bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening and assessment of cardiac autonomic neuropathy in long-standing type 2 diabetic women
Authors: Refaie Wael 
Published: September 2023

Abstract
Background
Patients with long-standing diabetes mellitus undergoing surgical interventions are under considerable risk, hence posing a surgical challenge, as they may have cardiovascular and/or cardiac autonomic neuropathy (CAN). CAN is serious, often overlooked and underdiagnosed, with possible arrhythmias and silent ischemia that may be life threatening.

Objectives
The aim of this study was to screen for one of the underdiagnosed high-risk problems by assessment of CAN in long-standing type 2 diabetic women undergoing stressful situations.

Study design
Cross-sectional study.

Patients and methods
Hundred type 2 diabetic women scheduled for major surgery were assessed by autonomic function tests. CAN was assessed by analyzing heart rate variations during three standard tests (deep breathing, lying to standing, and the valsalva maneuver). Sympathetic functions were assessed by checking orthostatic hypotension. The CAN score of each patient was analyzed. Continuous 24 h ECG monitoring was performed to evaluate arrhythmia, corrected QT (QTc), and QT dispersion (QTd). Transthoracic Doppler echocardiography, with a focus on left ventricular hypertrophy, diastolic, and systolic dysfunctions, was carried out. Patients were classified as having mild (with only one abnormal test) or severe CAN when two or more abnormal function tests were present. Exclusion criteria included any systemic illness that could affect the results of the study or the autonomic functions, smoking, hypertension, and patients with evident ischemia.

Results
CAN was detected in 70% of the patients studied, and 70% of them had a severe case of CAN. Postural hypotension was detected in 34% of the patients studied. QTc prolongation and QTd were frequent. ECG and Doppler echocardiography changes of left ventricular hypertrophy were more prevalent among patients with CAN. Diabetics with CAN were significantly older, had a longer duration of diabetes mellitus, and higher HbA1-c, higher pulse pressure, triglyceride, uric acid, and urinary albumin excretion rate. They also had a significantly increased left ventricular mass index and diastolic dysfunction.

Conclusion
Middle-aged women with long-standing diabetes are vulnerable to CAN with postural hypotension and prolonged QTc intervals, QTd, and increased left ventricular mass index. Identification of CAN is crucial to prevent the hazards of cardiovascular insults during stressful situations, and cases with severe CAN may require coronary artery disease screening preoperatively.
Fractalkine in type 2 Egyptian diabetics with and without nephropathy
Authors: Zakaria Ebtissam , Al-Rawi Hoda , Ghanem Nashwa S. , Elsayed Naglaa M. , Rashed Laila A. 
Published: September 2023

Abstract
Background
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Diabetic nephropathy is the major microvascular complication of diabetes mellitus; one of the earliest clinical signs of diabetic nephropathy is an elevated urinary albumin excretion (UAE), referred to as microalbuminuria. Fractalkine is a large cytokine protein of 373 amino acids; it contains multiple domains. Fractalkine (CX3CL1) is a unique chemokine and the only representative of the CX3C group. It exists as a membrane-bound and soluble form. It interacts with cells expressing CX3CR1, a G-coupled protein receptor. It is also commonly known by the names fractalkine (in humans) and neurotactin (in mice).

Aim
Our study aimed to assess fractalkine levels in type 2 Egyptian diabetic patients with and without diabetic nephropathy and its role as a marker in the development of diabetic nephropathy.

Patients and methods
Our study was carried out on 75 individuals: 25 controls, 25 type 2 diabetic patients without diabetic nephropathy, and 25 type 2 diabetic patients with diabetic nephropathy. These patients were subjected to a full laboratory workup including fasting and postprandial blood glucose, glycated hemoglobin A1C, serum urea and creatinine, 24-h UAE, and fractalkine level.

Results and conclusion
Our study showed that the serum fractalkine concentration was significantly elevated in type 2 diabetic patients with nephropathy (1153.14±261.1) compared with type 2 diabetic patients without nephropathy (705.78±150.59) and the control group (251.5±64) (both P=0.000). There was a significant correlation between serum fractalkine level and 24-h UAE, HBA1C, and serum creatinine. Thus, this positive correlation between serum fractalkine level and UAE could be an early predictor of microvascular complications in diabetic patients. We can conclude that serum fractalkine plays a pathogenic role in the development of diabetic nephropathy.
TMC: a new staging system for tympanomastoid cholesteatoma
Authors: Belal Aziz , Reda Mahmoud , Mehanna Ahmed , Belal Yousef 
Published: September 2023

EnAbstract
Objective
To present a new staging system for tympanomastoid cholesteatoma that is based on the primary site of pathology in the middle ear (T), its spread to the mastoid (M), and to the surrounding structures, either cranial, intracranial, or extracranial, and presence of complications (C).

Setting
Tertiary Care Center (ENT Department, Faculty of Medicine, University of Alexandria, Egypt).

Study design
Clinical Prospective Study.

Methods
The TMC staging system is based on the correlation of preoperative otoscopy findings with computed tomography examination of the temporal bone. Preoperative findings have also been correlated with intraoperative findings.

Patients
We included 120 patients with tympanomastoid cholesteatoma diagnosed preoperatively.

Results
In 87% of the patients, preoperative and intraoperative staging were well correlated.

Conclusion
The TMC staging system of cholesteatoma paves the way to a logical roadmap for functional surgery of the middle ear and mastoid; in addition, it makes the comparison of clinical studies about cholesteatoma meaningful.
Assessment of postural control system in autistic patients
Authors: Shabana Mohamed Ibrahim , El Shennawy Amira Mohamed , El Dessouky Tarek Mohamed , Sabry Shiama Ahmed 
Published: September 2023

EnAbstract
Introduction
Studies using clinical tests have reported abnormal postural balance in children with autism generally but it was only clinically significant when somatosensory input was disrupted alone or in combination with other sensory challenges.

Objective
To assess the postural control system in autistic children and correlate their age and Child Autism Rating Scale (CARS) score with their postural control.

Methods
Computerized dynamic posturography was performed in 20 autistic children with (IQ>70) between the ages of 5 and 15 years and 15 age-matched healthy children.

Results
There was a statistically significant positive correlation between age in both the study and the control groups and the Sensory Organization Test (SOT) results in all SOT conditions. As regards the degree of autism, this study included 20 autistic children diagnosed by CARS and their CARS values ranged from 30 to 46, with a mean (33.7±3.22). In our study, we found that there was a statistically significant negative correlation between the CARS score in the study group and SOT results in all conditions, except in SOT condition 1.

Conclusion
The evidence from this study suggests the more general involvement of neural circuitry beyond the neural systems for social behavior, communication, and reasoning, all of which share a high demand on neural integration of information.
Audiologic evaluation and communication disorders in a group of Egyptian children with autistic features
Authors: Samy Kamal Labib , Selim Mona Hassan , Osman Dalia Mostafa , Mohamed Reham Ahmed 
Published: September 2023

EnAbstract
Objectives
The aim of this work was to perform an audiological evaluation on a group of children with autistic features and to correlate the results with the intelligent quotient, communication skills, and sensory integration function of these children.

Study design
Descriptive cross-sectional study.

Patients and methods
The study was carried out on 25 Egyptian children with autistic features and 25 age-matched and sex-matched typically developing children. All the children’s age ranged from 4 to 9 years. All the children were subjected to the following: history taking, basic audiological evaluation, transient evoked otoacoustic emissions, N100, and P300. The children were also subjected to communication assessment, sensory integration dysfunction questionnaire, psychometric evaluation, and the Childhood Autism Rating Scale. The results obtained from the two groups were then compared. In addition, correlation studies were carried out for all the results obtained.

Results
Autistic children presented with normal hearing sensitivities and cochlear function, and delayed N100 and P300 latencies and small P300 amplitudes compared with the control group. There was a significant negative correlation between N100 latency and verbal and nonverbal communication abilities. In addition, there was a significant correlation between P300 latency and amplitude and each of the following: intelligent quotient, the Childhood Autism Rating Scale, and dynamic assessment of verbal and nonverbal communication. The auditory and visual modalities of the sensory integration dysfunction score correlated positively with P300 latency but not amplitude.

Conclusion
The auditory deficits in autism involve controlled attention processes, speed of perceptual classification, and allocation of attention. N100 is a correlate of the level of communication and language development rather than a marker of autism. P300 abnormalities affect verbal and nonverbal communication, mental development, autistic features, and sensory integration function in autism and may be used as a tool to assess the prognosis of autism.
Assessment of clinical and laboratory tests in predicting risks of fall in the elderly
Authors: Taha Hesham Mohammed Othman , Shafik Amr Gouda , Saber Naira Zakhlol 
Published: September 2023

EnAbstract
Introduction
Falls and unstable balance are multifactorial problems and rank high among serious clinical problems faced by the elderly. They are a cause of substantial rates of mortality and morbidity as unintentional injuries.

Aim of the work
The aim of the study was to explore the most common risk factors for falls in the elderly and to construct the most specific test battery including clinical and laboratory tests capable of determining risk for falls in the elderly.

Materials and methods
A 6-month prospective study was carried out on a sample of 30 elderly persons of age at least 60 years, reporting more than one fall within last 6 months. Detailed history on neuro-otological symptoms, previous falls, dizziness episodes, and symptoms of systemic disease or osteoarthritis was taken. Visual acuity, musculoskeletal examination, complete neurological examination, and a complete vestibular test battery in the form of the videonystagmography (VNG) test battery, vestibular-evoked myogenic potentials, and computerized dynamic posturography was performed. All participants underwent radiological diagnosis and grading of the osteoarthritic knee and hip. The mobility and gait screening protocol was used, which includes the timed up and go test (TUG), fall risk assessment screening tool (FRAST), and Dynamic Gait Index (DGI).

Results
Most patients suffered from peripheral vestibular dysfunction and the most frequent VNG abnormality was unilateral vestibular lesion. Radiological assessment of knee and hip osteoarthritis revealed 36.76% with grades II and III. Significant impairment of vision was found in 40% of the elderly. TUG test revealed high risk of falls in those elderly. In total, 20 participants revealed moderate or high risk for falls by FRAST. There was significant correlation between the number of falls and SOT tests (C5 and C6) together with adaptation tests reflecting vestibular pattern of dysfunction. Functional test of dynamic posturography revealed a highly significant correlation between limits of stability reaction time, movement velocity, and tandem of gait step and the number of falls. TUG showed a highly significant correlation in elderly people who experienced falls, whereas DGI showed only significant correlation and FRAST showed nonsignificant correlation. A highly significant correlation was found between SOT C5 and C6 scores and TUG and DGI with a weak correlation with FRAST. Vestibular-evoked myogenic potential asymmetry and unilateral canal paresis revealed nonsignificant results with all functional tests except DGI, which revealed a weak correlation with them. Analysis of variance test revealed that the vestibular dysfunction group is more vulnerable to falls than other groups.

Conclusion
The VNG test battery and computerized dynamic posturography in conjunction with stance tests in the elderly who complain of dizziness can identify those with high risk of a fall.
Vogt-Koyanagi-Harada syndrome (review of case reports)
Authors: AlBahkaly Sameer , AlKhunaizi Arwa , Algamdi Zyad 
Published: September 2023

AbstractVogt–Koyanagi–Harada (VKH) disease, also known as uveomeningitic syndrome, is a multisystem autoimmune disorder directed against any melanocyte-containing organ, including the eye, central nervous system, auditory, and integumentary system. We present a case of an African woman with total deafness and blindness of VKH, and discuss the histological characteristics, and review the classification and the management of VKH. The most important factor for prognosis is the immediate treatment. The rarity of this syndrome makes its diagnosis a challenge and the presence of deafness, tinnitus, and vertigo must be considered in its diagnosis.
Practical approach to the management of dizzy patients
Authors: Mansour Ossama I. 
Published: September 2023

EnAbstract
Introduction
Dizziness is a common symptom that may be caused by diverse pathologies. It requires a multidisciplinary approach and comprehensive workup to diagnose and treat the cause. A practical and simplified approach is presented.

Objectives
After reading this article you should be able to: (1) Remember the basics of balance control; (2) Assess a dizzy patient in the office; (3) Be familiar with available vestibular tests and the clinical yield of each; (4) Plan a practical workup algorithm; (5) Differentiate between the common causes of dizziness; (6) Know the current management strategies; (7) Understand the concepts of vestibular rehab.
Acute otitis media in children of Ismailia city: a bacteriological study
Authors: Naguib Mohammed A. , El Hennawi Diaa , Hessam Waheed F. , El Tabbakh Mohammed T. , Gamal Amira 
Published: September 2023

EnAbstract
Introduction
Acute suppurative otitis media is a very common health problem associated with emerging resistant organisms that require special attention.

Aim
The aim of this study was to determine the most common infecting microorganism causing acute suppurative otitis media in Ismailia city and to determine the organism’s sensitivity to antibiotics.

Patients and methods
This investigation was a cross-sectional study carried out in multiple hospitals and primary care clinics in Ismailia city targeting patients below 18 years of age. Each patient underwent history taking and a clinical examination. An ear swab and a nasopharyngeal specimen were taken and sent for culture and sensitivity testing.

Results
A total of 2003 patients with a mean age of 2.5 years were included in the study, 53.7% of whom were boys and 46.6% were girls. Haemophilus influenzae was the most prevalent organism in both the ear swab and nasopharyngeal aspirate culture and was mostly sensitive to amoxicillin–clavulanic acid, followed by azithromycin.

Conclusion
H. influenzae is the most common infecting organism causing acute suppurative otitis media and is highly sensitive to amoxicillin–clavulanic acid.
Audiological findings in children with chronic renal failure on regular hemodialysis
Authors: El-Anwar Mohammad W. , Elsayed Hany , Khater Ahmed , Nada Ebtessam 
Published: September 2023

EnAbstract
Background
The nephron in the kidney and the stria vascularis in the inner ear have many anatomical, physiological, and pathological similarities. Several studies have reported sensorineural hearing loss in adult chronic renal failure (CRF). However, there are only a few reported surveys on audiological affection in children with CRF.

Objectives
The aim of this study was to determine the presence, type, and severity of hearing loss (HL) and to evaluate the relationship of reported HL with the duration of hemodialysis and biochemical and hematological data of children with CRF on regular hemodialysis.

Patients and methods
This study included 30 patients with CRF on regular hemodialysis and 20 healthy children as a control group. All children were subjected to standard and extended high-frequency pure-tone audiometry, tympanometry, and otoacoustic emissions.

Results
Among 60 ears examined, 50 ears showed sensorineural hearing loss (83.3%), mainly at high frequencies (64%) and of mild and moderate severity, with a highly statistically significant difference between pure-tone thresholds in the patients and the control groups across frequencies 500–8000 Hz. High-frequency thresholds were significantly higher for the patients with CRF. No significant relation was found with the duration of hemodialysis or biochemical and hematological parameters. Transient-evoked otoacoustic emissions testing showed absent emission in 20 ears and those with preserved transient-evoked otoacoustic emissions had significantly lower amplitudes in all frequencies.

Conclusion
A high incidence of HL among children with CRF on regular hemodialysis was found in this study. Duration of hemodialysis treatment and biochemical and hematological parameters did not have a significant impact on HL. Thus, audiological evaluation must be considered in these children.
Endoscopic reconstruction of skull base defects using a nasal septal flap in paediatric patients
Authors: El-Bosraty Hossam M. , Shehata Wael 
Published: September 2023

EnAbstract
Introduction
The repair of skull base defects after skull base surgeries is a major problem. Postoperative cerebrospinal fluid leak in reconstruction of the anterior skull base defect using a nasal septal flap was minimal when compared with other techniques. The nasal septal flap should be considered as the first line of treatment after transnasal endoscopic skull base surgery.

Objectives
Evaluation of the usefulness and reliability of endoscopic endonasal skull base reconstruction using a nasal septal flap.

Patients and methods
This study was carried out on 10 paediatric patients with skull base defects because of different pathologies. These patients were admitted in El-Kasr El-Ainy Hospital, Otorhinolaryngology Department. These patients included one patient with a germ cell tumour, five patients with a congenital encephalocele and four patients with skull base defects because of trauma to the skull base.

Results and conclusion
Various endoscopic techniques have been described to separate the cranial cavity from the sinonasal cavity to prevent infection, pneumocephalus and cerebrospinal fluid leak. Different techniques were used to close the anterior skull base defects such as multilayer free graft, suturing the dural defect combined with free graft and reconstruction based on a vascularized graft. The nasal septal flap should be considered as the first line of treatment after transnasal endoscopic skull base resections.
Endoscopic approaches to the sphenoid: How I do it?
Authors: Youssef Tamer A. 
Published: September 2023

AbstractSphenoid sinus disease is recognized as an unusual clinical entity. It is likely that it is under-reported because of its lack of recognition as it has an insidious onset with nonspecific symptoms. Further, optimal physical examination is difficult because of the relative inaccessibility of the sinus. During the past decades, endoscopic sphenoid surgery has been the standard approach worldwide. There are many variables to be considered while selecting the best endoscopic approach to the sphenoid. In this work, the author describes different endoscopic approaches to the sphenoid with their clinical application.
Which side are they on? A review and case series of diagnosing primary ciliary dyskinesias in low- or middle-income countries.
Authors: Surdut S P , Van der Merwe E , Goussard P , Urban M F 
Published: September 2023

Primary ciliary dyskinesia (PCD) is a rare genetic condition with a variable clinical presentation, making its diagnosis a challenge. The authors describe two unrelated sibling pairs with PCD: adult siblings in the first and perinatal/neonatal in the second. Both families highlight the commoner and less common clinical manifestations of PCD. The authors use these cases to highlight (1) the current understanding of the underlying genetic and pathophysiological mechanisms of PCD, (2) the range of cardiac and respiratory features of PCD across a wide age-range (3), aspects of history and clinical exam that should raise suspicion of PCD, and (4) the role of NGS gene panel testing in confirmation of diagnosis.
The Haematology and Serum Biochemistry of Traditional Textile Dyers in Ntonso, Kumasi were Affected by Exposure to Synthetic Textile Dyes
Authors: Kuffour Osei B. , Larbie Christopher , Genfi Afua K. A. , Sedeafor Richard 
Published: September 2023

Aim: To study the effects of synthetic textile dyes on haematology and serum biochemistry of traditional textile industry practitioners at Ntonso in the Ashanti region of Ghana.
Study Design: Case-control study.
Place and Duration of Study: The study was carried out at Ntonso in the Ashanti region of Ghana and clinical analyses were carried out at the Clinical Analyses Laboratory at the Department of Biochemistry and Biotechnology, KNUST between October 2018 and February 2019.
Methodology: This study was conducted on 50 textile dyeing practitioners who have been using synthetic textile dyes for more than five years and 50 participants in the control group whose daily work does not expose them to any kind of synthetic textile dye. Participants over 70 years or less than 18 years, pregnant women and those with a medical history of kidney and liver diseases were excluded from the study. Haematological parameters such as White Blood Cell (WBC) counts, Red Blood Cell (RBC) counts, Platelet counts, Haemoglobin levels, etc. were measured. Liver function indicators such as Alanine transaminase (ALT), Protein, Aspartate aminotransferase (AST), Alkaline Phosphatase (ALP), Gamma-glutamyl transferase (GGT), Total Bilirubin (TBIL), and kidney function indicators such as Creatinine, urea, Na, K, Cl ion levels were assessed. Lipid profile parameters such as Total Cholesterol, Triglycerides, High-Density Lipoproteins, Low-Density Lipoproteins (LDL), and Very Low-Density Lipoproteins (VLDL) levels were also assessed.
Results: There were statistical differences in both groups regarding key haematological and key serum biochemical parameters such as protein, globulin, ALP, GGT, creatinine, chloride, VLDL and Triglyceride. A significant correlation was observed between the metal ions and haematological parameters, biochemical parameters and quantity of dye used.
Conclusion: Heavy metals found in synthetic textile dyes altered lipid profile, haematological and biochemical parameters of the dye practitioners.