bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic, Clinical and Imaging Characteristics of Axial Spondyloarthritis in Egyptian Patients
Authors: Eldeen Abdelbaky Mohamed Salah , Hassan Sameh Abd El-Mottleb , Morshedy Nashwa Aly , Farouk Alshymaa Mohamed , Eldeen Mohey Eldeen Noha Mohamed Gamal , Eldeen Hassan Mohamed Gamal
Published: November 2024

Introduction

Axial spondyloarthritis (axSpA) is a chronic, immune-mediated inflammatory disorder involving the sacroiliac (SI) joints and spine but can also involve entheses and peripheral joints. It encompasses both radiographic axial SpA (r-axSPA) and non-radiographic axial SpA (nr-axSPA), which are differentiated based upon the presence or absence of radiographic sacroiliitis, respectively.

Aim

To study the demographic features, clinical manifestations and imaging characteristics of axSpA in a cohort of Egyptian patients and to assess the differences between r-axSPA and nr- axSpA.

Patients and Methods

This cross sectional study was conducted on 80 patients who fulfilled the ASAS classification criteria for axSpA collected from Rheumatology outpatient clinic of Ain Shams University hospitals. Patients were further classified as r-axSpA or nr-axSpA based on radiographic findings according to modified New York classification criteria. All Patients were subjected to detailed medical history, assessment of disease activity, laboratory investigations & imaging.

Results

This study showed that the majority of r-axSpA patients were males while the majority of nr-axSpA patients were females. There is a statistically highly significant difference between both groups regarding smoking. hip arthritis was present more frequently in r-axSpA. Disease activity scores and modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) were higher in r- axSpA. There is no significant difference between both groups regarding co-morbidities, age at onset of symptoms, type of first symptoms, age at diagnosis, peripheral arthritis, extra- articular manifestations, family history, type of received drug & Human leukocyte antigen (HLA-B27).

Conclusion

Demographic features, clinical manifestations and imaging characteristics of axSpA of Egyptian patients are comparable with those of patients from different regions across the world except for low association with HLA-B27 & presentation of psoriasis as the most common extraarticular manifestaions. By comparing r-axSpA and nr-axSPA patients, both groups are significantly different regarding sex, smoking, hip arthritis, disease activity scores (ASDAS, BASDAI & BASFI) and mSASSS. Both groups are nearly similar regarding co-morbidities, age at onset of symptoms, type of first symptoms, age at diagnosis, peripheral arthritis, extra-articular manifestations, family history, type of received drug & HLA-B27.
(Vanin-1) Protein Level as Discriminating Factor between Primary Immune Thrombocytopenic Purpura and Thrombocytopenia Due to Acute Leukemia
Authors: Elsalakawy Walaa Ali , said Rasha Magdy Mohamed , Radwan Rania Abdel – Moniem , Hussein Abdalla Ahmed Nour Elhoda , Izzaldin Mohamed Ramadan
Published: November 2024

Background

Vanin-1 is an ectoenzyme with pantetheinase activity. It is highly expressed at the gene and protein level in many organs, such as the liver, intestine, and kidney.

Aim of the Work

The aim of this study was to measure Vanin-1 protein levels in patients with newly diagnosed primary immune thrombocytopenic purpura (ITP) and in patients with newly diagnosed thrombocytopenia due to acute myeloid leukemia (AML).

Patients and Methods

a comparative study made in Ain Shams University Hospitals, Clinical Haematology of Internal Medicine Department. The Vanin-1 protein level was measured by ELISA in patients with newly diagnosed ITP (n = 30), AML (n = 30), and healthy controls (n = 30). Demographic, clinical, and laboratory data were collected and analyzed.

Results

The mean age of the AML patients was higher than the mean age of the ITP and control groups. Male predominance was observed among the AML group, while female predominance was observed among the ITP group. Dyspnea, fatigue, and bleeding were the most common presentations among the AML group, while anemia and bleeding were the most common presentations among the ITP group. Vanin-1 levels were significantly higher in the ITP group compared to the AML group and healthy controls. ROC curve analysis showed that Vanin-1 could discriminate ITP patients from AML patients and healthy controls with high sensitivity and specificity.

Conclusion

Vanin-1 can be used as a predictive factor to differentiate ITP and AML cases from healthy non-diseased subjects, and also to differentiate thrombocytopenia due to AML from that due to ITP.
Effect of Vitamin D on Gastrointestinal Symptoms in Patients with IBS Randomized, Placebo-Controlled Study
Authors: Ahmed ElTouny Maha Abdel Aziz , El Maltawy Mohamed AbdelFattah , Bayoumy Essam Mohammed , Yaqut Hasan Muhammad Abdeltawab
Published: November 2024

Background

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, which can affect all members of a society, regardless of age, sex, race or socioeconomic status. Because of its high prevalence and chronic nature, it represents a significant economic burden. In fact, these patients have a relevant impairment of their quality of life, which limits their work productivity and daily social activities, especially when it is associated with other disorders, such as anxiety and depression.

Objective

To evaluate the Impact of Vitamin D as a potential therapy for treatment of IBS in Egyptian patients.

Patients and Methods

Our study was conducted on 90 Egyptian patients whose age is more than 18 years and have irritable bowel syndrome. Our study is a randomized placebo-controlled study that was conducted on Gastroenterology outpatient clinic at Ain Shams University Hospital from July 2018 to June 2020.

Results

There was non-statistical significant difference in baseline and 12 weeks IBSSS in placebo group (P = 0.075). There was non- significance difference between the two groups as regard baseline IBSSS (P = 0.572). However, mean of IBSSS after 12 weeks was lower in intervention group (155.0±53.9) than in placebo group (310.7±82.1) with statistical significance difference (p = 0.001). There was a significant negative correlation between serum vitamin D and baseline IBSSS (r = - 0.455) (P = 0.001).

Conclusion

High prevalence of Vitamin D deficiency about Egyptian patients with IBS. There was a significant negative correlation between serum vitamin D and baseline IBSSS. Vitamin D may be a potential therapy for treatment of IBS in Egyptian patients.
Prevalence of Selective Immunoglobulin A-Deficiency among Patients Diagnosed with Chronic Spontaneous Urticaria
Authors: EL-Deeb Mai Ahmed , Elkady Hossam Moustafa , Mahmoud Mayada Moneer , Ali Lamyaa Elsayed Mehriz , Lotfy Ibrahim Mostafa Mohamed
Published: November 2024

Background

Chronic spontaneous urticaria with angioedema is prevalent, affecting approximately 1% of the general population, and has a significant impact on quality of life, according to epidemiological data.

Aim of the Work

To determine the prevalence of Selective immunoglobulin A-deficiency among patients diagnosed with Chronic Spontaneous Urticaria.

Patients and Methods

This observational cross-sectional study was conducted on 104 patients attending Allergy Clinic at Ain Shams University Hospitals during the period from July 2023 to December 2023.

Results

Our results showed that 5 patients out of 104 cases were found to have Selective IgA deficiency. Our findings implicate that especially the combination of serum IgA and IgE levels is of relevance in the diagnostic workup of CSU patients. Notably, patients with lower IgA levels present different disease phenotypes such as recurrent respiratory tract infections, allergies, autoimmune diseases and gastrointestinal disorders and other complications. Such pathology urges patients with low IgA levels to seek early medical advice explaining why SIgAD patients in our study presented to us with a short-term duration of CSU. Not only low IgA levels was connected to lower eosinophil counts, but also, lower IgE level, independent of IgA values, is connected to lower eosinophil counts. The pathology underlying the decrease in immunoglobulin levels and their interaction in CSU was explained by impairment in antibody class switch with imbalanced immunoglobulin production, yet precise mechanism is still not well understood.

Conclusion

Our study focused on determining the prevalence of Selective immunoglobulin A-deficiency among patients diagnosed with Chronic Spontaneous Urticaria. Consistently, our results detected 5 patients out of 104 cases were found to have Selective IgA deficiency. Our research results strongly support that IgA and IgE level assessment is essential to further diagnose subtypes of CSU. Such assessment will potentiate the early formulation of appropriate therapy to each patient.
Endocrinopathies in Adult Egyptian Thalassemia Patients, A Cross Section Study
Authors: El-Salakawy Walaa Ali , Wahed Hassan Essam Abdel , Mohamed Said Rasha Magdy , Saeed Ahmed Alia Mohammed , moniem Radwan Rania Abdel , Hussien Abdalla Nour Elhoda
Published: November 2024

background

Endocrine abnormalities are the most common complications of transfusion dependent thalassemias (TDT). Although the prevalence of endocrinopathies is less in nontransfusion dependent thalassemias (NTDT), they are still encountered, especially with advancing age. This necessitates regular screening. Evaluation and treatment of endocrinological disorders are the same as that of transfusion dependent patients.

Aim

is to asses the common endocrinal disorders in patients with thalassemia; TDT and NTDT for early detection and replacement therapy.

Subjects and Methods

This study is across sectional study, it included 100 patients with thalassaemia; 50 patients who were (TDT) and 50 patients who were (NTDT). Patients who are ≥ 18 years old, with thalassemia major TM and thalassemia intermedia TI, Patients with or without splenectomy, Transfusion dependent and non-transfusion dependent patients, all were included in the study.

Results

Study showed that there is a statistically significant positive correlation between serum ferritin and thyroid stimulating hormone(TSH) and there is negative correlation with Sex Hormons, S.Cortisol, GH level. Also there is negative correlation between (Sex Hormons, S.Cortisol, Growth hormone GH) and frequency of transfusion. Study shows that Validity of serum ferritin at cutoff point more than 1100 for prediction of patients who are transfusion dependent.in terms of sensitivity was 100% and specificity was 90%.

Conclusion

thalassemia’s patients are still suffering from many endocrine disorders, and This necessitates early regular screening, as Early identification of endocrinal disorders and use of iron chelation reverse this disorders.
Effect of Dialysate Temperature and Patient Hematocrit on the Diffusive Permeability during Hemodialysis in Prevalent Hemodialysis Patients
Authors: Mohammed Essa Radwa Mohammed , El Sayed Hesham Mohammed , Abdelmageed Emara Ahmed Abdelmoniem , Elsharabasy Reem Mohsen
Published: November 2024

Introduction

Although hemodynamic stability with lower dialysate temperature is well established, it is still not known if there is a compromise in uremic clearance with cool dialysate therapy.

Objectives

Assessment of the effect of dialysate temperature and patient hematocrit on solute diffusion in hemodialysis patients.

Methods

Cross section of 50 adult clinically stable ESRD patients on thrice weekly hemodialysis sessions were recruited. Patients were divided into two groups according to their hematocrit (Hct) value into group (A): 25 patients with Hct below or equal to 30% and group (B): 25 patients with Hct above 30%. Each patient in both groups received two HD sessions with different dialysate temperature setting, one with 36° C and the other with temperature set on 37 °C. Laboratory investigations as serum, urea, creatinine, CBC, Kt/V and virology were done at the start of the study sessions and at the end of the same sessions.

Results

Patients were age and sex similar, with HTN being most common cause of ESKD in both groups. No significant change in URR, Kt\V or ultrafilteration volume between both groups at either dialysate temp. SBP showed higher value in patients with higher Hct with a trend of significance (p-value 0.09) with dialysate of 37ºc. Patients in both groups showed significant increase in intra-dialytic change in creatinine at dialysate temperature of 36ºc compared to 37ºc.

Conclusions

Our study suggests that lowering the dialysate temperature from 37 °C to 36 °C for patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (HD) does not significantly impact dialysis adequacy parameters (URR and KT/V) or blood pressure, unlike intradialytic creatinine change with cool dialysate sessions, which showed a significant increase. Moreover, hematocrit changes were not associated with significant difference in HD adequacy parameters.
Correlation between Serum Betatrophin Level and Histological Grading of Nonalcoholic Fatty Liver Disease
Authors: Hussein Reham Ekram , Ghaly Sameh Mohamed , Hegazy Nedal , Radwan Hisham Hamdy , Sabry Kareem , Allah Shaimaa Hussien Gad
Published: November 2024

Background

Nonalcoholic fatty liver disease (NAFLD) is recognized as the hepatic manifestation of metabolic syndrome frequently co-existing with obesity, dyslipidemia, and insulin resistance. It is characterized by hepatic steatosis in the absence of secondary causes such as significant alcohol consumption, chronic viral hepatitis, medications that induce steatosis, or other chronic liver diseases such as autoimmune hepatitis, hemochromatosis, or Wilson’s disease. NAFLD can be subcategorized into nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH).

Aim of the Work

to find out the role of Serum Betatrophin in predicting the presence of Nonalcoholic Fatty Liver Disease (NAFLD) and determining the correlation between Serum Betatrophin and Histological Grades of Nonalcoholic Fatty Liver Disease.

Patients and Methods

90 Patient from Hepatology outpatient clinic in Ain Shams university hospital and Ahmed Maher Teaching Hospital was included in our study. The study population was assigned in two groups: Group A: Patient with biopsy proved NAFLD. Group B: Patient with healthy liver.

Results

In addition to Renal Function Test: Serum Creatinine & Blood Urea, Lipid Profile (Serum Cholesterol, TAG, LDL, HDL),Thyroid Function Test (TSH, FreeT3, FreeT4), FBS, PPBS, HbA1c%, Iron Profile (Iron, Ferritin) ceruloplasmin level, and serum Betatrophin Level. Pelviabdominal ultrasouography. Liver Biopsy using 16-G Non reusable Needle for group A was done. All the liver biopsy samples was include at least 10 total portal tracts and it was as long as 20 mm, stained with Haematoxlin & Eosin and Masson Trichome for histopathology.

Conclusion

NAFLD is a disease which occur more common in male and obese people. Patients with NAFLD may have low hemoglobin level low platelet count and reduced number of white blood cells. Liver function test such as liver enzyme, bilirubin level, Prothrombin concentration and Alpha Feto protein all are affected with NAFLD. Increase level of triglycerides is an independent risk factor in pathogenesis of NAFLD. Glycemic control and HBA1C level play a vital role in the occurrence of NAFLD also poor control of blood glucose lead to increase risk of NASH and progression to fibrosis.
Prevalence of Zinc Deficiency in Sample of Egyptian Children with Short Stature
Authors: Ali Mohammed Saad Hassan , Botros Raef Malak , Bekhet Meram Mohamed , Nesim Mina Michael
Published: November 2024

Background

Zinc deficiency has adverse effect on growth and sexual development due to their direct effect on growth hormone metabolism. Zinc is a metal with great nutritional importance and is particular necessary in cellular replication.

Objective

to investigate the prevalence of zinc deficiency in sample of Egyptian children (in El Minya Government Primary School) with normal healthy and correlate it with short stature.

Methods

This is A Cross section simple randomization study for 6month from December 2022 to May 2023 At Elemam malk and Elweahada primary schools at Nazlet Elbarsha village on El Minia government over 500 health children all of them were subjected to full medical history taking and full clinical examination with weight, height body mass index and put on growth chart plot

Results

The prevalence of low serum zinc level was 25,8%, Normal zinc level was 74,6%, Highly significant association between serum zinc level and short stature, Zinc deficiency is less prevalent in male than female No significant correlation was found between serum zinc level and age, weight height, BMI, gender and anthroprometric. Finally serum zinc may contribute to short stature in primary school children in El minia government Egypt.

Conclusion

Serum zinc may contribute to short stature on small children aged (7-12 years) in EL Minia government Egypt.
Study of Musculoskeletal Involvement and Inflammatory Arthritis of the Hand and Wrist in Egyptian Systemic Sclerosis Patients
Authors: Habeeb Reem Abdelmoneim , Morad Caroline Samy , Motaher Alshaymaa Mohamed Farouk , Othman Sara Mahmoud
Published: November 2024

Background

Systemic sclerosis (SSc) is a complex autoimmune connective tissue disease characterized by widespread tissue and internal organ fibrosis, immune system activation, and vasculopathy. Articular symptoms are common and are associated with increased morbidity and mortality, ranging from arthralgia, tendon friction rubs to frank arthritis and contractures.

Aim of the Work

Is to study the musculoskeletal involvement and hand and wrist arthritis among Systemic Sclerosis patients.

Patients and Methods

This is a cross-sectional study with 30 SSc patients were selected from Rheumatology outpatient clinic and inpatient department Ain Shams University hospital. All the patients were diagnosed according to the 2013 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) SSc classification criteria. Informed consent was taken from all participating subjects.

Results

The mean age of all patients was (40 ± 9.9) years and the mean disease duration was 5.4 ± 4.1 years. Most patients were females, and some had positive family history of autoimmune disease. The majority of patients were receiving steroids, and some were receiving other medications. Regarding clinical manifestations, various symptoms were reported, including dysphagia, Raynaud’s phenomenon, digital ulcers, pitting scars, and telangiectasia. Joint space narrowing, erosions, osteophytes, and calcinosis were also observed in some patients.

Conclusion

In conclusion, this study sheds light on the musculoskeletal involvement and inflammatory arthritis of hand and wrist in SSc. However, further studies are needed to confirm these findings and explore other aspects of this disease.
Liver Injury in Non-ICU Hospitalized Patients with COVID-19: A Retrospective Single Center Study
Authors: ElKarmoty Khaled Zakaria , Ahmed Osama Ashraf , Samaan Amira Isaac , Abdelhaleem Tamer Abdelhaleem Nasr
Published: November 2024

Background

The new corona virus SARS-CoV-2 (COVID-19) is the cause of severe acute respiratory syndrome (SARS), a severe form of viral pneumonia. The virus spread rapidly from China to the rest of the world in a very short time and with considerable intensity and severity creating a “global emergency.” The global pandemic COVID-19 caused by the new coronavirus SARS-CoV-2 has already caused about 1.4 million deaths.

Aim of the Work

The main aim of this study was to evaluate the incidence of concurrent elevation of AST, ALT, and Bilirubin, examine their dynamic changes throughout the course of COVID-19 patients.

Patients and Methods

This was a retrospective cohort study that was carried out in Ain Shams University isolation Hospitals including 200 adult patients of both genders with confirmed COVID- 19 from March 2020 to June 2020.

Results

The mean age of mild severity group was 56.77 (±13.09 SD) with range (24 - 80) and among them there were 19 (30.6%) males. The mean age of severe group was 60.52 (±14.68 SD) with range (25-82) and among them there were 26 (54.7%) males. There was statistically significant difference between the studied groups as regard Sex. There was high statistically significant difference between the studied groups as regard Hospital stay. Hospital stays ranged from 2 - 20 days. Disease duration ranged from 8 - 27 days. There was no statistically significant difference between the studied groups as regard co-morbidity. The most common morbidities among the studied group were hypertension and diabetes mellitus. There was statistically significant difference between the studied groups as regard AST and bilirubin. As regard comparison between the studied groups as regard Lab finding During stay; there was statistically significant difference between the studied groups as regard AST and bilirubin. As regard comparison between the studied groups as regard Lab finding at discharge; there was statistically significant difference between the studied groups as regard bilirubin.

Conclusion

The hepatic consequences of SARS-CoV-2 infection are now recognized as an important component of COVID-19.
HCV Relapse in Hemodialysis Egyptian Patients after Treatment with Direct Acting Antiviral Drugs
Authors: Elhamid Eid Wael Ahmed Abd , Aziz Bahnacy Abdallah Abdel , Abdel Atty GadAllah Abdel Nasser , Abdel Wahed Aliaa Sabry
Published: November 2024

Background

HCV infection is a major health problem in Egypt and unfortunately its prevalence is more in hemodialysis patients than general population, the advent of DAA led to increased rate of recovery and lower rates of side effects rather than standard interferon therapy, but relapse of HCV is not uncommon among these patients. Purpose: the aim of the current study was to assess the incidence of relapse among hemodialysis patients with HCV after treatment with different regimens DAAs and to identify the risk factors that might be associated with this relapse.

Patients and Methods

This case- control study was held in Shibin El-Kom Teaching Hospital, Menoufia, Egypt in the period between June 2015 and June 2020. The study included 250 hemodialysis patients with chronic HCV and previously treated with DAAs. Patient were classified according to DAA treatment response into patients with HCV relapse (186 patients) and a non-relapse group(64 patients).both groups were assessed regarding predictors and risk factors for HCV relapse.

Results

There were no statistically significant differences between both groups as regard age, sex, diabetes and ischemic heart disease. Hypertension was prevalent in non-relapse group with statistical significance(p = 0.0001). Sofosbuvir + Daclatasvir + Ribavirin regimen was the most commonly used regimen in relapse group (53.2%0 while Ritonavir/Ombitasvir/Paritaprevir+Ribavirin combination therapy was utilized more in non- relapse group, both showed statistical significance (p = 0.0001). HCV viral load, liver cirrhosis and hepatic focal lesion were predictors of treatment non-response.

Conclusion

In conclusion, multiple risk factors exist for HCV relapse after primary response to direct acting antiviral. These factors included hypertension, cirrhotic liver, presence of space occupying lesions, Sofosbuvir- based regimen, degree of hypoalbuminemia, degree of liver enzymes elevation, high bilirubin, and elevated alfa fetoprotein and viral load by HCV PCR. cirrhotic liver, space occupying lesions, sofosbuvir- based regimen and high alfa fetoprotein are the most significant predictors for HCV recurrence after primary response to direct acting antiviral in hemodialysis population.
Nested PCR Targeting the Flagellin Gene (fliC) in Urine Sample for Diagnosis of Typhoid Fever – An Internal Pilot Study
Authors: Fouad Mona Mohammad , Fathy Maha Muhammad , Fathi Marwa Saad Mohammed , El-Folly Runia Fouad , Khater Walaa Shawky
Published: November 2024

Introduction

Typhoid fever remains a significant public health challenge, especially in developing countries. Diagnostic complexities arise from the disease’s non-specific clinical manifestations that overlap with other febrile illnesses. Hence, reliable laboratory testing is crucial. Nested polymerase chain reaction (PCR) stands out for its diagnostic performance, especially when utilizing urine due to its minimal PCR inhibitors and ease of collection.

Aim

The study aimed to test the performance of Salmonella enterica serotype Typhi (Salmonella Typhi) fliC gene specific nested PCR in urine for laboratory diagnosis of typhoid fever.

Subjects and Methods

This observational, cross-sectional study was conducted as an internal pilot study during the period from August 2021 to October 2022. It included 25 clinically diagnosed enteric fever patients, recruited from Al-Abasseya Fever Hospital, Cairo, Egypt, and 25 healthy individuals as controls, matched for age and sex. Nested PCR was performed to detect the fliC gene of Salmonella Typhi in urine samples from both patients and controls. Urine culture was conducted for subjects in both groups, while blood and stool cultures were exclusively performed for the patients' group.

Results

The sensitivity of the nested PCR test targeting the fliC gene in urine was 44%, with a specificity of 88%. The positive predictive value was 78.57%, the negative predictive value was 61.11%, the positive likelihood ratio was 3.7, and the negative likelihood ratio was 0.63. Blood culture isolation exhibited a very low positivity rate of 4%.

Conclusion

Nested PCR targeting the fliC gene in urine samples holds promise as a diagnostic tool for typhoid fever. Despite its moderate sensitivity, the relatively higher specificity suggests its potential utility in confirming typhoid fever cases. The test offers a valuable adjunctive tool alongside conventional diagnostic method. However, further research and validation may be necessary before widespread clinical application. The performance of the test needs to be evaluated in clinically diagnosed and laboratory confirmed cases of typhoid fever.
Electroencephalographic Abnormalities in Stuttering Children
Authors: Ahmed Nahed Salah Aldeen , Nada Maha Ali Mohamed , Elfiky Yomna Hassan , Behiry Amira Farah Hedaya
Published: November 2024

Background

Electroencephalography (EEG) can be used to acquire an on-going record of the electrical activity of the brain with excellent temporal resolution.

Aim of the Work

The aim of this study was to determine EEG patterns of stuttering children.

Patients and Methods

This was a cross sectional curried out at outpatient clinics in Ain Shams University hospitals.

Results

There was no statistically significant relation found between the change in EEG and age of the studied patients with p-value = 0.319 while there was statistically significant increase in male patients in patients with positive EEG changes (86.7%) than those with no EEG changes (56.0%) with p-value = 0.045.

Conclusion

Only 37.5% of cases had an abnormal EEG, all of whom were reported as right-handed. Varying EEG abnormalities were found, including focal epileptiform discharges were in (73.3%) of abnormal cases and multifocal epileptiform discharges were in the rest (26.7%).
Social Cognition and it’s Correlation with Alexithymia and Emotional Dysregulation in Patients with Borderline Personality Disorder
Authors: Hatata Hisham Ahmed , Hassan Elrassas Hanan Hany , Naguib Rehab Mohamed , Mahmoud Asmaa Ali Abdelsalam
Published: November 2024

Background

Borderline Personality Disorder (BPD) is a prevalent psychiatric illness characterized by interpersonal instability, self-image disturbances, affective dysregulation, and impulsivity. Despite its high prevalence, BPD often goes underdiagnosed. Social cognitive deficits, including impairments in recognizing facial emotions and mentalizing, have been proposed as potential contributors to the social difficulties observed in individuals with BPD.

Objectives

This study aimed to compare social cognitive performance between individuals with BPD and healthy controls, and to examine the correlations between social cognition, alexithymia, and emotional dysregulation in BPD.

Methods

A case-control study was conducted over a nine-month period, involving 30 BPD patients and 30 healthy controls. Participants underwent structured clinical interviews for psychiatric diagnosis, as well as assessments for social cognition using the Reading the Mind in the Eyes Test and the Faux Pas Recognition Test. Additionally, emotional dysregulation and alexithymia were evaluated using the Emotion Regulation Questionnaire and the Toronto Alexithymia Scale, respectively.

Results

BPD patients demonstrated deficits in recognizing intentions, thoughts, and emotions compared to controls. Significant differences were observed in Faux Pas Recognition and Mind in Eye Test scores, with BPD patients performing worse. Emotional regulation scores, specifically cognitive reappraisal and expressive suppression, were significantly lower in BPD patients. Valence testing indicated higher prevalence of negative valence in BPD patients. Notably, BPD patients exhibited significantly higher scores on the Toronto Alexithymia Scale, particularly in identifying and describing emotions.

Conclusion

This study highlights distinct social cognitive impairments in individuals with BPD, manifested through difficulties in recognizing emotions and intentions. Moreover, BPD patients demonstrated higher levels of alexithymia and emotional dysregulation. These findings underscore the importance of addressing social cognitive deficits and emotional dysregulation in the assessment and treatment of BPD, aiming to improve social functioning and overall quality of life for affected individuals.
Correlation between D-Dimer and Size of Non-Lacunar MCA Infarction and its Relation to Functional Outcome
Authors: Marwan Aya Ebrahim , Ibrahim Mohamed Hamdy , Helmy Shahinaz Mohamed , Khaled Elewa Mohamed
Published: November 2024

Background

Stroke is the second highest cause of death globally and a leading cause of disability, with an increasing incidence in developing countries. D-dimer (D-D) is the ultimate product of plasmin-mediated degradation of fibrin-rich thrombi. D-D is a simple readily accessible biomarker employed within the diagnostic algorithms for the exclusion of venous thromboembolism. The correlation between D-D and infarct size in MRI brain in acute stroke patients and predict their functional outcome by using modified Rankin scale (mRS) has not been fully investigated before.

Objectives

We aimed to investigate correlation between plasma D-Dimer level and the ischemic lesion size of non-lacunar MCA infarction in MRI brain and predict functional outcome of these patients.

Patients and Methods

This cross sectional study Included 30 acute ischemic stroke (MCA) patients fulfilled the inclusion and exclusion criteria admitted to Stroke Unites of Ain Shams University hospitals in which particle-enhanced, immunoturbidimetric assay to detect plasma D-Dimer concentration measured upon admission. additionally, demographic, clinical, laboratory, and neuroimaging information was Abstracted. Also, using mdified Rankin scale (mRS) to follow up patients as a tool to assess functional outcome.

Results

In this study there was a statistically significant positive correlation between of D-dimer levels on admission and the initial infarction volume in MRI (DWI) (Test-value)=21.28 and p-value.000). The Increase of D-dimer level was associated with increase of the initial infarction volume in MRI and vice versa. There was direct statistically significant positive correlation between the D-dimer and the mRS scores of the patients (r=.155 and p- value = .005)and the best cut- off limit of D-dimer levels done to patients early after admission (in the 1st 24 hours) in predicting poor outcome was 650 ng/ml which achieves 85.71 % sensitivity and 87.5% specificity.

Conclusion

The plasma D-D biomarker can be a simple readily available test reliable predictor of infarct lesion size in DW-MRI and functional outcome for patients with ischemic stroke in union with the common practice instrumental tests.
Stent Retriever versus Contact Aspiration in Management of Acute Ischemic Stroke; Egyptian Experience
Authors: Amin Aref Hany Mohammed , Elbassiouny Ahmed Ali Ibrahim , Mohammed Hossam Shokri , El-Sudany Ayman Hassan Othman , Abushady Eman Mones Mahmoud , Abd El Monem Eslam Ali Hamed
Published: November 2024

Background

Mechanical thrombectomy (MT) has become the standard treatment in patients suffering from acute ischemic stroke (AIS) due to large vessel occlusion (LVO). It can be classified into thrombo-aspiration, stent-retrieval, and aspiration-retriever combined technique. The evidence on the optimal therapy with acceptable outcomes of safety and efficacy is still limited. Therefore, we conducted this study to compare between stent retriever versus aspiration techniques in MT regarding procedural safety and incidence of complications.

Methods

This prospective cohort study was conducted at Ain Shams University Hospitals, Egypt. One hundred patients admitted to stroke unit with anterior circulation AIS who met inclusion criteria for MT were recruited over three years from March 2020 to March 2023. The included patients were divided into two groups: group one included 50 patients treated with stent retriever and group two included 50 patients treated with contact aspiration thrombectomy.

Results

The median (IQR) for age was 64 (52.5 – 71.5) years. 53 (53%) were males and 47 (47%) were females. No significant difference was found between the compared techniques regarding procedure time (p-value=0.551), time to recanalization (p-value=0.090), thrombolysis in cerebral infarction score (TICI) (p-value=0.461.

Conclusion

Among patients with ischemic stroke in anterior circulation undergoing MT, contact aspiration and stent retriever were comparable regarding successful recanalization rate.
Association between Serum Neurofilament Light Chain Level and Cognitive Performance in Multiple Sclerosis Patients
Authors: Awad Eman Mahmoud , Ahmed Metwally Fatma Metwally , Nada Maha Ali Mohammed , Ibrahim Shaimaa Sayed
Published: November 2024

Background

Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system (CNS) in young adults causing demyelination in its nerve fibers which lead to axonal damage resulting in many potential symptoms physically, mentally and even psychiatric symptoms. It’s also an autoimmune disease so it’s a lifelong condition which progress along its course through life.

Aim of the Work

To study the relationship between cognitive function and serum level of (NFL) in patients with MS.

Patients and Methods

cross sectional pilot study conducted on 64 Patients with clinically definite relapsing remitting MS and recruited from the MS unit, Ain Shams university. 32 MS patients according to inclusion criteria and 32 MS patients with no cognitive impairment, as a control group. Both groups were between 20 to 40 years old.

Results

we found a strong connection between cognitive function (measured by the SDMT) and the level of sNfL. This suggests that higher levels of sNfL may be linked to poorer cognitive function in individuals with MS. Additionally, the study provides a cut-off value of > 5.9, which can be utilized to classify cases as positive or negative.

Conclusion

found a highly statistically significant difference between the cases and the control group, indicating a strong relationship between cognitive function (measured by the SDMT) and the level of sNfL in patients with MS. This suggests that higher sNfL levels may be associated with worse cognitive function in MS patients. The cut-off value of > 5.9 is also provided, which can be used to classify cases as positive or negative.
Assessment of Visual Memory in Idiopathic Pediatric Age Epilepsy
Authors: Tharwat Hoda Abdallah , EL-din Ahmed Nahed Salah , EL-Khayat Naglaa Mohamed , Bedros Rady Yousif
Published: November 2024

Background

Epilepsy is defined as “at least two unprovoked seizures occurring more than 24 hours apart or a single unprovoked seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years or a diagnosis of an epilepsy syndrome”. In epileptic patients, memory is the most affected domain of the cognitive functions. There are many contributing factors were proposed to affect visual memory dysfunction as duration of uncontrolled seizures, age of onset, frequency of seizures, dosage of antiepileptic drugs (AEDs), and abnormal epileptiform discharges on the electroencephalogram (EEG), number of antiepileptic drugs.

Aim of the Work

To determine the prevalence and risk factors of visual memory affection in children and adolescent with idiopathic epilepsy for better detection, management and quality of life.

Patients and Methods

This study was across sectional study for 50 pediatric epileptic patient aged from 8-18years old Ain Shams University hospitals, at pediatric neurology and epilepsy outpatient clinics with study period 6 month, met the inclusion and exclusion criteria. Benton visual retention test used to measure visual memory affection in pediatric epilepsy.

Results

A study on 50 pediatric patients showed that there is significant correlation between Benton & age in pediatric epileptic patients with P value < 0.05. Also, it shows there is significant correlation between Benton and onset with P value < 0.01. It also shows there is a significant correlation between Benton and duration of illness with P value<0.05. It also shows there is a significant correlation between Benton and IQ with P value < 0.01.

Conclusion

In conclusion, Benton scale is a appropriate assessment scale that indicate memory dysfunction. This study allowed us to detect the incidence of visual memory impairment among our pediatric patients and it also predicts the influencing factors. This is help us in management of our patients as this make us paid more attention for age, early age of onset, for duration of illness and IQ this will encourage early treatment and control of fits and will lead to early referral for cognitive rehabilitation and IQ assessment.
Effect of Heparin Reversal by Protamine Sulfate on the Outcome of Thrombolysis in Acute Ischemic Stroke after Percutaneous Coronary Intervention
Authors: Fawzy Khaled Fayez , Aref Hany Mohamed , Abd ElAziz Azza Abd ElNasser , Elbassiouny Ahmed Ali Ibrahim , Kenawy Fatma Fathalla , Shehata Emad Effat Fakhry
Published: November 2024

Background

Acute ischemic stroke (AIS) after percutaneous cardiac catheterization (PCI) is a known complication with incidence reports of ranges between 0.2% and 0.5%. It is associated with an in-hospital mortality rate of 20%, with markedly increased long-term mortality (1). Administration of Intravenous thrombolysis (IVT) is the recommended standard of care in acute ischemic stroke during the first 4.5 hours from stroke onset. However, current guidelines exclude intravenous thrombolysis in heparinized patients with partial thromboplastin time (PTT) greater than 40 seconds (2) Protamine is an efficient antidote known for the anticoagulant effect of heparin, and it can neutralize its effect within 5 minutes (3).

Aim of the Work

To assess the safety of IVT after heparin reversal by protamine sulfate in ischemic Stroke patients After PCI.

Patient and Method

The total number of patients who developed early IP stroke (within 4.5 hours from the end of PCI) was 42. All of them received loading antiplatelets before PCI.

Results

out of 21 patients received IVT after heparin reversal by protamine, no patient had died, 2 cases had non symptomatic intracranial hemorrhage (ICH), with significant improvement in stroke parameters and shorter length of stay

Conclusion

IVT following heparin reversal by protamine in appropriately selected AIS patients appears to be safe from a symptomatic ICH standpoint and may be beneficial. Extreme caution is warranted in applying these results to routine clinical practice. Rather, we suggest that thrombolysis may still be considered in AIS patients on therapeutic heparin who are not candidates for MT
Neurocognitive Changes in Adolescents with Synthetic Cannabinoids Use Disorder
Authors: Azim El Toukhy Lamyaa Abdel , Mohamed Ahmed Saad , Razik Mohamed Yasser Abdel , El Din Abdel Moneam Mohamed Hossam , Morsy Mahmoud Hassan Ali
Published: November 2024

Background

Synthetic cannabinoids are one of the most used novel psychoactive substances among adolescents with eminent adverse effects affecting cognitive functions and psychomotor performances. It was previously thought that undesirable effects brought by synthetic cannabinoids are more potent than organic cannabis products in terms of duration and intensity. This study aimed to assess the effects cannabis and synthetic cannabinoids on executive functions, whether persistent use is associated with their impairments and if related with the severity of addiction.

Methods

We recruited 60 male adolescents from Okasha Institute of Psychiatry, Helwan Psychiatric hospital, and El Sahel youth center being 20 synthetic cannabinoids use disorder, 20 cannabis use disorder and controls. Teens Addiction Severity index was performed, then assessment of cognitive functions by Wisconsin card sorting test, Wechsler memory scale revised, Trail making tests, Benton visual Retention test and neurological soft signs with Cambridge neurological inventory.

Results

No statistical significance found regarding neurological soft signs and Benton Visual Retention test. In Wisconsin card sorting test, synthetic cannabinoids patients are statistically higher in trials administered and trials to complete 1st category while tetrahydro-cannabinoid patients are statistically higher in perservative responses and errors. Regarding trail making tests, synthetic cannabinoids patients are statistically higher. Concerning Wechsler memory scale revised, controls are statistically higher in Verbal Paired Associates I and II, Visual Paired Associates I and II, and digit span total while synthetic cannabinoids were statistically higher in memory span total.

Conclusion

There is no difference in neurological soft signs, visual perception, and visual memory. Frontal lobe executive functions are affected between substance use patients; synthetic cannabinoids affected more regarding initial conceptualization ability while tetrahydro-cannabinoid patients affected more regarding cognitive flexibility. Regarding visual scanning and working memory, synthetic cannabinoid patients are more affected. Concerning different memory functions, substance use patients are more affected than controls with synthetic cannabinoid patients being more affected.
The Interplay between Intimate Partner Violence during Pregnancy and Birth Outcome
Authors: Ali Radwa Gomaa Ahmed , Nahas Gihan Medhat Mohammed E L , Ramy Ahmed Ramy Mohammed , Gamal El Missiry Marwa Adel , El-din Abd Elmoneam Mohamed Hossam
Published: November 2024

Background

Intimate partner violence is behavior by a partner or ex-partner that causes physical, sexual, or psychological harm and includes physical aggression, sexual coercion, psychological abuse, and controlling activity An earlier study in 2019 was conducted on the data collected from the 2014 Egypt Demographic and Health Survey (EDHS) revealed that the total prevalence of all forms of abuse was 29.4%.

Aim of the Work

To explore the association between prenatal exposure to intimate partner violence (IPV) among pregnant women to adverse birth outcome either maternal or neonatal. Compared to those who are not exposed to IPV. Explore socio-demographic and clinical correlates.

Patients and Methods

This study is a cross sectional Comparative Cohort study conducted at obstetrics and Gynecology in ASU hospital, in Cairo, Egypt. And the study period starting March 2023 till October 2023.

Results

there was significant correlation between exposure to emotional and harassment abuse and wife’s education, with P-value of 0.046 and 0.014 respectively. Yet, there was no significant correlation between wife’s education and exposure to severe combined abuse, physical abuse and neither with total composite abuse scale scores with P-values of 0.086, 0.921 and 0.136 respectively. No significant correlation between partner’s education and exposure to any type of abuse (severe combined abuse, physical abuse and harassment) and neither with total composite abuse scale scores with P-values of 0.569, 0.111, 0.399, 0.701 and 0.777 respectively. This may be because most of the woman in the Arab countries is thought that her golden role is to be house wife and no need for high level of education. we explored 15 adverse outcomes in the relation to exposure to IPV during pregnancy: psychiatric sequalae in mother (post-partum depression, postpartum anxiety), physical sequalae in mother (Preterm labor, premature rupture of membrane, gestational hypertension, gestational diabetes, vaginal bleeding, abnormal placentation, dehydration, urinary tract infection, spontaneous abortion, induced abortion), physical sequalae in neonate (intrauterine growth retardation, preterm birth (born before 37 completed weeks) and low birth weight< 2500 g).

Conclusion

Involving 100 puerperal women, significant correlations were found between exposure to intimate partner violence (IPV) during pregnancy and various adverse outcomes, including preterm delivery and postpartum depression. The findings highlight the serious consequences of IPV on both maternal and neonatal health, with preterm birth rates being notably higher among women exposed to IPV.
Pain Characteristics in Egyptian Patients with Parkinson’s Disease
Authors: Mohamed Salma Reda , Shalash Ali Soliman Ali , Salem Haitham Hamdy , El Sayed Roushdy Tamer Mahmoud
Published: November 2024

Background

Parkinson’s disease (PD) is the most common movement disorder. The clinical findings of PD consist of cardinal motor features in addition to non-motor symptoms (NMS). Pain is one of the most common NMS in PD. The classification of pain in PD is still a matter of debate. However, in 2015, the King's Parkinson's disease Pain Scale (KPPS) was introduced as the first disease specific scale to assess pain in PD.

Objectives

To investigate the prevalence and severity of different types of pain in PD patients.

Patients and Methods

This cross-sectional observational study was conducted on 45 PD patients recruited from the movement disorder outpatient clinic at Ain Shams University Hospitals in which the KPPS was obtained from all participants.

Results

All the PD patients reported at least 1 type of pain. Regarding the number of pain types experienced per patient, 13.33% of patients had only 1 type of pain, 8.89% reported 2 types, and the majority (77.77%) had 3 types or more. Fluctuation- related pain was the most common (75.56%), followed by musculoskeletal pain (73.33%), nocturnal pain (68.89%), chronic pain (66.67%), edema/swelling (55.56%), orofacial pain (46.67%), then finally radicular pain (40%). The mean total KPPS score (reflecting both severity and frequency) in those patients was 39.73 ± 25.92 (range 1 – 98).

Conclusion

PD patients suffer from highly prevalent and severe forms of different types of pain. Therefore, proper assessment and management of different types of pain is essential for better care and QoL of people with PD. KPPS is an easy and fast tool to assess pain severity, frequency, and its different types.