bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Erector Spinae Plane Block on Postoperative Quality of Recovery after Laparoscopic Cholecystectomy
Authors: Abdelfattah Amr Mohamed , Said Alfred Maurice , Elsayed Ahmed El Sherif Ibrahim Mohamed , Abd el halim Yara Emad Saber 
Published: November 2024

Abstract

Background
The postoperative pain following laparoscopic cholecystectomy consists of both somatic and visceral components with pain originating from port entry wounds, gallbladder resection and abdominal insufflation that leads to peritoneal distention and peritoneal damage.

Objective
To determine whether erector spinae plane block improves post operative pain, opioid consumption, nausea, vomiting and early mobilization in patients undergoing (LC).

Patients and Methods
This prospective randomized controlled interventional study was conducted at operative theatres, Anesthesiology, Intensive Care and Pain Management Department, Faculty of Medicine, Ain Shams University Hospitals for 6 months.

Results
These results suggest that ESPB can be effective option for postoperative pain management in laparoscopic cholecystectomy, allowing healthcare providers and patients to choose the most suitable technique based on individual preferences and clinical considerations. However, further research with larger sample sizes and multicentric studies would be valuable to confirm these findings and explore potential variations in different patient populations or surgical settings.

Conclusion
The incorporation of specific numerical findings from multiple studies accentuates the robust evidence suggesting that erector spinae plane block is associated with superior pain control, faster recovery, and reduced reliance on rescue analgesia in laparoscopic cholecystectomy. These quantitative outcomes underscore the potential of ESP block as a transformative analgesic technique in the realm of perioperative care.
Outcomes of Extra-Anatomic Surgical Bypass in Treatment of Central Venous Occlusive Disease in Pediatric Chronic Hemodialysis Patients: One-Year Follow-Up
Authors: Elkenawy Moustafa Mahmoud , AbdelAzim Tarek Ahmed Adel , Fakhr Mohamed Emam 
Published: November 2024

Abstract

Background
Maintenance of hemodialysis vascular access patency in pediatric patients remains a key issue. Venous hypertension due to proximal central venous outflow obstruction is a major impediment to long-term arteriovenous access. Prior ipsilateral insertion of central venous catheters is a common risk factor. Management of Central venous occlusive disease (CVOD) in an attempt to avert sacrificing the fistula and improving symptoms of venous hypertension. Surgical bypass has the advantage of being a bale out technique for management of CVOD with maintaining the existing dialysis access and providing prolonged patency and satisfactory outcome specially with the scarce data about the role of endovascular intervention in management of CVOD in pediatric population.

Objectives
The aim of our prospective, observational study is to evaluate the efficacy and outcome of the surgical management of hemodialysis-related central venous occlusive disease in pediatric patients.

Patients and Methods
This study was conducted on (15) Pediatric patients with end stage renal disease on regular hemodialysis via upper extremity access who underwent extra-anatomic surgical bypass to treat symptomatic venous hypertension due to central venous occlusive disease. Bypass take-off was from subclavian vein, cephalic vein, or axillary vein of the affected side according to site of obstruction and outflow including contralateral subclavian vein, internal jugular vein or ipsilateral femoral vein. The study period started from June 2021 until May 2022. Patients included in the study were essentially attending the Vascular Outpatient Clinic at Ain Shams University Hospitals and Nasser Institute for Search & Treatment at Cairo.

Results
Regarding the type of bypass used in the studied patients, the most frequent type used is Lt Axillary to Rt Subclavian bypass and Lt Subclavian to Rt Subclavian bypass 3 (20%) followed by Rt Axillary to Lt Subclavian bypass, Rt Cephalic to Lt Subclavian bypass and Rt Axillary to Rt femoral bypass 2 (13.33%). Technical success was achieved in the 15 (100%) cases while functional success occurred in 13 (86.6%) cases; patients had performed their 4 hours hemodialysis sessions via their preexisting access within 24 h post-procedurally. No in-hospital morbidity or death was recorded. Primary patency rates at 1, 3, 6, and 12 months were 93.3, 86.6, 73.3, and 66.6%, respectively. Secondary patency rates at 1, 3, 6, and 12 months were 100, 93.3, 80, and 73.3%, respectively.

Conclusion
Extra-anatomic surgical bypass is safe and effective method for management of Central venous occlusive disease and has the advantage of being a bail out technique for maintaining the existing dialysis access and also providing symptomatic relief of venous hypertension, prolonged patency and satisfactory outcome.
Predictors of Isolated Coronary Artery Ectasia (CAE) in Egyptian Population
Authors: Tamara Ahmed Fathy , Tantawy Mahmoud Ahmed , Elbarbary Ahmed , Abdelmoamen Amr Hossam 
Published: November 2024

Abstract

Background
Coronary artery ectasia (CAE) is defined as a dilation of ≥ 1.5-fold compared to the diameter of adjacent normal segments of the same or other arteries. The term 'ectasia' refers to the diffuse dilation of a coronary artery, while focal coronary dilation is referred to as 'coronary aneurysm'. The exact pathophysiology of CAE remains unknown.

Objective
To evaluate risk factors and clinical criteria as predictors of isolated coronary artery ectasia in the Egyptian population referred to our Cath laboratory for coronary angiography.

Patients and Methods
This Retrospective Study was carried out at our Cath lab at Misr University for Science and Technology (MUST) hospital. Among patients attending Souad Kaafi University Hospital, undergoing coronary angiography from November 2018 to October 2022 that 2100 patients, we found 40 patients with isolated coronary artery ectasia who enrolled in this study, and 252 patients with normal coronary angiography as a control group.

Results
The multivariate logistic regression analysis to assess predictors of the incidence of CAE among the studied patients shows that the most important associated factor that affected the incidence of CAE was smoking with an odd ratio of 7.769 and 95% CI (3.311- 18.229). Among patients with isolated coronary artery ectasia, on the number of affected vessels, Smoking status was significantly associated with the extent of coronary artery involvement, with a significant decrease in the proportion of smokers from the three-vessel group (84%) to the two-vessel group (42.9%) and the single-vessel group (0%) (p = 0.000). Among patients, there was statistical significance between isolated coronary artery ectasia and multiple vessel affection.

Conclusion
This study revealed that smoking is significantly associated with the presence of coronary artery ectasia (CAE), while diabetes mellitus (DM) and smoking showed a potential link to more extensive coronary artery involvement. Although other cardiovascular risk factors did not show significant associations, most patients with isolated CAE demonstrated involvement of multiple coronary vessels.
Outcomes of Tocilizumab and Sarilumab for Hospitalized Patients with COVID-19: Retrospective Study
Authors: Madkour Ashraf Mokhtar , El Maraghy Ashraf Abbas , Ghaly Ragy Mamdouh , Fadly Boles Raafat 
Published: November 2024

Abstract

Background
Coronavirus disease 2019 (Covid-19) is associated with immune dysregulation and hyperinflammation, including elevated interleukin-6 levels. The use of tocilizumab, a monoclonal antibody against the interleukin-6 receptor, has resulted in better outcomes in patients with severe Covid-19 pneumonia in previous studies. However, more data are needed to emphasize these studies;

Objectives
The aim of this work was to study the outcomes of TZ and SL for hospitalized patients with COVID-19;

Patients and Methods
This retrospective study was carried out at Specialized Ain Shams University Obour Hospital on 100 severe or critically ill hospitalized COVID-19 patients;

Results
In critically ill patients with Covid-19, the interleukin-6 receptor antagonists tocilizumab and sarilumab were both effective as compared with the current standard of care, which included glucocorticoids in the majority of patients (&gt;80%). The benefit was consistent across primary and secondary outcomes and across subgroups and secondary analyses;

Conclusion
In this randomized trial involving hospitalized patients with severe Covid-19 pneumonia, the use of tocilizumab did not result in significantly better clinical status or lower mortality than sarilumab at 28 days. In which administration of either tocilizumab or sarilumab was associated with improve clinical and laboratory outcome compared. The association is not dependent on the choice of interleukin-6 receptor antagonist.
The Value of Non-Cultured Adipose Derived Stem Cells (ADSCs) in Mechanically Micro Emulsified Adipose Tissue (Nanofat) together with Platelet-Rich Plasma (PRP) in Female Pattern Hair Loss (FPHL)
Authors: Abdallah Marwa Abdel-Rahim , El-Sayed Abou-Noor Mahy El-Bassiouny , Tamim Mohamed Marwa Abdelfatah 
Published: November 2024

Abstract

Background
Female pattern hair loss (FPHL) is the most common cause of non- scaring alopecia in females and it significantly affects individuals' overall quality of life. Managing this condition poses a regular challenge in dermatological practice due to the limited supporting evidence for many therapeutic options, frequently resulting in unmet patient expectations. Nanofat grafts, generated by emulsification and filtering of microfat, contain growth factors and Adipose Derived Stem Cells (ADSCs) that can induce tissue regeneration and improve tissue quality

Objective
To assess the efficacy of Platelets Rich Plasma (PRP) added to Nanofat in Female Pattern Hair Loss (FPHL)

Methods
This is an Interventional study, which included 20 female patients with female pattern hair loss (FPHL) after exclusion of other causes of alopecia. Patients were selected from the outpatient clinic of Dermatology of Ain Shams University Hospitals from December 2022 till May 2023.

Results
In our study, 20 FPHL patients aging from 18 to 50 years. They were treated by Nanofat with PRP. They were followed up at12 and 24 weeks clinically by photography and trichoscopically by counting terminal and vellus hair and assessing the change in terminal and vellus hair thickness which were analyzed using image J data analysis software. Mean terminal hair count was increased highly significantly in number, as it increased from 73.90 hair/cm2 before treatment to 120.05 hair/cm2. There were high statistically significant decrease in vellus hair count, decreased from 46.60 to 25.20 (p &lt; 0.001). There was high statistically significant increase in terminal hair thickness after treatment from 0.044 to 0.062 after 6months, (p &lt; 0.001). There was high statistically significant increase in vellus hair thickness after treatment from 0.020 to 0.026 after 6 months from 0.020 to 0.023, p &lt; 0.001

Conclusion
The procedure seems safe, effective, well-tolerated by all the patients with encouraging response from these patients. We observed no adverse side effects in any. patient
The Impact of Probiotic Supplementation on Liver Enzymes in Patients with Non-Alcoholic Fatty Liver Disease Attending the Family Medicine Clinic at Ain Shams University Hospitals
Authors: Abd El Hamid Alaa Ahmed , Mohamed Azza Emam , sabry Manal , Amin Ghada Essam El-Din , Elessawy Hagar , Allam Mohamed Farouk 
Published: November 2024

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is a condition marked by the accumulation of fat (more than 5% of liver tissue) without the presence of alcohol abuse or other chronic liver ailments. NAFLD can lead to liver inflammation and advance to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and, in severe cases, may contribute to the development of hepatocellular carcinoma (HCC)

Objective
To assess the impact of probiotic supplementation, specifically lactobacillus, on liver enzymes (ALT & AST).

Patients and Methods
This study involved 50 participants (15 males and 35 females) with a body mass index equal to or greater than 25 and an age range of 18-60 years, all exhibiting evidence of bright fatty liver in ultrasonography. Exclusion criteria comprised any signs of other chronic liver diseases, including viral hepatitis (B and C), autoimmune hepatitis, a history of alcohol consumption, diabetes mellitus (DM), statin therapy for cardiovascular disease (CVD), recent surgery, gastroenteritis, or diarrhea in the last 2 weeks. The participants were divided into two groups: a probiotic group consisting of 25 patients who received daily probiotics for 12 weeks along with diet and lifestyle modifications, and a standard treatment group of 25 patients who underwent diet and lifestyle modifications only. The study involved clinical assessments, laboratory evaluations, and abdominal ultrasound for all participants.

Results
The average age of the entire study sample was 46.48. No statistically significant differences were observed between the standard treatment group and the probiotic- treated group with respect to smoking, weight, and BMI. The probiotic-treated group exhibited a significant reduction in ALT and AST (P values 0.014 and 0.004, respectively), while the standard treatment group showed a smaller decrease in AST only (P value 0.025).

Conclusion
The findings of the present study indicate that short-term treatment with the probiotic resulted in improvements in ALT and AST levels in the probiotic group
Study of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR) and C Reactive Protein (CRP) as Systemic Biomarkers of Inflammation among Apparently Healthy Egyptian Obese Subjects
Authors: Elsayed Nagy Menna-t-Allah , Rahman El Shayeb Mohamed Abdel , Farres Mohamed Nazmy , Ahmed Eman Elsayed , Mohamed Abdel Rahman Salwa Mostafa , Mahmoud Mayada Moneer 
Published: November 2024

Abstract

Background
Obesity is presumed to be a chronic state of subclinical inflammation which is a major risk factor for many disorders.

Objective
is to evaluate Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and C reactive protein (CRP) as biomarkers for the inflammatory state associated with obesity among apparently healthy Egyptian subjects.

Patients and Methods
The present study was conducted on 60 apparently healthy individuals, including 30 obese subjects and 30 non-obese subjects. They were recruited from the outpatient departments of Ain Shams University Hospitals. Inflammatory biomarkers NLR, PLR and CRP were compared between both groups.

Results
There was a statistically significant increase in the PLR and CRP level in the obese group compared to the non obese group while there was no statistically significant increase in the NLR between both groups.

Conclusion
Both CRP and PLR (but not NLR) can be used as markers for estimation of ongoing subclinical inflammation in apparently healthy obese subjects.
Assessment of Pre-Operative Predictive Factors Favoring Conversion from Laparoscopic to Open Cholecystectomy in Acute Cholecystitis
Authors: Abbas Ahmed Adel , Mohamed Amr Arafa , Abdelazim Mohamed Samy 
Published: November 2024

Abstract

Background
Acute cholecystitis refers to inflammation of the gallbladder. The pathophysiologic mechanism of acute cholecystitis is blockage of the cystic duct. Accurate diagnosis of cholecystitis requires a multifactorial, systematic approach that involves a detailed history, physical exam, serologic tests, and imaging. The (Tokyo guidelines 2018) diagnostic criteria for acute cholecystitis is widely used now days and well accepted.

Objective
To asses pre-operative predictive factors favoring conversion of laparoscopic cholecystectomy into open cholecystectomy in acute cholecystitis such as: (TLC- history of DM and previous abdominal surgery -gall bladder wall thickness _ pericholecystic fluid collection and loss of gallbladder wall enhancement on CT).

Patients and Methods
This study included 100 patients admitted to Ain Shams university hospitals diagnosed with acute cholecystitis, underwent laparoscopic cholecystectomy, half of them converted to open cholecystectomy, the two groups are compared to each other to figure out preoperative factors favoring conversion cholecystectomy

Results
Obesity (BMI≥30 kg/m2) in this study has shown to be associated with risk of conversion in this study. In converted group there is 25 (50%) patients who are obese compared to 14 (28%) patients in laparoscopic group with P-value of 0.04. In our study we haven’t assessed the role of intraoperative findings on conversion rate. We chose not to include this factor in our analysis to make primary concern regarding pre-operative factors.

Conclusion
Obesity, DM, previous abdominal surgery, loss of gallbladder wall enhancement in CT study and prolonged prothrombin time are risk factors of conversion cholecystectomy in acute cholecystitis. Appropriate management of risk-related preoperative factors may improve patients’ outcomes making in mind the concept of conversion to open cholecystectomy should not be viewed as a complication or a failure but just the opposite. It is showing good judgment to complete the operation in the safest manner possible.
Specimen Rejection in the Laboratory of a Secondary Medical Center in Egypt
Authors: Eltelbany Manal A Shams Eldin , Hussein Wafaa M , Aziz Lilian W 
Published: November 2024

Abstract

Background
Errors in Laboratory testing have a direct impact on patient safety, as it directly affects diagnosis and management. Most errors occur in the pre-analytical phase, which occurs outside the laboratory. This study aimed to investigate the laboratory specimen rejection rate and causes in the pre-analytical phase in the laboratory of petroleum medical center.

Methods
The present study was conducted at Petroleum medical center in Egypt from August 2022 to June 2023. The study included 1701 specimens, Checklist was used to collect data about specimens received at laboratory, it includes information about source of specimen, type of specimen, date and time specimen was collected and received at the laboratory, phlebotomist, specimen transports and storage conditions, whether a specimen was rejected, and the rejection reason.

Results
Out of 1701 specimens, 98 (5.76%) were rejected. Clotting of anticoagulated specimens caused 49 (50%) of the rejections, followed by insufficient volume and hemolysis accounting for 8 (8.1%) each. Most of the rejected specimens came from the Emergency department 16 (16.33%), intensive care unit 24 (24.94%) and medical ward “6” 27 (27.55%). About 12/69(17.39%) of the specimens collected by physicians were rejected compared to 65/1013 (6.42%) for nurses and 21/619 (3.39%) for laboratory technicians.

Conclusions
The specimen rejection rate in this study was around 98/1701(5.76%). Clotting of anticoagulated specimens was the most important cause for rejection.
Spectrum of Renal Diseases Diagnosed by Renal Biopsy and its Clinical Correlation in Ain Shams University Hospitals
Authors: El-Sayed Hesham , Said Heba El , M.I Salman , Behairy Maha , Gharib Mohamed Sary , Ahmed Al Shaimaa Ebrahem 
Published: November 2024

Abstract

Background
The spectrum of biopsy-proven renal diseases differs between locations and changes over time. It is therefore essential to describe the local epidemiological trends and the prevalence of renal biopsy in various regions to highlight new pathology of various renal diseases and provide a basis for further hypothesis-driven research.

Objective
To evaluate the Spectrum of renal diseases diagnosed by renal biopsy in Ain Shams University Hospitals and study the clinical correlation of renal biopsies.

Patients and Methods
This retrospective study reviewed 1851 renal biopsies from Ain Shams University Specialized Hospital Histopathology lab and Electron Microscopy (EM) lab, during the period from January 1, 2019, to December 31, 2022. Clinical data was collected regarding the patient`s age, clinical presentations at the time of biopsy, diagnostic tests at the time of biopsy, and systemic diseases. The specimen’s reports were verified by at least two histopathologists. Histopathological findings were organized according to the recent classification system.

Results
We have analyzed the data of 1851 renal biopsies, with a mean age of 38.43 ± 14.83. 52.4% of the study population are males, and 47.6% are females. Hypertension was present in 71.9% of the patients. Primary glomerulonephritis was the most common renal pathology diagnosis, accounting for 47.1% of the cases, followed by secondary glomerulonephritis (27.5%) and vascular diseases (21.5%). Hypertensive nephrosclerosis was diagnosed in 18.7% of the patients. There were significant differences in the diagnosis of renal pathology among different age groups. Lupus nephritis was the most common diagnosis in the age group of 18-39 (24.6%), while hypertensive nephrosclerosis was the most common in the age groups of 40-59 (27%) and ≥60 (25.6%).

Conclusion
Renal biopsy most commonly presents with nephrotic syndrome. Primary glomerulonephritis is the most common diagnosis, with membranous GN being the most prevalent. Lupus nephritis is the most common secondary glomerulonephritis.
Assessment of Interleukin-35 Expression in Adult Egyptian Immune Thrombocytopenic Purpura Patients
Authors: El-Razzaz Mostafa K , Abdou Dina M , Moussa Mohamed M , Mostafa Nevine N , Nabeeh Nermeen A , Saber Heba M 
Published: November 2024

Abstract

Background
Immune Thrombocytopenic Purpura (ITP) is one of the common autoimmune diseases in Egypt, this disease causes a considerable drop in platelet counts rendering the patients at very high risk of bleeding. For this, ongoing research to determine an accurate diagnostic tool that would help in rapid diagnosis and also the remote prognosis of the disease are continuous. IL-35 is one of the interleukin family that now has been highlighted as a useful prognostic marker in many autoimmune diseases e.g.: SLE. In the light of its significance that was detected in other autoimmune disease, this study was to specify this interleukin in the context of the diagnosis of ITP.

Method
This pilot observational study was carried out on 60 patients and 20 normal controls. The patient group was categorized into newly diagnosed, relapsed and resistant groups. IL-35 was measured in serum by ELISA.

Results
This study demonstrated that plasma IL-35 levels were significantly lower in ITP patients than those in healthy controls and that IL-35 expression levels positively correlated with circulating platelet counts. Moreover, it was noted that a decrease in IL-35 contributes to the pathogenesis of ITP, and a statistically significant association between IL-35 levels and disease outcomes in ITP patients (P = 0.033). Specifically, patients with elevated IL-35 levels exhibited higher remission rates (28.8%) than patients experiencing only partial remission or resistance to treatment.

Conclusion
This finding suggested that IL-35 may play a role in predicting or potentially influencing disease prognosis.