bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Serum Fetuin A in Psoriatic Patients and Its Correlation to Coronary Artery Disease
Authors: Saleh Hanan M , Hassen Samah I , Sheha Aliaa S , Eskander Nardeen N
Published: October 2021

Background

Psoriasis is a chronic, immune-mediated, inflammatory disease of the skin. It is a multifactorial disease with genetic background triggered by environmental factors and immunological mediators. Fetuin A is considered as a marker to detect cardiac risk.

Aim of the work

to evaluate Fetuin A level in psoriatic patients and its correlation to coronary artery calcification and cardiovascular risks.

Methods

This is a case control comparative study was conducted at Dermatology outpatient clinic, during the period from January 2019 to November 2019. The Forty eight patients who were recruited in this study were classified to two groups, Group A (cases group): included twenty four patients presented clinically with chronic generalized psoriasis randomly selected from Dermatology outpatient clinics of Ain Shams University Hospital. Group B (control group): included twenty four age and sex matched healthy volunteers who were nonsmokers, non-alcoholics and don’t suffer any systemic or organic illness.

Results

Our results showed no significant correlation between levels of Fetuin A and age, sex, BMI or serum levels of TG or total cholesterol among psoriatic patients. In addition, negative correlation was found between Fetuin A and calcium scoring CT scan where the median serum plasma level of Fetuin A was found to be significantly decreased in cases with plaque psoriasis with increasing calcium score, with p-value < 0.001 and r = -0.928. Also, there is no significant correlation was found between levels of calcium scoring and age, sex, BMI or serum levels of TG or total cholesterol nor PASI scoring among psoriatic patients.

Conclusion

Fetuin A and Ca scoring CT scan appear to be a useful, simple, and noninvasive examination to investigate the presence of subclinical calcification in coronary blood vessel even in psoriatic patients who seem to be otherwise healthy.
Ionic Anti-Viral Intralesional Therapy in Plantar Warts
Authors: Mohammed Ghada Fathy , Afify Ahmed Abd-Elfattah , Abdel Latif Wessam Moustafa Abo Elmagd
Published: October 2021

Background

Warts (verrucas) are an extremely common, benign, and usually self-limited skin disease. Their size ranges from a few millimetres to several centimetres. The normal skin lines are interrupted by skin coloured to brownish-grey proliferations, the diagnosis is established clinically; no supplementary histologic or virologic investigations are needed.

Objective

The aim of this two armed double blinded randomized clinical trial was to evaluate the clinical efficacy of intralesional combined digoxin and furosemide in the treatment of multiple planter warts.

Methods

This study included 40 patients with plantar warts, they were divided into 2 groups, 20 patients per group, the first group received intralesional normal saline, one injection session every week for maximum 5 injection sessions. The second group received intralesional combined digoxin and furosemide, one injection session every week for maximum 5 injection sessions. All the patients were recruited from the Dermatology outpatient clinic at Ain-Shams University Hospital and Shobra General Hospital during the period From July 2018 to July 2019.

Results

There was no statistically significant difference between the 2 studied groups as regard size of wart before treatment. While there was statistically significant difference between the 2 studied groups as regard size of wart after the 5th session. Also there was a steady increase in the response to treatment in group 2 showing an earlier response to treatment and most of patients with excellent and very good response to treatment after the 5th session. There was no statistically significant difference between the 2 studied groups as regard the number of warts before treatment. While there was statistically significant difference between the 2 studied groups as regard the number of warts after the 5th session. There was no statistically significant correlation between age, sex, disease duration and response to treatment (as regard reduction in number of warts) after the 5th session in group 2. While in group 1 there was no reduction in number of warts after the 5th session. There was a statistically significant difference between the number of warts before and after receiving the active treatment in group 1, in group 2 and for both groups together (all patients).

Conclusion

We concluded from this study that intralesional injection of combined digoxin and furosemide offers effective alternative form of treatment for plantar warts in adults. It is inexpensive and safe to treat plantar warts.
Cortical and subcortical processing of speech in cochlear implant recipients with Auditory Neuropathy Spectrum Disorder
Authors: Nassar Adel Abdel Maksoud , Hassan Dalia Mohammed , Rahman Tayseer Taha Abdel , Younis Amal
Published: October 2021

Background

Cochlear implantation (CI) is now recognized as one of the possible lines of interventions in ANSD patients to improve their hearing and speech communication. Desynchronized of the auditory information is the most widely accepted mechanism in ANSD.

Objectives

To study speech processing in the brainstem level as measured by speech-auditory brainstem response (S-ABR) in ANSD and CAEP P1 in ANSD subjects fitted with CIs and the results will be compared to SNHL subjects fitted with unilateral CIs.

Subjects and method

A total number of 45 subjects were included classified into three groups (one control and two study groups). The control group 16 subjects, age ranged from 5 to 29.5 years with mean of (11.1 years) with normal peripheral hearing sensitivity. The study group comprised 29 children who underwent cochlear implantation. It was subdivided into two subgroups: Group (SNHL) ;their age ranged from2.9 to 15.5 years with mean of (7.7 years) and group (ANSD); Their age ranged from 3.2 to 29 years with mean of (9.3 years) They were subjected to detailed history taking, aided warble-tone sound field audiometry, Questionnaire and Speech-evoked potentials (P1 &c-ABR) recording evoked by the 150-ms synthesized /da/ syllable stimulus.

Results

C-ABR waves were detected in 100% of control group, 75% of SNHL group and 53.8% of ANSD group. A statistically significant differences existed between the control group and the two study subgroups regarding the P1 latencies. While; there were no statistically significant differences between {SNHL group &ANSD}. Sound-field S-ABR in the CI recipients showed delayed latencies in both SNHL group &ANSD group comparable to the control group with more delay in ANSD group than SNHL group. Finally, the neural phase locking was significantly higher in CI recipients due to electrical artifact.

Conclusions

• There were no statistically significant differences between {SNHL group & ANSD group} regarding P1 latency.

• C-ABR waves were detected in 75% of SNHL group and 53.8% of ANSD group with delayed latencies and higher amplitude than control group with more delay in ANSD group than SNHL group. The findings of sound-field S-ABR demonstrated that CI recipients have neural encoding deficits in temporal and spectral domains at the brainstem level; therefore, the sound-field S-ABR can be considered an efficient clinical procedure to assess the speech processing in ANSD subjects fitted with cochlear implant.
Meta-Analysis of the Effects of Preoperative Embolization on the Outcomes of Carotid Body Tumor Surgery
Authors: Samir Mohamed Magdy , Elezz Tamer Abd ElWahab Abo , Mikahail Peter Milad , Bassam Mohamed Khaled Shafeek
Published: October 2021

Background

Carotid body tumors (CBTs) are situated at the bifurcation of the common carotid artery within the adventitia, and are reported to be the most common head and neck paragangliomas. Surgery is the gold standard for curative treatment of resectable CBTs and is recommended in otherwise healthy patients because of the risk of local complications related to tumor size and a small but definite risk of malignancy. Preoperative embolization has been shown to reduce potential intraoperative blood loss and provide the surgeon with greater ease and safety in excising the tumor, thus reducing the operation time and morbidity. However, other physicians have stated that although blood loss may be reduced after preoperative embolization, transfusion requirements are not affected, and that the embolization procedure adds a significant risk for stroke. Therefore, the purpose of the current study was to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization.

Aim

To evaluate the need for preoperative embolization for the treatment of carotid body tumor.

Methodology

A meta-analysis study is done to compare the surgical outcomes of patients undergoing CBT surgical resection with and without preoperative embolization.

Results

Our meta-analysis for evaluation of the effects of preoperative embolization on the outcomes of carotid body tumor surgery, included (14) studies with a total number of patients (n = 477).The results of these studies showed no statistically significant difference between preoperative embolization group and non embolization group in carotid body surgery for (blood loss & operation time). Preoperative embolization did not reduce risk of postoperative complications.

Conclusion

Preoperative embolization shows no statistically significant reducing in blood loss and operation time, also embolization does not decrease incidence of postoperative complications. It seems that embolization should not be a routine part of carotid body tumor surgery especially with the known potential risks and complications of this procedure .
Vitamin D levels in children with otitis media with effusion
Authors: Mohamed Ahmed Adly , EL-Begermy Marwa Mohamed , Teaima Ahmed Abdelmoneim , Abdelghafar Mohamed Ali
Published: October 2021

Objective

To investigate the relationship between otitis media with effusion (OME) and serum vitamin D level in children.

Methods

This prospective case control study was conducted at Ain Shams University Hospitals between February 2018 and May 2019. The study population included 50 children with OME confirmed by tympanometry type (B) who will undergo adenotonsillectomy and grommet tube insertion compared to 50 children without OME confirmed by tympanometry type (A) who will undergo adenotonsillectomy. Measurement of serum 25-hydroxy vitamin D using electrochemiluminescence technique from a blood sample (3cm) taken from them on the day of surgery.

Results

In this study, the mean age of the cases was 4.24 ± 0.80 and 5.34 ± 1.19 years for the controls besides 23 (46%) of the OME group were boys and 27 (54%) were girls, compared with 29 (58%) boys and 21 (42%) were girls in the control group. The mean levels of vitamin D in children with OME was 16.24 ± 7.14 ng/mL and in children in the control group was 15.89 ± 5.84 ng/mL (P = 0.815) and it was statistically non significant.

Conclusion

There was no significant relation between vitamin D serum level and the incidence of OME in children.
Prevalence and Risk Factors of Falls among Egyptian Elderly Attending Primary Health Centers in Suez Governorate
Authors: Ali Abeer Alsayed , Abdul-Rahman Samia Ahmed , Wahba Hoda MF , Amin Ghada Essam Al-Din
Published: October 2021

Objectives

To estimate the prevalence and probable risk factors of falls among a sample of community-dwelling older adults in Suez Governorate, Egypt.

Design

A cross-sectional comparative study.

Setting and Participants

Study included 300 older adults (both men and women) recruited from 3 primary healthcare centers, all located in Suez Governorate, Egypt (Alsalam medical center, Mubarak medical center and Alsabbah medical center).

Methods

All participants were questioned about their fall history in the precedent year and were assessed using: Structured interview questionnaire and physical examination, Fall Risk Assessment Tool, Basic and instrumental activities of daily living, Timed Up and Go test, Single leg stance test, handgrip strength measurement, Mini-Mental Status Examination and Geriatric Depression Scale-15. Participants were categorized as faller and non-faller groups according to their fall history in the precedent year and were then compared as regard common fall risk factors (intrinsic and extrinsic).

Results

Prevalence of falls among the studied populations was 29%. Women fell more frequently than men (accounting for 64.4% and 35.6% of fallers, p = 0.01). Most falls occurred indoors (58.3%). A significant association was found between fall history and age, sex, muscle weakness, depression, urinary incontinence, IHD, visual impairment, fear of falling, use of assistive device, postural hypotension, and polypharmacy.

Conclusion

Prevalence of falls in community-dwelling elderly in Suez Governorate is 29%. Identification of factors significantly affecting elderly falls can help in planning public health policies and programs for prevention of falls.
Rivaroxaban versus Warfarin in the Management of Deep Venous Thrombosis
Authors: El-metieni Mahmoud Shawky , Fekry Tamer Mohamed , Rady Mohammed Ahmed Hassan , Farrag Ahmed Magdy , Ismail Ahmed Mohamed
Published: October 2021

Background

Deep venous thrombosis (DVT) refers to the formation of one or more blood clots in one of the body’s large veins, most commonly in the lower limbs. The clot can cause partial or complete blocking of circulation in the vein, which in some patients leads to pain, swelling, tenderness, discolouration of the skin that is warm to touch.

Aim of the Work

Compare the effect of direct Oral Anticoagulant (Rivaroxaban) versus Antivitamin K (warfarin) in treatment of lower limb Deep Venous Thrombosis.

Patients and Methods

Type of study: prospective single blinded randomized study, study setting: was conducted at Kobri Elkobba hospitals, study period: 6 months, study population: Eligible all patients above 18 years had femoropopliteal vein thrombosis, confirmed with duplex ultrasound scanning and D-dimer test and qualified under the inclusion and exclusion criteria of the study.

Results

Our study shows that Rivaroxaban alone is as effective as standard therapy, with similar safety, for the treatment of acute DVT and in preventing recurrence and has low risk of bleeding. There was statistically significant increase in INR monitoring during 6 months in warfarin group than Rivaroxaban group with p-value < 0.001. This because warfarin has many drug and food interaction. There's no response in treatment out come after 3 months duplex as the study was on patient of femoro popliteal DVT, however there were clinical improvement in both groups. Complete recanalization with normal augmentation by muscle compression occurred in all Rivaroxaban patients compared to 5% were partially compressible with incomplete recanalization in warfarin group after 6 months of treatment.

Conclusion

We concluded in patients with unprovoked VTE, rivaroxaban has the potential to reduce both the risk of major bleeding and recurrent VTE compared to warfarin. And there’s no need for adjusting the dose and INR monitoring, and Rivaroxaban has no food nor drug interactions.
Comparative Study between Lichtenstein Repair and Trans Abdominal Pre Peritoneal Repair of Inguinal Hernia (TAPP)
Authors: Ain-shoka Prof. Dr./Adel Faheem , Hassan Dr/Mohamed Ibrahim , Elkholy General Dr./Khaled Abdel-Aziz , Matter Ahmed Wahid Said Mohamed
Published: October 2021

Background

Inguinal hernia repair is one of the most widely performed surgical procedure. Among the techniques used, the open Lichtenstein repair is still the most widely performed. However, in the last decade there has been an increased interest in the laparoscopic approach for inguinal hernia repair, mainly represented as the trans-abdominal pre- peritoneal (TAPP) technique. As described in recent studies, TAPP approach entails the benefits of minimally invasive surgery, such as less pain and early recovery.

Objective

s: This study aims to compare between lichtenstein repair of inguinal hernia and trans-abdominal pre-peritoneal repair of inguinal hernia (TAPP) as regard their hospital stay, cost, intra-operative & post-operative complications and short term recurrence.

Patients and Methods

Our study was carried out on (50) male patients with inguinal hernia, 25 patients underwent laparoscopic TAPP repair and 25 patients underwent open Lichtenstein repair. We found a highly significant difference of laparoscopic TAPP Repair in decreasing post-operative pain than in open repair.

Results

Comparative study between the 2 groups revealed non-significant difference as regards age and sex of the patients. Comparative study between the 2 groups revealed non-significant difference as regards all socio-demographic data. Comparative study between the 2 groups revealed non-significant difference as regards type and side of hernia. Comparative study between the 2 groups revealed; highly significant increase in operative duration in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in post-operative pain score and post-operative hospital stay; in laparoscopic group; compared to open group of patients; with highly significant statistical difference. Comparative study between the 2 groups revealed; highly significant decrease in intra-operative complications in laparoscopic group; compared to open group of patients; with highly significant statistical difference.

Conclusion

Our study showed that laparoscopic TAPP approach for inguinal hernia repair reduces early post-operative pain. Furthermore, it is related to less complications, although it takes a longer operative time and higher cost.
Comparative study between Single incision versus two separate incisions in conservative breast surgery and axillary clearance
Authors: Khalaf Mohamed , Gamal Ahmed , Talat Mahmoud , Hassan Zeinab , Awad Ibrahim
Published: October 2021

Background

Single incision technique is an oncoplastic surgery aimed to remove both the breast tumor and axillary clearance through one incision, thus providing better aesthetic results than the conventional breast conservative two incision technique. However this procedure is more difficult, since visualization and the resection space are limited, demanding greater experience from the surgeon.

Objective

To compere between single incision in excising upper outer breast tumor and axillary clearance versus two separate incisions in conservative breast surgery as regard cosmetic outcome, seroma formation and time needed for drainage for both breast and axilla.

Patients and Methods

This is a prospective cohort study to compere between single incision in excising upper outer breast tumor and axillary clearance versus two separate incisions in conservative breast surgery as regard cosmetic outcome, seroma formation and time needed for drainage for both breast and axilla.

Results

Single incision resulted in only one small scar and provided feasible breast cancer treatment with excellent acceptance and satisfaction by the patients. Double incision on breast and axilla is associated with lower rate of long-term postoperative lymphedema and minimizing disruption of axillary lymphatic and vascular channels.

Conclusion

The single incision technique was shown to be providing better cosmetic result but more seroma formation. With the confirmation of oncologic and surgical efficacy, future areas of study will include long term evaluation of patient oncologic, functional, and cosmetic outcomes following the single incision approach.
Successful Male Rabbit Whole Kidney Decellularization For Tissue Engineering
Authors: Abou-Rabia Naglaa Medhat , Megahed Gehan Khalaf , Gawad Elsebay Sara Abdel , Ayat Abdelnaby Elsayed
Published: October 2021

Background

Renal transplantation represents the only cure for end stage renal disease. Shortage of donated organs, immune compatibility and post-transplantation complications urges the search for another radical and revolutionary treatment . Whole kidney decellularization is a promising technique, hopefully offering a threedimensional natural kidney scaffold for engineering a patient’s compatible kidney after recellularization with patient’s own cells. The current study aimed at successfully decellularizing the male rabbit kidney while preserving the histological profile of the kidney decellularized extracellular matrix.

Materials and Methods

Kidneys of ten male New Zealand White Rabbits weighing (1000- 1500 gm) were harvested and sorted into two groups. Control Group I included the ten right kidneys. Decellularization Group II included the ten left kidneys; harvested carefully and kept frozen until decellularization. They were decellularized using 0.5% sodium dodecyl sulfate for 5-6 hours. Kidneys from both groups were processed similarly for histological examination.

Results

Decellularized kidney Scaffolds showed complete removal of cellular materials. Meanwhile, the structural profile of the decellularized kidney scaffolds was apparently well preserved.

Conclusion

The current study yielded an efficient decellularization of male rabbit kidney paving the way for future kidney recellularization.
The Potential Role of Human Derived Amniotic Membrane Graft in The Repair of Induced Tendon Tear in Adult Male Albino Rat: Histological Study
Authors: Yehia Dalia Ahmed Yousef , Aleem Mohammed Somaya Abd Al , Megahed Gehan Khalaf , Soliman Nevine Bahaa El din Mohamed
Published: October 2021

Introduction

Achilles tendon tears cause severe impairment in patient mobility and productivity, causing significant reduction in the quality of life. Many complications are associated with the tendon healing process such as peritendinous adhesions and excessive fibrotic scars. Unsatisfactory results appeared with the existing medical and surgical treatments to regain full tendon structure and function. Amniotic membrane is avascular, and characterized by low immunogenicity, anti-inflammatory, antiscarring properties. These criteria render it as a natural biological substitute and a novel therapeutic alternative for tendon tears. Aim: The aim of the work was to study the effect of human amniotic membrane graft application on the repair of induced Achilles tendon tear.

Material and methods

Fresh human amniotic membrane (AM) grafts were prepared from harvested human full-term caesarian sections-delivered placentas. Thirty adult male albino rats were divided into 3 equal groups (n = 10); group I (control group), group II (tendon tear group) and group III (AM treated group). After anesthesia, a full thickness transverse incision was induced in the rat right Achilles tendons of group II and III. Human derived amniotic membrane graft measuring 1 cm2 was applied circumferentially on the tendon tear in group III. Rats were sacrificed after 28 days.

Results

After the tendon tear, the untreated group (II) showed gradual accumulation of fat cells replacing the collagen bundles in focal areas. Areas of mononuclear cellular infiltration were demonstrated. The AM-treated group showed many thick parallel regularly arranged collagen fibers with a significant increase in the collagen fibers area percentage. It also showed apparent increase in tenoblasts with regular organization and apparent decrease of mononuclear inflammatory cells.

Conclusion

This study demonstrated the potential therapeutic role of the application of human amniotic membrane grafts in the repair of Achilles tendon tears, suggesting a future alternative therapy for patients suffering from Achilles tendon tears.
Serum Glucagon like peptide 1 Level and Peripheral Vascular Disease in Patients with Type 2 Diabetes
Authors: El Baki Rania Sayed Abd , Sami Nasr Merhan , Mostafa Bassem Murad , Ibrahim Ahmed Abe Bakr El Sayed
Published: October 2021

Background

Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Incretins are hormones produced by the intestinal mucosa in response to oral intake of nutrients that enhance glucose-stimulated insulin secretion and lower blood glucose levels. GLP-1 is of particular interest for its glucoselowering effects, as well as its ability to slow gastric emptying and suppress secretion of glucagon.

Objective

To assess the level of glucagon like peptide-1 in type 2 diabetic patients with peripheral vascular disease.

Patients and Methods

Our study was conducted in the period from 1st of January to 1st of June 2017. Our subjects were collected from the diabetes clinics of Ain Shams university Hospitals. The study included eighty (80) patients divided into 40 type 2 diabetic patients without peripheral vascular disease (Group 1) and 40 type 2 diabetic patients with peripheral vascular disease (Group 2).

Results

Diabetic patients with peripheral vascular disease show statistically significant higher HbA1c levels than diabetic patients without peripheral vascular disease with P-value 0.005 (P-value <0.05). GLP 1 was highly significantly positively correlated with APSV with P-value< 0.001. GLP 1 correlated negatively with BMI, FBS, 2h PPBS and HbA1C; with statistically significant difference; P-value (0.031, 0.015, 0.033 and 0.010 respectively) but was not significantly negatively correlated with age, SBP and DBP; P-value (0.232, 0.654 and 0.335 respectively).

Conclusion

GLP-1 levels are lower in diabetic patients with peripheral vascular disease than diabetic patients without peripheral vascular disease. GLP-1 levels showed significantly lower levels with increasing degree of obesity, FBS, PPBS and HbA1c.
Effect of hyperparathyroidism on vascular stiffness in hemodialysis patients
Authors: El-Sharkawy Magdy Mohamed Saeed , El Thakaby Ahmed Hassan Mohamed , Emara Ahmed Abdelmoniem , Mohamed Abdelkhalek Ahmed
Published: October 2021

Background

Cardiovascular disease (CVD) is present in > 50% of patients undergoing dialysis and the relative risk of death due to CVD events in HD patients is reported to be 20 times higher than in the general population. In fact, in patients on renal replacement therapy (RRT) the prevalence of coronary heart disease and ventricular hypertrophy has been described to be 40% and 70% respectively, other CVD events include hypertention, arrhythmias, valvular calcification and arterial stiffness.

Objective

To detect the prevalence of arterial stiffness among end stage renal disease patients on prevalent hemodialysis with hyperparathyroidism.

Patients and Methods

This observational cross sectional study was conducted on 60 prevalent hemodialysis patients attending at hemodialysis unit of Ain Shams University hospitals, with convenient sampling method. The included patients are clinically stable on thrice weekly hemodialysis sessions for 4 hours per session.

Results

The Dual Pulse Wave Doppler (DPWD) method we proposed in this study may be considered as a useful and convenient option for clinical local Pulse Wave Velocity (PWV) measurement, this clinical practical and reproducible method had the capability to detect an increased local PWV of LCCA (which reflect arterial stiffness) in the patients with PTH > 300 more than the patients with PTH < 300 as it showed that in Group B (PTH>300), the measured carotid artery local PWV values ranged from 6.22 m/s to 8.84 m/s and the mean value was 7.81 ± 0.72 m/s, which was higher than 6.72 ± 1.06 m/s (ranging from 4.48 m/s to 8.44 m/s) of Group A (PTH<300).

Conclusion

Our study showed that there is a high prevalence of arterial stiffness in prevalent hemodialysis patients.
Evaluation of MicroRNA-122 as A Non-invasive Diagnostic Biomarker For Non-Alcoholic Fatty Liver Disease and NASH related Cirrhosis
Authors: Musa Nevine Ibrahim , Agwa Sara Hassan , Faheem Heba Ahmed , Gharib Alam El-din Ahmed Mohamed
Published: October 2021

Background

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. NAFLD is considered to represent the hepatic manifestation of metabolic syndrome. NAFLD was traditionally considered as a relatively benign liver disease. However, some patients with NAFLD progress to liver fibrosis, cirrhosis and hepatocellular carcinoma 8-13. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important. Liver biopsy is the gold standard for the evaluation of NAFLD patients in terms of staging. However, liver biopsy is an invasive technique, and the identification of noninvasive biomarkers is required.

Objective

To assess the value of MicroRNA-122 as a non-invasive biomarker for diagnosis of NAFLD and NASH related Cirrhosis.

Patients and Methods

In the present study, we assess the value of MicroRNA-122 as a noninvasive biomarker for diagnosis of NAFLD and NASH related Cirrhosis. Gastroenterology and Hepatology outpatient clinic at: Ain Shams University Hospitals, Shebin El-Kom Teaching Hospital, Kafr Elsheikh University Hospitals. Clinical Pathology department at Faculty of Medicine, Ain Shams University.

Results

Patients with NASH had higher NAFLD score than patients with NAFLD than normal control. Patients with NASH had significantly higher frequency of upregulated miRNA-22. Patients with NASH had higher miRNA 122 expression than normal controls and patients with NAFLD. Likewise, patients with NAFLD had higher miRNA 122 expression than normal controls. The miRNA 122 was a significant discriminator of NAFLD and NASH with a sensitivity of 75% and specificity of 82% for NAFLD and a sensitivity of 91% and specificity of 86% for the NASH.

Conclusion

miRNA-122 is a sensitive and specific biomarker in the early detection of NAFLD and NASH as they are linked to the lipid metabolism reducing the need for liver biopsy. NAFLD fibrosis score had high sensitivity in differentiating the NAFLD groups from the control group and in differentiating the steatosis group from the NASH group. Serum levels of miRNA-122 were positively correlated with BMI, ALT and AST.
Comparison between Paricalcitol versus cinacalcet therapy in the management of secondary hyperparathyroidism among prevalent hemodialysis patients
Authors: Behairy Maha A , Mahmoud Osama , Ibrahim Ayman Rabie , Attallh Aber Halim
Published: October 2021

Background

Secondary hyperparathyroidism (SHPT) is one of the components of chronic kidney disease–mineral bone disorder (CKD-MBD) with significant contribution to the morbidity and mortality among prevalent hemodialysis (HD) patients.

Objectives

Multicentric experience study to compare the effectiveness of Intravenous (IV) paricalcitol versus oral cinacalcet and oral cinacalcet plus oral alfacalcidol as treatment regimens of secondary hyperparathyroidism (SHPT) among chronic haemodialysis (HD) patients.

Methods

Retrospective observational cohort study, 1year time horizon, 130 prevalent HD patients with SHPT were recruited from three main HD centres in Aljouf region in Saudi Arabia. Patients were divided into 3 groups: Group I (50) HD patients were treated by intravenous paricalcitol, group II (50) HD patients who received oral cinacalcet plus oral alfacalcidol, Group III (30) HD patients were on oral cinacalcet. Serum Intact parathyroid hormone, Calcium, Phosphorus and alkaline Phosphatase tests were assessed every 3 months.

Results

130 (61 (47%) females, (53%) 69 males) HD patients, mean age 56.30 ± 19.1 years, mean HD duration 4.86±4.15 year. The mean of PTH is significantly reduced in all studied groups (P < 0.001). Mean Δchanges in iPTH concentration in group I, II, III was (-242.11±148.75,225.54±153.91,-254.83±275.17)(P > 0.05) respectively with statistical non-significant differences. Increase of CaxPo4 with paricalcitol group as mean ΔChange in (CaxPO4) was in the group I, II, III(15.39±9.46,1.97±11.74,-2.89 ±9.37) respectively (P < 0.001). Significant increase in serum phosphorus from the baseline in patients in group II.

Conclusions

Intravenous Paricalcitol based regimen assumed to be equally effective in suppressing SHPT in prevalent hemodialysis patients when compared to the combination of oral Cinacalcet with oral alfacalcidol or treatment with oral cinacalcet alone, with less incidence of hyperphosphatemia with paricalcitol or cinacalcet in comparison to alfacalcidol regimen.
Evaluation of pancreatic cyst prostaglandin E2 as a Marker for Differentiation between Mucinous and Non Mucinous Cysts and Prediction of Dysplasia in Mucinous Pancreatic Cysts
Authors: Yousef Tarek , Okasha Hussein , Saleh Shereen Abo Bakr , Elessawy Hagar Ahmed Ahmed
Published: October 2021

Background

There are different types of pancreatic cysts.They can be classified by different ways. Each of them has different plan of management. that is why their differentiation became mandatory before setting their treatment plans.

Aim of the study

To Evaluate PGE2 as a marker of differentiation of mucin containing pancreatic cysts and prediction of dysplasia in these cyst.

A Secondary aim is differentiation of mucin from non mucin containing pancreatic cystic lesions

Patients and Methods

40 patients were recruited from the Department of Internal Medicine and the Outpatient Clinic of Cairo University hospital in the period between December 2018 and August 2019. A case control study design was adopted where the patients were grouped as follow

: Group 1

- composed of 20 patients with pancreatic mucinous cystic lesions defined by EUS guided samples, Histopathology and Radiological findings. Group 2: - composed of 20 patients with pancreatic non mucinous cystic lesions defined by EUS guided samples, Histopathology and Radiological findings.

Results

In our study, there was a significant differences in PGE2 level between true and inflammatory pancreatic cysts (p = 0.001) .However, there is insignificant differences between mucinous, non mucinous (p = 0.406). There was insignificant differences between different grades of IPMN dysplasia (p = 0.615)

Conclusion

Prostaglandin E2 is pancreatic cystic fluid marker which can be used for differentiation between true pancreatic cysts from inflammatory pancreatic cysts which have different plans of management. Prostaglandin E2 is not good marker to be used for differentiation between different grades of IPMN dysplasia.
The predective role of neutrophils to lymphocytes ratio in bronchial asthma
Authors: Ali Fawzia Hassan Abo , El Fadle Sylvia Wefky Abo , El Kady HossamMoustafa , Maksoud Nehal Anwar Abdel
Published: October 2021

Background

Neutrophil to lymphocyte ratio is an easy and rapid biomarker measured in peripheral blood, and plays a helpful role in assessing prognosis of bronchial asthma and its severity.

Aim

To assess NLR levels among atopic asthmatics, non-atopic asthmatics and healthy controls.

Patient and methods

The study included 120 asthmatic patients and 60 healthy control.

Results

A highly significant difference was observed between asthmatic patients and healthy controls regarding neutrophil\lymphocyte ratio (p < 0.0001).

Conclusion

Neutrophil to lymphocyte ratio is useful to assess asthma severity.
An observational retrospective cohort study of the effect of direct antiviral agents (DAAs) on glomerular filtration rate (GFR)
Authors: Sarhan Iman Ibrahem , Ahmed Fatma Abdelrahman , Elsharabasy Reem Mohsen , Abdelgawad Mohamed Hassan
Published: October 2021

Background

Hepatitis C virus (HCV) infection is known to be associated with high rates of liver related morbidities and mortality in the whole world. The interest of Public in HCV is growing, as more than 180 million people, (2.8%) of the global population, are infected with HCV.

Aim of the Study

To evaluate the effect of direct antiviral agents on glomerular filtrating rate (GFR).

Patients and Methods

The study performed on 120 subjects from the Hepatology outpatient clinic at Sharque elmadinah Hospital in Alexandria.

Results

The current results showed that the mean decrease in GFR in patients who received SOF/DAC were 5.21 ± 15.57 and 6.18 ± 16.13 after full 12 week regimen and after 1 year respectively while the mean decrease in patients SOF/SIM were 4.35 ± 14.9 and 3.57 ± 13.08 respectively. The decrease was not statistically significant in both regimens. Moreover, the mean GFR decrease in the only patient received SOF/Ribavirin was 12.8 and 30.9 after 12 weeks regimen and after one year respectively while for the only patient who received PAR/OMB/Rito/Ribavirin the decrease was 5.5 and 53.4 respectively. unfortunately, due to lack of sufficient patients number, the decrease an not be expressed statistically.

Conclusion

The new direct antiviral agents (sofosbuvir, daclatasvir and simeprevir) are effective and safe regarding glomerular filtration rate in patients with normal renal function. However, a meticulous monitoring of kidney function is mandatory during the course of these medications to early detect any untoward side effects. Moreover, such studies will yield beneficial data about the renal safety of these drugs if it could be performed on a larger scale of patients.
RETROSPECTIVE ANALYSIS OF EPIDEMIOLOGY, PROGNOSTIC FACTORS AND RESPONSE OF TREATMENT OF RECTAL CANCER
Authors: El Wakiel Hesham Mahmoud , El DinDinEl Ghamry Mai Mohamed Ali Ezz , Mohamed Abdullah Ahmed Essam
Published: October 2021

Background

Rectal cancers have always been considered as a part of CRCs in related epidemiological studies, it’s one of the major public health problems. Rectal cancers are the second most common (28%) cancers in large intestine after proximal colon cancers (42%).Colorectal cancer is the third most frequently diagnosed malignancy just behind lung and breast cancer, accounting for about 1.8 million cases each year, and the second cancer causing death worldwide, accounting to more than 850,000 deaths per year.

Objective

To evaluate the clinico-epidemiological factors in rectal cancer patients with response to treatment, duration of response and overall survival outcome.

Methods

This is a retrospective study which enrolled 60 patients diagnosed with rectal cancer treated at Clinical Oncology and Nuclear Medicine Department at AinShams University Hospitals in the period between January 2012 and December 2015. Data collected from the files of Ain Shams University.

Results

Among the studied population enrolled in our study, we found that major factors affected both OS & DFS were ECOGPS,histopathological differentiation, pathological staging, CRM, LVSI, PNI. While factors affected OS only with no impact on DFS were gender variant, clinical T & N stage, ECE and there is statistical significance in DFS and the tumor site. The median of overall, disease-free and progression free survival of all studied population were 37, 29 and 9 months respectively.

Conclusion

The fact that identified epidemiological and prognostic factors for disease free and overall survival in rectal cancer were not novel, this work reflect real life management of care and outcomes of rectal cancer patients.
Conservative versus Surgical Treatment in Management of Closed Mallet Finger:A Systematic Review and MetaAnalysis
Authors: Habib Abd Elrahman Salah El-deen , Atiyya Ahmed Naeem , Aly Amr Moustafa
Published: October 2021

Background

Several methods of treatment have been mentioned in management of closed mallet finger injury, as conservative methods using stack splint,dorsal aluminum splint or custom thermoplastic splint, or surgical procedures as direct pinning method, extention block technique or hook plate fixation, there is no consensus for the best method of treatment.

Objectives

to review and meta-analyze the outcomes of conservative versus surgical treatment in management of closed mallet finger injury and statistically compare between their results of pain, extensor lag, range of motion of distal inter-phalangeal joint.

Materials and Methods

The review will be restricted to randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of conservative versus surgical treatment in management of closed mallet finger, articles published in English.

PRISMA flow chart

950 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, 150 articles were found. By applications of all inclusion and exclusion criteria, only 55 articles which met all inclusion criteria, 50 studies were systematically reviewed, and 5 randomized controlled trials were fit to undergo a meta-analysis, after conducting meta-analysis we found that P value for pain svore based on visual analogue score (VAS) was 1, extensor lag P value < 0.001, and range of motion P value <0.001.

Conclusion

No significant differences was found between the conservative and the surgical groups regarding the pain score, distal inter-phalangeal joint extensor lag, and distal inter-phalangeal joint range of motion in treatment of closed mallet finger.
Role of Susceptibility Weighted Images (SWI) in Grading of Brain Glioma
Authors: Hassan Ayah Abdelaziz Ali , Abdel-Aziz Amany Moh. Rashad , Aziz Tougan Taha Abdel , Twadros Sameh Roshdy , Mamdouh Fady
Published: October 2021

Background

Glioma is the most common intracranial primary tumor of central nervous system (CNS) and accounts for about 70% of primary adult malignant brain tumors. The optimum therapeutic treatment and prognosis evaluation largely depends on the tumor pathological grades.

Objective

To evaluate the role of susceptibility weighted imaging (SWI) in grading of cerebral gliomas. The magnetic resonance imaging (MRI) results were compared and correlated to the pathology results to evaluate its role. The pathological grading of the glioma was done according to WHO 2007 classification system.

Patients and Methods

This was a retrospective study that included 35 adult patients, (11females & 24 males), their ages ranging from 18 years to 73 years. They were pathologically proven glioma patients ranging from grade I to grade IV. All the patients were referred from neurosurgeon to our radiology center (private center). This study was carried out during the period between January 2017 and November 2018.

Results

In our study, there were a strong positive correlation between both conventional imaging and pathological grading and between pathological and SWI grading. Using SWI sequence in grading of glioma will be very beneficial in patients with contraindication to contrast.

Conclusion

SWI using 3T MR system may provide quite useful information for preoperative glioma grading. There seems to be a strong positive correlation between pathological grading and SWI grading system for glioma. The main disadvantage for SWI is the extra time added to the usual time of routine MRI protocol used in cases of intra cranial space occupying lesions (SOL).
Reliability of Transient Elastography as a non-Invasive Technique for Detection of Fibrosis in Budd Chiari Syndrome Patients after Endovascular Intervention
Authors: Montasser Mohammed F , Barakat Eman M , Ghazy Mohamed S , Abdelhakam Sara M , Ebada Hend E , Elganzory Ahmed T
Published: October 2021

Aim of the work

To test the reliability of fibroscan in detection of fibrosis in patients with Budd Chiari syndrome before and after endovascular intervention (after elimination of hepatic congestion).

Background

transient elastography (TE) is a noninvasive methodology that has been used to monitor liver stiffness in patients with chronic viral hepatitis. One of the limitations for accurate assessment of liver fibrosis by TE is the liver congestion. Liver congestion can result from Budd Chiari syndrome (BCS).The treatment of BCS is through restoring the flow of the blood between the portal vein to the inferior vena cava, which will lead to decongestion of the liver.TE, will be tested after liver decongestion for proper detection of liver fibrosis.

Patients and methods

This was a prospective cohort study conducted on 25 Egyptian patients with confirmed diagnosis of primary Budd-Chiari Syndrome (BCS) in the period from June 2017 to September 2019. TE was performed three days before endovascular intervention and three months after it. Liver biopsy was taken during the intervention for assessment of METAVIR score. Comparison was done between TE assessments before and after intervention in detection of the degree of liver fibrosis in comparison to METAVIR score measured in liver biopsy.

Results

FVLM was the most common hypercoagulable cause in the involved patients.

There was significant drop in Liver Stiffness Measurements (LSM) measured three months post-intervention indicating improvement of liver fibrosis after relieving liver congestion but still not correlated to the METAVIR scores measured in the liver biopsy.

Conclusion

Liver congestion has high impact on Liver stiffness measurement giving overestimation which improves significantly after decongestion of the liver by the endovascular intervention.
Characteristics of Hepatitis B virus induced Hepatocellular Carcinoma in Egyptian patients
Authors: Fathy Barakat Eman Mahmoud , AbdAlaziz Khalid Mahmoud , Mahmoud El Tabbakh Mohamed Mahmoud , Alden Ali Mohamed Kamal
Published: October 2021

Background

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis. Alcohol consumption remains an important additional risk factor in the United States as alcohol abuse is five times higher than hepatitis C. Diagnosis is confirmed without pathologic confirmation. Screening includes both radiologic tests, such as ultrasound, computerized tomography, and magnetic resonance imaging, and serological markers such as αfetoprotein at 6-month interval.

Aim

To compare characteristics and behavior of Hepatocellular carcinoma (HCC) in chronic HCV patients and HVB patients

Patients and Methods

The current study was conducted on patients with de HCC presented at HCC clinic, Tropical medicine department Ain Shams University Hospitals between December 2017 and D ecember 2018, aged (18-70 years old) .

Results

eline characteristics of study population shown in Table 1 at enrolment, including gender, Education status, co-morbidity, underlying presence or absence of cirrhosis, Child-Pugh class of patients infected with viral hepatitis, and alpha-fetoprotein levels. Male proportion observed to be predominant in both HCV (62%) and HBV (75.4%) infected HCC population. Overall prevalence of HCV and HBV in patients having HCC was 65.95% and 34.04%, respectively. Presence of underlying liver cirrhosis was more significantly associated with HCV seropositives as compared to HBV seropositive patients (p0.05). Table 2 shows comparison of means between HCV and HBV seropositive patients with HCC. In univariate analysis, mean age difference (11.6 years), and total bilirubin levels (-1.91mg/dl) were the only statistically significant observations noted among HCV-HCC group (p = 0.05)

Conclusion

Hepatocellular carcinoma is mainly caused by Hepatitis C and Hepatitis B viruses, but latter showed predominance, comparatively worldwide and correlated HBV directly as a cause of HCC rather than HCV whose relation with HCC is still unclear (Shepard et al., 2006; Di Bisceglie, 2009). Because of the geographical differences and risk factors, the epidemiological burden of HCV and HBV has been observed different in different areas of the world. In developing countries due to high burden of HCV infection as compared to HBV such as in Taiwan (HCV 17.0%, HBV 13.8%) (Kao et al., 2011), Guam (HCV 19.6%, HBV 18%) (Haddock et al., 2013), and Pakistan (HCV 4.8%, HBV 2.5%) (Rehman et al., 1996; Raza et al., 2007; Qureshi et al., 2010; Butt et al., 2012;) will possibly