bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Human IFITM3 Polymorphism rs12252 on COVID-19 Severity and Mortality in an Egyptian Cohort
Authors: Mohamed Elessawy Sarah Mohamed Hesham , Ali Shehab Abeer Alsayed , Soliman Dina Ahmed , Eldeeb Mai Ahmed , Abdelfattah Taha Sara Ibrahim
Published: July 2024

Background

Coronavirus disease 2019 (COVID-19) is a pandemic respiratory disease with a high mortality rate, caused by infection with severe acute respiratory syndrome coronavirus 2. Variants of the gene encoding the interferon-induced membrane protein IFITM3 have been linked to severe viral illnesses. We investigated whether the COVID-19 clinical outcomes caused by SARS-CoV-2 infection in a cohort of COVID-19 Egyptian patients were inconsistent and could have been caused by the IFITM3-SNP rs12252 polymorphism.

Aim of the Work

The purpose of this study is to determine the frequency of the IFITM3 rs12252 SNP in a cohort of COVID-19 Egyptian patients, and its impact on illness severity and outcome, as well as its influence on IL-6 serum levels.

Patients and Methods

This cross-sectional study included 100 patients diagnosed as positive for COVID-19. They were enrolled in AL-Obour Quarantine Hospital. They were categorized into three groups, mild cases, who attended AL-Obour outpatient clinic, moderate and severe cases who were admitted to the hospital ward and ICU, respectively. All subjects of this study were subjected to full medical history, clinical evaluation, laboratory investigations, serum IL-6 levels by ELISA and IFITM3 gene polymorphism by real-time PCR.

Results

The results of the current study demonstrated a significant difference between mortality and the minor G allele of rs12252 within IFITM3 in COVID-19 patients (OR = 4.5 [95% CI; 1.4–14.30], P = 0.006). IL-6 showed no association either to disease severity or IFITM3 rs12252 genotype frequency.

Conclusion

The present study has shown a significant association between G allele variant of IFITM3 rs12252 and COVID-19 mortality. However, results failed to demonstrate any significant association between rs12252 polymorphism and disease severity, ICU admission or serum IL-6 levels. Therefore, understanding the interaction between SARS-CoV-2 and the IFITM3-rs12252 allele could help identify novel therapeutic targets, leading to precise biological and immune therapy for SARS-CoV-2 infection.
Evaluation of Micro-Needling Followed by Metformin Solution versus Micro-Needling Followed by Tranexamic Acid Solution in Treatment of Melasma: A Comparative Split Face Study
Authors: Abdel Fattah Nermeen Samy , Soltan Marwa Yassin , Mohammed Manar Magdy
Published: July 2024

Background

Melasma is a common acquired pigmentary disorder that manifests as symmetric hyperpigmented macules and patches on the face, more frequently affecting women of reproductive age. Various underling risk factors have been implicated in the etiology of melasma including; Genetic factors, pregnancy, oral contraceptives, endocrine dysfunction, hormone treatments, cosmetic contact sensitivity and exposure to ultraviolet (UV) light. Management of melasma is a frustrating experience both for the treating doctors and patients because of its recurrent and often recalcitrant nature. Numerous therapeutic modalities have been tried for this condition such as hydroquinone, kligman’s formula (hydroquinone + steroid + tretinoin), kojic acid, azelaic acid, arbutin, ascorbic acid, chemical peels, lasers, tranexamic acid, rucinol, oligopeptides, silymarin, orchid extracts, and various botanical extracts with variable success rates.

Objectives

Our aim was to assess and compare the therapeutic effects of topical metformin solution 30% with microneedling versus topical tranexamic acid (4mg\ml) solution with microneedling in treating patients with facial melasma.

Patients and Methods

This is a split-face study included 35 patients with facial melasma. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals. Topical metformin 30% solution with microneedling sessions were done for the right side of the face (4sessions - two weeks apart), and topical tranexamic acid solution (4mg/ml) with microneedling on the left side of the face (4 sessions – two weeks apart). The patients were followed up for 3 months. The response of treatment was evaluated by Hemi MASI score and Antera 3D camera.

Results

Our study revealed that both microneedling followed by topical metformin solution and microneedling followed by topical TXA solution were efficient in treatment of facial melasma as shown by significant decrease in h-MASI score and average melanin level assessed by Antera camera. Although statistically insignificant, the percentage of change in h- MASI score was more evident with TXA treatment than metformin treatment. The side effects were limited and transient in the form of erythema, burning sensation, and xerosis. The main problem with either treatment was the high relapse rate.

Conclusion

Both metformin and tranexamic acid applied topically following microneedling sessions led to statistically significant improvement of melasma according to Hemi MASI scores. Topical metformin appears to be a promising therapeutic option in the treatment of melasma without serious adverse effects.
Prevalence of Osteoporosis in Patients with Chronic Skin Diseases
Authors: Mokhtar M , Fathy G , Adel Y
Published: July 2024

Osteoporosis is a skeletal disorder resulting from decreased bone mass that results in increased liability to fractures. Several chronic diseases including dermatological diseases were reported to affect bone mineral density with resulting osteopenia and osteoporosis.

Aim of the Study

to evaluate the prevalence of osteopenia and osteoporosis in chronic skin diseases.

Patients and Methods

One hundred patients diagnosed with chronic primary dermatological diseases divided into 4 groups according to dermatological disease were included in the current study. Assessment of BMD by DEXA scan and estimation of serum level of vitamin D were performed.

Results

In all studied patients, there was no significant association between osteopenia/osteoporosis and studied dermatological diseases or vitamin D levels as T score analysis either lumbar, femoral or forearm in relation to vitamin D status and disease severity. There was significant association of insufficient vitamin D levels with all skin diseases but there was no significant association between T score results and vitamin D status in studied patients.

Conclusion

The current study revealed that dermatological diseases were associated with insufficient levels of vitamin D.
Gustatory Function in Patients with Chronic Rhinosinusitis with Nasal Polyposis
Authors: Elbeltagy Yasser Mohammed , Elsersy Hesham Abdelaty , Teaima Ahmed Abdelmoneim , Abd Elhay Mahmoud Mohamed
Published: July 2024

Background

Many patients with chronic rhinosinusitis (CRS) describe disturbances in taste. Recent research has shown that taste receptors in airway epithelial cells are involved in defending against upper respiratory tract infection. The aim of the present study was to investigate gustatory function in patients with chronic rhinosinusitis (CRS).

Methods

Taste function was assessed using the taste strip test in 63 patients with CRS (Study Group) (mean age was 42.05± 14, ranging between 19 to 68 years. More than half of cases (68.3%) were males) and 63 healthy controls (The mean age was 40.9± 13.6, ranging between 18 to 67 years. More than half of cases (68.3%) were males).

Results

The mean Sweet, Salt, Sour, Bitter, and Umami score among the study group was 3.6± 0.6, 3.9± 0.3, 3.8± 0.4, 3.4± 0.8, 3.5± 0.7 and 18.4± 2.6 respectively with a median equal to 4 among all of them. The mean total Taste score was 18.4± 2.6 with a median of 20 while The mean Sweet, Salt, Sour, Bitter, and Umami score among control group was 4± 0, with a median equal to 4 among all of them. The mean total taste score was 20± 0 with a median of 0

Conclusion

Taste dysfunction is a common complaint in CRS. Patients with CRS have decreased gustatory function.
Nutrition Screening for 2-5 Years Old Children by Screening Tool for the Assessment of Malnutrition in Paediatrics in Outpatient Setting
Authors: Emam Ehab Khairy , Nassar May Fouad , Allam Mohamed Farouk , Ahmed Mai Mamdouh , El-Kholy Heba Essam
Published: July 2024

Introduction and Aim of the work

Malnutrition is the primary causative factor of pediatric mortality and repeated hospitalization. The aim of this study is to highlight the role of nutrition screening in identifying those at risk of malnutrition who may benefit from nutritional interventions and test whether the nutritional supplements are essential during nutritional rehabilitation.

Patients and methods

Screening for malnutrition of 3640 children at the outpatient clinic of Ain Shams Pediatric hospital by Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) followed by assessing 100 patients at high risk of malnutrition by anthropometric measurements, then BMI and z scores were computed. Oral nutritional supplement was advised in the rehabilitation program only in group A. Nutritional response testing was performed by reassessment at three and six months.

Results

The prevalence of underweight, stunting and wasting were 5.9%, 15.6%, and 9.4% respectively. As per STAMP, 14.7% were found to be nutritionally at low risk, 7.3% at intermediate risk, and 5.1% at high risk compared to 72.83% without risk for malnutrition. STAMP showed a significant increase in patients at low risk and decrease in patients at high risk through follow up in both groups with better percentages in group A which coincides with improvement in anthropometric indices.

Conclusion

STAMP is a sensitive, quick, and easy to use nutritional screening tool with a crucial role in identifying nutrition risk at outpatient services which can lead to implementing prompt nutritional rehabilitation. Tailored nutritional plans can accomplish good response and adding a nutritional supplement to the dietary plan ensures earlier goal achievement.
A Comparative Study between Vacuum-Assisted Closure (VAC) versus Plaletets Rich Plasma (PRP) for Dressing of Diabetic Foot Ulcers
Authors: El Sayed Ahmed Osama Mahmound , Nageeb Ramy Mikhael , Abd El Salam Rizk Mohamed Abd El Monaem , Shafik Boles Bola Nasry
Published: July 2024

Background

Diabetic foot ulcers are among the most generally perceived troubles of patients who have diabetes mellitus which isn't particularly controlled. It is commonly the outcome of poor glycemic control, stowed away neuropathy, periphery vascular sickness, or sad foot care. It is similarly one of the typical justification for osteomyelitis of the foot and evacuation of lower uttermost focuses. These ulcers are ordinarily in the space of the foot which encounters repetitive injury and strain sensations.

Objective

To evaluate the effect of plasma rich platelets versus vacuum-assisted-closure dressing in the improvement of the healing process in diabetic foot ulcer.

Patients and Methods

The survey included 40 patients who had continuous diabetic foot ulcer and were treated at the piece of Vascular and General an operation, Ain Scams School Facilities and Luxor Overall Crisis center, Cairo, Egypt. Starting from December 2021 to May 2022.

Results

Larger piece of the patients in both control and cases had discharge. (Patients with sickness or purulent delivery were barred from study). In our examination of 40 patients the ulcer size went from 6 to 15 cm2. The mean size in pack (A) was 9.48±1.91 cm2 and among Get-together (B) 9.56 ±1.87 cm2. In our survey we saw that recovering in cases or exploratory get-together took in a general sense less time when differentiated and bundle (A). The mean length of retouching in control pack was 7.3 ±1.91 weeks and mean term of recovering for pack (B) was 4.38±1.94 weeks. The probability regard (p regard) gained ensuing to applying unpaired t test for the above data arises to be 0.0001 which is really gigantic.

Conclusion

Our case series showed that PRP and VAC is a secured and strong treatment technique for consistent non-retouching ulcers. Using PRP to treat persevering wounds/ulcers might further develop patching, yet also thwart lower limit evacuations achieved by non-recovering injuries. Appropriately, further investigation and randomized controlled clinical starters on greater patient people are essential to endorse the results.
The Identification and Preservation of Parathyroid Gland during Thyroidectomy Using Carbon Nanoparticles
Authors: Alaa el-Din Hisham Adel , Omran Hisham Mohamed , Saad Ahmed Saeed , Kadri Sharouda Ahmed Shawki Mohamed
Published: July 2024

Background

During thyroidectomy, the parathyroid gland as well as the recurrent laryngeal nerve iatrogenic injuries are the most serious complications in goiter surgery. However, recurrent laryngeal nerve injury has been reduced to minimum as a result of meticulous surgical techniques and intraoperative nerve monitoring.

Objective

To determine the potential role of intraoperative CN injections for identification and preservation of parathyroid glands, thereby reducing the postoperative hypocalcaemia and whether CNs can really improve the extent of thyroidectomy and neck dissection and help identify metastatic lymph nodes.

Patients and Methods

We did a prospective cohort study with comparative between two groups of patients, one group established with the conventional technique of thyroidectomy while the other group established using CN injection to see which group with less post-operative hypocalcemia. A hundred patients with benign and malignant goiter disorders underwent thyroidectomy assigned into two groups: group 1 (control group) included 50 cases established with the conventional technique and group 2 (interventional group) included 50 cases operated upon with CN injection technique.

Results

The results showed that in group 2; 47 patients had normal Ca ++ level (94%) while 3 cases had low Ca ++ level (hypocalcemia) (6%). But in group 1; 37 patients had normal Ca ++ level (74%) while 13 cases had low Ca ++ level (hypocalcemia) (26%). The three patients in group 2 and the 13 patients in group 1 who developed hypocalcemia were managed with IV and oral supplementation of calcium and vitamin D and recovery occurred within a period of 1 week to 1 month.

Conclusion

CN injection technique is safe, effective, and technically feasible which helped us to keep parathyroid gland during thyroidectomy and that led us to reduce the percentage of incidence post- operative complications. Also, it helped us to identify the parathyroid gland during the surgery, the safety for thyroid surgery is based on the protection and visualization of the normal anatomy of parathyroid glands and their blood supplies according to the CNs injection technique, as verified in our research. Others see that the sooner the parathyroid glands are identified, the lower the surgeon’s level of stress. New studies with larger numbers of cases and also application of the technique by different surgeons are important to confirm the reliability and effectiveness of this technique.
Assessment of Early Laparoscopic Cholecystectomy in Management of Acute Calcular Cholecystitis
Authors: Mounes Ibrahem David Kamal , Akhnoukh Samy Gamil , Mahfouz Remon Mamdouh
Published: July 2024

Background

Acute cholecystitis is one of the most significant diseases in the Western world and has a high socioeconomic impact. Mainly, patients with gallstones and older adults are affected. The main complication of acute cholecystitis is recurrent biliary colic and cholestasis. The latter may lead to ascending cholangitis, and while this can be managed with antibiotics, other complications cannot be cured conservatively such as gangrenous changes, gall bladder perforation and biliary leakage, and acute necrotic gallstone pancreatitis. Liver abscesses and underlying incidental carcinoma have also been reported in some cases.

Aim of the Work

The purpose of this study is to focus on success rate of early laparoscopic cholecystectomy as a management of acute calcular cholecystitis along with its operative and post- operative outcomes.

Patients and Methods

This is a prospective cohort study conducted on forty (40) patients presenting to Ain-Shams University hospitals and authorized hospitals presented with acute calcular cholecystitis starting from January 2021 and December 2021.

Results

Our study demonstrates that in terms of morbidity and mortality, early laparoscopic cholecystectomy is safe, feasible and cost-effective for cases of acute cholecystitis. The outcome of the patients in our study provides further evidence that early laparoscopic cholecystectomy can be performed within the first 72 hours of symptoms with no significant increase in length of operation. Moreover, there was no significant increase in the rate of major intra operative or post operative complications such as bleeding, bile duct injury, bowel injury, wound infection and conversion to open cholecystectomy. The major advantage of early cholecystectomy was that early laparoscopic cholecystectomy allows significantly shorter total hospital stay and reduction in days away from work. Moreover, it avoids repeated admissions for recurrent symptoms.

Conclusion

Early laparoscopic cholecystectomy is safe, feasible and cost-effective for cases of acute cholecystitis and its major advantage is that it allows significantly shorter total hospital stay and reduction in days away from work and avoids repeated admissions for recurrent symptoms.
Retrospective Comparative Study between Results of Neo Adjuvant Chemotherapy and Upfront Surgery in Breast Cancer in Aswan Oncology Center
Authors: Mahmoud Mahmoud Abdelbaqy , Mohamed Ali Mohamed Ebrahim , Khattab Hany Mahmoud , Abdalrahman Ali Alsaaed , Mohamed Ahmed Taher , Abdalaziz Abdalrahman Mohamed
Published: July 2024

Background

Breast cancer is a global health problem, with more than 1 million cases of breast cancer diagnosed worldwide each year. Introduction of neoadjuvant chemotherapy (NACT) has dramatically changed the management of breast cancer.

Aim and Objectives

To compare the clinicopathological features, surgical procedures, and outcome parameters of primary and post-neoadjuvant chemotherapy breast conseravtive surgery, with the aim of comparing the outcomes in terms of ipsilateral breast tumor recurrence rates and over all free survival in the two groups.

Subjects and Methods

This was a Comparative study, was conducted in Aswan oncology center on (40) women diagnosed with breast cancer, divided into two groups: (Group A): 20 up front surgery patients then adjuvant chemoherapy, (Group B): 20 Neo adjuvant chemotherapy then surgery patients during 6 months.

Result

There was statistically significant difference between the two studied groups as regard Metastatic work up and local recurrence.

Conclusion

The neoadjuvant chemotherapy has a nearby significant impact on pathological complete response (PCR) in patients with breast cancer with no significant increased toxicity and has significant lower rates of metastasis compared to upfront surgery.Neoadjuvant chemotherapy followed by surgery is a safe and effective rather than conventional method (primary surgery followed by Adjuvant chemotherapy) in treatment of Breast cancer.
Platelet/Lymphocyte Ratio (PLR) as Prognostic Factor Thrombocytopenic Purpura in Patients of Immune
Authors: Elsayed Amer Aya Atef , Hassan Essam Abdelwaheed , Mohamed Inas AbdElmoaty , Abbas Rana Zakariya
Published: July 2024

Background

platelet/lymphocyte ratio (PLR) is a new inflammatory marker and its level increases in many inflammatory diseases, diabetes and malignancy. In ITP patients thereis decrease in platelet count beside inflammation, so PLR is a good prognostic factor in ITP.

Objective

The aim of the study is to know the relation between platelet /lymphocytes ratio and the prognosis of immune thrombocytopenia

Patients and Methods

This was prospective study conducted on 96 patients diagnosed as immune thrombocytopenic purpura attending hematology unit of Ain Shams University divided into to3 groups (newly diagnosied, Resistant and splenectomized) and followed them after 3 months.

Results

Comparison between ITP sub-groups regarding CBC results at baseline revealed that Newly diagnosed ITP patients had significantly higher PLR compared to other groups while resistant/relapsed ITP patients had significantly lower PLR compared to other two groups. (table 2). Comparison between ITP sub-groups regarding CBC results after 3 months revealed that resistant/relapsed ITP patients had significantly lower PLR compared to other two groups, (table 3). on comparison PLR in newly-diagnosed ITP before and after 3 months of treatment PLR was higher Highly significant (P < 0.001) On comparison PLR in Resistant group pre and after 3 months of treatment it was lower highly significant (p < 0.001) On comparison PLR in splenectomy group pre and after 3 months of treatment PLR was higher Highly significant (p < 0.001)

Conclusion

PLR is a good indicator for ITP patient of different categories (newly diagnosied, Resistant and splenectomized).
Assessment of Serum Autophagy Related Protein Beclin1 in Egyptian Adult Beta Thalathemic Patients
Authors: Elafifi Amal Mostafa , Nabih Nermeen Adel , Mohamed Haydi Sayed , Helmy El Razzaz Mostafa Kamal , Mohammed Basyouni Esraa Magdy
Published: July 2024

Background

Beta-thalassemia is a chronic hemolytic anemia that is inherited in an autosomal recessive manner. It is characterized by reduced hemoglobin levels and red blood cell production.

Aim of the Work

Assessment of serum autophagy related protein beclin1 in Egyptian adult beta thalathemic patients and Its relation to ineffective erythropoiesis, transfusion requirements, iron overload.

Subjects and Methods

This is a case control study which was carried out at Ain Shams university hospitals. Internal medicine department, Clinical hematology and stem cell transplantation unit, outpatient clinic and inpatient department, during the period between January 2022 and August 2022.

Results

Our study revealed significant decreased fertility between patients group and control group (P = 0.011). Transfusion-dependent beta-thalassemia males have a high proportion of fertility impairment and iron overload might contribute to disturbed sperm quality and testicular tissue injury. Such findings might explain the high prevalence of impaired fertility in transfusion-dependent beta- thalassemia patients which agrees with our results. Also our study revealed significant differences between non-transfusion dependent group and transfusion-dependent group regarding spleen size (cm) below costal margin which was increased in (TD group), transfusion per year (ml/yr)(which was increased in (TD group), virology (HIV, HCV,HBV) revealed that percentage of HCV+ve higher in (TD group) with (P < 0.001): Our study revealed significant difference between non-transfusion- dependent group and Transfusion-dependent group regarding percentage of patients of with positive HCV which was increased in Transfusion-dependent group (P = 0.021): In our study Iron chelation therapy was found to be given in a higher percentage of TD patients compared to non TD patients (P < 0.001). Also our study revealed significant difference regarding cardic function(EF%) between patients group and control group (EF found to be lower in patients group than controls) (P < 0.001): Also our study showed that Beclin-1 level is significantly higher in patients group compared to control group (P < 0.001). We couldn’t find previous studies of Beclin-1 level in thalassemia patients. We postulate that Beclin 1 could be used as a marker of worsening cardiac functions in thalassemia patients, but further studies should measure serial levels of Beclin 1 and correlate it with cardiac parameters over longer periods of follow up.

Conclusion

Beclin 1 level increased in Adult Beta Thalasemia patients and it can be used as a prognostic marker for Adult Beta Thalasemia patients.
Evidence of Perivascular Mesenchymal Bone Marrow Microenvironment Affection in Poor Graft Function Post Allogenic Stem Cell Transplantation
Authors: Mahmoud Khatab Eman Ayman , Ibrahim Nahed Moawad Ibrahim , Abdel-Ghafar Nermin Adel Nabih , Youssef Mikhaeil Soha Raouf , Ahmed ELKourashy Shaza Abdel-Wahab
Published: July 2024

Allogeneic hematopoietic stem cell transplantation (HSCT) is regarded as a curative treatment option for a variety of hematological disorders. The prognosis of allogenic (HSCT) patients is dependent on a variety of factors that affect the bone marrow microenvironment. One of these factors is the number and function of CD146+ perivascular mesenchymal cells that support the hematopoietic stem cells in the bone marrow and help their proliferation.

Aim of the Study

The aim of this study was to assess how the bone marrow microenvironment is being affected in patients with poor graft function post allogenic stem cell transplantation targeting the perivascular mesenchymal cells using multiparameter flow cytometric analysis of CD146 antibody.

Patients and Methods

Forty patients were enrolled in this study with both benign and malignant hematological diseases who underwent allogenic HSCT from matched related donors. Patients were divided into 2 equal groups: poor graft function (PGF) group and good graft function group (GGF). Patients were subjected to full history recording, clinical examination, full laboratory and radiological work-up, tissue typing and chemotherapeutic conditioning before transplantation. After transplant, bone marrow aspirate was obtained and analyzed for CD146+ perivascular mesenchymal cells using Quantitative tri-color Flow cytometric assay.

Results

PGF group showed significantly lower counts of WBCs, platelets and hemoglobin concentration compared to GGF group. In addition, CD34 dose showed significantly lower concentration in PGF group compared to GGF group. CD146 expression intensity on non-stem cells was significantly higher in PGF group compared to the GGF group to increase the function of these cells in supporting the proliferation of stem cells in the bone marrow.

Conclusion

CD146 can have a potential therapeutic role if CD146+ selected mesenchymal cells are infused in patients with refractory poor graft function to enhance the proliferation of stem cells and help in recovery of patients with PGF however further studies are warranted to document its suggested therapeutic role.
Prevalence of GIT Symptoms in Patients of Covid 19
Authors: Awad Emad Ahmed , Sabry Mohamed Manal , Ahmed Ahmed Elmetwally , Abdelrady Abdelrhman Haggag
Published: July 2024

Background

In December 2019, a cluster of patients with pneumonia of undetermined etiology was recognized in Wuhan, Hubei, China. Subsequently, a novel coronavirus (SARS-CoV-2) was identified from lower respiratory tract samples obtained from affected patients. The clinical manifestation of COVID-19 is broad and ranges from asymptomatic and mild upper respiratory tract symptoms to severe illnesses with multiorgan failure and death. Furthermore, it is challenging to predict the clinical course or determine patients at risk of deterioration.

Aim of the Work

The aim of our study was to assess prevalence of GIT symptoms in patients of covid 19 infected patients

Patients and Methods

This study was conducted on 100 adult covid 19 patients recently diagnosed by polymerase chain reaction (PCR). All patients were submitted to clinical examination, laboratory testing for ESR, CRP, CBC, and D-dimer. Radiological investigations in the form of CT Chest were be reported by radiologist for all patients. High resolution computed tomography Parenchymal abnormalities on HRCT were assessed. Nasopharyngeal, oropharyngeal and rectal swabs were collected for COVID-19 (PCR) test. All patients received Covid-19 treatment according to protocols of WHO and ministry of health and population, Egypt.

Results

We found that GI symptoms are prevalent among COVID-19 Egyptian patients (64%). The most common GI symptoms were Nausea, vomiting and diarrhea. We observed that 25 patients (25%) had positive viral RNA in rectal swab.

Conclusion

Severe COVID-19 was more frequent in older age. Dyspnea and increased respiratory rate were associated with severity of covid 19 infection. Increased CRP and high serum levels of ferritin, d-dimer and lactate dehydrogenase were significantly associated with COVID-19 severity.
Diagnostic Value of Plasma Methylated Septin 9 in Detection of Hepatocellular Carcinoma in Egyptian Patient with Post Hepatitis C Liver Cirrhosis in Comparison to Serum Level of Alphafeto Protein
Authors: El moghney Moustafa Mohamed Abd , Ali- Eldin Zainab Ahmed , Elrahmen Ahmed Ghada Abd , Mahmoud Rizk Mahmoud Hassan
Published: July 2024

Background

Egypt has the highest hepatitis C virus (HCV) prevalence worldwide. Cirrhosis secondary to HCV is associated with the highest annual risk for developing hepatocellular carcinoma. The burden of HCC has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. HCC contributes to 14.8% of all cancer mortality in Egypt. Most HCCs (80%) arise in a cirrhotic liver, a situation where there has been longstanding hepatocyte damage and chronic inflammation leading to fibrosis.

Aim of the Work

This study aims to evaluate the diagnostic value of plasma mSEPT9 assay in detection of HCC in Egyptian patients with post hepatitis C liver cirrhosis in comparison to serum level of α-fetoprotein (AFP).

Patients and Methods

This is a prospective case-control study conducted at the Gastroenterology department in Ain Shams University Hospital. The study population consisted of 80 subjects, divided into three groups: 40 patients with hepatocellular carcinoma, 20 patients with liver cirrhosis, and 20 healthy subjects as controls with matched age and gender.

Results

The study found that hepatocellular carcinoma (HCC) was more frequent in male patients and that the age of HCC patients was statistically significantly higher than patients with cirrhosis and healthy controls. Patients with HCC and cirrhosis had a higher Child Pugh score than healthy controls. Portal hypertension and portal vein thrombosis were more frequent in HCC and cirrhosis patients than in the control group. Liver enzymes were higher in patients with HCC and cirrhosis compared to healthy controls, while hemoglobin and platelet levels were lower in patients with HCC. Hepatitis C antibody and PCR were positive in HCC and cirrhosis patient groups. AFP and Methylated Septin 9 levels were higher in patients with HCC and cirrhosis than in healthy controls, and AFP had better diagnostic accuracy than Methylated Septin 9. Both AFP and Methylated Septin 9 levels were positively correlated with age, Child Score, liver enzymes, and coagulation profile and negatively correlated with platelet count and hemoglobin level. AFP level was positively correlated with the number of focal lesions and liver size.

Conclusion

This study demonstrated that plasma Methylated Septin 9 can be a promising noninvasive and circulating epigenetic biomarker for HCC diagnosis at the individual level. However, our results showed that AFP was superior than Methylated Septin 9 in the detection of HCC, Methylated Septin 9 has higher Sensitivity. It was suggested that the combination of plasma mSEPT9 and AFP could enhance the sensitivity of Methylated Septin 9 or AFP alone in the diagnosis of HCC. Further comparative studies with larger sample size and longer follow-up are needed to confirm our results and to identify risk factors of adverse events.
Prevalence of Anti-PLA2R Antibodies in Biopsy Proven Membranous Nephropathy in Egyptian Patients
Authors: Saed El-Sharkawy Magdy , Abd-Elmoniem Emara Ahmed , Mohsen El-Sharabasy Reem , Mostafa Megahed Mohamed Mostafa
Published: July 2024

Background

Membranous nephropathy (MN) is among the most common causes of the nephrotic syndrome in nondiabetic adults, accounting for approximately 20 to 30 percent of cases of nephrotic syndrome in White adults. MN is most often primary (previously called idiopathic), although it may be secondary with hepatitis B infection, autoimmune diseases as systemic lupus erythematosus (SLE), malignancies, and the use of certain drugs such as nonsteroidal antiinflammatory drugs (NSAIDs). MN in young females should raise the suspicion of SLE.

Aim of the Work

The aim of this work was to study the prevalence of anti-PLA2R antibodies in Egyptian patients with biopsy proven membranous nephropathy.

Patients and Methods

Our cross-sectional study included 70 Egyptian patients with nephrotic range proteinuria on first presentation for whom laboratory investigations including serum anti- PLA2R antibodies titer by indirect immunoflouresence and kidney biopsy were done.

Results

Membranous nephropathy has been diagnosed in 35.71% of adult Egyptian patients presented with nephrotic range proteinuria. 84% of the cases of membranous nephropathy had been diagnosed with primary membranous nephropathy and 16% diagnosed with secondary membranous nephropathy. Sensitivity of circulating anti-PLA2R antibodies in primary MN was 42.85% versus 80.95% for its detection within the glomerular extracts. Specificity of PLA2R is close to 100%; however, in other studies; PLA2R has been detected in the immune deposits of some patients with secondary MN. Patients with high anti-PLA2R titer had higher baseline proteinuria than patients with lower anti-PLA2R titer.

Conclusion

Membranous nephropathy (primary and secondary) may be considered the most common glomerulonephritis by biopsy finding in patients presenting with nephrotic range proteinuria followed by focal segmental glomerulosclerosis (35.7 %& 30% respectively). 84% of the cases of membranous nephropathy had been diagnosed with primary membranous nephropathy and 16% had been diagnosed with secondary membranous nephropathy. Circulating anti-PLA2R antibodies were detected within serum in 42.85% of primary MN cases while detection of anti- PLA2R antibodies within the glomerular extracts of primary MN cases was much higher (80.95%). Specificity of PLA2R is close to 100%; however, in other studies; PLA2R has been detected in the immune deposits of some patients with secondary MN. Patients with high anti-PLA2R titer had higher baseline proteinuria than patients with lower anti-PLA2R titer.
Assessment of Accuracy of Blood Neutrophil to Lymphocyte Ratio (NLR) in Diagnosis of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotic Patients
Authors: Salem Amira , Al-Naqeeb Noha , Anwar Christina Alphonse , Salah Mohamed Hazem
Published: July 2024

Background

This was across-sectional study conducted on 40 Egyptian patients with decompensated cirrhosis and ascites selected from Internal Medicine and Hepatology outpatient clinics and wards at Ain-Shams University Hospitals.

Aim of the Work

The aim of this study is to compare accuracy of blood neutrophil lymphocyte ratio (NLR) to ascitic fluid neutrophil lymphocyte ratio (NLR) in diagnosis of SBP.

Patients and Methods

Patients in this study were divided into 2 groups: Group 1 (case):20 cirrhotic patients diagnosed with (SBP) on the basis of clinical manifestations (fever, abdominal tenderness, and pre-hepatic coma) and laboratory diagnostic criteria: ascitic fluid PMNs greater than 250/mm 3 and culture positive. Group 2 (control): 20 cirrhotic patients with ascites and were admitted with no evidence of (SBP) by clinical and laboratory evaluation.

Results

According to our results, we found that there was no statistically significant difference found between two groups regarding Age, Sex and Child Classification. There was no statistically significant difference found between two groups regarding WBCs, Platelets, ALT, Creat, Albumin, INR, Bilirubin and Adenosine deaminase, and there was statistically significant difference found between two groups regarding AST and Urea, and there was highly statistically significant difference found between two groups regarding HB. Also there was highly statistically significant difference found between two groups regarding MELD score, SERUM PMNLs, Ascitic PMNLs, Serum NLR and Ascitic NLR.

Conclusion

Spontaneous bacterial peritonitis is a serious complication in patients with liver cirrhosis and is associated with a considerable risk of mortality. The present study could be of clinical utility in predicting SBP, a major cause of mortality in patients with cirrhosis. NLR is considered an easy test that can be used to diagnose SBP.
Fluoroscopic C-Arm Guided versus Ultrasound Guided Therapeutic Injection of Lower Cervical Radiculopathies
Authors: EL-Husseiny Ahmed M M , Salem Haitham Hamdy , Abdelfatah Amr , Fathy Mai , Fahmy Nagia Aly , EL-Sadek Ahmed
Published: July 2024

Background

The burden of cervical radicular pain on patients and systems of health in different countries is an important medical issue that needs more significant medical researches to find a new solutions, treatment and limited interventional methods to improve patient's quality of life, prevent complications and decrease the cost on health systems.

Objective

To compare the effectiveness of cervical injection guided by either ultrasonography or fluoroscopy.

Patients and Methods

Sixty patients with lower cervical radiculopathy resistant to medical treatment were included in this study. Randomly, patients received cervical block ultrasonography guided or Fluoroscopic guided. Patients were followed up at 14 days and 90 days by Brief Pain Inventory Scale.

Results

In our study both groups showed significant decline in pain Inventory scale from baseline till 90 days after injection.

Conclusion

Both ways of injection guided by either ultrasonography or fluoroscopy showed the same effectiveness in relief of pain in lower cervical radiculopathy at 14 days and 90 days.
Autoantibodies in a Cohort of Egyptian Patients with Inflammatory Muscle Disease
Authors: Fahmy Yosra Mahmoud , Shehab Abeer , Mohsen Dahlia Abdel , Fahmy Nagia
Published: July 2024

Objective

Autoimmune myopathies can present with diverse phenotypes and extra muscular systems affection, our aim is the illustration of different clinical pictures, Magnetic resonance findings and laboratory data in relation to myositis auto antibodies in a cohort of Egyptian patients.

Methods

This descriptive observational study was conducted in Ain Shams university hospital over a period of 2 years, a total of 77 patients were recruited and 10 control samples were collected.

Results

A total of 34 patients tested positive for Myositis Auto-antibodies, they showed female sex predominance (61.7%), the mean values for their age and age of onset were 28.618±14.346 and 23.574±13.584 respectively.

Conclusion

Autoantibodies are an important tool in diagnosis and management of immune mediated myopathy, especially when paired with clinical picture, radiological and other laboratory findings, our studied sample showed higher percentage of inflammatory myopathy subtypes associated with connective tissue disorders followed by Immune medicated necrotizing myopathy subtype then anti-synthetase syndrome antibodies.
Surgical Options for Treatment of Medically Intractable Neuropathic Facial Pain: An Outcome Assessment Study
Authors: Simry Hisham A , Abdelbar Ahmad E , Sabry Hatem A , Raslan Ahmed M , Basha Ahmed Kamel
Published: July 2024

Background

Facial pain is a common condition with a worldwide prevalence of 10-25% in adults. It often us a serious condition that can have a significant impact on patients’ daily life activities. The three main categories of facial pain are trigeminal neuralgia, trigeminal neuropathic pain and persistent idiopathic facial pain. To date, trigeminal neuropathy remains a potentially surgical pathology for the purpose of pain control with poor response to medical treatment.

Aim and Objectives

The aim of this study is to present our experience in the management of different pathologies of trigeminal neuropathy and to review the effectiveness and long-term efficacy of the different surgical procedures.

Subjects and Methods

This is a mixed prospective-retrospective study conducted at Ain Shams University (ASU) hospital and Oregon Health and Science University (OHSU) during the period from December 2012 till July 2020 for the retrospective part and from January 2019 till September 2021 for the prospective part. Patients with neuropathic facial pain treated during this time frame were included in the study.

Result

28 patients were included in this study. They underwent 40 surgical interventions for the management of different categories of trigeminal neuropathy. Neuro-modulatory procedures were performed in 9 patients (3 ucSCS and 6 PNS) while neuro-ablative procedures were performed in 19 patients. Median time to pain recurrence after SCS device implantation for the neuropathic trigeminal neuralgia was 19.5 months. For the patients treated with PNS, 2 out of 6 of patients had satisfactory pain relief, whereas half of the patients had no improvement. Overall median time to pain recurrence after CT guided T/N was 5.6 months. In the cohort of patients treated with caudalis DREZ, 4 patients out of 6 had grade I pain relief at last follow up and the overall median time to pain recurrence was 3.9 months.

Conclusion

Trigeminal neuropathy is a difficult to treat entity of facial pain syndromes. Although many neuro- modulatory and neuro-ablative interventions are available in the armamentarium for the treatment of such pathology, outcomes remain suboptimal. Pain relief in the immediate postoperative period is usually higher than at last follow up which is a common finding in after these interventions. The long-term efficacy of most available interventions does not meet patients’ satisfaction.
Effect of Tethered Cord Release on Progression of Pediatric Scoliosis: A Systematic Review
Authors: Fathy Ismail Ibrahim Ismail , Mohamed Ismail Mohamed Awad , Hamza Emad Mamoun , Iskander Tawadros Sameh Roshdy
Published: July 2024

Background

Tethered cord syndrome is one of the intraspinal anomalies, caused by abnormal fixation of the spinal cord and classically result in low-lying and immobile conus medullaris. The incidence of TCS is estimated to be 0.05 to 0.25 per 1000 births. That abnormal fixation of the spinal cord may result from many causes, including intraspinal lipoma, lipomyelomeningocele, tight or thickened filum terminale, or scarring from previous myelomeningocele repair.

Methodology

All available studies concerning tethered cord associated with scoliosis and the progression rate of scoliosis after release of tethered cord including randomized controlled studies, cohort studies, and case series was reviewed in addition to the references of the included articles. Systematic reviews, technical notes, letters, and comments was excluded. Studies not written in English was excluded. Patients since birth up to 16 years old, patients with tethered cord associated with scoliosis.

Results

The current evaluation reveals that tethered cord release improve\stable the scoliosis angle by only 47% and 40% of patients required fusion despite the untethering, there are other factors affecting the progression such as riser grade and age.

Conclusion

Nevertheless, the lack of good quality evidence and scarcity of the literature on the topic was also propounded by this review. Prospective, randomised and multicentre RCT’s are required to establish the effect of this procedure on the progression of the deformity.
Neuromodulation in Management of Patients with Failed Back Surgery Syndrome. An Outcome Assessment Study
Authors: Simry Hisham A , Abdelbar Ahmad E , Nagaty Ahmed M , Raslan Ahmed M , Elkholy Mohamed Amgad
Published: July 2024

Background

Failed back surgery syndrome (FBSS) is a constellation of conditions that describes persistent or recurring low back pain following spine surgeries with a reported point prevalence in the general adult population of 37% and a lifetime prevalence of between 60% and 85%. It always has a significant impact on patients’ quality of life. Neuromodulation such as spinal cord stimulation has been showing significant effect and improvement in pain scores and functional capacity of the FBSS patients with a reflected effect on their daily activities and quality of life.

Aim and Objectives

Our aim in this study is to assess the change in pain scores, quality of life and opioid medications intake as an outcome of neuromodulation procedures performed to patients diagnosed with failed back surgery syndrome, and to detect the post procedure complications.

Subjects and Methods

This is a mixed prospective-retrospective study conducted at Ain Shams University (ASU) hospital and Oregon Health and Science University (OHSU) hospital during the period from September 2019 till December 2022. Patients who are 18 years old or older diagnosed with FBSS for more than 6 months and treated with spinal cord stimulation with successful trials during this time frame were included in the study.

Results

34 patients were included in this study who had successful SCS trials and underwent a permanent implantation of SCS devices with post procedure follow up period of 12 months. Patients showed median pain numerical rating scale (NRS) of 7/10 at baseline with median NRS of 4/10 through the follow up period, also, there was a significant improvement of functional capacity using metabolic equivalent assessment with 74% of patients became moderate capacity compared to 32% at baseline. Quality of life assessed by activity measure of post-acute care (AM-PAC) showed significant improvement from mean of 16.87 ± 2.74 at baseline to mean of 19.97 ± 2.93 through follow up. Also there was a significant reduction of opioid medication usage. Post procedure complications was of low percentage with the most commonly detected were battery dysfunction in 7 patients and pocket pain in 6 patients. Reoperation was needed in 13 patients with 4 needed just revision and 9 patients required a complete removal of the device.

Conclusion

Failed back surgery syndrome is a widely described chronic pain condition which has a negative impact on the patients’ quality of life and daily activities with an evidenced effect on chronic use and abuse of opioid analgesic medications. We presented in our study that SCS could be offered as an effective modality of treatment with a statistically significant reduction in pain scores and a significant improvement in functional capacity and quality of life. Also, it has a recognizable but not statistically significant reduction in opioid analgesic medications and a very low percentage of procedure related complications.
Pregnancy Outcome in Pregnancies Complicated by Fetal Growth Restriction and Severe Preeclampsia
Authors: Ali Hassan Mohamed , Adly Elbishry Gaser Mohamed , Sweed Mohamed Samir , Rasheedy Ali Radwa
Published: July 2024

Background

common pathophysiological feature favors parallel occurrence of severe pre-eclampsia (PET) and fetal growth restriction.

Objective

To identify pregnancy and neonatal outcome differences between early-onset and late-onset preeclampsia, in relation to fetal growth restriction (FGR)

Methods

this retrospective study included 50 singleton pregnancies with FGR and severe PET who were admitted in Ain Shams University Maternity Hospital. Fetal growth restriction was defined as EFW and/or AC < 10th percentile. Preeclampsia with severe features included patients with systolic BP ≥ 160 mmHg, diastolic BP ≥ 110 mmHg, elevated liver transaminases twice the normal values, elevated serum creatinine twice the normal levels, or > 1.1mg/dl, HELLP syndrome, features of impending eclampsia, pulmonary edema, and/or thrombocytopenia with platelets level < 100 x 109/L. obstetric and neonatal outcomes were compared in early and late onset PET.

Results

The current study revealed that there was no difference between early and late onset PET in fetal and pregnancy outcomes while there was significant difference in neonatal outcomes.

Conclusion

the current study showed that risk of adverse neonatal outcomes as respiratory distress syndrome and neonatal death were higher in cases with early onset PET.