bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Interleukin 10 (IL-10) Single Nucleotide Polymorphism (SNP) in Irritable Bowel Syndrome (IBS) Patients
Authors: Ghareeb Mohammed Mai Abdel-Aaty , Sayed Moataz Mohammed , Agwa Sara Hassan , Khayyall Ahmed El Saady , Ahmed Elessawy Hagar Ahmed
Published: July 2024

Background

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder characterized by the presence of abdominal pain, bloating and altered bowel habits. The pathophysiological mechanisms underlying IBS are unclear. The abnormalities of motility, visceral hypersensitivity, gut microbial alteration and psychological stress contribute to the clinical symptoms of IBS. The associations of IBS and its risk gene polymorphisms have been ascertained by many researchers. Single nucleotide polymorphisms (SNPs) represent the most widespread type of sequence variations in genomes. It is known to be valuable genetic markers, because it may reveal the evolutionary history and common genetic polymorphisms that explain the hereditary risks for common diseases. Cytokines are involved in the pathogenesis of IBS. To date, only a few studies concerned the association of interleukin-10 (IL-10) gene polymorphism (rs1800871) -819 position to IBS.

Objective

We assessed interleukin 10 (IL-10) single nucleotide polymorphism rs1800871 (-819 C/T) in IBS patients.

Method

This was comparative case - control study for 40 participants, 20 cases and 20 controls, IL-10 rs1800871 (−819 T/C) single nucleotide polymorphism (SNP) was done via real time polymerase chain reaction for both study groups to assess its relation with IBS.

Results

The studied participants were divided into two groups according to ROME IV _criteria. For the case group (n = 20), the mean age was 41.05 ± 17.45 years, with 50% being male and 50% being female. In the control group (n = 20), mean age was 39.80 ± 14.84 years, with 25% being male and 75% being female Compared to the controls subjects, the frequencies of the IL-10 -819 T/T genotype and T allele were observed to be overrepresented in patients with IBS (60%; odds ratio [OR] = 1.143; 95% confidence interval [CI]: (0.152 – 8.593) for the TT genotype; P = 0.897) and (72.5%; OR: 1.582; 95% CI: (0.615 – 4.066)for the T allele; P = 0.341, respectively). The results demonstrated that T/T genotype was the most common genotype in the case group (60%). T allele was the most prevalent in case group (72.5%), while the C allele was the least prevalent (27.5%). However, T/T polymorphism in cases was greater than in control with non- statistical significance (p = 0.157).

Conclusion

IL-10 polymorphism (rs-1800871) has no association with IBS, However, T/T genotype was shown frequently in cases, with strong association with IBS.

Abbreviations: IBS (irritable bowel syndrome), IL-10 (Interleukin-10 cytokine), SNP (single nucleotide polymorphism)
Study of the Relationship between Platelet Distribution Width, Red Blood Cell Distribution Width and Insulin Resistance in Type 2 Diabetic Patients with Non-Alcoholic Fatty Liver Disease
Authors: Abdel Salam Mona Mohammed , Alsherbeiny Aliaa Ahmed , Nesim Mina Micheal , Ali Ahmed Manar
Published: July 2024

Background

Insulin resistance is identified as an impaired biological response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue. The metabolic consequences of insulin resistance can result in hyperglycaemia, hypertension, dyslipidaemia, visceral adiposity, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombotic state. Progression of insulin resistance can lead to metabolic syndrome, non- alcoholic fatty liver disease, and type 2 diabetes mellitus.

Aim of the Work

We aimed by our study to assess the relationship of platelet distribution width and red blood cell distribution width with insulin resistance in patients with type 2 diabetes with and without non-alcoholic fatty liver disease (NAFLD) and to check if platelet distribution width or red blood cell distribution width could be easy predictors of insulin resistance.

Patients and Methods

The present study is a Case Control Study was conducted in Ain Shams University Hospital. This study includes 80 subjects with matched age and sex.

Results

The present study results confirmed that low RDW was associated with increased risk of developing diabetes mellitus. Their study found that RDW is negatively correlated with waist and FG, insulin and TG concentrations. We also found that the group with the lowest quartile of RDW had the highest glucose, insulin and HOMA levels. Moreover, our results were found that there is a significant negative correlation of RDW with poor glycemic control. Our results also found that decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin. Our study was documented a negative correlation between HbA1c and the platelet index PDW.

Conclusion

In our study, we found a relation between insulin resistance and red blood cell distribution width. RDW (fl) could be used to discriminate between patients with type II diabetes and controls.
The Association of Serum Ferritin with Disease Severity in Non-alcoholic Fatty Liver Disease
Authors: Ali–Eldin Zainab Ahmed , Matta George Safwat , Gad Allah Shimaa Hussein , Awad Youssef Rafik Youssef
Published: July 2024

Background

NONALCOHOLIC FATTY LIVER DISEASE is emerging as the most common chronic liver condition in the Western world. It is associated with insulin resistance and frequently occurs with features of the metabolic syndrome. Disease presentation ranges from asymptomatic elevated liver enzyme levels to cirrhosis with complications of liver failure and hepatocellular carcinoma. Current treatment recommendations are limited to weight loss and exercise, although several promising medications are on the horizon.

Aim of the Work

The aim of this study is to evaluate the association of serum ferritin with non- alcoholic fatty liver disease.

Patients and Methods

The study was cross sectional study which conducted at Ain Shams University Hospital. This study was conducted on 80 patients both sexes, with age (18years old - 60 years), duration of study will be 6 months. All study patients approved to participate in this study. Patients were divided in to 2 groups as following:

Results

Our study reveals that patients with non alcoholic steatohepatitis (NASH) have significantly higher median serum ferritin levels, compared to those with non alcohoholic fatty liver disease (NAFLD). Also ROC curve shows that the best cutoff point of serum ferritin to differentiate between normal lipid profile group and elevated lipid profile group was found > 80 with sensitivity of 82.5%, specificity of 60.0% and AUC of 69.5% while the best cutoff point of fatty liver index to differentiate between normal lipid profile group and elevated lipid profile group was found > 89 with sensitivity of 67.5%, specificity of 80.0% and AUC of 76.8%.

Conclusion

Elevated serum ferritin may reflect increased disease severity in NAFLD either because of increased ongoing hepatic or systemic inflammation or increased body iron stores or a combination of these factors. Our study also reveals that patients with non alcoholic steatohepatitis (NASH) have significantly higher median serum ferritin levels, compared to those with non alcohoholic fatty liver disease (NAFLD).
Evidence of Endothelial Bone Marrow Microenvironment Affection in Poor Graft Function Post Allogenic Stem Cell Transplanration
Authors: Mahmoud Bakry Radwa Mohamed , Naguib Mary Gamal , Abdel-Ghafar Nermin Adel Nabih , Youssef Mikhaeil Soha Raouf , Ahmed ELKourashy Shaza Abdel-Wahab
Published: July 2024

Allogeneic hematopoietic stem cell transplantation (HSCT) is considered a curative option for several hematological disorders. The prognosis of patients undergoing allogenic (HSCT) is dependable on various factors that affect bone marrow microenvironment and poor prognosis can results from poor graft function. On of these factors is the numbers of CD31+ endothelial cells that support the hematopoietic stem cells.

Aim of the Study

The aim of this study was to assess how the bone marrow microenvironment is being affected in patients with poor graft function post allogenic stem cell transplantation targeting the endothelial cells using multiparameter flow cytometric analysis of CD31 antibody.

Patients and Methods

Forty patients were enrolled in this study with both benign and malignant hematological diseases who underwent allogenic HSCT from matched related donors. Patients were divided into 2 equal groups: poor graft function (PGF) group and good graft function group (GGF). Patients were subjected to full history recording, clinical examination, full laboratory and radiological work-up, tissue typing and chemotherapeutic conditioning before transplantation. After transplant, bone marrow aspirate was obtained and analyzed for CD31+ endothelial cells using Quantitative tri-color Flow cytometric assay.

Results

PGF group showed significantly lower counts of WBCs, platelets and hemoglobin concentration compared to GGF group. In addition, CD34 dose showed significantly lower concentration in PGF group compared to GGF group. PGF group had statistically significant lower percentage of stem cells total count compared to GGF group in addition, PGF Group had a significantly higher mean fluorescence intensity (MFI) of CD31 on non-stem cells compared to GGF group.

Conclusion

PGF had significant increase in MFI of CD31+ve on non-stem cells compared to GGF group. In addition, PGF group had statistically significant lower percentage of CD31+ stem cells total count compared to GGF group.
The Effect of Taurolidine-Citrate-Heparin Combination on the Inflammatory Response and Hemodialysis Adequacy in Hemodialysis Patients
Authors: El-Sharkawy Magdy Mohamed , Abdelgawad Mostafa Abdelnasier , Emara Ahmad Abdelmoniem , Abd El-Hamid Gad Omar El-Sayed
Published: July 2024

Background

Catheter-related bloodstream infections (CRBSIs) are a significant cause of morbidity and mortality in critically ill patients, contributing to prolonged hospital stays and increased costs. Whether taurolidine lock solutions (TLS) are beneficial for the prevention of CRBSIs remains controversial. Aim and objectives to assess the effect of Taurolock-hep500TM as a lock solution on the incidence of Catheter Related Blood Stream Infections (CRBSI), performance of hemodialysis permanent catheters, and haemodialysis adequacy.

Subjects and Methods

This study was Randomized Controlled Trial, was carried out on 60 patients at Al-Zaitoun Specialized Hospital -Ministry of Health & Al-Demerdash Hospital – Ain Shams University divided into 2 groups: Taurolidine Group (Group 1): included 30 Patients received Taurolock-hep500TM, (Taurolidine, 4% citrate and 500 IU/ml heparin are combined in this solution), Heparin Group(Group 2)): included 30 Patients will receive unfractionated heparin (heparin sodium 5000i.u/ml) as a permanent catheter lock solution. Patients were followed up for 1 month for monitoring hemodialysis adequacy and incidence of CRBSI.

Result

CRP was significantly increased in heparin group more than Taurolidine Group. One case with CRBSIs was in Taurolidine Group, whereas five cases in heparin group.

Conclusion

The use of Taurolidine–citrate–heparin lock solution may be associated with better hemodialysis adequacy, lower incidence of Catheter Related Blood Stream Infections (CRBSI) and lower inflammatory markers in comparison to the use of Heparin.
Chronic Spontaneous Urticaria Severity in Association with the Severity of Anxiety and Depression among Egyptian Patients
Authors: Osman El Mahdi Eman Naguib , Naguib Rehab Mohamed , Mahmoud Wahdan Maha Magdy , Mahmoud Mayada Moneer , Mahmoud Atallah Mohamed Mahmoud Abdelmoamen
Published: July 2024

Background

Urticaria is a condition characterized by the development of wheals (hives), angioedema, or both. Chronic urticaria (CU) is defined as the presence of urticaria for a period exceeding 6 weeks, assuming symptoms for most days of the week. It is divided into chronic inducible urticarias and chronic spontaneous urticaria (CSU), previously termed chronic idiopathic urticaria. The latter designation emphasizes that patients can experience urticaria independent of any exogenous stimulus even if one can define circumstances that may worsen symptoms. Approximately 40% of patients with chronic spontaneous urticaria report accompanying episodes of angioedema, whereas 10% have angioedema as their primary manifestation. In most cases, it is a self-limiting disorder, persisting for 2 to 5 years in most cases, although 20% of patients suffer for more than 5 years.

Objective

To assess the severity of CSU; screen CSU patients for psychiatric illnesses i.e. Anxiety and Depression and to assess the severity of Anxiety and Depression in patients with CSU.

Patients and Methods

This was a cross-sectional analytical study that was conducted at allergy clinic Ain-Shams University Hospitals on 300 patients with chronic urticarial, Study Period was 6 months.

Results

Our study revealed that, there were statically significant Positive correlation Between UAS score and GHQ (Anxiety) score, GHQ (Depression) score, BDI score and HAS score. In this study, there was highly statistically significant difference between HAS level and UAS level. There was highly statistically significant difference between BDI level and UAS level.

Conclusion

Our data show that patients with CSU experience high rates of anxiety and depression. CSU disease activity affects the severity of depression. CSU patients with high disease activity should be explored for comorbid depression. Females were more likely than men to have CUS and more affected by anxiety and depression than males.
Comparative Study between Cyclosporine Dynamics and Other Immunosuppressants in Patients Post Allogenic Stem Cell Transplantation
Authors: wahed Hassan Essam Abdel , Shams El-din Gihan Mohamed Kamal , Mohamed Said Rasha Magdy , Abdelfattah Sally Mohamed
Published: July 2024

Background

Bone marrow transplant has been successfully to treat diseases such as leukemia, lymphomas, aplastic anemia, immune deficiency disorders, and some solid tumor cancers. There is two types of bone marrow transplantation, one of two types of transplant may be carried out either an autograft, using the patient’s own bone marrow cells or an allograft (or allogeneic transplant), which allows the replacement of the diseased bone marrow with an healthy bone marrow taken from a compatible donor (related or unrelated) and to use the immune system of the healthy donor to fight the recipient’s illness.

Aim of the Work

To assess impact of cyclosporine introduction post-transplant on different organs and other immune suppressant as regards side effects and prophylactic efficacy against GVHD and good outcome of the transplantation.

Patients and Methods

The study enrolled two groups, 128 post-transplant patient their ages between 16 and 65, group 1 include 106 patients was taking cyclosporine for prophylaxis of GVHD, group 2 include 22 patients was taking other immunosuppressants mainly Tacrolimus and MMF.

Results

Incidence of GVHD occurrence was lower in group of cyclosporine as 30.2 % of them has no GVHD with statistically significant difference with P-value 0.007 and was lower in combined occurrence of acute and chronic GVHD,22.6 % in group 1 and 54.5 % of group 2 with P-value 0.006 Incidence of mild anemia was lower in group 1 with statistically significant difference with P-value 0.022 Hyponatremia was higher in group 1 (60.4 %) with statistically significant difference with P-value 0.026 AST levels elevated one fold higher in group 1 with statistically significant difference with P-value 0.009 and elevated three fold higher in group 2 with statistically significant difference with P-value < 0.001 ALT levels elevated one fold higher in group 1 with statistically significant difference with P-value 0.039 21 patients were presented with impairment of renal functions,12.5% with mild impairment, 3.9 % with moderate impairment, all of them from group 1 with statistically significant difference with P-value 0.023, more commonly in females and in age group from 16 to 45 years old.

Conclusion

Hematopoietic stem cell transplantation (HSCT) is a particularly important treatment for hematologic malignant and nonmalignant diseases. Unfortunately, following allogeneic HSCT, graft-versus-host disease, immunosuppression and susceptibility to opportunistic infections remain among the most substantial problems restricting the efficacy and use of this procedure. Cyclosporine remains the most effective prophylaxis post HSCT for prevention of GVHD, more multi centric studies are needed on wide scale to prove more relevant results that will be significant.
Assessment of Sensitivity of Fib-4, Lok Score and Platelet Count / Spleen Diameter Ratio as Non-Invasive Indicator of Esophageal Varices in Egyptian Patients with Chronic Hepatitis C virus (HCV) Infection
Authors: Nashaat Ehab Hassan , El Nakeeb Noha A , Abdel Rahman Shereen Abou Bakr , Mohamed Ibraheem Khaled Farouk
Published: July 2024

Background

The development of esophageal varices is one of the major complications of portal hypertension, which is considered a main complication of liver cirrhosis.Variceal bleeding occurs in 20–40% of cirrhotic patients with esophageal varices and The use of endoscopic prophylactic band ligation and non-selective beta blockers can decrease the risk of esophageal bleeding by 50%, so the current guidelines recommend screening all liver cirrhosis patients by endoscopy.

Aim of the Work

Assessment of sensitivity of fib-4, lok score and platelet count / spleen diameter ratio as non-invasive indicator of oesphageal varices in egyptian patients with chronic hepatitis c virus (hcv) infection.

Patients and Methods

This study will include 100 egyptian patients selected from internal medicine and hepatology outpatient clinics and inpatient wards at matria teaching hospital.

Results

Plt count/spleen diameter ratio, plt count and spleen diameter demonstrated a high statistically significant correlation with the presence and grade of esophageal varices. as according to sensitivity and specificity test the most accurate screening test for diagnosis of esophageal varicose is PLT/SD ratio as AUC (87.4%), also it is a good negative test as specificity (86.7%) with cutoff value (1026.7), but for suspect a case most sensitive test is PLT count as sensitivity (93.3%) with cutoff value (120.5). these tests followed by spleen diameter with accuracy (78.2%), and the least test is right lobe/ albumin ratio which cannot depend on it in diagnosis of esophageal varices as its accuracy is (52.2%),sensitivity 66.7% and specificity 48.3%.

Conclusion

The use of plt count/spleen diameter ratio, plt count and spleen diameter, especially the platelet count/spleen diameter ratio, can help physicians as noninvasive predictors of esophageal varices to restrict the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited and endoscopic facilities are not present in all areas.While rt liver lobe/albumin ratio can not be used as a non invasive predictor of esophageal varices.
Evaluation of Serum Kallistatin in Patients with Hepatocellular Carcinoma
Authors: Al Swaff Reham , Aly Hany , Samir Ahmed , Assy Norhan Akram
Published: July 2024

Background

Liver cirrhosis is the most frequent long-term consequence of all chronic liver diseases. Cirrhosis is often asymptomatic and unsuspected until complications. The annual incidence rates of liver cirrhosis and hepatocellular carcinoma is related with chronic hepatitis B or C all over the world. The majority of patients with liver cirrhosis or hepatocellular carcinoma die from complications, which happened relatively early in the course of the disease. Thus, the early diagnosis of liver diseases is the only solution for this great problem.

Aim of the Work

In the current study we aimed to evaluate serum kallistatin in Egyptian patients with hepatitis C virus related liver cirrhosis and hepatocellular carcinoma.

Patients and Methods

This case control study enrolled 90 Egyptian subjects aged ≥ 18 years old at Ain shams university hospitals, participants were classified into 3 groups as follow: Group 1: 30 patients with hepatocellular carcinoma (patients have been diagnosed with triphasic CT). Group 2: 30 patients with hepatitis C virus related liver cirrhosis (patients diagnosed according to clinical, laboratory and radiological findings. Group 3: 30 healthy subjects serving as a control group.

Results

This study found that patients with liver cirrhosis and HCC have lower levels of serum Kallistatin compared to a control group. In the HCC group, patients with more severe liver disease (Child class C) had lower Kallistatin levels than those with less severe disease (Child class A and B). Kallistatin was negatively correlated with certain markers of liver disease and inflammation in both groups, and positively correlated with hemoglobin and albumin. The study also tested the diagnostic accuracy of Kallistatin for detecting liver cirrhosis and HCC, and found that it had 66.5% accuracy for cirrhosis and 98% accuracy for HCC at specific cutoff points.

Conclusion

Serum Kallistatin has a potential rule as a new biomarker for the diagnosis and evaluation of liver cirrhosis and HCC. The present study was limited by the small sample size. Also, all participants were from the Egyptian population with liver disease induced by HCV- infection with no information if our findings would be valid for other population with different etiologies. Thus, further investigation should be carried out in order to validate these findings
Serum Ferritin and Cellular Reactive Protein (CRP) in Non Alcoholic Fatty liver Disease (NAFLD) and Non Alcoholic Steatohepatitis (NASH) Patients
Authors: Salem Amira Ahmed , Abdelmageed Khaled Hamdy , Badawy Mohamed Nabil , Mohammed Dabiesh Mai Aboelkheir Awad
Published: July 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and it comprises a spectrum of hepatic abnormalities from simple hepatic steatosis to steatohepatitis, fibrosis, cirrhosis, and liver cancer. Simple steatosis (i.e., NAFL) rarely progresses to advanced disease whereas, in approximately 20% of patients with NASH, it progresses to fibrosis and cirrhosis and potentially to hepatocellular carcinoma over a 15-year time period.

Aim of the Work

To study the relation between serum ferritin and CRP levels and severity of non- alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH.

Patients and Methods

This case control study was conducted on patients attending the Hepatology Outpatient Clinic at Ain Shams University Hospital between December 2019 to May 2020.

Results

In group A there is significant correlation between ferritin and age, ALT, AST, albumin, CRP, LDL, BMI, cholesterol, triglycerides and NAFLD fibrosis score. But there is no significant correlation between ferritin and Hb, platelets, HDL and fasting blood sugar FBS in group A. In group B there is significant correlation between ferritin and ALT. Ferritin has cutoff point of > 168 with 80% sensitivy & 80% specificity. In group A there is significant correlation between CRP and age, BMI, ALT,AST, albumin, LDL, cholesterole, triglycerides and NAFLD fibrosis score. In group A there is no significant correlation between CRP and Hb, platelets, FBS and HDL. While in group B there is significant correlation between CRP and BMI, ALT, albumin, LDL, cholesterole and triglycerides. CRP cutoff point of > 1.3 with specificity 90% but sensitivity 35%.

Conclusion

In conclusion, in this study we tried to find a relation between serum ferritin and CRP levels and severity of non-alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH. We found that s. ferritin and CRP are significantly elevated in NAFLD and more elevated in NASH with a link between serum ferritin and insulin resistance and the whole metabolic syndrome. Serum ferritin and CRP are related to disease progression with significant correlation with NAFLD fibrosis score.
Evaluation of the Current Status of Home Hemodialysis in the Middle East Then Perspectives and Possibilities of Home Hemodialysis in Egypt
Authors: Saeed Al-Sharqawy Magdi Mohammed , Sarhan Iman Ibrahim , Abdel-Gawad Abdullah Mostafa Abdel-Naseer , Abdel-Magid Omara Ahmed Abdel-Monem , Ahmed Abou-zaid Khalid Aly , Ibrahim Omar Ibrahim Al-Sayed
Published: July 2024

Background

Chronic kidney disease (CKD) is a growing worldwide epidemic. The incidence and prevalence of end-stage renal disease (ESRD) are expected to continue to increase. The most recent United States Renal Data System (USRDS) reports indicate that the incident dialysis population has grown older, has more comorbid conditions than previous years, and is starting dialysis with higher levels of residual kidney function (RKF).

Aim of the Work

This study was done to evaluate the current status of home hemodialysis in the Middle East, then to study the perspectives and future possibilities of home hemodialysis in Egypt. It was carried out during the last 2 years; 2019 and 2020. It included 2 parts:

Patients and Methods

A retrospective and prospective study on 100 patients that was randomly selection and was adult ESRD patients (age > 18 years) either were treated and maintained on home hemodialysis during the last 5 years or will be treated and maintained on home hemodialysis during the period from march 2019 to march 2020.

Results

HD patients with volume overload or those with cardio-renal syndrome were found to better tolerate excessive UF with the use of home HD machines than that with the usual in-center machines. SLED and SCUF modes were very effectively managed with the use of these simple HD machines. It was noticed that the loss of residual renal functions in new HD patients, was significantly less with the use of home HD than with the usual in-center HD. This was related to less dialysate exposure other than the use of ultrapure dialysate.

Conclusion

The psychological status was significantly improved in those patients with having their sessions at their homes without any added stressors related to in-center HD. Even new ESRD patients who are too reluctant to start HD, were better convinced to start home HD. Home HD is a gentle and benign mode of HD with less reported intra-dialytic complications; attributed to the use of ultrapure dialysate solutions other than the treated tap/well water used in center HD.
Study of the Relationship between Insulin Resistance, Iron Status Markers and Body Weight in a Sample of Egyptian Population
Authors: Hussein Magda Shoukry , Bahaa El Din Ahmed Mohamed , Mohamed Amr Mahmoud , Hashem Shaimaa Shaaban
Published: July 2024

Background

Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Aim of the Work

The aim of this study is to investigate the relationship between insulin Resistance, iron Status Markers and body Weight in a sample of Egyptian population.

Patients and Methods

Our study was case control study conducted on 90 subjects their age was ranging form18 to 70 from diabetes outpatient clinic, and they were divided into 3 groups: Group (1): Non-obese non-diabetic as a control group, Group (2): Obese non diabetic and group (3): Obese diabetic.

Results

In our study, there was no statistical significant difference found between the three studied groups regarding iron study, Also our study showed that there was statistically non significant correlation between (ferritin level and TIBC), and (ferritin level, HOMA IR), but there was statistical significant positive correlation found between TIBC and FBS (p- value 0.045),Similarly, we did not observe either abnormally high or low ferritin values in our study on subjects with obesity. We found no association between this marker and body weight, in contrast with others. In our study, the higher insulin and HOMA-IR values observed in the subjects with TSAT<20% = 4.2(1.4-11.6) than those with TSAT >20% =2.4 (1.15-6.95), but statistically non significant p- value. The present study also showed that There was statistical significant positive correlation between (T.SAT, serum ferritin), (T.SAT, S.iron) and (T.SAT,SBP) (with p-value 0.03). Our study also showed that there was no statistical significant difference found between patients with T.sat ≤ 20% and those with T.sat > 20% regarding all the studied parameters except ferritin level and iron level was found higher in patients with T.sat >20% than those with T. sat ≤20% with p-value <0.001 and <0.001 respectively.

Conclusion

Characteristics of iron deficiency or iron overload were not observed in subjects with overweight/obesity and diabetic patients. Our results suggest a complex metabolic dysregulation.
The Role of Repetitive Transcranial Magnetic Stimulation in Reduction of Opioid Craving; A Single Blinded Randomized Sham Controlled Clinical Trial
Authors: Elrassas Hanan H , Morsy Mahmoud H , Abdelrazek Yasser M , El Rasheed Amany H , Saad Noha A , Azzam Lobna A
Published: July 2024

Background

Opioid use disorder (OUD) poses a great concern due to problems associated with their abuse as well as fatal and non fatal overdose consequences. Craving has a complex relationship with opioid use and relapse. Developing new, effective treatments for substance use disorders (SUDs), including opioid use disorders is crucial. This study aimed to assess the effect of 18 sessions of high frequency (HF) repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) on opioid craving in early abstinence using brief substance craving scale (BSCS) for Tramadol and morphine and Heroin craving questionnaire (HCQ) for Heroin craving.

Results

There was a statistically significant reduction in craving scores in the group of OUD patients receiving real rTMS compared to those receiving sham rTMS for both BSCS( p value = 0.044) and HCQ (p value = 0.002). A statistically significant positive correlation was revealed between the number of hospital admissions and the mean scores of post rTMS HCQ scores (r = 0.05, p value = 0.040).

Conclusion

High frequency 10 Hz rTMS over the left DLPFC for 18 treatment sessions reduced craving OUD patients during early abstinence. These preliminary results suggest that 10 Hz rTMS of the left DLPFC may be used in treatment of OUD; so our study recommends that use of rTMS in reduction of opioid craving in early abstinence.
Study of Inflammatory Markers in Patients with Uncontrolled Generalized Motor Tonic–Clonic Seizures
Authors: Lewis Andrawes Amir Hani , El Rakawy Mahmoud Hemeda , El Khayat Naglaa Mohamed , Abdelhamid Yousry Aboelnaga
Published: July 2024

Background

Epilepsy is a multifaceted chronic neurological disease characterized by recurrent spontaneous seizures. It affects almost 70 million patients around the globe, making it one of the most common chronic causes of neurological morbidities.

Aim of the Work

detect an association between some inflammatory markers {C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), and Platelet-lymphocyte ratio (PLR)}and epilepsy in order to detect a pathogenic relation that in turn can influence the course and management of epilepsy.

Patients and Methods

the current body of evidence recognizes the association between inflammation and epilepsy. Several inflammatory markers have been investigated in relation to different types of epilepsy. This study chose CRP as a convenient and widely used inflammatory marker, together with NLR and PLR, the two novel, readily available indices of inflammation that are yet to be fully investigated in relation to epilepsy. We included 50 patients with uncontrolled generalized motor tonic–clonic seizures. Ages ranged from 18 – 45 years and both genders were represented. Patients were compared with 50 controls of same age and gender. Strict inclusion and exclusion criteria were applied to all volunteers.

Results

In this study, levels of CRP, NLR and PLR in 50 patients with epilepsy were significantly higher than controls. These results add to the pool of evidence that support the association between epilepsy and inflammatory processes. This study managed to investigate the correlation between inflammatory markers and specific independent variables such as frequency of seizures, time interval between last seizure and presentation, number of status epilepticus per year, number of anti-epileptic medications, duration of postictal confusion, age of onset of seizures, duration of illness, and EEG findings, in addition to age and gender differences. This study found increased levels of CRP, NLR, and PLR in patients with high frequency seizures compared to those with intermittent seizures. Similar results were obtained with increased number of episodes of status epilepticus, number of anti-epileptic medications and shorter time interval between last reported seizure and sample withdrawal. Longer duration of postictal confusion was associated with high values of NLR and PLR.

Conclusion

systemic inflammatory response has been detected in patients with uncontrolled generalized motor tonic–clonic seizures, which confirms the association between inflammation and epilepsy. This association is specifically correlated to higher seizure frequency, shorter duration between last seizure and blood sample withdrawal, higher number of status epilepticus in the last 12 months, higher number of anti-epileptic medications, longer duration of post-ictal confusion and female gender.
Efficacy and Safety of Zonisamide as Adjunctive Therapy in Motor Symptoms of Advanced Parkinson's Disease (PD) in Egyptian Population
Authors: Mohamed Salim Mohamed Esam , Ibrahim El-Balkimy Mahmoud Haroun , Antonnini Angelo , Ali Shalash Ali Soliman , Abd El Dayem Eman Hamed , Mahmoud Abushady Eman Mones
Published: July 2024

Background

Management of motor complications -especially wearing off- in advanced PD is very challenging. Zonisamide (ZNS) is an antiepileptic drug that showed beneficial effects in motor symptoms of PD in previous studies.

Methods

To determine the efficacy and safety of ZNS in motor symptoms of advanced PD, we conducted a one month double blinded randomized placebo-controlled crossover study in Egypt. PD patients with Hoehn & Yahr stage ≥ 2 (onstate) and at least 2 hours off time daily were randomized to one of three groups: ZNS 25mg, ZNS 50 mg and placebo. Primary outcome measure was change in off time based on part IV MDS-UPDRS (Movement disorders society-Unified Parkinson’s disease rating scale). Secondary outcome measures were: change in on time based on part IV MDS- UPDRS, change in total score MDS-UPDRS, score of part III MDS-UPDRS.

Results

Of 69 patients enrolled in the study and underwent randomization to the 3 groups, 49 patients completed one month follow-up. Only 26 patients underwent crossover and 20 patients completed one month follow-up. So, the total number of patients analyzed at 1 month was: 69 patients (25 patients ZNS 25 mg group, 18 patients ZNS 50 mg group and 26 patients placebo group). Both ZNS 25 and 50 mg groups showed significant improvement of total MDS-UPDRS score, Tremors ON score and part 4. Except for sedation, there was no significant adverse effects in both ZNS 25,50 mg groups as compared to placebo.

Conclusion

ZNS (25,50 mg) is safe and effective in improving motor symptoms of advanced PD as adjunctive therapy.
Management of Cerebellopontine Angle Tumors
Authors: Mohamed Adel N , Kabil Mohamed S , Hamada Salah M , Elsayed Ahmed M , Abdel Naby Ali Mohamed
Published: July 2024

Background

Cerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa. Most CPA tumors are benign, with 80-94% being vestibular schwannomas (acoustic neuromas), lipomas, vascular malformations, and hemangiomas. Treatment options include observation, radiosurgery, and microsurgery.

Aim and Objectives

Evaluation of the clinical presentation of various lesions in the Cerebellopontine Angle area and evaluate the different surgical approaches for management of these lesions.

Subjects and Methods

The study included cases of CPA tumors that were admitted and treated in the neurosurgical departments in Ain Shams University Hospital as well as Al Galaa Armed Forces Hospital and Al Maadi Armed ForcesHospital.

Result

Abnormal planter response were the most frequent neurological abnormality (72.0%). The most cranial nerve affected was the vestibulocochlear nerve (60.0%).

Conclusion

CPA tumors are challenging lesions to be treated surgically, which requires a high level of surgical experience. Retrosigmoid and middle fossa approaches accomplished significant outcome among patients with CPA tumors. Preoperative V-P shunt procedure improved noticeably the manifestations of increased intracranial tension.
Antiepileptic Drugs as Prophylaxis for Seizures after Excision of Brain Tumors
Authors: Ashour Ahmed Maamoun , Fayed Zeiad Yossry , Sabry Ismail Ismail Hassan , Sherif Agiez Mostafa Ahmed
Published: July 2024

Background

Seizures are the most common & most serious side effect of cranial surgery. The latter condition requires chronic treatment with Antiepileptic drugs (AEDs) and comes with relevant socioeconomic sequelae. The routine prophylactic use of AEDs for people undergoing tumor resection has remained controversial due to the risk of postoperative seizures. Some Neurosurgeons are advocates to the use of AEDs to reduce the risk of these seizures.

Objective

To evaluate the efficacy of prophylactic AEDs routinely in brain tumor patients without previous history of seizures. Primary objective has been to identify the efficacy of AEDs in perioperative seizure prophylaxis. Secondary objective has been to highlight the most common type of post-operative AEDs.

Methods

All available studies from 2000-2021 including randomized or non-randomized clinical trials, prospective or retrospective observational cohort studies, and case series of six or more cases that address these criteria have been collected.

Results

Our search concluded that the most common type of post-operative seizure is the Early seizure which is of total 87 patients representing 12.3% of seizure reported patients, yet when comparing the P-value between the Early & late seizure it has a P-value of 0.415 which is nonsignificant rendering the comparison redundant. The Most common types of AED used are Phenytoin (PHT) 89 (71.8%) & Levetiracetam (LEV) 109 (81.8%). To measure the efficacy of AEDs two groups of patients with no history of AED administration or seizures preoperatively were created, one the control group of 268 participants were not administered AEDs postoperatively only 32 (11.94%) of them suffered from seizures postoperatively. The other group of 171 participants were administered the AEDs postoperatively only 25 (14.62%) of these participants suffered from postoperative seizure. Comparing both of these results statistically it had a P-value of 0.416 which is non-Significant statistically. On interpreting these results was that the AED have no influence in controlling the seizures.

Conclusion

Postoperative seizures are one of the main complications of brain tumor surgery. Neurosurgeons have a strong belief more of tradition that preventing seizures with Anti-Epileptic Drugs (AEDs) as a sort of seizure prophylaxis is not only effective but also necessary. Finally, there is not enough evidence of sufficient quality available to suggest that antiepileptic drugs AEDs treatment can or cannot be recommended to reduce Post-craniotomy seizures.
Vagus Nerve Stimulation for Intractable Focal Epilepsy
Authors: Habib Mohamed A , Talat Mohamed A , Ibrahim Amr Galal , Elgalab Mohamed H
Published: July 2024

Background

Epilepsy is a common neurological condition affecting 0.5-1% of the population. Despite the advances in the medical management of epilepsy 25-35% of patients have poor control of their seizures or have unacceptable side effects from the medication.

Aim and Objectives

To make up-to-date recommendations for the value of vagus nerve stimulation (VNS) in patients suffering from intractable focal epilepsy and not candidates for surgical resection.

Subjects and Methods

Eight studies were included in the present meta-analysis. The flow diagram of the study selection processes. The total number of patients in the eight included studies was 266. The follow-up periods ranged from 12–124 months. Because of significant heterogeneity (I2 = 94 %) among the included studies, a sensitivity analysis was performed.

Result

59.4% of all the included patients showed a 50% or greater reduction in seizure frequency after VNS. The patients with > 50% reduction in seizure frequency ranged from 25–66% among the eight included studies. Non-significant improvement in seizure frequency after VNS.

Conclusion

After VNS, the frequency of seizures was reduced by 50% in about 59.4% of the patients with intractable focal seizures. The present study's random effects forest plot, however, indicated that the reduction in seizure frequency following VNS was not statistically significant. The effectiveness of VNS in reducing seizure frequency in the population under study is therefore still unknown,.
Prospective Study to Assess the Clinicopathological and Prognostic Value of BRAF V600E Mutation in Metastatic Colorectal Cancer
Authors: ELsaeed Mona Taher , ELwakeel Hisham M , Mostafa Mohamed Y , Shakweer Marwa M , Elghamry Wesam R
Published: July 2024

Background

BRAF is a protein kinase downstream of RAS in the RAS-RAF-MEK- ERK kinase pathway. The majority (>95%) of BRAF mutations in metastatic colorectal cancer (mCRC) is the BRAFV600E mutation, which is considered an important negative prognostic marker and is associated with resistance to standard chemotherapies in mCRC patients.

Objectives

This study aimed to investigate the BRAF mutation in patients with mCRC and its association with clinicopathological factors and survival outcomes.

Patients and Methods

The included specimens were analysed for BRAFV600E mutation by immunohistochemistry (IHC) from confirmed CRC patients with radiological or pathological evidence of metastasis.

Results

The BRAF mutation was positive in 9.1% of patients. Synchronous metastasis was observed in patients with BRAF mutation with statistical significance (P = 0.033). With regard to treatment, there was no statistically significant difference in patients with BRAF mutations who received targeted chemotherapy as first-line therapy also there was no statistically significant difference in median PFS of patients with BRAF mutation (p = 0.789) and also in median OS (p = 0.343).

Conclusion

Although the BRAF mutation is a relatively rare finding in mCRC, it is characterized by a critical negative impact on treatment outcome. Given this poor outcome, optimization of therapy is an important goal.
Value of Anterior Segment Ocular Coherence Tomography (AS-OCT) in Dryness Evaluation in Vitiligo
Authors: Elgendy Zainab , Zaher Fikry , Shafik Ahmed , ElSherif Radwa
Published: July 2024

Background

Vitiligo is an acquired depigmentation disorder of the skin and mucous membranes with an autoimmune proposed pathogenesis. The concurrence of vitiligo and ocular abnormalities has been investigated in different studies, some of which have focused on ocular surface and dry eye evaluation in vitiligo.

Aim of the Work

Our study aimed at evaluating the tear film changes in patients with vitiligo using clinical assessment, severity indices and AS-OCT, and comparing these findings with healthy matching controls.

Patients and Methods

A case control observational study that included 60 eyes (the right eye of 30 patients with vitiligo and the right eye of 30 healthy age and sex matched controls). For every patient full dermatological assessment was done and drug history taken. Every study subject was evaluated regarding their dry eye symptomatology using the (OSDI) score questionnaire, clinical effect of dry eye in various tests (Schirmer’s test, TBUT, CFS using Oxford scheme), and using the AS OCT in measuring tear film height.

Results

We found that vitiligo patients had a lower tear film height when compared with controls (but statistically insignificant). Patients with vitiligo were more symptomatic regarding their dry eye symptoms assessed by OSDI score, they had a shorter tear breakup time than the control group, and a higher CFS grade using Oxford scheme indicating tear film instability.

Conclusion

Our study revealed lower, but statistically insignificant TFH as compared to the control group. TBUT was shorter, CFS was more evident and Schirmer’s test (although did not reach statistical significance) was shorter in vitiligo patients which revealed a tendency for dry eye syndrome. Supporting these findings, the OSDI score was higher in vitiligo patients. These results indicated worse symptomatology of dry eye in vitiligo patients and lack of stability of their tear film. The findings were supported by multiple previous studies mentioned earlier.
Efficacy of Indirect Laser Photocoagulation in Cases with Retinopathy of Prematurity Presenting with Late Stage 3 Turning into Stage 4A
Authors: Al-Feky Mariam
Published: July 2024

Background

Retinopathy of prematurity (ROP) is a preventable irreversible cause of blindness in children especially in developing countries. Early detection and management of type 1 ROP with intravitreal injection of Anti-VEGF or indirect laser photocoagulation is the cornerstone of preventing blindness from this disease. Screening programs for ROP are mandatory for picking cases early before retinal detachment develops. Standardized screening programs are still lacking in developing countries, like Egypt, so cases may present in later stages. Cases presenting too late with Stage 4 and 5 ROP are managed surgically with lens-sparing vitrectomy or lensectomy vitrectomy. A portion of the cases present at the transition from stage 3 into stage 4a ROP. Management of those cases with intravitreal anti-VEGF was reported to cause acute crunch and tractional retinal detachment. Management with laser photocoagulation has not been discussed before.

Methods

This is a retrospective interventional, non-comparative study. Review of records of ROP cases presenting after 4 weeks from delivery having stage 3 turning into stage 4a ROP for which indirect laser photocoagulation was done were collected in the period from January 2017 till May 2019. Gestational age, birth weight, postmenstrual age at first presentation, date of laser photocoagulation and number of sessions, fundus images showing initial regression and final regression and if any recurrences happened were recorded.

Results

Nine treatment naive eyes of five premature infants were included. Mean GA was 30.4+/- 1.5 wks (range, 28-32 wks; median, 31). Mean BW 1190+/- 174.6 gm (range, 900-1300; median = 1300). Mean PMA at presentation 42.5+/-5.7 wks (range, 38.5-52.5; median, 40.5). All 9 eyes presented with plus disease and highly elevated fibrovascular ridge with significant fibrous component in Zone II. 7 eyes (77.7%) had secondary retinoschisis, localized tractional retinal detachment. 2 eyes (22.2%) showed temporal dragging. All eyes received Indirect laser photocoagulation to the avascular retina (near confluent burns) one session for each eye. No skip areas were reported. 5 eyes (3 patients) were done under topical anesthesia and 4 (2 patients) under general anesthesia. All 9 eyes (100%) showed complete regression of ROP with release of traction, restoration of retinal anatomy at a mean of 3.7+/- 2.7 months (range, 2-8.5 months; median, 2.5 months).

Conclusion

Indirect laser photocoagulation is an effective treatment measure in premature infants presenting late with fibrovascular proliferation having high fibrous components and starting Stage 4a ROP in Zone II. Laser rather than IVI of Anti-VEGF may save those infants from crunch phenomenon and need for vitrectomy with final good anatomical and thus visual outcomes.