bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redo Nissen Fundoplication with and without Mesh to Re-Inforce Crural Repair: A Cohort Comparative Study
Authors: Omar Mohammed Mahfouz Mohamed , Abdelmenem Ayman Hossam Eldin , Abdelaziz Mohammed Hassan El Banna 
Published: November 2024

Abstract

Background
The incidence of hiatal hernias increases with age. Approximately 55%-60% of individuals over the age of 50 have a hiatal hernia. However, only about 9% have symptoms, and it depends on the type and competency of the lower esophageal sphincter. The vast majority of these hernias are type I sliding hiatal hernias. Type II, paraesophageal hernias, only make up about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. There is also an increased prevalence in women, which could be attributed to increased intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa.

Aim of the Work
This prospective – retrospective study aims to compare the efficacy of redo laparoscopic Nissen fundoplication with and without mesh repair for treatment of recurrent hiatus hernia after failed primary repair, regarding improvement of recurrent GERD symptoms, sliding hernia recurrence, and postoperative patients’ satisfaction.

Patients and Methods
In our study, prospective - retrospective randomized study was conducted on 30 patients who underwent redo laparoscopic Nissen fundoplication for the treatment of recurrent hiatus hernia with at least 1-year follow-up. A total of 15 patients underwent redo laparoscopic Nissen fundoplication, whereas 15 patients underwent the same technique with mesh reinforcement.

Results
Significant differences in postoperative reflux-associated symptoms were observed in both groups than preoperatively, but with a significant higher score for dysphagia noticed in the group in which mesh has been used. Anatomical recurrence occurred in four (26%) patients in the group of repair with out mesh after 12 months with relatively higher regurgitation, heartburn scores. Overall, patient's satisfaction was higher in the mesh group

Conclusion
Mesh reinforcement is associated with less recurrence rate in comparison with redo laparoscopic Nissen fundoplication alone during the short-term follow-up, but it is associated with more incidence of postoperative dysphagia. Mesh reinforcement is specially recommended for large defects more than 6 cm.
Screening for Large Vessels Vasculitis in Patients with Acute Cerebrovascular ISCHEMIA
Authors: El-mnesy Abdel-Aziz Mohamed , Abogabal Mervat Mamdouh , Abdelmoneim Reem , Hassan Sameh Abdelmotelab , Khalil Nermeen Samy , Elsadek Ahmed Mohamed 
Published: November 2024

Abstract

Background
Systemic vasculitides are heterogeneous disabling diseases characterized by chronic inflammation of the blood vessels potentially leading to tissue destruction and organ failure, Giant cell arteritis (GCA) is a granulomatous subtype of vasculitis involving large and medium-size arteries, both cranial and extra-cranial, Imaging techniques, both morphological and metabolic, are required to confirm the diagnosis of large-vessel vasculitis, Arterial duplex is a moderately sensitive but highly specific test for exclusion of temporal arteritis.

Purpose
The purpose of this study is Screening of large vessels vasculitis in patients with cerebrovascular Ischemia by arterial transcranial and peripheral duplex.

Patient and Methods
100 patients with cerebrovascular ischemia were further categorized into 3 groups: Group A: Seventy-four (74 %) pt of acute cerebrovascular stroke diagnosed according to National Institutes of Health Stroke Scale, Group B: Twenty-one (21%) pt with TIA diagnosed according to National Institutes of Health Stroke Scale, Group C: Five (5%) pt with GCA diagnosed according to 2022 American College of Rheumatology/EULAR classification criteria for Giant cell arteritis.

Results
Screening for large vessels vasculitis in patients with cerebrovascular Ischemia we found that five patients (5%) had GCA 2% with ischemic stroke 3% with TIA.

Conclusion
Our study indicates a significantly increased risk of CVA among patients with GCA
Endoscopic Ultrasound versus Triphasic Computed Tomography for Detection of Hepatic Metastasis during Staging of Pancreaticobiliary and Upper Gastrointestinal Malignancies
Authors: Mohamed Farag Sherif Mounir , Ahmed Osama Ashraf , Aziz Tari Magdy , Bahloul Khella Mena Romany 
Published: November 2024

Abstract

Background
Endoscopic ultrasound (EUS) is a useful tool for detection of liver metastasis compared with Triphasic CT scan.
We aimed to assess the value of Endoscopic Ultrasound (EUS) in detection of missed hepatic focal lesions during staging of pancreatic and Upper GI malignancies.

Methods
we included 90 cases with pancreatic and upper GI malignancies, all patients were subjected to laboratory investigations and CT abdomen. EUS was done to all patients, During EUS examination the liver was examined thoroughly to detect hepatic focal lesions with possible EUS- FNA of any detected lesions.

Results
The mean age of the included patients in our study was 58.02 ± 11.9 years and the majority of the patients were males. In the present study, the most common type of tumors was pancreatic cancer. Triphasic CT detected 25 cases of metastatic hepatic focal lesions, while EUS detected 29 cases. EUS FNA was done for 4 small hepatic focal lesions, which were not detected by triphasic CT, and histopathological examination revealed them to be metastatic in nature. EUS yielded 100% sensitivity and 97.3% specificity in the detection of small-sized liver metastasis, compared with a 96.7% sensitivity and 93.8% specificity through triphasic CT.

Conclusion
EUS and EUS-FNA is a useful diagnostic modality for the detecting small-sized liver metastasis that may be missed by other methods during TMN staging of pancreatic and GI malignancy.
Serum Myostatin Predicts the Risk of Hepatocellular Carcinoma in Patients with Alcoholic Cirrhosis: A Multicenter Study
Authors: Bayoumi Essam Mohamed , Al-Sheikh Mazen Musa , Raafat Khaled Abdel Hamid , Okasha Mostafa Ahmed Ibrahim 
Published: November 2024

Abstract

Background
Sarcopenia, characterized by age-related muscle loss, is common in patients with liver cirrhosis (LC). LC's metabolic burdens include protein and energy metabolism disorders, potentially leading to secondary sarcopenia. This study explores the prognostic role of serum myostatin levels in predicting hepatocellular carcinoma (HCC) development in individuals with alcoholic liver cirrhosis (ALC).

Aim of the Work
The aim of this study is to investigate the prognostic performance of serum myostatin levels on HCC development in patients with alcoholic liver cirrhosis (ALC).

Patients and Methods
We conducted a retrospective observational study using stored serum samples from a single center. We analyzed serum myostatin levels and assessed their correlation with HCC development in ALC patients.

Results
Serum myostatin levels were significantly higher in patients with HCC compared to those without (p &lt; 0.001). Our analysis revealed a significant correlation between baseline myostatin levels and various clinical parameters, including gender (p &lt; 0.0001), serum albumin (p &lt; 0.0001), prothrombin time (PT) (p = 0.0188), serum ammonia (p &lt; 0.002), and Child Pugh score (p &lt; 0.0001). Multivariate Cox analyses identified age, gender, body mass index (BMI), platelet counts, and serum myostatin levels as independent risk factors for HCC development (p &lt; 0.001).

Conclusion
Elevated serum myostatin levels are associated with an increased risk of HCC development in ALC patients. Myostatin may play a role in hepatic fibrogenesis and carcinogenesis, making it a potential prognostic marker for HCC in this population. A serum myostatin level cutoff of 3.9 ng/ml exhibited high sensitivity (92.3%) and specificity (82.35%) for detecting HCC. These findings suggest that serum myostatin levels could serve as a valuable tool for identifying high-risk ALC patients who may benefit from closer monitoring for HCC development.
Procalcitonin Level in Systemic Lupus Erythematosus Patients and its Correlation with Disease Activity and Infection
Authors: Ahmed Fathi Radwa Ayman , Eldin Abdel Baky Mohamed Salah , Morad Caroline Samy , Mohammad Hawwash Amr Mohammad 
Published: November 2024

Abstract

Background
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, characterized by a chronic autoimmune response to multiple autoantigens and involving multiple organs. With the development of medical technologies, the diagnosis and treatment of SLE have been significantly improved. So far, SLE treatment mainly relies on glucocorticoids and immuno- suppressive drugs. Thus, the SLE disease itself and the immunosuppressive therapy increase the risk of infection, multiple organ dysfunction syndrome, and multiple organ failure syndrome. Moreover, infection is considered as a common complication of SLE and one of the leading causes of death.

Aim of the Work
To evaluate the role of available biomarkers mainly procalcitonin (PCT) and C- reactive protein (CRP) to differentiate flare from infection in a febrile patient with SLE.

Patients and Methods
Patients age ranged between 18-50 years old from outpatient clinic and the inpatients of department of Rheumatology at Ain Shams University Hospital. Informed consent was taken from all subjects. Approvement by ethical committee of Ain Shams University was taken and included. All the patients were surely diagnosed with SLE and fulfilled the clinical criteria. Patients with other autoimmune diseases were excluded. Full history has been taken and thorough clinical examination was done including general and musculoskeletal system.

Results
Eighty patients (88.9%) of this study were females while 10 patients (11.1%) of them were males. Comparison between the study participants as regard clinical manifestations revealed that the most frequent SLE manifestations were 58.9% have arthritis, 51.1% have skin rash, 37.8% mucosal ulcers and 36.9% have nephritis. As regard laboratory data When we compared between active group and remission group as regard procalcitonin we found a statistically significant higher levels in active group of SLE patients. In the present study, there was a highly statistically significant difference between SLE patients with and without infection as regard procalcitonin. By comparing active SLE patients with and without infection, there was a statistically significant higher levels in infected group as regard N/L ratio and P/L ratio.

Conclusion
Although the serum PCL and CRP levels, and neutrophils to lymphocytes ratio rise with SLE disease activity, their levels are significantly higher when associated with infection, indicating that high levels of these inflammatory markers could be used in differentiation between infection and disease activity in SLE patients.
Role of Maternal Serum Fibroblast Growth Factor 21 Level in Prediction of Preeclampsia
Authors: Atef Karim El-din Alaa Mohamed , Kolib Magdy Hassan , Abdel-Rahman Bakhat Gehad Sayed , Yehia Amr Helmy 
Published: November 2024

Abstract

Background
Pregnancy complications resulting from hypertensive disorders are a serious problem that impact 2-10% of all pregnancies globally. Preeclampsia is defined as new onset hypertension and proteinuria after 20 weeks of gestation which may be associated with other maternal organ dysfunction, such as liver or renal insufficiency, hematological or neurological complications, uteroplacental dysfunction and fetal growth restriction.

Aim of the Work
To establish the relationship between maternal serum fibroblast growth factor 21 levels and preeclampsia as a predictor for preeclampsia.

Patients and Methods
This was a Nested case-control study that was conducted on 90 primigravidas at Ain Shams University maternity hospital from April 2021 to April 2022.

Results
our study showed that there was a significant difference in FGF21 levels between the groups, patients with preeclampsia having higher levels than controls, 15.9% of patients with preeclampsia experienced maternal complications compared to none in the control group. Meanwhile, 18.2% of patients with preeclampsia experienced fetal complications compared to 0% in the control group.

Conclusion
Serum FGF-21 levels are significantly higher in preeclamptic pregnant women compared to healthy normotensive pregnant women. So, it can be used as a predictor for preclampsia and maternal complications
Circulating Maternal Serum Cell Free Fetal DNA Levels for Prediction of Preeclampsia
Authors: Mohamed Ibrahim Mohamed El Mandouh , Bahaa El Din Ahmed Mohamed , Mohamed Nassar Salma Ashraf , Mohamed Helmy Mohamed Mahmoud 
Published: November 2024

Abstract

Objective
To measure the maternal serum cell free fetal DNA and establish the relationship between maternal serum cell free fetal DNA levels and preeclampsia (PE).

Study Design
A nested case-control study was conducted on 30 patients with PE and 30 matched controls aged (18-40 years) attending Ain Shams university maternity hospital, with single viable fetus beyond 20 weeks gestational age. Blood samples were withdrawn upon enrollment; then measuring the cell free fetal DNA was done upon identification of cases and matched controls.

Results
The study showed that there was a significant difference in CFFDNA level between the studied groups, with patients with preeclampsia having higher levels than controls. Also, the maternal serum CFFDNA level can accurately predict preeclampsia, with area under the curve 0.979.

Conclusion
Maternal serum cell free DNA can be used for prediction of PE. The mean levels of CFFDNA correlate with probability of developing maternal complications in cases of PE.
Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-Types of GERD
Authors: Baiomy Essam Mohamed , El-Nakeep Sara Abdelkader , Ahmed Elessawy Hager Ahmed , Abbas Mostafa Mohamed 
Published: November 2024

Abstract

Background
Gastroesophageal reflux disease (GERD) is a prevalent condition characterized by the troublesome reflux of stomach contents into the esophagus, significantly impacting the quality of life. Pepsin, a protease originating from the stomach, has been implicated in the pathogenesis of GERD and can serve as a potential biomarker for objective assessment.

Patients and Methods
In this cross-sectional observational study, 45 patients with GERD and 45 healthy volunteers as a control group were examined. Clinical evaluations, laboratory tests, and salivary pepsin measurements were conducted, and esophagogastroduodenoscopy was performed.

Results
The study revealed a statistically significant increase in body mass index (BMI) among GERD patients (32.2 ± 3.9 kg/m²) compared to the control group (27.8 ± 2.4 kg/m²). Smoking was identified as a significant risk factor for GERD, with 44.5% of GERD patients being smokers compared to 24.4% in the control group. Salivary pepsin levels were significantly higher in GERD patients (108.5 ± 46.6 ng/ml) compared to the control group (24.4 ± 9.9 ng/ml). Additionally, a significant correlation was observed between salivary pepsin levels and the Los Angeles classification of GERD severity.

Conclusion
This study indicates that obesity negatively impacts esophageal function and smoking is a significant risk factor for GERD. Salivary pepsin levels are significantly elevated in GERD patients and show a strong correlation with GERD severity as classified by the Los Angeles classification system. Salivary pepsin holds promise as a non-invasive biomarker for GERD diagnosis and monitoring.
Total Laparoscopic Hysterectomy with Prior Uterine Artery Clipping versus Conventional Laparoscopic Hysterectomy: A Randomized Controlled Trial
Authors: Salama Mohamed Hamed Abdelaziz , Taha Yasmeen Ahmed Mohamed , Hassan Sabry ElSayed , Elskaan Rania Gamal Anwar 
Published: November 2024

Abstract

Objective
To compare the efficacy of total laparoscopic hysterectomy (TLH) with prior uterine artery clipping versus conventional laparoscopic hysterectomy

Methods
A randomized controlled study was conducted at Ain Shams University Maternity Hospital. The study included 42 women who were admitted from the general gynecology outpatient clinic and were planned to undergo TLH. Patients participating in the study were randomized into 2 groups; the control group, including women who were subjected to conventional TLH, and the study group, including women who were subjected to TLH with prior uterine artery clipping at its origin.

Results
The patient profiles in both groups were found to be similar, indicating a lack of confounding factors. No significant differences were observed between both groups in terms of age, BMI, parity, medical and surgical history, and the cause of hysterectomy. Regarding blood loss, no statistically significant difference was found between the two groups suggesting comparable outcomes in this aspect. However, a notable disparity was identified in terms of operative time. The study group had a mean operative time of 72.76±7.05 minutes, while the control group had a mean operative time of 63.76±6.28 minutes. This difference was highly statistically significant (p-value of &lt; 0.001). All other outcomes (severe bleeding, post operative complications and operative time) were comparable between the two groups.

Conclusion
TLH with prior uterine artery clipping resulted in a longer operative time, without any added benefits regarding blood loss or other investigated outcomes.
Levels of Tumor Necrosis Factor Alpha and Serum Ferritin in Patients with Hemophilia and Correlation with Clinical Data and Joint Arthropathy
Authors: Saleh El-Alfy Mohsen , Makkeyah Sara Mostafa , Okba Ahmed Ashraf Mahmoud , Kader Salwa Mostafa Abdel , Hamdy Ibrahim Kholod Mohamed 
Published: November 2024

Abstract

Background
Hemophilic arthropathy still represents a major concern especially in resource- limited settings, despite major advances in the management of patients with hemophilia worldwide. TNF-α has been enrolled in the pathophysiology of chronic hemophilic arthropathy. Aim: To evaluate levels of TNF-α and ferritin in patients with hemophilia in relation to hemophilic arthropathy.

Methodology
We conducted a 6-months comparative cross-sectional study including 38 hemophiliacs with arthropathy (HA+) and without arthropathy (HA−), who are mild, moderate and sever hemophilia; as well as 53 age- and sex-matched healthy control. Patients with a history of acute bleeding or inflammatory conditions in the previous four weeks were excluded from the study. We assessed every patient annual bleeding rate(ABR) measured serum levels of ferritin and TNF-α by using enzyme linked immune-sorbent assay (ELISA). joint status was assessed clinically by the Hemophilia joint health score (HJHS), and radiologically by the six major joints ultrasound (US)

Results
The median (IQR) age of hemophiliacs was 11.8 (9-16.1) years opposed to 11 (8-13) years in the control group (p = 0.435). Most patients (97.3%) received regular low dose prophylaxis. The median (IQR) HJHS among (HA−) was 0 (0 - 1) versus 18 (9 - 22) in (HA+) group (p &lt; 0.001), and HJHS correlated well with the US score (p &lt; 0.001, p &lt; 0.001 and p = 0.005 for knee, ankle and elbow joints respectively). The annual bleeding rate (ABR) was comparable between both hemophilia groups with median (IQR) 0.88 (0- 2.25) in HA− group versus 1.25 (0.5- 1.75) in HA+ patients (p = 0.571). There was no significant difference in ferritin levels among hemophiliacs with median (IQR) in (HA+) and (HA-) of 40 (35-70) ng/ml and 30 (30-50) ng/ml respectively. On the other hand, TNF-α levels was significantly higher in hemophiliacs compared to control (p &lt; 0.001); with median (IQR) 500 (390 -780) in HA− patients, 485 (385 -580) in HA+ group and 65 (50 - 95) for healthy controls. In a post-hoc analysis TNF-α levels were comparable among patients with and without arthropathy (p = 0.56).

Conclusion
Hemophiliacs display higher TNF-α levels when compared to healthy controls, which may be a useful surrogate biomarker for bleeding episodes.
The Contribution of Intestinal Barrier and Microbiome Ecosystem in Progression of Chronic Kidney Disease
Authors: El-Kafoury Bataa M , Saad Dalia A , Ghonamy Elsayed , Din Bayomi Noha Salah El , Mehanna Nayra , Derias Marina Sorial Mina 
Published: November 2024

Abstract

Background
The introduction of concepts such as “Intestinal renal syndrome” and “The gut-kidney axis” has opened the door to the study of gut microbiota and intestinal barrier integrity.

Aim
This study is to focus on these two keys which link the interaction between CKD and intestine.

Material and Methods
This study was carried out on 20 adult male albino rats initially weighing 180 - 193 grams that were divided into sham operated (control) and 5/6th nephrectomized rats. After 8 weeks, all rats were subjected to anthropometric studies, measurement of serum level of creatinine, urea, NGAL, indoxyl sulphate, urine volume, eGFR, aIb/Cr ratio and arterial blood pressure. Serum SCFA an indicator for microbiome disturbances and tissue occludine an indicator for intestinal barrier as well as histological study to the wall of colon were determined. Also, serum TNF α, MDA, glutathione peroxidase was measured as possible interactive mechanism.

Results
In the present study, nephrectomy group showed significant decrease in body weight and body mass index gain compared to control group. In addition, 5/6th nephrectomy showed significant increase in mean arterial blood pressure and the levels of serum creatinine, urea, NGAL, indoxyl sulphate, alb / cr ratio, malondialdehyde and TNF- α. While volume of urine, eGFR and level of serum GPx were significantly decreased. Moreover, with nephrectomy SCFA in serum and intestinal tissue level of occludine were significantly reduced and the histological studies showed decreased thickness of mucosa, reduced number of goblet cell and increased inflammatory cell infiltration.

Conclusion
CKD could be considered as one of the chronic stressors affecting gut microbiota production of SCFA and intestinal barrier integrity marker and histology through the induction of gut inflammation and oxidative stress. This study provides a theoretical basis for subsequent targeted treatment.
Verification of Clot Burden Score Prognostic Value in Acute Middle Cerebral Artery Ischemic Insults
Authors: Hamid Soliman Abd El Aziz Mohamed Abd El , Rashad Abdel-Aziz Amany Mohamed , Ekladious Mena Elerian Youssef 
Published: November 2024

Abstract

Background
The Clot Burden Score (CBS) is a CT angiography-based grading system used to assess thrombus burden in acute ischemic stroke patients. CBS is a major determinant of stroke severity and outcome in anterior circulation stroke, offering advantages over invasive angiographic scores.

Aim of the Work
to investigate the prognostic value of CBS in predicting clinical outcomes using the modified Rankin Scale (mRS).

Patients and Methods
Type of study combined prospective and retrospective observational study. Sampling Method purposive sampling according to inclusion and exclusion criteria.

Results
The study included 40 patients with acute ischemic stroke, with a mean age of 58.35 ± 14.82 years. 60% of patients were male, and 40% were female. After 3 months, 17 patients (42.5%) achieved functional independence (mRS ≤ 2), while 23 patients (57.5%) had higher mRS scores (22 functionally dependent and 1 deceased). There was a statistically significant inverse correlation between CBS and mRS scores, indicating that patients with higher CBS scores had lower mRS scores. Receiver Operating Characteristic (ROC) curve analysis determined a CBS cutoff value of greater than 6 as predictive of a good prognosis, with high sensitivity and specificity.

Conclusion
The current study shows that CBS is a good predictor of patient outcome. It is a relatively easy and simple method in quantifying clot burden, apart from being systematic. This assists in selection of treatment strategies, and prognosticates patient outcome; and can be incorporated in routine radiological reporting of AIS cases.