bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Relationship between Stool Lactobacillus acidophilus and Grave’s Disease in a Sample of Egyptian Population
Authors: Sabry Inas Mohammed , Hendawy Laila Mahmoud Ali , Ali Hanan Mahmoud , Helmy Aya Madboly
Published: August 2023

Background

Graves’ disease is an autoimmune disease that leads to a generalized overactivity of the entire thyroid gland (hyperthyroidism). When unrecognized, It impacts negatively on quality of life and poses serious risks of psychosis, tachyarrhythmia and cardiac failure. It affect 0.5% of the population in the US, and represents 50-80% of cases of hyperthyroidism. It occurs more commonly amongst women, smokers and patients with other autoimmune diseases or a family history of thyroid autoimmunity.

Aim of the Work

The study is aimed to study the relationship between stool lactobacillus acidophilus and grave’s disease in a sample of Egyptian population

Patients and Methods

This study is a case control study, was carried out at Endocrine outpatient clinic at Ain Shams University Hospital, on 60 Egyptian patients age 25-40 years old, from September 2020 till March 2021.

Results

Among group1A, 5(25%) were 25 -30 years old, 6(30%) were 30 – 35 years old, 9(45%) were ≥ 35 years old, the mean of ages was 32.75 (±4.94 SD) with range (25.0 – 40.0), there were 5(25%) males, 15(75%) females, the mean of duration of the disease was 2.95(±2.14 SD) with range (1.0 – 7.0). Among group 1B, 8(40%) were 25 -30 years old, 5(25%) were 30 – 35 years old, 7(35%) were ≥ 35 years old, the mean of ages was 31.90(±4.69 SD) with range (26.0 – 40.0), there were 3(15%) males, 17(85%) females, the mean of duration of the disease was 3.25(±2.02 SD) with range (1.0 – 7.0). Among total cases of group 1, 13(32%) were 25 -30 years old, 11(27.5%) were 30 – 35 years old, 16(40%) were ≥ 35 years old, the mean of ages was 32.33(±4.77 SD) with range (25.0 – 40.0), there were 8(20%) males, 32(80%) females, the mean of duration of the disease was 3.10 (±2.06 SD) with range (1.0 – 7.0).

Conclusion

Stool Lactobacillus acidophilus PCR count was insignificantly different between studied groups, which may show no relationship of lactobacillus with graves’ disease. so, further studies are needed to determine correlation or causation of this relationship.
A Study of the Assessment of Serum Adropin Level as a Risk Factor of Ischaemic Heart Disease in Type 2 Diabetes Mellitus Cases
Authors: Makboul Khaled Mahmoud , Hussein Elhalawany Salah , Khairy Mansour Hany , Marwan Dina Ahmed , Ibrahim Baher Emil
Published: August 2023

Background

Adropin is a peptide hormone which was discovered in 2008 and originally described as playing an important role in glucose and fatty acid homeostasis that acts on peripheral tissues. We investigate the correlation of adropin and ischaemic heart disease in diabetic patients.

Aim

Study of the assessment of serum adropin level as a risk factor for ischaemic heart disease in type 2 diabetes mellitus cases.

Method

This case control study was conducted on 90 subjects, divided into 3 groups: Group (I): 30 T2DM patients with ischaemic heart disease Group (II): 30 T2DM patients without ischaemic heart disease Group (III): 30 healthy subjects as control.

Fasting plasma glucose, 2 h post prandial plasma glucose, Carotid artery intimal thickness using ultrasound, HbA1c, Lipid profile (cholesterol, triglycerides, LDL-C, HDL), HOMA IR Serum creatinine, AST, ALT, and Serum Adropin were assessed.

Result

There was a statistical significant increase in serum Adropin hormone in diabetic patients without ischaemic heart disease than diabetic one with ischaemic heart disease (p value ˂0.001), (26.867 ± 10.037) ng/L vs (87.500 ± 40.509) ng/L respectively. Also Serum Adropin was negatively correlated with fasting insulin and CIMT.

Assessment of serum adropin level could be a risk marker for ischaemic heart disease development in type 2 diabetes mellitus patients.
Value of Chromogranin A as a Prognostic Marker in Cirrhotic Patients with HCC before and after Radiofrequency
Authors: Hashem Basiony Mostafa Basiony , Maged El-Sakaty Tarek , Mohammed Enas Elkhedr , Hussein Hany Ali
Published: August 2023

Background

The majority of HCC cases are undetected until advanced stage owing to lack of symptoms and the absence of sensitive and convenient screening procedures. The overall AFP performance in this field has been inadequate in terms of its poor specificity and sensitivity. Various prior studies found an elevated serum Cg-A concentrations in HCC patients. Radiofrequency ablation (RFA) is the preferred approach for small sized lesion. Therefore, the aim of this study was to highlight the value of determination of CgA serum levels in monitoring patients with cirrhosis for early detection of HCC and its significance as a prognostic marker in patients with very early/early stage of HCC before and after radiofrequency.

Subjects and methods

The present study enrolled 30 cirrhotic patients with very early/early stage of HCC, 15 cirrhotic patients without HCC, and 15 healthy controls. Serum AFP & Cg-A levels were estimated in all patients before intervention and 1 month after radiofrequency ablation in the HCC group.

Results

Serum Cg-A was significantly higher in HCC cases compared to healthy subjects and cirrhotic patients (P = 0.001). At a cut off value of 250 (ng/ml), serum Cg-A had a 96.7% sensitivity and a 93.3% specificity for detecting HCC while AFP at 3.736 ng/ml had 93.3% sensitivity and 86.7% specificity. Furthermore, the selected cut-off values to distinguish HCC patients who have better (improved) outcome from those with bad outcome was 375 (ng/ml) with 96.7% sensitivity and 76.7% specificity (for Cg –A) and 17 (ng/ml) with 73.3% sensitivity and 70% specificity (for AFP).

Conclusion

Cg-A can act as valuable diagnostic as well as prognostic biomarkers for liver cirrhosis and HCC as it was significantly higher in HCC patients than in cirrhotic patients and controls and it had higher sensitivity, specificity than AFP for HCC diagnosis.
Plasma Levels of Pentraxin 3 and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus
Authors: Mohammed Magda Shokry , mahdy Maram Mohammed Maher , Ali Hanan Mahmoud , Mohammed bedir Fathy Bedir
Published: August 2023

Background

Diabetes mellitus is a heterogeneous metabolic disorder characterized by the presence of hyperglycemia which is associated with long-term micro-vascular complications affecting the eyes resulting in diabetic retinopathy (a leading cause of blindness). Pentraxin 3 (PTX3) is a recently discovered mediator of acute inflammation which has been shown to be a sensitive biomarker of localized inflammatory reactions with a possibility of being used as a biomarker of peripheral vascular damage.

Objective

To evaluate the relation between levels of plasma Pentraxin 3 (PTX3) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus.

Methods

This case control study was conducted on70 patients with type 2 DM and 20 healthy subjects as control and their ages ranged from 40-70 years, selected from outpatient diabetes and endocrinology clinic at El Demerdash Hospital/Ain-Shams University and outpatient diabetes and endocrinology clinic at National Institute of Diabetes and Endocrinology. The included subjects were allocated into three groups: Group I (type 2 DM complicated with DR) and this group was further subdivided to subgroup Ia (diabetic patients with proliferative diabetic retinopathy) and subgroup Ib (diabetic patients with nonproliferative diabetic retinopathy); group II (type 2 DM without retinopathy) and group III (apparently healthy subjects representing control group). All subjects were subjected to full medical history taking, physical examination including BMI and blood pressure measurement as well as fundus examination. Fasting and 2 hr post-prandial plasma glucose, HbA1C, serum creatinine and urea, ALT, AST, serum albumin, microalbuminuria as well as plasma PTX3 wereassessed.

Results

Plasma PTX3 level was significantly higher in diabetic patients with diabetic retinopathy than that in both diabetic patients without diabetic retinopathy and control healthy subjects (3.20 ± 0.035 ng/dl versus 2.88 ± 0.32 ng/dl and 2.88 ± 0.167 ng/dl respectively; P-value =0.000).The Correlation between pentraxin 3 and other measured parameters in all studied subjects showed a statistical positive correlation between log PTX3 and age, duration of diabetes, DBP, FBG, 2HPP, HBA1c, albumin, creatinine, urea, microalbuminuria.

Conclusion

Serum pentraxin 3 is strongly correlated to diabetic retinopathy and the higher the grade of retinopathy, the higher the pentraxin 3 level. So, pentraxin 3 can be considered a reliable predictor for diabetic retinopathy. Serum pentraxin 3 and diabetic retinopathy are strongly correlated to level of glycaemia and duration of diabetes as well as to creatinine, urea and micro-albuminuria. This draws the attention to the role of tight glycemic control in the prevention or slowing diabetic retinopathy progression and to the relation between diabetic retinopathy and nephropathy.
Study of IL-10 Serum Marker and Its Association with NAFLD in Adult Egyptian Patients
Authors: Badawy Hanan Mahmoud Mohamed , Abdelaziz Eslam Safwat Mohamed , Salama Mohamed Magdy , Harown Bishoy Refaat Rassmy
Published: August 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity and diabetes, and is characterized by insulin resistance (IR) Cytokines and adipocytokines (i.e. mediators mainly derived from adipose tissue) play a major role in the orchestration of inflammatory processes throughout the body.

Aim and objectives

To evaluate the relation between serum levels of IL-10 and NAFLD in Egyptian patients.

Subjects and methods

This study is A randomized case control cross sectional study, was carried out at Eldemrdash University Hospital, Internal medicine departments, on patients above 18 years old with Hepatic Steatosis Index (HSI) and NAFLD, duration of study about 6 months.

Result

There was high statistically significant difference between studied cases as regard IL-10.

Conclusion

High IL-10 levels limiting the effects of the inflammatory response that is, by counter regulating the effects of pro-inflammatory cytokine so that the protective function of IL-10 in steatotic liver relies on suppression of TNF-a production. Morbidly obese patients with increased age and elevated levels of LDL, fasting glucose, HOMA-IR, and TNF-a, in combination with low circulating levels of IL-10, seem to be at higher risk to develop severe-NAFLD and should be clinically monitored.
Evaluation of Reduced Glutathione Plasma Level in Type 2 Diabetic Patients with Fatty Liver
Authors: Mohamed Dalia Abdel-Wahab , Zakaria Zaky Doaa , Sayed Sheha Aliaa , mohamed Aid Yara , Ali-Labib Randa
Published: August 2023

Type 2 diabetes (T2DM) and its complications represent a main worldwide public health challenge, with high-rate morbidity and mortality. Non-alcoholic fatty liver disease (NAFLD) has a great focus worldwide, as it is expected to affect 75% of patients with type2 diabetes mellitus. In this study, we aimed to assess reduced glutathione plasma level then evaluate its correlation with fasting blood glucose levels, HBA1c and lipid profile in type 2 diabetic patients with fatty liver. This study included 40 participants divided into 20 type2 diabetics with fatty liver group and 20 healthy control group. Estimation of fasting blood glucose levels, HBA1c, lipid profile and liver function enzymes were done. reduced glutathione plasma levels were measured by ELISA. The results revealed that plasm levels of reduced glutathione were lower in type 2 diabetics with fatty liver compared to control subjects (P < 0.01). These low plasma GSH levels in diabetics was negatively correlated with FBG and HBA1C% (r= −0.641, −.0547 respectively; P < 0.01) indicating that chronic hyperglycemia and its resulted oxidative stress have negative impact on GSH concentrations in the body. This low GSH levels in type 2 diabetics with fatty liver can be an important prognostic factor as, GSH reduction causing increase of oxidative stress and may worsen the liver status that may progress to NASH.
Usefullness of a Combined Evaluation of the Serum Adiponectin Level and Insulin Growth Factor 1 to Predict the Early Stage of Nonalcoholic Steatohepatitis
Authors: Malatawy Mohamed Abdel-Fattah El , Ahmed Ossama Ashraf , Kaiser Hany Haron , Aziz Doaa Mohamed Abdel , Mohamed Dina Morsy Ahmed
Published: August 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Western industrialised countries and affects around 25% of the European population. The prevalence of NAFLD is increasing in parallel with the global increase in obesity and type 2 diabetes mellitus (T2DM).

Aim of the Work

To investigate the role of adiponectin and IGF1 in the diagnosis of NASH.

Patients and Methods

The present study included 60 patients who attending the outpatient clinic of Ain Shams University hospital, they age ranges from thirty to sixty years.

Results

It was found that highly significant decrease in Adiponectin and IGF-1 levels, in NASH group; compared to NAFLD control group (p < 0.01 respectively) a This data is similar to many studies done before in NAFLD and NASH patients. Our study also shows that; AST, ALT, total and direct bilirubin, had a highly significant negative correlation with IGF-1 and Adiponectin level (p < 0.01 respectively). This go with many studies who found a significant inverse correlation between IGF-I levels and liver enzymes, indicating that lower IGF-I levels in NAFLD are related to parenchymal dysfunction. With proven evidence that low circulating IGF-I levels correlate with the degree of liver dysfunction.

Conclusion

Serum adiponectin and insulin growth factor 1 are lower in patients with NASH compared to NAFLD patients which reflect the protective effect of both of adiponectin and IGF1 against the development of NASH.
Elevated Plasma Copeptin Levels Identify the Presence and Severity of Nonalcoholic Fatty Liver Disease in Obesity
Authors: Nashaat Ehab Hassan , Riad George Safwat , Ghait Ramy Samir , ELMaksod Ereny Emil Gerges Abd
Published: August 2023

Background

Non-alcoholic fatty liver disease is characterized by excessive fat accumulation in the liver with unclear mechanism may be due to epigenetic changes which take place at the transcriptional level without altering the underlying DNA sequence. this epigenetic alternation are involved in regulation of hepatic lipid metabolism, insulin resistance, mitochondrial damage, oxidative stress response, and the release of inflammatory cytokines, all of which have been implicated in the development and progression of NAFLD. Elevated copeptin, a vasopressin marker, is linked to metabolic disease, and obese rats with lowvasopressin concentration had a decreased risk of liver steatosis.

Aim and objectives

To Detect the elevation of plasma copeptin in obese patients with nonalcoholic fatty liver disease in relation to general population.

Subjects and Methods

This is A randomized case control cross sectional study, was carried out at internal medicine and gastroenterology department, Ain Shams University hospitals, on 100 patients above 18 years old with Hepatic Steatosis Index (HSI) and NAFLD-Liver Fat Score (LFS), over a period of 6 months.

Result

There was high statistically significant difference between the studied groups as regard Serum plasma copeptin.

Conclusion

Our study demonstrates for the first time that copeptin levels predict the presence of biopsy-proven NAFLD in obese individuals, regardless of body adiposity and the coexistence of other metabolic disorders. Studies with longitudinal design are warranted for exploring the possible involvement of AVP/V1aR system in the development and progression of NAFLD.
Clinical Significance of Serum Cholinesterase in the Diagnosis and Assessment of Clinical Activity in Patients with IBD
Authors: Adel Nanees Ahmed , El Khedr Mohamed Enas , Elhady Abeer Abd Elraof Abd , Khella Fady Samir Emil
Published: August 2023

Background

Inflammatory bowel diseases (IBD), including Crohn’s disease and Ulcerative colitis, witnessed dramatic rise in incidence in the past few decades. Fecal calprotectin has been widely established as laboratory marker in assessment, diagnosis and severity of IBD. It showed low specificity and high number of false positive results. Cholinesterase (ChE) enzymatic glycoprotein used in hydrolosis of acetylcholine, showed significant correlation with IBD activity, it showed also potential role in diagnosis and assessing clinical severity in IBD patients. We will evaluate the role of serum cholinesterase in diagnosis and assessment of severity in IBD patients.

Aim of the Work

The aim of this study is to evaluate the role of serum cholinesterase (ChE) in diagnosis and assessment of activity in IBD patients

Patients and Methods

A Case control study in outpatients and inpatients in departments of Internal Medicine, Ain Shams University Hospital for Six months since beginning of data collection (till fulfilling the sample size) on 70 subjects divided into 3 groups: Group A: 25 patients with Crohn’s disease evidenced by colonoscopy and tissue biopsy, group B: 25 patients with Ulcerative Colitis disease evidenced by colonoscopy and tissue biopsy, group C: 20 age-matched, sex-matched healthy controls

Results

Our results confirmed that, compared with healthy controls, serum ChE levels were decreased in patients with IBD, and the decline in serum ChE levels was more pronounced as clinical activity in IBD increased. We also found that the serum ChE levels of patients with CD and those with UC were significantly different. It needs to be further clarified the relationship between serum ChE and endoscopic activity in the future.

Conclusion

Serum ChE levels can be used as a simple, economical method to help diagnose and distinguish the different stages of IBD. With the increasing biomedical research on the cholinergic anti-inflammatory pathway and ChE, serum ChE is expected to become a new immunotherapy target for IBD.
Ascitic Calprotectin, as a New Marker of Spontaneous Bacterial Peritonitis (SBP)
Authors: Saeed Kadry Mohamed El , Sayed Engy Yousry El , Rasmy Hany Samir , Ansary Amira Roshdy Mohammed Al , Hajajy Fatma Badawy Mansour Al
Published: August 2023

Background

Liver cirrhosis results from different mechanisms of live injury that lead to necroinflammation and fibrogenesis; histologically it is characterized by diffuse nodular regeneration surrounded by dense fibrotic septa with subsequent parenchymal extinction and collapse of liver structures, together causing pronounced distortion of hepatic vascular architecture.

Objective

To evaluate the diagnostic role of ascetic fluid calprotectin in cirrhotic patients with spontaneous bacterial peritonitis before and after treatment.

Patients and Methods

This study was designed as a case-control study for evaluation of ascitic calprotectin as a diagnostic & prognostic test for spontaneous bacterial peritonitis. The study was conducted on 50 patients attended internal medicine department in El Dmerdash teaching hospital of Ain Shams University during 2018/2019.

Results

Regarding the ascetic calprotectin after treatment showed decreasing levels correlated with recovery among SBP patients with cut off ≤340 pg/ml had sensitivity 82.5%, specificity 78.0%, PPV 75.0%, NPV 84.8%, accuracy 82.6% in cirrhotic patients with SBP after treatment. Also, the present study found that ascetic calprotectin at cut off value ≤ 780 pg/ml had sensitivity 82.86%, specificity 100%, PPV 100%, NPV 45.5%, accuracy 96.3% in prediction of poor prognosis among SBP cirrhotic patients after treatment.

Conclusion

The best cut-off is level of ascitic calprotectin ≤ 320 pg/ml which had sensitivity 95%, specificity 90%, PPV 74.5%, NPV 81.8%, accuracy 94.1% in prediction of diagnosis of SBP among cirrhotic patients. The best cut-off level of Ascitic calprotectin ng/mL ≤ 780 pg/ml had sensitivity 82.86%, specificity 100%, PPV 100%, NPV 45.5%, accuracy 96.3% in prediction of poor prognosis among SBP cirrhotic patients after treatment.
Intestinal Ultrasound for Inflammatory Bowel Diseased Patients Who Receive Biological Treatment
Authors: Nashaat Ehab , Abd-Elkader Sarah , Salama Mohamed Magdy , Elnour Fatma Othman Abou
Published: August 2023

Background

Crohn’s disease (CD) and ulcerative colitis (UC) are two forms of chronic inflammatory bowel diseases (IBDs) characterized by recurrent episodes of intestinal inflammation and a heterogeneous range of symptoms and clinical courses. In contrast to CD, UC is a mucosal and to some extent submucosal disease restricted to the colon. Depending on the involved colonic segment, UC can be divided into proctitis, left- sided colitis or extensive colitis.

Aim of the Work

Prospective evaluation of intestinal ultrasound (iUs) for disease monitoring of patients with ulcerative colitis (Uc) and crhons disease receiving biological treatment with following up the efficacy on intestinal wall. Newly diagnosed patients who will receive biologics and compare with colonoscopy

Patients and Methods

This was a cohort study in ultrasound unit of gastroenterology department at Ain shams university hospitals, the patients selected from the department of gastroenterology and gastroenterology outpatient clinic from May 2021 till January 2022 on 50 patients.

Results

When comparing baseline ultrasound results of inflammatory signs and colonoscopy we found non-significant results that support using intestinal ultrasound results as non-invasive tool for diagnosis of inflammatory bowel disease. and also doppler signs it showed significant results in some parts of the colon like terminal ilium, left side, transverse and sigmoid and that is very important in patient who have strictures in terminal ilium prevent terminal ilium intubation during colonoscopy. Also on comparing results of pathology and intestinal ultrasound we found the sensitivity of intestinal ultrasound is very high inflammatory signs 93.8% sensitivity and doppler signs 85.4% but specificity was 50% only that was because it depends on the operators vision and also on the machine used and the patient also he may be not fasting and distended that make the field very hard, also when comparing with ct enterography results and MR enterography it showed the same specificity and sensitivity that confirm our vision also.

Conclusion

For conclusion intestinal ultrasound one of the best modalities for diagnosis and follow up inflammatory bowel disease, especially in short term response, our finding give rise to not only the assumption of bowel wall thickness but also inflammatory markers, doppler signs, bowel lumen and fibrofatty nodules had significant difference at long term follow up Christian Maaser et al findings give rise to the assumption that monitoring BWT alone has the potential to predict therapeutic response. The additional monitoring of FC could add further value in monitoring patients with UC. Future prospective studies are necessary to determine the value of IUS in predicting short and long-term response and outcomes of therapies in UC
Prevalence of Abnormal Liver Functions in Covid-19 Patients
Authors: Elnakeeb Noha Abedelrazek , Ibrahim Mohamed Magdy Mohamed , Elissaway Hagar Ahmed Ahmed , Fahmey Hagar Fawzy
Published: August 2023

Background

Coronaviruses are a family of viruses that are known to cause both respiratory and intestinal diseases in various animal species and humans. These viruses tend to target the upper respiratory tract, causing anywhere from moderate to severe illnesses, such as the cold or in more extreme cases, pneumonia. To date, 7 human coronaviruses have been identified, including the 3 epidemic viruses of severe acute respiratory syndrome (SARS)-CoV, middle east respiratory syndrome (MERS)-CoV and the newest, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2).

Aim of the Work

To evaluate the incidence of concurrent elevation of liver function tests (AST, ALT, Bilirubin), examine dynamic changes of it and its relationship with disease throughout the course of COVID-19 patients.

Patients and Methods

We retrospectively evaluated and analyzed the liver enzymes and total bilirubin results (Ast, Alt, bilirubin) along with the medical history obtained from 105 adult patients of both genders with confirmed COVID-19, moderate group (62) patients, severe group (43) patients from 15 March 2020 to 15 June 2020 admitted at Ain Shams University isolation hospitals.

Results

AST was significantly higher in patients with severe disease on admission compared to moderate cases, however it's median level did not show marked elevation from normal values (median AST level 45 u/l, range 12-2228), normal value of AST less than 40 U/L. During hospital stay AST also was significantly higher in severe group compared to moderate group with p value 0.022. ON discharge patients had almost normal AST level as patients were improved (2 COVID PCR were negative).

Conclusion

Liver injury not a frequent finding in patients with COVID-19. Any rise in liver function may indicate severe COVID disease. Monitoring liver functions during course of severe disease till recovery.
High Risk NAFLD among Patients with Irritable Bowel Syndrome: Frequency & Effect on Disease Severity
Authors: Allam Ahmed Samir , Saeed Kadry Mohamed El , Abozeid Hazem Mahmoud Osman , Raafat Kaled Mohamed
Published: August 2023

Background

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disease that significantly affects patient quality of life, interfere with daily activities, physical intimacy, traveling, and self-esteem. Because of its clinical heterogeneity and the unclear etiology of IBS, robust biomarkers and therapeutic targets for IBS are difficult to identify. On the other side, Non-alcoholic fatty liver disease (NAFLD) has become a common disease worldwide, affecting 25% of the adult population.

Aim of the Work

The aim of the study is to detect if there is a prevalent relation between those two diseases and the assessment of NAFLD prevalence and severity in IBS patients.

Patients and Methods

Our study has involved 75 patients with different degrees of IBS syndrome and variable severity patterns of NAFLD. Using inclusion and exclusion criteria for selecting the patients; IBS diagnosed according to modified ROME IV critera regardless of the type either constipation predominance or diarrhea predominance. While NAFLD was mainly detected using abdominal ultrasonography, both were differentiated into three grades determining the severity of each and their correlation.

Results

Our current study included 75 patients diagnosed with IBS (37 males and 38 females). Mean age of included patients was 42.17 ± 8.3 years. Mean height of included patients was 173.6 ± 9.07 cm, mean weight was 88.02 ± 14.9 Kg while mean BMI was 29.39 ± 4.4. Regarding evaluating the association of IBS with NAFLD there were high statisitical significant assocaiton between both diseases. The study of lipid profile parameters and liver enzymes in relation to IBS grade revealed no-significant association. The study of IBS grade regarding liver enzymes revealed no significant statistical difference between grades of IBS. Study of lipid profile parameters (S.cholesterol, S.triglycerides and LDL) in relation to U/S grade revealed high significant association between increased serum TAG and severe grade of NAFLD.

Conclusion

IBS had higher frequency of NAFLD. Also, there is significant association between IBS and NAFLD severity.
Study of the Relation between Serum Lipoprotein-Associated Phospholipase A2 (LP-PLA2) Level and Nonalcoholic Fatty Liver Disease (NAFLD)
Authors: Makhlof Mohamamed Ali Marai , Slama Mohamed Magdy , Elrahman Gada Abd , Gomaa Huda
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is one of the most common causes of chronic liver disease, worldwide. Lipoproteinassociated phospholipase A2 (Lp-PLA2) was recently characterized as a novel inflammatory biomarker that is correlated with several components constituting the metabolic syndrome.

Aim and Objectives

to study serum levels of Lp-PLA2 in patients with NAFLD to detect its relation to the incidence and severity of NAFLD.

Subjects and Methods

This is Case Control cross -sectional clinical Study, was carried out at Internal Medicine and Hepatology outpatient clinic at Ain Shams University Hospital on 80 persons were divided into 2 groups: (Group-I): 40 patient with NAFLD as a study group, (GroupII): Forty(40) healthy subjects as a control group.

Result

There was high statistically significant difference between the studied groups as regard LpPLA2.

Conclusion

The clinical use of Lp-PLA2, a biomarker for NAFLD, requires the standardization of analytical methods, characterization of analytical features, assessment of performance characteristics, incremental yield of different markers for given clinical indications, and demonstration of cost-effectiveness.
Evaluation of Culture and Sensitivity Guided Antibiotic Selection in Eradication of Helicobacter pylori
Authors: Hussein Hussam Ali , Mohamed Azza Emam , Nakeeb Sara Abdel Kader , Salama Mohamed Magdy
Published: August 2023

Background

Helicobacter pylori exhibits antibiotic resistance with regional differences. Antibiotics resistance is the main cause of eradication failure in H. pylori infection, thus our study aimed to evaluate the efficiency of standard triple therapy vs. Antibiotic -culture with susceptibility-based therapy and success rate of each in helicobacter pylori eradication.

Methods

This study was conducted on 100 patients with dyspepsia undergoing Upper GI Endoscopy in Gastroenterology department at Ain shams university hospital in the period between june2018 and june2019, the volunteered patients were divided into groups A and B. Group A patients received 2 weeks of pantoprazole 40 mg bid +two Antibiotics according to each patient’s result of culture and sensitivity, while Group B patients received 2 weeks of standard triple therapy PPI 40 mg bid + Amoxicillin 1 g bid + Clarithromycin 500 mg bid

Results

that patients of group A according to their culture and sensitivity results showed Significant increase in number of isolates sensitive to levofloxacin (26) than those resistant to it (14) with p-value 0.1(HS), Significant number of isolates resistant to clarithromycin (36) than those sensitive to it (14) with p-value o.011 and (HS), also Significant increase in number of isolate resistant to amoxicillin (40) than those sensitive to it (10) with p-value 0.003(HS) and finally significant increase in number of isolate resistant to metronidazole (40) than those sensitive to it (10) with p -value 0.003(HS). H. pylori results 4 weeks post treatment in groups A and B showed that there was a Significant number of positive helicobacter pylori patients 4 weeks post tr eatment in group B (30) than in group A (7) with p- value <0.01 (HS) and Significant number of negative helicobacter pylori patients 4 weeks post treatment in group A(43) than in group B (20) with p- value <0.01 (HS).

Conclusion

43 of group (A) patients (86%) showed successful helicobacter pylori eradication after culture guided antibiotic therapy. Only 20 of group (B) patients (60%) showed successful h. pylori eradication after standard triple therapy. The study showed high resistant rates of h. pylori to clarithromycin and amoxicillin and metronidazole and gradually increasing resistance against levofloxacin. Countries like Egypt seem to have a high clarithromycin resistance, and a large-scale clinical trial is needed to choose the first -line therapy for eradication of H. pylori infection.
Characteristics of Helicobacter pylori-Seropositive Subjects According to: A) The Stool Antigen Test Findings. B) Serum Pepsinogen Level. C) Upper Endoscopic Findings
Authors: Elqarmooty Khaled Zakria , Ahmed Osama Ashraf , Naguib Gina Gamal , Abdalla kabil Ibrahim Shawky
Published: August 2023

Background

Helicobacter pylori infection can be diagnosed by invasive methods using the gastric biopsied specimens or non-invasively by examining serum, urine, breath, or stool. Histological examination by Giemsa staining is usually recommended for the diagnosis, but it is difficult to visualize the bacterium when there is alow density of H.Pylori on the gastric mucosa with atrophic and metaplastic changes, Limitations of histological examination include increased false negative test findings due to various density of H. pylori at a different sites, high cost, long turn-around time, and inter observer variability. Therefore, in endemic countries like Egypt with s higher risk of chronic atrophic gastritis (CAG), intestinal metaplasia, and gastric cancer, noninvasive tests need to be added for a more reliable diagnosis of H.Pylori infection.

Aim of the Work

The aim of this study is to compare between the prevalence of chronic atrophic gastritis (CAG) and gastric corpus atrophy in Helicobacter pyloriseropositive subjects according to the stool antigen test, serum pepsinogen(PG) level and upper endoscopic findings.

Patients and Methods

The current study represents Cross- sectional study -Descriptive -Diagnostic study. This study had been carried at Ain Shams University and Abbasia fever hospital on 80 seropositive- patients attending to endoscopy ward for a regular check-up, All patients subjected to full history, clinical examination and investigation in the form of; complete blood count, serum antiH.Pylori immunoglobulin G (IgG), stool antigen test and serum pepsinogen.

Results

The current study showed that there was a significant difference between positive and negative H. pylori regarding pepsinogen I & II and endoscopic finding regarding CAG and CSG.

Conclusion

In conclusion, there is a link between positive stool H. pylori antigen test findings and a serum PG assay and upper endoscopic findings in seropositive subjects. Positive stool H. pylori antigen test findings are common in seropositive subjects with increased serum PG I levels indicating an ongoing H. pylori infection. Our study findings further suggest that, to reduce the infected subjects with H. pylori in their fecal material, seropositive subjects with increased gastric secreting ability need to be treated.
The Prevalence of Diabetic Retinopathy in Type 1 Diabetic Subjects Attending Ain Shams Diabetes Outpatient Clinic
Authors: Shady Manal Mohammed Abo , Abd-elazeem Islam Nasser , Mohammed Tamer Fahmy , Ali Hanan Mahmoud , Adly Nahla Nader
Published: August 2023

Background

Diabetic retinopathy is a chronic progressive, potentially sight threatening disease of the retinal microvasculature associated with the prolonged hyperglycaemia and other conditions linked to diabetes mellitus such as hypertension

Aim

detect the prevalence of diabetic retinopathy in type 1 diabetic subjects in relation to duration of diabetes, control of blood glucose level and other micro-vascular complications.

Patients and Methods

This was a cross sectional study conducted on 120 patients attending diabetes outpatient clinic at ain shams university hospital during period from april 2020 to October 2020 to detect the prevalence of diabetic retinopathy in type 1 diabetic subjects in relation to duration of diabetes, control of blood glucose level and other micro-vascular complications Patients were subjected to full history taking and clinical examination. DN4 questionnaire for neuropathy assessment, Laboratory investigations included; fasting blood sugar, 2 hour post prandial blood glucose, (glycated haemoglobin HBAIC), serum creatinine and albumin/creatinine ratio, also all patients subjected to detailed fundus examnation using ophthalmoscope.

Results

Our study show that total patients of study is 120 patient, fundus examination results revealed that 66 of them normal fundus (55%), 17 mderate NPDR (14.17%), 8 sever NPDR (6.67%), 29 PDR (24.17%).

Also show that there is statistically significant relation between fundus examination results and (age of the patient, duration of diabetes mellitus and smoking) also clinical data (SBP, DBP, pulse and BMI) also laboratory data (FBS, 2h PPBG, HBA1C and albumin /creatinine ratio).

Also show that there is statistically significant relation between fundus examination results and total insulin dose and DN4 questionnaire.

The study also show that there is no significant relation between fundus examination results and (gender, s. creatinine level, family history of diabetes or type of basal insulin).

Conclusion

DR. is a progressive blinding disease that affects 4.2 million people worldwide, making it a leading cause of blindness in adults and this number is expected to continue to increase. DR. affected by age of the patient, duration of diabetes mellitus and smoking also clinical data (SBP, DBP, pulse and BMI) also laboratory data (FBS, 2h PPBG, HBA1C and albumin /creatinine ratio) and total insulin dose.
Assessment of Liver Stiffness by Transient Elastography in Chronic Hepatitis C Patients with Chronic Kidney Disease before and after Receiving Treatment
Authors: Mohammed Khaled Abdel-Hameed , Mohammed Enas El-Khedr , Rasmy Hany Samir , Saber Mahmoud Abbas
Published: August 2023

Background

The changes in liver stiffness after receiving (ombitasvir, paritaprevir and ritonavir plus ribavirin) combination therapy for HCV in chronic hepatitis C patients with chronic kidney disease, using transient elastography (fibroscan).

Aim of the Work

This study aims to assess the changes in liver stiffness after receiving (ombitasvir, paritaprevir and ritonavir plus ribavirin) combination therapy for HCV in chronic hepatitis C patients with chronic kidney disease, using transient elastography (fibroscan).

Patients and Methods

This study was Prospective cohort clinical study that was conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital from August 2018 to march 2019 after informed consent. 50 patients who directed antiviral drugs (ombitasvir, paritaprevir and ritonavir plus ribavirin) for 12 weeks were included in this study after taking their consent for this clinical trial after full explanation of the trial. The 50 included patients with chronic HCV and chronic renal disease (naïve patients who did not receive any treatment before) and all were treated with quadrable therapy (ombitasvir, paritaprevir and ritonavir plus ribavirin) for 12 weeks. All patients had a Succes rate of 100%

Results

The present study showed significant reduction in ALT, AST and albumin after receiving DAAs in comparison to their levels before treatment with P value <.001.

Conclusion

Transient elastography has a diagnostic and prognostic role in patients with HCV and CKD during treatment with DAA. There was insignificant correlation between renal profile and degree of fibrosis by fibroscan.
Association between Helicobacter pylori Infection and Risk of Non-Alcoholic Fatty Liver Disease
Authors: Shawky Bakir Amal , Hussein Hany Ali , Galal Salah Shaarawy , Amer Mahmoud Mohamed Abdul Azeem
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is an epidemic liver disease affecting approximately 25% of the general population. It has a wide range of clinical phenotyping from hepatic steatosis to non- alcoholic steatohepatitis (NASH), advanced fibrosis and liver cirrhosis.

Aim of the Work

To find out the link between H. Pylori infection and the onset of Non-alcoholic fatty liver disease.

Patients and Methods

This cross sectional, case control study was conducted on 80 patients presented with H-Pylori in Ain Shams University Hospitals during the period from September 2020 to June 2021, after taking informed consents from the patients.

Results

Our study shows a statistically significant association between age and NAFLD occurrence. Our study showed that gender has no influence on occurrence of NAFLD. Also, we found that NAFLD is associated with elevated levels of TG, Cholesterol &LDL. Our study showed that high SBP, DBP is associated with increased risk of NAFLD. The levels of AST and ALT in our study were significantly higher in risky group patients than in non-risky group patients. Regarding the degree of fibrosis in patients with NAFLD using NFS we found that risky patients were associated with increased risk of fibrosis.

Conclusion

Our study suggested that H-Pylori infection may have a role in NAFLD occurrence. However, other metabolic risk factors such as dyslipidemia and obesity may have the major role in developing and progression of NAFLD taking in consideration the limitations of case-control study and the small sized population included.
Myostatin Level in CRF Patients with and without HBV and Its Correlation with Sarcopenia
Authors: Makhlouf Mohamed Ali Marie , Fathallah Ahmed Magdy , Al-Ghandour Ahmed , Gawish Marwa Rizk Mohamed
Published: August 2023

Introduction

Myostatin (MSTN), a member of TGF-β superfamily, is produced in the skeletal muscle to inhibit myocyte differentiation. MSTN expression is increased in the skeletal muscle in patients with chronic kidney disease (CKD), which may play a role in the pathogenesis of sarcopenia or in the protein energy wasting (PEW).

Aim and objectives

To assess myostatin level in CRF patients with HBV and its correlation with sarcopenia.

Subjects and Methods

This study is a cross - sectional study, was carried out at at outpatients' clinics and internal medicine and nephrology department Ain Shams university hospital and Sharq Elmadinah Hospital, Alexandria, on 70 patients on regular hemodialysis divided into 3 groups: (Group A); included 20 patients with HBV infection, (Group B); included 20 patients without HBV infection, (Group C); included 10 normal persons without CRF or HBV, during period from February 2021 till August 2021.

Result

Myostatin level showed a significant negative correlation with BMI and SMI.

Conclusion

The serum myostatin level was significantly higher in hemodialysis patients than controls, particularly in post-HCV cirrhotic than non-cirrhotic ones. Serum myostatin level was significantly related to sarcopenia pathogenesis as a predictor marker.
Incidence of Hepatocellular Carcinoma in Hepatitis C Patients Treated with Direct-Acting Antivirals and Its Relation to Hepatic Fibrosis Stage
Authors: Elsheikh Mazen , Shawky Amal , Shaaban Mostafa , Anwar Ayman , Abdelrahman Yasser , Eltouny Maha
Published: August 2023

Introduction

Significant advances in understanding of the molecular virology, life cycle, and pathogenesis of Hepatitis C Virus (HCV) led to the Direct-Acting Anti-viral (DAA) era of HCV therapy in 2011 (Hezode et al.,2015). It can be expected that rates of HCV-associated hepatocellular carcinoma (HCC) will decrease significantly after the widespread adoption of DAAs, However Hepatitis C patients with cirrhosis who were treated with direct-acting antivirals had increased likelihood of developing HCC (Tayyab et al., 2020) (Kozbial et al., 2016). HCC was also associated with greater liver stiffness according to transient elastography and lower platelet counts (Conti et al., 2016). The aim of this study is to investigate incidence of HCC in Egyptian HCV patients in whom other predominant HCV genotypes are prevalent and different treatment protocols followed.

Methods

This was a retrospective study including 400 chronic HCV patients who were following up their medical condition at Kobri El-Koba Military Hospital hepatology outpatient clinic from January 2018 to September 2019. Patients were divided into two main equal groups regarding either received HCV direct acting antivirals or not. Incidence of HCC after 18 months of follow up were compared between two groups. Its relation to hepatic fibrosis stage was calculated in both groups.

Results

DAA receiving group had significantly lower incidence of HCC than non DAA receiving group (control group). Eleven patients in DAA receiving group developed HCC (5.5%) compared to twenty-two patients in control group (11%) with P- value 0.04. Although there was no significant difference between two groups regarding pre-treatment prevalence of ascites, splenomegaly, or esophageal varices, DAA receiving group had statistically significant advanced hepatic fibrosis when compared to control group. Before starting treatment, DAA Receiving group shows (4.5% F0, 14% F1, 7% F2, 11.5% F3 and 63% F4) versus (20.5% F0, 14% F1, 18.5% F2, 6.5% F3 and 40.5% F4) in control group with highly significant P value 0.00.

Conclusion

Incidence of HCC decreased significantly after DAA in chronic HCV patients. Decreased incidence occurred despite advanced hepatic fibrosis in this group of patients.
Association between Nonalcoholic Fatty Liver Disease and Carotid Artery Disease in Type 2 Diabetic Patients
Authors: Samy Amir Helmy , Sayed Moataz Mohamed , Badawy Mohamed Nabil , Hawary Mohamed Kamal Mahmoud
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is a clinic-pathological syndrome closely associated with obesity, dyslipidemia, diabetes and atherosclerosis. Some authors suggest that NAFLD is, in fact, another component of the metabolic syndrome.

Aim of the Work

To assess the relationship between NAFLD and Diabetes mellitus as risk factors for atherosclerosis by measuring carotid intima-media thickness (CIMT), NAFLD Fibrosis Score and FIB-4 Score.

Patients and Methods

This study is a prospective case control study that was conducted on (40) NAFLD Patients (aged between 18-60 years), at Gastroenterology and Hepatology department, Ain shams university hospitals and Heliopolis hospital, divided into three groups (Group 1): included 15 patients with NAFLD and controlled T2DM, (Group 2): included 15 patients with NAFLD and uncontrolled T2DM, (Group 3): included 10 patients as with NAFLD and non-diabetic as a control group, through a period of 6 months.

Results

There was positive correlation between IMT with FBG (p = 0.012) and HbAIC (p = 0.011).

Conclusion

Our results suggest that NAFLD is extremely common in people with type 2 diabetes and is associated with a higher prevalence of CVD. The association between NAFLD and CVD appears to be independent of classical risk factors, glycemic control, medications, and presence of the metabolic syndrome. Thus, these results further confirm the hypothesis that the identification of NAFLD in type 2 diabetes may help in CVD risk prediction.