bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Early & Late Hypocalcemia Post Total Thyroidectomy in the Early Learning Curve Retrospective Study
Authors: Elanwar Ali Mohamed , Omran Hesham Mohamed Ali , Elhamied Mohamed Abd Elstaar Abd , Abdallah Amer Abdelghany
Published: August 2023

Background

Hypocalcemia post total thyroidectomy, is one of the most common complications observed in patients who undergo bilateral thyroid resection. Although hypocalcemia is self-limiting in most patients and does not require treatment, symptomatic hypocalcemia is of particular concern. We aimed to evaluate the incidence of hypocalcemia post total thyroidectomy with an evaluation of serum calcium levels as a cheap and available method so we can identify patients at risk of postoperative hypocalcemia who require supplementation treatment, and those not at risk who can be safely discharged without any supplementation treatment.

Aim of the Work

To analyze the data of post total thyroidectomy regarding calcium level temporary and permanent in the early learning curve and compare it with the standard incidence of developing hypocalcemia with total thyroidectomy in the literature.

Patients and Methods

Retrospective analysis of 120 patients undergoing total thyroidectomy. Preservation of parathyroid glands and their blood supply was attempted in all cases. The patients were assessed for manifestations of hypocalcaemia after thyroidectomy. The assessment was done through (1) monitoring the total and ionized calcium level 24 hours postoperatively, (2) Total and ionized calcium level was measured in the third week postoperative, (3) clinical examination and detection of symptoms and signs of hypocalcaemia, (4) In resistant cases assessment of total and ionized calcium and PTH at 3 and 6 months.

Results

The study included 103 females and 17 males, 37 was the mean age; 15 patients developed symptoms of hypocalcaemia all of them recovered from hypocalcaemia except 1 patient.

Conclusion

There is no difference between the incidence of temporary and permanent hypocalcemia in the early learning curve and the standard incidence of temporary and permanent hypocalcemia post total thyroidectomy
Doppler Guided Haemorrhoidal Artery Ligation in the Management of Symptomatic Hemorrhoids
Authors: Abdel-Mageed Ahmed Alaa-Eldin , Abdel-Samea Yasser Mohammed , Boutros Ayman Magdy , Morshed Ibram Nady Nashed
Published: August 2023

Background

Hemorrhoid ligation with mucopexy is a simple, safe and cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. It can be performed on an outpatient or day care basis on grade 3 and 4 hemorrhoids to control bleeding and prolapsing hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.

Objective

To evaluate prospectively the outcome of Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids.

Patients and Methods

Types of studies: A prospective study. Study setting: The study conducted in Ain Shams University Hospital (El Demerdash) under supervision of these supervisors. Study period: Six months.

Results

It is easy for the surgeon to learn it and acquire appropriate skills after a short learning curve. The HAL is a minimally invasive technique that is conceptually painless for patients since all maneuvers and sutures are endoanal and above the dentate line; this helps an early recovery and allows an ambulatory procedure. We must bear in mind that postoperative pain is often the most common concern for patients and professionals dealing with hemorrhoids. The results of HAL in this study show a very low postoperative pain rate (two patients_ lower than 7%); moreover, it is easily controlled with oral analgesia. One patient (3%) complained of retention of urine, which controlled easily.

Conclusion

Hemorrhoid ligation with mucopexy is a simple, safe and cost-effective ambulatory treatment for the patients of symptomatic hemorrhoids. It can be performed on an outpatient or day care basis on all grades of hemorrhoids to control bleeding and prolapsing hemorrhoids. Overall the results of hemorrhoid ligation and mucopexy were satisfactory with good control of patients complains.
Predictive Factors of Lymph Nodes Recurrence in Patients with Differentiated Thyroid Carcinoma Post Thyroidectomy in Clinically Node Negative Patients: A Systematic Review and Meta-Analysis Study
Authors: El-Shafaei Mahmoud Ahmed Mohamed , Omran Hesham Mohamed Ali , Saad Ahmed Saeed , Mansi Lamiaa Gomaa Abdel Hafez
Published: August 2023

Background

Differentiated thyroid cancer (DTC), a term used to describe papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and Hürthle cell thyroid cancer (HTC), accounts for approximately 95% of all thyroid malignancies. The expression clinically lymph node-negative (cN0)‘ was used to describe the patients that did not show the clinical evidence of CLNM on US or other imaging modalities preoperatively.

Objective

To assess the incidence of recurrence after surgery for DTC and to identify predictive factors of recurrence.

Patients and Methods

The search was conducted through PubMed, Web of science, Scopes, and the Cochrane Library for data from inception to November 1, 2021 with a combination of the following terms: "clinically node negative", "Risk Factors" and "Thyroid Neoplasms". All the studies were reviewed according to the eligible criteria. Abstract-based eligibility studies were obtained, and the manuscripts were fully reviewed.

Results

There was no evidence of publication bias. The funnel plot analysis demonstrated a symmetrical appearance, and the P values were greater than 0.05 for all comparisons according to the Begg-Mazumdar test and eggers test.

Data Sources

Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021.

Data Extraction

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

Conclusion

Young age (<45 years), male gender, Bilaterality, multifocality, capsular invasion, lymphovascular invasion and ETE were significantly associated with LNM in clinically N0 DTC patients and Prophylactic central neck dissection would be expected to have higher yield in patients with these factors.
Comparative Study of Reflux Esophagitis as a Complication between Mini-Gastric Bypass vs Sleeve Gastrectomy
Authors: Lashen Mohammed Ali , Helmy Elshayeb Bassem , Hellaly Mohammad Abdl Egani Muhammad
Published: August 2023

Background

All currently commonly performed bariatric operations involve manipulation and alteration of gastroesophageal anatomy, resulting in change of multiple physiologic parameters, such as gastric emptying and even the function of the lower esophageal sphincter (LES) itself. Reflux control involves a complex interplay of LES function, esophageal function, and gastric emptying. While all 3 can be affected by any foregut procedure, LES function and gastric emptying are most directly altered in bariatric surgery

Aim and Objectives

was for discussing the post-operative reflux esophagitis in both Mini gastric bypass & sleeve gastrectomy in the Treatment of Morbid Obesity.

Subjects and Methods

This prospective comparative study was carried out at ASU Hospital (El-Demerdash Hospital), Al Haram Hospital & other authorized hospitals between July 2017 and March 2019 and ethically approved. The study involved 40 Patients who were targeted to be recruited & randomly ordered to receive either Group 1 (MGBP (n = 20) or Group 2

Results

After 6 months of follow up, we found that reflux esophagitis symptoms remained postoperatively among patients who performed SG operation compared to the MGB group (15% vs 5%). This was statistically insignificant (p = 0.737). Although the resolve rate was higher in the SG group compared to the MGB group (15% vs 5%), this was statistically insignificant (p = 0.605).

Conclusion

LSG and LMGB are both safe and effective procedures for the surgical management of morbid obesity. Bleeding and leakage are the most common and most serious complications in both procedures. The incidence of complications between both procedures is not significantly different.
Rerouting as a Sphincter Saving Procedure for Management of Horseshoe Perianal Fistula
Authors: Abou-Zeid Ahmed Abdel Aziz , Ebied Essam Fakhery , Almoneim Mohammad Samir Abd
Published: August 2023

Background

Horseshoe fistula remains a complex and challenging clinical entity due to the configuration, depth, degree of sphincter involvement and confusing anatomy of the fistula. Lack of recognition, high rates of recurrence after insufficient treatment and incontinence are the dominant issues surrounding the management of the disease. We provide a new technique, which is staged fistulotomy with rerouting of transsphincteric track into intersphincteric position and the newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed, so we achieve the gold standard lay open of the fistula in addition to minimal sphincter sacrificing aiming to the least recurrence rate and avoiding functional complications as much as possible.

Aim

The aim was to describe the surgical technique that we use for the treatment of horseshoe perianal fistula and to study its effect on recurrence and continence.

Patients and Methods

A prospective study in which thirty patients to be operated upon was recruited from Ain Shams University Hospital & Dar Elshefa Hospital. Staged fistulotomy with rerouting of transsphincteric track of the fistula into intersphincteric position was done. The newly positioned intersphincteric fistula is then dealt with at a later date when the wound related to the external sphincter is soundly healed.

Results

23 cases (76%) out of 30 cases to be operated upon underwent all stages of the procedure. As regard Patients underwent all stages of the procedure 20 cases (87%) developed no degree of incontinence 3 cases (13%) developed degree of incontinence (wexner score 2)(gas leak once a week). There were no cases of recurrence.

Conclusion

Staged fistulotomy for horseshoe fistula with rerouting of transsphincteric track into intersphincteric position was associated with no recurrence and accepted functional complications.
Evaluation of Central Quadrentectomy and Immediate Reconstruction in Patients with Retroareolar Breast Cancer
Authors: Kamel Amr , Zaid Karim Fahmy Abdel-Moaty Mohammed Hamdy , Hafez Omar Afifi
Published: August 2023

Background

Centrally located breast cancer represents 5–20 % of all breast cancer cases. Oncoplastic breast surgery combines oncological principles with plastic surgical techniques; it requires knowledge of anatomy, and appreciation of symmetry, esthetics and breast function.

Aim of the Work

The aim of the current study is to present and assess multiple techniques of surgical outcome of oncoplastic techniques following the resection of centrally located breast cancer.

Patients and Methods

This prospective study comprised of 24 female patients with central breast cancer from November 2018 to Feb 2020 at the department of surgery Ain-Shams University Hospitals. Patients were followed up every 3 months for at least 12 months. Informed consent was obtained from the patients, and this study was approved by Al.Demerdash Hospital ethics committee.

Results

In our study, statistics shows to some extent, When NAC is not involved Flierl and Hanker [11] reported satisfactory results with central quadrentectomy and immediate reconstruction in patients with retroareolar breast cancer.

The mean age was 49.83 ± 7.6 years (range; 39 to 60). 13/24 patients (54.16%) were premenopausal while 11/24 (45.83%) patients were postmenopausal. 5 patients had diabetes mellitus and the rest of patients were non diabetic. Four patients (16.6%) had positive family history of breast cancer. Six patients had nipple retraction (25%). The mean tumour size was 2.52 ± 0.64 cm cm (0.9-2.8 cm). The spectrum of safety margin ranged from (1.9-2.8 cm) the mean safety margin in our study is 2.19±0.32, The overall percentage of complications was 5/24 (20.8%). Pathological nipple infiltration was found in 12 cases (50%) showed clinical and/or radiological evidence of nipple involvement and underwent resection of the NAC (Grissoti and Melon slice techniques). 14 patients (58.33%) had positive axillary lymph nodes, all staged as pN1; while the other 10 patients (41.66%) where staged as pN0. There is significant statistical difference between the two groups; Patient dissatisfaction is due to presence of scar, breast shape asymmetry and absence of NAC as in Grisotti and Melon slice groups or asymmetry as in Inferior pedicle group.

Conclusion

Multiple oncoplastic breast surgery techniques used in treatment of CLBC with good cosmetic and oncological outcome but need more training to have good results.
The Effect of Nigella Sativa Oil on Imiquimod Induced Model of Psoriasis in Thin Skin of Adult Male Mice. A Histological Study
Authors: Fadel Hussieny Ayat , Kalleny Nagwa Kostandy , Mohammed Safaa Mohammed Shaker , EL-Waseef Dalia Alaa EL-Din Aly
Published: August 2023

Background

Psoriasis was reported to be a chronic, immune-mediated inflammatory skin disease. Psoriasis can be induced in mice by Imiquimod which is an immune response modifier and it is the most widely used animal model of psoriasis. Nigella sativa oil is frequently used for its antiinflammatory and anti-oxidant activities. The current study is aimed to assess the effect of oral Nigella Sativa oil on imiquimod induced model of psoriasis in thin skin of adult male mice.

Materials & methods

The current study included twenty male albino mice. After seven days acclimatization period, animals were subjected to shaving of square shaped area 2 x 2 cm2 at the backs of all mice. Then, animals were divided into three groups: Group I: Control, n = 10: subdivided into: Subgroup IA (Negative Control), Subgroup IB: which received a daily dose of 20 mg of Nigella sativa oil orally. Group II, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. Group III, n = 5: Each mouse received a daily topical dose of 62.5 mg IMQ cream on the shaved back skin for fourteen days. On day seven after shaving and 4 hours after application of IMQ cream, each mouse in group III received 20 mg of Nigella sativa oil once daily for seven days. Skin specimens were obtained from the shaved parts of skin of the backs of all animals and were processed for light microscopic examination.

Results

Imiquimod (IMQ) application led to apparent increased epidermal thickness, apparent thickening of stratum corneum and alterations in the normal appearance of keratinocytes with vacuolation inside their cytoplasm and increased intracellular spaces between cells. Apparently Elongated epidermal rete ridges were observed along with abundant infiltrates of mononuclear inflammatory cells in the dermis. However, oral use of Nigella sativa oil (N.sativa) strongly inhibited IMQ-induced psoriasis-like inflammation and alleviated all epidermal and dermal changes observed after IMQ application.

Conclusion

N. sativa can be used as an effective treatment for modraete psoriasis.
G-EYE Colonoscopy Is Superior to Standard Colonoscopy for Increasing Adenoma/Polyp Detection Rate
Authors: Allam Ehab Hassan Nashaat , Aziz Ayman Mohamed Abdel , Elshafie Ahmed Ibrahim Mohamed , Mahmoud Karim Ahmed , Ahmed Abdallah Shehatah El-Sayed
Published: August 2023

Background

Colorectal cancer (CRC) is one of the most common cancers worldwide. Most CRCs develop from malignant potential polyps, especially adenomas, SSPs and SSLs. Screening is associated with a reduction in CRC incidence through the detection and removal of precancerous polyps and with reduction in CRC related death through reduction of the incidence and early detection of CRC. Colonoscopy is the most widely used screening tool. Unfortunately during colonoscopy examinations, a substantial number of polyps are still being missed. These missed polyps though to be at least 50% of interval CRCs.

Objective

comparison between G-EYE colonoscopy and standard colonoscopy (SC) for increasing adenoma/polyp detection rate.

Patients and Methods

prospective randomized study was conducted on 80 Patients as one group, selection done at Hepatology and Gastroenterology department in Theodor Bilharz Research Institute and Outpatient clinic of Gastroenterology unit at Ain Shams University Hospitals. From: June 2021 to November 2021, after ethical committee approval.

Results

prospective randomized study demonstrated that the polyp detection rate (PDR) was an increased rate by G-EYE colonoscopy, this difference was statistically significant (P ≤ 0.05) as the total number of patients having polyps detected by G-EYE was 28 (40.60%) and the total number of polyps was 43 polyps while by SC was 15 (21.70%) and the total number of polyps was 19 polyps. There is an advantage for G-EYE over SC in relation to the size of the detected polyps as this study compared the detected polyp size as diminutive (<5 mm), small (6-9 mm) and large polyps (>10 mm) by G-EYE versus SC. For the diminutive polyps, the difference was statistically significant (P ≤ 0.05) favoring the G-EYE, and for small polyps the G-EYE was superior to SC by 3 polyps, while for large polyps there was no difference. G-EYE increased the ADR in comparison with SC [22 (100%) vs 9 (13%) ] respectively as G-EYE colonoscopy detected an additional 15 adenomatous polyps in 13 patients missed from SC colonoscopy. The difference was statistically significant. Fortunately there were very few complications, abdominal pain reported in 3 cases after the end of procedures.

Conclusion

The study demonstrated that G-EYE is superior to SC in increasing adenoma and polyp detection rate as being more rapid and more precise for detection of diminutive and small adenomatous polyps. However G-EYE could not be done in certain conditions such as diverticulosis, masses, ulcerations or colonic strictures for fear of perforation or incomplete intubation, in this study those patients were excluded from the start as the aim of the study was polyp detection rate difference by balloon assisted colonoscopy (G-EYE) in comparison to the standard colonoscopy (SC).
Correlation between Plasma PCSK9 and Blood Lipids in Patients with Newly Diagnosed Primary Nephrotic Syndrome
Authors: Elshinnawy Howayda Abdelhamid , Gharib Mohamed Sary , Fahmy Abubakr Mohamed
Published: August 2023

Background

Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a major post-transcriptional regulator of low-density lipoprotein receptor degradation. Recently, PCSK9 was shown to be overexpressed by liver cells in rats with proteinuria. However, the levels of PCSK9 in newly diagnosed primary nephrotic syndrome (PNS) patients and correlations involving PCSK9 and blood lipids are not clearly understood.

Aim of the Work

The aim of this study is to assess the association between plasma pcsk 9 and blood lipids in patients with newly diagnosed primary nephrotic syndrome

Patients and Methods

This was a case control study in Ain Shams University hospital for 4 months on 50 patients, 35 control.

Results

in our study elevated plasma PCSK9 levels had a positive linear correlation with elevated serum TC (p value <0.001) and LDL-C (p value <0.001), triglycerides (p value 0.003), HDL (p value 0.012), VLDL(p value 0.001) A comparison of plasma PCSK9 levels of MCD, MN And primary focal segmental patients showed that they were not significantly different (p value 0.954). In our study, we found that the plasma levels of pcsk9 were significantly higher than in healthy controls 314.580 ± 73.835 ng/ml vs 253.429 ±36.666, and this difference was statistically significant P-value <0.001. In our study plasma PCSK9 levels in patients with PNS had no linear correlation with the amount of proteinuria per 24 h, p value 0.070 or with albumin p value 0.549 and there was no statistical difference between the the two groups of proteinuria (3.5-8 (g)/24 h vs > 8 (g)/24 h) p value 0.378.

Conclusion

Plasma PCSK9 levels in newly diagnosed primary nephrotic patients were markedly increased and positively correlated with total cholesterol, VLDL, LDL, HDL. suggesting that PCSK9 may emerge as a novel therapeutic target in nephrotic syndrome associated hypercholesterolemia
Evaluation of a Clinical Outcome of Resistant Gastroesophageal Reflux Disease after Treatment with Full Thickness Endoscopic Device
Authors: Bayoumy Essam Mohammed , Ahmed Gada Abd Elrahman , Galal Salah Shaarawy , Amer Ayman Mohamed Yousef
Published: August 2023

Introduction

The full-thickness Plicator® (Ethicon Endosurgery, Sommerville, NJ, USA) was developed for endoscopic treatment of gastroesophageal reflux disease (GERD). The goal is to restructure the antireflux barrier by delivering transmural pledgeted sutures through the gastric cardia. To date, studies using this device have involved the placement of a single suture to create the plication,

Aim of the Work

To evaluate clinical efficacy of endosural suturing using gastroscope for patients with resistant GERD,

Patients and Methods

This is A Prospective study, was carried out on 25 adult patients having resistant GERD or Hiatus hernia at Gastroenterology outpatient's clinic, endoscopic center, From September 2020 to March 2020,

Result

According to Endoscopy, there were 20 with Esophagitis in found GERD, and 1 case with Incompetent cardia in no GERD finding,

Conclusion

Endoscopic full-thickness plication using the GERDx™ device improves the distal acid exposure of the esophagus, typical reflux-related symptoms and QoL in well-selected patients. This procedure might constitute an option for patients with mild GERD. Long-term outcomes are required to expand our knowledge on the effects of this procedure,
Evaluation of a Clinical Outcome of Resistant Gastroesophageal Reflux Disease after Treatment with Full Thickness Endoscopic Device
Authors: Monis Ahmed Ali , Anwar Ayman Gamil , Galal Salah Shaarawy , El Aziz Emam Emam Gamal Abd
Published: August 2023

Background

Gastroesophageal reflux disease (GERD) is one of the most prevalent gastric disorders, defined as a condition in which reflux of gastric and duodenal contents back into esophagus causing troublesome symptoms and complications impairing quality of life.

Objective

To evaluate clinical efficacy of endosural suturing using gastroscope for patients with resistant GERD.

Subjects and Methods

This study is a prospective study. This study was carried out at Gastroenterology outpatient's clinic, endoscopic center of Ain Shams University Hospitals. The study was performed from September 2019 to December 2020. 25 adult patients having resistant GERD or Hiatus hernia.

Results

In our results we found that there was highly statistically significant difference according to symptoms grade between before treatment and after treatment. In our study we cleared that according to CBC, the mean of Hb 12.89 (± 0.80 SD), the mean of RDW 13.40 (±0.95 SD), the mean of platelets (*1000) 239.76 (± 60.37 SD), mean of RBCs 5.19 (± 0.51 SD). In study in our hands we found that there is highly statistically significant according to hill grade between before treatment and after treatment.

Conclusion

Our study has shown that endoscopic suturing of the gastroesophageal junction has significant improvements in reflux control that is sustained to 6 months and significant improvement in quality of life after procedure and significant reduction in symptoms severity after procedure.
Platelet to Lymphocyte Ratio and Neutrophils to Lymphocyte Ratio as Potential Markers for Lupus Nephritis Flares
Authors: Farres Mohamed Nazmy , khodree Mayada Moneer Mahmoud El , Fouad Shaimaa Hany , Mansour Eman Salah Abdel Shafi
Published: August 2023

Background

Systemic lupus erythematosus is chronic autoimmune disorder with variable clinical presentations and multi-organ involvement. The disease has female predominance and unpredictable course.

The aim of this study

was to measure platelet to lymphocyte, neutrophil to lymphocyte ratios in patients with lupus nephritis.

Subjects and Methods

This study was conducted on patients of lupus nephritis either in Nephrology clinic& Dialysis unit or admitted as inpatient in Ain Shams university Hospitals. For 60 Patients as two groups; the first group includes 30 SLE patients with ESRD. The second group includes of 30 lupus, and 3rd group 30 control healthy group.

Results

A highly significant difference was observed between lupus nephritis patients and healthy controls regarding neutrophil to lymphocyte ratio (p < 0.001)

Conclusion

In conclusion, NLR appear to be potentially useful biomarkers in lupus nephritis patients for disease activity and damage-compared with the other inflammatory cytokines as IL-6. Being easily obtained and cheap, they can be applied as predictors of not only disease activity and damage but also relapse and remission in lupus nephritis patients before applying other expensive and invasive measures. Dangerous disease activity and flares in SLE are unpredictable and represent a challenge in clinical practice.
Diagnostic Role of Serum Golgi Protein 73 as a Biomarker for the Assessment of Significant Hepatic Fibrosis in Patients with Chronic Hepatitis B Infection
Authors: Salem Amira Ahmed , ElGhandour Ahmed Mohamed , Ahmed Ahmed Elmetwally , Ali Esmail Husein Mohamud
Published: August 2023

Background

Significant fibrosis is the hallmark of progressive nature of chronic HBV infection. Therefore, it is fundamentally important to detect significant fibrosis accurately for decision on subsequent clinical management. Liver stiffness (LS) determined with Transient elastography (TE) and non-invasive indirect serum biomarkers (APRI score and FIB-4 Index) are most promising approaches in non- invasively evaluating significant liver fibrosis and minimizing the need of invasive liver biopsy. A recently introduced fibrosis biomarker in chronic liver diseases is Serum Golgi protein 73 (GP73).

Aim

The current study aimed at assessing the diagnostic accuracy of serum GP73 for significant fibrosis in antiviral-naïve HBV patients.

Methods

Forty patients who have never been treated for HBV infection were enrolled. They were subjected to full history, clinical, laboratory assessment and imaging by abdominal ultrasound. Serum Golgi protein 73 level were assessed for all patients and compared with APRI score, FIB-4 index results.

Results

Out of 40 patients who were enrolled, 65% % were males. The mean age was 43.78±11.58 years. 11 patients (27.5%) had significant liver fibrosis (≥ F2) and 29 patients (72.5%) had “No or Mild Fibrosis (<F2) as evidenced by both APRI and FIB-4. Our study showed Statistically significant correlation between APRI score and FIB-4 Index with age of the patients, haemoglobin level, Platelets, albumin, AST level, ALT level, INR and Direct bilirubin levels with p value <0.001 for the age, AST, ALT, Platelets and Albumin, with p value <0.015 for haemoglobin and Direct bilirubin and with p value <0.005 for INR By using Pearson Correlation Coefficient. Serum biomarker GP 73 showed statistically significant correlation with Age in years (P <0.005), AST level (P <0.017), ALT level (P <0.022) and Platelets (P <0.002) and statistically insignificant correlation with Haemoglobin, albumin level, INR, and direct bilirubin level.

Conclusions

Noninvasive simple biomarkers FIB-4, APRI and measurements of GP 73 can be used as good predictor of liver fibrosis in antiviral-naïve chronic HBV patients which can minimize the need for invasive liver biopsy in prediction of significant hepatic fibrosis.
Assessment of Depression in Hemodialysis Patients and Its Impact on Quality of Life
Authors: Mahmoud Fatma-Alzahraa Mohammed Naguib , Baqi Aber Halim , Rizk Khalid Mohammed , Abdelmobdy Ashraf Hassan
Published: August 2023

Background

End stage renal disease patients are thought to be highly susceptible to emotional problems. Depression is generally accepted to be the commonest psychological problem in patients with end stage renal disease which will affect the quality of life of these patients.

Aim of the Work

To assess depression in hemodialysis patients and its impact on physical and mental health.

Methods

A cross section study was made in Ain shams university hospital and other hemodialysis units on 500 patients on regular Hemodialysis.

Results

the study show a lower quality of life (both mentally and physically using SF-12 questionnaire) in patients with severe depression compared with those with mild to moderate depression. As quality of life is a predictor of survival in HD patients. Hence, correlation between quality of life and BDI score focuses on the effects of depression on HD patients’ survival.

Conclusion

Depression is so common among our dialysis patients whatever its degree. Different components of quality of life (physical and mental) are affected among our dialysis patients. Depression score (BDI score) is in direct relationship with age, marital status and employment. Physical, mental and total components of SF12v1 has a significant negative correlation with age, BMI, dialysis vintage and interdialytic weight gain. Associated comorbid diseases had significant correlation with depression and quality of life in our dialysis patients. Depression severity has significant negative correlation with PCS, MCS and the total score of SF12v1. Patients with mild depression have significantly higher scores of the various components of SF12v1 much more than those with moderate depression. Depression is highly statistically significant in predicting of PCS, MCS and the total score of SF12v1 and each increase in depression severity leads to significant decrease in them with different degrees.
Effect of Low and High Sodium Dialysate on Functional Capacity and Health Related Quality of Life in Hemodialysis Patients
Authors: Ezzat Abdelaziz Haitham , Abdelhady Ahmed Kadry , Abdel-Samea Marwa Shaaban , Ahmed Hossam Eldin Mostafa Mahmoud
Published: August 2023

Background

Patients on dialysis have low health related quality of life (HRQOL) and an annual mortality rate many-fold greater than the general population. There is uncertainty about whether low sodium in dialysis fluid improves overall health and wellbeing for people on haemodialysis, since there are mixtures of probably good and bad effects.

Aim

To assess the effect of low sodium and high sodium dialysate on functional capacity and HRQOL in hemodialysis patients.

Patients and Methods

comparative case-control study conducted on 60 ESRD patients on maintenance hemodialysis receiving their treatment at the Nephrology hemodialysis unit in Luxor International Hospital from June 2021 till November 2021. The study population was divided into 2 groups: Group 1: included 30 patients on low sodium dialysate (130 mmol/l). Group 2: included 30 patients on high sodium dialysate (138 mmol/l).

Results

Our data revealed a significant increase in the percentage of hypertensive patients recruited to be among the low sodium dialysate group as compared with high sodium group (P value <0.001). At the end of the study, there were a significant decrease in DBP, IDWG and UF among low sodium group compared with high sodium group, there were a significant increase in 6MWT and SF-36 in Low sodium group when compared with High sodium group. No statistical significant difference between the studied groups as regard each of the laboratory data, ECG, and ECHO at the end of the study (P value>0

Conclusion

Low sodium dialysate is effective in improving the health related quality of life of hypertensive hemodialysis patients, however, it did not reduce left ventricular mass relative to control despite improving fluid status.
Interleukin 32 as a New Biomarker for Non-Alcoholic Fatty Liver Disease
Authors: Ghaly Sameh , Sabry Mohamed Manal , AbdelRahman Ghada , Azmy Karim Hamed Mahmoud Mohamed
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) now refers to a spectrum of liver diseases that ranges from steatosis (i.e., fatty infiltration of the liver) to Non-alcoholic steatohepatitis (NASH) ie, steatosis with inflammation and hepatocyte necrosis, to fibrosis and cirrhosis with increased risk of hepatocellular carcinoma. NAFLD is the most common cause of cryptogenic cirrhosis, which is cirrhosis that cannot be explained by hepatitis, alcohol abuse, toxin exposure, autoimmune disease, congenital liver disease, vascular outflow obstruction, or biliary tract disease.

Objective

To study serum levels of interleukin 32 in patients with NAFLD to detect its relation to the incidence and severity of NAFLD.

Patients and Methods

Type of Study: Case control study. Study Setting: The study will be conducted at Ain Shams University Hospitals. Study Period: The study will take place from January 2019 to October 2019. To obtain this aim, we included 80 persons & divided them into 2 groups: Group I: 40 patients with NAFLD as a case group. Group II: 40 healthy subjects as a control group. We can sum up our results in the following points: Weight, BMI and Waist circumference were significantly higher among case group when compared with the control group (p < 0.001 for all). While there was non statistically significant difference found between two groups regarding Height.

Results

The best cut off point of Interleukin 32 Concentration (ng\ml) to detect Cases group was > 22.5 with sensitivity of 100%, specificity of 87.50%, PPV of 88.9%, NPV of 100% and total accuracy of 98.2%. The best cut off point of Interleukin 32 Concentration (ng\ml) to detect High group was found ≤165 with sensitivity of 90.91%, specificity of 28.57%, PPV of 85.7%, NPV of 40% and total accuracy of 55.8%. The best cut off point of Interleukin 32 Concentration (ng\ml) to detect Indeterminant group was ≤75 with sensitivity of 48.48%, specificity of 85.71%, PPV of 94.1%, NPV of 26.1% and total accuracy of 62%.

Conclusion

Interleukin 32 can be considered as a diagnostic marker for nonalcoholic fatty liver diseases with sensitivity of 100% and total accuracy of 98.2%. Interleukin 32 Concentration was found to be negatively correlated with serum Albumin level. Although, We found no correlation between Interleukin 32 Concentration & each of Fatty Liver Index score, nonalcoholic fatty liver diseases Fibrosis Score and PAUS Size.
Risk Stratification of Acute Upper Gastrointestinal Bleeding by AIMS65, Rockall, Glasgow Blatchford and Baylor Scores
Authors: Mohamed Sherif Monier , Musa Nevine Ibrahim , Faheem Heba Ahmed , Safian Mohammed Kamal Hussain
Published: August 2023

Background

Upper gastrointestinal bleeding (UGIB) is the most common cause of emergency admission in gastrointestinal disease. Despite the development of endoscopic therapies and pharmacological management, UGIB is still associated with considerable rates of mortality and morbidity, and high medical expenses. Different scoring systems have been suggested for diagnosing these patients.

Aim of the Work

In this study we aimed to compare the predictive value of three scoring systems Rockall, Glasgow Blatchfors scale (GBS) and AIMS65 in patients with UGIB.

Patients and Methods

This study was conducted on 120 adult Egyptian patients presented by UGIB at Emergency department of Ain Shams University Hospital in Cairo, Egypt at a period from October 2020 to June 2021. Patients underwent upper endoscopy within first day from an attack of UGIB. AIMS65, GBS, and PRS scores were calculated for each patient. The ability of these scores to predict clinical outcomes was determined. Area under the receiver-operating-characteristics (ROC) curve, sensitivity, specificity, positive and negative predictive values were calculated for rebleeding and mortality.

Results

GBS was superior to AIMS65, Rockall and Baylor scores in identifying the patients who are likely to need interventional endoscopy "cutoff ≥8.5, sensitivity 80.8%, specificity 54.4%", need blood transfusion "cutoff ≥11.5, sensitivity 54.2%, specificity 90.3%. While AIMS65 score was superior to GBS and other scores in prediction of unfavorable outcomes, namely risk of need for ICU admission "Cutoff ≥1.5, sensitivity 86.4% specificity 96.1%", need for rebleeding in hospital "cutoff ≥1.5, sensitivity 92.7%, specificity 96.2%" and death in hospital "cutoff ≥2.5, sensitivity 90.9%, specificity 98.2%. The reasons for differences in cutoff values compared to previous studies can including ethnicity, UGIB aetiology, period of follow up and number of patients.

Conclusion

Early risk stratification is recommended in patients presenting with acute UGIB to identify patients at higher risk of bleeding or death and guide management decisions regarding timing of endoscopy, triage to appropriate level of care, and disposition. The optimal cutoff of each scoring system should be specified for different population to maximize the power of identifying UGIB patients at high risk of death.
Correlation of Stool Lactobacillus acidophilus and Leaky Gut Syndrome in Patients with Hashimoto Thyroditis
Authors: Halawa Mohamed Reda , Hendawy Laila Mahmoud Ali , Michael Mina , EL dossoki Omneya Refaat Abdel Rahman
Published: August 2023

Background

Hashimoto thyroiditis (HT) is the most common autoimmune disease worldwide, characterized by chronic inflammation and circulating autoantibodies against thyroid peroxidase and thyroglobulin. Patients require hormone replacement with oral levothyroxine, and if untreated, they can develop serious adverse health effects and ultimately death. There is a lot of evidence that the intestinal dysbiosis, bacterial overgrowth, and increased intestinal permeability favor the HT development, and a thyroid–gut axis has been proposed, which seems to impact our entire metabolism.

Aim of the Work

To Study the Correlation of stool lactobacillus acidophilus and leaky gut syndrome in patients with hashimoto thyroditis.

Patients and Methods

This was a case control study that was conducted on 60 Egyptian patients that was divided into 2 groups, Group 1 that included 30 patients with Hashimoto s thyroiditis first diagnosed or on therapy and Group 2 that included 30 healthy subjects as a control and it was conducted at Ain Shams University hospital outpatient Endocrinology Clinic throughout 6 months.

Results

There was no statistically significant difference between two groups regarding Gender and Age, and there was highly statistically significant difference found between two groups regarding BMI. There was no statistically significant difference found between two groups regarding FT3, and there was highly statistically significant difference found between two groups regarding FT4 and TSH. There was highly statistically significant difference found between two groups regarding Anti tpo, Zonulin and Lactobacillus PCR. There was non statistically significant difference found between two groups regarding Gender, Age and BMI. No statistically significant difference was found between two groups regarding FT3, FT4 and TSH. There was highly statistically significant difference found between two groups regarding Anti tpo, and there was no statistically significant difference found between two groups regarding Zonulin.

Conclusion

There are alterations in the micro biota and intestinal permeability in Brazilian patients with HT. In addition, we suggest that diet might have played an important role in modulating the gut micro biota in patients with HT. These findings could help understand the HT development and progression, while.
Significance of Plasma Osteopontin in Diagnosis of Hepatitis C Virus Related Hepatocellular Carcinoma
Authors: Awad Emad , Eldeen Zaynab Ali , Samir Rasha , Ali Metawe Ragheda M
Published: August 2023

Background

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver that occurs predominantly in patients with underlying chronic liver disease and cirrhosis. Hepatocellular carcinoma is the sixth most common neoplasm and the third most frequent cause of cancer death. More than 700 000 cases of this malignant disease were diagnosed in 2008, with an age-adjusted worldwide incidence of 16 cases per 100 000 inhabitants. Hepatocellular carcinoma is the leading cause of death among patients with cirrhosis.

Aim of the Work

The aim of this study is to assess the diagnostic value of plasma OPN in the diagnosis of HCC among hepatitis C virus (HCV)-related LC.

Patients and Methods

Plasma levels of OPN will be measured in 20 healthy controls and 70 Egyptian patients with HCV-related LC. Patients will be divided into 2 groups: Group 1: 35 HCV patients with liver cirrhosis and HCC. Group 2: 35 HCV patients with liver cirrhosis without HCC.

Result

There was statistically significant difference between the studied groups as regard sex.

There was highly significant difference between the studied groups as regard CBC. As regard HB there was highly significant difference between (control and group 1) and (control and group 2) and significant difference between (group 1 and group 2). As regard INR there was highly significant difference between (control and group 1) and (control and group 2). As regard Platelets there was highly significant difference between (control and group 1) and (control and group 2) and significant difference between (group 1 and group 2). There was highly significant difference between the studied groups as regard Albumin and Total Bilirubin and significant difference as regard ALT and ALP. There was no significant difference between the studied groups as regard Child–Pugh class. There was highly significant difference between the studied groups as regard OPN. Using roc curve, it was shown that OPN level can be used to discriminate between patients and controls at a cutoff level of > 146.9, with 60% sensitivity, 97.14% specificity, 95.5% PPV and 70.8% NPV.

Conclusion

OPN level can be used to discriminate between patients and controls at a cutoff level of > 146.9, with 60% sensitivity, 97.14% specificity, 95.5% PPV and 70.8% NPV.
The Association of Uremic Pruritus with Blood Lead Level in Prevalent Hemodialysis Patients through Systemic Inflammation
Authors: Shawky Sahar Mahmoud , Khedr Lina Essam , Abd El-Hamid Reham Abd El-Aziz
Published: August 2023

Back ground and objective

Pruritus is a common and often distressing symptom in patients with chronic kidney disease. Though the pathogenesis of uremic pruritus remains poorly understood, however systemic inflammation is one of the possible pathogenesis of uremic pruritus, and blood lead level has been noted to be associated with inflammation and nutritional status in long-term hemodialysis patients. There might be an interaction or association, therefore, between blood lead level and uremic pruritus through systemic inflammation. Blood lead level in hemodialysis patients might increase the intensity or have an additive role of pruritus caused by other more common risk factors. This study aims to further verify or deny the relation between blood lead level and uremic pruritus.

Design, setting, participants, & measurements

The present study is a cross sectional study that investigates the relation between blood lead levels and pruritus in patients with end stage renal disease receiving hemodialysis. 50 patients were enrolled in this study, all were on regular hemodialysis 3 times a week, patients with primary skin diseases (psoriasis, erythroderma, etc), HCV positive patients, patients with chronic liver disease and patients with malignancies were excluded. Patients with PTH levels over 300 pg/dl And those with corrected calcium and phosphorus levels over 10.2 and 5.5 mg/dl Were excluded from the study. We divided the patients into 2 groups, group 1 (n = 10) with no pruritus and group 2 (n = 40) with varying degrees of pruritus.

Results

There was a significant difference in serum lead levels and ferritin levels between group 1 and 2. Group 2 was further divided according to intensity of Pruritus by VAS score into mild (n = 10), moderate (n = 20) and severe pruritus (n = 10) There was also a statistically significant difference in serum lead levels in different groups of intensity of pruritus, having higher serum lead levels in patients who exhibited severe pruritus. And there was a significant correlation between blood lead and duration of dialysis

Conclusion

Uremic pruritus is a multi-factorial phenomenon, our study showed that Blood lead level in HD patients might increase the intensity and have an additive role in the pathogenesis of pruritus in dialysis patients hence Blood lead level is positively correlated with Uremic Pruritus.

We were able to demonstrate that both blood lead and duration of dialysis together are the most sensitive predictors for pruritus, the best cut off value for blood lead is 6 together with duration above 10 with high sensitivity, specificity and efficacy.
Correlation between Primary Knee Osteoarthritis and Metabolic Syndrome among Egyptian Patients
Authors: Abdelaziz Amina Badreldin , Morshedi Nashwa Aly , Samaan Sara Farid , Mahmoud Sabreen Abdelkader
Published: August 2023

Background

Previous studies have suggested that metabolic syndrome is associated with osteoarthritis (OA). However, analyses have not addressed whether levels of individual metabolic syndrome components are related to OA. This study was undertaken to examine the relationship of metabolic syndrome and its components with radiographic and symptomatic knee OA

Objective

To assess the impact of metabolic syndrome and its components on the degree of structural damage and function impairment in a sample of Egyptian patients with symptomatic primary knee OA.

Patients and Methods

In this study, 116 Egyptian osteoarthritic patients were included, Patients were divided into 2 groups: Group A: includes 58 osteoarthritic patients with metabolic syndrome. Group B: includes 58 osteoarthritic patients without metabolic syndrome.

Results

There was a positive correlation detected between HAQ and hypertension with P-Value 0.002. There was a positive correlation detected between WOMAC and hypertension with P-Value 0.000.we found that OA was sever in hypertensive patients, old age, patients with high waist circumference and high levels of CRP, TG, FBG and 2HPP with P-value > 0.001. While there was no correlation between X-ray grading with and ESR, uric acid, cholesterol, LDL, HDL, HBA1C and insulin resistance with P-Value > 0.05

Conclusion

We concluded that patients with knee OA and metabolic syndrome has more radiological damage and severe grades of functional disability in comparative to patients with OA without MS.