bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern and Epidemiological Characters of Meningitis Infections, Cairo Egypt. 2016–2019
Authors: Abd El-Wahab Hanaa S , El Din Walid S , Hussein Rasha S , Dewedar Sahar A
Published: August 2023

Background and study aim

Egypt is an endemic area with meningitis infections, which is associated with high complications and death rates making it a medical emergency. The World Health Organization (WHO) estimates that there are around 1 million of cases per year worldwide with 135–200,000 fatal cases. The aim of the study is to describe the socio demographic, economic and clinical pattern of meningitis, to determine the outcomes of the disease in term of complications and fatality, to identify the causative organisms, and potential factors associated with either complications or mortality.

Patients and Methods

All patients presents with symptoms of meningitis according to the standardized case definition of CDC and confirmed with either cerebrospinal fluid analysis or brain imaging were recruited from Ain Shams University Hospitals by retrospective reviewing of medical records along the period from 2016 to the end of 2019. Socioedemographic, clinical and outcome data were also collected (extracted from the records)

Results

One thousand three hundred twenty-four (1324) patients were enrolled in the current study. males were more infected than females, children were the most vulnerable group. The main cause of septic meningitis was streptococcus meningitis, mainly among children after Haemophilic influenza due to the introducing the HIB vaccine in vaccination program November 2014. Bacterial meningitis was the leading cause of death among studied patient and deafness was the main neurological complication.

Conclusion

Early clinical suspicion of CNS infection and immediate management are crucial factors in reduction of the still high morbidity and mortality rates. The changes in the pattern of causative organisms must be considered when starting empiric antibiotic.
Internet Addiction among a Sample of Ain Shams University Students: A Cross Sectional Study
Authors: Mahmoud Mohamed Salah , Yehia El-Awady Mohamed , Boulos Dina Nabih Kamel , Gabal Hebat Allah M S
Published: August 2023

Introduction

Internet addiction (IA) is one of the addictive behaviors with a significant public health importance.

Aim of the Work

To measure the prevalence of Internet Addiction among Ain Shams university students, to identify different risk factors contributing to IA among them, and to identify the relationship between IA and self-esteem.

Materials andMethods

A crosssectional study was conducted among a sample of 1308 students from six faculties covering both Practical and literal faculties at Ain Shams University using self-administered questionnaire that include demographic characteristics, Internet related data, validated Arabic version of young’s internet addiction scale and Rosenberg’s self-esteem scale.

Results

89.7% of studied students had IA and 77.5% of the students had normal self-esteem. The majority of students (91.9%) used mobile phones to access the internet and (94.3%) accessed it from their homes. Face-book was the most used social media platform and most of students logged on the internet for social networking (87.5%). IA decreased with age advancement and increased for students living with their families. Internet addiction decreased with the improvement of students’ academic performance. IA was related to internet usage purposes in the form of studying activities, the social application used such as Instagram and twitter and the daily usage time. IA was significantly associated with Low self-esteem.

Conclusions and recommendations

Level of IA was high among Ain hams University students and it was associated with Low self-esteem. Awareness interventional campaign about the harmful consequences of excessive internet usage become an urgent issue.
Perception of Health Care Personnel in Ain Shams University Hospitals toward COVID-19 Vaccine and the Intention for Vaccination
Authors: Adly Remon Mosaad , Algamal Aisha Aboul Fotouh , AlBagoury Lamyaa Said , Magdy Maha , Wahdan Mahmoud
Published: August 2023

Background

Vaccination has significantly decreased the burden of infectious diseases. Its role in disease control has been well recognized, countries prioritize vaccinating health care personnel against COVID-19 because of their susceptibility to the virus. However, vaccine hesitancy remains a barrier to reach that aim.

Objective

This study aimed to assess the perception of health care personnel (HCP) in Ain Shams University hospitals toward COVID-19 vaccine, intention to receive COVID-19 vaccine.

Methods

A cross sectional study was conducted at Ain Shams University hospitals from the first of April 2021 till end of August 2021. An anonymous self-administered questionnaire designed to cover topics wanted to be addressed in the study.

Results

Out of 337 health care personnel, 256(76.0%) of them had a positive attitude with the vaccination. Regarding the intention to receive the available COVID-19 vaccine, 228(67.7%) of health care personnel intended to receive the vaccine, 59(17.5%) do not intend to receive it while 50(14.8%) were unsure “hesitant”. Among 228 who intended to receive the available vaccine 136(59.6%) were physicians, 57(25.0%) were nurses, 35 (15.4%) were workers.

Conclusion

A high proportion of health care personnel declared their willingness to receive the COVID-19 vaccine, and hence, this will play a leading role in combating the pandemic.
Relation between Postmenopausal Osteoporosis and IL-17 Serum Level
Authors: Nassar Nagwa M M , Abd El-Aziz Ola A , Elmallah Reem M , El-Hoseiny Samar S
Published: August 2023

Background

Osteoporosis is a bone condition that makes bones thinner and more fragile because of reduced bone density, and it puts people at risk of fractures, especially of the hip, spinal vertebrae and wrist.

Aim of the Work

to study possible relation between serum level of IL-17 and postmenopausal osteoporosis.

Patient and Methods

This was a cross sectional study that was conducted at Physical Medicine, Rheumatology and Rehabilitation department at Ain Shams University hospital including thirty postmenopausal females’ study were diagnosed as having primary post-menopausal“ type I”. Then they were further subdivided into 15 post-menopausal non-osteoporotic women with normal BMD and 15 Postmenopausal osteoporotic women with reduced bone mineral density BMD diagnosed as having Primary Post menopausal Osteoporosis According to the World Health Organization (WHO) definition of osteoporosis for post-menopausal women. The duration of the study ranged from 6-12 months.

Results

There was high statistically significant difference between with and without osteoporosis groups regarding DEXA Score and FRAX and IL-17 serum level. There was a significant negative correlation between IL-17 serum level and each of age and menopause duration, while there was highly significant positive correlation between FRAX and each of age and duration of menopause. ROC curve in our study showed that: IL-17 serum level can be used to diagnose osteoporosis at a cutoff level of > 80, AUC of 1.0, with 100% sensitivity, 100% specificity, 100% PPV and 100% NPV. DEXA Score can be used to diagnose osteoporosis at a cutoff level of ≤ -2.6, AUC of 1.0, with 100% sensitivity, 100% specificity, 100% PPV and 100% NPV. FRAX can be used to diagnose osteoporosis at a cutoff level of > 0.4, AUC of 0.92, with 93.33% sensitivity, 80% specificity, 82.4% PPV and 92.3% NPV.

Conclusion

Serum IL-17 is significantly elevated in postmenopausal osteoporosis which may indicate its role in bone-resorptive processes.
Role of Multi-Detector CT (MDCT) in Diagnosis of Intestinal Obstruction
Authors: Elhadidy Amany Mohammed , Mohammad Shaimaa Abdelsattar , Ragheb Samar Ramzy
Published: August 2023

Background

CT is appropriate imaging modality for evaluation of patients with suspected intestinal obstruction in whom clinical examination and radiography do not yield a definitive diagnosis. CT is sensitive for detection of high-grade obstruction and has the additional benefit of defining the cause and level of obstruction.

Aim of the Work

The aim of this study is to evaluate the role of MDCT in the diagnosing of intestinal obstruction, detection of its causes and possible complications, and to correlate the association between imaging features and operative finding.

Patients and Methods

A cross sectional study was conducted including 31 patients between 7 months and 75 years with clinically suspected intestinal obstruction. Patients underwent multi-detector CT. Image interpretations performed by Independent radiologists were compared with the final diagnosis that was based on clinical and lab information as well as surgical findings in operated cases.

Results

Adhesive intestinal obstruction was the main cause of small bowel obstruction while adenocarcinoma was the main cause of large bowel obstruction in our study. The most common site diagnosed on CT was jejunum (87.1%). Highly significant correlation was found between CT and operative findings in the diagnosis of the site and cause of obstruction with P value of < 0.001.

Conclusion

MDCT is highly accurate and specific in the diagnosis of intestinal obstruction. It can demonstrate the exact site of obstruction, as a result it is useful for developing an appropriate treatment plan and managing the patient.
Comparison between Lung Ultrasound and Chest Computed Tomography in the Assessment of Severity of Confirmed Coronavirus COVID-19 Pneumonia
Authors: Elhefnawy Suzan Bahig Ali , Fawzi Mohamed Mohsen Tolba , Gawargios Fayrouz Abdel Nour Adeab , El-Din Nourhan Mohammed Hossam
Published: August 2023

Background

Coronavirus disease 2019 (COVID-19) was reported for the first time in the Chinese province of Wuhan and then rapidly spread worldwide, to be declared a pandemic on March 11, 2020. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which has a genome similar to that of the RNA virus group that caused SARS and Middle East respiratory syndrome.

Aim of the Work

The aim of this study was to determine the correlation between LUS and CT findings in SARS-CoV-2 infection, to assess the performance of lung ultrasound (LUS) to classify lung abnormalities and to evaluate the possibility of using this technique to provide a quantitative assessment of pulmonary involvement in COVID-19 patients.

Patients and Methods

This was a cross sectional study that included 30 patients who had symptoms of variable degree of fever, cough, and dyspnea with RT-PCR confirmed COVID19 infection by nasopharyngeal swab on admission or during hospitalisation either at ward or intensive care unit (ICU) at Ain Shams University Hospitals and National Hepatology and Tropical Medicine Research Institute from May 2021 to March 2022, for whom CT chest was ordered before admission. An acceptance from the ethical committee of the Radiology Department and the ethical committee of Faculty of Medicine - Ain Shams University and NHTMRI was obtained to use the data stored on PACS with the patient’s consent to perform lung ultrasound. Patients who did not perform PCR test, age <18years, those with known history of interstitial lung disease or with previous lung and thoracic wall surgery, anatomically having thoracic wall abnormalities and patients who did not consent to participate in the study were not included in the study.

Results

This study showed that in a sample of patients with PCR proven COVID-19, Patients with respiratory symptoms or comorbidities tended to have more changes on LUS and more extensive disease on CT. There was a relationship between the abnormalities detected by the imaging modalities; In addition, LUS score is associated with severity as assessed by chest CT scan and clinical features

Conclusion

The advantages of ultrasonography compared to CT include portability, no exposure to radiation (pregnant women and patients with extra risk for radiation use), low cost, no need for auxiliary personnel, and repeatability. Thus, it can be used as an alternative to CT chest in severe cases (especially ICU cases).
Prevalence of Pulmonary Embolism among COVID-19 Patients Using Multidetector Computed Tomography
Authors: Mahmoud Gehad Reda , Mohamed Shaimaa Salah , Ibrahim Ahmed Samir
Published: August 2023

Background

Thrombotic complications in patients diagnosed with (COVID-19) are emerging as an important sequela that contribute to significant morbidity and mortality

Aim of the Work

To discuss prevalence of pulmonary embolism as one of the thrombotic complications in COVID-19 Egyptian population.

Patients and Methods

Our study is a retrospective study that included patients from period August 2020 to July 2021. The study included 50 patients who were diagnosed as having COVID19 infection, referred to the Radiology department, Ain Shams University Hospitals for a CT pulmonary angiography due to clinical suspicion of acute pulmonary embolism PE.

Results

Acute pulmonary embolism was found in 22% of patient diagnosed with COVID-19 who underwent CT pulmonary angiography. 81.8% of patients with acute PE were males. The most common distribution site for embolism was in segmental branches (81.8%). 100 % of patients with acute PE had high D-dimer levels, while only 50% pf patients with no PE had elevated D-dimer levels.

Conclusion

Pulmonary embolism is a relatively common complication during COVID-19 pandemic, and it is associated with high D-dimer levels. This is one of the thrombotic complications of this disease which needs early recognition and management.
Safety of Ultrasound Guided Endovenous Management of Varicose Veins and How to Avoid Potential Complications
Authors: Amer Hesham Said Abdelhamid Mohamed , Hetta Osama Mohamed Abdelhamid , Mesbah Mostafa Mohamed Farid Mohamed
Published: August 2023

Background

Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) have been used to treat superficial venous insufficiency, Ablation of veins has replaced operative saphenectomy as the procedure of choice for the treatment of superficial venous insufficiency. This change has likely taken place due to the minimally invasive nature and acceptable safety of endovenous ablation while remaining as efficacious and durable as saphenous ligation and stripping. Pattern of complications had been changed over the past decade, due to shifting from surgical stripping of varicose veins to endovenous procedures. The incidence of complications vary widely based on the level of operators as ecchymosis incidence post endovenous procedure range from (52-100%), parathesia (0.5 - 41.5%), phlebitis (0.5 – 5.5%), burn (0.46%), DVT (0.27%), and pulmonary embolism in 0.02% of cases.

Aim of the Work

assessing the incidence of complications during endovenous procedures of varicose veins and possible preventive measures. Assessing incidence of complications during Endovenous laser ablation (EVLA), radiofrequency ablation and injection sclerotherapy. Assessing the preventive measures that could be conducted to decrease the incidence of complications of endovenous surgeries.

Patients and Methods

Type of study retrospective cohort study study setting the study will be conducted at Ain Shams University Hospitals, interventional radiology department study period 2 years study population patients admitted in interventional radiology department during the past 2 years and scheduled for varicose veins treatment.

Results

was conducted on 20 patients, 70.0% were males and 30.0% were females with mean age of the study group was 45.35 ± 11.34 years ranged from 28 to 65 years. Most patients with no known medical or surgical history 65.5%, 25.0% were diabetic and 5.0% were hypertensive.

Conclusion

because most of the side effects are minor, and major complications are rare, EVLA is a safe and minimally invasive procedure with excellent efficacy in the treatment of varicose veins. Because optimizing laser parameters and the EVLA procedure may reduce the incidence and severity of complications associated with EVLA, additional research is warranted.
Use of PET/CT in Diagnosis and Staging of Malignant Pleural Mesothelioma
Authors: Emad Amany , Sayed Khaled , Magdy Kerolos , Sharobeem Wilson
Published: August 2023

Background

The pleural space is formed by two pleural membranes: the parietal pleura and the visceral pleura. Each is comprised of a single layer of mesothelial cells, a basement membrane, and a layer of connective tissue which contains blood vessels and lymphatics. Various benign, malignant, and tumor-like conditions can involve the pleura. Malignant neoplasms are more common than benign neoplasms. Pleural tumors can have a varied imaging spectrum – may be unilateral or bilateral, calcified, or noncalcified, and focal or diffuse.

Aim of the Work

To elucidate the role of PET/CT in diagnosing and staging of malignant pleural mesothelioma (MPM) patients.

Patients and Methods

A cross sectional analysis of all cases of malignant mesothelioma referred to Elmaadi Military hospital during the period from Nov. 2020 to Jun. 2021 for assessment of the role of F18-FDG PET/CT in staging, restaging and monitor of therapy response compared to CT. The total number of patients with mesothelioma was 30 patients, 20 males and 10 females.

Results

In the present study, 27 patients out of 30 patients evaluated with PET/CT showed positive findings at primary sites in pleura and accurately localized tumor sites in them. Also 9 patients of them had local lesions in pleura only with 6 patients had loco-regional lesions. Furthermore 12 patients had loco-regional and metastatic lesions. We demonstrate that PET/CT has high sensitivity than CT in detecting MPM lesions specially intrathoracic lymph node and extrathoracic metastasis as (37% vs. 18 %) of PET/CT and CT respectively.

Conclusion

FDG PET/CT increases the accuracy of overall staging in patients with MPM and significantly improves the selection of patients for curative surgical resection. Specifically, FDG PET/CT is particularly useful in identifying mediastinal lymph node involvement and detection of distant metastases.
Role of Magnetic Resonance Imaging in Evaluating of Non-Traumatic Chronic Ankle Pain in Adult
Authors: Boutros Kyrillos Soliman Kadous , Gamrah Sherif Hamed Abou , Ibrahim Suzan Farouk
Published: August 2023

Background

Chronic ankle pain is a common complaint that can interfere with a patient's routine activities. Despite careful and detailed clinical history and physical examination, providing an accurate diagnosis is often difficult because chronic ankle pain has a broad spectrum of potential causes. Therefore, imaging studies play a key role in diagnosis and management.

The ability of MRI to demonstrate soft tissue detail and to visualize high anatomical resolution gives it an advantage in characterization of the abnormal findings. (1)

Aim of the Study

To highlight the role of magnetic resonance imaging in the assessment of the underlying aetiology of chronic non traumatic ankle pain.

Patients and Methods

cross sectional study was conducted in Ain Shams University hospitals on patients confirmed with nontraumatic chronic ankle pain undergoing ankle MRI study.

Results

The most common causes of nontraumatic chronic ankle pain were haglund syndrome five cases (14.3%) and osteoarthritic changes five cases (14.3%). Overall MRI imaging was able to pick probable etiology in our study.

Conclusion

High soft tissue resolution, nonionizing, noninvasive nature, and multiplanar capabilities of magnetic resonance imaging (MRI) make it an investigation of choice for nontraumatic ankle pain. It demonstrates soft tissue structures including muscles, tendons, ligaments, cartilages, nerves, blood vessels as well as bony structures. It is also useful for guiding treatment decisions and determining response to therapy.
Role of Ultrasonography in Assessment of Painful Ankle
Authors: Geryes Lilian Michel Ayad , Mohamed Marwa Ibrahim , Bassiouny Ahmed Mohamed
Published: August 2023

Background

Musculoskeletal ultrasound (MSKUS) imaging is becoming more and more popular in the evaluation and management of various problems in rheumatology.

Aim of work

to document the prevalence and spectrum of MSKUS findings at different parts of the ankle in patients complaining of ankle pain.

Patients and Methods

- This study was carried out at the Radiology Department, Ain shams University Hospitals. Twenty-eight patients with ankle pain underwent ultrasound (US) examination.

Results

abnormalities were found in 54% of the examinations performed. The abnormalities were more common in female patients accounting for 57 % of the abnormalities detected. The most common finding was joint effusion/synovitis seen in 26% of the patients.

Conclusion

ankle US was able to identify a large number of pathologies. This demonstrates the usefulness of US in the evaluation of a patient with ankle pain.
Usefulness of Diffusion Weighted MRI in Differentiating Benign from Malignant Bone Lesions
Authors: Kamel Faten Mohamed Mahmoud , Wahby Hemada Tarek , Ali Mai Mohamed Mohamed
Published: August 2023

Background

Bone tumors represent a wide spectrum of disease in children & adult ranging from benign lesions to an aggressive malignancy, so finding a noninvasive diagnostic tool was needed.

Objective

We aimed to differentiate between benign and malignant bone lesions and to limits the number of patient with benign lesion who undergo biopsy.

Patients and Methods

Our study was carried out on 32 patients were diagnosed with bone tumors (21 benign & 11 malignant), at the MRI unit of the Radiology Department Ain Shams University, outpatient clinics and private centers after getting approval from each ethical committee. They were assessed with conventional & diffusion MR images, DW EPI carried out using different b values including 0 s/ mm², 500 s/ mm², and 800 s/ mm². ADC map were automatically calculated.

Results

The mean ADC value for benign tumors was 1.6±0.4 x 10 -3 mm2/s. while malignant tumors were 1.2±0.3 x 10 -3 mm2/s. ROC analysis was used to define the best cut off mean ADC value for detecting malignancy which was <1.3, with sensitivity of 81.8% specificity of 81%.

Conclusion

The present study showed high specificity and sensitivity of DWI as a complementary sequence with conventional MRI and ADC value measurements in discrimination between benign and malignant bone tumors with significant cut-off value, making it a noninvasive tool for increasing the accuracy in identifying bone lesions.
Ultrasound Tracking of Fetal Growth Characteristics during the Third Trimester of Pregnancy and the Prediction of Adverse Birth Outcomes
Authors: Mohamed Safaa Kamal , ELdeen Mohamed Hend Galal , Georgy Michael Saber Nan
Published: August 2023

Background

Fetal growth is the outcome of complex interactions between genes and the environment. A human being undergoes a synchronized balance of growth and development of body proportions throughout the prenatal and postnatal phases. Fetal growth is affected by many factors including maternal sociodemographic, maternal lifestyle-related characteristics, and pathological conditions, such as infections and some genetic conditions.

Objective

To assess the role of 3rd trimester ultrasound and fetal growth measurements in the prediction of adverse birth outcomes.

Patients and Methods

This study was a prospective cohort study of 141 pregnant females, conducted at Ain Shams University Hospitals.

Results

HC, AC, Expected fetal weight, HC percentile and weight percentile were significantly higher in normal cases than still birth, preterm, neonatal death and SGA, and lower than fetal macrosomia. AC percentile was significantly higher in normal cases than preterm, neonatal death and SGA, and lower than fetal macrosomia.

Conclusion

Fetal biometric and Doppler measurements during the third trimester of pregnancy play an important role in early detection of adverse growth outcomes in order to initiate further monitoring, planning and managing of delivery.
Mechanical Thrombectomy by Stent Retrievers for Treating Acute Ischemic Stroke due to Large Vessel Occlusion
Authors: Ismail Mohammad Amr Mohamed , Gamal-eldin Mostafa Mahmoud , Ibrahim Ayman Mohamed
Published: August 2023

Background

Recently multiple studies have evaluated the role of mechanical thrombectomy in treatment of acute ischemic stroke & demonstrated that it has a favorable impact on the functional outcome in patients with acute ischemic stroke related to proximal arterial occlusion. In addition to that, multiple systematic reviews and meta-analyses analyzed the results of these recent Randomized Control Trials and concluded that endovascular treatment is more likely to result in a better functional outcome for patients compared to IV thrombolysis alone for acute ischemic stroke due to large vessel occlusion, with no differences in mortality and symptomatic intracerebral hemorrhage at 90 days follow-up. Mechanical approaches have shown great potential of replacing locally applied thrombolytic agents as first-line therapy.

Objectives

The aim of work is to evaluate the safety and efficacy of endovascular treatment (EVT) of acute large vessel occlusion within the first 6 hours of symptoms onset, including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT]. We also compare our results to other main trials in recent years.

Methods

A one arm clinical trial was conducted on 25 patients with acute ischemic stroke at Ain Shams University hospitals as well as private centers, from the first of April 2020 to the end of September 2020. All participants subjected to full history taking, radiological assessment and assessment of the stroke severity.

Results

The median age of the studied patients was 64 years (Interquartile range 58-72.5) and about half (56%) of them were males. On pre-post intervention comparison, there was a highly significant statistical difference regarding NIHSS score, infarct volume, mRS score at 90 days (P < 0.001) and ASPECTS (P < 0.01) of the studied patients. 12% of patients had mortality at 30 days after mechanical thrombectomy with good functional outcome (mRS 0-2) rate of 60%.

Conclusion

Mechanical thrombectomy is effective and safe in treatment of acute ischemic stroke in patients with large cerebral artery occlusion with the first 6 hours of symptoms onset.
Non-Alcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma: Effect of Hepatic Steatosis on Major Hepatocellular Carcinoma Features at MRI
Authors: Botros Samer Malak , Ahmed Khaled Sayed , Ismail Mohamed Zaki , Ali Waseema Kamal Ibrahim Hassan
Published: August 2023

Background

Non-alcoholic fatty liver disease has become the leading chronic liver disease in the developed world, with a prevalence of 6%-35%. Its pathological spectrum ranges from simple steatosis (non-alcoholic fatty liver) to different degrees of inflammation and liver cell damage [nonalcoholic steatohepatitis (NAFLD)]. NAFLD has gained attention in recent years because of its association with hepatocellular carcinoma (HCC).

Objective

To see how hepatic fat fraction affects LIRADS major hepatocellular carcinoma features on magnetic resonance imaging.

Patients and Methods

Our study included 60 patients who had had a liver MR scan and exhibited MRI features in keeping with HCC. We categorize the patients into two groups: hepatic steatosis and non- hepatic steatosis groups based on MRI hepatic fat signal fraction. LI-RADS major and ancillary features were evaluated in all HCCs. Between October 2021 and April 2022, a retrospective search was conducted to find all patients with HCC who underwent an MRI of the liver at the radiology department of Ain Shams University's Faculty of medicine.

Results

In the current study, a higher proportion of HCCs show non- enhancing capsule in patients with hepatic steatosis; 5 HCC (5/30; 16.7%), while in the non-hepatic steatosis group no HCCs 0 (0%) showed non-enhancing capsule. The effect of ancillary features on diagnostic accuracy is still being researched. As regards the impact of the degree of fatty liver on the major and ancillary HCC features, the “enhancing capsule”, “mild-moderate T2 hyperintensity” and “restricted DWI” features are less commonly seen in cases of moderate to severe hepatic steatosis than in those of mild hepatic steatosis. Our study also showed that HCCs tends to be of a smaller size as the hepatic steatosis degree increased.

Conclusion

The findings of our retreopective study are coincide with a recent retrospective studies demonstrated that “enhancing capsule” feature of HCC was less frequently observed in patients with hepatic steatosis compared to non-hepatic steatosis patients. We compared the MRI features of HCC in patients with hepatic steatosis to those in patients without hepatic steatosis. Our findings imply that existing imaging criteria for the noninvasive characterization of HCC in individuals with hepatic steatosis should be utilised with care.
Effect of Genetic Polymorphism on Clinical Efficacy of Tacrolimus in Adult Living Donor-Liver Transplant Patients
Authors: El-Moez Amal Tohamy Abd , Askar Safaa Ragab Tawfik , Mansy Azza El-sayed , Kamal Abobakr
Published: August 2023

Background and Aim

The influence of genetic polymorphism on the clinical outcome including response and safety of immunosuppression in liver transplant (LT) recipients remains controversial among different races and ethnicities, especially for calcineurin inhibitors (CNIs). This study aims to evaluate the effect of different genotypes of the single nucleotide polymorphism (SNP) in the genes encoding CYP3A5 on the therapeutic response to the widely used calcineurin inhibitor; tacrolimus.

Method

In 49 living donor liver transplant (LDLT) recipients with tacrolimus as the backbone immunosuppressive, the rejection, delayed graft function, laboratory evidenced nephrotoxicity, new onset diabetes and hypertension rates were considered the primary therapeutic and safety outcomes of tacrolimus. The biochemical parameters of tacrolimus response and safety as evidence by the status of liver functions, renal functions, complete blood counts and serum electrolytes, as well as the need for Mycophenolate mofetil (MMF) were considered the secondary outcomes.

Results

the rejection and delayed graft function rates didn’t differ significantly among different genotypes (p = 1), similarly; the incidence of new onset diabetes and hypertension didn’t differ significantly among different genotypes (p = 1, and 0.4143 respectively). Moreover; laboratory evidenced nephrotoxicity rates didn’t differ significantly among different genotypes (p = 0.5040). No significant intergenotype differences were observed in the all biochemical outcomes. However the need for MMF was significantly higher among carriers of the CYP3A5*3 allele.

Conclusion

different genotypes did not offer an advantage over one another in predicting therapeutic response or toxicity of tacrolimus among LDLT recipients.
Sarcopenia as a Predictor of Prognosis and Risk of Recurrence in Patients Following Curative Treatment for Hepatocellular Carcinoma
Authors: AlBreedy Ashraf Mohammad Mahmoud , Salah el-din Manar Mohamed , El-Sadaney Mohamed Taha Hassan
Published: August 2023

Purpose

This study is designed to evaluate the prognostic value of sarcopenia as a predictive method for survival of patients with hepatocellular carcinoma (HCC) who will receive curative treatment.

Methods

To determine the influence of sarcopenia on prognosis, skeletal muscle index (SMI) was measured using computed tomography at the level of the third lumbar vertebra of 100 patients who underwent radiofrequency for hepatocellular carcinoma (HCC). They were followed up for at least 7 months and overall survival and recurrence were identified. We defined sarcopenia using cutoff values for SMI as less than 43.75cm /m for men and 41.10cm /m for women.

Results

Sarcopenia was present in 54 of 100 patients and correlated significantly with low body mass index (BMI) and DM. Sarcopenia and MELD Na score were significantly associated with poor survival of the patients.

Conclusions

The study concluded that sarcopenia seemed to have a negative impact on OS in patients with HCCs. Sarcopenia could significantly increase the incidence rates of post-treatment recurrence and overall complications in patients with HCCs.
Clinical Trends of Malaria in Abbasia Fever Hospital over a Period of Two Years
Authors: Fawzy Montaser Mohammed , Emara Sally Moustafa Mahmoud , Eldin Mona Soliman Zein , Salah Eldin Manar Mohammed
Published: August 2023

Background

Malaria is an acute systemic illness caused by infection with Plasmodium parasites that lives part of its life in humans and part in female Anopheles mosquitoes. It remains one of the major killers of humans, population worldwide.

Objective

To study clinical trends and prevalance of malaria in Abbasia Fever hospital over a period of two years.

Patients and Methods

This study was conducted in co-operation between Tropical Medicine Department, Faculty of Medicine, Ain Shams University and Abbasia Fever hospital. The current study was conducted on 200 Malarial patients admitted to Abbasia fever Hospital in Cairo (time) to be treated according to the protocol of treatment of malaria which was approved by Ministry of Health in Egypt.

Results

According to the treatment of malaria, the present study revealed that the best response in studied cases was to the mono-therapy. Concerning the clinical outcome of the studied cases, most of the studied cases (189 patients) were cured in the sense of clinical and parasitological improvement. Regarding comparative results among the studied cases, complicated malaria was more frequent in male and non-Egyptian and pregnant women.

Conclusion

Malaria should be considered as a cause of fever in relevant target patients. Malaria disease is commoner in the younger ago group. In Egypt, no endogenous malaria cases have been reported since1998 until 2014 a malaria outbreak was discovered in Aswan. Malaria cases in Egypt are usually coming from endemic area in Africa. Mortality due to malaria disease is unusual, and may result from improper chemoprophylaxis and missed diagnosis or late treatment. Monotherapy is preferable than Combined therapy (polytherapy) as it is more effective among the studied malarial cases. Tools of prophylaxis are insect repellents, protective clothes, bed nets and chemoprophylaxis.
The Outcome of Ulcerative Colitis Patients after One Year of Biological Therapy
Authors: El-Aziz Ashraf Amin Abd , Askar Safaa Ragab Tawfic , Ahmed Yasmeen Abdel-latif , Abokhatwa Nadeen Ashraf Ahmed
Published: August 2023

Background

Inflammatory bowel disease (IBD) comprises two types, namely, the ulcerative colitis (UC) and Crohn’s disease (CD). They are a spectrum of chronic idiopathic autoimmune inflammatory disorders with remission and relapses, primarily affecting the gastrointestinal system, UC is characterized by confluent mucosal inflammation and erosions starting from the anal verge and extending to a variable extent, where Patients often complain of diarrhea associated with rectal bleeding, abdominal tenderness, and weight loss A number of biological agents have been approved by the U.S Food and Drug Administration (FDA) for te treatment of UC.

Objectives

The aim beyond this study is to assess the effect of biological therapy after one year on ulcerative colitis patients regarding clinical manifestations, hospitalization, number of severe attacks, laboratory investigations, colonoscopy and histopathology.

Patients and Methods

The studied patients were selected from patients presented to IBD study group clinic.tropical medicine department in Ain Shams University hospitals. total number of cases during the study period was 28 cases fulfilling the inclusion criteria.

Results

The mean age of the patients was 30.14 ± 7.65. The majority of the cases were sightly more common in females. The duration of illness ranged from 1-10 years with median 3 years (2 - 5.5). the majority of the patients had pan colitis (75%). there were 19 biologic-naive patients (67.9 %) and 9 biologic-experienced patients (32.1%). In our study, 16 patients (57.1%) received adalimumab, 11 patients (39.3%) received infliximab and only one patient received ustekinumab. The majority of cases (71.4%) were taking azathioprine as a combination therapy with biologics. the majority of the patients (75%) achieved clinical response at 1-year follow-up.While clinical remission achievied in only 46.4%

Conclusion

Biological treatments are very successful in the therapy of IBD. However, these treatments are still expensive and new patients with IBD must begin first with the traditional treatments without knowing if they will work for them.
Non Invasive Biomarkers for Non-Alcoholic Fatty Liver Disease in Egyptian Obese Patients Undergoing Bariatric Surgeries
Authors: Taher Sarah Hassan , El Mahdy Manal Mohamed , Zaki Doaa Zakaria , Al-Hamid Mohamed Salaheldin Abd , Naga Mohamed Ahmed Aboul , Barakat Eman Mahmoud Fathy
Published: August 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the worldwide occurring in 33 % of the general population and in over 90% of the patients with morbid obesity that are undergoing bariatric surgery. NAFLD encompasses a histological spectrum ranging from simple steatosis (NAFLD) to nonalcoholic steatohepatitis (NASH) with various degrees of fibrosis that may progress eventually to cirrhosis. A key issue for the prognosis and management of NAFLD is the differentiation of simple steatosis from NASH. To date, liver biopsy remains the best gold standard for diagnosing NASH and grading the severity of liver damages but it is invasive procedure. There is an urgent need for a less invasive method than biopsy of screening the population, stratifying disease severity and following disease progression.

Aim of the Work

To evaluate promising non-invasive predictive biomarkers used to distinguish between NASH and simple steatosis in morbidly obese patients undergoing bariatric surgery.

Patients and Methods

This was a case control study conducted in morbidly obese patients before they had gone bariatric surgery between January 2018 and January 2020 with a total number of 30 patients.

We included morbidly obese patients (BMI≥40 kg/m²) undergoing bariatric surgeries. Liver biopsies were obtained at time of bariatric surgery and examined by single pathologist and graded according to NAFLD activity score (NAS),

Results

This study was conducted on 30 patients who were morbidly obese before they had gone bariatric surgery at Ain Shams University Hospitals. Among the 30 patients, 21 of them diagnosed as NASH by the liver biopsy, 42.9% of the NASH patients were diabetic, and 47.6% of them were hypertensive. The BMI and hip circumference were highly significant with NASH with cut off level of BMI >42.6 and 85.71% sensitivity and 66.67% specificity. Using AUC analysis, we established for these parameters the following cutoff levels being indicative of NASH with the highest accuracy (equal or above): BMI of 42.6 kg/m2, HOMAIR of > 3.6. For adiponectin, a value equal or below 2.9 mg/L was indicative of NASH and hs-CRP of above 1.5 mg/L.

Conclusion

BMI> 42.6 kg/m², HOMA-IR, adiponectin, hs-CRP are good non- invasive indicators for NASH in morbidly obese patients undergoing bariatric surgeries.
Co-Relation between MELD Scoring System prior Living Donor Liver Transplantation and Occurrence of Post-Transplant Biliary Complications
Authors: Hussein Mubarak Mohamed , Abdelwahab Sameh Mohamed , Dabbous H , Montasser Iman Fawzy , Al-Banna Wael M
Published: August 2023

Background

Liver transplantation is considered the treatment of choice for patients with end stage liver disease who have failed standard medical and surgical therapy. The development of liver transplantation has revolutionized the field of hepatology and greatly improved the outlook of patients suffering from various liver diseases. The Model for EndStage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease. It was initially developed to predict mortality within three months of surgery in patients who had undergone a transjugular intrahepatic portosystemic shunt (TIPS) procedure and was subsequently found to be useful in determining prognosis and prioritizing for receipt of a liver transplant. This score is now used by the United Network for Organ Sharing (UNOS) and Eurotransplant for prioritizing allocation of liver transplants instead of the older Child-Pugh score. Biliary tract complications are abundantly occurring post-operative, and they may include a variety of scenarios, as biliary leakage, ischemic bile duct injuries, and biliary stenosis.

Aim of the Work

Aim of the work is to study the relation between the Model of End Stage Liver Disease (MELD) scoring system and the occurrence of post liver transplantation biliary complications.

Patients and Methods

A combined retrospective and prospective cohort study was carried out. We retrospectively analyzed the available database of all patients that underwent LDLT, at Ain Shams Center of Organ Transplantation (ASCOT), during the period from January 2013 till May 2019, and suffered from post-operative biliary complications during the first 3 months Post-operative and correlated it with their MELD score before the operation. To do so, we studied 50 patients that are aged more than or equal 18 years old, any gender, that underwent living donor liver transplantation. We excluded patients with cholestatic liver disease and patients that underwent preoperative biliary intervention. All patients were subjected to complete history taking and thorough clinical examination, full laboratory workup, full radiological workup, post-operative cholangiography and Endoscopic retrograde colangio-pancreatography if needed.
Randomized Clinical Trial to Evaluate the Efficacy of Tamsulosin, Solifenacin, and Their Combination for the Treatment of Stent Related Symptoms
Authors: Kotb Youssef Mahmoud , Salem Ahmed Farouk , Hassan Ahmed Abd Elsalam Embaby
Published: August 2023

Background

Ureteral stents play a major role in a wide range of situations where urinary drainage is needed, the double-J stent which is the most common form of ureteral stent, has been used in obstructive pyelonephritis, intolerable acute renal colic, ureteral edema, ureter perforation following endoscopic procedures, and renal failure secondary to ureteral obstruction. Despite the usefulness of stents, some of the patients might encounter stent-related complications such as urinary tract infection (UTI), lower urinary tract symptoms (LUTS), stent-related body pain, and hematuria. These symptoms represent a prevalent problem with considerable effects on the quality of life, substantial general health, work performance, and sexual performance in both genders. For this reason, several attempts to minimize stentrelated symptoms have recently been reported. Pharmacologic management is one of these trials, especially the prescription of selective alpha-1-blockers as tamsulosin and antimuscarinic agents as solifenacin.

Aim of the Work

To analyze and assess the effectiveness of a selective alpha-1-blocker (tamsulosin) and antimuscarinic (solifenacin) and their combination in improving the lower urinary tract symptoms of patients with indwelling double-J ureteral stents.

Patients and Methods

The present study was a prospective randomized controlled comparative study conducted on 112 patients with double-J stent inserted in Ain Shams University Hospital and El-Agouza hospital. over a period of 6 months. The patients were randomized into 4 equal groups (1:1:1:1 randomization): Group A: 28 patients were received a daily oral dose of pepon plus as a placebo drug (control group). Group B: 28 patients were treated by Tamsulosin (0.4 mg) alone once daily. Group C: 28 patients were treated by Solifenacin (5 mg) once daily. Group D: 28 patients were treated by Tamsulosin (0.4 mg) once daily in combination with Solifenacin (5 mg) once daily. All patients were assessed first day postoperatively after Double-J stent insertion. Then, the patients were start the medical treatment and were assessed on the first and third week post treatment.

Results

The study show that the combination of the tamsulosin 0.4 mg/day and the solifenacin 5 mg /day are significantly different from tamsulosin only, solifenacin only and placebo groups. Generally superior to the all other groups for the stent related symptoms treatment. However, regarding the comparison between solifenacin only group and tamsulosin only group, the solifenacin only group was generally superior to tamsulosin group and both are better than placebo group.

Conclusion

The combination of the tamsulosin 0.4 mg/day and the solifenacin 5 mg /day are generally superior to the all other treatments for the stent related symptoms.
Effect of Shock Wave Frequency on Stone Disintegration in Extra Corporeal Shock Wave Lithotripsy
Authors: Agour Abdefattah , Radwan Ahmed , Zahra Ahmed Ali
Published: August 2023

Background

The use of Shock Wave Frequency (SWL) for the treatment of renal stones has brought a revolution in the field of urology. Not only has it decreased hospitalization duration and morbidity, but it has also shown to be cost-effective. SWL treatment is noninvasive, doesn't require anesthesia, and may be done in outpatient settings. As a result, when it comes to treating renal and upper and middle ureteric stones, ESWL is still the best option.

Objective

To evaluate of the effect of shock wave frequency on treatment outcomes in terms of success and complication rates.

Methods

This is a prospective study conducted on 135 patients with renal stone planned to have ESWL sessions attending urology outpatient clinic in Ain Shams University and Misr University for Science and Technology hospitals. Patients were recruited from the outpatient clinic from age 18 years to 70 years old with renal or upper ureteric stone who are candidate for ESWL. Patients were assigned to 3 equal groups who received the same number of shock waves (3000 shock waves) with different shockwave frequency.

Results

The results revealed that there was no statistically significant difference found between the three studied groups regarding age, sex, BMI, side, site, size of stone and house field unit (density of stone). As regard sensation of pain during session, there was difference between patients’ groups where pain sensation increases as the frequency rate increase. But there was no statistically significant difference found between frequency 60 and frequency 90 groups regarding pain score. While there was statistically significant increase in the pain score in frequency 120 group than the other both groups 60/min and 90/min. There was no statistically significant difference found between the three studied groups regarding results of stone clearance.

Conclusion

Extra corporeal shock wave lithotripsy (ESWL) is still one of the most effective methods in treatment of upper urinary tract stones. It also remains the only truly non-invasive treatment in renal and upper ureteric stone diseases. There is evidence that modifying lithotripsy parameters like frequency of disintegration is strongly related to the outcome of the treatment. Intermediate shock wave frequency (90/min) is associated with highest success rate (95.3%) followed by the low frequency group (60 /min) and both are better in outcome than high frequency (120/min). With increasing the frequency of disintegration, duration of session decrease with pain sensation during the treatment increase. Highest shock wave frequency (120/min) is associated with lowest success rate as well as highest pain sensation during session.