bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Trending Shock Index Paediatric Adjusted (SIPA) in Paediatric Trauma as a Predictor of Morbidity and Mortality
Authors: Elkarn Ahmed Talaat , El Naggar Osama Abd Al Elah , Ghanem Wael A Radwan , Dahab Mohamed Mousa , Allam Ayman M , Abdelhamid Sameh Abdelhay 
Published: July 2024

Abstract

Background and Purpose
There are several injury scoring systems, anatomic, physiologic and combined scores, which have been used for prediction of patients' outcome such as mortality. Among physiologic scoring systems evolved shock index (heart rate divided by systolic blood pressure) which has been first described in 1967. In the world of paediatric and due to the physiological differences between different age groups, few adjustments have to be done considering these changes evolving shock index paediatric adjusted (SIPA). This study was conducted to evaluate SIPA as a quick feasible method for triaging and managing pediatric trauma and also to predict ICU admission and need for CT scan as a primary outcome and also secondary outcomes like length of hospital stay and (need for surgical intervention) and mortality rate.

Study Design
Prospective randomized controlled study.

Setting
The children’s accident and emergency department in Armed Forces Hospitals and Ain Shams University hospitals.

Subjects
We included 124 pediatric trauma children, and they were divided into 2 groups: Group A (62 children): assessed by SIPA in an incidence of trauma, and Group B (62 children): assessed by traditional vital signs (blood pressure, pulse and capillary refill).

Methods
All patients were subjected to full history taking, SIPA assessment on admission and its daily changes (baseline up to 48 hours). Assessment for need for ICU admission, ventilation, CT scan, surgical intervention, and Length of hospital stay, along with mortality rate recording.

Results
In the studied population, the mean age of all patients was (6.8 ± 3.2) years, with (65.3%) of patient males; and (34.7%) females. Regarding outcome data, comparative study between the 2 groups revealed; significant decrease in ICU admission, need for CT scan, LOS and mortality rate in Group A (SIPA) (p &lt; 0.05). As regards SIPA trend, we found non-significant difference between mortality and no-mortality subgroups in SBP, heart rate, Capillary refill time and SIPA during the serial (baseline up to 48-h) measurements. Also, regarding ICU LOS, we found non-significant difference between mortality and no-mortality subgroups in SBP, heart rate, Capillary refill time and SIPA during the serial (baseline up to 48-h) measurements.

Conclusion
To conclude, SIPA score proven to be an accurate and specific predictor of morbidity, hospital stay and ICU admission, and mortality rate in pediatric trauma patients and is superior to capillary refill time, tachycardia or hypotension alone for predicting different outcomes.
Incidence of Complicated Appendicitis in Cases of Generalized Peritonitis Explored for Obscure Cause: A Systematic Review and Meta-Analysis
Authors: El-Akkad Hesham A , Farrag Ahmed M , Naguib Peter N 
Published: July 2024

Abstract

Background
2ry generalized peritonitis presents a common life-threatening condition associated with high mortality and morbidity. Complicated appendicitis is one of the most common dangerous causes of secondary of generalized peritonitis. Early stage of appendicitis will be in its characteristic usual clinical picture, but delay in diagnosis and lack of experience and practice and patient’s fear from surgical interventions with abuse of medical TTT make the condition developed to generalized peritonitis.

Aim and Objectives
to establish, through the available literature, incidence of complicated appendicitis in cases of generalized peritonitis explored for obscure cause through systematic review and meta-analysis.

Subjects and Methods
This is Meta-analysis study, conducted on generalized peritonitis on adults and elderly all over the world. The literature search yielded 1821 unique articles. A further screening of titles and Abstracts was conducted, and 32 studies were considered potentially relevant to our review. According to the inclusion criteria, 10 studies were identified in this study.

Results
age, duration of pain, presence of an appendicolith, size of appendix and abscess were significant predictors to complicated appendicitis.

Conclusion
Decreased healthcare facilities and investigations, low experience for medical service provider, ignorance, low socio-economic state, decreased awareness and mentally-ill patients will worsen the case and make it difficult to diagnose the main cause of generalized peritonitis which will lead to the only decision of choice which is exploration. It will be a lifesaving decision for diagnosis and quick management of the disease to decrease suffering of such cases.
Pattern of Cognitive Impairment among Community Dwelling Elderly in Egypt and Its Relation to Socioeconomic Status
Authors: Tawfik Amany Abass , Adly Nermien Naim , Hamza Sarah Ahmed , Abdel Kader Radwa Magdy 
Published: July 2024

Abstract

Background
Cognitive decline is well-recognized as a normative part of the aging process that strongly affects daily functioning and quality of life. Giving the different levels of cognitive health among people from different socioeconomic groups. Aim: To assess the prevalence and pattern of cognitive impairment among community dwelling elderly in Egypt and the contribution of socioeconomic status to inequality in cognitive impairment.

Patients and Methods
This study involved 470 elderly participants ≥ 60 years, males and females. The Montreal Cognitive Assessment (MoCA) was used to measure the prevalence of cognitive impairment, Ain Shams Cognitive Assessment (ASCA) to assess pattern of specific cognitive domain affection, and Socioeconomic status (SES) scale were used to describe the SES of participants.

Results
The prevalence of cognitive impairment was 50.2% in Egypt, 37.7% for MCI and 12.5% for Dementia. The most common type of cognitive impairment was degenerative type (47.8%). Pattern of specific domain affection among cognitively impaired subjects, ranged from 94% for visuospatial function to 12.7% for Abstraction. Cognitive impairment was significantly associated with increasing age, female sex, marital status single or widow, low education and with increasing total number of comorbidities, depression and positive family history of cognitive impairment. Cognitive impairment was mainly concentrated in the economically disadvantaged population (low educational level, non-occupied, limited computer use, low income and bad sanitation).

Conclusion
In Egypt, cognitive impairment is significantly prevalent and concentrated among those who are in low socioeconomic status. Increasing educational level of low SES population and improving their access to healthcare services will help to improve the inequity of cognitive impairment.
The Possible Effect of Platelet Rich Plasma on Liver and Small intestine in Adult and Aged Male Rats. A Histological and Immunohistochemical Study
Authors: Saleh Elham Ahmed , Abdel Samad Abeer Abdel Mohsen , Raafat Mona Hussien , ElKhalek Ibrahim Gehan Abd 
Published: July 2024

Abstract

Introduction
There is a general modest decline in the function of different organs in the body with aging. In the small intestine, there may be alterations in the intestinal morphology, as well as a decline in the absorption of fatty acids and sugars. The aging process decreases regenerative ability which significantly delays the restoration of liver function. Platelet-rich plasma (PRP) has recently attracted interest in many medical fields. PRP might has benefit effect on aged male rats.

Aim of the Work
This study aims to investigate the structural changes that might occur during normal aging and the possible effect of PRP intraperitoneal injection on adult and aged male albino rats.

Materias and Methods
Forty-two male albino rats were classified according to age into adult group and old aged groups. Adult male rats (300 -350 g), their age range between 6-8 months. Aged male rats (570-660 g), their age range between 12-24 months. They were divided randomly into four groups: Group I (Control adult): Included 14 rats that further subdivided into 2 equal subgroups: subgroup IA: untreated rats and subgroup Ib: rats were injected by sterile saline intraperitoneally (0.5 mL/kg by intraperitoneal injection 3 times/week). Group II (Control Aged): Included 14 rat that further subdivided into 2 similar subgroups as group I, Group III (Adult treated): Included 7 rats that received intraperitoneal injection of PRP (0.5 mL/kg by intraperitoneal injection 3 times/week), Group IV (Aged treated): Included 7 rats that received intraperitoneal injection of PRP as group III. Animals were kept under observation and the treated groups received intraperitoneal injections for 21 days. At the end of the experiment, Liver and small intestine specimens were processed for histological and immunohistochemical examination. Morphometric and statistical analysis was also done.

Results
Group II showed decrease in height of intestinal villi with disruption of their epithelium surface, increase spacing between enterocytes and abundant mononuclear cellular infiltration. Changes in the liver comprised nuclear and cytoplasmic changes that included an increase in nuclei number in hepatocytes with droplets fat infiltration. Treated Groups showed decreasing mononuclear cellular infiltration with decreasing collagen fibres and congested blood vessels.

Conclusion
Aging process enhanced the vulnerability to injury and inflammation in both the liver and small intestine. PRP had ameliorating effects on these changes.
Evaluation the Role of Lipocalin 2 as a New Non-Invasive Diagnostic Marker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients
Authors: El-Sayed Ashour Engy yousry , Ibrahim El-Baz Hossam Samir , Megahed Ahmed Sherif Ahmed , Abd EL-Mabood Menna Alla Mostafa Sediq 
Published: July 2024

Abstract

Background
Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide. In Egypt, it represents the fourth common cancer. Significant risk factors for hepatocellular carcinoma include viral hepatitis (hepatitis B and hepatitis C), alcoholic liver disease, and non-alcoholic liver steatohepatitis/non-alcoholic fatty liver disease. HCC occurs in 80%-90% of patients with cirrhosis. The annual incidence of HCC in patients with cirrhosis is 2-4%.

Aim of the Work
The aim of this study is to evaluate the role of lipocalin 2 (LCN 2) as a diagnostic marker in HCC Egyptian patients.

Patients and Methods
A case-control study in Ain- Shams University Hospital for 6 months period and the study will be conducted on 96 Egyptian patients (32 HCC patients, 32 liver cirrhosis without HCC, 32 normal control persons).

Res1ults
We found that LCN 2 level ranged from 150 to 380 in HCC group with mean±SD = 292.750±50.940, from 88 to 280 in cirrhotic patients with mean± SD = 129.313±36.605, from 40 to 62 in control group with mean± SD = 53.250± 4.958, being statistically significant higher in HCC group more than both cirrhotic group and control group and in cirrhotic patients more than control group (p-value = &lt;0.001). The results showing sensitivity of 96.87% and specificity 96.87% of LCN 2 as a marker for HCC with accuracy of 98.4%,with cut off &gt; 160. The presence of (LCN-2) in blood and urine, in combination with α-Fetoprotein (AFP), is a biomarker of early stages of HCC. LCN 2 is a promising serum tumor marker for HCC diagnosis.

Conclusion
We concluded from this study that: Serum LCN 2 level was significantly higher in patients with HCC and mildly elevated in patients with liver cirrhosis compared to the control group. So it can be used as a tumor marker for HCC diagnosis. Use of LCN 2 with AFP or possibly other markers will improve the diagnostic field and can help in early detection of HCC in surveillance programms. We need further studies on large number of HCC patients of different etiologies and on metastaic liver tumors to clarify the accuracy and potential diagnostic role of LCN 2 in the future.
Serum Resistin Level as a Novel Marker of Disease Activity in Patients with Ulcerative Colitis
Authors: Abd El-Hamid Khalid , Allam Ahmed Samir , Youssef Mohamed Gamal , Sayed Omnia Samir Mohamed 
Published: July 2024

Abstract

Background
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions.

Aim of the Work
The aim of our study is to asses serum resistin level in disease activity and remission in patients with ulcerative colitis disease.

Patients and Methods
A cohort study for 6 months on 40 Egyptian patients presented with ulcerative colitis disease over 18 years old visiting the outpatient clinics or admitted in Ain Shams University Hospitals.

Results
The present study revealed a highly significant elevation of serum Resistin in active ulcerative colitis patients with p-value &lt;0.001 which shows direct relationship between the activity of ulcerative colitis and serum Resistin. Resistin was positively correlated with inflammatory markers (CRP and ESR) in UC patients. And there is negative relation between resistin and Hb, fecal calprotectin.

Conclusion
Serum Resistin is a valuable noninvasive marker in the assessment of disease activity in ulcerative colitis patients, correlated positively with inflammatory markers (CRP and ESR). Other studies should be done on larger size of participants to determine the the role of serum Resistin as a marker of disease activity in patients with Inflammatory bowel disease.
Renoprotective Effect of Febuxostat on Contrast Induced Acute Kidney Injury in Chronic Kidney Disease Patients Stage 3. Randomized Controlled Trial
Authors: Sarhan Iman Ibrahim , Abdellatif Yasser A , Saad Rania Elsayed , Teama Nahla Mohamed 
Published: July 2024

Abstract

Introduction
Contrast induced acute kidney injury (CI-AKI) is known to be a complication of using intravascular contrast injection. Unfortunately, It is associated with adverse outcomes as prolonged length of hospitalization and increased burden of health care costs. So, we aimed to determine the efficacy of febuxostat in prevention of contrast induced acute kidney injury among patients with chronic kidney disease Stage 3 performing percutaneous coronary intervention (PCI).

Methods
In a randomized controlled trial we enrolled 120 CKD stage 3 Patients with acute coronary syndrome referred to the cardiology department Ain-Shams University hospital for performing PCI and stenting. Patients were randomly assigned to two arms: Group I (study group): Included 60 patients who received Febuxostat added to the traditional treatment (IV hydration and N-acetylcysteine). The patients received Feburic 80 mg within 6- 18 hours before and within 6-18 hours after the coronary intervention (a time gap of 24 hours between two doses).Group II (control group): included 60 patients who received only traditional treatment.

Results
The incidence of AKI was higher in the control group with a statistically significant difference. We found that Independent Significant risk factors that led to AKI were febuxostate avoidance, DM, high urea level, high creatinine level, CKD stage 3B, high Mehran score and high AKI risk.

Conclusion
We demonstrated that febuxostat has a renoprotective effect and it can help to reduce the incidence CI-AKI in CKD patients stage 3 performing PCI.
Serum Stabilin1 as a Prognostic Marker in Adults Acute Leukemia Patients
Authors: Mousa Mohamed Mahmoud , Abd-elsamee Hanaa Fathy , Radwan Rania Abd-elmoniem , Sheeba Mahmoud Soliman , Ibrahim Ali Mariam 
Published: July 2024

Abstract

Background
STAB-1 (common lymphatic endothelial and vascular endothelial receptor) was found to be expressed on tumor lymphatic vessels in different malignancies and it is a bad prognostic marker. This study will assess the role of serum stabilin1 (STAB1) as a prognostic marker in adult patients with newly diagnosed acute leukemia and correlate it with the other well established prognostic markers. Acute lymphoblastic leukemia (ALL) is a hematologic malignancy arising from precursors of the lymphoid lineage. Conventional cytotoxic chemotherapies have resulted in high cure rates of up to 90% in pediatric ALL, but the outcomes for adult patients remain suboptimal with 5-year survival rates of only 30%-40%.

Aim of the Work
To measure STAB1 expression in patients with AML and patients with ALL and assess its role as a prognostic factor with correlating it with other prognostic factors.

Patients and Methods
A case control study in Ain Shams University Hospitals, Clinical Haematology and Oncolgy division of Internal Medicine Department for one year on total 75 subjects divided into: 25 patients with newly diagnosed acute myeloid leukemia (AML), 25 patients with newly diagnosed acute lymphoblastic leukemia (ALL) and 25 age and sex matched healthy control subjects. The study population was recruited from Ain Shams University Hospitals, Clinical Haematology and Oncolgy division of Internal Medicine Department.

Results
There was no significant difference between cases of acute leukemia pts and control group as there was no statistically significant difference between control and patients group regarding sex, age, spleen size, liver size, LDH, CRP, uric acid and ESR of the studied subjects. Our study shows that as regard CBC; there was significant difference between the studied groups as regard leucocytic count, BUT Platelets, and hemoglobin was insignificant, which was also described in the study. Our study showed that there was high statistically significant difference between the acute leukemia patients and the healthy control group as regard sabilin1. Our study shows that the mean serum level of stabilin1 in the patients who didn’t respond to chemotherapy was higher than that of the patients that responded to chemotherapy.

Conclusion
There was high statistically significant difference between the studied groups as stabilin1. There was significant correlation between stabilin2 and chemotherapy response. Stabilin1 expression levels also identified a new subgroup at a higher risk for relapse and with a poor prognosis in acute leukemia patients. Stabilin 1 can be used as a prognostic factor in patients with acute leukemia.
Effect of Dialysis Modality and Membrane Permeability on FGF 23 Level and Cardiovascular Calcification in ESRD Patients
Authors: Elsayed Hesham M , Beshary Waleed A , Rezk Khaled M , Mohamed Mostafa A , Ahmed Fatma A 
Published: July 2024

Abstract

Introduction
Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD) and vascular calcification is one of the strongest predictors of cardiovascular risk. The prevalence of vascular calcification increases as glomerular filtration rate (GFR) declines and calcification occurs years earlier in CKD patients than in the general population. (26).

Aim of the Study
To study the effect of hemodialysis modality in controlling FGF-23and to determine the impact of FGF23 on cardiovascular calcification

Patients and Methods
We selected 50 patients ESRD maintained on hemodialysis divided into 2 groups, Group 1: comprised of 25 patients maintained on hemodialysis with high flux dialyzer and Group 2: comprised of 25 maintained on weekly session of hemodiafiltration and comparison between both groups regarding FGF23 serum level in addition to cardiovascular screening for calcifications using ECHO, Carotid intima-media thickness, and carotid duplex.

Results
we found that Post dialysis FGF23 was significantly lower in “hemodiafiltration patients” than ‘hemodialysis patients” and Reduction ratio was significantly higher in “hemodiafiltration patients”(P &lt; 0.001).ECHO score and carotid duplex score were insignificantly different between both groups, but carotid intima-media thickness was significantly higher in haemodialysis patients (P value 0.035). Post HDF FGF 23 had a significant positive correlation with IMT (r = 0.579, P = 0.008). Serum FGF23 post-HD and HDF had significant positive correlation with serum Calcium (r = 0.659, P = 0.002), (r = 0.474, P = 0.035), PTH (r = 0.485, P = 0.03), (r = 547, P = 0.013) and CRP (r = 0.646, P = 0.002), (r = 707, P &lt; 0.001) and serum Phosphorus (r = 0.462, P = 0.04), (r = 478, P = 0.033) respectively. In HD group Carotid Duplex Score had significant positive correlation with serum Ca (r = 0.469, P = 0.037), while in HDF group Carotid Duplex Score had significant positive correlation with PTH (r = 0.59, P = 0.006).

Conclusion
Using online HDF technique showed a significant reduction of FGF23 and improvement of carotid intima-media thickness calcification score.
The Effect of Dialysis Membranes on Coagulation Activation during Haemodialysis of Maintenance Haemodialysis Patients
Authors: Sayed Khalid Samir , El Sayed Hisham , Gharib Mohamed Sary 
Published: July 2024

Abstract

Background
Platelets, leukocytes, and the coagulation cascade are activated during hemodialysis. During hemodialysis, systemic anticoagulation is used to prevent clotting of the extracorporeal circuit which may lead either to complete clotting to the degree that prevent blood return to the patient or to a lesser extent can only affect the dialyzer membrane fibers which will decrease the effective surface area and that will decrease the session efficacy

Aim of the Work
The aim of the current study was to evaluate contact system activation and overall coagulation activation during in vivo hemodialysis in prevalent hemodialysis patients, using current generation dialyzer membranes. A crossover study design allowed assessment of differences among regular dialyzer membranes.

Patients and Methods
We performed a single-center sequential interventional clinical trial study. Twenty patients older than 18 years and treated with maintenance hemodialysis (&gt;3 months) underwent 2 hemodialysis study sessions at Ain Shams University hospitals dialysis unit. Exclusion criteria were clopidogrel or anticoagulant therapy, active infection, presence of central venous catheter or arteriovenous graft and known vascular access dysfunction.

Results
The increase of TAT at 240 minutes after dialysis start in our study, irrespective of the dialyzer membrane used, suggests a late-onset threshold for thrombin generation, which is well before the treatment effect of the UFH is expected to have faded. The changes in TAT dynamics are in line with previously published results. Dialysis treatments were standardized except for dialyzer membrane. Hence, the differences between membranes are most likely due to differences in physicochemical characteristics. Whether these differences are clinically meaningful needs further study. Analysis costs and the exploratory set-up of the trial drove the small sample size and design of the study. A more comprehensive evaluation of the coagulation activation over a longer time period of hemodialysis treatment would be of interest.

Conclusion
Driven by the recent interest in the therapeutic options of specific contact system inhibitors, we aimed to evaluate contact system activation during in vivo he-modialysis. Chronic hemodialysis patients dialyzed through arteriovenous dialysis access show coagulation activation during hemodialysis, marked by increased TAT levels, despite using systemic anticoagulation to prevent macroscopic clotting of the extracorporeal circuit. The increase in thrombin generation markers was not associated with measurable contact system activation. Our results argue against effective contact system activation during hemodialysis and generate the hypothesis that novel specific contact system inhibitors alone might not suffice as anticoagulant treatment during hemodialysis.