bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of serum adropin with risk and severity of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus
Authors: Rashad Nearmeen M. , Sabry Hanan M. , Afifi Samir A. , Fathy Maha A. 
Published: September 2023

Abstract
Background
Diabetic peripheral neuropathy (DPN) is the major microvascular complication of type 2 diabetes mellitus (T2DM). Adropin is a peptide hormone that has essential roles in metabolic homeostasis and the pathogenesis of T2DM and its complications. This study was designed to estimate serum adropin levels in patients with T2DM in correlation with risk factors of DPN. The authors also aimed to investigate the association between serum adropin level and clinical and electrophysiological tests of DPN.

Patients and methods
This case–control study enrolled 100 patients with T2DM (40 diabetic cases without DPN and 60 diabetic cases with DPN) and 50 controls. All participants were subjected to a complete neurological examination. The motor and sensory conduction velocities of the median nerve, ulnar nerve, and common peroneal nerve were measured. The severity of DPN was assessed by Toronto clinical scoring system (TCSS). Serum adropin levels were assessed using an enzyme-linked immunosorbent assay.

Results
Our results revealed decreased circulating serum adropin levels in patients with T2DM (3.5±1.2), especially diabetic patients with DPN (3.1±1.07), compared with controls (6.1±0.89). There is a negative correlation between serum adropin level and TCSS as well as electrophysiological tests: motor nerve conduction velocity of median and ulnar nerve, sensory nerve conduction velocity of median and ulnar nerve, compound muscle action potential amplitude (median and ulnar nerve), and sensory nerve action potential amplitude (median, ulnar, and perception threshold nerve) (P<0.001*).

Conclusion
Diabetic patients with DPN had lower values of serum adropin than diabetic patients without DPN, and serum adropin levels were negatively correlated with metabolic risk factors, TCSS, as well as electrophysiological tests of DPN.
Trimester-specific thyroid hormone changes in normal pregnant Egyptian women
Authors: Mousa Shrook , El-Sawy Shereen S. , Abdelraouf Maged , Farouk Dina , Rashed Laila , Saif Aasem 
Published: September 2023

Abstract
Introduction
The range of normal thyroid functions during pregnancy differs between ethnic groups. Establishment of trimester- and assay-specific reference intervals for every population is recommended.

Aim
Assessement of the changes in thyroid function tests across the different trimesters in normal pregnant Egyptian females.

Subjects and methods
The study included 150 normal pregnant Egyptian females, recruited from Cairo university hospital antenatal care clinic, with 100 age-matched non-pregnant females, as a control group. Serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured in the three trimesters of pregnancy for every patient. Thyroid peroxidase antibodies (TPO Abs) were also assessed.
Our study showed that TSH reference ranges, using the 2.5th and the 97th percentiles, were 0.6–4.3, 0.9–3.7 and 1.0–4.2 mIU/ml for the first, second and third trimesters respectively. The median TSH concentration (50th percentile) was lower in the first trimester (2.1 mIU/ml) in comparison with the second and third trimesters of (2.6 and 2.9 mIU/ml respectively). FT4 reference ranges, using 2.5th to 97th percentile, were 0.9–2 and 0.7–1.4 and 0.6–1.2 ng/dl for the first, second and third trimesters respectively. The median FT4 concentration was higher in the first trimester (1.5 ng/dl) in comparison with the second and third trimesters of (1.1 and 1.0 ng/dl respectively). The percentage of positive TPO Ab was higher in pregnant women than that of age matched non-pregnant ladies (15.3 vs 2%, P<0.001).

Conclusion
Our study established trimester-specific changes in thyroid hormone reference ranges in normal pregnant Egyptian females. A larger population-based study would help to confirm those ranges.
Study of the effect of metformin therapy on thyroid function in type 2 diabetic patients
Authors: Abdelmoez Fatema A. , Mohamed Ghada A. , Eldine Dina M. S. 
Published: September 2023

Abstract
Background
Metformin, the most widely used antidiabetic drug, is considered as the cornerstone of type 2 diabetes treatments. Surprisingly, a few years ago, it has been reported that serum thyroid-stimulating hormone (TSH) level in hypothyroid patients decreased in response to metformin therapy and increased again when metformin was discontinued. This study was performed at the Diabetic Outpatient Clinic and Internal Medicine Department at Assiut University Hospital during the period between January and June 2017.

Aim
The study aimed to assess the effect of metformin treatment on TSH in type 2 diabetic patients with or without thyroid dysfunction.

Results
A total of 100 patients, with type 2 diabetes mellitus, were enrolled in the study. The patients were divided into two groups: group I included 50 patients on metformin therapy and group II included 50 patients without metformin therapy. Their age was equal to or more than 40 years; their duration of diabetic treatment was equal to or more than 5 years.

Conclusion
In conclusion, there were significant relationships between TSH levels and metformin therapy, obesity, macroangiopathy, and hyperlipidemia, as the treatment with metformin caused suppression of TSH to subnormal levels without any change in free T4 or frees T3 in diabetic patients.
Vascular endothelial growth factor in systemic lupus erythematosus in correlations with disease activity and nailfold capillaroscopic changes
Authors: Hamza Sherin M. H. , Khalil Nermeen S. , Hamoda Rasha M. , El-Asfahani Marwa A. 
Published: September 2023

AbstractBackgroundAngiogenesis plays a role in the pathogenesis of systemic lupus erythematosus (SLE). Both serum vascular endothelial growth factor (VEGF) and capillaroscopic abnormalities may reflect intensity of microcirculatory changes in the course of SLE.AimsTo quantify serum VEGF level and its correlation with microvascular changes, assessed by nailfold capillaroscopy (NFC), and possible relationship with SLE activity.Patients and methodsA total of 90 patients with SLE were subjected to detailed medical history and clinical examination and assessment of disease activity using the SLE Disease Activity Index score and organ damage using Systemic Lupus International Collaborating Clinics/ American College of Rheumatology damage index. Laboratory investigations were done including autoantibodies [anti-nuclear antibody, anti-DNA, anti-cardiolipin (immunoglobulin G and immunoglobulin M), and lupus anticoagulant]. VEGF serum level was measured using enzyme-linked immunosorbent assay. NFC examination was done for recognition of NFC abnormalities.ResultsSerum VEGF level was elevated in the entire study group (mean of 831±572 ng/l), with a statistically highly significant correlation with Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index and SLE Disease Activity Index score of disease activity (r=0.349,P=0.001, andr=0.897,P<0.001, respectively), together with a significant positive correlation with the presence of nephritis (P=0.002), positive anti-double-stranded DNA (P≤0.001), and consumed C3 and C4 (P≤0.001), which are laboratory markers indicating lupus activity. Moreover, a higher serum VEGF level was associated with severe NFC changes with a statistically highly significant positive correlation with the capillary width (r=0.561,P<0.001), capillary length (r=0.411,P<0.001), and mean capillary density (r=0.308,P=0.003).ConclusionIncreased serum VEGF level and progression of NFC score had been directly related to lupus activity and internal organ involvement, especially nephritis.
Procalcitonin as a marker of diabetic foot ulcer infection
Authors: El-Kafrawy Nabil A. , Shaaban Mohammed A. , Korany Mohammed A. , Sonbol Ahmed A. , Ata Moustafa B. 
Published: September 2023

Abstract
Background
Procalcitonin (PCT), an amino acid protein precursor of calcitonin hormone released by thyroid C cells or other body cells, can be used as a marker for diagnosing infection. PCT has a suggestive role in diagnosing diabetic foot infection alone or in combination with other markers of infection.

Objective
The aim was to clarify the effectiveness of PCT as a marker for diagnosing of infection in Egyptian patients with diabetic foot ulcer (DFU) in comparison with other inflammatory markers such as C-reactive protein, white blood cell count, and erythrocyte sedimentation rate.

Patients and methods
This cross-sectional study was carried out at Menoufia University Hospitals, from the period of January 2018 to December 2018. In total, 90 patients were classified into three groups; each group contained 30 patients: group I served as diabetic control without foot ulcers, group II patients had noninfected DFU, and group III patients had infected diabetic foot ulcer (IDFU). Diagnosis of IDFU relied on Infectious Diseases Society of America-International Working Group on the Diabetic Foot classification of diabetic foot infection.

Results
Serum PCT levels were elevated in DFU groups, with significantly higher in infected more than noninfected DFU. In addition, PCT levels were significantly higher in patients with IDFU compared with traditional markers such as C-reactive protein, erythrocyte sedimentation rate, and white blood cell counts.

Conclusion
Based on our results, we conclude that PCT has a valuable role in diagnosing infection in DFUs.
Effect of iron therapy on red cell indices and hemoglobin subtypes on patients with beta-thalassemia trait who developed iron-deficiency anemia: a tertiary center experience
Authors: Moeen Sawsan M. , Thabet Ahmad F. , Thabet Marwa M. 
Published: September 2023

AbstractBackgroundThe combination of beta-thalassemia trait (BTT) and iron-deficiency anemia (IDA) is an interesting common issue in our country. However, treatment of this condition is challenging.ObjectivesThis prospective observational study was designed to evaluate the effect of oral iron therapy on red cell indices, iron status, and hemoglobin A2levels in patients with BTT who developed IDA.Patients and methodsA total of 50 patients with BTT who developed IDA were included. A complete blood count, iron status, and follow-up hemoglobin electrophoresis by high-performance liquid chromatography were done. The patients with BTT received oral iron therapy of 60mg elemental iron three times/day for a period of 5 months, and the investigations were repeated after 3 and 5 months of treatment.ResultsThere was a statistically significant increase in hemoglobin level (P<0.001 each), mean corpuscular volume (P<0.001 each), mean corpuscular hemoglobin (P=0.004 andP<0.001, respectively), mean corpuscular hemoglobin concentration (P=0.007 andP=0.001, respectively), serum iron (P<0.001 each), serum ferritin (P<0.001 each), and hemoglobin A2levels (P=0.001 andP=0.005, respectively), whereas significant decrease in the total iron-binding capacity (P=0.001, andP=0.005, respectively) after the third and fifth month of oral iron therapy.ConclusionIt is important to suspect, recognize, and correct IDA in patients with BTT and to repeat hemoglobin electrophoresis after iron therapy.
Detection of fundic varices obturation by endoscopic ultrasound versus multidetector computed tomography
Authors: Elrabat Amr , El-Gamal Salah , Kashwaa Mohammad M. , El-Rakhawy Mohamed M. 
Published: September 2023

Abstract
Background
Gastroesophageal varices (GVs) present in 50% of patients with liver cirrhosis. GVs bleed at a rate of 5–15%, and the 6-week mortality after hemorrhage is 20%. GVs are treated with a tissue adhesive, cyanoacrylate, where repeated sessions are performed 2–4 weeks until obliteration, and eradication is achieved with 2–4 injections using 1–2 ml/ session. Endoscopic ultrasonography (EUS) was found superior to endoscopy in detecting gastric varices. Gastric varices obturation can be detected using CD-EUS to assess blood flow in variceal lumen after cyanoacrylate injection. Multidetector computed tomography (MDCT) is an acceptable imaging modality for abdominal vascular system and assessment of endoscopic therapy of fundal varices. To our knowledge, there is no study for detecting GV obturation yet. The aim of this study to compare between EUS and MDCT in detecting obturation of GV and comparing EUS and upper endoscopy in detection of GV obturation.

Patients and methods
A total of 22 patients with liver cirrhosis presented with acute GV bleeding for the first time, which was confirmed and managed by upper endoscopy, being carried out in the first 12h after admission. Then the patients were subjected to monthly gastric varices injection of cyanoacrylate until they appeared to be obturated by upper endoscopy using blunt end of injection catheter sheath to palpate varices. After that EUS and CT were done for evaluation of GV, in addition to perigastric and paragastric collaterals.

Results
EUS is superior to CT in detecting GV obliteration, with a high significant difference (P=0.04), whereas EUS and upper endoscopy have similar results in detecting the obliteration of GV (P=0.68). There was a statistically significant association between splenic size and GV obliteration (P=0.002) and a significant negative correlation between size of paragastric collaterals and GV obturation.

Conclusion
EUS is superior to CT in detecting the obliteration of GV.
Thyroid dysfunction in Egyptian patients with hepatitis C virus: prevalence and possible triggering
Authors: Fayed Ahmed , Soliman Ahmed , Naguib Mervat , Ali Hala M. , Elhaddad Hemmat 
Published: September 2023

Abstract
Background
The contribution of chronic hepatitis C virus (HCV) infection per se in thyroid autoimmunity and dysfunction remains controversial. We investigate the prevalence of thyroid disorders and the possible association between thyroid dysfunction and different factors in a cohort of HCV-untreated patients.

Patients and methods
A total 1050 patients with untreated HCV infection were enrolled in this study. Thyroid function tests, antiperoxidase (TPO-Ab), antithyroglobulin, thyroid ultrasound, real-time PCR to assess HCV RNA viral load, and fibroscan to determine degree of hepatic fibrosis were done.

Results
Thyroid dysfunction was found in 17.1% of patients: 11.5% hypothyroidism and 5.6% hyperthyroidism. Subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were detected in 8.6, 2.8, 3.3, and 2.3% of patients, respectively. Thyroid ultrasound showed abnormality in 10.2% of patients. TPO-Ab and antithyroglobulin were positive in 5.1 and 6.4% of patients, respectively. TPO-Ab was more frequently positive in hyperthyroid patients compared with euthyroid (P<0.001) and hypothyroid (P<0.001) patients. Positive TPO-Ab was only significantly associated with thyroid state (P<0.001) and duration of HCV infection (P=0.02).

Conclusion
The prevalence of thyroid dysfunction is 17.1% among patients with HCV infection. Furthermore, thyroid disorder is related mainly to thyroid autoimmunity independent of age, sex, or level of viremia.
Serum osteocalcin level in end-stage renal disease patients on maintenance hemodialysis after parathyroidectomy in relation to parathyroid hormone level
Authors: Ellakany Soheir A. , Hashaad Doaa I. , Merghany Alyaa F. 
Published: September 2023

Abstract
Background
Parathyroidectomy (PTX) is an effective treatment for refractory hyperparathyroidism in end-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD). However, adynamic bone disease, a possible complication, is associated with persistent bone pain and increased fracture risk. Osteocalcin (OC) is a bone formation marker, produced by osteoblasts, stimulated by parathyroid hormone and active vitamin D, associated with overall survival. Late changes in its level after PTX need to be evaluated.

Aim
The aim of this study was to determine serum OC and its relation to intact parathyroid hormone (iPTH) in patients on MHD with and without a history of PTX.

Patients and methods
This case–control study was conducted on 50 patients with ESRD on MHD, subdivided into two groups (group I and group II), according to the history of PTX. Patients having diabetic mellitus or autoimmune disease were excluded. Patients were inquired about manifestations of bone disease. Serum concentrations of ionized total calcium, magnesium, phosphorus, alkaline phosphatase (ALP), iPTH, and OC (by ELISA) were determined. Serum OC concentration was also measured in the samples of 20 healthy participants (group III) to evaluate its reference value.

Results
Bone fracture was present in nine patients with or without PTX, with no significant difference from the other patients, as regards the studied parameters. Patients with ESRD on MHD had a significantly higher serum OC level than controls (P<0.001). Serum OC in patients who underwent PTX, and with adynamic bone disease (iPTH<150 pg/ml) (group IA), was significantly lower than that in the corresponding subgroup without PTX (group 2A) (P=0.001); similarly, the two subgroups were different, as regards serum ALP (P<0.001) and serum iPTH (P<0.001). There were significant positive correlations between serum OC and total ALP and iPTH in the total patient sample (P<0.001 and <0.001, respectively).

Conclusion
Adynamic bone disease after PTX in patients on MHD in comparison with those who have not undergone PTX is associated with a lower level of bone formation marker OC.
Usefulness of serum osteopontin level as a noninvasive parameter of portal hypertension
Authors: Fouad Ayman M. , Hussein Nagwa Ramadan Ahmed , Shaheen Iman A. E. , Ismael Mohammed A. 
Published: September 2023

Abstract
Background
Osteopontin (OPN) is a multifunctional protein that is physiologically expressed in the kidney and bone. Plasma OPN levels were shown to predict liver fibrosis in various chronic liver diseases and could be related to the degree of portal hypertension. The aim of the study is to investigate the usefulness of OPN as a noninvasive biomarker of portal hypertension.

Patients and methods
A case–control study including 90 (45 patients with confirmed liver cirrhosis and 45 normal healthy individuals) patients were enrolled in the study. Laboratory investigations with abdominal ultrasound and duplex of the portal system were carried out for all patients. OPN was measured using the enzyme-linked immunosorbent assay in the plasma.

Results
Compared with controls, the plasma levels of OPN in cirrhotic patients were significantly high (P<0.001). Also, plasma levels of OPN were significantly high in patients with portal hypertension (P<0.001). The cutoff value of OPN to detect the presence of portal hypertension is 1.65 ng/ml with sensitivity and specificity of 80 and 95.6%, respectively).

Conclusion
Serum OPN is a good noninvasive parameter to detect portal hypertension.
Noninvasive assessment of hepatic fibrosis regression in hepatitis C virus-infected patients treated with sofosbuvir-based therapy
Authors: Al-Khattib Ahmed , El-Nakeeb Adham , Musa Nevine I. , Dous Kerolous B. A. , Aly Heba 
Published: September 2023

AbstractBackgroundAccurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial to make therapeutic decisions and to determine the prognosis of liver disease and also the protocol of further follow-up. Multiple noninvasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive parameters of hepatic fibrosis after effective antiviral therapy are still not well unknown. The aim of the paper was to evaluate early changes in the hepatic fibrosis-related parameters in patients with chronic hepatitis C virus (HCV) infection using shear wave elastography (pSWE) and serum parameters [aspartate aminotransferase-platelet ratio index (APRI) and fibrosis-4 score (FIB4)] before and 24 weeks after sofosbuvir-based antiviral therapy.Materials and methodsThis is a prospective cohort study that included 109 Egyptian patients with chronic hepatitis C. pSWE values were recorded as well as APRI and FIB4 scores were calculated at baseline and at 12 and 24 weeks after treatment.ResultsA total of 109 HCV-infected patients were included, with mean age of 45.76±13.91 years. Overall, 25 (22.90%) patients had cirrhosis and were treated with sofosbuvir 400 mg/day, daclatasvir 60mg/day, and weight-based ribavirin. Moreover, 84 (77.10%) were treated with sofosbuvir 400 mg/day and daclatasvir 60mg/day. The overall sustained virological response-12 rate was 100%. There were significant improvements in APRI score (from 0.64±0.66 at baseline to 0.26±0.22 at 24 weeks after treatment) and FIB4 score (from 1.77±1.77 at baseline to 1.11±1.04 at 24 weeks after treatment), withPvalue of 0.0001 in both. In addition, there was a significant reduction in liver stiffness measurements by pSWE 24 weeks after treatment (from 1.72±0.55 m/s at baseline to 1.48±0.44 m/s at 24 weeks after treatment, withP=0.003).ConclusionSofosbuvir-based treatment regimens for chronic HCV infection result in significant improvement of the fibrosis scores (FIB4 and APRI) 24 weeks after treatment. Moreover, there was a significant reduction in the liver stiffness measurements by pSWE.
The relationship between serum level of matrix metalloproteinase-7 and interstitial lung disease in patients with systemic sclerosis
Authors: Gabal Mervat M. Abo , Shedid Noha H. , Mohamed Elham S. , Abdelfattah Warda 
Published: September 2023

Abstract
Background
Interstitial lung disease (ILD) remains a leading cause of mortality in systemic sclerosis (SSc). Matrix metalloproteinases (MMPs) play an important role in inflammation, autoimmune diseases and aberrant fibrotic tissue remodeling.

Aim
The aim of this work was to evaluate the relation between serum level of MMP-7 and ILD in SSc patients.

Patients and methods
The study was conducted on 30 SSc patients. Pulmonary function tests and chest high-resolution computed tomography were assessed. Degree of fibrosis was assessed according to Warrick severity and extent scores. Serum level of MMP-7 was measured.

Results
The 30 patients had a mean age of 41.60±11.11 years and disease duration of 3.50 ±1.81 years; 23 with diffuse and seven with limited subtype. ILD was present in 20 patients. Serum MMP-7 was significantly higher in those with ILD (412.5±52.4 ng/ml) compared with those without (disease control group) (351.4±56.4 ng/ml) (P=0.007). In patients with ILD, MMP-7 was significantly higher in those with ground-glass opacities, honeycombing and reticular infiltration on high-resolution computed tomography; yet, it was comparable among the different grades of pulmonary restriction by pulmonary function test. There was a significant negative correlation between serum MMP-7 level and forced vital capacity and forced expiratory volume in one second (r=−0.46, P< 0.05 and r=−0.65, P< 0.0001, respectively). Correlations between MMP-7 and Warrick severity and extent were significant (P=0.002 and 0.007, respectively). MMP-7 at a cutoff value of 367.4 ng/ml was 85% sensitive and 80% specific for detection of ILD.

Conclusion
There is a strong association between serum MMP-7 and the presence, severity and extent of ILD in scleroderma patients. It might be a useful marker for ILD in SSc.