bluuebunny/crossref_metadata_2025 huggingface dataset:
Handgrip strength in prediction of sarcopenia in Chronic HCV patient
Authors: Bayoumi Essam Mohammed , Sayed Moataz Mohammed , Abdul-Rahman Samia Ahmed , Saleh Shereen Abo Baker , Mohammed Mohammed Magdy , Samwel Zaky Ayman
Published: October 2021

Background

HCV is one of the major causes of morbidity and mortality in the world and especially in Egypt. However, there is numerous complications to HCV infection (e.g. liver cirrhosis, ascites, portal hypertension, encephalopathy …. etc.) but there is multiple unseen complication (e.g. sarcopenia, loss of electrolytes, loss of protein …etc.)

Objective

To evaluate value of handgrip strength in assessment of sarcopenia in HCV related chronic liver disease patients

Patients and Methods

This study was conducted on 64 adult persons older than 18 years. They were randomly collected from the outpatient clinics at department of internal Medicine in Ain Shams University during the period from June 2018 to August 2019.

Results

In our study there was a great significance relation between handgrip strength and child score in evaluating nutritional status more than anthropometric parameter. Therefore, even that several methods to evaluate nutritional and functional capacity status in patients with cirrhosis have been tested, they have reported diverse results.

Conclusion

Our study we can conclude that HGS is a simple, easy to be applied and more accurate method in evaluation of sarcopenia in chronic HCV patients.
Cardiovascular Manifestations of Behçet Disease among Egyptian Patients
Authors: Mohammed Dalia F , El-morshedy Nashwa A , Teama Mohamed A , Ibrahim Bassant M
Published: October 2021

Background

Behcet’s disease is an auto immune disease with multisystem affection, the most common manifestations are in the form of oral or genital ulcers, eye affection, recurrent thrombosis .

Behcet’s disease is a chronic disease with many sequelae, sometimes fatal, the treatment is by immunosuppressive therapy which also had its implications on the long term, unfortunately it has no sure diagnostic tests and relies mainly on clinical criteria, there are few scores to assess behcet’s disease activity (Behcet's Disease Current Activity Form) BDCAF score is a reliable follow up tool with wide accreditation. BD can virtually involve any organ system, cardiac involvement is variable and sought to occur in the range of 7-46% of patients and may cause myocardial infarction, pericarditis, valve problems, aneurysms or congestive heart failure. Different types of vessels, predominantly veins, can be affected in BD. The frequency of vascular lesions in BD, such as superficial and deep venous thromboses, arterial aneurysms and occlusions, ranges between 7-29%.

Aims

To assess cardiovascular manifestations for patient diagnosed as Behçet disease (BD) and its correlation to disease activity.

Methods

This was a cross sectional study which was done on 40 Behcet’s disease patients within the year 2019, it was done for the assessment of cardiovascular manifestations for patient diagnosed as Behçet disease (BD) and its correlation with BDCAF score (Behcet’s disease current activity form). The study group was subjected to full history, clinical examination including activity which was assessed according to BDCAF score (BEHCET'S DISEASE CURRENT ACTIVITY FORM), Assessment of any activity regarding the eyes using fundus examination, routine laboratory investigations including Complete blood count (CBC), Erythrocyte sedimentation rate (ESR), Creactive protein (CRP), lipid profile, liver enzymes.

Results

it was found that there is a positive correlation between BDCAF (behcet's disease current activity form) and cardiovascular affection (especially valvular lesions and vascular venous affection).
Prevalence of celiac disease in adult patients with iron deficiency anemia of obscure origin
Authors: Farris Mohamed N , Shaheen Rasha Y , Youssef El-Deeb Mai A , Ebraheem Eman A
Published: October 2021

Background

Celiac disease is an autoimmune disease which is underestimated over the world.

Iron deficiency anemia can be the only presentable symptom for patients with celiac disease.

Screening of patients with iron deficiency anemia of obscure origin by anti-tissue transglutaminase serum igA to diagnose celiac disease followed by upper GIT endoscopy is an important step.

Objective

to evaluate the prevalence of celiac disease in adult patients with iron-deficiency anemia of obscure origin.

Methods

The present study was a cross-sectional study which included

100 patients with a diagnosis of iron deficiency anemia recruited from Ain Shams University hospitals. All the patients were subjected to: Full history of gastrointestinal symptoms of celiac disease(CD), Age of onset of iron deficiency anemia, Complete blood picture, Serum iron, serum ferritin, transferrin saturation, Anti-tissue transglutaminase antibody immunoglobuline A, Upper gastrointestinal endoscopy and duodenal biopsy to patients who had positive serology.

Results

The present study showed that 8% of cases with iron deficiency anemia of obscure origin were ultimately diagnosed as cases of celiac diseases while 47% were diagnosed according to duodenal biopsy as potential celiac disease (where there was positive serology and intact villous architecture according to marsh classification) and 45%of cases were non-celiac disease.

Conclusion

Screening for celiac disease should be considered in patients with iron deficiency anemia of obscure origin
Effect of Metabolic Acidosis on Immunoregulation in Prevalent Hemodialysis Patients
Authors: Ahmed Abo Ali Fawzia Hassan , Elkady Hossam Moustafa , Gharib Mohamed Sary , William Adly Heba
Published: October 2021

Objective

to evaluate the relationship between IL-10 and serum bicarbonate and metabolic acidosis in prevalent hemodialysis patients.

Methods

Type of Study: prospective case control study. Study Setting: The study was conducted at Ain Shams University hospital hemodialysis unit. Sample Size: 40 patients with ESRD on regular HD and 20 healthy control. Study Population: Maintenance hemodialysis patients

Results

The results suggested that serum IL-10 level was significantly higher in chronic HD patients than healthy subjects and this is compatible with the idea that higher levels of IL‑10 are needed in HD patients to limit their strong inflammatory activation associated with uremia and the dialysis technique. There was no significant differences in IL-10 levels noticed between patients with different causes of ESRD. This study also showed negative correlation between IL-10 and serum bicarbonate levels. We also found that there was significant positive correlation between baseline levels of IL-10 and CRP which may be because of dialysis inadequacy that is associated with chronic inflammatory state resulting in high CRP levels.

Conclusion

The incidence and prevalence of ESRD have risen dramatically which may be due to the increasing prevalence of diabetes and hypertension. Although regular hemodialysis decreases levels of mortality in these patients, it is still considered a condition associated with inflammation. The current study revealed high IL-10 levels among HD patients who had metabolic acidosis. Further research needs to be done to reveal beneficial effects of these finding.
Correlation between Hypervolemia, Left Ventricular Hypertrophy and Fibroblast Growth Factor- 23 in Prevalent Hemodialysis Patients
Authors: Shawky Sahar Mahmoud , Hassan Mohamed Saeed , Khalifa Maha Mohamed , Mahmoud Amin Kholoud
Published: October 2021

Background

Patients with end-stage renal disease are exposed to extreme volume shifts and thereby cardiovascular strain as a consequence of interdialytic weight gain, fluid removal during hemodialysis and also chronic fluid overload. In long-term hemodialysis patients, higher IDWG (interdialytic weight gain) is associated with poor survival and increased cardiovascular death. Patients with the lowest interdialytic fluid retention have the greatest survival.

It was found that increased interdialytic volume load is associated with increased both LVMI and FGF-23 level.

Objective

To evaluate correlation between hypervolemia, left ventricular hypertrophy and FGF-23 in prevalent hemodialysis patients.

Patients and Methods

This cross sectional study was conducted in Ain shams university hospital and Al Agoza hospital, on 60 prevalent hemodialysis patients.Three patient died during the study.

Results

FGF-23 had a positive correlation with (weight gain, (PO4)3-, PTH, IVS, PW and LVMI).

Conclusion

FGF-23 might be a marker of volume overload and LVH in ESRD patients, as it positively correlated with (weight gain, IVS, PW and LVMI). FGF-23 is a marker of bone diseases, as it positively correlated with (PO4)3- and PTH. Volume overload has a negative impact on morbidity and mortality in ESRD patients.
High Cholesterol Level As A Marker of Allergic Rhinitis Severity
Authors: Sheha Dina S , El-Korashi Lobna A , El-Begermy Marwa M , Elmahdi Amira R
Published: October 2021

Background

There is some evidences illustrated the relation between abnormal blood lipid profile and atopy. But, the evidence about relation between allergic rhinitis (AR) and cholesterol level is conflicting. We aimed to assess correlation between Cholesterol level and severity of AR.

Methods

50 AR patients were recruited in this cross-sectional study. Blood samples for blood cholesterol level were drawn from all patients.

Results

There was a statistically significant positive correlation between TC and visual analogue scale (VAS) score.

Conclusion

High cholesterol level in AR patients can be a marker of disease severity.
Non-albumin proteinuria in lupus nephritis with tubulointerstitial inflammation and its clinical significance
Authors: Okba Ashraf Mahmoud , Mahmoud Nehal Elfawy , Amin Mariam Maged , Mamdouh Mariam Ahmed Mohamed
Published: October 2021

Background

Tubulointerstitial inflammation (TI) associated with systemic lupus erythematosis is an increasing finding in lupus nephritis. TI severity may have prognostic significance in the renal outcomes of lupus nephritis. Here, we aimed to determine whether non-albumin proteinuria is associated with TI severity and with the renal response in lupus nephritis.

Objective

To investigate the possible association between non-albumin proteinuria, tubulointerstial inflammation severity and poor renal response after immunosuppressive treatment.

Patients and Methods

This is a case series study which was conducted on 100 patients with systemic lupus erythematosis recruited from the outpatient clinic of Clinical Immunology at Ain Shams University Hospitals. Subject ages were between 13-53 years old, each one was subjected to detailed history, physical examination, laboratory investigations including serum creatinine before and after treatment, protein/creatinine ratio before and after treatment, albumin/creatinine ratio, ESR, CRP, CBC, C3 C4, anti DNA, eGFR and renal biopsy

Results

Our results showed that non-albumin proteinuria (uPCR − uACR) was significantly higher in patients with moderate-to-severe TI than in patients with no-tomild TI. Further, higher uPCR − uACR levels at baseline were associated with poor renal response after 6 months of treatment.

Conclusion

we found that non-albumin proteinuria (uPCR-uACR) is associated with severe tubulointerstitial inflammation (TI) in lupus nephritis.
Relation between Obesity and Maternal Hypothyroxenemia during Early Pregnancy
Authors: Amer HMA , Abdelsalam MM , Girgis CA , Algamal MM
Published: October 2021

Aim of the Work

To study the relation between maternal obesity (indicated by BMI), maternal hypothyroidism, thyroid peroxidase antibodies and anti-thyroglobulin positivity during early pregnancy.

Patients and Methods

The study was conducted in Ain shams University Hospital and National Institute of Diabetes and Endocrinology. The study included women aged 19–40 who were pregnant at the 4th –8th weeks of gestation.

Results

obese group had the highest prevalence of overt (5.33%) and subclinical hypothyroidism (2.6%), highest mean TSH value, p value (0.007*). And the lowest mean FT4 with p value (0.017*) .Also obesity was associated with the highest prevalence of anti TPO (16%) and anti TG Abs (12%).

Conclusion

we concluded that maternal obesity may be associated with TPO anti TG positivity, subclinical hypothyroidism and overt hypothyroidism. Screening of thyroid function in obese pregnant females can detect maternal hypothyroidism and prevention of its hazard’s effects for both mother and fetus.
Serum Adiponectin and Resistin Levels in Association with Bronchial Asthma in Adults
Authors: Hosny Salwa S , Farres Mohamed N , Melek Nermine A.E , EL Mahdi Amira R , Kamal Sylvia T , El fotoh Radwa H. Abou
Published: October 2021

Background

The association between obesity and bronchial asthma has been demonstrated by many studies, either observational or interventional studies in both children and adults. However, the mechanism behind this association is still unknown. Many studies proposed that adipokines provide a mechanistic link between asthma and obesity. Adipokines may be proinflammatory (e.g. resistin) or anti-inflammatory (e.g. adiponectin). The Effects of these adipokines on the lungs have been proposed to have the potential to cause or exacerbate existing asthma.

Objective

To determine serum levels of adiponectin and resistin in adult asthmatics in comparison to non-asthmatics.

Methods

96 subjects were included in this study; 64 with bronchial asthma and 32 healthy individuals as control group. All the patients were subjected to the following: Full history, clinical examination, calculation of body mass index (BMI), waist/hip ratio, body fat percentage, asthma control test (ACT), Skin prick test (SPT) for common allergens, CBC, Total IgE, Pulmonary functions and measurement of serum adiponectin and resistin after overnight fasting by ELISA.

Results

The present study proved that patients with bronchial asthma had higher levels of serum Adiponectin and serum Resistin in comparison to control subjects.

Conclusion

Serum Resistin is increased in bronchial asthma and act as proinflammatory marker while serum Adiponectin might not act as anti-inflammatory in asthma in fact, it may exacerbate inflammation. Interaction between different adipokines need to be further studied.
Efficacy of the new Direct Acting Antiviral drugs in the treatment of Thalassemic HCV patients
Authors: Megahed Sherif A , El Touny Maha A , Ragab Iman A , Ahmed Ossama A , Ibrahim Shereen A , Naguib Gina G
Published: October 2021

Background and Objectives

B-thalassemia major patients are susceptible to Hepatitis C Virus (HCV) infection owing to life-long dependency for blood-transfusion. Moreover, this patient population is at risk of progression of liver fibrosis or development of cirrhosis as a consequence of both iron overload and HCV infection. However, patients with haemoglobinopathies and CHC have been excluded from the major clinical trials that led to the approval of DAAs, Hence, at present, limited experience is available regarding the safety and efficacy of DAAs in this population which is traditionally considered difficult to treat. Hence, this study was carried out to evaluate efficacy and safety of the combination regimen of sofosbuvir and daclatasvir for HCV infection in B-thalassemia major patients.

Methods

This study was conducted on 200 subjects divided into two groups, first group contains150 HCVThalassemic patients while the second group contains 50 HCV only patients. Each group was classified into easy to treat or difficult to treat and received sofosbuvir 400mg + daclatasvir 60mg once/day for the duration of 12 or 24 weeks according to the NCCVH Hepatitis C treatment protocol 2015. Sustained virological response at post-treatment week-12 (SVR-12) was defined as negative HCV-RNA at week-12 post treatment.

Results

In group (I), successful SVR was achieved in all patients (100%) in subgroup (Ia) while in subgroup (Ib) 12 patients didn’t achieve SVR (15.38%), 4 patients stopped due to side effects(5.13%) and 62 patient achieved SVR (79.49) with overall successful SVR of 134 out of 150 HCV-Thalassemic patients in group (I) (89.33%). in group (II), 2 patients didn’t achieve SVR (5.71%)and 33 patients achieved SVR (94.29%) in subgroup (IIa) while in subgroup (IIb) 2 patients didn’t achieve SVR (13.33%) and 13 patients achieved SVR (86.67%) with overall successful SVR of 46out of 50 HCV only patients in group (II) (92%). few patients suffered from minor side effects that didn’t require cessation of treatment but 4 patients developed major side effects in group (Ib) that required cessation of treatment. There were marked improvement in liver enzymes, Fib4 score, hemoglobin level and transfusion requirements in HCVThalassemic group after treatment.

Conclusion

A combination of sofosbuvir and daclatasvir is an efficacious and tolerable treatment regimen with negligible side effects for patients with thalassemia major and HCV infection.
Effect of Direct Acting Anti-Viral Drugs on Insulin Resistance and sensitivity Among Egyptian Chronic HCV Infected Patients
Authors: Yosef Tareq M , Ibrahim Wesam A , El-Nakeep Sarah A , ElGhandour Ahmed M , attiya Soha saied
Published: October 2021

Background

Hepatitis C virus (HCV) infection is a worldwide infection, affecting up to 185 million people across the world. It carries a high risk for developing liver cirrhosis, hepatocellular carcinoma (HCC) and liver-related deaths.

Aim of the Work

to assess the impact of direct acting anti-viral drugs on the status of insulin resistance and sensitivity in non-diabetic chronic HCV infection patients

Patients and Methods

study included 100 treatment naive patients with chronic infection of HCV attending the out-patient clinic at Gastro-enterology and Hepatology Department, Ain shams University and Kobry El Kobba Military Hospital between September 2017 till June 2019. Patients were diagnosed by HCV antibodies & HCV RNA by PCR.

Results

The fasting blood glucose, seum insulin and HbA1c were significantly decreased between the baseline and after SVR12. The 2Hrs PP was significantly increased between the baseline and after SVR12. The HOMA-IR showed significant decrease between the baseline and SVR12. The QUICKI and Matsuda Index showed significant increase at SVR12.

Conclusion

HOMA-IR, QUICKI and Matsuda index showed significant improvement between the baseline and after SVR12.
Impact of Direct Acting Antiviral Agents on kidney function in Hepatitis C Virus infected patients with chronic kidney disease
Authors: Sarhan Iman I , Mohamed Osama M , Hebah Hayam A , Ahmed Ossama A , Khedr Lina E , Mahmoud Wedad A
Published: October 2021

Introduction

Despite the significant link between HCV and CKD progression, most of the patients with CKD infected with HCV remain untreated, because they have historically been difficult to treat due to common adverse effects associated with interferon (IFN), ribavirin, and first generation protease inhibitors. Recently, there have been major advancements in the treatment of HCV with the development of new directacting antivirals (DAAs).

Objectives

To evaluate the safety and efficacy of DAAs and their impact on kidney function in CKD patients.

Patients and Methods

We conducted a prospective observational study on 100 CKD patients stages 3-4, receiving treatment for HCV at MASRI (faculty of Medicine Ain Shams University Research Institute), with two different DAAs regimens, completed over six months follow up.

Kidney function was followed during and after treatment.

Results

Sustained virological response (SVR) was achieved in all patients. AKI (acute kidney injury) was uncommon; it occurred in three (3%) patients, out of them, two patients showed complete recovery. Adverse events were common (43%), but serious adverse events were uncommon (2%).Improvement of eGFR (8-15 ml/min/1.73 m2) and proteinuria was found in both study groups.

Conclusion

DAAs were effective and welltolerated for HCV infected patients with stage 3-4 chronic kidney disease, where viral clearance caused improvement in eGFR and proteinuria.
Role of Hepcidin as a biomarker for iron status in patients on regular hemodialysis after treatment of hepatitis C virus
Authors: El Sharkawy Magdy M , Abdelaziz Haitham E , Khedr Lina E , Sharaf Mohamed A
Published: October 2021

Background

Hepcidin, an acute phase reactant protein produced in the liver, is a key regulator of iron homeostasis. Because of its renal elimination and regulation by inflammation, it is possible that progressive renal insufficiency leads to altered hepcidin metabolism.

Aim of the work

to assess effect of HCV treatment on hepcidin levels in regular heamodialysis patients and its relation to iron status.

Patients and Methods

This cross sectional study was conducted on 45 ESRD patients on regular hemodialysis. All candidates included in this study subjected to careful history taking, full clinical examination and investigations (including complete blood count, HCVAb, HBVsAg and HIVAb). All patients had positive antibodies for hepatitis C; however, all of them had negative PCR and negative HIV, HBV antibodies.

Results

In our study, dry weight ranged from 46 to 117 kg with mean 77.36. Weight gain ranged from 2 to 5 kg with mean 3.09.About 87% of patients had LTAVF access. About 12 patients (27%) received blood transfusion once. Timing of transfusion ranged from 4 to 60 month with median of 24 months. Regarding frequency of epoetin dose, 11 patients (24.4%) did not receive epoetin, 16 patients (35.6%) received it twice/week. Only 3 patients (6.7%) received iron therapy for time ranging from 3 to 5 months with mean of 4 months. Mean Hb concentration in our study population was 10.11 ±1.64 gm/dl. The mean of iron was 64.22 ±19.52, TIBC was 409.96 ± 67.85, ferritin was 394.56 ± 239.22 and TSAT% was 22.6 ±7.36. The mean serum hepcidin was 218.51 ±127. Our study demonstrated that increase in serum hepcidin is associated with lower serum Hb and iron levels. On the other hand, there is statistically significant positive correlation between serum hepcidin and both serum ferritin and transferrin saturation.

Conclusion

Median hepcidin value is elevated in dialysis ESRD patients due to increased inflammation and decreased clearance of hepcidin. Also serum hepcidin levels were lowered in HCV patients. Therefore ESRD patients on maintenance HD after treatment of HCV infection showed elevated levels of serum hepcidin.
Eosinophilic inflammation in COPD: prevalence and clinical phenotype in COPD patients
Authors: Ahmed Eman E , shata Alaa h , Hassan Mohammed I , fouad Shaimaa H
Published: October 2021

Background

Eosinophilic COPD appears to be a distinct patient subgroup with a corticosteroid treatment response. Furthermore, some, but not all, studies have shown that higher blood eosinophil counts in COPD patients predict a higher exacerbation rate in the future. To date, to our knowledge, no population-based study has the prevalence of Eosinophilic COPD patients and their characteristics in Egypt.

Aims

To study prevalence of eosinophilic COPD and describe its phenotypic characteristics.

Methods

a cross sectional study in which we collected 112 COPD patients attending Ain Shams University outpatient clinics, to find the prevalence of eosinophilic COPD in Egypt and describe its phenotypic characteristics.

Results

the prevalence of eosinophilic COPD is 26.7% and there was a significant relationship between the eosinophilic COPD patients and BMI and smoking index, while there was no significant relationship between the eosinophilic COPD patients as regards age, sex, CAT score.

Conclusion

COPD is present in many apparent healthy persons; the prevalence of eosinophilic COPD in Egypt is 26.7%. COPD phenotype is more common in patients with higher BMI with higher smoking index and longer duration of smoking.
Association between Serum Asymetrical Dimethylarginine Level and Cardiac Functions in Chronic kidney Disease Patients
Authors: Saeed Saeed Abdelwahab , Abd-elmobdy Ashraf Hassan , Ammar Mostafa Ashour Mahmoud Farag
Published: October 2021

Background

Chronic kidney disease (CKD) is a major public health problem worldwide and is associated with a considerable increase in morbidity and mortality, cardiovascular disease is most common cause of death among chronic kidney disease patients.

Objectives

The aim of study was to determine the association between serum ADMA level and cardiac functions assessed by tissue Doppler imaging in chronic kidney disease patients.

Patients and Methods

our study conducted on 90 patients from outpatient clinic or inpatient department of national institute of nephrology and urology.

Results

All patients were subjected to full history, full clinical examination, laboratory investigations including: serum urea, serum albumin, complete blood picture, serum electrolytes (calcium and phosphorus), PTH, serum ADMA, lipid profile and echocardiography and Tissue Doppler imaging.

Conclusion

Serum ADMA is negatively correlated with diastolic function among CKD patients, tissue Doppler imaging is more accurate than echocardiography to estimate diastolic function.
EFFECT OF SODIUM GLUCOSE CO TRANSPORTER 2 INHIBITOR ON PROTEINURIA IN DIABETIC PATIENTS
Authors: Hussein Nahla , Abdelrahman Fatma , Khedr Abdelrahman , Aref Hayam , Halawa Mohamed Reda , ELSharkawy Magdy
Published: October 2021

Background

Diabetic kidney disease (DKD) is considered a major cause of end stage renal disease (ESRD). It has been established that controlling microalbuminuria can delay progression to ESRD. Sodium glucose co transporter 2 inhibitor (SGLT2 i) is a newer antidiabetic drug that has a renoprotective and antiproteinuric effect.

Aim of the Study

to study the effect of SGLT2 inhibitor on proteinuria in diabetic patients and compare it with classic antiproteinuric drugs.

Patients and Methods

we conducted a randomized interventional study, involving 60 adult patients with type 2 DM divided into 2 groups: group I were prescribed the classic antiproteinuric drugs in the form of ACE inhibitors or ARBs, aspirin and statins and group II were prescribed an additional dapagliflozin 10 mg/day. Follow up as regard changes in UACR, HbA1C, Blood pressure, body weight and e GFR was done after 6 months of treatment.

Results

There was statistically significant decline in UACR after 6 months of treatment with dapagliflozin in group II in comparison to group I (p-value < 0.001). There was also statistically significant decline in SBP in both groups with (p-value < 0.010) in group I and (p-value <0.001) in group II and there was significant decline in DBP in both groups (p-value < 0.001). HbA1c decreased significantly in both groups, (p-value <0.023) in group I and (p-value <0.001) in group II. We also noted a significant reduction of body weight in group II (p-value <0.001). There was a statistically significant negative correlation between the change in UACR and the change in e GFR.

Conclusion

There was better reduction in albuminuria when adding dapagliflozin to antiproteinuric drugs, so we recommend starting dapagliflozin early in patients with DKD to delay progreesion to ESRD.
Structural Magnetic Resonance Imaging Correlated with Motor Function of Upper Extremity in Patients with Chronic Stroke
Authors: Samy Dalia Maher , Mostafa Mohamed Mahmoud , Mahmoud Eman , Hazzou Ahmed Mohamed , Elewa Mohamed Khaled Ahmed , Aziz Tougan Taha Abdek
Published: October 2021

Background

Ischemic cerebrovascular stroke is defined as an acute neurological dysfunction caused by focal cerebral infarction after decrease in the blood supply of the brain either by stenosis or occlusion leading to gross physical impairment or disability lasting more than 24 hours.

Objective

To assess correlation between site of infarction and upper extremity ( UE) function in chronic stroke patients.

Methodology

A cross sectional study with (30) Patients with chronic ischemic stroke ( >3 months) suffering from persistent UE motor function impairment, MRI brain done to assess the site of infarction. UE motor function assessment using the Fugl Meyer Assessment (FMA-UE) Scale.

Results

The current study found that no significant correlation between the site of infarction and UE motor function.

Conclusion

We concluded that the site of infarction not correlated with UE motor function in chronic stroke patients.
Restless Legs Syndrome among Patients Receiving Antipsychotic and AntiDepressant drugs
Authors: Razek Elsayed Yasser Abdel , Elrassas Hanan Hany , Ali Morsy Mahmoud Hassan , Shady Mostafa Mohamed
Published: October 2021

Background

Restless Legs Syndrome (RLS) is an annoying problem, has a noticeable impact on all perspective of the life. RLS attract spots to its discussion as it became a challenge in all societies. Also, antipsychotic (AP) and antidepressant drugs (AD) is well known as a cause of RLS, But RLS occurrence and its prevalence among psychiatric patients who receive the antipsychotic and antidepressant drugs is un known in Egypt.

Aim of the Study

To estimate rate of Restless legs Syndrome among psychiatric patients who receive Antidepressant & Antipsychotic drugs. And to assess severity of RLS if detected in those patients

Subjects and Methods

A descriptive cross-sectional, case control comparative observational study, included two hundred Patients who received AP and AD for more than one month and one hundreds of volunteers as a control group from Psychiatry department, Ain Shams University Hospitals and Al- Abbassyia Mental Hospital in Cairo, Egypt, in the period between October 2018 and April 2019, Using validated Arabic version of Structured Clinical Interview for DSM-IV (SCID-I), four items questionnaire that was recommended by International Restless Legs Syndrome Study Group (IRLSSG) Arabic version for RLS diagnosis and validated Arabic version of Restless Legs Syndrome Rating Scale (IRLS).

Results

Eighty-three (41.5%) of patient group who received AP & AD and fifteen (15%) individual of control group met the diagnostic criteria of RLS. There was high statistically significance between the two groups regarding RLS occurrence (P = 0.000). Severity fluctuated in patients’ group between moderate and sever (69.9 % & 30.1%) respectively, while in control group it fluctuated between mild and moderate (40 % & 60%) respectively with high statistically significance between the two groups regarding RLS severity (P = 0.000). Family history and smoking are a risk factors for developing RLS as (OR = 2.705) & (OR = 6.390) respectively. While Trazadone and Haloperidol had a protective role against RLS (OR = 0.393 & 0.415) respectively.

Conclusion

RLS occurrence was higher in patients who received AP and AD drugs and its severity was more fluctuant among those patients, antipsychotic and antidepressant can induce RLS or worse it in patients who had past history of RLS before receiving the medications. Smoking and family history were risk factors for developing or worsening of RLS in our study. Both Haloperidol and Trazadone drugs in our study had protective role against RLS.
Retrospective Study about the Prevalence of (TILs) Tumor Infiltrating Lymphocytes in Non-Metastatic Triple Negative Breast Cancer Patients and its Prognostic Value
Authors: ElGhazaly Hesham Ahmed , El-Mahdy Manal Mohamed , Adel Azza Mohamed , Mostafa Nermeen , Ali Aya Magdy Kamal
Published: October 2021

Background

TNBC comprises a distinct disease entity with a unique microenvironment of TILs, the immunogenic potential of TNBC is derived from its genetic instability and high mutation rate. Tumors from patients with TNBC are more likely than tumors from patients with other subtypes to exhibit chromosomal instability and potential mutations.

Objectives

The study aims to evaluate the prevalence of CD8+ TILs biomarker by IHC in triple negative breast cancer and its prognostic value. TILs are an important prognostic value for the response of patient to chemotherapy the greater number of TILS is associated with higher probability of response to chemotherapy also decrease recurrence. TILS in triple negative breast cancer suggest a likely option for immunotherapy in this disease.

Patients and Methods

This is a retrospective study, which was carried on 30 female patients, Clinical data and paraffin wax block of female patients with triple negative breast cancer are to be collected from the breast cancer unit, department of clinical Oncology and Nuclear medicine Ain Shams university and Matarya teaching hospital.

Results

Several large systematic reviews and meta-analyses have confirmed that high levels of TILs are associated with better disease free survival and overall survival only in triple negative and HER2 positive subtypes, with no significant benefit seen in estrogen receptor positive breast carcinoma. In the Breast International Group (BIG) 02-98 trial shows that for every 10% increase in the intertumoral TILs there was a 17% reduced risk of relapse, and 27% reduced risk of death regardless of chemotherapy type. Also in eastern cooperative oncology group trial (ECOG) 2197, and 1199 showed that for every 10% increase in TILs, a 14% reduction of risk of recurrence, and 19% reduction in risk of death were observed.

Conclusion

Our study showed that All our patients (100%) were positive for CD8+, with a minimum range of 1% and a maximum range of 60%, most of the patients (20 patients) had CD8% between (10% to 20%). High levels of CD8 + TILs are good prognostic indicators in TNBC. our study showed that there were associations of CD8+ TILs infiltrate status with longer progression free survival and better overall survival in triple-negative breast cancer, but were not statistically significant probably due to our small sample size.
Effect of Delay in Initiation of Adjuvant Trastuzumab and Dose Interruptions on Overall Treatment Outcome in Breast Cancer Patients, a Retrospective Study
Authors: Riad Atef Youssef , Alkhateeb Azza Mohammed Adel , Kelany Mohammed Reda , Al-Shater Mohammed Al-Saeed Sakran Ali
Published: October 2021

Background

HER2 amplification or protein over-expression is found in 20% of invasive breast cancers. It’s clearly associated with accelerated cell growth and proliferation and poor clinical outcome. The amplification of HER2 was historically an adverse prognostic factor associated with a higher risk of recurrence, lack of or lower levels of ER expression, and relative resistance to endocrine therapy and CMF based chemotherapy.

Objectives

We aimed in this study to assess the impact of delaying the initiation of adjuvant Trastuzumab for more than three months after the diagnosis of breast cancer and the effect of irregular and interrupted doses of adjuvant Trastuzumab, on progression free Survival, relapse, and overall survival (OS) among patients with breast cancer.

Patients and Methods

A Retrospective cohort study was conducted in Ain Shams University Hospitals. The study included one hundred patients with HER2 positive breast cancer. from January 2011 till December 2016 at the" Department of Clinical Oncology and Nuclear Medicine, Ain Shams University Hospitals".

Results

The median time to progression in group I was 19 months compared to 30 months in group II. There was statistically significant decrease median of group I compared to group II according to PFS.

Conclusion

We concluded that delays in the initiation of adjuvant treatment may be particularly harmful in patients with more aggressive tumor types.
Evaluation of the Clinical Outcomes of Altered Fractionated Radiotherapy in Node Positive Breast Cancer (A Retrospective Study)
Authors: Muhammad Sahar Abdel-Hameed , Gado Nivine Mahmoud Ahmed , El-Lithy Mahmoud Abbas , Saleh Mohammed Essam
Published: October 2021

Background

Hypofractionated radiotherapy schedules provide alternative shorter courses of radiotherapy of more than 2 Gy per fraction and lower total doses compared to the conventionally fractionated schedule of 1.8–2.0 Gy per fraction in 25 fractions.

Hypofractionated radiotherapy offers the advantage of improving patients’ convenience and reducing cost and resource requirements.

Aim

To evaluate the efficacy and toxicity of hypofractionated radiotherapy compared to the conventional schedule.

Methods

In this retrospective study, the clinical data of 140 patients of node positive breast cancer patients were analyzed. Radiation toxicities and locoregional recurrence were compared between patients who received conventionally fractionated radiation schedule and those who received hypofractionated radiation schedules.

Results

After a median follow-up of 48 months, the incidence of loco-regional recurrence was comparable between the conventional and hypofractionated arms; 4% vs

3.1%, respectively (P-value = 0.769). Documented acute skin toxicity with ≥ grade 3 was found in 10.6% of the conventional group and in 5.6% of the hypofractionated group (p = 0.409).

Grade 1 late lung toxicity was manifested in 6.1% of the conventional group and 7.5% of the hypofractionated group and G2 lung toxicity was found in one case only (1.9%) in the hypofractionated group (p = 0.596). Cardiac toxicity was documented in five cases; 9.4% and 5.1% in the conventional group and hypofractionated groups, respectively (pvalue=0.486).

Conclusion

Hypofractionated radiotherapy is comparable to conventional radiotherapy regarding locoregional tumor control and treatment toxicities.
Denervation of the Wrist Joint and Its Long Term Effect
Authors: El-Mahy Mohammed Mostafa , Mohammed Amr Moustafa , Attia Ahmed Reda
Published: October 2021

Background

The wrist joint is a common site of traumatic, degenerative and inflammatory disease that, when symptoms are severe, can be treated by partial or complete arthrodesis, arthroplasty and/or wrist denervation.

Aim of the Work

to review systematically studies about total and partial wrist denervation for chronic painful wrist conditions and meta-analyze the long term improvement.

Materials and Methods

Literature searches was conducted using the following databases: "PubMed, Ovid, Web of Science, Science Direct, Scopus, Cochrane Library, Google Scholar, Medline" using the following key words: wrist joint, total denervation, partial denervation for published studies.

Results

This study provides long-term data regarding the outcomes of partial and total wrist denervation. We have found that this is a reliable motion preserving procedure for patients with chronic wrist pain. In the series, 85% and 70% of patients did not undergo revision surgery at average follow-up of approximately 54.7 months and 47.5 months in total and partial denervation respectively.

Conclusion

Denervation is a relatively quick procedure with low complication rates and does not preclude salvage procedures if pain persists. It has been shown that neurectomy of the articular branches is possible without any injury to the important sensory and motor nerves of the hand. Total denervation of the wrist is a useful method for treating wrist pain when other choices compromise functional capacity or a long period of post-operative recovery is not desired.
Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis
Authors: El-Ganzoury Ibrahim Mostafa , Zakaria Zeiad Mohamed , Elsayed Ahmed , Elwarwary Abd Ellah
Published: October 2021

Background

Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).

Objectives

The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country.

Patients and Methods

The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019.

Results

About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis.

Conclusion

In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.
Dynamic Locked Plating of Distal Femur Fractures
Authors: Thakeb Mootaz Fouad , Elbeshry Shady Samir , Basuony Amr Mostafa Ismaeil
Published: October 2021

Background

Distal femur fractures account for less than 1% of all fractures and 3%– 6% of all femur fractures. Epidemiological studies indicate 2 primary distributions of patients: elderly individuals with low energy mechanisms such as a fall from standing, and younger patients with high-energy mechanisms such as motor vehicle accidents. Fixation of the distal femur fracture with lateral locked plate had a nonunion rate between 0 to 32%. The concept of “Dynamic” Locked Plates, has been proposed to decrease construct stiffness & improve callus formation.

Objective

A systematic review and meta-analysis of literature to assess the outcomes of dynamic locked plate of distal femora fractures.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.

Data Extraction

If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion

Our systematic review and meta-analysis showed different method of distal femur locked plate dynamyzation. DLP of distal femur increased interfragmentery micro motion, decrease construct stiffness and improve healing & union rate of distal femur fractures. Finally it should be noticed that the orthopedic surgeon should be qualified to utilize either techniques & the choice depends on the preoperative planning & method of fixation available which leads to fracture union on time without complications.
Endoprosthetic Proximal Femoral Hemiarthroplasty Versus Total Hip Endoprosthetic Reconstruction After Proximal Femoral Resections in Young Adults
Authors: Mostafa Mohamed Abdel Rahman , Azmy Sherif Ishak , Rashid Kyrillos Magdy
Published: October 2021

Background

Metastatic tumors are the most common malignant lesion of the proximal femur, with carcinomas being the most frequent. The proximal femur and midfemur are common sites for primary bone sarcomas; approximately16% of Ewing's sarcomas, 13% chondrosarcomas and 10% of osteosarcomas develop at these locations. The major aim in the management of patients who have bone malignancies is prolonging their survival. Primary bone sarcomas that require surgical resection can be treated by either amputation or limb salvage. Most studies which compared both approaches reported that limb salvage had no adverse effect on patients’ survival on long-term.

Objective

This is a systematic review of literature with meta-analysis study that compare the functional outcomes and complications of the methods; proximal femoral hemi versus total arthroplasty after proximal femur resection followed by endoprosthetic reconstruction and provide recommendations by the best available evidence.

Methods

We included Randomized control trails (RCTs), including cluster RCTs, controlled (non-randomized) clinical trials or cluster trials, prospective and retrospective comparative cohort studies, and case-control or nested case-control studies and controlled clinical trials. We excluded cross-sectional studies, case reports, review articles, letters to the editor, meeting abstracts, and technique papers. Search results conducted to systematic review management software and manually screened for eligibility were included. Critical appraisal checklist was used to assess the search results based on the inclusion/exclusion criteria.

Results

Twenty-three studies are included. Quality appraisal demonstrated that all but one study is retrospective. The pooled results from the meta-analysis showed that the rate of aseptic loosening was only 2% when reconstruction occurs with endoprosthetic proximal femoral hemiarthroplasty. There was unimportant heterogeneity in the included studies. The rate of conversion to total hip arthroplasty (THA) is 4.6% to 8% of oncological patients. The rate of periprosthetic fracture was only 1%

Conclusion

Proximal femoral endoprosthesis has definitive benefits in the treatment of primary or metastatic tumors affecting the proximal femur. The implants tend to improve the function and quality of life of patients with metastatic disease and high-grade localized disease. It also provides them with a relatively pain-free limb with good functional capacity. With continuing advances in the surgical and oncological fields, there is a great potential for curative limb salvage surgery in the long term. Reconstruction with endoprosthetic Proximal femoral hemiarthroplasty after proximal femoral resection in young adults can confer additional stability with a reduced dislocation rates and systemic complications as compared to total hip arthroplasty.
Evaluation of the role of platelet gel in promoting healing of phalangeal fractures after fixation by Kirschner wires
Authors: Al Sabbagh Asmaa A , Farid Ashraf M , El Rouby Mohamed A , Abdalmaksoud Sarah A
Published: October 2021

Background

Autologous Platelet gel may become an ideal autologously prepared biologic blood-derived product that can be exogenously applied to a diversity of tissues, in which it releases high concentrations of platelet growth factors that enhance healing.

Aim of the Work

to evaluate the role of platelet gel in promoting healing in phalangeal fractures.

Patients and Methods

This study was conducted on 20 Patients were operated either by general or local anesthesia in a prospective interventional study for: evaluation the role of platelet gel in promoting healing of phalangeal fractures after fixation by Kirschner wires.

Results

In this study: clinical and radiographic signs of healing at 12wks were achieved in 70% of studied patients and 16wks were achieved in 30% of studied patients and early improvement of swelling and tenderness.

Conclusion

The use of Autologous platelet gel in phalangeal fractures after fixation by Kirschner wires gives a significant improvement quickly over the periods according to swelling, tenderness and x-ray healing So decrease recovery time and return to work and activities.