bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood monocyte subtypes in patients with pulmonary tuberculosis infection
Authors: El-Rab Attia Tamer G. , Abdelmeguid Mona M. , Mohammed Ali S. , Fayed Hamada K.S. 
Published: April 2024

Background and aim
Monocytes are the primary target for Mycobacterium tuberculosis infection. Important alterations in the proportions of circulating monocyte subpopulations were found in patients with active tuberculosis (aTB). Our aim was to investigate the peripheral blood monocyte subsets in patients with active pulmonary tuberculosis (aPTB) and to evaluate their role in treatment response.

Patients and methods
A case–control study included 30 patients with aPTB and 30 healthy controls. Laboratory investigations include sputum examination, tuberculin test, and nucleic acid amplification test using GeneXpert MTB/RIF assay on sputum sample for patients only to confirm the diagnosis of aPTB. For all participants; complete blood count, erythrocyte-sedimentation rate, HIV antibodies, and flow cytometry analysis of peripheral blood monocyte subsets were done using surface markers CD14 phycoerythrin cyanin 7 and CD16 fluoroisothiocyanate for identification of monocyte subsets. Flow cytometry analysis was repeated 2 months after the start of treatment in aTB patients only.

Results
Classical monocytes were decreased while intermediate, and nonclassical monocytes were increased in aTB patients before treatment more than after 2 months of treatment and control group (P≤0.0001 for each). There was no significant difference in the three monocyte subsets between PTB patients after treatment and healthy controls. Also, the classical monocytes decreased while intermediate, and nonclassical monocytes increased in aTB patients with positive tuberculin test more than healthy controls with positive tuberculin test (P<0.0001 for each).

Conclusion
The expansion of CD16+ monocytes was reversed after treatment with anti-TB drugs and could be used to follow up tuberculous patients for treatment effectiveness.
Restoration of natural killer cell activity in chronic hepatitis C-infected Egyptian patients treated by sofosbuvir/daclatasvir with or without ribavirin
Authors: Moustafa Hamdy M. , Abdel-Gawad Muhammad , Salaheldin Eman M. , Ibrahim Nagat F.S. 
Published: April 2024

Background and aim
Numerous studies demonstrate natural killer (NK) cell dysfunction in hepatitis C virus (HCV) infection. Direct-acting antivirals (DAAs) can change NK cell activation when HCV replication is inhibited. Only few studies have reported the effect of DAAs on NK cells, especially in genotype 4. Therefore, our study aimed to examine the effect of elimination of HCV by DAA therapy on NK activity in chronic hepatitis C-infected patients.

Patients and methods
A prospective cohort study was conducted on 50 Egyptian naïve chronic hepatitis C-infected patients. The patients were treated with sofosbuvir/daclatasvir±ribavirin for 12 weeks, and NK cells were detected at baseline and at 12 weeks after the end of the treatment by multicolor flow cytometry.

Results
Overall, 98% of studied patients achieved sustained virological response (SVR) 12. One patient did not achieve SVR 12; this patient was given a second course of treatment with sofosbuvir (ombitasvir/paritaprevir/ritonavir) and ribavirin for 12 weeks and successfully achieved SVR. Therefore, SVR 24 of studied patients was 100%, and there was a significant increase in cluster of differentiation 16+ cluster of differentiation 56+ after treatment compared with pretreatment data (P=0.000).

Conclusion
Elimination of HCV infection by DAA therapy can restore the frequency of NK cells of chronic hepatitis C-infected patients.
Carotid intima-media thickness as an indicator of subclinical atherosclerosis in systemic lupus erythematosus patients
Authors: Abozeid Asmaa A. , Hazem Mohammed , Altaher Ali M. , Abda Essam A. , Elsayed Sahar A. 
Published: April 2024

Background and aim
Accelerated atherosclerosis is a leading cause of increased cardiovascular morbidity and mortality in patients with systemic lupus erythematosus (SLE). Atherosclerosis is mediated by multifactorial processes including inflammation, endothelial dysfunction, autoantibodies, dyslipidemia, and traditional risk factors. So, we aimed to evaluate carotid intima-media thickness (CIMT) for early detection of subclinical atherosclerosis in patients with SLE and to determine its correlation with disease activity.

Patients and methods
A total of 50 patients with SLE and 50 healthy controls were included in this study. Full detailed history, clinical examination, and laboratory findings for all the participants were recorded. ECG was done for the patients and controls for the detection of QT dispersion. CIMT was measured bilaterally at the distal common carotid artery.

Results
On measuring CIMT, we found thickened CIMT (>0.8 mm) in 28% and plaques in 18% of the patients. There was a highly significant increase in the right CIMT, left CIMT, and mean CIMT of both sides in the patients in comparison with the controls (P<0.0001, P=0.004, and P<0.0001, respectively). The ECG findings showed that 40% of our patients had normal ECG, 10% had abnormal ST segment, 34% had sinus tachycardia, and 16% had QT dispersion. Moreover, CIMT was positively correlated with SLE disease activity index (SLEDAI) and associated with other nontraditional risk factors including age, disease duration, anti-dsDNA, C3, and nephritis.

Conclusion
Premature atherosclerosis is a devastating health problem in patients with SLE, which may be accelerated by multiple risk factors related to the disease process and medications; hence, early detection of subclinical atherosclerosis through the measurement of CIMT using carotid ultrasonography is a reliable noninvasive technique to allow early therapeutic intervention and to reduce the mortality.
Lung ultrasound for detection of pneumonic changes in patients with COVID-19 infection
Authors: Ati Moaz A.E.S.A. , El Deeb Ahmed M. , Shahin Mohamed A.A. , Kabil Ahmed E. 
Published: April 2024

Background and Aim
Given the pandemic crisis of COVID-19 pneumonia, the computed tomography (CT) chest is widely used for initial management of patients with suspected COVID-19 because of its well-known high sensitivity for detection of COVID-19 pneumonia, but its cost, which decreases its availability for certain populations, risk of radiation, need for transportation of the patient, the burden of proper disinfection of the CT room and its unsuitability for some patients like pregnant and lactating women certainly lead to the necessity for a more advantageous tool like lung ultrasound that could solve many of the previous obstacles encountered while deciding to perform the CT chest. This study aims to determine the suitability of lung ultrasound as an alternative to CT chest to aid in the initial management of these patients. The aim was to determine the value of lung ultrasound in the diagnosis of lung parenchymal affection in patients with COVID-19.

Patients and methods
A prospective including 150 patients was carried out in the Chest, Interventional Radiology and Clinical Pathology Departments in Bab-El-Sha'aria and Al-Hussin Hospitals, Al-Azhar University, during the period from May 2020 to September 2020. Lung ultrasound was performed in 150 patients with COVID-19 pneumonia diagnosed based on the integrated clinical, laboratory, and CT chest radiological data.

Results
Among 150 patients, there were 86 males and 64 males, ranging in age from 30 to 75 years and a mean age of 55.8±12.1 years. Bilateral lung infiltrates in the CT scan were present in 146 patients (97.3%), CXR infiltrates were present in 63 patients (42%), sonographic evidence of pleuropulmonary involvement was present in 139 patients (92.7%), B lines and pleural line thickening were present in all patients with ultrasound findings (100%), subpleural consolidation associated with B lines was present only in 33 patients (23.7%) and pleural effusion was absent in all cases; crackles were only present in 53 (35.3%) patients.

Conclusion
Because of its simplicity in interpretation, bedside availability, lack of risk of radiation and good sensitivity in the detection of lung parenchymal affection, the chest ultrasound is a useful tool in the management of patients with symptoms suspicious of COVID-19 infection and seems to be a suitable substitute for the CT chest in such circumstances.
Treatment of corneal astigmatism by limbal relaxing incisions during phacoemulsification surgery
Authors: Naguib Maged A. , Elrashidy Hussam E. , Samir Ghada 
Published: April 2024

Background and aim
The aim was to assess the effectiveness of limbal relaxing incisions (LRIs) in treatment of astigmatism in patients undergoing phacoemulsification surgeries.

Patients and methods
Forty-eight eyes of 48 patients suffering from senile cataracts of mean age 64.7±7.9 (range: 50–77) years, and mean corneal astigmatism 1.8±0.73 diopters (D) (range: 1.5–3.5 D) were included in this study. All LRIs were performed at the end of phacoemulsification. Corneal topography results were compared before surgeries and 2 and 6 months after surgeries.

Results
A statistically significant reduction in the mean corneal astigmatism was seen from 1.8±0.73 D (range: 1.50–3.50) preoperatively to 1.1±0.24 D (range: 0.5–1.7) and 1.4±0.52 D (range: 0.60–1.9) in the second and sixth postoperative months, respectively (P<0.001). Surgical-induced astigmatism (the amount and axis of astigmatism change induced by surgery) was 0.90±0.48 at 2 months and 0.96±0.59 at 6 months. Correction index (calculated by determining the ratio of surgical-induced astigmatism/target-induced astigmatism) was 0.56±0.42 and 0.57±0.33 at 2 and 6 months, respectively. Index of success (ratio of topographic residual astigmatism and target-induced astigmatism) was measured to be 0.45±0.42 and 0.48±0.33 at months 2 and 6 correspondingly.

Conclusion
Combined LRI and phacoemulsification appears to be safe and fairly effective to correct mild-to-moderate corneal astigmatism. However, undercorrection is a common limitation that may be further managed by modified nomograms in future studies.
Mean platelet volume (MPV) as a biomarker of disease activity in ulcerative colitis
Authors: Mohammed Nashaat Y. , Eid Khaled A. , Mohammad Ahmed Q. 
Published: April 2024

Background and aim
All platelet indices may be useful biomarkers for follow-up in inflammatory bowel disease patients as they show a strong correlation with disease activity. In this work, we aimed to investigate the relation between mean platelet volume (MPV) and ulcerative colitis (UC) activity by comparing the MPV values between cases with active UC, mild cases and normal individuals.

Patients and methods
This observational study was carried out on 90 individuals aged >18 years. They were divided equally into the following groups: group A: active UC, group B: remitting UC and group C: healthy controls free of any systemic diseases as a reference. UC was confirmed based on colonoscopy and biopsy.

Results
Patients with active UC have significantly smaller MPV in comparison with patients with disease remission or healthy controls (P value <0.001), without a difference between patients in remission and healthy controls. MPV was directly proportional to the Hemoglobin level among study populations (r=0.64, P<0.001). MPV was negatively correlated with erythrocyte sedimentation rate (r=−0.74, P<0.001), total leukocytic count (r=−0.49, P<0.001) and platelet count (r=−0.24, P=0.023) in all the study populations.

Conclusion
MPV decreases in the active phase of UC compared with the remission phase or healthy individuals. There is a relationship between the degree of disease activity and MPV in UC. Hence, MPV can be a useful biomarker for assessing disease activity for UC.
Role of vitamin D in children with otitis media with effusion
Authors: Mohammed Ghada A. , Rashed Rashida A.A. , Elsayed Asmaa F. , Mostafa Soad Y. 
Published: April 2024

Background and aim
Otitis media with effusion (OME) is characterized by retention of fluid behind an intact tympanic membrane. The association of vitamin D deficiency, upper respiratory tract infections, and otitis media has been reported by several studies. Aim: The aim was to investigate the relationship between OME and vitamin D level in children.

Patients and methods
This study is a case–control study that was carried out at Otorhinolaryngology and Pediatric Clinics at Al-Azhar University for Girls and Al Mataria General Hospital. In this study, 40 children were included, 20 children were controls and 20 children were diagnosed with OME (cases). Patients were subjected to history, otoscopic examination, and audiological evaluation (pure-tone audiometry and tympanometry). Blood samples (5 cm) were taken from case and control groups in the laboratory to measure serum 25-hydroxy vitamin D level.

Results
In the case group, mean vitamin D level was 17.02 ng/ml, SD±8.49, and the median was 14.90 (8.7–35.0) ng/ml. In the control group, mean vitamin D level was 25.85 ng/ml, SD±8.94, and the median was 30.20 (9.8–36.1) ng/ml with P significance equal to 0.007. Sixteen children (80%) out of 20 children of the case group and eight children (40%) out of 20 children of the control group had an abnormal value of vitamin D. An abnormal value of vitamin D was statistically significant in children with OME than the control group with P significance equal to 0.03.

Conclusion
It was found that vitamin D plays an important role in OME in our children and can share in the regimen of treatment of OME when it was found abnormal. Measuring vitamin D level in the case group is necessary and must be treated if abnormal.
Effect of treatment with hydroxyurea on calcium homeostasis in β-thalassemia-major patients
Authors: Hassan Khaled H. 
Published: April 2024

Background and aim
Thalassemia is a chronic illness that has a range of serious clinical and psychological effects, it does not only affect the physical functioning of patients but also their emotional and social functioning and school functionings, leading to impairment of health-related quality of life of the patients due to the effects of the disease and its treatment. The aim of this study was to assess the effect of treatment with hydroxyurea on calcium homeostasis in β-thalassemia-major patients.

Patients and methods
This study is a prospective, case–control one, it was done on 50 patients with β-thalassemia major who received regular blood transfusion at Luxor International Hospital [25 patients received hydroxyurea (group II) and 25 patients did not receive hydroxyurea (group I)] and 25 apparently healthy children as controls.

Results
Group II (received hydroxyurea) had better results than group I (not received hydroxyurea) regarding the frequency of blood transfusion, manifestations of hypocalcemia (tetany, convulsions, and carpopedal spasm), and the occurrence of the boneache and bone fractures. Group II (received hydroxyurea) had better hemoglobin levels as well as other complete blood count parameters than group I (not received hydroxyurea). Group II (received hydroxyurea) had better results regarding serum-ionized calcium as well as serum ferritin, serum alkaline phosphatase, and serum phosphorus levels than group I (not received hydroxyurea).

Conclusion
Disturbed calcium homeostasis is one of these iron-overload hazards; it has different clinical and laboratory manifestations that can be improved by using the hydroxyurea therapy in the management of β-thalassemia patients.
Comparative study between primary closure, reconstruction flap, and a 1470-nm diode laser for pilonidal sinus surgery
Authors: Hassan Ahmed M. , Khalaf Adel M. 
Published: April 2024

Background and Aim
Pilonidal sinus disease (PD) affects youngsters and is more recorded in males. Although a wide variety of treatment modalities to manage this disorder are still in use in everyday surgical practice, nevertheless, there was no consensus to which of those procedures is closer to perfect in providing definitive management. With recent advances in surgery, application of the laser was found to be an effective approach in the treatment of PD. The aim was to compare the outcome of management of PD by excision andprimary closure, excision and reconstruction by flap, and a 1470-nm diode laser, and to analyze its effectiveness, postoperative complications, recurrence rate, and satisfaction of the patient.

Patients and methods
This prospective comparative study between three methods of treatment of pilonidal sinus was made. This study includes 45 cases presented with PD disease: they are divided randomly into three groups. Group A (15 patients) was subjected to pilonidal excision and primary direct closure, while group B (15 patients) was subjected to pilonidal excision and local flap reconstruction, and group C (15 patients) was subjected to a 1470-nm diode laser.

Results
A significant difference was found to be between three groups regarding the duration of surgical procedures (in minutes). As regards to diode laser, all 15 cases had been managed efficiently on an outpatient procedure. Only one recurrent case was recorded.

Conclusion
Laser pilonidotomy is effective in the treatment of PD with a high rate of success, less complications, and high satisfaction of the patient.
Postoperative pulmonary embolism, risk factors, and medical thromboprophylaxis
Authors: Sobh Eman , Abdel Wahab Maisa A. , Adawy Zeinab R. , Abdelgalil Heba M. , Saleh Ola I. , Zakaria Doaa M. , Elshahat Randa S. 
Published: April 2024

Background and aim
The major surgical procedures have a significant risk of venous thromboembolism (VTE), especially pulmonary embolism (PE), leading to poor prognosis and life-threatening conditions. The major surgical procedure has 20-fold risk increase in VTE and the risk is increased by 30% in the absence of optimal prophylaxis. This study aimed to estimate the incidence of PE among surgical patients undergoing preoperative thromboprophylaxis according to Caprini score, these considerations can improve the clinical outcome and allow optimal use of thromboprophylactic strategies against VTE.

Patients and methods
We performed retrospective analysis of records of patients admitted to surgical wards at our hospital and identified those who developed postoperative PE. We calculated Caprini score to assess the risk for VTE.

Results
Among patients admitted to surgical wards, we identified 107 cases of postoperative PE. Most of them had major surgeries, most of them were females, and a considerable proportion of those who developed PE did not receive thromboprophylaxis although being at moderate or high risk for VTE according to Caprini score. Few patients had poor outcome.

Conclusion
Perioperative thromboprophylaxis is crucial to avoid complication with VTE. Caprini score may be a good clinical score to decide which patients to receive perioperative thromboprophylaxis.
Lepra Reactions: Mimickers and Mirror to Unmask Complex Cases of Leprosy
Authors: Kumari Sandhya , Verma Ghanshyam K. , Negi Ajeet K. , Sharma Aakanksha 
Published: April 2024

Abstract
Leprosy is a silent disease with protean manifestations, especially during lepra reactions (LRs). Cases with atypical leprosy or LR simulate a number of conditions misdiagnosed frequently. Here, three classical cases of leprosy are reported for their complex presentation. Leprosy was hidden in Case 1 due to co-existing diabetes. COVID vaccination induced LR unmasked all leprosy lesions, which were extensive, large, bizarre and spreading to various immune zones. Case 2 presented with high-grade fever, tachycardia, generalized erythema and body aches. A detailed workup unveiled his leprosy with a rare presentation of Type 1 lepra reaction (T1LR) with erythroderma and severe systemic symptoms. Case 3 mimicked sarcoidosis and lupus erythematosus (LE) on routine workup. She had facial lesions in the malar area, photosensitivity, joint pains, raised angiotensin-converting enzyme (ACE) levels and positive anti-nuclear antibodies. Peri-appendageal granulomas on histopathology and therapeutic response to multidrug therapy helped in the early diagnosis of leprosy.
Comparison of the Clinical Efficacy of Rituximab Infusion and Dexamethasone-Cyclophosphamide Pulse Therapy and Their Effect on Serum Th1, Th2, and Th17 Cytokines in Pemphigus Vulgaris–A Prospective, Nonrandomized, Comparative Pilot Study
Authors: Khandpur Sujay , Sharma Preeti , Sharma Vinod K. , Das Dayasagar , Sharma Alpana , Bhari Neetu , Sreenivas Vishnubhatla 
Published: April 2024

Abstract

Background:
Rituximab infusion and dexamethasone-cyclophosphamide pulse (DCP) are the two most popular regimens used in pemphigus vulgaris (PV) in India.

Objective:
The present study compared the clinical efficacy of rituximab and DCP in Indian PV patients and their effects on serum Th1,2, and 17 cytokine levels.

Materials and Methods:
A total of 37 patients received DCP (Group A, n = 22) or rituximab (Group B, rheumatoid arthritis protocol (n = 15)) as per patients’ preference. They were monitored for clinical response, adverse events (AEs), changes in serum anti-desmoglein-1,3 antibody titers and Th1,2 and 17 cytokine levels at baseline and weeks 20 and 52.

Results:
The proportion of patients attaining disease control, remission, and relapse in groups A and B were 82% and 93%; 73% and 93%; and 27% and 50%, respectively, after a median duration of 2 months each for disease control; 4 and 4.5 months for remission; and 5 and 7 months for relapse post remission. The musculoskeletal AEs were the highest in the two groups. Significant and comparable decreases in anti-dsg1 and 3 titers from baseline to weeks 20 and 52 were observed in both groups. Th1 and Th17 cytokine levels decreased, while Th2 cytokines increased post-treatment in both groups. However, no correlation was found between change in body surface area of involvement by PV and anti-dsg titers and cytokine levels before and after therapy in both groups.

Conclusion:
Comparable clinical efficacy between DCP and rituximab was observed.
A Brief Review on Good Clinical Practice and its Training Methods
Authors: Mondal Himel , Mondal Shaikat 
Published: April 2024

Abstract
The field of clinical research continues to advance, and for ethical conduct of research, researchers need to have a strong foundation in good clinical practice (GCP). GCP guidelines are internationally recognized standards that govern the conduct of clinical trials, ensuring the protection of human subjects and the generation of reliable data. However, novice researchers or postgraduate medical students who would delve into research activities may face difficulty getting avenues for GCP training. Hence, in this brief review article, we discuss the significance of GCP in the field of clinical research with a glimpse of its history, development, and key principles. We provide a list of online courses, benefits, and disadvantages of those courses, and a list of organizations that conduct GCP workshops or continued medical education programs in India.