bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of serum irisin level in patients with chronic kidney disease
Authors: Ali Eman S. , Ali Abeer A. , Al Ramly Aml M. , Muhamed Marwa A.
Published: March 2024

Background

Energy imbalance is common among patients with end-stage renal disease. Altered circulating irisin level may occur in patients with end-stage renal disease and result in energy dysfunction.

Aim

To estimate serum irisin level as a diagnostic marker for the protein-energy wasting syndrome in patients with chronic kidney disease (CKD) and its relation with glomerular filtration rate.

Patients and methods

This is a case–control study. It was carried out at Internal Medicine Department of Al-Zahraa University Hospital and Damanhur Fever Hospital from March 2018 to March 2020. This study included 85 participants, and their age ranged between 20 and 50 years. There were 31 males and 54 females. A total of 55 patients with CKD irrespective of cause were classified according to estimated-glomerular filtration rate into 36 patients with stage III CKD and 19 patients with stage IV CKD, and 30 patients were included as a control group. Serum irisin concentration and the levels of hemoglobin, urea, creatinine, uric acid, albumin/creatinine (A/C) ratio, estimated-glomerular filtration rate, lipid profile, calcium, phosphate, sodium, potassium, and anthropometric measurement were measured.

Results

This study did not find a positive or negative correlation between serum irisin level and BMI in the case group, and skeletal muscle mass adjusted for fat area was not correlated with serum irisin concentration.

Conclusion

Irisin could not be used as a diagnostic marker for protein-energy wasting syndrome in patients with CKD.
Maternal plasma adiponectin concentration and its association with risk of gestational diabetes
Authors: Aziz Fatema A.A. , Kawy Samia I.A.A. , Mohammed Shaymaa A. , Elmenam Hend S.A.
Published: March 2024

Background

Gestational diabetes mellitus (GDM) is a metabolic disorder characterized by glucose intolerance of variable degree, with onset or first recognition during pregnancy. The global prevalence of hyperglycemia in pregnant women aged 20–49 years is 16.9%, and more than 90% of cases of hyperglycemia in pregnancy are estimated to occur in low-income and middle-income countries.

Aim

To observe changes in maternal plasma adiponectin concentration during 24–32 weeks of gestation in both healthy pregnant women and women with GDM for early detection of GDM.

Patients and methods

This case–control study was carried out on 88 pregnant women divided into two groups: group I included 50 pregnant women with GDM, and group II included 38 apparently healthy pregnant women who were selected as a control group, and their age was matched with patients. All participants underwent history taking, clinical examination, and oral glucose tolerance test, and plasma adiponectin was measured in both groups. Their analyses were done at Al Azhar University Center for Virus Research and Studies.

Results

There was a highly significantly decrease in plasma adiponectin levels (P<0.001) in patients with GDM when compared with the control group. The significant association between adiponectin and GDM suggests that low adiponectin levels may predict the development of GDM.

Conclusion

Findings of our study have demonstrated that low plasma adiponectin concentration was associated with GDM
Comparison between subtenon block and extraconal block during cataract surgery
Authors: Abd El-Galeel Ahmed M. , Badr Osama I.A. , Mohamed Khaled G.
Published: March 2024

Background

Most ophthalmic procedures are performed under local anesthesia, and cataract extraction is the most frequently performed surgery in elderly patients. The aim of this study is to compare the intraoperative hemodynamic variables, efficacy, and efficiency of extraconal block versus subtenon block with low concentration of local anesthetic during cataract surgery.

Patients and methods

This prospective, randomized, and single-blind study was done on 80 patients American Society of anesthesiologists status I–III undergoing cataract surgery, of which 40 patients underwent subtenon block (group S) and 40 patients underwent extraconal block (group E). Five minutes after the start of anesthetic monitoring care, 5-ml mixture of lidocaine 1% and bupivacaine 0.25% containing 100 IU hyalorunidase, in a mixture ratio of 1 : 1, was injected intraocular slowly. Patients were monitored for intraoperative hemodynamics, ocular movement during surgery, and intraoperative pain sensation as primary outcome, and onset of blockade, pain assessment within 30 min postoperatively, number of patients need rescue dose, surgeon discomfort, and postoperative complications as secondary outcomes.

Results

Mean arterial blood pressure and heart rate in group S were significantly lower than those in group E but within safety margin. No significant difference was found between the two groups regarding full range of eye movement, surgeon's discomfort grade during cataract surgery, and also, intraoperative pain sensation. The onset of blockade was significantly faster in group S than group E. Although group S had better postoperative analgesic effect than group E, postoperative rescue dose was of insignificant value.

Conclusion

Subtenon block seems to be a better local anesthetic technique than extraconal for cataract surgery, as it is faster, has less surgeon discomfort grading, and better postoperative analgesia. However, on the contrary, both subtenon and extraconal blocks are equally effective in pain control during surgery and also have good ocular akinesia during operation.
Endometrial hyperplasia versus carcinoma
Authors: El Kholy Marwa A. , El Kholy Eman A.
Published: March 2024

Context

Phosphatase and tensin homolog (PTEN) is a protein that acts as a tumor suppressor by dephosphorylating the lipid second messenger phosphatidylinositol 3,4,5-trisphosphate. Loss of PTEN function and mutation in PTEN gene have been implicated in the pathogenesis of endometrial carcinoma (EC).

Objective

The aim was to evaluate the immunohistochemical expression of PTEN in endometrial hyperplasia and EC and to evaluate the relationship between its expression and tumor grade in EC.

Materials and methods

Specimens included 16 cases of endometrial hyperplasia without atypia, six cases of atypical endometrial hyperplasia, and 18 EC specimens. Immunohistochemical staining for PTEN was performed using diaminobenzidine detection kit on formalin-fixed and paraffin-embedded tissue samples. Tumor tissue blocks and clinical data were collected from the files of the Pathology Department of Al-Zahraa University Hospital during the period 2010–2014.

Results

Immunohistochemistry showed that PTEN was positive for nuclei and cytoplasm of glandular endometrial cells. The PTEN expression was decreased significantly in atypical hyperplasia or EC compared with simple or complex hyperplasia (P0.041). In EC, we proved that PTEN expression is downregulated in high-grade tumors.

Conclusion

A positive PTEN expression correlates significantly with hyperplasia without atypia and well-differentiated tumors. The downregulation of PTEN indicates a more malignant phenotype.
Hepatitis B Seroprevalence among Egyptian University students in the postinfant compulsory vaccination period
Authors: El-Sayed Noha A. , Elshazly Sumaya H. , Said Zeinab N. , El Ela Abeer M.A. , Abdelmageed Neamat A.
Published: March 2024

Background

The three doses constituting the hepatitis B (HB) vaccine series administered intramuscularly at birth, 1 month, and 6 months induce a protective antibody response (anti-HBs >10 IU/l) in more than 90% of recipients.

Aim

To analyze the long-term immunity and effectiveness of hepatitis B virus (HBV) vaccination and to detect hepatitis B infection situation and its risk factors among an adequate number of the university students in the postcompulsory infant vaccination period.

Patients and methods

A total of 400 university students (aged 17–25 years) were screened for quantitative detection of hepatitis B surface antibody, hepatitis B surface antigen (HBs Ag), and total hepatitis B core antibody (HBc Ab) using commercially available kits. HBV DNA PCR was evaluated in repeatedly positive HBs Ag and/or total HBc Ab.

Results

Nonprotective titer less than 10 IU/l was detected in 218/400 (54.5%), whereas protective titer more than or equal to 10 IU/l was detected in 182/400 (45.5%). Overall, 29/400 (7.3%) were positive for HBs Ag and 50/400 (12.5%) were positive for total HBc Ab, whereas only six (1.5%) were positive for HBV DNA PCR. Moreover, 45/400 (11.4%) students had a history of HBV vaccine booster dose in the protective group.

Conclusions

Marked reduction in HBs Ab titer was observed among university students where nonprotective titer less than 10 IU/l was detected in 54.5%. Chronic HBV inactive carrier was detected in 5.3%, chronic hepatitis B was detected in 1.5%, and resolved HBV infection was detected in 11%.
Effect of high serum uric acid level on systemic lupus erythematosus manifestations
Authors: Ali Amany F. , El Refaei Khalida E. , Maghraby Hend M.
Published: March 2024

Background

Systemic lupus erythematosus (SLE) is a chronic, progressive, autoimmune disorder that affects multiple organ systems, with a broad range of clinical and laboratory manifestations. Considering the role of uric acid (UA) as a pro-inflammatory compound in SLE, serum levels of UA and its relation to severity and activity of the disease were assessed in patients with SLE.

Objectives

To evaluate the relation between high serum UA and SLE manifestations and correlate it with the disease activity.

Patients and methods

This study was conducted on 40 patients with SLE fulfilling the 2012 SLICC criteria for SLE classification and 20 sex-matched and age-matched apparently healthy participants as control group. All patients and controls were assessed by full clinical examination and laboratory investigations including serum urea and creatinine, serum lipids, 24-h urinary protein, antinuclear antibody, anti-double-stranded DNA, C3, C4, and serum UA. All patients were assessed for SLE disease activity by the systemic lupus erythematosus disease activity index.

Results

Serum UA was significantly higher in patients with SLE compared with the control group (P<0.001), and there was a significant increase of mean UA level in patients with active SLE (group Ia) compared with patients with inactive SLE (group Ib) (P<0.01). There were significant positive correlations between UA and protein in urine, pulmonary artery pressure, and disease activity in patients with SLE (group I) (r=0.362, 0.372, and 0.650, respectively; P<0.05).

Conclusion

Serum UA was higher in patients with SLE than control and correlated with disease activity, suggesting that it might play a role in SLE pathogenesis and can be used as a marker for SLE activity.
Comparison study between the outcome of laparoscopic and open repair of perforated duodenal ulcer
Authors: Abdelwahed Abdallah , Mashal Anas
Published: March 2024

Background

Duodenal ulcer perforation is a surgical emergency that may lead to a risk for major morbidity and even mortality. Patient selection criteria are crucial to guide the surgeon in selecting the option of laparoscopic approach for patients with perforated duodenal ulcers. The purpose of this study was to compare the resulting outcomes for laparoscopic and open approaches for the repair of perforated duodenal ulcers.

Patients and methods

A total of 26 patients with perforated duodenal ulcers were included in this study, operated at Alain Hospital and Ain Shams University Hospitals, from June 2013 to June 2016. A total of 13 patients were operated by the laparoscopic approach and 13 patients were operated by the open approach. Follow-up indices such as mean operative time, hospitalization expense, and postoperative pain were included. The main outcomes were immediate surgical postoperative complications, fatalities, and reoperation. Secondary outcomes included operative time, postoperative pain, postoperative hospital stay, and time to resume diet.

Results

There were no major differences in the selected patients between these two procedures in main outcomes including overall surgical efficacy including surgical complication rate and surgery-related deaths. Further analysis of the surgical outcome revealed that laparoscopic repair had less surgical wound complication rate (wound infections and incisional hernias) compared with the open approach. Otherwise both approaches had almost similar rates of leakage, intra-abdominal collections, and ileus and thromboembolic complications. Regarding the secondary outcomes, it was notable that postoperative pain was much less, return to the regular diet was earlier, and hospital stay was decreased in the laparoscopic approach. This remarkable improvement of the secondary outcome attributed to overall patient satisfaction in the laparoscopic approach.

Conclusions

Laparoscopic approach is comparable with the open approach as a modality of repair for perforated peptic ulcer in the properly selected patients. The obvious advantages of laparoscopic surgery are the lower surgical site infection rates, early return to regular diet, shorter hospital stay, early return to work, less postoperative pain, better cosmetic outcome, and improved overall patient satisfaction. However, more studies should be undertaken to further assess the safety and efficacy of laparoscopic repair for peptic ulcer disease in the high risk patients’ category.
Assessment of normal-appearing brain white matter in patients with optic neuritis and multiple sclerosis by magnetic resonance spectroscopy
Authors: Elgezery Mohammed M.A.H. , Ebrahim Essam M. , Shakweer Mustafa M. , Ibrahim Ahmad F.
Published: March 2024

Background

Multiple sclerosis (MS) is an inflammatory, demyelinating, and neurodegenerative disease of the central nervous system, characterized pathologically by disseminated areas of demyelination and variable degrees of axonal loss and glial scarring. Typical optic neuritis may be associated with MS and is the most common type of optic neuritis. Nonconventional MRI such as magnetic resonance spectroscopy (MRS) has been used to enhance our knowledge of the pathophysiology of MS.

Objectives

To evaluate metabolic changes of brain normal-appearing white matter among patients either presented with optic neuritis alone or those already diagnosed as having MS.

Patients and methods

This is a cross-sectional study that was carried out on 30 patients with MS and 30 patients with typical optic neuritis attending neurology MS clinic of Al Azhar University Hospitals. All patients were subjected to the following: detailed history talking, assessment of disease severity by the Expanded Disability Status Scale, routine laboratory investigations, radiological evaluation (MS protocol), and MRS.

Results

The results of the study revealed significant metabolic changes by MRS in patients with optic neuritis and MS.

Conclusion

MRS provides advanced insights into the pathogenesis of optic neuritis and MS by obtaining information on the microenvironment within the brain. This enhances the understanding of the mechanisms involved in disease progression. MRS opens a window to detect early conversion of patient of the typical optic neuritis into MS.
The role of ultrasonography in evaluation of hand and wrist joints in patients with rheumatoid arthritis
Authors: Saad Asmaa A. , Ali Wafeik E. , Galal Heba M. , Ali Hany M.
Published: March 2024

Background

Ultrasound (US) has been increasingly applied over the last decade to assess disease activity and the response to therapy in patients with rheumatoid arthritis.

Aim

The aim of the study was to highlights the role of grey scale ad power Doppler ultrasound in evaluation of rheumatoid arthritis diseases in hands and wrist joints.

Patients and methods

This prospective study included a total of 30 patients with rheumatoid arthritis were collected from the Rheumatology outpatient clinic, Al-Hussein University Hospital. This study was conducted between June 2019 to January 2020.

Results

By gray scale ultrasound, synovial thickening was detected in 30 patients (100%), active synovitis detected by using Doppler US in 15 patients (50%), effusion was detected in 20 patients (66.7%), bone erosions were detected in 6 patients (20%) and X-ray finding was detected in 1 patients (3.3%). There is no positive correlation between X ray and any other sonographic nor laboratory finding. On the other hand, a positive correlation between ultrasound detected synovial hypertrophy, joint effusion and power doppler. Also, Power Doppler has a positive correlation with synovial hypertrophy, bone erosions, Erythrocyte Sedimentation Rate and Disease Activity Score.

Conclusion

Grey scale ultrasonography (GSUS) is a reliable technique for assessment of both soft tissue and erosive joint changes occur in early stage in rheumatoid arthritis. Also, power doppler ultrasonography (PDUS) can evaluate synovitis and differentiating between inactive and active synovial hypertrophy.
Effects of volatile versus intravenous anesthesia on oxygenation and hemodynamic response during thoracotomy with one-lung ventilation
Authors: Mohamed Sherin Abd Elazim , ELsayed Goda Ruqaya M.
Published: March 2024

Background

The aim of this study was to evaluate the effects of total intravenous anesthesia by propofol and ketamine (ketofol) versus that of inhalational anesthetic technique using sevoflurane on oxygenation and hemodynamics before, during, and after one-lung ventilation (OLV) in adults undergoing thoracic surgery.

Patients and methods

Twenty-eight patients (American Society of Anesthesiologists) II–III were undergoing thoracic surgery requiring OLV. Each patient was randomly allocated to one of two groups: ketofol group, in which induction was performed with 1% propofol 1.5–2.5 mg/kg, with ketamine 1 mg/kg and, in the second group (sevoflurane), 8% sevoflurane. Fentanyl 2 μg/kg and cisatracurium 0.1 mg/kg was administered to both groups. Anesthesia was maintained with ketamine and propofol in the ketofol group and 2% sevoflurane in the sevoflurane group.

Results

Arterial blood gas analysis, end-tidal carbon dioxide concentration, heart rate, mean arterial pressure, and end-tidal concentration of sevoflurane were noted in the sevoflurane group. In patients receiving ketofol, fentanyl requirements were decreased when compared with the sevoflurane group. However, the total dose of phenylephrine was greater in patients receiving sevofluran when compared with those receiving ketofol (5 µg/kg/patient vs. 1.1 µg/kg/patient). Mean arterial pressure was reduced during the course of OLV in both groups, as compared with levels found before OLV (P<0.05). Sevoflurane anesthesia induced a significant reduction in heart rate, whereas no significant difference in heart rate was found in the ketofol group. Initiation of OLV caused a significant decrease in PaO2 and SpO2 in both groups, especially in the sevoflurane group, as compared with the ketofol group.

Conclusions

The combination of ketamine and propofol anesthesia has a relatively mild influence on hypoxic pulmonary vasoconstriction and more hemodynamic stability compared with conventional inhalational anesthetics with sevoflurane for OLV anesthesia.
Serum mir-30e and mir-223 as novel noninvasive biomarkers for hepatocellular carcinoma
Authors: El Bagoury Iman M. , Al Ramly Amal M. , El Ghonimy Abd Elaty M. , Farrag Enas A.
Published: March 2024

Background

Liver cancer is the sixth most common cancer that accounts for 7% of all cancers. Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide with ∼600,000 new cases per year, and it is the second leading cause of cancer-related deaths alone.

Aim

The aim of this work was to study the clinical utility of miR-30e and miR-223 as early novel biomarkers for HCC in chronic viral hepatitis patients.

Patients and methods

In this study, we tested two serum microRNAs (miRNAs), 223 and 30e, that can be used as potential biomarkers to diagnose HCC. A total of 55 patients were divided into three groups. Group I included 20 newly diagnosed patients with HCC on top of chronic hepatitis C virus infection. The HCC group included 11 male patients and nine female patients with ages ranging from 55 to 65 years. Liver masses discovered on surveillance by abdominal ultrasound were further investigated by triphasic abdominal computed tomographic scan. Group II included 20 patients of chronic hepatitis C virus with no HCC (10 male patients and 10 female patients), with ages ranging from 53 to 63 years. Group III included 15 apparently healthy participants as a control group (five male individuals and 10 female individuals), with ages ranging from 55 to 61 years and who were selected from relatives and friends. The samples were analyzed by quantitative real time PCR to detect both miRNAs.

Result

Our study revealed that both miRNAs, 30e and 223, were expressed at significantly lower levels in the sera of patients with HCC compared with healthy participants.

Conclusion

Expression levels of miR-30e and miR-223 were reduced in HCC sera; they have potential as noninvasive biomarkers for diagnosis of HCC, with high specificity and sensitivity for miR-30e, although with moderate sensitivity and high specificity for miR-223.
Success factors of extracorporeal shock wave lithotripsy for renal and upper ureteric calculi in adults
Authors: Elmasry Hoda A. , Edris Ayman M. , Khalifa Mohammed K.
Published: March 2024

Background

Extracorporeal shock wave lithotripsy (ESWL) is considered the first-line treatment for most patients with renal and ureteric calculi, as it is safe and noninvasive.

Objective

The present study was undertaken to evaluate the most significant factors that influence the success rate of ESWL for renal and upper ureteric calculi in adults.

Patients and methods

This randomized prospective study for adult patients more than or equal to 18 years old included 50 patients with renal stone less than or equal to 2 cm and 50 patients with upper ureteric stone less than or equal to 2 cm. The included patients were treated with ESWL at Al-Zahraa University Hospital and National Institute of Urology and Nephrology between August 2018 and July 2019. Patients with multiple ipsilateral stones, bleeding disorders, impaired renal function, congenital abnormalities, untreated urinary tract infections, have BMI more than 30 kg/m2, pregnant women, and patients with radiolucent stones were excluded from the study. P value less than or equal to 0.05 was taken as the level of significance.

Results

The overall success of ESWL was 86 (86%), including 81 (94.2%) patients who had total stone clearance. The other five patients had Steinstrasse after the first session. The success rate of ESWL in males was 92.6% compared with 78.3% in females (P=0.040). The success rate of ESWL in patients with stent was 66.77%, whereas the success rate of ESWL in patients without stent was 90.2%, with P value 0.009. The success rate of ESWL in stone density more than 1000 HU was 80.8%, whereas the success rate of ESWL in stone density less than or equal to 1000 HU was 96.97%, with P value of 0.027.

Conclusion

ESWL should be considered a first-line therapy for treatment in patients with upper urinary tract calculi with density less than or equal to 1000 HU and size up to 20 mm. Stenting should be considered in certain cases when indicated.
Role of intraductal antibiotic in preventing cholangitis in post-endoscopic retrograde cholangiopancreatography patients
Authors: Ibrahim Fatma M. , Abd Elhamed Sally S. , Mahmoud Asem A. , Abdel Rahman Eman M.
Published: March 2024

Background

Acute cholangitis is one of the most serious life-threatening post-endoscopic retrograde cholangiopancreatography (ERCP) complications. Some have suggested that bacteria may play a role in the induction of post-ERCP cholangitis. Routine prophylactic systemic antibiotic use has an important role in reducing post-ERCP bacteremia. However, the beneficial effects of antibiotic use on preventing post-ERCP cholangitis are unclear.

Aim

The aim of the study was to assess post-ERCP cholangitis after intraductal antibiotic therapy in patients with obstructive jaundice.

Patients and methods

This cross-sectional prospective study was conducted on 60 Egyptian patients presented with obstructive jaundice who undergo elective ERCP procedure. In all, 20 patients received prophylactic intraductal 1 g ceftriaxone in contrast media; 20 patients received prophylactic intravenous ceftriaxone and 20 patients did not receive antibiotics. Pre-ERCP and post-ERCP laboratory tests and imaging were used to assess post-ERCP cholangitis. The study endpoint was developing cholangitis within 72 h after ERCP.

Results

There was highly significant increase in post-ERCP cholangitis in patients who did not receive antibiotics in comparison to other groups.

Conclusion

The use of prophylactic antibiotic prior to elective ERCP has a significant role in decreasing the frequency of post-ERCP cholangitis.
Bovine lactoferrin in preterm labor with sterile inflammation
Authors: Elmenam Hend S.A. , Farouk Mohammed H.
Published: March 2024

Background

Preterm delivery (PTD) that occurs before the 37th week of gestation complicates 10% of all pregnancies. Iron deficiency, iron-deficiency anemia, and inflammatory processes either related to infection or sterile inflammatory response represent risk factors for PTD (Genc and Ford, 2010). Bovine lactoferrin (BLF), an emerging important regulator of iron and inflammatory homeostasis, can represent a new therapeutic approach for PTD, with significant improvement of maternal serum interleukin 6 (IL-6) after oral administration.

Aim

The goal of the study was to evaluate the role of BLF in preventing PTD associated with sterile inflammation between the gestational age of 28 and 34 weeks.

Patients and methods

The study was carried out at Al Zahra University Hospital at the Department of Obstetrics and Gynecology, including 50 patients, with single pregnancy, no previous preterm birth, gestational age between 28 and 34 weeks, rhythmic uterine contraction (three to five contraction in 10 min; every one last from 40 to 60 s), cervical dilation of 2–4 cm and cervical effacement of ∼50–80% by local pelvic examination, and cervical length 2–3 cm and/or funneling by ultrasound. On admission, all patients were given 100 mg BLF and subjected to withdrawal of 5-ml blood, and samples were sent to Clinical Pathology Department to detect IL-6 before and after BLF intake.

Results

Oral BLF administration blocked further shortening of cervical length and prolonged pregnancy. This prospective study provides strong evidence for a role of BLF in PTD treatment, thus extending the therapeutic potential of this multifunctional protein.

Conclusion

Determination of maternal serum IL-6 may be useful for management of patients with preterm labor, and BLF can represent a new therapeutic approach of PTD.
Posterior tibial nerve stimulation vs trospium chloride in treatment of overactive bladder in elderly women
Authors: Elshora Islam A. , Soliman Amany A. , Ali Sayeda I.
Published: March 2024

Objective

This study aimed to assess the outcome of posterior tibial nerve (PTN) stimulation vs trospium chloride in the treatment of overactive bladder syndrome (OAB) in elderly women regarding safety and efficacy.

Patients and methods

A prospective randomized study was done on 30 postmenopausal women presented with OAB symptoms (wet or dry) in Al-Zahraa University Hospital from March 2019 to March 2020. Patients were classified into two groups. Group Ι included 15 patients who received trospium chloride. Group ΙΙ included 15 patients who were managed by percutaneous posterior tibial nerve stimulation (PTNS). The authors compared the patients in both groups for OAB symptoms (urgency, frequency, nocturia, and urge urinary incontinence) at 4, 8, and 12 weeks, and for urodynamic parameters at the beginning and the end of treatment.

Results

There was a statistically significant improvement regarding OAB symptoms and urodynamic parameters at the end of the treatment, with no significant difference between both groups. However, the adverse effects were observed mainly with trospium chloride group (dry mouth, constipation, and headache), which were not detected in the PTNS group.

Conclusion

The authors concluded that trospium chloride and PTN stimulation had the same effect in the treatment of OAB symptoms, and the two lines of treatment are effective and can be used safely in patients with OAB syndrome. However, PTNS is safe, and associated with significant improvement of OAB symptoms, with no significant adverse effect in comparison with trospium chloride, which led to discontinuation of treatment. However, initial studies showed promise. A more comprehensive evaluation of PTNS is needed to support its universal use for the treatment of OAB syndrome.
Trichoscopy of diseases leading to cicatricial alopecia
Authors: Kamel Abeer M. , Kamel Radwa O. , Amer Amina A.F.A.M.
Published: March 2024

Background

Scarring alopecias show loss of follicular ostia or atrophy. Clinical inflammation is frequently, but not always, present. Histologic inflammation may be present. Ultimately, histologic confirmation is the best method to confirm the presence of a fibrosing/scarring process with loss of hair follicles.

Objective

The aim was to identify possible characteristic trichoscopic patterns of diseases leading to primary cicatricial alopecia.

Patients and methods

Trichoscopy was carried out on 100 Egyptian patients clinically diagnosed to have cicatricial alopecia. Patients were randomly recruited from the Dermatology Outpatient Clinic, Al Zahraa University Hospital. Patients were categorized according to the cause of primary cicatricial alopecia into eight groups.

Results

In this study, the authors had 100 patients. The authors reached the final diagnosis by clinical examination in 83 patients, and 17 patients had a differential diagnosis by clinical examination. When the authors applied the trichoscope on 100 patients, the authors reached the final diagnosis in 98 of them, and two patients still had a differential diagnosis by trichoscopy, so the authors did biopsy for those two patients, and histopathological examination resulted in the final diagnosis.

Conclusion

This study confirms that a handheld trichoscope is a very efficient and simple diagnostic tool of cicatricial alopecia.
Single eye surgery by hang-back recession vs muscle transplantation in large-angle esotropia
Authors: Tawfik Ahmed M.R. , Ahmed Mahmoud M. , El Sayed Sayed M.
Published: March 2024

Background

A two horizontal muscle surgery cannot treat a very large angle of esotropia of more than 80 prism diopters (pd). A single eye surgery would not correct such a large angle. Supramaximal recession and resection would lead to restriction of ocular motility. True muscle transplantations have been tried for this abnormally wide-angle esotropia.

Purpose

The aim was to compare monocular surgery by hang-back recession vs muscle transplantation, regarding the technique, the expected results, and the possibility of minimizing the risk of complications, such as scleral perforation and a lost or slipped muscle.

Patients and methods

The study is a prospective and nonrandomized study that was held at the Ophthalmology Department, Al-Azhar University Hospitals, Egypt, during the period between May 2016 and May 2018 on 30 patients presenting with esotropia. A total of 15 patients had undergone medial rectus recession using the hang-back technique and 15 patients had undergone medial rectus recession with muscle transplantation. Conjunctival recession was done at the end of surgery, and lateral rectus resection was done in both groups. Their ages ranged from 4 to 58 years. Overall, 19 patients were males and 11 were females.

Results

There were nonstatistically significant differences between the two groups in all the follow-up visits.

Conclusion

True muscle transplantation is a safe alternative option and as effective as hang-back technique for large-angle esotropia. The procedure is stable in the long term, with some motility limitation in maximum adduction.
25-hydroxyvitamin D status and bone mineral density in Egyptian patients with type 1 diabetes
Authors: Fadl Amira M. , Hassan Zeinab A. , Basyouni Atef A. , Mohamed Doaa S. , Emara Ibrahim A.
Published: March 2024

Background

Vitamin D deficiency and diabetes mellitus are two common situations. Type 1 diabetes has been inconsistently associated with low bone mineral density (BMD) and increased fracture risk.

Aim

To assess serum vitamin D levels in relation to BMD in a sample of young Egyptian patients with type 1 diabetes mellitus.

Patients and methods

A case–control study was conducted on 90 participants, including 60 patients who were known to have type 1 diabetes and 30 age-matched, sex-matched, and BMI-matched healthy participants. Fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), serum calcium, serum phosphorus, alkaline phosphatase, 25(OH) vitamin D, and intact parathyroid hormone were measured. Left femur BMD and lumbar spine (L1–L4) BMD were measured by dual-energy radiograph absorptiometry.

Results

Mean values of vitamin D level and BMD were significantly lower in the patient than the control group. In the patient group, vitamin D deficiency and low BMD were found in 90.7 and 26.7%, respectively. In the patient group, a significant correlation was found between BMD Z-score at lumbar spine and left femur and fasting plasma glucose, postprandial, and HbA1c but not with vitamin D levels. A multivariate regression analysis was performed including different significant parameters, and only HbA1c was significantly correlated with left femur and spine BMD.

Conclusion

HbA1c is the only predictable variable for reduction of BMD in patients with type 1 diabetes mellitus.
Comparative study between ultrasound versus fluoroscopy-guided access during percutaneous nephrolithotomy
Authors: Elhashash Mahmoud M. , Fathi Basem A. , Awad Refaat M.
Published: March 2024

Aim

To evaluate percutaneous nephrolithotripsy (PCNL) guided by ultrasound (UG) versus fluoroscopy (FG) comparing both techniques regarding operative time, success, and complication rates.

Patients and methods

This is a randomized study that was carried out from March 2019 to February 2020 on 50 patients divided into two groups: group I included 25 patients who were guided by fluoroscopy, and group II included 25 patients who were guided by ultrasound.

Results

Stone-free rate was 88% in group I (FG PCNL), whereas it was 72% in group II (UG PCNL). Mean operative time was 90 min in group I (FG PCNL) compared with 97 min in group II (UG PCNL), with P value 0.001. The complications were intraoperative bleeding in six (24%) patients in group I (FG PCNL) and two (8%) patients in group II (UG PCNL), and postoperative fever in four (16%) patients in group I (FG PCNL) compared with two (8%) patients in group II (UG PCNL), with P value 0.051.

Conclusion

PCNL under US guidance is accompanied by high success rates with few complications, similar to that of fluoroscopy-guided PCNL, with decrease exposure to radiation.
Serum markers of iron metabolism in chronic hepatitis C virus infections
Authors: Diab Rania I. , El-Hagrasy Hanan A. , Mourad Fatma A. , Bahgat Seham
Published: March 2024

Background

Hepatitis C virus (HCV) infection is a common cause of chronic hepatitis, which leads to cirrhosis of the liver and hepatocellular carcinoma. Chronic hepatitis can cause iron buildup in the liver and result in liver injury. The major iron metabolism regulator, the hepatic hormone hepcidin, inhibits iron absorption and recycling, and as hepcidin is suppressed by the virus, it contributes to the pathogenesis of the liver.

Aim

To assess serum iron markers in patients with chronic hepatitis C (CHC) as opposed to people who are healthy and a summary of interactions of HCV and iron overload.

Patients and methods

This case–control study was performed on 30 hepatitis C-infected Egyptian patients (group I) and 15 apparently healthy control (group II). Routine laboratory investigations, as well as serum hepcidin and iron marker assessments were performed.

Results

Throughout this study, the serum hepcidin level in patients significantly decreased relative to the control group (P<0.001). The patients showed significantly higher serum iron, transferrin saturation, alanine aminotransferase, and aspartate aminotransferase compared with the control group (P<0.001). Serum albumin in patients’ group was considerably decreased in comparison with the control (P<0.05). There was a highly statistically significant lower platelet count value in patients compared with the control group (P<0.001). The interaction between hepcidin and iron, transferrin, and alanine aminotransferase is significantly negative.

Conclusion

Hepatic iron deposition is a joint feature in patients with CHC. Chronic HCV infection may reduce serum hepcidin, which may lead to iron overload in these patients. So hepcidin is a surrogate marker for evaluation of iron overload in patients with CHC.
(Quasi-)conformal methods in two-dimensional free boundary problems
Authors: De Philippis Guido , Spolaor Luca , Velichkov Bozhidar
Published: March 2024

In this paper, we relate the theory of quasi-conformal maps to the regularity of the solutions to nonlinear thin-obstacle problems; we prove that the contact set is locally a finite union of intervals and apply this result to the solutions of one-phase Bernoulli free boundary problems with geometric constraint. We also introduce a new conformal hodograph transform, which allows to obtain the precise expansion at branch points of both the solutions to the one-phase problem with geometric constraint and a class of symmetric solutions to the two-phase problem, as well as to construct examples of free boundaries with cusp-like singularities.
Amazon product recommendation system based on a modified convolutional neural network
Authors: Latha Yarasu Madhavi , Rao B. Srinivasa
Published: March 2024

In e‐commerce platforms, sentiment analysis on an enormous number of user reviews efficiently enhances user satisfaction. In this article, an automated product recommendation system is developed based on machine and deep‐learning models. In the initial step, the text data are acquired from the Amazon Product Reviews dataset, which includes 60 000 customer reviews with 14 806 neutral reviews, 19 567 negative reviews, and 25 627 positive reviews. Further, the text data denoising is carried out using techniques such as stop word removal, stemming, segregation, lemmatization, and tokenization. Removing stop‐words (duplicate and inconsistent text) and other denoising techniques improves the classification performance and decreases the training time of the model. Next, vectorization is accomplished utilizing the term frequency–inverse document frequency technique, which converts denoised text to numerical vectors for faster code execution. The obtained feature vectors are given to the modified convolutional neural network model for sentiment analysis on e‐commerce platforms. The empirical result shows that the proposed model obtained a mean accuracy of 97.40% on the APR dataset.
Games and narrative practice
Authors: Kulow Noor
Published: March 2024

In this presentation to the International Narrative Therapy and Community Work Conference in Rwanda, Noor Kulow introduces a range of narrative practices that have been used with children in Somalia who have lost their biological parents early in life. Externalising conversations, the Team of Life approach and traditional children’s games are used to respond to stigma, reconnect children with their hopes and dreams, and respond to trauma and hardship. Movement-based activities like leapfrog and jumping, and traditional games like girir and jar, provide entry points to therapeutic conversations.
On Critical Thinking
Authors: Heath Mary
Published: March 2024

In this audio recording of a favourite paper from the journal’s archives, Mary Heath sets out a personal history of her journey toward becoming a critical thinker. She considers two common barriers to critical thinking: cultural disapproval of critique, and confusing critical thinking with criticism. In response, Mary argues that rigorous thinking offers benefits – and not only risks – to cultures as well as individuals. The paper considers where cultural resources supportive of critique might be found. Further, Mary argues that critical analysis should be understood (and undertaken) as a process of collaborative support for rigorous thinking rather than as a form of hostile criticism. Some dimensions of critical thinking are outlined, together with questions that might allow readers to apply them to specific contexts. The paper closes with some reflections on the process of writing in which some of these dimensions of critical thinking are applied to the paper itself.
UNDERSTANDING OF AVARANA W.S.R TO KAPHAVRUTA AND
MEDHASAVRUTHA VATA IN THE PATHOGENESIS OF PAKSHAGATHA
Authors: - Sushmitha
Published: March 2024

Avarana is a unique concept in Ayurveda. Avarana is the path along which the pathogenesis of many diseases’
proceeds. There are many conditions which mimic Avarana. It is either unnamed or least diagnosed due to lack of
knowledge. Pakshagatha, one among the Vatajananatmaja vikara, is considered Vatavyadhi or Mahavatavyadhi.
It can either be due to kevala vataja, dosha samsrusta/margavarana or datukshayajanya. As the treatment principle is different for different types of pakshagatha, it is essential to understand the various types of pakshagatha.
Pakshagatha can be correlated to monoplegia, hemiplegia, paraplegia, and quadriplegia, which result after stroke
or CVA. Many kinds of Avarana vata are mentioned in Ayurvedic treatises based on Avruta and Avaraka. The
present article attempts to understand the role of kaphavruta and medasavruta vata in the pathogenesis of
pakshagatha.
Vegan labelling: use and understanding by consumers with food hypersensitivities
Authors: Turner Thomas , Pickles Harriet , Ipsos UK
Published: March 2024

In December 2023, the Food Standards Agency commissioned Ipsos UK to conduct an online survey with individuals who have or buy for those with food hypersensitivities (FHS) to allergens of animal origin to explore their use and understanding of vegan labelling as a proxy for allergen labelling.
The Use of Smartphone and Tablet Applications for Early Reading and Writing Skills
Authors: Aktay Sayım , Gök Seçkin
Published: March 2024

The aim of this study is to reveal teachers' views on smartphone and tablet applications for teaching reading and writing skills. The study was designed and conducted in the context of the phenomenology method, one of the qualitative research methods. The study group consisted of 15 volunteer primary school teachers who worked in Köşk district of Aydın province in the 2022-2023 academic year. The data were collected through semi-structured interviews. The data obtained from the interviews were analyzed using the "Nvivo for Windows" software and content analysis method. In this study, teachers found the reading and writing instruction applications designed for tablets and smartphones to be supportive and facilitative. Additionally, it was found that the applications contributed to capturing students' attention, provided opportunities for students to review what they learned, increased students' motivation, and shortened the learning process. Moreover, teachers were observed to use such applications at every stage, emphasizing the importance of auditory stimulation.
Spectral Expansion for Conformable Fractional Sturm- Liouville Problem on the Whole Line
Authors:   Department of Mathematics, University of Süleyman Demirel, Turkey, ALLAHVERDIEV BILENDER P. , TUNA HÜSEYIN ,   Department of Mathematics, University of Burdur Mehmet Akif Ersoy, Turkey, YALÇINKAYA YÜKSEL ,   Department of Mathematics, University of Süleyman Demirel, Turkey
Published: March 2024

In this article, we discuss a conformable fractional Sturm-Liouville boundary-value problem on the whole line. We prove the existence of a spectral function for the singular conformable fractional Sturm-Lioville problem. Further, we establish a Parseval equality and spectral expansion formula by terms of the spectral function for conformable fractional Sturm-Liouville problem on the whole line.
On the Proximal Point Algorithm of Hybrid-Type in Flat Hadamard Spaces with Applications
Authors:   Department of Mathematical Sciences, Kaduna State University, Nigeria, HARUNA LAWAL YUSUF , UGWUNNADI GODWIN CHIDI ,   Department of Mathematics, University of Eswatini, Nigeria, ALI BASHIR ,   Department of Mathematical Sciences, Bayero University, Nigeria
Published: March 2024

In this paper, we introduce a hybrid-type proximal point algorithm for approximating zero of monotone operator in Hadamard-type spaces. We then prove that a sequence generated by the algorithm involving Mann-type iteration converges strongly to a zero of the said operator in the setting of ﬂat Hadamard spaces. To the best of our knowledge, this result presents the ﬁrst hybrid-type proximal point algorithm in the space. The result is applied to convex minimization and ﬁxed point problems.
Sufficient Conditions of Subclasses of Spiral-Like Functions Associated with Mittag-Leffler Functions
Authors:   School of Advanced Sciences, Vellore Institute of Technology, deemed to be university, India, MURUGUSUNDARAMOORTHY GANGADHARAN , BULBOACĂ TEODOR ,   Faculty of Mathematics and Computer Science, Babeş-Bolyai University, Romania
Published: March 2024

The purpose of the present paper is to ﬁnd the suﬃcient conditions for some subclasses of analytic functions associated with Mittag-Leﬄer functions to be in subclasses of spiral-like univalent functions. Further, we discuss geometric properties of an integral operator related to Mittag-Leﬄer functions.
Representaciones Sociales del Aborto en un Contexto de Educación Superior de la Ciudad de Medellín-Colombia
Authors: Molina Paneso Natali , Pérez Cristián , Monsalve Yeison , Ocampo Daniela
Published: March 2024

El artículo presenta los resultados de un estudio orientado a comprender las representaciones sociales construidas sobre la práctica del aborto en mujeres estudiantes del Tecnológico de Antioquia, el cual es una Institución Universidad pública de Medellín, Colombia. El estudio tuvo un enfoque cualitativo, que se abordó desde una perspectiva fenomenológica; esto se realizó a través de grupos focales y entrevistas semiestructuradas; en los cuales se desarrollaron encuentros cercanos con las estudiantes, lo que les permitió expresarse libremente. La información se procesó mediante la técnica de matrices descriptivas, iniciando desde la transcripción de las técnicas de recolección, luego se trianguló dicha información, finalmente se elaboraron categorías inductivas y, se logró obtener como resultados que, el fenómeno del aborto es visto como un tema que aún es tabú en la sociedad, que en el ámbito religioso es un acto de pecado, se plantea, la necesidad de trabajar en el fenómeno, de forma profesional con asesorías psicológicas y políticas de bienestar institucional, para promover la atención oportuna y, prevenir afectaciones físicas y psicológicas en las mujeres que planteen realizarse un aborto, al igual que trabajar en programas enfocados a la prevención y promoción de la salud sexual y los derechos reproductivos.