bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intralesional vitamin D3 vs purified protein derivative in treatment of recalcitrant cutaneous and venereal warts
Authors: Pessar Doaa A.E.-M.H. , Mohamed Asmaa S.F. , Galal Sara A. 
Published: March 2024

Introduction
Human papilloma virus (HPV) can produce a significant amount of anxiety and stress in patients. Many therapeutic options are available for treating warts. More recent and effective treatment, including intralesional immunotherapy, have been tried in the recent times with variable success rates.

Aim
The aim was to compare the efficacy, safety, and the clinical response of intralesional vitamin D3 (Vit D3) vs purified protein derivative (PPD) in the treatment of recalcitrant cutaneous and venereal warts.

Patients and methods
This study was carried out on 30 patients with cutaneous and venereal recalcitrant warts. Fifteen patients (11 patients with recalcitrant cutaneous warts and four patients with recalcitrant venereal warts) were subjected to intralesional injection of Vit D3 in one up to three warty lesions in every patient; the other 15 patients (11 patients with recalcitrant cutaneous warts and four patients with recalcitrant venereal warts) were subjected to intralesional injection of PPD in one up to 15 warty lesions in every patient. Assessment of the results was done by clinical evaluation, patient satisfaction, and multiple digital photographs.

Results
We found that the total response rate to immune therapy was 83.3% in both groups of patients collectively. In the Vit D3-treated group, complete response was achieved in 73.3% of patients and partial response in 26.6%. However, in the PPD-treated group, complete response was achieved in 46.6% of patients, partial response in 20%, and 33.3% of the patients showed no response. The overall clinical response in Vit D3-treated group was significantly higher than in the PPD-treated group (100 vs 66.67%, respectively). We also found that the longer the duration of HPV infection, the poorer the response rate to treatment and the need for more sessions.

Conclusion
Clinical efficacy and safety of intralesional injection of Vit D3 vs PPD for treatment of HPV, the high response rate, the absence of adverse effects, low cost, and the affordability of the Vit D-treated group makes it a very useful tool in the treatment of HPV and is more superior than the PPD.
Expression of TWIST1 and CD44 as diagnostic and prognostic biomarkers in patients with gastric cancer
Authors: El Kholy Marwa A. , El Sayed Hala A. , Ahmed Eman M. 
Published: March 2024

Objective
The aim of this study was to investigate the association of TWIST1 and CD44 in gastric cancer (GC) with clinical parameters and their relation to prognosis, which may be beneficial for targeted therapeutic strategies in the future.

Materials and methods
The material of this work consisted of 40 primary GC specimens from patients who underwent radical gastrectomy. Patients who received neoadjuvant chemotherapy or chemoradiotherapy, those who presented with other cancers at the same time, or the patients with incomplete clinical data were excluded from the study. Hematoxylin and eosin-stained sections from all cases were re-evaluated and further stained immunohistochemically using antibodies against TWIST1 and CD44.

Results
TWIST1 and CD44-positive expressions were significantly increased in GC cases of diffuse type (P=0.019 and 0.002, respectively). Moreover, there was a statistically significant correlation between both markers and tumor grade, stage, and lymphovascular invasion (P=0.027 and 0.010, P=0.002 and 0.012, and P=0.001 and 0.005, respectively). A statistically significant correlation was found between TWIST1 and CD44 expressions in GCs (P=0.000).

Conclusion
The presence of TWIST1-positive carcinoma cells and CD44-positive cancer stem-like cells in GC tissue can be used as a diagnostic tool for GC and regarded as a marker of poor prognosis in patients with GC, which may provide potential targets for GC therapy.
Assessment of growth and nutrition in children with chronic diseases
Authors: Mohamed Walaa E.A. , Fayed Sohier B. , Manalabd-Elsalam  , Abdel-Dayem Soha , Rashad Hend 
Published: March 2024

Background
Growth failure in chronic childhood disease is a multifactorial entity. The nutritional outcome is affected by baseline nutritional status, disease state, and, rarely, an inherent genetic abnormality.

Aim
To assess growth and nutritional status in children with some chronic illnesses, including children with chronic kidney disease on regular hemodialysis and children with type 1 diabetes.

Patients and methods
This case–control study was conducted on 120 children. Their ages ranged from 6 to 18 years. The study was carried out at the nephrology and hemodialysis unit of Al-Zahraa Hospital, Al Azhar University, and at National Research Center. The study population was divided into three groups: group 1 included 40 children with end-stage renal disease on regular hemodialysis, group 2 included 40 children and adolescents with type 1 diabetes, and group 3 included 40 healthy controls of comparable age and sex. The patients were subjected to full medical history; etiology, onset, and duration of disease; and medication regularity. Moreover, selective routine follow-up laboratory investigations were done for patient and control groups in the same line with anthropometric measurements and dietary assessments and were compared regarding their daily recommended diet for each group.

Results
Children on regular hemodialysis consumed fewer proteins, fats, fruits, and vegetables in comparison with their standard dietary recommended daily intake, which was 82.9, 57.9, 70.1, and 33.6%, respectively, with a significant decrease in their anthropometric measurements in comparison with diabetic and healthy groups. Children with type 1 diabetes consume more starches, proteins, and dairy products in comparison with their standard dietary daily intake but consumed less fat, fruits, and vegetables, and they had poor glycemic control and a significant increase in their anthropometric measurements in comparison of those values with available norms. We found a significant positive correlation between starches consumption and anthropometric measurements in type 1 diabetic children.

Conclusion
It is necessary to consider nutritional status in the assessment of the etiology and treatment of growth failure in children on regular hemodialysis. Nutritional policies and nutritional assistance programs and actions must be taken in children with chronic kidney disease to avoid growth failure and in type 1 diabetes to achieve normal glycemia and normal growth.
Effect of recanalization of anterior tibial artery and peroneal artery on targeted angiosomes of posterior tibial artery in the foot through different aspects
Authors: Khedr Alhussein M. , Elimam Sameh E. 
Published: March 2024

Objective
The purpose of this study is to evaluate the outcome of percutaneous transluminal angioplasty of ipsilateral peroneal artery and the anterior tibial artery for revascularization of targeted angiosomes in the vascular territory of posterior tibial artery (PTA) in the foot, through interconnecting branches, and the resulting effect on existing wound healing and limb salvage, in comparison with the effect of percutaneous transluminal angioplasty on PTA alone on revascularization and wound healing in these angiosomes.

Patients and methods
We included 80 patients for 80 angioplasty procedure (80 limbs) who were divided into two equal groups. Group A included patients with peroneal and anterior tibial patent vessel runoff, who were fit for percutaneous transluminal angioplasty for both vessels, whereas group B were candidates for PTA angioplasty. We studied the arterial supply in 80 limbs with TASC C-D lesions with follow-up along 1 year, all with PTA occlusion. Patients with single-vessel or three-vessel runoff were excluded from the study. Outcome measures included wound healing of targeted angiosomes of PTA with complete epithelialization of the affected lesion with or without secondary interventions such as debridement or skin grafting and limb salvage with absence of major amputation.

Conclusions
We found that recanalization of peroneal artery together with anterior tibial artery can supply angiosomes of PTA and accelerate wound healing through communicating branches in the foot with comparable outcome on wound healing and decreased incidence of major amputation to single recanalization of PTA as primary and secondary outcome, obviating the need for lengthy and more risky interventional procedure.
The outcome of oral sildenafil therapy on persistent pulmonary hypertension of the newborn with respiratory distress
Authors: Monazea Esaad M. , Khattab Sahar S. , Ebrahim Asmaa A.W. , Mohamed Layla A. , Ahmed Howayda A.A.R. 
Published: March 2024

Background
Persistent pulmonary hypertension (PPHN) is defined as failure of normal pulmonary vascular adaptation at or soon after birth, resulting in a persistent high pulmonary vascular resistance, which leads to diminished pulmonary blood flow and shunting of unoxygenated blood into systemic circulation through an opened foramen ovale and/or the ductus arteriosus. The prevalence of this syndrome is about 1.9/1000 in the population of neonates born at term.

Objective
The aim was to evaluate the efficacy and safety of oral sildenafil in the treatment of PPHN.

Patients and methods
This prospective interventional study was conducted on 50 neonates who were of more than or equal to 37 weeks gestational age and less than 3 days old and were diagnosed as PPHN by echocardiogram and had an oxygenation index (OI) more than or equal to 20. All included cases were given oral sildenafil as per the study protocol with a starting dose of 0.5–2 mg/kg/dose. OI, oxygen saturation, alveolar arterial oxygen gradient, and mean airway pressure were monitored serially.

Results
This study showed a significant decrease in OI after 30 min of starting treatment and after 24 h of treatment in the studied cases 16.1±1.7 (P=0.010); also, there was a significant decrease in ESPAP? after treatment estimated by ECHO from mean 49.4±5,9 to 42.5±5.7 (P<0.001). Furthermore, this study showed a significant decrease in brain-type natriuretic peptide in studied cases after treatment with sildenafil.

Conclusion
Oral sildenafil may be of benefit in improving oxygenation in infants with PPHN as it can effectively improve OI and reduce right ventricular systolic pressure.
Efficacy of 24-week treatment with sofosbuvir/daclatasvir/ribavirin in chronic hepatitis C virus-infected Egyptian patients with previous sofosbuvir-based treatment failure
Authors: Sabal Aisha A. , Omar Hanaa M.M. , El-Taher Salwa M. , El-Deen Nesreen M.B. , El Kassas Mohamed 
Published: March 2024

Background
Hepatitis C virus (HCV) is a globally prevalent pathogen and a common leading cause of morbidity and mortality. Egypt has the highest HCV prevalence worldwide, with more than 14.7% of the Egyptian adults having been exposed to the virus.

Aim
To evaluate the efficacy of 24-week treatment with sofosbuvir (SOF)/daclatasvir/ribavirin in chronic HCV-infected Egyptian patients with previous SOF-based treatment failure.

Patients and methods
This cohort study was conducted on 247 patients with chronic hepatitis C infection. They all relapsed on SOF-based treatment regimens. Their ages ranged between 22 and 72 years. They were divided according to FIB-4 results into two groups: group I included 132 cirrhotic patients, and group II included 115 noncirrhotic patients. All patients were followed for 24 weeks with liver function tests, complete blood count, and international normalized ratio, and then along with PCR at 4 and 12 weeks after treatment, with recording of adverse events.

Results
Sustained virologic response (SVR) was achieved in 96% of patients. There was a significant improvement of platelet counts, alanine aminotransferase, and aspartate aminotransferase, causing significant improvement in FIB-4 (points from <1.45 to 3.25), APRI score (points from <0.5 to >2), and LOK index (fractions from <0.2 to >0.5), where all significantly declined at SVR 4 and 12. Anemia and hyperbilirubinemia were the most commonly reported adverse events.

Conclusion
The combination of SOF plus daclatasvir with ribavirin for 24 weeks has favorable outcomes with high SVR rates and safety profile in treatment of chronic HCV-infected Egyptian patients who relapsed on SOF-based regimens.
Aldosterone hormone levels in preeclamptic women in comparison with normal pregnancy
Authors: Mahar Aml S.M. , Abdel-Hakam Faiza A. , El Hakim Samia F.A. , El Baky Nashwa M.A. 
Published: March 2024

Objective
To assess the level of aldosterone hormone in preeclamptic pregnant woman and comparing it with normal pregnancy.

Patients and methods
A prospective case–control study that was conducted on 80 pregnant women with gestational age from 28 to 40 weeks and attended Al Zahraa University Hospital, Al Azhar University, in the period from December 2019 to December 2020. The selected participants were divided into two groups: group I (control group) (n=40), which included 40 normal pregnant women, and group II (n=40) (cases group), which is further subdivided into two subgroups: subgroup A (n=20): cases with mild preeclampsia, and subgroup B (n=20) cases with severe preeclampsia. Approximately 5 ml of venous blood was collected once from both study group and control group by antecubital venipuncture, using a sterile disposable syringe, without using elastic band tourniquet. Half of the amount collected was transferred immediately into commercially prepared concentration of ethylene diamine tetra-acetic acid containers. The remaining half was allowed to clot and the serum was obtained by centrifugation at 3000 rpm for 10 min or the remaining investigations including serum aldosterone concentration estimation by enzyme immunoassay.

Results
Regarding the serum aldosterone levels, there was a highly statistically significant difference among control, mild preeclampsia, and severe preeclampsia groups (P=0.003). The mean aldosterone of the study participants was 0.76, with SD of 0.27, and ranged from 0.2 to 1.39 in control group; 0.83, with SD of 0.13, and ranged from 0.59 to 1.06 weeks in mild preeclampsia group; and 1.10, with SD of 0.59, and ranged from 0.65 to 2.88 in severe preeclampsia group.

Conclusion
The aldosterone hormone may play an important role in the pathogenesis of elevated blood pressure in this pathological state and may be used in the prediction of the severity of preeclampsia.
Conservative breast surgery versus modified radical mastectomy in surgical management of early breast cancer
Authors: Ahmed Mostafa A.-E. , Bader Hazem Ahmed , Al Zamek Mona Mohammad Farid , Ali Rasha M.M. 
Published: March 2024

Objectives
To compare the advantages of conservative breast surgery (CBS) to modified radical mastectomy (MRM) regarding the outcome, prognosis, and survival in management of early breast cancer.

Patients and methods
This study included 100 patients attending Al Zahraa University Hospital from March 2016 to February 2019 diagnosed as having early breast cancer (stages I and II breast cancer). Their age ranged from 25 to 60 years old. They were classified into two group: group A, which underwent breast-conservative surgery (n=15), and group B, which MRM (n=85).

Results
The goals of using CBS and radiation therapy to treat patients with early breast cancer (stages I and II) are to provide surgical equivalent to that obtained with MRM. There was only a small risk of recurrence in the treated breast and had satisfactory cosmetic result. The success of CBS depends not only on appropriate patient selection but also on the combination of adequate surgical margins and an acceptable cosmetic result.

Conclusion
Breast-conservative surgery and mastectomy result in nearly equivalent survival rates for patients with stages 0, I, or II disease. The decision to conserve the breast must be made individually.
Serum irisin level and its relation to diabetic nephropathy in patients with type 2 diabetes mellitus
Authors: Salama Doaa M. , Hammad Fatma K. , Mohamed Eman E. , Ahmad Inass H. 
Published: March 2024

Background
Irisin is an adipo-myokine, which has broad implications for metabolism and energy homeostasis. However, evidence about its association with diabetic nephropathy (DN) is limited.

Aim
To evaluate serum irisin level and its relation to DN in patients with type 2 diabetes.

Patients and methods
This case–control study was conducted on 60 patients with type 2 diabetes and 30 healthy age-matched and sex-matched individuals. Patients were divided into three groups according to urinary albumin–creatinine ratio (ACR), namely, normoalbuminuric group, which included 15 patients; microalbuminuric group, which included 30 patients; and macroalbuminuric group, which included 15 patients. Detailed history, clinical examination, and anthropometric measurements were assessed for all participants. Fasting blood glucose and 2-h postprandial blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, urea, creatinine, uric acid, estimated glomerular filtration rate, and irisin were measured for all participants. Glycosylated hemoglobin and urinary ACR were measured for patients only.

Results
Irisin was significantly lower in diabetic groups compared with controls. Irisin was positively correlated with estimated glomerular filtration rate but negatively correlated with fasting blood glucose, creatinine, and ACR. Multivariable regression analysis revealed that lower irisin level was considered as an independent predictor for DN.

Conclusion
Serum irisin is significantly related to diabetic kidney disease, and it might be progressively decreasing with development of the different stages of DN.
Comparative study between sleeve gastrectomy and gastric bypass in morbid obese patient
Authors: Abdel-Razik Mahmoud A.A. , Rabia Omnia M. , El Menem Mohammed Hany A. 
Published: March 2024

Background
Morbid obesity is associated with many comorbidities. Our aim was to evaluate the reduction in weight and resolution of comorbidities after sleeve gastrectomy (SG) and gastric bypass operation.

Aim
To evaluate SG versus gastric bypass in morbid obese patient.

Patients and methods
A prospective review was conducted on patients who underwent SG and Roux-en-Y gastric bypass from 2015 to 2019 at General Surgery Department in Al-Zahraa University Hospital for Girl, Egypt. Outcomes include weight loss; improvement or resolution of comorbidities such as hypertension, type 2 diabetes, and hyperlipidemia; and postoperative complication at 12 months.

Results
A total of 50 patients met our inclusion criteria. Mean preoperative weight and BMI were 136.54±20.92 and 48.78±7.08, respectively. At 12 months, mean weight and BMI were 85.98±10.22 and 33.94±2.60, respectively. There was marked improvement or resolution of hypertension, type 2 diabetes, and hyperlipidemia.

Conclusions
SG and Roux-en-Y gastric bypass result in marked weight loss and improvement or resolution of comorbidities in morbidly obesity patients.
Tragal cartilage versus tragal perichondrial graft in tympanoplasty type 1
Authors: Hasan Manar I. , Mekhemer Sayed M. , Ibraheim Huda A. , Mohamed Bothina A. 
Published: March 2024

Background
Chronic suppurative otitis media is a common health problem. It causes tympanic membrane perforation, otorrhea, and conductive hearing loss. Type 1 tympanoplasty is a common otological procedure done to eliminate the infection and improve hearing and quality of life.

Objective
To compare graft uptake and hearing outcome using autologous grafts (tragal cartilage, temporalis fascia (control group), and tragal perichondrium) in tympanoplasty type 1.

Patients and methods
A total of 45 patients with chronic suppurative otitis media were included in this comparative study. They were divided into three groups, with 15 patients in each group: group A received tragal cartilage graft, group B received temporalis fascia graft (control group), and group C received tragal perichondrial graft. Patients were subjected to detailed history taking, proper clinical examination, routine blood investigations, audiometry, and tympanometry preoperatively. They underwent underlay tympanoplasty type 1. Postoperative follow-up was done after 3 months by otoscopy to evaluate graft uptake and hearing outcome by audiometry, and results were compared.

Results
Graft uptake was 93.3% in the cartilage group, 73.3% in fascia (control) group, and 66.7% in perichondrium group. There was hearing improvement in cartilage group than fascia (control) group, which was better than perichondrium group, with no statistically significant difference among the three groups regarding graft uptake (P=0.188) or hearing gain.

Conclusion
Graft uptake and hearing improvement were better with tragal cartilage graft in comparison with fascia (control group) and perichondrium grafts, with no statistically significant difference between them.
Architect HCV Ag assay is an efficient alternative tool to RNA qRT-PCR quantification for assessing viral load in HCV infection
Authors: El-Hassan Ahmed Abd El-Aleem Abue , Abdallah Mohamed Gaber , Azab Mohammed Mohammed , Hassan Tarek A. , Atta Abd-ElHameed , Elsawy Mohamed Abdelhamed , AboElenin Mabrouk M. 
Published: March 2024

Objective
To evaluate the performance characteristics of the automated Architect hepatitis C virus (HCV) core Ag assay versus HCV RNA by PCR among Egyptian patients and to assess its use for valuable clinical workup.

Background
HCV diagnosis by conventional anti-HCV assays has high rate of false positivity, false negativity, and a limited sensitivity for detection. Although HCV RNA assays are a reliable method for HCV diagnosis, they need technical skills and may also have false-positive results because of contamination. Moreover, the test is time consuming and more expensive. In contrast, the HCV core antigen test detects circulating HCV core antigen and identifies individuals who are actively infected with HCV. A commercialized test (the Architect HCV core antigen test) is supposed to have a sensitivity to detect ∼0.06 pg/ml and consequently a significant increase in sensitivity over the previous assay and a stronger correlation with HCV RNA testing.

Patients and methods
A descriptive, cross-sectional study was conducted on 60 HCV antibody-positive patients attending the outpatient clinic of Tropical Medicine Department, Al-Hussein University Hospital, Cairo, Egypt. The patients were classified into four groups based on the level of HCV viremia: group A included five patients with PCR below detection limit (12 IU/ml), group B included 39 patients with low viremia (<100 000 IU/ml), group C included 13 patients with moderate viremia (100 000–10 000 000 IU/ml), and group D included three patients with high viremia (>10 000 000 IU/ml). Each case was subjected to thorough clinical evaluation, HCV RNA quantification by Abbott Real Time HCV assay, and HCV Ag quantification by Architect HCV core antigen test.

Results
HCV Ag was found to be negative only in five of 55 HCV RNA-positive patients who had low level of viremia. The levels of HCV Ag showed a good correlation with those from the HCV RNA quantification (r=0.913, P≤0.001). Regarding HCV core antigen/HCV RNA ratio, it was not fixed for all patients. In most of them, each 1 pg/ml core Ag was equal to ∼10 000 IU/ml of RNA.

Conclusion
The Architect HCV Ag assay could be used as an alternative tool to HCV RNA PCR quantification in assessing viral load in HCV infection, and it has the advantages of lower cost, easy testing, and rapid reporting.