bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extrapulmonary tuberculosis situation in El-Behira Governorate, Egypt
Authors: Hibah Nabil A. Abdelghaffar 
Published: September 2023

Abstract
Aim
There have been little published data about extrapulmonary tuberculosis (EPTB) situation in Egypt. The aim was to throw some light over EPTB patterns in Egypt regarding demographics, sites of affection, and treatment outcome.

Methods
This work was a retrospective, descriptive analysis of EPTB cases, carried out at El-Behira Chest Hospital and 14 related dispensaries. All available data about registered EPTB cases from January 1996 to December 2010 (15 years duration) were collected including demographic data, site of EPTB, previous treatment history, treatment category, and treatment outcome. A descriptive analysis of the data was performed using the SPSS statistical program. Data were described in absolute numbers and percentages. Statistical significance was set at P value less than 0.05.

Results
EPTB [n = 2119 (21%) of all diagnosed tuberculosis] occurred more in age groups between 15 and 29 and 30 and 44 years [n = 965 (45.5%) and n = 572 (27%), respectively] and in male patients [n = 1233 (58%)] than in female patients [n = 886 (42%)]. Pleural [n = 1341 (63.3%)], bone [n = 157 (7.5%)], and renal [n = 34 (1.6%)] tuberculosis were more common in male patients [n = 856 (64%), n = 99 (63%), n = 22 (64.5%), respectively], whereas lymph node [n = 427 (20%)] and genital [n = 70 (3.3%)] tuberculosis were more common in female patients [n = 240 (56.5%), n = 42 (60%), respectively]. Regarding treatment outcomes, successful treatment was obtained in 1725 cases (81.5%), treatment failure in 13 cases (0.5%), defaulting in 179 cases (8.5%), death in 77 cases (3.5%), and transfer-out in 125 cases (6%). Number of cases diagnosed declined through the years of study and was the highest in winter months, peaking in March.

Conclusion
EPTB is a burden of reproductive age groups (15–44 years), with pleura being the commonest site of the disease that occurred more in male patients and age groups 15–44 years, followed by lymph nodes that occurred more in female patients and age group below 15 years. Successful treatment outcome was obtained in 81.5% of EPTB cases.
Incidence of tuberculosis before and after DOTS (direct observed therapy short course strategy) implementation in El-Behira Governorate, Egypt
Authors: Alwani Ali K. , Al-Aarag Abdelsadek H. , Omar Magdy M. , Hibah Nabil A. Abdelghaffar 
Published: September 2023

Abstract
Aim
The aim of this work was to study the incidence of tuberculosis (TB) in El-Behira Governorate before and after application of DOTS (direct observed therapy short course strategy) to evaluate the National Tuberculosis Control Program in El-Behira Governorate as a representative part of Egypt.

Patients and methods
This work was a retrospective, descriptive, analytical study of the TB situation before and after DOTS, carried out at Chest Hospital, El-Behira Governorate, Egypt, and related dispensaries. All available data on registered TB cases from January 1996 until December 2010 (15-year duration) were collected, including demographic data, diagnosis of disease, sputum smear results, previous treatment history, and treatment outcome. A descriptive analysis of the data was performed using the SPSS statistical program. Data were described in absolute numbers and percentages. Statistical significance was set at P values less than 0.05.

Results
The incidence of TB (n = 10 035) was higher in age groups 15–29 and 30–45 years [n = 3829 (38.2%) and n = 2827 (28.1%), respectively], and in male patients [n = 6511 (64.8%)] compared with female patients [n = 3524 (35.2%)]. Pulmonary cases (78.8%) were more than extrapulmonary cases (21.2%). There was improvement in cure rate, treatment completion rate, treatment success rate, number of retreatment cases, and default rate after DOTS application (46–61.1, 16.1–18.6, 62.1–79.7, 29.1–12.4, and 20.4–6.8%, respectively).

Conclusion
TB is a burden of the productive age group of 15–45 years, with a higher incidence in men than in women, and DOTS is an effective tool for controlling TB in El-Behira Governorate. The implementation of this tool has led to significant increase in treatment success and decrease in default and failure rates.
Behçet’s disease: case reports
Authors: Agmy Gamal M. 
Published: September 2023

AbstractBehcet diseases is not only orogenital ulcerations but also it can have many systemic manifestations. In this article we presented 3 cases of Behcet disease associated with pulmonary artery aneurysms affecting the large branches. Pulmonary artery aneurysms are common and serious vascular complication of Behcet disease.These are usully large and accompanied with intramural thrombi and multiple pulmonary infarctions with a common presentation of haemoptysis. A detailed discussion of pulmonary manifesttions of Behcet disease was demonstrated.
Assessment of the prevalence of depression in chronic obstructive pulmonary disease patients
Authors: Eissa Sherif A. , Essawy Tarek S. , Almahdy Mohammad A. , Mohammed Shaymaa A. , El-Hamady Mohammed M. 
Published: September 2023

Abstract
Background
Depression often occurs in patients with chronic obstructive pulmonary disease (COPD). In stable COPD, the prevalence of clinical depression ranges between 10 and 42%. The risk of depression is higher in patients with severe COPD, compared with control participants, reaching up to 62%, in oxygen-dependent patients.

Aim
The aim of this work was to study the prevalence of depression in COPD patients.

Patients and methods
The present study was carried out on 100 male COPD patients and 10 female COPD patients admitted to Mansoura Chest Hospital and the chest department of Benha University Hospital during the period from 2014 to 2016. All participants were submitted to Beck’s depression Inventory questionnaire.

Results
The degree of depression assessed by Beck’s score increased significantly with the degree of COPD, use of long-term oxygen therapy, and low BMI.

Conclusion
The prevalence and severity of depression increase with increasing severity of COPD.
Role of transthoracic ultrasound in differentiation of the causes of pleural thickening
Authors: Kamel Khaled M. , El-Hinnawy Yasmine H. 
Published: September 2023

Abstract
Objectives
Pleural thickening is defined as the increase in thickness of the pleura of more than 3mm and can be caused by a wide range of diseases, either nonmalignant or malignant. Thoracic ultrasound has high sensitivity in assessing the pleura.

Aim
The aim of this study was to assess the role of thoracic ultrasound in differentiation of the causes of pleural thickening.

Design
A prospective study included 48 patients selected from the inpatient Chest Department, Kasr Al-Ainy Hospital, from January 2016 till October 2017. Patients diagnosed as having pleural thickening underwent thoracic ultrasound as well as ultrasound-guided pleural biopsy by Tru-cut needle. Descriptive data were obtained including age and sex of the patients. Thoracic ultrasound was done for the side of pleural thickening. The distribution of pleural thickness, either localized or diffuse; the surface; invasion of chest wall or diaphragm; the echogenicity and vascularity; and the presence of pleural effusion and its pattern were determined. The patients were classified into two main groups: nonmalignant (subclassified as tuberculous and nonspecific infection) and malignant cases (subclassified as mesothelioma and metastatic cases).

Results
There was a statistically significant relation between the distribution either localized, diffuse, unilateral, or bilateral; the surface of the thickness; invasion of chest wall or diaphragm; the echogenicity; vascularity of the pleural thickness; and the presence of pleural effusion and its pattern on one hand and the diagnosis of pleural thickening on the other hand. There was insignificant statistical difference between pleural mesothelioma and pleural metastatic cases, and also there was insignificant statistical difference between tuberculous and nonspecific infection cases.

Conclusion
The transthoracic ultrasound had a very good predilection for the diagnosis of pleural thickening etiology whether malignant or nonmalignant.
The effect of triggering type on post-triggering pressure variations during pressure support ventilation: a simplified surrogate for dyssynchrony
Authors: Al-Najjar Maher M. H. , Fahmy Tamer S. , Al-Shafee Mohamed A. , Al-Atroush Hatem 
Published: September 2023

Abstract
Context
Several studies comparing flow and pressure triggering using invasive and noninvasive techniques have mostly focused on the trigger phase and favored flow triggering. Recently, there have been advancements in the technology of pressure triggering to improve its performance.

Aims
We sought to evaluate the effect of triggering type in old and new ventilators on patient’s synchrony in the post-trigger phase using variations in airway pressures with the set inspiratory pressure as a surrogate for dyssynchrony.

Patients and methods
Using three different ventilator types, 32 patients on pressure support ventilation were set on the two triggering types (at the same equivalent levels), each for 1 h, with all other ventilatory setting kept constant. At the end of the hour on each trigger mode, the measured peak pressure and its difference with the set inspiratory pressure [delta pressure (ΔP)], the mean airway pressure, and different ventilatory parameters and arterial blood gases were assessed.

Results
Pressure triggering resulted in a significantly higher peak pressure, ΔP, and lower dynamic compliance at any equivalent sensitivity and pressure support regardless of the level (<0.05). Moreover, at higher sensitivity levels (3 cmH2O and l/min), flow triggering produced higher mean airway pressures and oxygenation (<0.05). However, there was no significant difference as regards tidal volume, minute volume, frequency, rapid shallow breathing index, or PCO2.

Conclusion
Despite advances in pressure-triggering technology, flow triggering results in less pressure variation and better patient’s synchrony during pressure support ventilation; in this respect, ΔP and dynamic compliance are simple noninvasive measures for dyssynchrony.
Prevalence, causes, and clinical implications of pleural effusion in pulmonary ICU and correlation with patient outcomes
Authors: Farrag Mohamed , Masry Ahmed El , Shoukri Amr M. , ElSayed Mona 
Published: September 2023

Abstract
Introduction
Pleural effusion is common in medical ICU (MICU) patients, and it may develop owing to different causes and may affect patients outcomes.

Objective
The aim of this work was to study the prevalence and causes of pleural effusion in MICU and its effect on patient outcomes.

Patients and methods
A total of 90 patients admitted to MICU in Abbaseia Chest Hospital were included in the present study. The patients initially had pleural effusion or effusion developed during their ICU stay.

Results
Overall, 66 patients were males and 24 were females, and their mean age was 51.5±18.6 years. The prevalence rate of pleural effusion in our MICU during 1-year period was 12.7%. Pleural effusion was found to be exudates in 77.7% of cases and transudates in 22.3%. Uncomplicated parapneumonic effusion was the most common cause (36.7%), followed by heart failure (17.8%). The cause of pleural effusion did not significantly affect the patient outcome or duration of ICU stay. No significant reduction in duration of ICU stay or ICU mortality was seen in patients who received therapeutic aspiration or tube drainage compared with patients who received no specific management for effusion.

Conclusion
The commonest cause of pleural effusion in MICU is parapneumonic effusion, and chest ultrasonography is the best method of fluid detection. Different methods of management do not significantly affect patient outcomes.
Evaluation of the role of video - assisted thoracoscopic surgery in management of empyema
Authors: Farrag Mohammed Ali , Al Bawab Hatem Yazed , Mohamed Abd ELfattah Nevine Mohamed , Abd ElFattah Eman Badawy , Khalil Mahmoud Mohsen Mahmoud 
Published: September 2023

Abstract
Background
Video-assisted thoracoscopic surgery (VATS) is effective for fibropurulent thoracic empyema and less invasive, and it may be important as a bridge between minimally invasive and conventional open thoracic surgical management.

Aim
The aim of this study was to determine the optimal treatment of parapneumonic effusion in the fibrinopurulent stage comparing blind thoracostomy versus VATS with regard to efficacy, duration of hospitalization and intercostal tube (ICT) insertion, and need for further surgery or not.

Patients and methods
This study was a prospective comparative randomized study conducted on 60 patients with confirmed parapneumonic effusion where they were classified into two groups. The blind thoracostomy group: 30 patients underwent blind thoracostomy and the VATS group: 30 patients underwent VATS.

Results
The incidence of clinical improvement was more in the VATS group when compared to the blind thoracostomy group. The hospital outcome in the VATS group was much better than in the blind group, where in the VATS group, the postoperative length of hospital stay was around 4.8 days and the time of ICT removal was after 5 days from insertion, whereas in the blind group, the length of hospital stay was around 9.7 days and the time of ICT removal was after about 6 days of insertion. The incidence of postoperative complications was higher in the blind group than in the VATS group.

Conclusion
VATS provides more accurate staging for parapneumonic effusion, an excellent surgical view for a complicated empyema cavity, thus making it possible to perform a sufficient evacuation of all empyema membranes.
Magnetic resonance spectroscopy in evaluating cerebral metabolite imbalance in chronic obstructive pulmonary disease
Authors: El-Shinnawy Olfat M. , Khedr Eman M. , Metwally Mohamed M. , Thabiet Hassan Alaa EL-din , Shaddad Ahmad M. , Soliman Radwa Kamel 
Published: September 2023

Abstract
Rationale
Magnetic resonance spectroscopy (MRS) is a powerful research tool and has been proved to provide additional clinically relevant information for several diseases such as brain tumors, metabolic disorders, and systemic diseases.

Aim
The aims of this study were to evaluate cerebral metabolic imbalance in chronic obstructive pulmonary disease (COPD) and to correlate the abnormalities with spirometric and gasometric parameters.

Patients and methods
In a case–control study, eight COPD patients and eight age-matched and sex-matched healthy control individuals were compared. 1H-MRS was performed using 1.5-T MRI/MRS scanner. Using 1H-MRS single-voxel technique, N-acetyl aspartate/choline (NAA/Cho), choline/ creatine (Cho/Cr), and N-acetyl aspartate/creatine (NAA/Cr) ratios were estimated and compared in both groups.

Results
There were significant differences regarding the distribution of neurotransmitters in the temporal lobe only between COPD and control groups; there were significant positive correlations between the NAA/Cho ratio at the thalamus with both partial pressure of arterial carbon dioxide and base excess or base deficit. However, there was a significant positive correlation between the Cho/Cr ratio at the thalamus and forced vital capacity (l), and a significant positive correlation between the NAA/Cr ratio at the thalamus andBMI, and a negative correlation between the NAA/Cr ratio at the thalamus and partial pressure of arterial oxygen. There was a significant negative correlation between theNAA/Cr ratio at the temporal lobe and partial pressure of arterial carbon dioxide.

Conclusion
MRS provided an insight to study the neurochemical changes that occur in COPD patients. Chronic hypoxemia and hypercapnia seem to play a key role in the pathophysiology of neurochemical changes in COPD.
Psychological assessment of patients with bronchial asthma: focus on some predictors of abnormalities
Authors: Esmaeel Hend M. , Aly Hanan Y. 
Published: September 2023

Abstract
Background
Bronchial asthma is a common chronic respiratory illness. Psychiatric comorbidity is a neglected zone in the care and management of such important physical disorders as bronchial asthma.

Objective
The present study targeted a population sample of out-patient asthmatics, aiming at detailed psychocognitive evaluation. Predictors of depression, anxiety, and cognitive impairment were searched for by detailed assessment of patient sociodemographic and disease-related criteria.

Patients and methods
A total of 50 patients with confirmed asthma diagnosis were recruited and subjected to detailed respiratory and psychiatric evaluation using Mini-Mental State Examination, Beck Depression Inventory-II, and Taylor manifest anxiety scale tests.

Results
Mild, moderate, and severe depression were diagnosed in 26, 28, and 14% of patients, respectively, whereas mild, moderate, and severe anxiety were revealed in 32, 34, and 20%, respectively. Overall, 54% of the patients showed cognitive impairment. Asthmatic female patients were more common to have depression (P=0.022). The present analysis showed that predictors of cognitive impairment were older age, increasing frequency of hospital admission for asthma in the past year, improper adherence to treatment, and uncontrolled asthma. Meanwhile better education level proved to be protective from abnormal cognitive function.

Conclusion
There was high prevalence of depression, anxiety, and cognitive dysfunction among asthmatic patients in Sohag University. Improving patient education, patient adherence to treatment, and asthma level control may lessen the chance of cognitive abnormality.
Spontaneous pneumothorax: time to depart from the ‘chest tube underwater seal’?
Authors: Hassan Maged , Shaarawy Hany 
Published: September 2023

AbstractInitial management of spontaneous pneumothorax has traditionally been inserting a chest tube and attaching it to an underwater seal and hospitalizing the patient. New options have emerged that allow management to be on an outpatient basis without the need for hospitalization. These options are needle aspiration (similar to aspiration of effusion) or attaching the chest tube to a one-way valve. So, is chaining a patient with spontaneous pneumothorax to their hospital bed because of the heavy jar attached to the chest tube the most prudent way of management? This review attempts to answer this question.
Noninvasive positive pressure ventilation in acute hypercapnic respiratory failure
Authors: Hussein Khaled 
Published: September 2023

AbstractNPPV is well established in the management of acute on chronic hypercapnic respiratory failure secondary to acute exacerbation of COPD (AECOPD), obesity hypoventilation syndrome, and restrictive thoracic disorders. Because of its design, success depends largely on patient cooperation and acceptance. The most commonly used interfaces in acute hypercapnic respiratory failure are oronasal masks. During noninvasive ventilation patients respiratory system is maintained throughout the whole respiratory cycle at a constant pressure higher than the atmospheric pressure, usually termed the positive end-expiratory pressure (PEEP). Pressure support ventilation (PSV), is the most famous mode of partial ventilatory support that during spontaneous inspiratory efforts imposes a set level of positive pressure in a patient with intact respiratory drive. Bilevel positive airway pressure (BiPAP) include PSV during inspiration and EPAP during expiration. The highest pressure reached during inspiration is called inspiratory positive airway pressure (IPAP) which equal PSV + EPAP.
Bronchial asthma: clinical phenotypes and endotypes and their relation with glucocorticoids circadian rhythm and parasympathetic activity
Authors: Zedan Magdy M. , Moneim El-Ziny Magdy Abd El , Shabaan Abd Elazeez Atallah , Mosaad Youssef M. , Laimon Wafaa Nabil 
Published: September 2023

AbstractIntroductionAsthma is a heterogeneous disease and presents in different clinical patterns ‘phenotypes’ as a result of diverse pathobiological background ‘endotypes’.ObjectivesTheaim of this studywas to study serum interleukin-13 (IL-13) levels and the frequency of (IL-13) +1923C/Tgene polymorphism in Egyptian children with asthma and to study glucocorticoids circadian rhythm in nocturnal asthma.Patients and methodsThe frequency of (IL-13) +1923C/Tgene polymorphism genotypes was determined in 114 asthmatic Egyptian children and compared with a matched group of 152 healthy controls using PCR. Serum IL-13 and cortisol a.m. and p.m. concentrations in serum were assessed using enzyme linked immunosorbent assay.ResultsSerum IL-13 was found to be significantly higher in asthmatic patients when compared with the control group (P<0.0001). In the asthmatic group, forced expiratory volume in 1 s showed a significant negative correlation with serum IL-13 (ρ=−0.2,P=0.03), whereas peripheral blood eosinophilic % showed a significant positive correlation with serum IL-13 (ρ=0.18,P=0.05). No statistically significant differences were found between asthmatic patients and controls in IL-13 C1923T genotype frequency. A significantly lower serum cortisol pm was found in asthmatic patients with nocturnal symptoms when compared with those without nocturnal symptoms (P<0.0001).ConclusionSerum IL-13 is significantly higher in asthmatic patients when compared with controls. (IL-13) +1923C/Tgene polymorphism is not a risk factor for development of asthma in Egyptian children. Nocturnal symptoms in some asthmatic patients can be partly attributed to lower serum cortisol level at night.
The expression level of microRNA-122 in patients with type 2 diabetes mellitus in correlation with risk and severity of coronary artery disease
Authors: Rashad Nearmeen M. , Ezzat Tamer M. , Allam Reem M. , Soliman Mohamad H. , Yousef Mohammed S. 
Published: September 2023

Abstract
Background
Type 2 diabetes mellitus (T2DM) has reached epidemic proportions worldwide. Coronary artery disease (CAD) is one of the most important causes of mortality worldwide. MicroRNAs (miRNAs) modulate gene expression and is involved in the pathogenesis of T2DM and CAD. The objective of the current study was to explore the expression pattern of miR-122 in T2DM with or without CAD. Moreover, we aimed to evaluate the association between miR-122 and risk and severity of CAD in T2DM.

Participants and methods
This cross-sectional controlled study enrolled 130 patients with T2DM and 110 control group. The enrolled diabetic patients were classified into two groups: seventy patients without CAD and 60 patients without CAD. All patients were investigated using a 12-lead standard ECG, echocardiography, and coronary arteriography. The serum MiR-122 expression profile was measured using quantitative real-time (qRT) PCR.

Results
miRNA-122 expression levels were significantly higher in T2DM, in particular patients with T2DM with CAD, compared with the control group. Interestingly, miRNA-122 expression levels were positively correlated with cardiometabolic risks and severity of coronary occlusion. Linear regression analysis test showed that miRNA-122 were independently correlated with high-density lipoprotein, ejection fraction, and uric acid. The power of miRNA-122 expression level to diagnose T2DM among studied participants was evaluated using receiver operating characteristic. The area under curve was 0.997 (95% confidence interval=0.993–1.00), with sensitivity of 96.9% and specificity of 99%, and regarding the power for differentiating patients with T2DM with CAD from patients with T2DM without CAD, the area under curve was 0.832 (95% confidence interval=0.763–0.902), with sensitivity of 93.3% and specificity of 96.86%.

Conclusion
The miRNA-122 expression levels were higher in the T2DM group compared with controls, in particular patients with CAD. The higher levels of miR-122 expression were strongly correlated with cardiometabolic risk factors and severity of coronary occlusion. Therefore, miR-122 expression levels seem to be a noninvasive biomarker for CAD.