bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of interleukin-6 receptor, tumor necrosis factor receptor-associated factor-2, and tumor necrosis factor receptor-associated factor-5 as new reliable markers in psoriasis vulgaris
Authors: Risha Basma E.-S. , Al-Aziz Ghada A. , Ahmed Naglaa S. , Hamdino Mervat 
Published: March 2024

Background
Lacking data about tumor necrosis factor receptor (TNFR)-associated factor (TRAF) molecules in human inflammatory reactions with in-vitro studies which demonstrated the involvement of TRAF molecules in the pathogenesis of inflammatory diseases.

Aim
The authors aimed to perform a study evaluating expression of TRAF-2, TRAF-5, and interleukin-6 receptor (IL-6R) in psoriasis vulgaris and evaluate their role in IL-6 pathway involved in psoriasis pathogenesis.

Patients and methods
This is a case–control study, where 40 patients with psoriasis vulgaris and 40 healthy controls underwent taking of 4-mm punch skin biopsy. The diagnosis was confirmed with hematoxylin and eosin, and immunohistochemistry examination was done using IL-6R, TRAF-2, and TRAF-5 polyclonal antibodies for all specimens. The immunohistochemistry results were analyzed and scored either no staining (score 0) or positive staining (either +1, +2, or +3).

Results
Tissue level expression of IL-6R, TRAF-2, and TRAF-5 showed highly statistically significant difference between patients with psoriasis vulgaris and healthy controls, with no relation to clinical data, except for TRAF-2 in inflammatory lymphocytes, which showed a statistically significant relation with duration of the disease. There was a statistically significant relation between inflammatory expression of IL-6R and both TRAF-2 and TRAF-5 and a statistically significant relation between keratinocyte's nuclear expression of IL-6R and TRAF-5 only.

Conclusion
High expressions of TRAF-2 and TRAF-5 in patients with psoriasis vulgaris with IL-6R illustrate their contribution in psoriasis pathogenesis, with no relation to disease severity.
Early detection of atherosclerotic changes associated with long use of antiepileptic drugs in epileptic patients
Authors: Elsharkawy Rasha E. , Osman Marwa A. , Saleh Ola I. , Galal Heba M. 
Published: March 2024

Objective
Doppler ultrasound changes in the common carotid artery intima-media thickness (CCA IMT) and estimation of serum thiobarbituric acid reactive substances (TBARS) as predictors to the atherosclerotic complications of long use of antiepileptic drugs (AEDs).

Patients and methods
The study was done on 45 epileptic patients and 15 healthy individuals as a control group. All patients have been selected from the outpatient clinic of Neurology Department of Al-Zahraa University Hospital from period July 2018 to July 2020. They have been treated by monotherapy AEDs for at least 2 years. No other risk factors for atherosclerosis had been considered in these patients. They have been investigated for serum level of TBARS and Doppler ultrasound for assessment of CCA IMT. The patient group was also subdivided into three groups according to their type of treatment.

Results
The risk of carotid atherosclerosis in patients with epilepsy is linked with long use of older generation AEDs, namely carbamazepine and valproic acid, rather than levetiracetam which have no effect in vascular risk or CCA IMT changes.

Conclusion
The choice of AED therapy for long-term use should be guided with serum level of TBARS and CCA IMT as their mechanism of action as enzyme inducer might be a leading cause of vascular changes in epileptic patients.
Serum magnesium level in asthmatic children as an indicator of asthma severity
Authors: Gaber Eman M. , Mohammed Ensaf K. , Abdelwahab Amany E. , Mohammed Eman E. 
Published: March 2024

Background
Bronchial asthma is a chronic inflammatory disease of the respiratory tract, characterized by airway hyperresponsiveness. Magnesium (Mg++) has been shown to relax bronchial smooth muscle and influence the function of respiratory muscles. Hypomagnesemia has been associated with diminished respiratory muscle power.

Objective
This study aims to assess serum Mg level in children with asthma and its correlation with the severity of asthma.

Patients and methods
It was a case–control study carried out at Alzahraa University Hospital on two groups of children: group 1 consisted of 60 patients with bronchial asthma, comprising 41 males and 24 females, with age ranged from 6 to 15 years, with a mean 10.8±1.6 years, and the second group (control group) consisted of 30 apparently healthy children, with age and sex matched to the diseased patients. Pulmonary function test was done for the studied children, and serum levels of Mg were measured.

Results
The data hence collected were systematically tabulated and analyzed with SPSS software. The descriptive statistics for the case and control group showed there was a statistically significant decrease in mean serum Mg in asthmatic patients in comparison with controls (P<0.05). Moreover, there was a highly significant lower level of Mg in patients with severe persistent asthma compared with those with mild intermittent asthma and mild, moderate, and persistent asthma (P<0.001), and also, there were significant (P<0.001) positive correlations between serum Mg level and each of forced expiratory volume in 1 s (FEV1)% (r=0.712) and FEV1/forced vital capacity% (0.680) (i.e. in most cases, serum Mg level tended to decrease with the decrease in FEV1% and FEV1/forced vital capacity% ratio).

Conclusion
Children with bronchial asthma have a great risk of Mg deficiency, and serum Mg level has a significant relation to the severity of asthma and pulmonary function test.
Evaluation of serum irisin level in patients with chronic kidney disease
Authors: Ali Eman S. , Ali Abeer A. , Al Ramly Aml M. , Muhamed Marwa A. 
Published: March 2024

Background
Energy imbalance is common among patients with end-stage renal disease. Altered circulating irisin level may occur in patients with end-stage renal disease and result in energy dysfunction.

Aim
To estimate serum irisin level as a diagnostic marker for the protein-energy wasting syndrome in patients with chronic kidney disease (CKD) and its relation with glomerular filtration rate.

Patients and methods
This is a case–control study. It was carried out at Internal Medicine Department of Al-Zahraa University Hospital and Damanhur Fever Hospital from March 2018 to March 2020. This study included 85 participants, and their age ranged between 20 and 50 years. There were 31 males and 54 females. A total of 55 patients with CKD irrespective of cause were classified according to estimated-glomerular filtration rate into 36 patients with stage III CKD and 19 patients with stage IV CKD, and 30 patients were included as a control group. Serum irisin concentration and the levels of hemoglobin, urea, creatinine, uric acid, albumin/creatinine (A/C) ratio, estimated-glomerular filtration rate, lipid profile, calcium, phosphate, sodium, potassium, and anthropometric measurement were measured.

Results
This study did not find a positive or negative correlation between serum irisin level and BMI in the case group, and skeletal muscle mass adjusted for fat area was not correlated with serum irisin concentration.

Conclusion
Irisin could not be used as a diagnostic marker for protein-energy wasting syndrome in patients with CKD.
Maternal plasma adiponectin concentration and its association with risk of gestational diabetes
Authors: Aziz Fatema A.A. , Kawy Samia I.A.A. , Mohammed Shaymaa A. , Elmenam Hend S.A. 
Published: March 2024

Background
Gestational diabetes mellitus (GDM) is a metabolic disorder characterized by glucose intolerance of variable degree, with onset or first recognition during pregnancy. The global prevalence of hyperglycemia in pregnant women aged 20–49 years is 16.9%, and more than 90% of cases of hyperglycemia in pregnancy are estimated to occur in low-income and middle-income countries.

Aim
To observe changes in maternal plasma adiponectin concentration during 24–32 weeks of gestation in both healthy pregnant women and women with GDM for early detection of GDM.

Patients and methods
This case–control study was carried out on 88 pregnant women divided into two groups: group I included 50 pregnant women with GDM, and group II included 38 apparently healthy pregnant women who were selected as a control group, and their age was matched with patients. All participants underwent history taking, clinical examination, and oral glucose tolerance test, and plasma adiponectin was measured in both groups. Their analyses were done at Al Azhar University Center for Virus Research and Studies.

Results
There was a highly significantly decrease in plasma adiponectin levels (P<0.001) in patients with GDM when compared with the control group. The significant association between adiponectin and GDM suggests that low adiponectin levels may predict the development of GDM.

Conclusion
Findings of our study have demonstrated that low plasma adiponectin concentration was associated with GDM
Comparison between subtenon block and extraconal block during cataract surgery
Authors: Abd El-Galeel Ahmed M. , Badr Osama I.A. , Mohamed Khaled G. 
Published: March 2024

Background
Most ophthalmic procedures are performed under local anesthesia, and cataract extraction is the most frequently performed surgery in elderly patients. The aim of this study is to compare the intraoperative hemodynamic variables, efficacy, and efficiency of extraconal block versus subtenon block with low concentration of local anesthetic during cataract surgery.

Patients and methods
This prospective, randomized, and single-blind study was done on 80 patients American Society of anesthesiologists status I–III undergoing cataract surgery, of which 40 patients underwent subtenon block (group S) and 40 patients underwent extraconal block (group E). Five minutes after the start of anesthetic monitoring care, 5-ml mixture of lidocaine 1% and bupivacaine 0.25% containing 100 IU hyalorunidase, in a mixture ratio of 1 : 1, was injected intraocular slowly. Patients were monitored for intraoperative hemodynamics, ocular movement during surgery, and intraoperative pain sensation as primary outcome, and onset of blockade, pain assessment within 30 min postoperatively, number of patients need rescue dose, surgeon discomfort, and postoperative complications as secondary outcomes.

Results
Mean arterial blood pressure and heart rate in group S were significantly lower than those in group E but within safety margin. No significant difference was found between the two groups regarding full range of eye movement, surgeon's discomfort grade during cataract surgery, and also, intraoperative pain sensation. The onset of blockade was significantly faster in group S than group E. Although group S had better postoperative analgesic effect than group E, postoperative rescue dose was of insignificant value.

Conclusion
Subtenon block seems to be a better local anesthetic technique than extraconal for cataract surgery, as it is faster, has less surgeon discomfort grading, and better postoperative analgesia. However, on the contrary, both subtenon and extraconal blocks are equally effective in pain control during surgery and also have good ocular akinesia during operation.
Endometrial hyperplasia versus carcinoma
Authors: El Kholy Marwa A. , El Kholy Eman A. 
Published: March 2024

Context
Phosphatase and tensin homolog (PTEN) is a protein that acts as a tumor suppressor by dephosphorylating the lipid second messenger phosphatidylinositol 3,4,5-trisphosphate. Loss of PTEN function and mutation in PTEN gene have been implicated in the pathogenesis of endometrial carcinoma (EC).

Objective
The aim was to evaluate the immunohistochemical expression of PTEN in endometrial hyperplasia and EC and to evaluate the relationship between its expression and tumor grade in EC.

Materials and methods
Specimens included 16 cases of endometrial hyperplasia without atypia, six cases of atypical endometrial hyperplasia, and 18 EC specimens. Immunohistochemical staining for PTEN was performed using diaminobenzidine detection kit on formalin-fixed and paraffin-embedded tissue samples. Tumor tissue blocks and clinical data were collected from the files of the Pathology Department of Al-Zahraa University Hospital during the period 2010–2014.

Results
Immunohistochemistry showed that PTEN was positive for nuclei and cytoplasm of glandular endometrial cells. The PTEN expression was decreased significantly in atypical hyperplasia or EC compared with simple or complex hyperplasia (P0.041). In EC, we proved that PTEN expression is downregulated in high-grade tumors.

Conclusion
A positive PTEN expression correlates significantly with hyperplasia without atypia and well-differentiated tumors. The downregulation of PTEN indicates a more malignant phenotype.
Hepatitis B Seroprevalence among Egyptian University students in the postinfant compulsory vaccination period
Authors: El-Sayed Noha A. , Elshazly Sumaya H. , Said Zeinab N. , El Ela Abeer M.A. , Abdelmageed Neamat A. 
Published: March 2024

Background
The three doses constituting the hepatitis B (HB) vaccine series administered intramuscularly at birth, 1 month, and 6 months induce a protective antibody response (anti-HBs >10 IU/l) in more than 90% of recipients.

Aim
To analyze the long-term immunity and effectiveness of hepatitis B virus (HBV) vaccination and to detect hepatitis B infection situation and its risk factors among an adequate number of the university students in the postcompulsory infant vaccination period.

Patients and methods
A total of 400 university students (aged 17–25 years) were screened for quantitative detection of hepatitis B surface antibody, hepatitis B surface antigen (HBs Ag), and total hepatitis B core antibody (HBc Ab) using commercially available kits. HBV DNA PCR was evaluated in repeatedly positive HBs Ag and/or total HBc Ab.

Results
Nonprotective titer less than 10 IU/l was detected in 218/400 (54.5%), whereas protective titer more than or equal to 10 IU/l was detected in 182/400 (45.5%). Overall, 29/400 (7.3%) were positive for HBs Ag and 50/400 (12.5%) were positive for total HBc Ab, whereas only six (1.5%) were positive for HBV DNA PCR. Moreover, 45/400 (11.4%) students had a history of HBV vaccine booster dose in the protective group.

Conclusions
Marked reduction in HBs Ab titer was observed among university students where nonprotective titer less than 10 IU/l was detected in 54.5%. Chronic HBV inactive carrier was detected in 5.3%, chronic hepatitis B was detected in 1.5%, and resolved HBV infection was detected in 11%.
Effect of high serum uric acid level on systemic lupus erythematosus manifestations
Authors: Ali Amany F. , El Refaei Khalida E. , Maghraby Hend M. 
Published: March 2024

Background
Systemic lupus erythematosus (SLE) is a chronic, progressive, autoimmune disorder that affects multiple organ systems, with a broad range of clinical and laboratory manifestations. Considering the role of uric acid (UA) as a pro-inflammatory compound in SLE, serum levels of UA and its relation to severity and activity of the disease were assessed in patients with SLE.

Objectives
To evaluate the relation between high serum UA and SLE manifestations and correlate it with the disease activity.

Patients and methods
This study was conducted on 40 patients with SLE fulfilling the 2012 SLICC criteria for SLE classification and 20 sex-matched and age-matched apparently healthy participants as control group. All patients and controls were assessed by full clinical examination and laboratory investigations including serum urea and creatinine, serum lipids, 24-h urinary protein, antinuclear antibody, anti-double-stranded DNA, C3, C4, and serum UA. All patients were assessed for SLE disease activity by the systemic lupus erythematosus disease activity index.

Results
Serum UA was significantly higher in patients with SLE compared with the control group (P<0.001), and there was a significant increase of mean UA level in patients with active SLE (group Ia) compared with patients with inactive SLE (group Ib) (P<0.01). There were significant positive correlations between UA and protein in urine, pulmonary artery pressure, and disease activity in patients with SLE (group I) (r=0.362, 0.372, and 0.650, respectively; P<0.05).

Conclusion
Serum UA was higher in patients with SLE than control and correlated with disease activity, suggesting that it might play a role in SLE pathogenesis and can be used as a marker for SLE activity.
Comparison study between the outcome of laparoscopic and open repair of perforated duodenal ulcer
Authors: Abdelwahed Abdallah , Mashal Anas 
Published: March 2024

Background
Duodenal ulcer perforation is a surgical emergency that may lead to a risk for major morbidity and even mortality. Patient selection criteria are crucial to guide the surgeon in selecting the option of laparoscopic approach for patients with perforated duodenal ulcers. The purpose of this study was to compare the resulting outcomes for laparoscopic and open approaches for the repair of perforated duodenal ulcers.

Patients and methods
A total of 26 patients with perforated duodenal ulcers were included in this study, operated at Alain Hospital and Ain Shams University Hospitals, from June 2013 to June 2016. A total of 13 patients were operated by the laparoscopic approach and 13 patients were operated by the open approach. Follow-up indices such as mean operative time, hospitalization expense, and postoperative pain were included. The main outcomes were immediate surgical postoperative complications, fatalities, and reoperation. Secondary outcomes included operative time, postoperative pain, postoperative hospital stay, and time to resume diet.

Results
There were no major differences in the selected patients between these two procedures in main outcomes including overall surgical efficacy including surgical complication rate and surgery-related deaths. Further analysis of the surgical outcome revealed that laparoscopic repair had less surgical wound complication rate (wound infections and incisional hernias) compared with the open approach. Otherwise both approaches had almost similar rates of leakage, intra-abdominal collections, and ileus and thromboembolic complications. Regarding the secondary outcomes, it was notable that postoperative pain was much less, return to the regular diet was earlier, and hospital stay was decreased in the laparoscopic approach. This remarkable improvement of the secondary outcome attributed to overall patient satisfaction in the laparoscopic approach.

Conclusions
Laparoscopic approach is comparable with the open approach as a modality of repair for perforated peptic ulcer in the properly selected patients. The obvious advantages of laparoscopic surgery are the lower surgical site infection rates, early return to regular diet, shorter hospital stay, early return to work, less postoperative pain, better cosmetic outcome, and improved overall patient satisfaction. However, more studies should be undertaken to further assess the safety and efficacy of laparoscopic repair for peptic ulcer disease in the high risk patients’ category.
Assessment of normal-appearing brain white matter in patients with optic neuritis and multiple sclerosis by magnetic resonance spectroscopy
Authors: Elgezery Mohammed M.A.H. , Ebrahim Essam M. , Shakweer Mustafa M. , Ibrahim Ahmad F. 
Published: March 2024

Background
Multiple sclerosis (MS) is an inflammatory, demyelinating, and neurodegenerative disease of the central nervous system, characterized pathologically by disseminated areas of demyelination and variable degrees of axonal loss and glial scarring. Typical optic neuritis may be associated with MS and is the most common type of optic neuritis. Nonconventional MRI such as magnetic resonance spectroscopy (MRS) has been used to enhance our knowledge of the pathophysiology of MS.

Objectives
To evaluate metabolic changes of brain normal-appearing white matter among patients either presented with optic neuritis alone or those already diagnosed as having MS.

Patients and methods
This is a cross-sectional study that was carried out on 30 patients with MS and 30 patients with typical optic neuritis attending neurology MS clinic of Al Azhar University Hospitals. All patients were subjected to the following: detailed history talking, assessment of disease severity by the Expanded Disability Status Scale, routine laboratory investigations, radiological evaluation (MS protocol), and MRS.

Results
The results of the study revealed significant metabolic changes by MRS in patients with optic neuritis and MS.

Conclusion
MRS provides advanced insights into the pathogenesis of optic neuritis and MS by obtaining information on the microenvironment within the brain. This enhances the understanding of the mechanisms involved in disease progression. MRS opens a window to detect early conversion of patient of the typical optic neuritis into MS.
The role of ultrasonography in evaluation of hand and wrist joints in patients with rheumatoid arthritis
Authors: Saad Asmaa A. , Ali Wafeik E. , Galal Heba M. , Ali Hany M. 
Published: March 2024

Background
Ultrasound (US) has been increasingly applied over the last decade to assess disease activity and the response to therapy in patients with rheumatoid arthritis.

Aim
The aim of the study was to highlights the role of grey scale ad power Doppler ultrasound in evaluation of rheumatoid arthritis diseases in hands and wrist joints.

Patients and methods
This prospective study included a total of 30 patients with rheumatoid arthritis were collected from the Rheumatology outpatient clinic, Al-Hussein University Hospital. This study was conducted between June 2019 to January 2020.

Results
By gray scale ultrasound, synovial thickening was detected in 30 patients (100%), active synovitis detected by using Doppler US in 15 patients (50%), effusion was detected in 20 patients (66.7%), bone erosions were detected in 6 patients (20%) and X-ray finding was detected in 1 patients (3.3%). There is no positive correlation between X ray and any other sonographic nor laboratory finding. On the other hand, a positive correlation between ultrasound detected synovial hypertrophy, joint effusion and power doppler. Also, Power Doppler has a positive correlation with synovial hypertrophy, bone erosions, Erythrocyte Sedimentation Rate and Disease Activity Score.

Conclusion
Grey scale ultrasonography (GSUS) is a reliable technique for assessment of both soft tissue and erosive joint changes occur in early stage in rheumatoid arthritis. Also, power doppler ultrasonography (PDUS) can evaluate synovitis and differentiating between inactive and active synovial hypertrophy.