bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study Between Caudal Block And Local Wound Infiltration In Inguinal Hernia Repair In Pediatric Patients
Authors: Mageed Azza Mohamed Shafeek Abdel , Hussaein Wael Reda , Hafiez Rania Hassan Abdel , Hammouda Tarek Atef Abdullah 
Published: October 2021

Abstract

Background
Postoperative analgesia can be provided by a multimodal approach includes opioids, nonsteroidal anti-inflammatory drugs, paracetamol infusion and regional anesthetic techniques such as local infiltration or nerve blocks. In contrast to opioids, local anesthetics can be administered safely and in recent guidelines regional anesthesia is accepted as the cornerstone of postoperative pain relief in the pediatric patients.

Objective
Compare the postoperative analgesic effectiveness of local wound infiltration of bupivacaine against bupivacaine administered caudally in pediatric patients undergoing unilateral inguinal hernia repair.

Patients and methods
This study was carried out in Ain Shams University hospitals on 40 pediatric patients of both sexes aged from 6 months to 7 years belonging to ASA I or II undergoing elective unilateral inguinal hernia repair. They were randomly allocated into two groups: group C receiving caudal block, group L receiving local wound infiltration. Hemodynamic changes, postoperative pain score using FLACC pain score, postoperative analgesia and complications were recorded.

Results
There was no significant difference between the two groups as regard demographic data or hemodynamic variables. Pain score shows no statically significant differences between two groups in the first hour. But statistically significant decrease in FLACC score after (1, 2 and 3 hours) in group C in comparison with group L.decreased significantly in group C after 1 hour postoperative. Duration of analgesia longer in group C with no significant difference in total amount of postoperative analgesia. There was significant increase in incidence in complications in group C than group L

Conclusion
Caudal block provides better and longer analgesia but requires experience and may lead to complications. In contrast, wound infiltration is simple without significant side effects. Therefore, local wound infiltration may be a preferred technique for producing postoperative analgesia in pediatric inguinal hernia repair.
Assessment of aerosolized Colistin and Gentamicin in mechanically ventilated patient
Authors: Dayem Aya Mohamed Mohamed Abdel , Eldin Haitham Salah , Elhamy Karim Mohamed 
Published: October 2021

Abstract

Background and Objectives
ineffective parental antibiotic use in treatment of Ventilator associated pneumonia (VAP) open the window for using inhaled antibiotic formula to achieve higher local concentration of antibiotics and subsequently good recovery response, the aim of that work was evaluation of aerosolized antibiotics (Colistin and Gentamicin) efficacy in improving the mechanically ventilated patient as adjunctive to intravenous systemic antibiotics

Methods
30 mechanically ventilated patients classified equally in to 3 groups;

Group I
10 patients received aerosolized Colistin along with systematic antibiotics (SA). Group II: 10 patients received aerosolized Gentamicin along with systematic antibiotics (SA) and Group III (Control): 10 patients received only systematic antibiotics (SA). All patients were followed up for clinical response by bacteriological culture (after 5 days of aerosolized antibiotics), development of VAP, days of mechanical ventilation, length of stay in the ICU, and mortality.

Results
The incidence of VAP was 10%; in group I no cases had VAP, while in group II and control group, just (20%) and (10%) of cases had VAP respectively, with insignificant association of VAP with particular group, (P = 0.3). Clinically; only group I showed significant lower degree of temperature in comparison with control group, (P = 0.01). The mean days of MV and ICU in each groups were (6.8±2.15; 8.9±3.11, 5.9±2.23; 7.2±2.7, 5.1±1.1; 6.1±1.85) respectively, with insignificant statistical difference between the treatment groups, (P = 0.2 and 0.07) respectively. Finally, the survival rate in group I was 90%, and was slightly lower in group II and control group; 60% and 50% respectively, with insignificant association of survival status in particular group, (P = 0.1)

Conclusion
the empirical treatment by AA (Colistin) was effective as an adjuvant to systemic antibiotics for protection of VAP than aerosolized Gentamicin, it had rapid resolution of respiratory infection signs, and subsequently the mechanical ventilation days, ICU stay days, and probably the cost of ICU admission, but did not affect mortality.
Study of the antineoplastic effect of modulating apoptosis-related noncoding RNA in human hepatocellular carcinoma cell line (HepG2)
Authors: Sherif Mai Abdel Azeem , Ismail Emtiaz Abd-elkawy , Kassim Samar Kamal , Shehata Hanan Hussein , Abdel Khalek Marwa Ali , Abdel Hamid Marwa Mahmoud 
Published: October 2021

Abstract
MiR-421 is considered an important molecule that can prevent tumor growth. Bioinformatics analysis indicated that mRNA caspase-3 gene is a target gene of miR-421. The current study aimed to explore the functional role of miR-421 in hepatocellular carcinoma (HCC) and explore the interaction between miR-421 and caspase-3. To validate bioinformatics data, RT-qPCR was used to detect the expression of miR-421 and caspase-3 in 10 HCC tissues. The results showed miR-421 expression was significantly higher in HCC than non HCC liver tissues (P&lt;0.01), nevertheless caspase-3 gene expression was markedly lower in HCC than non HCC liver tissues (P&lt;0.01). Besides, miR-421 expression was negatively associated with caspase-3 expression. MiR-421 mimic and inhibitor was transfected into HCC cell lines (HepG2). Proliferation assay, showed that low-expression of miR-421 inhibited the proliferation of HCC cells. RT-qPCR was worked for detection the expression levels of miR-421 and caspase-3 in HepG2 cells before and after transfection. The results showed that miR-421 expression in HepG2 cells was significantly lower in miR-421 inhibitor transfected group than in mimic- transfected and control groups (Mock) (P≤ 0.05), and caspase-3 gene expression in HCC tissues was markedly higher in inhibitor transfected group than those transfected by mimic and control group (Mock) (P≤0.05). Thus, miR-421 inhibitor may inhibit the proliferation of HCC cells via over- expression of caspase-3.
Early Outcomes of Closed Versus Open Left Anterior Descending Artery Endarterectomy In Patients Undergoing Coronary Artery Bypass Grafting
Authors: Almaboud Hani Abd , Ali Ihab , Adel Mohamed , Samy Ahmed , Awed Ahmed 
Published: October 2021

Abstract
Coronary endarterectomy is an old surgical procedure against coronary artery disease which was first described by Baily et al. in 1957. In spite of the first adverse effects, several recent publications have demonstrated that coronary endarterectomy (CE) with coronary artery bypass grafting (CABG) can be done safely with appropriate mortality and morbidity. The main objective of CABG is complete revascularization of coronary vessels and, particularly, left internal mammary artery to left anterior descending artery (LIMA-LAD) anastomosis, Since; patent LIMA-LAD is the single most significant determinant for long-term and eventfree survival. A best evidence topic in cardiac surgery was written according to a structured protocol. The problem was whether LAD artery open endarterectomy (open-CE) with CABG compares favorably with LAD artery closed endarterectomy (closed-CE) with CABG in the myocardial revascularization of patients presenting with diffuse coronary artery disease (DCAD). The purpose of this review is just to determine the safety and feasibility of CE in general and open-CE versus closed-CE particularly. The last search date was December 2019 and the search period was from 1992 till 2019. Open-CE with CABG may carry a lower early mortality rate (range from 2.9% to 8.8%) than closed-CE with CABG (range from 6.8% to 10.9%) and CE + CABG has a significantly higher risk of death than isolated CABG. Internal thoracic artery (ITA) use may enhance mortality, while the saphenous vein (SV) conduit or two CE vessels may worsen the clinical outcome. The main complication of CE can be found in post-operative atrial fibrillation (AF), in our review; the rate ranged from 9% to 29%. Another devastating complication is postoperative myocardial infarction (MI) with a range of 0% to 13.9%.
Intermediate and Long-Term Outcome of Percutaneous Trans-catheter Device Closure of Ventricular Septal Defects
Authors: El Sayed Maiy Hamdy , Attia Hebatallah Mohammed , Mousa Tarek Khairy , El Alfy Ahmed Amr 
Published: October 2021

Abstract

Background
Ventricular septal defect (VSD) is the most common congenital heart defect in children and adults. Until recently, open-heart surgical closure has traditionally been considered the mainstay of intervention for the majority of VSDs. The development of a trans-catheter occlusion technique with the advancement of the newer percutaneous occluding VSD closure devices that can safely and effectively close these defects was welcomed by cardiologists, patients, and their families making trans-catheter device closure an attractive and feasible alternative.

Objective
We aim to evaluate the intermediate and long-term follow-up outcome of patients who underwent percutaneous trans-catheter closure of isolated ventricular septal defects.

Patients and Methods
This study is an exploratory pilot single-tertiary center study. The study included 25 patients who have successfully undergone percutaneous ventricular septal closure in the cardiac catheterization unit of the cardiology department at Ain Shams university Hospitals in the period from June 2015 till June 2018. The follow up protocol includes detailed history taking, clinical examination, and full 2D echocardiography with additional circumferential and radial strain imaging by speckle tracking technique (STE), resting and Holter electrocardiograms.

Results
A significant increase in growth parameters were noticed during 6.3 month mean follow up time, with an overall mean weight increase by 10% and an overall mean height increase by 6.2%. Sequential echocardiographic follow-up showed highly significant decrease in LV dimensions and volumes, circumferential LV strain values, pulmonary to systemic circulation (Qp:Qs) ratio, RVSP and mPAP. Significant complications occurred in (12%) of patients: symptomatic/significant Brady-arrhythmia (Complete heart block) that required permanent pacemaker implantation (4%), significant residual shunt causing hemolytic anemia requiring re-intervention (4%) and significant valvular regurgitation (Severe Tricuspid Regurgitation) (4%)

Conclusion
The development of a VSD trans-catheter occlusion technique with the advancement of the newer percutaneous occluding VSD closure devices is an attractive and feasible procedure with high success rates
Impact of Left Atrial Posterior Wall Isolation Technique on the Outcome of Ablation in Persistent Atrial Fibrillation
Authors: Elbatran Ahmed I , Elmaaty Nabih Mervat Abou- , Saba Magdi M , Samir Rania , Tawfik Mazen , Nabil Ahmed , Gallagher Mark M , Li Anthony , Sohal Manav , Bajpai Abhay 
Published: October 2021

Abstract

Background
Left atrial posterior wall (LAPW) isolation is an adjunct to pulmonary vein isolation (PVI) for persistent atrial fibrillation (AF).

Objective
To compare the effect of LAPW box isolation with LAPW point-by-point ablation and PVI in persistent AF on 12-month arrhythmia-free survival and procedure complications.

Methods
77 consecutive patients who underwent LAPW box isolation, 24 patients who underwent LAPW point-by-point ablation and 101 patients who underwent PVI for persistent AF were compared. All patients had undergone no prior ablation for AF and were followed up for one year.

Results
Mean time to atrial tachyarrhythmia recurrence was similar with LAPW box isolation (9.8 months, 95% CI = 9-10.7) and LAPW point-by-point ablation (10 months, 95% CI = 8.6-11.3), both were longer than PVI (8.2 months, 95% CI = 7.4-9.1, log-rank p = 0.003). There was no difference in peri-procedural complications (LAPW box isolation: 5/77, LAPW point-by-point ablation: 1/24, PVI: 6/101, p = 0.91). At 12 months, no difference in atrial tachyarrhythmia recurrence was observed between box isolation (23/77, 30%) and point-bypoint ablation (11/24, 46%, p = 0.15), but significantly higher recurrence occurred with PVI alone (58/101, 57%, p &lt; 0.001). Procedure time was similar with both approaches, with longer fluoroscopy with point-by-point ablation (median: 38 min, IQR: 29-47.75) vs box isolation (median: 28 min, IQR: 7.5-39.5, p = 0.2).

Conclusion
In persistent AF, there was no difference between LAPW box isolation and point-by-point ablation in terms of mean arrhythmia-free survival, 12-month recurrence or procedure complications. Arrhythmia-free survival with either technique was longer than PVI alone, with no increase in complications.
A Morphological Study of Left Atrial Appendage in Egyptian patients Using multidetector computed tomography (MDCT)
Authors: Hassan Ahmed Mohamed , Abdel Menaem Hazem Mohamed , Onsy Ahmed Mohamed , Omran Azza Alaa , Mohamed Rayan Mona Mostafa 
Published: October 2021

Abstract

Background
The most common etiology of stroke is known to be cardio- embolic type and left atrial appendage is the site of origin of thrombi in 90% of cardio embolic stroke .Most literature reports that left atrial appendage thrombi tend to be more common in females and black people1. In the past, the left atrial appendage (LAA) has been considered to be a relatively insignificant portion of cardiac anatomy. It is now recognized that it is a structure with important pathological associations as thrombus has a predilection to form within the LAA in patients with non-valvar atrial fibrillation and to a lesser extent in those with mitral valve disease (both in atrial fibrillation and in sinus rhythm).
The exact pathogenesis of thrombus formation inside left atrial appendage is still not fully elucidated, but many literature suppose that the cause is the stagnation within the long, blind-ended trabeculaed pouch2

Objective
to describe left atrial appendage morphology and identify the prevalence of its different subtypes in Egyptian patients.

Material and Methods
the study analyzed retrospectively the data of 100 consecutive Egyptian patients who underwent multidetector computed tomography (MDCT) at Ain shams university specialized hospital from August 2019 to February 2020.Axial source images, two and threedimensional data sets were evaluated for each of the patients .All images were analyzed by a qualified cardiologist using dedicated software called “Horos Workstation”, and were blinded to patient data. All images were assessed and evaluated for LAA morphology and volume and were categorized according to the classification of Wang et al. 2010.

Results
windsock morphology existed in 32% of patients followed by chicken wing in 25% of patients. Cauliflower morphology was reported in 23% of patients whereas 20% of patients had cactus morphology. There was significant gender difference in LAA morphology where female patients had more cauliflower and cactus morphology as compared to male gender (p &lt; 0.05). Left atrial appendage volume showed a statistically significant positive correlation with advanced age and significant negative correlation with Left ventricular ejection fraction.

Conclusion
Egyptian patients had predominantly windsock morphology in males and cactus morphology in females.
Differentiating the origin of outflow tract premature ventricular complexes using the QRS-right ventricular apex interval
Authors: Tawfik Ahmed Sayed , Abdelmoteleb Ayman Morttada , Zarif John Kamel , Fakhry Emad Effat 
Published: October 2021

Abstract

Background
For localization of outflow tract Premature ventricular complexes (PVCs) many ECG criteria have been proposed, however in some cases it is difficult to accurately localize the origin of PVCs using the surface ECG.

Objective
This study aims to study the relation between QRS-right ventricular apex interval and the origin of the outflow tract PVCs.

Patients and Methods
The study included 30 patients (27 female, age 37.20 ± 7.87, RVOT origin 18) referred for PVCs ablation and we measured the interval from the onset of the earliest QRS complex of premature ventricular contractions (PVCs) to the distal right ventricular apical signal, (the QRS-RVA interval) and correlated this interval with origin of outflow tract PVCs as identified by the successful ablation during the procedure.

Results
Compared to PVCs originating from RVOT, the QRS-RVA interval was significantly longer in PVCs originating from LVOT (67.33±7.56 for LVOT PVCs vs. 37.11±4.34 for RVOT PVCs, p &lt; 0.001). Receiver operating characteristic (ROC) analysis showed that a QRSRVA interval ≥47 ms has a sensitivity, specificity, positive and negative predictive values of 100%, 100%, 100%, 100% respectively, for prediction of an LVOT origin of PVCs

Conclusion
The QRS-RVA interval is a simple and accurate criterion for differentiating the origin of outflow tract arrhythmia during electrophysiology study, A QRS-RVA interval ≥47 ms suggests an LVOT origin of PVCs.
Impact of Anti-Hepatitis C Therapy on Cardiac rhythm
Authors: Awad Mohamed Medhat , Desoky Ahmed Ibrahim El , Omran Azza Ahmed , Mohamed Ghada Abdelrahman , Missiry Ahmed Mohamed El , Rayan Mona Mostafa 
Published: October 2021

Abstract

Background
The use of direct-acting antiviral (DAA) has raised some concerns about the possibilities of cardiac toxicity after US Food and Drug Administration (FDA) issued a safety announcement of serious slowing of the heart rate when Amiodarone was used with hepatitis C treatment .

Aim
The aim of the present study was to assess the impact of Anti-Hepatitis C Therapy on cardiac rhythm using 24 hours Holter monitoring.

Methods
The current study was conducted on fifty consecutive adult patients with chronic hepatitis C infection eligible for DAA therapy supplied in the outpatient clinic of Ain shams University Virology Center .Patients have received Sofosbuvir 400 mg and Daclatasvir 60 mg / day for 12 weeks. All patients underwent 24 hour Holter monitoring before and after the completion of therapy. Both recordings were compared as regards: heart rate, minimum and maximum heart rate, the presence and frequency of ectopic atrial or ventricular activity. The measurement of QRS intervals such PR, corrected QT intervals in msec.

Results
The pre and post analysis of the Holter recording was done with comparing different baseline and post therapy parameters, The pre and post therapy mean average heart rates were 79.44±10.14 bpm vs.79.96±8.77 bpm respectively (p = 0.534) which are non-significant changes. There is also non-significant change was observed in mean maximum and mean minimum heart rate 129.08±20.07 bpm 128.98±16.89 bpm (p = 0.964), 55.88±9.20 bpm 56.66±9.45 bpm (p = 0.457) respectively. And as regard corrected QT duration and PR interval duration, the mean pre-therapy PR interval was 154.00 ± 25.95 ms as compared to the mean post-medication PR interval duration 151.40 ± 23.82 ms (p = 0.124) and The mean premedication Corrected QT duration was 397.34 ± 29.38ms vs. post therapy 395.04 ± 30.23ms ( p = 0.403) Which showing a non-significant change of both intervals. And as regard the median pre-therapy and post medication PACs and PVCs numbers and the median pre-therapy and post medication attacks of tachycardia and bradycardia, they showed non-significant changes with P-value &gt; 0.05 .

Conclusions
Novel DAAs are safe to use as regards its effect on cardiac rhythm
Prevalence of paroxysmal atrial fibrillation in patients with cerebrovascular stroke of undetermined etiology
Authors: Elnwagy Mohammed , Shokery Hossam , Effat Emad , El Damnhory Hayam 
Published: October 2021

Abstract

Background
cerebrovascular stroke is major cause of morbidity and disability. Many causes may contribute to its presence, however. Some patients have none of the identified risk factors, yet face the consequences of stroke or transit ischemic attack. This type of stroke known to be stroke of undetermined source or etiology. It has a high rate of recurrence due to the persistence of the unknown etiology. Paroxysmal atrial fibrillation remains the hidden bottom of an iceberg representing a major part of the causes of ischemic cerebrovascular stroke of undetermined etiology .

Aim and Objectives: to
determine the prevalence of subclinical atrial fibrillation in patients with ischemic cerebrovascular stroke of undetermined etiology in a population in Egypt by 48h holter monitoring.

Patients and Methods
Patients diagnosed with acute cerebrovascular stroke of undetermined etiology at the neurology department of Ain Shams university hospitals underwent 48 hours holter monitoring within the first week of the insulting event.

Results
This study included 50 patients with cryptogenic stroke (CS) who underwent 48 hours holter monitoring. The patients' ages ranged between 22 and 77 years old (mean age 48.46 ± 12.74years). This study included 34 males and 16 females. Their body mass index BMI ranges from 21-35 kg/m2, with mean BMI of 24.78 ± 2.99 kg/m2. Their left atrial diameter ranges from 26-47mm, with mean diameter of 36.08 ± 5.23mm .Eight out of fifty patients newly diagnosed with subclinical atrial fibrillation with prevalence of 16%. There was statistically significant association between the atrial fibrillation (AF) and both age (p value, 009) and left atrial (LA) diameter (p value, 001) .There was an associated finding that need further investigation about the significant association between the ventricular ectopic beat VEB burden and the presence of AF or stroke.

Conclusion
The prevalence of paroxysmal atrial fibrillation among the population of ischemic stroke of undetermined etiology in a population in Egypt is close to worldwide percentage and the recent met analysis studies of 11%.
The Relationship between Elevated Pre-procedural Random Blood Glucose Level and Periprocedural Myocardial Injury in Patients Undergoing Elective Percutaneous Coronary Intervention
Authors: Elnahhas Nehal Badr , El-Menyawi Khaled , Mostafa Ahmad Elsayed , Nozahi Mostafa El 
Published: October 2021

Abstract

Background
Regardless of the diabetic status of patients with coronary artery disease, both hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. Numerous studies have concluded that hyperglycemia is common in diabetic and non-diabetic patients with STelevation myocardial infarction (STEMI) and is associated with a higher risk of death and in-hospital complications.

Aim and Objectives
The aim of this study is to assess the relationship between elevated preprocedural random blood glucose level and peri-procedural myocardial injury in patients undergoing elective percutaneous coronary intervention.

Patients and Methods
This Cohort study included 110 patients who presented with chronic coronary syndrome to the cardiology department of Ain Shams university hospitals and underwent elective PCI. They were divided into 2 equal groups, 55 as hyperglycemic group and 55 as euglycemic group. Blood glucose level was measured immediately before the procedure. Blood samples for cardiac troponin (I) were obtained before the procedure and 12 hours after the procedure.

Results
There was statistically significant difference between the two groups regarding incidence of both myocardial infarction and myocardial injury, both being higher among the hyperglycemic group (P-value: 0.022) &(P-value: 0.001) respectively. All five patients who had myocardial infarction belonged to the hyperglycemic group. 23 patients with myocardial injury belonged to the hyperglycemic group while only 7 patients with myocardial injury belonged to the euglycemic group.

Conclusion
We conclude that abnormally high pre-procedural plasma glucose levels in patients undergoing coronary angioplasty are associated with an increased incidence of peri-procedural myocardial injury and infarction in patients undergoing elective PCI.