bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-cultural linguistic adaptation of Arabic version of four dimensional symptom questionnaire (4DSQ) for assessing distress, anxiety, depression and somatization in Egyptian primary care attendees
Authors: Elmessiri Nour Muhammad Raouf , Elkholy Hussien Ahmed , Allam Mohamed Farouk , Abd el-Hamid Diaa Marzouk
Published: October 2021

Background

The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-administered screening tool that has been developed in primary care to differentiate non pathologic general distress from depression, anxiety and somatization. It has been validated in the English language as well as other languages yet it has not been validated in Arabic. For the sake of developing the appropriate Arabic version, linguistic validation has been sought with the guidance of crosscultural adaptation guidelines.

Objective

To design the appropriate Arabic version of the 4DSQ that has linguistic and conceptual equivalence to its validated English version and that is appropriate for administration to Egyptian primary care attendees.

Methods

The validated English version of the 4DSQ was translated by 5 translators (including specialist psychiatrist, internists and English language specialist) into Arabic (Egyptian spoken dialect) without mutual consultation. An expert committee that consisted of 2 professors of public health and family medicine and an associate professor of neuropsychiatry was formed. The consensus version was created after expert committee modification and approval of each questionnaire item using DELPHI method. After that the back translation to English was carried out by two independent bilingual physicians whose English is their mother tongue. A pilot study was carried out on 17 bilingual participants after answering the questionnaire in both languages to test its equivalence. The consensus Arabic version was updated based on the pilot study and the final version was developed. The final version was then tested on 278 Egyptian primary care attendees.

Results

After the course of forward and back translation, expert committee’s review and developer’s comments, the final version of Arabic 4DSQ was developed for assessment of distress, depression, anxiety and somatization. There was no significant difference between results of Arabic and English questionnaire using paired T test. Final testing showed very good internal consistency of each of the 4 scales of the questionnaire.

Conclusion

The Arabic 4DSQ linguistically and conceptually corresponds to the validated English 4DSQ. It has good structural validity and internal consistency reliability and thus could be used in primary care after further psychometric validation.
Evaluation of High Dose Preoperative Activated Vitamin D to Prevent Post Total Thyroidectomy Hypocalcemia
Authors: El-Shafaei Mahmoud Ahmed Mohamed , Omran Hesham Mohamed Ali , Fadl Ehab Mohammed Ali , Elbar Abanoub Magdy Abd El-Malak Ter
Published: October 2021

Background

With increase in the number of thyroidectomies, the incidence of postoperative hypocalcemia has seen a rise as well. Deficiency of vitamin D has long been debated as a risk factor for post thyroidectomy hypocalcemia. The advantage of using vitamin D as a predictor for postoperative hypocalcemia may be (i) easy to estimate (ii) any deficiency can be easily corrected.

Objective

To determine the effectiveness of preoperative high dose calcitriol supplementation in reducing hypocalcemia following total thyroidectomy.

Patients and Methods

to assess the effect of preoperative vitamin D3 deficiency on post thyroidectomy hypocalcemia. For that purpose, 40 Egyptian patients for whom total thyroidectomy was performed in general surgery department at El-demerdash and Ain Shams University Specialized Hospital form March 2020 to September 2020. Patients were divided into 2 Groups; Group 1 included patients receiving preoperative single oral dose of active vit D(300000 IU) and Group 2 included patients receiving placebo instead of vit D. The incidence of postoperative hypocalcemia was investigated in all patients.

Results

Preoperative vitamin D measurements revealed a deficiency prevalence of 66.7% and a mean Vitamin D level of 17.09 ± 6.01. The main findings of the current study as regards to calcium was that the mean preoperative level of calcium was 9.61 ± 0.48 mg/dl, the lowest level of postoperative calcium was detected after 48 hours and 72 hours. With respect to relation between calcium and preoperative vitamin D, the results showed that there is no big difference between two groups (hypocalcemia occurred in 30% from patients in vit D group and 35% in placebo group) and no patients with normal preoperative vitamin D had a postoperative hypocalcemia 24, 48 or 72 hours after the operation.

Conclusion

Giving of single preoperative high dose vitamin D doesn’t reduce the overall rate of hypocalcemia after total thyroidectomy. Postoperative hypocalcemia is closely related to the preoperative vitamin D level and patients with hypovitaminosis D are more labile to develop hypocalcemia.
Comparison of Postoperative complications between Conventional Ferguson’s Hemorrhoidectomy and LigaSureTM Hemorrhoidectomy
Authors: El-Halim Sherif Abd , El-Den Mohab Gamal , Husayn Ahmad Magdy Muhammad
Published: October 2021

Background

For symptomatic grade III and IV haemorrhoids, some form of hemorrhoidectomy remains the accepted modality of treatment. The traditional methods like the Milligan-Morgan method and the Ferguson‘s method have been in practice for more than half a century. Recently we acquired the LigaSureTM device. It is an electro-surgical device, which is an improved version of bipolar diathermy, now widely used for hemorrhoidectomy. This study will give a comprehensive overview on differences between conventional Ferguson‘s haemorrhoidectomy and LigaSureTM haemorrhoidectomy focusing on post-operative complications mainly postoperative pain, bleeding and peri-anal fistulae occurrence

Objective

To compere between closed hemorrhoidectomy, Ferguson‘s method, and LigaSureTM hemorrhoidectomy as regards post-operative pain, bleeding and peri-anal fistula occurrence.

Patients and Methods

It is a prospective study conducted over 40 patients with grade III and IV hemorrhoids, randomly divided into two groups to compare between closed hemorrhoidectomy, Ferguson‘s method, and LigaSure™ hemorrhoidectomy as regards post-operative pain, bleeding and peri-anal fistula occurrence.

Results

An overall favorable trend exists toward LigaSureTM hemorrhoidectomy in all parameters of the current study, in another word, the postoperative complications mainly pain, bleeding and peri-anal fistula occurrence was much lesser in the LigaSureTM group.

Conclusion

LigaSureTM hemorrhoidectomy is a sutureless, hemorrhoidectomy technique dependent on a modified electro- surgical unit to achieve vessel and tissue sealing. It is safe and effective, has less blood loss, postoperative pain, bleeding and perianal fistula occurrence compared to conventional Ferguson‘s hemorrhoidectomy.
Correlation between surgical site infection and obesity after exploratory laparotomy in trauma patients
Authors: Abdelaziz Ahmed , Sabry Ahmed , Fayek Mohamed
Published: October 2021

Background

Obesity has become a major contributor to the global burden of chronic disease and disability. Understanding the effect of obesity on the incidence of wound infections and other wound complications remains incomplete despite considerable attention to both the growing ‘‘epidemic’’ of obesity and the frequent occurrence of surgical site infection (SSI) after surgical procedures. Damage-control laparotomy specifically has been associated with a higher rate of infectious complications and a lower rate of primary fascial closure in obese patients.

Aim of the work

The aim of the study is to evaluate the correlation between obesity and surgical site infection (SSI) in patients undergoing exploratory laparotomy after abdominal trauma.

Patients and methods

A retrospective study performed on obese patients of both genders aged between 18 and 60 years old undergoing exploratory laparotomy after abdominal trauma at the surgery departments of Ain Shams University Hospitals, Al-Bank Al-Ahly Hospital, Al-Mataria Hospital and Al-Salam Hospital, Cairo, Egypt for two years (1st of January 2018 to 1st of January 2020). Patients with infected wounds, receiving antibiotic therapy at the time of injury, those with a known immunodeficiency, who died within 48 hours after injury, who had sustained burn injuries, who underwent surgery at another institution before admission to our hospital were excluded. The rate of 30-day SSI post-operatively among obese and non-obese patients were compared. Statistical analysis was also done.

Results

Out of 782 patients, only 480 of those patients for whom BMI data were available, 360 (75%) were males and 120 (25%) were females. Out of the 480 patients: 168 patients had BMI more than 30; 114 patients (67.8%) had SSI (P < 0.05), 312 patients had BMI less than 30; 61 patients (19.5%) had SSI. All of the included patients were fulfilling the inclusion and the exclusion criteria. On multivariate analysis, obesity was the strongest predictor of SSI (odds ratio = 1.59; 95% confidence interval, 1.32-1.91) after adjustment for sex and age. Obese patients with SSI compared with the non-obese had longer hospital stays (mean, 9.5 vs 8.1 days, respectively; P < .001) and markedly higher rates of hospital readmission (27.1% vs 6.5%, respectively; P < .001).

Conclusion

Obesity is considered as one of the risk factors in causing surgical site infection. Thus, this study showed the relation of BMI and obesity with surgical site infection in case of exploratory laparotomy after abdominal trauma.
Comparison of Milligan Morgan Hemorrhoidectomy and Stapled Hemorrhoidectomy In Recent Years For Patients With Grade III And IV Hemorrhoids: A Meta-Analysis
Authors: Abd-Elfattah Mohamed Kandel , Abd-Elmaksud Ibrahim Magid , Abd-Elmoniem Aya Essam Mohamed
Published: October 2021

Background

Hemorrhoids are one of the most common conditions in the world, and grade III and IV internal hemorrhoids are mainly treated with surgery. However, there are many different surgical methods, and many postoperative complications occur. Therefore, we aimed to compare of milligan morgan (MM) hemorrhoidectomy and stapled hemorrhoidectomy (ST) for patients with grade III And IV Hemorrhoids.

Objective

To compere between Milligan-Morgan hemorrhoidectomy and Stapled hemorrhoidectomy as regards postoperative anal stenosis and fecal incontinence in recent years for treatment grade III and IV hemorrhoids using a meta-analysis approach.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2020.

Data Extraction

If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion

It is concluded that ST appeared to be the best surgical procedure than MM for grade III and IV hemorrhoids based on the current evidence.
The Outcome of the Combined Procedure of Abdominoplasty and Repair of Umbilical Hernia
Authors: Kamel Refaat Refaat , Mabrouk Amr Reda , Moussa Mena Akladuos
Published: October 2021

Background

Umbilical hernias (UH) are common in patients seeking abdominal contouring surgery and the question of simultaneous abdominoplasty and UH repair is raised. This presents, however, a risk to the umbilicus vascularization with possible umbilical necrosis. As a result, the umbilicus maintains its only blood supply from the underlying fascial attachments via the umbilical stalk. Abdominoplasty in the setting of a hernia repair can improve patients satisfaction, particularly appearance, hygiene, self-confidence and decrease the incidence of recurrence.

Objective

To assess the outcome of the combined procedure of abdominoplasty and repair of umbilical hernia.

Patients and Methods

This study Included 26 patients (18 females and 8 males) who were selected from those who presented to the department of general surgery at EL Demerdash University Hospital and Nasr city insurance hospital during the period between april2019 and october 2019. All patients had a physical examination of the UH and diastasis. Divided into two groups, each group formed of 13 patients. First group (group A) with patients underwent herniorrphy alone and the other group (group B) with patients underwent hernioplasty with combined abdominoplasty.

Results

It may be concluded that (1) during an abdominoplasty, midline fascial plication and ventral hernia repair can be performed in defects <3 cm without mesh reinforcement with no increase in hernia recurrence rates, (2) in patients with defects > 3 cm, mesh reinforcement is indicated after suture hernia repair and midline plication,, yields lower recurrence of abdominal deformity and less refashioning procedures with minimal complications.

Conclusion

Finally, it may help to reduce the incidence of recurrence by enabling removal of a large pannus and the resultant weight on the anterior abdominal wall, though this has not been proven. Also it improves the quality of life and obtains patients satisfaction with this approach.
Paget’s Disease of the Breast and Our Clinical Experience at Ain Shams University Hospitals
Authors: Mostafa Ashraf abd el Moghny , Moaty Karim Fahmy abd el , Sadary Paula Samir Nazim
Published: October 2021

Background

Worldwide, breast cancer comprises 10.4% of all cancer incidences among women, making it the second most common type of non-skin cancer (after lung cancer) and the fifth most common cause of cancer death. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Breast cancer is about 100 times more common in women than in men, although males tend to have poorer outcomes due to delays in diagnosis.

Aim of the Work

To clarify clinical, pathological features and outcomes of the treatment modalities for Paget’s disease of the breast at Ain Shams University Hospitals.

Materials and Methods

Our study was held as a retrospective cohort study to clarify clinical, pathological features and outcomes of the treatment modalities for Paget’s disease of the breast at Ain Shams University Hospitals.

Results

At Ain Shams university hospitals patients having pagetoid cells by biopsy and no mass radiologically underwent simple mastectomy and if pathology proved any malignancy in breast tissue axillary clearance was done and might be followed by radiotherapy.

Conclusion

Patients having pagetoid cells by biopsy and a mass radiologically which is invasive or insitu with microinvasion will undergo modified radical mastectomy and may be followed by radiotherapy. But if pagetoid cells and mass radiologically which is in situ simple mastectomy will be done.
Assessment of Intra-Operative Difficulties and Early Post-Operative Complications in Laparoscopic Inguinal Hernia Repair using Conventional Polypropylene Mesh Versus 3D Mesh
Authors: Mohamed Hazem AbdelSalam , Fahmy Karim , Abd-erRazik Mohammad Ahmad , Elkomy Shaimaa Atef Ismaeil Awwad
Published: October 2021

Background

The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall.

Aim of the Work

To assess intra-operative difficulties of laparoscopic inguinal hernia repair using two different meshes: The conventional polyproline mesh and the three-dimensional (3D) mesh, as regard the operative time. And early post-operative complications including post-operative seroma, early postoperative pain, chronic pain and limitation of function.

Patients and Methods

In our study 30 patients were recruited according to our preset inclusion and exclusion criteria. They were divided randomly into two groups, a group in which the 3D mesh was used and a group in which the polypropylene mesh was used. The study was conducted in Ain Shams University hospitals for 6 months, in which patients where followed up from 3 to 6 months and compared in terms of intraoperative time, post-operative pain after one week, restriction of physical activity, seroma formation and presence of chronic pain.

Results

In our study the mean application time (minutes) in 3D group was found to be 7.07 ± 2.66 while in PP group it was found to be 12.53±3.66 with highly statistically significant difference between them at p < 0.001. We believe that this difference in fixation time in our present study is attributed to easy insertion through the port, easy intraoperative handling, and easy unfolding of 3D mesh.

Conclusion

The use of three-dimensional mesh (3D mesh) for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, early recovery with a better movement limitation score. Whereas chronic pain was found to be similar in both groups. Further, elimination of tacks for fixation and shorter hospital stay may reduce the cost of 3D mesh. Longer-term studies are recommended with a larger sample size and follow up duration for better assessment of chronic pain, also for following up on recurrence.
Breast Conservation Surgery versus Modified Radical Mastectomy in the Management of Non Metastatic Inflammatory Breast Cancer
Authors: Elshinawi Mohamed Elsayed , Osman Ahmed Gamal Eldin , Abdelmoaty Karim Fahmy , Anber Waleed Abdelsalam Abdelatty
Published: October 2021

Background

Inflammatory breast cancer (IBC), the most lethal form of breast cancer, constitutes 1–2% of all breast cancers in the United States. Multimodality therapy is the standard in management of non metastatic inflammatory breast cancer patients including neoadjuvant chemotherapy and endocrine therapy and mastectomy followed by post mastectomy radiation. A modified radical mastectomy has been the standard surgical procedure of choice. The objective of this systematic review and metanalysis is to estimate the pooled benefits and adverse effects of performing modified radical mastectomy versus breast conservation surgery in the management of non metastatic IBC.

Objective

To evaluate, review and analyze the outcome of non metastatic IBC patients treated with mastectomy or breast conservation surgery as an integral part of the multimodality treatment of the disease. To highlight the evidence and quality of the included studies. To share in modifying the current guidelines.

Methods

An electronic search was conducted from the inception till Jan 2020 in the following bibliographic databases: Medline via PubMed, SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Google Scholar to identify relevant articles. We used different combinations of the following queries: ("Inflammatory Breast cancer" OR "breast cancer") AND ("Conservative Treatment" [Mesh] OR "conservative surgery" OR "breast conservative surgery" OR "partial mastectomy"). The search have been done with no limit regarding the year publication.

Results

After reviewing five studies we found that our results favors the use of modified radical mastectomy over breast conservation surgery in terms of the overall survival and breast cancer specific free survival, however, partial mastectomy could be an effective and safe option in selected group of patients with non metastatic IBC based on the response to NAC an patient’s preference.

Conclusions

Breast surgery is of great significance to the clinical outcomes of IBC. Standard mastectomy shouldn’t be the only recommended surgical treatment. Individualized surgical procedures can be safely performed in non-metastatic IBC patients based on the response of NAC and patient’s preference.
Association between Serum 25-Hydroxyvitamin D Level and Cardiac Functions in Chronic kidney Disease Patients
Authors: Saeed Saeed Abdelwahab , Abd-elmobdy Ashraf Hassan , Hassan Ahmed Abd-elaziz Mohammed
Published: October 2021

Background

Chronic kidney disease (CKD) is a major public health problem worldwide and is associated with a considerable increase in morbidity and mortality, cardiovascular disease is most common cause of death among chronic kidney disease patients. There is an increasing interest in using vitamin D levels as a novel marker for CVD, because epidemiological data have shown a strong correlation between the risk of CVD and vitamin D deficiency.

Objectives

The aim of study was to determine the association between serum vitamin D level and cardiac functions assessed by tissue Doppler imaging in chronic kidney disease patients.

Patients and Methods

Our study conducted on 90 patients from outpatient clinic or inpatient department of national institute of nephrology and urology. All patients were subjected to full history, full clinical examination, laboratory investigations including: serum urea, serum albumin, complete blood picture, serum electrolytes (calcium and phosphorus), PTH, serum vitamin D, lipid profile and echocardiography and Tissue Doppler imaging.

Conclusion

Serum vitamin D is positively correlated with diastolic function among CKD patients, increased incidence of left ventricular hypertrophy in CKD patients especially with vitamin D deficiency, Tissue Doppler imaging is more accurate than echocardiography to estimate diastolic function.
The Role of Serum microRNA (hsa-miR-519d) And the Associated Target Gene (SQSTM1) As Diagnostic Biological Molecular Biomarkers for Hepatocellular Carcinoma
Authors: Youssef Tarek Mohamed , Ibrahim Wesam Ahmed , El Nakeep Sarah Abdel Kader , Swilam Amina Ahmed Mahmoud
Published: October 2021

Background

Hepatocellular carcinoma (HCC) is the most common primary liver cancer. The mortality of liver cancer worldwide is ranked as fourth between other cancer causes in males and females. In Egypt, it is a major problem due to the high prevalence of Hepatitis C Virus infection.

Objective

To characterize the expression of new serum non-coding RNA microRNA (hsa-miR519d) and the associated target gene (SQSTM1) to evaluate their usefulness as diagnostic molecular biomarkers for HCC.

Patients and Methods

we assessed the expression of the microRNA (hsa-miR-519d-3p) and the mRNA of (SQSTM1) gene in serum samples from 50 participants: (34) HCC patients, (11) chronic liver infection patients and (5) normal volunteers, using Quantitative Real Time Polymerase Chain Reaction (qPCR).

Results

The results of both microRNA (miR-519d-3p) and mRNA of (SQSTM1) gene showed a significant upregulation of their serum level in the HCC group in comparison to chronic liver infection group. In addition, the results of the serum microRNA (miR-519d) and the messenger RNA of (SQSTM1) gene using receiver operating characteristic (ROC) curve showed higher sensitivity and specificity than that of AFP, as it was (91.2%-81.8%), (97.1%-100%) and (76.5%72.7%) respectively.

Conclusion

The serum microRNA (hsa-mir-519d-3p) and the serum mRNA of its targeted gene (SQSTM1) are both significantly upregulated in the serum of Hepatocellular carcinoma (HCC) patients. And that the (hsa-mir-519d-3p) stimulates the gene (SQSTM1) at the transcriptional level. Finally, we could conclude that the serum microRNA (hsa-mir-519d-3p) and the serum mRNA of (SQSTM1) gene can be used as diagnostic biomarkers for HCC with good sensitivity and specificity even for early stages of HCC in comparison with AFP.
Detection of Occult Hepatitis C Virus Infection in Patients Who Achieved a Sustained Virologic Response to Direct-Acting Antiviral Agents
Authors: Yousef Tarek Mohamed , Kamal El Din Maha Mohsen Mohamed , George Tari Magdy Aziz , Mohamed Amr Adel Elzohary
Published: October 2021

Background

Occult infection with hepatitis C virus (HCV) is defined as the presence of the HCV genome in either liver tissue or peripheral blood monocytes, despite constant negative results from tests for HCV RNA in serum.

Objectives

The aim of the study to detect the prevalence of occult hepatitis C Virus infection in patients who achieved a sustained virologic response (SVR) to direct-acting antiviral agents and to outline predictors of OCI.

Patients and Methods

This study included 100 patients with chronic HCV infection without liver cirrhosis attending to hepatitis C clinics at Ain Shams University Hospital, Ahmed Maher Teaching hospital and Elgomhorya Teaching Hospital.who received sofosbuvir (400mg) plus daclatasvir (60mg) daily for 12 weeks with or without ribavirin according to National committee to combat viral hepatitis (NCCVH) protocol.

Results

We tested peripheral blood for HCV RNA in PBMCs to detect OCI. Occult HCV was found positive in 12% of the studied cases. Occult HCV was positive more in male cases. Positive cases had significantly lower age, and higher total bilirubin, direct bilirubin, AST and ALT levels. Age had significant moderate diagnostic performance in predicting occult HCV, while direct bilirubin has significant low diagnostic performance in predicting occult HCV.

Conclusion

OCI following direct antiviral therapy may be present in some cases, and this may require further testing of patients with SVR particularly in younger male patients with persistantly high liver enzymes.
Vascular Endothelial growth factor A in HCV infected patients before and after treatment with DAAS and its possible relation to HCC development
Authors: Helal Essam M , Ibraheem Wesam A , Sayed Moataz M , Salama Mohamed M , EL Ghandour Ahmed M , Salama Ashraf B
Published: October 2021

Background

HCC comprises 5.6% of all cancersworldwide representing the fifth most common cancer.It is also the second most common cause of cancer death.

Objective

To study the impact of DAAs on appearance of H.C.C in HCV infected patients.

Patients and Methods

After obtaining approval from the Institutional Review Board (IRB) and the Department of Internal Medicine, Ain Shams University and written informed consent obtained from all patients, this cross-sectional study was performed in Suez canal authority hospitals (Outpatient Clinic and the Inpatient Ward), at Ismailia Egypt.Sample size on 50 patients divided into 25 cases and 25 controls.

Results

Our results w obtained and show that there was no statistically significant difference could be detected between HCV subdivided groups.There was statistically significant difference could be detected between HCC subdivided groups.

Conclusion

Angiogenesis plays an important role in the progression of HCC. VEGF is aprimary driving force for both phisological and pathological angiogenesis and overexpression of VEGF is observed in HCC. Circulating levels of VEGF increase significantly remain high until end of treatment and decline to pretreatment level within 12 week of end of therapy.It has angiogenic properties. Elevated Circulating levels of VEGF after RF (radiofrequency) or TACE correlate with poor prognosis for patient with HCC (hepatocellular carcinoma).
Pregnancy Outcomes in A Group Egyptian Patients with Systemic Lupus Erythematosus: A Cohort Study
Authors: Mohammed DF , Mansour HE , El-Feky AE , Hosny SM , Morad CS , Abdel-Zaher AT
Published: October 2021

Background

Systemic lupus erythematosus (SLE) predominantly affects women of childbearing age thus pregnancy in lupus patients is a common clinical scenario. SLE adversely affects pregnancy outcomes and pregnancy leads to SLE flares

Aim of the work

Determining the frequencies and predictors of maternal and fetal pregnancy outcomes in women with SLE by a prospective cohort study

Patients and methods

seventy-one pregnant lupus patients were followed prospectively, and their data compared to age-matched pregnant healthy controls attending Ain Shams University Hospital clinics

Results

Thirteen Patients had activity at conception. Sixty-six(93%) Where on treatment. Flares occurred in 51 patients (72%) during pregnancy with nephritis being the most common occurring in 78%. The prevalence of anemia, AKI and hypertension (HTN) during pregnancy were higher in SLE group than control group (P < 0.01). The rate of delivery by Cesarean section (CS), PTL, postpartum hemorrhage, preeclampsia (PE), severe PE and HELLP were higher in SLE group then control group (P < 0.01) as well as an increase in rate of postpartum infection (P < 0.05). There was an increase in rate of fetal loss, prematurity, intrauterine growth restriction (IUGR), NICU admission, still birth/intrauterine fetal death and highly significant decrease in fetal weight in SLE group than control group (P < 0.01). Pregestational HTN was independently associated with PE (OR 91.228; CI 6.791-1225.538). Proteinuria and HTN during pregnancy were independently associated with prematurity (OR 14.162 CI 1.029-194.958 & OR 10.596, CI 1.460-76.894).

Conclusion

Pregnancy in lupus patients carries a higher risk of pregnancy morbidity and worse fetal outcomes than the controls.
Assessment of the prognostic impact of serum level of soluble cluster of differentiation (sCD155) in newly diagnosed Low grade cell Non Hodgjen Lymphoma in Adult Egyptian patients
Authors: Azzazi Mohamed Osman , Hegab Hany Mohamed Abd-Allah , Nabih Abd El-Ghafar Nermeen Adel , Melek Mary Gamal Nageb , Ahmed Dina Mostafa Fahmy
Published: October 2021

Background

CD155-dependent signals not only influenced net tumor growth but also responsiveness to immune checkpoint therapies. Thus, blocking CD155 could be a rational strategy to improve current immunotherapeutic

Aim of the work

To assess CD155 in newly diagnosed Low grade B non Hodgkin Lymphomas as prognostic marker for remission

Patients and methods

CD 155 measured by Ellisa at the time of diagnosis of 50 patients newly diagnosed low grade B non Hodgjen Lymphomas and the remission status followed up prospectively at 3 and 6 months in hematology unit at Ain Shams University Hospital

Results

there were high statistically significant difference between CD155 level and cytogenetic risk and Eligibility for auto transplantation, there were statistically significant difference between CD155 level and B symptoms, there were high statistically significant difference between CD155 level and Radiology stage, BM infiltation, protocol after 3months, There were high statistically significant difference between CD155 level and Radiology stage, BM infiltration, CBC after 6 months There were high statistically significant difference between CD155 level and non Remission and CD155 had Sensitivity88.46% and Specificity75% as poor predictor of remission

Conclusion

The CD155 level is prognostic factors for remission in Low grade B non Hodgkin Lymphomas as high CD155 level is poor prognostic factors for response and remission with Sensitivity 88.46%and Specificity75. %
The Role of Retinol Binding Protein 4 (RBP4) in Prediction of Response to New Direct Acting Antiviral Drugs (DAAS) in Chronic Hepatitis C
Authors: Elmalatawy Mohammed Abd Elfattah , Elqarmoty Khaled Zakaria , Rasmy Hany Samir , Abdelwarth Ebrahim Youssef
Published: October 2021

Background

Hepatitis c virus is global health burden and major health hazard in Egypt, since the virus is the etiological factor of chronic hepatitis that frequently progress to a cirrhosis and hepatocellular carcinoma (HCC). In addition to cirrhosis and hepatocellular carcinoma, HCV is thought to cause metabolic alterations, including steatosis, dyslipidemia, insulin resistance (IR), diabetes, obesity, and cardiovascular events.

Objective

To determine the value of RPB4 in the prediction of response to new DAAS treatment in chronic HCV infected patients and to correlate its level with the metabolic profile and fibrosis degree among chronic HCV

Patients and Methods

This study was Prospective cohort clinical study that was conducted at hepatology and virology outpatient clinic at Ain Shams University Hospital &Hepatology and virology outpatient clinic at Kafr –El Sheikh liver institute from January 2019 to October 2019 after informed consent.

Results

The present study showed that the best level of RBP4 in prediction of hepatic fibrosis stage 4 was ≤ 46 pg/ml and had sensitivity of 100% while the specificity was 66.67%.The positive predictive value was 50%while the negative predictive value was 100% and test accuracy was 80.5%.

Conclusion

Serum RBP4 was found to be higher in chronic hepatitis C naïve patients than normal person; there was significant reduction of RBP4 post treatment. Fibroscan showed marked reduction of fibrosis degree after treatment with Directly acting antiviral in both cirrhotic and noncirrhotic patients regardless the treatment regimen used with improved overall liver function tests, liver enzymes and platelet count in patients who reached SVR and maintained negative PCR after treatment.
Nail Fold Capillaroscopy in a Cohort of Egyptian Dermatomyositis/Polymyositis Patients
Authors: Mansour Howaida Elsayed , Ibrahim Shafica Ibrahim , Hussein Safaa Abdelsalam Aly , Azrag Gamer Abdelrahman
Published: October 2021

ABASTRACT

Background

Nailfold capillaroscopy (NC) has been demonstrated to be an important tool in the diagnosis and treatment of patients with juvenile dermatomyositis (JDM) and systemic sclerosis. However, NC has been scarcely studied in adult patients with DM.

Objectives

Is to visualize capillary changes in DM/PM patients, trying to find a specific capillary pattern and its correlation if any- with disease activity in those patients.

Methodology

This is a cross sectional observational study included 20 patients (DM.Diagnosed on base of clinical, laboratory and histopathological findings. We excluded patients with hypertension or diabetes mellitus. The NFC performed using videocapillaroscope. A semiquantitative rating scale was used to score capillaroscopy changes. Myositis disease activity assessment tools were used to assess disease activity [Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Visual Analogue Scales (MYOACT), Health Assessment Questionnaire (HAQ), physician’s VAS, patient’s VAS, skin scoring, serum muscle enzymes levels]

Result

The median age of our patients was 36 (S.D.12) Mean disease duration was 24months (S.D.19).The results presented mean value 3,8 (S.D.3,3) for muscle disease activity score,2(S.D.3) for skin score and 3,92 (S.D.3,09) for global disease activity .Enlarged capillaries was found in12 patients (100%), avascular areas in 10 patients (83.3%), capillaries hemorrhage in 8 patients (66,7%), and branched capillaries in 6 patients (50%).Sixteen patient (80%) had scleroderma like pattern. We found that disease activity positively correlate with branched capillaries(p = 0,04), muscle disease activity correlate positively with capillaries density score(p = 0,002) while hemorrhage correlate positively with skin score(p = 0,024). In our study major capillaroscopic abnormalities appeared to be virtually confined to patients with DM while patients with PM had only minor changes. No signifcant correlations between NFC and other demographic, clinical and laboratory parameters were observed.

Conclusion

NFC may provide helpful information about patients with PM/DM by: (a) contributing to the diagnosis and (b) correlating with disease activity parameters. Additional investigations with larger series of patients and prospective studies may be useful to reinforce our data.
Relation of Lactobacilli acidophilus to Obesity in Egyptian Population
Authors: Hany Hany Naser Abbas , Eltouny Maha Abdelaziz Ahmed , Riad George Safwat , Mohammed Rasha Samir
Published: October 2021

Background

Current considerations are existed about the sharing role of gut microbiota in the enhancement of obesity and its allied comorbidities

Objective

The aim of this observational case-control study was to assess the possible relation of lactobacilli acidophilus to obesity in a sample of Egyptian population by realtime PCR of lactobacilli acidophilus in stool.

Subjects and methods

The present study enrolled 20 healthy slim subjects and 40 subjects who had BMI >25 kg/m2. Routine laboratory analysis and identification of stool Lactobacillus acidophilus by quantitative real time PCR technique was performed for all enrolled subjects.

Results

Lactobacillus acidophilus was expressed in 21 out of 40 (52.5%) faecal samples of obese cases and 16 out of 20 (80%) of faecal samples of non-obese cases. In rest of samples in both studied groups, the expression was below the detection limit. The results showed that the mean CT at which Lactobacilli were expressed in the obese cases was (38.89±2.57) compared to (36.08±4.63) in non-obese cases and this indicated that the expression of lactobacilli was statistically higher in non-obese subjects compared to obese cases (P = 0.04).

Conclusion

Lactobacillus acidophilus was significantly lowered in obese Egyptian patients. The argument about the significance of correlation between imbalance in gut microbiota and obesity is considered one of the hottest open topics in medicine.
Femoral Cartilage Thickness in Patients with Systemic Sclerosis and Its Relation to Vitamin D
Authors: Farouk Hanan Mohamed , Badr Fatma Mohammed , El Monem Teama Mohammed Abd , El-Deen Mohammed Aref Hazem Mohey
Published: October 2021

Background

Systemic sclerosis (SSc) is a connective tissue disease characterized by different degrees of skin fibrosis and visceral organ involvement. The etiology of SSc remains obscure; the disease appears to be the result of a multistep and multifactorial process, including immune system alterations, under the influence of genetic and exogenous factors. The aim of this work is to study levels of vitamin D in relation to the femoral cartilage thickness (FCT) in patients with SSc and to analyze the associations between the (FCT), vitamin D levels, SSc- disease severity score.

Patients and methods

This is a cross sectional study which included 40 adult systemic sclerosis patients diagnosed according to ACR/EULAR (2013) classification criteria of systemic sclerosis. Patients were categorized into two groups according to vitamin D sufficiency; Group I: n = 14, sufficient vitamin D (level ≥ 30 ng/ml), Group II: n = 26, insufficient vitamin D (level < 30 ng/ml). Serum levels of 25-hydroxyvitamin D (25[OH] D) were assessed by (ELISA). The thickness of femoral articular cartilage was measured by muscloskeletal ultrasound. Three measurements were taken from each knee: lateral femoral condyle (LFC), femoral intercondylar area (ICA) and medial femoral condyle (MFC).

Results

The majority of patients (60%) had thin femoral cartilage of knee joint, we found that (35%) of patients had sufficient vitamin D level while (65%) of patients had insufficient vitamin D level. We compared the insufficient vitamin D level group with sufficient vitamin D level group according to femoral cartilage thickness, and concluded that vitamin D level related to femoral cartilage thickness at left medial condylar area and left lateral condyle, meanwhile we found no relation between disease severity and cartilage thickness or vitamin D level. There was significant relation between vitamin D sufficiency and sex of studied patients more in females, also showed significant inverse correlation between parity in females and femoral cartilage thickness at Rt intercondylar area and Rt medial condyle. There was highly significant statistical relation between disease severity grades and proximal muscle weakness among studied patients.

Conclusion

Vitamin D level has significant relation with femoral cartilage thickness in SSc patients in two of six of measured cartilage areas and proximal muscle weakness was associated with vitamin D insufficiency and disease severity.
Assessment of the association between neuropeptide Y and chronic kidney disease progression
Authors: Saeed Saeed Abdel Wahab , Abdelaziz Haitham Ezzat , Teama Nahla Mohamed , Abouelsaad Hend Ahmed
Published: October 2021

Background

Neuropeptide Y (NPY) is a sympathetic neurotransmitter with wide-ranging effects in various organ systems, from the central nervous system (CNS) to the cardiovascular (CV) system, the bone and the renal system. There is a strong association between serum concentration of NpY and deterioration of eGFR and proteinuria as suggested by recent studies [1,2], however, its real effect on chronic kidney disease (CKD) progression is uncertain.

Purpose of the study

Assess the relationship between NpY and progression of CKD.

Settings and Design

An observational, prospective case-control study of thirty CKD adult patients and thirty healthy control adult subjects.

Methods and Material

All participants were conducted to renal function tests (serum creatinin, blood urea, serum Na, K, P and Ca and calculation of estimated glomerular filtration rate), complete blood count, urinary protein/creatinin ratio, serum NpY and pelvi-abdominal ultrasonography at baseline and repeated for the patients only after six months as follow up.

Statistical analysis used

Statistical presentation and analysis of the present study was conducted, using the mean, standard deviation, student t-test, Paired t-test, Chi-square, Linear Correlation Coefficient and Analysis of variance [ANOVA] tests by SPSS V17.

Results

The mean of serum NpY was 438.333 ± 206.850 at baseline then became 630.667 ± 264.926 after follow up. Urinary PCR ranged from 0.2- 3.1 at baseline to 0.2- 2 after six months. The patients’ group mean eGFR was 36.900±17.851 and became 31.373±17.852 ml/min/1.73m2.

Conclusion

Serum NpY could be a useful marker that can be used as diagnostic and progression predictor for CKD.
Role of Nail Fold Capillaroscopy as A Method of Early Detection of Atherosclerosis in Systemic Lupus Erythematosus Patients
Authors: Farouk Hanan Mohamed , Mohamed Rasha Mahmoud , Aboud Fatma Mohammad , Hussein Huda Taha
Published: October 2021

Background

The development of atherosclerosis and cardiovascular disease as a consequence Systemic Lupus Erythematosis is a common and dangerous complication in patients with SLE. However, since the prevalence of atherosclerosis and cardiovascular disease is variable and increasing by time, universal screening would imply a large number of unnecessary carotid Doppler.

Objective

To study the early prediction of atherosclerosis and the cardiovascular risk in SLE patients by Nail fold capillaroscopy and the Intima media thickness of the Carotid artery.

Patients and Methods

All Patients were subjected to full history taking, full clinical examination, laboratory investigations, carotid Doppler and nail fold capillaroscopy. In this study, we prospectively collected data on 30 consecutive patients referred to Ain Shams University hospitals and The National Research Institute.

Results

However, nail fold changes was significantly higher in patients with IM thickness changes indicative of atherosclerosis with SLE: it was proved to be highly sensitive and adequately specific in predicting the atherosclerosis in those patients.

Conclusion

IM thickness and nail fold capillaroscopy could be used as a guiding noninvasive screening tool in patients with SLE to predict the atherosclerosis and CV risk. Nail fold changes is correlated to the atherosclerotic changes happening in SLE patients. These results may lead to a reduction in the number of SLE patients with undiagnosed atherosclerosis and CV risk. Nail fold capillarscopy may also help alleviate the financial and disinfection burdens of radiology units as well as the medical costs associated with atherosclerosis and CV risk. Nail fold capillaroscopy can be used as a screening tool before doing carotid Doppler.
Hematological effects of antiviral drugs for Hepatitis C virus
Authors: Shawky Amal , Hamdy Hesham , Samir Rasha , Ahmed Harhor Esraa Elsayed
Published: October 2021

Objective

The treatment of HCV infection has evolved from interferon-based treatment approaches to direct-acting antivirals (DAAs). Despite the overall success, antiviral treatment of certain groups of patients remains challenging. Even if severe side effects are rare, they are not completely absent especially in patients with advanced liver disease. So, we aimed to evaluate hematological effects of antiviral drugs in chronic HCV patients.

Patients and methods

We randomly assigned 50 patients to treatment with daclatasvir/sofosbuvir for 12 weeks. Laboratory data were collected 3 and 6 months after end of treatment and compared to those before treatment.

Results

Our study showed SVR of 100% (P-value < 0.001). there was statistically significant increase of mean corpuscular volume (MCV) and hematocrit (HCT) (P-value = 0.035 and 0.048 respectively) 3 and 6 months after treatment. Hemoglobin was increased 3 months after treatment however changes in hemoglobin wasn’t statistically significant (P-value = 0.719). There was statistically improvement of hemoglobin 6 months after treatment (P-value = 0.019). There was statistically significant increase of platelet count 6 months after treatment (P-value = 0.038). Our study showed statistically significant improvement of total bilirubin (P-value = 0.001), ALT (P-value = 0.012), AST (P-value = 0.001), AFP (P-value = 0.002) 6 months after treatment.

Conclusions

Results support the safety of sofosbuvir-daclatasvir regimen among Egyptians and suggest a significant role of those drug regimens in the treatment of HCV with least adverse events.
Relation Between Matrix Gla Protein and Cardiac Vavular Calcifications in Haemodialysis Patients
Authors: El-Sharkawy Magdy Mohamed Saeed , El Thakaby Ahmed Hassan Mohamed , El Sharabasy Reem Mohsen , ElBahrawy Mahmoud Fathy Mohamed
Published: October 2021

Background

Heart valve calcification was first described a century ago. Its pathologic features were first described by Dewitsky in 1910. Valvular heart disease is common in end-stage renal disease patients. The incidence of valvular heart disease is 5 times greater in dialysis patients than in the general population MGP plays a key role in the inhibition of tissue calcification, which was demonstrated in MGP-deficient mice

Objective

To detect the prevalence of cardiac valvular calcifications among end stage renal disease patients on prevalent haemodialysis and its relation to Matirx Gla protein.

Patients and Methods

Enrolled patients were recruited from Ain shams hospitals, divided into two groups according to the presence/absence of valvular calcifications on echocardiographic examination as follows: Group A: included patients with valvular calcifications. Group B: included patients without valvular calcifications.

Results

In current study, 19 (23.8%) patients showed mitral calcification, 30 (37.5%) showed aortic calcification and 44 (55.0%) had calcification in general as 5 patients had both mitral and aortic calcifications. In current study, the patient who had calcification were significantly older, heavier in weight and BMI and were had HD for longer than those who didn’t have calcification. Patient who had calcification had lower levels of both platelets and urea than those who didn’t have calcification. In current study, the mean ucMGP was 549.5 ± 160.1 and the patient who had calcification had higher levels of ucMGP than those who did not have calcification. There was a significant positive correlation between age, weight, BMI, duration of HD and ucMGP. And there was a significant negative correlation between platelet count, serum albumin and ucMGP.

Conclusion

In current study, MGP was able to significantly differentiate between patients with and without calcification at a cutoff point (>564 pg/mlv) with sensitivity 86.36%, specificity 97.22. Our study confirmed that older age, hypertension, diabetes mellitus low platelet, higher ucMGP and blood urea are the most predictive parameters of valvular calcifications in hemodialysis patients. Other markers were not associated with valvular calcifications. ucMGP serum levels can significantly differentiate between HD cases with valvular calcifications and those not and those who had findings in CXR.