bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Ventricular Systolic and Diastolic Functions after Cardiac Rehabilitation in Successfully Revascularized Patients with Acute Myocardial Infarction
Authors: Rashed M I A S , Bastawy I M , Khorshid H M , Sharafeldin A A 
Published: May 2020

Abstract

Background
Coronary artery disease (CAD) is a widely prevalent disease with many adverse sequelae. As survival after myocardial infarction or coronary revascularization has improved, cardiac rehabilitation and secondary prevention services have become more important. Advances in ultrasound such as Doppler imaging, strain or strain rate imaging provide comprehensive information on left ventricle (LV) myocardial contractility.

Objective
to evaluate the possible early effect of intensive supervised Cardiac rehabilitation on the LV systolic and diastolic functions in patients with acute myocardial infarction (AMI) who had been successfully revascularized by primary percutaneous coronary intervention (PCI) using two dimensional (2D) speckle tracking and doppler imaging.

Patients and Methods
thirty patients with AMI and successfully revascularized by primary PCI were enrolled in the study. LV global longitudinal strain (LVGLS) analysis was performed using 2D speckle tracking echocardiography before and after Cardiac rehabilitation. LV ejection fraction (EF) was measured using the modified Simpson’s method. Pulsed-wave Doppler at the tip of mitral valve leaflets was also done allowing us to measure the early (E) and late (A) diastolic filling velocities, E/A ratio. The LV tissue velocity was measured by TDI of the lateral mitral annulus (e’) and E/e’ was calculated and LV diastolic dysfunction (DD) grade was estimated.

Results
There was significant improvement in LVEF measurements before and after Cardiac rehabilitation (47.50 ± 6.42 before vs. 52.17 ± 6.64 after; p = 0.000).The improvement in 2D speckle tracking LVGLS after Cardiac rehabilitation was statistically significant (p = 0.000). the diastolic function as assessed by TDI after a 3-month program of exercise-based cardiac rehabilitation has improved with decrease in the number of patients with DD grade I and increase in the number of normal diastolic function with p-value P &lt; 0.01(highly significant).

Conclusion
cardiac rehabilitation has beneficial effects on LVGLS, LVEF as well as diastolic function after AMI and successful revascularization.
Polymer free drug-eluting stents versus durable polymer drug-eluting stents in elective percutaneous coronary interventions in patients with stable coronary artery disease patients
Authors: Altoukhy S M A , Rezq A A A , Anany B A M , Elhamady W A M , Metwally M F , Taher M A A 
Published: May 2020

Abstract

Aim
To compare the inflammatory response of polymer-free versus permanent polymer drug-eluting stents in patients with stable coronary artery disease undergoing elective PCI, and the effect of this inflammatory response on the 6 month clinical outcomes.

Methods
This randomized prospective comparative study was conducted on 100 patients with stable coronary artery disease planned for elective PCI divided into 50 patients with deployed permanent polymer DES (PP-DES) groups and 50 patients with polymer free DES (PF-DES). Blood samples were taken to assess serum level of hsCRP before the procedure and the first day after the procedure. The target end points were the recurrence of effort angina, incidence of target lesion revascularization (TLR) over a period of 6 months and the inflammatory response by measuring the percentage of rise in hsCRP level.

Results
There was no statistically significant difference in the clinical outcome in the first six months between the patients who had PP-DES and the patients who had PF-DES regarding recurrence of effort angina (p-value = 0.822) and TLR (p-value = 0.727), with no patients developing myocardial infarction or stent thrombosis. There was a statistically significant inflammatory response after stent deployment in both groups represented by a significant rise in the serum level of hsCRP on the first day after the procedure in both groups (p-value &lt; 0.001), but there was no statistically significant difference in the inflammatory response between PP-DES and PF-DES (p-value = 0.978). The number of patients having recurrence of anginal symptoms and TLR with hsCRP rise ≥ 11.36% was higher than those having the same with hsCRP &lt; 11.36%. However, this difference was not statistically significant regarding recurrence of anginal symptoms (p = 0.057) and TLR (p = 0.092).

Conclusion
The PF-DES was proved to be non-inferior to PP-DES regarding the short-term clinical outcome and the early inflammatory response. It was concluded that the presence of polymeric coating in PP-DES did not add to the magnitude of the inflammatory response and it did not significantly increase the incidence of recurrence of anginal symptoms and TLR in this group of patients.
Effect of cardiac rhythm on serum levels of the inflammatory mediators; Interleukin-6 and C-Reactive Protein in patients with chronic rheumatic heart disease
Authors: Mohammad A M Y , Rifaie O A , Hamza M A , Amin S A 
Published: May 2020

Abstract

Background
Rheumatic fever has a marked tendency to recur leading to high risk of chronic heart lesions or worsening lesions in patients with previous rheumatic heart disease. For secondary prevention of RF, long acting penicillin can be used. Some rheumatic heart disease patients suffer from atrial fibrillation. Cardiac rhythm may affect the response of the body to the long acting penicillin, so it would be helpful to study the effect of cardiac rhythm on serum levels of inflammatory mediators in patients with chronic rheumatic heart disease.

Objectives
Our study is a prospective cross-sectional controlled study that aims to study the effect of cardiac rhythm on serum levels of the inflammatory mediators; C-Reactive Protein and Interleukin-6 in patients with chronic rheumatic heart disease.

Methods
The study included 70 rheumatic heart disease patients on regular long acting penicillin. Patients were divided into to 2 groups: Group A; 56 patients with rheumatic heart disease who have sinus rhythm, and Group B; 14 patients with rheumatic heart disease who have atrial fibrillation (AF) and Group C; control group of 10 healthy individuals.

Results
There was no significant difference between sinus patients and AF patients in CRP and IL-6 levels (p = 0.3050 and 0.6758, respectively). Also, there was no significant difference between 15, 21 and 30 days regimens of penicillin in CRP and IL-6 levels (p = 0.9467and 0.0795, respectively). IL6 values were significantly correlated with CRP values (r = 0.5435, p &lt; 0.0001). There was a significant difference in CRP and IL-6 levels between compliant and non-compliant patients (p = 0.0053 and 0.0308).

Conclusion
Our study results disprove that cardiac rhythm has an effect on the serum levels of the inflammatory mediators C-Reactive Protein and Interleukin-6 in chronic rheumatic heart disease. Our study also disproves the preference of any regimen of long acting penicillin (15 days, 21 days and 30 days) over each other for secondary prevention of chronic rheumatic heart disease. Our study results emphasized that chronic rheumatic heart disease is an inflammatory process mediated with some mediators as CRP and IL-6 that are strongly correlated with each other.
Prevalence of Peripheral Arterial Disease among End Stage Renal Disease Patients
Authors: Morkos R R W , Shabana A M , Elserafy A S , Hanna H F 
Published: May 2020

Abstract

Background
Patients with End Stage Renal Disease are more susceptible to develop Peripheral Arterial Disease. so, screening is helpful for early diagnosis.

Objectives
The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD.

Aim of Study
The aim of this study is to screen and calculate the prevalence of asymptomatic patients on regular hemodialysis for presence of PAD.

Patients and Methods
The study included 100 asymptomatic patients on regular hemodialysis and below 60 years old to be screened for presence of PAD. Patients who refused the test, above 60 years old, or diabetic have been excluded from the study. All selected patients have been subjected to complete history taking, full clinical examination including extremities examination, Lab workup including; CBC, liver function test, kidney function test, A1C level, lipid profile, Resting 12 lead ECG, Echocardiography to assess systolic function, valvular disease, and resting SWMA, and ABI assessment using the Doppler. Patients then were divided into two groups; control group who has negative PAD with ABI &gt; 0.9 and study group who has PAD with ABI ≤ 0.9.

Results
It was found that the prevalence of PAD among ESRD patients is 26%. Regarding the laterality; 21% had bilateral PAD and the rest 5% had unilateral disease. The results showed that females had statistically significant higher risk of developing PAD that males. 55% of patients were females and the other 45% were males. 36.4% of females studied had positive ABI but only 13.3% of studied males found positive for PAD. The p value was 0.017. The study showed also that A1C level in patients who have no diabetes carries statistically significant results. The mean A1C level for the study group was 5.56 ± 0.70 and the control group was 4.92 ± 0.73. The p value was 0.000. The A1C level cut off value was &gt; 5.3. This means that patients who have A1C &gt; 5.3 should be paid more attention and be screened because they have higher risk to develop PAD.

Conclusion
Renal impairment is an important risk factor for developing PAD in absence of traditional risk factors such as DM, hypertension, or dyslipidemia. Prevalence of PAD was 26% in our study. ABI is a simple non-invasive modality of screening for PAD. Females are at higher risk to develop PAD than males by ∼ 2.7 fold. Although diabetes is absent, A1C level &gt; 5.3 is significantly correlating with the risk of PAD.
Custodiol for myocardial protection and preservation
Authors: Gobran M A , Elkerdany A B , Elnahhas Y , Omar A H 
Published: May 2020

Abstract

Introduction
Custodiol cardioplegia is attractive for minimally invasive cardiac surgery, as a single dose provides a long period of myocardial protection. Despite widespread use in Europe, there is little data confirming its efficacy compared with conventional (blood or crystalloid) cardioplegia. There is similar enthusiasm for its use in organ preservation for transplant, but also a lack of data. This systematic review aimed to assess the evidence for the efficacy of Custodiol in myocardial protection and as a preservation solution in heart transplant.

Methods
Electronic searches were performed of six databases from inception to October 2013. Reviewers independently identified studies that compared Custodiol with conventional cardioplegia (blood or extracellular crystalloid) in adult patients for meta-analysis; large case series that reported results using Custodiol were analyzed. Next, we identified studies that compared Custodiol with other organ preservation solutions for organ preservation in heart transplant.

Results
Fourteen studies compared Custodiol with conventional cardioplegia for myocardial protection in adult cardiac surgery. No difference was identified in mortality; there was a trend for increased incidence of ventricular fibrillation in the Custodiol group that did not reach statistical significance. No difference was identified in studies that compared Custodiol with other solutions for heart transplant.

Conclusions
Despite widespread clinical use, the evidence supporting the superiority of Custodiol over other solutions for myocardial protection or organ preservation is limited. Large randomised trials are required.
Postoperative Complication in Overweight Patients Undergoing Coronary Artery Bypass Graft Surgery
Authors: Fedala M A , Metwaly H A , Hikal T S , Abdelmotaleb M A 
Published: May 2020

Abstract

Background
Considering the impact of obesity on mortality and morbidity after coronary artery bypass graft surgery (CABG), we had to investigate the association between central obesity and the body mass index (BMI) and the post-CABG mortality and morbidity.

Methods
98 patients with multi-vessel CAD and candidate for CABG were included in the study, and divided into two groups Group I: 53 patients with BMI over 30.Group II: 45 patients with BMI under 30. The primary end point was wound infection and mediastinitis. Secondary end points included mortality, prolonged ICU and hospital stay, stroke,renal and hepatic impairment

Results
Total of 98 patients (36 female) with amean age 54 + 6.5.group 1(53 patients) with BMI more than 30 and group2 (45 patients) with BMI under 30.wound infection ,mediastinitis, intensive care unit (ICU ) and in-hospital stay were significantly increased in patients with BMI ≥ 30 with (p value = 0.025, 0.02, 0.04) respectively.

Conclusion
Obesity was associated with wound infection and mediastinitis more than non-obese patients This lead to long ICU and in-hospital stay. And not associated with other morbidity or mortality
Comparison of Single and Double Chest Tube Drainage Management in Patients Undergoing Thoracotomy
Authors: Elnori A A , Elsayed H H , Mostafa A M , Kamal M M M 
Published: May 2020

Abstract

Background
chest tube is the most commonly performed surgical procedure in thoracic surgery practice. It is defined as insertion of (chest tube) into the pleural cavity to drain air, blood, bile, pus, chyle or other fluids.

Aim of the Work
comparison of single and double chest tube drainage management in patients undergoing thoracotomy in the form of pain score, hospital stay, total drainage, residual collection after removal of chest tube and need for another chest tube at Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital (ASUSH).

Patients and Methods
this study was conducted on patients who undergone thoracotomy at the Cardiothoracic Academy Hospital and Ain Shams University Specialized Hospital throughout the last 6 months from March 2018 till August 2018. Data was collected retrospectively from 40 patients, 20 patients in each group. In the 20 patients in the ‘single-tube group', only one chest tube was inserted, and in the 20 patients in the ‘double-tube group', two chest tubes were inserted. Pre-, intra- and postoperative variables in both groups were compared.

Results
40 patients met all inclusion criteria. The pre- and intraoperative characteristics of the patients were similar in both groups with no significant differences. The single-tube group was found to have a lesser amount of total pleural drainage than the double-tube group but there was no significant difference 202.50 cc vs 297.50 cc, respectively; (p &gt; 0.05).

Conclusion
our results showed that the single chest tube drainage is more effective, reduces postoperative pain, hospitalization times and duration of drainage in patients who undergo thoracotomy.
National data on non-modifiable risk factors of coronary artery diseases in Egypt
Authors: Sedky M , Hassan W , Sedky N , Zarif B 
Published: May 2020

Abstract

Background
CAD accounts for approximately 42% of all cardiovascular deaths. A lot of predisposing risk factors for CAD exist and they are generally divided into modifiable and non-modifiable risk factors. Genetic variants were found to be among the non-modifiable risk factors where they strongly contribute to the incidence of CAD in Egyptian populations.

Purpose
highlighting the different genetic polymorphisms and non-modifiable risk factors for CAD in Egyptians and ranking them according to the degree of importance.

Methods
Intensive research was done in the period between 15 May 2018 and 15 September 2018 on both Science Direct, SCOPUS and Pubmed with the keywords (((myocardial infarction) OR (myocardial ischemia) OR (MI) OR (coronary artery disease) OR (CAD)) AND ((risk) OR (risk factors)) AND ((Egypt) OR (Egyptian))). 1060 studies were retrieved. Three reviewers screened the results and chose 84, from which, only 7 studies from 7 different centers from different parts of Egypt shown on map were included after full text screening with total no of 523 of various coronary artery disease patients and 396 healthy matched controls. Exclusion criteria was as follows: Full text not available (only abstract or protocol is published)The study was not randomized with a risk of biased resultsThe presence of any other comorbid disease as renal failure and autoimmune diseasesThe absence of control group in the study.
Inclusion criteria was as following: Randomized controlled studyCross sectional studiesMean age of the patients above 30 years oldStudy on Egyptian populationsFull text and results available

Results
The polymorphisms (TPA, PAI-1, Paraoxonase-1, Manganese superoxide dismutase Ala16Val polymorphism, Platelet derived growth factor B gene polymorphism, rs854560 PON1, rs1790349 and rs12785878 of NADSYN1/ DHCR7 Locus, rs10741657, rs2060793, rs1993116 and rs10766197 of CYP2R1) demonstrated a significant association with the incidence of CAD in the Egyptian population. The odds ratios (ORs) for the putatively at high risk homozygous genotype vs. other genotypic groups of the different polymorphisms are shown clearly in the figure 1. The highest association is recorded for SNP rs1993116 of the CYP2R1 gene (ORs 8.5), followed by manganese superoxide dismutase Ala16Val polymorphism (ORs 3.6).

Conclusion
Many SNPs were found to be associated with CAD incidence in Egyptians, on top of which lies the SNP rs1993116 of the CYP2R1 gene and manganese superoxide dismutase Ala16Val polymorphism
Study of The Polymorphism BsmI and TaqI in Vitamin D Receptor Gene in Egyptian Patients With Chronic Kidney Disease
Authors: Mohamed F M K , Osman M M , Nessim I G , Abdelmageed A I , Abdelsattar H A , Waked E A 
Published: May 2020

Abstract

Background
Chronic kidney disease (CKD) is a major public health problem and a leading cause of morbidity and mortality worldwide. Chronic kidney disease mineral and bone disorders (CKD-MBD) is a common complication of CKD and an important cause of morbidity and decreased quality of life. Serum levels of 25-hydroxy vitamin D and parathyroid hormone (PTH) provide an accurate picture of bone turnover and mineralization states therefore they could be used with other serum bone biomarkers as non-invasive sensitive bone markers to help management of MBD in CKD. Due to the complex role played by vitamin D in kidney disease, the genotyping for vitamin D receptor (VDR) variants in CKD patients has been regarded as a way for improving the management of the disease.

Objective
The aim of the present work was to study the association of vitamin D receptor gene polymorphisms BsmI and TaqI with the chronic kidney disease and to assess its relationship with development and progression of chronic kidney disease-mineral bone disease.

Subjects and Methods
The study was conducted on 60 CKD-MBD patients in addition to 30 age- and sex- matched subjects serving as a healthy control group. Patients were subdivided into two subgroups according to the stage of CKD: subgroup 1a; 30 patients with CKD-MBD under conservative management (stages: 3 and 4 CKD) and subgroup 1b; 30 CKD-MBD patients with end-stage CKD on regular hemodialysis. Determination of BsmI (rs1544410, A&gt;G) and TaqI (rs731236, C&gt;T) polymorphisms of VDR gene was carried out using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).

Results
The result of the present study revealed that VDR BsmI (rs1544410) gene polymorphism and alleles (Bb, bb) were not associated with susceptibility to the CKD or development and progression of CKD-MBD in the studied CKD-MBD patients. However, having the gene variants of VDR TaqI (rs731236) tt homotypic genotype increased the susceptibility to CKD-MBD compared to having the gene variant TT wild genotype and Tt heterotypic genotype. Moreover, VDR polymorphisms were associated with the mineral status in CKD-MBD Egyptian patients. The VDR BsmI wild (BB) genotypes and the VDR TaqI homotypic (tt) variant were found to be associated with development of severe secondary hyperparathyroidism, hypocalcemia and vitamin D deficiency in the studied Egyptian patients with CKD-MBD.

Conclusion
VDR BsmI gene polymorphism failed to prove any association with susceptibility to the CKD or development and progression of CKD-MBD. However, VDR TaqI tt homotypic genotype increased the susceptibility to CKD-MBD and progression toward severe secondary hyperparathyroidism, hypocalcemia and vitamin D deficiency.
Study of the Levels of Advanced Glycation End Products in Sickle Cell Patients
Authors: Shalaby N A , Elgamal R A , Kenny M A , Sabrah A A 
Published: May 2020

Abstract

Background
Sickle cell disease (SCD) is a hemoglobinopathy characterized by hemolytic anemia, increased susceptibility to infections and vaso-occlusion leading to reduced quality of life and life expectancy. SCD is caused by a point mutation in a single gene, which results in a mutant β-globin protein (HbS), in which the sixth amino acid is changed from glutamic acid to valine. In the homozygous and some compound heterozygous states, deoxygenated HbS molecules form polymers, which damage the red cell membrane and increase its rigidity.

Aim of the Work
to study the AGE levels in sickle cell patients and determine its relationship to the presence of SCD-related organ complications, in addition to exploring the association of AGE levels to other clinical and laboratory data.

Patients and Methods
This study was conducted on 40 Sickle cell patients, including sickle cell anemia (HbSS) and compound heterozygous states. In addition to 20 race, sex, and age matched healthy control subjects will also be included. They were recruited from patients attending Pediatric Hematology Clinic, Pediatric Hospital, Ain Shams University from September 2017 to September 2018. A verbal informed consent was taken from all patients.

Results
A statistically significant difference was found between SC patients and control group as regards their CBC data; including TLC, which showed a significant statistical difference being higher in patients group (P &lt; 0.001).

Conclusion
Plasma levels of pentosidine and CML are increased and associated with haemolysis and haemolysis-related organ complications in sickle cell patients, suggesting that AGEs might be implicated in vascular damage and chronic organ complications in SCD. Measurement of these AGEs might be useful in assessing disease severity and predicting organ complications in SCD.
Association of CYP2J2 Gene Polymorphism with Ischemic Stroke
Authors: Elhadidi E S , Hamed A I , Abdelsattar H A , Amer A S A 
Published: May 2020

Abstract

Background
Stroke is regarded as a severe disorder with high morbidity and high mortality, which is a major healthcare problem and a serious economic burden worldwide. It claims over 6 million deaths each year worldwide.

Aim
To investigate the association of CYP2J2 gene polymorphism with increased risk of ischemic stroke in a group of Egyptian patients.

Subjects and Methods
This study was conducted at Clinical Pathology and Stroke Units of Ain Shams University Hospitals, between November 2017 and July 2018. A total number of 30 subjects were included (20 patients and 10 controls).

Results
Our study concluded that risk of hypertension is higher in heterozygous GT population (100%) compared to the wild type (51.22%), whereas no significant increase in the ischemic stroke risk was observed between wild and heterozygous groups.

Conclusion
The most frequent genotype among the chosen sample of Egyptian population in the study (acute ischemic stroke patients and controls) was the wild TT genotype although not statistically different than other genotypes.