bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of A new Weaning Index of Discontinuation From Mechanical Ventilation in Intensive Care Unit
Authors: Kamal Eman Sabry , Al Rahman Salem Gamal Abd , Dwedar Ibrahim Aly , El Embabi Dalia Abd El Sattar 
Published: July 2024

Abstract

Background
Failure to wean from mechanical ventilation (MV) is a frequent problem in the intensive care unit (ICU) setting. Herein, we investigate a new WI measured at the initial spontaneous breathing trial (SBT) in order to predict successful liberation from MV in mechanically ventilated ICU cases.

Patients and methods
This prospective cross-sectional study consisted of two phases; Phase I was designed to create a new WI from the criteria of 60 mechanically ventilated patients, while Phase II aimed to assess the accuracy of that index in another 40 patients. Patients aged older than 18 years who were receiving controlled-mode MV from day 3 to day 14 and planned to be weaned off MV were included in our study. Contrarily, patients with prior history of poor tolerance to SBT, weaning failure were excluded. Additionally, we also excluded patients with neurological or neuromuscular disorders, tracheostomy, pregnancy, or an active COVID-19 infection.

Results
The incidence of failed weaning was 33.3% in phase I, and 35% in phase II. Pulmonary causes were the most common indication in both groups. Multivariate regression analysis was done for phase I variables, and the following equation was created; (((Cough strength* 0.743) - 1.927) *0.05 + ((PaCO2 (mmHg)* - 0.126) + 6.786) *0.08 + ((mean airway pressure (CmH2O) * -1.304) + 14.119) *0.193 + ((PaO2/FIO2 * 0.268) - 58.555) *0.328 + ((rapid shallow breathing index * -0.485) + 24.406) *0.353). Using a cut-off value of &gt; 0.69 and applying this index in phase II, it showed a mean value of -1.43 and 4.67 in the failure and success groups, respectively (p &lt; 0.001). This new WI with cutoff value (&gt; 0.69) had 88.5% sensitivity, 57.1% specificity, and a 77.5% accuracy to predict the success of weaning from MV.

Conclusion
We developed a new WI with good sensitivity and moderate specificity for predicting successful weaning from MV in ICU patients. Its use should be encouraged in the ICU setting, especially by less experienced ICU physicians.
X-ray Repair Cross Complementing 1 (XRCC1) Gene Polymorphism in Hepatocellular Carcinoma (HCC)
Authors: Ali Shaaban Menat Allah , Abdelhamed Nada Atef , Saad Wessam El-Sayed , Kamal El-Din Maha Mohsen Mohamed , Mahmoud Marwa Elazab 
Published: July 2024

Abstract

Background
Several risk factors for hepatocellular carcinoma (HCC) have been identified, including chronic infection of hepatitis B virus (HBV) and hepatitis C virus (HCV). Nevertheless, only a fraction of infected patients develops HCC during their lifetime suggesting that genetic factors might modulate HCC development. The human X-ray repair cross- complementing protein 1 (XRCC1) gene encodes for one of the major repair factors involved in base excision repair (BER), which is reported to be associated with the risk of several cancers. A few studies have explored the association between risk of hepatocellular carcinoma (HCC) and single-nucleotide polymorphisms (SNPs) in different DNA repair genes.

Aim of the Work
to investigate the possible association between XRCC1-G28152A (rs25487) single nucleotide polymorphism (SNP) and hepatocellular carcinoma (HCC) in chronic hepatitis C patients.

Patients and Methods
The study included 35 patients who had HCC and 15 patients who had liver cirrhosis. XRCC1 gene polymorphism was done to all participants by RT-PCR After collection of relevant clinical data and basic laboratory tests.

Results
A statistically higher frequency of XRCC1 (GG, GA) genotypes and increased (G) allele frequency in patients with HCC was found in comparison to cirrhotic HCV patients as well as control group but Our results revealed that the genotypic and allelic frequencies of XRCC1 gene polymorphism rs25487 didn’t show statistically significant difference between HCC patients group and liver cirrhosis control group.

Conclusion
The present study had demonstrated that there was no significant association between XRCC1 gene polymorphism (rs25487) and HCC in the sample of Egyptian population included in our study. Also, non-significant differences among the XRCC1 genotypes and alleles were found regarding age, sex, BMI and laboratory data including CBC, AFP, coagulation profile (PT, INR), liver function test ( total protein, albumin, AST, total bilirubin and direct bilirubin), BCLC and Milan criteria. While a statistically significant difference was observed as regards PTT and ALT between genotypes.
A Comparative Study on the Efficacy and Safety of 10% Topical Minoxidil versus 5% Topical Minoxidil in the Treatment of Male Pattern Hair Loss
Authors: Ali El-sayed Mahinaz El-sayed , Abdel Fattah Nermeen Samy , Afify Ahmed Abd-elfattah 
Published: July 2024

Abstract

Background
Androgenetic alopecia is a genetically disorder characterized by the gradual conversion of terminal hairs into vellus hairs, called miniaturized hairs. It is an extremely common disease that affects men and women. Specifically, DP cells that are the main regulators of hair growth and are the only site of 5α-DHT action. Male-pattern hair loss; Male note gradual recession of the frontal hair line early in the process. Men present with gradual thinning in the temporal areas, producing a reshaping of the anterior part of the hair line.

Aim of this Study
To evaluate and compare topical minoxidil 10% versus topical minoxidil 5% in the treatment of MPHL as regards the efficacy, safety and side effects. This study included 51 patients with MPHL divided into 2 groups received topical minoxidil 5% 1ml twice daily for 6 months and the second group received topical minoxidil 10% 1ml twice daily for 6 months.

Patients and Methods: Results
The current study revealed that there was significant difference between the studied groups as regard the percentage of improvement in Frontal Total hair count with superiority for 10% group. But the improvement in other parameters were comparable between the studied groups. Comparison of treatment response in both groups revealed nearly the same efficacy of both concentrations of topical minoxidil 5% and 10% in MPHL, higher concentration more than 5% could decrease the compliance and the tolerance.

Conclusion
We found that using higher doses of topical minoxidil was associated with higher improvement in frontal total hair count and higher side effects.
Meta-Analysis in Comparison between Cisplatin with Radiotherapy and Cetuximab with Radiotherapy in the Management of Locally Advanced Head and Neck Squamous Cell Carcinoma
Authors: Elnashar Abdelhamid Abdelhamid , Mikahail Peter Milad , Mohammed Mohammed Abdelaleem , Omran Mohammed Mansour 
Published: July 2024

Abstract

Background
Nowadays there is an increasing in the numbers of cases of head and neck squamous cell carcinoma (HNSCC) all over the world. Which affect upper aerodigestive tract including the nasopharynx, paranasal sinuses, oral cavity, oropharynx, hypopharynx and larynx.

Objective
To compare the using of radiotherapy (RT) with cisplatin versus cetuximab with RT in the treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC). The comparison between these two treatment regimens will be done in terms of overall survival rate and toxicity.

Patients and Methods
We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists.

Results
cetuximab with RT is associated with lower overall survival compared to cisplatin with RT in management of locally advanced head and neck squamous cell carcinoma, also patient treated with cetuximab were associated with higher rates of mortality compared to those treated with cisplatin

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2020.

Conclusion
According to our study in the comparison between cisplatin with RT versus cetuximab with RT, cetuximab with RT is associated with lower overall survival compared to cisplatin with RT in management of locally advanced head and neck squamous cell carcinoma, also patient treated with cetuximab were associated with higher rates of mortality compared to those treated with cisplatin
Assessment of the Role of Keratin 18 and High Mobility Group Box 1 Biomarkers for Early Prediction of Drugs and Chemicals Induced Hepatotoxicity A Prospective Study in the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH)
Authors: Ebeid Ghada Mohamed , Abd Manal El Sayed , Eglal El Salam , Awady Hassan El , Hussien Rania 
Published: July 2024

Abstract

Background
Drug-induced hepatotoxicity represents a major clinical problem worldwide. Hepatotoxicity may be caused by drugs, chemicals used in laboratories and industries or natural products and rodenticides such as metal phosphides. Early identification of hepatotoxicity would facilitate patient- individualized treatment strategies. New biomarkers (HMGB1and K18) used to identify subsequent acute liver injury (ALI) in patients on admission to the hospital.

Objectives
This study aims to assess the role of keratin 18 and high mobility group box 1 biomarkers in early prediction of drugs and chemicals induced hepatotoxicity for better outcome and to compare these new liver biomarkers with the currently used parameters (ALT & AST) in the early prediction of drugs and chemicals induced hepatotoxicity.

Methods
This prospective study was conducted on 50 adult patients of both sex presented to the PCC- ASUH with acute intoxication of hepatotoxic drugs or chemicals. For all patients, we measured high mobility group box-1 (HMGB1), keratin-18 (K18), AST and ALT on admission then patients were followed- up for development of liver injury . Subjects were classified into group I (control group), group II (no liver affection) and group III (with liver affection). Receiver operator characteristic (ROC) curve was used to compare sensitivity and specificity to report liver injury versus alanine transaminase (ALT) and aspartate transaminase (AST).

Results
This study showed that HMGB1 and K18 were much more elevated in patients who developed liver injury in the first hospital presentation when ALT and AST were within normal ranges with a highly significant difference between the hepatotoxic and non-hepatotoxic group. ROC analysis showed that HMGB1 and K18 were more sensitive than ALT and AST and more specific than AST in predicting ALI.

Conclusion
Elevations in plasma HMGB1, and K18 identified subsequent ALI development in patients on admission to the hospital, soon after drug and chemical overdose, and in patients with ALT and AST in the normal range.
Meta-Analysis of Predictive Value of Ki-67 before Neoadjuvant Chemotherapy in Breast Cancer Patients
Authors: El Rahman Sami Ahmed Abd , El Din Osman Ahmed Gamal , Ragheb Ayoub Bishoy Refaat , Maurice Gerges Andrew Malek 
Published: July 2024

Abstract

Background
Breast cancer is the second most common malignancy among female patients. Early breast cancer is considered potentially curable. Immunohistochemistry has an important role in the pathology of breast disease. It is widely used to localize specifically proteins in cells and tissues. Ki-67, a marker of cell proliferation, is a specific nuclear antigen expressed in all phases of the cell cycle, which can be readily detected using immunohistochemistry methods. Many guidelines and international groups concluded that measurement of Ki-67 could be important both in standard clinical practice and within clinical trials.

Objective
To clarify relation between expression of Ki67 and response of malignant cells to neoadjuvant chemotherapy in breast cancer.

Methods
The search was directed through PubMed / MEDLINE, Scopes, Web of science, and the Cochrane Library for information from inception to July 1, 2022, with a combination of the following terms: “Ki-67”, “breast cancer” and “NCT”. More searches by Google Scholar have been used to supplement the search with the sites mentioned above. Abstract-based eligibility studies were obtained, and the manuscripts were fully reviewed. Report bibliographies that meet the eligibility criteria were reviewed for further studies.

Results
A recently published meta-analysis reported that a high Ki-67 level was associated with a high pCR rate. Our results demonstrate that patients with a Ki- 67 are more sensitive to NCT, have higher pCR rates, and benefit more from NCT compared to those with a low Ki-67. However, it remains unclear whether other factors such as therapy regimens and cycles of NCT, the clinical stage, and tumor location have an impact on Ki-67-based health outcomes.

Conclusion
The meta-analysis reported here demonstrates that pretherapeutic Ki-67 is associated with pCR in breast cancer patients undergoing neo-adjuvant chemotherapy.
Endovascular Management of Intestinal Ischemia
Authors: Elassar Eslam Samy , Ali Ahmed Helmy , Monaem Rizk Mohammed Abdel , Majed Ibrahim 
Published: July 2024

Abstract

Background
Mesenteric ischemia requiring revascularization is associated with high mortality in both chronic and acute forms. Disparate etiologies and nonspecific symptoms make the diagnosis challenging and often result in delayed diagnosis and intervention. More often surgery is required and is frequently lifesaving. Percutaneous transcatheter techniques are increasingly employed in both diagnosis and treatment.

Aim and Objectives
To highlight the recent trends in management of patients with mesenteric vascular occlusion.

Subjects and Methods
This was is a prospective study, conducted at Ain Shams University Hospitals and Nasser institute Hospital in Cairo on 30 patients complaining of acute or chronic intestinal ischemia in the form of abdominal pain and post prandial meal.

Result
Among the studied cases there were 4 (13.3%) with complete effect of thrombolysis, 1 (3.3%) with partial effect, 2 (6.7%) with no lysis, 8 (25.7%) with dilatation, 13 (43.3%) dilatation and stent and 13 (43.3%) with failed dilatation.

Conclusion
Endovascular intervention can be an alternative to open surgery for intestinal revascularization for the management of early cases of acute SMA occlusion. CTA rapid diagnosis, urgent endovascular management and intensive care and follow up are the cornerstone for good prognosis.
Incidence of Thyroid Carcinoma in Multinodular Goiter versus Solitary Thyroid Nodule: Meta-Analysis
Authors: Kamal Ahmed Mohamed , Saad Ahmed Saeed , Abdellah Abdellatif Seham Alsayed 
Published: July 2024

Abstract

Background
Thyroid carcinoma (TC) is a relatively rare tumour, but it represents the most frequent form of cancer of the endocrine glands. It represents 1% of human neoplasias. Thyroid nodules are common. Palpable Thyroid nodules are found in 5% of persons aged an average of 60 years.

Objective
To determine the incidence of thyroid carcinoma in multinodular goiter versus solitary thyroid nodule.

Patients and Methods
Recent clinical trials or cluster trials, prospective and retrospective comparative cohort studies. Search results were uploaded to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart was introduced on the search results and the inclusion/exclusion criteria.

Results
Initially, 1240 observational studies were identified through the literature search. When the duplicates were removed, 1087 remained. Eight studies fulfilled the inclusion criteria and included in the meta- analysis. The study included five retrospective studies, two prospective and one Cross- sectional comparative study. The frequency of thyroid cancer among them varied from 13.7 9 to 41.4%.

Conclusion
To conclude, the current meta-analysis revealed that there is no difference between thyroid carcinoma in multinodular goiter and thyroid carcinoma in solitary thyroid nodule although malignancy in follicular thyroid carcinoma is higher in MNG than STN.
A Comparative Study in Elective Repair of Large Incisional Hernias Using On-Lay Mesh vs. Sub-Lay Mesh – A Meta-Analysis
Authors: Maaty Sameh Abdallah , Fawzi Fawzi Salah , El-Shayeb Bassem Helmy , Louiz Kamel Kirollos Adel 
Published: July 2024

Abstract

Background
Ventral abdominal wall incisional hernia is defined as a defect in the musculo-fascial layers of the abdominal wall in the region of postoperative scar. There is a slight increase in the incidence of incisional hernia in the female gender. The higher percentage of incisional hernia in females might be due to laxity of abdominal wall muscles after multiple pregnancies and also increased incidence of obesity in females.

Objective
To assess incisional hernia repair using two different techniques: on-lay mesh and sub- lay mesh, as regards operative time, postoperative recurrence, wound infection, seroma, hematoma and flap necrosis.

Patients and Methods
The Pubmed, web of science and Scopus were searched on 15 March, 2022. The keywords incisional hernia, sub-lay mesh on-lay mesh, retromuscular mesh, polypropylene.

Results and Conclusion
According to our results, there is a statistical difference between onlay and sublay regarding intra-operative time as sublay mesh is more time consuming. Regarding post- operative complications there is no statistical difference in recurrence, seroma, hematoma, flap necrosis and infection but there is a statistical difference regarding in hospital stay as patients with sublay repair stays less than onlay.
Laser Hemorrhoidoplasty vs Conventional Milligan-Morgan Hemorrhoidectomy for Treatment of Third and Fourth Degree Hemorrhoids: A Prospective Comparative Study
Authors: Mohamed Amer Hazem Abdelsalam , Kamal Ahmed Nabil , Abdel- Maksoud Ibrahim Magid , Fouad Elias Amir Adel 
Published: July 2024

Abstract

Background
Hemorrhoids are the most common disease of anal canal affecting a large number of people at least once during their lifetime and can interfere with their daily functioning. Surgical treatment is the best available option for symptomatic hemorrhoid cases, which are refractory to medical treatment. In spite of many modifications made to the hemorrhoid surgical techniques, postoperative pain and discomfort remain the major concern for patients, which is why they often refuse to undergo surgical treatment. Laser ablation has opened new possibilities for the minimally invasive treatment of hemorrhoids.

Objective
To compare the outcomes between laser hemorrhoidoplasty and the conventional Milligan-Morgan hemorrhoidectomy for treatment of third and fourth degree haemorrhoids especially postoperative pain, bleeding, and recurrence.

Patients and Methods
Recent studies have proven that laser ablation was much better regarding postoperative pain and hemorrhage in the various degrees of hemorrhoids. Our study also confirmed that laser ablation technique has shorter operative time, less severe postoperative pain, bleeding and comparable regression of hemorrhoid columns. Studies with longer follow-up period (around 2 years) have also reported effectiveness of laser for the treatment of hemorrhoids which was confirmed in our study over 6 months.

Results
Although some studies showed that wound inflammation or hemorrhoid thrombosis could be a problem however our study showed no postoperative local infection in the group treated with laser ablation and only two patients were presented with thrombosis of external hemorrhoid 7–10 days after the surgery, which was resolved with medical treatment.

Conclusion
Laser hemorroidoplasty has better outcomes than the traditional surgical resection of hemorrhoid disease for the control of grade III and IV symptomatic refractory hemorrhoids specially regarding post-operative pain and bleeding which are the main concerns for most patients.
Acute Kidney Injury in COVID-19 Patients
Authors: Wahab Saeed Saeed Abdul , Hassan Mohamed Saeed , Abu EL-Naga Moataz Mohamed 
Published: July 2024

Abstract

Background
This was a prospective study that was held in KOBRY ALKOBBA military complex to evaluate the prognosis of COVID-19 patients with Acute kidney injury (AKI). Evaluation of AKI in hospitalized patients with COVID-19, which included adult patients with laboratory and radiologically confirmed SARS-COV-2 infection admitted to ward and ICU patients at KOBRY ALKOBBA military complex, Cairo, Egypt.

Aim of the Work
The aim of this work is to study the incidence and outcome of Acute Kidney Injury (AKI) in all patients admitted with COVID-19 infection in ward and ICU during 3 months at Ainshams university hospitals.

Patients and Methods
A prospective cohort study for 3 months on Inward and ICU patients at Ainshams university hospitals. Informed consent was taken from each patient and study will be approved from ethical committee of the department of internal medicine faculty of medicine Ain Shams university.

Results
As a result, the findings of our study required additional validation. This study was conducted during the COVID-19 pandemic in a single medical center in Cairo governorate: thus, we were unable to generalize our findings to all individuals infected with COVID-19 in Egypt.

Conclusion
Incidence of AKI in our study was 9.19% in all patients admitted in ICU and ward during 3 months. Our findings suggest that COVID-19 cases, particularly those in ICU, should be closely monitored for the progression of AKI. Early detection of AKI and prompt meditation may improve COVID-19 patients outcomes. The occurrence of AKI is a poor prognostic factor in SARS-CoV-2 infected patients. The mortality rate in COVID-19 patients complicated with AKI group is very high.
Adherence of Mild and Asymptomatic Covid-19 Positive Patients to Ain Shams University Home Isolation Protocol
Authors: Farres Mohamed N , Wahba Hoda M F , El-Mahdi Amira R , Ali Alaa G H 
Published: July 2024

Abstract

Background
Egypt has reported almost 515,103 confirmed cases of coronavirus disease (COVID-19) with 24,779 deaths from January 3rd, 2020 to May 29th, 2022. To date, the clinical picture of coronavirus infection among Egyptian patients has not been well-characterized. Asymptomatic infection and mild cases make up a large proportion of infections all over the world. According to Ain Shams University guidelines, asymptomatic and mild cases can be isolated at home; however it is unclear to what extent patients adhere to home isolation guidelines, and whether home isolation was in fact effective in reducing infection among the patient’s family contacts.

Aim of the Work
The aim of this study was: Describe the socio-demographic characteristics of asymptomatic and mild patients eligible for home isolation and measure the adherence of patients isolated at home to the recommended control measures with telemedicine follow up.

Patients and Methods
This is a retrospective cohort study conducted in Ain Shams University on 400 patients who were diagnosed as positive for covid-19, classified as asymptomatic or mild cases at presentation and recommended for home isolation.

Results
In our cohort, Patients that were adherent to home isolation guidelines had similar household infection rate to those with less compliance except for those who had more than one bathroom, household infection had significant negative correlation to number of bathrooms (p = 0.003) because the patient was able to have personal bathrooms. Regarding family members, 57.8% of cases had members with no symptoms of COVID-19 and 43.2 % had members with symptoms or positive test.

Conclusion
Our study was limited with the low number of patients from a single centre. However, our findings showed that self-isolation at home may be an alternative to manage mild cases or asymptomatic patients when applied with careful and close observation.