bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study between Inverted U Shaped Incision & Round Block Technique in Management of Grade II & III Gynecomastia
Authors: Talaat Ayman Ahmed , Abdel-Moaty Karim Fahmy , Youssef Omar Abdelrahman Youssef 
Published: August 2023

Abstract

Background
Gynecomastia is defined clinically as generalized enlargement of the male breast tissue, with the presence of a rubbery or firm mass extending concentrically and symmetrically from the nipple, accompanied by histopathological benign proliferation of the glandular male breast tissue. It usually occurs bilaterally and is the most common breast condition in males.

Aim of the Work
To review the differentiate between Inverted U shaped incision & round block technique used in management of grade II & III gyencomastia according to results, complications and patient satisfaction for operation.

Patients and Methods
This is a prospective clinical trial that conducted on thirty two (32) patients presented to Ain Shams University Hospital & Um El Masyreen General Hospital with gynecomastia grade II & III. Study period was One year, including (operation and 3-6 months follow up).

Results
In our study, statistics shows to some extent the preference of inverted U shaped incision over round block technique according to operation time, but verses according to post-operative Drain duration. However, there is no significant difference between the two approaches in incidence of seroma, hematoma, nipple areola complex complications, patient satisfaction and Aesthetic outcome.

Conclusion
Surgical management of high grades gynecomastia is a big challenge and there is no single approach is recommended between surgeons.
Difficult Diagnosis in a Patient with Phenylketonuria (PKU) and Metachromatic Leukodystrophy (MLD)
Authors: mohamed Mohamed, E , Elsayed Solaf, M 
Published: August 2023

Abstract

Introduction
Since phenylalanine level was included in the national newborn screening program in Egypt, patients with phenylketonuria (PKU) were early diagnosed and management and have better outcome with nearly normal motor and mental development. Neuro-regression or poor cognition is never recognized in compliant patients.

Case presentation
Herein we present an Egyptian child who was diagnosed by neonatal screening as PKU who was compliant on dietary treatment and normal development. After the age of 18 months, he started to loose previously acquired developmental milestones. Because of his average phenylalanine levels all through, a second neurodegenerative disease was suspected. Several investigations were done and the diagnosis of metachromatic leukodystrophy was suspected and was later confirmed by molecular testing showing homozygous frame shift mutation in ARSA gene c.583del, p. (Trp 195Glyfs*5) in addition to homozygous Missense mutation in PAH gene c.842C&gt;T, p. (Pro281 Leu).

Conclusion
The presence of two genetic diseases in the same family should be suspected in consanguineous communities like ours especially if the clinical data of the primary disease does not fit.
Neutrophil- and Platelet-to-Lymphocyte Ratios (NLR & PLR) and Their Relation with Disease Activity in Rheumatoid Arthritis Patients
Authors: Elbakry Samah AbdelRahman , Hassan Sameh AbdelMoteleb , Ibrahim Shafica Ibrahim , Boga Ahmed Elsayed Ahmed 
Published: August 2023

Abstract

Background
RA is the most common chronic inflammatory arthritis and is associated with progressive destruction of synovial joints and physical disability. It is a polygenic disease characterized by autoimmunity and systemic inflammation with progressive impairment of the joints, resulting in lifelong disability and increased mortality.

Aim of the Work
The aim of the study is to study the correlation between both of Neutrophil- and platelet-to-lymphocyte ratios (NLR&PLR) and disease activity in RA patients.

Patients and Methods
Our cross-sectional case-control study enrolled 50 patients with RA, in addition to 30 healthy volunteers as a control group.All included patients were subjected to full history taking with special emphasis on history of RA, thorough clinical examination was done with special emphasis on musculoskeletal examination.

Results
When we compared RA patients with the controls, we found a highly statistically significant difference between them regarding NLR and PLR being higher in the RA group. In our study we found that both NLR and PLR has fair diagnostic value to discriminate between RA patients and controls using the ROC curve at a cut-off value of 2.58 and 151.05 respectively. In RA patients, highly statistically significant correlation was found between both NLR and PLR. In addition, statistically significant correlation was found between NLR with both VAS score and DAS28_ESR and also between PLR with ESR, VAS score and RF.PLR also correlated significantly with US7 score, PDUS synovitis and gray GSUS tenosynovitis.

Conclusion
NLR and PLR that can be obtained via CBC (which is convenient, inexpensive and fast), can serve as an additional useful marker for the diagnosis of RA. NLR and PLR has important value in the assessment of RA related disease activity. In contrast to traditional markers, they are less expensive and effective measure of inflammation that is not impacted by the cytokines influencing the ESR and CRP. US7 score is a simple and effective measure to detect subclinical synovitis in RA patients and to assess and follow up disease activity.
Nutritional Assessment in Patients with Inflammatory Bowel Disease
Authors: Shawky Bakir Amal , Kaiser Hany Haroun , Allah Shaimaa Hussein Gad , Wahab Ahmed Kamal Abd el 
Published: August 2023

Abstract

Background
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract, which clinically contains Crohn’s disease, ulcerative colitis, and other conditions. The inflammation of the intestinal mucosa in IBD is characterized by episodes of abdominal pain, diarrhea, bloody stools, weight loss, and the influx of neutrophils and macrophages that produce cytokines, proteolytic enzymes, and free radicals that result in inflammation and ulceration.

Aim of the Work
The aims of our study is to assess the nutrient status of individuals with CD and UC in relation to the recommended nutrient intake values, anthropometric measures, and biochemical indices of nutrition, and to determine the extent to which reduced food and nutrient intake contributes to the nutrition deficiencies in this population.

Materials and Methods
This was across-sectional study was conducted on patients with IBD, including Crohńs disease (CD), ulcerative colitis (UC)and undtermined colitis, who attended to the outpatient clinic for IBD of the Department of Internal Medicine, University Hospital of Ain Shams University, between january 2020 to july 2020. 90 patients with IBD (65 UC patients, 22 CD patients and 3 UD colitis) were included in the study.

Results
Our study show that The majority of our IBD patients showed a normal BMI indicating that malnutrition, especially underweight, is not as common a described in former studies with up to 85% in IBD patients. Our study show that majority of patients are suffering from GI upset following certain meals, all of them are suffering from flatulance, some of them suffering from nausea, vomiting, heart burn and 79(87.7%) patients are suffering from diarrhea, most of patients with crohns disease are suffering from constipation, and some of them are suffering from intestinal colick. So Many patients with IBD suppose that the diet influences the courseof their disease or even cause a relapse Our study groups showed an unfavorable ratio of essential fatty acids (FA) compared to the recent guidelines. Whereas the ratio of the n-6 fatty acid linolic acid (LA) to the n-3 fatty acid α-linolenic acid (ALA) should be 5:1, the actual ratio was more than in all participants because of the high incidence of margarine ingestion.

Conclusion
The worldwide rising incidence of IBD is paralleled by a ―Westernization‖ of dietary habits in developing countries. It is therefore obvious that, in addition to a genetic influence, environmental factors, especially diet, undoubtedly play a major role in the development of IBD. Impairment of nutritional status in BID patients has a multifactorial etiology. Main reasons include suboptimal energy intake, malabsorption, enteric nutrient loss, increased basal energy expenditure, and medications.
Impact of Direct Acting Antiviral (DAA) Agents on Hematological and Hepatic Statuses of Patients with Chronic Hemolytic Anemias and Chronically Infected with Hepatitis C Virus (HCV)
Authors: Moussa Mohamed Mahmoud , Ahmed Osama Ashraf , El-Ghammaz Amro Mohamed Sedky , Mohamed Inas Abdel Moaty , Khamis Ahmed 
Published: August 2023

Abstract

Background
Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients.

Aim and objectives
To investigate the impact of DAA-based regimens on hematological and hepatic statuses of patients with chronic hemolytic anemias and chronically infected with HCV.

Subjects and Methods
This is a cross sectional study, was carried out at viral hepatitis research and treatment center of Ain Shams University Hospitals, on 50 patients with chronic hemolytic anemias and has HCV infection, from December 2019 till June 2020.

Result
There was high statistically significant difference before treatment, first month, third month and sixth month follow up in chronic liver disease group as regard HGB, statistically significant in Hemolytic anemia group (no splenectomy) as regard HGB and there was high statistically significant difference between the studied groups as regard HGB.

Conclusion
DAAs therapy is effective and tolerable in patients with chronic HCV patients. It improves liver necro-inflammatory changes in patients, evidenced by decreased liver enzymes' level, but still require careful observation during DAAs therapy for being more susceptible for hemolytic anemia.
Efficacy and Safety of Probiotic versus Conventional Treatment of Irritable Bowel Syndrome
Authors: Elgaaly Sonya Ahmed , Khayyal Ahmed Elsaady , Anwar Christina Alphonse , Elmetwally Ahmed Salem 
Published: August 2023

Abstract

Background
Irritable bowel syndrome is a gastrointestinal syndrome characterized by chronic abdominal pain and a change in intestinal habits without any organic cause. It affects 11% of the world-wide population. irritable bowel syndrome reduces health-related quality of life and leads to a significant economic healthcare burden.

Aim of the Work
The aim of this study is to investigate the efficacy of probiotics in irritable bowel syndrome (IBS) patients.

Patients and Methods
A randomized controlled clinical trial in Gastroenterology and Hepatology outpatient clinic at: Ain Shams University Hospitals for 6 months from November 2020 till April, 2021. 120 Person were included in this study divided into 2 group: Group 1:60 patient with irritable bowel syndrome received conventional treatment and and Lactobacillus Acidophilus probiotics. Group 2: 60 patient with irritable bowel syndrome received conventional treatment.

Results
There was a significant increase of passage of gas in group 1 than in group 2 but no significant difference in between group 1 and group 2 regarding stool consistency, mucus with stool, abdominal pain, Bloating and passage of stools. There was 46.7% in group 1 and 55% in group 2 had a very good treatment success with no significant difference in between. Regarding to the treatment success in group 1, there were 46.7% in group 1 had a very good treatment success, 33.3% had a good treatment success and 20% had poor response. There was 80% in group 1 had a very good overall tolerability to probiotic treatment.

Conclusion
This study shows moderate evidence for the use and safety of probiotics in irritable bowel syndrome. Probiotics provide a new strategy as a safer treatment for irritable bowel syndrome. In general, the use of Probiotics has been successful in practice, especially for symptom control and maintenance of remission in these entities. However, it is necessary to take into account the specific condition of the patient and their comorbidities to make informed decisions about management.
Rheumatological and Immunological Manifestations among a Cohort of Human Immunodeficiency Virus Egyptian Patients
Authors: Mohamed Dalia Fayez , Hosny Sherin Mohamed , Hussein Safaa Abdelsalam Aly , Hamed Ayman Mohamed 
Published: August 2023

Abstract

Background
The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that is able to persist in the form of integrated proviruses in a predominantly CD4 T cell reservoir causing HIV infection and over time acquired immunodeficiency syndrome (AIDS).

Objective
Detection of frequency and pattern of rheumatological and immunological disorders in HIV infected Egyptian patients.

Patients and Methods
This study was observational cross sectional study conducted in tertiary hospital of infectious diseases in Giza, Egypt outpatient clinics and inpatient departments. It included one hundred human immune deficiency virus infected Egyptian patients diagnosed according to national AIDS program criteria having an immunological or a musculoskeletal disorder with age of ≥ 18 years.

Results
Results from our study which revealed a highly significant correlation between both CD4 count, HIV-PCR level and the incidence of oral ulcers. There was only a significant value between HIV-PCR level and the presence of myositis or thromboembolic manifestations. Within our 100 HIV positive patients the mean levels of ESR, CRP and SGOT levels were elevated. There was a weak inverse correlation between the CD4-positive lymphocyte count and ESR. There was a highly significant negative correlation between CD4 count and HIV infection duration ESR, CRP, urea, creatinine, blood urea level, SGOT, SGPT. Also, significant negative correlation between CD4 count and uric acid level. Moreover, there were a highly significant positive correlation between the HIVPCR level and ESR, CRP, serum creatinine level, SGOT and SGPT. There was a high significant negative correlation between the HIV-PCR level and hemoglobin level, platelets count and CD4 count. There was a significant negative correlation between HIV-PCR level and absolute lymphocyte count.

Conclusion
Rheumatologic manifestations are commonly occurring in HIV positive patients. Raynaud’s phenomenon, oral ulcers, and hepatosplenomegaly are significantly more prevalent in patients under non-HAART. ESR and CRP are significantly higher in patients not receiving HAART. Viral load is significantly higher in patients with non-specific antiviral treatment, while CD4 count is significantly lower in the same patient cohort. There is a significant relation between incidence of oral ulcers with lower CD4 count and higher viral load.
Validity of CBC Differential Count for Diagnosis of COVID-19
Authors: Melek Nermine A , Allam Mohamed F , Mahmoud Mayada M , Zeada Omneya M , Labib Bassem G 
Published: August 2023

Abstract

Background
With rapid spreading of the outbreak of 2019-nCoV infection, the WHO announced a public health emergency of international concern. Among most common easily performed and inexpensive diagnostic procedures are Complete blood counts (CBC).

Aim of the Work
to evaluate efficacy of complete blood picture (CBC) in diagnosis and identifying cases of COVID-19.

Patients and Methods
A case control study was conducted on a total of 173 patients at Ain Shams University Hospitals during a period of three months since beginning of data collection. Patients were allocated into 2 groups according to COVID-19 PCR result: GROUP 1: Patients with COVID-19 Positive PCR; GROUP 2: Patients with COVID-19 Negative PCR.

Results
CBC differential count has significant value in diagnosing of covid-19 disease, many of COVID patients have lymphopenia and leucopenia in comparison to non COVID suspected patients.

Conclusion
The definitive diagnosis of COVID-19 was made by RT-PCR analysis, but this was a time-consuming and less accessible test. With this test, the time it takes to diagnose and treat patients can be delayed. In our study, low values of leukocytes, neutrophils, lymphocytes and eosinophils with a CBC test which is easily available, were found to be valuable in terms of the initial diagnosis of COVID-19.
Role of Ultrasound in Diagnosis of IBD
Authors: Mohamed Azza Emam , Ahmed Ghada Abdelrahman , Awadein Mohamed Ali , Ezzat Eltohamy Eslam Mohammed 
Published: August 2023

Abstract

Background
Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a relapsing and remitting lifelong illness and over 3 million people have inflammatory bowel disease worldwide.

Objective
To evaluate the role of intestinal ultrasound in diagnosis of IBD.

Patients and Methods
This is a cross-sectional study that was conducted at the gastroenterology and hepatology unit, department of internal medicine, Ain Shams University at period from 20192021. 72 Egyptian patients with clinical manifestations suggestive of IBD according to true and love criteria and CDAI (Diarrhea, bleeding per rectum, abdominal cramps, tenderness, tenesmus and mucus in stool).

Results
This study revealed significant difference between the two groups regarding bowel wall thickness, stratification, haustration and color Doppler changes. These results strongly point to the value of intestinal ultrasound in the diagnosis of inflammatory bowel disease.

Conclusion
The cut-off point of intestinal wall thickness for diagnosis of IBD is 3.1.mm with sensitivity, specificity and diagnostic accuracy of 90.6%, 87.5% and 91.9% respectively. Color Doppler has sensitivity, specificity and diagnostic accuracy of 75%, 100% and 86.1% respectively for diagnosis of IBD. Intestinal ultrasound and color Doppler are reliable noninvasive tools for diagnosis of inflammatory bowel disease in clinical practice.
Assessment of Ventricular Arrhythmias Risk in Gastroesophageal Reflux Disease Patients
Authors: Samy Amir Helmy , Kayser Hany Haroun , Gamil Anwar Ayman , Elrawie Mohamed Salaheldin Mohamed 
Published: August 2023

Abstract
Gastroesophageal reflux disease (GERD) is characterized by acid regurgitation and epigastric burning that occur as the result of reflux of gastric content into the esophagus. Disturbances in the autonomic nervous system (ANS) were observed in patients with GERD. The evidence suggests that chronic GERD can cause an autonomic response, which results in ventricular arrhythmias (VAs). Our aim in the study is to examine T wave peak-to-end interval (TpeI) and the TpeI/QT ratio as highly sensitive gauges of ventricular repolarization anomalies and VAs potential in patients with GERD. In our study, The ECG measurements of both GERD and control groups are as follow; The QT wave dispersion (QTd) and corrected QT dispersion (cQTd) were higher in patients with GERD in comparison to controls (p = 0.002 and P = 0.09, respectively). Moreover, TpeI, corrected TpeI (cTpeI), and the TpeI/QT ratio were increased in patients with GERD in comparison to controls (p &lt; 0.001, p = 0.018, and p &lt; 0.001, respectively). We can conclude that patients with GERD may have an increased risk for VAs, and the VAs risk in patients with GERD can be predicted by measuring TpeI and the TpeI/QT ratio, which are the indicators of ventricular repolarization anomalies.
The Impact of Low Sodium Dialysate on Different Echocardiographic Parameters in Prevalent Hemodialysis Patients
Authors: Mahmoud Osama Mohamed , Abdelmobdy Ashraf Hassan , Tawfik Reham Saeed 
Published: August 2023

Abstract

Background
ESRD affects about 15% of adult population, leading to increased morbidity and mortality. Historically, hemodialysis treatments used low dialysate sodium (D-NA) in the range of 120 mEq/L to enable elimination of excess sodium from the body. Over time, higher D-Na (∼140 mEq/L) was used to improve hemodynamic stability during dialysis.

Aim of the Work
To determine the impact of decreased dialysate Na on cardiac functions and different echocardiographic parameters in prevalent heamodialysis patients.

Patients and Methods
A Prospective study was conducted, consisted of 45 patients on regular Hemodialysis at Rod Elfarag Hospital dialysis unit for 6 months.

Results
In the current study, there was high statistically significant difference between baseline lab investigation and after 6 months lab investigation as regard Hemoglobin, WBCs, Platelets, Ht, URR, serum albumin, Ca, Na, Phosphorus and BNP (p &lt; 0.001). We found that there was high statistically significant difference between baseline ECG and after 6 months ECG as regard PR interval, QRS duration and QT interval (p &lt; 0.001). There was high statistically significant difference between baseline Echocardiography and after 6 months Echocardiography as regard left atrium diameter, EF%, Diastolic BP and Systolic BP (p &lt; 0.001).

Conclusion
A reduction of the dialysate sodium concentration based on the predialysis sodium levels of the patients could reduce the SBP and decrease the volume load on heart. Within this short period, DBP could not be lowered. The effect of this approach should be studied in broad and lengthy series.
Fibroblast Gross Factor-23 and Carotid Artery Stiffness in Hemodialysis Patient
Authors: Al-Layl Hisham Mohamed Atef Abu , Wahab Khaled Gouda Abdel , Ali Salwa Yasser Mohammed 
Published: August 2023

Abstract

Background
FGF23 is a free circulating hormone secreted by osteocytes affecting mainly phosphate metabolism as it inhibits its renal tubular reabsorption by suppressing the expression of luminal sodium-phosphate co –transporters (Na Pi).

Aim of the Work
Aim of study is to verify the usefulness of FGF23 as a marker for diagnosis of arterial stiffness in CKD patients on regular hemodialysis (3 sessions per week, 4 hours each).

Patients and Methods
The present study enrolled 30 living end stage renal disease patients on regular hemodialysis randomly selected from hemodialysis unit at Ain Shams University hospitals after exclusion of patients of known cardiovascular disease or ischemic heart disease, also patients of age below 18 years and above 50 years were excluded as well as patients having arterio venous fistulas on both arms. All patients were subjected to complete medical history taking, including (Age, Sex, Etiology of chronic kidney disease, drugs and duration of dialysis), and detailed clinical examination was done.

Results
In this study patients have elevated serum levels of FGF-23 ranging from 100 up to 700 pg/ml. when the normal reference range is 18-108 pg/ml. Also our study result revealed a statistical significance of negative correlation between FGF-23 and diabetes mellitus duration, serum phosphorous, corrected calcium and estimated glomerular filtration rate as well. The current study shows statistical correlation of positive significance between FGF-23 and hypertension duration where, common carotid artery intima media thickness as well as present plaques in common carotid artery. Moreover there is no statistical significant correlation between FGF-23 and pulse pressure.

Conclusion
FGF23 serum levels are markedly elevated in chronic kidney disease CKD and among patients on regular hemodialysis causing arterial stiffness.