bluuebunny/crossref_metadata_2025 huggingface dataset:
Dickkopf-1 (DKK1): A Diagnostic Marker for Hepatocellular Carcinoma (HCC) on Top of Chronic Hepatitis C Virus Related Diseases
Authors: Ali-Eldin Zainab Ahmed , Al Baz Hossam Samir , Naguib Gina Gamal , Samy Mina Helal
Published: August 2023

Background

Hepatocellular carcinoma (HCC) is a common form of cancer in the world and is the third leading cause of cancer-related death. More than 80% of its incidence is found in developing countries; rates are more than twice as high in men compared with women. HCC is the most common form among primary liver cancers occurring worldwide, about 70–85% of liver tumors.

Aim of the Work

This study was aimed to evaluate the clinical significance of serum Dickkopf-1 (DKK1) as a diagnostic and prognostic marker in hepatocellular carcinoma.

Patients and Methods

This was a prospective study that was conducted on 60 patients and 30 healty control subjects recruited from Al Sahel Teaching Hospital.

Results

Regarding the demographic data, there was no statistically significant difference found between 3 groups regarding age and sex. Tumor Size was < 2 cm in 10.0% of HCC patients, 2 – 3 cm in 56.7% of them & > 5 cm in 33.3% of HCC patients. While number of tumors was Single in 33.3% of HCC patients, 2 – 3 in 30.0% & Multiple masses in 36.7% of patients. PV thrombosis was reported in 30% of patients. Incidence of child score c in our study was significantly higher in HCC Group when compared with Liver Cirrhosis group. According to this study, there was Non statistically significant correlation Between DKKA1 (pg/ml) & each of Age, HB, WBCs, Platelets, ALT, AST, Creat, Urea, Albumin, INR, Bilirubin and AFP in both all patients & Liver Cirrhosis groups. While for HCC group, there was Non statistically significant correlation Between DKKA1(pg/ml), Age, HB, Platelets, ALT, Creat, Urea, Albumin, INR, Bilirubin and AFP, but there was statically significant Positive correlation Between DKKA1(pg/ml), WBCs and AST. Serum DKK1 was significantly higher in HCC group comparing with liver cirrhosis group and control group. According to our study, ROC curve showed that the best cut off point of DKKA1 to detect Liver Cirrhosis group was > 264.9 pg/ml with sensitivity of 56.67%, specificity of 86.67%, PPV of 81.0%, NPV of 66.7%. Another ROC curve showed that the best cut off point of DKKA1 to detect HCC group was found > 453 with sensitivity of 83.33%, specificity of 93.33%, PPV of 92.6%, NPV of 84.8%. Assessment of diagnostic performance of serum DKK1 when used in discriminating Group (HCC) from Group (Liver Cirrhosis), revealed a better diagnostic performance of DKK1) as the best ROC cut-off for DKK1 was > 1674.8 ng/mL, this had a diagnostic sensitivity of 50%, specificity 96.67%, positive predictive value 93.7%, negative predictive value 65.9%.

Conclusion

In conclusion, our study suggests that DKK-1 may be a key regulator in HCC progression, a promising potential therapeutic target for HCC. We also demonstrated that serum DDK-1 could be a useful marker for diagnosing HCC.
Association of Non-Alcoholic Fatty Liver Disease with Chronic Obstructive Lung Disease Patients: An Egyptian Study
Authors: El Sayed Ashour Engy Yousry , Beshay Amir Helmy Samy , George Tari Magdy Aziz , Salah eldin Noha Osman Ahmed , Faheem Mina Mofreh Ramzy
Published: August 2023

Background

Chronic Obstructive Pulmonary Disease (COPD) and Non-Alcholic Fatty Liver Disease (NAFLD) share common risk factors, such as reduced physical activity, and pathophysiological mechanisms including oxidative stress, low grade inflammation, and metabolic syndrome. COPD severity is also recognized as an independent risk factor of NAFLD. Interestingly, the literature reports a higher prevalence of all-cause liver disease in patients with COPD, but only a small number of patients with NAFLD. Therefore, the specific links between NAFLD and COPD need to be confirmed and further evaluated.

Aim of the Work

The aim of the study is to determine the possible association between Chronic Obstructive Lung Disease and Non-Alcoholic Fatty Liver Disease.

Patients and Methods

This cross-sectional study was conducted at outpatient clinics at Ain Shams Hospital during a Period 1 year. This study was performed on 60 Egyptian Patients divided into two groups as follow: Group 1:40 Patients diagnosed with COPD (Patients diagnosed by history of disease, smoking history and A ration of post bronchodilator FEV1 10 FVC of less than 70% of the predicted value). Group2: 20 Normal Healthy People (Control Group)

Results

There was no statistically significant difference with p-value >0.05 between both groups as regards age and sex, which indicated proper matching between groups. The present study showed that there was a statistically significant difference with p-value <0.05 between study groups as regards obstructive sleep apnea with high percentage of obstructive sleep apnea among cases. On the other hands, there was no statistically significant difference with p-value >0.05 between both groups as regards smoking and hypertension. The current study showed that there was no statistically significant difference with p-value >0.05 between study groups as regards systolic blood pressure, weight, height, waist circumference and BMI. On the other hand, there was a statistical significance difference with p-value <0.05 with higher mean of diastolic blood pressure among cases.

Conclusion

This study showed that NAFLD is associated with COPD. Physicians should be aware of possible liver comorbidities in COPD patients and that extrahepatic disease in NAFLD patients may vary more than previously thought. Further studies concerning the biochemical and metabolic mechanisms of NAFLD and COPD are required.
Tumor Necrosis Factor Alpha and Neutrophil Lymphocytic Ratio in Non-Alcoholic Fatty Liver Diseases
Authors: Badawy Hanan Mahmoud Mohamed , El Baaz Hossam Samir Ibrahim , Badawy Al Ashram Mohamed Nabil , El Akroty Mohamed El Demerdash Mohamed
Published: August 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Some patients with NAFLD progress to liver fibrosis, cirrhosis and hepatocellular carcinoma. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important.

Objective

To investigate the relationship between tumor necrosis factor alpha level and neutrophil lymphocytic ratio with the development of nonalcoholic fatty liver disease (NAFLD) from simple steatosis stage to liver fibrosis.

Patients and Methods

In the present study, we assess the value of TNF-α and N/L ratio as a noninvasive biomarker for diagnosis of NAFLD and NASH. All patients enrolled in the study fulfilled the mentioned inclusion criteria. They all were subjected to history taking and clinical examination upon admission. An informed consent was taken from all patients before enrollment in the study. Privacy of the participants and confidently of the data is preserved. Any unexpected risk appeared during the course of the study were being cleared to the participants and ethical committee on time.

Results

Patients with NASH had lower platelet count, higher INR, higher total bilirubin, higher serum AST, and higher serum ALT, lower serum albumin than normal controls and NAFLD patients. Likewise, patients with NAFLD had lower platelet count, higher INR, higher total bilirubin, higher serum AST, and higher serum ALT, lower serum albumin than normal controls. Patients with NASH had higher serum FBS and serum cholesterol, higher NAFLD score than normal controls and NAFLD patients. Likewise, patients with NAFLD had higher serum FBS and serum cholesterol, higher NAFLD score than normal controls. Patients with NASH had significantly higher values of TNF-α and N/L ratio.

Conclusion

Nonalcoholic fatty liver disease (NAFLD) increasing in parallel with obesity, insulin resistance, hypertension and dyslipidemia and is now regarded as the liver manifestation of the metabolic syndrome. Serum levels of TNF-α and N/L ratio may represent novel, noninvasive biomarkers of diagnosis and histological disease severity in patients with NAFLD and NASH. And can be a useful predictive marker of liver fibrosis.
The Role of Serum Calgranulin C as a Non-Invasive Marker for Inflammatory Bowel Disease
Authors: El Nakeeb Noha Abd El Razek , Samir Elbaz Hossam , Rasmy Hany Samir , Ismael Mohamed Fayez Mohamed
Published: August 2023

Background

IBD has been recognized as a systemic inflammatory entity and as such, it is anticipated to induce changes exceeding the boundaries of bowel mucosa, being reflected in a broader spectrum of tissues, including blood. Calgranulin c is a calcium binding protein with proinflammatory properties. It has been associated with different diseases of inflammatory origin, including inflammatory bowel disease (IBD). In our present study, the utility of serum calgranulin c as marker for inflammatory bowel disease was tested.

Objective

is to evaluate the role of serum calgranulin c as a diagnostic and prognostic marker in IBD patients and to correlate it's level with different biochemical, endoscopic and clinical parameters.

Patients and Methods

Calgranulin c serum levels were determined in 50 patients with ulcerative colitis (UC), 20 patients with Crohn’s disease (CD) and 73 with functional bowel disorder (IBS). Calgranulin c serum concentrations were analysed using double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) to assay the level of Human S100 Calcium Binding Protein A12(S100A12) in samples.

Results

In the present study we found that the mean serum calgranulin c were 723.640±529.055 ng/ml (range: 63-2000) in UC, 759.233±797.963 ng/ml (range: 110-2000) in CD and 80.850±24.416 ng/mL (range: 52-135) in control group. UC and CD patients had significantly higher serum calgranulin c levels compared to IBS patients with p < 0.001 for both. the best cut-off for serum calgranulin c levels in prediction of IBD was >110 ng/Ml with sensitivity 96.67%, specificity 85.00%, and test accuracy was 97.8%. best cut-off for serum calgranulin c levels in prediction of UC was >135 ng/mL. the best cut-off for serum calgranulin c levels in prediction of CD was >110 ng/Ml. Moreover, the best cut-off for serum calgranulin c levels of > 435 ng/mL could predict activity in UC group depend on UCEIS, depend on ACGUCAI and Erosions and ulcers in endoscopy. another cut off level of Serum calgranulin c in prediction of luminal bleeding in endoscopy in UC patients was >625 ng/ml. the best cut off level of Serum calgranulin c in prediction of activity among CD patients depend on CDAI was >437 ng/ml.

Conclusion

Serum calgranulin c was found to be higher in patients with IBD than with functional bowel disorded (IBS). Levels of serum calgranulin c varied significantly with disease severity in patients with UC and CD. Serum calgranulin c was found to be higher among patients with active CD and UC than those in remission. Serum calgranulin c can be used as a non invasive marker of inflammatory bowel disease. It can distinguish IBD from IBS and can be considered as a maker of activity in IBD patients.
CD 133 Gene Polymorphisms as Predictive Markers for Development of Cancer Pancreas
Authors: El Razek Kamel Elnakeeb Noha Abd , Saad Rafaat Atta Ibrahim , George Tari Magdy Aziz , Ahmed Marwa Hassan Mohamed , Abdelhaleem Mostafa Khairy Mohamed
Published: August 2023

Background

Pancreatic cancer is one of the most aggressive human malignancies, it ranks the fourth leading cause of cancer death in the Western world and the 13th commonest cancer.

Aim of the Work

The aim of this study is to evaluate the genetic variants CD133 (rs1029728, rs2240688, rs2286455, and rs3130) as possible non-invasive predictive biomarker for Pancreatic cancer in the Egyptian population, this could help to detect the susceptible individuals, diagnose patients earlier, and this improve the therapeutic outcome.

Patients and Methods

This study was conducted in co-operation between Gastroenterology and Hepatology Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute “between” september 2020 to march 2021. It included total participants of 133

Results

Our study demonstrated that there are three gene polymorphisms showed significant increase in pancreatic cancer group vs. control group, rs2240688 (TT) (65.5%) vs. (44.9%), rs1029728 (AA) (20.2%) vs. (2.0%), and rs3130 (TT) (32.1%) vs. (16.3%) respectively. There is significant increase in rs2240688 (TT), rs1029728 (AG) and rs3130 (TT) with smoking in pancreatic cancer group. And There is significant increase in males in pancreatic cancer group vs. control group in rs3130 (TT) with rs2240688 (TT) polymorphism. While rs2286455 showed no statically significance. The functional polymorphisms rs3130 (CC) and rs2240688 (CC) were found to be higher in control group vs. pancreatic cancer group that may represent a protective value against the disease. So, CD133 gene polymorphisms, rs2240688 (TT) rs1029728 (AA) and rs3130 (TT) could be used as a predictive marker for Pancreatic cancer after validation by larger studies or met analysis.

Conclusion

We concluded that the Genetic polymorphisms of the CD133 gene were associated with risk of Pancreatic cancer are three polymorphisms and represented as rs2240688 (TT) (65.5%) vs. (44.9%), rs1029728 (AA) (20.2%) vs. (2.0%), and rs3130 (TT) (32.1%) vs. (16.3%) Vs. control group. There is significant increase in rs2240688 (TT), rs1029728 (AG) and rs3130 (TT) with smoking in pancreatic cancer group vs. control group. rs3130 (TT) with rs2240688 (TT) gene polymorphisms showed significant increase in pancreatic cancer group group vs. control in male gender only as. According to the age as a demographic variable, mean age for pancreatic cancer group was 61.5 years with percentage of (76.2%) for age more than 50 years vs. (23.8%) for age less than or equal 50 years these. The functional polymorphisms rs3130 (CC) and rs2240688 (CC) were found to be higher in control group vs. pancreatic cancer group that may represent a protective value against the disease.
Assessment of Right Lobe Size/Serum Albumin Ratio as a Non-Invasive Marker for EsophagealVarices in HCV Patients
Authors: Bayoumy Essam Mohammed , Samir Ahmed , Salem Salem Hamed
Published: August 2023

Background

Oesophageal varices are the most critical porto-systemic shunts that develop secondary to portal hypertension, which is considered the main complication of liver cirrhosis. Many studies recommend the screening of all cirrhotic patients by endoscopy, but repeated endoscopic examinations are unpleasant for patients and have a high- cost impact and burden on endoscopic units.

Aim and of the work

To investigate the value of measurement of (Rt. lobe diameter/ serum albumin ratio) in the prediction of esophageal varices.

Subjects and Methods

This was Case- control study, was carried out at outpatient clinics of Hepatology and inpatient department of Gastroenterology at Ain Shams University Hospital on 100 patients divided into 3 groups: (Group 1): 30 patients with Child-Pugh A, (Group 2): 30 patients with Child-Pugh, (Group 3): 40 patients with Child-Pugh C, during a period of 6 months.

Result

There were highly significant difference between both groups as regard Platelet count /spleen diameter ratio and Right liver lobe size/Serum Albumin ratio.

Conclusion

The use of Right liver lobe/serum albumin ratio can help physicians by restricting 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.
Vit D Assessment in Patients with Covid-19 Virus
Authors: Youssef Tarek Mohamed , Abdelrahman Shereen Abo Bakr , Ahmed Ahmed Elmetwally , Ali Sara Fekry
Published: August 2023

Background

vitamin D may potentially play an important role in preventing or ameliorating the multi-system consequences of COVID-19 infections.

Aim of the Work

The aims of this study is to assess that there is a potential association between mean levels of vitamin D in the cases and mortality caused by COVID-19.

Patients and Methods

This was a case control study that was conducted on 80 Egyptian Patients attending at El medani hospital, El Obour specialized hospital, and the outpatient clinics at Ain shams University hospitals through six months.

Results

Vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, a major cause of death associated with COVID-19. Vitamin D plays a role in strengthening the body‟s immunity by inducing monocyte differentiation and inhibiting lymphocyte proliferation. Regarding to the laboratory investigations: We have found that the number and percentage of WBC, LYM and NEU were significantly different between positive and negative RT-PCR cases for COVID-19/or SARS-CoV-2. In comparison to the normal range, we found low WBC and LYM counts in patients with positive RT-PCR COVID-19. Regarding to vitamin D: Our study showed statistically significant positive correlation between vit D and lymphocytes, and there was statistically significant negative correlation between vit D, neutrophil-lymphocyte ratio, CRP, BUN, S. creatinine, AST, ALT, FERRITIN, LDH and D-DIMER.

Conclusion

Vitamin D deficiency is a risk factor for infections as well as for insufficient innate immune system reactivity, therefore the winter time testing for serum vitamin D status (lowest levels expected) should be mandatory as part of regular health check status. The test is even more mandatory in patients with chronic diseases, where we expect vitamin D deficiency during all the year and an increased burden of risk factors for further disease severity and even mortality. In conclusion, this study confirms that vitamin D deficiency is associated with more severe lung involvement, longer disease duration, in COVID-19 patients.
Comparative Study Evaluating the Effect of the Administration of Vitamin K2 versus Placebo on Vascular Calcification in Haemodialysis Patients
Authors: Elshinnawy Howayda Abdelhamid , Elsaid Tamer Wahid , Elsharabasy Reem Mohsen , Zakhrious Shereen Ibrahem
Published: August 2023

Background

Vitamin K deficiency serves as risk factor for vascular calcification in CKD patients. Vitamin K family includes phylloquinone (vitamin K1) and several menaquinones (vitamin K2). Until trials are designed to compare the effects of phylloquinone and menaquinone on CAC and other cardiovascular outcomes, it is not known if one form of vitamin K is superior to any other form of vitamin in terms of cardiovascular health.

Objective

To evaluate the effect of supplementation of vitamin K2 (menaquinone, MK-7) on circulating levels of calcification regulators and to assess their safety in patients on regular hemodialysis patients.

Patients and Methods

The study was conducted on 84 ESRD patient on regular Hemodialysis recruited from Ain shams university Hospitals hemodialysis unit, their age ranged from 18 to 75 years This study was conducted from June 2020 to September 2020 in Hemodialysis Unit of Ain Shams University Hospitals, each participant signed informed consent. The study was approved by the Research Ethical Committee of Faculty of Medicine, Ain Shams University in April 2020. Patients were equally divided into two groups: Vitamin K2 group: 42 patients will receive 90 ug per day orally in addition to their standard treatment for 3 months period. Placebo group: 42 patients will receive placebo orally in addition to their standard treatment for 3 months period.

Results

In our study there was no statistically significant difference between the two groups according to their risk factors regarding smoking, HTN, HCV, DM, and ISHD. In this work only 22.5 % of patients were diabetic in 1st group and 35% were diabetic in placebo group, but their diabetes was well controlled and there was no significant difference between groups regarding incidence of There was no significant difference between groups regarding vascular access (AVF, Permicath) and duration of dialysis this study did not find a significant difference in blood pressure, BMI, serum levels of calcium, phosphorus, hemoglobin%, PTH, between group I and group II at the start of the study and after 3 months.

Conclusion

The study are that it is a pilot study with a small sample size, no funding was present., also carotid duplex was not done so effect of vitamin k2 administration and rise in serum MGP level on vessels calcification and atherosclerotic changes couldn’t be assessed.
Effect of Direct Acting Antiviral Therapy on Lipid Profile in Egyptian Patients with Chronic Hepatitis C Infection
Authors: Awed Emad Ahmed , AL Baz Hossam Samir Ebrahim , Allah Shimaa Hussein Gad , Ahmed Shimaa Adel Mahdy
Published: August 2023

Background

Chronic hepatitis viral infection is associated with wide metabolic disarrangements. HCV interacts with lipid metabolism leading to steatosis, hepatitis c virus infection is linked to the lower lipid profiles and progression of the chronic liver disease.

Aim of the Work

The aim of this study was to evaluate the Effect of Direct Acting Antivirals therapy on serum lipid profile in egyptian patients with chronic hepatitis C infection.

Patients and Methods

This study was prospective Cohort clinical study and carried out on 60 patients have chronic infection with hepatitis C who was treated with direct acting antiviral therapy on patients admitted to Aswan Fever Hospital.

Results

The results of this study showed that the basic demographic and clinical data in the two studied groups including age, sex, smoking habitat, comorbidity, BMI, and pre treatment laboratory findings which include blood picture, FBS and liver function, show insignificant difference between the two studied groups, this results was important to eliminate the effect of demographic and clinical data on the net results and the only variable affected on the net results was the type of treatment. In our results, the lipid profile show the following result, regarding triglyceride and cholesterol, it was found that there was no significant difference between the two groups pre treatment and all over the period of follow up, on the other hand at end of follow up after three months it was found that there was a significant increase in triglyceride and cholesterol in the two groups, but the increasing in group I (Sof+Dacal) was more than the increase in group II (sof+dacal+ribavirin). Regarding LDL and HDL, the levels of two variables pre treatment was matched without significant difference, the increase in LDL and decrease in HDL in group II was significantly higher than the increase in group II after one and three months, on the other hand on comparing the level of LDL and HDL pre treatment with the final follow up after 3 months, it was found that there was a significant increase in LDL and decrease in HDL in the two groups.

Conclusion

In this study, we could conclude that there was a significant increase in lipid profile in patients with chronic HCV infection treated with Sofosbuvir & Daclatasvir + Ribavirin and Sofosbuvir & Daclatasvir.
Glypican-3: A Promising Biomarker for Hepatocellular Carcinoma Diagnosis
Authors: Makhlof Mohammed Ali Marai , Slama Mohamed Magdy , Ahmed Ahmed Abbas Abdo , Abdella Tarek Mohamed
Published: August 2023

Background

Molecular targets are urgently required for the early detection of HCC and the development of novel therapeutic approaches. in HCC patients, GPC3 is overexpressed at both the gene and protein levels, and its expression predicts a poor prognosis. Moreover, GPC3 has been used as a target for molecular imaging and therapeutic intervention in HCC.

Aim and objectives

to study the role of Glypican 3 levels in the diagnosis of hepatocellular carcinoma in Egyptian patients and its prognostic role after successful treatment.

Subjects and Methods

This is a Case control study, was conducted in Internal Medicine department - Ain Shams University Hospitals on 60 patients divided into 2 groups: (Group 1): included 30 patients with liver cirrhosis and HCC on top, (Group 2): included 30 patients with liver cirrhosis and no evidence of HCC.

Result

There were high significant difference between both groups as regard GPC3.

Conclusion

Glypican-3 can be a valuable diagnostic marker for HCC diagnosis and prognosis after various treatment modalities and may be complementary to alpha fetoprotein increasing overall sensitivity of HCC detection.
Genetic study of inherited peripheral neuropathy disease (Charcot–Marie Tooth) disease
Authors: Fahmy Nagia Ali , Omar Khalda Sayed , Helal Suzette Ibrahim , Nada Maha Ali , Emara Tamer Husein , Salama Amal Mohamed Hasan
Published: August 2023

Background

Charcot-Marie-Tooth disease (CMT) is the most common hereditary neuromuscular disorder. Charcot-Marie-Tooth disease can be caused by mutations in many different genes. These genes provide instructions for making proteins involved in the functioning of the peripheral nerves of the feet, legs, and hands. Peripheral myelin protein 22 (PMP22) related neuropathies account for over 50% of inherited peripheral neuropathies. Agene copy variation results in CMT1A (duplication of 17p11.2.p12) and hereditary neuropathy with liability to pressure palsies (HNPP; single deletion). Point mutation comprise both phenotypes. The underlying pathological mechanisms are incompletely understood and biallilic mutations of PMP22 are very rare.

Objective

To study clinical characteristics of a cohort of Egyptian patients with CMT; frequency of PMP22 gene duplication and deletion by MLPA and molecular diagnosis.

Methodology

We applied our study on 97 Egyptian patients from 70 unrelated families with suspected CMT disease, patients were referred from different provinces to Ain Shams neuromuscular outpatient clinic. After an informed and written consent, all patients were examined neurologically and systemically. Diagnosis was based on clinical symptoms, electromyography and genetic study.

Results

Clinical classification of our patients revealed high incidence rate of AR CMT type patients (43.3%) and sporadic cases (39.3%), while AD CMT type represents (17.5%), the cause of the high rate of negative family history of same disease affection may be for many reasons mild subclinical expression in other family members, autosomal recessive inheritance, or a de novo heterozygous pathogenic variant in a gene associated with autosomal dominant inheritance. Neurophysiological classification according to median NCV shows that 53 patients (51.5%) have axonal sensory-motor affection with median NCV <38 m/s, 26 patients (26.8%) have demyelinating CMT type, and 19 patients (19.6%) have intermediate type (mixed axonal and demyelinating affection with median NCV range between 35 m/s to 45 m/s. Thus the commonest form is CMT 2 (axonal AR type) followed by CMT 4 (demyelinating AR type) with lower incidence of CMT 1 (demyelinating AD type).

Conclusion

from our study we concluded that (AR CMT type) is not uncommon in Egypt because of the high prevalence of consanguinity, and that PMP22 duplication is not a common cause of Egyptian inherited neuropathy disease.
Demographic and Clinical Characteristics of a Sample of Egyptian Stroke Patients Admitted to the Stroke Unit of a University Hospital
Authors: Aref Hani Mohamed Amin , El Nahas Nevine , Eldine Hany Zaki , Moustafa Ramez Reda , Turk Mohamed Amir , Hassan Rana Mohamed
Published: August 2023

Background

Stroke is a catastrophic life-changing event which influences not only stroke patients but also their families and care givers. The recommended treatments for ischemic stroke that are guideline include systematic supportive care in a stroke unit or stroke center is still deficient.

Aim of the Work

To present the demographic profile, and clinical characteristics of a sample of Egyptian patients, with acute ischemic stroke, admitted to stroke unit in Ain Shams University Hospital, and compare to other ethnic groups reported in other studies.

Subjects and Methods

This is a retrospective study, derived from the database of stroke patients admitted to the stroke unit in Ain Shams University Hospital and Ain shams specialized hospital in the period from (the first of January 2016 to 30th of March 2020).

Results

A favorable early outcome (mRS≤2) showed high significant correlation with male gender, younger age and less prevalence of AF, and a significant correlation with less prevalence of hypertension and dyslipidemia.

Conclusion

The burden of stroke and high prevalence of stroke risk factors in Egypt are alarming. Research is critically needed to fully evaluate the burden of stroke in Egypt, and organization of stroke care locally and nationally requires coordinated efforts by multiple stakeholders. The most common risk factor for stroke was hypertension followed by dyslipidemia and then smoking with higher incidence of rheumatic heart diseases due to lowered living conditions.
Impact of Extent of Resection of Glioblastomas on Patients Survival (Systematic Review)
Authors: Ali Ali Kotb , Hamza Emad Maamoun , Mohamed Mohamed Abdel Rahman , Ahmed Mohamed Ahmed Saeed
Published: August 2023

Background

Glioblastoma (GBM) is the most common and most aggressive primary malignant brain tumor. It has a dismal prognosis. The importance of the extent of resection for glioblastoma has been debated for decades.

Aim of the Work

The aim of this systematic review is to evaluate the impact of the extent of resection of glioblastomas on patients’ survival through examining the recent literature.

Patients and Methods

The present study investigated the impact of the extent of resection of a primary GBM on patients survival, through systemically reviewing the recent literature. Four electronic databases were systematically searched, including PubMed, Embase, the Cochrane library, and Science Direct to review the recent literature from January 2009 up till now.

Results

Hazard ratios (HRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to express the summary effect estimates using the randomeffects model. Eight studies involving a total of 2249 patients with high-grade glioma were included in this study. A total of 1247 patients underwent gross total resection of the GBM and 1002 had an incomplete resection. The mean progression-free survival (GTR vs incomplete resection) was 10 vs 6.3 months and the mean overall survival (GTR vs incomplete resection) was 28.7 vs 13.5 months.

Conclusion

The quality of evidence of the available studies are poor. Therefore, it remains unclear whether GTR is safe and actually improves the survival of patients with GBM. Future prospective trials and a standardized definition of GTR are needed.
Telovelar versus Transvermian Approach in Management of Patients with Fourth Ventricular Tumors
Authors: Abd Allah Adel Nabieh Mohamed , Elayouty Ahmad Elsayed Desoukey , Emara Ahmed Mohamed Elsayed , Ali Mohamed Hamed
Published: August 2023

Background

Approaching the fourth ventricle surgically is particularly challenging due to the limited working space provided by the important surrounding cerebrovascular structures. Its close relationship to the surrounding neural structures, including the brainstem and cerebellum, is the major limitation for surgical access. Various surgical routes to the fourth ventricular space will be described in the literature, including the conventional transvermian approach. Recent clinical and anatomical studies have suggested that the telovelar approach will maximize the extent of surgical exposure and working angle while minimizing operative morbidity.

Objectives

Our primary objective is to evaluate the efficacy and outcome of each approach in handling tumors within different parts of 4th ventricle. Our secondary objective is to analyze approach related complication and limitations of application to find best surgical option for those patients with posterior fossa lesions.

Methods

The following electronic databases will be searched from 2000 to 2019: PubMed, Google scholar, Cocharne database of systematic reviews, EMBASE and Science direct using Keywords ''Telovelar approach'', ''Transvermian approach'', ''fourth ventricular tumours'', ''Medullary velum''.

Studies will be eligible if they contain the target Keywords in title or abstract, addressing our subject. Afterwards the full text of the article will be reviewed to exclude full texts not fulfilling the criteria or deviating from the initial impression taken from the title/abstract reviewing. References\ bibliography of the selected article will be sorted by discussion between study team (Student, Director and Codirectors).

Results

A total of 130 study were screened for eligibility, 6 studies were included in our systematic review for comparing the Telovelar and Transvermian approach in reaching posterior fossa lesions located within 4th ventricle regarding efficacy, clinical outcome and improvement, safety and complication. It was found that each approach has its own merits and demerits with nearly no difference between them regarding efficacy and safety, however slight superiority was linked to Telovelar approach in minimizing post-operative posterior fossa syndrome and Hydrocephalic changes.

Conclusion

we concluded that, Both transvermian -without sustained retraction- and telovelar approaches have no significant difference in safety, feasibility of total tumor excision, clinical outcome, postoperative complications and cerebellar mutism. The choice of either approach depends mainly on the surgeon's skills and preference, However the telovelar approach is generally preferred.
Propranolol and Misoprostol versus Misoprostol Alone for Induction of Labour in Primigravidas
Authors: Elzeneiny Hazem Amin Hassan , el-Hamid Ahmed Sherif Abd , Nawara Maii Medhat , Ismael Ahmed Mohamed Fathy
Published: August 2023

Background

Induction of labor is indicated when risks to maternal or fetal health out weight benefits of continuing the pregnancy. One of the most common reasons for labor induction is postterm pregnancy (ie,> 41 weeks of gestation).

Objectives

The aim of the study is to compare propranolol and misoprostol versus misoprostol alone for induction of labour in primigravidas.

Patients and Methods

This study included one hundred and twenty eight pregnant fullterm primigravida women, they were divided randomly into two equal groups. In both group, every patient received 25 microgram of misoprostol vaginally under aseptic prequations then every 6 hours with maximum 4 doses until efficient uterine contractions is reached three or more in 10 minutes each lasting for 45 seconds for induction of labor. Then after 30 minutes patients in group A received oral propranolol 20 mg and patients in group B received oral placebo in the form of sugary tablets, then womens monitored for fetal and maternal wellbeing and progress of labor.

Results

In this study, all the parturients were primigravid, it was highly considered to recruit parturient of almost similar conditions. The mean age of women included in the study was (23.3+/4.1) and the mean gestational age of the parturient was range (38 – 42) weeks. The mean pre induction Bishop score was range (2-6), we select only women with Bishop score of 6 or less considering the fact that the main goal for using medication for induction of labor was the reppening of an unfaverable cervix. There was no statistical difference between both groups as regards initial basic characteristics. There was no statically significant difference between propranolol and placebo research group regarding birth weight, apgar score at 1 and 5 minutes and NICU administration and patients satisfaction.

Conclusion

From the previous results regarding the propranolol effectiveness and safety, it dose not seem to negatively influence the fetus as apgar score at 1 and 5 minutes and the need for NICU admission were not influenced by its administration. And on the other hand, propranolol was significant in reduction the time latent phase and therefore the total duration of labor. Taking in mind this significant results it seems that propranolol might become a useful obestetrical tool for induction of labor in the future.
Oxytocin Infusion versus Vaginal Misoprostol in Reducing Blood Loss during Abdominal Myomectomy: A Randomized Controlled Trial
Authors: AbdElGawaad Magdy Mohamed Mahmoud , El Husseiny Salama Ahmed , Salama Mohammed Hamed , Elfar Marwan Hassan Alsaid
Published: August 2023

Background

Uterine myomas are most prevalent benign tumors in reproductive-aged women. Myomectomy is an alternative to hysterectomy for women who wish to retain their uterus but it is associated with higher risk of blood loss, greater operative time and need for blood transfusion. Knowledge of the effectiveness of the interventions to reduce bleeding during myomectomy is essential to enable evidence-based clinical decisions.

Aim of the Work

The aim of the study is to compare between the efficacy of intraoperative oxytocin infusion and preoperative vaginal misoprostol in reducing blood loss during abdominal myomectomies.

Methods

In a prospective randomized controlled trial which was conducted at Ain shams maternity Hospital in Cairo from July 2017 to May 2021.100 women who had abdominal myomectomy for symptomatic leiomyomas were enrolled. Patients were randomly assigned to 2 groups. Group O (Oxytocin group) patients (n = 50) received 30 U oxytocin in 500 ml normal saline infusion intraoperative and Group M (Misoprostol group) An hour before the operation, patients (n = 50) received a single dose of vaginal misoprostol (400 μg). The primary outcome was the operative blood loss. The secondary outcomes were the need for blood transfusion, change in hemoglobin (Hb) and hematocrit (Hct) levels 24 h after operation, conversion to hysterectomy, hospitalization and the prevalence of side effects.

Results

Intra-operative blood loss was significantly lower in those women randomized to receive vaginal misoprostol versus the oxytocin infusion group (458.5 ± 115.4 mL vs 618.8 ± 115.1 ml {P = < 0.001}). Misoprostol group showed lower mean blood loss by – 160.3 ml (95% CI -206.0 to -114.6) and reduced need for blood transfusion (RR 0.22, 95% CI 0.005 to 0.98) {P = 0.025}. Additionally, there was a highly significant statistical difference between Misoprostol group and Oxytocin group as regards the postoperative hemoglobin, hematocrit concentration, operative time as Misoprostol group showed a higher postoperative hemoglobin and hematocrit concentration, and less operative time. There was no difference in the patient demographics, intraoperative characteristics, postoperative stay, complications, and the side effects between the two groups.

Conclusion

As evident from the current study, pre-operative misoprostol in abdominal myomectomy is a safe and reliable method that offers some practical advantages, such as reducing intra-operative blood loss and blood transfusion needs
Evaluation of Endothelial Cell Density after Torsional Phaco-Emulsification in Patients with Pseudo-Exfoliation
Authors: Said Gaafar Ayman Abd El Moneim Al , Youssef Mohamed Omar , Fayez Aziz Bassem , Rahman Ali Mohamed Ali Abd El
Published: August 2023

Background

The corneal endothelium is a single layer of hexagonal cells that do not have the ability to regenerate. The normal density of corneal endothelial cells in adults is approximately 2500 cells/mm² and it is reduced by about 0.6% a year. The endothelium performs an essential function of maintaining the hydration of the cornea. When the endothelial cells density is reduced to approximately 800cells/mm², it may lead to corneal decompensation causing corneal edema and loss of corneal transparency which disrupts vision.

Aim of the Work

The aim of this study is to compare pre-operative corneal thickness between normal subjects and subjects with pseudo-exfoliation and to determine the effects of phaco-emulsification surgery on corneal endothelial cell density in cataract patients with pseudo-exfoliation syndrome.

Patients and Methods

The type of study was case controlled study, at department of Ophthalmology at Ain Shams University hospitals. This study included 66 patients divided to two equal groups (33 each): study group: 33 patients with pseudo-exfoliation, control group: 33 patients with senile cataract without pseudo-exfoliation.

Results

We found that ECD loss was 11.42% in the study group and 8.11% in the Control group 4 weeks after surgery. Phaco time and used BSS values were significantly higher in patients with PXS but had no significant influence on endothelial cell loss. They also suggested that the corneal endothelium in PXS be vulnerable to cataract surgery.

Conclusion

Torsional mode phacoemulsification and IOL implantation provided a safe and favorable surgical outcome in patients with/without PXS. Torsional phacoemulsification led to significantly higher ECD loss in the PXS than that in the control group during the whole follow up period.
Quality of Vision and Ocular Higher Order Aberrations after SMILE for Myopia and Myopic Astigmatism
Authors: Assaf Ahmed Samir , Youssef Mohamed Omar , Elrahman Sameh Hany Abd , Youssef Madonna Mimi Samaan
Published: August 2023

Background

Previous studies have shown considerable amounts of higher order aberrations following SMILE. In our study we aim at accurately quantifying the higher order aberrations following SMILE in myopia and myopic astigmatism.

Objective

To detect the effect of SMILE on quality of vision and the incidence of higher order aberrations following SMILE.

Patients and Methods

This is a prospective study that included 30 eyes of 18 patients presented in the outpatient clinic seeking advice for myopic refractive surgical correction. The study was conducted in accordance with the ethical standards stated by the ethical committee of Ain shams university hospitals with informed consents obtained from all participants.

Results

On studying the post-operative corneal third order aberrations we detected increase in post-operative vertical and horizontal coma, and spherical aberrations with non-significant change in vertical and horizontal trefoil. According to our study results, SMILE is an effective refractive surgery that improves visual acuity. That causes decrease in quality of vision through modulation transfer ratio and increase in ocular higher order aberrations.

Conclusion

SMILE (small incision lenticule extraction) is an efficient modality for refractive surgical correction of myopia and myopic astigmatism, with significant post-operative improvement in unaided visual acuity detected post-operative increase in the ocular HOAs. Total coma, trefoil and sphere increase significantly in mesopic more than photopic pupil. The degree of myopia didn’t affect the ocular higher order aberrations except for modulation transfer ratio.
Assessment of Macular Function by Multifocal Electroretinography Following Idiopathic Epiretinal Membrane Surgery with Internal Limiting Membrane Peeling
Authors: Fathy Nada , Habib Ahmed , Magdy Karim , Embabi Sherif
Published: August 2023

Purpose

To evaluate macular function before and after vitrectomy for idiopathic epiretinal membrane (ERM) with internal limiting membrane (ILM) peeling by multifocal electroretinography (mfERG) and their correlations with visual acuity (VA) and central subfoveal thickness (CST) by optical coherence tomography (OCT).

Settings and Design

A prospective interventional case series of 15 eyes with idiopathic ERM of 14 patients who underwent pars plana vitrectomy (PPV) for ERM removal with ILM peeling.

Methods

Multifocal electroretinography (mfERG) and OCT were performed preoperatively and one month after surgery. The response amplitude densities and implicit times of mfERG were analyzed. Correlation analyses among visual acuity, CST and mfERG values in the five concentric rings were performed.

Results

The first order responses of mfERG recorded preoperatively showed diffuse reduction in P1 amplitudes in all 5 rings with no statistically significant differences in mfERG responses after ERM surgery. Correlation coefficients showed a significant correlation between postoperative VA and P1 amplitude of ring 2 (P = 0.005). There was no significant correlation between postoperative CST and P1 amplitude for all rings

Conclusions

The mfERG responses in eyes with idiopathic ERM show macular function abnormalities and correlate with VA after surgery. The residual retinal distortion along with the damage to inner retinal layers and Muller cell dysfunction associated with ILM peeling affect the mfERG responses after surgery. The incorporation of mfERG into the pre- and post-operative assessment of patients with iERM, allow for identification of functional impairment and predict visual outcomes.
Triple Innominate Osteotomy in Management of Residual Acetabular Dysplasia in Young Adolescent Patients (Systematic Review and Meta-Analysis)
Authors: Mousa Thusly Mohamed , Aly Ahmad Saeed , Refaat Andrew Osama
Published: August 2023

Background: Aim of the Work

The aim of this work is to provide cumulative data about the effic cy and safety of triple innominate osteotomy in management of residual acetabular dysplasia in young adolescent patients.

Methods

This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses

Results

We found that; the total number of patients in all the included studies was 631 patients; while their average follow up time was (7.2 ± 4.6 years); with longest follow up time of 14.5 years. The average age of all patients was (12.67 ± 3.7 years); with youngest mean age of 7.5 years. Regarding Pre-operative assessment, the average CE angle was (10.4 ± 7.2) degrees, and the average HHS score was (77.7 ± 17.69) degrees.

Regarding Post-operative sequel, the overall complications rate was (184/631) (29.1%), and the overall AVN rate was (123/631) (19.5%). Regarding 1 ry efficacy outcome measures,

Conclusion

Acetabular dysplasia is among the anatomical abnormalities seen in developmental dyplasia of the hip (DDH). One of the goals of surgical treatment during childhood is to achieve optimal femoral head coverage by correcting this architectural flaw, thereby preventing osteoarthritis. Pelvic osteotomy is a treatment option in children and adolescents with residual acetabular dysplasia after developmental dyplasia of the hip.