bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambulatory Blood Pressure Monitoring in Assessment of Systemic Hypertension Following Successful Aortic Coarctation Repair
Authors: Mahmoud Sameh Ali , Alimam Ahmed Mowad , Esmail Yasmin Abdelrazek , Attia Hebatalla Mohamed , Hamdy ElSayed Maiy
Published: August 2023

Background

Hypertension following primary coarctation repair affects up to a third of subjects. A number of studies suggest that future hypertension risk is reduced if primary repair is performed at a younger age. This study aims to assess prevalence of systemic hypertension after early coarctation repair (within the first two years of life) compared with late coarctation repair (after the first two years of life), including both catheter-based and surgical intervention using twenty-four hour ambulatory blood pressure monitoring. the study included 30 patients who underwent successful repair of aortic coarctation. All patients underwent complete history taking and clinical examination.All patients underwent full transthoracic echocardiographic study and ambulatory blood pressure monitoring.

Results

HTN had higher incidence in patients who underwent late coarctation repair than patients underwent early coarctation repair but difference was statistically insignificant.

Conclusions

Early intervention of aortic coarctation during infancy decreases the risk of late systemic hypertension. However, further studies are needed to evaluate increased risk of recoarctation after early intervention of aortic coarctation.
Diagnostic Efficacy of Carba NP Strip Test for Carbapenemase Detection
Authors: El-masry Shereen Ahmed , Fahim NohaAlaaEldin , Badawy Lamya Ahmed ElnasserElsayed
Published: August 2023

Background

Bacterial resistance to carbapenems is in the focus of attention because it envoys a time without effective antibiotics. Carbapenemase enzyme production is the main mechanism of resistance exhibited by carbapenem resistant organisms. Rapid detection of carbapenemase producing bacteria is important for initiation of treatment and infection control measures.

Aim of the Work

Determination of the diagnostic performance of the Carba NP strip test for the detection of carabapenemase producing gram negative bacteria.

Materials and Methods

The study included a total of 50 gram negative clinical isolates. All isolates were subjected to: Carba NP tube test, Carba NP strip test, and meropenem disc diffusion. All techniques were performed according to Clinical and laboratory standard institute (2018).

Results

Compared to the results of the meropenem (10 ug) disc diffusion method, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the Carba NP tube test was found to be 77.5%, 100%, 100% and 52.6 % respectively. On the other hand, the Carba NP strips test was found to have 82.5% sensitivity, 100% specificity, 100% PPV and 58.8% NPV.

Conclusion

The Carba NP test performed by use of the modified strip method was found to be a simple and inexpensive method that can be used for the rapid detection of carbapenemase producing gram negative bacteria with high sensitivity and specificity.
Effect of Narrow Band UVB Therapy and Methotrexate Treatment on Serum Adenosine Deaminase Enzyme Level in Severe Psoriasis Vulgaris Patients
Authors: Mabrouk Delbent Ibrahim , Elhusseiny Rania Mahmoud , Abdullah Hala Jabbar Hussein
Published: August 2023

Background

Psoriasis is a common, chronic inflammatory disease effects mainly skin, nails and joints. Adenosine deaminase (ADA) is an enzyme involved in purine metabolism and it is essential for the breakdown of adenosine from food and the turnover of nucleic acids in tissue. ADA possess a pivotal role in function and maturation of lymphoid cells, especially T-cell lineage, and its altered status was reported in diseases with immunological disturbances as in psoriasis. Moreover, ADA regulates the plasma adenosine level, which is involved in synthesis of inflammatory molecules and cytokine production. Increased ADA may be also due to increased nucleic acid catabolism associated with the hyperproliferative status of epidermis in psoriasis patients.

Aim of the Study

To measure serum level of adenosine deaminase enzyme by modified Guisti procedures in severe psoriasis vulgaris patients before and after treatment with narrow band ultraviolet B therapy and intramuscular methotrexate injection or combination of both and compare it with healthy controls.

Subjects and Methods

The present study included 45 severe psoriasis vulgaris patients and 15 apparent healthy age and sex matched controls. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research. All patients received full information about description of the procedure of treatment, possible side effects, photo documentation and they all provided informed consent.

Results

The current study revealed significant decrease in disease severity after treatment in all 3 groups with decreased PASI score. Serum ADA was significantly higher in patients groups compared to controls. Moreover, significant reduction of serum ADA was detected after treatment in all three groups being higher in combined MTX and NBUVB group. However, no significant correlation was detected between serum ADA levels and PASI scores before and after treatment.

Conclusion

We concluded that Adenosine deaminase possesses a significant role in the pathogenesis of psoriasis. Measurement of serum ADA level could be used as both diagnostic and prognostic marker for psoriasis and monitoring progress of treatment.
Assessment of YKL-40 as a Potential Biomarker of the Disease Severity in Psoriatic Patients with or without Psoriatic Arthritis Treated with Methotrexate
Authors: ahmed Elziaty Samira , Fakkar Nehal M Zu El , Abd elsabour Hala Mohamed , Soltan Marwa Yassin
Published: August 2023

Introduction

Psoriasis is an inflammatory disease of a complex pathogenesis with its typical cutaneous symptoms are papules& plaques covered with silvery scales and arthritis is one of its most common complications. The biological role of chitinase-3-like protein 1 (YKL-40) remains unknown. It is suggested that this protein takes part in processes such as proliferation, inflammation, angiogenesis and tissue remodelling.

Aim

To investigate the serum level of YKL-40 in psoriatic patients with or without psoriatic arthritis and to study the effect of treatment with methotrexate on the serum levels of YKL-40.

Material and methods

The study was performed on 40 patients with psoriasis vulgaris with or without psoriatic arthritis. All patients showed the clinical signs of psoriasis vulgaris with or without psoriatic arthritis. The diagnosis of cutaneous psoriasis was made clinically based on the characteristic lesions and scored according to Psoriasis Area and Severity Index (PASI) and, additionally, the Body Surface Area (BSA). Psoriatic arthritis patients had fulfilled the diagnostic criteria defined by the classification of Psoriatic Arthritis (CASPAR) criteria. The severity of psoriatic arthritis was assessed using DAPSA Score. Blood samples were taken to measure the serum concentration of YKL-40.

Results

YKL-40 serum levels were significantly higher in patients with psoriatic arthritis, compared to patients with psoriasis only & a significant reduction inYKL-40 levels in both groups, psoriasis patients with and without psoriatic arthritis, after receiving methotrexate treatment. There was a positive correlation between serum YKL-40 and PASI.

Conclusions

YKL-40 can be a useful biomarker for assessment of the disease severity in psoriatic patients with or without psoriatic arthritis. It also detects the efficacy of treatment with methotrexate.
The Role of Human Papilloma Virus in the Pathogenesis of Sinonasal Inverted Papilloma; A Metanalytical Study
Authors: Hakim Ehab Kamal , Hamdy Tarek Abd Elhamid , Mikahail Peter Milad , Abdelhameed Abdelhameed Hassan
Published: August 2023

Background

Sinonasal inverted papilloma (SNIP) is a benign and relatively rare tumor of the nasal cavity and paranasal sinuses, most commonly originates from the lateral nasal wall or maxillary sinus from the schneiderian sinonasal epithelium. There is a male predominance with a male-to-female ratio of 3.4:1. Sinonasal Squamous Cell Carcinoma (SCC) associated with IP has an incidence of approx. 0.38 cases/million persons/year. Patients with carcinoma in IP are older than those IP patients without carcinoma. Some authors assume an influence of Human Papilloma Virus (HPV) subtyping. Transcripts of HPV DNA were found in malignant IP.

Objective

To perform a meta-analytical study to determine the relationship between human papilloma virus and the occurrence of sinonasal inverted papilloma.

Patients and Methods

The review will be restricted to RCTs, clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of Negative HPV group versus Positive HPV group of patients.

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 measures.

Results

In our study HPV positive cases were (23.6%) (107/ 452) among SNIP patients. Malignant SNIP rate was (10.8%) (49/ 452). HPV positive cases among malignant SNIP patients was (51.02%) (25/49).

Conclusion

In this meta-analytical study HPV positive cases were (23.6%) (107/ 452) among SNIP patients. Malignant SNIP rate was (10.8%) (49/ 452). Though the etiology of SNIP remains controversial, the studies reviewed in this study indicate a role for HPV infection. Further studies in the future regarding the impact of other risk factors on the occurrence of SNIP would be of value, these factors include angiogenic factors, environmental factors, genetic, viral and chronic sinonasal inflammation.
Assessment of Pragmatic Aspect of Language in Children Diagnosed with Attention Deficit Hyperactivity Disorder
Authors: Abdalla Eman Abdallah Fadel , Hassan Sabah Mohamed , Boshnaq Maha Hussein
Published: August 2023

Background

Assessment of the pragmatic language development in the Arabic speaking societies was a competence in the previous years. Recently, an Egyptian Arabic Pragmatic Language Test was developed (EAPLT). The relation between ADHD and language is especially intuitive in young children. No previous study used the EAPLT to evaluate pragmatic aspect of language in children with ADHD.

Aim

This study aimed to assess the pragmatic aspect of language in children with ADHD.

Methods

A case control study design was used. Fifty patients with ADHD were enrolled randomly from 4 to 8 years old and a normal group of children with the same age and number randomly selected by systemic random sampling from classrooms of different schools in Cairo. Data regarding the child’s age, sex, IQ, mental age, the expressive and the receptive language ages by the Modified PLS4, the pragmatic language age range, percentile, the acquired and the delayed pragmatic language skills according to EAPLT were collected.

Results

Results showed that Language in general was affected in children diagnosed with ADHD, receptive and expressive language age was significantly different than the normal group (p value for receptive=0.017) (p value for expressive=0.024). In the ADHD group 25 children (50%) of the group showed delayed receptive language, and 28 children (56%) of them showed delayed expressive language. The pragmatics aspect of language assessment (p < 0.001) showed significant difference between ADHD and control groups in almost all aspect of pragmatics. Also in conversation skills the results (p < 0.001) showed significant difference between ADHD and control group.

Conclusion

This study showed that children with ADHD had a delayed language, pragmatics and conversational skills compared to normal controls within the same age and IQ.
Success and Complication Rates of Different Techniques and Materials Used for Nasal Dorsal Augmentation in Rhinoplasty
Authors: Fatallah Eman Soliman , Shafik Amr Gouda , Mohamed Mohamed Naguib , Mady Ossama Mustafa
Published: August 2023

Background

Autologous materials, homograft and alloplastic implants are commonly used in nasal dorsal augmentation. So far, there is no satisfactory evidence to ascertain the safest, efficient, and superior in aesthetic outcomes among different materials. Thus, we aimed to conduct a systematic review and metaanalysis (SR, MA) of published literature to review rates of outcomes and complications of different materials used for nasal dorsal augmentation, in trial for better future surgical results.

Methods

Thirteen electronic databases were searched from inception through December 2018 and a manual search in October 2019.

Results

A total of 280 eligible studies were included, of which 165 articles were included in the meta-analysis. Compared to others, alloplastic expanded polytetrafluoroethylene (alloplastic e-PTFE) was considered first place, for having the highest graft scores in most of its outcomes; secondary deformity, resorption, patients’ satisfaction, displacement, extrusion, seroma, graft deviation, swelling, and hematoma outcomes with rates of (2%, 0.6%, 96.5%, 1.3%, 1.2%, 1%, 1%, 0.8%, 0.8%)respectively. Alloplastic silicone came after e-PTFE, for its superior results in revision rhinoplasty, success rate, aesthetic function, and scarring outcomes (4.1%, 99.9%, 98.8%, 2.7%) respectively. Autologous bone graft came at the last place as it had the least graft scores in patients’ satisfaction, displacement, perforation, and hematoma outcomes (50.7%, 9.3%, 8.3%, 5.4%)respectively. Autologous diced cartilage was superior in those outcomes; edema, bruising, and donor site complications (7.1%, 7.4%, 4.4%) respectively. Autologous costal cartilage had the highest graft scores in necrosis and graft exposure outcomes (4.3% and 1.9%), while it had the lowest graft scores in warping and success rate (7.1% and 87.3%). Autologous auricular cartilage had the highest graft scores in warping and foreign body reaction outcomes (1.4% and 6.3%), while it had the lowest graft scores in nasal obstruction and donor site complications rate (72.7% and 33.3%). Infection was the most common reported complication in MA, where autologous alar cartilage had the lowest infection rate of 0.2%, unlike alloplastic Medpor recorded the highest risk of 6.6%.

Conclusions

Regarding our results, we concluded that alloplastic e-PTFE yielded superior position in comparison to other materials, that would succeed as an alternative to convential autologous grafts, as had superior results in most of nasal dorsal augmentation outcomes. On the other hand, autologous bone graft was in the last place in all its outcomes. Future studies are needed to improve reporting of races variety, follow-up times, and diverse participants, as to resolve uncertainty regarding the ideal material for dorsal augmentation in rhinoplasty, with concentrating on proper assessment of races variety, which will improve selecting the proper graft implant.
Cochlear Implantation or Stapes Surgery in Far Advanced Otosclerosis
Authors: Abd El-Aziz Hanaa Sabry Hadaey , Abdelhamid Elnashar Abdelhamid , Kamal Ehab , Teaima Ahmed
Published: August 2023

Background

Otosclerosis is a process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone. It usually occurs during the postlingual period between the second and fifth decade of life. The most commonly affected location is around the oval window (fenestral otosclerosis), which results in conductive hearing loss due to stapes footplate fixation. As it undergoes a maturation process, the sclerotic bone increases in size and depth.

Objective

To compare the hearing outcomes and complications of stapes surgery vs cochlear implantation in patients with far advanced otosclerosis.

Data Sources

Medline databases (PubMed, Medscape, Scopus, Google Scholar, Cochrane, 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 measures.

Patients and Methods

The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The detailed steps of methods were described elsewhere as well as PRISMA checklist.

Results

The results of this meta-analysis show that comparing the outcomes and complications of cochlear implantation and stapes surgery in far advanced otosclerosis patients have different results, in some of them there was a highly favorable and recommended procedure than the other, other results declared no significant difference in postoperative outcomes.

Conclusion

Both Stapes surgery and CI are reliable treatment options for FAO with very close success rates. Statistics of CI are greater than Stapes surgery and CI has a consistent improvement in speech discrimination scores in comparison to Stapes surgery. Patients must receive adequate counseling regarding all the factors mentioned above and the decision must be made by surgeons and the informed patients.
Impact of Age on Reading Abilities in Egyptian Children with Unilateral Cochlear Implant
Authors: Taha Shereen Alaa EL-Din Taha , EL-Din Hafez Nirvana Gamal , Hassan Elham Magdy
Published: August 2023

Background

Reading problems means difficulty in learning to read or interpret words, letters, and other symbols. Children with cochlear implants generally suffer from reading problems which have been partly attributed to underlying deficit in phonological awareness. Chronological age represents important factor that affects their reading abilities.

Aim of the Work

This work aims to assess reading abilities in cochlear implant school children in order to highlight their reading problem profile, as to consider such problems in earlier years of life. This would subsequently solve their expected academic delay.

Subjects and Methods

This study was applied on 30 Egyptian Arabic-speaking children with unilateral cochlear implant in the age range between 5 to 11 years old. All of them underwent audiological evaluation, psychometric evaluation, Phonological Awareness Test, and Arabic Reading Screening Test (ARST).

Results

Analysis of the results of the participated children to the phonological awareness test and Arabic reading screening test, revealed that the majority of the studied patients were below the 5th percentile in all sub items of both tests. This indicates that cochlear implanted children have reading problems. There is positive correlation between most of subitems of both tests and chronological age of children.

Conclusion and recommendation

Cochlear implanted children had poor scores in phonological awareness test and Arabic reading screening test, their reading abilities were extremely impaired. Chronological age may be considered a factor that affects this relation. This higher susceptibility to reading problems as well as the importance of reading for their academic careers should be considered in their rehabilitation plan.
Rivaroxaban versus Low Molecular Weight Heparin in Treatment of Acute Deep Vein Thrombosis
Authors: Mahrouse Mahmoud Ali , El-Mallah Said Ibrahim , Greida Hisham Abu , Othman Nahla
Published: August 2023

Objectives

The purpose of this study is to examine the use of low molecular weight heparin, warfarin, and rivaroxban in the treatment of acute deep vein thrombosis.

Background

A blood clot stops the passage of blood via vein, usually in the legs, causing deep vein thrombosis (DVT). Clots can detach and obstruct blood flow to the pulmonary, which can be deadly (pulmonary embolism (PE).

Methodology

This prospective study included 250 Patients with acute deep vein thrombosis 20 patients died (9 died due to Pulmonary embolism 1 died due to bleeding – 10 died due to myocardial infarction, stroke and cardiac aresst) during study, 30 patients lack of follow up. 100 Patients are subjected to low molecular weight heparin followed by warfarin and the other 100 subjected to rivaroxban. During the period of the study from Mars 2017 to July 2019 at emergency department in Menofia university.

Results

The total number of Patient selected for the tests was 200 Patient. The main age was 39 and the Minimum of age was 20 year and the maximum age are 55 year. the disruption of sex are not show any concentration in any groups, the mean BMI in Warfarin Group and Rivaroxban Group are the same with no significant, the age groups shows no statistically significant of data.

Conclusion

According to this study Warfarin need long term monitoring, Rivaroxaban does not require laboratory surveillance, which makes treatment easier, and there are no medication or dietary interactions with Rivaroxaban.
Breast Conserving Surgery versus Mastectomy: Overall and Relative Survival – A Population Based Study by Ain Shams University Hospital
Authors: Helmy Mohamed Ahmed , Shehab Mohamed , El Din Osman Ahmed Gamal , Talaat Mahmoud , Taha Mohamed Hassan Ali Ahmed
Published: August 2023

Background

Breast cancer is one of the most frequently diagnosed cancers worldwide and is a major contributor to cancer mortality in women. Breast cancer is treated with a multidisciplinary approach involving surgical oncology, radiation oncology, and medical oncology, which has been associated with a reduction in breast cancer.

Aim of the Work

The aim is to compare the outcome of Ain Shams university hospitals patients treated by mastectomy and BCS. The comparison takes the available prognostic variables into a multivariate analysis and includes an intention to treat analysis.

Patients and Methods

We randomized 20 patients in a retrospective cohort study who received either modified radical mastectomy or breast conserving surgery in period 2019-2020. We compared the outcome of patients after 1-2 year as regard post-operative hospital stay, time of Redivac drain removal, development of post-operative seroma, wound infection, wound hematoma, wound dehiscence, development of ugly scar with evaluation of recurrence be clinical examination and ultrasound follow up and take in consideration the type of adjuvant therapy that has been taken.

Results

We found that there's no significance between Modified radical mastectomy and conservative breast surgery according to recurrence, post-operative adjuvant therapy and hospital stay with small significance according to post-operative wound healing, seroma, hematoma, infection, wound dehiscence with better outcome to the conservative breast surgery. We found also high significance between the two invasive procedures according to the patient satisfaction with high satisfaction to the conservative breast surgery mostly due to the preservation of the breast and less wound complications

Conclusion

Both Breast cancer invasive procedures as regard mastectomy and conservative breast surgery have the same results according to recurrence, hospital stay and adjuvant therapy. Conservative breast surgery is better than mastectomy when indicated as regard wound complications and preservation of the breast tissue which increase patient satisfaction towards it.
Another Chanarin-Dorfman Syndrome (CDS) in an Egyptian Patient
Authors: Gamal Radwa , Elsayed Solaf M
Published: August 2023

Introduction

Chanarin–Dorfman syndrome is a very rare autosomal recessive syndrome caused by mutation in ABHD5 a cofactor for adipose triglyceride lipase resulting in intracellular accumulation of triacylglycerol in various body tissues. Several patients were previously reported from Egypt and middle East but still the diagnosis is missed for several years. Here we report another case with this syndrome and describe his journey to diagnosis.

Case report

A 4.4 year old boy, the fifth in order of birth of first cousin Egyptian parents presented to the Genetics Clinic because of abnormal scaling all over the body since birth. On examination, he had short stature, hepatomegaly, and generalized ichthyosis. His chest, heart and neurological examination showed no abnormalities. Ocular examination revealed refractive errors. Audiometry revealed hearing loss. Peripheral blood smear examination demonstrated cytoplasmic vacuoles within the neutrophils (Jordans bodies ) confirming the diagnosis of CDS.

He had family history of sibling death at age of 2 day with extensive scaling overall the body.

Conclusion

CDS should be suspected in patients with congenital ichthyosis and hepatomegaly. Diagnosis is simple using blood smear to find Jordans bodies.
The Possible Protective Role of Propolis on a Model of Restraint Stress in Rat Spleen Histological & Immunohistochemical Study
Authors: Sayed Aya Salah El , Shawarby Amany Mohamed El , El Sebay Sara Abdel gawad , Hegazi Mohamed Ahmed Abdou
Published: August 2023

Introduction

Stress is a generic term that summarizes how psychosocial and environmental factors influence physical and mental well-being. The effects of stress on the immune system are complex and depend on the nature and duration of stress. Recently, the attention of researchers has been attracted to the use of propolis in many therapeutic fields including protection of the body from the effect of stress.

Aim of the Work

To study the effect of immobilization stress on the structure of spleen of restrained rats and the protective role of propolis.

Materials and methods

Thirty-two male rats (6-8) weeks old were used in this study. The animals were randomly divided to 4 groups, as follows: Group I (Control group), Group II in which rats were treated daily with propolis (3 g/kg) by gavage for 10 days. Group III (stress group): in which rats were subjected to restraint stress test 2 h/day for 10 days. Group IV (stress group with propolis): in which rats underwent the restraint stress test as in group III and were treated daily with propolis (3 g/kg) one hour before the start of the immobilization. At the end of experiment all animals were sacrificed; spleen specimens were collected from all rats and were subjected to microscopic &immunohistochemical studies. Histomorphometry study and statistical analysis were also done.

Results

Compared to group I, some specimens of group III showed atrophy of spleen with significance decrease in surface area of PALS & CD3 +ve cells immune reaction. These results were accompanied by significant decrease in surface area of the follicle with apparent decrease in CD20 +ve B lymphocytes immune reactivity. Moreover, apparent increase in CD68 immune reactivity in white pulp was recorded. Other specimens revaled thickened fibrosed splenic capsule and septa, widening and congestion of splenic sinusoid and prominent hemosiderin laden macrophage.

Meanwhile group IV showed general improvement in spleen architecture with daily propolis intake.

Conclusion

Propolis is effective as a protective measure against the effect of restrained stress on spleen in adult rats.
The Effect of Platelet Rich Plasma versus MSCs Derived Exosomes on the Healing of Burn Injury in Albino Rat: Histological Study
Authors: Elshawarby Amany Mohamed , Elsebay Sara Abdel Gawad , Hegazy Mohamed Ahmed Abdou , Naser Mai Mostafa Mohamed
Published: August 2023

Background

The clinical treatment of skin loss due to severe and massive burns or wounds continues to be a major problem in surgical procedures. Although different kinds of dressings and therapies have been developed, but most of them are expensive. Therefore, new strategies are needed to promote and help in wound healing and repair. Recent studies have demonstrated that exosomes help tissue repair because of high stability, non immune rejection and easy control of dosage and concentration. Platelet-rich plasma (PRP) is an autologous concentration of platelets in concentrated plasma. It has been used to promote soft and hard tissue healing.

Aim

to compare the effect of MSCs derived exosomes versus PRP on the promotion of healing of experimentally induced second degree partial thickness burn injury in adult male albino rats.

Methods

The thirty-two adult male albino rats were divided randomly into 4 groups. Group I (control). Group II (burn injury group) that will be left for spontaneous healing. Group III (burn injury treated with PRP intradermal injection). Group IV (burn injury treated with intradermal MSCs derived exosome). All the animals were sacrificed at 7th day (subgroup a) and 21th day (subgroup b). The skin biopsies will be taken and processed for light microscope examination.

Results

H&E stained section of untreated burn (subgroup IIa) showed coagulative necrosis in epidermis and papillary layer of the dermis. Sign of epithelial migration from the edge of the wound appeared. In Subgroup IIb the surface of the wound was covered by an eschar that converted partial thickness into complete thickness. This resulted in formation of granulation tissue in the dermis. In Subgroup IIIa showed the formation of thin layer of epidermis containing undifferentiated keratinocytes. The underlying dermis contained collagen fibers and beginning of new hair follicles formation. Some specimens in Subgroup IIIb revealed thin epidermis with incomplete differentiation of keratinocytes. Numerous hair follicles were detected in the dermis. However some specimens showed thickened epidermis with presence of rete ridges. The dermis showed few irregularly distributed collagen fibers in granulation tissue with absence of skin appendages. In exosome treated group (subgroup IVa) showed thin epidermis with well differentiated keratinocytes. The dermis contained collagen fibers with absence of skin appendages. Subgroup IVb was more or less similar to the control group.

Conclusion

The current study revealed that burn treated exosomes group was better than PRP treated group. In addition PRP treated group revealed hyperplastic changes in epidermis with delay in remodeling phase of burn healing.
The Significance of Neutrophil-to-Lymphocyte Ratio as an Inflammatory Marker of COVID-19 in Hemodialysis Patients
Authors: El- Shinnawy Howayda Abdel-Hamid , Shawky Sahar Mahmoud , Abdel-Samea Marwa Shaaban , Rady Aliaa Osama Ahmed
Published: August 2023

Background

One of the emerging -rapidly spreading- leading causes of pneumonia worldwide is a novel Corona virus, severe acute respiratory syndrome (SARS-CoV-2) causing coronavirus disease 2019. (COVID 19). ESRD patients are at high risk for COVID 19 associated morbidity and mortality.

Aim

To determine the significance of Neutrophil-to-Lymphocyte Ratio (NLR) as an inflammatory marker of COVID 19 in ESRD patients.

Patients and Methods

This is a prospective cohort study conducted on 84 ESRD patients on maintenance hemodialysis, receiving their treatment at Ain Shams University Hospitals from February 2021 till the end of July 2021. The study population was divided into 2 groups: Group 1: 42 ESRD patients who tested positive by reverse transcription polymerase chain reaction (RT-PCR) for SARSCoV-2 on nasopharyngeal swab samples or by typical COVID 19 radiological images on thoracic computed tomography scan. Group 2: 42 ESRD patients who tested negative by RT-PCR for SARS-CoV2 on nasopharyngeal swab samples or by normal images on thoracic computed tomography scan.

Results

Our data revealed that a higher level of NLR in COVID 19 group with a cut off value of 5.26. NLR was the most specific (95.24%) and sensitive (76.19%) predictor of COVID 19 among other hematological parameters. Also, NLR has a significant positive correlation with the mortality of the COVID group. Compared to the lymphocyte and neutrophil counts, NLR alone was positively correlated with the CRP in the COVID group. Our data stated that the use of anticoagulation and antiviral significantly improved the outcome of the COVID 19 patients on maintenance hemodialysis. Our study showed that COVID 19 ESRD patients had a significantly higher D dimer, LDH, CRP and hyperferritinemia than the non- COVID 19 ESRD patients. The COVID group in our study had significant hypoalbuminemia, anemia and reduced urea reduction rate (URR).

Conclusion

NLR, neutrophilia and lymphopenia are considered predictors of COVID 19 disease in ESRD patients. However, NLR has the highest sensitivity and specificity. Higher levels of NLR were attributed to higher mortality in ESRD patients with COVID 19 disease.
Nail Folds Capillaries Abnormalities Association with Type 2 Diabetes Progression and Correlation with Diabetic Retinopathy
Authors: Hafez Eman A , Morshedy Nashwa A , Abd EL-Khalik Dina M , Mostafa Asmaa E E
Published: August 2023

Background

Retinopathy is regarded one of the most important complications of diabetes that occurs after long duration of the disease with untight glycemic control, and it is regarded as one of the preventable causes of blindness so proper evaluation of diabetic patients and their complications can prevent blindness.

Aim of the Work

to assess the capillaroscopic changes in type 2 diabetes mellitus patients and correlate the findings to the microvascular complication of the retina (diabetic retinopathy).

Patients and Methods

Our study was conducted on 62 patients of type 2 diabetes mellitus (16 male, 46 female) their ages above 18 years lies between (36-66) years. All patients were subjected to full history taking and thorough clinical examination.

Results

Nailfold capillaroscopy imaging revealed that 31 patients with positive capillaroscopic findings had branched and tortuous capillaries, 34 patients had hemorrhage,5 patients with dilated apical capillary, 46 patients had elongated capillaries,16 with normal capillary length and 48 patients with dilated capillary width capillary. Fundus examination revealed 26 patients with DR and 36 patients nonDR. Our study reported that DR patients had higher duration of diabetes more than non-DR patients. Also, DR patients showed higher levels of HbA1c more than the non-DR patients. Patients with diabetic retinopathy show high percentages of tortuous, branched capillaries. 46.2% of the DR patients had precapillary edema verses 19.4% of the non-DR patients. The mean capillary width in the DR group of patients was 27.68 ± 5.7 verses 23.02 ± 3.29 in the non-DR patients which indicate that patients with DR had more wide capillaries than the non-DR patients. Higher fasting glucose levels were detected in the DR patients than the non-DR patients. Branched, tortuous capillaries, hemorrhage and dilated apical capillaries are documented in the patients with higher median diabetic years 15-20 years in the DR group of patients. Tortuosity, precapillary edema and dilated apical capillaries are positive in patients with higher median diabetic years. (24) patients documented to have DR with HbA1c ≥7% and only 2 DR patients with HbA1c <7. (29) patients had tortuous capillaries with HbA1c ≥7 verses 2 patients had tortuous capillaries with HbA1c <7. Also, (19) patients had precapillary edema in HbA1c ≥7 group while (0) patient had precapillary edema in the HbA1c <7 group. Capillary width and branched capillaries are found to be a predictor of diabetic retinopathy in multivariant analysis.

Conclusion

nailfold capillaroscopy is regarded a helpful noninvasive newly emerging tool to assess the capillaroscopic changes in diabetic patients as an indicator to diabetic complication development such as diabetic retinopathy.
The Relation between Vitamin D Status and Anemia in Patients with End Stage Renal Disease on Regular Hemodialysis
Authors: Nour el Din Afifi Essam , Abdulkhalek Essam Eldin Rashad Saeed , Tawfeek Ahmed Mohamed , Khedr Lina Essam
Published: August 2023

Background

Anemia is a common complication in end stage renal disease patients on regular hemodialysis (HD). several factors are linked to the pathogenesis of anemia in this population. There has been a lot of interest in the non-classical effects of vitamin D, including its association with erythropoiesis and anemia pathogenesis.

Objectives

To establish whether there is an association between anemia and the status of 25 OH (Hydroxy) vitamin D level in dialysis patients

Methods

This study is a cross sectional study that enrolled 90 patients on regular hemodialysis. Laboratory tests included Serum calcium, phosphorus, 25(OH) vitamin D and intact parathyroid hormone (iPTH) levels, Hemoglobin level, ferritin level, serum iron, total iron binding capacity and calculation of transferrin saturation. 25(OH) vitamin D level was measured by ELISA (Calbiotech. USA, REF: VD2208. Vitamin D status was classified into deficient (< 20 ng/ml), insufficient (20-30 ng/ml) and sufficient (>30 ng/ml).

Results

The level of Vitamin D measured in the patients ranged between 3.5 to 66 ng/ml with median 16.35 (8 – 34). 24 patients had vitamin D deficiency (vitamin D levels < 20 ng/dl), Patients with insufficient levels (vitamin D levels 20-30 ng/dl) were 32 patients, while patients with sufficient (> 30 ng/dl) levels were 34 patients. there were no statistically significant relations between vitamin D levels and the gender of the patients (p = 0.536), their age (p = 0.973), duration of HD (p = 0.600), Diabetes mellitus (p = 0.064) and hypertension (p = 0.249). There were statistically significant positive correlations between Vitamin D levels and the level of hemoglobin of the patients (P = 0.000), serum calcium levels (P = 0.000) and serum PO4 levels (P = 0.023). However, significant negative correlation between Vitamin D levels and serum iPTH levels (p = 0.000), serum iron (p = 0.019) and Transferrin saturation (%) (p = 0.012). Using Spearman correlation coefficient, there were highly significant positive correlations between vitamin D3 levels in all patients and both hemoglobin levels (p = 0.000) and serum calcium levels (p = 0.000). Meanwhile, there were highly significant negative correlations between vitamin D3 levels in all patients and serum iPTH levels (p = 0.000) and T.SAT of the patients (p = 0.003).

Conclusion

There was a significant association between the status of vitamin D and the level of hemoglobin in dialysis population who were studied, other associations with hemoglobin levels included PTH level and calcium.
Fibro-scan Based Score and Novel Noninvasive Serum Marker, FGF-21, to Assess Liver Fibrosis in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease
Authors: Shawky Amal , Ashraf Ossama , Fahim Heba Ahmed , Henin Marian Talaat Mansour
Published: August 2023

Background

Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of liver disease in the Western world, affecting up to 20-30% of the general adult population. It is a growing public health problem, because of the increasing prevalence of the pathologies that contribute to its development such as obesity and inflammation status.

Aim of the Work

This prospective cohort study aims to develop and validate noninvasive scoring system for assessment liver fibrosis in morbidly obese patients with NAFLD.

Subjects and Methods

This is a Prospective cohort study, was carried out on 50 morbidly obese patients selected from endocrinology department, AIN SHAMS UNIVERSITY, through a period of six months.

Results

The main results of the study revealed that: There were 32(64.0%) male and 18(36.0%) female with mean age 40.48 (± 12.16) SD. There were 14(28.0%) between (20 -30), 11(22.0%) between (30-40), 9(18.0%) between (40-50) and 16(32.0%) ≥50. Mean Weight (Kg) was 106.6 (± 13.31) SD with range (82.50 – 145.5), mean Height (Cm) was 171.7 (± 6.25) SD with range (158.0 – 185.0), mean BMI (Kg/m2) was 36.17 (± 4.15) SD with range (29.30 – 43.40), mean Waist circumference 113.1 (± 8.64) SD with range (92.0 – 129.0). There were 37(74.0%) with Comorbidity. 10(20.0%) have DM, 11(22.0%) have HTN, 11(22.0%) have CDK and 5(10.0%) have COPD. mean Hb was 12.24 with range (11.0 – 13.50), mean Plts was 193.2 with range (151.0 – 250.0), mean WBCs with range (4.70 – 8.20), mean AST was 85.20 with range (21.0 – 210.0), mean ALT was 86.64 with range (15.0 – 212.0), mean Cholesterol was 181.4 with range (122.0 – 248.0), mean Triglycerides was 156.3 with range (12.0 – 294.0), mean LDL was 119.1 with range (61.0 – 193.0), mean HDL was 61.32 with range (23.0 – 96.0), mean GGT (U/l) was 18.22 with range (7.0 – 33.0), mean HBA1C was 5.72 with range (4.70 – 9.30), mean Fasting blood sugar was 101.8 with range (81.0 – 155.0) and mean Uric acid was 6.23 with range (4.0 – 10.10). Regarding ultrasound outcome there were 33(66.0%) have Gallbladder wall blurring, 34(68.0%) have Portal vein wall blurring, 42(84.0%) have Hepatic vein blurring and 50 (100.0%) have fatty liver. Regarding fibrosis grade there were 12(24.0%) F1, 17(34.0%) F2, 18(36.0%) F3 and 3(6.0%) F4.

Conclusion

That the combination of Fibroscan and, APRI, FGF-21 and FIB-4 methods provides a valuable approach for assessing liver fibrosis in NAFLD patients. This can eliminate the need for liver biopsy in patients without clear indication. In addition, several recent studies have also validated the used of non-invasive markers in the diagnosis of NAFLD. The establishment of a national program for the recognition of NAFLD is therefore essential to reduce the risk of liver disease progression.
Assessment of Carotid Atherosclerosis in Egyptian Chronic Hepatitis C Patients after Treatment by Direct Acting Antiviral Drugs
Authors: bayoumy Essam M , Allam Ahmed Samir , Mohamed Marwa Ahmed , Swailam Mostafa Mohamed Fikry Elhady
Published: August 2023

Background

Recent studies suggested association between hepatitis C virus (HCV) infection cardiovascular disorders, including carotid atherosclerosis with evidence of an effect of HCV clearance on carotid atherosclerosis.

Objectives

We aimed to evaluate the impact of direct acting antiviral (DAA) therapy for chronic hepatitis c virus (HCV) infection on carotid atherosclerosis.

Subjects and methods

This is a prospective cohort study that was carried out in Internal Medicine and Hepatology Department and outpatient clinics of the Ain shams university hospitals included 80 Egyptian patients with chronic HCV infection who started treatment in form of IFN-free, DAA-based regimen and completed the course of treatment and six months follow up period. All patients were subjected to detailed history taking, full physical examination, full laboratory investigations. Radiological assessment by abdominal ultrasonography and high-resolution B mode ultrasonography of both the common carotid arteries.

Results

the mean age of cases 58.13± 7.56 years 49 (61.25%) males and 31 (38.75%) females. IMT was significantly decreased after treatment 1.24 vs. 1.57 mm p < 0.001. The number of patients with IMT ≥ 1 mm was significantly decreased after 6 months 45 (56.3%) vs 57 (71.3%). there was significant positive correlation between baseline carotid IMT and age, BMI, bilirubin, INR, CTP score, Carotid plaques, total cholesterol. Meanwhile, there was significant negative correlation between baseline carotid IMT and hemoglobin, platelets, albumin, HDL. In patients who achieved SVR, total cholesterol, triglycerides, LDL and HDL was significantly increased after treatment. IMT was significantly lower in SVR group compared to non- SVR (p = 0.016).

Conclusion

Hepatitis C virus eradication by DAAs improves carotid atherosclerosis in by decreasing intima media thickening.
Serum Interleukin 4 Level in Asthma Patient in Relation to Body Mass Index (BMI)
Authors: Mohamed Sara M , Refaat Maged M , latif Osama M Abdel , Ahmed Eman E
Published: August 2023

Background

The association between obesity and bronchial asthma has been demonstrated by many studies, either observational or interventional studies in both children and adults. The interrelationship between obesity and asthma derives from a complex interplay of biologic, physiologic, and environmental factors. Obesity considered as an important risk factor for asthma development and this mediated by release of proinflammatory mediators, such as interleukin (IL-6) (IL-4), tumor necrosis factor-alpha, and leptin, into the circulation, while release of anti-inflammatory adipokines, such as adiponectin, is decreased.

Aim

To determine relation between serum interleukin (IL-4) level and body mass index (BMI) in asthmatic patients.

Methods

This study was conducted on 86 individuals. They were equally classified into two groups: group 1 (overweight and obese asthmatics) group 2 (average weight asthmatics) all of them were subjected to full history and examination, chest x ray, measurement of BMI, CBC, serum total IgE level, serum IL-4 level and pulmonary function test.

Results

Serum IL-4 level is significantly elevated in group 1(overweight and obese asthmatics) rather than group 2(average weight asthmatics) at p-value 0.000. There was no statistically significant difference between the two groups as regard eosinophils, total igE level, FEV1, FVC and FEV1/FVC%.

Conclusion

IL-4 level is significantly elevated in overweight and obese asthmatics rather than average weight asthmatics this may be indicate a pathogenic role in development of asthma in overweight and obese asthmatics.
Prevalence of Liver Injury, Gastrointestinal Tract Symptoms, and H. Pylori Infection in Patients of Coronavirus Disease 2019 (COVID-19)
Authors: Makhlouf Mohamed Maray , Salama Mohamed Magdy , Fathallah Ahmed , Zakaria Yasser Yehia
Published: August 2023

Background

COVID-19 most commonly presents with respiratory symptoms, including cough, shortness of breath, sore throat with characteristics of loss of smell and taste. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease.

Objective

To estimate the rate of GI symptoms, liver enzyme levels outside reference ranges, and fecal tests for H. Pylori antigen among patients with the suspected or proven COVID-19.

Patients and Methods

The research performed on 70 Egyptian patients who have suspected COVID-19 symptoms included in this study. The patients are divided into four groups. Asymptomatic group, group with respiratory symptoms, group with digestive symptoms, and group with respiratory and digestive symptoms.

Results

The asymptomatic patient was 10%, gastrointestinal symptoms with or without respiratory symptoms 24.3%, digestive symptoms only 11.8% of COVID-19, and H. pylori present in 50% of the digestive group of COVID-19 patients. The use of corticosteroids in the low effective dose for ten days to 2 weeks and anticoagulant play an important role in the management of COVID-19, especially in moderate cases.

Conclusion

The prevalence of gastrointestinal symptoms in COVID-19 increase up to 24.3% and the prevalence of patients with digestive symptoms only was 11.4%. In some cases, the digestive symptoms, particularly diarrhea, can be the initial or only presentation of COVID-19.