bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Troponin elevation in Non- ST Acute Coronary Syndrome Patients presenting to The Emergency Department Using Neutrophil-lymphocyte ratio
Authors: Mahmoud Sarah Mohamed , Sobhy Bassam , Raymond Ramy 
Published: October 2021

Abstract

Background
The neutrophil–lymphocyte ratio (NLR) is considered an independent predictor of mortality and myocardial infarction (MI) in stable coronary artery disease (SCAD). Also NLR have prognostic value in patients with acute coronary syndromes (ACSs). However the diagnostic power of NLR in patients suspected of ACS is still under study

Objective
is to determine the ability of neutrophil-lymphocyte ratio to predict troponin elevation in patients presenting to emergency department with acute coronary syndrome

Material and Methods
From June 2018 to March 2019, 100 patients were enrolled who presented to the ER with NST-ACS. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. Baseline Complete blood count with calculation of NLR is done

Results
The study population was divided into 2 groups: troponin- negative group (n = 50) and troponin-positive group (n = 50). Mean age was 55.8 ± 11.3. 77% of the patients were male. No significance difference in the level of hemoglobin, WBCs and platelets between the 2 groups. The neutrophil count was significantly higher in the troponin-positive group (p &lt; 0.001). The median admission. NLR was significantly higher in the troponin-positive group (2 vs. 3.9, P &lt; 0.001). A cutoff point of 3.4 for NLR measured on admission had 84% sensitivity and 84% specificity in predicting follow-up troponin positivity. A highly significant correlation was found between NLR and level of troponin change (p value &lt;0.01)

Conclusion
NLR can be used as a diagnostic tool in the differentiation of patients with acute coronary syndrome. NLR is a non-expensive, simple and available parameter that can be used in diagnosis of NSTEMI.
Frequency and Antibiotic Resistance Profile of Uropathogens Associated With Community Acquired Urinary Tract Infections
Authors: Saber Sally Mohammed , El-Ashry Marwa Abd el Rasoul , Assad Christina Magdy Lotfy Mikhail 
Published: October 2021

Abstract

Background
Community acquired urinary tract infections (CAUTIs) are among the most common bacterial infections diagnosed in community health practice resulting in high rates of morbidity and high economic costs associated with its treatment. CAUTIs are usually treated empirically. Geographical variations in etiologic agents and their antibiotic sensitivity patterns are common. Knowledge of antibiotic resistance trends is important for improving evidence-based recommendations for empirical treatment of UTIs. Adequate empirical treatment can cause decrease in unnecessary hospital stays, treatment cost, antibiotic side effects as well as reducing antimicrobial resistance spread.

Aim of the Work
To determine the implicated uropathogens associated with community-acquired UTIs and their respective antimicrobial resistance pattern to improve the efficacy of empirical treatment of this infection.

Patients and Methods
This a cross-sectional descriptive study conducted from November 2018 to November 2019 at the main Microbiology Lab in Clinical Pathology Department, Ain Shams University Hospitals. Samples were received from patients attending different outpatient clinics in Ain Shams University Hospitals having UTI symptoms and whose urine samples showed significant bacterial growth (≥105 CFU/mL) associated with pyuria (more than 8–10 pus cells by microscopic urine analysis) and nitrite and leukocyte esterase positive by chemical analysis of urine strip.

Results
A total of 1600 patients who fulfilled our inclusion criteria were sampled. Of these, 1058 patients had urine samples that showed significant bacterial growth while about 34% of the samples were contaminated and excluded . Of the 1058 significant samples, 764 (72.21%) were from females and 294 (27.79%) from males with female to male ratio 2.6:1. Escherichia coli was found the dominant bacteria among a with the prevalence rate of 24.4% followed by Klebsiella pneumoniae (13.8%). Tetracycline was found the most resistant antibiotic 929 (95.4%) followed by Ampicillin, Tazobactam-piperacillin, and Ampicillin- sulbactam by 90.1%, 81.7% and 77.7% respectively; however, the most sensitive antibiotics against all uropathogens were Carbapenems (Ertapenem 72.9% fol Imipenem 66.5% and Meropenem 66.4%) followed by Nitrofurantoin and Amikacin showing 64.3% and 58.01% sensitivity respectively . However, For gram positive uropathogens, Linezolid showed the highest sensitivity in 84% of the isolates.

Conclusion
The present study reveals a familiar pattern with respect to the species of uropathogens involved in community acquired urinary tract infections, however with considerable bacterial resistance to common empirically prescribed antibiotics.
Evaluation of Natural Killer Cells in HCV Patients undergoing Hemodialysis
Authors: Zeitoun Yasser Ahmed , HamdyEl-Kabarity Rania , Elsaid Tamer Wahid , Ragab Dina Aly Mohamed Aly , Sedhom Mariam Talaat Shaker 
Published: October 2021

ABSTRACT

Background
Hepatitis C virus (HCV) is a hepatotropic virus and one of the major causes of liver disease and a potential cause of substantial morbidity and mortality worldwide. Patients on hemodialysis are at high risk for HCV, with frequency of infection several times higher than that in non-uremic patients. Natural killer (NK) cells are best appreciated for innate defense against viral infections and in tumor cell surveillance.

Objective
To study the percentage of peripheral blood natural killer cells among chronic hepatitis C patients undergoing hemodialysis compared to chronic HCV patients with normal kidney functionsby flowcytometry immunophenotyping.

Methodology
Frequency of CD3- CD56+ cells was assessed in two distinct groups. Group I: 35 chronic HCV patients with end stage renal disease and undergoing hemodialysis, group II: 35 age and sex matched chronic HCV patients with no kidney disease.

Results
No significant difference was observed between HCV hemodialysis patients with ESRD and HCV patients with normal kidney function regarding the frequency of both NK cells (CD3CD56+) and NKT cells (CD3+CD56+). However, group I had significantly higher percentage of CD3+ cells than group II.

Conclusion
no difference was found in this study between HCV patients on hemodialysis and HCV with normal kidney function regarding NK cell frequency. However, assessment of NK cell function in future studies might reveal differences.
Serum Leptin Level in Children with Acute Lymphoblastic Leukemia
Authors: Ghozlan Manal Fawzy , Eissa Deena Samir , AbdelRahman Nada Ahmed Hamed 
Published: October 2021

Abstract

Background
Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer .It is a disease of monoclonal proliferation of hematopoietic precursor cells of the lymphoid series within the bone marrow. Leptin is a peptide hormone which is predominantly produced by white adipose tissue. The main function of leptin in the human body is the regulation of energy expenditure and control of appetite .It is supposed to be involved in the pathogenesis of hematological malignancy through its proliferative, anti-apoptotic, and differentiating effects on hematopoietic neoplastic cells, in addition to its synergestic effect on vascular endothelial growth factor (VGEF) .

Objectives
To evaluate serum leptin level in children with acute lymphoblastic leukemia at diagnosis and at day 28 post induction chemotherapy,and to test the association between serum leptin levels and anthropometric measures of ALL patients and prognostic markers of ALL as age, gender, initial WBCS count, extramedullary infiltration to organs and CSF, cytogenetics, and response to treatment .

Patients and Methods
This is a case- control study performed at Clinical Pathology Department, Ain Shams University Hospitals. The study was conducted on 30 ALL pediatric patients admitted to Hematology & Oncology Unit, Pediatric Department, Ain Shams University Hospitals.The patients were evaluated at diagnosis before intake of chemotherapy and at day 28 post-induction chemotherapy, and 25 healthy controls matched with patients in age, sex, BMI.

Results
Serum leptin level is elevated in ALL patients at diagnosis as compared to controls .It has no significant relation with patients age, sex, BMI. It is elevated in patients who received cranial radiotherapy and those who relapsed. .However, it has no significant relation with clinical data (fever, lymphadenopathy and organomegaly) and laboratory characteristics (CBC, percentage of blasts infiltrating bone marrow and peripheral blood, immunophenotyping and cytogenetics) of ALL patients.

Conclusion
Data from our study showed that elevated leptin level in ALL patients can be considered a risk factor involved in ALL pathogenesis.It can be used as a biomarker for ALL diagnosis, a prognostic factor for ALL patients on chemotherapy, and a predicting factor for relapse.
Phenotype of Memory HCV CD8+ T Cells in Chronic HCV
Authors: Yasin Aisha , Talkhan Hala , El-Aleem Afaf Abd , Shady Rania Abo , El-Kabareety Rania , Nasr Noha Ibrahim 
Published: October 2021

Abstract

Background
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. After acute infection, a majority of healthy adults will develop persistent viremia. An infection with HCV activates the immune system to defend the host with a broad range of innate and adaptive immune responses. Cellular immune response shows antiviral immunity by means of virus specific CD8+ T cytotoxic lymphocytes and CD4+ T helper cells. After resolution of infection, a population of the virus-specific memory CD8+ T cells protects the host against reinfection. These subsets of memory cells differ with respect to their anatomical localization, their phenotype and their protective potential.

Objectives
The aim of the present study is to find out the phenotype pattern of HCV specific memory CD8+ T cells in chronic HCV patients in comparison to HCV exposed seronegative high-risk individuals.

Patients and Methods
This case control study included 60 individuals categorized into two main groups, (group I) included 20 chronic HCV patients and (group II= control group) included 40 HCV seronegative healthcare workers. Both groups were subjected to carboxyfluorescein diacetate succinimidyl ester (CFSE) proliferation assay in response to HCV specific peptides. Group II was divided into 2 subgroups according to proliferation index (cut-off&lt;2) into, proliferation index +ve high-risk group (+PIHRG) (20 healthcare workers) and proliferation index -ve high-risk group (-PIHRG) (20 healthcare workers). Then flow cytometric analysis of HCV specific CD8+ T cells was done for the all subjects to determine the expression of CD127, CCR7, CD45RO and CD45RA on both proliferating and non-proliferating fractions of cells.

Results
We found that expression of CD45RA was significantly increased and CCR7 was significantly decreased on HCV CD8+ T cells in the chronic HCV group than in the high risk groups in response to different HCV peptides.

Conclusion
During persistent viremia in chronic HCV infection subthreshold signal levels established by HCV different proteins provide anergy of virus specific memory CD8+ T cells that are unable to differentiate into full effector cells upon a possible reencounter with the antigen. So, chronic HCV patients in our study showed predominance of less differentiated effector memory phenotype (CD45RA+, CCR7-) in peripheral blood in comparison to HCV exposed seronegative high-risk individuals who don’t show overt infection.
Serum Interleukin-15 in Alopecia Areata and its correlation with dermoscopic findings
Authors: Khafagy Naziha Hafez , El Din Zaki Marwa Salah , Hussein Aya Mahmoud 
Published: October 2021

Abstract

Background
Alopecia areata is an autoimmune hair loss which frequently starts in childhood. Its presentation had an extreme variability not only in the time of initial onset but also in the duration, extent, and pattern of hair loss during any given episode of active loss. Moreover, the course of disease is unpredictable, with spontaneous regrowth of hair occurring in 80% of patients within the first year and sudden relapse at any given time. Due to the clinical variability and unpredictable nature of spontaneous regrowth, diagnosis and management may be difficult and challenging.

Objective
The aim of this study is to evaluate the serum levels of IL-15 in active alopecia areata and correlate them with disease severity and activity according to dermoscopic findings.

Methods
This case-control study were conducted in Dermatology, Venereology and Andrology department, Ain Shams University Hospitals included 30 patients with different clinical variants of AA, the diagnosis was made via clinical examination and dermoscopic findings. In addition, 30 apparently healthy individuals of matched age and sex as a control group were included in the study.

Results
Dermoscopic examination among cases showed that the most common dermoscopic findings in patients were vellus hair and yellow dots, while the least common finding was exclamation mark hairs. On comparing serum IL-15 in patients and control groups, it was found that serum levels of IL-15 in patients were significantly higher than those in the control group. There was no statistically significant difference in serum IL-15 levels between patients with negative and positive pull test, nail involvement, or body involvement. Similarly, no statistically significant difference in serum IL-15 levels in patients with various subjective disease activity was detected. However, there was a highly significant difference between serum IL-15 levels in different SALT score groups, with the highest levels being in the S3 group. There was a highly significant difference between IL-15 levels in patients with and without black dots. Also, there was significant difference between IL-15 in patients with and without broken hair, and exclamation mark hair. There was no significant difference in level of IL-15 among patients with and without yellow dots, and with and without vellus hair.

Conclusion
On the basis of the current study, we can conclude that IL-15 is significantly elevated in AA patients when compared to the control subjects. It is also a possible marker of AA severity. It is positively correlated with dermoscopic findings in AA patients, so dermoscopic findings can be useful in evaluating severity of alopecia areata.
Comparative Study between Intense Pulsed Light and Fractional CO2 Laser in the Treatment of Periorbital Wrinkles
Authors: El Sayed Ahmed Sahar , El Din Zaki Marwa Salah , Mahmoud Ali Eman 
Published: October 2021

Abstract

Background
The periorbital region is one of the areas showing the earliest signs of aging and is especially prone to skin wrinkles and discoloration. Both fractional carbon dioxide (CO2) laser and intense pulsed light (IPL) have been evaluated in treatment of periorbital wrinkles.

Objective
The objective of this study was to evaluate and compare the efficacy of fractional CO2 laser and IPL in the treatment of periorbital wrinkles.

Patients and Methods
The present study is a prospective comparative split face study which included 20 adult female patients with mild to moderate periorbital wrinkles. Their age ranged from 30 to 40 years. Each patient received four treatment sessions with three weeks intervals on each side of the periorbital region, one with IPL and one with fractional CO2 laser. Evaluation was done before each treatment session and two months after last session with ordinary photographs and by wrinkles indentation index as calculated by the Antera 3D camera.

Results
There was a highly statistically difference between the mean percentage of improvement of the wrinkles indentation index by fractional CO2 laser as compared to IPL.

Conclusion
Both IPL and fractional CO2 laser are promising effective modalities of treatment of periorbital wrinkles which are easy and safe to use. However, fractional CO2 laser is more effective and leads to more improvement in wrinkles indentation index by Antera camera score.
Fractional carbon dioxide laser, platelet –rich plasma and narrow band ultraviolet B in the treatment of Vitiligo (A prospective randomized comparative trial)
Authors: Eshafi Mohamed Abdullah , Zuelfakkar Nehal Mohamed , Elfattah Afify Ahmed Abd 
Published: October 2021

Abstract
Vitiligo is a disease that causes the loss of skin color in patches due to loss of melanin pigmentation of specific areas of the skin. Although several hypotheses have been proposed, the leading theory is still the auto-immune etiology linked to specific genetic mutations. Vitiligo can also be associated with several autoimmune diseases. There is no curative treatment for vitiligo but, several treatment modalities are considered. Topical therapies like steroids and Calcineurin inhibitors are of popular use in clinical settings also, steroids can be administered systemically in vitiligo patients. Physical therapies as fractionated CO2 (Fr: CO2) laser and Narrowband-UV (NBUV) phototherapy represent a gold standard in treatment in clinical practice. Moreover, intralesional therapies are emerging, one of which is autologous platelet-rich plasma injection.

Aim of the study
This study aimed to evaluate and compare the efficacy and safety of Fr: CO2 laser, PRP, combined Fr: CO2 laser and PRP, combined Fr: CO2 laser and NB-UVB, combined Fr: CO2 laser, PRP and NB-UVB in the treatment of vitiligo as well as reporting the side effects.

Patients and methods
This study included 20 vitiligo patients with at least 6 patches of stable vitiligo (120 patches), the patches were divided into six groups according to the treatment modality. Assessment of treatment response was done through patient satisfaction score and Vitiligo analysis by computer-assisted grid (VACAG).

Results
Regarding surface area reduction in included patients, fractional CO2 laser achieved the best results followed by triple combination therapy (CO2 with PRP and NB-UVB), the least response was with CO2 with PRP treatment. Patient satisfaction in the current study had a different outcome, PRP treated patients exhibited the highest satisfaction scores while triple combination treated group showed the least satisfaction scores.
Therapeutic Effect of Superficial Cryotherapy versus Intralesional Corticosteroids injection in Alopecia Areata
Authors: El-dissouki Ibrahim Nour , Elsayed Mahira Hamdy , Abdel-Fattah Afify Ahmed 
Published: October 2021

Abstract
Alopecia areata, one or more round bald patches appear suddenly, most often on the scalp. It can affect males and females at any age. It starts in childhood in about 50%, and before the age of 40 years in 80%. The exact mechanism is not yet understood. There is not yet any reliable cure for alopecia areata. Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Their role and efficacy are unknown. Injections of triamcinolone acetonide 2.5–10 mg/ml into patchy scalp, its efficacy is temporary. Oral and pulse intravenous steroids in high dose can lead to temporary regrowth of hair. The sensitisers diphenylcyclopropenone provoke hair growth in treated areas
Now, superficial cryotheray is introduced as a possible treatment for Alopecia Areata. With minimial side effects and being less painful. So, this study clarifies the therapeutic efficacy and safety of superficial cryotherapy for treatment of patchy Alopecia areata.

Aim of the study
The aim of the study is to evaluate and compare the efficacy and safety of Superficial Cryotherapy and Intralesional corticosteroids in the treatment of patchy Alopecia Areata.

Patients and methods
study included 20 patients complaining of Alopecia Areata. 3 patches of scalp alopecia areata will be randomly subjected to either superficial cryotherapy twice monthly for 3 months (3 cycles, 2-3 seconds) or intralesional steroid injections once monthly for 3 months (triaminoclone acetonide 1:7, 1ml) or intralesional saline (1 ml). Assessment for the response to treatment will be done at one month and three month following treatment by digital photography and by phototrichogram by comparing number of Terminal, and vellus and hair thickness, Also assessment for side effects of therapy will be done.

Results
Patients treated with TCA showed statistically significant high response compared to patients treated with cryotherapy. Also, side effects assessment showed minimal side effects with treatment with TCA compared to cryotherapy.

Conclusion
TCA treatment of alopecia areata is much tolerable than treatment with cryotherapy with also better response rates.
Folliscope Assessment of Lyophilized Growth Factors Scalp Injection in Androgenetic Alopecia
Authors: El Samahy May Hussein , Fahmy Hossam Mostafa , Mostafa Azza Esmat , El Sawaf Samar Ibrahim Salama 
Published: October 2021

Abstract

Background
Androgenetic alopecia (AGA) is a non-scarring disease with a progressive thinning of the scalp hair that follows a characteristic pattern. It is the most common form of alopecia, affecting up to 80% of men and 50% of women in the course of their life.

Objectives
The aim of this study is to evaluate the possible clinical benefit of lyophilized platelet derived growth factors(L-GF) locally injected in cases of AGA.

Patients and Methods
The present pilot study included 20 female patients with AGA. Patients were recruited from the outpatient clinic of Ain Shams University Hospital, in the period at the period from September 2018 till March 2019. The study was approved by the Research Ethical Committee, Faculty of Medicine, Ain Shams University and fulfilled all the ethical aspects required in human research.

Results
Treatment with L-GF resulted in improvement of AGA patients with minimal side effects.

Conclusion
Lyophilized platelet derived growth factors (L-GF) injection for AGA could represent new therapeutic option for delivering platelet growth factors. As a pilot study, the sample size of this work was small, despite the fact that we had statistical significant results. Further randomized wide scale comparative studies between conventional autologous PRP and L-GF are demanding to draw concrete results.
Evaluation of Endoscopic Transnasal versus Non-endoscopic Routes as Surgical Treatment of Cerebrospinal Fluid Rhinorrhea
Authors: Farrag Mohamed Ashraf Mohamed , Samnni Talaat Ali Hassan El , Ezz Tamer Abdul Wahab El Sabri Abou El , Sayed Mohamed Naguib Mohamed El 
Published: October 2021

Abstract

Introduction
Cerebrospinal fluid (CSF) leak happens when there is an abnormal connection between the brain cavity inside and environment outside. It is important to establish a good barrier between the brain tissue and the nose to prevent cerebrospinal fluid leak and protect the brain from exposure to infection. which can be done either by endoscopic or non-endoscopic surgical repair.

Patients and methods
The aim of this work is to evaluate the effectiveness of endoscopic and non-endoscopic repair of CSF leakage in patients suffering from CSF rhinorrhea. The search retrieved 1693 unique records. We then retained 89 potentially eligible records for full-texts screening. Finally, 11 studies (Total No. of patients = 355) were included in the present systematic review and meta-analysis.

Results
CSF rhinorrhea resolved in endoscopic surgery group giving a success rate of 88.8%to 100%. recurrence rate is 2% to 12.2% and postoperative complications occurred in 5% to 16.7%.

Conclusion
The endoscopic approach is highly effective, better than non-endoscopic route and is associated with low morbidity for the management of CSF rhinorrhea .