bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Laparoscopic versus Open Hernioplasty in Repair of Unilateral Non Recurrent Inguinal Hernia
Authors: Wagdy Hesham Hassan , Mohamed Mostafa Abdo , Khalil Ahmed , El Ebiedy Osama Mohamed Ali 
Published: October 2021

Abstract

Background
Laparoscopic surgery has led to many changes in the management of surgical patients and significantly reduced the incidence of complications associated with open surgical procedures 1. At present, laparoscopic hernia repair has gained clinical significance in patients with bilateral or recurrent hernia. 2

Objectives
The aim of this study is to compare open hernioplasty and laparoscopic hernia repair in unilateral non recurrent inguinal hernia. The present study will be performed on 30 patients to compare the effectiveness of laparoscopic hernia repair and open hernioplasty and to assess the intra operative and post-operative complications, duration of surgery, hospital stay, postoperative morbidity, recurrence and patient satisfaction.

Patients and Methods
. Comparative studies on 30 patients were classified according the type of operative technique into 2 groups: Group A patients underwent laparoscopic technique (15 patients), group B patients underwent open technique (15 patients) to evaluate and compare the open and laparoscopic techniques in unilateral non recurrent inguinal hernia repair as regard operative time,post operative pain, hospital stay, urine retention, parathesia, numbness, seroma,, wound infection and recurrence

Results
Our study revealed highly significant increase in operative time in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value &lt; 0.0001), highly significant decrease in post-operative pain score in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.00434),highly significant decrease in postoperative hospital stay in laparoscopic group; compared to open group of patients; with highly significant statistical difference. (p value = 0.000003), significant decrease in post operative parathesia and numbness in laparoscopic group; compared to open group of patients; (p value =0.000414),highly significant decrease in post-operative urine retention in laparoscopic group; compared to open group of patients; with highly significant statistical difference (p value= 0.000267).

Conclusion
The laparoscopic technique is superior to the open technique of tensionfree repair, in terms of immediate post-operative complications and delayed pain and paresthesia also in terms of safety.
Enhanced Recovery After Colo-Rectal Surgeries (ERAS) V.S Conventional Care A systematic review and meta-analysis
Authors: Hanna Hanna Habib , Abdelhalim Sherif , Khairy Aboelatta , Al-Abbasi Rihaj Mohammed Abdulfattah 
Published: October 2021

Abstract

Background
ERAS programs are not only used in abdominal surgeries, they are also used in cardiothoracic, gynecology, urology, orthopedic, and neurosurgery. Many authors and surgeons worldwide have been adapting this program, also trying to modify it due to its promising outcomes and it’s low damage toit’s continence.

Objective
To present an updated assessment of perioperative care in colorectal surgery from the available evidence and Enhanced Recovery After Surgery (ERAS) group recommendations.

Patients and Methods
We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. An electronic search was conducted from the inception till March 2019 in the following bibliographic databases: Medline via PubMed, SCOPUS, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Google Scholar to identify relevant articles. We used different combinations of the following queries: ("Colorectal Surgery"[Mesh]) AND ("Enhanced recovery" OR "conventional care"). The search have been done with no limit regarding the year publication or language.

Results
In the present study, we searched Medline via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar from their inception till March 2019. The search retrieved 2861 unique records. We then retained 41 potentially eligible records for full-texts screening. Finally, 28 reports of 25 RCTs were included in the present systematic review and meta-analysis

Conclusion
ERAS was proven to be feasible, minimally invasive, cheap, relatively easy, which is safe and effective at the same time. This program can be ideal for patients undergoing elective colo-rectal surgery, yet more studies should be conducted in Egypt to compare results regarding different approaches of this program with longer follow up and randomization of patients.
Prospective Study to Evaluate Effect of Autologus Plasma Injection in the Wound Site immediately after Primary Wound Closure on Wound Healing
Authors: Elshafai Mahmoud A , Reyad Khaled A , Elrifai Ahmed Y , Sallam Samar E 
Published: October 2021

Abstract

Corresponding Background
Wound healing Process and Scars are still a nightmare for the surgeon and the author: patient as well, because of the large number and wide variability of factors affecting the process itself. Plasma injection is a very promising futuristic therapy and can be superior to PRP injection having more abundant growth factors, fibrin and healing promoters.

Aim of the Work
to evaluate the effect of injection of the whole plasma components in the wound site intradermally immediately after primary wound closure on the process of wound healing.

Patients and Methods
This prospective co-operative study included 20 patients having wounds in different sites of the abdomen after approval of research ethical committee of the Faculty of Medicine, Ain Shams University at July 2018, The patients are divided into two groups: an interventional group (group A) 10 cases which are received plasma treatment together with the usual wound care, and a control group (group B) 10 cases which are received the usual wound care only without plasma treatment, in the period between August 2018 to March 2019.

Results
We have found a faster wound healing process, higher cosmetic results, better color match, more patients' satisfaction and lower susceptibility to complications in the interventional group (A) that received plasma injection than in the control group (B) which received only the usual wound care without plasma injection reflecting the positive impact of plasma injection on the wound healing process.

Conclusion
We concluded that there are reasonable amount of data that warrant continued research and usage of plasma in the process of wound healing.
Effects of RTTN gene mutations and the need for complementary cDNA analysis for some transcripts: case report
Authors: PourMirza Afshin , Attia Azza Abd El Moneim , Tawil Mohamed Issa , Amin Dina A 
Published: October 2021

Abstract
RTTN is a gene coding for Rotatin protein which has been localized at ciliary body and centriole of human fibroblasts. Its exact function in human is not well identified. However, it is thought to play important role in maintenance of normal structure of primary cilia and hence in left to right organ specification, axial rotation, development of notochord as well as early cellular division in mice.
Overall 28 cases have been reported with homozygous pathogenic mutations of RTTN gene till 2019 to our knowledge. They presented with primary microcephaly, short stature, polymicrogyria with or without seizures (MPPS). These symptoms can be summarized in microcephaly, generalized growth delay, malformation of the developing cortex (MDC) and hence neurodevelopmental delay with or without seizures. Meanwhile all of these signs usually appear in late prenatal or even postnatal life which emphasizes the need for other diagnostic tools in case of detection of RTTN variables of unknown significance or in case of accidental detection of multiple transcripts by NGS in prenatal genetic testing.
A case with prenatal diagnosis of two different RTTN gene transcripts in fetal WES analysis. One of the transcripts showed RTTN homozygous gene mutation while the other transcript was normal. This article presents the multidisciplinary approach followed in prenatal as well as postnatal period. It also highlights the importance of gene expression analysis in prenatal genetics.
Mean platelet volume indicator for systemic inflammation in cirrhotic patients with spontaneous bacterial peritonitis
Authors: Abd El-Wahab Khaled Mohamed , Mohamed Sayed Moataz , Osama Ali Mohamed , Abd El-Azem Abd El-Azem Mostafa 
Published: October 2021

Abstract

Introduction
spontaneous bacterial peritonitis (SBP) is the most common infection in patients with cirrhosis [1] .Spontaneous bacterial peritonitis is found in patients where besides the increase of polymorphonuclear counting, they present a positive result of culture [2] . The BMN count as not always quickly available in clinical practice and the culture result usually takes 72 hours or more [3] .The use of additional markers that are rapidly and easily applicable, may add significant benefit for predicting the development of spontaneous bacterial peritonitis and achieving diagnostic accuracy [4] .Platelet size is a determinant factor of platelet proinflammatory functions. Several studies have found relationship between the mean platelet volume (MPV) and pro-inflammatory conditions, particularly acute infections [5] .

Aim
to identify a mean platelet volume (MPV) cutoff value which should be able to predict the presence of sponataneous bacterial peritonitis.

Settings and designs
a cross sectional observational study, carried out on 40 patients with AFI and 40 patients without AFI.

Methods
Patients were classified into two groups, group A (SBP) which included 40 patients with ascetic fluid PMN count ≤ 250 cells/mm3 and group B (non/SBP) which included another 40 patients with ascetic fluid PMN count &lt; 250 cells/mm3. All studied patients were subjected to history taking, Clinical examination and routine laboratory investigations including: CBC including platelet number and MPV, liver function test including (ALT, AST, albumin, and direct & total bilirubin), kidney function test including (BUN &creatinine), PT, PTT, INR, ESR and CRP .Abdominal-pelvic ultrasonography was done for all patients. Aspirated ascetic fluid samples were immediately examined for bacteriological cultures.

Statistical analysis used
Statistical presentation and analysis of the present study was conducted, using the mean, standard deviation, independent samples t-test, Chi-square, Mann-Whitney U test and Analysis of variance [ANOVA] tests by SPSS version 22 software .Tukey test was used .Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of MPV and with maximum sensitivity and specificity for differentiation of cirrhotic patients with SBP from those without SBP. Spearman’s correlation analysis was done.

Results
MPV was significantly higher in SBP-patients (Group A) than that of non-SBP patients (Group B) (11.6820±1.19303 fL versus 9.0325±1.12441 fL) (P-value = 0.001) .MPV has positive correlation with Ascitic sample TLC and Ascitic sample PMNC in Group A. ROC curve shows that MPV cut off value is10.25with 85% sensitivity and 75% specificity .

Conclusion
MPV may serve as a non-invasive, cheap and rapid test for detection and diagnosis of spontaneous bacterial peritonitis (SBP) with a sensitivity and specificity of 85% and 75% respectively.
Endoscopic Ultrasound versus Conventional Ultrasonography as A Diagnostic Tool for Patients with Obstructive Jaundice
Authors: Saleh Shereen A , Abo Elezz Muhammad A , Elessawy Hagar A , Ali Ahmed Farahat Muhammad 
Published: October 2021

Abstract

Background
Patient presented with jaundice, initial evaluation should be ultrasonography for evaluation of liver parenchymal changes, cirrhosis and assessment of hepatic vascularity and evaluation of intrahepatic, extrahepatic biliary system.

Aim of the Work
to compare between the Conventional US and Endoscopic Ultrasound in diagnosis of obstructive jaundice and other diagnostic modality including CT/MRI, ERCP for diagnosis and evaluation of the cause of OJ.

Patients and Methods
This study was conducted on 60 patients with obstructed jaundice as evident by ultrasonography in the form of dilated CBD with IHBRDs, with visualization of Gall bladder content and pancreas if can be well visualized, all patients had clinically apparent jaundice with disturbance of liver biochemical profile, all patient underwent EUS and compare finding with US including CBD diameter and IHBRDs degree.

Results
EUS provide better visualization of CBD and IHBRDs with diagnosis of pathological lesion including stones, malignancy. EUS also has better visualization of pancreatic pathology including inflammation and malignancy and extent of the tumor including local extent, lymphatic spread with vascular invasion.

Conclusion
EUS is better than US and other modality CT&MRI and ERCP in diagnosis of distal CBD stricture including malignant obstruction especially in cases of early malignancy and small tumors, and calculary distal obstruction. CT is insensitive in diagnosis of periampullary cancer, EUS provide early diagnosis of Pancreaticobiliary malignancy and give better advandage for early resectability .
Effects of Oral Vitamin C on Hepcidin Levels and Erythropoietin Requirements in Functional Iron Deficiency Anemia among Hemodialysis Patients
Authors: Mohamed Zaki Ali Mahmoud , ElMoniem Behairy Maha Abd , El Sharabasy Reem Mohsen , Ahmed Gharib Ahmed Hamed 
Published: October 2021

Abstract

Background
Hepcidin has long been postulated as a key regulatory peptide in iron homeostasis. Its reduced clearance and elevated levels in hemodialysis (HD) patients lead to functional iron deficiency (FID) and ESA resistance. Vitamin C may be used as adjuvant therapy in FID anemia, but there are limited studies investigating the direct relation between vitamin C and hepcidin levels in HD patients. We aimed to test the reducing effect of Oral vitamin C therapy on hepcidin levels among hemodialysis patients with functional iron deficiency anemia.

Patients and Methods
This study is an open label randomized controlled clinical trial. It was conducted in the hemodialysis units of Ain Shams University hospitals. 48 adult prevalent HD patients were included and were divided into two groups. Group 1 (study group) included 31 patients who received the conventional treatment of erythropoietin stimulating agents (ESAs) together with oral supplementation of vitamin C 500 mg every other day for 3 months in addition to IV iron therapy. Group 2 (control group) included 17 patients who received only the conventional therapy of ESAs according to their hemoglobin (Hb) levels in addition to IV iron therapy. Laboratory parameters including serum hepcidin levels, highly sensitive CRP (hs-CRP) titer, CBC, kidney function tests and iron indices were measured at the baseline of the study and after 3 months.

Results
Oral vitamin C therapy resulted in a statistically significant reduction in both hepcidin and hs-CRP levels in the study group after 3 months. The study group showed a significant reduction in serum iron and ferritin levels (P &lt; 0.05). A Decrease in EPO requirements and elevation of hemoglobin level were observed in the study group but were not statistically significant as a short term effect of oral vitamin C, in comparison to the control group. A highly significant correlation was observed between serum hepcidin and hs-CRP (R=0.46, P&lt;0.01).

Conclusion
Oral vitamin C may be a promising therapy in decreasing serum hepcidin and hs-CRP levels in prevalent hemodialysis patients with functional iron deficiency anemia.
A Diagnostic Value of Serum Level Cyclase-Associated Plasma Protein 2 Versus Alpha Fetoproteins as a novel Biomarker for Detection of Hepato-Cellular Carcinoma in Egyptian Patients with Liver Cirrhosis
Authors: Moustafa Mohamed Abd Elmaghny , Ali- Eldin Zainab Ahmed Ahmed , Musa Nevine Ibrahim , Milad Milad Emad 
Published: October 2021

Abstract

Background
HCC is the third deadliest and fifth most common cancer worldwide, despite the widespread use of surveillance programs in at risk populations, more than half of HCC cases are diagnosed late, and curative therapies such as surgical resection, radiofrequency ablation or TACE are possible in less than 30% of patients.

Objective
To assess the value of plasma cyclase-associated protein 2 level in diagnosis of hepatocellular carcinoma among the Egyptian patients with chronic hepatitis c virus.

Patients and Methods
This study has been carried out in the department of Internal Medicine and Gastroenterology in Ain Shams University Hospitals and Manshiet El-Bakry general hospital, Department of Gastrohepatology. This study evaluate the significance of Plasma CAP2 level as a new diagnostic marker for HCC patients with post hepatitis C liver cirrhosis where (80) persons, divided into three groups; Group A included (30) patients with post hepatitis C liver cirrhosis without HCC, Group B included (40) patients with post hepatitis C liver cirrhosis and HCC, and Group C included (10) healthy subjects as a control group.

Results
In this study CAP2 was significantly higher in HCC group than in cirrhotic and control groups (p &lt; 0.001) with mean levels (30.7±12.4), (14.4±7.6), and (6.9±4.3) ng/ml respectively although in HCC patients with negative or low AFP levels. This finding could imply the role of CAP2 in diagnosing early and AFP negative HCC patients.

Conclusion
CAP2 is significantly elevated in HCC group than in cirrhotic and control groups with better sensitivity and specificity than AFP at cut off values ≥15.9 ng/ml and ≥53.2 ng/ml respectively. Such results support using of CAP2 as a better diagnostic marker for HCC. AFP and CAP-2 were higher in multiple lesions than in single lesions, but the differences were significant only in CAP-2 with ≥27.3 ng/ml in differentiating multiple from solitary lesions Considering the HCC if both of them were positive decreased sensitivity but had perfect specificity.
Video Capsule Endoscopy In Comparison To Radiological Examination In Detection Of Small Bowel Lesions
Authors: Samy Amir Helmy , Musa Nevine Ibrahim , Bakr Saleh Shereen Abou , Elgammal Ahmed Sayed 
Published: October 2021

Abstract

BACKGROUND
Small bowel obscured its lesions as secrets which were difficult to diagnose before video capsule endoscopy as a new modality for investigation.

Aim of the study
Evaluation of video capsule endoscopy in comparison to radiological examination in detection of small bowel lesions.

Patients and methods
Fifty patients were recruited from Kafrawy Video Capsule Endoscopy Unit of Internal Medicine Department and endoscopy unit of Ain Shams University Hospital. The study included patients with occult or overt GIT bleeding, patients with unexplained microcytic iron deficiency anemia, patients with chronic diarrhea and abdominal pain, with normal upper GI endoscopy and colonoscopy. Exclusion of any patient younger than 18 years old, has intestinal stricture, achalasia, or dysphagia. All patients were studied biochemically with CBC and radiological by CT pelvis and abdomen with IV and oral positive contrast some of them were radiologically examined with CTE or CT mesenteric angiography. All patients were endoscopically examined by OGD, colonoscopy, VCE, and some of them were examined also with enteroscope.

Results
The study revealed that the detection rate of SB lesions with VCE was 84%.
In the current study, (44%) of cases had AVMs, (72.73) % of them were above the age of forty five, and (27.27) % were below the age of forty five. All patients who were investigated with CT mesenteric angiography revealed negative results. In this study (20) % of patients had SB masses and polyps, (70) % of them were at age of forty five or more and only (30) % of them were below the age of forty five. All patients underwent CT pelvis and abdomen with IV and oral positive contrast, and we found that all patients had a negative results regarding the SB lesions. In comparison between CTE and VCE in detection of SB vascular lesions CTE did not detect SB vacular lesions. On the other hand, VCE detected the AVMs in the cases with negative CTE results. In this study one patient (2)% was diagnosed with hookworm infection. All patient underwent for OGD. We found that (20)% of patients had a significant gastric or duodenal lesions (proximal to the papilla) by VCE but missed by upper GI endoscopy. In our study the concomitant of VCE and enteroscope increase the detection of SB vascular lesions than isolated use of VCE only.

Conclusion
VCE has a high detection rate of SB lesions (84)%. CTE has a low significance in detection of SB vascular lesions and CT mesenteric angiography sensitivity relatively low. AVMs more common with increasing the age. PHE and SB ectopic varicies, were found to be common causes of GIT bleeding in CLD patient. There is a significant rate of missed gastric and duodenal (proximal to the papilla) lesions that the cause of GIT bleeding and unexplained iron deficiency anemia in OGD examination that were detected by VCE.
Association of Hydroxy (Steroid) Dehydrogenase 11b1 Gene with Type 2 Diabetes Mellitus in Egyptian Population
Authors: Botros Raef M , Hendawy Laila M , Fahmy Eman M , Halawani Salah H , Younis Alaa T 
Published: October 2021

Abstract

Background
Type 2 diabetes mellitus is a heterogeneous group of metabolic disorders caused by the interaction between genetic predisposition and environmental factors. The incidence of type 2 diabetes mellitus has increased over the last decades with more than 170 million individuals suffering from type 2 diabetes mellitus all over the world which imposes a greater economic impact on individuals, families and health systems. Though the genetic susceptibility to type 2 diabetes mellitus is polygenic, single nucleotide polymorphisms (SNP) at Hydroxy steroid dehydrogenase (HSD11B1) gene have been strongly associated with type 2 diabetes risk in various populations and ethnic groups.

Objectives
The aim of this study is to assess the association of Hydroxy-Steroid-Dehydrogenase-11B1 gene (rs846910) with type 2 diabetes mellitus in a sample of Egyptian population.

Patients and Methods
In the present study, we included 60 diabetic obese patients and 40 age and sex-matched controls. The mean age of the included patients was 50.26 ±9.1 year; while the majority of them were females (70%). All the participating patients were subjected to detailed history and the following investigations: fasting blood sugar, post prandial sugar,HbA1c, and lipid profile. Detection of gene polymorphism by real time PCR was performed for all subjects in the study.

Results
The study showed that homozygous GG genotype was more prelevant than GA genotype. No significant difference between GG and GA in terms of fasting and postprandial sugar and in terms of lipid profile: cholesterol (p = 0.642), TG (p = 0.808), LDL (p = 0.238), and HDL (p = 0.945).It showed no statistically significant difference between cases and controls in terms of HSD11B1 polymorphism (rs846910). The regression analysis showed that the HSD11B1 polymorphism did not significantly increase the risk of diabetes mellitus (OR 1.724, 95% CI [0.601 – 4.94]).

Conclusion
In conclusion, multiple further studies involving other single nucleotide polymorphism of 11 beta hydroxysteroid dehydrogenase gene as well as other genes involved in type 2 diabetes mellitus and obesity need to be done.