bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of serum 25-hydroxy vitamin D in cirrhotic patients with and without spontaneous bacterial peritonitis (SBP)
Authors: Shalaby S M , Baiumy E M , Abdelrahman M G , Sayed M M , Abdelhalim R M , Amer A A
Published: May 2020

Background

Vitamin D has pleotropic effect including the immune function, it increases innate immunity and modifies lymphocyte activation. The risk for bacterial infections is increased in cirrhotic patients due to low levels of vitamin D, so its deficiency may be linked with the prevalence of SBP in cirrhotic patients

Aim of the work

To assess the 25-OH vitamin D serum level in cirrhotic patients and it’s relation to spontaneous bacterial peritonitis.

Patient & Methods

The current study included 90 patients divided into three groups; group one; patients with compensated liver cirrhosis, group two; patients with decompensated liver cirrhosis without SBP and group three; patients who had decompensated cirrhosis with SBP. The following laboratory work up was done: Serum 25-OH vitamin D level, liver functions test, kidney functions test, complete blood count, and ascitic neutrophil count.

Results

We report a highly significant difference between the studied groups as regards 25-OH vitamin D level, being lowest in group three. A negative correlation between markers of severe cirrhosis and vitamin D concentrations was found in our cirrhotic patients.

Conclusion

Vitamin D deficiency is associated with increased incidence of infections in cirrhotic patients including spontaneous bacterial peritonitis, suggesting that Vitamin D supplementation may be useful in these patients.
Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters inHigh Risk Hemodialysis Patients
Authors: Ebrahim M B , Elsharkawy M M , Elsaid H W , Hassan M S
Published: May 2020

Introduction

One of the greatest challenges for physicians caring for hemodialysis (HD) patients is assessing their extracellular fluid volume (ECFV), so different strategies have been investigated to aid in this evaluation. The clinical examination, biochemical markers of volume overload, Inferior vena cava ultrasound, lung ultrasound, Continuous blood volume monitoring (CBVM) and Bio impedance measurement of intra- and extracellular water (ECW).

Aim

Aim of the present study is to evaluate the effect of fluid management guided by bio impedance spectroscopy on CV parameters and BP in high risk HD patients.

Patients and Methods

This is a prospective interventional one year study. Fifty (50) maintenance HD patients have been recruited from Nasr City Insurance Hospital dialysis centre, the study population divided into two groups followed over (12) months, the groups were classified as follows: Intervention group (high risk group) included (25) CV compromised HD patients. (FO pre (L)) was assessed by BIS monthly before dialysis session. Control Group (low risk group) included (25) clinically stable HD patients. Dry weight was assessed clinically in the control group.

Results

Statistically significant decline in pre& post-dialysis systolic BP, the rate of use of BB & ACEI drugs& the rate of IDH in the intervention group. FO pre (L), TAFO (L), IDWG (L),post-dialysis weight (Kg), but in intergroup analysis, however it became evident that pre FO (L), TAFO (L), IDWG (L) and post-dialysis weight (Kg) decrease in the intervention group was significantly higher than the control group. (LVMI, LVIDD, RVDD and left atrium volume) values assessed by Echo showed a statistically significant decline in the two groups, however in intergroup analysis; it became evident that (LVMI, LVIDD and RVDD) values and left atria volume decrease in the intervention group were significantly higher than the control group.

Conclusion

Assessment of fluid overload with bio-impedance spectroscopy is a helpful tool beside clinical examination to better recognize hidden fluid overload which leads to significant improvement in the CV status of high risk HD patients.
Interdialytic Weight Gain and Its Relation to Outcome among Patients on Maintenance Hemodialysis
Authors: Ibrahim M K , Kamal O M M , Hassan M S , Khalifa M M M
Published: May 2020

Introduction

The most common cause of mortality among chronic hemodialysis (HD) patients is cardiovascular disease. Hypervolemia is an important risk factor for hypertension and cardiovascular mortality in HD patients that include chronic volume overload and interdialytic weight gain (IDWG).IDWG affects cardiovascular morbidity and mortality Daily fluctuations in extracellular fluid volume might promote cardiac remodeling resulting in left ventricular hypertrophy (LVH) and cardiac fibrosis.

Aim of the study

to assess interdialytic weight gain and (its relation to morbidity and mortality) among patients on maintenance hemodialysis.

Patient and methods

100 ESRD patients on regular hemodialysis included in study in Ain Shams University hospitals in march 2016 and followed up after one year in march 2017.

Type of study

cohort study

Patients were divided into two groups according to interdialytic weight gain (IDWG):

Group I (high IDWG)

50 patients with Absolute weight gain 4kg or more. Or relative IDWG more than 3.5% of total body weight.

Group II (low IDWG)

50 patients with absolute weight gain less than 3kg

Or relative IDWG less than 3.5% of total body weight.

Echocardiography (TTE) for all patients at the start of the study and followed up after one year for detecting outcomes included all-cause mortality, cardiovascular mortality, hospitalization for heart failure/volume overload, hospitalization for myocardial infarction, stroke.

Results

we found that patient with high (IDWG) group II has significantly higher increase in left ventricular mass index (LVMI),inferior vena cava (IVC) diameter and significantly higher decrease in ejection fraction more than low IDWG group I.

Conclusions

Patients with high IDWG group II at higher risk of increase LVMI, decrease ejection fraction, increase in interventricular septum (IVS), increase in inferior vena cava diameter more than patients of low IDWG group I and has more cardiovascular morbidity and mortality.
Hematological Effects of Direct Acting Antiviral Drugs (DAAs) During and After Successful Treatment of Hepatitis C Patients with Ribavirin Free Regimen
Authors: Elsayed O A , Fouda E M , Yassin A E , Abouemira M S
Published: May 2020

Background

Hepatitis C virus is a major public health problem in Egypt. The standard of care for treatment of HCV has always been Peg-INF and Ribavirin carrying a lot of side effects. This was changed with emergence of Direct Acting Antiviral Drugs.

Objective

The aim of this study was to evaluate the hematological effects of DAAs in patients receiving Ribavirin free regimens to assess the beneficial or the adverse effects of these medications.

Subjects and Methods

The study was conducted on 120 patients with chronic HCV who were child A according to Child-Pugh score, receiving Sofosbuvir and Simeprevir or Sofosbuvir and Daclatasvir for 12 weeks.

All patients were subjected to history taking, clinical examination and pretreatment assessment including laboratory evaluation with CBC, Liver enzymes, Liver functions at baseline, after 4 weeks, 12 weeks and 24 weeks.

Results

Serial laboratory follow up of 120 patients showed significant improvement in hemoglobin level and platelet count. Improvement in liver enzymes and bilirubin was detected with transient elevation of bilirubin in week 4. 116 patients (96.7%) showed negative HCV-PCR Quantitative after 12 weeks of treatment while 114 patients (95%) of achieved SVR 12.

Conclusion

DAAs have a good impact on blood profile and liver biochemistry and high cure rate with minimal side effects.
Assessment of Minimal Residual Disease in Acute Myeloid Leukemia patient in Adult Egyptian Acute myeloid Leukemia Patients
Authors: Moussa M M , Abdelhady E A , Abdallah N H , Mahmoud I J
Published: May 2020

Background

The term minimal residual disease (MRD) is used to describe residual disease after suboptimal induction chemotherapy, but at the same time refers to the lowest levels of disease potentially compatible with cure or to molecularly defined relapse after long term remission.

This study assesses the minimal residual disease in relation to the outcome in acute myeloid leukemia patients after 6 months of treatment of chemotherapy.

Aim of the work

The aim of this study is assessment of measurable minimal residual disease after treatment to identify acute myeloid leukemia patients who are at high risk of poor outcome.

Patients and methods

Minimal Residual Disease was measured using Flow cytometry in 30 newly diagnosed a 30 newly diagnosed acute myeloid leukemia (AML) patients. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from May 2017 to November 2018.

Results

A total number of 30 acute myeloid leukemia patients were recruited from Ain Shams University hospital, hematology and Oncology Unit outpatient clinic, with age ranging from 18-60 years old (median age 40 years), 14 of them were males representing 46.6% of the total number and 16 were females representing 53.3% of the total number.

There was no statistical significance between the age of the studied group and the MRD with P-value 0.147, the sex of the patients doesn’t contribute to the risk stratification with a P-value of 0.200.

The number of cases with negative MRD after induction was 13 representing 43.3% of the total number, and was 12 patients after 6 months representing 70.5% of the remitted patients, considering that the cut out value of MRD is 0.1.

There was a significant relationship between TLC and MRD, the higher the TLC the more positive the MRD.

Positive MRD is associated with higher mortality rates, exhibiting a statistical significance with P-value of 0.005.

Conclusion

We concluded that assessment of minimal residual disease in AML is of great value in determination of prognosis of the disease and its outcome and it is of great value to determine the levels of minimal residual disease (MRD) during the course of therapy and to stratify patient to identify high risk patient and to plan the therapeutic program accordingly.
Sputum periostin in patients with different asthma phenotypes
Authors: Refaat M M , Ahmed E E , Elsayed H M , Elbanna A H
Published: May 2020

Background

Asthma is a common respiratory condition causing symptoms such as cough, chest tightness and wheezing that are triggered by factors as exercise, allergens and viral infection. Asthma is characterized by airflow limitation, airway hyper-responsiveness and bronchial inflammation.

Aim of the work

to identify the different phenotypes in a group of asthmatic patients; and to evaluate the role of periostin in bronchial asthma and its different cellular phenotypes and its correlation asthma severity.

Subjects and Methods

This observational cross-sectional study was conducted on 96 adult asthmatic patients. They were classified into two groups: group (A) 48 patients with severe asthma (persistent airflow limitation), group (B) 48 patients with mild to moderate asthma according to (GINA 2016) criteria attending the Allergy and Clinical Immunology outpatient clinic, Ain Shams University Hospitals. The study also included 10 healthy controls of matched age and sex group.

Results

sputum periostin levels in asthmatic patients are higher than its levels in healthy controls. Sputum eosinophil percentage in asthmatic patients is higher than those in healthy controls. Sputum periostin levels in patients with severe asthma were found to be higher than sputum periostin levels in patients with mild to moderate asthma. There is high positive correlation between sputum periostin and asthma severity and age and there is negative but significant correlation between sputum periostin and (FEV1) and it is found to be correlated with duration of asthma and pattern of (PFT) abnormality (higher in mixed pattern) and sputum eosinophilia.

Conclusion

Sputum periostin is correlated with asthma severity and eosinophilic asthma. Periostin is considered to be an important biomarker for severe asthma and eosinophilic phenotype of asthma.
Changes of MicroRNA-377 in Diabetic Nephropathy
Authors: Elshinnawy H A , Kamel C R , Elkeleng M H A
Published: May 2020

Background

as one of the most important long term complications of diabetes, Diabetic nephropathy is the major cause of end stage renal disease and high mortality.

Purpose

to identify the pattern of microRNA-377 changes specific for diabetic nephropathy in diabetic patients and in patients with chronic kidney disease of different etiology.

Patients and Methods

the study was conducted from 2016 to 2018, included 50 patients for analysis of MicroRNA-377 and its control gene U18 at El Demrdash Hospital Ain shams university and Quessena Hospital El Monfia. The miRNA-U18 was analyzed for normalization of correction ratio.

Results

the results of our research found that the highest median IQR of miR-377 was significantly present in DN stage 1&2 and the lowest median IQR was significantly present in CKD stage 1&2, and there was significant difference between group 1 (DN stage 1&2) versus group 2 (DN stage 3&4), group 3 (Diabetics without nephropathy) and all stages of CKD.

Conclusion

in diabetic nephropathy stage 1&2, serum miR-377 was highly significant increased more than diabetics without nephropathy, diabetic nephropathy stage 3&4 and all satges of CKD.
Effect of statins on atherosclerosis in chronic kidney disease patients guided by CD4+CD28nullT cells over duration of six months
Authors: Okba A M , Abdelawi H S , Shaheen R Y , Amin M N , Amin M M , Ibrahim M A
Published: May 2020

Objectives

Chronic kidney disease and atherosclerosis are considered to be inflammatory process in which T cells and cytokines participate. This study determines the effect of statin therapy as an anti-inflammatory agent on the level of CD4+CD28null T lymphocyte population, and subsequently on atherosclerosis in patients with chronic renal disease.

Methods

We recruited 90 chronic kidney disease patients. The patients were divided into three groups according to carotid intimal medial thickness (CIMT) as an indicator of atherosclerosis. Two groups (group A in whom CIMT above 0.95 mm and B in whom CIMT below 0.95 mm) were given statin (atorvastatin 20mg) while the third group (group C in whom CIMT below 0.95 mm) continue only on the conservative treatment for CKD patients. CD4+CD28null T cells was measured in the three groups at the beginning of the study and after 6 months of statin therapy.

Results

CD4+CD28null T cells was decreased in statin groups (group A and B) when compared to no-statin group (group C) at the end of the study. Multivariable regression analysis for the effect of statin therapy showed that statin can independently increase the percentage of decrease both CD4+CD28null cells at the end of our study (p-value <0.0001).

Conclusion

Our study demonstrates that statins reduce CD4+CD28null T cells in CKD patients especially with atherosclerosis suggesting that statins may help in altering the inflammatory process that lead to atherosclerosis.
Elevated IL 23 in Hypertensive Patients with Acutely Increased Blood Pressure
Authors: Abo-Ali F , Ahmed E E , El-deeb M A , Basry A E A
Published: May 2020

Background

As a chronic medical condition characterized by elevated blood pressure, hypertension is recognized as a major risk factor for a variety of life threatening diseases including stroke, myocardial infarction, heart failure and aortic aneurysm. And most of these severe complications occur in the hypertensive patients with a sudden increase of blood pressure.

Aim of the Work

The aim of this study is To evaluate the role of IL23 in the immune pathogenesis of hypertension.

Subjects and Methods

This was a prospective Case-Control study was carried out in the Internal Medicine Department, faculty of medicine, Ain Shams university hospital during the period from November 2016 to December 2017.In this study we performed full history taking and examination, we also performed complete blood count, liver function tests, kidney function tests, estimation of IL23 level in plasma by ELISA in peripheral blood by Flowcytometry.

Forty five adult individual were recruited in the study and were further divided into three groups according to the symptoms of blood pressure as follow:group A patients with acute increase of blood pressure, group B patients without acute increase of blood pressure.and group C healthy volunteers with normal blood pressure as control

Results

we found that mean of IL23/CD4% was higher in group A, followed by group B then group C, all these differences was high significant

Conclusion

We demonstrated that IL-23 may be involved in the pathogenesis of acute blood pressure increase in the patients with hypertension. Understanding its inflammatory characterization might be of fundamental importance for the prevention and treatment of acute blood pressure increase in hypertensive patients.
Assessment of Serum IL-15 in Adult Acute Leukemia Patients
Authors: Moussa M M , Abdelhady E A , Shazly M A , Abdallah N H , Sheeba M S
Published: May 2020

Background

Interleukin 15 (IL-15), a proinflammatory cytokine, regulates the functions of the immune system and controls the differentiation of hematopoietic cells. However, it may also promote the development of leukemia through its role in enhancing the survival, proliferation and differentiation of leukemic precursors.

Aim of the work

To assess expression of IL-15 level in adult Egyptian acute leukemia patients, its correlation with disease free survival, overall survival and relapse rate, as well as its possible correlation with other prognostic parameters.

Patients and methods

Serum IL-15 level was measured using enzyme-linked immunosorbent assay in 30 newly diagnosed acute lymphoblastic leukemia (ALL) patients, 30 newly diagnosed acute myeloid leukemia (AML) patients and 30 age and sex-matched healthy control subjects. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from April 2017 to October 2018.

Results

In ALL patients: The serum IL-15 level was higher in ALL patients compared to control subjects (P = 0.015). Patients with ALL with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P = 0.005).

In AML patients: The serum IL-15 level was higher in AML patients compared to control subjects (P = 0.010). Patients with AML with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P < 0.001). Serum IL15 level has negative correlation with the date of death in patients with AML (P = 0.001).

Conclusion

Interleukin 15 (IL-15) is a useful poor prognostic marker in patients with newly diagnosed acute leukemia, also it can be used as a predictor for survival.

Abbreviations

AML (acute myeloid leukemia), ALL (acute lymphoblastic leukemia), IL-15 (Interleukin 15).
Endoscopic Ultrasound Versus Endoscopic Retrograde Cholangiography As A Diagnostic Tool For Patients With Dilated Common Bile Duct Of Undetermined Etiology Detected By Abdominal Ultrasound
Authors: Helal E M B , Hassan A M A , Faheem H A F , Fayed M A A A
Published: May 2020

Background

Common bile duct dilatation could result from various etiologies: choledochocholithiasis, common bile duct stricture, cholangiocarcinoma, periampullary diverticulum, pancreatic head mass, Oddi sphincter dysfunction and papillary stenosis, etc. A dilated common bile duct could denote a hidden pathological biliary condition; on the other hand it occurs in cases with advanced age or postcholecystectomy status in the absence of pathological affection.

Objective

The aim of this study is to compare between the accuracy of endoscopic ultrasound and endoscopic retrograde cholangiography as a diagnostic tool for patients with dilated common bile duct in whom abdominal ultrasonography could not demonstrate the cause of dilation.

Methods

This study was conducted on eighty (80) patients who underwent EUS and ERCP to compare between the accuracy of both as a diagnostic tool in whom TUS couldn’t demonstrate the cause of CBD dilatation, the study was performed as a retrospective analysis of prospectively collected data at TBRI (Theodor Bilharz Research Institute) after approval was obtained from the ethics and indications committee of TBRI. The study protocol was approved by the medical ethics committee of Ain Shams University and TBRI.

Results

In the current research study it was revealed that among 80 study subjects there were 24 cases having stone (30%), 26 cases having stricture(32.5%), benign cases were only 2 (2.5%), prominent CBD with no obstruction were4 cases (5%).

Conclusion

Endoscopic ultrasound is a complementary imaging modality after transabdominal ultrasound for assessment of CBD dilatation and have a crucial role in the benign and malignant periampullary tumors diagnosis additional research studies are required to be performed in a multicentric fashion considering racial and ethnic differences.
Evaluation of the Relationship between Glycated Albumin and Peripheral Diabetic Neuropathy
Authors: Elgayar M H , Abdelsalam M M , Ali H M , Ahmed R A
Published: May 2020

Background

Diabetic peripheral neuropathy (DPN) is a common complication estimated to affect 30-50% of individuals with diabetes. It is the most frequent and annoying complication of diabetes mellitus (DM), leading to the greatest morbidity and mortality and giving rise to a huge economic trouble for diabetes care, 2-3%develop a foot ulcer annually.

Objective

The aim of the present study is to evaluate the relationship between Glycated albumin and peripheral diabetic neuropathy.

Method

The present study was conducted on 40 patients with diabetes mellitus, who were collected from outpatient clinic in Ain Shams University Hospitals and national institute of diabetes and endocrinology (NIDE), from May to September 2017.

Results

It found that demyelinted type of diabetic neuropathy (n = 5) significantly had highest FBG (P = 0.031), 2PPBG (P = 0.039) and glycated albumin (P = 0.033) and no significant HbA1c (P = 0.199) however in axonal and mixed types of diabetic neuropathy showed no significant different regards FBG, 2PPBG, HbA1c and glycated albumin (P > 0.05).

Conclusion

glycated albumin has relationship with peripheral diabetic neuropathy. Also, Glycated albumin≥12.5 (gm/dL) had perfect diagnostic characteristics in diabetic neuropathy.
Comorbidity and clinical impacts of Attention-Deficit/hyperactivity disorder (ADHD) in child and adolescent with epilepsy
Authors: Khalifa O S , Ahmed N S , Nada M A , Amin R M
Published: May 2020

Aims and objectives

To highlight the comorbidity and clinical impacts of ADHD in Egyptian children and adolescent with epilepsy regarding its different characteristics and effect on quality of life.

Patients and Methods

A cross-sectional study of 115 children with epilepsy was carried out and assessed for ADHD prevalence using the DSM5 criteria, Conner’s Parent Rating Scale for ADHD, Wechsler Intelligence Scale for Children and Quality of Life in Childhood Epilepsy Questionnaire: QOLCE-55.

Results

36 founded to have ADHD (31.3%) and 79 non-ADHD (68%), the inattention type was the most common by 19 child (52.7%) , 15 (41.6%) child with combined type and only 2 (5.5%) child with hyperactive type,

The factors that were significantly associated with the co-morbidity were Lower age of onset of 1st seizure with nearly statically significant ratio (P value 0.051), the seizure presence in last 3 months group (P value 0.03), epileptic EEG abnormalities in the most recent EEG (P value 0.01), lower IQs (P value 0.002).and There was no statically significant association with sex, type of epilepsy, history of febrile seizure.

There was strong statically significant decrease in quality of life with ADHD comorbidity (P value 0.001), and decrease school attendance between ADHD and non-ADHD groups (P value 0.015).

Conclusion

ADHD is a common comorbidity in epileptic children with about 2\3 of ADHD children were not diagnosed, and severe effect on quality of life, so frequent assessment for ADHD in epileptic children is mandatory.
Assessment of Cognitive Functions in Patients with Carotid Stenosis Undergoing Carotid Intervention
Authors: Helal S A M , Elboulkemy M H , Abdelaziz A A , Mohamed A N , Elbassiouny A A I , Helmy E F O
Published: May 2020

Background

Symptomatic carotid stenosis is commonly defined as stenosis in the internal carotid artery, intracranial or extracranial, leading to symptoms of amaurosis fugax, transient ischemic attacks, or ischemic stroke ipsilateral to the lesion. Degree of stenosis varies among the major therapeutic trials studying treatment of carotid stenosis, but severe stenosis (70–99%) has been demonstrated to confer the highest risk for recurrent stroke or TIA. The number of people suffering from arteriosclerosis with vascular risk factors has been increasing recently due to the westernization of diet patterns and changing living environments, which has led to the increase in the number of patients with carotid stenosis (CS) or cerebral infarction. Severe CS is one of the important culprits underlying cerebral infarction, and can cause cognitive impairments due to continuous perfusion defects.

Aim

The aim of this study was to detect the effect of revascularization procedures on cognitive functions from baseline to 3 months follow up post-procedure in patients with CS using comprehensive psychometric tests.

Methodology

A prospective nonrandomized hospital based study was done at Ain Shams University hospitals. The study was conducted over 3 years from January 2015 till March 2018. Eighty patients with CS were enrolled, 34 patients underwent CAS procedure, six patients underwent CEA using standard techniques and the other 40 control patients follow up on conservative medical treatment. Decisions about whether and which method of treatment was applied (CEA, CAS, conservative) were taken independently of the study and were up to the treating physicians and patients. All CEAs and stents were performed under local anesthesia; periprocedural embolization was detected using follow up DW MRI imaging.

Results

Comparisons of clinical information at baseline between two groups On the basis of inclusion and exclusion criteria, a total of 80 patients were recruited into the present study and received regular follow-up. 2 were lost to follow-up from the control group (died after 2 months of study). The main determinants (age, males/ females ratio, education level, DM, HTN, dyslipidemia, ISHD, smoking, laterality and degree of stenosis by CD and DSA) were compared between patients of the two groups to make sure that both groups were homogenous with no selection bias. There was no significant difference between the two groups except for the age, total number of previous strokes as well as presence of contralateral stenosis which were more prevalent in the intervention group (p < 0.05) and thus may affect their cognitive results.

Conclusion

that extracranial carotid intervention either CAS or CEA exerts beneficial effects on some of the cognitive functions of symptomatic CS patients at 3 months after treatment, in particular, the visual, working memory and executive functions.
Early Cognitive Impairment in Multiple Sclerosis Patients In Relation To Brain Atrophy, Egyptian Sample
Authors: Zakaria M F , Abdo T A , Abdelaziz A A , Zamzam D A , Abdullah Y A , Abousteit A M
Published: May 2020

Background

Approximately half of all patients with multiple sclerosis (MS) experience cognitive impairment, most commonly with regard to new learning and memory. Cognitive dysfunction is a leading cause of disability in MS and it can have profound social and economic consequences for patients and their families.

Objective

This study was conducted to discover the early cognitive domains affected in multiple sclerosis patients concomitant with the postulated brain atrophy in an Egyptian sample of multiple sclerosis patients.

Patients and Methods

A cross-sectional observational case-control study conducted on seventy (60) patients who came for follow-up in Ain Shams University hospitals. 40 patients were taken as cases that followed up in MS unit in Ain-Shams university hospitals. 20 participants were taken as controls taken from the general medicine clinics age and sex matched to our patient group. An informed written consent was taken from parents of each person included in the study.

Results

There was a statistically significant difference between the two groups in brain volumetric changes and in the parameters of cognitive assessment

Conclusion

Early detection and examination of cognitive functions is important for patient evaluation, follow up and treatment regimen used.
Efficacy of repetitive peripheral magnetic stimulation on the functional recovery in stroke patients
Authors: Kenawy F F , Helal S A , Moustafa M M , Elnahas N M , Elnabil L M , Tork M A
Published: May 2020

© 2018 Institute of Psychiatry, Ain Shams University

Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited.

Background

Optimizing the management of stroke is a national priority. In Egypt, the mean crude prevalence rate of stroke is 721.6/100,000 1of which almost 30 percent suffer from post stroke spasticity. Theta Burst Stimulation (TBS) is a new faster modality of the conventional rTMS that is used to improve functional recovery after stroke.

Objective

This work was carried out to assess the effects of peripheral TBS in improving the functional recovery of the lower limb after stroke.

Patients and methods

A case–control study was conducted to include 27 patients with chronic stroke, who were selected from the attendants of the neurology outpatient clinic in Ain Shams University Hospital, along with 19 participants of age-matched and sex-matched stroke patients as a control group. Case and control groups were subjected to neurological and functional assessment using gait assessment rating scale (GARS) at baseline and after the sessions. An informed written consent was taken from patients included in the study. All patients received 6 sessions of peripheral TBS on affected lower limb.

Results

There was a statistically significant difference between the two groups in the improvement of functional scale (GARS).

Conclusion

Peripheral TBS improves gait and functional recovery in chronic stroke patients.
Non suicidal self injury and emotional eating in sexually abused children. relation to emotion regulation and alexithymia
Authors: Ahmed D M T , Ahmed Z M , Esmail D M H , Rabie M A
Published: May 2020

Background

Child abuse plays a role in non-suicidal self-injury (NSSI), and experience of sexual abuse in both childhood and adolescence would further increase risk of NSSI. It was found that the risk of NSSI increased over time, and this effect was considerably stronger for adolescents who reported sexual abuse or assault within the previous 12 months, potentially indicating a group at ‘‘high risk’’ for NSSI.

Emotion dysregulation (ED), including lower levels of emotional awareness and clarity must be assessed in NSSI patients. NSSI has functions in terms of emotional regulation. The relationships between NSSI, emotional eating and alexithymia should be assessed.

Objective

This study aims to investigate the effects of child sexual abuse (CSA) on emotional regulation, non-suicidal self-injury and alexithymia, independent from the psychiatric disorders.

Patients and Methods

Between October 2018 and Feb 2019, 30 healthy adolescent volunteers and 30 victims of CSA aged 8 –24 years from both outpatient clinic & inpatient department of psychiatry Ain Shams University were subjected to Full history taking, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), self punishment scale, Difficulties in Emotion Regulation Scale (DERS), The Toronto Alexithymia Scale and The Eating Attitudes test.

Results

there was a highly significant association between Child sexual abuse and the sAlexithymia Parameters in difficulty describing feelings and externally oriented thinking. Regarding the relation between CSA and Self-punishment parameters, there was a highly significant association between CSA and physical, thinking and affective and self neglegction. Regarding the association between CSA and emotional dysregulation we found highly significant association between CSA and Impulse control difficulties, limited access to emotional regulation strategies, lack of emotional clarity and difficulty engaging in goal directed behavior and there was significant association with lack of emotional awarness.

Conclusion

Child sexual abuse is associated with higher grades of Alexithymia, self-punishment, emotional dysregulation and not emotional eating.
Pre-micro RNA polymorphism detection in small versus large vessel disease in stroke patients
Authors: Elkhawas H H , Afify H H , Shokri H , Hassan E , Alzahaby A
Published: May 2020

Article Outline

Abstract Introduction Patients and methods Procedure Statistical analysis Results Discussion Conclusion References

Background

Cerebrovascular accidents are the second leading cause of death and the third leading cause of disability worldwide. The methods currently available for diagnosis and prognosis of cerebral ischaemia still require further improvements. Micro-RNAs (small non-coding RNAs) have been recently reported as useful biomarkers in diseases such as cancer and diabetes. Further research concerned with microRNA (miRNA) profiling from peripheral blood to detect and identify characteristic patterns in ischaemic stroke is crucial.

Aim of the work

This study aims to investigate the association between three potentially functional polymorphisms in pre-miRNAs and stroke subtypes (small vessel disease and large vessel disease) in a sample of Egyptian stroke patients.

Patients and Methods

This is a cross sectional study conducted in Ain Shams University Hospitals in which 81 patients presenting with cerebrovascular stroke fulfilling criteria of small vessel disease (SVD) or large vessel disease (LVD) according to TOAST [2] classification in the period from March 2018 to August 2018 were included. Blood samples were withdrawn for DNA extraction to investigate the association between three potentially functional polymorphisms (rs2910164, rs11614913, and rs3746444) in pre-miRNAs (hsamiR-146a, hsa-miR-196a2, and hsa-miR-499, respectively).

Results

Smoking, hypertension and diabetes were significant value in both stroke subtypes. Meanwhile, age and gender showed no significance between both stroke subtypes.

Conclusion

Ischemic stroke has polygenic basis, but identification of stroke susceptibility gene and quantification of associated risks has been hindered by conflicting results from different studies.
Role of Repetitive Transcranial Magnetic Stimulation on Drug Resistant Focal Epilepsy: A Controlled Clinical Study
Authors: Ashour S , Gaber A , Hussein T , Kamal A
Published: May 2020

Copyright 2019 Department of Neuropsychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited

Purpose

This study was designed to evaluate the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with drug resistant focal epilepsy.

Methods

Fifty-five patients with drug resistant neocortical focal epilepsy were screened and 30 patients were divided into two groups (active and sham ) were given (0.5 hz , 1000 pulses , 90%of resting motor threshold (rMT)) on stimulation site detected by correlation between clinical semiology, EEG and or MRI finding. Seizures frequency, severity and seizure free days were compared for one month before and after rTMS with no change in antiepileptic drugs. We assumed 50% seizure reductionrate after rTMS.

Results

Seizures significantly decreased following rTMS treatment 50% seizure reduction was achieved 87.5%inthe active rTMS groupand50% in the sham rTMS group(p > 0.03).in the follow-up period compared to baseline period. Seizure free days %increase in active group 20.7% compared to sham group 7.5% (p = 0.0501).

Significance

Low-frequency rTMS delivered into the epileptogenic zone had a significant antiepileptic effect on patients with drug resistant neocortical focal epilepsy.

© 2018 Department of Neuropsychiatry, Ain Shams University
Cryptogenic stroke: An approach towards discovery of its possible hidden causes
Authors: Soliman N L , Helala S A , Saleh M A , Elkhawas H M , Elhadidi E S , Elsadek A M
Published: May 2020

Background

lschemic stroke is among the leading causes of death and disability. The cause remains unexplained after routine evaluation in 20 to 40% of cases, resulting in the classification, by exclusion, of cryptogenic stroke

Objective

To unleash possible hidden causes of cryptogenic stroke.

Patients and Methods

A cross-sectional study was conducted to include 55 cryptogenic stroke patients admitted in stroke units in Ain shams university hospitals, patients were subjected to full general and neurological examination and labs were done to detect presence of autoantibodies Antinuclear Antibodies (ANA), Anti-Double Stranded DNA(anti-dsDNA). Antineutrophil Cytoplasmic Antibodies (ANCA), Lupus Anticoagulant (LAS) and Anticardiolipin antibody (ACA).

Results

11% of the study group tested positive for LAC and 4 % tested positive for ACA.

Conclusion

LAC and ACA might be linked to the etiology of cryptogenic stroke
Follow up study on Attention Deficit Hyperactivity Disorder patients with and without comorbid mood disorders receiving Non Stimulant medication
Authors: Shaker N , Helmy D , Adel A , Fahmy Y O M
Published: May 2020

Article Outline

Abstract Introduction Patients and methods Procedure Statistical analysis Results Discussion Conclusion References

Background

Irritability is common in Attention deficit hyperactivity disorder (ADHD) which is sometimes associated with Mood symptoms. Results from community samples suggest that 4.3–23.5% of those with ADHD meet Disruptive mood dysregulation disorder diagnostic criteria.

The Aim of this study: To compare the prognostic outcome of ADHD symptoms in ADHD children with comorbid mood disorders compared to those without comorbid mood disorders receiving non-stimulant medication.

Patients and Methods

This is An observational prognostic prospective study in which two groups of ADHD patients were included in the study, group 1 includes 40 ADHD patients without comorbid mood disorders and group 2 includes 40 ADHD patients with comorbid mood disorders, they were assessed using; The Kiddie Schedule for Affective Disorder and Schizophrenia for School Age Children

Rating scales as Conners’ Parent Rating Scale-Revised Long Version, Pediatric behavior rating scale and Children Depression Inventory.

Results

ADHD symptoms (hyperactivity and inattention) were found to be improved regarding the hyperactivity in a statistically significant way in the mood group after 1 week of receiving non stimulant medications, while there was no significant change in the non-mood group, Also there was significant improvement of the inattention symptoms among the two groups after receiving non stimulant medication.

Meanwhile severity of depressive symptoms showed an improvement in the mood group while there was no change in severity in the non-mood group. As regards the irritability symptoms it showed insignificant change in both groups among the two follow-ups.

Conclusion

There is a more significant decrease in inattention symptoms in ADHD children with comorbid mood disorder who received non-stimulant treatment for one week more than the children without comorbid mood disorder. Moreover the depressive symptoms decreases among patients with ADHD and mood disorders after one week of receiving non-stimulant treatment.
Delusions in a Sample of Patients with Schizophrenia and Bipolar Disorder: The same or different?
Authors: Azzam H M E , Hamed M A , Elhawary Y A , Mohammed A H A
Published: May 2020

Background

Growing evidences indicate that there is overlapping between schizophrenia (SCZ) and bipolar disorder (BP) in neurobiology, phenomenology or even in changing of diagnosis from schizophrenia to bipolar disorder or vice versa. Psychotic symptoms can be observed during manic or depressive episodes in bipolar disorder. While manic or depressive episodes can be observed between or during psychotic episodes in schizophrenia.

Aim of the work

To describe delusional types present in both groups of study sample: a group of patients with schizophrenia and a group of patients with bipolar disorder accompanied by psychotic features. Also to compare between types of delusions in patients with schizophrenia and patients with bipolar disorder accompanied by psychotic features.

Patients and Methods

total 80 patients (40 in group of Schizophrenia and 40 in group of bipolar disorder accompanied by psychotic features) were selected as convenient sampling from patients during the first two weeks of their admission in the Institute of Psychiatry, Ain Shams University Hospitals. Nature and types of the delusions were assessed by using Scale for the Assessment of Negative Symptoms (SANS), Positive and Negative Syndrome Scale (PANSS) and Young Mania Rating Scale (YMRS) in study period from 1st of October 2017 till 1st of April 2018.

Results

Delusion of persecution is the commonest delusion in group of SCZ (37.5%), while delusion of grandiosity is the commonest delusion in group of BP accompanied by psychotic features (32.5%). Monothematic delusions are doubling frequent in group of BP accompanied by psychotic features (75%) if it compared to group of SCZ (35%). Non systematized delusions are the dominant in group of SCZ (45%) while most delusions in other group are some systematized (45%). Delusions of most patients in group of SCZ are incongruent with mood (77.5%). While delusions of most patients in group of BP accompanied by psychotic features are congruent with mood (65%). The presence of delusion is positively correlated to higher score of: SANS (in both groups), PANSS (in both groups) and YMRS (in BP accompanied by psychotic features).

Conclusion

delusions of schizophrenia are different in nature and types when it compared to delusions of bipolar disorder.
Prevalence of Psychiatric Disorders in the Out Patient Clinic of a University Hospital- Focus on Conversion disorder- A cross- Sectional Study
Authors: Okasha A M , Abdo T A , Mahmoud N Z , Elmissiry M M , Elqitqat R S
Published: May 2020

Background

Common mental disorders are highly prevalent globally, affecting people across all regions of the world. Mental disorders are not only highly prevalent medical conditions but they are also highly disabling. Conversion disorders tend to be poorly understood and can be difficult to diagnose and distinguish from other psychiatric disorders that involve physical symptoms.

Objectives

This study was carried out to study the prevalence and frequency of different psychiatric disorders in a sample of Egyptian patients attending the outpatient clinic of the institute of psychiatry – Ain-Shams university hospital with a focus on hysteria, both conversion and dissociative type.

Patients and Methods

This case control observational study was started from December 2016 till December 2017. The subjects were selected from outpatient clinics of Institute of Psychiatry, Faculty of medicine, Ain Shams University. The first 1000 random patients who present to the above mentioned clinics were recruited. Patients were subjected to Arabic version of Structured Clinical Interview for DSM-IV-TR Axis I Disorders.

Results

Our study reveals that the most common diagnosis was that of mood disorders (24.6%), followed by schizophrenia (23.4%). Somatoform disorders, of which conversion is a subcategory, came as the 5th most common diagnosis with (5.2%).

Conclusion

our study reveals that hysteria, in both conversion and dissociative disorders, is a surviving diagnosis, despite of the separation of both diagnoses into different diagnostic categories
Management of sellar and suprasellar lesions
Authors: Elbakeei H A , Ali A K , Ebrahim K S , Noseir M E , Elsebeely O E
Published: May 2020

Background

Pathology in the sellar and suprasellar regions accounts for several disabling and distinctive neurological syndromes characterized by visual failure and upper cranial neuropathies. These features have a major impact on functional outcome more than the commonly associated endocrine morbidity.

Objective

this study aimed to present the incidence of various lesions in the sellar and suprasellar area and evaluate the different protocols for management of these lesions.

Methods

The study will include 40 cases of sellar& suprasellar lesions that will be admitted and treated in the neurosurgical departments in Ain Shams University Hospital as well as El-Galaa armed forces hospitals and 57375 Children Cancer Hospital between 12/2015-9/2018

Results: Pituitary adenoma was the most frequent(42.5%), followed by craniopharyngioma(30%), then Meningioma(12.5%) with other low frequent diagnoses , Headache was the most common complaint followed by blurring of vision, diplopia and nausea & vomiting. MRI sella was the most valuable investigation. 3 approaches were used and trans-sphenoidal approach was the most common used approach. Postoperative radiotherapy was significantly most frequent in Craniopharyngioma followed by pituitary adenoma and least frequent in meningioma.

Conclusion

we have reached to conclusion from this study, that transsphenoidal approach was suitable for most pituitary adenomas and Its main indication was mainly midline sellar and suprasellar tumors with limited lateral or posterior extension. The pterional approach was suitable for meningiomas and craniopharyngiomas and Its indication was a supra-or parasellar lesions with both lateral and posterior extension specially those reaching the clivus. Total excision was most frequent in pituitary adenoma followed by meningioma and least frequent in craniopharyngioma. Postoperative radiotherapy was significantly most frequent in Craniopharyngioma followed by Pituitary Adenoma and least frequent in meningioma.
Posterior Fossa Mid-Line Space Occupying Lesions Diagnosis and Surgical Outcome
Authors: Abd-allah A N M , Hammad O Y , Elshehaby A M N , Morad S H , Abdelkareem E M
Published: May 2020

Background

posterior fossa tumors are more common in children that in adults. Between 54% and 70% of all childhood brain tumors originate in the posterior fossa. About 15-20% of brain tumors in adults occur in the posterior fossa. Certain types of poeterior fossa tumors, such as medulloblastoma, pineoblastoma, ependymomas, primitive neuroectodermal tumors, and astrocytomas of the cerebellum and brain stem, occur more frequently in children.

Aim of the Work

the aim of this study was to review the preoperative diagnostic modalities, surgical procedures and outcome for different midline posterior fossa space occupying lesions.

Patients and Methods

this is retrospective study has been conducted on 50 patients with posterior fossa midline space occupying lesions during the period March 2013 to October 2015, at Department of Neurosurgery, Ain Shams University. All Patients have been subjected to preoperative clinical assessment; thorough history taking, complete general and neurological examination according to Ain Shams University neurosurgical sheet.

Results

this study was conducted on 50 patients with midline posterior fossa space occupying lesions. All of them underwent a midline suboccipital approach. The pre and post-operative data were collected and analyzed. This study included 50 patient, 26 female (52%) and 24 male (48%) patients. The mean age ranges from 1 year to 60 years.

Conclusion

surgery is the treatment of choice for the cases of posterior fossa mid line lesions especially in children and adolescents to decreases the risk of disabilities and increases the survival.