bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Functional Gastrointestinal Disorders among School-aged Children and adolescents, A Multicenter Study
Authors: Ibrahim A T A , Hamdy A M , Elhodhod M A
Published: May 2020

Background

The term Functional Gastrointestinal Disorder ‘(FGID)’ defines several and variable combinations of recurrent or chronic gastrointestinal (GI) symptoms that do not have an identified underlying pathophysiology. Without an objective marker, the classification of FGIDs depends on symptoms.

The aim of the Work: To measure the prevalence of FGIDs among a representative sample of school-aged children/adolescents aging 4-18 years, to determine the socio-demographic characteristics of children affected by FGID and to assess the effect of FGIDs on health-related quality of life concerning both the child and the parent/caregiver.

Patients and Methods

The present cross-sectional study included 1082 Egyptian children/adolescents with age varying between 4-18 yrs. They were randomly selected among those attending primary, preparatory and secondary schools at Cairo, El-Gharbya and El-Sharqia governorates in the period from September 2017 to September 2018. Each child was subjected to clinical history taking, assessment of socioeconomic standard of family, assessment for presence of FGIDs using an Arabic translation of “Rome 4 diagnostic Questionnaire for pediatric functional GI disorders” and using Arabic translation of HRQOL score which included social and school functioning to study the effect of FGIDs on quality of life of children and parents.

Results

Mean age for screened children was 8.05 ± 3.03 years. 574 (53.1%) were males. The prevalence of FGIDs among studied children was 30.4%. Irritable bowel syndrome (IBS) was the most common type of FGIDs (11.6%), followed by functional constipation (8.4%), then functional dyspepsia (4.6%). Late order of birth and more members in the family, lower income per capita were all significantly related to positive FGID diagnosis. Children with FGID had lower scores for health-related quality of life (HRQOL).

Conclusion

FGIDs are common in school-aged Egyptian children/adolescents; IBS is the most common. Risk factors associated with having FGID include increased family members and decreased income per capita. FGIDs adversely affect the HRQOL of patients.
Growth hormone and ghrelin status in autistic children
Authors: Abozaid H M , Algohary E A A , Zaky E A , Mahmoud R A A
Published: May 2020

Background

Autism spectrum disorders (ASD) is a neurodevelopmental disorder with multifaceted etiology; with the hormonal imbalance playing an important role. Recent evidence suggests that plasma levels of Growth Hormone (GH) and ghrelin are altered in autistic children. Both hormones play a role in mucosal integrity which is crucial in immune tolerance. Ghrelin also modulates neuroinflammatory and apoptotic processes, thus both may have an impact on pathogenesis of autism.

Aim

To study the GH and ghrelin status in children with ASD and their relation to anthropometry and clinical phenotype.

Patients and Methods

This is a cross-sectional case-controlled study that included 45 children (30 males and 15 females) diagnosed with ASD compared to 30 age, sex and pubertal stage matched clinically normal controls. Psychometric evaluation including DSM 5, IQ, and CARS were done for the patients, while serum Acyl ghrelin, GH levels and anthropometric measurements were done for both the patients and controls.

Results

Compared to controls, patients had significantly higher weight and BMI (19.07 ± 4.56 kg versus 23.66 ± 11.44 kg, p 0.004) and (16.20 ± 0.89 kg/m2versus 17.94 ± 4.22 kg/m2, p 0.003) respectively. Ghrelin levels were significantly lower in our cases (7.04 ± 3.95 versus 1.90 ± 0.82, p 0.000) with significant positive correlation to the age. GH levels were also significantly lower in our cases (5.86 ± 2.21 versus 2.99 ± 1.51, p 0.000) with significant negative correlation to their CARS score.

Conclusion

Children with ASD have lower levels of ghrelin, GH compared to their normal counterparts. These findings support the hypothesis that hormones may modulate pathogenesis of autism, thus may play a key role in diagnosis and treatment response.
Anti-myelin oligodendrocyte glycoprotein antibodies in an Egyptian boy with recurrent paraplegia
Authors: Mohammed M Z R , Kevin R , Tomoum H Y
Published: May 2020

We report a case of NMOSD anti-MOG demyelinating disorder in a 5-year-old male.

Case presentation

A previously healthy 5-year-old male presented due to secondary inability to walk and incontinence. Initial neuroimaging identified demyelinating lesions of both corona radiata and centrum semiovale with intramedullary abnormal signal intensity opposite C5 and a long segment at upper dorsal spinal cord extending from D2 to D4. The patient received oral steroid with complete resolution of his symptoms. 2 years later, the patient presented with quadriparesis and incontinence. MRI brain and cervical spine revealed multiple cerebral demyelinating lesions and intramedullary high signal intensity opposite most of cervical spinal cord. After a course of oral steroid, the patient showed complete resolution of his symptoms except for mild right-hand weakness. CBC, ESR, ANA were normal. Aquaporin- 4 was negative. VEP showed mild bilateral optic nerve affection. CSF revealed no cells with no abnormal oligoclonal bands, but high IgG index was detected. As a result, IV methyl-prednisolone was initiated. Four months later, the patient presented with sudden diminution of vision. MRI brain showed bilateral symmetrical occipital T2 hyperintense signal. Anti-MOG antibody evaluation was positive. The patient received IV methyl-prednisolone and was commenced on mycophenolate mofetil. He showed complete clinical remission with no relapses.

Conclusions

This case outlines the management of anti-MOG demyelinating disorder. Understanding the presentation of this clinical entity may allow for earlier intervention and diagnosis with concomitant reduction of morbidity.
Assessment of Toll Like receptor 2 Gene Polymorphism in Children with B Cell Defects and Respiratory Tract Infections
Authors: Mahana N A A , Reda S M , Kamel T B , Elfeky R A , Erfan D M , Kamal T M
Published: May 2020

Acute respiratory tract infections are the most common illnesses in childhood. Respiratory defenses against infection involve a diverse and complex system. Toll-like receptors (TLRs) are a type of pattern recognition receptors (PRRs), recognize pathogen-associated molecular patterns (PAMPs), resulting in initiation of innate immune response and promotion of adaptive immunity. TLR single nucleotide polymorphisms (SNPs) impair the ability to respond properly to TLR ligands and increase susceptibility to infectious or inflammatory diseases. The aim of the work: To examine TLR2 Arginine 677Tryptophan (Arg 677Trp) and Arginine753Glutamine (Arg753Gln) gene polymorphisms in patients with recurrent or chronic respiratory tract infections with or without predominantly antibody deficiency (PAD). Subjects and methods: This cross-sectional case-control study included 30 patients with known PAD with/ or without respiratory tract infections, 20 non-PAD patients with recurrent chest infections and 20 age and sex-matched healthy controls. All children included in the study were subjected to full history taking, complete physical examination and laboratory investigations including CBC, serum immunoglobulins levels and genetic analysis of the TLR2 Arg677Trp and Arg753Gln polymorphisms. Computed tomography (CT) scan of the chest with contrast, pulmonary function tests (PFTs) and Bronchoalveolar lavage (BAL) fluid culture and sensitivity were performed to patients with recurrent and/or chronic chest infections. Results: There was a significant difference in the expression of Arg753Gln polymorphism (p 0.04) between PAD patients with and without recurrent chest infections. Patients with mutant or heterozygote state of this polymorphism had a short diagnosis lag (time elapsed between onset of symptoms and date of diagnosis). There was a significant relationship between this polymorphism and the duration of hospital admission (longer hospital stay in patients with mutant allele). A significant difference between non-PAD patients with recurrent chest infections and healthy controls regarding Arg 677 Trp polymorphism (p 0.04) was elicited. Conclusion: Our results suggest that Arg 677 Trp polymorphism could be a risk factor for increased susceptibility to recurrent and /or chronic respiratory tract infections in patients without PAD, while Arg753Gln polymorphism might be an additional risk factor for severe infections in PAD patients.
Evaluation Of Serum Neurotensin Level In Fatty Diet Induced Obesity
Authors: Moharram J , Elhelow M , Ghoneima E I , Elmikkawy M E D
Published: May 2020

Introduction

Neurotensin is expressed in the brain as well as it is localized in specialized enteroendocrine cells of the small intestine.

Objectives

This paper aims to evaluate the serum level of neurotensin in various grades of obesity and it’s relation to fatty diet.

Patients and Methods

A sample of 60 patients were subjected to Full medical History, bowel habits , detailed dietary habits (Detailed fat-intake questionnaire) and body mass index (BMI). Also serum neurotensin , random blood sugar, thyroid profile and lipid profile were measured. Patients were subdivided into four groups according to their degree of obesity as follow: fifteen overweight patients, fifteen obese class I patients, fifteen obese class II patients and fifteen obese class III patients. Twenty five apparently healthy non obese individuals of matched age and sex were taken as a control group.

Results

Our study revealed 84% rise of the mean NT in cases compared to controls with highly statistical significant difference. Significant positive correlation was found between serum neurotensin, high cholesterol, low HDL and total fat intake questionnaire. But no correlation was found between serum neurotensin and TGs, LDL, age and sex.

Conclusion

Our limited data suggest that serum neurotensin may play a potentially important role in the development of obesity in people with high BMI consuming fatty diet.
Serum and synovial fluid levels of matrix metalloproteinase-3 as a biomarker of joint damage in patients with rheumatoid arthritis
Authors: Hafez E A , Elbakry S A , Abdelrahman M A , Sakr H M , Mohamed N A , Khalil S
Published: May 2020

Background

Rheumatoid arthritis (RA) is one of the systemic autoimmune diseases characterized by chronic synovitis and progressive joint destruction leading to decline in functional capacity, eventual work disability, and reduced quality of life. Considering the common disease activity indicators are unspecific for arthritis, novel biomarkers have been rapidly developed for predicting structural destruction progression in RA. Matrix metalloproteinase-3 plays a special role in rheumatoid arthritis pathogenesis and has been suggested as a marker of disease activity and joint damage.

Patients and Methods

MMP-3 was measured by ELISA in serum samples of 40 early RA patients and compared to age and sex matched control group of 40 healthy volunteers. Synovial levels of MMP-3 were measured only in 8 RA patients, who were indicated for knee arthrocentesis. Joint damage was assessed using SENS score on plain radiography.

Results

Serum MMP-3 levels were significantly higher in RA patients than healthy volunteers (P-value <0.001). Measured synovial levels of MMP-3 were significantly correlated to the serum levels. There were statistically significant positive correlations between serum MMP-3 with RF titers, AntiCCP titres, CRP, and DAS28 -ESR activity score. There was no significant correlation to total SENS score. ROC curve was used to define the best cut off value of serum MMP3 to discriminate between RA and healthy controls, which was found to be >50ng/ml.

Conclusion

Serum levels of MMP-3 can be used as noninvasive biomarker of RA, and also indicator of disease activity in early RA patients.
Combined Sensory Index Test versus Diagnostic Ultrasonography in Early Detection of Carpal Tunnel Syndrome
Authors: Mustafa M M M A , Nassar N , Amen I , Abdelmohsen H
Published: May 2020

Objectives

to evaluate combined sensory index test (CSI) versus diagnostic ultrasonography in early detection of carpal tunnel syndrome.

Patients and Methods

case control cross sectional study was performed on twenty patients with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months and twenty apparently healthy volunteers included as a control group. All patients and controls were assessed and underwent ultrasound of the wrist and electrophysiological testing. Data from patients and control groups were compared to determine the diagnostic relations in patients with CTS.

Results

This study include 20 Patient with ages ranged from 25 to 45 with mean±SD (36.8±6.1) years with symptoms and signs suggestive of carpal tunnel syndrome with duration 1 to 4 months. The control group ages ranged from 25 to 45 with mean±SD (57.63±6.41) years.

Our results revealed that CSI ranged from (0.7-1.9ms) with mean ± SD (1.36± 0.366) in CTS group and ranged from (0.2-0.8ms) with mean ±SD (0.59± 0.187) in control group (P < 0.001), cutoff point was > 0.8ms with sensitivity 85%, specificity 100% and accuracy 97.5%. Our diagnostic ultrasound results revealed that Inlet Outlet Ratio of CSA of median nerve ranged from (1-1.6) with mean ± SD (1.26 ± 0.226) in CTS group and from (0.7-1.1) with mean ± SD (0.92 ± 0.134) in control group (P < 0.001) with sensitivity was 80%, specificity 70% and accuracy 85%. By combination of both electrodiagnostic test (CSI) and diagnostic ultrasound (IOR) in early detection of CTS, our results revealed highly statistically significant difference between patient and control groups (P < 0.001) with sensitivity 100%, specificity 70%, and accuracy 85%.

Conclusion

Combined sensory index (CSI) is indicated in suspected cases of CTS with positive symptoms and negative signs. US is not an alternative diagnostic tool to electrodiagnostic tests but they are complementary.
The Role of Prolotherapy in Fibromyalgia Patients
Authors: Elsheshtawy N , Fouda N , Nassif M , Ahmed N
Published: May 2020

Objectives

To assess the potential role of prolotherapy in treating the most tender points of FM patients as a trial to improve symptoms.

Patients and Methods

20 primary FM Patients were injected with 3 cc of 25 % dextrose with 2 cc of 1 % lidocaine and then filled to 6 cc total volume with saline, making dextrose concentration of 12.5%, with 0.5 ml of the solution prepared per point,with a maximum of 6 points/ session. - Follow up visit were required every two weeks for other injections over a course of six weeks (duration of healing cascade). After 6 weeks, patients were assessed using NRS, FIQ VAS , MFI - 20 , SQS and PHQ-9 scales.

Results

As regard number of tender points, there was a highly Statistically significant P- value (<0.001) between number of tenderpoints (6-16) before injection, which decreased to (5-9) after injection, with a change of 34.17%. As regard whole body average pain, there was a highly Statistically significant difference (<0.001) between NRS before injection(5-10), which decreased to a range of (2-6) after injection, with a change of 39.57%. PHQ-9 scale total score showed a highly Statistically significant difference (P – value<0.001), ranging from (15-22) pre injectionand dropped to (10-18) post injection, with an improvement of 25.37%.

Conclusion

Prolotherapy may offer great therapeutic advantages for FM patients, as it is well tolerated with minimal or no side effects. Moreover, prolotherapy injection reduces pain intensity and functional disability in daily life activities.
Vitamin D Promotes Adiposity But Improves Associated Metabolic Derangements In An Obese Rat Model
Authors: Mohamed N A , Seif A A , Abdelhamid M S , Eissa R S A
Published: May 2020

Background

Obesity is a worldwide problem and is a major risk factor for chronic diseases. The relation between obesity and vitamin D is not completely understood. Obesity is associated with vitamin D insufficiency. Some studies claim that vitamin D may reduce lipogenesis and others claim that vitamin D can promote adipogenesis.

Aim of the study

This study was planned to evaluate the effect of alteration in vitamin D level on body weight and adipose tissue metabolism in an obese rat model.

Methods

32 Female Albino-rats were randomly allocated into: control group (C, n = 8), fed on control diet containing 1000 IU vitamin D/kg diet, and a high caloric diet group (HCD, n = 32). The HCD group was further subdivided into 3 groups according to the vitamin D dose into: standard vitamin D dose group (HCD+SVD) containing 1000 IU vitamin D/kg diet, low vitamin D dose group (HCD+LVD) containing 25 IU vitamin D/kg diet and high vitamin D dose group (HCD+HVD) containing 5169 IU vitamin D/kg diet. Body mass index, serum vitamin D, glucose, lipid profile, TNF-α and adipose tissue UCP-1 were measured. Different fat depots were weighed and histopathologically assessed.

Results

HCD+HVD group showed a significant increase in the final body mass index and in the different fat depot weights compared to all groups. Compared to the HCD+SVD group, the HCD+HVD group showed significantly lower serum total cholesterol and LDL-c levels, while it showed a non-significant change in serum glucose, TNF-α and visceral adipose tissue UCP-1. A significant negative correlation was found between serum 25(OH)D and visceral adipose tissue UCP-1. HCD+LVD showed the highest visceral adipose tissue UCP-1 compared to all groups.

Conclusion

Vitamin D promoted adiposity and decreased visceral adipose tissue UCP-1 but improved the associated derangements in lipid profile.
Probiotic versus Symbiotic in cardiac protection against indoxyl sulphate and urea toxins in experimental model of chronic kidney disease in rats
Authors: Abdelsalam D , Elkafory B
Published: May 2020

Background

The occurrence of reno-cardiac syndrome is associated with poor clinical outcome. Uremic toxins in chronic kidney diseases disrupt intestinal equilibrium and increase aerobic bacteria/anerobic bacteria ratio. As a result indoxyl sulphate level in blood increases and contributes to pathogenesis of reno-cardiac syndrome. Probiotic and symbiotic are anerobic bacteria that correct the intestinal equilibrium.

Aim of work

We aimed to study the pathogenesis of reno-cardiac syndrome and compare the possible protective effects of probiotics and symbiotic.

Design

48 white albino rats were assigned into 6 groups: Sham group, 5/6 nephrectomy, early and late probiotic treated nephrectomy rats, early and late symbiotic treated nephrectomy rats.

Methods

Heart was exposed to 30 min ischemia followed by 30 min reperfusion. PT, TPT, HRT, HR and CBF were measured at 5, 15 and 30 min of reperfusion. We measured serum levels of creatinine, urea, indoxyl sulphate, and heart tissue level of TGF-β and NADPH.

Results

uremic toxins, TGF-β and NADPH levels were significantly increased in all groups compared to sham group. In treated groups, uremic toxins significantly decreased while TGF-β and NADPH levels increased compared to nephrectomy group. PT, TPT, HRT, HR and CBF of the heart at 30 min reperfusion were decreased in nephrectomy group compared to sham one, while these functions were improved in treated groups compared to nephrectomy one.

Conclusion

Use of probiotic and symbiotic in reno-cardiac syndrome can protect the heart by improving the intestinal barrier, antioxidant effects and decreasing indoxyl sulphate level. Symbiotic had better outcomes than probiotic.
Effect of Mesenchymal Stem Cells Therapy on Cardiovascular Risk in Experimental Diabetic Kidney Disease
Authors: Nagib E M , Abuzahra F A , Seif A A , Ahmed M A , Hamed G M
Published: May 2020

Background

Bone Marrow-derived Mesenchymal stem cells (MSC)s were experimentally used in treating diabetes mellitus (DM) and its complications, particularly, diabetic kidney disease (DKD). Cardiovascular diseases are the leading cause of mortality in diabetic patients, which has been strongly associated with progression of DKD.

Aim

This study was designed to explore the effect of MSCs in modulating cardiovascular risk factors that develop with DKD.

Study Design

60 adult female albino rats were allocated into three groups: control group, untreated diabetic kidney disease group (un-DKD) and MSCs treated diabetic kidney disease group (MSC-DKD). DM was induced by a single dose of Streptozotocin at a dose of 35mg/kg, then rats were sacrificed 8 weeks later. MSC-DKD rats were treated by IV injection of bone marrow-derived MSCs 4 weeks after DM induction. DKD establishment was confirmed by histopathological kidney changes and elevated plasma creatinine and urea in both un-DKD and MSC-DKD rats.

Methods

Blood Pressure and lipid profile were measured, and atherogenic index was calculated to assess cardiovascular risk accompanying the progression of the diabetic renal damage. Moreover, aortic reactivity studies were performed in vitro.

Results

A single MSCs injection to MSC-DKD rats resulted in significant decrease in final blood glucose, mean arterial blood pressure and atherogenic index, together with a significant increase in plasma HDL level compared to untreated rats, thus minimizing cardiovascular risk factors. MSC-DKD aortae also exhibited significant enhancement of vascular reactivity parameters, particularly vasorelaxation which could partially explain the improvement of blood pressure. On the other hand, DKD didn’t improve by MSCs therapy. These results conformed to tracking labelled MSCs which were found in abundance in both aortic and pancreatic tissues and absent in kidneys.

Conclusion

MSCs therapy holds hope of improving cardiovascular risk and mortality for diabetic patients with diabetic Kidney disease.
Sex Differences in Metabolic Responses to Chronic Immobilization Stress in Rats
Authors: Bahaaeldein I M , Aboubakr D A , Lasheen N N , Soliman N B E , Ahmed M A
Published: May 2020

Background

Responses to stress could range from homeostatic variations to life-threatening effects depending on the type, timing and severity of the applied stimulus. Gender is accompanied by variations in oxidative stress, which causes the development of metabolic diseases. Under physiological conditions, females were found to be less susceptible to oxidative stress.

Aim of work: This study was conducted to highlight the sex differences in the metabolic responses to chronic immobilization stress in rats, and to elucidate the possible underlying mechanisms.

Materials and Methods

Forty adult Wistar rats of both sexes; were randomly divided into 2 main groups: control group and stressed group, each of which was further subdivided into male and female groups. Stressed groups were exposed to chronic immobilization for 4 weeks. All rats were subjected to determination of body mass index, visceral fat weight, absolute and relative weights of liver and pancreas, plasma glucose, glucose uptake by diaphragm, glucose output by kidneys, lipid profile and plasma levels of insulin, leptin and sex hormones, malodialdehyde (MDA), total antioxidant capacity (TAC) and nitrite. HOMA-B and HOMA-IR were calculated. Also, caspase 3 was assessed in pancreas by immunohistochemistry.

Results

Stressed male rats showed lower BMI, higher relative liver weight, dyslipidemia, fasting hyperglycemia, higher glucose output by kidneys, lower glucose uptake by diaphragm, HOMA-B and plasma levels of insulin, testosterone and TAC and higher plasma estrogen and MDA levels compared to the control male group. Compared to the control female group, stressed female rate exhibited hyperglycemia, hypoinsulinemia, dyslipidemia, oxidative stress, higher plasma sex hormones. Compared to stressed male rats, stressed female group showed significantly higher BMI percentage change and plasma levels of TAC, estrogen and testosterone, but significantly lower absolute liver weight, glucose output by the kidneys, plasma levels of total cholesterol and triglycerides, and atherogenic index.

Conclusion

Chronic immobilization stress imposes greater hyperglycemic and hyperlipidemic status in males than in females. The altered sex hormonal pattern and lowered antioxidant defences could be contributory mechanisms
Correlation between Serum and Tissue Levels of Adipokines in Obesity in Adult Male Rats with and without Antioxidant
Authors: Elshawwa M M
Published: May 2020

Background

Obesity is associated with insulin resistance, type2 diabetes, dyslipidemia and cardiovascular diseases. Apelin and chemerin are identified as adipokines and adipose tissue markers. Several adipose-derived peptides are known to influence food intake, including apelin, whose expression is regulated by insulin and chemerin. Oxidative stress thought to be involved in the development of complications associated with obesity.

Objective

To study the nature of correlation between serum and liver levels of apelin, chemerin and oxidative parameters in obese rats with and without antioxidant. Aiming to clarify the pathophysiology of obesity.

Material and Methods

Thirty adult male albino rats, divided into three equal groups.

Group I (control), group II (obese) and group III (obese and Lepidium sativum (LS) as an antioxidants). At the end of the experiment, blood samples were collected for estimation of the serum levels of chemerin, apelin, fasting glucose, insulin, insulin resistance (IR), lipid profile, reduced glutathione (GSH) and malondialdehyde (MDA). In addition to tissue homogenous extracts of liver were taken for the levels of MDA, CAT, chemerin and apelin.

Results

After eight weeks, high fat diet group showed a significant increase in serum levels of apelin, chemerin, fasting glucose, insulin, IR, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) & MDA and a significant decrease in high-density lipoprotein cholesterol (HDL-C) & GSH. HFD also caused a significant increase in tissue levels of MDA, CAT & chemerin and a significant decrease in apelin, compared to control group.

While addition of LS to HFD caused a significant decrease in serum levels of apelin, chemerin, fasting glucose, insulin, IR, TC, TG, LDL-C & MDA and a significant increase in HDL-C & GSH. LS also caused a significant decrease in tissue levels of MDA, chemerin & insignificant decrease in CAT and a significant increase in apelin, compared to HFD group.

Conclusion

This study showed a significant positive correlation between liver & serum chemerin and between liver and serum MDA. On the other hand, it showed a significant negative correlation between liver and serum apelin and liver CAT and serum GSH
Role of Transvaginal Ultrasound in Detection of Endometrial Changes in Breast Cancer Patients under Hormonal Therapy
Authors: Hetta W , Samy A , Romeih M , Salah A
Published: May 2020

Background

Hormonal therapy is widely utilized as adjuvant therapy in women diagnosed with breast cancer, in those patients, Despite its positive risk/benefit ratio, It may cause secondary effects on the endometrium, Including endometrial atrophy, Endometrial polyp, Endometrial hyperplasia, and up to Endometrial carcinoma.

Aim of the Work

We aim to determine the role of TVUS in detection of endometrial changes.

Aim and Patients and Methods

Cross sectional Prospective study. We analyzed the data from previous scans and current scan and correlate it with the results of histopathology. All US examinations were performed by our senior radiologists at radiology department of Helwan university hospital. Study period from March 2018 to November 2018.

Results

The study group comprised 50 patients with breast cancer who were treated with tamoxifen for a period ranging from 3months to 5 years, by TVUS endometrial thickness measurement was ranging from (3 to 30 mm) the mean is 10.22 mm and standard deviation ± 5.76 mm, all patients were examined by TVUS, gynecological examination and they were candidate for endometrial biopsy either by D&C or hysteroscopic resection. Their histopathology results were: normal endometrium with no changes (52%), endometrial hyperplasia (14%), endometrial polyp (14%), adenomyosis (10%), endometrial atrophy (6%) and endometrial carcinoma (4) %.

Conclusion

We evaluated the correlation between tamoxifen therapy and endometrial benign and malignant conditions and correlate the findings seen in TVUS by the histopathological results .We concluded that TVUS is a necessary screening tool for detection of endometrial abnormalities in breast cancer patients under hormonal therapy.
Role of Pet/Ct In Follow Up of Post Therapeutic Colorectal Cancer
Authors: Mohamed M S , Nasr M A , Botros S M , Hafez A A
Published: May 2020

Background

Colorectal cancer (CRC) is one of the most common malignancies worldwide and is a major health problem in developed countries with local and distant recurrences develops in 30–50% of patients during follow-up after primary surgery.

Aim of Work

The present study is aiming at emphasizing the role of PET/CT in Follow up of patients with colorectal carcinoma after treatment, as well as detection of local recurrence and distant metastasis.

Methods

The study included 25 patients with past history of colorectal cancer, they underwent PET/CT examination with the following protocol: Patients were fasting for at least 6 hrs before undergoing scanning. A standard dose of 1-1.5 mCi/kg of F-FDG was intravenously injected 45-60 mins before imaging then initially low dose CT was performed for attenuation correction. After that PET emission scanning was performed immediately after the CT. This was followed by diagnostic CT using IV contrast administration and hyperosmolar oral contrast (diluted mannitol solution) to achieve bowel distension. All data acquired a combined PET/CT in-line system.

Results

The study showed that there is significant paired differences between the number of local lesions as well as metastatic deposition detected in the initial and follow up PET/CT.

Conclusion

FDG PET/CT is extremely useful for therapy response assessment due to its capacity to help distinguish between residual metabolically active tumor and areas of necrosis and fibrosis, thus identifying which of these patients have achieved satisfactory functional remission and which one of them needs further treatment.
The Role of Multi-slice CT in Preoperative Assessment of Temporal bone in patients prepared to cochlear implantation
Authors: Abdulrahman L A , Bakry A M O , Elghobashy M S A
Published: May 2020

Background

MDCT plays a critical role in evaluation and management of different causes of hearing loss which require many therapeutic techniques including cochlear implantation. In general, most causes of hearing impairment are best diagnosed using computed tomography scan of the temporal bone using bone algorithm and windowing techniques.

Patients and Methods

The study included a total of 20 patients referred to the Radiodiagnosis department from the E.N.T department in EL-Galaa Military Hospital. CT was done for assessment of the cochlear state prior to the cochlear implantation operation. The CT was used to delineate the different cochlear and middle ear anatomy and to orient and modify the surgical strategy.

Results

Only 18 patients from 20 patients underwent cochlear implantation, the other two cases were diagnosed as Otosclerosis & Bilateral longitudinal fractures. Patients with multiple other congenital anomalies in the external or internal ear had the cochlear implantation in the other ear (To raise the % of success).

Conclusion

MDCT is the technique of choice in preoperative assessment of patient of SNHL.
MRI versus Ultrasonography in detection of suspected placental invasion
Authors: Abdallah R H , Habib L A , Abdallah Y A , Seweed M S , Youssry N M
Published: May 2020

Purpose

of this study is to highlight the role of MRI and U/S in suspected placental invasion.

Methods

40 patients were included in our study. All clinically suspected patients with previous CS or surgical intervention were subjected to US and MRI.

Results

Our study demonstrated that MRI has a significant promising tool factor for detection of placental invasion degree with high sensitivity, specificity and accuracy and superior to ultrasound in detection of degree of invasion.

Conclusion

MRI imaging of the placenta is of high sensitivity the diagnosis of degree of invasion better than US which couldn’t accurately detect the depth of invasion. Another advantage of MRI is that it’s not operator dependent and gives better tissue characterization.
Evaluation of Different Regimens of New Direct Acting Antiviral drugs (DAAs) for treatment of Recurrent Hepatitis C Virus Infection after Liver Transplantation
Authors: Reda M A , Bahaa M M , Montasser I F , Shamkh M A
Published: May 2020

Aim of the work

To compare between different available regimens of DAAs (sofosbuvir/ daclatasvir and sofosbuvir / ledipasvir) regarding the efficacy and safety for treatment of compensated recurrent hepatitis C Virus infection after liver transplantation in Egyptian patients and to study the correlation between sofosbuvir / daclatasvir and sofosbuvir / ledipasvir and post-transplant complications.

Background

Liver transplantation is the only curative treatment for ESLD and HCC. Liver disease resulting from chronic HCV infection is the leading indication for liver transplantation. For patients with detectable HCV-RNA levels at the time of transplantation, postoperative recurrence of HCV infection was “immediate and universal.” Recurrent HCV infection follows an aggressive course and retransplantation frequently is associated with a poor outcome.

Patients and Methods

This prospective study was conducted on recipients, who underwent living donor liver transplantation in Ain Shams Center for Organ Transplantation (ASCOT) at Ain Shams University Specialized Hospital (ASUSH), Cairo, Egypt between June, 2016 and May, 2017. Data of the recipients, who underwent living donor liver transplantation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and received antiviral treatment were followed up monthly during their treatment and after finishing treatment for at least 3 months.

Results

Treatment of HCV recurrence in liver transplant recipients with SOF+DCV+RBV or SOF/LDV+RBV seems to confer high rates of SVR. There was no difference between both regimens regarding adverse events. Prolonged treatment of HCV recurrence after LDLT (24 weeks) was significantly associated with a higher SVR (P = 0.035).

Conclusion

Adding RBV to antiviral regimens in the treatment of HCV recurrence in liver transplant recipients doesn’t seem to add to the efficacy of DAAs. Adherence to prolonged course of antiviral treatment (6 months) when treating HCV recurrence post liver transplantation seems to be associated with higher rates of SVR than shorter course (3 months) with no increase in the incidence of adverse events or rejection episodes.
Evaluation of the Role of Early Second Look Cystoscopy after Complete Resection of Non-Muscle Invasive Bladder Tumors
Authors: Taema K A , Shabayek M , Tawfeek A M , Emam A M , Khafaga M M S
Published: May 2020

Background

most of the bladder cancers are non-muscle invasion at the time of diagnosis. Non-Muscle invasive tumors confined to the mucosa and invading the lamina propria are classified as stage Ta and T1, respectively, according to the Tumor, Node, Metastasis (TNM) classification system.

Aim of the Study

to determine the efficacy of early second look cystoscopy after complete resection of non-muscle invasive urinary bladder tumors and its impact on subsequent treatment policy.

Patients and Methods

this is a prospective clinical study that was done at Urology Department, Faculty of Medicine, Ain Shams University and Damanhur Oncology Centre. A total of 40 consecutive patients with newly diagnosed non-muscle invasive bladder cancer will be enrolled in this prospective study for second-look cystoscopy with TURBT in two to six weeks after initial TURBT and follow them up in one year.

Results

Single tumor was found in 22 cases (55%), while multiple tumors were recognized in 18 cases (45%) with average sizes ranging from 12mm to 70mm. Low-grade transitional cell carcinoma (TCC) was found in 26 cases (65%), whereas high-grade TCC was found in 14 cases (35%). Stage PTa tumors was found in 12 cases (30%) while 28 cases (70%) have had tumors of PT1 stage. All cases underwent an early second TURBT after (2-6) weeks which has reviled the following data. The majority of cases (28 cases) representing 70% of whole study population were free with no detection of any tumors either residual or recurrence. Residual tumors were detected in six cases (15%) all of which detected in patient with large primary tumor size exceeding 50mm or patients with multiple tumors. Whole detected residual tumors were found at edges of primary tumors ranging 2-5 mm in size which were completely resected and they were of the same stage and grade as the initial tumor.

Conclusion

Our findings in this study support the notion that second-look cystoscopy with or without TURBT is a prerequisite in patients with superficial bladder cancers except for patients with solitary, small low-grade pTa tumors. It is particularly highly recommended for patients with extensive and multiple tumors at the first TURBT
Semi-rigid Ureteroscopy and Holmium laser stone dusting for Proximal Ureteral Stones Does Adjuvant Tamsulosin Therapy Increase the Chance of Success?
Authors: Malky P H , Emam A M , Shaker H S
Published: May 2020

Background

Alpha blockers decrease peristalsis above and below the stone, which increases the urine bolus and intraureteral pressure above it and lowers intraureteral pressure below it in association with the decrease in basal and micturition pressure, even at the bladder neck; thus, it increases the chance of stone expulsion.We aim to evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance. Since our aim in ureteroscopic treatment of upper ureteric stones is laser dusting rather than stone retrieval, its possible that alpha blockers can improve the access to upper ureter and clearance of fragmented stones.

Objective

To evaluate whether peri-operative tamsulosin in stented ureteroscopic laser lithotripsy for proximal ureteric stones increase the procedure success rate of stone clearance.

Patients and Methods

This prospective, randomized, multicenter study included 60 patients and carried out between March 2018 and December 2018 in Police hospital Nasr City and Ain Shams University Hospitals included adult patients (at least 15 years) with proximal ureteral stones (≥ 5mm) scheduled for URS lithotripsy.

Results

In this study, the overall failure rate was 18.3%. In most cases 8/11(72.7%), failure of the procedure was due to the difficulty experienced in advancing the ureteroscope. We should mention that this technical problem was reported only in 2 (6.7%) patients receiving pre-URS tamsulosin but in 6 (20%) patients of the control group. The mean operative time in this series was significantly shorter operative time in Group 2(51.8min) compared to Group 1(58.8 min).At follow-up 4 weeks after URS, SFR was (86.7% for Group 2 and 66.7% for Group 1).

Conclusion

Adjunctive tamsulosin therapy prior to laser-assisted semi-rigid URS for the management of proximal ureteral stones improves ureteroscopic access, reduces the operative time and improves the SFR with an acceptable complication rate. Further research should be conducted on a larger scale to evaluate the various predictors of the outcome of URS and analyze the results with different pre-URS tamsulosin time periods in order to consolidate the results and to confirm the conclusion.
Effect of High Dose Tranexamic Acid and Etamsylate in Reducing Blood Loss during Trans-Urethral Resection of Prostate, Bladder Tumours and Percutaneous Nephrolithotomy
Authors: Safan A M , Samir M , Saeed A M , Farag A S I
Published: May 2020

Background

Bleeding is one of the most serious events that can occur intra-operative as well as post-operative in TURP, TURBT, PCNL and minimizing blood loss is of vital role in preventing or reducing morbidity and mortality following these procedures.

Aim of the Work

The aim of the present study was to to evaluate the efficacy of high dose tranexamic acid and etamsylate in reducing blood Loss during TURP, PCNL, TURBT and to determine if we can use them as a routine or not.

Patient and Methods

The study, was a prospective randomized control study, would be conducted on 70 patients admitted through the outpatient urology clinic in Ain shams University Hospitals and Nasser institute hospital. The 70 patients were divided into two main groups. Each one was 35 patients, each group is subdivided into 3 subgroups ((a)TURP,(b)PCNL AND (c)TURBT). Group 1 (all did not receive the combination of high dose tranexamic acid and ethamsylate) Group 2 (all received the combination of high dose tranexamic acid 2g per day and ethamsylate2.5g per day).

Results

We found that hemoglobin and hematocrit drop was significantly smaller in cases group and subgroups compared with the control group and subgroups, we also found that blood transfusion is reduced in control group and subgroups than in cases. Also procedure time was highly significant decreased in cases compared with controls. the high dose combination tranexamic acid 2g per day and ethamsylate2.5g per day was found to be safe without side effects especially thromboembolic side effects.

Conclusion

The study showed that High dose tranexamic acid and etamsylate is safe and effective in reducing blood loss during TURP,PCNL and TURBT. but we still cannot use them as a routine in all patients because our study is conducted on patients with selected criteria so further studies are needed.
Comparative Study between Negative Pressure Wound Therapy (NPWT) and Standard Moist Wound Dressing (SMWD) In Management of Diabetic Non- Ischemic Foot Ulcers
Authors: Zekri M G , Sabbour A S , Mahmoud M S , Abdelmohsen A F , Zaki M M
Published: May 2020

Background

Diabetic Foot Ulcer(DFU) is a common complication of diabetis that has shown an increasing trend over previous decades, 15% of patients with diabetes will suffer from DFU. and approximately 20% of hospital admissions among patients with DM are the result of DFU. Standard moist wound dressing (SMWD) is considered the traditional method for management of DFU. Supporting evidence for NPWT in the treatment of diabetic foot wounds include numerous prospective and multi-centered randomized controlled trials.

Aim of the Work

This study aimed to compare wound outcome, limb salvage between NPWT and SMWT in management of diabetic non ischemic foot ulcers.

Patients and Methods

This is a randomized controlled study involving 60 patients with active diabetic foot ulcers. A computer generated randomization pattern will be used to segregate the patients into 2 groups (NPWT and SMWD groups). Primary end point of the study is to achieve full healthy granulating wound (without necrotic tissues, bone or tendon exposure and without local signs of infection). follow up included change in wound diameter, depth, up or down scaling along UTWC, wound status every 2 weeks.

Results

there was a statistically significant difference in rate of depth improvement for the NPWT group in 2 and 4 weeks. In six weeks follow up, the rate of depth reduction was better in NPWT group but it wasn’t statistically significant (p-value 0.14). There was a statistically significant difference in reaching full healthy granulation in 4 and 6 weeks in favor of the NPWT group compared to the SMWD, there was no statistically significant difference in number of cases reaching full healthy granulation in 8 weeks as many cases of SMWD group started to achieve full healthy granulation. Number of bed side debridement or surgical debridement was not statistically significant between the 2 groups. major amputation was seen in 4 cases of the SMWD group, and one trans-metatarsal amputation and 2 toes amputation was seen in NPWT group and none of these was statistically significant.

Conclusion

NPWT use in DFU provides a significant reduction in duration till reaching full healthy granulation. No significant difference was observed in ulcer related complications such as infection, cellulitis, and osteomyelitis. However, the study showed that SMWD patients had more secondary amputations than those receiving NPWT but it wasn’t statistically significant
An evaluation of the effectiveness of teaching anatomy to rheumatologists through combined musculoskeletal sonoanatomy and human cadaveric dissection
Authors: Manghani Mona , Cheung Peter P , Mogali Sreenivasulu Reddy , Prakash Ashutosh , Chew Li-Ching
Published: May 2020

Objective

Our aim was to evaluate the effectiveness of teaching anatomy through combined musculoskeletal sonoanatomy and human cadaveric dissection for rheumatologists practising musculoskeletal US.

Methods

The principal focus was on scanning and then dissecting relevant musculoskeletal structures. Outcomes measured included confidence levels and objective knowledge. A mixed-methods approach of evaluation and descriptive statistical data analysis was performed.

Results

The change in confidence ratings by delegates after the teaching event as represented by the mean difference (s.d.) (s.e.m.) for identification of surface anatomy was 1.846 (1.281) (0.355), with Student’s paired t = 5.196 and P=0.000223. The mean difference (s.d.) (s.e.m) for performing IA injections was 1.538 (1.266) (0.351), with Student’s paired t = 4.382, P=0.001, and for recognizing sonoanatomical structures it was 1.769 (1.235) (0.343), with Student’s paired t  = 5.165 and P= 0.000235. There was a significant increase in correct identification of anatomical and sonoanatomical knowledge in the pre- and post-course assessments. Rotator cuff interval region improved from 13 to 73%, P  = 0.004; knee tendons insertion sites from 47 to 93%, P  = 0.016; and muscles not adjacent to joints from 27 to 93%, P  = 0.002.

Conclusion

Dissection of joints enabled a three-dimensional relational mind map of the relevant regions of the human body, producing clarity in understanding regional relational topographic anatomy and sonoanatomy. The combination of US and cadaveric dissection improved learners’ satisfaction, confidence and knowledge in areas where soft tissue complaints are common, which is likely to lead to accurate early diagnosis and cost-conscious, better overall care.
A clinical and radiographic comparison of patients with psoriatic arthritis from different ethnic backgrounds
Authors: Aslam Tariq , Mahmood Farrouq , Sabanathan Anetha , Waxman Robin , Helliwell Philip S
Published: May 2020

Objectives

There are few papers concerning ethnic differences in disease expression in PsA, which may be influenced by a number of genetic, lifestyle and cultural factors. This article aims to compare clinical and radiographic phenotypes in people of South Asian (SA) and North European (NE) origin with a diagnosis of PsA.

Methods

This was a cross-sectional observational study recruiting patients of SA and NE origin from two hospitals in a well-defined area in the North of England.

Results

A total of 58 SA and 48 NE patients were recruited. SA patients had a more severe clinical phenotype with more tender (median 5 vs 2) and swollen (median 1 vs 0) joints, more severe enthesitis (median 3 vs 1.5), more patients with dactylitis (24% vs 8%), more severe skin disease (median PASI 2.2 vs 1) and worse disease activity as measured by the composite Psoriatic Arthritis Disease Activity Score (mean 4.5 vs 3.6). With regards to patient-completed measures, SA patients had worse impact with poorer quality of life and function (mean HAQ 0.9 vs 0.6; mean PsAQoL 10.8 vs 6.2; mean 36-item short form physical component score 33.5 vs 38.9). No significant differences in current MTX and biologics use were found.

Conclusions

SA patients had a worse clinical phenotype and worse impact of disease than NE patients. Further studies are needed to confirm and explore the reasons behind these differences.