bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxidative stress and risk of polycystic ovarian syndrome in women with epilepsy: implications of malondialdehyde and superoxide dismutase serum levels on female fertility
Authors: Rashad Nearmeen M. , Ashour Waleed M. Reda , Allam Reem M. , Saraya Yasser S. , Emad George 
Published: September 2023

Abstract
Background
Epilepsy is a common neurologic disease and has important implications for women’s fertility, as approximately half of the epileptic women have reproductive disorders. Oxidative stress is a key contributor in the pathogenesis of polycystic ovary syndrome (PCOS) and epilepsy. We aimed to investigate the role of malondialdehyde (MDA) and superoxide dismutase (SOD) serum levels as predictors of PCOS in women with epilepsy (WWE) and to evaluate the possible relationship between oxidative stress and epilepsy characteristics as well as clinicomorphological features of PCOS.

Patients and methods
A cross-sectional study enrolled 130 WWE. They were classified to two subgroups; women with PCOS (n=50) and women without PCOS (n=80) according to Rotterdam criteria. Metabolic markers and markers of PCOS were measured. Serum MDA and SOD concentrations were estimated by enzyme-linked immunosorbent assay.

Results
Our results revealed higher levels of MDA and SOD in WWE, in particular, women with PCOS. Moreover, serum MDA and SOD levels were significantly positively correlated with PCOS phenotypes. Linear regression test revealed that Low-density lipoprotein cholesterol (LDL) and luteinizing hormone (LH) were the main predictors of serum MDA levels in PCOS, whereas BMI and LH were the main predictors of serum SOD levels. Regarding antiepileptic medication, there were significantly higher levels of MDA and SOD in patients treated with valproic acid compared with the ones treated with carbamazepine.

Conclusion
The high levels of MDA and SOD among WWE, in particular, women with PCOS, were positively correlated with obesity indices and PCOS phenotypes. Thus, we recommended avoid using valproic acid in women during childbearing period.
Effect of direct-acting antivirals on elastographic measures in patients with chronic hepatitis C virus infection
Authors: Sakr Mohamed M. , El-Agrody Ahmed I. , Farrag Hesham A. 
Published: September 2023

Abstract
Background
Hepatitis C virus (HCV) infection is a worldwide health problem. Liver fibrosis has been a major topic of research for decades. However, recent data have shown the occurrence of fibrosis fall in a wide spectrum of chronic liver diseases.

Aim
We aimed to evaluate the changes in transient elastography (TE) values of different direct-acting antivirals regimens in HCV chronic liver disease patients.

Settings and design
This observational analytic study was carried out at the Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Participants and methods
100 Egyptian chronic hepatitis C patients were recruited into this study. All participants were included according to the inclusion criteria approved by the national committee in Egypt for control of viral hepatitis. They were subjected to a thorough assessment of history and clinical examination, routine investigations, ECG, radiological examination, and TE 2 weeks before treatment initiation, at the end of the course, and 6 months after treatment.

Results
There was a significant improvement in liver stiffness (LS) values in cirrhotic patients, but they still had cirrhosis, with lower LS values than pretreatment values. This study reported a significant decrease 12 weeks after the end of treatment for LS measurements and validated fibrosis scores such as FIB-4 and APRI. Patients with F4 grade fibrosis showed a significant improvement in the score, and the percentage decreased from 56% before treatment to 42 and 38% after sustained virological response 1 and sustained virological response 2, respectively.

Conclusion
Direct-acting antivirals based treatment results in a significant improvement in hepatic fibrosis measures, indicated by TE as well as noninvasive fibrosis scores such as fibrosis score (FIB-4) and APRI.
Assessment of fibroblast growth factor 23 in relation to peripheral arterial disease in type 2 diabetes mellitus
Authors: Halawa Mohamed R. , Abdalah Abeer A. , Eid Yara M. , Nasr Merhan S. , Mostafa Bassem M. , Ahmed Nesma H. 
Published: September 2023

Abstract
Background
Peripheral arterial disease (PAD) is a major vascular complication and the leading cause of amputation in people with diabetes. Fibroblast growth factor 23 (FGF-23) is a recently discovered 30-kD secreted hormone glycoprotein that plays a role in the complex and tightly regulated mechanisms of mineral metabolism. Increase in serum FGF-23 concentration was an independent predictor of coronary artery diseases in patients with mild chronic kidney disease and of mortality in patients undergoing hemodialysis. Recently, FGF-23 has been found to be associated with total body atherosclerosis and vascular dysfunction.

Objective
To evaluate the relation between FGF-23 and PAD in patients having type 2 diabetes with normal kidney function.

Patients and methods
A case-control study was conducted on 120 diabetic patients, where 60 patients having type 2 diabetes with PAD were compared with 60 patients having type 2 diabetes without PAD. All patients were subjected to full history taking, thorough clinical examination, ankle-brachial index assessment, and laboratory measurement of glycated hemoglobin%, estimated glomerular filtration rate, microalbuminuria, lipid profile, serum ionized calcium and phosphorous, and serum FGF-23.

Results
Significantly higher serum FGF-23 was found in diabetic patients with PAD compared with diabetic patients without PAD. Logistic regression analysis showed that duration of diabetes, triglycerides level, phosphorous level, glycated hemoglobin, and FGF-23 were independent predictors for PAD.

Conclusion
FGF-23 level was higher in type 2 diabetic patients with PAD, which highlights a possible implication of FGF-23 in the pathogenesis of PAD in type 2 diabetes.
Value of endoscopic ultrasound in prediction of dysplasia in ulcerative colitis
Authors: Elrabat Amr M. , Ibraheem Neveen F. , Maher Maha M. , Abozeid Fatma A. , Abelrahman Maha A. 
Published: September 2023

Abstract
Background
Ulcerative colitis (UC) is one of the most common forms of chronic inflammatory bowel disease. Its diagnosis is based on history, clinical, radiological, laboratory, endoscopic, and histological examinations. Endoscopic ultrasound (EUS) is a highly accurate diagnostic endoscopic and radiological modality for assessing of rectal pathology. However, EUS data remain scarce for patients with UC. The aim of this study was to assess the correlation between EUS indices and clinical, endoscopic, and histological scores of inflammation in UC and to evaluate the usefulness of EUS in assessing the activity and dysplasia of UC.

Patients and methods
A total of 57 patients with UC were cross-sectionally evaluated based on clinical (Truelove score), laboratory [complete blood count (CBC), c reactive protein (CRP), erythrocte sedementaion rate (ESR), and fecal calprotectin], and endoscopic (Mayo score) parameters. The patients were divided into three groups: mild UC, moderate UC, and severe UC. They were subjected to EUS at 10, 20, and 30cm from the anal verge to assess the correlation between severity of UC and histopathological examination results.

Results
Total wall thickness (TWT) at 10cm from the anal verge was positively and highly significantly correlated to histopathological severity in comparison with 20 and 30 cm from anal verge (P=0.001). TWT at 10 cm by EUS was a significant predictor of the histopathological severity of UC (P=0.007). For TWT of the colon at 10 cm from the anal verge, significant discrimination (P=0.02) between severe UC and mild to moderate UC could be achieved by utilizing a cutoff of 3.5 mm with sensitivity of 60.5% and specificity of 85.7%. In addition, highly significant (P=0.006) discrimination of mucosal dysplasia in UC could be achieved using TWT cutoff of 5.05mm at 10cm from the anus with sensitivity of 75% and specificity of 94.3%.

Conclusion
For EUS at 10cm from the anal verge, TWT cutoff of 3.5mm can assess histopathological severity of UC, and TWT cutoff of 5.05 mm can predict dysplasia in UC.
The significance of bariatric surgery in Egyptian patients with metabolic syndrome: a multicenter study
Authors: Bassiony Mohamed A. A. , Mohamed Mohamed S. , Elgohary Marwan N. , Nawar Abdelrahman M. H. , Abdelrahman Emad M. , Elshoura Ahmed A. 
Published: September 2023

Abstract
Background
Obesity and metabolic syndrome (MS) are global health concerns, with high rates of cardiovascular morbidity and mortality. The current guidelines recommend lifestyle modifications as the best initial treatment for obesity and MS. However, lifestyle interventions have modest effects and high 1-year failure rates. Bariatric surgery offers more weight loss with sustained effect in the long term.

Aim
The aim was to assess the effect of bariatric surgery on MS and all its components and to detect the probable risk factors for persistent MS after bariatric surgery in Egyptian patients.

Patients and methods
This prospective multicenter study included 250 obese patients who underwent bariatric surgery and completed 1 year of postoperative follow-up. The patients were evaluated preoperatively and at 1, 6, and 12 months postoperatively for presence of MS and its components according to criteria of the third report of National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III).

Results and discussion
After 1 year of follow-up, the percentages of patients who had MS, obesity, type 2 diabetes mellitus, hypertension, hypertriglyceridemia, and low high-density lipoprotein-cholesterol were significantly decreased from 92, 100, 84, 50, 74, and 50% to 17, 2, 8, 17, 42, and 25%, respectively. Smoking, family history of obesity, and less percentage of excess weight loss were the most important risk factors for persistence of MS after bariatric surgery.
Occult hepatitis C virus infection among Egyptian hemodialysis patients and its potential effect on anemia management
Authors: Abdelsalam Mostafa , Tawfik Mona M. , Habib Alaa , Abdel-Razik Ahmed , Anber Nahla , Zaki Maysaa , Marie Mohammad S. 
Published: September 2023

Abstract
Background
Hepatitis C virus (HCV) infection is still a main health problem in hemodialysis (HD) patients. The prevalence of occult hepatitis C infection (OCI) in HD patients may be underestimated, and its possible influence on anemia management has not been studied. We aimed to determine the existence of OCI in Egyptian HD patients as well as its possible effect on anemia management.

Patients and methods
This cross-sectional multicenter study included 98 HCV-negative HD patients (negative for both anti-HCV antibody and HCV-RNA), 43 anti-HCV-positive HD patients, and 10 volunteer people matched for age and sex as a healthy control group. Serology test for anti-HCV antibody, reverse-transcription PCR for HCV-RNA (both serum and peripheral mononuclear cell (PMNC)), complete blood count (CBC), liver transaminases, serum iron, serum ferritin, and high-sensitivity C-reactive protein (hsCRP) were done. The average erythropoiesis-stimulating agent (ESA) doses were calculated over 6 months, and ESA resistance index was calculated. The frequency of packed red blood corpuscle (RBC) transfusion for each patient was recorded.

Results
Our HD patients had significant higher levels of serum ferritin (P=0.011), higher serum alanine aminotransferase and aspartate aminotransferase (P=0.002 and 0.006, respectively), higher hsCRP (P<0.0001), and significant lower level of hemoglobin (P<0.0001) compared with the healthy control group. The prevalence of OCI was 8.16% (8 of 98 patients). OCI patients had significant longer dialysis duration, higher transaminases, higher hsCRP, higher serum ferritin, and higher frequency of packed RBCs transfusion (P<0.0001), whereas mean hemoglobin levels and ESA resistance index showed insignificant differences compared with HCV-negative HD patients. Using logistic regression analysis, frequency of packed RBC transfusion and aspartate aminotransferase were the only independent predictors for OCI (P=0.012 and 0.049, respectively), and by multivariate analysis, no significant predictors were found to be associated with anemia in patients with OCI.

Conclusion
The prevalence of OCI in our study was 8.16%. OCI had no effect on anemia managements.
Gastroduodenal pathology in the light of Helicobacter pylori genotype in Egyptian patients
Authors: Azzam Eman , Ali Ezzat , Ahmed Shwikar , Talha Ahmed 
Published: September 2023

Abstract
Context
Infection with Helicobacter pylori is associated with gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, and mucosa-associated lymphoid tissue lymphoma.

Aim
The aim of this study was to detect the nature of gastroduodenal pathology in the light of the genotype of the associated H. pylori organism.

Materials and methods
The study was conducted on 100 patients with upper gastrointestinal tract symptoms; infection with H. pylori was detected by stool antigen test. Moreover, 20 asymptomatic patients, infected with H. pylori, were included in the study as controls.
Upper gastrointestinal tract endoscopy was performed in all participants to take biopsies to diagnose the disease microscopically and to determine H. pylori virulence factors [cytotoxin-associated protein A (CagA) and VacA] by PCR.

Results
Patients infected by H. pylori organisms having CagA-positive genes (41 patients) developed gastritis in 53.7%, peptic ulcer disease (PUD) in 36.6%, and gastric malignancy in 9.8%. Patients infected with organisms that have VacA s1 in addition to CagA genes (19 patients) were found to have gastritis in 21.1%, PUD in 63.2%, and gastric malignancy in 15.8%. However, patients infected with H. pylori organism that have VacAs2 in addition to CagA genes (34 patients) developed gastritis in 79.4%, PUD in 20.6%, and no malignancy.

Discussion
The presence of VacA s1 gene in addition to CagA significantly increases the virulence of the organism toward development of PUD and gastric malignancy. The presence of VacA s2 gene significantly decreases the virulence of CagA gene to develop PUD and prevent completely its carcinogenicity.
Congenital nasal stenosis: a report of two cases
Authors: El-Wany Samy , El-Hennawi Diaa M. , Ahmed Mohamed R. , Abou-Halawa Ashraf S. , Madian Yasser T. , Ibrahim Ibrahim H. 
Published: September 2023

AbstractThe human neonate is an obligate nasal breather for a variable period of time after birth. Congenital nasal airway anomalies are potentially dangerous if they are not immediately recognized at birth and if appropriate intervention is not instituted. Here, we report two clinical cases of congenital nasal stenosis seen in the Suez Canal University Hospital in Ismailia in 2016. Approval from our institutional ethics committee and consent from parents of the patients to publish the cases and their photos were obtained. Level of Evidence: 3b.
Evaluation of hearing outcome of tympanoplasty using cartilage graft versus temporalis fascia graft
Authors: El-Sheikh Mohamed M. 
Published: September 2023

Abstract
Background
Various materials such as fascia, perichondrium, and cartilage have been used for the reconstruction of the tympanic membrane in middle ear surgery. Owing to its stiffness, cartilage is resistant to resorption and retraction.

Patients and Methods
This study comprised a randomized, controlled trial conducted to analyze the audiological gain when using cartilage grafts in type 1 tympanoplasty compared with temporalis fascia grafts on 60 patients suffering from chronic otitis media after successful tympanoplasty. The follow-up period was at least 6 months. All patients were subjected to audiological evaluation before and at least 6 months postoperatively.

Results
There was a significant reduction in mean air-bone gap (ABG) in both groups, whereas in group A (fascial graft) the mean preoperative ABG was 25±10.2 dB and the mean postoperative ABG was 13.5±7.3 dB, whereas in group B (cartilage graft) the mean preoperative ABG was 30.6±8.6 dB and the mean postoperative ABG was 15.9±8.7 dB, analyzing the effectiveness of both surgical techniques showed that both were equally effective in reducing ABG from preintervention to postintervention with no statistical significance among both groups (P=0.212).

Conclusion
Patients who had cartilage grafts showed similar hearing outcomes to those who had fascial grafts after a successful tympanoplasty procedure.
Role of vitamin D in chronic rhinosinusitis: a systematic review and meta-analysis study
Authors: Al-Ebiary Hassan A. , Shafik Amr G. , Hassan Mohammed A. , Taha Mohammed S. , El-Naggar Yahya M. 
Published: September 2023

Abstract
Background
Chronic rhinosinusitis (CRS) is one of the most common diseases with no specific long-term treatment. CRS can present in two phenotypes: chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP). Vitamin D (VD) is considered to have an immunomodulatory role, especially in allergic diseases. Recent studies have found that patients with CRS have VD level lower than normal, especially patients with CRSwNP.

Aim
The aim of this study was to systematically evaluate and find out whether there is a relationship between serum VD level and CRS and its phenotypes.

Materials and methods
Using Medline database, we conducted a systematic search to find all related articles published up to 31 August 2016 using the keywords Vitamin D, allergic rhinitis, CRSwNP, and CRSsNP and applying certain inclusion and exclusion criteria.

Results
Six articles were included with a total number of participants of 309 with serum VD level. Four comparisons were made. The first comparison showed no statistically significant difference in VD level between the CRSsNP and the control group. The second comparison showed a statistically significantly lower VD level in the CRSwNP group than in the control group. The third comparison showed a statistically significantly lower VD level in the CRSwNP than in the CRSsNP group. The last comparison showed no statistically significant difference in VD level between CRS with or without nasal polyps and controls.

Conclusion
VD level was significantly low in patients with CRSwNP, which might have a causative relationship. However, there was no relation between VD level and CRSsNP.
An algorithm for management of nasal caudal septal deformities
Authors: Younes Ahmed , El-Dsowkey Rasha , Ragab Sameh M. , Romaih Hosam E. , Elsheikh Mohamed N. 
Published: September 2023

AbstractIntroductionCaudal end septal deformities are common deformities. Trauma is a main cause of these deformities. there is lack of an algorithm for choosing the suitable technique for the type of deformity. The aim of this retrospective study was to put an algorithm for approaching different caudal end deformities.Patients and methodsRetrospective review of 136 patients underwent surgical correction for caudal end deformities. Data collection included functional breathing outcomes and drawbacks of different techniques as postop caudal end sublaxation and firm nasal tip sensation.ResultsPatients were divided into 4 groups (according to the technique by which the caudal end of nasal septum was managed) as following: Group A: 90 patients who had undergone surgeries with swinging door or modified swinging door techniques with fixation to anterior nasal spine technique, Group B: 26 patients who had undergone surgery with tongue in groove technique, Group C: 10 patients who had undergone surgery with caudal end splinting using septal bone, Group D: 10 patients who had undergone surgery with septal extension graft with tongue in groove technique.ConclusionAn algorithm was obtained to help in deciding a methodology for correcting the caudal end deformities according to preoperative patient data.
The sensitivity of the ce-chirp auditory brainstem response in estimating hearing thresholds in different audiometric configurations
Authors: El Kousht Moustafa , El Minawy Mohamed S. , El Dessouky Tarek M. , Koura Rabab A. , Essam Mona 
Published: September 2023

Abstract
Background
CE-Chirp is a new broadband stimulus that permits the energy from the stimulus to reach the whole regions of the cochlea at approximately the same time.

Aim
Comparison of auditory brainstem response (ABR) thresholds obtained by using click stimulus, broadband CE-Chirp and 500 Hz, 1, 2, and 4 kHz narrow band CE-Chirp stimuli to those obtained by behavioral hearing thresholds in adults with normal hearing and with varying configurations of sensorineural hearing loss (SNHL).

Patients and Methods
Ten adult patients with normal-hearing thresholds, whose age ranged from 19 to 50 years, with a mean age of 30.4±9.1 years constituted a control group (group 1). Thirty adult patients with different configurations of SNHL constituted group 2, whose age ranged from 18 to 65 years, with a mean age of 32.5±9.8 years. All cases and controls were subjected to pure-tone audiometry, click, CE-Chirp and four narrow band CE-Chirp (at 500, 1000, 2000, and 4000 Hz) evoked ABRs.

Results
ABR thresholds to chirps have a relationship closer to behavioral hearing thresholds than ABR thresholds to clicks in individuals with normal-hearing thresholds and SNHL. Wave V mean latencies at threshold in response to click stimuli were earlier than those obtained using CE-Chirp in both groups. Wave V mean amplitudes at threshold with CE-Chirp were significantly larger than those with click in both groups. Wave V amplitude increased and latency decreased as the stimulus frequency increased in both groups.

Conclusion
There are evidences to suggest that ABR recording in response to CE-Chirps provide an efficient tool for estimating hearing thresholds in normal-hearing thresholds and individuals suffering from SNHL in comparison to click stimuli. The use of CE-Chirp had the potential to provide high sensitivity and accuracy for frequency-specific thresholds estimation in young children and difficult to test adults.
Impact of mastoidectomy on tympanoplasty for recurrent suppurative otitis media
Authors: Kadah Sayed Mohammed Said , Mokhemar Sayed Mohammed , Ibrahim Hoda. Ali , Ibrahim Hanem Elsayed 
Published: September 2023

Abstract
Background
There are still many questions about the pathogenesis of chronic suppurative otitis media (CSOM) and consequently about the optimal management medical or surgical interventions. Many otolaryngologists continue to routinely perform mastoidectomy with tympanoplasty, arguing that surgical aeration of the mastoid will improve outcomes by providing a reservoir of air that can buffer pressure changes in the middle ear according to Boyle’s law.

Patients and methods
During the period from December 2013 to October 2017, the mean age was ranging from 20 to 50 years; 25 (62.5%) patients were females, whereas 15 (37.5%) patients were male who were attending the Otorhinolaryngology Department, Al Zahraa University Hospital, with recurrent suppurative otitis media refractory to medical treatment. The 20 patients selected for this study were randomly assigned to undergo tympanoplasty with cortical mastoidectomy (n=20) and tympanoplasty alone (n=20).

Results
The factors that may influence surgery success rates are age, perforation location and size, Eustachian tube conditions, status of the middle-ear mucosa, the type of graft used, and surgeon experience. The primary argument in favor of mastoidectomy has been an improvement in the middle ear and mastoid environment through clearance of the diseased mucosa and through the ventilatory mechanisms of an open mastoid system, as a buffer to the changes in pressure within the middle ear.

Conclusion
There was no additional benefit to performing mastoidectomy with tympanoplasty for uncomplicated perforations. Mastoidectomies were generally performed with a worst disease, as suggested by the presence of extensive inflammation, or a sclerotic middle ear or mastoid.