bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation the Role of Serum Epidermal Growth Factor Like Domain 7 as a New Non-Invasive Diagnostic Marker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients
Authors: Ibrahim El-Baz Hossam Samir , Mostafa Elsayed Mohamed Abdelmoghny , Fahmy Abdelmeged Mohamed Lotfy , Hassan Abdullah Amr Salah
Published: November 2024

Background

Hepatocellular carcinoma (HCC) is a significant global health concern, ranking as the sixth most common cancer worldwide. In Egypt, it is the fourth most prevalent malignancy. The rising incidence of HCC has been attributed to advancements in screening programs, improved diagnostic tools, increased survival rates in cirrhotic patients, and a higher prevalence of hepatitis C virus (HCV) infections.

Objective

Point this study is to assess job serum epidermal development factor like space 7 as a demonstrative marker in HCC Egyptian cirrhotic patients.

Methods

A total of 90 subjects were enrolled in this study, categorized into two groups: Group A (HCC), comprising 45 patients with Hepatocellular carcinoma, and Group B (Cirrhotic), comprising 45 patients with liver cirrhosis without HCC. The study subjects underwent history taking, physical examination, routine laboratory tests, measurement of AFP and EGFL7 levels, and radiological evaluations.

Results

EGFL7, a molecule with signaling and EGF-like domains, was significantly upregulated in HCC tissues compared to cirrhotic tissues. High EGFL7 expression was associated with adverse clinicopathological features and poor prognosis in HCC patients. The study demonstrated that EGFL7 exhibited higher diagnostic performance in distinguishing between cirrhosis and HCC compared to AFP. Moreover, EGFL7 levels were positively correlated with the Child-Pugh score and the size of hepatic lesions in the HCC group.

Conclusion

This research highlights that serum EGFL7 is substantially elevated in HCC patients, particularly those with co-existing conditions such as diabetes, hypertension, or viral markers. EGFL7 emerges as a more sensitive and accurate marker than AFP for early HCC detection. Incorporating EGFL7 into diagnostic algorithms could enhance the effectiveness of surveillance programs for early HCC detection, ultimately leading to improved clinical outcomes and patient management.
Effect of Pentoxifylline on Inflammatory Marker in Non-Diabetic Chronic Kidney Disease Patients
Authors: Mohamed Basant Abdelkarim Eid , Hebah Hayam Ahmed , AbdelMobdy Ashraf Hassan , Ahmed Fatma Abdelrahman , Ezzat Mohamed Ali
Published: November 2024

Background

Chronic kidney disease is a progressive condition that affects >10% of the general population worldwide, amounting to > 800 million individuals in 2017. CKD has emerged as one of the most prominent causes of death and suffering in the 21st century.

Aim of the Work

To assess the effect of pentoxifylline on inflammatory marker and Chronic Kidney Disease progression in non- diabetic chronic kidney disease.

Patients and Methods

The current study design was a prospective, interventional, open- label, randomized controlled clinical trial conducted on adult patients with Chronic Kidney Disease at the outpatient clinics of AinShams University hospital, Cairo, Egypt, from the start of February (2023) to the end of July (2023).

Results

TNF-alpha, CRP, UPCR, and GFR were measured at baseline and after a six-month follow-up period. TNF-alpha and CRP levels were determined using enzyme-linked immunosorbent assay (ELISA) kits, while UPCR was calculated by dividing the urinary protein concentration by the urinary creatinine concentration. GFR was estimated using CKD-EPI. The results of this study showed a significant decrease in CRP levels in group 2 compared to group 1, indicating a greater reduction in systemic inflammation with the addition of Pentoxifylline. Similarly, UPCR decreased significantly in group 2, suggesting a beneficial effect of Pentoxifylline on proteinuria. In contrast, there was no statistical difference in the reduction of TNF-alpha levels between the two groups, although both groups exhibited a significant decrease in TNF-alpha. Furthermore, there was no significant difference in GFR changes between the two groups.

Conclusion

The addition of pentoxifylline to the standard therapy in non-diabetic CKD patients resulted in a significant reduction in CRP levels and proteinuria, indicating its potential as an adjunctive treatment to mitigate inflammation and proteinuria. However, no significant difference was observed in the reduction of TNF-alpha levels or GFR changes between the two groups. These findings suggest that pentoxifylline's anti-inflammatory effects may be mediated through pathways other than TNF-alpha inhibition. Further research is warranted to explore the underlying mechanisms and optimize the use of pentoxifylline in the management of CKD patients.
Musculoskeletal Ultrasound Findings in First Degree Relatives of Rheumatoid Arthritis Patients
Authors: Ibrahim Hassanien Bassant Megahed , EL Hefny Abdelazim Mohamed , Morad Caroline Samy , Aly Hussein Safaa Abdelsalam , Mohamed Abdelkader Mohamed Rizk
Published: November 2024

Background

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease that primarily targets synovial joints. Retrospective analysis of individuals who ultimately developed RA have shown RA autoantibodies such as rheumatoid factor (RF) and anticitrullinated protein antibodies (ACPA) develop months to years prior to the onset of clinically evident synovitis. So there has been increasing interest in identifying individuals at risk for future development of RA, with the hope of intervening to prevent the onset of disease.

Aim of the Work

To detect the presence of early synovitis (preclinical stage of RA) among healthy first degree relatives of RA patients by MSUS and its correlation to serological markers.

Patients and Methods

This was a cross sectional study which was conducted on 60 subjects with high risk of developing arthritis; healthy first degree relatives (FDR) of RA patients classified according to ACR/EULAR 2010 criteria. It was carried out at Ain Shams University Hospital. All patients were recruited from Rheumatology outpatient clinic and the inpatient department of Ain Shams University Hospital.

Results

The study included subjects aged 16 to 55 years, predominantly female, with a mean BMI of 26.44 kg/m². Rheumatoid arthritis (RA) duration ranged from 1 month to 30 years, averaging 6.96 years. Among familial disease relatives (FDRs), 78.3% were nonsmokers. Arthralgia was common (58.3%), with varied joint involvement. Laboratory findings showed elevated ESR and CRP levels. Wrist and MTP-II joints were most frequently affected on ultrasound. A 7-joint ultrasound score (US7) was developed for efficient rheumatological evaluation.

Conclusion

This cross-sectional study aimed to assess preclinical synovitis by musculoskeletal ultrasound (MSUS) in first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients and its correlation with laboratory findings. We found a prevalence of 51.6% for MSUS positive findings, primarily synovitis. ESR was significantly higher in FDRs with positive MSUS findings. RF showed the highest positive predictive value (75%) for MSUS positivity. Clinical arthralgia exhibited the highest sensitivity (58%). Our study underscores the potential of combining RF, Anti-CCP, and clinical arthralgia in predicting preclinical synovitis in at-risk populations, facilitating early intervention strategies.
Study the Role of Cadherin-11 as a Novel Biomarker of Kidney Fibrosis
Authors: Gaafar Ghada M , Abdelwahab Saeed , Aref Hayam , Salman Manal , Khedr Abdelrahman , Elbraky Abdelrahman
Published: November 2024

Introduction

Kidney fibrosis constitutes the shared final pathway of all chronic nephropathies and it is attributed to the pathologic deposition of ECM components in response to chronic injury. Biopsy is the gold standard diagnostic tool but it is invasive and has some limitations. CDH-11 is an excellent non- invasive biomarker of kidney fibrosis.

Objectives

To measure serum CDH-11 among patients indicated for native kidney biopsy correlating its levels with IFTA score of kidney biopsy to investigate its sensitivity and specificity as a biomarker of kidney fibrosis.

Patients and Methods

This cross sectional study comprised 100 patients clinically indicated for native kidney biopsy. All of them were subjected to measurement of serum CDH-11 on the day of biopsy. This study was carried out in Ain Shams university and Ain Shams university specialized hospitals.

Results

Median of CDH-11 was 3.9 (2.2–7.6), it was significantly higher in cases with Arteriosclerosis with p-value <0.001, also it was highest in grade -3 followed by 2 fo1lowed by 1 then zero of all chronicity grading scale points (Global and segmental, Tubular atrophy and interstitial fibrosis) with p-value <0.001, Consequently it was highest in severe, followed by moderate, then mild, and lowest in minimal IFTA with (Median 12.0 (7.6–16.0), 6.1 (4.4–7.7), 3.5 (2.2–4.6), 1.2 (0.5–2.6) respectively. The area under the curve was 0.645 and the best cut-off level was ≥5.6 ng/dl (90.9% sensitivity, 71.8% % specificity).

Conclusion

CDH-11 is highly sensitive and specific marker in patients with kidney fibrosis and its level can predict degree of fibrosis in different causes of kidney disease.
Sofosbuvir, Velpatasvir and Voxilaprevir for Treatment of Chronic Hepatitis C Virus Patients Non-Responder to Previous Sofosbuvir-Daclatasvir Therapy
Authors: Ghareeb Hassan A , Kamal Maha M , Anwar Christina A , Saad Ahmed Mohamed A , Abdel-Mageed Hala M
Published: November 2024

Background

Egypt is one of the countries with a high HCV burden; the percentage of HCV antibody positivity is 4.61 % of Egyptian general population. The advent of oral direct-acting antivirals (DAAs), as a treatment for chronic hepatitis C (CHC), has revolutionized the field with obvious safety and efficacy privileges. Despite the high rates of SVR achieved with DAAs, HCV is not eliminated from a considerable proportion of patients (1-15%). So, a new problem has emerged which is the need for re-treatment of patients who couldn’t be cured with DAAs in the first instance.

Aim of the Work

to evaluate the efficacy of sofosbuvir, velpatasvir, voxilaprevir for previously DAA-(Sofosbuvir–Daclatasvir)-treated Egyptian patients who failed to achieve SVR after their treatment.

Patients and Methods

This study was performed in Ahmed Maher Teaching Hospital, Cairo, Egypt, Internal Medicine Department. The study included 139 patients with chronic hepatitis C Non- responder to Previous Sofosbuvir-Daclatasvir Therapy. Patients enrolled in the study were prospectively evaluated as outpatients by the study staff at 4, 8, 12 weeks and at 12 weeks post-treatment. All the patients were subjected to history taking, clinical examination, complete biochemical and virological studies.

Results

The overall treatment outcome: there was a statistically highly significant difference in PCR before treatment (100%+ve) and after treatment (97.1%-ve) 3 month after treatment. Throughout the study, most of the patients were responders (97.1% achieved SVR 12).

Conclusion

Rescue therapy with SOF/VEL/VOX is safe and highly effective, for treatment of chronic hepatitis C virus patients non-responder to previous Sofosbuvir-Daclatasvir therapy achieving SVR12 rates 97.1%.
Assessment of Nutrition Risk in Patients with Inflammatory Bowel Disease
Authors: Ibrahim Wesam Ahmed , Ali El-Gaaly Sonya Ahmed , Ahmed Elessawy Hagar Ahmed , Mousa Mahmoud Ali
Published: November 2024

Background

Inflammatory Bowel Disease (IBD), encompassing Crohn's disease, ulcerative colitis, and related disorders, presents a significant challenge as a chronic inflammatory condition affecting the gastrointestinal tract. Malnutrition is a prevalent and often overlooked complication in IBD patients, contributing to poor clinical outcomes.

Aim of the Work

This study aimed to assess the prevalence of malnutrition and nutritional risk among IBD patients attending or admitted to the gastroenterology unit at Ain Shams University Hospital and to evaluate the effectiveness of the SaskIBD-NR tool in identifying patients at risk.

Patients and Methods

A cross-sectional study involving 100 diagnosed IBD patients was conducted. Data regarding demographics, disease characteristics, unintended weight loss, and nutritional risk were collected. The SaskIBD-NR tool was employed to assess malnutrition risk.

Results

The study revealed a notable prevalence of malnutrition and nutritional risk among IBD patients, with a considerable proportion experiencing unintended weight loss. The SaskIBD-NR tool showed promise in identifying patients at nutritional risk, with a significant correlation observed between SaskIBD-NR scores and body mass index (BMI).

Conclusion

Malnutrition is a common issue in IBD patients, affecting clinical outcomes and quality of life. Routine screening for malnutrition using tools such as SaskIBD-NR can aid in early identification and intervention, potentially improving patient outcomes and reducing healthcare burdens.
Effect of Ascorbic Acid Alone versus Combined Ascorbic Acid with Iron Supplement in Management of Functional Iron Deficiency Anemia in Hemodialysis Patients
Authors: Shenouda Hanna Maria Hanna , Baky Aber Halim , Eldin Zaki Mohamed salah , Mansour Amr Mohamed
Published: November 2024

Background

Anemia is a prevalent symptom of ESKD and is associated with an increased risk of hospitalization and mortality. Anemia is defined as a lack of erythropoietin production, decreased red blood cell survival, and blood loss from the dialysis circuit.

Aim of the Work

The goal of this study is to determine the efficacy of oral ascorbic acid (AA) in treating anemia in persons with ESKD who also have elevated ferritin levels.

Patients and Methods

50 patients with early-stage kidney disease (ESKD) who underwent standard HD were divided into two groups: group A (25 patients) received oral ascorbic acid 250 mg once daily for six months along with iron supplementation, while group B (25 patients of the same age and sex) received oral ascorbic acid without iron supplementation.

Results

Group A (combined vitamin C and iron) exhibited considerably increased transferrin saturation after 3 and 6 months of treatment. At 3 and 6 months following treatment, transferrin saturation increased in individuals in Group A (combined vitamin C and iron) compared to baseline.

Conclusion

The current study's findings suggest that anemia is a common concern among ESRD patients, particularly those on hemodialysis. Iron and vitamin C can be used together to treat iron deficient anemia more effectively.
Association between Chronic Kidney Disease and Non-Alcoholic Fatty Liver Disease: A Cross Sectional Study
Authors: Baioumy Essam Mohammed , Elgaaly Sonia Ahmed , Fathallah Ahmed Magdy , Bebawy Marina Maurice
Published: November 2024

Background

The concept of chronic kidney disease (CKD) continues to evolve from a common pathway initiated by unrelated diseases into a number of complications and adaptations that affect the function of every organ. Non-alcoholic fatty liver disease (NAFLD) is a public health problem worldwide. Evidence linking NAFLD to the development and progression of CKD is emerging as a popular area of scientific interest. NAFLD and CKD are associated with poor outcomes and high costs; they have become major public health problems.

Aim of the Work

To assess the prevalence of NAFLD in CKD patients

Patients and Methods

This was a retrospective cross-sectional study that was conducted on patients with CKD at the National Institute of Urology and Nephrology, Cairo, Egypt.

Results

Our study revealed that, there was highly statistically significant increase among NAFLD Group than No NAFLD Group regarding CKD stages. Also, there was statistically significant increase among NAFLD Group than No NAFLD Group regarding Obesity and Hypertension, and there was highly statistically significant increase among NAFLD Group than No NAFLD Group regarding metabolic syndrome, and there was no statistically significant difference between the non NAFLD Group and NAFLD Group regarding Diabetes.

Conclusion

NAFLD and NAFLD with traditional comorbidities are associated with the risk of prevalence of CKD. It is recommended that patients with NAFLD, especially those with coexisting comorbidities, should be carefully accessed for the development of CKD. Future studies should focus on the mechanisms and therapeutic targets for both NAFLD and CKD in a comorbid setting.
The Effect of Hypoglycemia on Central Retinal Function in Patients with Diabetes
Authors: Ahmed Matared Marwa Mohsen , Eid Yara Mohamed , El Shazly Amany Abd El-Fatah , Eldin Ahmed Mohamed Bahaa , Pios Mark Nabil , Ashour Doaa Maamoun Mohamed
Published: November 2024

Background

According to the International Diabetes Federation report for 2021, approximately 537 million individuals are living with diabetes, and it is projected to reach 783 million by 2045. Diabetic ocular complications are asymptomatic at early stages and cause visual impairment unless diagnosed early and treated. In addition to the well-known effect of hyperglycemia, previous studies highlighted the possible structural and functional effects of profound hypoglycemia in both the central (CNS) and the peripheral nervous system (PN).

Objective

The aim of this study was to explore the effect of recurrent hypoglycemic attacks and its effect on central retinal function in human's eye.

Methods

This was a prospective case control study which was conducted on 20 eyes of diabetic patients type 2 at diabetes outpatient clinic at Ain Shams university Hospital, over a period of 10 months from Jan 2023 to October 2023, divided into two groups: group A which included type 2 diabetic patients who experienced minimal level 1 hypoglycemic episodes within 3 months and group B which included type 2 diabetic patients who experienced recurrent episodes of level 2/level 3 hypoglycemia within 3 months, to explore the effect of recurrent hypoglycemia on central retinal function in type 2 diabetic patients.

Results

the present study suggests that recurrent hypoglycemia affects the function of retina by the decrease in p1 amplitude mainly in central retina in a sequential manner evident by affection of rings 1 and 2 in first visit then rings 2 and 3 in follow up visit, and that stage of hypoglycemia is the most determinant factor

Conclusion

Hypoglycemia affects the central retinal function as evident by decrease in p1 amplitudes and retinal response densities in rings 1 and 2 by MF-ERG corresponding to fovea and parafovea. Recurrent attacks of hypoglycemia has a sequential effect that it affects perifovea ring 3 P1, N1 amplitude with no effect on peripheral retina.
Effect of Different Vascular Accesses on Inflammatory Markers and Outcome in Maintenance Hemodialysis Patients
Authors: Gerges Boshra Mikhaiel , El Said Heba Wahid Mohamed , Ahmed Fatma Abdelrahman , Tawfik Ahmed Mohamed
Published: November 2024

Background

Haemodialysis is a vital treatment for all uremic patients to survive. For those who need dialysis for a long time, establishing and maintaining permanent vascular accesses with good function is a crucial condition for prolonging their survival.

Aim of the Work

To study the effect of different types of vascular access on infection risk (apparent, hidden infection, patterns of microbial infection, antibiotic sensitivity, and outcome among maintenance hemodialysis patients).

Patients and Methods

This study is a prospective cohort study. This study conducted in Ain Shams University Hospitals, Nephrology Department Hemodialysis units. In 6 months.

Results

In the current study we found that Mean ± SD of Age (years) 49.5±8.4 and Duration of HD (years) was 3.2±1.9. Males and females were almost equal (46.0 % and 54.0% respectively). Cases from El-Demerdash and ASHUSH were 60.3% and 39.7% respectively. Catheters were temporary catheter, AVF and AVG; 49.2%, 31.7% and 19.0% respectively. In the current study we found that less than fifth of cases had Leucocytosis and Elevated procalcitonin in months 2 and 3. No significant statistical differences according to catheter type regarding demographic characteristics. Leucocytosis and Elevated procalcitonin in months 2 and 3 were most frequent in temporary catheter, followed by AVG and least frequent in AVF, the differences were significant only in leucocytosis. In the current study we found that Mean ± SD of temporary catheter duration (weeks) was 3.4±1. The access sites were Right jugular, right subclavian, left jugular and left subclavian; 41.9%, 25.8%, 22.6% and 9.7% respectively. Duration of temporary catheter was significantly higher in cases with peripheral positive culture. No statistically significant difference according to peripheral culture findings regarding temporary catheter access site. Duration of temporary catheter was significantly higher in cases with central positive culture. No significant statistical difference according to peripheral culture findings regarding temporary catheter access site.

Conclusion

the growing body of knowledge in nephrology and infectious disease management, offering insights that can inform clinical practice and improve patient outcomes in the haemodialysis setting.
The Role of Fecal Matrix Metalloprotease-9 as a Non-Invasive Marker in Diagnosis and Assessment of Clinical Activity in Inflammatory Bowel Disease Patients
Authors: Wardhere Mohamed Abdulkadir , Abd Elmageed Khaled Hamdy , Halima Ahmed Samir Abo , Elhady Abeer Abd Elraof Abd
Published: November 2024

Background

The two main types of inflammatory bowel diseases [IBD] are —Crohn’s disease [CD] and ulcerative colitis [UC]. Only limited data are available regarding the diagnostic accuracy of fecal matrix metalloprotease-9 [MMP-9] for inflammatory bowel disease [IBD].

Aim of the Work

the aim of our study was to assess the diagnostic role of fecal MMP-9 in patients with active CD and UC and its accuracy in predicting the disease remission

Patients and Methods

This case-control study was conducted at Ain Shams University Hospitals, Cases were enrolled over 9 months from june - 2022 to february - 2023. This study was performed on 80 subjects divided into 3 groups: Group A: 30 patients with Crohn’s disease evidenced by endoscopy (ileo-colonoscopy and upper GI endoscopy) and tissue biopsy 15 patients with active disease & 15 patients in remission). Group B: 30 patients with Ulcerative Colitis disease evidenced by colonoscopy and tissue biopsy (15 patients with active disease & 15 patients in remission). Group C: 20 age-matched, sex-matched healthy controls

Results

FC can significantly assess CD and UC (AUC= 0.991 for CD and 0.996 for UC at cut off >743 µg/g for CD and >245 µg/g for UC, 93.33% sensitivity, 100% specificity, 100% PPV and 93.7 NPV (P value <0.001). Fecal MMP-9 can significantly assess CD and UC (AUC= 0.998 for CD and 0.991 for UC at cut off >0.34 ng/mL for CD and >0.36 ng/mL for UC, 93.33% sensitivity, 100% specificity, 100% PPV and 93.7 NPV (P value <0.001);

Conclusion

this study assesed the diagnostic accuracy of fecal MMP-9 in the different types of IBD. The results showed that fecal MMP-9 has high sensitivity in the detection of endoscopically active UC and CD, and these non-invasive methods help in assessing intestinal inflammation.
Serum Visfatin Level Role in Diagnosis of Active Inflamatory Bowel Diseases
Authors: Aboghanm Mohamed Ali Abdelghany , Sayed Tarek Mohamed Youssef , Elshafie Ahmed Ibrahim Mohamed , Abdelnaby Karim Ahmed Mahmoud
Published: November 2024

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory disorder of the gastrointestinal tract, including ulcerative colitis (UC) and Crohn's disease (CD). The pathophysiology of IBD involves various factors such as intestinal microbiota, aberrant immune responses, environmental variables, and genetic predisposition. Immunological dysregulation characterized by inflammation and immune cell infiltration contributes to the development of IBD. Proinflammatory cytokines, including TNF, IL-1, IFN-, and cytokines of the IL-23/Th17 pathway, are produced in large quantities, leading to inflammation and tissue damage. Adipose tissue, particularly visceral adipose tissue, produces adipokines that can exacerbate inflammation in IBD.

Aim of the Work

to evaluate the role of visfatin, an adipokine, in the diagnosis, disease activity, and correlation with clinical findings in newly diagnosed IBD patients. This study was a Case Control study that was conducted in gastroenterology outpatient clinic, Alex fever hospital and Ain Shams University over 60 studied subjects divided into two groups.

Patients and Methods

Demographic data, clinical parameters, inflammatory markers, and serum visfatin levels were analyzed in IBD patients and healthy controls. The severity and activity of the disease were assessed using various diagnostic procedures, including endoscopy, blood testing, stool analysis, and imaging examinations.

Results

There were no statistically significant differences in demographic data between the IBD patients and healthy controls. However, significant differences were observed in clinical parameters, inflammatory markers, and serum visfatin levels among the studied groups. IBD patients showed abnormal findings in CBC, lipid profile, HbA1C, inflammatory tests, and fecal calprotectin compared to healthy controls. Serum visfatin levels were significantly higher in IBD patients than in the control group, indicating its potential role in IBD pathogenesis. Previous studies have suggested that adipokines, including visfatin, can modulate inflammation in IBD. Elevated visfatin levels have been associated with bowel inflammation and have been proposed as a marker for disease activity and severity. However, the correlation between serum visfatin levels and disease activity remains inconclusive. Some studies have reported higher visfatin levels in CD compared to UC, while others have found no significant difference between the two subtypes.

Conclusion

The serum visfatin level was significantly higher in newly diagnosed patients with IBD than in controls. Serum visfatin might be a novel noninvasive marker to detect activity in IBD patients and can be used as a predictor of disease extension in patients with UC. Further studies on big sample sizes and on different populations are recommended to confirm these results.
Evaluation of Albumin-Bilirubin Score in Predicting Post-Transplant Complications Following Adult Living Donor Liver Transplantation
Authors: Farag Mohamed Ali , Abd-Elaleem Mostafa Hamed , Abdel-Baset Hany Saied , Eltabbakh Mohamed Mahmoud
Published: November 2024

Background

Liver transplantation is a life-saving therapeutic intervention that contributes to a better quality of life in patients with end-stage or acute liver failure. Receiving a lobe of liver from living donor is a life time gift don’t waste it and be grateful.

Patients and Methods

Our study was conducted on patients underwent LT at Liver Transplantation Unit, Cairo Fatemic Hospital (Cairo, Egypt) from April 2018 till December 2021 with follow up of enrolled patient for 6 months' afterword. There were 112 patients underwent LT at the period of the study, 108 of them met the inclusion criteria and were enrolled in the study while 4 cases were excluded (pediatric cases). The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki, and was approved by Ain Shams University Research Ethics Committee (REC).

Results

This study showed male predominance among enrolled patients 71 cases (65.7%), with mean age of 48.09 ± 12.79 years' old and mean BMI of 27.84 ± 5.99. The most commonly recorded indications of LT in our study were HCC, ESLD due to HCV or HBV, AIH and cryptogenic liver cirrhosis. The overall incidence of post-operative complications was 43.5% (47 out of 108 cases) and the most frequent cause was biliary complications. ALBI score was higher in complicated cases than uncomplicated cases without reaching statistical significance.

Conclusion

The study concluded that ALBI score may be a good prognostic score for prediction of post- transplant complications following living donor liver transplantation to be evaluated in larger scale studies.
Comparison between Low Flux and High Flux Hemodialysis in Rebound of the Metabolic Profile and in Post-Dialysis Recovery Time in Prevalent Hemodialysis Patients
Authors: Elshemy Mohamed Rashad , Elsayed Hesham Mohamed , Kamel Chery Reda , Abd Elaziz Haitham Ezzat , Hussein Hussein Sayed
Published: November 2024

Background

It is known that the high flux membranes now are widely used all over the world due to the higher permeability of the high flux membranes compared to low flux ones to middle molecules, remove more serum endotoxins and improve the patient general condition and quality of life. This study aims at exploring the effect of using High flux membrane in rebound metabolic profile in the prevalent hemodialysis patients and also its effect on post dialysis recovery time

Methods

This descriptive analytic study included the available data in hemodialysis patients in Port- Said Al Eman Hemodialysis Unit. Data was collected between March and September 2022. This clinical trial, 100 patients who met the inclusion criteria were randomly assigned to have their regular hemodialysis sessions with low flux dialysis membranes and examined for rebound metabolic laboratory investigations (4 hours post dialysis) and post dialysis recovery time questionnaire DRT, then compare the same previois parameters while using high flux dialysis membranes and consider which of both dialysers is better to use for the hemodialysis patients

Results

Of the 100 patients in the sample the Mean 4 hours post dialysis urea in low flux was 106.65 ± 3.1 and in high flux was 76.67 ± 3.1. Mean 4 hours post dialysis phosphorus in low flux was 6.17 ± 0.14 and in high flux was 4.45 ± 0.14. Mean 4 hours post dialysis CRP in low flux was 7.88 ± 0.72 and in high flux which was 3.84 ± 0.72. Mean 4 hours post dialysis Calcium in low flux was 9.17 ± 0.09 and in high flux which was 9.77 ± 0.09. Mean 4 hours post dialysis Potassium in low flux was 5.3 ± 0.08 and in high flux which was 4.7 ± 0.08. Mean 4 hours post dialysis Magnesium in low flux was 2.24 ± 0.03 and in high flux which was 2.33 ± 0.03. Mean 4 hours post dialysis Bicarbonate in low flux was 21.96 ± 0.27 and in high flux which was 24.23 ± 0.27. Significant strong correlation between The fewer CRP Rebound 4 hours post and the shorter the post dialysis recovery time in high flux membrane p = 0.003. Significant strong correlation between The fewer Ultrafiltration volume removal and the shorter the post dialysis recovery time in both dialysers p < 0.001. Significant strong correlation between The lower decrease in serum Bicarbonate level and post dialysis 4 hours and post dialysis recovery time in high flux membranes p < 0.001.

Conclusion

The fewer CRP rebound and higher Bicarbonate serum concentration 4 hours post dialysis and the shorter the post dialysis recovery time.
Gelsolin as a Potential Biomarker for Endoscopic Activity and Mucosal Healing in Ulcerative Colitis
Authors: Shokry Fanous Monica Nagy , Musa Nevine Ibrahim , Allam Ahmed Samir , Ghait Shady Samir
Published: November 2024

Background

UC is a chronic, relapsing and remitting inflammatory condition of the colon. The diagnosis of UC is based on signs, symptoms, endoscopic evaluation, and histologic parameters. Accurate diagnosis and disease staging are important as these affect treatment options and prognosis. The main target in UC treatment is mucosal healing, which is related to long-term remission, reduced rates of hospitalization, and colectomy. Despite the advantages in the management of UC over the past few decades, much less has been achieved in the diagnosis and monitoring of the disease where colonoscopy remains the “gold standard” method. Therefore, a non-invasive marker correlating with mucosal healing is being sought.

Aim of the Work

to evaluate the role of serum gelsolin level (SGN) as a simple, easy, and available predictor for mucosal healing in patients with ulcerative colitis as compared to endoscopic scores and other widely used laboratory biomarkers.

Patients and Methods

The present study was conducted on 40 patients with clinical, biochemical, and endoscopic active UC and followed up during disease activity and remission. All patients were subjected to full history taking, clinical examination, routine laboratory investigations, ESR and CRP, CBC, fecal calprotectin, SGN, colonoscopy and biopsies with histopathological examination.

Results

The current study revealed a statistically significantly higher TLC, Platelet count, CRP, ESR and Fecal calprotectin among disease activity in relation to remission. However, serum gelsolin level, hemoglobin and albumin levels were statistically significantly lower in activity patients in comparison to remission patients. There was no statistically significant relation between SGN and gender, different laboratory parameters. There was statistically significant relation between SGN and mayo endoscopic sore as it has the highest level in MES 0. In the present study, SGN was found to be higher in patients with clinical and endoscopic remission and healing with statistically significant correlation with endoscopic mucosal scores representing mucosal healing like Mayo score and UCEIS and may be a possible useful marker for predicting endoscopic activity and mucosal healing in UC patients. It would be more helpful when used together with serum laboratory inflammatory indices (ESR, CRP and fecal calprotectin).

Conclusion

Serum gelsolin level can be used for prediction of mucosal healing in ulcerative colitis and endoscopic activity. A greater sample size would have resulted in more reliable subgroup analyses for UC. Larger studies are needed to be conducted to be conclude correlation between SGN and endoscopic scores and microscopic histopathological scores
Plasma Fibrinogen as a Diagnostic Marker in Sample Patients with Type 2 Diabetes
Authors: Hosni Salwa Seddik , Bahaaeldin Ahmed Mohamed , Elhalawany Salah Hussein , Bios Mark Nabil , Bayomi Mostafa Magdy Elsayed
Published: November 2024

Background

Diabetes, a heterogeneous metabolic disorder characterized by hyperglycemia, poses a significant global health challenge. Diabetic neuropathy, a nerve damage condition associated with diabetes, presents various clinical symptoms and contributes to the burden of diabetic complications.

Aim of the Work

The aim of the study to identify the relationship between the level of plasma fibrinogen and occurrence of diabetic peripheral neuropathy.

Patients and Methods

A case-control study included 60 type 2 diabetic patients, equally divided into two groups: those with diabetic neuropathy (Group 2) and those without neuropathy (Group 1). Several clinical and laboratory parameters were evaluated, including age, gender, diabetes duration, smoking habits, BMI, glycemic profile, lipid profile, fundus examination findings, and severity of neuropathic symptoms. Plasma fibrinogen levels were measured, and statistical analyses were performed.

Results

In our study, we found no significant differences between groups in age (p = 0.507), gender (p = 0.592), smoking (p = 0.389), and hypertension (p = 0.432). However, patients with diabetic neuropathy had longer diabetes duration (p = 0.019*). While BMI (p = 0.069) and mean arterial pressure (p = 0.265) showed no significant differences, diabetic neuropathy patients exhibited higher fasting blood glucose (p = 0.013*), 2 H PP blood glucose (p = 0.033*), HBA1C (p > 0.001), total cholesterol (p = 0.017*), triglycerides (p = 0.025*), and LDL (p = 0.019*), with lower HDL (p = 0.010) and higher albumin/creat ratio (p = 4.773*). Serum fibrinogen was significantly elevated in diabetic neuropathy patients, especially in those with more severe symptoms and PDR (p < 0.001*). Additionally, fibrinogen correlated positively with age (p = 0.009), diabetes duration (p < 0.001), fasting and 2 H PP blood glucose (p = 0.007, p = 0.010), HBA1C (p < 0.001), total cholesterol (p = 0.03), triglycerides (p = 0.022), LDL (p = 0.013), albumin/creat ratio (p = 0.002), and inversely with HDL (p = 0.016). Regression analysis identified diabetes duration as the most significant predictor of hyperfibrinogenemia (p = 0.007). Serum fibrinogen >2.8 showed high sensitivity and specificity in predicting diabetic neuropathy, suggesting its potential as a diagnostic marker for this condition. Kidney function parameters, eGFR and creatinine levels, showed no significant differences between the two groups. Serum fibrinogen was significantly elevated in diabetic neuropathy patients, especially in those with more severe symptoms and PDR (p < 0.001*).

Conclusion

Our study had given us an Abstract about the role of the plasma fibrinogen in prediction the occurrence of diabetic peripheral neuropathy, which help in control and management of this microvascular complication.
Role of Human Beta-Defensin 2 (HBD2) in the Diagnosis and Monitoring Activity of Ulcerative Colitis
Authors: Shawky Nora Magdy , Youssef Tarek Mohamed , Elshafie Ahmed Ibrahim Mohamed , Ahmed Ahmed Elmetwally
Published: November 2024

Background

Ulcerative colitis is a chronic, relapsing and debilitating condition that have significant impact on quality of life. It is characterised by superficial inflammation limited to the mucosa of the colon.

Aim of the Work

to evaluate the role of human beta-defensin 2 (HBD2) in the diagnosis and monitoring activity of ulcerative colitis.

Patients and Methods

This was a Case Control study that was conducted at Internal Medicine and Hepatology Department at Ain Shams University Hospitals. The study was performed on 30 patients who had ulcerative colitis and a group of 30 healthy subjects as a reference range for HBD2 marker.

Results

The mean age of cases with UC was 29.8 years, while control subjects had a slightly higher mean age of 33.9 years. However, this age difference did not reach statistical significance (p = 0.155). Furthermore, the distribution of males and females in the UC group (50% each) and the control group (53.3% male and 46.7% female) did not show a significant difference (p = 0.796). No significant differences between the studied groups regarding age, sex, smoking and comorbidities. Mean±SD of ulcerative colitis Duration (years) and Motions number / day was 7.0±4.0 and 6.3±1.4 respectively. Pain, Arthralgia and Bloody diarrhea were the most frequent presentation (100.0%, 60.0% and 60.0% respectively).

Conclusion

Based on these findings, it can be concluded that HBD2 is a valuable marker for the diagnosis and monitoring of UC, showing superior diagnostic performance compared to fecal calprotectin.
Plasma Hpg80 (Circulating Progastrin) as a Novel Diagnostic Biomarker for Early and Intermediate Stages of HCC
Authors: Zaky Gohar Askar Radwa Samy , Abdel Aziz Mahmoud Hossam El Din , El-Gaaly Sonya Ahmed , Hashem Walaa Mohamed
Published: November 2024

Background

Hepatocellular carcinoma is one of the most common malignancies worldwide and the most common primary malignant tumour of the liver. It is the second leading cause of cancer related deaths in the world. It occurs most commonly on top of a cirrhotic liver due to chronic HCV infection.

Aim of the Work

to evaluate the diagnostic value of progastrin in patients with HCC at early and intermediate stages.

Patients and Methods

The study was conducted upon 80 subjects who were divided into three groups: group I included 30 patients with clinically diagnosed HCC at early stages (stage 0 and stage A by BCLC staging system), group II 30 patients with clinically diagnosed HCC at intermediate stage (stage B) and group III 20 apparently healthy subjects

Results

Our analysis showed that the mean levels of progastrin was higher in patients with HCC (group A and group B) compared with control group (759.330 ± 582.929) and 510.577± 255.168 vs 33.943 ± 14.692 ng/ml respectively) which was statistically significant (P-value less than 0.001). This strengthens our conclusion about the possibility of using progastrin as a novel biomarker for diagnosis of HCC.

Conclusion

Serum progastrin alone or in combination with AFP improves diagnostic evaluation of HCC patients. progastrin is easily detectable in the plasma and could be tested throughout the patient’s journey to potentially identify patients who may need a deeper biological assessment at an acceptable economic cost. Further ongoing studies will warrant that the evaluation.
Clinical Outcomes in COVID-19 and Liver Cirrhosis
Authors: Shoaib Elsheikh Shoaib Hamada , Nashaat Ehab Hassan , Mohammed Ahmed Elsaedy , Mahmoud Abdelnabi Kareem Ahmed
Published: November 2024

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the ongoing COVID-19 pandemic. While pre-existing conditions contribute to COVID-19 severity, the impact of liver disease on outcomes remains unclear. The global impact of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has prompted investigations into its association with pre- existing conditions. Notably, the influence of liver disease on COVID-19 outcomes remains poorly understood.

Aim of the Work

to study the clinical outcomes of covid-19 in the cirrhotic patients

Patients and Methods

We conducted a retrospective analysis of COVID-19 patients with liver disease, liver cirrhosis, and COVID-19 without liver involvement. Demographics, comorbidities, laboratory results, and imaging findings were assessed.

Results

Significant variations in biochemical markers were observed among the groups. AST, ALT, and bilirubin levels demonstrated distinct patterns in patients with liver cirrhosis compared to those without liver involvement. These findings underscore the need to consider liver function parameters when assessing COVID-19 patients. Liver cirrhosis appears to correlate with worse COVID-19 outcomes. Altered biochemical markers and inflammatory responses in cirrhosis warrant further investigation. This retrospective study underscores the importance of understanding liver disease's implications for COVID-19. Liver cirrhosis patients exhibit unique biochemical profiles that contribute to their outcomes.

Conclusion

in this retrospective analysis, we shed light on the potential impact of underlying liver disease, particularly cirrhosis, on COVID-19 outcomes. The distinct biochemical profiles observed in patients with liver cirrhosis suggest that liver status may influence disease severity. As the COVID-19 pandemic evolves, understanding these interactions becomes pivotal for tailored patient care.
Assessment of Lysosome-Associated Membrane Protein (LAMP5) in Newly Diagnosed Multiple Myeloma Patients and Correlation to Prognosis and Outcome
Authors: El Afifi Amal Mostafa , Mohamed Haidy Sayed , Ibrahim Ibrahim Rakha Nahed Moawad , Abbas Rana Zakaria , Salah Mahmoud Shrouk Mahmoud
Published: November 2024

Background

Multiple myeloma is a neoplastic plasma cell disorder that is characterized by clonal proliferation of malignant plasma cells in the bone marrow. Despite improved survival rates in the past decade, therapy is not curative, and almost all patients relapse.

Aim of the Work

In our study, we will measure level of (LAMP5) in multiple myloma patients using ELISA and correlation with patient data and outcome and prognosis.

Patients and Methods

This case control study was conducted on 32 patients with multiple myloma recruited from Ain Shams University Hospitals, Clinical Haematology and Oncology division of Internal Medicine Department in a period starting from august 2023 and January 2024. They were 21 females (65.6%) and 11 males (34.4%) with age ranged from 35 - 79 years and with mean±SD of 58.66±10.48 years.

Results

In our study a statistically significant difference was found. The mean LAMP5 in the case group is much higher than in the control group (p < 0.0001) suggesting that LAMP5 is highly expressed in newly diagnosed multiple myeloma patients using ELISA. In our study we found no correlation between LAMP5 overexpression and initial percentage of plasma cells infiltrating bonemarrow in aspirate, immunophenotyping and trephine. There was no correlation between highly expressed LAMP5 and initial percentage of M band and type of the band detected by immunofixation.

Conclusion

Along side with LAMP5 being highly expressed in newly diagnosed multiple myeloma patients in our study with cut off point >1.96, it has 100% sensitivity and 96.87 specificity and we still need more sample size for better evaluation of its role in progression of myeloma and overall survival and prognosis.
Prevalence of Neurotic Disorders in Patients with Multiple Sclerosis: A Cross-Sectional Study in an Egyptian Sample
Authors: Abd El-Aziz Azza Abd El-Nasser , El-din Abd El-Monem Mohamed Hossam , El-Hafeez Mohammed Aly Abd , Mohamed Abdelrahman Mohsen
Published: November 2024

Background

Multiple Sclerosis (MS) is a chronic, autoimmune inflammatory disease of the CNS. It is the most common chronic disabling disease of the CNS in young adults, affecting 2.3 million people worldwide. It is two times more common in females than in males and its onset is usually at young ages, namely around 30 years of age. Its most frequent and typical initial forms of presentation are neuritis optica or arrays of sensory-motor symptoms. Nevertheless, a small minority of patients (about 1%) experience changes in mood, behaviour, personality, or cognition as initial manifestations of MS. In contrast, as cases of MS progress, neuropsychiatric symptoms are very likely to appear; estimates indicate that they will affect two-thirds of all patients at some point.

Objective

To determine the percent and severity of neurotic disorders in a sample of Egyptian multiple sclerosis patients.

Patients and Methods

We conducted this observational cross sectional study at Nasr City health insurance outpatient clinic and MS unit at Ain Shams university Hospitals. We included 100 MS patients of all types according to McDonald's criteria (The 2017 revisions), adult age group above 18 years old. We excluded patients with other diseases that could clearly affect the patient psychiatric condition prior to the diagnosis of MS and patients with recent drug intake that could clearly affect psychiatric condition other than for documented psychiatric disease or MS.

Results

The current study shows that anxiety, and OCD are frequent among patients with MS in Egypt. There was significant relationship between development of neurotic illnesses and feeling pain/discomfort, also between development of neurotic illnesses and reporting anxiety/depression.

Conclusion

The current study shows that depression, anxiety, and OCD are frequent among patients with MS in Egypt. The results of this study are important for the improvement of the clinical management of MS patients. The psychiatric state of patients in this group should be investigated systematically, simultaneously with the assessment of their neurological state. Clinicians should have more focus on neurotic symptoms among people with MS disease to develop appropriate treatments for those patients. Finally, support programs should be made available for patients with MS to ensure adequate coping with the disease.