bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Mesothelioma At Imbaba Chest Hospital From 2013 To 2016
Authors: Ahmed El Naggar Taher Abd Elhameed , Saeed El Maraghy Ashraf Abbas , Abd El Dayem Elwazier Mohamed Mohamed 
Published: October 2021

Abstract

Background
Malignant pleural mesothelioma (MPM) is a rare but aggressive and often fatal malignancy. Most patients present with advanced disease, and the median overall survival is approximately one year.

Objective
To review the cases of malignant mesothelioma admitted to Imbaba Chest Hospital in the period between 2013 and 2016.

Subjects and Methods
The current study spotted the light over the malignant mesothelioma from epidemiological view, as a retrospective cohort study, conducted on all cases of malignant mesothelioma that were diagnosed at Embaba Chest Hospital in the period between 2013 until 2016 to explore the incidence of that disease and its characteristic features. The medical records of patients had been revised for the demographic criteria of patients, which included; age, sex, smoking status, residence and occupation, clinical presentation of cases, radiological findings, cytological examination of pleural fluid, pleural biopsy either thoracoscopic or open, and finally, histopathological diagnosis.

Results
The prevalence of mesothelioma across years of the study was 1.5% (60 out of 4000cases) with increasing annual incidence; 1.7, 2 and 2.3% respectively. The mean age of mesothelioma patients was 57.96 years, most of them above 40 years (91.67%) and more than half of them were males (55%). In spite of decreasing percentage of male with mesothelioma within the study time (2014-2016), which was accompanied with increasing the percentage of female patients, it did not reach statistical significance.

Conclusion
The overall incidence of malignant mesothelioma was 1.5% with increasing annual incidence from 1.7% up to 2.3%. The male gender was the more presentable one with gradual growing of female percent. The urban area was more affected than the rural one, specially the area near industries. Non-exposed persons (unemployed industrial workers) showed higher frequency of MM. Right-sided MM was more common than Left one, beside that the epithelial form of MM was the dominant histological pattern.
Outcomes of Peripheral Blood Eosinophilia in Hospitalized Exacerbations of COPD
Authors: Sharkawy Samar El , Raafat Riham Hazem , Qassem Reem Osama Mohamed Ahmed 
Published: October 2021

Abstract

Background
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines define COPD as a disease state characterized by airflow limitation that is not fully reversible, is usually progressive, and is associated with an abnormal inflammatory response of the lungs to inhaled noxious particles or gases.

Objective
To identify outcomes of patients with eosinophilic COPD exacerbations requiring hospital admission.

Patients and Methods
This study is a prospective cohort study that was conducted on two groups of total 60 patients recruited from Ain Shams University hospitals between October 2019 and July 2020. Group 1: Eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is ≥ 200 cells/µL and/or ≥2% of the total leukocyte count Group 2: Non-eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is &lt; 200 cells/µL and/or &lt; 2% of the total leukocyte count.

Results
There was significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, percent (%) and NLR cutoff points had high characteristics (highest in NLR ≥3.1 at discharge) in predicting readmission at 6-month among eosinophilic group. Diagnostic performance of Eosinophils count, percent (%) and NLR were assessed. Eosinophils count, percent (%) and NLR had significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, % and NLR cutoff points had high characteristics (highest in NLR ≥2.1 at discharge) in predicting readmission at 6month among non-eosinophilic group.

Conclusion
Eosinophils can be used as a prognostic marker in non-infective COPD exacerbations. Validity of eosinophil count and percent as a prognostic parameter in COPD exacerbation can be increased by combining with other parameters for example NLR.
The Potential Role of The Long non-coding RNA MEG3 in Bronchial Asthma in children
Authors: Rezk Basma Tarek , Motaleb Fayda Ibrahim Abdel , Kamel Terez Boshra , Nabih Enas Samir , El-Khalek Marwa Ali Abd 
Published: October 2021

Abstract

Aim and Background
Asthma is an inflammatory disease affecting the airways of the lungs being characterized by reversible airflow obstruction and bronchospasm. Environmental and genetic factors play a role in the pathogenesis of the disease; these factors are controlled by epigenetic mechanisms. There is a demand of clinical biomarkers for diagnosis of asthma and monitoring the response to therapy. In this study, we aimed to evaluate the role of lnc-MEG3 expression and its downstream effector in the pathogenesis of bronchial asthma disease.

Methods
Based on bioinformatics analysis using online databases, the current work has been designed to study the expression status of lnc-MEG3 and GDF15 mRNA in serum and sputum of asthmatic children aiming to find its clinical significance. This study was conducted on 30 children, 15 children newly diagnosed with bronchial asthma as patient group (A) and 15 age and sex matched healthy children as control group (B). Quantitative PCR was carried out to evaluate the expression pattern of selected biomarkers in serum and sputum of asthmatic children.

Results
The expression of circulating lnc-MEG3 was highly significantly up-regulated in asthmatic children than in control group (p ≤ 0.01), while the expression of circulating GDF15 mRNA was highly significantly down-regulated in asthmatic children than in control group (p ≤ 0.01). The findings showed a negative significant correlation between both investigated biomarkers.

Conclusion
This study supports the role of lnc-MEG3 and GDF15 protein as potential biomarkers in diagnosis of bronchial asthma in children.
Sternotomy versus Mini-Sternotomy in Pediatric Patients undergoing Modified Blalock-Taussig Shunt
Authors: Azab Sherif , El Midany Ashraf A , Doghish Ayman A , Salah El-din Abugabal Abdelfatah E 
Published: October 2021

Abstract

Background
In the present era, primary correction is the preferred approach to the neonate or young infant with a cardiac anomaly who has two ventricles. However, when only one functional ventricle is present or pulmonary blood flow is reduced, an initial palliative systemic-to-pulmonary arterial shunt is mandatory. In this study we compare post-operative short term outcomes of sternotomy versus mini-sternotomy approaches in pediatric patients undergoing Modified Blalock Taussig Shunt.

Patients and Methods
A prospective randomized study was conducted on 90 patients who were schedueled for MBT shunt due to a group of cyanotic heart disease. They comprised 2 groups G1: sternotomy group (n = 45) and G2: ministernotomy group (n = 45).

Results
Mean age was 11± 3.39 months and mean weight was 6.75±1.96 kg in the sternotomy group, while for ministernotomy group the mean age was 10.55± 4.65 and mean weight was 7.00±2.03 kg. The change (%) between preoperative and postoperative oxygen saturation was 35.6% for sternotomy group and 43.8% for ministernotomy group. There were seven cases of mortality (15.6%) in sternotomy grouped compared to three cases of mortality (6.7%) in ministernotomy with P value of 0.314. Superficial wound infection occurred in one case (2.2%) in each group. Mean duration of ventilation was 52.53 ± 15.76 h for sternotomy group and 46.93±19.23 h for ministernotomy group with P value of 0.025, mean ICU stay was 7.42 ± 2.94 days for sternotomy group and 5.13± 2.37 days for ministernotomy with P value of &lt; 0.001.

Conclusion
Upper ministernotomy is a safe alternative approach for MBT shunt in pediatric patients. It provides the advantages of less ventilation time, less post operative bleeding, and ICU stay.
Deep Wound Infection in Pediatrics after Open Cardiac Surgery
Authors: Shoeb Mohammed Ayman Abd-Elhakeem , El-Midany Ashraf Abd-Elhameed , Ibrahiem Waleed Ismail Kamel , Atiea Waleed Abd-Allah Abd-Elrazzak 
Published: October 2021

Abstract
Surgical site infection (SSI) is a serious complication requiring prolonged hospitalization, intravenous antibiotics, wound care and dressings resulting in increased cost and resistant bacteria. In pediatric cardiac surgery, Median sternotomy is the most frequently used incision for the correction of congenital anomalies. Sternal wound infections (SWIs) are well described complications of cardiac surgery and can occur in 3% to 8% of children. Furthermore, the mortality rate can increase 2-fold after SSIs. Also, SSIs are associated with an increased length of hospital stay, readmissions, and higher health care expenditures.
Mediastinitis is a retrosternal wound infection frequently associated with a macroscopically sternal osteomyelitis. Mediastinitis is uncomfortable for patients, is poorly accepted by parents, leads to a prolonged hospital stay repeated surgery and prolonged antibiotic therapy. Mediastinitis are costly for patients, providers, and health-care institutions. In A recent survey among congenital heart programs, the incidence of mediastinitis has been reported to occur in 0.2–1.4%. Gram-positive cocci are the most common pathogen. Gram negative organisms are increasingly recognized, especially in neonates, and are related to delayed sternal closure. Fungal organisms are not infrequently found.
Mediastinitis generally presents 2–3 weeks after cardiac surgery. Child often appear irritable, tired, and febrile. The incision is erythematous and painful. Wound separation and purulent drainage from the incision are frequent. Some but not all will also have sternal instability or dehiscence. Associated bacteremia is not uncommon, present in up to 40% of patients.
Postoperative mediastinitis is a life-threatening infection and increase health expenditure. Young age, malnutrition, hypothermia, hyperglycemia, longer duration of surgery, long time of delayed sternal closure, postoperative low cardiac output and long ICU stay were a risk factor of mediastinitis. Stick to1999 CDC's Guideline for prevention of surgical site infection and their update in 2017 especially proper timing of antibiotic prophylaxis and post-operative blood glucose management is important in prevention of these life-threatening complication. procalcitonin can be useful biologic marker of infection. Management of mediastinitis consist of debridement and culture-based antibiotics. Primary closure over mediastinal drain or high vacuum drain gave good result, less time consuming, more economic and more cosmetic. Vacuum assisted closure gave excellent result, but more time consuming, less economic and delayed closure is necessary. Larger studies are needed to compare both techniques in effectiveness and coast benefit.
Estimation of Radiation Exposure in the Pediatric Cath Lab in Ain Shams University; Cross-Sectional Observational Study
Authors: Abdelrazik Ahmed , Amin Youssef , Roushdy Alaa , El Sayed Maiy 
Published: October 2021

Abstract

Aim and objectives
The aim of the study is to assess the average radiation doses recorded per procedure in Ain Shams University Hospital pediatric cath lab to set benchmarks of radiation exposure in our institute.

Patients and Methods
The study included 198 patients who presented to Ain Shams cardiac pediatric cath lab who undergone interventional (BPV, BAV, ASD device closure, VSD device closure, PDA coil/device closure, Coarctation Stent/balloon) and diagnostic (Hemodynamics study, Diagnostic cath) heart catheterization. Radiation doses were measured without any interference with the operator’s preferences.

Results
Radiation dosages were measured in total AirKerma, Dose area product (DAP), and fluoroscopy time to set the benchmarks for radiation exposure in our institute per procedure. VSD device closure showed the highest radiation exposure followed by Coarctation stenting.
Lowest radiation dosage was in PDA coil closure followed by ASD device closure then BPV.

Conclusion
Benchmarks for radiation exposure per procedure in pediatric cath lab in our institute were set and compared to each other.
Echocardiographic Evaluation of Changes in Cardiac Hemodynamics, Loading Conditions, and Atrial Function after Transcatheter Closure of Atrial Septal Defect
Authors: Shoeir Mohamed Abdelfattah , Elshahed Ghada , Esmail Yasmin Abdelrazek , Ezz Eldin Dina Adel 
Published: October 2021

Abstract

Background
The changes in loading conditions, atrial function, and the different echocardiographic parameters before and after transcatheter atrial septal defect (ASD) closure are still under study. So we felt the need to evaluate the echocardiographic changes that occur and detect the timing after closure at which the right-sided heart hemodynamics, and measurements are back to normal.

Objectives
To evaluate the changes in cardiac hemodynamics, loading conditions, and atrial function after percutaneous closure of ASD using echocardiography.

Patients and Methods
The study included 30 patients referred to percutaneous closure of ASD in Ain Shams University hospital we performed echocardiography before, 1 week, and 3 months after closure.

Results
The study showed that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure (p &lt; 0.001). LA dimensions and volumes increased significantly 1 week, and 3 months after ASD closure (P &lt; 0.001). LA peak systolic strain showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.063), and strain rate showed no significant difference before, 1week, and 3 months after ASD closure (P = 0.207).

Conclusion
In our study, we have concluded that RV dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA dimensions and volumes decreased significantly 1 week, and 3 months after ASD closure. RA peak systolic strain, and strain rate increased significantly 1 week, and 3 months after ASD closure, as a result of improvement of the RA wall velocity, due to relief of the volume overload after closure of the shunt. LA peak systolic strain, and strain rate showed no significant difference before, 1week, and 3 months after ASD closure.

Abbreviations list
ASD (atrial septal defect), RV (right ventricle), RA (right atrium), LA (left atrium).
Epicardial Fat Volume Assessed by Multi-Detector Computed Tomography and it’s Relation with the Severity of Coronary Artery Disease
Authors: Ali Mohamed Mohamed , Onsy Ahmed Mohamed , Abdelmonaem Mostafa Mohamed , Khashaba Ahmed Ahmed 
Published: October 2021

Abstract

Background
Recent studies have suggested that fat disposition in epicardial tissue may be a predictor of the severity of coronary artery disease (CAD). Epicardial adipose tissue (EAT) is defined as the adipose tissue located between the outer wall of the myocardium and the visceral layer of pericardium, surrounding the heart and the coronary vessels. EAT is closely related to the adventitia of the coronary arteries without a barrier that may directly influence the development and progression of atherosclerosis and CAD through pro-inflammatory mediators.

Objective
The aim of the work is to investigate the relation between epicardial fat volume (EFV) [assessed by multidetector computed tomography (MDCT)] and severity of CAD.

Methods
This cross sectional study was conducted on 40 patients referred for MDCT coronary angiography to assess their complaint. EFV was quantified during non-contrast phase and severity of CAD was assessed by segment involvement score (SIS) and segment stenosis score (SSS) during contrast phase at Nasr City Police Hospital in the period between August 2018 and April 2019.

Results
The 40 consecutive subjects consisted of 30 males (75%) and 10 females (25%) with mean age 56 ±10.27 years. Risk factors of atherosclerosis were analyzed among the studied population as followed; the BMI ranged between 24 and 30.9 kg/m2, hypertensive patients were 77.5%, diabetic patients were 55% and smokers were 67.5%. The laboratory finding of the studied group revealed that the serum LDL.C ranged between 70 and 218 mg/dl (Mean±SD =163.88±43.37, Median= 183.5). The serum HDL.C ranged between 30 and 62 mg/dl (Mean±SD = 41.45±9.87, Median= 37). The serum total cholesterol ranged between 136 and 280 mg/dl (Mean±SD = 214.35± 35.51, Median= 224). The serum triglycerides ranged between 110 and 215 mg/dl (Mean±SD = 164.13±27.38, Median= 173).The serum creatinine ranged between 0.8 and 1.8 mg/dl (Mean±SD = 1.12±0.19, Median= 1.1). 17.5% of the studied patients had normal coronaries while 37.5% had single vessel disease and 45% had multi-vessel disease. There was a significant relationship between EFV and CAC score (p = 0.011, r = 0.397), a highly significant relationship between EFV and SSS score (p = 0.001, r = 0.518) and significant relationship between EFV & SIS score (P = 0.003, r = 0.459). Patients with normal coronary arteries were noted to have a lower EFV value than those with coronary lesions (highly significant relationship, p = 0.004) either single vessel disease or multi-vessel disease. There is no significant difference between the effects of EFV on number of diseased coronaries either single vessel disease or multi-vessel disease.

Conclusion
EFV increased in patients with both significant coronary artery stenosis or coronary calcification. EFV is considered an independent risk factor for CAD.
The Relationship between Bariatric surgery-induced Weight Loss and Heart Rate Variability
Authors: Mikawy Mohamed G , Ramadan Ahmed Y , Badran Haitham A , Nabih Mervat A 
Published: October 2021

Abstract

Background
Obesity is associated with an increased risk of sudden death that may be due to abnormal cardiac vagal modulation reflected by reduced Heart rate variability (HRV). Weight loss after diet or gastroplasty in morbidly obese patients has been shown to reverse the deleterious impacts of obesity on cardiac autonomic nervous system modulation, with subjects showing enhanced HRV after reduction in body mass index (BMI), through increased cardiac vagal modulation

Objective
The aim of this study is to assess weight loss effect after bariatric surgery on Heart rate variability (HRV) by 24-hour Holter monitoring.

Methods
This is an observational cross section study was done on thirty morbidly obese patients (twenty female and ten males) undergoing bariatric surgery (Roux-en-Y gastric bypass) were enrolled in the study from Ain Shams University Hospitals within the period 1/7/2019 till 1/3/2020.

Results
Our study results proved that weight loss after bariatric surgery (Roux-en-Y gastric bypass) improves the heart rate variability and hence cardiac autonomic modulation. This is of importance because higher heart rate is associated with increased mortality, and decreased the heart rate variability is associated with increased cardiac mortality independent of ejection fraction. Weight loss after bariatric surgery (Roux-en-Y gastric bypass) achieved better glycemic control of the diabetic patients. Even more, a complete resolution of diabetes occurred in a large number of the diabetic patients (50% of total diabetic patients).

Conclusion
The Significant weight loss after bariatric surgery (Roux-en-Y gastric bypass) improves the heart rate variability and hence cardiac autonomic modulation.
CHA2 DS2 -VASc score as a predictor for contrast-induced nephropathy in patients with acute coronary syndrome undergoing percutaneous coronary intervention
Authors: Hamdy Montaser , Shehata Hassan , Abuarab Tamer 
Published: October 2021

Abstract

Background
Contrast induced nephropathy (CIN) is one of the most important complications of PCI. It is a common cause of acute renal failure following invasive procedures, resulting in increased medical resources, longer hospital stay, and higher mortality so it is important to detect early high risk patients for CIN and provide them with preventive measures. In recent years, several studies have demonstrated an association of CHA2DS2-VASc score with cardiovascular prognosis and adverse outcomes in different populations including heart failure, SCAD and ACS beyond the original AF field. The predictive value of the CHA2DS2-VASc score on CIN still remains unclear although all of the components of the CHA2DS2-VASc score are important risk factors for CIN. For this reason, the present study was designed to evaluate the predictive value of preprocedural CHA2DS2-VASc score on the development of CIN in patients with ACS who underwent PCI.

Objective
To assess the predictive value of the CHA2DS2-VASc Score for contrast induced nephropathy among acute coronary syndrome patients who underwent percutaneous coronary intervention.

Material and Methods
This study is a prospective study conducted over 300 patients with myocardial infarction who presented at ain shams university hospitals for primary coronary intervention. It took place from February 2019 till September 2019.

Results
From the study population collected (n = 300), 25.7% of which were females (n = 77), statistically significant relation was found between CIN and CHA2DS2-VASc score. (P value 0.000). A significant relationship existed between CIN and CHA2DS2-VASc score more than 3, and each of: age, female gender, DM, HTN, door to needle time, ACS type (NSTEMI) and killip class above one. (P values 0.000), Patients with previous intervention using contrast (P value = 0.001), anemia (P value 0.014) (p value = 0.000) and contrast volume (p value = 0.002) and number of coronary vessels affected (p value = 0.031). However, non-significant relationship could be concluded between CIN and each of Stroke, TIA and previous thromboembolism (P value = 0.446), ejection fraction (P value = 0.155), Time of procedure (p value = 0.131), culprit vessel (p value = 0.317), type of STEMI (p value = 0.140), Revascularization of culprit vessel (p value = 0.143), TIMI grade (p value = 0.278) and antiplatelet type. (P value 0.934)

Conclusion
CHA2DS2-VASc score is a simple risk score for bedside, preprocedure CIN risk stratification among ACS patients who underwent primary PCI.