bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Follistatin-Like 1 in Development of Insulin Resistance in Overweight and Obese Children
Authors: Monir Eman Nader , Moustafa Amr S , El Gendy Yasmin G , Ibrahim Haya E , Tarek Marwa 
Published: July 2024

Abstract
The increasing prevalence of childhood obesity is considered a public health issue in both developed and developing countries. The state of chronic low-grade inflammation associated with obesity contributes to the development of insulin resistance. However, the molecular mechanisms that link obesity to inflammation are not fully understood. Follistatin-like 1 (FSTL1) is a proinflammatory cytokine that is expressed in adipose tissue and secreted by preadipocytes/adipocytes. The aim of this study is to evaluate serum level of FSTL1 in overweight/obese children as compared to normal healthy subjects, and correlate serum FSTL1 level with inflammation and insulin resistance. Our work showed that overweight and obese children had significantly higher levels of serum FSTL1, high sensitivity C-reactive protein (hs-CRP) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). In conclusion, serum FSTL1 can be a useful biomarker for obesity in children. Moreover, FSTL1, being a pro inflammatory cytokine, may provide a possible link between obesity, inflammation, and the development of insulin resistance in the overweight/obese children.
Effect of Right Ventricular Pressure versus Volume Overload on Right Ventricular Arterial Coupling Ratio: A 3-Dimensional Echocardiographic Study
Authors: Kamal Mohamed S , Amin Youssef , Roushdy Alaa , El fiky Azza 
Published: July 2024

Abstract

Background
In congenital heart disease, the RV has been the forgotten chamber for many decades. Congenital ASD leads to volume overload on the RV while PH leads to pressure overload. The 3D ECHO has become noninvasive and readily available method for assessment of the RV-PA coupling ratio by dividing the RV SV/ RV ESV which correlates with the RV function. The aim of our study was to compare that ratio between ASD (RV volume overloaded) patients and PH (RV pressure overloaded) patients .

Methods
The study included 90 patients divided into 3 equal subgroups; congenital ASD group, PH group and control group. ECG-gated 2D and 3D ECHO study was done to the whole subjects.

Results
Showed that ASD and PH groups showed statically significant difference as regarding RV volumes and RV-PA coupling ratio in relation to the control group. However, the PH group was affected more than the ASD group as regarding the RV- PA coupling ratio with mean coupling of ASD group was 1.14, 0.77 in PH group and 1.25 in controls with P value between ASD and control groups was 0.054 Vs &lt; 0.0001 between PH and control groups.

Conclusion
In the current study the RV-PA coupling ratio as measured by 3D ECHO by dividing SV /ESV was markedly reduced (uncoupling) in patient with pressures overload (PH group) and to lesser extent in volume overload (ASD group) compared to the control group.
Efficacy and safety of colchicine use on LV systolic function using speckle – tracking Echocardiography in patients with anterior ST segment elevation myocardial infarction (STEMI) Undergoing Primary Percutaneous Coronary Intervention
Authors: Radwan Mohamed , EL Etriby Shehab , Khorshid Hazem , abdelrahman Ahmed 
Published: July 2024

Abstract

Background
acute ischemia causes myocardial necrosis with subsequent endogenous inflammation, leading to myocardial damage, ventricular dilatation, dysfunction, cardiac remodeling and dysfunction. Colchicine is a substance with potent anti- inflammatory properties, which allows for safe use in patients with cardiovascular disease, STE-based GLS can be used to assess global and regional LV function. The aim of this work is to study the efficacy and safety of colchicine administration on LV systolic function in patients with STEMI underwent primary PCI by using 2D speckle tracking Echocardiography.

Methods
The study included 200 STEMI patients divided into 2 equal subgroups; colchicine group, and control group. speckle tracking echocardiography was done to the whole subjects to asses LV systolic function.

Results
Assessment of LV systolic function (EF%) as calculated by Simpson’s method showed higher significant improvement in colchicine group (P-value = 0.011) and highly statically significant average GLS by speckle tracking echocardiography during follow up after 6 months, also colchicine was non inferior to placebo regarding acute and chronic complication.

Conclusion
the safety and efficacy of colchicine in anterior STEMI patients underwent PPCI. It significantly improve LV systolic function measured by Ejection fraction and average GLS speckle tracking Echocardiography after 6 months follow up.
Short-term outcomes of complete coronary revascularization compared to staged revascularization during primary percutaneous coronary intervention in patients with multivessel coronary artery disease: Presenting with ST segment elevation myocardial infarction
Authors: Alnashar Islam Alsayed , Almissiri Ahmed Mohamed , Guindy Ramez Raouf , Zahran Mohamed 
Published: July 2024

Abstract

Background
Complete revascularization has been recently popularized for management of ST-Segment–Elevation Myocardial Infarction (STEMI) patients with multivessel disease scheduled for Primary Percutaneous Coronary Intervention (PPCI). We assessed the three months outcomes of Compete Revascularization (CR) compared to staged revascularization in patients with multivessel disease undergoing PPCI.

Materials and methods
We conducted a randomized, open-label, comparative trial on STEMI patients with multivessel disease indicated for PPCI in the setting of STEMI. Patients were randomly assigned to undergo PCI revascularization of the non-culprit lesions during the index procedure, Complete Revascularization (CR) or within 30 days later after discharge, Staged Revascularization (SR). The primary endpoint was the composite of all-cause mortality, re-infarction, Heart Failure (HF), recurrence of angina symptoms, cerebrovascular stroke, and need for revascularization.

Results
A total of 100 patients were randomized in 1:1 ratio. The primary end point occurred in 24% of the patients in CR and 20% in SR group (p = 0.62). The incidence of HF (14% vs. 12%; p = 0.76), repeated revascularization (4% in each group), persistent angina (8% vs. 2%, p = 0.16), all-cause mortality (2% in each group), MI (4% in each group), stent thrombosis (0% vs. 4%; p = 0.15), and cerebrovascular accident (0% vs. 2%; p = 0.32).

Conclusion
Staged revascularization provided comparable short-term benefits to complete revascularization in STEMI patients with multivessel disease undergoing PPCI. The present trial demonstrated that complete revascularization was associated with a trend towards higher incidence of stent thrombosis and CVA than staged revascularization.
Key words: ST-segment&#x96;elevation myocardial infarction, Primary percutaneous coronary intervention, Revascularization, Multivessel disease.
Abbreviations: CAD: Coronary Artery Disease; FFR: Fractional Flow Reserve; PCI: Percutaneous Coronary Intervention; PPCI: Primary Percutaneous Coronary Intervention; STEMI: ST-segment–Elevation Myocardial Infarction; CVA: Cerebrovascular Accidents.
Prognostic Value of QRS Complex Fragmentation in Patients with Acute Anterior STEMI undergoing Primary PCI During in-Hospital Stay
Authors: Elgaly Mahmoud Gamal , Farouk Mohamed Moustafa , Abdeltawab Adham Ahmed 
Published: July 2024

Abstract

Background
Primary percutaneous coronary intervention (PCI) as a type of coronary reperfusion therapy may lead to recanalization and improved myocardial reperfusion in patients with ST elevation myocardial infarction (STEMI).

Aim of the Work
The aim of our study is sought to investigate the prevelance of fQRS complex in ECG of patients admitted with acute anterior STEMI undergoing primary PCI and its short-term prognostic value during hospital stay.

Patient and Methods
In the current study, 156 consecutive patients with anterior STEMI being treated with primary PCI between July 2021 and March 2022 were enrolled. Patients were included in the study if they presented with symptoms that were identified typically as typical chest pain lasting for more than 20 min; had ST-segment elevation ≥1 mm in two contiguous electrocardiographic and had undergone primary PCI including balloon angioplasty, thrombus aspira tion and/or stent implantation.

Results
Our results study showed that, in patients with a diagnosis of anterior STEMI, the presence of fQRS at admission ECG is associated with the development of MACE at short-term follow-up and higher mortality. In addition, fQRS was the strongest predictor of MACE in patients with acute MI after adjustment for the risk factors of ischemic heart disease.

Conclusion
Prevalence of fQRS complex on admission ECG in patients with acute anterior STEMI undergoing primary PCI is common. Presence of fQRS in these patients has independently predicted prognosis regarding LVEF values, Cath lab events, MACE and mortality during hospital stay. Therefore, fQRS can be incorporated in risk stratification tools and help in management of patients with acute anterior STEMI undergoing primary PCI.
COVID 19 Radiological Severity and Its Correlation with Complete Blood Picture Indices
Authors: Mohamed Sahar Mamdouh , Abd Eldaym Aya Mohamed , Ezzelregal Hieba Gamal , Eldiasty Shaimaa Elmetwally 
Published: July 2024

Abstract

Background
The International Committee on Taxonomy of Viruses (ICTV) named this novel coronavirus as SARS-CoV-2. This infection is still spreading but now less than before, and this virus poses a serious threat to public health, though joint prevention and quarantine mechanisms in almost all provinces of mainland China have been confirmed to be enacted. Due to a lack of specific antiviral treatments and pressure of clinical treatment, thousands of severe cases have died every day worldwide. Our university isolation hospitals as a part from the Egyptian isolation hospitals were in the first line in facing this epidemic.

Objectives
This work was to investigate the radiological severity in COVID 19 patients and its correlation with complete blood picture indices among a sample of Egyptians.

Patients and method
This was an observational, analytical & prospective study, recruited 30 cases of COVID 19 patients admitted to Ain Shams University isolation Hospitals. All patients were confirmed to be COVID 19 positive by PCR. Through history taking and clinical examination was done. On admission CBC and CT chest were documented analyzed and correlated.

Result
30 COVID 19 patients were recruited with 60% of them were mals, 66% have no comorbidities. Their ages were 54.833± 13.097 ranging from 25 to 85 years old, their most distressing symptom was dyspnoea (53%). Their radiological probability of CT chest were CORADS 5, CORADS 4 and CORADS 3 representing (63.33%, 23%.33, 13.33%) respectively. Almost more than 4/5 (83.33%) of them were admitted in the ward. All patients admitted in the ICU died (16.67%). A highly significant decrease in absolute lymphocytic count with the increase in the degree of probability of CT chest (CORADS degree) with (P value less than 0.001). Also a significant decrease in absolute monocytic count with the increase in the degree of probability of CT chest (P value 0.015). No other CBC indices were found to be have any significant correlation with CT chest severity or probability scoring. A cutoff value of 1.16 thousand /ml or less for lymphocytes and 0.4 thousand /ml or less for monocytes can predict CT chest to be CORADS 5.

Conclusion
A strong association with lymohocytic and monocytic count of the complete blood picture of COVID 19 patients with the radiological probability of CT chest.
Immunohistochemical Assessment of Phosphodiesterase 4A and Phosphodiesterase 4D in Relation to Serum Levels of Phosphodiesterase 4 in Patients with Chronic Plaque Psoriasis
Authors: Abou El-Fadl Dalia Abd El-Gawad , El-Sayed Mahira Hamdy , Abdel-fattah Nermeen Samy , Nada Ola Hassan 
Published: July 2024

Abstract
Psoriasis is an immune-mediated genetic skin disease. The underlying pathomechanisms involve complex interaction between the innate and adaptive immune system. T-cells interact with dendritic cells, macrophages, and keratinocytes, which can be mediated by their secreted cytokines. Dysregulation of the immune response is thought to result in a chronic imbalance in the production of pro-inflammatory and anti-inflammatory cytokines.
Phosphodiesterase (PDE4) act as proinflammatory enzymes via degradation of cAMP, whereas PDE4 inhibitors play an anti-inflammatory role in vitro and in vivo. In particular, topical and systemic PDE4 inhibitor has been approved for the treatment of psoriasis and psoriatic arthritis. However, little is known on the expression pattern of PDE4 in psoriasis. We report that serum PDE4 are overexpressed in blood of patients with chronic plaque psoriasis, as compared with normal controls. PDE4 expression is up-regulated in psoriatic dermis as compared with normal skin, with particular regard to dermal lymphocytes. Taken together, these results indicate that PDE4 play an important role in psoriasis pathogenesis and supports promises put on topical PDE4 inhibitors in treatment of psoriasis.
Comparative Study between Endoscopic Surgical Excision of Anterior Glottic Web with or without Keel Placement
Authors: Hasan Mohamed Amir , Elaty El Sersy Hesham Abd , Saad Alansary Mohamed Adel , Abd Elaty Ahmed Mohamed Kamel 
Published: July 2024

Abstract

Background
A focal narrowing of the airway caused by fibrotic tissue at the level of the true vocal folds is known as anterior glottic web. Congenital anterior glottic webs are less common than acquired anterior glottic webs. Endotracheal intubation, laryngeal trauma or surgery close to the anterior commissure, radiotherapy, and, in rare cases, inflammatory processes can cause them at any age.

Objective
To decide the need for endoscopic keel placement for management of anterior glottic web, prevention of vocal cord adhesions and to reduce the recurrence.

Patients and Methods
This study was systematic review and meta-analysis study included research articles with the following criteria; retrospective, prospective, case series, case report studies, published in English language, in the last 25 years, only studies on humans, studies on congenital and acquired anterior glottic web, studies with endoscopic keel placement, and studies without keel placement.

Results
The main findings of the current study was that; among keel used studies, the recurrence proportion was 13.5% with 95% Confidence interval (5.5%-24.2%), the proportion of granulation from pooled studies was found in 3.44% with 95% Confidence interval (1.16%-7.5%)and regarding voice improvement in this meta-analysis high significant improvement (94.2%) with 95% Confidence interval (85.8%-99%) was reported; Recurrence among the 3 studies did not use keel was 30.6% with 95% Confidence interval (7%-61. 8%). However, the voice improvement was reported among 97.4% with 95% Confidence interval (91.5 %-99.9%)

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2019.

Conclusion
The optimal treatment of acquired anterior glottic web remains controversial; Placement of a keel has low recurrent rate and good voice improvement but had several disadvantages such as the need for two separate operations under general anaesthesia, prolonged recovery, and the risk of infection and granuloma formation. However other techniques as the mucosal flap technique had better voice improvement without granulation formation with high success rates.
Serum Vitamin-D and Benign Paroxysmal Positional Vertigo (BPPV)
Authors: Elsayed Ahmed Rafat A , Taha Hesham M , Elserafi Gamal M , Elkabarity Rasha H 
Published: July 2024

Abstract

Background
Vitamin D deficiency can occur when usual intake is lower than recommended levels over time, exposure to sunlight is limited, the kidneys cannot convert 25(OH)D to its active form, or absorption of vitamin D from the digestive tract is inadequate. Decreases vitamin D levels show complex relationships with diseases, which can affect the inner ear. The aim of study: To examine the level of serum 25-OH vitamin D concentrations on patients diagnosed with BPPV.

Patients and Methods
This study included 60 subjects; 40 subjects with BPPV (study group) and 20 healthy persons (control group). Both groups underwent full history taking, vitamin D level assay, otological examination and audio-vestibular evaluation.

Results
Subjects with BPPV (study group) have lower vitamin D levels than norms (control group). The recurrence of BPPV occurs in subjects have lowest vitamin D levels. Vitamin D deficiency more in elderly & females. Hearing may be affected.

Conclusion
This study supports the relationship of lower vitamin D level with the occurrence of BPPV. Also, recurrent BPPV episodes are associated with a low level of vitamin D.
Assessment of Anti-Reflux Suture in One Anastomosis Gastric Bypass for Prevention of Biliary Gastritis
Authors: Abdelhamed Waleed Ebrahim , Abdelaziz Bassem Helmy , Rayan Mahmoud Talaat , Khayrat Moustafa Hassan Ahmed 
Published: July 2024

Abstract

Background
Obesity continues to be a leading public health concern associated with many comorbidities and major hindering effect on the daily lifestyle of many people around the world. Surgical treatment for obesity has proved that it is the best and most effective, durable means of preventing the life-threatening complications and serious problems associated with morbid obesity.

Objective
Assessing the effect of the anti-reflux suture on the incidence and clinical consequences of bile reflux in OAGB Procedure.

Patients and Methods
In this prospective randomized study, 30 patients were selected in Ain Shams University hospitals between November 2021 and May 2022 for assessment of impact of Anti reflux suture on the incidence of post OAGB biliary gastritis.

Results
The cases presented in this study did not undergo upper GI endoscopy when they presented with symptoms of reflux or gastritis and thus it was not possible to differentiate between the presence of GERD or biliary gastritis as the source of their symptoms.

Conclusion
OAGB is safe and one of the leading procedures for treatment of obesity but it is still surrounded by controversy regarding its relation and effect on bile reflux gastritis. As far as this study shows, the anti-reflux suture modification alone does not seem to prevent the incidence of biliary reflux gastritis post OAGB.
Comparative Study between Matrix Rotation Technique versus Wide Local Excision of Carcinoma of the Breast Located in the Upper / Upper Outer Quadrant
Authors: Khalaf Abotaleb Mohamed Ahmed Mohamed , El Din Osman Ahmed Gamal , El Tayeb Al Azazi Mohamed Atef Mohamed , Galal Ahmed Mahmoud 
Published: July 2024

Abstract

Background
The breast is a cornerstone image of femininity, and the heart of womanhood, as nourisher and comforter. These roles evoke the idea of the importance and the affection of this delicate organ has in the minds of women. Breast, according to national cancer institute, is the chief site of cancer in women in Egypt, representing ∼38.8% of total malignancies among Egyptian women; it is a crucial cause of mortality among women.

Aim of the Work
The aim of this work is to assess and evaluate wide local excision technique as an oncoplastic procedure for management of breast carcinoma in the upper/upper lateral quadrant with matrix rotation technique regarding cosmetic, surgical outcomes, and patient satisfaction.

Patients and Methods
This prospective randomized controlled study included 30 patients separated into two groupings cancer breast scheduled for oncology breast surgery divided to two equal group: Group I: wide local excision technique. Group II: matrix rotation technique.

Conclusion
Wide local excision is a safe oncoplastic technique, causing significantly less post- operative hematoma, mild seroma, minimal blood loss, less areolar deviation and better breast symmetry than matrix rotation technique.
Assessment of Wide Local Excision in Patients with Multifocal Breast Cancer using Wire Clip Bracketing
Authors: ElHiani Eslam Ibrahim , Rady Mohammed Ahmed , Eldin Osman Ahmed Gamal , Soliman Ahmed Hassan , Elsaid Kamal M , El-Bahnasy Mohammed Ahmed 
Published: July 2024

Abstract

Background
Breast-conserving surgery, also known as BCS, is both oncologically and surgically safe and has a long term survival rate in comparison to modified radical mastectomy. BCS can be performed with a simple wide excision or with variant levels of oncoplastic surgical techniques. There are many factors that can affect aesthetic outcomes, these factors are either both patient-related or surgeon-related, however the volume of breast tissue that needs to be excised is the most important factor.

Aim
To assess the feasibility and the safety of wide local excision in patient that have multifocal breast cancer using wire clip bracketing.

Patients and Methods
The Population was female patients with multifocal breast cancer at Breast unit general surgery department, Ain shams university.

Results
The mean size of tumors were 2.2 ± 1.1 mm according to mastographic characteristics, There were 55.0% with Non-palpable masses, 45.0 % with Palpable. 40% Positive LNs, we had 100% free resection margins with least resection margin being 0.8 cm as we confirmed all margins intraoperative with frozen section, 13 patients (65%) got excellent degree of satisfaction with the post-operative cosmetic outcome of our surgical procedure, 4 patients (20%) got good degree and 3 patient (15%) got fair degree of satisfaction.

Conclusion
Wide local Excision using the wire bracketing technique leads to more optimal resection volumes for multifocal breast cancer without compromising margin status with good aesthetic outcomes.