bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Micro RNA-148a (miR-148a) as an Early Diagnostic Biomarker for Hepatocellular Carcinoma in Egyptian Patients
Authors: Elgohary Eman Abdel Monem , El assaly Nihal Moustafa , Shaaban Menat Allah Ali , Kabiel Walaa Ahmed Yousry , Amin Hanan S , Elsawy Hadeer W 
Published: August 2023

Abstract

Background
Hepatocellular carcinoma (HCC) is a difficult disease to diagnose in its early stages. It has a high mortality rate due to its dismal prognosis. MiRNAs are dysregulated in HCC, rendering them a promising marker of the disease's progress and outcome.

Objective
The purpose of this study was to look at the potential use of miR-148a as a non-invasive biomarker detection and prognosis of HCC.

Subjects and methods
This case-control study was applied on (64) subjects, divided into three groups: the first group (HCC patients “n = 34”); the second group (HCV patients “n = 20”) and the third group (control group “n = 10”). miR-148a expression was estimated by quantitative real time PCR. miR-148a expression was recorded and studied with the clinical parameters of each group.

Results
There was a highly statistically significant difference between three groups in terms of AFP, AST, ALT, Hb, and, platelets (p &lt; 0.001); 82.4 percent of HCC patients tested positive for HCV and 50% tested positive for vascular invasion. T2 and T4 tumors were found in less than half of patients; TNM stage III was found in 50% of HCC patients and the majority of HCC patients (76.5%) had a tumor size of ≤ 5 cm. There was a significant statistical difference between groups in terms of miR148a expression (P &lt; 0.05) with the lowest value in the HCC patients. In the HCC group, there was a negative correlation between serum miR-148a and AFP (p = 0.031), tumor size (p = 0.018), primary tumor (T) (p = 0.022), and TNM staging (p = 0.009). Receiver operator characteristics (ROC) curves showed that the best cut off value for early prediction of HCC using miR-148a was ≤ 7.331, with sensitivity of 82.4 percent and specificity of 80 percent in HCC. In addition, there was statistically significant difference between the HCC and HCV & control group, according to cut-off of miR148a (P &lt; 0.001).

Conclusion
miR-148a was found to be down regulated in HCC patients; our findings suggested that it could be utilized as a non-invasive biological marker for HCC detection and prediction of the prognosis.
Assessment of Asymmetric Dimethylarginine Level in Pediatrics with Beta-Thalassemia: Relation to Cardiovascular Complications
Authors: Omar Iman Mohamed Amin , Safwat Nesma Ahmed , Kenny Mahmoud Adel , Abdel-Maksoud Mai Mostafa Mahmoud 
Published: August 2023

Abstract

Background
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases (NOS) that limits nitric oxide (NO) bioavailability and can increase production of NOS derived reactive oxidative species. ADMA has been found as a novel risk marker in cardiovascular diseases.In Beta-Thalassemia, little is known about the importance of the baseline ADMA determination as a risk marker of cardiovascular complications in β thalassemic patients

Objectives
to assess the levels of ADMA in children and adolescents with β thalassemia major and intermedia and determine their correlation with cardiovascular complications.

Patients and Methods
The level of ADMA was measured in 60 children and adolescent with β thalassemia syndrome without known heart disease compared with 20 healthy controls using enzyme-linked immunosorbent assay (ELISA).

Results
ADMA levels were significantly higher in patients with β-thalassemia than control group (P&lt; 0.001). Body weight, male gender, regular blood transfusion and blood transfusion index had significant impact on serum ADMA. A significant correlation was found between ADMA and both bilirubin and lactate dehydrogenas (LDH) levels.Moreover, a significant positive correlation was reported between ADMA level and both left ventricular end diastolic diameter (LVEDD) and right ventricular systolic pressure (RVSP) in addition to a significant negative correlation between ADMA and ejection fraction (EF) as well as fractional shortening (FS). Additionaly, association of serum ADMA concentration to left ventricular dysfunction and pulmonary hypertension in β thalassemia patients was found.

Conclusion
ADMA could be considered as an early marker of cardiovascular complications in thalassemic patients. It should be incorporated in follow-up of thalassemics so identifying and treating appropriately subclinical conditions, reducing the burden of deleterious heart failure.
Assessment of Serum Chitinase-3-Like Protein 1 (YKL-40) in Lichen Planus
Authors: Abdelhalim Hend Mohamed Mahmoud , Afify Ahmed Abdelfattah , Ahmed Walid Abdelhady , Diab Heba Mahmoud El-Sayed 
Published: August 2023

Abstract

Introduction
Lichen planus (LP) is a papulosquamous inflammatory disease of unknown etiology. Chitinase-3-like protein 1 (YKL-40) is proinflammatory multifunctional protein with significant role in immunity, inflammation and regulation of proliferation, differentiation and apoptosis of cell.

Aim of the Study
To investigate whether YKL-40 protein has any role in the pathogenesis of LP and to estimate its level in different LP patients with different degrees of severity in an attempt to reach a novel role of it in the pathogenesis of this disease in an attempt for better understanding and treatment of LP.

Patients and Methods
38 patients with LP and 32 controls were included. Full history recording and physical examination were performed. Assessment of LP severity was done by LPAASI score and VAS score. Measurement of YKL-40 was done using ELISA.

Results
Assessment of serum YKL-40 revealed higher serum YKL-40 level in LP cases compared to controls with excellent discriminative power and sensitivity and specificity of 100%. A significant positive correlation was demonstrated between the YKL-40 level and LPAASI and pruritis scores.

Conclusion
Serum YKL-40 revealed significant high levels in LP patients compared to control subjects.
Assessment of Serum Apelin Levels and Its Relation to Insulin Resistance in Acne Vulgaris Patients
Authors: Abdel-hamid Rana safwat moustafa , EMAM ADEL , SOLTAN MARWA YASSIN 
Published: August 2023

Abstract

Introduction
Apelin is one of the adipokines. Acne vulgaris is a very common dermatological disease with a multifactorial background and hyperinsulinemia and insulin resistance are considered to play a pivotal role in its development and severity.

Aim
To evaluate serum apelin levels in acne vulgaris patients and to reveal the possible relation between its serum levels and the insulin resistance state in acne vulgaris patients.

Material and methods
Thirty-two acne vulgaris patients and thirty-two healthy controls were enrolled into the study. The blood levels of apelin, insulin and glucose were measured in patients and controls. Homeostasis model assessment index (HOMA-IR) was calculated to evaluate the insulin resistance state.

Results
Acne vulgaris patients experienced significant higher levels of fasting insulin, serum apelin, and HOMA-IR compared to controls.

Conclusions
These results suggest that serum apelin and insulin resistance may have a role in the pathogenesis of acne.
Various Postoperative Medical Lines for Management of Allegic Fungal Rhinosinusitis (Meta-Analyical Study)
Authors: Youssef Tamer Ali , Askoura Anas Mohamed , Dhel Natale Tong Tong , Mohamed Mohamed Naguib 
Published: August 2023

Abstract

Background
Allergic fungal rhinosinusitits (AFRS) is a subset of polypoid chronic rhinosinusitis that is characterized by the presence of eosinophilic mucin with fungal hyphae within the sinuses and a type I hypersensitivity to fungi. The treatment of allergic fungal rhinosinusitis usually involves surgery in combination with medical therapies to keep the disease in a dormant state. However, what constitutes an optimal post-operative medical regimen is still controversial. Hence, the purpose of this study is to assess the efficacy of various postoperative medical lines for management of AFRS.

Objective
To find out the role and efficacy of various medical therapies for postoperative treatment of allergic fungal rhinosinusitis (through a systematic review study).

Materials and Methods
Fifty studies were included in the present systematic review and meta-analysis, the total number of patients included in all studies (No = 1,655 patients). Our review has investigated the literature on 5 medical therapies (steroids, antifungal, immunotherapy, mepolizumab, and omalizumab) concerning the management of postoperative AFRS patients.

Results
The results showed that the recurrence rate after postoperative systemic steroids was 26.3%, topical steroids was 38.4%, antifungals therapy was 32.1%, immunotherapy was 17.4%, the percentage of recurrence after combination of antifungal and steroids was 9.6%, recurrence risk difference between antifungal and placebo was 18.2%, recurrence risk difference between steroids and placebo was 6.5%. Base on the above results, the combination of steroids and antifungal therapy is the best treatment for postoperative patients with AFRS.

Conclusion
This review investigated the literature on 5 medical therapies (steroids, antifungal, immunotherapy, mepolizumab, and omalizumab) concerning the management of postoperative AFRS, and provided an evidence-based review with recommendations, the use of steroids alone or antifungals as well, resulted in some degree of recurrence reduction in disease, the evidence supports the use of postoperative combination (oral steroids and systemic antifungal) as a better line of post-operative medical treatment in AFRS patients.
Language Development in Egyptian Arabic Speaking Children with Attention Deficit Hyperactivity Disorder
Authors: Mohamed Sarah Mosaad , Abdel-Fattah Hegazi Mona , Khodeir Mona Sameeh , Khalil Ghada Moharram 
Published: August 2023

Abstract

Background
Children with ADHD were found to have language impairment in many studies. The way they use language in their everyday life may be affected, namely, the pragmatic aspect of language. Measuring the affected parameters in all aspects of language will help to reach better intervention.

Aim of the Work
This study was set out to observe relationships between hyperactivity/impulsivity and inattention with all language domains in the Egyptian Arabic speaking children with attention deficit hyperactive disorder with aim of better intervention.

Subjects and Methods
This study was an observational analytical study conducted on 30 Egyptian Arabic-speaking children who were diagnosed as having ADHD with age ranging from 4-7 years. The study was carried out at the Units of Phoniatrics and Audiology of Ain-Shams University hospitals (El-Demerdash and Ain-Shams University Specialized hospital). Children were evaluated to establish the diagnosis of ADHD and its type following the diagnostic criteria of the DSM-V criteria (1) and The Conners‟ Parent Rating Scale – Revised “CPRS-R” (8). The children language abilities were assessed using the Modified PLS-4, the Arabic version, the Standardized Egyptian Arabic Pragmatic Language Test “EAPLT” (13). This assessment covered receptive and expressive language abilities, as well as pragmatic and phonological skills.

Results
Compared to norms, it was found that the ADHD children who participated in this study had non-significant language delays in parameters of. Seventy % of the participating ADHD children had total pragmatic test scores below their 5th percentile, while 30% of the children had total pragmatic test score above their 5th percentile. Results also revealed that 50% of the ADHD children failed to master certain sounds corresponding to their phonological age. A statistically significant negative correlation was observed between each of Inattention scores, Hyperactivity scores, and Impulsivity with receptive language age, expressive language age, total language age, and pragmatic language scores.

Conclusion
Receptive and expressive language, children with ADHD in this study did not show major difficulties in areas beyond what would be expected in normally developing children. The majority of children with ADHD in the present study had problems with pragmatic aspects. Half of the children failed to master certain sounds corresponding to their chronological age.
Association of Maternal and Paternal Education and Developmental Domains in 2–36 Months Old Children in Primary Care Setting in Cairo Egypt
Authors: Mahmoud Omnya Atef , Maher Shaymaa Ahmed , El Din Amin Ghada Essam , Marzouk Diaa 
Published: August 2023

Abstract

Background
Developmental delays (DDs) in children are increasing in prevalence and necessitate routine screening of young children for early recognition and management.

Objective
To determine the association of Maternal and Paternal education and developmental delays among children 2-36 months of age and determine the associated factors in Saraya El Koba primary care center in Cairo, Egypt.

Methods
This crosssectional study that enrolled a total of 193 children at the ages 2 to 36 months. Data were collected using the official Arabic version of the Ages and Stages Questionnaires, third edition (ASQ-3) to assess five domains of development (Gross Motor, Fine Motor, Language and Communication, Problem-Solving, and Personal and Social Skills). Sociodemographic data and risk factors related to DDs of children and parents were asked for.

Results
The overall prevalence of children with DDs was 9. 3%. The most developmental domain with delayed children were the communication and gross motor (3.1%each). Lower rates of DDs were identified for fine motor (1.04%). Girls scored higher than boys in problem solving domain (p &lt; 0.05). Maternal and Paternal education is associated with developmental domains in this group of children. Mothers with university education and above had children with higher fine motor and total developmental scores (p &lt; 0.05). Fathers with university education and above had children with higher communication scores (p &lt; 0.001).

Conclusion
The study recognized a high prevalence (9.3%) of DDs especially for communication and gross motor skills. Maternal and Paternal education was associated with DDs. Creating a standardized developmental screening program for prompt recognition and timely intervention is recommended.
Study of Knowledge, Attitude and Practice Regarding Adolescent’s Rights to Autonomy and Confidentiality among Physicians Working in Ain Shams University Hospitals
Authors: Aal Seham Fouad Abd El , Azab Sonya Mohamed Sayed Ahmed , Moustafa Emad Ahmed El Sayed , El-Safoury Alaa Ali Ahmed 
Published: August 2023

Abstract

Background
Legally, adolescents are not capable of making medical decisions and considered incompetent because of their age. However, psychological studies found adolescents are capable of making informed choices about involvement in health care and research.

Aim
This study aimed at assessment of physicians knowledge, attitude and practice regarding sharing of adolescents in medical decision making and their right in confidentiality.

Methods
An online self -administered structured questionnaire was used for 384 physicians working at Ain Shams University Hospitals during the period from December 2019 to December 2020.

Results
Most of the participants were knowledgeable of variable ages of legal consent between countries (54.7%) while 46.97% of them know the legal age for consent in Egypt. Most of them were aware that they should obtain consent from the adolescents before their involvement in clinical research (87.7%); their duty to breach the confidentiality of the patient’s medical information if this is necessary to protect him/ her or the surrounding people (85.4%). About 45% of them agreed with the adolescent’s ability to make a sound decision regarding his/her health and 47.1% of them were neutral with the adolescent’s right to refuse the proposed treatment even if this against parents’ decision. Most of them agreed with the adolescent’s right to confidentiality if there is no risk for the patient or the surrounding persons (64.3%). Almost all of them obtain consent from both the adolescent patients and their parents/guardians (either always (69.8%) or sometimes (26.3%,)); and give the adolescent an opportunity to speak in private (either always (43.5%) or sometimes (55.2%)).

Conclusion
Although of the participants’ positive attitude toward sharing the adolescent patient in medical decisions- making, and their right to confidentiality, their practice showed variable responses. This may be due to deficient knowledge of the laws and absence of definite ethical guidelines for health care of adolescent patients.

Recommendation
Training of the physicians on judgment and assessment of adolescent patient’s capacity is an important step to ensure their involvement in decision making. Also, it is important to formulate ethical guidelines for management of adolescent patients in our community.
The Role of Methylene Blue Spray to Keep Parathyroid Gland Safe during Thyroidectomy
Authors: elshafei Mahmoud , Omran Hisham , Hisham Mohamed , Ali Ahmed Mahmoud Abdelsalam 
Published: August 2023

Abstract

Background
Thyroidectomy is one of the most surgical interventions in endocrine surgery. When the operation is performed in respective surgical centers, the operation is safe with low morbidity and 0% mortality.

Patients and Methods
The study was a quasi-experimental study carried out at Ain Shams University Hospital. Sixty patients with benign and malignant goiter disorders underwent primary (not recurrent) total thyroidectomy. The patients were assigned into two groups: group 1 (interventional group) included 30 cases operated upon with methylene blue spraying technique and group 2 (control group) 30 cases established with the conventional technique. Methylene blue was sprayed over the thyroid lobe and perilober area. Parathyroides and recurrent laryngeal nerve were identified and evaluated.

Results
Recurrent laryngeal nerve was not stained and remained white in all cases while all other tissues were stained blue. Four to seven minutes later the parathyroid glands washed out the blue stain and regain their original yellow color. Thyroid gland wash-out time was 19 min.

Conclusion
Methylene blue spraying is a new technique that allows identification of both parathyroid glands and recurrent laryngeal nerves. This technique is safe, effective, and technically feasible.
Diagnostic Accuracy of Modified Alvarado Scoring System in Acute Appendicitis in the Egyptian Patients
Authors: Abdraboh Ayman Abdullah , Omran Hisham Mohamed , Younes Ali Ahmed Mohammed , Abdellah Khaled Hegazy 
Published: August 2023

Abstract

Background
Approximately 7% of population will suffer from acute appendicitis during their life time. In 1889 Mc Burney in New York pioneered early diagnosis of appendicitis and was the first to point out the importance of early surgical intervention.

Objective
To assess the diagnostic accuracy of modified Alvarado scoring system in acute appendicitis in the Egyptian patients correlated with the operative findings and histo-pathological results.

Patients and Methods
This was a prospective; was conducted in Ain Shams University Hospitals and Nasr City Police Hospital, over a period of 6 Months, from February 2019 to August 2019, the study was carried out on 40 cases of both genders presenting to the emergency department with suspected acute appendicitis.

Results
There was statistically significant association between Histo-pathological findings and MASS (p &lt; 0.001). There was statistically significant association between MASS and US findings (p &lt; 0.001). Modified Alvarado Scoring System (MASS) showed a very high diagnostic value (AUC = 0.84, specificity = 88.6%, sensitivity = 80%, PPV=96.9%, NPV=50.0%, p-value =0.0001.

Conclusion
The present study has shown that MASS provides high degree of sensitivity, specificity, PPV, NPV and accuracy in the diagnosis of acute appendicitis, Alvarado scoring system increases the sensitivity and specificity for diagnosis of acute appendicitis with the added advantages of being simple and easy to use. Moreover it is repeatable at no cost. Thus the application of this scoring system improves diagnostic accuracy and consequently reduces appendicectomy.
Management of Leakage after Gastroesophageal Anastomosis
Authors: Mohamed Mohamed Mahfouz , Hefny Amr Mohamed Mahmoud El , El Moenem Ayman Hossam El din Abd , Refaat Mohamed Riad Mohamed 
Published: August 2023

Abstract

Background
Esophagectomy is needed for a variety of esophageal disorders, the most common indication is cancer esophagus, however, it is needed in benign disorders as postcorrosive strictures & endstage achalasia with esophageal dilatation. Anastomotic leakage is one of the most severe complications leading to significant morbidity and increased risk of mortality.

Objective
To evaluate different approaches in management of leakage after gastroesophageal anastomosis in Upper GIT surgery unit in Ain Shams University Hospitals.

Patients and Methods
This study was conducted at General surgery department, Ain Shams University Hospitals. Approval of the Ethical Committee was obtained. The study was conducted over patients with postoperative gastroesophageal leakage during the period from 3/2019 to 3/2021.

Results
Patients managed after cervical anastomosis leakage needed less time to start oral intake& had shorter hospital stay in comparison to those managed after thoracic leakage. There was a higher perioperative morbidity and mortality in patients who underwent surgical intervention as compared with patients who underwent conservative treatment.

Conclusion
Anastomotic leak after surgery for esophageal diseases can vary in location, onset time, size, and extent. For local management, personalized treatment should be decided based on patient’s particular situations. Cervical anastomosis leakage has less morbidity & mortality compared to thoracic anastomosis. Conservative treatment is safe and successful in many cases, in cervical leakage conservative management is effective in most cases. Stent implantation is an effective method with other emerging endoscopic techniques. Resurgery should be considered carefully and reserved to uncontrolled leakage or patients with failed conservative management.
A Comparative Study between Onlay versus Sublay Mesh Repair in Treatment of Midline Incisional Hernia
Authors: Ahmed Sherif A , Abd_Elaksoud Ibrahem M , Saad Mohamed N 
Published: August 2023

Abstract

Background
Incisional hernia is a common complication following laparotomy and is the most common indication for reoperation. However, the optimal approach for its repair is still a matter of debate.

Aim of Study
The aim of this study was to compare between onlay and sublay mesh repairs in treatment of midline incisional hernia regarding the operative technique and postoperative complications.

Patients and Methods
This randomized controlled prospective comparative study was conducted in general surgery department Ain-Shams University Hospital and Damanhour Medical National Institute in the period between November 2019 and April 2020. It included 40 patients with Midline incisional hernia who were randomly divided into two equal groups: A (treated with sublay repair) and B (treated with onblay repair).

Results
The mean operative time in group A was 104.2 minutes and in group B was 82.9 minutes. The mean time of drain removal in group A was 4.3 days while in group B was 13.6x days. Seroma formation after drain removal was not recorded in any patients of group A while it occurred in 4 patients in group B (20%). The other postoperative complications were comparable in both groups. During 6 months of follow up, hernia recurrence didn’t occurs in any patient in group A nor group B.

Conclusion
Sublay mesh repair of incisional hernia is a good alternative to onlay repair. It is applicable to all sites of incisional hernia with a low recurrence rate and acceptable complication rates.