bluuebunny/crossref_metadata_2025 huggingface dataset:
The Utility of Serum Procalcitonin Level as an Early Diagnostic Biomarker For COVID in Patients Presenting with ST-Elevation Myocardial Infarction Post Primary Percutaneous Coronary Intervention
Authors: Abdelhamid Yara Mostafa Mohamed , Ibrahim Mostafa Ibrahim , Taher Mohamed Awad , Abdelrahman Mohamed Ahmed
Published: July 2024

Aim and Objectives

The aim of the study was to detect if serum procalcitonin could be used as an early diagnostic marker for COVID in asymptomatic patients presenting with ST-segment elevation Myocardial infarction and if procalcitonin is related to the extent of myocardial injury after the infarction.

Patients and Methods

The study was carried out on 150 patients (age 53.39 ± 13.16) presenting to Ain shams university hospitals with ST-segment elevation Myocardial Infarction and received the standard of care management which is Primary PCI. The patients were assessed regarding the demographic data, presence of any symptoms and signs of infection, risk factors, echocardiography and laboratory measures. COVID PCR and Procalcitonin were withdrawn from all patients.

Results

Out of all the asymptomatic patients presenting with STEMI whose COVID PCR turned out to be positive, the procalcitonin was positive 24 and 48 hours post presentation with P value 0.000. Procalcitonin had no statistical significance with any demographical data, risk factors and comorbidities for cardiovascular disease, extent of myocardial injury and most laboratory findings. There was high statistical significance between positive procalcitonin and TLC count where there was a drop from a median of 11/mm3 with range (4.5– 19) /mm3 in negative procalcitonin to a median of 3.7 /mm3 with range (1.4 –12) /mm3 in procalcitonin positive patients. There was high statistical significance between positive procalcitonin and rise of CRP value where there was a rise from CRP median value from 12 mg/dL range (2– 40) mg/dL in negative procalcitonin patients to 47 mg/dL range (14– 163) mg/dL in positive procalcitonin patients.

Conclusion

Procalcitonin as an inflammatory marker has no relationship to myocardial infarction nor extent of myocardial injury. There was a strong relationship between procalcitonin and COVID infection in asymptomatic patients thus procalcitonin can be used as an early diagnostic biomarker for covid infection in patients presenting with myocardial infarction.
Pilot study: Measurement of first phase ejection fraction in a sample of Egyptian people
Authors: Takla Andrew , Soud Mona Aboul , William Viola , Abdeltawab Adham
Published: July 2024

Background

Left ventricular dysfunction (LVD) constitutes the final common pathway for a number of cardiac disorders. Ischemic heart disease (IHD) is the dominant cause of heart failure (HF). The remaining etiologies include cardiomyopathy, hypertension (HTN), valvular heart diseases (VHD) and myocarditis. Data from the Framingham heart study shows that it develops in approximately 16% of men and 18% of women who had diabetes; 12% of men and 8% of women who had HTN; and 30% of both sexes who had myocardial infarction (MI).

Aim of the Work

to measure the first phase ejection fraction (EF1) in a sample of Egyptian population and to determine its normal value and to assess its reliability in assessment of systolic function.

Patients and Methods

This study is a prospective and observational clinical that was conducted at El- Mokattam health insurance & Ain Shams University hospitals from October 2019 to March 2022.

Results

we found that mean EF1 was 35.41 ± 4.16 %, its minimal value was 26.9% and its maximal value was 43.4%. We found that EF1 was reliable and reproducible as there was no statistically significant intra observer nor inter observer variabilities (p-value was 0.547 & 0.602 respectively). We found that there was no significant statistical correlation between EF1 and gender or heart rate or other demographic or clinical data.

Conclusion

EF1 is a simple and reproducible measurement of LV systolic function that is easily measured by transthoracic echocardiography and is considered comparable to other indices that measure LV systolic function.
Correlation analysis of central venous pressure and Intra-thoracic pressures in Acute Respiratory Distress Syndrome mechanical ventilated patients, a pilot Study
Authors: Taha Ebtihal Abdelhakim , Elrahman Gamal Abd , Al Maraghy Ashraf
Published: July 2024

Background

Positive end expiratory pressure can affect measurement of central venous pressure through increased intrathoracic pressure. However, when positive end expiratory pressure (PEEP) is applied, central venous pressure and pleural pressure often increases more than right atrial pressure, so that transmural right atrial pressure (true filling pressure) decreases.

Aim of the study

Primary end point was to recognizing correlation coefficient between mean CVP and intra- thoracic pressures on volume-controlled mode and spontaneous modes on same population of mechanically ventilated ARDS patients. The secondary end point is to compare the correlation coefficient R during both modes with parameters of ventilatory settings.

Patient and Methods

A cohort observational prospective study was done enrolling single group of patients with acute respiratory distress syndrome, who necessitate mechanical ventilation more than two days after connection to ventilators, the study was performed with demonstration of central venous pressure in cmH2O upon application of needed PEEP. Central venous catheter inserted for measuring CVP were processed in accordance with the standard guidelines.

Results

There were statistically significant differences between control and support group regarding the PEEP, Plateau pressure, mean CVP and mean airway pressure MAP. The data were higher in control than support group with p-value <0.001, 0.002 and 0.004, respectively. There was statistically significant positive correlation between R and CVP in the control group with p < 0.001 and r = 0.918. There was statistically significant positive correlation between R and ΔPIT in support group with p 0.001 and r = 0.926. The correlation between CVP and R among the control group was R = 0.028 + 0.032 * CVP with p-value <0.001, whereas the correlation between ΔPIT and R among the support group was R = 0.465 + 0.020 * ΔPIT with p-value = 0.022

Conclusion

The relation between hemodynamics change of central venous pressures and intrathoracic pressure is new independent marker for evaluating ARDS mechanically ventilated patients. Values of R correlation are different in controlled mode relative to spontaneous mode during ARDS ventilated patients.
Cardiac Magnetic Resonance Imaging for the Evaluation of Pulmonary Hypertension
Authors: Mohamed Shaimaa Saeed , El Korashy Reem Ibrahim , Ahmed Mona Mansour , Mohamed Ali Tamer , Osman Ahmed Mohamed , Abd Elkader Maryam Aly , Kamel Khalil Sameh Nabil
Published: July 2024

Purpose

Evaluate the utility of cardiac magnetic resonance imaging for noninvasive estimation of the key hemodynamic parameters that are measured by the right heart catheterization i.e. mean pulmonary artery pressure, pulmonary artery wedge pressure and pulmonary vascular resistance through cardiac magnetic resonance based numerical models.

Materials and Methods

29 pulmonary hypertension patients, fitting the inclusion criteria were randomly selected and included in the study. CMR Imaging and right- sided heart catheterization (RHC) were performed within 1 month. 3 Cardiac MRI based models in literature that showed high accuracy were tested. Two equations for mPAP calculation; mPAP= - 231.423 + loge inter-ventricular septal angle X 53.8 + log10 ventricular mass index (right ventricular mass/left ventricular mass) X 8.708 + diastolic pulmonary artery area X 0.009 and mPAP = –4.6 + (interventricular septal angle × 0.23) + (ventricular mass index × 16.3). One equation for PAWP; PAWP = 6.43 + LA volume index x 0.22.

Results

The Pearson correlation test correlation between invasively quantified and CMR-estimated mPAP had good correlation with r = 0.594 and r = 0.599 (p < 0.001) for CMR based mPAP model 1 and 2, respectively. While, Altman and Bland test showed that The mean bias between the RHC-derived and CMR-estimated mPAP was 7.9 (agreement interval -24.8 to 40.6 mmHg) and mean bias -3 (agreement interval -34.8 to 28.2 mmHg) for CMR based mPAP model 1 and 2, respectively. There was no correlation between invasively quantified and CMR-estimated PAWP with (p = 0.092) for CMR based PAWP model. The mean bias between the RHC- derived and CMR-estimated PAWP was 2.4 (agreement interval –13.5 to 18.2 mmHg). The correlation between invasively calculated and CMR-estimated PVR had good correlation with r = 0.703 and r = 0.704 (p < 0.001) for CMR based PVR model 1 and 2, respectively. The mean bias between the RHC-derived and CMR- estimated mPAP was 0.6 (agreement interval -11.6 to 12.8 mmHg) and mean bias -1.3 (agreement interval -12.1 to 9.5 mmHg) for CMR based mPAP model 1 and 2, respectively.

Conclusion

our results showed good correlations between CMR findings and RHC as regard mPAP and PVR. Thus Non-invasive estimation of mPAP, PAWP and PVR using CMR is feasible but needs further studies to improve accuracy.
Serum Glial Fibrillary Acidic Protein as a Blood Biomarker in Relapsing Remitting Multiple Sclerosis Egyptian Patients
Authors: Zeitoun Yasser Ahmed , El-Kabarity Rania Hamdy , Ahmed Walid Abdelhady , Aboustate Alaa Mohamed , Rashad Salma
Published: July 2024

Background

Multiple sclerosis (MS) is a neurodegenerative disease with various clinical subtypes. Glial fibrillary acidic protein (GFAP) is significantly elevated in the cerebrospinal fluid (CSF) of MS patients compared with that of healthy controls and serum concentrations have been shown to reflect CSF levels.

Objectives

The aim of this study was to evaluate serum levels of GFAP in relation to disease activity in relapsing-remitting MS patients and to compare them with those of healthy controls.

Subjects and Methods

This case-control study involved 45 RRMS patients; 21 in relapse and 24 in remission, and 45 healthy individuals as age- and sex-matched controls. Blood samples were taken from the patients at inpatient ward and outpatient clinic of Neurology Department of Ain Shams University hospitals and the serum levels of GFAP were determined using the enzyme-linked immunosorbent assay (ELISA) technique.

Results

Patients in relapse showed higher serum concentration of GFAP than that of patients in remission and this result was highly significantly different (p = 0.000). ROC curve of serum GFAP demonstrated at cut off point >200 pg/ml, it yielded a sensitivity of 76% being in relapse and specificity of 82%.

Conclusion

GFAP biomarker is an indicator of disease activity in RRMS patients and its serum level may correlate with the state of disease activity.
Fractional Carbon Dioxide Laser versus Cryotherapy in the Treatment of Alopecia Areata: A Pilot Comparative Study
Authors: Ojaimi Mays Qays , Elfattah Afify Ahmed Abd , Shaheen Maha Adel
Published: July 2024

Alopecia areata, one or more round bald patches appear suddenly, most often on the scalp. It can affect males and females at any age. The exact mechanism is not yet understood and there is not yet any reliable cure for alopecia areata. Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Superficial cryotheray is introduced as a possible treatment for Alopecia Areata with minimal side effects and being less painful. In addition, fractional CO2 laser is introduced as a effective option in AA treatment.

Aim of the Study

the current study aimed to assess the efficacy and safety of FCO2 laser in comparison to cryotherapy in the treatment of AA.

Patients and Methods

this study included 22 patients (with patchy AA (at least three patches) of both sexes. Patients were subjected to full history taking, complete general and dermatological examination then digital photography and dermoscopic examination were performed. The three patches in each patient were divided according to therapy used; one patch was treated with Fractional CO2 laser, second one was treated with superficial cryotherapy and the third was left without treatment as control.

Results

Regarding FCO2 laser treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. In addition, SVHs count showed significant increase after treatment compared to before treatment. Concerning cryotherapy treated patches, trichoscopic assessment revealed that BDs, YDs and EMHs count showed significant decrease after treatment compared to before treatment. Also, there was as increase in the TH and SVHs count after treatment in comparison to before treatment, but the results were statistically insignificant.

Conclusion

Both cryotherapy and fractional CO2 laser therapy are safe and effective modalities in the treatment of AA with superiority for FCO2 laser.
The Efficacy of Intralesional Pentoxifylline Injection versus the Standard Intralesional Corticosteroid Injection in The Treatment of Alopecia Areata
Authors: Abdel fattah Nermeen Samy , Abdallah Tarek Nabil , Ibrahim Samah , Hamdy Mohammed Samar Elaraby
Published: July 2024

Background

Alopecia areata is a nonscarring skin disease affecting the scalp or other body parts. The etiology of AA is still controversial and various pathogenic causes are under investigation. Several treatment modalities are used in managing AA.

Objective

to evaluate the efficacy and safety of (PTX) injection in treatment of localized AA compared to intralesional corticosteroids TRA on 30 patients with multiple patches of AA.

Patients and Methods

The current study was a prospective intra-patient comparative controlled clinical trial. Patients were recruited form outpatient clinic of Dermatology, Ain Shams University Hospital in the period from November 2019 to May 2020. 30 Egyptian patients (11 males &19 females) with at least three patches were enrolled to the study. The diagnosis of AA patients enrolled in the study based on clinical signs.

Results

To sum up, both PTX and ILCS has good results in treatment of AA, as each of them has its own advantages. Corticosteroids are rapidly acting while PTX effects are delayed but increased progressively throughout consecutive sessions. So using corticosteroids in combination with PTX can augment each other and give better results.

Conclusion

Treatment of AA with intralesional PTX exerted significant increase in hair density, total hair count, terminal hair count and percentage of terminal hair which is evident after completion of the sessions. Treatment with ILCS exerted significant increase hair density, total hair count, terminal hair count and percentage of terminal hair after treatment. Comparison of both treatment modalities revealed slight better response with PTX compared to ILCS. In conclusion, the current study revealed that Intralesional combined administration of PTX and TRA can be beneficial for patients suffering from AA. Steroid showed a rapid response that could be maintained by adding PTX.
Prevalence of Sexual Dysfunction among Psoriatic Male Patients
Authors: Ibrahim Shaheen Sarah Shaheen , Lofty Rania Adel , Elfattah Afify Ahmed Abd
Published: July 2024

Background

psoriasis is a recurring, cutaneous-articular, chronic inflammatory disease, resulting from immune and proliferative changes that affect the skin and mucosa. The worldwide incidence is 1-3% and the majority of the patients also have emotional difficulties like anxiety, depression, and sexual dysfunction. These issues along with the extent of body surface area affected have an impact on the quality of life, in particular, the sexual life, all aspects of sexual function were negatively affected by the disease process.

Aim of the Work

to evaluate the prevalence of sexual dysfunction among psoriatic male patients and the role of depression on sexual dysfunction.

Patients and Methods

the study included 60 male psoriatic patients (married sexually active with no genital abnormalities, malignancy, chronic diseases such as pulmonary, hepatic, renal, hematological, neurologic, psychosis, and similar psychiatric disorders, and not on medications that interfere with erectile function). All patients were subjected to the following: Full medical history taking, local examination of the genitalia, dermatological examination, sexual function evaluation using the Arabic version of IIEF (the international index of erectile function questionnaire) which is a validated questionnaire applied to all cases, and psychiatric evaluation using the Arabic version of Hence Hamilton Depression rating scale (HAM-D) to determine the patient’s level of depression.

Results

The study revealed a high prevalence of ED (86.7%) and depression (65%) among psoriatic male patients, the ED was statistically significantly affected by the severity, duration of the disease, and genital affection. Also, there was a significant correlation between ED, metabolic parameters, and depression with a significant P value.

Conclusion

there is a high prevalence of sexual dysfunction and depression among psoriatic male patients. Screening of sexual dysfunction among psoriatic male patients using the IIEF, depression using HAM-D, and metabolic risk factors is recommended for a better quality of life.
Comparative Clinical Trial of Dermapen Microneedling and Platelet-Rich Plasma versus Dermapen Microneedling Alone in the Treatment of Stretch Marks in Egyptian Adults
Authors: Anis Basily Amir Adel , Halim Imam Adel Ahmed , Ahmed Saleh Hanan Mohamed
Published: July 2024

Background

Striae distensae are common skin lesions affecting up to 90% of pregnant women, and many adolescents and men. They pose a psychological burden to many people and no known treatment is completely effective for them. The current treatment options are limited by significant side effects, operator skill, cost, prolonged treatment period, or a combination thereof. Platelet-rich plasma (PRP), along with microneedling (MN), are promising dermatologic procedures with a wide range of applications, excellent safety profiles, yet only partially understood mechanisms of action.

Aim of the Work

to evaluate the effectiveness and side effects of MN with PRP versus MN alone in the treatment of striae distensae. This work included 40 patients who were divided into left-side lesions (MN alone) versus right-side lesions (PRP + MN). PRP was prepared using single-spin technique, and applied topically just before MN on right-side lesions. An automated MN pen device was used on both sides.

Patients and Methods

This was a prospective case control study with a split-body design which included 40 adult patients with striae distensae. The patients were recruited from the outpatient dermatology clinic in Ain Shams University hospitals, Cairo. Miravex Antera TM 3D Camera system measured the efficacy by indentation and roughness indices, and patients’ subjective improvement and reported side effects were recorded and analysed.

Results

A significant improvement was illustrated in both MN and MN + PRP sides in both the indentation and roughness indices measured by the Antera 3D camera system, and most patients reported subjective improvement in color (62.5%), smoothness (97.5%), size (82.5% vs 85%), and general appearance (92.5% vs 90%). Side effects including pain and erythema affected virtually all cases, while pruritis, edema, bleeding, and tram-tracking were less common and short-lasting. Post-inflammatory hyperpigmentation affected about 20% of patients and lasted more than one month in about half of those affected. No significant difference was found between MN and MN + PRP in efficacy or side effects.

Conclusion

Microneedling offers an effective, cheap, and relatively safe treatment option for striae distensae. Miravex Antera TM 3D Camera system is a powerful objective method of documenting lesions and following up the treatment process. Platelet-rich plasma did not offer additional benefit over microneedling alone.
Linear Measurement of Females' Vocal Fold Across Different Ages
Authors: El Kholy Basma Ahmed , Aziz Rifaie Nahla Abdel , Quriba Amal Saeed , Elfiky Yomna Hassan
Published: July 2024

Background

One of the most complex oragns of the human body is the larynx so Understanding its morphology is an important step toward understanding the detailed laryngeal anatomy, and physiology. Different studies have described the linear measurements of the larynx in different measuring methods. but no studies have been structured to describe vocal fold length in vivo in females at different stages of their lives.The vocal instrument is comprised of the vibratory body, the respiratory power source and the oropharyngeal resonating chambers. Voice is characterized by its intensity, frequency, and harmonics. The harmonics are hormonally dependent.

Aim of the Work

The aim of this study is to screen the membranous vocal fold length in different ages throughout females’ life and if it is affected by hormonal changes in their lives or not.

Study Design

a comparative cross-sectional study.

Patients and Methods

This comparative cross-sectional study was carried out on 120 Egyptian Arabic speaking apparently healthy females at the outpatient clinic of the Units of Phoniatrics, ENT Department of both Ain Shams University Hospitals and Zagazig University Hospitals.

Results

It was obvious that female’s larynx is affected by age and sex hormones that is reflected on the laryngeal structure and function. Although the results showed non significant relation between the length of the membranous part to aging this may be due to small sample size that could not reflect that difference.

Conclusion

The vocal imprint is characteristic to each individual. It reveals personality and translates emotions. The voice evolves with age. It bears both the scars of life, as well as its joys and pleasures. Nevertheless, the human voice remains intangible and a fertile field for future research in the cycle of life.
Efficacy of Barbed Reposition Pharyngoplasty and Uvulopalatopharyngoplasty for Retro Palatal Obstruction
Authors: Hassan Mohamed Amir , Mostafa Mostafa Mohamed , Beder Mohamed Ashraf , Kamel Ahmed Mohamed
Published: July 2024

Background

Obstructive sleep apnoea (OSA) is a common problem affecting almost 4% of the population. Although continuous positive airway pressure (CPAP) is considered the standard of care, the patient compliance for long term use is poor. Clinicians have explored surgical options for cure with varying success.

Objective

To analyze the efficacy of a new modified pharyngoplasty technique (BRP) in comparison with other UPPP techniques to displace the soft palate anteriorly and lateralize the lateral pharyngeal wall in the treatment of OSA.

Patients and Methods

Types of studies: Systematic review/Meta-analysis. Types of participants: Patients Complain of OSA caused by mild to moderate retropalatal obstruction. Study outcome: efficacy of barbed suture and UPPP operations for retropalatal obstruction, study of success rate. Study of failure rate. Study of complications.

Results

Regarding Change in ODI Associated with Barbed Sutures, it was found that only 2 studies assessed ODI, and this analysis showed that Weighted mean difference = -23.32 (95% CI = -35.08 to -11.56). There is substantial heterogeneity across studies (Cochran Q test P-value = 0.099, I-squared = 63.33%). In the UPPP procedure, only two studies assessed the ODI, this analysis showed that the weighted mean difference = -14.27 (95% CI = -20.62 to -7.92). There is substantial heterogeneity across studies.

Data Sources

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

Conclusion

Both Barbed reposition pharyngoplasty and Uvulopalatopharyngoplasty techniques were effective in the treatment of cases with obstructive sleep apnoea (OSA). Barbed reposition pharyngoplasty (BRP) can be considered as the gold standard procedure. BRP seem to be more effective than UPPP in a single-level surgical setting. However, being quick, easy to learn and less invasive, BRP is a safe, effective and promising option for treatment of patients with OSA.
Role of Adjuvant Mitomycin C in The Endoscopic Treatment of Laryngotracheal Stenosis (Meta-Analytic Study)
Authors: Eldin Elhalabi Hisham Salah , El Aty Elsersy Hesham Abd , Mohamed Amr Hamed , Hassan Ahmed Mohamed Shokry
Published: July 2024

Background

Laryngotracheal stenosis is a life-threatening restriction in pulmonary ventilation. It is an umbrella term, including luminal compromise at the level of the larynx, subglottis, or trachea. Etiology of laryngotracheal stenosis is multifactorial. In adults and adolescents it is mostly acquired, where in children it may be acquired or congenital. Acquired laryngotracheal stenosis can result from previous intubation or tracheostomy, systemic disease, trauma, infection, or idiopathic causes. Historically, infectious etiology was common. Currently, laryngotracheal stenosis most frequently results from prolonged intubation or trauma from intubation itself.

Objective

To evaluate the effectiveness of topical Mitomycin C as an adjuvant treatment with the endoscopic management of laryngotreacheal stenosis.

Patients and Methods

The total number of patients in all the included studies was 454, 379 patients in MMC group and 75 patients in non-MMC group.

Results

This meta-analysis study showed that resolution (success) rate in MMC group was (68.7%) and there was a significant increase in resolution (success) rate in MMC compared to non- MMC group (p = 0.011) with the odds of being 5 times higher in MMC group (OR = 5.04). The Complications rate in MMC using patients was (4%). The result of this meta-analysis study showed that Mitomycin C is an effective and safe adjuvant in the endoscopic treatment of laryngotracheal stenosis. However, this study included limitations. We recommend the need of more high quality prospective randomized controlled trials, two armed studies and further studies in the future to achieve stronger results.

Conclusion

We suggest that that Mitomycin C is an effective and safe adjuvant in the endoscopic treatment of laryngotracheal stenosis. However, this study included limitations. We recommend the need of more high quality prospective randomized controlled trials, two armed studies and further studies in the future to achieve stronger results.
Barbed Expansion Sphincter Pharyngoplasty (BESP) for the Treatment of OSA. “A Step Ahead”
Authors: El Salamawy Ahmed , El Fatah Gamal Abd , Fathi Hesham , Farahat Ahmed , Youssef Mysara
Published: July 2024

Background

expansion sphincter pharyngoplasty is one of the newly introduced techniques for treating OSA in the last 20 years that showed promising results by increasing the lateral dimensions of the oropharynx by pulling the lateral pharyngeal wall and anchoring it to the pterygomandibular raphe, the paper study the efficacy of performing the procedure using the barbed suture on moderate to severe OSA.

Methods

Twelve patients with moderate to severe OSA due to oropharyngeal collapse according to VOTE classification after DISE were assigned to the study. Pre- and post-operative Epworth sleepiness scale questionnaire was completed, Pre- and post-operative polysomnography was performed as an objective measurement, all patients underwent BESP and the duration, post- operative complications, and pain records were plotted.

Results

The technique was confirmed to be feasible with a success rate of 91.7%, with reduction of median AHI from (38.75 to 8.7 event/hour) and reduction of the mean ESS from (20.83 to 5.67) and mean ODI (37.62 to 9.38).

Conclusion

The barbed expansion sphincter pharyngoplasty is an effective technique for treating obstructive sleep apnea in patients with retropalatal and oropharyngeal collapse.
Quality of Life in Pediatric Iritable Bowel Syndrome among a Sample of Egyptian Children at Ain Shams University Hospitals
Authors: El Ezaby Sarah Abdel Rahman A , Anzour Ayat Farouk M , El Gendy Yasmin Gamal A , El Deeb Marwa Talaat , Abdel Hamed Diaa Marzouk
Published: July 2024

Background

Iritable bowel syndrome (IBS) is one of the pediatric functional gastrointestinal disorder with upper and lower gastrointestinal symptoms.IBS afects the child’s daily activities and quality of life (QoL) negatively, and can often persist into adulthood.

Objectives

To measure the dimensions of QoL of children with IBS among a sample of Egyptian pediatric patients at Ain Shams University Hospitals.

Methods

A cross-sectional study was conducted on 80 children aged 5-15 years old, who were diagnosed as IBS, according to Rome IV criteria Pediatric quality of life Inventory Generic Core (PedsQL generic core scale was used to measure QoL of the patients,where 100 is the maximum quality score.

Results

A total of 80 children participated in the study ; 48 (60%) males and 32 (40%) females with mean age 10.6 (SD2.7) years. Physical functioningscorewascalculatedtobe96.04(SD5.5), socialfunctioning score was 99.37 (SD3.95), emotional functioning score was 90.37 (SD8.85), and school functioning score was 73.25 (SD27.34).The school functioning scale was higher among male participants (P-value0.31), also the emotional scale was higher among male participants with no statistical significant diference (P-value0.70).

Conclusion

IBS afects the school functioning dimension of OoL among the pediatric age group rather than other dimensions.
Influence of Female Genital Mutilation on Women Sexual Function in Egypt
Authors: Abo Ghanima W A , Ragab M H , Hegab M H , Abd El Gawad A M , Elhelaly H M
Published: July 2024

Background

Although Female genital mutilation (FGM) is internationally recognized as a violation of human rights with Short term and long term complications include death due to shock, painful menstruation, dyspareunia, cysts and keloid formation.

Aim of the Work

aimed to assess the effect of FGM on Women reproductive and sexual function.

Subjects and Method

This is a cross sectional hospital based study included 800 married or previously married females, between (18 - 40) year old who are apparently healthy. They were recruited from Outpatient clinic of Gynecology and Obstetrics in Etay Elbaroud general hospital, Behaira Governate, Egypt and classified into case group who were circumcised and control non circumcised group. They were subjected to detailed history including history of sexual function and local genital examination after informed consent was taken. During labor; a partogram was used to assess the progess of labor and occurrence of complicated delivery. Partogram is a graph reporting labor events against time which includes cervical dilatation, fetal heart rate, state of membrane and liquor.

Results

among case group age of FGM ranged from 9-13 with mean value 10.27±0.98 and majority of cases had type I. There was statistically significant difference between the two studied groups regarding regularity of menses and dysmenorrhea. 66% of cases had short term complication and pain was the most common (52%). Assisted mode delivery was higher in cases group with 220(55%) and normal was higher in control group with 244(61%). There was statistical significant difference between two studied groups regarding sexual desire, arousal, orgasm, satisfaction, and pain while there was no statistical significant difference regarding lubrication.

Conclusions and Recommendations

FGM still being a community problem in Egypt esecially in rural area which running in certain families. The most common type in Egypt is type I and common complication is pain following FGM. Sexual function is affected in all cases experienced FGM especially with type III. Assisted delivery was more common in cases had passed FGM before. It is recommended to raise community awareness about complications and hazard of FGM on sexual function as well as reproductive life.
Surgical and Morphological Outcome of One Stage Laparoscopic Orchidopexy with Preservation of Gubernaculum and Interruption of Spermatic Vessels in Comparison to Two Stages Fowler–Stephens’s Orchidopexy Technique with Preservation of Gubernaculum for Impalpable Testis
Authors: El Kashory Ahmed Ibramim Abd El Hamid , Abdelhamid Sameh Abdelhay , El Asmar Khaled Mohamed , El Sherbeny Mohamed Saeed , Dahab Mohamed Mousa
Published: July 2024

Introduction

Laparoscopy has attained full acceptance, both diagnostically and therapeutically for the management of non-palpable testis. Conventional laparoscopic Fowler-Stephens’s orchidopexy is a common accepted technique for cases where spermatic vessels` length can preclude tension-free testicular mobilization in the scrotum. Gubernaculum sparing with cutting of testicular vessels has an important role to keep a good vascularity of the testis. Our study suggests performing F-S technique with preservation of the gubernaculums in one stage instead of two stages with the same final results.

Patients and Methods

This was a Randomized controlled clinical trial (RCT), conducted on Boys with Non-palpable testicle between 1 year to 6 years old, in 2 Egyptian pediatric surgery units, between October 2019 and September 2022.The patients met our inclusion criteria were divided into 2 groups to compare their outcome (atrophy and success rate): ( Group A with 25 impalpable testicle were subjected to one-stage laparoscopic assisted orchidopexy with interruption of spermatic vessels and preservation of the gubernaculums, while Group B with 25 impalpable testicle were subjected to two-stages laparoscopic assisted orchidopexy with interruption of spermatic vessels and preservation of the gubernaculums).

Results

The mean age of all patients were (3.9 ± 1.8), 113 non-palpable testicle were examined during the period of our study, 50 non-palpable tesicle were met our inclusion criteria. They were divided into 2 groups according to surgical procedure. There were no significant differences between the 2 groups according to age, preoperative testicular volume. Post operative outcome (atrophy and success rate) had no significant differences. Operative time and hospital stay were statistically decreased in the group performed with one stage.

Conclusion

One-stage laparoscopic orchidopexy with preservation of gubernaculum and ligation of testicular vessels to be as effective as two-stage laparoscopic Fowler–Stephens’s orchidopexy with preservation of gubernaculum.
The Role of Trending Shock Index Paediatric Adjusted (SIPA) in Paediatric Trauma as a Predictor of Morbidity and Mortality
Authors: Elkarn Ahmed Talaat , El Naggar Osama Abd Al Elah , Ghanem Wael A Radwan , Dahab Mohamed Mousa , Allam Ayman M , Abdelhamid Sameh Abdelhay
Published: July 2024

Background and Purpose

There are several injury scoring systems, anatomic, physiologic and combined scores, which have been used for prediction of patients' outcome such as mortality. Among physiologic scoring systems evolved shock index (heart rate divided by systolic blood pressure) which has been first described in 1967. In the world of paediatric and due to the physiological differences between different age groups, few adjustments have to be done considering these changes evolving shock index paediatric adjusted (SIPA). This study was conducted to evaluate SIPA as a quick feasible method for triaging and managing pediatric trauma and also to predict ICU admission and need for CT scan as a primary outcome and also secondary outcomes like length of hospital stay and (need for surgical intervention) and mortality rate.

Study Design

Prospective randomized controlled study.

Setting

The children’s accident and emergency department in Armed Forces Hospitals and Ain Shams University hospitals.

Subjects

We included 124 pediatric trauma children, and they were divided into 2 groups: Group A (62 children): assessed by SIPA in an incidence of trauma, and Group B (62 children): assessed by traditional vital signs (blood pressure, pulse and capillary refill).

Methods

All patients were subjected to full history taking, SIPA assessment on admission and its daily changes (baseline up to 48 hours). Assessment for need for ICU admission, ventilation, CT scan, surgical intervention, and Length of hospital stay, along with mortality rate recording.

Results

In the studied population, the mean age of all patients was (6.8 ± 3.2) years, with (65.3%) of patient males; and (34.7%) females. Regarding outcome data, comparative study between the 2 groups revealed; significant decrease in ICU admission, need for CT scan, LOS and mortality rate in Group A (SIPA) (p < 0.05). As regards SIPA trend, we found non-significant difference between mortality and no-mortality subgroups in SBP, heart rate, Capillary refill time and SIPA during the serial (baseline up to 48-h) measurements. Also, regarding ICU LOS, we found non-significant difference between mortality and no-mortality subgroups in SBP, heart rate, Capillary refill time and SIPA during the serial (baseline up to 48-h) measurements.

Conclusion

To conclude, SIPA score proven to be an accurate and specific predictor of morbidity, hospital stay and ICU admission, and mortality rate in pediatric trauma patients and is superior to capillary refill time, tachycardia or hypotension alone for predicting different outcomes.
Incidence of Complicated Appendicitis in Cases of Generalized Peritonitis Explored for Obscure Cause: A Systematic Review and Meta-Analysis
Authors: El-Akkad Hesham A , Farrag Ahmed M , Naguib Peter N
Published: July 2024

Background

2ry generalized peritonitis presents a common life-threatening condition associated with high mortality and morbidity. Complicated appendicitis is one of the most common dangerous causes of secondary of generalized peritonitis. Early stage of appendicitis will be in its characteristic usual clinical picture, but delay in diagnosis and lack of experience and practice and patient’s fear from surgical interventions with abuse of medical TTT make the condition developed to generalized peritonitis.

Aim and Objectives

to establish, through the available literature, incidence of complicated appendicitis in cases of generalized peritonitis explored for obscure cause through systematic review and meta-analysis.

Subjects and Methods

This is Meta-analysis study, conducted on generalized peritonitis on adults and elderly all over the world. The literature search yielded 1821 unique articles. A further screening of titles and Abstracts was conducted, and 32 studies were considered potentially relevant to our review. According to the inclusion criteria, 10 studies were identified in this study.

Results

age, duration of pain, presence of an appendicolith, size of appendix and abscess were significant predictors to complicated appendicitis.

Conclusion

Decreased healthcare facilities and investigations, low experience for medical service provider, ignorance, low socio-economic state, decreased awareness and mentally-ill patients will worsen the case and make it difficult to diagnose the main cause of generalized peritonitis which will lead to the only decision of choice which is exploration. It will be a lifesaving decision for diagnosis and quick management of the disease to decrease suffering of such cases.
Pattern of Cognitive Impairment among Community Dwelling Elderly in Egypt and Its Relation to Socioeconomic Status
Authors: Tawfik Amany Abass , Adly Nermien Naim , Hamza Sarah Ahmed , Abdel Kader Radwa Magdy
Published: July 2024

Background

Cognitive decline is well-recognized as a normative part of the aging process that strongly affects daily functioning and quality of life. Giving the different levels of cognitive health among people from different socioeconomic groups. Aim: To assess the prevalence and pattern of cognitive impairment among community dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment.

Patients and Methods

This study involved 470 elderly participants ≥ 60 years, males and females. The Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) to assess pattern of specific cognitive domain affection, and Socioeconomic status (SES) scale were used to describe the SES of participants.

Results

The prevalence of cognitive impairment was 50.2% in Egypt, 37.7% for MCI and 12.5% for Dementia. The most common type of cognitive impairment was degenerative type (47.8%). Pattern of specific domain affection among cognitively impaired subjects, ranged from 94% for visuospatial function to 12.7% for Abstraction. Cognitive impairment was significantly associated with increasing age, female sex, marital status single or widow, low education and with increasing total number of comorbidities, depression and positive family history of cognitive impairment. Cognitive impairment was mainly concentrated in the economically disadvantaged population (low educational level, non-occupied, limited computer use, low income and bad sanitation).

Conclusion

In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
The Possible Effect of Platelet Rich Plasma on Liver and Small intestine in Adult and Aged Male Rats. A Histological and Immunohistochemical Study
Authors: Saleh Elham Ahmed , Abdel Samad Abeer Abdel Mohsen , Raafat Mona Hussien , ElKhalek Ibrahim Gehan Abd
Published: July 2024

Introduction

There is a general modest decline in the function of different organs in the body with aging. In the small intestine, there may be alterations in the intestinal morphology, as well as a decline in the absorption of fatty acids and sugars. The aging process decreases regenerative ability which significantly delays the restoration of liver function. Platelet-rich plasma (PRP) has recently attracted interest in many medical fields. PRP might has benefit effect on aged male rats.

Aim of the Work

This study aims to investigate the structural changes that might occur during normal aging and the possible effect of PRP intraperitoneal injection on adult and aged male albino rats.

Materias and Methods

Forty-two male albino rats were classified according to age into adult group and old aged groups. Adult male rats (300 -350 g), their age range between 6-8 months. Aged male rats (570-660 g), their age range between 12-24 months. They were divided randomly into four groups: Group I (Control adult): Included 14 rats that further subdivided into 2 equal subgroups: subgroup IA: untreated rats and subgroup Ib: rats were injected by sterile saline intraperitoneally (0.5 mL/kg by intraperitoneal injection 3 times/week). Group II (Control Aged): Included 14 rat that further subdivided into 2 similar subgroups as group I, Group III (Adult treated): Included 7 rats that received intraperitoneal injection of PRP (0.5 mL/kg by intraperitoneal injection 3 times/week), Group IV (Aged treated): Included 7 rats that received intraperitoneal injection of PRP as group III. Animals were kept under observation and the treated groups received intraperitoneal injections for 21 days. At the end of the experiment, Liver and small intestine specimens were processed for histological and immunohistochemical examination. Morphometric and statistical analysis was also done.

Results

Group II showed decrease in height of intestinal villi with disruption of their epithelium surface, increase spacing between enterocytes and abundant mononuclear cellular infiltration. Changes in the liver comprised nuclear and cytoplasmic changes that included an increase in nuclei number in hepatocytes with droplets fat infiltration. Treated Groups showed decreasing mononuclear cellular infiltration with decreasing collagen fibres and congested blood vessels.

Conclusion

Aging process enhanced the vulnerability to injury and inflammation in both the liver and small intestine. PRP had ameliorating effects on these changes.
Evaluation the Role of Lipocalin 2 as a New Non-Invasive Diagnostic Marker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients
Authors: El-Sayed Ashour Engy yousry , Ibrahim El-Baz Hossam Samir , Megahed Ahmed Sherif Ahmed , Abd EL-Mabood Menna Alla Mostafa Sediq
Published: July 2024

Background

Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide. In Egypt, it represents the fourth common cancer. Significant risk factors for hepatocellular carcinoma include viral hepatitis (hepatitis B and hepatitis C), alcoholic liver disease, and non-alcoholic liver steatohepatitis/non-alcoholic fatty liver disease. HCC occurs in 80%-90% of patients with cirrhosis. The annual incidence of HCC in patients with cirrhosis is 2-4%.

Aim of the Work

The aim of this study is to evaluate the role of lipocalin 2 (LCN 2) as a diagnostic marker in HCC Egyptian patients.

Patients and Methods

A case-control study in Ain- Shams University Hospital for 6 months period and the study will be conducted on 96 Egyptian patients (32 HCC patients, 32 liver cirrhosis without HCC, 32 normal control persons).

Res1ults

We found that LCN 2 level ranged from 150 to 380 in HCC group with mean±SD = 292.750±50.940, from 88 to 280 in cirrhotic patients with mean± SD = 129.313±36.605, from 40 to 62 in control group with mean± SD = 53.250± 4.958, being statistically significant higher in HCC group more than both cirrhotic group and control group and in cirrhotic patients more than control group (p-value = <0.001). The results showing sensitivity of 96.87% and specificity 96.87% of LCN 2 as a marker for HCC with accuracy of 98.4%,with cut off > 160. The presence of (LCN-2) in blood and urine, in combination with α-Fetoprotein (AFP), is a biomarker of early stages of HCC. LCN 2 is a promising serum tumor marker for HCC diagnosis.

Conclusion

We concluded from this study that: Serum LCN 2 level was significantly higher in patients with HCC and mildly elevated in patients with liver cirrhosis compared to the control group. So it can be used as a tumor marker for HCC diagnosis. Use of LCN 2 with AFP or possibly other markers will improve the diagnostic field and can help in early detection of HCC in surveillance programms. We need further studies on large number of HCC patients of different etiologies and on metastaic liver tumors to clarify the accuracy and potential diagnostic role of LCN 2 in the future.
Serum Resistin Level as a Novel Marker of Disease Activity in Patients with Ulcerative Colitis
Authors: Abd El-Hamid Khalid , Allam Ahmed Samir , Youssef Mohamed Gamal , Sayed Omnia Samir Mohamed
Published: July 2024

Background

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions.

Aim of the Work

The aim of our study is to asses serum resistin level in disease activity and remission in patients with ulcerative colitis disease.

Patients and Methods

A cohort study for 6 months on 40 Egyptian patients presented with ulcerative colitis disease over 18 years old visiting the outpatient clinics or admitted in Ain Shams University Hospitals.

Results

The present study revealed a highly significant elevation of serum Resistin in active ulcerative colitis patients with p-value <0.001 which shows direct relationship between the activity of ulcerative colitis and serum Resistin. Resistin was positively correlated with inflammatory markers (CRP and ESR) in UC patients. And there is negative relation between resistin and Hb, fecal calprotectin.

Conclusion

Serum Resistin is a valuable noninvasive marker in the assessment of disease activity in ulcerative colitis patients, correlated positively with inflammatory markers (CRP and ESR). Other studies should be done on larger size of participants to determine the the role of serum Resistin as a marker of disease activity in patients with Inflammatory bowel disease.