bluuebunny/crossref_metadata_2025 huggingface dataset:
Audiological evaluation in patients with psoriasis
Authors: Ahmed Maha Elsayed , Younes Abdel-Khalek Hassan , Elmoursy Mohamed Mohamed , Makki Mahmoud Abd Elsabour
Published: April 2024

Background

Psoriasis is a multisystem, immune disorder driven by inflammatory processes, characterized by skin and joint manifestations, and may be associated with hearing loss.

Aim

To assess the hearing function in patients with psoriasis and if psoriasis could cause sensorineural hearing loss (SNHL).

Patients and methods

A total of 50 patients with psoriasis and 50 apparently healthy controls matched for age and sex were included in a cross-sectional comparative study between May 2017 and April 2018. Medical history of patients was taken. Demographics, type of psoriasis, and disease severity evaluated by PASI score were assessed. All patients who were included in this study provided a complete history and audiological history. All patients underwent otoscopic examination, pure tone audiometry, speech audiometry, and immittancemetry including tympanometry and acoustic reflexes.

Results

There was no statistically significant difference in age or sex for patients with psoriasis and the control group. Eight patients with psoriasis showed impaired hearing function with significant longer duration with psoriasis and older age more than 20 years old in comparison with the rest of the patient.

Conclusion

Psoriasis is a chronic inflammatory immune-mediated skin disease with estimated prevalence in Upper Egypt at a rate of 0.19% of skin diseases. There were eight (16%) patients who had SNHL in psoriatic group in comparison with three (6%) cases in nonpsoriatic group. There was a statistically significant difference for the age and the duration of psoriasis in relation to hearing loss. SNHL increased with age in psoriatic patients much more than in healthy controls.
The possible mitigating effect of hawthorn on some cold stress-induced changes in rats
Authors: Ibrahim Samah El-Metwally , Al-Saeed Hanan F. , A. F. Yousuf
Published: April 2024

Background

Cold stress is one of the potentially life-threatening challenges that could exert dramatic effects on adult health. Cold stress could affect the synthesis of some important neuroproteins and increase the susceptibility for infection. Besides, it is one of the famous predisposing causes that can affect mood and result in actual mood effect. Hawthorn plant possesses various bioactive natural compounds. However, there has been little attempt toward exploring the potential health effects of hawthorn.

Objective

The aim of the research is to validate if hawthorn extract could be used as a strategy against the multiple health adverse effects that might result from cold stress.

Materials and methods

A total of 50 adult male albino rats were equally divided into five groups: control; hawthorn administered; cold stress exposed; cold stress exposed and pretreated by hawthorn; and cold stress-exposed and concomitantly treated by hawthorn. Blood samples were collected to investigate the proinflammatory markers, such as serum interleukin-6 (IL-6), oxidative stress markers, superoxide dismutase (SOD), and malondialdehyde (MDA), as well as the brain-derived neurotrophic factor (BDNF).

Results

Rats exposed to cold stress showed significant increase in serum IL-6 and MDA, whereas serum SOD and BDNF were significantly decreased. Fortunately, hawthorn-administered rats revealed alleviation of these disturbances, as serum IL-6 and MDA were significantly decreased, with an associated significant increases in serum SOD as well as BDNF.

Conclusion

Hawthorn extract can be used as a neuromodulator, an antioxidant, and an anti-inflammatory agent for reversing the adverse effects of cold stress.
Hepatoprotective effect of dipeptidyl peptidase-4 inhibitor sitagliptin against carbon tetrachloride-induced liver fibrosis in mice
Authors: Ahmed Ahmed A.N. , Omar Zainab M.M. , El-Bakry Mohamed H. , Ahmed Mohammed A.
Published: April 2024

Background and Aim

Sitagliptin is a selective dipeptidyl peptidase-4 inhibitor that is used worldwide to ameliorate hyperglycemia and insulin insensitivity-induced dysmetabolism. The current study assessed the effect of sitagliptin as well as silymarin (the standard hepatoprotective drug) against experimentally carbon tetrachloride (CCl4)-induced liver toxicity in male mice.

Materials and methods

Mice chronic liver fibrosis models were established and divided into olive oil-induced control group, CCl4-induced model group, silymarin-treated group, and sitagliptin-treated group. Hepatic fibrotic changes were evaluated by measuring hepatic enzymes (alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase), histopathological score, activation of hepatic stellate cells (α-smooth muscle actin expression with special stain), and oxidative stress (malondialdehyde, glutathione, total nitrate/nitrite, and manganese superoxide dismutase levels).

Results

The injection of mice with CCl4 for 7 weeks resulted in a marked elevation of hepatic fibrotic changes and reduction of glutathione level; both silymarin and sitagliptin therapy showed a significant decrease in the fibrotic changes and a significant increase in endogenous antioxidants.

Conclusion

This study shows that sitagliptin ameliorates hepatic fibrosis in mice and announces a new strategy for treating hepatic fibrosis in humans.
Spleen stiffness measurement based on shear-wave elastography for noninvasive assessment of esophageal varices in liver cirrhosis cases
Authors: Soliman Walid K. , Eid Khaled A. , Mohammad Ahmed Q.
Published: April 2024

Background and aim

Several laboratory tests and procedures have been considered as noninvasive prediction of esophageal varices (OV). This study assessed the usefulness of shear-wave elastography in splenic stiffness measurement (SSM) as a noninvasive assessment for OV prediction.

Patients and methods

This study was performed on 100 cases in Sohag Cardiology and Gastroenterology 1Center who were categorized into three groups: group A: (n=40) included liver cirrhosis of any cause proved clinically, laboratory, and by ultrasound; group B: (n=30) included chronic hepatitis of any cause; and group C: (n=30) included nonhepatic cases attending the hospital with gastrointestinal tract complaints. All cases have been subjected to full history taking and clinical examination before classification, complete blood count, alanine aminotransferase, aspartate transaminase, serum albumin, coagulation profile and serum bilirubin, hepatitis C virus antibody (HCV Ab) and hepatitis B surface antigen (HB Ag), abdominal ultrasonography, SSM by shear-wave elastography, and upper endoscopy for diagnosing of OV.

Results

As regards to abdominal ultrasound and upper endoscopy, significant differences were noted between three groups regarding spleen, spleen diameter, SSM, ascites, and OV (as 27.5 and 65% cases in group I had ascites and OV versus no cases in groups II and III as P<0.001). As regards to spleen diameter and SSM, significant increase was noted in group A than B and C, but insignificant differences were noted among groups B and C. As regards to OV grades in group A, there were five cases with grade I, nine cases with grade II, five cases with grade III, and seven cases with grade IV. Considerable positive correlations were noted among OV grades and acoustic radiation force impulse elastography (r=0.904, P <0.001).

Conclusion

SSM by shear-wave elastography is a useful noninvasive parameter for detection of OV presence and grading in cases of liver cirrhosis.
Dexmedetomidine versus fentanyl in ultrasound-guided transversus Abdominis plane block for pain relief after elective cesarean delivery
Authors: Abdelraouf Hesham Said , Amin Mohamed Abd-Allah , Elsawy Ahmed G.
Published: April 2024

Background

Transversus abdominus plane (TAP) block is one of the multimodal techniques that are used to relieve postoperative pain in cesarean delivery. Addition of adjuvants to local anesthetic agents reduces postoperative opioid consumption and helps in prolonging their analgesic effect.

Aim

This study compared the influences of addition of dexmedetomidine versus fentanyl to bupivacaine in ultrasound-guided TAP block for postoperative analgesia after spinal anesthesia in cesarean delivery and evaluating the time to the first dose of analgesia postoperatively as the primary outcome.

Patients and methods

A total of 120 female patients scheduled for elective cesarean delivery were conducted in this study. Patients were divided into four equal groups. All patients received spinal anesthesia. Group TAP received ultrasound-guided TAP block using bupivacaine, group TAP-F received TAP block with addition of fentanyl to bupivacaine, group TAP-D received TAP block with addition of dexmedetomidine to bupivacaine, whereas control group received spinal anesthesia only, and morphine was used for pain relief. Postoperative, time to first dose of rescue analgesia, number of patients who requested rescue analgesia, patient satisfaction, and visual analog pain scale were recorded.

Results

The time to give rescue analgesic in TAP-D group was the longest in comparison with the other studied groups. Regarding the number of patients who requested rescue analgesia, at the end of 24 h, significant differences were observed between control group and the other groups, and least number of patients who requested rescue analgesia was in TAP-D group during 24 h postoperatively, and differences between this group and the other groups were highly significant.

Conclusion

Dexmedetomidine as an adjuvant to bupivacaine in TAP block delayed the time to first rescue analgesia when added to bupivacaine using ultrasound-guided technique and improved patients’ satisfaction with decrease in total morphine consumption, whereas addition of fentanyl to bupivacaine has no added advantage.
Determinants of bone mineral density in young and premenopausal females
Authors: Elsayed Sahar A. , Mohafez Omar M.M. , Abozaid Hanan Sayed M.
Published: April 2024

Background and aim

Vitamin D deficiency is a challenging health problem in premenopausal females that negatively affects bone mineral density (BMD). Low BMD in premenopausal women is related to lifestyle, vitamin D insufficiency, and secondary hyperparathyroidism. So, we aimed to evaluate BMD in young and premenopausal females and its relation with vitamin D, parathormone (PTH), BMI, and lifestyle factors.

Patients and methods

A total of 86 young and premenopausal females were included, and BMD, serum calcium, vitamin D, PTH, BMI, and lifestyle were determined.

Results

Z score of the spine showed that 26.7% of the patients were below expected. According to T score, 30% were osteopenic, and 9% were osteoporotic. Overall, 59.3% had vitamin D deficiency, and 20.9% had insufficiency. Patients with below expected BMD, osteopenic, and osteoporotic had significantly low vitamin D and BMI and high PTH. Spine and hip-BMD and spine T and Z scores were positively correlated with BMI and vitamin D and negatively correlated with PTH. Hip T and Z scores were positively correlated with BMI and vitamin D. PTH was negatively correlated with vitamin D and BMI. Spine and hip BMDs were positively correlated with sunlight exposure and physical activity but negatively correlated with carbonated and caffeinated beverage consumption and family history of osteoporosis.

Conclusion

Low BMD is a challenging health problem in young and premenopausal females, which may be related to low BMI, vitamin D deficiency, and lifestyle factors in the form of inadequate sunlight exposure, excessive consumption of caffeinated and carbonated beverages, and decreased physical activity, in addition to hyperparathyroidism and positive family history of osteoporosis.
Comparative study between tactile electrosurgical ablation guided by rectal ultrasound and versapoint hysteroscopic ablation in cases of perimenopausal uterine bleeding
Authors: El-kholy Mohamed , Mustafa Faisal A. , Badawy Mahmoud A.
Published: April 2024

Background and aim

Bleeding is considered one of the most common problems in perimenopausal women. The menopausal transition is an imprecise period and can be established from the moment of appearance of menstrual disturbances and elevation of the serum follicle-stimulating hormone (FSH) level. The objective of this study was to evaluate the efficacy of tactile electrosurgical ablation of endometrium under rectal ultrasound guidance versus modified tactile versapoint hysteroscopic ablation in the management of perimenopausal abnormal uterine bleeding.

Patients and methods

This study was conducted in the Department of Obstetrics and Gynecology of Al-Azhar University Hospital (Assuit), Egypt on 50 perimenopausal patients with abnormal uterine bleeding. Patients were divided into two groups according to the method used. Group 1 included 25 participants, and ablation was done using tactile ablation guided by rectal ultrasound. Group 2 included 25 participants, who underwent hysteroscopic ablation using versapoint hysteroscope.

Results

Regarding sociodemographic study data, age in both groups ranged from 38 to 45 years, withPvalue of 0.903. Parity also showed no statistically significant difference between both groups. The incidence of complication was more in group 1 but less dangerous. Thermal injury of genital tract was seen in two cases in group 1 but no cases in group 2, withPvalue of 0.245. Cervical injury was seen in two cases in group 1 and one case in group 2, withPvalue of 0.500. Perforation occurred in two cases in group 1 and one case in group 2, withPvalue of 0.500. Regarding specific complication of endometrial ablation by versapoint hysteroscopic ablation, which occurred in group 2 only, by distension media, four cases had complications such as hyponatremia (decrease in serum sodium of 10 mmol/l). Postoperative complication such as hematometra occurred in one case only in group 1, withPvalue 0.500. The cost range in group 1 was from $14 to 20 and in group 2 it was from $40 to 50, withPvalue less than 0.001**. The time of surgery ranged from 10 to −15 min in group 1 and from 20 to 30 min in group 2, withPvalue less than 0.001**. After 6 months, two cases came back with recurrent Hge in group 1 and six cases in group 2, withPvalue 0.123.

Conclusion

Tactile ablation is easier, effective, and less costly.
Vestibular assessment in occupational noise-induced hearing loss
Authors: Ismail Naema M. , Behairy Reda M.A.A. , Galhom Dalia H. , Metwally Shimaa A.E.A.A. E.A.
Published: April 2024

Background

Occupational noise can cause hearing loss and also may affect the vestibular system and result in vestibular dysfunction.

Aim

To study the effect of noise exposure on the cervical vestibular-evoked myogenic potential (cVEMP) and ocular vestibular-evoked myogenic potential (oVEMP) and to correlate between duration of noise exposure and vestibular dysfunction if present.

Patients and methods

A total of 60 patients were included in this study, comprising a study group of 30 patients with noise-induced hearing loss and a control group of 30 healthy participants with normal hearing and vestibular function. Patients of both groups underwent cVEMP and oVEMP.

Results

cVEMPs showed a highly statistically significant difference between the study and control groups regarding P13 and N23 latencies and P13–N23 amplitude, and oVEMPs showed a statistically significant difference between the study and control groups regarding N1 and P1 in latencies and N1–P1 amplitude. A positive correlation was found between duration of noise exposure and VEMPs latencies, whereas a negative correlation between it and VEMPs amplitude.

Conclusion

Noise exposure is a hazard to inner ear structures that can enhance the damage of vestibular part, especially the sacculocolic pathway.
Comparative study between noninvasive techniques for diagnosis of helicobacter pylori in patients with dyspepsia
Authors: Khirala Seham K.A. , El-dydamoni Omnia A. , Abdel Rehim Soad E. , El missiry Mervat M.
Published: April 2024

Background and Aim

Helicobacter pylori (H. pylori) is a common etiology for infection-related cancers and represents 5.5% of global cancer burden that increases the need for more sensitive noninvasive diagnostic techniques. The aim was to evaluate the role of saliva and stool samples in the diagnosis of H. pylori infection to replace invasive techniques and to compare between three noninvasive diagnostic tests: salivary culture, PCR, and rapid stool antigen test (RSAT).

Patients and methods

The study was conducted on 45 patients with dyspepsia and 45 healthy participants as a control. Saliva and stool samples were taken from all groups and subjected to culture, PCR for detection of 16SrRNA gene of H. pylori, and RSAT to detect H. pylori. Gastric biopsy samples were taken for H. pylori culture, rapid urea test, and histopathology from 20 patients.

Results

A total of 15.6% specimens were positive by salivary culture in patients’ group and 2.2% specimens were positive in the control group. About 31% were positive by salivary PCR in patients’ group and 6.7% were positive by salivary PCR in the control group. About 71% were positive by RSAT in patients and 49% were positive by RSAT in controls. From 20 patients, gastric biopsy samples were taken, 11 patients were positive for H. pylori infection by gastric biopsy culture, 20 were positive by histopathological examination, and 13 were positive by rapid urea test. The salivary culture showed (100%) specificity, (38.5%) sensitivity, and (60%) accuracy. While PCR on saliva showed specificity (100%), (61.5%) sensitivity, and (75%) accuracy. RSAT showed (71.4%) specificity, 92.3% sensitivity, and 85% accuracy.

Conclusion

The oral cavity is an important extragastric reservoir of H. pylori; salivary PCR technique shows a much higher specificity and sensitivity than salivary culture. RSAT shows high sensitivity but with lower specificity.
Role of computed tomography and MRI in children with sensorineural hearing loss
Authors: Alkady Ahmad Mohamed Saeed , Al-Wahed El-Gebaly Saad Rezk Abd , Mansour Tarek Mohamed Mohamed , Elmoursy Kasem Mohamed M.
Published: April 2024

Background and aim

Given the tremendous developments in visualization science, there are many congenital and acquired internal ear anomalies that have no radiological signs. However, visualization is an important instrument for the assessment of congenital and acquired sensory neural hearing loss (SNHL) triggers. The aim is to assess the value of multidetector computed tomography (MDCT) and MRI in internal ear abnormality detection in children with SNHL.

Patients and methods

This study included 100 children of 10 years or younger with SNHL. The cochlea, the vestibule, the three semicircular canals, the endolymphatic duct, and the internal acoustic canal. In addition, three-dimensional DRIVE MRI gives good demonstration of all four nerves within the internal acoustic canal.

Results

A total of 46 malformations were detected in only 25 patients with 42 malformations that were detected in MDCT examination presenting 91% of all abnormalities, while in MRI examination, 44 malformations are detected presenting 96% of all abnormalities. MDCT showed accuracy, sensitivity, and specificity 96.7, 91.3, and 100%, respectively, while for MRI, it showed accuracy, sensitivity, and specificity 98.3, 95.7, and 100%, respectively.

Conclusion

Imaging plays an important role in the workup of children with SNHL. Therefore, it is imperative to define the etiology of hearing loss. High-resolution CT and MRI modalities are the two principal radiological investigations to detect various pathologies in the inner ear. ‘Dual-modality imaging’ using both MRI and CT, made sense for many patients because the dual-scan approaches detect abnormalities related to hearing loss that would not otherwise be found using either modality alone.
Growth arrest-specific 6 as a predictor of gastroesophageal varices in patients with liver cirrhosis
Authors: Eid Khaled A.-A. , Abdelmeguid Mona M. , Abdel-Gawad Muhammad , Kotb Amera A.N.
Published: April 2024

Background and aim

Early detection of patients with gastroesophageal varices at high risk of bleeding is crucial. Nevertheless, sparing endoscopy to low-risk patients would be of value. Therefore, noninvasive methods have been proposed. Our study aimed to verify whether plasma GAS6 concentrations are related to the presence and/or degree of esophageal varices in patients with LC.

Patients and methods

This cross-sectional study included 100 patients with LC who underwent upper gastrointestinal endoscopy.

Results

Mean level of GAS6 was 77.70±21.31 among enrolled patients. Patients with varices had significantly higher level of GAS6 in comparison with those without varices (82.93±18.12 vs. 45.57±4.18 ng/ml; P<0.001). Level of serum GAS6 was also increased with advancement in the variceal grade.

Conclusion

Plasma level of GAS6 was higher among patients having varices in comparison with those without, and its level was increased with advancement in the grade of varices. GAS6 is reported to have a good predictive value for hepatic fibrosis in patients with chronic liver disease.
Association between iron-deficiency anemia and febrile convulsion in children
Authors: Rashwan Sarah M.H. , Ahmed Yasser Abd El-Rahman , Ibrahim Ahmed K. , Kasem Ismail Abd El-Razek
Published: April 2024

Background and aim

Previous studies reported that iron-deficiency could be a risk factor for febrile seizure (FS), as the latter is more common in children younger than 2 years, and iron-deficiency anemia is also common in children of the same age. Yet, the relationship between iron deficiency and FS is not yet determined, and that is why this study was suggested. The aim of this study was to assess the association between iron-deficiency anemia and febrile convulsion (FC).

Patients and methods

This study included 60 children aged 6 months to 5 years. These children were divided into three groups: a group of 20 patients with FC, a group of 20 patients with fever but without FC, and a group of 20 healthy children.

Results

The main findings of this study were that there was a higher incidence of FSs found among children who received formula feeding. Furthermore, children with FSs had the lowest level of hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and transferrin saturation values. However, iron-deficiency anemia was not associated with increased incidence of FCs.

Conclusion

It can be concluded that formula feeding, low hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and transferrin saturation are reinforcing factors for FSs.
Trichoscopic criteria of different stages of male pattern hair loss
Authors: Mohammed Essam El-Deen Mohammed , Mahmoud Waleed Ahmed , Abd El-Hamid Mona Mostafa
Published: April 2024

Background and aim

Male pattern hair loss is a common noncicatricial alopecia that results from progressive miniaturization of the hair follicle. The aim of this study is to evaluate the role of trichoscopy in differentiating between severe and mild cases of male pattern hair loss.

Patients and methods

A hospital-based cross-sectional study was carried out on 300 males with pattern hair loss. Detailed history, clinical examination, and trichoscopy were performed. All participants were divided according to severity into two groups. Group 1 (n=207) included stages one, two, and three, while group 2 (n=93) included stages four, five, six, and seven on the basis of the Hamilton Norwood classification.

Results

The frequency of yellow dots, white dots, vellus hair, and hair shaft diversity (HSD) more than 20% was higher in group 2 than group 1 (P≤0.05).

Conclusion

Trichoscopy is a very valuable and useful method to differentiate between severe and mild cases of male pattern hair loss.
Serum sodium and potassium in asthmatic children
Authors: Ahmed Omar S. , Hamed Amira M.M. , Kassem Ismael A.R. , Fayed Hamada K. , Elmorsy Walid A.
Published: April 2024

Background

Asthma is a disease outlined by its clinical, physiological, and pathological features. Airways inflammation and hyperreactivity of bronchial tissues were the most important manifestations of bronchial asthma.

Aim

The aim was to evaluate serum sodium and potassium levels in pediatric asthmatic patients and match these levels during and in between the attack and with healthy control children.

Participants and methods

This was a case–control study that was done on pediatric patients with asthma. The cases were children with confirmed asthma of an age group of 5–12 years old, and the age-matched controls were children without respiratory signs or symptoms. Serum sample for measuring absolute eosinophilic count, sodium, and potassium value was obtained.

Results

The mean values of serum sodium during the attack and in between the attack were 136.78±2.66 and 140.51±2.62 mmol/l, respectively, with significant difference (P<0.05). Both the mean values of serum sodium were found to be significantly lower than the mean value of the control (141.58±2.34 mmol/l). The mean values of serum potassium during the attacks and in between the attacks were 3.28±0.44 and 3.94±0.32 mmol/l, respectively (P<0.05). Both the mean values of serum sodium, i.e., during and in between, were found to be significantly lower than the mean value of the control (4.12±0.32 mmol/l). Hyponatremia was detected in 8 and 6% of the asthmatic patients during the attacks and in between attacks, whereas hypokalemia was detected in 56 and 9% of the asthmatic patients during the attacks and in between the attacks.

Conclusion

The study showed that asthmatic patients presented with hyponatremia and hypokalemia, and there is a significant difference between serum sodium and potassium levels during attacks and in between attacks and when compared with the control group.
Effect of amlodipine and L-carnitine on bone metabolism in ovariectomized rats
Authors: Ghany Ahmed F.A. , Ashour Yasser M. , Aly Nawal B. , Abdelzaher Lobna A. , Mahmoud Ahmed S.
Published: April 2024

Background

Amlodipine as a calcium channel blocker has anti-inflammatory effect through overaugmentation of nitric oxide production and antioxidant effect by reduced superoxide radicals and increased level of superoxide dismutase. l-carnitine has anti-inflammatory action through reaction with acyl group that is accumulated in anoxic cells and antioxidant effect through decreasing the superoxide anion production.

Aim

The aim was to evaluate the possible ameliorating effect of amlodipine (AML) and L-Carnitine (L-C) combination on osteoporotic bony changes in ovariectomized (OVX) rats versus each drug separately. A total of 50 adult female albino rats (weighting 100–125 g) of local strain were chosen as an animal model for this study. The animals were randomly divided into five groups. Each group comprised ten rats: group 1, negative control; group 2, OVX rats, positive control; group 3, AML-treated OVX rats; group 4, L-C-treated OVX rats, and group 5, AML and L-C-treated OVX rats. Bony changes were examined through evaluating markers of bone turnover, such as alkaline phosphatase and osteocalcin; femoral metaphyseal histomorphology; and serum proinflammatory cytokines, such as tumor necrosis factor-α, expression.

Results

alkaline phosphatase, osteocalcin, and tumor necrosis factor-α were significantly elevated in positive control group, which was associated with marked deterioration of bone microarchitecture. Treatment with AML and L-C combination significantly mitigated inflammation and histopathological osteoporotic changes compared with each of AML and L-C drugs separately.

Conclusion

AML and L-C combination could have a synergistic role in management of radical osteoporosis in OVX rats over each drug separately.
The effect of antioxidant and iron chelator on metabolic bone turnover in ovariectomized rats
Authors: El-Refaey Mohamed E. , Ashour Yasser M. , Abdelzaher Lobna A. , Shabaan Maher A.
Published: April 2024

Background

Osteoporosis affects women severely, especially in older ages after menopause. It may lead to bad drawbacks that may be prone to considerable pathological conditions, for example, fracture and sever pain.

Objective

This study aims to identify the effect of antioxidant and iron chelator on metabolic bone turnover in ovariectomized rats.

Materials and methods

The rats were divided into five groups: negative control, positive control, desferal-treated, vitamin E-treated, and desferal+vitamin E-treated groups. Determination of serum estrogen, ferritin, alkaline phosphatase (ALP), tumor necrosis factor-α (TNF-α), and osteocalcin was done at the end of experiment. Moreover, morphology of bone in female rats was evaluated at the end of experiment.

Results

Ovariectomy led to decrease in serum estrogen level and increase in serum levels of ferritin, ALP, TNF-α, and osteocalcin. On the contrary, usage of desferal and vitamin E led to decrease in serum levels of ferritin, ALP, TNF-α, and osteocalcin. Regarding histological picture of bone, our results showed abnormal structure of the bone of the untreated group vs improved histological picture of the treated groups.

Conclusion

The female rats that were subjected to ovariectomy and experienced osteoporosis showed improvement in their bone by using desferal and vitamin E alone or in combination.
Comparison of hypertensive patients with left ventricular hypertrophy versus hypertensive patients without left ventricular hypertrophy using echocardiography and tissue doppler imaging
Authors: Yousof Waleed , Abdelghafar Mahmoud , El-Tayeb Ahmed
Published: April 2024

Background and aim

Systemic hypertension (SH) causes a gradual increase in the mass of the left ventricle, resulting in left ventricular hypertrophy (LVH). Derangement of LV function is caused by morphologic changes in the left ventricular (LV) walls, which result in hypertrophy. According to a recent meta-analysis, LVH raises the risk of cardiovascular morbidity and mortality. The aim was to compare between hypertensive patients with LVH and hypertensive patients without LVH regarding LV function (by Simpson's method) and myocardial performance index (by Tissue Doppler echocardiography).

Patients and methods

The study included 40 selected hypertensive patients and 20 healthy participants undergoing echocardiographic assessment at the echocardiography unit. The patients were classified into two groups: group I included 20 normotensive healthy control, and group II included 40 hypertensive patients. Group II was further divided into two subgroups according to the absence or presence of echocardiographic signs of LVH: group IIa included 20 hypertensive patients without echocardiographic signs of LVH, and group IIb included 20 hypertensive patients with echocardiographic signs of LVH.

Results

Regarding systolic and diastolic blood pressures, there was an extremely statistically significant difference between the two groups. Regarding LV mass index, there was a highly statistically significant difference. However, LVMI in subgroup IIa was normal in comparison with subgroup IIb, with an extremely statistically significant difference. Regarding ejection fraction (EF%), there was an extremely statistically significant difference between the two groups. Regarding EF%, there was an extremely statistically significant difference between group I and group IIa. Regarding EF%, there was an extremely statistically significant difference between subgroup IIa and subgroup IIb. Regarding myocardial performance index, there was an extremely statistically significant difference between the two groups (0.36±3.2 in group I vs. 0.51±4.8 in group II).

Conclusion

First, SH causes a cascade of LV hemodynamic changes that can range from maladaptive hypertrophy to heart failure. Second, Tissue Doppler echocardiography appears to be able to differentiate between the many types and degrees of LV dysfunction in SH, as well as the various stages of the hypertensive disease process. Third, Myocyte apoptosis and collagen deposition in the interstitial space appear to be factors that favor the transition from LVH to heart failure.
Tailored Helicobacter pylori therapy is more effective than conventional therapy
Authors: Elrakeeb Adel , Eltayyeb Sawsan H. , Elgazzar Amr , Elgendy Abdelaleem A. , Alboraie Mohamed
Published: April 2024

Background and aims

Tailored (culture and sensitivity) therapy has gained attention over recent years as an effective option for eradication of Helicobacter pylori infection. The authors aimed to assess the efficacy of antibiotics sensitivity-guided therapy versus clarithromycin or levofloxacin triple therapies as the first-line therapy for H. pylori.

Patients and methods

Dyspeptic patients who underwent esophagogastroduodenoscopy were prospectively enrolled. Patients with positive H. pylori results by the rapid urease test were randomized to receive either antibiotics sensitivity-guided therapy or empirical clarithromycin or levofloxacin-based triple therapy for 14 days. Antimicrobial sensitivity tests for seven antibiotics (clarithromycin, amoxicillin, metronidazole, levofloxacin, tetracycline, nitrofurantoin, and rifampicin) were performed using the disk-diffusion method. Group A received antibiotics sensitivity-guided therapies that included esomeprazole plus two antibiotics for which the isolates were sensitive and group B received conventional therapies that included esomeprazole, amoxicillin plus clarithromycin or levofloxacin for 2 weeks. Eradication of H. pylori was checked using stool antigen 4 weeks after therapy.

Results

A total of 25 patients completed the study in each group. Both studied groups were matched for baseline characteristics. The most commonly used regimen in the antimicrobial sensitivity-based therapy was clarithromycin-based triple therapy (46.5%), followed by levofloxacin-based triple therapy and levofloxacin and nitrofurantoin plus esomeprazole. The association analysis demonstrated that, in the intention-to-treat populations, the H. pylori eradication rate was significantly higher in the antibiotic sensitivity-guided therapy group [85.7% (24/28) vs. 53.3% (16/30) in the conventional therapy group (P=0.035). In the per-protocol populations, the eradication rate was 96% for the sensitivity-guided therapy group and 64% for the conventional therapy group (P=0.005). The rates of adverse events were similar in both sensitivity-guided and conventional therapies, with no significant differences (P=0.527).

Conclusions

Culture-based eradication therapy demonstrated superior eradication rates than empirical therapy as a first-line therapy for H. pylori in a region with high rates of antimicrobial resistance.
Electroretinography and visual-evoked potential changes in patients with nystagmus
Authors: Hassan Nihal Adel , Elaskary Abd Elhakeem Elsayed , Wahdan Mahmoud Abd Elrahman Ramadan
Published: April 2024

Background and aim

Nystagmus is an ocular motility disorder in which the eyes make uncontrollable, repeated movements. These movements can cause vision and depth perception problems, as well as affect balance and coordination. The aim was to study electrophysiological changes that occur in patients with nystagmus and pattern of changes in each disease.

Patients and methods

A prospective, institutional, clinical trial was conducted on 60 eyes with nystagmus. The age of the patients ranged between 5 and 50 years, and the patients were chosen from Al-Hassan Eye Center, Giza and Al-Azhar University Hospital outpatient clinic.

Results

The study revealed the relation between photopic electroretinogram (ERG), scotopic ERG, and flash visual-evoked potential (VEP) and each of fundus examination and final diagnosis of the studied group, and it shows highly statistically significant differences between groups according to fundus examination and final diagnosis.

Conclusions

Electrophysiological examination is an essential step in the assessment of patients with early-onset nystagmus especially when the eyes are apparently normal on routine examination and should be enrolled within their medical records. This study clarified the need to investigate cases with nystagmus by ERG and suggested that the ERG was useful where the diagnosis was uncertain. Visual-evoked potential is complementary to ERG and can be tested simultaneously.
Functional and radiological outcomes of impaction grafts and cemented cup for the treatment of acetabular bone deficiency in total hip arthroplasty
Authors: Bayoumy Maysara A. , Mohamed Mohamed M.
Published: April 2024

Background and Aim

Acetabular bone defects are one of the most difficult problems in both primary and revision total hip replacements. Many techniques have been described to deal with acetabular bone defects in total hip replacement, including the use of cement with or without cages and rings, structural bone grafting, and impaction bone grafts with cementless or cemented cups. The aim of this study was to asses short-term to midterm clinical and radiological outcomes of acetabular reconstruction by impaction bone grafts and cemented cups in both primary and revision cases indicated for total hip arthroplasty (THA) with acetabular bone deficiency.

Patients and methods

This is a retrospective study that included 26 patients with total hip arthroplasty (THA) who underwent acetabular bone defect reconstructions with grafting and cemented cups between December 2014 and January 2019. The mean age at operation was 45.3 years. Among the procedures, 12 were primary THAs, whereas 14 procedures were revision THAs. The morselized grafts were used in eight cases only, along with combined strut graft and morselized grafts in five cases, acetabular rim mesh and morselized grafts in 12 cases, and Kerboul cross-ring with morselized grafts in one case. All cases were clinically evaluated by Harris hip score in addition to radiological evaluation.

Results

All the patients except one showed clinical improvement, where the mean postoperative Harris hip score became 84. Radiograph follow-up for all the cases showed graft incorporation without loosening or any significant cup migration, except one case, which was revised owing to loosening around the cup.

Conclusion

The use of impaction graft and cemented cups is safe and reproductive even in young patients. Moreover, this technique reconstitutes bone and gives a stable platform of bone stock for further revision, especially in young population.
Corticosteroid treatment versus surgical treatment of chronic rhinosinusitis with nasal polyposis
Authors: El-Emam Amal M.M. , Mohamed Magda A. , Saif Eldin Doaa A. , Mostafa Soaad Y.
Published: April 2024

Background and Aim

The definition of chronic rhinosinusitis is inflammation of the nose and paranasal sinuses characterized by two or more symptoms like nasal obstruction, congestion of nasal mucosa, reduction or loss of smell, facial pain, and either endoscopic signs of polyps edema or mucosal obstruction primarily in middle meatus, maybe computed tomography changes showing mucosal changes within the ostiomeatal complex and sinuses. The aim of this study was to assess the outcome of medical treatment in comparison with functional endoscopic sinus surgery as a treatment of allergic nasal polyposis.

Patients and methods

A prospective study was carried out at Al-Zahraa University Hospital, Faculty of Medicine for Girls, Al-Azhar University, which included 40 patients (30 males and10 females) divided into two groups, mean age of group A (36.9±10.2) and mean age of group B (39.8±9).

Results

There is no statistically significant difference between both groups as regards runny nose, nasal obstruction, postnasal drip, smell sensation, taste sensation, sneezing, fascial pain, or headache before intervention. There is a statistically significant difference between both groups after intervention (by medication or surgery) as regards runny nose (P=0.034), nasal obstruction was highly significant (P=0.001), and smell sensation was highly significant (P=0.005), while there was no significant difference between both groups as regards other symptoms like postnasal drip, fascial pain, headache, sneezing, and taste sensation (P>0.05).

Conclusion

We conclude from our data that medical treatment was cost-effective and time-saving. Many patients who received medical treatment responded well to the point of refusing any surgical procedure, functional endoscopic sinus surgery is essential when medical treatment was not sufficient in improving manifestations.
Type 2 diabetes mellitus in lean Egyptian patients
Authors: Mahmoud Mahmoud E. , Shabana Hossam E.S. , Ahmed Mohamed A.E. , Selim Mohamed M.
Published: April 2024

Background

The prevalence of diabetes has increased exponentially over the past decade. Much has been published on its characteristics and its association with the obesity, but relatively little is known about the incidence of lean type 2 diabetes and its pathophysiology.

Aim

The aim was to determine the role of insulin resistance and β-cell dysfunction in disease pathophysiology in lean type 2 diabetic patients.

Patients and methods

The authors evaluated parameters including BMI, fasting blood glucose, fasting insulin, homeostatic model assessment for insulin resistance, and homeostatic model assessment for β-cell function percentage. This study was carried out on 300 adult patients who were classified into four groups: group I (lean type 2 diabetic patients with BMI ≤27 kg/m2), group II (obese type 2 diabetic patients with BMI >27), group III (lean controls), and group IV (obese controls).

Results

When comparing group I with group II, there was a statistically significant difference regarding the sex, where males (64%) were more in group I. Regarding homeostatic model assessment for insulin resistance, in group I, it was 2.00±0.79, whereas in group II, it was 4.97±1.22, with statistically significant difference (P=0.00), and regarding homeostatic model assessment for β-cell function percentage, in group I, it was 33.76±19.89, whereas in group II, it was 56.45±17.69, with statistically significant difference (P=0.00).

Conclusion

This study showed that lean type 2 diabetes was common in male sex and characterized by low level of insulin resistance and was associated with markedly reduced β-cell function in contrary to what occurred in obese type 2 diabetes with marked insulin resistance.
Endovascular evaluation of intracranial atherosclerotic stenosis in a sample of Egyptian patients presented with ischemic stroke
Authors: Hassan Mahmoud M. , Sobh Khalid M. , Galal Mahmoud , Ahmed Salah I. , Al Shazly Sherief M. , Shokry Abd E.
Published: April 2024

Background and aim

Intracranial atherosclerosis is an important etiology of ischemic stroke and is associated with multiple vascular risk factors. Endovascular evaluation is used for assessing patterns and distributions of intracranial atherosclerotic stenosis in a sample of Egyptian patients presented with ischemic stroke.

Patients and methods

A total of 50 patients with ischemic stroke or transient ischemic attack were included. Assessment of the state of cerebral vessels before the procedure was done by duplex ultrasound, magnetic resonance angiography, and/or computed tomography angiography to confirm any stenosis in intracranial vessels. Neurological assessment was done before and after the procedure using the National Institutes of Health Stroke Scale score. Digital subtraction angiography was done to evaluate the degrees and patterns of stenosis.

Results

A total of 50 participants (29 males and 21 females) were included. Their ages ranged from 30 to 78 years. The major risk factors were dyslipidemia (62.0%), hypertension (60.0%), diabetes mellitus (54.0%), smoking (48.0%), and atrial fibrillation (22.0%). The procedure was performed on 50 patients. A total of 39 (78.0%) patients had angiographic findings of vessel stenosis in either extracranial or intracranial vessels or both. In those 39 patients, 32 (64.0%) patients had arterial stenosis, and seven (14.0%) patients were found to have total occlusion. A total of 18 (36.0%) patients had angiographic findings of intracranial atherosclerotic stenosis. Of these 18 patients, 14 (28.0%) patients had arterial stenosis, and four (8.0%) patients were found to have total occlusion. The most common site of intracranial stenosis was middle cerebral artery (33.3%).

Conclusion

Endovascular evaluation of patients with ischemic stroke is yielding, informative, safe, and easy to be done.
Role of dialysate sodium and serum sodium gradient in intradialytic hypertension of regular hemodialysis patients
Authors: Fayed Mohamed M. , Mohamed Emad A. , Zidan Hindawy A. , Assem Ahmed A. , El-Sayed Moahmed A.
Published: April 2024

Background and aim

Sodium (Na+) balance largely depends on interdialytic dietary salt intake and intradialytic Na+ removal during hemodialysis (HD) for chronic renal failure cases. To preserve a normal Na+ equilibrium, interdialytic Na+ increase should be filtered during HD. Sodium gradient (Na+ G) is obtained by subtraction of the dialysate Na+ concentration and the patient's own pre-HD plasma sodium concentration. The aim was to evaluate the role of dialysate and serum Na+ G in patients with intradialytic hypertension (IDH).

Patients and methods

A cross-sectional observational study was done to evaluate the role of Na+ G in IDH in a cohort of HD patients followed in the dialysis center of Damanhur Fever Hospital. Among 119 prevalent patients on MHD in our center during period from March 2021 to July 2021, we found 26 patients with IDH, so we selected a control group of 26 patients with intradialytic normotension (age and sex matched). So, the study included 52 patients (age and sex matched) who were divided into two groups: group A included 26 patients who were intradialytic normotensive, and group B included 26 patients with IDH.

Results

A total of 52 patients were included in our final analysis. The sample included patients who are diagnosed with ESRD and under regular HD schedule, with a mean±SD age of 54.4±12.3 years. Comparison of different sodium concentrations revealed that there was no significant difference between pre-dialytic, and postdialytic Na serum levels, along with no difference in sodium gradients, with P values greater than 0.05.

Conclusion

IDH was not significantly associated with sodium gradient, age, sex, hemoglobin level, and predialytic and postdialytic serum sodium concentrations.
Comparison between ultrasonography and MRI in diagnosis of knee joint meniscal injuries
Authors: Abuomira Ibrahem Elsayed Abdellatif , Ahmed Yasser Abdelaal , Elshahat Mohamed Taha Abd Elghafar
Published: April 2024

Background and Aim

Meniscal tears are one of the most frequent disorders affecting the knee joint in athletes and normal people. MRI the first choice of imaging of knee joint but in recent days, ultrasound (US) has made strides in imaging of musculoskeletal disorders due to improvement of imaging qualities. This study aimed to investigate the role of US in diagnosis of meniscus tears as compared to MRI.

Patients and Methods

A total of 100 patients examined by high definition US and under go to MRI examination of the knee joint.

Results

Regarding the diagnostic performance of US compared to MRI, the sensitivity reached (89.1%), specificity (∼72.2%), positive predictive value (∼90.1%), negative predictive value (70.1%), and accuracy (84.7%).

Conclusion

Ultrasonography may be used as a screening tool before arthroscopy in selected cases where MRI was a contraindication or is not available or if the patient was not affording. Ultrasonography showed a dynamic image of the meniscus and thus may prove useful if studied in conjunction with correct clinical examination.