bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of HCV among ESRD Patients on Regular Hemodialysis in Ain Shams University Hospitals after Implementation of National Eradication Initiative
Authors: Ahmed Abdelkareem Mohand Abdelnasser , Sarhan Iman Ibrahim , Gaafary Maha Mohamed El , Tawfik Ahmed Mohamed , Abd El-Mohsen Mohammed Atef
Published: November 2024

Background

Egypt is one of the highest countries in the world regarding the prevalence of hepatitis C virus (HCV) infection. End stage renal disease (ESRD) patients are at higher risk for HCV infection more than general population. Since 2014 Egypt has started a large elimination program for screening and treatment of HCV. Goal was early detection and treatment of HCV patients. Intending HCV prevalence reduction to < 2% in 10 years, in line with global targets. In addition, Egypt has aimed to treat 250000 people annually up to 2020 in the first phase of their treatment program aiming at reducing the number of viremic patients, thus limiting the ongoing HCV transmission.

Aim of the Work

to measure the prevalence of HCV infection among ESRD patients and to identify the reasons of missed treatment among those who were offered the treatment free of charge.

Patients and Methods

This multi-center cross sectional study included 410 patients receiving hemodialysis sessions on regular basis 4 hours/3 times per week for more than 6 months in Ain Shams University Hospitals, patient recruitment from March 2023 to August 2023.

Results

Our studied 410 patients had mean age of 47.13 ± 18.19 ranging between 18 – 85 years old with male predominance (62.4%). With different educational levels. Most of them had comorbidities (85.6%), as HTN (54.1%) being most predominant. Prevalence of HCV infection is (27.6%), Among patients with HCV infection, (84.1 %) received treatment and (15.9%) didn't receive treatment due to several causes. The patients with positive HCV infection had a lower educational level than negative HCV infection with a statistically significant difference (P = 0.027). The patients with positive HCV PCR had a prolonged onset of renal function impairment than negative HCV PCR with a statistically highly significant difference (P = 0.009), and also positive HCV PCR had prolonged dialysis duration and a prolonged duration of HCV infection than negative HCV PCR with a statistically significant difference.

Conclusion

The low prevalence of HCV among hemodialysis patients of HCV in hemodialysis patients confirms that HCV infection doesn’t become a major health problem among patients on maintenance hemodialysis. However, strict adherence to effective and proper procedures for controlling hepatitis infections will warrant preventing and reducing the prevalence of hepatitis infections. Clinically, hemodialysis patients require more attention and resources than the general population.
Study of Plasma Cyclic Guanosine Monophosphate as a New Marker in Patients with Portal Hypertension
Authors: Adel Nannes Ahmed , Mohamed Eslam Safwat , Faheem Heba Ahmed , Moustafa El Kassas Omar Galal El Din
Published: November 2024

Background

Clinically significant portal hypertension (CSPH), which causes a number of problems such variceal haemorrhage, ascites, and hepatorenal syndrome and is linked to a drastically decreased chance of survival, is a turning point in the development of liver cirrhosis. Therefore, the diagnosis of CSPH has significant prognostic significance. The measurement of the invasive hepatic venous pressure gradient (HVPG) is the gold standard for the diagnosis of portal hypertension.

Objective

To evaluate plasma level of cyclic guanosine monophosphate as a possible biomarker in patients with liver cirrhosis and portal hypertension

Patients and Methods

The type of study is a case control study; which were performed at Ain Shams university hospitals inpatients and outpatients settings for one year. The study population includes 80 patients with liver cirrhosis (40 cirrhotic patients without portal hypertension and 40 cirrhotic patients with portal hypertension 20 healthy controls). Inclusion Criteria involves adult over 18years old patients form both sexes.

Results

In this study we found that there was high statistically significant difference between the studied groups as regard Plasma cGMP, as level of cGMP in patients with portal hypertension is higher than in patients without portal hypertension (p < 0.001). In the present study we found that there was no statistically significant relation between Plasma cGMP and varices in patients with portal hypertension or without portal hypertension (mean 85±14.96 range:46.4-111.3, mean 82.05±20.96 range 62.5-111.3 respectively, p = 0.608).

Conclusion

The current investigation shows that cirrhotic patients with CSPH have dramatically disturbed plasma cGMP homeostasis. Our findings suggest that cGMP may be used as a blood- derived CSPH biomarker, particularly in the context of esophageal varices screening.
Mac-2 Binding Protein Glycosylation Isomer as a Hepatocellular Carcinoma Marker in Patients with Chronic Hepatitis B or C Infection
Authors: Mohamed Farag Sherif Monier , Halima Sami Mahmoud Abdou Mahmoud Ahmed Samir Abo
Published: November 2024

Background

Hpatocellular carcinoma HCC is now the sixth most common cause of cancer worldwide. The second leading cause of cancer death after lung cancer in men is HCC. The most frequently used screening tests for HCC patients are hepatic ultrasound (US) with or without assessment of alpha-fetoprotein, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity. So the aim of this study was to evaluate the role of mac 2 as a diagnostic marker in HCC Egyptian patients.

Objective

This study will assess the role of Mac-2 Binding Protein Glycosylation Isomer as a Hepatocellular Carcinoma Marker in Patients With Chronic Hepatitis B or C Infection.

Patients and Methods

This study had been carried out on 70 subjects, age range more than 18 year selected from Internal medicine and Hepatology outpatient clinics and inpatient wards at Ain Shams university hospitals from august 2022 to june 2023, after informed consent were taken from the patients

Results

This study was carried out on 70 participants divided into 2 group: 35 patient post viral cirrhotic patients with Hepatocellular Carcinoma, 35 patient post viral cirrhotic patients without hepatocellar Carcinoma selected from Ain Shams university hospitals, after informed consent were taken from the patients. Subjects were divided as follow: Group A (Hcc): 35 patients with Hepatocellular carcinoma, More than 18 years. Group B (Cirrhotic): 35 patients with liver cirrhosis without Hepatocellular carcinoma, age more than 18 years

Conclusion

We concluded from this study that: Serum Mac2 level was significantly higher in patients with HCC regardless of other characteristics as presence of combined conditions as DM and HTN or Viral markers and mildly elevated in patients with liver cirrhosis compared to HCC group. MAC 2 is more sensitive than AFP in differentiation between HCC and cirrhoitic patients but AFP is more specific. Using of mac 2 will improve the diagnostic field and can help in early detection of HCC in surveillance programs Together with AFP.
Effect of Probiotic Supplementation on Disease Activity in Rheumatoid Arthritis Patients
Authors: Elsayed Adel Mahmoud , Morshedy Nashwa Aly , Abdalkader Ahmed Abdallah , Hany Sabrina Mohamed
Published: November 2024

Background

Rheumatoid arthritis (RA), a prevalent inflammatory arthritis with a global incidence of 0.5–1%, is characterized by autoimmune-driven articular pain, cartilage degradation, bone destruction, and functional disability. Emerging evidence suggests a potential link between alterations in gastrointestinal microflora and the development of autoimmune diseases, including RA. Probiotic bacteria have gained attention as a potential adjunctive therapy due to their immunomodulatory properties, offering promise for improving clinical and metabolic outcomes in RA patients.

Aim of the Work

To study the effects of probiotic supplementation on clinical status of patients with RA.

Patients and Methods

Sixty Egyptian RA patients aged 18-60 years, diagnosed and screened in the Rheumatology department at Ain Shams University Hospital, were enrolled in this study. The patients were divided into two groups: group A received daily probiotic supplementation for 8 weeks, while group B served as the control. Detailed clinical assessments and laboratory investigations were conducted.

Results

There were no significant differences in age, sex distribution, disease duration, or disease- modifying antirheumatic drugs (DMARDs) usage between the two groups, consistent with previous research. The probiotic regimen included Lactobacillus acidophilus and Bifidobacterium animalis.

Conclusion

Probiotic supplementation in RA patients yielded mixed results in this study, with improvements in TJC and ESR but no significant changes in SJC, CRP, or disease activity scores. Further research is needed to elucidate the complex relationship between gut microbiota and RA pathogenesis and to determine the optimal probiotic regimen for improving clinical outcomes in RA patients.
Outcome of Integrated Motivational Interviewing and Cognitive Behavioral Therapy in Egyptian patients with Substance Use Disorder
Authors: EL-Din Mohamed Hossam , Mohsen Nesreen , Azzam Lobna AbuBakr , Elsayed Yasser Abdel Razek , Alghonaimy Ahmed Adel
Published: November 2024

Objectives

The authors aimed to evaluate the outcome of combined motivational in- terviewing and cognitive-behavioral therapy (MICBT) for substance use disorder com- pared to Twelve-step program of Narcotic Anonymous (NA) in terms of the number of relapses and the period of abstinence after discharge.

Method

This randomized controlled trial included 60 individuals with a substance use disorder. Participants were randomly allocated to equal groups. The MICBT group re- ceived 20 sessions of approximately 90 minutes of MICBT group therapy. The NA (control) group was assigned to twelve-step NA program. The assessment was con- ducted 6 months after the intervention.

Result

The implementation of MICBT in a group setting leads to a significant decline in the number of days of drug use in 6 months follow- up (P < 0.001), an increase in the number of days of abstinence in 6 months follow up (P < 0.001), and a longer time to the first lapse (P < 0.001).

Conclusion

Using MICBT in group settings presents a favorable outcome in clinical contexts.
Serum Alpha Synuclein Autoantibodies in patients with Essential Tremor
Authors: Shalash Ali , Salama Mohamed , Hamed Eman , Doma Ahmed
Published: November 2024

Essential tremor (ET) is one of the most common neurological disorders. However, there’s no definite ET biomarker and the diagnosis depends on its clinical presentation. Therefore, ET can be easily misdiagnosed with other diseases especially parkinson’s disease (PD). PD, being one of a group of neurodegenerative diseases calked synucleinopathies, can be difficult to differentiate from ET both in the early stages of these diseases and as they progress, since various types of tremors (such as rest, postural, kinetic, and intention tremors) can be observed in both conditions. We aimed to investigate the relation between ET and alpha synuclein (aSyn) protein in patients with ET and healthy controls.

We enrolled 32 patients with ET and 32 age and sex matched controls, aiming to investigate serum level of aSyn protein and its autoantibodies. Additionally, we also investigated neuropsychiatric, non-motor symptoms (NMS), and quality of life (QoL) among two groups.

The study found that serum aSyn levels in healthy controls are significantly higher than those in ET cases, in the other hand, serum aSyn autoantibodies shows no significant difference between the two groups. Furthermore, we found that patients with ET had more cognitive impairment, higher depression and anxiety, higher frequency of NMS, and lower quality of life than healthy controls.

Conclusion: serum aSyn level can differentiate between patients with ET and healthy controls while serum aSyn autoantibodies cannot differentiate between the two groups.
Seeking Traditional Healers in the Management of Epilepsy
Authors: Sheikh Mohamed Ahmed Omar , Adin Nahid Salah , Ali Shalash Ali Soliman , Roushdy Tamer Mohamoud
Published: November 2024

Background/Aims

The best of the available literature, data about seeking traditional healers by patients with epilepsy are lacking in Egypt.

Methods

The current study was conducted on Epilepsy patients from Egypt to determine the prevalence of traditional healers among individuals with epilepsy during the period from June-2022 to may-2023. Sixty four patients, male or female ≥18 years old, with epilepsy, were included. All patients were subjected to the assessment Questionnaire for knowledge, attitude to and perception of epilepsy, and seeking traditional healers (THs) using an interviewer. The questionnaire was in Arabic.

Results

The study included 64 Epilepsy patients. Seeking TH is Egypt 22/64 (34.4%); however, Seeking THs is affected by gender, location, employment status, educational level; but not by age, duration of disease, presence of similar cases in the family or by being an offspring of consanguineous marriage. The percentage of cases who believe the reason behind the symptoms is envy/ Eye /super powers/ Evil spirits/magi in the overall sample is higher in the THs seekers (52.3%) than in the non-seekers (10.3%), p < 0.001. in Egypt it is (54.5%) versus (14.3%), p = 0.001.

Conclusions

The current study showed that seeking traditional healers is still prevalent. Our work showed that seeking traditional healers is more in rural areas, unemployment, females, low educational levels, lack of facilities with specialization in neurology in rural areas.
Rate of Personality Disorders in a Sample of Egyptian Students from Ain Shams University
Authors: Mohammed Hassan Yasser Abdelrazek , Abdelmegeed Hatata Hesham Ahmed , El-Rassas Hanan Hany Hassan , Elsaid Abdelkader Mostafa Ahmed , Ahmed Ahmed Alaa Eladawy
Published: November 2024

Background

An individual is considered to have a personality disorder (PD) when his or her thoughts, emotional manifestations, impulsiveness, and interpersonal behaviour deviate markedly from the expectations of that individual’s culture. Between 6 % and 10 % of the global population is estimated to suffer from a PD.

Aim of the Work

Estimation rate of personality disorders among students of Ain Shams University, compare between rate of personality disorders among medical, literary students.

Patients and Methods

This study is a comparative, cross sectional study, the sample was selected from students of Ain Shams University. This study was started after approval of the protocol by the department of Neuropsychiatry as well as Ethics Committee till accomplishment of the number of the subjects.

Results

There was significant difference between medical group and literature group according to socioeconomic level and academic “years”. This could be explained due to cultural preferences as higher socioeconomic level families are more able to withstand the cost of education in medical colleges. Regarding significance in academic years this could be simply due to longer faculty years in medical colleges (5 and 6 years) compared to literature colleges (only 4 years). Among the two groups, the rate of personality disorder was 26 students (10.4%). The most common personality disorder was obsessive-compulsive personality disorder (7 students) followed by depressive personality disorder (6 students) then dependent and narcissistic personality disorders (3 students each). There was no significant difference between medical group and literature group regarding personality disorders. Comorbid psychiatric disorders were evident in 26 students (10.4%). Of these students, dysthymic disorder was the most common (6 students, 23.1%) followed by depression and GAD (3 students each, 11.5%). There was no statistically significant difference between medical group and literature group according to comorbid psychiatric disorder.

Conclusion

This study was conducted to assess rate of PDs among Egyptian university students. The rate of PD was 10.4%, as the most common PD was obsessive-compulsive PD followed by depressive PD. Comorbid psychiatric disorders were evident in 10.4% of students. Of these students, dysthymic disorder was the most common (23.1%) followed by depression and GAD (11.5%). Moreover, there was significant association between presence of PDs and troubles in school and the most significant predictors of PD were comorbid psychiatric disorder.
Role of Transcranial Duplex in Detection of Patent Foramen Ovale in Migraine Patients and its Correlation to White Matter Changes in the Brain
Authors: Abdelfattah Arij Ibrahim , El-Khawas Hala Mahmoud , El-Sadek Ahmed Mohammed , Mahmoud Fatma Fath-Allah , Mahmoud Eman Mones , Taha Nourhan Abdelmohsen , Omran Azza
Published: November 2024

Background

Many studies show increased prevalence of PFO among migraine patients. Is it a causation relationship or co-existence? That’s not clear yet. Migraine is a well-known independent risk factor for subclinical focal deep white matter lesions (WMLs), even in young and otherwise healthy individuals with no cardiovascular risk factors. The relationship between Right to Left Shunt (RLS) and WMLs is not known.

Objective

Several studies have shown significant relationship between PFO and migraine. We investigate the percentage of PFO in migraine patients in El-Demerdash outpatient headache clinic.

Methods

It’s a cross-sectional time interval study conducted between 9 September2022 to March 2023. we conducted our study on 31 patients at our outpatient headache clinic were diagnosed as migraine according to ICH-3rd edition. Each patient was investigated with TCD and TEE to diagnose PFO.

Results

The percentage of all RLS is 38.7% and the percentage of PFO is 32.6%, about 60% of them are small size PFO.

Conclusion

PFO was found over third of our patients 32.6% of the migraine patients.
Serum Zonulin Level in Patients with Bipolar Disorder
Authors: Thabet Dina Mohamed , Abd EL Aziz Mohamed Fekry , Hashem Nivert Zaki , Mahmoud Dalia Abdel Moneim
Published: November 2024

Background

Bipolar disorder is a chronic and recurrent condition, associated with significantly impaired functioning and reduced quality of life. Given the importance of immune system in the etiology of bipolar disorder, studies on the gut, the largest immune system in the body, represent an important area for research. A change in intestinal permeability may be considered biomarker of local or even distant immune-mediated disorders. Increased gut permeability allows the passage, through the intestinal epithelial layer, of macromolecules, toxins, and bacterial species (both pathogenic and commensal) that may trigger immune-mediated diseases in different systems. Zonulin is regarded as a non-invasive biomarker for intestinal permeability. This study aimed at assessment of the serum zonulin level in patients with bipolar disorder I and its relation with the severity of the symptoms of the disorder, the age of onset of the disorder, the frequency of relapses and response to therapeutic trials.

Methods

two hundred patients with bipolar I disorder, divided into one hundred patients in acute manic or depressive episode and one hundred patients in full remission were compared to one hundred age and sex matched healthy controls. The patients were administered Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) to determine the severity of manic and depressive symptoms, respectively. Venous blood samples were collected, and serum zonulin was measured.

Results

The mean serum zonulin in patients was significantly higher than healthy controls. Serum zonulin levels was significantly higher in patients with acute episodes than patients in remission.

Conclusion

The current research indicates that zonulin is increased in patients with bipolar disorder and this finding may contribute to the role of intestinal permeability or BBB in the pathogenesis of bipolar disorder.
Prevalence and Risk Factors of Non-Suicidal Self-Injury in a Sample of Egyptian University Students in Ain Shams University
Authors: Elserafi Doha Mostafa , Hashem Reem Elsayed , Ghobrial Fiby Fayez , sayed Fatma el-zahraa
Published: November 2024

Background

Non-suicidal self-injury (NSSI) is a global health concern, with a prevalence ranging from 1.5% to 54.8%. Typically starting during adolescence, it was proposed that there is a correlation between NSSI and adverse childhood experiences (ACEs), such as parental antagonism, neglect, physical abuse, and sexual abuse. Many turn to NSSI as a strategy to cope with emotional regulation difficulties, using it as a means to navigate and manage their emotions effectively.

Aim of the Work

Examining the prevalence of non-suicidal self-injury (NSSI) in young adult students at Ain Shams University, exploring the methods and functions of NSSI, assessing the correlation with emotional regulation difficulties and adverse childhood experiences.

Patients and Methods

This study is an observational cross-sectional study, A convenient sample of 400 Undergraduate students at Ain Shams university was obtained equally distributed between the Faculties of Medicine and Education.

Results

Among Ain Shams University students, non-suicidal self-injury (NSSI) prevalence was 18% engaging in NSSI last year, and 4.3% reporting repetitive instances. Common forms included pounding oneself (16.2%), cutting (15.4%), and biting (15.4%). NSSI functions revealed relief from negative feelings (14.2%) and self-punishment (11.7%) as major goals. Academic challenges were a top motivating factor, alongside guilt, problem confrontation difficulties, and unstable relationships. Those with multiple adverse childhood experiences (ACEs) were more likely to engage in NSSI, showing a positive correlation with NSSI frequency. Emotional regulation difficulties, were also linked to NSSI, indicating a predictive relationship between emotional regulation challenges and self-injurious behavior in young adults.

Conclusion

Non-suicidal self-injury (NSSI) is prevalent among young adults. The study emphasizes the considerable influence of adverse childhood experiences (ACEs) and challenges in emotional regulation on NSSI in this demographic. In conclusion, these results underscore the crucial role of addressing early life experiences and emotional regulation to comprehend and prevent NSSI among young adults.
Rate of Occurrence of Eating Disorders in Patients Suffering from Depression and Schizophrenia
Authors: El Essawy Heba Ibrahim , El Batrawy Amira Nassieb , ElRassas Hanan Hany , El Said Abd EL Kader Hashim Mostafa Ahmed , Lashen Heba Ali Abuelmaaty
Published: November 2024

Background

Eating disorders (EDs) have substantial Axis I comorbidity (schizophrenia and depression). Since Psychiatric comorbidity may increase ED severity, chronicity, and treatment resistance, it is necessary to consider the correlation between eating disorders, schizophrenia and major depressive disorder.

Objective

To estimate the rate of eating disorders in patients with major depressive disorders. To estimate the rate of eating disorders in patients with schizophrenia. To estimate the correlation between the eating disorders, major depressive disorder and schizophrenia.

Subject and Methods

This is an observational, cross-sectional study conducted on patients diagnosed with eating disorder, major depressive disorder and schizophrenia at outpatient clinics, Institute of Psychiatry, Ain Shams University Hospitals to estimate the correlation between the eating disorders, major depressive disorder and schizophrenia. Study participants were divided into 3 groups. Group Depression: 85 patients diagnosed with major depressive disorder, Group Schizophrenic patients: 40 patients diagnosed with schizophrenia, and Group Control: 20 healthy controls.

Results

There was a significant positive correlation between HDRS score and EAT-40 test score in group (r = 0.516, p < 0.001) and between HDRS score and EDE-Q test score (r = 0.415, p < 0.001). There was a significant positive correlation between EAT-40 test score and EDE-Q test score and PANSS total score (r = 0.489, p = 0.001), PANSS +ve symptoms score (r = 0.459, p = 0.003), and PANSS -ve symptoms score (r = 0.494, p = 0.001). There was a strong statistically significant positive correlation between depression and schizophrenia and eating disorders which indicate a proper evaluation and assessment for patients with eating disorders for these two comorbidities for better treatment and prognosis.

Conclusion

In the current study the rate of eating disorders in depression patients and schizophrenic patients was statistically significantly higher compared to the rate of eating disorders in the control group. Furthermore, there was a strong association between depression, schizophrenia and eating disorder related impairment. Thus, it is a mandatory evaluation and assessment for these comorbidities for proper treatment and prognosis of eating disordered patients.
Sensitivity of Ultrasound in Detection of Neuropathic Changes in Chronic Kidney Disease Patients
Authors: Abd El-Aziz Azza Abd El-Naser , El-Sadek Ahmed Mohamed , Behairy Maha Abd El-Moneim , Ahmed Mai Fathy , Faltas John Nabeeh Nemr
Published: November 2024

Background

Neurological complications secondary to the uremic state, contribute largely to morbidity and mortality in patients with renal failure. The prevalence of peripheral neuropathy remains high in advanced renal dysfunction. Recently Sonographic alterations of peripheral nerves in chronic kidney disease disease have become a concern for early diagnosis of neuropathy in such patients hence decrease morbidity for these patients. The current study aims to investigate sensitivity of nerve ultra-sound in detection of uremic neuropathy in comparison to nerve conduction study.

Objective

To investigate the sensitivity of nerve US in detecting peripheral neuropathy by measuring CSA in CKD patients in comparison to nerve conduction velocity.

Patients and Methods

The present study is acase control study which was conducted at the Neurosonography unit in Ain Shams University Hospital, on patients of chronic kidney disease visiting outpatient nephrology clinic. We enrolled 30 patients (60 arms and legs) and 25 controls (50 arms and legs) in the study. The aim of our study to assess sensitivity of ultrasound in detection of neuropathic changes in CKD patients and to correlate the extent of nerve damage to renal dysfunction as measured by laboratory investigations.

Results

To the best of our knowledge, most recent studies that evaluated use of US in uremic neuropathy, focused on dialysis patients and including diabetic patients, most of these studies focused on carpal tunnel syndrome as a common comorbidity in end stage renal disease (ESRD) patients. Few studies evaluated the use of nerve ultrasound in CKD patients pre-dialysis, excluding other risk factors for neuropathy (like diabetes mellitus, autoimmune diseases, etc…) in comparison to nerve conduction studies.

Conclusion

Mean age of patients was 44 years with males constituting 53.3%% of the sample. The present study demonstrated increased cross-sectional area of nerves in uremic neuropathy by ultrasound. The results in our study showed that nerve ultrasound is a useful diagnostic tool for diagnosis of peripheral neuropathy in pre-dialytic chonic kidney disease patients. It was observed that normal CSA by US in the majority of nerves corresponded to normal NCS. Increased CSA was correlated to demylinating neuropathy more than axonal neuropathy. In axonal neuropathy, majority of nerves showed decreased CSA but normal and high CSA was found in nerves with axonal neuropathy.
Clinical Predictors for the Prognosis of Myasthenia Gravis in Egyptian patients
Authors: Fahmy Nagia Aly , Tork Mohamed Amir , Atiah Amr Saeed , Youssef Elkady Mahmoud Hosny Hassan
Published: November 2024

Background

The clinical course of myasthenia gravis (MG) is variable, and spontaneous remission is still not common as well as predictors and prognostic factors for relapse or secondary generalization of ocular myasthenia gravis remain deficiently clear. In this study we attempt to explore clinical predictors for the Myasthenia Gravis prognosis for better recognition of the disease course and effective management.

Objective

Determine clinical predictors for the prognosis of myasthenia gravis.

Patients and Methods

This case control study was conducted on sixty Myasthenia Gravis patients (30 relapsed and 30 non-relapsed). They were recruited from Neuromuscular Clinic at Ain Shams University Hospitals.

Results

Late onset of the disease (Age>40) was more evident in the relapsed group on the other hand the non-relapsed group showed Early age of onset. Patients showing higher MGFA classification in the disease activity showed higher risk of relapse. Majority of patients with Thymus pathology (thymoma and Thymus hyperplasia) were among the relapsed group.

Conclusion

Thymus hyperplasia and thymoma were risk factors that could contribute to MG relapse. Age of disease onset and MGFA classification are a significant predictor of MG relapse.
The Relation between Burnout, Life Event Stresses and Coping Strategies in Mental Health Workers
Authors: Estafanos Nakhla Marina Yohanna , Eissa Mohamed Fekry , Mahmoud Nivert Zaki , Moneim Mahmoud Dalia Abdel , Mohamed Rehab Serag
Published: November 2024

Background

The care of patients, the health system, and the personal health of healthcare professionals are all negatively impacted by burnout. Burnout has been linked to reduced patient satisfaction, prolonged recovery periods, medical errors, and poor outcomes. Health organizations may also be impacted by burnout, which can result in higher employee turnover, lower productivity, fewer patient access, and more expenses. The thoughts and acts employed for managing the demands of stressful events, both internal and external, are referred to as coping strategies.

Aim of the Work

In the current study, Maslach burnout inventory was used to assess the rate of occurence of burnout also, coping strategies scale and life events stresses scale by Holmes and Rahe were used in this study.

Patients and Methods

This cross-sectional observational study was done on 95 mental health workers to assess the rate of occurence of burnout, the life event stressess and the coping styles used in order to cope with stress.

Results

In the current study, we found that 49.5% had high emotional exhaustion, 40% had high rates of depersonalization and 22.1% had low scores of personal accomplishments. Our results showed a statistically significant association of gender with EE and DP but no association with PA. As regarding coping strategies, the most frequently reported strategy is religious conditioning (type of emotion focused coping) followed by planning (problem focused coping) followed by positive reassessment (emotion focused coping). The least used strategies are behaviour withdrawal, humour and denial, which is the least used strategy, and the three of them are considered dysfunctional coping.

Conclusion

Burnout is a challenge facing mental health workers and it has a signifcant impact on their capacity to offer service and care to patients. Several measures are needed to reduce staff burnout especially among physicians and nurses. Healthy coping strategies need to be promoted in order to reduce and help to deal with burnout.
Game Genres, Behavioural Difficulties and Internet Gaming Disorder among a Sample of Egyptian Adolescents
Authors: Malek Yaman Adel Zaki , Azzam Hanan M E , Elmissiry Marwa Adel Gamal , Taleb Mariam Yehia Mohamed Abou
Published: November 2024

Background

Decades of research shows a rise in the number of young people playing videogames, with the content of violent video games becoming increasingly realistic, interactive and unequivocal in depicting violent activity. The combination of these two factors: growing numbers of players in addition to progressively violent games appears to have important consequences.

Aim of the Work

Measure the Rate of Internet Gaming Disorder among a community sample of Egyptian adolescents. To Assess the most frequently played type of Game genres. Finding out the association between different game genres and behavioural dysregulation. Finding out the association between different game genres and sociodemographic correlates. Assess and Measure the association of Violent Video Game Use and Internet Gaming disorder with psychological correlates.

Patients and Methods

This study is a cross-sectional observational study. Study population A sample of Egyptian Adolescents aged 14-17 males and females randomly selected from study sites. relatives of patients in outpatient clinics. Relatives of fellow doctors and nursing staff. study started from September 2022 till October 2023.

Results

The Strengths and Difficulties Questionnaire was used to assess the psychological well-being of children and adolescents, grouped into five subscales: Emotional difficulties, conduct symptoms, Hyperactivity, Peer Relationship problems, Prosocial Behaviour, and an Impact Supplement that assesses chronicity, distress, social impairment, and burden to others. The Rate of game addiction among the studied sample was 4%. Significant difference was found in game addiction scores between violent and nonviolent gamers. Our study results showed that violent games were more frequently played than nonviolent ones (64.5%) played violent games whereas (35.5%) played nonviolent games, with a higher preference of violent games among males. Conduct symptoms, and prosocial behaviour were more affected in subjects who played violent games than those who played nonviolent games.

Conclusion

The observed correlation between exposure to violent games and an increased likelihood of developing game addiction, prolonged gaming sessions, conduct symptoms, and diminished prosocial behavior highlights the need for a more nuanced approach to understanding and managing video game-related difficulties.
Comparative Study between Endoscopic Lumbar Discectomy and Lumbar Fixation in Management of Recurrent Lumbar Disc Prolapse
Authors: Bahgat Elkalyoubi A M , Abdelfatah Mohamed A R , Elserry Tarek H , Desoky Elayouty Ahmad Elsayed , Hammad Omar Y
Published: November 2024

Background

There is a great controversy in operative methods which can be used for recurrent lumbar disc herniation such as repeated endoscopic discectomy or repeated open discectomy either using fusion or not Endoscopic revision surgery can be conducted using the endoscopic interlaminar discectomy. Open surgery can be used for recurrent discectomy and lumbar fixation can be used in addition. Interbody fusion might be used as well.

Patients and Methods

The current study is a prospective, comparative study that included 90 patients with recurrent lumbar disc prolapse, who were scheduled for reoperation in Neurosurgical departments in Ain Shams University Hospitals and Other Affiliated Hospitals during time period from November 2016 to February 2022. Using spine endoscopy in 45 patients with recurrent disc prolapse (group 1) and fixation in another 45 patients (group 2).

Results

Operative time, wound length in centimeters, intraoperative bleeding, and the presence of a drain were compared between Group 1 and Group 2. All these variables showed statistically significant differences between the two groups showing better results in endoscopic group. Preoperatively, there was no statistically significant difference in JOA scores between Group 1 and Group 2. Immediately postoperative and at 1 week interval, endoscopic group had significantly higher JOA scores, indicating better outcomes. Preoperatively, there was no statistically significant difference in disability scores between Group 1 and Group 2. Immediately postoperative and at early time intervals, endoscopic group had significantly lower disability scores compared to fixation group. There were no statistically significant differences between Group 1 and Group 2 in terms of recurrence and stability rates. There was no statistically significant difference between Group 1 and Group 2 in terms of motor power outcome index.

Conclusion

Endoscopic lumbar discectomy is superior to open lumbar discectomy using fixation with or without fusion in the management of recurrent lumbar disc herniation, as for short-term results, however both techniques are equal in long-term results
Efficacy of Gamma Knife Radiosurgery in Tumor Control of Cerebellopontine Angle Meningiomas: A Systematic Review
Authors: Hemeida Salah A , Elmolla Shafik T , Tawadros Sameh R , Asfour Mohamed Z
Published: November 2024

Background

Meningiomas arising from the cerebellopontine angle are relatively uncommon, comprising only 1% of intracranial meningiomas and 6% to 15% of tumors occupying this anatomic region. Because of their intimate relationship with adjacent neurovascular structures, cerebellopontine angle (CPA) meningiomas represent a formidable surgical challenge. The morbidity and mortality associated with surgical resection of CPA meningiomas is not inconsequential. Radiosurgery has been demonstrated to provide high rates of tumor control for skull base meningiomas with acceptably low complication rates. The rarity of CPA meningiomas has limited the statistical power of previous radiosurgery series describing the outcomes for these lesions.

Aim of the Work

Evaluate the efficacy of gamma knife stereotactic radiosurgery (GK-SRS) in tumor control of CPA meningiomas and the effect of this control on the function of the facial muscles and hearing.

Methodology

This systematic review included a discussion of all available studies meeting the eligible criteria including randomized controlled studies, cohort studies, and case series and the literature of reviews.

Results

Mean tumor control rate was 94%, 259 cases had decreased tumor volume, 271 had stable tumor growth. Increased tumor volume occurred in 27 cases. As regard facial muscles function, 13 cases had improved function, 241 cases remained unchanged, and 8 cases experienced worse function. As regard auditory function, 25 cases had improved hearing, 256 cases remained unchanged, and 25 cases experienced worse hearing. Post GK-SRS hydrocephalus was reported in six cases, trigeminal dysfunction was reported in 114 cases, and peritumoral edema was observed in 19 cases.

Conclusion

GK-SRS for CPA meningiomas could be considered as a highly effective technique for the management of those lesions with acceptable rates of side effects.
Impact of Changing Sterile Glove at the Time of Wound Closure to Reduce Surgical Site Infection in Women Undergoing Elective Cesarean Section; A Prospective Randomized Controlled Clinical Trial
Authors: Abbas Mustafa M , El-Feky Alaa El-Din H , Abd El-Aal Fatma H
Published: November 2024

Background

Among surgical patients, surgical site infections (SSIs) are the most common nosocomial infection, accounting for 38 percent of nosocomial infections. It is estimated that SSIs develop in 2 to 5 percent of the more than 30 million patients undergoing surgical procedures each year (ie, 1 in 24 patients who undergo inpatient surgery in the United States has a postoperative SSI).

Aim of the Work

Assessment of the impact of changing sterile gloves at the time of wound closure to reduce SSI in women undergoing elective cesarean section (CS).

Patients and Methods

A total of 283 cases of CS were assessed for eligibility according to the present criteria. 220 Women meeting the criteria and consenting for participating in the study were randomly distributed and blindly allocated into two groups. Group A (operative glove changing group “n=110”), Group B (usual care group “n=110”), with the same inclusion and exclusion criteria. At the end of the study, Group A had 102 cases and 8 were lost during follow up, Group B had 100 cases and 10 were lost during follow up. The study population had achieved the present study size calculated. Surgical site infection occurs within one and three weeks following delivery, febrile morbidity, cellulitis, need for antibiotics for skin- or wound related infection and endometritis were compared between study groups.

Results

Postoperative wound complications were statistically significant higher among cases not subjected to change of sterile gloves 28.0% vs. 9.8%. On the other hand, no differences were noted between study groups as regard operative duration 61.39 ± 7.76 vs. 59.35 ± 8.11 minutes.

Conclusion

Changing sterile gloves at the time of wound closure reduce surgical site infection and associated morbidity in women undergoing elective CS.
Comparative Study of Epidemiology of HCC in the (HCV) Patients in the Egyptian Population before and after Hepatitis C National Screening Program (100 Million Seha)
Authors: Ghali Ramy Refaat Yousef , Abdella Heba Mohamed Mohamed , abd elmonem Waleed , Elghamry Wesam Reda , Refla Abanoub Ashraf Joseph
Published: November 2024

Background

HCC is considerd one of the most common tumors in Egypt and one of the most common predisposing factors is HCV

Objectives

The aim of this study is to determine the clinical characteristics and relevance between HCC patients before and after national screening of HCV (two groups) according to child score, stage of disease, effect of treatment at clinical oncology department of Ain Shams University, Cairo, Egypt

Subjects and Methods

This retrospective analytical study included HCC patients (pathologically confirmed or diagnosed by radiological criteria) from Clinical Oncology Department, Ain Shams University Faculty of Medicine, Cairo, Egypt. from January 2017 to December 2020. and stratified into two groups 1stgroup was for patients who were diagnosed as HCC 2 years before national screening program of HCV (100 million seha), 2nd group was for patients who presented after national screening program

Results

In Group (1) most of the patients were diagnosed as HCV (86) patients (97.7%) of the patients with Co HBV infection (4) patients (4.2%), in Group (2) most of the patients were diagnosed as HCV (92) patients declined to (82.1%) while Co HBV declined to (1) patient (1%), number of patients who had Child A classification in Group (1) (36) patients and Child C (7) patients (10.9%), in Group (2) number of the patients who were Child A (62) patients (69.7%), Child C (3) patients (3.4%), in Group (1) number of patients who were ECOG PS 1 (26) patients (41.3%) while ECOG PS 4 were (4) patients (6.3%), On the other hand in Group 2 number of the patients who had ECOG PS1 (46) patients (46.5%) while ECOG PS 4 declined to (2) patients (2%), According to (BCLC) in Group 1, number of the patients with BCLC (C), (56) patients (63.6%), BCLC (A) were only (10) patients (11.4%) of the patients, BCLC (D) (5) patients (5.7%), in Group (2), BCLC (C) (62) patients declined to (54.4%), BCLC (A) increased to (32) patients (28.1%), BCLC (D) (3) patients (2.6%) of the total patients in Group 2.

Conclusion

our study demonstarted the efficacy of national screening program of HCV in the screening, diagnosis and treatment of HCC, we conducted that the results of the screening program could affect the diagnosis and treatment of HCC so its very considrable that discovery of HCC in earlier Child classification, Stage after national screening affected the treatment.
Randomized Prospective Trial Comparing 2 Schedules of Hypofractionated Adjuvant Radiotherapy 3 Weeks Against One Week Fractionation Regimen in Females with Breast Cancer
Authors: Naguib Khaled , Mostafa Ehab , Moussa Diaa El Din , Ammar Hany , Yassin Radwa A
Published: November 2024

Purpose

Acceleration of radiotherapy in 5 fractions for breast cancer can reduce the burden of treatment especially in Low middle income countries. We report on acute toxicity after whole breast irradiation /chest wall irradiation ± nodal irradiation, QOL score & Local recurrence incidence with ultra- hypofractionation schedule compared to modest hypofractionation protocol.

Material and Methods

Acute toxicity and health-related quality of life (HRQoL) of 101 patients, randomized between a 15- or 5-fractions schedule, were collected, using the RTOG acute toxicity scoring system, EORTC QLQ-C30 and BR23 questionnaire. The prescribed dose to the breast was either 15∗2.67 Gy (40.05 Gy) or 5∗5.2 Gy (26 Gy),60.1% of patients received tumor boost divided in both arms, with prescribed dose 5∗200cGy with 3D conformal radiotherapy technique. Inclusion criteria were: T1–T3 invasive breast cancer with or without axillary involvement (N0-N1&N2) after breast conserving or modified radical surgery.

Results

A total of 101 patients included in the study. Median age was 53±10.29 years, most of the cases enrolled were stage II with 38 patients in arm 1 (26 Gy) and 26 in arm 2(40Gy),only 19 cases had stage III breast cancer with 14 cases included in arm 2,while nodal negative status reported in 49 cases. A significant difference was observed for acute skin toxicity after radiotherapy in favor of better tolerability for arm 1 (P value <0.0001),also patients in ultra hypofractionation arm reported significant lower score for symptom scale including breast pain (P value >0.0001),swollen breast (P value <0.0001),difficulty to move arm (P value=0.0001),swollen hand (P value <0.0001)and QOL deterioration was less also in ultra fractionation arm (P value <0.0001) and none of the cases in both arms had local recurrence till time of data collection (12-20 months follow up duration).

Conclusion

In this single institute study, acute toxicity of accelerated breast radiotherapy in 5 fractions over 5 days seems to compare favorably to hypofractionated breast radiotherapy in 15 fractions. Less radiation dermatitis, breast edema, breast pain, difficulty to move arm and swollen hand. Quality of life is also less disturbed and patients have a better future perspective, however longer time for follow up &larger enrolled numbers needed to confirm non inferiority of this approach.