bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and diagnostic yield of thoracic ultrasound-assisted transthoracic biopsy performed by a pulmonologist
Authors: Ashour Laila , Ramzy Eman , El-Gharib Mohamed , Maher Rehab , El-Embaby Dalia
Published: September 2023

Background

Transthoracic ultrasonography (US) is still not utilized to its full potential by respiratory physicians, despite being a well-established and validated imaging modality. It allows for an immediate and mobile assessment that can potentially augment the physical examination of the chest. This work aims to assess safety and diagnostic yield of thoracic US-assisted transthoracic biopsy performed by a pulmonologist . Patients and methods The present study was conducted upon 75 patients who are referred to the Pulmonary Medicine Department, Ain Shams University Hospitals with radiological assessment that reveals pleural-based mass with or without pleural effusion, anterior mediastinal mass, peripheral lung lesions or chest wall lesions. The present study was conducted upon 75 (67 male and 8 female) patients with mean±SD age 58.8±15.64.

Results

This study showed that 31 cases were presented by peripheral pulmonary mass, 29 pleural lesions, nine mediastinal and six chest wall lesions, 57 of them diagnosed by sonar guided biopsy, 51 of them were malignant and the remaining six were benign.

Conclusion

Transthoracic US-assisted cutting-needle biopsy is an excellent first-line diagnostic tool for pleural-based lesions of at least 3 cm in diameter. It is a quick, low-cost, safe and well-tolerated tool in the hands of pulmonologists and has a high sensitivity for pleural-based malignancies.
Erectile dysfunction in pulmonary tuberculosis: is it a common association?
Authors: Magdy Doaa M. , Metwally Ahmed , El Zohne Randa A.
Published: September 2023

Background

Genital tuberculosis (TB) has negative influences on the reproductive function, and pulmonary TB causes disruption of the sexual function as well. The purpose of this study was to estimate the influence of pulmonary TB on male sexual function and sex hormones.

Patients and methods

Of the 55 newly diagnosed male patients with pulmonary TB (40 pulmonary and 15 extrapulmonary: six with TB lymphadenitis and nine with TB pleuritis), 20 healthy volunteers served as control. All patients were evaluated: full clinical data, sputum smear examination, chest radiography, serum testosterone levels, and The International Index of Erectile Function (IIEF-5) questionnaires.

Results

Of the studied TB cases 78.1% had erectile dysfunction, with a higher prevalence in pulmonary TB (67.2%) when compared with the 10.9% in extrapulmonary TB. As regards radiographic patterns, the patients presented with consolidation/cavitary lesion had the highest prevalence (60%). According to the IIEF questionnaires, the total score in the pulmonary group was significantly lower than that in the extrapulmonary group (10.8±2.05 vs. 20.2±3.09) (P=0.000*). The mean testosterone level was significantly decreased in pulmonary TB cases. Sputum grading of acid-fast bacilli in patients with pulmonary TB showed that the testosterone level was significantly decreased among patients with ‘3+’ (>10 acid-fast bacilli/field) sputum smears (3.23±2.88 ng/ml) when compared with sputum negative. A significant correlation was found between bacillary load and the total score of IIEF and serum testosterone levels (r=−0.323, P=0.000*).

Conclusion

Pulmonary TB has a negative impact on male sexual function. Thus, sexual problems should be in mind during the assessment and evaluation of patients with TB.
Evaluation of lung cancer patterns and bronchoscopic presentations in patients admitted to Abbasia Chest Hospital
Authors: Muhammad Farrag A. , Haytham Diab S. , Mostafa Khalaf A.
Published: September 2023

Background

Lung cancer is the most common cause of cancer-related death worldwide, accounting for more cancer-related deaths compared with colon, breast, and prostate combined.

Aim

The aim of this work is to detect the predominant bronchoscopic presentations and anatomical sites for all histopathological types of lung cancer.

Patients and methods

This study was conducted prospectively in the bronchoscopy units in Abbasia Chest Hospital. It included 132 patients suspected clinically and radiologically to have lung cancer and admitted to the hospital during the period from July 2016 to March 2017. Of them, 81 patients were pathologically diagnosed as having primary lung cancer.

Statistical analysis

χ2 test was used to examine the relationship between the two qualitative variables. Student’s t test was used to assess the statistical significance of the difference between the two study group means. McNamara test was used assess the statistical significance of the difference between a qualitative variable measured twice for the same study group.

Results

A total of 81 patients (73 males and eight females) with primary lung cancer were included in the study; most of them were in the sixth decade of life. The main anatomical sites of bronchogenic carcinoma were main bronchi and lower lobe bronchi equally (24% each), followed by lower lobe bronchi (20%). Most common macroscopic bronchoscopic presentations of bronchogenic carcinoma were end bronchial lesion (46.91%) followed by external compression (12.35%) and then mucosal infiltration and external compression (9.88%).

Conclusion

Persistent pulmonary complaints like productive cough, dyspnea, chest pain, and hemoptysis should be investigated immediately. Proper screening and early diagnostic methods should be applied on a large scale to find out suspected patients who at risk to develop lung cancer.
Frequency of hepatopulmonary syndrome and portopulmonary hypertension in cirrhotic liver patients
Authors: El-Maraghy Abbas S. , Abu Naglah Ahmed A. , Amin Ayman , Merghany Kamal A. , Khalil Mohamed M.
Published: September 2023

Background

Chronic liver diseases may cause abnormal changes in the pulmonary vascular bed. There are two important and pathophysiologically different pulmonary vascular abnormalities – hepatopulmonary syndrome (HPS) and portopulmonary hypertension (PPHTN). Pathophysiologically, HPS results from vasodilatation, whereas PPHTN results from vasoconstriction.

Objective

The objective of this study was to determine the frequency of HPS and PPHTN in dyspneic cirrhotic hepatic patients.

Patients and methods

This study included 87 patients with cirrhotic liver disease admitted to Al-Azhar University Hospitals from September 2013 to September 2015. The diagnosis of cirrhosis was based on clinical, biochemical, serological, and metabolic workup, abdominal ultrasound, or liver biopsy. All patients in this study were subjected to complete medical history taking and clinical examination, liver function tests, plain chest radiography, and thoracic high-resolution computed tomography, abdominal ultrasonography, arterial blood gas analysis in the supine and standing positions, calculation of alveolar–arterial oxygen gradient, saline two-dimensional contrast-enhanced echocardiography, and right-heart catheterization only for all cases with PPHTN.

Results

The present study showed that the prevalence of HPS was 25.28% (22 out of 87 cases) and was higher than the prevalence of PPHTN, which was 5.7% (5 out of 87 cases).

Conclusion

HPS and PPHTN are not uncommon in patients with hypoxemia and chronic hepatic disease. Diagnoses of such disorders are essential, especially in patients who are listed for liver transplantation.
Cardiac evaluation of patients with chronic obstructive pulmonary disease using echocardiography
Authors: Mohammed Yasser Moustfa , ElShahid Ghada Samir , Osman Nehad Mohammed , Abd ElHameed Nehal Qadry
Published: September 2023

Background

Chronic obstructive pulmonary disease (COPD) is a significant cause of death. Cardiovascular disease is a significant cause of morbidity and mortality in COPD.

Aim

We used echocardiography to evaluate cardiac function in patients with COPD and correlated echocardiographic findings with COPD severity.

Patients and methods

We performed a prospective cross-sectional study on 60 patients with stable COPD who presented to the Abbasia Chest Hospital during the period from November 2016 till August 2017. Spirometry was performed for all participants using American and European Thoracic Society (2005) recommendations. They were classified according to GOLD guidelines (2017) and evaluated by two-dimensional Doppler echocardiography according to American and European Association of Echocardiography ASE recommendations.

Results

Echocardiographic examination of left ventricular functions revealed no cases of left ventricular systolic dysfunction, but left ventricular diastolic dysfunction was found in ~25%. Right ventricle dilatation was found in ~18% of the patients. Tricuspid regurge was seen in ~75%, with variable grades from mild to severe. Pulmonary hypertension (PH) was found in ~40% of the patients. It was more prevalent in patients with severe and very severe disease. Correlation between echocardiographic findings and severity of COPD revealed significant positive correlation only with right ventricle size, tricuspid regurgitation, and PH.

Conclusion

Left ventricular diastolic dysfunction appears to be frequent in patients with COPD, but it is not related to the disease severity. Abnormal right heart changes could be expected. Presence of PH has a linear relationship with COPD severity.
Assessment of severe dyspnea in critically ill patients by transthoracic sonography: Fayoum experience of the Bedside Lung Ultrasonography in Emergency protocol
Authors: Agmy Gamal R. , Hamed Sherif , Saad Mohamed A. , Ibrahim Randa , Mohamed Aliaa A.
Published: September 2023

Background

Management of critically ill patients requires imaging tools, which are important for optimizing diagnostic and therapeutic actions. Both bedside chest radiography and thoracic computed tomography have limitations that constrain their utility. The aim of our work is to explore the value of transthoracic ultrasound (TUS) using the Bedside Lung Ultrasonography in Emergency (BLUE) protocol in critical ill patients with severe dyspnea.

Patients and methods

This study included 109 ICU patients with acute dyspnea at Fayoum University Hospital. The judgments of chest ultrasound using the BLUE protocol were compared with the final diagnoses; rare diagnoses and uncertain diagnoses were excluded.

Results

By application of the BLUE protocol, TUS was absolutely sensitive, specific, and accurate for the diagnosis of pneumothorax. For pneumonia, the sensitivity, specificity, and diagnostic accuracy were 93.8, 95.7, and 95.8%, respectively, whereas these parameters for pulmonary edema were 100, 96.8, and 99%, respectively. TUS was absolutely sensitive in the diagnosis of chronic obstructive pulmonary disease, asthma, or diffuse parenchymal lung disease, whereas the specificity and diagnostic accuracy were 88.9 and 88.9%, respectively, for chronic obstructive pulmonary disease and asthma and 96.8 and 100%, respectively, for diffuse parenchymal lung disease.
Clinical and laboratory profile of chronic pulmonary aspergillosis: a retrospective study
Authors: Jakribettu Ramakrishna Pai , George Thomas , Abraham Soniya , Fazal Farhan , Kinila Shreevidya , Baliga Manjeshwar Shrinath
Published: September 2023

Introduction

Chronic pulmonary aspergillosis (CPA) is a type of semi-invasive aspergillosis seen mainly in immunocompetent individuals. These are slow, progressive, and not involved in angio-invasion compared with invasive pulmonary aspergillosis. The predisposing factors being compromised lung parenchyma owing to chronic obstructive pulmonary disease and previous pulmonary tuberculosis. As not many studies have been conducted in CPA with respect to clinical and laboratory profile, the study was undertaken to examine the profile in our population.

Patients and methods

This was a retrospective study. All patients older than 18 years, who had evidence of pulmonary fungal infection on chest radiography or computed tomographic scan, from whom the Aspergillus sp. was isolated from respiratory sample (broncho-alveolar wash, bronchoscopic sample, etc.) and diagnosed with CPA from 2008 to 2016, were included in the study.

Results

A total of 30 patients were included in the study. Most patients presented with pulmonary symptoms like cough with expectoration, hemoptysis, fever, breathlessness, and chest pain. Among the systemic comorbid conditions, diabetes mellitus was the most common (7/30), and nearly 50% (14/30) of the patients had a history of pulmonary tuberculosis. Among the hematological parameters, a significant difference was observed in hemoglobin, total leukocyte count, differential leukocyte count, and erythrocyte sedimentation rate. In all the four dead patients, the cause of death was respiratory failure and all patients were previously treated for pulmonary tuberculosis.

Conclusion

When a patient with pre-existing lung disease like chronic obstructive pulmonary disease or old tuberculosis cavity presents with cough with expectoration, breathlessness, and hemoptysis, CPA should be considered as the first differential diagnosis.
Combined pulmonary fibrosis and emphysema syndrome: clinical, functional, and radiological assessment
Authors: Ghanem Maha K. , Makhlouf Hoda A. , Hassan Ali A. , Hamed Heba A.
Published: September 2023

Background

The coexistence of pulmonary fibrosis and emphysema is increasingly recognized.

Objective

To assess the clinical, physiological and radiological characteristics of patients with combined pulmonary fibrosis and emphysema (CPFE) and compare it with patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) alone.

Patients and methods

One hundred-twenty patients were enrolled and divided into three groups; 40 had COPD based on poorly reversible airflow obstruction in spirometry; 40 had ILD based on high-resolution computed tomography (HRCT); and 40 had CPFE based on the presence of emphysematous changes in the upper lung zones and pulmonary fibrosis in lower zones in HRCT. Modified Medical Research Council dyspnea scale, arterial blood gas analysis, spirometry, diffusion capacity for carbon monoxide (DLCO), polythesmography, HRCT chest, and echocardiography were done.

Results

More than 57% of patients with CPFE were men and the majority of them were smokers. There was no significant difference in dyspnea grade between CPFE group and other groups (P>0.05). The rate of exacerbation per year was significantly higher in the CPFE group (4.2±1.02) compared with either COPD group (3.33±1.56) or ILD group (3.15 ±1.05). CPFE patients had both emphysematous and fibrotic changes on radiological examination. Lung volumes were preserved but DLCO% was significantly lower and the mean pulmonary artery systolic pressure was significantly higher in the CPFE group compared with COPD and ILD.

Conclusion

CPFE is a distinct syndrome that has characteristic radiological findings and lung function profile with a significant reduction of DLCO and a significant increase in pulmonary artery systolic pressure.
Study of diaphragmatic mobility by chest ultrasound and echocardiographic changes in chronic obstructive pulmonary disease patients on different modes of mechanical ventilation
Authors: Saeed Adel M. , Elshahed Ghada S. , Osman Nehad M. , Gomaa Ashraf A. , Fahyim Samir M.
Published: September 2023

Objective

This study aimed to assess diaphragmatic mobility by chest ultrasonography and echocardiographic changes in mechanically ventilated chronic obstructive pulmonary disease patients on different modes of mechanical ventilation.

Patients and methods

The present study was carried out on 50 mechanically ventilated chronic obstructive pulmonary disease patients. Chest ultrasonography for the assessment of diaphragmatic mobility in addition to echocardiography was performed on different modes of mechanical ventilation in the same session at any time since mechanical ventilation.

Results

There was a highly statistically significant relation between diaphragmatic excursion and different modes of mechanical ventilation, where excursion increased significantly, with its peak at pressure-support ventilation (PSV). In terms of diaphragmatic thickness, the thickness of diaphragm decreased significantly at PSV. No significant correlation was detected between echocardiography in Ejection fraction, right ventricular systolic pressure, tricuspid annular plane systolic excursion, and different modes of mechanical ventilation.

Conclusion

The best diaphragmatic mobility was on PSV, which improved lung volumes and ventilation, and may accelerate the weaning process. In addition, we concluded that the echocardiographic finding was not affected by different modes of mechanical ventilation.
The effect of continuous positive airway pressure on dyslipidemia in patients with obstructive sleep apnea
Authors: Shehab-Eldin Walid Abdelmohsen , Elhabashy Mahmoud
Published: September 2023

Background

Obstructive sleep apnea (OSA) is a prevalent disease associated with increased risk of cardiovascular mortality. However, the exact causal relationship is not clear. One of the proposed mechanisms is dyslipidemia.

Aim

To study the effect of continuous positive airway pressure (CPAP) on dyslipidemia in patients with OSA.

Patients and methods

Forty obese patients with OSA were recruited. All patients were subjected to history taking, physical examination, and polysomnography. Fasting blood sugar, liver function, kidney function, and lipid profile were measured after fasting for 14 h. Apnea/hypopnea index and BMI were calculated. The patients then received CPAP treatment during night for 3 months. Polysomnography and laboratory parameters were remeasured after 1 and 3 months of treatment.

Results

The natural correlation between body weight and lipid profile is lost. Apnea/hypopnea index and high-density lipoprotein improved significantly after 1 month and more significantly after 3 months. Triglycerides were lowered after 1 month without more improvement after 3 months. Low-density lipoprotein-cholesterol and total-C did not change after 1 month with significant reduction after 3 months.

Conclusion

Treatment with CPAP improves lipid profile in patients with OSA.
Relationship between platelet count, platelet indices, and inflammatory markers in stable and acute exacerbation of bronchiectasis patients
Authors: Yigitbas Burcu A. , Sibel Yurt , Berat Uslu , Satici Celal , Pelin Uysal , Ayse Kosar F.
Published: September 2023

Background and objective

Persistent and chronic infection is one of the reasons underlying the sustained inflammation in bronchiectasis patients, and inflammatory markers may possess important clinical implications in the follow-up. Platelets are known to have effects on inflammatory response; in addition, a negative correlation has been shown between mean platelet volume (MPV) and inflammatory disease activity. The objective of this paper is to investigate and compare the levels of platelet (PLT) count and platelet indices during stable and acute exacerbation of bronchiectasis patients.

Patients and methods

Data were retrospectively collected from medical files of 63 patients (39 women) and 29 controls without bronchiectasis. Thirty patients had an acute exacerbation, and 33 were in a stable state of disease. Descriptive data, clinical, radiologic, and laboratory information were noted. The relationship between inflammatory markers and pulmonary function tests was evaluated.

Results

White blood cell (WBC) count, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and PLT count were significantly higher; however, hemoglobin level and MPV were lower during exacerbation. There was a correlation between PLT and CRP, WBC, and ESR, and a negative correlation between PLT and forced vital capacity and forced expiratory volume in 1 s. However, we found an inverse correlation between MPV and WBC, and ESR, a positive correlation between MPV and forced expiratory volume in 1 s.

Conclusion

We have found that platelet indices PLT and MPV were significant in exacerbation of bronchiectasis patients compared with stable and control patients. Cell blood count, compared with CRP and other inflammatory markers, is a more practical, useful, cost-effective laboratory examination. Not just looking at the WBC, but just taking a glance at the platelet indices would be a useful and simple way to evaluate bronchiectasis patients.
The role of chest ultrasound in detection of pulmonary congestion in hemodialysis patients
Authors: Koraa Emad El-Din Abdel-Wahab , Aly Tamer Mohamed , Hussein Hussein Sayed , Beshara Sally Kamil
Published: September 2023

Background

Volume overload is a risk factor for mortality in hemodialysis. Pulmonary congestion may be present and mostly asymptomatic between hemodialysis patients, but its outcomes are unknown.

Aim

The aim of this study was to assess the role of chest ultrasound (US) in detecting pulmonary congestion in hemodialysis patients.

Patients and methods

This study included 40 patients diagnosed with chronic renal failure on regular hemodialysis. The patients were selected from the Hemodialysis Unit, Dar El Shefa Hospital. Chest US was done predialysis and postdialysis.

Results

The study was conducted on 40 patients. The age of our patients ranged between 19 and 55 years old; history of hemodialysis ranged between 1 and 8 years; 35% were smokers; 26 (65%) patients were hypertensive; and 17 (42.5%) patients were diabetic. Lung congestion, detected by chest US predialysis, was mild in nine (22.5%) patients, moderate in 17 (42.5%) patients, and severe in 14 (35%) patients. The chest US Kerly’s B-line scores significantly reduced after dialysis, and were normal in seven (17.5%) patients, were mild in 19 (47%) patients, moderate in 12 (30%) patients, and severe in two (5%) patients.

Conclusion

Chest US can be used as a bedside test for the assessment of lung congestion in hemodialysis patients.
Study of some methods of smoking cessation
Authors: Saeed Adel M. , Osman Nehad M. , Mohamed Alaa Eldin A.
Published: September 2023

Background

Addiction of tobacco is both mental and physical. For many smokers, the best way to quit is a combination of medical, behavioral, and emotional support. The aim of the work was to study the effectiveness of aversion therapy using onion-powdered cigarette as a method of quitting compared with nicotine replacement therapy and conventional behavioral (5As) therapy in smoking cessation.

Patients and methods

A prospective, randomized study recruited 60 smokers from Ain Shams University Hospitals who were divided into three groups. Group I: included 20 participants subjected to a brief verbal (5As) therapy for smoking cessation; group II: included 20 participants subjected to a brief verbal (5As) with adding nicotine gum; group III: included 20 participants subjected to brief verbal (5As) with adding aversion therapy in the form of single onion-powdered cigarette by mixing tobacco with dried onion powder by an equal amount. Weekly interviews were conducted for follow-up, for at least 6 months from the beginning of treatment.

Results

All participants were male smokers within the age range of 21–70 years. There were significant statistical differences (P≤0.05) between the three studied groups as regards the outcome: the complete success rate of quitting was significantly higher among group 1 (30%) versus 15% in group II and 15% in group III. On other hand, the partial success was recorded in 45, 55, and 20% of group I, II, and III, respectively. Lastly failed attempts were recorded in 25, 30, and 65% of group I, II, and III, respectively. There were significance statistical correlations (P<0.05) found between the outcome and the age, pack/year, duration of smoking, craving time, presence of relapsing causes, and nicotine dependence score. However, there was no statically significant correlation (P>0.05) found between the outcome and age of initiation, occupation, presence of comorbidities, marital status, and previous quitting attempts.

Conclusion

Behavioral therapy (5As) is most effective in smoking cessation program. Nicotine replacement therapy and aversion therapy may be an adjuvant in the smoking cessation program. Aversion therapy is a simple procedure, economic, practical, easy to apply, and may be effective in smoking cessation.
Serum and synovial matrix metalloproteinases 1 and 3 in patients with early rheumatoid arthritis: potentially prospective biomarkers of ultrasonographic joint damage and disease activity
Authors: Abdelrahman Maryam A. , Sakr Hossam M. , Shaaban Menat A. A. , Afifi Naglaa
Published: September 2023

Background

Matrix metalloproteinase-1 (MMP-1) and MMP-3 play important roles in the pathogenesis of rheumatoid arthritis (RA) and have been suggested as markers of disease activity and joint damage.

Objective The aim was to analyze the clinical significance of MMP-1 and MMP-3 in relation to markers of disease activity and degree of joint destruction in patients with early RA at presentation and after 6 months.

Patients and methods

Baseline levels of serum MMP-1 and MMP-3 were assessed in 50 patients with early RA (symptoms <1 year), 20 patients with osteoarthritis (OA), and 20 age-matched and sex-matched healthy controls. Serum MPP-1 and MPP-3 were correlated with disease activity markers [erythrocyte sedimentation rate (ESR), C-reactive protein, disease activity score 28–ESR] and radiographic joint damage using simple erosion narrowing score and musculoskeletal ultrasound of wrist and hand joints. Baseline synovial fluid MMP-1 and MMP-3 levels were evaluated for 20 patients indicated for arthrocentesis.

Results

Baseline serum MMP-1 and MMP-3 were significantly higher in RA group versus OA group and healthy controls (P<0.001). Synovial MMP-1 and MMP-3 levels were significantly higher in RA versus OA group. Serum MMP-1 and MMP-3 levels significantly correlated with rheumatoid factor titers, anticyclic citrullinated peptide, disease activity score 28-ESR score, joint erosions, and Outcome Measures in Rheumatology score of synovitis and Doppler signals. Serum MMP-1 did not correlate with C-reactive protein, but significantly correlated with the number of erosions at presentation and on follow-up. The number of patients with erosions and the number of erosions per patient increased after 6 months and correlated with serum MMP-1 and MMP-3. The best cutoff values of serum MMP-1 and MMP-3 to discriminate between RA and healthy controls were greater than 20 and greater than 50ng/ml, respectively.

Conclusion

Elevated serum levels of MMP-1 and MMP-3 can be used as an indicator of disease activity in patients with early RA and can reflect the degree of joint damage and correlate with the number of new joint erosions.
Study of proinflammatory and anti-inflammatory states in myelodysplastic syndrome patients
Authors: Hassan Alaa E. , Tahoon Marwa , Bediera Hanan
Published: September 2023

Background

The myelodysplastic syndrome (MDS) are a group of clonal bone marrow neoplasms characterized by ineffective hematopoiesis, manifested by morphologic dysplasia in hematopoietic cells and by peripheral cytopenia(s) although previous studies have shown cytogenetic and molecular abnormalities, the underlying defect in the molecular pathway for inflammation milieu, extensive apoptosis, and dysplasia observed in the disease is yet to be studied.

Aim of the work

The aim of this study was to show the proinflammatory [tumor necrosis factor-α (TNF-α)/anti-inflammatory [interleukin-10 (IL-10)] balance in different subclassifications of MDS.

Patients and methods

From September 2017 through September 2018, serum levels were measured in 49 patients for TNF-α, IL-10 in patients diagnosed as having MDS. Also, these inflammatory cytokines had been measured in 46 apparently healthy participants as matched controls for the study. The diagnosis of MDS was confirmed by a hematopathologist after review of bone marrow aspiration and/or peripheral blood samples. Conventional cytogenetic studies were performed on bone marrow aspirate material using standard G-banding techniques. These patients were then subclassified according to the revised 2016 WHO classification for MDS.

Results

There is a statically significant difference between MDS patients and control group according to the results of serum level of TNF-α and IL-10. They were higher in MDS patients. Also, there was a statically significant difference between the subclassified groups of MDS patients according the results of serum level of TNF-α and IL-10. TNF-α was higher in MDS with multilineage dysplasia and MDS unclassifiable than the others. Also, IL-10 was higher in MDS with excess blasts 1 and MDS with excess blasts 2 than the others.

Conclusion

TNF-α and IL-10 are increased in MDS patients indicating an inflammatory disturbance. TNF-α and IL-10 serum level are inversely related to each other in the different subclasses of MDS.
Excessive use of electronic gadgets: health effects
Authors: Sarla Gurmeet Singh
Published: September 2023

Mobile phones, internet, social networking sites, and texting have changed the way we see the world. There are ~6.9 billion mobile users, almost as many as people on earth. People who excessively use electronic gadgets develop musculoskeletal disorders. Repetitive strain injury is a chronic condition that develops because of repetitive, forceful, or awkward hand movements for prolonged periods leading to damage to muscles, tendons, and nerves of the neck, shoulder, forearm, and hand, which can cause pain, weakness, numbness, or impairment of motor control. Eyes, neck muscles, arm, and wrist are affected with prolonged use of electronic gadgets. People who use smartphones excessively, because of their reduced amounts of face-to-face interaction, are likely to have a feeling that their social relationships are not supportive and rewarding and that they are not actively contributing to the happiness and well-being of others. The aim of this review article is to study literature and list the problems associated with prolonged use of electronic gadgets and ways to minimize the symptoms owing to increased ‘screen time’. Smartphone overuse may lead to development of repetitive stress injury or overuse syndrome thereby affecting hand function resulting in pain in the thumb. Prolonged use of electronic gadgets may affect the human body adversely. There is a critical need to promote healthy ways of smartphone use, as well as the importance of friendship and family connectedness as a way of promoting the psychological well-being. Physicians should get themselves updated of these new disorders and younger generation needs to be educated adequately about the ergonomic practices and health safety of gadget usage.
Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire
Authors: Elsherbiny Tamer M.
Published: September 2023

Background

Autoimmune hypothyroidism, also commonly known as Hashimoto thyroiditis (HT), is the most common cause of hypothyroidism in iodine-replete areas. Thyroid autoimmunity was shown to be associated with lower quality of life, higher symptom load, and poor physical and psychological well-being. The aim of this study is to evaluate the disease burden of HT using a thyroid-specific questionnaire, the thyroid patient reported outcomes (ThyPRO).

Patients and methods

The study included 194 patients, divided into two groups: group 1 included 124 patients with HT stable in euthyroidism 6 months before inclusion in the study, and group 2 included 70 patients with euthyroid benign thyroid disease other than HT. All patients completed a professionally translated, carefully revised version of the ThyPRO questionnaire into Arabic language. All patients had their thyroid stimulating hormone (TSH) measured at inclusion. Anti-thyroperoxidase and/or anti-thyroglobulin antibodies were recorded for each patient where available.

Results

There were no significant differences between the two studied groups regarding age, sex, and TSH. Both anti-thyroperoxidase and anti-thyroglobulin antibodies were significantly higher in HT group versus group 2. Group 1, HT group, showed significantly higher score in the hypothyroid symptom scale compared with group 2. No significant differences were found regarding the remaining symptom scales. Within hypothyroid symptom score scale, group 1 showed significantly higher scores in dry skin and swollen hands and feet items but not in cold sensitivity and itchy skin questions.

Conclusion

This study showed that thyroid autoimmunity, independent of thyroid function status, is associated with hypothyroid-like symptoms compared with benign thyroid disease other than HT. This may be caused by a direct or an indirect role of thyroid autoantibodies.
Sustained virological response 12 versus sustained virological response 24 as evaluation endpoints in chronic hepatitis C virus Egyptian patients treated with sofosbuvir-based regimens
Authors: Elsabaawy Maha M. , Gameel Khalid , Eldemerdash Heba , Zakareia Talaat , Eltahawy Mahmoud , Albert Marry , Fekry Marwa , Ouda Enas , Elshazly Helmy , Eljaky Ashraf
Published: September 2023

Background

The recommended reliance on 12 weeks posttreatment sustained virological response (SVR12) instead of SVR24 was validated for treatment evaluation.

Aim

Judging claimed concordance between SVR12 and SVR24.

Patients and methods

In a prospective study, 91 patients received sofosbuvir (SOF)+interferon+ribavirin (RV) for 12 weeks; 52 patients received SOF+RV for 24 weeks; and 56 patients received SOF+simeprevir for 12 weeks. Demographic and laboratory data, transient elastography, treatment regimens, hepatitis C virus RNA at week 4, week 12, and SVR12 and were reported. Patients who failed to achieve undetectable hepatitis C virus RNA at the end of therapy were excluded.

Results

Concordance between SVR12 and SVR24 was 96.5%, with a positive predictive value of 96.4%. Regarding treatment groups it was found to be 95.6% for SVR24 in SOF+interferon+RV-treated patients, 94.2% in SOF+RV-treated patients, and 100% concordance in SOF+simeprevir-treated patients with insignificant values (P=0.2). In spite of nonsignificance, the reported seven (3.5%) relapsers were mainly male gender (five cases, P=0.9), naïvely treated (five cases, P=0.6), achieved rapid virological response (five cases, P>0.005), with advanced fibrosis (F4) by fibroscan (five cases, P=0.7). Regression analysis failed to detect any predictors of relapse.

Conclusion

In spite of the high grade of concordance between SVR12 and SVR24, the reported rate of relapsers necessitates the backward commitment to SVR24 as a reliable primary endpoint of treatment response evaluation.
Comparing outcome of formal and informal remediation programs in children with central auditory processing disorder
Authors: Oraky Samah M. , Tawfik Somaia , Salama Mohamed , Mohamed Enass S.
Published: September 2023

Aim

The aim of this study was to compare the outcome of central auditory processing rehabilitation when using two different strategies:

In the first strategy, computer-based remediation program (temporal processing and phonemic awareness training) was used.

In the second strategy, informal remediation program (temporal processing and phonemic awareness training) was used.

Patients and methods

Fifty children with learning disability due to Central Auditory Processing Disorder (CAPD) were selected from primary schools in Assiut city. They were subjected to psychophysical test battery. It comprised dichotic digits, pitch pattern sequence, auditory fusion test and electrophysiological test (cortical P1). They were divided into two equal groups (A and B): group A received the formal auditory training (AT) and group B received the informal AT for a minimum duration of 2 months. Re-evaluation of those children was performed using the same test battery used in the diagnosis.

Results

There was a statistically significant difference in all psychophysical tests and electrophysiological P1. Subjective improvement was noticed also at the level of the questionnaire.

Conclusion

Both formal and informal remediation programs used in this study proved to be effective and promising AT strategies for ameliorating central auditory disorder.
The role of simple office-based surgery in small central tympanic membrane perforation
Authors: El-Rasheedy Abdel-Latif I. , Abdel-Fattah Ayman A. , El-Naga Heba A. Abo , El-Barbary Mustafa M.
Published: September 2023

Objective

The aim of this study was to evaluate the outcome of simple office-based surgery in small central tympanic membrane (TM) perforation.

Background

The purpose of closure of TM perforations is to restore the continuity of the TM in order to improve hearing and decrease the risk of middle ear infections. Rapid and cost-effective procedures like chemical cauterization and fat plug myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement.

Patients and Methods

Our prospective study was carried out on 40 patients aged more than 15 years with dry small central persistent perforation during the period spanning from April 2017 to March 2018, divided in two groups: group A (20 patients underwent fat graft myringoplasty) and group B (20 patients underwent chemical cautery of the edge of perforation).

Results

Our study included 26 male patients and 14 female patients; the mean age was 27.2 ±9.3 years. Our study showed a 70% success rate in the healing of TM perforation in group A while there was a 55% success rate in group B.

Conclusion

From our study, we found that the two procedures are easy to perform, reliable with a satisfactory outcome, simple, rapid, risk free, and also lessen the financial burden and morbidity on the patient.
Effect on postoperative pain after topical application of local anesthetics in the tonsillar fossa after tonsillectomy
Authors: El Daly Ahmed , El Naby Moustafa Abd , Emad Pola
Published: September 2023

Background

Tonsillectomy is one of the most commonly performed surgeries in ENT practice. Despite improvements in anesthetic and surgical techniques, post-tonsillectomy morbidities continue to be a significant clinical concern. Pain is the cause of most of the postoperative morbidity after tonsillectomy. An effective pain therapy to block or modify the physiological responses to stress has become an essential component of modern pediatric anesthesia and surgical practice.

Aim

The present study compares the results between the effect of lidocaine 2% infiltration, lidocaine 10 % spray, and bupivacaine 0.5% spray in the tonsillar bed after tonsillectomy on postoperative pain.

Materials and methods

The study included a total of 120 patients aged 5–18 years who were candidates for tonsillectomy at the Otorhinolaryngology Department of Alexandria Main University Hospital. The patients were randomly divided into three groups of 40 patients each. Group A received lidocaine 2% (Xylocaine) peritonsillar infiltration 2ml in one tonsillar bed and posterior pillar; group B received lidocaine 10% (Xylocaine) spray 2 puff in one tonsillar bed; group C received bupivacaine 0.5% (Marcaine) solution 2ml in one tonsillar bed spray by syringe and the other tonsillar bed in each group receives pack with similar amounts of normal saline for 5 min as a control group after tonsillectomy before recovery from anesthesia.

Results

There was no statistical difference between the three studied groups as regards age and sex. There is significant statistical difference according to the frequency of throat pain and ear pain by comparing cases and controls of each group within the first 24 h after surgery. It appears that increased frequency of postoperative throat pain and ear pain is present with the control side (saline).

Conclusion

Topical application of the tonsillar bed with a local anesthetic after tonsillectomy results in significant reduction of postoperative throat pain and referred otalgia and should be used during surgery for tonsillectomy.
Surgical complications and morbidity in cochlear implantation
Authors: Sefein Ihab K.
Published: September 2023

Introduction

Cochlear implantation (CI) has been established worldwide as the surgical treatment for individuals with bilateral severe-to-profound hearing loss. This is a safe and standard procedure in the hands of experienced implant surgeons. Complications due to surgery are minimal and are often encountered in cases of congenital anomalies of the temporal bone and inner ear.

Patients and Methods

All patients receiving CI at our institution between 2014 and 2015 were included in the study.

Aim

The aim of this study was to report the frequency of surgical complications following 112 consecutive CIs in 102 children and 10 adults in the National Hearing and Speech Institute (HIS), Cairo, Egypt. The international consensus on the reporting of CI complications proposed by Hansen and colleagues was used and evaluated.

Results

In all, 112 implantations were performed in 102 pediatric and 10 adult patients. Overall, complications occurred in 21 (18.75%) patients, including minor complications in nine (8.03%) and major complications in 12 (10.71%) cases. Complications were delayed in nine (8.03%) cases. No death was attributed to device implantation. Major complications occurred in 12 cases, which included misplaced electrodes in two cases, cerebrospinal fluid leak (gusher) in four cases, labyrinthitis ossificans in one patient, magnet displacement in one case (chronic suppurative otitis media), central perforation in one case, seroma and hematoma (severe cutaneous infections) in one case, wound infection in one case, and persistent pain/discomfort (migration) in one case.

Conclusion

Complications of CI are more common in children than in adults with trauma as a major factor. Inner ear malformations should prompt specific preventive management. CI in young children did not appear to be a risk factor in this study.
Database System Based on 3Dmax Big Data Mining Technology
Authors: Chen Xiaoyu , Zhang Junkai , Ren Pengshan , Hua Xian , Ni Yanfeng
Published: September 2023

INTRODUCTION: This project intends to study the mining method of FP-growth frequent items in 3Dmax big data under the Hadoop framework and combined with the Map Reduce development model. Firstly, the transaction database is selected according to the frequency of each transaction and the corresponding projection library is generated. Then the obtained image database is distributed on each node computer. Then, under the guidance of the node machine, the projection is divided into different regions to produce several smaller sub-databases. The method is parallelized by using node machine to generate local frequency items. Finally, all the local frequency sets are merged into one complete frequency set. This method does not need to generate as many FP trees as the regular FP-growth method. This method can overcome the computational failure problem caused by the limited memory of a single computer by the conventional FP-Growth method and other methods. At the same time, because the sublibraries of partitions are similar in size, the load distributed to each node machine is more balanced. The effectiveness of the algorithm is improved.
Development of a Sustainable Polyculture Technique Using Asian Watergrass as Fish Feed in the Southern Coastal Region of Bangladesh
Authors: Hossain Md. Moazzem , Shahjahan Md. , Rahman Md. Hafijur , Khan Saleha , Saha Newton
Published: September 2023

Globally, the quality and high cost of fish feed are vital issues for the development of sustainable aquaculture and food security. Present study was investigated in 4 treatments to find out the compatible species combination for polyculture using Asian watergrass as natural feed for fish in the tidally flooded coastal wetlands for a period of 6 months. Grass carp, common carp, tilapia, mrigal and silver barb were stocked in different species combination with an identical density of 12500 fish ha-1. In all treatments, grass carp and common carp were commonly stocked but other 3 species were disparate to stock among the treatments. Important water quality parameters were monitored those were suitable and acceptable range for aquaculture. The survival of fishes varied from 66.7±8.3 to 91.2±2.9% irrespective of fish species. The total fish production was found significantly higher (p<0.05), 5579.04±238.74 kg ha-1 in T3 followed by 4582.21±200.01 kg ha-1 in T2, 4571.52±189.78 kg ha-1 in T4 and 4448.37±247.26 kg ha-1 in T1 respectively. The results demonstrate that the combination of grass carp, common carp, tilapia, and silver barb in T3 was ideal compatible species for polyculture in coastal wetlands. This technique should be applied in haor, baor, beel, canals, and other water-logged areas pervaded by climate changes.
Predicting the Trajectories of Drifting Objects in the Eastern Mediterranean Sea
Authors: Tombul Serdar , Tukenmez Emre , Oksuz Murat , Altiok Husne
Published: September 2023

Forecasting of the tracks of drifting objects in the sea is a complicated process due to the effects of many phenomena such currents and wind. In this research, the problem is solved with model data and a basic approach. In this approach, we apply an iterative method based on surface current and wind data to predict the trajectories of possible drifting objects in the Eastern Mediterranean Sea. The main surface current circulation has a cyclonic nature, and its impact on the routes of drifting objects is clearly seen. The results of the study are useful for predicting the trajectories of drifting objects and the proposed method and calculations can be roughly used for drifting trajectory prediction. The advantage of this method is that it is user-friendly and provides many tracks in a minute. The biggest uncertainty in this work is obtaining accurate information about where and when the object started to drift.
Probiotic Potential of Bacillus pumilus COFAHE_Pro08 and Lysinibacillus macroides COFAHE_Pro06 Isolated from the Intestine of Labeo catla
Authors: Devi Wangkheimayum Malemnganbi , Irungbam Surajkumar , Kumar Monalisha , Choudhury Tanmoy Gon , Kamilya Dibyendu
Published: September 2023

This study aimed to evaluate the autochthonous bacterial strains of intestinal origin from the Labeo catla for their prospective use as probiotic. COFAHE_Pro08 and COFAHE_Pro06 were selected (out of 31 bacteria strains) for their potent antimicrobial activity against pathogenic Aeromonas hydrophila ATCC 7965. The Pro08 and Pro06 strains were identified as Bacillus pumilus and Lysinibacillus macroides, respectively, by 16S rRNA sequencing. The Pro08 showed a high multi-specific antibiosis efficiency score and a high spectrum of antibacterial activity. The Pro08 showed more pH and bile tolerance than the Pro06. In the in vitro adhesion study, Pro06 exhibited more cell-surface hydrophobicity while Pro08 showed a better capability of auto and co-aggregation along with biofilm-forming ability. The Pro08 significantly adhered to mucosal-surfaces. The Pro08 showed positive protease, amylase, lipase, and cellulase activity, the Pro06 was positive only for lipase activity. The radical-scavenging activity was significantly higher in Pro08 than Pro06. The Pro06 was resistant to oxacillin antibiotics, while pro08 was susceptible to all the tested antibiotics. Both strains were non-haemolytic and were non-toxic to fish embryos. No mortality or clinical-signs were observed during the challenged study in L. catla. B. pumilus exhibited better probiotic attributes than L. macrolides for a novel application in aquaculture.
Filters, Conventional, Electromagnetic Interference Reduction General Specification For
Authors:   AE-4 Electromagnetic Compatibility (EMC) Committee
Published: September 2023

This specification covers the general requirements for conventional AC and/or DC current carrying filter networks for the reduction of electromagnetic interference. A conventional filter is defined herein as a component containing definitive, lumped, R-L-C components and not employing distributed parameters as a required characteristic.