bluuebunny/crossref_metadata_2025 huggingface dataset:
Meta-Analysis of Predictors of Post-Thyroidectomy Hypocalcaemia
Authors: El-kharadly Mahmoud , Saad Mahmoud , Al-maleh Haitham , Fadl Ehab Mohammed Ali
Published: August 2023

Background

Hypocalcaemia is common after thyroidectomy. Accurate prediction and appropriate management may help reduce morbidity and hospital stay. The aim of this study was to perform a systematic literature review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia.

Patients and Methods

A systematic search of PubMed and the Cochrane Library databases was undertaken, and the evaluation of titles, abstracts, eligibility and quality of studies.

Results

11 articles were included. Clinical predictors that had a significant association with post thyroidectomy hypocalcemia include female patients [OR = 0.625, 95% CI (0.420–0.932), p-value = 0.021], patients who did autotransplantation [OR = 2.020, 95% CI (0.968–4.215), p-value = 0.061] and patients who did cervical LN dissection [OR = 1.680, 95% CI (1.054–2.679), p-value = 0.029]. Clinical predictors that had higher insignificant association with post thyroidectomy hypocalcemia include patients with Graves' disease [Odds ratio (OR) = 1.054, 95% CI (0.623–1.784), p-value = 0.844], patients with more than two parathyroid glands preserved [OR = 1.131, 95% CI (0.259–4.939), p-value = 0.870] and patients who did not undergo reoperation [OR = 0.963, 95% CI (0.594–1.563), p-value=0.879].

Conclusion

Clinical predictors of post Thyroidectomy hypocalcaemia include female sex, autotransplantation and cervical LN dissection.
A Modified Surgical Technique in Biliary Reconstruction in Living Donor Liver Transplantation and Its Impact on Postoperative Incidence of Biliary Leakage and Stricture
Authors: Abdelghaffar Mohammed F , Abd El wahab Sameh , Elghandoor Abdelrahman M , Mohammed Motafa Abdelrahman , Gouda Mohammed Hisham , Atalla Martina
Published: August 2023

Background

Biliary complications continue to be a challenging territory in living donor liver transplantation that could lead eventually to graft loss and increased mortality. Despite the continuous evolution of biliary reconstruction techniques, there is no single full proof method that could possibly ensure the best biliary reconstruction.

Aim of work

In this study we compare the results of our combined modified technique of biliary reconstruction to the results of the conventional techniques in terms of improving biliary complications particularly biliary leaks and strictures.

Methods

This study was conducted on two equal groups of patients (recipients), 52 each, one of them received the conventional technique and the other received the modified technique.

Results

Our results have shown that the modified technique dropped the biliary complications from 36.5 to 9.6%, bile leaks dropped from 9.6% to 3.8%, and strictures dropped from 30.8% to 7.7%.

Conclusion

HPGS approach in the donor surgery together with en bloc hilar dissection and the eversion technique in the recipient surgery improve postoperative biliary complications.
Comparative Study between Total Thyroidectomy with Ipsilateral versus Bilateral Prophylactic Central Neck Dissection in Patients with Clinically Node – Negative Papillary Thyroid Carcinoma. A Meta-Analysis
Authors: El-Shafaei Mahmoud Ahmed Mohamed , Abd elmageed Shaaban Mohamed Mohamed , Omran Hesham Mohamed Ali , Academic Mohamed Hesham Saeed Hassan Gouda , Hassan Mohamed Hassan Mohamed
Published: August 2023

Background

Papillary thyroid carcinoma (PTC) accounts for > 80% of all thyroid malignancies. It is generally slow-growing and the overall prognosis is excellent, with 5-year, 10-year, and 20-year survival rates of 94%, 89%, and 87%, respectively.

Aim of the Work

The aim of this study is to compare between unilateral PCND and bilateral PCND in patients with clinically unifocal cN0 PTC using meta-analysis approach

Methodology

A Systemic review and meta-analysis Study was performed after the data extraction process. Five studies comparing the out-comes of unilateral PCND and bilateral PCND procedures in adult patients with PTC CN0 were included in this study. The publicly available literature on PubMed, and, the Web of Knowledge, and the China Journal Net, EMBASE, Cochrane Library, and Scopus databases and the ClinicalTrials.gov registry. Published from January 2005 to December 2020 concerning TT plus ipsilateral PCND versus TT plus bilateral PCND for PTC CN0 will be retrieved by searching the national and international online databases.

Results

The result of our study revealed that: Bilateral central neck dissection had higher insignificant operative time than ipsilateral one, bilateral central neck dissection had higher overall significant complications rate than ipsilateral one, bilateral central neck dissection had higher significant permanent hypo PTH and insignificant hematoma, seroma, and transient hypo PTH rate than ipsilateral one, ipsilateral central neck dissection had higher insignificant PRLNP, TRLNP rate nearly equal with bilateral one, ipsilateral CND appears to be sufficient in patients with tumors<1 cm as bilateral central neck dissection had higher insignificant tumor size than ipsilateral one, there was no statistically significant difference found between unilateral PCND and bilateral PCND regarding rate of recurrence.

Conclusion

We suggest that, ipsilateral central neck dissection may be a reasonable surgical option for prophylactic CND in unilateral PTC with clinically negative lymph nodes because of its lower rates of contralateral paratracheal node metastasis and transient hypoparathyroidism and lower complications than bilateral pCND. and effective for selected patients undergoing a total thyroidecto- my for cN0 unilateral PTC.
Incidental Parathyroidectomy during Thyroidectomy: Risk Factors and Outcomes: A Systematic Review and Meta-Analysis
Authors: Ahmed Osama Mahmoud Elsayed , Nageeb Ramy Mikhael , Goda Mohamed Hesham , Shalaby Mohamed Kadry Abdelsamea
Published: August 2023

Background

Thyroidectomy is a widely used and relatively safe procedure having a major postoperative morbidity of less than 5% for experienced surgeons. Major complications include recurrent laryngeal nerve injury, postoperative hemorrhage and hypocalcemia.

Aim of the Work

It aims to perform a systematic review and meta-analysis of studies and reports to identify the risk factors of IP and the effect of IP on postoperative hypocalcemia during thyroidectomy.

Patients and Methods

We followed the PRISMA statement guidelines during this systematic review and meta-analysis preparation and performed all steps according to the Cochrane handbook of systematic reviews of intervention. We searched PubMed, Scopus, Cochrane, and Web of Science, Embase, and Science Direct from 2000 till September 2021 relevant keywords. We used the following search strategy for searching different databases: (“incidental parathyroidectomy” OR “unintentional parathyroidectomy” OR “inadvertent parathyroidectomy”, “thyroidectomy” OR “thyroid surgery” OR “thyroid resection” OR “incidental parathyroidectomy” OR “unintentional parathyroidectomy” OR “inadvertent parathyroidectomy”, “thyroidectomy” OR “thyroid surgery” OR “thyroid resection”) AND (“hypocalcemia” OR “low calcium level” OR “hypocalcemia” OR “hypoparathyroidism”). All the references of the included studies were searched for relevant studies.

Results

Even in the hands of experienced surgeons, incidental parathyroidectomy can occur during any thyroid operation. The incidence of IP in thyroidectomy ranged from 2.9 percent to 51.1 percent, according to the articles included in our review. Postoperatively, 2.2–50.0 percent of incidentally excised parathyroid glands were identified as intrathyroidal, indicating that complete IP elimination is nearly impossible. However, because 16.7–40.0 percent of incidentally excised parathyroid glands were found in an intracapsular location and 15.7–81.1 percent were found in an extracapsular location, more diligent intraoperative identification of the parathyroid gland may reduce the incidence of IP. We found that malignancy, total thyroidectomy, central neck dissection and reoperation are significant risk factors of incidental parathyriodectomy. IP was found to increase the incidence of temporary/ permanent and permanent postoperative hypocalcemia

Conclusion

Malignancy, total thyroidectomy, central neck dissection, and reoperation are all significant risk factors for IP, according to this meta-analysis. IP was found to increase the incidence of temporary/ permanent and permanent postoperative hypocalcemia.
Histological Study on the Potential Role of Exosomes Released from Mesenchymal Stem Cells on Healing of Cutaneous Wound in Adult Male Albino Rats
Authors: Ahmed Asmaa Ali Mohamed , Hafez Manal Shaaban , Hamam Ghada Galal , Ibrahim Gehan Abd ElKhalek
Published: August 2023

Introduction

Skin wounds are frequent injuries that cause heavy financial burdens at both the familial and societal levels with physical and mental suffering. Recently, the attention of researchers has been attracted to the use of exosomes derived from mesenchymal stem cells (MSCs) as a novel non-cell therapy.

Aim

To study the potential effects of exosomes derived from MSCs on the healing of cutaneous skin wound in adult male albino rats.

Materials and methods

47 adult male albino rats were used in this study. They were divided into three groups: group I (control group), group II (cutaneous wound group, that were left for spontaneous healing), and group III (cutaneous wound treated with intravenous injection of exosomes). Each group was subdivided into subgroup a (lasted for two weeks) and subgroup b (lasted for three weeks). A full thickness skin wound was generated through surgery on the back of rats in groups II and III. Exosomes were isolated from bone marrow derived-MSCs through ultracentrifugation. Then, they were characterized by transmission electron microscope. At the end of experiment, skin specimens were collected from all rats and were subjected to proper histological techniques.

Results

This study showed that MSCs-derived exosomes have significantly improved wound healing, accelerated wound closure, promoted the reepithelialization and the recovery of skin appendages as well as enhancing the organization of newly formed collagen fibers.

Conclusion

Intravenous injection of MSCs-derived exosomes is effective in healing of full thickness skin wound.
A Comparative Histological Study on the Role of Umbilical Cord Mesenchymal Stem Cells versus Their Conditioned Medium on the Pancreatic Beta Cells in Experimentally Induced Diabetes Mellitus in Albino Rat
Authors: Kader Nermeen Hamed Abd El , Zeid Asmaa Abd ElMonem Abo , Raafat Mona Hussien , Mekawy Mohamed Abd El-Rahman
Published: August 2023

Background

Mesenchymal stem cells (MSCs) represent a promising population for supporting new clinical concepts in cellular therapy. Umbilical cord blood (UCB) has turned out to be an excellent alternative source of MSCs. This study had compared the role of human umbilical cord blood derived mesenchymal stem cells (UCB-MSCs) versus their conditioned medium (CM) alone on pancreatic beta cells in a rat model of Streptozotocin (STZ)-induced type I diabetes Mellitus.

Material and Methods

Forty adult male albino rats were divided randomly into 4 groups; Group I (control), Group II (STZ), rats received a single dose of intraperitoneal injection of 35 mg/kg of STZ dissolved in 1 ml sodium citrate buffer. Group III (STZ + UCB-MSCs) after rats had been confirmed to be diabetic they received single dose of 1 × 106 cells /ml of UCB-MSCs into tail vein, meanwhile Group IV (STZ+ CM) rats received 0.5 ml of CM that was injected intramuscularly once per week for 4 weeks. After 4 weeks the Pancreas from all groups were dissected and stained by Hematoxylin & eosin stain and by immunohistochemical method using anti-insulin antibody to detect insulin granules in the Beta cells of the islets. Mean area percent of insulin positive reactions were measured and statistically analyzed.

Results

H&E-stained section of group II (STZ) showed the nuclei of the islet cells small condensed and darkly stained while, the blood capillaries were congested in endocrine pancreas.Meanwhile, Group III (STZ + UCB-MSCs) restored nearly normal histological features. Sections of Group IV (STZ+CM) showed few cells of the islets sections of showed vacuolations and small darkly stained condensed nuclei. Studying the groups immunohistochemically, revealed decrease in insulin positive reactions in Group II (STZ) while an increase in insulin positive reactions noticed in group III (STZ +UCB-MSC) and group IV (STZ+CM) when compared to group II (STZ) with more increase in group III (STZ+UCB-MSC) than group IV (STZ+CM).

Conclusion

It can be considered that intravenous UCB-MSCs could be more effective than CM in treatment of STZ-induced type I diabetes in the pancreas.
Acute Effects of Online Hemodiafiltration versus High Flux Hemodialysis on Serum Levels of Asymmetric Dimethylarginine (ADMA), and Tumor Necrosis Factor (TNF)-Alpha
Authors: Elsayed Hesham M , Said Heba W El , Beshary Waleed A , Rahman Fatma Abdel , Helmy Ahmad A
Published: August 2023

Background

In ESRD patients, chronic inflammation is a common feature and results in cardiovascular morbidity and mortality.

Aim of the Work

to identify a superior merit for convective dialysis over high flux dialysis in decreasing the serum level of tumour necrosis factor alpha (TNF α) and Asymmetric dimethylarginine (ADMA) in ESRD adult population.

Patients and Methods

This study was conducted on 20 patients from the ESRD patients attending the dialysis unit of nephrology department in Ain Shams specialized hospital, the selected subjects were being treated by dialytic support in the form of two sessions of high flux standard haemodialysis and one session of hemodiafiltration each week. All the selected patients were clinically stable, aged ≥18 years, receiving dialysis for≥ 3 months, with wellfunctioning AV fistulas, not on anti-inflammatory or immunosuppressive drugs for 3 months earlier and during the study.

Results

there was a highly statistically significant increase in Percent of change (drop) in TNFα post HDF session versus high flux HD session. Similarly, the Percent of change (drop) in ADMA was higher post HDF session versus high flux HD session which represented a highly statistically significant difference. The results of our study showed superiority of HDF over HF HD in TNF α and ADMA clearance.

Conclusion

Convective clearance plays a crucial role in improving the biomarker profile. Using online hemodiafiltration technique that combines the use of high-flux synthetic membrane with low bio reactive profile and the use of ultrapure dialysis fluid showed a significant reduction of ADMA and TNF alpha in adult with ESRD.
Relation of Serum Homocysteine Levels and Chronic Kidney Disease in Patients with Systemic Lupus Erythematosus
Authors: Elbaky Mohamed Salah Eldin Abd , Ali Adel Mahmoud , Habeeb Reem Abd El-Moneem , El-Rhaman Maryam Ahmed Abd , Ali Ahmed Abdulkhabeer
Published: August 2023

Background

SLE is an autoimmune disease characterized by the production of autoantibodies to components of the cell nucleus in association with diverse clinical manifestations affecting almost all organ systems. It is a complex disease with variable presentations, course, and prognosis characterized by remissions and flares. The etiology of SLE remains unknown and is clearly multifactorial. Many observations suggest a role for genetic, hormonal, immunologic, and environmental factors.

Objective

To evaluate the relation between serum homocysteine levels and occurrence of chronic renal disease, renal functions, severity of proteinuria and progression to end stage renal disease in patients with systemic lupus erythematosus.

Patients and Methods

This study include 70 SLE patients with biopsy proven lupus nephritis who fulfill four or more of 2012 American College of Rheumatology (ACR) criteria for SLE. They were recruited from Rheumatology Outpatient Clinic and Rheumatology Inpatient Department of Ain Shams University Hospitals. Twenty healthy individuals were included as controls. Written consents were obtained from all patients participating in the study.

Results

In this study there was highly statistically significant difference between patients and controls as regards serum homocysteine levels, 17 patients had mild, 8 moderate and 5 severe hyperhomocysteinaemia, with (p- <0.001). Hypertension was recorded in 32 SLE patients (45.7%) and no one of controls was hypertensive. Carotid examination showed an overall increased intimal thickness (CIMT) in the 8 (11.4 %) SLE patients (3 of them have hypertension). There was highly statistically significant relation between levels of homocysteine with carotid intimal thickness imaging in patients group p-value <0.001. The current study proved that there statistically a significant correlation between serum homocysteine levels and class of CKD, 40 had normal and 30 had subnormal HC levels, mild HHC was observed in 17, moderate HHC in 8 cases, while sever HHC was 5 of cases with p- <0.001.

Conclusion

This study demonstrates that homocysteine is modifiable marker in SLE patients; hyperhomocysteinemia was significantly correlated with renal function and progression to end stage renal disease. The current study shows statistically significant relation between serum homocysteine levels and patients age, disease duration, diabetes mellitus, and hypertension. There were significant positive correlation between homocysteine levels and both blood urea nitrogen (BUN) and 24 hr urinary protein. Also, there statistically significant relation between homocysteine and CKD classes in SLE patients, 40% of patients with class IV LN had hyperhomocysteinamia.
Evaluation of Serum Cathelicidin in Patients with Chronic Spontaneous Urticaria
Authors: El Nour Melek Nermine Abd , El Latif Osama Mohamed Abd , Mahdi Amira Ramadan El , El Gamal Ahmed Mohammed El Nogoly
Published: August 2023

Background

Chronic spontaneous urticaria (CSU) has long been recognized as a major clinical problem with unknown cause, and it is well known that part of it is autoimmune. Cathelicidin as antimicrobial peptides was linked to autoimmune diseases. So, this study will be conducted as a step forward for better understanding of (CSU) pathophysiology.

Aim of the Work

Assessment of Serum Cathelicidin levels in patients with chronic spontaneous urticarial and correlate Serum Cathelicidin with Urticaria Activity Score.

Patients and Methods

This was a case control study conducted on 40 patients with chronic spontaneous urticaria attending the outpatient allergy and immunology clinic at Ain Shams University hospitals between October 2020 and August 2021 with 40 controls with matched age and sex were also included to evaluate serum Cathelicidin in patients with chronic spontaneous urticaria.

Results

The mean age of our CSU patients was 36.88 years; 67.5% were female. These demographic data are consistent with those of the literature. Our results showed that the distribution of the studied cases regarding demographic data, family history and duration of urticaria was no statistically significant difference between studied groups regarding sex, age. While for the family history there were 36 negative cases and only 4 had positive history. Regarding lab tests, we found that there was statistically significant difference between the studied Groups as regard the following WBC: (p value 0.023) being higher in group of patients than group of control, while for Total IgE: (p value <0.001) was being higher in group of patients than group of control. Also showed that there is no statistically significant difference between studied Groups regarding Hemoglobin, Plts, Eosinophils, with p value (0.056,0.989,0.411) respectively. The distribution of the studied cases according to Urticaria activity score (UAS7) in patients group was demonstrated as 12.5 % in Score 1, 50 % in score 2, 37.5 % in score 3.

Conclusion

Chronic spontaneous urticaria (CSU) has long been recognized as a major clinical problem with unknown cause, and it is well known that part of it is autoimmune. Cathelicidin as antimicrobial peptides was linked to autoimmune diseases. So, this study was conducted as a step forward for better understanding of (CSU) pathophysiology.
Salivary Pepsin versus Oesophageal PH Metry as a Diagnostic Test for Laryngopharyngeal Reflux Disease
Authors: Yousif Tarek Mohamed , Mohammed Manal Sabry , Geogre Tary Magdy Aziz , Mostafa Ahmed Mohammed Mahmoud
Published: August 2023

Background

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents (acid and enzymes such as pepsin) into the laryngopharynx leading to symptoms referable to the larynx/hypopharynx.

Objective

To evaluation of salivary pepsin as a non-invasive rapid test for diagnosis of laryngopharyngeal reflux versus oesophageal ph metry.

Patients and Methods

This was a prospective comparative study conducted on 50 subjects; to evaluate the salivary pepsin as a non-invasive rapid test for diagnosis of laryngo-pharyngeal reflux (LPR) versus oesophageal pH metry.

Results

The increase in age, laryngoscopic abnormality, and pH metry; had an independent effect on increasing salivary Pepsin; with significant statistical difference (p < 0.05 respectively). The increase in laryngoscopic abnormality; had an independent effect on increasing pH metry (% Time pH < 4); with significant statistical difference (p = 0.00002). The increase in pH metry (% Time pH < 4); had an independent effect on increasing the probability of LPR occurrence; with significant statistical difference (p < 0.005). Salivary Pepsin at a cutoff point (>5) predicted patients with LPR, with fair (77.9%) accuracy, sensitivity= 100% and specificity= 56% (p = 0.0001). PH metry (% Time pH < 4) at a cutoff point (>14) predicted patients with LPR, with good (87%) accuracy, sensitivity= 80% and specificity= 100% (p < 0.0001).

Conclusion

In this study we have shown that pepsin in saliva of patients with LPR is significantly higher than normal individuals, this may help as a diagnostic tool without using invasive methods for diagnosis of LPR.
Clinicopathological and Prognostic Value of Plasma CD24 Level in Hepatocellular Carcinoma
Authors: Awad Emad , Safwat Eslam , Rasmy Hany Samir , Samy Amal
Published: August 2023

Background

Hepatocellular carcinoma (HCC) is the sixth most common form of cancer worldwide and the second most common cause of cancer-related deaths. HCC often occurs in the background of a cirrhotic liver. there is an increased incidence of HCC due to the rise of Hepatitis B Virus, HCV infections and chronic alcohol use. Western’s HCC usually developed in cirrhotic liver while over 50% of Asian countries developed in noncirrhotic liver. More recent studies suggest metabolic syndrome, such as type II diabetes and obesity, is an additional risk factor for development of HCC.

Aim of the Work

The aim of this work is to determine the clinicopathological and prognostic value of plasma CD24 Level in hepatocellular carcinoma to help in choose best treatment, recurrence rate and metastasis.

Patients and Methods

This case control study was carried out in Ain Shams University on 60 patients divided into two groups, Group (A) that included 20 patients liver cirrhosis without hepatocellular carcinoma and Group (B) that included 40 patients liver cirrhosis with HCC.

Results

The current study demonstrated that CD24 protein expression was detectable in plasma of HCC patients and the controls, and plasma CD24 level was significantly higher in HCC patients over the controls. Furthermore, plasma CD24 level was associated with tumor differentiation however, it wasnot correlated with other clinic- pathologic parameters including gender, age, tumor size, tumor number, capsulation status, TNM stage, HBsAg status, ALT, AFP and GGT level. The present study showed that plasma CD24 level is higher in HCC patients and it is a valuable biomarker for prognosis of HCC patients. Therefore, CD24 might be used as a potential biomarker for evaluation of postoperative survival.

Conclusion

It is concluded that plasma CD24 level is higher in HCC patients and it is a valuable biomarker for prognosis of HCC patients. Therefore, CD24 might be used as a potential biomarker for evaluation of postoperative survival of HCC patients.
High Flux versus Hemodiafiltration in Removal of Indoxyl Sulphate
Authors: Sarhan Iman Ibrahim , Gharib Mohamed Sary , el samea Marwa Shaban Abd , Mahmoud Amira Mohamed , Hassan Mohamed Saeed
Published: August 2023

Background

protein-bound compounds such as the p-cresol conjugates p-cresyl sulphate (p-CS) and Indoxyl sulphate (IS) have attracted most interest in recent years due to their poor clearance by conventional dialysis and their potential toxicity.

Aim of the Study

To compare removal of indoxyl sulphate toxin during single session between low flux, high flux hemodialysis and hemodiafiltration.

Methods

Cross sectional study was concluded upon 60 randomly selected ESRD patients on regular hemodialysis from nephrology Department in Ain Shams University Hospitals. Serum indoxyl sulphate was measured (pre dialysis and post dialysis) using low flux, high flux hemodialysis and hemodiafiltration.

Results

60 test subjects were randomly selected had mean age 43.95 (±11.91 years) in low flux HD group, 48.35 (±13.25 years) in high flux HD group and 45.10 (±18.56 years) in HDF group, were males 66.67 % (n = 40) and females 33.33% (n = 20). The mean indoxyl sulphate reduction ratio using low flux filter was 13.5% (±9.52), using high flux 19.7% (±14.31) and in hemodiafiltration 24.2% (±10.73). There was a statistically significant difference between low flux HD group and HDF group as regard indoxyl sulphate reduction ratio (P value 0.015). There was no statistically significant difference between high flux HD group and HDF group as regard indoxyl sulphate reduction ratio.

Conclusion

Removal of indoxyl sulphate by hemodiafiltration is higher than hemodialysis using low flux membrane and there is no difference between hemodiafiltration and high flux hemodialysis.
Serum Clusterin Level as a Diagnostic and Prognostic Marker for Hepatocellular Carcinoma
Authors: Mohammed Hatem Abdellatif , Mohammed Eslam Safwat , Rasmy Hany Samir , Ahmed Aml Salah Mohamed
Published: August 2023

Background

Hepatocellular carcinoma (HCC) is the third deadliest and fifth most common cancer worldwide, despite the widespread use of surveillance programs in at risk populations, more than half of HCC cases are diagnosed late, and curative therapies such as surgical resection, radiofrequency ablation (RFA) or TACE are possible in less than 30% of patients.

Objective

To assess the diagnostic and prognostic role of detection of serum Clusterin as a biomarker of hepatocellular carcinoma among the Egyptian patients before and after interventional treatment.

Patients and Methods

This study has been carried out in the department of Internal Medicine and Gastroenterology in Ain Shams University Hospitals and Hepatology department in Manshiyet El Bakry General Hospital in the period between July to December 2020.

Results

There was significant positive correlation between Clusterin and the mRecist score with pvalue (<0.001) where it increases with advancing in stages.

Conclusion

AFP is significantly elevated in HCC groups than in cirrhotic (control) and with better sensitivity and specificity than Clusterin. Clusterin has significant positive correlation with Mrecist score of HCC patients which means it acts better as a prognostic tool for following HCC patients. Patients who had recurrence in both HCC groups (RF and TACE) showed less decrease in Clusterine level than those with non-recurrence among both groups. Serum clusterin level was significantly higher among patients with progressive disease (PD) than those with partial response (PR) than those with complete response (CR). Also follow up serum clusterin level after intervention was statistically significant higher among patients with progressive disease (PD) than those with partial response (PR) than those with complete response (CR).
Prevalence of Selective Immunoglobulin A Deficiency in Egyptian Asthmatic Patients
Authors: Sayed Amr Y EL , Ali Fawzia H Abo , Mahmoud Nehal E , Fouad Shaimaa H
Published: August 2023

Background

Asthma is the most common chronic illness in childhood and a major cause of morbidity in adults, affecting 9.6-13% of children, 7.7-10.1% of adults in the US, and 300 million people globally.

Aim of the Work

to assess prevalence of selective immunoglobulin A (sIgA) deficiency in Egyptian Asthmatic patients.

Patients and Methods

This case control study conducted on patients 60 with bronchial asthma according to GINA2011 attending allergy and clinical immunology outpatient clinic at Ain Shams University hospital. They were divided into three groups: the first group includes 20 Asthmatic patients with recurrent chest infections. The second group includes 20 Asthmatic patients without recurrent chest infections and the third group includes 20 healthy controls. All participants were subjected to the following: full history, full clinical examination in addition to the following investigations, complete blood count (CBC) with differential, spirometery, chest X-ray, serum IgG, serum Ig A, serum Ig E, serum IgM and CRP.

Conclusions

Asthma is one of the most common diseases in the world that can be triggered with SIgAD. Asthmatic patient is more prone to the risk of infections. It may be due to impaired innate and adaptive immune system that predisposes individuals to microbial infections or may be related to the presence of one type of primary immune deficiency such as; SIgAD.
Effectiveness of Muscle Stretching Exercise on Quality of Life of Hemodialysis Patients
Authors: Sarhan Iman Ibrahim , Shawky Sahar Mahmoud , El-deeb Manal Mohamed , Teama Nahla Mohamed , Salah Azza Mohamed
Published: August 2023

Background

Chronic kidney disease (CKD) is a disease affecting both kidneys in which progressive irreversible destruction of the renal tissues occurs. This leads to alteration of the metabolic function of the kidneys due to destruction of the nephrons. Kidney dysfunction is considered to occur when the glomerular filtration rate (GFR) falls below 60 ml/min/1.73 m2, for longer than three months.

Aim of the Work

To determine the effectiveness of structured muscles stretching exercise program on Quality of Life among patients undergoing haemodialysis

Methodology

We recruited 60 patients with hemodialysis from dialysis unit within Misr University for science and technology (MUST), faculty of medicine. Patients with mean age between 30 and 60 years old undergoing hemodialysis for at least 6 months in a regular form for at least 2 times a week were included. Patients with a history of orthopedic or psychological problems were excluded. Patients who were critically ill or have a prior history of dopamine receptor antagonist, benzodiazepines, opioids, anticonvulsants were also excluded. Informed consent was obtained from all participants before enrollment into the study. All methods correspond to the STROBE statement for cross sectional study.

Results

In our study, we applied the regular exercises programs for 6 months after each session and then administrated the KDQOL questionnaire again after completion of the exercises. We found that there was a slight increase in the quality of life with all domains. This increase was more evident especially in BKD domain in which the median increased from 0 (0 – 12.5) to 6.25 (0 – 12.5), and PCS in which the mean increased from 6.25 ± 5.8 to 8.13 ± 5.1 post exercise. However, none of those changes was statistically significant (p = 0.236, p = 0.510) respectively.

Conclusion

End stage kidney disease (ESKD) is a chronic disease that forms a great burden on the societies and governments. Regular monitoring and follow up of those patients and trying to improve their quality of life is extremely important. Regular physical exercises are considered the most useful nonpharmacological alternative that helps improves their QOL and prevents the dialysis induced complications as impaired muscle catabolism and sensation of chronic fatigue.
Anti-IFI16 Antibodies in Inflammatory Bowel Disease and Their Variation with Infliximab Therapy in Comparison to Other Modalities of Treatment
Authors: Awad Emad Ahmed , Mohamed Wessam Ahmed Ibrahim , George Tari Magdy Aziz , Elshennawy Ebtesam Alaa Mohamed Awad
Published: August 2023

Background

Amatory bowel diseases (IBDs) are remittent or progressive conditions that may affect the entire gastrointestinal tract and the colonic mucosa and are associated with an increased risk for colon cancer. Patients with mucosal lesions may not have clinical symptoms, or only present with mild symptoms. Objective measurements are required to assess and monitor IBD disease activity. Moreover responses to treatments must be closely monitored to determine effectiveness and avoid disease complications.

Aim of the Work

The aim of this study is to assess the utility of IFI16 antibodies as a predictor of infliximab-induced remission in IBD patients in comparison to other modalities of treatment.

Patients and Methods

A Comparative cross sectional study in internal medicine and gastroenterology outpatient clinic at Ain Shams University Hospital. With 60 IBD patients are included in this study divided into three groups.

Results

Patients with low levels of IgG antibodies against IFI16 at baseline had a higher probability of a clinical response or remission at the end of induction therapy with IFX (OR 1/4 0.143; 95% CI 0.027–0.761). The only statistically significant association found in patients with UC was that between anti-IFI16 IgG and extensive colitis (E3) (OR 1/4 7.255; 95% CI 2.452–21.463; P 1/4 0.0001) (data not shown).

Conclusion

Overall, the findings presented in this study deserve more investigation to verify the possibility of exploiting a patient’s reac- tivity against the IFI16 autoantigen as a predictive marker of response to IFX therapy. Anti-IFI16 IgG titers may be of great clinical relevance and provide guidance when tailoring therapeutic choices to individual patients.
Prevalence of Latex Sensitization among a Sample of Healthcare Workers at a Tertiary Hospital in Cairo 2020
Authors: kader Fatema Elzahraa Abd El , Sheha Dina Sayed , Mostafa Nayera Samy , Elkady Hossam Moustafa
Published: August 2023

Background

Rubber (polyisoprene) is a vital natural resource that is used in the synthesis of a wide variety of commercial products ranging from airplane tires to protective medical gloves. Ninety-nine percent of natural rubber comes from one source: the sap-like fluid (latex) from the commercial rubber tree, Hevea brasiliensis (Hev b), found in Africa and Southeast Asia, Hundreds of allergens have been identified from natural rubber latex (NRL) and almost 15 official ones given numbers (Hev b1 to Hev b15) and Latex allergy is a well-known problem among healthcare workers (HCWs) (clinicians, nurses, dentists, laboratory worker, emergency medical technicians and patient transporters) while utilizing gloves or inhaling aerosolized particles.

Patients and Methods

To identify the prevalence of latex allergy among tertiary hospital HCWs as Ain shams university hospital. 45 nurses participated in our study after applying exclusion criteria (use of beta-blockers, pregnancy or breast feeding). They were subjected to completion of Questionnaire then underwent skin prick test (SPT).

Results

The prevalence of latex allergy was 22 % among HCWs; several factors are associated with symptoms of latex allergy including female gender, history of atopy. The most common allergic symptoms reported were skin allergy and the second most common symptoms were symptoms of allergic rhinitis and conjunctivitis followed by symptoms of bronchial asthma and systemic reactions.

Conclusion

The prevalence of latex allergy in HCWs at Ain Shams University Hospitals is high, and represents a serious occupational disease. It is important to strive for a latex-free working environment for HCWs, it is important to increase awareness of the sensitizing and disease-causing effect of latex gloves in HCWs. Powdered latex gloves can be a hazard not only to the wearer but also to other people in the workstation. In an ideal situation latex-free gloves should be used, especially in highexposure areas.
Incidence of Reactivation of Hepatitis B in Co-Infected HB V/HCV Patients Treated with Regiments of Sofosbuvir and Daclatasvir with or without Ribavirin
Authors: Mohamed Azza Emam , Kaiser Hany Harron , el hamid Ghait Ramy Samir Abd , Al-Basry Fatma Moustafa Abdien
Published: August 2023

Background

HCV management was dramatically changed by the recent advent of direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection, where DAA regimens are associated with a sustained virological response (SVR) rate of > 90–95% and are considered safe; nevertheless, a few complications have been reported including reactivation of hepatitis B virus (HBV).

Aim of the Work

To evaluate the incidence of re activation of HBV among patients treated by sof/dac with or without RBV

Patients and Methods

This study was held in out in centers for treatment of HCV in –Ain- Shams University Hospital and Aswan Fever Hospital from May 2019 to October 2020., All patients were subjected to history taking, clinical examination, abdominal ultrasound, laboratory investigations (CBC, liver function, HCV Ab, HBsAg, HBV eAg PCR for HCV RNAand PCR for HBV DNA. All patients were positive for HCVAb, HCV PCR, HBVsAg with HBV DNA less than 2000IU/ML and negative for HBVeAg. This study was conducted on 90 patients who were selected according to National Committee for Control of Viral Hepatitis (NCCVH) protocol were divided according to treatment protocol into two groups.

Results

In our study, 57% of cases aged < 50 years, 33% aged > 50 years, and 61% were males and 39% were females; In the present study, there were 23 patients were smokers,16 patients were diabetics and 21 patients were hypertensives. All treated patients were negative PCR for HCV RNA at week 12 with 100% (SVR12)response in all treated patients which is still negative till end of treatment and 12 week after end of treatment (SVR 24), AS regard HBV DNA, no statistically significant difference was found at the beginning, at the end of 12 weeks, and at the end of 24 week of treatment by DAAs (p-value > 0.05), except for one patient who was treated with SOF/DAC/RBV. This patient, with compensated cirrhosis at baseline, developed fatigue and anorexia at week 12, with HBV reactivation (HBV DNA levels increased from245 IU/mL at baseline to 532000IU/mL), after which entecavir was added to the SOF/RBV regimen. This patient did not show significant increase in ALT level.

Conclusion

Our study confirmed the importance of screening for HBV in patients undergoing DAA therapy and importance of follow. For those for positive HBsAg, to avoid HBV reactivation and particularly HBV-related hepatitis. Our study limits the benefit of systematic nucleoside analogue prophylaxis for all HBsAg-positive patients. In our Egyptian cohort, for example, if we had followed the EASL recommendation (ie, starting nucleos(t)ide analogue prophylaxis for all 90 HBsAg-positive patients irrespective of their HBV DNA levels at baseline), this could have prevented 1 case of HBV-related reactivation during the course of DAAs, but resulted in overtreatment in the rest of patients
Neutrophil Gelatinase-Associated Lipocalin as a Marker of Disease Activity in Patients with Ulcerative Colitis Disease
Authors: El Rhman Hany Ali Hessuin abd , Allam Ahmed Samir , Raafat Khaled Mohammed , El Ghany Ali Maha Ezzat Abd
Published: August 2023

Background

Inflammatory bowel disease (IBD) is an idiopathic disease caused by a dysregulated immune response to host intestinal microflora. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the genetic, environmental, or microbial factors and the immune responses.

Aim of the Work

This study will assess the the role of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of disease activity in patients with Inflammatory bowel disease.

Patients and Methods

A cohort prospective study. The study conducted at Ain Shams University Hospitals. The study will take place from August 2020 to February 2021. Our study conducted on 60 Egyptian person over 18 years old visiting the outpatient clinics or admitted in Ain Shams University Hospitals. The study conducted on 40 Egyptian patients with inflammatory bowel disease.

Results

The present study revealed a highly significant elevation of serum NGAL in active IBD patients with p-value <0.001 which show direct relationship between the activity and severity of UC and CD disease and serum NGAL was positively correlated with inflammatory markers (CRP and ESR) in UC and CD patients. And there is negative relation between serum hemoglobin and NGAL.

Conclusion

Serum NGAL is a valuable noninvasive marker in the assessment of activity in IBD patients correlated positively with inflammatory markers (CRP and ESR) and markers of disease activity (UCAI and UC histopathology grading in UC patients and clinical CDAI in CD patients). Other studies should be done on larger size of participants to determine the the role of neutrophil gelatinase-associated lipocalin (NGAL) as a marker of disease activity in patients with Inflammatory bowel disease.
Evaluation of Protein C and Protein S Levels in Covid Patients Compared to Normal Population and Their Relation to Disease Severity
Authors: Fouda Enas Mahmoud , Shafie Ahmed Ibrahim Mohamed El , El-Naby Kareem Ahmed Mahmoud Abd , Yousef Mahmoud Mohamed Gamal
Published: August 2023

Background

The novel coronavirus, SARS-CoV-2, has caused a global outbreak starting December 2019 in China. Since then, it caused a global pandemic infecting more than 140 million patients worldwide. The viral transmission happens primarily through direct contact or droplet transmission. However airborne transmission in certain circumstances was demonstrated in multiple studies.

Aim of the Work

Primary Objective: Comparing Protein C & S levels in normal population to patients infected with COVID 19. Secondary Objective: Measuring the correlation of protein C & S levels in plasma & it’s relation to COVID 19 infection severity.

Patients and Methods

This is a case control study measuring Protein C & S levels in patients infected with COVID 19 compared to normal population over a period of six months, to assess their consumption as an anti-thrombotic protein against COVID 19 infection associated state of hypercoagulability. The study included a hundred participant divided into two groups. The first group had sixty patients infected with COVID 19 and the second group had forty normal healthy Egyptian adults.

Results

Our study showed that when comparing the patients blood indices to the controls there was a significant increase in TLC. Regarding the serum chemistry, our study showed that in the patients group the serum creatinine and blood urea nitrogen. For liver enzymes and liver function tests, our study showed that AST, ALT, Alkaline phosphatase, and gamma G. T. all of them are elevated in the Covid 19 patients when compared to the control group.

Conclusion

This study concluded that the level of protein C activity and the level of Protein S activity are both decreased in patients of the Covid 19 when compared to normal population. It also, concluded that the decrease in their levels is in statistical significance relation to the disease severity in the Covid 19 patients. Also, their levels were lower in patients who developed DVT or thrombosis in the Covid 19 infected group. Finally in chronic kidney disease patients only protein C was related to the disease severity not protein S nor D-dimer.
Comparison between Serum Vaspin in Chronic Kidney Disease and with Hepatitis C Virus and Normal Control Group
Authors: Makhlouf Mohamed Ali Maraay , Elessawy Hager Ahmed , Naby Kareem Ahmed Mahmoud Abdel , Mohamed Mai Abdel Azeem Abdel Azeem
Published: August 2023

Background

Chronic kidney disease ―CKD|| patients have insulin secretion disorders and resistance to insulin effects, that is responsible for the development of cardiovascular proceedings. Vaspin is an adipcytokine that regulates glucose and lipid metabolism.

Aim and objectives

To compare serum level of Vaspin in Chronic kidney disease& chronic hepatitis C patients group and normal control group.

Subjects and Methods

This study is comparative case - control study, was conducted at in Ain shams university hospitals & El Zaitoun Specialized hospital on patients attending gastroenterology and hepatology clinic and nephrology clinic0.

Result

There was high statistically significant difference between the studied groups as regard vaspin.

Conclusion

Diabetic nephropathy‖ patients presented a significant increased levels of serum Vaspin when compared to levels to control, serum Vaspin are protective roles. Also, vaspin could be used as specific predictors for liver fibrosis in CHC patients with and without diabetes.
Study of Selenium Status in Grave’s Disease Patients
Authors: Halawa Mohamed Reda , Abo-Shadi Manal Mohamed , Marawan Dina Ahmed , El kateb Mai Ahmed Abdel-Maksoud Moustafa
Published: August 2023

Background

Grave’s disease is one of the common autoimmune diseases, it affects thyroid gland causing hyperthyroidism and goiter. It also affects eyes, and rarely skin and bones. Multiple etiological factors contribute to its pathogenesis as gender, smoking, stress, iodine status, vitamin D level and selenium status. In addition, genetic and immunological factors are also suggested. GD is presented by variety of clinical signs and symptoms including hyperthyroidism picture, goiter, eyes affection (GO), menstrual irregularities, cognitive changes, thyroid acropachy and dermopathy. Its management plan is variable and should be tailored according to each patient’s clinical presentation and personal preference. This may include antithyroid drugs, radioactive iodine, surgery, and other supportive measures. Grave’s ophthalmopathy may be a sight- threatening complication of GD. Early detection and management are essential to avoid irreversible damage to eye structure and function. The activity and severity of GO were graded according to many algorithms to help assessment of patient’s case and management plan.

Aim of the Work

To evaluate the selenium status in Grave’s disease patients, in comparison to healthy subjects in Egypt.

Patients and Methods

This is a case control study that was conducted on 80 subjects; Group (A): 40 patients diagnosed with GD and Group (B): 40 healthy control subjects at Endocrinology clinic at Ain Shams university hospitals in the period between December 2020 and June 2021. All the included GD patients suffered from GO.

Results

Our study interpreted a statistically significant diagnostic ability of selenoprotein P in detection of Grave’s disease as with 100% sensitivity, 62.5% specificity and a cut off value of ≤ 37.

Conclusion

Our study interpreted that selenoprotein P ―as a marker of selenium status‖ is significantly lower in GD patients. GO activity and severity were not correlated to selenium status. Free T4 can be used for prediction of selenoprotein p level which increased by 1.32 in each unit Free T4 increase.