bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of microRNA-34a as a molecular link between insulin resistance and nonalcoholic fatty liver disease
Authors: Mohamed M A , Yosef T M , Samy A H , Salama M M , Agwa S H , Ahmed A A A , Abdelsamie A M 
Published: May 2020

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is a chronic progressive disease of the liver that occurs in the absence of excessive alcohol consumption, evolving from simple hepatic steatosis, non-alcoholic steatohepatitis (NASH), fibrosis to cirrhosis and hepatocellular carcinoma (HCC). With a global prevalence of 25.24% (22.10-28.65), NAFLD has become a major public health problem. The principal risk factors associated with NAFLD include metabolic syndrome such as obesity, type-2 diabetes and hyperlipidemia. In particular, the prevalence of obesity in European patients with NAFLD varied from 25% to 94%. Insulin resistance resulting in a hyperinsulinemic state increases de novo lipogenesis, which further exacerbates hepatic lipid deposition and boosts the development of the disease.

Objective
The aim of this study is to evaluate Circulating microRNA-34a as a molecular link between insulin resistance and nonalcoholic fatty liver disease.

Methods
This study was carried out on 40 participants between June 2017 and June 2018. They were classified into 2 groups: Group I included 20 patients newly diagnosed as Nonalcoholic fatty liver disease (NAFLD) and had not received any treatment. Group II included 20 apparently healthy volunteers defined as those with normal transaminases, normal hepatic ultrasound and negative for HBsAg, HCV¬Ab.

Results
Results were compared to results of similar researches; where this study found that there was statistically significant increase in MiR-34a levels in group I Clan group II with p-value &lt; 0.001. Also there was statistically significant positive correlation between MiR-34a and age, BMI, HOMA-IR, NAFLD-fibrosis score, ALT, AST, TGs, F.ins and F.Glu. The best cut off point to differentiate between normal and NAFLD group regarding MIR34-a was found &gt; 1.46 with sensitivity of 80%, specificity of 100% and area under curve (AUC) of 92.2%.

Conclusion
Circulating microRNA-34a provides a good molecular link between insulin resistance and nonalcoholic ratty liver disease. All data were statistically analyzed. Results were compared to results of similar researches; where this study found that the best cut off point to differentiate between normal and NAFLD group regarding MIR34-a was found &gt; 1.46 with sensitivity of 80%, specificity of 100% and area under curve (AUC) of 92.2%.
Cardiovascular Autonomic Nervous System Dysfunction in Patients with Systemic Lupus Erythematosus
Authors: Hussein D A , Abdelaziz A B E , Abdelmoteleb A M , Elserwy M A , Arafa S G 
Published: May 2020

Abstract

Background
involvement of central and peripheral nervous systems are well-documented in SLE but literature on prevalence and pattern of autonomic neuropathy are few. Women with SLE have been found to have 5-8 fold increased risk of coronary heart disease. Autonomic dysfunction in the presence of structural cardiovascular disease is associated with adverse prognosis.

Aim of the Work
the purpose of this study is to evaluate the cardiovascular autonomic function in patients with Systemic lupus erythematosus, and to correlate it with SLE clinical features.

Patients and Methods
we conducted our study on one-hundred Egyptian SLE patients diagnosed according to SLICC classification criteria for SLE recruited from rheumatology outpatient clinic and inpatient department at Ain Shams University Hospitals. All the studied patients were subjected to history taking, clinical examination, and laboratory and radiological investigations related to SLE diagnosis and activity. SLE disease activity was assessed by SLE disease activity index-2000 (SLEDAI-2K).Tilt table test was used to assess for presence of cardiovascular autonomic neuropathy.

Results
we found that fifty (50%) of our SLE patients had symptoms suggestive for autonomic dysfunction, including orthostatic hypotension, palpitation and or Raynaud’s phenomenon. Regarding the result of tilt table test, sixty eight (68%) of the studied SLE patients were found to have positive tilt table responses. By doing the uni-variate analysis for predictors of SLE patients with positive tilt table test, we found that vasculitis, proteinuria, DNA, low TLC and complement levels, high SLEDAI, ESR and urinary P/C all were predictors for positivity of tilt table testing.

Conclusion
The prevalence of autonomic dysfunction was high among SLE patients.
Brain Volumetric Changes and Cognitive Functions in Epileptic Patients
Authors: Ashour A A , Nassef A M A , Awad E M , Hazzou A M , Nada M A , Abdullah Y A 
Published: May 2020

Abstract

Background
Epilepsy is a serious common neurological disorder that can affect any age. Cognitive functions are highly prevalent in patients with epilepsy and is more likely to occur in patients with idiopathic generalized epilepsy (IGE). Associations were found between cognitive functions and brain volume loss in patients with epilepsy.

Objective
This work was carried out to assess the volumetric changes in brain of epileptic patients to use it as a biomarker for cognitive dysfunction in adult and adolescent patients with epilepsy.

Patients and Methods
A case control study was conducted to include 61 patients, 20 of which diagnosed with idiopathic generalized epilepsy (IGE), 21 with temporal lobe epilepsy (TLE) and 20 with frontal lobe epilepsy (FLE) who were selected from the epilepsy outpatient clinic in Ain Shams university hospitals along with 23 age and sex matched healthy controls. Both cases and control groups were subjected to Magnetic resonance imaging MRI brain volumetry and detailed cognitive testing. An informed consent was taken from each adult patient, guardian of adolescent patient and healthy control.

Results
Statistically significant difference in comprehension subcategory of the Wechsler adult intelligence scale (WAIS) between patients with IGE and healthy controls denoting poorer social judgment in the IGE group. The IGE group also showed poorer performance in digit symbol subcategory of the same test denoting worse psychomotor speed and sustained attention. Also, significant difference in similarities subcategory was found between TLE group and control group denoting poorer abstract thinking among the TLE group. The IGE and TLE groups also showed lower attention and concentration than control group in the mental control subcategory of the Wechsler memory scale (WMS) yet failed to show superiority over each other.
No statistically significant difference was found on comparing the whole brain volume between cases and control groups.
A statistically significant direct relationship was found between the arithmetic subcategory of WAIS and the whole brain volume of the patients among the patients of the FLE group.

Conclusion
Patients with IGE had worse psychomotor speed, sustained attention and concentration than healthy controls in addition to poorer social judgment. Also, patients with TLE showed lower attention and concentration together with poorer abstract thinking despite normal IQ. The study also concluded that increased whole brain volume in patients with frontal lobe epilepsy is associated with better mathematical problem solving.
Causes of delayed management of multiple sclerosis patients in Nasr city health insurance hospital
Authors: Wahib M M , Abdulghani M O , Aref H M A , Nasef A M A 
Published: May 2020

Abstract
In multiple sclerosis (MS), the immune system attacks and destroys the fatty myelin coating that surrounds and insulates nerve cells in a process known as demyelination. MS is a lifelong condition, and common symptoms include fatigue, muscle spasms, walking difficulties, or numbness and tingling of the face, body, arms and legs. These symptoms can worsen with time, affecting daily activities and reducing a person’s quality of life.
The disease is highly variable, and some people are affected more than others upon and after diagnosis. Treatments are available to help manage a number of symptoms.
Life expectancy for people with MS has increased considerably in the last 20 to 25 years. On average, however, a person with MS can expect to live seven fewer years than someone without this disease.
According to the National MS Society, on average, an MS patient lives about seven fewer years than someone in the general public, largely because of disease complications or other medical conditions, like cardiovascular disease. Only rarely does the disease progress so quickly that it is deadly.
Due to advances in treatments, care, and lifestyle adjustments, MS often progresses slowly. Many studies show that, nowadays, about two-thirds of all patients retain a fair degree of mobility—the ability to walk, although likely with an assisted device—some 20 years after being diagnosed. Assisted devices can range from supports to aid in walking, to scooters used on occasion to save energy and avoid fatigue.
The course of the disease depends on each patient’s risk factors, like having a family member with MS, cigarette smoking, and vitamin D sunlight exposure. And, among African-Americans, the disease tends to be a more progressive form and progression can be quicker.
MS prognosis is thought to be better for people with relapsing-remitting MS than for those with progressive forms of MS, likely because of a better response to disease-modifying therapies.
The Prognostic Value of Reversed Ophthalmic Artery Flow Direction in Acute Stroke Patients with Ipsilateral Extra Cranial Carotid Artery Stenosis
Authors: Abouelnaga Y , Hazzou A , Helmy S , Fahmy Y M 
Published: May 2020

Abstract

Background
According to the World Health Organization, about 15 million people suffer a stroke each year with roughly one-third resulting in death and another one-third sustaining severe permanent disability. Even in developed nations, stroke is the third leading cause of death. It also costs billions of dollars through lost productivity, premature mortality and care for stroke survivors. The evaluation of hemodynamics, autoregulation and collaterals is cardinal for clinical outcomes. The Use of Transcranial Doppler (TCD) in detecting reversal of blood flow direction especially in anterior communicating and ophthalmic arteries, and flow diversion between anterior and posterior circulation provide critical information on ipsilateral collateral status. The impact of collateral status has been correlated with clinical symptoms, reperfusion success and functional outcome at discharge. A rationale now exists for imaging assessment to guide physicians in the precision medicine of stroke care.

Aim of the work
This study is performed for evaluation of hemodynamics in ophthalmic artery as a collateral and its value as a prognostic factor in patients with carotid artery extra cranial stenosis in acute cerebrovascular stroke.

Patients and Methods
30 patients with acute cerebrovascular stroke were recruited in this cross-sectional study admitted in stroke unit at the department of neurology of Ain Shams University hospitals.

Results
There was a statistically significant difference between the Modified Rankin Scale on discharge and follow up after 3 months in patients suffering from acute cerebrovascular stroke with ipsilateral severe extra cranial carotid artery stenosis and reversed ophthalmic artery flow direction (p value =0.042), compared to the group with direct ophthalmic artery flow direction where the (p = 0.086).

Conclusion
Transcranial Duplex is a diagnostic tool that provides a non-invasive, real time, safe technique information data on intracerebral hemodynamics. It was used in this study to detect that there is a significant difference in functional outcome between patients with forward and reversed ophthalmic artery flow direction with acute cerebrovascular stroke and ipsilateral extracranial carotid artery stenosis.
Outcome of Endovascular Treatment of Cerebral Arteriovenous Malformations with Ethylene Vinyl Alcohol Coploymer
Authors: Mohram H E , Habib M A , Mourad S H , Abozeid A H , Salem A M M 
Published: May 2020

Abstract

Background
Cerebral AVMs are very rare lesions, and this rarity contributes to the difficulty of treating them. There is no consensus concerning the method of treatment to be chosen among neurosurgery, radiosurgery or embolization. Onyx embolization could serve as a curative option with accepted morbidity and mortality. The introduction of Onyx and of catheters with detachable tips has no doubt increased the rate of endovascular occlusion, and decreased the risks associated with treatment in our experience.

Objective
The aim of the study was to assess the outcome of the use of Onyx in the treatment of intracranial AVMs as curative embolization or before neuro- or radiosurgery

Patients and Methods
This analytical prospective study was conducted on 25 patients who were diagnosed with cerebral arteriovenous malformations and underwent endovascular embolization with EVOH copolymer with curative intent during the study period. Interventional procedures were done in the neuro – endovascular unit, neurosurgery department Ain Shams University Hospitals and associate neuroendovascular unit in El Matarya Teaching Hospital in the period between September 2014 and April 2017.

Results
Actually comparing these results especially concerning the cure rate along with other studies was somewhat confusing and problematic owing to the diversity in results between studies across the last 15 years.

Conclusion
For the cases that are not fulfilling these criteria, embolization should be offered as preparing step for other modality of treatment. In our experience, for curative embolization, the AVM should be small sized (&lt; 3 cm), supplied by one vascular territory, with feeders that can tolerate reflux up to 2–3 cm, with clear proximal parts of the draining veins, and not located in deep structures.
Clinical and Neuroradiological Features of Hereditary Ataxia Patients: Hospital Based Study
Authors: Fahmy N A , Shalash A S A , Roushdy T M E , Gaber M A 
Published: May 2020

Abstract

Background
Ataxia (GK Taxis mean lack of orders) is defined by imbalance in coordination in gait, limbs and speech. It usually results from disorders in cerebellum or its connections. It is disorder of rate, range, direction and force of movements.

Aim of the Work
to investigate and identify the prevalence of hereditary ataxias regarding clinical and radiological.

Subjects and Methods
our study is composed of 23 patients, (their age range from 15 years old to 40 years old).We study the effect of positive family history and consanguinity on the prevalence of hereditary ataxias. We assess patients functionally using SARA score.

Results
there was positive relationship between positive family history and consanguinity and appearance of disease in cases so, it is important to ask about family history, similar condition and do family pedigree to know mode of inheritance if possible. Also, we found positive correlation between duration of disease and SARA score. There was positive correlation between MRI brain finding (cerebellar atrophy or brain stem atrophy), neurophysiological studies (axonal neuropathy) and disease.

Conclusion
positive family history and consanguinity are risk factors for hereditary ataxias. SARA score is a useful tool to assess hereditary ataxias functionally. MRI brain and neurophysiological studies are useful tools to diagnose hereditary ataxias.
Causes of delayed diagnosis of multiple sclerosis in egypt
Authors: Tohamy A A , Swelam M S , Abdelgawad D M , Aref H A 
Published: May 2020

Abstract

© 2018 Institute of Psychiatry, Ain Shams University
Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited.

Background
MS is an inflammatory and neurodegenerative disease. Early inflammatory activity might have a profound impact on the risk of developing early disability, and might be a risk factor for early transition into the progressive phase of the illness. However, there are a number of barriers implementing early MS diagnosis and treatment as the patients may delay consulting a physician about their neurological symptoms or may be reluctant to start DMT.

Objective
The aim of this study is to highlight the causes of delayed diagnosis of multiple sclerosis in Egypt to shorten the time of diagnosis and improve the prognosis for patients with MS.

Patients and Methods
Retrospective descriptive study .500 Patients coming to multiple sclerosis unit at Ain Shams University hospitals with delayed diagnosis of MS for more than 2 years had been screened. A questionnaire could be applied on 320 patients out of 500. Contacting (direct and via phone calls) the patients for evaluating the causes of delayed diagnosis of MS was done.

Results
In this study we found number of significant factors adversely affected a timely diagnosis including the age at onset finding that those younger at onset of MS (vs. older) experienced diagnostic delays (P-value = 0.005) and denial of symptoms which was a leading cause for delayed time to first doctor consultation and delayed diagnosis of MS (P-value =0.009). Also there was a correlation between types of MS and delayed diagnosis as we found that PPMS versus RRMS had delayed diagnosis for more than 2 years. Meanwhile, sensory symptoms at onset of the disease were associated with longer diagnostic delay. Although the first specialties the patients visit were ophthalmology and orthopedic services, that the most common Source of referral to a neurologist was suggestion by family and media.

Conclusion
multiple causes significantly affect time to diagnosis of MS including age at onset of the disease, denial of symptoms sensorial symptoms at the disease onset and referral delay from other specialties.
Depression and suicidal ideations in relation to occupational stress in a sample of Egyptian medical residents
Authors: Elbatrawy A N , Mahmoud D A , Mohamed M Y , Mohamed M M 
Published: May 2020

Abstract

Background
Studies have suggested that medical students experience high rates of depression and suicidal ideation. However, estimates of the prevalence of depression or depressive symptoms among students vary across studies from 1.4% to 73.5% and those of suicidal ideation vary from 4.9% to 35.6%.
Reliable estimates of depression and suicidal ideation prevalence during medical training are important to prevent, treat, and identify causes of emotional distress among medical students, especially in light of recent work revealing a high prevalence of depression in resident physicians

Aim of the work
to assess the occurrence of depression and its severity in a sample of Egyptian medical residents of Ain Shams university hospitals, as well as demonstrate the occurrence of suicidal ideations in residents and highlight relation between it and occupational stress.

Patients and Methods
This is a Cross sectional analytical study conducted in Ain Shams University hospitals. This present study aimed at analyzing the data of 256 medical residents graduation year 2013-2016, and at different periods of residency, 36 of which were excluded due to previous diagnosis with psychiatric illness before residency, over six months period from June 2018 to January 2019, and were screened for depression, suicidal ideations, socioeconomic stress and stressful aspects of residency.

Results
A total of 256 questionnaires were done by medical residents of Ain Shams University, 36 were excluded mostly due to previous psychiatric diagnosis before residency. Only 60 (27.27%) of the remaining 220 residents had normal ups and downs according to Beck depression inventory (BDI) with the rest of the 160 residents having depression of different severity ranging from mild (54, 24.55%), borderline (38, 17.27%), Moderate (51, 2.18%), severe (10, 4.55%), extreme(7, 3.18%). 50(22.7%) out of the 220 residents were considered to have high suicide risk according to beck suicidal ideation scale.

Conclusion
Professional and personal stress is a significant and frequently overlooked component of a resident’s life. In addition, residents are at higher risk to develop depression as studies have suggested that medical students experience high rates of depression and suicidal ideation.
Intervention studies are needed, e.g. support groups, more intense coaching by senior physicians, training programs on ‘breaking bad news’ and teaching of stress management skills to study how to prevent or reverse burnout.
Correlation of psychopathology and white matter abnormalities in fathers of children with ADHD: Cross sectional study
Authors: Effat S M , Elshahawy H , Sakr H M , Shorub E M , Azab S E 
Published: May 2020

Abstract

Background
Attention-deficit/hyperactivity disorder (ADM)) is one of the most common neurobehavioral disorders of childhood. Children with ADHD may experience significant adaptation problems because their functional level and behavior may not correspond to their chronological age or expected development level. ADHD is a chronic disease, the symptoms of which can persist into adulthood and become lifelong.

Aim of the work
evaluating the biological substrate in fathers of children with ADHD, assessing rate of occurrence of ADHD among fathers of children with ADHD.

Subjects and Methods
This descriptive observational cross-sectional study was conducted on 40 children with a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) according to the DSNI-IV criteria who attended to the Child and Adolescent Outpatient clinics of the Institute of Psychiatry, Ain Shams University Hospital.

Results
Prevalence rate of diagnosis of adult ADHD among fathers of children with ADHD (6 to 12) years old was 60%, 20% with mixed hyperactive—inattentive type, 15%.predominantly hyperactive—impulsive type and 25% predominantly inattentive type. There were statistically significant differences between ADHD group of children’s fathers in comparison to Non-ADHD group, as the mean ADC of right and left middle cerebellar peduncle, was lower in ADHD group which indicates absence of abnormalities in white matter integrity in those areas.

Conclusion
prevalence rate of adult ADHD among fathers was 60%. There were no abnormalities in white matter integrity in group of fathers with diagnosis of adult ADHD.