bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dermatoscopic Evaluation of Nail Changes among End Stage Renal Disease Patients
Authors: Khafagy Naziha Hafez , Abd-ElfattahAfify Ahmed , Hassan Mohamed Saeed , Saber Amal Hosny 
Published: November 2024

Abstract

Background
Nail changes observed in end stage renal disease (ESRD) patients undergoing regular hemodialysis (HD) are polymorphic and diverse. HD causes heterogeneous pathology of nail which may be related to renal condition itself, complications related to it and drugs.

Aim of the Work
To study nail changes in ESRD patients undergoing regular HD by clinical and dermoscopic examination and to correlate these changes with age of patients, duration of hemodialysis, laboratory investigations, etiology of renal failure and type of vascular access.

Patients and Methods
The study consists of 100 ESRD patients on regular hemodialysis. Nails of these 100 patients were examined clinically and by dermoscopy. Different nail changes were detected and their frequencies were noted. Also, we correlated these changes with age of patients, duration of hemodialysis, laboratory investigations, etiology of renal failure and type of vascular access.

Results
Nail changes found in ESRD patients on HD were scales, leukonychia, thickening and crumbling, longitudinal striations, transverse striations, onycholysis, splinter hemorrhage, subungual hematoma, trachyonychia, subungual hyperkeratosis, Terry’s nail, onychomycosis, pincer nail, melanonychia, pitting, Lindsay nail, onychomadesis, dilated nail bed capillaries, Beau’s lines, Muehrcke’s lines, onychodystrophy, Mee’s line, loss of lunula, koilonychia and onychogryphosis in decreasing manner. Also, we found statistical significant correlation between some of these changes and age of patients, duration of hemodialysis, laboratory investigations, etiology of renal failure and type of vascular access.

Conclusion
Nail changes that were seen on examination of ESRD patients undergoing regular HD were very frequent and the dermoscopic examination helped us to detect nail changes not seen by clinical examination.
Serum Irisin and its Relation to Insulin Resistance in Patients with Psoriasis
Authors: Lotfi Ahmed Amany Ahmed , Ahmed Saleh Hanan Mohamed , Elhusseiny Rania Mahmoud , Ismail Mostafa Shimaa Mostafa 
Published: November 2024

Abstract

Background
Psoriasis is a chronic inflammatory disease that affects the skin and joints. Psoriasis affects about 2-3% of the world population. The pathogenesis of psoriasis involves dynamic interactions between multiple cell types and numerous cytokines in response to triggers leading to disruption of skin immune homeostasis in genetically predisposed individuals.

Aim of the Work
This study done aimed to evaluate serum irisin level in psoriatic patients and elucidate possible associations with insulin resistance and disease activity.

Patients and Methods
This comparative case control study included thirty five psoriatic patients with generalized plaque psoriasis and thirty five non psoriatic, sex and age matched persons who served as a control group. The patients were selected from patients attending the Outpatient Clinic of Dermatology, venerology and Andrology Department of Ain Shams University Hospitals, from March 2022 to July 2022.

Results
We measured serum level of irisin, fasting insulin and glucose level then calculated HOMA IR. Our results showed statistically significant increase in fasting insulin levels, FBG levels and HOMA IR between Psoriasis patients and controls. Also, median serum irisin level was higher in psoriatic patients compared with controls and there was statistically positive correlation found between serum levels of irisin and severity of psoriasis (PASI). Yet, no significant correlation found between serum irisin levels and HOMA-IR among studied subjects.

Conclusion
Serum irisin levels were insignificantly increased in patients with psoriasis reflecting its possible role in pathogenesis of psoriasis. Moreover, it was positively correlated with severity of disease. Thus, can be possibly used as an indicator of disease severity.
Assessment of Serum CXCL10 in the Sera of Patients with Active Vitiligo before and after Treatment with Oral Mini-Pulse Steroid Therapy versus Parenteral Corticosteroids Therapy: An Interventional Prospective Clinical Study
Authors: Abdel-Rahim Abdallah Marwa M , Soltan Marwa Yassin Ahmed , Fahmy Mary Wadie 
Published: November 2024

Abstract

Background
Vitiligo is the most common depigmenting skin disorder. The complexity of its pathogenesis, influenced by genetic factors, oxidative stress and abnormal cell adhesion that collectively impact melanocyte survival and trigger immune system attacks, resulting in melanocyte death. Melanocytes in vitiligo are believed to exhibit genetic susceptibility and defects in cellular mechanisms, such as defects in autophagy, that reduce their ability to resist oxidative stress. leading to increased expression of the pro-inflammatory protein HSP70. The low expression of adhesion molecules, such as DDR1 and E-cadherin, accelerates melanocyte damage and antigen exposure. Consequently, autoimmune attacks centered on IFN-γ-CXCR9/10-CXCR3-CD8+ T cells are initiated, causing vitiligo

Objective
To study the difference between weekend oral mini-pulse steroids or depot triamcinolone acetonide injection given every 3 weeks in stabilization of active vitiligo by measuring serum level of CXCL10

Methods
This study was an interventional prospective clinical trial study that included 46 cases with active vitiligo divided as 23 cases in group A received low dose oral minipulse dexamethasone 2.5 mg on two consecutive days per week and 23 cases in group B received IM triamcinolone acetonide injection every 3 weeks. Both groups were evaluated at baseline, 4,8 and 12 weeks using activity scores as VIDA, VASI, VES, Score/7and at laboratory level by measuring serum CXCL10

Results
When comparing both regimens as regarding halting vitiligo activity, both treatments could stop disease activity as assessed by activity scores and serum level of CXCL10 this effect was as early as week 4 in both groups with no statistically significant difference

Conclusion
We concluded that the level of CXCL10 was elevated in active vitiligo patients and decreased after the treatment with systemic steroids both low dose oral minipulse dexamethasone and Triamcinolone acetonide intramuscular injection. These findings may point to the role of CXCL10 in the activity of vitiligo which should be furtherly investigated
Value of Sulfotransferase Enzyme Assay in Predicting Minoxidil Response in Patients with Androgenetic Alopecia
Authors: Lotfi Ranya Adel , Youssef Merna Ashraf , ElNahas Khaled Ahmed 
Published: November 2024

Abstract

Background
Androgenetic Alopecia (AGA) is the most common type of progressive nonscarring hair loss in men and women. AGA features a progressive miniaturization of the hair follicle leading to transformation of terminal hair to vellus hair. These results from an alteration of hair cycle dynamic in which anagen phase duration gradually decreases and that of the telogen phase increases.

Objective
To compare Minoxidil result among patients with low versus high sulfotransferase activity in order to evaluate the validity of sulfotransferase enzyme testing before minoxidil use.

Patients and Methods
This was a prospective observational study that was conducted at Dermatology outpatient clinic, Ain Shams University Hospital on 60 male patients presenting with androgenetic alopecia grade II, III, IV.

Results
Vellus hair count/cm2 increased from baseline (17.4±9.2) to Month-4 (20.1±9.6), the differences (2.7±5.6) were statistically significant (p &lt; 0.001). Terminal hair count/cm2 increased from baseline (6.1±3.3) to Month-4 (9.5±6.3), the differences (3.4±5.3) were statistically significant (p &lt; 0.001). Terminal hair percent increased from baseline (25.7±3.6) to Month-4 (29.8±8.2), the differences (4.1±8.8) were statistically significant (p &lt; 0.001). Total hair count/cm2 increased from baseline (23.5±12.4) to Month-4 (29.6±15.3), the differences (6.1±10.2) were statistically significant (p &lt; 0.001). Mean hair width increased from baseline (0.04±0.02) to Month-4 (0.06±0.03), the differences (0.02±0.03) were statistically significant (p &lt; 0.001). Less than half of the study cases showed increasing response (46.7%). Baseline Sulfotransferase enzyme was higher in responder cases (0.78±0.37) than in non-responder cases (0.31±0.16), the differences were statistically significant (&lt;0.001).

Conclusion
The clinical response to 5% minoxidil commonly seen after 3-6 months and approximately 40% of patients will experience hair growth. considering the long time of treatment needed to produce a response by minoxidil in AGA, Sulfotransferase enzyme assay has a significant impact on minoxidil response in hair follicles and can be used as a diagnostic test perior the use of minoxidil to exclude the nonresponders.
Comparative Study between the Efficacy of Microneedling with Topical Triamcinolone Application and Intralesional Triamcinolone Injection for Treatment of Alopecia Areata
Authors: Salem Khamis Sally Mohammed , Fattah Nermeen Samy Abdel , El Nahas Khaled Ahmed 
Published: November 2024

Abstract

Background
Alopecia areata presents as one or more round bald patches that appears suddenly and 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.

Aim of the Study
The aim of the present study is to assess the efficacy of uses of microneedling with topical triamcinolone versus intralesional injection with triamcinolone in treatment of alopecia areata.

Patients and Methods
This study included 30 patients with scalp AA of at least 2 patches. One patch was treated with microneedling with Derma roller and topical triamcinolone acetonide (10 mg/mL) and the second patch was treated with intralesional injection of triamcinolone acetonide (2.5 mg/mL). Clinical, photographic and trichoscopic examination were performed before and 1 month after last session.

Results
Comparison of clinical response between the 2 treated patches revealed statistically significant better response with intralesional triamcinolone acetonide compared to microneedling and topical triamcinolone acetonide treated patches.
Efficacy of Interalesional Botulinum Toxin Type A vs Cryotherapy in Treatment of Keloids: Comparative Clinical, Histopathological and Immunohistochemical Study
Authors: Obaid Hamad Alhafeity Shamsa Mohamed , Salem Samar Abdallah , Afify Ahmed Abdelfattah , Ahmed Naglaa Samir 
Published: November 2024

Abstract

Background
Keloid is a common dermatological complaint produced by disruption of the normal wound healing process. Several treatment modalities for keloids are available with variable degrees of response such as surgical excision, topical and intralesional corticosteroids, interferon, botulinum toxin, cryotherapy and laser therapy.

Aim of the Study
The aim of the present study is to compare the clinical efficacy and safety of intralesional botulinum toxin type A and cryotherapy in the treatment of keloids.

Patients and Methods
This study included 10 patients complaining of keloids (at least 2 lesions). Keloids were treated by either cryotherapy (one session every two weeks) or intralesional BTX-A (5 IU/cm2 once every 4 weeks). Punch biopsy was done for every lesion before the start of treatment and repeated 4 weeks after the end of treatment.

Results
Both treatment modalities achieved statistically significant clinical response (keloid pliability, height and VSS score) histological response (epidermal thickness) and immunohistochemical response (fibronectin spot count). Both treatments were well tolerated and satisfying to included patients.
Stem Cells Therapy in Sensorineural Hearing Loss (Systematic Review)
Authors: Ezzat Waleed Farag , Askoura Anas Mohamed , Mady Ossama Mustafa , Elbadawy Gamal Mohamed Gamal 
Published: November 2024

Abstract

Background
Damage to the inner ear or cochlear nerve results in sensorineural hearing loss (SNHL), which is typically a persistent deafness. SNHL can range in severity from mild to profound. The shape of the audiogram is used to categorise it as high frequency hearing loss, low frequency, flat, peaked, or notched. Pure tone audiometry can be used to diagnose SNHL.

Objective
To summarization the recent updates in usage of stem cells in sensory neural hearing loss (SNHL).

Methods
Published studies about using stem cell therapy in ENT practice through comprehensive Pubmed, EKG and Google Scholar search (from 2010-2022).

Results
Progenitor stem cells may be employed to repair damaged cells and restore sensorineural hearing function, according to 37 of the publications. The majority of these articles—about 90%—discussed animal model-based experimental investigations; the remaining 10% were reviews.

Conclusion
The application of stem cells in the treatment of SNHL will be a significant step in the future since it will change the way that patients are now treated in the hopes of regaining their hearing. The application to the clinical setting is still in its early stage. Although, a number of encouraging researches illustrate how progenitor stem cells differentiate into sensorineural cells.
Language and Speech Outcome of Young Children with Bimodal Fitting versus Unilateral Cochlear Implants
Authors: Ahmed Nehal Adel Lotfy , Hegazi Mona Abd El-Fattah , Saber Amal El Said , Darweesh Mohamed El Said , El Fiky Youmna Hassan 
Published: November 2024

Abstract

Background
Hearing impairment is the most common sensory loss in the human population. The ability of hearing challenged individuals to communicate is influenced by factors such as the level of remaining hearing, the specific kind of deafness, their language proficiency, the age at which hearing difficulties began, their ability to understand speech via lip-reading, and their educational background. The objective of this study was to evaluate the language and speech acquisition and perception in children who had bimodal fitting (combining a hearing aid and a cochlear implant in opposite ears) and those who with unilateral cochlear implantation to determine whether there is a more favourable outcome of either condition or not. The study was applied on 30 children (15 with unilateral cochlear implant and 15 with bimodal fitting). The baseline evaluation was done 6 months after finishing programming of the cochlear implant device. Then they were re-evaluated after 12 months during which they received intensive language and speech therapy. The evaluation was done by the Modified Preschool Language Scale (PLS4) and the Standardized Arabic Articulation Test.

Results
On comparing unilateral CI and bimodal fitting results, there was statistically significant differences between total, receptive and expressive language age in 1st and 2nd evaluations as well as various aptitudes of receptive and expressive language, while there was no statistically significant difference in articulatory defects between the same groups.

Conclusion
The findings indicated that the use of both cochlear implants (CI) and hearing aids (HA) (bimodal fitting), has an advantage over unilateral CI on language skills development in children.
Role of Sublingual Immunotherapy in Management of Patients with Moderate to Severe Allergic Rhinitis
Authors: Mohamed Waled Ahmed Mohieldin , Elbeltagy Yasser Mohamed Fawzy , Youssef Tamer Ali , Mady Ossama Mustafa , Sayed Fatma Samy , Mohamed Manar Farouk 
Published: November 2024

Abstract

Background
Specific immunotherapy is the only effective etiological treatment for allergic rhinitis. Subcutaneous immunotherapy has several disadvantages like inconvenience, invasiveness, potentially severe systemic reaction and poor compliance. SLIT as an alternative route has been demonstrated. The safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in Egypt, the research on efficacy and safety in patients with allergic rhinitis (AR) is still has to be elucidated.

Objective
The aim of this prospective study is to evaluate the efficacy and safety of SLIT in moderately to severe monosensitized and polysensitized allergic rhinitis patients.

Methods
In this study, 75 patients with moderate to severe allergic rhinitis were randomized to receive SLIT (n = 50) or placebo (n = 25) for one year duration. Evaluation of the patients regarding TNSS, RQLQ scores, TMS and VAS score were performed at baseline, and then at 6 and 12 months of therapy. Allergen specific IgG, nasal smear for eosinophilic count were studied at baseline and 12 months.

Results
A total of 40 of 50 SLIT and 20 of 25 placebo patients completed the study. SLIT demonstrated a significant reduction of miniRQLQ score (p&lt;.001), (TNS) (p&lt;.001), (TMS) (p&lt;.001) and VAS (p&lt;.001) when compared with placebo. In objective parameters, Serum sIgG levels increased significantly in the SLIT group at 12 months (13.36 to 35.19) compared with placebo group (7.72 to 9.82) (p&lt;.001). Nasal smear for eosinophilic count significantly decreased in SLIT group at 12 months (from 1.477 to 0.542) compared to placebo (1.547 to 1.409) (p =.012). No relevant systemic symptoms were registered, the only advere events occurred in SLIT group was oral itching and tingling with no effects on patient contiuity of the study

Conclusion
SLIT is effective, safe and well tolerated treatment for allergic rhinitis and the clinical efficacy on rhinitis symptoms was more evident when compared with the placebo.
Troponin I versus Creatinine Kinase-MB as Predictor Markers of the Severity and Outcomes in Acute Theophylline Toxicity
Authors: Abdel Hafiz Selim Hadeer Nady , Mahmoud Suzan Mostafa , El Helaly Hend Mohammad Abdelrahman 
Published: November 2024

Abstract
Theophylline is a type of diethylxanthine that continues to be widely used in many developing countries for the treatment of acute and chronic bronchial asthma, chronic obstructive pulmonary disease (COPD) and apnea of prematurity. Methylxanthine cardiotoxicity is based on diverse, complex mechanisms. PDE inhibition and blocking adenosine receptors cannot explain all the cardiotoxic effects of methylxanthine. In addition, methylxanthines are cardiac stimulants and result in positive inotropy and chronotropy even with therapeutic dosing; myocardial ischemia and myocardial infarction (MI) are associated with acute theophylline poisoning. The current study aimed to investigate troponin I and creatine kinase-MB as predictors of the severity and outcomes in cases of acute theophylline intoxication. No previous studies have proposed early predictors of cardiovascular toxicities among methylxanthine users, early recognition of the severity of theophylline toxicity can be lifesaving and needs aggressive supportive care to improve clinical outcomes in patients. This study was a prospective cohort study conducted on 34 patients admitted to the Poison Control Center at Ain Shams University Hospitals (PCC-ASUH) for a 6-month duration from January 2022 to June 2022 with a history of acute exposure to theophylline toxicity. with history of acute exposure to theophylline toxicity. Patients were subjected to personal and toxicological history taking, vital signs collection, grading of acute theophylline toxicity and measurement of serum theophylline level. Both troponin I and creatine kinase-MB were measured at 6 and 12 hours post admission. Results revealed that, troponin I level at 6 hours post ingestion and 12 hours post ingestion in addition to creatine kinase-MB level at 12 hours post ingestion were significantly higher in cases with severe acute theophylline intoxication and patients who required intensive care unit admission and hemodialysis. It was concluded that, troponin I could predict the severity and the requirement of ICU admission and hemodialysis in patients with acute theophylline toxicity either with early or delayed presentation. On the other hand, CK-MB could be considered for patients with delayed presentation. Depending on time of admission, proper choosing of the biomarker to be investigated will allow for better evaluation of patients with saving extra cost.
Medico-Legal Importance of Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 in Traumatic Brain Injuries: Prospective Study
Authors: Abo-Seria fahmy Manar , Abdel-Rahman Amany El-Sayed , Hammad Omar Yousef , Mohamed Noha Farid 
Published: November 2024

Abstract
Traumatic brain injuries are one of the most common causes of lifelong disability and violent death (Refaat et al., 2019). Since several complications may occur after traumatic brain injuries, some of them are fatal. So, the allegation of negligence may be common. The patient relatives may claim that death is the result of improper management of treating medical team rather than the unavoidable complications (El- Sarnagawy et al., 2018).

Objectives
The present study was designed to investigate the medico legal importance of serum GFAP and UCHL-1 as predictive biomarkers of outcome and evaluation of medical care in mild and moderate TBIs to ascertain malpractice claims.

Subjects and Methods
The present study was carried out on 60 admitted cases with mild and moderate traumatic brain injuries in neurosurgery department, Ain Shams University Hospitals in the period between March2021 to Febraury2022. Serum level of GFAP and UCHL-1 was measured within 12 hours after traumatic brain injuries.

Results
Males cases were more predominant than females. Age group (18-25 years) represents the most common group subjected to TBIs while age group (&gt;61 years) was the least common among the studied cases. Road traffic accidents were the most frequent cause of traumatic brain injuries while firearm was the least frequent among the studied cases. There was a high significant increase in serum UCHL-1 levels in moderate TBIs cases in comparison to that in mild TBIs cases with 95% and 90% sensitivity and 95% and 75% specificity respectively. Also, there was a high significant increase in serum GFAP and UCHL-1 level in diffuse brain lesions than focal lesions seen in CT scan of the studied cases with TBIs with 78.95% and 89.46% sensitivity and 100% and 91.43% specificity respectively. The combination of GFAP and UCHL-1 increased the sensitivity to 94.74% and specificity to 97.14%.

Conclusion
The accuracy of serum GFAP alone was greater than accuracy of measurement of both biomarkers, the accuracy of combination of all variables was slightly better than the accuracy of serum GFAP alone as predicators of unfavorable outcome. So, depending on serum GFAP alone instead of combination of all variables didn’t change the sensitivity, specificity and accuracy of predication of unfavorable outcome obviously.