bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between Blood Ammonia Level and Severity of Portal Hypertensive Gastropathy in Egyptian Patients with Post Hepatitis C Virus Cirrhosis
Authors: Sayed Moataz Mohamed , Mohamed Eslam Safwat , Mohamed Marwa Ahmed , Hasan Al sayed Hasan Mohamed 
Published: August 2023

Abstract

Background
Cirrhosis often is an indolent disease; most patients remain asymptomatic until the occurrence of decompensation, characterized by ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, or variceal bleeding from portal hypertension. In most persons, approximately 80 to 90 percent of the liver parenchyma must be destroyed before liver failure is manifested clinically. When complications of cirrhosis occur, they typically are related to impaired hepatic function or actual physical disruption and re organization of the liver parenchyma.

Aim of the Work
The aim of this study is to assess the correlation between blood ammonia level and severity of PHG (to determine if serum ammonia level could be used as a non invasive predictor for severity of PHG). Also, to find out if there is a causal relationship between blood ammonia level and severity of PHG which encourage trials of ammonia-lowering treatments for the management of severe PHG with a tendency to bleed)

Patients and Methods
This case control study was conducted upon 100 Egyptian cirrhotic patients attending at Ain Shams University Hospital (gastroenterology and hepatology department) and Kafr –El Sheikh liver center after informed written consent.

Results
There was a significant difference between studied groups regarding ammonia levels, with a significant increase in serum ammonia level in group 1, group 2 and group 3 versus group 4 (Pvalue ˂ 0.001). There was a significant difference between studied groups regarding haemoglobin, Platelet count, serum albumin, INR, serum bilrirubin (P-value 0.006, ˂0.001, ˂0.001, ˂0.001, ˂0.001, ˂0.001 respectively). There was a significant difference between studied groups regarding SLD (P- value ˂0.001). Splenic longitudinal diameter can be used as a good predictor for OVs. There was a significant difference between studied groups regarding PVD, portal vein flow direction and PVV (P-value ˂0.001, ˂0.001,˂0.001 respectively). There was a significant positive correlation between blood ammonia level and Child Pugh score (P 0.004), PVD (P 0.005) and SLD (P˂0.001), but ammonia has a negative correlation with PVV (P ˂0.001). There was a positive correlation between PHG score and serumammonia level (r0.830, P ˂0.001).

Conclusion
Blood ammonia levels correlate with the presence, severity, and score of portal hypertensive gastropathy in cirrhosis
Evaluation of the Effect of Glycemic Control on Insulin-Like Growth Factor 1 and Growth in a Sample of Pre-Pubertal Egyptian Children with Type 1 Diabetes Mellitus
Authors: Botros Raef M , El-Sherbeeny Aliaa A , Barbary Nancy S El , Ali Hanan M , Abulayla Ala M 
Published: August 2023

Abstract

Background
Pre-Pubertal children with type 1 diabetes mellitus are shorter than their non- diabetic peers. We aimed to evaluate the role of HbAlc and IGF-1 in this phenomenon.

Methods
This study was a cross sectional study conducted on 80 prepubertal Egyptian children, divided into 30 Males and 30 Females with T1DM and 20 age matched controls (10 Males and 10 Females), the participants were recruited from the Outpatient Clinic of the Pediatric Department of Ain Shams University Hospitals and the National Institute of Diabetes and Endocrinology in Cairo, Egypt during the period from July 2018 to January 2019. Anthropometric measures including height and weight were obtained and used to calculate the height and weight percentiles using the CDC calculators. HbA1c as well as IGF-1 levels were tested.

Results
The mean age (years) of the participants was (9.781 ± 2.23) for male patients, (9.126 ± 2.199) for female patients and (8.437 ± 2.034) for controls. The height and weight percentiles (%) were found to be lower in the children with T1DM when compared to the disease-free controls with median values of 14.50 (IQR 27.98) in male patients, 17.95 (IQR 29.18) in female patients and 87 (IQR 20.58) in the controls. A negative correlation between serum IGF-1(ng/ml) and HbA1c (%) as well as height and weight percentiles (%), was found with (P = 0.014, 0.009 and 0.05 respectively). Serum IGF-1 levels were also found to be significantly lower in patients (P &lt; 0.001) with a mean value of (77.60 ± 69.377) in male patients and (64.0 ± 29.402) in female patients and (201.0 ± 102.798) in the disease-free controls. HbA1c (%) was also found to be negatively correlated with height percentile (P = 0.012).

Conclusion
Serum IGF-1 levels (ng/ml) as well as growth are negatively affected in pre-pubertal children with T1DM in relation to the glycemic control.
Validation and Sensitivity of HCV Core Antigen in Patient with HCV Infection in Diagnosis and Monitoring Post DAA Therapy
Authors: Al Malatawy Mohamed Abd Alfatah , Alkelany Hesham Hamdy , Rafat Khalid Abd Alhamid , Sheta Alaa Mohamed Mohamed 
Published: August 2023

Abstract

Background
Successful eradication of hepatitis C virus (HCV) has great impact on the prognosis of HCV-related complications and the associated mortality. The development of the new directacting antiviral drugs (DAAs) has revolutionized the treatment of HCV infection. HCV core antigen (HCVcAg) is a recently developed marker that displayed a good correlation with HCV RNA assays,

Aim of the Work
to evaluate the clinical utility of hepatitis C virus core antigen in detection of chronic hepatitis C virus at pre-treatment and eradication of HCV post DAAs treatment using core antigen ELISA and detection of its sensitivity and specificity in comparison to HCV RNA,

Subjects and Methods
This was Cross sectional study, carried out at El Galaa and Kobri Al koba military hospitals on 90 Egyptian individuals, divided into 3 groups: (Group A); included 30 healthy individual with HCV Ab and HCV RNA negative as a control, (Group B); included 30 patients with chronic HCV infection in pre-treatment, (Group C): included 30 patients who have received anti HCV treatment (DAAs) 12 weeks post treatment,

Result
There were insignificant correlation between laboratory parameters of the patient group with HCV-cAg before treatment,

Conclusion
Fast and immediate results, lower costs of the technique are some of the main advantages of HCVcAg. Therefore, ELISA for HCV-cAg can replace the high sensitivity HCV RNA molecular assay to confirm the presence of HCV infection and to monitor treatment outcome especially in low-income countries with limited resources,
Neutrophils to Lymphocytes Ratio and Platelets to Lymphocytes Ratio as Predictors of Small Intestinal Lesions Detected by Video Capsule Endoscopy
Authors: Samy Amir Helmy , Saleh Shereen Abu Bakr , Ahmed Ghada Abd Elrahman , Hussein Alaa Salah Khaled 
Published: August 2023

Abstract

Background
Capsule endoscopy (CE), also known as wireless capsule endoscopy or video capsule endoscopy, is a gastrointestinal study that uses a pill camera to take images of the intestinal lumen.
Objective:

Patients and Methods
The study was conducted on 93 subjects from the Gastroenterology and Hepatology Department of Ain Shams University Hospital. They were divided into three different groups as following: Crohn’s disease group, arteriovenous malformation group and small intestinal tumor group. All patients and controls were subjected to routine laboratory tests and NLR and PLR was estimated.

Results
There was statistically significant difference between control group and AVM group and Crohn's group as regard N/L ratio, while this difference is less significant in tumor group patient. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect AVM group was found &gt;1.97 with sensitivity of 67.74, specificity of 72.04% and total accuracy of 73%, and the best cut off point of P/L ratio to detect AVM group was found &gt;158.02 with sensitivity of 61.29%, specificity of 96.77%, and total accuracy of 78%. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect Tumor group was found &gt;1.97 with sensitivity of 45.16%, specificity of 72.04% and total accuracy of 59%, and Receiver operating characteristic curve (ROC) shows that the best cut off point of P/L ratio to detect Tumor group was found &gt;145.83 with sensitivity of 32.26%, specificity of 91.40% and total accuracy of 62%. Receiver operating characteristic curve (ROC) shows that the best cut off point of N/L ratio to detect Crohn's group was found &gt;2.44 with sensitivity of 100.0%, specificity of 84.95 and total accuracy of 96%, and Receiver operating characteristic curve (ROC) shows that the best cut off point of P/L ratio to detect Crohn's group was found &gt;138.35 with sensitivity of 80.65%, specificity of 89.25% and total accuracy of 92%.

Conclusion
N/L ratio and P/L ratio can be used as non- invasive and cheap predictors for severity of crohn's disease, arteriovenous malformations and stage of malignancy in small intestinal tract.
Role of FGF21 in Gestational Diabetes Mellitus in a Sample of Egyptian Population
Authors: Sabry Inas Mohamed , Mahdy Maram Mohamed Maher , Ahmed Ammar Ramadan Abdelrahman , Nassim Mina Mikhail 
Published: August 2023

Abstract

Background
Gestational diabetes (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Gestational diabetes mellitus (GDM) affects approximately 5 to 7% of pregnancies and is associated with increased risk for fetal overgrowth, cesarean delivery, birth trauma, and pre-eclampsia.

Objective
To investigate serum FGF21 concentrations in a sample of Egyptian patients with GDM as compared with healthy pregnant controls matched for gestational age And its correlation to clinical and biochemical changes (Glucose, insulin, lipids) and fetal wellbeing using obstetric ultrasound to assess fetal size and development of congenital malformation.

Methods
This cross-sectional study was conducted on 80 participants collected from Obstetrics and Gynecology clinic at Ain Shams University Hospital during the period from November 2019 to March 2021.

Results
Shows that there is statistically significant increase in FGF21 in female pregnants with GDM as compared to female pregnants without GDM. The high FGF21 level didn’t affect fetal wellbeing. And both groups had normal fetal development with absence of macrosomia and congenital malformation as shown on results of obstetric ultrasound. In addition, there is statistically significant positive correlation between fasting FGF21 level and each of total cholesterol, LDL, HDL and TG (R +ve, P.&lt; 0.05).

Conclusion
This high level of FGF21 may be FGF21 resistance or compensatory response to the underlying metabolic stress. FGF21 may have reduced an even higher level of blood glucose than the measured one, blood glucose level could have been in the Range of 400-500 mg/dl instead the measured range 200-300 mg/dl. Obstetric ultrasound results revealed normal fetal wellbeing and no change in fetal size nor development of congenital malformation between both groups.
The Use of Nuetrophil Gelatinase Associated Lipocalin (NGAL) as a Novel Marker in Early Diagnosis of Hepato Renal Syndrome in Advanced Cirrhotic Patients
Authors: Musa Nevine Ibrahim , Halima Ahmed Samir Abo , Allam Ahmed Samir , Okasha Amr Ahmed 
Published: August 2023

Abstract

Background
Acute kidney injury (AKI) in cirrhosis, including hepatorenal syndrome (HRS), is a common and serious complication in cirrhotic patients, leading to significant morbidity and mortality.

Objective
To predict value of serum and urinary NGAL as an early predictor of hepatorenal syndrome in cirrhotic patients.

Patients and Methods
The study was conducted on 60 participants with cirrhosis child C on Child-Pugh score, each one was investigated for both Urinary and Plasma NGAL level. Randomized controlled clinical trial. This study is a prospective, random, clinical trial conducted at Kafr El Sheikh Liver Institution

Results
Group I had Urinary NGAL ranged from 12 - 120, with a mean value of 61.45 ± 36.17. While group II A, ranged from 211-493 with a mean value of 379 ± 72.825. And in group II B, ranged from 306- 732 with a mean value of 438.05 ± 111.26. There was statistical difference between studied groups, p value &lt;0.001. It was found that Urinary NGAL not only good predictor for early renal affection, but also it can differentiate between HRS and non HRS AKI due to the marked difference readings of its level in groups with renal impairment.

Conclusion
Both Plasma and urinary NGAL levels are markedly elevated in renal affection whatever the cause, so they are highly sensitive in detecting early renal impairment. However, the rate of elevation of plasma NGAL is so close in different types of AKI so it’s not advisable to use it alone to diagnose HRS. On the other hand, Urinary NGAL show noticeable differences between degree of elevation with different causes of AKI, so it’s somehow could be a trusted diagnostic tool to diagnose HRS.
Study for the Significance of Osteopontin vs Alpha Feto Protein as a Diagnostic Marker for Hepatocellular Carcinoma in Cirrhotic Patients with HCV
Authors: Mostafa Mohamed Abdelmoghny , Kaisar Hany Haroun , Ghait Ramy Samir , Aty Amr Salah El-din Abdel 
Published: August 2023

Abstract

Background
Outcome of hepatocellular carcinoma (HCC) depends mainly on its early diagnosis. The performance of traditional biomarkers is not satisfactory. Alpha-fetoprotein (AFP) is the most widely used serum biomarker for hepatocellular carcinoma (HCC), despite its limitations. Several studies have reported that osteopontin (OPN) is a promising marker for the diagnosis of hepatocellular carcinoma (HCC); however, some studies emerged with conflicting results,

Aim of the Work
To evaluate the clinical significance of the plasma osteopontin (OPN) versus alpha-fetoprotein (AFP) in the diagnosis of HCC in cirrhotic patients

Patients and Methods
This study was Case-Control study, was conducted at internal Medicine and Gastroenterology outpatient clinics and ward in Ain Shams University Hospitals on Patients divided into 3 groups: (Group 1): 50 patients with previously diagnosed HCC on top of chronic HCV induced cirrhosis, (Group II): 15 chronic HCV patients with cirrhosis, (Group III):15 healthy controls during a period of Six months

Results
There was high statistically significant difference between the studied groups as regard OPN and AFP,

Conclusion
Plasma OPN level was elevated in the HCV-related HCC patients by comparison to the chronic HCV patients with cirrhosis and healthy controls. OPN is a promising tumor marker that could be added to the current standard tests for the diagnosis of HCC in patients with liver cirrhosis, due to Chronic HCV infection, in order to detect the disease at an early stage and, hence, improve the prognosis and survival rates of these patients
Nitazoxanide Based New Regimens versus Metronidazole Standard Quardable Regimen as Rescue Therapy in Treatment of Resistant H. Pylori gastritis
Authors: Abd El-Aziz Hossam , Safwat George , Kader El-Nakeep Sarah Abdel , Mustafa Amr Samir Labeeb 
Published: August 2023

Abstract

Background
Helicobacter pylori (H. pylori) is a small, Gram-negative spirochete inhabiting the mucous layer overlying the gastric epithelial cells in humans. It is the most common prevalent chronic human bacterial infection estimated in 50% of the global population

Aim of the Work
This study aimed to evaluate the efficacy of nitazoxanide and doxycycline as a new regimen in treatment of H.pylori

Patients and Methods
A Prospective observational cohort study for each patient the time for antibiotic therapy for two weeks and continue PPI therapy for three months.

Results
In this study we found that there is insignificant difference between both studied groups as regards demographic data. This table shows that there is insignificant difference between both studied groups as regards smoking, chronic illness, main complaint and pelvic-abd US. In this study we demonstrated that there is significant difference between both studied groups as regards PLT and INR. In study in our hands, the eradication rates were found to be higher in LOAD therapy group compared to Concomitant therapy group (83.3% vs. 71.4%), Also there is insignificant difference between both studied groups as regards outcome (P = 0.03) In this thesis we found that increased age is independently associated with higher probability of cure (negative Ag in stool).

Conclusion
We concluded that LOAD therapy is preferable to clarithromycin-contained triple therapy in H. pylori infection eradication particularly in countries like Egypt with great clarithromycin resistance. This is at least until we can get the bismuth in our country. Recently, the increasing concepts about levofloxacin resistance and decreasing efficacy as a second line treatment directed us towards thinking in levofloxacin contained quadruple therapy including doxycycline and NTZ as alternative line of regimen therapy for better H. pylori eradication in our country. Further studies are needed on larger scale of patients, and culture and sensitivity tests are frequently required to evaluate the resistant emergent bacteria. Although culture and sensitivity might not be carried out, the detection of mutations by molecular methods provides an alternative way in which we can relay in the future.
Correlation between Gastrointestinal Symptoms Questionnaire and Findings of Upper Gastrointestinal Endoscopy in Gastrointestinal Disorders
Authors: Majeed Khaled Hamdy Abd El , El Fattah Allam Ahmed Samir Abd , El Hamid Raafat Khaled Mohamed Abd , Ahmed Asmaa Ibrahim Sayed 
Published: August 2023

Abstract

Background
Gastrointestinal diseases are among the most common problems in tropical countries and commonly manifest as diarrhea, abdominal pain, abdominal distention, gastrointestinal bleeding, intestinal obstruction, malabsorption, or malnutrition.

Aim of the Work
The aim of this work is to compare the efficacy of gastrointestinal Symptoms questionnaire and results of upper gastrointestinal endoscopy to create an optimally reliable tool for measuring the presence and severity of GI symptoms and to measure the symptomatic response to treatment more objectively.

Subjects and Methods
This study has been conducted on 100 patients complaining of gastrointestinal symptoms attending the gastrointestinal endoscopy unit in Faculty of Medicine, Ain Shams University hospital. All patients have been evaluated by upper GI endoscopy to measure the correlation between gastrointestinal symptoms questionnaire and upper GI endoscopy.

Results
There was significant correlation between gastrointestinal symptoms questionnaire and results of upper gastrointestinal disorders.

Conclusion
Gastrointestinal symptoms questionnaire is an easy used tool which can be used to measure the presence, severity of gastrointestinal symptoms and the symptomatic response to treatment more objectively.
Study of Relationship between Stool Lactobacillus acidophilus and Grave’s Disease in a Sample of Egyptian Population
Authors: Sabry Inas Mohammed , Hendawy Laila Mahmoud Ali , Ali Hanan Mahmoud , Helmy Aya Madboly 
Published: August 2023

Abstract

Background
Graves’ disease is an autoimmune disease that leads to a generalized overactivity of the entire thyroid gland (hyperthyroidism). When unrecognized, It impacts negatively on quality of life and poses serious risks of psychosis, tachyarrhythmia and cardiac failure. It affect 0.5% of the population in the US, and represents 50-80% of cases of hyperthyroidism. It occurs more commonly amongst women, smokers and patients with other autoimmune diseases or a family history of thyroid autoimmunity.

Aim of the Work
The study is aimed to study the relationship between stool lactobacillus acidophilus and grave’s disease in a sample of Egyptian population

Patients and Methods
This study is a case control study, was carried out at Endocrine outpatient clinic at Ain Shams University Hospital, on 60 Egyptian patients age 25-40 years old, from September 2020 till March 2021.

Results
Among group1A, 5(25%) were 25 -30 years old, 6(30%) were 30 – 35 years old, 9(45%) were ≥ 35 years old, the mean of ages was 32.75 (±4.94 SD) with range (25.0 – 40.0), there were 5(25%) males, 15(75%) females, the mean of duration of the disease was 2.95(±2.14 SD) with range (1.0 – 7.0). Among group 1B, 8(40%) were 25 -30 years old, 5(25%) were 30 – 35 years old, 7(35%) were ≥ 35 years old, the mean of ages was 31.90(±4.69 SD) with range (26.0 – 40.0), there were 3(15%) males, 17(85%) females, the mean of duration of the disease was 3.25(±2.02 SD) with range (1.0 – 7.0). Among total cases of group 1, 13(32%) were 25 -30 years old, 11(27.5%) were 30 – 35 years old, 16(40%) were ≥ 35 years old, the mean of ages was 32.33(±4.77 SD) with range (25.0 – 40.0), there were 8(20%) males, 32(80%) females, the mean of duration of the disease was 3.10 (±2.06 SD) with range (1.0 – 7.0).

Conclusion
Stool Lactobacillus acidophilus PCR count was insignificantly different between studied groups, which may show no relationship of lactobacillus with graves’ disease. so, further studies are needed to determine correlation or causation of this relationship.
A Study of the Assessment of Serum Adropin Level as a Risk Factor of Ischaemic Heart Disease in Type 2 Diabetes Mellitus Cases
Authors: Makboul Khaled Mahmoud , Hussein Elhalawany Salah , Khairy Mansour Hany , Marwan Dina Ahmed , Ibrahim Baher Emil 
Published: August 2023

Abstract

Background
Adropin is a peptide hormone which was discovered in 2008 and originally described as playing an important role in glucose and fatty acid homeostasis that acts on peripheral tissues. We investigate the correlation of adropin and ischaemic heart disease in diabetic patients.

Aim
Study of the assessment of serum adropin level as a risk factor for ischaemic heart disease in type 2 diabetes mellitus cases.

Method
This case control study was conducted on 90 subjects, divided into 3 groups: Group (I): 30 T2DM patients with ischaemic heart disease Group (II): 30 T2DM patients without ischaemic heart disease Group (III): 30 healthy subjects as control.
Fasting plasma glucose, 2 h post prandial plasma glucose, Carotid artery intimal thickness using ultrasound, HbA1c, Lipid profile (cholesterol, triglycerides, LDL-C, HDL), HOMA IR Serum creatinine, AST, ALT, and Serum Adropin were assessed.

Result
There was a statistical significant increase in serum Adropin hormone in diabetic patients without ischaemic heart disease than diabetic one with ischaemic heart disease (p value ˂0.001), (26.867 ± 10.037) ng/L vs (87.500 ± 40.509) ng/L respectively. Also Serum Adropin was negatively correlated with fasting insulin and CIMT.
Assessment of serum adropin level could be a risk marker for ischaemic heart disease development in type 2 diabetes mellitus patients.