bluuebunny/crossref_metadata_2025 huggingface dataset:
Neutrophil- and Platelet-to-Lymphocyte Ratios (NLR & PLR) and Their Relation with Disease Activity in Rheumatoid Arthritis Patients
Authors: Elbakry Samah AbdelRahman , Hassan Sameh AbdelMoteleb , Ibrahim Shafica Ibrahim , Boga Ahmed Elsayed Ahmed
Published: August 2023

Background

RA is the most common chronic inflammatory arthritis and is associated with progressive destruction of synovial joints and physical disability. It is a polygenic disease characterized by autoimmunity and systemic inflammation with progressive impairment of the joints, resulting in lifelong disability and increased mortality.

Aim of the Work

The aim of the study is to study the correlation between both of Neutrophil- and platelet-to-lymphocyte ratios (NLR&PLR) and disease activity in RA patients.

Patients and Methods

Our cross-sectional case-control study enrolled 50 patients with RA, in addition to 30 healthy volunteers as a control group.All included patients were subjected to full history taking with special emphasis on history of RA, thorough clinical examination was done with special emphasis on musculoskeletal examination.

Results

When we compared RA patients with the controls, we found a highly statistically significant difference between them regarding NLR and PLR being higher in the RA group. In our study we found that both NLR and PLR has fair diagnostic value to discriminate between RA patients and controls using the ROC curve at a cut-off value of 2.58 and 151.05 respectively. In RA patients, highly statistically significant correlation was found between both NLR and PLR. In addition, statistically significant correlation was found between NLR with both VAS score and DAS28_ESR and also between PLR with ESR, VAS score and RF.PLR also correlated significantly with US7 score, PDUS synovitis and gray GSUS tenosynovitis.

Conclusion

NLR and PLR that can be obtained via CBC (which is convenient, inexpensive and fast), can serve as an additional useful marker for the diagnosis of RA. NLR and PLR has important value in the assessment of RA related disease activity. In contrast to traditional markers, they are less expensive and effective measure of inflammation that is not impacted by the cytokines influencing the ESR and CRP. US7 score is a simple and effective measure to detect subclinical synovitis in RA patients and to assess and follow up disease activity.
Nutritional Assessment in Patients with Inflammatory Bowel Disease
Authors: Shawky Bakir Amal , Kaiser Hany Haroun , Allah Shaimaa Hussein Gad , Wahab Ahmed Kamal Abd el
Published: August 2023

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions. The inflammation of the intestinal mucosa in IBD is characterized by episodes of abdominal pain, diarrhea, bloody stools, weight loss, and the influx of neutrophils and macrophages that produce cytokines, proteolytic enzymes, and free radicals that result in inflammation and ulceration.

Aim of the Work

The aims of our study is to assess the nutrient status of individuals with CD and UC in relation to the recommended nutrient intake values, anthropometric measures, and biochemical indices of nutrition, and to determine the extent to which reduced food and nutrient intake contributes to the nutrition deficiencies in this population.

Materials and Methods

This was across-sectional study was conducted on patients with IBD, including Crohńs disease (CD), ulcerative colitis (UC)and undtermined colitis, who attended to the outpatient clinic for IBD of the Department of Internal Medicine, University Hospital of Ain Shams University, between january 2020 to july 2020. 90 patients with IBD (65 UC patients, 22 CD patients and 3 UD colitis) were included in the study.

Results

Our study show that The majority of our IBD patients showed a normal BMI indicating that malnutrition, especially underweight, is not as common a described in former studies with up to 85% in IBD patients. Our study show that majority of patients are suffering from GI upset following certain meals, all of them are suffering from flatulance, some of them suffering from nausea, vomiting, heart burn and 79(87.7%) patients are suffering from diarrhea, most of patients with crohns disease are suffering from constipation, and some of them are suffering from intestinal colick. So Many patients with IBD suppose that the diet influences the courseof their disease or even cause a relapse Our study groups showed an unfavorable ratio of essential fatty acids (FA) compared to the recent guidelines. Whereas the ratio of the n-6 fatty acid linolic acid (LA) to the n-3 fatty acid α-linolenic acid (ALA) should be 5:1, the actual ratio was more than in all participants because of the high incidence of margarine ingestion.

Conclusion

The worldwide rising incidence of IBD is paralleled by a ―Westernization‖ of dietary habits in developing countries. It is therefore obvious that, in addition to a genetic influence, environmental factors, especially diet, undoubtedly play a major role in the development of IBD. Impairment of nutritional status in BID patients has a multifactorial etiology. Main reasons include suboptimal energy intake, malabsorption, enteric nutrient loss, increased basal energy expenditure, and medications.
Impact of Direct Acting Antiviral (DAA) Agents on Hematological and Hepatic Statuses of Patients with Chronic Hemolytic Anemias and Chronically Infected with Hepatitis C Virus (HCV)
Authors: Moussa Mohamed Mahmoud , Ahmed Osama Ashraf , El-Ghammaz Amro Mohamed Sedky , Mohamed Inas Abdel Moaty , Khamis Ahmed
Published: August 2023

Background

Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients.

Aim and objectives

To investigate the impact of DAA-based regimens on hematological and hepatic statuses of patients with chronic hemolytic anemias and chronically infected with HCV.

Subjects and Methods

This is a cross sectional study, was carried out at viral hepatitis research and treatment center of Ain Shams University Hospitals, on 50 patients with chronic hemolytic anemias and has HCV infection, from December 2019 till June 2020.

Result

There was high statistically significant difference before treatment, first month, third month and sixth month follow up in chronic liver disease group as regard HGB, statistically significant in Hemolytic anemia group (no splenectomy) as regard HGB and there was high statistically significant difference between the studied groups as regard HGB.

Conclusion

DAAs therapy is effective and tolerable in patients with chronic HCV patients. It improves liver necro-inflammatory changes in patients, evidenced by decreased liver enzymes' level, but still require careful observation during DAAs therapy for being more susceptible for hemolytic anemia.
Efficacy and Safety of Probiotic versus Conventional Treatment of Irritable Bowel Syndrome
Authors: Elgaaly Sonya Ahmed , Khayyal Ahmed Elsaady , Anwar Christina Alphonse , Elmetwally Ahmed Salem
Published: August 2023

Background

Irritable bowel syndrome is a gastrointestinal syndrome characterized by chronic abdominal pain and a change in intestinal habits without any organic cause. It affects 11% of the world-wide population. irritable bowel syndrome reduces health-related quality of life and leads to a significant economic healthcare burden.

Aim of the Work

The aim of this study is to investigate the efficacy of probiotics in irritable bowel syndrome (IBS) patients.

Patients and Methods

A randomized controlled clinical trial in Gastroenterology and Hepatology outpatient clinic at: Ain Shams University Hospitals for 6 months from November 2020 till April, 2021. 120 Person were included in this study divided into 2 group: Group 1:60 patient with irritable bowel syndrome received conventional treatment and and Lactobacillus Acidophilus probiotics. Group 2: 60 patient with irritable bowel syndrome received conventional treatment.

Results

There was a significant increase of passage of gas in group 1 than in group 2 but no significant difference in between group 1 and group 2 regarding stool consistency, mucus with stool, abdominal pain, Bloating and passage of stools. There was 46.7% in group 1 and 55% in group 2 had a very good treatment success with no significant difference in between. Regarding to the treatment success in group 1, there were 46.7% in group 1 had a very good treatment success, 33.3% had a good treatment success and 20% had poor response. There was 80% in group 1 had a very good overall tolerability to probiotic treatment.

Conclusion

This study shows moderate evidence for the use and safety of probiotics in irritable bowel syndrome. Probiotics provide a new strategy as a safer treatment for irritable bowel syndrome. In general, the use of Probiotics has been successful in practice, especially for symptom control and maintenance of remission in these entities. However, it is necessary to take into account the specific condition of the patient and their comorbidities to make informed decisions about management.
Rheumatological and Immunological Manifestations among a Cohort of Human Immunodeficiency Virus Egyptian Patients
Authors: Mohamed Dalia Fayez , Hosny Sherin Mohamed , Hussein Safaa Abdelsalam Aly , Hamed Ayman Mohamed
Published: August 2023

Background

The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that is able to persist in the form of integrated proviruses in a predominantly CD4 T cell reservoir causing HIV infection and over time acquired immunodeficiency syndrome (AIDS).

Objective

Detection of frequency and pattern of rheumatological and immunological disorders in HIV infected Egyptian patients.

Patients and Methods

This study was observational cross sectional study conducted in tertiary hospital of infectious diseases in Giza, Egypt outpatient clinics and inpatient departments. It included one hundred human immune deficiency virus infected Egyptian patients diagnosed according to national AIDS program criteria having an immunological or a musculoskeletal disorder with age of ≥ 18 years.

Results

Results from our study which revealed a highly significant correlation between both CD4 count, HIV-PCR level and the incidence of oral ulcers. There was only a significant value between HIV-PCR level and the presence of myositis or thromboembolic manifestations. Within our 100 HIV positive patients the mean levels of ESR, CRP and SGOT levels were elevated. There was a weak inverse correlation between the CD4-positive lymphocyte count and ESR. There was a highly significant negative correlation between CD4 count and HIV infection duration ESR, CRP, urea, creatinine, blood urea level, SGOT, SGPT. Also, significant negative correlation between CD4 count and uric acid level. Moreover, there were a highly significant positive correlation between the HIVPCR level and ESR, CRP, serum creatinine level, SGOT and SGPT. There was a high significant negative correlation between the HIV-PCR level and hemoglobin level, platelets count and CD4 count. There was a significant negative correlation between HIV-PCR level and absolute lymphocyte count.

Conclusion

Rheumatologic manifestations are commonly occurring in HIV positive patients. Raynaud’s phenomenon, oral ulcers, and hepatosplenomegaly are significantly more prevalent in patients under non-HAART. ESR and CRP are significantly higher in patients not receiving HAART. Viral load is significantly higher in patients with non-specific antiviral treatment, while CD4 count is significantly lower in the same patient cohort. There is a significant relation between incidence of oral ulcers with lower CD4 count and higher viral load.
Validity of CBC Differential Count for Diagnosis of COVID-19
Authors: Melek Nermine A , Allam Mohamed F , Mahmoud Mayada M , Zeada Omneya M , Labib Bassem G
Published: August 2023

Background

With rapid spreading of the outbreak of 2019-nCoV infection, the WHO announced a public health emergency of international concern. Among most common easily performed and inexpensive diagnostic procedures are Complete blood counts (CBC).

Aim of the Work

to evaluate efficacy of complete blood picture (CBC) in diagnosis and identifying cases of COVID-19.

Patients and Methods

A case control study was conducted on a total of 173 patients at Ain Shams University Hospitals during a period of three months since beginning of data collection. Patients were allocated into 2 groups according to COVID-19 PCR result: GROUP 1: Patients with COVID-19 Positive PCR; GROUP 2: Patients with COVID-19 Negative PCR.

Results

CBC differential count has significant value in diagnosing of covid-19 disease, many of COVID patients have lymphopenia and leucopenia in comparison to non COVID suspected patients.

Conclusion

The definitive diagnosis of COVID-19 was made by RT-PCR analysis, but this was a time-consuming and less accessible test. With this test, the time it takes to diagnose and treat patients can be delayed. In our study, low values of leukocytes, neutrophils, lymphocytes and eosinophils with a CBC test which is easily available, were found to be valuable in terms of the initial diagnosis of COVID-19.
Role of Ultrasound in Diagnosis of IBD
Authors: Mohamed Azza Emam , Ahmed Ghada Abdelrahman , Awadein Mohamed Ali , Ezzat Eltohamy Eslam Mohammed
Published: August 2023

Background

Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a relapsing and remitting lifelong illness and over 3 million people have inflammatory bowel disease worldwide.

Objective

To evaluate the role of intestinal ultrasound in diagnosis of IBD.

Patients and Methods

This is a cross-sectional study that was conducted at the gastroenterology and hepatology unit, department of internal medicine, Ain Shams University at period from 20192021. 72 Egyptian patients with clinical manifestations suggestive of IBD according to true and love criteria and CDAI (Diarrhea, bleeding per rectum, abdominal cramps, tenderness, tenesmus and mucus in stool).

Results

This study revealed significant difference between the two groups regarding bowel wall thickness, stratification, haustration and color Doppler changes. These results strongly point to the value of intestinal ultrasound in the diagnosis of inflammatory bowel disease.

Conclusion

The cut-off point of intestinal wall thickness for diagnosis of IBD is 3.1.mm with sensitivity, specificity and diagnostic accuracy of 90.6%, 87.5% and 91.9% respectively. Color Doppler has sensitivity, specificity and diagnostic accuracy of 75%, 100% and 86.1% respectively for diagnosis of IBD. Intestinal ultrasound and color Doppler are reliable noninvasive tools for diagnosis of inflammatory bowel disease in clinical practice.
Assessment of Ventricular Arrhythmias Risk in Gastroesophageal Reflux Disease Patients
Authors: Samy Amir Helmy , Kayser Hany Haroun , Gamil Anwar Ayman , Elrawie Mohamed Salaheldin Mohamed
Published: August 2023

Gastroesophageal reflux disease (GERD) is characterized by acid regurgitation and epigastric burning that occur as the result of reflux of gastric content into the esophagus. Disturbances in the autonomic nervous system (ANS) were observed in patients with GERD. The evidence suggests that chronic GERD can cause an autonomic response, which results in ventricular arrhythmias (VAs). Our aim in the study is to examine T wave peak-to-end interval (TpeI) and the TpeI/QT ratio as highly sensitive gauges of ventricular repolarization anomalies and VAs potential in patients with GERD. In our study, The ECG measurements of both GERD and control groups are as follow; The QT wave dispersion (QTd) and corrected QT dispersion (cQTd) were higher in patients with GERD in comparison to controls (p = 0.002 and P = 0.09, respectively). Moreover, TpeI, corrected TpeI (cTpeI), and the TpeI/QT ratio were increased in patients with GERD in comparison to controls (p < 0.001, p = 0.018, and p < 0.001, respectively). We can conclude that patients with GERD may have an increased risk for VAs, and the VAs risk in patients with GERD can be predicted by measuring TpeI and the TpeI/QT ratio, which are the indicators of ventricular repolarization anomalies.
The Impact of Low Sodium Dialysate on Different Echocardiographic Parameters in Prevalent Hemodialysis Patients
Authors: Mahmoud Osama Mohamed , Abdelmobdy Ashraf Hassan , Tawfik Reham Saeed
Published: August 2023

Background

ESRD affects about 15% of adult population, leading to increased morbidity and mortality. Historically, hemodialysis treatments used low dialysate sodium (D-NA) in the range of 120 mEq/L to enable elimination of excess sodium from the body. Over time, higher D-Na (∼140 mEq/L) was used to improve hemodynamic stability during dialysis.

Aim of the Work

To determine the impact of decreased dialysate Na on cardiac functions and different echocardiographic parameters in prevalent heamodialysis patients.

Patients and Methods

A Prospective study was conducted, consisted of 45 patients on regular Hemodialysis at Rod Elfarag Hospital dialysis unit for 6 months.

Results

In the current study, there was high statistically significant difference between baseline lab investigation and after 6 months lab investigation as regard Hemoglobin, WBCs, Platelets, Ht, URR, serum albumin, Ca, Na, Phosphorus and BNP (p < 0.001). We found that there was high statistically significant difference between baseline ECG and after 6 months ECG as regard PR interval, QRS duration and QT interval (p < 0.001). There was high statistically significant difference between baseline Echocardiography and after 6 months Echocardiography as regard left atrium diameter, EF%, Diastolic BP and Systolic BP (p < 0.001).

Conclusion

A reduction of the dialysate sodium concentration based on the predialysis sodium levels of the patients could reduce the SBP and decrease the volume load on heart. Within this short period, DBP could not be lowered. The effect of this approach should be studied in broad and lengthy series.
Fibroblast Gross Factor-23 and Carotid Artery Stiffness in Hemodialysis Patient
Authors: Al-Layl Hisham Mohamed Atef Abu , Wahab Khaled Gouda Abdel , Ali Salwa Yasser Mohammed
Published: August 2023

Background

FGF23 is a free circulating hormone secreted by osteocytes affecting mainly phosphate metabolism as it inhibits its renal tubular reabsorption by suppressing the expression of luminal sodium-phosphate co –transporters (Na Pi).

Aim of the Work

Aim of study is to verify the usefulness of FGF23 as a marker for diagnosis of arterial stiffness in CKD patients on regular hemodialysis (3 sessions per week, 4 hours each).

Patients and Methods

The present study enrolled 30 living end stage renal disease patients on regular hemodialysis randomly selected from hemodialysis unit at Ain Shams University hospitals after exclusion of patients of known cardiovascular disease or ischemic heart disease, also patients of age below 18 years and above 50 years were excluded as well as patients having arterio venous fistulas on both arms. All patients were subjected to complete medical history taking, including (Age, Sex, Etiology of chronic kidney disease, drugs and duration of dialysis), and detailed clinical examination was done.

Results

In this study patients have elevated serum levels of FGF-23 ranging from 100 up to 700 pg/ml. when the normal reference range is 18-108 pg/ml. Also our study result revealed a statistical significance of negative correlation between FGF-23 and diabetes mellitus duration, serum phosphorous, corrected calcium and estimated glomerular filtration rate as well. The current study shows statistical correlation of positive significance between FGF-23 and hypertension duration where, common carotid artery intima media thickness as well as present plaques in common carotid artery. Moreover there is no statistical significant correlation between FGF-23 and pulse pressure.

Conclusion

FGF23 serum levels are markedly elevated in chronic kidney disease CKD and among patients on regular hemodialysis causing arterial stiffness.
MRI Spectroscopy as a Diagnostic Model for Assessment of Liver Steatosis in NAFLD Non-Diabetic Patients
Authors: Foda Enas Mahmoud , Nakeep Sarah Abdelkader El , Sayed Aliaa Sheha , Ahmed Ghada Abdelrahman , Abdelazeem Sara Mohamed
Published: August 2023

Background

Non-alcoholic fatty liver disease, the hepatic pandemic of the XXI century, being the number one cause of chronic hepatic disease in the occidental world.

Aim of the Work

To evaluate the diagnostic performance of MRI spectroscopy for assessing hepatic steatosis in nonalcoholic fatty liver disease (NAFLD) in non diabetic patients.

Patients and Methods

A case control study was conducted on 40 patients inhepatology and gastroenterology department & Radiology department ain shams university hospital from Jan 2020 to November 2020 to study role of MRI spectroscopy as adiagnostic model for assessment of liver steatosis in NAFLD non diabetic patients.

Results

There was statically significant Positive correlation Between hepatic steatosis score, fat peak and fat fraction %, and there was statically significant Negative correlation Between Hepatic steatosis score and water peak.

Conclusion

MRI Spectroscopy can be reliably used as an accurate and specific noninvasive method for the diagnosis of Nonalcoholic fatty Liver Disease.
Role of Dynamic Magnetic Resonance Imaging in Differentiating Benign from Malignant Thyroid Nodule
Authors: Sarah M W , Mohamed S H , Mona M A , Bassem M M , Caroline A G , Nesma A I
Published: August 2023

Objective

To determine the diagnostic accuracy of Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) in differentiating benign from malignant thyroid nodules

Study Design

A cross-sectional analytical study.

Methodology

Thirty-four patients who determined to have suspicious thyroid nodules by ultrasonography who attend endocrinology outpatient clinic at Ain-Shams university hospital, fulfilling the inclusion and exclusion criteria, were included in the study. They were evaluated on 1.5 Tesla MRI machine with T1- and T2- weighted imaging. DWI was done using b-values of 0 and 1000 s/mm2 and ADC values were calculated for the thyroid nodules. All of these patients were subjected to full history taking, general and local clinical examination, thyroid profile, TPO Abs, ultrasound, fine needle biopsy and histopathology results were correlated with ADC values.

Results

The benign nodules showed facilitated diffusion while malignant nodules showed restricted diffusion. T-test was used to assess the difference in mean ADC values between benign and malignant nodules. The mean ADC value of the malignant thyroid nodules (0.8±0.1 x 10-3 mm2/s) was significantly lower than that of the benign thyroid nodules (1.3±0.2 x 10-3 mm2/s) (p-value < 0.001). ADC value of 1.15 x 10-3 mm2/s was used as a cut-off, for differentiating benign from malignant thyroid nodules. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of DWI and ADC values in differentiating benign from malignant thyroid nodules were 88.2%, 92.3%, 80%, 100% and, respectively.

Conclusion

FNAC is gold standard diagnostic modality but has limitations. However, DWI and (ADC) is a non-invasive diagnostic tool for characterization and differentiation between benign and malignant thyroid nodules. It decreases the burden of unnecessary surgeries when pre-operative FNAC and biopsy are inconclusive
Study of the Relationship between Insulin-Like Growth Factor 1, Myostatin and Muscle Status in a Sample of Egyptian Patients on Hemodialysis
Authors: Makboul Khaled Mahmoud , Mahmoud Hanan Mahmoud Ali , Marawan Dina Ahmed Marawan , Younis Sayed Abdou Sayed
Published: August 2023

Background

Myostatin and IGF-1 are two biomarkers of muscle strength and muscle mass in patients on hemodialysis. These biomarkers are also able to detect low HGS values and are also associated with muscular mass. These biomarkers could be of clinical use as screening tools of sarcopenia in patients on hemodialysis.

Aim of the Work

The aim of this study is to evaluate the relationship between Insulin-Like Growth Factor 1 and myostatin and Muscle status (strength and mass) in a sample of Egyptian patients on Hemodialysis.

Patients and Methods

This study was a case control study conducted on 30 apparently healthy individuals as a control group and 30 patients on hemodialysis with muscle wasting attending hemodialysis unit at Ain Shams University Hospital to study the relationship between insulin like growth factor-1, Myostatin and muscle status in a sample of Egyptian patients on hemodialysis.

Results

This study results Showed Myostatin and IGF-1 are two biomarkers of interest to assess muscle status of dialysis patients. Both biomarkers are associated with HGS, Muscular mass. Regarding the comparison between the clinical examination and between our two groups we found that there were statically highly significantly difference between both groups regarding weight and BMI with P value (< 0.001) and shows that statically non significantly difference between both group regarding Age, height, dialysis vintage, DBP, Pulse with P-value (0.395).

Conclusion

In conclusion, our findings indicate that myostatin might be a useful biomarker for predicting muscle mass contents in hemodialysis patients, and serum IGF-1 might be a useful predictor of nutritional status including muscle mass in hemodialysis patients. Further studies of larger populations and longitudinal research are needed to confirm these results.
Flow Diverters versus Clipping in the Management of Blister Like Intracranial Aneurysms
Authors: Habib Mohamed Alaa Eldin Abdou , El Molla Shafik Tahseen Shafik , Ibrahim Aly Ibrahim Soliman Mohamed Abdo , Fattah Abdel Fattah Kadry Abdel
Published: August 2023

Background

Blister like aneurysms (BLA) are a rare form of aneurysms contributing to around 0.3 to 1% of all intracranial aneurysms. They are small, broad-based aneurysms usually less than 3 mm in diameter with very thin walls. They are most commonly found along the non-branching points of the supraclinoid portion of the internal carotid artery. It appears as thorn-like protrusions on angiography such as Computed Tomography angiography (CTA) and Digital Subtraction Angiography (DSA) the latter having a higher sensitivity than the former for BLAs albeit more invasive. BLAs may show early aneurysm growth within days to weeks after diagnosis. They have a slight female preponderance and are associated with atherosclerosis although their actual pathophysiology remains elusive.

Aim of the Work

To compare the degree of occlusion on conventional angiography in BLA patients treated with flow diverters with those treated by microsurgical clipping within one year of intervention.

Patients and Methods

Most BLAs are diagnosed after an episode of subarachnoid hemorrhage (SAH) and present clinically with a high WFNS score (World Federation of Neurological Surgeons) while the rest of BLAs are diagnosed incidentally on imaging. Due to their unique histology, BLAs are associated with higher rates of rebleed and intraoperative and post-operative rupture. Due to their small size, thin walls and tendency to re-bleed BLA are considered a challenge to both neurosurgeons and neuroradiologists.

Results

Our search strategy using previously mentioned key wards identified a total of 67 citations. Search was done for studies conducted or published within 2010 to 2020 duration. After removal of duplicate studies, eligibility criteria were applied to the titles of 43 articles with exclusion of non-human population and non-appropriate study design. This yielded 23 studies that underwent full-text analysis, of which 17 did not meet the inclusion criteria of having and lacking of quantitative comparison data. Six studies were included in our systematic review for analysis of population demographics and management outcome with attention to the clinical and radiological outcomes of both microsurgical clipping and flow diversion for treatment of BBAs.

Conclusion

In our mid-term follow-up study, we saw high occlusion and low retreatment/rerupture rates with good clinical outcomes in the majority of cases. However, dual antiplatelet therapy in the acute ruptured setting can be challenging, and requires special considerations.
Treatment Modalities of Complex Anterior Circulation Intracranial Aneurysms
Authors: Hussein Eslam M , Moharram Hussein , Lawton Micheal T , Habib Mohammed A , Tolias Christos , Kotb Mohammed M
Published: August 2023

Background

Complex intracranial aneurysms (CIAs) are the most technically demanding neurosurgical pathologies. Although extensive work and effort has been directed to the treatment of these challenging vascular lesions, no formal definition exists on what complex aneurysms are, and it is rather subjective to individual interpretation that an aneurysm receives such label.

Aim of the Study

The overall aim of the study is to assess the clinical outcomes of the different modalities in management of complex intracranial anterior circulation aneurysms and to try to set up a clear and concrete treatment algorithm for the management dilemma.

Patients and Methods

This study is a prospective observational study that included 40 patients. All patients were evaluated by an interdisciplinary conference consisting of neuroendovascular surgeons and vascular neurosurgeons for assessment of the therapeutic options and the suitability of endovascular and/or surgical treatment. Initially, study setting was supposed to be in Ain Shams University teaching hospitals, Egypt, King’s College Hospital, United Kingdom and Barrow’s Neurological institute, USA. Unfortunately, due to COVID-19 Pandemic, Cases from King’s College Hospital in London were only included.

Results

Twenty cases were managed surgically, while 18 were treated by different endovascular techniques. Both surgical and endovascular modalities were used as a hybrid approach to treat 2 cases. Recurrence of treated aneurysms was seen only in the endovascular modality. Four cases out of the 18 cases treated by endovascular techniques showed either residual or recurrence of the previously treated aneurysms. Four documented intervention related mortalities occurred during the first 6 months. Two cases out of the 4 were treated by endovascular techniques (balloon assisted coiling & parent vessel occlusion), one case was surgically treated by clip/wrap technique and the last mortality was seen in a case treated by the hybrid approach (Clipping+ flow diverter).

Conclusion

Complex intracranial aneurysms managed surgically showed less recurrence rate than those treated by different endovascular techniques. CIAs treated by endovascular modalities showed much lower length of hospital stay and better modified Rankin scale after 6 months. Complications rate and mortality rate were nearly similar in both groups and were usually related to the initial poor presentation with hight WFNS grade upon the initial ictus.
A Systematic Review for Cervical Intervertebral Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion in the Treatment of Cervical Degenerative Spine Disorders
Authors: El-Shahaby Amr Mohammed Nageeb , Hamada Salah Mostafa , El-Gayar Abd-Elrahman Mohammed Hesham , Ali Mohammed Ismaeil
Published: August 2023

Background

Cervical disc arthroplasty (CDA) is an increasingly accepted procedure for the treatment of symptomatic cervical degenerative disc disease. Multiple Level I evidence clinical trials have established cervical TDR to be a safe and effective procedure in the short-term.

Aim of the Study

is to provide a long-term assessment of cervical disc arthroplasty (CDA) versus anterior discectomy and fusion (ACDF) for the treatment of one- and two-level disc disease.

Patients and Methods

Systematic review of published English literature, the study was done from July 2014 to June 2020 and the study setting was Internet search through MEDLINE and Cochrane Collaboration Library.

Results

Our study provided further evidence that CDA is superior in achieving long-term clinical outcomes such as overall success, NDI success and neurological success, VAS neck pain and arm pain, symptomatic ASD, total secondary surgery, and secondary surgery at the index level and at the adjacent level.

Conclusion

However, no clear benefit could be identified in regard to NDI score, total reported AE, serious AE, device/surgery- related AE, and radiological superior and inferior ASD. Welldesigned worldwide RCT with long-term follow up are still necessary for further evaluation in the future.
Prevalence of Vitamin D Deficiency in Recurrent Early Pregnancy Loss
Authors: Hemeda Hosam Mohammad , Fayed Salah Taha , Mohamed Noha Refaat , Hikal Mona Abdel Sabour Amin
Published: August 2023

Background

Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed.

Aim of the Work

The aim of the current study was to assess the association between vitamin D status and recurrent pregnancy loss.

Patients and Methods

The current study was conducted at Ain shams University Maternity Hospital during the period between October 2020 and April 2021. This research recruited 60 pregnant women categorized in to two research groups: Group A - study group: 30 pregnant women with early pregnancy loss and history of repeated pregnancy loss, Group B - control group: 30 pregnant women complete the first trimester with no early pregnancy loss. The 25(OH)D concentration measured in this case control study with predominantly first-trimester blood sampling.

Results

Choosing matched controls was to decrease confounders so according demographic variables; there was a statistically insignificant difference between group A (RPL) and group B (Normal pregnancy) as regards the demographic research data of study subjects recruited, the mean age was 24.5±2.6 years, the mean BMI was 25.8±2.1 Kg/m2. There was a statistically significant difference between Group A (RPL) and group B (Normal pregnancy) as regard 25(OH)D level (p < 0.001), mean was 11.9±3.2 ng/ml and 16.9±6.5 ng/ml respectively. Vitamin D was significantly associated with recurrent pregnancy loss.

Conclusion

The current study showed a significant association between vitamin D deficiency in pregnancy and occurrence of Recurrent pregnancy loss. A lot of researches needed to increase the quality of evidence about the association between low levels of vitamin D and recurrent pregnancy loss.
Study of Optic Disc and Macular Vascularity in Central Retinal Vein Occlusion Using Optical Coherence Tomography Angiography
Authors: Yousif Hussein Mohamed Mohamed , Amin Mona Kamal Abdellatif , Abdeldayem Hisham Mohammad Khairy , Rashad Mohammad Ahmad
Published: August 2023

Background

Retinal vein occlusion (RVO) is a sight threatening disease. It is the second most common vascular retinal disease after diabetic retinopathy. Central retinal vein occlusion (CRVO) is considered as the most dreadful form, with prevalence of nearly 1 in 1000 in the population aged ≥30 years.

Aim of the Work

To quantify changes in optic disc and macular vasculature in patients with CRVO using optical coherence tomography angiography.

Patients and Methods

In our study, we included 20 eyes of twenty patients with treatment naïve cases of CRVO. These cases were selected from the outpatient clinic at Ain shams University Hospital between January 2020 and October 2021. Included subjects were patients diagnosed with CRVO, who received no previous treatment neither by injection nor by laser. Only patients with media opacity that are dense enough to impede sufficient image quality for reliable interpretation were excluded.

Results

Our study was able to prove the agreement between the quantitative vessel density (VD) measurement in the macula and the current fundus fluorescein angiography (FFA) based assessment of macular ischemia. We were able to confirm a deep component to the pathological process in CRVO as proposed by the current literature and be able to assess it simultaneously in relation to the superficial microcirculation using optical coherence tomography angiography (OCTA) and FFA. We found the optic disc VD parameters to be a significant indicator of global retina perfusion which could be of value in assessment and follow up of patients especially in the presence of confounding factors for macular VD measurement as extensive edema. We found significant correlation between FAZ size and measured macular vessel density indicating congruity of the two ischemic parameters.

Conclusion

OCTA is a new modality for retinal imaging, providing a noninvasive alternative for the gold standard FFA. It visualizes microvascular changes in cases of vascular diseases at least with the same sensitivity as FFA. It has the definite advantage of being easily repeated in case of poor quality and patients who needs recurrent follow up imaging. It can be also used in patients who don’t qualify for or with contraindications to FFA. However, OCTA is liable to inaccuracy due to inherent disadvantages as segmentation and projection artifacts.
Evaluation of Myopic Macular Function and Structure
Authors: Farweez Yousra A T , El-Shazly Amany A , Mohamed Ahmed A
Published: August 2023

Purpose

to assess the functional and structural changes in non-pathologic myopia in relation to the degree of myopia.

Methods

Cross sectional study of myopic patients. Our participants are classified into age matched four groups according to the degree of their spherical equivalent (SE): emmetropia, mild myopia; moderate myopia and high myopia. Participants underwent full ophthalmological examination, axial length (AL) measurement, Spectral domain optical coherence tomography and multifocal ERG (mf-ERG).

Results

Central foveal thickness showed significant thinning among the control participants in comparison to myopes, while inner and outer macular ring thicknesses were significantly thicker in the control participants than myopic ones. Subfoveal, inner and outer macular ring choroidal thickness were significantly thicker in the controls than myopes. Mf-ERG retinal response density [RRD] and P1 amplitudes of the three rings (R1-R3) were significantly higher in the control participants than myopic ones while P1 latency showed significant delay in the myopes in comparison to their control participants.

Conclusion

Macular thickness is related to the degree of refractive error, AL, choroidal thickness and multifocal changes in myopic patients. We should consider the correlation between functional and structural alterations in the macula when interpreting retinal structure in the assessment of macular diseases in the context of refractive errors.
Femoral Head Reduction Osteotomy versus Relative Femoral Neck Lengthening in Management of Perthes Sequelae: A Systematic Review and Meta-Analysis
Authors: Elnewishy Ahmed Awad , Mahran Mahmoud Ali , Aly El Abd Mostafa
Published: August 2023

Background

The single most important predictor determining the long-term prognosis following healed Perthes disease is the shape of the proximal femur. A high riding greater trochanter, a short femoral neck, and proximal femur abnormalities can induce both intraarticular and extra-articular femoro-acetabular impingement, resulting in degenerative hip discomfort, limited range of motion, and decreased abductor function.

Aim of the Work

to perform systematic review about surgical techniques in treatment of perthes in young adult population.

Patients and Methods

We searched the MEDLINE database via PubMed, EMBASE, and Cochrane Library using the following Keywords; “Legg-Calve-Perthes”, “Perthes' disease”, “osteotomy”, “surgical hip dislocation in perthes” and “young adult population”.

Results

Seven full text articles met our inclusion criteria and were included in the final analysis.

Conclusion

The single most important predictor determining the long-term prognosis following healed Perthes disease is the shape of the proximal femur. A high- riding greater trochanter, a short femoral neck, and proximal femur abnormalities can induce both intraarticular and extra-articular femoro- acetabular impingement, resulting in degenerative hip discomfort, limited range of motion, and decreased abductor function.
Short Stem versus Standard Stem Hip Arthroplasty
Authors: Kamel Ahmed Samy , Mohassab Ahmed , Abdelhady Mohamed Ismail
Published: August 2023

Background

Minimally invasive total hip arthroplasty (MIS THA) has recently increased in popularity. Concurrently, newly developed short femoral components are being used. These short components may make insertion during MIS approaches easier and preserve more bone than traditional femoral stems, while providing a more anatomic stress distribution in the proximal femur.

Aim and objectives

To perform an evaluation and meta-analysis of all available trials and studies demonstrating the different clinical outcomes following cementless THR using short stem and standard stem in young patients.

Subjects and Methods

Published observational analytical studies (Case-control, case reference, cohort studies or systematic reviews) On the outcomes of short stem and standard stem total hip replacement. Trials which involve English papers from the year 2000 till 2020.

Result

We found 220 records, of them 90 unique records identified (duplicate, non English records and records before 2000 were removed) by the database searches, 65 records were excluded (not describing outcomes or inaccessible artilcles), leaving 25 studies that met all inclusion criteria.

Conclusion

Despite favorable medium-term revision rates suggested by observational studies, there remains a need for long-term RCTs, registry data, biomechanical analyses, and bone density measurement to affirm the benefits of short-stem hip arthroplasty.
Relation between Serum and Dietary Zinc Levels and Irritable Bowel Syndrome (IBS) in Medical Students of Ain Shams University
Authors: EL-Din Hala EL-Sayed Abd EL-Hafiz Shams , Amin Ghada Essam Aldin , Sallam Reem Mohamed , Shehata Isis Magdy Mossad
Published: August 2023

Background

Irritable bowel syndrome (IBS), is one of the commonest gastrointestinal disorders and IBS symptoms control often involve food restrictions that may cause zinc deficiency which is in turn may contribute to pathophysiology of IBS.

Objectives

To measure the proportion of IBS and its subtypes in medical students and to correlate between serum zinc level and dietary zinc intake with IBS.

Methods

A cross sectional study was carried out among a sample of students at The Nutritional Assessment of Medical Students of Ain Shams University (NAMS/ASU). A total of 199 students were involved, all participants were subjected to direct interviews self-administered questionnaires including GIT clinical symptoms, 24 hours food recall and food frequency questionnaire. They were also subjected to serum zinc level measurement. In addition to calculation of dietary zinc intake daily using food composition analysis software according to the Egyptian Food Composition Tables.

Results

The number of medical students that had positive ROME IV criteria were 104 students, in a proportion of 8.5% of the students participated in NAMES/ASU, with IBS-C was the commonest type. Serum zinc level was significantly low in IBS students with positive significance correlation to dietary zinc intake. Dietary consumption of zinc rich food showed significant reduction of serum zinc level with milk and dairy products intake of less than 3 servings per week.

Conclusion

the proportion of IBS in NAMES/ASU project was about 8.5% with the IBS-C was the most common subtype. They had low serum zinc level and a positive significant correlation with dietary zinc intake.
Evaluation of Serum Markers of Iron Metabolism in Pediatric Patients with Chronic Liver Disease
Authors: El Qabany Zainab Anwar , Abdelaziz Asmaa Wafeeq , Ragab Dina Ali , Hassan Senosy Eman Ali
Published: August 2023

Introduction

The liver is a critical controller of iron metabolism as it represents a large iron storage compartment and a major producer of ferritin, transferrin and hepcidin (Pietrangelo, 2015 & Meynard et al., 2014). Disorders in the metabolism of iron in the direction of iron overload are observed not only in primary hemochromatosis but also in chronic liver diseases with other eitiologies. (Ibrahim, 2013).

Objectives

-To describe the parameters of iron metabolism in pediatric patients with chronic liver disease.

-To correlate serum parameters of iron metabolism and severity of chronic liver disease.

Methods

An analytical case-control study was performed in Ain Shams University Pediatric Hospital, we conducted 40 pediatric patients presented to the hepatology clinic and 20 control children collected by convenience sample, cases and controls were age and gender matched. The severity of the diseases was assessed by Child’s-Pugh Classification score (Patients were 15 % class A, 42.5% class B and 42.5 % class C) and iron profile assessment was done by separated plasma analyzed in AU480 Chemistry Analyzer Beckman Coulter, correlation between iron profile parameters and severity of liver disease was done.

Results

- Iron overload was significant in cases over controls presented by increase serum iron in cases (Mean 116.53 SD ± 18.35) over controls (Mean 70.3 ± SD 18.82)(p < 0.001), increase serum ferritin levels in cases (Mean 138.38 SD ± 17.82) over controls (87.55 ± 22.76) (p < 0.001), increase transferrin saturation in cases (Mean 41.88 SD ± 10.85) over controls (Mean 17.83 ± SD 6.01) (p < 0.001), and decrease total iron binding capacity in cases (Mean 291.33 ± SD 51.87) lower than controls (Mean 405.05 ± SD 46.13) (p < 0.001). -- There was a positive significant correlation between S iron 0.773(p < 0.001), S ferritin 0.367(p < 0.001), Transferrin Sat. 0.788(p < 0.001) and progression in Child'sPugh classification score. And a negative significant correlation between TIBC -0.736(p < 0.001) and progression in Child’s-Pugh classification score.

Conclusion

- Iron overload correlates with increase chronic liver disease severity (assessed by Child’s-Pugh Classification).

-The serum parameters of iron (S iron, S ferritin, Transferrin Sat and TIBC) may serve as biomarkers for monitoring the increase in severity of liver disease in pediatrics with chronic liver disease.