bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interpretation of conventional magnetic resonance imaging with diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient map in characterization of uterine adnexal lesions
Authors: Abdelrahman Sarah A. , Abdullatif Nahed A. , Elfeshawy Mohamed S. 
Published: March 2024

Background
Diffusion-weighted imaging (DWI) is one of the promising new functional imaging techniques that have shown to be effective in the differentiation of benign from malignant adnexal masses.

Patients and methods
This prospective study was conducted on 21 female patients with 25 adnexal masses based on pelvi-abdominal or trans-vaginal ultrasound study. The study was conducted during the period from September 2019 to March 2020 at the Radiology Department and approved by the ethics committee, and all patients gave their informed consent before inclusion in the study. Pelvic MRI with DWI was performed for all cases. The radiological and histopathological results were collected and then analyzed using a specialized computer statistical program.

Results
Among the 25 ovarian masses included in our study, 80% (20/25) were benign and 20% (5/25) were malignant according to histopathological results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI have been increased from 80, 75, 44, 94, and 76%, respectively, for conventional MRI to 100, 90, 71, 100, and 92%, respectively, for DWI.

Conclusion
Combination of DWI and conventional MRI provides an effective noninvasive technique for assessment of the adnexal masses. It improves the sensitivity and specificity of MRI and thus increasing radiologist's confidence in image interpretation which will finally reflect on patient's outcome and prognosis.
Vitamin D status in Egyptian young children and its correlation with iron deficiency
Authors: Menazie Esaad M. , Okda Heba T. , El Tabiey Noha M. , Kamel Noha M. 
Published: March 2024

Background
Vitamin D deficiency (VDD) and iron deficiency are two common nutritional problems and cause a variety of health issues in children even if they are asymptomatic. The potential relationship between the two remains poorly understood.

Propose
To study the status of vitamin D in Egyptian young children and its correlation with iron deficiency.

Patients and methods
This cross-sectional study included 85 apparently healthy Egyptian children between 6 and 9 years old randomly selected from pediatric outpatient clinic of General Port Fouad Hospital, Port Said City, in the period from July to November 2019. A written informed consent was taken from all participants’ parents after proper explanation of the study. All children were subjected to complete history taking, anthropometric measurements, systemic examination, and laboratory investigations, including complete blood count, serum vitamin D level, serum iron, and ferritin level, which were performed for children expected to have iron deficiency through red blood cells indices in complete blood count.

Results
A total of 85 patients (age, 7.36±1.1 years; male to female ratio was 1 : 1) were classified according to their 25-hydroxyvitamin D levels into three groups: VDD 40% (<20 ng/ml), vitamin D insufficiency 40% (20–29 ng/ml), and vitamin D sufficiency 20% (≥30 ng/ml). Of 24 suspected iron-deficient cases, 80% of them were in the VDD+insufficient vitamin D groups compared with 20% in the sufficient group (P<0.001).

Conclusion
Among the apparently healthy young Egyptian children, VDD is common with increased risk of iron deficiency. There is a significant positive correlation between vitamin D level and age, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and serum iron levels but not with serum ferritin level. Physicians should therefore ensure that vitamin D levels are evaluated in anemic children and provide adequate supplementation to prevent deficiencies of both nutrients.
Outcome of limb salvage in single peroneal versus other tibial revascularization in infra-popliteal arterial disease
Authors: Abdelhafez Abdelaziz A. , Shalamesh Mohamed , Amin Mohammed A. 
Published: March 2024

Background
The importance of the angiosome concept in critical limb ischemia remains controversial. The peroneal artery is relatively spared from the terminal stages of atherosclerosis and is often the last tibial vessel to become occluded in diabetes or end-stage vascular disease. The main prejudice, on the contrary, against its use in distal revascularizations is that the perfusion of the foot is indirect, via collaterals from its anterior and posterior branches, despite an extensive collateral arterial bed, so the target vessel may be inadequate for treating a septic or gangrenous foot. The value of peroneal artery revascularization has always been debatable, especially in patients with tissue loss. As one of the most important factors of wound healing is the establishment of in-line flow to the foot, the role of peroneal angioplasty has to be defined. The aim of this retrospective study was to assess the outcomes of single peroneal indirect revascularization (IR) (nonangiosome-targeted tibial angioplasty) versus other tibial direct revascularization (DR) (angiosome-targeted), in infra-popliteal arterial disease.

Patients and methods
Thirty patients were included and presented to the Vascular Surgery Department of Al-Azhar University Hospitals and El araby Specialized Hospital, Menoufia with infra-popliteal arterial lesions, distributed into two equal groups: 15 patients were treated with single peroneal IR, while 15 patients were treated with other tibial DR during the period from June 2019 to June 2019.

Results
Fifteen patients reached the endpoint of adequate healing (nine patients with ‘DR’ technique and six patients with ‘ID’ technique) and nine patients underwent major amputations. The limb salvage after 1 year was 70%.

Conclusion
DR of tibial vessels appears to improve wound healing and limb salvage rates compared with IR, with no effect on patency, morbidity, mortality, or reintervention rates.
Association between serum apolipoprotein B and diabetic retinopathy in type 2 diabetic patients
Authors: Yousef Aya M. , Hammad Fatma K. , Abdelrahman Heba M. , Mohammed Shaymaa A. , Ahmad Inass H. 
Published: March 2024

Background
Diabetic retinopathy (DR) is a major microvascular complication of diabetes.

Aim of the work
To study the association between serum apolipoprotein B (Apo-B) and DR in type 2 diabetes.

Patients and methods
This comparative study was conducted on 75 patients with type 2 diabetes recruited from the Endocrinology and Ophthalmology Departments of Al-Zahraa University Hospital. They were divided into three groups according to DR grading: group A included 31 patients without DR, group B included 27 patients with nonproliferative DR, and group C included 17 patients with proliferative DR. Detailed history, clinical examination, and anthropometric measurements were assessed for all selected patients. Fasting and 2-h postprandial blood glucose levels, glycosylated hemoglobin, total cholesterol (CHO), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and Apo-B were measured. Fundus examination was done for all participants.

Results
CHO, TGs, LDL-C, and Apo-B were statistically significantly higher in group C followed by group B and then group A. However, HDL-C was statistically significantly lower in group C followed by group B and then group A. A significant positive correlation was found between DR on one hand and age, diabetes duration, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, CHO, TGs, LDL-C, and Apo-B on the other hand. DR correlated negatively with HDL-C.

Conclusion
Serum Apo-B levels may be a strong biomarker for DR than traditional lipids.
Direct detection of Acinetobacter baumannii by loop-mediated isothermal amplification in patients with respiratory tract infection
Authors: Khirala Seham K. , Elthoqapy Azza A. , Awad Ragaa A. , Badr Gamal A. 
Published: March 2024

Background
Rapid detection and treatment of Acinetobacter baumannii which is a health-care-associated pathogen that causes outbreaks and frequently encountered in ICU patients on mechanical ventilation is very important.

Aim
The present study aimed to detect the frequency of A. baumannii in sputum sample by loop-mediated isothermal amplification (LAMP) assay in comparison with the different culture methods.

Patients and methods
In all, 200 sputum samples and 100 tracheal aspirates (TA) were included to detect the frequency of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, A. baumannii, Pseudomonas aeruginosa, and Enterobacter spp. (ESKAPE) pathogens by cultural methods and to detect A. baumannii from sputum sample by LAMP assay comparing its results with CHROMagar Acinetobacter and conventional culture methods referring to the rate of multidrug-resistant A. baumannii.

Results
By conventional culture, positive culture was reported in 228/300 (76%) of all samples. A. baumannii and Klebsiella spp. were the most identified pathogens as they were detected in 27/145 (18.6%) and 19/145 (13%) of sputum samples and 19/83 (22%) and 43/83 (51.8%) of TA. Regarding culture on CHROMagar 46 isolates were identified as A. baumannii, 27 were from sputum sample, and 19 from TA. Out of 46 A. baumannii isolates multidrug-resistant A. baumannii were detected in 9/27 (33.3%) and 15/19 (78.9%) in sputum samples and TA, respectively. DNA of A. baumannii was detected in 28/200 (14%) by LAMP assay from sputum samples. Sensitivity and specificity of LAMP assay were 100 and 99.5% when compared with the conventional culture.

Conclusion
CHROMagar Acinetobacter and LAMP assay are cost-efficient methods in comparison to conventional culture. LAMP assay is distinguished from the others for its simplicity and rapid detection of pathogens.
Evaluation of carotid intima-media thickness and serum homocysteine level as markers of subclinical atherosclerosis in lichen planus
Authors: Omar Nouran , El-Barbary Rasha , Maghraby Hala , Alhabibi Alshaymaa M. , Abd-Elhafeez Hala 
Published: March 2024

Background
Lichen planus (LP) is a chronic mucocutaneous inflammatory disease. Its etiology remains unknown and may be caused by a cell-mediated immunological response, where autoreactive cytotoxic T lymphocytes are the effector cells, which cause degeneration and destruction of keratinocytes. Inflammation produces disturbances of lipid metabolism such as serum increase of triglycerides or decrease of high-density lipoprotein. Hyperhomocysteinemia has been regarded as a new modifiable risk factor for atherosclerosis and vascular disease. Homocysteine increases the damage to the cardiovascular system in different ways. It is widely seen now as an independent risk factor of cardiovascular disease in adults. Carotid intima-media thickness (CIMT) is a well-recognized clinical predictor of subclinical atherosclerosis. In several previous studies, patients with psoriasis exhibited greater CIMT than did the controls. In light of these studies, authorities might think that LP would also be associated with the formation of subclinical atherosclerosis, given the similarity between the pathogenesis of psoriasis and that of LP.

Aim
To assess carotid intima thickness and serum homocysteine level as markers of subclinical atherosclerosis in patients with LP.

Patients and methods
Abstract Peripheral blood samples were collected from 25 patients with LP and 25 controls to assess serum homocysteine level, blood glucose, cholesterol, and triglycerides. CIMT was measured by B mode ultrasound.

Results
Both serum homocysteine and CIMT were significantly higher in patients with LP than controls.

Conclusion
Serum homocysteine and CIMT could be reliable predictors of subclinical atherosclerosis in LP.
Recent evaluation of decompressive craniectomy in severe traumatic brain injuries
Authors: Ellabbad Mohamed A. , El Shokhaiby Usama M. , Abd El-Aziz Amr M. 
Published: March 2024

Background
An injury to the brain or intracranial hemorrhage may cause it to swell. The pressure within the skull then increases as the brain has no room to expand; this excess pressure, known as intracranial hypertension, can cause further brain injury. High intracranial pressure (ICP) is the most frequent cause of death and disability in brain-injured patients. If high ICP cannot be controlled using general or first-line therapeutic measures such as adjusting body temperature or carbon dioxide levels in the blood and sedation, second-line treatments are initiated. One of these is a procedure called decompressive craniectomy (DC). DC involves the removal of a section of skull so that the brain has room to expand and the pressure decreases.

Patients and methods
We studied 20 patients who presented to the Neuroemergency Unit in AL-Azhar University Hospitals in Cairo and Damanhur Medical National Institute in Damanhur from January 2017 to December 2017 with severe traumatic brain injury with clinical and radiological evidence of increased ICP and indicated for DC. All patients were followed up postoperatively in ICU with serial follow-up computed tomography. Consciousness level was evaluated using the Glasgow Coma Scale and Glasgow outcome score.

Results
The overall mortality was five (25%) cases, four severely disabled (20%), and 11 (55%) patients had favorable outcome.

Conclusion
In 20 cases with severely raised ICP resistant to conservative management, DC allowed 55% of cases to be discharged from hospitals with mild degree of disability for rehabilitation.
Assessment of right and left ventricular functions in interstitial lung diseases
Authors: Salama Khadiga S.M. , Abou Bakr Samiha M. , Farag Taghreed S. , Eid Hoda A. , Mohamed Layla A. 
Published: March 2024

Background
Subclinical or overt cardiovascular affection in patients with interstitial lung diseases (ILD) may expect to have increased mortality and/or reduced exercise capacity.

Objective
Echocardiographic (echo) assessment of right ventricular (RV) and left ventricular (LV) functions in patients with ILD.

Patients and methods
Conventional echo, tissue Doppler imaging (TDI) and two-dimensional speckle tracking echo (2D STE), spirometry [forced vital capacity (FVC%), forced expiratory volume in 1 s% and forced expiratory volume in 1 s/FVC], and functional exercise capacity (6 min walking test) were performed on 60 patients with ILD and 60 age-matched and sex-matched controls. Pulmonary involvement was identified in high-resolution computed tomography (HRCT) and scored according to a semiquantitative Warrick score.

Results
Using conventional echo-Doppler, TDI, and 2D STE, there are statistically significant impairments in both RV systolic and diastolic functions, as well as LV diastolic functions in ILD patients compared with controls (P<0.05). LV systolic dysfunction was detected by TDI and STE only; however, ejection fraction was normal by standard echo. In the ILD group, the tricuspid annular plane systolic excursion was positively correlated with PaO2 and FVC%, while it was negatively correlated with the HRCT score. RV global longitudinal strain% was positively correlated with both 6 min walking distance and FVC%. Moreover, LV global longitudinal strain% was positively correlated with both 6 min walking distance and PaO2, while it was negatively correlated with HRCT score.

Conclusion
Both RV and LV systolic and diastolic dysfunctions were detected by echo in ILD patients. Ventricular dysfunctions were related to hypoxemia, radiological score, and vital capacity of the lungs. Ventricular dysfunction has a negative impact on function exercise capacity of patients with ILD.
Ultrasonograph versus β-human chorionic gonadotropin titer for verification of termination of missed first trimester miscarriage
Authors: Nassef Aziza H. , Mohammed Nahed H. , Ibrahim Samar M. 
Published: March 2024

Introduction
Miscarriage is one of the common complications of pregnancy. Up to 20% of recognized pregnancies will end in miscarriage. However, when women were followed with serial serum human chorionic gonadotropin (hCG) measurements, the actual miscarriage rate was found to be 31%. Many pregnancies are lost spontaneously before a woman recognizes that she is pregnant, and the clinical signs of miscarriage are mistaken for a heavy or late menses. In some countries with low resources, ultrasound may be not available in all medical centers. So, confirmation of complete termination of first trimesteric miscarriage may be not possible, and these cases may present with complications of inadequate treatment. So, we need to study other method for verification of successful management such as β-hCG titter.

Objective
The aim was to assess the usefulness of testing serum β-hCG titer to confirm the effective medical termination of the first trimester miscarriage.

Patients and methods
A prospective study was conducted at the Department of Obstetrics and Gynecology at Al Zahraa university Hospital in the period between December 2017 and April 2018. A total of 34 pregnant women with first trimester miscarriage (7–13 weeks from the first day of last menstrual period) were submitted for medical termination of miscarriage, and each case was subjected to ultrasonography 7 days after termination of miscarriage (for measurements of endometrial thickness) and serum β-hCG at 3 and 7 days after termination of miscarriage.

Results
Endometrial thickness decreased after termination of miscarriage (with cut-off value <15 mm). Moreover, β-hCG decreased after medical termination of miscarriage. In our study, receiver operating characteristics curve was used to define the best cut-off value of β-hCG, which was greater than 34 mIU/ml, with sensitivity of 90%, specificity of 70.8%, positive predictive value of 56.4%, and negative predictive value of 94.4%, with diagnostic accuracy of 83.5%.

Conclusion
Measuring β-hCG level is an effective alternative to transvaginal ultrasound measurements of endometrial thickness to verify the completion of termination of early miscarriage.
Bone mineral density in young adult Egyptian women and its relations to different anthropometric measures
Authors: Hamoda Noura Z. , Eltokhy Hanan M. , Mohamed Eman F. , Mohammed Doaa S. 
Published: March 2024

Background
Low bone mass often leads to osteoporosis and increased risk of bone fractures. Body composition is a new aspect that may contribute to an imbalance, leading to decreased bone mineral density (BMD) and general bone health.

Objective
This study was done to evaluate the BMD in young adult Egyptian women by using dual-energy radiograph absorptiometry (DEXA) technique and to identify probable relations between different anthropometric measures and BMD.

Patients and methods
This study was performed at the Internal Medicine Department of Al-Zahraa University Hospital from March 2019 to August 2019 on 80 adult Egyptian women. Their ages ranged from 18 to 40 years old. All study participants were subjected to anthropometric measurements, including weight, height, BMI, waist circumference, hip circumference, and waist/hip ratio; assessment of body composition, including fat mass, lean mass, and water volume in the body, using bioelectrical impedance by body fat analyzer 905; and assessment of BMD using dual-energy radiograph absorptiometry technique at the lumbar spine, left femoral neck, and left forearm.

Results
Based on WHO diagnostic criteria, osteoporosis was present in 3.75% of samples, whereas osteopenia represented 25% of the cases. There were highly positive significant associations between BMD and each of weight, height, serum alanine transferase, and CA levels, and there was a positive significant association between BMD and each of age, BMI, waist circumference, and hip circumference.

Conclusion
A significant portion of adult women are at high risk of development of osteoporosis and increased risk of bone fractures. So young women in particular need to be aware of their vulnerability to osteoporosis. They can take steps early to slow its progress and prevent complications.
Plasma cell-free erythroid DNA as a new marker for differentiation between many types of anemia
Authors: Elwardany Reham M. , Kotb Fatma M. , Alhabibi Alshaymaa M. , El-ghafour Seham Mohamed Abd 
Published: March 2024

Background
The study of cell-free DNA (cfDNA) has attracted great interest these years. Some research studies detected the origin of cfDNA and used it to monitor the treatment response and predict disease progression.

Objective
We aimed to detect the erythroid cfDNA as a valuable noninvasive marker for differentiation between many types of anemia.

Patients and methods
A total of 76 patients and 25 age-matched and sex-matched controls were enrolled in this study. Patients were divided into four groups depending on type of anemia: group I (n=20, patients with ß-thalassemia major), group II (n=20, patients with chronic kidney disease), group III [n=16, patients with aplastic anemia (AA)], and group IV (n=20, patients with iron-deficiency anemia). Group III was further subdivided into two subgroups: subgroup A (n=8 patients with AA responsive to treatment) and subgroup B (n=8 patients with AA not responding to treatment). Erythroid cfDNA (E%) was estimated using quantitative real-time PCR.

Results
There was a highly significant difference in the percentage of erythroid DNA (E%) when comparing each group with the control group; furthermore, E% was more sensitive than the reticulocyte count for discrimination between group II and the control group, and more specific for discrimination between groups III and IV and the control group.

Conclusion
The erythroid cfDNA is a sensitive noninvasive tool when compared with reticulocytic count for discrimination between different types of anemia.
Treatment of three-part fracture of proximal humerus in adults with plate and screws
Authors: Yehya Mohamed A. , Hassan Yaser E. , Gaafar Ahmed K. 
Published: March 2024

Objective
The aim of this study was to evaluate our results for the treatment of three-part fracture of proximal humerus in adults with plate and screws.

Patients and methods
The study was done and followed up on 15 patients for 2 years. Deltopectoral approach has been used for all the patients. All patients had clinical and radiological evaluation at regular periods during their follow-up. The age of patients range from 23 to 77 years with a mean age of 51.9 years.

Results
The constant score was used for clinical evaluation of patients. In the constant method of functional assessment, a 100-point score is based on the assessment of a number of individual subjective and objective parameters in an entirely clinical setting. We have four cases representing 26.67% of all patients who had complications; one patient was complicated by stiffness, two patients with nonunion, and one patient with infection.

Conclusion
With short-term follow-up, the internal fixation with plate and screws is effective in the treatment of three-part fractures of the proximal humerus in adults.