bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative Risk Factors of Atrial Fibrillation Post CABG Surgeries, a Retrospective Non-Randomized Study
Authors: Karim Mohsen Abdel , Omar Ahmed Helmy , Hikal Tamer El-Shahat , Youssef Hazem Mohamed
Published: October 2021

Background

Atrial fibrillation represents a common complication after coronary artery bypass and valvular surgery, although it is a benign arrhythmia it may contribute to the morbidity, high cost and prolonged ICU stay.

Objectives

The purpose of this study is to investigate and analyze the incidence and risk factors associated with postoperative atrial fibrillation (POAF) and its impact on intensive care unit (ICU) and postoperative hospital stay in patients undergoing coronary artery bypass graft surgeries (CABG) at Ain Shams University hospitals using the medical records of patients who underwent(CABG) surgeries from July 2018 to July 2019.

Patients and Methods

Our study was conducted in Ain Shams University hospitals from July 2018 to July 2019. This study was a retrospective non randomized on total 660 patients who undergone isolated Coronary artery bypass graft surgeries (CABG) during this period, of them we targeted 100 cases who developed POAF after surgery.

Results

Our results show that age, history of hypertension,smoking,history of renal impairment and recent myocardial infarction were all predictors of atrial fibrillation after cardiac surgery. POAF developed more frequent in patients who had larger left atrium diameter and lower ejection fraction. Our present results indicate that there is significant association between longer bypass and cross clamping time and development of POAF. We also found that patients who had postoperative lower serum potassium experienced more frequent POAF than who had normal potassium levels. In our study, we found that use of preoperative beta blocking drugs reduces risk of developing POAF. Early electrocardiographic ischemic postop. changes was also associated with high risk to develop POAF. No significant relation between use of intra-aortic balloon pump and development of POAF. Also, no significant relation between POAF and development of stroke or thromboembolic manifestations as POAF is usually self limiting,transient and resolves spontaneously in most of cases.

Conclusion

The current study found that low ejection fraction, dilated left atrium, hypertension, smoking, old age, male gender, prolonged bypass time, prolonged cross clamping time, renal impairment, previous myocardial infarction, ungrafted dominant right coronary artery, low temperatures on bypass, early ischemic changes postoperative, hypokalemia, use of adrenaline and nor adrenaline, all of these factors were a significant predictors for development of atrial fibrillation after cardiac surgery.
Assessment of the effects of cardiac rhythm device implantation on right sided heart function and tricuspid valve
Authors: Abd Elaziz Ahmed Mohamed , Ramadan Ahmed Yehia , Badran Haitham Abd Elfatah , Khalid Saied Abd Elhafiz
Published: October 2021

Objective

To assess the effects of trans-tricuspid placement of permanent pacemaker (PPM), on the right-sided heart function and tricuspid valve function.

Background

Over the last decade there has been a significant increase in the number of cardiac device implantation as permanent pacemakers (PPM) worldwide in patients with cardiac rhythm disorders. Tricuspid regurgitation (TR) due to the endocardial lead is a known complication of this procedure, however the incidence of new or worsening TR had not been well studied.

Patients and Methods

We reviewed patients who underwent permanent pacemaker implantation in our cardiology department in Ain Shams University. Patients who had pacemaker implantation less than one year ago, had severe tricuspid regurgitation before implantation or had previous tricuspid valve repair were excluded. A total of one hundred patients with an echocardiographic study before and another echocardiographic study at least one year after device implantation were included in our study. TR severity was graded as (0 none/trace, 1 mild, 2 moderate, 3 severe).

Results

Of the 100 patients (Mean age: 53.10 ± 16.04, 50% of patients were males) 65 had DDD and 35 had VVI. Before implantation 25 patient had trace TR (grade 0) vs. 6 patients after, 75 patients had mild TR (grade 1) vs. 82 after, with no patient had moderate TR (grade 2) vs. 12 patients after. TR worsened by one grade in 25 patients, (16 patients from grade 0 to grade 1 and 9 patients from grade 1 to grade 2) and by 2 grades in 3 patients (from grade 0 to grade 2), Pvalue < 0.01. TR jet area size (Mean ± SD: 2.80 ± 0.77 before vs. 4.15 ± 1.29 after, P-value < 0.01). Also, 99 patients had normal RV size and one had dilated RV before implantation vs. 95 patient had normal RV and 5 had dilated RV (p-value= 0.097). RV size, LVEF (Mean ± SD: 56.41% ± 7.52 before vs. 55.77% ± 8.00 after), RV function by TASPE (Mean ± SD: 19.15 ±

1.00 before vs. 18.96 ± 0.96 after), RVSP (Mean ± SD: 29.48mmHg ± 5.54 before vs. 29.81 ± 5.09 after) and diastolic function by E/A ratio (Mean ± SD: 1.60 ± 0.39 before vs. 1.57 ± 0.38 after implantation) did not show significant change.

Conclusion

Permanent pacemaker (PPM) implantation is associated with worsening of tricuspid regurgitation. Echocardiography plays an important role in assessing and grading this condition. Further studies are needed in order to illustrate the effects of these finding on patients outcomes.
Echocardiographic Predictors of Atrial Fibrillation after Coronary Artery Bypass Grafting
Authors: Kame Karim Mounir , Hennawy Bassam Sobhy , Abd-Elsalam Ahmed Mohammed , Onsy Ahmed Mohammed
Published: October 2021

Background

Postoperative atrial fibrillation (POAF) complicates 20–40% of cardiac surgical procedures and 10–20% of non-cardiac thoracic operations. Typical features include onset at 2–4 days postoperatively, episodes that are often fleeting and a self-limited time course. Associated adverse consequences of POAF include hemodynamic instability, increased risk of stroke, lengthened hospital and intensive care unit stays and greater costs (Dobrev et al., 2019).

Aim

The aim of this work is to detect the echo-cardio graphic parameters for prediction of post-operative atrial fibrillation in patients with ischemic heart disease undergoing isolated coronary artery bypass graft.

Methods

One hundred patients with multivessel disease for CABG were prospectively enrolled; all of them were in sinus rhythm at the moment of enrollment. LA maximal volume, LV ejection fraction, LVESV &LVEDV and TDI were assessed. Moreover, LA strain and Left Ventricular Global Longitudinal Strain % were analyzed by speckle tracking technique.

Patients were followed up for 1 week after surgery in order to identify occurrence of atrial fibrillation.

Results

We found a statistically significant difference between patients undergoing CABG who are older in age with mean ± SD 64.455 ± 6.254 in group I (AF) vs. 54.577 ± 6.710 in group II with p value <0.001*, we found also that patients undergoing CABG with POAF (group I) 50 % of them had left main diseases vs. 23% in group II (NSR) with other lesions (RCA&LCX), p value = 0.014*.

Conclusions

There is no significant difference between the two groups regarding conventional echo parameters, TDI & by speckle tracking technique (LA strain & LVGLS %).

However, patients who developed POAF were older, & left main lesions are more likely to have left main lesions.
Effect of high dose statin preloading on TIMI flow in patients presenting with ST-Elevation Myocardial Infarction undergoing Primary Percutaneous Coronary Intervention
Authors: Eletriby K , Desoky A , Shawky N , Farag A
Published: October 2021

Aim and objectives

The aim of this study was to assess the impact of high intensity statins used prior to primary PCI in patients presenting with acute STEMI (ST-elevation Myocardial Infarction) on myocardial perfusion and in-hospital MACE (major adverse cardiac events).

Patients and Methods

The study included 170 patients who presented with acute STEMI to the cardiology department of Ain Shams university hospitals and underwent primary PCI (percutaneous coronary intervention). They were divided into two groups where the first group received high intensity statins (40-80mg of atorvastatin or 20-40mg of rosuvastatin) besides guideline recommended therapy before primary PCI and the 2nd group served as a control group and received guideline recommended therapy, and high intensity statins after going back to the coronary care unit after primary PCI. Post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded and ST-segment resolution was measured.

Results

The majority of patients in both groups had the LAD as the culprit vessel for their presentation. In the control group there were 4 patients with TIMI I flow and MBG I, 13 with TIMI II flow and MBG II and 68 with TIMI III flow and MBG III. Meanwhile in the cases group there was 1 patient with TIMI I flow and MBG I, 3 with TIMI II flow and MBG II and 81 with TIMI III flow and MBG III. This difference was statistically significant with a P value of 0.010. There were 34 patients in the cases group who showed complete ST-segment resolution (40%) vs 19 patients (22.4%) in the control group which was statistically significant with a P value of 0.013. In addition, ejection fraction measured by M-mode had values of Mean+-SD of 45.91 ± 5.49 in cases group vs 43.01 ± 8.80 in control group which was statistically significant with a P value of 0.011. There was not a statistically significant difference between the two groups regarding in-hospital death of all causes and stroke after primary PCI.

Conclusion

High intensity statin loading before primary PCI resulted in improved post-procedural TIMI flow, MBG, complete ST-segment resolution and ejection fraction as measured by M-mode but did not decrease incidence of in-hospital MACE.
Effect of colchicine on serum levels of the inflammatory markers: C - reactive protein and Interleukin-6 in patients with chronic rheumatic heart disease
Authors: Mahmoud Badr Mahmoud Saied , Mohammed Haitham Galal , Sallam Ahmed Abdel , Aziz Rifaie Osama Abdel
Published: October 2021

Corrsponding author: Mahmoud Saied Mahmoud Badr. E-mail: mahmoudsaeed716@grnail.com
Impact of Oral Nicorandil Intake on Incidence of Acute Kidney Injury in Diabetic Patients with Renal dysfunction Undergoing Elective Percutaneous Coronary Intervention
Authors: Rabea Mahmoud , Salem Ashraf , Shehata Mohamed , Adel Walaa
Published: October 2021

Background

Nicorandil is a nicotinamide ester commonly prescribed for treatment of patients with chronic coronary syndrome, there is an ongoing controversy about its effectiveness in prevention of contrast induced acute kidney injury.

Aim of the Work

The aim of this work is to evaluate the effect of pretreatment with oral nicorandil 40 mg/day on the incidence of contrast-induced acute kidney injury in type II diabetic patients with renal dysfunction (mild- moderate CKD) undergoing elective percutaneous coronary intervention.

Patients and Methods

This prospective, randomized, controlled study included 100 consecutive diabetic patients, carrying the diagnosis of chronic coronary syndrome and suffering from mild or moderate CKD, their age ranged between 39 and 81 years. They were referred to the catheterization laboratory for planned PCI in the period between January 2018 and August 2018. Mild-to-moderate CKD was defined by means of estimated glomerular filtration rate (e GFR) of 30 to < 90 mL/min/1.73 m.. Results There was statistically significant increase in control group in comparison to nicorandil group regarding serum creatinine 72 hours after the procedure(p < 0.05), the incidence of contrast induced acute kidney injury was 12% (6/50) in the nicorandil group vs. 24% (12/50) in the control group.

Conclusion

Nicorandil dose of 40 mg per day for 7 days before PCI, And for 48 hours after PCI is associated with decreased incidence of CI- AKI in diabetic patients with chronic kidney disease compared to the conventional treatment.

Abbreviations

CI-AKI: contrast induced acute idney injury; PCI: percutaneous coronary angiography; CKD: chronic kidney disease; GFR: glomerular filtration rate; CAD: Coronary artery disease.
Impact of the Severity of Mitral Stenosis on the LV Systolic function as assessed by 2D Strain using Speckle tracking
Authors: Adel Mohamed , Mosa Tarek K , Yehia Ahmed , Shawqi Ahmed
Published: October 2021

Background

Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries and mitral stenosis is the most common valve affection of rheumatic heart disease worldwide.The left ventricular ejection fraction is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective leading to inter-observer variability.Speckle-tracking echocardiography is an imaging technique developed as a method to objectively quantify myocardial function and analyzes cardiac motion and deformation by tracking naturally occurring speckle patterns in the myocardium.

Objective

To evaluate the effect of the severity of mitral stenosis on LV systolic function as assessed by speckle tracking.

Patients and Methods

This study was a case-control study involving 80 individuals which included 60 patients having mitral stenosis who presented to the outpatient clinics of Ain Shams University Hospitals and 20 healthy volunteers, The patients suffering from mitral stenosis were subdivided into 3 sub-groups: GROUP(1) 20 Patients having severe mitral stenosis (MV Area less than 1 cm²) GROUP (2) 20 Patients having moderate mitral stenosis (MV Area more than 1 cm² and less than 1.5 cm²) GROUP(3) 20 Patients having mild mitral stenosis (MV Area more than 1.5 cm²) A Control group involved 20 healthy volunteers recruited from health care workers in Ain Shams University hospitals.

Results

Study included 60 patients,16 males (26.7%) and 44 females (73.3%), with mean age of 41.30 ± 8.64 years. Patients living in rural Areas were 34 (57.7%) while those in urban areas were 26 (43.3%).Which was significant.There was no significant difference between gender or habitat and the severity of mitral Stenosis.There was a strong significance between the duration of the disease and its severity. The more the duration of mitral Stenosis, the more severe the mitral stenosis.A strong positive relation was noticed between the severity of mitral stenosis and both RVSP and LA diameter, while a strong negative relation between severity of mitral stenosis and GLPS. GLPS was affected in severe mitral stenosis only.

Conclusion

Subtle LV systolic dysfunction is present in large number of patients with severe mitral stenosis even in patients with normal ejection fraction by conventional 2D echocardiography.There was a significant relationship between the duration of mitral stenosis and its severity. The longer the duration of mitral stenosis, the more severe the mitral stenosis.Speckle tracking echocardiography (STE) can play a great role in identification of higher risk subgroups in whom earlier and more aggressive intervention could have a significant impact on their prognosis.
Short and intermediate term outcome post right ventricle to pulmonary artery conduit surgery
Authors: Hegab Mohammed Abdullah Mohammed Mustafa , Mohammed Amr Mansour , Elrazek Ismail Yasmine Abd , Roshdy Alaa Mahmoud
Published: October 2021

Background

Surgery for congenital heart disease has progressed by leaps and bounds in the last few decades, but the right ventricular outflow tract continues to pose a challenge to the congenital heart surgeon.

Objective

To describe short and intermediate term outcome in congenital heart disease patients undergoing surgical repair using right ventricle to pulmonary artery conduits.

Patients and Methods

Our study included 33 patients that were operated upon by putting a conduit between the right ventricle and the pulmonary artery in a single center (Al Agouza police hospital) between 2015 and 2019.

Results

This study was done in order to follow up patients who underwent surgery for conduit placement between the right ventricle (RV) and the pulmonary artery (PA), to observe the reintervention rates and to determine the most important determinants of re-operation. 33 patients were included in this study, with age range 1.5-17 years and mean age of 8.29 +/- 4.7 years. The mean age at placement of the first conduit was 3.57 +/- 3.18 years. The youngest patient at time of conduit placement for the first time was 0.2 years old and the oldest had 12.5 years.

Conclusion

The use of conduits to treat the RV to PA discontinuity is a cornerstone in the treatment of some congenital heart diseases requiring construction of the right ventricle outflow tract (RVOT). Nevertheless, conduit failure and replacement is inevitable, and depends on many factors: as age at first operation, type of conduit, mean and peak pressure gradient across the conduit. The higher the age at first conduit, the bigger the event / re-intervention free survival period.
The Role of Cardiac Magnetic Resonance in Assessment of Myocardial Contractile Function After Exercise Training Based Cardiac Rehabilitation Program in Anterior ST-Elevated Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention
Authors: Hasan Rana Lateef , Ibrahim Mohamed Ayman Abdel Wahab Saleh Ahmed Samir , Elshazly Hazem Reda Khorshid Ahmed Mohamed
Published: October 2021

Back ground

Regular exercise training program has been shown to reduce mortality, improve functional capacity and control risk factors in myocardial infarcted patients. Wall motion score index (WMSI) is a strong independent mortality predicator in patient with previous MI

AIM

The main objective of this study was to investigate the impact of exercise training on regional left ventricular systolic function, in patients post anterior myocardial infarction. using cardiac magnetic resonance imaging

Methods

We recruited twenty-six adult patients on optimal medical therapy one month after an anterior myocardial infarction underwent successful percutaneous coronary intervention (PCI) were assigned to a three-month exercise training program group or to a control group, (control group: n = 10, training group: n = 16). Symptom limited treadmill exercise (Modified Bruce Protocol) test was done to exercise training group before and repeated after finishing the CR program. Cardiac Magnetic Resonance (CMR) was performed for all patients 4 weeks after PCI and was repeated after completion of the study period that was lasted for 12 weeks.

Results

A total number of patients, included 26 (100%) males, assigned to control group n:10 without an exercise mean age 50± 8 years, weigh 84 ±17 kg, height 175±7.7 cm and EF was 36.62 ±14.23 and to training group n:16 with 3-months exercise training program, the mean age, weight, height and EF were 50.19±8.68 years, 82.69±16 kg, 172.81±7.74 cm, 36.62±14.32% respectively While there was significant improvement in EF (P < 0.0008), WMSI (P < 0.00003) without significant change in LVESV and LVEDV in exercise training group, there was no significant change in EF, WMSI, LVESV and LVEDV in control group.

Conclusion

CMR revealed that exercise training in post-myocardial infarction patients could have beneficial effects on LV global and regional function without adversely affecting LV remodeling or causing serious cardiac complications with significant improvement in exercise capacity after 3 months of exercise training program.
Comparison between preoperative loading dose with Ticagrelor and Clopidogrel on myocardial perfusion during intervention in patients with STsegment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Authors: Sallam T , Fakhry E , El Mahmoudy A , El Etriby A
Published: October 2021

Aim and Objectives

The aim of this study is to compare between clopidogrel and ticagrelor loading doses used prior to primary PCI in patients presenting with acute STEMI (ST-elevation Myocardial Infarction) on myocardial perfusion and in-hospital MACE (major adverse cardiac events).

Patients and Methods

The study included 170 patients who presented with acute STEMI to the cardiology department of Ain Shams university hospitals and underwent primary PCI. They were divided into 2 groups where the1st group 85 patients received clopidogrel loading dose (600mg) and the 2nd group 85 patients received ticagrelor loading dose (180mg). Post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded.

Results

The majority of patients in both groups had the LAD as the culprit vessel for their presentation (71.8% in the clopidogrel group and 50.6% in ticagrelor group). In the clopidogrel group there were 4 patients with TIMI I flow and MBG I, 13 with TIMI II flow and MBG II and 68 with TIMI III flow and MBG III. Meanwhile in the ticagrelor group there was 2 patients with TIMI I flow and MBG I, s with TIMI II flow and MBG II and 81 with TIMI III flow and MBG III. There was no statistical significance between the two groups regarding in-hospital death of all causes and stroke after primary PCI.

Conclusion

Ticagrelor loading before primary PCI resulted in improved TIMI flow, MBG but did not decrease incidence of in-hospital MACE.
Impact of high doses of Statins on testosterone level in males with atherosclerotic coronary artery disease
Authors: Ibrahim Walid Said , Farouk Mohamed Moustafa , Tawfik Mazen , Elzahwy Sherif Samir
Published: October 2021

Background

Concern has always existed that statins might impair testosterone production either by reducing availability of its preferred substrate, that is, locally produced de novo cholesterol in the gonads and elsewhere, or by inhibiting steps in the steroidogenesis process, but this concern has been considered of little clinical significance.

Objective

To demonstrate the impact of high doses of statins on testosterone level in ischemic heart disease patients and to compare it with the impact of low doses of statins.

Patients and Methods

This study was approved by Ain Shams University. 90 candidates were randomly enrolled in the study divided into two groups, high dose group consisting of 45 patients and Low dose group including 45 patients. All patients were recruited from International Medical Center in Cairo, they were selected randomly from the outpatient clinic from the cardiology department.

Results

In our study there were a significant reduction in total cholesterol, LDL and TGs in both low dose and high dose groups, but the effect on testosterone was quite different between them, the reduction in testosterone was about 33% from the baseline in the high dose group while in the low dose there was no significant reduction in the testosterone level.

Conclusion

This study shows that statins reduce testosterone level. This finding does not demonstrate that androgens mediate any health effect of statins, but raises the question as to whether testosterone modulation plays a role in statins' effects on health, particularly among men where testosterone is an important hormone.
Interleukin 37 Levels in Relation to Serum Vitamin D Levels Among Ain Shams University Medical Students
Authors: Mabrouk Randa Reda , Mostafa Afaf Abdelalim , Ragab Dina Aly Mohamed Aly , zaki Fouad Mohamed Fouad
Published: October 2021

Background

The extraskeletal role of vitamin D is being increasingly recognized. This has important clinical implications, as vitamin D deficiency has reached epidemic proportions worldwide. Vitamin D has proposed anti-inflammatory properties as recent data suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. Interleukin-37(IL-37) is an IL1 family cytokine discovered in recent years and has 5 different isoforms. As an immunosuppressive factor, IL-37 can suppress excessive immune response .IL37 plays a role in protecting the body against endotoxin shock, ischemia reperfusion injury, autoimmune diseases, and cardiovascular diseases. In addition, IL-37 has a potential antitumor effect. IL-37 and its receptors may serve as novel targets for the study, diagnosis, and treatment of immune-related diseases and tumors.

Aim of the Work

The aim of this study is to determine the relation between the level of interleukin-37 and 25-hydroxy Vitamin D among Ain Shams University medical students.

Subjects and Methods

The study was conducted at Clinical Pathology Department, Ain Shams University Hospitals. Ninety individuals, from medical students of Ain Shams University who participated in the Nutritional Assessment of Ain Shams University Medical Students (NAMESASU) Project, were selected to be in the study. The study included 2 groups: Group I: included 45 subjects selected from the NAMES-ASU project with deficient vitamin D serum levels. Group II: included 45 subjects selected from the NAMES-ASU project with sufficient vitamin D serum levels.

Results

There was a highly significant difference between the two groups regarding vitamin D levels. Serum IL-37 levels were significantly higher in group I subjects compared to group II subjects. No significant difference was observed between group I and group II regarding BMI, BFM, PBF and hsCRP. No significant difference was observed between the two subgroups regarding IL-37 levels and hsCRP levels. A highly significant negative correlation was observed between vitamin D levels and IL-37. A significant negative correlation was observed between hsCRP and vitamin D levels. However, no correlation was observed between hsCRP and IL-37 levels.

Conclusion

Data from our study showed that present study denote that in case of vitamin D deficiency, irrespective of BMI, a subclinical state of inflammation may be present as reflected by the increased hsCRP levels and this state of inflammation might induce an increase in IL-37, an anti-inflammatory cytokine, in an attempt to reduce the inflammation.
Screening of Asymptomatic Bacteriuria in Sickle Cell Pediatric Patients
Authors: Kader Nouran Osama Abdel , Hamid Dalia Hosni Abdel , El-Ashry Marwa Abdel Rasoul , Makkeyah Sara Moustafa
Published: October 2021

Background

Asymptomatic bacteriuria (ASB) refers to two consecutive urine cultures growing more than 100,000 colony forming units (CFU)/ml of a bacterial species in a patient with no symptoms of urinary tract infection (UTI). In sickle cell disease (SCD) patients, the anatomical and physiological defects associated with the disease make ASB more prone to worsen the sickle nephropathy and cause more kidney damage. Also, the urine concentration and acidification defects associated with SCD enhance urinary bacterial formation and proliferation. In resource poor settings where renal replacement therapy is limited, early detection and management of ASB in SCD children may retard this progression.

Aim of the Work

The current study aims to investigate the prevalence of asymptomatic bacteriuria, its major determinants and its effect on kidney functions in SCD patients for early detection and treatment.

Patients and Methods

The study was conducted at Ain Shams University Children's Hospital and the Main Microbiology Laboratory at Clinical Pathology Department during the period between June 2019 and February 2020.The study included 30 children previously diagnosed as SCD by HB electrophoresis. A fresh voided mid-stream urine samples were collected once from all patients and subjected to urinalysis and culture on chromogenic media. Patients with positive culture results were asked to get another sample to confirm their culture results, while those with contaminated results were re-Instructed with precautions to get another fresh voided mid-stream urine samples. Only significant isolates were identified and subjected to antimicrobial susceptibility testing using disk diffusion method according to CLSI 2017. Patients were divided either into ASB or sterile urine groups according to their culture results. All SCD Patients were subjected to complete blood picture (CBC), reticulocytic count, markers of haemolysis (total, indirect bilirubin and LDH) and serum creatinine.

Results

The prevalence of confirmed ASB was 16.7% (5/30).All children in ASB group had pyuria(100%). Staph.saprophyticus (60%) (3/5)was the commonest organism isolated from the urine of these patients, followed by E.coli (20%)(1/5) & Klebsiella pnuemoniae (20%)(1/5).Sulfamethoxazole +Trimethoprim (Sutrim) was the most sensitive antibiotic among all isolated microorganisms.The difference in kidney funtion results among the two groups were statistically insignificant.

Conclusion

Asymptomatic bacteriuria was of high prevalence in SCD pediatric patients in Egypt at Ain Shams University Hospitals. Pyuria was the only major determinant of ASB in this study.Staph.saprophyticus was the predominant organism isolated from ASB group. Sulfamethoxazole +Trimethoprim (Sutrim) was the drug of choice for empirical treatment of UTI.

Serum creatinine was a non-sensitive marker to monitor any minor impairment in kidney functions.
Effect of Anabolic-Androgenic Steroids on Semen Parameters and Serum Sex Hormonal Levels in Egyptian Male Bodybuilders
Authors: El-Naeem Sallam Mohamed Abd , Hassan Samah Ibrahim , Abdelfattah Ahmed Mohamed
Published: October 2021

Background

First identified in 1935, testosterone is the principal hormone controlling the development of androgenic-masculinizing effects in the male body, along with its anabolic properties that increase lean muscle mass.

Objectives

We aim at studying the influence of anabolic androgenic steroids on the semen parameters and serum sex hormonal levels in Egyptian male bodybuilders.

Patients and Methods

The type of study was cross sectional study. Study setting was conducted in Dermatology, Venereology and Andrology Department, Ain Shams University Hospitals. The study included 20 male body builders using AAS as the study group and 20 body builders who exercise only and not using AAS. 20 subjects who exercise only without androgenic anabolic steroids use.

Results

In the present study, there were statistical significant differences between ASS group and control group as regard semen volume, sperm concentration, total sperm count, sperm agglutination and rounded cells. Bodybuilders in ASS group had significantly lower semen volume, sperm concentration, total sperm count; and higher liquefaction, sperm agglutination, and rounded cells.

Conclusion

AAS has a negative impact on semen quality and sex hormone levels among male bodybuilders. In the present study, AAS users exhibited significantly lower plasma testosterone levels and increase FSH and decrease LH hormone higher frequencies of abnormal semen parameters than healthy control participants. These results should provoke concern, particularly because the use of anabolic steroids by exercising men for muscle building is based on self-designed personal schemes or is suggested by a partner, by field magazines, or by trainers at the gyms. Further, large-scale, studies are still needed to confirm our findings.
Evaluation of E- cadherin and Hydrogen Peroxide in Skin of Patients with Vitiligo
Authors: Abdel-Rahim Abdallah Marwa M , Raafat Ahmed Mona Hussien , Louka Manal Louis , Gobrial Christine Kamal Thabet , Abdel-Magid Alaa Abdel-Hakim
Published: October 2021

Background

Vitiligo is acquired depigmentary disorder characterized by destruction of the epidermal melanocytes leading to the loss of the skin color. Oxidative stress has a major role in the aetiopathogenesis and in melanocytic destruction due to its accumulation in the melanocytes and the hazardous effects to all compartments of the cell.

Objective

The aim of the work was to evaluate the level of E-cadherin and H2O2 level in vitiligo versus controls.

Subjects

This is a case control study which was carried out at Department of

Dermatology, Venereology and Andrology,New Cairo Police Academy Hospital on 20 Subjects were divided into two groups, Group I included 10 patients having non segemental vitiligo. Group II included 10 non vitilignous controls were included in the study.

Results

We found that H2O2 level is increased in NSV patients when compared with healthy individuals. While E-cadherin level is significantly decreased in vitiligo skin compared to normal skin.

Conclusion

As compared to controls, increased H2O2 levels levels were suggestive of oxidative stress in patients of vitiligo in our study. From our results we can conclude that vitiligo is not a disease confined to melanocytes only, keratinocytes also showed certain pathological changes in vitiliginous lesions. As functional and structural units with melanocytes, keratinocytes in depigmented epidermis may constitute a different microenvironment compared to those in normally pigmented epidermis. These differences include obvious loss of cell to cell adhesion between keratinocytes and melanocytes and between keratinocytes and each other, which in turn may affect the pigmentary system of the skin.
Effect of Narrow- band UVB on serum and tissue vitamin D level in vitiligo
Authors: Al-Shabkhon Ali Abdulkareem , Halim Emam Adel Ahmed , Elfattah Afify Ahmed Abd
Published: October 2021

Background

Immunologic background of vitiligo, role of vitamin D on its pathogenesis, role of NB-UVB on its treatment and its stimulatory effect NB-UVB on VDR expression are challenging area of research. The current study will focus on evaluating the effect of NB-UVB on serum and tissue level of vitamin D in vitiligo patients and correlating it with the degree of improvement.

Aim of the study

The aim of the present study is to evaluate and compare the serum and tissue vitamin D level in vitiligo patients before and after NB- UVB therapy and correlate them together and with the degree of improvement.

Patients and methods

A case-control study included 16 vitiligo patients and 16 age and sex matched healthy controls. All patients will be examined by one dermatologist (demonstrating the extent of depigmentation according to rule of nines), and photographs will be taken before and after phototherapy to be evaluated by two different dermatologists to document the extent of repigmentation. Estimation of serum level of vitamin D by ELISA

Results

Five of the 15 patients achieved more than 55% repigmentation; the mean duration of disease was 13 months. The remaining 10 patients had 30% - 40% repigmentation.
Serum Level of Interleukin 17 in Alopecia Areata Patients and Its Relation with the Severity of the Disease: a Case Control Study
Authors: Zuelfakkar Nehal , Ibrahim Samah , Mahmoud Assar Hadeel Abdelwahed
Published: October 2021

Background

Alopecia Areata (AA) is one of the most common autoimmune diseases that’s characterized by hair loss on the scalp and/or body. It is an organ-specific autoimmune disease characterized by T-cell infiltrates and cytokine production. T-helper 17 (Th17) cells are crucially involved in the pathogenesis of autoimmune diseases.

Objectives

Our aim was to compare the serum level of interleukin-17 (IL-17) between alopecia areata patients and healthy controls to demonstrate its proposed role in the pathogenesis of alopecia areata and to correlate it with the severity of the disease.

Subjects and methods

The serum concentration of IL-17 was measured in 26 patients with AA and 26 healthy controls. The clinical type of AA was determined, and the severity of scalp hair loss was assessed in accordance with the Alopecia Areata Investigational Assessment Guideline criteria.

Results

The serum concentration of IL-17 was significantly higher in patients with AA as compared with healthy. The IL-17 concentration among cases ranged from 133.38 – 325.99 pg/ml with a median of 195.38, while among controls, the IL-17 concentration ranged from 13.59 – 225.73 pg/ml with a median of 48.42. No statistically significant difference was found in IL-17 levels regarding age, sex, clinical type, duration of disease or severity.

Conclusion

The significantly higher levels of serum IL-17 in patients with AA suggest a possible role of IL-17 as a proinflammatory cytokine in the pathogenesis of AA. This could point to the potential benefit of IL-17 inhibitors in recalcitrant cases of alopecia areata.
A comparative study of Fractional co2 laser combined with topical methotrexate versus Fractional co2 laser combined with topical [Calcipotriol + Betamethasone] in the treatment of nail psoriasis
Authors: Shahin Maha Adel , Abd -Elfattah Afify Ahmed , El - Sadek El-Banna Mahmoud Gamal
Published: October 2021

Background

Nail psoriasis is a distressing clinical condition as it is known that psoriasis on visible areas of the skin, such as the face, hands and nails, may have a substantial negative impact on physical, psychological, and social dimensions of quality of life. The additional negative consequences of nail involvement in psoriasis are pain, inability to grasp small objects, tie shoe laces or button clothes, and cause an altered sense of fine touch.

Objective

To evaluate and compare the efficacy, safety and side effects of co2 laser combined with topical methotrexate in one side and topical (calcipotriol +betamethasone) in the other side of the patient for the treatment of nail psoriasis.

Patients and Methods

This comparative pilot study included 20 patients with nail psoriasis. They were recruited from the dermatology out-patient clinic of Ain–Shams University Hospitals, during the period from March 2019 till October 2019. The study was approved by Research Ethical Committee of Ain Shams University (FMASU M S 71/2019) and fulfilled all the ethical aspects required for a human research.

Results

Our study revealed that both medications showed marked statistical and clinical improvement of the nail condition in a period of 2 months when applied topically after nail exposure to fractional co2 laser which facilitated the delivery of both medications through the nail plates to the site of the psoriasis inflammation in therapeutic concentrations by creating pores through the nails. There was no statistical or clinical difference between both medications regarding the improvement of the NAPSI scores or the level of patient satisfaction. However, there were some nail symptoms that didn’t show any improvement as (sub-ungual hyperkeratosis and nail ridging).

Conclusion

Our treatment protocol’s side effects based mainly on the action of fractional co2 laser which caused pain and nail bleeding during sessions for some of the patients in each group, while topical methotrexate caused nail yellowish discoloration for the all involved group. However, these side effects lasted for very short time and didn’t have any impact on the level of the patient satisfaction. There was no statistical difference in the level of the patient satisfaction between both groups.
Diagnostic Value of Video-Dermatoscopy in Patients with Systemic Sclerosis and Dermatomyositis with its relation to Serum Vascular Endothelial Growth Factor (S.VEGF)
Authors: Sayed Naglaa Fathy Salama , Mounib Hoda Ahmed , Elhusseiny Rania Mahmoud
Published: October 2021

Background

Systemic sclerosis and dermatomyositis are autoimmune connective tissue diseases affecting the skin and various internal organs. Systemic sclerosis is characterized by fibrotic arteriosclerosis of peripheral and visceral vasculature.

Objective

Analysis of video dermatoscopic picture of systemic sclerosis and dermatomyositis patients and find a characteristic feature for both. Assess serum vascular endothelial growth factor (VEGF) in these patients using enzyme linked immunosorbent assay (ELISA) kits. Perform a statistical analysis of the results to find a relation between video dermatoscopic Picture of systemic sclerosis and dermatomyositis patients and their serum VEGF to help in diagnosis, grading, prognosis and management.

Patients and Methods

Our case control study included 25 patients with SSc or DM (2555 years) recruited from Ain Shams University Hospitals and 25 apparent healthy controls with matched age and sex. After the study had been approved by Ain shams University of Medical Sciences Research Ethics Committee, all the subjects signed an informed consent before inclusion in the study.

Results

Serum VEGF level was highly significant in patients than in controls. This may be explained by the excessive release of VEGF in patients due to hypoxia caused by microvascular occlusion that not present in healthy controls.

Conclusion

Microvascular abnormalities are the earliest features of SSc and DM with elevation of serum VEGF level indicating its role in disease pathogenesis and disturbance of microvessls. Videodermoscopy and measurement of serum VEGF are effective tools in diagnosis, prognosis and grading of autoimmune connective tissue diseases as SSc and DM.
Therapeutic Effects of Tranexamic Acid Cream in Comparison to Hydroquinone 4% Cream in Treatment of Melasma: A Split Face Comparative Study
Authors: El Dosouky Rakha Noha Shukry , Abdel Fattah Nermeen Samy , El Husseiny Rania Mahmoud , Al Naeem Sallam Mohamad Abd
Published: October 2021

Background

Melasma is a chronic, acquired pigmentary disorder characterized by gray-brown macules and patches affecting photodistributed part of the face such as the bridge of the nose, cheek, upper lip, forehead, and mandible. It is seen mostly in women of reproductive age group and has an onset usually after pregnancy. However, in around 10% of the cases, males are also affected.

Objectives

The aim of our study was to assess and compare the therapeutic effects of tranexamic acid cream versus hydroquinone 4% cream in treating patients with melasma.

Patients and Methods

This prospective split face comparative study included thirty three patients with their age ranging from 18 to 40 years, participated for treatment of different types of melasma, recruited from outpatient clinic of Dermatology department Ain Shams University Hospitals during the period from January to June 2019. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided informed consent.

Results

Both topical TA and HQ 4% cream were efficient in treatment of different types of melasma as shown by significant decrease in Hemi MASI score, patient satisfaction score, significant decrease in average level of melanin measured by Antera 3D camera and significant decrease in area % of melanin by histopathological evaluation after 3 months of treatment, although slight recurrence of melasma was observed one month after stopping both treatments. Meanwhile, no significant difference was observed in treatment response of TA and HQ regarding Hemi MASI score, patient satisfaction score, average level of melanin (Antera 3D camera). This could be attributed to the small number of included patients.

Conclusion

We concluded that the TA appears to be a promising therapeutic option in the treatment of melasma. TA has fewer adverse effects, same or even better results in comparison with other melasma targeting therapies as hydroquinone cream.
Identification of Malassezia Species Isolated from Pityriasis Versicolor by CHROMagar-Medium
Authors: El-Naeem Sallam Mohamed Abd , El-Sayed Mohamed Taha Mahmoud , El-husseiny Rania Mahmoud , El-Aleem Ibrahim Shaheen Sara Hossam Abd
Published: October 2021

Background

Pityriasis versicolor is a chronic superficial fungal infection seen worldwide, with high prevalence observed in hot and humid climates.

Objectives

The aim of this work was to isolate and identify Malassezia species from pityriasis versicolor using specific fast gtowth media; Chrom agar to obtain a better understanding of the role of each species in the etiology of disease.

Patients and Methods

This study was conducted on 70 patients with clinical diagnosis of pityriasis versicolor with positive KOH test. All of the participants were subjected to a well informed consents, full history taking including age, sex, site of the lesions and any previous treatment, full general and dermatological examination to determine site, color of the lesions and Wood's light examination.

Results

Our results reported 94.3% of studied patients yielded growth on culture while 5.7% did not show any growth. The predominant age group was ≥ 25 years old. Furthermore it was found that PV affected male subjects (62.90%) more than the females (37.1%).

Conclusion

Malassezia yeasts, although are considered a part of normal skin microbiome, is a known cause of pityriasis versicolor. PV was more common in males in the age group ≥ 25yrs. The most affected body site was the chest, the most common variant is hyperpigmented type, and the commonest isolate was M.furfur.
Effect of Balance Training Versus Stretching Relaxation Exercise in Memory and Spatial Cognition Enhancement on Healthy Adults
Authors: Soliman Salah , Taha Hisham Mohamed , Shafik Noha Ali , Ahmed Ahmed Abd El-Hameed
Published: October 2021

Background

Physical exercise has been shown to improve cognitive functions. However, it is still unknown which type of exercise affects cognition. In the present study, we tested the hypothesis that demanding balance training program improves memory and spatial cognition.

Objective

To test the effect of balance training versus stretching relaxation exercise on memory and spatial cognition in cognitive enhancement.

Patients and Methods

Participants randomly assigned into 2 groups, 40 participants in balance training group and 40 participants in stretching relaxation training group: Participants trained in groups of 10–12 individuals. Each group trained four times a week for 6 weeks. Each session lasts for 50 minutes. Training groups instructed by the same professional trainers. Each participant took part in 24 training sessions in total. All participants advised not to change their habitual level of physical activity throughout the intervention period.

Results

Balance performance improved only in the balance group from pre- to post-training from 85.8±3.0 to 95.0±2.2. Only the balance group improved in memory in wechsler IQ test from 94.6±2.6 to 108.0±4.5 and spatial cognitive abilities in spatial reasoning from 17.5±5.0 to 26.2±5.2. Finally, none of the two groups displayed changes in mismatch negativity test. The findings suggest that systematic balance training is capable of enhancing some cognitive functions, such as memory and spatial cognition.

Conclusion

In sum, we are able to conclude that 6 weeks of balance training in healthy adults has positive effects on memory and spatial cognition, and an increase in cardiorespiratory fitness does not seem to be necessary to induce beneficial effects of physical exercise on cognition. From an applied perspective, balance training might represent a promising alternative intervention for individuals who are not able to participate in aerobic training following health restrictions.