bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Helicobacter pylori infection among Patients with Acne Vulgaris
Authors: Ahmed Saleh Hanan Mohamed , Afify Ahmed Abdelfattah , Abdel Aziz Abeer Farrag Hussein
Published: July 2024

Background

Acne vulgaris is one of the most common dermatologic complaints. About 85% of adolescent population and 3% of the adults between the age of 35-44 years have this disease worldwide. It is a chronic inflammatory disorder of the pilosebaceous unit. Helicobacter pylori is a gastric Gram-negative, spiral-shaped microaerophilic pathogen closely associated with gastric and extra-gastric diseases (chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, gastric cancer, iron deficiency anemia, etc). It has been shown that H. pylori may play a potential pathogenic role in extra-intestinal diseases such as hepatobiliary, respiratory, cardiovascular, and dermatological disorders. The latter included chronic urticaria, psoriasis, henoch-schonlein purpura, and rosacea.

Objective

To determine the prevalence of H. Pylori infection among AV patients and correlate it with the disease severity. We included 45 patients with AV and 45 matched age and sex apparent healthy controls.

Methods

This case control study included 45 Patients with AV. They were recruited from the Dermatology outpatient clinic, Ain Shams University Hospitals and Teba specialized hospital in Luxur government. The study also included 45 age and sex matched healthy volunteers as a control group. They were recruited from people who don't have AV attending Al Demerdash Hospital Ain Shams University and Tepa Specialized Hospital. The study was done in the period from November 2021 to October 2022.

Results

Detection of H. pylori antigen in stool and H. pylori antibody IgG in serum in both groups revealed that the rates of H. pylori antigen in stool and H. pylori antibody IgG in serum were significantly higher in AV patients compared to control subjects. Also the patients with severe AV had statistically significant higher rates of H. pylori antigen in stool and H. pylori antibody in serum as compared to the patients with mild Acne and healthy controls. Also the number of AV involved sites and severity of AV were significantly correlated with H. pylori Ag in stool and H pylori Ab in serum. While there was no statistical significant correlation between (the type of AV, onset of AV and duration of AV) and H. pylori Ag in stool and H. pylori Ab in serum.

Conclusion

The prevalence of H. pylori infection in patients with acne vulgaris is high so it may represent a risk factor for this skin disease. Also the indicators of H. pylori infection were positively correlated with the severity of AV.
Microscopic versus Endoscopic Stapes Surgery – A Meta-Analysis
Authors: Fawaz Samia Ahmed , Mikahail Peter Milad , Mady Ossama Mustafa , Elbagory Mahmoud Mohamed
Published: July 2024

Background

The microscope is the conventional method used by ear surgeons to view the middle ear structures, allowing for binocular vision and the freedom of both hands. Its main disadvantage is the need for an unobstructed, direct view of the operating area. The end-aural incision, drilling of the bony auditory canal, and regular repositioning of the patient and the surgeon are a few examples of how the operation has to adapt to the microscope. Nevertheless, the microscope has proven itself as the tool of choice in stapes surgery with reliable outcomes.

Objective

to compare endoscopic and microscopic interventions in stapes surgery regarding intraoperative and post-operative outcomes.

Patients and Methods

The review was a meta analytic & systematic review that included randomized controlled trials (RCT), case series and retrospective studies which studied the comparison of microscopic and endoscopic stapes surgery, 15 articles published between 2014 and 2020 were included in our study.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2020.

Results

Our results showed that the injury to the chorda tympani nerve was significantly higher in microscopic vs endoscopic groups. And also as regard the operative times, it was significant longer in microscopic vs. endoscopic groups. But there is no significant difference as regarde pain, dizziness, perforation of tympanic membrane, delayed conductive hearing & post-operative Air- bone gap improvement and taste disturbance between both groups.

Conclusion

Endoscopic stapes surgeries are technically feasible, safe and promising. Overall, our study indicates endoscopic and microscopic stapes surgery has similar audiological success, with some data suggesting a lower risk of chorda tympani injury and postoperative taste disturbance with the endoscope. Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with similar complications (chorda tympani nerve injury, pain, Perforation of tympanic membrane, taste disturbance, Dizziness, and delayed conductive hearing). Shorter operative times shorter and lower postoperative air-bone gap were found in endoscopic stapes surgery. Superior visibility with the endoscope was consistently reported in all the studies. This meta-analysis of the current evidence supports the use of endoscopic techniques for stapes surgery.
Efficacy of Virtual Reality as Vestibular Rehabilitative Therapy in Peripheral Vestibular Dysfunction: A Systematic Review and Meta-Analysis
Authors: Abd-Elhamid Eman El-Saied Yahia , Hazzaa Nagwa Mohamed , Manzour Ayat Farouk , Galal Eman Mohamed
Published: July 2024

Background

Vestibular rehabilitation therapy is a safe, effective and non-invasive treatment for the uncompensated peripheral vestibular lesions. Virtual reality can be utilized in vestibular rehabilitation. There are no standardized guidelines settled in the literature involving virtual reality settings for the treatment of the peripheral vestibular lesions.

Aim of the Work

To study the efficacy of virtual reality (VR) interventions in vestibular rehabilitation in patients with peripheral vestibular disorders.

Methods

The following databases were examined: PubMed, Google scholar andEmbase. The following search terms were utilized: (Virtual reality – video games – Vestibular rehabilitation – peripheral vestibular dysfunction).

Results

Based on the inclusion and exclusion criteria, four studies were selected for inclusion in this study. Statistical analysis was done using outcome measures as Dizziness Handicap Inventory (DHI) and Activities-specific Balance Confidence questionnaire (ABC). This study found that virtual reality interventions can improve balance function in patients with peripheral vestibular disorders.

Conclusions

This study suggests that virtual reality has potential clinical benefit for vestibular rehabilitation in peripheral vestibular dysfunction compared with conventional vestibular rehabilitation.
Hip Fracture and The Associated Risk Factors among Egyptian Males
Authors: Abbas Adel Adel , Allam Mohamed Farouk , Sweed Hala Samir , Abdulrahman Samia Ahmed , Wessam Ali Walaa
Published: July 2024

Background

Fragility fractures caused by osteoporosis are well-known to increase the risk of further fragility fractures; a history of the wrist, vertebral body, or hip fractures increases the risk of further fractures accordingly. Fragility fractures induce lower activities of daily living (ADL), and repeated fractures further reduce mobility. Studies found that persons who experienced at least one vertebral body fracture had a higher mortality rate than persons without vertebral body fractures. Also, the one year survival rate of patients with hip fractures was lower than that of the general population. The objective of this study was to find the proportion of concomitant hidden vertebral fractures among males with fragility hip fracture.

Patients and Methods

Observational analytical case control study, on 150 male cases of osteoporotic hip fractures with matching 150 controls, 40 years of age and older, presented to orthopedic emergency room in the period from Jan, 2019 to Jan, 2020. Cases and controls underwent structured interview questionnaire including all medical and socio- demographic characteristics. Cases in addition underwent plain x-ray for lumbosacral vertebra to assess for concomitant hidden vertebral fractures, in addition.

Results

We had 150 patients conforming to our inclusion criteria, visiting the orthopedic emergency department, of a total number 48000 patients, only 13000 of them are males during the study period, from Jan 2019 to Jan. 2020. The proportion of fragility hip fracture among males was 1.2%, with mean age 74.32 +/- 10.7. Cases also had a number of co- morbidities ranging from 4-7 chronic diseases. Of those cases, 26% had a concomitant hidden vertebral fracture.

Conclusion

Concomitant vertebral fracture is prevalent among males with other fragility fractures, especially hip fracture, which warrants identification and management to evade complications and mortality.
The Potential Role of Bone Marrow Mesenchymal Stem Cells Derived Exosomes on Experimentally Induced Osteoarthritis of Knee Joint in Male Albino Rats. Histological and Immunohistochemical Study
Authors: Baraka Asmaa Tarek , Negm Eman Ali , Raafat Mona Hussien , Atalla Suzi Sobhy
Published: July 2024

Introduction

Osteoarthritis (OA) is the most common joint disorder worldwide characterized by progressive loss of articular cartilage. This study was conducted to evaluate the role of bone marrow mesenchymal stem cells (BMSCs) derived Exosomes as a promising therapy for treating osteoarthritis.

Aim of the Work

to study the healing potential of BMSCs derived exosomes on experimentally induced knee osteoarthritis.

Materials and Methods

Forty adult male albino rats, weighing 200-250 gm, were used in this study, five rats used as a source of BM-MSCs derived exosomes. The other thirty-five rats were randomly divided into three main groups Group I: The control group (20 rats) in which rats were subdivided into four subgroups. Subgroups IA and IB were sacrificed 2 and 6 weeks after the beginning of the experiment. Subgroup IC left for 2 weeks then were received intra-articular injection of 0.1ml Phosphate buffer saline (PBS) in right knee joint once weekly for 4 weeks Subgroup ID: left for 2 weeks then given intra-articular injection of purified exosome concentrate in the right knee joint once weekly for 4 weeks then the animals were sacrificed Group II:(15 rats) in which OA was induced by intra-articular injection of 2% formaldehyde solution in the right knee joints. The rats of group II were subdivided into two subgroups. Subgroups IIA and IIB were sacrificed 2 and 6 weeks after induction of OA respectively. Group III (5 rats), Osteoarthritis induced, as in group II and animals left for 2 weeks then treated by intra-articular injection of purified exosome concentrate in right knee joint once weekly for 4 weeks. The right joints from all groups were collected, decalcified and processed for histological studies. Morphometric and statistical measurements were done.

Results

Histological examination of the right knee joints of OA group (subgroups IIA and IIB) showed surface erosions, decrease cartilage thickness, chondrocytes with pyknotic nuclei and areas of chondrocytes loss with longitudinal clefts reaching the deep zone. Synovial membrane of group II showed increased thickness of the intima, mononuclear cellular infiltration with abundant collagen fibres deposition and dilated congested blood vessels in subintima, apparent increase in the number of iNOS positive intimal synovial cells. Meanwhile, group III showed smooth articular surface, with multiple colonies of chondrocytes and multiple cell nests, significant increase in the mean area percentage of PCNA positive chondrocytes in animals of group Ш when compared to all the other groups.

Conclusion

BMSCs derived exosomes improved OA induced damage of articular cartilage and synovial membrane. Therefore, it offers a cell-free treatment of OA and joint damage.
A Comparative Histological Study Between the Protective and the Therapeutic Effect of Probiotic on Cisplatin Induced Nephrotoxicity in Adult Male Albino Rat
Authors: Mostafa Rawan Hasan , Sadek Doaa Ramadan , El Khalek Ibrahim Gehan Abd , Abd El Salam Nevert Farid
Published: July 2024

Introduction

Although cisplatin (CP) is one of the most effective chemotherapies, it is associated with significant nephrotoxicity (Acute kidney injury). Lactobacillus plantarum is often used as a probiotic on its own for its beneficial properties and anti-inflammatory activity.

Aim

to compare the protective and therapeutic role of probiotics on the microscopic structure of the kidney in a model of cisplatin-induced nephrotoxicity.

Material and Methods

thirty-five adult male albino rats weighing (200-220gm) were divided into 4 groups. Group I (control group), Group II (Cisplatin group): rats received intraperitoneal injection of CP (7.5 mg/kg) for 3 days. Group III (protective group): Rats received 1 mL of probiotic orally for 7 days. From the fifth day, the rats received intraperitoneal injections of CP (7.5mg/kg) for 3 days. Group IV (Therapeutic group): Rats received intraperitoneal injection of CP for 3 days. From the fourth day, the rats received probiotic L. plantarum orally at a dose of (1 mL/day) for 14 days. The concentration of probiotics in group III and group IV was 109 Colony forming units (CFU)/mL/100 g of body weight. Kidney specimens were proceeded for light microscopic examination, as well as Morphometrical and statistical analyses.

Results

H&E-stained sections of Group II showed marked renal affection in which most glomeruli showed atrophy. Renal tubules were mostly distorted, necrotic, and degenerative with interstitial hemorrhage, congestion, and cellular infiltration. PAS-stained sections showed marked increased reaction in glomerular and tubular Basement membranes with an apparent loss of Brush borders of most of the PCTs. Masson`s trichrome-stained sections showed a marked increase in collagen fibers in renal interstitia mostly around blood vessels. Immunohistochemically stained sections showed a marked increase in positive cytoplasmic reaction to caspase -3 antibodies mostly in renal tubules. On the other hand, the renal structure of The protective group showed marked improvement which appeared nearly comparable to that of the control group while the therapeutic group showed minimal improvement.

Conclusion

The protective effect of probiotics on cisplatin-induced Acute Kidney Injury (Nephrotoxicity) was markedly better than the therapeutic effect as detected by microscopic, morphometric, and statistical studies.
Elevation in Liver Enzymes as a Predictor for COVID-19 Severity
Authors: Fouda Enas Mahmoud , Abdel-Latif Hatem , Aziz George Tari Magdy , El-Aal Mohamed Salem Mohamed Abd
Published: July 2024

Background

The coronavirus disease 2019 (COVID-19) started in December of 2019 as a cluster of pneumonia cases of unclear etiology in Wuhan city of Hubei province in China. Later, it was found to be caused by a coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease rapidly spread throughout the world, becoming a pandemic, and as of April, 2022, there were more than 500 million cases worldwide with more than 6 million deaths. It is postulated that the virus enters the human body by binding to the angiotensin-converting enzyme receptor-2 (ACE-2) with the help of spike protein on its cell membrane.

Aim of the Work

To compare the serum liver chemistries such as hepatic transaminases to evaluate whether they can predict severity and mortality in COVID-19.

Patients and Methods

A comparative cross-sectional study for 6 months in Ain-Shams University hospitals, we studied 100 hospitalized patients with confirmed COVID-19 by RT- PCR for SARS- CoV-2. They included 70 patients with non-severe COVID-19 and 30 patients with severe COVID- 19 on hospital admission. This classification was based on the quick COVID-19 severity index (qCSI) and CT- severity index.

Results

The results of our study showed that levels of inflammatory markers such as CRP, serum ferritin, d-dimer, and procalcitonin were significantly higher in the severe group when compared to the non-severe group. This could be an indicator of a more intense inflammatory state in patients with severe COVID- 19 admitted to ICU. Our study showed that 40% of the severe group admitted to the ICU passed away. In our study, the median levels for ALT, AST at admission were 51 and 46 U/L, respectively, which are considered higher than the upper limit of normal levels. Our study showed that during hospitalization, the group of patients with severe COVID-19 who were admitted to ICU had significantly higher prevalence of abnormal ALT levels when compared to the non- severe group (86% versus 32%, respectively).

Conclusion

Our study showed that patients with severe COVID-19 have significantly higher levels of AST and ALT and that, on admission, patients with abnormal ALT and AST levels have significantly higher odds for developing severe COVID-19 compared to patients with normal levels. We confirm the importance of monitoring liver enzymes in hospitalized patients with COVID-19 as patients with abnormally elevated AST and ALT are more expected to progress to severe COVID- 19 which have prognostic implications in the COVID-19 disease course.
Directly Acting Anti-Viral Drugs and Its Metabolic Side Effects in Patients with Chronic HCV
Authors: Ahmed Osama Ashraf , ELkhayal Ahmed ELsady , Zaki Khaled Amr , Ragaae Amira Adel
Published: July 2024

Background

Hepatitis C virus (HCV) is a major cause of chronic liver disease, with an estimated 170 million people infected worldwide. Treatment of hepatitis C virus has traditionally been difficult because of low rates of treatment success and high rates of treatment discontinuation due to side effects.

Aim of the Work

The aim of this work is to study side effects of directly acting anti HCV drug (DAA) and its progression in metabolism of lipid profile, blood sugar level, and renal function.

Patients and Methods

This case study had been carried out on 200 subjects presented to Department of Internal Medicine at Kobbri ELkobba hospital inpatient and outpatient clinics between March 2016 and September 2016.

Results

sustained virological response (12 weeks) after end of the treatment in more than 90% of patients, Liver function parameters including albumin, bilirubin, and prothrombin time and liver enzymes Ast, Alt improved in the majority of patients during and after the end of therapy,but there is significant increase in urea level, serum creatinin and HbA1C. There is significant decrease in LDL and mild increase in TG level.

Conclusion

Once-daily oral daclatasvir plus sofosbuvir with or without Ribavirin was associated with high rates of sustained virologic response among patients infected with HCV, including chronic cirrhotic patients and relapsers, successful treatment associated with Improvement of liver function parameters in the majority of patients, Increase in urea level, serum creatinin and HbA1C. There is significant decrease in LDL and mild increase in TG level.
Study of Serum Complement 3 Split Product iC3b /C3 Ratio in a Cohort of Systemic Lupus Erythematosus Patients
Authors: Mansour Howaida El sayed , Hosny Sherin Mohamed , Shaaban Mohamed Elham , Abd El Fattah Mohamed Salah Sayed
Published: July 2024

Background

Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease that causes widespread multi organ inflammation. The exact cause of SLE remains unclear; however, genetic, hormonal, and environmental factors contribute to the development of the disease.

Aim of the Work

The aim of this study is to measure the ratio of complement split product iC3b to C3 and its relation to disease activity and lupus nephritis in a cohort of SLE patients.

Patients and Methods

This study is a Cross sectional case control study conducted in internal medicine and Rheumatology unit, Ain Shams university hospital and Rheumatology unit, Maadi military hospital. Our study included.

Results

The present study shows that female were (76%) in active group of SLE patients and (60%) in inactive group while male were (24%) and (40%) respectively. with no significant difference. The mean of Disease Duration was (5.66 ± 1.97) with a range from 3 and 10 years in active group of SLE patients and (5.08 ± 1.54) with a range from 3 and 9 years in inactive group. with no significant difference. Regarding clinical manifestations of SLE the present study shows that active group of SLE patients had statistically highly significant increase in incidence of lupus nephritis, arthritis, serositis, oral ulcers, malar rash (p < 0.001) with significant increase in incidence of alopecia and neurological manifestations (p < 0.05). The current study shows that active group of SLE patients had statistically significantly higher mean ESR, anti-DNA titre, 24hr urinary proteins, serum creatinine, serum urea, and GFR levels (p = 0.000) than inactive group, Also active group had significant leucopenia, anemia (p = 0.000, 0.005 respectively) and C3 was significantly more consumed than inactive group (p < 0.05)

Conclusion

The ratio of complement split product iC3b to C3 concentrations correlates with the extent of SLE disease activity more than C3 alone. Furthermore, the iC3b:C3 ratio may discriminate between patients with lupus nephritis and patients without lupus nephritis. Detection of SLE disease activity and lupus nephritis by iC3b/C3 ratio help to make a proper decision in management to induce remission.
The Effect of Hemodiafiltration vs. High-Flux Hemodialysis on Alpha 1-Microglobulin level and Dialysate Albumin Loss Using a Dialyzer Surface Area of 2.6 m2
Authors: ElSayed Hesham , ElSharkawy Magdy , Khedr Abdelrahman , Hussein Hussein Sayed , Elbraky Abdelrahman , Fathy Mohamed
Published: July 2024

Background

Dialysis therapy has remarkably evolved through the innovation in dialyzers and hemodialysis modalities, enhancing patients’ quality of life. The efficacy of dialysis can be determined by measuring the reduction ratio (RR) of middle molecules, such as alpha 1-microglobulin (A1M).

Objectives

In our study, we tested a high-flux dialyzer, BIOPURE (Biorema) 260 HF, with a surface area (SA) of 2.6 m2, in terms of A1M removal and concurrent albumin loss in dialysate while receiving high-flux hemodialysis (HF-HD) and post-dilution online hemodiafiltration (OL-HDF).

Patients and Methods

This crossover study comprised 25 patients who received a session of HF-HD using the BIOPURE (Biorema) 260 H, followed by a session of post-dilution OL-HDF. A washout period of 2 weeks was instilled between the two sessions, during which the patients received HF-HD using high-flux dialyzers (maximum SA 2.0 m2). All patients' hourly dialysate albumin and pre/post dialysis concentrations of A1M were measured.

Results

The dialyzer used in this study resulted in an A1M RR of 41.9±7.93% (p < 0.001) with HDF and 27.12±7.65% (p < 0.001) with HF-HD; and a median cumulative dialysate albumin loss of 2.97g (IQR 1.98 – 3.37) with HDF, and 0.67g (IQR 0.49 – 1.13) with HF-HD.

Conclusion

The dialyzer BIOPURE (Biorema) 260 HF (SA 2.6 m2) is efficient in eliminating A1M, especially with OL-HDF compared to HF-HD, with acceptable albumin loss in the dialysate.
Impact of Diabetes in Pregnancy on Stage II Lactogenesis among Postpartum Diabetic Women Compared to Non-Diabetics
Authors: Halawa Mohamed Reda , Eid Yara Mohamed , Ahmad Gihan Fouad , Ali Hendawy Laila Mahmoud , Mobarez Muhammad Manar Muhammad
Published: July 2024

Background

Diabetes in pregnancy -whether preexisting or gestational can have negative impact on pregnancy, labor and lactation. Infants of diabetic mothers benefit most from early establishment of breastfeeding as it helps them regulate their blood glucose levels on the short term and decrease their risk of developing diabetes later on life.

Aim of the Work

This study aims to compare diabetic and non-diabetic pregnant women regarding the onset of stage II lactogenesis at 72 hours postpartum and to associate the degree of diabetes control in antepartum period with the delay in stage II of lactogenesis.

Subjects and Methods

This study is an observational prospective cohort study, carried out on 203 pregnant women aged from 18 to 40 years old during their routine antenatal care visits in the third trimester of pregnancy at Ain-Shams University Maternity hospital outpatient clinic from December 2020 to August 2021, Cairo, Egypt.

Results

We found that Diabetes in pregnancy can cause a delay in the onset of Lactogenesis stage II regardless of the degree of control. We can also say that diabetes can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother and delayed initiation of first breastfeed which was found to cause DOLII. And early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers.

Conclusion

Diabetes can cause series of unfortunate events in pregnancy, labor, and lactation. Many of diabetes implications on peripartum health can affect lactation directly and indirectly. For example, Diabetes can cause higher rates of cesarean section, infant separation from mother, delayed initiation of first breastfeed and other birth complications. All these can cause DOL II. Diabetes itself is a risk factor for delayed onset of lactogenesis II which can cause further neonatal hypoglycemia and/or early introduction of infant formula. The cascade of these events can hinder the breastfeeding establishment when it is most needed. The control of diabetes was not found to have impact on DOL II. Further research needs to be done in this regard. Early initiation of lactation can be a modifiable risk factor to protect from DOLII especially in Diabetic mothers.
Comparative Study Evaluating the Effect of the Administration of Vitamin K1 versus Placebo on Vascular Calcification in Haemodialysis Patients
Authors: Kamel Sherry Reda , Mohamed Mohamed Saeed , Tawfik Ahmed Mohamed , Nabil Mohamed Heba Mahmoud
Published: July 2024

Background

Cardiovascular calcification is a risk factor and contributor to morbidity and mortality in End stage kidney disease patients. Cardiovascular calcification is most likely due to an imbalance of promoters (e.g. Calcium and phosphate) and inhibitors (e.g. fetuin-A and matrix Gla protein).

Aim of the Work

We aimed to study the effect of oral vitamin k1 on serum carboxylated Matrix gla protein in patients on maintenance hemodialysis and to study its effect as an important marker of vascular calcification.

Patients and Methods

This Placebo Controlled clinical trial was conducted for 3 months on 80 adult ESRD patients on regular Hemodialysis randomly allocated into 2 groups of either vitamin K1 versus oral placebo tablet administration for 3 months. Patients in both groups were age and sex matched, study group included 18 (45%) males and 22 (55%) females with mean age ± SD 47.350 ± 14.420 years, while the placebo group included 16 (40%) males and 24 (60%) with mean age ± SD 49.500 ± 14.509 years, with no significant difference between both groups as regard demographic data, access of hemodialysis, and duration of Hemodialysis.

Results

There was no significant change in bone parameters (serum Ca, PO4 & Ca/PO4 product) after 3 months of vit K1 administration compared to baseline in the study group. Serum phosphorus levels showed a minimal, yet statistically significant decrease after 3 months of placebo administration, this might be attributed to the different doses of PO4 binders in patients of both groups. Consequently, Ca/ PO4 product showed a statistically significant decrease after 3 months of placebo administration (P = 0.002), mostly attributed to the significant decrease in serum phosphorus in the same group over the same period. We observed that serum MGP levels significantly increased after administration of vitamin k1 in study group (P < 0.001) with 78.05% increase. However, a much lower increase, yet statistically significant increase in serum MGP level was noticed in the placebo group (P < 0.001) with 40.60 % increase. There was no statistically significant difference between the two groups according to their risk factors regarding smoking, HTN, HCV, DM, and ISHD.

Conclusion

We concluded that Oral vitamin K1 therapy significantly increased serum active form of Matrix GLA protein levels among hemodialysis patients with potential decrease in cardiovascular calcification and cardiovascular diseases.
Changes in Serum Oncostatin M Levels During Treatment of Inflammatory Bowel Disease
Authors: El-Latif Mohamed Hatem Abd , Abo Halima Ahmed Samir , El-Rahman Ahmed Ghada Abd , Ali Elshaarawy Mohamed Elsayed
Published: July 2024

Background

Inflammatory bowel diseases (IBD) consist of Crohn’s disease (CD) and ulcerative colitis (UC). They are characterized by a chronic relapsing and remitting disease course that results in intestinal symptoms but also frequently in extra-intestinal manifestations. Among potential targets and biomarkers, oncostatin M (OSM) has gained a lot of interest. OSM is a pleiotropic cytokine produced by activated T cells, monocytes, macrophages, and neutrophils. It is considered proinflammatory given its ability to promote leukocyte recruitment.

Objective

To evaluate the changes in serum Oncostatin M levels during treatment of inflammatory bowel disease.

Patients and Methods

To elucidate this aim 30 IBD patients and 30 controls were included in this study.

Results

The mean Oncostatin M in IBD cases before treatment was 120.13 while after treatment was 91.17 with high significant difference. There was high statistical correlation in between Fecal Calprotectin Level after treatment and Oncostatin M After Treatment. The relation between UC, CD and Oncostatin level before and after treatment shows high statistical significant difference. There was no statistical relation in between Oncostatin level (after treatemnt) and type of treatment. That there was a high statistically significant difference in between cases and control group regarding to HB, WBCs, ESR, CRP, Urea, ALT, Oncostatin M and a statistically significant difference in between cases and control group regarding to Platelets.

Conclusion

Oncostatin M is a promising marker for the diagnosis and follow up of IBD patients, however it has a limited predictive performance for the prediction of the response for IBD treatment.
Diagnostic Role of Serum Chitinase 3 Like Protein 1 as Potential Marker for Fibrosis Assessment in Patient with Chronic Hepatitis B Infection
Authors: Elsaeed Kadry Mohamed , Allam Ahmed Samir , Megahed Ahmed Sherif Ahmed , Warsame Omar Mohamoud
Published: July 2024

Objectives

The main objective of this research was to study to evaluate the diagnostic accuracy of serum chitinase-3 like protein-1 (CHI3L1) in comparison with transient elastography (TE) and non- invasive indirect serum indices (Fib-4 and APRI) for the prediction of significant hepatic fibrosis in patients with chronic HBV infection.

Methods

The current cross-sectional was carried out on 30 individuals with CHB who attended the viral hepatitis unit outpatient clinic, Faculty of Medicine, Ain Shams University, from Aug-2021 to Mar-2022. The primary outcome measures are the correlation of CHI3L1 level to TE, Fib-4, and APRI and calculating the sensitivity and specificity.

Results

The mean age of CHB cases enrolled was 41.60 ± 11.68 years. Male accounted for 21(70%) of cases. The serum level of CHI3L1 was statistically significantly higher in the enrolled patients' group (CHB) median (IQR): 317.5 (300 – 380) ng/ml than healthy control group 28 (25 – 35) with a p-value <0.001. The results of the current study showed a highly significant (p < 0.001) positive correlation (r = +0.702) between CHI3L1 and TE. However, no statistically significant correlations have been found between the level of CHI3L1 and either Fib-4 or APRI. CHI3L1 levels were significantly higher in CHB patients with significant hepatic fibrosis than in those without significant fibrosis in our study. ROC curve shows that CHI3L1 at the cut-off > 307.5 can differentiate between patients with significant fibrosis and patients with no or mild fibrosis according to TE with a sensitivity of 85.5%, specificity of 62.5%, and area under the curve (AUC) of 0.80 (95% CI: 0.64-0.96). Our study showed that significant fibrosis had been found more in older age. The higher the CHI3L1 serum levels, the higher the degree of hepatic fibrosis.

Conclusion

In conclusion, as the CHI3L1 levels were significantly higher in CHB patients with significant hepatic fibrosis than in those without significant fibrosis, the beneficial effect of CHI3L1 for the prediction of significant hepatic fibrosis in patients with chronic HBV infection has some evidence.
Study of Plasma Pentraxin Levels as a Novel Marker versus Liver Stiffness for Nonalcoholic Steatohepatitis (NASH) in Egyptian Patients
Authors: Gadallah Shaimaa Husein , Badawy Hanan Mahmoud , Mohammed Eslam Safwt , Hassan Hanan Emam , Ghait Ramy Samir , Ghait Shady Samir
Published: July 2024

Background

Nonalcoholic fatty liver disease (NAFLD) includes a variety of histopathological findings ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) which can only be differentiated by liver biopsy. There is yet no unique biomarker found to discriminate NASH from simple steatosis. We aimed to investigate the relationship of plasma pentraxin 3 (PTX3) and liver elasticity measured by fibroscan both with the degree of liver damage in NAFLD.

Methods

Plasma PTX3 levels & fibroscan measurements were estimated in 60 patients with NAFLD (30 with NASH, 30 with non-NASH) and 20 controls

Results

PTX3 levels were found significantly higher in the NAFLD group than in the control group (3.59 ± 1.77 vs. 1.16 + –0.29 ng/mL, P < 0.001), and in NASH subgroup than non-NASH subgroup (4.97 + –1.36 vs. 21 + –.75 ng/mL, P = 0.001). To discriminate NASH from non-NASH PTX3 had 96.67% sensitivity and 93.33% specificity at the cutoff value of 3.1 ng/mL. Plasma PTX3 levels showed no significant correlation with NAFLD activity score, fibrosis stage and steatosis.

Conclusion

This study demonstrated markedly higher PTX3 levels in NAFLD patients compared with controls, and in NASH patients compared with non-NASH ones and no correlation wih fibroscan stages. Thus, in this cohort we showed that plasma PTX3 may be a promising biomarker for the presence of NASH.
Evaluation of Thyroid functions in Patients with End Stage Renal Disease in a Sample of Egyptian Populations
Authors: Bahaa Eldin Ahmed Mohamed , Shafik David Ezzat , Sabry Inas Mohammed , El Rouf Raafat Manar Abdl , Ali Mahmoud Hanan Mahmoud
Published: July 2024

Background

In most cases, hypothyroidism is not linked to kidney disease. However, hypothyroidism has been shown to hasten the development of chronic kidney disease (CKD).

Aim of the Work

to evaluate thyroid abnormalities in patients with end stage renal disease in a sample of Egyptian populations.

Patients and Methods

This study was conducted with 70 Egyptian Patients selected from Nephrology department in Theodor Bilharz Research Institute, in a case control study, they were categorized into 2 groups Group 1: Stage V renal disease group (n = 40): patients with eGFR <15 mL/min with no history of thyroid disease or receiving any thyroid medications. Group 2: Age and sex matched health population group (n = 30): with normal renal function with no history of thyroid disease or receiving any thyroid medications. All subjects underwent full thyroid profile, and estimated GFR.

Results

Symptoms of thyroid dysfunction were more frequent in end stage group, the difference statistically were significant only in muscle weakness. TSH was statistically significantly higher in cases with hypothyroidism. TGABs were statistically significantly higher in cases with hypothyroidism. Antimicrosomal antibodies recorded only in hypothyroid cases, the differences were statistically significant. FT3, TSH, TGABs and thyroid volume statistically had perfect diagnostic performance in diagnosing hypothyroidism among end stage renal disease group.

Conclusion

Frequency of hypothyroidism was higher in end stage renal disease patients compared to control group. So, it is important to keep monitoring thyroid functions in patients with advanced renal impairment that may enhance quality of life.
Value of Zonulin as a Diagnostic and Prognostic Marker in Patients with Nonalcoholic Fatty Liver Disease
Authors: Bioumy Essam Mohamed , Sayed Motaz Mohamed , Sabry Mohamed Manal , Eskandaros Moheb Sharaby , ElGhandour Ahmed Mohamed , Mohamed Emam Abdelmomen Momen
Published: July 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver disorders ranging from simple fat accumulation in the hepatocytes (hepatic steatosis), to liver inflammation and hepatocytes injury (nonalcoholic steatohepatitis, NASH) with increasing levels of fibrosis to cirrhosis and hepatocellular carcinoma (HCC). The gut microbiota is involved in the occurrence and development of chronic liver diseases. Zonulin is considered a marker of intestinal permeability.

Aim and Objectives

to study the value of zonulin as a diagnostic and prognostic marker in different degrees of Non-alcoholic fatty liver disease (Steatosis, Steatohepatitis, Cirrhosis) in patients with and without Diabetes Mellitus.

Subjects and Methods

This was Case control study, was conducted in Ain-Shams University Hospitals Internal medicine& Gastroenterology department and bariatric surgery unit over 60 subjects divided into 3 groups:(Group A): 20 Patients have mild NASH, (Group B): 20 Patients have moderate to severe NASH, (Group C): 20 Healthy controls, during a period 1 year.

Result

There was high statistically significant difference between the studied groups as regard Zonulin concentration.

Conclusion

serum zonulin concentration is increased in patients with NAFLD and correlates with the severity of steatosis. However, the cross-sectional design of our study precludes the establishment of causal or temporal relationships between increased zonulin concentrations and severity of steatosis and the presence of NASH. Follow up studies may be helpful in elucidating the cause-and effect relations and the underlying mechanisms.
Micro-RNA in a Sample of Egyptian Patients with Incidental Cerebral Small Vessel Disease
Authors: Maged Mohamed , El Nahas Nevine , Aref Hany , Kilany Ayman , Hamid Eman , Fathy Mai
Published: July 2024

Background

Cerebral small vessel disease (CSVD) causes great disability at increasing age such as cognitive impairment, gait and sphincteric problems affecting a person’s quality of life. That is why it’s important to detect and manage early. The aim of this study is to investigate certain micro-RNA in Egyptian patients with CSVD.

Methods

Thirty patients with CSVD were compared to thirty controls undergoing assessment for cognitive, gait and sphincteric control together with MRI brain and blood sampling for miRNA (miR-409-3p, miR-502-3p, miR-486-5p and miR-451a).

Results

No difference regarding age, gender or risk factors, yet MiRNA-451a was up-regulated in cases with a median fold change of 3.4 in comparison to healthy controls.

Conclusion

The studied microRNA can may have a role in pathophysiology of CSVD.
The Effect of Oral Isosorbide Mononitrate Therapy on Umbilical Artery Doppler Resistance Index in Pregnancies with Intrauterine Growth Restriction: A Prospective Randomized Control Trial
Authors: El Husseiny Amro Salah El Din , Mohsen Sabea Haitham Abdel , Abd El- Razek Maya Mahmoud , Nessim Amin Gena Nader
Published: July 2024

Background

Intrauterine growth restriction (IUGR) is associated with impaired placentation. Patients who are at risk of developing IUGR can be identified by abnormal umbilical artery Doppler at mid-trimester pregnancy. Nitric oxide (NO)-donors like isosorbide mononitrate reduce the impedance in the uteroplacental vessels and possess protecting effects on the endothelium.

Objective

To evaluate the efficacy and tolerability of Isosorbide Mononitrate therapy in reducing umbilical artery Doppler resistance index (RI) in pregnancies with fetal growth restriction.

Patients and Methods

This prospective randomized control trial was conducted at Obstetric Outpatient Clinic – Obstetrics and Gynaecology Department, Faculty of Medicine, Ain Shams University Maternity Hospitals from February 2021 until February 2022 and performed on women who attended ASUMH ECDU with IUGR.

Results

Finally, as regard side effects of isosorbide mononitrate therapy, our study reported that headache and overall side effects were statistically significant higher compared with control group.

Conclusion

Evident from the current study, nitric oxide (NO)-donors like isosorbide mononitrate had no prophylactic or therapeutic effects in management of pregnant cases associated with IUGR. It had no improving effect on umbilical artery Doppler or placental circulation. On the other hand it had unfavorable maternal adverse effects.
Effect of Intravitreal Injection of Ranibizumab (Lucentis®) on Corneal Endothelial Cell Density and Morphology
Authors: Hussein Nawar Sarah Mahmoud Abdul Hameed , El Raggal Tamer Mohamed , Rashed Hazem Omar , Mostafa Mouamen Mohamed
Published: July 2024

Background

VEGF has an essential role in initiating wound and inflammation-related neovascularization. Several studies have demonstrated that VEGF is an important mediator of blood– retinal-barrier breakdown, leading to fluid leakage below the macula and inducing the development of macular edema and choroidal neovascular membranes. Anti-VEGF agents interfere with its receptor binding, thus inhibiting VEGF’s signal, which results in inhibition of abnormal blood vessel formation and decreasing vascular permeability.

Aim of the Work

This study aimed is to report early changes in the corneal endothelial cell density (ECD) and morphology in patients undergoing intravitreal anti-VEGF injections (ranibizumab) for treatment of macular edema.

Patients and Methods

This prospective study included 22 eyes of 22 DME patients indicated for IVI of Ranibizumab, with mean age 57.1±7.4 years, ranging from 42.0 years to 70.0 years. The majority of them were females (77.3%).

Results

Cell density (endothelial cell count) at baseline (2601.8±220.0) didn’t show statistically significant difference than that at one month (2598.9±198.1) after IVI. Coefficient variant was not significantly changed at month-1 as compared to baseline. Coefficient variant at baseline was 29.8±4.0, ranging from 22.0 to 39.0. and at one month was 31.3±5.4, ranging from 21.0 to 48.0. Hexagonal cells (HEX) were not significantly changed at one month as compared to baseline. Hexagonal cells at baseline were 68.9±3.2, ranging from 63.0 to 75.0 and after one month, it was 67.8±4.1, ranging from 60.0 to 76.0. Pachymetry was not significantly changed at one month as compared to baseline. The corneal thickness (pachymetry) at baseline was 538.8±40.1 ranging from 448.0–587.0 to 447.0–597.0. after one month of IV ranibizumab it was 536.3±42.1 0.183.

Conclusion

A single IV injection of Ranibizumab in phakic and otherwise normal eyes with DME showed no change in ECD and pachymetry but a statistically non-significant increase in CV and decrease in HEX 1-month after injection.
Coalition Excision and Corrective Osteotomies versus Coalition Excision and Arthroereisis in the Management of Pes Planovalgus with Talocalcaneal Coalition in Adolescents: A Randomized Controlled Trial
Authors: Ali Mousa Awab , Fathy Hewaidy Ayman Ibrahim , Fathy Elbeltagy Atef Mohamed , Abd-Ella Mohamed Mokhtar , Mohamed Amr Farouk
Published: July 2024

Level of evidence: ΙΙ

Background

Talocalcaneal coalition is the most common cause of rigid flat foot in adolescents. It presents with recurrent ankle sprains, ankle pain, and foot deformity. Management is still controversial. Multiple options were utilized during the last 40 years, including arthroerisis; however, the role of arthroerisis in the management of rigid pes planovalgus remains questionable.

Patients and Methods

Thirty feet in 28 patients with rigid flat foot due to talocalcaneal coalition who presented to our institution between September 2018 and November 2020 were prospectively analyzed. Randomization was performed by random allocation using a computer- based system into two groups: group A for arthroereisis and coalition excision and group B for osteotomies and coalition excision. Functional and radiological outcomes and complications were recorded and analyzed using Statistical Package for Social Sciences software.

Results

Thirty feet in 28 patients were included in the final analysis (group A, 15 feet; group B, 15 feet). The mean age and follow-up duration of the participants were 14.5 years and 24 months, respectively. The mean AOFAS and foot and ankle ability measurement scores were 78.8±4.04 and 76.73±4.66 and 80±5 and 79±3 for groups A and B, respectively. The complication rate was higher in group A; however, this difference did not reach statistical significance. No difference was found regarding functional outcomes.

Conclusion

We believe that the combination of talocalcaneal coalition resection with either corrective osteotomies or arthroerisis resulted in a significant improvement of functional and radiological outcomes with no difference between both in the management of rigid pes planovalgus.
Association between Autoimmune Hepatitis and Celiac Disease among Egyptian Children and Adolescents
Authors: El-Din Ahmed Lerine Bahy , Magied Elfaramawy Amel Abdel , Hamdy Saber Ahmed Mohammed , Talaat Iman Mohammed , Abdullah Fatma Abd Ellah , Ahmed Mohammed Ahmed Badawy
Published: July 2024

Background

Celiac disease (CD) is an immune-mediated intolerance to gluten .CD has been recognized as a multisystem disorder which may affect other extra intestinal organs, such as the skin, thyroid, heart, nervous system, pancreas and liver. Individuals with CD are at increased risk of liver disease namely cryptogenic liver disorder and autoimmune liver disorder. However, until now, it remains unknown whether these two forms of liver disease are really different entities or only different severities of the same disorder.

Objective

To evaluate the association of CD with autoimmune hepatitis in pediatrics.

Subjects and Methods

This was a cross-sectional study that was conducted at the Pediatric Hepatology Clinic and Pediatric Gastroenterology Clinic, Children’s Hospital, Ain Shams University. The study included 2 groups of patients each comprised 20 children and adolescents as follow: Group I: Patients with established diagnosis of autoimmune hepatitis (AIH). All patients were receiving corticosteroids and azathioprine Group II: Patients with established diagnosis of CD. In group I patients with AIH, CD was screened for using anti-tissue transglutaminase (tTG) IgA in addition to measuring serum IgA to determine the need to measure anti-tTG IgG. Immunological markers (ANA, anti-smooth muscle antibody (ASMA) and liver and kidney microsomal (LKM) antibodies in addition to protein electrophoresis were done for group II patients with CD to screen for AIH.

Results

All patients in group I with AIH had normal serum IgA levels and were found negative for anti-tTG IgA. Also, group II patients with CD were negative for ANA, ASMA and LKM antibodies with normal protein electrophoresis.

Conclusion

The current study showed that CD does not seem to have significant association with AIH, however, the small sample size is a study limitation. Further wider scale studies are needed to evaluate the risk of AIH in CD.