bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of pleurodesis using ethanolamine oleate through ultrasound-guided pigtail
Authors: Saeed Adel M. , Ali Tamer M. , Gomaa Ashraf A. , Kamel Mohamed N. 
Published: September 2023

AbstractBackgroundMalignant pleural effusion (MPE) is a common and serious condition that is associated with poor quality of life, morbidity and mortality.AimStudy of pleurodesis using ethanolamine oleate (ETH) through ultrasound-guided pigtail to evaluate the efficacy and complications of ETH and pigtail.DesignThirty-three patients with MPE were included and were subjected to history taking, clinical examination, chest radiographs (on admission, every day before pleurodesis to ensure complete lung expansion and to exclude pneumothorax, every day after pleurodesis till the removal of the catheter and on follow-up – 2 months after pleurodesis – to check for reaccumulation of pleural effusion), chest sonography, pleural tapping, chest computed tomography scan (in some patients), pleural biopsy using Abram’s needle or through ultrasonography (in some cases), lymph node biopsy (in some cases) and spirometry before and 2 months after pleurodesis. Patients were subjected to pigtail catheter insertion using chest sonography. When the amount of effusion became less than 100 ml/day and when the chest radiography shows complete lung expansion and there is no evidence of bronchopleural fistula, pleurodesis with ETH was done. Then after 12 h, the pigtail was connected to a drainage device. Follow-up radiographs were done every day till the removal of the catheter. When the amount of the effusion became less than 100 ml/day, the catheter was removed. Assessment of the response was made after 2 months of pleurodesis, before death that may occur to the patient within 3 to 12 months after diagnosis. Despite the progress in cancer treatment, the management of MPE remains palliative, with median survival ranging from 3 to 12 months.ResultsComplete response was 81.8% of studied cases, while no/partial response was 18.2%. Pleurodesis complications were fever (21.1%), chest pain (33.3%), nausea (24.2%), vomiting (12.1%) and hypotension (6.1%). Pigtail complications were pigtail obstruction (3.03%), chest pain (3.03%) and obstruction and pain (12.12%) of the studied cases. There was a decrease in FVC% and FEV1% 2 months after pleurodesis. However, no significant difference as regards actual (measured) FEV1/FVC% before and 2 months after pleurodesis in all cases. Whereas, complete response was 81.8% by CXR and chest ultrasound.ConclusionETH injection through pigtail was safe and effective in pleurodesis of MPE.
Validity of three scoring systems in assessing the severity and outcome in Al-Abbassia Chest Hospital Respiratory Intensive Care Unit patients
Authors: El-Naggar Taher Abd El-Hamid , Raafat Riham H. , Mohamed Safaa A. 
Published: September 2023

Abstract
Background
ICU scoring systems allowed an assessment of the severity of disease and death prediction. As ICU populations, investigations and management were changed, scoring systems should be updated.

Aim
The aim of this study was to evaluate three scoring systems in predicting outcome in Al-Abbassia Chest Hospital Respiratory ICU patients in 6 months.

Patients and methods
It was conducted on newly admitted cases in Al-Abbassia Respiratory ICU from July 2016 till January 2017. All patients were evaluated on admission and after 48 h by Acute Physiology and Chronic Health Evaluation IV (APACHE IV), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score II (SAPS II).

Results
APACHE IV and SAPS II scores were significantly higher between dead than alive patients on admission and after 48 h, but were not able to predict death in ICU. SOFA score was insignificantly higher on admission and after 48 h between nonsurvivors. None of the three scores could predict the length of stay in ICU.

Conclusion
APACHE IV and SAPS II scores were better than SOFA score as they were significantly higher between nonsurvivors but not to the extent to predict mortality or length of stay.
Investigation of association of biomarkers of iron metabolism and insulin resistance in Egyptian patients with impaired glucose metabolism and type 2 diabetes
Authors: ElEbrashy Ibrahim N. , Shaker Olfat , Abdelgalil Sarah I. , Yousief Elham M. 
Published: September 2023

Abstract
Introduction
Type 2 diabetes is an expanding overall medical issue. A large portion of the enthusiasm for the job of supplements in diabetes is fixated on macronutrients, yet a micronutrient, iron, is additionally closely connected with diabetes.

Aim
To study biomarkers of iron metabolism, including serum ferritin, transferrin saturation, iron, and insulin resistance, in diabetic and prediabetes patients.

Patients and methods
This is a cross-sectional study directed on a cohort of 50 patients, comprising 25 patients with impaired glucose tolerance and 25 patients recently discovered to have type 2 diabetes mellitus (T2DM), as well as 20 healthy controls of matched age and both sexes. All patients enrolled in the study were subjected to full history taking, full examination, laboratory investigations including iron, total iron-binding capacity, ferritin, insulin, lipid profile, fasting blood glucose, 2-h postprandial glucose, urea, creatinine, complete blood count, alanine aminotransferase, and aspartate aminotransferase.

Results
We found that patients with T2DM have significant higher body weight and BMI than prediabetes patients and controls, and also statistically significant difference in serum iron between the studied groups, but no statistical significance in serum ferritin between the studied groups. In addition, we found a positive correlation of serum iron and insulin resistance in T2DM, a significant positive correlation of serum ferritin with low-density lipoprotein and negative correlation with high-density lipoprotein in T2DM, positive correlation of ferritin with cholesterol and triglycerides in impaired glucose tolerance group. Moreover, transferrin saturation was negatively correlated with glycated hemoglobin, BMI, and total iron-binding capacity and is positively correlated with iron and creatinine and hemoglobin among the studied groups.

Conclusion
The distinguished relationship of several markers of iron metabolism with hyperglycemia and insulin resistance recommends that iron stores add to the pathogenesis of IGM and T2DM.
Serum copeptin as a diagnostic and prognostic biomarker of coronary artery disease among patients with type 2 diabetes mellitus
Authors: Rashad Nearmeen M. , Ezzat Tamer M. , Allam Reem M. , Ashour Wesam M. R. , Ali Ayman E. , Soliman Mohamad H. 
Published: September 2023

Abstract
Background
Diabetes is one of the major risk factors for coronary artery disease (CAD); hormones implicated in cardiac diseases may play a role in diabetes development. Increased activities of the arginine-vasopressin (AVP) system were shown to be associated with type 2 diabetes mellitus (T2DM). The aim of this study was to estimate the values of serum copeptin as a predictive biomarker of CAD and to assess the correlation between copeptin and cardiometabolic risk factors in patients with T2DM.

Patients and methods
The case–control study included 110 patients with T2DM and 80 age-matched and sex-matched control group. All the participants were subjected to B-mode ultrasonography of both common carotid arteries to measure carotid intima-media thickness (mm), echocardiography, and coronary arteriography. Serum copeptin levels were measured with a new sandwich immunoassay by using a human copeptin enzyme-linked immunosorbent assay kit.

Results
Patients with T2DM had significantly higher serum copeptin levels (7.64±1.98 pmol/l) compared with control groups (4.64±1.11 pmol/l). Serum copeptin levels were significantly higher in patients with CAD (8.64±2.55 pmol/l) compared with patients without CAD (6.36±0.86 pmol/l). Interestingly, copeptin was positively correlated with cardiometabolic risks. The area under the curve of serum copeptin levels in differentiating patient with T2DM from control was 0.768 (P<0.001) and differentiating patient with CAD from the nonischemic group was 0.818 (P<0.001).

Conclusion
The higher serum level of copeptin in patients with T2DM especially in the patient with CAD is strongly correlated with cardiometabolic risk factors.
Urinary cyclophilin A in Egyptian patients with type 2 diabetes and diabetic nephropathy: correlation with urine albumin/creatinine ratio
Authors: Saif Aasem , Elsayed Eman , Shaker Amr , Ramzy Tarek , Zaghlol Basma , Mousa Shrook 
Published: September 2023

Abstract
Introduction
Albuminuria is commonly used to predict the onset and to follow the progression of diabetic nephropathy (DN), but it lacks both sensitivity and specificity in early stages.

Aim
We assessed urinary cyclophilin A (CypA) as a biomarker for the diagnosis of DN in Egyptian patients with type 2 diabetes.

Patients and methods
The study was conducted on 150 Egyptian participants aged 30–65 years; 125 (58 male individuals and 67 female individuals) patients with type 2 diabetes mellitus (diabetes duration>5 years) in different stages of DN and 25 age-matched and sex-matched healthy control participants comprised the study cohort. Estimated glomerular filtration rate and urine albumin/creatinine ratio (ACR) were assessed in all participants. Urinary CypA was measured in the morning specimen.

Results
Urinary CypA was significantly higher in patients with stage 2 DN, as compared with stage 1 patients (P=0.02) and the control group (P=0.017), with no significant change in urine ACR between stages 1 and 2 (P=0.809). Urinary CypA also showed a steady rise in DN stages 3, 4 and 5 (P<0.001). Urinary CypA had strong positive correlations with creatinine and urine ACR and a strong negative correlation with estimated glomerular filtration rate in patients with DN (P<0.001 for all).

Conclusion
We suggest that urinary CypA is a good biomarker for early detection of DN in patients with type 2 diabetes. It starts to rise before urine ACR. It also correlates well with the progression of DN. A larger study is needed to confirm its superiority over urine ACR in the early stages of DN.
Efficacy and disposal of drugs after the expiry date
Authors: Sarla Gurmeet S. 
Published: September 2023

AbstractEvery drug manufacturer is legally bound to display the date of expiry on all pharmaceutical products. Excluding certain medicines such as nitroglycerin, insulin, epinephrine, and tetracycline, most medicines stored under reasonable conditions retain at least 70–80% of their original potency for at least 1–2 years after the expiration date, even after the container has been opened. The drug is likely to lose some potency after the expiration date, but it is not clear how much potency is lost over a certain period of time past expiration dates. Placing medication in a cool place, such as a refrigerator, will help it remain potent for many years. Even though both the American Medical Association and the Food and Drug Administration do not recommend the dosing of expired pharmaceuticals at this time, discussion of the issue is warranted in order to understand the potential behind some expired drugs. This review article studies the financial implications and reason for stock piling of unused and expired pharmaceuticals, health hazards, common and ideal ways of disposal of unused and expiry medications and the way forward.
Fecal B-cell-activating factor as a new noninvasive marker in the evaluation of ulcerative colitis Egyptian patients: a comparative cross-sectional study
Authors: Hussein Hany A. , Mohamed Rasha S. 
Published: September 2023

Abstract
Background and aim
Diagnosis of ulcerative colitis (UC) is suspected clinically and confirmed through endoscopic biopsy. It can be followed-up and assessed by noninvasive biomarkers such as fecal calprotectin. Recently, B-cell-activating factor (BAFF) has been proposed to be a regulator of B-cell and T-cell immune responses and to be associated with inflammatory processes in autoimmunity. The aim of our study was to clarify the role of fecal BAFF as a simple predictor for disease activity and severity in patients with UC.

Patients and methods
Fifty Egyptian patients with UC were divided into two groups: group I including 40 patients with active UC (newly diagnosed) and group II including 10 patients with inactive UC (previously diagnosed); disease activity was assessed according to the Mayo activity scoring index; fecal BAFF and fecal calprotectin were measured for all patients using enzyme-linked immunosorbent assay.

Results
Significantly higher levels of Fecal BAFF and fecal calprotectin were found among patients with active UC, as compared with inactive UC patients. Fecal BAFF more than or equal to 50 μg/g had 97.5% sensitivity and 100% specificity in predicting disease activity in comparison with fecal calprotectin, which had a sensitivity and specificity of 90% at a cut off value more than or equal to 47 μg/g. In predicting disease severity, fecal BAFF more than or equal to 340 μg/g had a sensitivity of 95% and specificity of 100%, while fecal calprotectin more than or equal to 170 μg/g had a sensitivity of 80% and specificity of 95%.

Conclusion
Fecal BAFF is more sensitive and specific in predicting UC activity and severity than fecal calprotectin.
Albumin-corrected serum calcium and serum parathyroid hormone-related polypeptide determined by enzyme-linked immunosorbent assay in cirrhotic patients with hepatocellular carcinoma – a pilot study
Authors: Fouda Ragai M. F. R. , Sheir Rania E. , Selim Nora M. , Hammad Ahmed A. 
Published: September 2023

Abstract
Context
Parathyroid hormone-related peptide (PTHrP) is produced by many malignant tumors. It is responsible for most cases of hypercalcemia in patients with malignancy. Few published studies shed light on the relation between serum calcium levels and serum PTHrP levels in cirrhotic patients with hepatocellular carcinoma (HCC).

Aim
The aim of the current work was to evaluate serum PTHrP in cirrhotic patients with HCC and a possible correlation between serum PTHrP levels and albumin-corrected serum calcium levels in these patients.

Patients and methods
This is a cross-sectional study. The study included 35 cirrhotic patients with HCC (diagnosed depending upon α-fetoprotein and abdominal imaging studies). Data about their serum albumin and albumin-corrected serum calcium levels were collected. Sera of the studied patients were collected for determination of PTHrP levels by enzyme-linked immunosorbent assay (ELISA). Numerical data were summarized in the form of mean±SD. Strength of association between variables was tested using Pearson correlation coefficient.

Results
Approximately 8.6% of studied patients were hypercalcemic, and no statistically significant positive correlation was detected between serum PTHrP determined by ELISA and albumin-corrected serum calcium in these patients.

Conclusion
Approximately 8.6% of studied cirrhotic patients with HCC were hypercalcemic. NO statistically significant positive correlation was detected between serum PTHrP determined by ELISA and albumin-corrected serum calcium in these patients. Studies involving a larger number of patients could clarify the exact role of PTHrP in the development of hypercalcemia in cirrhotic patients with HCC.
Frequency of malignant biliary strictures in Upper Egypt: a pilot study
Authors: Mohamed Adnan A. , Ali Ahmed M. , Shehata Mahmoud R. , Elsewify Wael A. , Maklad Salah 
Published: September 2023

Abstract
Background and aim
Biliary strictures are challenging clinical condition for gastroenterologists, radiologists, and surgical specialists. We aimed to find out the frequency of malignant biliary strictures in our institutions.

Patients and methods
This prospective study included 44 patients with biliary strictures who had undergone endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) in Aswan and Assiut University Hospitals.

Results
Thirty two patients (72.7%) had malignant strictures where distal stricture was the most frequent (68.8%) followed by hilar (25%) then mid and long segment strictures (3.1% each).

Conclusion
The vast majority of indeterminate biliary strictures are malignant (72.7%), so all indeterminate bile duct strictures in patients with obstructive jaundice should be considered malignant unless a benign etiology is definitively identifiable.
The incidence of type 2 diabetes in patients with bronchial asthma
Authors: Al-Jarhi Ula M. , Mostafa Amira I. , Alnaggar Alshaimaa R. L. R. 
Published: September 2023

Abstract
Background
The effect of bronchial asthma on development of new-onset type 2 diabetes has not been studied.

Aim
The aim was to study the association of bronchial asthma and its severity with the incidence of type 2 diabetes after 5 years in patients without diabetes at the disease onset.

Patients and methods
A total of 200 consecutive patients with a physician diagnosis of bronchial asthma (120 not known to be diabetic and 80 known to have diabetes) presenting to the outpatient chest clinic in Kasr Alainy Hospital were included. Fasting blood glucose, 2h 75 g oral glucose tolerance test, glycated hemoglobin, and lipid profile were done. Spirometry, blood pressure, BMI, and other risk factors of diabetes were sought.

Results
Of the 120 nondiabetic patients, 30 patients met at least one criterion of prediabetes and 90 patients met at least one criterion of diabetes. Multivariable regression model demonstrated that forced vital capacity (FVC)%, maximal expiratory flow 75%, and inhaled bronchodilators are independent risk factors for elevated glycated hemoglobin, independent of inhaled or oral corticosteroids, family history, blood pressure, BMI, high-density lipoprotein, and triglycerides. Logistic multivariable regression model demonstrated that FVC% and forced expiratory volume in the first second % are independent risk factors for development of new-onset type 2 diabetes (hazard ratio for FVC%: 1.1589, 95% confidence interval: 1.0684–1.2571, P=0.0004; hazard ratio for forced expiratory volume in the first second %: 0.8754, 95% confidence interval: 0.8155–0.9396, P=0.0002).

Conclusion
The incidence of diabetes and prediabetes in patients with bronchial asthma who are not known to have diabetes at disease onset is 75 and 25%, respectively. Poor pulmonary function tests were independently associated with new-onset diabetes in such patients. This association is linked to the severity of asthma and not related to treatment.
Value of right ventricular dimensions’ swings on weaning from mechanical ventilation
Authors: Ahamed Soheir Mostafa Kasem , Maghrapy Muhammad Hossam El-Din Hassan , Shehata Khaled Mohamed Ali , Sadek Samiaa Hamdy , Tawfek Samir El-Hadidy 
Published: September 2023

Abstract
Background
Cardiac dysfunction is a common cause of weaning failure. Previous studies focused on the role of LV diastolic dysfunction in the occurrence of weaning failure, and there are no more studies yet interested in RV dysfunction.
Herein we evaluate cardiac changes using tissue Doppler echocardiography in critically ill patients during the weaning process and to compare between left and right ventricular functions as a predictor of weaning failure from mechanical ventilation.

Methods
We recruited 40 mechanically ventilated patients admitted to our ICU in this cross-sectional study. Echocardiography was performed during baseline ventilator settings and during spontaneous breathing trial (SBT) to assess changes in cardiac dimensions and functions. of left and right ventricular contractility and relaxation in this subset of patients.

Results
Among 40 patients included, there was a significant increase in cardiac dimensions during SBT. There was a statistically significant decrease in LV EF with (P=0.000) during SBT. Also, there was a statistically significant decrease in RV systolic function during SBT. There was a significant increase in the E/E′ ratio of lateral mitral annulus due to the evolution of impaired LV relaxation and diastolic dysfunction (P=0.008). Moreover, the development of right ventricular diastolic dysfunction presented by E/E′ ratio of tricuspid annulus, (P value=0.03).

Conclusions
RV dysfunction, as detected by systolic wave velocity of anterior tricuspid annulus (S′) by Doppler tissue imaging during SBT, also has good sensitivity and specificity in weaning failure prediction from mechanical ventilation.
Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios as noninvasive predictors for renal involvement in systemic lupus erythematosus in health clinics
Authors: Soliman Mona M. , Makarem Yasmine S. , El Wafaa Ahmed A. , Khairallah Marwa K. A. 
Published: September 2023

Abstract
Objective
Renal injury is a prevalent complication related to lupus erythematosus and its occurrence is linked with bad alarms. Yet, a noninvasive procedure to predict renal impairment in health clinics has not been settled. Consequently, the authors postulated that platelet-to-lymphocyte (PLR) ratio and neutrophil-to-lymphocyte ratio (NLR) might be used as valid noninvasive indicators for kidney impairment.

Participants and methods
In this cross-sectional research, 270 participants were enrolled into the research after exclusion of 70 patients; the included patients were classified into four groups: 80 patients with lupus nephritis (LN) diagnosed by renal biopsy, 12 active lupus patients without renal involvement, 28 lupus patients on remission, and 80 healthy participants as controls. The authors evaluated levels of PLR and NLR in addition to other renal and lupus markers.

Results
The results have shown that PLR and NLR had significantly higher levels in active lupus patients as in biopsy-proven LN in comparison to inactive systemic lupus erythematosus and control groups. NLR was positively correlated with serum creatinine in patients with LN; however, they did not show significant association with other predictors of renal diseases. The study demonstrated that PLR and NLR had significant association to advanced classes of LN. Furthermore, the receiver-operating characteristic curve showed a higher sensitivity of PLR in early detection of kidney function impairment in LN patients (88.9%) while NLR showed more specificity (87.5%).

Conclusion
PLR and NLR could act as noninvasive markers for detection of renal involvement in lupus patients in health clinics as for the prediction of renal pathological class.
Noninvasive prediction of hepatitis C-associated hepatocellular carcinoma using circulating apolipoproteins
Authors: El Garem Hasan , Esmat Gamal , Salama Rabab , Fouad Hanan , Sabry Dina , Mostafa Yomna , Omran Dalia , Omar Heba 
Published: September 2023

Abstract
Background and aims
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. We investigated the potential usefulness of circulating apolipoproteins (Apo-A1 and Apo-A4) in HCC screening and diagnosis.

Patients and methods
We included 60 adult patients with hepatitis C virus-related chronic liver disease including HCC, in addition to 20 healthy controls. Patients were stratified into three equal groups, with 20 patients each: chronic hepatitis C, posthepatitis C cirrhosis (liver cirrhosis), and HCC. All patients and controls underwent full clinical assessment, laboratory investigations, and evaluation of candidate apolipoproteins by enzyme-linked immunoassay.

Results
Significantly higher Apo-A1 and Apo-A4 levels were detected in patients with HCC than in those with liver cirrhosis (P<0.001). Receiver operator characteristic curve showed that for HCC diagnosis, a cutoff of 78.6 mg/dl for Apo-A1 yielded 90% sensitivity and 100% specificity and a cutoff of 16.5 mg/dl for Apo-A4 yielded 85% sensitivity and 80% specificity. Furthermore, within HCC group, Apo-A1 was significantly higher in patients with small HCC (>2 cm) than those with large tumors (P=0.01). Lower Apo-A1 level correlated significantly with pylethrombosis (P=0.007).

Conclusion
Apo-A1 and Apo-A4 are novel biomarkers for HCC screening and diagnosis, with a special discriminative ability for Apo-A1 for those with small tumors and those with pylethrombosis.