bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Regional Network on the Management of STEMI Patients in North Cairo
Authors: Saleh Atef K , Guindy Ramez R , Shahin Sameh M , Okasha Nireen K , Abdalhamid Mohammed A , Fakhry Hany M 
Published: August 2023

Abstract

Background
Worldwide, coronary artery disease (CAD) is the single most frequent cause of death.
Over seven million people every year die from CAD. The management of patients with STElevation myocardial infarction (STEMI) is influenced by health care service organizations. Regional STEMI networks for acute myocardial infarction facilitate primary percutaneous coronary intervention (PPCI) and its efficacy in reducing mortality and improving its outcomes.

Aim of the Work
The aim of the present study was to examine the impact of regional STEMI network on patients' management and on hospital outcomes in north Cairo governorate, Egypt.

Methods
The present study is a Prospective observational multicenter study that was conducted on 352 patients with STEMI and symptom onset within 48 hours who presented to north Cairo hospitals. The patients were divided into 2 groups, group I in the first six months before establishment of a network between the north Cairo hospitals and group II in the second six months when the network between those hospitals was activated. Comparison was done between the two groups as regards patients' demographics, logistics of presentation and in hospital outcomes.

Results
The number of patients upon implementation of STEMI network increased from 140 to 212 (51.4%) to the same hospitals with the same facilities and in equal periods of time (6 months). It was found that the mean time of chest pain to first medical contact (FMC) between the two groups before and after establishment of STEMI network did not change, it was 4 hours in both groups (P = 0.36) while the mean door to balloon time improved from 54.3 to 44.1 minutes (P = 0.01). In our study thrombolytic therapy use declined from 36.4% before STEMI network set up to only 7.5% (P &gt; 0.001), Ejection fraction (EF) improved from 51.3% to 55.4% (P &gt; 0.001), mitral regurge (MR) also improved upon establishment of STEMI network from 53.6% to 78.8 with (P &gt; 0.001), the mean CCU stay in group II was 2 days versus 3 days before implementation of STEMI network (P &gt; 0.001), the mean door in door out from the spokes was 40 minutes. In-hospital mortality improved upon establishment of STEMI network from 6.4% to 2.8% (P = 0.10).

Conclusion
The establishment of the STEMI network in Egypt is feasible and can lead to improvement of patients' outcomes. Thrombolytic therapy was no longer the main reperfusion therapy and primary PCI was offered to most patients after establishment of STEMI network.
Effect of Radiofrequency Current Application during Catheter Ablation on Heart Rate Variability in Patients with Supraventricular Tachycardia
Authors: Lotfy Nashaat , Effat Emad , Samir Rania , Eldamnhoury Hayam 
Published: August 2023

Abstract

Background
The autonomic nervous system has a significant regulatory effect on heart function; in addition to heart rate, cardiac conduction properties, hemodynamics, the cellular properties of cardiac myocytes, and cardiac arrhythmogenesis are also affected by the autonomic nervous system.

Objectives
In this study, we aimed to assess the Relationship between RF current application during Catheter ablation and it's effect on Heart Rate variability in patients undergoing RF catheter ablation for supraventricular Tachycardia.

Patients and Methods
This study is a cohort study, randomized clinical study, recruiting 20 patients from Ain Shams University hospitals, Cairo, Egypt. All patients were symptomatic with drug refractory documented supraventricular tachycardias. who underwent RF ablation March 2020 till February 2021 and were followed up for 1 month after the procedure.

Results
Compared with preablation data, HRV were shorter in all the RFA at the follow-up assessment. The 24-h Holter monitoring showed that mean and maximal HR were increased, whereas the HRV parameters, including time domain indices (SDNN, rMSSD) and frequency domain index, which reflect the attenuation of parasympathetic tone, were decreased in the RFA during the postablation period. In this study, there was significant increasing in mean heart rate regarding basal and the subsequent follow up after 1 week and 1 month. Post ablation high sinus rate (PA-HSR) was defined as an increase in resting sinus rate &gt; or = 20 bpm or a resting sinus rate &gt; or = 92 bpm without physiological or hemodynamic causes. In this study PAHSR was found in 10 patients (50%) by month-1 follow up. There is relation between the target site of RF ablation and the difference of HRV parameters.

Conclusion
Cardiac autonomic dysfunction assessed by changes in time domain and frequency domain heart rate variability parameters persisted for 1 month after radiofrequency ablation. Parasympathetic denervation may be one mechanism of Post ablation high sinus rate.
Outcomes of COPD Patients in RICU Ain Shams University Hospital and ICU Mansura
Authors: EL Monem Aya Kamal Abd , EL Sabour Faramawy Mohammad Abd , Ali Tamer Mohamed 
Published: August 2023

Abstract

Background
Chronic obstructive pulmonary disease (COPD) is a disease characterized by progressive, persistent, expiratory airflow limitation that is not fully reversible. In the United States, COPD annually accounts for $29.5 billion in direct health care costs, 750,000 hospitalizations, and 1.5 million emergency visits. Globally it is now ranked as the fifth leading cause of death. An exacerbation of COPD is characterized by an acute worsening of a patient's respiratory symptoms that result in change in treatment and increased utilization of health care resources.

Objective
the aim of this work was to evaluate the characteristics and clinical outcomes of COPD patients admitted to RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital.

Patients and Methods
This was an observational study conducted on a total of 100 patients admitted to ICU with acute exacerbation of Chronic Obstructive Pulmonary Disease at RICU in Ain Shams University Hospital and ICU Mansoura Chest Diseases Hospital within the period from November 2019 to April 2020. We excluded patients with obstructive lung disease other than COPD, Restrective lung disease, Malignancy and TB. The all cases were subjected to Full detailed medical history and full thorough clinical examination. We assessed the outcomes in regard to Length of stay (LOS) and MV duration. Assessment of the outcome which was be either death or discharge to chest ward, home or referral to any other department to complete the treatment.

Results
The study demonstrated that, the prevalence was 78% survival versus 22% mortality. there was a statistically significant difference among survivors and dead in terms of the cause of admission, there was statistically significant increase among dead cases compared to the survivors regarding APACHE II score, there was there was highly statistically significant decrease in terms of all PH measurements and all PCO2 measurements but there were no statistically significant differences among dead cases and survivors regarding all PO2 measurements, all HCO3 measurements and all SaO2 measurements.

Conclusion
Mortality was demonstrated to be correlated with several factors such as presence of co-morbidity, original cause of admission, APACHE II score, ABG parameters, WBCs, neutrophils, creatinine, urea, Reintubation, and complications of invasive ventilation.
Study of the Effect of CYP3A5 Single Nucleotide Polymorphism on Tacrolimus Metabolism in Liver Transplant Patients
Authors: Saleh ElHadidi Eman , Hussein Maha Mohsen , Kamal El-Din Manal Mohsen Mohamed , Ghani Amani Mohamed Abdel , Habib Dina Ayed Abdel Moez 
Published: August 2023

Abstract

Background
Liver transplantation (LT) is currently recognized as the most effective treatment for all types of end stage liver diseases. Major advances have been made in the field of liver transplantation due to improvements in surgical techniques and organ conservation as well as optimization of intensive care and immunosuppressive management.

Aim of the Work
To assess the influence of CYP3A5 rs776746 gene polymorphism on tacrolimus dose and its role in individualizing tacrolimus dose in Egyptian liver transplant recipient.

Patients and Methods
The study included 25 liver transplant recipients and their corresponding donors. CYP3A5 gene polymorphism was done to all participants by RTPCR. For recipients, tacrolimus trough level was measured and tacrolimus weight adjusted dose was recorded. Drug concentration over dose ratio was calculated (C/D ratio).

Results
The present study showed that recipients carrying 3*1 and 1*1 genotypes required higher dose of tacrolimus than recipients with 3*3 genotype but was not statistical significance. Donors carrying 3*1 and 1*1 genotypes, their corresponding recepients needed higher doses of tacrolimus to achieve the desired trough levels and thus lower C/D ratio compared to recipients with donors carrying 3*3 genotype with statistically significant difference in the first month post transpalnt.

Conclusion
The present study revealed that recipients and grafts carrying 3*1 and 1*1 genotypes require higher dose of tacrolimus than those with 3*3 genotype. Effect of graft’s CYP3A5 genotype has higher significance than recipient’s genotype on tacrolimus dose and C/D ratio.
The Clinical Utility of Transcription Factor 7-Like-2 (TCF7L2) Gene Polymorphism rs12255372 in Type 2 Diabetes Mellitus
Authors: Mahmoud Nermine Helmy , Hassan Somia Abd El-Hamid , Abdel-Wahed Marwa Ali , Farouk Manar Hassan 
Published: August 2023

Abstract

Background
Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from defect of insulin secretion and/or increased cellular resistance to insulin.

Aim of the Work
Our study aimed to evaluate the association of TCF7L2 rs12255372 gene polymorphism with T2D.

Patients and Methods
The study was conducted on forty seven (47) diabetic patients who were recruited from the out-patient clinic and in-patient Department of Endocrinology at Ain Shams University Hospitals; in addition, twenty three (23) age- and sex-matched healthy subjects taken as healthy control group. Assay of TCF7L2 rs12255372 gene polymorphism was performed by real-time PCR analysis.

Results
The study had demonstrated that there was no significant association between TCF7L2 rs12255372 G&gt;T gene polymorphism and T2D. However, there was significant association between the concordance of risk T allele and the occurrence of dyslipidemia.

Conclusion
Our study did not confirm the presence of significant association between the TCF7L2 rs12255372 (G/T) polymorphism and T2D inspite of higher frequency of T allele in diabetic patients than healthy controls, however, it pointed to the association between the concordance of T allele in T2D patients with poor glycemic control with sulphonylurea.
Diagnostic Evaluation of Modified Hematological Sepsis Score and Presepsin in Neonatal Sepsis
Authors: Ibrahim Marina Mamdouh Malky , El-Sewefy Dalia Ahmed , Ibrahim Mariam John Amin , Pessar Shaimaa Abdelmalik 
Published: August 2023

Abstract

Background
Early diagnosis of neonatal sepsis and assessment of the severity of the disease is not yet effectively achieved. Some hematological parameters are used to formulate a hematological scoring system (HSS) and a modified hematological scoring system(MHSS), for diagnosis of neonatal sepsis. A promising biomarker is Presepsin, or Soluble Cluster of Differentiation 14 SubType (sCD14-ST), which is a proteolysis product of CD14, that is produced after immune activation during infections.

Aim of the Work
To evaluate the performance of both HSS, MHSS and serum presepsin level, in neonatal sepsis, and compare them to C-reactive protein (CRP) as diagnostic tools and predictors of mortality.

Methods
The study was divided into two groups, one group comprised 51 neonates who further subgrouped into suspected & proved sepsis, along with 30 neonates who were admitted for non-infectious causes who served as control group. Both groups were subjected to calculation of HSS, MHSS, serum presepsin levels, CRP measurement, blood culture and, assessed for clinical severity and mortality.

Results
Hematological sepsis scores and presepsin levels were significantly higher in sepsis group. Presepsin showed the best diagnostic performance at &gt; 0.5 ng/ml (AUC 0.979; sensitivity of 94.1% and specificity of 100%). While HSS and MHSS at a cutoff value &gt; 1 achieved comparable specificity but lower sensitivity, 72.6% for the former and 76.5% for the later. Presepsin also was significantly higher in died group with the best predictive performance over CRP at cut-off value &gt;1.9 ng/ml (AUC 0.83; sensitivity of 85.7% and specificity of 79.6%)

Conclusions
Hematological sepsis scores and presepsin were found to be useful diagnostic tools in neonatal sepsis with presepsin as a good predictor of mortality comparable to CRP.
Disclosure: The authors declare that they have no conflict of interest.
Study of Clinical Utility of miRNA-31 in Diagnosis of Bladder Cancer in Egyptian Patients
Authors: Sabbour Ghada Sadek , Hassan Mona Mohamed , Aly Heba Hassan , Ismaiil Shimaa Mostafa , El-Leithy Tarek Ramzy , Mahgoub Eman Seyam , El-Sisy Mostafa Mostafa Mohamed 
Published: August 2023

Abstract

Background
Bladder cancer ranks as one of the most prevalent cancers worldwide, with a rising incidence and prevalence; also it is accompanied by a high morbidity and mortality. BC is a complex disease with several molecular and pathological pathways, thus reflecting different behaviors depending on the clinical staging of the tumor and molecular type.

Objective
To evaluate the clinical utility of miRNA-31 in plasma as an early novel diagnostic marker for patients with bladder cancer, in comparison to cystoscopy with histopathology as a conventionally used technique for cancer detection.

Patients and Methods
This study was performed on a total of 45 subjects selected from Urosurgery department at Theodor Bilharz Research Institute (TBRI) and Ain shams university hospitals in the period from January to October 2020. They were divided into the following groups: Group 1: 30 Bladder cancer (BCA) patients diagnosed by clinical examination, laboratory investigations (Urine cytology, urine analysis, complete blood count, liver & kidney functions) & cystoscopy with histopathology. Group 2: 15 apparently healthy volunteers matched in age and sex with the patients taken as the control group.

Results
It is found that miRNA 31 is abnormally expressed in cancer cells and play an important role in cancer development. It functions as an oncogene or a tumor suppressor in different cancer types which made it a candidate for our study. The present study revealed a statistical significance of miRNA-31 upregulation in plasma of late BC patients in comparison with early BC patients and control group, but there was no significance between its upregulation in the plasma of early BC patients in comparison with the control group. This shows that circulating miRNA-31 in plasma can be used as a prognostic biomarker for BC.

Conclusion
The present study revealed that the circulating miRNA-31 in plasma has no role as a diagnostic biomarker for BC.
Efficacy of Ablative Fractional Carbon Dioxide Laser Alone and Combined with Platelet-Rich Plasma in the Treatment of Androgenetic Alopecia
Authors: Galal Amira Nagy Mohamed , Afify Ahmed Abd Elfattah , Nabil Tarek , Samahy Mai Hussein El 
Published: August 2023

Abstract

Androgenetic alopecia (AGA) is a common form of hair loss in both men and women. In men, this condition is also known as male-pattern baldness. Fractional CO2 laser treatment has effectively induced hair regrowth through the wound-healing process. Platelet-rich plasma (PRP) ensures local delivery of growth factors, modification of the inflammatory response, and stimulation of cell proliferation and differentiation within the target tissue. PRP therefore showed a beneficial effect in treatment of AGA.

Aim of the Study
The aim of this study is to evaluate and compare the efficacy and safety of ablative carbon dioxide (CO2) fractional laser alone or combined with platelets rich plasma therapy in the treatment of Male Androgenetic Alopecia.

Patients and Methods
The study included 35 patients suffering from AGA. All patients will receive bilateral ablative fractional CO2 laser treatment on the alopecic scalp and the right or left side of the scalp will be randomly selected to be covered with platelet-rich plasma and the other half of the scalp will be covered with saline after the laser at the same session.

Results
Combined ablative fractional CO2 laser treatment and platelet-rich plasma showed statistically significant improvement compared to ablative fractional CO2 laser alone.
Assessment of the Role of Dermoscope for Monitoring Patients with Chronic Plaque Psoriasis before and after Narrowband Ultraviolet B Phototherapy
Authors: Sayed Mahira H El , Lotfi Ranya A , Ragheb Pola O 
Published: August 2023

Abstract

Background
Phototherapy is a traditional treatment for psoriasis, but its prolonged use is associated with cumulative toxicity, so physicians are in continuous need of tools to predict and monitor the progress of the disease.

Objectives
To detect if there is any role for dermoscopy in monitoring patients with chronic plaque psoriasis on narrowband ultraviolet B phototherapy.

Patients and Methods
A total of 30 patients with Chronic Plaque psoriasis were treated by narrow-band ultraviolet B phototherapy for three months according to their local and general conditions. Psoriasis Area and Severity Index score calculation and dermoscopic examination were done at baseline, after 6 weeks, and after 12 weeks of starting treatment.

Results
A significant association was noted between changes in the vessel distribution in psoriatic lesions and the response to treatment according to Psoriasis Area and Severity Index score assessment along with treatment visits, whereas the presence of globular blood vessels was significantly associated with poor clinical response.

Conclusion
Dermoscope is a rapid simple tool to predict the response of psoriatic patients to phototherapy using vascular pattern assessment.
Evaluation of Serum Lipocalin-2 Level and Its Relation to Insulin Resistance in Patients with Inflammatory Acne Vulgaris
Authors: Al Hashimi Sara Hameed Samin , Zaki Marwa SalahEldin , Soltan Marwa Yassin 
Published: August 2023

Abstract

Introduction
Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous unit. It is characterized by the formation of non-inflammatory comedones and inflammatory papules, pustules, nodules and cysts. Lipocalin-2 (LCN2) is an attractive biomarker of inflammation, ischemia, infection, and kidney damage.

Aim of the Study
The current study aimed to evaluate serum Lipocalin-2 levels in inflammatory acne vulgaris patients and to reveal the possible relation between its serum levels and the insulin resistance status in acne patients.

Patients and Methods
The study included 60 patients suffering from inflammatory acne vulgaris and 60 healthy control subjects. Full general and dermatological examination were performed, recording of BMI, GAGS score was done. Then, measurement of fasting insulin and fasting glucose was performed to calculate HOMA-IR.

Results
Serum lipocalin-2, fasting insulin and HOMA-IR levels were significantly higher in acne patients compared to control subjects.

Conclusion
Inflammatory acne vulgaris patients have higher levels of serum lipocalin-2 which might be related to acne pathogenesis.
Reliability of Fine Needle Aspiration Cytology for Salivary Gland Tumours Meta-Analytical Study
Authors: Fawzy Yasser Mohamed , Abdelkader Hesham Abdelaaty , Shafik Michael Rezk , Fayek Hany Shoukry 
Published: August 2023

Abstract

Background
Fine needle aspiration (FNA) cytology is a safe, reliable, minimally invasive and cost- effective technique for the diagnosis of salivary gland lesions.

Aim and objectives
to assess the accuracy, sensitivity and specificity of FNAC for diagnosis of salivary gland tumors in comparison with biopsy as definite diagnostic tool for these tumors.

Subjects and methods
This is a Retrospective and prospective studies, was carried out on Patients diagnosed with salivary gland tumors, treated with surgical management.

Result
FNA was associated with statistically significant fewer nondiagnostic results, Pooled analysis of all studies (n = 3605) revealed that rate of nondiagnostic results is 2.992% with 95% CI of rate 91.10–95.09 with absence of publication bias.

Conclusion
Fine needle aspiration biopsy is an important diagnostic tool for evaluating parotid gland tumors. It is more accurate in detecting benign tumors. In tumors greater than 2 cm and extending to the deep lobe, the sensitivity of fine needle aspiration biopsy is high. The use of fine needle aspiration biopsy in conjunction with clinical and radiological evaluation may help to reduce false positive and false negative results

Funding Sources
This research received no grant from any funding agency in the public, commercial or not-for-profit sectors.
Frequency and Pattern of Antibiotic Prescription for Common Infections Presented in Five Primary Healthcare Centers, Cairo, Egypt
Authors: Albahi Abeer Subhi Mohamed , Wahdan Maha M , Amen Ghada Essam Elden , Hassan Ahmed Nour Eldin 
Published: August 2023

Abstract

Background
rationale antibiotic prescription is a key strategy to control antibacterial resistance.

Objectives
to measure the antibiotic prescription rate, and to identify the most commonly prescribed antibiotic, and to explore the reasons for irrational antibiotic prescription in five primary healthcare (PHC) settings in Egypt.

Method
A Cross-sectional study was conducted on 535 prescriptions collected from five primary healthcare centres; and checklists about symptoms and signs of common health problems of respiratory tract, gastrointestinal tract and urinary tract for antibiotic prescription was fulfilled.

Results
Antibiotic prescription rate was (33.8%) and the most commonly prescribed antibiotic was Amoxil (Penicillin) (31.5%). Only (26.4%) of antibiotic prescriptions were adherence to the guidelines of Ministry of health of Egypt. Only (31.3%) of patients had upper respiratory tract infection were treated according to the guidelines where Tonsillitis was the most common URT diagnosis (43%), where only (34.3%) of them took Amoxil, followed by bronchitis (67.2%), where (46.3%) of them took Amoxil (adherent to guidelines). Only (31.2%) of patients had lower respiratory tract infection were treated according to the guidelines. Most of urinary tract infections were found among females (86.8%) and cipro was the most commonly prescribed antibiotic (39.5%).

Conclusion
Antibiotics are frequently prescribed in primary health care centers in Egypt, and most of these prescriptions are inappropriate. Training sessions for physicians is mandatory to improve their awareness, attitude and practice towards antibiotics prescription.