bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Mortality Predictors among Elderly Patients Admitted to Geriatrics and Gerontology Department, Ain Shams University Hospitals
Authors: Hassan Nourhan E , Elaraby Mennatallah S. S , Abdul-Rahman Samia A , Allam Mohamed Farouk , Ebeid Somaia M 
Published: October 2021

Abstract

Background
Elderly persons are prone to frequent hospitalization for a longer period of time. It has been reported that approximately 5% of elderly die during hospital stay, whereas 20%– 30% die within one year following hospital discharge. Many factors including aging-associated diseases, chronic diseases, drug abuse, poly pharmacy, functional disability, feeding problems, prolonged length of hospital stay are associated with increasing mortality risk. In addition, symptoms and signs are significantly variable in the elderly and usually atypically represented.

Objective
To identify predictive factors associated with in-hospital mortality in elderly patients admitted to Ain Shams University Geriatric hospital wards and intermediate care unit.

Methods
A prospective cohort study of all Egyptian elderly patients (aged 60 years old or above) admitted at Geriatric Hospital (general ward and intermediate care unit), Ain Shams University Hospitals (Cairo, Egypt), over a period of 6 months (from April 2019 to September 2019). Patients were subjected to structured interview questionnaire including data pertaining socio-demographic data, past medical history, relevant physical examination, Short-form of Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and SOFA score. Association between different risk factors and mortality rate was done to identify the most significant predictive factors leading to mortality in elderly in order to implement specific geriatric interventions in the future to prevent such fatal consequences.

Results
The present study included 140 patients, of whom 73 (52.1%) were females and 67 (47.8%) were males. Nearly, 80% of the studied sample were discharged, while 20% died during hospitalization. The most common pre-morbid conditions were hypertension (58.6%), diabetes mellitus (40%), gastrointestinal tract diseases (40.7%), cerebrovascular strokes (37.8%) and ischemic heart disease (35.7%). On admission, the mean SOFA score of the discharged group was (6±2.8) while the mean score of the deceased group was (8.9± 3.6). Evaluation of the general characteristics of the discharged and deceased groups revealed that the mortality rate is significantly associated with male gender (p = 0.018), depressive disorders (p &lt; 0.001), hepatic diseases (p = 0.008), gastrointestinal tract diseases (p = 0.048), length of hospital stay (p = 0.001) and initial SOFA score on admission to acute care setting (p &lt; 0.001).

Conclusion
Predictors of mortality during hospitalization of elderly patients include; male gender, depression, hepatic diseases, GIT diseases, length of hospital stay and initial SOFA score on admission. These factors must be evaluated to identify the potential candidates for specific geriatric interventions and specific plan of care.
Relation between pre-procedural increase in urinary albumin excretion and changes in estimated glomerular filtration rate after coronary angiography in diabetic patients
Authors: El Sharkawy Magdy M , Mohammed Abd El-monem , Ramadan Ahmed Yehia , Khedr Lina Essam 
Published: October 2021

Abstract

Background
Contrast-induced nephropathy (CIN), is an acute impairment in renal function, and typically occurs within 3 days following the exposure to a contrast medium (CM). It is associated with increased hospital stay and increased morbidity and mortality, Adult patients with diabetes have a higher risk than the general population for developing contrast induced nephropathy.

Methods
The current study includes 40 patients with diabetes mellitus, scheduled for coronary angiography with estimated GFR &gt;60 ml/min .the patients were divided according to their pre-procedural urinary albumin creatinine ratio (ACR) results into 3 groups: Group 1 included patients with pre-procedure urinary albumin creatinine ratio &lt; 30mg/g, Group 2 included patients with pre- procedure albumin creatinine ratio 30- 300 mg/g and Group 3 included patients with pre-procedure albumin creatinine ratio &gt;300 mg/g . Estimated GFR (glomerular filtration rate) calculated using MDRD and serum creatinine were measured at day 2 and 3 (Day +2 +3) after coronary angiography.

Results
There was no statistically significant difference in the age and gender distribution, the use of ACEIs (angiotension converting enzyme inhibitors) or diuretics between the cases who developed and who didn’t develop CIN. The mean ACR in the group with no contrast induced nephropathy was 225.38 ± 209.53 which was statistically significantly lower when compared with the cases with contrast induced nephropathy (420.43± 348.52) (p = 0.033). The mean HbA1c in no contrast induced nephropathy group was 7.11 ± 0.64 and in contrast induced nephropathy group it was 9.09 ± 0.66 which is significantly higher (P &gt; 0.001).With univariate regression analysis, ACR, HbA1c and number of vessels affected were shown to be risk factors for occurrence of CIN after use of contrast, but with multivariate analysis, both ACR and HbA1c were shown to be risk factors for CIN.

Conclusion
An increase in albumin creatinine ratio in itself can be a risk factor for development of contrast induced nephropathy in diabetic patients.
The Effect of Hemodialysis vintage on pulmonary functions in patients with End Stage Renal Disease
Authors: Abouellail Hesham Atef , Hussien Hussien Sayed , Raafat Riham Hazem , El-Sayed Ibrahim Ahmed Ibrahim 
Published: October 2021

Abstract

Background
Chronic kidney disease (CKD) is an irreversible and progressive disorder characterized by loss of kidney function. CKD gradually progresses to end-stage renal disease (ESRD). ESRD patients eventually need renal replacement therapy via dialysis (subdivided into hemodialysis and peritoneal dialysis) or kidney transplantation in order to survive.

Aim of the Work
To see the effect of hemodialysis vintage on pulmonary function in patients with ESRD in Ain-Shams University Hospitals.

Methods
This was a prospective study at the Ain-Shams University hospitals for six month duration on patient with ESRD on regular dialysis, 100 patients were chosen for this study, divided into 2 groups each group consists of 50 patients. Incident group (on chronic hemodialysis for 1-6 months duration) and Prevalent group (on chronic hemodialysis for more than 2 years).

Results
this study reveals that there was statistically higher indices among incident compared to prevalent hemodialysis research groups before and after hemodialysis as regards improved Pulmonary Functions.

Conclusion
prevalent cases on hemodialysis sessions have been improved clinically as regards basal crepitations and lower limb edema but didn't improve significantly in comparison to incident cases as regards Pulmonary functions on the other hand incident cases have been improved as regards Pulmonary functions In a more significant manner then prevalent cases but didn't improve as regards clinical basis concerning lower limb edema and basal crepitations.
Culture and Susceptibility of Levofloxacin Resistant H.pylori
Authors: Ghaly Sameh Mohamed Fahiem , Ali Hussien Abd El-Rahman Hany , Osama Aly Aly Mohamed , Youssef Ibrahim Youssef Ahmed Medhat 
Published: October 2021

Abstract

Background
Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Prevalence of H.pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim is to investigate H.pylori resistant patients toward Levofloxacin and detect the most effective antibiotic in eradication of H.pylori.

Objective
To investigate H.pylori resistant patients toward Levofloxacin including regimens and to detect the most effective antibiotic in H.pylori eradication.

Patients and Methods
The present study aimed to investigate the Susceptibility of Levofloxacin Resistant H.pylori in patients who had been diagnosed and received any regimen including Levofloxacin and still signs and symptoms of H.pylori infection not releaved and after proper time of stoppage of PPI and antibiotics H.pylori Ag in stool still positive at the period from January 2019 to February 2020.

Results
In the present study we found a wide spectrum of resistance to rates of H. pylori, from nearly negligible rates of Rifampicin (0%), Imipenem (0%), Cefotaxime (2%), Tetracycline (6%), Doxycycline(10%), and Amoxicillin(38%). To high rates resistance to Metronidazole (100%), Erythromycin (72%), Clarithromycin (68%), Azithromycin (60%), Ciprofloxacin (52%), and Levofloxacin (48%).

Conclusion
Helicobacter pylori is the most common chronic bacterial infection in humans. Antibiotic resistance is a major issue nowadays. Prior use of macrolide antibiotics or metronidazole appears to increase the risk of H. pylori resistance. Clarithromycin resistance appears to be an "absolute" condition that can not be overcome by increasing the macrolide dose. Levofloxacin resistance seems to be increasing. Culture and susceptibility should be done before starting second line treatment.
Assessment of Doppler haemodynamic changes suggestive of portal hypertension in cirrhotic HCV patients after sustained virological response to direct antiviral agents
Authors: Ezzat Mennatullah M , Abdelhakam Sara M , Al-Balakosy Amira M , Ghalwash Ahmed A 
Published: October 2021

Abstract

Background
Egypt has the highest prevalence rate of HCV in the world. About 14.7% of the Egyptian people have HCV antibodies and 9.8% have an active infection. The death rate due to liver disease about 40,000 each year (near10% of all deaths). It is the second after the cardiac diseases.

Aim of Work
to assess Doppler haemodynamic changes suggestive of portal hypertension in cirrhotic HCV Egyptian patients after sustained virological response to direct antiviral agents, and their correlation with liver stiffness measurements by Fibroscan.

Patients and Methods
This prospective cohort study was conducted at Viral Hepatitis Unit at Ain Shams University Hospital and Al-Agouza Police Hospital during the period from May 2018 to July 2019. The study included 50 Egyptian treatment-naïve chronic hepatitis C patients with cirrhosis on Sofosbuvir, Daclatasvir for 12 weeks. Patients were subjected to history and full physical examination, radiology assessment (Abdominal Ultrasound and color Doppler), Upper GI endoscopy and Fibroscan before treatment and 6 months after treatment. Followed up with CBC, AST, ALT, Total bilirubin, Albumin, creatinine and Coagulation profile before and after 12 weeks of treatment And HCV RNA by PCR and HCV CORE Antigen before and then after 12 weeks of treatment.

Results
Treatment with sofosbuvir plus Daclatasvir for 12weeks resulted in undetectable HCV RNA by PCR in 100% of the patients at the end of treatment. There was a significant improvement in portal hemodynamics 6 months after treatment as well as a significant correlation between Doppler indices and fibroscan. Conclusion: Doppler portal hypertensive parameters, as a marker of portal hypertension, were improved in parallel with the improvement in fibroscan values after viral clearance and its improvement in the current study mandate urgent treatment to avoid possible complications.
Prevalence of Occult Hepatitis C Virus Infection among Egyptian Haemodialysis Patients
Authors: EL-Razek El-Nakeeb Noha Abd , El-Sayed Moataz Mohamed , George Tari Magdy Aziz , El-Araishy Amira Mohamed Helmy Okasha 
Published: October 2021

Abstract

Background
Hepatitis C Virus (HCV) infection is a global health problem. OCI is characterized by presence of HCV-RNA in the liver tissue only and/or Peripheral Blood Mononuclear Cells (PBMCs) with undetectable HCV-RNA or antibodies in the serum. Support for presence of this entity comes from the observation that HCV, even though a hepatotropic virus, can replicate as well at extrahepatic sites, including peripheral blood mononuclear cells.

Objectives
The current study evaluated the hidden infection of hepatitis C virus among patients on maintenance hemodialysis with negative ELISA and PCR by using PCR in mononuclear cells as a marker in these patients. Our study was done in Sharkia Governorate.

Patients and Methods
In our study, the 60 included subjects had an average age of 48.27 years with range from 19 to 77 years and included 33 males (55%) and 27 females (45%). The subjects had average dialysis duration of 6.51 ± 4.10years with range from 7 months to 19 years.

Results
Our study showed no statistically significant differences between occult HCV cases and negative cases in frequency of blood transfusion. There were no statistically significant differences between occult HCV cases and negative cases in splenomegaly, hepatomegaly or coarse liver but there was a statistically significant increase in frequency of severe ascites, moderate LL edema and jaundice among occult HCV cases compared to negative cases. There were no statistically significant differences between occult HCV cases and negative cases in urea, creatinine, ALT, AST or albumin. In our study total bilirubin&gt;1.7 and direct bilirubin &gt;0.4 were significant predictors for the presence of occult HCV in hemodialysis patients. Our study showed that there were no statistically significant correlation between viral load in PBMCs and laboratory findings among occult HCV cases.

Conclusion
Hemodialysis patients are liable for occult HCV infections with a considerable impact on their health. Total and direct bilirubin are predictors of presence of occult hepatitis C infection at cut-off values of 1.7 mg/dl and 0.4 mg/dl respectively.
Study the Relation between Peripheral Arterial Disease and vitamin D Level among Maintenance Hemodialysis Patients
Authors: Bichari Walid Ahmed , Abdelmobdy Ashraf Hassan , Aboud Amr Abd Elshafy 
Published: October 2021

Abstract

Background
Chronic kidney disease (CKD) represents a global health concern. The Global Burden of Disease study stated that, worldwide mortality attributed to renal failure showed a tremendous rise with around 1.2 million deaths from renal failure in 2015. Hemodialysis
(HD) patients are at increased risk for atherosclerotic disorders including peripheral arterial disease (PAD). Among dialysis patients, many of the risk factors for PAD are the same as for the general population, but there are associations that seem to be unique to dialysis patients.

Objective
To study the relation between PAD assessed by ankle brachial index (ABI) and serum level of 25(OH) vitamin D among Maintenance HD Patients.

Patients and Methods
The present study included 90 subjects, 45 end stage renal disease patients patients(ESRD) on maintenance HD with PAD assessed by ABI (value less than 0.9) and 45 ESRD patients on maintenance HD without PAD assessed by ABI (value more than or equal 0.9).

Results
There was a statistically significant difference between the two studied groups as regard serum 25(OH) vitamin D level (P = 0.000). We also found a statistically significant positive correlation between ABI and serum vitamin D level in both patients and control groups (P = 0.000).

Conclusion
Vitamin D deficiency is associated with PAD among maintenance HD patients.
Handgrip strength in prediction of sarcopenia in Chronic HCV patient
Authors: Bayoumi Essam Mohammed , Sayed Moataz Mohammed , Abdul-Rahman Samia Ahmed , Saleh Shereen Abo Baker , Mohammed Mohammed Magdy , Samwel Zaky Ayman 
Published: October 2021

Abstract

Background
HCV is one of the major causes of morbidity and mortality in the world and especially in Egypt. However, there is numerous complications to HCV infection (e.g. liver cirrhosis, ascites, portal hypertension, encephalopathy …. etc.) but there is multiple unseen complication (e.g. sarcopenia, loss of electrolytes, loss of protein …etc.)

Objective
To evaluate value of handgrip strength in assessment of sarcopenia in HCV related chronic liver disease patients

Patients and Methods
This study was conducted on 64 adult persons older than 18 years. They were randomly collected from the outpatient clinics at department of internal Medicine in Ain Shams University during the period from June 2018 to August 2019.

Results
In our study there was a great significance relation between handgrip strength and child score in evaluating nutritional status more than anthropometric parameter. Therefore, even that several methods to evaluate nutritional and functional capacity status in patients with cirrhosis have been tested, they have reported diverse results.

Conclusion
Our study we can conclude that HGS is a simple, easy to be applied and more accurate method in evaluation of sarcopenia in chronic HCV patients.
Cardiovascular Manifestations of Behçet Disease among Egyptian Patients
Authors: Mohammed Dalia F , El-morshedy Nashwa A , Teama Mohamed A , Ibrahim Bassant M 
Published: October 2021

Abstract

Background
Behcet’s disease is an auto immune disease with multisystem affection, the most common manifestations are in the form of oral or genital ulcers, eye affection, recurrent thrombosis .
Behcet’s disease is a chronic disease with many sequelae, sometimes fatal, the treatment is by immunosuppressive therapy which also had its implications on the long term, unfortunately it has no sure diagnostic tests and relies mainly on clinical criteria, there are few scores to assess behcet’s disease activity (Behcet's Disease Current Activity Form) BDCAF score is a reliable follow up tool with wide accreditation. BD can virtually involve any organ system, cardiac involvement is variable and sought to occur in the range of 7-46% of patients and may cause myocardial infarction, pericarditis, valve problems, aneurysms or congestive heart failure. Different types of vessels, predominantly veins, can be affected in BD. The frequency of vascular lesions in BD, such as superficial and deep venous thromboses, arterial aneurysms and occlusions, ranges between 7-29%.

Aims
To assess cardiovascular manifestations for patient diagnosed as Behçet disease (BD) and its correlation to disease activity.

Methods
This was a cross sectional study which was done on 40 Behcet’s disease patients within the year 2019, it was done for the assessment of cardiovascular manifestations for patient diagnosed as Behçet disease (BD) and its correlation with BDCAF score (Behcet’s disease current activity form). The study group was subjected to full history, clinical examination including activity which was assessed according to BDCAF score (BEHCET'S DISEASE CURRENT ACTIVITY FORM), Assessment of any activity regarding the eyes using fundus examination, routine laboratory investigations including Complete blood count (CBC), Erythrocyte sedimentation rate (ESR), Creactive protein (CRP), lipid profile, liver enzymes.

Results
it was found that there is a positive correlation between BDCAF (behcet's disease current activity form) and cardiovascular affection (especially valvular lesions and vascular venous affection).
Prevalence of celiac disease in adult patients with iron deficiency anemia of obscure origin
Authors: Farris Mohamed N , Shaheen Rasha Y , Youssef El-Deeb Mai A , Ebraheem Eman A 
Published: October 2021

Abstract

Background
Celiac disease is an autoimmune disease which is underestimated over the world.
Iron deficiency anemia can be the only presentable symptom for patients with celiac disease.
Screening of patients with iron deficiency anemia of obscure origin by anti-tissue transglutaminase serum igA to diagnose celiac disease followed by upper GIT endoscopy is an important step.

Objective
to evaluate the prevalence of celiac disease in adult patients with iron-deficiency anemia of obscure origin.

Methods
The present study was a cross-sectional study which included
100 patients with a diagnosis of iron deficiency anemia recruited from Ain Shams University hospitals. All the patients were subjected to: Full history of gastrointestinal symptoms of celiac disease(CD), Age of onset of iron deficiency anemia, Complete blood picture, Serum iron, serum ferritin, transferrin saturation, Anti-tissue transglutaminase antibody immunoglobuline A, Upper gastrointestinal endoscopy and duodenal biopsy to patients who had positive serology.

Results
The present study showed that 8% of cases with iron deficiency anemia of obscure origin were ultimately diagnosed as cases of celiac diseases while 47% were diagnosed according to duodenal biopsy as potential celiac disease (where there was positive serology and intact villous architecture according to marsh classification) and 45%of cases were non-celiac disease.

Conclusion
Screening for celiac disease should be considered in patients with iron deficiency anemia of obscure origin
Effect of Metabolic Acidosis on Immunoregulation in Prevalent Hemodialysis Patients
Authors: Ahmed Abo Ali Fawzia Hassan , Elkady Hossam Moustafa , Gharib Mohamed Sary , William Adly Heba 
Published: October 2021

Abstract

Objective
to evaluate the relationship between IL-10 and serum bicarbonate and metabolic acidosis in prevalent hemodialysis patients.

Methods
Type of Study: prospective case control study. Study Setting: The study was conducted at Ain Shams University hospital hemodialysis unit. Sample Size: 40 patients with ESRD on regular HD and 20 healthy control. Study Population: Maintenance hemodialysis patients

Results
The results suggested that serum IL-10 level was significantly higher in chronic HD patients than healthy subjects and this is compatible with the idea that higher levels of IL‑10 are needed in HD patients to limit their strong inflammatory activation associated with uremia and the dialysis technique. There was no significant differences in IL-10 levels noticed between patients with different causes of ESRD. This study also showed negative correlation between IL-10 and serum bicarbonate levels. We also found that there was significant positive correlation between baseline levels of IL-10 and CRP which may be because of dialysis inadequacy that is associated with chronic inflammatory state resulting in high CRP levels.

Conclusion
The incidence and prevalence of ESRD have risen dramatically which may be due to the increasing prevalence of diabetes and hypertension. Although regular hemodialysis decreases levels of mortality in these patients, it is still considered a condition associated with inflammation. The current study revealed high IL-10 levels among HD patients who had metabolic acidosis. Further research needs to be done to reveal beneficial effects of these finding.
Correlation between Hypervolemia, Left Ventricular Hypertrophy and Fibroblast Growth Factor- 23 in Prevalent Hemodialysis Patients
Authors: Shawky Sahar Mahmoud , Hassan Mohamed Saeed , Khalifa Maha Mohamed , Mahmoud Amin Kholoud 
Published: October 2021

Abstract

Background
Patients with end-stage renal disease are exposed to extreme volume shifts and thereby cardiovascular strain as a consequence of interdialytic weight gain, fluid removal during hemodialysis and also chronic fluid overload. In long-term hemodialysis patients, higher IDWG (interdialytic weight gain) is associated with poor survival and increased cardiovascular death. Patients with the lowest interdialytic fluid retention have the greatest survival.
It was found that increased interdialytic volume load is associated with increased both LVMI and FGF-23 level.

Objective
To evaluate correlation between hypervolemia, left ventricular hypertrophy and FGF-23 in prevalent hemodialysis patients.

Patients and Methods
This cross sectional study was conducted in Ain shams university hospital and Al Agoza hospital, on 60 prevalent hemodialysis patients.Three patient died during the study.

Results
FGF-23 had a positive correlation with (weight gain, (PO4)3-, PTH, IVS, PW and LVMI).

Conclusion
FGF-23 might be a marker of volume overload and LVH in ESRD patients, as it positively correlated with (weight gain, IVS, PW and LVMI). FGF-23 is a marker of bone diseases, as it positively correlated with (PO4)3- and PTH. Volume overload has a negative impact on morbidity and mortality in ESRD patients.