bluuebunny/crossref_metadata_2025 huggingface dataset:
SOLUBLE TRANSFERRIN RECEPTOR IS A PROMISING MARKER of IRON DEFICIENCY ANEMIA IN PREVALENT HEMODIALYSIS PATIENTS
Authors: seif Khaled Abou , Hussien Hussien Sayed , Abdelmegied Shaimaa , Abdulhady Marwa
Published: October 2021

Background

Diagnosis of iron deficiency is traditionally based on ferritin and other iron parameters becomes difficult in end stage renal disease patients due to the inflammatory condition which affects these markers and masks the iron deficiency. Serum soluble transferrin receptor (sTfR) is able to be a reliable indicator for assessing iron status, as it is not affected by inflammatory procedures.

Aim

To evaluate the usefulness of serum soluble transferrin receptors in iron deficiency anemia detection in comparison to the classic markers of iron status in prevalent hemodialysis patients.

Methods

This case-control study assessed sTfR in 80 prevalent ESRD patients on regular hemodialysis in 2 groups. Group A (N = 40): CRP >10 and group B (N = 40):CRP <10 and apparently healthy 8 control subjects.

Results

The cut of value of STFRs in hemodialysis patients was 12.5 mg\l. The prevalence of STFRs in patients with CRP<10 was 85%, while in patients with CRP>10 was 92.5% (P-value 0.288). STFRs have high sensitivity 88.75, specificity 100, PPV100% and NPV 47.1%. The hemodialysis patients who have elevated STFRs have risk 1.22 times to have iron deficiency anemia if CRP <10 (odds ratio: 1.22) and 3.14 times if CRP>10 (odds ratio: 3.14). There was significant difference on comparing patients with CRP<10, CRP>10 and control as regard Hb and STFR with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference in both between the patients with CRP<10 and control also in patients with CRP>10 and control (p value <0.0001). while on comparing patients with CRP<10 with patients with CRP>10 there was significant difference in STFRs p value 0.0001 despite no significant difference in hemoglobin (p value 0.642) and classic marker of iron deficiency (s.iron, TIBC, TSAT) with p value 0.701,0.192,0.382 respectively. Serum STFRs was negatively correlated with s.iron and Kt\v (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively in patients with CRP <10.

Conclusion

Serum soluble transferrin receptor is highly sensitive and specific marker for iron deficiency in hemodialysis patients especially in patients with high CRP level.
Incidence of Atrial Fibrillation in Haemodialysis Patients
Authors: El-Tayeb Nasser Mohamed , Abdeltawab Adham Ahmed , Mehany Raafat Boshra , El-Gawad Mostafa Abd El-Nassier Abd
Published: October 2021

Background

Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy.

Aim of the Work

To detect the incidence of AF in hemodialysis patients during six months.

Patients and Methods

The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in CAIRO, EGYPT for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study.

Results

The study includes 250 patients from whom 37 patients refuse follow up after 6 months and 18 patients was died before our follow up holter ECG so mortality rate 14.4% .1n our study population there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 — 6) with range (1 — 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000).

Conclusion

The incidence of AF in patients with ESRD is 16.4%. The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.
Clinical Characteristics of Behçet Disease in an Egyptian Cohort
Authors: Farouk Hanan Mohamed , El-Maamoun Tarek A , Elbakry Samah A , Rahman Maryam Ahmed Abdul , Samy Nermeen , Elziaty Rahma Ahmed
Published: October 2021

Aim of the work

To study the clinical characteristics of Behcet’s disease (BD) in Egyptian patients.

Patients and methods

150 BD patients were recruited from the Rheumatology and Internal medicine Department, Ain Shams University Hospitals. Demographic and clinical data were collected. Disease activity was assessed using Behcet Disease Current Activity Form (BDCAF).

Results

150 BD patients were included in this study. Their ages were 34.05 ± 9.28 years (14 – 66 years) and with disease duration range (1–20 years). There were 116 males (77.3%)and 34 females (22.7%), with male to female ratio of 3.4:1. The BDCAF was 4.44 ± 1.97 (2–10). The frequency of the clinical manifestations was oral ulcers in 86.7%, followed by genital ulcers in 82.0%, ocular involvement in 68.7%, vascular affection in 58.7%, articular manifestations in 32.7%, pathergy test was positive in 28.0%, skin manifestations in 26.0% (pustular lesions, folicilitis,erythema nodosum and pyoderma gangrenosum), neurological in 25.3% in the form of (CNS infarction in 12.7%,vasculitis in 6.7%, Cerebral sinus thrombosis in 4.0% and Seizures in 2.0%) and gastrointestinal in 7.3% in the form of (nausea, vomiting and abdominal pain).

Conclusion

In Egypt, there is a male predominance in BD patients as other areas in worldwide countries. The clinical characteristics are comparable to other studies. However, in Egypt the gastrointestinal manifestations showed the lowest recorded frequency
Study of Urinary Iodine Level Assessment and its Relation to Thyroid Function during Pregnancy
Authors: Mohamed Magda Shoukry , Nasr Merhan Samy , El-Halawany Salah Hussien , Abbas Ahmed Mohamed , Tayeh Salma Said Hassan
Published: October 2021

Background

The global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to poor monitoring, is currently a more frequent occurrence than iodine deficiency. Iodine excess is a precipitating environmental factor in the development of autoimmune thyroid disease.

Aim of the study

to evaluate the urinary iodine level as a marker of iodine status in pregnant women in 3rd trimester and assess its relation to thyroid functions.

Patients and Methods

This Cross Sectional Study was conducted on 100 subjects with their ages ranging from 18-35 years old, pregnant females, at the third trimester, selected from Obstetric Out- patient Clinic of Ain shams University Hospitals. Samples were collected from participants in cairo, during the Spring and Summer from March to August.

Results

in our study, there was a significant negative correlation between Urinary Iodine level and TSH as Iodine difficient group has the Highest TSH, and the Highest Thyroid Volume, as there was a significant negative correlation between Urinary Iodine level and Thyroid Volume.

Conclusion

TSH level and Thyroid Volume were global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to significantly higher in Iodine difficient group than Excess iodine group, And FT4 level was lower in Iodine difficient group than excess iodine group.
Serum MicroRNA-222 Expression for Malignancy Prediction in Euthyroid Patients with Indeterminate Thyroid Nodule
Authors: Mohamed Sherihan AboElyazed , Halawa Mohamed Reda , Ahmed Yara Mohamed , Maher Maram Mohamed , Elhalawany Salah Hussein , Salem Lamyaa
Published: October 2021

Background

The Prevalence of thyroid nodules is rising nowadays, luckily most of them are benign. The risk of malignancy 5-15%, which necessitates the ultimate need to accurately distinguish benign from malignant nodule to avoid unnecessary thyroidectomy with risk of recurrent laryngeal nerve injury, postoperative hypothyroidism and lifetime thyroid replacement therapy, and other complications related to surgery and anaesthesia. Recent evidence suggests that circulating miRNA might have probable advantage as diagnostic or prognostic markers for numerous cancers. Given their reproducible and constant presence in sera, miRNA profiles have emerged as a non-invasive method to categorise a wide variety of human cancers.

Aim of the study

To evaluate a possible relationship between the expression level of circulating miRNA-222 and the histological outcome of euthyroid patients undergoing thyroidectomy for thyroid nodules with indeterminate FNAB cytology.

Patients and Methods

45 patients of both genders, of age ranging from 19-70 years old visiting endocrine clinic or admitted to the endocrine surgical department with indeterminate thyroid nodules planned for thyroidectomy were included. All pateints were subjected to full medical history taking, general and local clinical examination, laboratory investigations (thyroid function tests), quantitative assay of serum micro RNA-222 expression by quantitative Real-Time polymerase chain reaction (qRT-PCR), ultrasonography imaging of thyroid gland, fine needle aspiration biopsy and cytology of the thyroid nodule, histopathological examination after thyroidectomy.

Results

The incidence of thyroid nodules was predominant in female gender in benign group and malignant group. Risk of malignancy increases as TI-RADS and Bethesda scores increases. Also, larger nodule in size has a more risk of malignancy (p = 0.034). Expression level of circulating miRNA222 in serum can’t differentiate between healthy, benign and malignant patients where there was no significant difference between them statistically (p = 0.867). Circulating miRNA-222 is a poor predicator for malignant nodules with sensitivity of 50%, specificity of 32.43%, with high negative predictive value (NPV=75%).

Conclusion

Expression level of circulating miRNA-222 is a poor predictor of malignant nodules in our studied group. The larger the nodule size the more risk of malignancy. Also, as TI-RADS and Bethesda scores increases the more risk of malignancy.
Urinary Neutrophil Gelatinase-Associated Lipocalin as a Novel Predictor in Treatment of Active Lupus Nephritis
Authors: Mady Gamal E , Shawky Sahar M , Bichari Walid A , Hassan Mohamed S , Tawfik Ahmed M , Abd El-Mohsen Mohamed A
Published: October 2021

Introduction

Lupus nephritis (LN) affects almost two-thirds of Systemic lupus erythematosus (SLE) patients. Despite initial aggressive therapy, up to 25% of patients with LN will progress to end stage renal disease (ESRD). Conventional serum markers for LN lack the sensitivity of an ideal biomarker. Urinary Neutrophil gelatinase-associated lipocalin (UNGAL) is an excellent biomarker for early diagnosis of acute kidney injury and predicting renal outcomes.

Objectives

To measure UNGAL among LN patients correlating its levels with renal disease activity to investigate its predictive performance in response to induction therapy.

Patients and Methods

40 SLE patients with biopsy-proven LN, class III, IV, or V were randomly selected. The study was conducted in internal medicine department and Outpatient clinic in Ain Shams University Hospitals on and completed after six months. UNGAL was measured at baseline and after complete induction therapy.

Results

In LN patients at baseline; mean UNGAL levels of complete response, partial response, and no response groups were 14.48 ±2.99 ng/ml, 34.49 ±4.09, and 62.07 ±14.44 ng/ml respectively. Based on ROC curve, we found better performance of baseline UNGAL to discriminate complete response group from partial and non-response groups to predict response to induction, outperforming conventional biomarkers. The area under the curve was 0.943 (92.31% sensitivity, 88.89% specificity), and the best cut-off level was 26.5 ng/ml.

Conclusion

UNGAL performed better than conventional biomarkers in predicting response to treatment of active LN.
Role of hepcidin as a biomarker for iron status and its effect on anemia management in patients with chronic kidney disease (stage II-Iv) after HCV treatment
Authors: El Sharkawy Magdy M , Khedr Lina E , Abdelmbdy Ashraf H , Mohamed Mohamed T
Published: October 2021

Background

Anemia is a severe complication of chronic kidney disease (CKD) that is seen in more than 80% of patients with impaired renal function. Although there are many mechanisms involved in the pathogenesis of anemia of renal disease, the primary cause is the inadequate production of erythropoietin by the damaged kidneys.

Aim of the work

to assess hepcidin level in non dialysis patients (CKD stage 4 &5) treated from Hepatitis C virus and its relation to iron parameters.

Patients and Methods

This study was conducted on 20 CKD patients (stage 4 and 5) treated from hepatitis C virus. All candidates included in this study subjected to careful history taking, full clinical examination and investigations (including complete blood count, renal chemistry, HCVAb, serum iron, total iron binding capacity, TSAT%, ferritin and hsCRP. Serum hepcidin was analyzed by ELISA technique.

Results

Serum hepcidin was 26.35±7.26; 40% in stage III, 37.8% in stage IV and 22.2% in stage V. There was statistically significant difference between GFR stages according to Hb., Drug intake ACE inhibitor/ARB, Plt., Creatinine, BUN, Iron, TIBC, Ferritin, T SAT%, CRP and Serum Hepcidin. We showed significant correlations between serum hepcidin and TIC, Iron, TIBC, Ferritin and TSAT%.

Conclusion

Median hepcidin value is elevated in nondialysis CKD patients due to increased inflammation and decreased clearance of hepcidin. Furthermore, iron status modifies serum hepcidin level and its association with Hb. Increased hepcidin level leads to iron-restricted erythropoiesis and recombinant human EPO (rhEPO) resistance by inhibiting iron absorption from gut and iron recycling from macrophages. Hence, elevated hepcidin can predict need for parenteral iron to overcome hepcidin-mediated iron-restricted erythropoiesis and need for relatively higher rhEPO doses to suppress hepcidin.
Evaluation of urinary TNF-α and KIM-1 biomarkers in T2DM in Upper Egypt
Authors: Sharkawy Magdy EL , Abdul-Hamid Samir K , Elmelegy Tarek T , Adawy Mohammed F
Published: October 2021

Background

Diabetes mellitus (DM) is the most frequent cause of chronic kidney failure in both developed and developing countries. Diabetic nephropathy, is a clinical syndrome characterized by albuminuria (>300 mg/day) with permanent and irreversible decrease in glomerular filtration rate (GFR).

Aim of the Work

To study the role of urinary TNF-α and urine KIM-1 in type 2 diabetic patients as predictors of DN comparative with albuminuria.

Patients and Methods

This is a cross-sectional study which include 90 type-2 diabetic patients and 30 controls selected from the outpatient clinic of Assiut University hospitals. All patients gave an informed consent and approval for the study was obtained from the IRB committee of the Assiut Medical Faculty. The recruited patients were divided into three groups: Normo-albuminuria Group (A) (n = 30): UACR less than 30 mg/gm, Microalbuminuria Group (B) (n = 30): UACR between 30-299 mg/gm and Macro-albuminuria Group (C) (n = 30): UACR equal or more than 300 mg/gm. Assess Urinary TNF-α and urine KIM-1 in comparision with albuminuria.

Results

Urinary KIM-1 and urinary TNF-α are statically significant with albuminuria in patients in the early stage of diabetic nephropathy (eGFR _60 mL/min/1.73 m2).Also there are statically significance between patients with macroalbuminuria than microalbuminuria.

Conclusion

The results of this study recommend the use of KIM-1 and TNF-α as good predictors of early detection of development of diabetic nephropathy.
Comparative study between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection
Authors: Osman Mahmoud Abd -Elmageed , Allam Ehab Hassan Nashat , Anwar Christina Alfonse , Allam Mohammed Soliman Mahmoud
Published: October 2021

Background

HCC is one of the most common malignancies worldwide and is a major cause of death, because of its high frequency and poor prognosis. It is especially common in Egypt, where it develops on top of cirrhosis secondary to viral hepatitis C and B. Since HCV infection is highly prevalent in Egypt, it accounts to most of the cases of HCC in Egypt. HCV infection is found in a variable proportion in HCC cases in different populations, accounting for 75-90% of cases in Japan, 31-47% in the U.S, 44-76% in Italy, and 60%-75% of HCC cases in Spain.

Objective

To compare between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection.

Patients and Methods

Our study was a comparative study including 60 patients divided into 2 groups as follow patients successfully treated with Ledipasvir based regimen (Group A) and patients successfully treated with Daclatasvir based regimen (Group B) from January 2016 to June 2017.

Results

There were no statistically significant difference between the two groups as regard demographic and laboratory data. In comparison between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection in the first group there were 3/30 cases of percentage of 10% has developed HCC and in the second group there were 2/30 cases of percentage 6.6% has developed HCC after successful therapy for each group, there were no statistically significant difference between the two groups as regard the incidence of HCC after successful treatment, but generally DAA as Ledipasvir based regimen and daclatasvir based regimen both have low incidence of HCC after successful therapy of HCV infection.

Conclusion

There were several researches to study relation between DAA as treatment for HCV infection and HCC incidence after successful therapy. Our study was done to compare between Ledipasvir based regimen and Daclatasvir based regimen as regard incidence of Hepatocellular Carcinoma after successful Therapy for patients with chronic hepatitis C virus infection.
Myo-Inositol Oxygenase as a Predictor of Acute Kidney Injury in Critically ill Patients
Authors: Aref Hayem M , Ezzat Haitham , Hussein Hussein S , Asaad Mona E
Published: October 2021

Background

Acute kidney injury (AKI) affects 45% of critically ill patients, resulting in increased morbidity and mortality. The diagnostic standard, plasma creatinine, is nonspecific and may not increase until days after injury.

Aim of the work

to assess myo inositol oxygenase as noval marker in early detection of acute kidney injury critically ill patients.

Patients and Methods

In this prospective study, 40 critically ill patients were followed up in ICU up regarding development of Aki in ICU according to KDIGO definition. They were categorized into two subgroups; 20 patients developed AKI in and 20 patients who did not develop AKI. In addition, a control group of 20 individuals in Ain Shams Hospital during the period from 2018 to 2019, we did myoinositol oxygenase level test at time of admission and repeated in patients group which develop AKI within 24-48 hours.

Results

MIOX for the diagnosis of AKI When the cut-off value was taken as above 800, the diagnostic sensitivity and specificity of MIOX for AKI were 100%). For creatinine, at the cut-off value of above 0.9, the sensitivity for AKI were found 90% and specificity for AKI were found 65%.

Conclusion

The measurement of serum MIOX is valuable for the diagnosis of AKI. Further research is needed for the evaluation of the potential use of MIOX as a kidney-specific enzyme in the early diagnosis of AKI.
Potential Anti-carcinogenic Effect of Acetazolamide, a Carbonic Anhydrase Enzyme Inhibitor, in Diethylnitrosamine - Induced Hepatocarcinogenesis in Rats
Authors: Sayed Moataz Mohamed , Soliman Mohamed Lotfy , Tamim Yomna Mohamed , Osman Ahmed H , Hussain Muhammad Saleh Abdul-Rasheed
Published: October 2021

Background

Despite the progress achieved in early detection and treatment of HCC, it still accounts for a significant number of cancer-related deaths worldwide. Tumoral microenvironment acidity plays a pivotal role in tumoral cell survival, tumoral progression and metastasis. CA-IX and XII are two of several mechanisms by which tumor maintain optimal intracellular pH at the expense of the extracellular environment that turns into acidic pH. ACT is a CA inhibitor that is used in many medical indications. It is effective, safe and inexpensive. It has some side effects and it may be even contraindicated in some cases.

Aim of the work

To evaluate the possible anticarcinogenic role of ACT in DEN-induced HCC animal model.

Materials and Methods

This study showed that using DEN for 10 weeks caused significant increase in the levels of AST, ALT, total bilirubin, direct bilirubin and AFP and significant decrease in albumin level in DEN-induced HCC rat groups when compared to normal control rats. Administration of ACT for 3 weeks in ACT-treated DEN-induced HCC group caused marked improvement in the mentioned biochemical measurements (AST, ALT, total bilirubin, direct bilirubin and AFP) when compared to DEN-induced HCC rat group without ACT treatment, yet still higher than the lab values of normal control group.

Results

The present study demonstrated that using DEN in rat groups had induced polyhedral to round hepatocytes with dense, centrally located vesicular nuclei. The neoplastic areas showed poorly differentiated large cells with hyperchromatic nuclei and prominent nucleoli. The neoplastic cells showed anisokaryosis, anisocytosis, and deeply basophilic scanty cytoplasm and frequent mitotic figures mostly Grade III. The hepatic lobule displayed disorganization of hepatic cords with hyperplasia of Kupffer cells, multinucleated tumor giant cells with prominent basophilic nuclei and basophilic spindle cells.

Conclusion

Acetazolamide showed significant antitumor effect in DEN-induced HCC in rats, making it a promising agent to use against HCC either individually or in combination with any other therapeutic modalities. Further researches should be conducted in this anti HCC aspect.
Comorbid Psychiatric Disorders in Subjects with Self-injurious Behavior
Authors: Abd Al Aziz Mohamed Fikry , Abd Al Rahman Sultan Marwa , Elhabiby Mahmoud Mamdouh , Khalifa Ahmed Rashad Mahfouz
Published: October 2021

Background

Self-injurious behavior (SIB) is one of the common psychiatric emergencies in medical practice. It has become a global health problem with rates increasing over time. What makes young people cut, scratch, carve or burn their skin, hit or punch themselves, or even bang their heads against a wall? For years, psychologists theorized that such self-injurious behaviors helped to regulate these sufferers' negative emotions.

Objectives

The aim of this study is: to determine association between psychiatric disorders and selfinjurious behaviour, to highlight types of self-injurious behavior, to explore motives of self-injurious behavior.

Patients and Methods

Our study is a case control study which was conducted on 100 self- injurious patients who presented to ER and not known to have a psychiatric illness, 50 subjects with no history of psychiatric disorders or self-injury behaviour, case group was referred to institute of psychiatry, Ain Shams University Hospitals.

Results

The two groups were matched with a mean age of 22.21 ± 2.02 in group (A) Subjects with self- injurious behavior, 21.82±1.84 in group (B) Controls. Socio-demographics in our study indicates that the samples were matched and fit for the comparative study (i.e. a homogenous sample). Axis 1 psychiatric disorders Adjustment disorder 13 (13%), Mixed anxiety-depressive disorder 17 (17%), Schizophrenia 6 (6%), None 64 (64%), Axis 2 personality disorders BPD 59 (59%), Mixed personality traits 41 (41%).

Conclusion

Our study's main interest is to determine association between psychiatric disorders and selfinjurious behaviour, highlight types and explore motives of self-injurious behaviour among a sample of patients with self-injurious behaviour Group (A) and controls Group (B). Psychiatric diagnosis is prominent in self-injurious patients than controls.
Relationship of Internet and Gaming Addiction with Adult Attention Deficit Hyperactivity Disorder among Male University Students
Authors: Nagy Professor / Nahla EL Sayed , El Habiby Assistant Professor. Mahmoud Mamdouh
Published: October 2021

Background

In the modern trends life is impractical without computer and internet, scientific literature supported that internet addiction might have a close association with ADHD symptoms. Therefore, there was a dire need to extend this theory within the context of developing nations such as Egypt.

Objectives

The current study aims to investigate internet and gaming addiction in undergraduate university students of Ain shams University and its significant association with ADHD symptoms.

Methodology

This is a cross sectional comparative study. All data will be collected from Ain Shams University students from 4 different faculties (2 theoretical & 2 practical faculties). A sample comprised of 400 undergraduate students distributed across 4 different faculties meeting the inclusion and exclusion criteria.

Results

Overall 33% and 5 % of students fall in the moderate & severe Internet addiction level respectively, among which 37% & 7% have comorbid ADHD symptoms in theoretical faculties and 10% & 10 % in practical faculties. Also, 16.5% & 12% were risky and disordered gamers among which 37.1% & 29% and 25%, 60 % have comorbid ADHD symptoms in theoretical and practical faculties respectively. Implications, significance of the study, and limitation are enclosed

Conclusion

The results of the present study concluded that there is a significant relationship between internet and gaming addiction with ADHD symptoms among undergraduate university students in the selected sample.

Recommendations

Further in-depth research is needed to help in understanding the relationship between internet and gaming addiction at a larger scale.
DWI Lesion Characteristics As A Predictor For Outcome In Acute Stroke Patients Treated By IV-tPA
Authors: Aref H , Farag S , Helmy S , Mahmoud H
Published: October 2021

Background

Thrombolysis with tissue-type plasminogen activator (IV-tPA) is a well-proved, widely used treatment in acute ischemic stroke patients, many predictors of functional outcome have been proposed as Age, vascular risk factors, initial clinical evaluation on admission using National institute of health stroke scale(NIHSS), functional state of patient(b.L) baseline before stroke and 3 months (3m) after stroke using modified Rankin stroke scale (MRS)and the most controversial Diffusion weighted image characteristics (volume, heterogeneity)

Objective

To evaluate DWI MRI characteristics (volume, heterogeneity) as a predictor for outcome in Acute stroke patients treated by IV-tPA

Patients and Methods

This study will be done on a sample of 100 acute ischemic stroke Egyptian patients receiving intra-venous tissue -type plasminogen activator presenting to Ain-Shams university hospitals

Results

Highly statistically significant (p-value < 0.001) Positive correlation (r = 0.394) between volume (DWI) and MRS (3m) post discharge in studied patients, No statistically significant (pvalue > 0.05) relation between heterogeneity and other studied parameters (MRS, NIHSS D & ADC values) in studied patients

Conclusion

DWI infarct volume is a predictor for outcome in acute ischemic stroke patients treated by tPA
Correlation between vitamin D and lipid profile in multiple sclerosis patients
Authors: AbdelAziz Azza AbdelNaser , Saleh Prof Dr. Rasha Mamdouh , Swelam Mahmoud Saad , Ayad Janet Masoud
Published: October 2021

Background

Studies have suggested that vitamin D and lipid profile have been linked to the etiology of multiple sclerosis and have an impact on the activity and progression of the disease.

Objectives

The aim of the present study was to determine correlation between vitamin D level and lipid profile in multiple sclerosis (MS) patients and their effect on disease activity and progression for better management and control of risk factors.

Patients and Methods

It is a cross-sectional hospital based study carried on clinically definite 111 Relapsing Remitting MS (RRMS) patients according to McDonald criteria 2010 recruited from Multiple sclerosis unit at Ain Shams University Hospitals, both genders included and aged from 18 to 50 years old. All subjects were assessed regarding their basic demographic data, serum vitamin D level and lipid profile and correlated these data with their state of disease activity and degree of disability.

Results

The mean level of serum vitamin D was 18.93 ± 9.85 ng/mL. Serum vitamin D level was insufficient (< 30 ng/mL) in 81.08% of patients and sufficient (≥ 30 ng/mL) in 18.92% of patients. The mean level of total cholesterol (TC) was 204.9 ± 50.9 mg/dL, of tri-glycerides (TG) was 105.4 ± 44.6 mg/dL, of low density lipoprotein (LDL) was 122.2 ± 38.8 mg/dL and of high density lipoprotein (HDL) level was 56.2 ± 16.6 mg/dL. High relapse frequency was found to be significantly related to low serum vitamin D level with P-value 0.005. Near all lipid related variables were positively correlated to disease duration. TC and TG were positively related to EDSS while HDL was negatively related with it. Number of brain T2 lesions was significantly correlated with TC and TG levels with P-value 0.001 and 0.002 respectively. Fingolimod was found to be associated with dyslipidemia. We found that each 1 ng/mL increase in vitamin D was associated with decrease in TC of 1.48 mg/dL (95% CI: -2.42 to -0.54, P-value 0.002) and increase in HDL of 0.35 mg/dL (95% CI: 0.04 to -0.66, P-value 0.028).

Conclusion

Vitamin D deficiency is predominant among Egyptian MS patients. Patients with insufficient vitamin D were found to have higher annualized relapse rate (ARR). Patients with dyslipidemia found to have longer duration, more disability and higher brain T2 lesion load. Vitamin D was correlated positively with HDL and negatively with TC.
Suicidal Ideations and Behaviors in victims of cyberbullying
Authors: Abdelsamea A. M , Elserafy D. M , Naguib R , Omran K. H
Published: October 2021

Background

Involvement in bullying as well as cyberbullying has been identified as a risk factor for depression and anxiety symptom as well as suicide ideation/behavior. Results from community samples suggest that youth who are bullied, are at an elevated risk for suicidal thoughts, attempts, and completed suicides. Statistically both victims of cyberbullying as well as offenders proved to be much more likely to have attempted “bullycide,” the act of committing suicide due to the effects of bullying, than youth who had not been affected.

The Aim of this study

To determine the correlation between being a cyberbullying victim and suicidal ideation and/or behavior in adults and young adult population.

Patients and Methods

This is a cross-sectional, analytical study that includes 408 subjects of both genders of online social-media above the age of 18. All subjects have been screened using GHQ28 for the exclusion of mental illness at the time of study. Then subjects completed Cyberbullying Self Rated Questionnaire (CBQ) and Suicide Probability Scale (SPS) both in Arabic.

Results

suicidal probability was found to be increased proportionately in a statistically significant way with the degree of exposure to cyberbullying.

Conclusion

There is a significant increase in suicidal ideations/behaviors among cyberbullying victims whom have been exposed to higher levels of cyberbullying, even in the absence of major psychiatric disorders.
QT INTERVAL IN TEMPORAL LOBE EPILEPSY VERSUS NON TEMPORAL LOBE EPILEPSY
Authors: Gaber Ahmed A , Abdelhamed Yousry A , Wahid Eldin Mona M , Bastawy Islam M , Nasef Maram S
Published: October 2021

Introduction Background

SUDEP is leading cause of mortality in patients with chronic refractory epilepsy. Despite several epidemiological studies, case series , monitored and witnessed SUDEP the exact mechanism is not proposed

Objective

This work was carried out to assess QT interval prolongation in epilepsy and whether there’s a difference in QT interval prolongation between temporal epilepsy and non-temporal epilepsy.

Patients and methods

This study was conducted on 100 patients, 50 aged and sex matched healthy controls who underwent a prolonged (6 to 24 hours) 22 channel computerized EEG monitor with 10-20 system electrode placement and 12 lead electrocardiogram (25 millisecond speed). QT, QTd and QTc using Bazzet’s formulae were calculated.

Results

The results showed statistically significant difference prolongation of QT interval in epilepsy particularly temporal lobe epilepsy.

Conclusion

Significant prolongation of QT interval in epilepsy patients (11% suffered pathological prolonged QT). Marked prolongation of QTc and QTd in temporal lobe epilepsy over non temporal group.
Prevalence of Eating Disorders and Alexithymia among a sample of Egyptian Medical Students Not Attending Psychiatric Clinics
Authors: Essawy Heba I , Hashem Nivert Z , El hawary Youmna A , Morsy Mahmoud H , El Awady Sara A
Published: October 2021

Background

Eating disorders are prevalent psychiatric disorders and a major Public health burden worldwide, having huge impact on physical and mental health, The student population seems to be vulnerable to eating disorders, but is this in relation to their ability to express their emotions or alexithymia?

Aim of the work

To evaluate the relationship between alexithymia and eating disorders.

Subjects and methods

this is a cross sectional study done on a stratified random sample of 575 medical students in Ain- Shams University, started from 2018 till July 2019, those with history of chronic physical or mental illness were excluded, all students were subjected to Designed clinical sheet for demographic data, Arabic version of Eating Attitude Test -26 (EAT-26) as screening tool for eating disturbances in non-clinical populations and Arabic version of Toronto scale 20 to measure alexithymia.

Results

our study revealed disordered eating 12.3% among the study sample, alexithymia 24.4% and significant variation in scores of eating disorder according to alexithymia scores.

Conclusion

our study revealed positive correlation between eating disorders and alexithymia consistently with hypothesis of emotional regulation deficits in eating disorders.
Studying the relationship between tobacco use and eating behavior among Egyptian university students
Authors: Elesawy Heba Ibrahim , ElHabiby Mahmoud Mamdouh , Mohsen Nesreen Mohamed , Samy Tawfik Mohamed
Published: October 2021

Background

Cigarette smoking is a leading cause of morbidity and mortality. In addition to the independent risks related to cigarettes, smoking is highly associated with obesity-related behaviors including unhealthy diet. Despite the public health significance, little is known about mechanisms underlying with the paired relationship of smoking and unhealthy dietary behaviors.

Aim of the Work

This study aimed to Detect the relationship among smoking status and total and specific types of food cravings (i.e., high-fats, sweets, fast-food fats, and complex carbohydrates/starches), the influence of demographic, clinical, and psychological factors on this relationship and estimate the frequency of nicotine dependence among a sample of 420 egyptian students from 4 theoritical and 4 practical faculties in Ain Shams University

Patients and Methods

This is an observational Cross sectional study study conducted in 8 different faculties in Ain Shams University. The present study aimed at analyzing the demographic data of 420 egyptian university students, during the academic year 2018-2019.The severity of nicotine dependence among those students was assessed using Fagerstrom Test for Nicotine Dependence (FTND), eating behavior was assessed using Yale Food Addiction Scale (YFAS), Socio-Economic Status (SES) Scale for assessing socio-economic level and Eating Disorder Examination Scale for assessing eating disorders.

Results

Compared to never smokers, current smokers reported more frequent cravings for high-fat foods and fast-food fats, after controlling for BMI and demographic factors. Current smokers also reported consuming more high-fat foods and fast-food fats. Nicotine dependence was positively correlated with the frequency of general food cravings and cravings for high fats, sweets, and carbohydrates/starches.

Conclusion

Cigarette smokers, and especially those with higher nicotine dependence, may have greater difficulties in addressing food craving and changing eating habits
Distal Femoral Extension Osteotomy and Patellar Tendon Advancement in Management of Fixed Knee Flexion Deformity and Crouch Gait in Cerebral Palsy
Authors: Emara Khaled Mohamed , El-Ghazaly Sherif Ahmed , Mahran Mahmoud Ali , Alsehemy Mahmoud Ahmed
Published: October 2021

Background

Cerebral palsy (CP) is generally associated with musculoskeletal deformities that occur during body growth. Fixed knee flexion deformity (FKFD) results from long standing knee flexion that is due to progressive contracture of spastic hamstrings combined with a quadriceps weakness. Fixed knee flexion compromises the passive mechanisms of joint stabilization at mid and terminal stance in children with CP. The aim of this study is to highlight the results of distal femoral extension osteotomy and patellar tendon advancement (DFEO + PTA) for management of FKFD in crouching CP patients with spastic or mixed tone diplegic ambulatory cerebral palsy children.

Patients and Methods

A prospective study was conducted involving twenty CP patients with fixed knee flexion deformity (14 males and 6 females). The 20 cases with fixed knee flexion deformity were GMFCS level II (4 cases), and III (16 cases). All patients were clinically and radiologically assessed according to knee flexion angle, extension lag, koshino index and the Gross motor function measure pre- and post-operative. All patients underwent DFEO ± PTA. Eighteen limbs had DFEO on the RT side, and twenty on the LT side.

Results

The mean age of the patients was 11.18±3.23 (6-16) years. The period of follow up ranged from 12 to 24 months (The mean follow up was 16.20 ± 2.46). At last follow up, the median knee flexion angle improved from 25 to 0. The median extension lag improved from 17.5 to 0. The mean koshino index improved from 1.59 ± 0.32 to 1.05 ± 0.10. the GMFM improved from 52.86 ± 7.36 to 68.15 ± 5. 82.

Conclusion

The combined procedure (DFEO + PTA) is effective in increasing knee extension in the stance phase, reducing knee pain and improving knee extension strength.
Outcomes of Combined Unicompartmental Knee Replacement and Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: El-Husseini Timour Fekry , Ahmed Mustafa Ali , Sadek Yahia Ahmed
Published: October 2021

Background

The incidence of osteoarthritis of the medial compartment after ACL injury has been quoted to range from 33% to 70%. Medial osteoarthritis in ACL deficient knee is a challenge. Patients are mainly young and active. First reports highlighted a higher incidence of complications, in terms of tibial loosening and higher revision rate, when UKA were performed in ACL-deficient knees. They defined ACL deficiency is a contraindication to UKA.

Objectives

A systematic review and meta-analysis of literature to assess functional outcomes of combined unicompartmental knee arthroplasty with ACL reconstruction and revision rate.

Data Sources

The following electronic databases were searched up to 2019: PubMed, Google Scholar search engine, JBJS {Journal of bone and joint Surgery}, Cochrane database of systematic reviews, EMBASE and Science Direct.

Results

A total of 10 studies met the inclusion criteria encompassing 218 patients who were treated with simultaneous ACL reconstruction and unicompartmental knee arthroplasty. The mean age was 49.5 years (range from 36 to 71) with a mean follow-up of 49.3 months (range from 9 to 258). There was an improvement in mean Oxford Score from 29 to 42.5. The mean knee society score improved from 88.3 to 159. Complications reported included tibial inlay dislocation (n = 3), conversion to a total knee arthroplasty (n = 2), infection requiring two-stage revision (n = 2), stiffness requiring manipulation under anaesthesia (n = 1). Average revision rate was 1.8%.

Conclusion

Literature has strong evidence to support that combined UKA and ACL reconstruction show good functional outcomes and less revision rate. It is a valid treatment option for MOA more in young age group in whom MOA secondary to ACL tear and intact other knee compartments. there is no clinical trial or study suggest that UKA and ACL reconstruction is superior to UKA with tibial slope change or using fixed bearing prosthesis for MOA in ACL deficient knee with instability.
Evaluation of flexor tendon repair (zone II) with Wide Awake Anesthesia
Authors: Fayed Ahmed Adel Zaghloul , Aziz Naglaa Mohamed Abdel , Gawad Ebrahim Mohamed Amin Abdel , Kamel Ibrahim Hussien , Elshahat Ahmed
Published: October 2021

Background

Recent advances in hand surgery has been the movement away from tourniquet surgery, which often requires sedation or GA and the patient will be awake and cooperative. Wide awake approach depends on the safety of adrenaline which is now well established. This review will evaluate the role of the wide awake approach in reducing rupture and tenolysis rate after flexor tendon repair zone 2.

Objective

To evaluate the functional outcome of flexor tendon repair zone II (most challengeable) under wide awake anesthesia.

Patients and Methods

After approval of local ethical committee of faculty of medicine Ain Shams University, this Prospective study has been conducted targeting patients with acute zone II flexor tendon injuries admitted at El Sahel Teaching Hospital within the period from September 2019 till January 2020, and their follow up for minimum three months at outpatient clinic. A Written informed consent explaining the whole procedure under study in this research has been obtained from all patients and absolute confidentiality as regard the patients’ names and addresses was given special care and attention. Final outcome evaluated by Original Strickland evaluation system.

Results

Using the wide awake technique provides an optimal opportunity to test repair strength through Intra-operative Total Active Movement (ITAM) making the surgeon much more comfortable to initiate early active motion. Besides, rising trend toward using early active rehabilitation protocol in case of strong repair using four or more strands repairs is recently supported in literature. This study adopted early active rehabilitation protocol with slight differences among them

Conclusion

This preliminary study assessing the outcomes of primary tendon repair in flexor tendon injuries in zone II using the wide-awake technique demonstrates encouraging results, being satisfactory for both surgeons and patients that makes this new approach a competitive to the other approaches of flexor tendon repair implemented under conventional methods of anesthesia.
Evaluation of Fingertip Injuries and Modalities of Flap Coverage in the Emergency Settings: A Retrospective Study
Authors: Mohamed Salah Nasser , AbdeIAal AbdelRahman , Estawrow Mina Agaiby , Attia Andrew Adel Wassef
Published: October 2021

Background

Fingertip comprises the nail complex and glabrous pulp, which is richly vascularized and innervated, built around the distal phalanx. The fingertip is commonly affected because it is the most distal part of the hand so it's easily to be injured during athletic participation, occupational activities or in accidents. Various fingertip reconstruction methods are reported as healing by secondary intention, shortening and primary closure, skin grafts and flaps. Flaps are considered when there's a big soft tissue loss or an exposed bone. Complications of fingertip reconstructions are common such as flexion deformity and neuroma.

Objective

In this study, we assessed and compared the outcomes of different modalities of soft tissue covemge using different flap techniques in cases of fingertip injuries as regalding the incidence of neuroma, necrosis, donor site morbidity, joint stiffness and sensory impairment, together with the patient satisfaction.

Patients and Methods

We analyzed a retrospective cohort study of 90 patients with 96 fingertip injuries who underwent coverage by various flap techniques at Ain Shams University Hospitals in the period between July 2017 and July 2019.

Results

The V-Y Advancement flap and the Cross-finger flap were the commonest flaps done in 26 cases (27.1%) and 25 cases (26.0%) respectively. There's a highly statistically significance in the incidence of necrosis in abdominal flap (100%) followed by Moberg flap (46.2%). In addition, there is a statistically significance in the incidence of neuroma in Moberg flap (53.8%). Most of patients who underwent coverage by flap technique were very satisfied by the results (60.4%).

Conclusion

Many techniques have been described for reconstruction of fingertip trauma including revision amputation, skin grafting, local flaps, distant flaps and free flaps. The treatment choice depends on many factors such as patient preference, culture, resources available and surgeon skills. The goals of reconstruction in fingertip amputations are to cover the defect with a satisfactory cosmetic appearance, establish maximum function and preservation of sensation.