bluuebunny/crossref_metadata_2025 huggingface dataset:
Intralesional Mitomycin C Injection in Management of Caustic Esophageal Stricture in Children
Authors: Abdelhamid H S , Elasmar K M , Zaki A A , Ghanem W A , Elbehery M M
Published: May 2020

Background

Corrosive ingestion is a devastating event that induces significant burdens on modern health systems worldwide. The management of resulting esophageal strictures is challenging where endoscopic dilatation is the first line of management with varying rate of success.

Aim of the Work

We aimed at this work to study the feasibility and safety of intralesional Mitomycin C injection in patients with caustic localized esophageal stricture.

Patients and Methods

This study has been conducted at Pediatric Surgery Department, Pediatric Hospital, Ain Shams University Hospitals on eight pediatric patients with caustic esophageal stricture with variable degrees of dysphagia. We evaluated the clinical improvement of the dysphagia, as well as the intra and postoperative complications of Mitomycin C injection.

Results

Eight patients with short caustic esophageal stricture were managed with intralesional Mitomycin C injection adjuvant to endoscopic dilatation. Seven patients were completely cured from dysphagia with at least 6 months dysphagia free period. No intraoperative complications were documented while there were two cases who reported GIT side effect postoperative in the form of colics and non-bilious vomiting that resolved by medical treatment.

Conclusion

Intralesional Mitomycin C injection could be a good adjuvant therapy with endoscopic dilatation for caustic esophageal stricture. However, long-term observations are mandatory on a large scale of patients.
Soy Skin Prick Test in Patients with Physician-Diagnosed Atopic Disorders
Authors: Reda S M , Radwan N M , Abdelghany H R
Published: May 2020

Background

Soy protein is an important component of soybeans and is one the 8 most significant food allergens. Yet, the prevalence of soy allergy in the pediatric population is not well defined.

Objectives

To evaluate the incidence of IgE mediated soy protein sensitization among children with clinical manifestation of atopic disorders by the use of skin prick test (SPT) for soy protein.

Methods

Two hundred patients with atopic manifestations attending the Pediatric Allergy and Immunology Clinic at the Pediatric Department of Ain shams University, were recruited between January 2017 till January 2018. They were subjected to SPT to soy protein, measurement of total serum IgE and eosinophilic count in the peripheral blood.

Results

Of the 200 patients, 108 (54%) were males and 92 (46%) were females with a male to female ratio of 1.17:1. Their ages ranged between 2 years and 15 years (mean±SD; 6.0±33.3 years). Seven patients (3.5%) had positive skin prick test to soy protein. The mean value for the absolute eosinophilic count was 0.4x109/L. The median for the total serum IgE level was 50 IU/L. According to age, the highest percentage of soy protein sensitivity was elicited among patients less than 3 years (57.14%), followed by those between 3 to 6 years (28.5%) and those between 6 and 15 years (14.28%). A positive family history of atopy was recorded in 122 (61%) of all cases. In terms of gender, incidence of soya sensitivity was higher among males than females but with no statistical difference. Although the most common allergic manifestations of all studied patients were respiratory (83%), and atopic dermatitis (22.5%), yet positive SPT to soy proteins was elicited in 43% in allergic rhinitis cases, in 29% of asthma patients, in 14% of patients with combined asthma and allergic rhinitis, and 14.3% of patients having eczema.

Conclusion

Soy protein sensitization is not uncommon in children especially in those with atopic manifestations. Large scale studies are needed to evaluate the actual incidence of soy protein hypersensitivity in children.
Study of Diagnostic Criteria of Hemophagocytic Lymphohistiocytosis in Neonatal and Pediatric Sepsis
Authors: Elalfy M S , Ragab I A , Noureldin  , Ahmed A R , Mohammed S M
Published: May 2020

Background

sepsis, a syndrome of physiologic, pathologic, and biochemical abnormalities induced by infection, is a major public health concern; There is overlap between clinical and laboratory criteria induced by sepsis and hemophagocytosis

Aim of the Work

to compare HLH by its known criteria among patients with neonatal sepsis admitted to NICU and childhood sepsis admitted to PICU and compare the outcome of patients with and without HLH criteria.

Patients and Methods

a cross-sectional study including 50 neonates and children with severe sepsis and/or septic shock was performed in Ain Shams University, Pediatric Hospital; 25 of patients were admitted to neonatal ICU and 25 to pediatric ICU. Clinical and laboratory data together with criteria for hemaophagocytic lymphohistiocytosis were analysed and studied in relation to patients outcome.

Results

the young age of our enrolled patients ranging from neonatal to pediatric age with mean age of 30 days in neonatal group and 1.5 years in pediatric group, with 4% fulfilled 5 criteria, 2% fulfilled 4 criteria, 18% fulfilled 3 criteria. All patients who fulfilled 3 or more criteria for HLH died, there was no difference in mortality rate or age groups neonates versus pediatrics according to HLH criteria.

Conclusion

some criteria of HLH were positive among patients with sepsis with no difference between pediatric and neonatal group. However, patients fulfilling 5 criteria of HLH were 4% in our study with no difference in mortality between those with 5 criteria positive and negative ones.
Gut priming with oral Bovine Colostrum for preterm neonates: A randomized control trial
Authors: Awad H A , Imam S S , Aboushady N M , Ismail R I H , Abdou R M , Azzam N T
Published: May 2020

Objective

to determine whether gut priming with bovine colostrum reduces nosocomial sepsis episodes, feeding intolerance and necrotizing enterocolitis (NEC) in premature infants and to evaluate the possible effects of bovine colostrum on T regulatory cells (Treg) levels.

Study Design

a prospective, placebo-controlled, double-blind, randomized trial, infants born before 34 weeks were assigned to receive either placebo (n 48), or bovine colostrum (n 32) as gut priming. Episodes of nosocomial sepsis by using Rodwell and Töllner sepsis score, feeding intolerance and NEC according to Bell’s criteria were recorded. The level of FOXP3 + CD4 + CD25hi lymphocytes was studied by flow cytometry at birth and after 10 days.

Results

Fewer sepsis episodes were observed in bovine colostrum-treated infants (3 vs. 10, p-value 0.174) with none developing NEC (0 vs. 5, p-value 0.059). Also bovine colostrum gut priming significantly reduced feeding intolerance (1 vs. 9, p-value 0.038) and mortality (0 vs. 8, p-value 0.015). Treg levels initially and follow up were similar, However, Treg levels change difference were higher in the bovine colostrum group (p-value 0.8) with statistically significant difference in FOXP3 expression (p-value 0.018).

Conclusion

Gut priming with oral Bovine Colostrum decreases feeding intolerance, NEC, late onset sepsis and mortality in preterm neonates. We recommend bovine colostrum usage as gut priming.
The psycho phenotypic profile of an Egyptian sample of patients with ADHD
Authors: Zaky E A , Zahra S S , Abdelaziz A W , Abdelhakim R , Abdelmageed R I
Published: May 2020

Objectives

The current study aimed to investigate the psycho-phenotypic profile of an Egyptian sample with ADHD cases.

Subjects & Methods

Eighty cases diagnosed as ADHD (according to the DSMV) were enrolled in the current study. They were selected sequentially from those following up in the child and adolescent clinic, children hospital, Ain shams University.

Results

The ages of the enrolled sample ranged between 4&12 years. Males were (86%) and Female (14%) with ratio 7:1. Consanguinity rate was (25%) while positive family history was (12%). Perinatal insult was detected in (22%). Inattentive ADHD was seen in 90% of cases while combined type in 10%. According to Conner’s parents’ scale (5%) had mild, (25%) moderate and (70%) severe ADHD symptoms. Comorbid conditions were seen as follows; Delayed language development (30%), stuttering (9%), delayed bladder control (15%), pica (2%), polyphagia (2%), sleep disorders [nightmares (4%), insomnia (9%), somnambulism (3%)], poor academic performance (95%), dyslexia (15%), dysgraphia (18%), conduct disorder (5%) and aggression (12%).

Conclusion

The current study delineated that there are so many phenotypic variation in Egyptian ADHD cases. This high-lightened the importance of individual assessment of such cases in order to configure the subtype, severity and identification of possible comorbidity. This enable the clinicians to individualize a treatment plan for each patient aiming at better outcome.
Comparison between the effect of platelet rich plasma (PRP) and hyaluronic acid local injection in treatment of thumb carpometacarpal joint osteoarthritis
Authors: Abdelfattah R , Abdelsabour H , Alzifzaf D , Saad H
Published: May 2020

Base of the thumb OA represents one of challenges to clinicians due to limited efficacy of treatment options. Resulting in OA pain, in addition it can cause deformity, stiffness with decreased range of motion and strength. The conservative therapeutic approach is the main line in management. Local injection treatment could be a good choice because of low systemic side effects and rapid improvement.

Objectives

to compare the effectiveness of PRP versus hyaluronic acid injection in osteoarthritis of thumb carpometacarpal joint based on clinical and functional outcome measures.

Patients and Methods

Prospective interventional study conducted on thirty patients with thumb CMC OA. Patient was assessed by joint Palpation for tenderness with grading from I-IV, Provocative tests (Grind test and Lever test), VAS for pain, AUSCAN score, grip and pinch strength. The patients were randomly divided into two equal groups, Group 1: received single Platelet-Rich Plasma (PRP) intra-articular injection. Group 2 received single hyaluronic acid injection. Re-evaluation at 4 and 12 weeks was done for tenderness, VAS, AUSCAN index, Grip and pinch strength.

Results

This study was conducted on thirty patients with ages ranged from 40 to 70 years (mean: 52.77 ± 8.59). Our results revealed that both groups showed a highly significant improvement after 4 weeks regarding pain relief assessed by VAS, tenderness grading, AUSCAN hand function score, grip and pinch strength after injection in comparison to before injection (P = 0.000). However, these improvement couldn’t be sustained for the PRP group after 12 weeks, there was a highly statistically significant increase (deterioration) in hand functional score from 4 to 12 weeks follow up (P = 0.000) and total score (P = 0.004) , highly statistically increase in VAS(P = 0.000) and decrease in grip & pinch strength (P = 0.000) , while HA group showed a highly statistically significant improvement regarding pain, hand function score , grip and pinch strength after 12 weeks of injection.

Conclusion

We observed clinical improvement in both groups of CMC OA treated either with single dose of HA or PRP at 4 and 12 weeks follow up. However, HA provide a superior improvement with respect to PRP at 12 weeks follow up regarding VAS for pain, joint tenderness, AUSCAN hand function score, grip and pinch strength. So we support the use of a single hyaluronic acid injection as therapy for thumb CMC OA in preference to PRP injection.
The relation between cardiovascular affection and erosive articular changes in patients with rheumatoid arthritis
Authors: Hassabelnabi M M H , Assaf N Y , Zidan H F , Abushanab G M M
Published: May 2020

Background

rheumatoid arthritis is currently regarded as independent cardiovascular risk factor. Accelerated atherosclerosis considered as an extra-articular manifestation of RA that occurs as a result of interaction between traditional CV risk factors and inflammatory activity of joint disease. Both atherosclerosis and RA have in common inflammatory mediators.

Objectives

the presented study aimed to find the relation between cardiovascular affection and erosive articular changes in RA.

Subjects and Methods

The presented study included 40 patients’ men and premenopausal women that were diagnosed with rheumatoid arthritis fulfilling the 2010 ACR/EULAR classification criteria for rheumatoid arthritis recruited from the physical Medicine, Rheumatology, and Rehabilitation outpatient clinics of Ain Shams University, patients underwent laboratory investigation, carotid duplex, musculoskeletal ultrasound and echocardiography.

Results

Among 40 RA patients, 16 (40%) had erosions in both hands and 24 (60%) without erosion with no statistically significance difference between both sides of hand and feet, only 3 patients (7.5%) had active erosion exhibited by power Doppler.

The presence of erosion positively correlated with the mean CIMT (p-value < 0.001) with mean 0.827±0.149, The presence of carotid plaques as a marker of advanced atherosclerosis showed statistically significant value with erosions (p = 0.001). There was positive relation between erosions with disease duration (p-value < 0.001), and negatively with DAS-28 (p = 0.083). Out of 33 patients with positive RF, 16 patients had erosions with statistically significant value (p = 0.017).

Conclusion

Since the presence of bone erosions was highly associated with higher mean CIMT, consequently, we recommend that when finding bone erosions in rheumatoid arthritis patient, good monitoring should be given to cardiovascular risk factors with early and proper treatment to limit the progression of erosions and protect against atherosclerosis and its complications.
Dry needling versus ultrasonic in treating cervical myofascial pain syndrome
Authors: Ali H A , Elzohiery A K , Arafa M M , Elkadery N A
Published: May 2020

Background

Myofascial pain syndrome (MPS) is a complex pain syndrome characterized by myofascial trigger points (MTrPs) in skeletal muscles. Ultrasound (US) therapy is one of the main devices used in physical therapy, for the treatment of MTrPs in MPS. Dry needling is skilled technique also used in the treatment of MTrPs in MPS.

Purpose

This study aimed to compare the effect of dry needling with the effect of ultrasonic waves in the treatment of cervical myofascial pain.

Subjects

a sample of 30 patients with myofascial trigger points in trapezius muscle was randomly chosen and divided into 2 groups each contains 15 patients.

Methods

the first group was treated by ultrasonic waves in a pulsed mode (1MHz, 1W/cm², 1:1 ratio) 5 min to each trigger point and the second group was treated with deep dry needling (peppering technique) to each trigger point with a rate of 3 times per week for 3 weeks.

Results

All patients shows significant improvement (P > 0.001) immediately after treatment period with disappearance of trigger points, increasing in cervical ROM and decreasing in VAS ; but 3 weeks later trigger points reappeared, ROM decreased and VAS increased again.

Conclusion

both modalities of treatment were considered effective in treating myofascial pain syndrome.
The Effect of Perineural Injection in the Treatment of Carpal Tunnel Syndrome
Authors: Elsebaie M A , Elarousi N H , Elattar E A , Mohamed A A
Published: May 2020

Background

This study was carried out to determine the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS. It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002).

Objectives

To study the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS.

Patients and Methods

It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002). All patients received PIT sessions. The injection done once weekly for 6 weeks. They were assessed before and after the treatment sessions by the following: provocative tests (Tinel, phalen and reverse phalen), clinical assessment scale (VAS and BCTQ"SSS, FSS") and nerve conduction study.

Results

By the end of the treatment, All provocative tests & All assessment scores showed a highly statistical significant difference (p > 0.01). Regarding sensory examination: night parethesia, hand pain and tingling &numbness showed a highly statistical significant difference (p > 0.01). Our results as regard nerve conduction studies of DML, sensory CV and DSL —difference between median and ulnar nerves showed that there was a statistical significant difference with improvement and there was a highly statistical significant difference with improvement as regard DSL and DML-difference between median and ulnar nerves. Before treatment VAS has a positive correlation with DML (r = 0.448, P < 0.05), another significant positive correlation was found between SSS and DSI (r = 0.45 , p < 0.05), but there was a negative correlation between VAS and the following MCV (r=-0.536, p < 0.05) and SCV (r= -0.462, p < 0.05). After treatment there was a negative correlation between VAS and the following SCV (r = -0.528, p < 0.05) and MCV (r= -0.618, p- 0,01 ).

Conclusion

Our study revealed that PIT Of D5W is an effective treatment for patients with mild to moderate CIS.
The Tale of Two Challanges: Stem Cells and Diabetic Vasculopathy
Authors: Naguib Y M , Abdelghany S M , Noreldin R I
Published: May 2020

Background

Diabetes is a metabolic disorder highly linked to several systemic complications. Diabetic patients largely suffer from hyperglycemia-induced macro- and micro-vascular abnormalities. Accumulating data have suggested a beneficial role of endothelial progenitor cells in diabetic microvascular diseases.

Objective

We evaluated the possible therapeutic effect of injecting transformed human umbilical cord mesenchymal stem cells on cardiovascular and renal functions in old diabetic rats.

Methods

Thirty old (18-14 months) male Wistar albino rats weighing 300-350g were used in the present study. Diabetes was induced by intra-peritoneal streptozotocin injection. Rats were assigned (10/group) to Naive (received no treatment), diabetic control (injected with saline), and diabetic transformed mesenchymal stem cell treated (TMSCs). Measurement of blood pressure and doppler studies were performed, and blood samples were collected. Animals were then scarified and large and small vessels were collected for immunohistopathology.

Results

Anti-CD31 immuno-staining has shown successful homing of the injected transformed stem cells to the vascular endothelium. TMSCs treated group featured reduced systolic blood pressure, heart rate and pulse wave velocity when compared to control group. TMSCs treated group had lower serum level of vascular endothelial growth factor (VEGF), interleukin1β (IL-1β) and tumor necrosis factor alpha (TNFα). Renal function parameters (KIM-1 and cystatin C)) were significantly lower in TMSCs treated group. Renal artery doppler study revealed improved blood flow and reduced resistance in the TMSCs treated group when compared to the control group.

Conclusion

We show here that transformed mesenchymal stem cells could be a potential therapeutic approach against hyperglycemia-induced macro- and micro-vascular complications in aged diabetics.
Role of ultrasound in assessment of abnormalities in knee trauma in comparison to MRI
Authors: Fahmy M I , Abdelghany A F , Aly A H , Farid D S
Published: May 2020

Aim of the Work

to assess the role of high resolution ultrasonography (US) in the evaluation and assessment of different abnormalities resulting from knee trauma compared to Magnetic resonance imaging MRI

Aim and Patients and Methods

51 patients presenting with knee pain after variable degrees of knee trauma and referred to radiology department will be examined by US and MRI. Results are compared and data analysed.

Results

US had significant results in medial collateral ligament (MCL), menisci, quadriceps and patellar tendons, joint effusion and parameniscal cysts. Poor US results were obtained in cruciate, lateral collateral ligament (LCL) and bone injuries.

Conclusion

Ultrasound can be used in the initial assessment of patients after knee trauma. It has comparable results to MRI in tendons, periarticular ligaments, joint effusion and menisci assessment with still some limitations noted in the cruciate ligaments and bone injuries assessment.
The value of Transcranial Doppler sonography in children with sickle cell disease compared to non-transfusion depenendent thalassemias: Cohort Randomized study
Authors: Ahmed K A , Abdelrahaman H I , Kenny M A , Abdou S M
Published: May 2020

Background

Transcranial Doppler ultrasonography is the only method provides a relatively inexpensive, noninvasive real-time measurement of blood flow characteristics and cerebrovascular hemodynamics within the basal arteries of the brain, adding physiologic information to the anatomic images. It seems ideally suited to screening for large-vessel disease, because it is safe, noninvasive, relatively low in cost, and well tolerated by children.

Objective

Is to measure the blood velocity in cerebral vessels by Transcranial Doppler in patients with sickle cell anaemia according to transfusion status and in patients with non transfusion dependent thalassemia.

Patients and Methods

Cohort study of sixty patients on children following up paediatric haematology clinic at children hospital, Ain shams university from March 2018 till September 2018.

Results

according to the STOP trial the Doppler velocity of the right MCA among the 60 patients are 55 patients were normal (91%), 1 patient was very low (1.7%),1 patient was conditional (1.7%) and 3 patients were abnormal ( 5.0%) and 5 patients are at risk (8.3%),and the Doppler velocity of the left MCA among the 60 patients are 54 patients were normal (90.0%), 2 patients were very low (3.3%), 3patients were conditional (5.0%) and 1 patient was abnormal (1.7%).

Conclusion

TCD is the recommended method of assessing stroke risk in SCD patients and NTDT, it is particularly useful in children because it is painless, noninvasive, available relatively inexpensive, easy to perform, and requires no sedation or contrast media or radiation exposure.
The Value of Contrast Enhanced Spectral Mammography in BIRADS Categorization of Equivocal and Suspicious Breast Lesions
Authors: Ali S B , Elshinawi M E , Chalabi N A , Keriakos N N H , Attia W A M H
Published: May 2020

Aim

To evaluate the capability of CESM to upgrade/downgrade BIRADS category of equivocal and suspicious breast lesions.

Patients and Methods

Thirty female patients with 44 equivocal and suspicious breast lesions, were enrolled in our study, age ranged from 20 to 76 years. All patients underwent conventional mammography and ultrasound then CESM.

Results

Mammography+Ultrasound categorized 40/44 lesions (90.9%) lesions to be malignant (BIRADS 4,5) and 4/44 lesions (9.1%) to be benign (BIRADS1,3). CESM categorized 35/44 lesions (79.5% )to be malignant (BIRADS 4,5) and 9/44 lesions (20.5% ) to be benign (BIRADS1,3). Disagreement about BIRADS category was observed in 25% of the examined lesions including upgraded and down graded lesions in 11.36 % and 13.6 % respectively. 100% of up/down graded lesions also proved CESM to be correct in reference to the final diagnosis.

Conclusion

CESM has better diagnostic performance than mammography plus Ultrasound and provides a valuable tool to accurately evaluate equivocal and suspicious breast lesions.
Added value of diffusion weighted mri to conventional mri in the assessment of uterine cervix cancer post therapy
Authors: Nasr A M , Kamal O A , Kamel O F , Hashim S A N
Published: May 2020

Purpose

of this study is: Assessing the role of Diffusion weighted imaging with ADC mapping in the evaluation of uterine cervical cancer post therapy regarding tumor residual, recurrence or post treatment benign changes/ complications after tumor resection and/or chemotherapy/radiotherapy.

Methods

The study included 48 female underwent cervical cancer treatment, referred to Radio diagnosis Department of National Cancer Institute for post therapy assessment. Each patient included in the study was subjected to full history taking, reviewing medical sheet and MR examination including: Conventional MR examination and Diffusion Weighted imaging.

Results

The study showed that the use of quantitative DW imaging with ADC mapping provide added value in the detection of post-treatment malignant masses and differentiating it from post-treatment benign changes.

Conclusion

The current application of diffusion Weighted MRI as a routine with conventional MRI sequences increased the accuracy of detection of post therapy benign and malignant masses , Our results suggested also that the use of ADC can be helpful in differentiating post-treatment malignant masses from benign post-treatment changes.
Evaluation of Role of Beta 2 Microglobulin and P- ANCA in the diagnosis of Ulcerative Colitis and Their Correlation to Disease Activity
Authors: Aboelmaged W A , Abdelhalym A S A , Eltabbakh M M M , Omar Y N A
Published: May 2020

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract. Diagnosis of IBD has been based on a combination of clinical data, blood parameters, radiology and endoscopy. Activity in IBD is determined by direct and non-invasive laboratory markers. The ideal marker for IBD that is easy, specific and predictor of relapse of the disease has not yet been identified. The aim of this work is to evaluate the role of P-ANCA and Beta 2 microglobulin as new biomarkers in predictors of diagnosis and disease activity in patients with ulcerative colitis.

Materials and Methods

The current case control study was conducted in Tropical Department of Ain-Shams University Hospitals on 40 cases of ulcerative colitis which included twenty patients in activity and twenty patients in remission. 40 controls were consisting of twenty patients with irritable bowel syndrome and twenty healthy controls in the period from October 2016 to May 2018.

Results

Mean B2-M values were significantly higher in active ulcerative colitis (2.26± 0.55mg/L) than in healthy controls (1.43 ± 0.22 mg/L) and IBS (1.51 ± 0.23 mg/L). Also, mean B2-M values were significantly higher in active disease when compared to patients in remission. The difference between different disease severities according to endoscopic picture in terms of serum B2-M levels was statistically insignificant (P > 0.05).Also the difference between mild disease and inactive group was insignificant. Regarding the P-ANCA, most of active UC cases (80 %) have positive P-ANCA. While only 15 % of the inactive cases have positive P-ANCA and the difference between them is highly statistically significant (P = 0.000). Most of P-ANCA positive ulcerative colitis patients (52.6%) have moderate endoscopic activity and (21.1%) have severe endoscopic activity, while only (10.5%) have mild activity with high statistical significance (P = 0.001).

Conclusion

B2-M and P-ANCA may be a predictor of disease activity in UC
Immune Response for Newely HBV Vaccinated Health-Care Workers at Ain Shams University Hospitals
Authors: Elfolly R F , Ahmed T A , Aly H H , Khalil A M
Published: May 2020

Background

hepatitis B is a major global health problem and a potentially life-threatening liver infection caused by the hepatitis B virus (HBV). Hepatitis B virus belongs to the hepadnaviridae class of viruses.

Aim of the work

to estimate the non-responder rates to the hepatitis B vaccine, to identify possible risk factors of non-response (to determine the need for revaccination and to guide for post-exposure prophylaxis).

Patients and Methods

this study included one hundred healthcare workers at Ain-Shams University Hospitals from different departments after taking informed consents to participate in the study. The study group included all healthcare workers who are currently subjected to HB vaccine standard schedule. The work was performed in-between October 2017 till May 2018.

Results

the mean age of candidates was 34.8±9.0 years with 38% of them were males and 62% were females. About 22% of candidates were smokers, 14% were diabetic and 33% were hypertensive. In our study, the mean HBsAb titer among candidates was 307.9±264.2 IU/mL. It was found that 12% of candidates were non-responders with HBsAB titer < 10 IU/mL. On the other hand, 88% of them were responders with HBsAb titer 10-99 and 100-1000 in 24% and 64% of candidates, respectively.

Conclusion

the non-responder rate to the hepatitis B vaccine (non-significant HBsAbs titer) was 12%. On the other hand, 88% of them were responders with HBsAbs titer 10-99 and 100-1000 in 24% and 64% of candidates, respectively.
Sofosbuvir/ledipasvir in treatment of HCV infected Egyptian patients with decompensated liver cirrhosis Child Pugh class (B)
Authors: Abbass A M , Ghalwash A , Abdelhamid M S , Hamdy H S
Published: May 2020

Background

The main goal of anti-HCV therapy in patients with decompensated (Child-Pugh B) cirrhosis not on a transplant waiting list is to achieve improvement in liver function and survival. Several studies have demonstrated acceptably high SVR rates, equivalent in Child-Pugh B patients, in individuals with decompensated cirrhosis, together with an effect of therapeutic viral clearance on liver function, with significant improvements in bilirubin, albumin and international normalized ratio values and, as a result, in MELD and Child-Pugh scores in one-third to half of patients. Similar results were reported in real-world studies. Patients with Child-Pugh B cirrhosis benefited more from viral clearance in terms of adverse event-free survival at 15 months than those with Child-Pugh C cirrhosis.

Aim of the Work

Assessment of the safety & efficacy of sofosbuvir/ ledipasvir in infected naïve and experienced HCV Egyptian patients with decompensated liver disease.

Patients and Method

This study was conducted on 100 patients with HCV related decompensated liver disease who presented to the hepatology outpatient clinic in El Agouza Police hospital and were evaluated according to the inclusion and exclusion criteria.

Conclusion

Ledipasvir/sofosbuvir is effective and safe in the treatment of HCV decompensated patients Child Pugh B. MELD and Child scores significantly improved with HCV treatment in decompensated patients

Recommendations

Longer follow up with assessment of the need for liver transplantation or HCC development is important. Larger number of patients is required.
Evaluation of β-Catenin in Bladder Transitional Cell Carcinoma
Authors: Elzayat T M , Shaban M I , Radwan A I , Elwardany H Z
Published: May 2020

Background

Bladder cancer is the fourth most common cancer occurring in United States, second most prevalent cancer in men and tenth most prevalent cancer in women, with age adjusted incidence rate of 24.5 per 100.000 population and mortality rate of 4.2 per 100.000 population per year Because of its high recurrence rate, the actual prevalence of active bladder cancer is estimated to be about 10 times the number of new cases.

Aim of the Work

This study aims at investigating β-catenin protein expression in bladder transitional cell carcinoma and its possible relation to the clinic-pathological data.

Patients and Methods

The study was carried out on 80 patients; 60 patients with urothelial Bladder Carcinoma (UBC) and 20 patients with non-malignant lesions (control group); between May 2015 and May 2017. The 60 UBC cases were further divided, according to histopathological criteria, into non-muscle invasive UBC (30 patients) and muscle invasive UBC (30 patients).

Results

There was a highly a significant difference between β-catenin expression and tumor grade (P = 0.03) ,lymphnode metastasis (P = 0.005), tumor necrosis (P = 0.001) vascular invasion(P = 0.004), and perineural invasion (P = 0.001) No statistical significant relation was found between β-catenin expression either bilharziasis (P = 0.08) ,muscl invasion (p = 0.54) ,or stage (p = 0.7).

Conclusion

1-β-Catenin has a role in carcinogenises of UB due to absence of nucleocytoplasmic pattern of β-catenin expression in non- neoplastic cases with its expression in a considerable number of invasive malignant cases and dysplastic urothelium adjacent to carcinoma could refer to the oncogenic role of this expression pattern.

Recommendations

Further studies on large number of cases of urothelial carcinoma on a longer period of follow up using more accurate diagnostic tools is recommended to elicit the predictive value of these markers on patients’ survival; also further studies on new therapies that target β-catenin or other component of Wnt pathway to detect its efficacy in preventing tumor recurrence or progression especially in non-muscle invasive bladder carcinoma.
Prediction of Surgical Outcome after Percutaneous Nephrolithotomy through Guy’s Score and Nephrolithometric Nomogram
Authors: Teama K A , Shabayek M I , Aly T I S
Published: May 2020

Background

Urolithiasis has a well documented common occurrence in the general population. Percutaneous nephrolithotomy (PCNL), has prevailed over other more morbid procedures, like open surgeries in the management of such stones PNL in complex renal stones is a challenging procedure because it requires considerable experience in gaining percutaneous tracts, performing delicate and judicious intrarenal manipulations, mastering all techniques of intracorporeal stone disintegration, and weighing the benefits of complete stone clearance against the risks of complications.

Aim of the Work

GSS and Nephrolithometric Nomogram. Scoring system in predicting PCNL outcomes. The ability of the GSS and STONE score to correlate with the post-operative change in the quality of life.

Patients and Methods

In a non-randomized prospective study we evaluated the two scoring systems Guy’s and S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNl and the quality of life. This study included 100 patients with renal stones who were scheduled for PCNL at El Demerdash University Hospitals and Nasser institute hospital in the period from April 2017 to October 2018.

Results

Our study included 100 patients (34 were female, 66 were male) with a mean age of 46.16 (range from 28 to 68). The mean GUY score was 1.57± 0.73 and the mean STONE score was 5.76± 1.19.the overall stone free rate was 89% with a complication rate of 18% with a mean stone burden <400 mm.GUY and STONE score were able to predict SFR and complications after PCNL.

Conclusion

Both GSS and S.T.O.N.E Nephrolithometry Score can be used to stratify the complexity of renal stone before PCNL to predict the stone clearance and complication. Both can be valuable tools for providing uniformity for comparison of outcome, proper planning of the surgery and preoperative counseling of the patient.
Safety and Efficacy of Percutaneous Nephrolithotomy in The Treatment of Renal Stones in Children
Authors: Badran A M A , Kotb Y M , Tolba M K A
Published: May 2020

Background

the incidence of urinary stone disease has been increased due to the change in dietary habits, lifestyle factors and obesity. The prevalence of urinary stone disease was reported as 11.1% in the adult population, while the prevalence in children varies with age, it is approximately 2-3%. Open surgery was the only surgical treatment option in the past, now most pediatric urinary stones can be treated effectively by other procedures as extracorporial shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS) and laparoscopy.

Aim of the Study

to assess the safety and efficacy of percutaneous nephrolithotomy in the treatment of renal stones more than 15 mm in children aged 2-14 years old.

Patients and Methods

our study included 40 patients (28 males and 12 females) with a mean age (8.35 ± 3.69) with a range (2 to 14 years) managed by PCNL in 2 groups: Group A (Preschool age group): included 18 patients, 12 males (67%) and 6 females (33%) aged (2-6 years) managed by mini PCNL.Group B (School age group): included 22 patients, 16 male (73%) and 6 females (27%) aged (7-14 years) managed by standard PCNL.

Results

Success rate was nearly similar in both groups, it was 88.9% in group A and 95.5% in group B. Regarding the mean operative time it was 72.22 ± 12.63 in group A and 70.00 ± 15.74 in group B. Regarding the intraoperative blood loss it was more significant in group B with the mean intraoperative blood loss as 76.67 ± 15.34 in group A and 116.36 ± 22.79 in group B. Postoperative pain was more in group B than in group A, so 6 patients (33.3%) postoperative weak opiate analgesia in group A for less than 24 hours, while 16 patients (72.7%) needed postoperative weak opiate analgesia in group B. Hospital stay was 2.44 ± 0.51 in group A and 2.91 ± 1.02 in group B.

Conclusion

PCNL is a safe and effective procedure for management of renal stones in children, with accepted stone clearance rates and postoperative morbidity in addition to short hospital stay.
Cyanoacrylate Based Products as Interpositioning Substance versus Reintervention Alone for Urethrocutaneous Fistula Repair after Hypospadias
Authors: Abdallah H M , Tawfeek A M , Mohareb A M W
Published: May 2020

Background

urethrocutaneous fistula (UCF) is still the commonest complication after hypospadias repair. Although recent advances in the surgical procedures of hypospadias repair have reduced the rate of urethrocutaneous fistula formation, it remains a real complication of hypospadias and frustrating problem for surgeons.

Aim of the Work

evaluation of success and failure rates of using cyanoacrylate based productes as an interpositioning substance in surgical repair of fistula after hypospadias in comparison to the classic surgical repair technique.

Patients and Methods

this is a prospective, randomized-controled study, conducted on 40 patients from the date of the approval of the study. It is comparing two different modalities for repair of urethrocutaneous fistula that has developed after hypospadias repair. Our study was assigned on a randomized basis method according to a 1:1 ratio and patients underwent either multilayered closure using dartos facial flap or using cyanoacrylate glue as an interpositioning layer before suturing of the dartos flap for the closure of the urethrocutaneous fistula. All cases were divided into 2 equal groups, 20 cases each. The cases were distributed randomly into the two groups.

Results

the success rate was higher for patients using cyanoacrylate glue as a protective interpositioning layer as 16 patients (80%) were successfully repaired and 4 patients (20%) developed a recurrent fistula. However, there was no statistically significant difference between 2 groups p-value was 0.465.

Conclusion

there was no statistically significant difference in adding cyanoacrylate glue to multilayered closure of urethrocutaneous fistula after hypospadias repair. However, cyanoacrylates showed that they are a favourable additional protective substance and they resulted in a high success rate without adding any surgical complications.
Comparative study between dusting versus fragmentation of proximal ureteric stones using Holmium Laser Lithotripsy
Authors: Elzayat T M , Fahim H A , Abdelaziz M S
Published: May 2020

Objective

to compare between the outcome and complications of proximal ureteric stone disintegration using dusting versus fragmentation technique with focusing on stone free rate.

Materials and Methods

in a prospective randomized clinical study, 20 patients will undergo laser disintegration of ureteric stones by dusting technique; another 20 patients will undergo laser disintegration of ureteric stones by fragmentation technique. The inclusion criteria include symptomatic single primary proximal ureteric stone< 2 cm. The Exclusion criteria were pregnant women, children, and patients with coagulation disorders, medical problems that hinder anesthesia, recent active infection, urinary tract abnormalities and previous ureteric surgery.

Results

Our laser settings in this research were energy 0.5 J and frequency 20 Hz for dusting technique and 2 J energy and 5 Hz frequency for fragmentation technique. Stone free rates of dusting and fragmentation techniques were 75% and 90% respectively. Post operative complications were 15% with dusting technique and 20% with fragmentation group.

Conclusions

Our study shows that the active retrieval after laser lithotripsy (fragmentation technique) more efficient than waiting tiny fragments to pass spontaneously after laser lithotripsy (dusting technique) as fragmentation technique has lower mean operative time, lower incidence of stone migration during procedure and higher stone free rate than dusting technique. Dusting technique seems to be more efficient than fragmentation in double-J stenting and post-operative complications as it has the lower incidence of jj stenting and post operative complications. To obtain fair and precise results we have to apply this study in larger population.
Effect of perioperative alpha1-blocker on non-stented ureteroscopic laser lithotripsy for ureteric stones
Authors: Mohammed M S , Tawfeek A M , Shaker H S
Published: May 2020

Background

Nowadays, ureteroscopy is the first line of surgical treatment of ureteric stones and holmium YAG laser is commonly used in stone fragmentation. Guidelines 2018 recommended not fixing ureteric stent in uncomplicated ureteroscopy. Therefore, when we decrease intra-operative dilatation, we may decrease the complicated ureteroscopy.

Objective

To assess the safety, efficacy and outcome of peri-operative alpha1 blockers on non-stented ureteroscopic laser lithotripsy for ureteric stones.

Patients and Methods

Our study was conducted at Urology Department, Ain Shams University Hospitals and National Institute of Urology and Nephrology starting from September 2017 to December 2018. Sixty patients with lower ureteric stone included in this study underwent non-stented laser lithotripsy and were divided into two equal groups; group A (tamsulosin) and group B (no tamsulosin).

Results

Our study revealed that using peri-operative tamsulosin statistically reduced the need for ureteric dilatation, mean operative time, mean hospital stay, post-operative pain, the need for pain medications and post-operative lower urinary tract symptoms.

Conclusion

Administration of peri-operative tamsulosin seems to significantly decrease the need for intra-operative dilatation, post-operative LUTs, post-operative pain and the need for analgesia and shorten operative time and hospital stay.
Does The Use Of Povidone Iodine Suppository Decrease The Infective Complications Of TRUS Guided Prostate Biopsies? A Randomized Prospective Study
Authors: Abdulbaki M S , Emam A , Badawy M , Shaker H S
Published: May 2020

Purpose

Trans rectal ultrasound guided prostate biopsy can lead to urinary tract infections in 3% to 11% and sepsis in 0.1% to 5% of patients. We investigated the prevalence of different organisms among rectal flora in our community, the virulence of the most prevalent one and the effect of combined standard antibiotic prophylaxis with the use of povidone iodine suppository prior to TRUS guided biopsy of the prostate in decreasing post biopsy infectious complications.

Materials and Methods

Between December 2016 and September 2017, 50 men were prospectively randomized to povidone iodine rectal cleansing (50) or no cleansing (50) before transrectal ultrasound guided prostate biopsy. Rectal swab cultures, urinalaysis, urine cultures, total leukocytic count and CRP were obtained before transrectal ultrasound guided prostate biopsy. Patients received ciprofloxacin prophylaxis and attended at 1 week follow up visit. Urinalaysis, urine cultures, total leukocytic count and CRP were obtained at follow up visit and asked about fever, UTI symptoms and examined for prostatitis and epididymo-orchitis.

Results

Infectious complications were observed in 5 (10%) patients, including 2 (8%) in the treatment group and 3 (12%) in the control group (p = 0.0001). No cases of sepsis were recorded. Mean increase of CRP was higher in control group (P = 0.011). 17 patients among study population had Ciprofloxacin resistant rectal organisms on rectal swab cultures (34%).

Conclusion

Usage of pre TRUS-Bx intrarectal povidone iodine suppository together with standard antibiotic prophylaxis with ciprofloxacin helps decrease post procedure infectious complications and proved to decrease incidence of infection among patients having ciprofloxacin resistant rectal organisms.
Evaluation of Endovenous Laser Ablation in Management of Varicose Veins
Authors: Ouf T I , Nada M A , Salem A M , Elzefzaf N Y
Published: May 2020

Background

There have been tremendous changes to the treatment of varicose veins over the years. High ligation of the SFJ and stripping of the GSV have been considered as standard treatments for GSV insufficiency for more than one century and it is still adopted as the preferred method in the majority of the surgical centers.

Aim of the Work

To discuss the advances in the treatment of varicose veins and their advantages over traditional methods in an attempt to choose the best method of treatment with least complications and highest success rate of cure and to review the recently advanced endovenous laser ablation as a promising line of management of primary varicose veins.

Patients and Methods

This observational prospective was conducted on 30 patients 30 patients with varicose veins in multiple centers carrying out endovenous laser ablation.during the period from October 2017 till March 2018.

Results

After the EVL ablation +/- sclerotherapy, no major complications occurred, minor complication however, was quite common and included bruising (33.3%), ecchymosis (16.6%), postoperative pain (66%) that require analgesic, superficial thrombophlebitis (16.6%) and skin burn (3.3%).

Conclusion

EVLA is continuing to be an outstanding minimal invasive method for treatment of varicose veins with minimal complications and a very short recovery period which sounds appealing to the patients.
Proteomic biomarkers of sleep apnea
Authors: Ambati Aditya , Ju Yo-El , Lin Ling , Olesen Alexander N , Koch Henriette , Hedou Julien Jacques , Leary Eileen B , Sempere Vicente Peris , Mignot Emmanuel , Taheri Shahrad
Published: May 2020

Study Objectives

Obstructive sleep apnea (OSA) is characterized by recurrent partial to complete upper airway obstructions during sleep, leading to repetitive arousals and oxygen desaturations. Although many OSA biomarkers have been reported individually, only a small subset have been validated through both cross-sectional and intervention studies. We sought to profile serum protein biomarkers in OSA in unbiased high throughput assay.

Methods

A highly multiplexed aptamer array (SomaScan) was used to profile 1300 proteins in serum samples from 713 individuals in the Stanford Sleep Cohort, a patient-based registry. Outcome measures derived from overnight polysomnography included Obstructive Apnea Hypopnea Index (OAHI), Central Apnea Index (CAI), 2% Oxygen Desaturation index, mean and minimum oxygen saturation indices during sleep. Additionally, a separate intervention-based cohort of 16 individuals was used to assess proteomic profiles pre- and post-intervention with positive airway pressure.

Results

OAHI was associated with 65 proteins, predominantly pathways of complement, coagulation, cytokine signaling, and hemostasis which were upregulated. CAI was associated with two proteins including Roundabout homolog 3 (ROBO3), a protein involved in bilateral synchronization of the pre-Bötzinger complex and cystatin F. Analysis of pre- and post intervention samples revealed IGFBP-3 protein to be increased while LEAP1 (Hepicidin) to be decreased with intervention. An OAHI machine learning classifier (OAHI >=15 vs OAHI<15) trained on SomaScan protein measures alone performed robustly, achieving 76% accuracy in a validation dataset.

Conclusions

Multiplex protein assays offer diagnostic potential and provide new insights into the biological basis of sleep disordered breathing.