bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ministernotomy for Aortic Valve Replacement Versus Conventional Sternotomy, a Choice for a Better outcome
Authors: Refaat Ahmed Refaat Mohamed , Samy Gamal , Morad Faisal , Gawad Nabil Abd 
Published: October 2021

Abstract

Background
​ In the era of minimal invasive cardiac surgery, Ministernotomy Aortic valve .replacement have been proposed as an alternative to conventional full sternotomy approach

Aim of the Work
​: ​​To evaluate the safety and efficacy of AVR through ministernotomy in comparison to full sternotomy AVR in terms of Cardiac cause mortality, Neurological and .Renal complication​s

Patients and Methods
​After gaining the institutional ethical committee approval, the study included all patients who underwent isolated, DE novo, open aortic valve replacement during the period from June 2017 till June 2019 performed by multiple surgeons at cardiothoracic .academy Ain Shams University

Results
​ The study included 60 patients; 32 patients performed through full sternotomy (53.3%) and 28 patients through ministernotomy (46.6%).​ ​Post-operative arrhythmias occurred in full sternotomy in 6 cases (18.8%) where in mini-sternotomy, only 3 cases (12%) developed arrhythmias with no significant statistical difference (p value = ​0.558)​. Cerebrovascular stroke was recorded 1 patient (3%) versus 4 cases (14.3%) in the full sternotomy versus the ministernotomy groups respectively with no Statistical difference between the 2 groups (p value = 0.119).​ Postoperative acute renal impairment was recorded​ in 3 cases (9.4%) vs 2 patients (7.1%) in the full sternotomy vs the ministernotomy groups respectively (p value = 0.755). There was no​ mortality in either groups. Mean post-operative Ventilation hours were 17.21hrs with SD ± 11.026 versus 14.97hrs with SD ​± ​6.473 (p value is 0.35) for the full sternotomy versus the ministernotomy groups respectively. Mean blood loss was 305.51ml with SD ± 282.662 versus 230.36ml with SD ​± ​247.708 (p value is 0.277) for the full versus the ministernotomy groups respectively. Mean units of blood transfused was 2.31Units with SD ​± ​0.926 versus 1.14Units with SD ​±​ 0.591 in the full sternotomy versus the ministernotomy groups with high statistical significance between both groups (p value less than 0.01). Mean ICU stay was 2.66 days with SD ​±​ 0.915 and was 3.1days with SD ​±​ 2.743 (p .value is 0.424) for the full sternotomy versus the ministernotomy groups respectively

Conclusion
​ Ministernotomy Aortic valve replacement was found to be a safe procedure​ compared to full sternotomy approach. Patients who had their surgery through the mini approach had less amount of blood loss, blood transfusion requirements, ventilation time which all led to less duration of ICU and hospital stay, resulting in a better outcome for the .patients
Importance of Intraoperative Detection of Graft Patency by Using Transit Time Flowmetry and Its Impact on Revascularization of the Myocardium
Authors: Ezzat Mohamed Ayman , Ibrahim Ahmed Abdel-Aziz , El Nahhas Yasser Mahmoud , El-din Ahmed Mohamed Seif , Mostafa Mohamed Ahmed Gamal 
Published: October 2021

Abstract

Background
Coronary artery bypass surgery (CABG) has contributed to an increase in survival, quality of life and life expectancy. The anastomotic quality and graft patency is directly associated with both early and long-term clinical results after CABG. It is a complication that can lead to refractory angina, myocardial infarction, arrhythmias, and even mortality.

Objectives
This study was aiming to evaluate the effect of use of TTFM on the outcome of CABG operations and it was carried out on 100 patients and examined 282 grafts, we use inotropic agents to maintain the systolic pressure at 90- 100 mmHg if the blood pressure was lower than that limit.

Patients and Methods
An observational exploratory study was carried on 100 patients operated in Police authority hospitals, cardiothoracic surgery department. The study period of the study was 6 months, study population: The included population will be patients with Coronary Artery Disease (CAD) undergoing Coronary Artery Bypass Grafting (CABG) surgery.

Results
TTFM data was described as two main readings which are MF in ml/min (mean flow), PI (pulsatility index) and it was measured for the all types of the grafts. In MF it was the highest in AO-OM system (34.5 ± 18.46) followed by LIMA- LAD system (33.0 ± 19.65) then AO-Diagonal (31.0 ± 26.38) and lastly AO-RCA(29.50 ± 32.22). For the PI the lowest measurements was 0.8 and it was for both LIMA to LAD and then 1.2 for AO-OM system and 1.4 for AO-DIAG system and 1.8 for AO-RCA system. The most important finding in this study which represents the usefulness of the usage of TTFM is how much grafts needed to be revised according to the grafts measurements and it was 14 grafts in 14 patients (one grafts for each patient) among 100 patients which account for 14%.

Conclusion
Regarding the other studies that compare the TTEM with other ways for detection of graft patency, they prefer the TTFM due to: TTFM is easy to use, accurate and relatively inexpensive, TTFM helps prevent missed technical surgical errors in distal and proximal anastomosis, it has shown that TTFM improved outcome in many situations, TTFM provides excellent documentation of the surgical outcome and allows for better understanding of procedural complications.
Sutureless aortic valve replacement: a meta-analysis
Authors: Metwaly Hani Abd El Mabood , Omar Ahmed Helmy Ali , Jawad Mohammed Nabil Mohammed Abd Al , Amer Mohamed Saad Mohamed 
Published: October 2021

Abstract

Background and objectives
Sutureless aortic valves aim to achieve better outcomes and to aid and facilitate the minimally invasive aortic valve replacement procedure by tackling the issue of cross clamp time, which is an independent predictor of post-operative outcomes especially in patients with serious comorbidities. (2, 3) By reducing the number of sutures, the time for sutures placement is reduced. (1)
Our Meta-analysis tries to assess the safety and hemodynamic performance of the sutureless aortic valve prosthesis’s in an attempt to ascertain their benefits as a viable alternative to current established measures.

Methodology
From their beginnings to February 2017, electronic searches were conducted using six databases. Relevant studies using commercially accessible suture-free valves to replace the aortic valve have been recognized. Based on the predefined endpoints, data were collected and analyzed.

Results
FC For incorporation in qualitative and quantitative analyses, twenty-four studies were recognized, with a total number of 5073 patients undergoing sutureless aortic valve replacement (SU-AVR). Mortality incidence at 30 days and 12 months follow-ups were 2.5% and 2.7%, respectively, while the incidence of thromboembolic events (1.6%) and paravalvular leak (PVL) (0.5%) were acceptable.

Conclusion
Current available evidence indicates that sutureless aortic valve replacement is a safe operation showing low mortality and complication rates, with satisfactory hemodynamic performance.
Predictors of Right ventricular Pacing induced Left Ventricular dysfunction in Pacemaker Recipients with Preserved Ejection Fraction
Authors: Sayed Mohamed Abdelmohsen , Effat Emad , Badran Haitham , Khaled Said 
Published: October 2021

Abstract

Background
Pacemaker (PM) has been an effective treatment in the management of patients with brady-arrhythmias. Chronic RV pacing may cause electrical and mechanical dyssynchrony which lead finally to reduced left ventricular ejection fraction (LVEF). This deterioration of LVEF has been defined as pacemaker induced cardiomyopathy (PICM). The incidence of PICM was described by many studies and ranged between 10% to 26%. The predictors for PICM have not been well studied. These studies were limited by variation in follow-up period and definition of PICM.

Objective
to study the incidence and predictors of PICM in patients who underwent pacemaker implantation in Ain shams University hospital.

Patients and Methods
This retrospective study included 160 patients who underwent single or dual chamber pacemaker implantation in Ain shams university hospital between 2010 and 2017 with the mean period 4.7±2.0 years. Implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) patients were excluded. Individuals who had baseline transthoracic echocardiography (TTE) with normal LVEF ≥ 50% before implantation were included.

Results
This study included 160 patients who had single or dual chamber pacemaker implantation between 2010 and 2017. 45% were males and 55% were females, mean age was 55.5 years. It showed that the incidence of PICM is 7.5%. Wider native QRS durations, particularly &gt;140 ms (p &lt; 0.001), wider pQRS duration &gt;150 ms (p &lt; 0.001), Low normal ejection fraction &lt;56 % preimplantation (p = 0.023) and increased LVEDD&gt;53 mm and LVESD&gt;38 mm (p &lt; 0.001) are predictors for the development of PICM. Female gender was independent predictor for PICM (p = 0.058). There was no association between burden of right ventricular pacing (p = 0.782) or pacing site (p = 0.876) with the risk of development of left ventricular dysfunction.

Conclusion
The incidence of right ventricular pacing-induced left ventricular dysfunction is not uncommon, with an observed incidence of 7.5% in the current study. Wider native and paced QRS durations, Low normal ejection fraction (&lt; 56 %) pre-implantation and increased LVEDD /LVESD post implantation are the most important predictors for the development of PICM.

List of abbreviations
PM= pacemaker, RV= Right ventricle, PICM = pacemaker induced cardiomyopathy, TTE= transthoracic echocardiography, DM= Diabetes Mellitus, HTN= Hypertension, BMI= Body Mass index, pQRSd= Paced QRS duration, SWMA= segmental wall motion abnormality, AF= Atrial fibrillation, SSS= Sick sinus syndrome, CHB= Complete heart block, AVB= Atrioventricular block, LVEF = left ventricular ejection fraction, LVEDD= Left ventricular end diastolic diameter, LVESD= Left ventricular end systolic diameter, ms= milli second.
Growth Differentiation Factor 15: An Emerging Diagnostic Biomarker of Liver Fibrosis in Chronic Hepatitis C Patients
Authors: Sebai Aziza Ahmed El , Ahmed Ossama Ashraf , Saab Azza Abdel Rahman , Adel Abou Zaghla Heba M , Naguib Gina Gamal , Ahmed Ayat Fawzy 
Published: October 2021

Abstract

Background
Chronic liver disease and cirrhosis are a major health concern worldwide being the sixth leading cause of all-cause mortality in people aged 25–64 years. Assessment of liver fibrosis is necessary to determine disease severity and prognosis at the time of presentation to determine suitable treatment. The gold standard method of diagnosis is liver biopsy; however, this procedure is invasive; thus, multiple laboratory and radiologic tests are used to help determine the degree of fibrosis. Growth differentiation factor 15 (GDF-15) is a pleiotropic cytokine involved in regulating inflammatory and apoptotic pathways. It plays a role in cardiovascular disease, inflammation, body weight regulation and cancer. It is suggested that GDF-15 plays an important role in pathogenesis of liver fibrosis.

Aim of the Work
In this study we aimed to evaluate efficiency of growth differentiation factor 15 in diagnosing liver fibrosis.

Patients and Methods
The study was a case- control study conducted on 55 chronic HCV patients recruited from Hepatitis C virus Clinic at Faculty of Medicine Ain Shams Research Institute (MARSI), and 30 healthy subjects age and sex matched. The patients were classified into three subgroups according to the degree of liver fibrosis assessed by fibro-scan. Serum concentration of GDF-15 was determined by enzyme-linked immunosorbent assay (ELISA).

Results
Results of our study revealed a highly significant statistical rise in GDF-15 levels among studied chronic HCV patients with liver fibrosis when compared to the control group (p &lt; 0.01). Furthermore, there was a significant positive correlation between the degree of fibrosis assessed by fibro-scan and GDF-15 serum levels. Levels of GDF-15 were significantly higher in patients with mild degree of fibrosis (patients’ subgroup І when compared with the controls’ group (p &lt; 0.01) suggesting the role of this marker in early detection of liver fibrosis. A statistically significant increase in serum GDF-15 levels was noticed among patients with advanced fibrosis “subgroup ІІІ” compared to those with mild fibrosis “subgroup І” (p &lt; 0.05). The diagnostic sensitivity and specificity of GDF-15 were 96.7%, 98.2%, respectively at a cutoff value of 150 ng/L for discrimination between patients’ and controls’ groups.

Conclusion
Growth differentiation factor 15 could be a potential marker of liver fibrosis especially in early detection as its levels were significantly higher in patients’ group with liver fibrosis than controls’ group and there was a significant positive correlation between the degree of liver fibrosis and GDF-15 serum levels.
Expression of BECN1 gene in Acute Myeloid Leukemia: Association with Hematological and Clinical Parameters
Authors: Ahmed Mohamed Moustafa , Ghozlan Manal Fawzy , Mohamed Walaa Ali , Safwat Nesma Ahmed , Hassan Noha Bassiouny 
Published: October 2021

Abstract

Background
In acute myeloid leukemia (AML), there is copy number loss in autophagic genes such as BECN1. Accordingly, decreased autophagy and the development of AML are related. BECN1 is a critical mediator that influences the onset and progress of autophagy.

Objective
To investigate the expression status of BECN1 gene in newly diagnosed adult AML patients and its association with various hematological parameters and clinical outcomes.

Methods
Case control study to study BECN1 gene expression variability between 50 newly diagnosed adult AML patients and 20 healthy age and sex matched controls, with follow up of the patients to detect its effect on induction therapy. All AML patients underwent full history taking, through clinical examination, laboratory investigations such as complete blood count (CBC) with examination of peripheral blood and bone marrow Leishman stained films, immunophenotyping, cytogenetic analysis (karyotyping/FISH analysis) and BECN1 gene expression analysis using real-time quantitative polymerase chain reaction (qRT-PCR).

Results
In our study, a highly significant difference was found as regards reduced expression of BECN1 gene in patients group compared to control group. We also found reduced BECN1 gene expression in both intermediate and adverse risk groups compared to favorable risk group. Reduced expression of BECN1 gene was associated with increasing age and total leukocytic count (TLC), peripheral blood (PB) and bone marrow (BM) blasts, the presence of FLT3-ITD mutation, CD34 and CD117 and in non-responders group. No statistically significant difference was found as regards haemoglobin (Hb) level, platelet (PLT) count and FAB subtypes.

Conclusion
Autophagy plays an important role in the pathogenesis of AML. Furthermore; the reductive regulation of the BECN1 gene may carry a poor prognosis and is associated with many well established bad prognostic factors especially FLT3-ITD mutation. Targeting autophagy pathways especially its major regulator (BECN1 gene) may become an effective and promising new line of therapy for AML patients.
Study of Platelet Rich Plasma Injection versus Plasma Gel in Periorbital Rejuvenation
Authors: El-Sayed Diab Heba Mahmoud , Elhusseiny Rania Mahmoud , Elsayed Bedair Nermeen Ibrahim , Abdel-Aziz Rostom Khorshed Ahmed Hamid 
Published: October 2021

Abstract

Background
Aging of the skin consists of a combination of genetically predisposed factors (intrinsic aging) and environmental factors (photo aging). The resulting clinical manifestations include mottled pigmentation, wrinkles, and change of the superficial texture leading to coarseness of the skin Dermal components such as collagen and elastic fibers gradually decrease, skin loses its elasticity and shows wrinkles. Loss of skin moisture and subcutaneous fat accelerates the process.

Objective
To evaluate the efficacy, possible side effects, durability and study of platelet rich plasma injection versus Plasma gel injection in periorbital rejuvenation.

Methods
This comparative split face study included 40 females with periorbital wrinkles and/or dark circles recruited from the Dermatology outpatient clinic of Ain-Shams University Hospitals.Right periorbital wrinkles was injected by platelet rich plasma while left periorbital side was injected by plasma gel.

Results
Treatment with plasma gel resulted in significant improvement of periorbital wrinkles with minimal complications compared to platelet rich plasma. While, dark haloes and skin texture were minimally affected whether with plasma gel or PRP injection.

Conclusion
Plasma gel as well as platelet rich plasma injections may play role in treatment of periorbital wrinkles but mostly for short durations. Plasma gel injection is more effective in periorbital rejuvenation than PRP injection although it has relatively higher complications rate. Both plasma gel and PRP injections has only minimal role in treatment of periorbital dark hallows.
A comparative Study Between Needling and Homologous Autoimplantation Techniques in Treatment of Multiple Plantar Warts
Authors: Abdel Fattah Nermeen Samy , Elhusseiny Rania Mahmoud , Darahem Aml Magdy 
Published: October 2021

Abstract

Background
Warts are a common dermatologic complaint resulting from infection with HPV which spread by direct skin-to-skin contact or by autoinoculation. The clinical appearance of warts is variable depends on the type of HPV involved and the site of infection. There are various types of viral warts including common warts, plantar warts, plane warts and genital warts, usually diagnosis of warts is made through clinical examination of the lesions and no laboratory investigations are required.

Objective
To compare between the therapeutic efficacy and safety of needling versus homologous autoimplantation techniques in treatment of multiple plantar warts and assess their recurrence rate.

Patients and Methods
Our study included 40 patients with multiple de novo planter warts(3 -10 warts) of (&gt;1 and &lt;3 years duration) divided into 2 groups, 20 patients per group, one group subjected to autoimplantation of wart tissue and the other subjected to needling procedure. Follow up of studied patients was assessed by physician after 2,8 and 12 weeks of procedure through clinical and dermoscopic examination to assess treatment response and after 16 weeks to assess recurrence

Results
Results of our study reported that there was high statistically significant difference between the 2 studied groups as regard response to treatment after 12 weeks being higher among autoimplantation group (p = 0.001). Moreover, there were no significant relations between treatment response of both patient groups and each of gender, age of patients, number of warts and duration of lesions.

Conclusion
Autoimplantation technique is more effective and less painful than needling procedure in treatment of multiple plantar warts (both manipulated and remote warts). No significant relations were found between treatment response of either techniques and demographic or clinical characteristics of studied patients.
Effectiveness of Photodynamic Therapy for Management of Primary Palmar Hyperhidrosis
Authors: Shaheen Maha Adel , Soltan Marwa Yassin , Shabaik Aya Hassan Ahmed 
Published: October 2021

Abstract

Background
Hyperhidorsis is a condition in which sweat production exceeds that which is needed for thermoregulation, and can affect the hands, feet, axiall, face, back, grain, and legs. It is adisabling condition that affect, both children and adults, with in audience rate of 1-3% and onset usually during childhood or adokscne. Although not a dangerous condition, hyperhidrosis can cause social and occupational impairment and emotional distress and facilitate the development of secondary morbidity.

Objectives
So our aim to study the efficacy and safety of photodynamic therapy in management of primary palmar hyperhidrosis using two photosensitizers [MB2% and eosin].

Patients and Methods
Twenty patients with primary palmar hyperhidrosis were recruited from the outpatient clinic of the Dermatology and Venereology department, Faculty of Medicine – Ain Shams University during the period from 2017 to 2018. The protocol was approved by Faculty of Medicine, Ain Shams University ethical committee (FWA000017585). An informed written consent was obtained from all patients prior to enrolment in the study. It is a right-left controlled study which included 20 patients with primary palmar hyperhidrosis.

Results
Our study showed that the PDT had positive treatment outcome in palmar hyperhidrosis with sustainable efficacy for at least twelve weeks after treatment stoppage.

Conclusion
Photodynamic therapy is an effective, safe and cheap method for management of primary palmar hyperhidrosis. Both eosin and methylene blue 2% can be used effectively as photosensitizers for photodynamic therapy with good results for treatment of primary palmar hyperhidrosis with minimal tolerable side effects.
Prevalence of Metabolic Syndrome in Men with Erectile Dysfunction
Authors: Abd-Elnaeem Sallam Mohamed , Salah Eldin Zaki Marwa , Gamal Elsalibi Mohamed 
Published: October 2021

Abstract

Background
Erectile dysfunction, as defined by the International Consultation on Sexual Medicine, is the consistent and recurrent inability to acquire or sustain an erection of sufficient rigidity and duration to engage in satisfactory sexual intercourse.

Objectives
The aim of this study was to identify the prevalence of MetS among patients with ED.

Patients and Methods
This was a cross sectional study conducted on 200 patients attending the Andrology clinic of Dermatology, Venereology and Andrology department, Ain-Shams University starting from March 2019 till December 2019. The 15-question IIEF Questionnaire is a validated, multi- dimensional, self-administered investigation that has been found useful in the clinical assessment of ED and treatment outcomes in clinical trials.

Results
The mean ± SD of age of patients with ED in our study was 58.3 ± 20.1 years. Out of the 200 patients, 110(55%) of them had BMI (25-29.9). and over 30 in 35(17.5%) patients. The mean ± SD of WC was 41.4±4.9 inches. Among the 200 patients, hypertension was present in 125(62.5%) and smoking in 165 (82.5%) patients. Among the 200 patients, 96 (48%) patients had MetS. Among 200 patients, 90 (45 %) had mild, 54 (27.0 %) had moderate. and 56 (28 %) had severe ED. A significant association was determined between the presence of MetS and severity of ED. The prevalence of moderate and severe ED was significantly higher in patients with MetS than patients without MetS. There was a negative significant correlation between IIEF scores and age, systolic BP, and diastolic BP.

Conclusion
Among the 200 patients, 96 (48%) patients had MetS. Incidence of moderate to severe ED was higher among patients with MetS versus those without. There was a negative significant correlation between IIEF scores and age, systolic BP, and diastolic BP.