bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of Ascetic Fluid Lactoferrin and Calprotectin as a Novel Diagnostic Markers in Cirrhotic Patients with Spontaneous Bacterial Peritonitis
Authors: Yousef Mohamed Gamal , Mohamed Sayed Khalid Abd-Elhamid , Abd-Elsadik Abo-Halima Ahmed Samir , Hassan Aly Omar Aly 
Published: November 2024

Abstract

Background
Spontaneous bacterial peritonitis (SBP) is a critical infection in patients with liver cirrhosis and ascites, necessitating early diagnosis for effective intervention. The standard diagnostic criterion for SBP is an ascitic fluid polymorphonuclear leukocyte (PMN) count of ≥ 250 cells/mm³. This study explored alternative diagnostic markers for SBP, including high sensitivity C-reactive protein (hsCRP), serum procalcitonin, urinary lipocalin, ascitic lactoferrin, homocysteine, and fecal or ascitic calprotectin.

Aim of the Work
The aim of this study is to evaluate the diagnostic accuracy of both ascitic fluid calprotectin and lactoferrin in detecting SBP in cirrhotic patients.

Patients and Methods
The research was conducted at the Hepatology and Gastroenterology Department at Ain Shams University in Egypt from September 2022 to May 2023. Patient data, including demographics, clinical symptoms, laboratory results, and ascitic fluid markers (calprotectin and lactoferrin), were collected and analyzed to assess their diagnostic accuracy for SBP in cirrhotic patients.

Results
Among the studied population, bleeding, abdominal pain, and fever were significantly more frequent in patients with SBP than those without SBP. Patients with SBP exhibited higher levels of leucocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), and lower levels of albumin compared to those without SBP. Ascitic fluid parameters, including PMN, calprotectin, and lactoferrin, were significantly higher in patients with SBP. These biomarkers also showed a positive correlation with liver disease severity and were positively correlated with white blood cell count, ESR, and CRP, while calprotectin showed a negative correlation with albumin. At a cut-off point of &gt; 221, ascitic fluid calprotectin demonstrated a sensitivity of 92% and specificity of 96% for predicting SBP, while ascitic fluid lactoferrin, at a cut-off point of &gt; 64.5, had a sensitivity of 92% and specificity of 80% for SBP prediction.

Conclusion
Both ascitic fluid calprotectin and lactoferrin were significantly elevated in cirrhotic patients with SBP compared to those without SBP. These findings suggest that ascitic fluid calprotectin and lactoferrin can serve as valuable diagnostic tests for screening and diagnosing SBP in patients with liver cirrhosis. Early detection of SBP is crucial for timely intervention and improved patient outcomes.
Evaluation of Hepatic Affection and Complications in COVID-19 Infected Patients
Authors: Mohamed Maha Mohsen , Mohammed Manal Sabry , Elessawy Hagar Ahmed Ahmed , Eissa Ramy Raouf Ramzy 
Published: November 2024

Abstract

Background
The definition of liver damage caused by COVID-19 has not yet been established. COVID-19 may contribute to both primary and secondary liver injury in people with pre- existing chronic disease and impaired liver reserves, leading to exacerbation of underlying disease, liver decompensation, or acute chronic liver failure. Therefore, many researchers have interpreted it as clinical or laboratory abnormalities in the course of the disease and treatment in patients with or without pre-existing liver disease.

Aim and Objectives
To evaluate the relation between liver function tests in COVID-19 patients and disease severity & prognosis.

Subjects and Methods
This retrospective study, was carried on 200 patients attended to Ain Shams university hospital divided into 2 groups: Group I (Non hepatic patients): COVID-19 patients with no preexisting hepatic diseases who were followed for any changes in liver function tests, Group II (patients with preexisting hepatic diseases): COVID-19 patients with pre-existing hepatic diseases, were followed clinically and laboratory and by Child-Puch score, during a period of 6 months.

Result
There was high statistically significant relation between Preexisting hepatic diseases and ALT, AST, TB, ALP, PT and INR.

Conclusion
A higher occurrence of liver injury has been consorted with COVID-19. Moreover, the severity of the disarray in serum liver function indicators is linked to higher acuity. Thus, special attention should be given to any liver dysfunction while treating patients with COVID-19. Patients with abnormal liver tests were at increased risk of progressing to severe disease. The detrimental effects on liver injury mainly related to certain medications used during hospitalization, and should be monitored and evaluated frequently.
The Impact of Mediterranean Diet on Patients with Hashimoto Thyroiditis
Authors: Shady Manal Abu , Adly Nahla Nader , Ibrahim Sarah , Aboelyazed Sherihan 
Published: November 2024

Abstract

Background
Hashimoto's thyroiditis is one of the most common autoimmune disorders. Patients typically present with nonspecific symptoms, such as fatigue, weight gain, cold intolerance, constipation, and dry skin, which can significantly impair patients' quality of life. Conventional treatments focus on hormone replacement therapy for hypothyroidism, but emerging research suggests dietary interventions, like the Mediterranean diet, may provide added benefits. Many patients continue to suffer from difficulty losing weight despite reaching an euthyroid state while on Levothyroxine. The Mediterranean diet emphasizes fruits, vegetables, whole grains, legumes, nuts, olive oil, fish, poultry, and dairy in moderation. The diet has been known for promoting cardiovascular health and reducing inflammation.

Aim
Our aim was to explore the Mediterranean diet's impact on Hashimoto's disease and how it affects thyroid autoantibodies and thyroid profile parameters.

Methods
A single arm clinical trial was performed on 40 female patients diagnosed with Hashimoto’s thyroiditis. Our study participants were started on a modified mediterranean dietary plan for 12 weeks. Evaluation of TSH, free T3, free T4, thyroid peroxidase autoantibodies, thyroglobulin autoantibodies, and BMI was done at baseline and at the end of the study. All of our study participants were kept on their pre-intervention Levothyroxine doses throughout the study.

Results
We achieved statistically significant reductions in autoantibodies levels, with median % change of (−28.36% (−45.75– −19.05)) for thyroid peroxidase autoantibodies and (−26.09% (−42.76– −14.15)) for thyroglobulin autoantibodies (P &lt; 0.01). Regarding thyroid function tests, statistically significant changes were seen in TSH (−24.95% (−39.6– 18.51)), free T3 (28.4% (9.38 – 66.79)), and free T4 (29.05% (12.79 – 60.49)), with a P-value &lt;0.01. BMI reductions achieved were also statistically significant with a mean % change of −6.78% (−10.34– −3.70), P &lt; 0.01.

Conclusion
In conclusion, the Mediterranean diet shows promise as a complementary therapy for Hashimoto's thyroiditis, offering lower disease activity, as well as weight reduction. Further research, including randomized controlled trials, is needed for confirmation. Nonetheless, promoting adherence to this diet could offer a safe, accessible, and cost-effective approach to better disease control.
POEM in Achalasia Type III and Non-Achalasia Esophageal Motility Disorders
Authors: Ibrahim Sohaib Mohamed , Allam Ehab Hassan Nashaat , Mahmoud Hossam Abdelaziz , Badawy Mohammed Nabil , Madkour Ahmad 
Published: November 2024

Abstract

Background
POEM has gained popularity in the treatment of achalasia and other esophageal motility disorders worldwide and most of reports have demonstrated the remarkable efficiency of POEM as a treatment of achalasia. This study will demonstrate efficiency of POEM as a treatment of achalasia type 3 and other non-achalasia esophageal disorders. Type III achalasia represents about 10% of all cases of achalasia with most of cases presenting near age 60. It presents with similar clinical profile to other types of achalasia and spastic EMD; in which chest pain occur mainly during swallowing, with more severe dysphagia and regurgitation, and thus, more weight loss.

Aim of the Work
To demonstrate efficiency of POEM as a treatment of achalasia type 3 and other non-achalasia esophageal disorders.

Patients and Methods
This was a pilot prospective observational study and patients will be selected from endoscopy centers in Egypt.

Results
Our study showed that statistically significant decrease in mean Eckardt score was present in patients who underwent POEM indicating resolution of symptoms of esophageal motility disorder. Also, adverse outcomes were present, indicating high safety of POEM as a therapeutic procedure.

Conclusion
POEM is safe and effective in the management of achalasia type III as well as other non-achalasia EMD. However, more research is needed to generalize the utilization of this procedure to help more patients.
Evaluation of Serum Tenascin-C Level in Patients with Bronchial Asthma
Authors: Rahman Al-Shayeb Muhammad Abdul , El-Kady Hossam Moustafa , Al-Jundi Aya Muhammad , Hassanein Yasmine Ali Farag 
Published: November 2024

Abstract

Background
Serum TNC is an extracellular matrix protein and a pro-inflammatory marker that is released mainly in inflammatory processes such as asthma exacerbation as well as tissue remodeling in cardiovascular events, septic conditions, and autoimmune diseases. However, serum TNC level measurement has not yet been used as an inflammatory marker for the diagnosis and severity of bronchial asthma. We will discuss how serum TNC can be utilized as a marker for the diagnosis and severity of bronchial asthma in this study.

Aim of the Work
To meausure seum levels of Tenascin-C in patients with bronchial asthma compared to healthy individuals and its relation to the severity of the disease.

Patients and Methods
We evaluated 90 adult patients with mild to severe asthma. Serum TNC, periostin, and total IgE concentrations were quantified using enzyme-linked immunosorbent assays.

Results
Serum TNC levels were significantly higher in patients with bronchial asthma compared to those who are non asthmatic. Serum TNC was also higher in patients with severe asthma compared to thsose with mild to moderate asthma with statiscally significant ratio.

Conclusion
Serum TNC can be utilized as a new biomarker for diagnosis of the presence of bronchial asthma and in prediction of the severity of asthma.
Posterior Circulation Ultrasound Assessment of Patients with Isolated Central Vertigo versus Ischemic Posterior Circulation Stroke: A Comparative Study
Authors: ElKhawas Hala Mahmoud , El Sadek Ahmed Mohamed , Mahmoud Eman Moe’nes , Abdelatif Ahmed Khaled Mohamed 
Published: November 2024

Abstract

Background
Vertigo is the illusory sense of movement, while unsteadiness is the feeling of being unstable while seated, standing, or walking. These symptoms represent 4% of the access to the Emergency Department (ED) and they can be related to both benign diseases of the inner ear or serious central nervous system diseases, including posterior circulation stroke.

Aim of the Work
The aim of the study was to compare between carotid duplex findings of patients with isolated central vertigo and vertigo due to posterior circulation stroke for better diagnosis and seeking for earlier detection of stroke.

Patients and Methods
This was a cross sectional comparative study that included about 56 patients. The patients who presented to the emergency department with vertigo in Ain Shams University hospitals from December 2022 to February 2024.

Results
Our study showed that RI and PI, which are the most frequently used CD parameters to determine the blood flow resistance, were markedly higher for patients with posterior circulation CVS than in patients with isolated central vertigo.

Conclusion
Those findings denote that atherosclerosis has a major role in CVS etiology, and thus CD can be a useful, rapid and reliable tool that can aid in screening and prediction of population at high risk of CVS.
The Effect of Topiramate and Propranolol on Serum Calcitonin Gene Related Peptide (CGRP) Level on Migraine Patients
Authors: Moustafa Ramez Reda , Helmy Shahinaz Mohamed , Hassan Ahmed Salah Salem 
Published: November 2024

Abstract

Background
Migraine is a common multi-factorial, neurovascular disorder with major individual and social effect. Although the mechanisms are unknown, activation of the TNC leads to peripheral release of calcitonin gene-related protein (CGRP), most likely from C-fibers. Topiramate is `a first-choice oral medication for migraine prophylaxis. It is one of the most frequently prescribed preventative anti-migraine drugs. Other first-line, non-specific preventatives include β-blockers, flunarizine, and amitriptyline. All these medications are inexpensive treatment options, which are effective in a large population of patients.

Objective
to study the effect of topiramate and propranolol on serum calcitonin gene related peptide (CGRP) level in peripheral blood in migraine in Headache outpatient clinic and neurology department at Ain Shams University hospital.

Methods
it’s a cross-sectional time interval study conducted between October 2022 to April 2023. we conducted our study on 50 patients at our outpatient headache clinic were diagnosed as migraine according to ICH-3rd edition. blood sampling was obtained from all 50 patients for estimation of CGRP in peripheral blood before receiving any medication then all patients received propranolol 40mg and topiramate 25 mg after two months blood sample obtained for estimation of cgrp.

Results
Highly statistical significant (p-value &lt; 0.001) decreased CGRP (after medication) (mean = 141.1 ± 62.5, range = 53 – 320) when compared with CGRP (before medication) (mean = 190.3 ± 71.7, range = 92 – 395) in all studied patients

Conclusion
both topiramate and propranolol show significant decrease in serum calcitonin gene related peptide in migraine patients.
Effect of Transcranial Direct Current Stimulation on Outcome of Patients with Acute Ischemic Middle Cerebral Artery Stroke
Authors: Alzahaby Alaa , Nahas Nevine El , El-bokl Ahmed , Samy Ahmed , Fathallah Fatma 
Published: November 2024

Abstract

Background
Stroke continues to hold its position as the second most prevalent cause of death and stands as a prominent contributor to depression and dementia on a worldwide scale. In the absence of adequate care, individuals who have experienced a stroke face an elevated susceptibility to dependency on caregivers and encounter significant limitations in their ability to engage in societal activities. The rescue of penumbral tissue through early reperfusion correlates with proportionate clinical recuperation. Transcranial direct current stimulation (tDCS) is being explored as a promising therapeutic approach for various neurological conditions, including the management of strokes. Our objective was to investigate the impact of cathodal tDCS on patients who have recently suffered a stroke affecting the middle cerebral artery.

Methods
Egyptian patients with middle cerebral artery strokes were randomly allocated into active and sham tDCs groups after stroke onset.

Results
No difference regarding age, gender, risk factors or final clinical outcome.

Conclusion
Earlier application of tDCS may be beneficial.
Serum Vitamin D Level in Children with Attention Deficit Hyperactivity Disorder (ADHD)
Authors: Elshahawi Heba , Amin Ghada , Khalil Sherien , Kasem Rania , Mostafa Amany 
Published: November 2024

Abstract

Background
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorders in childhood and adolescence. Dietary interventions such as omega-3 FA, vitamin and mineral supplementations might affect ADHD symptoms.

Aim
To compare serum level of vitamin D in children with ADHD with its different subtypes in relation to healthy controls.

Methods
a case control study was conducted on 108 children divided equally between healthy children and ADHD cases. Vit D was measured. Assessment of habitual vitamin D intake was done by using a vitamin D food frequency questionnaire.

Results
The median weekly vitamin D intake for the ADHD group was significantly lower than that for the control group, p &lt; 0. 001. The ADHD group had significantly lower 25-Hydroxy Vitamin D level the control group (p &lt; 0. 001). Vitamin D level was considered independent predictor of ADHD susceptibility.

Conclusion
Patients with ADHD have lower serum concentrations of 25- hydroxyvitamin D than do healthy children.
Prevalence of Catatonia in the Sample of Patients Admitted to the Psychiatric Institute of Ain Shams University Hospital: A 2 Year Hospital Based Descriptive Study
Authors: Ali Dina Ahmed , Omar Abdel Nasser Mahmoud , Sayed Maha Mohamed , Gamal El Missiry Marwa Adel , Naguib Rehab Mohamed , Mohamed Mohamed Youssef 
Published: November 2024

Abstract

Background
Catatonia is characterized by a number of impressive motor phenomena (rigor, dyskinesia, posturing, catalepsy, gegenhalten, stereotypies, etc.) as much as flamboyant affective symptoms (anxiety, aggression, flat affect or affect incontinence) and bizarre behavioral abnormalities (autism, mutism, echolalia, echopraxia, etc.). Despite a renewed interest in the disorder over the last several decades, a number of questions remain regarding its prevalence, causes and treatment. Clinical manifestations of catatonia are extremely heterogeneous and at least 40 separate signs of catatonia have been described, making recognition challenging with frequent misdiagnoses. The difficulties in the clinical diagnosis, conceptualization and management of catatonia have been described as “The catatonic dilemma”. The relative prevalence and diagnostic significance of catatonic signs differ among studies and patient populations. This study aimed to measure the prevalence of catatonia in the patients admitted at the Institute of Psychiatry through the two years (2019 and 2020), to describe different causes, types of catatonia, to identify the most frequent cause and type during this period and to identify different clinical and demographic correlates affecting the prevalence and severity of the cases. It was held at the Institute of Psychiatry of Ain Shams University Hospital, located In Eastern Cairo, serve both urban and rural areas in Cairo and other governorates in Egypt.

Methods
The sample consisted of a group of patients diagnosed with catatonia (n = 49) and another group of all psychiatric patients without catatonia admitted at the Institute during these two years (n = 1056). The sample was assessed using The Structured Clinical Interview for DSM-V Axis I Disorders (SCID- 5), Structured Clinical Interview for the DSM V (SCID-5PD), The Bush- Francis Catatonia Rating Scale (BFCRS) and designed questionnaire.

Results
Patients with younger age, with abnormal prenatal history and with authoritarian paternal control showed significantly higher odds of experiencing catatonia than those with older age, normal history and authoritative paternal control. Moreover, patients using more than one substance had significantly lower odds of experiencing catatonia than those not using at all. Furthermore, patients who elicited depressive symptoms with psychotic features prior to catatonic symptoms onset had significantly higher catatonia rating scale (CRS) than those with psychotic symptoms. Also, patients with malignant catatonia showed significantly higher CRS than those with retarded catatonia.

Conclusion
The prevalence rate of catatonia was 4.4%. There are several socio-demographic and clinical correlates affecting the prevalence and the severity of catatonia
Orthorexia Nervosa and its Association with Obsessive Compulsive Personality Disorder in a Sample of Egyptian Medical Students
Authors: Essawy Heba Ibrahim , ElGhonemy Soheir Helmy , Mohamed Mohamed Youssef , Kasem Rania elsayed , AbouEl-leil Dina Hussein Mohamed 
Published: November 2024

Abstract

Background
To our knowledge, ON correlation with OCPD has been recently investigated, with many studies supporting a relationship between them, either being a risk factor or a common co-occurrence, which is considered an important contribution to the field of mental health and eating disorders research.

Objective
To measure the prevalence of Orthorexia Nervosa in a sample of Egyptian medical students, to measure the prevalence of Obsessive-Compulsive Personality Disorder in the study sample, to study the association between Orthorexia Nervosa and Obsessive-Compulsive Personality Disorder in the study sample, and to compare the prevalence of ON and OCPD among students in academic years and clinical years of medical school.

Methods
This study is a comparative observational cross-sectional study that included 427 medical students will be assessed for orthorexia nervosa symptoms and OCPD traits, conducted between February 2023 and august 2023 in Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Results
Orthorexia nervosa had prevalence of (8.7%), tendency (10.8%), with mean (18.1±7.2) which is consistent with prevalence in general population of (7%). There was no correlation between mean age, BMI, gender and orthorexia. The differences were statistically significant between third and fourth grade, yet DOS score was non-significantly higher in academic than clinical grades. OCPD prevalence was (42.2%) - (64.9%), which is higher than general population of (6.5%). OCPD results were significantly higher in academic than clinical grades. ON was significantly correlated to OCPD scores on both PDQ-4 and PID-5, and had significant positive correlations with rigid perfectionism, Intimacy avoidance, perseveration traits.

Conclusion
Our study showed that Orthorexia Nervosa is significantly higher in patients with obsessive compulsive personality disorder in comparison to negative participants. Furthermore, prevalence of orthorexia showed no correlation to either gender or BMI or study year of the patients. Obsessive compulsive personality disorder is significantly higher in academic than clinical grades of medical school.