bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive function in elderly patients with Chronic Kidney disease
Authors: Elgazzar Yumna A , Mahmoud Ramy M , Kamel Heba Y , Abdel Rahman Tomader T , Sweed Hala S
Published: October 2021

Background

Many elderly patients with Chronic Kidney disease (CKD) develop cognitive impairment and dementia. Cognitive impairment impacts CKD patients negatively by functional dependence and recurrent hospitalization. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery was originally developed to identify early Alzheimer’s disease, but it has become a widely used instrument to assess different levels & domains of cognitive and executive functions.

Aim

the aim of the study was to assess cognitive function in elderly patients with CKD.

Patients and Methods

one hundred CKD patients were recruited from outpatient clinics of Ain Shams University hospital. CERAD neuropsychological battery was used to measure cognitive functions in different domains (language functions, verbal learning, visuospatial functions, delayed recall, memory consolidation, recognition memory, and executive functions).

Results

CKD patients had low mean verbal fluency and mean MMSE while language functions score hadn’t been affected. There was a significant positive correlation (p < 0.001) between the mean eGFR and the CERAD total score.

Conclusion

This study contributes to the belief that an association exists between renal impairment and cognition, CERAD total score in CKD patients was inversely correlated to eGFR. Age and educational level significantly affect cognitive performance.
Histological Study on the effect of losartan in healing of an experimentally induced muscle laceration in adult male albino rat
Authors: Eltantawy Eman Hamdy Badr , Abdeltawab Salwa Mohamed , Salam Nevert Farid Abd El , Bahaa Nevine
Published: October 2021

Background

Skeletal muscle injuries are frequently encountered in athletes and military personnel. Incomplete functional recovery of these injuries usually occurs due to fibrosis of the skeletal muscle. Recently, oral administration of losartan antihypertensive drug was claimed to have a role in improving skeletal muscle healing, but still to be furtherly investigated.

Aim of the work

This work aimed to assess the healing effect of losartan on the histological structure of induced lacerated skeletal muscle fibers of adult male albino rats.

Material and Methods

Forty male albino rats were used in this study. They were divided into three groups: Group I: served as a control group and included 15 adult rats. Group II (muscle laceration group): consisted of 15 rats that were subjected to muscle laceration injury. They were subdivided into subgroup IIa: consisted of five rats that were sacrificed one day after injury, subgroup IIb: it included 10 rats that were left for spontaneous recovery for two weeks after injury. Group III (losartan-treated group): it consisted of 10 rats that were subjected to muscle laceration injury then they received oral losartan from day three till end of experiment. All rats, except rats of subgroup IIa, were sacrificed two weeks after injury. Right gastrocnemius muscle specimens were taken and processed for light microscopic examination by H & E and Masson's trichome stains as well as morphometric and statistical analysis.

Results

In group II, there was almost complete affection of myofibers at site of injury after 1 day of induced laceration in the form of myofibers fragmentation, disorganization and distortion with apparent mononuclear cellular infiltration mainly neutrophils and macrophages. After 2 weeks some myofibers were seen distorted and ended abruptly into connective tissue, others were branched with unclear striations. Mononuclear cellular infiltration between myofibers and apparent dilated blood vessels at laceration site were also noticed. A significant increase in collagen fibers deposition between regenerating muscle fibers (p<0.05) was also demonstrated. Treatment of the muscle laceration by losartan in group III showed apparent partial improvement in the form of significant decrease in collagen fibers deposition (p<0.05) and apparent decrease in mononuclear cellular infiltration as compared to that of group II. Also, some of the regenerated myotubes were noticed with chains of central nuclei.

Conclusion

Excess collagen fibers deposition between myofibers hinders regular arrangement of generating myotubes. Losartan might enhance muscle regeneration through decreasing collagen fibers deposition. However, it needs longer duration to assure complete muscle healing.
Isolation and Characterization of Female Rabbit Periosteal Derived Progenitor Cells
Authors: Hammouda Gehad Ahmed Ahmed , El-Samad Abeer Abd El-Mohsen Abd , Al- Khalek Ali Hadwa Ali Abd , Hassan Manal Ashour Mohammed
Published: October 2021

Background

Periosteum is a specialized highly vascularized connective tissue that is formed of an external fibrous layer containing collagen fibers and micro vessels and an inner cambium layer that facing the bone. Cambium layer includes periosteum derived progenitor cells (PDPCs) which have osteochondrogenic potential both in vitro and in vivo and act as major players in bone development and fracture healing. Periosteum derived progenitor cells display properties of mesenchymal stem cells (MSCs), including clonogenicity, phenotypic marker expression, and ability to differentiate into osteoblasts, chondrocytes and adipocytes. So, they are recognized to be essential for the initiation of bone graft healing and remodeling, but their clinical application is still limited due to inaccessibility. The aim of the present study is isolation, culture and characterization of rabbit’s PDPCs.

Methods

twenty-five adult female rabbits were used to harvest periosteal samples. Cell cultures were obtained by migration of cells from periosteal fragments (explant culture). Immunostaining of the cells of PDPCs in subculture (third passage) was performed.

Result

On day three of primary culture, the PDPCs were not started to migrate from the periosteal explant edges. However, on day six of primary culture, few spindle PDPCs cells appeared at the edge of explant. on day 20 of primary culture, PDPCs were mostly confluent ( about 9095%) . Immunostaining of PDPCs in subculture (third passage) showed positive brownish reaction of the branched cells for CD105 and CD44 and negative immune reaction for both CD34 and CD45.

Conclusion

The current study yielded isolation and cultured of female rabbit Periosteal derived progenitor cells. Periosteal derived stem cells are display properties of mesenchymal stem cells (MSCs), including clonogenicity, phenotypic marker expression.
Histological study of an experimentally constructed decellularized rat lung as a model of whole organ three-dimensional natural scaffold
Authors: Abdelsayed Marium Romany , Atalla Suzi Sobhy , Megahed Gehan Khalaf , Zeid Asmaa Abd El-Monem Abo
Published: October 2021

Introduction

With the increase of end stage lung diseases and the great problems facing lung transplantation tissue engineering become a promising solution. The first step in lung engineering is to obtain a 3D Extracellular matrix lung scaffold via decellularization. Decellularization aims to remove cells from tissue ultrastructure while preserving the mechanical and biological properties of the tissue. Intact ECM provides critical cues for differentiation and migration of cells that are seeded onto the organ scaffold.

Objectives

This study aimed to obtain an intact and well-preserved ECM lung scaffold by decellularization of rat lungs.

Methods

Decellularization of lungs of ten Wistar rats was achieved by perfusing detergents through the pulmonary artery. The resultant scaffolds were fixed and analyzed histologically.

Results

It was found that the decellularization process effectively removed the cellular and nuclear material while retaining native the 3D ECM of lung tissue. The architecture of the collagen and elastic fibers networks were preserved as comparable to the native lungs. Furthermore, the basement membranes of the bronchiolar and interalveolar septa were intact.

Conclusions

This methodology is expected to allow decellularization of human lung tissues and permits future scientific exploration in tissue engineering.
Serum Osteopontin and its Relation to Colorectal Carcinoma in Egyptian Patient
Authors: Mostafa Mohamed Abd Elmoghny , Kayser Hany Haron , Allam Ahmed Samir , Saeed Hakim Abanoub Refaat
Published: October 2021

Background

Colorectal cancer had a low incidence several decades ago. However, it has become a predominant cancer and now accounts for approximately 10% of cancer-related mortality in western countries. The ‘rise’ of colorectal cancer in developed countries can be attributed to the increasingly ageing population, unfavourable modern dietary habits and an increase in risk factors such as smoking, low physical exercise and obesity.

Objectives

The aim of this study to evaluate the role of serum level of osteopontin in prediction of Colorectal Carcinomain in correlation with tissue histopathology which it is the gold standard test in Egyptian patient.

Patients and Methods

The study was a Randomized controlled clinical trial. Which is a prospective, random, clinical trial conducted at Ain Shams University Hospitals at endoscopic unit on patients who refered for colonscopy. This study was conducted on 80 patients who were divided into 2 groups: Group A: 40 patients diagnosed as Colorectal Carcinoma as a patient group, Group B: 40 patients with age and sex matched control group who have normal colonscopy.

Results

There was statistically significant difference between CRC patients and normal colonscopic patients regarding the level ofosteopontin being higher in CRC patients (P value = 0.000). Also ROC curve for osteopontin in prediction of CRC showed the best cut of value >12 ng/ml with area under the curve (AUC) = 0.889, sensitivity =85%, specificity =77.5% with positive predictive value =79.1%

Conclusion

Serum Osteopontin (OPN) level is higher in patients with CRC than patients with normal colonscopy, so it can be used as a diagnostic marker for HCC.
Relation between Vitamin D deficiency and the Occurrence of Knee Osteoarthritis and Its Severity
Authors: Hafez Eman Ahmed , Ahmed El-Azizi Noran Osama , Mohammed Naglaa Affify , Fetouh Eisa Ahmed Abdelnasser
Published: October 2021

Background

Vitamin D is important to normal bone and cartilage metabolism. Insufficient concentrations of vitamin D adversely affect calcium metabolism, osteoblastic activity, matrix ossification, bone density, and articular cartilage turnover. Osteoarthritis (OA) is a degenerative joint disease involving the cartilage and many of its surrounding tissues. In addition to damage and loss of articular cartilage, there is remodelling of subarticular bone, osteophyte formation, ligamentous laxity, weakening of periarticular muscles, and, in some cases, synovial inflammation. Pain is the major clinical symptom in knee OA joint.

Objective

To estimate a relation between Vit.D deficiency and the severity of knee osteoarthritis.

Patients and Methods

This study was a cross sectional study conducted on ninety (90) patients diagnosed (aged 40-55 years old) with knee osteoarthritis according to according to American college of rheumatology (ARC) criteria 2016 for diagnosis of OA. Patients were recruited from the Rheumatology Outpatient Clinic and Internal Medicine and Rheumatology Department at Ain Shams University Hospitals.

Results

Our studied cases show that VAS pain score ranges from 3–7 with a mean 4.70 ± 0.93 and median 4. As regard pain domini of WOMAC, it had significant relation with Vit D significant (p value = 0.007) while VAS Pain Score not significant related to Vit D (p value = 0.121). In current study, the correlation between stiffness and Vit D is statistically significant (p value =0.001), the correlation between physical function and Vit D is statistically significant (p value = 0.001), the correlation between WOMAC score and Vit D was statistically significant (p value = 0.001) As regard relation between Vit. D and X-Ray Kellgran-Lawrence system, it was significant in grade 1and grade 3. But it was non-significant n grade 2 &4.

Conclusion

This study has demonstrated a significant association between knee OA and vitamin D deficiency and corresponding with the development of knee cartilage damage. As Low levels of vitamin D may not play a critical role in OA pathogenesis and progression.
Outcome of Direct Acting Antiviral Drugs (DAADs) for Hepatitis C Virus (HCV) in the Setting of Chronic Kidney Disease (CKD) in Upper Egypt
Authors: El Monem Hassan Ahmed Abd , Sarhan Iman Ibrahim , Abd El Gawad Mostafa Abd Elnasier , Mostafa Ali Mohamed
Published: October 2021

Background

The frequency of hepatitis C virus (HCV) infection remains high in patients with chronic kidney disease (CKD) and plays a detrimental role in mortality in this population, Patients on maintenance dialysis remain at risk of acquiring hepatitis C virus (HCV) infection and the prevalence of anti-HCV seropositive patients undergoing long-term hemodialysis is significantly greater than in those with normal kidney function.

Aim and objectives

the aim of the study was to assess outcomes (efficacy, side effects, and possible complications) of DAADs for HCV in presence of CKD,

Subjects and methods

this was retrospective cohort study that was conducted at Aswan Fever Hospital and Luxor fever hospital for anti HCV therapy between Jan 2018 and July 2018 including 60 patients with all stages of CKD whom receiving DAADs were be recruited from both Aswan fever hospital and Luxor fever hospital,

Results

the results revealed that Patient’s PC (%) in patients from Aswan was ranged between 61-100 with mean±S.D. 83.09±9.258 while in patients from Luxor was ranged between 66-100 with mean±S.D. 84.95±6.764. There was no statistically significant difference between groups where P = 0.458, Patient’s HCV PCR in patients from Aswan at baseline show that all patients were positive while after 3 months 27(90%) were negative and 3(10%) were positive and after 6months all patients were negative while in patients from Luxor all patients were positive while after 3 months 28(93.3%) were negative and 2(6.7%) were positive and after 6 months all patients were negative. There was no statistically significant difference between groups

Conclusion

Treatment with newer DAAs is effective and safe for the treatment of HCV-infected chronic kidney disease patients,
Evaluation of MicroRNA-122 as A Non-invasive Diagnostic Biomarker For Non-Alcoholic Fatty Liver Disease and NASH related Cirrhosis
Authors: Musa Nevine Ibrahim , Agwa Sara Hassan , Faheem Heba Ahmed , El-din Ahmed Mohamed Gharib Alam
Published: October 2021

Background

Nonalcoholic 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 8-13. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important. Liver biopsy is the gold standard for the evaluation of NAFLD patients in terms of staging. However, liver biopsy is an invasive technique, and the identification of noninvasive biomarkers is required.

Objective

To assess the value of MicroRNA-122 as a non-invasive biomarker for diagnosis of NAFLD and NASH related Cirrhosis.

Patients and Methods

In the present study, we assess the value of MicroRNA-122 as a noninvasive biomarker for diagnosis of NAFLD and NASH related Cirrhosis. Gastroenterology and Hepatology outpatient clinic at: Ain Shams University Hospitals, Shebin El-Kom Teaching Hospital, Kafr Elsheikh University Hospitals. Clinical Pathology department at Faculty of Medicine, Ain Shams University.

Results

Patients with NASH had higher NAFLD score than patients with NAFLD than normal control. Patients with NASH had significantly higher frequency of upregulated miRNA-22. Patients with NASH had higher miRNA 122 expression than normal controls and patients with NAFLD. Likewise, patients with NAFLD had higher miRNA 122 expression than normal controls. The miRNA 122 was a significant discriminator of NAFLD and NASH with a sensitivity of 75% and specificity of 82% for NAFLD and a sensitivity of 91% and specificity of 86% for the NASH.

Conclusion

miRNA-122 is a sensitive and specific biomarker in the early detection of NAFLD and NASH as they are linked to the lipid metabolism reducing the need for liver biopsy. NAFLD fibrosis score had high sensitivity in differentiating the NAFLD groups from the control group and in differentiating the steatosis group from the NASH group. Serum levels of miRNA-122 were positively correlated with BMI, ALT and AST.
Effect of Central Dialysis Fluid Delivery System (CDDS) on IL6 & CRP Levels in Prevalent Haemodialysis Patients
Authors: Elsayed Hesham Mohamed , Mahmoud Badawy Labeeb , Hassan Mohamed Saeed , Moustafa Ahmed Elsayed Elsayed Mohamed
Published: October 2021

Background

Dialysis is a chronic inflammatory state due to both decreased renal clearance and increased production of procytokines, moreover extracorporeal factors, such as impurities in dialysis water,etc. The central dialysis fluid delivery system (CDDS) is a cost-effective, laborsaving, time-tested system with good microbial safety, which has been used for 45 years in many countries & this study, studies the effect of (CDDS) on IL6 & hs-CRP levels in prevalent hemodialysis patients.

Aim of the Work

To compare the effect of central dialysis fluid delivery system (CDDS) versus single-patient dialysis fluid delivery system (SPDDS) in purification of water that used in dialysate and its effect on inflammatory markers (hs-CRP & IL-6) levels in prevalent hemodialysis patients.

Patients and Methods

A Case control study that was conducted on 100 patients of end-stage renal disease on hemodialysis in a university-affiliated hospital. Patients were classified into two groups, each included 50 patients; group (1) receiving regular dialysis by central dialysis fluid delivery system (CDDS), while group (2) receiving regular dialysis by single patient dialysis fluid delivery system (SPDDS) . Patients underwent full clinical assessment including thorough history taking, clinical examination, routine investigation, IL-6 and hsCRP testing to all patients.

Results

One hundred prevalent hemodialysis patients were included in this study. In this study, the levels of IL-6 and hs-CRP were found to be significantly higher in group 2 (SPDS) as compared to group 1 (CDDS).

Conclusion

In conclusion, central dialysis fluid delivery system (CDDS) seems to have a better effect on systemic inflammation (IL-6 and hsCRP) as compared with single-patient dialysis fluid delivery system (SPDDS). There is a statistically negative correlation between serum IL-6 and hsCRP levels with dry weight, Hemoglobin level, serum creatinine level & serum albumin level for group (1) (CDDS). However, there is a statistically positive correlation between serum IL-6 and hsCRP levels with Total Leuckocytic Count (TLC), serum ferritin level, serum potassium level, weight gain and duration of dialysis for group (2) (SPDS).
Pulmonary Hypertension versus pulmonary congestion in Haemodialysis patients in relation to increased Interdialytic weight gain
Authors: El Sharkawy Magdy M , Khedr Lina E , Samy El Shimy Ahmed M , Abdel Rahman Ali E , Shebl Draz Ahmed M
Published: October 2021

Background

Volume overload is considered as an important clinical problem in end stage renal disease patients. It is associated with morbid situations such as pulmonary hypertension and lung congestion.

Aim of the Work

to assess the effect of increased the patient weight between haemodialysis sessions that is known as interdialytic weight gain (IDWG) on pulmonary hypertension using Echocardiography (Echo) and lung congestion using lung ultrasound (LUS) in two groups: First group with IDWG < 3.5% of their dry weight while Second group with IDWG > 3.5% of their dry weight, compare between the two groups and to detect statistically the effects of IDWG & ultrafiltration on PAP and lung congestion.

Patients and Methods

This observational cross sectional study was conducted at on 60 patients who have end stage kidney disease &are currently on haemodialysis at Nasser Institute Hospital: 30 patients with an IDWG < 3.5% and 30 patients with an IDWG > 3.5% of their dry weight. Pulmonary artery pressure was measured by echo and patients classified according to PAP into mild, moderate and severe pulmonary hypertension. Lung congestion in all patients was measured by lung ultrasound and patients classified into minimal, mild, moderate and severe lung congestion.

Results

Our study showed that pulmonary hypertension prevalence was 30% while lung congestion was 100%. pulmonary hypertension pathophysiology includes acute and chronic processes and HD therapy alone is not effective in complete treatment of pulmonary hypertension and require medical treatment. Patients with increased IDWG > 3.5% (group 2) had pre HD higher PAP than those with IDWG < 3.5% (group 1) and patients with IDWG > 3.5% had more change in their PAP post HD session than those with IDWG < 3.5% but no significant difference between the change after the HD session in both groups. HD duration is an important factor in PH development over years. There is a significant relation anemia and hypercalcemia with PH. Patients with more increased IDWG > 3.5% (group 2) had higher pulmonary congestion than those with IDWG < 3.5% (group 1) and patients with IDWG < 3.5% had more change in their lung congestion level after the HD session than those with IDWG > 3.5% but no statistical significance between the change in both groups. There was a significant relation between HD therapy duration with pulmonary congestion measured prior to the session.

Conclusion

on the short term increased IDWG% affect lung congestion more than pulmonary hypertension.
Neutrophil to Lymphocyte Ratio in Diagnosis of Inflammatory Bowel Disease and Correlation with Disease Severity Assessed by Ultrasound and Colonoscopy
Authors: Ebrahem Wesam A , Saleh Shereen A , Aly Mohamed O , Mohamed Dina S
Published: October 2021

Background

Inflammatory bowel disease (IBD) is a chronic idiopathic disease affecting

author

the gastrointestinal tract that is comprised of two separate, but related intestinal disorders; Crohn’ s disease (CD) and ulcerative colitis (UC). The diagnosis of IBD is most commonly made on the basis of clinical features in combination with findings on ultrasonography, endoscopy and histopathology.

Patients and Methods

This is a crosssectional prospective observational study. This study included 40 IBD patients (19 females and 21 males), presented to Internal Medicine department, El-Demerdash Hospital, Ain Shams University from June 2018 to June 2019. Patients were matched with 10 healthy subjects (7 females and 3 males) as a control group. All patients subjected to the following: Thorough medical history, clinical examination (general and local) and laboratory investigations including complete blood count with calculation of neutrophils to lymphocyte ratio, ESR and CRP on the day of the colonoscopic procedure. US examination and endoscopic examination were done for every patient.

Results

Mean value of NLR in IBD patients was significantly higher than those in control group representing 3.12±1.87 and 1.88±0.42 respectively but it was statisitically insignificant between active and inactive IBD patients with best cut off >2,01 to differentiate active from inactive patient.THE NLR value was correllating with CRP only with no correlation with ESR,NLR value also has association with US findings that suggesting activity with best cut off >2.5 to detect these findings by US in active patients.US has high sensitivity and specificity in discriminating patients with moderate and severe activity from those with mild activity or those in remission but it was unable to discriminate patient of moderate activity from patients with severe activity with strong assossiation with endoscopic scores of activity.

Conclusion

NLR values had higher sensitivity and specificity than CRP and ESR with the benefit of being readily available with an affordable price. They are more useful when utilized together with serum laboratory inflammatory indices (CRP and ESR).
Study of Circulating Apelin in Type 1 Diabetic Patients and its Association with Glycemic Control in a Group of Egyptian Population
Authors: Amer Hanan Mohammed Ali , Mahdy Maram Mohammed Maher , Marwan Dina Ahmed Marwan , Taha Doaa Abd Ellatif Ahmed
Published: October 2021

Background

Type 1 diabetes mellitus (T1DM) is one of the most common chronic and metabolic diseases worldwide. The incidence of T1DM is reported to be increasing by 3-5% per year, and the number of people with diabetes is estimated to reach 380 million by 2025. Several studies have shown that TIDM is associated with metabolic abnormalities and alteration of adipose tissue hormones (adipokines). Apelin, one of the most abundantly expressed adipocytokine, is a bioactive peptide and produces its effects through a cell surface G protein-coupled receptor called APJ.The apelinergic system, is involved in a wide range of functions including regulation of body fluid homeostasis, cardiovascular system, angiogenesis and energy metabolism . Additionally, apelin participates in pathological processes, including obesity and diabetes. Apelin plays a beneficial role in energy metabolism.

Objectives

The aim of this study is to evaluate serum Apelin levels in patients with type 1 diabetes and to correlate the serum Apelin level and glycemic control.

Patients and Methods

This study was a cross sectional study. Participants were classified into two groups. The first group included 60 patient with T1DM recruited from Ain Shams University Endocrinology and Diabetes outpatient clinics in Cairo during the period from June 2019 to January2002 and the second group included 40 healthy controls. Serum apelin (APLN), FBS, 2hrPP, HbA1c, lipid profile and eGDR were measured for each case.

Results

Comparison between T1DM patients and controls revealed that serum apelin levels, were significantly increased in cases compared to controls. Negative correlations were found between Apelin and HbA1c% in the diabetic group as a marker for glycemic control so apelin may have a promising role as biomarkers in T1DM.

Conclusion

Our study showed that apelin concentrations were increased in type 1 diabetic patients compared to healthy controls. The potential association of apelin with insulin secretion and action may reveal new pathways in the pathogenesis of type 1 diabetes. Apelin in T1DM patients may be considered as promising adipokines for predicting glycemic control.
Lipocalin-2 Level in Patients with Polycystic Ovary Syndrome: Association with Insulin Resistance and Metformin Therapy
Authors: Halawa Mohamed Reda , Ali Hendawy Laila Mahmoud , Hassanin Alaa Sayed , Ali El Halawany Salah Hussein , Abdel Kader Hanem Ibrahim Abdel Fattah
Published: October 2021

Background

PCOS appears to be associated with an increased risk of metabolic aberrations, including insulin resistance and hyperinsulinemia, type 2 diabetes mellitus, dyslipidemia, and cardiovascular disease throughout womens’ lifespan. Obesity is a state of chronic low-grade systemic inflammation. This chronic inflammation is characterized by abnormal cytokine production and activation of inflammatory signaling pathways in adipose tissues, which contributes to insulin resistance and its related diseases such as PCOS and metabolic syndrome.

Objective

To evaluate Lipocalin-2 level in a sample of Egyptian females with PCOS and study the effect of metformin therapy on Lipocalin-2 level in patients with PCOS.

Methods

This case control study was conducted on 52 females, collected from the outpatient obstetrics and gynaecology clinics of Ain Shams University Hospitals from June 2018 to March 2019, their age ranged between 17-43 years old. divided into 2 groups:

Group (I)

32 women with polycystic ovary syndrome According to the Rotterdam diagnostic criteria of PCOS, and Group (II) 20 healthy women old with normal ovulatory cycle as a control group. All subjects were subjected to full medical history taking, thorough physical examination including BMI and waist circumference. Fasting plasma glucose, Fasting s.insulin, HOMA-IR, lipocalin-2 level were assessed.

Results

Serum lipocalin-2 levels did not differ between patients with PCOS and BMI-matched healthy controls (P-value 0.193), and there was no significant difference between the 2 studied groups as regard HOMA-IR (p = 0.375). Metformin therapy for 3 months in patients with PCOS in the present study, resulted in significant reduction in lipocalin-2 level (p-value<0.01), (mean 54.2±15.3ng/ml before metformin therapy vs 42.9±14.2 ng/ml after metformin therapy). Moreover, metformin therapy in PCOS group resulted in significant reduction in weight, BMI, waist circumference and HOMA-IR. Furthermore, linear regression analysis for the parameters affecting lipocalin level in our study, showed that BMI was the only significant confounder affecting lipocalin level. So, the reduction in lipocalin level following metformin therapy in PCOS group in our study may be due to weight reduction perse.

Conclusion

PCOS per se is not associated with elevated serum lipocalin-2 levels. Metformin therapy induces a significant reduction in serum lipocalin-2 levels, weight, BMI, waist circumference and HOMA-IR in patients with PCOS. Reduction of BMI was the only significant confounder affecting lipocalin level after metformin therapy. So the reduction in lipocalin level following metformin therapy in patients with PCOS in our study may be due to weight reduction perse.
Evaluation of Metabolic Changes in HCV Diabetic Patients Treated With Direct Acting Antiviral Agents
Authors: Elsayed Engy Yousry , Saad Hany Haroun , Naguib Gina Gamal , Abouelela Hazem Ibrahim
Published: October 2021

Background

Viral hepatitis is a major public health problem in need of urgent response. The prevalence of hepatitis C virus (HCV) infection in Egypt is the highest in the world. Seroprevalence was modeled to 10.6% and viraemic prevalence to 7.3% in 2014. The association between hepatitis C virus (HCV) infection and diabetes has been widely postulated. Prospective studies have demonstrated a higher risk of developing type 2 diabetes mellitus (T2DM) and insulin resistance in the HCV population.

Objective

to evaluate metabolic changes in HCV-positive diabetic patients following combination therapy of hepatitis C, clarifying the role of DAAs in these changes.

Patients and Methods

This study was conducted in Ain Shams University Hospital outpatient clinics who attended from March to December 2018. our study included 70 patients, and were subdivided into the following two groups: Group I: Easy to treat group. Contains 35 diabetic patients with HCV related chronic liver disease treated with sofosbuvir, daclatasvir. Group II: Difficult to treat group. Contains 35 diabetic patients with HCV related chronic liver disease treated with sofosbuvir and daclatasvir and ribavirin.

Results

Treatment was considered successful when patients became non-viraemic as identified by negative HCV RNA serum PCR at 12 weeks from the end of the treatment regimens (SVR). It was found that diabetic patients treated with DAAs achieved reduction of HbA1C by mean of (0.724±0.3%). The mean increase of serum uric acid level was (0.607±0.4 mg/dL). There were increases in Cholesterol (by mean of 16.85±3.4), HDL (by mean of 5.34±2.1) and LDL (by mean of 13.91±4.2) as well as a decrease in TG (by mean of 13.56±5.1).

Conclusion

Our study concludes that HCV eradication in diabetic patients leads to various metabolic changes in the form of: Reduction of serum HbA1c level. Elevation of serum uric acid. Elevation of serum cholesterol, HDL, LDL as well as a decrease in TG. Further and larger studies are needed to evaluate the full magnitude of RBV effects on the patients’ metabolism.
Identifying the Clinical Pattern of Eosinophilic and Non-Eosinophilic Asthma subtype in adult patients with Bronchial Asthma
Authors: Refaat Maged Mohammed , Sheha Dina Sayed , Raaft Riham Hazem , Refaat Maged Mohamed , Alia Heba Eid Farhat Abo , mohammed EL-Begermy Marwa , ElRasoul El-Ashry Marwa Abd , Sayed Sheha Dina
Published: October 2021

Background

Context:- Asthma is a heterogenous disease with various phenotypes, it is the most common chronic disease characterized by airway limitation due to bronchospasm and airway inflammation associated with excessive mucus secretion from agitated mucus gland that occur due to air way hyper responiveness.

Purpose of the study

Comparison between eosinophilic and non-eosinophilic asthma patients.

Patients and Methods

100 bronchial asthma patients of age ≥ 18 years old divided into2 groups according to blood eosinophilia. All patients were subjected to: history. Total Asthma Control Test. Spirometry. Sputum eosinophil count. IgE levels 6-Skin prick testing (SPT). Nasal endoscopy.

Results

the mean age of all patients was (35.4 ± 12.8) years, majority (61%) of patients were males,; the mean ACT score was (18.7 ± 2); 39% of cases have obstructive pattern by spirometry, 39% of cases had abnormal nasal endoscopy, SPT had significant relation with asthma, there is significant correlation between total IGE,sputum eosinophilia with eosinophilic asthma.

Conclusion

Blood eosinophils had the highest accuracy in the identification of sputum eosinophilia in asthma. Total IgE values and sutum eosinophilia were markedly increased in patients with eosinophilic asthma more than patients with non-eosinophilic asthma.
The Role of Helicobacter Pylori Eradication on the Pathogenesis of Minimal Hepatic Encephalopathy in Egyptian Patients with Liver Cirrhosis
Authors: Elmaltawy Mohamed Abdelftah , Khayyal Ahmed Saady , Osama Aly Mohamed , Elghandour Hisham Ashraf Elhussieny
Published: October 2021

Background

Hepatic Encephalopathy (HE) is defined as alteration of mental state in the absence of other causes of encephalopathy due to liver failure and/or abnormal shunting of blood from portal to systemic circulation often accompanied by elevated blood ammonia.

Objectives

The aim of this study was to determine the relation between the Helicobacter pylori infectionand minimal hepatic encephalopathy (MHE) in cirrhotic patients and to assess the outcome after treatment of H. pylori.

Patients and Methods

This study was can•ied out at Egyptian Railway Medical Centre at the in-patients section at Gastroenterology and Hepatology Medicine Department with chronic liver disease who agreed to participate in the study. After performing the psychometric tests the patients were allocated in one of the two groups according to test results: Group I: consisted of 30 consecutive patients who have chronic liver disease and presented with evidence of Minimal hepatic encephalopathy (MHE), as recognized by positive psychometric tests, Group Il: included 30 consecutive patients who presented with chronic liver disease and did not have Minimal hepatic encephalopathy, as confirmed by negative psychometric test.

Results

In this study a significant reduction was found in blood ammonia levels in MHE and non- MHE after triple-drug anti-H. pylori treatment (p < 0.001). This reduction was more marked in patients with MHE group compared to non-MHE group with % improvement in ammonia level 26.1 ± 8.36 umol/L and 17.79 ± 7.308 for MHE and non-MHE respectively. This finding indicates that H. pylori may contribute to the development of hyperammonemia in patients with liver disease and MHE. The role of H. pylori in the pathogenesis of hyperammonemia has been shown in previous studies which showed a reduction in blood ammonia levels after eradication of H.pylori infection.

Conclusion

Helicobacter Pylori infection was more prevalent in patients with MHE than without MHE. Serum arnrnonia levels were significantly higher in MHE patients than without MHE and even higher in H.pylori positive patients than without H.pylori infection. Helicobacter Pylori eradication treatment significantly improves ammonia levels, results of psychometric tests and improves manifestations of MHE.
Impact of Different Modalities of Treatment of Hepatorenal Syndrome as Midodrine, Somatostatin analogue, Albumin infusion and Tapping of Ascites on Renal Artery Resistive Index by Doppler ultrasound
Authors: ElTouny Maha , ElKelany Hesham H , ElBaz Hossam , Zaki Kristeen E
Published: October 2021

Background

Liver cirrhosis is a major cause of morbidity and mortality worldwide, mainly due to complications of portal hypertension. Ascites formation in patients with Kristeen E. cirrhosis, portal hypertension, or both usually results from hyperdynamic circulatory Zaki dysfunction.

Aim of the Work

to investigate the effect and prognostic value of treatment of hepatorenal syndrome in patients with liver cirrhosis and massive ascites by LVP, somatostatin analogue and midodrine intake and its effect on renal resistive index.

Patients and Methods

This study was carried on 40 patients divided into 4 groups where 10 patients (G1) received midodrine therapy and albumin infusion, 10 patients (G2) had tapping of ascites with albumin infusion, 10 patients (G3) received octreotide therapy and albumin infusion and the last 10 patients (G4) received octreotide, midodrine and albumin infusion. All patients were subjected to careful history taking and thorough clinical examination. Before and after intervention, patients had laboratory investigation including complete blood picture, liver function tests, renal function test and ascitic fluid analysis in addition to renal artery Doppler imaging.

Results

The study revealed considerable decline in RI in G1 (midodrine group), the change fell short of statistical significance. However, our study showed significant effect of midodrine administration on renal functions as expressed by serum creatinine, blood urea and creatinine clearance. In G3 (octreotide group), the effect of treatment on renal artery RI was minimal. The other group that perceived significant decline in renal artery resistive index was G4 (midodrine and octreotide group).

Conclusions

LVP and midodrine combination administration resulted in significant decrease in creatinine clearance. Renal artery resistive index has significant correlation with creatinine clearance in studied group and can be used as non-invasive tool.
Safety & Efficacy of Directly Acting Antivirals (Sofosbuvir & Daclatasvir) in Treatment of Chronic HCV in HIV-HCV Co-Infected Egyptian Patients
Authors: EL-Saeed Kadry Mohamed , EL-Khedr Inas , Anwar Christina Alphonse , Hassan Mahmoud Hassan Al-Sadik
Published: October 2021

Background

The introduction of direct-acting antiviral agents, has revolutionized the treatment for chronic HCV with higher cure rates, shorter duration of treatment and more tolerability have been achieved.

Objectives

The aim of our study is to estimate the efficacy and safety of DAAs in treatment of chronic HCV in patients co-infected with HIV.

Patients and Methods

This study of previously untreated patients with HCV and HIV co- infection conducted at Abbasia Fever Hospital, from July 2019 to February 2020. Patients included those who are chronic HCV infection and receiving antiretroviral therapy with a CD4 T-lymphocyte count of 200 cells/mL or greater. Serial measurements of safety parameters, virologic and host immune correlates, and adherence were performed during treatment by combination of daclatasvir 90mg and sofosbuvir 400mg+/- ribavirin 800mg daily for 12 weeks.

Results

In this study, AST & ALT were significantly decreased at end of treatment and 12 weeks after treatment, CD4 count was significantly increased. Otherwise there are no significant changes in both hematological and biochemical laboratory results. The demographic features of the patients and HIV disease characteristics were not predictors of HCV treatment failure.

Conclusion

More studies on larger numbers of patients are required for proper evaluation of the safety and efficacy of direct acting antiviral agents generally and sofosbuvir plus daclatasvir combination particularly in HIV/HCV coinfected patients. Longer follow-up studies are still recommended to fully understand the impact of sustained virological response on dynamics of liver fibrosis, biochemical profile and rate of relapse.
Effect of intradialytic exercise on the inflammatory markers in prevalent hemodialysis patients
Authors: Elshinnawy Howayda Abdelhamid , Fayez Mahmoud Mohamed , Farrag Dina Abou-Bakr , AbdElgawad Mostafa AbdElnassier
Published: October 2021

Background

Chronic low-grade inflammation is a feature of chronic kidney disease associated with increased risk of multiple morbidities and mortalities. Dialysis patients lead a sedentary life style which could add to this risk.

Aim

assessment of the effect of intradialytic exercise IDE on inflammatory markers in prevalent hemodialysis HD patients.

Patients and Methods

This longitudinal prospective study included 40 adult patients on regular HD, divided equally into 2 groups; Exercise Group (n = 20); received IDE 3 times/week for 3 months and Non-exercise Group (n = 20) matched in age and sex acting as controls. Patients were subjected to full history taking and clinical examination. Physical performance assessment using Short Physical Performance Battery tests (SPBT), Laboratory investigations included; Complete blood picture, C-reactive protein (CRP) and interleukin 6 (IL6) assessed using Enzyme linked immunosorbent assay. All assessments were repeated 3 months after regular IDE.

Results

At baseline, there was no difference between both groups regarding physical performance or inflammatory markers. After 3 months, SPBT was significantly increased in Exercise group (P < 0.001). Also, both serum CRP and IL-6 levels showed significant decrease in Exercise group compared to baseline (P < 0.001), while no similar change was noticed in non-exercise group.

Conclusion

The significant decrease in serum CRP and IL-6 levels after 3 months of regular IDE and the improvement in physical performance in exercise group implements that regular IDE exercise training program can improve physical function and inflammation in hemodialysis patients.

Further studies on larger number of patients is warranted.
A study of Vitamin D supplementation to patients with chronic diseases admitted to Ain Shams University Hospital
Authors: Botros Raef Malak , El Din Ahmed Mohamed Bahaa , Mansour Hany Khairy , Ayad Grace Mariam Michel
Published: October 2021

Background

Vitamin D deficiency and insufficiency have become a common problem worldwide. Vitamin D has been associated with all causes of mortality in chronic diseases and associated with a longer hospital stay and poor outcome.

Aim of the Study

to evaluate the role of vitamin D supplementation on the outcome of hospitalization for patients with CLD or CHF admitted to Ain Shams University Hospitals (ASUH) with acute deterioration of their illness.

Subjects and methods

We conducted prospective case control on 80 patients collected from inpatient ward of endocrinology, divided into 2 groups; 40 patients with chronic liver diseases and 40 patients with heart failure. Serum 25OH-vitamin D and calcium, phosphate and PTH were measured to all participants before intervention. 20 patients of each group (Intervention group) received single dose of vitamin D within 3 days of admission and the other 20 patients of each group (control group) did not receive vitamin D vitamin D.

Results

no significant difference between patients who received vitamin D supplementation and who did not receive vitamin D supplementation as regards outcome and survival with P value 1.000 in patients with CLD and 0.823 in patients with CHF. On the other hand, we found baseline vitamin D level was an independent predictor of mortality (P value .018).

Conclusion

We found that a beneficial effect of vitamin D supplementation can't be achieved with single dose vitamin D (200,000 IU) on CHF or CLD hospitalized patients’ mortality. We recommend that vitamin D supplementation should be considered in CLD and CHF outpatients, with exception of hypercalcemic and hyperphosphatemic patients, as baseline vitamin D status affects the disease course and mortality prior to disease deterioration and hospitalization.
Relation of Gut Lactobacillus Acidophilus and Atherosclerosis in type 2 diabetic patients with and without atherosclerosis
Authors: Hosny Salwa Seddik , Abd El Baky Rania Sayed , Mohamed Eid Yara , Mohamed Nagwa Roushdy , Ibrahim Rana Hashem
Published: October 2021

Background

Recent researches show that alteration of GUT bacterial population is found to be an important factor for development of atherosclerosis either directly or indirectly through augmenting other known risk factors for atherosclerosis like; diabetes and dyslipidemia.

On the other hand, many members of the gut microbiota are probiotics; Bifidobacterium and Lactobacillus are two well-known probiotics, many studies show their athero-protective role and their protective effect against insulin resistance and metabolic syndrome.

Aim of the work

To study the role of gut Lactobacillus Acidophilus in the development of atherosclerosis in type 2 diabetic patients (T2DM).

Patients and methods

The study was conducted on 64 type 2 diabetic patients, with their age ranging between 25 and 60 years old. They will be divided into two groups; Group 1: 32 Type 2 diabetic patients with atherosclerosis. Group 2: 32 Type 2 diabetic patients without atherosclerosis. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, two-hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile

(Total cholesterol-LDL-HDL-Triglycerides), and Liver and kidney function test.

Identification of stool Lactobacillus Acidophilus by Polymerase chain reaction (PCR) semi- quantitative technique. Carotid ultrasonography for estimation of intimamedia thickness (IMT).

Results

As regards PCR for Lactobacillus Acidophilus 68.8% of group one patients were positive for PCR for Lactobacillus Acidophilus, compared to 75.0% of group two, but there was no statistical difference among the two groups (P value = 0.578).As regards PCR cut-off time in PCR positive cases, there was a statistically significant difference among the two groups (P value= 0.016). Applying Receiver operating characteristic curve (ROC), it showed that PCR cut-off time more than 26.82 can be used as a predictor for atherosclerosis in type two diabetic patients (T2DM) with sensitivity of 72.73%, specificity of 70.83% and area under curve (AUC) of 0.723. In group one, there was a statistically significant positive correlation between PCR cut off time and the two hours post prandial blood sugar (P value= 0.005), the glycated hemoglobin (HBa1c) (P value= 0.049) and intimal media thickness (IMT) (P-value= 0.045).

Conclusion

Lactobacillus Acidophilus concentration is higher in type 2 diabetes patients without atherosclerosis than in atherosclerotic patients and detection of their level in stool using PCR can be used as a predictor for atherosclerosis in type two diabetes patients.