bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Different Modalities of Treatment of Hepatorenal Syndrome as Midodrine, Somatostatin analogue, Albumin infusion and Tapping of Ascites on Renal Artery Resistive Index by Doppler ultrasound
Authors: ElTouny Maha , ElKelany Hesham H , ElBaz Hossam , Zaki Kristeen E 
Published: October 2021

Abstract

Background
Liver cirrhosis is a major cause of morbidity and mortality worldwide, mainly due to complications of portal hypertension. Ascites formation in patients with Kristeen E. cirrhosis, portal hypertension, or both usually results from hyperdynamic circulatory Zaki dysfunction.

Aim of the Work
to investigate the effect and prognostic value of treatment of hepatorenal syndrome in patients with liver cirrhosis and massive ascites by LVP, somatostatin analogue and midodrine intake and its effect on renal resistive index.

Patients and Methods
This study was carried on 40 patients divided into 4 groups where 10 patients (G1) received midodrine therapy and albumin infusion, 10 patients (G2) had tapping of ascites with albumin infusion, 10 patients (G3) received octreotide therapy and albumin infusion and the last 10 patients (G4) received octreotide, midodrine and albumin infusion. All patients were subjected to careful history taking and thorough clinical examination. Before and after intervention, patients had laboratory investigation including complete blood picture, liver function tests, renal function test and ascitic fluid analysis in addition to renal artery Doppler imaging.

Results
The study revealed considerable decline in RI in G1 (midodrine group), the change fell short of statistical significance. However, our study showed significant effect of midodrine administration on renal functions as expressed by serum creatinine, blood urea and creatinine clearance. In G3 (octreotide group), the effect of treatment on renal artery RI was minimal. The other group that perceived significant decline in renal artery resistive index was G4 (midodrine and octreotide group).

Conclusions
LVP and midodrine combination administration resulted in significant decrease in creatinine clearance. Renal artery resistive index has significant correlation with creatinine clearance in studied group and can be used as non-invasive tool.
Safety & Efficacy of Directly Acting Antivirals (Sofosbuvir & Daclatasvir) in Treatment of Chronic HCV in HIV-HCV Co-Infected Egyptian Patients
Authors: EL-Saeed Kadry Mohamed , EL-Khedr Inas , Anwar Christina Alphonse , Hassan Mahmoud Hassan Al-Sadik 
Published: October 2021

Abstract

Background
The introduction of direct-acting antiviral agents, has revolutionized the treatment for chronic HCV with higher cure rates, shorter duration of treatment and more tolerability have been achieved.

Objectives
The aim of our study is to estimate the efficacy and safety of DAAs in treatment of chronic HCV in patients co-infected with HIV.

Patients and Methods
This study of previously untreated patients with HCV and HIV co- infection conducted at Abbasia Fever Hospital, from July 2019 to February 2020. Patients included those who are chronic HCV infection and receiving antiretroviral therapy with a CD4 T-lymphocyte count of 200 cells/mL or greater. Serial measurements of safety parameters, virologic and host immune correlates, and adherence were performed during treatment by combination of daclatasvir 90mg and sofosbuvir 400mg+/- ribavirin 800mg daily for 12 weeks.

Results
In this study, AST & ALT were significantly decreased at end of treatment and 12 weeks after treatment, CD4 count was significantly increased. Otherwise there are no significant changes in both hematological and biochemical laboratory results. The demographic features of the patients and HIV disease characteristics were not predictors of HCV treatment failure.

Conclusion
More studies on larger numbers of patients are required for proper evaluation of the safety and efficacy of direct acting antiviral agents generally and sofosbuvir plus daclatasvir combination particularly in HIV/HCV coinfected patients. Longer follow-up studies are still recommended to fully understand the impact of sustained virological response on dynamics of liver fibrosis, biochemical profile and rate of relapse.
Effect of intradialytic exercise on the inflammatory markers in prevalent hemodialysis patients
Authors: Elshinnawy Howayda Abdelhamid , Fayez Mahmoud Mohamed , Farrag Dina Abou-Bakr , AbdElgawad Mostafa AbdElnassier 
Published: October 2021

Abstract

Background
Chronic low-grade inflammation is a feature of chronic kidney disease associated with increased risk of multiple morbidities and mortalities. Dialysis patients lead a sedentary life style which could add to this risk.

Aim
assessment of the effect of intradialytic exercise IDE on inflammatory markers in prevalent hemodialysis HD patients.

Patients and Methods
This longitudinal prospective study included 40 adult patients on regular HD, divided equally into 2 groups; Exercise Group (n = 20); received IDE 3 times/week for 3 months and Non-exercise Group (n = 20) matched in age and sex acting as controls. Patients were subjected to full history taking and clinical examination. Physical performance assessment using Short Physical Performance Battery tests (SPBT), Laboratory investigations included; Complete blood picture, C-reactive protein (CRP) and interleukin 6 (IL6) assessed using Enzyme linked immunosorbent assay. All assessments were repeated 3 months after regular IDE.

Results
At baseline, there was no difference between both groups regarding physical performance or inflammatory markers. After 3 months, SPBT was significantly increased in Exercise group (P &lt; 0.001). Also, both serum CRP and IL-6 levels showed significant decrease in Exercise group compared to baseline (P &lt; 0.001), while no similar change was noticed in non-exercise group.

Conclusion
The significant decrease in serum CRP and IL-6 levels after 3 months of regular IDE and the improvement in physical performance in exercise group implements that regular IDE exercise training program can improve physical function and inflammation in hemodialysis patients.
Further studies on larger number of patients is warranted.
A study of Vitamin D supplementation to patients with chronic diseases admitted to Ain Shams University Hospital
Authors: Botros Raef Malak , El Din Ahmed Mohamed Bahaa , Mansour Hany Khairy , Ayad Grace Mariam Michel 
Published: October 2021

Abstract

Background
Vitamin D deficiency and insufficiency have become a common problem worldwide. Vitamin D has been associated with all causes of mortality in chronic diseases and associated with a longer hospital stay and poor outcome.

Aim of the Study
to evaluate the role of vitamin D supplementation on the outcome of hospitalization for patients with CLD or CHF admitted to Ain Shams University Hospitals (ASUH) with acute deterioration of their illness.

Subjects and methods
We conducted prospective case control on 80 patients collected from inpatient ward of endocrinology, divided into 2 groups; 40 patients with chronic liver diseases and 40 patients with heart failure. Serum 25OH-vitamin D and calcium, phosphate and PTH were measured to all participants before intervention. 20 patients of each group (Intervention group) received single dose of vitamin D within 3 days of admission and the other 20 patients of each group (control group) did not receive vitamin D vitamin D.

Results
no significant difference between patients who received vitamin D supplementation and who did not receive vitamin D supplementation as regards outcome and survival with P value 1.000 in patients with CLD and 0.823 in patients with CHF. On the other hand, we found baseline vitamin D level was an independent predictor of mortality (P value .018).

Conclusion
We found that a beneficial effect of vitamin D supplementation can't be achieved with single dose vitamin D (200,000 IU) on CHF or CLD hospitalized patients’ mortality. We recommend that vitamin D supplementation should be considered in CLD and CHF outpatients, with exception of hypercalcemic and hyperphosphatemic patients, as baseline vitamin D status affects the disease course and mortality prior to disease deterioration and hospitalization.
Relation of Gut Lactobacillus Acidophilus and Atherosclerosis in type 2 diabetic patients with and without atherosclerosis
Authors: Hosny Salwa Seddik , Abd El Baky Rania Sayed , Mohamed Eid Yara , Mohamed Nagwa Roushdy , Ibrahim Rana Hashem 
Published: October 2021

Abstract:

Background
Recent researches show that alteration of GUT bacterial population is found to be an important factor for development of atherosclerosis either directly or indirectly through augmenting other known risk factors for atherosclerosis like; diabetes and dyslipidemia.
On the other hand, many members of the gut microbiota are probiotics; Bifidobacterium and Lactobacillus are two well-known probiotics, many studies show their athero-protective role and their protective effect against insulin resistance and metabolic syndrome.

Aim of the work
To study the role of gut Lactobacillus Acidophilus in the development of atherosclerosis in type 2 diabetic patients (T2DM).

Patients and methods
The study was conducted on 64 type 2 diabetic patients, with their age ranging between 25 and 60 years old. They will be divided into two groups; Group 1: 32 Type 2 diabetic patients with atherosclerosis. Group 2: 32 Type 2 diabetic patients without atherosclerosis. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, two-hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile
(Total cholesterol-LDL-HDL-Triglycerides), and Liver and kidney function test.
Identification of stool Lactobacillus Acidophilus by Polymerase chain reaction (PCR) semi- quantitative technique. Carotid ultrasonography for estimation of intimamedia thickness (IMT).

Results
As regards PCR for Lactobacillus Acidophilus 68.8% of group one patients were positive for PCR for Lactobacillus Acidophilus, compared to 75.0% of group two, but there was no statistical difference among the two groups (P value = 0.578).As regards PCR cut-off time in PCR positive cases, there was a statistically significant difference among the two groups (P value= 0.016). Applying Receiver operating characteristic curve (ROC), it showed that PCR cut-off time more than 26.82 can be used as a predictor for atherosclerosis in type two diabetic patients (T2DM) with sensitivity of 72.73%, specificity of 70.83% and area under curve (AUC) of 0.723. In group one, there was a statistically significant positive correlation between PCR cut off time and the two hours post prandial blood sugar (P value= 0.005), the glycated hemoglobin (HBa1c) (P value= 0.049) and intimal media thickness (IMT) (P-value= 0.045).

Conclusion
Lactobacillus Acidophilus concentration is higher in type 2 diabetes patients without atherosclerosis than in atherosclerotic patients and detection of their level in stool using PCR can be used as a predictor for atherosclerosis in type two diabetes patients.
SOLUBLE TRANSFERRIN RECEPTOR IS A PROMISING MARKER of IRON DEFICIENCY ANEMIA IN PREVALENT HEMODIALYSIS PATIENTS
Authors: seif Khaled Abou , Hussien Hussien Sayed , Abdelmegied Shaimaa , Abdulhady Marwa 
Published: October 2021

Abstract:

Background
Diagnosis of iron deficiency is traditionally based on ferritin and other iron parameters becomes difficult in end stage renal disease patients due to the inflammatory condition which affects these markers and masks the iron deficiency. Serum soluble transferrin receptor (sTfR) is able to be a reliable indicator for assessing iron status, as it is not affected by inflammatory procedures.

Aim
To evaluate the usefulness of serum soluble transferrin receptors in iron deficiency anemia detection in comparison to the classic markers of iron status in prevalent hemodialysis patients.

Methods
This case-control study assessed sTfR in 80 prevalent ESRD patients on regular hemodialysis in 2 groups. Group A (N = 40): CRP &gt;10 and group B (N = 40):CRP &lt;10 and apparently healthy 8 control subjects.

Results
The cut of value of STFRs in hemodialysis patients was 12.5 mg\l. The prevalence of STFRs in patients with CRP&lt;10 was 85%, while in patients with CRP&gt;10 was 92.5% (P-value 0.288). STFRs have high sensitivity 88.75, specificity 100, PPV100% and NPV 47.1%. The hemodialysis patients who have elevated STFRs have risk 1.22 times to have iron deficiency anemia if CRP &lt;10 (odds ratio: 1.22) and 3.14 times if CRP&gt;10 (odds ratio: 3.14). There was significant difference on comparing patients with CRP&lt;10, CRP&gt;10 and control as regard Hb and STFR with P-value 0.0001 and 0.0001 respectively. Post Hoc analysis showed significant difference in both between the patients with CRP&lt;10 and control also in patients with CRP&gt;10 and control (p value &lt;0.0001). while on comparing patients with CRP&lt;10 with patients with CRP&gt;10 there was significant difference in STFRs p value 0.0001 despite no significant difference in hemoglobin (p value 0.642) and classic marker of iron deficiency (s.iron, TIBC, TSAT) with p value 0.701,0.192,0.382 respectively. Serum STFRs was negatively correlated with s.iron and Kt\v (r -0.372, P-value 0.018) and (r-0.416, p value 0.008) respectively in patients with CRP &lt;10.

Conclusion
Serum soluble transferrin receptor is highly sensitive and specific marker for iron deficiency in hemodialysis patients especially in patients with high CRP level.
Incidence of Atrial Fibrillation in Haemodialysis Patients
Authors: El-Tayeb Nasser Mohamed , Abdeltawab Adham Ahmed , Mehany Raafat Boshra , El-Gawad Mostafa Abd El-Nassier Abd 
Published: October 2021

Abstract

Background
Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy.

Aim of the Work
To detect the incidence of AF in hemodialysis patients during six months.

Patients and Methods
The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in CAIRO, EGYPT for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study.

Results
The study includes 250 patients from whom 37 patients refuse follow up after 6 months and 18 patients was died before our follow up holter ECG so mortality rate 14.4% .1n our study population there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 — 6) with range (1 — 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000).

Conclusion
The incidence of AF in patients with ESRD is 16.4%. The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.
Clinical Characteristics of Behçet Disease in an Egyptian Cohort
Authors: Farouk Hanan Mohamed , El-Maamoun Tarek A , Elbakry Samah A , Rahman Maryam Ahmed Abdul , Samy Nermeen , Elziaty Rahma Ahmed 
Published: October 2021

Abstract

Aim of the work
To study the clinical characteristics of Behcet’s disease (BD) in Egyptian patients.

Patients and methods
150 BD patients were recruited from the Rheumatology and Internal medicine Department, Ain Shams University Hospitals. Demographic and clinical data were collected. Disease activity was assessed using Behcet Disease Current Activity Form (BDCAF).

Results
150 BD patients were included in this study. Their ages were 34.05 ± 9.28 years (14 – 66 years) and with disease duration range (1–20 years). There were 116 males (77.3%)and 34 females (22.7%), with male to female ratio of 3.4:1. The BDCAF was 4.44 ± 1.97 (2–10). The frequency of the clinical manifestations was oral ulcers in 86.7%, followed by genital ulcers in 82.0%, ocular involvement in 68.7%, vascular affection in 58.7%, articular manifestations in 32.7%, pathergy test was positive in 28.0%, skin manifestations in 26.0% (pustular lesions, folicilitis,erythema nodosum and pyoderma gangrenosum), neurological in 25.3% in the form of (CNS infarction in 12.7%,vasculitis in 6.7%, Cerebral sinus thrombosis in 4.0% and Seizures in 2.0%) and gastrointestinal in 7.3% in the form of (nausea, vomiting and abdominal pain).

Conclusion
In Egypt, there is a male predominance in BD patients as other areas in worldwide countries. The clinical characteristics are comparable to other studies. However, in Egypt the gastrointestinal manifestations showed the lowest recorded frequency
Study of Urinary Iodine Level Assessment and its Relation to Thyroid Function during Pregnancy
Authors: Mohamed Magda Shoukry , Nasr Merhan Samy , El-Halawany Salah Hussien , Abbas Ahmed Mohamed , Tayeh Salma Said Hassan 
Published: October 2021

Abstract

Background
The global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to poor monitoring, is currently a more frequent occurrence than iodine deficiency. Iodine excess is a precipitating environmental factor in the development of autoimmune thyroid disease.

Aim of the study
to evaluate the urinary iodine level as a marker of iodine status in pregnant women in 3rd trimester and assess its relation to thyroid functions.

Patients and Methods
This Cross Sectional Study was conducted on 100 subjects with their ages ranging from 18-35 years old, pregnant females, at the third trimester, selected from Obstetric Out- patient Clinic of Ain shams University Hospitals. Samples were collected from participants in cairo, during the Spring and Summer from March to August.

Results
in our study, there was a significant negative correlation between Urinary Iodine level and TSH as Iodine difficient group has the Highest TSH, and the Highest Thyroid Volume, as there was a significant negative correlation between Urinary Iodine level and Thyroid Volume.

Conclusion
TSH level and Thyroid Volume were global effort to prevent iodine deficiency disorders through iodine supplementation, such as universal salt iodization, has achieved impressive progress during the last few decades. However, iodine excess, due to extensive environmental iodine exposure in addition to significantly higher in Iodine difficient group than Excess iodine group, And FT4 level was lower in Iodine difficient group than excess iodine group.
Serum MicroRNA-222 Expression for Malignancy Prediction in Euthyroid Patients with Indeterminate Thyroid Nodule
Authors: Mohamed Sherihan AboElyazed , Halawa Mohamed Reda , Ahmed Yara Mohamed , Maher Maram Mohamed , Elhalawany Salah Hussein , Salem Lamyaa 
Published: October 2021

Abstract

Background
The Prevalence of thyroid nodules is rising nowadays, luckily most of them are benign. The risk of malignancy 5-15%, which necessitates the ultimate need to accurately distinguish benign from malignant nodule to avoid unnecessary thyroidectomy with risk of recurrent laryngeal nerve injury, postoperative hypothyroidism and lifetime thyroid replacement therapy, and other complications related to surgery and anaesthesia. Recent evidence suggests that circulating miRNA might have probable advantage as diagnostic or prognostic markers for numerous cancers. Given their reproducible and constant presence in sera, miRNA profiles have emerged as a non-invasive method to categorise a wide variety of human cancers.

Aim of the study
To evaluate a possible relationship between the expression level of circulating miRNA-222 and the histological outcome of euthyroid patients undergoing thyroidectomy for thyroid nodules with indeterminate FNAB cytology.

Patients and Methods
45 patients of both genders, of age ranging from 19-70 years old visiting endocrine clinic or admitted to the endocrine surgical department with indeterminate thyroid nodules planned for thyroidectomy were included. All pateints were subjected to full medical history taking, general and local clinical examination, laboratory investigations (thyroid function tests), quantitative assay of serum micro RNA-222 expression by quantitative Real-Time polymerase chain reaction (qRT-PCR), ultrasonography imaging of thyroid gland, fine needle aspiration biopsy and cytology of the thyroid nodule, histopathological examination after thyroidectomy.

Results
The incidence of thyroid nodules was predominant in female gender in benign group and malignant group. Risk of malignancy increases as TI-RADS and Bethesda scores increases. Also, larger nodule in size has a more risk of malignancy (p = 0.034). Expression level of circulating miRNA222 in serum can’t differentiate between healthy, benign and malignant patients where there was no significant difference between them statistically (p = 0.867). Circulating miRNA-222 is a poor predicator for malignant nodules with sensitivity of 50%, specificity of 32.43%, with high negative predictive value (NPV=75%).

Conclusion
Expression level of circulating miRNA-222 is a poor predictor of malignant nodules in our studied group. The larger the nodule size the more risk of malignancy. Also, as TI-RADS and Bethesda scores increases the more risk of malignancy.