bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oligoclonal Band versus Chitinase-3-Like Protein-1 in CSF of Newly Diagnosed Relapsing Remitting Multiple Sclerosis
Authors: Zeitoun Yasser Ahmed , Fouad Nermin Tayseer Aly , Aziz Azza Abdel Nasser Abdel , Samaha Dalia Youssef , Saad Marehan Ahmed Ibrahim 
Published: August 2023

Abstract

Background
Multiple sclerosis (MS) is a chronic autoimmune-mediated demyelinating disease of the central nervous system (CNS) that is usually associated with varying degrees of progressive disability. Chitinase-3-like protein-1 (CHI3L1) has attracted growing attention as a marker of ongoing inflammation and oncogenic transformation.

Aim of the Work
The aim of this work was to try to assess the diagnostic accuracy of CHI3L1 versus IgG oligoclonal bands (OCBs) in the CSF of newly diagnosed RRMS patients in an attempt to throw light on a new simpler non subjective potential diagnostic marker in MS.

Patients and Methods
This was a cross-sectional study of MS patients carried at Ain Shams University Hospitals during the period from January 2021 till January 2022. Subjects included in this study were 40 patients diagnosed as having RRMS, on the basis of their MRI findings, clinical presentation and according to the revised McDonald criteria 2017. The group included 10 males and 30 females; their ages ranged from 20 to 45 years.

Results
We found a significant correlation between CSF CHI3L1 levels and presence of oligoclonal bands, and that a cut off value of 30 ng/ml could be used for diagnosis of MS with sensitivity 84.85% and specificity 85.71%. A highly significant association was also found between CHI3L1 levels in CSF and EDSS score.

Conclusion
We concluded that there were high levels of CHI3L1 in the CSF of MS patients and there was a significant correlation between CHI3L1 and oligoclonal bands and that CHI3L1 is a promising diagnostic marker of MS.
Detection of NCF-1 Gene Expression as a Diagnostic Tool for Autosomal Recessive Chronic Granulomatous Disease among Egyptian Children with Phagocytic Dysfunction
Authors: Abd El Ghaffar Aisha Y , Fedawy Shahira F El , El-Owaidy Rasha H , Ahmed Walid A , Nassar Noura A 
Published: August 2023

Abstract

Background
Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency disorder caused by functional impairment of the nicotinamide dinucleotide phosphate (NADPH) oxidase complex in neutrophilic granulocytes and monocytes and characterized by recurrent and severe infections, dysregulated inflammation and autoimmunity.

Aim of the Work
To diagnose the autosomal recessive (AR) type of CGD among a group of Egyptian pediatric patients with phagocytic dysfunction by detection of Neutrophil Cytosolic Factor-1 (NCF-1) gene expression using reverse transcription polymerase chain reaction (RT-PCR) and to correlate it with other diagnostic tests.

Subjects and Methods
A case-control study was conducted on 15 provisionally diagnosed CGD pediatric patients (Group I) by the use of DHR test, with the stimulation index using PMA &lt; 30%. They were recruited from different university hospitals in Egypt. The study also included 12 mothers of the studied patients to detect the genetic mutations in carriers, if any, (Group II) and 14 apparently healthy children as a control group (Group III). Full medical history was taken and thorough clinical examination was done. The selected groups underwent testing for phagocytic and lytic indices, measurement of NCF-1 gene expression by real time RT-PCR.

Results
The comparative statistics between group I and group III as regards the phagocytic index (PI) revealed a high statistical significant difference between both groups. In addition, a statistically significant difference between both groups as regards lytic index (LI) was also revealed. Correlation studies were done between fold change of NCF-1 gene expression and each of PI, LI and DHR and showed no significant statistical correlation between these parameters in the 3 studied groups. Cases with a fold change of NCF-1 gene expression less than 0.48 (cut-off value calculated by the 25th percentile fold change of the control group), are considered having defective NCF-1 gene expression. At this cut-off value 2 out of 15 CGD cases and 3 mothers out of 12 showed NCF-1 gene under-expression.

Conclusion
Assessment of NCF-1 gene expression which encodes p47phox by real time RT- PCR in the present study could detect defective gene expression only among two CGD children and their mother as well as two other mothers with no correlation to other studied parameters. Since CGD is a genotypically heterogeneous disease; the findings of the present study highlight the importance of molecular testing for diagnosis after screening for NADPH oxidase protein deficiency by flow cytometry.
Determination of Antibiotic Resistance Pattern of Haemophilus influenzae Isolated from Egyptian Patients in Ain Shams University Hospitals
Authors: Abd El Hamid Dalia Hosni , Girgis Samia Abdou , Riad Radwa Shereen , Mahmoud Ramy Mohammed 
Published: August 2023

Abstract

Background
Haemophilus influenzae is small, non motile, non spore-forming, non acid fast, pleomorphic, gram negative bacilli with fastidious growth requirements. Cells in this genus are Cocobacilli or short rods. Haemophilus influenzae type b causes meningitis, epiglottitis, septicemia and osteomyelitis. Non-typeable H. influenzae is the cause of otitis media, sinusitis, pneumonia, and exacerbation in patients with COPD. The resistance to commonly used antibiotics has risen in recent years. Some of the main mechanisms of antimicrobial resistance of H. influenzae are those to β-lactam antibiotics. More frequent (in about 30%) is the plasmid-mediated production of β-lactamase of types TEM1 and ROB1, called β-lactamase positive ampicillin-resistant strains (BLPAR). In a small percentage of the ampicillin-nonsusceptible strains a change in penicillin-binding protein (PBP3) is detected, which reduces its affinity to penicillins and cephalosporins. PBP3 is a transpeptidase, which is encoded by the ftsI gene. Mutations in this gene lead to amino acid substitution in the transpeptidase domain of РВР3. These strains are called β-lactamase negative ampicillin resistant (BLNAR).

Objective
The aim of our study is to identify the Haemophilus species isolated from clinical samples of patients referred to the Main Microbiology Laboratory, Ain Shams University Hospitals & determine its local resistance pattern.

Materials and Methods
The present study was conducted on fifty (50) different isolates of Haemophilus Influenzae isolated from different clinical specimens submitted to the Main Microbiology laboratory of Ain Shams University Hospitals. All isolates were subjected to subculture on chocolate agar, Phenotypic identification of colonies by routine methods, antibiotic susceptibility testing by using disk diffusion method according to Clinical and Laboratory Standard Institute recommendations (2019), and Multiplex PCR for detection of TEM & ROB genes.

Results
Susceptibility to Ampicillin was 12% (6/50) while 88% (44/50) were resistant to ampicillin. TEM gene was detected in 66% (33/50) while ROB gene was detected in 2% (1/50). 35.3% (6/17) isolates that were TEM negative were sensitive to ampicillin & 64.7% (11/17) isolates that were TEM negative were resistant to ampicllin. 100% (33/33) isolates that were TEM positive were resistant to ampicillin.

Conclusions
Detection of CYBA Gene Expression by Reverse Transcription PCR as a Diagnostic Tool for Autosomal Recessive Chronic Granulomatous Disease in a Sample of Egyptian Children
Authors: Zakaria Nahla , Shehab Abeer , El Owaidy Rasha , Rushdy Marwa , Latif Rania 
Published: August 2023

Abstract
Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency disease caused by functional impairment of the nicotinamide dinucleotide phosphate (NADPH) oxidase complex in neutrophilic granulocytes and monocytes, characterized by recurrent and severe infections, dysregulated inflammation, and autoimmunity. Approximately two-thirds of patients with CGD have defects in Cytochrome Bβ (CYBB), the X-linked gene encoding glycoprotein 91 phagocytic oxidase (gp91phox). Rarer autosomal recessive (AR) forms of CGD are caused by autosomal recessive mutations in CYBA genes encoding protein 22 phagocytic oxidase (p22phox). However, the incidence of autosomal recessive CGD can be higher than X-linked CGD in countries with high rates of consanguineous marriage. In the present study we aimed to diagnose the commonest AR-type of CGD by detection of CYBA gene expression using real time RT-PCR as a cheaper diagnostic method for CGD subtypes categorization among immunodeficient children. This case-control study was conducted on 15 children provisionally diagnosed as CGD patients with DHR stimulation index using phorbol myristate acetate (PMA) &lt; 30% (Group I). The study also included 12 mothers and 8 fathers of the studied patients to detect the genetic mutations in carriers, if any (Group IIa and IIb respectively), and 14 apparently healthy children as a control group (Group III). We found that cases with a fold change of CYBA gene expression less than 0.6 were considered under-expressed. At this cut-off value, from our molecularly studied subjects 1 case and 2 mothers showed under-expression of CYBA gene. In conclusion, we could establish the diagnosis of AR-form of CGD, derives from defects in the CYBA gene, which encodes p22phox of the NADPH oxidase using real time RT-PCR, without the need to use complex and expensive methodologies such as northern blot, slot blot, or genomic DNA sequencing.
Rapid Identification and Antimicrobial Susceptibility Testing of Gram Positive Bacteria by Direct Inoculation from Positive Blood Culture Bottles
Authors: Hafez Hala Mahmoud , El-Din Fahim Noha Alaa , Elhamed Sara Mohammad Abd 
Published: August 2023

Abstract

Background
Rapid identification of the causative agent for sepsis and determination of its susceptibility profile by direct inoculation of the biochemical and susceptibility testing media with the blood-broth mixtures from signal positive bottles might help reducing the time needed for provision of results compared to the standard isolated-colony based method and hence would help the rapid initiation of effective and targeted antimicrobial therapy and reduce the bacteremia-related morbidity and mortality

Aim of the Work
To validate the direct inoculation method as a rapid method for the identification of Gram-positive bacteremic isolates and determination of their antimicrobial susceptibility profile by comparing its results to that of the standard isolate-based method routinely used in our laboratories.

Patients and Methods
This study included a total of 100 positive blood culture bottles submitted to the Main Microbiology laboratory for identification and antimicrobial susceptibility testing via disk diffusion method directly from blood culture bottles and according to standard isolate-based identification method.

Results
There was a 100% categorical agreement between the results of the direct (primary) biochemical identification method and those of the standard isolate-based identification method. As regard AST the overall categorical agreement between both methods was 96.9%, the minor error rate was 0.8% and the major error rate was 2.3%.

Conclusion
Rapid Identification and Antimicrobial Susceptibility Testing of Gram-positive Bacteria is a time saving method and can help in reducing turnaround time to obtain AST results.
Anti-CASPR2, Anti-LGI1, and Anti-GAD65 Autoantibodies in Patients with Intractable Epilepsy
Authors: Bakr Salwa Ibrahim , Shehab Abeer Al-Sayed Ali , Zakieldine Hany Mahmoud , Mohamed Nesrine Aly , Masry Yara Younis Mohamed 
Published: August 2023

Abstract

Background
Autoimmunity is increasingly being recognized as a cause of intractable epilepsy. The autoimmune epilepsies (AE) are immunologically mediated disorders in which recurrent seizures are a primary and persistent clinical feature. When other etiologies have been excluded, an autoimmune etiology of epilepsy is suggested in the presence of resistance to anti-epileptic drugs (AED). In such patients, immunotherapy may be highly effective, depending on the particular autoimmune epilepsy syndrome present.

Objective
To investigate the presence of Contactin associated protein like 2 (CASPR2), leucine rich Glioma inactivated1 (LGI1) and Glutamic acid decarboxylase 65 (GAD65) autoantibodies in intractable epilepsy, and their association with clinical and imaging findings.

Subjects and Methods
Seventeen patients with intractable epilepsy were included. LGI1, CASPR2 and GAD65 autoantibodies testing by indirect immunofluorescence cellbased assay in both serum and cerebrospinal fluid (CSF) were assessed in all patients.

Results
Both serum and CSF samples of the 17 patients were tested negative for the 3 autoantibodies (Anti CASPR2, Anti LGI1 and Anti GAD 65). Regarding CSF examination, only 5 patients had normal CSF, the other 12 showed some changes; 7 had elevated levels of proteins, 3 showed positive oligoclonal bands and elevated IgG index and 2 patients showed both elevated proteins and cells.

Conclusion
Some cases of AE are associated with specific autoantibodies to neuronal proteins. Clinicians must make a diagnosis based on a combination of clinical phenotypes, CSF results, and neuroimaging. Meanwhile, patients should be followed-up systematically due to the constant discovery of new neuronal auto antibodies.
Diffuse Alopecia: Clinical, Trichoscopic, Histopathological and Immunohistochemical Challenges in the Diagnosis
Authors: Monib Hoda Ahmed Mohamed , Soltan Marwa Yassin , Ahmed Naglaa Samir , Adan Aisha Bashir Sheikh 
Published: August 2023

Abstract

Background
Diffuse alopecia is characterized by a general loss of hair with no patches of full baldness. In dermatology, diffuse hair loss, particularly in women, is a common complaint. Common illnesses such as telogen effluvium, androgenetic alopecia, and widespread alopecia areata can be difficult to distinguish. The clinical signs of these three types of alopecia may be identical.

Aim of Work
The current study aimed to study the clinical, trichoscopic findings, histopathological in patients with acute diffuse hair shedding: female pattern hair loss (FPHL), acute telogen effluvium (TE) and alopecia areata incognita (AAI). Immunohistochemistry analysis for CD3 was done for differentiation and detection of the prognostic values of these markers. Subjects and methods: The study included 40 patients with acute diffuse hair shedding within the last 6 months with the diagnoses of AAI, TE, FPHL. All patients were subjected to full history recording, general and local examination. Hair evaluation was performed through trichoscopic assessment and punch scalp biopsy that was analyzed by hematoxylin and eosin and immunohistochemical analysis for CD3.

Results
Trichoscopic assessment of studied patients revealed that hair diameter diversity was significantly presented in FPHL patients. Number of thin hairs in frontal area, number of hair units with one hair, and vellus hairs were significantly presented in FPHL and TE+ FPHL patients compared to TE patients. Short regrowing hair was significantly presented in TE patients and TE +FPHL patients compared to FPHL patients. Peripilar sign and empty hair follicles in frontal area were significantly presented in FPHL patients. Multiple upright regrowing hair in all areas was significantly presented in TE+ FPHL patients.

Conclusion
FPH and TE represents common types of hair loss disease, each with specific trichoscopic and histochemical findings.
Assessment of the Serum Paraoxonase1 Level and Its Relation to Total Oxidant Status and Disease Activity in Vitiligo Patients
Authors: Saleh Hanan Mohamed , Soltan Marwa Yassin , Yassin Haiam Mahmoud Thakeb 
Published: August 2023

Abstract

Background
Vitiligo is characterized by white macules and patches, whose size increases over time, due to the loss of melanocytes.It can appear at any time, and it significantly impairs the patients’ quality-of-life. Vitiligo is a multifactorial disorder due to genetic and environmental factors. One of the important hypotheses in the pathogenesis of vitiligo is the oxidative stress hypothesis, which is based on the reality of the formation of some toxic metabolites throughout pigment biosynthesis. Human paraoxonase-1 (PON1) is a Ca2+ dependent esterase synthesized in the liver. Reduced serum PON1 activity has been reported to be associated with some diseases under oxidative stress and inflammation conditions.

Aim of the Work
The aim of the work was to evaluate the serum level of paraoxonase1 in patients with vitiligo and its relation to total oxidant status and disease activity in vitiligous patients.

Patients and Methods
This is a case control study which included 48 vitiligo patients and 48 ageand sex-matched controls. The patients recruited from the Outpatient Dermatology Clinic at Ain Shams University Hospitals during the period from August 2020 till March 2021. Serum level of paraoxonase1 (PON1) and total oxidant status (TOS) where assessed by ELISA technique.

Results
We observed a statistically significant higher oxidative stress reflected by the high serum TOS levels among the vitiligo compared to controls. This finding supports the aforementioned hypothesis and it also came in accordance with the observations of high oxidative stress state in vitiligo patients which was repeatedly reported in many studies. Furthermore, we also reported the significant inverse relation between PON1 levels and the oxidative stress reflected by the serum TOS levels in vitiligo patients. This reflected the reduced protective antioxidant mechanisms in vitiligo patient making them more vulnerable to oxidative stress

Conclusion
Oxidative stress may play an important role in the pathogenesis of vitiligo. The finding of a PON1 decrease in vitiligo patients emphasises the underlying hypothesis in the progression of the disease, and it can highlight the effect of free radicals and leading oxidative damage in vitiligo disease. However, further, larger studies are necessary to confirm our results.
Epidemiology of Psoriasis in Cairo Governorate
Authors: Sayed Mahira Hamdy El , Zaki Marwa SalahEldin , Younis Mahmoud Fawzi Saleh 
Published: August 2023

Abstract

Background
Psoriasis is a chronic, non-communicable, painful, disfiguring and disabling disease with great negative impact on patients’ quality of life (QoL). It can occur at any age, and is most common in the age group 50–69.

Aim of the Study
To identify the prevalence of psoriasis in Cairo governorate, the associated socio-demographic and anthropometric data, and percentage of each clinical type, as well as to define the possible precipitating factors and other diseases related to psoriasis.

Patients and Methods
This cross-sectional observational study included patients with psoriasis collected from patients attending the outpatient Dermatology and Andrology Department of Educational Hospitals of Cairo Governorate (Al Haud AlMarsoud Hospital & Ain Shams University Hospital) during a period of six months that started from June 2020 to December 2020. It was a multi-center study including 2 Educational Dermatology hospitals.

Results
We found significant association between severity of psoriasis with male gender, with degree of impairment of life, with skin type III, and with higher age of onset.

Conclusion
We observed no association of psoriasis severity with DM, hypertension, BMI, or joint manifestations. Our findings are similar to most of other published epidemiological studies on psoriasis.
Efficacy and Safety of Diphenylcyclopropenone (DPCP) as a Depigmenting Therapy in Extensive Vitiligo
Authors: Abdel-Rahim Abdallah Marwa M , Elhusseiny Rania Mahmoud , Abdelmotaleb Maysoon Asem Elsayed 
Published: August 2023

Abstract

Background
Patients with extensive vitiligo who have residual pigmentation affecting exposed areas especially acral sites or patients with vitiligo universalis often seek depigmentation. At present, there is no ideal depigmenting therapy available. Possible options include; monobenzyl ether of hydroquinone (MBEH) cream, phenol, cryotherapy and Q-switched lasers. Diphenylcyclopropenone (DPCP) has been reported to rarely cause vitiligo as a side effect during the treatment of alopecia areata.

Aim
The aim of the present work is to evaluate the efficacy and safety of DPCP as a depigmenting therapy in extensive Vitiligo.

Patients and Methods
This is a pilot single arm clinical trial study. Twenty patients with extensive vitiligo were recruited from the vitiligo outpatient clinic of Dermatology, Venereology and Andrology Department, Ain Shams University Hospitals. We used DPCP applied topically to residual pigmented patches (sensitization session then therapeutic sessions).

Results
Depigmentation occurred among 5 patients (25% of cases). Depigmentation occurred in different tested sites including the scalp, forearm and back. Itching and blister formation were the main side effects leading to intolerability to the DPCP treatment.

Conclusion
Cosmetic result of DPCP depigmentation was acceptable with no skin atrophy. Further studies could be done following other protocols using sensitization dose with less concentrations of DPCP to avoid patients' intolerance to the therapy.
Analysis of Serum Chemerin Level in Acanthosis Nigricans Patients: A Case Control Study
Authors: Mohammed Ghada Fathy , Afify Ahmed Abdel-Fattah , Ibrahim Sarah , Zawahry Menna Mohamed El 
Published: August 2023

Abstract

Background
Acanthosis nigricans (AN) describes clinically a darkly pigmented thickening skin, which demonstrates epidermal/dermal hyperplasia with orthokeratotic hyperkeratosis and papillomatosis of stratum spinosum with basal layer hyperpigmentation, in the absence of actual acanthosis and melanocytosis in histology.

Aim of the Work
The aim of our work was assessment of serum concentrations of Chemerin level in obese patients with AN and the healthy control group, as well as evaluation of a possible correlation between chemerin concentrations and metabolic syndrome components.

Patients and Methods
Our study included 75 subjects, divided into three groups. The first group included 25 obese patients with AN, the second group included 25 obese patients without AN. In addition to the control group which included 25 healthy individuals. Each subject was assessed for blood pressure, body mass index and waist hip ratio. 3ml blood sample was taken from each subject. Lipid profile, serum glucose level, fasting serum insulin were measured. Chemerin concentration was assessed by quantitative ELISA.

Results
In our study, 100% of the included obese patients with AN and 88% of those without AN had metabolic syndrome. No statistically significant difference between them as regards BMI, SBP, DBP, WHR, fasting Insulin (P &gt; 0.05). However, statistically significant higher levels of serum, Cholesterol, TG, HDL, and LDL were observed in obese patients with AN compared with those without AN (P ≤ 0.001). This result showed that AN is a clinical surrogate for laboratory-determined hyperinsulinemia and insulin resistance indicating the highest risk for type 2 diabetes.

Conclusion
Acanthosis Nigricans has been demonstrated to be a useful screening marker for obesity and insulin resistance. In addition, there is correlation between chemerin concentrations and acanthosis nigricans. Serum chemerin could be considered one of the metabolic risk factors leading to insulin resistance in metabolic syndrome and may represent a novel marker of these derangement.