bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of Perivascular Mesenchymal Bone Marrow Microenvironment Affection in Poor Graft Function Post Allogenic Stem Cell Transplantation
Authors: Mahmoud Khatab Eman Ayman , Ibrahim Nahed Moawad Ibrahim , Abdel-Ghafar Nermin Adel Nabih , Youssef Mikhaeil Soha Raouf , Ahmed ELKourashy Shaza Abdel-Wahab 
Published: July 2024

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is regarded as a curative treatment option for a variety of hematological disorders. The prognosis of allogenic (HSCT) patients is dependent on a variety of factors that affect the bone marrow microenvironment. One of these factors is the number and function of CD146+ perivascular mesenchymal cells that support the hematopoietic stem cells in the bone marrow and help their proliferation.

Aim of the Study
The aim of this study was to assess how the bone marrow microenvironment is being affected in patients with poor graft function post allogenic stem cell transplantation targeting the perivascular mesenchymal cells using multiparameter flow cytometric analysis of CD146 antibody.

Patients and Methods
Forty patients were enrolled in this study with both benign and malignant hematological diseases who underwent allogenic HSCT from matched related donors. Patients were divided into 2 equal groups: poor graft function (PGF) group and good graft function group (GGF). Patients were subjected to full history recording, clinical examination, full laboratory and radiological work-up, tissue typing and chemotherapeutic conditioning before transplantation. After transplant, bone marrow aspirate was obtained and analyzed for CD146+ perivascular mesenchymal cells using Quantitative tri-color Flow cytometric assay.

Results
PGF group showed significantly lower counts of WBCs, platelets and hemoglobin concentration compared to GGF group. In addition, CD34 dose showed significantly lower concentration in PGF group compared to GGF group. CD146 expression intensity on non-stem cells was significantly higher in PGF group compared to the GGF group to increase the function of these cells in supporting the proliferation of stem cells in the bone marrow.

Conclusion
CD146 can have a potential therapeutic role if CD146+ selected mesenchymal cells are infused in patients with refractory poor graft function to enhance the proliferation of stem cells and help in recovery of patients with PGF however further studies are warranted to document its suggested therapeutic role.
Prevalence of GIT Symptoms in Patients of Covid 19
Authors: Awad Emad Ahmed , Sabry Mohamed Manal , Ahmed Ahmed Elmetwally , Abdelrady Abdelrhman Haggag 
Published: July 2024

Abstract

Background
In December 2019, a cluster of patients with pneumonia of undetermined etiology was recognized in Wuhan, Hubei, China. Subsequently, a novel coronavirus (SARS-CoV-2) was identified from lower respiratory tract samples obtained from affected patients. The clinical manifestation of COVID-19 is broad and ranges from asymptomatic and mild upper respiratory tract symptoms to severe illnesses with multiorgan failure and death. Furthermore, it is challenging to predict the clinical course or determine patients at risk of deterioration.

Aim of the Work
The aim of our study was to assess prevalence of GIT symptoms in patients of covid 19 infected patients

Patients and Methods
This study was conducted on 100 adult covid 19 patients recently diagnosed by polymerase chain reaction (PCR). All patients were submitted to clinical examination, laboratory testing for ESR, CRP, CBC, and D-dimer. Radiological investigations in the form of CT Chest were be reported by radiologist for all patients. High resolution computed tomography Parenchymal abnormalities on HRCT were assessed. Nasopharyngeal, oropharyngeal and rectal swabs were collected for COVID-19 (PCR) test. All patients received Covid-19 treatment according to protocols of WHO and ministry of health and population, Egypt.

Results
We found that GI symptoms are prevalent among COVID-19 Egyptian patients (64%). The most common GI symptoms were Nausea, vomiting and diarrhea. We observed that 25 patients (25%) had positive viral RNA in rectal swab.

Conclusion
Severe COVID-19 was more frequent in older age. Dyspnea and increased respiratory rate were associated with severity of covid 19 infection. Increased CRP and high serum levels of ferritin, d-dimer and lactate dehydrogenase were significantly associated with COVID-19 severity.
Diagnostic Value of Plasma Methylated Septin 9 in Detection of Hepatocellular Carcinoma in Egyptian Patient with Post Hepatitis C Liver Cirrhosis in Comparison to Serum Level of Alphafeto Protein
Authors: El moghney Moustafa Mohamed Abd , Ali- Eldin Zainab Ahmed , Elrahmen Ahmed Ghada Abd , Mahmoud Rizk Mahmoud Hassan 
Published: July 2024

Abstract

Background
Egypt has the highest hepatitis C virus (HCV) prevalence worldwide. Cirrhosis secondary to HCV is associated with the highest annual risk for developing hepatocellular carcinoma. The burden of HCC has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. HCC contributes to 14.8% of all cancer mortality in Egypt. Most HCCs (80%) arise in a cirrhotic liver, a situation where there has been longstanding hepatocyte damage and chronic inflammation leading to fibrosis.

Aim of the Work
This study aims to evaluate the diagnostic value of plasma mSEPT9 assay in detection of HCC in Egyptian patients with post hepatitis C liver cirrhosis in comparison to serum level of α-fetoprotein (AFP).

Patients and Methods
This is a prospective case-control study conducted at the Gastroenterology department in Ain Shams University Hospital. The study population consisted of 80 subjects, divided into three groups: 40 patients with hepatocellular carcinoma, 20 patients with liver cirrhosis, and 20 healthy subjects as controls with matched age and gender.

Results
The study found that hepatocellular carcinoma (HCC) was more frequent in male patients and that the age of HCC patients was statistically significantly higher than patients with cirrhosis and healthy controls. Patients with HCC and cirrhosis had a higher Child Pugh score than healthy controls. Portal hypertension and portal vein thrombosis were more frequent in HCC and cirrhosis patients than in the control group. Liver enzymes were higher in patients with HCC and cirrhosis compared to healthy controls, while hemoglobin and platelet levels were lower in patients with HCC. Hepatitis C antibody and PCR were positive in HCC and cirrhosis patient groups. AFP and Methylated Septin 9 levels were higher in patients with HCC and cirrhosis than in healthy controls, and AFP had better diagnostic accuracy than Methylated Septin 9. Both AFP and Methylated Septin 9 levels were positively correlated with age, Child Score, liver enzymes, and coagulation profile and negatively correlated with platelet count and hemoglobin level. AFP level was positively correlated with the number of focal lesions and liver size.

Conclusion
This study demonstrated that plasma Methylated Septin 9 can be a promising noninvasive and circulating epigenetic biomarker for HCC diagnosis at the individual level. However, our results showed that AFP was superior than Methylated Septin 9 in the detection of HCC, Methylated Septin 9 has higher Sensitivity. It was suggested that the combination of plasma mSEPT9 and AFP could enhance the sensitivity of Methylated Septin 9 or AFP alone in the diagnosis of HCC. Further comparative studies with larger sample size and longer follow-up are needed to confirm our results and to identify risk factors of adverse events.
Prevalence of Anti-PLA2R Antibodies in Biopsy Proven Membranous Nephropathy in Egyptian Patients
Authors: Saed El-Sharkawy Magdy , Abd-Elmoniem Emara Ahmed , Mohsen El-Sharabasy Reem , Mostafa Megahed Mohamed Mostafa 
Published: July 2024

Abstract

Background
Membranous nephropathy (MN) is among the most common causes of the nephrotic syndrome in nondiabetic adults, accounting for approximately 20 to 30 percent of cases of nephrotic syndrome in White adults. MN is most often primary (previously called idiopathic), although it may be secondary with hepatitis B infection, autoimmune diseases as systemic lupus erythematosus (SLE), malignancies, and the use of certain drugs such as nonsteroidal antiinflammatory drugs (NSAIDs). MN in young females should raise the suspicion of SLE.

Aim of the Work
The aim of this work was to study the prevalence of anti-PLA2R antibodies in Egyptian patients with biopsy proven membranous nephropathy.

Patients and Methods
Our cross-sectional study included 70 Egyptian patients with nephrotic range proteinuria on first presentation for whom laboratory investigations including serum anti- PLA2R antibodies titer by indirect immunoflouresence and kidney biopsy were done.

Results
Membranous nephropathy has been diagnosed in 35.71% of adult Egyptian patients presented with nephrotic range proteinuria. 84% of the cases of membranous nephropathy had been diagnosed with primary membranous nephropathy and 16% diagnosed with secondary membranous nephropathy. Sensitivity of circulating anti-PLA2R antibodies in primary MN was 42.85% versus 80.95% for its detection within the glomerular extracts. Specificity of PLA2R is close to 100%; however, in other studies; PLA2R has been detected in the immune deposits of some patients with secondary MN. Patients with high anti-PLA2R titer had higher baseline proteinuria than patients with lower anti-PLA2R titer.

Conclusion
Membranous nephropathy (primary and secondary) may be considered the most common glomerulonephritis by biopsy finding in patients presenting with nephrotic range proteinuria followed by focal segmental glomerulosclerosis (35.7 %& 30% respectively). 84% of the cases of membranous nephropathy had been diagnosed with primary membranous nephropathy and 16% had been diagnosed with secondary membranous nephropathy. Circulating anti-PLA2R antibodies were detected within serum in 42.85% of primary MN cases while detection of anti- PLA2R antibodies within the glomerular extracts of primary MN cases was much higher (80.95%). Specificity of PLA2R is close to 100%; however, in other studies; PLA2R has been detected in the immune deposits of some patients with secondary MN. Patients with high anti-PLA2R titer had higher baseline proteinuria than patients with lower anti-PLA2R titer.
Assessment of Accuracy of Blood Neutrophil to Lymphocyte Ratio (NLR) in Diagnosis of Spontaneous Bacterial Peritonitis (SBP) in Cirrhotic Patients
Authors: Salem Amira , Al-Naqeeb Noha , Anwar Christina Alphonse , Salah Mohamed Hazem 
Published: July 2024

Abstract

Background
This was across-sectional study conducted on 40 Egyptian patients with decompensated cirrhosis and ascites selected from Internal Medicine and Hepatology outpatient clinics and wards at Ain-Shams University Hospitals.

Aim of the Work
The aim of this study is to compare accuracy of blood neutrophil lymphocyte ratio (NLR) to ascitic fluid neutrophil lymphocyte ratio (NLR) in diagnosis of SBP.

Patients and Methods
Patients in this study were divided into 2 groups: Group 1 (case):20 cirrhotic patients diagnosed with (SBP) on the basis of clinical manifestations (fever, abdominal tenderness, and pre-hepatic coma) and laboratory diagnostic criteria: ascitic fluid PMNs greater than 250/mm 3 and culture positive. Group 2 (control): 20 cirrhotic patients with ascites and were admitted with no evidence of (SBP) by clinical and laboratory evaluation.

Results
According to our results, we found that there was no statistically significant difference found between two groups regarding Age, Sex and Child Classification. There was no statistically significant difference found between two groups regarding WBCs, Platelets, ALT, Creat, Albumin, INR, Bilirubin and Adenosine deaminase, and there was statistically significant difference found between two groups regarding AST and Urea, and there was highly statistically significant difference found between two groups regarding HB. Also there was highly statistically significant difference found between two groups regarding MELD score, SERUM PMNLs, Ascitic PMNLs, Serum NLR and Ascitic NLR.

Conclusion
Spontaneous bacterial peritonitis is a serious complication in patients with liver cirrhosis and is associated with a considerable risk of mortality. The present study could be of clinical utility in predicting SBP, a major cause of mortality in patients with cirrhosis. NLR is considered an easy test that can be used to diagnose SBP.
Fluoroscopic C-Arm Guided versus Ultrasound Guided Therapeutic Injection of Lower Cervical Radiculopathies
Authors: EL-Husseiny Ahmed M M , Salem Haitham Hamdy , Abdelfatah Amr , Fathy Mai , Fahmy Nagia Aly , EL-Sadek Ahmed 
Published: July 2024

Abstract

Background
The burden of cervical radicular pain on patients and systems of health in different countries is an important medical issue that needs more significant medical researches to find a new solutions, treatment and limited interventional methods to improve patient's quality of life, prevent complications and decrease the cost on health systems.

Objective
To compare the effectiveness of cervical injection guided by either ultrasonography or fluoroscopy.

Patients and Methods
Sixty patients with lower cervical radiculopathy resistant to medical treatment were included in this study. Randomly, patients received cervical block ultrasonography guided or Fluoroscopic guided. Patients were followed up at 14 days and 90 days by Brief Pain Inventory Scale.

Results
In our study both groups showed significant decline in pain Inventory scale from baseline till 90 days after injection.

Conclusion
Both ways of injection guided by either ultrasonography or fluoroscopy showed the same effectiveness in relief of pain in lower cervical radiculopathy at 14 days and 90 days.
Autoantibodies in a Cohort of Egyptian Patients with Inflammatory Muscle Disease
Authors: Fahmy Yosra Mahmoud , Shehab Abeer , Mohsen Dahlia Abdel , Fahmy Nagia 
Published: July 2024

Abstract

Objective
Autoimmune myopathies can present with diverse phenotypes and extra muscular systems affection, our aim is the illustration of different clinical pictures, Magnetic resonance findings and laboratory data in relation to myositis auto antibodies in a cohort of Egyptian patients.

Methods
This descriptive observational study was conducted in Ain Shams university hospital over a period of 2 years, a total of 77 patients were recruited and 10 control samples were collected.

Results
A total of 34 patients tested positive for Myositis Auto-antibodies, they showed female sex predominance (61.7%), the mean values for their age and age of onset were 28.618±14.346 and 23.574±13.584 respectively.

Conclusion
Autoantibodies are an important tool in diagnosis and management of immune mediated myopathy, especially when paired with clinical picture, radiological and other laboratory findings, our studied sample showed higher percentage of inflammatory myopathy subtypes associated with connective tissue disorders followed by Immune medicated necrotizing myopathy subtype then anti-synthetase syndrome antibodies.
Surgical Options for Treatment of Medically Intractable Neuropathic Facial Pain: An Outcome Assessment Study
Authors: Simry Hisham A , Abdelbar Ahmad E , Sabry Hatem A , Raslan Ahmed M , Basha Ahmed Kamel 
Published: July 2024

Abstract

Background
Facial pain is a common condition with a worldwide prevalence of 10-25% in adults. It often us a serious condition that can have a significant impact on patients’ daily life activities. The three main categories of facial pain are trigeminal neuralgia, trigeminal neuropathic pain and persistent idiopathic facial pain. To date, trigeminal neuropathy remains a potentially surgical pathology for the purpose of pain control with poor response to medical treatment.

Aim and Objectives
The aim of this study is to present our experience in the management of different pathologies of trigeminal neuropathy and to review the effectiveness and long-term efficacy of the different surgical procedures.

Subjects and Methods
This is a mixed prospective-retrospective study conducted at Ain Shams University (ASU) hospital and Oregon Health and Science University (OHSU) during the period from December 2012 till July 2020 for the retrospective part and from January 2019 till September 2021 for the prospective part. Patients with neuropathic facial pain treated during this time frame were included in the study.

Result
28 patients were included in this study. They underwent 40 surgical interventions for the management of different categories of trigeminal neuropathy. Neuro-modulatory procedures were performed in 9 patients (3 ucSCS and 6 PNS) while neuro-ablative procedures were performed in 19 patients. Median time to pain recurrence after SCS device implantation for the neuropathic trigeminal neuralgia was 19.5 months. For the patients treated with PNS, 2 out of 6 of patients had satisfactory pain relief, whereas half of the patients had no improvement. Overall median time to pain recurrence after CT guided T/N was 5.6 months. In the cohort of patients treated with caudalis DREZ, 4 patients out of 6 had grade I pain relief at last follow up and the overall median time to pain recurrence was 3.9 months.

Conclusion
Trigeminal neuropathy is a difficult to treat entity of facial pain syndromes. Although many neuro- modulatory and neuro-ablative interventions are available in the armamentarium for the treatment of such pathology, outcomes remain suboptimal. Pain relief in the immediate postoperative period is usually higher than at last follow up which is a common finding in after these interventions. The long-term efficacy of most available interventions does not meet patients’ satisfaction.
Effect of Tethered Cord Release on Progression of Pediatric Scoliosis: A Systematic Review
Authors: Fathy Ismail Ibrahim Ismail , Mohamed Ismail Mohamed Awad , Hamza Emad Mamoun , Iskander Tawadros Sameh Roshdy 
Published: July 2024

Abstract

Background
Tethered cord syndrome is one of the intraspinal anomalies, caused by abnormal fixation of the spinal cord and classically result in low-lying and immobile conus medullaris. The incidence of TCS is estimated to be 0.05 to 0.25 per 1000 births. That abnormal fixation of the spinal cord may result from many causes, including intraspinal lipoma, lipomyelomeningocele, tight or thickened filum terminale, or scarring from previous myelomeningocele repair.

Methodology
All available studies concerning tethered cord associated with scoliosis and the progression rate of scoliosis after release of tethered cord including randomized controlled studies, cohort studies, and case series was reviewed in addition to the references of the included articles. Systematic reviews, technical notes, letters, and comments was excluded. Studies not written in English was excluded. Patients since birth up to 16 years old, patients with tethered cord associated with scoliosis.

Results
The current evaluation reveals that tethered cord release improve\stable the scoliosis angle by only 47% and 40% of patients required fusion despite the untethering, there are other factors affecting the progression such as riser grade and age.

Conclusion
Nevertheless, the lack of good quality evidence and scarcity of the literature on the topic was also propounded by this review. Prospective, randomised and multicentre RCT’s are required to establish the effect of this procedure on the progression of the deformity.
Neuromodulation in Management of Patients with Failed Back Surgery Syndrome. An Outcome Assessment Study
Authors: Simry Hisham A , Abdelbar Ahmad E , Nagaty Ahmed M , Raslan Ahmed M , Elkholy Mohamed Amgad 
Published: July 2024

Abstract

Background
Failed back surgery syndrome (FBSS) is a constellation of conditions that describes persistent or recurring low back pain following spine surgeries with a reported point prevalence in the general adult population of 37% and a lifetime prevalence of between 60% and 85%. It always has a significant impact on patients’ quality of life. Neuromodulation such as spinal cord stimulation has been showing significant effect and improvement in pain scores and functional capacity of the FBSS patients with a reflected effect on their daily activities and quality of life.

Aim and Objectives
Our aim in this study is to assess the change in pain scores, quality of life and opioid medications intake as an outcome of neuromodulation procedures performed to patients diagnosed with failed back surgery syndrome, and to detect the post procedure complications.

Subjects and Methods
This is a mixed prospective-retrospective study conducted at Ain Shams University (ASU) hospital and Oregon Health and Science University (OHSU) hospital during the period from September 2019 till December 2022. Patients who are 18 years old or older diagnosed with FBSS for more than 6 months and treated with spinal cord stimulation with successful trials during this time frame were included in the study.

Results
34 patients were included in this study who had successful SCS trials and underwent a permanent implantation of SCS devices with post procedure follow up period of 12 months. Patients showed median pain numerical rating scale (NRS) of 7/10 at baseline with median NRS of 4/10 through the follow up period, also, there was a significant improvement of functional capacity using metabolic equivalent assessment with 74% of patients became moderate capacity compared to 32% at baseline. Quality of life assessed by activity measure of post-acute care (AM-PAC) showed significant improvement from mean of 16.87 ± 2.74 at baseline to mean of 19.97 ± 2.93 through follow up. Also there was a significant reduction of opioid medication usage. Post procedure complications was of low percentage with the most commonly detected were battery dysfunction in 7 patients and pocket pain in 6 patients. Reoperation was needed in 13 patients with 4 needed just revision and 9 patients required a complete removal of the device.

Conclusion
Failed back surgery syndrome is a widely described chronic pain condition which has a negative impact on the patients’ quality of life and daily activities with an evidenced effect on chronic use and abuse of opioid analgesic medications. We presented in our study that SCS could be offered as an effective modality of treatment with a statistically significant reduction in pain scores and a significant improvement in functional capacity and quality of life. Also, it has a recognizable but not statistically significant reduction in opioid analgesic medications and a very low percentage of procedure related complications.
Pregnancy Outcome in Pregnancies Complicated by Fetal Growth Restriction and Severe Preeclampsia
Authors: Ali Hassan Mohamed , Adly Elbishry Gaser Mohamed , Sweed Mohamed Samir , Rasheedy Ali Radwa 
Published: July 2024

Abstract

Background
common pathophysiological feature favors parallel occurrence of severe pre-eclampsia (PET) and fetal growth restriction.

Objective
To identify pregnancy and neonatal outcome differences between early-onset and late-onset preeclampsia, in relation to fetal growth restriction (FGR)

Methods
this retrospective study included 50 singleton pregnancies with FGR and severe PET who were admitted in Ain Shams University Maternity Hospital. Fetal growth restriction was defined as EFW and/or AC &lt; 10th percentile. Preeclampsia with severe features included patients with systolic BP ≥ 160 mmHg, diastolic BP ≥ 110 mmHg, elevated liver transaminases twice the normal values, elevated serum creatinine twice the normal levels, or &gt; 1.1mg/dl, HELLP syndrome, features of impending eclampsia, pulmonary edema, and/or thrombocytopenia with platelets level &lt; 100 x 109/L. obstetric and neonatal outcomes were compared in early and late onset PET.

Results
The current study revealed that there was no difference between early and late onset PET in fetal and pregnancy outcomes while there was significant difference in neonatal outcomes.

Conclusion
the current study showed that risk of adverse neonatal outcomes as respiratory distress syndrome and neonatal death were higher in cases with early onset PET.