriegy Ahmed Soliman Almorsy
Published: November 2024

Background

The nonalcoholic fatty liver disease (NAFLD), which affects 20 to 45 percent of people worldwide, is the liver pandemic of the twenty-first century. As a result of the growing obesity epidemic, NAFLD is now a chronic liver condition that has a global distribution. NAFLD affects between 15 to 40 percent of the general population and 90 percent of obese people.

Aim of the Work

The aim of our study is to measure serum level of asprosin in patients with Non- alcoholic Fatty Liver disease (NAFLD) to detect its relation to the incidence and severity of non- alcoholic Fatty Liver Disease (NAFLD).

Patients and Methods

The current case-control study was conducted at Damietta Gastroenterology & Cardiology Center aiming to evaluate serum asprosin levels in NAFLD patients compared to healthy controls, and to elucidate its relation to disease severity. We included a total of 90 subjects who were divided into two groups; Cases group included 45 patients with NAFLD, and Control group included 45 healthy matched controls. All participants were subjected to history taking, clinical examination (including anthropometric body measurements like BMI, waist and hip circumference), pelviabdominal ultrasound (for assessment of liver and spleen size), and laboratory investigations (including CBC, liver and renal function tests; lipid profile, blood glucose and glycosylated haemoglobin). Additionally, serum asprosin was measured in both groups.

Results

The study found that BMI, waist and hip circumference, WH ratio, prevalence of diabetes, liver size, fasting and postprandial glucose, HbA1C, serum cholesterol and triglyceride levels, LDL and HDL levels, ALT, AST, ALP, GGT, FIB-4 score, and asprosin levels were significantly higher in the NAFLD group compared to controls. Platelet count, total leucocytic count, serum bilirubin, albumin, and INR were not significantly different between the two groups. Serum asprosin levels showed a sensitivity and specificity of 77.8% and 51.1%, respectively, in identifying patients with NAFLD.

Conclusion

Based on our study findings, serum asprosin could be used a surrogate marker for the diagnosis of NAFLD with high sensitivity and moderate specificity. However, its level has no significant correlation with the degree of liver fibrosis in such cases.
The Value of Protein Carbonyl as a Marker of Oxidative Stress in Prevalent Hemodialysis Patients
Authors: Aref Hayam Mohamed , Hussein Hussein Sayed , AbdelMobdy Ashraf Hassan , AbdElmonem Amany Gamal
Published: November 2024

Introduction

Patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) experience oxidative/carbonyl stress. oxidative stress plays a role in the pathophysiology of chronic kidney disease (CKD) and its progression; during renal replacement therapy, oxidative stress-derived oxidative damage also contributes to the development of CKD systemic complications, such as cardiovascular disease, hypertension, atherosclerosis, inflammation, anemia, and impaired host defense.

Aim of the Study

The current study aimed to measure serum level of protein carbonyl as a marker of oxidative damage in prevalent hemodialysis patients and study its relation to nutritional status.

Patients and Methods

The study included 60 patients with End Stage Renal Disease (ESRD) on regular hemodialysis and 30 apparently healthy people as a control group. Patients were subjected to clinical assessment, laboratory assessment of Hemoglobin, urea, creatinine, albumin, iron, transferrin, ferritin, Ca, Po4, CRP and parathyroid hormone. Serum protein carbonyls was measured using ELISA. Nutritional status was assessed with the subjective global assessment

Results

Serum assessment of Protein Carbonyl and CRP revealed significantly higher levels in ESRD group (mean 239.8±107.7 and 16.8±14.3 respectively) compared to controls (mean 72.2±16.7: 1±2.3 respectively) (P value < 0.001, P value < 0.001 respectively). Concerning nutritional status, significant worse nutritional status was detected among ESRD group compared to control group (P value < 0.001). There was no significant correlation between protein carbonyl and nutritional status (P value = 0.526).

Conclusion

Protein Carbonyl revealed significantly higher levels in ESRD group compared to controls, reflecting that ESRD patients exposed to severe oxidative stress.
The Effect of Oral Sodium Bicarbonate on the Improvement of Interdialytic Acidosis and Hyperkalemia
Authors: Soliman Ammar Yasser , Hamid El Shennawy Howaida Abd El , Wahab Saeed Saeed Abd El , Deeb Manal El , Mansour Amr Mohammad , Abd El Wahab Khaled Gouda
Published: November 2024

Background

Uraemic toxins closely fitting the saw-toothed profile including electrolytes, such as potassium, which is statistically associated with peri-dialytic morbidity and mortality. Acidosis follows a similar inverse pattern, with the bicarbonate levels gradually falling during the inter-dialytic period, before rapid supplementation during dialysis. Observational studies of clinical outcome support the view that acidosis is harmful, showing that, after adjustment for comorbidity, pre-dialysis bicarbonate levels below 22 mmol/L are associated with excess mortality.

Aim of the Work

to understand the effect of oral sodium bicarbonate supplementation on patients on regular hemodialysis on improvement of inter-dialytic acidosis, and hyperkalemia

Patients and Methods

This was a one arm interventional study that was conducted on a group of 50 ESRD patients on regular hemodialysis 3 times/ week for at least 3 months.

Results

In the current study, mean ± SD of age (years) was 41.8 ± 10.5. Males and females were 58.0% and 42.0% respectively. In this study, systolic blood pressure (mmHg) before, and after sodium bicarbonate supplementation as well as its change was 123.8 ± 11.4, 125.6 ± 14.3 and 1.8 ± 9.4 respectively. The change was statistically non-significant. Diastolic blood pressure (mmHg) before, and after sodium bicarbonate supplementation as well as its change was 76.0 ± 7.6, 77.0 ± 8.1 and 1.0 ± 9.5 respectively. The change was statistically non- significant. This study showed that, Na (mmol/L) before, and after sodium bicarbonate supplementation as well as its change was 137.3 ± 4.6, 137.6 ± 4.6 and 0.3 ± 1.6 respectively. The change was statistically non-significant.

Conclusion

Oral sodium bicarbonate supplementation is effective in correcting metabolic acidosis, and does not cause increased interdialytic body weight gain, different plasma sodium concentrations and different systolic-diastolic blood pressure levels.
Risk Factors and Outcomes of Management in Fistulizing Crohn's Disease
Authors: Awad Emad Ahmad , Saleh Shereen Abou Bakr , ElFors Mostafa Attya , Yehia Abd El-Khalek Amr Mohammed
Published: November 2024

Background

Crohn's disease (CD) patients often encounter perianal fistula formation, which can cause significant morbidity. Chronic transmural bowel inflammation in CD can lead to sinus tracts evolving into fistulas—abnormal connections between epithelial surfaces. Roughly 35-40% of patients develop fistulas, primarily perianal (54%), with internal fistulas posing diagnostic and therapeutic challenges. Fistulizing CD manifests severe symptoms, affecting quality of life and necessitating frequent hospitalizations and surgeries.

Aim of the Work

The aim of the work was to develop risk prediction and identify outcomes of management in fistulizing Crohn's disease.

Patients and Methods

This case-control study encompassed 90 Egyptian CD patients, divided into two groups: those with fistulas (external or internal) and those without. Patients were recruited from the Ain Shams outpatient clinic and Gastroenterology and Hepatology department. Clinical, radiological (CT or MR enterography), and colonoscopic assessments were performed. Risk factors, clinical characteristics, and treatment outcomes were examined.

Results

In the study, males were more prevalent in the fistula group; however, the difference wasn't statistically significant. Similarly, age and smoking differences were not statistically significant between the study groups. Entero-Entero fistulas were the most common, with Remicade and surgery being the predominant management strategy. NSAID intake significantly correlated with the fistula group. CDAI scores were higher in the fistula group but improved significantly with treatment in both groups. While colonoscopy findings varied minimally before and after treatment, cecum lesions showed significant increase post-treatment in the fistula group. No significant differences existed in outcomes according to management strategy within the fistula group.

Conclusion

In conclusion, this study underscores the heightened risk of NSAID intake in fistulizing Crohn's disease, emphasizes the effectiveness of CDAI scores in assessing disease activity and monitoring treatment outcomes, and highlights the importance of personalized management strategies for fistula patients. The significant increase in cecum lesions after treatment within the fistula group suggests the need for focused attention to this aspect. However, the study's limited scope on Egyptian CD patients calls for careful consideration when applying these findings to broader populations.
Effect of Hemodiafiltration on Obestatin Hormone Level as a Marker of Malnutrition in Prevalent Hemodialysis Patients
Authors: Abdel Mohsen Waleed Anwar , Youssef Asmaa Moneer , Hassan Mohamed Saeed
Published: November 2024

Background and Aim

Obestatin, is a ghrelin-associated peptide have anorexigenic effect, known as appetite regulatory hormone, we postulated a potential correlation between obestatin level and malnutrition in hemodialysis (HD) patients. Measurement of obestatin concentration in HD patients would help assess the potential contribution of this hormone to uremic protein energy wasting. The purpose of this study was to assay effect of hemodiafiltration (HDF) on serum level of obestatin in HD patients.

Patients and Methods

We Conducted a cross sectional analytical study of the patients with ESRD undergoing HD recruited from the Department of Nephrology, Ain Shams University hospitals. Serum level of obestatin pre and post sessions was measured using enzyme linked immunosorbent assay (ELISA) in 40 prevalent hemodialysis patients: 20 on high flux HD & 20 on online HDF. 20 healthy individuals served as controls. Full history in details was taken & full clinical examination was done with the calculation of Malnutrition-Inflammation Score (MIS). Routine labs were done as well.

Results

Anthropometric measurements were significantly lower in HD & HDF groups compared with control group, Obestatin level was significantly higher in HD & HDF groups in comparison to control group. (P value < 0.000), with higher obestatin reduction ratio post sessions in HDF group than HD group. (P value < 0.001). Plasma obestatin concentration were negatively correlated with BMI & S. iron (P value < 0.05), while positively correlated with creatinine, urea, uric acid and CRP (P value < 0.05).

Conclusion

The current observational data suggests obestatin hormone was elevated in prevalent HD patients than control group & this hormone might be implicated in renal functions and markers of inflammation.
Evaluation of Dialysis Catheter Related Infections and its Relation to Patient Outcome
Authors: Hussein Ibrahim Bassant Mohamed , Abdelmohsen Waleed Anwar Mohamed , Kamel Cherry Reda , Abdelmegied Shimaa Zaki , Abdelrahman Nahla Hussein
Published: November 2024

Background

Hemodialysis (HD) is an important life-saving procedure in patients with acute kidney injury (AKI) and chronic kidney disease requiring renal replacement therapy. Well- functioning vascular access (VA) is a mainstay for performing an efficient HD procedure.

Aim of the Work

to asses bacterial spectrum of dialysis catheter related infection and its relation to patient outcome (either recovery or developing complications as septicemia, endocarditis, septic emboli, death).

Patients and Methods

This was prospective study, was conducted at Ain Shams university hemodialysis (HD) units, included 57 adult hemodialysis patients with catheter related infection selected from our HD unit. The inclusion criteria include Patient’s age 18-70 years and Patients on hemodialysis through double way venous catheter. Patients with sepsis evident by other causes that will be excluded by proper data from history, examination and individualized patient investigation according to symptoms.

Results

there was significant statistical difference as regard outcome (IEC, septic emboli) compared to surviving patients P-value 0.001 and IEC as a predictor of death with p-value=0.001 and Ods-ratio (Lower limit-Upper limit) = 100.00 (7.371 – 1356.594). Period of recovery was positively correlated in patient with temporary catheter with K, PO4, CRP. time to recovery was positively correlated with CRP on admission, k, total protein and R/P value was (0.828/ 0.042) (0.840 /0.036) (0.840/0.036) respectively.

Conclusion

Catheter related infection most common organism is Staph while complications including IEC and MDR organisms are associated with delayed recovery moreover IEC had higher mortality risk.
Study of Neutrophil Gelatinase-Associated Lipocalin for Early Detection of Acute Kidney Injury in Post Hepatitis C Decompensated Cirrhotics
Authors: Gad-Allah Abdel-Naser Abdel-Atty , Dala Ashraf Ghareib , Adly Eman , Toulan Safwa O
Published: November 2024

Background

The biomarker neutrophil gelatinase-associated lipocalin (NGAL) is a protein involved in complex biological activities such as bacteriostatic effects, cell proliferation and differentiation, and cellular apoptosis. Chronic hepatitis C virus (HCV) infection may result in chronic kidney disease (CKD) and end-stage renal disease (ESRD).

Aim and Objectives

to investigate the accuracy of serum level of Neutrophil gelatinase-associated lipocalin as a biomarker for early detection of Acute Kidney Injury and predict survival in patient with post hepatitis C decompensated cirrhotics.

Patients and Methods

A total of 90 subjects with chronic hepatitis C virus infection from outpatient clinics and the inpatient department of Internal Medicine department, Menoufia University hospital, was enrolled into this study.

Results

there was significant difference between both groups regarding baseline biochemical data and Baseline complete blood picture and NGAL. There was positive correlation between NGAL and each of MELD score, serum creatinine, TB, DB, ALT, AST, ALP while there was negative correlation with platelets.

Conclusion

There is no single ideal biomarker that had not been identified as the only diagnostic biomarker for AKI. However, NGAL accomplishes high sensitivity which is highly needed in life threatening conditions with high morbidity and mortality.
Diagnostic Value of Glypican 3 as a Marker of Hepatocellular Carcinoma in Egyptian Cirrhotic Patients
Authors: Eldin Kamel Ragheb Fatma Elzahraa Emad , Ahmed Ossama Ashraf , Dawod Ayman Gamil Anwar , Talkhan Mohamed Gamal
Published: November 2024

Background

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third cause of cancer-related mortality world-wide. Early detection improves survival, and several HCC biomarkers have been studied for this purpose. However, aside from alpha- fetoprotein (AFP), none have entered broad clinical use globally.

Aim of the Work

to assess the diagnostic value of Glypican 3 as a marker of hepatocellular carcinoma in Egyptian cirrhotic patient.

Patients and Methods

This study is a comparative case control study. The period of the study is a 6th months. Post viral cirrhotic Egyptian patients treated in Ain Shams University hospitals. The study will be conducted on 60 Egyptian Cirrhotic patients with HBV OR HCV infection with or without HCC treated in Ain Shams University Hospitals

Results

In our study, The AFP level was significantly higher in high group [1700 (1122 – 5200)] than low group [700 (100 – 855)] and also significantly higher in both low and high groups than control group [2.6 (1.7 – 3.6)] and cirrhotic group [3.4 (1.5 – 5.8)] with p-value <0.001 and with no difference between cirrhotic and control. Regarding serum Glypican 3 which is the new marker addressed in this study, show that The GP3 level was significantly higher in low group [6.4 (5.6 – 7.53)] and high group [6.21 (5.16 – 7.98)] than control group [1.38 (1.22 – 1.54)] and cirrhotic group [1.65 (1.22 – 6.18)] with p-value <0.001 and with no difference between cirrhotic and control. In our study, there was statistically significant positive correlation found between GP3 level, total and direct bilirubin with (p value 0.004, 0.001) which is agreed with many studies as A 2,416 patient HCC cohort was studied and dichotomized into normal and abnormal plasma bilirubin groups. Their HCC characteristics were compared for tumor aggressiveness features, namely blood AFP levels, tumor size, presence of PVT and tumor multifocality.

Conclusion

Serum Glypican 3 level was significantly higher in patients with HCC regardless of other characteristics as presence of combined conditions as DM and HTN or Viral markers and mildly elevated in patients with liver cirrhosis compared to HCC group. Using of Glypican 3 will improve the diagnostic field and can help in early detection of HCC in surveillance programs Together with AFP. Glypican 3 can be used as prognostic factor and predictor of mortality from oesphogeal bleeding in patients with HCC
Association between Proton Pump Inhibitors Use and Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascitis
Authors: Eldin Hassan Hassan Hossam , Nashaat Ehab Hassan , Mansour Khalid Amr , Mahmoud Abdelnaby Kareem Ahmed
Published: November 2024

Background

The most common infection of cirrhosis is spontaneous bacterial peritonitis (SBP). Prompt identification and diagnosis is important to decrease the resulting morbidity and mortality. A main SBP implementation process for bacterial translocation was identified.

Aim of the Work

To assess whether the use of PPIs in cirrhotic patients with ascites is associated with an increased risk for SBP.

Patients and Methods

This experiment was performed for cirrhosis and scientifically diagnosed ascites (100) in patients older than 18 years of both sexes. Cirrhotic patients with ascites and proton pump experience use more than standard dose/day (50 people) during the last 15 days. Cirrhotic patients with ascites without history of proton pump inhibitors use (50 patients).

Results

Comparison of age and gender has shown statistically insignificant differences between the two groups. The disparity between the two classes was statistically insignificant: hemoglobin, platelet, ALT, AST, serum albumin, AFP, SAAG ratio in ascetic blood, HCV antibody. PPI group showed statistically significant increase of white blood cells in blood and in ascitic fluid as compared to second group.

Conclusion

There is a risk in cirrhotic patients who have ascites and using Proton pump inhibitors to develop spontaneous bacterial peritonitis.
1PNPLA3 and Neutophil Lymphocyte Ratio as a Genetic and Inflammatory Predictors of Histopathological Severity by Liver Biopsy in Nonalcoholic Fatty Liver Disease
Authors: Fouda Enas Mahmoud , Saleh Shereen Abu Bakr , Eskandaros Moheb Shoraby , Rahman Ghada Abdel , El Khazragy Nashwa Nagy , Bakr Abu Bakr Heba Mohamed Abu
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver condition characterized by fat accumulation in the liver, which can lead to inflammation and scarring, resulting in irreversible liver damage. NAFLD is often associated with other metabolic comorbidities and is considered the hepatic manifestation of metabolic syndrome. In addition to liver-related morbidity and mortality, NAFLD is also associated with cardiovascular disease (CVD).

Aim of the Work

The aim of the study is to determine the relation between genetic and inflammatory markers in one side to the degree of histopathological changes by liver biopsy in patients with NAFLD on the other side.

Patients and Methods

This study was conducted on 20 patients who were candidate for bariatric surgery with fatty liver in abdominal ultrasonography and from donors for liver transplantation from internal medicine and surgical department in Ain Shams University hospitals and 10 healthy persons who were donors for liver transplantation as control group.

Results

The study found that neutrophil lymphocyte ratio (N/L ratio) and mean platelet volume (MPV) were significantly different between NAFLD patients and the control group. Additionally, the distribution of the PNPLA3 gene variant (rs738409 C/G) was significantly different between NAFLD patients and the control group, with most NAFLD patients having the homozygous GG variant. The study also found a significant difference between the PNPLA3 gene variant and steatosis percentage in NAFLD patients. However, there was no significant difference between the PNPLA3 gene variant and other clinical markers, including hepatic cell ballooning, fibrosis, glycemic status, liver enzymes, lipid profile, N/L ratio, or MPV.

Conclusion

NAFLD is more common in subjects with Homozygous GG variant of PNPLA3 gene. NAFLD patients with Homozygous GG variant of PNPLA3 gene are more prone to high grade of steatosis. Liver cell ballooning and liver fibrosis have no relation with different variants of PNPLA3 gene. Neutrophil to lymphocyte ratio (N/L ratio) and mean platlet volume (MPV) are good inflammatory markers to detect NAFLD.
Assessment of Cystatin C in Adult β Thalassemia Patients as a Marker of Subclinical Cardiovascular Dysfunction
Authors: Moussa Mohamed Mahmoud , Mohamed Haydey Said , Ibrahim Rakha Nahed Maowad , El Moaty Mohamed Inas Abd , Saber Hafez Heba Mohamed
Published: November 2024

Background

Beta-thalassemia syndromes are a group of hereditary blood disorders characterized by reduced or absent beta globin chain synthesis, resulting in reduced Hb in red blood cells (RBC), decreased RBC production and anemia. Cardiovascular complications in patients with beta thalassemia such as cardiomyopathy and arrhythmia are considered the most common cause of death in those patients. Cystatin C is a popular marker of nephropathy in sickle cell disease and beta thalassemia that has been recently used for prediction of subclinical cardiovascular dysfunction in patients with or without renal affection.

Aim of the Work

This study aimed to assess the role of serum cystatin C in adult patients with beta thalassemia as a predictor of subclinical cardiovascular dysfunction.

Patients and Methods

The study was a case control study including 50 beta thalassemia patients and 50 age and sex matched healthy controls. Serum cystatin c was assessed by ELISA in both patients and controls.

Results

our study found highly significant serum cystatin c level in beta thalassemia patients in comparison with the control group with p value < 0.001. there was statistically significant correlation between the level of serum cystatin c and cardiovascular dysfunction in thalassemic patients with p value=0.038.

Conclusion

There was statistically significant correlation between the level of serum cystatin C and cardiovascular dysfunction in thalassemic patients making serum cystatin C an encouraging factor for the prediction of subclinical cardiovascular dysfunction in beta thalassemia patients.
Nonalcoholic Fatty Liver Disease among Diabetic Patients on Oral Hypoglycemic versus Insulin
Authors: Garady Khaled Abdullah Ali El , Ghaly Sameh Mohamed Fahem , Safwat Eslam Mohamed , Mikhail Guirguis Reginia Nabil
Published: November 2024

Background

Non-alcoholic fatty liver disease (NAFLD) is a group of clinicopathologic diseases defined by lipid buildup in the liver parenchyma in people with no history of heavy alcohol consumption. Steatosis alone appears to be benign within this spectrum, but non-alcoholic steatohepatitis (NASH), marked by ballooning degeneration and sinusoidal/pericellular fibrosis, can be progressive.

Aim of the Work

to detect the prevalence of non-alcoholic fatty liver disease among diabetic patients on oral hypoglycemic versus insulin.

Patients and Methods

this cross-sectional study was conducted in Internal medicine Department, Ain Shams hospitals in 6 months from April till October 2022 on Diabetic Patients on Oral Hypoglycemic or Insulin. All patients were divided into two groups: Group A: Diabetic patients on Oral Hypoglycemic drugs. Group B: Diabetic patients on Insulin.

Results

There was no statistically significant difference between the studied groups as regard baseline data (Age, sex, BMI and hypertension). There was statistically significant difference between the studied groups as regard fast blood glucose and non-significant difference as regard HBA1C. There was no statistically significant difference between the studied groups as regard CRP.

Conclusion

the prevalence of non-alcoholic fatty liver disease (NAFLD) in diabetic patients on hypoglycemic group was less than in patient taking insulin
Arteriovenous Fistula Has Better Cardiac Outcome Than Permanent Catheter in Hemodialysis Patients with Heart Failure
Authors: ElSayed Hesham , Emara Ahmed , Abdelhadi Mai , Abdelmegied Shaimaa
Published: November 2024

Background and Aims

End stage renal disease patients with heart failure (HF) are at high-risk to develop clinical worsening after arteriovenous fistula (AVF) construction. This study evaluates effects of AVF versus permanent catheter on cardiac parameters in prevalent hemodialysis patients with heart failure and its relation to short term dialysis outcome.

Methods

A prospective study included 60 hemodialysis patients with HF ejection fraction (EF) 35- 50%. Patients were divided into: 30 patients with distal AVF, 30 patients with permanent hemodialysis catheter. Echocardiography was done for all patients at the beginning of the study and after 6 months with follow up of short term dialysis outcome.

Result

Patients with AVF after 6 months had significant improvement in TSAT, KT/v, URR, with increase in left atrial diameter (LAD) (p < 0.001, <0.001, <0.001,0.013) respectively while no significance in pulmonary hypertension, RAD, LVEDD (p value 1.000, 0.226,0.100) respectively. Patients with permanent catheter after 6 months had deterioration in TAST, serum albumin, URR, kt/v, hemoglobin, EF, LAD, RAD, LVEDD (p value <0.001, <0.001, 0.014, 0.010, 0.012, <0.001, 0.002, 0.001, <0.001) respectively. In comparing both groups: permanent catheter had significant deterioration in {hemoglobin, WBC, ferritin, TAST, albumin, EF} compared to AVF (p value <0.001, <0.001, <0.001, <0.001,0.001, <0.001) respectively, while no significance in LAD, RAD, LVEDD, pulmonary hypertension (p value 0.137, 0.435,0.052,0.315) respectively. Patients with Permanent catheter had a risk 10 times to have lower EF than AVF (odds ratio10.000). The EF after 6 months was positively correlated with URR, p value (0.028) and negatively correlated with dialysis duration p value (0.022) in AVF, while in permanent catheter was negatively correlated with-phosphorus, and potassium, p value (0.01, 0.048) respectively.

Conclusion

AVF is the preferred vascular access in heart failure for hemodialysis with better cardiac and dialysis outcome compared to permanent hemodialysis catheter. Adequatedialysis linked to positive effect on EF.
Prevalence of Thyroiditis Following Either COVID-19 Infection or Vaccination in a Group of Egyptian Hashimoto Cases
Authors: Adel Mohammed Menna Allah , Makboul Khaled Mahmoud , Hendawy Laila Mahmoud Ali , Khairy Mansour Hany
Published: November 2024

Background

Hashimoto's thyroiditis (HT), the most frequent autoimmune thyroid disorders (AITDs), is the leading cause of hypothyroidism in the iodine-sufficient areas of the world. COVID-19 is a highly transmissible infectious disease caused by the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV- 2), belong to the family of beta-coronaviruses. The disease rapidly spread, leading to COVID-19 pandemic on March 11, 2020.

Aim of the Work

The aim of this study was to evaluate the thyroid function consequences following either (COVID-19) infection or vaccination, in relation to their clinical features, biochemical, immunological, and inflammatory markers.

Patients and Methods

This study was a pilot study, conducted on 80 subjects attending COVID vaccination center and Emergency isolation in Ain Shams university hospital during the period from August to October 2022 14 males, 66 females, age>18 years old and <70 years’ old to evaluate the thyroid function consequences following either (COVID-19) infection or vaccination, in relation to their clinical features, biochemical, immunological, and inflammatory markers.

Results

Our study showed significant increase in the level of TSH and decrease in the level of free T3, Free T4 in Hashimoto’s patients who exposed to COVID19 infection. Also it showed significant increase in the level of free T3, Free T4 and decrease level of TSH in normal subjects after exposure to COVID19 infection. Additionally, our study showed increase level of free T3, Free T4 in normal subjects after being exposed to COVID19 vaccine (AstraZeneca) in contrast to TSH being decreased in them. Furthermore, we found significant increase in the level of free T3, Free T4 in Hashimoto’s subjects after their exposure to AstraZeneca vaccine, with non significant difference regarding –anti- TPO, Antithyroglobulin.

Conclusion

COVID19 infection and vaccination against COVID might be followed by an attack of thyroiditis (disturbed thyroid function test) in Hashimoto patient and even in normal person.
Association of Autoimmune Markers with the Disease Activity in Patients with Systemic Lupus Erythematosus
Authors: Osman El Mahdi Eman Naguib , Zeyada Omneya Mohamed , El Fotoh ElAdwey Radwa Hassan Abou , Saied Mghanam Mohamed Alsayed
Published: November 2024

Background

Systemic lupus erythematosus (SLE) is a multisystem chronic autoimmune disease with a relapsing and remitting course. Predicting changes in SLE disease activity could allow for closer monitoring and preemptive treatment. SLE is diagnosed using a combination of immunological markers, clinical symptoms.

Aim of the Work

To assess the relation between level of autoimmune markers in SLE patients with disease activity.

Subjects and Methods

Our study was a case control study, conducted on 60 patients of matched age and sex attending immunology & rheumatology outpatient clinics and wards at Ain Shams university hospital during the period from September 2023 to February 2024. 30 were medically free individuals and they made the control group. As regards the cases group it was divided into further 2 groups where 30 were SLE patients not in activity and the remaining 30 patients were SLE patients in activity.

Results

Markers of activity as C3, C4, Anti-dsDNA, ESR, CRP, PR/CR ratio was highly significant when compared between three studied groups, p-value <0.01. ESR and CRP was high in active group than inactive group than control group. C3 and C4 was high in control group than inactive group than active group. PR/CR ratio was high in active group than control group inactive group. Anti-dsDNA was significance in comparison between Active SLE and Inactive SLE groups, also between active SLE and control groups, being positive only in active group. Antiphospholipid antibodies (LAC IgG and IgM, ACL IgG and IgM, β2 glycoprotein IgG and IgM) was highly significant when compared between three studied groups, p-value <0.01, being higher in inactive group than active group than control group.

Conclusion

Autoimmune markers as markers of activity and antiphospholipid antibodies showed strong significance when compared between three studied groups, and in comparison between active and inactive SLE groups.
Membrane versus Centrifuge Based Therapeutic Plasma Exchange
Authors: Elhagrasy Mohamed Ayman Mahmoud , El Sayed Hesham Mohamed , Emara Ahmed Abdelmoneam , Abdel-Samea Marwa Shaaban , Abdelrahman Nahla Hussein
Published: November 2024

Background

Therapeutic plasma exchange (TPE) is an extracorporeal technique that involves separating a large volume of a patient’s plasma from the cellular components of the blood and replacing it with appropriate fluids. In patients with conditions that are induced and/or exacerbated by pathologic factors and toxins circulating in the plasma, TPE can help eliminate symptoms or prevent damage to the organs or systems involved.

Aim of the Work

To compare between the two methods of plasma exchange “centrifugal therapeutic plasma exchange (cTPE) and membrane therapeutic plasma exchange (mTPE)” as regard efficacy and tolerability.

Patients and Methods

This study is aprospective observational study. This study conducted plasma exchange unit in Ain Shams university hospitals (Eldemerdash and Ain Shams university specialized hospital). Study period: six months 40 patients.

Results

In our study we made a comparison between the 2 types as regard total procedure time, plasma removal efficiency, hemostatic parameters and removal efficiency. As regards procedure time, cTPE was longer than mTPE but less in preparation and priming time. As regard plasma removal efficiency, cTPE is higher than mTPE but the difference is not significant. Also, no significant platelets loss with the 2 modalities, but there is significant decrease in hemoglobin post treatment using the 2 modalities. Removal efficiency of IgG and fibrinogen is significantly high but with no significant difference between them.

Conclusion

This study comparing centrifugal therapeutic plasma exchange (cTPE) and membrane therapeutic plasma exchange (mTPE) revealed that cTPE had significantly shorter treatment time, while mTPE showed comparable patient removal efficiency and adverse event rates. Hemostatic parameter changes varied between studies. Individual device and protocol differences may contribute to these outcomes, emphasizing the need for tailored treatment approaches.