bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of ventricular morphology on myocardial deformation in patients with single ventricle
Authors: Shoman K A E A , Ezzeldin D A , Esmail Y A , Attia H 
Published: May 2020

Abstract

Background
Functional single ventricle (FSV) is a spectrum of severe congenital heart disease, with multiple anatomic variations but similar surgical treatment strategies. FSV patients are living longer into adulthood compared to two or three decades ago, and they are more frequently undergoing imaging to assist in clinical and surgical management.

Objective
To determine impact of ventricular morphology on myocardial deformation in patients with single ventricle.

Material and Methods
From November 2017 to July 2018, 41 patients with single ventricle morphology or Physiology who were referred to Ain-Shams University hospitals for follow up Echocardiography or diagnostic cardiac catheterization were enrolled in the study.All patients subjected to history, clinical examination Echocardiography (conventional 2D and speckle tracking “global longitudinal strain and strain rate”.Dominant ventricular strain was analyzed using conventional two-dimensional echocardiographic. The region of interest was obtained by tracing the dominant ventricle endocardial borders at end-systole. An automated software program was used to calculate the frame-to-frame displacements of speckle pattern within the region of interest throughout the cardiac cycle.

Results
There is statiscially significance between the basic anatomy of the single ventricle and the ejection fraction (p value 0.001) and global longitudinal strain pattern by speckle tracking echocardiography with (p value 0.031) with no statistically effect of the side of dominance.

Conclusion:
Regarding the side of dominant ventricle there is no significant relation between the side of dominant ventricle on myocardial deformation (by ejection fraction, global strain and strain rate by speckle tracking echocardiography) but there is significant relation between the ventricular morphology and the myocardial deformation that was assessed by by the ejection fraction and global longitudinal strain (by speckle tracking echocardiography) but with no significant effect on the strain rate (by speckle tracking echocardiography)
Evaluation of Cardioprotective Effect of a Single Oral Dose of Nicorandil before Primary PCI in Patients presenting with Anterior STEMI
Authors: Louis B R , Elnozahi M A M , Abdeldayem T K 
Published: May 2020

Abstract

Background
Nicorandil in conjunction with primary percutaneous coronary intervention (PPCI) has been reported to exert cardioprotective effect in patients with ST segment elevation myocardial infarction (STEMI). Intravenous and intracoronary Nicorandil administration with PPCI have been reported to reduce reperfusion injury consequences and improve cardiac function in patients with STEMI even on the long term .However, there is limited information on the cardioprotective effect of oral Nicorandil in STEMI patients .

Objective
The Aim of this study was to evaluate Cardioprotective effect of a single oral dose of Nicorandil 20 mg given before primary PCI in patients presenting with a first anterior STEMI within 6 hours from symptoms onset.

Material and Methods
This study is a Prospective multicenter Study that included 80 Patients who were presenting with first anterior STEMI and undergone primary PCI as a myocardial reperfusion method in the period between June 2016 and May 2018. Patients were divided into two groups: Group A (40 patients) was the Study group which received Nicorandil 20mg single oral dose immediately on admission with the loading doses of aspirin and clopidogril prior to the PPCI procedure and Group B (40 patients) was the Control group that did not receive Nicorandil .

Results
There were no statistically significant differences between two groups as regards demographic data, risk factors for coronary artery disease and procedural data . There was statistically significant lower peak levels of cardiac enzymes and higher left ventricle ejection fraction (LVEF%) in group (A) compared to group (B). The peak level of CKT in group (A) was 1899.1± 601.000 compared to 2386.300 ± 844.318 in group (B), (P = 0.004) .The peak level of CK MB in group (A) was 264.100 ± 86.982 compared to 329.325 ± 147.404 in group (B), (P = 0.018) .The LVEF% in group (A) was (43.550±5.114) compared to (40.325±5.753) in group (B), (P = 0.010).

Conclusion
Single dose of Nicorandil 20 mg administered orally and given to patients who were presenting with a first anterior STEMI within 6 hours from symptoms onset prior to reperfusion with primary PCI had a significant cardioprotective effect in the form of higher left ventricular ejection fraction and lesser release of cardiac enzymes (CKT and CK MB) compared to control group which reflects more myocardial salvage of the area at risk and lesser reperfusion induced myocardial damage.
Short-term outcome of Manual Thrombus Aspiration for patients Undergoing Primary PCI for Acute STEMI Showing LargeThrombus burden
Authors: Penjameen M N , Elfekky E M , Elias R R , Nassar A I 
Published: May 2020

Abstract

Background
Thrombus aspiration (TA) might have a potential role in STEMI patients with heavy thrombus burden. The objective of several prospective trials whether routine TA in STEMI patients, contributes to a reduced mortality. After the first promising results, mainly based on the single center (TAPAS trial), results of the largest randomized trials to date (TASTE) study and (TOTAL) study, have not shown any significant differences in all-cause mortality, re-hospitalizations or stent thrombosis after a maximum of one-year follow-up period

Objectives
The aim of this prospective study is to study the in-hospital & short term out-come of using manual thrombus aspiration in STEMI patients undergoing primary PCI & showing large thrombus burden.

Results
The study included 209 patients referred to (CCU) of (Ain Shams University hospitals) with diagnosis of STEMI, who had under-gone primary PCI, with evidence of heavy thrombus burden . All the patients received DAPT, 99% had received GPIIbIIIa antagonists. The patients were divided into 2 groups: group (A) included 73 patients, who had under-gone manual thrombus aspiration followed by PCI to culprit lesion +/- other vessels & and group (B) included 136 patients, who had under-gone primary PCI of culprit lesion+/- other vessels, using the standard technique, without thrombus aspiration, within the period from 11/2016 till 7/2018(21 months),and they were followed up during hospital stay & for one month following hospital discharge. No stents were used in 13.7% of group (A), but no stents were used on 3.7% of group (B) (p value= 0.007). TIMI III flow had been achieved in 94.5% of group (A), 80.1% of group (B)(p value = (0.020) . MBG 3 had been achieved in 82.2% of group (A), 58.1% of group (B) . ST-segment resolution &gt; 70% had been achieved in 8.2% of group (A), that hadnot been achieved in group (B) (p value =0.003). Mortality(among MACE) was the only event detected (p value 0.026). Follow up MACE were statisticalLy significant results (p value=0.022) . Statistically highly significant results regarding, LV systolic function EF %, p vaue= 0.001, had been achieved .

Conclusion
In STEMI patients with evidence of heavy thrombus burden, a strategy of manual aspiration thrombectomy is valuable in reducing index hospitalization mortality, and 1 month follow-up rates of mortality, TIMI flow, better MBG, ST-segment resolution, in addition to left ventricular systolic function .
A predictive model for the left atrial diameter in estimating success rates of radio-frequency ablation treating atrial fibrillation
Authors: Elsayegh M T , Elghannam M A , Ammar A M , Taha A S , Elkerdany A B 
Published: May 2020

Abstract

Background
Ablation devices are being utilized in surgical procedures treating atrial fibrillation. Few studies seek to define a cut-off value for left atrial diameter size beyond which risks of procedure outweigh chance of sinus recovery. This study aims to identify a cut-off value for pre-operative left atrial diameter to assess the efficacy of surgical radio-frequency ablation for treatment of chronic atrial fibrillation in patients undergoing mitral valve surgery.

Methods
A prospective 6-month follow-up cohort study was done, in which 40 patients were recruited during the period from May 2016 till April 2018. All patients had rheumatic mitral valve disease and permanent atrial fibrillation. Receiver operator characteristic (ROC) curves were used to calculate the area under the curve and cut-off value for left atrial diameter. The efficacy of the overall survival time was estimated using the Kaplan-Meier method.

Results
Pre-operatively left atrial diameter of &gt; 59 mm was significantly associated with decrease in the possibility of reverting to sinus rhythm after surgery (OR 0.292, p-value = 0.001). The cut-off value for left atrial diameter was 59mm (sensitivity = 93.3%, specificity = 96.1%). Kaplan-Meier survival estimates were 175.07 days (156.3 - 193.9) for patients with left atrial diameter &lt; 59mm and 62.64 days (26.6-98.7) for patients with left atrial diameter &gt; 59mm.

Conclusion
In patients undergoing mitral valve surgery, higher degrees of ablation success are associated with smaller left atrial diameter in terms of conservation of the sinus rhythm post operatively.
Major Adverse Cardiac Events after first time elective isolated Coronary Artery
Authors: Hikal T , Hassouna A , Ashour H , Tarek A 
Published: May 2020

Abstract

Background
Major adverse cardiovascular events (MACE) are useful endpoints to evaluate cardiovascular outcomes. The aim of this study was to report our results in concordance with the expected improvement of records after using the online Research Electronic Data Capture (RedCap) software. Methods: We included patients who benefited from first time elective isolated coronary bypass grafting (CABG) at Ain-Shams university main hospital, in the period between April 2014 and April 2016; providing a minimum 2 years follow-up . Incidences, risk factors and independent predictors for MACE were calculated including; mortality, the occurrence or re-hospitalization for: heart failure, recurrence of angina or myocardial infarction (MI), cerebrovascular stroke (CVS), need of coronary angiography (CA), repeat percutaneous intervention (PTCA) or CABG. Results: 607 cases met our inclusion criteria and 105 patients (18.7%) developed 184 MACE, including 45 hospital mortalities (7.4%), 13 late mortalities (2.1%) and 126 non-fatal events recorded in 47 patients (7.7%); a majority (40 patients; 6.6%) had suffered from at least 3 non-fatal events. Two-years follow-up was complete for the 562 hospital survivors with a total of 1113 patient-years. The annualized incidence rates of ICU admission, repeated angina or MI, need for CA, PTCA, or CABG, development of CVS, heart failure, and late mortality were: 3.6%, 2.8%, 1.8%, 0.5%, 0.09%, 0.35%, 2% and 1.2% per patient-year; respectively. Independent predictors of hospital mortality were: advanced age at surgery (OR 1.06: 1-1.12; P = 0.049), female sex (OR 3.4: 1.3-8.9; P = 0.01), prolonged durations of: cardiopulmonary bypass CPB (OR 1.02: 1.01- 1.04; P &lt; 0.001), mechanical ventilation (OR 1.07: 1.04- 1.09; P &lt; 0.001) positive inotropic support (OR 1.03: 1.02- 1.05; P &lt; 0.001) and ICU stay (OR 1.09: 1.07- 1.11; P &lt; 0.001). Independent predictors of overall MACE were advanced age at surgery (OR 1.04: 1.01-1.07; P = 0.011), prolonged durations of: aortic cross clamp (OR 1.09: 1.04-1.11; P = 0.003), CPB (OR 1.06: 1.04-1.08; P &lt; 0.001) and mechanical ventilation (OR 1.02: 1.01-1.03; P &lt; 0.001). Conclusion: Our results suggested that more care should be given to females, elderly and to shorten and improve the quality of our operative times. The repetition of non-fatal MACE could be modified by closer observation of the patient, once developing his first event.
Clinical Utility of Serum Adipocyte Fatty Acid Binding Protein (A-FABP) in Type 2 Diabetes Mellitus Patients Complicated with Metabolic Syndrome
Authors: Elfeky S , Elhadidy E , Maher M , Awad D M 
Published: May 2020

Abstract

Objective
The adipocyte fatty acid-binding protein (A-FABP) has been described as a biomarker for adiposity and obesity-related disease. The aim of this study was to assess the association between fasting serum A-FABP level and the development of metabolic syndrome (MetS) among type 2 DM patients.

Methods
Fasting blood samples were obtained from 60 type 2 diabetic patients for assessment of serum A-FABP level (30 subjects without MetS and 30 subjects with MetS) compared to 30 healthy control subjects recruited from Endocrinology Department, Ain Shams University Hospitals. A-FABP protein was assayed using ELISA technique, MetS component (waist circumference, fasting serum glucose, triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and blood pressure), as well as homeostasis model assessment of insulin resistance (HOMA-IR) and highly sensitive C-reactive protein ( hsCRP) were assayed for all subjects.

Results
Diabetic persons who had MetS had significantly higher serum A-FABP levels than either without MetS or healthy controls [Median (25-75 percentiles): 10.5(8.25-14.25); 3.4(0.20-6.00) and 1.5(0.78-2.63) respectively ; p &lt; 0.01). However (HOMA-IR) and hsCRP did not show significant difference between diabetic patients with MetS versus diabetic patients without MetS (p &gt; 0.05).

Conclusions
Our results indicate that serum A-FABP level is an early marker for the development of MetS in type 2 DM patients, thus its assessment could be beneficial in diagnosis of MetS.
Assessment of CYP1A1 (MspI) Gene Polymorphism in Patients with Chronic Obstructive Pulmonary Disease
Authors: Atta R S , Shaheen K Y , Hamed A I , Kabiel W A Y 
Published: May 2020

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is one of the most important causes of morbidity and mortality worldwide, characterized by persistent and progressive airflow limitations. The etiology seems to be an interaction between genetic and environmental factors.

Objectives
We aim in this present study to evaluate the role of Cytochrome P450 1A1 (CYP1A1 MspI) (3801 T/C) gene polymorphism in the development of Chronic Obstructive Pulmonary Disease ( COPD) by PCR-RFLP.

Subjects and Methods
Our study was performed on 50 subjects ( 35 COPD patients & 15 control ). Pulmonary function test was performed for patient group,DNA extraction was done and polymorphism was assayed for all participants by polymerase chain reaction-restriction fraction length polymorphism ( PCR-RFLP).

Results
We found that smoking rate among COPD patients was significantly higher than the control group ( P value = 0.003). The genotypic distribution of the single nucleotide polymorphisms (SNP) 3801 T/C did not differ significantly between patients and healthy controls (P value = 0.78).As regards disease severity , the genotype distribution was found to be significantly different between GOLD 1&2 and Gold 3&4 groups. Combined TC +CC alleles was found in 6 patients ( 100%) of Gold 3&4 ( P value&lt;0.001)

Conclusion
Our study demonstrated that there is no relation between CYP1A1 gene polymorphism and development of COPD.It shows significant relation between COPD development and smoking, it also shows significant relation between MSPI gene polymorphism and disease severity regarding Gold staging and decline in lung function.
Using Reticulocyte Hemoglobin Equivalent (RET- He) in Diagnosis of Iron Deficiency Anemia
Authors: Ahmed R A R , Fayek M H A , Salem D A D 
Published: May 2020

Abstract

Background
Anemia is a significant worldwide health problem. Approximately one third of the world's population suffers from anemia, half of which is due to iron deficiency (ID). Evaluation of parameters relating to serum ferritin and iron is critically important in the diagnosis of iron deficiency anemia (IDA). The recent development of automated systems for hematology analysis has made it possible to measure reticulocyte hemoglobin equivalent (RET-He), which is thought to reflect iron content in reticulocytes, in the same sample used for complete blood count tests.

Aim of the work
We aimed to assess the role of RET- He in diagnosis of iron deficiency anemia.

Subjects and Methods
Blood samples were obtained from 102 subjects. Patients were classified into three groups: IDA, ID, and anemia of chronic disorder (ACD). In addition 20 age and sex matched healthy volunteers were enrolled as control. RET- He was assessed by Sysmex XN1000 hematology analyzer.

Results
Patients in the IDA group had significantly lower RET-He levels than those in the control group. RET-He was correlated with serum ferritin in the IDA and ID groups. The area under the curve for RET-He was 0.883. The cut-off value of RET- He for detecting IDA was ≤ 26.5 pg with 80% sensitivity and 90% specificity.

Conclusion
RET-He facilitates the diagnosis of IDA with high accuracy and may be a clinically useful marker for determining IDA.
Implication of Flow Cytometry-Based Maturity Score in Risk Stratification of Acute Myeloid Leukemia in Adult Egyptians
Authors: Eldebaky E A M , Afifi H M E , Pessar S A , Ahmed A M S 
Published: May 2020

Abstract

Background
Already for decades, controversy exists as to whether immunophenotyping has a prognostic significance in acute myeloid leukemia (AML). However, the impact of the immunophenotypic assessment of blast maturity is largely unknown.

Objectives
Studying the influence of the degree of immunophenotypic maturity, via the application of the flow-cytometric based maturity score, on the clinical outcome as well as the laboratory and clinical parameters of patients with AML.

Methods
This study was conducted on 40 newly diagnosed AML patients with the quantifications of the variable expressions of three early myeloid progenitor markers namely CD34, CD117 and TdT. After that, the estimation of the blast maturity was based on a previous score proposed in a study by Schneider et al. (2015).

Results
Out of forty patients enrolled, 8 patients (20%) were assigned to the mature group whereas 32 patients were assigned to the immature group. There was no statistically significant difference between both groups in terms of demographics, clinical and laboratory data, cytogenetic risk groups as well as treatment outcome determined by mortality and response to chemotherapy on day 28 and at 6 months. Mature group showed slightly higher median survival in comparison to the immature group.

Conclusion
There is no evident relationship between maturity score of the blast population of a patient and the clinical outcome despite mild prolongation of median survival of the mature group. Higher sample size is needed to confirm this observation.
Expression of G Protein–Coupled Receptor 56 (GPR56) in Acute Myeloid Leukemia
Authors: Afifi H M S , Elgamal R A , Abdelbary H M , Rashad M A 
Published: May 2020

Abstract

Background
Acute myeloid leukemia (AML) is a heterogeneous marrow-based clonal group of neoplasms that affects hematopoietic cells responsible for the production of myeloid lineages. Prognosis of AML is multifactorial and has been extensively studied, yet it’s highly dependent on the presence of leukemic stem cells (LSCs). G protein–coupled receptor 56 (GPR56) was introduced as a novel human LSC marker in AML patients as acknowledged by the engraftment potential of GPR56+ cells sorted from selected AML specimens, which contributed to leukemia propagation in mice.

Aim of the work
The aim of this study is to analyze GPR56 expression in de novo AML patients using flow cytometry. The results of GPR56 expression will be correlated with the clinical outcome of the patients as well as other laboratory parameters.

Subjects and Methods
The study was carried out at Ain Shams University hospitals on a total number of 40 AML patients attending hematology-oncology unit during the period from November 2016 to July 2017, in addition to 20 healthy control subjects. Patients were assessed at day 28 after induction of treatment by bone marrow examination and minimal residual disease analysis, and follow up of the disease course was done.

Results
GPR56 was highly expressed above mean in 62.5% of AML patients. High values were significantly related to failure to attain complete remission, whereas it lacked prognostic significance to patient outcome and cytogenetic subgroups.

Conclusion
The poor prognostic impact of GPR56 was partially validated in our study.

Recommendations
Flow cytometric evaluation of GPR56 should be incorporated into the initial laboratory work-up for all newly diagnosed AML patients.
Risk Perception and Occupational Accidents among a Group of Egyptian Construction Workers in a Construction Company in Cairo
Authors: Ellaban M M I , Rady M H , Gabal H M S , Mostafa N S 
Published: May 2020

Abstract

Background
Construction sector is one of the main pillars of the global economy, even though it is a risky business in which fatal and non-fatal occupational injuries occur frequently. Information about workers’ awareness about health and safety hazards, risk perception and safe work practices can help to understand where to apply prevention strategies. Unfortunately, construction sites are workplaces with limited access for research; studies at work level represent 2.28% of all available research.

Objectives
To estimate the perception of construction workers to the occupational hazards, to identify types of common occupational accidents involving construction workers in an Egyptian company and to identify the workers’ personal and work related characteristics determinants on their risk perception.

Material and Methods
A cross sectional study was conducted among construction workers in one of the projects in Cairo. During the period from January to August 2018; a sample of 104 workers were interviewed using a structured questionnaire inquiring about socio-demographic characteristics, work related variables together with assessment of workers’ risk perception.

Results
the majority of the workers had low risk perception for falls, contact with chemicals, struck by objects, sharp objects, manual lifting, repetitive movements and heat stress, while the noise was reported as “ no or acceptable risk category”. The study identified age, health and safety training, working hours and the use of PPEs as significantly related factors to risk perception.

Conclusion
risk perception among studied workers in average is low. Older age, prolonged working hours, lack of training and not wearing PPEs are significant risk factors shaping workers’ perception.

Recommendation
safety training and change of work environment may improve workers’ perception toward occupational accidents and subsequently reduce the risk of injuries.