bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Plasma Malondialdehyde in Acne Patients on Isotretinoin Therapy
Authors: Saleh H M A , Alzawahry K M A , Gad R E M 
Published: May 2020

Abstract

Background
Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that affects predominantly adolescents and young adults. Oral isotretinoin is a highly effective treatment agent for patients with nodulocystic acne and moderate to severe acne resistant to conventional therapy, isotretinoin might have side effects of oxidative stress and lipid peroxidation. . Malondialdehyde is the end product of lipid peroxidation and is a good marker of free radical-mediated damage and oxidative stress.

Objective
The purpose of this study to estimate malondialdehyde level in patients on Isotretinoin treatment for moderate to severe acne and compare them with healthy control group.

Patients and Methods
The case-control study was conducted at Ain. Shams University Faculty of Medicine, Egypt, from October 2017 to April 2017, and comprised male or non-pregnant female patients more than 18 years of age. 88 participants were included in the study; 44 cases, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne in comparison to equal healthy matching group. Isotretinoin was started in a dosage of 0.5mg/kg/day, and1.0mg/kg/day in patients with moderate and severe acne vulgaris respectively. Malondialdehyde, liver function tests, lipid profile and CBC were tested at the baseline for all participants and after 3 months for the patients who started isotretnoin therapy.

Results
In the current study, the mean baseline level malondialdehyde among all cases was 141.39 µmo1/m1±88.90, (range: 34.5 -360) and in controls it was 40 [µmo1/m1 ±11.3, (range: 9.5-90.4) this difference was statistically highly significant (P = 0.001). There was highly significant difference in malondialdehyde serum level (p = 0.0001) among all cases after 3 months of isotretnoin therapy, also there was a significant increase in MDA serum level among moderate cases (p = 0.021) and highly significant increase of MDA in severe cases (p=.001).ALP, ALT, serum cholesterol and triglyceride significant increases were seen in all cases.

Conclusion
low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and Malondialdehyde serum levels than high dose.
Comparative Study Between Medical Treatment and Intervention in Acute Iliofemoral DVT
Authors: Hussein K , Mohamed M M , Mohamed M I , Elanany S H S 
Published: May 2020

Abstract

Background
The cornerstone of current management of deep vein thrombosis (DVT) are the routine use of anticoagulant therapy, graduated elastic compression stockings (ECS), and early ambulation. Thrombolytic therapy was previously reserved only for patients with life-, limb-, or organ-threatening complications. However, the Post-Thrombotic Syndrome (PTS) has been increasingly recognized as a frequent and serious long-term complication of DVT. In this study I will use systematic review techniques to compare between the medical and intervention management outcome and possible complications and I will try to find out if although of high expenses of the new techniques especially catheter directed thrombolysis CDT it worth it as regarding the post-operative care and complications.

Objective
To review the literature comparing between medical treatment of acute iliofemoral DVT and intervention in the form of endovenous or surgical management of acute iliofemoral DVT as regards short and long term benefits.

Methodology
A systematic Review of published English literature from their date of inception till 2018. Only published English literature will be included in the study. All studies from their inception date till 2018 will be included.

Results
The literature search from the specified electronic databases identified 179 articles. After application of the inclusion and exclusion criteria, 7 comparative studies were finally included in this systematic review. There were 5 randomized trials and 2 observational studies. 1 prospective and 1 was retrospective. Various other approaches were used in combination with conservative/pharmacological thrombolysis according to the underlying pathology A total of 631 patients underwent CDT compared to 675 patients who underwent conservative strategy for management of acute iliofemoral DVT

Conclusion
Pharmacological and pharmacomechanical thrombolysis offers significant benefits to proximal dvt patients in the long term period. However, it does not show an advantage over conservative management in short -term outcome. Furthermore, CDT carries more risk of bleeding and recurrent VTE in the shortterm. More randomized control studies focused on quality of life after conservative and endovasculat intervention in proximal dvt patients as well as on studies on newer generation devices is needed to provide more information for clinical decisions.
Study of Pregnancy related AKI in Egyptian patients: Incidence, Risk factors and Outcome
Authors: Elshinnawy H A , Aref H M , Rezk K M , Elkotb A M , Mohamed A Y 
Published: May 2020

Abstract

Background
Acute kidney injury (AKI) is a serious problem during pregnancy. Once occurred, it causes devastating maternal and fetal outcomes. In developed nations, the trend of pregnancy-related AKI (PRAKI) is on a decline due to the advances in obstetrics care and the legality of abortion. On the contrary, this situation remains a major health problem in the developing countries.

Aim of the work
in the present study, we determine the incidence, etiology and outcome of PRAKI in a sample of Egyptian patients.

Methods
Prospective observational study to determine the incidence, etiology and outcome of PRAKI was conducted over a period of one year from January to December 2017 at Ain Shams university obstetrics & gynecology hospital. Patients were enrolled in this study once PRAKI at antepartum as well as postpartum period was diagnosed according to the definition of KDIGO AKI guidelines diagnostic criteria

Results
During the period of the study a total of 13050 obstetric patients were admitted in Ain Shams university obstetrics & gynecology hospital. In total, 78 patients met the diagnostic criteria of PRAKI representing an incidence of 0.59% (78/13050). Pre-eclampsia & sepsis were the two most common causes of PRAKI, others were dehydration, postpartum hge, antepartum hge, UTI, proteinuria for investigation, SLE activity, DIC, TTP, Acute fatty liver of pregnancy, eclampsia, eclampsia complicated with HELLP syndrome, eclampsia with acute fatty liver of pregnancy, HUS, hyperemesis gravidarum, hypertensive emergency. Fifty five patients (70.5%) received conservative management. Hemodialysis was initiated in twelve patients (15.3%) based on standard indication (azotemia, oliguria volume overload, hyperkalemia and/or metabolic acidosis). Hemodialysis and plasma exchange was used for four patients (5.1%). Plasma exchange was indicated for seven patients. None of the patients received peritoneal dialysis or continuous renal replacement therapy. The ultimate evolution was good in 47 (60%) patients with complete recovery of the kidney function.14 women (17.9%) had an increased serum creatinine level at discharge for follow up at outpatient clinic. 6 patients (7.6%) had kept with advanced renal failure requiring hemodialysis. There were 11 cases of death, mortality rate was 14%.

Conclusion
AKI during pregnancy poses a challenge for physicians. In view of the multifaceted problems that potentially complicate pregnancy in women with AKI. Fortunately, with ongoing improvements in obstetrical care, multidisciplinary approaches comprising nephrologists, obstetricians and neonatologists maternal and perinatal mortality in this setting are largely avoidable. Therefore early recognition of signs and symptoms, close monitoring in high risk cases, early referral and a multidisciplinary team management could potentially prevent progression to higher stages of PRAKI and reduce morbidity and mortality.
Urinary Claudin-1 Level as a Marker of Podocyte Injury in Patients with Proteinuria
Authors: Nasser M E , Shawky S M , Sanad E A M 
Published: May 2020

Abstract

Background
The biology of claudins is a rapidly evolving field, and many intriguing questions remain unanswered. Although it had been assumed that the reason there are ≥24 isoforms of claudin is that each one has distinct permeability properties. The nephron displays a wide spectrum of claudins, whose distribution varies in each tubular segment. In diabetic nephropathy and glomerulonephritis the gene expression of claudin-1, is markedly upregulated in the podocyte, accompanied by a tighter filtration slit diaphragm (cell-cell junction made by the glomerular podocytes) and the appearance of TJ-like structures between the foot processes causing further podocytes injury and proteinuria.

Aim of the work
to assess urinary claudin -1 level as a marker of podocyte injury in patients with proteinuria.

Patients and Methods
it is a case control study which was conducted upon 90 subjects who were divided into three groups: group I included 30 patients with type II DM, group II included 30 patients with glomerulonephritis and group III had 30 healthy subjects as controls. Urinary claudin-1 level was measured by Enzyme linked Immunosorbent Assay (ELISA)

Results
In this study, we found that urinary claudin-1 level was significantly higher in diabetics group and GN group than in control group. In comparison between GN group and diabetic group, we found that urinary claudin-1 level was higher in GN group than in diabetics group but with no statistically significant difference between the two groups.

Conclusion
urinary claudin-1 level was significantly higher in diabetics and GN group and has positive correlation with uACR. So it can be used as marker of podocytes injury and proteinuria
HCV Core Antigen as an alternative test to Quantitative HCV RNA for assessment of SVR in Chronic HCV infected patients treated with Direct Acting Antiviral agents
Authors: Mohamed S M , Musa N I , Ghait R S , Abdelrhiem B M 
Published: May 2020

Abstract

Background and aims
Widespread use of direct-acting antiviral (DAA) agents to treat patients with hepatitis C virus (HCV) infection has reduced the need for monitoring of HCV-RNA levels, because viral kinetics do not predict sustained virologic response (SVR) to these drugs. However, the performance of cheaper tests, such as the assay to quantify HCV core antigen (HCV Ag), has not been determined. This study was aimed at investigating the accuracy of the HCV Ag test in predicting which patients receiving DAAs will achieve SVR at week 12 (SVR12).

Methods
We performed a prospective study on 90 patients, chronically infected with HCV, receiving DAAs therapy from different NCCVH centers in Cairo during the period from August 2017 to June 2018. We collected blood samples and measured the levels of HCV core Ag and HCV-RNA at baseline and 12 weeks after end of treatment. We compared the ability of these assays to predict which patients would have SVR12.

Results
The median baseline level of HCV-RNA was 1688529.6 ± 994697.3 IU/ml (range, 312700 IU/ml to 3491100 IU/ml) and HCV Ag was 179.2 ± 83.5 pg/ml (range, 33.5 pg/ml to 315.6 pg/ml). HCV Ag became undetectable in 92.2% 12 weeks after the end of treatment. HCV-RNA became undetectable in 87.8% at the end of treatment (P&lt;.0001). 79 out of 90 patients (87.8%) achieved an SVR12; the test for HCV Ag identified 63.6% of these patients.

Conclusions
Tests that measure HCV Ag monitor efficacy of DAA therapy for HCV infection as well as assays that measure HCV-RNA, and hence could be recommended for clinical practice.
IgA Deficiency in type 1 Diabetes Mellitus patients
Authors: Abouali F H , Sheha D S , Elsayed H M , Ibrahim N A , Kamal S T , Sharawy Y S 
Published: May 2020

Abstract

Background
Selective IgA deficiency (SIgAD) in Type 1 diabetes mellitus patients (T1DM) has been reported, but the exact prevalence of SIgAD in Egyptian adults with T1DM is not known.

Aim of the Work
The aim of this work was to measure serum IgA level in patients with T1DM as compared to healthy controls.

Patients and Methods
Our study was a case control study conducted on 50 adult patients with T1DM recruited from the outpatient diabetes clinic of Ain Shams University Hospitals, with 50 healthy participants of comparable age and sex included as controls. All patients enrolled in the study were subjected to detailed history taking, serum levels of IgA, IgG and IgM levels were measured by Nephlometry. Patients with low sIgG or sIgM were excluded.

Results
The mean age of patients’ group was 24.5 ± 5.3 years. We report that 30 out of 50 patients (60%) with T1DM had associated SIgAD with a female predominance (20 females (66.7%) had SIgAD compared to 10 males (33.3%)). We also found a statistically significant relationship between SIgAD and diabetic ketoacidosis (DKA) (P-value&lt;0.001). Moreover, 6 out of 50 (12%) of T1DM patients had associated autoimmune diseases but their sIgA level was normal.

Conclusion
The current study displays 60% prevalence of SIgAD among Egyptian patients with T1DM, which is higher than reported in other populations. Moreover, our data show a higher prevalence of SIgAD in female gender.
Paracetamol versus Nalbuphine in Relieving Pain in the First Stage of Labour in Primigravida: Double-Blinded Randomized Controlled Trial
Authors: Nadim A A , Elghareeb N A M , Eid S H M 
Published: May 2020

Abstract

Background
First stage of labor begins with regular uterine contractions and ends with complete cervical dilatation at 10 cm. It is divided into a latent phase and an active phase. The latent phase begins with mild, irregular uterine contractions that soften and shorten the cervix.

Objectives
To compare between intravenous nalbuphine and paracetamol in relieving pain in first stage of labour.

Patients and Methods
This double-blinded randomized controlled trial was conducted on 120 women primigravida with term and viable pregnancy, presenting with the vertex attending the labor ward for delivery in Ain Shams Maternity Hospital.

Results
Our study showed remarkably noticeable change on comparing the pre-injection and post-injection SPADI Scoring system at 4,8,12 and 24 weeks. There is highly statistically significant pain and disability score and percentage improvement, yet on the other hand the radiological improvement shows no statistically significant difference found between baseline tendon thickness and its follow up at 4, 8 and 12 weeks while only there was statistically significant decrease in tendon thickness found at 24 weeks with p-value = 0.043.

Conclusion
The ultrasound-guided PRP injection for supraspinatus tendinopathy cases is a safe, cheap, and easily prepared outpatient procedure which showed competitive, promising, and well-proved results when compared to other modalities outcomes such as conventional surgeries, arthroscopic procedures, and physiotherapy. It deserves our attention to its value and efficacy for the sake of the patient as a minimally invasive procedure providing better quality of life.
Addition of azithromycin to cefazolin pre elective CS reduces post operative infections
Authors: Mohamed M E , Allam H A , Abdelgaber M A 
Published: May 2020

Abstract

Introduction
The results of the Cesarean Section Optimal Antibiotic Prophylaxis(C/SOAP) trial describe an absolute reduction of 5.9 percentage points in the rate of the primary composite outcome of endometritis, wound infection,or other infection occurring within 6 weeks after non elective cesarean section with the use of adjuvant azithromycin prophylaxis. The absolute reduction in maternal postpartum use of antibiotics was 4.3 percentage points. The study drug was administered after the first incision in 12.4%of the patients who received azithromycin and in12.3% of those who received placebo. The authors did not indicate when the standard prophylaxis(mainly cefazolin) was delivered.

Objective
The aim of our study is to evaluate the efficacy of addition of azithromycin to cefazolin pre-operative in reducing the risk of postoperative infection after elective CS.

Methods
Four hundred patients were randomized to two groups. Control Group included 200 women undergoing elective CS. Patients received standard antibiotic prophylaxis cefazolin (at a dose of 1 gm) and azithromycin (at a dose of 1 gm) 2 hours preoperatively. Study Group included 200 women undergoing elective CS. Patients received only standard prophylaxis antibiotic (cefazolin).

Results
Our study showed that majority of the mothers were housewives (70% in cefazolin-azithromycin group and 85.5% in cefazolin group), with a statistically high significant difference between the two groups regarding occupation (p &lt; 0.001). But, there was no statistically significant difference regarding residence (p &gt; 0.05) between both studied groups. Regarding demographic characteristics, majority of the mothers had similar mean age/years; 25.5 years in cefazolin-azithromycin group and 24.7 years in cefazolin group, with no statistically significant difference between both studied groups (p &gt; 0.05) but body mass index illustrated statistically a significant difference (p &lt; 0.05). On the other hand, preoperative hemoglobin showed no statistically significant difference between both studied groups (p &gt; 0.05). Regarding obstetric history, there were statistically significnat differences between both studied groups regarding parity and previous cesarean sections (p &lt; 0.05) and a high significant difference regarding previous abortions (p &lt; 0.001).

Conclusion
At the end of this study, we observed that, with regards to postoperative fever, wound healing duration, infection post-surgery and per-vaginal discharge, addition of azithromycin to cefazolin (Zinol) is effective than cefazolin only in reducing the risk of postoperative infection after elective CS and maternal use of healthcare resources.
Association between Preeclampsia and vitamin D Deficiency
Authors: Elhoussieny A S , Ibrahim M E , Gad H F , Mahdi E H 
Published: May 2020

Abstract

Background
Preeclampsia is a pregnancy-specific disorder that affects 3–5% of pregnant women worldwide and is one of the most frequently encountered medical complications of pregnancy. Recent research has pointed towards some role of vitamin D deficiency in pathogenesis of preeclampsia. Vitamin D deficiency in pregnant women and their children is a major health problem, with potential adverse consequences for overall health.

Aim of the Study
The aim of this study is to investigate the serum vitamin D levels in preeclampsia and healthy normotensive pregnant women.

Patients and Methods
This case control study was conducted at Ain Shams University Maternity Hospital from November 2017. The study included pregnant women 20-35years this study will be carried out on pregnant women recruited at pre labour room (preeclamptic group) and (non preeclamptic group) at Ain Shams University Maternity Hospital, 50 women in each group.

Results
All samples were screened by DRG® 25-OH Vitamin D (total) ELISA (EIA-5396) and it was found that mean 25 hydroxy vitamin D levels were lower in preeclamptic group than normotensive control group. Mean level of 25 hydroxy vitamin D between preeclamptic cases was 13.98 ±4.98 ng/ml and between normotensive controls was15.62± 3.51 ng/ml.

Conclusion
This study has shown no association between vitamin D deficiency and pre-eclampsia, supporting no role for vitamin D as a preventative agent against preeclampsia.
Role of Ki67 in predicting response to adjuvant tamoxifen in postmenopausal hormonal positive breast cancer patient
Authors: Abdelaziz H M , Naguib K , Moussa D , Mohammad N 
Published: May 2020

Abstract

Background
Breast cancer (BC) is a major health problem in Egypt and worldwide. Its prognosis depends not only on tumor stage but also on tumor biology.

Aim of the Work
To correlate the percentage of expression of Ki67 with the clinical outcomes of early hormone-receptor positive for postmenopausal breast cancer patients who are receiving adjuvant tamoxifen

Material and Methods
we retrospectively reviewed 52 patients treated for non-metastatic postmenopausal breast cancer with adjuvant tamoxifen at Ain-Shams University hospital, Clinical Oncology department between January 2010 and December 2015. Ki67 value and other clinicopathological data were retrieved.

Results
Out of 52 patients fulfilling research criteria, the age rannged from 45 to 71 years.All patients were stage0-ΙΙΙ. Stage II was the most common represented 38.5 %, while Stage 0 was the least common presents 3.8%. Using a ki67cut-off value of 20, patients were stratified into two risk groups; the low risk group had ki67 &lt;20 % and represented (67.3%) of cases and the high risk group were ≥ 20% and represented 32.7%. The median Ki67 value was 12.00 (IQR 5 – 20).Median DFS was 42.5 months (IQR 31.2 – 57). Median of OS was 49 moths (IQR 34 – 58).Among multiple prognostic factors Stage, luminal A subtype was significantly related to better OS and DFS In our study, there was no difference regarding OS and DFS between low and high ki67 group’s results ρ = 0.308 and ρ = 0.064 respectively.

Conclusion
Ki67 is not a predictive factor for resistance to adjuvant tamoxifen in post-menopausal female breast cancer patients.
Assessment of Epithelial Thickness in Keratoconic Patients Before and After Intracorneal Ring Segment Implantation Using Anterior Segment Optical Coherence Tomography
Authors: Mohamed R F , Elghazawy R M F , Fawzy S M , Badran T A 
Published: May 2020

Abstract

Background
Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration accompanied with local corneal thinning and occurs mostly in the inferior and central part of the cornea, it usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease, while corneal graft preserved for more advanced disease. In advent of alternative treatments, intrastromal ring implantation have been introduced which improves visual acuity and optical aberrations and also corrects refractive errors and mean keratometric data, anterior segment Optical cohehernce Tomography epithelial mapping is anew modality to assess epithelial thickness. Objective: To investigate epithelial thickness changes in keratoconic patients before and after intracorneal ring segment implantation using AS OCT. Methods: Thirty eyes with early to moderate keratoconus were included in this prospective interventional case series study which has been conducted at patients from Ain shams university hospitals, after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University between March to October. All cases underwent a Complete ophthalmological examination before surgery. the examination included Visual acuity assessment and Best corrected visual acuity. Slit Lamp Biomicroscopy examination with fundus examination through dilated pupil using D lens & Corneal Topography, Anterior segment Optical cohehernce Tomography Epithelial mapping(zeiss). Results: we found that epithelial thickness showing statistically significant change comparing pre and post operative epithelial mapping especially in certain areas in the map,area ( _ ),( _ )  mm. Conclusion: There is increase in epithelium thickness in keratoconic corneas after intracorneal ring segment implantation to compensate for stromal irregularities in patients with keratoconus.