bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immediate versus deferred PCI in patients presenting with acute ST Segment elevation myocardial infarction with moderate to high thrombus burden
Authors: Mohammed M Y , Alfiqy E , Said K , Rifaie O 
Published: May 2020

Abstract

Background
Primary PCI is considered the standard of care treatment for STEMI when timely done. However, the proper management of the culprit artery with moderate to high thrombus burden is still unclear.

Objective
We sought to compare the outcome of deferred primary PCI in patients presenting with STEMI with moderate to high thrombus burden after a course of intensive dual anti-platelet and IV Glycoprotein IIb/IIIa receptor blockers with immediate PCI.

Methods
We analyzed the data of 100 patients with STEMI and high or moderate thrombus burden who underwent primary PCI in a prospective nonrandomized case control study. Patients were divided into 2 groups, 50 in each group. The first group(A) included patients who underwent coronary angiography with immediate PCI. While the second group(B) included the patients who were deferred and received dual antiplatelet and Glycoprotein IIb/IIIa receptor blockers .After 24-48 hours, coronary angiogram was repeated and PCI was done when needed. All patients had a pre-discharge echo for assessment and followed up for 4 weeks after discharge for major adverse cardiac events (MACE)

Results
The baseline data were similar in both groups.There was no statistical difference between both groups as regards the TIMI flow of the culprit artery at the end of the procedure TIMI III was 84% in the groupA and was 86% in group B (P. value = 0.114)). There was a significant difference between both groups for the need of PCI being lower in the deferral group 50 patients had PCI in the group A (100.0%) and 29 patients only had PCI in group B (58.0%), P value = 0.000). Thrombuss aspiration decreased the need for PCI (22 patients out of 35 had PCI from the aspiration group while 58 patients out of 63 had PCI, (P value = 0.001).There was no statistical difference between the immediate and the deferral group as regards the in-hospital morbidity and mortality nor left ventricular functions.At follow up, there was no statistical difference between both groups as regards MACE.

Conclusion
Deferring PCI in patients with STEMI and high or moderate thrombus burden, did not affect neither the TIMI flow at the end of the procedure nor the in-hospital morbidity or mortality. After 4 weeks.MACE was similar in the deferral and immediate PCI groups.However, deferral carries an advantage of reducing the need for PCI. Thrombus aspiration may enhance the flow in the culprit artery and reduce the need for PCI.
Comparison of Short Term Outcomes of De Vega Repair versus Ring Annuloplasty in Cases of Functional Tricuspid Regurgitation
Authors: Ibrahim M A , Saber W A , Abdelhamid H A , Mansour S A , Mostafa M G 
Published: May 2020

Abstract

Background
functional tricuspid valve regurgitation (FTR) is a common problem accompanying left-sided heart lesions e.g. mitral stenosis. FTR is a serious disease which affects survival and quality of life if left untreated. Many techniques can be used to repair the tricuspid valve (TV), but the optimal method for repair is still controversial. The aim of our study is to compare ring annuloplasty and De Vega repair of TV as regard effectiveness and durability.

Patients and Methods
sixty patients who are candidate for mitral valve (MV) replacement and TV repair were randomized into two groups, 30 patients each. Group (A) underwent ring annuloplasty, and group (B) underwent De Vega repair of TV. Patients from both groups were followed up after the operation for one year.

Results
Ring annuloplasty was more effective as the mean grade of TR in this group (1.6 ± 1.2) was significantly lower than that in De Vega group (2.2 ± 1.0), p value 0.041. After one year of follow up, no significant increase was present in the mean grade of TR in the ring annuloplasty group. However, grade of TR increased significantly in the De Vega group from 2.2 to 2.6, p value &lt; 0.001.

Conclusion
Ring annuloplasty provides more effective and durable reduction of FTR compared to De Vega repair of TV.
Early Outcomes of Custodiol versus Blood Cardioplegia in Coronary Artery Bypass Graft Surgery at Ain Shams University Hospitals
Authors: Sayed G S , Ismail I A , Khorshid R M R , Mohamed A H 
Published: May 2020

Abstract

Background
Inadequate myocardial protection in long ischemic periods followed by reperfusion is an issue of concern in cardiac surgery. Cardioplegic solutions improve the tolerance to ischemia and reperfusion by preserving myocardial energy reserves, preventing osmotic and electrolyte imbalances and buffering acidosis. The aim of the study was to compare early outcomes of Histidine–tryptophan–ketoglutarate (HTK) solution versus blood cardioplegia in coronary artery bypass graft surgery at Ain Shams University Hospitals.

Methodology
This was a retrospective study conducted on patients who underwent isolated elective CABG at the department of cardiothoracic surgery at Ain Shams University Hospitals from the 1stof January, 2017 to the 1st of August, 2018.

Results
the analysis between these two groups divided as the following: first group who received Histidine–tryptophan–ketoglutarate (HTK) and the second who received conventional blood cardioplegia , There was no statistically significant difference between the two groups of myocardial protection in terms of morbidity and mortality with a p-value &gt;0.05. With a stastically significant increase in Total bypass time with a p value &lt;0.05 and a highly significant difference in terms of post operative Ventilation time and ICU stay which was higher in HTK group with a p-value of &lt; 0.01 between the two groups.

Conclusion
Conventional blood cardioplegia showed superiority in terms of metabolic recovery based on the incidence of spontaneous defibrillation, ventilation time and ICU stay on the other hand Histidine–tryptophan–ketoglutarate (HTK) cardioplegia is a much more easily administered cardiolplegia technique without the need of preparation or repeated administration. Both Solutions showed efficacy in different areas that could be owed to the small sample size we used which cannot asses the ultimum superiority of one solution over the other .
Developing of a Simple Screening Tool for Opportunistic COPD Case Finding
Authors: Mohamed Y M , Sharkawy S H , Darwish D I 
Published: May 2020

Abstract

Background
Under diagnosis of COPD is serious problem in many countries world-wide because there are no generally detection tools available to detect high-risk patients for spirometry, and patients will not go for COPD check-up until a serious issue happens like exacerbation.

Objective
The aim of the work is trying to assess a new screening tool for early diagnosis of COPD.

Patients and Methods
The present study was conducted upon 500 subjects during the period from march 2018 to august 2018 who admitted to our chest department or visit our outpatient clinic, employees and visitors to Ain Sham hospitals.All subjects &gt;40yrs who smoker or ex-smoker(≥10pack-years) applied a six variants(age,sex,packed years smoked during life ,dyspnea,chronic phlegmand chronic cohgh)questionnaire modified from PUMA questionnaire Subjects with score ≥5 did spirometry

Results
500 subjects shared in the study 497 of them were males ( 99.4% )and 3 were females (.6%). 152of them(30.4%) had score &lt;5 and 348 of them (69.6%)had score ≥5 who did spirometry.152 subjects did not perform spirometry. By spirometry we diagnosed 81(23.3) case COPD (fev1-fvc &lt;.7) out of 348 subjects under gone spirometry and 16.2% of total subjects(500) .

Conclusion
Modified puma score is a simple and easy screening questionnaire for early detection of COPD cases and spirometry should be done to confirm the diagnosis or rule out.COPD is prevalent in many healthy apparent persons.
Retrospective Study of the Outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair in Ain Shams University
Authors: Elfeky A M A , Fadala M M A , Abdelhameed O A , Khorshid R M R 
Published: May 2020

Abstract

Background
Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center.

Objective
The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair.

Patients and Methods
This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease.

Results
This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%)

Conclusion
The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.
The Effect of Glycosylated Hemoglobin Oil Post-Operative Coronay Artery Bypass Graft Surgery Outcomes
Authors: Elsaka A B B B , Abdelkarim M , Mourad F , Elkilany I 
Published: May 2020

Abstract

Background
type 2 diabetes mellitus (T2DM) is a known risk factor of coronary artery disease (CAD). Cardiovascular disease is the leading cause of death in T2DM patients. Antecedent to and associated with epicardial coronary artery stenosis, T2DM patients develop abnormal microvascular function in systemic circulatory beds. Glycosylated hemoglobin (HgbA1c) has been established as a risk factor for T2DM patients developing microvascular atherosclerosis.

Aim of the Work
the Effect of Glycosylated Hemoglobin Control on Post-Operative Coronary Artery Bypass Graft Surgery Outcomes this is widely across studies and patient populations, and this heterogeneity must be controlled when using the literature to indicate safety.

Patients and Methods
this study was performed on 60 patients, who underwent CABG at Cardiothoracic Academy from January 2018 to August 2018. Retrospective Descriptive Observational Study. Cardiothoracic Academy, Ain Shams University Hospitals. Study Period: 6 Months. This study included all patients operated upon for CABG in our hospital and who fulfilled our inclusion and exclusion criteria.

Results
preoperative HbA1c is not the only predictor of surgical site infection after cardiac surgery in diabetic patients and in patients with previously undiagnosed diabetes. Baseline HbA1c 8.6 was associated with the higher risk of chest wound infection. Interestingly, in this series.

Conclusion
this study shows that the incidence of chest and leg wound infections are significantly related to the value of the glycosylated hemoglobin and rate of infection increases with poor control of diabetes and from this study we recommend measurement of glycosylated hemoglobin value for all patient undergoing cardiac surgery.
Nadir oxygen delivery to the brain as a risk factor for postoperative neurocognitive impairment in patients undergoing coronary artery bypass grafting: A myth or fact
Authors: Abdaljawad M N , Taha S 
Published: May 2020

Abstract

Background
There are many factors that determine the best neurocognitive outcome following cardiac surgery. Optimum oxygen delivery to the tissues has always been the goal to optimum perfusion. Some patients may exhibit neurocognitive impairments in the early postoperative period; that could be easily missed clinically as they are not associated with radiographic evidence of structural brain damage. At this study we aimed to correlate the lowest oxygen delivery levels with incidence of neurocognitive impairment in the early postoperative period by Folstein test.

Methods
A non-randomized, prospective pilot study was designed to correlate the nadir oxygen delivery (DO2) during CPB with post-operative cognitive impairment. The study included 271 patients of both sexes, an age group of 50e60 years with university level of education, scheduled for elective, isolated CABG for three vessel disease. All patients underwent pre-and post-operative neurocognitive test by a specialized neuropsychiatric doctor.

Results
with a mean nadir DO2 of 291 mL/min/m2, the majority of the patients exhibited “normal” results, with a mean nadir DO2 of 266 mL/min/m2 92 patients showed mild impairment in their cognitive behavior, while the worst results “moderate” and “severe” were associated with means of 244,200 mL/min/m2 successively.

Conclusions
The nadir oxygen delivery is a risk factor for development of post-operative neurocognitive impairment. A level below 260 mL/min/m2 is generally associated with higher risk while a level below 220 mL/min/m2 carries the worst prognosis.
Study of Chronic Obstructive Pulmonary Disease patients in Gamal Abd El-Nasser Hospital in 2017
Authors: Ahmed M M , Ali T M , Khalafallah K H 
Published: May 2020

Abstract

Background
COPD is characterized by non-remitting airflow limitation and persistent respiratory symptoms which is an enhanced inflammatory response to prolonged exposure to smoking or noxious gases or particles and manifested through chronic cough, effort dyspnea, expectoration and wheezing, symptoms that appears in context of airways hyper-responsiveness and may be partially reversible.

Objective
Assessment of COPD patients in Gamal Abd El Nasser Hospital during period from January 2017 to June 2017.

Subjects and Methods
This study was a cross sectional study that included 290 COPD patients recommended for spirometric assessment. The patients were classified into 2 groups: Outpatients and inpatients in the period from January 2017 to June 2017, they were subjected to full medical history, general and local examination, Pre and post bronchodilator spirometric study according to (GOLD,2017) and each patient will be subjected to the following questionnaire [Serial number, Name, Age, Sex, Occupation, Residence, Level of education, Smoking, Smoking index, Family history of COPD, Symptoms, Number and severity of exacerbation attacks in the last year, Number of Hospitalization during the last year, Vaccination status, Spirometry, Treatment prescribed by, Treatment, Inhalation therapy, Regulation of treatment, Non pharmacological therapy, Satisfaction of treatment, co morbidities, Complications, Outcome for inpatient]

Results
The study included 290 patients, 259 males and 31 females with age range of 29 _ 83 years, the majority of the studied cases were Current smoking but only 22.5% was ex-smoker. Mean FEV1% pred. Post-bronchodilator was 75.9± 16.9 in outpatients and mean FEV1% pred. Post – bronchodilator was 52.9 ± 13.4 in inpatient. The most common co morbidities in COPD patients were hypertension in 25% of cases. More than half of all studied cases had complications and the most frequent complication was Cor-pulmonale and respiratory Failure. In this study, Severity of COPD according to GOLD 2017 was 27.8% in mild stage, 34.2% in moderate stage, 35.8% in severe stage and 2.5% in very severe stage.

Conclusion
Spirometry had a great role in diagnosis of COPD and its differential diagnosis from asthma. Smoking is the major risk factors in developing COPD and this reflects on the disease occurrence and severity. Some of COPD patients refuse to use inhalers due to fear of addiction and incorrect method in using it. Inhaler steroids were preferred due to fear of systemic complications of steroids. There is great defect in vaccination and trials of quitting smoking as a non-pharmacological treatment for COPD patients.
Detection of Antibiotic Susceptibility by Colorimetric Minimum Inhibitory Concentration in Staphylococcal Isolates
Authors: Mahmoud B S , ElMasry S A , Fahim N A , Shaker O A , Abdelsattar M A 
Published: May 2020

Abstract

Background
Staphylococcus species are implicated in a wide range of community and hospital-acquired infections, which necessitates rapid provision of antibiotic susceptibility results for patients at risk. The current study evaluated the usefulness of applying broth microdilution (BMD) and agar dilution methods for antimicrobial susceptibility testing of Staphylococci using tetrazolium salts as redox indicators.

Methods
Minimum inhibitory concentration (MICs) of eight antimicrobials representing different antibiotic classes as recommended by CLSI; vancomycin (VA), linezolid (LZD), oxacillin (OX), gentamicin (CN), tetracycline (TE), ciprofloxacin (CIP), erythromycin (E) and clindamycin (DA) was investigated for 80 isolates of Staphylococci by a modified BMD with the addition of dimethyl thiazole diphenyl tetrazolium bromide (MTT). As well as agar dilution with the addition of MTT & triphenyl tetrazolium chloride (TTC) at the standard bacterial concentration together with addition of MTT at an experimental bacterial concentration.

Results
BMD (MTT) showed the highest agreement regarding most antibiotics among different isolates in comparison with the standard BMD. All performed methods showed significant agreement except agar dilution (TTC) using TE, DA, E, and agar dilution (MTT 108) using DA as well as agar dilution (MTT 104) using E among S. aureus.

Conclusions
Colorimetric BMD was rapid, easy to interpret and showed the highest agreement with the standard BMD. Colorimetric agar dilution (MTT) was less tedious than BMD. The colorimetric MIC method using MTT may be a useful surrogate of antimicrobial susceptibility testing among Staphylococcus isolates.
Value of E-test in the Determination of Synergistic Antimicrobial Combinations Active Against Multi-Drug Resistant Enterobacteriacae
Authors: Kassem N N , Ismail G A , Hafez H M , Gomaa F A M , Fahim N A , Mohamed M R 
Published: May 2020

Abstract

Background
A number of methods have been used to study the in-vitro synergy between antibiotics with the checker board titration and E-test being the most widely described.

Aim of the Study
The aim of the present study is to determine the prevelence of Multi-Drug Resistance (MDR) among Enterobacteriacae and to compare between the E-test and the checkerboard titration method as rapid in-vitro diagnostic tests that can help to determine the synergy between selected antimicrobial combinations thought to be active against multi-drug resistant Enterobacteriacae.

Materials and Methods
The present study was conducted during the period between May 2017 and December 2017. A total number of 34 MDR Enterobacteriacae isolates were recovered from different clinical specimens submitted to the Main Microbiology Laboratory, Ain Shams University Hospitals. The isolates were tested using checkerboard titration method and E-test to determine the synergistic activity of selected antimicrobial combinations thought to be active against the MDR organisms.

Results
Out of 46 Enterobacteriacae isolates 34(74%) were MDR. According to antibiotic combination the combinations of Amikacin/Ceftazidime, Amikacin/Meropenem and Amikacin/Ampicillin+Sulbactam have synergistic effect against MDR Enterobacteriacae by E-test and checkerboard method. A statistically poor agreement was observed between the checkerboard BMD method and the E-test method regarding the results of the studied antibiotic combinations

Conclusion
The Checkerboard method, being the reference method for assessing antimicrobial synery, showed that the highest synergic activity belongs to Meropenem and Amikacin (40%).
Assessment of serum visfatin level in beta thalassemia patients
Authors: Abdelwahab S E , Habashy D M M , Shams M A , Amin A H M 
Published: May 2020

Abstract

Background
Thalassemias are monogenetic hematologic disorders which are caused by faulty synthesis of one or more of the Hb chains which leads to imbalance in globin chains resulting in hemolysis and impaired erythropoiesis and chronic inflammatory condition. Visfatin is a pro-inflammatory adipocytokine which is mostly expressed in visceral adipose tissue and its testing may help in assessment of severity of the disease.

Aim of the work
This study aims at measuring serum visfatin level in Beta thalassemia patients and its possible correlation to disease severity (major andintermedia).

Patients and methods
Forty-one patients diagnosed as β-thalassemia (major, intermedia) and twenty age and sex-matched healthy individuals as the control group were tested for serum visfatin levels by enzyme-linked immunosorbent assay.

Results
Serum visfatin was higher in theß-thalassemia major(ß-TM) group than in the control group (P&lt;0.001). Serum visfatinand serum ferritin were higher inß-TM group than in ß-thalassemia intermediagroup (ß-TI)(p &lt; 0.001).Serum visfatin was found positively correlated with platelet count (P&lt; 0.001) in the ß-TM group.As per ROC curve analysis, measured serum visfatin level was found to discriminate ß-TM group from β-TI group and control group.

Conclusion
There is an association between serum visfatin and the degree of severity of β thalassemia disease.

Recommendations
Testing of the relationship between serum visfatin level and other vascular inflammatory markers in β-thalassemia disease (asadiponectin, resistin, intracellular adhesion molecule (ICAM)) to clarify the exact mechanism of the inflammatory process in the disease and its complications to alter the course of the disease.Also to study serum visfatin in complicated β-thalassemia patients to establish its possible role in cardiac, vascular, endocrine or any other complications and comparing it with non-complicated patients.