bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long Term Follow Up of Biatrial Function after Transcatheter Closure of Atrial Septal Defect
Authors: Khaled Amr , Tarek El-Sayegh Aya , Ezz eldin Dina Adel , Roushdy Alaa Mahmoud 
Published: November 2024

Abstract

Aim and Objectives
The aim of the study is to evaluate long term right and left atrial function using volumetric analysis and strain indices in patients who underwent transcatheter atrial septal defect (ASD) device closure more than 3 years ago.

Patients and Methods
This study included a group of 40 patients diagnosed with ASD who came for regular follow up at congenital heart disease clinic and another group of 40 healthy controls (age and sex matched). Basic transthoracic echocardiographic examination was done to both groups followed by assessment of atrial function using modified simpson’s method to measure right and left atrial volumes and 2D speckle tracking technique to assess biatrial strain in the three different phases (reservoir, conduit and contractile strain).

Results
In our study the results showed that there is no significant difference between the patients group and control group regarding volumetric analysis. Regarding left atrial (LA) strain values, there was no difference in reservoir and conduit strain while contractile strain was significantly lower in the patients group (p- value=0.047). On the other hand, all right atrial (RA) strain values were significantly lower in the patients group than control group (p-value&lt;0.05). A subgroup analysis based on age at closure showed that patients underwent closure at age less than 15 years old had significantly higher strain values for all right and left strain indices compared to those who underwent ASD closure at age of 15 years old or older.

Conclusion
ASD closure at earlier age is associated with better outcomes regarding atrial function. Long term follow-up in patients who underwent ASD closure more than 3 years ago showed similar LA strain values to control except for lower contractile strain while RA strain values were significantly lower in the patients group. Patients who underwent closure at age less than 15 years old had almost normal right and left strain values while those who underwent closure equal to or more than 15 years old had impaired strain values. Earlier closure is associated with better reverse remodeling and atrial function can turn into normal in patients treated earlier.
Impact of Successful Antegrade & Retrograde CTO PCI on Short Term Prognosis
Authors: Etriby Khaled A El , Okasha Nireen K , Mohamed Tarek R , Zahran Mohamed E 
Published: November 2024

Abstract

Background
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) carries risk of complications and should be attempted when the anticipated benefits exceed the potential risks. The primary indication for CTO-PCI is symptom improvement. However, the impact of CTO PCI on angina and subsequent incidence of major adverse cardiovascular event (MACE) rate remains controversial.

Objective
Our aim was to study the impact of the antegrade and retrograde approaches for elective CTO PCI on the procedural success rate & short-term MACE.

Patients and Methods
The current study was a prospective cohort study that included a total of 80 patients who were referred to our center (Ain Shams University Hospitals) for elective CTO PCI and underwent technically successful CTO PCI. Data was collected on patient arrival to our department and then the patients were observed during hospital admission to record any In-Hospital MACE. These patients were then followed up for 6 months to record improvement or worsening of their symptoms and to assess occurrence of any MACE including hospitalization and undergoing symptom driven coronary angiography.

Results
The mean age of our patients was 56±9.6 years and 91% of the patients were men. Seventy- seven % of patients were done via an ante-grade approach and 23% were done via a retro-grade approach with an overall procedural success rate of 91.25% (Antegrade 93.5%, Retrograde 83.3%). The overall mean procedure time was 102 minutes, the mean contrast volume used was 371 ml and the mean cumulative Air Kerma dose was 7.2 Gy. The retrograde group required longer procedure times, larger volumes of contrast and higher exposure to radiation. The overall in-hospital MACE was 8.75%. 81.25% of patients in our study showed an improvement in the grade of their exertional dyspnea or angina within the 6-month follow-up period. 16.25% of patients in our study needed re-hospitalization within a 6-month period after PCI. The overall Target lesion re-vascularization rate at 6 months was 8.75%. Three out of the 7 patients (42.86%) who suffered from in-hospital MACE developed another Major adverse cardiac event during the 6 months follow up period. This was a higher percentage than the patients who did not suffer from in-hospital MACE and was statistically significant.

Conclusion
Technically successful CTO PCI in a well-equipped center with highly qualified CTO operators resulted in high procedural success rates and low incidence of short-term MACE.
C-Reactive Protein to Albumin Ratio as a Marker of Atheromatous Plaque Instability in NSTE-ACS
Authors: Mohamed Abulnasr Mahmoud Khairy , Atteya Amr Adel Alsayed , Ellias Ramy Raymond , Abdalla Iskandar Mina Magued 
Published: November 2024

Abstract

Background
Acute coronary syndrome (ACS) can be divided into subgroups of ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. ACS carries significant morbidity and mortality and the prompt diagnosis, and appropriate treatment is essential. The current 2018 clinical definition of myocardial infarction (MI) requires the confirmation of the myocardial ischemic injury with abnormal cardiac biomarkers.

Objective
to assess correlation between C-reactive protein to albumin ratio (CAR) as a marker of instability of atheromatous plaque and the extent of CAD and the presence of coronary ectasia as a secondary endpoint.

Methods
This is a Case control Study that included one hundred patients who presented to Ain Shams University hospitals.

Results
CAR was higher in patients group than in control group with a highly significant relation with p – value 0.000. CAR was correlated to syntax score revealing a highly significant correlation with p –value 0.000. There was no statistical significance between CAR and coronary ectasia. CAR is superior to albumin in detecting the patient group, but not superior to CRP.

Conclusion
CAR was found higher in the patient group than in the control group suggesting its potential use as a marker of atheromatous plaque instability. CAR can serve as a marker of Coronary artery severity as it was observed that patients with higher SS also had higher CAR levels.
Effect of Empagliflozin on No-Reflow in Patients with ST Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Authors: Nasef Mostafa Ayman , Saber Mohamed , Kamal Diaa , Gomaa Yasser 
Published: November 2024

Abstract

Aim and Objectives
To Assess the effect of Empagliflozin preloading in non-diabetic STEMI patients before PPCI on procedural, in-hospital outcomes and short-term MACE in a single tertiary center.

Patients and Methods
The study was carried out on 200 non-diabetic STEMI patients presenting to Ain Shams university hospitals within the first 8 hours of symptom onset. Patients were randomised into 2 groups, the intervention group received 10mg Empagliflozin before primary percutaneous coronary intervention (PPCI)with the standard medical therapy while the control group received only the standard medical therapy. Patients were assessed for demographic data, risk factors, procedural outcomes, clinical and in-hospital outcomes, and short-term MACE up to 1 month.

Results
Our study found a significant difference between the intervention and control groups regarding contrast volume with a mean of 131 ml in intervention group and 144 ml in control group with a p value of 0.009, incidence of no-reflow with 34.5% in the control group and only 18.2% in the intervention group and a p value of 0.014, myocardial blush grade were 84.1% of the patients in intervention group showed MBG III while only 65.5% of the patients in the control group showed the same results with a p value of 0.019, St-segment resolution post PCI as 59.1% had complete ST segment resolution and only 39.1% in the control group with a p-value of 0.027, and total Major Adverse Cardiovascular events (MACE) in the first month affecting 44.8% of the patients in the control group and only 28.4% in the intervention group with a p- value of 0.024.

Conclusion
Our study showed that pre-loading of STEMI patients with Empagliflozin resulted in improvement in procedural outcomes, decreasing the incidence of coronary no-reflow, improvement in patient’s course during hospital stay and short-term MACE. Improvement in MACE was mainly due to reduced HF hospitalisations and anginal symptoms.
Effect of Cardiac Rehabilitation Program on Left Ventricular Systolic Function in Patients with Breast Cancer Receiving Anthracycline-Based Chemotherapy Using Two-Dimensional Speckle Tracking Echocardiography
Authors: Mahmoud Sarah M , Hasanen Adel G , Elias Ramy R , Shabana Adel M , Abdelhady Ahmed K 
Published: November 2024

Abstract

Background
Anthracyclines used in the treatment of breast cancer are known for their cumulative cardiotoxic effect, which remains a limiting factor. Cardio-oncology rehabilitation (CORE) is an new concept which aims to simultaneously decrease the risk of CVD and improve cardiopulmonary fitness among cancer patients during and after treatment. Two dimensional speckle tracking echocardiography is a promising technique for the early detection of nonclinical cardiotoxicity.

Objective
to determine the Effect of cardiac rehabilitation program on Left Ventricular systolic function in patients with breast cancer receiving Anthracycline based chemotherapy using two-dimensional speckle tracking echocardiography

Patients and Methods
The current study is a prospective, randomized, single-blind trial that included a total of 100 female patients with newly diagnosed breast cancer who received anthracycline-based chemotherapy. Patients were randomly assigned in a 1:1 ratio into two groups, the study group (Group 1) in which patients were allocated cardiac rehabilitation program in addition to their regular chemotherapeutic drugs and the control group (group 2) in which patients received chemotherapy. A comprehensive echocardiographic examination was performed to all patients before receiving the chemotherapy and at 3 and 6 months after, assessment of LV- Global longitudinal strain was done by 2D- speckle tracking echocardiography.

Results
The mean age of patients assigned to the Group 1 was 49.10 ± 9.31 years, while patients assigned to the Group 2 had a mean age of 52.20 ± 7.07 years, both groups were similar in demographic data, baseline clinical characteristics and Echocardiographic Data. At 3 months, no significant difference was found in
Left Ventricular Global Longitudinal Strain and H2FPEF Score in Chronic Kidney Disease Patients with Preserved Left Ventricular Ejection Fraction
Authors: Sallam Tarief O , El-Demerdash Salah Eldin H , El-Kilany Wael M , Hassan Mohamed S , Bastawy Islam M 
Published: November 2024

Abstract

Background
Cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD). Although they have mostly normal left ventricular systolic functions using conventional echocardiography some of them develop symptoms of heart failure with preserved ejection fraction (HFpEF) (Dubin et al, 2017), (Edwards et al, 2008).

Objective
This study aims to assess left ventricular global longitudinal strain and H2FPEF score in chronic kidney disease patients with preserved left ventricular ejection fraction.

Patients and Methods
The current study was a prospective study that included a total of 100 patients who were referred to our center (Ain Shams University Hospitals) nephrology clinic. Data was collected on patient arrival to our hospital and then echocardiography including LVGLS was done to all patients. All clinical and echocardiographic data were utilized do assess HfPEF probability using H2FPEF score.

Results
The mean age of our patients was 43.2±15.7 years and 58% of the patients were men. Ninety- five % of patients were hypertensives with more than 94 % receiving two or more anti-hypertensive medications while atrial fibrillation was found in 30% of the patients. Dialysis patients (stage Vd CKD) represented 52% of patients while stage III CKD represented 43% of patients. The patients’ hemoglobin ranged from 9-13.5 gm/dl with mean 10.415 ± 1.259. According to H2FPEF score, 29 (29%) patients had high probability to have HFpEF. Left ventricular Global longitudinal strain (GLS) in 54 patients was less negative than -16 (65.85%). Global longitudinal strain GLS showed positive correlation with H2FPEF score r = 0.406, P-value &lt;0.001. Figure 1

Conclusion
Chronic kidney disease is strongly associated with reduced global longitudinal strain and with high probability of HFPEF.
Bronchial Bacterial Colonization in Patients with Lung Cancer
Authors: Saad Melegy Amira Sabry , Madkour Ashraf Mokhtar , Elhady Elkady Mona Ahmed , Mahmood Ali Ibraheem Yasmeen Mohammad 
Published: November 2024

Abstract

Background
The first step in bacterial respiratory tract infection is bacterial colonization of the lower respiratory tract. The lower respiratory tract is sterile in contrast to the gastrointestinal tract. This sterility is maintained through a variety of mechanisms that counteract bacterial adherence and virulence factors and once overwhelmed bacterial colonization and infection occurs. The clinical course of lung cancer is often complicated by lung infections proved in 84% of cases.

Objective
to evaluate the prevalence and nature of bronchial bacterial colonization in patient with primary lung cancer at time of diagnosis.

Methods
This prospective cross-sectional study was performed on a total of 69 consecutive patients with suspected lung cancer during study duration from December 2022 to June 2023 referred to our bronchoscopy unit at chest department-Ain Shams University for diagnostic bronchoscopy.

Results
In 26 (52%) of 50 patients no bacterial growth was found in the bronchial tree. In four cases (8%), potentially pathological bacteria were cultured but their number was &lt; 104 cfu/ml. In 20 (40%) cases, the colonization of potentially pathogenic bacteria was ≥ 104 cfu/ml. most common organisms were Gram-negative. The most frequently was pseudomonas (n = 15), and in the second group klebsiella (n = 5). In three cases (61%) the bronchial tree was colonized simultaneously by two types of micro-organism.

Conclusion
The current study found that 48% of patients with lung cancer are colonized by potentially pathogenic bacteria during their initial bronchoscopy work up. The dominant organisms colonizing the lower respiratory tract were gram negative bacteria and in which 40% of bronchial bacterial colonization had a cut-off level ≥104 CFU/ml. Oldest and COPD patients have higher risk of colonization. However, additional studies are suggested to further examine the clinical impact of bronchial colonization on lung cancer patients outcomes as regards infection rate and survival.
Comparison between Ultrasound Guided Pleural Biopsy and Thoracoscopy in Diagnosis of Exudative Pleural Effusion
Authors: Mansour Mona A , Ali Eman R , El-maraghy Ashrf A , Abbas Enas K 
Published: November 2024

Abstract

Background
Ultrasound guided pleural biopsy is a good alternative to thoracoscopy in friable cases and in places where thoracoscopy is not available.

Objective
To review the benefits, complications and outcomes of ultrasound guided pleural biopsy versus thoracoscopic pleural biopsy.

Patients and Methods
A prospective study was conducted on 114 subjects. They were divided into 2 groups. 62 patients underwent thoracoscopic pleural biopsy (group A), 52 patients underwent ultrasound guided pleural biopsy (group B).

Results
In comparing the 2 groups, there was no statistically significant difference between the two groups concerning comorbidity, complaint, diagnosis, diagnostic yield and complications. While there was highly significant statistical difference between the two groups regarding radiology (p value &lt; 0.001). Furthermore, duration of procedure and length of hospital stay were statically significant higher in group A (p value &lt; 0.001).

Conclusion
Both thoracoscopy and ultrasound guided pleural biopsy have comparable diagnostic yields. But ultrasound guided pleural biopsy has the advantage of being done in shorter time with less hospital stay. Patients who cannot stand thoracoscopy or cannot afford for it have the choice of ultrasound guided pleural biopsy when there is clear radiological pleural lesion
Implementation of Antimicrobial Stewardship Program in A Tertiary Surgery Hospital: Barriers and Challenges
Authors: Elshamy Amira , Halim Rania Abdel , Elmasry Shereen , Mokhtar Amira , Girgis Samia 
Published: November 2024

Abstract

Introduction
Many interventions have been demonstrated to beat the spread of antimicrobial resistance, one of which is the antimicrobial stewardship programs on the international, national and facility levels. One of the major pillars of the antimicrobial stewardship programs is the perioperative antibiotic surgical prophylaxis (PAP) which is critical to preventing the emergence of bacterial resistances. On the other hand, it is critical to preventing surgical site infections (SSIs), which are the second most common healthcare-associated infection and complicate approximately 5% of surgical procedures each year, according to the Centers for Disease Control (CDC).

Materials and Methods
In our study, we conducted improvement project with the use of FOCUS PDCA method to implement antimicrobial stewardship program and find the barriers to implementation.

Results
According to the WHO assessment checklist, almost all of the core elements declared by CDC concerning ASP were implemented. Leadership commitment elements increased from 33% to 66%. Accountability and education elements were 100% implemented although none of them were implemented before. ASP actions were increased from 57% to 100 as well. Although there was a trained clinical pharmacist representing 100% of pharmacy expertise elements, only 50% of tracking antibiotics use and outcomes elements were implemented. On the other hand, Reporting antibiotics Use and Outcomes elements were increased from 50% to 100%. The main challenge we faced was the behavioral change and proper tracking of the dispensed antibiotics.

Conclusions
Preauthorization combined with training, monitoring and reporting were effective in the implementation of the ASP but some challenges may interfere with the full implementation of the program.
Evaluation of CD96 Expression in Acute Myeloid Leukemia Patients: Relation to Prognosis and Induction Chemotherapy
Authors: Mohamed Soliman Ayat Soliman , Osman Amany Ahmed , Diaa El-Dine Dalia Ahmed 
Published: November 2024

Abstract

Background
In acute myeloid leukemia (AML), leukemic stem cells (LSCs) form a distinct group of leukemia cells showing stem cell-like features like self-renewal and proliferation. These potent cells significantly contribute to chemotherapy resistance, a major obstacle in AML therapy. LSCs express the characteristic phenotype CD34+/CD38- and have several specific markers, including CD33, CD96, CD123, CD90 and Death associated protein kinase (DAPK). Successful LSC eradication demands a combination of approaches, including targeting LSC-specific surface molecules.

Objective
To assess the expression of CD96 in AML patients at initial diagnosis and to correlate it with prognostic factors and response to induction chemotherapy.

Materials and Methods
This Case control study was conducted on 40 newly diagnosed AML patients in addition to 10 controls at Ain Shams University Hospitals between March 2022 and March 2023. Multicolor flowcytometry was employed to analyze CD96 expression in the CD34+/CD38- cell population of AML patients. The study further investigated the correlation between CD96 expression and both prognostic factors and response to induction chemotherapy.

Results
CD96 expression was significantly higher in AML patients group than control group (p-value = 0.008). CD96 was positive in 60% of AML patients and there was a highly significant association between CD96 expression and response to induction chemotherapy (p-value = &lt;0.001). However, there was no statistically significant relation between CD96 expression with laboratory findings and standard prognostic factors.

Conclusion
Our study identified CD96 as a promising marker for LSCs in AML patients. Its frequent expression in the CD34+/CD38- LSC population and association with lower response rate to induction chemotherapy suggest its potential as a valuable tool for LSC identification, targeted therapy development and improved treatment outcome prediction in AML.
Prognostic Impact of CD200 and CD56 Expression in Patients with Acute Myeloid Leukemia
Authors: Ahmed Israa Yosry Ali Elsayed , Omar Iman Mohamed Amin , Metawaa Maha Ahmed Abdel Rady 
Published: November 2024

Abstract

Background
Acute myeloid leukemia (AML) is a clonal malignant disease of hematopoietic tissue which results from a block of normal differentiation of hematopoietic progenitor cells along with uncontrolled proliferation of cells of myeloid origin with maturation arrest leading to infiltration of bone marrow and other tissues by myeloblasts. It escapes from immunosurveillance by induction of immunosuppression through expression of specific cell surface molecules with immune modulatory function. Novel immune-directed therapeutic approaches form a major focus of current and clinical research.

Objective
to assess the expression level of CD200 and CD56 in de-novo acute myeloid leukemia patients and evaluate the prognostic value of their positive expressions in patients with AML.

Methods
This Cohort study was conducted at Ain Shams University Hospitals, on 51 newly diagnosed adult AML patients attending the Hematology Oncology Unit of Ain Shams University Hospitals from February, 2022 until June, 2023.

Results
CD200+ expression was reported in 74.5% of patients while 9.8% of patients showed CD56+ expression. M1-M2 were found to be the most common FAB subtypes. CD200+ was higher among female patients (p = 0.045). On the other hand, CD56+ patients were younger in comparison to CD56- patients (p = 0.002). Total death was higher among CD200+ patients than CD200- patients (p = 0.037).

Conclusion
Our study reveals that CD200 expression is associated with higher incidence of mortality which suggests a negative impact of CD200 expression on survival rate while CD56 is not associated with a significant mortality.