bluuebunny/crossref_metadata_2025_split huggingface dataset:
Updates in evaluation of optic nerve head in patients with multiple sclerosis
Authors: Abdel Ghany Mai E. , Abd Allah Ahmed S. , Kamel Rehab M. , El Sharkawy Rasha E. 
Published: March 2024

Background
The most common demyelinating disease of the central nervous system is multiple sclerosis (MS), which is considered an acquired chronic progressive inflammatory process. Overall, 25% of the patients have an optic neuritis (ON) as a first neurological presentation.

Aim
To evaluate optic nerve head microcirculation in patients with MS without ON by using an optical coherence tomography angiography (OCTA).

Patients and methods
Our prospective study included 50 patients divided into two groups: patient group, which included 25 patients with relapsing-remitting MS without ON, and control group, which included 25 healthy participants matched with patient group regarding age and sex.

Results
The mean for average ganglion cell complex, average retinal nerve fiber layer thickness, and whole image retinal peripapillary capillary density % was 84.56±15.60, 80.64±21.89, and 46.42±5.48, respectively, for the patients group, whereas it was 95.84±5.13, 105.56±4.27, and 50.72±2.93, respectively, for the control group, and the differences between the two groups were highly statistically significant.

Conclusion
Significant decreases in vessel density and perfusion of optic nerve vasculature are evidenced in OCTA in patients with MS without ON in comparison with the normal control. So, OCTA is considered a promising paraclinical technology that can aid in early diagnosis of ON in MS for better management.
The effect of multiple sclerosis on retinal nerve fiber layer in eyes without history of optic neuritis
Authors: Azim Ghada S.A. , El-Haddad Nermien S. El-Dien Mohammed , Osman Marwa A. 
Published: March 2024

Background
Multiple sclerosis (MS) is a disabling disease that is characterized by an axonal damage in the central nervous system, leading to progressive neurologic deficits. Evidence indicates that axonal damage occurs already in the early stages of the disease.

Objective
To discover the ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) changes using optical coherence tomography in patients with early relapsing-remitting MS [expanded disability status scale (EDSS)<3] and their relation to the degree of disability and duration of the disease.

Patients and methods
Overall, 48 eyes of 24 patients with relapsing-remitting MS [31 eyes without history of optic neuritis (ON) and 17 with history of ON] were scanned by using optical coherence tomography and compared with 12 eyes of six age-matched and sex-matched healthy participants. Full history taking and neurological and ophthalmological examination was done. In addition, assessment of disability by EDSS was done for patients.

Results
Both total and sectorial RNFL thickness were significantly decreased in affected eyes (with ON) and nonaffected eyes in comparison with control eyes; however, RNFL thickness (average and sectorial) was not significantly correlated with duration of the disease or disability assessed by EDSS. In contrast, superior and inferior GCC thickness was significantly correlated with EDSS, although they were not significantly decreased in nonaffected eyes in comparison with control eyes.

Conclusion
RNFL thinning takes place without a historical record of ON and may be considered as a chronic optic neuropathy in patients with MS. GCC thickness is perhaps a reliable marker for indicating progression of disease.
Endothelial dysfunction as an early marker for cardiovascular disease in patients with chronic kidney disease on maintenance hemodialysis
Authors: Abo Alia Mona M.S.A.E. , El-Wakil Hala S. , Abou Zeid Abla A. , Ahmad Lamia I. , Emara Doaa M. , Mohamed Ragaa R. 
Published: March 2024

Background
Cardiovascular disease is a major cause of mortality in dialysis patients. Magnesium (Mg) level has been found to correlate positively with endothelial function. Moreover, it is suggested that low Mg is associated with increased all-cause and cardiovascular mortality in hemodialysis (HD) patients.

Objective
Therefore, this study was conducted to define the relationship between Mg level and endothelial dysfunction as an early marker of cardiovascular disease in patients with end-stage renal disease (ESRD) on maintenance HD.

Patients and methods
In this cross-sectional study, 85 patients with ESRD on maintenance HD were included. Serum angiopoietin-2 (Ang-2) level, brachial flow-mediated dilation (BFMD), and carotid intima-media thickness (CIMT) were measured as indicators of endothelial dysfunction and atherosclerosis. Patients’ serum Mg levels were measured. All data are presented as mean and SD or percent frequency. Statistical tests, mainly t test, Mann–Whitney test, or χ
2 test, are used in comparison between groups for quantitative and qualitative data correspondingly.

Results
Our results indicate that Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients (P=0.036 and 0.006, respectively). When the patients were divided according to their serum Mg, there was no significant difference regarding Ang-2, BFMD, and CIMT between the two groups.

Conclusion
This study demonstrated that endothelial dysfunction markers such as Ang-2 and BFMD are associated and can predict atherosclerosis early in HD patients. On the contrary, Mg might not affect neither endothelial function (FMD and Ang-2) nor CIMT as a marker of atherosclerosis in ESRD on HD.
Plasma homocysteine levels in polycystic ovarian syndrome with early recurrent pregnancy loss
Authors: Elhamid Shymaa A.A. , Hanafy Madiha M. , Elwahed Rania M.A. 
Published: March 2024

Background
A pregnancy loss (miscarriage) is defined as the spontaneous demise of a pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses (PLs) from the time of conception until 24 weeks of gestation. Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women in which levels of the sex hormones are disrupted. Hyperhomocysteinemia has been associated with clinical vascular thrombosis, and this could be the cause for early decidual and chorionic vessel damage that might result in disturbed implantation of the conceptus.

Objective
To determine the plasma homocysteine levels in patients with PCOS having recurrent pregnancy loss (RPL) compared with women with PCOS without RPL.

Patients and methods
This is a case–control study on 30 women with PCOS with RPL and 30 control women with PCOS without RPL. Plasma homocysteine levels were assessed from February 2019 to February 2020 at Al Zahraa University Hospital.

Results
There was a significant increase in the mean homocysteine level in the case group (20.14±3.21) compared with controls (9.01±2.24) (P=0.001), with odds ratio=2.193 (confidence interval 0.171–23.294) by homocysteine through cut-off more than 12 mmol/l.

Conclusion
Risk of RPL in patients with PCOS is increased with hyperhomocysteinemia (P<0.001).
Occult hepatitis B virus among patients with chronic hepatitis and hepatocellular carcinoma
Authors: Naeima Khodeir A. , Eman Abd-El-Samae M. , Dina Aly R. , Ola El-Moatassem M. 
Published: March 2024

Background
Hepatitis B virus (HBV) infection is diagnosed when the circulating HBV surface antigen (HBsAg) is serologically detected. Occult HBV infection is defined as the infection state negative for HBsAg serology, but it has shown viral genome persistence in infected individuals. The aim of the study is to determine the prevalence of occult HBV among patients with chronic hepatitis negative to HBsAg in the presence or absence of hepatitis C virus (HCV) infection.

Patients and methods
This study was conducted on a total number of 55 patients with chronic hepatitis (liver cirrhosis in 44 cases, nonalcoholic fatty liver in six cases) and hepatocellular carcinoma in five cases. All studied cases were subjected to routine liver function tests, HBsAg, HBsAb, hepatitis c virus immunoglobulin G (HbcIgG), α-fetoprotein, HCV RNA, and HBV DNA detection.

Result
All cases were negative to HBsAg and HBsAb in the presence or absence of HCV infection. HBV DNA detection by real-time RT-PCR confirmed the positivity of HBV infection [occult hepatitis b infection (OBI)] in two (4.5%) out of 44 cases of cirrhotic liver and represented 3.6% of the total cases studied with a viral DNA of 116 and 159 copies/ml, respectively. One case of OBI had a high level of α-fetoprotein (392 Iu/ml) and the second case had high copies of HCV RNA 127 000 copies/ml, that is coinfection. HbcIgG was positive in 31.8% in cirrhotic patients (including one out of the two positive OBI). HCV RNA was negative in 100.0% of nonalcoholic fatty liver, positive in 39 (one was positive OBI) cases with cirrhosis with a median value of 45 000 copies and in four out of the five hepatocellular carcinoma cases with a median value of 1.85E+08. This is statistically significant (P=0.01). We come to the conclusion that occult HBV do exist in our community. The diagnosis of OBI should be based on high sensitivity of HBsAg and HBV DNA testing.
The effect of laparoscopic sleeve gastrectomy on hemoglobin, calcium, and lipid metabolism
Authors: Hassan Sayed Eslam H. , Mostafa Elsayed A. , Futooh Zahraa 
Published: March 2024

Background
Obesity is great health problem facing a large section of the population, being associated with many complications. Sleeve gastrectomy is one of the most popular, safe, and easy surgical ways for weight loss, though some nutritional deficiencies occur after removal of a large part of the stomach.

Objective
This study is designed to assess the effect of laparoscopic sleeve gastrectomy on blood hemoglobin, lipid profile, and calcium levels.

Patients and methods
This is a retrospective clinical trial conducted in Al-Zahraa University Hospital and Ahmed Maher Teaching Hospital that involved 40 patients who underwent sleeve gastrectomy 1 year ago. The data were collected during the period from October 2018 till November 2019, assessing hemoglobin, serum calcium, and lipid profile preoperatively and after 1 year postoperatively.

Results
There are decreases in postoperative laboratory results, as the mean of hemoglobin decreased from 11.61 to 11.54, serum calcium from 9.08 to 8.88, total cholesterol from 202.25 to 168.10, and triglycerides from 208.62 to 160.90, with a statistically significant difference regarding serum calcium, total cholesterol, and triglycerides (P=0.004, P<0.001, and P<0.001, respectively).

Conclusion
There is no significant decrease of hemoglobin level with minimal decrease in serum calcium level with supplements and significant decrease in lipid profile after 1 year of laparoscopic sleeve gastrectomy.
Biosynthesis of silver nanoparticles and study of their activities against drug-resistant pathogenic organisms
Authors: Ali Asmaa R. , Anani Haneya A.A. , Selim Fatma M. 
Published: March 2024

Objective
To determine biosynthesis of silver nanoparticles (AgNPs) by different bacteria and Aspergillus species and to study the effect of these prepared AgNPs alone and in combination with selected antimicrobial agents against resistant bacteria and Candida.

Methods
AgNPs were synthesized using different bacterial isolates (Bacillus cereus, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, and Aspergillus niger). AgNPs were characterized by ultraviolet/visible spectrophotometer, transmission electron microscopy, scanning electron microscope, and energy-dispersive radiograph spectroscopy analysis. Antimicrobial activity of biosynthesized AgNPs was assessed alone and in combination with antimicrobial agents against resistant bacteria and Candida. Cytotoxicity assay of biosynthesized AgNPs was also assessed.

Results
The AgNPs thus obtained were confirmed through observed color change, and their evaluation using ultraviolet/visible showed the highest optical density at 410–430 nm wavelength. Transmission electron microscopy and scanning electron microscope showed that the small particle size ranged and strong signal was detected by the energy-dispersive radiograph spectroscopy analysis. Antimicrobial efficacy was increased in combination with biosynthesized AgNPs (P<0.001). There was low cytotoxic activity of B. cereus AgNPs on Medical Research Council cell strain 5 (MRC-5) cells.

Conclusion

B. cereus-biosynthesized AgNPs have the best antimicrobial effect against resistant bacteria and Candida, in addition to their low cytotoxicity effect on normal cells.
Three-dimensional hemodynamic study of carotid bulb in patients with evolving stroke
Authors: Sakr Ahmed K. , Sadek Yahia K. , Mostafa Alsayed A. , Abdel Wahab Maisa A. 
Published: March 2024

Objectives
Determining carotid stenosis severity, monitoring of carotid plaque, and identification of vulnerable plaques are important in identifying patients who would benefit from carotid endarterectomy (CEA). Our work aimed to evaluate the role of three-dimensional (3D) hemodynamic study in patient with evolving stroke.

Patients and methods
The study enrolled 20 patients diagnosed with forebrain stroke selected from our university hospital from March 2017 to February 2019. The severity of stenosis and the length and type of plaques were quantified by 3D ultrasound (US). Overall, 17 patients underwent CEA. The follow-up after operation was done by 3D US with measuring the free lumen area and the operated artery.

Results
There are significant increases in postoperative peak systolic velocity and free lumen area in all patients with stenosis or occlusion, with P value 0.001 and 0.0001, respectively, in most critical cases of the soft plaques. Moreover, there is a higher significant P value (0.003) regarding peak systolic velocity related to carotid end-arterectomy (CEA) with patching than nonpatching.

Conclusion
3D US imaging is a recent tool for improving the visualization and quantification of complex anatomy and pathology as well as monitoring progression of atherosclerosis.
Intrathecal versus intravenous infusion of dexmedetomidine during subarachnoid block in lower abdominal surgeries
Authors: Ashour Fatma H. , Abdellah Asmaa S. , Sayed Ruqaya Mohamed El 
Published: March 2024

Background
Adjunct analgesic strategy is an alternative to prolong the analgesic duration and decrease the potential risk of side effects. The objective of this study was to evaluate the efficacy of dexmedetomidine as an adjuvant to subarachnoid anesthesia during lower abdominal surgeries compared with dexmedetomidine intravenous infusion.

Patients and methods
Forty patients, classified as American Society of Anesthesiologists I and II patients, aged 20–50 years, undergoing elective lower abdominal surgeries, were randomly allocated into two equal groups. Group I (n=20) consisted of patients who received intrathecal 0.5% hyperbaric bupivacaine 15 mg (3 ml)+dexmedetomidine (10 µg) for subarachnoid block. Group II (n=20) consisted of patients who received intravenous infusion of dexmedetomidine 0.5 μg/kg/h (without loading) after subarachnoid block. The onset and duration of sensory and motor block, the hemodynamic effects, the duration of analgesia and the incidence of side effects were recorded. Interleukin-6 level was estimated.

Results
Hemodynamic data were comparable between both groups. The mean time taken for the sensory block to reach T10 dermatome and motor block to reach B3 was significantly fast in group I as compared with group II. The time for two segment regressions and regression of sensory block to S2 dermatome and B0 motor block were significantly prolonged in group I compared with group II. The time to first rescue analgesic was prolonged, and the amount of analgesic/24 h was decreased significantly by the addition of dexmedetomidine to bupivacaine. Ramsay sedation scores were highly significant, being higher in group II. The level of interleukin-6 and the incidence of side effects were significantly lower in group I compared with group II.

Conclusion
In lower abdominal surgery, the use of intrathecal dexmedetomidine as an adjuvant to local anesthesia provides good motor and sensory blockade and is associated with mild sedation, decreased incidence of side effects, and inflammatory response compared with intravenous infusion.
Evaluation of plasma fibrinogen and plasminogen activator inhibitor- 1 in type 2 diabetes mellitus patients with coronary artery disease
Authors: El Sayed Zeinab H. , Ismail Sahar Mohamed , ELhakeem Heba A. 
Published: March 2024

Introduction
Coronary artery disease (CAD) remains the main cause of death in patients with type 2 diabetes mellitus (T2DM). It is more extensive and diffuse in diabetics in spite of antiplatelet therapy. Hence, the prevention and the early diagnosis of CAD among patients with T2DM are very important. There is a variety of hemostasis abnormalities in T2DM. Therefore, fibrinogen and plasminogen activator inhibitor-1 (PAI-1) may have a link between T2DM and CAD.

Aim
The aim was to evaluate the plasma fibrinogen and PAI-1 levels in some Egyptian patients with T2DM with and without CAD.

Patients and methods
A total of 30 Egyptian patients with T2DM attending the Internal Medicine Department of Al Zahraa Hospital were included in this study. Their ages ranged between 31 and 54 years. Based on ECG changes and echocardiography, the patients were divided into the following: 15 who had CAD and 15 without. Another 15 apparently healthy participants were enrolled as a control group. Blood samples were analyzed for routine blood tests, fasting lipid profile, renal function, liver function, glycosylated hemoglobin, plasma fibrinogen, and PAI-1, which was measured by enzyme-linked immunosorbent assay.

Results
Plasma fibrinogen and PAI-1 were significantly higher in Egyptian patients with T2DM with CAD than those who had only T2DM, and both markers were higher in Egyptian patients with T2DM than healthy controls. Fibrinogen and PAI-1 levels were positively correlated with glycosylated hemoglobin in Egyptian patients with T2DM.

Conclusion
Egyptian type 2 diabetic patients with T2DM are prone to develop CAD more often than not owing to increase in plasma fibrinogen and PAI-1 levels; therefore, we can give a small dose of anticoagulant for all patients with T2DM.
The relationship between Helicobacter pylori infection and control of type 2 diabetes mellitus
Authors: Eisa Shimaa Y. , Ahmed Karima Y. , El Sayed Wagenat E. 
Published: March 2024

Backgrou
nd Dyspepsia is a common symptom with a heterogeneous pathophysiology. It occurs in at least 20% of the population. Helicobacter pylori is one of the most common human bacterial pathogen that is present in ∼50% of the global population. It normally is a resident of gastric epithelium. Type 2 diabetes mellitus (T2DM) is a major public health problem, with increasing prevalence globally. It is a metabolic disorder that occurs owing to insulin resistance and relative insulin deficiency.

Objectives
To study the association between H. pylori infection and T2DM and glycated hemoglobin (HbA1c) and comparing it with nondiabetic patients.

Patients and methods
This cross-section study was conducted on 60 patients with age more than or equal to 35 years, of either sex, with history of dyspepsia. There were 20 (33%) males and 40 (67%) females, and their ages ranged between 35 and 62 years, with mean age of 46.5±9.15 years. They were divided into two groups of patients: group I included 30 patients with T2DM, and group II included 30 nondiabetic patients. Patients in group II are subdivided into two groups (according to HbA1c results): group IIA (prediabetic) included 13 patients, and group IIB (nondiabetic) included 17 patients.

Results

H. pylori infection is significantly associated with T2DM, and the incidence of H. pylori in type 2 diabetic patients was significantly higher than nondiabetic patients. H pylori infection is significantly associated with HbA1c level, and HbA1c in H. pylori-positive group was significantly higher than H. pylori-negative group. Moreover, H. pylori infection is significantly associated with prediabetes, and the incidence of H. pylori in prediabetic patients was significantly higher than nondiabetic patients.

Conclusion
The incidence of H. pylori infection was significantly higher in T2DM and prediabetes than nondiabetic patients. Moreover, H. pylori was significantly associated with increased HbA1c level. Further studies are needed to evaluate the effect of H. pylori eradication in glycemic control of T2DM and prediabetes and the effect of glycemic control on reinfection with H. pylori.
Evaluation of early complications after laparoscopic sleeve gastrectomy for the treatment of morbid obesity
Authors: Abdel Razek Mahmoud Abdella , Rabie Omnia Mohamed H. 
Published: March 2024

Background
Laparoscopic sleeve gastrectomy (LSG) nowadays is one of the most popular operations for the treatment of morbid obesity. It has good effect in weight reduction and has less complications. The most common complications include leakage, hemorrhage, splenic injury, gastric stenosis, and gastroesophageal reflux.

Aim
To evaluate our experience in LSG in the management of morbid obesity as regards intraoperative and early postoperative complications.

Patients
and methods One hundred and fifty patients with morbid obesity and/or obesity-related comorbidities were included in this study. Their BMI range from 35 to 60 kg/m2 and were managed at Al-Zahraa University Hospital from July 2015 to June 2018. Preoperative demographic data, operative procedure, intraoperative, and short-term follow-up results of LSG are analyzed.

Results
LSG was performed successfully on 149 cases while conversion to open was done in one case due to intraoperative bleeding. The mean operative time was 105±25 min. The mean postoperative hospital stay was 4 days (3–10 days). There was no intraoperative mortality but in two cases mortality was recorded in the postoperative period. Hemorrhage in 1.3%, leakage in 2%, and other complications such as vomiting in three cases and pulmonary embolism in one case were recorded.

Conclusion
LSG safe operation in the management of morbid obesity and the hazards of its complications can be avoided if diagnosed early and managed well. Leakage is the most serious complications which may end by death if not probably treated.
Comparative study between open preperitoneal mesh and Lichtenstein's mesh in inguinal hernia repair
Authors: Hefida Mohamed G. , Razek Mahmoud A.A. , Youssef Hoda A.A. 
Published: March 2024

Background
There is still a great debate regarding the optimal approach for inguinal hernial repair.

Objective
This study aims to compare between the preperitoneal and Lichtenstein approaches in the management of inguinal hernias.

Patients and methods
We included 50 cases that were randomly divided into two groups: the first group included 25 cases that underwent the preperitoneal repair, whereas the other group included the remaining cases that underwent Lichtenstein repair.

Results
Intraoperative bleeding was encountered more in the preperitoneal group. Regarding complications, seroma and scrotal edema were encountered more in the Lichtenstein group (P<0.05). Moreover, chronic inguinal pain was more prevalent in the same group.

Conclusion
Preperitoneal mesh repair offers more advantages over Lichtenstein repair, especially regarding seroma, scrotal edema, and chronic inguinal pain.