bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endovascular Laser Therapy versus Open Surgery for the Treatment of Primary Varicose Veins of the Lower Limb
Authors: Mohamed Hazem Abd Elsalam , Wahba Assist. Prof. Dr. Ramez Mounir , Fawzy Fawzy Salah , Gebrael Beshoy Maher Yacoub 
Published: October 2021

Abstract

Background
Venous drainage of the lower extremities is accomplished by a network of superficial veins connected to the deep veins by small perforator veins. Through a variety of pathophysiological mechanisms, weakness develops in the vein wall that results in varicosity over time. Varicosities typically form in the greater and lesser saphenous veins but also develop in branch vessels. Obstruction of the iliac veins or inferior vena cava can result in extensive varicose veins

Objective
s: The aim of this work is to compare the outcome of endovascular laser therapy versus open surgery in management of primary varicose veins in lower limb.

Patients and Methods
Type of study is a prospective, randomized, clinical study. This study was conducted on 30 patients with primary varicose veins of the lower limb, 15 patients were subjected to endovascular laser therapy for treatment of varicose veins of the lower limb (EVLA group) and 15 patients were managed by standard open surgery for treatment of varicose veins of the lower limb (surgery group). The patients were randomized selected from surgery clinic in Eldemerdash Hospital. The work was carried out in the period from June 2017 to December 2018.

Results
Both groups were well matched regarding age(P = 0.352) and sex (P = 0.713), type of vein diseased(P = 0.913), CEAP classification (P = 0.910) and also regarding BMI (P = 0.761). Regarding preoperative venous clinical severity score, the median(IQR) for group A (surgery group) was (5), and for group B (laser group) was (5) without statistical significant differences between both groups (P value =0.524). Many studies have shown that there was some difference in between two methods of treatment of primary varicose veins of the lower limbs open vascular surgery and endovascular laser therapy. Regarding Six weeks post-operative VCSS assessment, the VCSS score in the surgery group was statistically significantly higher (p &lt; 0.001). However, at one and two years after the intervention The VCSS scores converged and the difference between the groups was no longer statistically significant.

Conclusion
The presented results show that intreatment of varicose veins with both endovascular laser ablation and open surgery there was improvement in the clinical status of the patient occur after both but EVLA was more effective early which was observed by measuring venous clinical severity score. EVLA show distinct advantages over open surgery especially in post operative pain, analgesia use and time needed to return to work.
Comparison between Crystalloid Versus Colloid in Septic Shock
Authors: Amer Mohamed Ahmed Mahmoud , Eskander Moheb Shraby , Ryad Fady Markos 
Published: October 2021

Abstract

Background
Fluid resuscitation is a critical component to the emergency department (ED) management of patients with sepsis and septic shock. Fluids are administered to patients with sepsis in order to augment cardiac output and improve tissue perfusion and oxygenation. Recent evidence has suggested that the composition of fluids used in sepsis resuscitation may affect patient-centered outcomes.

Objective
To systematically review the effects of colloids compared with crystalloids in fluid resuscitation for septic shock.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2017.

Data Extraction
If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures.

Conclusion
In contrast to 0.9% NS, balanced crystalloid solutions contain significantly lower concentrations of chloride. Instead of large amounts of chloride, balanced solutions contain organic anions (i.e., lactate, gluconate, citrate, acetate) which act as physiologic buffers and are rapidly converted to bicarbonate upon administration. In addition, balanced solutions have less of an adverse effect on acid-base equilibrium than 0.9% NS. Balanced solutions also contain varying amounts of cations (i.e., potassium, calcium). Many critically ill patients across the world receive HES solutions for resuscitation. HES solutions are defined by their molecular weight and degree of hydroxyethylation. Recent evidence has demonstrated significant harm with the use of HES solutions. The administration of albumin in the critical patient is not associated to demonstrated adverse effects, though it should be reserved for specific patient groups in which it has been shown to offer benefit.
Comparison between Early Results of Laparoscopic Mini Gastric Bypass and Sleeve Gastrectomy regarding Weight Loss, Remission of Type II Diabetes Mellitus and Hypertension
Authors: Kayal Awad El , Elsadek Hossam , Ebrahim Mohamed , El din Ebrahim El Ghamrawy Mohamed Salah 
Published: October 2021

Abstract

Background
Bariatric Surgery leads to a dramatic improvement in morbid obesity and associated type 2 Diabetes Mellitus (T2DM) and hypertension.

Objectives
The aim of the study was to compare between early results of Laparoscopic Mini Gastric Bypass and Sleeve gastrectomy regarding excess weight loss, remission of Type II diabetes mellitus and hypertension.

Patients and Methods
Type of the study, retrospective study. study setting, Our study was carried out at The General Surgery Department Ain Shams University Hospitals. study period,. All cases were operated during the period February and march 2019. Follow up of patients 6 months after operation was done (retrospective study). Last follow up was done on September 2019. The study included 50 patients aged 18-60 years with Type II Diabetes Mellitus and hypertension of at least 6 months duration, BMI 35 65 kg/m2 for at least 5 years.

Results
In this study There was no statistical significant difference between studied groups as regard age,gender,and baseline clinical data.
there was a statistical significant difference between patients in LMGB group as well as between patients in LGS group before and six months after surgery as regard weight in kg, BMI and HbA1C and.remission of hypertention (P value 0.000).
there was high statistical significant difference between studied groups as regard percentage of change of weight and BMI(P value 0.000) However, there was no statistical significant difference between studied groups as regard percent of change of HbA1C. (P value 0.613),remission of T2DM.(p value 0.123 ) and control of hypertension. (p value 0.136 ). Further results and data could be reached on long-term follow up of patients involved in this study.

Conclusion
Patients receiving mini-gastric bypass had more advantageous indexes than patients receiving sleeve gastrectomy, such as higher six months EWL% (excess weight loss), higher T2DM remission rate and higher hypertension remission rate. Especially on long term follow up and that was proved by meta analysis of previous studies but on short term follow up there is no statistical singnificant difference between both studied groups except in percentage of change of weight and BMI.
Mini-gastric bypass is simple, safe and more effective bariatric procedure than laparoscopic sleeve gastrectomy.
Prospective study to evaluate the value of Identification of nerves crossing inguinal canal during inguinal mesh hernioplasty
Authors: Abdraboh Ayman Abdullah , Hafez Ramy Fouad , Abozeid Mohammed Elsayed Youssef 
Published: October 2021

Abstract

Background
Long-term morbidity associated with open inguinal hernia repair mainly consists of postoperative chronic pain. The mechanism responsible for the development of this postoperative pain is thought to be the entrapment, inflammation, and fibrotic reactions of the nerve around the mesh.

Aim of the Work
To analyse and provide comprehensive data on their incidence (identification rates), anatomical characteristics, and possible sources of heterogenecity, to decrease the risk of iatrogenic injury/ entrapment to these nerves during inguinal hernioplasty.

Patients and Methods
This study identified 40 patients who underwent inguinal hernia repairs with either routine repair or nerve identification and preservation. As several studies point out, a nerve-recognizing procedure is a logical step for minimizing postoperative groin pain. Such an approach can be advocated for two reasons: identification of the nerves for preservation or for performing standard neurectomy in case of interference with the position of the mesh.

Results
In the present study, there was no difference in pain scorings at one or 3-months after repair between different surgical techniques in patients undergoing open repair of a primary inguinal hernia. In present work, in addition to identifying and preserving all neural structures, specific maneuvers have been adopted for preventing postherniorrhaphy inguinodynia

Conclusion
The results indicated that routine nerve identification and preservation was associated with a significantly lower incidence of postoperative neuralgia compared with no nerve identification.
Cognitive function in elderly patients with Chronic Kidney disease
Authors: Elgazzar Yumna A , Mahmoud Ramy M , Kamel Heba Y , Abdel Rahman Tomader T , Sweed Hala S 
Published: October 2021

Abstract

Background
Many elderly patients with Chronic Kidney disease (CKD) develop cognitive impairment and dementia. Cognitive impairment impacts CKD patients negatively by functional dependence and recurrent hospitalization. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery was originally developed to identify early Alzheimer’s disease, but it has become a widely used instrument to assess different levels & domains of cognitive and executive functions.

Aim
the aim of the study was to assess cognitive function in elderly patients with CKD.

Patients and Methods
one hundred CKD patients were recruited from outpatient clinics of Ain Shams University hospital. CERAD neuropsychological battery was used to measure cognitive functions in different domains (language functions, verbal learning, visuospatial functions, delayed recall, memory consolidation, recognition memory, and executive functions).

Results
CKD patients had low mean verbal fluency and mean MMSE while language functions score hadn’t been affected. There was a significant positive correlation (p &lt; 0.001) between the mean eGFR and the CERAD total score.

Conclusion
This study contributes to the belief that an association exists between renal impairment and cognition, CERAD total score in CKD patients was inversely correlated to eGFR. Age and educational level significantly affect cognitive performance.
Histological Study on the effect of losartan in healing of an experimentally induced muscle laceration in adult male albino rat
Authors: Eltantawy Eman Hamdy Badr , Abdeltawab Salwa Mohamed , Salam Nevert Farid Abd El , Bahaa Nevine 
Published: October 2021

Abstract

Background
Skeletal muscle injuries are frequently encountered in athletes and military personnel. Incomplete functional recovery of these injuries usually occurs due to fibrosis of the skeletal muscle. Recently, oral administration of losartan antihypertensive drug was claimed to have a role in improving skeletal muscle healing, but still to be furtherly investigated.

Aim of the work
This work aimed to assess the healing effect of losartan on the histological structure of induced lacerated skeletal muscle fibers of adult male albino rats.

Material and Methods
Forty male albino rats were used in this study. They were divided into three groups: Group I: served as a control group and included 15 adult rats. Group II (muscle laceration group): consisted of 15 rats that were subjected to muscle laceration injury. They were subdivided into subgroup IIa: consisted of five rats that were sacrificed one day after injury, subgroup IIb: it included 10 rats that were left for spontaneous recovery for two weeks after injury. Group III (losartan-treated group): it consisted of 10 rats that were subjected to muscle laceration injury then they received oral losartan from day three till end of experiment. All rats, except rats of subgroup IIa, were sacrificed two weeks after injury. Right gastrocnemius muscle specimens were taken and processed for light microscopic examination by H & E and Masson's trichome stains as well as morphometric and statistical analysis.

Results
In group II, there was almost complete affection of myofibers at site of injury after 1 day of induced laceration in the form of myofibers fragmentation, disorganization and distortion with apparent mononuclear cellular infiltration mainly neutrophils and macrophages. After 2 weeks some myofibers were seen distorted and ended abruptly into connective tissue, others were branched with unclear striations. Mononuclear cellular infiltration between myofibers and apparent dilated blood vessels at laceration site were also noticed. A significant increase in collagen fibers deposition between regenerating muscle fibers (p&lt;0.05) was also demonstrated. Treatment of the muscle laceration by losartan in group III showed apparent partial improvement in the form of significant decrease in collagen fibers deposition (p&lt;0.05) and apparent decrease in mononuclear cellular infiltration as compared to that of group II. Also, some of the regenerated myotubes were noticed with chains of central nuclei.

Conclusion
Excess collagen fibers deposition between myofibers hinders regular arrangement of generating myotubes. Losartan might enhance muscle regeneration through decreasing collagen fibers deposition. However, it needs longer duration to assure complete muscle healing.
Isolation and Characterization of Female Rabbit Periosteal Derived Progenitor Cells
Authors: Hammouda Gehad Ahmed Ahmed , El-Samad Abeer Abd El-Mohsen Abd , Al- Khalek Ali Hadwa Ali Abd , Hassan Manal Ashour Mohammed 
Published: October 2021

Abstract

Background
Periosteum is a specialized highly vascularized connective tissue that is formed of an external fibrous layer containing collagen fibers and micro vessels and an inner cambium layer that facing the bone. Cambium layer includes periosteum derived progenitor cells (PDPCs) which have osteochondrogenic potential both in vitro and in vivo and act as major players in bone development and fracture healing. Periosteum derived progenitor cells display properties of mesenchymal stem cells (MSCs), including clonogenicity, phenotypic marker expression, and ability to differentiate into osteoblasts, chondrocytes and adipocytes. So, they are recognized to be essential for the initiation of bone graft healing and remodeling, but their clinical application is still limited due to inaccessibility. The aim of the present study is isolation, culture and characterization of rabbit’s PDPCs.

Methods
twenty-five adult female rabbits were used to harvest periosteal samples. Cell cultures were obtained by migration of cells from periosteal fragments (explant culture). Immunostaining of the cells of PDPCs in subculture (third passage) was performed.

Result
On day three of primary culture, the PDPCs were not started to migrate from the periosteal explant edges. However, on day six of primary culture, few spindle PDPCs cells appeared at the edge of explant. on day 20 of primary culture, PDPCs were mostly confluent ( about 9095%) . Immunostaining of PDPCs in subculture (third passage) showed positive brownish reaction of the branched cells for CD105 and CD44 and negative immune reaction for both CD34 and CD45.

Conclusion
The current study yielded isolation and cultured of female rabbit Periosteal derived progenitor cells. Periosteal derived stem cells are display properties of mesenchymal stem cells (MSCs), including clonogenicity, phenotypic marker expression.
Histological study of an experimentally constructed decellularized rat lung as a model of whole organ three-dimensional natural scaffold
Authors: Abdelsayed Marium Romany , Atalla Suzi Sobhy , Megahed Gehan Khalaf , Zeid Asmaa Abd El-Monem Abo 
Published: October 2021

Abstract

Introduction
With the increase of end stage lung diseases and the great problems facing lung transplantation tissue engineering become a promising solution. The first step in lung engineering is to obtain a 3D Extracellular matrix lung scaffold via decellularization. Decellularization aims to remove cells from tissue ultrastructure while preserving the mechanical and biological properties of the tissue. Intact ECM provides critical cues for differentiation and migration of cells that are seeded onto the organ scaffold.

Objectives
This study aimed to obtain an intact and well-preserved ECM lung scaffold by decellularization of rat lungs.

Methods
Decellularization of lungs of ten Wistar rats was achieved by perfusing detergents through the pulmonary artery. The resultant scaffolds were fixed and analyzed histologically.

Results
It was found that the decellularization process effectively removed the cellular and nuclear material while retaining native the 3D ECM of lung tissue. The architecture of the collagen and elastic fibers networks were preserved as comparable to the native lungs. Furthermore, the basement membranes of the bronchiolar and interalveolar septa were intact.

Conclusions
This methodology is expected to allow decellularization of human lung tissues and permits future scientific exploration in tissue engineering.
Serum Osteopontin and its Relation to Colorectal Carcinoma in Egyptian Patient
Authors: Mostafa Mohamed Abd Elmoghny , Kayser Hany Haron , Allam Ahmed Samir , Saeed Hakim Abanoub Refaat 
Published: October 2021

Abstract

Background
Colorectal cancer had a low incidence several decades ago. However, it has become a predominant cancer and now accounts for approximately 10% of cancer-related mortality in western countries. The ‘rise’ of colorectal cancer in developed countries can be attributed to the increasingly ageing population, unfavourable modern dietary habits and an increase in risk factors such as smoking, low physical exercise and obesity.

Objectives
The aim of this study to evaluate the role of serum level of osteopontin in prediction of Colorectal Carcinomain in correlation with tissue histopathology which it is the gold standard test in Egyptian patient.

Patients and Methods
The study was a Randomized controlled clinical trial. Which is a prospective, random, clinical trial conducted at Ain Shams University Hospitals at endoscopic unit on patients who refered for colonscopy. This study was conducted on 80 patients who were divided into 2 groups: Group A: 40 patients diagnosed as Colorectal Carcinoma as a patient group, Group B: 40 patients with age and sex matched control group who have normal colonscopy.

Results
There was statistically significant difference between CRC patients and normal colonscopic patients regarding the level ofosteopontin being higher in CRC patients (P value = 0.000). Also ROC curve for osteopontin in prediction of CRC showed the best cut of value &gt;12 ng/ml with area under the curve (AUC) = 0.889, sensitivity =85%, specificity =77.5% with positive predictive value =79.1%

Conclusion
Serum Osteopontin (OPN) level is higher in patients with CRC than patients with normal colonscopy, so it can be used as a diagnostic marker for HCC.
Relation between Vitamin D deficiency and the Occurrence of Knee Osteoarthritis and Its Severity
Authors: Hafez Eman Ahmed , Ahmed El-Azizi Noran Osama , Mohammed Naglaa Affify , Fetouh Eisa Ahmed Abdelnasser 
Published: October 2021

Abstract

Background
Vitamin D is important to normal bone and cartilage metabolism. Insufficient concentrations of vitamin D adversely affect calcium metabolism, osteoblastic activity, matrix ossification, bone density, and articular cartilage turnover. Osteoarthritis (OA) is a degenerative joint disease involving the cartilage and many of its surrounding tissues. In addition to damage and loss of articular cartilage, there is remodelling of subarticular bone, osteophyte formation, ligamentous laxity, weakening of periarticular muscles, and, in some cases, synovial inflammation. Pain is the major clinical symptom in knee OA joint.

Objective
To estimate a relation between Vit.D deficiency and the severity of knee osteoarthritis.

Patients and Methods
This study was a cross sectional study conducted on ninety (90) patients diagnosed (aged 40-55 years old) with knee osteoarthritis according to according to American college of rheumatology (ARC) criteria 2016 for diagnosis of OA. Patients were recruited from the Rheumatology Outpatient Clinic and Internal Medicine and Rheumatology Department at Ain Shams University Hospitals.

Results
Our studied cases show that VAS pain score ranges from 3–7 with a mean 4.70 ± 0.93 and median 4. As regard pain domini of WOMAC, it had significant relation with Vit D significant (p value = 0.007) while VAS Pain Score not significant related to Vit D (p value = 0.121). In current study, the correlation between stiffness and Vit D is statistically significant (p value =0.001), the correlation between physical function and Vit D is statistically significant (p value = 0.001), the correlation between WOMAC score and Vit D was statistically significant (p value = 0.001) As regard relation between Vit. D and X-Ray Kellgran-Lawrence system, it was significant in grade 1and grade 3. But it was non-significant n grade 2 &4.

Conclusion
This study has demonstrated a significant association between knee OA and vitamin D deficiency and corresponding with the development of knee cartilage damage. As Low levels of vitamin D may not play a critical role in OA pathogenesis and progression.
Outcome of Direct Acting Antiviral Drugs (DAADs) for Hepatitis C Virus (HCV) in the Setting of Chronic Kidney Disease (CKD) in Upper Egypt
Authors: El Monem Hassan Ahmed Abd , Sarhan Iman Ibrahim , Abd El Gawad Mostafa Abd Elnasier , Mostafa Ali Mohamed 
Published: October 2021

Abstract

Background
The frequency of hepatitis C virus (HCV) infection remains high in patients with chronic kidney disease (CKD) and plays a detrimental role in mortality in this population, Patients on maintenance dialysis remain at risk of acquiring hepatitis C virus (HCV) infection and the prevalence of anti-HCV seropositive patients undergoing long-term hemodialysis is significantly greater than in those with normal kidney function.

Aim and objectives
the aim of the study was to assess outcomes (efficacy, side effects, and possible complications) of DAADs for HCV in presence of CKD,

Subjects and methods
this was retrospective cohort study that was conducted at Aswan Fever Hospital and Luxor fever hospital for anti HCV therapy between Jan 2018 and July 2018 including 60 patients with all stages of CKD whom receiving DAADs were be recruited from both Aswan fever hospital and Luxor fever hospital,

Results
the results revealed that Patient’s PC (%) in patients from Aswan was ranged between 61-100 with mean±S.D. 83.09±9.258 while in patients from Luxor was ranged between 66-100 with mean±S.D. 84.95±6.764. There was no statistically significant difference between groups where P = 0.458, Patient’s HCV PCR in patients from Aswan at baseline show that all patients were positive while after 3 months 27(90%) were negative and 3(10%) were positive and after 6months all patients were negative while in patients from Luxor all patients were positive while after 3 months 28(93.3%) were negative and 2(6.7%) were positive and after 6 months all patients were negative. There was no statistically significant difference between groups

Conclusion
Treatment with newer DAAs is effective and safe for the treatment of HCV-infected chronic kidney disease patients,