bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome and Prognostic Factors of Class V Membranous Nephropathy (Pure and Mixed Form) in a Cohort of Egyptian Patients with Systemic Lupus Erythematosus
Authors: Attia Allah Duaa Farghaly , Hosny Hamza Sherin Mohamed , Khalil Nermeen Samy , Mohamed Mansour Mohamed Maher 
Published: November 2024

Abstract

Background
Renal disease is a frequent and severe cause of morbidity in systemic lupus erythematosus (SLE). Lupus membranous nephropathy (LMN), which is an uncommon subtype of lupus nephritis, is usually associated with nephrotic syndrome and can have a variable course; some patients maintain stable kidney function or show a slow progression, while others can have renal flares and transformation to more severe proliferative forms eventually leading to ESRD or to life-threatening extrarenal complications, including thrombotic events, cardiovascular disease (CVD), or infections. In many cases, a combination of membranous and proliferative lesions may be seen in renal biopsies.

Objective
To study the clinical presentation, course, outcome and prognostic factors of class V membranous nephropathy (pure and mixed) in a cohort of Egyptian patients with SLE.

Methods
This was an observational study which was conducted on ninety six (96) adult Egyptian patients diagnosed with LMN recruited from the outpatient clinic and inpatient department of rheumatology, at Ain Shams university hospitals, during a period of 12 months.

Results
In this study, the univariate logistic regression analysis shows that (low level of WBCs, low level of hemoglobin, high level creatinne, high level of urine, Protein / Cr ratio, low level of Creatinine clearance) were found significantly associated with poor outcome in patients with mixed type. Also, the multivariate logistic regression analysis shows that the most important factors associated with poor outcome in patients with mixed type was found WBCs level ≤3. WBC of urine analysis&gt;10, that ESR &gt;28, partial remission and SLEDAI score &gt;13 were found significantly associated with poor outcome among patients with pure MLN. Also, the multivariate logistic regression analysis shows that the most important factor associated with poor outcome in patients with pure type was found partial remission.

Conclusion
The present study can burden the knowledge and shed some light on future prospective studies with larger sample sizes and longer follow up to reassess our findings.
COVID-19 and DKA of Type 2 Diabetes, Impact and Outcome
Authors: Abd Albaky Mohamed Rania Al Sayed , Ali Hendawy Laila Mahmoud , Mohamed Abd Al Hady Saleh Amr Mahmoud , Mahmoud Farghaly Eman Elsayed 
Published: November 2024

Abstract

Background
Recent evidence suggests a potential link between COVID-19 infection and the development of insulin dependence in individuals with diabetes, particularly through direct damage to pancreatic insulin-producing beta-cells mediated by the virus's affinity for ACE2 receptors. This association bears similarities to the role of other viruses like enteroviruses and mumps in causing fulminant ketoacidosis. While it is feasible that the insulin dependence seen in diabetic ketoacidosis (DKA) during COVID-19 arises from SARS-CoV-2-induced beta cell dysfunction, stronger evidence supports an alternate pathway involving indirect factors like systemic hypoxia, sepsis, inflammatory responses, and cytokine storms resulting from the infection.

Aim of the Work
This study aimed to assess the risk factors and outcomes related to DKA in COVID-19-infected patients with type 2 diabetes.

Patients and Methods
The research analyzed data from 70 patients, comprising 35 with DKA and 35 without DKA, focusing on variables such as age, sex, comorbidities, laboratory results, and clinical symptoms. The mean age was found to be significantly higher in the DKA group, aligning with previous studies that linked older age to increased DKA susceptibility during COVID-19. Sex distribution did not show significant differences between the DKA and non-DKA groups.

Results
Notably, patients with DKA displayed longer diabetes duration and significantly higher hemoglobin A1c levels, suggesting a potential role of poor glucose control in precipitating DKA during COVID-19 infection. Furthermore, DKA patients exhibited more severe acid-base disturbances and electrolyte imbalances compared to their non-DKA counterparts. These imbalances, along with respiratory and cardiovascular symptoms, characterized the clinical presentation of DKA during COVID-19.

Conclusion
Ultimately, the mortality rate was found to be markedly higher among DKA patients than among non-DKA patients. These findings emphasize the importance of recognizing the complex interplay between COVID-19 infection, diabetes, and DKA, especially in older individuals with longer diabetes duration and poor glycemic control. This study provides valuable insights into the risk factors and clinical outcomes associated with DKA in COVID-19-infected patients with type 2 diabetes, contributing to our understanding of the multifaceted relationship between these medical conditions. Further research is needed to elucidate the underlying mechanisms and optimize management strategies for this vulnerable patient population.
Correlation of Magnesium Levels and Retinopathy in Patients with Type 2 Diabetes Mellitus
Authors: Ahmed Iman Zaky , Bekhet Meram Mohamed , Elsamkary Mahmoud Ahmed , Girgis Bishay Caroline Adel , Mohammed Bahaa Mahmoud , Mohamed Ahmed Eman Mahmoud 
Published: November 2024

Abstract

Background
Diabetes mellitus is a set of metabolic diseases characterized by chronic hyperglycemia as a consequence of lack in insulin action, secretion, or both. All of which lead to long-term damage and dysfunction of different organs predominantly the eyes, kidneys, nerves, heart, and blood vessels. Diabetic retinopathy (DR) is a chronic inflammatory neurovascular complication linked to DM, and it is known to be the leading cause of preventable blindness, affecting more than 415 million people worldwide. Recent studies showed that Magnesium deficiency has been correlated to type 2 diabetes mellitus and diabetic retinopathy (DR).

Objective
To investigate the correlation of magnesium levels and retinopathy in patients with type 2 diabetes mellitus and magnesium status in type 2 diabetes mellitus in comparison to healthy population.

Methods
The study was a case-control study conducted on 180 cases attending diabetes outpatient clinic at Ain Shams university hospital: 38 males, 62 females divided into 3 groups, Group Ι: 60 type 2 diabetic patient without diabetic retinopathy, Group ΙΙ: 60 type 2 diabetic patients with diabetic retinopathy & Group ΙΙΙ: 60 cases as a control group of non-diabetic patients.

Results
In our study results, serum magnesium (Mg) levels remarkably lower in type 2 diabetes patients (groups Ι & ΙΙ) compared to controls (group ΙΙΙ). On comparing groups I & II serum Mg levels were significantly lower in group II (type 2 diabetes patients with diabetic retinopathy) compared to group I (type 2 diabetes patients without diabetic retinopathy). This study showed that serum Mg levels had a (PPV) Positive predictive value for diabetic retinopathy 80 % when their levels are ≤ 1.5 mg/dl, with sensitivity 46.67% and specificity 88.33% (this means that serum Mg levels can predict diabetic retinopathy among patients with type 2 diabetes mellitus when their levels are below or equal 1.5 mg/dl). In a multivariate analysis magnesium is considered an independent risk factor for diabetic retinopathy in type 2 diabetes mellitus after adjustment of Age, SBP, cholesterol and eGFR.

Conclusion
Magnesium level is lower among patients with type 2 diabetes compared to normal population. Magnesium is considered an independent risk factor for diabetic retinopathy in type 2 diabetes mellitus. Magnesium level ≤ 1.5 mg/dl has a PPV for DR with sensitivity 46.67% and specificity 88.33%.
The Effectiveness of Potassium-Competitive Acid Blocker in Eradication of Helicopacter Pylori in Comparison with Proton Pump Inhibtor
Authors: Faheem Ghaly Sameh Mohamed , Sabry Manal Sabry Mohamed , Aziz George Tari Magdy , Mogahed Esraa Ali El-Desoky 
Published: November 2024

Abstract

Background
Helicobacter pylori (H. pylori) disease is becoming a debilitating and chronic infection as it invades the gastric mucosa and causes gastritis. Chronic inflammation caused by H. pylori in the gastric mucosa can lead to atrophic gastritis, gastroduodenal ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, gastric adenocarcinoma, and even idiopathic thrombocytopenic purpura. These conditions can be prevented and treated by H. pylori eradication.

Aim of the Work
To assess the efficacy including symptoms improvement and cure rate, in addition to evaluation of the adverse events of vonoprazan triple therapy in treatment of H. pylori.

Patients and Methods
The study participants consisted of 72 adults that visited Outpatient clinics at Ain Shams University hospital, Egypt, with various dyspeptic cases with symptoms like upper abdominal pain, bloating, nausea, or early satiety. All the study participants underwent upper endoscopy to enable appropriate disease diagnosis.

Results
There is no significant difference between the two groups regarding age, sex, height, weight, and BMI. Also, there is no significant difference between the two groups regarding neither comorbidities nor routine laboratory parameters, positive antigen was lower among group B (61.1%) compared to group A (69.4%) but without statistically significant difference, and there is no significant difference between the two groups regarding side effects.

Conclusion
Based on these findings, it can be concluded that the P-CAB-based triple therapy demonstrated comparable efficacy to the standard PPI-based triple therapy for H. pylori eradication. These results suggest that P-CAB, with its stronger acid inhibitory effect, can be considered as an effective alternative treatment as a part of triple therapy for H. pylori infection.
Plateletcrit and Mean Platelet Volume in the Evaluation of Liver Cirrhosis and Nonalcoholic Fatty Liver Disease in Egyptian Patients
Authors: Gadallah Abdel-Naser Abdel-Atty , Elshayeb Elsayed Ibrahim , Shaheen Ghada Ahmed Abdel-Fattah , Montaser Belal Abd El-Mohsen 
Published: November 2024

Abstract

Background
Chronic liver disease secondary to liver cirrhosis from non alcoholic fatty liver disease is a leading cause of morbidity and mortality and a major public health problem in Egypt. Mean platelet volume (MPV) is a marker that reflects platelet activation and function. MPV values were increased in patients with nonalcoholic fatty liver disease, intrahepatic cholestasis of pregnancy, chronic hepatitis, and liver cirrhosis. Recently, MPV and MPV/platelet count ratio were proposed as markers for the diagnosis of HCC in patients with chronic liver disease.

Objective
To identify noninvasive, easy, and cheap markers for diagnosis and staging of NAFLD and cirrhotic patients without the need for liver biopsy.

Patients and Methods
A case control study conducted on 133 patients with liver cirrhosis and non-alcoholic fatty liver patients in hepatology outpatient clinics, inpatient ward, and intensive care unit at Menoufia University hospital, during a period time from April 2022 to May 2023.

Results
RBCs and HGB were significantly increased in control group (4.95±0.56, 11.97±1.56) than NAFLD (4.58±0.70, 11.11±1.94) and Cirrhosis (4.11±0.75, 10.89±2.02), respectively. While, PCT was significant increase in Cirrhosis (0.31±0.15) group than NAFLD (0.23±0.12) and control (0.14±0.06). MPV was significantly increased in NAFLD (10.75±2.18) than control (9.46±1.72) and cirrhosis (8.61±0.58), (P &lt; 0.05). However, there were no significant differences among studied groups according to WBCs, Platelets and PDW (P &gt; 0.05)

Conclusion
A current survey revealed that PLT indices can be treated as potential prognostic markers in liver cancer (LC) and NAFLD patients, correlating significantly with biochemical markers of liver fibrosis. According to our observations, PCT in LC and MPV in NAFLD turned out to be the most powerful markers. The study results showed an increase in MPV in patients with NAFLD. Rise in MPV in NAFLD can suggest the need for early evaluation and appropriate treatment by clinicians.
Association between Serum Beclin 1 Level and Cardiac Valvular Calcification in Hemodialysis Patients
Authors: Hebah Hayam Ahmed , Kamel Ali Morsi Hadeer Moamen , Bastawy Islam Mahmoud , Ahmed Fatma Abdelrahman 
Published: November 2024

Abstract

Introduction
Cardiovascular calcification is a prevalent condition at all stages of chronic kidney disease (CKD). Autophagy is a natural cellular phenomenon that is considered to have a great ability to modulate pathology of cardiac diseases such as cardiac arrhythmias, atherosclerosis, heart failure and especially cardiac valvular and vascular calcifications. Beclin- 1, a highly conserved eukaryotic protein, has a major regulatory role in autophagy. It is a component of the phosphatidylinositol-3-kinase (PI3K) complex. Recent studies showed that autophagy effect of beclin 1 might play a protective role in CKD vascular calcification. Autophagy is expected to become a new therapeutic target for CKD vascular calcification.

Methods
This study enrolled 102 hemodialysis patients divided into 2 equal groups according to echo results. All the participants were subjected to serum Beclin 1 and transthoracic echocardiography. Patients with acute kidney injury, active malignancy and diabetics were excluded.

Results
There was statistically significant difference between the two groups regarding serum Beclin 1, all parameters of lipid profile, ischemic heart disease, serum albumin, and total calcium. the echocardiography findings regarding aortic valve calcification in group 1 showed that the majority of cases exhibited mild calcification (60.78%), there was a significant relation between beclin 1 and both of IHD (p = 0.011), and ECHO findings Aortic valve calcification (p˂0.001). (lower level of beclin was associated with severe valvular calcification). The best cutoff value of beclim 1 was ≤ 35.5 ng/ml, with the best sensitivity (98%) and specificity (92%).

Conclusion
The serum beclin 1 level assessment could be used as a tool for the prediction of cardiac valvular calcification in hemodialysis patients.
Evaluation of Vitro Score (Von Willebrand Factor Antigen/Thrombocyte Ratio) as a New Marker for Presence of Esophageal Varices due to Clinically Significant Portal Hypertension (CSPH) in Liver Cirrhosis
Authors: Muhammad Hala Saleh , Karmoty Khaled El , Hamdy Hesham , Shaarawy Salah 
Published: November 2024

Abstract

Background
Bleeding due to esophageal varices is one of the causes of high mortality in cirrhotic patients. Esophageal varices occurs with the presence of clinically significant portal hypertension that is more than 10 mmHg. The most diagnostic method for clinically significant portal hypertension is the measurement of HVPG and the most diagnostic to detect esophageal varices is UGIE, both of which are invasive procedures and costly.

Aim of the Work
to evaluqate the vitro score as a non-invasive marker for presence of esophageal varices in clinically significant portal hypertension.

Patients and Methods
The study was carried out on 60 Egyptian patients. These were divided into two groups (varices and no varices) based on the findings of UGIE. For all participant in this study, full clinical assessment by history and physical examination was done in addition to laboratory hematological and biochemical assessment and detection of varices was done by UGIE, We also assessed serum vWF antigen in all study participant.

Results
In this study, we found the VITRO score was higher in patients with esophageal varices. We found that the VITRO score ranged from 0.78 to 1.92 in patients with varices with median (IQR) 1.22(1.03-1.32); and from 0.08 to 0.82 in patients with no cirrhosis with median(IQR) 0.23 (0.15-0.4), being statistically significant higher in patients with varices with p-value= 0. There was no significant correlation between VITRO score and (age, WBCs, HB, BUN, Creat, Na, K, Total and direct bilirubin, AST, ALT, AFP and MELD score). The results showed sensitivity 93.75% and specificity 100% for VITRO score as a marker for detection of esophageal varices, with cut-off point &gt; 0.82

Conclusion
VITRO score is a promising non-invasive marker for detection of esophageal varices.
Cardio-Metabolic Index as a Novel Predictor for Metabolic Associated Fatty Liver Disease (MAFLD) In Egyptian Patients
Authors: Khalil Sultan Hanan Sedki , Abd Elmageed Khaled Hamdy , Allam Ahmed Samir , Abd Elhady Abeer Abd Elraof 
Published: November 2024

Abstract

Background
Metabolic associated fatty liver disease (MAFLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a new definition of liver disease associated with known metabolic dysfunction and is the most common chronic liver disease worldwide.

Aim of the Work
to investigate the association between the cardiometabolic index (CMI) with risk of metabolism-associated fatty liver disease (MAFLD).

Patients and Methods
a cross-sectional study. It included 50 patients. It was conducted in Ain Shams University Internal Medicine department for six months from June 2023 to December 2023.

Results
the study revealed that a wide age group ranging from 22 to 70 years, (mean age of 49.86±12.91 years). There was male to female ratio 1:1, mean of BMI [wt/ (ht)∧2] was 34.17±5.28, WHtR was 0.59±0.09, DM was 22 (44.0%) and HTN was 22 (44.0%). Association between CMI and different parameters was done and resulted in no statistically significant association between CMI and sex, obesity. While it showed statistically significant association between CMI and age groups, higher score of steatosis, higher score of fibrosis, and enlarged liver size. Correlation between CMI with different parameters in patients, using Pearson's correlation coefficient (r) was done and resulted in; statistically significant positive correlation between CMI with age (years), HTN, TG, steatosis score, fibrosis score and size liver, with p-value (p &lt; 0.05). While, there was a statistically significant negative correlation between Cardio-metabolic Index with WHtR and HDL, with p-value (p &lt; 0.05). As for the rest have insignificant correlation, with p-value (p &gt; 0.05). ROC curve analysis proved good discriminating power of the (Cardio-metabolic Index) between positive liver and negative liver for Fibrosis where Area under the ROC curve (AUC) = 0.86 with SE 0.163 (95% Confidence interval 0.72 – 0.94. Z statistic= 6.332, p &lt; 0.001. Cutoff point &gt;5.5 with sensitivity= 87.2% and specificity=81.8.

Conclusion
The cardiometabolic index (CMI), a recently developed index reflecting visceral adipose tissue (VAT) distribution and dysfunction consisting of anthropometric and biochemical indicators, including waist-to-height ratio (WHtR) and triglyceride to high- density lipoprotein cholesterol ratio (TG/HDL-C), which can be easily obtained during a health examination.
The Relation of Residual Kidney Function to Post-Dialysis Fatigue
Authors: Abdelaziz Haitham Ezzat , Abdelmobdy Ashraf Hassan , Metwally Mohammed Hend Mahmoud 
Published: November 2024

Abstract

Background
End-stage kidney disease (ESKD) poses intricate challenges in its management, often requiring long-term dialysis or kidney transplantation to sustain metabolic balance and fluid- electrolyte equilibrium. Despite these treatments, ESKD patients frequently experience debilitating symptoms, such as fatigue. Fatigue's prevalence is substantial in both dialysis and non-dialysis ESKD patients, impacting their daily lives and overall well-being. Residual kidney function (RKF) after dialysis initiation plays a pivotal role in influencing various health outcomes.

Aim of the Work
To estimate post-dialysis fatigue in chronic haemodialysis patients and its relation to residual kidney function and other associated variables.

Patients and Methods
The study included 70 Patients with ESKD who underwent regular HD and they were divided into 2 groups; group A (Included 35 patients who had residual kidney function) and group B (Included 35 patients who did not have residual kidney function).

Results
Fatigue was widespread, as indicated by FAS scores ranging from 16 to 37. Most patients experienced fatigue, with 67.1% reporting fatigue and 15.7% extreme fatigue. Although there was no significant correlation between FAS scores and RKF, RKF's role was evident in parameters like urea post-hemodialysis, influencing patient outcomes.

Conclusion
In conclusion, the complex interaction involving RKF and the exhaustion experienced after dialysis calls for a more profound exploration. This research brings into focus the elaborate correlation between RKF and fatigue, underscoring the diverse aspects of symptomatology in ESKD. Additional inquiries are merited to gain a more comprehensive comprehension of the variables influencing fatigue and to formulate precise interventions aimed at enhancing the quality of life for individuals with ESKD.
Serum Calprotectin as an Inflammatory Marker in a Cohort of Egyptian Patients with Psoriatic Arthritis and its Correlation with Disease Activity and Radiological Findings
Authors: Farouk Hanan Mohamed , Habeeb Reem Abd El-Monem , Badr Fatma Mohamed , Hamada Magdeldin Naghim Ibrahim , ElSherbiny Dalia AbdelHamid 
Published: November 2024

Abstract

Background
Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis and is found in about 20 to 30% of psoriatic patients. The use of inflammatory markers can be disappointing in PsA, since they are elevated in only half of the patients with PsA., in this study we assessed serum calprotectin as a marker of inflammation in psoriatic arthritis and correlated it to disease activity and radiological findings.

Objective
To measure serum calprotectin level in psoriatic arthritis patients and to assess its association with disease activity score and radiological findings using musculoskeletal ultrasound.

Methods
This was a Case-Control Study Rheumatology inpatient departments and outpatient clinics at Ain Shams University Hospitals. This study was conducted on 50 patients with psoriatic arthritis according to the classification criteria for psoriatic arthritis (CASPAR) criteria and 30 Normal subjects with no past medical history and with no family history of psoriasis.

Results
Patients serum calprotectin level had statistically significant higher value in comparison to the control group P-Value &lt; 0.001., and with cutoff point 106.36 ng/ml with sensitivity 98% and specificity of 86.6 %, There was highly statistically significant relation between the level of serum calprotectin and synovial hypertrophy in small hand joints P-Value=0.004 and it can predict synovial hypertrophy in hands by joint ultrasound at the level of 258.9 ng/ml with sensitivity and specificity of 71%, 83% respectively There was also a with statistically significant relation nail bed affection in ultrasound P-Value=0.034. Multiple regression analysis was done in psoriatic arthritis patients and it was found that serum calprotectin was the most predictive for the presence of psoriatic arthritis in comparison to ESR and CRP.

Conclusion
in psoriatic arthritis patients, serum calprotectin level is significantly higher and is correlated to radiographic and nail changes. Further studies are required to define a specific cutoff serum level for diagnosis.