bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of a Telegeriatrics Post Discharge Follow Up Model on the Outcome of Acute Care Patients
Authors: Kordy Seham Saad Abd Elsattar , Sweed Hala Samir , Wahba Hoda Mohamed Farid , Shaltoot Heba Mohamed Hamed
Published: November 2024

Background

The post discharge period is a critical time for vulnerable patients, like the elderly, prone to unnecessary readmissions. This is mainly because post discharge care continuity is often interrupted after hospital care. The implementation of close monitoring and effective communication strategies has proven to be effective in mitigating adverse events and reducing the incidence of readmissions. Due to the pressing need for medical care that is both cost-effective and time-efficient, there has been a growing interest in exploring remote or telehealth methods for delivering healthcare services.

Aim

To assess the effect of a telegeriatrics post discharge follow up service on the primary outcome measures of patients as regard rate of readmission, mortality rate, and complications from the disease or medications.

Patients and Methods

A prospective descriptive study that was conducted from June 2021 till January 2023 on a total of 139 elderly patients discharged from the acute care units of Ain Shams University Hospitals. We collected data using asynchronous telemedicine (WhatsApp) and synchronous method (phone). The follow up was at 2 weeks, 1 month, 3 months and 6 months post discharge.

Results

Hypertension was the most frequent comorbidity (71.9%). Cases that followed up by both methods of telemedicine had better compliance than cases that only followed up using synchronous telemedicine (90.8% vs. 57.9%). They were also less likely to require hospital care (28.3% vs. 52.6%). They also suffered less complications from disease (20.0% vs. 52.6%) and lower risk of all-cause mortality (7.5% vs. 15.8%).

Conclusion

Telemedicine is a valuable tool. Using a post-discharge protocol of both synchronous and asynchronous methods of telemedicine improves patients’ compliance and outcomes.
A Histological Study on the Effect of Oral Collagen on Age Related Skin Changes in Female Albino Rats
Authors: Farid Hend , El-Alim Mohammed Somaya Abd , Shaker Safaa Mohammed , El-Din Dalia Alaa
Published: November 2024

Background

Skin is the mirror of aging. Therefore, for many people, especially females, a considerable amount of daily expense is occupied by cosmetics and pharmaceuticals attempting to prevent or reverse skin aging. Nowadays; researches are directed at naturally occurring substances such as collagen hydrolysate (CH). Due to its high solubility, low molecular weight, high bioavailability, as well as a wider range of functional and biological properties, CH can be used in drinks and as a jelly-like form, making it ideal as a food supplement being easily digestible, highly absorbed and distributed in the human body.

Aim

Histological assessment of the possible role of oral collagen peptides on age related skin changes in female albino rats.

Materials and Methods

Twenty female albino rats were used. they were divided into two groups, Group I which included 5 rats 5-6 months age, and Group II which included 15 rats 18-20 months age, they were further subdivided into 3 subgroups 5 rats each: Subgroup IIA: rats were left without intervention, Subgroup IIB: rats received 0.5 ml distilled water (DW) orally by gastric tube once daily for 4 weeks and Subgroup IIC: rats received collagen peptides orally by gastric tube in the form of powder dissolved in DW at a dose of 2.5 g/kg once daily for 4 weeks.

Results

H&E-stained sections of Subgroups IIA & IIB revealed an apparent decrease in epidermal thickness and disorganized collagen fibers in the dermis. Masson`s Trichrome & orcin stained sections showed apparent decrease in collagen and elastic fibres density and disorganized arrangement. Transmission electron microscopy showed perinuclear vacuolations in keratinocytes and wide separation between them. On the other hand, the structure of skin in Subgroup IIC showed significant improvement in all parameters.

Conclusion

The study showed that collagen hydrolysate can help in improvement of age-related skin changes.
A Histological Study on the Effect of Different Methods of Mobile Phone Exposure on the Hippocampus in Adult Male Albino Rat
Authors: Ali Moussa Nourhan Ahmad , Rahim Mohamed Farrag Kawther Abd Al , Kostandy Kalleny Nagwa , Hamam Ghada Galal
Published: November 2024

Introduction

Using mobile phones has dramatically increased in the last few years. Mobile phones are carried mainly near the head during talking. Electromagnetic fields (EMF) emitted from cell phones may exert detrimental effects on human organs especially hippocampus which is an important organ concerned with memory and cognitive function.

Aim

To study the effect of different methods of mobile phone EMF exposure on the structure of hippocampus in adult male rats.

Materials and Methods

28 adult male albino Wistar rats were equally divided into four groups: Group I (Control): were left without any interference. Group II (silent non-vibrating): exposed to continuous 900-1800 megahertz cell phone- emitted EMF for 60 minutes/day, for four weeks. Mobile phones were kept in silent, non-vibrating mode. Group III (silent vibrating): exposed to EMF as in group II, but with mobile phones kept in vibrating mode. Group IV (ringing non- vibrating): exposed to EMF as in group II, but with ringtone turned on and adjusted at 80 decibels. After four weeks of exposure, hippocampi were harvested form all rats. They were subjected to hematoxylin and eosin, toluidine blue, Caspase-3, and glial fibrillary acidic protein (GFAP) immunohistochemical stain as well as transmission electron microscopic examination. Morphometric and statistical studies were also done.

Results

pyramidal cells in CA3 area of Group IV (ringing non-vibrating) showed condensed chromatin clumps, distorted mitochondria, and clumped neurofilaments. A significant decrease in the mean thickness of the pyramidal cell layer of the CA3 area was noticed compared to other groups. While a significant increase in the mean number of degenerated pyramidal cells, number of caspase-3 positive cells as well as number of astrocytes was noticed in CA3 area of group IV compared to other groups. A significant increase in the mean optical density of caspase-3 and GFAP was also noticed in CA3 of group IV compared to other groups.

Conclusions

Exposure to EMF caused significant changes in the structure of hippocampus especially CA3 area. There was no significant difference between silent and vibrating mode. The worst changes were detected in ringing mode.
Histological Study of the Protective Effect of CoQ10 on Aluminium Chloride-Induced Alzheimer's Disease in Adult Male Albino Rats' Hippocampus
Authors: El-Aziz Ibrahim Shalaan Salma Osama Abd , Shaker Mohammed Safaa Mohammed , EL-Din Aly EL-Waseef Dalia Alaa , Hasan Reda Ahmed Hasan
Published: November 2024

Background

Alzheimer’s disease (AD) is a neurodegenerative disorder that leads to cognitive decline associated with memory loss and dementia. Oxidative stress has a role as a cause of AD. Coenzyme Q10 (Q10) is a powerful antioxidant that buffers the potential adverse consequences of free radicals.

Aim of the Work

to detect the protective effect of CoQ10 on aluminium chloride-induced Alzheimer’s disease in albino rats’ hippocampus histologically.

Materials and Methods

Thirty-six adult male albino rats weighing 200-250 g were divided into four groups. Group I (control group) included 15 rats. Group II included 7 rats that were given CoQ10 dissolved in corn oil, at a dose of (200 mg/kg/day, by oral gavage) for 6 weeks. Group III included 7 rats that were received AlCl3 dissolved in distilled water, at a dose of (100 mg/kg/day, intraperitoneal) for 6 weeks. Group IV included 7 rats that were given AlCl3 along with CoQ10 for 6 weeks. At the end of the experiment, brains were excised and processed for light microscopic examination. Morphometrical measurements and statistical analysis were performed.

Results

Group III revealed many structural changes, such as disarrangement of the pyramidal cell layer in areas of the Cornu Ammonis of the hippocampus proper, which also exhibited deeply stained nuclei and vacuolated cytoplasm that were the same for granule cells in the dentate gyrus (DG). CoQ10 administration ameliorated these histological alterations.

Conclusion

CoQ10 has a protective effect on AD induced by AlCl3 in rats.
Association between Triglyceride-Glucose Index and Hepatic Steatosis and Fibrosis in Nonalcoholic Fatty Liver Disease in Egyptian People
Authors: Abdelaziz Mahmoud Hossam Eldin , Mohamed Morsy Manal Sabry , Naguib Amer Ahmed Mohamed , Mahmoud Badr Amina Mohamed
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is increasingly becoming a major health burden. Due to the difficulty of liver biopsy, there is no reliable indicator to evaluate the outcomes of NAFLD. The triglyceride–glucose (TyG) index is a simple and convenient marker of insulin resistance for use in medical practice.

Aim and Objectives

To examine the association between triglyceride-glucose index and hepatic steatosis and fibrosis in nonalcoholic fatty liver disease in a sample of Egyptian adults.

Subjects and Methods

This was Observational prospective study, was conducted at Al Sahel Teaching Hospital, Gastroenterology and hepatology “outpatient clinic”, on 100 supjects divided after history, labs and ultrasound to 50 case with NAFLD and 50 healthy control, from January 2022 to July 2022.

Result

There were significant difference between both groups as regard Fasting blood sugar, TGS and TyG-index.

Conclusion

The TyG index is an independent risk factor for hepatic steatosis and the presence of liver fibrosis in participants with NAFLD. Compared with other IR markers, the TyG index is easy to calculate, and the testing cost is inexpensive.
Galectin 3 and Transient Elastography as Noninvasive Methods to Assess Liver Fibrosis in Nonalcoholic Fatty Liver Disease Patients
Authors: Ibrahim Asmaa Asem , Bayoumi Essam Mohamed , Khayyal Ahmed El Saady , Anwar Christina Alphons
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a condition defined by excessive fat accumulation in the liver. It is one of the most common and emerging problems worldwide which is estimated to be approximately 20% -30% in the general population. The pathogenesis is multifactor, including dietary factors, insulin resistance, adipokines, innate and adaptive immunity.

Aim of the Work

To evaluate serum level of Galectin 3 and Transient Elastography as Noninvasive Methods to assess Liver Fibrosis in patient with Nonalcoholic Fatty Liver Disease.

Patients and Methods

This was an observational prospective cross sectional study that was conducted on 150 patients with NAFLD, who had risk factors including hyperlipidemia, diabetes mellitus with NAFLD, who were attending or admitted to Hepatology unit, Ain Shams University Hospital and Bani Suef General Hospital. In this study, diagnosis was based on abdominal ultrasonic findings including increased echogenicity, loss of definition of the diaphragm, and blurring of vascular margins. This work was carried out in accordance with the World Medical Association Declaration of Helsinki. An informed written consent was obtained from the patients before enrollment in the study. The consent was taken in a separate room to ensure confidentiality. The study sought approval from the Ethics Review Committee of the Faculty of Medicine, Ain Shams University by written consent.

Results

In our study we found that there no statistically significant difference between studied groups regarding BMI. In our study we found that regarding comorbidities, there was no statistically significant difference between the studied groups according to hypertension while there was statistically significant difference according to DM with higher prevalence among NAFL group. In our study we found that regarding lipid profile between the studied groups, there was high statistically significant difference between the studied groups regarding cholesterol and TAG.

Conclusion

We revealed that there was highly statistically significant difference between the studied groups regarding cholesterol, TAG AST, ALT, serum creatine hemoglobin and platelet. Also, we found that non-invasive elastography is beneficial in the diagnosis and assessment of NAFLD when compared to the gold standard, transient hepatic elastography presented the best performance for the diagnosis and exclusion of advanced fibrosis in patients with NAFLD.
The Value of PDGFRβ-Based Score in Predicting Liver Fibrosis Stage in Egyptian Patients with NAFLD and Viral Liver Disease
Authors: Hassan Basma M , Badawy Hanan M , Abo-Halima Ahmed Samir , Naguib Gina Gamal , Youssef Mohamed Gamal , Mohamed Marwa A
Published: November 2024

Background

Multiple therapeutic efforts have focused on Platelet Derived Growth Factor Receptor beta (PDGFRB) because of its association with hepatic stellate cell activation in liver fibrosis. Yet, its potential as a diagnostic tool is essentially unexplored.

Objective

This research was done to assess the value of the sPDGFRβ based-score in predicting liver fibrosis stages in Egyptian patients with NAFLD and viral liver disease in correlation with NAFLD fibrosis score and Fibro-scan.

Methods

In this case-control study, patients with liver fibrosis/cirrhosis related to viral hepatitis and non-alcoholic fatty liver disease (NAFLD) were categorized according to the degree of fibrosis detected by Fibro-scan, and their circulating PDGFRB levels were compared. The diagnostic roles of PDGFRβ as an individual blood parameter or combined with other metabolic parameters were assessed and compared to previously validated clinical fibrosis scores Fib-4, APRI, and AST/ALT ratio in both groups of patients and to NAFLD fibrosis score in NAFLD patients.

Findings

Patients with advanced fibrosis showed the greatest rise in sPDGFRB compared to those with absent or mild fibrosis. Combining sPDGFRB-levels with platelet counts and albumin levels into a new diagnostic algorithm, the PRTA-score, improved the accuracy of sPDGFRB-levels in predicting fibrosis; the score generated a predictive value that was higher than Fib-4, APRI, and AST/ALT in NAFLD and viral liver disease, and higher than the NAFLD fibrosis score in the NAFLD group. Finally, we used case-control research to verify the diagnostic significance of sPDGFRB levels and the PRTA-score in identifying severe liver fibrosis in NAFLD and viral hepatitis.

Interpretation

This research concluded that patients with viral hepatitis and non-alcoholic fatty liver disease (NAFLD).may benefit from the PRTA-score since it is an effective method for diagnosing advanced liver fibrosis
Study of Serum Homocysteine Level in Cirrhotic Ascitic Patients as a New Diagnostic Marker for Spontaneous Bacterial Peritonitis
Authors: Ibrahim Elsais Belal Mohamed , Mohammed Khalid AbdElhamed , Ahmed Ahmed Elmetwally , Hashem Walaa Mohamed
Published: November 2024

Background

SBP is the commonest life-threatening infection encountered in cirrhotic patients with ascites. It accounts for more than half of all infections. The outpatient prevalence of SBP is 1.5–3.5% and exceeds 10% in hospitalized patients. The immune dysfunction in decompensated cirrhotic patients along with vulnerability of gut mucosa leading to translocation of bacteria and bacterial endotoxins from bowel lumen into ascitic fluid (AF) underlines the pathogenesis of SBP

Objective

This study is to assess the value and the accuracy of serum Homocysteine Level in cirrhotic ascitic patients as a new diagnostic marker for spontaneous bacterial peritonitis

Patients and Methods

This case control study was conducted on 60 cirrhotic patients recruited from the outpatient clinic and the ward of hepatology department of Ain Shams University Hospitals, during the period from January 2021 to August 2021

Results

This study was conducted in Ain Shams University ward and outpatient clinic of the Hepatology department. The study included 60 cirrhotic patients who were divided into 2 groups

Conclusion

Serum homocysteine level is elevated in cirrhotic patients with SBP. Serum homocysteine value of > 15.73 μmol/l had a sensitivity of 85.93%, and specificity of 83.45% for diagnosis of SBP. Serum homocysteine is positively correlated with severity of liver disease.
Fatty Liver Disease and its Impaction on Insulin Resistance
Authors: Salib Hens Bishoy Malak , Latif Hatem Abdel , El-Gaaly Sonia Ahmed , Alfons Christina
Published: November 2024

Background

Non-alcoholic fatty liver disease (NAFLD) involves excess liver fat accumulation without specific causes like alcohol or viral infections, categorized into simple steatosis and nonalcoholic steatohepatitis (NASH). While simple steatosis is generally stable, NASH is linked to progressive liver disease. Diagnosis excludes secondary causes, and NAFLD, marked by hepatocyte changes, inflammation, and fibrosis, may lead to severe complications. Strongly associated with insulin resistance in liver and adipose tissues, NAFLD disrupts glucose-insulin interplay, compromising insulin's regulatory functions and contributing to metabolic disorders and disease progression.

Aim of the Work

The aim of the study is to investigate fatty liver disease and evaluate its impact of on insulin resistance.

Patients and Methods

This cross-sectional study, conducted at Ain Shams University, focuses on adults with NAFLD to assess insulin resistance. Inclusion criteria involve fatty liver disease, impaired glucose tolerance, and informed consent, while exclusions include alcohol intake and hepatitis. Data collection comprises demographics, anthropometrics, metabolic syndrome assessment, ultrasound grading of steatosis, and laboratory tests for liver function, FIB-4 index, and insulin resistance using HOMA-IR. The study aims to understand the relationship between NAFLD and insulin resistance in a clinical setting.

Results

In this study of 98 patients with Non-alcoholic Fatty Liver Disease (NAFLD), characterized by liver fat accumulation, insulin resistance (IR) was prevalent in 63.3%. The cases, predominantly females (52%), had mean age of 43 years, 50% were hypertensive, and 48% were diabetic. IR was directly related to age, and its prevalence was significantly higher in patients with diabetes and hypertension. IR correlated positively with body weight, BMI, ALT, AST, FIB-4, TG, and cholesterol. Fatty liver grading showed a significant association with IR, particularly in grade 2 cases. The optimal HOMA-IR cutoff for distinguishing between grade I and II fatty liver was >2.56, with high sensitivity (100%) and specificity (88.73%). These findings emphasize the intricate relationship between NAFLD, IR, and associated metabolic factors.

Conclusion

The study established a robust link between insulin resistance (IR) and Non- alcoholic Fatty Liver Disease (NAFLD), noting a 63.3% prevalence of IR in the subjects. Employing HOMA-IR, a cutoff point >2.56 effectively differentiated between NAFLD grades I and II, demonstrating 100% sensitivity, 88.73% specificity, and a remarkable AUC of 98. This underscores HOMA-IR's valuable role in identifying and stratifying NAFLD, especially in individuals with diabetes.
Assessment of Pro Collagen III as Non Invasive Biomarker for Diagnosis of Non Alcoholic Steatohepatitis
Authors: Ahmed Ashoush Esam Abdel-aty , Badawy Hanan Mahmoud , Allam Ahmed Samir , Galal Salah Sharawy
Published: November 2024

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. NAFLD is considered to represent the hepatic manifestation of metabolic syndrome. NAFLD was traditionally considered as a relatively benign liver disease. However, some patients with NAFLD progress to liver fibrosis, cirrhosis and hepatocellular carcinoma. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important. Liver biopsy is the current gold standard in diagnosis and prognosis. Because of poor patient acceptance of this invasive standard technique and Significant sampling variability of routine liver biopsy in patients with NAFLD, there is an urgent need for reliable, accurate, and non- or minimally invasive biomarker.

Aim of the Work

Assess the performance of Pro Collagen III As a NASH-Fibrosis biomarker within the best diagnostic context of use in comparison with FIB-4

Patients and Methods

this study is a Case control study. Gastroenterology and Hepatology outpatient clinic at Damas centre for liver and GIT. 6 months from August 2022 to January 2023. This study will be performed on 56 Egyptian patients who are ≥18years of age and are overweight with Body Mass Index ≥ 25 and diagnosed with NAFLD by US.

Results

As regard age; there is no significant difference between NAFL and NASH groups. As regard sex; there is no significant difference between NAFL and NASH groups. The mean BMI was significant higher in NASH group than NAFLD group. Patients with NASH have relatively low platelet count in comparison with NAFLD patients. Patients with NASH has Higher AST & ALT levels than NAFLD patients. FIB-4 was higher in NASH group than NAFLD group. Pro Collagen III level was higher in patients with NASH than Patients with NAFLD. Pro Collagen III was a significant discriminator of NAFLD & NASH. Pro Collagen III correlates with the grades of histological steatohepatitis, and stage of fibrosis. Pro Collagen III can diagnose steatohepatitis at cut-off 9.57 with sensitivity & specificity was 92.9 & 92.9 respectively.

Conclusion

Pro Collagen III is a sensitive biomarker to discriminate between NAFLD & NASH. Pro Collagen III level correlate positively with BMI, AST & ALT. Pro Collagen III level correlate with grades of histological steatohepatitis, and grades of fibrosis.
Serum Soluble Urokinase Plasminogen Activator Receptor in Diabetic Nephropathy
Authors: Ahmed Eman El-Sayed , El-Sayed Hoda Mohamed , Salem Lamyaa , Fouad Haidy Ahmed , ElKady Hossam Moustafa
Published: November 2024

Background

Diabetes mellitus (DM) is a rapidly growing global health problem. Persistent hyperglycemia in uncontrolled DM can cause several complications including diabetic retinopathy and nephropathy. The prognostic value of serum soluble urokinase-type plasminogen activator (suPAR) levels across diseases positions suPAR as a new promising inflammatory biomarker. Elevated suPAR levels are strongly associated with decline in kidney function.

Objective

The aim of this study is to investigate the prognostic value of suPAR in patients with DM and its capacity as a biomarker for renal impairment severity.

Patients and Methods

This study included 180 subjects divided into 2 age and gender matched groups; the first group consisted of 140 diabetic patients and the second group consisted of 40 apparently healthy controls. Serum urokinase plasminogen activator receptor was measured for all subjects

Results

SuPAR showed significantly higher values among patients with DN when compared with those without DN. There was a statistically significant positive correlation found between suPAR level and albumin/creatinine ratio and serum creatinine level in all diabetic patients. There was a statistically significant negative correlation found between suPAR level and eGFR in all diabetic patients.

Conclusion

In conclusion, suPAR appears to be a promising biomarker, indicating early diagnosis of diabetic nephropathy in patients with DM.
Liver Fatty Acid-Binding Protein as a Diagnostic Marker for Non-Alcoholic Fatty Liver Disease
Authors: Mohamed Maha Mohsen , Mohamed Manal Sabry , Salama Mohamed Magdy , Ahmed Ghada Abdelrahman , Hassan Hassan Mokhtar , George Tari Magdy Aziz
Published: November 2024

Background

NAFLD is the most common cause of chronic liver disease in the developed world and represents a spectrum of diseases with some patients developing cirrhosis and hepatocellular carcinoma. Fatty acid-binding proteins (FABPs) are a family of small and highly conserved lipid chaperone molecules with highly varied functions. Different members of the FABP family exhibit unique patterns of tissue expression and are expressed most abundantly in tissues involved in active lipid metabolism in hepatocytes, adipocytes and cardiac myocytes, where fatty acids are prominent substrates for lipid biosynthesis, storage or breakdown, the respective FABPs make up between 1% and 5% of all soluble cytosolic proteins. In the hepatic lobule, L-FABP is expressed in hepatocytes in a declining gradient from portal to central location. L-FABP is a protein involved in multiple biologic functions, such as intracellular fatty acid transport, cholesterol and phospholopid metabolism, which plays an important facilitative role in hepatic fatty acid oxidation. Some studies reported that L-FABP level is increased in NAFLD. Therefore, it is preferable to use effective noninvasive methods in clinical practice for identifying NAFLD, tracking disease processes, and monitoring treatment effects. Many studies demonstrated that serological markers are beneficial as noninvasive tools for diagnosis of NAFLD. This study was conducted to determine whether serum L-FABP has a diagnostic value as a marker for NAFLD.

Patients and Methods

We enrolled in this study 80 consecutive patients with NAFLD who were diagnosed with Ultrasonography and Fibroscan with CAP. The control group consisted of 20 healthy control subjects matched for age and gender. Serum levels of L-FABP were determined by enzyme-linked immunosorbent assay.

Results

L-FABP levels in NAFLD patients were higher than in the control group (p < 0.05).

Conclusion

Serum L-FABP could be considered as a reliable non-invasive marker for detection of NAFLD.
Role of Beta-D-Glucan in the Diagnosis of Invasive Fungal Infections in Patients with Hematological Malignancies
Authors: Hashem Heba Ezzat , Attia Mohamed Hamdy , Abdou Dina Mohamed , El Wahed Hasan Esam Abd
Published: November 2024

Background

Invasive fungal infections (IFIs) are important causes of high morbidity and mortality rates among immunocompromised patients with special consideration on patients with hematological malignancies (HMs), Establishing the diagnosis of IFIs in immunocompromised patients is challenging due to nonspecific clinical presentations and the limited sensitivity of traditional culture-based methods. Rapid non-culture-based diagnostics such as 1,3- beta-D-glucan (BDG) assay have emerged as promising adjuncts to conventional diagnostic modalities, The aim of this work is to determine the diagnostic performance of beta-D-glucan (BDG) as an adjunct diagnostic strategy for invasive fungal infections (IFIs) in patients with hematological. malignancies (HMs).

Methods

Fifty-one patients were enrolled from hemato-oncology department - Ain Shams University Hospital during the period from May 2022 till April 2023, enrolled subjects were classified into healthy controls (n = 13), pathological controls (n = 13), and cases group (n = 25), patients were subjected for BDG test, CBC with differential count, highly sensitive-CRP, and Microbiological cultures and/or Histopathological examination.

Results

at cut off 187.21 pg/ ml the maximum efficacy of BDG test was achieved concerning the cases versus the total controls with sensitivity 84%, specificity 84.6%, NPV 84.6%, PPV 84% and efficacy 84.3%.

conclusion

Detection of BDG antigen can be a valuable diagnostic modality if used in the proper clinical setting (i.e., immunosuppressed, neutropenic patients and patients with HMs) by a provider knowledgeable of both the advantages and limitations of the test being tailored to each individual patient for best clinical judgement.
The Relation of Neutrophil Lymphocyte Ratio to the Steatosis and Fibrosis Stage in Patient with Non-Alcoholic Fatty Liver Disease Using Fibroscan with Controlled Attenuation Parameter and FIB-4 and FIB-5 Scores
Authors: Anwar Ayman Gamil , Abd El megeed Khaled Hamdy , Hussien Hany Ali , Mohamed Anwar Hossam Ahmed
Published: November 2024

Background

Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Fibroscan with controlled attenuation parameter (CAP), a noninvasive imaging procedure in diagnosis of NAFLD patients. Also Neutrophil / lymphocyte ratio (NLR) is a simple marker for inflammation, may be used to predict disease outcome.

Objectives

Is to determine whether there is a correlation between NLR and the degree of steatosis and fibrosis measured by fibroscan with CAP, FIB-4 and FIB-5 score.

Patients and Methods

This was a cross sectional study involving 2 groups, group (1): included 115 patients of NAFLD and group (2): included 30 healthy controls. All participants were supjected to complete personal and medical history (history of other comorbidities as DM, Hypertension syndrome and drug/herb intake). Complete physical examination including anthropometric measurements, vital signs, local examination and general examination of any signs of liver dysfunction as hepatomegaly, Jaundice, ascites, splenomegaly and varices. Laboratory tests including (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), Bilirubin, hemoglobin A1c, fasting glucose level, Lipid profile, Antinuclear antibody (ANA) test (to exclude autoimmune hepatitis), serum Uric acid and viral markers (HBsAg & Hcv Ab), Abdominal ultrasound, Fibroscan with CAP and FIB-4 and FIB -5 scoring, complete blood count with calculation of neutrophils /lymphocytes ratio(NLR).

Results

Both studied groups were comparable in age and sex distribution. Out of NAFLD cases (group 1), more than half (53.9%) had comorbidities (manifested as DM in 37.4%, hypertension in 36.5%, CVD in 8.7% and hypothyroidism in 1.7% of patients), there was no statistically significant difference between the studied groups regarding anthropometric measurements, NAFLD cases (group 1) had significantly lower Hb, HDL level and PLT p value <0.001 and higher NLR, ALT, AST, GGT, cholesterol, triglycerides and LDL levels p < 0.001,there was a significant positive correlation between NLR and each of steatosis and fibrosis p < 0.001,NLR was significantly positively correlated with FIB-4 (r = 0.667, P < 0.001) and FIB-5 (r = 0.361, P < 0.001), NLR was a significant predictor of hepatic steatosis (AUC= 0.816, P = 0.011) and fibrosis (AUC=0.739, P < 0.001) in NAFLD cases.

Conclusion

The study conducted on NAFLD patients at Ain Shams University Hospital found significant associations between NLR and liver steatosis/fibrosis. NLR proved to be a valuable predictor, with optimal cutoff values for steatosis and fibrosis, aiding in noninvasive assessment and management of NAFLD patients.
Assessment of the Autophagy Biomarker Level In Diabetic Kidney Disease Patients
Authors: Abdelmobdy Ashraf Hassan , Saeed Saeed Abdelwahab , Mohamed Khaled Magdy , Ibrahim Rakha Nahed Moawad
Published: November 2024

Introduction

Diabetic nephropathy is the most common long-term complication of diabetes mellitus and one of its major complications is diabetic kidney disease which is a major cause of end-stage renal disease (ESRD). Recent studies suggested defective autophagy involved in the pathogenesis and progression of diabetic kidney disease. So, we aimed to assess the autophagy biomarker Beclin-1 level in diabetic kidney disease patients.

Methods

In a cross sectional study, we enrolled 100 patients with Diabetic Kidney Disease (DKD) referred to Ain Shams University hospital. The patients were divided into 5 groups according to the estimated glomerular filtration rate (eGFR). Each group consisted of 20 patients to Compare the level of serum Beclin-1 in different groups. Beclin 1 assay: Human Beclin 1 (BECN1) ELISA kit uses a double antibody sandwich enzyme linked immunosorbent assay (ELISA) to assay the level of Human Beclin 1 (BECN1) in samples.

Results

There was statistically significant difference between the studied groups (p < 0.001) regarding hemoglobin, creatinine, hemoglobin A1c, calcium, phosphate, protein creatinine ratio, eGFR, and Beclin-1 levels with highest value among group (2, 5, 4, 2, 5, 5, 5 and 5) respectively and lowest value among group (5, 1, 5, 5, 2, 1, 5 and 5) respectively. There was statistically significant inverse correlation between Beclin-1 and diabetes duration, creatinine, urea, CRP and protein creatinine ratio (r: −0.24; p = 0.026), (r: −0.44; p < 0.001), (r: −0.44; p < 0.001), (r: −0.52; p < 0.001), (r: −0.56; p < 0.001) respectively. There was statistically significant positive correlation between Beclin-1 and hemoglobin, calcium and eGFR (r: 0.242; p = 0.015), (r: 0.248; p = 0.013) and (r: 0.568; p < 0.001) respectively. At cutoff value equal to (3.3, 1.2, 1.8 and 1.1) Beclin-1 had sensitivity equal to (100%, 55%, 80% and 85%) respectively and specificity equal to (85%, 85%, 75% and 100%) respectively in prediction of CKD progression from (stage 1 to stage 2), (stage 2 to stage 3), (stage 3 to stage 4) and (stage 4 to stage 5) respectively.

Conclusion

In conclusion we found that eGFR was the most influential parameter affecting Beclin-1 level and by using multivariate model, linear regression analysis adjusted factors for confounders eGFR was the only factor which kept his significant correlation with Beclin-1.
Diagnostic Value of Plasma Methylated Septin 9 in Detection of Hepatocellular Carcinoma in Egyptian Patient with post Hepatitis C Liver Cirrhosis in Comparison to Serum Level of Alphafeto Protein
Authors: El moghney Moustafa Mohamed Abd , Ali- Eldin Zainab Ahmed , Elrahmen Ahmed Ghada Abd , Mahmoud Rizk Mahmoud Hassan
Published: November 2024

Background

Egypt has the highest hepatitis C virus (HCV) prevalence worldwide. Cirrhosis secondary to HCV is associated with the highest annual risk for developing hepatocellular carcinoma. The burden of HCC has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. HCC contributes to 14.8% of all cancer mortality in Egypt. Most HCCs (80%) arise in a cirrhotic liver, a situation where there has been longstanding hepatocyte damage and chronic inflammation leading to fibrosis.

Aim of the Work

This study aims to evaluate the diagnostic value of plasma mSEPT9 assay in detection of HCC in Egyptian patients with post hepatitis C liver cirrhosis in comparison to serum level of α-fetoprotein (AFP).

Patients and Methods

This is a prospective case-control study conducted at the Gastroenterology department in Ain Shams University Hospital. The study population consisted of 80 subjects, divided into three groups: 40 patients with hepatocellular carcinoma, 20 patients with liver cirrhosis, and 20 healthy subjects as controls with matched age and gender.

Results

The study found that hepatocellular carcinoma (HCC) was more frequent in male patients and that the age of HCC patients was statistically significantly higher than patients with cirrhosis and healthy controls. Patients with HCC and cirrhosis had a higher Child Pugh score than healthy controls. Portal hypertension and portal vein thrombosis were more frequent in HCC and cirrhosis patients than in the control group. Liver enzymes were higher in patients with HCC and cirrhosis compared to healthy controls, while hemoglobin and platelet levels were lower in patients with HCC. Hepatitis C antibody and PCR were positive in HCC and cirrhosis patient groups. AFP and Methylated Septin 9 levels were higher in patients with HCC and cirrhosis than in healthy controls, and AFP had better diagnostic accuracy than Methylated Septin 9. Both AFP and Methylated Septin 9 levels were positively correlated with age, Child Score, liver enzymes, and coagulation profile and negatively correlated with platelet count and hemoglobin level. AFP level was positively correlated with the number of focal lesions and liver size.

Conclusion

This study demonstrated that plasma Methylated Septin 9 can be a promising noninvasive and circulating epigenetic biomarker for HCC diagnosis at the individual level. However, our results showed that AFP was superior than Methylated Septin 9 in the detection of HCC, Methylated Septin 9 has higher Sensitivity. It was suggested that the combination of plasma mSEPT9 and AFP could enhance the sensitivity of Methylated Septin 9 or AFP alone in the diagnosis of HCC. Further comparative studies with larger sample size and longer follow-up are needed to confirm our results and to identify risk factors of adverse events.
Association between Chronic Kidney Disease and Non-Alcoholic Fatty Liver Disease: A Cross Sectional Study
Authors: Baioumy Essam Mohammed , Elgaaly Sonia Ahmed , Fathallah Ahmed Magdy , Bebawy Marina Maurice
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is a growing health problem that poses a significant burden as it is currently the most prevalent form of chronic liver disease, affecting an estimated 25% of the worldwide population.

Aim of the Work

to evaluate the role of plasma LCN2 levels in the diagnosis and prognosis of patients with non-alcoholic fatty liver disease.

Patients and Methods

Our case-control study was conducted on 102 Egyptian subjects between the ages of 18 and 70, recruited from the Internal Medicine and Hepatology Department and Clinics at Ain Shams University Hospital during the period from March 2023 to August 2023, and divided them into two groups. Group I: 51 Egyptian patients diagnosed with NAFLD (61% males; 39% females). Group II: 51 Egyptian healthy controls (51% males; 49% females)

Results

In this study, LCN2 levels were significantly higher in cases than in the control group (p < 0.001), with a mean of 1893.214 ±1002.852 in the cases and a mean of 466.020 ± 397.699 in the controls. This suggests the use of LCN2 as a possible diagnostic marker of NAFLD. The mean LCN2 levels in this study also significantly increased as the grade of fatty liver increased from I to III (p < 0.001). This in turn proposes the use of LCN2 as a prognostic marker for NAFLD progression. LCN2 also significantly correlated with the fatty liver index and NAFLD Fibrosis scoring systems, but not with Fib-4. It showed an excellent diagnostic performance in this study with an area under ROC of 0.906, an 84% sensitivity, a 90% specificity, 89.6% PPV and 85.2% NPV for the prediction of NAFLD patients.

Conclusion

Lipocalin-2 performs as a diagnostic marker for non-alcoholic liver disease, and a possible prognostic test that may be used to follow up the degree of steatosis. Other studies should be done on a larger size of participants to determine the prevalence of LCN2 in Egyptian population as well as other populations. Other studies should also be expanded to include NAFLD with degrees of fibrosis, and more quantitative imaging tools could be used to compare LCN2 levels with the NAFLD stage. The levels of LCN2 can be also measured in cohort studies before and after treatment of NAFLD to evaluate its sensitivity to the response of treatment.
Role of Plasma Lipocalin-2 Levels as a Diagnostic and Prognostic Marker in Patients with Non-Alcoholic Fatty Liver Disease
Authors: Kamal Marwa Abdullah Muhammad , Nashaat Ehab Hassan , ElGhandour Ahmed Mohamed , Abdo Ahmad Abbas
Published: November 2024

Background

Rheumatoid arthritis, the most common connective tissue disease associated with Sjogren syndrome, may result in some extra-articular manifestations called sicca symptoms that are including keratoconjunctivitis sicca or dry eyes and xerostomia or dry mouth. RA usually has high morbidity and mortality and in patients with RA occurrence of SS makes its course worse.

Aim of the Work

to evaluate diagnostic accuracy of salivary gland US in differentiating RA patients with or without SS by use of probability method and evaluate the relation of SS with RA disease characteristics.

Patients and Methods

This cross-sectional study (Diagnostic test accuracy study) included (100) RA adult patients for 5 years or more who were recruited randomly from Rheumatology outpatient clinic and inpatient internal medicine department, Ain Shams University Hospitals.

Results

In our study, there was a statistically highly significant increase in number and percent of RA patients in area of certainty (≤20%&≥80% probability) after salivary glands US. Also, there was a statistically highly significant decrease in number and percent of RA patients in vague or borderline area (40-60%) after salivary glands US, making SGUS a good tool for diagnosing SS that may replace the need for invasive biopsy. In the current study, there was a statistically significant longer RA disease duration and higher Anti CCP antibody titer in RA patients with secondary SS compared to those without secondary SS. There was statistically highly significant higher percentage of RA patients with secondary SS who had CTS compared to RA patients without secondary SS.

Conclusion

SS is a frequent complication in RA patients especially in association with longer disease duration, higher Anti CCP antibody titer and CTS. US of SG is a useful tool that help diagnosis and grading of severity of SS in RA
Clinical Value of Adding Dapagliflozin in Patients with Nephrotic Syndrome
Authors: Mahmoud Ahmed Mohamed Mohyeldin Mohamed , ElSharkawy Magdy Mohamed , Teama Nahla Mohamed , Emara Ahmed Abdelmonem
Published: November 2024

Background

The nephrotic syndrome has one of the best-known presentations of adult and pediatric kidney disease. The incidence of nephrotic syndrome is approximately 2 to 4 new cases per 100,000 population per year. While advances had been made in the treatment of various glomerulonephritides, some uncertainty still exists regarding the management of nephrotic syndrome owing to the lack of high-quality randomized trials of treatment or interventions and systematic reviews.

Aim of the Work

to assess whether dapagliflozin compared with placebo reduces edema and proteinuria in patients with nephrotic syndrome. Additional exploratory endpoints include changes in eGFR and bodyweight.

Patients and Methods

The present study was a randomized controlled trial conducted to assess the clinical value of adding dapagliflozin to the standard of care in patients with nephrotic syndrome.

Results

A notable and statistically significant mean difference in baseline proteinuria was observed between the two study groups (3645.17 ± 928.1 mg/g; p < 0.001). However, as the study progressed, this difference decreased and eventually became non-significant. Although the dapagliflozin arm started with markedly higher proteinuria and achieved remission similar to the control group, the specific impact of dapagliflozin could not be definitively determined due to both groups receiving immunosuppression therapy. The dapagliflozin group experienced an initial decline in renal function, with eGFR decreasing to 80.63 mL/min/1.73m². However, from Months 2 to 6, there was a progressive increase in eGFR, reaching 94.53 mL/min/1.73m² at 6 months. A post hoc analysis revealed a significant difference between the second month vs. months 4, 5, and 6, as well as the third month vs. months 4 and 6 (p < 0.001). In contrast, the control group's eGFR values remained relatively stable throughout the study period, ranging from 96.7 mL/min/1.73m² at baseline to 103.37 mL/min/1.73m² at 6 months (p = 0.463). These findings suggest that dapagliflozin may initially impact renal function with a temporary decrease in eGFR, but the effects are reversible as eGFR values gradually improved later on.

Conclusion

The evolving understanding of SGLT2 inhibitors' role in patients with nephrotic syndrome. The findings suggest their potential to influence proteinuria reduction, renal function improvement, weight management, glycemic control, and lipid profile enhancement. he manageable incidence of UTIs further supports the safety profile of dapagliflozin in this context. These findings contribute to the growing body of evidence on the clinical value of SGLT2 inhibitors in glomerular diseases, emphasizing their potential to complement standard treatments and enhance patient outcomes. Further research is warranted to fully elucidate the long-term benefits and safety of dapagliflozin in this patient population.
Frequency of Microscopic Colitis among Patients with Diarrhea Predominant Irritable Bowel Syndrome
Authors: Elsayed Engy Yousry , Academic Hany Aly Abdel Rahman , Raafat Khaled , Ibrahim Gad Mohamed Talaat
Published: November 2024

Background

Microscopic colitis is a chronic inflammatory disease of the colon that frequently causes chronic watery diarrhoea that might be accompanied by abdominal pain, nocturnal diarrhoea, urgency, and faecal incontinence. These symptoms lead to poor quality of life and increased health-care costs. Diagnosis relies on histological examination of multiple biopsy samples from the colonic mucosa, which often show no or only few abnormalities on endoscopy. Two major histological subtypes can be distinguished-collagenous colitis and lymphocytic colitis-but incomplete and variant forms with fewer characteristic features have been reported. Here we summarise the latest evidence on epidemiology, pathogenesis, and risk factors, and discuss established and novel therapeutic options for clinical remission. Finally, we propose an updated treatment algorithm. Further prospective studies are needed to clarify the natural history of microscopic colitis, supported by validated criteria for the assessment of disease activity.

Aim of the Work

The aim of this study is to assess the frequency of collagenous colitis and lymphocytic colitis among patients diagnosed with diarrhea predominant -IBS according to Rome III criteria in a scale of Egyptian population and its relation to bilharziasis.

Patients and Methods

Type of Study: Cross-sectional study of 50 patients with IBS-D who will undergo medical history and clinical examination.

Results

The present study showed significant elevation of ESR levels in MC patients with range (5-15mg/dl) than other patients levels which showed range (3-13 mg/dl), as ESR is acute phase reactant. Our study showed significant decrease in the level of Hb in patients with MC with range (10-12gm/dl) than patients with normal biopsy which showed range (12-15.7gm/dl) which may be due to chronic illness in patients with MC.

Conclusion

The present study showed significant decrease of albumin levels in MC patients with range (3- 4.5gm/dl) than other patients levels which showed range (3.4- 5.4 gm/dl), which may be due to severe attacks of diarrhea in patients with MC.