bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Stratification in Egyptian Patients with Upper Gastro Intestinal Bleeding
Authors: Al swaff Reham , Hamdy Hesham , Gamal Gina , kamal Ahmed Elsayed 
Published: August 2023

Abstract

Introduction
Acute upper gastrointestinal bleeding is a common and life-threatening condition. It remains a common cause of visits to the emergency department with an estimated incidence of about 100 per 100000 hospitalizations and being associated with significant morbidity, 30 day mortality and health-care costs. Urgent triage in emergency departments and risk stratification can help to identify patients who warrant urgent diagnostic and therapeutic procedures. We aimed to assess the correlation between Glasgow-Blatchford Bleeding Score, the AIMS65 score and Rockall score in sixty Egyptian patients with upper gastrointestinal bleeding, and to evaluate the best scoring system for risk stratification in these patients.

Methods
This prospective study included 60 Egyptian patients presented to Ain shams university hospital with upper gastrointestinal bleeding. All patients underwent emergency endoscopic evaluation within 12 hours of presentation. Surgical and radiological interventions were considered for patients who failed or were not feasible for endoscopic therapy. Rockall score, Glascow-Blatchford and AIMS65 were calculated for each patient.

Results
the age of the studied patients ranging between 20 and 81 years old with a mean age of 55.57 ± 13.14, of them 66.7% were males and 33.3% were females. Most of the patients (90%) had co-morbidities in the form of hepato-billiary diseases (70%), HTN (30%), DM (26.7%), cardiac disease (8.3%), and GIT related disorders (6.7%). Portal hypertension gastropathy was the most common finding in UGIT endoscopy (58.3%) followed by esophageal varcies (56.7%), then gastritis (30%), then peptic ulcer (20%) and lastly gastric mass (6.7%). Rockall score had significant association with altered mental status and liver cirrhosis. Rockall score was found to be the most effective predictor for mortality (sensitivity 100%, specificity 67.92% and AUC 91.0%).

Conclusion
complete Rockall score is the most effective scoring system for prediction of in hospital mortality in patients with upper gastrointestinal bleeding.
Correlation of Circulating Cathelcidin Level and Inflammatory Bowel Disease Activity
Authors: Adel Nanees , Halima Ahmed Samir Abo , Samir Elbaz Hossam , Hossam Eldin Ahmed Farahat Saleh 
Published: August 2023

Abstract

Background
Inflammatory bowel diseases (IBDs), which include Crohn’s disease (CD) and ulcerative colitis (UC), are a group of idiopathic, chronic and relapsing inflammatory disorders of the gastrointestinal tract, whose incidence and prevalence has been increasing in the last decade.

Objective
To correlate circulating cathelicidin levels with mucosal disease activity in patients with IBD.

Patients and Methods
This case control cross sectional study was conducted on 45 adult subjects referred to Gastrointestinal Endoscopy and Liver Unit, EL-Haram Hospital.40 of the patients had IBD, the other 40 were non IBD patients studied as case control. All subjects were submitted to complete medical history, physical examination, laboratory investigations, colonoscopic examination and cathelicidin serum level.

Results
Our results showed that there was no statistically significant difference between both studied groups regarding both age and sex distribution. In this study we found highly significant decrease in Hemoglobin level in cases group compared to control group (p value &lt; 0.001). Also, there was significant increase in platelets level among cases group compared to control (p value &lt; 0.05). Also, we found that serum albumin was decreased among IBD patients compared to control.

Conclusion
Serum Cathelicidin has shown significant increase in patients with IBD activity. Serum cathelicidin levels showed statistically significant reverse correlation with Partial Mayo Scores of severity in UC patients. Serum cathelicidin levels showed Non-statistically significant correlation with Harvey Bradshaw Indices of severity in CD patients. Co-evaluation of LL-37 and CRP levels was more accurate than CRP alone or LL-37 alone in the correlation with Mayo Endoscopic Score of UC patients.
Study the Efficacy of Argon Plasma Coagulation or Endoscopic Band Ligation versus Their Companion in Management of Gastric Antral Vascular Ectasia in Cirrhotic Patients
Authors: Youssef Tarek Mohamed , Mohamed Enas El-Khedr , El-Talkhawy Mohamed Darwish , Fathallah Ahmed Magdy , Al-Bendary Ahmed Hamed Hamza 
Published: August 2023

Abstract

Background
Gastric antral vascular ectasia (GAVE) is a rare and often misdiagnosed cause of upper gastrointestinal bleeding accounts for up to 4% of all non-variceal upper gastrointestinal bleedings. Multiple options are available for the treatment of GAVE including endoscopic, surgical and medical therapies.

Aim of the Work
The aim of this study to evaluate the effect of APC followed by EBL in comparison to APC or EBL alone for the treatment of bleeding GAVE in cirrhotic patients.

Patients and Methods
We conducted this study on 45 adult cirrhotic patients with overt or occult bleeding from GAVE. Patients were divided into 3 groups: 15 patients in each group. Group I was treated with APC alone, group II was treated with EBL alone and Group III was treated with APC followed by EBL.

Results
In the current study, no statistically significant difference was detected between both groups regarding the etiology of liver cirrhosis, clinical presentation, laboratory or ultrasound findings with special emphasis on pre-treatment hemoglobin value, hospitalizations. APC alone was found to was found to be less effective in the treatment of GAVE when compared to both techniques (EBL and the combined therapy) which were effective in the treatment of GAVE and GAVE recurrence. EBL alone was found to require less number of treatment sessions but required more number of rubber bands and. Combined therapy (APC followed by EBL) successfully decreased the number of banding sessions and decreased the number of rubber bands required to treat GAVE.

Conclusion
Combined therapy (APC followed by EBL) and EBL alone are effective methods in the treatment of bleeding GAVE in Egyptian cirrhotic patients. EBL alone requires less number of treatment sessions but may require a big number of applied rubber bands. Combined therapy (APC followed by EBL) successfully decreased the number of banding sessions and decreased the number of rubber bands required to treat GAVE. So, in mild cases when less number of rubber bands seems to be required, it is advisable to start with EBL alone: while in severe cases where a large number of rubber bands seems to be required, it is advisable to use combination therapy of APC and EBL.
A Randomized Controlled Clinical Trial of Trisodium Citrate 30% versus Heparin as a Lock Solution for the Prevention of Catheter-Related Infections in Adult Hemodialysis Patients
Authors: EL-Sharkawy Magdy Mohamed , Khedr Lina Essam , Emara Ahmed Abdelmoniem , Elsayed Ahmed Kamal Abdelhamid Ali 
Published: August 2023

Abstract

Background
Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. Interdialytic hemodialysis catheter-locking solutions could contribute to reduction of catheter-related complications, especially infections.

Aim of the Work
To assess the possible effect of using Trisodium citrate 30% (TSC 30%) in comparison to unfractionated heparin, as a lock solution for hemodialysis catheters, on inflammatory status in HD patients

Patients and Methods
This was a randomized controlled clinical trial, conducted on 70 patients on regular hemodialysis, selected from hemodialysis unit in Nasser Institute Hospital in Cairo government, divided into two groups: (Citrate Group); 35 patients received trisodium citrate, (Heparin Group); 35 patients received unfractionated heparin (5000i.u) as a hemodialysis lock solution after the end of HD session and followed up for 3 months.

Result
In our study, the catheter-related bacteremia episodes were significantly lower in the Citrate group when compared with those in the Heparin group. Only 2 patients (5.7%) in Citrate group had CRBSI, whereas in Heparin group, 8 patients (22.9%) had CRBSI (P = 0.04). Also, Bacteremia-free time was longer in the Citrate group. The mean bacteremia free time in Citrate group was 10.97 ± 2.36 weeks, while in Heparin group it was 9.43 ± 3.91 weeks (P = 0.032). At base line, there was no significant difference between both groups regarding hsCRP (P = 0.596) and WBCs (P = 0.528). While after 3 months of using TSC 30% as a lock solution, there was a significant difference as regards levels of hsCRP (P = 0.030) and WBCs (P = 0.036), with the higher levels of inflammatory markers showed in Heparin group. There was no difference between the two studied groups regarding thrombosis, however, catheter performance was higher in citrate group after 3 months assessed by URR (P = 0.005) compared to baseline (P = 0.108),

Conclusion
We found that Trisodium citrate 30% may be a better alternative to heparin as a catheter lock solution as it reduces the inflammatory markers and CRBSI incidence. We therefore believe that TSC 30% may be used safely as catheter lock solution in Hemodialysis
Assessment of Incidence of Metachronous Neoplasms after Surgical Resection of Colorectal Cancer
Authors: Moenis Ahmed Ali , Mohammed Eslam Safwat , Said Nouran Mohamed , Omar Ahmed Khaled Abd El-Razzak 
Published: August 2023

Abstract

Background
Cancer colon is the second most common cause of cancer in women and the third most common in men. Globally incidences vary 10-fold with highest rates in Australia, New Zealand, Europe and the US and lowest rates in Africa and South-Central Asia. However, in Egypt, CRC represent 4.2% of all cancers in male and 3.8% in females.

Aim of the Work
The aim of our study was to assess the incidence of Metachronous neoplasms after curative surgical resection of colorectal cancer and assess different risk factors for metachronous Cancer colon occurrence.

Patients and Methods
We enrolled 100 patients in this retrospective cohort study to predict incidence and risk factors of metachronous colorectal cancer (CRC) after 6 months of curative surgical resection of colorectal cancer.

Results
After 6 months of post-operative follow up, 90% of cases had no recurrence of CRC, 5% had polyps and did polypectomy, 5% had mass lesion. So patients were divided into two groups, Group (1) included patients with no recurrent CRC. Group (2) included patients with recurrent CRC. The incidence of metachronous CRC was 5% for mass and 5% for polyps in patients who underwent curative surgical resection of colorectal cancer. In both Univariate and multivariate Logistic regression analysis for the parameters affecting recurrent mass, DM was the only significant risk factor associated with the incidence of metachronous CRC with P values (0.043, 0.049) respectively.

Conclusion
The incidence of metachronous CRC in this study was 5% for mass and 5% for polyps in patients who underwent curative surgical resection of colorectal cancer. DM is a significant risk factor of metachronous CRC.
Screening of Cirrhotic Compensated Hepatitis C Virus Infected Patients Who Received Oral Direct Acting Antiviral Drugs for Hepatocellular Carcinoma and Other Malignancies
Authors: Aly Osama A , Fouda Enas M , Abdelrahman Magdy G E , Aboubakr Ashraf , Sabry Ahmed M 
Published: August 2023

Abstract

Background
HCV is now recognized as a major factor in the development of severe liver damage as chronic infection is associated with the development of hepatic steatosis, cirrhosis and hepatocellular carcinoma.

Aim of the Work
screening of our patients for the incidence of hepatocellular carcinoma and other malignancies during or after end of treatment with orally direct acting antiviral drugs to prove or disprove this allegation.

Patients and Methods
This retrospective observational study was performed at Maadi Military Hospital during the period from July 2015 to July 2016 including 290 naive compensated cirrhotic hepatitis C virus infected patients with no prior history of hepatocellular carcinoma or any other malignancy and divided into 5 groups: Group (A) patients treated with combined sofosbuvir and ribavirin for 24 weeks. Group (B) patients treated with combined sofosbuvir and daclatasvir and low dose ribavirin for 12 weeks. Group(C) patients treated with combined sofosbuvir and ledipasvir with weight based ribavirin for 12 weeks. Group (D) patients with chronic renal failure on regular hemodialysis treated with combined ompitasvir+paritaprevir+ritonavir and low dose ribavirin for 12 weeks. Group (E) patients with the same criteria were taken from the waiting list of treatment and studied as the control group and were subjected to the same investigations and follow up.

Results
Highly significant increase in HCC prevalence in A group (23.3%) during follow up period. Significant increase in HCC prevalence in B group (8%) during follow up period. Non-significant difference in HCC prevalence in C group; during follow up period. In group D; non-significant difference in HCC prevalence during treatment and follow up periods. There was no detected occurrence of HCC or any other malignancies during the course of the study in group E.

Conclusion
Increased HCV detection combined with the availability of simple, well-tolerated treatment regimens can potentially reduce the need for liver transplantation and reduce HCV-related mortality. No evidence of an increased risk of de novo HCC by patients treated with interferon free SOF-based regimens. However, cirrhosis was strongly associated with the short-term development of HCC after HCV eradication. Treatment of HCV in patients with CKD is highly effective, with SVR12 rates similar to those seen in patients without CKD. The role of SVR by DAAs on the incidence or recurrence of hepatocellular carcinoma (HCC) is still a matter of debate, although it is known that SVR does not eliminate the risk of HCC.
Role of Circulating Endocan as a Biomarker in Non-Alcoholic Fatty Liver Disease
Authors: El Nakeeb Noha Abd EL Razek , Mohamed Manal Sabry , ElGhandour Ahmed Mohamed , Awad Ahmed Mohamed Elsaid 
Published: August 2023

Abstract

Background
Nonalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include high body mass index and abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-densitylipoproteins), age, male sex, and alcohol consumption.

Aim of the Work
The aim of this study is to study serum level of Endocan in patients with nonalcoholic Fatty Liver disease (NAFLD) to detect its relation to the incidence and severity of nonalcoholic Fatty Liver Disease (NAFLD).

Patients and Methods
This study was conducted at Ain Shams University hospitals to evaluate the role of serum endocan as a diagnostic biomarker for NAFLD. We included a total of 100 subjects who were divided into two equal groups; Group 1 included 50 patients with NAFLD, and Group 2 included 50 healthy controls.

Results
Both BMI and waist circumference showed a significant increase in cases compared to controls. The prevalence of DM in the NAFLD group was 36% which was statistically significantly higher as compared with the control group. The mean SBP was statistically significantly higher in the NAFLD group, while DBP showed comparable findings. The mean liver size as detected by US was statistically significantly higher in the NAFLD group as compared with the control group, while spleen size didn’t reveal a statistically significant difference between the two groups. The mean fasting blood glucose, mean HbA1C, mean post-prandial glucose, mean cholesterol level, mean TGs, mean LDL, mean ALT and mean AST, mean ALP, mean GGT and mean ferritin level were statistically significantly higher in the NAFLD group as compared with the control group. The mean HDL level was statistically significantly lower in the NAFLD group as compared with the control group. Other laboratory variables were comparable between the two groups. The mean serum endocan level was statistically significantly higher in the NAFLD group as compared with the control group (54.58 ± 18.61 and 30.69 ± 6.49 respectively). Each of APRI, FIB-4 and NAFLD scores showed significant difference between the two groups.

Conclusion
Based on the previous findings, one can conclude that: Serum endocan may act as a surrogate marker for the diagnosis of NAFLD as it was significantly elevated in cases compared to controls. As well as detection of disease severity as it has a positive correlation with APRI, FIB-4 score yet still further studies on larger scales are required. This confirms the state of endothelial dysfunction associated with this disease NAFLD is associated with impaired lipid profile, impaired liver functions, and higher incidence of diabetes compared to controls.
Diagnostic Value of Ascitic Endocan Levels in the Diagnosis of the Spontaneous Bacterial Peritonitis
Authors: Badawy Hanan Mahmoud Mohamed , Allam Ahmed Samir , Fathallah Ahmed Magdy , Abotaleb Ahmed Ragab Mohamed 
Published: August 2023

Abstract

Background
Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. One of the possible mechanisms of developing Spontaneous bacterial peritonitis is bacterial translocation.

Aim of the Work
The aim of this study is to assess the role of ascitic endocan levels in the diagnosis of SBP in decompensated cirrhosis.

Patients and Methods
90 cirrhotic patients with ascites were included in the current study and divided into 2 groups: SBP group with positive ascites culture or with an AF PMNL count ≥ 250/mm3 included 45 subjects. Non SBP group with negative ascites culture or with an AF PMNL count &gt; 250/mm3 included 45 subjects. In the SBP group, the mean age was 58.77 years with male predominance (68.8%).As regard to Non SBP group, the mean age was 59.31 years with male predominance 57.8%.

Results
There was a statistical significant difference in between SBP group and Non-SBP group as regard to Platelets, ALT, ascetic Total leucocyte count, Protein and LDH. The most common presentation in SBP group was Upper GIT bleeding and Abdominal pain and the most common organism detected in the culture of ascitic fluid Escherichia coli (80%) followed by Streptococcus viridans (15.5%). Ascitic Endocan level was significantly higher in SBP group than Non-SBP group with P &lt; 0.001. The sensitivity and specificity of Ascitic Endocan in detection of SBP were 84.85% and 82.69% respectively. There was a positive significant correlation in between Ascitic Endocan level and ALT, AST, bilirubin, CRP, Child class, MELD score, Blood Leukocytes and TLC (cell/mm3) in ascitic fluid in SBP group. The significant predictors of bad outcome in patients with SBP were higher ascitic fluid Endocan level, CRP and higher Glucose in ascitic fluid (mg/dl) levels

Conclusion
High Ascitic endocan level is common in cirrhotic patients with SBP than in Non-SBP and that means Ascitic endocan is related to the severity of the disease. Ascitic endocan level is an independent risk factor for SBP. High Ascitic endocan level is a significant predictor of bad outcome in patients with SBP. Therefore, measurement of Ascitic endocan level provide a new strategy to more aggressive treatments for high-risk groups. Ascitic endocan level could be used as an inflammatory biomarker for the prognosis of patients with SBP
Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients
Authors: Gabal Mervat Mamdouh Abo , Elazizi Noran Osama Ahmed , Elserwy Maha Ahmed , Elkhayat Naglaa Mohamed , Benjamin Dina Benjamin Azmy 
Published: August 2023

Abstract

Background
Carpal tunnel syndrome (CTS) is one of the most frequent extra-articular manifestations of rheumatoid arthritis (RA).

Aim and objectives
to assess the presence and severity of Carpal tunnel syndrome in rheumatoid arthritis patients and its relation to disease activity.

Patients and Methods
This is observational cross sectional study, was carried out 30 rheumatoid arthritis patients recruited from Ain Shams University Hospital)inpatient internal medicine department and rheumotology outpatient clinic) in the period from November (2018) till November (2020).

Result
Only ultrasound assesment of CTS by measuring Of CSA&gt;10 at wrist showed significant positive correlation with RA Patients ages, RA disease duration, CTS symptoms duration, CRP, RF and anti ccp positivity and negative correlation with HB% indicating association with disease compare to others activity.

Conclusion
CTS frequency in RA is found higher than normal population, especially in patients with additional risk factors of CTS. There was no relationship between CTS and disease activity, and CTS group had long disease duration and worse functional status. CTS could be a result of the chronic course in RA.