bluuebunny/crossref_metadata_2025_split huggingface dataset:
Procalcitonin versus C-reactive protein as indicator of acute rejection during orthotropic liver transplanation
Authors: Marzouk M M , Shoukery R A , Mohammed M H , Khalil G M , Mohamed M A 
Published: May 2020

Abstract

Background
Procalcitonin is the precursor for the hormone calcitonin (CT), which is found in the thyroid C cells and the pulmonary endocrine cells, it has a metabolic role in calcium homeostasis. In normal subjects, PCT is found in the blood at a very low concentration but during bacterial infection, there is more than 1,000 fold increase in its blood concentration as it is released by many other tissues as Liver, Spleen and Lungs.

Aim of the Work
to compare between procalcitonin and CRP as a markers of infection versus rejection in orthotropic liver transplantation; this comparison with their plasma level and the clinical difference during postoperative period.

Patients and Methods
This study was conducted on 25 patients aged 2-60 years old of both sexes scheduled for elective liver transplantation from living donors; after ethical committee approval and informed consent from patients and/or their first degree relatives, Ain Shams Specialized Hospitals.

Results
The study revealed that the normal course after liver transplantation for postoperative 28 days was (48%), rejection (16%), sepsis (24%) and rejection and sepsis (12%).

Conclusion
Procalcitonin is a good early diagnostic marker and is superior to CRP and WBCs in early detection of postoperative sepsis after orthotropic liver transplantation.
Hyperglycemia Is A Predictive Of Poor Outcome In Stroke Patients: A Prospective Randomized Trial
Authors: Elazzazi H M , Esmat I M , Aly R M , Senosy A M M 
Published: May 2020

Abstract

Stroke is the third most common cause of disability and second most common cause of death worldwide. Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Hyperglycemia is common during acute ischemic stroke. Several studies have shown admission blood glucose is elevated in &gt; 40% of patients with acute ischemic stroke, most commonly among patients with a history of diabetes mellitus. The question is whether it is possible to determine a patient’s prognosis based on the data available during an initial hospitalization for stroke.

Aim of the Work
To evaluate the prognostic significance of stress hyperglycemia in acute ischemic stroke.

Summary
Our study confirmed the association between hyperglycemia and poor clinical outcome among patients with acute stroke. Our data indicates that hyperglycemia is an independent risk factor for worse clinical short-term outcome after acute ischemic stroke. A more severe degree of NIHSS score was observed in patients with hyperglycemia both at presentation and 48 hours later.
The Influence of Body Mass Index on Sensorimotor Block and Vasopressor Requirement during Spinal Anesthesia for Elective Cesarean Delivery
Authors: Elsayed N M A , Rizkallah S S W , Maamoon R M H , Ahmed S H A 
Published: May 2020

Abstract

Background
Physiological changes associated with pregnancy are significant enough to have serious anesthetic implications. When these are compounded by obesity, the anesthesiologists may have to deal with a patient with seriously limited physiological reserve. Obese patients often had co-morbidities and pathological changes in different organ systems.

Aim
The objective of this study is to determine if obesity have a clinical important effect on the vasopressor requirements or the block height following a standard fixed dose of spinal anesthesia during elective cesarean delivery.

Methodology
In this prospective randomized comparative clinical study, two groups of 33 patients were recruited with widely differing body mass indices to examine the influence of body mass index (BMI) on the responses to a specific dose of spinal bupivacaine. One group includes women with BMI &lt; 32 kg/m2 (group N) and the other group has a BMI of &gt; 40 kg/m2 (group O).

Results
This study showed that Body Mass Index doesn’t have much influence on sensorimotor block level and vasopressor requirement during spinal anesthesia for elective cesarean delivery &so the dose of spinal bupivacaine should not be reduced in morbidly obese parturients.

Conclusion
The result of the present study showed that Body Mass Index up to 50 doesn’t have much influence on sensorimotor block level or vasopressor requirement during spinal anesthesia for elective cesarean delivery &so the dose of spinal bupivacaine should not be reduced in morbidly obese parturients.
Conscious Sedation with Local Anesthesia versus General Anesthesia for Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Abdelhafez O S M , Abdou A M H , Ismail A E A , Aboseif E M K , Kamaly A M 
Published: May 2020

Abstract

Background
Transcatheter Aortic Valve Implantation (TAVI) procedure is being performed under general anesthesia (GA), conscious sedation associated with local anesthesia (CSLA) and local anesthesia alone. There have been limited studies to determine which plan of anesthesia is associated with better results.

Aim
We aimed in this study to assess the role of CSLA in outcome, complications, mortality and to assess quality of life in immediate post-procedural period (ICU and hospital stay).

Methodology
After approval of ethical committee, seventy cases of moderate to severe aortic stenosis planned for TAVI were randomized into two groups. Group-GA: received general anesthesia and Group-CSLA: received conscious sedation combined with local anesthesia. We measured intraoperative hemodynamic changes, pH, PaO2, PaCO2, need for inotropic support and need for blood products. Post-operative variables were need for inotropic support, prolonged respiratory support, need for renal dialysis, and incidence of stroke, heart block, aortic regurge as well as mortality.

Results
The CSLA group showed more incidence of respiratory acidosis with increase in PaCO2 (p=0.024), less decrease in mean arterial blood pressure (p=0.028), less need for inotropic support both intraoperative (p=0.001) and post-operative (p=0.005). The CSLA patients showed less hospital length of stay (LOS) (p=0.006) and less prolonged respiratory support more than 24h (p=0.001) compared to the GA group patients. However, there was no significant difference between the two groups as regards need for blood products (p=0.587) and incidence of complications in the form of renal failure (p=0.113), heart block (p=0.756), aortic regurge (paravalvular leak) (p=0.168) and mortality (p=0.238). There was no incidence of stroke in either group.

Conclusion
CSLA for TAVI patients in the current study showed better intraoperative hemodynamic stability, less need for inotropic support whether intaoperative or postoperative and less hospital LOS despite the presence of mild acceptable respiratory acidosis. So we can recommend to consider CSLA in such patients.
The Role of laryngeal ultrasound in comparison with cuff leak test in prediction of post extubation stridor
Authors: Nashed S W , Elsharnouby N M , Abdulnaiem M A , Eltaher S M 
Published: May 2020

Abstract

Background
Endotracheal intubation is commonly used in (ICU) for different causes. However, intubation/extubation may lead to the development of complications such as post-extubation stridor (PES), one of the most frequent causes of reintubation, prolonged mechanical ventilation, and increased morbidity in the ICU patients. PES and upper-airway obstruction are multifactorial in etiology and can occur as a result of laryngotracheal edema, intubation trauma, excessive cuff pressure with mucosal ulceration, and prolonged intubation with secondary inflammation and granuloma formation.
Objective: The aim of this study was to evaluate the value of laryngeal ultrasonography versus cuff leak test in predicting post-extubation stridor.

Patients and Methods
Our study included fifty patients admitted to the critical care department, Misr University for Science and Technology Hospitals from the period of November 2017 to July 2018 intubated for different causes for a minimum of 24 h. excluded patients primarily intubated for the upper airway obstruction, patients with laryngeal carcinoma, Previous tracheostomy, neck radiotherapy. All patients will undergo for laryngeal ultrasonography versus cuff leak test to predict post-extubation stridor.

Results
In our study CLT identified PES patients with a sensitivity of 75%. But with low PPV of 50% for leakage volume of (132.5 mm ) . Laryngeal ultrasound showed a sensitivity of 50% for those patients with air column width before deflation less than 10.955 mm and ACWD 0.905 mm with PPV of 11.8% and 14.3% for air column width and ACWD respectively

Conclusion
Both CLT (Cuff leak test) and laryngeal US (ultrasound) might have sensitivity in predicting PES and should be used with caution in this regard.
Minimally Invasive versus Conventional Mitral Valve Surgery Comparison of Early Outcomes
Authors: Mohamed M A , Elsayegh T M , Elbawab H Y , Elnahas Y M , Omar A H 
Published: May 2020

Abstract
The mitral valve has been traditionally approached through a median sternotomy. However, mitral valve surgery could be performed using smaller incisions including the right minithoracotomy. This study was a case-control non randomized conducted on 60 patients. All patients had isolated mitral valve disease for mitral valve surgery, 30 of them were operated through right anterolateral minithoracotomy and the others through full median sternotomy to study the effects of minimally invasive mitral valve surgery through right anterolateral minithoracotomy on morbidity and mortality compared with conventional mitral surgery. Medico legal concent was taken from all the patients in this study. All the patients completed the study and there was no mortality among the patients. There was no statistically significant difference as regards the demograohic data, NYHA score and the preoperative echocardiographic findings. Regarding intraoperative comparison, there was statistically significant difference in the cross-clamp time, total bypass time & total operation time. This difference may be due to the new experiences in this MIMVS and the lack of instrumentation that narrow the field of MIMVS. The length of the incision was highly significantly lesser in the minimally invasive group than the full sternotomy group. There was significant difference in the intensive care parameters. The blood loss and the blood transfusion required were lesser in the minimally invasive group. But the ventilation hours and ICU stay was nearly the same in both groups. There was highly significantly less postoperative pain in the minimally invasive group than in the stenotomy group. Total hospital stay was nearly the same in both groups. Minimally invasive mitral valve surgery is a safe alternative to a conventional approach and is associated with less morbidity especially with expert surgeon in simple mitral valve surgery.
Comparative Study between the Use of Self-Fixating Mesh and Non Self-Fixating Mesh in Laprascopic Inguinal Hernia Repair Transabdominal Preperitoneal (TAPP) Technique
Authors: Ebied E F , Khalil A A , Soliman A I I 
Published: May 2020

Abstract

Background
Hernia is a common problem of the modern world with an incidence ranging from 5%-7%. Of all groin hernias, around 75% are inguinal hernias. Recently with advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work.

Aim of the Work
To compare between self fixating mesh and non self fixating mesh in laproscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence.

Patients and Methods
This study was conducted on 30 adult patients presenting with inguinal hernias. They were divided into 2 equal groups of 15 patients each. The first group (A): includes fifteen patients and was operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique using self -gripping (SGM group) (Parietex ProGrip] Laparoscopic (PPL) meshes), while the second group (B): includes fifteen patients and were operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique with non-self fixating mesh.

Results
The postoperative pain assessment at 24 hours and 4 weeks shows that the mean VAS score for GROUP A was (3.70 ± 1.72) and for GROUP B (3.90 ± 1.25) while after 1 month duration follow up, the mean VAS score was (1.25 ± 0.79) for Group A and (1.20 ± 0.77) for Group B with no difference between the two groups confirming the atraumatic nature of the self gripping mesh.

Conclusion
After this comparative study, both mesh fixation with absorpable tacks and fixation using SGM approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.
Three minutes walking test in correlation to six minutes walking test in COPD patients
Authors: Koraa E E A , Ali E R , Elshaer T K 
Published: May 2020

Abstract

Background
Chronic Obstructive Pulmonary Disease (COPD) is a common preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particels or gases.

Aim of the Work
The present objective is to analyze whether the distance covered over a short time period, 3 min, can be considered a reproducible test, determine whether there is a learning effect, and correlate the results with those obtained from the standard 6 min test.

Patients and Methods
This prospective study was performed on 40 COPD patients recruited from the Emergency room or outpatient clinic at Chest Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt) who will fulfill the inclusion criteria, Spirometry is required to make the diagnosis; the presence of post-bronchodilator FEVI/FVC &lt; 0.70 confirms the presence of persistent air flow limitation). Without resting hypoxemia with FEVI/FVC &lt;70%, Oxygen saturation of hemoglobin by pulse oximetry (SpO2) at room air&gt;88%y. All eligible patients were asked to perform 3 minutes and 6 minutes walking test

Results
learning effect exists with the 3 and 6 min distances repeated over short periods of time. A good correlation was observed between the distance walked at 3 and 6 min.

Conclusion
Our results suggest that the 3 min walking test is sub-maximal strength test that is simple and easy to carry out both in the hospital as well as outpatients environment, with a low cost, facilitating the evaluation of the functional capacity of patients with COPD, not very severe patients. Potential use includes evaluation of results after therapeutic treatment: bronchodilator drugs therapy, lung volume surgery, lung transplant and respiratory rehabilitation programs.
Impact of Diabetes Mellitus on Pulmonary functions in COPD patients
Authors: Ahmed M M , Abdelfattah N M M , Elsherbeny A A , Afifi S A 
Published: May 2020

Abstract

Introduction
COPD is known to be a multisystemic inflammatory disease that goes beyond lung involvement. The association of decreased lung functions and diabetes mellitus has been studied for many years suggesting that the lung could be a target organ in diabetes mellitus.

Objective
assessment of pulmonary functions in COPD patients with normoglycemia and with diabetes mellitus, and patients with diabetes mellitus.

Patients and Methods
The study was conducted in Ain shams university hospitals After the inclusion criteria was met, patients were divided into 3 groups, each group was 20 patients,(group 1): diabetes mellitus patients,(group 2): COPD patients, and (group 3): COPD with diabetes mellitus patients. spirometry was performed and results were analyzed.

Results
In COPD with diabetes mellitus patients (group 3), the lung functions were the least. Diabetes mellitus was also an independent risk factor for reduced lung functions as was seen in nonsmoking diabetic patients (group 1).

Conclusion
Pulmonary functions are reduced in DM independent of smoking.
Interventional Nutrition Education Program for Sixth Grade Students in a Governmental Primary School in Giza Governorate
Authors: Farah S K , Abouseif H A , Gamaleldin D A , Fahim H I 
Published: May 2020

Abstract

Background
Nutrition is a critical part of health and development. Better nutrition is related to improvement of child health, stronger immune systems, and lower risk of non-communicable diseases.

Objectives
the study aimed to describe knowledge, attitude and practice of sixth grade, primary school students about healthy eating habits and healthy diet and to implement and assess a nutrition education program for healthy eating habits and healthy diet.

Participants and Tools
An interventional study was conducted in one governmental primary school in Giza governorate and included 120 sixth grade students. The health education program was divided into three stages: Pre-intervention stage in which the knowledge, attitude and practice (KAP) of students about healthy and unhealthy dietary habits was assessed. Then educational program was implemented and (KAP) of students was re-assessed again twice after the education session immediately and then two months later.

Results
Most of the children (69.6%) had fair nutrition knowledge, (23.2%) had good knowledge, while (7.2%) had poor knowledge. After the intervention, there was an improvement in nutrition knowledge score of participated students (p &lt; 0.05) and this change was maintained after 2 months of the intervention. The total mean score percentage was (68% ± 9.8%) before intervention and had improved after 2 months of the intervention than before. The attitude of participated students had improved after intervention in relation to the concept that eating a lot of fat can make one become obese and eating a lot of sugar and sweets is harmful for health (p &lt; 0.001) The practice had improved among the study participants after 2 months of the intervention than before intervention (80.1% ± 5.1 vs. 68.5 ± 9.8%).

Conclusion
School nutrition intervention programs can have a great impact on knowledge and behavior of primary school students especially if various methods of teaching and learning were applied.
Sleep quality among a sample of Egyptian truck drivers
Authors: Yosef M , Abdelhamid M A , Salaheldin W , Elhabiby M , Rady M 
Published: May 2020

Abstract

Background
“Road traffic accidents” is a major health problem and it is significantly related to the mean daily sleep hours and sleep quality. This study aims to explore the sleep quality among a group of Egyptian truck drivers.

Methodology
A convenience sample of 117 male truck drivers working on Cairo – Suez highway was selected. Socio-demographic and occupational history were collected using an interview questionnaire and the Pittsburgh sleep quality index (PSQI) was calculated.

Results
The mean age of the studied drivers was 38.7 ± 9.7 y, 82.1% were married and 79.5% were current smokers. The mean driving hours per day was 15.35 ± 4.77, the mean sleeping hours per day was 5.8 ± 2.3 and 48 drivers (41%) had poor sleep quality according to the cutoff 5 for PSQI questionnaire. There was a significant difference between drivers with good vs poor sleep quality regarding number of cigarettes smoked per day, hours of work per day and mean distance travelled per day. Multivariate logistic regression showed that hours of work per day was the only significant predictor with poor sleep quality. Among drivers with poor sleep quality 16.3% reported having accidents in the past year which was significantly higher (p = 0.016) than those who had good sleep quality (2.9%), Odds Ratio: 6.4, 95% CI; 1.3-31.8.

Conclusion
Poor sleep quality is associate with increased risk of road traffic accidents among the studied truck drivers and the main factor that affect sleep quality is the number of working hours per day.
Tumor Necrosis Factor alpha 238 G/A polymorphism and its relation to severity and cardiovascular risk in psoriasis
Authors: ElSayed M H , Ahmed S E , Ali K , ElKhazragy N N , Attia M S 
Published: May 2020

Abstract

Background
Psoriasis is known as chronic immune-mediated inflammatory skin disease affecting about 3% of the world’s population. Cytokine gene polymorphism attracted considerable interest as they have been found to alter gene transcription thereby influencing inflammatory processes in response to various diseases.

Subjects
A total of 50 psoraitic patients and 50 controls were genotyped for TNF–α −238G/A polymorphism by using polymerase chain reaction. ECG and lipid profile were done to assess cardiovascular risk.

Results
Polymorphism of TNF–α −238 was not found to be associated with an increased risk for psoriasis (p value 0.98). There is significant difference between cases and controls as regard systolic and diastolic blood pressure .

Conclusion
Our findings suggest that there is no association between TNF alpha polymorphism and risk of psoriasis in Egyptian psoraitic patients.
Role of Lactoferrin in Chronic Telgon Effluvium
Authors: Milad G T , Diab H M , Elhusseiny R M 
Published: May 2020

Abstract

Background
Telogen effluvium (TE) is a widely prevalent hair condition and the second most common cause of hair loss after androgenetic alopecia. It presents as a nonpatterned increase in shedding of terminal hairs, diffusely over the entire scalp that can produce an apparent thinning of hair in severe cases. Both genders can experience telgon effluvium but females are the greater proportion of those who complain. Acute telgon effluvium is a form of non scarring alopecia with sudden conversion of large numbers of actively growing anagen to telogen hair leading to diffuse hair shedding. It is usually seen after severe illness, surgery, nutritional deficiency specially iron deficiency, postpartum, thyroid disease and in association with medications such as retionids, captopril and propranolol. It is reversible once the initiating factor is eliminated. Chronic TE (CTE) is a primary or idiopathic generalized telogen hair shedding from the scalp lasting more than 6 months without any apparent cause. It is characterized by insidious onset and fluctuating course. On examination, the hair appears normal in thickness with shorter re-growing hairs in the frontal and a bitemporal area, the hair pull test is commonly positive.

Objectives
The aim of this work was to assess the correlation between serum iron, ferritin and lactoferrin in chronic telgon effluvium with different clinical severities further supporting the notion for iron and lactoferrin supplementation in treatment of chronic telgon effluvium.

Patients and Methods
This study included 48 randomly selected patients suffering from chronic telogen effluvium attending outpatient clinics of Cairo hospital for dermatology and venerology (Al Haud Al Marsoud) and 40 control subjects, both cases and controls were age & sex matched. Laboratory assessment of CBC, serum iron, serum ferritin and lactoferrin in both cases and control groups.

Results
This study comprised of 48 patients with chronic telogen effluvium and 40 control subjects. Patients aged from 19-37 years old (mean 23.4 ± 5.4). 6 patients (12.5%) were males and 42 patients (87.5%) were females. The 40 control subjects involved in our study; aged from 20-36 years (mean 27.6 ± 5.4). 62.5% of patients had positive family history of similar condition; mean duration of disease was 25.4±14.9 months while associated androgenetic alopecia (diagnosed by trichoscopy) was seen in 56.3% of patients. Regarding severity, mean hair shedding visual scale was 4.38±1.47, while mean manual daily counting was 257.94±149.4.

Conclusion
Serum ferritin and lactoferrin were significantly lower in chronic telogen effluvium patients compared to controls while no significant difference in hemoglobin and serum iron was recorded.