bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients
Authors: Maher M , Abdelaziz H , yossif T , Ossama M 
Published: May 2020

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is one of the types of fatty liver which occurs when exceeive fat is deposited in the liver due to causes other than excessive alcohol use, NAFLD is subdivided into non alcoholic fatty liver (NAFLD) and nonalcoholic steatohepatitis (NASH). In NAFLD, hepatic steatosis is present without evidence of significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation

Aims
To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients.

Patients and Methods
60 subjects were divided into 2 groups: group I: including 30 patients with NAFLD, group II: including 30 matched healthy controls Diagnosis of NASH and its discrimination from NAFL was done by fibroscan. CK-18 level in plasma was measured for all subjects using ELISA.

Results
CK-18 was significantly elevated in patients of group I in comparison to group II, with mean ± SD: 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value: 0.001. with mean ±SD: 59.6± 28, when compared with control group (with 23±8) P value &lt; 0.001. ROC curve between Cases and Control regard CK18 with Area Under the Curve (AUC): 0.925. Cutoff &gt; 30 ug/l With Sensitivity: 86.67% & Specificity: 83.33%. Ck-18 was found to correlate with steatosis and fibrosis assessed by fibroscan with P value&lt; 0.001.

Conclusion
Measurement of serum cytokeratin 18 fragment levels (CK18) correlate with the Fibroscan (Transient Elastograph) as a non invasive tests in diagnosis & prognosis of non alcoholic fatty liver diseases (NAFLD).
Assessment of serum 25-hydroxy vitamin D in cirrhotic patients with and without spontaneous bacterial peritonitis (SBP)
Authors: Shalaby S M , Baiumy E M , Abdelrahman M G , Sayed M M , Abdelhalim R M , Amer A A 
Published: May 2020

Abstract

Background
Vitamin D has pleotropic effect including the immune function, it increases innate immunity and modifies lymphocyte activation. The risk for bacterial infections is increased in cirrhotic patients due to low levels of vitamin D, so its deficiency may be linked with the prevalence of SBP in cirrhotic patients

Aim of the work
To assess the 25-OH vitamin D serum level in cirrhotic patients and it’s relation to spontaneous bacterial peritonitis.

Patient & Methods
The current study included 90 patients divided into three groups; group one; patients with compensated liver cirrhosis, group two; patients with decompensated liver cirrhosis without SBP and group three; patients who had decompensated cirrhosis with SBP. The following laboratory work up was done: Serum 25-OH vitamin D level, liver functions test, kidney functions test, complete blood count, and ascitic neutrophil count.

Results
We report a highly significant difference between the studied groups as regards 25-OH vitamin D level, being lowest in group three. A negative correlation between markers of severe cirrhosis and vitamin D concentrations was found in our cirrhotic patients.

Conclusion
Vitamin D deficiency is associated with increased incidence of infections in cirrhotic patients including spontaneous bacterial peritonitis, suggesting that Vitamin D supplementation may be useful in these patients.
Effect of Fluid Management Guided by Bioimpedance Spectroscopy on Cardiovascular Parameters inHigh Risk Hemodialysis Patients
Authors: Ebrahim M B , Elsharkawy M M , Elsaid H W , Hassan M S 
Published: May 2020

Abstract

Introduction
One of the greatest challenges for physicians caring for hemodialysis (HD) patients is assessing their extracellular fluid volume (ECFV), so different strategies have been investigated to aid in this evaluation. The clinical examination, biochemical markers of volume overload, Inferior vena cava ultrasound, lung ultrasound, Continuous blood volume monitoring (CBVM) and Bio impedance measurement of intra- and extracellular water (ECW).

Aim
Aim of the present study is to evaluate the effect of fluid management guided by bio impedance spectroscopy on CV parameters and BP in high risk HD patients.

Patients and Methods
This is a prospective interventional one year study. Fifty (50) maintenance HD patients have been recruited from Nasr City Insurance Hospital dialysis centre, the study population divided into two groups followed over (12) months, the groups were classified as follows: Intervention group (high risk group) included (25) CV compromised HD patients. (FO pre (L)) was assessed by BIS monthly before dialysis session. Control Group (low risk group) included (25) clinically stable HD patients. Dry weight was assessed clinically in the control group.

Results
Statistically significant decline in pre& post-dialysis systolic BP, the rate of use of BB & ACEI drugs& the rate of IDH in the intervention group. FO pre (L), TAFO (L), IDWG (L),post-dialysis weight (Kg), but in intergroup analysis, however it became evident that pre FO (L), TAFO (L), IDWG (L) and post-dialysis weight (Kg) decrease in the intervention group was significantly higher than the control group. (LVMI, LVIDD, RVDD and left atrium volume) values assessed by Echo showed a statistically significant decline in the two groups, however in intergroup analysis; it became evident that (LVMI, LVIDD and RVDD) values and left atria volume decrease in the intervention group were significantly higher than the control group.

Conclusion
Assessment of fluid overload with bio-impedance spectroscopy is a helpful tool beside clinical examination to better recognize hidden fluid overload which leads to significant improvement in the CV status of high risk HD patients.
Interdialytic Weight Gain and Its Relation to Outcome among Patients on Maintenance Hemodialysis
Authors: Ibrahim M K , Kamal O M M , Hassan M S , Khalifa M M M 
Published: May 2020

Abstract

Introduction
The most common cause of mortality among chronic hemodialysis (HD) patients is cardiovascular disease. Hypervolemia is an important risk factor for hypertension and cardiovascular mortality in HD patients that include chronic volume overload and interdialytic weight gain (IDWG).IDWG affects cardiovascular morbidity and mortality Daily fluctuations in extracellular fluid volume might promote cardiac remodeling resulting in left ventricular hypertrophy (LVH) and cardiac fibrosis.

Aim of the study
to assess interdialytic weight gain and (its relation to morbidity and mortality) among patients on maintenance hemodialysis.

Patient and methods
100 ESRD patients on regular hemodialysis included in study in Ain Shams University hospitals in march 2016 and followed up after one year in march 2017.

Type of study
cohort study
Patients were divided into two groups according to interdialytic weight gain (IDWG):

Group I (high IDWG)
50 patients with Absolute weight gain 4kg or more. Or relative IDWG more than 3.5% of total body weight.

Group II (low IDWG)
50 patients with absolute weight gain less than 3kg
Or relative IDWG less than 3.5% of total body weight.
Echocardiography (TTE) for all patients at the start of the study and followed up after one year for detecting outcomes included all-cause mortality, cardiovascular mortality, hospitalization for heart failure/volume overload, hospitalization for myocardial infarction, stroke.

Results
we found that patient with high (IDWG) group II has significantly higher increase in left ventricular mass index (LVMI),inferior vena cava (IVC) diameter and significantly higher decrease in ejection fraction more than low IDWG group I.

Conclusions
Patients with high IDWG group II at higher risk of increase LVMI, decrease ejection fraction, increase in interventricular septum (IVS), increase in inferior vena cava diameter more than patients of low IDWG group I and has more cardiovascular morbidity and mortality.
Hematological Effects of Direct Acting Antiviral Drugs (DAAs) During and After Successful Treatment of Hepatitis C Patients with Ribavirin Free Regimen
Authors: Elsayed O A , Fouda E M , Yassin A E , Abouemira M S 
Published: May 2020

Abstract

Background
Hepatitis C virus is a major public health problem in Egypt. The standard of care for treatment of HCV has always been Peg-INF and Ribavirin carrying a lot of side effects. This was changed with emergence of Direct Acting Antiviral Drugs.

Objective
The aim of this study was to evaluate the hematological effects of DAAs in patients receiving Ribavirin free regimens to assess the beneficial or the adverse effects of these medications.

Subjects and Methods
The study was conducted on 120 patients with chronic HCV who were child A according to Child-Pugh score, receiving Sofosbuvir and Simeprevir or Sofosbuvir and Daclatasvir for 12 weeks.
All patients were subjected to history taking, clinical examination and pretreatment assessment including laboratory evaluation with CBC, Liver enzymes, Liver functions at baseline, after 4 weeks, 12 weeks and 24 weeks.

Results
Serial laboratory follow up of 120 patients showed significant improvement in hemoglobin level and platelet count. Improvement in liver enzymes and bilirubin was detected with transient elevation of bilirubin in week 4. 116 patients (96.7%) showed negative HCV-PCR Quantitative after 12 weeks of treatment while 114 patients (95%) of achieved SVR 12.

Conclusion
DAAs have a good impact on blood profile and liver biochemistry and high cure rate with minimal side effects.
Assessment of Minimal Residual Disease in Acute Myeloid Leukemia patient in Adult Egyptian Acute myeloid Leukemia Patients
Authors: Moussa M M , Abdelhady E A , Abdallah N H , Mahmoud I J 
Published: May 2020

Abstract

Background
The term minimal residual disease (MRD) is used to describe residual disease after suboptimal induction chemotherapy, but at the same time refers to the lowest levels of disease potentially compatible with cure or to molecularly defined relapse after long term remission.
This study assesses the minimal residual disease in relation to the outcome in acute myeloid leukemia patients after 6 months of treatment of chemotherapy.

Aim of the work
The aim of this study is assessment of measurable minimal residual disease after treatment to identify acute myeloid leukemia patients who are at high risk of poor outcome.

Patients and methods
Minimal Residual Disease was measured using Flow cytometry in 30 newly diagnosed a 30 newly diagnosed acute myeloid leukemia (AML) patients. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from May 2017 to November 2018.

Results
A total number of 30 acute myeloid leukemia patients were recruited from Ain Shams University hospital, hematology and Oncology Unit outpatient clinic, with age ranging from 18-60 years old (median age 40 years), 14 of them were males representing 46.6% of the total number and 16 were females representing 53.3% of the total number.
There was no statistical significance between the age of the studied group and the MRD with P-value 0.147, the sex of the patients doesn’t contribute to the risk stratification with a P-value of 0.200.
The number of cases with negative MRD after induction was 13 representing 43.3% of the total number, and was 12 patients after 6 months representing 70.5% of the remitted patients, considering that the cut out value of MRD is 0.1.
There was a significant relationship between TLC and MRD, the higher the TLC the more positive the MRD.
Positive MRD is associated with higher mortality rates, exhibiting a statistical significance with P-value of 0.005.

Conclusion
We concluded that assessment of minimal residual disease in AML is of great value in determination of prognosis of the disease and its outcome and it is of great value to determine the levels of minimal residual disease (MRD) during the course of therapy and to stratify patient to identify high risk patient and to plan the therapeutic program accordingly.
Sputum periostin in patients with different asthma phenotypes
Authors: Refaat M M , Ahmed E E , Elsayed H M , Elbanna A H 
Published: May 2020

Abstract

Background
Asthma is a common respiratory condition causing symptoms such as cough, chest tightness and wheezing that are triggered by factors as exercise, allergens and viral infection. Asthma is characterized by airflow limitation, airway hyper-responsiveness and bronchial inflammation.

Aim of the work
to identify the different phenotypes in a group of asthmatic patients; and to evaluate the role of periostin in bronchial asthma and its different cellular phenotypes and its correlation asthma severity.

Subjects and Methods
This observational cross-sectional study was conducted on 96 adult asthmatic patients. They were classified into two groups: group (A) 48 patients with severe asthma (persistent airflow limitation), group (B) 48 patients with mild to moderate asthma according to (GINA 2016) criteria attending the Allergy and Clinical Immunology outpatient clinic, Ain Shams University Hospitals. The study also included 10 healthy controls of matched age and sex group.

Results
sputum periostin levels in asthmatic patients are higher than its levels in healthy controls. Sputum eosinophil percentage in asthmatic patients is higher than those in healthy controls. Sputum periostin levels in patients with severe asthma were found to be higher than sputum periostin levels in patients with mild to moderate asthma. There is high positive correlation between sputum periostin and asthma severity and age and there is negative but significant correlation between sputum periostin and (FEV1) and it is found to be correlated with duration of asthma and pattern of (PFT) abnormality (higher in mixed pattern) and sputum eosinophilia.

Conclusion
Sputum periostin is correlated with asthma severity and eosinophilic asthma. Periostin is considered to be an important biomarker for severe asthma and eosinophilic phenotype of asthma.
Changes of MicroRNA-377 in Diabetic Nephropathy
Authors: Elshinnawy H A , Kamel C R , Elkeleng M H A 
Published: May 2020

Abstract

Background
as one of the most important long term complications of diabetes, Diabetic nephropathy is the major cause of end stage renal disease and high mortality.

Purpose
to identify the pattern of microRNA-377 changes specific for diabetic nephropathy in diabetic patients and in patients with chronic kidney disease of different etiology.

Patients and Methods
the study was conducted from 2016 to 2018, included 50 patients for analysis of MicroRNA-377 and its control gene U18 at El Demrdash Hospital Ain shams university and Quessena Hospital El Monfia. The miRNA-U18 was analyzed for normalization of correction ratio.

Results
the results of our research found that the highest median IQR of miR-377 was significantly present in DN stage 1&2 and the lowest median IQR was significantly present in CKD stage 1&2, and there was significant difference between group 1 (DN stage 1&2) versus group 2 (DN stage 3&4), group 3 (Diabetics without nephropathy) and all stages of CKD.

Conclusion
in diabetic nephropathy stage 1&2, serum miR-377 was highly significant increased more than diabetics without nephropathy, diabetic nephropathy stage 3&4 and all satges of CKD.
Effect of statins on atherosclerosis in chronic kidney disease patients guided by CD4+CD28nullT cells over duration of six months
Authors: Okba A M , Abdelawi H S , Shaheen R Y , Amin M N , Amin M M , Ibrahim M A 
Published: May 2020

Abstract

Objectives
Chronic kidney disease and atherosclerosis are considered to be inflammatory process in which T cells and cytokines participate. This study determines the effect of statin therapy as an anti-inflammatory agent on the level of CD4+CD28null T lymphocyte population, and subsequently on atherosclerosis in patients with chronic renal disease.

Methods
We recruited 90 chronic kidney disease patients. The patients were divided into three groups according to carotid intimal medial thickness (CIMT) as an indicator of atherosclerosis. Two groups (group A in whom CIMT above 0.95 mm and B in whom CIMT below 0.95 mm) were given statin (atorvastatin 20mg) while the third group (group C in whom CIMT below 0.95 mm) continue only on the conservative treatment for CKD patients. CD4+CD28null T cells was measured in the three groups at the beginning of the study and after 6 months of statin therapy.

Results
CD4+CD28null T cells was decreased in statin groups (group A and B) when compared to no-statin group (group C) at the end of the study. Multivariable regression analysis for the effect of statin therapy showed that statin can independently increase the percentage of decrease both CD4+CD28null cells at the end of our study (p-value &lt;0.0001).

Conclusion
Our study demonstrates that statins reduce CD4+CD28null T cells in CKD patients especially with atherosclerosis suggesting that statins may help in altering the inflammatory process that lead to atherosclerosis.
Elevated IL 23 in Hypertensive Patients with Acutely Increased Blood Pressure
Authors: Abo-Ali F , Ahmed E E , El-deeb M A , Basry A E A 
Published: May 2020

Abstract

Background
As a chronic medical condition characterized by elevated blood pressure, hypertension is recognized as a major risk factor for a variety of life threatening diseases including stroke, myocardial infarction, heart failure and aortic aneurysm. And most of these severe complications occur in the hypertensive patients with a sudden increase of blood pressure.

Aim of the Work
The aim of this study is To evaluate the role of IL23 in the immune pathogenesis of hypertension.

Subjects and Methods
This was a prospective Case-Control study was carried out in the Internal Medicine Department, faculty of medicine, Ain Shams university hospital during the period from November 2016 to December 2017.In this study we performed full history taking and examination, we also performed complete blood count, liver function tests, kidney function tests, estimation of IL23 level in plasma by ELISA in peripheral blood by Flowcytometry.
Forty five adult individual were recruited in the study and were further divided into three groups according to the symptoms of blood pressure as follow:group A patients with acute increase of blood pressure, group B patients without acute increase of blood pressure.and group C healthy volunteers with normal blood pressure as control

Results
we found that mean of IL23/CD4% was higher in group A, followed by group B then group C, all these differences was high significant

Conclusion
We demonstrated that IL-23 may be involved in the pathogenesis of acute blood pressure increase in the patients with hypertension. Understanding its inflammatory characterization might be of fundamental importance for the prevention and treatment of acute blood pressure increase in hypertensive patients.
Assessment of Serum IL-15 in Adult Acute Leukemia Patients
Authors: Moussa M M , Abdelhady E A , Shazly M A , Abdallah N H , Sheeba M S 
Published: May 2020

Abstract

Background
Interleukin 15 (IL-15), a proinflammatory cytokine, regulates the functions of the immune system and controls the differentiation of hematopoietic cells. However, it may also promote the development of leukemia through its role in enhancing the survival, proliferation and differentiation of leukemic precursors.

Aim of the work
To assess expression of IL-15 level in adult Egyptian acute leukemia patients, its correlation with disease free survival, overall survival and relapse rate, as well as its possible correlation with other prognostic parameters.

Patients and methods
Serum IL-15 level was measured using enzyme-linked immunosorbent assay in 30 newly diagnosed acute lymphoblastic leukemia (ALL) patients, 30 newly diagnosed acute myeloid leukemia (AML) patients and 30 age and sex-matched healthy control subjects. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from April 2017 to October 2018.

Results
In ALL patients: The serum IL-15 level was higher in ALL patients compared to control subjects (P = 0.015). Patients with ALL with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P = 0.005).
In AML patients: The serum IL-15 level was higher in AML patients compared to control subjects (P = 0.010). Patients with AML with high serum IL 15 level had shorter survival compared to those with low or average serum IL 15 level (P &lt; 0.001). Serum IL15 level has negative correlation with the date of death in patients with AML (P = 0.001).

Conclusion
Interleukin 15 (IL-15) is a useful poor prognostic marker in patients with newly diagnosed acute leukemia, also it can be used as a predictor for survival.

Abbreviations
AML (acute myeloid leukemia), ALL (acute lymphoblastic leukemia), IL-15 (Interleukin 15).
Endoscopic Ultrasound Versus Endoscopic Retrograde Cholangiography As A Diagnostic Tool For Patients With Dilated Common Bile Duct Of Undetermined Etiology Detected By Abdominal Ultrasound
Authors: Helal E M B , Hassan A M A , Faheem H A F , Fayed M A A A 
Published: May 2020

Abstract

Background
Common bile duct dilatation could result from various etiologies: choledochocholithiasis, common bile duct stricture, cholangiocarcinoma, periampullary diverticulum, pancreatic head mass, Oddi sphincter dysfunction and papillary stenosis, etc. A dilated common bile duct could denote a hidden pathological biliary condition; on the other hand it occurs in cases with advanced age or postcholecystectomy status in the absence of pathological affection.

Objective
The aim of this study is to compare between the accuracy of endoscopic ultrasound and endoscopic retrograde cholangiography as a diagnostic tool for patients with dilated common bile duct in whom abdominal ultrasonography could not demonstrate the cause of dilation.

Methods
This study was conducted on eighty (80) patients who underwent EUS and ERCP to compare between the accuracy of both as a diagnostic tool in whom TUS couldn’t demonstrate the cause of CBD dilatation, the study was performed as a retrospective analysis of prospectively collected data at TBRI (Theodor Bilharz Research Institute) after approval was obtained from the ethics and indications committee of TBRI. The study protocol was approved by the medical ethics committee of Ain Shams University and TBRI.

Results
In the current research study it was revealed that among 80 study subjects there were 24 cases having stone (30%), 26 cases having stricture(32.5%), benign cases were only 2 (2.5%), prominent CBD with no obstruction were4 cases (5%).

Conclusion
Endoscopic ultrasound is a complementary imaging modality after transabdominal ultrasound for assessment of CBD dilatation and have a crucial role in the benign and malignant periampullary tumors diagnosis additional research studies are required to be performed in a multicentric fashion considering racial and ethnic differences.