bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study for the Outcome of Living Donor Liver Transplantation in Patients with Portal Vein Thrombosis in Comparison to Patients without Portal Vein Thrombosis
Authors: Musalam Muhammad , Khalil Ahmed , Nasser Amr Abdel , Abdelaal Amr , Saber Hatem Sayed
Published: November 2024

Background

Portal vein thrombosis (PVT) is a relative contraindication in living donor liver transplantation (LDLT). We monitored the outcome of adult patients with PVT in comparison to patients without PVT in LDLT.

Methods

This study is a retrospective cohort study. LDLTs that was performed at Liver Transplantation Unit in Air Forces Specialized Hospital and Nasser Institute for Research and Treatment, Cairo, Egypt, between July 2019 to July 2020 were evaluated. 176 cases were divided into two groups according to presence of PVT, group A included 55 recipients who had PVT compared to group B including 121 recipients without PVT.

Results

In our study (N = 176), postoperative PV complications was recorded in 11 cases (6.3%). Five case in each group had postoperative PVT (9.8% versus 4.1%) respectively and a single case of PV stenosis (0.8%) was documented in non-PVT group. All patients who develop early postoperative PV (n = 3/10) complications unfortunately died because of it, unlike those who developed late PV complications, their one year survival rate was 70% of cases (n = 7/10) and the overall mortality rate in patients developed PV complications was 40%; 4 out of 10 cases.

Conclusion

PVT is established not to be a contraindication for liver transplantation but needs complex procedures and sophisticated techniques and Surgeons should be aware with these techniques to restore adequate portal flow in transplant for recipients with PVT.
Breast Surgical Conservation Therapy versus Mastectomy in Multifocal or Multicentric Breast Cancer; A Systematic Review and Meta-Analysis
Authors: Abd El-Moghny Ashraf , Nabil Ahmed , Hanafy Dina Mohamed , Mahmoud Reem Mohamed Korany
Published: November 2024

Background

Breast cancer affects 1.7 million women annually worldwide, the majority of whom are treated surgically. Multiple ipsilateral breast cancers are collectively defined as more than one synchronous ipsilateral cancer at diagnosis. The term Multiple ipsilateral breast cancers denotes either multifocal breast cancers that occur within proximity separated by approximate radiological distances of 20–50 mm of normal tissue, or multicentric cancers occurring further apart in the breast at distances exceeding 50 mm.

Objective

To assess overall survival (OS), local recurrence and cosmetic results between conservative surgical approach and mastectomy in ipsilateral MF and MC breast cancer and to explore whether BCT was feasible for female patients with MF/MC breast cancer.

Patients and Methods

The PubMed, web of science and Scopus were searched on November 2010. The keywords were ipsilateral multiple breast cancer, conservative surgery and Radical mastectomy.

Results

In our Study twelve trials included 1906 patients, six trials regarding comparison between Breast conservative surgery and mastectomy and six trials regarding Breast conservative surgery in the management of the multifocal/multicentric breast lesions. Regarding local recurrence was assessed in six trials comparing between Breast conservative surgery and mastectomy and six trials regarding Breast conservative surgery in the management of the multifocal/multicentric breast lesions.

Conclusion

In MF/MC breast cancer patients, Local and regional recurrence in addition to, distant metastasis in patients undergoing BCT has no statistically difference compared to patients undergoing mastectomy. Further prospective studies should be investigated to refine the prognosis and to optimize the treatment in patients with MF/MC breast cancer.
Comparison of Oncoplastic Breast Surgery and Breast Conserving Surgery without Reconstruction, A Systematic Review and Meta-Analysis
Authors: Ahmady Rania El , Gamal Ahmed , Taalat Mahmoud , Maher Shenouda Malak
Published: November 2024

Introduction

Breast cancer, the second leading cause of cancer-related mortality, poses unique challenges to patients, encompassing physical, emotional, and sexual dimensions. Surgical interventions, such as modified radical mastectomy and breast-conserving surgery (BCS), can exacerbate these challenges. This study explores the integration of oncoplastic breast surgery to address shortcomings associated with traditional approaches.

Methods

A systematic review of PubMed, Web of Science, and Scopus identified 28 relevant studies, encompassing 28,162 patients. Cosmetic outcomes and patient satisfaction were compared between oncoplastic breast surgery (OBCS) and BCS groups, with a focus on psychological and physical well-being domains.

Results

The meta-analysis revealed that OBCS demonstrated superior outcomes in satisfaction with breast appearance, psychological well-being, and physical well-being compared to BCS. Patient satisfaction questionnaire results consistently favored the OBCS group. Recurrence Risk: A meta- analysis estimated a significant reduction in the odds of recurrence in OBCS patients with positive margins (odds ratio = 2.44, P < 0.001). This underscores the oncological safety of oncoplastic techniques. Evolution of Breast Cancer Surgery: Oncoplastic breast surgery represents a pivotal advancement in breast cancer surgery. The convergence of surgical oncology and plastic surgery has allowed continual refinement of techniques, ensuring both oncological safety and improved quality of life.

Conclusion

Accumulating evidence suggests that oncoplastic breast surgery plays a crucial role in achieving wide local resection with enhanced safety margins for malignant breast tumors. By preserving aesthetic and symmetrical breast shapes, oncoplastic procedures contribute to improved patient outcomes, reinforcing the evolving landscape of breast cancer surgery.
Evaluation of Cognition in Mild Cognitive Impairment and Cognitively Intact Group: A Follow Up Study
Authors: Sweed Hala Samir , Kamal Heba Yousif Yousif , Helmy El Malah Dina Mostafa , Hassan Marwa Elsayed Abbas
Published: November 2024

Introduction

Assessment of cognition in elderly is essential. Mild cognitive impairment (that also known as isolated memory impairment or incipient dementia) is a brain function syndrome involving both the evolution and onset of cognitive impairments that is beyond what would be expected based on an individual's age education, but is not significant enough to interfere with their daily activities.

Objective

To evaluate whether there is change of cognition in mild cognitive impairment and control group over a period of 6 months.

Methods

A case control study was conducted on total160 elderly patients (80 person in MCI group and 80 persons in cognitively intact group) that were recruited from ASU hospitals (inpatients and outpatients). All patients underwent comprehensive geriatric assessment and follow up after 6 months by cognitive function tests.

Results

Cognitive assessment at first visit and follow up visit in MCI group regarding MOCA test executive (P = 0.021) and orientation (P = 0.035) were, in case of MMSE attention (P = 0.023), recall (P = 0.034) and language (P = 0.020) were statically significant. Also regarding CDR, orientation (P = 0.005), community affairs (P = 0.028) and home and hobbies (P = 0.042) were statistically significant. While the cognitive assessment of cognitively intact group, that there was no statistical significant regarding MMSE, CDR, MOCA at first visit and follow up visit.

Conclusion

Different cognitive assessment items were affected in MCI group over a 6 month period.
Fracture Risk Assessment in Elderly with Chronic Liver Disease and its Relationship with Serum Albumin Level
Authors: Hamza Sarah Ahmed , Kamel Heba Yousif Yousif , Mohamed Enas Ramadan , Elbehery Hesham Mosad , Hashish Ramy Mahdy Ahmed
Published: November 2024

Background

Falls and fractures have detrimental effect on health of elderly population. Detection of risk factors for this syndrome is crucial in its prevention, especially in populations suffering negative bone alterations such as patients with chronic liver disease (Stains et al., 2020).

Objective

To estimate and detect fracture risk factors among elderly with chronic liver disease and relation to serum albumin level.

Subjects and Methods

A case control study included total number of one hundred and thirty (130) participants recruited form the geriatric outpatient clinic in Ain Shams university hospital in Cairo and chosen by convenience sampling method. The study sample was distributed into two groups: cases (n = 65) with positive history of falls, fall related fracture or risk falls, while controls (n = 65) were negative for these factors. All subjects underwent comprehensive geriatric assessment with focus on liver disease, drug history, assessment of risk of falls using timed up and go test (TUG), with radiological assessment for chronic liver disease and laboratory assessment for serum albumin

Results

Age difference between cases and controls was statistically significant, where cases had higher mean (74.37 ± 7.17) compared to that of the control group (67.12 ± 5.81). the cases group had higher prevalence of females (66.2%) compared to the control group (44.6%). The diagnosis of hepatic focal lesion was also more prevalent among cases compared to controls (13.8% vs 1.5%). Lower serum albumin levels were found among cases (3.1 ± 0.46) compared to controls (3.1 ± 0.46).

Conclusion

Higher age, female sex and lower serum albumin level were associated with higher risk of falls, falls and fall related fractures in patients with chronic liver disease. Categories: Preventive Medicine, Public Health, Geriatrics.
The Possible Protective Effect of Chia Seed Oil on Atropine Induced Dry Eye Model in Male Adult Albino Rat: A Histological Study
Authors: Abd Elaziz Yasmin Tarek Rashad , Mohamed Safaa Mohamed Shaker , Ibrahim Gehan Abd Elkhalek , Elrazick M. Elkhateb Lobna Abd
Published: November 2024

Background

Dry eye disease is a multifactorial disease that could be presented by discomfort, burning, itching, redness, light sensitivity, visual problems, and instability of the tear film. It might be complicated by damage to the surface of the eye. The nutritional composition of chia seed oil (CSO) provided many health-promoting properties. CSO is generally considered to be the best plant source of Omega-3 fatty acids. In ophthalmology, omega-3 is considered as essential fatty acid for ocular surface homeostasis. It works by blocking proinflammatory eicosanoids and reducing cytokines through anti-inflammatory activity.

Aim of the Work

assess possible protective effect of chia seed oil on atropine induced dry eye in male adult albino rat.

Materials and Methods

Forty adult male albino rats were used in this study and were divided in to four groups (10 in each group): Group I (Control group), Group II (CSO group) CSO 2. 5 ml/kg/day orally by gavage feeding tube for 14 days, Group III (DED group) induction of DED by injecting 1 mg/kg atropine (single dose) into the extra orbital lacrimal gland in the right eye, Group IV (treated group) CSO was given as in group II and on day 7, dry eye was induced as in group III.

Results

In group III, there was prominent detachment in the corneal epithelium and increase in the conjunctival epithelium thickness with irregular cellular arrangement. Newly formed blood vessels were observed in substantia propria of cornea with irregular organization of collagen lamellae. Inflammatory cells infiltration was seen in subconjunctival connective tissue. All these findings showed improvement in group IV.

Conclusion

Chia seed oil extract could be beneficial in reducing the symptoms associated with DED.
Comparison between Skin Prick Test and Specific IgE in Diagnosis of House Dust Mite Sensitization in Respiratory Allergy of Seniors
Authors: Youssef Ashour Zienab Ahmed , Abdellatif Osama Mohamed , Ali Al-Bdry Mai Asem , Mahmoud ELNahas Amira Wael
Published: November 2024

Background

Respiratory allergies, including asthma, chronic rhinosinusitis, and allergic rhinitis, represent prevalent global health concerns with significant implications for public health and economic burdens.

Aim of the Work

The aim of this study is to evaluate which tool is best in diagnosis of respiratory allergy caused by house dust mites in seniors, skin prick test versus specific IgE.

Patients and Methods

A total of 60 patients with respiratory allergic diseases were enrolled in a year-long study conducted at Ain Shams University hospitals. Patients were categorized into two groups: 30 seniors (aged ≥ 60 years) and 30 young individuals (aged 15-30 years), with sensitivity and specificity of the diagnostic tools compared between the groups.

Results

A total of 60 patients with respiratory allergic diseases were enrolled in a year-long study conducted at Ain Shams University hospitals. Patients were categorized into two groups: 30 seniors (aged ≥ 60 years) and 30 young individuals (aged 15-30 years), with sensitivity and specificity of the diagnostic tools compared between the groups.

Conclusion

In conclusion, this study suggests that specific IgE may be more accurate than the skin prick test for diagnosing house dust mite allergy in seniors. Further research with a larger sample size and consideration of various allergens is recommended. This study is the first of its kind to compare specific IgE and the skin prick test in elderly individuals.
Role of Serum Alpha-1-Acid Glycoprotein as a New Biomarker for Cirrhotic and Hepatocellular Carcinoma Patients
Authors: Mohammed Amr Adel Ibrahim , Moghny Mostafa El Sayed Mohammed Abd-El , Riad George Safwat , Gamil Anwar Ayman
Published: November 2024

Background

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, it is the second leading cause of malignancy related mortality all over the world and is primarily due to the hepatitis C virus (HCV) epidemic.

Aim of the Work

to evaluate the diagnostic value of serum AAG level as a novel biomarker for HCC and cirrhotic patients

Patients and Methods

This study was conducted on ninety cases chosen from El Demerdash hospital (Ain Shams University) divided into three groups group (A) ten normal control people, group (B) forty known HCC patients which was further subdivided into two small subgroups B (I) twenty with low AFP level and B (II) twenty with high AFP level, as well as forty patients with liver cirrhosis group (C) during the period from June 2022 to December 2022.

Results

The mean value of AAG in HCC low AFP cases was 1307 μg/ml which was higher than that of patients with HCC high AFP (850 μg/ml) and chronic liver disease patients (309 μg/ml). AAG as a diagnostic marker for HCC the cut-off value was 740 ng/ml with sensitivity 73% and specificity 74% for HCC low AFP, which was higher than that of patients with HCC high AFP sensitivity 68% and specificity 71%.

Conclusion

Alpha 1 Acid Glycoprotein had better performance in diagnosing HCC patients with low AFP. Serum Alpha 1 Acid Glycoprotein (AAG) concentrations can used as a potential marker for hepatocellular carcinoma.
Evaluation of the Effect of Sevelamer Hydrochloride on Fibroblast Growth Factor-23 Level in Prevalent Hemodialysis Patients
Authors: Elsaied Tamer Wahid , Ahmed Fatma Abdelrahman , Khalil Amr Mohammed Ali
Published: November 2024

Background

In people with chronic kidney disease (CKD), high levels of FGF23 in the blood which linked to an increased risk of heart problems and death. Phosphate binders to treat CKD patients by lowering their blood phosphate levels, which can also help reduce FGF23 levels.

Aim of the Work

Evaluation of Sevelamer Hydrochloride effect on FGF23 level in Hemodialysis patients who started hemodialysis sessions more than three months ago.

Patients and Methods

This study was designed to investigate the potential benefits of sevelamer hydrochloride in hemodialysis patients. It involved 100 participants randomly divided into two equal groups (50 each) using a 1:1 ratio. One group (Group I) received sevelamer hydrochloride treatment. The other group (Group II) did not receive the medication and served as a control group.

Results

Our study found significant improvements in several key markers in the sevelamer group compared to the group didn’t receive the medications: FGF-23 levels: Decreased significantly by nearly 39.6 pg/ml in the sevelamer group, while in group II showed minimal change (only 0.4 pg/ml) also, showed significantly lower phosphorus (PO4) levels (p-value < 0.001), in addition to parathyroid hormone (PTH) and alkaline phosphatase: Significantly decreased in the sevelamer group compared to group II (p-value < 0.001), and high-sensitivity C-reactive protein (hsCRP): also significantly decreased (p-value < 0.001). Overall, this study suggests that sevelamer treatment may offer potential benefits for hemodialysis patients by: Lowering FGF-23, PO4, PTH, alkaline phosphatase, and hsCRP levels and having minimal side effects.

Conclusion

Non-calcium-based phosphate binder (Sevelamer hydrochloride) treatment resulted in significant reductions in FGF-23 levels, phosphate levels (PO4), parathyroid hormone levels (PTH), alkaline phosphatase levels, and hsCRP levels suggesting that Sevelamer may be effective in improving the biochemical markers associated with kidney disease, potentially leading to a reduced risk of cardiovascular complications and death.
Study of the Relationship between Insulin Resistance and Risk of Developing Depression and Anxiety Disorders
Authors: Abdelfattah Hadia Elsayed , Bekhet Meram Mohamed Mahmoud , Saleh Amr Mahmoud Mohamed , Tawfik Fairouz Ahmed , Elias Diana Guirguis
Published: November 2024

Background

Studies have suggested that diabetes increases the risk of incident depression and anxiety. Also, it can contribute to a more severe course of depression and anxiety with different mechanisms. Moreover, Insulin resistance is an essential component in development of diabetes in diabetic patients. Yet, no sufficient studies revealed the relationship between insulin resistance and depression and anxiety. Hence, this is important to prevent, early detect, treat, and identify factors affecting their incidence, as this affects prognosis and insulin resistant individuals’ quality of life.

Aim of the Work

To study the relationship between insulin resistance and risk of developing depression and anxiety disorders.

Patients and Methods

This is a case control study conducted on patients from diabetes and Internal medicine clinics and department of Ain Shams University Hospitals. This present study aimed at analyzing the data of 60 participants divided into 3 groups. Group 1has 20 Insulin resistant diabetic patients. Group 2 has 20 Insulin resistant non diabetic patients. Group 3 has 20 Non insulin resistant non diabetic normal subjects, over two months period from December 2022 to March 2023. They were subjected to clinical examination and laboratory work up including (HbA1c, HOMA IR, lipid profile), then they were screened by PHQ and GAD.

Results

A total of 60 participants who are composed of 56.6% females, 70% non workers, 78% married, 30% smokers and 62% with BMI more than 25. As regards psychiatric assessment, PHQ assessment shows a total of 34 participants having depression representing (56.67%), while GAD assessment shows 28 subjects having anxiety disorder (46.67%). As regard the comparison between the 3 groups the HOMA IR values are higher in group 1 and 2, while, HbA1c values are more in group 1 which show a statistical significance with p value <0.001 each. As regards, psychiatric assessment of the participants, 75% of group 1, 60% of group 2 and only 35% of group 3 suffer from depression scored by PHQ. This shows a statistically significant correlation between DM, IR and depression (p value = 0.036) Furthermore, 65% of group 1, 55% of group 2 and only 20% of group 3 suffer from scored by GAD. This shows a statistically significant correlation between DM, IR and anxiety (p value = 0.011)

Conclusion

Depression shows significant correlation with HbA1c value and Anxiety shows significant correlation with HOMA IR value. Hence, psychiatric evaluation can’t be ignored in any case with insulin resistance or diabetes. Detecting factors which affect the prevalence of such complications will help in preventing them in the future. So, further research to establish management protocols to reduce these complications is needed.
The Prognostic Value of Interleukin 4 and Interleukin 6 in H-pylori Peptic Ulcer Disease
Authors: Salama Mohamed Magdy , Bayomy Esraa Gamal Abd Elsattar , Awad Emad Ahmed , Abdo Ahmed Abbas
Published: November 2024

Background

Helicobacter pylori is a Gram-negative bacteria that colonizes the gastrointestinal mucosa and causes chronic inflammation and leads to different diseases such as peptic ulcer, bile reflux, gastritis, autoimmunity, or allergic response etc. This also develops into gastric cancer.

Aim of the Work

The present study aims to evaluate the prognostic value of interleukin 4, interleukin 6 in hpylori infected patients before and after treatment

Patients and Methods

This cohort study was conducted in Ain Shams University Hospital inpatient ward and Gastroenterology outpatient clinic for 6 month between August 2023 to February 2024 in Ain Shams University Hospital. This study was performed on 45 Egyptian patients with peptic ulcer due to H-pylori.

Results

There was significant difference between before and after treatment as regards HB, WBCs, Albumin and CRP (P < 0.05). There was significant difference between before and after treatment as regards IL-6 and IL-4 (P < 0.05). There was significant positive correlation between IL-6, CRP and WBCs (p < 0.05). Also, there was significant positive correlation between IL-4, CRP and WBCs (p < 0.05). The diagnostic accuracy of IL-4 as a discriminatory marker between before and after treatment among H-pylori infected patients was assessed using ROC curve which revealed a sensitivity 91.7% and specificity of 66.7% at cutoff value >50.7 pg/ml, with an acceptable discriminative accuracy of 80%. While the diagnostic accuracy of IL-6 as a discriminatory marker between before and after treatment among H-pylori infected patients was assessed using ROC curve which revealed a sensitivity 98.11% and specificity of 90.1% at cutoff value >40.8 pg/ml, with an acceptable discriminative accuracy of 87%.

Conclusion

In this study we concluded that there is an increased production of IL-6 and IL-4 among H- pylori infected patients that may be an important mediator of the inflammatory response. Serum IL-6 and IL- 4 is significantly lower after treatment of H. Pylori infected patients. Still, we caution that studies with larger groups of patients and properly matched control groups, are needed to confirm these findings.
Potential Role of Gall Bladder Wall Thickness as Non-Invasive Screening Parameter for Detecting Oesophageal Varices
Authors: Moones Ahmed Ali , Rahman Hany Aly Hussein Abd El , Youssef Mohamed Gamal , Gawargy Hedra Nader Ibrahim
Published: November 2024

Background

Liver cirrhosis is defined pathologically as fibrosis and inflammation of the liver which is caused by chronic HBV, chronic HCV, NASH, NAFLD, chronic alcohol use and auto immune diseases which lead to portal hypertension.

Aim and Objectives

The aim of this study is to evaluate whether non-inflammatory gall bladder wall thickness serve as predictor of oesophageal varices in combination and comparison with other non- invasive clinical and laboratory parameters.

Subjects and Methods

This case-control study was conducted at the Hepatology and Gastroenterology Department, Ain Shams University, Egypt. The study was conducted over a period of one year, from January 2022 until January 2023.

Result

There was no statistically significant difference between both groups as regard age, sex and associated comorbidities. There was statistically significant higher rate of clinical findings either gastrointestinal or systematic in subjects with esophageal varices that those without varices. 37.78% of subjects with cirrhosis without esophageal varices have normal clinical examination.

Conclusion

According our study, measuring gallbladder wall thickness is very useful for detection of esophageal varices in cirrhotic patients as we find significant association between gallbladder wall thickness and liver cirrhosis patients with esophageal varices. GBWT improve the non-invasive monitoring of liver disease patients to assess the risk for the presence of EV.
Evaluation of Methylated Septin 9 as a Biomarker in Colorectal Carcinoma
Authors: Ghaly Sameh Mohammad , Khayyal Ahmed ElSaady , Naguib Ahmed Mohamed , Abdelshafi Israa Adel Abdelaziz
Published: November 2024

Background

Colorectal cancer (CRC) is a significant global health concern, with increasing incidence rates associated with economic development and lifestyle changes. Conventional diagnostic methods for CRC suffer from limitations, prompting the exploration of novel biomarkers such as methylated Septin 9 (mSEPT9).

Aim of the Work

This case-control study aimed to determine the diagnostic efficacy of mSEPT9 for blood-based CRC detection in an Egyptian population. The study also sought to compare the diagnostic performance of mSEPT9 with two established tumor biomarkers, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9).

Patients and Methods

Forty CRC patients from outpatient clinics at Ain Shams University Hospital and 40 matched healthy individuals were enrolled. Levels of mSEPT9, CEA, and CA19-9 were measured in both groups. Receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminative power of these markers.

Results

Demographic data showed no significant differences between groups (p > 0.05). Methylated Septin 9 levels were markedly higher in the CRC group (225.1 [164.2-344.8]) compared to controls (19.9 [12.1-43.2]) (p < 0.001). Positive CEA results were more frequent in the CRC group (50%) compared to controls (96.7%) (p < 0.001). Positive CA19-9 results were found in 20% of the CRC group and none in controls (p < 0.05). ROC curve analysis demonstrated good discriminative power for mSEPT9 (accuracy = 88%, p < 0.001) with a sensitivity of 89.2% and specificity of 86.7%. CEA showed moderate discriminative power (accuracy = 73.3%, p < 0.05) with a sensitivity of 59% and specificity of 96.7%. CA19-9 exhibited poor discriminative power (accuracy = 60%, p < 0.05) with a sensitivity of 20% and specificity of 100%. Combining all markers yielded an accuracy of 86.7% (p < 0.001), sensitivity of 86.7%, and specificity of 86.7%.

Conclusion

Our results showed that plasma mSEPT9 represents a promising biomarker in CRC diagnosis. Therefore, further investigations on the diagnostic performance of the fecal test by different cut-off values are highly warranted. Along with the advantage of convenience and non-invasiveness, mSEPT9 is a promising biomarker in CRC detection. It could be expected that a further colonoscopy targeting the high-risk population (mSEPT9 positive) could improve the confirmation ability of CRC diagnosis, which avoids the repeated screening and reduces the invasive procedures. Combined use of mSEPT9 with traditional method could improve the diagnostic sensitivity especially among CRC patients in early stage, which may provide a new approach for future CRC screening, while further investigations with large sample size are highly warranted.
Study of the Effect of HCO3 Supplementation on Serum α-Klotho Protein Level in Diabetic Kidney Disease. Pilot Study
Authors: Shaker Manal Mohammed , Wahab Saeed Saeed Abd El , Hassan Mohamed Saeed , Khedr Lina Essam , Elsharabasy Reem Mohsen
Published: November 2024

Background

Chronic kidney disease (CKD) was prevalent worldwide in the middle-aged and old-aged population. It has been recognized as an important disease threatening human health. Individuals with CKD are at risk of bone disorders, vascular abnormalities, and premature mortality due to changes in Ca2 and PO4 haemostasis.

Aim of the Work

To study the effect of oral sodium bicarbonate supplementation on soluble α-Klotho serum levels in diabetic patients with chronic kidney disease (stage 3b:4) according to the CKD-EPI formula.

Patients and Methods

This study was conducted on 44 diabetic patients with CKD stages 3b-4 according to the CKD-EPI formula ESRD recruited from Inward and OPC patients at El-Demerdash Internal Medicine Hospital. Their age ranged from 26 to 76 year. This study was conducted from June 2023 to November 2023; each participant signed informed consent. The study was approved by the Research Ethical Committee of Faculty of Medicine, Ain Shams University in April 2023.

Results

The mean age in cases was 57.1 ± 12.9 years was comparable to the control 55.1 ± 11.3 years with no significant difference between groups (p > 0.05). As regard sex distribution of the 44 patients included, males were 45.5% and females 54.5% with no significant difference between groups (p > 0.05). In our study there was no statistically significant difference between the two groups regarding DM duration (p > 0.05) or treatment also regarding presence of HTN or antihypertensive (p > 0.05). Also results showed no significant difference between cases and control as regard serum creatinine, eGFR, calcium, phosphorus, PTH and HBA1c (p > 0.05). As regards p/c ratio, there was significant difference between cases and control (P < 0.05). An interesting finding in this work was the significant increase in serum alpha klotho after 6 months of HCO3 supplementation, The Klotho (pg/mL) Before ranged from 296.1 to 730.2 with mean 388.5 ± 100.6 and the Klotho (pg/mL) After ranged from 426.1 to 933.3 with mean 641.5 ± 131.1.

Conclusion

There was highly significant difference found between before and after sodium bicarbonate supplementation in terms of Klotho and Hco3 in chronic kidney disease patients stage 3b to 4.
Gut Microbiome Lactobacillus acidophilus and its Relation to Thyroid Nodules and Thyroid Hormonal Profile
Authors: Elfatah Mohamed Mojahed Mohamed Abd , Elfatah Morsy Hadia Elsayed Abd , Mohamed Elnbrawy Inas Mohamed Sabry , Ali Hendawy Laila Mahmoud , Mohamed Abd Elhady Amr Mahmoud
Published: November 2024

Background

Thyroid nodules are a common clinical problem. Epidemiologic studies have shown that the prevalence of palpable thyroid nodules is approximately 5% in women and 1% in men living in iodine-sufficient parts of the world. It is well-known that any thyroid disease is closely related to thyroid hormone levels or the hormone functioning, which could influence the gut microbiomes composition. Lactobacillus is an important genus in the human gut which could improve the concentration of various trace elements in human cells.

Aim of the Work

To assess the relation between gut microbiome Lactobacillus acidophilus and its relation to thyroid nodules and thyroid hormonal profile.

Patients and Methods

This was a case control study that was conducted on 90 Egyptian subjects aged 16-60 years old that was divided into 3 groups, Group A that included 30 patients with benign thyroid nodule Group B that included 30 patients with Malignant thyroid nodule and Group C that included 30 healthy subjects as a control group, it was carried out at Endocrine outpatient clinic at Ain Shams University Hospital in Cairo, Egypt. It was conducted from September 2021 till September 2022. Systematic random sampling was performed.

Results

There was a significant increase in cycle threshold at which lactobacillus acidophilus PCR expressed (which indicate lower colony count of lactobacillus acidophilus) in group B (malignant thyroid nodules) than group C (control group) with P < 0.001 and there was a significant increase in cycle threshold at which lactobacillus acidophilus PCR expressed in group A (benign thyroid nodules) than group C (control group) with P value 0.003. Serum Selenium in Group (B) (malignant thyroid nodule) was lower than in Group (C) (healthy control) There was high statistically significant differences between groups (P-Value <0.001*). Serum Selenium in Group (A) (Benign thyroid nodule) was lower than in Group (C) (healthy control) There was high statistically significant differences between groups (P-Value <0.001*). Serum zinc was lower in Group (A) (benign thyroid nodule) than Group (C) (healthy control) There was high statistically significant differences between groups (P-Value <0.001*). Serum zinc was lower in Group (B) (Malignant thyroid nodule) than Group (C) (healthy control). There was high statistically significant differences between groups (P- Value <0.001*).

Conclusion

Stool Lactobacillus acidophilus count was significantly different between studied groups. Being lower in patients with thyroid cancer and patients with benign thyroid nodules than healthy group. This data may reflect the interaction between the gut microbiota lactobacillus acidophilus and the development of thyroid nodules and thyroid cancer.
Impact and Incidence of Food Allergy in Patients with Irritable Bowel Syndrome
Authors: Abdelmagied Hamza Mohamed Ahmed , Nashaat Ehab Hassan , Elgaaly Sonya Ahmed , Elfors Mostafa Attya
Published: November 2024

Background

Irritable bowel syndrome (IBS) is a multifactorial gastrointestinal disorder affecting 5.2–22% of the population. It is not a single disease, but a name given to a group of gastrointestinal symptoms that commonly present together.

Aim and Objectives

The study aimed to evaluate the impact and the incidence of food allergy in patients with IBS.

Subjects and Methods

This was a prospective cohort study conducted at The Gastroenterology and Hepatology Clinic, or the inpatient Internal Medicine Department, at the Faculty of Medicine, Ain Shams University.

Result

the mean age was 34.8± 5.2, 30% were male while 70% were female. 38% were rural while 62% were urban. In Multivariate correlation regression, there were strong significant correlations between Food Allergy and age, sex, Family history, Smoking and IBS- D.

Conclusion

The observation that the administration of a monoclonal antibody against IgE resulted in almost complete resolution of this patient’s IBS symptoms suggests that this immunoglobulin plays a part in the pathogenesis of IBS, in at least a subset of patients. Consequently, in patients with atopy and IBS, targeting this abnormality might have therapeutic potential, particularly in those individuals not responding to conventional IBS therapies. There is some evidence that sodium cromoglycate has an effect in patients with atopic IBS, especially in those who have positive skin prick tests to food antigens.
Assessment of the Relationship between IGF-1 and Painful Diabetic Neuropathy in Patients with Diabetes Mellitus
Authors: Nasr Merhan Samy , Bekhet Meram Mohamed , Adly Nahla Nader , Ahmed Nesma Hussien , Mostafa Noor Mohamed Abdulnabi
Published: November 2024

Background

IGF-1 has been presented to restore micro-circulation in damaged nerves along with functional recovery, hence suggesting protective effects of growth factors against the development of neuropathy associated with diabetes mellitus.

Objective

To assess the relationship between insulin-like growth factor-1 (IGF-1) and painful diabetic neuropathy (DNP) in diabetic patients.

Patients and Methods

This study was conducted at the diabetes outpatient clinic at Ain Shams University Hospital, during the period from April 2023 to September 2023. Patients were randomly selected according to the study inclusion and exclusion criteria. A written informed consent was taken from all subjects included in the study.

Results

The differences in diagnostic methodologies could partially account for this difference. Ethnic differences in predisposition and differential exposure to risk factors are other probable mechanisms.

Conclusion

IGF-1 was protective against the development of DPN in patients with DM and was protective against neuropathic pain. Patients with DPN exhibit dysregulated IGF-1, which is thought to contribute to the development of DPN. In fact, studies report lower systemic IGF-1 levels in people with diabetes with DPN compared to those without. As such, therapeutically raising IGF-1 levels may be a promising avenue for the prevention and treatment of DPN.
Prevalence of Common Variable Immune Deficiency in Immune Thrombocytopenic Purpura Patients
Authors: Shahin Rasha Youssef , Kamal Tanagho Sylvia Talaat , El-badry Mai Asem , Taha Sara Ibrahim Abdelfattah , Mohamed Hamed Nourhan Hassan
Published: November 2024

Background

Liver cirrhosis is the most frequent long-term consequence of all chronic liver diseases. Cirrhosis is often asymptomatic and unsuspected until complications occur. The majority of patients with liver cirrhosis or hepatocellular carcinoma die from complications, which happen relatively early in the course of the disease. Thus, the early diagnosis of liver diseases is the only solution for this problem.

Aim of the Work

We aimed to evaluate serum kallistatin in Egyptian patients with hepatitis C virus related liver cirrhosis and hepatocellular carcinoma.

Patients and Methods

This case control study enrolled 90 Egyptian subjects aged ≥ 18 years old, participants were classified into 3 groups as follow: Group 1: 30 patients with hepatocellular carcinoma. Group 2: 30 patients with hepatitis C virus related liver cirrhosis. Group 3: 30 healthy subjects serving as a control group.

Results

Patients with liver cirrhosis and HCC have lower levels of serum Kallistatin compared to a control group. In the HCC group, patients with more severe liver disease (Child C class) had lower Kallistatin levels than those with less severe disease (Child class A and B). Kallistatin was negatively correlated with age, platelets, INR, bilirubin, C-reactive protein and alpha feto protein and positively correlated with hemoglobin and albumin. The study also tested the diagnostic accuracy of Kallistatin for detecting liver cirrhosis and HCC, and found that it had 96.6% accuracy for cirrhosis and 98% accuracy for HCC at specific cutoff points (<31.10ng/ml and <39.09ng/ml).

Conclusion

Serum Kallistatin has a potential rule as a new biomarker for the diagnosis and evaluation of liver cirrhosis and HCC.
Prevalence and Risk Factors of Multidrug-Resistant Urinary Tract Infections among Critically Ill Patients in Ain Shams University Hospitals
Authors: Elshinnawy Howayda Abdelhameed , Behairy Maha Abd El Moneim , El-Ashry Marwa Abd El- Rasoul , Abdel-Samea Marwa Shaaban , Ali Olfat Tarek
Published: November 2024

Background

Multidrug-resistant infections are becoming a major source of in-hospital mortality and morbidity in ICU patients, numerous independent risk factors for infections by MDR bacteria have been identified, ICUs are often considered the epicenter of development, amplification and dissemination of drug-resistant microorganisms

Aim and Objectives

To determine the prevalence, possible risk factors and outcome in critically ill patients in ICU with multidrug resistant urinary tract infections in Ain Shams University Hospitals.

Subjects and Methods

This was cross-sectional study that included 383 patients who were admitted to different intensive care units in Ain Shams university hospitals during a period of Six months (March 2022 – August 2022). Patients were identified by review of urine specimens sent to the microbiology laboratory for urine cultures, for patients suspected clinically of UTI or in those with urinalysis demonstrating increased white blood cells count, Multidrug resistant (MDR) was defined as isolates that were resistant or intermediate susceptible to ≥ 3 of the following antimicrobial categories: (a1) penicillin (b) cephalosporins (c) carbapenems; (d) fluoroquinolones; (e) gentamicin or amikacin; (f) TMP-SMX; and (g) nitrofurantoin

Results

The prevalence of multi- drug resistant UTI was about 45.2%. Hypertension and Diabetes mellitus were the most common medical comorbidities. The presence of chronic indwelling urinary catheters was the most common healthcare-associated risk factor for MDR UTI. Klebsiella and enterococcus were significantly more prevalent among MDR cases (41.6 % and 46.8% respectively). Penicillin had the most common antimicrobial resistance in our study. 59% of the patients with MDR UTI presented with septic shock, 18.5% presented with AKI as the second most common cause of hospital admission in MDR UTI patients. MDR UTI patients had higher mean serum creatinine and lower eGFR in comparison to non-MDR group.

Conclusion

Multi- drug resistant UTI had 45.2% prevalence among critically ill patients in Ain Shams university hospitals with many risk factors. In addition, higher CRP, lower eGFR and lower haemoglobin level are associated with MDR urinary tract infections.
Effect of Nutritional Status and Haemodialysis Parameters on Health Related Quality of Life and Post Dialysis Recovery Time in Prevalent Haemodialysis Patients
Authors: Kasem Rabah Elsayed , Elsharkawy Magdy Said , Shawky Sahar Mahmoud , Hebah Hayam Ahmed , Kamel Cherry Reda , Emara Ahmed Abd-Elmonem
Published: November 2024

Background

The majority of patients with an impaired renal function may be classified as to a certain stage of chronic kidney disease (CKD) progressing to end-stage renal disease (ESRD) and requiring renal replacement therapy (RRT).

Aim of the Work

To study the effect of current nutritional status of haemodialysis patients and other variables (socio-demographic, physical, biochemical and dialysis treatment parameters) on health related quality of life and post dialysis recovery time among haemodialysis patients in haemodialysis units in Desouq general hospital, Kafr-Elshiekh Governorate.

Patients and Methods

Type of Study: We conducted an observational cross-sectional study. Study Setting: The study was conducted in haemodialysis units in Desouq general hospital, Kafr-Elshiekh governorate. Study Period: from July to September in 2021. Study Population: 100 prevalent End Stage Renal Disease (ESRD) patients on regular haemodialysis 3 times per week in Desouq general hospital.

Results

The result of this study concluded that the factors affecting nutritional status for those patients were age & dialysis wintage, serum HB, serum calcium, both serum albumin & serum pre-albumin, intake of: (carbohydrate, potassium, calcium, phosphorous & magnesium) & anthropometric measurement of; (Weight, BMI, calf circumference, BSF, TSF, MAMC & MAC). Also, our study concluded that the factors affecting QOL for our patients were; SGA score (as a surrogate for nutritional status), duration of session, serum albumin & prealbumin, height, MAC, MAMC &calf circumference. Patients with poor nutrition have a poor physical and mental quality of life. Hence, it becomes important (not only for us but also for them) to identify such patients and intervene earlier, in order to improve their quality of life and also reduce morbidity which in turn helps in reducing mortality.

Conclusion

Malnutrition is one of the most commonly encountered (&treatable) problems in haemodialysis population in Egypt as it increases the morbidity and mortality. SGA (M- SGAS) and HRQOL SF 36 (Kidney Disease and Quality of Life--Short Form (KDQOL- SF™) version 1.3) are simple to use, bedside and readily available tools for nutritional & QOL assessment of MHD patients, respectively.
Assessment of Serum Phospholipase D1 (PLD1) in Adult Patients with Newly Diagnosed Acute Myeloid Leukemia
Authors: Wahed Hassan Essam Abd El , Nagib Mary Gamal , El Moaty Mohamed Inas Abd , Sheeba Mahmoud Soliman , Sabor Rana Ayman Abd El
Published: November 2024

Introduction

Phospholipase D (PLD) enzymes have been implicated in diverse cellular processes in cancer, including the Warburg effect and pro-survival pathways. However, the significance of PLD's role in tumorigenesis remains uncertain due to its genomic proximity to PI3Kinase-a, which is amplified in various cancers. Additionally, PLD signaling mechanisms are complex and context- dependent.

Objective

This study aimed to assess the level of PLD1 in newly diagnosed acute myeloid leukemia (AML) patients and its potential role as a prognostic indicator.

Methods

A case-control study was conducted on 30 newly diagnosed AML patients and 30 age and sex-matched healthy controls. Serum samples were collected, and PLD1 levels were detected using ELISA. Correlations between PLD1 expression and clinical parameters were analyzed.

Results

A statistically significant increase in PLD1 level was observed in AML patients compared to healthy controls (p < 0.0001).while there is no correlation between pld1, survival rate and other prognostic markers.

Conclusion

The present study highlights the significant upregulation of PLD1 in AML patients and its association with specific FAB subtypes. While some clinical parameters showed correlations with PLD1, its direct impact on survival remains uncertain, warranting further investigation with larger sample sizes. This study contributes to the understanding of PLD1's role in cancer biology and its potential as a prognostic marker in AML.
N-Cadherin as a New Marker for Diagnosis of Diabetic Nephropathy
Authors: Ibrahim Seif Reem Hany Ahmed , Sherbeny Alyaa Ahmed El , Bekhet Meram Mohamed , Taha Bahaa Mahmoud
Published: November 2024

Background

Diabetic kidney disease (DKD) is a highly prevalent condition worldwide. It represents one of the most frequent complications of diabetes mellitus (DM) and is the primary cause of end-stage renal disease (ESRD). The early detection of inflammatory biomarkers is essential in reducing complications related to the disease.

Objective

To investigate N-Cadherin in serum as a screening and diagnostic indicator for assessing diabetic nephropathy in diabetic patients.

Methods

An observational study carried out in 6 months included 90 patients with type 2 diabetes mellites equally divided into 3 groups: Those without diabetic nephropathy (group 1), those with microalbuminuria (group 2), does with macroalbuminuria (group 3).

Results

N-cadherin levels were increased in diabetic nephropathy compared to those without diabetic nephropathy (p value: 0.000), and most importantly there is significant increase in N-cadherin level between microalbuminuria group and normoalbuminuric (p value: <0.001). Also this study revealed significant difference between reading of 3 groups regarding 2hPP, HbA1c, TC, LDL, BUN and creatinine (p value: 0.000, 0.005, 0.003, 0.003, 0.006 and 0.024 respectively). We found a significant negative correlation between N-cadherin and eGFR (P value: 0.014) which indicates that N-cadherin is an important marker in renal disease. Our study had given us an Abstract about the role of the N-cadherin in prediction of detecting DN early and in monitoring treatment outcomes.

Conclusion

This study provides preliminary evidence suggesting N-cadherin as a novel renal biomarker associated with increased albuminuria and decreased eGFR levels in type 2 diabetic patients which can be used as a valuable prognostic and diagnostic tool to slow down or even inhibit ESRD. The study has also demonstrated that N-cadherin levels increased in microalbuminuria group of diabetic nephropathy compared to those without diabetic nephropathy.