bluuebunny/crossref_metadata_2025 huggingface dataset:
Neutrophil Gelatinase Associated Lipocalin: A Possible Role in β Thalassemia Syndromes
Authors: Ismail Amira Reda Mohamed , Fayek Manal Hashem , Pessar Shaimaa Abdelmalik
Published: August 2023

Background

Beta Thalassemia is a group of inherited blood disorders that caused by reduced or absent synthesis of the beta chains of hemoglobin resulting in variable outcomes ranging from severe anaemia to clinically asymptomatic individuals. Neutrophil gelatinase-associated lipocalin (NGAL), is a protein which is encoded by the LCN2 gene. NGAL is involved in innate immunity by sequestrating iron that in turn limits bacterial growth. It is expressed in neutrophils and in low levels in the kidney, prostate, and epithelia of the respiratory and the alimentary tracts. It also plays a key role in the physiology and pathophysiology of red blood cells, particularly in anemia.

Aim of the Work

The aim of the present work is to assess plasma level of NGAL in Beta thalassemia syndromes and correlate with laboratory hematological data and iron profile.

Patients and Methods

A Case-Control study conducted on Beta Thalassemia patients of both sexes attending the outpatient clinic of Ain Shams University Hospitals, this Pilot study of 50 previously diagnosed Beta Thalassemia patients and 30 sex and age matched healthy control subjects.

Results

The results were correlated with clinical and laboratory parameters. Comparative analysis of the results showed that all groups were homogeneous in terms of size and demographic characteristics. This can explain our results that shows that there is a highly statistically significant difference (p-value < 0.001) between the cases subgroups regarding the inter-transfusion interval with longer intervals among the thalassemia intermedia subgroup. While by comparing the Hb electrophoresis parameter between the 2 groups HbA% levels were higher is the group of serum ferritin <1000 ng/ml and HbF% where higher in group of serum ferritin >1000 ng/ml with (p-value < 0.05) for both of them. On conducting a linear regression analysis we found that the intertransfusion interval was the only independent parameter to have an effect on NGAL level on our patient group with regression coefficient -5.78 and this complies with our results of correlation between NGAL and those parameters mentioned and discussed previously.

Conclusion

The relationship between NGAL and iron level in Egyptian β-TM patients proved in our results has confirmed the proposed regulatory role played by NGAL on erythropoiesis and iron metabolism in β-thalassemia, NGAL at a cutoff value of > 100 proved to be an efficient predictor of increased serum ferritin > 1000 ng/ml. we believe that incorporating NGAL testing in the work up of β-TM patients in the early phases of iron transfusion dependency would provide a promising sensitive and predictive tool for early iron accumulation. We recommend further studies β-TM patients with larger samples size to clarify the co-regulatory role of erythropoiesis and iron metabolism played by NGAL.
Oligoclonal Band versus Chitinase-3-Like Protein-1 in CSF of Newly Diagnosed Relapsing Remitting Multiple Sclerosis
Authors: Zeitoun Yasser Ahmed , Fouad Nermin Tayseer Aly , Aziz Azza Abdel Nasser Abdel , Samaha Dalia Youssef , Saad Marehan Ahmed Ibrahim
Published: August 2023

Background

Multiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS) that is usually associated with varying degrees of progressive disability. Chitinase-3-like protein-1 (CHI3L1) has attracted growing attention as a marker of ongoing inflammation and oncogenic transformation.

Aim of the Work

The aim of this work was to try to assess the diagnostic accuracy of CHI3L1 versus IgG oligoclonal bands (OCBs) in the CSF of newly diagnosed RRMS patients in an attempt to throw light on a new simpler non subjective potential diagnostic marker in MS.

Patients and Methods

This was a cross-sectional study of MS patients carried at Ain Shams University Hospitals during the period from January 2021 till January 2022. Subjects included in this study were 40 patients diagnosed as having RRMS, on the basis of their MRI findings, clinical presentation and according to the revised McDonald criteria 2017. The group included 10 males and 30 females; their ages ranged from 20 to 45 years.

Results

We found a significant correlation between CSF CHI3L1 levels and presence of oligoclonal bands, and that a cut off value of 30 ng/ml could be used for diagnosis of MS with sensitivity 84.85% and specificity 85.71%. A highly significant association was also found between CHI3L1 levels in CSF and EDSS score.

Conclusion

We concluded that there were high levels of CHI3L1 in the CSF of MS patients and there was a significant correlation between CHI3L1 and oligoclonal bands and that CHI3L1 is a promising diagnostic marker of MS.
Detection of NCF-1 Gene Expression as a Diagnostic Tool for Autosomal Recessive Chronic Granulomatous Disease among Egyptian Children with Phagocytic Dysfunction
Authors: Abd El Ghaffar Aisha Y , Fedawy Shahira F El , El-Owaidy Rasha H , Ahmed Walid A , Nassar Noura A
Published: August 2023

Background

Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency disorder caused by functional impairment of the nicotinamide dinucleotide phosphate (NADPH) oxidase complex in neutrophilic granulocytes and monocytes and characterized by recurrent and severe infections, dysregulated inflammation and autoimmunity.

Aim of the Work

To diagnose the autosomal recessive (AR) type of CGD among a group of Egyptian pediatric patients with phagocytic dysfunction by detection of Neutrophil Cytosolic Factor-1 (NCF-1) gene expression using reverse transcription polymerase chain reaction (RT-PCR) and to correlate it with other diagnostic tests.

Subjects and Methods

A case-control study was conducted on 15 provisionally diagnosed CGD pediatric patients (Group I) by the use of DHR test, with the stimulation index using PMA < 30%. They were recruited from different university hospitals in Egypt. The study also included 12 mothers of the studied patients to detect the genetic mutations in carriers, if any, (Group II) and 14 apparently healthy children as a control group (Group III). Full medical history was taken and thorough clinical examination was done. The selected groups underwent testing for phagocytic and lytic indices, measurement of NCF-1 gene expression by real time RT-PCR.

Results

The comparative statistics between group I and group III as regards the phagocytic index (PI) revealed a high statistical significant difference between both groups. In addition, a statistically significant difference between both groups as regards lytic index (LI) was also revealed. Correlation studies were done between fold change of NCF-1 gene expression and each of PI, LI and DHR and showed no significant statistical correlation between these parameters in the 3 studied groups. Cases with a fold change of NCF-1 gene expression less than 0.48 (cut-off value calculated by the 25th percentile fold change of the control group), are considered having defective NCF-1 gene expression. At this cut-off value 2 out of 15 CGD cases and 3 mothers out of 12 showed NCF-1 gene under-expression.

Conclusion

Assessment of NCF-1 gene expression which encodes p47phox by real time RT- PCR in the present study could detect defective gene expression only among two CGD children and their mother as well as two other mothers with no correlation to other studied parameters. Since CGD is a genotypically heterogeneous disease; the findings of the present study highlight the importance of molecular testing for diagnosis after screening for NADPH oxidase protein deficiency by flow cytometry.
Determination of Antibiotic Resistance Pattern of Haemophilus influenzae Isolated from Egyptian Patients in Ain Shams University Hospitals
Authors: Abd El Hamid Dalia Hosni , Girgis Samia Abdou , Riad Radwa Shereen , Mahmoud Ramy Mohammed
Published: August 2023

Background

Haemophilus influenzae is small, non motile, non spore-forming, non acid fast, pleomorphic, gram negative bacilli with fastidious growth requirements. Cells in this genus are Cocobacilli or short rods. Haemophilus influenzae type b causes meningitis, epiglottitis, septicemia and osteomyelitis. Non-typeable H. influenzae is the cause of otitis media, sinusitis, pneumonia, and exacerbation in patients with COPD. The resistance to commonly used antibiotics has risen in recent years. Some of the main mechanisms of antimicrobial resistance of H. influenzae are those to β-lactam antibiotics. More frequent (in about 30%) is the plasmid-mediated production of β-lactamase of types TEM1 and ROB1, called β-lactamase positive ampicillin-resistant strains (BLPAR). In a small percentage of the ampicillin-nonsusceptible strains a change in penicillin-binding protein (PBP3) is detected, which reduces its affinity to penicillins and cephalosporins. PBP3 is a transpeptidase, which is encoded by the ftsI gene. Mutations in this gene lead to amino acid substitution in the transpeptidase domain of РВР3. These strains are called β-lactamase negative ampicillin resistant (BLNAR).

Objective

The aim of our study is to identify the Haemophilus species isolated from clinical samples of patients referred to the Main Microbiology Laboratory, Ain Shams University Hospitals & determine its local resistance pattern.

Materials and Methods

The present study was conducted on fifty (50) different isolates of Haemophilus Influenzae isolated from different clinical specimens submitted to the Main Microbiology laboratory of Ain Shams University Hospitals. All isolates were subjected to subculture on chocolate agar, Phenotypic identification of colonies by routine methods, antibiotic susceptibility testing by using disk diffusion method according to Clinical and Laboratory Standard Institute recommendations (2019), and Multiplex PCR for detection of TEM & ROB genes.

Results

Susceptibility to Ampicillin was 12% (6/50) while 88% (44/50) were resistant to ampicillin. TEM gene was detected in 66% (33/50) while ROB gene was detected in 2% (1/50). 35.3% (6/17) isolates that were TEM negative were sensitive to ampicillin & 64.7% (11/17) isolates that were TEM negative were resistant to ampicllin. 100% (33/33) isolates that were TEM positive were resistant to ampicillin.

Conclusions
Detection of CYBA Gene Expression by Reverse Transcription PCR as a Diagnostic Tool for Autosomal Recessive Chronic Granulomatous Disease in a Sample of Egyptian Children
Authors: Zakaria Nahla , Shehab Abeer , El Owaidy Rasha , Rushdy Marwa , Latif Rania
Published: August 2023

Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency disease caused by functional impairment of the nicotinamide dinucleotide phosphate (NADPH) oxidase complex in neutrophilic granulocytes and monocytes, characterized by recurrent and severe infections, dysregulated inflammation, and autoimmunity. Approximately two-thirds of patients with CGD have defects in Cytochrome Bβ (CYBB), the X-linked gene encoding glycoprotein 91 phagocytic oxidase (gp91phox). Rarer autosomal recessive (AR) forms of CGD are caused by autosomal recessive mutations in CYBA genes encoding protein 22 phagocytic oxidase (p22phox). However, the incidence of autosomal recessive CGD can be higher than X-linked CGD in countries with high rates of consanguineous marriage. In the present study we aimed to diagnose the commonest AR-type of CGD by detection of CYBA gene expression using real time RT-PCR as a cheaper diagnostic method for CGD subtypes categorization among immunodeficient children. This case-control study was conducted on 15 children provisionally diagnosed as CGD patients with DHR stimulation index using phorbol myristate acetate (PMA) < 30% (Group I). The study also included 12 mothers and 8 fathers of the studied patients to detect the genetic mutations in carriers, if any (Group IIa and IIb respectively), and 14 apparently healthy children as a control group (Group III). We found that cases with a fold change of CYBA gene expression less than 0.6 were considered under-expressed. At this cut-off value, from our molecularly studied subjects 1 case and 2 mothers showed under-expression of CYBA gene. In conclusion, we could establish the diagnosis of AR-form of CGD, derives from defects in the CYBA gene, which encodes p22phox of the NADPH oxidase using real time RT-PCR, without the need to use complex and expensive methodologies such as northern blot, slot blot, or genomic DNA sequencing.
Rapid Identification and Antimicrobial Susceptibility Testing of Gram Positive Bacteria by Direct Inoculation from Positive Blood Culture Bottles
Authors: Hafez Hala Mahmoud , El-Din Fahim Noha Alaa , Elhamed Sara Mohammad Abd
Published: August 2023

Background

Rapid identification of the causative agent for sepsis and determination of its susceptibility profile by direct inoculation of the biochemical and susceptibility testing media with the blood-broth mixtures from signal positive bottles might help reducing the time needed for provision of results compared to the standard isolated-colony based method and hence would help the rapid initiation of effective and targeted antimicrobial therapy and reduce the bacteremia-related morbidity and mortality

Aim of the Work

To validate the direct inoculation method as a rapid method for the identification of Gram-positive bacteremic isolates and determination of their antimicrobial susceptibility profile by comparing its results to that of the standard isolate-based method routinely used in our laboratories.

Patients and Methods

This study included a total of 100 positive blood culture bottles submitted to the Main Microbiology laboratory for identification and antimicrobial susceptibility testing via disk diffusion method directly from blood culture bottles and according to standard isolate-based identification method.

Results

There was a 100% categorical agreement between the results of the direct (primary) biochemical identification method and those of the standard isolate-based identification method. As regard AST the overall categorical agreement between both methods was 96.9%, the minor error rate was 0.8% and the major error rate was 2.3%.

Conclusion

Rapid Identification and Antimicrobial Susceptibility Testing of Gram-positive Bacteria is a time saving method and can help in reducing turnaround time to obtain AST results.
Anti-CASPR2, Anti-LGI1, and Anti-GAD65 Autoantibodies in Patients with Intractable Epilepsy
Authors: Bakr Salwa Ibrahim , Shehab Abeer Al-Sayed Ali , Zakieldine Hany Mahmoud , Mohamed Nesrine Aly , Masry Yara Younis Mohamed
Published: August 2023

Background

Autoimmunity is increasingly being recognized as a cause of intractable epilepsy. The autoimmune epilepsies (AE) are immunologically mediated disorders in which recurrent seizures are a primary and persistent clinical feature. When other etiologies have been excluded, an autoimmune etiology of epilepsy is suggested in the presence of resistance to anti-epileptic drugs (AED). In such patients, immunotherapy may be highly effective, depending on the particular autoimmune epilepsy syndrome present.

Objective

To investigate the presence of Contactin associated protein like 2 (CASPR2), leucine rich Glioma inactivated1 (LGI1) and Glutamic acid decarboxylase 65 (GAD65) autoantibodies in intractable epilepsy, and their association with clinical and imaging findings.

Subjects and Methods

Seventeen patients with intractable epilepsy were included. LGI1, CASPR2 and GAD65 autoantibodies testing by indirect immunofluorescence cellbased assay in both serum and cerebrospinal fluid (CSF) were assessed in all patients.

Results

Both serum and CSF samples of the 17 patients were tested negative for the 3 autoantibodies (Anti CASPR2, Anti LGI1 and Anti GAD 65). Regarding CSF examination, only 5 patients had normal CSF, the other 12 showed some changes; 7 had elevated levels of proteins, 3 showed positive oligoclonal bands and elevated IgG index and 2 patients showed both elevated proteins and cells.

Conclusion

Some cases of AE are associated with specific autoantibodies to neuronal proteins. Clinicians must make a diagnosis based on a combination of clinical phenotypes, CSF results, and neuroimaging. Meanwhile, patients should be followed-up systematically due to the constant discovery of new neuronal auto antibodies.
Diffuse Alopecia: Clinical, Trichoscopic, Histopathological and Immunohistochemical Challenges in the Diagnosis
Authors: Monib Hoda Ahmed Mohamed , Soltan Marwa Yassin , Ahmed Naglaa Samir , Adan Aisha Bashir Sheikh
Published: August 2023

Background

Diffuse alopecia is characterized by a general loss of hair with no patches of full baldness. In dermatology, diffuse hair loss, particularly in women, is a common complaint. Common illnesses such as telogen effluvium, androgenetic alopecia, and widespread alopecia areata can be difficult to distinguish. The clinical signs of these three types of alopecia may be identical.

Aim of Work

The current study aimed to study the clinical, trichoscopic findings, histopathological in patients with acute diffuse hair shedding: female pattern hair loss (FPHL), acute telogen effluvium (TE) and alopecia areata incognita (AAI). Immunohistochemistry analysis for CD3 was done for differentiation and detection of the prognostic values of these markers. Subjects and methods: The study included 40 patients with acute diffuse hair shedding within the last 6 months with the diagnoses of AAI, TE, FPHL. All patients were subjected to full history recording, general and local examination. Hair evaluation was performed through trichoscopic assessment and punch scalp biopsy that was analyzed by hematoxylin and eosin and immunohistochemical analysis for CD3.

Results

Trichoscopic assessment of studied patients revealed that hair diameter diversity was significantly presented in FPHL patients. Number of thin hairs in frontal area, number of hair units with one hair, and vellus hairs were significantly presented in FPHL and TE+ FPHL patients compared to TE patients. Short regrowing hair was significantly presented in TE patients and TE +FPHL patients compared to FPHL patients. Peripilar sign and empty hair follicles in frontal area were significantly presented in FPHL patients. Multiple upright regrowing hair in all areas was significantly presented in TE+ FPHL patients.

Conclusion

FPH and TE represents common types of hair loss disease, each with specific trichoscopic and histochemical findings.
Assessment of the Serum Paraoxonase1 Level and Its Relation to Total Oxidant Status and Disease Activity in Vitiligo Patients
Authors: Saleh Hanan Mohamed , Soltan Marwa Yassin , Yassin Haiam Mahmoud Thakeb
Published: August 2023

Background

Vitiligo is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes.It can appear at any time, and it significantly impairs the patients’ quality-of-life. Vitiligo is a multifactorial disorder due to genetic and environmental factors. One of the important hypotheses in the pathogenesis of vitiligo is the oxidative stress hypothesis, which is based on the reality of the formation of some toxic metabolites throughout pigment biosynthesis. Human paraoxonase-1 (PON1) is a Ca2+ dependent esterase synthesized in the liver. Reduced serum PON1 activity has been reported to be associated with some diseases under oxidative stress and inflammation conditions.

Aim of the Work

The aim of the work was to evaluate the serum level of paraoxonase1 in patients with vitiligo and its relation to total oxidant status and disease activity in vitiligous patients.

Patients and Methods

This is a case control study which included 48 vitiligo patients and 48 ageand sex-matched controls. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals during the period from August 2020 till March 2021. Serum level of paraoxonase1 (PON1) and total oxidant status (TOS) where assessed by ELISA technique.

Results

We observed a statistically significant higher oxidative stress reflected by the high serum TOS levels among the vitiligo compared to controls. This finding supports the aforementioned hypothesis and it also came in accordance with the observations of high oxidative stress state in vitiligo patients which was repeatedly reported in many studies. Furthermore, we also reported the significant inverse relation between PON1 levels and the oxidative stress reflected by the serum TOS levels in vitiligo patients. This reflected the reduced protective antioxidant mechanisms in vitiligo patient making them more vulnerable to oxidative stress

Conclusion

Oxidative stress may play an important role in the pathogenesis of vitiligo. The finding of a PON1 decrease in vitiligo patients emphasises the underlying hypothesis in the progression of the disease, and it can highlight the effect of free radicals and leading oxidative damage in vitiligo disease. However, further, larger studies are necessary to confirm our results.
Epidemiology of Psoriasis in Cairo Governorate
Authors: Sayed Mahira Hamdy El , Zaki Marwa SalahEldin , Younis Mahmoud Fawzi Saleh
Published: August 2023

Background

Psoriasis is a chronic, non-communicable, painful, disfiguring and disabling disease with great negative impact on patients’ quality of life (QoL). It can occur at any age, and is most common in the age group 50–69.

Aim of the Study

To identify the prevalence of psoriasis in Cairo governorate, the associated socio-demographic and anthropometric data, and percentage of each clinical type, as well as to define the possible precipitating factors and other diseases related to psoriasis.

Patients and Methods

This cross-sectional observational study included patients with psoriasis collected from patients attending the outpatient Dermatology and Andrology Department of Educational Hospitals of Cairo Governorate (Al Haud AlMarsoud Hospital & Ain Shams University Hospital) during a period of six months that started from June 2020 to December 2020. It was a multi-center study including 2 Educational Dermatology hospitals.

Results

We found significant association between severity of psoriasis with male gender, with degree of impairment of life, with skin type III, and with higher age of onset.

Conclusion

We observed no association of psoriasis severity with DM, hypertension, BMI, or joint manifestations. Our findings are similar to most of other published epidemiological studies on psoriasis.
Efficacy and Safety of Diphenylcyclopropenone (DPCP) as a Depigmenting Therapy in Extensive Vitiligo
Authors: Abdel-Rahim Abdallah Marwa M , Elhusseiny Rania Mahmoud , Abdelmotaleb Maysoon Asem Elsayed
Published: August 2023

Background

Patients with extensive vitiligo who have residual pigmentation affecting exposed areas especially acral sites or patients with vitiligo universalis often seek depigmentation. At present, there is no ideal depigmenting therapy available. Possible options include; monobenzyl ether of hydroquinone (MBEH) cream, phenol, cryotherapy and Q-switched lasers. Diphenylcyclopropenone (DPCP) has been reported to rarely cause vitiligo as a side effect during the treatment of alopecia areata.

Aim

The aim of the present work is to evaluate the efficacy and safety of DPCP as a depigmenting therapy in extensive Vitiligo.

Patients and Methods

This is a pilot single arm clinical trial study. Twenty patients with extensive vitiligo were recruited from the vitiligo outpatient clinic of Dermatology, Venereology and Andrology Department, Ain Shams University Hospitals. We used DPCP applied topically to residual pigmented patches (sensitization session then therapeutic sessions).

Results

Depigmentation occurred among 5 patients (25% of cases). Depigmentation occurred in different tested sites including the scalp, forearm and back. Itching and blister formation were the main side effects leading to intolerability to the DPCP treatment.

Conclusion

Cosmetic result of DPCP depigmentation was acceptable with no skin atrophy. Further studies could be done following other protocols using sensitization dose with less concentrations of DPCP to avoid patients' intolerance to the therapy.
Analysis of Serum Chemerin Level in Acanthosis Nigricans Patients: A Case Control Study
Authors: Mohammed Ghada Fathy , Afify Ahmed Abdel-Fattah , Ibrahim Sarah , Zawahry Menna Mohamed El
Published: August 2023

Background

Acanthosis nigricans (AN) describes clinically a darkly pigmented thickening skin, which demonstrates epidermal/dermal hyperplasia with orthokeratotic hyperkeratosis and papillomatosis of stratum spinosum with basal layer hyperpigmentation, in the absence of actual acanthosis and melanocytosis in histology.

Aim of the Work

The aim of our work was assessment of serum concentrations of Chemerin level in obese patients with AN and the healthy control group, as well as evaluation of a possible correlation between chemerin concentrations and metabolic syndrome components.

Patients and Methods

Our study included 75 subjects, divided into three groups. The first group included 25 obese patients with AN, the second group included 25 obese patients without AN. In addition to the control group which included 25 healthy individuals. Each subject was assessed for blood pressure, body mass index and waist hip ratio. 3ml blood sample was taken from each subject. Lipid profile, serum glucose level, fasting serum insulin were measured. Chemerin concentration was assessed by quantitative ELISA.

Results

In our study, 100% of the included obese patients with AN and 88% of those without AN had metabolic syndrome. No statistically significant difference between them as regards BMI, SBP, DBP, WHR, fasting Insulin (P > 0.05). However, statistically significant higher levels of serum, Cholesterol, TG, HDL, and LDL were observed in obese patients with AN compared with those without AN (P ≤ 0.001). This result showed that AN is a clinical surrogate for laboratory-determined hyperinsulinemia and insulin resistance indicating the highest risk for type 2 diabetes.

Conclusion

Acanthosis Nigricans has been demonstrated to be a useful screening marker for obesity and insulin resistance. In addition, there is correlation between chemerin concentrations and acanthosis nigricans. Serum chemerin could be considered one of the metabolic risk factors leading to insulin resistance in metabolic syndrome and may represent a novel marker of these derangement.
Serum Hepcidin and C Reactive Proteins as Predictive Markers for Post Acne Scarring
Authors: Ahmed Sahar El-Sayed , Seoudy Wael Mohamed , Elhusseiny Rania Mahmoud , Saber Nesma Ibrahem
Published: August 2023

Background

Acne vulgaris is a common inflammatory skin condition affecting a large section of population. Hepcidin, a small peptide produced by the liver, is a recently discovered key regulator of iron homeostasis that was classified as a typeII acute phase protein. The synthesis of hepcidin is greatly stimulated by inflammation or by iron overload. C‑reactive protein (CRP) is one of the best indicators of systemic inflammation, considering that its serum levels show no circadian change across the 24 hrs. IL‑1, IL‑6 and TNF‑α that are found in the acne lesions are also major inducers of CRP production by the liver. Thus, CRP levels could be elevated in acne if the amount of local inflammation is high enough.

Aim of the Work

To measure serum Hepcidin and C reactive proteins in acne vulgaris patients & assess their ability as predictive serum markers for postacne scarring.

Patients and Methods

This Observational Cross sectional study, was carried out on 60 moderate, severe & very severe acne patients aged from 16 to 40 years old (with and without postacne scarring), recruited from the outpatient clinics of Dermatology, Venereology & Andrology departments of Ain-Shams University and MUST university Hospitals, from February 2019 toFebruary 2020.

Results

Levels of serum hepcidin protein of studied acne pateints were higher than normal range, while CRP serum levels were almost within normal range. Besides, Pateints with post acne scars had significantly lower serum hepcidin levels and higher CRP levels than pateints without. Furthermore, there was highly significant negative correlation between Hepcidin protein serum levels and duration and grade of acne, as well as post acne scarring grade. However, there was highly significant positive correlation between CRP serum levels and duration and grade of acne, as well as post acne scarring grade.

Conclusion

Serum hepcidin and CRP levels may provide an objective tool to predict the clinical outcome of acne vulgaris lesions and might help in determining the susceptible patients for scarring thus, configuring the therapeutic plan to start an aggressive treatment in patients prone to scar formation regardless of the clinical severity of acne vulgaris itself.
Evaluation of Serum Level of Interleukin 15 in Active Vitiligo Compared to Stable Disease and Healthy Control
Authors: Elfakkar Nehal Mohamed Zu , Karaly Rana Mohamed Desoky , Abdallah Mahmoud Mohamed Abdelreheem
Published: August 2023

Background

Vitiligo is a common acquired disorder of depigmentation. Its pathogenesis entails a T helper (TH) 1-cytotoxic T (CT) lymphocytes mediated autoimmune melanocyte destruction. Interleukin (IL)-15 is one of the IL-2 family of cytokines and shares several actions with IL-2. IL-15 enhances survival, maturation, and functional activity of natural killer, neutrophils, and dendritic cells. Furthermore, it potentiates survival, maturation, and cytotoxicity of memory CT cells. IL-15 has been shown to play a crucial role in the pathogenesis of several autoimmune diseases but was poorly investigated in patients with vitiligo.

Aims

To investigate the role of IL-15 in the pathogenesis of vitiligo.

Patients and Methods

In total, 40 Patients with vitiligo and 20 controls matched for age and gender were enrolled in the study. Vitiligo Extent Score (VES) and Vitiligo Disease Activity (VIDA) score were used to assess vitiligo severity and activity, respectively. Serum level of IL-15 was assessed by enzyme-linked immune-sorbent assay.

Results

Serum IL-15 level, in patients with vitiligo, was significantly higher in comparison with the control group (P =. 001). A significant positive correlation was found between serum IL-15 level and VES score (P =. 001)

Conclusion

IL-15 level was elevated in the sera of patients with vitiligo. IL-15 may therefore have a significant impact on vitiligo autoimmune pathogenesis, and further identification of its molecular roles may highlight new therapeutic strategies for vitiligo.
Evaluation of Serum Visfatin Level and Its Relation to Insulin Resistance in Patients with Inflammatory Acne Vulgaris
Authors: Hassan Sara Ashraf Ali , Soltan Marwa Yassin , Fattah Nermeen Samy Abdel
Published: August 2023

Acne vulgaris is a multifactorial pilosebaceous unit disorder, with histological, immunological and evidence suggesting inflammatory involvement in its different stages. Acne vulgaris possess psychological impact on affected patients due to facial disfigurement especially if severe. Visfatin is an adipokine of proinflammatory characteristics. It was related to insulin resistance, obesity and some inflammatory skin diseases.

Aim of the Study

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

Patients and Methods

The study included 30 patients suffering from inflammatory acne vulgaris and 30 healthy control subjects. Full general and dermatological examination were performed, recording of BMI, GAGS score was done. Then, measurement of fasting insulin and fasting glucose was performed to calculate HOMAIR. Measurement of serum visfatin was done using ELISA.

Results

Serum visfatin and HOMAIR levels were significantly higher in acne patients compared to control subjects. Serum visfatin and HOMAIR provided significant discriminative power to differentiate acne patients from control subjetcs.
Effect of Intralesional Steroid Injection in Bilateral Benign Vocal Fold Lesions
Authors: Ghandour Hassan Hosny , Youssef Tanvr Ali , Refaat Ahmed Mohamnwd , El-sayed Hager Mohantmed
Published: August 2023

Background

Corticosteroids are one of the most potent inhibitors of inflammation and wound repair. Local injection of steroid gives the option of administration of a potent drug locally, thereby avoiding the systemic side effects of them. They have been used in the last decade in managing benign vocal fold lesions as intralesional steroid injection has the advantages of rapid subsidence of the inflammation and edema with rapid improvement of voice postoperatively

Ailil of the work

This study is designed to show clinical ancl encloscopic voice Iinprovelnent of microlaryngeal surgery alone versus microlaryngeal surgery of the prilnary lesion combined with steroid injection in the opposing lesion in patients with bilateral vocal fold benign lesions.

Patients and methods

40 patients with bilateral benign vocal fold lesions with Inoclerate to severe dysphonia are divided into two groups, one group underwent microlaryngo-surgery with excision of the primary lesion and injection of steroids into the contralateral lesions. The second group underwent microlaryngo-surgery with excision of the primary lesion only. Each subject was evaluated, preoperatively and postoperatively through a protocol including auditory perceptual assessment, laryngoscopic picture and self-rating by the patient using VHI.

Results

Comparing pre and post therapy results for each group, there was statistically significant improvcmcnt (reduction) in the size of thc contralatcral lesion and significant improvement in the quality of voice quality resulting in overall improvement in VHI.

Conclusion

Intralesional steroid injection in the contralateral lesion in bilateral benign vocal fold lesions is effective in improving voice quality postoperatively
Exploring Symptoms of Gastroesophageal Reflux in the Egyptian Patients with Non-Organic Voice Disorders
Authors: Alhanafy Hend Mohamed , Saad Baraka Mohamed Ali , Khodeir Mona Sameeh
Published: August 2023

Background

Gastroesophageal reflux disease (GERD) is an entity with heartburn, regurgitation, chest and stomach pain, and the feeling of gastric acid coming up.

Aim of the Work

This study aimed to explore symptoms of GERD in patients with nonorganic voice disorders using the Arabic version of Reflux Symptom Index (A-RSI).

Subjects and Methods

This study was applied on 50 Egyptian Arabic-speaking patients in the age range between 20 to 59 years old. Patients included were diagnosed with non-organic voice disorders according to the protocol of voice assessment used in the Phoniatrics outpatient clinic in Ain Shams University Hospitals. The participated patients were asked to fulfill the ARSI questions and their answers were related to their age, gender, duration of their voice symptoms, and the overall grade of their dysphonia as assessed by the GRBAS scale.

Results

Analysis of the answers of the participated patients to the A-RSI, revealed that only 40% of patients had a total score of the A-RSI above 13. This indicates that the participated patients with non-organic voice disorders have symptoms of GER. There was an insignificant correlation between the scores of the A-RSI and the age, gender, and duration of voice symptoms. The total score of A-RSI is indirectly related to the overall grade of dysphonia of the participated patients.

Conclusion

Patients with non-organic voice disorders have symptoms of GERD, however these symptoms are not related to the duration of their voice symptoms and related indirectly to the overall grade of their dysphonic voices. GER may be a contributing etiological factor in non-organic voice disorders but need to be confirmed by further assessment.
Efficacy of Anti-Reflux Medications on Improvement of Symptoms of Reflux Laryngitis
Authors: WF Ezzat , OM Mady , MT Bassiouny
Published: August 2023

Objectives/Hypothesis

reflux laryngitis is an inflammatory condition of the upper airway tract tissues due to the effect of gastric or duodenal content reflux, which provokes morphological changes in the upper aero digestive tract. Reflux laryngitis related symptoms affect up to 50% of patients in the Division of Laryngology. The purpose of this systematic review to shed light on the current therapeutic strategies used for the management of reflux laryngitis in order to determine the efficacy on improvement of symptoms.

Methods

the included studies published between 2003 and 2018. Regarding the type of included studies. All patients who suffer from reflux laryngitis in otorhinolaryngology clinics in included studies and treated by proton pump inhibitors or H2 blockers or prokinetics were added. Reviewed papers should include degree of improvement of any of the following symptoms: hoarseness, cough, Globus sensation, sore throat, dysphonic attacks, throat clearing non-productive cough, dysphagia, excessive throat mucus, etc. When using antireflux medications.

Results

The demographic characteristics and clinical data in all 15 studies are shown in the following tables: #Studies were arranged according to publication year. This table showed that; the included studies published between 2003 and 2018. The search identified 49 relevant papers, of which 15 studies met the inclusion criteria, accounting for 990 patients. The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk. The most used PPIs were omeprazole, esomeprazole, rabeprazole, lansoprazole and pantoprazole with a success rate ranging from 18% to 87%. Other composite treatments have been prescribed including PPIs, prokinetics, and H2 Receptor antagonists.

Conclusions

LPRD is more common in the age group of 31-40 years and proton pump inhibitors and prokinetics are highly effective in controlling laryngeal reflux symptom index and laryngeal reflux finding score.
Validation of a Modified Cow’s Milk-Related Symptom Score (CoMiSS) for Screening of Lactose Intolerance in Adults
Authors: Mohammed Heba Ibrahim , Baioumy Essam , Allam Mohamed Farouk , Al-Ashram Mohamed Nabil Badawy
Published: August 2023

Introduction

Lactose intolerance is the failure to digest foods and beverages containing the lactose present in milk. Lactose intolerance can be presented by many digestive symptoms.

Objective

To validate the modified CoMiSS score for the prediction of lactose intolerance, that was confirmed by a stool acidity test.

Patients and Methods

A crosssectional study, conducted on Ain Shams University Hospitals/ Gastrointestinal Clinics, enrolled100 adult participants during the period from December 2018 to December 2019, with the presence of one or more gastrointestinal symptoms, and subjected to a stool acidity test as a reference test and modified CoMiSS as index test.

Results

The mean age of participants was 35.30 ± 10.714 years old; 55% were females, and mean BMI was 23.08 ± 2.080 kg/m2, with no statistically significant difference between lactose intolerance and patients gender or body mass index BMI, 24% of participants had positive stool PH, lactose Intolerance diagnosed according to modified CoMISS Score among 19% of study participants, the mean of modified CoMISS Score in positive cases (12.37) were highly statistically significant than those negative lactose intolerance (2.33) as p < 0.001, Area under ROC Curve was 0.998, with cut-off value >8. Sensitivity 89.5% and specificity was 100%.

Conclusion

Modified CoMiSS is a simple, fast, and easy-to-use tool that can predict lactose intolerance, with a cut-off value of > 8, the Area under the ROC Curve was 0.998, sensitivity 89.5%, and specificity was 100%.
Development of Practice Guidelines for Peripartum Depression in Primary Healthcare
Authors: Korany Wafaa Mohamed , Marzouk Diaa , El-Hamid Abd , Allam Mohamed Farouk
Published: August 2023

Background

Antenatal and postpartum major depressive episode (MDE) according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) is defined as either daily sustained sad mood or lack of enjoyment or desire for a minimum two weeks plus four associated manifestations (only three if the two major symptoms are present): 1) Unintentional notable slimming up or down; 2) Sleepiness or sleeplessness; 3)Tiredness sensation; 4) Guilty or futility sensation; 5) Declined concentration capacity; 6) Frequent suicidal thoughts or 7) Psychomotor excitation or delay, that start throughout pregnancy or during the first 4 weeks postpartum respectively.

Objective

To develop Egyptian practice guidelines for peripartum depression in Primary Healthcare (PHC).

Methods

The current study was conducted thorough Delphi technique by participation of Thirteen experts at psychiatry and family medicine specialties from different governmental universities, Ministry of Health and Population (MOHP), World Health Organization (WHO) and World Organization of Family Doctors (WONCA) via email thorough three consecutive phases of Delphi technique.

Results

The current study recommended health education programs, provision of awareness about physical exercise’s importance for prevention of antenatal and postnatal depression, adding telephone- based peer support for the preventive measures of the antenatal depression and family therapy for the postpartum depression prevention. Screening for all the pregnant women every trimester by patient health questionnaire II and screening for all the new mothers every well child clinic visit in the first year after delivery by Edinburg Postpartum Depression Scale (EPDS). Diagnosis by beck depression inventory II questionnaire and Postpartum Depression Screening Scale (PDSS) for antenatal and postnatal depression respectively with post diagnosis evaluation for: 1) Comorbid anxiety; 2) Bipolar disorder; 3) Thoughts of harming intrauterine fetus or newborns; 4) Suicidal thoughts and 5) Psychotic features. Cognitive Behavioral Therapy (CBT) for treatment of mild cases and CBT with half dose sertraline for moderate cases of antenatal depression. Cognitive Behavioral Therapy (CBT) for mild cases, CBT and the usual dose sertraline for moderate cases with no hormonal therapy for any patient. Referral for patients with: 1) severe depression; 2) comorbid anxiety; 3) bipolar disorder; 4) thoughts of harming intrauterine fetus or newborns; 5) suicidal thoughts; 6) psychotic features; 7) substance abuse.

Conclusion

development of Egyptian practice guidelines for peripartum depression in PHC. Wide dissemination of the practice guidelines to all the Egyptian PHC facilities via a suitable method and training programs for the family physicians on practicing these guidelines must be ensured.
Comparative Evaluation of Onlay vs Sublay Mesh in Treatment of Ventral Hernias
Authors: Abd El- Naser Amr Abd El- Raouf , El- Aziz Ahmed Abd El- Razek Abd , Mahfouz Remon Mamdouh , El-Rahiem Ahmed Ezzat Abd
Published: August 2023

Background

Hernias of the anterior abdominal wall, or ventral hernias have a various type that can be categorized into primary ventral hernias which include two subtypes lateral ventral hernia, and midline ventral hernias, and incisional hernias (acquired hernias) is another type according to the location, occur at the site of a pervious surgical scar.

Objective

To compare the outcome of the onlay versus sublay mesh repair for ventral hernias in terms of mean operative time, frequency of post-operative wound infection, seroma formation, hematoma formation, flap necrosis, mesh infection, hospital stay and time for drain removal.

Patients and Methods

This study will be conducted on 30 patients presenting to Ain shams University hospitals with uncomplicated ventral hernias starting from February 2021 till July 2021.

Results

Regarding the post operative complications, Seroma formation was more in the onlay group and this was statistically significant. Other post operative complications like wound infection, flap necrosis, Mesh infection, hematoma formation was more in the onlay group but were found to be statistically insignificant in the present study. Regarding the time taken for drain removal was more in the onlay group and this was statistically significant.

Conclusion

Sublay mesh repair is a good alternative to onlay mesh repair. This study advocates this method of ventral hernia repair, as it is applicable to all sites of ventral hernia. The mesh is mostly hidden and anchored behind the rectus sheath, the complication rate is low, and there is low recurrence rate. Finally, we suggest carrying out more trials on the sublay mesh repair technique to include bigger number of cases and longer period of follow-up.
Role of Laser Ablation of Fistula Tract in High Perianal Fistula
Authors: Nada Mohamed Ali , Abbas Ahmed Adel , Abdel-Makasoud Ibrahim Maged , Awad Ahmed Khairy
Published: August 2023

Background

Complex anal fistula has been a hot topic in clinic. Many surgical techniques have been described for the treatment of such anal fistula, including the use of seton, fibrin glue, collagen plugs, rectal advancement flaps, fistulotomy with sphincter repair, and rerouting the fistula tract. However, the results have been variable, and no one procedure is superior to the others absolutely. It is worth our concern that the goal of any treatment procedure is to obliterate the tract and to have low recurrence rates while maintaining full continence. A fistulotomy lays open the fistulous tract, thus leaving smaller unepithelized wounds, which hastens the wound healing. Until now, fistulotomy is still the most widely used. But, the high cure rate is limited by the fact that laying open a transsphincteric fistula tract and cutting both the internal and the external sphincter has the risk of fecal incontinence ranging up to 40%.

Aim of the Work

To assess and evaluate the efficacy and safety of LASER ablation of high perianal fistula.

Patients and Methods

This study is a randomized prospective study which will be conducted at Ain Shams University hospitals recruiting (20) patients and will be operated upon between January 2021 and July 2021 with minimal follow up to 3 months postoperatively.

Results

From these studies, it emerges that this procedure has some advantages. It doesn’t affect continence, administers controlled hyperthermic effect to the tissues, has a short learning-curve and reduces postoperative hospital stay as compared to endorectal advancement flap or LIFT. However, it has also some drawbacks. It is a blind procedure, as it’s not possible a direct visualization of the fistula tract or any secondary tracts and this may lead to recurrence. It requires expensive equipment, particularly if compared to other sphincter-saving techniques.

Conclusion

LASER ablation is a technique that has a promising results regarding complex perianal fistula preserving anal continence and short healing period and low recurrence rate as regarding classic and other techniques.