bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiopoietin-2 as a Predictor of Fibrosis Regression in Hepatitis C Virus-Patients after Direct Acting Antiviral Drugs
Authors: Bakouk Sarah H , Sakty Tarek Maged El , Ahmed Osama A , Samaan Amira I 
Published: August 2023

Abstract

Background
Hepatitis C virus (HCV) infection is the major cause of liver cirrhosis and hepatocellular carcinoma (HCC); thus, effective and safe treatment is crucial.

Aim of the Work
to evaluate the serum angiopoietin-2 as non-invasive marker of fibrosis regression in patients with Hepatitis C Virus receiving DAA drugs.

Patients and Methods
This study was conducted on 40 chronic HCV-patients who received DAA therapy in the Hepatic Virology Unit and the gastroenterology department of Ain Shams University hospitals. All patients were subjected to the following: Full history taking with stress concerning the hepatology system, clinical evaluation, laboratory investigations, Routine investigations: Abdominal and Pelvic ultrasonography and Transient elastography (Fibroscan) to measure liver stiffness measurement (LSM) for detection the degree of liver fibrosis in the chronic HCV-patients.

Results
Hematological findings, biochemical liver profile and liver fibrosis indices except hemoglobin level and platelets counts were significantly improved after DAA therapy. There was a significant improvement concerning the fibrosis stage after the treatment fibrosis staging at SVR12. The liver size, the spleen size and portal vein diameter were also significant after DAA therapy. There was improvement in the Child-Pugh score after successful HCV eradication by DAAs but the difference was no statistically significant. There was a statistically significant higher mean of Ang-2 levels in higher stages of liver fibrosis stages. Overall, serum Ang-2 levels significantly decrease after DAA therapy. In F0, F1, F2 & F3 fibrosis stage; the mean Ang2 levels decrease after DAA therapy but in F4 fibrosis stage; the mean Ang2 levels did not change almost. Baseline Ang-2 and WBCs, AST, ALT, total bilirubin, INR, serum albumin, alpha-fetoprotein, serum creatinine, LSM, FIB-4 index, APRI score, liver size and portal vein diameter were significantly correlated. There were also a significant correlation between Ang-2 and all the fibrosis stages (from F0 to F4) before DAA treatment. Ang-2 levels were significantly associated with LSM based liver fibrosis stage regression after successful DAA therapy. Ang-2 levels did not correlate with hemoglobin, platelets and spleen size at baseline. Ang-2 levels did not correlate with hemoglobin, platelets, WBCs, INR, spleen size and portal vein diameter after DAA therapy. Ang-2 levels did not show significant correlation with the Child-Pugh score after DAA therapy.

Conclusion
Liver fibrosis stage after successful HCV eradication by DAAs. But in stage F4 (cirrhosis), mean Ang-2 remained almost unchanged after DAA therapy. Significant decrease of Serum Ang-2 could suggest its use as a predictor of liver fibrosis regression in Hepatitis C Virus-patients after Direct Acting Antiviral drugs after DAA therapy.
Assessment of Nutritional State in Prevalent Hemodialysis Patients and Its Impact on Quality of Life
Authors: Bichari Walid Ahmed , Mahmoud Osama Mohammed , EL-fakharany Wesam Nasr , Abdelmobdy Ashraf Hassan 
Published: August 2023

Objective
Malnutrition and poor quality of life are very common among the hemodialysis patients for many reasons, having also severe consequences such as increased hospitalization and mortality rates. Recently, both of them are considered as two important targets of dialysis adequacy so we aimed to hypothesize whether there is a relationship between nutritional status and quality of life among our hemodialysis patients.

Design and Methods
it was a crosssectional study among 100 patients on regular hemodialysis at Damanhur Medical National Institute. We assessed nutritional status using malnutrition inflammation score (MIS) and quality of life (QOL) using short form 12 questionnaire version1 (SF-12v1) with its valid Arabic version in order to find any correlation by Pearson correlation. Univariate analysis was also used to assess the degree of MIS effect on SF-12v1 components.

Results
MIS had significant negative correlation with SF-12v1 components regarding physical component summary (PCS) where (r= .498, p=.0001), mental component summary (MCS) (r= -.497, p=.0001) and total QOL score (r= .554, p=.0001). MIS of patients was highly statistically significant in predicting of PCS as Model explained (24.8%) of variability in PCS of QoL of patients, as each increase in MIS lead to significant decrease in PCS by 3.17 as (b, t, p) = (-3.17,-5.69, .0001) respectively. Also in affecting of MCS as Model explained (24.7%) of variability in MCS, where (b, t, p) = (-2.8,-5.67, .0001) respectively. As well, in affecting the total score, as Model explained (30.6%) of variability in total score, with (b, t, p) = (-2.97,-6.58, .0001) respectively.

Conclusion
MIS had significant negative correlation with PCS, MCS and the total score of SF12v1 among our patients. MIS of patients was highly statistically significant in predicting of PCS, MCS and the total score of SF12v1 and each increase in MIS lead to significant decrease in them with different degrees.
Evaluation of the Role of Serum Vimentin as a Diagnostic Biomarker for Hepatocellular Carcinoma
Authors: Salem Amira Ahmed , Mohamed Manal Sabry , Fathallah Ahmed Magdy , El Sayed Yousef El Sayed Mohamed 
Published: August 2023

Background
Hepatocellular carcinoma (HCC) is a major unresolved medical issue, which is considered as the seventh most common cancer globally and the fourth leading cause of cancer deaths, with approximately 700,000 deaths per year.

Aim of the Work
The aim of this study; to evaluate the role of serum vimentin as a diagnostic biomarker in patients with HCC.

Patients and Methods
This case control study enrolled 60 patients; divided into two groups: Group (I): included 20 patients with liver cirrhosis without HCC as a control group and Group (II): 20 patients divided into 2 subgroups: (IIa): includes 20 patients with HCC and serum AFP is high and (IIb): includes 20 patients with HCC and serum AFP is normal.

Results
The present study found statistical significant decrease in Hb level in group IIb compared to group I, there was high statistical significant decrease in platelet count in patients of group IIa and IIb compared to control group. a statistical significant elevation of total bilirubin and INR with decrease of albumin in group II compared to control group.There was high statistical significant elevation in AFP in group IIa and IIb compared to control group and in group IIa compared to group IIb, a high statistical significant elevation in Vimentin level in group IIa and IIb compared to control group while there was no statistical significant difference between group IIa and group IIb.

Conclusion
Vimentin can be considered as an important independent and discriminative serological biomarker for detecting early stage HCC in patients with normal serum AFP.
Clinical Types of Movement Disorders in Patients with Multiple Sclerosis
Authors: Nasef Ayman , Elsayed Abdel Aty Ahmed Mohamed , Saad Mahmoud , Hamid Eman , Shalash Ali 
Published: August 2023

Background
Little is known about the true prevalence and clinical characteristics of movement disorders in early multiple sclerosis (MS), associated clinical disability and their effect on QOL. We conducted a cross sectional study to fill this knowledge gap.

Objectives
to study the prevalence of movement disorders in early stages of multiple sclerosis, presence of other clinical disability and their effect on QOL.

Patients and method
This is a cross sectional observational study. The patients group included 250 patients with RRMS whom were recruited consecutively from the MS clinic of Ain Shams and Nasr institute hospitals. Each eligible patient was interviewed and examined for presence of movement disorders, Patients were divided into 2 groups, group A without movement disorders and group B showing movement disorders. General and neurological examination including Expanded Disability Status Scale (EDSS) score at time of interview for both groups. Magnetic resonance imaging (MRI) of brain and cervical spinal cord (with contrast whenever available) obtained at the time of interview with documentation of MS plaques involvement for both groups. RRMS patients with movement disorders (group B) are subjected to different assessment for depression by Beck Depression Inventory (BDI), cognitive assessment by Montreal Cognitive Assessment (MOCA) scale, disability and quality of life (QOL) by the Short Form 36 Health Survey Questionnaire.

Results
This study included 250 RRMS. onset of their movement disorders was 2.69 ± 2.34 years from MS diagnosis with mean EDSS 3.515 ± 1.04. Cerebellar signs are present in 97% of total number of movement disorders and 26% of total sample, regarding tremors, 36 patients in this study showed tremors representing 53.7% of movement disorders patients, 14.4% of total sample of RRMS patients. This study showed presence of 5 cases of restless leg syndrome 7.5% of total number of MD. 4 cases of dystonia are present in this study representing 6% of MD patients. Patients with MD showed presence of depressive symptoms and cognitive affection with negative impact on QOL. Tremors severity is not correlated with either cognition or depression scores where ataxia is correlated with depression score only. MRI assessment of patients with MD showed higher lesion load and involvement of infratentorial structures especially cerebellum and its connections and cerebellum.

Conclusion
Movement disorders are common to occur than previously known especially ataxia and tremors early in the course of the disease. Presence of MD is related to high lesion load and strategic location of these lesions. special assessment of movement disorders as independent cause of disability with concomitant depression and cognitive impairment especially early in the disease course should be taken in consideration due to their negative impact on QOL.
Registry of Patients with Spinal Muscular Atrophy in a Tertiary Care Unit in Egypt
Authors: Fahmy Nagia Ali , Saleh Hala Abdulhady , Rashed Hebatallah Reda , Elsayed Mekkawy Yosra 
Published: August 2023

Background
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disease characterized by degeneration of alpha motor neurons in the spinal cord, resulting in progressive proximal muscle weakness and paralysis.

Objectives
To register patients with SMA who are diagnosed clinically and genetically (typical and atypical forms) in a tertiary care unit in Egypt.

Patient and methods
80 Patients with SMA who are diagnosed clinically and genetically at Neuromuscular Unit of Ain Shams University Hospital were registered. Demographical data and genetics of the patients were collected and analyzed. The patients were assessed for skeletal deformities, cardiac evaluation by echo and pulmonary evaluation by PFTs (for patients above 5 years old) and functional assessment by motor scales according to age and type of each patient was done.

Results
SMA was more common in males with predominance of type II and median age of 4.5 years old, a considerable number of cases had positive history of consanguinity and similar cases in family, 98.8% of cases had the typical form of SMA with homozygous deletion of SMN1 gene with variable SMN2 copy number according to type. 32.5% of cases had skeletal deformities in the form of scoliosis with or without kyphosis, extremities contractures and chest cave deformities. 4 cases had restrictive pattern due to scoliosis cardiac abnormalities were detected in 3 cases of type I. 31 cases were assessed by CHOP INTEND and 49 cases were assessed by HFMSE giving a good tool for assessing disease progress and role of physiotherapy. Severe chest infection and respiratory failure was the cause of death of 3 cases of type I during the period of study.

Conclusion
registry of SMA patients will lead to a better understanding of the natural history of SMA and the influence of drug treatment. This is crucial to improve the care of SMA patients.
Evaluation of Outcomes of Percutaneous Endoscopic Discectomy in the Treatment of Patients with Lumbar Degenerative Disc Herniation
Authors: Abou kila Mohammad Yousof Mohammad Abd Alla , Sabry Ismail H , Fayed Zeiad Y , Ismaiel Ibrahim A 
Published: August 2023

Background
Lumbar discectomy is one of the most common operations performed worldwide for lumbarrelated symptoms. During the latter half of the 19th century, more techniques were developed to remove the herniated disc with minimal invasiveness.

Aim and objectives
The aim of this study was to analyze the safety and efficacy of percutaneous endoscopic discectomy in the treatment of lumbar degenerative disc herniation for adult patients.

Subjects and methods
A systematic review was conducted, including adult patients (&gt; 18 years and less than 80 years old) with surgical treatment of lumbar radiculopathy secondary to degenerative herniated discs.

Results
results revealed that mean preoperative VAS was 6.05 which improved post operation to 1.35. Mean preoperative ODI score was 56.5 which decreased to 14.2 post operation, and SF-36 physical was used by four studies and mean preoperative score was 42.07 which increased to 76.2 post operation. SF-36 mental score used by three studies with mean preoperative score was 41.08 which increased post operation to 65.5.

Conclusion
PELD appears to be an effective intervention for LDH, as it has a small amount of intraoperative blood loss, short postoperative hospital stay, and good clinical and functional outcomes. It needs more training, as it has a long learning curve.
Role of Prophylactic Dexamethasone Administration before Elective Cesarean Section at Term in Reducing the Incidence of Neonatal Respiratory Distress Syndrome (A Randomized Controlled Trial)
Authors: Bayoumy Hassan Awwad , Abbas Ahmed Mohamed , El Aziz Saleh Hayam Anwar Abd 
Published: August 2023

Background
Caesarean section rate has been increased, half of which are elective. This may be due to abnormal presentation during pregnancy, increased maternal choice about mode of delivery and due to changing practice in the management of previous caeserean sections.

Aim of the Work
The objective of this study is to assess the effect of prophylactic dexamethasone 48 h before elective cesarean section at term (less than 39 weeks) on decreasing the neonatal respiratory distress syndrome and NICU admission.

Patients and Methods
Design: A randomized controlled clinical trial. 2 groups; (Group A, Dexa) which consists of 460 pregnants who received prophylactic 4 intramuscular doses of 6mg dexamethasone 12 hours apart 48 hours before delivery. And (Groups B, Control) 460 pregnants who received No treatment before elective caesarean section at term (37-39 wks).

Results
Regarding the indication for the C.S, there was no significant difference between women of both groups. There was no significant statistical difference between the two groups as regarding birth weight. Neonates of dexamethasone group significantly had higher APGAR scores. Transient tachypnea of neonates (TTN) was significantly less frequent among dexamethasone group (2.8%) while in the control group was (6.5%). Respiratory distress syndrome (RDS) was significantly less frequent among dexamethasone (A) group 3/460 (0.7%) while was 15/460 (3.3%) in control (B) group. Also (RDS) grade was significantly less frequent among dexamethasone group. The intraventricular hemorrhage was non-significantly less frequent among dexamethasone group (0.2%). The need to resuscitation was significantly less frequent among dexamethasone group (6.3%) while in control group was (11.5%). NICU admission was significantly less frequent among dexamethasone group (3.5%) vs (9.1%) in control group. Also NICU admission duration was significantly shorter among dexamethasone group. The need for mechanical ventilation was significantly less frequent among dexamethasone group (0.2%) while in control group was (1.7%). Mechanical ventilation duration was significantly shorter among dexamethasone group. Neonatal mortality was nonsignificantly less frequent among dexamethasone group (0.2%) while in control group (0.4%).

Conclusion
Antenatal Corticosteroids are effective in prevention of respiratory complications after elective caesarean section at term including: the incidence of neonatal respiratory distress syndrome, the incidence of admission with respiratory distress to neonatal ICU and the incidence of transient tachyponea of the newborn.
Accuracy of 2D Greyscale and 2D and 3D Color Power Doppler Ultrasound in the Diagnosis of Morbidly Adherent Placenta (MAP)
Authors: Fathy Hesham Mohamed , Hussain Sherif Hanafi , Nassar Salma Ashraf Mohamed , Mohamed Tamer Mohamed Faried 
Published: August 2023

Background
Prenatal diagnosis of placental accreta (PA) is essential to carry out adequate surgical planning in centers where multidisciplinary teams are in place, which improve results and reduce complications. These ideal scenarios should be developed in countries with more significant difficulties in the availability of human and technological resources, through teamwork in the different hospital centres and the adequate transfer of patients at higher risk to centres with the best interdisciplinary management skills.

Objective
To evaluate the diagnostic accuracy of each sign (2D grayscale US signs), 2D Doppler signs, and 3D Doppler signs modified from Collins SL in diagnosis of morbidly adherent placenta in patients with one or more previous cesarean section diagnosed as placenta previa.

Methods
The present study is a diagnostic test accuracy study was carried out at Ain Shams University Maternity Hospital during the period from January 2020 to March 2021. 126 women were recruited from Special Care Center of the fetus – Ain Shams University Maternity Hospital. All included women were scanned by 2D grayscale, 3D power Doppler ultrasound.

Results
The current study showed that cases underwent cesarean hysterectomy had significantly higher previous cesarean sections. The results of the current study showed a significant association between all criteria of the 2D grayscale, Color Doppler, 3D Power Doppler ultrasound and presence of placental adherence, considerable intraoperative blood loss, need for added surgical steps, CS hysterectomy and bladder injury with the presence of more than 4 sign or more are predictive for placental invasion with the need of emergency hysterectomy.

Conclusion
The result of the current study proves the diagnostic accuracy of the ultrasound concerning the prediction of difficult placental separation, considerable intraoperative blood loss, CS hysterectomy and bladder invasion.
Assessment of Quality of Life in Patients with Malignant Pleural Mesothelioma
Authors: Taha Tarek Hussein Kamel , Ghali Ramy Refaat Youssef , Kamal Khaled Abdel-Aziz Mohamed , El-Sayed Fatma Radwan Ahmed 
Published: August 2023

Background
Pleural mesothelioma represents 92% of all malignant mesotheliomas. There is no MPM curative treatment. Multimodality treatment is commonly used including chemotherapy, targeted therapy and radiotherapy. Because of MPM poor prognosis (OS 8-14 months), maintaining quality of life of patients became more important in MPM treatment.

Aim of the Work
To investigate the quality of life (QOL) of patients with malignant pleural mesothelioma and to determine the factors that correlate with their QOL comparing different therapies.

Patients and Methods
This is a prospective, observational multi-center study conducted between November 2018 and November 2019. 55 consecutive patients with newly diagnosed MPM were enrolled in Ain Shams University Hospital, El-Nasr Hospital in Helwan and Ismailia Oncology Hospital. The study was approved by the ethical committee at the faculty of medicine, Ain Shams University.

Results
In our study we evaluated quality of life of MPM patients using EORTC questionnaires (QLQ-C30 & QLQ-LC-13), and correlated the score with different chemotherapy types and other factors.

Conclusion
Our study found correlation between QLQ baseline scores and both weight loss & chest pain, and no correlation of QLQ scores change with types of chemotherapy. Median Progression-free survival was 6.5 months and correlated with disease stage and chemotherapy used.
Relation between Vitamin D Deficiency and Dry Eye
Authors: Samy Magda Mohamed Mahmoud , Naguib Karim Magdi , Ezzat Nashwa Mohamed , El-Din Mohamed Anwer Hagar Ahmed Ezz 
Published: August 2023

Background
Tears are very important to the overall health of the eye and vision. The tear film is mechanically distributed over the ocular surface through a neuronally controlled blinking mechanism. Normal blink reflex, contact between the external ocular surface and the eye lids, and normal corneal epithelium are three factors required for effective resurfacing of the tear film (tear stability). (1)

Objective
To demonstrate the relation between vitamin D deficiency and dry eye disease searching for finding a correlation between dry eye parameters with vitamin D deficiency.

Patients and Methods
Cross sectional study. A total 50 patients attending the ophthalmology outpatient clinic of General Ain Shams Hospital, from February 2019 to October 2019 were enrolled in the study after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University. They were divided randomly into 2 groups. Group 1: consisted of 35 patients who were vitamin D deficient. Group 2: consisted of 15 patients who had normal vitamin D levels (control group).

Results
The study showed that there was statistically significant increase in symptoms of dry eye in female patients than male patients and there was statistically significant decrease in the level of tear film break up time, Shirmer test and serum 25 (OH) vitamin D in cases with dry eye than those without. It was found that there was statistically significant decrease in vitamin D level in female cases than male cases. Also, there was statistically significant decrease in vitamin D level in cases with symptoms of dry eye and conjunctival hyperemia than cases without. There was also statistically significant positive correlation between serum 25 (OH) vitamin D and tear film break up time and Shirmer test.

Conclusion
The present study suggests that patients with vitamin D deficiency may suffer from dry eye. Investigations to confirm and quantify a clinical diagnosis of dry eye should include serum 25 (OH) vitamin D when suspecting vitamin D deficiency especially in patients prone to this type of vitamin deficiency.