bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of severe dyspnea in critically ill patients by transthoracic sonography: Fayoum experience of the Bedside Lung Ultrasonography in Emergency protocol
Authors: Agmy Gamal R. , Hamed Sherif , Saad Mohamed A. , Ibrahim Randa , Mohamed Aliaa A. 
Published: September 2023

Abstract
Background
Management of critically ill patients requires imaging tools, which are important for optimizing diagnostic and therapeutic actions. Both bedside chest radiography and thoracic computed tomography have limitations that constrain their utility. The aim of our work is to explore the value of transthoracic ultrasound (TUS) using the Bedside Lung Ultrasonography in Emergency (BLUE) protocol in critical ill patients with severe dyspnea.

Patients and methods
This study included 109 ICU patients with acute dyspnea at Fayoum University Hospital. The judgments of chest ultrasound using the BLUE protocol were compared with the final diagnoses; rare diagnoses and uncertain diagnoses were excluded.

Results
By application of the BLUE protocol, TUS was absolutely sensitive, specific, and accurate for the diagnosis of pneumothorax. For pneumonia, the sensitivity, specificity, and diagnostic accuracy were 93.8, 95.7, and 95.8%, respectively, whereas these parameters for pulmonary edema were 100, 96.8, and 99%, respectively. TUS was absolutely sensitive in the diagnosis of chronic obstructive pulmonary disease, asthma, or diffuse parenchymal lung disease, whereas the specificity and diagnostic accuracy were 88.9 and 88.9%, respectively, for chronic obstructive pulmonary disease and asthma and 96.8 and 100%, respectively, for diffuse parenchymal lung disease.
Clinical and laboratory profile of chronic pulmonary aspergillosis: a retrospective study
Authors: Jakribettu Ramakrishna Pai , George Thomas , Abraham Soniya , Fazal Farhan , Kinila Shreevidya , Baliga Manjeshwar Shrinath 
Published: September 2023

Abstract
Introduction
Chronic pulmonary aspergillosis (CPA) is a type of semi-invasive aspergillosis seen mainly in immunocompetent individuals. These are slow, progressive, and not involved in angio-invasion compared with invasive pulmonary aspergillosis. The predisposing factors being compromised lung parenchyma owing to chronic obstructive pulmonary disease and previous pulmonary tuberculosis. As not many studies have been conducted in CPA with respect to clinical and laboratory profile, the study was undertaken to examine the profile in our population.

Patients and methods
This was a retrospective study. All patients older than 18 years, who had evidence of pulmonary fungal infection on chest radiography or computed tomographic scan, from whom the Aspergillus sp. was isolated from respiratory sample (broncho-alveolar wash, bronchoscopic sample, etc.) and diagnosed with CPA from 2008 to 2016, were included in the study.

Results
A total of 30 patients were included in the study. Most patients presented with pulmonary symptoms like cough with expectoration, hemoptysis, fever, breathlessness, and chest pain. Among the systemic comorbid conditions, diabetes mellitus was the most common (7/30), and nearly 50% (14/30) of the patients had a history of pulmonary tuberculosis. Among the hematological parameters, a significant difference was observed in hemoglobin, total leukocyte count, differential leukocyte count, and erythrocyte sedimentation rate. In all the four dead patients, the cause of death was respiratory failure and all patients were previously treated for pulmonary tuberculosis.

Conclusion
When a patient with pre-existing lung disease like chronic obstructive pulmonary disease or old tuberculosis cavity presents with cough with expectoration, breathlessness, and hemoptysis, CPA should be considered as the first differential diagnosis.
Combined pulmonary fibrosis and emphysema syndrome: clinical, functional, and radiological assessment
Authors: Ghanem Maha K. , Makhlouf Hoda A. , Hassan Ali A. , Hamed Heba A. 
Published: September 2023

Abstract
Background
The coexistence of pulmonary fibrosis and emphysema is increasingly recognized.

Objective
To assess the clinical, physiological and radiological characteristics of patients with combined pulmonary fibrosis and emphysema (CPFE) and compare it with patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) alone.

Patients and methods
One hundred-twenty patients were enrolled and divided into three groups; 40 had COPD based on poorly reversible airflow obstruction in spirometry; 40 had ILD based on high-resolution computed tomography (HRCT); and 40 had CPFE based on the presence of emphysematous changes in the upper lung zones and pulmonary fibrosis in lower zones in HRCT. Modified Medical Research Council dyspnea scale, arterial blood gas analysis, spirometry, diffusion capacity for carbon monoxide (DLCO), polythesmography, HRCT chest, and echocardiography were done.

Results
More than 57% of patients with CPFE were men and the majority of them were smokers. There was no significant difference in dyspnea grade between CPFE group and other groups (P>0.05). The rate of exacerbation per year was significantly higher in the CPFE group (4.2±1.02) compared with either COPD group (3.33±1.56) or ILD group (3.15 ±1.05). CPFE patients had both emphysematous and fibrotic changes on radiological examination. Lung volumes were preserved but DLCO% was significantly lower and the mean pulmonary artery systolic pressure was significantly higher in the CPFE group compared with COPD and ILD.

Conclusion
CPFE is a distinct syndrome that has characteristic radiological findings and lung function profile with a significant reduction of DLCO and a significant increase in pulmonary artery systolic pressure.
Study of diaphragmatic mobility by chest ultrasound and echocardiographic changes in chronic obstructive pulmonary disease patients on different modes of mechanical ventilation
Authors: Saeed Adel M. , Elshahed Ghada S. , Osman Nehad M. , Gomaa Ashraf A. , Fahyim Samir M. 
Published: September 2023

Abstract
Objective
This study aimed to assess diaphragmatic mobility by chest ultrasonography and echocardiographic changes in mechanically ventilated chronic obstructive pulmonary disease patients on different modes of mechanical ventilation.

Patients and methods
The present study was carried out on 50 mechanically ventilated chronic obstructive pulmonary disease patients. Chest ultrasonography for the assessment of diaphragmatic mobility in addition to echocardiography was performed on different modes of mechanical ventilation in the same session at any time since mechanical ventilation.

Results
There was a highly statistically significant relation between diaphragmatic excursion and different modes of mechanical ventilation, where excursion increased significantly, with its peak at pressure-support ventilation (PSV). In terms of diaphragmatic thickness, the thickness of diaphragm decreased significantly at PSV. No significant correlation was detected between echocardiography in Ejection fraction, right ventricular systolic pressure, tricuspid annular plane systolic excursion, and different modes of mechanical ventilation.

Conclusion
The best diaphragmatic mobility was on PSV, which improved lung volumes and ventilation, and may accelerate the weaning process. In addition, we concluded that the echocardiographic finding was not affected by different modes of mechanical ventilation.
The effect of continuous positive airway pressure on dyslipidemia in patients with obstructive sleep apnea
Authors: Shehab-Eldin Walid Abdelmohsen , Elhabashy Mahmoud 
Published: September 2023

Abstract
Background
Obstructive sleep apnea (OSA) is a prevalent disease associated with increased risk of cardiovascular mortality. However, the exact causal relationship is not clear. One of the proposed mechanisms is dyslipidemia.

Aim
To study the effect of continuous positive airway pressure (CPAP) on dyslipidemia in patients with OSA.

Patients and methods
Forty obese patients with OSA were recruited. All patients were subjected to history taking, physical examination, and polysomnography. Fasting blood sugar, liver function, kidney function, and lipid profile were measured after fasting for 14 h. Apnea/hypopnea index and BMI were calculated. The patients then received CPAP treatment during night for 3 months. Polysomnography and laboratory parameters were remeasured after 1 and 3 months of treatment.

Results
The natural correlation between body weight and lipid profile is lost. Apnea/hypopnea index and high-density lipoprotein improved significantly after 1 month and more significantly after 3 months. Triglycerides were lowered after 1 month without more improvement after 3 months. Low-density lipoprotein-cholesterol and total-C did not change after 1 month with significant reduction after 3 months.

Conclusion
Treatment with CPAP improves lipid profile in patients with OSA.
Relationship between platelet count, platelet indices, and inflammatory markers in stable and acute exacerbation of bronchiectasis patients
Authors: Yigitbas Burcu A. , Sibel Yurt , Berat Uslu , Satici Celal , Pelin Uysal , Ayse Kosar F. 
Published: September 2023

Abstract
Background and objective
Persistent and chronic infection is one of the reasons underlying the sustained inflammation in bronchiectasis patients, and inflammatory markers may possess important clinical implications in the follow-up. Platelets are known to have effects on inflammatory response; in addition, a negative correlation has been shown between mean platelet volume (MPV) and inflammatory disease activity. The objective of this paper is to investigate and compare the levels of platelet (PLT) count and platelet indices during stable and acute exacerbation of bronchiectasis patients.

Patients and methods
Data were retrospectively collected from medical files of 63 patients (39 women) and 29 controls without bronchiectasis. Thirty patients had an acute exacerbation, and 33 were in a stable state of disease. Descriptive data, clinical, radiologic, and laboratory information were noted. The relationship between inflammatory markers and pulmonary function tests was evaluated.

Results
White blood cell (WBC) count, C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and PLT count were significantly higher; however, hemoglobin level and MPV were lower during exacerbation. There was a correlation between PLT and CRP, WBC, and ESR, and a negative correlation between PLT and forced vital capacity and forced expiratory volume in 1 s. However, we found an inverse correlation between MPV and WBC, and ESR, a positive correlation between MPV and forced expiratory volume in 1 s.

Conclusion
We have found that platelet indices PLT and MPV were significant in exacerbation of bronchiectasis patients compared with stable and control patients. Cell blood count, compared with CRP and other inflammatory markers, is a more practical, useful, cost-effective laboratory examination. Not just looking at the WBC, but just taking a glance at the platelet indices would be a useful and simple way to evaluate bronchiectasis patients.
The role of chest ultrasound in detection of pulmonary congestion in hemodialysis patients
Authors: Koraa Emad El-Din Abdel-Wahab , Aly Tamer Mohamed , Hussein Hussein Sayed , Beshara Sally Kamil 
Published: September 2023

Abstract
Background
Volume overload is a risk factor for mortality in hemodialysis. Pulmonary congestion may be present and mostly asymptomatic between hemodialysis patients, but its outcomes are unknown.

Aim
The aim of this study was to assess the role of chest ultrasound (US) in detecting pulmonary congestion in hemodialysis patients.

Patients and methods
This study included 40 patients diagnosed with chronic renal failure on regular hemodialysis. The patients were selected from the Hemodialysis Unit, Dar El Shefa Hospital. Chest US was done predialysis and postdialysis.

Results
The study was conducted on 40 patients. The age of our patients ranged between 19 and 55 years old; history of hemodialysis ranged between 1 and 8 years; 35% were smokers; 26 (65%) patients were hypertensive; and 17 (42.5%) patients were diabetic. Lung congestion, detected by chest US predialysis, was mild in nine (22.5%) patients, moderate in 17 (42.5%) patients, and severe in 14 (35%) patients. The chest US Kerly’s B-line scores significantly reduced after dialysis, and were normal in seven (17.5%) patients, were mild in 19 (47%) patients, moderate in 12 (30%) patients, and severe in two (5%) patients.

Conclusion
Chest US can be used as a bedside test for the assessment of lung congestion in hemodialysis patients.
Study of some methods of smoking cessation
Authors: Saeed Adel M. , Osman Nehad M. , Mohamed Alaa Eldin A. 
Published: September 2023

Abstract
Background
Addiction of tobacco is both mental and physical. For many smokers, the best way to quit is a combination of medical, behavioral, and emotional support. The aim of the work was to study the effectiveness of aversion therapy using onion-powdered cigarette as a method of quitting compared with nicotine replacement therapy and conventional behavioral (5As) therapy in smoking cessation.

Patients and methods
A prospective, randomized study recruited 60 smokers from Ain Shams University Hospitals who were divided into three groups. Group I: included 20 participants subjected to a brief verbal (5As) therapy for smoking cessation; group II: included 20 participants subjected to a brief verbal (5As) with adding nicotine gum; group III: included 20 participants subjected to brief verbal (5As) with adding aversion therapy in the form of single onion-powdered cigarette by mixing tobacco with dried onion powder by an equal amount. Weekly interviews were conducted for follow-up, for at least 6 months from the beginning of treatment.

Results
All participants were male smokers within the age range of 21–70 years. There were significant statistical differences (P≤0.05) between the three studied groups as regards the outcome: the complete success rate of quitting was significantly higher among group 1 (30%) versus 15% in group II and 15% in group III. On other hand, the partial success was recorded in 45, 55, and 20% of group I, II, and III, respectively. Lastly failed attempts were recorded in 25, 30, and 65% of group I, II, and III, respectively. There were significance statistical correlations (P<0.05) found between the outcome and the age, pack/year, duration of smoking, craving time, presence of relapsing causes, and nicotine dependence score. However, there was no statically significant correlation (P>0.05) found between the outcome and age of initiation, occupation, presence of comorbidities, marital status, and previous quitting attempts.

Conclusion
Behavioral therapy (5As) is most effective in smoking cessation program. Nicotine replacement therapy and aversion therapy may be an adjuvant in the smoking cessation program. Aversion therapy is a simple procedure, economic, practical, easy to apply, and may be effective in smoking cessation.
Serum and synovial matrix metalloproteinases 1 and 3 in patients with early rheumatoid arthritis: potentially prospective biomarkers of ultrasonographic joint damage and disease activity
Authors: Abdelrahman Maryam A. , Sakr Hossam M. , Shaaban Menat A. A. , Afifi Naglaa 
Published: September 2023

Abstract
Background
Matrix metalloproteinase-1 (MMP-1) and MMP-3 play important roles in the pathogenesis of rheumatoid arthritis (RA) and have been suggested as markers of disease activity and joint damage.
Objective The aim was to analyze the clinical significance of MMP-1 and MMP-3 in relation to markers of disease activity and degree of joint destruction in patients with early RA at presentation and after 6 months.

Patients and methods
Baseline levels of serum MMP-1 and MMP-3 were assessed in 50 patients with early RA (symptoms <1 year), 20 patients with osteoarthritis (OA), and 20 age-matched and sex-matched healthy controls. Serum MPP-1 and MPP-3 were correlated with disease activity markers [erythrocyte sedimentation rate (ESR), C-reactive protein, disease activity score 28–ESR] and radiographic joint damage using simple erosion narrowing score and musculoskeletal ultrasound of wrist and hand joints. Baseline synovial fluid MMP-1 and MMP-3 levels were evaluated for 20 patients indicated for arthrocentesis.

Results
Baseline serum MMP-1 and MMP-3 were significantly higher in RA group versus OA group and healthy controls (P<0.001). Synovial MMP-1 and MMP-3 levels were significantly higher in RA versus OA group. Serum MMP-1 and MMP-3 levels significantly correlated with rheumatoid factor titers, anticyclic citrullinated peptide, disease activity score 28-ESR score, joint erosions, and Outcome Measures in Rheumatology score of synovitis and Doppler signals. Serum MMP-1 did not correlate with C-reactive protein, but significantly correlated with the number of erosions at presentation and on follow-up. The number of patients with erosions and the number of erosions per patient increased after 6 months and correlated with serum MMP-1 and MMP-3. The best cutoff values of serum MMP-1 and MMP-3 to discriminate between RA and healthy controls were greater than 20 and greater than 50ng/ml, respectively.

Conclusion
Elevated serum levels of MMP-1 and MMP-3 can be used as an indicator of disease activity in patients with early RA and can reflect the degree of joint damage and correlate with the number of new joint erosions.
Study of proinflammatory and anti-inflammatory states in myelodysplastic syndrome patients
Authors: Hassan Alaa E. , Tahoon Marwa , Bediera Hanan 
Published: September 2023

Abstract
Background
The myelodysplastic syndrome (MDS) are a group of clonal bone marrow neoplasms characterized by ineffective hematopoiesis, manifested by morphologic dysplasia in hematopoietic cells and by peripheral cytopenia(s) although previous studies have shown cytogenetic and molecular abnormalities, the underlying defect in the molecular pathway for inflammation milieu, extensive apoptosis, and dysplasia observed in the disease is yet to be studied.

Aim of the work
The aim of this study was to show the proinflammatory [tumor necrosis factor-α (TNF-α)/anti-inflammatory [interleukin-10 (IL-10)] balance in different subclassifications of MDS.

Patients and methods
From September 2017 through September 2018, serum levels were measured in 49 patients for TNF-α, IL-10 in patients diagnosed as having MDS. Also, these inflammatory cytokines had been measured in 46 apparently healthy participants as matched controls for the study. The diagnosis of MDS was confirmed by a hematopathologist after review of bone marrow aspiration and/or peripheral blood samples. Conventional cytogenetic studies were performed on bone marrow aspirate material using standard G-banding techniques. These patients were then subclassified according to the revised 2016 WHO classification for MDS.

Results
There is a statically significant difference between MDS patients and control group according to the results of serum level of TNF-α and IL-10. They were higher in MDS patients. Also, there was a statically significant difference between the subclassified groups of MDS patients according the results of serum level of TNF-α and IL-10. TNF-α was higher in MDS with multilineage dysplasia and MDS unclassifiable than the others. Also, IL-10 was higher in MDS with excess blasts 1 and MDS with excess blasts 2 than the others.

Conclusion
TNF-α and IL-10 are increased in MDS patients indicating an inflammatory disturbance. TNF-α and IL-10 serum level are inversely related to each other in the different subclasses of MDS.
Excessive use of electronic gadgets: health effects
Authors: Sarla Gurmeet Singh 
Published: September 2023

AbstractMobile phones, internet, social networking sites, and texting have changed the way we see the world. There are ~6.9 billion mobile users, almost as many as people on earth. People who excessively use electronic gadgets develop musculoskeletal disorders. Repetitive strain injury is a chronic condition that develops because of repetitive, forceful, or awkward hand movements for prolonged periods leading to damage to muscles, tendons, and nerves of the neck, shoulder, forearm, and hand, which can cause pain, weakness, numbness, or impairment of motor control. Eyes, neck muscles, arm, and wrist are affected with prolonged use of electronic gadgets. People who use smartphones excessively, because of their reduced amounts of face-to-face interaction, are likely to have a feeling that their social relationships are not supportive and rewarding and that they are not actively contributing to the happiness and well-being of others. The aim of this review article is to study literature and list the problems associated with prolonged use of electronic gadgets and ways to minimize the symptoms owing to increased ‘screen time’. Smartphone overuse may lead to development of repetitive stress injury or overuse syndrome thereby affecting hand function resulting in pain in the thumb. Prolonged use of electronic gadgets may affect the human body adversely. There is a critical need to promote healthy ways of smartphone use, as well as the importance of friendship and family connectedness as a way of promoting the psychological well-being. Physicians should get themselves updated of these new disorders and younger generation needs to be educated adequately about the ergonomic practices and health safety of gadget usage.
Thyroid autoimmunity is associated with hypothyroid-like symptoms compared with nonautoimmune benign thyroid diseases using a thyroid-specific questionnaire
Authors: Elsherbiny Tamer M. 
Published: September 2023

Abstract
Background
Autoimmune hypothyroidism, also commonly known as Hashimoto thyroiditis (HT), is the most common cause of hypothyroidism in iodine-replete areas. Thyroid autoimmunity was shown to be associated with lower quality of life, higher symptom load, and poor physical and psychological well-being. The aim of this study is to evaluate the disease burden of HT using a thyroid-specific questionnaire, the thyroid patient reported outcomes (ThyPRO).

Patients and methods
The study included 194 patients, divided into two groups: group 1 included 124 patients with HT stable in euthyroidism 6 months before inclusion in the study, and group 2 included 70 patients with euthyroid benign thyroid disease other than HT. All patients completed a professionally translated, carefully revised version of the ThyPRO questionnaire into Arabic language. All patients had their thyroid stimulating hormone (TSH) measured at inclusion. Anti-thyroperoxidase and/or anti-thyroglobulin antibodies were recorded for each patient where available.

Results
There were no significant differences between the two studied groups regarding age, sex, and TSH. Both anti-thyroperoxidase and anti-thyroglobulin antibodies were significantly higher in HT group versus group 2. Group 1, HT group, showed significantly higher score in the hypothyroid symptom scale compared with group 2. No significant differences were found regarding the remaining symptom scales. Within hypothyroid symptom score scale, group 1 showed significantly higher scores in dry skin and swollen hands and feet items but not in cold sensitivity and itchy skin questions.

Conclusion
This study showed that thyroid autoimmunity, independent of thyroid function status, is associated with hypothyroid-like symptoms compared with benign thyroid disease other than HT. This may be caused by a direct or an indirect role of thyroid autoantibodies.