bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Offloading versus Medical Conservative Methods in Management of Diabetic Foot Plantar Ulcers (Interventional study)
Authors: Abdelwahab S , AbdElbary M , Abd Elnasser A 
Published: July 2024

Abstract

Background
As a result, peripheral neuropathy is frequently caused by diabetes (DM). Diabetic plantar foot pressure ulcers develop from the lack of protective pain sensibility as a result of recurrent shear and tear pressures. Relieving pressure on the foot's sole is necessary for the ulcers to heal. The purpose of the study is to compare the effectiveness of surgical and nonsurgical unloading procedures in the healing of plantar ulcers.

Subjects and Methods
50 diabetic foot ulcer patients who visited Ain Shams University, the national institute of DM, and the endocrinology outpatient clinic participated in this interventional trial (NIDE). We employed mechanical and surgical unloading methods in this trial, and patients were monitored for 6 months to see how long it took for their injuries to recover.

Results
At the conclusion of the follow-up period, 88% of the surgical group's pressure ulcers were fully healed, compared to 86.7% of the non-surgical patients (6 months). Infection, recurrence, and non-healing were complications we encountered throughout the follow-up period. Regarding the treatment of plantar diabetic foot ulcers, offloading is crucial (DFUs). Compared to using only non-surgical methods, surgical offloading may hasten the recovery time. A well- trained team is necessary to prevent the issues with improperly fitting footwear and to teach the patient how to use them on a regular basis with the non-surgical offloading technique.
Evaluation of Focused Mini-Incision Parathyroidectomy in Primary Hyperparathyroidism
Authors: Lasheen Mohammed Fakhruddeen , Kamal Ahmed Mohammed , Abdelrahim Hossam S 
Published: July 2024

Abstract

Background
In the era of effective preoperative localization and availability of intraoperative parathyroid hormone (IOPTH) assay, the trend now in parathyroidectomy is shifting from bilateral neck exploration (BNE) into minimal invasive parathyroidectomy (MIP). The concept of MIP is based on the fact that 85% of cases have single adenoma. This study highlights the outcomes of focused mini- incision parathyroidectomy (FMIP) for the treatment of selected cases of primary hyperparathyroidism. Aim of study: To evaluate and assess the outcome and advantages of focused mini-incision parathyroidectomy in parathyroid adenoma of primary hyperparathyroidism.

Patients and Methods
This cohort study was conducted at endocrine surgery unit, Ain Shams University Hospital, and Sohag Cancer Institute including 22 patients with benign solitary parathyroid adenoma; 17 retrospective cases & 5 prospective cases. These included patients had been operated with focused mini-incision parathyroidectomy within the time period from January 2018 to December 2020 as retrospective cases and from January 2021 to December 2021 as prospective cases.

Results
In this study, age ranged from 30 to 70 years with mean age 50.23 ± 10.71 years. The preoperative serum calcium level ranged from 10.8 to 14.2 mg/dl (mean 12.28 ± 1.16 mg/dl). The preoperative parathyroid hormone level was elevated ranging from 256 to 2090 pg/mL (mean 970.68 ± 563.97 pg/mL). In this study, the operative time ranged from 55 to 75 minutes with mean 64.36 ± 6.33 minutes, percentage of IOPTH decrease level ranged from 75-95 % with mean percentage 85.72 ± 6.28 %. There were no cases with intraoperative bleeding or recurrent laryngeal nerve (RLN) injury. Hospital stay ranged from 6-16 days with mean 10.77 ± 3.10 days. There is no wound infection in all cases. All cases reached a success rate up to 100% (decrease the IOPTH level ≥ 75 %, and resolution of preoperative hypercalcemic manifestations).

Conclusion
Depending to the high successful rate, very low intraoperative morbidity and better postoperative recovery and cosmoses of FMIP technique, it should be the first choice for pHPT cases with solitary parathyroid adenoma, provided by the concordance localization study of U/S and MIBI scan preoperative.
Retrospective Study for Evaluation of TIRAD Scoring System Irrespective of FNAC in Decision Making Outcomes in Thyroidectomy
Authors: Elsayed Osama Mahmoud , Ghazy Mohamed Shaker , Elsayed Mohamed Gamal , Naeem Tasnim Rizk , Zaki Asmaa Ali 
Published: July 2024

Abstract

Background
Thyroid nodules present a common clinical problem. Palpable nodules are present in about 5% of the population, and are noted incidentally on ultrasound in up to 70% of people, with increased prevalence in older patients. The incidence of thyroid nodules has increased due to exposure to medical radiation, iodine intake, obesity, insulin resistance, genetics and inorganic phosphates. With a 300% increase in the annual thyroid cancer rate.

Aim of the Work
The aim of this study is to evaluate the value of Ultrasound and TIRAD scoring system for decision making outcomes in thyroidectomy done for thyroid nodules.

Patients and Methods
This Retrospective cohort study was conducted at (General surgery department), Ain Shams University Hospitals and Ain shams University specialized Hospitals and was conducted over a period of six months starting from date of approval of the protocol.

Results
In our study, Conventional sonography has 66.66% sensitivity and 92.5% specificity as it suspected malignancy (positive suspecting findings) in 14 patients; eight of them were proved to be malignant and six of them were benign by histopathology accounting for low positive predictive value (57.14%) and it suspected benignity (negative suspecting findings) in 78 patients; 74 of them were perfectly correlated with the histopathology accounting for high negative predictive value (94.87%). In our study, the rate of detecting patients with thyroid cancer (sensitivity) was calculated as 80%, the rate of distinguishing healthy individuals (specificity) was 88.88%, the Positive Predictive Value (PPV) was 57.14% and the negative predictive value (NPV) was 96% for FNAC. In our study, the sensitivity and the specificity of FNAC in detecting cancer was near to the literature but the (PPV) was lower than the literature and was non diagnostic in fourty patients (40%), we think that this discrepancy depends on many factors including radiology, pathology, and the materials used in FNAC method, and patients with multiple nodules.

Conclusion
Neck US and FNAC have proven low sensitivity in differentiating malignant from benign thyroid nodules
Safety and Efficacy of Directly Acting Antivirals (Sofosbuvir & Daclatasvir) in Treatment of Chronic HCV
Authors: Makhlof Mohamed Mari , AbdElsadk Ahmed Samir , AbdElrahman Gada , Ali Ahmed Mohamed 
Published: July 2024

Abstract

Background
The introduction of direct-acting antiviral agents, has revolutionized the treatment for chronic HCV with higher cure rates, shorter duration of treatment and more tolerability have been achieved.

Aim of the Work
The aim of our study is to estimate the efficacy and safety of DAAs in treatment of chronic HCV in patients co-infected with HIV.

Patients and Methods
This study of previously untreated HCV infection in patients with HCV and HIV co-infection conducted at Abbasia Fever Hospital, from July 2019 to February 2020. Patients included are chronic HCV infection and were receiving antiretroviral therapy for the HIV with a CD4 T-lymphocyte count of 200 cells/mL or greater. Serial measurements of safety parameters, virologic and host immune correlates, and adherence were performed during treatment by combination of daclatasvir 90mg and sofosbuvir 400mg+/- ribavirin 800mg daily for 12 weeks.

Results
In this study, the rate of a sustained virologic response (SVR) at post-treatment week 12 (SVR 12) were high (29/30, 96.67%). The most common adverse events were fatigue (73.33%), headache (46.67%), and there was a high safety profile on using DAAs. No patient discontinued treatment because of adverse events. No serious adverse events or mortality were reported. In this study, AST & ALT were significantly decreased at end of treatment and 12 weeks after treatment, CD4 count was significantly increased. Otherwise there are no significant changes in both hematological and biochemical laboratory results.

Conclusion
Combination of daclatasvir and sofosbuvir have showed 96.67% sustained virologic response at 12 weeks after treatment (SVR 12) among HIV/HCV co-infected patients, with a very good safety profile. Moreover, the treated patients showed a significant increase in CD4 count. Accordingly, HIV/HCV co-infected patients should be treated with sofosbuvir and daclatesvir containing regimens.
Serum Soluble B Cell Maturation Antigen Level as a Prognostic Marker for Low Grade Lymphoma
Authors: Hasan Esam Abdelwahid , Nabih Nermeen Adel , Ibrahim Nahed Moawad , Elmoaty Mohamed Inas Abd , Zakaria Maha Ibrahim 
Published: July 2024

Abstract

Background
Despite the Indolent lymphoma is a slowly growing tumor that has many therapeutic options and good initial response, it is usually incurable. Relapses and HT to aggressive form may occur and some patients die from their disease. For the RR iNHL Several novel targeted therapies may be recommended such as antibody–drug conjugates (ADC) and bispecific T cell engagers (BiTE). B cell maturation antigen is a transmembrane glycoprotein that regulate B cell proliferation, survival, maturation and differentiation into PCs. IT is expressed in multiple myeloma and B cell neoplasms. The effects of BCMA have been studied in multiple myeloma and a new BCMA-targeted immunotherapy has been approved for the treatment RRMM patients. Few studies done to detect BCMA in other Hematologic malignancies as a diagnostic or prognostic tool and a therapeutic potential of antiBCMa targeted therapy in these malignancies. In this study we detect sBCMA in the serum of iNHL patients.

Aim of the Work
To measure the levels soluble BCMA (sBCMA) in the serum of adult patients with indolent non Hodgkin lymphoma (iNHL).

Patients and Methods
A case control study conducted on adult patients of iNHL attending hematology department of Ain Shams university with a participant of 40 cases of newly diagnosed and RR iNHL plus 40 control.

Results
In the present study we found that there was no statistically significant difference between the studied groups as regard sex, TLC, Hb, platelet counts and tumor subtypes in relation to BCMA level . While there is a statistically significant correlation between Age, stage and LDH to the BCMA level. The results suggest that the BCMA level is significantly higher in patients with iNHL than the healthy controls.

Conclusion
This study suggest that the BCMA level is significantly higher in patients with iNHL than the healthy controls. By increasing the Age ≥ 40 years the risk of iNHL is increased by 1.71 folds than otherwise healthy controls. The BCMA level was positively correlated to LDH implying that BCMA could be related to iNHL proliferation rate and possibly lymphoma aggressiveness. The level of BCMA more than 430 ng/dL correlated with a more than a 4.5-fold rise in the risk of higher disease stage with borderline significance. Further studies are needed to detect the relation between The BCMA level and the disease prognosis that may be useful for a promising AntiBCMA targeted therapy for RR patients.
Assessment of Galectin 3 as a New Biomarker of Liver Fibrosis in Chronic HCV Egyptian Patients and its Correlation to Transient Elastography, FIB-4 Index, and APRI Score
Authors: Mohamed Badawy Hanan Mahmoud , El-Kilany Hesham Hamdy , Samaan Amira Isaac , Maksoud Mohamed Ibrahim Nasr Abdel 
Published: July 2024

Abstract

Background
Invasive liver biopsy is the current method for the assessment of liver fibrosis. In search of noninvasive alternatives, galectin-3-binding protein (G3BP) was introduced as a candidate-marker of hepatitis C-related fibrosis based on serum proteomics.

Aim of the Work
to evaluate serum Galectin-3 as a marker of liver fibrosis and correlate it to the stage of fibrosis assessed by FibroScan, FIB-4 index and APRI score

Patients and Methods
This was prospective study, was carried out on 30 patients with liver fibrosis/cirrhosis due to chronic HCV inthe Hepatic Virology Unit and the gastroenterology department of Ain Shams university hospitals and 30 health controls with normal, non fibrotic and non cirrhotic, liver, from January 2022 to June 2022

Results
There were high significant difference between both groups as regard Serum level of Galectin-3 and APRI score.

Conclusion
Serum level of galectin-3 was highly expressed in chronic HCV Egyptain patients and positively correlated to FIB-4 index, APRI score and fibroscan.so the serum level of galectin-3 beside other modalities, lab investigations and clinical examination may guide us about the progression to fibrosis and cirrhosis in those patients. In these patients, if galectin-3 levels were found to be high, serum alpha-feto protein level and ultrasonographic examination could be repeated at more frequent intervals. This may also guide us in terms of the treatment plan. Measurement of galectin-3 in sera of large number of patients and follow up may pave the way to pick up early fibrosis and showed its prognostic effect.
Late Onset Systemic Lupus Erythematosus: Different Clinical, Serological Presentations and Damage Compared to Adult Lupus in Egypt
Authors: Elsayed Mohamed Hefny Marwa Mohamed , Elbakry Samah Abd-ElRahman , Abdul-Rahman Maryam Ahmad , Mohammed Badr Fatma 
Published: July 2024

Abstract

Background
Comparing cases of adult onset and late onset systemic lupus erythematous (SLE) reveals significant differences in clinical, serological, disease activity, and damage score.

Objective
This study aimed to analyze clinical manifestations, laboratory data, serological markers, and prognosis of late-onset SLE (L-SLE) and for comparing with adult- onset SLE.

Patients and Methods
One hundred fifty individuals with SLE were included in a cross-sectional study conducted at Ain Shams University Hospital divide into Group 1: 100 cases with adult-onset (age of onset ≥ 19 years and below 50 years). Group 2: 50 Patients with L-SLE (age of onset ≥ 50 years). All patients were subjected to medical history, physical examination, disease activity measured by the SLE disease activity index (SLEDAI-2K) and a damage score. Laboratory investigations as complete blood count (CBC), serum creatinine, anticardiolipin antibodies, lupus anticoagulant, protein creatinine ratio, serum complement (C3, C4), anti-dsDNA antibody, and antinuclear antibodies (ANA).

Results
Mucocutaneous manifestations, frequency of hematuria, proteinuria, urinary cast, consumed C3, positive anti-dsDNA antibodies, anti-cardiolipin antibody and lupus anticoagulant titers had considerably greater rates in-group 1 compared to group 2 (P-value &lt;0.05) while group 2 had significantly more musculoskeletal symptoms (P-value &lt;0.05). The SLEDAI scores of the two groups were equivalent, however the damage index was greater in group 2 (P-value 0.00). Neuropsychiatric, cutaneous, renal, and skin damage were more frequent in group 1, while musculoskeletal, endocrinal, pulmonary, cardiovascular and ocular damage were more frequent in- group 2.

Conclusion
L-SLE is different from adult onset SLE with more frequent damage.
Role of Lipocalin-2 Levels in Non-Alcoholic Fatty Pancreatic Disease and its Association with Non-Alcoholic Fatty Liver Disease
Authors: Marei Makhlouf Mohamed Ali , Salama Mohamed Magdy , Abdo Ahmed Abbas , Gaber Hagag Heba El-Sayed 
Published: July 2024

Abstract

Background
Lipocalin-2 (LCN2) is a 25-kDa secretory protein with great importance as a sensitive and specific screening and diagnostic biomarker for hepatic inflammation, acute hepatic injury, hepatic cancer, and radiation-induced early phase hepatic damage and lipid abnormalities. However, little is known about LCN2's functions in the homeostasis and metabolism of hepatic lipids or in the development of steatosis as well as its actual role in the event of inflammation.

Aim and Objectives
To establish a correlation between the levels of lipocalin as a useful biomarker with increasing severity of steatosis in NAFLD and NAFPD patients.

Subjects and Methods
This was observational prospective case–control study, was conducted at Hepatology Unit of Ain Shams University Hospital on 50 patients diagnosed with NAFPD and 50 healthy age and sex-matched volunteers without NAFPD during a period of 6 months. All patients were subjected to; Full history taking and thorough clinical examination, Anthropometric measurements, Laboratory investigations, and abdominal ultrasonography.

Result
There was a significant Positive correlation between Lipocalin 2, BMI, LDL (mg/dL), Cholesterol (mg/dL), Insulin (μU/mL) and HOMA-IR in patient group(P-value ≤ 0.001), Conclusion; lipocalin-2 is a good blood biomarker for detection of hepatic and Pancreatic steatosis. The lipocalin levels increase with increasing severity of steatosis. In addition to this, lipocalin will be useful for early diagnosis of NAFLD, NAFPD and convenient to do with other blood tests. The early intervention may prevent high morbidity and mortality and to manage the disease properly.
Tenascin-C is a Promising Marker of High Bone Turnover and Vascular Calcification in Prevalent Hemodialysis Patients
Authors: El-Shenawy Howyda , Shawky Sahar , Fouad Mohammed , Abdelmegied Shaimaa 
Published: July 2024

Abstract

Background and Aims
Tenascin-C (TN-C) is an extracellular matrix glycoprotein associated with high cell turnover and vascular calcification and atherosclerosis. This study determines the frequency of Tenascin-C in uncontrolled parathyroid hormone state and its relation to vascular calcification.

Method
A cross sectional study included 90 prevalent hemodialysis patients divided into 2 equal groups: uncontrolled iPTH level &gt;300 pg /ml and controlled iPTH (150-300 pg/ml) groups. Serum Tenascin-C was measured by ELISA and vascular calcification was assessed by simple vascular calcification score (adragao score): by Plain X ray on hands, pelvis & vascular access for all patients.

Results
The prevalence of Tenascin-C and vascular calcification in patient with uncontrolled PTH were 84.4% (38 patients), 46.7% (21 patients) respectively. Tenascin-C was positively correlated with PTH level (r 0.494 p &lt; 0.001) in patients with high bone turnover. Tenascin-C was high in patients with uncontrolled PTH [median (IQR) 637 (4245)u/ml] compared with patients with controlled PTH [median (IQR) 211 (143) u/ml] P value &lt;0.0001. According to Adragao calcification score, in uncontrolled PTH: 31.1% (14 patients) had score 1 and 15.6% (7 patients) score 2. In controlled iPTH all patients had score 0. Patients with vascular calcification had high Tenascin-C median [(IQR) 10697 (53974)] compared with patients without vascular calcification [median (IQR)7697 (18000) u/ml)] P value &lt;0.001. Serum Tenascin-C can predict high bone turnover at cutoff value 7377 ng/ml with AUC 0.794, sensitivity 84.4% and specificity 60 % while predict vascular calcification at cut of value &gt; 8859 ng/ml AUC 0.745, sensitivity 72.7 %, specificity 72.1 %. Patients who have elevated level of tenascin C had 10.3, 3.7 times the risk to have high bone turnover and vascular calcification than negative one respectively.

Conclusion
Tenascin-C appears to be a sensitive marker for assessment of high bone turnover and vascular calcification in Prevalent Hemodialysis Patients.
Effect of Enteral Protein Supplements on Malnourished Hemodialysis Patients
Authors: El-Said Tamer Wahid , Gharib Mohamed Sary , Nazeih Mariem Shaker 
Published: July 2024

Abstract

Background
Protein-calorie malnutrition is common in chronic hemodialysis patients and correlates with morbidity and mortality. There are limited trials evaluating the efficacy of oral nutritional supplementation in malnourished CHD patients.

Aim of the Work
To evaluate the effect of 6-month-long intradialytic amino acids (AA) supplementation on selected nutritional variables in malnourished hemodialysis (HD) patients.

Patients and Methods
This was prospective, intervention-controlled study, was conducted in haemodialysis unit Ahmed Maher Teaching Hospital, and other authorized hospitals nephrology clinics on 60 patients divided into 2 groups: (Group A); received oral formula, (Group B); the control group on their normal diet.

Results
There were high statistically difference between the studied groups on nutritional markers.

Conclusion
Malnutrition is common in incident and prevalent HD patients however enteral protein supplements can also help on increasing nutritional markers.
Prevalence of Tobacco Smoking in A Sample of General Secondary School Students in Cairo and Its Correlation to Other Psychiatric Disorders
Authors: Farwiez Mohamed Gamal , ElShahawi Heba Hamed , Amin Ghada Refaat , Khalil Sherien Ahmed , Morsy Mahmoud Hassan , Nawara Mayar Medhat 
Published: July 2024

Abstract

Background
Tobacco smoking is considered currently as a global public health concern among youth especially school student. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes and waterpipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt.

Results
A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette using, Barratt impulsivity scale 11, The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% (n = 50) were smokers. There is significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity and mood symptoms.

Conclusions
Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.