bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Skin Microbiome in Patients with Alopecia Areata: Case Control Study
Authors: Monieb Hoda Ahmed , Salem Samar Abdallah Mohamed , Mahmoud Ramy Mohamed , Ahmed Abdel Aziz Mariam Abdel Aziz
Published: November 2024

Background

Alopecia areata (AA) is a non-scarring, inflammatory, autoimmune form of hair loss caused by immunological attack on the hair follicle. Patchy alopecia areata affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime.

Objective

To study skin microbiome in patients with alopecia areata compared to healthy controls in Egyptian patients.

Subjects and Method

This study included 50 subjects (25 patients and 25 controls). The patients were recruited from those attending the dermatology outpatient clinic of Ain Shams university Hospital in the period between October 2021-2022. The procedures were explained to the patients and controls and informed consent was obtained.

Results

AA patients showed no significant difference in Staphylococcus epidermidis gene expression or in the ratio between them among the patient’s group and healthy subjects. There was a statistically significant negative correlation between the relative gene expression of Staphylococcus epidermidis and the SALT score. Staphylococcus epidermidis gene expression was not significantly correlated with age or duration of last attack.

Conclusion

Quantifying the relative gene expression of Staphylococcus especially Staphylococcus epidermidis targeting the 16S region may help to assess the severity of alopecia areata as disequilibrium of the microorganisms may be involved in this disease severity.
Immuno-Histochemical Assessment of the Expression of IL-33 in Inflammatory Acne Vulgaris and the Effect of Treatment with Intense Pulsed Light on Its Expression
Authors: Mohamed Salem Samar Abdallah , Lotfi Ranya Adel , Ahmed Naglaa Samir , Soltan Marwa Yassin Ahmed , Zarif Mirna Michel Ibrahim
Published: November 2024

Background

Acne vulgaris is the most common inflammatory skin condition. Inflammation is the main event in pathogenesis of acne but little is known about role of IL-33 in the pathogenesis.

Objective

To assess the expression of IL-33 in the tissue of inflammatory acne vulgaris patients versus controls and its relation to severity of the disease and to assess the efficacy of intense pulsed light (IPL) in treatment of inflammatory acne and on IL-33 expression.

Patients and Methods

We performed clinical and dermatological for thirty (30) patients complaining of inflammatory acne vulgaris divided as 15 patients with mild to moderate acne (group A) and 15 patients with severe acne (group B). Skin biopsy was taken from the lesions of the patients and normal acne prone skin from controls and immune-histochemical staining by anti-IL-33 monoclonal antibody was done. Then patients were treated by IPL sessions and another biopsy was taken from them and IHC was done to compare IL-33 expression before and after treatment.

Results

IL-33 was positive in 100% of patients and 80% of controls. GAGS score significantly decreased in both groups after IPL treatment; for group A GAGS score was 17.40 ± 3.46 before and 8.00 ± 2.51 after treatment and for group B it was 31.80 ± 0.94 before and 14.67 ± 3.35 after treatment. In group A, IL-33 was found to be mild in 20%, moderate in 66.7% and dense in only 13.3% of patients after treatment (compared to 20% moderate and 80% dense before treatment). In group B it turned negative in 13.3%, mild in 20%, moderate in 60.0% and dense in only 6.7% of patients after treatment (compared to 6.7% mild, 20% moderate and 73.3% dense before treatment). This means that IPL improved inflammation in acne lesions and decreased the density of inflammatory cytokines including IL-33.

Conclusion

IL-33 is elevated in Acne vulgaris compared to controls and IPL treatment lead to decrease expression.
Exploring the Relationship between Vitiligo and Male Fertility: A Comparative Study
Authors: Tolba Eissa Mohamed Salem , Al-Naeem Sallam Mohamed Abd , Khalil Othman Soleit Mohamed Ahmed
Published: November 2024

Background

Vitiligo is a chronic, acquired dyschromia that promotes autoimmune aggression against melanocytes. It causes hypochromic or achromic macules and patches on the skin and mucous membranes, with potential involvement of hair follicles in various extensions of the skin and may be accompanied by systemic manifestations and multisystem affection.

Aim of the Work

to explore the possible relation between vitiligo and male reproductive health and fertility status. This evaluation was conducted on a hormonal and seminal background.

Patients and Methods

This comparative cross-sectional study included 60 patients (30 with vitiligo & 30 healthy age and body mass index (BMI) matched controls). They were recruited from the dermatology & andrology out-patient clinics of Ain Shams University Hospitals, during the period from March 2023 till July 2023. The study was approved by Research Ethical Committee of Ain Shams University (FMASU M S 667/2023) and fulfilled all the ethical aspects required for human research.

Results

There was no statistically significant difference between cases and controls regarding LH and total testosterone while there was statistically significant increase found in estrogen in vitiligo cases with p-value = 0.001 and decrease in FSH in vitiligo cases with p- value = <0.001. There was no statistically significant difference between cases and controls regarding semen concentration, total motility, and normal morphology with p-value = 0.581, 0.270 and 0.065 respectively, while there was statistically significant increase found in progressive motility in control group with p-value = 0.006.

Conclusion

The evaluation of seminal fluid analysis and hormone profiles among vitiligo patients showed minor variability. However, it was evident that the levels of sex hormones and seminal parameters were different in patients with vitiligo compared to healthy controls. Serum estradiol levels were significantly increased among vitiligo patients relative to control patients, on the contrary to FSH levels which showed significant decrease among vitiligo cases. while serum total testosterone and LH showed no significant changes. There was statistically significant difference in sperm progressive motility between cases & controls with higher percentage of progressive(A+B) motility among controls. The sperm morphology & count were not different between patients & controls.
Impact of Depression on Semen Parameters
Authors: Ahmed El-Khateeb Ekramy , El-Husseiny Rania Mahmoud , Ghobrial Phoebe Fayez , Salah Nada Mohamed
Published: November 2024

Background

Male factor plays a role in about 50% of infertility cases world-wide. This may be attributed to pretesticular, testicular, post testicular causes or it may be idiopathic. Psychological disorders including depression are being investigated as one of the risk factors responsible for idiopathic infertility with contradicting reports.

Aim

The aim of this study is to assess the potential impact of depression on semen parameters and to evaluate the potential role of improving the score of depression in improving these parameters.

Patients and Methods

This is a prospective observational pilot study. Twenty one male patients with moderate, severe or very severe depression were recruited from the psychiatry outpatient clinic then were examined and evaluated at the andrology clinic of Dermatology, Venereology and Andrology Department, Ain Shams University Hospitals. Each patient had baseline semen analysis and 2nd assessment semen analysis after depression improvement. The improvement of depression was assessed by Hamilton depression rating scale (HAM-D).

Results

When comparing semen parameters before and after depression improvement in the whole studied patients, the only significant change was the increase in semen volume.

Conclusion

Depression has an evident relation with male infertility through affecting semen volume and this can be reversed by treating depression leading to improvement of male fertility.
Autologous Cultured Fibroblast Cell Therapy for Treatment of Stria Alba
Authors: Saleh Hanan Mohammed Ahmed , Mohammed Ghada Fathy , Khazragy Nashwa El , Ali El Meligi Norhan Khaled Mohammed
Published: November 2024

Background

There is growing evidence showing that human autologous cultured fibroblast transplantation is a safe alternative treatment to prevent and reduce the structural changes in aging skin. Previous data indicate that injections of autologous fibroblasts increase collagen formation, accompanied by a concomitant increase in thickness and density of dermal collagen. our study will highlight the technique of autologous cultured fibroblast and it is indication for treatment of stria alba and this wasn't done before.

Objective

To evaluate the efficacy and safety of autologous cultured fibroblast for improvement of stria alba.

Patients and Methods

The present study included 15 patients a with stria alba. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided written consent. the patients were injected intradermally by autologous fibroblast suspension at 2 weeks intervals with total of 3 sessions.

Results

Before autologous fibroblast injection (baseline), the width of stria ranged from 4-17.4 mm (mean 8.18 ± 3.85). After treatment at 3rd month, stria ranged from 2.9 – 14.8 (mean 7.17 ± 3.26) and at the 6th month ranged from 2.9 – 14.8 (mean 7.16 ± 3.27). Comparison of width of stria before versus after injection showed non significant difference (p value 0.062)On contrast, the histopathological examination by H&E, Masson Trichome and Orcein stain a showed significant improvement in the form of increased epidermal thickness, better collagen arrangement and thickness and increased elastic fibers contents.

Conclusion

Autologous fibroblast injection in treatment of stria alba may have promising results in the future especially if combined with other tretment modalities.
Screening of Voice and Vocal Tract Changes in Professional Wind Instrument Players
Authors: Rezk Kerollos Magdy , Hafez Nirvana Gamal El-Din , EL-Demerdash General Ahmed Mohammed , Shadi Mariam Salah , Tanious Hanaa Naguib
Published: November 2024

Background

Purpose Playing wind instruments is a strenuous task on the larynx, predisposing players to voice disorders.

Aim of the Work

This study aims to evaluate potential vocal symptoms and vocal tract alterations in professional wind instrumentalists.

Patients and Methods

Methods In this cross-sectional study, 26 male military subjects were interviewed, completed the voice handicap index (VHI)-10 questionnaire, and subjected to auditory-perceptual assessment, neck examination, rigid laryngostroboscopy and flexible nasofiberoscopy both before and during instrument playing.

Results

All participants had vocal fatigue symptoms, around one-quarter complained of voice change, one-quarter complained of shortness of breath while or after performing, and one-third complained of neck symptoms. The average score of VHI-10 was 16.2±6.5, and approximately three-quarters of participants scored above the cut-off point. There were no significant correlations between age, years of instrument playing, average hours of daily practice, and VHI-10. Participants with neck symptoms had significantly higher VHI-10 scores. Those (around one-fifth) with an external neck swelling during Valsalva maneuver had a significantly higher VHI-10 score. Dysphonia, mainly mild and of strained, leaky quality, was detected in almost one-third of participants. While the instrument was being played, the vocal folds were somewhat adducted, and the vocal tract became more compressed as the task became more demanding. The most frequent observations in the vocal tract examination were hyperemia of the vocal folds or all over the laryngeal and pharyngeal mucosa, excessive secretions over the vocal folds, signs of hyperadduction, arytenoid edema, and phonatory waste.

Conclusion and Recommendations

Wind instrumentalists frequently experience voice disorders, which necessitate further care and investigation.
Assessment of Listening Effort Experience in Normal and Hearing Impaired Adult Population
Authors: Salah Sarah Mohamed , El-Kabarity Rasha , El-Kholi Wafaa , Kamal Nadia
Published: November 2024

Background

Hearing impaired patients often report difficulties on attending to auditory message. These difficulties are not only exclusive to understanding the auditory message, rather, the process itself become effortful and induce tiredness or fatigue. While conventional Puretone audiometry and speech audiometry are efficient tools to access hearing impaired individuals, they do not address the perceived Listening Effort (LE) that the patient faces on daily basis. Accordingly, LE assessment tools represent a relatively new dimension in evaluating hearing impaired population. These tools include a subjective self-report questionnaires as the Speech, Spatial, Qualities of hearing scale (SSQ), a behavioral tool such as the dual task paradigms, and an objective physiological tool such as pupillometry, skin conductance, heart rate, Electroencephalography (EEG), functional magnetic resonance imaging(fMRI). This study has used subjective self-rating Arabic version of SSQ scale, and an objective physiological tool which is pupillometry to measure LE for adult hearing aid users.

Aim of the Work

To standardize LE assessment tools namely the Arabic version of SSQ, and Pupillometry in normal hearing adults. To assess LE in adult Hearing aids (HA) users to investigate whether they still suffer even after being optimally fitted with HA.

Patients and Methods

The study consisted of one hundred and eleven adult individuals divided into two groups; a normal hearing group (sixty normal individuals) with mean age 40 years and a study group (fifty-one HA users with bilateral symmetrical sensorineural hearing loss of variable degrees) with mean age 35 years and hearing loss duration ranging from 2-49 years. Patients were recruited from Audiology Unit, ORL department, Ain Shams University. Listening effort was measured by a subjective self-report scale (Arabic version of Speech, Spatial, and Qualities of Hearing scale (SSQ)), and a physiological objective tool (Pupillometry) to measure pupil dilation quotient.

Results

Hearing aid users group revealed statistically significant increased listening effort for both subjective and objective methods referenced to age matched normal group.

Conclusions

Listening effort test battery is clinically feasible in audiology practice and could help understand the challenges the hearing impaired faces. HA algorithms and technology have not resolved LE for the majority of HA users.
Risk of Developing Chronic Kidney Disease among Obese Metabolically Free Adults: A Systematic Review/Meta-Analysis
Authors: Mousa Abeer Mohammed Mahmoud , Abdel-Wahab Saeed , Essam El-Din Ghada , Abdel mobdy Ashraf , Mostafa Salwa , Abd El Samea Marwa Shaban
Published: November 2024

Background

Metabolically healthy obesity (MHO) is a type of obesity characterized by a favorable metabolic picture. Yet, the relationship between chronic kidney disease (CKD) and MHO has not been established. This review investigates the relationship between the metabolic healthy phenotype of obesity and the development or progression of CKD.

Objective

To determine the risk of development or progression of chronic kidney disease (eGFR <60 ml/min/1.73 m2) in metabolically healthy obese individuals.

Methods

A literature search was performed in 5 databases using the following search strategies: (” chronic kidney disease” OR “end-stage renal disease” OR “estimated glomerular filtration rate” OR “kidney function”) AND (“obesity” OR “metabolic syndrome” OR “metabolically healthy” OR “metabolically healthy obesity” OR “overweight” OR “metabolically healthy overweight “OR “metabolic parameters” OR “metabolic profile” OR “obesity without metabolic abnormality” OR “healthy obesity”). We included prospective, retrospective cohort studies and case-control studies in English, French, Spanish, and Arabic until December 2022 that investigated the development or progression of CKD in adults > 18 years with a baseline GFR of ≥ 60 ml/min/1.73 m2 exposed to MHO. A total of 12579 studies were retrieved, and 12564 were excluded due to different populations, exposures, or outcomes. Studies with missing data, narrative reviews, systematic reviews, meta-analyses, case reports, case series, and commentaries, along with studies conducted on animals, were also excluded. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for reporting.

Results

We included 15 cohort studies with 5,039,394 participants. MHO subjects showed an increased risk for CKD with a pooled risk ratio (RR) of 1.42, 95% CI (1.25–1.61), p < 0.001 using the random effects model. Heterogeneity is high, as indicated by Cochrane Q = 73.35 and I squared (I2) = 81%.

Conclusion

Metabolic healthy obese adults have a significantly higher risk of the development or progression of CKD.
Glycogen Phosphorylase-BB and Corrected QT Interval in Early Prediction of Cardiotoxicity in Patients with Acute Aluminum Phosphide Poisoning
Authors: Abdulkhalik Asmaa Gamil , Azab Gehan Boshra , Nabil Hafez Rabab
Published: November 2024

Background

Aluminum phosphide (ALP) is a highly toxic pesticide that cause multi-organ affection. Cardiovascular affection accounts for high mortality. So, early prediction of myocardial injury and arrhythmias are important in the management.

Aim

This study aimed at investigating the role of Glycogen phosphorylase BB (GPBB) and corrected QT interval (QTc) in early prediction of ALP induced cardiotoxicity.

Methods and Results

The current study was a prospective study carried at Poison Control Center of Ain Shams University on thirty ALP intoxicated adults and thirty age and sex matched healthy controls. Patients were subjected to history taking, clinical examination, grading of severity according to Poison Severity Score (PSS) and on admission investigations including electrocardiogram (ECG) and GPBB. Outcome was also recorded. The results revealed that GPBB was higher in intoxicated patients than controls and there was significant difference among outcome groups. GPBB also was able to detect cardiotoxicity and predict mortality. QTc interval was longer in intoxicated patients than healthy controls and was able to predict occurrence of arrhythmias.

Conclusion

It was concluded that GPBB is a promising biomarker to predict myocardial injury following aluminum phosphide intoxication and on admission corrected QT interval is simple bed side tool to predict arrhythmias.

Recommendations

The present study recommended the use of GPBB and corrected QT interval as useful markers for prediction of ALP cardiotoxicity.
Single Versus Separate Incisions in Oncoplastic Breast Surgery Techniques
Authors: Elfiky Amr Kamel , Othman Farag Ahmed Gamal Eldin , Abd Almoaty Karim Fahmy , Ahmed Ahmed Abdelkader
Published: November 2024

Background

Patient concerns with aesthetics have prompted the improvement of oncoplastic surgical approaches. It has been shown that the aesthetic success in breast malignancy surgical treatment leads enhanced sexual and social recovery. In this study a prospective comparison between cohorts of early-stage breast cancer patients treated with oncoplastic breast surgery. The first cohort will be treated with the single incision approach and the second cohort will be treated by the conventional breast conservative technique, which will be performed with double incision (one for the tumour resection and the other for the axillary dissection).

Objective

to compare between single incision & separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery.

Patients and Methods

This is a prospective cohort comparative study between single incision & separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery. This study will be conducted at breast surgery unit at Ain Shams University Hospitals and Maddi Military Complex starting from June 2022 to June 2023. Approval of the Ethical Committee and written informed consent from all participants will be obtained.

Results

There was significant no statistical difference in both group as regards the operative timing, seroma and the hospital stay but there is a statistical difference regarding hematoma between the two groups. In our study, 86.7% of the patients attained good to excellent cosmetic outcomes (70% as excellent and 26.7% as good) regarding single incision and 79.7% of the patients attained good to excellent cosmetic outcomes (65% as excellent and 26.7% as good) regarding separate incision. High cosmetic outcome was obtained as the patients were satisfied with presence and shape of their breasts relatively.

Conclusion

The choice of the oncoplastic technique is mainly based upon the location of the tumor, size of the breast and distance of the tumor from the nipple areola complex. So all cases should be adequately reviewed in order to tailor the decisions for every single case. There is statistically difference between Single incision in breast cancer lesion and separate incision as regards hematoma and the cosmetic outcome.
Complications of Laparoscopic Management of GERD. Systematic Review and Meta Analysis
Authors: Hussien Khaled , Shaban Mohammed , Fawzy Fawzy Salah , El-Malah Ahmed Samir Shahhat Mohamed
Published: November 2024

Background

Anti-reflux surgery is an effective alternative to medical treatment of GERD and is the only definitive therapy for the prevention of its severe long-term consequences. For this reason, since its idealization by Nissen, who first described total fundoplication in 1956, it has gained a wide consensus in the international surgical community.

Aim of the Study

The aim of this study is to detect the types and incidence of postoperative complications after laparoscopic management of GERD.

Patients and Methods

These studies reported a total of 1791 patients, of whom 941 (52.69 %) underwent laparoscopic partial fundoplication (LPF) either Dor or Toupet and 850 (47.31 %) underwent laparoscopic Nissen fundoplication (LNF).

Results

There were no statistical differences between LPF and LNF in the perioperative events as operative time and interaoperative complications. This Meta-analysis revealed a significant difference in the late postoperative dysphagia parameter between the two arms of the study, in favour of LPF which has significantly less dysphagia than that recorded with LNF. However, it was found that lower esophageal sphnicter pressure (LESP)(objective parameter of dysphagia) is significantly higher in the group of LNF than that measured in the LPF group, As regard gas related sysmptoms in the form of gas bloating syndrome, ability to relieve bloating and ability to belch. When performing forest plot meta ananlysis for each complication of the gas related symptoms, It was found that there is no statistical difference between LPF and LNF. Also the same results of insignificant difference were obtained when estimating patient's satisfaction. Also, measuring of De meester score that evaluate acid reflux symptoms (objective), it was found that there is no significant difference between the LPF and LNF groups. But when estimating the use of antisecretory drugs (PPIs), this meta-analysis show significant less use of anti secretory drugs among the LNF groups than that the LPF group.

Conclusion

Both procedure partial and complete wrap are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. Dysphagia found to be significant after Nissen fundoplication when follow up is 5 years or more. Also there is significant use of antisecretory drugs among the group of partial fundoplication although there is no significant difference in the heart burn symptoms which means that depending on symptoms only is not always the right way of recurrence detection. Also more objective studies are needed to evaluate the clinical outcome and recurrence prior to offering re-visional surgery.
The Optimal Bilio Pancreatic Limb (BPL) Length in One Anastomosis Gastric Bypass (OAGB), A Systematic Review
Authors: Abdel Samea Kareem Sabry , Elsayed Mohamed Gamal , Mohamed Ahmed Taha
Published: November 2024

Background

The number of patients undergoing bariatric surgery for morbid obesity has progressively increased in the last 20 years worldwide. The procedures most performed nowadays are sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), accounting for 46% and 38.2% of all procedures, respectively. Among the other bariatric procedures, one anastomosis gastric bypass (OAGB) has rapidly gained acceptance and diffusion worldwide and represents 7.6% of all bariatric interventions The one anastomosis gastric bypass (OAGB) has currently gained a widespread diffusion among bariatric surgeons, being the third commonest procedure worldwide performed after sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB). OAGB gained many supporters but also several criticisms for the possible onset of biliary reflux and malabsorption with consequent nutritional deficits

Objective

To find the most optimal length of biliopancreatic limb length in one anastomosis gastric bypass with best weight loss, outcomes and least possible malnutrition.

Patients and Methods

Out of the included studies, there was five Cohort study, while the remaining studies was RCT. Follow-up periods ranged between one and 12 months to 36 months. Regarding patients’ characteristics, 7343 patients were studied in the included articles.

Results

The rates of anemia were significantly higher in the long limb procedures due to the reduced capacity to absorb iron. However, we could not find significant differences between long and short limb procedures in the rates of iron deficiency; the small number of studies in such a comparison might have contributed to this finding.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023.

Conclusion

While long limb surgery induced significantly higher weight loss than short limb procedures as indicated by %EWL and %TWL, long limb procedures were associated with multiple nutritional deficiencies, including hypoalbuminemia, hypoproteinemia, and hypocalcemia. Additionally, higher proportions of anemia and malnutrition were observed after long limb procedures compared to short limb procedures. The results should be interpreted with caution given the inherent limitations of studies’ design (primarily retrospective investigations) and the small number of studies that assessed nutritional differences over long follow-up periods. Future large- sized RCTs are required to assess the efficacy and safety of long limb procedures on weight loss and nutritional outcomes, considering the roles of BPL length, ethnic variation, gut hormonal response, and the malabsorptive paradigm of gastric bypass surgeries.
Evaluation of Biliopancreatic Limb Length in Laparoscopic One Anastomosis Gastric Bypass on Resolution of Metabolic Syndrome
Authors: Iskandaros Moheb Sharaby , Khalil Ahmed , Sabry Ahmed Mohamed , Ayad Amgad Adel
Published: November 2024

Background

One-anastomosis gastric bypass (OAGB) has been assessed in several studies, with most indicating excellent weight loss and improvement in comorbidities after OAGB.

Aims and Objectives

to compare the effect of biliopancreatic limb length (150cm versus 200cm) regarding weight loss, resolution of comorbidities and post-operative complications especially nutritional deficiency along 2 years of follow up.

Subjects and Methods

This Retrospective study was conducted at Ain Shams university hospital (Eldemerdash). It was carried out on 80 obese patients with type 2 diabetes mellitus who underwent laparoscopic mini gastric bypass.

Result

regarding Vit D3 (nmol/L) Deficiency, Ferritin (ng/mL) Deficiency, Albumin (g/dL) Deficiency, Ca (mg/dL) Deficiency, Vit B12 (pg/mL) Deficiency, PTH (pg/mL) and regarding Hyper-Parathyroidism, there was statistically significant difference between the two studied groups. there was a higher significant difference in OAGB with biliopancreatic limb length 200 cm than OAGB with biliopancreatic limb length 150 cm regarding Cholesterol and Triglycerides remission.

Conclusion

Results showed significant differences in Vit D3, Ferritin, albumin, calcium and Vit B12 deficiencies and Hyper-Parathyroidism. OAGB with biliopancreatic limb length 150 cm was as effective in weight loss and duration of DM, but had a higher significant difference in cholesterol and triglycerides remission.
Evaluation of Management and Outcome of Blunt Liver Trauma in Pediatrics and Adults
Authors: Wagdy Hesham Hasan Hasan , Abdelrahman Ahmed Hamed , Bersy Mohamed Aly Mahmoud , Abdelaal Hamza Mohamed Mahmoud
Published: November 2024

Background

The options for the management of blunt hepatic trauma in adults and children are nonoperative management, adjuncts of conservative management such as angioembolization, and open surgery.

Objective

To describe and compare the management strategies and outcomes of blunt liver trauma in pediatrics and adults over a specified period of time in Ain Shams University hospitals.

Patients and Methods

A retrospective analytical comparative study conducted at Ain Shams University Hospitals during the period from August 2022 to September 2023. 53 cases of admitted blunt liver injuries were included: 34 in the pediatric age group and 19 in the adult group.

Results

Outcome of conservative management was very promising regarding resolution and fewer rate of complications in both groups. However, Adjuncts of conservative management (angioembolization and image- guided drainage) were crucial in some patients managed conservatively and needed more often in the adult group.

Conclusion

Our study highlights significant differences in the management and outcomes of blunt liver trauma between pediatric and adult patients. Despite similarities in the mode of trauma, pediatric patients generally experienced less severe liver injuries and had higher success rates with conservative management compared to adults. Operative interventions and blood transfusion requirements were more common in adults, reflecting the higher incidence of high- grade injuries and active bleeding in this group. While the incidence of complications did not differ significantly, clinical outcomes were better in pediatric patients, with all experiencing complete resolution. These findings underscore the importance of tailored treatment approaches based on age and injury severity to optimize outcomes in blunt liver trauma.
A Prospective Randomized Comparative Study Comparing Clipping versus Thermal Ablation in Thoracoscopic Sympathectomy for Treatment of Hyperhidrosis
Authors: Monem Rizk Mohamed Abd El , Shoka Ahmed Adel , Samee Hassab Allah Mahmoud Adel Abdel
Published: November 2024

Background

Hyperhidrosis can be defined as a pathologic condition characterized by excessive sweating beyond the body’s physiological needs to maintain its temperature within an adequate range.

Aim of the Work

The aim of this work is to Compare Clipping Versus Thermal Ablation in Thoracoscopic Sympathectomy according to the effectiveness, recurrence, and reversibility for Treatment of hyperhidrosis.

Patients and Methods

A randomized comparative prospective study was conducted in general and vascular surgery departments in Ain Shams University Hospital and Nasser institute hospital for research and treatment. The study included 20 patients diagnosed with primary hyperhidrosis either palmer and/or axillary.

Results

In our study the operative time in group A ranged from 55 – 81 minutes with mean time of 68.00 ± 8.78 minutes, While in group B, Time ranged from 45 – 70 minutes with mean time of 55.20 ± 8.59 minutes and that difference was statistically significant (P=0.004), despite that the difference between the operative time of the 2 groups was statistically significant, yet it was only about 12 minutes. The previous results indicated high success rate for both procedures and that there is no statistically significant difference between the two techniques regarding the efficacy, yet the clipping technique offered the theoretical reversibility. In our study no patients requested reversal of the effect even those who suffered from postoperative compensatory hyperhidrosis and all patients were satisfied with the result of the procedure.

Conclusion

Our study found that there is no statistically significant difference between the clipping and the cautery technique regarding operative time, rate of complication, compensatory hyperhidrosis, patient satisfaction and success rate, Yet the clipping technique has the potential theoritical reversibility in case of severe compensatory hyperhidrosis developed.
Comparative Study between Endovenous Radiofrequency Ablation and Conventional Surgery of Primary Varicose Veins of Lower Limbs
Authors: El-Ahmady Rania , Abdelmoaty Karim Fahmy , Gamil Zekry Mina , Shahin Mostafa Hany Mokhtar
Published: November 2024

Background

Varicose veins are the main manifestations of chronic venous disease (CVD), and present as dilated and elongated incompetent superficial veins in the lower limbs. The most common method of treatment for this condition is an open surgery proposed by W. Keller 110 years ago. Radio- Frequency ablation (RFA) was proved to be effective in the treatment in many randomized controlled trials.

Aim of the Work

to throw light and compare Radio-Frequency Ablation to conventional surgery in treating primary varicose veins in lower limbs.

Patients and Methods

This prospective study included 30 patients, who were treated for symptomatic varicose veins of the lower limbs divided into two groups. In first one, 15 patients underwent open surgery (the surgery group), while in the other, 15 patients received the Radio- Frequency Ablation (the RF group). The patients were invited to follow-up evaluations at first and second weeks then one and six months after the surgery.

Results

VCSS scores at one month were better in the RFA group (median VCSS scores 1 (0–2) vs. 4 (3 – 5), p < 0.0001). Patients in the RFA group experienced less postoperative pain (p < .00163). In addition, patients in the RFA group managed to return to work and normal activities sooner than those in the surgery group (p < 0.0001). No statistically significant differences were found between groups for overall satisfaction, rate of complications except hematoma which was higher in surgery group.

Conclusion

Both treatment techniques yielded similar results in terms of efficacy, complications and overall patient satisfaction. However, early postoperative results in the RF group were superior to those of patients in the surgery group.
Assessment of Bone Microarchitecture by Trabecular Bone Score (TBS) to Evaluate Osteoporosis Independent of Bone Density
Authors: Saeed Alaa Ibrahim , Abd Elmohdy Mohamed Adel , Sweed Hala Samir , Elsaid Salma M S , Safwat El Araby Mennat-ullah
Published: November 2024

Background

Osteoporosis (OP) is defined as low bone mineral density caused by altered bone microstructure, ultimately predisposing patients to low-impact, fragility fractures. Trabecular bone score (TBS) is an indicator of bone quality that has been used to assess bone microarchitecture and can predict fragility fracture. The objective of the current study is to evaluate the ability of lumbar spine TBS to assess osteoporosis independent of bone mineral density.

Patients and Methods

a cross sectional study was conducted on patients coming to Geriatric inpatient and outpatient clinic of Mansoura University Hospitals in Mansoura, Egypt, from January 1, 2021, to July 1, 2022. Our inclusion criteria included elderly male (60 years and above) and Postmenopausal females aged 50 years or above. DXA scan, TBS and QCT were done for patients presented to Geriatric inpatient and outpatient clinic.

Results

During the study period 45 persons, TBS significantly associated with bone micro- architecture, diagnose osteoporosis independent of BMD and helpful for early detection of fragility fracture.

Conclusion

TBS is significantly associated with direct measurements of bone micro-architecture, diagnose primary osteoporosis, and may be a useful adjunct to BMD for fracture detection and prediction.
Prevalence and Risk Factors of Cardiotoxicity in Elderly Cancer Patients
Authors: Ali Maha A , Sweed Hala S , Alsadany Mohamad A , Kazamel Ghada , Tolba Mohammad F
Published: November 2024

Background

Heart disease and cancer are the leading causes of death in older adults. Concerns regarding cardiotoxicity of anticancer agents may lead to under-treatment, resulting in suboptimal outcomes.

Aim

to assess the prevalence and risk factors of cardiotoxicity in elderly patients with cancer.

Patients and Methods

The study sample comprised one hundred (100) elderly participants, men and women, sixty years and above. All participants included in the study were subjected to: comprehensive geriatric assessment (CGA), laboratory investigations (including: lipid profile, fasting blood glucose, C-reactive protein), echocardiography (ECHO) and electrocardiogram (ECG).

Results

In the current study, the prevalence of cardiotoxicity was 57%. Participants who experienced cardiotoxicity were older, had higher smoking index, lower body mass index, and longer cancer duration. They had higher prevalence of diabetes, hypertension and dyslipidemia and had higher mean value of C-reactive protein. Participants who had received certain chemotherapy agents (Anthracycline, 5-Fluorouracil, Capecitabine, Arsenic trioxide, and Lapatinib), certain targeted therapy agents (Pertuzumab and Trastuzumab); and those who received radiotherapy (most commonly radiotherapy to the chest) were more liable for cardiotoxicity. Cardiotoxicity was associated with depression, malnutrition, and functional decline of the affected patients.

Conclusion

Cardiotoxicity is common in elderly cancer patients. It is associated with risk factors as older age, higher smoking index, longer cancer duration, higher prevalence of hypertension, diabetes and dyslipidemia, and treatment with certain anticancer agents. Comprehensive geriatric assessment is essential in elderly cancer patients.
Proportion of Hip Fracture and the Associated Risk Factors among Egyptian Females
Authors: Abd el Rahman Ali Mohamed Azzam , Sweed Hala Samir , Allam Mohamed Farouk , Aly Walaa Wessam , Matter Abeer Hassan Mohamed , El Aliem El Shabrawy Walid El Sayed Abd
Published: November 2024

Background

Fragility fractures caused by osteoporosis are well-known to increase the risk of further fragility fractures; a history of the wrist, vertebral body, or hip fractures increases the risk of further fractures accordingly. Fragility fractures induce lower activities of daily living, and repeated fractures further reduce mobility.

Aim of the Work

The objective of this study was to identify the proportion of hip fracture among Egyptian females and its associated risk factors, and also to identify the proportion of hidden vertebral fractures among those with fragility hip fractures.

Patients and Methods

To assess the proportion of fragility hip fractures among males aging 40 years and older we collected the cases of fragility hip fractures presented to orthopedic emergency room during the period from January 1, 2019 to December 31, 2020, excluding those with high impact fractures or pathological fractures.

Results

Assessment of the anthropometric measures revealed groups differed significantly in the BMI. Assessment of the geriatric depression scale (GDS), mini mental state examination (MMSE), and mini nutritional assessment (MNA) in the two groups demonstrated that the patient's group had significantly higher score in GDS suggestive of depression, and significantly lower score in MMSE and MNA suggestive of associated dementia and malnuitrition respectively. Also evaluation of the prevalence of chronic diseases revealed that patient's group had significantly higher prevalence of diabetes mellitus, higher intake of oral antidiabetics, higher prevalence of dementia, chronic kidney disease. Medical history assessment demonstrated that patient's group were more prevalently using steroid and antiepileptics. GDS, MMSE, and MNA had a diagnostic value for hip fractures predictors of hip fractures highlighted that significant predictors were older age, marital status, low BMI, smoking, depression, poor nutritional status, DM, dementia, CKD, and oral steroids intake.

Conclusion

Osteoporosis is a complex and costly disease, osteoporotic fractures may be largely preventable, as environmental factors are open to intervention, and effective pharmacological agents are available. From both clinical and economic perspectives, aggressive measures to detect osteoporosis at earlier stages may be warranted.
Prevalence of Cognitive Impairment in Post Stroke Patients
Authors: Sayed Sara Abdelaziz , Hamza Sarah Ahmed , Adly Nermien Naim , Tawfik Heba Mohamed
Published: November 2024

Background

Stroke is a leading cause of vascular dementia. Cognitive dysfunction strongly contributes to disability and loss in quality of life.

Objective

Our study aimed to detect post stroke cognitive impairment in a sample of Egyptian people with stroke, six months after the last cerebrovascular accident.

Methods

A cross sectional study was conducted on 120 patients with stroke, six months after the last cerebro vascular accident. Comprehensive Geriatric Assessment was performed. Cognitive assessment was done using MMSE(Mini Mental State Examination) test, functional evaluation using Modified Rankin Scale and Barthel index, Diagnosis of vascular dementia by NINDS AIREN criteria (National Institute of Neurological Disorders and Stroke (NINDS) and the Association Internationale pour la Recherche et l’Enseignement en Neurosciences (AIREN)), Hachiniski ischemic scale and radiological evidence of vascular insult

Results

Mean age of the patients was 69.17. Prevalence of cognitive impairment assessed by MMSE was 33.3%. Age was the only factor associated with poststroke cognitive impairment in regression analysis (p value 0.01). NINDSAIREN criteria is positive in 80% of patients diagnosed to have cognitive impairment (dementia) by MMSE. Patients with cognitive impairment had depression (p value 0.03), no satisfactory sleep (p value 0.01), longer post-stroke duration (p value 0.04), higher scores in Hachiniski ischemic score (p value 0.002), more than one infarction (p value 0.03) and impaired function by Barthel Index (p value 0.01). Pre stroke cognitive impairment was significantly higher in (patients with post stroke cognitive impairment (p value 0.003

Conclusion

Cognitive impairment is prevalent in stroke patients. Age was the only factor associated with poststroke cognitive impairment in regression analysis. NINDSAIREN criteria is positive in 80% of patients diagnosed to have cognitive impairment (dementia) by MMSE. Patients with cognitive impairment had depression, no satisfactory sleep, longer post-stroke duration, higher scores in Hachiniski ischemic score, more than one infarction and impaired function by Barthel Index. Pre stroke cognitive impairment was significantly higher in patients with post stroke cognitive impairment
Impact of Serum Albumin & Pre-albumin as well as Anthropometric Measurements on Long Term Survival Outcomes after Allogeneic Stem Cell Transplantation
Authors: El Afifi Amal Mostafa , El-Ghammaz Amro Mohammed Sedky , Ahmed Alia Mohammed Saeed , Hussien Abdallah Nour El Hoda , Ali Saad Ahmed ELsayed Mahmoud
Published: November 2024

Background

Allogeneic HSCT is the treatment of choice for treatment of patients with high risk features of acute leukemia or those who are relapsed after standard treatment. By now, there are few studies on nutritional assessment of hematological patients before and after HSCT, and additionally, most rely on one single assessment method.

Objective

Evaluating nutritional indicators as well as anthropometric measurements in long term survivors post-transplant, identifying their relationship on transplant outcomes.

Methods

The present work included 30 patients with two or more years after allogeneic stem cell transplantation who were following up at Bone Marrow Transplantation Unit, Ain Shams University Hospitals, during the Jan-2019 till Jan- 2023. We assessed nutritional lab parameters including albumin, prealbumin as well as anthropometric measurements including BMI, waist, circumference, waist hip ratio and body fat percentage using bioelectric impendence in long term survivors as well as assessment of quality of life using FACT-BMT questionnaire.

Results

We found statistically significant association between nutritional lab parameters as well as anthropometric measurements with late transplant outcome including incidence of chronic GVHD, disease relapse and transplant related mortality as well as post-transplant quality of life.

Conclusion

Nutritional lab biomarkers and anthropometric measurements in long term survivors post-allogeneic stem cell transplantation were a low cost, non- invasive biomarkers for early and late transplant complications, patients’ survival and quality of life.
Association between Hyperparathyrodism and Intradialytic Hypertension in Prevalent Hemodialysis Patients
Authors: Saeed Saeed Abdelwahaab , Abdelwahaab Sanad Khaled Gouda , Ezzat Mohamed Ali , Mahmoud Henna Amira Mahmoud
Published: November 2024

Background

Intradialytic hypertension is a recognized short-term risk marker associated with increased 30-day morbidity and mortality in end-stage kidney disease (ESKD) patients undergoing hemodialysis. Biomarker dynamics, reflecting changes over time, have gained importance in predicting clinical outcomes. This study investigated the relationship between hyperparathyroidism and intradialytic hypertension in prevalent hemodialysis patients, focusing on dynamic changes in intact parathyroid hormone (iPTH) levels.

Aim of the Work

This study aimed to investigate the association between hyperparathyrodism and intradialytic hypertension in prevalent hemodialysis patients.

Patients and Methods

A cross-sectional study was conducted at El Dakahlia Governorate Hospital, involving 70 ESKD patients on regular hemodialysis. Patient demographics, comorbidities, medication use, and dialysis-related parameters were recorded. Blood pressure, body mass index (BMI), and laboratory results, including iPTH, were measured pre- and post-dialysis.

Results

The mean age of the study cohort was 41.24 years, with 54.3% males. Half of the patients were on beta-blockers, 40% on ACE inhibitors/ARBs, and calcium channel blockers, reflecting the prevalence of comorbid hypertension. Patients with intradialytic hypertension (14.3%) exhibited significantly higher post-dialytic BMI and systolic blood pressure (p < 0.001), while diastolic blood pressure decreased post-dialysis (p < 0.001). No significant differences were observed in age, gender, smoking, comorbidities, or antihypertensive drug usage between patients with and without intradialytic hypertension.

Conclusion

From this study we found that the prevalence of iHTN was (14.3%). Intradialytic hypertension was significantly associated with metabolic disorders including anemia, low iPTH level. There were significant indirect moderate correlations between iPTH and SBP pre, intra and postdialytic. There was significant indirect moderate correlation between iPTH and serum creatinine. Also, there were significant indirect weak correlations between iPTH with serum BUN, serum potassium and serum phosphorus.