bluuebunny/crossref_metadata_2025_split huggingface dataset:
Erector Spinae Plane Block for Postoperative Analgesia after Video-Assisted Thoracoscopic Surgery (VATS)
Authors: Fawzi Hanna Marina Emad , Abdel Latif Samia Abdel Mohsen , Hussien Maamoon Rania Maher , Abdel-Mouty Taher Islam Abdel-Aal 
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. Ultrasound guided nerve block is considered a recent technique for pain management. It provides better visualization of the nerves and reduces the risk for complications.

Aim of the Work
The present study was designed to assess the analgesic efficacy of ultrasound guided Erector Spinae Plane Block done at the fifth thoracic transverse process level in patients undergoing VATS surgeries for postoperative analgesia.

Patients and Methods
This prospective randomized clinical study was conducted in Ain Shams University Hospitals. It included a total of 60 adult patients aged 21-60 years, Scheduled for VATS surgeries. Patients were randomly divided into two equal groups 30 patients each. The ESPB group (n = 30): received ESPB after induction of anaethesia, while the Control group (n = 30): received only fentanyl 1- 2 mcg/kg during induction of anesthesia and additional boluses of fentanyl.5 mcg/kg were given according to the patient’s vital data.

Results
The main finding in this study was that ultrasound guided ESPB provided a good analgesic effect in patients undergoing VATS surgery, it also reduced the need for rescue analgesia and the total amount of postoperative opioid consumption in comparison to controlled group, Prolonged the time to first request of analgesia, allowed early mobilization, Increase patient satisfaction in 1st 24 hour and Decrease incidence of nausea and vomiting.

Conclusion
Ultrasound-guided erector spinae plane block was found statistically significantly in reducing postoperative opioid consumption, alleviating postoperative pain scores and improving patients’ satisfaction in the first 24 hours after VATS surgeries, without associated adverse effects as postoperative nausea and vomiting, nerve injury, respiratory depression and hematoma formation.
A Comparative Study between Ultrasound Guided Interscalene and Ultrasound Guided Suprascapular Nerve Blocks in Postoperative Pain and Hand Motor Power Affection in Shoulder Scope Surgeries
Authors: Mohamed Hashem Mohamed Medhat , Ibrahim Sherif Farouk , Mansour Waleed Ahmed , Abdelaziz Noha Mohamed , Fahmy Neveen Gerges 
Published: July 2024

Abstract

Background
Interscalene approach of brachial plexus nerve block is recognized as the gold standard technique for postoperative pain control after shoulder scope surgeries. However, it is associated with major adverse effects and patient discomfort due to paralysis of the hand muscles. The suprascapular nerve block is considered to be a safe and effective alternative to interscalene nerve block for shoulder surgery without affecting the motor function of the hand muscles and other serious complications of interscalene nerve block, especially in ambulatory surgery.

Aim of the work
The aim of this study is to compare interscalene and suprascapular nerve block in terms of postoperative pain, opioid consumption, and hand grip strength in shoulderscopic surgeries.

Patients and Methods
This prospective, randomized trial was done in Ain Shams University Hospitals. A sample of 50 patients; 25 patients in each group, namely Group ISB (interscalene approach of brachial plexus block) and Group SSNB (suprascapular nerve block). Visual Analogue Scale (VAS) was used to assess Shoulder pain at rest and upon flexion in the first 24 hours. The degree of hand motor power affection, the total amount of opioids used as rescue analgesia, and the incidence of complications were also recorded.

Results
The findings revealed no statistically significant difference between groups (p-value &gt; 0.05) in pain control all over the 24 hours by VAS score at rest and at arm flexion. SSNB received a larger total narcotic dose (60±26.02) mg of pethidine than ISB (52±22.73). However, there was no statistical difference between them throughout the 24 hours regarding total narcotic consumption and 1st time for pethidine administration. The ISB group showed a statistically significant reduction in the hand power grip strength postoperatively (83.68±4.75 %).

Conclusions
The results of the present study favour SSNB as the first choice of pain control after shoulderscopic surgeries for a patient scheduled for early home discharge because of the complete recovery of the hand muscles’ motor power.
Evaluation of the Efficacy of Targeted Microbiome Therapy in Non-Alcoholic Steatohepatitis Rat Model
Authors: Salah Noha , Matboli Marwa , Mansour Amal , Abo El Magd Nagwa M , Kamel Hassan Amany Helmy Hasanin Mohamed , Eissa Sanaa 
Published: July 2024

Abstract
Non-alcoholic steatohepatitis (NASH) is the clinically aggressive variant of non-alcoholic fatty liver disease. Hippo pathway dysregulation can contribute to NASH development and progression. The use of probiotics is effective in NASH management. Our aim is to investigate the efficacy of kefir Milk in NASH management via modulation of hepatic mRNA-miRNA based panel linked to NAFLD/NASH Hippo signaling and gut microbita regulated genes which was identified using bioinformatics tools. Firstly, we analyzed mRNAs (SOX11, SMAD4 and AMOTL2), and their epigenetic regulator (miR-6807) followed by validation of target effector proteins (TGFB1, IL6 and HepPar1). Molecular, biochemical, and histopathological, analyses were used to evaluate the effects of kefir on high sucrose high fat (HSHF) diet -induced NASH in rats. We found that administration of Kefir proved to prevent steatosis and development of the inflammatory component of NASH. Moreover, Kefir improved liver function and lipid panel. At the molecular level, kefir down-regulated the expression of miR 6807-5p with subsequent increase in the expression of SOX 11, AMOTL2 associated with downregulated SMAD4, resulting in reduction in the expression of the inflammatory and fibrotic markers, IL6 and TGF-β1 in the treated and prophylactic groups compared to the untreated rats. In conclusion, Kefir suppressed NASH progression and improved both fibrosis and hepatic inflammation. The produced effect was correlated with modulation of SOX11, SMAD4 and AMOTL2 mRNAs) – (miR-6807-5p) – (TGFB, IL6 and, HepPar1) expression.
Investigating the Effect of Phototherapy on Expression of CXCR3-B Gene in Vitiligo
Authors: Mansour Amal Abdelsalam , Diab Heba Mahmoud , Badawy Seham Adel , Hay Ibrahim Nesma Hussein Abdel , Mohammed Agag Fatma Al-Zahraa 
Published: July 2024

Abstract

Background
Vitiligo is acquired depigmentary disorder characterized by destruction of the epidermal melanocytes leading to the loss of the skin color. Oxidative stress, genetic susceptibility together with autoimmunity are the main players of melanocytic destruction aetiopathogenesis.

Aim of the Work
The primary aim of the work was to investigate the effect of phototherapy (NBUVB and excimer laser) on CXCR3B expression in vitiligo. The secondary aim was to confirm the claim of causal relationship between CXCR3B levels and vitiligo in an attempt to evaluate CXCR3B role in the pathogenesis of vitiligo.

Patients and Methods
A prospective cohort study in department of Dermatology, Venereology and Andrology Ain Shams University, (El Demerdash and Al-Haud Al-Marsoud) vitiligo clinics and Biochemistry Department Ain Shams University between 2020 - 2022. In our study we measured CXCR3B mRNA expression in skin of vitiligo patients before and after generalized ‘NBUVB’ and targeted ‘Excimer laser’ phototherapy. Our study was conducted on 25 patients suffering from non-segmental vitiligo. All biopsies were stored in -80C till RNA extraction that was performed using QIAGEN RNeasy Mini Kit, QuantiTect Reverse Transcription Kit and QuantiNova SYBR Green PCR Kit.

Results
We found that CXCR3B mRNA expression was significantly increased after phototherapy that is well known for immune modulatory properties. Moreover this was higher in excimer group therapy than NBUVB. Such findings highlight CXCR3B as an inherit defect in skin of patients with vitiligo and raise questions about its possible roles in maintaining vitiligo or causing relapses.

Conclusion
CXCR3B mRNA levels were significantly increased after treatment with either NBUVB or Excimer laser compared to mRNA levels before therapy. From our results we can conclude that elevated CXCR3B mRNA levels are obviously characteristic to patients with vitiligo and suggestive of persistent inherit defect of their melanocytes. It may also be responsible for the relapse and chronicity of vitiligo.
Impact of 3D TEE guided ASD transcatheter closure on procedure outcome and radiation exposure
Authors: EL Okl Reham Atef , Mosa Tarek khairy , Mansour Amr , Ezzeldin Dina , Roushdy Alaa , EL Fiky Azza 
Published: July 2024

Abstract

Background
Transcatheter ASD device closure of secondum ASD is widely accepted in closure of ASD. Radiation exposure increases the risk of cancer for both patients and staff members, fusion of 3- D TEE and fluoroscopy has helped us decrease radiation exposure during whole procedure.

Aim
to assess feasibility of 3 D TEE guidance in transcatheter ASD closure and assess its value in reducing radiation exposure as compared to control patients.

Methods
This study was conducted on 30 patients with secundum ASD referred to cardiology department - Ain Shams University for percutaneous ASD device closure under 3D TEE guidance and 54 control patients who performed percutaneous ASD device closure using conventional method. we calculated total procedure time (min), total DAP (mGy/cm2), (FT) fluoroscopy time (min), total air kerma (mGy), maximum ASD diameter (mm) and we recorded implanted device size and device type for all the patients.

Results
There was no significant difference between both groups regarding FT, total air kerma, dose area product. Operative time of study group was significantly longer than control group although FT reduced significantly in last case of the study. In the last 10 cases of the study radiation exposure decreases and was significantly lower than control group.

Conclusion
The Use of 3 D-TEE by well-trained imaging cardiologist on tracking catheter during percutaneous ASD device closure decrease significantly radiation exposure of patients as well as medical personnel.
Three years' registry on myocardial perfusion imaging patients in Ain shams university nuclear cardiology unit
Authors: Alzebak Osama , Mansour Hazem , Rayan Mona , Adel Amr 
Published: July 2024

Abstract

Background
The development in nuclear myocardial perfusion imaging (MPI) has provided diagnostic and prognostic implications in CAD patients, leading to an explosive increase in the performanceofthesestudies. Thisexpansionofimagingspectrumisassociatedwithwidespread concern regarding imaging utilization and increased healthcare costs. There is no comparative data that guide the use of these modalities with respect to appropriateness and patients’ benefit. Targeted data collection, through registry studies, enable analysis of both quality and outcomes with big advantages of reflecting real world daily practice and identifying the gaps in care which may not otherwise be feasible in high-quality randomized control trials.

Objective
To explore the extent to which stress myocardial perfusion imaging (MPI) studies met published appropriate use criteria (AUC), and the real world practice in the nuclear cardiology unit of Ain shams University.

Patients and Methods
It was a retrospective cohort study that included 2598 patients who underwent myocardial perfusion imaging in Ain Shams university nuclear cardiology unit throughout the period from January 2017 to December2019. All patients were subjected to thorough demographic data, history of cardiovascular risk factors (arterial hypertension, diabetes mellitus, smoking, family history of premature cardiovascular diseases), indication of the test, preprocedural ECG, ejection fraction by echocardiography, previous coronary angiography and PCI or CABG, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability.

Results
The study included 2598 patients with mean age of 57.76 years, with male predominance (68.1%), 38.2% were diabetics and 53% had hypertension. The most common indications to undergo MPI was the exclusion of CAD as a cause of chest pain in 38.8% of patients followed by the evaluation of symptomatic post PCI patients in 21.9%. Moreover 63.8% of patients showed appropriate tests, while 18.6% of patients showed uncertain tests. Whereas 17.6% of patients had inappropriate studies. 81% of appropriate tests showed positive results of SPECT. Whereas in the inappropriate and the uncertain category, the negative test for ischemia predominated.

Conclusion
We have established that appropriateness criteria are effective in identifying appropriateness of SPECT in a university center located in Cairo. Also, we concluded that in our unit the appropriate tests were more prominent than inappropriate and unclassified tests. Most of the appropriate studies were positive for ischemia. While, most of the inappropriate and uncertain tests were normal and the commonest cause of referral for MPI was exclusion of CAD as a cause of chest pain.
Short term clinical outcomes of Complex Percutaneous Coronary Intervention in patients with intermediate to high SYNTAX score: Ain Shams complex PCI Registry
Authors: Mohamed Labib Mohamed Mostafa , Mahmoud Abdellatif Yasser AlaaEldin , Abu Arab Tamer Mohamed 
Published: July 2024

Abstract

Background
Risk stratification is an important and essential component in proper patient counseling when dealing with complex coronary anatomy and decision making between either coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI). The SYNTAX score was pioneered as an anatomical-based risk score that aided in this decision-making process.

Objective
To develop an electronic registry for patients with complex coronary anatomy with intermediate to high SYNTAX score undergoing non-emergent PCI who were indicated for CABG but either they were rejected by the surgeons or they refused it.

Patients and Methods
Our registry was conducted on 193 patients presented during eight months from the first of July 2021 till the end of February 2022 to Ain Shams University Hospitals and underwent PCI.

Results
comparing the intermediate to high SYNTAX score groups, there is a statistically significant increase in the in hospital and short term MACE and mortality with high SYNTAX score patients, while there was no difference regarding in hospital CIN. Regarding MACE it significantly increases in patients with anemia, CKD, LV dysfunction. For multivariate analysis it is shown that both incomplete revascularization and clinical SYNTAX II are independent predictors for the occurrence of short term MACE.

Conclusion
Both incomplete revascularization and clinical SYNTAX II score are independent predictors of short term (6 months) occurrence of MACE.
Prognostic Utility of Ratio of Systolic Blood Pressure to Left Ventricular End- Diastolic Pressure Post Successful Primary Percutaneous Coronary Intervention in Prediction of Major Adverse Cardiac Events in Patients with ST-segment Elevation Myocardial Infarction
Authors: Said Mohamed Mohamed Ahmed , Mahmoud Yasser Alaaeldin , Said Khaled Mohamed , Hassan Osama Mohamed 
Published: July 2024

Abstract

Background
Of all causes of Cardiovascular disease (CVD), ischemic heart disease (IHD) remains the major contributor, accounting for half of all CVD-associated morbidity and mortality. IHD as measured by the Global Burden of Disease project is driven predominantly by acute myocardial infarction (MI) and, to a lesser extent, angina.

Aim of the Work
To evaluate the prognostic utility of the ratio of SBP/LVEDP at the time of PPCI in prediction of MACE both in-hospital and during 3-months follow up in patients presented with STEMI with a single vessel disease.

Patients and Methods
This was a prospective study that was conducted on 153 patients presented with STEMI and underwent successful PPCI for a single vessel disease in Ain-Shams University Hospitals and Nasr City Health Insurance Hospital in the period from March 2019 to March 2021.

Results
Our results demonstrated, that SBP/LVEDP ratio can be used to predict MACE occurrence at a cutoff level of ≤ 3.9, and can be used to predict patients who are MACE-free at cutoff level of ≥ 9.2. The lower ratio of SBP/LVEDP (≤3.9) was detected at 27 patients (17.6%) from the whole study population (153 patients) with higher statistical significance difference of older age group. Different risk factors and positive family history showed no statistical significance difference with lower ratio. In this study, lower ratio showed higher statistical significant difference in anterior STEMI group, lower EF% “Simpson”, higher LVESV, DD grade II, higher WMSI, with the culprit lesion vessel when its LAD, with higher LVEDP, lower invasive SBP, and lower invasive DBP. This study found that lower ratio had a better prognostic ability with a higher AUC (0.880) when compared to the widely used GRACE and TIMI risk scores. Lower ratio ≤3.9 showed higher statistical significant difference with higher GRACE RS and higher TIMI RS when compared with higher ratio. Our ratio had a strong prognostic ability in prediction of MACE with lower ratio with higher statistical significant difference of occurrence of MACE in 26 patients (96.3%, P = 0.000) when compared with patients with the same ratio but without occurrence of MACE in 1 patient (3.7%).

Conclusion
Our study concluded that SBP/LVEDP is an easily rapidly determined ratio at the time of PPCI that can provide important prognostic information regarding risk stratification of STEMI patients, with a high predictive ability for occurrence of MACE at a cutoff point of ≤ 3.9, during hospital stay and short term follow up.
Incidence and Prognostic Value of Single Lead QRS Fragmentation in Successfully Revascularized Inferior STEMI Patients
Authors: Elbialy Hashish Sherif Abdelhamid , Sharafeldin Ahmed Abdelrahman , Amin Sameh Attia 
Published: July 2024

Abstract

Background
the main therapeutic strategy for acute ST segment elevation myocardial infarction (STEMI) is the rapid restoration of epicardial blood flow in the infarcted related artery (IRA). Primary percutaneous coronary intervention (pPCI) is the most effective and recommended therapeutic intervention for the reperfusion strategy.

Aim of the Work
to investigate the incidence of QRS fragmentation among successfully revascularized inferior STEMI patients including single lead fragmentation (sl-fQRS) and classic QRS fragmentation (fQRS) and the prognostic importance of (sl-QRS) in patients with inferior STEMI who achieved TIMI 3 flow by primary PCI and its relation to results of angiography, poor prognosis prediction including in hospital mortality and Major Adverse Cardiac Events (MACE).

Patients and Methods
this prospective cohort study was carried out on 150 patients with successfully revascularized inferior STEMI patients by primary PCI, Patients were recruited postoperative from cardiology department, Ain Shams University Hospitals after undergoing Coronary Angiography for myocardial infarction which is the standard of care for such patients for follow-up during the study period (6 months). All patients were given informed consent. The study protocol was approved by the ethical committee, Faculty of Medicine, Ain Shams University.

Results
150 patients with acute myocardial infarction, who were referred to the cardiology department for primary PCI, were eligible to participate in the study. Their mean age was 54.45 ± 11.11 years old. Most of them were males (78.7% of patients, 118 patients). 95 patients (63.3% of patients) had history of smoking wether current or ex-smokers. Nearly, one third of patients (34.7% of patients, 52 patients) were diabetic. Similarly, 34.7% of patients (52 patients) were dyslipidemic. 43.3% of patients (65 patients) were hypertensive. Their mean BMI was 26.69 ± 2.65 kg/m2. Most of patients (76.7% of patients, 115 patients) had positive family history.

Conclusion
The concept of at least two derivations is mentioned for the classical definition of fQRS, and only one lead with fQRS has not been accepted for the presence of fQRS. However, we showed that sl-fQRS is associated with MACE and higher risk. Therefore, instead of the concept of at least two derivations, the presence of fQRS in only one lead and/or ≥1 leads with fQRS may also be enough when describing the patients under high cardiac risk.
The Role of Cardiopulmonary Exercise Testing in Assessment of Patients with Interstitial Lung Disease
Authors: Wgeih Khaled Mohammed , Gomaa Ashraf Adel , Abd ElDayem Aya Mohammed , Saad Ahmed Mahmoud 
Published: July 2024

Abstract

Background
Cardiopulmonary exercise testing (CPET) is considered as the gold standard for evaluating the causes of exercise intolerance in patients with pulmonary and cardiac disease, and is based on the principle that system failure typically occurs while the system (e.g muscle-energetic, cardiovascular or pulmonary) is under stress.

Objective
To evaluate the role of cardiopulmonary exercise test in assessment of patients with interstitial lung disease.

Patients and Methods
This is observational study included 30 consecutive examined with the diagnosis of ILDs in Kobry El Kopa military hospital. The study was carried out over the period from February 2016 to August 2019. All patients with dyspnea to be investigated and ILDs diagnosed and assessed in rehabilitation department who undergo cardio pulmonary exercise test.

Results
Reduction on the compliance of the lung and/ or chest wall cause change in lung volumes and tachypnea during exercise. Also agreed with harris EzeAo Who showed that alterations on breathing pattern such as lower Vt, increased respiratory effort, rapid shallow breathing were reported in individual with interstitial lung diseases.

Conclusion
The pathophysiology of ILD has a negative impact on the ventilatory, cardiovascular, and skeletal muscle responses to exercise, thereby leading to exertional dyspnea and reduced exercise capacity. CPET is an excellent tool for assessing the severity of exertional dyspnea and mechanisms of exercise limitation in patients with various forms of cardiorespiratory disease; however, its application in ILD has remained limited. A growing body of evidence supports the use of CPET in patients with ILD. CPET is currently used to assess functional capacity, to inform exercise prescription, and to evaluate the effects of various interventions. Recent findings highlight that, in addition to its current uses, CPET-derived measures may help improve the management of patients with ILD. Despite these recent advances, additional research is required in order to confirm the utility of CPET in this population.