bluuebunny/crossref_metadata_2025_split huggingface dataset:
Graft and patient survival in portal vein thrombosis in living donor liver transplantation
Authors: Ramadan A M , Hytham N M , Mamdouh K K , Fathy A M 
Published: May 2020

Abstract

Background and Rational
To date, only few studies have evaluated the benefits of anticoagulation in individuals with cirrhosis. An obvious goal of anticoagulation is PV recanalization: when cirrhotic individuals with PVT are treated with anticoagulation, complete recanalization has been described in 33–45% while partial PV recanalization is observed in 15–35% of cases. LDLT has emerged as the alternative life-saving treatment to DDLT. Over the past 2 decades, the number of LDLTs has steadily increased in many transplant centers, especially in Asia. The separation between occlusive and non-occlusive thrombosis is very important; in patients with partial PVT, post-transplant mortality outcomes are no different from non-PVT patients but it is significantly increased in patients with complete PVT.

Patients and Methods
This randomized prospective study will include 79 patients who will undergo LDLT in Ain Shams Specialized and Egypt Air hospitals, there are two groups of patients according to presence of portal vein thrombosis or not group A 39 patients of non PVT and group B 40 patient of PVT including different grades of PVT according Yerdel classification.

Results
In this study, there is no significant difference between groups regard age but Males were significantly associated with group B. In this study, there is no significant difference between groups regard CHILD and MELD scores and this findings. In our study there is no significantly difference between groups A and B regarding ICU stay, hospital stay and cell saver. In this study, comparisons of the PVT patients and controls showed no statistical significant differences regard HA thrombosis, post operative pulmonary embolism and biliary leak but PV rethrombosis is significantly associated with PVT patients, mortality sig associated with PVT patients.

Conclusion
The outcomes of patients with PVT who underwent LDLT are inferior to those without PVT. Patients with PVT has lower survival rate, higher postoperative PV rethrombosis.
Comparative study between Single Anastomosis Duodeno–Ileal Bypass with Sleeve Gastrectomy and Mini-Gastric Bypass Surgery for the Treatment of Morbid Obesity
Authors: Abdelhamid A , Albalkiny S , Abdel-Samee K , Mustafa A 
Published: May 2020

Abstract

Background
Metabolic and bariatric surgery is a proven therapy for the treatment of obesity and its related comorbidities. Malabsorptive operations usually offer a higher rate of metabolic improvement, despite higher rate of complications and secondary effects.

Objectives
To compare Single Anastomosis Duodeno–Ileal bypass with Sleeve gastrectomy (SADIS) and Mini-Gastric Bypass operation as two types of bariatric surgeries with regard to weight loss, metabolic outcome and nutritional deficiencies within one year of post-operative follow up.

Methods
We performed a prospective comparison of 40 morbidly obese patients submitted to SADIS (n. = 20) and MGB (n. = 20) between July 2016 to July 2017 with one year of postoperative follow up.

Results
The groups were nearly similar in terms of age and sex. The SADI-S group had BMI of (47.4 vs 46.1) with 100% prevalence of DM in both groups, hypertension in SADIS 70% vs 65% in MGB and almost equal incidence of dyslipidemia. The SADI-S group presented markedly higher percentage of EWL of 91.4% vs 71.6% after one year. Control of DM, with HbA1c below 6%, was obtained in 85% in both groups with more decrease in mean HbA1c of SADIS being 5.44 vs 5.815 in MGB after one year. Most patients abandoned antidiabetic therapy or at least were controlled by less medications and lower doses. The SADI-S group presented remission of hypertension by 90% of patients as those of MGB but with far less medications. Lipid profile improvement was noticed in both groups with slightly higher resolution in SADIS group by 95% vs 90% for total cholesterol, 85% in both groups for T.G, 80% vs 85% for LDL, 65% vs 70% for HDL in SADIS and MGB patients respectively. Although the nutritional deficiency is still a considerable concern after SADIS, ours study didn’t show intense difference from MGB provided that proper vitamin supplementation and patient compliance are maintained postoperatively.

Conclusion
When compared to gastric bypass, SADI-S appears to be an effective and safe therapeutic technique with excellent short-term results for treating morbid obesity and its associated comorbidities with a low rate of nutritional complications. Proving its safety and efficacy by further studies will grant it more popularity in the future.
The study of prognostic factors in resistant spontaneous bacterial peritonitis in cirrhotic patients
Authors: Abdelwahab K M , Yousry W A , Mansour K A , Mohammed S G 
Published: May 2020

Abstract

Background
Spontaneous Bacterial Peritonitis is the most common form of infection seen in-patient with cirrhosis and is responsible of hospital mortality rate of approximately 32%, the increasing trend of resistance associated with low treatment efficacy of traditional therapy in nosocomial infection. It has been considered a life-threatening infection that requires a prompt diagnosis and treatment.

Aim
To evaluate the effect of certain prognostic factors namely Child -Pugh score, MELD Score and isolated organisms by bacterial cultures & Identifying organisms responsible for resistant SBP will guide in modification of antimicrobial treatment regimen.

Methods
A prospective cohort Study was conducted on 100 Egyptian cirrhotic and Ascetic patients for whom suspected for Spontaneous bacterial peritonitis (SBP) with no prior antimicrobial treatment. SBP and RSBP(Resistant spontaneous bacterial peritonitis) was diagnosed through history-taking through examination, clinical assessment and laboratory investigations, including ascetic fluid study analysis and the detection of culture sensitivity, recruited from the Gastrointestinal and Hepatology Unit of Nasser Institute Hospital, over a period from December 2016 to April 2017.

Results
Our study showed that out of 100 cirrhotic and Ascetic, out of 100; 60 were diagnosed SBP, out of those 60 resistant SBP were diagnosed in 30 patients with culture positive that responded on 2nd line treatment; Meropenem; 1g IV (with dose modification according creatinine clearance level) every 8 h for 5 days are the cases group and remained 30 that respond on the usual 1st line treatment; 2g of intravenous (IV) Cefotaxime (CTX) every 8h for 5days; are the control group. We found that there was no statistical significant difference between the studied groups as regards age and sex, Fever and abdominal pain were the most frequent manifestations in both group.
There was statistically significant difference between both groups according to the grade of Ascites, Hepatic encephalopathy and at the peritoneal fluid analysis after 48 h of 2 gram of CTX for TLC and Neutrophil & also Cl, Glucose and LDH (P value&lt;0.05).
The RSBP prediction by Child score at cut off value ≥9.5 and the most frequent organism is Klebsiella in cultures results among RSBP which is being responded on Meropenem treatment.

Conclusion
RSBP associated with child c patients at cut off value≥9.5 so Child score is more useful as prognostic tool than MELD score although MELD score has higher accuracy prediction than Child score because it is vulnerable in Laboratory measurement.
Study of IL28B gene variation as a predictor of response to directly acting antiviral therapy in hepatic transplantation hepatitis C Egyptian patients
Authors: Badawy H M , Taha S S , Abdelrahman Y O , Gadallah S H , Samir R , Ghait S S 
Published: May 2020

Abstract

Background
IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients in the non-transplant setting.

Objective
To determine the prevalence and impact on clinical outcomes of donor and recipient IL28B genotypes among liver transplant recipients receiving directly acting antiviral therapy compared to those of HCV non-transplant patients.

Patient and Methods
This study included 60 patients divided into 2 groups: group 1 included 30 patients subjected to living donor liver transplantation and group 2 included 30 patients of HCV infection. Each group was subdivided into group A and group B according to the regimen of directly acting antiviral therapy (sofosbuvir-ledibasvir, sofosbuvir-daclatasvir). Liver transplantation was done between January 2016 and April 2018. Genotyping of the polymorphism was performed on DNA collected from all donors and recipients in group 1 before and after liver transplantation and also collected from all patients of group 2. Sustained virological response was found in 28 patients in group 1 (transplanted group) and 29 patients in group 2 (non-transplanted group) with no significant difference.

Results
No significant difference also was found in both groups according to the type of regimen. Also the type of genotype CC, CT and TT of IL28B in donors and recipients were not significantly associated or affecting the results of SVR in both groups of patients.

Conclusion
Our results support no role of recipient IL28B genotype in the response to directly acting antiviral drugs for hepatitis C recurrence. Interestingly, donor genotype seems not to influence the response pattern in recipients who have different IL28B genotype.
Effect of using Direct Acting Antivirals on the Synthetic Liver Functions in Treatment-Naïve Patients with Chronic Hepatitis C Virus Infection Genotype 4
Authors: Hamdy K , Ibrahim N , Safwat E , Elrefaei A 
Published: May 2020

Abstract

Background and aim of the study
Interferon-free direct-acting antivirals (DAAs) combination therapies, including sofosbuvir (SOF), daclatasvir (DCV) and paritaprevir -r/ombitasvir therapy with or without ribavirin, eradicate chronic hepatitis C virus (HCV) in a high percentage of patients, but its impact on improvement of synthetic liver function is unclear. The aim of this study was to evaluate the effect of DAAs on the synthetic functions of the liver in treatment- naïve chronic HCV genotype 4 patients who treated by different regimens of DAAs for 12 weeks and achieved a sustained virological response at 12 weeks after treatment completion (SVR 12).

Patients and Methods
From September 2017 to March 2018, 150 treatment- naïve chronic HCV genotype 4 Egyptian patients received different DAAs regimens for 12 weeks were enrolled for this prospective cohort study, to evaluate the effect of DAAs on serum albumin, total bilirubin, INR, prothrombin concentration and platelets count at the end of treatment (WK12) and at week 12 post treatment in comparison to baseline. Patients were categorized to three groups; Group 1 (easy to treat) included 60 patients treated by SOF/DAC regimen, Group 2 (Difficult to treat) included 60 patients treated by SOF/DAC + ribavirin regimen and Group 3 included 30 chronic HCV patients with chronic kidney disease (eGFR ≤ 30 ml/min and Haemoglobin level &gt;10g/dl) treated by Qurevo (paritaprevir-r/ombitasvir) + ribavirin and all included patients were treated for 12 weeks and achieved a sustained virological response at week 12 post treatment (SVR 12).

Results
There was a statistically highly significant improvement of serum albumin, total bilirubin, PC and INR (P = 0.001) among groups 1 and 2 patients at both time points _the end of treatment and WK12 post treatment_ (except for s. total bilirubin; P value was 0.11 at the end of treatment as compared to baseline). Platelets count showed a statistically highly significant improvement (P = 0.001) at both time points among group 1 patients, however among groups 2 and 3, it showed a statistically highly significant decline at the end of treatment (P = 0.001) as compared to baseline then showed a statistically highly significant improvement at WK12 post treatment (P = 0.001) among group 2 patients and (P = 0.027) among group 3 patients as compared to baseline value. Among group 3 cases there was a statistically significant improvement of serum albumin (P = 0.001) and PC (P = 0.025) at WK12 post treatment as compared to baseline.

Conclusion
In conclusion, based on analysis of all laboratory parameters in this study, we can conclude that direct acting antiviral therapy (DAAs) is effective in improvement of synthetic liver functions in chronic hepatitis C genotype 4 patients who achieved a sustained virological response.
Study of the role of soluble transferrin receptor/ferritin index in the assessment of anemia in inflammatory bowel disease patients
Authors: Awad E A , Soliman M L , George T M A , Elshabasy S G F 
Published: May 2020

Abstract

Background
Idiopathic inflammatory bowel disease (IBD) includes those conditions characterized by a tendency for chronic or relapsing immune activation and inflammation within the gastrointestinal tract, Crohn’s disease (CD) and ulcerative colitis (UC) are the two major forms of idiopathic IBD.

Aim of the Work
The aim of this study is to evaluate the clinical usefulness of the soluble transferrin receptor-Ferritin index in the evaluation of anemia in patients with IBD and especially for differentiation between iron deficiency anemia and anemia of chronic disease.

Patients and Methods
This study included fifty patients with established diagnosis of IBD either Ulcerative Colitis or Crohn’s disease. They were collected at Internal Medicine and Gastroenterology outpatient clinics and inpatient wards at Ain Shams University hospitals as well at New Cairo hospital in the period from March 2017 to September 2017. They were classified into 2 groups:

group I
25 patients with Crohn’s disease and anemia with active or inactive disease,

group II
25 patients with ulcerative colitis and anemia with active or inactive disease,

group III
25 healthy controls with no significant medical or family history of IBD.

Results
In the current study there was no significant difference between the different study groups regarding the demographic data except for the disease localization as there was significant difference between ulcerative and crohn’s disease.

Conclusion
The results of the current study stated that the sTfR and sTfR-F index seems to be very efficient in the detection and diagnosis of IDA, among patients with IBD. Its detection rate is higher using sTfR/F index than sTfR alone and of course higher than the other existing markers. It is essential to mention that the clinical use of this sTfR/F index rather adds to the value of other established markers, such as ferritin, transferrin and Tsat, than replaces them in the diagnosis of IDA. Therefore, sTfR-F index could be proposed as an additional parameter, which can improve the diagnosis of iron deficiency anemia in patients with IBD. This remains to be confirmed with other larger studies.
Chronic Spontaneous Urticaria and Gut Flora (Lactobacilli)
Authors: Refaat M M , Kamal S T , Elgendy A M M , Ismail D H 
Published: May 2020

Abstract

Background and Aims
Chronic Urticaria is a common disorder which is defined by recurrent occurrence of wheals and sometimes angioedema. It has a notable influence on the patient’s quality of life. Regulation of the immune system is one of the important roles of the gut microbiota.

Objective
Comparing the frequency and bacterial load of Lactobacillus between patients with chronic urticaria and healthy controls.

Methods
Forty patients with chronic urticaria were recruited from the outpatient clinic of Allergy and Clinical Immunology at Ain Shams University Hospitals and 40 age and sex matched healthy individuals were included in the present study. Stool samples were analyzed for determining the frequency and bacterial load of Lactobacillus.

Results
There was a difference among the frequency of detectable Lactobacillus in stool samples of patients with chronic urticaria and healthy controls. The relative amounts of Lactobacillus were significantly higher in fecal samples from controls compared to patients with chronic urticaria (P &lt; 0.001).

Conclusion
Our study showed that some types of gut microbiota are found in normal individuals in a higher amounts than patients with chronic spontaneous urticaria.
Incidence & outcome of invasive fungal infections in patients with febrile neutropenia
Authors: Hennawy F S K , Elzimaity M M T , Moustafa N N , Kamal G M , Abdelhady E A , Said R M M 
Published: May 2020

Abstract

Background
Invasive fungal infection (IFI) is a major cause morbidity and mortality among patients with hematological malignancies who receive chemotherapy or hematopoietic stem cell transplantation (HSCT). Thus, early diagnosis and treatment of these infections are of crucial importance. Certain factors have been identified as risk factors for IFI.

Objectives
Assessment of incidence and outcome of IFI in Egyptian patients with febrile neutropenia.

Patients and Methods
50 febrile neutropenia episodes were studied. Patients were all subjected to history taking, clinical examination and further investigations including imaging studies, Galactomannan and Mannan antigen assays, and patients were followed up for observing the outcome.

Results
Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value &lt; 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP.

Conclusion
IFI incidence is affected by age, gender, primary diagnosis and severity of neutropenia, and IFI has a worse outcome compared to other causes of febrile neutropenia.
Prognostic significance of serum Growth differentiating factor15(GDF) in adult acute myeloid leukemia patients
Authors: Hegab H M A , Elghammaz A M S , Elrazzaz M K H , Helal R A A 
Published: May 2020

Abstract

Background
Growth differentiation factor 15 (GDF-15)3 is a stress responsive member of the transforming growth Factor-B(TGF-B) cytokine superfamily. In health GDF-15 is weakly expressed in human tissues. Under pathological conditions, GDF-15 can be produced by many malignant and non-malignant conditions.
The aim of the present study is to assess expression of Growth differentiation factor 15 (GDF15) in the serum of adult patients with acute myeloid leukemia and its influence on remission and survival statuses of AML patients.

Material and methods
The serum level of GDF15 was measured in 30 AML patients in comparison to 15 healthy adult controls.

Results and conclusion
Higher GDF15 levels were observed in AML patients than in controls with a sensitivity of 93% and a specificity of 93.3% at cut off level of 1530 pg/ml assessed by ROC curve. Comparing the outcome (alive and dead) between patients above and below the mean level of GDF15(5674pg/ml) it was statistically significant (P = 0.028), but there is no statistical difference between the resistant patients and patients in remission (P-value= 0.593) Comparison between the overall survival (OS) in AML patients with GDF15&gt; 5674pg/ml and those with GDF15&lt;5674pg/ml,It was statistically significant.(P-value &lt;0.001).A statistically significant positive correlation is detected between age and the GDF15 level in the patients group (P-value= 0.011).
CD 44 as a Marker of Rejection in Patients with Post Liver Transplantation
Authors: Bayomy E M , Yousef T M , Ahmed M B , Zaki K A , Elghandour A M , Elfors M A A , Agwa S H 
Published: May 2020

Abstract

Background
The first human orthotopic liver transplantation (LT) in Europe was performed by Sir Roy Calne in Cambridge in 1968, only one year after the first successful human liver transplantation reported by Thomas Starzl in the United States. Since then LT has evolved rapidly, becoming the standard therapy for acute and chronic liver failure of all aetiologies, with more than 80,000 procedures performed to date. Survival rates have improved significantly in the last 25 years, achieving rates of 96% and 71% at 1 and 10 years after LT respectively.

Objective
To assessment of value of serum level of CD44 as a marker of rejection in patients with post liver transplantation.

Patients and Methods
The study was conducted on patient all were recruited from ASCOT from May 2017 till December 2018. It included 20 adult patients with Post LDLT with elevated liver function tests and they were reviewed to determine if the serum level of CD44 had a value in diagnosis of acute rejection depending on proving the rejection by liver biopsy. They were distributed as 14 males and 6 females with age ranging 16 - 59 years. After obtaining the results of liver biopsy we had 14 patients with rejection, 4 patients with cholangitis with biliary obstruction and 2 patient with rejection with vascular insult.

Results
The control group was with irrelevant past medical history and normal liver functions, normal liver biopsy and underwent measurement of CD44 serum level. They were distributed as 14 males and 6 females with age ranging 26 – 41 years.

Conclusion
There was correlation between different pathological findings in liver biopsy and Serum level of CD44 that the low levels being with rejection and higher levels being with control group, that the CD44 may be used as a marker for rejection.
Quantification of Core Antigen Monitors Efficacy of Combination Therapy of Sofosbuvir, Daclatasvir and Ribavirin in Egyptian Cirrhotic Patients with HCV Infection as an Alternative to PCR
Authors: Nashaat E H , Abdel-azziz H , Mohammed A I , Hassan A H 
Published: May 2020

Abstract

Background
Hepatitis C virus (HCV) is a major public health problem throughout the world. Acute HCV infection is asymptomatic in most cases, and only 15% of cases are symptomatic,but Chronic hepatitis C (CHC) shows a variable clinical course, ranging from mild histopathological changes to active hepatitis and the development of hepatic fibrosis, cirrhosis and HCC. The aim of this work is to detect accuracy of core antigen in Egyptian cirrhotic patients with HCV Infection treated with combination therapy of Sofosbuvir, Daclatasvir and Ribavirin as an alternative to PCR. Patients and methods: The study included20 Egyptian treatment-naïve chronic hepatitis C patients with cirrhosis (Cirrhosis was diagnosed on ultrasound basis) on Sofosbuvir, Daclatasvir and Ribavirin. Results Treatment with sofosbuvir plus Daclatasvir and Ribavirin for 12 weeks resulted in undetectable HCV RNA by PCR in 95% (19/20) of the patients at the end of treatment and only 5% (1/20) of the patients achieved SVR after 6 months not 3(both HCV RNA AND HCV Core Antigen tests were negative for all patients). Conclusion: In our study there was a correlation between HCV RNA and HCV core antigen results, so HCV core antigen can be used as an alternative marker to HCV RNA in treatment of HCV infected cirrhotic patients receiving Sofosbuvir, Daclatasvir and Ribavirin.during treatment and for monitoring its efficacy.