bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound Guided Bilateral Erector Spinae Plane Block vs Intravenous Patient-Controlled Analgesia for Pain after Total Laparoscopic Hysterectomy
Authors: Reyad Mostafa Kamel , Ahmed El-Fawy Dalia Mahmoud , Kamel Walid Youssef , Abdelrazek Saeed Hazem Khaled 
Published: July 2024

Abstract

Background
Pain is an everyday challenge during all surgeries and it is a chief postoperative complication, so pain management is a corner stone in anesthetic practice. Total Laparoscopic Hysterectomy (TLH) is a minimally invasive procedure, it has certain advantages over an open abdominal hysterectomy, such as reduced pain, less incidences of wound infection, a rapid recovery, a shorter hospital stay and lower complication

Aim of the Work
The present study was designed to assess the analgesic efficacy and safety of ultrasound guided ESPB done at lower thoracic transverse process level in patients undergoing TLH for postoperative analgesia versus intravenous patient-controlled analgesia.

Patients and Methods
This study is as Prospective double blinded cohort study, it was performed on Patients undergoing elective Total laparoscopic hysterectomy (TLH) in the hospital of gynecology of Ain Shams university hospitals over a period of six months. Patients who fulfilled the inclusion criteria and agreed to participate in the study were randomly divided into two groups using computer-generated randomized list such that group A for ESPB and group B for PCA.

Results
The main finding in this study was that ultrasound guided ESPB at level of thoracic process provided a good analgesic effect in patients undergoing TLH also reduced the need for rescue analgesia and the total amount of postoperative opioid consumption in comparison to PCA group, Prolonged the time to first request of analgesia (duration of analgesia), Provided early mobilization, Increase patient satisfaction in 1st 24 hour and Decrease incidence of nausea and vomiting due to decrease opioids intake.

Conclusion
Ultrasound-guided erector spinae plane block was found statistically efficient in reducing postoperative opioid consumption, alleviating postoperative pain scores and improving patients’ satisfaction in the first 24 hours after TLH, without associated adverse effects or complications like nausea and vomiting, nerve injury, respiratory depression and hematoma formation.
Prognostic Value of Systemic Arterial Lactate Levels in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Authors: Abdelhasseeb Ahmed Hamdy , Ibrahim Moustafa Ibrahim , Abdelsalam Ahmed Mouhamed , Elsayed Amr Adel 
Published: July 2024

Abstract

Background
Acute myocardial infarction is the most severe manifestation of coronary artery disease, which causes more than 2.4 million deaths in the USA, more than 4 million deaths in Europe and northern Asia, and more than a third of deaths in developed nations annually.

Objective
To assess the prognostic value of systemic arterial lactate levels in patients with ST segment elevation myocardial infarction undergoing primary PCI and correlate with the results of primary PCI and 30 days MACE follow up.

Patients and Methods
This study included 300 patients who presented with documented STEMI and underwent reperfusion by successful primary PCI in Ain Shams University hospitals.

Results
There was statistically significant positive correlation found between serum lactate and (WBCs) count, (HbA1C) level and cardiac enzymes (CKtotal - CKmb – troponin) and negative correlation found between serum lactate and ejection fraction in echocardiography. Also, we found that other parameters were associated with MACE follow up in 30 days such as Killip class at admission, ST segment elevation resolution, heart block in ECG, lower ejection fraction, dyslipidemia, post-procedure TIMI flow, peri-procedural time intervals and occurrence of complications.

Conclusion
The value of an early lactate measurement in patients with STEMI is to be a part of the risk stratification of these patients and intensified medical care should be considered to patients with strongly elevated lactate levels. Also, increasing arterial lactate levels were associated with occurrence of MACE in 30 days, worse hemodynamics, lower ejection fraction in echocardiography, higher HbA1C level, large infarct area (cardiac biomarkers peak level), poor post-procedure TIMI flow and thrombus grade.
Carotid Intima-Media Thickness as a Cardiovascular Risk Factor in Patients with Chronic Kidney Disease
Authors: Naem Mariam , Karem Khalid , William Viola , Ghareeb Magdi 
Published: July 2024

Abstract

Background
Atherosclerosis is a systemic arterial disease which frequently involve multiple vascular beds. Etiologically, cases of atherosclerosis occurring in different arterial vascular beds may share the same set of traditional risk factors.

Aim of the Work
In this present study we aimed to- evaluate the effect of chronic kidney disease on carotid intima media thickness as a cardiovascular risk factor in these patients.

Patients and Methods
This is a Case-control study conducted at Ain shams university hospitals during the period between January 2022 and June 2022.

Results
We found that patients with chronic kidney disease had significantly higher values of carotid intima media thickness (mean value of 1.10± 0.16 mm) versus control group (mean value of 0.49± 0.15mm).Also we noticed that with progression of kidney disease carotid intima media thickness (CIMT) becomes higher.CIMT showed a trend of gradual increase with decreased eGFR.Also we found that CIMT correlated positively with age, blood pressure, serum reatinine, urea and total cholesterol, but negatively with eGFR and we found that patients with diabetes and hypertension had CIMT higher than patients without diabetes and hypertension.The ROC curve analysis showed that the AUC for using eGFR cut off value of ≤ 75 mL/min for predicting CIMT thickness (&gt;0.7 mm) was 1.And both the specificity and Sensitivity of eGFR in predicting CIMT thickening to be 100%.

Conclusion
Carotid IMT is significantly increased in Chronic kidney disease patients and may be usefully applied for risk stratification in this group of patients.Our study shows that, eGFR (≤ 75ml/min) has a positive predictive value for CIMT thickness(&gt;0.7mm) with specificity and sensitivity 100%.
Impact of DApagliflozin on Cardiac Functionnfollowing Anterior Myocardial Infarction in Non-diabetic Patients – DACAMI (a Randomized Controlled Clinical Trial)
Authors: Younis Omar , Attia Sameh , AbdelSalam Ahmed , Zarif Bassem , Dayem Khairy Abdul 
Published: July 2024

Abstract

Background
This study aims at identifying if there is a role for Sodium glucose co- transporter 2 inhibitors (SGLT2i) in the event of acute myocardial infarction. Patients who presented with anterior ST- elevation myocardial infarction (STEMI) & had undergone successful primary percutaneous coronary intervention for the left anterior descending coronary were randomized into a study group & a control group. The study group received dapagliflozin 10 mg once daily. The primary endpoint was cardiac function assessed by both; a biomarker (i.e.: N-terminal pro-Brain Natriuretic Peptide – NT-proBNP) measured at baseline & at 12 weeks post the cardiac event & echocardiographic parameters (left ventricular ejection fraction, left ventricular diastolic dimension & left ventricular mass index) assessed at baseline, 4-weeks & 12-weeks post the cardiac event.

Results
From October 2021 to April 2022, a final 100 patients were randomized. The median drop of NT- proBNP in the study group was significant compared to the control group (p-value 0.043). In addition, the decrease in the left ventricular mass index (LV mass index) was also significant in the study group compared to the control group.

Conclusions
Dapagliflozin seems to have a role in preventing left ventricular dysfunction & maintaining cardiac function following anterior ST-elevation myocardial infarction. More Large-scale trials need to be done to further confirm these findings.
This trial is registered retrospectively at the US National Institutes of Health (ClinicalTrial.gov) with identifier number: NCT05424315 – June 16th, 2022. (https://ClinicalTrials.gov/ct2/show/nct05424315)
Risk of Atrial Fibrillation Induced by Ivabradine in Correlation with Left Atrial Size
Authors: Ibrahim Mahmoud Mahmoud Ali , Sallam Walid Mohamed , Khorshid Hazem Mohamed , Tamara Ahmed Fathy 
Published: July 2024

Abstract

Background
Ivabradine (Procoralan, Servier) is a heart rate lowering drug which acts by specifically inhibiting the pacemaker If current, which causes spontaneous depolarization in the sino-atrial node that regulates the heart rate.

Objective
To correlate Left atrial size with development of AF in patients treated with ivabradine over a 12 week period.

Patients and Methods
Our study was conducted upon 180 patients referred to Ain Shams University Hospital and Misr University for Science and Technology hospital, from September 2020 to February 2021 to undergo treatment for HF or IHD with the appropriate medications with AF being the primary outcome of interest and how it correlates with Ivabradine therapy.

Results
Our results showed that there was no statistically significant difference between the two groups regarding the incidence of AF (p = 0.587). Likewise, there was no statistically significant difference between the two groups regarding duration till AF at 1st month, 2nd month and 3rd month (p &gt; 0.05). This could be explained by the lower number of patients included in the study as compared to other similar studies. When the entire patient population who developed AF was pooled regardless of their Ivabradine use, there was a statistically significant increase in AF incidence with larger left atrial volume indices.

Conclusion
In the present study, Ivabradine treatment was not associated with a higher incidence of AF in patients with heart failure and/or ischemic heart disease. Also, there was no significant difference in the duration until AF occurrence when it was evaluated at the end of the 1st, 2nd, and 3rd months. Higher LAVI was associated with a higher incidence of AF in the total studied patient population regardless of Ivabradine use.
Predictors of Contrast induced nephropathy following percutaneous coronary intervention in patients with chronic total occlusion
Authors: Elshafei Talal A , Hassanein Adel Gamal , El-Fekky Ehab M 
Published: July 2024

Abstract

Objectives
The aim is to predict the development of contrast induced nephropathy (CIN) and corresponding parameters in patients with chronic total occlusion (CTO) after per-cutaneous coronary intervention (PCI).

Background
Up to this moment few data was collected on the effect of different parameters and approaches on the development of contrast induced nephropathy in patients undergoing per- cutaneous coronary intervention to chronic total occlusion (CTO) lesion to coronary vessels.

Methods
Our study involved 75 patients with documented CTO lesions with planned revascularization over period of 6 months commencing in June 2021. Detailed baseline clinical, angiographic and baseline/follow up creatinine level outcomes were evaluated using data from Ainshams University affiliated hospitals.

Results
The incidence of CIN among population was 17.3% and 26.7% at 24h and 48h consecutively. Four different parameters showed a good diagnostic value in predicting CIN at 48hrs among patients with CTO who underwent planned elective interventional therapy PCI. The receiver-operating characteristic (ROC) curve analysis for prediction of CIN at 48 h showed that contrast volume (sensitivity, 85%; specificity, 67.0%; AUC, 0.812; 95% CI, 0.705–0.893; P &lt; 0.001); Procedure time (sensitivity, 100%; specificity, 60.0%; AUC, 0.835; 95% CI, 0.731–0.910; P &lt; 0.001); Δ Creatinine at 24 h (sensitivity, 90%; specificity, 76.0%; AUC, 0.918; 95% CI, 0.831–0.969; P &lt; 0.001); Δ% Creatinine at 24 h (sensitivity, 75%; specificity, 96%; AUC, 0.915; 95% CI, 0.827–0.967; P &lt; 0.001) have impact on the development of CIN. The results of multivariable binary logistic regression analysis for prediction of CIN at 48 h. showed that both contrast volume (odds ratio = 1.007, 95% CI = 1.001 to 1.013, p = .021) and Percentage change in creatinine at 24 h (odds ratio = 1.132, 95% CI = 1.053 to 1.218, p = .0008) are independent predictors of CIN at 48 h.

Conclusions
Contrast volume, Absolute rise/percentage change of serum in creatinine in 24 hrs and procedure time Can be used as a simple pre-procedural predictor of CIN among patients with CTO who undergoing interventional therapy PCI for revascularization.
Outcome of Pulmonary Complications after Hematopoietic stem cell transplantations
Authors: Abdelwahab Koraa Emad Elden , Madkour Ashraf Mokhtar , Mohammad Rehab Maher , El Razzaz Mostafa Kamal , Abbas Mohamed Samer , Abdelrahman Abdelrazik Marwa Ibrahim 
Published: July 2024

Abstract

Background
Pulmonary complications (PCs) are common and often lethal in hematopoietic stem cell transplantation (HSCT) recipients.

Aim of Work
to evaluate incidence, types, diagnostic procedures used, risk factors, and outcome of PCs in cohort of HSCT recipients.

Patients and Methods
This study conducted prospectively on 80 HSCT recipients at Bone marrow transplantation unit, Ain-Shams University Hospitals during the period between January 2018 and March 2020.

Results
For patients suffering from a pulmonary complication, a diagnostic algorithm was performed. We identified 14 pulmonary complications in 80 patients: 12 (85.7%) were infections; 2 (14.28%) were non- infectious complications inform of engraftment syndrome and pulmonary embolism. 50% of infections were mixed, the most common bacterial pathogen was mycoplasma pneumonia, reported as isolated organism in 4 cases (28.57%) and mixed with other bacterial infections in 3 cases (21.42%), overall mortality was 21.43%.

Conclusion
17.5% of HSCT recipients develop PCs within 1 year of transplant. Most of the complications are infections.
Cell Free DNA in SLE Patients: A Possible Marker of Disease Activity and Organ Damage
Authors: Rafik Mona Mohamed , Amer Hanaa Ahmed , Zaitoun Yasser , El Shnnawy Dina , Lotfy Neama , El azizi Noran Osama , Youssef Mahmoud Amin 
Published: July 2024

Abstract

Background
Systemic lupus erythematous (SLE) is a prototypic autoimmune disease with a complex pathogenesis involving multiple genetic and environmental factors. Cell death has been regarded as an important event in lupus pathogenesis as it leads to release of antigens as nucleic acids for immune complex formation. DNA-antibody complex in the circulation are one of the hallmarks of SLE that leads to detrimental effects causing manifestations of SLE. Fluctuation in circulating DNA level might be one of the driving factors behind flare-ups of SLE.

Objectives
This study aims to measure the circulating cell free DNA (cf-DNA) in patients with SLE as a potential marker for disease activity and organ damage.

Methods
This case control study included 100 participants categorized into 75 SLE patients as patient group (Group I), further divided to 39 SLE patients without therapy (group Ia), 36 SLE patients with therapy (Group Ib) and 25 age and sex matched healthy subjects as a control group (Group II). All participants were subjected to full history taking, thorough rheumatological examination and lab assessment of complete blood count (CBC), ESR, CRP, C3, C4 levels, ANA titer, anti-ds-DNA concentration by ELIZA and measurement of plasma cf-DNA levels by real time PCR. Cf- DNA concentration is expressed as concentration (ng/ml).

Results
SLE patients (Group Ia and Ib) showed significant increase in (plasma cf-DNA,CRP, ESR, ANA, anti-ds-DNA), significant decrease in (C3 and C4, hemoglobin, total leucocytic count and platelet count). Plasma cf-DNA (ng/ml) was significantly lower in group Ib compared to group Ia. There was significant positive correlation between plasma cf-DNA (ng/ml) and levels of ANA and anti-ds-DNA in all SLE patients and with SLEDAI-2k score in all patients.

Conclusion
Plasma level of cf-DNA is significantly increased in SLE patients especially before starting therapy these data may suggest it to be a possible marker of treatment follow up. Further studies on a larger patient population are still needed to confirm these results.
Comparative Evaluation of Prostatic Smear and Semen Analysis in The Diagnosis of Chronic Prostatitis
Authors: Abdou Nada Ibrahim , El-Sayed Rasheed Ahmed Ibrahim , Abdallah Mahmoud Abdel-Rahim , Elhusseiny Rania Mahmoud 
Published: July 2024

Abstract

Background
Chronic prostatitis is one of the most common medical problems among andrology and urology patients. Besides being the primary problem in many cases, it seems to play an important contributing role “major or minor” in a significant proportion of patients whether at the level of fertility, sexology or venerology. Consequently, effective management of the prostatic pathology has a great impact on the overall successful management of such andrologic problem.

Aim of the Work
to provide an objective comparison between traditional prostatic discharge analysis and traditional semen analysis as regards detection of pus cells in cases of prostatitis as well as to assess the possible advantage(s) of applying some modifications to enhance the diagnostic value of the previous techniques. These would include preliminary centrifugation of expressed prostatic discharge and preliminary peroxidase staining of semen sample before microscopic examination.

Patients and Methods
This pilot study included 40 patients suffering from prostatitis except acute prostatitis. The patients were recruited from the outpatient clinic of Venerology and Andrology department of Ain Shams University Hospitals in the period from February 2021 to November 2021.

Results
The current study included 40 patients suffering from any kind of prostatitis except acute prostatitis. Their age ranged between 30 and 50 years old with a mean age of 39.60 ± 4.52 years. Duration of disease ranged from 4-18 months with a mean of 7 ± 3.1 months. Most of patients were married (38, 95%). Main symptoms presented among studied patients were groin pain (37.5%), groin pain and painful micturition (20%) and groin pain, painful micturition and sexual problems (42.5%)

Conclusion
prostatic smear examination revealed higher sensitivity in detection of infection compared to semen analysis especially if combined with centrifugation. In addition, peroxidase positive cell testing revealed a significant role in detection of infection if the diagnosis is made solely on semen analysis results.
Microneedling with Topical Insulin versus Microneedling with Topical Saline in Treatment of Striae Alba
Authors: Abdallah Marwa M A , Ibrahim Samah , Mohamed Aya Ragab 
Published: July 2024

Abstract

Background
Striae distensae, an extremely common condition, are a challenging cosmetic problem and pose a significant psychological burden for patients. Various treatment modalities have been applied with low satisfaction rate.

Objectives
To evaluate the clinical response, efficacy, safety and adverse effect of combined microneedling with topical insulin compared to microneedling alone in the treatment of striae alba.

Patients and Methods
This randomized prospective controlled comparative study included 20 patients suffering from stria albae on both sides of the abdomen. The diagnosis was made via clinical diagnosis of dermatological findings. All patients were consecutively selected from the dermatology outpatient clinic, Ain-Shams University Hospitals in the period from November 2021 till April 2022.

Results
The result The study showed that there was significant improvement in striea alba indentation index after treatment in both the insulin sides and placebo sides, the insulin sides being superior. In comparing both methods, there was no statistically significant difference between them as regards Erythema and hyperpigmentation. The current study showed nearly equal patient satisfaction scores in both groups.

Conclusion
Both microneedling alone and microneedling with topical insulin were effective and safe methods in treating patients with striae alba. Using topical insulin had better result than microneedling alone. Both methods are tolerated regarding Microneedling with insulin had no short term side effects.
Central Hepatectomy versus Major Hepatectomy for Patients with Centrally Located Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis
Authors: Abdelaal Amr Ahmed , Khalil Ahmed Abdelrazk , Fawzy Fawzy Salah , Youssef Gadallah Edward Atef 
Published: July 2024

Abstract

Background
Hepatocellular carcinoma (HCC) is the fifth-most common cancer globally and the third highest cause of cancer-related death exceeded only by cancers of the lung and stomach. It is estimated that 782,000 new cases are diagnosed with HCC annually and 600,000 die of this tumor globally each year. Therapeutic treatment modalities are available for patients with local disease including ablation, liver resection, and liver transplantation (LT). However, for those with respectable tumor and without an underlying liver disease, liver resection offers the best treatment.

Aim of the Work
The aim of this meta-analysis was to compare the short- and long- term outcomes including overall survival, recurrence rate and complications between patients treated with CH and patients treated with hemi-/extended hepatectomy for those with centrally located HCC.

Patients and Methods
A systematic review and meta-analysis, PubMed / MEDLINE, Scopes, Web of science, and the Cochrane Library were searched for data from inception to 1 April, 2022 with the following terms: major hepatectomy and Mesohepatectomy or central Hepatectomy and hepatocellular carcinoma. More searches by Google Scholar have been used to supplement the search with the sites mentioned above. according to the eligibility process. 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
Our meta-analysis showed that the overall incidence of complications was comparable between the two modalities. However, on one hand, the incidence of post-operative liver cell failure was significantly higher in those who underwent major hepatectomy. This could be attributed to the fact that major hepatectomy is associated with the removal of 60–85% of liver parenchyma.6,7 On the other hand, a higher incidence of biliary fistula was detected for those who underwent central hepatectomy.

Conclusion
This study showed no significant difference in the short and long term survival and recurrence between CH and MH for CL-HCC. However, CH is associated with greater future remnant liver volume that decrease the incidence of LCF and provides more opportunities for a repeat hepatectomy after tumor recurrence.