bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of Hypoglycemia in Type 2 Diabetic Patients in Sample of Egyptian People in Clinic Based Study
Authors: Hamed M S , Mostafa B M , Bahaaeldin A M , Ibrahim N A , Mohamed M A 
Published: May 2020

Abstract

Background
Hypoglycemia is a true medical emergency which requires prompt recognition and treatment to prevent organ and brain damage. Hypoglycemia is not a disease in itself; it is a sign of a health problem; whose importance lies in its effects upon brain function. With increasing incidence of diabetes and with various modalities of intensive control of blood glucose levels, there is always a risk of a proportional increase in the incidence of hypoglycemia.

Aim of The Work
we measured the frequency of hypoglycemic attacks in type 2 diabetic patients (T2DM) in clinic based study and correlate the attacks of hypoglycemia with treatment regimens and duration of the diabetes mellitus (DM)

Methods
Copies of pre-tested questionnaire were administered directly to 1000 patients with T2DM at the study site. This questionnaire was previously published as a part of the Workgroup of the American Diabetes Association and The Endocrine Society (ADA) on 2013. After translating it into public traditional Egyptian Arabic language.

Results
Our main finding was that for people with T2DM the incidence of hypoglycemia was 36% (360 out of 1000 patients). 26.39% (95 out of 360 patients) on oral hypoglycemic drugs compared to 71.94% (259 from 360 patients) on insulin. hypoglycemia was 48.42% (46 out of 95 patients) in Diabetic patients having diabetes for more than five years and on oral hypoglycemic drugs, compared to 76.83% (199 out of 259 patients) in diabetic patients on insulin. there is a highly statistically significant difference between diabetic patients on insulin and long duration of diabetes (p &lt; 0.001). Also show that there is a statistically significant difference between diabetic patients on oral hypoglycemic and long duration of diabetes p value 0.034. Prevalence of (IAH) impaired awareness of hypoglycemia is 49.94%&unawareness 27.72%

Conclusion
Hypoglycemia is common in T2DM (36%). It is a significant complication of diabetes therapy and although mild hypoglycemia causes unpleasant symptoms and disrupts patients’ daily activities, severe hypoglycemia can result in coma, seizures, and death.
Effect of Hepatitis C Virus Treatment on Rejection Incidence and Severity in Post-Liver Transplant Recipients
Authors: Othman M A , Elsayed M M , Kamaleldin M M M , Elshafie A I M , Nabil Z M 
Published: May 2020

Abstract

Background and Aims
HCV is a worldwide cause of chronic liver disease, particularly in Egypt where the most prevalent is genotype 4. HCV-associated cirrhosis is the most common indication for orthotopic liver transplantation (OLT) among adults. HCV infection remains a problem after transplantation, and recurrent hepatic infection is the leading cause of graft failure. Little is known about the long-term effects of direct acting antiviral therapy in patients after liver transplantation. We examined the incidence and severity of liver transplantation rejection in patients treated for HCV, post liver transplantation, with DAAs relative to the incidence and severity of liver transplantation rejection in patients treated for HCV, post liver transplantation, with Interferon based therapy and patients who didn’t receive any treatment for HCV after transplantation.

Patients and Methods
The study was conducted on 90 patients who had underwent liver transplantation between 2010 and 2017 at Ain Shams Center for Organ Transplantation (ASCOT) with a minimum follow up period of 6 months. Patients were divided into three groups: group I included 16 patients that didn’t receive antiviral treatment after liver transplantation, group II included 20 patients that had received interferon based therapy after liver transplantation and group III included 54 patients that had received direct acting antivirals after liver transplantation.

Results
Amongst group I, 2 patients (12.5%) developed acute graft rejection while in group II 2 patients (10%) developed chronic graft rejection and in group III 6 patients (11.11%) developed chronic rejection. In group I, all the patients (100%) had developed rejection that was diagnosed within one year of liver transplantation. In group II, 2 patients (100%) developed chronic graft rejection which occurred after one year of liver transplantation, one of them was on treatment with peg interferon and the other had already completed treatment. In group III, 2 patients (40%) had developed chronic rejection within one year of transplantation, while 4 patients (60%) had developed chronic rejection after one year of transplantation. One patient (16.67%) had developed rejection on treatment while 5 patients (83.33%) had developed rejection after the end of treatment.

Conclusion
It was found that the incidence of chronic rejection was more in patients that had received antiviral treatment after liver transplantation, however no difference was noted between DAAs and peg-interferon. Chronic rejection was found to be more common when treatment was given over one year after liver transplantation (6 cases) as compared to within the 1st year (2 cases). This may be related to the withdrawal of immunosuppression treatment after one year of transplantation and maintenance on monotherapy.
3-Nitro-Tyrosine as a Biomarker of Minimal Hepatic Encephalopathy in Patients with Liver Cirrhosis
Authors: Awad E A , Mohammed M N , Sayyed M M , Elkhayal A E , Ahmed M A S 
Published: May 2020

Abstract

Background
hepatic encephalopathy (HE) is a common complication in patient with liver cirrhosis. It comprises of a broad spectrum of neuropsychiatric abnormalities of varying severity, and affected patients usually suffer from psychomotor, cognitive, emotional, behavioural, and motor coordination dysfunctions. Patients with minimal HE (MHE), a subclinical form of HE, usually have a normal mental and neurological status upon routine clinical examination. The subtle deficits in patients with MHE can only be elicited by specialized neuropsychological tests.

Aim of the Work
the aim of this study was to evaluate the role of 3-Nitro-Tyrosine as a biomarker of Minimal Hepatic Encephalopathy in patients with liver cirrhosis.

Patients and Methods
our conducted study was a prospective case control study carried on 60 adult patients and 30 age matched controls. All were recruited from Internal Medicine and Hepatology and Gastroenterology Department at Ain Shams University Hospitals in the period between September 2016 and June 2018. All patients enrolled in the study were subjected to detailed history taking, full physical examination, laboratory investigations, psychometric tests for detection of MHE using specially digit symbol test (DST), Trail making test A (TMT A), Trail making test B (TMT B), serial dotting test (SDT) and 3-Nitro-Tyrosine level (3NT).

Results
our study found that the serum levels of 3-nitro-tyrosine are a good predictor of the presence of MHE in patients with liver cirrhosis, with good sensitivity (90%) and specificity (93.33%) and positive and negative predictive values were 93.1% and 90.3% respectively at a cutoff of 14.8 ng.

Conclusion
determination of 3-nitro-tyrosine in serum is easy and is not time consuming. It only requires taking a serum sample from the patient and determining 3-nitro-tyrosine concentration. This procedure can be therefore easily added to the routine clinical determinations in patients with liver cirrhosis. This would also allow extending the diagnosis of MHE to most clinical settings, helping to identify patients with MHE.
Assessment of the early reach ability of major molecular response (MMR) in chronic phase of CML Egyption patients on first(1st) and second(2nd) generation TKI(as regard 1st and 2nd line of treatment
Authors: Azzazi M O , Said R M M , Abdallah M , Elshazly A , Allam A A M 
Published: May 2020

Abstract

Background
Nilotinib has been shown to be a more potent inhibitor of BCR-ABL than imatinib. We evaluated the efficacy and safety of nilotinib, as compared with imatinib, in patients with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia (CML) in the chronic phase

Aim of the work
Comparsion between the early reach ability of major molecular response (MMR) in chronic phase of CML patients on first(1st) and second(2nd) generation TKI(as regard 1st and 2nd line of treatmen t

Patients and methods
major molecular response (MMR) was assessed by quantative PCRfor BCR –ABL in 100 paients with newly diagnosed CML d ivided to three groups, group 1 included 40 patients on first generation tKI(imitinib), group 2 included 40 patients shifted from 1st generation (imitinib) to 2nd generation (nilotinib) and groups 3 included 20 patients on 2nd generation (nilotinib) from the start. The patients were recruited from clinical hematology department at Ain shams university hospital over the period from1/2018 to1/2019

Results
in CML patients, rate of MMRat 12 months of treatment on 2nd generation TKI (nilotinib) as 1st line was higher than other groups (p = 0.025*), rate of EMR was higher in patients on nilotinib 300 mg than on imitinib 400 mg(p = &lt;0.001) in CMl patients started on imitinib 400mg with additional cyto genetics abnormalities had high numbers of failure of MMR(p = 0.001) in comparsion to patients on nilotinib either 1st line or shifted. in CMl patients started on nilotinib 300mg had rising of liver functions than patients on imitinib(p = 0.002 in CMl patients started on nilotinib 3oomg as 1st line had high numbers of ECG chnges than patients on imitinib4oomg(p = 0.005) in CMl patientswith high sockal score started on imitinib 400mg had high number s of failure of MMR in comparsion to patients on nilotinib 300 mg(p &lt; 0.001) in CMl patients, rateof CCR at6 and 12month had higher in patients started on nilotinib 300mgthan imitinib 400mg (p = 0.020)

Conclusion
treatment with first-line nilotinib is a better clinical strategy than starting with imatinib followed by switching to nilotinib for inadequate responses
Diagnostic value of serum leptin as a tumor marker in hepatocellular carcinoma
Authors: Abdelwahab K , Abdelmaaboud M , Magdy M , Abdelhalim M A 
Published: May 2020

Abstract

Background
Leptin is a peptide hormone produced by adipocytes, acts on the energy balance of reproduction and immunomodulation, and this action is linked to the pathogenesis of many diseases. High levels of this hormone increase hepatic response to various stimuli of liver fibrosis. Leptin acts to mediate hepatic stellate cell activation and liver fibrosis throughout indirect effects on Kupffer cells

The aim
The aim is to evaluate diagnostic value of serum leptin as a tumor marker in hepatocellular carcinoma (HCC).

Methods
90 Egyptian subjects were conducted to this study after their written informed consent. They divided into 4 groups (30 patients with untreated HCC, 30 patients with treated HCC, 15 patients with end stage chronic liver disease without HCC and 15 healthy controls). They subjected to full history, examination, laboratory investigation and abdominal ultrasound. Serum leptin assessment is done using ELISA method.

Results
Leptin level is increased in all patients groups compared to control ((med. 40 IQR 37-50, med. 8 IQR 3-20, med. 2 IQR 1-4 VS med.1 IQR 1-1 ng/ml respectively) also it was higher in untreated HCC and treated HCC patients than patients without HCC. (med. 40 IQR 37-50, med. 8 IQR 3-20 VS med. 2 IQR 1-4) . Furthermore, leptin level is higher in untreated HCC than treated HCC(med. 40 IQR 37-50 VS med. 8 IQR 3-20)
Leptin positively correlated with HCC

Conclusion
Leptin level in HCC either untreated or treated patients and in end stage CLD patients is higher than healthy .Also, it’s higher in HCC patients either untreated or treated than cirrhotic patients without HCC . Furthermore, leptin level is higher in un treated HCC than treated HCC patients.
Studying Studying the relationship between Dipeptidyl peptidase-4 enzyme level, Tumor necrosis factor alpha enzyme level, and insulin resistance in type 1 Diabetes Mellitus patients
Authors: Amer H M , Mahdy M M M , Saad W E , Abdelsalam M N A 
Published: May 2020

Abstract

Background
Type 1 diabetes mellitus (T1DM) is an inflammatory disease of the pancreatic islets that results in absolute insulin deficiency and the consecutive hyperglycemia due to immune-mediated beta cell destruction throughout the globe, the incidence of T1DM is increasing at 3% to 5% per year

Purpose
To study the relationship between DPP-4 serum level, TNF a concentration measurements, and insulin sensitivity in T1DM patient

Patients and Methods
Patients were selected from the inpatient department of National Institute of Diabetes and Endocrinology during Januaray 2017, venous blood samples were collected to measure Serum level of creatinine, C-peptide, HbA1c%, DPP-4, TNFα . Measurement of eGDR was done using the formula
24.31 - 12.2 x (WHR) – 3.29 x (BLP) – 0.57 X HbA1c

Study Design
Cross sectional study that included 80 patients with type 1 Diabetes,

Results
The study population was divided according to median eGDR value of 6.125 mg kg-1 min-1 The group with higher IR(eGDR≤ 6.125)had higher value of DPP-4 enzyme level (1127.3 ± 40.9 ng/ml vs. 870.6 ± 30.2 ng/ml, p &lt; 0.001) and TNF α concentration (11.4 ± 4.8 pg/ml vs 5.3 ± 1.6 pg/ml, p &lt; 0.001). TNF α concentration negatively correlated with eGDR (r= -0.515, p value &lt;0.001) DPP-4 level negatively correlated with eGDR (r= -0.826 and p value &lt;0.001) while DPP-4 was positively correlated with TNF α (r = 0.441 p value ≤ 0.001)
Interrelationship Between Chitotriosidase, Type2 Diabetes Mellitus and Atherosclerosis
Authors: Hosny S S , Maher M M , Bekhet M M , Bahaaeldin A M , Mahmoud H M A , Saleh A M M A 
Published: May 2020

Abstract

Background
Type-2 diabetes mellitus (T2DM) is the leading cause of cardiovascular morbidity and mortality worldwide . Poor glucose control, hypertension, and dyslipidemia are the main factors that increase the risk of atherosclerotic disease in T2DM.

Aim of the Work
To study the relationship between Chitotriosidase level in patients with Type 2 Diabetes Mellitus and the development of atherosclerosis.

Patients and Methods
This study was conducted on 75 persons. Cases were selected from Internal medicine & endocrinology outpatient clinics at Ain Shams University Hospital.
They were divided into Two groups:

Group 1
formed of 50 Type 2 Diabetic patients.

Group 2
formed of 25 healthy subjects as control

Results
Serum Chitotriosidae level was higher in type 2 diabetic patients than healthy control.and its level was significantly higher in type 2 diabetic patients with atherosclerosis. There was also positive significant correlation between Chitotriosidase and Fasting blood glucose, 2 h p.p,HBA1C, cholesterol, LDL, Triglycerides, BMI and W/H

Conclusion
serum chitotriosidase can be used as predictble marker for diabetic vasculopathy.
Study of Vitamin D Deficiency in Adolescent Females (10-18 years old) In Cairo
Authors: Botros R M , Eid Y M , Mostafa B M , Elmeligy Y H E 
Published: May 2020

Abstract

Background
Vitamin D deficiency is a common problem among Egyptian females across all age groups, for whom contributing factors include inadequate sun exposure possibly related to cultural/social factors, and insufficient dietary calcium, wearing a sunscreen reduces vitamin D synthesis in the skin by more than 95%. Not only environmental factors, such as sun exposure and nutrition, but also genetic and possibly also epigenetic factors are determinants of serum 25(OH) D.

Aim
We sought to determine the frequency of occurrence of vit D deficiency in Egyptian adolescent females aged 10-18 years in Cairo.

Methods
Study was conducted on 90 healthy adult females aged (10-18) years and classified them into: Sufficient group: with vitamin D level &gt;30ng/ml, (40%) of participants. Mild deficient group: with vitamin D level between 21-29ng/ml (14.44%) of participants. Moderate deficient group: with vitamin D level between 10-20ng/ml (11.11%) of participants. Severe deficient group: with vitamin D level &lt;10ng/ml (34.44%) of participants.

Results
Our study showed a high prevalence of low vitamin D level among healthy adolescent females aged (10-18) years old. There were a significant difference On comparing vitamin D status groups as regard vitamin D rich food intake, duration of sun exposure and height for age (p &lt; 0.001), (p &lt; 0.001) and (p = 0.012) respectively. There were significant difference on comparing vit D status groups with s.Ca, PTH and Alk.Ph (p &lt; 0.001).

Conclusion
Vitamin D deficiency became endemic in Egypt. Large-scale studies are needed to properly evaluate the size of the problem.
Cryoablation of goiter irrespective of thyroid profile
Authors: Hamed M S , Mansour S Z , Halawa M R , Bahaaeldin A M , Ibrahim N A , Ghoneim A Z 
Published: May 2020

Abstract

Background
Thyroid nodules are extremely common. By age 60, about one-half of all people have a thyroid nodule. Cryoablation is used in a variety of clinical applications, using hollow needles (cryoprobes). Cryoprobes are inserted into or placed adjacent to diseased tissue which is desired to be ablated.

Aim of work
To evaluate the effect of Cryoablation on the size & function of thyroid noduleWhich may replace the need for surgery or radiotherapy.

Patients & methods
This is an interventional therapeutic study, conducted in Ain-Shams University hospitals; endocrinology clinic. Our study sample included 80 subjects, age between 20 & 60, having thyroid nodule diagnosed by ultrasound. Subjects were divided into 2 groups: Group 1 included 40 subjects “control group” who were not subjected to cryoablation. Group 2 included 40 subjects “cases” upon which cryoablation was done. Neck ultrasound was done for subjects & they were sampled for their TSH, free T4 & free T3 levels at start and after 3 & 6 months.

Results
There was high statistical significant difference between group 1 & group 2 regarding nodule size after 6 months. Group 1 showed mean nodule size (0.89 cm ± 0.25 SD) while group 2 showed (0.62 cm ± 0.35 SD),(p-value&lt;0.001). Non-thyrotoxic cases were 6 times more liable to show nodule size reduction, from 0-6 months, more than thyrotoxiccases, which shows thyrotoxicosis as a factor against nodule size reduction in significant statistical relation. Females were more liable than males, to show nodule size reduction. There was no statistical significant difference between cases & controls regarding TSH, free T4 nor free T3 values, before study, at 3 months nor after 6 months.

Conclusions
Cryoablation causes nodule size reduction, especially after 2nd session. Cryoablation doesn’t affect thyroid function tests, all through our study.
Assessment of 25-hydroxy vitamen d in patients on regular hemodialysis in ain shams university hospital
Authors: Elshinnawy H A , Shawky S M , Abdelgawad M A , Ebrahim M H M 
Published: May 2020

Abstract
Address correspondence to M.H.M. Ebrahim, Department of Nephrology, Abo Kir Insurance Hospital, Alexandria, Egypt. email: d.mohamedhosny3@gmail.com
Comparison of Disease Characteristics, Course and Outcome between Adults with Juvenile and Adult- onset Systemic Lupus Erythematosus
Authors: Al-Hefny A M , Mohammad R A , Abdelrhaman M A , Morshedi N A , Soliman M E E 
Published: May 2020

Abstract

Aim of the Work
This study was performed to evaluate disease characteristics, activity and damage in adult patients with either juvenile or adult onset SLE.

Patients and Method
One hundred and fifty consecutive patients with SLE fulfilling the SLICC criteria for the classification of SLE were included in the study. The patients were classified according to the age at disease onset, 100 Adult-onset (ASLE) and 50 juvenile onset (JSLE). Patients records were reviewed for clinical and laboratory evaluation. Disease activity was assessed using SLE Disease Activity Index (SLEDAI). Disease damage was assessed using Systemic Lupus International Collaborating Clinics (SLICC/ACR) damage index.

Results
The mean age at disease onset of JSLE was 14.120± 1.534 and of ASLE was 22.460± 2.732. The female to male ratio was 9:1 in JSLE compared to 13:1 in ASLE. JSLE had butterfly rash (66%), photosensitivity (30%), oral ulcers (34%), arthritis (44%) and neuropsychiatric manifestations (6%).While ASLE had butterfly rash (35%), photosensitivity (10%), oral ulcers (17%), arthritis (65%) and neuropsychiatric manifestations (13%). There was higher prevalence of anemia, thrombocytopenia, ESR, CRP, 24 h and creatinine in JSLE more than ASLE with statistically significant differences. The mean SLEDAI was significantly higher in JSLE (14.080 ± 4.780) compared to ASLE, (10.760 ± 2.738) (P &lt; 0.001).

Conclusion
The age at onset of SLE influences its clinical manifestations and laboratory findings. JSLE patients have a more aggressive presentation and course than ASLE patients with a higher frequency of lupus nephritis, more cutaneous symptoms and hematological manifestations. JSLE patients have more severe disease activity with very high SLEDAI and SLICC damage scores. ASLE patients have more musculoskeletal manifestations.
Effect of Using Direct Acting Anti-Virals In Treatment of HCV Naive Patient with and without Portal Hypertension
Authors: Alkarmouty K Z , Mohamed E S , Fahim H A , Elsabagh A R E A 
Published: May 2020

Abstract

Background
Hepatitis C Virus (HCV) infection is a major global health challenge; it is estimated that more than 80 million people are chronically infected worldwide. Egypt has the highest prevalence of HCV in the world (predominantly genotype 4) secondary to the previous schistosomiasis eradication campaigns with very high incidence rates among elderly, rural areas and in lower social classes.
However, several oral anti-HCV drugs (direct acting antivirals; DAAs) have been developed over the last several years. Now, HCV can be eliminated from the infected host within 12 wk of DAA combination therapy without noticeable side effects
Aims: to evaluate the Effect of presence of portal hypertension on the results of treatment of chronic HCV infected naive patient with direct acting antivirals

Patients and Methods
200 subjects were divided into 2 groups: group I: including 100 cirrhotic patients with HCV infection and portal hypertension, group II: including 100 cirrhotic patients with HCV infection without portal hypertension.
Diagnosis of portal hypertension was confirmed by presence of esophageal varices in endoscopy.
Both group received combination of IFN-free DAAs.

Results
CK-18 was significantly elevated in patients of group I in comparison to group 11, 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 as regards 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 be correlated with steatosis and fibrosis assessed by fibroscan with P value&lt; 0.001.

Conclusion
treatment of 200 patients with HCV and compensated cirrhosis, HCV eradication reduced risk for liver decompensation, regardless of whether the patients had EVs.