bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Hepatic Affection and Complications in COVID-19 Infected Patients
Authors: Mohamed Maha Mohsen , Mohammed Manal Sabry , Elessawy Hagar Ahmed Ahmed , Eissa Ramy Raouf Ramzy
Published: November 2024

Background

The definition of liver damage caused by COVID-19 has not yet been established. COVID-19 may contribute to both primary and secondary liver injury in people with pre- existing chronic disease and impaired liver reserves, leading to exacerbation of underlying disease, liver decompensation, or acute chronic liver failure. Therefore, many researchers have interpreted it as clinical or laboratory abnormalities in the course of the disease and treatment in patients with or without pre-existing liver disease.

Aim and Objectives

To evaluate the relation between liver function tests in COVID-19 patients and disease severity & prognosis.

Subjects and Methods

This retrospective study, was carried on 200 patients attended to Ain Shams university hospital divided into 2 groups: Group I (Non hepatic patients): COVID-19 patients with no preexisting hepatic diseases who were followed for any changes in liver function tests, Group II (patients with preexisting hepatic diseases): COVID-19 patients with pre-existing hepatic diseases, were followed clinically and laboratory and by Child-Puch score, during a period of 6 months.

Result

There was high statistically significant relation between Preexisting hepatic diseases and ALT, AST, TB, ALP, PT and INR.

Conclusion

A higher occurrence of liver injury has been consorted with COVID-19. Moreover, the severity of the disarray in serum liver function indicators is linked to higher acuity. Thus, special attention should be given to any liver dysfunction while treating patients with COVID-19. Patients with abnormal liver tests were at increased risk of progressing to severe disease. The detrimental effects on liver injury mainly related to certain medications used during hospitalization, and should be monitored and evaluated frequently.
The Impact of Mediterranean Diet on Patients with Hashimoto Thyroiditis
Authors: Shady Manal Abu , Adly Nahla Nader , Ibrahim Sarah , Aboelyazed Sherihan
Published: November 2024

Background

Hashimoto's thyroiditis is one of the most common autoimmune disorders. Patients typically present with nonspecific symptoms, such as fatigue, weight gain, cold intolerance, constipation, and dry skin, which can significantly impair patients' quality of life. Conventional treatments focus on hormone replacement therapy for hypothyroidism, but emerging research suggests dietary interventions, like the Mediterranean diet, may provide added benefits. Many patients continue to suffer from difficulty losing weight despite reaching an euthyroid state while on Levothyroxine. The Mediterranean diet emphasizes fruits, vegetables, whole grains, legumes, nuts, olive oil, fish, poultry, and dairy in moderation. The diet has been known for promoting cardiovascular health and reducing inflammation.

Aim

Our aim was to explore the Mediterranean diet's impact on Hashimoto's disease and how it affects thyroid autoantibodies and thyroid profile parameters.

Methods

A single arm clinical trial was performed on 40 female patients diagnosed with Hashimoto’s thyroiditis. Our study participants were started on a modified mediterranean dietary plan for 12 weeks. Evaluation of TSH, free T3, free T4, thyroid peroxidase autoantibodies, thyroglobulin autoantibodies, and BMI was done at baseline and at the end of the study. All of our study participants were kept on their pre-intervention Levothyroxine doses throughout the study.

Results

We achieved statistically significant reductions in autoantibodies levels, with median % change of (−28.36% (−45.75– −19.05)) for thyroid peroxidase autoantibodies and (−26.09% (−42.76– −14.15)) for thyroglobulin autoantibodies (P < 0.01). Regarding thyroid function tests, statistically significant changes were seen in TSH (−24.95% (−39.6– 18.51)), free T3 (28.4% (9.38 – 66.79)), and free T4 (29.05% (12.79 – 60.49)), with a P-value <0.01. BMI reductions achieved were also statistically significant with a mean % change of −6.78% (−10.34– −3.70), P < 0.01.

Conclusion

In conclusion, the Mediterranean diet shows promise as a complementary therapy for Hashimoto's thyroiditis, offering lower disease activity, as well as weight reduction. Further research, including randomized controlled trials, is needed for confirmation. Nonetheless, promoting adherence to this diet could offer a safe, accessible, and cost-effective approach to better disease control.
POEM in Achalasia Type III and Non-Achalasia Esophageal Motility Disorders
Authors: Ibrahim Sohaib Mohamed , Allam Ehab Hassan Nashaat , Mahmoud Hossam Abdelaziz , Badawy Mohammed Nabil , Madkour Ahmad
Published: November 2024

Background

POEM has gained popularity in the treatment of achalasia and other esophageal motility disorders worldwide and most of reports have demonstrated the remarkable efficiency of POEM as a treatment of achalasia. This study will demonstrate efficiency of POEM as a treatment of achalasia type 3 and other non-achalasia esophageal disorders. Type III achalasia represents about 10% of all cases of achalasia with most of cases presenting near age 60. It presents with similar clinical profile to other types of achalasia and spastic EMD; in which chest pain occur mainly during swallowing, with more severe dysphagia and regurgitation, and thus, more weight loss.

Aim of the Work

To demonstrate efficiency of POEM as a treatment of achalasia type 3 and other non-achalasia esophageal disorders.

Patients and Methods

This was a pilot prospective observational study and patients will be selected from endoscopy centers in Egypt.

Results

Our study showed that statistically significant decrease in mean Eckardt score was present in patients who underwent POEM indicating resolution of symptoms of esophageal motility disorder. Also, adverse outcomes were present, indicating high safety of POEM as a therapeutic procedure.

Conclusion

POEM is safe and effective in the management of achalasia type III as well as other non-achalasia EMD. However, more research is needed to generalize the utilization of this procedure to help more patients.
Evaluation of Serum Tenascin-C Level in Patients with Bronchial Asthma
Authors: Rahman Al-Shayeb Muhammad Abdul , El-Kady Hossam Moustafa , Al-Jundi Aya Muhammad , Hassanein Yasmine Ali Farag
Published: November 2024

Background

Serum TNC is an extracellular matrix protein and a pro-inflammatory marker that is released mainly in inflammatory processes such as asthma exacerbation as well as tissue remodeling in cardiovascular events, septic conditions, and autoimmune diseases. However, serum TNC level measurement has not yet been used as an inflammatory marker for the diagnosis and severity of bronchial asthma. We will discuss how serum TNC can be utilized as a marker for the diagnosis and severity of bronchial asthma in this study.

Aim of the Work

To meausure seum levels of Tenascin-C in patients with bronchial asthma compared to healthy individuals and its relation to the severity of the disease.

Patients and Methods

We evaluated 90 adult patients with mild to severe asthma. Serum TNC, periostin, and total IgE concentrations were quantified using enzyme-linked immunosorbent assays.

Results

Serum TNC levels were significantly higher in patients with bronchial asthma compared to those who are non asthmatic. Serum TNC was also higher in patients with severe asthma compared to thsose with mild to moderate asthma with statiscally significant ratio.

Conclusion

Serum TNC can be utilized as a new biomarker for diagnosis of the presence of bronchial asthma and in prediction of the severity of asthma.
Posterior Circulation Ultrasound Assessment of Patients with Isolated Central Vertigo versus Ischemic Posterior Circulation Stroke: A Comparative Study
Authors: ElKhawas Hala Mahmoud , El Sadek Ahmed Mohamed , Mahmoud Eman Moe’nes , Abdelatif Ahmed Khaled Mohamed
Published: November 2024

Background

Vertigo is the illusory sense of movement, while unsteadiness is the feeling of being unstable while seated, standing, or walking. These symptoms represent 4% of the access to the Emergency Department (ED) and they can be related to both benign diseases of the inner ear or serious central nervous system diseases, including posterior circulation stroke.

Aim of the Work

The aim of the study was to compare between carotid duplex findings of patients with isolated central vertigo and vertigo due to posterior circulation stroke for better diagnosis and seeking for earlier detection of stroke.

Patients and Methods

This was a cross sectional comparative study that included about 56 patients. The patients who presented to the emergency department with vertigo in Ain Shams University hospitals from December 2022 to February 2024.

Results

Our study showed that RI and PI, which are the most frequently used CD parameters to determine the blood flow resistance, were markedly higher for patients with posterior circulation CVS than in patients with isolated central vertigo.

Conclusion

Those findings denote that atherosclerosis has a major role in CVS etiology, and thus CD can be a useful, rapid and reliable tool that can aid in screening and prediction of population at high risk of CVS.
The Effect of Topiramate and Propranolol on Serum Calcitonin Gene Related Peptide (CGRP) Level on Migraine Patients
Authors: Moustafa Ramez Reda , Helmy Shahinaz Mohamed , Hassan Ahmed Salah Salem
Published: November 2024

Background

Migraine is a common multi-factorial, neurovascular disorder with major individual and social effect. Although the mechanisms are unknown, activation of the TNC leads to peripheral release of calcitonin gene-related protein (CGRP), most likely from C-fibers. Topiramate is `a first-choice oral medication for migraine prophylaxis. It is one of the most frequently prescribed preventative anti-migraine drugs. Other first-line, non-specific preventatives include β-blockers, flunarizine, and amitriptyline. All these medications are inexpensive treatment options, which are effective in a large population of patients.

Objective

to study the effect of topiramate and propranolol on serum calcitonin gene related peptide (CGRP) level in peripheral blood in migraine in Headache outpatient clinic and neurology department at Ain Shams University hospital.

Methods

it’s a cross-sectional time interval study conducted between October 2022 to April 2023. we conducted our study on 50 patients at our outpatient headache clinic were diagnosed as migraine according to ICH-3rd edition. blood sampling was obtained from all 50 patients for estimation of CGRP in peripheral blood before receiving any medication then all patients received propranolol 40mg and topiramate 25 mg after two months blood sample obtained for estimation of cgrp.

Results

Highly statistical significant (p-value < 0.001) decreased CGRP (after medication) (mean = 141.1 ± 62.5, range = 53 – 320) when compared with CGRP (before medication) (mean = 190.3 ± 71.7, range = 92 – 395) in all studied patients

Conclusion

both topiramate and propranolol show significant decrease in serum calcitonin gene related peptide in migraine patients.
Effect of Transcranial Direct Current Stimulation on Outcome of Patients with Acute Ischemic Middle Cerebral Artery Stroke
Authors: Alzahaby Alaa , Nahas Nevine El , El-bokl Ahmed , Samy Ahmed , Fathallah Fatma
Published: November 2024

Background

Stroke continues to hold its position as the second most prevalent cause of death and stands as a prominent contributor to depression and dementia on a worldwide scale. In the absence of adequate care, individuals who have experienced a stroke face an elevated susceptibility to dependency on caregivers and encounter significant limitations in their ability to engage in societal activities. The rescue of penumbral tissue through early reperfusion correlates with proportionate clinical recuperation. Transcranial direct current stimulation (tDCS) is being explored as a promising therapeutic approach for various neurological conditions, including the management of strokes. Our objective was to investigate the impact of cathodal tDCS on patients who have recently suffered a stroke affecting the middle cerebral artery.

Methods

Egyptian patients with middle cerebral artery strokes were randomly allocated into active and sham tDCs groups after stroke onset.

Results

No difference regarding age, gender, risk factors or final clinical outcome.

Conclusion

Earlier application of tDCS may be beneficial.
Serum Vitamin D Level in Children with Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Elshahawi Heba , Amin Ghada , Khalil Sherien , Kasem Rania , Mostafa Amany
Published: November 2024

Background

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence. Dietary interventions such as omega-3 FA, vitamin and mineral supplementations might affect ADHD symptoms.

Aim

To compare serum level of vitamin D in children with ADHD with its different subtypes in relation to healthy controls.

Methods

a case control study was conducted on 108 children divided equally between healthy children and ADHD cases. Vit D was measured. Assessment of habitual vitamin D intake was done by using a vitamin D food frequency questionnaire.

Results

The median weekly vitamin D intake for the ADHD group was significantly lower than that for the control group, p < 0. 001. The ADHD group had significantly lower 25-Hydroxy Vitamin D level the control group (p < 0. 001). Vitamin D level was considered independent predictor of ADHD susceptibility.

Conclusion

Patients with ADHD have lower serum concentrations of 25- hydroxyvitamin D than do healthy children.
Prevalence of Catatonia in the Sample of Patients Admitted to the Psychiatric Institute of Ain Shams University Hospital: A 2 Year Hospital Based Descriptive Study
Authors: Ali Dina Ahmed , Omar Abdel Nasser Mahmoud , Sayed Maha Mohamed , Gamal El Missiry Marwa Adel , Naguib Rehab Mohamed , Mohamed Mohamed Youssef
Published: November 2024

Background

Catatonia is characterized by a number of impressive motor phenomena (rigor, dyskinesia, posturing, catalepsy, gegenhalten, stereotypies, etc.) as much as flamboyant affective symptoms (anxiety, aggression, flat affect or affect incontinence) and bizarre behavioral abnormalities (autism, mutism, echolalia, echopraxia, etc.). Despite a renewed interest in the disorder over the last several decades, a number of questions remain regarding its prevalence, causes and treatment. Clinical manifestations of catatonia are extremely heterogeneous and at least 40 separate signs of catatonia have been described, making recognition challenging with frequent misdiagnoses. The difficulties in the clinical diagnosis, conceptualization and management of catatonia have been described as “The catatonic dilemma”. The relative prevalence and diagnostic significance of catatonic signs differ among studies and patient populations. This study aimed to measure the prevalence of catatonia in the patients admitted at the Institute of Psychiatry through the two years (2019 and 2020), to describe different causes, types of catatonia, to identify the most frequent cause and type during this period and to identify different clinical and demographic correlates affecting the prevalence and severity of the cases. It was held at the Institute of Psychiatry of Ain Shams University Hospital, located In Eastern Cairo, serve both urban and rural areas in Cairo and other governorates in Egypt.

Methods

The sample consisted of a group of patients diagnosed with catatonia (n = 49) and another group of all psychiatric patients without catatonia admitted at the Institute during these two years (n = 1056). The sample was assessed using The Structured Clinical Interview for DSM-V Axis I Disorders (SCID- 5), Structured Clinical Interview for the DSM V (SCID-5PD), The Bush- Francis Catatonia Rating Scale (BFCRS) and designed questionnaire.

Results

Patients with younger age, with abnormal prenatal history and with authoritarian paternal control showed significantly higher odds of experiencing catatonia than those with older age, normal history and authoritative paternal control. Moreover, patients using more than one substance had significantly lower odds of experiencing catatonia than those not using at all. Furthermore, patients who elicited depressive symptoms with psychotic features prior to catatonic symptoms onset had significantly higher catatonia rating scale (CRS) than those with psychotic symptoms. Also, patients with malignant catatonia showed significantly higher CRS than those with retarded catatonia.

Conclusion

The prevalence rate of catatonia was 4.4%. There are several socio-demographic and clinical correlates affecting the prevalence and the severity of catatonia
Orthorexia Nervosa and its Association with Obsessive Compulsive Personality Disorder in a Sample of Egyptian Medical Students
Authors: Essawy Heba Ibrahim , ElGhonemy Soheir Helmy , Mohamed Mohamed Youssef , Kasem Rania elsayed , AbouEl-leil Dina Hussein Mohamed
Published: November 2024

Background

To our knowledge, ON correlation with OCPD has been recently investigated, with many studies supporting a relationship between them, either being a risk factor or a common co-occurrence, which is considered an important contribution to the field of mental health and eating disorders research.

Objective

To measure the prevalence of Orthorexia Nervosa in a sample of Egyptian medical students, to measure the prevalence of Obsessive-Compulsive Personality Disorder in the study sample, to study the association between Orthorexia Nervosa and Obsessive-Compulsive Personality Disorder in the study sample, and to compare the prevalence of ON and OCPD among students in academic years and clinical years of medical school.

Methods

This study is a comparative observational cross-sectional study that included 427 medical students will be assessed for orthorexia nervosa symptoms and OCPD traits, conducted between February 2023 and august 2023 in Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Results

Orthorexia nervosa had prevalence of (8.7%), tendency (10.8%), with mean (18.1±7.2) which is consistent with prevalence in general population of (7%). There was no correlation between mean age, BMI, gender and orthorexia. The differences were statistically significant between third and fourth grade, yet DOS score was non-significantly higher in academic than clinical grades. OCPD prevalence was (42.2%) - (64.9%), which is higher than general population of (6.5%). OCPD results were significantly higher in academic than clinical grades. ON was significantly correlated to OCPD scores on both PDQ-4 and PID-5, and had significant positive correlations with rigid perfectionism, Intimacy avoidance, perseveration traits.

Conclusion

Our study showed that Orthorexia Nervosa is significantly higher in patients with obsessive compulsive personality disorder in comparison to negative participants. Furthermore, prevalence of orthorexia showed no correlation to either gender or BMI or study year of the patients. Obsessive compulsive personality disorder is significantly higher in academic than clinical grades of medical school.
Domestic Violence among Female Psychiatric Patients in Ain Shams University Hospitals
Authors: Abdel-Samei Afaf Mohammad , Mohamed Hashem Reem El-Sayed , Mohammad Rehab Serag , Mohammad Doaa Ibrahim Eid
Published: November 2024

Background

Domestic violence can be defined as “any incident of threatening behavior, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been an intimate partner or family member, regardless of gender or sexuality” and is one of the most common forms of interpersonal violence internationally.

Objective

To assess the rate of domestic violence in a sample of female psychiatric patients. To assess the correlation between domestic violence and sociodemographic and clinical correlates.

Patients and Methods

Study was conducted in outpatient psychiatric services in Okasha institute of psychiatry Ain Shams University Hospitals. Ain Shams University is in Cairo and serves a catchment area of about the third of Greater Cairo. It serves both urban and rural areas, including areas around Greater Cairo as well. (Clinics are Saturday, Sunday, Wednesday, and Thursday of each week).

Results

There was significant correlation between exposure to all subtypes of violence (emotional, physical, severe combined abuse, and harassment) and different psychiatric illnesses. Exposure was more to emotional abuse (85.5%), then physical abuse (67%), followed by severe combined abusr (65.5%), and then harassment (45.5%). It was found that there was significant correlation between exposure to severe combined abuse and exposure to physical abuse with different psychiatric diagnoses with P-value of < 0.001 in all of them. Similarly, there was significant correlation between exposure to emotional abuse and different psychiatric illnesses with P-value of 0.001. There was also significant correlation between exposure to harassment and different psychiatric illnesses with P-value of 0.036.

Conclusion

Our study concluded significant correlation between different psychiatric illnesses and exposure to domestic violence.
Demographics and Clinical Assessment of Familial Multiple Sclerosis Patients in Ain Shams University Hospitals
Authors: Abdelaziz Azza Abdel Nasser , ElSayed Lobna Mohammed ElNabil , Swelam Mahmoud Saad , Eldin Nouran Mohammed Salah , Hamada Hadeer Samir Ahmed
Published: November 2024

Background

Multiple sclerosis (MS) is the most seen demyelinating disease. The exact cause of MS is still uncertain; many genes significantly increase the disease susceptibility along with several well-defined environmental factors. Genetic factors play an important role in the pathogenesis and clinical presentations of MS.

Aim of the Work

This study aims to detect the prevalence of familial multiple sclerosis among Egyptian patients suffering from MS at Ain Shams University hospitals, to register the demographics and the clinical characteristics of familial multiple sclerosis patients and to demonstrate the effect of inheritance on the severity and progression.

Patients and Methods

This study aimed to detect the prevalence of familial multiple sclerosis among Egyptian patients suffering from MS at Ain Shams University hospitals, to register the demographics and the clinical characteristics of familial multiple sclerosis patients and to demonstrate the effect of inheritance on the severity and progression. The current study showed that the prevalence of familial multiple sclerosis among MS Egyptian at Ain Shams University hospitals was 6,4%. Female to male percentages were found to be (73.8%) to (26.2%) respectively.

Results

The mean age of onset among the FMS cases was found to be (26.1±7.8). The mean time elapsed between symptoms onset and diagnosis was found to be (19.9±34.0) months and it was found that time from disease onset to MS diagnosis is significantly shorter in the 2nd and 3rd family-members diagnosed in familial cases compared to 1st family member diagnosed with MS. Regarding focality of presentation at the first attack, in this study there was found that monofocal presentation was more common than multifocal presentation (64.4%). The current study also showed that affection of the pyramidal functional system is significantly the most frequent in cases with an affected relative of first degree while it was least frequent in cases with an affected relative of third-degree consanguinity. Sensory affection in the first attack was the most common functional system affected. Most of the familial MS cases showed relapsing remitting pattern of the disease (76.6%) that was followed by SPMS (20.9%) and the least frequent form was PPMS (2.3%) with no significant relation between the degree of consanguinity between the relatives affected within the same family and the pattern of progression of the disease.

Conclusion

The number of exacerbations per year in the studied cases was 0.9±0.8 and the mean MSSS of the studied cases was (4.9±2.5) and there were significant agreement between type in cases and relatives indicating that the presence of a family member diagnosed with a certain MS clinical phenotype can be a predictor to the clinical phenotype in the patient calling for special consideration to the choice of treatment for the patient.
Impulsivity in Euthymic Patients with Unipolar and Bipolar Disorders
Authors: Okasha Tarek Ahmed , Missiry Marwa Adel El , Mohamed Mohamed Youssef , Aboshahin Heba Ashraf Wageh
Published: November 2024

Background

There is marked interest to research to find out the differences between unipolar and bipolar depression. Consequently we aimed to study impulsivity in euthymic unipolar and bipolar patients to find any difference.

Aim of the Work

Comparing impulsivity in euthymic major depressive and bipolar patients and healthy controls, to find out if these two different disorders have different impulsivity profiles. To find any clinical correlation with impulsivity scores in unipolar and bipolar patients.

Subjects and Methods

It is a cross sectional case-control study of 50 euthymic unipolar and bipolar patients and25 matched healthy controls. They were subjected to: Structured Clinical Interview for DSM-IV disorders, (SCID-I) to ascertain clinical diagnosis, Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HRSD) to validate euthymia. Barratt impulsiveness scale. Also general health questionnaire is applied for controls to exclude any psychiatric disorder and an information sheet gathering patient data was done.

Results

Regarding barratt impulsiveness subscales, the most affected group with non-planning impulsivity was unipolar depression group with Mean± SD (29.88±3.94). while regarding attentional impulsivity, unipolar and bipolar depression groups were similarly affected with Mean± SD (19.4±3.8). While regarding motor impulsivity the most affected group was bipolar depression group with Mean± SD (30.56±4.49).

Conclusions

Analysis of Barratt impulsiveness scale in our study revealed that the unipolar and bipolar groups scored almost the same on total impulsivity measures. The most affected group with non-planning impulsivity was unipolar depression group while regarding motor impulsivity, the most affected group with motor impulsivity was bipolar depression group. Regarding attentions impulsivity, unipolar and bipolar depression groups were similarly affected.
Clinical, Radiological and B Cell Count Follow Up of Egyptian Patients with Neuromyelitis Optica Spectrum Disorder on Rituximab Therapy
Authors: Masoud Janet , Nasser Azza Abdel , Saleh Rasha Mamdouh , Zamzam Dina A , Fouad Mohamed M , Abdel Hafeez Mohamed A
Published: November 2024

Background

Neuromyelitis optica spectrum disorder is an uncommon chronic inflammatory disease of the central nervous system, manifesting clinically as optic neuritis, myelitis, and certain brain and brainstem syndromes. Rituximab targets the CD20 antigen on B-cells and leads to profound B-cell depletion, principally over an antibody-dependent cell cytotoxicity mechanism and decreases attack frequency and severity in patients with NMOSD. This study aimed to assess the correlation between clinical, radiological findings and the count of peripheral circulating B cells (CD 19) during rituximab treatment over 12 months. It included 15 Egyptian adult patients diagnosed with NMOSD.

Results

There was a predominance of women with female: male ratio 2:1. AQP4- IgG antibody was detected in 65% of the patients. The mean age was 36.47 years, mean duration of illness was 3.71 years. MRI of brain showed no abnormality in 82% of patients. Cord MRI showed single lesion in 59% and multiple lesions in 41%. Visual evoked potential showed that most of patients have optic nerve affection either unilateral or bilateral. Median CD19 B cell percentage depleted significantly from 7.3 to 0.2 after treatment. No serious adverse event was encountered in our patients; 35% developed either hypersensitivity or mild infections.

Conclusion

The effect of rituximab treatment on B cells has no correlation with clinical or radiological outcome of patients.
The Relationship between Multiple Sclerosis Relapse Recovery and Blood Glucose Response to Intravenous Methylprednisolone
Authors: Abd El-Aziz Azza Abd El-Nasser , Nassef Ayman Mohamed Ahmed , El- Hafeez Mohammed Aly Abd , Michael Joseph Francis Gerges
Published: November 2024

Background

The study investigated the relationship between random blood sugar (RBS) levels and clinical outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) following intravenous methylprednisolone (IVMP) treatment.

Objective

Determine the relationship between blood glucose level during intravenous methylprednisolone (IVMP) treatment and the degree of motor & cognitive recovery afterwards in relapsing remitting multiple sclerosis patient.

Subjects and Methods

This observational analytical prospective study was conducted on 40 patients with relapsing remitting multiple sclerosis (RRMS) at Nasr city hospital of health insurance – Ain Shams University Hospital between May 2022 and November 2022. The study population was adults with confirmed diagnosis of relapsing-remitting multiple sclerosis who are currently experiencing a relapse. Patients with other neurological diseases, cognitive disorders, diabetes, certain medications, learning disabilities, or who are pregnant or using hormone replacement therapy are excluded. The study tools for this study include a clinical assessment of MS patients, the use of the Expanded Disability Status Scale (EDSS) to assess motor deficit, the use of the Symbol Digit Modalities Test (SDMT) to assess cognitive function, and the measurement of fasting blood glucose. The purpose of these study tools is to assess the effects of IVMP induced hyperglycemia on motor & cognitive relapse recovery in relapsing remitting multiple sclerosis patients.

Results

The study sample included 40 patients with definite RRMS, and the primary outcome measure was EDSS. The study found that hyperglycemia may be a potential predictor of poor treatment response in MS patients. The study also identified cut-off values for RBS levels that can predict the probability of recovery after IVMP treatment. The significant relationship between older age of onset and poorer SDMT performance supports previous research that has found age to be a risk factor for cognitive decline in MS. Similarly, the significant relationship between longer duration of illness and poorer SDMT performance is consistent with previous studies that have found disease duration to be a predictor of cognitive impairment in MS.

Conclusion

The present study provides further evidence of the association between hyperglycemia and poor outcomes in patients with RRMS following IVMP treatment. The findings suggest that RBS levels may be a useful prognostic marker for predicting cognitive and functional outcomes in MS patients. Clinicians should consider monitoring and managing RBS levels in MS patients to optimize treatment outcomes. However, further studies are needed to elucidate the underlying mechanisms and to determine the optimal cut-off values for RBS levels in predicting MS outcomes.
Effect of Dalfamperidine on Cognitive Impairment, Gait Disorders and Fatigue in Multiple Sclerosis Patients
Authors: Abdeldayem Mai , Shalash Ali , Hamid Eman , Abusteit Alaa , Hamed Salma , Nasser Azza Abdel
Published: November 2024

Background

Multiple sclerosis (MS) is one of the most common disabling diseases of the Central Nervous System (CNS) especially during early adult life. Walking impairment is considered one of the most disabling symptoms to patient with MS. The only approved treatment for impaired ambulation in MS is Dalfampridine.

Objective

To investigate the effect of dalfampridine on gait, cognitive functions and fatigue in Egyptian patients with multiple sclerosis.

Methods

This randomized double blinded placebo-controlled study was conducted on 100 patients with multiple sclerosis undergoing assessment for cognition, gait and fatigue.

Results

Baseline characteristics of dalfampridine group significantly showed more infratentorial lesions in MRI and lesser use of symptomatic treatment compared to placebo group. Along with visuospatial functions that was better in placebo group and even though this current study showed significant improvement in dalfampridinegroup better than placebo as concluded by increased endpoint (mean difference) between two groups.

Conclusions

dalfampridine may has role in improvement of total EDSS.
Evaluation of Serum Magnesium Level in a Sample of Egyptian Major Depressive Disorder Patients
Authors: Okasha Tarek Ahmed , Elserafi Doha Mostafa , Naguib Rehab Mohamed , Dessouki Nahla AbdelRahim , Abdelhadi Mariam Abdelhamid
Published: November 2024

Background

Major depressive disorder (MDD); is a leading psychiatric illness across the world, severely affecting quality of life and causing an increased incidence of suicide, although its underlying pathophysiology is still unclear and recently multiple studies were concerned with the relation between serum Magnesium (Mg) level and MDD. Mg is a cofactor for over 300 enzymes and is essential for anaerobic and aerobic energy production, glycolysis, mitochondrial oxidative phosphorylation, as well as potassium and calcium regulation. Moreover, Mg has significant antidepressant action through the blockade of the glutamatergic N-methyl-D-aspartate receptor (NMDAR).

Aim of the Work

To examine serum Mg level in patients of MDD, to evaluate the relation between serum Mg level and MDD, to correlate serum Mg level to severity of symptoms of MDD.

Patients and Methods

30 patients were included, selected from inpatient ward and outpatient clinics at Okasha institute of psychiatry, neuropsychiatry department, faculty of medicine, Ain Shams University and fulfilled the criteria of diagnosis of MDD by Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and 30 healthy controls who were age and sex matched, selected from workers at Okasha institute of psychiatry, Hamilton depression scale (Ham-D 17) was used for assessment of severity of depressive symptoms in patients, in addition a sample of 2 ml blood was withdrawn from both groups for assessment of serum Mg level using Serum Mg colorimetric assay kit.

Results

Our study showed that there was non-significant difference as regards the age and gender between the two groups, on the other hand there was significant difference between the patients and controls regarding the serum Mg level (p = 0.015) denoting that MDD patients had lower serum Mg level than healthy controls, with statistically significant inverse correlation between serum Mg level and the severity of depression (p = 0.001).

Conclusion

The findings in our study highlight that MDD patients had lower serum Mg level than healthy controls with a significant inverse correlation between serum Mg level and the severity of depression.
Optic Nerve Diameter and Elevation in Acute Large Stroke Patients
Authors: Aloush Taha Kamel Taha , Khawas Hala Mahmoud El , Zakey El Din Hany Mahmoud , Mahmoud Afifi Hossam El Din , Farag Borham Sherien Mohamed , Ahmed Ali Hassab-Allah Mennat-Allah Mohamed
Published: November 2024

Background

Elevated intracranial pressure (ICP) is a potentially devastating condition resulting from various neurological and non-neurological disorders.

Aim of the Work

To assess the correlation between optic nerve diameter, optic disc elevation and increased intracranial tension due to intracranial heamorrhage or large stroke and to compare it with control group.

Patients and Methods

This study was conducted on 51 patients diagnosed with acute large stroke, admitted in stroke unit neurology department at Ain Shams university hospitals and 56 Controls diagnosed with lacunar stroke or healthy individuals age and sex matched.

Results

A significant positive correlation between Peak systolic velocity and both optic disc elevation and optic nerve sheath diameter. There was also significant positive correlation between Pulsatility index and optic nerve sheath diameter while there was no significant correlation between the Pulsatility index and optic disc elevation. A significant positive correlation between NIH stroke scale and both optic disc elevation and optic nerve sheath diameter. There was also significant positive correlation between Size of infarction and both optic nerve sheath diameter and optic nerve sheath diameter.

Conclusion

Increase in ONSD measurement was associated with increased hospital mortality and poor functional outcomes at 6 months. ONSD measurements may be performed using just one eye and one probe orientation to make the serial examinations easier to adopt and perform. ONSD may be used to screen stroke patients at risk of poor prognosis, especially when used in conjunction with abnormal clinical examination and CT imaging.
Prevalence of CSF Dysregulation Related Headache Disorders among Headache Patients: A Hospital-Based Study
Authors: Moustafa Ramez Reda , Farag Sherien Mohamed , Swelam Mahmoud Saad , Ibraheem Hassab Rehab Mennatallah Mohamed
Published: November 2024

Background

Headache is one of the most common disorders of the central nervous system and causes multiple levels of dysfunction. One of the most underestimated types of headaches is headaches due to CSF dysregulation disorders either idiopathic intracranial tension or spontaneous intracranial hypotension.

Aim of the Work

Measurement of the prevalence of CSF dysregulation-related headaches in a hospital- based headache population, assessment of the demographic data of a group of headache patients, assessment of the correlation between CSF dysregulation headache and BMI, assessment of the correlation between CSF dysregulation-related headache and fundus examination, assessment of the correlation between CSF dysregulation-related headache and MRI brain& MRV findings and assessment of the correlation between IIH and optic nerve sheath diameter ONSD assessment by trans orbital sonography TOS.

Patients and Methods

In our observational study, conducted between 1 November 2022 and 30 April 2023, at the headache clinic of Ain Shams University hospitals, we studied the prevalence of IIH among the headache population, demographic characteristics, sleep quality, MRI brain findings suggestive of IIH, fundus examination, opening pressure reading values, and efficiency of USG in the evaluation of patients with IIH.

Results

Among the 168 headache patients, IIH prevalence came out to be 30.35%, IIH patients had higher age, with site of headache being vertical in most of cases, higher BMI, with the character of headache being throbbing in most cases. We found that the empty sella turcica sign has a sensitivity of 41.2%, specificity of 98.9%, transverse sinus stenosis sign has a sensitivity of 82.4%, specificity of 88.8%, posterior globe flattening sign has a sensitivity of 21.6%, specificity of 100.0%, Optic nerve head protrusion sign has a sensitivity of 27.5%, specificity of 98.9%, Optic nerve sheath distention, tortuosity sign has a sensitivity of 43.1%, specificity of 96.6% in the detection of IIH cases. Also, it shows that fundus examination has a sensitivity of 52.9%, specificity of 96.6%, in detection of IIH cases. Also, optic nerve sheath diameter assessment through sonography has sensitivity of 66.7%, specificity of 26.7%.

Conclusion

Our study estimated the prevalence of CSF dysregulation headache disorder among headache patients showing that 30.35% of the included patients fulfilled the diagnostic criteria for IIH whereas 69.64% did not. We highlight the importance of neuroimaging signs in IIH as empty sella turcica sign, transverse sinus stenosis sign, flattening of the posterior aspect of the globe, optic nerve head protrusion sign, and optic nerve dilation and tortuosity sign were highly associated with IIH and elevated OP.
Safety and Efficacy of Combined Thrombolysis and Thrombectomy in the Extended Time Window of Acute Ischemic Stroke
Authors: Hashim Mostafa , Aref Hany , El-Bassiouny Ahmed , El-Sudany Ayman H , Abushady Eman M , Zaki Amr S
Published: November 2024

Background

Endovascular thrombectomy (EVT) is the standard of care for proximal anterior circulation acute ischemic stroke. (1) Treatment with intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MT), known as bridging therapy, is recommended for candidate patients within 4.5 hours therapeutic window. (2) Updated guidelines from the American Stroke Association extended the time limit of mechanical clot removal from 6 hours to up to 24 hours in selected patients . (3) In this study, we plan to focus on treatment with intravenous thrombolytic therapy prior to endovascular thrombectomy in the extended time window beyond 4.5 hours with safety and efficacy concerns.

Methods

50 large vessel occlusion (LVO) stroke patients presenting in the extended time window of 4.5-9 hours were enrolled in the study divided into two groups, the first received IV thrombolysis before mechanical thrombectomy, the 2nd underwent mechanical thrombectomy only. Assessment was done using NIHSS, mRS, collaterals score, Thrombolysis In Cerebral Ischemia (TICI) score, and Heidelberg bleeding classification for hemorrhagic transformation.

Results

there was difference between the two groups regarding NIHSS, mRS, first pass effect and hemorrhagic transformation.

Conclusion

IV thrombolysis before mechanical thrombectomy can have an effect on outcome of LVO stroke patients presenting in the extended time window.
The Impact of Family Relations on a Sample of Egyptian Patients with Substance Use Disorder
Authors: El-ella Eman Ibrahim Abo , Elsheikh Mona Mahmoud , Ghamry Reem Hassan El , Ghobrial Phoebe Fayez , El-Maseh Sara Rafat Abd
Published: November 2024

Background

Substance use disorders (SUD) present a complex condition characterized by uncontrolled substance use despite adverse consequences, often intertwined with social and family problems. Dysfunctional family relationships, including violence, stress, parental drug use, and poor communication, have been linked to adolescent drug use. The current study investigates the association between family relation dysfunction and substance use, aiming to understand the quality of this connection.

Aim of the Work

This case - control study aims to examine the relationship between family relations and substance use, assessing the impact on the type and severity of substance abuse. Specific objectives include exploring the association between family dysfunction and SUD, comparing family interaction in SUD patients and normal individuals, and evaluating variations in family interaction based on sociodemographic factors.

Patients and Methods

Seventy participants, comprising 35 SUD patients and 35 healthy controls, were recruited from EL-Abbsia Mental Health Hospital. Participants were assessed using socio- demographic data sheets, Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Quality of Family Relationships Scale (KOBI), and Addiction Severity Index. Urine tests were conducted for psychoactive substances. Statistical analysis involved various tests, including t-tests, Mann-Whitney, chi-square, and correlation analyses.

Results

The study revealed a significant prevalence of smoking among SUD patients compared to controls, along with longer smoking duration and higher daily cigarette consumption. SUD patients exhibited increased medical issues and higher incidences of substance use, particularly cannabis and heroin. Family rejection and non-acceptance were significantly higher in SUD cases, correlating with the severity and duration of substance abuse.

Conclusion

The findings underscore the significant connection between family relationship dysfunction and substance use. Rejection and non-acceptance within the family environment emerge as crucial predictors of addiction. The study highlights the need for comprehensive interventions addressing family dynamics in substance abuse treatment.
Sexual Dysfunctions and Psychiatric Correlates among a Sample of Egyptian Female Patients with Ischemic Heart Diseases Following Percutaneous Coronary Intervention
Authors: Wahba Shenouda Abdelshahid , Sayed Maha Mohammed , Rahman AL-Moghazi Marwa Abdel , Mohamed Mariam Yehia , Saber Hafez Mohamed
Published: November 2024

Background

Female sexual dysfunction is a wide range of illnesses that can affect a patient's capacity to respond to or enjoy sexual activity in orgasm, interest/arousal, or Genito-pelvic pain/penetration which occurs most of the time and represents a problem to the patient (in DSM5 TR).

Aim of the Work

To assess the correlation between ischemic heart disease and female sexual function in patients who underwent percutaneous female intervention in the last year. To study the risk factors of female sexual dysfunction after percutaneous coronary angiography in group 1. To assess the correlation between ischemic heart disease and depression, anxiety and post-traumatic stress disorder in patients who underwent percutaneous female intervention in the last year

Patients and Methods

This study is a comparative cross-sectional study. This study conducted at cardiology outpatient Clinics at Ain Shams University Hospital. Ain Shams University is in Cairo and serves a catchment area of about the third of Greater Cairo. It serves both urban and rural areas, including areas around Greater Cairo as well. The Study period from March 2023 till end of the study.

Results

Both groups showed 100% of cases have sexual dysfunction regardless undergoing intervention or not with no statistical difference between both group neither regarding the total score or each domain score and this may be explained by presence of worsening factors in both groups like presence of chest pain, most of patients are menopausal (60% in each group) with the most important factors seen in our study is the cultural concepts among women to have sexual relation in presence of chronic disease like ischemic heart disease and this has been shown when looking deeply in the patients we will found 7 patients (23.3%) who underwent the intervention scored only 2 in FSFI total score which is the minimal (indicating lack of any sexual activity in spite of presence of partner) with the same number seen in the group which didn’t undergo the intervention this rate of having sexual activity.

Conclusion

Comprehensive examination of the impact of sexual dysfunction, PTSD, depression, and anxiety in patients with ischemic heart disease, and how these factors interrelate with each other as well as with the intervention of stenting or angioplasty. The finding that sexual dysfunction is universally present across your study groups, regardless of intervention, underscores the complexity of sexual health in the context of chronic diseases.