bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between Clinical, Serological and Ultrasound Assessment of Rheumatoid Arthritis Activity
Authors: Gabal Mervat Mamdouh Abo , Elaziz Amina Badr Eldin Abd , Hassan Sameh Abdel Moteleb , Mohammed Elham Shaaban , Mohammed Mostafa Adel Mohammed 
Published: August 2023

Abstract

Background
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of synovial tissue that leads to damage of cartilage and bone, resulting in irreversible joint destruction.

Aim of the Work
Our study’s aim was to assess the relationship between systematic ultrasound (US) evaluation using 7-joint and 12-joint scores and both clinical and serological evaluations in the determination of disease activity in rheumatoid arthritis patients. Also, we assessed the difference between both scores to know which is more accurate in assessing disease activity.

Patients and Methods
It was a cross sectional study that was carried out on fifty-five Egyptian RA patients diagnosed according to the 2010 American College of Rheumatology (ACR)/EULAR criteria. Patients were recruited from the rheumatology outpatient clinic at Ain Shams university hospital.

Results
Regarding 7-joint score parameters, mean and standard deviation for GS synovitis was 5.72 ± 4.44, PD synovitis was 3.74 ± 5.24, GS tenosynovitis was 1.15 ± 1.68, PD tenosynovitis was 1.76 ± 3.44 and erosions 1.07 ± 1.37. Regarding the examined areas for 7-joint score, wrist dorsal synovitis was the most common synovitis (98%), 2nd metacarpo-phalangeal joint (56%) then 2nd metatarso-phalangeal joint (49%). Wrist dorsal tenosynovitis (36%) was the most frequent tenosynovitis. Radial (33%), dorsal erosions (18%) of 2nd metacarpo-phalangeal joint and radial erosions (13%) of 5th metatarso-phalangeal joint were the most common erosions found. Our study detected significant positive correlation (P value &lt;0.05 and positive correlation coefficient) between majority of 7-joint and 12-joint score parameters (both GS and PD) and clinical disease activity variables, ESR, CRP and platelet count. Our study showed highly significant positive correlation (P value &lt;0.01 and positive correlation coefficient) between all parameters of 7-joint and 12-joint scores. We found that 12 joint score is slightly better than 7 joint score in accuracy and sensitivity in assessing rheumatoid arthritis disease activity despite being more time-consuming.

Conclusion
The 7-joint and 12-joint ultrasound scores were simple and practical sum scoring systems for use in the detection of synovitis in patients with RA and in assessment of disease activity in synovium. The correlations between the clinical disease activity indices, ESR, CRP, platelet count and components of the 7-joint and 12-joint scores may indicate their value in assessment of disease activity and severity up to date. The composite score (Combined synovitis score) for 12-joint score was significantly differentiating between moderate-severe patient groups (classified according to DAS28) with P value 0.029, so 12-joint score was better in identifying minimal difference in disease activity despite being time-consuming.
Association of Serum Zinc Level and Clinical Outcome in Patients with COVID19 Virus
Authors: Alnaqeeb Noha Abdelrazeq , ElGhandour Ahmed Mohamed , Fathallah Ahmed Magdy , Kamal Norhan Khaled Mohamed 
Published: August 2023

Abstract

Background
Zinc, one of the anti-inflammatory and antioxidant micronutrient found in food with well-established role in immunity, is currently being used in some clinical trials against COVID-19.

Objective
The aim of our study was to assess the association between mean levels of Zinc in the patients and mortality caused by COVID-19.

Patients and Methods
This was a comparative cross-sectional study that was performed on 60 Egyptian patients at Ain Shams University Quarantine field hospital, Ain Shams University Quarantine hospital In Al OboUr, and outpatient clinics at Ain shams university hospitals for 6 months period This study patients were divided according to clinical outcome into: Group I that included patients admitted to ICU and Group II that included patients admitted to ward.

Results
There was no statistically significant difference found between two groups regarding Sex, Age and Special habits, and there was no statistically significant difference found between two groups regarding CO-RADS classification, and there was statistically highly significant difference found found between two groups regarding Medical history. There was statistically significant difference found between two groups regarding Zinc level. There was statistically no significant difference found between two groups regarding Lymphocytes, Hemoglobin, Platelets, BUN, S. Creatinine, Total Bilirubin and S. Albumin, and there was statistically significant difference found between two groups regarding Neutrophil- Lymphocyte ratio, CRP, ESR, AST, ALT, FERRITIN and LDH, and there was statistically highly significant difference found between two groups regarding TLC, Neutrophils, D-DIMER and VIT D.

Conclusion
This study concluded a correlation between low SZC and COVID-19 severity and mortality. The cause is likely to be a combination of immune system imbalance and a direct benefit of viral replication. Thus, we propose SZC as a novel and additional parameter to predict COVID19 outcome.
Effect of Vitamin D on Irritable Bowel Syndrome on Ain Shams University Medical Students
Authors: Ibrahim Wesam A , Eid Yara M , Zaky Doaa Z , El Nabawy Omnia M , Elsheikh Noseila M 
Published: August 2023

Abstract

Objective
Irritable Bowel Syndrome (IBS) can be divided into three subtypes according to bowel habits –IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), and IBS with mixed bowel habits (IBS-M). Incidence of IBS has been increasing over last two decades. Recent studies have suggested a relationship between vitamin D and IBS. Vitamin D has a potential role as immune modulator, antiinflammatory, and anti-microbial agent that can explain its role in IBS.

Method
This study is part of The Nutritional Assessment of Medical Students of Ain Shams University (NAMS/ASU), the project was designed to evaluate the nutritional status of the undergraduate medical students. All participants were subjected to: Interview questionnaires including data: name, age, sex, study grade, past medical history and family history. Dietary recall: 24 hrs food recall, food frequency related iron intake. All data was analyzed using food composition table National Nutritional Institute (NNI). General clinical examination laying stress on: Systolic blood pressure & Diastolic blood pressure. This study was applied on 40 students who were diagnosed as IBS by ROME 4 criteria and vitamin D deficiency (&lt;20 IU). They were advised to eat rich vitamin D food and vitamin D supplementation by vitamin D oral drops cholecalciferol 42000 IU per week for 12 weeks then vitamin D level was reevaluated again and check ROME IV criteria for IBS.

Results
Demographic data of Irritable Bowel Syndrome among Ain Shams University Medical Students according to their demographic data regarding age, sex and BMI shows that the ranged age 20-24 with mean 22.33±1.37, while female (65%) and male (35%), as well as ranged BMI 1930 with mean 23.75±3.02 and the ranged systolic blood pressure 95-130 with mean 113.13±10.23, also ranged diastolic 60-85 with mean 73.88±7.02 of blood pressure of demographic data. After three months of vitmin D intervention participants were divided into 2 groups according to IBS symptoms relief group 1 was with no symptoms (ROME IV criteria are not fulfilled), while group 2 are the candidates whom ROME IV criteria are fulfilled but with a less degree and improvement of Rome IV criteria.%.

Conclusion
Female sex is more liable for IBS, being a student in a medical college and lack of exercise. Our study indicated that Vitamin D supplementation could play a therapeutic role in the control of IBS in medical students.
Effects of Ramadan Fasting on Diabetic Nephropathy in Type 2 Diabetic Patients
Authors: Mohammad Magda Shukry , Mahdy Maram Mohamed Maher , Ibrahim Nesma Ali , Jalil NourAlhoda Ahmed Abdul 
Published: August 2023

Abstract

Background
Type 2 diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients, as well as on the health care system. Diabetic nephropathy is one of the major complications of diabetes, characterized by proteinuria and renal insufficiency. The development of microalbuminuria is an early marker for diabetic nephropathy, which is potentially modifiable through lifestyle changes and pharmacological interventions targeting blood glucose and blood pressure, specifically through the renin angiotensin system.

Aim of the Work
The aim of this work is to study the effect of Ramadan fasting on diabetic nephropathy in type 2 diabetic patients.

Patients and Methods
Our study conducted on 90 type 2 diabetic patients, their age between 40-60 years; all of them are welling to fast the whole month of Ramadan, selected from the outpatient clinic of endocrinology, Ain Shams University Hospitals.

Results
There was a highly statistically significant increase in Creatinine (p &lt; 0.001) as well as a highly statistically significant increase in urea after Ramdan in all studied group (P &lt; 0.001). The Percentage change in GFR was significantly higher in macroalbuminuria. The Percentage change in A/C ratio in micro and macroalbuminuria were significantly lower when compared to normoalbuminuria, as well as in macroalbuminuria when compared to microalbuminuria groups. (P = 0.001). There were no significant differences found regarding, body mass index;, systolic blood pressure, diastolic blood pressure fasting blood glucose, postprandial blood glucose, HbA1c before and after Ramadan.

Conclusion
Ramadan fasting has no harmful impact on albuminuria among patients with T2DM. However, fasting leads to a significant decline in renal function parameters among diabetic patients with albuminuria. This decline is more prominent in patients with macroalbuminuria than patients with microalbuminuria. Thus, fasting should be avoided in patients with a severe decline in renal functions. Patients should be advised regarding adequate hydration and dietary modification during Pre-Ramadan health care education. On the other hand, Ramadan fasting has no negative impacts on glycemic control and other metabolic parameters. Nevertheless, further trials that assess the role of fasting in at-risk patients are still needed.
The Benefit of an Intensive Training Course on ERCP Artificial Simulator on Decreasing the Cannulation Time Achieved by the Trainees
Authors: Mounis Ahmed Ali , Al Baz Hossam Samir , Mostafa Mostafa Ibrahim , Badawy Al Ashram Mohamed Nabil , Gawad Nouran Roshdy Abd Ellah Abd El 
Published: August 2023

Abstract

Background
Trainees learn to perform ERCP with hands-on training in a clinical setting on real patients under the supervision of a trained endoscopist: the so-called master apprentice model. This setting offers immediate feedback from an experienced endoscopist, but it also has certain drawbacks. Trainees learn by “trial and error,” which potentially increases patient discomfort and risk of complications and prolongs procedure time, which has additional economic consequences. Simulators offer the potential to train in a dedicated „learning environment, offering a less stressful situation with less potential risks and the opportunity to endlessly repeat specific tasks.

Aim of the Work
The aim of this study is to test the benefit of a two weeks intensive training course on ERCP artificial simulator on decreasing the cannulation time achieved by the trainees.

Patients and Methods
This is a prospective study including 20 trainees classified into 2 equal groups; group (1) included 10 trainees were enrolled in a clinical training program only, and group (2) included 10 trainees were enrolled in an intensive two weeks hands on training on BoskoskiCostamagna ERCP trainer followed by clinical training. Another group (3) included 10 expert endoscopist represent the control group.

Results
All steps for ERCP shows successful ERCP steps of the three studied groups, however group (2) showed better improvement than group (1) as compared to group (3). None had failed for the overall technique. All steps for ERCP in the current study shows statistically highly significant difference (p &lt; 0.001) in comparison between the three studied groups. Group (2) with intensive training program had a highly significant difference than group (1) and group (3) had a highly significant difference than both groups (1) & (2). The total biliary and pancreatic cannulation times were statistically highly significant difference in comparison between the three studied groups.

Conclusion
ERCP is a skill demanding procedure, therefore trainees who will train in ERCP should be selected between those who are likely to achieve competence and will make good use of the valuable skills. Structured ERCP training programs are still not widely available, especially in developing countries. Scientific societies should promote training in endoscopy on all levels especially through scholarships for doctors from developing countries.
Study of the Relation between Atherosclerosis and Serum Level of 25(OH) Vitamin D among Maintenance Hemodialysis Patients
Authors: Wahab Saeed Abdel , Bichari Walid Ahmed , Abdelmobdy Ashraf Hassan , Othman Omaira Ahmed 
Published: August 2023

Abstract

Background
Cardiovascular (CV) disease is considered the main cause of exceedingly high overall mortality observed in hemodialysis patients. A number of studies have shown variable results on the relationship between 25 (OH) D deficiency and subclinical atherosclerosis.

Aim and objectives
To measure the relationship of serum 25(OH) D with Carotid intima-media thickness (cIMT) as a surrogate marker for the presence of atherosclerosis in hemodialysis patients,

Subjects and methods
This was a cross sectional study, was conducted on 90 patients (ESRD) undergoing hemodialysis in The National Institute of Nephrology and Urology divided into two groups: (Group A); included 45 ESRD patients on maintenance hemodialysis with normal carotid intima media thickness, (Group B): included 45 ESRD patients on maintenance hemodialysis with increased carotid intima media thickness during a period of 6 months.

Result
There were highly significant difference between both groups as regard 1, 25(OH) 2D, ng/ml.

Conclusion
Our findings suggested that vitamin D deficiency is not an independent predictor of subclinical atherosclerosis in elderly patients after adjusting confounding factors. Future studies to address the association between serum 25(OH) D and the cIMT need to be explored carefully. Finally we came to the conclusion that in patients on HD, the deficiency of vitamin D is related to rising of ESR asan inflammatory marke,
Study of the Relation between 8_Hydroxy-2′-deoxyguanosin (8_OHDG) and Suspicious Thyroid Nodule in a Patients with Multinodular Goiter
Authors: Sheriba Nermin Ahmed , Mahdy Maram Mohamed Maher , Marawan Dina Ahmed , Eljazwi Ruwida Fouli Farag Mohamed 
Published: August 2023

Abstract

Background
Nodular disease of the thyroid gland is prevalent. The lifetime risk for developing a palpable thyroid nodule is estimated to be 5-10%, however, high resolution ultrasound has revealed thyroid nodules in 19-68% of randomly selected individuals. The condition affects more women than men.

Aim of the Work
In this study we aimed to study the relation between 8_Hydroxy-2'deoxyguanosin (8_OHDG) and Suspicious Thyroid nodule in a Patients with Multinodular Goiter.

Patients and Methods
The present study was a case-control study that was conducted on 60 subjects patients presented with MNG at Ain Shams University hospital during the period from January to December 2019.

Results
The results of our study demonstrated that plasma 8_OHDG levels were higher in patients with Multinodular goiter than in control group, and were higher in MNG patients with cancer than MNG without cancer. Which confirms the presence of oxidative stress in patients with non-toxic multinodular goiter and 8-OHDG levels may be markers of the carcinogenic potential of Multinodular goiter.

Conclusion
Our study confirms the presence of oxidative stress in patients with non-toxic multinodular goitre. The plasma 8-OHDG levels may be markers of the carcinogenic potential of multinodular goiter and could be used for early detection of different cancer types, including thyroid cancer. This warrants nutritional support with antioxidant agents in patients with non-toxic multinodular goiter. Further studies are warranted for better understanding of underlying pathogenic mechanism of oxidative stress in non-toxic Multinodulargoitre.
Role of Activin A as a Novel Marker for Diagnosis and Evaluation of Nonalchoholic Fatty Liver Disease
Authors: Bakir Amal Shawky Mohamed , Abohalima Ahmed Samir , Ghait Ramy Samir , Atalla Samir Yousry Barsoum 
Published: August 2023

Abstract

Background
Nonalcoholic fatty liver disease (NAFLD) is a disease gaining increasing interest worldwide. It ranges from simple nonalcoholic steatosis to nonalcoholic steatohepatitis (NASH), is characterized by steatosis, inflammation and fibrosis, and may lead to liver cirrhosis and hepatocellular carcinoma. Nonalcoholic fatty liver disease shares common pathogenetic mechanisms with other components of the insulin resistance or metabolic syndrome, with adipokines playing a crucial role.

Aim of the Work
Recent studies suggest that activin A, a member of the transforming growth factor (TGF) superfamily, is involved in the pathogenesis of liver disorders. We sought to explore its possible role in non-alcoholic fatty liver disease (NAFLD).

Patients and Methods
This study is a comparative case control study. This study was carried out at outpatient’s clinics of internal medicine department of Ain Shams University.

Target population
Group 1: Including 35 patients with NAS (steatosis) with exclusion criteria of intake of hepatotoxic drugs. Group 2: Including 35 patients with fatty liver and elevated liver enzymes (NASH). Group 3: Including 20 patients as a control group.

Results
There was high statistically significant difference between the studied groups as regard weight and BMI. In the Steatosis group the mean Liver size was 13.97 (±1.29 SD) with range (1216) cm, all the patients (100%) had enlarged- echogenic liver. In the NASH group the mean Liver size was 13.71 (±1.36 SD) with range (12-16) cm, all the patients (100%) had enlarged-echogenic liver. In the control group the mean Liver size was 9.85 (±1.5 SD) with range (8-12) cm, all the patients (100%) had Normal liver. There was high statistically significant difference between the studied groups as regard liver size. There was high statistically significant difference between the studied groups as regard ALT, AST, total and direct bilirubin, plts count and activin A, significant difference between the studied groups as regard Albumin. There was high statistically significant difference between the studied groups as regard APRI score, FIB-4. There was high correlation between Activin A and BMI, APRI score, FIB-4 and liver size with high significance (p &lt; 0.001). Using Activin A. it was shown that above 858.5, it can discriminate between NAFLD and nonNAFLD with level of sensitivity 100% and specificity 100%.

Conclusion
Serum activin A showed a trend towards progressive increase from controls, to SS and NASH patients, but the significance was lost after adjustment for measures of adiposity. Activin A was not independently associated with NASH or any specific hepatic lesion within NAFLD patients. Prospective studies are needed to confirm the hypothesis raised herein, before mechanistic studies attempt to elucidate mechanism and prove causality.
Impact of Dialysis Fluid Delivery System on Anemia in Hemodialysis Patients
Authors: Hebah Hayam Ahmed , Hassan Mohamed Saeed , Mohsen EL-sharabasy Reem , Mourad Tarek Ali Hasan Ali 
Published: August 2023

Background
Patients on standard dialysis, in particular those on high-flux and high-efficiency dialysis, are exposed to hundreds of liters of dialysis-water per week. The quality of dialysis-water is a factor responsible for inflammation which is a potent trigger of atherosclerosis and a pathogenic factor in anemia, increasing mortality and morbidity in these patients. Current systems for water treatment do not completely eliminate bacteria and endotoxins. Our study tests if improved dialysiswater purity by using Central dialysis Fluid Delivery System (CDDS) can reduce inflammation and ameliorate hemoglobin levels.

Aim of the Work
The aim of this work is to compare between the effect of using Central Dialysis Fluid Delivery System (CDDS) and Single Dialysis Fluid Delivery System (SDDS) on Anemia in prevalent Hemodialysis Patients

Patients and Methods
This prospective observational cohort study was conducted between May 2019 and July 2019 and was conducted on 100 prevalent Hemodialysis Patient divided into 2 groups, each group included 50 patients, one group receiving Hemodialysis treatment using the central dialysis fluid delivery system (CDDS), while the other group receiving Hemodialysis treatment using the single-patient dialysis fluid delivery system (SPPDS).

Results
Endotoxin level in the dialysate fluid was found to be markedly lower in the CDDS group (0.05 EU/ml) compared to the SPDDS group (0.11 EU/ml). Baseline CRP level didn’t differ significantly between both groups (P-value: 0.88), however throughout the follow up period patients who were on dialysis using the CDDS showed a sustained significant decrease in CRP level compared to those using the SPDDS (P-value: &lt;0.001 for the 3m follow up period), denoting improvement of their chronic inflammatory status. Baseline hemoglobin level didn’t differ significantly between both groups (P-value: 0.52), however throughout the follow up period patients who received dialysis using CDDS showed a sustained significant increase in their hemoglobin level, while those receiving dialysis using SPDDS showed no significant change in their hemoglobin level, also hemoglobin level in the CDDS Group was higher than in the SPDDS group at 1st, 2nd and 3rd months. (P-value: 0.008, &lt;0.001 and &lt;0.001 for the follow up month 1, 2 and 3 respectively). Using URR as an indicator for efficiency of the HD session, there was no statistically significant difference between both groups among three months of follow-up.

Conclusion
Ultrapure dialysis fluid (UPD) produced by the Central dialysis