bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Cyclosporine Dynamics and Other Immunosuppressants in Patients Post Allogenic Stem Cell Transplantation
Authors: wahed Hassan Essam Abdel , Shams El-din Gihan Mohamed Kamal , Mohamed Said Rasha Magdy , Abdelfattah Sally Mohamed 
Published: July 2024

Abstract

Background
Bone marrow transplant has been successfully to treat diseases such as leukemia, lymphomas, aplastic anemia, immune deficiency disorders, and some solid tumor cancers. There is two types of bone marrow transplantation, one of two types of transplant may be carried out either an autograft, using the patient’s own bone marrow cells or an allograft (or allogeneic transplant), which allows the replacement of the diseased bone marrow with an healthy bone marrow taken from a compatible donor (related or unrelated) and to use the immune system of the healthy donor to fight the recipient’s illness.

Aim of the Work
To assess impact of cyclosporine introduction post-transplant on different organs and other immune suppressant as regards side effects and prophylactic efficacy against GVHD and good outcome of the transplantation.

Patients and Methods
The study enrolled two groups, 128 post-transplant patient their ages between 16 and 65, group 1 include 106 patients was taking cyclosporine for prophylaxis of GVHD, group 2 include 22 patients was taking other immunosuppressants mainly Tacrolimus and MMF.

Results
Incidence of GVHD occurrence was lower in group of cyclosporine as 30.2 % of them has no GVHD with statistically significant difference with P-value 0.007 and was lower in combined occurrence of acute and chronic GVHD,22.6 % in group 1 and 54.5 % of group 2 with P-value 0.006 Incidence of mild anemia was lower in group 1 with statistically significant difference with P-value 0.022 Hyponatremia was higher in group 1 (60.4 %) with statistically significant difference with P-value 0.026 AST levels elevated one fold higher in group 1 with statistically significant difference with P-value 0.009 and elevated three fold higher in group 2 with statistically significant difference with P-value &lt; 0.001 ALT levels elevated one fold higher in group 1 with statistically significant difference with P-value 0.039 21 patients were presented with impairment of renal functions,12.5% with mild impairment, 3.9 % with moderate impairment, all of them from group 1 with statistically significant difference with P-value 0.023, more commonly in females and in age group from 16 to 45 years old.

Conclusion
Hematopoietic stem cell transplantation (HSCT) is a particularly important treatment for hematologic malignant and nonmalignant diseases. Unfortunately, following allogeneic HSCT, graft-versus-host disease, immunosuppression and susceptibility to opportunistic infections remain among the most substantial problems restricting the efficacy and use of this procedure. Cyclosporine remains the most effective prophylaxis post HSCT for prevention of GVHD, more multi centric studies are needed on wide scale to prove more relevant results that will be significant.
Assessment of Sensitivity of Fib-4, Lok Score and Platelet Count / Spleen Diameter Ratio as Non-Invasive Indicator of Esophageal Varices in Egyptian Patients with Chronic Hepatitis C virus (HCV) Infection
Authors: Nashaat Ehab Hassan , El Nakeeb Noha A , Abdel Rahman Shereen Abou Bakr , Mohamed Ibraheem Khaled Farouk 
Published: July 2024

Abstract

Background
The development of esophageal varices is one of the major complications of portal hypertension, which is considered a main complication of liver cirrhosis.Variceal bleeding occurs in 20–40% of cirrhotic patients with esophageal varices and The use of endoscopic prophylactic band ligation and non-selective beta blockers can decrease the risk of esophageal bleeding by 50%, so the current guidelines recommend screening all liver cirrhosis patients by endoscopy.

Aim of the Work
Assessment of sensitivity of fib-4, lok score and platelet count / spleen diameter ratio as non-invasive indicator of oesphageal varices in egyptian patients with chronic hepatitis c virus (hcv) infection.

Patients and Methods
This study will include 100 egyptian patients selected from internal medicine and hepatology outpatient clinics and inpatient wards at matria teaching hospital.

Results
Plt count/spleen diameter ratio, plt count and spleen diameter demonstrated a high statistically significant correlation with the presence and grade of esophageal varices. as according to sensitivity and specificity test the most accurate screening test for diagnosis of esophageal varicose is PLT/SD ratio as AUC (87.4%), also it is a good negative test as specificity (86.7%) with cutoff value (1026.7), but for suspect a case most sensitive test is PLT count as sensitivity (93.3%) with cutoff value (120.5). these tests followed by spleen diameter with accuracy (78.2%), and the least test is right lobe/ albumin ratio which cannot depend on it in diagnosis of esophageal varices as its accuracy is (52.2%),sensitivity 66.7% and specificity 48.3%.

Conclusion
The use of plt count/spleen diameter ratio, plt count and spleen diameter, especially the platelet count/spleen diameter ratio, can help physicians as noninvasive predictors of esophageal varices to restrict the use of endoscopic screening only to patients presenting a high probability of esophageal varices. This is especially useful in clinical settings where resources are limited and endoscopic facilities are not present in all areas.While rt liver lobe/albumin ratio can not be used as a non invasive predictor of esophageal varices.
Evaluation of Serum Kallistatin in Patients with Hepatocellular Carcinoma
Authors: Al Swaff Reham , Aly Hany , Samir Ahmed , Assy Norhan Akram 
Published: July 2024

Abstract

Background
Liver cirrhosis is the most frequent long-term consequence of all chronic liver diseases. Cirrhosis is often asymptomatic and unsuspected until complications. The annual incidence rates of liver cirrhosis and hepatocellular carcinoma is related with chronic hepatitis B or C all over the world. The majority of patients with liver cirrhosis or hepatocellular carcinoma die from complications, which happened relatively early in the course of the disease. Thus, the early diagnosis of liver diseases is the only solution for this great problem.

Aim of the Work
In the current study we aimed to evaluate serum kallistatin in Egyptian patients with hepatitis C virus related liver cirrhosis and hepatocellular carcinoma.

Patients and Methods
This case control study enrolled 90 Egyptian subjects aged ≥ 18 years old at Ain shams university hospitals, participants were classified into 3 groups as follow: Group 1: 30 patients with hepatocellular carcinoma (patients have been diagnosed with triphasic CT). Group 2: 30 patients with hepatitis C virus related liver cirrhosis (patients diagnosed according to clinical, laboratory and radiological findings. Group 3: 30 healthy subjects serving as a control group.

Results
This study found that patients with liver cirrhosis and HCC have lower levels of serum Kallistatin compared to a control group. In the HCC group, patients with more severe liver disease (Child class C) had lower Kallistatin levels than those with less severe disease (Child class A and B). Kallistatin was negatively correlated with certain markers of liver disease and inflammation in both groups, and positively correlated with hemoglobin and albumin. The study also tested the diagnostic accuracy of Kallistatin for detecting liver cirrhosis and HCC, and found that it had 66.5% accuracy for cirrhosis and 98% accuracy for HCC at specific cutoff points.

Conclusion
Serum Kallistatin has a potential rule as a new biomarker for the diagnosis and evaluation of liver cirrhosis and HCC. The present study was limited by the small sample size. Also, all participants were from the Egyptian population with liver disease induced by HCV- infection with no information if our findings would be valid for other population with different etiologies. Thus, further investigation should be carried out in order to validate these findings
Serum Ferritin and Cellular Reactive Protein (CRP) in Non Alcoholic Fatty liver Disease (NAFLD) and Non Alcoholic Steatohepatitis (NASH) Patients
Authors: Salem Amira Ahmed , Abdelmageed Khaled Hamdy , Badawy Mohamed Nabil , Mohammed Dabiesh Mai Aboelkheir Awad 
Published: July 2024

Abstract

Background
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and it comprises a spectrum of hepatic abnormalities from simple hepatic steatosis to steatohepatitis, fibrosis, cirrhosis, and liver cancer. Simple steatosis (i.e., NAFL) rarely progresses to advanced disease whereas, in approximately 20% of patients with NASH, it progresses to fibrosis and cirrhosis and potentially to hepatocellular carcinoma over a 15-year time period.

Aim of the Work
To study the relation between serum ferritin and CRP levels and severity of non- alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH.

Patients and Methods
This case control study was conducted on patients attending the Hepatology Outpatient Clinic at Ain Shams University Hospital between December 2019 to May 2020.

Results
In group A there is significant correlation between ferritin and age, ALT, AST, albumin, CRP, LDL, BMI, cholesterol, triglycerides and NAFLD fibrosis score. But there is no significant correlation between ferritin and Hb, platelets, HDL and fasting blood sugar FBS in group A. In group B there is significant correlation between ferritin and ALT. Ferritin has cutoff point of &gt; 168 with 80% sensitivy & 80% specificity. In group A there is significant correlation between CRP and age, BMI, ALT,AST, albumin, LDL, cholesterole, triglycerides and NAFLD fibrosis score. In group A there is no significant correlation between CRP and Hb, platelets, FBS and HDL. While in group B there is significant correlation between CRP and BMI, ALT, albumin, LDL, cholesterole and triglycerides. CRP cutoff point of &gt; 1.3 with specificity 90% but sensitivity 35%.

Conclusion
In conclusion, in this study we tried to find a relation between serum ferritin and CRP levels and severity of non-alcoholic fatty liver disease NAFLD and non-alcoholic steatohepatitis NASH. We found that s. ferritin and CRP are significantly elevated in NAFLD and more elevated in NASH with a link between serum ferritin and insulin resistance and the whole metabolic syndrome. Serum ferritin and CRP are related to disease progression with significant correlation with NAFLD fibrosis score.
Evaluation of the Current Status of Home Hemodialysis in the Middle East Then Perspectives and Possibilities of Home Hemodialysis in Egypt
Authors: Saeed Al-Sharqawy Magdi Mohammed , Sarhan Iman Ibrahim , Abdel-Gawad Abdullah Mostafa Abdel-Naseer , Abdel-Magid Omara Ahmed Abdel-Monem , Ahmed Abou-zaid Khalid Aly , Ibrahim Omar Ibrahim Al-Sayed 
Published: July 2024

Abstract

Background
Chronic kidney disease (CKD) is a growing worldwide epidemic. The incidence and prevalence of end-stage renal disease (ESRD) are expected to continue to increase. The most recent United States Renal Data System (USRDS) reports indicate that the incident dialysis population has grown older, has more comorbid conditions than previous years, and is starting dialysis with higher levels of residual kidney function (RKF).

Aim of the Work
This study was done to evaluate the current status of home hemodialysis in the Middle East, then to study the perspectives and future possibilities of home hemodialysis in Egypt. It was carried out during the last 2 years; 2019 and 2020. It included 2 parts:

Patients and Methods
A retrospective and prospective study on 100 patients that was randomly selection and was adult ESRD patients (age &gt; 18 years) either were treated and maintained on home hemodialysis during the last 5 years or will be treated and maintained on home hemodialysis during the period from march 2019 to march 2020.

Results
HD patients with volume overload or those with cardio-renal syndrome were found to better tolerate excessive UF with the use of home HD machines than that with the usual in-center machines. SLED and SCUF modes were very effectively managed with the use of these simple HD machines. It was noticed that the loss of residual renal functions in new HD patients, was significantly less with the use of home HD than with the usual in-center HD. This was related to less dialysate exposure other than the use of ultrapure dialysate.

Conclusion
The psychological status was significantly improved in those patients with having their sessions at their homes without any added stressors related to in-center HD. Even new ESRD patients who are too reluctant to start HD, were better convinced to start home HD. Home HD is a gentle and benign mode of HD with less reported intra-dialytic complications; attributed to the use of ultrapure dialysate solutions other than the treated tap/well water used in center HD.
Study of the Relationship between Insulin Resistance, Iron Status Markers and Body Weight in a Sample of Egyptian Population
Authors: Hussein Magda Shoukry , Bahaa El Din Ahmed Mohamed , Mohamed Amr Mahmoud , Hashem Shaimaa Shaaban 
Published: July 2024

Abstract

Background
Diabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Aim of the Work
The aim of this study is to investigate the relationship between insulin Resistance, iron Status Markers and body Weight in a sample of Egyptian population.

Patients and Methods
Our study was case control study conducted on 90 subjects their age was ranging form18 to 70 from diabetes outpatient clinic, and they were divided into 3 groups: Group (1): Non-obese non-diabetic as a control group, Group (2): Obese non diabetic and group (3): Obese diabetic.

Results
In our study, there was no statistical significant difference found between the three studied groups regarding iron study, Also our study showed that there was statistically non significant correlation between (ferritin level and TIBC), and (ferritin level, HOMA IR), but there was statistical significant positive correlation found between TIBC and FBS (p- value 0.045),Similarly, we did not observe either abnormally high or low ferritin values in our study on subjects with obesity. We found no association between this marker and body weight, in contrast with others. In our study, the higher insulin and HOMA-IR values observed in the subjects with TSAT&lt;20% = 4.2(1.4-11.6) than those with TSAT &gt;20% =2.4 (1.15-6.95), but statistically non significant p- value. The present study also showed that There was statistical significant positive correlation between (T.SAT, serum ferritin), (T.SAT, S.iron) and (T.SAT,SBP) (with p-value 0.03). Our study also showed that there was no statistical significant difference found between patients with T.sat ≤ 20% and those with T.sat &gt; 20% regarding all the studied parameters except ferritin level and iron level was found higher in patients with T.sat &gt;20% than those with T. sat ≤20% with p-value &lt;0.001 and &lt;0.001 respectively.

Conclusion
Characteristics of iron deficiency or iron overload were not observed in subjects with overweight/obesity and diabetic patients. Our results suggest a complex metabolic dysregulation.
The Role of Repetitive Transcranial Magnetic Stimulation in Reduction of Opioid Craving; A Single Blinded Randomized Sham Controlled Clinical Trial
Authors: Elrassas Hanan H , Morsy Mahmoud H , Abdelrazek Yasser M , El Rasheed Amany H , Saad Noha A , Azzam Lobna A 
Published: July 2024

Abstract

Background
Opioid use disorder (OUD) poses a great concern due to problems associated with their abuse as well as fatal and non fatal overdose consequences. Craving has a complex relationship with opioid use and relapse. Developing new, effective treatments for substance use disorders (SUDs), including opioid use disorders is crucial. This study aimed to assess the effect of 18 sessions of high frequency (HF) repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) on opioid craving in early abstinence using brief substance craving scale (BSCS) for Tramadol and morphine and Heroin craving questionnaire (HCQ) for Heroin craving.

Results
There was a statistically significant reduction in craving scores in the group of OUD patients receiving real rTMS compared to those receiving sham rTMS for both BSCS( p value = 0.044) and HCQ (p value = 0.002). A statistically significant positive correlation was revealed between the number of hospital admissions and the mean scores of post rTMS HCQ scores (r = 0.05, p value = 0.040).

Conclusion
High frequency 10 Hz rTMS over the left DLPFC for 18 treatment sessions reduced craving OUD patients during early abstinence. These preliminary results suggest that 10 Hz rTMS of the left DLPFC may be used in treatment of OUD; so our study recommends that use of rTMS in reduction of opioid craving in early abstinence.
Study of Inflammatory Markers in Patients with Uncontrolled Generalized Motor Tonic–Clonic Seizures
Authors: Lewis Andrawes Amir Hani , El Rakawy Mahmoud Hemeda , El Khayat Naglaa Mohamed , Abdelhamid Yousry Aboelnaga 
Published: July 2024

Abstract

Background
Epilepsy is a multifaceted chronic neurological disease characterized by recurrent spontaneous seizures. It affects almost 70 million patients around the globe, making it one of the most common chronic causes of neurological morbidities.

Aim of the Work
detect an association between some inflammatory markers {C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), and Platelet-lymphocyte ratio (PLR)}and epilepsy in order to detect a pathogenic relation that in turn can influence the course and management of epilepsy.

Patients and Methods
the current body of evidence recognizes the association between inflammation and epilepsy. Several inflammatory markers have been investigated in relation to different types of epilepsy. This study chose CRP as a convenient and widely used inflammatory marker, together with NLR and PLR, the two novel, readily available indices of inflammation that are yet to be fully investigated in relation to epilepsy. We included 50 patients with uncontrolled generalized motor tonic–clonic seizures. Ages ranged from 18 – 45 years and both genders were represented. Patients were compared with 50 controls of same age and gender. Strict inclusion and exclusion criteria were applied to all volunteers.

Results
In this study, levels of CRP, NLR and PLR in 50 patients with epilepsy were significantly higher than controls. These results add to the pool of evidence that support the association between epilepsy and inflammatory processes. This study managed to investigate the correlation between inflammatory markers and specific independent variables such as frequency of seizures, time interval between last seizure and presentation, number of status epilepticus per year, number of anti-epileptic medications, duration of postictal confusion, age of onset of seizures, duration of illness, and EEG findings, in addition to age and gender differences. This study found increased levels of CRP, NLR, and PLR in patients with high frequency seizures compared to those with intermittent seizures. Similar results were obtained with increased number of episodes of status epilepticus, number of anti-epileptic medications and shorter time interval between last reported seizure and sample withdrawal. Longer duration of postictal confusion was associated with high values of NLR and PLR.

Conclusion
systemic inflammatory response has been detected in patients with uncontrolled generalized motor tonic–clonic seizures, which confirms the association between inflammation and epilepsy. This association is specifically correlated to higher seizure frequency, shorter duration between last seizure and blood sample withdrawal, higher number of status epilepticus in the last 12 months, higher number of anti-epileptic medications, longer duration of post-ictal confusion and female gender.
Efficacy and Safety of Zonisamide as Adjunctive Therapy in Motor Symptoms of Advanced Parkinson's Disease (PD) in Egyptian Population
Authors: Mohamed Salim Mohamed Esam , Ibrahim El-Balkimy Mahmoud Haroun , Antonnini Angelo , Ali Shalash Ali Soliman , Abd El Dayem Eman Hamed , Mahmoud Abushady Eman Mones 
Published: July 2024

Abstract

Background
Management of motor complications -especially wearing off- in advanced PD is very challenging. Zonisamide (ZNS) is an antiepileptic drug that showed beneficial effects in motor symptoms of PD in previous studies.

Methods
To determine the efficacy and safety of ZNS in motor symptoms of advanced PD, we conducted a one month double blinded randomized placebo-controlled crossover study in Egypt. PD patients with Hoehn &amp; Yahr stage ≥ 2 (onstate) and at least 2 hours off time daily were randomized to one of three groups: ZNS 25mg, ZNS 50 mg and placebo. Primary outcome measure was change in off time based on part IV MDS-UPDRS (Movement disorders society-Unified Parkinson’s disease rating scale). Secondary outcome measures were: change in on time based on part IV MDS- UPDRS, change in total score MDS-UPDRS, score of part III MDS-UPDRS.

Results
Of 69 patients enrolled in the study and underwent randomization to the 3 groups, 49 patients completed one month follow-up. Only 26 patients underwent crossover and 20 patients completed one month follow-up. So, the total number of patients analyzed at 1 month was: 69 patients (25 patients ZNS 25 mg group, 18 patients ZNS 50 mg group and 26 patients placebo group). Both ZNS 25 and 50 mg groups showed significant improvement of total MDS-UPDRS score, Tremors ON score and part 4. Except for sedation, there was no significant adverse effects in both ZNS 25,50 mg groups as compared to placebo.

Conclusion
ZNS (25,50 mg) is safe and effective in improving motor symptoms of advanced PD as adjunctive therapy.
Management of Cerebellopontine Angle Tumors
Authors: Mohamed Adel N , Kabil Mohamed S , Hamada Salah M , Elsayed Ahmed M , Abdel Naby Ali Mohamed 
Published: July 2024

Abstract

Background
Cerebellopontine angle (CPA) tumors are the most common neoplasms in the posterior fossa. Most CPA tumors are benign, with 80-94% being vestibular schwannomas (acoustic neuromas), lipomas, vascular malformations, and hemangiomas. Treatment options include observation, radiosurgery, and microsurgery.

Aim and Objectives
Evaluation of the clinical presentation of various lesions in the Cerebellopontine Angle area and evaluate the different surgical approaches for management of these lesions.

Subjects and Methods
The study included cases of CPA tumors that were admitted and treated in the neurosurgical departments in Ain Shams University Hospital as well as Al Galaa Armed Forces Hospital and Al Maadi Armed ForcesHospital.

Result
Abnormal planter response were the most frequent neurological abnormality (72.0%). The most cranial nerve affected was the vestibulocochlear nerve (60.0%).

Conclusion
CPA tumors are challenging lesions to be treated surgically, which requires a high level of surgical experience. Retrosigmoid and middle fossa approaches accomplished significant outcome among patients with CPA tumors. Preoperative V-P shunt procedure improved noticeably the manifestations of increased intracranial tension.