bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of the Diagnostic and Prognostic Value of Squamous Cell Carcinoma Antigen and Alfa-foeto Protien in Hepatocellular Carcinoma Before and After Therapeutic Intervention
Authors: Abdelhamid S , Alsakty T M , Radwan H H , Abouelmaaty M E , Allam A S , Abdelhamid R S , Yousef M G 
Published: May 2020

Abstract

Background
hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients.

Aim of the Work
was to verify the possibility of using the plasma squamous cell carcinoma antigen level as a tumor marker for hepatocellular carcinoma and to evaluate its prognostic value in management of HCC.

Patients and Methods
the study included 60 subjects divided into three groups: group I was 30 patients with hepatocellular carcinomas, group II was 15 patients with liver cirrhosis and group III was 15 normal subjects serving as a control group. Follow up of the patients who had HCC and undergone either RFA or TACE will be done after 1 month by measuring serum level of alfa feto protein & SCCA.

Results
the plasma SCCA level was significantly higher in group I patients (with HCC), than in the group II patients (cirrhosis) and control group. SCCA showed direct significant correlation with the most of laboratory data specially AST, INR, number and size of lesion and its values were decreased after intervention.

Conclusion
plasma SCCA is a sensitive and specific serum marker for the diagnosis and prognosis of HCC and combination of AFP and SCCA in screening and diagnosis of HCC yielded a better sensitivity in diagnosis of HCC.
Serum Beta 2-Microglobulin as a Biomarker of Activity in Ulcerative Colitis
Authors: Nashaat E H , Mohamed M M , Aziz T M , Nakhla M W 
Published: May 2020

Abstract

Background
ulcerative colitis (UC) is a chronic, idiopathic, inflammatory bowel disease that causes inflammation and ulcers in the innermost layers of the large intestine (colon) and rectum. Assessment of intestinal inflammation in UC is crucial and still remains a difficult challenge for the clinician. Although endoscopic modalities with biopsy sampling seem to be the most reliable method for estimating disease severity, they are invasive and costly. Apart from endoscopic interventions, disease severity can be assessed using both laboratory studies and non-invasive imaging tests. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBCs), acid glycoprotein, platelet count and albumin are in common use but have only modest accuracy in reflecting UC disease activity. Therefore, adjunctive use of additional serum markers that will be more sensitive and specific for determination of disease activity and achieving diagnostic accuracy is strongly needed in daily clinical practice.

Aim of the Work
to investigate the diagnostic utility of beta 2 microglobulin (B2-M) levels and analyze this correlation with the activity of ulcerative colitis disease.

Patients and Methods
a case control study that was conducted at the Gastroenterology Clinic, Internal Medicine Department, Ain Shams University during the period of January to July 2018. 60 patients were recruited for the study. They were divided as follows; Group “A”: 40 patients newly diagnosed as ulcerative colitis based on colonoscopy and biopsy, subdivided as follows; 20 patients with active ulcerative colitis and 20 patients with inactive ulcerative colitis. Group “B”: 20 healthy individuals free from any systemic diseases serving as a control group.

Results
in this study, the serum levels of serum B2-microglobulins were highest in patients with active ulcerative colitis compared to those with inactive ulcerative colitis and the control groups. Also B2-microglobulins values become higher with higher number of presenting symptoms and endoscopic activity, which becomes higher in severe disease.

Conclusion
our results revealed that serum B2-microglobulin was simple and non-invasive marker that could be helpful for differentiating active UC from inactive disease. Moreover, it was more helpful when used together with serum laboratory inflammatory indices (ESR and CRP).
Impact of Direct Acting Antiviral Therapy for Hepatitis C Virus Infection on Recurrence of Hepatitis C Virus Related Hepatocellular Carcinoma
Authors: Ghaly S M , Mohamed I A , Musa N I , Ahmed O A , Abuhalima A S , Said N M 
Published: May 2020

Abstract

Background
hepatocellular carcinoma is the fifth most common tumor worldwide and the second most common cause of cancer-related death with a male-to-female predominance greater than 2:1. The presence of cirrhosis represents a key risk factor for the development of HCC. The prevalence of cirrhosis among patients with HCC has been estimated to be 85%-95% and the HCC incidence rate among patients with cirrhosis has been shown to be 2%-4% per year. HCV infection is a leading cause of liver cirrhosis and hence the development of HCC. Egypt has the highest HCV prevalence worldwide; with estimated rate of 10% of Egyptians between 15 – 59 years as reported by the Egyptian Health Issues Survey (EHIS) in 2015.

Aim of the Work
the aim of this study was to evaluate the impact of Direct Acting Antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on recurrence of HCV related HCC after intervention.

Patients and Methods
this study was conducted on 50 patients with previously treated HCC who were treated for HCV infection using direct acting antiviral agents after confirming HCC regression and response to different treatment modalities and were followed for one year after antiviral treatment. A control group of another 50 patients with cured HCC who didn’t receive DAA therapy was included in the study to compare the recurrence rate in both groups and its relation to the antiviral therapy.

Results
the two groups didn’t differ as regards age, sex, biochemical profile, AFP, CBC and child score. The results of the study came to show an HCC recurrence rate of 38% in patients who received direct acting antiviral therapy after HCC intervention versus 62% in those who didn’t receive antiviral therapy.

Conclusion
direct acting antiviral drugs didn’t show to increase the risk of HCC recurrence in comparison to the control group. Yet it did not abolish it. So, close follow up of patients with HCC receiving antiviral therapy is highly recommended.
The Relation between Diabetes-Related Distress and Glycemic Control
Authors: Hamed M S , Ibrahim N A , Ali H M , Kheir C G 
Published: May 2020

Abstract

Background
Diabetes Distress is the understandable sense of burden or defeat that may occasionally punctuate the diabetic patient life. Also, Diabetes distress (DD) refers to the unique, often hidden emotional burdens and worries that are part of the spectrum of patient experience when man-aging a severe demanding chronic disease like diabetes.

Objectives
is to assess the relationship between Diabetes-related distress (using a Diabetes Distress Screening Scale) and the glycemic control (using A1C) and inflammation (using hs-CRP) in diabetic patients.

Patients and Methods
This study is a cross sectional study which had been carried out in outpatient clinic of endocrinology department of El Agouza Police Hospital during the period between June 2017 to June 2018.The study was done on 350 Type2 Diabetic patients.BMI,Wist/Hip Ratio, Fasting blood glucose,Post prandial blood glucose,HbA1c,hs-CRP,Creatinin,BUN,SGPT and SGPT were done to the patients, also Diabetes Distress Screening Scale Quastionnaire was completed by the patients.

Results
In this study we found that there is a highly significant positive relationship between HbA1c and both Fasting Blood Glucose and Post Prandial Blood Glucose. Also,there was a highly significant positive relationship between CRP and Fasting Blood Glucose while there was a non significant relationship between CRP and Post Prandial Blood Glucose.Fasting blood glucose and Post Prandial Blood Glucose showed a highly significant positive relationship with Total DDS score, Emotional burden and Physician realted distress, and showed non significant relationship with Regimen related distress and interpersonal distress.As regard the relation between HbA1c and Total DDS score, there was a highly significant positive relationship between them and also highly significant positive relationship between HbA1c and Emotional burden and physician related distress, but there was non significant relation between HbA1c and Regimen related distress and interpersonal distress. There was highly significant positive relationship between CRP and Total DDS score and also emotional burden, and there was significant positive relationship between CRP and Regimen related distress, and non significant relation between CRP and physician related distress and interpersonal distress.

Conclusion
In this study 350 type 2 diabetic patients were included. 55 diabetic patients show moderate distress with a highly significant relationship with the glycemic control (HbA1c) and significant relationship with CRP. In this age and sex were non significant factors while duration of diabetes, BMI and Wist-hip ratio show significant relation with HbA1c which reflect the glycemic control.
Frequency of Microscopic Colitis in Patients with Diarrhea predominant Irritable bowel syndrome in Egyptian Patients
Authors: Abdelmageed K H , Riad G S , Mousa N I , Sharafeldin D B A 
Published: May 2020

Abstract

Background
Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. Irritable bowel syndrome is considered a functional illiness wih no diagnostic biomarkers or pathologic findings. The most common diagnosis made in patients with chronic diarrhea is IBS. MC is a clinical syndrome of unknown etiology, characterized by chonic watery diarrhea in the absence of macroscopic changes in the large bowel, but with histological examination changes

Objective
The aim of this study is to determine the frequency of microscopic colitis in patients with IBS of diarrhea predominant sub type.

Methods
This prospective study had been conducted on 100 subjects, age range 19-65 year from National Hepatology and Tropical medicine reaserch Institute and Ain Shams University hospital inpatient and outpatient clinics. The study was carried on over 2 years (2016-2018) duration. The study subjects were fulfilling Rome criteria. The main complain of the selected patients was abdominal pain associated with chronic watery diarrhea.

Results
This study showed that patients with microscopic colitis can be misdiagnosed as IBS – diarrhea predominant due similar presentation and normal macroscopic picture in endoscopy. In this study we found that 14 (14%) had microscopic colitis. This study showed that there is a significant difference between patients with normal biopsy and others with microscopic colitis as regard age and sex.

Conclusions
Our study showed that MC is not uncommon in Upper Egypt patients with chronic watery diarrhea and normal colonoscopic findings. Biopsy of the normal colonic mucosa in patient with chronic watery diarrhea is emphasized to reach a definite diagnosis of MC. Abdominal pain, nocturnal diarrhea and weight loss were the most common clinical manifestations of MC. MC types, LC, and CC have almost similar clinical presentations and there is no diagnostic laboratory marker; thus, histopathologic diagnosis is the only reliable method for differentiation between these subtypes. Nocturnal diarrhea and slight weight loss can be helpful in distinguishing microscopic colitis from diarrhea predominant IBS. Collaboration between treating physicians, endoscopists and pathologists is crucial for diagnosing MC.
Effect of ramadan fasting on microvascular complications in type1 diabetic patients
Authors: Abushady M M , Eid Y M , Ibrahim R H , Abdelsayed D E 
Published: May 2020

Abstract

Background
Diabetes is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Ongoing patient self-management education and support are critical to preventing acute complications and reducing the risk of long-term complications. Significant evidence exists that supports a range of interventions to improve diabetes outcomes.

Objective
This study aimed to demonstrate the impact of fasting on primarily on ẻGFR & microalbuminuria in people with type 1 diabetes and secondarily on neuropathy & retinopathy. It was conducted on 60 patients with T1DM. All patients underwent full history taking, full clinical examination and biochemical tests including FBG, 2h PPBG, HbA1c, fructosamine, s.creatinine, BUN, uACR, eGFR, fundus examination and DN4 Q.

Methods
This study was conducted on 60 type 1 diabetic patients with microalbuminuria intending to fast Ramadan. Patients were recruited from internal medicine and diabetes clinics of Ain Shams University. The study performed health education 2 months prior to Ramadan 1438 (2017) with follow up throughout the month and after Ramadan. The patients were on basal-bolus regimen, 36 were on lantus, 17 were on NPH and the remaining 7 patients didnot complete the follow up after Ramadan for family reasons.

Results
There had been significant difference between pre and post-fasting as regards weight and BMI, and non significant difference regards waist circumference. Also highly significant difference between basal and bolus doses before and during Ramadan. There had been no significant difference between pre and post Ramadan regarding fundus examination, systolic and diastolic blood pressure and a significant difference regarding DN4 Q. Regarding no. of successful fasting days and attacks of hypoglycemia, a significant difference was found. Significant difference in FBS, 2hr PPBG, BUN, s.creatinine, uACR and eGFR, and fructosamine. There was a significant positive correlation between eGFR and height, weight before Ramadan and between eGFR and height, weight after Ramadan, no. of successful fasting days Ramadan 2017. Also a significant negative correlation was shown between eGFR and A / C ratio, Cr, BUN before Ramadan and between éGFR and Cr, BUN after Ramadan. Height, BUN before and after Ramadan and A / C ratio before Ramadan were found to be independent predictors of eGFR.

Conclusion
Ramadan fasting appears to have significant impact on microvascular complications of type 1 DM patients. These impacts can be attributed to many factors as physical sloth, change of time and pattern of feeding, climate conditions at time of fasting especially hot humid weather predisposing to more frequent dehydration with its sequelae as well as non-compliance of some patients to the proper lifestyle, diet and medications.
Effects of Ginger Powder Supplementation on Glycemic Status and Lipid Profile in Patients with Type 2 Diabetes Mellitus
Authors: Elgayar M H , Mahdy M M M , Ibrahim N A , Abdelhafiz M H 
Published: May 2020

Abstract

Background
Diabetes is a huge problem affecting 387 million adults by a global prevalence of (8.3%) which is expected to rise to (10.1%) affecting 592 million adults by 2035. Type 2 diabetes, a growing public health problem, is associated with increased morbidity and mortality.

Purpose
To evaluate the effects of ginger powder supplementation on glycemic status, lipid profile, insulin resistance, insulin sensitivity, and beta-cell function in obese Egyptian patients with new-onset type 2 Diabetes Mellitus.

Patients and Methods
This study was conducted at the Diabetes outpatient clinic of the National Institute of Diabetes and Endocrinology (NIDE) during the period from January 2016 to January 2017.

Study Design
A randomized, single blind, placebo-controlled clinical trial, was performed on 80 subjects newly diagnosed with T2DM. Subjects were randomly & equally subdivided into two groups: Group 1: Ginger Group (GG), which consumed three capsules daily, each capsule containing: 600-mg of ginger powder (total daily dose was 1.8 g), they also underwent certain diet and physical activity changes, and also received metformin as one 850-mg tablet twice a day with meals for a duration of 8 weeks.Group 2: Placebo Group (PG), which received capsules of the same color, size, and number as (Group 1) but containing wheat flour, they also underwent the same diet, physical activity, and metformin dosage as (Group 1) during the 8 weeks of the study.

Results
Ginger powder supplementation significantly reduced body mass index, fasting blood glucose, 2-hour postprandial blood glucose, glycated hemoglobin, total cholesterol, low density lipoprotein cholesterol, triglycerides, fasting insulin levels, and homeostasis model assessment-insulin resistance index (HOMA2-IR). Ginger also significantly increased high density lipoprotein cholesterol levels, beta cell function index (HOMA2-%β), and insulin sensitivity index (HOMA2-%S).

Conclusion
Ginger is considered a safe and effective adjuvant antidiabetic agent in treatment of T2DM; improving glycemic status, lipid profile, insulin resistance, and promoting weight loss.
Rituximab and Cyclosporine in Idiopathic Membranous Nephropathy Who Failed to Respond to Ponticelli Regimen
Authors: Nasser M E , Hebah H A , Alaaeldeen H 
Published: May 2020

Abstract

Background
Membranous nephropathy is the chief etiology of nephrotic syndrome in adults. It is clinically featured and presented by investigational tool as very high of protein levels in urine, edema, hypoalbuminemia and elevated serum level. Idiopathic membranous nephropathy is a chronic pathological form of clinical scenarios and its pathophysiological course involves spontaneous remissions or remissions by immunosupressions with frequent relapses.

Aim
To assess the efficiency of Rituximab as a secondary line immunosuppression in Patients with Idiopathic Membranous Nephropathy (IMN) who failed to respond to Ponticelli regimen and to compare it with Cyclosporine.

Methods
This study is a retrospective cohort study including 40 Egyptian patients with biopsy proven IMN who failed primary immunosuppression with cyclophosphamide and steroids according to Ponticelli regimen divided into two equal groups, 20 patients each. Cyclosporine Group: received Cyclosporine, given daily for a minimum of 6 months at doses of 3.5 mg/kg orally and Rituximab Group: received Rituximab weekly for 4 weeks at doses of 375 mg/m2 intravenously. Data collected included UPCR, eGFR, serum albumin, serum creatinine, CBC, lipid profile for 6 times: before giving cyclosporine or rituximab (time 0), after 1month, 3, 6,9 and 12 months.

Results
17 patients achieved remission (7 CR and 10 PR) in CSA treated group while 13 patients (1 CR and 12 PR) in RTX group, P = 0.077. UPCR was reduced for &gt;50% in patients receiving Cyclosporine compared to 30% in Rituximab treated group: UPCR was decreased from 5.9±3.5 at time 0 to 2.0±2.8 (p = 0.002) & decreased from 7.3±5.2 to 4.6±3.9 (P = 0.031) in Cyclosporine and Rituximab groups respectively. There was improvement of serum albumin in both groups by the end of study more remarkable in cyclosporine group. The eGFR was non significantly reduced by the end of study in RTX group while it showed significant reduction in CSA group. No serious adverse events were reported all through the study period in both groups.

Conclusion
Rituximab is an efficient, well tolerated secondary immunosuppressant drug in IMN. Its effect is comparable to CSA regarding remission induction. It induces better results than CSA regarding effect on eGFR but worse results regarding proteinuria improvement. Individualization of immunosuppressant use in IMN should be considered.
The association of tumor necrosis factor alpha levels with Depression symptoms in Systemic lupus erythematosus patients
Authors: Okba A M , Farris M N , Shaheen R Y , Abdelmonaem H , Kamal S T , Amin D A M 
Published: May 2020

Abstract

Background
Effects of the cytokine system, in which of tumor necrosis factor alpha (TNF-α) is a part, on serotonin metabolism as well as on the hypothalamic-pituitary-adrenal (HPA)-axis, may induce changes in the structure and function of the brain, possibly leading to the development of depression in SLE patients. For this purpose, we aimed to assess serum TNF-α levels in SLE patients, and to explore its possible relationship with depression among these patients.Methods: 60 SLE adult patients were enrolled in this study and further subdivided into two equal groups (30 with active SLE and 30 with inactive SLE) using SLEDAI score, in addition to 30 age and sex matched healthy controls. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to provide broad coverage of psychiatric diagnoses was done for all subjects, and severity of depression was assessed using Beck depression Inventory. TNF-α levels were measured using ELISA technique. Results: Depression was identified in 63.3% of active SLE group, 40% in the inactive SLE group and 16.7% in the control group with p value &lt;0.001. TNF-α levels were higher significantly in the active group versus inactive group and control p value &lt;0.001.In the multivariate analysis, sera TNF-α levels were independently associated with depressive symptoms odds ratio = 1.004, 95% CI = 1.001 to 1.006, p-value =0.020). Conclusions: Depression was more prevalent among SLE patients with active disease. Serum TNF-α was the only independent predictor of depression in SLE patients.
Non motor symptoms in patients with essential tremor
Authors: Elbelkemy M , Shalash A , Mansour A , Hamed E , Abdelalim H M 
Published: May 2020

Abstract

Article Outline
Abstract Introduction Patients and methods Procedure Statistical analysis Results Discussion Conclusion References

Background
Essential tremor (ET) is the most prevalent tremor disorder. ET has traditionally been viewed as a monosymptomatic disorder characterized by a kinetic arm tremor but now there is a growing amount of evidence to suggest that besides motor features, patients with essential tremor may exhibit significant non-motor features.
The Aim of this study: To assess non-motor features in Egyptian patients with ET in comparison to controls.

Patients and Methods
This is a Case control observational study in which 30 patients with ET and 30 matched healthy controls ET was assessed using; Fahn Tolosa Marin Tremor Rating Scale (FTM); non-motor symptoms were evaluated using; Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI), Hamilton anxiety rating scale (HARS), Pittsburgh Sleep quality index (PSQI).

Results
ET patients had significant cognitive dysfunction, neuropsychiatric problems including depression, anxiety, poor sleep and other NMS compared to controls.

Conclusion
The presence of numerous non motor features in ET is increasingly evident. Therefore, NMS should be considered in the clinical evaluation and management of ET.