bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relation of Neutrophil Lymphocyte Ratio to the Steatosis and Fibrosis Stage in Patient with Non-Alcoholic Fatty Liver Disease Using Fibroscan with Controlled Attenuation Parameter and FIB-4 and FIB-5 Scores
Authors: Anwar Ayman Gamil , Abd El megeed Khaled Hamdy , Hussien Hany Ali , Mohamed Anwar Hossam Ahmed 
Published: November 2024

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Fibroscan with controlled attenuation parameter (CAP), a noninvasive imaging procedure in diagnosis of NAFLD patients. Also Neutrophil / lymphocyte ratio (NLR) is a simple marker for inflammation, may be used to predict disease outcome.

Objectives
Is to determine whether there is a correlation between NLR and the degree of steatosis and fibrosis measured by fibroscan with CAP, FIB-4 and FIB-5 score.

Patients and Methods
This was a cross sectional study involving 2 groups, group (1): included 115 patients of NAFLD and group (2): included 30 healthy controls. All participants were supjected to complete personal and medical history (history of other comorbidities as DM, Hypertension syndrome and drug/herb intake). Complete physical examination including anthropometric measurements, vital signs, local examination and general examination of any signs of liver dysfunction as hepatomegaly, Jaundice, ascites, splenomegaly and varices. Laboratory tests including (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), Bilirubin, hemoglobin A1c, fasting glucose level, Lipid profile, Antinuclear antibody (ANA) test (to exclude autoimmune hepatitis), serum Uric acid and viral markers (HBsAg & Hcv Ab), Abdominal ultrasound, Fibroscan with CAP and FIB-4 and FIB -5 scoring, complete blood count with calculation of neutrophils /lymphocytes ratio(NLR).

Results
Both studied groups were comparable in age and sex distribution. Out of NAFLD cases (group 1), more than half (53.9%) had comorbidities (manifested as DM in 37.4%, hypertension in 36.5%, CVD in 8.7% and hypothyroidism in 1.7% of patients), there was no statistically significant difference between the studied groups regarding anthropometric measurements, NAFLD cases (group 1) had significantly lower Hb, HDL level and PLT p value &lt;0.001 and higher NLR, ALT, AST, GGT, cholesterol, triglycerides and LDL levels p &lt; 0.001,there was a significant positive correlation between NLR and each of steatosis and fibrosis p &lt; 0.001,NLR was significantly positively correlated with FIB-4 (r = 0.667, P &lt; 0.001) and FIB-5 (r = 0.361, P &lt; 0.001), NLR was a significant predictor of hepatic steatosis (AUC= 0.816, P = 0.011) and fibrosis (AUC=0.739, P &lt; 0.001) in NAFLD cases.

Conclusion
The study conducted on NAFLD patients at Ain Shams University Hospital found significant associations between NLR and liver steatosis/fibrosis. NLR proved to be a valuable predictor, with optimal cutoff values for steatosis and fibrosis, aiding in noninvasive assessment and management of NAFLD patients.
Assessment of the Autophagy Biomarker Level In Diabetic Kidney Disease Patients
Authors: Abdelmobdy Ashraf Hassan , Saeed Saeed Abdelwahab , Mohamed Khaled Magdy , Ibrahim Rakha Nahed Moawad 
Published: November 2024

Abstract

Introduction
Diabetic nephropathy is the most common long-term complication of diabetes mellitus and one of its major complications is diabetic kidney disease which is a major cause of end-stage renal disease (ESRD). Recent studies suggested defective autophagy involved in the pathogenesis and progression of diabetic kidney disease. So, we aimed to assess the autophagy biomarker Beclin-1 level in diabetic kidney disease patients.

Methods
In a cross sectional study, we enrolled 100 patients with Diabetic Kidney Disease (DKD) referred to Ain Shams University hospital. The patients were divided into 5 groups according to the estimated glomerular filtration rate (eGFR). Each group consisted of 20 patients to Compare the level of serum Beclin-1 in different groups. Beclin 1 assay: Human Beclin 1 (BECN1) ELISA kit uses a double antibody sandwich enzyme linked immunosorbent assay (ELISA) to assay the level of Human Beclin 1 (BECN1) in samples.

Results
There was statistically significant difference between the studied groups (p &lt; 0.001) regarding hemoglobin, creatinine, hemoglobin A1c, calcium, phosphate, protein creatinine ratio, eGFR, and Beclin-1 levels with highest value among group (2, 5, 4, 2, 5, 5, 5 and 5) respectively and lowest value among group (5, 1, 5, 5, 2, 1, 5 and 5) respectively. There was statistically significant inverse correlation between Beclin-1 and diabetes duration, creatinine, urea, CRP and protein creatinine ratio (r: −0.24; p = 0.026), (r: −0.44; p &lt; 0.001), (r: −0.44; p &lt; 0.001), (r: −0.52; p &lt; 0.001), (r: −0.56; p &lt; 0.001) respectively. There was statistically significant positive correlation between Beclin-1 and hemoglobin, calcium and eGFR (r: 0.242; p = 0.015), (r: 0.248; p = 0.013) and (r: 0.568; p &lt; 0.001) respectively. At cutoff value equal to (3.3, 1.2, 1.8 and 1.1) Beclin-1 had sensitivity equal to (100%, 55%, 80% and 85%) respectively and specificity equal to (85%, 85%, 75% and 100%) respectively in prediction of CKD progression from (stage 1 to stage 2), (stage 2 to stage 3), (stage 3 to stage 4) and (stage 4 to stage 5) respectively.

Conclusion
In conclusion we found that eGFR was the most influential parameter affecting Beclin-1 level and by using multivariate model, linear regression analysis adjusted factors for confounders eGFR was the only factor which kept his significant correlation with Beclin-1.
Association between Chronic Kidney Disease and Non-Alcoholic Fatty Liver Disease: A Cross Sectional Study
Authors: Baioumy Essam Mohammed , Elgaaly Sonia Ahmed , Fathallah Ahmed Magdy , Bebawy Marina Maurice 
Published: November 2024

Abstract

Background
Nonalcoholic fatty liver disease (NAFLD) is a growing health problem that poses a significant burden as it is currently the most prevalent form of chronic liver disease, affecting an estimated 25% of the worldwide population.

Aim of the Work
to evaluate the role of plasma LCN2 levels in the diagnosis and prognosis of patients with non-alcoholic fatty liver disease.

Patients and Methods
Our case-control study was conducted on 102 Egyptian subjects between the ages of 18 and 70, recruited from the Internal Medicine and Hepatology Department and Clinics at Ain Shams University Hospital during the period from March 2023 to August 2023, and divided them into two groups. Group I: 51 Egyptian patients diagnosed with NAFLD (61% males; 39% females). Group II: 51 Egyptian healthy controls (51% males; 49% females)

Results
In this study, LCN2 levels were significantly higher in cases than in the control group (p &lt; 0.001), with a mean of 1893.214 ±1002.852 in the cases and a mean of 466.020 ± 397.699 in the controls. This suggests the use of LCN2 as a possible diagnostic marker of NAFLD. The mean LCN2 levels in this study also significantly increased as the grade of fatty liver increased from I to III (p &lt; 0.001). This in turn proposes the use of LCN2 as a prognostic marker for NAFLD progression. LCN2 also significantly correlated with the fatty liver index and NAFLD Fibrosis scoring systems, but not with Fib-4. It showed an excellent diagnostic performance in this study with an area under ROC of 0.906, an 84% sensitivity, a 90% specificity, 89.6% PPV and 85.2% NPV for the prediction of NAFLD patients.

Conclusion
Lipocalin-2 performs as a diagnostic marker for non-alcoholic liver disease, and a possible prognostic test that may be used to follow up the degree of steatosis. Other studies should be done on a larger size of participants to determine the prevalence of LCN2 in Egyptian population as well as other populations. Other studies should also be expanded to include NAFLD with degrees of fibrosis, and more quantitative imaging tools could be used to compare LCN2 levels with the NAFLD stage. The levels of LCN2 can be also measured in cohort studies before and after treatment of NAFLD to evaluate its sensitivity to the response of treatment.
Role of Plasma Lipocalin-2 Levels as a Diagnostic and Prognostic Marker in Patients with Non-Alcoholic Fatty Liver Disease
Authors: Kamal Marwa Abdullah Muhammad , Nashaat Ehab Hassan , ElGhandour Ahmed Mohamed , Abdo Ahmad Abbas 
Published: November 2024

Abstract

Background
Rheumatoid arthritis, the most common connective tissue disease associated with Sjogren syndrome, may result in some extra-articular manifestations called sicca symptoms that are including keratoconjunctivitis sicca or dry eyes and xerostomia or dry mouth. RA usually has high morbidity and mortality and in patients with RA occurrence of SS makes its course worse.

Aim of the Work
to evaluate diagnostic accuracy of salivary gland US in differentiating RA patients with or without SS by use of probability method and evaluate the relation of SS with RA disease characteristics.

Patients and Methods
This cross-sectional study (Diagnostic test accuracy study) included (100) RA adult patients for 5 years or more who were recruited randomly from Rheumatology outpatient clinic and inpatient internal medicine department, Ain Shams University Hospitals.

Results
In our study, there was a statistically highly significant increase in number and percent of RA patients in area of certainty (≤20%&≥80% probability) after salivary glands US. Also, there was a statistically highly significant decrease in number and percent of RA patients in vague or borderline area (40-60%) after salivary glands US, making SGUS a good tool for diagnosing SS that may replace the need for invasive biopsy. In the current study, there was a statistically significant longer RA disease duration and higher Anti CCP antibody titer in RA patients with secondary SS compared to those without secondary SS. There was statistically highly significant higher percentage of RA patients with secondary SS who had CTS compared to RA patients without secondary SS.

Conclusion
SS is a frequent complication in RA patients especially in association with longer disease duration, higher Anti CCP antibody titer and CTS. US of SG is a useful tool that help diagnosis and grading of severity of SS in RA
Clinical Value of Adding Dapagliflozin in Patients with Nephrotic Syndrome
Authors: Mahmoud Ahmed Mohamed Mohyeldin Mohamed , ElSharkawy Magdy Mohamed , Teama Nahla Mohamed , Emara Ahmed Abdelmonem 
Published: November 2024

Abstract

Background
The nephrotic syndrome has one of the best-known presentations of adult and pediatric kidney disease. The incidence of nephrotic syndrome is approximately 2 to 4 new cases per 100,000 population per year. While advances had been made in the treatment of various glomerulonephritides, some uncertainty still exists regarding the management of nephrotic syndrome owing to the lack of high-quality randomized trials of treatment or interventions and systematic reviews.

Aim of the Work
to assess whether dapagliflozin compared with placebo reduces edema and proteinuria in patients with nephrotic syndrome. Additional exploratory endpoints include changes in eGFR and bodyweight.

Patients and Methods
The present study was a randomized controlled trial conducted to assess the clinical value of adding dapagliflozin to the standard of care in patients with nephrotic syndrome.

Results
A notable and statistically significant mean difference in baseline proteinuria was observed between the two study groups (3645.17 ± 928.1 mg/g; p &lt; 0.001). However, as the study progressed, this difference decreased and eventually became non-significant. Although the dapagliflozin arm started with markedly higher proteinuria and achieved remission similar to the control group, the specific impact of dapagliflozin could not be definitively determined due to both groups receiving immunosuppression therapy. The dapagliflozin group experienced an initial decline in renal function, with eGFR decreasing to 80.63 mL/min/1.73m². However, from Months 2 to 6, there was a progressive increase in eGFR, reaching 94.53 mL/min/1.73m² at 6 months. A post hoc analysis revealed a significant difference between the second month vs. months 4, 5, and 6, as well as the third month vs. months 4 and 6 (p &lt; 0.001). In contrast, the control group's eGFR values remained relatively stable throughout the study period, ranging from 96.7 mL/min/1.73m² at baseline to 103.37 mL/min/1.73m² at 6 months (p = 0.463). These findings suggest that dapagliflozin may initially impact renal function with a temporary decrease in eGFR, but the effects are reversible as eGFR values gradually improved later on.

Conclusion
The evolving understanding of SGLT2 inhibitors' role in patients with nephrotic syndrome. The findings suggest their potential to influence proteinuria reduction, renal function improvement, weight management, glycemic control, and lipid profile enhancement. he manageable incidence of UTIs further supports the safety profile of dapagliflozin in this context. These findings contribute to the growing body of evidence on the clinical value of SGLT2 inhibitors in glomerular diseases, emphasizing their potential to complement standard treatments and enhance patient outcomes. Further research is warranted to fully elucidate the long-term benefits and safety of dapagliflozin in this patient population.
Frequency of Microscopic Colitis among Patients with Diarrhea Predominant Irritable Bowel Syndrome
Authors: Elsayed Engy Yousry , Academic Hany Aly Abdel Rahman , Raafat Khaled , Ibrahim Gad Mohamed Talaat 
Published: November 2024

Abstract

Background
Microscopic colitis is a chronic inflammatory disease of the colon that frequently causes chronic watery diarrhoea that might be accompanied by abdominal pain, nocturnal diarrhoea, urgency, and faecal incontinence. These symptoms lead to poor quality of life and increased health-care costs. Diagnosis relies on histological examination of multiple biopsy samples from the colonic mucosa, which often show no or only few abnormalities on endoscopy. Two major histological subtypes can be distinguished-collagenous colitis and lymphocytic colitis-but incomplete and variant forms with fewer characteristic features have been reported. Here we summarise the latest evidence on epidemiology, pathogenesis, and risk factors, and discuss established and novel therapeutic options for clinical remission. Finally, we propose an updated treatment algorithm. Further prospective studies are needed to clarify the natural history of microscopic colitis, supported by validated criteria for the assessment of disease activity.

Aim of the Work
The aim of this study is to assess the frequency of collagenous colitis and lymphocytic colitis among patients diagnosed with diarrhea predominant -IBS according to Rome III criteria in a scale of Egyptian population and its relation to bilharziasis.

Patients and Methods
Type of Study: Cross-sectional study of 50 patients with IBS-D who will undergo medical history and clinical examination.

Results
The present study showed significant elevation of ESR levels in MC patients with range (5-15mg/dl) than other patients levels which showed range (3-13 mg/dl), as ESR is acute phase reactant. Our study showed significant decrease in the level of Hb in patients with MC with range (10-12gm/dl) than patients with normal biopsy which showed range (12-15.7gm/dl) which may be due to chronic illness in patients with MC.

Conclusion
The present study showed significant decrease of albumin levels in MC patients with range (3- 4.5gm/dl) than other patients levels which showed range (3.4- 5.4 gm/dl), which may be due to severe attacks of diarrhea in patients with MC.
Prevalence of HCV among ESRD Patients on Regular Hemodialysis in Ain Shams University Hospitals after Implementation of National Eradication Initiative
Authors: Ahmed Abdelkareem Mohand Abdelnasser , Sarhan Iman Ibrahim , Gaafary Maha Mohamed El , Tawfik Ahmed Mohamed , Abd El-Mohsen Mohammed Atef 
Published: November 2024

Abstract

Background
Egypt is one of the highest countries in the world regarding the prevalence of hepatitis C virus (HCV) infection. End stage renal disease (ESRD) patients are at higher risk for HCV infection more than general population. Since 2014 Egypt has started a large elimination program for screening and treatment of HCV. Goal was early detection and treatment of HCV patients. Intending HCV prevalence reduction to &lt; 2% in 10 years, in line with global targets. In addition, Egypt has aimed to treat 250000 people annually up to 2020 in the first phase of their treatment program aiming at reducing the number of viremic patients, thus limiting the ongoing HCV transmission.

Aim of the Work
to measure the prevalence of HCV infection among ESRD patients and to identify the reasons of missed treatment among those who were offered the treatment free of charge.

Patients and Methods
This multi-center cross sectional study included 410 patients receiving hemodialysis sessions on regular basis 4 hours/3 times per week for more than 6 months in Ain Shams University Hospitals, patient recruitment from March 2023 to August 2023.

Results
Our studied 410 patients had mean age of 47.13 ± 18.19 ranging between 18 – 85 years old with male predominance (62.4%). With different educational levels. Most of them had comorbidities (85.6%), as HTN (54.1%) being most predominant. Prevalence of HCV infection is (27.6%), Among patients with HCV infection, (84.1 %) received treatment and (15.9%) didn't receive treatment due to several causes. The patients with positive HCV infection had a lower educational level than negative HCV infection with a statistically significant difference (P = 0.027). The patients with positive HCV PCR had a prolonged onset of renal function impairment than negative HCV PCR with a statistically highly significant difference (P = 0.009), and also positive HCV PCR had prolonged dialysis duration and a prolonged duration of HCV infection than negative HCV PCR with a statistically significant difference.

Conclusion
The low prevalence of HCV among hemodialysis patients of HCV in hemodialysis patients confirms that HCV infection doesn’t become a major health problem among patients on maintenance hemodialysis. However, strict adherence to effective and proper procedures for controlling hepatitis infections will warrant preventing and reducing the prevalence of hepatitis infections. Clinically, hemodialysis patients require more attention and resources than the general population.
Study of Plasma Cyclic Guanosine Monophosphate as a New Marker in Patients with Portal Hypertension
Authors: Adel Nannes Ahmed , Mohamed Eslam Safwat , Faheem Heba Ahmed , Moustafa El Kassas Omar Galal El Din 
Published: November 2024

Abstract

Background
Clinically significant portal hypertension (CSPH), which causes a number of problems such variceal haemorrhage, ascites, and hepatorenal syndrome and is linked to a drastically decreased chance of survival, is a turning point in the development of liver cirrhosis. Therefore, the diagnosis of CSPH has significant prognostic significance. The measurement of the invasive hepatic venous pressure gradient (HVPG) is the gold standard for the diagnosis of portal hypertension.

Objective
To evaluate plasma level of cyclic guanosine monophosphate as a possible biomarker in patients with liver cirrhosis and portal hypertension

Patients and Methods
The type of study is a case control study; which were performed at Ain Shams university hospitals inpatients and outpatients settings for one year. The study population includes 80 patients with liver cirrhosis (40 cirrhotic patients without portal hypertension and 40 cirrhotic patients with portal hypertension 20 healthy controls). Inclusion Criteria involves adult over 18years old patients form both sexes.

Results
In this study we found that there was high statistically significant difference between the studied groups as regard Plasma cGMP, as level of cGMP in patients with portal hypertension is higher than in patients without portal hypertension (p &lt; 0.001). In the present study we found that there was no statistically significant relation between Plasma cGMP and varices in patients with portal hypertension or without portal hypertension (mean 85±14.96 range:46.4-111.3, mean 82.05±20.96 range 62.5-111.3 respectively, p = 0.608).

Conclusion
The current investigation shows that cirrhotic patients with CSPH have dramatically disturbed plasma cGMP homeostasis. Our findings suggest that cGMP may be used as a blood- derived CSPH biomarker, particularly in the context of esophageal varices screening.
Mac-2 Binding Protein Glycosylation Isomer as a Hepatocellular Carcinoma Marker in Patients with Chronic Hepatitis B or C Infection
Authors: Mohamed Farag Sherif Monier , Halima Sami Mahmoud Abdou Mahmoud Ahmed Samir Abo 
Published: November 2024

Abstract

Background
Hpatocellular carcinoma HCC is now the sixth most common cause of cancer worldwide. The second leading cause of cancer death after lung cancer in men is HCC. The most frequently used screening tests for HCC patients are hepatic ultrasound (US) with or without assessment of alpha-fetoprotein, but the diagnostic value of AFP is recently challenged due to its low sensitivity and specificity. So the aim of this study was to evaluate the role of mac 2 as a diagnostic marker in HCC Egyptian patients.

Objective
This study will assess the role of Mac-2 Binding Protein Glycosylation Isomer as a Hepatocellular Carcinoma Marker in Patients With Chronic Hepatitis B or C Infection.

Patients and Methods
This study had been carried out on 70 subjects, age range more than 18 year selected from Internal medicine and Hepatology outpatient clinics and inpatient wards at Ain Shams university hospitals from august 2022 to june 2023, after informed consent were taken from the patients

Results
This study was carried out on 70 participants divided into 2 group: 35 patient post viral cirrhotic patients with Hepatocellular Carcinoma, 35 patient post viral cirrhotic patients without hepatocellar Carcinoma selected from Ain Shams university hospitals, after informed consent were taken from the patients. Subjects were divided as follow: Group A (Hcc): 35 patients with Hepatocellular carcinoma, More than 18 years. Group B (Cirrhotic): 35 patients with liver cirrhosis without Hepatocellular carcinoma, age more than 18 years

Conclusion
We concluded from this study that: Serum Mac2 level was significantly higher in patients with HCC regardless of other characteristics as presence of combined conditions as DM and HTN or Viral markers and mildly elevated in patients with liver cirrhosis compared to HCC group. MAC 2 is more sensitive than AFP in differentiation between HCC and cirrhoitic patients but AFP is more specific. Using of mac 2 will improve the diagnostic field and can help in early detection of HCC in surveillance programs Together with AFP.