bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study of the Diagnostic and Prognostic Value of Macrophage Activation Marker Soluble CD163 and Alpha Fetoprotein in Cirrhotic Patients with Hepatitis C Virus-related Hepatocellular Carcinoma treated by Loco-Regional Therapy
Authors: Mohamed K A , Mohamed E S , Hussein A M , Fouad M H A , Allam A S , Sakr M A M M
Published: May 2020

Background

hepatocellular carcinoma (HCC) shows an increasing incidence and represents the third most common cause of cancer-related death.

Aim of the Work

is to evaluate the diagnostic value of serum level of Macrophage activation marker soluble CD163 as a tumor marker for HCC and its prognostic value after transarterial chemo-embolization (TACE) or radiofrequency ablation (RFA), in comparison to alpha-feto protein (AFP).

Patients and Methods

this study was performed on 60 subjects from the outpatient Hepatology clinic and inpatient Gastroenterology and Hepatology Department at Ain Shams University Hospital.

Group I

includes 40 randomly selected cirrhotic patients with hepatitis C virus-related hepatocellular carcinoma (excluding BCLC class D) who underwent either RFA or TACE.

Group II

includes 20 patients with liver cirrhosis without hepatocellular carcinoma considered as control.

Results

soluble CD163 expression did not differ significantly between HCC group and liver cirrhosis group. This proves that soluble CD163 is not suitable for diagnostic use. On the other hand, soluble CD163 was associated with the severity of liver disease. Baseline soluble CD163 was significantly associated with disease progression independent of other risk factors known to be associated with an unfavorable course in HCC. Also the marked significant reduction of serum soluble CD163 levels in HCC patients subjected to either RF ablation or TACE proved that soluble CD163 may play a prognostic marker in HCC monitoring.

Conclusion

soluble CD163 is not suitable as a diagnostic marker for HCC but can be used as a prognostic marker for HCC.
Effect of hemodiafiltration on sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis
Authors: Elsayed H M , Elsharkawy M M , Kamel C R , Hussein H S , Abdelgawad M A , Abdelsamea M S
Published: May 2020

Background

sclerostin, an osteocyte-derived glycoprotein acts as a soluble inhibitor of the Wnt signaling pathway and its physiological role is to reduce bone formation. The serum sclerostin levels increase with the progression of CKD.

Aim of the work

in the present study, we investigated the effect of three months thrice weekly hemodiafiltration on serum sclerostin level and bone specific alkaline phosphatase in comparison with high flux dialysis in stable HD patients.

Methods

prospective study was concluded upon 32 randomly selected ESRD patients from Dialysis Department in Ain Shams University Hospitals and Maadi Military Hospital. Serum sclerostin and bone specific alkaline phosphatase were measured at the start of the study (Zero months) and after 3 months of HDF dialysis between September 2017 and December 2017.

Results

32 test subjects were randomly selected had mean age 47.38 (± 18.68 years) in HDF group and 55.31 (± 7.40 years) in high flux group. 56.3% were male in HDF group, 81.3% male in high flux group. Patients in HDF group had serum sclerostin reduction ratio with mean 24.72 ± 10.34 pre-3 months and mean 30.34 ± 12.22 in post-3 months. While, serum sclerostin reduction ratio mean was 18.97 ± 7.87 in high flux group. There was a statistically significant difference between HDF group post-3months and high flux group as regard sclerostin reduction ratio (P-value: 0.015). There was no statistically significant difference between group HDF post-3 months and group high flux as regard BS-AP reduction ratio (P-value: 0.212).

Conclusion

Sclerostin decreased by HDF. Yet, HDF has no effect on bone specific alkaline phosphatase in comparison to high flux hemodialysis.
A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention
Authors: Abdelhamid S , Alsakty T M , Radwan H H , Abouelmaaty M E , Allam A S , Abdelhamid R S , Yousef M G
Published: May 2020

Background

hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients.

Aim of the Work

was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC.

Patients and Methods

the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Follow up of the patients who had HCC and undergone either RFA or TACE will be done after 1 month by measuring serum level of alfa feto protein & SCCA.

Results

the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion and its values were decreased after intervention.

Conclusion

plasma SCCA is a sensitive and specific serum marker for the diagnosis and prognosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.
Serum Beta 2-Microglobulin as a Biomarker of Activity in Ulcerative Colitis
Authors: Nashaat E H , Mohamed M M , Aziz T M , Nakhla M W
Published: May 2020

Background

ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease that causes inflammation and ulcers in the innermost layers of the large intestine (colon) and rectum. Assessment of intestinal inflammation in UC is crucial and still remains a difficult challenge for the clinician. Although endoscopic modalities with biopsy sampling seem to be the most reliable method for estimating disease severity, they are invasive and costly. Apart from endoscopic interventions, disease severity can be assessed using both laboratory studies and non-invasive imaging tests. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), acid glycoprotein, platelet count and albumin are in common use but have only modest accuracy in reflecting UC disease activity. Therefore, adjunctive use of additional serum markers that will be more sensitive and specific for determination of disease activity and achieving diagnostic accuracy is strongly needed in daily clinical practice.

Aim of the Work

to investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of ulcerative colitis disease.

Patients and Methods

a case control study that was conducted at the Gastroenterology Clinic, Internal Medicine Department, Ain Shams University during the period of January to July 2018. 60 patients were recruited for the study. They were divided as follows; Group “A”: 40 patients newly diagnosed as ulcerative colitis based on colonoscopy and biopsy, subdivided as follows; 20 patients with active ulcerative colitis and 20 patients with inactive ulcerative colitis. Group “B”: 20 healthy individuals free from any systemic diseases serving as a control group.

Results

in this study, the serum levels of serum B2-microglobulins were highest in patients with active ulcerative colitis compared to those with inactive ulcerative colitis and the control groups. Also B2-microglobulins values become higher with higher number of presenting symptoms and endoscopic activity, which becomes higher in severe disease.

Conclusion

our results revealed that serum B2-microglobulin was simple and non-invasive marker that could be helpful for differentiating active UC from inactive disease. Moreover, it was more helpful when used together with serum laboratory inflammatory indices (ESR and CRP).
Impact of Direct Acting Antiviral Therapy for Hepatitis C Virus Infection on Recurrence of Hepatitis C Virus Related Hepatocellular Carcinoma
Authors: Ghaly S M , Mohamed I A , Musa N I , Ahmed O A , Abuhalima A S , Said N M
Published: May 2020

Background

hepatocellular carcinoma is the fifth most common tumor worldwide and the second most common cause of cancer-related death with a male-to-female predominance greater than 2:1. The presence of cirrhosis represents a key risk factor for the development of HCC. The prevalence of cirrhosis among patients with HCC has been estimated to be 85%-95% and the HCC incidence rate among patients with cirrhosis has been shown to be 2%-4% per year. HCV infection is a leading cause of liver cirrhosis and hence the development of HCC. Egypt has the highest HCV prevalence worldwide; with estimated rate of 10% of Egyptians between 15 – 59 years as reported by the Egyptian Health Issues Survey (EHIS) in 2015.

Aim of the Work

the aim of this study was to evaluate the impact of Direct Acting Antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on recurrence of HCV related HCC after intervention.

Patients and Methods

this study was conducted on 50 patients with previously treated HCC who were treated for HCV infection using direct acting antiviral agents after confirming HCC regression and response to different treatment modalities and were followed for one year after antiviral treatment. A control group of another 50 patients with cured HCC who didn’t receive DAA therapy was included in the study to compare the recurrence rate in both groups and its relation to the antiviral therapy.

Results

the two groups didn’t differ as regards age, sex, biochemical profile, AFP, CBC and child score. The results of the study came to show an HCC recurrence rate of 38% in patients who received direct acting antiviral therapy after HCC intervention versus 62% in those who didn’t receive antiviral therapy.

Conclusion

direct acting antiviral drugs didn’t show to increase the risk of HCC recurrence in comparison to the control group. Yet it did not abolish it. So, close follow up of patients with HCC receiving antiviral therapy is highly recommended.
The Relation between Diabetes-Related Distress and Glycemic Control
Authors: Hamed M S , Ibrahim N A , Ali H M , Kheir C G
Published: May 2020

Background

Diabetes Distress is the understandable sense of burden or defeat that may occasionally punctuate the diabetic patient life. Also, Diabetes distress (DD) refers to the unique, often hidden emotional burdens and worries that are part of the spectrum of patient experience when man-aging a severe demanding chronic disease like diabetes.

Objectives

is to assess the relationship between Diabetes-related distress (using a Diabetes Distress Screening Scale) and the glycemic control (using A1C) and inflammation (using hs-CRP) in diabetic patients.

Patients and Methods

This study is a cross sectional study which had been carried out in outpatient clinic of endocrinology department of El Agouza Police Hospital during the period between June 2017 to June 2018.The study was done on 350 Type2 Diabetic patients.BMI,Wist/Hip Ratio, Fasting blood glucose,Post prandial blood glucose,HbA1c,hs-CRP,Creatinin,BUN,SGPT and SGPT were done to the patients, also Diabetes Distress Screening Scale Quastionnaire was completed by the patients.

Results

In this study we found that there is a highly significant positive relationship between HbA1c and both Fasting Blood Glucose and Post Prandial Blood Glucose. Also,there was a highly significant positive relationship between CRP and Fasting Blood Glucose while there was a non significant relationship between CRP and Post Prandial Blood Glucose.Fasting blood glucose and Post Prandial Blood Glucose showed a highly significant positive relationship with Total DDS score, Emotional burden and Physician realted distress, and showed non significant relationship with Regimen related distress and interpersonal distress.As regard the relation between HbA1c and Total DDS score, there was a highly significant positive relationship between them and also highly significant positive relationship between HbA1c and Emotional burden and physician related distress, but there was non significant relation between HbA1c and Regimen related distress and interpersonal distress. There was highly significant positive relationship between CRP and Total DDS score and also emotional burden, and there was significant positive relationship between CRP and Regimen related distress, and non significant relation between CRP and physician related distress and interpersonal distress.

Conclusion

In this study 350 type 2 diabetic patients were included. 55 diabetic patients show moderate distress with a highly significant relationship with the glycemic control (HbA1c) and significant relationship with CRP. In this age and sex were non significant factors while duration of diabetes, BMI and Wist-hip ratio show significant relation with HbA1c which reflect the glycemic control.
Frequency of Microscopic Colitis in Patients with Diarrhea predominant Irritable bowel syndrome in Egyptian Patients
Authors: Abdelmageed K H , Riad G S , Mousa N I , Sharafeldin D B A
Published: May 2020

Background

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. Irritable bowel syndrome is considered a functional illiness wih no diagnostic biomarkers or pathologic findings. The most common diagnosis made in patients with chronic diarrhea is IBS. MC is a clinical syndrome of unknown etiology, characterized by chonic watery diarrhea in the absence of macroscopic changes in the large bowel, but with histological examination changes

Objective

The aim of this study is to determine the frequency of microscopic colitis in patients with IBS of diarrhea predominant sub type.

Methods

This prospective study had been conducted on 100 subjects, age range 19-65 year from National Hepatology and Tropical medicine reaserch Institute and Ain Shams University hospital inpatient and outpatient clinics. The study was carried on over 2 years (2016-2018) duration. The study subjects were fulfilling Rome criteria. The main complain of the selected patients was abdominal pain associated with chronic watery diarrhea.

Results

This study showed that patients with microscopic colitis can be misdiagnosed as IBS – diarrhea predominant due similar presentation and normal macroscopic picture in endoscopy. In this study we found that 14 (14%) had microscopic colitis. This study showed that there is a significant difference between patients with normal biopsy and others with microscopic colitis as regard age and sex.

Conclusions

Our study showed that MC is not uncommon in Upper Egypt patients with chronic watery diarrhea and normal colonoscopic findings. Biopsy of the normal colonic mucosa in patient with chronic watery diarrhea is emphasized to reach a definite diagnosis of MC. Abdominal pain, nocturnal diarrhea and weight loss were the most common clinical manifestations of MC. MC types, LC, and CC have almost similar clinical presentations and there is no diagnostic laboratory marker; thus, histopathologic diagnosis is the only reliable method for differentiation between these subtypes. Nocturnal diarrhea and slight weight loss can be helpful in distinguishing microscopic colitis from diarrhea predominant IBS. Collaboration between treating physicians, endoscopists and pathologists is crucial for diagnosing MC.
Effect of ramadan fasting on microvascular complications in type1 diabetic patients
Authors: Abushady M M , Eid Y M , Ibrahim R H , Abdelsayed D E
Published: May 2020

Background

Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Significant evidence exists that supports a range of interventions to improve diabetes outcomes.

Objective

This study aimed to demonstrate the impact of fasting on primarily on ẻGFR & microalbuminuria in people with type 1 diabetes and secondarily on neuropathy & retinopathy. It was conducted on 60 patients with T1DM. All patients underwent full history taking, full clinical examination and biochemical tests including FBG, 2h PPBG, HbA1c, fructosamine, s.creatinine, BUN, uACR, eGFR, fundus examination and DN4 Q.

Methods

This study was conducted on 60 type 1 diabetic patients with microalbuminuria intending to fast Ramadan. Patients were recruited from internal medicine and diabetes clinics of Ain Shams University. The study performed health education 2 months prior to Ramadan 1438 (2017) with follow up throughout the month and after Ramadan. The patients were on basal-bolus regimen, 36 were on lantus, 17 were on NPH and the remaining 7 patients didnot complete the follow up after Ramadan for family reasons.

Results

There had been significant difference between pre and post-fasting as regards weight and BMI, and non significant difference regards waist circumference. Also highly significant difference between basal and bolus doses before and during Ramadan. There had been no significant difference between pre and post Ramadan regarding fundus examination, systolic and diastolic blood pressure and a significant difference regarding DN4 Q. Regarding no. of successful fasting days and attacks of hypoglycemia, a significant difference was found. Significant difference in FBS, 2hr PPBG, BUN, s.creatinine, uACR and eGFR, and fructosamine. There was a significant positive correlation between eGFR and height, weight before Ramadan and between eGFR and height, weight after Ramadan, no. of successful fasting days Ramadan 2017. Also a significant negative correlation was shown between eGFR and A / C ratio, Cr, BUN before Ramadan and between éGFR and Cr, BUN after Ramadan. Height, BUN before and after Ramadan and A / C ratio before Ramadan were found to be independent predictors of eGFR.

Conclusion

Ramadan fasting appears to have significant impact on microvascular complications of type 1 DM patients. These impacts can be attributed to many factors as physical sloth, change of time and pattern of feeding, climate conditions at time of fasting especially hot humid weather predisposing to more frequent dehydration with its sequelae as well as non-compliance of some patients to the proper lifestyle, diet and medications.
Effects of Ginger Powder Supplementation on Glycemic Status and Lipid Profile in Patients with Type 2 Diabetes Mellitus
Authors: Elgayar M H , Mahdy M M M , Ibrahim N A , Abdelhafiz M H
Published: May 2020

Background

Diabetes is a huge problem affecting 387 million adults by a global prevalence of (8.3%) which is expected to rise to (10.1%) affecting 592 million adults by 2035. Type 2 diabetes, a growing public health problem, is associated with increased morbidity and mortality.

Purpose

To evaluate the effects of ginger powder supplementation on glycemic status, lipid profile, insulin resistance, insulin sensitivity, and beta-cell function in obese Egyptian patients with new-onset type 2 Diabetes Mellitus.

Patients and Methods

This study was conducted at the Diabetes outpatient clinic of the National Institute of Diabetes and Endocrinology (NIDE) during the period from January 2016 to January 2017.

Study Design

A randomized, single blind, placebo-controlled clinical trial, was performed on 80 subjects newly diagnosed with T2DM. Subjects were randomly & equally subdivided into two groups: Group 1: Ginger Group (GG), which consumed three capsules daily, each capsule containing: 600-mg of ginger powder (total daily dose was 1.8 g), they also underwent certain diet and physical activity changes, and also received metformin as one 850-mg tablet twice a day with meals for a duration of 8 weeks.Group 2: Placebo Group (PG), which received capsules of the same color, size, and number as (Group 1) but containing wheat flour, they also underwent the same diet, physical activity, and metformin dosage as (Group 1) during the 8 weeks of the study.

Results

Ginger powder supplementation significantly reduced body mass index, fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, total cholesterol, low density lipoprotein cholesterol, triglycerides, fasting insulin levels, and homeostasis model assessment-insulin resistance index (HOMA2-IR). Ginger also significantly increased high density lipoprotein cholesterol levels, beta cell function index (HOMA2-%β), and insulin sensitivity index (HOMA2-%S).

Conclusion

Ginger is considered a safe and effective adjuvant antidiabetic agent in treatment of T2DM; improving glycemic status, lipid profile, insulin resistance, and promoting weight loss.
Rituximab and Cyclosporine in Idiopathic Membranous Nephropathy Who Failed to Respond to Ponticelli Regimen
Authors: Nasser M E , Hebah H A , Alaaeldeen H
Published: May 2020

Background

Membranous nephropathy is the chief etiology of nephrotic syndrome in adults. It is clinically featured and presented by investigational tool as very high of protein levels in urine, edema, hypoalbuminemia and elevated serum level. Idiopathic membranous nephropathy is a chronic pathological form of clinical scenarios and its pathophysiological course involves spontaneous remissions or remissions by immunosupressions with frequent relapses.

Aim

To assess the efficiency of Rituximab as a secondary line immunosuppression in Patients with Idiopathic Membranous Nephropathy (IMN) who failed to respond to Ponticelli regimen and to compare it with Cyclosporine.

Methods

This study is a retrospective cohort study including 40 Egyptian patients with biopsy proven IMN who failed primary immunosuppression with cyclophosphamide and steroids according to Ponticelli regimen divided into two equal groups, 20 patients each. Cyclosporine Group: received Cyclosporine, given daily for a minimum of 6 months at doses of 3.5 mg/kg orally and Rituximab Group: received Rituximab weekly for 4 weeks at doses of 375 mg/m2 intravenously. Data collected included UPCR, eGFR, serum albumin, serum creatinine, CBC, lipid profile for 6 times: before giving cyclosporine or rituximab (time 0), after 1month, 3, 6,9 and 12 months.

Results

17 patients achieved remission (7 CR and 10 PR) in CSA treated group while 13 patients (1 CR and 12 PR) in RTX group, P = 0.077. UPCR was reduced for >50% in patients receiving Cyclosporine compared to 30% in Rituximab treated group: UPCR was decreased from 5.9±3.5 at time 0 to 2.0±2.8 (p = 0.002) & decreased from 7.3±5.2 to 4.6±3.9 (P = 0.031) in Cyclosporine and Rituximab groups respectively. There was improvement of serum albumin in both groups by the end of study more remarkable in cyclosporine group. The eGFR was non significantly reduced by the end of study in RTX group while it showed significant reduction in CSA group. No serious adverse events were reported all through the study period in both groups.

Conclusion

Rituximab is an efficient, well tolerated secondary immunosuppressant drug in IMN. Its effect is comparable to CSA regarding remission induction. It induces better results than CSA regarding effect on eGFR but worse results regarding proteinuria improvement. Individualization of immunosuppressant use in IMN should be considered.
The association of tumor necrosis factor alpha levels with Depression symptoms in Systemic lupus erythematosus patients
Authors: Okba A M , Farris M N , Shaheen R Y , Abdelmonaem H , Kamal S T , Amin D A M
Published: May 2020

Background

Effects of the cytokine system, in which of tumor necrosis factor alpha (TNF-α) is a part, on serotonin metabolism as well as on the hypothalamic-pituitary-adrenal (HPA)-axis, may induce changes in the structure and function of the brain, possibly leading to the development of depression in SLE patients. For this purpose, we aimed to assess serum TNF-α levels in SLE patients, and to explore its possible relationship with depression among these patients.Methods: 60 SLE adult patients were enrolled in this study and further subdivided into two equal groups (30 with active SLE and 30 with inactive SLE) using SLEDAI score, in addition to 30 age and sex matched healthy controls. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to provide broad coverage of psychiatric diagnoses was done for all subjects, and severity of depression was assessed using Beck depression Inventory. TNF-α levels were measured using ELISA technique. Results: Depression was identified in 63.3% of active SLE group, 40% in the inactive SLE group and 16.7% in the control group with p value <0.001. TNF-α levels were higher significantly in the active group versus inactive group and control p value <0.001.In the multivariate analysis, sera TNF-α levels were independently associated with depressive symptoms odds ratio = 1.004, 95% CI = 1.001 to 1.006, p-value =0.020). Conclusions: Depression was more prevalent among SLE patients with active disease. Serum TNF-α was the only independent predictor of depression in SLE patients.
Non motor symptoms in patients with essential tremor
Authors: Elbelkemy M , Shalash A , Mansour A , Hamed E , Abdelalim H M
Published: May 2020

Article Outline

Abstract Introduction Patients and methods Procedure Statistical analysis Results Discussion Conclusion References

Background

Essential tremor (ET) is the most prevalent tremor disorder. ET has traditionally been viewed as a monosymptomatic disorder characterized by a kinetic arm tremor but now there is a growing amount of evidence to suggest that besides motor features, patients with essential tremor may exhibit significant non-motor features.

The Aim of this study: To assess non-motor features in Egyptian patients with ET in comparison to controls.

Patients and Methods

This is a Case control observational study in which 30 patients with ET and 30 matched healthy controls ET was assessed using; Fahn Tolosa Marin Tremor Rating Scale (FTM); non-motor symptoms were evaluated using; Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton anxiety rating scale (HARS), Pittsburgh Sleep quality index (PSQI).

Results

ET patients had significant cognitive dysfunction, neuropsychiatric problems including depression, anxiety, poor sleep and other NMS compared to controls.

Conclusion

The presence of numerous non motor features in ET is increasingly evident. Therefore, NMS should be considered in the clinical evaluation and management of ET.
Memory disturbances in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes
Authors: Ahmed N S , Nada M A , Afeefy H H E , Abdellah E M R
Published: May 2020

Objectives

We aimed to compare and characterize the memory function of children with childhood absence epilepsy (CAE), frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE) for early diagnosis, better management and good quality of life

Subjects and Methods

Memory was examined in 40 children with epilepsy ,aged 8-16.

Results

Children with FLE showed significant deficits in verbal and visual memory. In addition, type of epilepsy, earlier age at epilepsy onset, and longer active duration of epilepsy were associated with memory problems. Seizure frequency and treatment, however, did not influence memory performance. This study indicates that children with FLE show greater risk of developing memory deficits than children with CAE or BECTS

Conclusion

Memory disturbances are more common in epileptic children, affecting their school achievement and hence their quality of life in a negative manner and may be linked to a higher incidence of behavioral changes
Predictors of Hemorrhagic Transformation in Patients Receiving r-tPA
Authors: Alosh T K , Aref H , Elewa M K , Mohamed A A
Published: May 2020

Background

intravenous recombinant tissue-type plasminogen activator (r-tPA) is a proven intervention for acute ischemic stroke patients. The rationale behind the use of r-tPA in ischemic stroke is breaking down the clot and recanalization of the occluded blood vessels. The restoration of blood vessel patency is meaningful only if the brain tissue of the ischemic area is still viable. Intravenous thrombolysis showed moderate benefit upon administration between three and four and half hours from stroke onset.

Aim of the Work

assess the risk factors that lead to occurrence of hemorrhagic transformation in patients with acute ischemic stroke received intravenous thrombolytic during their hospital stay.

Patients and Methods

This is a retrospective cross-sectional observational study conducted in Ain Shams University hospital and Ain Shams University Specialized hospital. 200 patients were included in the study. All were in-patients, admitted in the stroke unit either in Ain Shams University hospital or Ain Shams University Specialized hospital. Patients were diagnosed by neurological history, clinical examination and radiological investigations (CT scan with or without MRI brain stroke protocol). The diagnosis of stroke must be made by a neurologist.

Results

there was statistically significant association found between hemorrhagic transformation and smoking and also onset of stroke while no statistically significant association found with BP during injection and RBS.

Conclusion

there was highly statistically significant associaton between hemorrhagic transformation and onset of stroke with p-value = 0.006 and OR (95% CI) 5.92 (1.656–21.165) while there was statistically significant association found with smoking with p-value = 0.012 and OR (95% CI) 2.424 (1.214–4.844).
Eating disorders among a sample of secondary school students in Eastern Tanta
Authors: Elmehallawy N M N , Essawy H I , Alsaleet G M , Sabry W M , Abdelsalam M S
Published: May 2020

Although a growing body of evidence supported that adolescents are considered a group of population at risk for the development of eating disorders, only very few studies have been carried out on the eating disorders among Egyptian adolescents. The current study conducted to investigate socio-cultural and clinical characteristics of eating disorders among a sample of secondary school students in Eastern Tanta. Four hundred and seven students were included in the study. Socio-demographic data were reported and height & weight were measured for all students who agreed to participate in the study. The household crowding index was calculated and EAT- 40 was done for all students who agreed to participate in the study. SCID-I was done for the students with EAT - 40 score ≥ 30 in private places that were determined by their school manager. The prevalence of eating disorders was 9.3%. These results demonstrate the high prevalence of eating disorders among secondary school students in Eastern Tanta. These findings are inviting further efforts to research in different areas in Tanta and other Egyptian cities where eating disorders are expected to be as more, equal or less prevalent among secondary school students as what we found in Eastern Tanta in order to determine the magnitude of eating disorders problem and to assess their epidemiology in Egypt. Also, these findings stimulate the mental health organizations and the educational authorities to put plans of management and helping these suffering students.
Impulsivity as a Clinical Marker for Bipolar Affective Disorder
Authors: Omar A M , Elbatrawy A N , Sabry W M , Elkholy H A , Farrag W A
Published: May 2020

Background

Bipolar disorder is one of the world’s 10 most disabling conditions, taking away years of healthy functioning from individuals, all bipolar disorders are chronically recurring illnesses associated with substantial morbidity and mortality. Impulsivity considered an integral part of bipolar disorder. Operationalized as a predisposition to action without reﬂection or regard for consequences. Potential consequences of this increased impulsivity include substance abuse, suicidal attempts, and other serious behavioral problems.

Aim of the Study

The aim of the current study was to measure impulsivity in both BD euthymic patients and in healthy first-degree relatives of BD patients. And to assess the functional implications of impulsiveness, on psychosocial functioning and in bipolar disorder patients, their first-degree relatives.

Patients and Methods

A convenient sample of 50 patients; diagnosed with bipolar affective disorder according to DSM-IV diagnostic criteria were selected from the general adult psychiatry clinics and a convenient sample of 50 healthy first degree relatives of BD patients.

Results

We concluded by the end of this study that both cases and relatives have high overall impulsivity, and cases have higher impulsivity in comparison to relatives.

Conclusion

We suggest that impulsivity may be a potentially valuable candidate endophenotype for bipolar disorder.
Impact of the Length of Interpregnancy Interval on Obstetric Outcomes
Authors: Mohammed S S T , Ashoush S A , Sweedan K H , Ali R R
Published: May 2020

Background

Inter-pregnancy interval (IPI) is defined as the period between the last delivery and conception of the current pregnancy. Both short and long intervals between pregnancies have been associated with an increased risk of variable adverse outcomes, such as preterm birth, low birth weight (LBW), small size for gestational age, and perinatal death.

Aim of the Work

To assess the impact of IPI as a risk factor for adverse pregnancy and perinatal outcomes.

Patients and Methods

This study was held in Ain Shams University Maternity Hospital on 1719 patients ranging between the ages of 18-35 years. They were divided into three groups according to the length of their IPI [444 patients in group p1 (6-18 months), 847 patients in group p2 (18-48) and 428 patients in group p3 (> 48 months)]. The aim of this study was to assess the impact of IPI as a risk factor for adverse pregnancy and perinatal outcomes.

Results

The incidence of LBW among patients with IPI 6-18 months was 11.5%, 12.5% among those with IPI 18-48 months and 16.8% among those with IPI > 48 months. It was also found that the rate of short IPI decreases with age, being more common among the younger age, lower parity groups. The incidence of gestational DM increased with longer IPI. Parity, previous miscarriages, cesarean sections and preterm labor were all significantly associated with the length of IPI.

Conclusion

This study confirms that both shorter and longer IPIs are associated with increased risks of adverse pregnancy outcomes. This study provides critical information relevant for improving pregnancy outcomes and fetal survival.
Role of Dexamethasone in Induction of Labor: (A Randomized Clinical Trial)
Authors: Elsayed H M , Bahaa A M , Alanwar A A , Mohamed K M
Published: May 2020

Background

Labor induction is a common obstetric procedure which is done for many indications. Ripening of the cervix is a complex process involving hormonal, vasodilatory and inflammatory changes. There are broad range of methods for cervical ripening and induction of labor.

Aim of the study: to assess the efficacy of intramuscular administration of dexamethasone on the induction delivery-interval in full term women undergoing induction of labor.

Patients and Methods

This study was carried out between July 2018 and January 2019, at the labor ward of Ain Shams university maternity hospital, a double bind randomized control trial of 80 pregnant women undergoing induction of labor after obtaining the approval of the local ethical committee and a fully-informed written consent. They were randomized into two groups: group D (Dexamethasone group n = 40) and group C (control group n = 40).

Results

Of 80 pregnant women undergoing induction of labor there were no statistically significant differences between the two groups as regard their age, body mass index, gestational age and bishop score at time of intervention. There was significant statistical difference between the two groups as regard induction-active phase interval (P < 0.05), mean induction-active phase interval in group D was (4.91±.85 hours) while in group C was (5.44±.83 hours). There was no significant statistical difference between the two groups as regard duration of active phase of labor, mean duration of active phase in group D was (4.10±.97 hours) and in group C (4.47±1.20 hours). There was significant statistical difference between the two groups as regard induction-delivery interval (P < 0.05), mean induction-delivery interval in group D was (9.73±.1.52hours) while in group C was (10.70±1.87 hours). There were no statistically significant differences between the two groups as regard duration of 2nd and 3rd stages of labor.

Conclusion

Single intramuscular injections of 2 ml. (8mg) of dexamethasone before induction of labor seems to shorten induction-delivery interval by shortening the induction-active phase interval.
Can Placental Thickness predict Fetal Weight?
Authors: El-Kady M A , Mansour A M , Ismail M H
Published: May 2020

Background

The placenta is the principal influence on fetal birth weight, and it is thought that abnormalities of placental growth may precede abnormalities in fetal growth. Because the placenta may be the first organ to manifest changes of disease in pregnancy, placental features may have a role in screening for pregnancy complications.

Aim of the Work

The aim this study is to assess the accuracy of placental thickness (estimated by ultrasonography) in predicting fetal weight.

Patients and Methods

This prospective observational study was conducted at Ain Shams University Maternity Hospital November, 15th, 2016 to November, 1st, 2017. 100 Normal antenatal pregnant women at 24-28 weeks of pregnancy who attended antenatal clinic at the department of obstetrics and gynecology, Ain Shams University Maternity Hospital were recruited, after fulfilling the inclusion and exclusion criteria.

Results

The predictive rule could estimate actual birth weight with an accuracy of ± 0.450 kg (SEest = 0.450 kg). In visits 1 and 2; ± 0.448 kg (SEest = 0.448 kg) in visit 3.

Conclusion

The actual birth weight was regressed on the placental thickness using simple linear regression to obtain a predictive rule. There is very weak correlation between the actual neonatal weight and placental thickness. The current study deduced a new formula for correction of EFW using placental thickness which has a promising role to offer in the prediction of birth weight.
The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage
Authors: Diab K M , Mohamed R M , Abdelhay A G
Published: May 2020

Background

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere.

Aim of the Work

To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period.

Patients and Methods

This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology.

Results

No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24).

Conclusion

The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.
Sildenafil versus Nifedipine Treatment of PRETERM LABOR: RCT
Authors: Alkady M A , Mostafa M H , Elkattan R K
Published: May 2020

Background

a normal pregnancy lasts 37 to 42 weeks, counting from the first day of the last menstrual period. A pregnancy that continues beyond 37 weeks is called a “term” pregnancy. Preterm labor is defined as labor that begins before 37 weeks of pregnancy. Approximately 12 percent of babies in the United States are born preterm; 80 percent of these are due to preterm labor that occurs on its own or after preterm premature rupture of the fetal membranes (or “broken bag of waters”). The remaining 20 percent are planned early deliveries that are done for maternal or fetal problems that prevent the woman from being able to safely continue with her pregnancy.

Aim of the Work

to assess the efficacy of sildenafil for stopping the labor for 48 hrs compared to nifedipine in women with preterm labor.

Patients and Methods

this prospective study was carried on pregnant women with preterm labor pain at Ain Shams University Hospital from March 2018 till September 2018. Study includes 88 patients which were distributed into two groups: Group S: received Sildenafil to stop preterm labor.Group N: received Nifedipine to stop preterm labor.

Results

in the present study we found that mean age in group receiving sildenafil (group S) was 26.55 years and in group receiving nifidpine (group N) was 26.75 years with insignificant differences between two groups as regard age p-value 0.798, also as regard. BMI and parity there was insignificant differences between two groups as regard BMI p-value 0.727, 0.815 respectively, Mean Gestational age at admission was 27.1 weeks in group S and in group N was 28.16 with insignificant differences between two groups p-value 0.705.

Conclusion

administration of Sildenafil in women with preterm labor pain seems to be a promising future therapy of preterm labor with, limiting the teratogenic influence of the drugs on the fetus.
Antibiotic prophylaxis before skin incision versus after cord clamping in the prevention of maternal and neonatal infectious morbidity after cesarean section
Authors: Eltantawy W H , Labib K M , Farag A M
Published: May 2020

Background

the purpose of antibiotic prophylaxis in surgical procedures is not to sterilize tissues but to reduce colonisation pressure of microorganisms introduced at the time of the operation to a level that can be overcome by the patient’s immune system.

Aim of the study

to compare the effects of antibiotic prophylaxis administered in cesarean section preoperatively versus after neonatal cord clamp on postoperative infectious complications for both the mother and the neonate.

Patients and Methods

This comparative study was carried out between August 2017 and February 2018, at Ain Shams maternity hospital and Al-Galaa teaching hospital, a prospective randomized control comparativestudy of 874 pregnant ladies undergoing cesarean section after obtaining the approval of the local ethical committee and a fully-informed written consent.

Results

Of 874 pregnant ladies undergoing cesarean section, mean gestational age in group A (38.71±1.09); while in group B mean gestational age (38.86±1.06). In group A, wound infection 8 cases (1.6%), endometritis 25 cases (5.7%), UTI 18 case (4.1%). In group B, wound infection 16 cases (3.7%), endometritis 35 cases (8%), UTI 28 case (6.4%). No cases suffered from early or long term neonatal complications.

Conclusion

there is no significant difference between timing of antibiotic either before skin incision or after cord clamping, however there are risk factors that increase the maternal, fetal infectious morbidity as high BMI, low gestational age, previous section, general anaesthesia.
Comparison between Single Fraction versus Multiple Fraction Radiotherapy in Terms of Pain Control and Prevention of Skeletal Related Events in Patients with Bone Metastasis Candidates for Radiotherapy
Authors: Azmy A M , Adel A M , Nagy A A , Ibrahim S A
Published: May 2020

Background

Metastasis are the most common type of malignant tumor which involve bone, according to OSCER (Oncology Services Comprehensive Electronic Record) among 382,733 study patients, breast cancer (36 %), lunge cancer (60%), and colorectal cancer (12%) were the most common, incidence of bone metastasis was 2.9% at 30 days, 4.9% at 1 year, 5.6% at 2 years, 6.9% at 5 years, 8.4 % at 10 years. Incidence varied by tumor type with prostate cancer patients were at highest risk (18%-29%) followed by lunge, renal and breast cancer.

Aim of the Work

This study aim to prove the equivalency and the efficacy of single fraction radiotherapy (800cGY) and multiple fraction radiotherapy (10 fractions, 300 cGY / fraction, 1 fraction / day, 5 days per week over 2 weeks to a total of 3000cGy) in terms of pain relief and prevention of skeletal related events.

Results

In this study we collected data of 60 patients, 5 patients died and 55 patients received active treatment who were divided into 2 arms, Arm I represented 28 patients received single fraction radiotherapy on sites of bone metastasis (800cGY) and Arm II represented 27 patients received multiple fraction radiotherapy on sites of bone metastasis (total of 3000cGY in 10 fractions). Regarding to pain response, it was evaluated at zero, 2,4 weeks and 2,4 months using Visual Analogue Scale and Numeric Rating Scale or telephone interviews. Complete response was defined as no pain for 4 months, partial response was defined as at least 2 points lower than initial response, stable response was defined as 1 point change in pain score and progressive response was defined as pain score that’s at least 2 points higher than initial response. In our study, in Arm I patient achieving complete response represented 50% and in Arm II 40.7% which is non significant of P value 0.490, while partial response in Arm I represented 39.3% and 18.5 % in Arm II which is non significant of P value 0.090, stable response in Arm I represented 3.6% and 33.3% in Arm II which is highly significant of P value 0.004 and progressive response in Arm I represented 7.1% and in Arm II 7.4% which is non significant of P value 0.974.

Conclusion

Single fraction radiotherapy is equivalent to multiple fraction radiotherapy in terms of palliating pain of bone metastasis and prevention of skeletal related events.