bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Value of Fructosamine in Prediction of Angiographic Outcomes in Diabetic Patients Presented with Anterior STEMI Undergoing Their First Primary PCI
Authors: Borham Mohammed Borham , Ahmed Mohammed Esmail , Elias Rami Raymond , Desoky Ahmed Ibrahim El 
Published: August 2023

Abstract

Background
Cardiovascular diseases are the leading most common cause of death in industrialized countries. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction and failure of different organs especially heart and blood vessels.

Objective
To study the predictive value of Fructosamine as a marker of short-term glycemic control over 2-3 weeks on the angiographic and clinical outcomes in diabetic patients presented with anterior STEMI in Ain shams university hospital.

Patients and Methods
This is an observational study recruiting 100 patients presented with anterior STEMI who underwent their first primary percutaneous coronary intervention (PPCI) from May 2020 to December 2020.

Results
Angiographic results of patients post PCI were as follows: Regarding Thrombolysis in myocardial infarction (TIMI Flow), 8 patients had TIMI flow 0, 18 had TIMI I, 27 had TIMI II and 37 had TIMI III flow. Regarding myocardial blush grade (MBG) 12 patients had MBG grade 0, 27 had grade I, 20 had grade II and 4 had grade III. During follow up for one-month, Major adverse cardiac events (MACE) occurred in 56% of patients. Measured serum Fructosamine levels were ranging between (233 to 557 µmoll/L) the results showed a strong correlation between serum Fructosamine and TIMI flow MBG. Patients with higher Fructosamine level had worsen TIMI flow and MBG and more occurrence of MACE in diabetic patients after PPCI.

Conclusion
High Fructosamine level can be used as a predictor for worse outcomes in diabetic patients presented with Anterior STEMI.

Abbreviations
STEMI: ST segment elevation myocardial infarction; PPCI: primary percutaneous coronary intervention; TIMI: Thrombolysis in myocardial infarction; MBG: Myocardial blush grade; DM: Diabetes Mellitus; MACE: Major adverse cardiac events
Predictors of Successful Radiofrequency Catheter Ablation of Premature Ventricular Complexes
Authors: Elalfy Mohammed Mahmoud , Zarif John , Ali Ahmed Nabil , Ahmad Rania Samir , Nabih Mervat Aboul Maaty 
Published: August 2023

Abstract

Introduction
Patients with a high premature ventricular complexes PVC burden can benefit from catheter ablation, which is an effective and curative strategy for improving symptoms while simultaneously reducing PVC burden. Depending on the origin of the PVC, catheter ablation can be used as first-line therapy or as a last resort in cases of more rare origins when medication fails or is not tolerated/wanted.

Aim
The aim of this study is to determine the predictors of successful Radiofrequency catheter ablation of premature ventricular complexes.

Participants &Methods
A total of 100 patients with PVCs burden greater than 15% who were scheduled for conventional or 3D ablation at electrophysiology unit of Ain Shams University between 2018 and 2020 were included in the study. Success was defined as acute elimination of PVCs in Cath-lab with a 30 minutes waiting period and PVCs burden &lt;3% on follow up Holter recording.

Results
The success rate was 83% among 100 patients (mean age 41.31 ± 17.69 years, 52% female patients), with 68% of the patients undergoing conventional ablations. Success was predicted by age (&lt;58 years), outflow tract (OT) origin of PVCs, and the existence of a pre-QRS signal on the ablation catheter&gt; 33 msec (Pvalue &lt; 0.001).There was no statistical difference between conventional ablation and 3D ablation in this study regarding predictors of success.

Conclusion
Age, Origin of PVCs and pre-QRS signal are predictors of success of PVCs ablation.

Abbreviations
ECG: electrocardiogram; LVEF: left ventricular ejection fraction; LVOT: left ventricular outflow tract; PVC: premature ventricular contraction; RFCA: radiofrequency catheter ablation; RV: right ventricular/ventricle; RVOT: right ventricular outflow tract; OT: Outflow tract
ICD/CRT-D Registry Ain Shams University Hospitals
Authors: Elnady Mohammed Hafez Abbas , Galal Wagdy Abdelhamid , Tamara Ahmed Fathy , Allam Lamyaa Elsayed 
Published: August 2023

Abstract

Background
The idea of the ICD registry was prompted from the National Coverage Decision that was published by the Centers for Medicare and Medicaid Services (CMS) in 2005 and based on the Sudden Cardiac Death in Heart Failure Trial, Ain Shams University Hospitals aim to take the lead by documenting the first ICD/CRT-D Registry in Egypt.

Aim of the Work
To capture the characteristics, treatments, and outcomes of patients receiving ICDs to improve care for patients receiving ICDs and CRT-Ds in Egypt.

Methods
102 consecutive patient that received an ICD/CRT-D (initial or generator change) for primary or secondary prevention of SCD and came for ICD/CRT-D follow up at Ain Shams University hospitals pacemaker outpatient clinics in a timeline of one year (7-2019 till 11-2020).

Results
Males were around two thirds of cases (68.6%), and more than half of cases (52%) were smokers. Implantation for primary prevention of SCD was in 58.8% of patients. Most of cases had their ICDs follow-up at a time between 1 to 3 years after implantation. HFrEF was significantly more common in primary prevention group (93.3%) of patients of primary prevention group, while IsHD was the most common comorbidity in patients that had ICD implantation for secondary prevention of SCD (66.7% of them). Total complication rate was 6.86% including, pocket hematoma occurred in 2.9% of cases, and lead dislodgment that required repositioning without a plan to add a transvenous lead occurred in 3.9% of cases. Beta Blockers and Amiodarone were the most common drugs used among patients as regard 88.2% and 65.7% respectively. VTs and NSVTs were the most frequent post implantation events among the studied cases 45.1% and 42.2% respectively. 52% of patients had ATP therapy to events, Failed ATP therapy occurred in 60% of them. 33.3% of patient received ICD shock therapy, Inappropriate Shocks was in 20.6% of them. 50.9% of the patients had a bradycardia pacing as about 34% of patient had CRT-D for pump failure. VF detection zone interval was significantly longer in primary prevention group. No significant differences according to implantation indication regarding VT2 zone interval. Regarding VT1 zone; monitor only was the mainly action in 58.7% of patients. Only 20.6% of patients had VT1 zone off.

Conclusion
This observational and descriptive study provides strong evidence that ICD has an effective role to improve survival in primary and secondary prevention of SCD. We noticed increase in implantation rate of ICD for primary prevention of SCD who gain great benefits from the device later on, minimal complication rate of ICD implantation.
Assessment of Left Atrial Function in Ischemic Heart Patients before and after Cardiac Rehabilitation Using Speckle Tracking Echocardiography
Authors: Alijla Salah , Desoky Ahmed El , Said Khaled 
Published: August 2023

Abstract

Background
Coronary heart disease (CHD) is one of the most common forms of heart disease. It affects the heart by restricting or blocking the flow of blood around it. This can lead to anginal pain or myocardial infarction. Exercisebased cardiac rehabilitation aims to restore people with CHD to health through combination of exercise with education and psychological support.

Aim of the Work
to evaluate left atrial function in ischemic patients before and after cardiac rehabilitation using speckles tracking.

Patients and Methods
The study included 60 individuals who were recruited from Ain Shams University hospital. All patients were recruited from the cardiac rehabilitation unit. These patients had recent MI that was successfully revascularized one month before inclusion. They were recruited in the period between December 2019, and complete in December 2020, Echocardiography (including 2D STE for assessment of LA function) was performed at baseline, and after a 3-month follow-up for all patients.

Results
This result reveal that CR could improve LV global and regional function and should be used routinely as a part of management of patient after acute myocardial infarction, also LA function improved Regarding LA diameter (considered as the standard single plane dimension of left atrium) dropped from 36.93 ± 4.60 mm to 33.85 ± 4.86 after CR showing highly significant change, Left atrial volume index (LAVI) dropped from 20.63 ± 8.05 mL/m2 to 17.40 ± 6.37, after CR, Showing highly significant changes, Peak atrial longitudinal strain mean value and systolic strain rate median, both improved significantly (p &lt; 0.001) after cardiac rehabilitation, with the former increasing from 15.21 ± 5.49 cm/s to 20.69 ± 8.13 cm/s and the latter increasing from 0.4 (0.25 ‒ 0.75)s-1 to 0.65 (0.5 ‒ 1.1) s-1. after CR.

Conclusion
Speckle tracking imaging of left atrium has proved to be a feasible and reproducible tool for the assessment of left atrial mechanics. With significant improvement in left atrial function after 3 months of exercise training CR program.
Efficacy of Radiofrequency Catheter Ablation versus Antiarrhythmic Drugs in Treating High Burden Premature Ventricular Contractions in Children with Structurally Normal Heart
Authors: Alahwany Salaheldin Hefny , Abdelhamid Galal Wagdy , Ghaniem Mazen Tawfik , Khalifa Maha Mohamed , Allam Lamyaa Elsayed 
Published: August 2023

Abstract

Background
Scarce literature on whether antiarrhythmic drugs (AADs) or radiofrequency catheter ablation (RFCA) is more efficacious when treating idiopathic high burden premature ventricular contractions (PVCs) in children with many questions remain unanswered in this age group.

Objectives
To compare the efficacy of RFCA versus AADs on high burden idiopathic PVCs in children.

Methods
A total of 60 eligible child ≤18 years with High burden PVCs (≥10% of total beats per day) that were treated by either AADs (group A) or RFCA (group B). Both Baseline and followup clinical symptoms were collected, Physical examination, repeat standard ECG, standard or 12-lead Holter recording, and echocardiography were performed.

Results
Among RFCA (n = 30) and AADs (n = 30) groups, treatment success was 80.0% and 20.0% respectively, while AADs medications cessation was 73.3% and 26.7% respectively, the differences were statistically significant.

Conclusion
RFCA appears to be more efficacious than AADs in PVC reduction and consequently AADs medications cessation postablation. Performing RFCA in children with classical mapping and navigation was a safe and highly effective therapeutic option.

Abbreviations
AADs: antiarrhythmic drugs; BBB: bundle branch block; CCB: calcium channel blocker; ECG: electrocardiogram; LVEDD: left ventricular end-diastolic dimension; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic dimension; LVOT: left ventricular outflow tract; NSVT: non sustained ventricular tachycardia; PVC: premature ventricular contraction; RFCA: radiofrequency catheter ablation; RV: right ventricular/ventricle; RVOT: right ventricular outflow tract
The Value of Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Marker for Discriminating Pulmonary Tuberculosis from Community Acquired Pneumonia
Authors: Mohammed Effat A , Koraa Emad Eldin A , Osman Nehad M 
Published: August 2023

Abstract

Background
Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. On the other hand, pneumonia is usually caused by viral or bacteria and less commonly by other microorganisms.

Objectives
To evaluate the value of Neutrophil to Monocyte plus lymphocyte ratio (NMLR) as a marker for discriminating pulmonary tuberculosis from community acquired pneumonia.

Patients and Methods
A case control study, was conducted at Abbassia Chest Hospital and included 60 patients with pulmonary infection (TB and community acquired pneumonia, 30 patients in each group) and 30 healthy controlled individuals. All patients subjected to full history, physical examination, Chest X-ray and 2 cc of blood sample was collected for total and differential peripheral leucocytic count before starting antibiotic therapy, Neutrophil-toMonocyte-Plus-Lymphocyte Ratio (NMLR) was calculated as the quotient of the absolute neutrophils, Monocyte and lymphocyte counts and Neutrophil-to-Lymphocyte Ratio (NLR) was calculated).

Result
The study involved 90 subjects; the mean of age of TB patients was (29±8.17) years, which significantly lower than other with community acquired pneumonia (40.4±16.81) years. Moreover, male sex was significantly associated with TB group. By blood analysis, NLR and NMLR were significantly higher in pneumonia than TB or control group, P value&lt; 0.001 for both. Also, NLR &gt; 2.96 and NMLR &gt;2.385 cutoff values have sensitivity and specificity of 90% and 100% respectively for both.

Conclusion
We concluded that Cutoff value of NLR &gt; 2.96 and NMLR &gt;2.385 may use for prediction of pneumonia and T.B. the modified blood indices as NLR and NMLR had the capability to discriminate between inflammatory condition as pneumonia and TB and healthy condition as same as ordinary marker like CRP and ESR did.
Role of GeneXpert in Diagnosis of Smear Negative Pulmonary Tuberculosis
Authors: Helmy Khaled Mohamed Wagih , Elsayed Mohamed Ali , Othman Marwa Ibrahim 
Published: August 2023

Abstract

Background
Pulmonary TB considered as a global health problem with specific concern in developing countries that need rapid methods in diagnosis with accurate results.

Objective
To evaluate the diagnostic yield of GeneXpert assay in diagnosis of TB infection in patients with negative sputum smear.

Methods
A total 346 cases with suspect clinical and radiological finding for TB infection was subjected to direct sputum analysis under microscope to find acid fast bacilli (AFB); the negative smear then subjected to GeneXpet assay analysis and sputum culture on LJ media.

Results
All cases with negative GeneXpert results, had negative culture, while 45 cases of 50 that had positive GeneXpert assay finding showed positive culture. The diagnostic yield of test was excellent (94.7%). The sensitivity, specificity, PPV and NPV were 100, 89.8, 90 and 100 respectively.

Conclusion
The performance of GeneXpert assay in diagnosing TB among smear negative patients was reasonable, and may fast the decision of treatment.
The Reliability of Ultrasound in Diagnosis of Idiopathic Pulmonary Fibrosis
Authors: Farrag Mohamed Ali , Elembaby Dalia Abd El-Sattar , Pasha Mohamed Ali Ahmed El 
Published: August 2023

Abstract

Background
Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause. IPF is the most common and severe form of idiopathic interstitial pneumonia, with an unpredictable and variable clinical course, and is associated with an extremely poor prognosis.

Objective
To determine role of Ultrasound in diagnosis of idiopathic pulmonary fibrosis.

Patients and Methods
This cross-sectional study was conducted at tertiary care hospital at Ain Shams University hospitals from May 2021 till November 2021 and performed on total 60 patients diagnosed with idiopathic pulmonary fibrosis and had previous clinical features, documented high-resolution computed tomography (HRCT) scan findings and comparing it with lung ultrasound findings.

Results
Consequently, B-lines number and Pleural lines thickness statistically had significant high diagnostic performance in the diagnosis of IPF with cut-off of ≥ 3.0 which indicates that B-lines number ≥3.0 and Pleural lines thickness ≥3.0 mm had perfect sensitivity and LR+, while Pleural lines interruption had perfect specificity. B-lines number ≥3.0 had highest diagnostic accuracy, Youden’s index and kappa. Our research study revealed that B-lines number and Pleural lines thickness statistically were significantly higher in multiple zones spread cases (p value&lt;0.001). Pleural lines interruption statistically was significantly more frequent in multiple zones spread cases.

Conclusion
As evident from the current study, this study introduced and thoroughly evaluated lung US features, which showed a high correlation with the high-resolution CT findings. Chest ultrasound could constitute an additional monitoring tool for IPF, which is a rapidly progressive disease, usable by the pulmonologist at the patient’s bedside or during a consultation, easily available, non-irradiating, achievable in a short time and immediately informative, for a trained sonographer.
Impact of qSOFA Score on the Outcome of Patients in ICU with Respiratory Tract Infection
Authors: Younes Kedis Mohamed , Wagih Khaled Mohamed , Gomaa Ashraf Adel 
Published: August 2023

Abstract

Background
The quick Sequential Organ Failure Assessment (qSOFA) score is a bedside prompt that may identify patients with suspected infections who are greater risk for poor outcome in the intensive care unit (ICU).

Objectives
To assess the impact of qSOFA score on the outcome of patients in ICU with respiratory tract infection.

Patients and Methods
This Observational prospective study study carried out at ICU department of Ain Shams University Hospitals and Al Mahala Chest Hospital during the period from 1 February 2020 till March 2021 and included 122 patients presented by respiratory infection. Diagnosis of infection based on clinical, laboratory, radiological and/or microbiological evidence in accordance with guidelines for diagnosis of infection. All patients subjected to full history, physical examination, full laboratory tests (including arterial blood gas, complete blood cell with differentiation, international normalized ratio, kidney function tests, liver function tests, random blood sugar, C-reactive protein, erythrocyte sedimentation rate, serum sodium and serum potassium), chest X-ray and/or computerized tomography of chest, sputum cytological analysis and sputum culture. Measurement of qSOFA done in all patients.

Results
The median of qSOFA score in survivors was 0 while in nonsurvivors 1 at admission and after 48 hours with a significant difference between both groups. In overall patients qSOFA cutoff 1 has sensitivity and specificity 70% & 80.37%, respectively.

Conclusion
The qSOFA scores were associated with in hospital mortality, hospital admission, ICU admission, and hospital length of stay in patients likely to be admitted both with and without suspected infection, qSOFA is an easy tool that can be used to predict outcomes.
Factor V Leiden (FVL), Prothrombin G20210A and MTHFR C677T Mutations among Patients of Budd-Chiari Syndrome
Authors: Ghaffar Afaf Abdel Aziz Abdel , Hamza Mohamed Tarif , Ahmad Ahmad Mahmoud 
Published: August 2023

Abstract

Background
Many studies ask whether screening Factor V Leiden (FVL), Prothrombin G20210A and Methyl Tetra Hydro Folate Reductase (MTHFR) C677T Mutations should be routinely performed in patients with Budd–Chiari syndrome (BCS). However, the prevalence of these mutations in such patients is substantially variable.
This is the first study in clinical pathology department in Ain Shams University to evaluate the importance of this mutational screening in patients with Budd-Chiari syndrome to detect occult genetic susceptibility to thrombophilia.

Aim of the Work
This study aims to detect Factor V Leiden (FVL), Prothrombin G20210A and MTHFR C677T Mutations among Patients with Budd-Chiari Syndrome.

Patients and Methods
This study was a cross sectional study conducted on 35 newly of Budd Chiari syndrome patients who were attending tropical department at Ain Shams University Hospitals during the period from April 2020 to January 2021. Informed consent was obtained from all patients in the study.

Results
results of our study revealed that JAK2 mutation it was detected in 17.1% of patients (6 patients), While PGM was detected in 2.9% of our patients. Furthermore Factor V Leiden Mutation was detected in 65.7%of patients and MTHFR mutation was detected in 48.6% of patients.
The present study found no significant statistical difference between patients with Factor V Leiden Mutation & patients with normal Factor V Leiden regarding CBC parameters, levels of ANA, ACL IgM, ACL IgG, PC Deficiency, PS Deficiency and AT III Deficiency. In addition, our study revealed that there was no effect of MTHFR Mutation & JAK2 Mutation on levels of ANA, ACL IgM, ACL IgG, PC Deficiency, PS Deficiency and AT III Deficiency. Also there was no effect for MTHFR Mutation & JAK2 Mutation on outcome of patients, survival and response to treatment.

Conclusion
BCS is associated usually with genetic thrombophilia. Most commonly Factor V Leiden Mutation in 65.7%, followed by MTHFR mutation in 48.6% of our patients. Although, only Factor V Leiden Mutation has an effect on patients Outcome, Survival and Response to treatment through its effect on CBC parameters, levels of ANA, ACL IgM, ACL IgG, PC Deficiency, PS Deficiency and AT III Deficiency. Otherwise, JAK2 Mutation have significant effect on hemopoiesis.
NMDA, AMPA and GABA Receptor Antibodies: Relation to Clinical and Electrophysiological Findings in Drug-Resistant Epilepsy
Authors: Tuhami Ahmed Magdy , Talkhan Hala Ahmed , El Rakawi Mahmoud Hemeda , El-Shennawy Dina El-Sayed , El Najjar Marwa Rushdy , El-Aziz Doaa Mohammed Abd 
Published: August 2023

Abstract

Background
Epilepsy is a neurological disorder characterized by sudden recurrent episodes of convulsions, sensory disturbance, or loss of consciousness, resulting from abnormal electrical brain activity. It can have both genetic and acquired causes, with interaction of these factors in many cases. Auto-antibodies against synaptic receptors have been detected in a number of neurological conditions such as anti-NMDA receptor encephalitis and limbic encephalitis. Recently, three types of synaptic receptors have been the subject of research as regarding their role in the normal physiology of the nervous system, and their involvement in various neurological conditions. These receptors include AMPA receptors, NMDA receptors and GABAB receptors. Antibodies directed against these receptors may be the underlying cause of many cases of drug resistant epilepsy.

Objectives
To determine the prescence of autoantibodies against AMPA, NMDA and GABAB receptors in drug-resistant epilepsy and their correlation with clinical and electrophysiological findings.

Methods
The study was conducted on 17 epilepsy patients (12 males and 5 females) who were sampled for both CSF and blood. All CSF and serum samples were examined by the Indirect Immunofluorescence cell based technique for the detection of AntiAMPAR, Anti-NMDAR and Anti-GABAB antibodies.

Results
Only one case tested positive for Anti-NMDAR antibodies in CSF, while all other serum and CSF samples were negative for other antibodies. These results are still in process since our data will be used in a further study related to auto-immune drug-resistant epilepsy patients involving other auto-antibodies such as Ant-LGI1, Anti-CASPR2 and Anti-DPPX antibodies.

Conclusion
Testing Anti-NMDAR antibodies can be promising in detecteing drug resistant epilepsy patients even after receiving immunomodulatory treatment protocols.